Middle Face Research Articles

English language learners’ language and literacy development: A brief synopsis of major theoretical orientations for middle school teachers

The purpose of this article is to present a brief synopsis of major theoretical orientations of second language acquisition (SLA) processes and offer practical implications for middle school teachers who work with English language learners (ELLs). ELLs’ academic needs in middle school settings are particularly unique. Compared to younger children, middle school ELLs face more challenging tasks. They need to develop both complex content knowledge and language skills at the same time to be successful in school. Given that ELLs’ language and literacy development is foundational to their successful academic learning across the curriculum, it is important for middle school teachers to deepen their theoretical understanding of ELLs’ language and literacy learning processes. Yet, many teachers experience difficulties in understanding SLA theories because the conceptually complex theories are often presented in an inaccessible manner, obscured by linguistic jargon. This article, drawn from a review of theoretical perspectives in the literature and over a decade of classroom studies, provides a synopsis of the major theoretical orientations. These theories provide important instructional implications on how middle school teachers can successfully support ELLs’ language and literacy learning across the curriculum.

Comparison of Single- Versus Dual-Vector Technique Using Facial Suspension Threads: A Cadaveric Study Using Skin Vector Displacement Analysis.

Facial suspension threads have been successfully used for facial soft-tissue repositioning. When using facial suspension threads, it is unclear which technique and/or material has the greatest lifting effect for the middle and lower face or which technique/material best reduces the appearance of the jowls. Three female and 2 male cephalic specimens of Caucasian ethnicity (65.2 ± 8.3 years; 20.72 ± 2.6 kg/m) were analyzed in an upright secured position. Polydioxanone and polycaprolactone bidirectional barbed facial suspension threads were introduced by an 18 G, 100 mm cannula. The single-vector technique aimed toward the labiomandibular sulcus, and the dual-vector technique aimed toward the labiomandibular sulcus and the mandibular angle. Computation of vertical lifting, horizontal lifting, and volume reduction at the jowls and along the jawline were calculated using 3D imaging. The dual-vector technique effected a greater vertical lifting effect (4.45 ± 2.78 mm vs 2.99 ± 2.23 mm) but a reduced horizontal lifting effect (0.33 ± 1.34 mm vs 0.49 ± 1.32 mm). The dual-vector technique effected less volume reduction at the jowls 0.32 ± 0.24 cc versus 0.41 ± 0.46 cc and less volume reduction along the jawline 0.46 ± 0.48 cc versus 0.87 ± 0.53 cc (dual-vector vs single-vector). This study provides evidence resulting from cadaveric observations for the overall nonsuperiority of the dual-vector technique compared with the single-vector technique.

Deep feature learning for gender classification with covered/camouflaged faces

The great attention to gender classification is increasing recently as genders carry rich information related to male and female social activities. Extracting discriminating visual representations for gender classification is challenging especially with covered or camouflaged faces. In this work, the authors propose a network that uses a combination of inceptions with variational feature learning (VFL) loss function. The proposed network recognises the gender of normal or covered/camouflaged faces through the middle face part. This network trained on the middle part of the faces that contain both eyes with a small margin from the top-left corner to the bottom-right corner of the area of the eyes. Experimental results showed that the proposed network achieved state-of-art performance on five public data sets: FEI, SCIEN, AR FACES, LFW, and ADIENCE. They also evaluated the authors’ network on another new collected data set for covered and camouflaged faces and obtained encouraging outcomes.

