Evaluation Of The Effects And Consequences Of M...

Teachers commonly report voice problems and often seek medical assistance for voice-related complaints. Despite the prevalence of voice disorders within this occupation, there are no studies evaluating the effectiveness of treatment programs designed to remedy the voice problems of teachers. To assess the functional effects of two voice therapy approaches, 58 voice-disordered teachers were randomly assigned to 1 of 3 groups: vocal hygiene (VH, n = 20), vocal function exercises (VFE, n = 19), and a nontreatment control group (CON, n = 19). Subjects completed the Voice Handicap Index (VHI)-an instrument designed to appraise the self-perceived psychosocial consequences of voice disorders-before and following a 6-week treatment phase. The VFE and VH subjects also completed a posttreatment questionnaire regarding the perceived benefits of treatment. Only the group who adhered to the VFE regimen reported a significant reduction in mean VHI scores (p

Evaluation of the Effects and Consequences of M...

Higgins JPT, Thompson SG, Spiegelhalter DJ. A re-evaluation of random-effects meta-analysis. Journal of the Royal Statistical Society: Series A (Statistics in Society) 2009; 172: 137-159.

This meta-analysis has several limitations. (1) Only published Chinese and English articles were included, so the comprehensiveness of the search was limited. (2) Only two of the included articles fully described allocation concealment and only one mentioned blinded outcome assessment. (3) All the articles used subjective self-reported outcomes, with a lack of objective evaluation (such as biomarkers). (4) There was a high degree of heterogeneity among the studies of adolescents with depressive symptoms. (5) There was a lack of uniform standards and controls for exercise intensity variables. (6) The physical activity level of the subjects may affect the intervention effect, while this variable was not found or included when compiling relevant data. (7) The optimal exercise program in this research was based on the summary of current evidence. More RCTs are needed in the future to further discuss the intervention effects of different variables.

More evidence and research from multi-disciplinary teams are crucial to understanding the causes, mechanisms, and risks to develop preventive measures, rehabilitation techniques, and clinical management strategies with whole-patient perspectives designed to address the after-COVID-19 care. There is a need for more information about prospective studies to better evaluate the natural course of COVID-19 infection and define the long- COVID-19 syndrome. From the clinical point of view, physicians should be aware of the symptoms, signs, and biomarkers present in patients previously affected by COVID-19 to promptly assess, identify and halt long COVID-19 progression, minimize the risk of chronic effects help reestablish pre-COVID-19 health. Management of all these effects requires further understanding to design individualized, dynamic cross-sectoral interventions in Post-COVID-19 clinics with multiple specialties, including graded exercise, physical therapy, frequent medical evaluations, and cognitive behavioral therapy when required51,52.

In this context, a randomized evaluation can inform decisions about scaling up the program. For example, consider the summer jobs program One Summer Chicago Plus (OSC+), which partners with local community organizations to place youth in nonprofit and government jobs (such as camp counselors, community garden workers, or office assistants). Youth employment programs such as OSC+ had been used in the United States for decades to address issues such as high youth unemployment and crime rates, yet there was little evidence on their effects. (Gelber et al., 2014).

In some cases, ethical concerns about providing the intervention to a treatment group or withholding it from a comparison group prevent a randomized evaluation. For example, there is broad agreement that a randomized evaluation should not be used to test the effects of an entitlement that all members of the target population have the right to receive. In this case, it would be unethical to create a comparison group that is prevented from receiving the program, even if additional insights could be gained from conducting a randomized evaluation. By the same token, researchers cannot test interventions that are highly likely to cause harm.

Results should also be understood in a comprehensive sense, covering the whole of the results chain: outputs, outcomes and impacts. Depending on the type of evaluation, some organisations associate efficiency with outputs only; however, the criteria is defined and conceptualised here to encourage evaluating efficiency also in relation to higher-level effects such as impacts, though this can often be challenging.

