Support For Programs Research Articles

Determinants of Occupational Health and Safety Compliance by Malaysian SMEs

Occupational safety and health (OSH) are a critical component of effective business governance. Efficient management of occupational safety and health fosters potential for growth and sustainability, and conversely. Disregarding occupational safety and health negatively impacts all stakeholders, from individual workers to national healthcare systems. This indicates that stakeholders can benefit from enhanced OSH compliance via consistent approaches. The primary principle of global OSH compliance is the mitigation and reduction of accidents, incidents, and diseases. A comparable viewpoint is relevant for small and medium-sized firms (SMEs), including those in Malaysia. This study investigated the factors influencing OSH compliance among Malaysian SMEs using a quantitative research methodology. The impact of five critical determinants: top management support, human resource practices, training and education, organisational attitude, and organisational awareness, on the attainment of OSH compliance was evaluated, drawing from literature support. A survey was done utilising convenience sampling with 400 SMEs in Malaysia. Data was gathered from 380 responding SMEs and examined using structural equation modelling (SEM) with partial least squares (PLS). The statistical findings indicated that human resource practices, organisational attitudes, and organisational awareness were key predictors of occupational safety and health compliance in the sampled Malaysian SMEs. The significance of administering OSH focused human resource policy, particularly the HR practice of endorsing safety and related training programs, has facilitated enhanced support for OSH training programs and employee awareness. The findings indicated that SMEs’ practice of displaying hazardous warning signs and promoting incident reporting has resulted in improved occupational safety and health compliance. The level of SMEs’ awareness regarding the necessity to review standard operating procedures before initiating work, safety information related to hazardous materials, understanding the risks associated with chemical substances, and the segregation of waste materials prior to disposal has facilitated effective OSH compliance among the participating SMEs. The investigation yielded multiple implications derived from the results obtained.

ADULT EDUCATION PROGRAM IMPLEMENTATION FACTORS AND ADULT LITERACY LEARNING OUTCOMES IN RWANDAA CASE OF GICUMBI DISTRICT

The research assessed adult education program implementation factorsand adult literacy learning outcomes in GicumbiDistrict, Rwanda. Specifically, the research identified teaching methods that affect adult literacy learning outcomes in GicumbiDistrict, Rwanda, established the extent of adult literacy learning outcomes in GicumbiDistrict, Rwanda and assessed the relationship between adult education program implementation factors and adult literacy learning outcomes in GicumbiDistrict, Rwanda. The population in this study consisted of 4625 respondents, while their sample size was 368. Sample size determination was done by using Yamane formula.Descriptive survey design was adopted by the researcher as the study wanted to obtain insight for basic information provision in the study area. This study used questionnaire, interview, and observation to gather data. The questionnaire was administered to instructors and learners while the interview was given to District Director of Education, District Education Officer and Sector Education Officers. It usedpurposive, simple random sampling and stratified methods. The data of the study were analyzed in tables and charts by relying on descriptive statistics. The researcher used statistical tools like means, percentages, standarddeviations, correlation coefficients and coefficients as regression models.IBM SPSS Version 21 was used to organize and summarize data with accuracy and finding evidences assurance. Both quantitative and qualitative methodologies were used, including content analysis. Regarding the first objective, results indicate that 74.9% strongly agreed that their instructor puts them in a small group to complete tasks, 64.2% strongly agreed that they take an active role in their learning by setting their own goals, 75.6% strongly agreed that their instructor uses games to increase their motivation, and 88.1% strongly agreed that they act out specific roles to learn different concepts.The implication of this is that the instructors use learner-centered teaching methods in order to improve adult literacy learning outcomes. For the second objective, 86.6% strongly agreed that improved learners living standards indicate adult literacy learning outcomes 74.9% strongly agreed that an increased number of small businesses indicates adult literacy learning outcomes 75.6% strongly agreed that increased digital communication indicates adult literacy learning outcomes and 63.2% strongly agreed that improved health practices indicate adult literacy learning outcomes. Results on the effects of teaching methods on adult literacy learning outcomes in public adult literacy centres in Gicumbi District. The study revealed a strong positive relationship between group learning, self-directed learning, and role-playing, as well as between game-based learning and improved learners living standards, small business growth, and digital communication. The positive correlation was less than 0.05, indicating that adjustments in group learning and self-directed learning positively impacted these factors. The study also found a significant positive correlation between game-based learning and improved learners living standards, small business growth, and high attractiveness rate. This implied that there is a positive correlation among adult education factors and adult literacy learning outcomes. The Pearsons p value was than 0.05. The researcher recommended that the Ministry of Education should provide robust government, support, clear guidelines, and infrastructure for adult education programs. Rwanda Basic Education Board should involve NGOs and local communities and authorities in monitoring and evaluating the functioning of adult education at grass root level. Gicumbi District should use quality materials, well-trained teachers for improved effectiveness.