Unusual features in a child with Marshall-Smith syndrome due to a novel NFIX variant: Evidence for an abnormal protein function

Marshall-Smith syndrome (MSS) is a rare genetic condition characterized by different clinical features, such as accelerated skeletal maturation, growth retardation, neuropsychomotor delay, and characteristic facial abnormalities. This study describes a 2-year-old boy presenting longiline appearance, macrocephalus with trigonocephaly, prominent eyes with bluish sclera, middle face hypoplasia, micrognathia, dysplastic ears, hirsutism, narrow and asymmetrical thorax, hypoplastic scrotal sac, cryptorchidism, joint laxity, hypoplastic toenails, and large sacral dimple with prominent coccyx. Abdominal ultrasonography showed an enlarged left ectopic kidney and skull computed tomography revealed signs of early closure of the metopic suture. High-resolution GTG banding karyotype and high-density CytoScan HD array did not identify abnormalities associated to the patient clinical findings. NFIX sequencing revealed a de novo variant consisted of a seven nucleotides duplication in exon 8. We suggest that some clinical findings, as glaucoma, trigonocephaly and ectopic kidney are underestimated and should be considered within the clinical spectrum of the syndrome. In addition, the NFIX variant identified in our patient is unusual among patients with MSS and has not yet been described in the literature. We present some mechanisms that could be involved in the impairment of proper NFIX protein function.

The time is now! Preparing middle and high school teachers for Dual Immersion Programs (Spanish-English) in California: a readying examination of current practices, needs, and potentialities

ABSTRACT Teachers working in middle and high school Dual Immersion (DI) programs (Spanish-English) face unique sets of challenges: linguistic equity between the two languages of instruction, attrition due to high linguistic and academic expectations, and preparing DI students for standardized tests in English. In this article, we reflect on our current experiences both from the teacher preparation perspective and from daily teaching and learning in DI classrooms. From the intersection of our positionalities and lived experiences, we conceptualize the next steps in the preparation of future Dual Immersion (Spanish-English) secondary teachers. In doing so, we outline the specific skills middle and high school DI teachers must have in order to build effective practices around three key areas for Dual Immersion instruction: Bilingualism and Biliteracy, Student Achievement, and Socio-Cultural Competence. We argue that in order to guarantee the success and high quality of DI programs in middle and high school, Teacher Preparation Programs and School Districts should work together now developing a comprehensive and intentional preparation and support for middle and high school DI teachers and administrators working in these school sites.

Pattern and Causes of Oral and Maxillofacial Injuries Presented to a Tertiary Care Public Dental Hospital in Strictly Imposed COVID-19 Lockdown Scenario

The unprecedented COVID-19 pandemic has indelibly impacted routine healthcare provision across the globe. Nevertheless, management of traumatic injuries has remained a priority patient care service of oral and maxillofacial (OMF) practice. This study aimed to explore the pattern and mechanisms of OMF injuries presenting at a major public dental hospital during a COVID-19 lockdown period in Sri Lanka. An enhanced OMF injury surveillance system was established at the National Dental Hospital (Teaching) Sri Lanka (NDHTSL) on 1 March 2020. OMF injury surveillance data from 1 March 2020 to 31 May 2020 were collated from the “enhanced injury surveillance form”. This period overlapped with the strictly imposed island-wide COVID-19 community lockdown. Pre-COVID-19 period (November 2017 to January 2020) OMF injury data were compared with this period. OMF injuries were categorized as hard tissue, extra-oral or intra-oral soft tissue, upper and middle face fractures and mandibular fractures. Data were analyzed with descriptive statistics, Fisher’s exact and Chi-square tests of significance. A total of 361 OMF injuries were identified among 208 patients who were predominantly males (71.6%); mean age was 24.95 ± 2.76 years. Injuries to gingivae and oral mucosa (26.9%) were the leading type, followed by extra-oral soft tissues (22.1%), periodontal injuries (20.7%) and hard tissue injuries (20.2%). Upper face and mandibular fractures accounted for 2.9% and 1.9%, respectively. Most patients sustained their injuries due to falls at their homes and surrounds. This was significantly increased compared to the pre-COVID-19 period (p = 0.0001). The significant increase in OMF injuries associated with falls around the home during the COVID-19 lockdown scenario in Sri Lanka compared to the pre-COVID-19 period may need further investigation in order to understand the how these injuries may be prevented.

Stable middle-aged face recognition: No moderation of the own-age bias across contexts.

