The politics of abortion rights in the 2022 United States midterm election: Lessons for fledgling democracies around the world.

The United States government, under President Donald Trump, retreated from its traditional role as an exemplar of democracy, defender of press freedom and the rule of law but embraced conspiracy theories, virulent anti-Semites, and authoritarian regimes worldwide. Today, democracy is in crisis and is under assault and in retreat globally. The 2022 United States midterm election has come and is now history with many unexpected outcomes. The three impactful issues during the campaign that produced many upsets were abortion rights, election denialism, and threats to democracy. This editorial examines the history of abortion rights in the United States, the impacts of the Dobbs vs. Jackson ruling on the 2022 midterm election, the threats of election deniers to global democracy, the global status of reproductive health rights, and the lessons of abortion ban for burgeoning democracies worldwide.

An evaluation of the nature and level of musculoskeletal imaging training in physiotherapy educational programmes in Nigeria.

BACKGROUND: Deficiency in musculoskeletal imaging (MI) education will pose a great challenge to physiotherapists in clinical decision making in this era of first-contact physiotherapy practices in many developed and developing countries. This study evaluated the nature and the level of MI training received by physiotherapists who graduate from Nigerian universities. METHODS: An online version of the previously validated Physiotherapist Musculoskeletal Imaging Profiling Questionnaire (PMIPQ) was administered to all eligible physiotherapists identified through the database of the Medical Rehabilitation Therapist Board of Nigeria. Data were obtained on demographics, nature, and level of training on MI procedures using the PMIPQ. Logistic regression, Friedman's analysis of variance (ANOVA) and Kruskal-Wallis tests were used for the statistical analysis of collected data. RESULTS: The results (n = 400) showed that only 10.0% of the respondents had a stand-alone entry-level course in MI, 92.8% did not have any MI placement during their clinical internship, and 67.3% had never attended a MI workshop. There was a significant difference in the level of training received across MI procedures [χ2 (15) = 1285.899; p = 0.001]. However, there was no significant difference in the level of MI training across institutions of entry-level programme (p = 0.36). The study participants with transitional Doctor of Physiotherapy education were better trained in MI than their counterparts with a bachelor's degree only (p = 0.047). CONCLUSIONS: Most physiotherapy programmes in Nigeria did not include a specific MI module; imaging instructions were mainly provided through clinical science courses. The overall self-reported level of MI training among the respondents was deficient. It is recommended that stand-alone MI education should be introduced in the early part of the entry-level physiotherapy curriculum.

The Epidemiology of COVID-19: A Review.

COVID-19 is a new lethal disease with limited information on its transmissibility, the severity of its sequelae, its clinical manifestations, and epidemiology. This commentary analyzed the global epidemiology of COVID-19 among the vulnerable population. The analysis revealed that most pediatric COVID-19 cases are not severe, but related severe illness still occurs in children. All ages of children are susceptible to COVID-19, and no significant gender difference exists. COVID-19 infection during pregnancy produced fatal outcomes for mothers, but less risky for the baby. The hot spot clusters for COVID-19 are the prisons/jails, nursing/group homes, and long-term facilities where most of the vulnerable populations reside. Ethnic minority groups in the USA and UK are disproportionately exposed to COVID-19 infection and death than Caucasians. The difference may be because ethnic minorities are exposed to higher risks at work and the long-standing structural economic and health disparities in the two countries. There are now changes in guidelines on who is qualified to receive ventilators in dire situations in many countries around the world if the healthcare system is overwhelmed.

HIV sexual risk behaviors and perception of risk among college students: implications for planning interventions.