PASTA: Programming and Automation Support for Scalable Task-Parallel HLS Programs on Modern Multi-Die FPGAs

In recent years, the adoption of FPGAs in datacenters has increased, with a growing number of users choosing High-Level Synthesis (HLS) as their preferred programming method. While HLS simplifies FPGA programming, one notable challenge arises when scaling up designs for modern datacenter FPGAs that comprise multiple dies. The extra delays introduced due to die crossings and routing congestion can significantly degrade the frequency of large designs on these FPGA boards. Due to the gap between HLS design and physical design, it is challenging for HLS programmers to analyze and identify the root causes, and fix their HLS design to achieve better timing closure. Recent efforts have aimed to address these issues by employing coarse-grained floorplanning and pipelining strategies on task-parallel HLS designs where multiple tasks run concurrently and communicate through FIFO stream channels. However, many applications are not streaming friendly and many existing accelerator designs heavily rely on buffer channel based communication between tasks. In this work, we take a step further to support a task-parallel programming model where tasks can communicate via both FIFO stream channels and buffer channels. To achieve this goal, we design and implement the PASTA framework, which takes a large task-parallel HLS design as input and automatically generates a high-frequency FPGA accelerator via HLS and physical design co-optimization. Our framework introduces a latency-insensitive buffer channel design, which supports memory partitioning and ping-pong buffering while remaining compatible with vendor HLS tools. On the frontend, we provide an easy-to-use programming model for utilizing the proposed buffer channel; while on the backend, we implement efficient placement and pipelining strategies for the proposed buffer channel. To validate the effectiveness of our framework, we test it on four widely used Rodinia HLS benchmarks and two real-world accelerator designs and show an average frequency improvement of 25%, with peak improvements of up to 89% on AMD/Xilinx Alveo U280 boards compared to Vitis HLS baselines.

Opportunities and Challenges of CSR Digitalization: Lessons from Major Companies in Indonesia in Mitigating Post-COVID-19 Unemployment

In the aftermath of the COVID-19 pandemic, global impacts extended beyond communities' physical and mental health, encompassing nations' economic stability. Many companies responded actively by contributing to government efforts in addressing post-pandemic economic challenges, particularly through Corporate Social Responsibility (CSR) initiatives. This research aims to identify opportunities and challenges in digitalizing CSR to mitigate the financial impacts of the COVID-19 pandemic. The study focuses on the CSR program, Indosat Digital Camp (IDCamp), implemented by Indosat Ooredoo. The objective is to evaluate the opportunities and challenges faced by Indosat Ooredoo in digitizing CSR to address the economic impacts of the COVID-19 pandemic. Utilizing a qualitative methodology and a single case study design, the research involves interviews with 6 representatives from Indosat Ooredoo and 10 IDCamp participants from Yogyakarta, Bandung, Jakarta, Kabupaten Ogan Komering Ulu, and Kota Tangerang. Research findings reveal that digitalizing CSR presents sustainable opportunities as it can reduce unemployment, provide industry-relevant competencies, align with Indonesia's digital era, remain relevant to post-COVID-19 digital activities, align with government programs, support the demand for digital talents, and attract community participation due to its practical nature. However, IDCamp implementation poses potential challenges, including responsive organization, internet network issues, government program support, program updates, established execution systems, coordination with mass media, and ensuring digitalization facilitates community participation in CSR programs. Keywords: COVID-19 pandemic, CSR digitization, CSR Collaboration, CSR opportunities, CSR challenges.