The own-age bias (OAB) has been proposed to be caused by perceptual expertise and/or social-cognitive mechanisms. Investigations into the role of social cognition have, however, yielded mixed results. One reason for this might be the tendency for research to focus on the OAB in young adults, between young and older adult faces where other-age individuation experience is low. To explore whether social-cognitive manipulations may be successful when observers have sufficient other-age individuation experience, we examined biases involving middle-aged other-age faces and the influence of a context manipulation. Across four experiments, young adult participants were presented with middle-aged faces alongside young or older adult faces to remember. We predicted that in contexts where middle-aged faces were positioned as other-age faces (alongside young adult faces), recognition performance would be worse than when they were positioned as relative own-age faces (alongside older adult faces). However, the context manipulations did not moderate middle age face recognition. This suggests that past findings that context does not change other-age face recognition holds for other-age faces for which observers have higher individuation experience. These findings are consistent with a perceptual expertise account of the OAB but more investigation of the generality of these results is required.

Effects of Persistent Concussion Symptoms on Executive Function in Working-aged Adults using a Novel Sensorimotor Assessment Tool

To examine neurocognitive performance of persistent concussion symptom patients using a novel sensorimotor technology. In patients with persistent concussion symptoms, neurocognitive deficits have been routinely identified; however, most of the current literature focuses on athletes and military veterans. Middle aged community members face unique challenges related to jobs, family, and transportation which can all be adversely affected by neurocognitive deficits. Thirteen adults (44.3 ± 12.6 years) with self-reported persistent-concussion symptoms (PCS) at least 3 months post-injury, and thirteen sex and age matched healthy controls (37.5 ± 8.8 years) were recruited. Participants performed the Trail-Making Test A (TMT-A) and Trail-Making Test B (TMT-B) on a novel sensorimotor assessment tool, the KINARM (BKIN Technologies, Kingston, ON, Canada). Using their dominant hand, TMT-A required participants to connect numbered dots in ascending order as quickly as possible. TMT-B required connecting dots with either a number or letter inside, in an alternating number-letter fashion (i.e.,: 1-A-2-B-3-C…). Total number of symptoms and a symptom severity score were assessed using the Rivermead Post Concussion Symptoms Questionnaire (RPQ). An independent samples t-test was used to analyze group differences of total time to completion, dwell time, and number of errors. As expected, PCS patients had a significantly higher number of symptoms and severity score (PCS: 13.4 ± 2.3 and 36.2 ± 14.5, respectively; Controls: 3.4 ± 3.7 and 5.3 ± 5.6, respectively, p < 0.001). PCS patients were significantly slower on TMT-A (46.3 ± 20.1 sec; and 34.7 ± 6.5 sec respectively, p = 0.047). There were no group differences in TMT-B. Our results suggest that neurocognitive function may remain unaffected by persistent concussion symptoms in working-aged adults. The lack of task performance differences may be a result of neurocognitive function recovery, or the need for a more sensitive task to assess neurocognitive function in this population.

Housing tenure and educational opportunity in the Paris metropolitan area

This paper examines the relationship between housing tenure and educational opportunities in the Paris metropolitan area. Using census microdata, we show that the middle classes face uneasy trade-offs between housing tenure and access to attractive educational resources. Living in high-quality school contexts is associated with renting, whereas access to homeownership mostly unfolds in poor-performing school areas. This tension is not observed for other social strata. Based on fieldwork conducted in Paris suburbs, we highlight the interweaving of middle-class housing and school choices. Some families may use the rental sector to live close to attractive schools. In mixed neighbourhoods, homeowners either choose the local school or opt for circumvention strategies. Because of the dramatic increase of housing prices, the interplay between housing tenure and the unequal geography of education is crucial to understand social stratification and social mobility patterns in large cities, particularly among the middle classes, as well as to improve public policies aimed at reducing housing and school inequalities.

