#2020 review questionnaire

[mariacallous]

Twenty-seven years since the last revision in 1997, the White House Office of Management and Budget (OMB) has altered its Statistical Policy Directive No. 15 (SPD 15)—providing a much-needed update in the standards for defining race and ethnic categories for use in data collection across all government agencies.

The revised standards are not perfect, and OMB promises to continue monitoring their use. But they are a marked improvement in light of ongoing shifts in U.S. racial and ethnic demographics, because they will allow more flexibility for individuals in identifying how they see themselves.

The new changes will affect the “minimal categories” for data collection—the race and ethnicity data that every federal survey will be required to ask about. In addition to the five “race” categories that have been used for decades (reflecting persons identifying as White, Black or African American, Asian, Native Hawaiian or Pacific Islander, or American Indian or Alaska Native), the new minimal categories will also include “Hispanic or Latino” and “Middle Eastern or North African” (or MENA). These two new categories are not traditional racial categories; therefore, this classification will be noted as one of “race and/or ethnicity.”

The addition of the Hispanic or Latino category results from the elimination of the separate “Hispanic/Non Hispanic” question which was previously asked in addition the race question. Research from the Census Bureau and others showed that when posed with separate ethnicity and race questions, a large share of Hispanic or Latino respondents did not identify with traditional racial categories and that a “combined” race/ethnic question yielded far more valid results. In this new classification, Hispanic or Latino respondents, like those of other groups, can choose to identify with other racial categories as well, but will not be required to.

The addition of the MENA category for people of Middle Eastern and North African descent stems from years of lobbying from MENA-related communities. Prior to the new standards, MENA was often offered as subcategory of “White.”

Perhaps most importantly, the new standards dictate that as a default, government agencies will collect data on detailed race and ethnic groups within each of the seven minimal race and ethnic categories. And where possible, agencies will provide “check boxes” for the five largest detailed groups (based on the 2020 census) as well as an open-ended “write in” box to capture other groups. (One exception is for the American Indian or Alaska Native category, for which only a write-in option is required.) Moreover, the instructions on questionnaires that allow both minimal and detailed categories encourage respondents to select “all that apply,” thus facilitating the collection of multiracial and multiethnic categories.

Clearly, the expansion of the data that government agencies collect will provide far greater opportunities to examine racial and ethnic disparities on measures of economic well-being, health, education, and more from variety of sources. With that said, OMB is aware of the challenges involved with their implementation—it provides guidelines for their presentation and promises to maintain a standing Interagency Committee to carry out continuing research and review of SPD 15. Now, it is up to policymakers, scholars, and practitioners to communicate their experiences with the new standards to the wider network of stakeholders and agencies in order to take advantage of this long overdue effort to improve the nation’s diversity data.

In this Around the Halls piece, scholars from across Brookings give their early thoughts on these changes and their potential impacts.

[allthebrazilianpolitics]

Radiotherapy resources in Brazil (RT2030): a comprehensive analysis and projections for 2030

Background

The demand for radiotherapy in Brazil is unfulfilled, and the scarcity of data on the national network hampers the development of effective policies. We aimed to evaluate the current situation, estimate demands and requirements, and provide an action plan to ensure access to radiotherapy for those in need by 2030.

Methods

The Brazilian Society for Radiation Oncology created a task force (RT2030) including physicians, medical physicists, policy makers, patient advocates, and suppliers, all of whom were major stakeholders involved in Brazilian radiotherapy care. The group was further divided into seven working groups to address themes associated with radiotherapy care in Brazil. From March 1, 2019, to Aug 3, 2020, there were monthly meetings between the group's leaders and the Central Committee and six general meetings. First, a comprehensive search of all different national databases was done to identify all radiotherapy centres. Questionnaires evaluating radiotherapy infrastructure and human resources and assing the availability, distribution, capacity, and workload of resources were created and sent to the radioprotection supervisor of each centre. Results were analysed nationally and across the country's regions and health-care systems. A pre-planned review of available databases was done to gather data on active radiation oncology centres and the distribution of radiotherapy machines (linear accelerators [LINACs]) across Brazil. We used national population and cancer incidence projections, recommended radiotherapy usage from the medical literature, and national working patterns to project radiotherapy demands in 2030. An action plan was established with suggestions to address the gaps and meet the demands.

Findings

The database search yielded 279 centres with an active radiotherapy registry. After applying predefined exclusion criteria, 263 centres were identified that provided external beam radiotherapy machines with or without brachytherapy. All 263 operational centres answered the questionnaires sent on Dec 9, 2019, which were then returned between Jan 1 and June 30, 2020. There were 409 therapy machines, 646 radiation oncologists, 533 physicists, and 230 989 patients undergoing radiotherapy (150 628 [65·2%] in the public health-care system and 80 937 [35·0%] in private). The mean annual occupation rate was 566 patients per treatment machine (SD 250). The number of residents per treatment machine ranged from 258 333 to 1 800 000. Technology availability varied considerably among regions and systems. In 2030, 639 994 new cancer cases are expected, which will require 332 797 radiotherapy courses. Therefore, 530 LINACs, 1079 radiation oncologists, and 1060 medical physicists will be needed.

Interpretation

The expected increase in cancer incidence in the coming years will probably increase the disparities in cancer care and the burden for Brazilian patients. We provide a roadmap of the current situation and the particularities of the Brazilian radiotherapy network, which can serve as a starting point for cancer policy planning to improve this scenario.

Read the paper.

#brazil #science #politics #healthcare #brazilian politics #mod nise da silveira #image description in alt

[dehlia-swen]

Texas Family Court Extortion & DCPS Child Neglect

After seeing the June 6th, 2022 article The Texas Tribune released, “Judge plans to levy “substantial fines” after Texas failed to comply with court-ordered fixes to its foster care system”. (For a link to the article, see below) I thought maybe I would add on to the Texas DCPS failures while adding in Texas Civil Court extortion, in a hybrid exposé questionnaire format…

How much does it cost to buy your children back from the state of Texas? Why did DCPS not follow proper procedures for three young girls in crisis? Why is DCPS worried more about a meth-addicted Mother, who had refused for years to get help for her schizophrenia and drug addictions, (while emotionally, physically, and mentally torturing these children), than the safety & happiness of the children? Why did no one help these young girls when the Mother burned down their rental home and took the children on a nationwide drive during the school year for over a month, where they wrote “HELP” on the fogged-up car window? Why did DCPS and a Dallas County law firm lie in court about not knowing the Father had Supervised Visitation, (according to the 2020 Divorce Decree), when the law firm charged over $500 to review the Decree & The children were verbally told that their father had a Supervised Visitation Order from other DCPS Social Workers in other DCPS cases against the Mother? Why has no one asked the children about the inappropriate relations between their Mother and the Police Officer that filed the paperwork for their Father’s arrest in 2021, a double jeopardy case, from the first case in 2018 in which she fabricated and used to get Supervised Visitation in the 2020 Divorce Decree? Will the courts admit that the Father’s Misdemeanor of Disorderly Conduct shouldn’t have been enough evidence to require a Supervised Visitation Order in the first place? Why does the Judge not want to hear about any incident that happened before the Divorce, when the father was a victim of Parent Alienation and the incident where one of the children was struck by a car, no one called 911, and the mother didn’t take her to a hospital for over 3 hours? Furthermore, why did they [DCPS and the lawyer] both, also lie in court about verbally telling the Father to come to get his Children, (on his dime), before calling him mid-flight, and advising that he needed to bring the three children back to Texas? Will DCPS and the Dallas County law firm ever admit to lying in court or will their silence admit their inability to conduct their jobs properly for them?

If the American population is suffering financially, then which family member is the children to be in the temporary custody of when none have enough financial stability to care for them? Do these girls get thrown into the broken Texas Foster Care System next, or placed back in the Mother’s hands, who has threatened the children with horrible acts if they ever tried to run away to their Father? The Father lives in another State, how is he supposed to work, live 16 hours away, and comply with this court system? How does the Father get a new lawyer when the current lawyers have sucked up all of his finances? Is it the Texas Legal System’s goal to run a parent out of money, rendering them unable to fight, and the State and/or their friends (Foster Families) reaping the benefits of money awarded because of the children being in the Texas State Foster Care System?

This is the Texas Family Court Extortion Racket, which is not about the health, safety, and well-being of children, but how much a parent is willing to pay and sacrifice to get their children out of the hands of the State, and these are all good questions. I would love some answers, how about you?

The Texas Tribune Article Mentioned Above, Click Here https://www.texastribune.org/2022/06/06/texas-foster-care-sanctions/.

#fraud #meth texas #texas government #dallas #family court #dcps #child protective services #civil court #lawyer #judge #child abuse #child trafficking #extortion #corruption #courts #government #politicians #democracy

[malonepace99]

Pneumococcal colonization amid healthy and also in the hospital vaccine-naive Sri Lankan children.

