A Student-Centric Evaluation of a Program Addressing Prevention of Gender-Based Violence in Three African Countries.

Studies investigating the effectiveness of school-related gender-based violence prevention programs seldom report on the extent to which students themselves value and recommend such programs. Yet, along with evidence about effectiveness in relation to shifts in knowledge, attitudes, or intentions, student-valuing is a significant indicator that the programs can make a positive contribution to students' lives. This mixed-method study analyses survey and focus group data collected from ninety-two schools in three African countries (Tanzania, Zambia, and Eswatini). Students found the program contributed to improved peer relationships and identified the five most useful components as learning about gender equality and human rights, learning how to obtain help for those affected by violence, understanding and communicating about their emotions, strategies to avoid joining in with bullying and harassment, and understanding the effects of gender-based violence.

Career change teachers in hard-to-staff schools: should I stay or leave?

Recruiting career changers into teaching has emerged as a part of a strategy by governments worldwide to address complex teacher shortage problems in hard-to-staff schools. In this paper, we present a case study of two career change teachers and trace their career journey into Initial Teacher Education (ITE) and the teaching profession in two separate hard-to-staff schools. We interviewed these teachers during the first 2 years of their career change journey. During this period, 'push-and-pull' factors impacted their intentions to stay in the profession. Challenges included inadequate school-level mentorship support, social-geographic isolation in a regional school setting during the COVID-19 remote learning and the more complex working conditions in hard-to-staff schools. The adverse impacts of these challenges were, to some extent, mitigated by the participants' commitment to making a positive difference in the lives of children and young people through the teaching profession, a strong work ethic and support provided by their ITE programme in the form of university-based mentors and adjustment to study requirements. The participants responded to these push-and-pull factors in ways that highlighted their reflexive decision-making and determination to stay in teaching despite challenges. We discuss the implications of these findings for workforce planning strategies aimed at recruiting career change teachers in hard-to-staff schools.

Injectable soft-tissue fillers: clinical overview.

LEARNING OBJECTIVES: After studying this article, the participant should be able to: 1. Know the composition and biology of injectable fillers. 2. Understand the advantages and disadvantages of each injectable filler. 3. Understand the U.S. Food and Drug Administration regulatory status of each type of injectable filler, including their indications. BACKGROUND: The use of injectable filling agents for soft-tissue facial defects has a long history of successful use based on xenogeneic collagen materials. New materials of differing compositions for injection treatments either are now available or will soon be available for clinical use. METHODS: A review of the medical literature was performed to provide chemical compositions, methods of preparation, biological behavior, and clinical outcomes for every known injectable filler material that is either currently used or being evaluated in clinical trials. RESULTS: Hyaluronic acid-based materials have now replaced animal or human-derived collagen as the standard injection materials. Synthetic alternatives offer the potential of longer lasting results, but the long-term outcome with their use in large numbers of patients is not yet known. CONCLUSIONS: As there is no single injectable filler that has all of the desired characteristics, understanding the advantages and disadvantages of one filler over another is extremely helpful in guiding the patient to an informed decision. Although all of the reviewed injectable fillers are safe, the concepts of their long-term volume persistence and how they compare with each other remain largely anecdotal, with few prospective controlled clinical trials.

Functional outcome, quality of life, and complications after ileal pouch-anal anastomosis in selected septuagenarians.

PURPOSE: Concerns about morbidity and functional outcome have lead some authors to suggest that ileal pouch-anal anastomosis should not be performed in older patients. This article evaluates the outcome of selected septuagenarians undergoing ileal pouch-anal anastomosis at this institution. METHODS: Seventeen of 1,911 patients undergoing ileal pouch-anal anastomosis for ulcerative colitis were older than the age of 70 at the time of surgery. Functional outcome, quality of life, and manometric data were assessed prospectively, whereas complications were assessed by chart review. RESULTS: There was one mortality related to sepsis after small-bowel obstruction and one reoperation at 18 months for pelvic abscess. Minor complications occurred in five patients. Median (interquartile range) quality of life and health and levels of energy and happiness (scored out of 10) were 9 (7-10), 9 (7-10), 8 (5-10), and 9.5 (7-10), respectively. Medical Outcomes Study Short Form 36 quality of life scores were not different from those for the healthy population older than 65 years. There was complete continence in 38 percent, rare incontinence in 12 percent, and some incontinence in 50 percent. Nobody was usually or always incontinent. Overall, 82 percent would undergo pouch surgery again, and 89 percent would recommend it to others. CONCLUSIONS: Ileal pouch-anal anastomosis is an acceptable surgical option for selected healthy, motivated septuagenarians with ulcerative colitis who are eager to preserve fecal continence.

Equivalent function, quality of life and pouch survival rates after ileal pouch-anal anastomosis for indeterminate and ulcerative colitis.

OBJECTIVE: To compare the function, complications, and quality of life after ileal pouch-anal anastomosis (IPAA) for patients with indeterminate colitis (IndC) and ulcerative colitis (UC). SUMMARY BACKGROUND DATA: Reports on the outcome of IPAA for IndC have been inconclusive because of the small numbers available for analysis. Concerns about functional outcome, infectious perineal complications, pouch loss and the development of Crohn's disease remain, while there is no data on the quality of life after IPAA for IndC. METHODS: One thousand nine hundred and eleven patients undergoing IPAA for Ind and UC from 1983 to 1999 were evaluated. IndC was confirmed by repeat pathologic evaluation in 115 patients. Functional outcome and quality of life were assessed prospectively for all office visits (IndC = 230; UC = 5388) using previously reported systems. Complications were evaluated retrospectively. RESULTS: Functional results and the incidence of anastomotic complications and major pouch fistulae were the same in UC and IndC patients. Although IndC patients were more likely to develop minor perineal fistulae, pelvic abscess, and Crohn's disease, the rate of pouch failure was 3.4%, identical to that of UC patients. There was no clinically significant difference in quality of life, or satisfaction with IPAA surgery. Patients were equally happy to recommend surgery to IndC or UC patients, but 3% fewer IndC would undergo the same surgery again for their disease. CONCLUSIONS: While functional outcome, quality of life, and pouch survival rates are equivalent after IPAA for IndC and UC, there is an increase in some complications and the late diagnosis of Crohn's disease. Over 93% of IndC patients would undergo the same procedure again, and 98% would recommend IPAA to others with IndC. Patients with IndC should not be precluded from having IPAA surgery.