Аналіз особливостей травматичних ушкоджень середньої зони обличчя

Currently, fractures of the middle face area remain a serious problem of maxillofacial traumatology because there is not only an increase in the number of injuries to the bones of the facial skull, but also the sever character of these injuries, and an increasing number of post-traumatic complications. This is due to the increase in crime, alcoholism, the proliferation of weapons among the population, the increase in traffic accidents, and injuries in the war zone. The purpose of the study was a retrospective analysis of the features of the damage to the middle face area of patients in a large industrial region. Material and methods. We conducted a retrospective analysis of the injury features of the middle face area in 416 patients who became patients of the department of head and neck surgery for the period from January 1, 2010 to December 31, 2019. Results and discussion. The study results showed that the vast majority (χ2 = 529.9; F = 0.000000; p &lt;0.05) of patients were male. Men had by 79.3 (OR = 79.29; F = 0.000000) times higher risk of middle face injury than women. The risk of traumatic face injury in women increased with the age. Thus, in the group of women aged 61+ it was by 29.6 times higher than in the group of women aged 21-30 (OR = 29.6; F = 0.003203). The greatest number of injuries was observed in the age group of 21-30 years. Assessment of the injury risk in this age group showed that it was by 35.5 times higher than in the group of patients aged 61+ and by 2.1 times higher than in the group aged 31-40. Conclusion. The main etiological factor of injuries of the middle face area was domestic trauma, which was 369 (88.7±1.5)% of cases, which was significantly more (χ2 = 498.5; F = 0.000000; p &lt;0.05) than other types of injuries. The risk of domestic injury was by 61.6 times higher than other types of injury. The study results proved that criminal injuries had the highest frequency among all types of injuries (50% of all types of injuries), fall injury was on second place (38%), and road accidents injuries were on third place (7%). A significant majority of the middle face injuries had men, the number of women with injuries of the middle face area increased significantly with the age. The largest number of patients (71.4%) with injuries of the middle face area occurred in the age groups 21-30 and 31-40, that is people of working age

Prevalence of damage to the jaw, cheekbones, nose and orbital zone according to the department of maxillofacial reconstructive and plastic surgery of the national hospital of the ministry of health of the kyrgyz republic in 2010–2018

The article presents a systematic literature review of data on fractures of the jaws, middle part of the face. The types, causes of injuries of maxillofacial area are considered. It highlighted the main methods of diagnosis and treatment of patients with lesions of the middle face. The retrospective analysis of the history of the diseases indicates the need for comprehensive studies aimed at studying the frequency, structure, and location of damage to the middle facial bones in modern conditions.

Temporal Fossa Atrophy in Aesthetic Medicine: Anatomy, Classification, and Treatment.

Summary:Hyaluronic acid fillers indisputably represent an important tool for face rejuvenation and volume restoration. The temporal area has recently been considered as a potential site of injection. As it happens in the middle face and in other regions of the face, the temporal fossa changes according to the aging process. In a young person, the temple profile has a fullness aspect, and this contributes to giving the face a beautiful and healthy appearance. With age, the loss of volume leads the bone prominences to be visible. The aim of this article is to classify the temporal fossa atrophy and get better into the anatomy, identifying the ideal plane to inject in, through the use of a safe and reliable technique. Cadaver dissections have been performed to specifically describe the anatomy of the temple layer by layer. The authors’ preferred technique, called interfascial by cannula implantation, is discussed. All the treated patients reported a good improvement by survey according to the Global Aesthetic Improvement Scale scale. No major complications were detected. No ecchymosis neither swelling were documented. Although further studies are necessary to broaden the casuistry and better verify the potentiality of this technique, the authors do believe that it could be considered a very reliable procedure with pretty consistent results, if supported by an adequate and imperative anatomical knowledge.

