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To inform prevention strategies, we assessed the extent of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission and settings in which transmission occurred in a Georgia public school district.During 1 December 2020-22 January 2021, SARS-CoV-2-infected index cases and their close contacts in schools were identified by school and public health officials. For in-school contacts, we assessed symptoms and offered SARS-CoV-2 reverse-transcription polymerase chain reaction (RT-PCR) testing; performed epidemiologic investigations and whole-genome sequencing to identify in-school transmission; and calculated secondary attack rate (SAR) by school setting (eg, sports, elementary school classroom), index case role (ie, staff, student), and index case symptomatic status.We identified 86 index cases and 1119 contacts, 688 (61.5%) of whom received testing. Fifty-nine of 679 (8.7%) contacts tested positive; 15 of 86 (17.4%) index cases resulted in ≥2 positive contacts. Among 55 persons testing positive with available symptom data, 31 (56.4%) were asymptomatic. Highest SARs were in indoor, high-contact sports settings (23.8% [95% confidence interval {CI}, 12.7%-33.3%]), staff meetings/lunches (18.2% [95% CI, 4.5%-31.8%]), and elementary school classrooms (9.5% [95% CI, 6.5%-12.5%]). The SAR was higher for staff (13.1% [95% CI, 9.0%-17.2%]) vs student index cases (5.8% [95% CI, 3.6%-8.0%]) and for symptomatic (10.9% [95% CI, 8.1%-13.9%]) vs asymptomatic index cases (3.0% [95% CI, 1.0%-5.5%]).Indoor sports may pose a risk to the safe operation of in-person learning. Preventing infection in staff members, through measures that include coronavirus disease 2019 vaccination, is critical to reducing in-school transmission. Because many positive contacts were asymptomatic, contact tracing should be paired with testing, regardless of symptoms.

The Association of Female Genital Mutilation in Sexual Behaviors and Marriageability, Ethiopia DHS 2016 By Lemlem Eyob Mehari INTRODUCTION: Female genital mutilation (FGM) is a public health issue affecting girls and women worldwide. FGM is practiced in many countries primarily in Africa. In Ethiopia, the prevalence of FGM has been decreasing nationally over the years. However, among different regions and ethnic groups the prevalence varies greatly. FGM is used as a tool to control female sexuality and believed to make girls and women more marriageable. There is limited research studying the relationship of FGM in sexual behaviors and marriageability in Ethiopia. AIM: The purpose of this study is to determine the relationship of FGM in sexual behaviors and marriageability. METHODS: This study used secondary data from the 2016 Ethiopia Demographic and Health Survey (EDHS). In this study the sample size of the study’s population included 7,151 women between the ages of 15 to 49 who have heard of female genital mutilation/cutting (FGM/C). Multiple lifetime number of sexual partners and early sexual debut were the dependent variables used to measure sexual behaviors. Premarital sex was another dependent variable created to evaluate marriageability since female virginity is considered a prerequisite for marriage. SAS 9.4 was used to run chi-square tests and logistic regressions. Chi-square tests were used to examine associations for categorical variables to compare background characteristics by circumcision status and the dependent variables. Bivariate and multivariate logistic regression were used to analyze the association of FGM to sexual behaviors and marriageability. Sociodemographic characteristics were controlled for during analysis. RESULTS: In this study, the proportion of the women who knew about FGM and were circumcised was 71%. After controlling for sociodemographic characteristics, a multivariable logistic regression model showed that circumcised women were less likely to have multiple lifetime number of sexual partners (OR = .748; 95% CI = .566, .988). Although nonsignificant, FGM was protective against early sexual debut and premarital sex. The odds of multiple lifetime number of sexual partners increased among ages 24 to 49, non-educated women, Amhara ethnicity, Tigray ethnicity, urban, and in the regions of Tigray, Afar, Amhara, Oromia, Benishangula, Gambela, Addis Ababa, and Dira Dawa. Women who were circumcised, ages 15 to 19, Orthodox, Amhara ethnicity and Sidama ethnicity were more likely to have an early sexual debut. The chances of premarital sex increased among women who were circumcised, ages 20 to 49, Orthodox, and in the region Addis Ababa. DISCUSSION: Although, FGM was shown to be protective against female sexuality, depending on the type of circumcision done such as Type III which is infibulation, are less likely to engage in sexual intercourse often which may have an effect on the results. CONCLUSION: These findings suggest a need for more programs and strategies for FGM eradication to be specific for different regions and ethnicities as the prevalence varied based on these two factors. The study shows that further research is needed to show the effects of different types of circumcision has on controlling female sexuality.