Schizophrenia is really a multifactorial disorder the consequence of mix of hereditary versions and experience environmental insults. Rest as well as circadian rhythm disruptions are a well known and everywhere attribute of several psychiatric issues, which include schizophrenia. There's expanding interest in unveiling your mechanistic outcomes of schizophrenia and circadian tempos, that might directly impact problem results. On this assessment, we explore the actual discussion between schizophrenia and also circadian rhythms coming from 2 contrasting angles. Very first, we review proof amn-107 inhibitor which slumber and also circadian beat disorder comprise significant element of schizophrenia, since backed up by equally human studies as well as animal versions with hereditary mutations in connection with schizophrenia. Subsequent, all of us go over the notion that circadian beat dysfunction interacts together with existing risks pertaining to schizophrenia to advertise schizophrenia-relevant behaviour along with neurobiological irregularities. Learning the mechanistic link between schizophrenia as well as circadian rhythms may have effects with regard to alleviating danger to the problem and also educating the introduction of circadian-based treatments.Street lock up can be a major reason behind demise and also handicaps throughout Namibia as well as other developing international locations. Based on the latest styles, the World Health Firm indicated that development to appreciate Eco friendly Development Aim (SDG) targeted Several.Some -- which requires any 50% reduction in the quantity of traffic massive by simply 2020 -- is still far from sufficient. To give rise to initiatives in cutting path deaths inside Namibia, this study looked at risk factors associated with the seriousness of crashes recorded in the nation. Put together logit custom modeling rendering methodology was utilized to address the problem of unobserved heterogeneity in harm severeness analysis. Style estimation outcomes show collision along with pedestrians, head-on collisions, ran-off street crashes and also accidents concerning substantial occupancy passenger vehicles ended up very likely to cause deaths and also severe accidental injuries. The particular findings and recommendations of this research are anticipated to enhance countermeasure execution to scale back street lock-ups inside Namibia.Objective Genetic cardiovascular disease (CHD) is the most typical birth trouble to represent the top reason for fatality and deaths within infants as well as the younger generation. Earlier fetal echocardiography is usually regarded a very particular check out. The purpose of this study would be to assess the affect regarding operator's expertise in assessing nevertheless pictures of the actual 4-chamber watch along with 3-vessels view also to evaluate the practicality along with the efficiency of a first trimester verification process regarding CHD.Strategies An online questionnaire composed of even now pictures of the actual 4-camber look at and 3-vessel see via 55 regular and also excessive instances ended up being evaluated simply by an expert team created from several healthcare professionals focused on baby remedies as well as a nonexpert party manufactured from 13 healthcare professionals which can be qualified in sonography.

#inhibitor #small molecules #chemicals #kinase inhibitors #tyrosine kinase inhibitors #enzyme inhibitors #protein inhibitors #proteins kinase inhibitors #phosphatase inhibitors #compound library #activators #modulators #agonists #antagonists

[internationalrealestatenews]

[ad_1] Embattled Austin developer Nate Paul continues to delay the stack of authorized challenges towards him. The World Class Holdings CEO is looking for a delay in his financial institution and wire fraud trial till January 2025 as a result of sheer quantity of proof and the complexity of the case, KXAN reported.   The trial, already postponed as soon as for related causes, was slated to start on July 29. However Paul’s authorized staff argued that the present timeline is inadequate for reviewing over 4 million paperwork, exacerbated by a current superseding indictment that introduces recent complexities. “The federal government investigated this case for almost a decade, and little question has its personal view of what's most vital,” Paul’s attorneys mentioned within the movement. “Protection counsel is entitled to enough time to conduct its personal assessment of the invention, and assess its relative significance.” The mountain of proof features a Microsoft Entry database encompassing 700 financial institution accounts, FBI e-mail correspondences relationship again to 2014, Texas State Securities Board recordsdata, questionnaires despatched by the FBI to World Class traders in 2020 and different information instrumental to the case, the outlet reported.  Whereas federal prosecutors didn’t oppose rescheduling, they prompt a trial date in October 2024, which Paul’s staff rejected. The case towards Paul originated in June 2023, with costs of creating false statements to mortgage lenders. A superseding indictment in November included 4 extra wire fraud and conspiracy costs spanning eight years, implicating Paul in fraudulent actions associated to restricted partnerships and misrepresentation of monetary info. Paul has maintained his innocence and pleaded not responsible to all costs.  A once-thriving Austin actual property participant, he has handled a slew of lawsuits, bankruptcies and foreclosures because the FBI raided his workplaces in 2019.  He was on the middle of Texas Lawyer Common Ken Paxton’s impeachment trial final 12 months, as he was accused of bribing Paxton in trade for authorized help associated to the foreclosures.  In December, Paul failed to look in courtroom in a case associated to a number of properties he previously owned that had been offered through foreclosures public sale. —Quinn Donoghue  Learn extra [ad_2] Supply hyperlink

[thxnews]

GAD Empowers Ofgem: Power Sector Insights

  GAD's Pivotal Role in Power Sector Pension Review

In a significant move, the Government Actuary's Department (GAD) has provided crucial support to the Office of Gas and Electricity Markets (Ofgem). The collaboration involved a meticulous reasonableness review of pension schemes associated with various power companies operating in the UK.   GAD's High-Level Assessment GAD, through its expertise, conducted a comprehensive high-level review of the defined-benefit pension costs incurred by network operators (NWOs). The findings of this review play a vital role in assisting Ofgem in evaluating price control allowances, particularly concerning the deficits in established pension schemes.   Addressing Consumer Interests: NWO Questionnaires GAD actively engaged with responses from NWOs, as provided in questionnaires by Ofgem. These responses shed light on how pension schemes considered the interests of consumers. This consumer-centric approach aligns with Ofgem's commitment to ensuring fairness and transparency in the regulated power sector.   Regular Ofgem Scrutiny on Pension Allowances NWOs extend occupational pension schemes to their employees, contributing to their retirement income. Ofgem, in its regulatory capacity, consistently reviews the pension allowances that NWOs can recover from consumers through regulated revenue charges. GAD's involvement in this sphere is not new; it previously supported Ofgem in a similar review in 2020. In the latest 2023 review, GAD examined changes in benefit design, investment strategy, and actuarial valuations since the last assessment.   Insights and Key Findings GAD's thorough review revealed a series of noteworthy developments within the power sector's pension landscape: - Improved Funding Positions: Five schemes now boast a surplus, indicating a positive trend in funding positions. - De-Risking Strategies: There is an observed increase in de-risking strategies within the investment approaches. - Inflation Considerations: High inflation rates prompted a closer look at how pension schemes handle inflation-linked increases, with provisions to cap such increases if inflation exceeds 5%.   Consumer-Centric Actions by Power Companies All companies involved demonstrated their commitment to consumer interests by undertaking various actions, including: - Commissioning analyses focused on consumer interests. - Negotiating with trustees for valuation concessions. - Engaging with trustees on investment strategies. - Managing liabilities to prevent consumers from facing undue exposure to higher costs.   Ofgem's Decision Letter and Regulatory Policy In response to GAD's report, Ofgem issued a decision letter, reflecting the regulatory policies shaped by the insights gained from the pension scheme review. This underscores Ofgem's dedication to transparency and responsiveness in the power sector.   GAD's Insights: A Changing Landscape Scott Madden, a GAD actuary and one of the report's authors highlighted the evolving defined benefit landscape. He noted the recent environment characterized by higher inflation and interest rates, coupled with the development of longer-term objectives reflected in the pension schemes of network operators. Madden stated, "These stakeholders have a particular challenge in ensuring that the consumer interest is appropriately taken into account, and we were happy to support Ofgem in forming its view."   Contributions and Actuarial Valuations Contributions required to sustain defined benefit pension schemes are periodically assessed through actuarial valuations. GAD's scrutiny did not identify major concerns in these areas during the latest review, reinforcing confidence in the robustness of the pension systems within the power sector. As the power sector continues to evolve, GAD's invaluable support ensures that consumer interests remain at the forefront of decision-making, fostering transparency, and accountability in the regulated industry.   Sources: THX News & Government Actuary's Department. Read the full article

#Actuarialvaluationsdefinedbenefitpension #Consumer-centricactionspowercompanies #Defined-benefitpensioncosts #GADinsightspowersectorevolution #GADOfgempensionschemereview #Inflationconsiderationspensionschemes #NWOspensionallowancesconsumers #Ofgemdecisionletterregulatorypolicy #Powersectorregulatoryscrutiny #ScottMaddenevolvingpensionlandscape

[sciencespies]

More than 1.1 million sea turtles poached over last three decades

https://sciencespies.com/nature/more-than-1-1-million-sea-turtles-poached-over-last-three-decades/

More than 1.1 million sea turtles poached over last three decades

One of the most serious threats to wildlife biodiversity, in addition to the climate crisis, is the illegal killing and trafficking of animals and plants. Despite many laws against the black-market wildlife trade, it is considered to be one of the most lucrative illicit industries in the world.

Animals, especially endangered and threatened species, are often exploited and sold for their pelts or used as medicine, aphrodisiacs, curios, food and spiritual artifacts.

In a new study published in Global Change Biology, Arizona State University researchers estimate that more than 1.1 million sea turtles have been illegally killed and, in some cases, trafficked between 1990 and 2020. Even with existing laws prohibiting their capture and use, as many as 44,000 sea turtles were exploited each year over the past decade in 65 countries or territories and in 44 of the world’s 58 major sea turtle populations.

Despite the seemingly large number of poached turtles, the study shows that the reported illegal exploitation of sea turtles declined by approximately 28% over the last decade — something that surprised the researchers. They initially expected to see an overall increase in reported poaching.

“The decline over the past decade could be due to increased protective legislation and enhanced conservation efforts, coupled with an increase in awareness of the problem or changing local norms and traditions,” says Kayla Burgher, co-first author of the study and a doctoral student in ASU’s environmental life sciences program in the School of Life Sciences.

In addition to the slight decline, the researchers found that most of the reported illegal exploitation over the past decade occurred in large, stable and genetically diverse sea turtle populations.

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Jesse Senko, co-first author of the study and an assistant research professor with the ASU School for the Future of Innovation in Society says this discovery may be a silver lining to the high number of turtles illegally exploited. “What this means is that most of these sea turtles came from healthy, low-risk populations, which suggests that, with a few exceptions, current levels of illegal exploitation are likely not having a major detrimental impact on most major sea turtle populations throughout the world’s oceans.”

Senko adds, however, the results should be cautiously considered. “Assessing any illegal activity is difficult, and the take and trade of sea turtles is no exception, especially when it becomes organized or connected to crime syndicates. Our assessment also did not include eggs or turtle products, such as bracelets or earrings made from sea turtle shells that could not be easily attributed to individual turtles,” says Senko.

