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Quantitative microbial risk assessment (QMRA) is a growing interdisciplinary field addressing exposures to microbial pathogens and infectious disease processes. Risk science is inherently interdisciplinary, but few of the contributing disciplinary programs offer courses and training specifically in QMRA. To develop multidisciplinary training in QMRA, an annual 10-day long intensive workshop was conducted from 2015 to 2019--the Quantitative Microbial Risk Assessment Interdisciplinary Instructional Institute (QMRA III). National leaders in the fields of public health, engineering, microbiology, epidemiology, communications, public policy, and QMRA served as instructors and mentors over the course of the program. To provide cross-training, multidisciplinary teams of 5-6 trainees were created from the approximately 30 trainees each year. A formal assessment of the program was performed based on observations and surveys containing Likert-type scales and open-ended prompts. In addition, a longitudinal alumni survey was also disseminated to facilitate the future redevelopment of QMRA institutes and determine the impact of the program. Across all years, trainees experienced statistically significant increases (P < 0.05) in their perceptions of their QMRA abilities (e.g., use of specific computer programs) and knowledge of QMRA constructs (e.g., risk management). In addition, 12 publications, three conference presentations, and two research grants were derived from the QMRA III institute projects or tangential research. The success of QMRA III indicates that a short course format can effectively address many multidisciplinary training needs. Key features of QMRA III, including the inter-disciplinary training approach, hands-on exercises, real-world institute projects, and interaction through a mentoring process, were vital for training multidisciplinary teams housing multiple forms of expertise. Future QMRA institutes are being redeveloped to leverage hybrid learning formats that can further the multidisciplinary training and mentoring objectives.

4-H academics responded to the COVID pandemic by rapidly adapting CDC and other resources for virtual delivery. A statewide epidemiology project was taught to 48 youth with the goal of minimizing fears and confusion, increasing prevention measures, leveraging current topics for education, and bolstering the social-emotional health of youth participants. Results indicated that youth enjoyed the project and adopted behaviors to reduce the spread of infectious diseases, such as increased mask-wearing.

The reported prevalence of autism spectrum disorder (ASD) has more than tripled in the past two decades in the United States, due in part to improved screening and diagnostic techniques. Epidemiologic data on ASD, however, are largely limited to population-based surveillance systems. We examined epidemiologic patterns in ASD diagnoses among inpatients aged 1-20 years, using data from the Kids' Inpatient Database (KID) from 1997 to 2019. ASD cases were identified using ICD-9-CM and ICD-10-CM codes. Of 9,267,881 hospital discharges studied, 110,090 (1.19%) had a diagnosis of ASD. The prevalence of ASD was higher among males compared to females (1.53% vs. 0.54%) and was highest among non-Hispanic Whites (1.28% vs. 0.95% in non-Hispanic Blacks, 0.94% in Hispanics, and 1.18% in Other races). ASD prevalence increased from 0.18% to 1997 to 3.36% in 2019 (Z= -273.40, p < 0.001). The absolute increase was higher among males compared to females (0.26-4.90% vs. 0.08-1.77%) and among non-Hispanic Whites (0.18-2.88%) compared to non-Hispanic Blacks (0.23-2.72%), Hispanics (0.14-2.60%), and Other races (0.19-2.97%). The epidemiologic patterns of ASD based on inpatient data are generally consistent with reports from the community-based autism surveillance system. Our findings indicate that KID and other health services data might play a complementary role in ASD surveillance.

The network scale-up method (NSUM) is a survey-based method for estimating the number of individuals in a hidden or hard-to-reach subgroup of a general population. In NSUM surveys, sampled individuals report how many others they know in the subpopulation of interest (e.g. "How many sex workers do you know?") and how many others they know in subpopulations of the general population (e.g. "How many bus drivers do you know?"). NSUM is widely used to estimate the size of important sociological and epidemiological risk groups, including men who have sex with men, sex workers, HIV+ individuals, and drug users. Unlike several other methods for population size estimation, NSUM requires only a single random sample and the estimator has a conveniently simple form. Despite its popularity, there are no published guidelines for the minimum sample size calculation to achieve a desired statistical precision. Here, we provide a sample size formula that can be employed in any NSUM survey. We show analytically and by simulation that the sample size controls error at the nominal rate and is robust to some forms of network model mis-specification. We apply this methodology to study the minimum sample size and relative error properties of several published NSUM surveys.

