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Background/Objectives: Recurrent shoulder instability following Bankart lesion repair often necessitates surgical revision. This systematic review aims to understand the failure rates of arthroscopic revision Bankart repair. Methods: Following the PRISMA guidelines and registered on PROSPERO, this systematic review examined twenty-five articles written between 2000 and 2024. Two independent reviewers assessed eligibility across three databases, focusing on recurrent instability as the primary endpoint, while also noting functional measures, adverse events, revision operations, and return-to-sport rates when available. Results: The key surgical techniques for recurrent instability post-Bankart repair were identified, with revision arthroscopic Bankart being the most common (685/1032). A comparative analysis revealed a significantly lower recurrence for open coracoid transfer compared to arthroscopic revision Bankart repair (9.67% vs. 17.14%; p < 0.001), while no significant difference was observed between remplissage plus Bankart repair and Bankart repair alone (23.75% vs. 17.14%; p = 0.24). The majority of studies did not include supracritical glenoid bone loss or engaging Hill–Sachs lesions, and neither subcritical nor non-engaging lesions significantly influenced recurrence rates (p = 0.85 and p = 0.80, respectively). Conclusions: Revision arthroscopic Bankart repair remains a viable option in the absence of bipolar bone loss; however, open coracoid transfer appears to have lower recurrence rates than arthroscopic Bankart repair, consistent with prior evidence. Further studies should define cutoffs and investigate the roles of critical glenoid bone loss and off-track Hill–Sachs lesions. Preoperative measurements of GBL on three-dimensional computed tomography and characterizing lesions based on glenoid track will help surgeons to choose ideal candidates for arthroscopic revision Bankart repair. [ABSTRACT FROM AUTHOR]

As a skill that experts place at the highest level in language acquisition, writing skills become considered the most difficult. BIPA level 4 is the initial level of complex writing according to the SKL BIPA Permendikbud No. 27 of 2017. Writing skills considered difficult should be packaged with a fun and meaningful learning model, one of which is developing a Game-based Learning model. Identifying curriculum and empirical needs is the initial stage carried out in developing Game-based Learning. This research aims to identify the curriculum and syllabus of BIPA 4 writing, which aligns with identifying empirical learning needs through field studies of BIPA teachers at home and abroad. The results showed that argumentation text is the most challenging text to learn, while the most accessible text to learn is persuasion text. In terms of grammar, the affixes me-kan, ke-an, and ter- are the most difficult languages to learn, while the most accessible grammar to learn is sentence expansion, conjunctions, rephrases, and technical terms. The results also found that BIPA 4 learners need to read texts related to Indonesian insights, including culinary, biodiversity, culture, local wisdom, and tourism. Abstrak Keterampilan menulis sebagai keterampilan yang ditempatkan para ahli pada tataran paling tinggi dalam pemerolehan bahasa menjadi sebuah keterampilan yang dianggap paling sulit. Jenjang BIPA 4 merupakan jenjang awal pembelajaran menulis yang kompleks menurut Standar Kompetensi Lulusan BIPA Permendikbud No. 27 Tahun 2017. Keterampilan menulis yang dianggap sulit sebaiknya dikemas dengan model pembelajaran yang menyenangkan dan bermakna, salah satunya dengan mengembangkan model pembelajaran berbasis game edukasi atau Game-based Learning. Identifikasi kurikulum dan kebutuhan empiris di lapangan merupakan tahap awal yang dilakukan dalam pengembangan Game-based Learning. Penelitian ini bertujuan untuk mengidentifikasi kurikulum dan silabus menulis BIPA 4 yang kemudian diselaraskan dengan identifikasi kebutuhan pembelajaran secara empiris melalui studi lapangan terhadap pengajar BIPA di dalam dan luar negeri. Hasil penelitian didapatkan bahwa teks argumentasi merupakan teks yang paling sulit dipelajari sedangkan teks yang paling mudah dipelajari adalah teks persuasi. Dari segi kebahasaan, imbuhan me-kan, ke-an, dan ter- merupakan kebahasaan yang paling sulit dipelajari sedangkan kebahasaan yang paling mudah dipelajari adalah perluasan kalimat, kata hubung, kata ulang dan istilah teknis. Hasil penelitian juga menemukan bahwa pemelajar BIPA 4 memerlukan teks-teks bacaan yang berkaitan dengan wawasan nusantara atau wawasan ke-Indonesiaan, di antaranya yaitu kuliner, keanekaragaman hayati, budaya, kearifan lokal dan wisata. Kata Kunci: BIPA 4; GBL; identifikasi kurikulum; kebutuhan pembelajaran empiris; keterampilan menulis

