Initial Education Research Articles

Mpox outbreak among men who have sex with men in Kraków, Poland; June 2022-November 2022.

Mpox is a zoonotic disease caused by the mpox virus (MPXV). Sporadic cases reported before 2022 were almost universally linked to direct contact with animals or travel to endemic regions in Africa. However, in 2022, a significant shift occurred with human-to-human transmission, leading to a global outbreak in 117 countries. In Poland, 217 cases of mpox were reported. The aim of this study was to evaluate the epidemiology, clinical presentations, laboratory findings, and co-infections with sexually transmitted pathogens among patients with mpox. A retrospective analysis of all mpox cases diagnosed at the University Hospital in Kraków between June 2022 and November 2022 was performed. Forty-five patients aged 19-48 years (median age 34) were diagnosed with mpox. Most of them were male 44 (98%) and 42 (93%) identified themselves as men who have sex with men (MSM). Twenty-two (49%) of the patients had previously been diagnosed with HIV. During mpox diagnosis, new cases of sexually transmitted infections (STIs) were identified. Specifically, 4 patients (9%) were newly diagnosed with HIV, 5 with syphilis, 4 with Chlamydia trachomatis, 3 with Neisseria gonorrhoeae infection, and 2 with Ureaplasma urealyticum infection; among this group, 4 patients (33%) had more than one sexually transmitted co-infection. The mpox outbreak in Kraków in 2022 primarily affected MSM and was transmitted through sexual contact. Healthcare professionals should be aware of emerging STIs. Educational initiatives should emphasize the importance of vaccinations, safe sexual practices and regular testing.

Enhancing referral practices: A bariatric department's education initiative to reduce unnecessary referrals to hematology oncology.

82 Background: Bariatric surgery patients face an elevated risk of iron deficiency anemia. Referrals from the Bariatric department to Hematology Oncology for work up of these anemias strain clinic resources and delay timely care for cancer patients. We initiated a targeted education program to reduce unnecessary referrals from the Bariatric department to Hematology Oncology by raising awareness among staff about appropriate referral criteria. Methods: We developed a curriculum highlighting the differences between symptoms of bariatric surgery complications and hematologic malignancies. Interactive training sessions were held with Bariatric department staff, supplemented by informational materials. Case studies and real-world examples reinforced understanding and decision-making. Staff were also educated on managing iron deficiency anemia internally. Referral rates were tracked before and after the intervention. Results: Baseline data were collected from July 2023 to November 2023, showing an average of 17 referrals per month (85 total over 5 months). The educational initiative included three sessions in December 2023 on anemia management and referral criteria. These sessions highlighted the distinction between symptoms of bariatric complications and hematologic malignancies, as well as education to the bariatric surgery providers on management of hematologic diagnoses resulting from bariatric surgery. Post-intervention data from January 2024 to May 2024 showed a substantial reduction in referrals for bariatric-related iron deficiency anemias to an average of 4.4 referrals per month (22 total over 5 months), indicating a 74% reduction. Improved internal management of iron deficiency anemia contributed to this outcome. The percentage of cancer patients receiving a consult within 7 days of referral contemporaneously improved from 85.7% to 88.1%, indicating improved access to oncology care. Conclusions: The educational intervention significantly reduced unnecessary referrals from the Bariatric department to Hematology Oncology, improving access for cancer patients. Empowering staff with the knowledge to make informed referral decisions and manage common hematologic issues internally improved patient care and clinic efficiency, reducing healthcare costs and patient burden in both departments.

Insights Into Antimicrobial Resistance From Dental Students in the Asia–Pacific Region