The objective of this meta-epidemiological study was to explore the impact of attrition rates on treatment effect estimates in randomised trials of chronic inflammatory diseases (CID) treated with biological and targeted synthetic disease-modifying drugs. We sampled trials from Cochrane reviews. Attrition rates and primary endpoint results were retrieved from trial publications; Odds ratios (ORs) were calculated from the odds of withdrawing in the experimental intervention compared to the control comparison groups (i.e., differential attrition), as well as the odds of achieving a clinical response (i.e., the trial outcome). Trials were combined using random effects restricted maximum likelihood meta-regression models and associations between estimates of treatment effects and attrition rates were analysed. From 37 meta-analyses, 179 trials were included, and 163 were analysed (301 randomised comparisons; n = 62,220 patients). Overall, the odds of withdrawal were lower in the experimental compared to control groups (random effects summary OR = 0.45, 95% CI, 0.41-0.50). The corresponding overall treatment effects were large (random effects summary OR = 4.43, 95% CI 3.92-4.99) with considerable heterogeneity across interventions and clinical specialties (I2 = 85.7%). The ORs estimating treatment effect showed larger treatment benefits when the differential attrition was more prominent with more attrition in the control group (OR = 0.73, 95% CI 0.55-0.96). Higher attrition rates from the control arm are associated with larger estimated benefits of treatments with biological or targeted synthetic disease-modifying drugs in CID trials; differential attrition may affect estimates of treatment benefit in randomised trials.

The objectives of this article are to examine the epidemiology of suicide for Black college men; social determinants of mental health, mental health inequities, and suicide prevention for Black college men; role of mental health utilization for Black college men; role of culture in addressing mental health needs for Black college men; racial trauma and mental health for Black college men; role of socio-economic barriers for Black college men; mental health needs of Black college men amid the COVID-19 pandemic; mental health needs of African and Caribbean college men; mental health needs of Black gay, bisexual, queer, and trans+ college men; and implications for colleges and universities in addressing the mental health needs of Black college men.

Immune literacy--the ability to hear, learn, read, write, explain, and discuss immunological content with varied audiences--has become critically important in recent years. Yet, with its complex terminology and discipline-specific concepts, educating individuals about the immune system and its role in health and disease may seem daunting. Here, we reflect on how to demystify the discipline and increase its accessibility for a broader audience. To address this, a working group of immunology educators from diverse institutions associated with the research coordination network, ImmunoReach, convened virtually. As a result of these discussions, we request a call to action for a system-level change and present a set of practical recommendations that novice and experienced educators from diverse institutions, professional societies, and policymakers may adopt to foster immune literacy in their classrooms and communities.

Background: Constipation impacts health-related quality of life with a burden similar to other chronic conditions. This study characterises the prevalence of constipation and its associated factors in older adults with intellectual disability. Methods: Data from the Intellectual Disability Supplement of The Irish Longitudinal Study on Ageing was analysed using bivariate and multivariate approaches. Results: Constipation affected 43.5% of this cohort and was more common in females, those in residential settings, and those with a severe/profound level of intellectual disability. The type of residence, level of intellectual disability, a low fat diet, high cholesterol, multimorbidity and, physical activity predicted constipation status with 67.7% accuracy. Physical activity was associated with lower constipation prevalence, where minimal activity was sufficient to observe this effect. Conclusions: Constipation is a common health concern in older people with intellectual disability. This analysis reveals characteristics that should inform the careful monitoring of bowel health in this population.

Purpose: This study explored undergraduate college students' opinions of the CDC's online "Solve the Outbreak" (StO) game, a recommended aid in higher education for teaching concepts epidemiological outbreak investigations. Methods: The study was conducted as a game debriefing, in which 16 students enrolled in an undergraduate-level epidemiology course were interviewed to receive feedback about their experiences of StO after completing the game. Results: A total of four common themes emerged from the interveiews as framed by the Persuasive Game Design model--(1) Enjoying the Game World, (2) Cheating the Game's Elements, (3) Suggesting Improvements to the Game's Elements, and (4) Inverted Transfer Effect. Conclusions: Students reported that they enjoyed playing StO, and that it was effective for applying their knowledge of epidemiology course content on the process of investigating outbreaks. However, students found ways to cheat the game's answers, and they recommended ways that the game's elements could be improved. Instructors should consider using StO as a tool for teaching their students about investigating infectious outbreaks. Designers of the game should consider adapting the game based on students' constructive feedback.

Objective: We provide a step-by-step guide for developing, administering, evaluating, and acting on a survey-based study of graduate student mental health. Methods: Blueprint focuses on forging student-faculty collaboration and is based on Harvard University's Graduate Student Mental Health Initiative (GSMHI). The survey tool we use includes validated screening instruments for depression, anxiety, imposter phenomenon, self-esteem, alcohol consumption, exercise and sleep habits, and loneliness. It also includes environmental questions that collect epidemiologic data, as well as ratings of advising relationships and student dynamics. Results: After 6 years, GSMHI has analyzed data from 30 different PhD programs and 4,866 students, overseen the implementation of more than 60 departmental action plans, and performed 9 follow-up surveys to assess progress. It has achieved high response rates (60-90%), discovered wide variation in mental health and environmental factors across departments, and supported experiments with interventions. Conclusion: We hope this blueprint helps other universities run similar initiatives.