Learning experiences from an online QI fellowship programme during COVID-19 – a qualitative study

BackgroundDuring the COVID-19 pandemic in the United Kingdom, multiple aspects of everyday human existence were disrupted. In contrast, almost all levels of educational learning continued, albeit with modifications, including adaptation to virtual—or online—classroom experiences. This pedagogic transition also occurred in the National Institute of Health and Care Research Applied Research Collaboration Northwest London’s (NIHR ARC NWL) Improvement Leader Fellowship, an annual programme focusing on quality improvement (QI). This qualitative study aimed to understand how these changes impacted the Fellows’ learning experience.MethodsWe explored the experiences of two cohorts of programme Fellows (n = 18, 2020–2021 and n = 15, 2021–2022) with focus groups, analysed under a constructivist qualitative research paradigm.ResultsThe two primary and four sub-themes that emerged were: Online QI learning experience (benefits and challenges) and Implementing online QI learning (facilitators and barriers). While benefits had three further sub-themes (i.e., digital flexibility, connection between learners, and respite from impact of COVID-19), challenges had four (i.e., lack of interaction, technological challenges and digital exclusion, human dimension, and digital fatigue). While the facilitators had three sub-themes (i.e., mutual and programmatic support, online resource access, and personal resilience), barriers had one (i.e., preventing implementation and lack of protected time).ConclusionDespite challenges to in-person ways of working, online learning generally worked for action-orientated QI learning, but changes are needed to ensure the effectiveness of future use of virtual learning for QI. Understanding the challenges of the translation of learning into action is crucial for implementation learning, gaining insight into how improvement Fellows navigated this translation when learning remotely and implementing directly in their workplace is key to understanding the evolving nature of implementation over the pandemic years and beyond.

Acceptable outcomes of liver transplantation in uninsured patients under the coverage of a state assistance program.

The lack of health insurance is a major barrier in the access to healthcare even in case of life-saving procedures such as liver transplantation (LT). Concerns about worse outcomes in uninsured patients have also discouraged the evaluation and transplantation of patients without adequate health insurance coverage. The aim of this study is to evaluate outcomes from the largest cohort of uninsured patients who underwent LT with the support of a state payment assistance program (also called charity care). This study included all consecutive patients who underwent LT at a single center from 2002 to 2020. Demographic, clinical, social variables and outcome metrics were collected and compared between insured and uninsured patients. Among a total of 978 LT recipients, 594 had private insurance, 324 government insurance (Medicare/Medicaid), 60 were uninsured and covered under a state charity care program. In the charity care group, there was a higher proportion of Hispanic subjects, single marital status, younger age, and high-MELD score patients. The 1- and 3-year patient survival rates were 89.0% and 81.8% in private insurance patients, 88.8% and 80.1% in government insurance recipients, and 93.3% and 79.6% in those with charity care (p=0.49). There was no difference in graft survival between insured and uninsured patients (p=0.62). The three insurance groups presented similar hospital length-of-stay and 30-day readmission rates. In both univariate and multivariate analysis, uninsured status (charity care) was not associated with worse patient survival (HR:1.23, 95%CI: 0.84-1.80, p=0.29) or graft survival (HR:1.22, 95%CI:0.84-1.78, p=0.29). In conclusion, there was no difference in outcomes after LT between insured and uninsured patients. A charity care program may be an effective tool to mitigate socio-economic disparities in both outcomes and access to LT.

The equity road ahead for financing non-national immunization program vaccines in China: challenges and opportunities from a qualitative study

BackgroundIn China, national immunization program (NIP) vaccines benefit from robust financial support and have achieved high coverage. Non-NIP vaccines rely on fragmented funding sources, mostly out-of-pocket payment, and face sub-optimal and inequitable coverage. Sustainable financing needs to be secured for addressing equity in non-NIP vaccine delivery. However, discussion and understanding of this issue remain limited. This study aims to analyze the current situation, comprehensively identify challenges and opportunities in non-NIP vaccine financing, and offer suggestions to enhance vaccine uptake and improve public health.MethodsBetween July and December 2023, we conducted a series of semi-structured, in-person interviews with 55 stakeholders from the Health Bureau, Centers for Disease Control and Prevention, Medical Insurance Bureau, and Finance Bureau across five provinces in China. Participants were selected through stratified sampling, and the interviews mainly included their involvement in non-NIP vaccine financing, challenges faced, and strategies for improvement to enhance financing performance. Informed consent was obtained, and thematic analysis was used to analyze the data.ResultsNon-NIP vaccine financing sources include out-of-pocket payments, government fiscal, health insurance and other external funds. These four channels differ in vaccine types covered, costs, and target populations, each with unique challenges and opportunities. High out-of-pocket costs remain a significant barrier to equitable vaccine uptake, while market competition has lowered the vaccine price and improved accessibility. Local fiscal support for free vaccination programs faces challenges related to sustainability and regional disparity, though governmental commitment to vaccination is growing. Nevertheless, centralized procurement organized by the government has lowered the price and reduced the financial burden. Despite legal restrictions on using basic health insurance for vaccinations and limited commercial insurance options, private medical savings accounts and mutual-aid mechanisms present new opportunities. Although the scope and impact of external support are limited, it has successfully increased awareness and social attention to vaccination.ConclusionRelying on individual payments as the main financing channel for non-NIP vaccines is unsustainable and inadequate for ensuring universal vaccine access. A concerted and synergistic approach is essential to ensure sufficient, sustainable resources and enhance public financial management to improve equity in the non-NIP vaccines.