BackgroundDentists, as prominent prescribers, are key stakeholders in addressing the antimicrobial resistance (AMR) crisis. Dental students’ perceptions about the topic have been underexplored in the Asia–Pacific region, a key location for the development and spread of AMR. Thus, the aim of this study was to evaluate the awareness and confidence to prescribe antimicrobials amongst dental students studying in the region. MethodsStudents from 15 dental schools in 4 countries were invited to participate in a cross-sectional online survey during 2022–2023. A previously validated and standardised 14-item instrument was utilised. ResultsIn all, 1413 responses were collected from Australia (n = 165), Sri Lanka (n = 112), Japan (n = 173), and Vietnam (n = 963). Of those, 201 were from final-year students (14.2%). On a scale from 1 to 10, awareness on AMR was placed at a mean (SEM) priority of 8.09 (0.05). With regards to target areas to address for mitigation of the AMR crisis, participants placed general public awareness at the top (mean [SEM] 8.53 [0.05]). Final-year students presented a mean (SEM) level of confidence to prescribe antibiotics of 6.01 (0.14) on a scale from 1 to 10, whilst 59.7% and 56.8% indicated feeling pressured to prescribe by patients or when lacking time, respectively. Final-year students participating in research activities assigned a higher priority to AMR compared to their peers not involved in research (mean [SEM] 8.6 [0.19] vs 7.81 [0.16]; P = .01). ConclusionsThis study highlights a need for increased awareness and confidence to prescribe amongst dental students in the Asia–Pacific region, an understudied population thus far. To mitigate this issue, the implementation (followed by assessment) of local educational and antibiotic stewardship initiatives is warranted.

Quality improvement project to reduce inpatient chemotherapy usage on a solid tumor oncology service.

333 Background: Inpatient chemotherapy is not routinely recommended for patients with solid tumors as administration is associated with increased length of stay (LOS), higher healthcare costs, and higher morbidity; and chemotherapy administration within 14 days of death is considered poor quality care. However, inpatient chemotherapy may sometimes be indicated for toxicity monitoring or due to barriers that limit prompt delivery of medications with clinically meaningful benefit. To ensure judicious use of inpatient chemotherapy we are undertaking iterative Plan, Do, Study, Act (PDSA) cycles involving education and policy initiatives on a solid tumor oncology service at an urban, academic medical center. Methods: PDSA cycles followed standard methodology. The initial goal was to reduce inappropriate inpatient chemotherapy use, which was expected to correspond with a 25% overall reduction. The initial intervention consisted of two main components: 1) division-wide education about the indications for inpatient chemotherapy, and 2) formation of a committee to review all chemotherapy requests for adult inpatients with solid tumors. The committee consists of clinicians within division leadership, including the division chief and representatives from operations, quality and safety, and ethics. Requests are sent from inpatient teams to the committee, who review each case for factors supporting inpatient treatment such as patient stability/performance status, clinically meaningful benefit, and practical barriers to outpatient administration. To evaluate the impact of the intervention, data were extracted from the electronic medical record for all patients admitted to the service for the 8.5 months before (12/1/22-8/15/23) and after (8/16/23-4/30/24) the initiation of the first PDSA cycle. Results: At baseline, prior to PDSA cycle 1, there were 930 admissions (n=606 patients), and 111 (11.9%, n=82 patients) received inpatient chemotherapy. During PDSA cycle 1 there were 889 admissions (n=557 patients), and 57 (6.4%, n=35 patients) received inpatient chemotherapy (p<0.001). There was no significant change in the proportion of patients receiving chemotherapy within 14 days or 30 days of death pre-PDSA cycle and post, 7.5% vs. 6.6% within 14 days of death (p>0.9), and 13.1% vs. 11.5% within 30 days of death (p>0.9). Overall, mean LOS for all admissions decreased from 11.1 days to 8.8 days (p<0.001). Conclusions: Preliminary results of this quality improvement initiative using iterative PDSA cycles to optimize inpatient chemotherapy use suggest a benefit. After the first PDSA cycle, there was a 46.3% decrease in the proportion of admissions receiving inpatient chemotherapy, and an overall decrease in LOS. Future PDSA cycles are aimed at limiting end-of-life chemotherapy and streamlining the transition from inpatient to outpatient chemotherapy to reduce delays and improve the patient experience.