The COVID-19 pandemic, like past historical events such as the Vietnam War or 9/11, will shape a generation. Mathematics educators can seize this unprecedented opportunity to teach the principles of mathematical modeling in epidemiology. Compartmental epidemiological models, such as the SIR (susceptible-infected-recovered), are widely used by researchers and educators to study and teach infectious disease dynamics, particularly for COVID-19. The SIR model is considered a fundamental mathematical model for the spread of epidemic disease and employs Ordinary Differential Equations to determine the number of individuals in each compartment of a population at a given time. In this note, we demonstrate how to build a basic SIR model. We show how to simulate, plot, and interpret the results using numerical simulation with R, a popular programming language widely used in data analysis and scientific research.

The emergence of COVID-19 favoured the development at Université de Montréal of an educational initiative aimed at promoting modelling and simulation in teaching and learning postsecondary mathematics. In our learning activities, modelling is not reduced to curve fitting; software is used and questions are asked to get a deeper understanding of the structure of a situation. In particular, compartmental epidemiological models were the topic of activities using digital tools (Insight Maker and Excel) that generated interest among teachers and students. With the possibilities offered by such tools of reflecting more adequately the complexity of the situation, we considered it relevant to model the perceptions related to significant effects of nonpharmaceutical interventions (NPIs) as well as the apparent social divide in behaviours regarding mandated measures and its effect on the epidemic. A study carried out on these aspects, based on data collected in Québec, led us to develop a new model which could form the basis for a new activity and be explored and further refined by students. This work leads to considering a social dimension to the teaching of modelling with differential equations and to include this teaching in the development of critical thinking.

This article explores the first field epidemiology training programme (FETP) through a case study to understand its approach to learning and education. Field epidemiologists deploy to outbreaks to investigate, control, and prevent future epidemics and pandemics. Since the 1950s, they have learned their trade through FETP. FETP arose at a paradigmatic crossroads, has endured for seventy years, and is now delivered in over ninety countries. COVID-19 has highlighted the urgency for re-thinking learning in the health sector, hence the analysis of this case can inform FETP, public health, and the adult education field. Inductive content analysis of this case using published accounts from the programme designer-leader and participants suggests the programme's approach to learning reflected Knowles's andragogical assumptions, Kolb's experiential learning cycle, and Lave and Wenger's legitimate peripheral participation in communities of practice. Alignment with such influential contributors to the field of adult learning clarifies the programme's paradigm and explains its endurance. Now, given the lessons of COVID-19, critical learning approaches are needed to enable field epidemiologists to engage issues of culture and power as they investigate epidemics. Recent adult learning theories offer opportunities for adult educators to collaborate with public health programmes. COVID-19 urges that we do not hesitate.

Missing data can significantly influence results of epidemiological studies. The National Health and Nutrition Examination Survey (NHANES) is a popular epidemiological dataset. We examined recent practices related to the prevalence and the reporting of the amount of missing data, the underlying mechanisms, and the methods used for handling missing data in recent doctoral dissertations and subsequent publications using NHANES data as a case study. We also explored missing data handling coverage in top-selling applied statistical textbooks. Thirty-seven doctoral dissertations (published from 2007 to 2017) and 17 subsequent journal articles were included in the analysis. Overall, 29 (78.4%) dissertations did not explicitly state whether they had missing data. Five (62.5%) dissertations reporting missing data did not report an assumed mechanism of missingness. Only one subsequent journal article reported the missing data percent for key variables. 28 (75.7%) dissertations and 16 (94.1%) journal articles reported the use of NHANES sample weights. Of the top-selling 20 applied statistics/biostatistics textbooks examined, 14 did not mention imputation. This sample reflects poor rigor in analysis, reporting, and handling of missing data found among recent graduates and poor coverage in textbooks. Checklist utilization and improvement in statistical training on missing data handling are needed. Supplementary materials for this article are available online.

There is a public health epidemic in adolescents' use of Electronic Nicotine Delivery Systems (ENDSs), also known as electronic cigarettes, vaping products, or JUULs. However, little is known about the level of knowledge school staff have about ENDS. The purpose of this study is to examine outcomes of a nurse-led educational intervention designed to increase school staff knowledge about ENDS. A descriptive, nonrandomly selected pre-test/post-test design was used with 125 Wisconsin school staff. Results revealed further educational needs of school staff in content areas including advertising to youth and flavoring of ENDS. Following the educational intervention, post-test results showed a significant overall improvement in participant knowledge scores. Recommendations include implementing nurse-led education about ENDS to a more diverse population of school staff. Providing nurse-led ENDS education to school staff offers an upstream, proactive approach for school nurses to help address this public health epidemic.