In the study, the researchers reviewed data from peer-reviewed journal articles, archived media reports, NGO reports, and online questionnaires to determine a comprehensive look at existing information on exploited sea turtles. The study revealed additional patterns and trends that may assist in determining conservation management priorities. For example, Vietnam was the most common country of origin for illegal sea turtle trafficking, while China and Japan served as destinations for nearly all trafficked sea turtle products. Similarly, Vietnam to China was the most common trade route across all three decades.

Across the 30-year study period, 95% of poached sea turtles came from two species — green and hawksbill turtles — both of which are listed under the U.S. Endangered Species Act. Also, Southeast Asia and Madagascar emerged as major hotspots for illegal sea turtle take and trade, particularly for critically endangered hawksbills, which are prized in the illicit wildlife trade for their beautiful shells.

“Our assessment is an important foundation for future research and outreach efforts regarding illegal sea turtle exploitation. We believe this study can help conservation practitioners and legislators prioritize conservation efforts and allocate their resources to best help protect sea turtle populations from harmful levels of exploitation worldwide,” says Burgher.

The research team says much more needs to be done to sustain global biodiversity.

“Increased support for governments lacking the resources to protect sea turtles is needed, along with support for communities to sustain human well-being in the face of restrictions or bans on sea turtle exploitation. We must develop conservation strategies that benefit both people and turtles,” says Senko.

#Nature

#2022 Science News #9-2022 Science News #acts of science #Earth Environment #earth science #Environment and Nature #everyday items #Nature Science #New #News Science Spies #Our Nature #planetary science #production line #sci_evergreen1 #Science #Science Channel #science documentary #Science News #Science Spies #Science Spies News #September 2022 Science News #Space Physics & Nature #Space Science #Nature

[emmanatics2]

Emman Andrew Lantaca

COVID 19 PANDEMIC

Introduction:

The World Health Organization (WHO) declared coronavirus disease 2019 (COVID-19) to be a Public Health Emergency of International Concern on January 30 and a pandemic on March 11, 2020 (2). COVID-19 predominantly presents with respiratory symptoms (cough, sneezing, and sore throat), along with fever, fatigue and myalgia. It is thought to spread through droplets, contaminated surfaces, and asymptomatic individuals By the end of April, over 3 million people have been infected globally.

The first country to identify the novel virus as the cause of the pandemic was China. The authorities responded with unprecedented restrictions on movement. The response included stopping public transport before Chinese New Year, an annual event that sees workers' mass emigration to At the beginning of May, the Philippines recorded 8,772 cases and 579 deaths .

China was one of the more severely affected countries in Asia in the early stage of pandemic (7) while the Philippines is still experiencing an upward trend in the COVID-19 cases (6). The gross national income (GNI) per capita of the Philippines and China are USD 3,830 and 9,460, respectively, were classified with lower (LMIC) and upper-middle-income countries (UMIC) by the Worldbank (8). During the COVID-19 pandemic, five high-income countries (HIC), including the United States, Italy, the United Kingdom, Spain, and France, account for 70% of global deaths (9). The HIC faced the following challenges: (1) the lack of personal protection equipment (PPE) for healthcare workers; (2) the an overstretched healthcare system with the shortage of hospital beds, and a large number of death cases from nursing homes. The COVID-19 crisis threatens to hit lower and middle-income countries due to lockdown excessively and economic recession. A systematic review on mental health in LMIC in Asia and Africa found that LMIC: do not have enough mental health professionals; the negative economic impact led to an exacerbation of mental issues; there was a scarcity of COVID-19 related mental health research in Asian LMIC. This systematic review could not compare participants from different middle-income countries because each study used different questionnaires. During the previous Severe Acute Respiratory Syndrome (SARS) epidemic, the promotion of protective personal health practices to reduce transmission of the SARS virus was found to reduce the anxiety levels in the community.

Objective: The differences between the physical and mental health of people living in a lower-middle-income country (LMIC) and upper-middle-income country (UMIC) during the COVID-19 pandemic was unknown. This study aimed to compare the levels of psychological impact and mental health between people from the Philippines (LMIC) and China (UMIC) and correlate mental health parameters with variables relating to physical symptoms and knowledge about COVID-19.

Methods: The survey collected information on demographic data, physical symptoms, contact history, and knowledge about COVID-19. The psychological impact was assessed using the Impact of Event Scale-Revised (IES-R), and mental health status was assessed by the Depression, Anxiety, and Stress Scale (DASS-21).

Findings: The study population included 849 participants from 71 cities in the Philippines and 861 participants from 159 cities in China. Filipino (LMIC) respondents reported significantly higher levels of depression, anxiety, and stress than Chinese (UMIC) during the COVID-19 (p < 0.01) while only Chinese respondents' IES-R scores were above the cut-off for PTSD symptoms. Filipino respondents were more likely to report physical symptoms resembling COVID-19 infection (p < 0.05), recent use of but with lower confidence on medical services (p < 0.01), recent direct and indirect contact with COVID (p < 0.01), concerns about family members contracting COVID-19 (p < 0.001), dissatisfaction with health information (p < 0.001). In contrast, Chinese respondents requested more health information about COVID-19. For the Philippines, student status, low confidence in doctors, dissatisfaction with health information, long daily duration spent on health information, worries about family members contracting COVID-19, ostracization, and unnecessary worries about COVID-19 were associated with adverse mental health. Physical symptoms and poor self-rated health were associated with adverse mental health in both countries (p < 0.05).

Conclusion: The findings of this study suggest the need for widely available COVID-19 testing in MIC to alleviate the adverse mental health in people who present with symptoms. A health education and literacy campaign is required in the Philippines to enhance the satisfaction of health information

Living through the Covid-19 pandemic, many have seen a number of ethical, legal, and social issues arise as a result of the virus rapidly spreading worldwide. This timely special issue is designed to be a mid-stream retrospective: look at presenting a broad array of topics at the intersection of science and society, from a range of researchers, in many different fields, in light of what we have learned so far. The issues that have arisen are both as a direct result of the virus itself, whereas others arose as a result of various responses to the virus.

Like the virus itself, the issues that the pandemic raises are moving targets with factors and conditions changing over time, often due to unprecedented necessity. Hollywood and some percipient billionaires have been predicting this event for some time, and some of the issues that we are now facing have been raised before, but not taken seriously enough. Even with their foresight, we were far from ready for the many ethical, legal, and social concerns that have arisen.

The question is, when is the next event like this, and will we be ready for that one. Especially pertinent is what we have learned from this experience, both good and bad.

This issue will collect papers from those who would like to make sure that we are ready, or at least trying to get there.

The aim of this topic is to summarize the ethical information related to triage, contact tracing, quarantine measures, international law changes as we are going through coronavirus pandemic, and to reassess what we have seen thus far in light of this new knowledge.

Keywords: covid-19, pandemic, ESLI, patient screening, data privacy, contact tracing, quarantine measures, lockdown, drug and vaccine development

Important Note: All contributions to this Research Topic must be within the scope of the section and journal to which they are submitted, as defined in their mission statements. Frontiers reserves the right to guide an out-of-scope manuscript to a more suitable section or journal at any stage of peer review.

#etechblog

[lexabey]

#6

I read two peer reviewed articles having to do with homelessness. The first one is titled Who’s Homeless and Whose Homeless by Ingrid Sahlin. This article is a report on research taken from Swedish Parliament transcripts containing mentions of homelessness and policy. Sahlin’s aim was to find a definition of which houseless populations were considered homeless and therefore Sweden’s responsibility, and which populations the government didn’t claim as theirs. She defines homeless as a person who is without a home, living in an emergency shelter, short term lodging, an institution, or in a “sublease contract with social services” (2020). Refugees and undocumented migrants are excluded from this definition, and therefore are not considered homeless and are not under the care of the Swedish government. 

The conclusion found was that, for Swedish Parliament, “the term ‘our homeless often refers only to Swedish citizens…” (2020). Anyone who is houseless but without citizenship is seen as a possible threat to the economy, and to what is considered the “deserving poor” and homeless.

Sahlin’s research displays a clear association between homelessness and individual problems, such as mental health issues, drug abuse, and economic problems. This line of thought coincides with the research conducted by Vázquez et al. They performed a study questioning what attributes people believe to be likely causes of homelessness. 

The study was performed in Madrid, Spain. These people were separated into two groups and were asked to complete a questionnaire on if they agreed or disagreed with a series of causes of homelessness, also known as causal attributes. One group was comprised of homeless people. The other group, called the domicile group, was made up of people “who had housing, were not using services designed for the homeless, and were not at risk of becoming homeless” (2018).

The causal attributes belong in three categories: individualistic, fatalistic, and societal (2018). Individualistic attributes are things like mental or physical illness, drug use, and being lazy. An example of a fatalistic attribute would be someone saying that they just have bad luck, or that it was fate that they ended up where they were. Societal attributes are outside an individual’s control, like economic crisis or being born into poverty.

The study found that both the homeless group and the domicile group agreed on similar reasons for homelessness. The consensus was that homelessness was most likely to have been the result of individualistic causes. The study also found that most viewed homeless people as “victims of circumstance”, seeing the negative individualistic attributes in a paternalistic light (2018).

While Sahlin and Vázquez et al both set out to discuss homelessness, they approached the topic from differing angles. Sahlin’s report showed how a societal entity view the homelessness, while the study in Madrid was done with individual people’s views in mind.

 References

  Sahlin, I. (2020). Who’s Homeless and Whose Homeless? Social Inclusion, 8(3), 43–53. https://doi.org/10.17645/si.v8i3.2818.

