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Background: Tier 1 exposure tools recommended for use under REACH are designed to easily identify situations that may pose a risk to health through conservative exposure predictions. However, no comprehensive evaluation of the performance of the lower tier tools has previously been carried out. The ETEAM project aimed to evaluate several lower tier exposure tools (ECETOC TRA, MEASE, and EMKG-EXPO-TOOL) as well as one higher tier tool (STOFFENMANAGER®). This paper describes the results of the external validation of tool estimates using measurement data. Methods: Measurement data were collected from a range of providers, both in Europe and United States, together with contextual information. Individual measurement and aggregated measurement data were obtained. The contextual information was coded into the tools to obtain exposure estimates. Results were expressed as percentage of measurements exceeding the tool estimates and presented by exposure category (non-volatile liquid, volatile liquid, metal abrasion, metal processing, and powder handling). We also explored tool performance for different process activities as well as different scenario conditions and exposure levels. Results: In total, results from nearly 4000 measurements were obtained, with the majority for the use of volatile liquids and powder handling. The comparisons of measurement results with tool estimates suggest that the tools are generally conservative. However, the tools were more conservative when estimating exposure from powder handling compared to volatile liquids and other exposure categories. In addition, results suggested that tool performance varies between process activities and scenario conditions. For example, tools were less conservative when estimating exposure during activities involving tabletting, compression, extrusion, pelletisation, granulation (common process activity PROC14) and transfer of substance or mixture (charging and discharging) at nondedicated facilities (PROC8a; powder handling only). With the exception of STOFFENMANAGER® (for estimating exposure during powder handling), the tools were less conservative for scenarios with lower estimated exposure levels. Conclusions: This is the most comprehensive evaluation of the performance of REACH exposure tools carried out to date. The results show that, although generally conservative, the tools may not always achieve the performance specified in the REACH guidance, i.e. using the 75th or 90th percentile of the exposure distribution for the risk characterisation. Ongoing development, adjustment, and recalibration of the tools with new measurement data are essential to ensure adequate characterisation and control of worker exposure to hazardous substances. [ABSTRACT FROM AUTHOR]

The past two decades have witnessed an increase in ethnicity-related peer aggression, driven by the intensification of the migration phenomenon and rise of information and communication technologies. The goal of the current study is to extend the scope of previous reviews on peer aggression to examine the emerging evidence on the role of technological tools in the prevention, detection, and handling of ethnicity-related peer aggression among young people. We have identified 14 relevant papers published between 2005 and 2020 that help us answer the following research questions: What forms of aggression among young ethnic minorities do these technological interventions try to address? What types of technological interventions are being used? The results indicate that the technological tools are being used to tackle both intergroup as well as intragroup peer aggression, in which ethnic minorities youth is involved (as a victim, perpetrator or bystander). Most studies have focused on adolescents and young adults in the US or in Europe. The technological tools reported on, include: online games, videos, social media, and chat-based programmes, or machine learning algorithms aimed at tackling online and offline peer aggression. They can be used either as stand - alone tools, or as part of intervention programmes (at the school, family or community level). These findings can be useful to improve and elaborate future digital technologies developed to address ethnicity-related peer aggression. • The review maps the existing literature on the role of technological tools in tackling ethnicity-related peer aggression. • All forms of peer aggression are considered in which ethnic minorities youth was involved. • Three groups of technological interventions are identified and categorized into intra- or intergroup ethnicity-related peer aggression. • The digital tools presented include: online games, video, social media, chat-based programmes, and machine learning algorithms. • Our study reveals some follow-up research questions needed to expand current knowledge on digital technologies. [ABSTRACT FROM AUTHOR]

Therapy for polymyalgia rheumatica (PMR) varies widely in clinical practice as international recommendations for PMR treatment are not currently available. In this paper, we report the 2015 European League Against Rheumatism (EULAR)/American College of Rheumatology (ACR) recommendations for the management of PMR. We used the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) methodology as a framework for the project. Accordingly, the direction and strength of the recommendations are based on the quality of evidence, the balance between desirable and undesirable effects, patients' and clinicians' values and preferences, and resource use. Eight overarching principles and nine specific recommendations were developed covering several aspects of PMR, including basic and follow-up investigations of patients under treatment, risk factor assessment, medical access for patients and specialist referral, treatment strategies such as initial glucocorticoid (GC) doses and subsequent tapering regimens, use of intramuscular GCs and disease modifying anti-rheumatic drugs (DMARDs), as well as the roles of non-steroidal anti-rheumatic drugs and non-pharmacological interventions. These recommendations will inform primary, secondary and tertiary care physicians about an international consensus on the management of PMR. These recommendations should serve to inform clinicians about best practices in the care of patients with PMR. [ABSTRACT FROM AUTHOR]