ChatGPT and AI programs are creating a stir on college campuses nationwide. Concerns about cheating are strong and many instructors are adopting new teaching strategies to dissuade students from using the technology in assignments. In the present study, undergraduate students in an introductory epidemiology course were assigned to use ChatGPT to produce essays about topics related to course content and, in pairs, critically analyze the resulting essays. Individually, students responded to reflection questions regarding the technology and its implications for college classrooms. In this study, those qualitative reflection responses were analyzed for themes. While a variety of viewpoints were expressed regarding expectations of the program, most students were aware of the potential for cheating but remained cautiously optimistic about the use of ChatGPT as an educational tool.

It is common for social scientists to use formal quantitative methods to compare ecological units such as towns, schools, or nations. In many cases, the size of these units in terms of the number of individuals subsumed in each differs substantially. When the variables in question are counts, there is generally some attempt to neutralize differences in size by turning variables into ratios or by controlling for size. But methods that are appropriate in many demographic and epidemiological contexts have been used in settings where they may not be justified and may well introduce spurious relations between variables. We suggest local regressions as a simple diagnostic and generalized additive models as a superior modeling strategy, with double-residualized regressions as a backup for certain cases.

We aimed to screen children aged 18-48 months in the general population of nine Russian regions for risk of mental, behavioral and developmental disorders (MBDDs) including autism spectrum disorders (ASD) using an original screening tool. The prevalence of the risk for MBDDs is 1307:10,000 (13.07%), the prevalence of clinically verified cases of MBDDs is 151:10,000 (1.51%), whereas the prevalence of ASD among them is 18:10,000 (0.18%). Basing on our results, the screening procedures are already integrated into the Russian primary care system since the end of 2019. Screening of the risk for MBDDs including ASD in Russia among children in the general pediatric population is a promising area of preventive medicine.

Cognitive epidemiology investigates cognitive predictors of health and disease outcomes. Post-operative cognitive impairment is a common complication of surgery but has been neglected as a health outcome in cognitive epidemiology research. This is despite the fact that knowledge of cognitive predictors of post-operative cognitive impairment can be utilized for risk stratification, informed decision-making (in elective surgery), and personalized care of patients during the postoperative period. In this narrative review, the current literature on cognitive predictors of post-operative cognitive impairment and gaps therein are summarized.

Oral health is a very critical component of individuals' physical and psychological well-being. The present study aimed to investigate the dental health knowledge, attitude, and practice among schoolchildren in Abha. A cross-sectional epidemiological study was conducted. Each student completed a questionnaire regarding oral health. The participants were 800 students: 54.8% were male and 45.2% were female. Knowledge scores showed that -59.1% of the participants have fair knowledge. Statistically significant results were found between the age, school type, and students' educational level with the knowledge of oral health care (p < 0.05). More than half of the participants had positive attitudes (57.2%) and less than half demonstrated satisfactory oral health habits (45.3%). Students' educational level was significantly associated with attitudes and practices (p < 0.05). It can be concluded that the average knowledge, attitude, and practice level was 53.9%, which is not a positive indicator and needs to be strengthened.

Simplified, reductionist approaches to curriculum design and delivery are pervasive in science education. In ecological curricula--particularly in, but not limited to K-12--biomes, ecosystems, habitats, and other units of study are simplified and presented as static, easily identified and described entities. Characteristics, components, and representative phenomena of each are taught, and student learning of these things is evaluated. However, this approach minimizes the complexity and dynamic nature of environments whether natural, human built, or some hybrid of the two. In this paper, I make a case for studying environments and environmental issues in all of their spatial, temporal, and compositional complexity from the very earliest ages as a way to increase environmental literacy among individuals as well as in the population as a whole. This, in effect, will cultivate learners with a better, more nuanced understanding of the natural world and will lead to citizens, professionals, and policymakers who are more inclined, have more efficacious intellectual tools, and who are better able to address the environmental issues and crises such as climate change, sea-level rise, wildfires, epidemics and pandemics, drought, and crop failure, that are becoming more common and more critical in the 21st century.

This paper aims to explore student experiences resulting from collaborative teaching and learning of academic literacy and content knowledge, for multiple objectives at a South African University of Technology. Using the qualitative research approach, undergraduate students who attended the Communication Skills course were randomly selected. Data were collected using in-depth interviews and questionnaires. The data were thematically coded to make sense of the experiences shared by the participants. The results indicated that academic literacy courses in the Faculty of Applied Sciences at the Cape Peninsula University of Technology (CPUT) were often regarded as peripheral, until we the lecturers in the present study collaborated to align disciplinary or content knowledge with academic literacy. Our alignment included the practice of decolonising the language and academic literacy curriculum, collaborative teaching, integrating content and language teaching and learning, and implementing a range of blended pedagogies, along with social media. Based on the student reflection and feedback, we are inclined to conclude that this pedagogy enhanced the overall teaching and learning experience. We further found that student learning experiences improved as the literacy course was moved from the periphery to the mainstream of the academic project by adopting various approaches in teaching and learning, guided by student needs, the language context of the class, and the learning outcomes or needs of the discipline.