Exploring Gender Differences in Self- Efficacy and Academic Performance among College Students

This study explored the relationship between self-efficacy and academic performance on gender and academic program differences among 204 undergraduate students at a university in Misamis Occidental. This study employed a descriptive-correlational method. The respondents were predominantly female with the majority enrolled in Social Work and Psychology. While they showed a strong belief in their academic abilities, this inconsistently translate into higher academic performance. Significant differences in self-efficacy were observed across academic programs, with Social Work students reporting the highest levels and Psychology students the lowest. However, gender insignificantly impact either self-efficacy or academic performance. This study suggests that self-efficacy must interact with other factors, such as motivation, learning strategies, and program-specific influences, instead of making it a direct predictor of academic success. Investigating the long-term impact of self-efficacy on academic outcomes, the role of external factors and their interaction with self-efficacy, and their contribution to a deeper understanding of its influence on academic outcomes must also be considered for further studies. Institutions should implement targeted interventions to enhance student self-efficacy and academic resilience as additional support for lower-performing programs for a more holistic approach to student development in higher education.

Meaningful Results with Limited Resources: Evidence from a Program to Support Graduate Students’ Scholarly Writing

Although writing is an essential skill for graduate students (in and beyond their degree programs), limited programmatic support exists to help students develop mindsets and habits needed to become effective, scholarly writers. Furthermore, attrition rates are on the rise in the U.S., with many students dropping out at the “all but dissertation” stage. The timing of departure indicates writing may be a widespread issue warranting direct intervention. We developed a campus-wide, six-week learning community and certificate program intended to increase students’ self-efficacy in academic writing, using readings, reflection, and discussion among graduate students. Pilot results from 32 participants indicate that a noncredit-bearing, short course can have positive impacts on graduate students’ emotions about writing, their literature management approaches, awareness of the social context of writing, and their understanding of writing resources and academic voice. Potential exists for this low-budget model to be applied more broadly and thereby improve efforts to retain and support graduate students.

Abstract C177: Increasing cervical cancer screening among women living with HIV (WLWH) in Jamaica

Abstract Background: Cervical cancer (CCA) is the third most common cancer and the third leading cause of cancer deaths among women in Jamaica. Although human papilloma virus (HPV), the primary risk factor for CCA, has a prevalence of 54% among sexually active Jamaican women, HPV vaccination uptake is low, and CCA is often diagnosed at advanced stages due to inadequate screening. Women comprise 50% of persons living with HIV in Jamaica and are about six times more likely to develop cervical cancer than women without HIV. However, despite national guidelines requiring annual screenings, a national audit found that fewer than one-third of eligible WLWH underwent a Pap smear in the past year. Objective: We aimed to address gaps in CCA screening among WLWH attending four large HIV treatment sites in Jamaica through programmatic and operational support integrated into HIV care. Method: Working through the UCSF Jamaica Country Programme, funded by PEPFAR, clinical advisors completed site reviews to identify gaps in the CCA screening process. Critical gaps identified at the four sites included insufficient supplies (speculums, slides, cytology brushes, fixative, Pap smear jackets, and bed rolls), limited provider knowledge, delays in sample processing, and the delayed return of results from the national public health lab. From January 2023 to May 2024, our team provided technical assistance and resources for sample collection, private laboratory testing, delivery of samples, and collection and review of results. Results: Cervical cancer modules were integrated into an ongoing clinical management training series that reached 33 clinicians across multiple sessions. With supportive supervision, the sites strengthened patient notification and sample transportation, that facilitated appointment adherence, timely sample delivery, and prompt collection of results. Clinical advisors further supported site teams to identify abnormal results and ensure timely and appropriate follow-up diagnostic tests and treatment referrals. This intervention supported 656 eligible WLWH to complete Pap smears, with 614 timely results returned to the sites by May 2024. Conclusion: Targeted programmatic interventions can increase CCA screening by improving the availability of Pap supplies, clinic workflow, and operational efficiency within HIV care clinics thereby reaching a population at high risk for CCA. Technical and financial support from donors can be expanded to explore clinic-based models for improving and integrating HPV screening and vaccine uptake among vulnerable WLWH. The impact of these interventions can be tested through quality improvement and implementation science frameworks. Citation Format: Sharlene T Beckford Jarrett, Sasha-Kaye Blackwood, Kimlin Tam Ashing, Kamelia Bryan, Tyrone O Ellis, Jeffrey Edwards, Willi McFarland, Nicola Skyers. Increasing cervical cancer screening among women living with HIV (WLWH) in Jamaica [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr C177.

