Are Institutions Heavily Invested In Stockland’s (ASX:SGP) Shares?
A look at the shareholders of Stockland ( ) can tell us which group is most powerful. Institutions often own shares in more established companies, while it’s not unusual to see insiders own a fair bit of smaller companies. We also tend to see lower insider ownership in companies that were previously publicly owned.
Stockland has a market capitalization of AU$11b, so it’s too big to fly under the radar. We’d expect to see both institutions and retail investors owning a portion of the company. Our analysis of the ownership of the company, below, shows that institutional investors have bought into the company. Let’s take a closer look to see what the different types of shareholders can tell us about Stockland.
ASX:SGP Ownership Breakdown September 5th 2021
What Does The Institutional Ownership Tell Us About Stockland?
Institutional investors commonly compare their own returns to the returns of a commonly followed index. So they generally do consider buying larger companies that are included in the relevant benchmark index.
We can see that Stockland does have institutional investors; and they hold a good portion of the company’s stock. This implies the analysts working for those institutions have looked at the stock and they like it. But just like anyone else, they could be wrong. When multiple institutions own a stock, there’s always a risk that they are in a ‘crowded trade’. When such a trade goes wrong, multiple parties may compete to sell stock fast. This risk is higher in a company without a history of growth. You can see Stockland’s historic earnings and revenue below, but keep in mind there’s always more to the story.
ASX:SGP Earnings and Revenue Growth September 5th 2021
Institutional investors own over 50% of the company, so together than can probably strongly influence board decisions. Hedge funds don’t have many shares in Stockland. The company’s largest shareholder is The Vanguard Group, Inc., with ownership of 10%. In comparison, the second and third largest shareholders hold about 9.7% and 7.0% of the stock.
On studying our ownership data, we found that 25 of the top shareholders collectively own less than 50% of the share register, implying that no single individual has a majority interest.
While it makes sense to study institutional ownership data for a company, it also makes sense to study analyst sentiments to know which way the wind is blowing. There are a reasonable number of analysts covering the stock, so it might be useful to find out their aggregate view on the future.
Insider Ownership Of Stockland
The definition of an insider can differ slightly between different countries, but members of the board of directors always count. Company management run the business, but the CEO will answer to the board, even if he or she is a member of it.
Insider ownership is positive when it signals leadership are thinking like the true owners of the company. However, high insider ownership can also give immense power to a small group within the company. This can be negative in some circumstances.
Our most recent data indicates that insiders own less than 1% of Stockland. It is a very large company, so it would be surprising to see insiders own a large proportion of the company. Though their holding amounts to less than 1%, we can see that board members collectively own AU$31m worth of shares (at current prices). It is always good to see at least some insider ownership, but it might be worth checking
General Public Ownership
With a 49% ownership, the general public have some degree of sway over Stockland. While this group can’t necessarily call the shots, it can certainly have a real influence on how the company is run.
Next Steps:
While it is well worth considering the different groups that own a company, there are other factors that are even more important. To that end, you should learn about the .
If you are like me, you may want to think about whether this company will grow or shrink. Luckily, you can check .
NB: Figures in this article are calculated using data from the last twelve months, which refer to the 12-month period ending on the last date of the month the financial statement is dated. This may not be consistent with full year annual report figures.
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This article by Simply Wall St is general in nature. We provide commentary based on historical data and analyst forecasts only using an unbiased methodology and our articles are not intended to be financial advice. It does not constitute a recommendation to buy or sell any stock, and does not take account of your objectives, or your financial situation. We aim to bring you long-term focused analysis driven by fundamental data. Note that our analysis may not factor in the latest price-sensitive company announcements or qualitative material. Simply Wall St has no position in any stocks mentioned.
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Seeking a New Balance for U.S. Policy in the Middle East
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Download the PDF here.
The ongoing crisis in Afghanistan has raised concerns about how the United States can best manage and balance its interests and values in complicated places around the globe. The fallout from events in Afghanistan will impact America’s approach in other key regions in the world, including the Middle East. As with its recent moves in Afghanistan, the Biden administration has signaled it seeks to decrease its military engagement in the broader Middle East.