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The central axis of the didactic proposal described in this contribution is the educational approach to the question: are microbes good or bad? Schoolchildren of all levels suffer a constant family, social and, especially media, bombardment about the dangers of microbes and the need to eliminate them. This generates an oversized biophobia towards microbes, which is not counteracted by the meager content of microbiology in educational curricula. Given this situation, it is necessary to develop new innovative educational materials for the teaching of microorganisms and their relationship (both positive and negative) with human beings. This contribution describes a didactic board game on microbiology, which addresses, in addition to viruses, different types of microorganisms, both beneficial and harmful, and opportunistic, as well as their characteristics and their relationship with humans. This relationship is addressed through a series of events that include vaccines, antibiotics, sex, hygiene, food, environment, biotechnology, etc. It is a versatile educational resource, easily adaptable to different levels of education, with which it is possible to approach microorganisms from Primary Education to Higher Education, including initial teacher training. [ABSTRACT FROM AUTHOR]

Gama-butirolakton (GBL) je zaradi lahke dostopnosti in nizke cene priljubljena rekreativna droga v nočnih klubih. Gre za prekurzor endogenega nevrotransmiterja, gama-hidroksibutirata (GHB), ki deluje kot agonist na receptorje GABAB in GHB v centralnem živčnem sistemu (CŽS). V nižjih odmerkih inhibira izločanje dopamina, povzroča evforične učinke in niža centralno inhibicijo. Višji odmerki spodbujajo izločanje opioidom podobnih substanc in povzročijo hitro depresijo CŽS. Odvisnost nastopi po nekaj tednih do mesecih vsakodnevne uporabe. Odtegnitev načeloma oponaša klinično sliko odtegnitve od alkohola in/ali benzodiazepinov. Predstavljamo primer odtegnitvenega sindroma od GBL, ki se je pokazal z razvojem delirija, zmedenostjo, halucinacijami in agitacijo. Zdravljenje vključuje visoke odmerke benzodiazepinov, po potrebi pa tudi barbiturate, antikonvulzive in antipsihotike.

Rationale: Regular consumption of gamma-hydroxybutyrate (GHB) may result in a dependence syndrome that can lead to withdrawal symptoms. There are limited data on medications to manage GHB withdrawal. Objectives: To examine characteristics associated with delirium and discharge against medical advice (DAMA), in the context of implementing a GHB withdrawal management protocol at an inner-city hospital in 2020. Methods: We retrospectively reviewed records (01 January 2017–31 March 2021), and included admissions that were ≥ 18 years of age, admitted for GHB withdrawal, and with documented recent GHB use. Admissions were assessed for demographics, medications administered, features of delirium, ICU admission, and DAMA. Exploratory analyses were conducted to examine factors associated (p < 0.2) with features of delirium and DAMA. Results: We identified 135 admissions amongst 91 patients. Medications administered included diazepam (133 admissions, 98.5%), antipsychotics (olanzapine [70 admissions, 51.9%]), baclofen (114 admissions, 84%), and phenobarbital (8 admissions, 5.9%). Features of delirium were diagnosed in 21 (16%) admissions. Delirium was associated with higher daily GHB consumption prior to admission, while duration of GHB use, time from presentation to first dose of diazepam, and concomitant methamphetamine use were inversely associated with delirium. DAMA occurred amongst 41 (30%) admissions, and was associated with a longer time from presentation to first dose of baclofen, while being female and receiving a loading dose of diazepam were inversely associated. Conclusions: This study adds to the literature in support of the safety and feasibility of diazepam and baclofen for the management of GHB withdrawal. Prospective, randomised trials are required. [ABSTRACT FROM AUTHOR]