BACKGROUND: The college environment offers great opportunity for HIV high-risk behaviors, including unsafe sex and multiple partnerships. While the overall incidence of HIV infection has seen some decline in recent years, rates of HIV infection among young adults have not seen a proportionate decline. As in the general population, African American young adults have been disproportionately affected by the HIV/AIDS epidemic. This study examined the sexual risk behaviors and perception of HIV risk of students in a predominantly African American commuter urban university in the Midwest. METHODS: Students enrolled in randomly selected general education courses completed a paper and pencil survey. Data were collected in Fall 2007, and univariate, bivariate, and multivariate analyses were conducted using SPSS for Windows v.16. RESULTS: The sample included 390 students, the majority (83%) of whom were never married and 87% were sexually experienced. Among males reporting male partnerships those who used marijuana (OR = 17.5, p = 0.01) and those who used alcohol along with illegal drugs (OR = 8.8, p = 0.03) were significantly more likely to report multiple partnerships. Among females reporting male partnerships, those 30 years and older were significantly less likely (OR = 0.09, p = 0.03) to report having multiple male partners. There were significant differences in condom use last sex (p = 0.01) and consistent condom use (p = 0.002) among the different age groups. Older students were less likely to report condom use. Females age 30 years and older (OR = 3.74, p = 0.05) and respondents age 2029 years (OR = 2.41, p = 0.03) were more likely to report inconsistent condom use than those below 20 years. Marijuana use was correlated with inconsistent condom use (p = 0.02) and alcohol with not using condom last sex among females. Perception of HIV risk was generally poor with 54% of those age 30 years and older, 48.1% of 2029 year olds, and 57.9% of those below the age of 20 years perceived themselves as not having any chance of being infected with HIV. Predictors of moderate/good perception of HIV risk were drug and alcohol use, inconsistent condom use, and multiple partnerships. CONCLUSION: Students in the study sample engaged in various HIV risk behaviors but have a poor appreciation of their risk of HIV infection. While low rates of condom use was a problem among older students (30 years and older), multiple partnerships were more common among younger students, and marijuana and alcohol use were related to low condom use among females. Our findings support the need for targeted HIV prevention interventions on college campuses.

Relationship between incarceration frequency and human immunodeficiency virus risk behaviors of African American inmates.

OBJECTIVE: We examined the relationship between frequency of incarceration and preincarceration risk behaviors and determined the demographic factors associated with risk behaviors among a sample of African American inmates. METHODS: We surveyed 229 (102 female and 127 male) randomly selected inmates. Risk behaviors between inmates serving their first prison sentence and those who had been incarcerated in prison more than once were compared using the chi2 test. Multivariate logistic regression analysis was used to determine factors associated with risk behaviors. RESULTS: For most risk behaviors, there were no significant differences between inmates serving their first prison sentence and inmates incarcerated more than once; however, male inmates who had been incarcerated more than once were more likely to report having had multiple vaginal sex partners (OR, 2.42; 95% CI, 1.10-5.32; P = .03). No demographic variable was found to be independently associated with risk behaviors. CONCLUSIONS: Frequency of incarceration did not affect preincarceration human immunodeficiency virus (HIV) risk behaviors among this sample of African American inmates. HIV prevention efforts should be directed at addressing the individual and structural factors associated with high-risk behaviors among African Americans.

Maternal death review and surveillance: The case of Central Hospital, Benin City, Nigeria.

BACKGROUND: Despite the adoption of Maternal and Perinatal Death Surveillance and Response (MPDSR) by Nigeria's Federal Ministry of Health to track and rectify the causes of maternal mortality, very limited documentation exists on experiences with the method and its outcomes at institutional and policy levels. OBJECTIVE: The objective of this study was to identify through the MPDSR process, the medical causes and contributory factors of maternal mortality, and to elucidate the policy response that took place after the dissemination of the results. METHODS: The study was conducted at the Central Hospital, Benin between October 1, 2017, and May 31, 2019. We first developed a strategic plan with the objective to reduce maternal mortality by 50% in the hospital in two years. An MPDSR committee was established and the members and all staff of the Maternity Department of the hospital were trained to use the nationally approved protocol. All consecutive cases of maternal deaths in the hospital were then reviewed using the MPDSR protocol. The results were submitted to the hospital Management and its supporting agencies for administrative action to correct the identified deficiencies. RESULTS: There were 18 maternal deaths in the hospital during the period, and 4,557 deliveries giving a maternal mortality ratio (MMR) of 395/100,000 deliveries. This amounted to a seven-fold reduction in MMR in the hospital at the onset of the project. The main medical causes identified were obstetric hemorrhage (n = 10), pulmonary embolism (n = 2), ruptured uterus (n = 2), eclampsia (n = 1), anemic heart failure (n = 1) and post-partum sepsis (n = 2). Several facility-based and patient contributory factors were identified such as lack of blood in the hospital and late reporting with severe obstetric complication among others. Response to the recommendations from the committee include increased commitment of hospital managers to immediately rectify the attributable causes of deaths, the establishment of a couples health education program, mobilization and sensitization of staff to handle pregnant women with great sensitivity, promptness and care, the refurbishing of an intensive care unit, and the increased availability of blood for transfusion through the intensification of blood donation drive in the hospital. CONCLUSION: We conclude that the results of MPDSR, when acted upon by hospital managers and policymakers can lead to an improvement in quality of care and a consequent decline in maternal mortality ratio in referral hospitals.