Comparative Analysis of Biblical Statements and Contemporary Science Views

This comparative analysis delves into the intricate relationship between Biblical science views and contemporary scientific perspectives. Examining biblical narratives through the lens of modern scientific understanding, the study navigates the complexities inherent in reconciling ancient wisdom with empirical methodologies. The analysis encompasses key themes such as the creation narrative, cosmology, and natural phenomena, emphasizing the symbolic richness and cultural contexts embedded in biblical texts. Acknowledging the Bible’s role as a sacred and moral guide, the study contrasts it with the evidence-based approaches of contemporary science. While the Bible offers timeless wisdom and moral teachings, its scientific views often reflect the understanding of the ancient world. Contemporary science, grounded in observation, experimentation, and empirical data, explores the natural world’s intricacies with a methodological rigor distinct from religious texts. The dialogue between these perspectives underscores the importance of recognizing the distinct purposes and realms of religious and scientific knowledge. Recommendations include fostering interdisciplinary collaborations, promoting educational initiatives that integrate both perspectives, and facilitating public dialogues to enhance mutual understanding. Ethical reflections derived from shared principles offer common ground, while continued research into the historical and cultural contexts of biblical texts contributes to nuanced interpretations. Ultimately, the study advocates for an inclusive and enlightened approach that nurtures a harmonious coexistence between faith and reason. By implementing these recommendations, it aims to create an environment fostering dialogue and collaboration between theologians, scientists, and the wider public. Through such efforts, a richer understanding of the universe and the diversity of human knowledge emerges, embracing the complexities of existence and celebrating the shared pursuit of wisdom.

Cross-sectional study of assessment of lung cancer (LC) screening awareness in an underserved community in the Bronx, New York.

155 Background: LC remains the second most diagnosed cancer but is the leading cause of cancer death in the USA, accounting for 21% of all cancer deaths. Despite advances in screening and treatment, it remains the principal cause of cancer mortality worldwide. Notably, survival rates have improved from 21% to 25% over the past 5 years. However, LC screening with low-dose computed tomography (LDCT) is underutilized, with only 5.8% of eligible individuals screened in 2021. Methods: A prospective 29-question survey was conducted at St. Barnabas Health Care System in the Bronx, NY, from February to April 2024. The survey included patients aged 50-80, both former and active smokers. Data on demographics, social determinants, and knowledge of LC and LDCT screening were collected and processed using JASP Version 0.18.3. The study aimed to assess the community's knowledge of lung cancer screening, with demographic characteristics as secondary outcomes. Results: From all the surveys collected, 115 met the inclusion criteria, 53% male (61) and 47% female (54), with no significant difference between proportions (p=0.576). The median age was 63 years. Race: 73% were Hispanic, 22% Black, and 5% White, with significant differences from an equal distribution (p< 0.001). Legal Status, citizens (74%), followed by green card holders (17%). Most of the patients lived in the USA for over 20 years (90%), with very few having lived for less than five years (1%), indicating a long-term residency trend (p < 0.001). Education Level: high school education was the most common (58%), followed by middle school (17%) and elementary school (15%). Doctorate and graduate degrees were less common (7%). 91% of patients were aware of the relationship between cigarette smoking and LC, while 9% did not (p<0.001). On the other hand, 66% believed there was a relationship between e-cigarette use and LC, while 44% believed there was not. Patients with an income greater than $50,000 have significantly more knowledge of the screening tool for LC (STLC), as indicated by a Chi-square value of 50.87 (p < 0.05, with a critical value of 5.99). Patients with low education levels have less knowledge of the existing STLC, with a Chi-square of 143.587 (p<0.05 and a critical value of 9.488). Conclusions: Our study highlights critical disparities in LC awareness and knowledge of screening tools among different demographic groups. There is a clear need for targeted educational initiatives, especially for lower-income and less-educated populations, to improve understanding of LC risks associated with both traditional and electronic cigarette use. The significant presence of long-term Hispanic residents suggests that culturally tailored interventions could be particularly effective. Addressing these gaps is essential for enhancing lung cancer prevention and early detection efforts across diverse communities.

Comprehensive Benefits of Sodium-Glucose Cotransporter 2 Inhibitors in Heart Failure With Reduced Ejection Fraction: A Literature Review.