Paradigm Shift: Outcomes from a Physician-Scientist Undergraduate Pipeline Program.

Diverse medical and research teams are essential to culturally-responsive care and robust progress of biomedical research. However, structural inequities stymie the entry of trainees from underrepresented in medicine (URiM) backgrounds into the physician-scientist pipeline. The Preparation for Graduate and Medical Education (PARAdiGM) program was designed to provide students from underrepresented backgrounds early exposure to physician-scientist training in the context of ample mentorship and programmatic support. By emphasizing research experience, career exposure, presentation skills, mentorship, and application assistance, PARAdiGM is an incipient experience priming this student group to pursue careers in academic medicine. Since its establishment in 2014, PARAdiGM is already increasing entry of URiM students into the physician-scientist pipeline. Encouragingly, the majority of PARAdiGM alumni have matriculated into US medical schools, of which 16% are currently enrolled in MD-PhD programs. Early outcomes from PARAdiGM suggest that an immersive framework, longitudinal mentoring, and opportunity for self-growth should be incorporated into URiM pipeline programs on a larger scale. In these ways, helping students to envision themselves as members of the physician-scientist community is a step toward breaking down the barriers currently limiting URiM entry into academic medicine.

Lived Experiences and Perceptions of Autistic Young Adults Participating in Employment Readiness Skills Training.

This study aimed to examine the experiences and perceptions of participants engaged in an employment readiness program, Employment Preparation And Skills Support (EPASS), which is a manualized group-based training program designed to improve employment readiness among autistic young adults. A qualitative descriptive design was utilized to generate thick descriptions through semi-structured interviews with 22 transition-age autistic individuals (Mage = 20; 6 females; 16 males). Thematic analysis was employed to understand the experiences and career outcomes of transition-age autistic individuals pre- and post-participation in the EPASS program. Five main themes were identified: (1) More Negative Than Positive Employment-related Experiences; (2) Insight about Training Needs despite Hesitation to Participate; (3) Improved Perception and Confidence of Employment readiness through Experiential Learning; (4) Emerging Career Goals and Plans in Future Application of Knowledge and Skills; and (5) Learning Preference for More Interactive and Practice Experience. Participants reported a better understanding of job preparation skills, work-related social skills and interview etiquette. They also reported that what they learned in EPASS helped them improve their skills and confidence in obtaining and maintaining employment. Overall, participants expressed satisfaction with participating in EPASS and anticipated potential long-term impacts on their employability. This study sheds light on the training needs for transition-age autistic individuals and informs future employment readiness program development. Future studies should focus on collaborating with stakeholders to address training gaps and support needs that foster improved employment outcomes for this population.

Exploring Predictors of Teachers' Sustained Use of Data-Based Instruction.

The purpose of this logistic regression study was to identify predictors of teacher-reported sustained use of data-based instruction (DBI) during the COVID-19 pandemic and assess the extent to which the identified predictors explained teachers' sustained use after completing programmatic support for intensive early writing instruction. We surveyed 58 teachers who participated in a professional development efficacy trial regarding their sustained use of DBI in writing. The model indicated a higher predicted probability of sustaining DBI for teachers who received the full treatment (tools, learning modules, and coaching for 20 weeks of intervention during their year of participation in the efficacy trial) compared to teachers in the control group who only received tools and learning modules at the end of their participation year. In addition, teachers who taught in-person were more likely to sustain compared to those who taught in remote or hybrid models, controlling for other variables. Furthermore, as the number of facilitators that teachers reported increased, teachers were more likely to sustain their use of DBI components, controlling for other variables. Further research could shed light on the relative impact of different types of facilitators and different levels of support.