Core values and evaluation processes associated with academic tenure.

This study replicated the 1989 national study by the Carnegie Foundation for the Advancement of Teaching in which the relative importance of teaching, scholarship, and service in tenure decisions was examined. The deans of the National League for Nursing accredited programs (N= 187) and deans of Allied Health programs belonging to the Association of Schools of Allied Health Professions (N=75) were surveyed to identify the core values and evaluation processes used in granting tenure. Most deans who participated stated it is difficult to achieve tenure in the absence of publication in refereed journals. The number of journal publications, reputation of the journal, presentation at scientific conferences, and published reviews of the scholars' books are considered critical in granting tenure. Furthermore, advising students, service in the department and university, and course evaluation by students were considered critical to granting tenure. Overall, the opinions of the nursing and allied health deans on the core values and the evaluation processes used in tenure decisions were similar, but divergent from those of the "health sciences" faculty members in the Carnegie Foundation study. These findings suggest a shift in the criteria used in tenure decisions today.

Emerging trends on tenure policies and practices in nursing and allied health education.

The tenure system in academia is under attack, and there is a need for empirical data on the emerging national trends relating to tenure. This comparative study investigated the emerging trends on tenure policies and practices in nursing and allied health education. We surveyed the deans of National League for Nursing-accredited programs and deans of allied health programs belonging to the Association of Schools of Allied Health Professions nationwide. The nursing (n = 187) and allied health (n = 75) deans completed a research questionnaire designed to capture the critical issues relating to tenure in higher education. We found no significant difference (p > 0.05) between the perceptions of the allied health and nursing deans on the policies and practices associated with tenure. The allied health and nursing deans had similar views on posttenure review, changes in traditional tenure, tenure quota practice, inducements for faculty to forego tenure, review of the tenure criteria, and the ranking of the primary criteria used in granting tenure. Both groups of deans expressed strong support for the tenure system. Overall, 72% of the allied health deans and 68% of the nursing deans indicated that a doctorate is the degree required for tenure in their institutions. The preponderance of allied health and nursing deans, 77% each, ranked teaching as the primary criterion used in tenure decision. On the other hand, only 22% of allied health deans and 19% of nursing deans rated research as the most important criterion used for tenure. Only 1% of allied health deans and 4% of nursing deans considered service as the most important criterion used in tenure decision. The role of clinical practice in tenure decision was not evaluated in our study and is worth investigating in follow-up studies.

Health professions career awareness program for seventh- and eighth-grade African-American students: a pilot study.

This exploratory, cross-sectional study was designed to gauge the interest and health career choices of African-American students before high school and to determine their level of satisfaction with a health career awareness program. Over a three-year period, 133 seventh-grade students (47%) and eighth-grade students (53%) enrolled in a Southside Chicago Catholic school were recruited; 98% were African-American. The students participated in a career awareness program, which consisted of lectures, video presentation, interactive discussion, and college campus visits. Each student completed a questionnaire that sought demographic information, health career choice, career preference, and level of satisfaction with the awareness program implemented. For career choice, 39% of the students selected "doctor" and dentist, 28% selected occupational therapy, 15% selected social work, 11% selected nursing, and 7% selected health information administration. The majority of the students (51%) were "very satisfied" and 49% were "satisfied" with the program that was implemented. We found no discernable difference in the health career interest and career choice of the study participants over the three-year period. Our findings reconfirmed a continuing limited level of awareness about allied health professions among African-American students before high school. Follow-up studies should expand the scope and contents of the awareness program to include other health professions, field trips, and mentoring by health care providers or health professional students.

