Perceptions of teachers towards COVID appropriate behaviors for school children in coastal South India

COVID appropriate behavioral measures need to be followed once school reopens. School teachers being in the forefront could substantiate the feasibility of suggested safety measures. This study aimed to assess teachers’ perceptions towards COVID appropriate behaviors for children with school reopening and compare their mean scores between public versus private schools and across school boards. We conducted an observational school-based study of teachers over two months. Perceptions were scored using a five-point Likert symmetric agree to disagree scale. Results were expressed as proportions and analyzed using an independent sample t-test. Of the 547 teachers surveyed, most (> 90%) agreed to the suggested social distancing and hygiene measures. There was a significant difference in perception scores between private versus public schools and across boards regarding i) reducing the academic syllabus, ii) adopting a cloud-based system to integrate online-offline learning, and iii) conducting meetings online. In addition, measures such as i) teaching classes on alternate days with a limited number of children, ii) arranging benches/desks to maintain six feet distance between students, iii) dealing with psychological stress by counselors, and iv) arrangement with local hospitals for medical services were significant statistically across school boards. To conclude, most schoolteachers agreed with the need for social distancing and hygiene measures for children. There was a significant difference in perceptions between public versus private schools and across boards regarding academic syllabus, integration of online-offline student learning, number of children per class, the timing of classes, student seating arrangement, and medical/psychological guidance availability.

Suicide Risk in Adolescents During the COVID-19 Pandemic

BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic created high levels of psychological distress and may have increased suicide risk. METHODS: We used the 4-item Ask Suicide-Screening Questions (ASQ) to assess suicide risk among all patients 12 to 24 years of age at a children’s hospital. We compared demographics, encounter type (telehealth or face-to-face [F2F]), and screening results from April to June 2020 (T2) to those from April to June 2019 (T1). RESULTS: Fewer patients were seen at T2 than T1 (17 986 vs 24 863). A greater proportion of visits at T2 were by telehealth (0% vs 43%). The rate of positive suicide screens was higher in T2 than in T1 (12.2% vs 11.1%, adjusted odds ration [aOR], 1.24; 95% confidence interval [CI], 1.15–1.35). The odds of a positive screen were greater for older patients (aOR of 1.12 for age in years; 95% CI, 1.10–1.14), female patients (aOR, 2.23; 95% CI, 2.00–2.48), patients with public versus private insurance (aOR, 1.88; 95% CI, 1.72–2.07), and lower for Black versus White patients (aOR, 0.85; 95% CI, 0.77–0.95). Rates of positive screens were highest among inpatients (20.0%), intermediate for emergency department patients (14.4%), and lowest in outpatient clinics (9.9%) (P < .05). CONCLUSIONS: Rates of positive suicide risk screens among adolescents rose in the pandemic’s early months with differences related to sociodemographics and visit type. Changes in health care delivery highlight the complexities of assessing and responding to mental health needs of adolescents. Additional research might determine the effects of screening methods and patient populations on screening results.

Political Order and Poverty Eradication

Introducing the concept of viability, this study clarifies that the key to solving the poverty problem is to provide external assistance to nonviable residents. The study then proposes a simple model and explains that 1) although private market mechanisms are efficient for economic growth, public market mechanisms mobilizing societal resources are necessary and effective for poverty eradication; and 2) strong state capacity, competent leadership, and high social trust and support will benefit poverty eradication. The concept of viability and the model was further applied to compare the war on poverty in the US and the poverty alleviation plan in China in the following aspects: background and top design, public versus private market mechanism, leadership, social trust, and achievement. In addition, a cross-country investigation was conducted to obtain preliminary empirical evidence. The findings in this study support the concept and the model, which inspired us to provide some discussions.

Differences in the Distribution of Non-Hodgkin Lymphoma in Public Versus Private Institution in a Latin American Country: A Cohort of 5,807 Cases

Differences in the Distribution of non-Hodgkin Lymphoma in public versus private institution in a Latin American country: A cohort of 5,807 cases. Background: Non-Hodgkin lymphoma (NHL) is the most frequent hematological malignancy. B-cell (BCL) and T-cell (TCL) NHL subtypes differs in high income and low-and middle-income countries. In Peru, the healthcare system (HCS) is divided mainly into public and private institutions. We previously demonstrated that there is a difference in the distribution of NHL between the HCS. We aimed to describe the subtypes of NHL seen according to healthcare facilities in a large cohort. Methods: We reviewed medical records at National Cancer Institute and Oncosalud, both the leading public and private cancer centers in Peru, respectively. All patients diagnosed with NHL from 2010-2019 according to the 2016 WHO classification were included. Baseline characteristics were compared between public and private institutions using Student's t test and Chi-square as appropriate. Results: A total of 5,807 NHL were included from both institutions. The median age was 60 years (range 15-103), 50.6% were male. Most patients NHL cases were encountered at the public institution (92.4%, n = 5,368); 82.9% (n = 4,815) were BCL and 17.1% (n = 992) TCL. Differences of BCL and TCL frequencies were seen among institutions. More BCL cases were seen at the private institution (86.1%, n = 378 versus 82.7%, n = 4,437, respectively) whereas TCL were common in the public institution (17.3%, n = 931 versus 13.9%, n = 61, respectively) (p < 0.065). The most frequent BCL was DLBCL with 68.6% (n = 3045) and 54.2% (n = 205) seen in public and private institutions, respectively (p < 0.001). The second most frequent BCL was follicular lymphoma (FL) with 11.2% (n = 495) and 20.9% (n = 79) seen in the public and private institutions, respectively (p < 0.001). Chronic lymphocytic lymphoma (CLL) and Burkitt lymphoma (BL) were most frequent in private institution (CLL 6.3%, n = 24 vs. 3.5%, n = 154, p = 0.004; BL 3.4%, n = 13 vs. 1.4%, n = 60, p = 0.001). The most frequent TCL was peripheral T-cell lymphoma, not otherwise specified (PTCL, NOS) (24.5%, n = 228) for the public institution and mycosis fungoides (MF) (42.6%, n = 26) for the private institution. The second most frequent TCL was natural killer/TCL (NKTCL) (23.5%, n = 219) for the public institution, and PTCL, NOS (21.3%, n = 13) for the private institution. There was significant difference in the number of NKTCL and MF cases seen during the study period among institutions (NKTCL public 23.5%, n = 219 vs. private 4.9%, n = 3, p = 0.001; MF public 9.1%, n = 90 vs. private 42.6%, n = 26, p <0.001). Conclusions: The distribution of NHL subtypes differs according to the type of healthcare system in Peru. Our large cohort confirms that DLBCL and NKTCL are more frequent in patients treated at the public cancer center than in private center. On the contrary FL, CLL, BL and MF are more frequent in private cancer center. The difference in the distribution of BCL and TCL was not statistically significant. Disclosures No relevant conflicts of interest to declare.