The Authority of The Integrated Assessment Team For Legal Certainty Regarding Rehabilitation For Suspected Drug Abusers

This study aims to analyze the authority of the Integrated Assessment Team (TAT) in determining rehabilitation for narcotics abuse victims and to identify obstacles in implementing rehabilitation recommendations, especially for those undergoing legal proceedings. The research uses a normative legal method, supported by empirical data, relying on primary legal materials such as laws and regulations, and secondary materials like literature related to the authority of TAT. The findings show that the TAT holds a crucial role in recommending medical and social rehabilitation for narcotics abusers. However, several obstacles hinder the effective implementation of TAT's recommendations, including poor coordination among law enforcement agencies and the limited resources available to support the rehabilitation process. Additionally, the social stigma surrounding narcotics abuse further complicates the rehabilitation process. The discussion emphasizes the need for stronger inter-agency coordination and increased support for rehabilitation programs to ensure better outcomes for narcotics abuse victims. The study concludes that despite the TAT’s authority being clearly regulated, several implementation challenges remain, which require urgent attention to improve the effectiveness of rehabilitation for narcotics abusers within the legal system.

A Content Analysis of Health Library Support for Australian Medical Training Programs

ABSTRACT Health libraries play a critical role in supporting medical training in Australia. Accreditation is an important means of ensuring a program of study and the education provider suitably equips trainees with the knowledge, skills and professional attributes necessary to practice in the profession. This study identifies a lack of consistency and specificity in Australian medical colleges accreditation requirements as they pertain to health libraries. The recommended accreditation standard developed in this study provides a benchmark for training providers that will ensure consistency of access to high-quality library collections, services and spaces for all medical trainees. Accreditation standards from 52 medical colleges and associations supporting Australian medical training programs were reviewed. Information extracted from accreditation documents was entered into a working text spreadsheet. Data was organized under three key categories: Collections, Services and Space. Additional categories were added to record the use of the noun Library and expectations for journal access. A data extraction tool was created in Microsoft Excel to note the requirements of each provider for libraries and collections, services and spaces. The results of the content analysis highlight a lack of consistency in accreditation providers’ expectations for library collections, services and spaces. Most providers (87% n = 45) required host organizations to provide access to collections. Requirements for library space were mandated by 54% of providers (n = 28). Less than 50% of providers (n = 22) specified library services as requirements. This content analysis highlights the role of health libraries in supporting medical education, research and evidence-based practice. It also reinforces the need for improved specificity, consistency and clarity in accreditation requirements for health libraries in post-graduate medical training. The recommended benchmark accreditation standard developed in this study is a step toward addressing these issues and ensuring equity of access to library services and facilities for all medical trainees in Australia.

School-Based Protective Factors for HIV Prevention in the United States: Secondary Analysis of the Youth Risk Behavior Survey 2015-2019.

This secondary analysis of the National Youth Risk Behavior Survey (years 2015-2019) examines associations between school-based protective factors (i.e., safe school environments and academic achievement) and HIV risk behaviors among sexually experienced adolescent gay and bisexual men ( n = 644), a population with the highest prevalence of undiagnosed HIV infections. Demographics included Hispanics/Latinos (25%, n = 158), Other race/ethnicity (14%, n = 88), and non-Hispanic Blacks/African Americans (13%, n = 81). Adjusted models showed that protective factors reduced odds for early sexual debut, multiple sexual partners, sex under the influence of drugs/alcohol, and condomless sex, with an additive effect demonstrated when two protective factors were present. Hispanics/Latinos had greater odds of reporting multiple sexual partners and HIV testing, indicating opportunities for school-based HIV prevention and further research. Our findings provide support for school-based programs that aim to improve social and structural determinants of health and ultimately reduce adolescent HIV burdens.

Principal Leadership of Pre-K Programs in Elementary Schools: Evidence from North Carolina

Pre-Kindergarten (Pre-K) programs are becoming increasingly common in elementary schools across the United States—in fact, a recent analysis of federal data revealed that 57% of public schools have a Pre-K grade. Despite the prevalence of Pre-K programs in schools, principals—known to be among the most important factors in school success—often lack the knowledge and professional supports to effectively lead Pre-K programs. In this study, guided by sensemaking theory, we work to advance knowledge on Pre-K principal leadership through a sequential mixed-methods analysis of elementary school principals in the state of North Carolina. Our study includes a statewide survey of all lead and assistant principals in the state ( N = 520) as well as follow-up interviews with 27 of the surveyed principals. Our findings reveal that while they report strong conceptual support for the Pre-K programs in their schools, principals demonstrate limited engagement with them. We also find that principal background and preparation in early education and the proportion of students from a Pre-K program that ultimately enroll in the school for kindergarten are important factors that help explain variation in principal orientations to Pre-K leadership.