Beim zukunftsorientierten Lernen geht es darum, Kinder und Jugendliche auf einen exponentielle und ungewisse Zukunft vorzubereiten. Dies bedeutet, bekannte Wege zu verlassen und jenseits der aktuellen Unterrichtspraxis neue Wege einzuschlagen. Wir müssen die Lernenden dabei unterstützen, die Dinge zu lernen, die sie für ihre Zukunft als mündige (deutsche, europäische, Welt‐) Bürger im Zeitalter der digitalen Transformationen benötigen werden, um ihre (und unsere) Zukunft mitzugestalten. Dazu gehört u.a. die Fähigkeit, in unterschiedlichen Sprachen zu kommunizieren. Besonders interessant ist im Sprachlernkontext Extended Reality (XR), also Virtual, Mixed und Augmented Reality, einschließlich Game-based Learning. Dabei ist es von allergrößter Bedeutung, dass die Lernenden aktiv und in Kooperation mit Mitlernenden Inhalte gestalten und diese teilen. #transformationdeslernens #immersion #gbl #zukunftsorientierteslernen #exponenziellezukunft #europa

[Display omitted] Solution crystallization techniques of hybrid lead halides for perovskite photovoltaics, while remaining the most common method for fabricating solar cells, are inevitably complicated by the formation of numerous intermediate solvates that predetermine the morphology and properties of the final perovskite light-harvesting layer. Here, for the first time, a chemical classification of known solvates is proposed based on a comprehensive analysis of their structural features and relationships with possible structural types. [ABSTRACT FROM AUTHOR]

Gamification and game-based learning (GBL) is the newly introduced learning strategies considered fit for English fun learning. . This study aims to investigate the implementation of teaching Speaking in Foreign Language for Specific Purposes (FLSP) at Universitas Muhammadiyah Malang. The employed research design was Classroom Action Research (CAR) with two cycles. The GBL employed was modified from the Family 100 and Trivia game show. Subjects of the study were the Psychology students 2021/2022. Data collection methods were a survey and observation checklist, and the obtained data were analyzed using Activity Theory. The data triangulation was obtained by comparing researchers’ observation notes and questionnaire responses. . Results show that students were not enthusiastic when learning about Speaking through games. Their enthusiasm increased when the game level, rules, and topics were adjusted. The findings of this study imply that GBL enhanced students’ understanding, motivated their learning, and increased their positive behaviours

The present study aimed to measure Portuguese referees’ motivation to study the Laws of the Game and Competition Rules (LGCR). This longitudinal empirical study measured the evolution of referees’ motivation, whose study needs are essential for their preparation, evolution and career progression. The study was carried out in two different periods, in the beginning and during the 2017/2018 sports season. 179 referees completed a questionnaire, in order to assess the motivation. The same scale was replicated in the middle of the season, after the referees had used a game called RefereeGame, to evaluate the evolution in motivation over the time. The data were processed using longitudinal Structural Equation Models, estimated in the SPSS/AMOS 27 software. The referees used a Game-Based Learning (GBL) tool to study and test their knowledge. The results showed that Intrinsic Motivation to Know increased between Moment 1 and Moment 2. Intrinsic and extrinsic motivation also presented considerable differences between both moments, showing that GBL can be considered as valid tool, to regulate technical and regulatory preparation of referees. This research may help sports researchers to understand the use of games as strategic tools to involve referees in learning the LGCR. [ABSTRACT FROM AUTHOR]

[Display omitted] • Fast, simple and direct determination of GBL in adulterated beverages. • GBL prediction capability statistically comparable in all samples evaluated. • Suitable methodology for in-situ forensic Analytical Chemistry without solvent and reagents. • Developed procedure in good agreement with the principles of Green Analytical Chemistry. • Simplicity in calibration model required. A green partial least square (PLS) attenuated total reflectance infrared spectroscopy (ATR-FTIR) method has been developed for the prediction of the γ-butyrolactone (GBL) in all type of soft and alcoholic beverages. The method involves the use of a drop (less than 5 µL) of sample and a single calibration model based on aqueous and alcoholic solutions of GBL and beverages free from GBL. A selected wavenumber range from 1225 to 1171 cm−1 and from 999 to 972 cm−1 of the second derivative (SD) spectra of samples and standards were employed. The validation set provided root mean square error of prediction (RMSEP) of the order of 300 µg g−1 GBL with a ratio of standard error of performance to standard deviation value (RPD) of 13.4. The prediction of unknown samples not considered in the calibration nor in the validation sets offered accuracy relative errors between −1.0 and 2.9 % GBL. The proposed PLS-FTIR based method allows a fast and direct determination of GBL in all type of beverages, in less than 2 min and avoiding the use of neither reagents nor solvents, without any sample treatment required, being in agreement with the principles of Green Analytical Chemistry. [ABSTRACT FROM AUTHOR]