The Biden administration’s first six months in the Middle East focused on limiting direct U.S. involvement in the region, instead prioritizing the COVID-19 pandemic response and the economic crisis at home while starting to address key global challenges such as climate change and competition with China and Russia. One common mantra among some members of the new Middle East team in the Biden administration is “no more failed states,” indicating modest and pragmatic goals for U.S. policy in the region. This new approach is more cautious than the previous administration’s efforts in the Middle East, which took risks in its policies on Iran and sent decidedly mixed signals about America’s overall posture in the region.
Looking ahead to the next six months and beyond, the United States is likely to face challenges on two main fronts. First, diplomacy with Iran over the revival of the nuclear deal has not produced a breakthrough at a time when Iran and its proxies continue to threaten U.S. troops and U.S. partners. These forces continue to undermine stability in key parts of the Middle East, including Iraq, Syria, Lebanon, Jordan, Israel, the Palestinian territories, and Yemen. Second, existing tensions between Israel and some of its neighbors, including Hamas in the Gaza Strip, Hezbollah in Lebanon, and a range of groups operating from Syrian territory, could erupt into a wider conflict. Navigating these two fronts—Iran and the Arab-Israeli front—in a way that produces increased stability and reduces threats from retrograde groups will be one central strategic challenge for the Biden administration in the Middle East.
But the biggest emerging challenge facing the region remains the chronic human security challenges that threaten to produce even greater violence and unrest. First among these is the unfinished COVID-19 pandemic. In addition, this summer witnessed record heat waves that led to widespread electricity shortages across key countries in the Middle East already experiencing poor services and governance hampered by endemic corruption. Furthermore, the looming climate crisis has already produced more acute challenges for water security in places such as Iran. Finally, broad deficits in freedom across most parts of the Middle East and North Africa—which remains dominated by autocratic governments—presents another overwhelming challenge to the goal of supporting democracy and human rights.
Early on, the Biden administration sought to put diplomacy first by working with European partners and other global powers to reengage Iran in diplomatic talks aimed at reviving the 2015 nuclear deal. It also appointed special envoys tasked with ending conflicts in Yemen and Libya as well as one to address multiple issues in the Horn of Africa. Those efforts all engaged regional players such as Saudi Arabia, Egypt, Qatar, and the United Arab Emirates (UAE). This summer Biden hosted the leaders of Jordan, Iraq, and Israel. In addition, Biden’s secretaries of State and Defense and their respective Middle East teams began engaging leaders and officials in Israel, Egypt, Saudi Arabia, and other key partners to coordinate a new approach on the region.
The Biden administration also signaled its intent to rebalance America’s military posture in the Central Command area of operations as it conducted a global posture review. The most significant move made by the administration in this broader area of operations was a complete troop withdrawal from Afghanistan, an effort that has come with major complications still being managed by the United States. In addition, the Biden administration repositioned military assets and equipment from key parts of the Middle East. And even as the administration sought to rebalance its approach, it conducted military strikes against adversaries threatening U.S. troops and partner countries across the region, including strikes against Iranian-backed militias in Iraq and Syria.
The May conflict between Israel and Hamas drew the United States more directly into the Israeli-Palestinian issue than the Biden administration had initially planned. A prolonged political deadlock in Israel and continued divisions among Palestinians led this administration to adopt a restrained approach involving renewal of some U.S. aid stopped by the previous administration and the restart of diplomatic contacts with Palestinian Authority leaders. The crisis that erupted in May drew the United States into a role of working with key regional actors such as Egypt and taking practical measures to end the conflict. But the current environment on the Israeli-Palestinian front continues to face challenges from major gaps in basic human security, including the ongoing pandemic.
In sum, the conditions that produced popular uprisings across key parts of the Middle East and North Africa in 2011 remain present, as overwhelming economic, social, political, and human security demands could spark movements for change and generate instability. These challenges present an opportunity for the United States to recast its overall engagement with the Middle East to put a higher priority on diplomacy backed by a balanced security strategy, with a stronger focus on broader human security issues that will impact the region and inevitably affect the broader international system.
This brief offers highlights of the Biden administration’s actions in the Middle East and North Africa in its first six months on five key fronts: human security, conflict resolution, Iran, Arab-Israeli affairs, and overall U.S. military posture and engagement in the region. It provides an assessment of where the administration has had success thus far and where it’s fallen short. In addition, this brief looks ahead to the challenges the region will present moving forward.
