Austrian Students’ Perceptions of Social Distancing and Their Emotional Experiences During Distance Learning Due to the COVID-19 Pandemic

The COVID-19 pandemic has led to far-reaching changes in various aspects of students’ lives. In the particular case of the educational field, classroom teaching was drastically shifted to a distance learning format. Consequently, students needed to deal with a completely different everyday school life. Learning was carried out online, which implied that students could not see some of their regular, important social contacts such as teachers, classmates or friends. It is already proven that such social distancing measures had impacts on students’ emotional experiences during the lockdown. Following a mixed-methods concurrent single-phase design, this study examined students’ perceptions of social distancing and their emotional experiences during the first school lockdown in Austria. Data from an online survey (n = 263 students) and from qualitative interviews (n = 56 students) were analyzed. The results show that distance learning drastically reduced interaction among students and between students and their teachers. Furthermore, the results indicate negative emotional experiences due to less social contact, increased learning pressures, and less structure. However, findings revealed that students also experience and perceived positive emotional experiences during distance learning because of more freedom, autonomy, and to some extent, less performance pressure. Based on the findings, the present study discusses possible perspectives on how to support students during and after distance learning, as well as further lines of research.Peer Reviewe

Exploring inclusive education in times of COVID-19: an international comparison of German, Austrian and Portuguese teachers

With the start of the Coronavirus (COVID-19) pandemic, the global education system has a faced immense challenges and disruptions resulting in and the necessity for an immediate redesign of teaching and learning in the school context. Face-to-face classroom instruction had to be replaced by ‘emergency remote teaching’, requiring teacher to adapt their daily routines to a new and unprecedented educational reality. Researchers and policymakers worldwide have agreed that, despite the fact that efforts were made to immediately adapt to emergency remote teaching, disadvantaged and vulnerable students may be especially at risk in emergency remote teaching. Given the differences in schooling organization across countries during the COVID-19 pandemic it can be expected that teachers performed inclusive instructional practices significantly different. Against the unpredictable situation, cross-country research has been urgently required to provide data that could inform education policy. Thus, this study explored teachers’ perceptions of supporting at risk students during the first COVID-19 school closures, as well as examining teachers’ inclusive teaching practices in three countries: Germany, Austria and Portugal. ANOVA results revealed important country differences. In general, it appears that teachers in Germany and Austria reported to have implemented less practices to address vulnerable and at-risk students compared to Portuguese teachers. Implications of the results, as well as further lines of research are outlined.info:eu-repo/semantics/publishedVersio

Agreement between administrative data and the Resident Assessment Instrument Minimum Dataset (RAI-MDS) for medication use in long-term care facilities: a population-based study

Background: Prescription medication use, which is common among long-term care facility (LTCF) residents, is routinely used to describe quality of care and predict health outcomes. Data sources that capture medication information, which include surveys, medical charts, administrative health databases, and clinical assessment records, may not collect concordant information, which can result in comparable prevalence and effect size estimates. The purpose of this research was to estimate agreement between two population-based electronic data sources for measuring use of several medication classes among LTCF residents: outpatient prescription drug administrative data and the Resident Assessment Instrument Minimum Data Set (RAI-MDS) Version 2.0. Methods: Prescription drug and RAI-MDS data from the province of Saskatchewan, Canada (population 1.1 million) were linked for 2010/11 in this cross-sectional study. Agreement for anti-psychotic, anti-depressant, and anti-anxiety/hypnotic medication classes was examined using prevalence estimates, Cohen’s κ, and positive and negative agreement. Mixed-effects logistic regression models tested resident and facility characteristics associated with disagreement. Results: The cohort was comprised of 8,866 LTCF residents. In the RAI-MDS data, prevalence of anti-psychotics was 35.7%, while for anti-depressants it was 37.9% and for hypnotics it was 27.1%. Prevalence was similar in prescription drug data for anti-psychotics and anti-depressants, but lower for hypnotics (18.0%). Cohen’s κ ranged from 0.39 to 0.85 and was highest for the first two medication classes. Diagnosis of a mood disorder and facility affiliation was associated with disagreement for hypnotics. Conclusions: Agreement between prescription drug administrative data and RAI-MDS assessment data was influenced by the type of medication class, as well as selected patient and facility characteristics. Researchers should carefully consider the purpose of their study, whether it is to capture medication that are dispensed or medications that are currently used by residents, when selecting a data source for research on LTCF populations

