Prevalence and factors associated with school failure in children with type 1 diabetes.

INTRODUCTION: Type 1 diabetes mellitus (T1DM) is a health problem that can be difficult for young people to accept. The aim of this study is to determine the prevalence and characteristics of school failure in children with T1DM and to identify the associated factors. MATERIAL AND METHODS: This is a retrospective study conducted in the endocrinology department of the Farhat Hached Hospital in Sousse, regarding T1DM patients, by analysing their school and career paths according to their clinicobiological and social data. School failure was defined in our study by the presence of at least one year's repetition and/or exclusion from school. RESULTS: Our study included 70 patients. School failure was recorded in 71.4% of cases. School drop-out was observed in 47.1% of patients. The reasons for school drop-out were iterative hospitalizations in 31.4% of cases and glycaemic instability with hyper/hypoglycaemic fluctuations in 17.1%. Multivariate analysis showed that the risk factors significantly associated with school failure were, respectively, number of hospitalizations for ketosis ≥ 5 (p = 0.037) and higher mean HbA1c at the last consultations (p = 0.001). Use of functional insulin therapy (p = 0.031) and use of insulin analogue (p = 0.004) were significantly protective factors. CONCLUSIONS: The risk of school failure in T1DM is real and should not be underestimated. Socioeconomic factors such as lack of financial resources, limited family support, and an unfavourable social environment can contribute to school avoidance.

A life marked by early school leaving: gendered working life paths linked to health and well-being over 40 years.

BACKGROUND: There is increasing awareness of the need to analyse symptoms of mental ill-health among early school leavers. Dropping out of compulsory education limits access to the labour market and education and could be related to deteriorating mental health over the course of a lifetime. The aim of this longitudinal study is to explore how early school leavers not in education, employment or training (NEET) narrate their working life trajectories linked to health, agency and gender relations. METHODS: Twelve early school leavers in the Swedish Northern Cohort (six women and six men) were interviewed over 40 years about their working life and health. Their life stories were analysed using structural narrative analysis to examine the evolution of their working life paths and to identify commonalities, variations and gendered patterns. RESULTS: All the participants started in the same position of "an unhealthy gendered working life in youth due to NEET status". Subsequently, three distinct working life paths evolved: "a precarious gendered working life with negative health implications", "a stable gendered working life in health challenging jobs" and "a self-realising gendered working life with improved health". Agency was negotiated through struggle narratives, survival narratives, coping narratives and redemption narratives. CONCLUSIONS: Even in a welfare regime like Sweden's in the early 1980s, early school leavers not in education, employment or training experienced class-related and gendered working and living conditions, which created unequal conditions for health. Despite Sweden's active labour market policies and their own practices of agency, the participants still ended up NEET and with precarious working life paths. Labour market policies should prioritise reducing unemployment, combating precarious employment, creating job opportunities, providing training and subsidised employment in healthy environments, and offering grants to re-enter further education. Our study highlights the need for further analyses of the contextual and gendered expressions of health among early school leavers throughout their lifetime, and of individual agency in various contexts for overcoming adversities.

Early school leaving in Spain: a longitudinal analysis by gender.

Spain is one of the eight EU-27 countries that failed to reduce early school leaving (ESL) below 10% in 2020, and now faces the challenge of achieving a rate below 9% by 2030. The determinants of this phenomenon are usually studied using cross-sectional data at the micro level and without differentiation by gender. In this study, we analyse it for the first time for Spain using panel data (between 2002 and 2020), taking into account the high regional inequalities at the macroeconomic level and the masculinisation of the phenomenon. The results show a positive relationship between ESL and socio-economic variables such as the adolescent fertility rate, immigration, unemployment or the weight of the industrial and construction sectors in the regional economy, with significant gender differences that invite us to discuss educational policies. Surprisingly, youth unemployment has only small but significant impact on female ESL.

Machine learning predicts upper secondary education dropout as early as the end of primary school.

Education plays a pivotal role in alleviating poverty, driving economic growth, and empowering individuals, thereby significantly influencing societal and personal development. However, the persistent issue of school dropout poses a significant challenge, with its effects extending beyond the individual. While previous research has employed machine learning for dropout classification, these studies often suffer from a short-term focus, relying on data collected only a few years into the study period. This study expanded the modeling horizon by utilizing a 13-year longitudinal dataset, encompassing data from kindergarten to Grade 9. Our methodology incorporated a comprehensive range of parameters, including students' academic and cognitive skills, motivation, behavior, well-being, and officially recorded dropout data. The machine learning models developed in this study demonstrated notable classification ability, achieving a mean area under the curve (AUC) of 0.61 with data up to Grade 6 and an improved AUC of 0.65 with data up to Grade 9. Further data collection and independent correlational and causal analyses are crucial. In future iterations, such models may have the potential to proactively support educators' processes and existing protocols for identifying at-risk students, thereby potentially aiding in the reinvention of student retention and success strategies and ultimately contributing to improved educational outcomes.

