The remaining 3061 (76.3%) outcomes recommended primary care management.The number of iLFT requests rose each month from launch, from 159 in November 2018 to 431 in December 2019, and these now make up over 3% of all LFT requests in Tayside.Conclusions iLFT safely and rapidly detects patients at risk of chronic liver disease using reflex fibrosis scores and autoimmune, virology and genetic tests. Secondary care referral is recommended in only 24% of cases, and thus 76% of patients can be managed in primary care. The number of iLFT requests is rising each month. GPs initially used iLFT to investigate patients known to have abnormal LFTs, resulting in high numbers of full test cascades. iLFT is now being used as the first test, so the number cascading is falling, but still improving the diagnosis of liver disease. This ensures patients who require secondary care are seen, whilst reducing unnecessary referrals.
SummaryBackgroundPrimary prophylaxis of variceal haemorrhage with non‐selective beta blockers (NSBB) or variceal band ligation (VBL) is now standard of care in patients with cirrhosis with portal hypertension. NSBB, and particularly carvedilol, may be associated with improved survival.AimTo assess mortality in a cohort of patients previously randomised to either carvedilol or VBL.MethodsWe retrospectively analysed 152 patients recruited to a multi‐centre randomised controlled trial between 7 April 2000 and 24 June 2006 designed to assess the efficacy of VBL versus carvedilol in preventing first variceal bleed. We used electronic records to undertake long‐term follow‐up (up to 20 years) with the primary outcome of all‐cause mortality and secondary end points of liver‐related mortality and decompensation events (ascites, encephalopathy, variceal bleeding).ResultsWe included 152 patients in analysis with baseline characteristics well matched between the carvedilol (n = 77) and VBL (n = 75) groups. In the intention‐to‐treat analysis, carvedilol offered a significant survival advantage with median survival of 7.8 years compared to 4.2 years in the VBL group (P = 0.03). This survival benefit was maintained in per‐protocol analysis when patients who crossed between treatment arms were excluded (P = 0.02). Transplant‐free survival, liver‐related mortality and decompensation events were similar in both groups.ConclusionThese data suggest that carvedilol offers a significant survival benefit for patients with cirrhosis and portal hypertension. The difference in all‐cause and liver‐related mortality suggests that this survival benefit may not be entirely liver‐related. Prospective, studies are required to confirm these important findings.
Classroom incivility is a critical concept relating to the academic and psychosocial well-being of children and youth. However, there has yet to be research investigating whether there are social benefits to this behavior in early adolescence. Therefore, the goal of this study was to explore the relationship between classroom incivility and measures of social network position, including incoming and mutual friendships, two forms of centrality, and social network prestige. We investigated network position of 488 students between the ages of 9 and 14 ( M = 11.48; SD = 1.14). Our findings highlight a general negative curvilinear association between classroom incivility and social network position. Specifically, children and youth who engage in moderate levels of classroom incivility have more friends and are leaders in the group (higher network prestige). In contrast, those who engage in higher or lower levels of classroom incivility have fewer friends and are less prestigious.
In social groups, such as school-based peer networks, youth often vie for power and dominance over others. Different strategies may be used to gain power (i.e., coercive and/or cooperative strategies), and with varying levels of success. Using a social networks approach, we examined whether and how social network centrality and social network prestige were associated with social strategies, social power, and peer reputation. Participants were fifthto eighth-grade elementary school students (N = 466, 51% girls, 63% White) in southern Ontario, Canada. Peer nominations were used to assess social network centrality and prestige (via friendship nominations), social power strategies (coercive and cooperative strategies), social power, and peer reputation (popularity and likeability). Results indicated that coercive and cooperative strategies were used by youth high in both centrality and prestige, but that only high prestige related to power, popularity, and likeability. Results have implications for the usefulness of a social networks approach to understanding the structure of youths' social relationships and power in school settings, as well as practical implications for teachers and other school staff. Impact and ImplicationsThrough a social networks approach, we found that both coercive and cooperative strategies were used by youth who were central (connected to many others and active within the school-based peer network) and prestigious (chosen by many as friends and influential among peers). Only social network prestige, however, was associated with social power and peer reputation. Given the impact of the social dominance hierarchy within the classroom and school, this study has implications for teachers, in that results help to differentiate between who is likely to use different social power strategies and who is likely to be successful in terms of their social power.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.