Komunikasi Partisipatif Kepala Sekolah dalam Mengembangkan Kolaborasi dengan Komunitas dan Stakeholder

This study aims to explore the communication strategies employed by the school principal in building collaboration with the community and stakeholders at SMK Diponegoro Tumpang. The principal plays a key role in improving the quality of education through participatory communication, involving parents, teachers, and the local community in decision-making. This research employs a qualitative method with a case study approach, conducting in-depth interviews with the principal to understand the challenges and successes in building collaboration. The findings indicate that the principal's use of face-to-face and digital communication successfully increased stakeholder engagement and strengthened support for school programs. However, the main challenges identified include the digital divide and differing expectations among stakeholders. This study highlights the importance of open, participatory, and flexible communication to ensure successful collaboration between schools and the community.

Estimated Deaths Averted in Adults by COVID-19 Vaccination in Select Latin American and Caribbean Countries.

The coronavirus disease 2019 (COVID-19) pandemic has had a significant impact on global health, with millions of lives lost worldwide. Vaccination has emerged as a crucial strategy in mitigating the impact of the disease. This study aims to estimate the number of deaths averted through vaccination in Latin America and the Caribbean region (LAC) during the first year and a half of vaccination rollout (January 2021-May 2022). Publicly available data on COVID-19 deaths and vaccination rates were used to estimate the total number of deaths averted via vaccination in LAC. Using estimates for number of deaths, number of vaccinated, and vaccine effectiveness, a counterfactual estimated number of deaths observed without vaccination was calculated. Vaccine effectiveness estimates were obtained from published studies. The analysis focused on 17 countries in LAC and considered adults aged 18 years and older. After accounting for underreporting, the analysis estimated that >1.49 million deaths were caused by COVID-19 in the selected countries during the study period. Without vaccination, the model estimated that between 2.10 and 4.11 million COVID-19 deaths would have occurred. Consequently, vaccination efforts resulted in ∼610 000 to 2.61 million deaths averted. This study represents the first large-scale, multicenter estimate of population-level vaccine impact on COVID-19 mortality in LAC. The findings underscore the substantial impact of timely and widespread vaccination in averting COVID-19 deaths. These results provide crucial support for vaccination programs aimed at combating epidemic infectious diseases in the region and future pandemics.

Genetic variation in susceptibility of Phytophthora cinnamomi-infected holm oak in the absence or presence of severe drought

Abstract The evergreen oaks Quercus ilex and Quercus suber are exposed to widespread Phytophthora infestation in natural forests. To restore diseased forests, deploying trees less susceptible to combined stress is the most promising approach. We aimed to determine whether drought affects the susceptibility of Q. ilex and Q. suber seedlings to Phytophthora cinnamomi (Pc) differently. Additionally, to provide scientific support for a genetic improvement program to reduce the susceptibility of holm oak to decline, genetic variation and heritability in susceptibility to Pc in Q. ilex in the absence or presence of drought were estimated. About 7000 seedlings of 66 Q. ilex and 9 Q. suber trees from the Extremadura region (Spain) were inoculated with Pc at age 1. The following year, half the experimental blocks were regularly watered and half were exposed to severe drought, and inoculated again with Pc. In the absence of drought, Q. ilex was more susceptible than Q. suber to Pc (mortality 97% and 59%, respectively), but in the presence of drought after Pc infection the species were equally susceptible (~97% plant mortality). It could therefore be expected that under the climate change scenarios predicted for the south of the Iberian Peninsula, offspring of Q. suber will be as compromised as offspring of Q. ilex to soil infestation by Pc. Significant additive genetic variation and heritability in the susceptibility of Q. ilex to combined Pc infection and drought were observed (hi2 = 0.46 for time to death of plants), indicating that breeding for tolerance to combined stress is possible. Family variance component estimates of time to death in Q. ilex were highest in the presence of drought, and genetic control of susceptibility in Q. ilex decreased over time as plant stress increased. This is the first study to define a production population against combined stress in oak.