Sodium-glucose cotransporter 2 (SGLT2) inhibitors, initially developed for type 2 diabetes, have emerged as a promising treatment for heart failure with reduced ejection fraction (HFrEF). They show significant cardiovascular benefits, including reduced cardiovascular mortality and heart failure hospitalizations. This review consolidates knowledge on the efficacy of SGLT2 inhibitors in HFrEF, focusing on their mechanisms of action, clinical benefits, and patient outcomes. To consolidate existing knowledge on the efficacy of SGLT2 inhibitors in reducing cardiovascular mortality in HFrEF, with an emphasis on pathophysiology, clinical benefits, and patient outcomes, major medical databases such as PubMed, Scopus, and Web of Science were reviewed, prioritizing research published from 2020 to 2024. Key studies and clinical trials, including DAPA-HF and EMPEROR-Reduced, were analyzed to understand the impacts of SGLT2 inhibitors on HFrEF management. The review highlights the multifaceted mechanisms by which SGLT2 inhibitors exert their cardiovascular benefits, including osmotic diuresis, natriuresis, improved myocardial energetics, and anti-inflammatory and antifibrotic effects. Clinical trials have consistently demonstrated significant reductions in cardiovascular mortality and hospitalizations among HFrEF patients treated with SGLT2 inhibitors. These benefits are observed across diverse demographic and clinical subgroups, indicating their broad applicability in clinical practice. SGLT2 inhibitors significantly advance HFrEF management, reducing cardiovascular mortality and hospitalizations. However, gaps remain in long-term outcomes, early diagnostic indicators, and mechanisms of action. Future research should address these gaps and explore personalized medicine to optimize treatment. Integrating SGLT2 inhibitors into standard HFrEF management guidelines, supported by updated policies and educational initiatives for healthcare providers, will be crucial to maximize their therapeutic potential and improve patient outcomes.

The Influence of AI Literacy on User's Trust in AI in Practical Scenarios: A Digital Divide Pilot Study

ABSTRACTThis study explores the impact of Artificial Intelligence (AI) literacy on trust in AI across critical sectors, including transportation, healthcare, and social relationships. An online survey of 300 participants was conducted to examine trust levels in six practical AI application scenarios. The findings revealed that individuals with advanced AI literacy consistently demonstrate higher trust across all scenarios. In contrast, those with intermediate AI literacy exhibit more skepticism, particularly in high‐stakes contexts such as transportation and healthcare. This result indicates that the disparities in AI literacy can significantly shape trust levels, and the context of AI use matters. Therefore, targeted educational programs are needed to improve AI literacy, rectify misconceptions, and promote broader acceptance and trust in AI technologies. Further research should expand the demographic scope to further validate these findings and optimize educational initiatives for inclusive and equitable AI integration.

Cybersecurity Threats and Vulnerabilities in Online Banking Systems

The rapid expansion of online banking has introduced significant convenience and accessibility for consumers and financial institutions alike. However, it also brings a substantial increase in cybersecurity threats, making online banking systems prime targets for cybercriminals. This paper provides a comprehensive examination of the prevalent cybersecurity threats that online banking faces, including phishing attacks, malware, ransomware, man-in-the-middle (MITM) attacks, insider threats, and distributed denial-of-service (DDoS) attacks. We analyze these threats in-depth, exploring how each tactic is deployed to compromise security and exploit vulnerabilities within online banking systems. Moreover, this paper discusses specific vulnerabilities that exist in online banking platforms, such as weak authentication practices, insecure network connections, outdated software, and risks associated with third-party integrations. Through tables and graphical data, the paper offers a clear overview of the most common vulnerabilities and their prevalence, providing insights into how these weak points are exploited in the cyber landscape. The impact of such cybersecurity breaches on financial institutions is also considered, highlighting the consequences that follow a security breach, such as financial losses, reputational damage, regulatory fines, and customer distrust. The findings reveal that these impacts not only affect individual financial institutions but can also undermine public confidence in digital banking as a whole. Finally, the paper proposes several strategic defenses against these threats. Solutions include multi-factor authentication, end-to-end encryption, robust threat monitoring, regular security audits, and customer education initiatives, among others. Statistical data on the effectiveness of these strategies demonstrates their role in mitigating cyber risks and fortifying online banking systems against future attacks. This study concludes by emphasizing the critical need for continuous innovation in cybersecurity practices, as cyber threats continue to evolve in sophistication.