We investigated to which degree commercial funding is associated with estimated intervention effects in randomized trials. We included meta-epidemiological studies with published data on the association between commercial funding and results or conclusions of randomized trials. We searched five databases and other sources. We selected one result per meta-epidemiological study, preferably unadjusted ratio of odds ratios (ROR), for example, odds ratio(commercial funding)/odds ratio(noncommercial funding). We pooled RORs in random-effects meta-analyses (ROR <1 indicated exaggerated intervention effects in commercially funded trials), subgrouped (preplanned) by study aim: commercial funding per se versus risk of commercial funder influence. We included eight meta-epidemiological studies (264 meta-analyses, 2725 trials). The summary ROR was 0.95 (95% confidence interval 0.85-1.06). Subgroup analysis revealed a difference (p = 0.02) between studies of commercial funding per se, ROR 1.06 (0.95-1.17) and studies of risk of commercial funder influence, ROR 0.88 (0.79-0.97). In conclusion, we found no statistically significant association between commercial funding and estimated intervention effects when combining studies of commercial funding per se and studies of risk of commercial funder influence. A preplanned subgroup analysis indicated that trials with high risk of commercial funder influence exaggerated intervention effects by 12% (21%-3%), on average. Our results differ from previous theoretical considerations and findings from methodological studies and therefore call for confirmation. We suggest it is prudent to interpret results from commercially funded trials with caution, especially when there is a risk that the funder had direct influence on trial design, conduct, analysis, or reporting.

The global epidemic of noncommunicable diseases (NCDs), such as cardiovascular disease and diabetes, is creating unsustainable burdens on health systems worldwide. NCDs are treatable but not curable. They are less amenable to top-down prevention and control than are the infectious diseases now in retreat. NCDs are mostly preventable, but only individuals themselves have the power to prevent and manage the diseases to which the enticements of modernity and rising prosperity have made them so susceptible (e.g., tobacco, fat-salt-carbohydrate laden food products). Rates of nonadherence to healthcare regimens for controlling NCDs are high, despite the predictable long-term ravages of not self-managing an NCD effectively. I use international data on adult functional literacy to show why the cognitive demands of today's NCD self-management (NCD-SM) regimens invite nonadherence, especially among individuals of below-average or declining cognitive capacity. I then describe ways to improve the cognitive accessibility of NCD-SM regimens, where required, so that more patients are better able and motivated to self-manage and less likely to err in life-threatening ways. For the healthcare professions, I list tools they can develop and deploy to increase patients' cognitive access to NCD-SM. Epidemiologists could identify more WHO "best buy" interventions to slow or reverse the world's "slow-motion disaster" of NCDs were they to add two neglected variables when modeling the rising burdens of disease. The neglected two are both cognitive: the distribution of cognitive capacity levels of people in a population and the cognitive complexity of their health environments.

Background/purpose: This sequential explanatory mixed-methods study inspected the impact of an online ESP course on postgraduate students' content knowledge development about epidemiology in general and COVID-19 in particular. The course was titled "English for Pandemics" and was administered via a Learning Management System (Edmodo). Materials/methods: Needs Analysis was (informally) deployed to trace participants' needs, preferences, and wants in order to shape the landscape of the treatment. The researcher employed a quasi-experimental design (a one-group, pretest-posttest design). Participants were pretested prior to the treatment. The treatment consisted of online exposure to eight units (English for Pandemics), capitalizing on Edmodo in content delivery, receipt, mastery, and assessment. Following the treatment, after 8 weeks, the participants were post-tested. Results: Quantitative results revealed a statistically significant difference in the participants' content knowledge regarding epidemiology and COVID-19. Qualitative findings divulged that participants highly appreciated Edmodo interactive features (simplicity, functionality, control, communal learning, and real-time feedback), and voiced their readiness to opt for Edmodo in future learning experiences. Conclusion: Based on empirical evidence, the current study argues that the Edmodo learning management system has the potential to push content delivery, receipt, mastery, and assessment in ESP courses to the next level.

Computational thinking is an essential skill in the modern global workforce. The current public health crisis has highlighted the need for students and educators to have a deeper understanding of epidemiology. While existing STEM curricula has addressed these topics in the past, current events present an opportunity for new curricula that can be designed to present epidemiology, the science of public health, as a modern topic for students that embeds the problem-solving and mathematics skills of computational thinking practices authentically. Using the Computational Thinking Taxonomy within the informal education setting of a STEM outreach program, a curriculum was developed to introduce middle school students to epidemiological concepts while developing their problem-solving skills, a subset of their computational thinking and mathematical thinking practices, in a contextually rich environment. The informal education setting at a Research I Institution provides avenues to connect diverse learners to visually engaging computational thinking and data science curricula to understand emerging teaching and learning approaches. This paper documents the theory and design approach used by researchers and practitioners to create a Pandemic Awareness STEM Curriculum and future implications for teaching and learning computational thinking practices through engaging with data science.

