Engaging men and boys in gender equity programs in humanitarian settings: A scoping review

Background

Engaging men and boys in interventions designed to achieve gender equity has demonstrated positive impact on reducing gender-based violence (GBV) and improving women's and girls' health. This scoping review describes the content of published gender equity programs that engage men/boys in humanitarian settings.

Methods

We searched five databases for peer-reviewed articles of GBV programs implemented with men/boys in humanitarian settings (published between Jan 2000 and Dec 2019). From each article, we extracted information on program evaluation strategies, theoretical frameworks, and modes of adaptation to the humanitarian setting.

Results

Of 21 published articles of GBV programs with men/boys (implemented in 17 countries), the majority utilized a psychosocial (attitudes) or structural (feminism) theory and only seven were not theoretically based. As to evaluation, nine programs employed quantitative methods whilst the rest employed qualitative or mixed methods; outcome evaluation data were gathered from both men only or men and women. In most articles, authors described how they developed the program taking into account the humanitarian setting and incorporated practical delivery components to overcome contextual barriers.

Conclusions

In describing the content of published GBV interventions that include men/boys in humanitarian settings, this scoping review can guide future efforts to improve women's/girls' health. Such programs can help realize SDG5 to “achieve gender equality and empower all women and girls.”

Key messages

Including men in interventions designed to improve women’s/girls’ health in humanitarian settings is critical. A scoping review of the published literature can identify existing knowledge and guide future programs.

Impact of a Three-Year Obesity Prevention Study on Healthy Behaviors and BMI among Lebanese Schoolchildren: Findings from Ajyal Salima Program

Most school-based obesity prevention programs in low- to middle-income countries are of short duration, and few undertake follow-up analyses after the termination of the project. The aims of the current study are to investigate (1) the long-term effects of a school-based intervention program when implemented over two years on body mass index (BMI), healthy dietary behaviors, and physical activity (PA); and (2) whether the effects are sustained after one-year washout. The study is a cluster-randomized trial; 36 public and private schools were randomized into either intervention or control groups. Students (8–12 years) completed pre-and post-assessment anthropometric measurements and questionnaires about their eating and physical activity habits. Students in the intervention groups received the program components for two consecutive years. Multiple logistic regression models were used to examine the effect of the intervention on BMI and healthy behaviors. Students in the intervention groups were less likely to be overweight at washout, only in public schools. The number of children reporting change in dietary behaviors significantly increased in intervention groups, with a sustained effect only in public schools. Policies aiming at securing a positive nutrition environment in schools, and adoption of nutrition programs, are needed for achieving sustained behavior and prompting BMI changes in children.

Impact of a one-year school-based teacher-implemented nutrition and physical activity intervention: main findings and future recommendations

BACKGROUND

The aim of the current study is to describe the effectiveness of a school-based intervention when delivered by a non-nutrition specialist (trained schoolteachers) as compared to an expert in nutrition.

METHODS

Two trials of the same school-based intervention using the same intervention package were delivered, one by nutritionists and another by trained schoolteachers. The intervention focused mainly on dietary behaviours, as well as physical activity. In both trials, purposively selected schools were randomized to intervention or control groups; students (aged 9-11 years) in both groups were compared at post-test on knowledge and self-efficacy scores, as well as dietary and physical activity behaviours, controlling for their baseline status on the various measures. All analyses accounted for clustering at the school level.

RESULTS

In both trials, a statistically significantly greater improvement was observed for both the knowledge and self-efficacy scores in intervention vs. school students. When the programme was delivered by trained schoolteachers, frequency of breakfast intake was increased, crisps consumption was reduced, but no change in fruit and vegetable consumption was observed (latter increased when delivered by nutrition professionals only). Physical activity did not improve in both trials.

CONCLUSION

Trained schoolteachers can have a positive impact on students' dietary behaviours with the appropriate training to ensure they are equipped with the right information, skills, and resources to deliver the programme with the highest fidelity.

TRIAL REGISTRATION

ClinicalTrial.gov Identifier: NCT03040271. Retrospectively registered on 2 February 2017.

Treatment of dentigerous cysts with a modified Hawley plate in children: report of two cases with radiographic results

Dentigerous cysts in young adults may compromise the natural evolution of the dentition and can be treated surgically or non-surgically. We report the minimally-invasive treatment of dentigerous cysts in two young patients using a modified Hawley plate to avoid traumatic injury to anatomical structures, with up to four years' follow up.

