Violence against girls during COVID-19 pandemic and associated factors in Gondar city, North West Ethiopia.

In Ethiopia, the magnitude of violence against girls during COVID-19 in the study area is not known. Therefore, this study aimed to assess the violence and associated factors during COVID-19 pandemic among Gondar city secondary school girls in North West Ethiopia. An institution-based cross-sectional study was conducted from January to February 2021. Data were collected from four public and two private Gondar city secondary schools. Investigators used stratified simple random sampling to select participants and the investigators used roster of the students at selected schools. Investigators collected the data using self-reported history of experiencing violence (victimisation). Investigators analysed data using descriptive statistics and multivariable logistic regression. Investigators invited a total of 371 sampled female students to complete self-administered questionnaires. The proportion of girls who experienced violence was 42.05% and psychological violence was the highest form of violence. Having a father who attended informal education (AOR = 1.95, 95% CI 1.08-3.51), ever use of social media 1.65 (AOR = 1.65, 95% CI 1.02-2.69), ever watching sexually explicit material (AOR = 2.04, 95% CI 1.24-3.36) and use of a substance (AOR = 1.92, 95% CI 1.17-3.15) were significantly associated variables with violence. Almost for every five girls, more than two of them experienced violence during the COVID-19 lockdown. The prevalence of violence might be under reported due to desirability bias. Therefore, it is better to create awareness towards violence among substance users, fathers with informal education and social media including user females.

Impact of Fellow Participation During Colonoscopy on Adenoma Detection Rates.

BACKGROUND: An endoscopist's adenoma detection rate (ADR) is inversely related to interval colorectal cancer risk and cancer mortality. Previous studies evaluating the impact of gastroenterology fellow participation in colonoscopy on ADR have generated conflicting results. AIMS: We aimed to determine the impact of fellow participation, duration of fellowship training, and physician sex on ADR and advanced ADR (AADR). METHODS: We retrospectively analyzed average-risk patients undergoing screening colonoscopy at Veterans Affairs New York Harbor Healthcare System Brooklyn Campus and Kings County Hospital Center. Review of colonoscopy and pathology reports were performed to obtain adenoma-specific details, including the presence of advanced adenoma and adenoma location (right vs. left colon). RESULTS: There were 893 colonoscopies performed by attending only and 502 performed with fellow participation. Fellow participation improved overall ADR (44.6% vs. 35.4%, p < 0.001), right-sided ADR (34.1% vs. 25.2%, p < 0.001), and AADR (15.3% vs. 8.3%, p < 0.001); however, these findings were institution-specific. Year of fellowship training did not impact overall ADR or overall AADR, but did significantly improve right-sided AADR (p-value for trend 0.03). Female attending physicians were associated with increased ADR (47.1% vs. 37.0%, p = 0.0037). Fellow sex did not impact ADR. CONCLUSIONS: Fellow participation in colonoscopy improved overall ADR and AADR, and female attending physicians were associated with improved ADR. Year of fellowship training did not impact overall ADR or AADR.

Adequate emergency department resource usage: Applying simulation-based workshop to improve teaching competence among elementary and junior high school teachers in Taiwan.

INTRODUCTION: More than 80% of patients who visited Emergency Department (ED) was not urgent in Taiwan in 2019. It causes insufficient medical services and a latent fiscal threat to the Nation Health Insurance (NHI). This study adopted simulation-based educating modules to explore the effect in teaching competence among primary and middle school teachers for efficient AEDRU (adequate emergency department resource usage) education in the future. METHOD: The subjects were 414 elementary and junior high school teachers in Taiwan. 214 participants attended the simulation-based workshop as the simulation-based group, whereas 200 participants took an online self-learning module as the self-learning group. The workshop was created by an expert panel for decreasing the unnecessary usage amount of ED medial resources. The materials are lecture, board games, miniature ED modules, and simulation-based scenarios. A teaching competence questionnaire including ED knowledge, teaching attitude, teaching skills, and teaching self-efficacy was conducted among participants before and after the intervention. Data were analyzed via McNemar, paired t test and the generalized estimating equations (GEE). RESULTS: The study showed that teachers who participated in the simulation-based workshop had improved more in teaching competence than those who received the online self-learning module. In addition, there were significant differences between the pre-test and post-test among the two groups in teaching competence. CONCLUSION: The simulation-based workshop is effective and it should be spread out. When students know how to use ED medical resources properly, they could affect their families. It can help the ED service to be used properly and benefits the finance of the NHI. The health care cost will be managed while also improving health.