Non-partner Sexual Violence Among International College Students in the United States

The prevalence of non-partner sexual violence among college students is a pressing concern that demands urgent attention. Although an integral part of the education system, international college students are often underrepresented in various studies. This calls attention to understanding the cultural nuances and multiple factors affecting this population. The current research delves into the experiences of sexual abuse among international students within the last 12 months, focusing specifically on incidents where sexual penetration or unwanted sexual touching occurred without consent. The study sheds light on the frequency and demographics associated with these distressing incidents using data from a large-scale survey conducted over the past year, encompassing a sample size of 13,242 international student respondents. Results reveal alarming statistics, with a substantial proportion of international students reporting experiences of non-partner sexual violence. Specifically, 4.8% of participants reported being sexually touched without consent, 1.9% reported attempted sexual penetration without consent, and 1.6% reported actual sexual penetration or being made to penetrate someone without consent. Moreover, the analysis indicates significant associations between experiences of sexual abuse and key demographic variables such as gender, relationship status, and number of sexual partners. Further exploration through univariate regression unveils compelling insights into the intersectionality of sexual violence, highlighting disparities based on biological sex, relationship status, and number of sexual partners among international students. The present study underscores the urgent need for comprehensive prevention and intervention strategies to address the pervasive issue of non-partner sexual violence among international college students. By understanding the dynamics of these incidents and their correlates, institutions can tailor support services, advocacy efforts, and educational initiatives to create safer and more inclusive environments for all international students.

S346 Enhancing Anal Cancer Screening Proficiency in Internal Medicine Residents: A Targeted Educational Initiative

S346 Enhancing Anal Cancer Screening Proficiency in Internal Medicine Residents: A Targeted Educational Initiative

CP4-4 Oncology education initiatives at Taiwan Oncology Society (TOS)

CP4-4 Oncology education initiatives at Taiwan Oncology Society (TOS)

Deprescribing in Older Adults: Attitudes, Awareness, Training, and Clinical Practice Among Portuguese Physicians.

The importance of deprescribing in clinical practice is growing, particularly in aging populations with polypharmacy scenarios, making it a crucial matter in Portugal, one of Europe's most aged nations. The aim of this study was to investigate deprescribing awareness, training, attitudes, and practices among Portuguese physicians to inform future healthcare strategies. A cross-sectional study using an anonymous online questionnaire was disseminated through the Portuguese Medical Association. It gathered sociodemographic and professional data, and insights into deprescribing awareness, attitudes, training, and practices. Descriptive statistics were summarized as frequencies, percentages, medians, and interquartile ranges. For inferential analysis, the Chi-square test and Fisher's exact test were used to evaluate categorical variables, and the Mann-Whitney U test was used for continuous variables. The significance level was set at p < 0.05. A total of 425 valid questionnaires were included. The participants were mostly women (61.6%), with a median age of 45 (IQR 34 - 42). General practice/family medicine (34.1%) and internal medicine (16.2%) were the most common medical specialties. While 81.2% of the respondents were familiar with the term 'deprescribing', 55.4% reported no training. A vast majority (91.9%) reported practicing deprescribing, but a smaller fraction employed specific methodologies to deprescribe (39.8%) and criteria for identifying potentially inappropriate medications (38.7%). Training in deprescribing was significantly associated with higher deprescribing awareness (p < 0.001), the use of specific deprescribing methods (p < 0.001), the use of criteria to identify potentially inappropriate medications (p < 0.001) and having certification in geriatrics by the Portuguese Medical Association (p = 0.006). Family physicians showed higher familiarity with and training in deprescribing than hospital-based specialists (p < 0.001). Deprescribing methodologies were adopted more often by family physicians than by hospital-based specialists (p = 0.004). This study highlights widespread deprescribing awareness among Portuguese physicians, while simultaneously uncovering considerable gaps in training and inconsistencies in its application. These findings highlight the pressing need for targeted educational initiatives that could contribute to medication optimization for older adults in the national healthcare system. Furthermore, these findings emphasize the importance of policy development and medical education in promoting safe deprescribing.

