Schulformen als differenzielle Lernmilieus: Institutionelle und kompositionelle Effekte auf die Leistungsentwicklung im Fach Französisch

Based on two representative samples of eighth grade students from the Swiss cantons Wallis (N = 926) and Fribourg of (N = 778), the present study examines achievement gains in French as a foreign language in the different tracks of the Swiss secondary school system. The main focus lies on effects resulting from differences in the educational environments of the tracks. Beside differences in group compositional characteristics (compositional effects), differences in institutionalized learning opportunities (institutional effects; e.g., track-specific traditions of teacher education, didactics, curricula) need to be considered here. Results of multilevel analyses showed that students’ learning progress differed between the tracks, even when controlling for various intake characteristics (including prior knowledge) at the student level. Further analyses revealed that track differences in student gains persisted, even when controlling for the intellectual and social composition of the student body at the class level.Auf der Basis von zwei repräsentativen Schülerstichproben der Schweizer Kantone Wallis (N = 926) und Fribourg (N = 778), die während der 8. Jahrgangsstufe im Fach Französisch als Fremdsprache unterrichtet wurden, geht der vorliegende Beitrag der Frage nach, ob Schülerinnen und Schüler je nach besuchtem Bildungsgang unterschiedliche Fortschritte in der Entwicklung ihrer Fachleistungen machen. Von besonderem Interesse ist dabei, ob und in welchem Ausmaß die Zusammensetzung der Schülerschaft (Kompositionseffekte) und möglicherweise auch institutionell differierende didaktische und curriculare Angebote zwischen den Bildungsgängen (Institutionseffekte) als lernmilieuprägende Faktoren von Bedeutung für die Entwicklung der Fachleistungen sind. In Mehrebenenanalysen zeigten sich auch nach Kontrolle der individuellen Eingangsvoraussetzungen (einschließlich des Vorwissens) bedeutsame Unterschiede in den Lernzuwächsen an den verschiedenen Bildungsgängen. Die weiteren Analysen lassen darauf schließen, dass sowohl von kompositionellen als auch institutionellen Effekten auf die Leistungsentwicklung auszugehen ist

The Rhetoric of Solidarity: Nature and Measurement of Social Cohesion in the Self-representation of Civil Society Organizations

Scholars have called to study how social cohesion is discursively negotiated and produced in communication behavior. However, empirical evidence remains scarce. In this study, we investigate to what extent and how civil society organizations (CSOs), part of the backbone of social integration in modern democracies, make references to social cohesion in their public self-portrayals. We develop a standardized measure for content analyzing the manifestation of social cohesion along three theoretical dimensions: social relations, connectedness, and orientation towards the common good. We apply our innovative content measure to the external communication of an original sample of nearly 800 CSOs in Germany, using their websites. Subsequently, we use data from an accompanying organizational survey of these institutions to investigate whether and how certain organizational features help explain variance in social cohesion rhetoric. Findings suggest that CSOs’ external communications employ themes from all key dimensions of social cohesion, revealing a fair amount of variation on all three subdimensions and a summary index of the overall strength social cohesion rhetoric. These different emphases are contingent upon various organizational characteristics, namely the spheres in which CSOs are primarily active, their locations, and their target groups. Whereas culturally and media-oriented organizations as well as sports clubs are largely reluctant to make references to social cohesion, politically active CSOs and those addressing socially disadvantaged communities tend to push more in this direction. The latter tend to operate in more professionalized structures, indicating that referencing social cohesion legitimizes these groups’ political and social purposes in the public sphere

Survey participation as a function of democratic engagement, trust in institutions, and perceptions of surveys

Objective: With response rates of large-scale surveys having decreased significantly over the years and rebounds seeming unlikely, many studies now examine how response rates vary with methodological design and incentives. This investigation delves into how individual-level factors shape survey participation. Specifically, we examine the influence of individuals’ democratic engagement and their trust in institutions on intent to participate in surveys, both directly and indirectly through their perceptions of surveys. Methods: We collected survey data from a probability sample of adults (N = 1343) in Mannheim, Germany, from November 2019 to March 2020. Structural equation models were estimated to test the hypothesized relationships. Results: The analyses support most, but not all, hypothesized relationships. Democratic engagement bolstered intent to participate, directly as well as indirectly through perceptions of surveys. Institutional trust, on the other hand, only influenced the outcome measure indirectly. Perceptions of surveys had a strong bearing overall effect on intent to participate. Conclusion: The study's results suggest that the response rates and larger issues related to the perceived legitimacy of public opinion and survey research might be intertwined with orientations related to people's civic and political life. The article discusses potential ways survey researchers can counteract distrust in surveys

Methylmercury exposure in a subsistence fishing community in Lake Chapala, Mexico: an ecological approach