COVID-19-Related School Closures and Learning Modality Changes - United States, August 1-September 17, 2021.

Beginning in January 2021, the U.S. government prioritized ensuring continuity of learning for all students during the COVID-19 pandemic (1). To estimate the extent of COVID-19-associated school disruptions, CDC and the Johns Hopkins University Applied Physics Laboratory used a Hidden Markov Model (HMM) (2) statistical approach to estimate the most likely actual learning modality based on patterns observed in past data, accounting for conflicting or missing information and systematic Internet searches (3) for COVID-19-related school closures. This information was used to assess how many U.S. schools were open, and in which learning modalities, during August 1-September 17, 2021. Learning modalities included 1) full in-person learning, 2) a hybrid of in-person and remote learning, and 3) full remote learning.

Nationwide evidence that education disrupts the intergenerational transmission of disadvantage.

Despite overall improvements in health and living standards in the Western world, health and social disadvantages persist across generations. Using nationwide administrative databases linked for 2.1 million Danish citizens, we leveraged a three-generation approach to test whether multiple, different health and social disadvantages-poor physical health, poor mental health, social welfare dependency, criminal offending, and Child Protective Services involvement-were transmitted within families and whether education disrupted these statistical associations. Health and social disadvantages concentrated, aggregated, and accumulated within a small, high-need segment of families: Adults who relied disproportionately on multiple, different health and social services tended to have parents who relied disproportionately on multiple, different health and social services and tended to have children who evidenced risk for disadvantage at an early age, through appearance in protective services records. Intra- and intergenerational comparisons were consistent with the possibility that education disrupted this transmission. Within families, siblings who obtained more education were at a reduced risk for later-life disadvantage compared with their cosiblings who obtained less education, despite shared family background. Supporting the education potential of the most vulnerable citizens might mitigate the multigenerational transmission of multiple disadvantages and reduce health and social disparities.

COVID-19 pandemic: A review of the global lockdown and its far-reaching effects.

COVID-19, caused by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), was declared a pandemic by the World Health Organization (WHO) on the 11th of March 2020, leading to some form of lockdown across almost all countries of the world. The extent of the global pandemic due to COVID-19 has a significant impact on our lives that must be studied carefully to combat it. This study highlights the impacts of the COVID-19 pandemic lockdown on crucial aspects of daily life globally, including; Food security, Global economy, Education, Tourism, hospitality, sports and leisure, Gender Relation, Domestic Violence/Abuse, Mental Health and Environmental air pollution through a systematic search of the literature. The COVID-19 global lockdown was initiated to stem the spread of the virus and 'flatten the curve' of the pandemic. However, the impact of the lockdown has had far-reaching effects in different strata of life, including; changes in the accessibility and structure of education delivery to students, food insecurity as a result of unavailability and fluctuation in prices, the depression of the global economy, increase in mental health challenges, wellbeing and quality of life amongst others. This review article highlights the impacts of the COVID-19 pandemic lockdown across the globe. As the global lockdown is being lifted in a phased manner in various countries of the world, it is necessary to explore its impacts to understand its consequences comprehensively. This will guide future decisions that will be made in a possible future wave of the COVID-19 pandemic or other global disease outbreak.

Transcultural Adaptation of Tibetan Nursing Trainees: A Case Study of "9+3" Vocational Technical Students in Sichuan Province, China.

BACKGROUND Nursing education is an important part of the "9+3" vocational education program led by Sichuan Province. In the internship stage, nursing students of Tibetan ethnicity may have problems of intercultural adaptation in the process of getting along with patients, which may affect the effective nursing outcome. The purpose of this study was to clarify the current situation of transcultural adaptation of Tibetan trainee nurses and to provide more theoretical support and guidance. MATERIAL AND METHODS We collected 237 valid survey questionnaires, based on Ward's acculturation process model, from a total of 363 Tibetan trainee nurses in the "9+3" free vocational education program in Chengdu, Luzhou, and Nanchong of Sichuan Province. The SPSSAU project (2020), an online application software retrieved from https://www.spssau.com, was used for data coding and archiving. RESULTS The results of questionnaire and data analysis showed that the overall level of transcultural adaptation of Tibetan trainee nurses was that the number of people with poor adaptation was slightly higher than those with good adaptation, and most Tibetan trainee nurses were in the middle level. Meanwhile, sociocultural adaptation was better than psychological adaptation. There were no statistically significant differences among the 4 grouping variables: gender, student home region, the city where the internship hospital was located, and whether they were from a single-child family or not. CONCLUSIONS The results revealed that there was still transcultural maladjustment among Tibetan nurses in the internship stage, and the psychological maladjustment was more obvious than the sociocultural maladjustment. We provide countermeasures and suggestions to solve the problems of transcultural adaptation reflected in the research.

