Background This study aimed to determine the impact of pulmonary complications on death after surgery both before and during the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic. Methods This was a patient-level, comparative analysis of two, international prospective cohort studies: one before the pandemic (January–October 2019) and the second during the SARS-CoV-2 pandemic (local emergence of COVID-19 up to 19 April 2020). Both included patients undergoing elective resection of an intra-abdominal cancer with curative intent across five surgical oncology disciplines. Patient selection and rates of 30-day postoperative pulmonary complications were compared. The primary outcome was 30-day postoperative mortality. Mediation analysis using a natural-effects model was used to estimate the proportion of deaths during the pandemic attributable to SARS-CoV-2 infection. Results This study included 7402 patients from 50 countries; 3031 (40.9 per cent) underwent surgery before and 4371 (59.1 per cent) during the pandemic. Overall, 4.3 per cent (187 of 4371) developed postoperative SARS-CoV-2 in the pandemic cohort. The pulmonary complication rate was similar (7.1 per cent (216 of 3031) versus 6.3 per cent (274 of 4371); P = 0.158) but the mortality rate was significantly higher (0.7 per cent (20 of 3031) versus 2.0 per cent (87 of 4371); P < 0.001) among patients who had surgery during the pandemic. The adjusted odds of death were higher during than before the pandemic (odds ratio (OR) 2.72, 95 per cent c.i. 1.58 to 4.67; P < 0.001). In mediation analysis, 54.8 per cent of excess postoperative deaths during the pandemic were estimated to be attributable to SARS-CoV-2 (OR 1.73, 1.40 to 2.13; P < 0.001). Conclusion Although providers may have selected patients with a lower risk profile for surgery during the pandemic, this did not mitigate the likelihood of death through SARS-CoV-2 infection. Care providers must act urgently to protect surgical patients from SARS-CoV-2 infection.

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This article describes current federal, state, and local initiatives affecting school-linked integrated services and notes significant changes in federal policies and programs that will influence future developments. after delineating barriers to services integration efforts, outlining state policy trends, and addressing issues of finance, we describe some promising state approaches and consider implications of recent federal actions devolving much responsibility for federal programs to states and localities. the article is intended to be a useful guide for educators seeking to understand how state and local policies and programs related to school-linked services integration efforts affect the ability of school and communities to operate effective, inclusive education programs.

The Center for Applied Linguistics (CAL) is a private, nonprofit organization dedicated to the application of research on language and culture to educational and societal concerns. Through its work in research, information dissemination, development of instructional materials and language tests, and professional development and technical assistance to schools, districts, and states, CAL serves as a liaison between the academic world of research and the practical world of language education and language-related concerns. CAL plays a leading role in articulating language-and culture-related issues that affect policy decisions; conducting research on language use, language learning, and effective teaching methods; and translating research into practical applications that help language learners succeed.CAL is involved in a variety of research areas related to language, ranging across age, language background, and educational settings for language teaching and learning. Research studies are funded by the US government, private foundations, and state education agencies. The following summaries represent a selection of recent and ongoing research projects related to K-12 (elementary and secondary) English as a second language (ESL) education, and elementary through adult foreign language instruction. Within these two areas of language education research, CAL's work covers such topics as instructional methodology, language assessment, effective program models, and national trends in language learning. (For more information on CAL, visit www.cal.org.)

The Center for Applied Linguistics (CAL) is a private, nonprofit organization with over 50 years’ experience in the application of research on language and culture to educational and societal concerns. CAL carries out its mission to improve communication through better understanding of language and culture by engaging in a variety of projects in the areas of primary, secondary, and adult education, including research on effective strategies for the instruction of linguistically and ethnically diverse students; evaluation of the effectiveness of educational programs for such students; professional development for teachers and other staff working with linguistically diverse students; development of instructional materials and language tests; and services to support cultural orientation of immigrants and refugees.