The Queen Elizabeth II recently made her fifth public speech on COVID-19 since taking office. Through the use of systemic functional linguistics to analyze her speech text, this article mainly analyzes the text from the perspective of the concept of function and finds this speech text involves only four processes: material process, metal process, relational process and verbal process. This article discusses the political, economic and cultural characteristics of the UK's response to COVID-19. In addition, this paper compares China and the UK, and discusses the different measures taken in the face of the epidemic and the underlying cultural background. This study found out that the Queen's speech is mainly aimed at expressing gratitude to those working on the front lines of the fight against the epidemic and encouraging people to respond to the call of the British government and face the epidemic positively. The analysis of speech with the transitivity can enrich and update the study contents of transitivity.

Autism spectrum disorder (ASD) is an etiologically heterogeneous neurodevelopmental condition that eludes a single explanation or cure. Epidemiological studies reveal risk factors, relevant comorbidities, and behavioral correlates to reach a better understanding of ASD. To contribute such data from an understudied ASD population, this paper presents epidemiological data from a Turkish sample of individuals with ASD (n = 911, 748 boys (82.1%) and 163 girls (17.9%) between 1 and 18 years of age). Average age at diagnosis was 31.06 ± 11.88 months, and the male-to-female ratio was 4.6:1. Three in 4 individuals with ASD had obsessive behaviors, and 1 in 4 had allergic conditions, inappropriate sexual behaviors, self-harming behaviors, and harmful behaviors towards others. One in 3 received a dietary treatment for at least 3 months; almost half received vitamin supplements; the majority (70%) did not experience constipation; and 2 in 3 were picky eaters. This paper presents data on the age of diagnosis, gender ratios, accompanying behaviors, and dietary interventions in Turkish individuals with ASD, which are topics of current research interest about ASD. Such data from non-Western populations may supplement epidemiological knowledge gained from Western populations to help reach a more comprehensive understanding of this condition with many unknowns.

A capacity-building programme between a veterinary school in the UK and the veterinary school in Sri Lanka was developed. Scholarships for two distance learning MSc programmes were offered to Sri Lankan veterinarians: 'Veterinary Epidemiology and Public Health' and 'Livestock Health and Production'. In addition, scholarships were offered to academic staff members at the veterinary school to undertake the Postgraduate Certificate in Veterinary Education. A blended learning approach was taken, though the majority of learning was by distance. This study used a case-study approach to assess the programmes' impact at different levels: individual, institutional, institution's students, the profession, the public and animals. Previous students were interviewed and current students participated in a focus group. Staff of the Sri Lankan university were interviewed. Data were transcribed and qualitative content analysis conducted. Participants had achieved personal satisfaction, gained new knowledge and skills and progressed professionally. These impacts translated to societal impacts including disseminating understanding of One Health, improving animal welfare laws and assisting the development of the undergraduate veterinary curriculum. The graduates from the blended learning programmes are experts at the centre of a new community of practice and have the ability to inspire future generations of Sri Lankan veterinary surgeons.

In this study we designed, implemented, and evaluated a Problem-based Learning (PBL) course to teach undergraduate students about Viral Hepatitis from a Health Geography perspective. The course was attended by undergraduate students with no previous experience with PBL from a college in the Brazilian Amazon state of Acre. The course design was based on a combination of features from different PBL frameworks, allowing the students to gradually switch from a content-centered educational environment to a student-centered one. The PBL unit was based on an ill-structured real-life problem concerning the division of a hypothetical budget among actions to fight Viral Hepatitis in the state's municipalities. Student problem solutions indicated that they learned basic Viral Hepatitis and Health Geography concepts. Furthermore, perceptions of their own learning demonstrated that students regarded their acquired problem-solving skills and their knowledge of the course subject as their main educational outcomes. We argue that the combination of different PBL frameworks, the gradual transition from lectures to active learning and the social relevance of the course subject to students are among the putative factors that contributed to the course's success. This study, therefore, provides insights into the design of PBL courses for students inexperienced in active learning.

In this article, we consider what would happen if the resources and energy devoted to formal, school-based sex education were redirected into a syndemic sex education approach that centres the individual, social, and structural conditions that shape adolescents' sexual and reproductive health (SRH). Drawing on a case study of youth in Malawi, we argue that sex education in its current form fails to broadly prevent negative SRH outcomes and meaningfully improve wellbeing. Yet it, and the (female) sexuality it seeks to prevent, remain the subjects of considerable attention and moral anxiety. We call to move beyond sex as a focus for institutionalised teaching and learning, replacing it with holistic efforts to support the wellbeing of young people living in syndemic conditions.