Is antibacterial treatment intensity lower in elderly patients? A retrospective cohort study in a German surgical intensive care unit

Background: Demographic change concurrent with medical progress leads to an increasing number of elderly patients in intensive care units (ICUs). Antibacterial treatment is an important, often life-saving, aspect of intensive care but burdened by the associated antimicrobial resistance risk. Elderly patients are simultaneously at greater risk of infections and may be more restrictively treated because, generally, treatment intensity declines with age. We therefore described utilization of antibacterials in ICU patients older and younger than 80 years and examined differences in the intensity of antibacterial therapy between both groups. Methods: We analysed 17,464 valid admissions from the electronic patient data management system of our surgical ICU from April 2006 – October 2013. Antibacterial treatment rates were defined as days of treatment (exposed patient days) relative to patient days of ICU stay and calculated for old and young patients. Rates were compared in zero-inflated Poisson regression models adjusted for patients’ sex, mean SAPS II- and TISS-scores, and calendar years yielding adjusted rate ratios (aRRs). Rate ratios exceeding 1 represent higher rates in old patients reflecting greater treatment intensity in old compared to younger patients. Results: Observed antibacterial treatment rates were lower in patients 80 years and older compared to younger patients (30.97 and 39.73 exposed patient days per 100 patient days in the ICU, respectively). No difference in treatment intensity, however, was found from zero-inflated Poisson regression models permitting more adequate consideration of patient days with low treatment probability: for all antibacterials the adjusted rate ratio (aRR) was 1.02 (95%CI: 0.98–1.07). Treatment intensities were higher in elderly patients for penicillins (aRR 1.37 (95%CI: 1.26–1.48)), cephalosporins (aRR 1.20 (95%CI: 1.09–1.31)), carbapenems (aRR 1.35 (95%CI: 1.20–1.50)), fluoroquinolones (aRR 1.17 (95%CI: 1.05–1.30), and imidazoles (aRR 1.34 (95%CI: 1.23–1.46)). Conclusions: Elderly patients were generally less likely to be treated with antibacterials. This observation, however, did not persist in patients with comparable treatment probability. In these, antibacterial treatment intensity did not differ between younger and older ICU patients, for some antibacterial classes treatment intensity was even higher in the latter. Patient-level covariates are instrumental for a nuanced evaluation of age-effects in antibacterial treatment in the ICU

Mortality after infection with methicillin-resistant Staphylococcus aureus (MRSA) diagnosed in the community

<p>Abstract</p> <p>Background</p> <p>Outbreak reports suggest that community-acquired methicillin-resistant <it>Staphylococcus aureus </it>(MRSA) infections can be life-threatening. We conducted a population based cohort study to assess the magnitude of mortality associated with MRSA infections diagnosed in the community.</p> <p>Methods</p> <p>We used the United Kingdom's General Practice Research Database (GPRD) to form a cohort of all patients with MRSA diagnosed in the community from 2001 through 2004 and up to ten patients without an MRSA diagnosis. The latter were frequency-matched with the MRSA patients on age, GPRD practice and diagnosis date. All patients were older than 18 years, had no hospitalization in the 2 years prior to cohort entry and medical history information of at least 2 years prior to cohort entry. The cohort was followed up for 1 year and all deaths and hospitalizations were identified. Hazard ratios of all-cause mortality were estimated using the Cox proportional hazards model adjusted for patient characteristics.</p> <p>Results</p> <p>The cohort included 1439 patients diagnosed with MRSA and 14,090 patients with no MRSA diagnosis. Mean age at cohort entry was 70 years in both groups, while co-morbid conditions were more prevalent in the patients with MRSA. Within 1 year, 21.8% of MRSA patients died as compared with 5.0% of non-MRSA patients. The risk of death was increased in patients diagnosed with MRSA in the community (adjusted hazard ratio 4.1; 95% confidence interval: 3.5–4.7).</p> <p>Conclusion</p> <p>MRSA infections diagnosed in the community are associated with significant mortality in the year after diagnosis.</p