512 Critical Care Documentation Basics: An Educational Initiative to Support Quality Improvement

512 Critical Care Documentation Basics: An Educational Initiative to Support Quality Improvement

Latent democratic potential: reflections on contemporary citizenship education in Singapore

AbstractDemocratic citizenship education aims to empower students for active participation in democratic deliberation and meaningful public action. However, defining 'democratic' is complex, and ideals vary. Singapore's education system has faced criticism for perceived shortcomings in preparing students for democratic engagement. Concerns include a lack of understanding of democracy, a tendency to accept hierarchy without critical assessment, and a superficial grasp of citizenship concepts. The social studies curriculum and overall school environment are often seen as limited in fostering democratic involvement. This is attributed in the literature to a lack of explicit commitment to democracy in Singapore's citizenship education. Instead, the system appears to lean towards uncritical adherence to national values and commitment to the nation. This paper challenges the focus on formal citizenship education by exploring the potential for democratic engagement within the broader Singapore curriculum. It argues that implicit democratic values emerge through initiatives like "Thinking School, Learning Nation" and the 21st-century competencies framework, fostering critical thinking, which is crucial for developing democratic dispositions. The analysis of alignment between competencies in Singapore education initiatives and those crucial for contemporary democratic participation offers a nuanced understanding of citizenship education beyond its traditional link to notions of liberal democracy. The paper contributes to debates about democracy's relevance in non-liberal democratic contexts, enriching our understanding of alternative pathways to civic engagement and possible futures for democratic citizenship.

Knowledge, Attitudes, and Practices Among Guardians of Boys Toward Concealed Penis.

Concealed penis (CP) is a condition involving a congenital abnormality of the external genitalia, wherein the penile shaft is partially or completely obscured by surrounding skin tissues, negatively affecting the psychological and physical health of children. The guardians, who are primarily responsible for the daily care of children, play a crucial role in the early detection of this condition. Therefore, this study aims to explore knowledge, attitude, and practices (KAP) toward CP among guardians of young boys; results would provide a theoretical basis for the development of health education programs. This web-based cross-sectional study was conducted among guardians of boys in the Department of Pediatric Surgery, local hospital between June 2023 and September 2023. A self-designed questionnaire was developed to collect demographic information of the guardians and to assess their knowledge, attitudes and practices toward CP. A total of 394 questionnaires were collected. Among the guardians, 143 (36.29%) of them were male, 375 (95.18%) were the parents of the children, 279 (70.81%) had a junior college or bachelor's degree, and 46 (11.68%) reported their children had CP. The knowledge, attitudes and practices scores were 4.00±2.00 (possible range: 0-7), 35.63±3.40 (possible range: 9-45), and 23.03±6.97 (possible range: 9-45), respectively. The structural equation model demonstrated that knowledge had direct effects on attitudes (β=0.63, p<0.001), and practices (β=0.81, p<0.001). Moreover, attitudes had direct effects on practices (β=0.43, p<0.001). This study found insufficient knowledge, positive attitudes, but poor practices toward the CP in guardians of boys, especially among participants from rural areas of families with lower income. It is recommended to tailor educational initiatives and implement strategies to bridge the knowledge-practice gap toward concealed penis in boys.

Community Participation in Development Planning is Driven by Leadership, Communication, and Education

General Background: Community participation in infrastructure development planning is crucial for ensuring sustainable growth and addressing local needs. Specific Background: In Wedoroklurak Village, Candi District, Sidoarjo Regency, low levels of community engagement in planning processes have raised concerns among local authorities and scholars. Knowledge Gap: While existing literature emphasizes the importance of community involvement, there is limited research focusing on the specific factors influencing participation in rural Indonesian contexts, particularly in relation to leadership, communication, and education. Aims: This study aims to analyze the factors affecting community participation in infrastructure development planning in Wedoroklurak Village, employing a qualitative descriptive approach. Results: Data were collected through interviews, observations, and documentation from key informants, including the Village Head, village secretary, and community leaders. The findings reveal three primary factors influencing low participation: (1) effective leadership by the Village Head, characterized by openness and authenticity; (2) robust communication between the village government and the community, facilitating a platform for dialogue; and (3) the educational background of residents, which impacts their understanding of development processes. Novelty: This research highlights the interplay between these factors, contributing to the understanding of community dynamics in rural Indonesia. Implications: The results underscore the need for enhancing educational initiatives and fostering transparent communication strategies to boost community participation in development planning. By addressing these aspects, local governments can improve engagement, leading to more effective and sustainable infrastructure projects that meet the needs of the community. Highlights: Leadership encourages community involvement in development planning. Good communication enhances community feedback and engagement. Education influences participation in infrastructure development processes. Keywords: Community Participation, Infrastructure Development, Leadership, Communication, Education