<p>Abstract</p> <p>Background</p> <p>Elevated concentrations of mercury have been documented in fish in Lake Chapala in central Mexico, an area that is home to a large subsistence fishing community. However, neither the extent of human mercury exposure nor its sources and routes have been elucidated.</p> <p>Methods</p> <p>Total mercury concentrations were measured in samples of fish from Lake Chapala; in sections of sediment cores from the delta of Rio Lerma, the major tributary to the lake; and in a series of suspended-particle samples collected at sites from the mouth of the Lerma to mid-Lake. A cross-sectional survey of 92 women ranging in age from 18-45 years was conducted in three communities along the Lake to investigate the relationship between fish consumption and hair mercury concentrations among women of child-bearing age.</p> <p>Results</p> <p>Highest concentrations of mercury in fish samples were found in carp (mean 0.87 ppm). Sediment data suggest a pattern of moderate ongoing contamination. Analyses of particles filtered from the water column showed highest concentrations of mercury near the mouth of the Lerma. In the human study, 27.2% of women had >1 ppm hair mercury. On multivariable analysis, carp consumption and consumption of fish purchased or captured from Lake Chapala were both associated with significantly higher mean hair mercury concentrations.</p> <p>Conclusions</p> <p>Our preliminary data indicate that, despite a moderate level of contamination in recent sediments and suspended particulate matter, carp in Lake Chapala contain mercury concentrations of concern for local fish consumers. Consumption of carp appears to contribute significantly to body burden in this population. Further studies of the consequences of prenatal exposure for child neurodevelopment are being initiated.</p

The use of mesenchymal stem cells for cartilage repair and regeneration: a systematic review.

BACKGROUND: The management of articular cartilage defects presents many clinical challenges due to its avascular, aneural and alymphatic nature. Bone marrow stimulation techniques, such as microfracture, are the most frequently used method in clinical practice however the resulting mixed fibrocartilage tissue which is inferior to native hyaline cartilage. Other methods have shown promise but are far from perfect. There is an unmet need and growing interest in regenerative medicine and tissue engineering to improve the outcome for patients requiring cartilage repair. Many published reviews on cartilage repair only list human clinical trials, underestimating the wealth of basic sciences and animal studies that are precursors to future research. We therefore set out to perform a systematic review of the literature to assess the translation of stem cell therapy to explore what research had been carried out at each of the stages of translation from bench-top (in vitro), animal (pre-clinical) and human studies (clinical) and assemble an evidence-based cascade for the responsible introduction of stem cell therapy for cartilage defects. This review was conducted in accordance to PRISMA guidelines using CINHAL, MEDLINE, EMBASE, Scopus and Web of Knowledge databases from 1st January 1900 to 30th June 2015. In total, there were 2880 studies identified of which 252 studies were included for analysis (100 articles for in vitro studies, 111 studies for animal studies; and 31 studies for human studies). There was a huge variance in cell source in pre-clinical studies both of terms of animal used, location of harvest (fat, marrow, blood or synovium) and allogeneicity. The use of scaffolds, growth factors, number of cell passages and number of cells used was hugely heterogeneous. SHORT CONCLUSIONS: This review offers a comprehensive assessment of the evidence behind the translation of basic science to the clinical practice of cartilage repair. It has revealed a lack of connectivity between the in vitro, pre-clinical and human data and a patchwork quilt of synergistic evidence. Drivers for progress in this space are largely driven by patient demand, surgeon inquisition and a regulatory framework that is learning at the same pace as new developments take place

Difficult tracheal intubation in neonates and infants. NEonate and Children audiT of Anaesthesia pRactice IN Europe (NECTARINE): a prospective European multicentre observational study

Background: Neonates and infants are susceptible to hypoxaemia in the perioperative period. The aim of this study was to analyse interventions related to anaesthesia tracheal intubations in this European cohort and identify their clinical consequences. Methods: We performed a secondary analysis of tracheal intubations of the European multicentre observational trial (NEonate and Children audiT of Anaesthesia pRactice IN Europe [NECTARINE]) in neonates and small infants with difficult tracheal intubation. The primary endpoint was the incidence of difficult intubation and the related complications. The secondary endpoints were the risk factors for severe hypoxaemia attributed to difficult airway management, and 30 and 90 day outcomes. Results: Tracheal intubation was planned in 4683 procedures. Difficult tracheal intubation, defined as two failed attempts of direct laryngoscopy, occurred in 266 children (271 procedures) with an incidence (95% confidence interval [CI]) of 5.8% (95% CI, 5.1e6.5). Bradycardia occurred in 8% of the cases with difficult intubation, whereas a significant decrease in oxygen saturation (SpO2&lt;90% for 60 s) was reported in 40%. No associated risk factors could be identified among comorbidities, surgical, or anaesthesia management. Using propensity scoring to adjust for confounders, difficult anaesthesia tracheal intubation did not lead to an increase in 30 and 90 day morbidity or mortality. Conclusions: The results of the present study demonstrate a high incidence of difficult tracheal intubation in children less than 60 weeks post-conceptual age commonly resulting in severe hypoxaemia. Reassuringly, the morbidity and mortality at 30 and 90 days was not increased by the occurrence of a difficult intubation event. Clinical trial registration: NCT02350348