 Vázquez, J. J., Panadero, S., & Zúñiga, C. (2018). Attributions About Homelessness in Homeless and Domiciled People in Madrid, Spain: “Why Are They Homeless People?” American Journal of Orthopsychiatry, 88(2), 236–247. https://doi.org/10.1037/ort0000246. 

[mackenzieamyx]

Ulrich Baer and Smaran Dayal on American Literature

Ulrich Baer is University Professor at New York University where he teaches literature and photography. He has published books on poetry, photography, and culture, and written for the New York Times, the New York Review of Books, and the Los Angeles Book Review. His translations of poet Rainer Maria Rilke’s letters are available as audiobooks read by Ethan Hawke and Rosanne Cash. He hosts the ideas podcasts, Think About It and The Proust Questionnaire, and has published editions of numerous classic books with Warbler Press, including Pride and Prejudice, The Scarlet Letter, The Great Gatsby, Beyond Good and Evil, Heart of Darkness, and others. Smaran Dayal is a Ph.D. candidate in Comparative Literature at New York University, where he is writing a dissertation on literary Afrofuturism. He was the recipient of the Rosa Luxemburg Foundation’s Masters Scholarship and the European Council’s Erasmus Mundus Fellowship. He is one of the co-organizers of the NYU Postcolonial, Race and Diaspora Studies Colloquium, co-translator of the book The Queer Intersectional in Contemporary Germany (2018) and co-editor of the anthology of American literature, Fictions of America: The Book of Firsts (2020). His writing has previously appeared or will soon appear in The Los Angeles Review of Books, the Harvard Review, Social Text, Citizenship Studies, Interventions, and the Journal of Postcolonial Writing.

About Mackenzie Amyx

Gen Z authority.

Website: http://mackenzieamyx.com/ Instagram: @mackenzieamyx YouTube: https://www.youtube.com/channel/UC3lo5qcDh5MRhzjqieg7szg?view_as=public

Check out this episode!

[clinicalsurgery]

Prevalence of Unplanned Pregnancies and their Associated Factors among Antenatal Clinic Attendees in Thimbirigasyaya Divisional Secretariat Division, Colombo, Sri Lanka in Open Access Journal of Medical and Clinical Surgery by Praveen Shankar Nagendran

Abstract

Unplanned pregnancies are a major public health issue globally causing poor maternal and foetal outcomes. The objective of this study was to determine the prevalence of unplanned pregnancies & their associated factors among antenatal clinic attendees in Thimbirigasyaya Divisional Secretariat Division, Colombo, Sri Lanka. A cross-sectional study was conducted in three randomly selected antenatal clinics of the Thimbirigasyaya Divisional Secretariat Division of the Colombo Municipal Council. A total of 425 antenatal mothers were included in the study using a consecutive sampling method. Data collection was done using interviewer-administered questionnaires. Statistical analysis was done using the Chi-Square test, Odds Ratio and 95% confidence interval. The prevalence of unplanned pregnancies was 32.7% in the study population. The 95 % confidence interval was 28.26 – 37.39. Being married, the mother being employed in the preceding 12 months, the number of past conceptions being two or less & intake of folic acid before pregnancy had statistically significant associations with planned pregnancies at 95% confidence interval (p < 0.05). Marital age less than 20 years, highest education level of the mother being less than Grade 11, highest education level of the spouse being less than Grade 11, monthly household income of less than LKR 25,000, the interpregnancy interval of fewer than 24 months, using family planning practices in the past, never wanting or expecting the current pregnancy and not planning for another pregnancy had statistically significant associations with unplanned pregnancies at 95% confidence interval (p < 0.05). According to the study, one-third of the pregnancies were unplanned & a statistical significance at 95% confidence interval was seen between the planning status of the current pregnancy and twelve of the eighteen variables studied.

Keywords: Prevalence, unplanned pregnancies, associated factors, antenatal mothers, Sri Lanka

Introduction

Data on prevalence is important to help in resource allocation and prioritisation of activities by relevant stakeholders. The prevalence data would also help to identify the magnitude of the problem related to unplanned pregnancies in a given population under study by assessing its overall burden. It would also support the process of identification of priorities in healthcare, preventive activities and policymaking which is needed to develop a health economics model to address issues related to unplanned pregnancies.

There is a lack of recent data on the prevalence of unplanned pregnancies in this study population in an urban community setting in Thimbirigasyaya Divisional Secretariat Division which falls under the Colombo Municipal Council. It is important to identify associated factors for any public health problem, as it would provide data on the most important associated factors to be addressed and would help to prioritise them. Identifying and addressing associated factors for unplanned pregnancies among the targeted population would improve their sexual and reproductive health and help to implement necessary interventions and provide health-related services on unplanned pregnancies.

Lay Summary

This study is a retrospective chart review of the electronic medical records of 68 patients diagnosed with acute appendicitis (AA) and admitted to the general surgery department of Dubai Hospital, UAE, for conservative or surgical management of acute appendicitis between March 1 and December 31, 2020. Conservative treatment was defined as treatment with antibiotics and supportive management alone. Ethical approval was obtained from the Dubai Scientific Research Ethics Committee (DSREC). Patients admitted within this time period without a nasopharyngeal RT-PCR swab for COVID-19 on admission were excluded from the study. All demographic, clinical, radiological, and laboratory data was retrieved from the SALAMA electronic file system.

Variables evaluated for each patient include: age, sex, COVID-19 status, modality of management (conservative or operative), incidence of complications, type of surgical technique if managed operatively (open or laparoscopic appendicectomy), past medical and drug history, presence of pre-existing comorbidities, smoking status, preoperative vital signs (temperature, heart rate, respiratory rate, and blood pressure), radiological findings on chest x-ray if COVID-19 positive, preoperative laboratory markers, and length of hospital stay. The data was entered into the data collection tool (Microsoft Excel spreadsheet), exported, and analyzed in SPSS Version 22 software using Fisher’s exact test. The analysis was carried out in accordance with the Strengthening the Reporting of Observational studies in Epidemiology (STROBE) guidelines for observational studies.

Text

Introduction

Unplanned pregnancies: Pregnancies can be broadly divided into planned/wanted pregnancies and unplanned pregnancies. Unplanned pregnancy is a major public health issue the world over. In unplanned pregnancies, conception has occurred not at the desired time and was expected later or was never expected or wanted.

Associated factors for unplanned pregnancies: The common cause of unplanned pregnancies has been identified as not using contraception or due to not using a contraceptive method consistently or correctly or both [1]. Marital age, marital status, age at first pregnancy, education level of the couple, employment status of the mother, monthly household income, interpregnancy interval, disrupted marital life and gender-based issues are some of the factors associated with unplanned pregnancies [2].

Adverse outcomes of unplanned pregnancies: Unplanned pregnancies have been a major cause of induced abortions the world over and have been linked to poor maternal and child health outcomes causing an increased risk of abortion-related death and morbidity, especially in countries where abortion is illegal [3]. Women with unplanned pregnancies are more vulnerable to committing suicide, have poor nutrition during gestation, and have adverse mental health issues, unstable family relationships, experience physical and psychological violence, risk of bad pregnancy outcomes and delay in seeking prenatal care [4].

The children born of mothers with unplanned pregnancies are at risk for low birth weight, poor academic performance, violence and neglect [5]. These children are exposed to greater risk factors, hence are more likely to experience negative psychological and physical health issues, increased school dropouts and tend to show delinquent behaviour during their adolescent period. A study conducted in Australia showed higher levels of depression, delinquency and anxiety among children born out of unplanned pregnancies as compared to planned pregnancies [6].

The global situation on unplanned pregnancies: Unplanned pregnancies can negatively affect women physically, emotionally and financially. Effective, equitable and easier access to effective contraception methods, especially to long-acting reversible contraception, would certainly help to address this issue of public health concern [7].

Between 2015 to 2019, there had been 121 million unplanned pregnancies annually the world over (80% confidence interval of 112.8-131.5) which corresponds to a global rate of 64 unplanned pregnancies per 1000 women aged 15 - 49 years. Out of this amount, 61% of the unplanned pregnancies ended in abortions, which accounts for an abortion rate of 39 abortions per 1000 women aged 15 - 49 years [8]. According to the latest estimates by the World Health Organisation, almost half the pregnancies between 2015 to 2019 in low and low middle-income countries had been unplanned. Women living in the poorest regions are almost three times likely to have unplanned pregnancies than women from wealthier regions [9].

Sri Lankan situation on unplanned pregnancies

In Sri Lanka, approximately 360,000 women become pregnant annually, of which one in three (33.3%) are estimated to have an unplanned pregnancy. Demographic and Health Survey (DHS) of 2016 reports that 35% of married women in Sri Lanka do not use any form of contraception and teenage pregnancies are around 4.6% [10]. Approximately 150,000 to 175,000 abortions are expected to take place annually in Sri Lanka [11], with no recent data indicating any decrease. According to the National Post Abortion Care Guideline of 2015, unsafe abortion is responsible for 10% to 13% of maternal deaths in Sri Lanka, making it the second leading cause of maternal mortality in the country (Family Health Bureau, 2015). In 2017, approximately 326,000 live births had taken place in Sri Lanka, along with 127 reported maternal deaths in that same year. Among the 127 maternal deaths, 28 were due to unplanned pregnancies (Family Health Bureau, 2015). Another study concluded that 23.3% of pregnancies in Sri Lanka were unplanned [12].