Although healthcare information systems improve healthcare and efficiency they are often complex and provide a limited service. For these and other similar reasons, users often take it upon themselves to create their own solutions. These user created solutions are called feral information systems. It is not always that these feral information systems meet the standard requirements of healthcare information systems and as a result of this they have the potential to create risk that might put the patient, management and the organization at risk. This is an undergraduate thesis that aims to research the risks that can rise when feral information systems fail to meet the standard requirements of healthcare information systems. The report is an interpretive case study that focuses on three different feral information system within a regional healthcare organization. Ten standard requirements of healthcare information systems are described and written from three distinctive divisions – Technique oriented, information oriented and user oriented requirements. Information is gathered using a semi-structured interview with the developer of the three systems, a user of one of the systems and two managers from the maintenance department of the organization. The data gathered about the feral information system is then interpreted and analyzed using the ten requirements of IT system in healthcare from the perspective of the three different divisions. As a result of the research we have come to the conclusion that the failure to meet the user and information and technical oriented requirements have the potential to create certain risk in some aspects but not all. Feral information systems in health care services can pose a risk to patient safety and that there are probably several of these systems that violate the patient data act or personal data law. Failure to handle data integrity and follow the patient data law in feral information systems often results in lacking user traceability. In addition, there is an extra cost to maintain systems that are usually not analyzed by the operations. We see that feral information systems often uses self- defined healthcare terminology which obstructs the ability to integrate with other systems. The lack of documentation obstructs the use of the system without a special training. These trainings take time, resources and are often not free. Making the organization more and more dependent on the experienced users. Furthermore, the lack of documentation also obstructs the possibility of further developing the system. However, the potential of feral information system to cause risk is often neglected and underestimated. This is because feral information systems often fulfill only a small and particular need within a certain division of the organization. IT-system inom hälso- och sjukvård förbättrar vården och effektiviteten. De är dock ofta komplexa och ger en begränsad service. Av detta och andra liknande skäl skapar ofta användarna egenutvecklade IT-system. Dessa användarskapade IT-system kallas feral information systems. Det är inte alltid så att dessa feral information system uppfyller de krav som ställs på IT-system inom hälso- och sjukvård och som ett resultat av detta har de potential att skapa risker för patienten, förvaltningen och organisationen i helhet. Denna kandidatuppsats syftar till att undersöka de risker som kan uppstå när feral information systems inte uppfyller de krav som ställs på IT-system inom hälso- och sjukvård. Studien är en tolkande fallstudie som fokuserar på tre olika feral information systems inom en regional hälsovårdsorganisation. Vi har tagit fram tio kriterier som vi anser IT-system inom hälso- och sjukvård bör uppfylla. Dessa kriterier beskrivs och uttrycks från tre kategorier: teknikorienterade, informationsorienterade och användarorienterade krav. Vårt empiriska material samlas in med hjälp av semistrukturerade intervjuer med utvecklaren av de tre systemen, en användare av ett av systemen samt två chefer från organisationens förvaltningsorganisation. Insamlade data om dessa feral information systems tolkas och analyseras sedan med hjälp av de tio kriterierna vi tagit fram för IT-system inom hälso- och sjukvård och summeras i de tre kategorierna. Feral information systems i vårdverksamheter kan innebära risk för patientsäkerheten och att det troligen är flera av dessa system som bryter mot patientdatalagen eller personuppgiftslagen. Brister i att hantera dataintegritet och patientdatalagen leder till att feral information systems ofta saknar spårbarhet. Dessutom finns en kostnad för att underhålla systemen som oftast inte är analyserade av verksamheterna. Vi ser att feral information systems ofta följer sina egna definitioner av begrepp vilket försvårar integrationen med andra system. Avsaknaden av dokumentation leder till svårigheter i att använda systemen utan utbildning. Utbildningen tar tid, så denna resurs är oftast inte gratis. Detta gör att verksamheten blir beroende av de mer erfarna användarna. Avsaknaden av dokumentation skapar även svårigheter i övertagandet av existerande feral information systems samt vid behovet av vidareutveckling. Eftersom feral information systems oftast uppfyller små och nischade behov inom en verksamhet, försummas och underskattas systemets potential att skapa risk.