scholarly journals Closing schools for SARS-CoV-2: a pragmatic rapid recommendation

2021 ◽  
Vol 5 (1) ◽  
pp. e000971
Author(s):  
Geertruida Bekkering ◽  
Nicolas Delvaux ◽  
Patrik Vankrunkelsven ◽  
Jaan Toelen ◽  
Sigrid Aertgeerts ◽  
...  
Keyword(s):  
Support Services ◽  
International Studies ◽  
Vulnerable Children ◽  
Social Contacts ◽  
Strong Recommendation ◽  
Weak Recommendation ◽  
Guideline Panel ◽  
Study Results ◽  
Belgian Study ◽  
Teachers And Parents

BackgroundIn Belgium, schools closed during the first lockdown in March 2020, with a partial reopening in May. They fully reopened in September. During the summer, infections started to increase in the general population, speeding up in September. Some measures were taken to limit social contacts but those were insufficient to mitigate the exponential rise of infections in October. Children were still receiving all lessons at school at that time and it was questioned whether this position was tenable. We systematically compared the benefits and harms of closing primary and secondary schools and developed a recommendation.MethodsA multidisciplinary panel, including school pupils and teachers, educational experts, clinicians and researchers, produced this recommendation in compliance with the standards for trustworthy rapid guidelines. The recommendation is based on data collected through national surveillance or studies from Belgium, and supported by a rapid literature review.ResultsClosing schools during the first lockdown probably resulted in a large learning delay and possibly led to more cases of child abuse. We are uncertain about the effect on the infection rate, hospitalisations, transmission rates, mental health of children, teachers and parents. The panel concluded that the balance of benefits and harms of closing schools clearly shifts against closing schools. Detrimental effects are even worse for vulnerable children. This recommendation is affected by the local virus circulation.ConclusionThe guideline panel issues a strong recommendation against closing schools when the virus circulation is low to moderate, and a weak recommendation against closing schools when the virus circulation is high. It does not apply when the school system cannot function due to lack of teachers, too many children who are at home or a shortage of support services. As the results of international studies are consistent with Belgian study results, this recommendation may also be relevant internationally.

scholarly journals SGLT-2 inhibitors or GLP-1 receptor agonists for adults with type 2 diabetes: a clinical practice guideline

BMJ ◽  
2021 ◽  
pp. n1091
Author(s):  
Sheyu Li ◽  
Per Olav Vandvik ◽  
Lyubov Lytvyn ◽  
Gordon H Guyatt ◽  
Suetonia C Palmer ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Type 2 Diabetes ◽  
Individual Risk ◽  
Strong Recommendation ◽  
Receptor Agonists ◽  
Weak Recommendation ◽  
Guideline Panel ◽  
Evidence Summaries