Prevalence and determinants of burnout among physical and occupational therapists.

It is generally speculated that the ongoing changes in the health care system may increase the incidence of burnout among health care providers. The purposes of this cross-sectional study were to determine (1) the prevalence of burnout among physical therapists (PTs) and occupational therapists (OTs), (2) sociodemographic and work-related factors associated with emotional exhaustion (EE), depersonalization (DP), and personal achievement (PA) traits of PTs and OTs. In fall 1998, 169 PTs and 138 OTs employed in various clinical settings in New York City completed the survey. Part I of the research questionnaire solicited sociodemographic and work-related information such as age, marital status, number of children (NC), religious affiliation (RA), exercise habits, level of support from supervisor (LSS), and level of support from colleagues (LSC). Part II of the questionnaire contained the Maslach Burnout Inventory (MBI). From the MBI, each subject's EE, DP, and PA scores were obtained. The data were analyzed with oneway analysis of variance and linear, multiple, and stepwise regression models to determine the relative and combined contributions of the independent (sociodemographic and work-related) variables toward predicting EE, DP, and PA. Overall the MBI scores revealed high (28.9 +/- 6.8) EE, high (18.3 +/- 4.7) DP, and low (18.0 +/- 7.0) PA. The contribution of sociodemographic and work-related variables toward the prediction of EE (26.7%), DP (12.8%) and PA (19.8%) was minimal. Of the 20 independent variables examined in this study, only 3 (LSS, NC and RA) were viable predictors of EE. The only viable predictor of PA trait was LSC. None of the variables examined accurately predicted DP trait. The EE, DP, and PA scores of the PTs and OTs in this study were higher than the norms reported in previous studies for the general population and other human service professionals, including PTs and OTs. The findings suggest the need for reorganization of the work environment to address the stressors responsible for burnout in this cohort of therapists.

Perception of risk of HIV and sexual risk behaviours among students in the United States, Turkey and South Africa.

The aim of this study was to examine HIV sexual risk behaviours and perception of HIV risk among 1 095 students from the United States of America (US), Turkey and South Africa. Randomly selected students who were enrolled in general education courses completed a structured questionnaire. Results revealed statistically significant differences in specific HIV-related sexual behaviours among students from the three countries and among male and female students in each country. A higher percentage of US and South African students engage in HIV risky sexual behaviours compared with their Turkish counterparts, and a higher percentage of female students in the US and South Africa engage in HIV sexual risk behaviours compared with their male colleagues. A higher proportion of Turkish male students engaged in sexual risk behaviours compared with their female counterparts. The perception of HIV risk was low among US and Turkish students, and high among South African students. There was no agreement between engaging in risky sexual behaviour and self-perception of HIV risk among South African female students, while agreement was poor for US male and female students, Turkish male and female students, and South African male students. The observed optimistic bias needs to be considered in the design and implementation of HIV prevention programmes for these populations.

Evaluation of a psychometric instrument designed to assess the HIV risk behaviors of ex-prisoners.

This study determined the readability, test-retest reliability, and internal consistency of a questionnaire designed to assess the HIV risk behaviors of ex-prisoners. The questionnaire was administered twice within a 2-week interval to 119 ex-prisoners. The test-retest agreement for the questionnaire's 25 HIV behavior items ranges from 82% to 100%. Of these 25 items, agreement was ''fair'' (k = .20 to .40) for 1, ''moderate'' (k = .40 to .60) for 5, ''substantial'' (k = .60 to .80) for 11, ''almost perfect'' (k = .80 to .99) for 7, and ''perfect'' (k = 1.00) for 1. The overall Cronbach's alpha (Cα) is .81 (p < .001). By subscale, the Cα for tattooing, .89; body piercing, .93; injection drug use, .93; and HIV risk sexual behavior, .79. Based on these findings, the authors conclude that the questionnaire is reliable and internally consistent.

Body art practices among inmates: Implications for transmission of bloodborne infections.