Human security
The Biden administration delivered targeted COVID-19 aid and other assistance aimed at helping the people of the region and supporting certain key governments. These initial moves were overshadowed by crises such as the spring conflict between Israel and Hamas and diplomacy and tensions with Iran. Still, the moves made by the Biden administration on the human security front represent important steps to engage the people of the region and address concerns that impact regional security and political dynamics.
COVID response: A domestic and global policy priority with specific actions in the Middle East and North Africa
More than 230,000 people across the Middle East and North Africa have died from COVID-19, with Tunisia, Iran, and Lebanon hardest hit as a proportion of their populations. Over 56.4 million people in the region have been fully vaccinated against COVID-19, with vaccination rates in the UAE, Qatar, Bahrain, and Israel at 60 percent and higher.
The United States has provided more than 3 million COVID-19 vaccine doses to nations in the region. Tunisia received 1 million Moderna doses via COVAX—the international vaccine distribution mechanism—as well as 200,000 Pfizer doses delivered under private contract with the Tunisian government; 500,000 Pfizer doses have been directly delivered to Jordan; 500,000 Pfizer doses have been delivered to Iraq via COVAX; 500,000 Moderna doses have been delivered to the West Bank and Gaza via COVAX; and 302,400 Johnson and Johnson doses have been delivered to Morocco via COVAX. In August, the U.S. State Department announced that it had provided 151,200 doses of the Johnson and Johnson vaccine to the people of Yemen.
Economic and aid engagement: Restarting some programs and initiating new efforts
The Biden administration restored more than $250 million in assistance to the Palestinians cut by the Trump administration; $183 million for the U.N. Relief and Works Agency; $150 million for economic assistance; and $15 million for emergency COVID-19 response.
The U.S. International Finance Development Corporation announced the launch of the Joint Investment for Peace Initiative, a new program created by the Nita M. Lowey Middle East Partnership for Peace Act that will focus on promoting investment in Palestinian-owned small- and medium-sized businesses that work with American and Israeli partners.
In early August, the Biden administration announced $100 million in additional economic support to Lebanon and $165 million in addition humanitarian aid to Yemen.
Climate change: Planting the seeds for future cooperation
Record heat waves struck the Middle East this summer, with temperatures reaching over 120 degrees Fahrenheit in Kuwait, Oman, the UAE, Saudi Arabia, Iraq, and Iran over the summer. Elderly and neglected power grids wilted under this hear, with electricity cuts and water shortages leading to protests in Iran, Iraq, and Lebanon.
Special Presidential Envoy for Climate John Kerry traveled to the region, visiting the UAE in early April to attend a regional climate forum in Abu Dhabi and traveling to the UAE, Saudi Arabia, and Egypt in June to discuss climate issues and renewable energy with all three countries. Egypt will host COP27, the next iteration of the U.N. Climate Change Conference.
The leaders of Israel, Saudi Arabia, and the UAE were invited to President Biden’s April virtual climate summit. At the summit, the United States and UAE agreed to create the Agriculture Innovation Mission for Climate—an initiative that will be formally launched at the COP26 summit in Glasgow and includes Israel—while Qatar and Saudi Arabia agreed to establish a Net-Zero Producers Forum along with the energy ministries of the United States, Canada, and Norway.
Human rights: Voicing support as a priority, awaiting major actions
During the Biden administration’s first six months in office, a number of repressive Middle Eastern governments released political activists and human rights campaigners from prison. Saudi women’s rights activist Loujain al-Hathloul, for instance, was released from prison in February, as were two other activists with American citizenship. In mid-July, Egyptian authorities released three activists and three journalists days after human rights criticism from the U.S. State Department. Quiet U.S. diplomacy were part of the efforts to gain these releases.
Conflict resolution
The Biden administration came into office seeking to lower tensions across the region, and it has been active in the diplomatic arena in Yemen, Libya, and the Horn of Africa. It has taken modest steps to engage on the Syrian conflict, with a focus on humanitarian aid delivery.
Yemen: Signaling peace as a priority but finding diplomatic pathways difficult to navigate
The Biden administration appointed veteran diplomat Tim Lenderking as special envoy to Yemen and publicly stated that it was ending U.S. support for “offensive operations” carried out by the Saudi-led coalition in Yemen, though it remains unclear how this is defined. Lenderking has shuttled back and forth to the region multiple times in his efforts to end the fighting, notably observing in early June that the Houthis “bear major responsibility for refusing to engage meaningfully on a ceasefire.” However, these policy efforts have not moved the conflict closer to resolution.