AbstractClinical questionWhat are the benefits and harms of sodium-glucose cotransporter 2 (SGLT-2) inhibitors and glucagon-like peptide 1 (GLP-1) receptor agonists when added to usual care (lifestyle interventions and/or other diabetes drugs) in adults with type 2 diabetes at different risk for cardiovascular and kidney outcomes?Current practiceClinical decisions about treatment of type 2 diabetes have been led by glycaemic control for decades. SGLT-2 inhibitors and GLP-1 receptor agonists are traditionally used in people with elevated glucose level after metformin treatment. This has changed through trials demonstrating atherosclerotic cardiovascular disease (CVD) and chronic kidney disease (CKD) benefits independent of medications’ glucose-lowering potential.RecommendationsThe guideline panel issued risk-stratified recommendations concerning the use of SGLT-2 inhibitors or GLP-1 receptor agonists in adults with type 2 diabetes• Three or fewer cardiovascular risk factors without established CVD or CKD: Weak recommendation against starting SGLT-2 inhibitors or GLP-1 receptor agonists.• More than three cardiovascular risk factors without established CVD or CKD: Weak recommendation for starting SGLT-2 inhibitors and weak against starting GLP-1 receptor agonists.• Established CVD or CKD: Weak recommendation for starting SGLT-2 inhibitors and GLP-1 receptor agonists.• Established CVD and CKD: Strong recommendation for starting SGLT-2 inhibitors and weak recommendation for starting GLP-1 receptor agonists.• For those committed to further reducing their risk for CVD and CKD outcomes: Weak recommendation for starting SGLT-2 inhibitors rather than GLP-1 receptor agonists.How this guideline was createdAn international panel including patients, clinicians, and methodologists created these recommendations following standards for trustworthy guidelines and using the GRADE approach. The panel applied an individual patient perspective.The evidenceA linked systematic review and network meta-analysis (764 randomised trials included 421 346 participants) of benefits and harms found that SGLT-2 inhibitors and GLP-1 receptor agonists generally reduce overall death, and incidence of myocardial infarctions, and end-stage kidney disease or kidney failure (moderate to high certainty evidence). These medications exert different effects on stroke, hospitalisations for heart failure, and key adverse events in different subgroups. Absolute effects of benefit varied widely based on patients’ individual risk (for example, from five fewer deaths in the lowest risk to 48 fewer deaths in the highest risk, for 1000 patients treated over five years). A prognosis review identified 14 eligible risk prediction models, one of which (RECODe) informed most baseline risk estimates in evidence summaries to underpin the risk-stratified recommendations. Concerning patients’ values and preferences, the recommendations were supported by evidence from a systematic review of published literature, a patient focus group study, a practical issues summary, and a guideline panel survey.Understanding the recommendationWe stratified the recommendations by the levels of risk for CVD and CKD and systematically considered the balance of benefits, harms, other considerations, and practical issues for each risk group. The strong recommendation for SGLT-2 inhibitors in patients with CVD and CKD reflects what the panel considered to be a clear benefit. For all other adults with type 2 diabetes, the weak recommendations reflect what the panel considered to be a finer balance between benefits, harms, and burdens of treatment options. Clinicians using the guideline can identify their patient’s individual risk for cardiovascular and kidney outcomes using credible risk calculators such as RECODe. Interactive evidence summaries and decision aids may support well informed treatment choices, including shared decision making.

Information-seeking to Support Personal and Community Wellbeing: Report of a study of New Zealand Men Using Focus Groups

2016 ◽  
Author(s):  
Peta Wellstead
Keyword(s):  
New Zealand ◽  
Focus Groups ◽  
Support Services ◽  
Information Seeking ◽  
Service Providers ◽  
Structural Constraints ◽  
Health And Wellbeing ◽  
Study Results ◽  
Groupes De Discussion

This paper reports part of an ongoing study exploring the information behaviour of New Zealand men during periods of diminished health and wellbeing. Focus groups were used for this iteration of the study. Results indicate that New Zealand men face both personal and structural constraints to their information-seeking during periods when their health and wellbeing may be compromised. This study highlights that service providers need to develop more effective information delivery mechanisms and support services for men. These services need to be appealing to men and reflect men’s information seeking preferences. The role of LIS professionals in supporting this endeavour is discussed. Cet article présente une étude en cours explorant le comportement informationnel d’ hommes néo-zélandais durant des périodes où leur état de santé et de bien-être est amoindri. Des groupes de discussion ont été utilisés pour cette itération de l'étude. Les résultats indiquent que les hommes en Nouvelle-Zélande font face à des contraintes à la fois  personnelles et structurelles dans leur recherche d'information pendant les périodes où leur santé et leur bien-être peuvent être affaiblis. Cette étude met en évidence le besoin pour les fournisseurs de services de développer des mécanismes de diffusion de l'information plus efficaces et des services de soutien pour les hommes. Ces services doivent être attrayants et refléter les préférences des hommes dans leurs recherches d’information. Le rôle des professionnels de l'information dans le soutien à cette entreprise est discuté.