Methods

A descriptive cross-sectional study was conducted between April 2020 and January 2021 in three randomly Medical Officer of Health areas in the Thimbirigasyaya Divisional Secretariat Division of the Colombo Municipal Council. A total of 425 antenatal mothers who fulfilled the inclusion criteria were included in the study. Any antenatal mother who had difficulties in hearing the questions asked or difficulties in speaking in response to the questions asked by the interviewer, antenatal mothers residing in that area for less than six months duration and mothers who visited the clinics while being registered in antenatal clinics not belonging to the study setting were excluded from the study. The sample size was calculated using the formula by Lwanga & Lemeshow [13]. Since the exact prevalence of the main outcome variable (prevalence of unplanned pregnancies) is not available and since there were no recent (within 5 years) literature or studies done on this topic in this setting, prevalence (p) was assumed as 50% to calculate the sample size.

The consecutive sampling method was used and the final sample size included 425 antenatal mothers from three antenatal clinics in the Thimbirigasyaya Divisional Secretariat. There were no nonresponders as all antenatal mothers who fulfilled the inclusion criteria were willing to participate in the study. Interviewer administered questionnaire was used for data collection. Construction of the interviewer-administered questionnaire was done by doing a thorough literature review and analysing the variables and associated factors for unplanned pregnancies. Pre-testing of the questionnaire was done at the antenatal clinic in Slave Island which belongs to the Colombo Divisional Secretariat Division of the Colombo Municipal Council. Following the pretesting, some questions were modified to make it more easily understood by antenatal mothers with basic educational levels by reducing scientific and technical terms. Prior permission had been obtained from relevant authorities to carry out this study. On each day of data collection, the principal investigator clearly explained the purpose of the study to the antenatal mothers in the waiting area of the clinic. Thereafter information sheets were distributed for further information. Subsequently, consent forms were given to obtain written consent from mothers willing to participate in the study who fulfilled the inclusion criteria. Duplication of data was prevented by taking note of the pregnancy record registration numbers of antenatal mothers who had attended the clinic during the previous week or weeks.

Interviewer bias was nil as only the principal investigator was involved in data collection, analysis, and interpretation. Recall bias was kept to a minimum by asking the antenatal mothers about their most recent pregnancies. Perusing pregnancy records for additional information on the current pregnancy was used to minimise information bias. Selection bias was kept to a minimum, as all antenatal mothers attending the respective antenatal clinics on the day of data collection, who fulfilled the inclusion criteria were included in the study. The reliability of the questionnaire was checked by translating it from English to Sinhala and Tamil and then translating it back to English. Statistical analysis of the data was done using Chi-Square testing and p values at a 95% confidence interval. Odds Ratio was used to assess the strength of association between the planning status of the pregnancy and its associated factors. Data analysis was conducted using the Statistical Package for Social Sciences (SPSS) version 21.

Ethical clearance was obtained from the Ethics Review Committee of the Postgraduate Institute of Medicine, University of Colombo, Sri Lanka (Approval Number: ERC/PGIM/2020/091).

There was no lack in antenatal care for the study participants by withdrawing from data collection. Data collection was carried out thus maintaining the privacy of the participant while giving them all the necessary information about the study. They had full control over their decision-making ability, autonomy and enrolment in the study. The knowledge obtained from the data collection was only used for research purposes and all study participants were made aware of it. There are no conflicts of interest.

Results

The total sample size was 425 and there were no non responders as all participants were willing to join the study. The age distribution was between 15 to 44 years. The age group of 22 to 34 years included 83.2% of the total study population. There were 37.2% Sinhalese, 33.9% Moors and 28.9% Tamils in the study sample. The prevalence of unplanned pregnancies was 32.7% in the study population. The 95 % confidence interval was 28.26 – 37.39. Being married (p = <0.05, OR = 3.08, CI. = 1.15-8.3), mother being employed in the preceding 12 months (p = <0.001, OR = 4.18, CI. = 2.32-7.53), number of past conceptions being two or less (p = <0.05, OR = 2.1, CI. = 1.06-4.12), intake of folic acid before pregnancy (p = <0.001, OR = 2.27, CI. = 1.5-3.43) had statistically significant associations with planned pregnancies at 95% confidence interval (p < 0.05). Marital age less than 20 years (p = <0.001, OR = 0.3, CI. = 0.19-0.47), highest education level of mother being less than Grade 11 (p = < 0.001, OR = 0.42, CI. = 0.25-0.68), highest education level of spouse being less than Grade 11 (p = <0.05, OR = 0.48, CI. = 0.29-0.79), monthly household income of less than LKR 25,000 (p = <0.001, OR = 0.47, CI. = 0.31-0.72), interpregnancy interval of less than 24 months (p = <0.001, OR = 0.25, CI. = 0.12-0.53), using family planning practices in the past (p = <0.05, OR = 0.62, CI. = 0.4-0.94), never wanting or expecting the current pregnancy (p = <0.001, OR = 0.02, CI. = 0.0096-0.064) and not planning for another pregnancy (p = <0.001, OR = 0.31, CI. = 0.2-0.47) had statistically significant associations with unplanned pregnancies at 95% confidence interval (p < 0.05).

Being less than 20 years of age at first pregnancy (OR = 0.67, CI. = 0.36-1.24), contraception use in the month of pregnancy (OR = 0.57, CI. = 0.32-1.05), time of first antenatal clinic registration within 12 weeks of gestation (OR = 1.5, CI. = 0.88-2.56), number of children expected after marriage being two or less (OR = 1.04, CI. = 0.61-1.74), having home visits by health care workers during antenatal period (OR = 0.79, CI. = 0.53-1.19) and mother visiting the hospital for any other medical condition during the pre-pregnancy period (OR = 0.66, CI. = 0.39-1.13) did not show any statistically significant association with planning status of the current pregnancy at 95% confidence interval (p > 0.05).

Discussion

Unplanned pregnancy is either unwanted, such as one that occurs when there are no other children or when no further children are desired, or the pregnancy was mistimed, with the baby arriving earlier than expected (Centers for Disease Control & Prevention, 2021). The prevalence of unplanned pregnancies in the Thimbirigasyaya Divisional Secretariat Division of the Colombo Municipal Council was 32.7% (139 out 425 study participants) and the 95 % confidence interval was 28.26 – 37.39.  There is a statistically significant association between the planning status of the current pregnancy and the marital status of the mother at a 95% confidence interval (p < 0.05). Being married is three times more likely to have a planned pregnancy (OR = 3.08, 95% CI: 1.15-8.3). Similar findings were seen in studies conducted in South Africa and Kenya. In South Africa, those married or living with their partners are more likely to have planned pregnancies and a significant association between marital status and unplanned pregnancies (p < 0.001) was seen [14].

There is a statistically significant association between the planning status of the current pregnancy and marital age at a 95% confidence interval (p < 0.001). Marital age of fewer than 20 years is 70% less likely to be associated with a planned pregnancy (OR = 0.3. 95% CI: 0.19-0.47). In a study done in Kenya, the prevalence of unplanned pregnancies was 51% between the ages of 15 and 19 years and 31% between the ages of 20 and 22 years [15].

The association between the planning status of the current pregnancy and the highest maternal education is statistically significant at a 95 % confidence interval (p < 0.001). The highest education level of the mother being less than Grade 11 shows a 58% less likelihood of having a planned pregnancy (OR = 0.42, 95% CI: 0.25-0.68). A sub–Saharan African multi-country analysis of the Demographic and Health Surveys of 29 countries showed that women with primary (OR = 0.74, CI = 0.69–0.80) and secondary (OR = 0.71, CI = 0.65–0.77) levels of education had fewer chances of unplanned pregnancies as compared to women with no education (Ameyaw et al., 2019). A statistically significant association between the planning status of the current pregnancy and maternal employment in the last 12 months is seen at a 95% confidence interval (p < 0.001). The antenatal mother being employed in the preceding 12 months has a four-time likelihood of having a planned pregnancy (OR = 4.18, 95% CI: 2.32-7.53). Similar findings were seen in a study done in Western Iran where unplanned pregnancies were 5.08 times more among housewives (p < 0.001) as compared to employed women [16].

There is a statistically significant association between the planning status of the current pregnancy and the husband’s education at a 95% confidence interval (p < 0.05). The highest education level of the spouse being less than Grade 11 is 52% less likely to have a planned pregnancy with his spouse (OR = 0.48, 95% CI: 0.29-0.79). There were more spouses among the planned pregnancy group who had completed Tertiary education as compared to the unplanned pregnancy category. Unplanned pregnancies were less common and least likely to occur (p < 0.05) among women who had husbands with some College or University education according to a study done in Southern Ethiopia [17]. There is a statistically significant association at a 95% confidence interval between the planning status of the current pregnancy and monthly household income (p < 0.001). Antenatal mothers having a monthly household income of less than LKR 25,000 are 53% less likely to have planned pregnancies (OR = 0.47, 95% CI: 0.31-0.72). Poor household income has been shown to cause unplanned pregnancies (p < 0.001) with an odds ratio of 1.7 in a study conducted in Canada [18].

There is a statistically significant association between the planning status of the current pregnancy and the interpregnancy interval of the mother at a 95% confidence interval (p < 0.001) in this study. Having an interpregnancy interval of fewer than 24 months has a 75% less likelihood of having a planned pregnancy (OR = 0.25, 95% CI: 0.12-0.53). The National Survey of Family Growth conducted in the United States of America showed that of the 40% of unplanned pregnancies, 36% had an interpregnancy interval of fewer than 18 months. It also concluded that as the interpregnancy interval increased, the prevalence of unplanned pregnancies decreased [19]. The association between the planning status of the current pregnancy and the timing of folic acid intake is statistically significant at a 95% confidence interval (p < 0.001). Antenatal mothers who had consumed folic acid before the current pregnancy have more than twice the chance of having a planned pregnancy (OR = 2.27, 95% CI: 1.5-3.43). A study done in the United States of America showed that women who said that their pregnancies were planned are more likely to confirm taking folic acid in the preconception period, with an odds ratio of 3.7 (95% confidence interval: 2.38 – 5.56) after controlling for maternal age and income [20].