Antimicrobial Drugs and Community-acquired Methicillin-Resistant Staphylococcus aureus, United Kingdom

Antimicrobial drugs are associated with an increased risk for community-acquired MRSA infections

Comprehensive genomic profiles of small cell lung cancer

We have sequenced the genomes of 110 small cell lung cancers (SCLC), one of the deadliest human cancers. In nearly all the tumours analysed we found bi-allelic inactivation of TP53 and RB1, sometimes by complex genomic rearrangements. Two tumours with wild-type RB1 had evidence of chromothripsis leading to overexpression of cyclin D1 (encoded by the CCND1 gene), revealing an alternative mechanism of Rb1 deregulation. Thus, loss of the tumour suppressors TP53 and RB1 is obligatory in SCLC. We discovered somatic genomic rearrangements of TP73 that create an oncogenic version of this gene, TP73Dex2/3. In rare cases, SCLC tumours exhibited kinase gene mutations, providing a possible therapeutic opportunity for individual patients. Finally, we observed inactivating mutations in NOTCH family genes in 25% of human SCLC. Accordingly, activation of Notch signalling in a pre-clinical SCLC mouse model strikingly reduced the number of tumours and extended the survival of the mutant mice. Furthermore, neuroendocrine gene expression was abrogated by Notch activity in SCLC cells. This first comprehensive study of somatic genome alterations in SCLC uncovers several key biological processes and identifies candidate therapeutic targets in this highly lethal form of cancer

Antibiotic use in children: Assessing the risk of methicillin resistance using different study designs