Taxpayer behavioural factors influencing entrenched tax gaps

2021 ◽  
Author(s):  
◽  
Divakaran Reddy
Keyword(s):  
Meta Analysis ◽  
Tax Compliance ◽  
Public Trust ◽  
Accurate Estimate ◽  
Research Approach ◽  
International Studies ◽  
Tax Revenues ◽  
Study Results ◽  
The Government ◽  
Tax Noncompliance

Tax compliance is the willingness of taxpayers to obey tax rules of a nation, whilst tax noncompliance is the unwilling behaviour of citizens to act under tax regulations. Taxpayer compliance enables the government to collect tax revenues, which is one of the most important sources of government income. Altering the non-compliant behaviour of citizens is an important barometer for increasing tax revenues that contribute to the socio-economic development of a nation. Numerous quondam studies have been conducted strikingly in the past few decades on taxpayer compliance. However, there is a dearth of sufficient research currently on tax noncompliance behaviour. Moreover, the phenomenon of tax noncompliance has limited exploration from the vantage point of meta-analysis of primary research studies conducted, focussing on interrogating, and systematically categorising their results. Resultantly, the purpose of this study was to examine the previously related primary studies to determine those factors that have been judged to have influenced the tax compliance behaviour of citizens. This study has adopted the quantitative research approach and followed the preferred reporting items for systematic review (PRISMA) method and meta-analysis to provide an accurate estimate of the relationship that exists in a population of relevant tax noncompliance behavioural studies. The population comprised of 45 international studies conducted between the period 2015 to 2020 is selected for analysis. The study results indicate that the quality of tax administration systems and public trust in institutional governance are factors that have influenced taxpayer compliance positively. Poor government accountability mechanisms entrenched tax gaps, and developing public trust in government institutions were found to be universal to promote voluntary taxpayer compliance. This study has contributed significantly to the open discussion on tax compliance among researchers, governments, and businesses.

scholarly journals Technical aspects of endoscopic ultrasound (EUS)-guided sampling in gastroenterology: European Society of Gastrointestinal Endoscopy (ESGE) Technical Guideline – March 2017

Endoscopy ◽  
2017 ◽  
Vol 49 (10) ◽  
pp. 989-1006 ◽  
Author(s):  
Marcin Polkowski ◽  
Christian Jenssen ◽  
Philip Kaye ◽  
Silvia Carrara ◽  
Pierre Deprez ◽  
...  
Keyword(s):  
Antibiotic Prophylaxis ◽  
Solid Component ◽  
Cystic Lesions ◽  
High Quality ◽  
Strong Recommendation ◽  
Fine Needle ◽  
Weak Recommendation ◽  
Moderate Quality ◽  
High Quality Evidence ◽  
Quality Evidence

RECOMMENDATIONSFor routine EUS-guided sampling of solid masses and lymph nodes (LNs) ESGE recommends 25G or 22G needles (high quality evidence, strong recommendation); fine needle aspiration (FNA) and fine needle biopsy (FNB) needles are equally recommended (high quality evidence, strong recommendation).When the primary aim of sampling is to obtain a core tissue specimen, ESGE suggests using 19G FNA or FNB needles or 22G FNB needles (low quality evidence, weak recommendation).ESGE recommends using 10-mL syringe suction for EUS-guided sampling of solid masses and LNs with 25G or 22G FNA needles (high quality evidence, strong recommendation) and other types of needles (low quality evidence, weak recommendation). ESGE suggests neutralizing residual negative pressure in the needle before withdrawing the needle from the target lesion (moderate quality evidence, weak recommendation).ESGE does not recommend for or against using the needle stylet for EUS-guided sampling of solid masses and LNs with FNA needles (high quality evidence, strong recommendation) and suggests using the needle stylet for EUS-guided sampling with FNB needles (low quality evidence, weak recommendation).ESGE suggests fanning the needle throughout the lesion when sampling solid masses and LNs (moderate quality evidence, weak recommendation).ESGE equally recommends EUS-guided sampling with or without on-site cytologic evaluation (moderate quality evidence, strong recommendation). When on-site cytologic evaluation is unavailable, ESGE suggests performance of three to four needle passes with an FNA needle or two to three passes with an FNB needle (low quality evidence, weak recommendation).For diagnostic sampling of pancreatic cystic lesions without a solid component, ESGE suggests emptying the cyst with a single pass of a 22G or 19G needle (low quality evidence, weak recommendation). For pancreatic cystic lesions with a solid component, ESGE suggests sampling of the solid component using the same technique as in the case of other solid lesions (low quality evidence, weak recommendation).ESGE does not recommend antibiotic prophylaxis for EUS-guided sampling of solid masses or LNs (low quality evidence, strong recommendation), and suggests antibiotic prophylaxis with fluoroquinolones or beta-lactam antibiotics for EUS-guided sampling of cystic lesions (low quality evidence, weak recommendation). ESGE suggests that evaluation of tissue obtained by EUS-guided sampling should include histologic preparations (e. g., cell blocks and/or formalin-fixed and paraffin-embedded tissue fragments) and should not be limited to smear cytology (low quality evidence, weak recommendation).