Effectiveness and impact: The evaluation of the continuation of results relies firstly on results having been achieved (effectiveness) and secondly, that higher-level effects were demonstrated (impact). Therefore, effectiveness and impact can be seen as overriding criteria for sustainability because if their analysis does not show the intervention achieving outputs, outcomes or impacts, there will be no clear benefits to sustain. Box 4.19 provides an example of how impact and sustainability can be examined together. Considering synergies between impact, effectiveness and sustainability by evaluating conditions that are sufficient and necessary for results to continue after the intervention has finished enables evaluators to explore effectiveness and impact over the longer term.

The electronic cigarette (e-cigarette), for many considered as a safe alternative to conventional cigarettes, has revolutionised the tobacco industry in the last decades. In e-cigarettes, tobacco combustion is replaced by e-liquid heating, leading some manufacturers to propose that e-cigarettes have less harmful respiratory effects than tobacco consumption. Other innovative features such as the adjustment of nicotine content and the choice of pleasant flavours have won over many users. Nevertheless, the safety of e-cigarette consumption and its potential as a smoking cessation method remain controversial due to limited evidence. Moreover, it has been reported that the heating process itself can lead to the formation of new decomposition compounds of questionable toxicity. Numerous in vivo and in vitro studies have been performed to better understand the impact of these new inhalable compounds on human health. Results of toxicological analyses suggest that e-cigarettes can be safer than conventional cigarettes, although harmful effects from short-term e-cigarette use have been described. Worryingly, the potential long-term effects of e-cigarette consumption have been scarcely investigated. In this review, we take stock of the main findings in this field and their consequences for human health including coronavirus disease 2019 (COVID-19).

Little is known about the effect of vaping on the immune system. Interestingly, both traditional and e-cigarette consumption by non-smokers was found to provoke short-term effects on platelet function, increasing platelet activation (levels of soluble CD40 ligand and the adhesion molecule P-selectin) and platelet aggregation, although to a lesser extent with e-cigarettes [11]. As found with platelets, the exposure of neutrophils to e-cigarette aerosol resulted in increased CD11b and CD66b expression being both markers of neutrophil activation [12]. Additionally, increased oxidative stress, vascular endothelial damage, impaired endothelial function, and changes in vascular tone have all been reported in different human studies on vaping [13,14,15,16,17]. In this context, it is widely accepted that platelet and leukocyte activation as well as endothelial dysfunction are associated with atherogenesis and cardiovascular morbidity [18, 19]. In line with these observations the potential association of daily e-cigarettes consumption and the increased risk of myocardial infarction remains controversial but benefits may occur when switching from tobacco to chronic e-cigarette use in blood pressure regulation, endothelial function and vascular stiffness (reviewed in [20]). Nevertheless, whether or not e-cigarette vaping has cardiovascular consequences requires further investigation.

The harmful effects of CS and their deleterious consequences are both well recognised and widely investigated. However, and based on the studies carried out so far, it seems that e-cigarette consumption is less toxic than tobacco smoking. This does not necessarily mean, however, that e-cigarettes are free from hazardous effects. Indeed, studies investigating their long-term effects on human health are urgently required. In this regard, the main additional studies needed in this field are summarized in Table 3.

Peer assessments tend to be highly correlated with teacher assessments of the same students (Falchikov and Goldfinch 2000; Li et al. 2016; Sanchez et al. 2017). However, in addition to establishing comparability between teacher and peer assessment scores, it is important to determine whether peer assessment also has a positive effect on future academic performance. Several narrative reviews have argued for the positive formative effects of peer assessment (e.g., Black and Wiliam 1998a; Topping 1998; van Zundert et al. 2010) and have additionally identified a number of potentially important moderators for the effect of peer assessment. This meta-analysis will build upon these reviews and provide quantitative evaluations for some of the instructional features identified in these narrative reviews by utilising them as moderators within our analysis. 041b061a72