A statistically significant association is seen at a 95% confidence interval between the planning status of the current pregnancy and the number of past conceptions (p < 0.05). Having less than two past conceptions is twice as more likely to have a planned pregnancy (OR = 2.1, 95% CI: 1.6-4.12). A case-control study in Western Iran revealed a significant association between unplanned pregnancies and previous live births (p < 0.001), with risk increasing by 2.97 per one already living child. A statistically significant association is not seen between the planning status of the current pregnancy and maternal age at birth of the first child at a 95% confidence interval (p > 0.05). In a community-based cross-sectional study done in Nepal, 60.5% of unplanned pregnancies were among women who had delivered their first child at or before they were 20 years of age [21]. As only mothers having at least one live birth were considered, and a significant amount of the study population (204 out of 425) were either having their first pregnancy or not having a live birth in the past, a statistically significant association with the planning status of the current pregnancy was not found.

There is no statistically significant association between the planning status of the current pregnancy and the time of first antenatal clinic registration by the antenatal mothers at a 95 % confidence interval (p > 0.05). Though there is no statistically significant association in this study, a systematic review and meta-analysis done in 2013 on the effects of pregnancy intention on the use of antenatal care services showed that a significantly higher number of women with unplanned pregnancies not attending their first antenatal care clinics on time as compared to women with planned pregnancies (Odds ratio: 1.42, 95% confidence interval: 1.27 – 1.59) [22]. In the above systematic review, the median duration of pregnancy at the time of the first antenatal clinic registration by the pregnant mother was five months, as compared to Sri Lanka, where antenatal mothers register by 12 weeks. The meta-analysis included only 32 articles though 422 were initially identified through searches and was conducted in a rural population in Ethiopia as compared to this study which was done in an urban setting. These could be reasons for the difference in the findings between this study and the systematic review [23,24] Table 1.

There is no statistically significant association at a 95% confidence interval between the planning status of the current pregnancy and home visits by health care workers in the antenatal period (p > 0.05). According to data from the Family Health Bureau, the percentage of pregnant women having at least one home visit by a Public Health Midwife (PHM) was 91.9% (Family Health Bureau, 2015). As most antenatal mothers in Sri Lanka receive at least one home visit during their antenatal period by a health care worker, there is no statistically significant association with the planning status of pregnancy.

Declaration of interest

No conflict of interest could be perceived as prejudicing the impartiality of the research reported.

Funding

This research did not receive any specific grant from any funding agency in the public, commercial or not for profit sector.

Author contribution

Psn was the principal investigator in the study and was involved in data collection, analysis and report writing.

Acknowledgements

The dissertation was mainly based on the experience the principal investigator had while working as a Senior House Officer in Obstetrics and Gynaecology at Teaching Hospital Batticaloa between the years of 2014 to 2017. The principal investigator, especially among antenatal mothers who attended the hospital antenatal clinics, observed unplanned pregnancies and their adverse outcomes. It is also a major public health problem all over the world and hence the principal investigator thought it would be an ideal topic to do a dissertation on, especially at a time when there is a COVID 19 pandemic. The principal investigator would also like to thank the various officials who were involved in permitting to collect data at Borella, Kirula and Wellawatte antenatal clinics, especially during the COVID 19 pandemic. Many people were very helpful during the period of data collection, analysis, and dissertation writing. The principal investigator would like to thank all of them.

There was no funding, grants or equipment provided as a source of support for this study. There are no conflicts of interest.

Regarding our Journal: https://oajclinicalsurgery.com/ Know more about this article https://oajsurcasestudies.com/oajcs.ms.id.10052/ https://oajsurcasestudies.com/pdf/OAJCS.MS.ID.10052.pdf

#Prevalence #unplanned pregnancies #associated factors #antenatal mothers #Sri Lanka #Praveen Shankar Nagendran #OAJCS #Clinical Surgery

[sahrahblog]

Life insurance rates by age

Life insurance quotes can vary quite a lot between individuals. One of the more significant factors in determining the average cost of life insurance is an applicant’s age. Generally, the older a person is, the higher the cost of their life insurance premiums will be. Life insurance policies are designed to pay a death benefit when the insured passes away. Anything that increases the odds of an insured’s death can also increase rates. Age is one of the strongest determiners of future life expectancy, so it is also one of the most impactful variables in determining life insurance rates.

Many other variables are also used to calculate these rates. The health of an applicant, their family medical history and risky lifestyles and hobbies can factor into rate determination when underwriters review an applicant. Still, few, if any, of these factors are as impactful as age when it comes to rates.

How life insurance rates are determined Life insurance companies use a few different criteria to calculate your premium. Some of the most significant ones include your age, overall health, gender, the type of policy you buy and the amount of coverage you choose. Here is a deeper look into these five categories and how they impact your life insurance premium.

-Age The first factor that determines your life insurance premium is your age. Young people tend to pay the lowest life insurance rates and older people pay the highest rates. Although there are exceptions, a 30-year-old will likely receive a lower premium quote than a 40-year-old, and a 40-year-old will pay less than someone who is 55 or older.

Life insurance rates increase as you get older because advanced age typically corresponds to health complications or just a shorter lifespan. This means insurance companies can expect a claim payout will come sooner for an older person, and will often charge a higher premium to offset that risk.

-Health Health is another major factor that contributes to the cost of life insurance. People who suffer from pre-existing health issues — like diabetes, heart disease or obesity — typically do not live as long as healthy people with no conditions. As a result, insurance companies may charge higher rates for people with health issues or a family history of disease.

In addition to a traditional medical exam or health questionnaire, insurance companies use a rating system to determine your health risks. Represented are the following categories:

Preferred Plus: People in the Preferred Plus category are in excellent health, with no family history of disease or pre-existing conditions. Preferred: Those in the Preferred category are typically in great health, but they might have a family history of one or two illnesses. Standard Plus: The Standard Plus category means the individuals are mostly healthy, but may be slightly overweight, or suffer from minor conditions without a long family history of disease. Standard: People in the Standard category suffer from moderate health issues and have a strong family history of disease. Substandard: This category is for applications with moderate to severe health issues or risky health habits, like smoking. Insurance companies may use different categories, depending on their own regulations.

-Gender It may not come as a surprise to learn that your gender also plays a key role in your life insurance premium. Men typically pay more for life insurance than women. This is because statistics show that women have a longer lifespan than men. According to data from the U.S. Census, the projected average life expectancy for a female in 2020 was 81.9 years old, and for men, the projected average was 77.1 years old.

-Policy type Life insurance premiums are also a reflection of the kind of policy you buy. Term life insurance is the most affordable policy because it offers coverage for a limited number of years. If you do not pass away during the term, the policy expires without a death benefit being paid out. On the other hand, permanent life insurance policies are generally more expensive because they provide coverage for your entire lifetime.

If you purchase a guaranteed life insurance policy, you could end up paying the highest rate. Guaranteed life insurance policies do not require a medical exam, so to make up for the added risk of insuring older or health-compromised individuals, insurance companies charge extremely expensive premiums in comparison to other forms of life insurance. Despite the high rates, guaranteed life insurance policies usually have very low policy limits, as they are generally designed to cover end-of-life expenses.

-Coverage limit The last factor that determines your life insurance premium is your policy’s coverage limit. The higher your coverage limit is, the more expensive your insurance premium will be. When you pass away, your insurance company agrees to pay your beneficiaries a certain amount of money. To mitigate that payout, the insurance company will price your policy accordingly.

For example, someone who has a coverage limit of $100,000 will likely have a much lower premium than someone with $1,000,000 in coverage. Ultimately, it will cost the insurance company less money to pay out $100,000 than it would to pay out $1,000,000, so the average cost of premiums would be much lower.

-Life insurance rates by age When you are shopping for life insurance, it is important to consider your age and understand how that will affect your premium. Depending on your age, you might decide to choose one type of life insurance over another in order to get a more affordable rate. Here is a brief overview of life insurance rates by age:

-Young adult life insurance Young adults are generally at their peak of health and may only need a small amount of coverage. Most individuals will find that a term life insurance policy offers adequate coverage for their needs and budget. For example, a 35-year-old couple with a 5-year-old child might consider purchasing term life insurance policies with $500,000 in coverage over a 30-year term. This could help provide a financial cushion for the surviving spouse if one passes away. The death benefit could be used to help pay the mortgage, replace the lost spouse’s income and cover the child’s educational expenses. In most cases, life insurance policies for young adults are based on what fits your budget and covers immediate outstanding financial concerns, such as funeral expenses or outstanding debts or loans.

-Middle-age life insurance People who are between 40-60 years old will usually benefit the most from a permanent life insurance policy that offers protection for their lifetime. Life insurance for middle-aged policyholders may be geared toward helping a spouse pay down the remaining amount on a mortgage and pay off other debts if their partner passes away. Life insurance can also be used to leave a financial gift to a spouse or loved one without necessarily earmarking the money for a certain use.

-Life insurance for seniors Most insurance companies will not sell new life insurance policies to people over a certain age, usually around 70 to 80. For people who are older or suffer from pre-existing health conditions, a guaranteed life insurance policy may be the best or only option. This type of policy does not have a medical exam, and coverage is approved for almost everyone. Guaranteed life insurance policies usually have a death benefit cap around $25,000.

-Life insurance rates typically increase as you get older. However, insurance companies look at other factors, like your overall health, your gender, the type of policy you buy and the amount of coverage you need in order to calculate your personalized rate. If you are thinking about buying life insurance, it is a good idea to figure out what type of policy makes sense for your age, your budget and your coverage needs.

Frequently asked questions

Who has the best life insurance policies? The best life insurance company for one individual will not always be the best for another. Each policyholder has their own unique needs. Additionally, some insurance companies specialize in different areas. For instance, the best company for a term life policy may not be the best for a whole life policy, and the best for individual policies may not be the best for business life insurance.