Children have generally received a considerable number of outpatient antibacterial prescriptions, but recent trends in utilization are unknown. Concurrently, resistance to methicillin has been increasingly reported for infections with Staphylococcus aureus in the community, but an association with antibacterials has not been shown for children. In assessing this association, within-subject study designs such as the case-time-control can control exposure time trends in addition to unmeasured and unmeasurable stable confounders. The efficiency of such analyses has not yet been assessed for matched case-control data. The objectives of this thesis are to study the patterns of antibacterial use in outpatient children, to assess the association between antibacterial prescriptions and the risk of methicillin-resistant Staphylococcus aureus (MRSA) in children in the community using a matched case-control design, and to establish the statistical efficiency of case-crossover and case-time-control analyses from these data.Using the UK General Practice Research Database, I identified the cohort of all children aged 0-19 years and their antibacterial prescriptions from 1993-2007. I described current use and changes with a Poisson model. Next, I obtained odds ratios for the risk of MRSA diagnoses in children prescribed antibiotics compared to non-users from conditional logistic regression in a matched case-control study nested in this cohort. I then compared the standard error (SE) with those from case-crossover and case-time-control analyses.The cohort included 1,751,645 children with 5,835,891 antibiotic prescriptions. After 2000, prescribing rates increased steadily to 568/1000 person-years (95% confidence interval (CI) 559-577) in 2007. This increase was largest in boys and girls aged 1-4 years and similar for most classes of anti¬bacterials. From 1994-2007, 297 children were diagnosed with MRSA in the cohort to which 9,357 controls were matched. The adjusted rate ratio (RR) of MRSA with any prescription was 3.5 (95% CI 2.6-4.8). The risk generally increased with increasing numbers of prescriptions. It also varied for different antibacterial classes. Results were robust in sensitivity analyses. Of 297 cases, 60 and 28 received antibacterials only during risk and control period, respectively, leading to a case-crossover odds ratio (OR) of 2.1, 95% CI 1.4-3.4, SE 0.229. The case-time-control OR was 2.0, its unweighted SE decreased from 0.326 with one control per case to 0.234 with all 9,357 controls. The increase in antibacterial prescribing suggests a waning awareness of the antibacterial resistance threat. MRSA in children in the community can occur without preceding antibacterial drug exposure. However, concordant with findings in adults, there is a dose-dependent association. While lower than the case-control's and case-crossover's, the case-time-control design's empirical efficiency from matched data based on standard error can be close if the control-to-case ratio is large.Les enfants ont reçu généralement une proportion considérable des prescriptions d'antibiotiques en ville, toutefois les tendances récentes de l'utilisation ne sont pas connues. En même temps, dans la communauté, il y a de plus en plus d'infections dues au Staphylococcus aureus résistant à la méthicilline (SARM) et la relation entre ces infections et l'utilisation des antibiotiques n'a pas encore été démontrée chez les enfants. En évaluant cette relation, des devis d'étude intra-sujet comme les analyses de type cas-temps-témoins (case-time-control) sont utiles pour contrôler les variations dans le temps de l'exposition en plus de permettre de contrôler les biais introduits par les facteurs confondants stables, qu'ils soient inconnus ou non-mesurables. L'efficacité de ce type d'analyse sur des données d'une étude cas-témoins appariés est encore indéterminée. Cette thèse a donc trois objectifs. Le premier est de décrire les habitudes de prescription des antibiotiques dans la communauté chez les enfants. Le second est de quantifier, en utilisant un devis cas-témoins apparié, la relation entre la prescription d'antibiotique et le risque de SARM. Le troisième est de comparer l'efficacité des analyses cas-croisé et cas-temps-témoins à l'aide des données de l'étude sur le SARM.La base de données General Practice Research Database (GPRD) a été utilisée pour identifier la cohorte de tous les enfants âgés de moins de 19 ans entre 1993 et 2007 ainsi que toutes leurs prescriptions d'antibiotiques. Cette cohorte a servi à décrire l'utilisation d'antibiotiques et les changements de traitements à l'aide d'une régression de Poisson. Par la suite, une régression logistique conditionnelle m'a permis d'obtenir le rapport de cotes comparant le risque de SARM chez les enfants avec antibiothérapie au risque parmi ceux sans prescriptions antibiotiques (analyse cas-témoins appariés). Finalement, j'ai comparé l'erreur type de cette analyse à celles obtenues par analyses cas-croisé et cas-temps-témoins basées sur les mêmes données.La cohorte comprend 1 751 645 enfants ayant reçu 5 835 891 prescriptions d'antibiotiques. Après l'an 2000, le taux de prescription augmente continuellement pour atteindre 568/1000 personnes-années (intervalle de confiance à 95% (IC) 559-577) en 2007. Cette croissance est plus marquée pour les filles et les garçons âgés entre 1 à 4 ans et elle est comparable pour la plupart des classes d'antibiotiques. Entre 1994 et 2007, 297 enfants de la cohorte ont eu un code diagnostic de SARM et ont été appariés à 9357 témoins. Le rapport de cote ajusté entre au moins une prescription et SARM est 3,5 (95% IC 2,6-4,8). En général, le risque augmente avec chaque nouvelle prescription d'antibiotique. De plus, il y a une variation considérable entre les classes d'antibiotiques. J'ai observé ces mêmes résultats lors des analyses de sensibilité. Parmi les 297 cas de SARM, 60 ont reçu des prescriptions d'antibiotiques seulement durant la période de risque alors que 28 cas en ont reçu seulement durant la période de contrôle. Le rapport de cotes pour l'analyse cas-croisé est 2,1 (95% IC 1,4-3,4) avec une erreur type de 0,229. L'analyse cas-temps-témoins donne un rapport de cotes de 2 avec une erreur type de 0,326 en sélectionnant un témoin par cas. Lorsque tous les témoins sont inclus dans l'analyse, l'erreur type non pondérée est de 0,234. L'augmentation du taux de prescriptions d'antibiotiques en pratique communautaire pourrait possiblement s'expliquer par le déclin de la sensibilisation face aux dangers de résistance aux antibiotiques. Chez les enfants, le SARM peut être diagnostiqué dans la communauté malgré l'absence d'exposition aux antibiotiques. Toutefois, conformément aux observations dans la population adulte, la relation entre le SARM et les antibiotiques est dépendante de la dose. Lorsque le ratio cas-témoins est élevé, la performance empirique de l'analyse cas-temps-témoins s'approche de celle des analyses cas-témoins ou cas-croisé