[Display omitted] • Highly viscous electrolyte has been applied in dye-sensitized solar cells (DSSCs). • The best efficiency was gained by the cell with dimethylformamide (DMF) as solvent. • DSSC with DMF-based electrolyte produces low charge transfer resistance. • The best cell exhibited small reduction in efficiency after 4 weeks of storage. Dye-sensitized solar cell (DSSC) performance with a liquid electrolyte depends strongly on the choice of electrolyte solvent. Acetonitrile (AN) is the most widely used organic solvent due to its low viscosity and good solubility to dissolve iodide salts. However, the stability has become critical due to the high vapor pressure of AN. In this study, the efficiency and stability of DSSC using iodide-based electrolyte were observed by using high viscosity solvents namely dimethylformamide (DMF) and γ-butyrolactone (GBL). The cell using DMF shows the best performance with an efficiency of 7.69 %, higher than that of the cell with commercial AN-based electrolyte with an efficiency of 7.14 %. Impedance spectroscopy measurement to the cell using DMF reveals a relatively low charge transfer resistance, both at TiO 2 -dye/electrolyte and counter electrode/electrolyte interfaces, compared to other solvents. Furthermore, the efficiency is retained at 76 % after 4 weeks of storage under ambient air, the best among various solvents tested in the present study. [ABSTRACT FROM AUTHOR]

Total Vaporization Solid‐Phase Microextraction (TV‐SPME) relies on the same technique as standard SPME but completely vaporizes a sample extract, and analytes are sorbed directly from the vapor phase. On‐fiber derivatization may also be performed using TV‐SPME, where the fiber is first exposed to the headspace of a vial containing the derivatization agent, then exposed to a new vial containing the sample. ɣ‐Hydroxybutyric acid (GHB) and ɣ‐butyrolactone (GBL) are drugs of concern in that they may be used in drug facilitated sexual assault by surreptitiously spiking them into a victim's beverage. These drugs cause sedation, memory loss, and are difficult to detect in biological samples. One challenge in their analysis is that they can interconvert in aqueous samples, which was demonstrated in samples allowed to stand at room temperature for long periods. A volume study of GBL in water was performed with volumes ranging from 1 to 10,000 µl to compare the efficacy of TV‐SPME, headspace SPME, and immersion SPME. Lastly, water, beer, wine, liquor, and mixed drinks were spiked with either GHB or GBL with realistic concentrations (mg/ml) and microliter quantities were analyzed using a TV‐SPME Gas Chromatography‐Mass Spectrometry method. The GBL volume study demonstrated an increased sensitivity in GBL detection when TV‐SPME was utilized. Additionally, GHB and GBL were identified in various beverages at realistic concentrations. Overall, TV‐SPME is beneficial because it requires no sample preparation and uses smaller sample volumes than immersion and headspace SPME. [ABSTRACT FROM AUTHOR]

Government digital agendas worldwide want to help develop the digital transformation in businesses and public administra-tions, while acknowledging the digital changes taking place in society and the need to integrate information security (IS). Although information communication technology (ICT) shapes our lives, we tend to have an insufficient knowledge of the risks involved, of information security (IS), and of the General Data Protection Regulation (GDPR); this is compounded by carelessness in handling data and insufficient IS awareness (ISA). Backed by a clear conceptual approach, information security awareness trainings (ISAT) are also essential for everyone. However, classical trainings are not currently working. Psychologically based research shows that a systemic approach might be helpful. This is where analogue game-based learning (GBL) comes into play.