Libya: Working toward greater stability and renewed political engagement
The Biden administration appointed U.S. Ambassador to Libya Richard Norland as special envoy for Libya, while Secretary of State Antony Blinken participated in the Second Berlin Conference on Libya. The conference and subsequent bilateral discussions reaffirmed U.S. and international support for planned December national elections. While foreign mercenaries have yet to depart the country as stipulated under the terms of the 2020 cease-fire deal, other elements—such as the reopening of the coastal road between the towns of Misrata and Sirte—have gone forward.
Horn of Africa: Engaging preventative diplomacy aimed at stopping broader tensions
The Biden administration named former U.N. Undersecretary-General Jeffrey Feltman as special envoy for the Horn of Africa, tasked with mediating regional disputes over the Grand Ethiopian Renaissance Dam and the Tigray conflict.
Secretary of State Blinken imposed visa restrictions on individuals involved in the fighting in Tigray as well as “wide-ranging restrictions on economic and security assistance to Ethiopia,” while the U.S. Agency for International Development announced the provision of an additional $149 million in humanitarian aid for the region.
The Tigray conflict continues to escalate, with the Ethiopian government mobilizing paramilitaries despite international calls for negotiation. Egypt and Sudan have both requested U.N. Security Council intervention over the Grand Ethiopian Renaissance Dam, saying negotiations with Ethiopia over the project have failed.
Syria: No major strategic shifts
At the U.N. Security Council, the United States led a successful diplomatic effort to renew Syria’s cross-border humanitarian aid mechanism for an additional year. In addition, Secretary of State Blinken announced $436 million in additional humanitarian assistance to Syrians in Syria and neighboring countries. Syria remains divided between the Assad regime; an enclave around Idlib run by an al-Qaida-affiliated group; a Turkish zone along the northern border; and a U.S.-backed Kurdish zone in the country’s northeast.
Iran: Diplomacy and regional security tensions
The Biden administration has made rejoining the 2015 nuclear deal with Iran a central pillar of its approach to the Middle East and made some significant progress toward that goal in indirect talks earlier this year. However, it has also had to contend with Iran’s continued destabilizing security role across the region.
Indirect talks to revive the nuclear deal started in Vienna on April 6. Though some progress had been reported by mid-June, Iran put the talks on hold until after the new Iranian president, Ebrahim Raisi, assumed office in August.
In February and June, the U.S. military carried out two sets of airstrikes against Iranian-backed militias in Iraq and Syria in retaliation for rocket and drone attacks by those militias against U.S. military facilities in Iraq. More recently, the United States, United Kingdom, and Israel held Iran responsible for a lethal drone attack on an oil tanker off the coast of Oman.
Secretary of State Blinken and National Security Adviser Jake Sullivan met with Iranian-American activist Masih Alinejad after the Department of Justice charged four Iranian officials with a plot to abduct her.
Biden administration officials have warned that nuclear talks with Iran cannot go on forever, with Iran further violating the terms of the 2015 nuclear deal and barring inspectors from the key enrichment plant at Natanz.
Arab-Israeli affairs: Crisis management overshadows broader regional openings
Unlike its predecessors, the Biden administration entered office without ambitious plans on the Arab-Israeli front beyond undoing the negative policies of the Trump administration. Fighting in Gaza in May forced the administration to pay closer attention to the Israeli-Palestinian conflict, however, and the advent of a new Israeli government holds the potential for a reset of bilateral relations.
The Biden administration announced some $388.5 million in aid to the Palestinians, including the resumption of funding cut by the previous administration. This funding includes $183 million for the U.N. Relief and Works Agency; $150 million for economic assistance; and $38 million for humanitarian assistance.
During the most recent conflict in Gaza, the Biden administration engaged in quiet diplomacy with Israel and Egypt to bring about a cease-fire after 11 days of fighting. Biden consulted with Palestinian Authority Mahmoud President Abbas and dispatched Secretary of State Blinken to Israel, the West Bank, Jordan, and Egypt.
