Search

BackgroundThe coronavirus disease (COVID-19) pandemic has resulted in significant morbidity and mortality; large numbers of patients require intensive care, which is placing strain on health care systems worldwide. There is an urgent need for a COVID-19 disease severity assessment that can assist in patient triage and resource allocation for patients at risk for severe disease. ObjectiveThe goal of this study was to develop, validate, and scale a clinical decision support system and mobile app to assist in COVID-19 severity assessment, management, and care. MethodsModel training data from 701 patients with COVID-19 were collected across practices within the Family Health Centers network at New York University Langone Health. A two-tiered model was developed. Tier 1 uses easily available, nonlaboratory data to help determine whether biomarker-based testing and/or hospitalization is necessary. Tier 2 predicts the probability of mortality using biomarker measurements (C-reactive protein, procalcitonin, D-dimer) and age. Both the Tier 1 and Tier 2 models were validated using two external datasets from hospitals in Wuhan, China, comprising 160 and 375 patients, respectively. ResultsAll biomarkers were measured at significantly higher levels in patients who died vs those who were not hospitalized or discharged (P

Displacing the largest number of refugees in recent time is one of the devastating impacts of the Syrian war. Turkey hosts over 3.6 million Syrian refugees. Almost half of them are children in the preschool or primary school stage. Because refugee children are five times more likely to miss schooling than nonrefugee children, the provision of high-quality education in refugee settings is emphasized in the literature, as it offers children and their community protection, security, social cohesion, and it also prevents conflicts. Therefore, the purpose of this paper is to report some key findings of a qualitative study that primarily examined Syrian refugee teachers' perceptions of quality education and their experiences of pedagogical change, which included adoption of more learner-centered practices in line with the standards set by the International Network for Education in Emergencies (INEE), an organization that guides the delivery of quality education in emergencies. This paper explores teachers' beliefs about learning, their education, training, and their perceptions of learner-centered education (LCE) and the implementation of LCE in an urban Syrian refugee school in Turkey. In addition, the paper investigates teachers' vision of good pedagogy within their realities and capacities. The findings from this study showed complex contextual influences affecting the educational provision for Syrian refugees and LCE implementation challenges. A key implication that arises from this study relates to the suitability of LCE as "best practice" in the refugee context.

Displacing the largest number of refugees in recent time is one of the devastating impacts of the Syrian war. Turkey hosts over 3.6 million Syrian refugees. Almost half of them are children in the preschool or primary school stage. Because refugee children are five times more likely to miss schooling than non-refugee children, the provision of high-quality education in refugee settings is emphasized in the literature, as it offers children and their community protection, security, social cohesion, and it also prevents conflicts. Therefore, the purpose of this paper is to report some key findings of a qualitative study that primarily examined Syrian refugee teachers' perceptions of quality education and their experiences of pedagogical change, which included adoption of more learner-centered practices in line with the standards set by the International Network for Education in Emergencies (INEE), an organization that guides the delivery of quality education in emergencies. This paper explores teachers' beliefs about learning, their education, training, and their perceptions of learner-centered education (LCE) and the implementation of LCE in an urban Syrian refugee school in Turkey. In addition, the paper investigates teachers' vision of good pedagogy within their realities and capacities. The findings from this study showed complex contextual influences affecting the educational provision for Syrian refugees and LCE implementation challenges. A key implication that arises from this study relates to the suitability of LCE as 'best practice' in the refugee context. Keywords Syrian refugees, quality education, good pedagogy, INEE, learner-centered education, Quality Education in Refugee Settings Providing education for children affected by conflict is as old as history. Nevertheless, the interest in researching education in conflict and emergencies is growing and [...]

This study examined the impact of a literacy intervention comprised of four parent workshops about reading to children on preschoolers' receptive vocabulary. Findings indicated that children of parents attending the workshops had a significant 7- point increase in their Peabody Picture Vocabulary Test scores at a 7-month follow-up. Parent educational level related to score increase. (Author/KB)

SARS-CoV-2 is the virus that causes coronavirus disease (COVID-19) which has reached pandemic levels resulting in significant morbidity and mortality affecting every inhabited continent. The large number of patients requiring intensive care threatens to overwhelm healthcare systems globally. Likewise, there is a compelling need for a COVID-19 disease severity test to prioritize care and resources for patients at elevated risk of mortality. Here, an integrated point-of-care COVID-19 Severity Score and clinical decision support system is presented using biomarker measurements of C-reactive protein (CRP), N-terminus pro B type natriuretic peptide (NT-proBNP), myoglobin (MYO), D-dimer, procalcitonin (PCT), creatine kinase-myocardial band (CK-MB), and cardiac troponin I (cTnI). The COVID-19 Severity Score combines multiplex biomarker measurements and risk factors in a statistical learning algorithm to predict mortality. The COVID-19 Severity Score was trained and evaluated using data from 160 hospitalized COVID-19 patients from Wuhan, China. Our analysis finds that COVID-19 Severity Scores were significantly higher for the group that died versus the group that was discharged with median (interquartile range) scores of 59 (40–83) and 9 (6–17), respectively, and area under the curve of 0.94 (95% CI 0.89–0.99). Although this analysis represents patients with cardiac comorbidities (hypertension), the inclusion of biomarkers from other pathophysiologies implicated in COVID-19 (e.g., D-dimer for thrombotic events, CRP for infection or inflammation, and PCT for bacterial co-infection and sepsis) may improve future predictions for a more general population. These promising initial models pave the way for a point-of-care COVID-19 Severity Score system to impact patient care after further validation with externally collected clinical data. Clinical decision support tools for COVID-19 have strong potential to empower healthcare providers to save lives by prioritizing critical care in patients at high risk for adverse outcomes. [ABSTRACT FROM AUTHOR]

To the Editor.-- I am concerned that one of the conclusions of the study "Association Between Television, Movie, and Video Game Exposure and School Performance" (1) might easily be misinterpreted [...]

BACKGROUND. The relationship between media exposure and school performance has not been studied extensively in adolescents. OBJECTIVE. The purpose of this work was to test the relative effects of television, movie, and video game screen time and content on adolescent school performance. METHODS. We conducted a population-based cross-sectional survey of middle school students (grades 5-8) in the Northeastern United States. We looked at weekday television and video game screen time, weekend television and video game screen time, cable movie channel availability, parental R-rated movie restriction, and television content restriction. The main outcome was self-report of school performance (excellent, good, average, or below average). We used ordinal logistic-regression analysis to test the independent effects of each variable, adjusting for demographics, child personality, and parenting style. RESULTS. There were 4508 students who participated in the study; gender was equally represented, and 95% were white. In multivariate analyses, after adjusting for other covariates, the odds of poorer school performance increased with increasing weekday television screen time and cable movie channel availability and decreased with parental restriction of television content restriction. As compared with children whose parents never allowed them to watch R-rated movies, children who watched R-rated movies once in a while, sometimes, or all of the time had significantly increased cumulative odds of poorer school performance. Weekend screen time and video game use were not associated with school performance. CONCLUSIONS. We found that both content exposure and screen time had independent detrimental associations with school performance. These findings support parental enforcement of American Academy of Pediatrics guidelines for media time (particularly weekdays) and content limits to enhance school success. KEYWORDS. television, media exposure, school performance, parenting. URL: www.pediatrics.org/cgi/doi/10.1542/peds.2005-2854