The relative age effect shifts students’ choice of educational track even within a school system promoting equal opportunities

In most education systems, the age of a given cohort of students spans up to 12 months, which creates a within-class age difference, or relative age effect, that tends to disadvantage younger students. Because birth month indeed correlates with academic performance, with poorer outcomes for students born later in the year, the effect can have lifelong consequences for students, whose academic performance justifies their acceptance into different educational tracks. Although past studies have identified the relative age effect in students’ choice of educational track in school systems in which students make such choices at the age of 10–14 years, we examined data from the Norwegian school system, in which education tracks are chosen at the age of 15–16 years. The dataset included the variables birth month, track choice, and gender, of all 28,231 pupils at the upper secondary school level in a school county in Norway. Birth month was compared between vocational and academic track choices and the results revealed a significant relative age effect on educational choices between academic and vocational tracks, such that younger students were significantly more likely to apply for vocational tracks. The effect was significantly stronger for boys compared to girls. This indicates that the choice of educational track may reflect students’ relative age, especially among boys, and hence, not be based on interests alone. Those findings have implications for actors involved in ensuring equity in education systems in Norway and elsewhere. Keywords: relative age effect, vocational track, academic track, gender, upper secondary school, Norway, trackingpublishedVersio

Selfreported health status, treatment decision and survival in asymptomatic and symptomatic patients with aortic stenosis in a Western Norway population undergoing conservative treatment: a cross-sectional study with 18 months follow-up

Objectives: To investigate symptoms and self-reported health of patients conservatively treated for aortic stenosis (AS) and to identify factors associated with treatment decision and patient outcomes. Design: A cross-sectional survey with an 18-month follow-up. Setting: One tertiary university hospital in Western Norway. Participants: In all, 1436 patients were diagnosed with AS between 2000 and 2012, and those 245 still under conservative treatment in 2013 were included in this study. Primary and secondary outcome measures: Primary outcome measures were symptoms and self-reported health status. Secondary outcomes were treatment decision and patient survival after 18 months. Results: A total of 136 patients with mean (SD) age 79 (12) years, 52% men responded. Among conservatively treated patients 77% were symptomatic. The symptom most frequently experienced was dyspnoea. Symptomatic patients reported worse physical and mental health compared with asymptomatic patients (effect size 1.24 and 0.74, respectively). In addition, symptomatic patients reported significantly higher levels of anxiety and depression compared with asymptomatic patients. However, symptom status did not correlate with haemodynamic severity of AS. After 18 months, 117 (86%) were still alive, 20% had undergone surgical aortic valve replacement (AVR) and 7% transcatheter aortic valve implantation (TAVI). When adjusting for age, gender, symptomatic status, severity of AS and European system for cardiac operative risk evaluation (EuroSCORE), patients with severe AS had more than sixfold chance of being scheduled for AVR or TAVI compared with those with moderate AS (HR 6.3, 95% CI 1.9 to 21.2, p=0.003). Patients with EuroSCORE ≥11 had less chance for undergoing AVR or TAVI compared with those with EuroSCORE ≤5 (HR 0.06, 95% CI 0.01 to 0.46, p=0.007). Conclusions: Symptoms affected both physical and mental health in conservatively treated patients with AS. Many patients with symptomatic severe AS are not scheduled for surgery, despite the recommendations in current guidelines. The referral practice for AVR is a path for further investigation.publishedVersio

Age at nomination among soccer players nominated for major international individual awards : a better proxy for the age of peak individual soccer performance?

Individual soccer performance is notoriously difficult to measure due to the many contributing sub-variables and the variety of contexts within which skills must be utilised. Furthermore, performance differs across rather specialised playing positions. In research, soccer performance is often measured using combinations of, or even single, sub-variables. All too often these variables have not been validated against actual performance. Another approach is the use of proxies. In sports research, the age of athletes when winning championship medals has been used as a proxy for determining their age of peak performance. In soccer, studies have used the average age of players in top European leagues or in the Champions League to determine the age of individual peak performance. Such approaches have methodological shortcomings and may underestimate the peak. We explore the use of a new proxy, the age at nomination for major individual awards, to determine the average age at peak individual soccer performance. A total of 1,981 players nominated for major awards from 1956 to 2019 were included, and a subset of 653 retired players was extracted, thus including players’ complete careers. Players’ average ages at nomination, at their first nomination, and at their last ever nomination were calculated, and differences across playing positions were calculated together with changes over time in the average age at peak. Based on our proxy, the age of individual peak soccer performance occurs around 27–28 years, varying across playing positions from 26 to 31 years. A player’s first peak, on average, seems to coincide with known peaks of physiological variables; their last-ever peak occurs long after physiological performance has started to decline, indicating that the decline can be compensated for by other variables. The peak age is higher than previously reported for soccer; however, it is similar to those in other team ball sports. The average age at peak performance has increased over time, especially in the last decade. Our approach of using proxies for unearthing information about hidden features of otherwise immeasurable complex performance appears to be viable, and such proxies may be used to validate sub-variables that measure complex behaviour.publishedVersio

Self-reported health status, treatment decision and survival in asymptomatic and symptomatic patients with aortic stenosis in a Western Norway population undergoing conservative treatment: a cross-sectional study with 18 months follow-up

Objectives: To investigate symptoms and self-reported health of patients conservatively treated for aortic stenosis (AS) and to identify factors associated with treatment decision and patient outcomes. Design: A cross-sectional survey with an 18-month follow-up. Setting: One tertiary university hospital in Western Norway. Participants: In all, 1436 patients were diagnosed with AS between 2000 and 2012, and those 245 still under conservative treatment in 2013 were included in this study. Primary and secondary outcome measures: Primary outcome measures were symptoms and self-reported health status. Secondary outcomes were treatment decision and patient survival after 18 months. Results: A total of 136 patients with mean (SD) age 79 (12) years, 52% men responded. Among conservatively treated patients 77% were symptomatic. The symptom most frequently experienced was dyspnoea. Symptomatic patients reported worse physical and mental health compared with asymptomatic patients (effect size 1.24 and 0.74, respectively). In addition, symptomatic patients reported significantly higher levels of anxiety and depression compared with asymptomatic patients. However, symptom status did not correlate with haemodynamic severity of AS. After 18 months, 117 (86%) were still alive, 20% had undergone surgical aortic valve replacement (AVR) and 7% transcatheter aortic valve implantation (TAVI). When adjusting for age, gender, symptomatic status, severity of AS and European system for cardiac operative risk evaluation (EuroSCORE), patients with severe AS had more than sixfold chance of being scheduled for AVR or TAVI compared with those with moderate AS (HR 6.3, 95% CI 1.9 to 21.2, p=0.003). Patients with EuroSCORE ≥11 had less chance for undergoing AVR or TAVI compared with those with EuroSCORE ≤5 (HR 0.06, 95% CI 0.01 to 0.46, p=0.007). Conclusions: Symptoms affected both physical and mental health in conservatively treated patients with AS. Many patients with symptomatic severe AS are not scheduled for surgery, despite the recommendations in current guidelines. The referral practice for AVR is a path for further investigation