The Impact of Menstrual Hygiene Education on School Attendance Among Adolescent Girls in Rural Nepal: A Case Study of Gorkha District

This study explores the impact of menstrual hygiene education on school attendance among adolescent girls in rural Nepal, focusing on the Gorkha District as a case study. Despite existing initiatives to promote menstrual health education, significant challenges remain, including cultural stigma, lack of resources, and inadequate infrastructure, which contribute to high absenteeism rates among girls during their menstrual periods. The research examines the relationship between education programs and school attendance, highlighting examples where improved menstrual hygiene management has led to positive changes in attendance rates. The study also identifies gaps in knowledge, resources, and practices that hinder the effectiveness of current programs. Recommendations are made for expanding and enhancing education initiatives, along with policy and community strategies to support regular attendance, such as improved infrastructure, community engagement, and broader education efforts. This paper argues that addressing these gaps through targeted interventions is crucial for promoting gender equality in education and ensuring that menstruation does not become a barrier to learning.

Cultural adaptation and validation of the French version of the Antwerp pelvic floor knowledge questionnaire

AimsThe Antwerp Pelvic Floor Knowledge Questionnaire (APFK-Q) is a self-administered tool used for assessing women’s knowledge of the pelvic floor, an essential element of pelvic health education initiatives. The aim of this study was to validate the French version of the APFK-Q and to assess its psychometric properties. MethodsAcceptability of the cultural adaptation of APFK-Q in French (translation/back-translation) was assessed in two groups of women: one group not working in the healthcare sector (non-healthworkers, n = 112), and another of student midwives (n = 29). Twenty-three of the non-healthworkers agreed to take part in a test–retest step to assess reproducibility. Agreement of responses was measured for each question using Cohen’s kappa coefficient. Sensitivity to change was assessed before and after a pelvic-floor health education workshop. The proportion of correct answers was compared before and after the workshop using McNemar’s Chi2 test. Readability and the reading level required for optimal comprehension were assessed using the Flesch Reading Ease Score (FRES) and Flesch-Kincaid Grade Level test, respectively. ResultsSeventy percent (n = 72) of the non-healthworkers and 72 % (n = 21) of the students reported no comprehension difficulties. Agreement was very good (k > 0.8) for 46 % of the items and good (0.6–0.8) for 25 %. The proportion of correct answers was significantly higher for 72 % of the items after the pelvic-floor health education workshop. The French version of the APFK-Q was judged to be easy to understand according to the FRES test, with a score of 60.6. The school level required for optimal comprehension was estimated at 8th grade. ConclusionThe French version of the APFK-Q is an acceptable, reproducible, and easily understandable questionnaire that provides a broad description of women’s knowledge of the pelvic-floor sphere. Sensitivity to change was confirmed for most items, making it a useful tool for assessing the impact of pelvic-floor health education initiatives.

Unwanted cardiopulmonary resuscitation against patients' "Do Not Attempt Resuscitation" orders in community settings in Japan: A narrative review.

We aimed to synthesize existing research to elucidate the underlying factors and causes responsible for the high prevalence of unwanted cardiopulmonary resuscitation (CPR) occurring outside a hospital setting in Japan despite patients' Do Not Attempt Resuscitation (DNAR) orders. We conducted a narrative review by searching PubMed, EMBASE, and Scopus for English literature, and Google Scholar for Japanese literature. The key factors we identified included lack of documentation of resuscitation preferences, variation in the perception of other life-sustaining measures associated with DNAR, non-inclusion of the patient in discussions of goals of care, unlegislated and unstandardized DNAR orders, emergency medical service activation by the family or facility, the Fire Service Act that mandates life-saving measures irrespective of the presence of advance directives, fire department protocols and CPR decision-making, and death pronouncement authorization limited to physicians. This study identified the multifaceted factors and the potential triggers for unwanted CPR despite DNAR orders. These findings underscore the urgent need for comprehensive interventions encompassing educational initiatives, ethical considerations, systemic reforms, and legal adjustments to prevent future unwanted CPRs in Japan. Geriatr Gerontol Int 2024; ••: ••-••.