Rational emotive education for reducing stress of undergraduate students of religious education program: An experimental study.

BACKGROUND: Rational emotive education (REE) program aims to improve the behavioral and mental health of students. This study objective was to evaluate the effect of an REE program on stress among undergraduate students of religious education program in Nigerian Universities. METHOD: One hundred and fifty (150) religious education undergraduates who had high level of stress participated in the study. Participants were assigned to 2 different groups. The treatment group had 75 participants and while control group also had 75 participants. Data collection was done using the Perceived Stress Scale (PSS-10) while data analysis was done using independent sample t test and paired t test statistics at .05 probability level. RESULTS: The REE program resulted in a significant decrease in level of stress among undergraduate students of religious education program in the treatment group compared with those students in the control group. Also, the effect of the REE program was maintained during the follow-up among undergraduate students of religious education program exposed to it. CONCLUSION: The REE program can be used to assist undergraduate students of religious education program to manage their stress.

The impact of girl child marriage on the completion of the first cycle of secondary education in Zimbabwe: A propensity score analysis.

BACKGROUND: The association between girl child marriage and education is widely acknowledged; however, there is no large body of demographic studies from Zimbabwe that have addressed this aspect. This study aimed to examine the extent to which child marriage affects one academic milestone, i.e. completion of the Ordinary Level, the first cycle of high school, which is also the most critical indicator of educational achievement in Zimbabwe. METHODS: We used the 2015 Zimbabwe Demographic and Health Survey and extracted 2380 cases of ever-married women aged between 20-29 years. We applied a propensity score-based method, which allowed us to mimic a hypothetical experiment and estimate outcomes between treated and untreated subjects. RESULTS: Our results suggest that child age at first marriage is concentrated between the ages of 15-22, with the typical age at first marriage being 18 years. Both logistic regression and PSM models revealed that early marriage decreased the chances of completing the first cycle of high school. Regression adjustment produced an estimate of prevalence ratio (PR) of 0.446 (95% CI: 0.374-0.532), while PSM resulted in an estimate (PR = 0.381; 95% CI: 0.298-0.488). CONCLUSION: These results have implications for Zimbabwe's development policy and suggest that girl-child marriage is a significant barrier to educational attainment. If not addressed, the country will most likely fail to meet sustainable development Goal 4.2 and 5.3. Social change interventions that target adults and counter beliefs about adolescent sexuality and prepubescent marriage should be put in place. Moreover, interventions that keep teenage girls in school beyond the first cycle of high school should be prioritised.

Mindfulness Workshops Effects on Nurses' Burnout, Stress, and Mindfulness Skills.

Burnout decreases work performance and quality of care and can result in medical errors, lower patient satisfaction, and higher rates of turnover. A study of 68 000 registered nurses showed that 35% of hospital nurses were experiencing symptoms of burnout. A systematic review identified that mindfulness-based interventions for health care professionals reduced stress and burnout and increased self-compassion and general health. However, the authors determined that more high-quality research is needed. This study examined the impact of a 4-hour workshop on burnout syndrome, perceived stress, and mindfulness skills. The objective of this study was to determine whether a 4-hour mindfulness workshop was effective in reducing burnout and perceived levels of stress and increasing mindfulness. Nurses at a Midwest academic medical center were recruited through e-mail to attend a 4-hour mindfulness workshop. Participants completed the Maslach Burnout Inventory-Human Service Survey, Perceived Stress Scale, and Cognitive and Affective Mindfulness Scale-Revised prior to the start of the workshop and 1 and 6 months after the workshop. The study design allowed for comparisons preintervention and postintervention. Of the 52 nurses who completed the baseline questionnaires, 94% were female with an average age of 38 years. Thirty-one percent completed the questionnaires at 1 month and 20 nurses at 6 months. At 1 month, nurses reported statistically significant decreased perceptions of stress (-2.31, P = .01) and emotional exhaustion (-4.78, P = .03). Mindfulness skills, personal accomplishment, and depersonalization improved but were not statistically significant. At 6 months, statistically significant findings included increased perceptions of mindfulness (2.50, P = .04), personal accomplishment (4.43, P = .04), and decreased emotional exhaustion (-6.21, P = .05). Perceptions of stress and depersonalization improved but were not statistically significant. In this study, nurses reported decreases in burnout and perceived stress and increases in mindfulness after attending a 4-hour mindfulness workshop. Further research is needed to determine the long-term impact of mindfulness-based training on nurses' burnout, stress, and mindfulness skills. The results of this study add to the body of literature that supports the benefits of mindfulness-based interventions.