Facial vascular danger zones for filler injections

Filler injections are widely used for facial rejuvenation. The technique is safe as long as some precautions are respected. In this review we will focus on vascular anatomy in the upper, middle and lower face. We performed a PUBMED research on "facial danger zones" and "filler injections" and "hyaluronic acid" and "vascular compromise" with a focus on the last decade. This is of particular importance since vascular compromise is one of the most severe adverse events possibly leading to tissue necrosis and in rare cases to loss of vision. We describe the danger zones in these esthetic units and provide recommendations how to avoid severe adverse events. We report on temporal region, glabella and nose, infraorbital region, nasolabial folds and nasal triangle, lips, and chin. Although we focus on hyaluronic acid fillers, our recommendations will also scope other filler types and autologous adipose tissue transfer. We also take a closer look on innovations to improve the safety of facial filler injections. Facial rejuvenation with hyaluronic acid fillers is a popular method. It is safe if the facial danger zones are recognized and proper injection techniques and fillers are used.

Healthcare worker perceptions of the implementation context surrounding an infection prevention intervention in a Zambian neonatal intensive care unit

BackgroundInfants in the neonatal intensive care unit (NICU) are particularly susceptible to healthcare-associated infections (HAIs). NICUs in low- and middle income countries face additional challenges to HAI prevention. There is a need to better understand the role of the implementation context surrounding infection prevention interventions in low- and middle income countries.AimThe aim of this study was to identify NICU healthcare worker perceptions of an intervention to reduce bloodstream infections in a large Zambian NICU.MethodsSemi-structured interviews were conducted with NICU staff during a prospective cohort study examining the impact of an infection prevention bundle on bloodstream infections. Interviews were analyzed using an integrated approach, combining inductive theme generation with an application of the Consolidated Framework for Implementation Research (CFIR).ResultsInterviews were conducted with 17 NICU staff (5 physicians and 12 nurses). Respondents believed the bundle elements were easy to use, well-designed and facilitated improved performance. Four organizational characteristics that facilitated HAI transmission were identified – (1) lack of NICU admission protocols; (2) physical crowding; (3) understaffing; and (4) equipment shortages. Respondents suggested that NICU resource constraints reflected a societal ethos that devalued the medical care of infants. Despite the challenges, respondents were highly motivated to prevent HAIs and believed this was an achievable goal. They enthusiastically welcomed the bundle but expressed serious concern about sustainability following the study.ConclusionsBy eliciting healthcare worker perceptions about the context surrounding an infection prevention intervention, our study identified key organizational and societal factors to inform implementation strategies to achieve sustained improvement.

Individual and environmental dimensions influencing the middle managers’ contribution to safety: the emergence of a ‘safety-related universe’

Even if enhancing safety remains a key challenge in civil aviation, safety research has mainly focussed on front line operators, senior managers and safety managers. This paper aims to shed light on the middle managers, more specifically on the overall context that influences their contribution to safety in their daily operations, and the challenges they face. Over a two-year period, extensive field research was undertaken involving six sector organisations, and overall forty-three middle managers. Interviews were conducted to capture the participants’ views and experiences in embedding safety-related aspects in their daily activities and actions. A data-driven approach was used to support the emergence of recurring codes/themes that could describe the conditions the middle managers face in their organisations, and explain how the specific factors interplay and impact on their action. NVivo, with its tools, supported the entire research process (data storage, codification, both qualitatively and quantitatively descriptive analysis at code level, and explanatory analysis at codes-relationship level). Our results suggest a number of conditions/dimensions (internal and external to the organisation) that interplay to either support or hinder the middle managers’ contribution to safety. This contribution is translated in practices (i.e. strategies and actions that the middle managers apply to support safety-related outcomes) modulated by a certain ‘mindset’ that each middle manager possesses as a result of past experiences, background education and view on the role of a manager. These aspects are interrelated not only with the middle managers’ safety-related practices directly, but also with one another. To understand management contribution to safety, and what may promote or hinder it, one should adopt a systemic view combining individual, organisational, external aspects and their interrelations.