scholarly journals VALIDITY ANALYSIS OF 2A + 2B GRAMMAR - VOCABULARY TESTS AT THE FACULTY OF FRENCH LANGUAGE AND CULTURE, UNIVERSITY OF LANGUAGES AND INTERNATIONAL STUDIES - VIETNAM NATIONAL UNIVERSITY, HANOI

2018 ◽  
Vol 34 (6) ◽  
Author(s):  
Do Thi Bich Thuy
Keyword(s):  
French Language ◽  
International Studies ◽  
Language And Culture ◽  
Validity Analysis ◽  
Language Level ◽  
Test Specifications ◽  
Study Results ◽  
National University ◽  
Difficulty Index ◽  
Academic Year

This paper investigated the validity of two grammar - vocabulary tests (2A + 2B proficiency units in the academic year 2016-2017) at the Faculty of French Language and Culture, University of Languages and International Studies - Vietnam National University, Hanoi. The study aimed to evaluate the relevance of the content in these tests in comparison with the test specifications, to measure the difficulty index of each item and some indicators of the tests. The study results showed a relatively high validity of the investigated tests, with a better validity for the second test. However, the language level and items with irrelevant difficulty index should be reviewed to better fit the test specifications.

scholarly journals Increasing Cultural Awareness Through a Cultural Awareness Program

2015 ◽  
Vol 5 (1) ◽  
Author(s):  
Beate Baltes ◽  
David Hernandez ◽  
Christina Collins
Keyword(s):  
High School Students ◽  
Intercultural Competence ◽  
Role Models ◽  
Cultural Awareness ◽  
Positive Impact ◽  
International Studies ◽  
Theoretical Frameworks ◽  
School Students ◽  
Study Results ◽  
Students Attitudes

Racial tension motivates strife and violence in the metropolitan Detroit, Michigan, area. The purpose of this study was to determine the effectiveness of a collaborative partnership, the Cultural Awareness Consortium (CAC), in making a positive impact on the attitudes of a group of diverse high school students regarding multicultural relations. The two theoretical frameworks guiding this study were Allport’s intergroup contact theory and intercultural competence theory originating from International Education and International Studies. The research questions concerned whether attending the CAC for 4 months, the treatment, changed students’ attitudes on multicultural relations, and whether a student’s gender or ethnicity was a predictor of changes in these attitudes. A single group, pre-experimental design with data collection from two administrations of the Student Multicultural Relations Survey was used in the study. Fifty-four students completed the survey, which yielded four multicultural relations scales (dependent variables), eight single-item attitudinal variables on multicultural issues, and two demographic variables (independent variables), and inferential analysis included <em>t </em>tests and multiple regression. According to study results, students’ attitudes on multicultural relations had changed significantly, and students talked to and mixed with students from different cultural backgrounds more after the treatment. Educational institutions providing experiences like the CAC can make a positive impact on students’ attitudes on multicultural relations. This can lead to positive social change as students increase their acceptance of others and take those attitudes and values with them into the workforce after they graduate, serving as role models of acceptance for their peers.