How can I find cheaper life insurance? One of the best ways to find the cheapest life insurance company for you is to understand your coverage needs. While shopping around might help you save a bit of money, life insurance rates don’t vary as much between companies as home or auto insurance rates. Working with an agent to determine the best type of policy, level of coverage and riders for your situation could help you find a policy that fits your needs and budget.

How much life insurance do I need? Deciding how much life insurance coverage to purchase can seem daunting, but there are strategies that can help. Before determining how much life insurance you need, it’s important to assess a few relevant variables. The amount of debt you have, how much you contribute to household income and financial goals for your children (like saving for college) are all essential variables to consider. From here, it can help to follow a guide (or use a calculator) to determine how much financial protection you may need in the face of these variables.

Credits to: Elizabeth Rivelli

Date Posted: 2022

Source: https://www.bankrate.com/insurance/life-insurance/rates-by-age/

#areteautomation #lifehealthadvisors

[nellieannmones]

Life Insurance Underwriting Amid a Pandemic

COVID-19 has changed the rules for insurance companies and consumers

The coronavirus pandemic has increased consumers’ interest in life insurance. In a 2020 PwC survey, 15% of respondents said they were likely to buy life insurance as a result of COVID-19. At the same time, the pandemic has made the life insurance underwriting process, particularly in-person health exams, more challenging and changed the way that many consumers now go about purchasing a policy.

KEY TAKEAWAYS

More people have expressed interest in buying life insurance as a result of the coronavirus pandemic.

It is still possible to purchase life insurance during the pandemic, though it may mean going through a slightly different underwriting process, without an in-person health exam.

No-exam life insurance policies are an alternative to traditional life insurance but typically cost more.

When purchasing life insurance during a pandemic (or at any time), it’s important to compare policies and insurers.

How Traditional Life Insurance Underwriting Works

Life insurance underwriting is a process through which an insurance company assesses a person’s various risk factors to determine how much to charge them for coverage. That means an assessment of lifestyle risk factors (such as having a dangerous occupation or hazardous hobbies) as well as health risk factors.

When you apply for life insurance, whether you’re considering a term life or permanent life policy, it’s typical to have to go through a paramedical exam. This exam is designed to provide a snapshot of your overall health and often involves blood and urine samples as well as height and weight measurements.

You may also be asked to complete a health questionnaire to assess your risk level for serious health conditions that might develop later in life. The insurance company can also ask lifestyle-related questions.

All of this information is evaluated by the insurance company to determine how much you’ll pay for your insurance. As a general rule, the younger and healthier you are and the fewer risk factors you have, the less you’ll pay in life insurance premiums.

Tip: Consider using an online life insurance calculator to estimate how much life insurance you need and what you might pay based on your age, gender, and overall health.

Life Insurance Underwriting During a Pandemic

The COVID-19 pandemic has brought the implementation of social distancing guidelines, encouraging people to maintain a minimum 6-foot distance between one another. For life insurance companies, those guidelines have presented a challenge to traditional underwriting, particularly with regard to in-person health exams.

As a result, two-thirds of life insurance providers have changed their underwriting policies to address the lack of access to health exams, according to a survey by LIMRA, an industry trade association. Rather than conduct in-person testing, insurers are increasingly relying on physician statements, phone interviews, or FaceTime screenings to assess the health status of their applicants.

The survey also found that among the life insurance companies that have changed their underwriting approach, two-thirds are increasing automated/accelerated underwriting limits to make larger policies available.2 All told, this means that people shopping for life insurance during the pandemic may find it easier and faster to obtain the coverage they want.

Note

Life insurance policies that were in place prior to the pandemic may see no changes unless you have a term policy coming up for renewal that you’d like to convert to permanent life insurance.

No-Exam Life Insurance During a Pandemic

No-exam life insurance is a type of life insurance you can purchase without going through a health exam. These policies existed before the coronavirus pandemic, and they’re an alternative to consider alongside traditional term or permanent life insurance.

With no-exam policies, you complete a health questionnaire. The life insurance company will review your answers, along with your medical history, to make a determination about your risk class and what to charge you for insurance.

The advantage of getting a no-exam life insurance policy during a pandemic is that you don’t have to worry about the health exam or social distancing requirements at all. It’s possible to apply for no-exam life insurance online and get a decision in just a few business days.

The downside of no-exam life insurance is that the premium costs may be higher compared with traditional coverage. Without a medical exam to assess factors like cholesterol levels or body mass index, the insurance company may be taking on more risk to insure you and charge more for coverage, as a result.

How to Buy Life Insurance During a Pandemic

If you’re interested in purchasing life insurance during the pandemic, there are some important questions to ask initially. For example:

Is term life or permanent life insurance more appropriate for your needs?

How much coverage do you think you’ll need?

Are you interested in no-exam coverage or would you prefer a traditional life insurance policy?

What type of premiums would be affordable for your budget?

Are you looking to add any riders or specialized coverage, such as a long-term care rider, to the policy?

Term life insurance is something you might consider if you only need coverage for a set term, say 20 or 30 years. Permanent life insurance can offer lifetime coverage, along with the potential for cash value accumulation. The catch is that permanent life insurance tends to carry considerably higher premiums compared with term life.

In terms of how much coverage you need, that will obviously vary from person to person, but you may want enough to pay for funeral expenses, settle any outstanding debts, and provide your dependents with sufficient income to cover their living expenses for a number of years after you’re gone. As a general rule of thumb, many financial experts suggest having insurance equal to 10 to 15 times your annual salary.

Consider getting online quotes from the best life insurance companies as you look for a policy. This can be a simple way to compare costs side by side and find the most affordable coverage. Remember, however, that these are quotes, not final pricing. You’ll still need to complete the insurance company’s application and underwriting process, whether that involves a health exam or not, to determine what you’ll actually pay for life insurance.

Credits: Rebecca Lake

Published: February 14, 2022

Source: https://www.investopedia.com/life-insurance-underwriting-amid-a-pandemic-5101719

#areteautomation #lifehealthadvisors #healthiswealth

[midnatt-heronweather]

1. What did you do in 2020 that you’d never done before? * An FCD convention (2258) * got quarantined due to a international pandemic. 

2. Did you keep your new years’ resolutions, and will you make more for next year? I don’t do them 

3. Did anyone close to you give birth? not sure of timing, but my cousin Jade i think, though by “close” i only mean by blood, we’ve not had dealings since she was in High School. 

4. Did anyone close to you die? a friend  (no names for the sake of honour) a friends father  (no names for the sake of honour) a cousins familiar (no names for the sake of honour)

 5. What countries did you visit? none.

6. What would you like to have in 2021 that you lacked in 2020?. Have some semblance of an actual life.  

7. What dates from 2020 will remain etched upon your memory, and why? the end of Feb 2020 - I finally me Jason Carter, and yes I will be going on about this repeatedly for years to come.  also in Feb I saw Counterfeit for what..i never believed would be the last time.  

8. What was your biggest achievement of the year? not murdering someone count? 

9. What was your biggest failure? for a change i don’t have an answer to that.. not on I’m willing to post publicly anyway.

 10. Did you suffer illness or injury? no 

11. What was the best thing you bought? either my little black owl bag (codenam Morningstar) or one of the ghosts.  

12. Whose behaviour merited celebration? Heather Louise Sharpe. takes a lot to survive what she has this year and not go to pieces.  

13. Whose behaviour made you appalled and depressed? as always i could quote a number of politicians and people in and out of showbiz.  there have been a few fandom people and moments too. but personally speaking..  I was rather.. disgusted by someone I had thought actually possessed a brain (a hard thing to do where they come from) but as always I was proved wrong  

14. Where did most of your money go?} survival. and for me that means geekery 

15. What did you get really, really, really excited about? MEETING - JASON - CARTER and some other stuff which consequently never happened and never likely will. 

16. What song will always remind you of 2020? COunterfeit - It gets better. both becaue it got me through a lot of the year and cos.. well. just cause

17. Compared to this time last year, are you:

a) happier or sadder? meh.

b) thinner or fatter? meh.

c) richer or poorer? poorer

 18. What do you wish you’d done more of? anything. 

19. What do you wish you’d done less of? being stuck in the house. 

20. How did you spend Christmas? not happened yet but will likely be stuck in the house watching reruns. in my family unit its not classed as a ‘big’ thing, even less so this year

 21. What was your favourite month of 2020? Feb: Hu, Counterfeit, 2258

 22. Did you fall in love in 2020? & 23. How many one-night stands? I am a Sex repulsed Aromantic Asexual.. form your own answer

24. What was your favourite TV programme? Cursed/Roswell/Charmed 

25. Do you hate anyone now that you didn’t hate this time last year? several. one in particular 

26. What was the best book you read? Ben  Aaronovitch - False Values 

27. What was your greatest musical discovery? this year i’ve personally not made one, but Allys sent me 2 bands who i now love. re-discovery however is another story - Black Veil Bridges saved my soul when Counterfeit split. 

28. What did you want and get? the 13th doctors coat. AND IT ACTUALLY FITS not got it “yet” but I’ve finally ordered a Zat.

29. What did you want and not get? question is mute cos if i wanted it i’ll get it next year unless your talking events due to the pandemic in which case.. hindsight is 2020 aint it

 30. What was your favourite film of this year? Cant say I have on tbf 

31. What did you do on your birthday, and how old were you? its this week lik 4 days from now. i’ll be 36 and short of on of my breif trips to york i’m doing exactly fuck all.(december + pandemic) 

32. What one thing would have made your year immeasurably more satisfying? how long you got? * getting a holiday * seeing my friends for more than a few hours  * getting to a con  * one of the few decent bands left not fracturing * this country not being subjected to a bunch of silver spoon fed, tunnel visioned inbreeds and their leader the great hair fail. 