An analysis for the variability of soft tissue facial profile

The purpose of this study was to investigate whether there is relationships between the skeletal craniofacial structures and the variability of facial profile. The sample consist of 100 cephalometric films [50 males & 50 females for adults (18-25years) having normal dental class I occlusion] collected from POP department, collage of dentistry in Mosul university. The sample classified according to skeletal classification into class I, II, & III also classified according to the profile into:- cisprofile,orthoprofile&transprofiles We measured the length of 3 skeletal bases, in addition to the position of pogonion& the thickness of soft tissue covering the anterior aspect of middle and lower face area. The variables entered spss computer system for analysis, we found that males have more skeletal CII & III than females, but females have more skeletal Cl II. males have larger records for all the variables & the difference is significant

The Unmet Need for Clinical Guidelines on the Management of Patients with Plaque Psoriasis in Africa and the Middle East.

PurposeDermatologists practicing in African and Middle Eastern countries face numerous challenges when managing patients with plaque psoriasis, especially those with disease in a difficult-to-treat anatomic area or those who are a pediatric, geriatric, or pregnant patient. The publication of comprehensive, up-to-date, region-specific clinical guidelines may help to address some of these challenges and improve outcomes. We conducted a literature review to identify recent guidelines and other publications describing patients with plaque psoriasis in Africa and the Middle East.Patients and MethodsAn online literature search of the PubMed database was conducted to identify publications reporting clinical guidelines and research studies on plaque psoriasis. The search included all articles published from January 2008 to March 2020 inclusive. The titles and abstracts of all search results were screened by a reader to identify those that described patients in Africa or the Middle East.ResultsA total of 145 publications were identified by the literature search and screened by a reader. There were 10 publications that described patients in Africa or the Middle East: 4 research articles, 3 reviews, 2 guidelines, and 1 case study. The 2010 guidelines from South Africa made recommendations for treating plaque psoriasis of varying severity, although without specific recommendations for difficult-to-treat anatomic areas or pediatric, geriatric, or pregnant patients. The 2014 guideline on biologics from Saudi Arabia included recommendations for the use of these agents in patients with plaque psoriasis, including difficult-to-treat anatomic areas and pediatric patients (TNF inhibitors only), but provided no recommendations for pregnant or geriatric patients.ConclusionThere is an urgent unmet need for comprehensive clinical guidelines on the management of patients with plaque psoriasis in Africa and the Middle East. Region-specific studies on the epidemiology, burden of disease, and the safety and effectiveness of newer pharmacotherapies are needed to support the development of such guidelines.

Students’ Resistance Behaviors: What Do Turkish Primary Teachers Face?

Abstract Introduction: Students could react to the learning activities, teachers, or administrators knowingly and willfully, many times intentionally by resisting in various ways. A detailed analysis of this definition indicates that unlike naughty behaviors, resistance behaviors do not develop suddenly, they are often planned beforehand by the student, and they contain some messages to the person or institution they are directed at. These kinds of behaviors could have negative effects not only on students’ academic, social, and psychological development but also on teachers’ professional satisfaction. Therefore, these issues should be elaborated carefully. However, despite the importance indicated in the literature, students’ resistance behaviors are one of the neglected issues that are not investigated adequately. With reference to this need, the presented study aims to identify perceptions of primary school teachers about students’ resistance behaviors. Methods: The participants were 152 primary school teachers. Data were collected through the Student Resistance Behaviors Scale for Teachers (SRBS-T) and Teacher Interview Form. In addition to descriptive statistics, data were analyzed using t-test and one-way ANOVA. Also, a qualitative descriptive analysis was conducted regarding qualitative data of the study. Results: Results show that the mean scores for SRBS were “medium” on a 5-point Likert scale. While teachers’ perceptions about resistance behaviors showed no significant differences according to gender and the type of school they graduated from, scores showed significant differences in terms of teachers’ years of seniority. According to the teachers, the most encountered resistant behaviors were gathered under the themes of resistance to teacher authority and hostile attitudes towards the teacher/peers. Discussion: Through discussion, the results obtained by the scale and interviews were discussed. All the findings showed that teachers are important receivers of resistance behaviors and they are facing with different types of resistance in the classroom. Limitations: It is obvious that these results were limited to the reached primary school teachers. Another limitation was that the data within the study collected via SRBS-T and interviews. Conclusions: The study showed that teachers and students are the key components of the educational process and students could show resistance to both the process and teachers in different ways. As this study only focused on primary teachers’ experiences, more studies could be organized through understanding the resistance middle and high school teachers face with as well. Further research could be conducted with students to see how they feel and behave when they feel resistance as well as with other teachers working at various levels of education and in various institutions.