The new Naftali Bennett-Yair Lapid government in Israel has taken steps to improve relations with Jordan, and Israeli courts have attempted to forge a compromise in the Sheikh Jarrah neighborhood of East Jerusalem—the flashpoint for last spring’s fighting. Palestinian Authority President Abbas faces renewed political challenges at home after the death of a West Bank dissident in the custody of Palestinian security forces.
The August visit of new Israeli Prime Minister Naftali Bennett to Washington, D.C., to meet President Joe Biden was aimed at putting bilateral relations on a smoother track than they have been over the past decade. Immediately following this visit, Israeli Defense Minister Benny Gantz met with Palestinian President Mahmoud Abbas in an effort to improve ties and coordination between the Palestinian Authority and Israel. This meeting represents the type of step-by-step approach the Biden administration is likely to adopt in handling Israeli-Palestinian relations.
U.S. military: Beginning to reposition in the region while still engaged in threat response
With widespread consensus in foreign policy circles that the Middle East lacks the strategic importance of Europe or the Asia-Pacific region, the Biden administration has made early moves toward reducing and rightsizing America’s military presence in the region. At the same time, however, it has launched strikes against Iranian-backed militias in Iraq and Syria while utilizing American bases in the Gulf to execute the evacuation airlift from Afghanistan.
President Biden and Iraqi Prime Minister Mustafa al-Kadhimi agreed to formally end the U.S. military’s “combat mission” in Iraq by the end of 2021. However, few U.S. troops will leave Iraq and most will remain in the country on a training and advisory mission.
Secretary of Defense Lloyd Austin pulled at least 11 Patriot and THAAD missile batteries from Iraq, Kuwait, Jordan, and Saudi Arabia since the start of the Biden administration. At the same time, the U.S. military forged preliminary agreements with Saudi Arabia for access to bases in the country’s west.
In February, Secretary Austin launched a broader global posture review to “to ensure the footprint of American service members worldwide is correctly sized and supports strategy.”
Conclusion
In its first six months in office, the Biden administration has shown a clear desire to limit direct American engagement in the Middle East in favor of a focus on higher foreign policy priorities such as Asia and Europe and the global challenge of the COVID-19 pandemic. Though it has made some high-profile moves such as starting talks to revive the Iran nuclear deal; renewing diplomacy to end the fighting in Yemen; and extending cross-border humanitarian access to Syria for another year, in general, the Biden team has adopted an approach that seeks to limit the costs of U.S. engagement. In so doing, however, it risks putting the United States in a reactive strategic position, beholden to events instead of seeking to proactively shape trends through diplomacy and other forms of engagement.
The Biden administration’s inclination toward a hands-off approach may end up placing the United States in a crisis management mode similar to the one that overtook the Obama administration from 2014 to 2016 in reaction to the rise of the Islamic State group. If the Iran nuclear deal cannot be revived—which seems more likely now than six months ago—tensions between Tehran and Washington will remain high. On a more fundamental level, though, the region’s basic human security problems will not go away, particularly those likely resulting from climate change. As a result, even the more modest and pragmatic goals the Biden team has set out for itself in the Middle East will require strategic reengagement in a region that’s been largely on the back burner during the administration’s first six months in office.
Brian Katulis is a senior fellow on the National Security and International Policy team at the Center for American Progress. Peter Juul is a senior policy analyst on the National Security and International Policy team at the Center for American Progress
The authors would like to thank Mara Rudman, Gordon Gray, and Rudy deLeon for their suggestions in helping shape up the issue brief.
Endnotes
Research debunks myth that COVID vaccination promotes mutations
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A study conducted by researchers at the University of Maryland, USA, has highlighted the importance of coronavirus disease 2019 (COVID-19) vaccination in reducing the frequency of mutations in the delta variant of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The study also presents an evolutionary algorithm that can accurately predict new COVID-19 outbreaks. A detailed description of the study is currently available on the medRxiv* preprint server.
Background
Currently, the best possible way to end the COVID-19 pandemic is mass vaccination. However, public distrust and hesitancy to accept COVID-19 vaccines have added an extra level of complicacy in combating the global spread of SARS-CoV-2. Despite proven efficacy against SARS-CoV-2 infections, a large proportion of the global population is still uncertain about the risk-benefit ratio of COVID-19 vaccines.