Streptomyces )-butyrolactones (GBLs) are quorum sensing communication signals triggering antibiotic production. The GBL system of Streptomyces filipinensis, the producer of the antifungal agent filipin, has been investigated. Inactivation of sfbR (for S. filipinensis )-butyrolactone receptor), a GBL receptor, resulted in a strong decrease in production of filipin, and deletion of sfbR2, a pseudo-receptor, boosted it, in agreement with lower and higher levels of transcription of filipin biosynthetic genes, respectively. It is noteworthy that none of the mutations affected growth or morphological development. While no ARE (autoregulatory element)-like sequences were found in the promoters of filipin genes, suggesting indirect control of production, five ARE sequences were found in five genes of the GBL cluster, whose transcription has been shown to be controlled by both S. filipinensis SfbR and SfbR2. In vitro binding of recombinant SfbR and SfbR2 to such sequences indicated that such control is direct. Transcription start points were identified by 5= rapid amplification of cDNA ends, and precise binding regions were investigated by the use of DNase I protection studies. Binding of both regulators took place in the promoter of target genes and at the same sites. Information content analysis of protected sequences in target promoters yielded an 18-nucleotide consensus ARE sequence. Quantitative transcriptional analyses revealed that both regulators are self-regulated and that each represses the transcription of the other as well as that of the remaining target genes. Unlike other GBL receptor homologues, SfbR activates its own transcription whereas SfbR2 has a canonical autorepression profile. Additionally, SfbR2 was found here to bind the antifungal antimycin A as a way to modulate its DNA-binding activity. [ABSTRACT FROM AUTHOR]

Research skills are challenging to teach in a way that is meaningful to students and has ongoing impact in research practice. This paper investigates constructivist and experiential strategies for effective learning and deep understanding of postgraduate research skills and proposes a game-based learning (GBL) solution. A (non-digital) game called How to Fail Your Research Degree was designed and iteratively developed. Gameplay loop analysis identifies various learning and game mechanics and contextualises them in relation to GBL theory. Evaluation of gameplay (n = 127) demonstrates effective transmission of intended learning outcomes and positive game experience based on Keller's Attention-Relevance-Confidence-Satisfaction (ARCS) model. Discussion proposes that the game has high cognitive authenticity, relies heavily on tutor facilitation, can create tension between knowledge and confidence, and is applicable to multiple domains and learning situations. GBL is proposed to be an original and effective approach to teaching high-level, functional learning outcomes such as academic research skills. [ABSTRACT FROM AUTHOR]

Abstract Background Overdoses from so-called “club drugs” (GHB/GBL) have become a more frequent cause of overdoses attended by ambulance services. Given its availability, affordability, and lack of awareness of risks, there is a common misconception among users that the drug is relatively safe. Methods This study reviewed ambulance records in Bergen, Norway between 2009 and 2015 for cases of acute poisonings, particularly from suspected GHB/GBL intoxication. Results In total, 1112 cases of GHB and GBL poisoning were identified. GHB was suspected for 995 (89%) of the patients. Men made up the majority of the cases (n = 752, 67.6%) with a median age of 27 years old. Temporal trends for GHB/GBL overdoses displayed a late-night, weekend pattern. The most frequent initial symptoms reported were unconsciousness, or reduced consciousness. Most of the patients required further treatment and transport. During the period from 2009 to 2015, there was a nearly 50% decrease in GHB/GBL overdoses from 2013 to 2014. Discussion The characteristics of GHB/GBL overdose victims shed light on this patient group. The decrease in incidence over the years may be partly due to a legal ban on GBL in Norway, declared in 2010. It may also be due to an increase in the use of MDMA/ecstasy. Conclusion The review of ambulance records on the prehospital treatment of overdoses can be beneficial in monitoring, preparing, and prevention efforts aimed to benefit this vulnerable group.

Gamification incorporates elements of gameplay into real-word activities and behaviours. These elements include progress mechanics, player development and narrative structure. Gamification is being increasingly used in an educational context as it has the ability to make learning fun, memorable and more effective. We recommend ways in which gamification can be effectively implemented in medical education, including common pitfalls and hurdles to avoid.