BACKGROUND: Unsterile body art practices among inmates in prison have been implicated in the transmission of bloodborne viruses. The objectives of this study were to determine the prevalence of tattooing and body piercing among inmates, identify factors associated with receiving a tattoo in prison, and explore the contexts of tattooing and body piercing in prison. METHODS: A cross-sectional survey was conducted among randomly selected inmates in 17 state prisons in Illinois; a convenient sample of recently released exprisoners in Chicago, IL, participated in focus group discussions (FGDs). RESULTS: A total of 1819 (1293 men and 526 women) inmates participated in the survey, and 47 exprisoners participated in the FGDs. Sixty-seven percent of the survey sample had tattoos, and 60% had body piercings. More men (19.3%) than women (8.7%) had received tattoos in prison (odds ratio, 0.40; 95% confidence interval: 0.29-0.56); prevalence of body piercing in prison was low (1.3%) and similar for men and women. Factors associated with tattooing in prison include incarceration for 1 year or longer and having had sex in prison among both men and women; nonheterosexual identity for women only; and for men, being 30-39 years old; incarcerated 4 or more times; having a history of sharing needles, multiple vaginal sex partners, and inconsistent condom use in the 6 months before arrest. Focus groups provided information on body art practices in prison. Inmates had a variety of reasons for getting body art, equipment was often shared, and cleansing agents were not readily available. CONCLUSION: Tattooing and body piercing practices exist in prison and could constitute risks for transmission of bloodborne viral infections. Interventions to reduce these risks are discussed.

Development and evaluation of a psychometric instrument designed to assess HIV risk behaviors of prison inmates.

Clinicians and researchers interested in HIV interventions for prisoners lack an appropriate psychometric instrument to assess HIV risk behaviors. This study evaluated the readability and internal consistency of a questionnaire designed to assess such behaviors. The questionnaire was administered to 277 inmates. The Flesch Reading Ease score was 78.3 with a Flesch-Kincaid grade level of 3.7, suggesting limited comprehension difficulties. Internal consistency was evaluated by determining Cronbach's alpha (Calpha) for total items and for each subscale. Following factor analyses, 25 items converged into five subscales and combined they account for 72% of the variance. The overall Calpha was .86 and the subscales Calpha ranged from .82 to .98. Findings reveal that the questionnaire is internally consistent and suitable for use with prisoners with low literacy skills. The use of this instrument for intervention studies in prisons has the potential to reduce inmates' HIV risk behaviors.

Advocacy for research evidence in academic public policy development

The World Ranking of Universities The impetus for this review came from reading the July 2019 Webometrics global survey of universities. The Webometrics survey is embraced widely in Africa, but it is less respected around the world when compared to more influential reviews like the Academic Ranking of World Universities, UK Times Higher Education World University Rankings and QS World University Rankings. The low prestige is because Webometrics consider primarily institution web-presence and activities instead of the quality of instruction, student learning, and research productivity; the central core functions of the universities. In the most recent Webometrics survey, the University of Cape Town is the first mentioned university in Africa but ranked number 274 in the world1. The study also revealed the dominance of South African universities, capturing nine of the top ten institutions in Africa. The University of Ibadan first listed Nigerian university, ranked number 17 in Africa and number 1,233 in the world; outperformed by the University of Ghana, which ranked 16 in Africa and 1,209 globally. After perusing through the report, I immediately called a colleague to share the bad news of the overall poor performance of African universities. We both agreed that the result of the survey is symbolic of the quality of education decline in Nigeria; a country with an educational system that was once the envy of most African nations. Given the dismal ranking of Nigerian universities, our conversation quickly shifted to another equally important academic topic - the recurring and apathetic lack of evidence when private and government establishments in Africa put forth public policies. As I begin to write this review, the motion picture by Jerry Maguire titled "Show me the Money" immediately came to mind. The film is a Hollywood romantic comedy-drama sports movie that grossed more than $273 million and ranked ninth highest in revenue in 1996. Cuba Gooding Jr. won the Academy Award for best-supporting actor role while Tom Cruise won the Golden Globes for best actor in a motion picture musical or comedy. He also bagged three other Guild Awards for his performance in the movie. But this review is not about Tinseltown, the land of make-believe. It is about the need to use empirical data when formulating public policies. For two decades now, evidence-based practice is globally accepted across different academic disciplines. Despite these developments, many academic policy decisions are still made in a vacuum without bibliometric research evidence by many science academies and government establishments in particular