Epidemiological models have enhanced relevance because of the COVID-19 pandemic. In this note, we emphasize visual tools that can be part of a learning module geared to teaching the SIR epidemiological model, suitable for advanced undergraduates or beginning graduate students in disciplines where the level of prior mathematical knowledge of students may not be very strong. Visual tools -- phase portrait, flow field and trajectory and line plots -- available in the R software are presented in a step by step manner, moving from the exponential growth model to the logistic growth model and then to the SIR model. Code for numerical simulation of differential equations and estimation of parameters is presented for the SIR model. Suggestions for students to connect the learning from these examples with research papers on COVID-19 are provided.

In the past, my mathematics students have frequently complained at any suggestion that they should communicate ideas through the medium of a written report. This article discusses student responses when they were asked to write a short report for the mayor of a (hypothetical) small town in response to the mayor's plan to eliminate a contagious disease by locking the town down for three weeks. I discuss the approaches that students took in constructing their reports and summarize some of the great ideas that they had. Many students could see the parallel between what they were asked to do in the assignment and concurrent discussions in the communities that they came from with regard to the spread of COVID-19. The idea that mathematicians might have to communicate ideas in the form of a written report was not dismissed out of hand. I also reflect on ways in which the learning experience could have been improved. This hinges on providing a mechanism by which an individual student has the opportunity to read the reports of all the other students.

Teaching is increasingly called upon to become a clinical practice profession, like medicine. The term 'clinical' is used in a common-sense way to describe idealized teaching practice, as if universally understood to be a superior and desirable way to enact professionalism. Yet there is little in the literature that mounts a feminist critique of the cultural politics put to work through the word 'clinical' in education. We ask what it reifies and how it operates to firm up inequalities and binaries, especially in relation to the gendered concept of 'mastery', the unquestioning adoption of epidemiological-style evidence-based practice and the worship of masculinist data cults. We call for further work to explore how teachers both take up and resist the clinical label.

The ongoing COVID-19 pandemic has highlighted the role of informed decision-making in times of crisis and the need for equipping teachers with the ability to address socioscientific issues in the classroom. In this study, we examine the features of socioscientific reasoning found in preservice elementary teachers' group discussions on the issue of school reopening during the pandemic. Using socioscientific reasoning and perspective taking as theoretical lenses, we analyzed how the participants constructed and justified arguments about the issue from the perspectives of three stakeholders the Minister of Education, a teacher, and a parent. The analysis revealed the participants' tendency to reach a premature decision and then cherry-pick evidence supporting the predetermined conclusion. As they examined relevant evidence, they often specified their initial claims by adding conditions to make it less objectionable and more defensible. We also illustrate how they used two different types of evidence, mechanistic and epidemiological, to support their claims about school reopening, and how perspective taking influenced their reasoning processes. Based on these findings, we discuss the potential of the perspective-based approach for supporting elementary teachers' decision-making about socioscientific issues.

Objective: To assess knowledge, attitudes, and practices (KAP) related to antimicrobial resistance (AMR) among college students. Participants: Undergraduate students at a large public university in the United States. Methods: Anonymous online questionnaire completed in early 2020. Results: While 82% of participants knew that resistant pathogens can spread between people, 38% believed that antibiotics weaken the immune system and 32% believed that AMR is only a problem for people who take antibiotics often. Many undergraduates have or would stop taking antibiotics before completing a full course because of side effects (44%) or feeling better (38%), and some would take (23%) or share (13%) antibiotics that had not been prescribed to the recipient. Only 57% are worried about AMR, compared to 88% who are worried about global climate change. Conclusions: Health education about antimicrobial stewardship and other global health issues must improve knowledge, perceptions, health behaviors, self-efficacy, and social norms.

Since 1998, educators at Wheeling Jesuit University's Challenger Learning Center and Center for Educational Technologies have created realistic live simulations of science and medical emergencies in which students act as astronauts, scientists or doctors to solve STEM problems such as diagnosing diseases, stopping epidemics, picking a safe spacecraft landing spot, and rescuing stranded astronauts. These 90 to 120-minute simulations, "e-Missions," are video-conferenced into classrooms, with companion websites providing pre-mission preparation, supplemental resources and teacher tutorials. "e-Missions" have been used more than 11,000 times at schools in 50 states and 22 nations. More than 310,000 elementary, middle and high school students have role-played STEM experts, and 10,000 teachers were trained to use technology and problem-based learning. Shorter live missions, "e-Labs," were created to demonstrate science topics in 3-9 grade classrooms, and "e-Labs" Jr do the same for K-3. The simulations and "e-Labs" are developed with funding from agencies, foundations and corporations, and are maintained through payments by schools of $400 to $550 for each "e-Mission," and $200 for "e-Labs," often year after year as culminating events for relevant curricula. More than $5 million dollars have been earned over the last 20 years, supporting the sustained delivery of these innovative STEM experiences, and software and hardware updates. Evaluations have identified positive changes in "e-Mission" student attitudes and perceptions toward science and science careers.