Improving Graduate Medical Education Through Faculty Empowerment Instead of Detailed Guidelines.

Calls for improvement and reform in graduate medical education (GME) have led to more detail in educational and curricular guidelines. The current level of detail in curriculum guidelines for GME training programs is high, encompassing, for example, competency frameworks, entrustable professional activities, and milestones. In addition, faculty must employ an increasing number of assessment tools and elaborate portfolio systems for their residents. It is questionable whether any further increase in curriculum detail and assessment formats leads to better GME programs. Focusing on this type of system development may even lead to less engaged faculty if faculty are not encouraged to use their own professional judgment and creativity for teaching residents. Therefore, faculty members must be empowered to engage in curricular innovation, since system development alone will not result in better training programs. Raising faculty members' awareness of their virtues and value as teachers and involving them in the debate about how GME can be enhanced might increase their engagement in resident training.

UC Davis Train-the-Trainer Primary Care Pain Management Fellowship: Addressing the Pain Management Education Gap.

PROBLEM: Primary care providers are responsible for the majority of pain care and opioid prescribing, but they are often inadequately trained. Training current providers to address the crisis of excessive opioid prescribing and inadequate pain management is a substantial workforce problem that requires urgent action. This educational need is vast and requires a staged solution to amplify its effect. APPROACH: The University of California, Davis Train-the-Trainer (T3) Primary Care Pain Management Fellowship targets the most pressing topics related to pain management, including prescription drug abuse, responsible opioid prescribing, and substance abuse, as well as broad coverage of comprehensive pain management. It offers an innovative, scalable solution to address the education gap in pain management that, in part, fuels the opioid epidemic in the United States. The T3 Fellowship incorporates a competency-based curriculum and a hybrid educational model of in-person and distance-based learning and direct faculty-fellow mentoring to comprehensively train primary care providers in pain care and prepare them to train others. Since it was established in 2017, 2 cohorts (of 17 and 26 fellows) have completed the 10-month fellowship and a third cohort of 38 fellows started the program in September 2019. OUTCOMES: Pre- and postprogram surveys for the first 2 cohorts, and a 6-month postprogram survey for the first cohort, demonstrated fellows' improvement and sustained performance in pain competencies as well as increased recognition and understanding of pain and related topics. NEXT STEPS: If adopted by other institutions and expanded across the country, the T3 Fellowship holds potential for developing an ever-growing legion of trained professionals who will locally fill the need for effective pain management, including appropriate opioid prescribing. Advancing this model will require further economic and feasibility studies to assess costs, resources, and other variables, as well as a robust comprehensive outcomes program.

Public Workshop Summary Report on Fiscal Year 2021 Generic Drug Regulatory Science Initiatives: Data Analysis and Model-Based Bioequivalence.

On May 4, 2020, the US Food and Drug Administration (FDA) hosted an online public workshop titled "FY 2020 Generic Drug Regulatory Science Initiatives Public Workshop" to provide an overview of the status of the science and research priorities and to solicit input on the development of Generic Drug User Fee Amendments fiscal year 2021 priorities. This report summarizes the podium presentations and the outcome of discussions along with innovative ways to overcome challenges and significant opportunities related to model-based approaches in bioequivalence assessment for breakout session 4 titled, "Data analysis and model-based bioequivalence (BE)." This session focused on the application of model-based approaches in the generic drug development, with a vision of accelerating regulatory decision making for abbreviated new drug application assessments. The session included both podium presentations and panel discussions with three topics of interest: (i) in vitro study evaluation methods and their clinical relevance, (ii) challenges in model-based BE, (iii) emerging expertise and tools in implementing new BE approaches.