Clinical validation of the temporal lifting technique using soft tissue fillers.

While the temporal lifting technique has gained increasing attention, there is a dearth of objective and reliable evidence of its effects. The objective of the present study is to analyze the ability of the temporal lifting technique to reduce the midfacial volume by soft tissue repositioning and to achieve an improved pan-facial appearance by targeting exclusively the subdermal plane of the posterior and superior temple with soft tissue fillers. A total of 12 patients (1 male and 11 females) with a mean age of 36.75±6.6years and a mean body mass index of 23.04±1.3kg/m2 were included in this prospective clinical single-center interventional study. Injection-related outcome was evaluated utilizing 3D skin vector displacement and surface volume analyses and scoring based on five different evaluators. Three months after the treatment, the global esthetic improvement scale rating showed an improved outcome (3.08) when evaluated by the independent observers, very improved outcome when evaluated by the treating physician (4.33), and exceptional improvement when rated by the patient (4.83). Temporal volume improved by 0.36 (P<.001), lower cheek fullness by 0.47 (P<.001), and jawline contouring by 0.51 (P<.001). No major adverse events were reported during the 3-month observational period. Objective outcome measures have provided evidence that by augmenting the posterior superior temple the volume of the middle face can be reduced and the contour of the jawline can be accentuated; this is due to the underlying fascial anatomy and the resulting soft tissue re-position.

A social-ecological examination into the research, policy and health service delivery environment related to early marriage and sexual and gender-based violence among youth in Jordan

BackgroundThe determinants of sexual- and gender-based violence (SGBV) and early marriage are embedded across different levels of the social ecological system, including at the individual, family, community, and policy levels. In Jordan and the Middle East, SGBV, honor killing, and early marriage are priority public health and human rights issues that often overlap, and affect a significant percentage of youth. Jordan is home to a large number of refugees from across the Middle East, who may be even more vulnerable to these forms of violence than the local youth. The purpose of this analysis is to 1) synthesize the existing literature and 2) present the perspectives of key stakeholders to identify research gaps, programmatic lessons learned, and opportunities for policy change from an ecological perspective at the individual, community, health-system, and policy/legal levels.MethodsThis study includes 1) a systematic literature review of both published and unpublished literature since 2008 and 2) focus group discussions (FGDs) with key stakeholders representing 18 international and local governmental and non-governmental organizations.ResultsThe literature review included 27 documents. Stakeholder discussions highlighted important research and policy gaps. Prevalence estimates of SGBV, honor killing, and early marriage vary across sources; however, all of them indicate that they remain important issues for youth in Jordan. Several sources indicate that early marriage has been increasing in Jordan since the beginning of the war in Syria, especially among Syrian refugees. Refugee youth are particularly vulnerable to SGBV and early marriage given the worsening economic situation in Jordan. The norms, attitudes, and practices that support SGBV in Jordan appear to be reinforced within families and communities. Despite ongoing programs, SGBV services are limited, especially for youth, and there is little awareness of service availability amongst target populations. Laws and policies continue to offer legal justification for SGBV, honor killing, and early marriage.DiscussionAs countries across the Middle East face instability and continue to struggle with the urgent health needs of large refugee and youth populations, this review provides valuable insight relevant to research, programs, and policy in Jordan and across the region.