In addition to increasing the risk of viral transmission, under-vaccination may affect the rate of viral mutations. On average, the mutation rate of SARS-CoV-2 is 7.23 mutations per viral sample. Mutations that emerged under positive selection pressure, such as vaccine/therapy-induced immunity, are the main driving force of viral evolution. Thus, novel viral variants evolving during the pandemic are likely to develop resistance against vaccines and therapeutics.
In the current study, the scientists have explored the association between vaccine coverage rate and mutation frequency of the SARS-CoV-2 delta variant (B.1.617.2).
For the analysis, they have collected complete genome sequences of SARS-CoV-2 from the Global Initiative on Sharing All Influenza Data (GISAID) database. In total, viral sequences from 20 countries have been included in the analysis.
(A) Correlation between full vaccinated rate [13] and mutation frequency (Mf) from June 20 to July 3 2021 in 20 countries: Australia (AUS), France (FRA), Germany (GER), Indonesia (IDA), India (IND), Ireland (IRL), Israel (ISR), Italy (ITA), Japan (JPN), Mexico (MEX), Netherland (NED), Norway (NOR), Portugal (POR), Singapore (SGP), Spain (ESP), Switzerland (SUI), Sweden (SWE), Turkey (TUR), United States (USA), and UK. Logarithmic regression (solid) line was draw based on 16 countries (pink dots) with a calculated 95% confidence interval (dashed lines). Japan, Switzerland, USA, and Australia are labeled in different colors as outliers. (B and C) Chronology of nucleotide diversity (π) (B) and Tajima D’ value (C) of SARS CoV-2 delta variants in UK (N=27,344, blue), Indian (N=4,451, red), and Australian (N=305, green). Data were plotted every two weeks, and the data only represent the effective population size with more than 3 high quality sequences. The arrows label the epidemiological events of COVID-19 delta variants announced by the World Health Organization (WHO). WHO classified the delta variant as a global variant of interest (VOI) on 4 April 2021, and variants of concern (VOC) on 11 May 2021 [5]. The dashed line in (C) labels the cut-off threshold -2.50 in Tajima D’ test.
Important observations
The analysis revealed that with an increase in vaccination rate, there is a reduction in the frequency of viral mutations. This inverse correlation between vaccination rate and mutation frequency was observed in 16 out of 20 countries.
As an exception, Australia exhibited a very low mutation frequency with a vaccination rate of around 10%. In contrast, a high mutation frequency was observed in the United States, Japan, and Switzerland, despite higher vaccination rates than in Australia. These observations indicate more successful implementation of control measures in Australia than in these countries.
Prediction of new outbreaks
To determine whether vaccine-induced immunity acts as a positive selection pressure to initiate viral evolution, the scientists analyzed genome sequences of the delta variant in the UK, India, and Australia. They performed the Tajima D test to determine whether mutations emerge neutrally or via non-random processes, including directional selection or demographic expansion. Tajima’s D is a statistical test used in population genetics to compare pair-wise genetic diversity and total polymorphism to deduce selection and demographic events.
The findings of the Tajima D test revealed that the delta variants in the UK emerged with rapid clonal expansion. In contrast, the variants in India and Australia mainly emerged with singleton mutations (single nucleotide variants). The values obtained from the Tajima D test were between -2.68 and -2.84 for all the delta variants. These D’ values were equivalent to that calculated from the sequences of B.1.1.7 variant in the UK during the study period. Negative D’ values observed in both the UK and Indian variants throughout the study period indicate more substantial demographic expansion or positive selection.
With further analysis, the scientists observed that new COVID-19 outbreaks occurred in the UK and India 1 – 3 weeks after the reduction of D’ values below -2.50. Based on these findings, they proposed that a D’ value of -2.50 could be used as a threshold to predict new outbreaks.
Study significance
The study reveals that the frequency of viral mutations can be reduced by increasing the rate of full vaccination. In other words, countries with high vaccine coverage are less likely to experience new COVID-19 outbreaks. Thus, public hesitancy to COVID-19 vaccination could potentially lead to the emergence of more pathogenic viral variants and failure to achieve herd immunity.
As recommended by the scientists, mass vaccination, control measure implementation, and continuous genomic surveillance are the most vital strategies to combat the COVID-19 pandemic.
*Important Notice
medRxiv publishes preliminary scientific reports that are not peer-reviewed and, therefore, should not be regarded as conclusive, guide clinical practice/health-related behavior, or treated as established information.