33. How would you describe your personal fashion concept in 2020? PJ dont last a year if you werar them 5/7 days

34. What kept you sane? thats been debatable since i was 6 lol/.  but this year.. whats kept me “anchored.” is: * My Pack  * Teen Wolf and other fandoms  * planing for 2021 even though I know my countries fked. 

35. Which celebrity/public figure did you fancy the most? see queston 22  

36. What political issue stirred you the most? I try to avoid politics, my family are all socialists and its like verbal torture in this house since i was old enough to realise it. 

37. Who did you miss? My Pack.  yes i got to see Adam, Heather and Ally for a few hours on and off throughout the yar, but thats like being stuck in solitary and only gettng to go outside once a month out of all 12 months.. not even that if i’m honest 

40. Quote a song lyric that sums up your year. Happy! Happy! Happy! Happy! Happy! Happy!Choose your poison Poison! Choose your poison Poison! Choose your poison Poison!Everything is shutting down (Shutting down, shutting down) Everything is shutting down (Shutting down, shutting down) Everything is shutting down (Shutting down, shutting down)

 <Danny Elfman - Happy>

41. sum your __2020 up in pictures (IN NO ORDER) will be dong that in another post as always

#2020 review questionnaire #2020

[filmnoirsbian]

Favorite books read in 2021....I'll be honest, I don't easily remember everything I've read. That's why I started recording it all at the end of each month, but even that I only started doing in August. For instance, I know I read a number of nonfiction and poetry books this year which I really liked, but cannot for the life of me remember which. I'll remember certain titles only to vaguely recall reading them in 2020, during the first round of pandemia. So here are my favorites of the ones I've read since August of 2021, and had the good sense to write down:

1. House of Leaves by Mark Z. Danielewski

What is there to say about this book that hasn't been said? I cannot explain it in a way that will make sense to anyone who hasn't at least peeked inside the cover, like tucking your head around to peer down a long, dark hallway. It should be empty. You know it's empty. There hasn't been any sign that it's not empty. And yet, you still feel watched. This book is an experiment. A puzzle. A cipher. A love story. A nightmare. A questionnaire. If you do choose to read it, there will be no skimming. No distractions. No half measures. You must either give into the book fully, jumping into the lake without testing the water's temperature, or not at all.

2. Lighthousekeeping by Jeanette Winterson

This was my first foray into Ms. Winterson's writing, and I'm very glad for that. I spent the first half of this book thinking it was somewhat of a memoir, and I'm still not totally convinced it's not. The story (stories) is whimsical and dreamlike but entirely plausible, in a surreal sort of way. As if looking through a window smeared by the rain. It's a lovely little read for a cold day spent under the covers.

3. Uzumaki by Junji Ito

Oh boy what a fun and delightful and easy read! Certainly not a fucked up story with no light at the end of the long and spiraling tunnel, no sir.

4. Books of Blood by Clive Barker

Everytime I read good, cosmic horror (like Uzumaki) or contemporary horror (this one is a mix of both), I wonder yet again why anyone still reads HP Lovecraft or Stephen King...Clive Barker is, I believe, the most comparable to King. He touches on many of the same themes and fears, but in a refreshingly concise, much more enjoyable way. Finding out he's gay, and also wrote the Hellraiser and Candyman movies, was just a bonus.

5. Convenience Store Woman by Sayaka Murata

What a captivating little story! I loved the voice of the titular convenience store woman, and Murata's simple, elegant writing style. Most of the reviews I read of this book viewed it as a comedy or strange romance, but for me the story seemed sadder and darker than that. I think Convenience Store Woman is the story of a person whose neuroatypicalness means that in a world not designed with that in mind, she takes hold of the one thing she can do, which our capitalistic society has taught her is important: work. Her job becomes her identity. Her job becomes her meaning for life.

6. The Girl With All the Gifts by M. R. Carey

I watched the film adaptation before reading the book, but I highly recommend both. Zombie stories are my absolute favorite subgenre, so I'm constantly on the lookout for new and interesting versions of the concept. This book isn't the first zombie media to make the zombie the protagonist (Dead Heat by Del Stone Jr. was published in 1996, Stubbs the Zombie: Rebel Without a Pulse came out in 2005, The Sinister Mr. Corpse by Jeff Strand was published in 2007, Colin came out in 2008, Warm Bodies in 2010, etc. The first zombie protagonist is often credited to HP Lovecraft's story The Outsider, first published in 1926, but I hate that guy so I hesitate to credit him with anything.), or to create an evolved, more human-like zombie (The Resident Evil franchise has been evolving zombies since the first game release in 1996, In the Flesh premiered in 2011, Dylan Dog: Dead of Night (a truly terrible but fun movie about the underbelly of the monster world) came out in 2010, etc.) or even the first to question the very nature of the human vs zombies plot line: after all, if these zombies can think, speak and feel like humans, if they are for all intents and purposes alive, then what makes the survival of humanity more important than the survival of zombies? What makes a prey animal more integral to its ecosystem than its predator? But this book is the first to ask these questions from the mouth of a zombie child, which turns the conversation into one about generations: isn't it the adults' duty to let their children inherit the earth? Isn't that what evolution means?

7. The Refrigerator Monologues by Catherynne M. Valente

This is the book I recommend to anyone knee-deep in the "fanfiction vs real books" debate, because so far every book I see given as an example of fanfiction (Dante's Inferno, literal Greek mythology, etc) simply isn't, and furthermore I doubt anyone arguing that they are has ever actually read them. The Refrigerator Monologues, on the other hand, is fanfiction, and not only is it fanfiction, it's an open-palmed critique of the comic industry's treatment of women. It's a collection of short stories, each very clearly based on a famous fridged woman from classic superhero comics, though all the names and powers have been changed. It cannot be divorced from the media it's based on, because it exists to examine that media. If you like superhero media, this is a necessary read.

8. Aurora Leigh by Elizabeth Barrett Browning

A lovely epic poem with love and grief embroidered throughout--love of art, love of people, romantic love and platonic love and maternal love. Ultimately it's about two women who keep getting lost and then manage to find their ways together.

#thank u for tagging me amatullah 🫂 #an open window #tcp

[ukrfeminism]

Teachers say they do not feel equipped to deal with peer-on-peer sexual abuse because they have had no training.

More than 1,500 UK teachers replied to a questionnaire from BBC Radio 4's File on 4 and teachers' union the NASUWT.

More than half said they did not think adequate procedures were in place in their schools to deal with abuse.

Many are also unsure how to deliver elements of a new sex-and-relationships curriculum, which the government says third parties might now help with.

In England, the Department for Education has introduced a compulsory Sex and Relationships Education (RSE) curriculum in all schools, focusing on relationships in primary schools and sex and relationships in secondaries.

It has also asked Ofsted to review peer-on-peer safeguarding procedures.

Of the teachers surveyed, almost a third said they had witnessed peer-on-peer sexual harassment or abuse and almost one in 10 said they saw it on a weekly basis.

The debate about a culture of sexual abuse at schools has escalated in recent months after a website set up for victims to post their experiences anonymously gained more than 16,000 posts - some from children as young as nine.

The Everyone's Invited website publishes anonymous allegations which refer mostly to sexual harassment carried out against young women by young men at their school or university.

The government has now launched a dedicated hotline with the NSPCC for young people who feel they have been harassed and abused.

Since the helpline launched at the beginning of April, it has received more than 350 calls, and 65 referrals have been made to agencies including social services and the police.

'I felt so alone'

Amina is now 19 and still trying to come to terms with what happened to her at high school. She says her harassment started when she was in Year 7, aged 11.

"I started to get bullied and people were making rumours up about me. They were saying I would go home with so many different guys and have sex with them - that was really upsetting for me.

"It was during the summertime and we were practising for PE, and then I'm sitting there with my friends and then there's this group of boys next to us. And then I just feel a hand on my back, forcing me onto the floor and then this boy starts grinding on me, and I think during that moment - I just completely froze.

"And then I look up at my teacher and then he looks at me and then he looks away. I just felt so alone in that moment. Part of me felt like it was my fault because of other people's responses. I remember telling myself just to stay strong and just wait until I got home to cry."

Amina is now being supported by the Rape Crisis charity.

The new RSE curriculum in England was introduced in September 2020.

Andrew Fellows, associate head of policy at child-protection charity the NSPCC, says that while the new lessons are a positive development, schools have not been given the support and guidance to deliver the new curriculum effectively.

"Coercive control, sexual consent, healthy relationships, online safety, pornography - that's all in there.

"But what schools haven't been given is the guidance and the support to cover that and to deliver that in a way that works for their students," he said.

Flora Cooper, head teacher of Crowmarsh Primary School in Oxfordshire, where staff have just started to teach the new RSE lessons, said: "In terms of external training, we've not had any.

"We actually haven't seen much being offered in terms of training and it is absolutely in the training - that's what is essential, which we don't have.

"Until the teachers are confident with the delivery of the content, then I don't think any of them will be confident and fully teaching the children the full curriculum. It feels as though we are on our own."

Ofsted is currently conducting a review of safeguarding policies and practices relating to sexual abuse in state and independent schools and colleges.

It was ordered by the government after thousands of young people - mostly girls and young women - contacted the Everyone's Invited website.

Children's Minister Vicky Ford said: "We've seen these enormously worrying and very shocking allegations that have come through the Everyone's Invited site.

"One of the things that Ofsted will be looking at in this review is, are schools getting enough training and support? Do they need, for example, third parties to come in and train elements of that curriculum?"

Anyone who has suffered sexual abuse at school can contact the dedicated NSPCC helpline on 0800 136 663.

#uk radfem #uk radical feminism #uk radical feminist #uk feminism