A Review of Literature on Adjustment Issues of International Students

2016 ◽  
pp. 223-242
Author(s):  
Eunjin Hwang ◽  
Nara M. Martirosyan ◽  
George W. Moore
Keyword(s):  
International Students ◽  
Theoretical Model ◽  
Support Services ◽  
Critical Review ◽  
Academic Adjustment ◽  
Critical Role ◽  
Review Of Literature ◽  
Study Results ◽  
Diverse Groups ◽  
Adjustment Issues

There is a scarcity of studies wherein a critical review or synthesis exists on the adjustment of international students with a few exceptional works. Therefore, through critical analyses of recent studies from various disciplines, the authors examine conceptual applications of existing models or typologies incorporated in previous studies, and redefine the nature of problems encountered by international students with a synthesis of study results on their adjustment issues: psychological, socio-cultural, and academic adjustment. Furthermore, suggestions for both practitioners and researchers are elaborated in the chapter. These suggestions include creating a new conceptual/theoretical model, emphasizing a critical role played by the host university, and tailoring support services to satisfy specific needs of diverse groups of international students within the specific campus context.

scholarly journals Gastrointestinal bleeding prophylaxis for critically ill patients: a clinical practice guideline

BMJ ◽  
2020 ◽  
pp. l6722 ◽  
Author(s):  
Zhikang Ye ◽  
Annika Reintam Blaser ◽  
Lyubov Lytvyn ◽  
Ying Wang ◽  
Gordon H Guyatt ◽  
...  
Keyword(s):  
Systematic Review ◽  
Mechanical Ventilation ◽  
Gastrointestinal Bleeding ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Meta Analysis ◽  
Risk Of Bleeding ◽  
Weak Recommendation ◽  
Guideline Panel ◽  
Bleeding Prophylaxis

AbstractClinical questionWhat is the role of gastrointestinal bleeding prophylaxis (stress ulcer prophylaxis) in critically ill patients? This guideline was prompted by the publication of a new large randomised controlled trial.Current practiceGastric acid suppression with proton pump inhibitors (PPIs) or histamine-2 receptor antagonists (H2RAs) is commonly done to prevent gastrointestinal bleeding in critically ill patients. Existing guidelines vary in their recommendations of which population to treat and which agent to use.RecommendationsThis guideline panel makes a weak recommendation for using gastrointestinal bleeding prophylaxis in critically ill patients at high risk (>4%) of clinically important gastrointestinal bleeding, and a weak recommendation for not using prophylaxis in patients at lower risk of clinically important bleeding (≤4%). The panel identified risk categories based on evidence, with variable certainty regarding risk factors. The panel suggests using a PPI rather than a H2RA (weak recommendation) and recommends against using sucralfate (strong recommendation).How this guideline was createdA guideline panel including patients, clinicians, and methodologists produced these recommendations using standards for trustworthy guidelines and the GRADE approach. The recommendations are based on a linked systematic review and network meta-analysis. A weak recommendation means that both options are reasonable.The evidenceThe linked systematic review and network meta-analysis estimated the benefit and harm of these medications in 12 660 critically ill patients in 72 trials. Both PPIs and H2RAs reduce the risk of clinically important bleeding. The effect is larger in patients at higher bleeding risk (those with a coagulopathy, chronic liver disease, or receiving mechanical ventilation but not enteral nutrition or two or more of mechanical ventilation with enteral nutrition, acute kidney injury, sepsis, and shock) (moderate certainty). PPIs and H2RAs might increase the risk of pneumonia (low certainty). They probably do not have an effect on mortality (moderate certainty), length of hospital stay, or any other important outcomes. PPIs probably reduce the risk of bleeding more than H2RAs (moderate certainty).Understanding the recommendationIn most critically ill patients, the reduction in clinically important gastrointestinal bleeding from gastric acid suppressants is closely balanced with the possibility of pneumonia. Clinicians should consider individual patient values, risk of bleeding, and other factors such as medication availability when deciding whether to use gastrointestinal bleeding prophylaxis. Visual overviews provide the relative and absolute benefits and harms of the options in multilayered evidence summaries and decision aids available on MAGICapp.

scholarly journals Exploring the Use of Mobile Instant Messaging for Parent-Teacher Communication