Autonomous microfluidic capillaric circuits replicated from 3D-printed molds

We recently developed capillaric circuits (CCs) - advanced capillary microfluidic devices assembled from capillary fluidic elements in a modular manner similar to the design of electric circuits (Safavieh & Juncker, Lab Chip, 2013, 13, 4180-4189). CCs choreograph liquid delivery operations according to pre-programmed capillary pressure differences with minimal user intervention. CCs were thought to require high-precision micron-scale features manufactured by conventional photolithography, which is slow and expensive. Here we present CCs manufactured rapidly and inexpensively using 3D-printed molds. Molds for CCs were fabricated with a benchtop 3D-printer, poly(dimethylsiloxane) replicas were made, and fluidic functionality was verified with aqueous solutions. We established design rules for CCs by a combination of modelling and experimentation. The functionality and reliability of trigger valves - an essential fluidic element that stops one liquid until flow is triggered by a second liquid - was tested for different geometries and different solutions. Trigger valves with geometries up to 80-fold larger than cleanroom-fabricated ones were found to function reliably. We designed retention burst valves that encode sequential liquid delivery using capillary pressure differences encoded by systematically varied heights and widths. Using an electrical circuit analogue of the CC, we established design rules to ensure strictly sequential liquid delivery. CCs autonomously delivered eight liquids in a pre-determined sequence in <7 min. Taken together, our results demonstrate that 3D-printing lowers the bar for other researchers to access capillary microfluidic valves and CCs for autonomous liquid delivery with applications in diagnostics, research and education.

Effective ED complaint management

Handling patient complaints is possibly one of the most delicate tasks any manager must face. Although managing patient complaints is never a pleasant experience, a detailed plan can make it easier and more uniform, resulting in less stress and anxiety. Before improvements can be accomplished, deficiencies in the system must be corrected. Only after the department's processes have been deemned stable can the qualiuty of care be improved and the customer satisfied.

Developing EMS quality assessment indicators

An emergency medical service (EMS) system is part of a broad health care system which no longer can be concerned exclusively with patient transportation. Integration of prehospital and in-hospital emergency care must be achieved to provide quality patient care. This article suggests modifications in the Joint Commission on Accreditation of Healthcare Organization's (JCAHO) 10-Step Model indicators that should help in an evaluation of the issues associated with the diversion of patients from Emergency Departments. The JCAHO model is one that can be used to help integrate prehospital and inhospital care.

An emergency department perspective--Part III, Outcomes

The outcome of care has traditionally been defined as a "change in the patient's current and future health status that can be attributed to antecedent health care." However, this definition provides a "unidimensional view of quality." It fails to take into account the customer's attributes and the many small steps or process variances that can contribute to an unexpected outcome. This failure can be especially pronounced in the emergency department.

An emergency department perspective: Part II. Process review

Webster defines process as a "series of actions or operations conducting to an end." Each of the many processes that may be involved with providing a service or procedure comprises many smaller steps. It is the monitoring of those steps that we call a process review. The process review for quality management begins when a patient perceives the need to receive emergency care. It embodies the technical and interpersonal aspects of the patients, and the staff's interpersonal relationships.

Managing negative outcome by reducing variances in the emergency department

Negative outcome management depends upon reducing variances in the structure and process of health care. In the multitask environment of a hospital's emergency department (ED), a system is required to monitor the many tasks for variances. Without a monitoring system in place, the cumulative effect of these structure and process variances will significantly contribute to negative outcomes. Structure and process variance management requires a customer-focused, process-conceptualization approach that attempts to manage the many small variances in care along the entire chain of interdependent processes making up the ED system. Process mapping is one technique that enables management to understand and anticipate variances and take corrective action to eliminate them before they occur.

An emergency department perspective--Part one

High patient volumes requiring rapid turn around times, critical decision making processes, and a necessity for establishing an accurate working diagnosis are a few of the many challenges in hospital emergency departments. Quality management, rather than quality assurance, most accurately describes how activities in the emergency department should be monitored to meet these challenges. Already an important factor in manufacturing and service industries across the United States, quality management will become the essential driving force in the health care industry. To survive in the '90s, the emergency department must include in its goals the development of plans and processes that meet the challenge of the ED environment and that focus on customer satisfaction.

Mesenteroaxial gastric volvulus in children

We have presented a case of mesenteroaxial volvulus in a 12-year-old girl. Since this entity is rare in children, one must be especially alert to its possibility for early diagnosis and treatment of this potential catastrophe.