• Co-ingestion of ethanol increases the adverse effects of patients intoxicated by GHB/GBL. • The most common features were reduction in consciousness. • Patients with ethanol co-ingestion had a higher frequencies of arrivals by ambulance, reduction in consciousness, need for treatment in the ED, use of sedatives, admission to critical care units, and prolonged hospital stay. Ethanol intake can increase the sedative effects of gamma-hydroxybutyrate / gamma-butyrolactone (GHB/GBL), although the real clinical impact is unknown. We studied the clinical impact of the co-ingestion of ethanol in patients presenting to the Emergency Department (ED) with acute toxicity related to GHB/GBL use. We performed a secondary analysis of the Euro-DEN Plus Registry (14 countries, 22 EDs) which includes 17,371 consecutive patients presenting to the ED with acute recreational drug toxicity over 39 consecutive months (October 2013 – December 2016). We compared the epidemiological and clinical characteristics and ED management of patients identified as presenting with acute toxicity related to lone GHB/GBL (Group A) or GHB/GBL combined with ethanol (Group B) without other concomitant drugs. A total of 609 patients were included (age 32 (8) years; 116 women (19%); Group A: 183 patients and Group B: 426). The most common features were reduction in consciousness (defined as Glasgow Coma Score <13 points: 56.1%) and agitation/aggressiveness (33.6%). Those with ethanol co-ingestion were younger patients (Group A/B: 31.5/33.1 years, p = 0.029) and ethanol co-ingestion was associated with a lower frequency of bradycardia (23.5%/15.7%, p = 0.027) and more frequent arrival at the ED by ambulance (68.3/86.6%; p < 0.001), reduction in consciousness (58.9%/49.1%; p = 0.031), need for treatment in the ED (49.2%/60.4%; p = 0.011), use of sedatives (20.1%/12.8%; p = 0.034), admission to critical care units (22.4%/55.3%; p < 0.001), and longer hospital stay (stay longer than 6 h: 16.9%/28.4%; p = 0.003). Co-ingestion of ethanol increases the adverse effects of patients intoxicated by GHB/GBL, leading to greater depression of consciousness, need for treatment, admission to the ICU and longer hospital stay. [ABSTRACT FROM AUTHOR]

The authors examine the determinants of the effective implementation of game-based learning (GBL) for experiential learning. They focus on the successful GBL initiative called Management Game (MG) and adopt the theory-driven deductive thematic analysis approach of Boyatzis along with the Matsuo model as theoretical rationale. Overall, the findings show that MG is an effective GBL that addresses the five seminal factors of the Matsuo model. Further, the study sheds light on the optimal structure of the successful GBL that allows learners to effectively acquire knowledge and skills. Several implications of the study are discussed in the conclusion together with the limitations of the study. [ABSTRACT FROM AUTHOR]

Γ-valerolactone (GVL), marketed online as "Tranquilli-G" and "excellent Valium", is used as a legal substitute for γ-hydroxybutyric acid (GHB); however, until now, GVL has only been connected to one Drug-Facilitated Sexual Assault (DFSA) case. Moreover, the pharmaco-toxicological effects of GVL are poorly studied. The aim of this study was to investigate the 1) in vivo effects of gavage administration of GVL (100–3000 mg/kg) on neurological (myoclonia, convulsions), sensorimotor (visual, acoustic, and overall tactile) responses, righting reflex, thermoregulation, motor activity (bar, drag, and accelerod test) and cardiorespiratory changes (heart rate, breath rate, oxygen saturation, and pulse distension) in CD-1 male mice and the 2) in silico ADMET profile of GVL in comparison to GHB and the open active form γ-hydroxyvaleric acid (GHV). The present study demonstrates that GVL inhibits, in a dose-dependent manner, sensorimotor and motor responses and induces cardiorespiratory depression (at a dose of 3000 mg/kg) in mice. The determination of the ED 50 in sensorimotor and motor responses revealed that GVL is about 4–5 times less potent than GHB. In silico prediction of ADMET profiles revealed toxicokinetic similarities between GHB and GHV, and differences with GVL. These results suggest that GVL could be used as a substitute for GHB and should be added to forensic toxicology screenings. • GVL inhibits sensorimotor, motor and cardiorespiratory responses in mice. • GVL is about 4–5 times less potent than GHB. • In silico ADMET prediction reveals toxicokinetic differences between GVL and GHB. [ABSTRACT FROM AUTHOR]

The adoption of games in the classroom has been studied from different angles, such as the readiness of teachers to use games or the barriers encountered. However, actual classroom practices with regard to the use of games have not been examined on a larger scale. With this research, we gave teachers a voice to report on their actual practices. We examined the current practices of a large sample of Estonian teachers (N = 1258, which constitutes almost 9% of the total Estonian teacher population) in primary and secondary education in 2017. We found that most of the teachers use games on a regular basis. Mainly, they use the games for motivation and alternation, but they also use them to consolidate and teach new skills. While awareness and motivation are high and experimentation on using games is widespread, practices appear fragmentary and not widely sustained. As a result of this study, we suggest the creation of an evidence base and a better integration of social support structures into teacher education. This is the first large-scale study to look into Estonian teacher’s actual practices, and although Estonian teachers have relatively high autonomy and technical skills, we believe that these results and further investigations are applicable in other contexts as well.