2020 ◽  
Vol 14 (04) ◽  
pp. 152
Author(s):  
Azidah Abu Ziden ◽  
Muhammad Faizal Abdul Rahman ◽  
Too Woon Ching
Keyword(s):  
Parental Involvement ◽  
Qualitative Data ◽  
Instant Messaging ◽  
Educational Background ◽  
Teacher Communication ◽  
Study Results ◽  
Attitudes And Perceptions ◽  
Economic Background ◽  
Teachers And Parents ◽  
The Relationship

Communication between teachers and parents is essential to foster parental involvement in school related activities. The purpose of this study is to evaluate the effectiveness of mobile instant messaging for parent-teacher communication in enhancing two-way communication between parents and teachers. In particular, the research examines the barriers on parental involvement and investigates the relationship between the use of mobile instant messaging for parent-teacher communication, as well as for families of different socio-economic and educational background. In addition, the study also evaluates parents’ attitudes and perceptions towards the use of mobile instant messaging for communication with teachers. The respondents for this study were 251 parents with different background. This study employed a mix-method research design which involved quantitative and qualitative data. The findings revealed that time constraint is the primary reason for parents to be involved in school related activities. The study results also indicated that there is no relationship between family socio-economic background and the use of mobile instant messaging for parent-teacher communication. However, the findings show a significant relationship between parents’ educational background and the use of mobile instant messaging for parents-teacher communication. Moreover, the study also found a receptive attitude among parents towards mobile based communications with teachers and school

scholarly journals Advanced imaging for detection and differentiation of colorectal neoplasia: European Society of Gastrointestinal Endoscopy (ESGE) Guideline – Update 2019

Endoscopy ◽  
2019 ◽  
Vol 51 (12) ◽  
pp. 1155-1179 ◽  
Author(s):  
Raf Bisschops ◽  
James E. East ◽  
Cesare Hassan ◽  
Yark Hazewinkel ◽  
Michał F. Kamiński ◽  
...  
Keyword(s):  
Colorectal Neoplasia ◽  
Colorectal Polyps ◽  
High Definition ◽  
High Quality ◽  
Strong Recommendation ◽  
Weak Recommendation ◽  
Moderate Quality ◽  
High Quality Evidence ◽  
Virtual Chromoendoscopy ◽  
Quality Evidence

Main Recommendations 1 ESGE suggests that high definition endoscopy, and dye or virtual chromoendoscopy, as well as add-on devices, can be used in average risk patients to increase the endoscopist’s adenoma detection rate. However, their routine use must be balanced against costs and practical considerations.Weak recommendation, high quality evidence. 2 ESGE recommends the routine use of high definition systems in individuals with Lynch syndrome.Strong recommendation, high quality evidence. 3 ESGE recommends the routine use, with targeted biopsies, of dye-based pancolonic chromoendoscopy or virtual chromoendoscopy for neoplasia surveillance in patients with long-standing colitis.Strong recommendation, moderate quality evidence. 4 ESGE suggests that virtual chromoendoscopy and dye-based chromoendoscopy can be used, under strictly controlled conditions, for real-time optical diagnosis of diminutive (≤ 5 mm) colorectal polyps and can replace histopathological diagnosis. The optical diagnosis has to be reported using validated scales, must be adequately photodocumented, and can be performed only by experienced endoscopists who are adequately trained, as defined in the ESGE curriculum, and audited.Weak recommendation, high quality evidence. 5 ESGE recommends the use of high definition white-light endoscopy in combination with (virtual) chromoendoscopy to predict the presence and depth of any submucosal invasion in nonpedunculated colorectal polyps prior to any treatment. Strong recommendation, moderate quality evidence. 6 ESGE recommends the use of virtual or dye-based chromoendoscopy in addition to white-light endoscopy for the detection of residual neoplasia at a piecemeal polypectomy scar site. Strong recommendation, moderate quality evidence. 7 ESGE suggests the possible incorporation of computer-aided diagnosis (detection and characterization of lesions) to colonoscopy, if acceptable and reproducible accuracy for colorectal neoplasia is demonstrated in high quality multicenter in vivo clinical studies. Possible significant risks with implementation, specifically endoscopist deskilling and over-reliance on artificial intelligence, unrepresentative training datasets, and hacking, need to be considered. Weak recommendation, low quality evidence.

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