A data driven methodology for social science research with left-behind children as a case study.

For decades, traditional correlation analysis and regression models have been used in social science research. However, the development of machine learning algorithms makes it possible to apply machine learning techniques for social science research and social issues, which may outperform standard regression methods in some cases. Under the circumstances, this article proposes a methodological workflow for data analysis by machine learning techniques that have the possibility to be widely applied in social issues. Specifically, the workflow tries to uncover the natural mechanisms behind the social issues through a data-driven perspective from feature selection to model building. The advantage of data-driven techniques in feature selection is that the workflow can be built without so much restriction of related knowledge and theory in social science. The advantage of using machine learning techniques in modelling is to uncover non-linear and complex relationships behind social issues. The main purpose of our methodological workflow is to find important fields relevant to the target and provide appropriate predictions. However, to explain the result still needs theory and knowledge from social science. In this paper, we trained a methodological workflow with left-behind children as the social issue case, and all steps and full results are included.

Effect of mass media on comprehensive knowledge of HIV/AIDS and its spatial distribution among reproductive-age women in Ethiopia: a spatial and multilevel analysis.

BACKGROUND: Globally, HIV/AIDS remains a significant public health issue particularly in Sub-Saharan Africa. Media exposure plays a significant role in raising community knowledge about HIV. Therefore, this study aimed to investigate the effect of media on comprehensive knowledge of HIV and its spatial distribution among reproductive-age women in Ethiopia. METHODS: A secondary data analysis was done based on the 2016 Ethiopian Demographic and Health Surveys (EDHS). A total weighted sample of 15,683 reproductive-age women was included for analysis. For the spatial analysis, ArcGIS version 10.3 and SaTScan version 9.6 software were employed to explore the spatial distribution of comprehensive knowledge of HIV/AIDS and for identifying significant hotspot areas. For associated factors, the mixed-effect logistic regression model was fitted. Deviance and ICC were used for model comparison. In the multivariable analysis, Adjusted Odds Ratio (AOR) with 95% Confidence Interval (CI) was reported to declare significantly associated factors of comprehensive knowledge of HIV/AIDS. RESULTS: The spatial analysis revealed that the spatial distribution of comprehensive knowledge of HIV/AIDS among reproductive-age women was significantly varied across the country. The SaTScan analysis identified significant clusters in the entire Somali region, the eastern part of Dire Dawa and Harari regions. Being rural (AOR = 1.52,95% CI:1.21-1.91), maternal age 25-34 years (AOR = 1.26,95% CI:1.14-1.40), aged ≥35 years (AOR = 1.20,95%CI:1.07-1.35), being Muslim (AOR = 0.68,95% CI:0.60-0.78), being protestant (AOR = 0.83,95% CI:0.71-0.96), poorer wealth (AOR = 1.26,95%CI:1.06-1.51), middle wealth (AOR = 1.34,95%CI:1.11-1.60), richer wealth (AOR = 1.36,95% CI:1.12-1.63), richest wealth (AOR = 1.72,95% CI:1.37-2.15), reading newspaper (AOR = 1.20,95%CI: 1.06-1.37), listening radio (AOR = 1.24,95% CI:1.10, 1.41), covered by health insurance (AOR = 1.23,95%CI:1.01-1.51), having primary education (AOR = 1.77,95% CI:1.57-1.99), having secondary education (AOR = 2.45,95%CI:2.10-2.86) and having higher education (AOR = 3.04,95%CI:2.52-3.65) were significantly associated with comprehensive knowledge of HIV/AIDS. CONCLUSION: Spatial distribution of comprehensive knowledge of HIV/AIDS among reproductive-age women was significantly varied across the country with significant hotspot areas with poor comprehensive knowledge of HIV/AIDS identified in the Somali region, the eastern part of Dire Dawa and Harari Regions. media exposure was a significant predictor of comprehensive knowledge of HIV/AIDS among reproductive-age women in Ethiopia. Therefore, the government should scale up public health programs in the hot spot areas and provide health information using different media.