Health Care Fictions: The Business of Medicine and Modern US Literature

The literary and cultural dimensions of the longstanding US political debate over public versus private health care have been critically underexplored. How did early twentieth-century US writers portray the business of medical care within a stratified US economy? In Robert Herrick’s The Healer (1911), Wallace Thurman and A. L. Furman’s The Interne (1932), and Frank G. Slaughter’s That None Should Die (1941), the problems of inequality, profit, and corruption plague the practice of professional medicine. The writers of these novels do not, for the most part, blame the trouble with care on individual nurses, doctors, or other medical staff. Instead of exposing the power of individual medical practitioners to exploit bodies, these novels call attention to the power of capitalism and inequality to distort and derange the mission of medicine. Yet, the political critiques offered by health care fictions are foreclosed by anxieties about collective reform and government intervention in health care. So, this article asks why some of the most sustained literary treatments of capitalist medicine in US literature ultimately retreat from the structural critiques that they themselves raise.

Disparities in Youth Sports and Barriers to Participation

Purpose of Review Youth sports participation has shifted from a school-based, seasonal activity to club-based, year-round activity over the past 10–15 years. Single sport specialization has become increasingly common with a concurrent increase in injury and burnout. Paralleling trends seen in other aspects of health care, disparities in regard to participation in youth sports, and subsequent injury treatment exist as well. Recognition of these disparities amongst coaches, parents, and athletes involved in youth sports are essential to promote the short- and long-term health of pediatric and adolescent athletes. Recent Findings Multiple barriers exist for youth in regard to sports participation. Youth who come from families without extensive financial means are increasingly finding it difficult to play organized sports, with this trend holding when broken down by insurance status (public versus private). This problem is further exacerbated by the lack of community-based programming in locations where organized (albeit expensive) options do not exist. The lack of athletic trainers increases the divide, as well as the care that injured athletes receive (particularly in public schools within communities of color) is not equivalent to schools with extensive financial resources. Thus, ability to quickly return to play after injury and/or access the health care system is limited. This is further exemplified by inferior outcomes in regard to care for anterior cruciate ligament, meniscus, shoulder instability, and concussions in this population. Summary Youth sports participation is laden with multiple disparities. This is unfortunately reflective of historical barriers to opportunities/advancements in multiple other areas of society. These disparities place certain groups of children at an uphill battle not only for participation when healthy, but also returning to participation when injured. Larger structural changes in youth sports are necessary to promote life-long, healthy physical activities for individuals most at risk.

How to Do Surgery on the Constitutional Law of Libel

Of late, the constitutional law of libel has become the focus of increasing dissatisfaction. This dissatisfaction has taken various forms. The argument below, however, is that the most crucial defect of constitutional libel law lies in the Court’s continuing attempts to draw and utilize distinctions among public figure and private figure libel plaintiffs. The Court should abandon these attempts. Instead, the Court should attend, broadly and fundamentally, to the constitutionally vital distinction between libelous speech that does or does not address some matter of public interest and concern. The argument below first emphasizes the constitutional logic underlying the Court’s initial imposition of First Amendment limitations on the state tort law of libel. The argument then critiques the Court’s initial embrace of a supposedly fundamental but actually distracting distinction between public and private figure libel plaintiffs. Interestingly, for a brief time, a divided Court returned to a focus on the underlying logic of putting First Amendment limits on the tort of libel, only to then re-distract itself with a renewed focus on questions of public and private figure status. Perhaps inevitably though, the Court’s emphasis on public versus private figure status has been qualified, in limited ways, by recourse to the genuinely basic and more valuable distinction between speech that does or does not address some matter of public interest and concern. The argument then catalogs some additional problems inherent in the Court’s public versus private figure libel plaintiff distinction. The argument then defends the essential priority of a focus on the public interest versus merely private interest nature of the subject matter of the libel defendant’s speech. A brief, but comprehensive, conclusion then follows.