School students can use a sequence of contextual tasks to learn mathematics. We can use COVID-19 as a phenomenon or context to exploit in learning mathematics. This article describes how students learn with mathematical problems that adapted PISA tasks and used the COVID-19 context. This study involved 29 secondary-level students, 15 years old, and each has different levels of mathematical skills. We use three phases of design research as the research method. Data were collected using observation, interviews, and documents. Then, they were analyzed descriptively. The result showed there were ten problems developed, and students were asked to work with those problems. We found that there are steps in how students understand and solve the problem. First, if students find a picture in the task, then they observe at the picture, read the question, and then start working to solve the problem. Second, if students find a table with less data, students refer to all data in solving the problem. Third if students find a table which has a lot of data, then some students calculate all of the data and other only compared among them. We'd like to encourage students to understand the problem before solving the problem. They do this by observing the pictures, comprehending the tables and also the questions.

As we have seen from the current COVID-19 pandemic, misconceptions concerning viruses can lead to disease spread and panic. Therefore, it is imperative to determine misconceptions held concerning epidemics and pandemics. One virus that warrants study of misconceptions, albeit given limited attention in the West, is the Ebola virus. An assessment of college students' knowledge and misconceptions about the Ebola virus was created and validated using data from 203 non-science majors at a Midwestern United States university. The data were analyzed using both classical and Rasch measurement methods to make a case for the validity of the assessment and to explore students' misconceptions. The assessment was shown to be a valid and useful measure for students' knowledge and misconceptions concerning Ebola. Integrating a confidence scale into students' responses made the scale more reliable and assisted in identifying students' tenacious misconceptions. Students displayed multiple misconceptions about viruses, including confusion between the characteristics of viruses and prokaryotes. Students also displayed misconceptions about Ebola itself, including the overestimation of the number of Ebola strains and the number of patients who experience massive blood loss, misunderstandings about the incubation period, and overestimation of the mortality in comparison to other diseases like Influenza and Anthrax. This assessment can be used as a starting point in future studies to determine what misconceptions people have about Ebola and which types of educational and behavioral interventions need to be undertaken.

On 11 March 2020, the World Health Organization (WHO) declared the outbreak of coronavirus disease (COVID-19) to be a pandemic. As a result, the OpenWHO.org online platform, which serves as WHO's learning hub for emergencies, was tested for the first time on its core purpose of scaling up trusted public health information in a global emergency. This descriptive study examines and documents the WHO learning response in the early months of the pandemic by comparing epidemiological information and OpenWHO.org use in the countries with the highest COVID-19 cases. Statistical datasets from OpenWHO.org and WHO's COVID-19 dashboard were overlaid for the period 11 March--22 May 2020. During this period, for most of the 24 countries with the highest COVID-19 cases, platform use showed a corresponding trend. Courses published in the official languages spoken in these countries were well utilized, indicating a need to produce materials in languages spoken by affected communities. Of the countries with the highest number of users on OpenWHO, only half were top users of the platform before the pandemic. The existence of an established online platform for health emergencies assisted WHO in massively and quickly scaling up the dissemination of essential learning materials for COVID-19.

Employee performance is a critical factor in the success, or failure, of any organization. Therefore, it is paramount that the leadership and/or management team in an organization establishes and implements an approach that can effectively assess and evaluate the performance of its employees in an objective manner. Research administrators are often involved with the performance evaluation process at their respective institutions. However, there is a limited amount of publicly available information on the use of work performance and assessment methods in research settings. The primary aim of this pilot project was to establish a structured performance-based assessment tool that would allow for an objective and clearly articulated evaluation of staff performance at our clinical research center. The secondary aim was to determine if a structured performance-based assessment tool would improve staff satisfaction with the Center's overall performance evaluation process (PEP). A baseline survey was conducted to examine employee perspectives of and satisfaction with the current performance evaluation process. A follow-up survey was conducted after the mid-year performance review period and implementation of the new PEP, including goals templates and performance evaluation guidance documents. The results of the baseline survey showed that staff had mixed reviews of the overall performance evaluation process (somewhat satisfied-33%, very dissatisfied, dissatisfied, neutral, satisfied -all 16%) and all thought the evaluation criteria could be improved (100%). The results of the followup survey showed that staff reviews of the overall mid-year performance evaluation process had improved (63% satisfied, 12% very satisfied, 25% somewhat satisfied) and that 50% of respondents were satisfied with the ease of use and clarity of the templates that were used to record their progress towards achieving their goals. Staff shared additional suggestions for strengthening and better aligning the templates with Center-specific roles and activities. Overall, the leadership/management team at our research Center was successful in creating a performance-based assessment approach that facilitated a more objective and clearly articulated evaluation of staff performance. There are numerous challenges to effectively evaluating staff performance in both research and non-research organizations. As a result, the strategies outlined here may be transferable to other types of work settings.