Difficult tracheal intubation in neonates and infants. NEonate and Children audiT of Anaesthesia pRactice IN Europe (NECTARINE): a prospective European multicentre observational study

BACKGROUND: Neonates and infants are susceptible to hypoxaemia in the perioperative period. The aim of this study was to analyse interventions related to anaesthesia tracheal intubations in this European cohort and identify their clinical consequences. METHODS: We performed a secondary analysis of tracheal intubations of the European multicentre observational trial (NEonate and Children audiT of Anaesthesia pRactice IN Europe [NECTARINE]) in neonates and small infants with difficult tracheal intubation. The primary endpoint was the incidence of difficult intubation and the related complications. The secondary endpoints were the risk factors for severe hypoxaemia attributed to difficult airway management, and 30 and 90 day outcomes. RESULTS: Tracheal intubation was planned in 4683 procedures. Difficult tracheal intubation, defined as two failed attempts of direct laryngoscopy, occurred in 266 children (271 procedures) with an incidence (95% confidence interval [CI]) of 5.8% (95% CI, 5.1–6.5). Bradycardia occurred in 8% of the cases with difficult intubation, whereas a significant decrease in oxygen saturation (SpO2<90% for 60 s) was reported in 40%. No associated risk factors could be identified among co-morbidities, surgical, or anaesthesia management. Using propensity scoring to adjust for confounders, difficult anaesthesia tracheal intubation did not lead to an increase in 30 and 90 day morbidity or mortality. CONCLUSIONS: The results of the present study demonstrate a high incidence of difficult tracheal intubation in children less than 60 weeks post-conceptual age commonly resulting in severe hypoxaemia. Reassuringly, the morbidity and mortality at 30 and 90 days was not increased by the occurrence of a difficult intubation event

Peri-operative red blood cell transfusion in neonates and infants: NEonate and Children audiT of Anaesthesia pRactice IN Europe: A prospective European multicentre observational study

BACKGROUND: Little is known about current clinical practice concerning peri-operative red blood cell transfusion in neonates and small infants. Guidelines suggest transfusions based on haemoglobin thresholds ranging from 8.5 to 12 g dl-1, distinguishing between children from birth to day 7 (week 1), from day 8 to day 14 (week 2) or from day 15 (≥week 3) onwards. OBJECTIVE: To observe peri-operative red blood cell transfusion practice according to guidelines in relation to patient outcome. DESIGN: A multicentre observational study. SETTING: The NEonate-Children sTudy of Anaesthesia pRactice IN Europe (NECTARINE) trial recruited patients up to 60 weeks' postmenstrual age undergoing anaesthesia for surgical or diagnostic procedures from 165 centres in 31 European countries between March 2016 and January 2017. PATIENTS: The data included 5609 patients undergoing 6542 procedures. Inclusion criteria was a peri-operative red blood cell transfusion. MAIN OUTCOME MEASURES: The primary endpoint was the haemoglobin level triggering a transfusion for neonates in week 1, week 2 and week 3. Secondary endpoints were transfusion volumes, 'delta haemoglobin' (preprocedure - transfusion-triggering) and 30-day and 90-day morbidity and mortality. RESULTS: Peri-operative red blood cell transfusions were recorded during 447 procedures (6.9%). The median haemoglobin levels triggering a transfusion were 9.6 [IQR 8.7 to 10.9] g dl-1 for neonates in week 1, 9.6 [7.7 to 10.4] g dl-1 in week 2 and 8.0 [7.3 to 9.0] g dl-1 in week 3. The median transfusion volume was 17.1 [11.1 to 26.4] ml kg-1 with a median delta haemoglobin of 1.8 [0.0 to 3.6] g dl-1. Thirty-day morbidity was 47.8% with an overall mortality of 11.3%. CONCLUSIONS: Results indicate lower transfusion-triggering haemoglobin thresholds in clinical practice than suggested by current guidelines. The high morbidity and mortality of this NECTARINE sub-cohort calls for investigative action and evidence-based guidelines addressing peri-operative red blood cell transfusions strategies. TRIAL REGISTRATION: ClinicalTrials.gov, identifier: NCT02350348

Key Learning Outcomes for Clinical Pharmacology and Therapeutics Education in Europe: A Modified Delphi Study.

Harmonizing clinical pharmacology and therapeutics (CPT) education in Europe is necessary to ensure that the prescribing competency of future doctors is of a uniform high standard. As there are currently no uniform requirements, our aim was to achieve consensus on key learning outcomes for undergraduate CPT education in Europe. We used a modified Delphi method consisting of three questionnaire rounds and a panel meeting. A total of 129 experts from 27 European countries were asked to rate 307 learning outcomes. In all, 92 experts (71%) completed all three questionnaire rounds, and 33 experts (26%) attended the meeting. 232 learning outcomes from the original list, 15 newly suggested and 5 rephrased outcomes were included. These 252 learning outcomes should be included in undergraduate CPT curricula to ensure that European graduates are able to prescribe safely and effectively. We provide a blueprint of a European core curriculum describing when and how the learning outcomes might be acquired