Leave of Absence and Medical Student Placement Into Graduate Medical Education by Race and Ethnicity.

This study examines the association between taking a leave of absence from medical school and placement into graduate medical education (GME) by race and ethnicity.

Adolescents' effort in vocational education and training and upper secondary general education: Analyses of stability, determinants, and group differences.

INTRODUCTION: The effort adolescents make determines the risk for dropping out of vocational education and training (VET) early and their chances of graduating upper secondary education. Studies have shown that adolescents' efforts decrease during the transition to upper secondary general education and increases for the transition to VET. In this study, we examined adolescent self-efficacy in lower secondary education, adolescent-instructor relationship (AIR) in VET and general education, and perceived person-environment fit (PEF) as predictors of adolescent effort. METHOD: We calculated two longitudinal multigroup structural equation models. Group 1 comprised 1266 (mean age in T1 = 15.7 years; female: 44%) lower secondary education graduates who moved on to VET with two learning contexts, company and vocational school in Switzerland. Group 2 included 517 (mean age in T1 = 15.7 years; female: 44%) lower secondary education graduates who moved on to upper secondary general education and thus stayed in a school. Adolescents' survey data was collected in 2016 and 2017. RESULTS: Self-efficacy in lower secondary education and AIR in upper secondary education indirectly predicted effort in upper secondary education via PEF, controlling for effort in lower secondary education. Findings were similar for general education and vocational school. However, the effects differed between company and general education (moderation). The positive effect of AIR on PEF was statistically significantly weaker for adolescents in general education than for adolescents in VET and their company learning context. CONCLUSION: We discuss strategies to enhance adolescents' efforts in upper secondary education.

Terminal efficiency, Lag and dropout in cohorts from 2007 to 2014 of dental students at the University of Costa Rica / Eficiencia terminal, rezago y abandono en las cohortes del 2007 al 2014 de estudiantes de Odontología de la Universidad de Costa Rica

Abstract Determine the terminal efficiency, lag and dropout in the cohorts of students who entered the dentistry career at the Faculty of Dentistry at University of Costa Rica in the lapse 2007 to 2014. Data from 736 files were collected. The variables considered were sex, admission age, nationality, marital status, children, admission note, domicile and high school. The data was collected from the Student Application System, the physical files, and the data base from the Supreme Court of Elections of Costa Rica. Descriptive statistics, bivariate and multivariate analysis were made, which were implemented from two logistic regression models. 98% of the students were Costa Rican, 68% women, 79% entered according to the admission note, 43% entered with an age of 18 years or less, 50% came from a public school, 77% resided in the Greater Metropolitan Area and 95% were single and remained without children. The average terminal efficiency was 6%; 46% of students have graduated with lag, 16% are still enrolled and 32% dropped out. Sex, age, admission note, and motherhood are sociodemographic variables that are associated with terminal efficiency and dropout. The average terminal efficiency in the cohorts from 2007 to 2014 in the courses at the Faculty of Dentistry University of Costa Rica was very low, almost half of the students graduated with lag and about a third dropped out the studies. The grade from the admission note seems to be a predictor of students'academic behavior, higher grade had more chances of graduating and less likely to dropout.

Resumen Determinar la eficiencia terminal, el rezago y el abandono en las cohortes de los estudiantes que ingresaron a la carrera de Odontología de la Facultad de Odontología UCR en el período 2007 al 2014. Se recopilaron los datos de 736 expedientes. Las variables consideradas fueron: sexo, edad de ingreso, nacionalidad, estado civil, hijos, lugar y colegio de procedencia, y nota de examen de admisión. Los datos se recopilaron del Sistema de Aplicaciones Estudiantiles, los expedientes físicos y del Tribunal Supremo de Elecciones de Costa Rica. Se realizó estadística descriptiva, análisis bivariado y multivariado que se implementó a partir de dos modelos de regresión logística. El 98% de los estudiantes fueron costarricenses, el 68% mujeres, el 79% ingresó según la nota de admisión, el 43% ingresó con una edad de 18 años o menos, el 50% provenía de un colegio público, el 77% residía en la gran área Metropolitana y el 95% eran solteros y permanecieron sin hijos. La eficiencia terminal en promedio fue de 6%; el 46% de los estudiantes se han graduado con rezago, el 16% continúan matriculados y el 32% hizo abandono de los estudios. El sexo, la edad, la nota del examen de admisión y la maternidad son variables sociodemográficas que se asocian con la eficiencia terminal y el abandono. El promedio de la eficiencia terminal en las cohortes del 2007 al 2014 en la carrera de Odontología de la Facultad de Odontología UCR fue muy bajo, casi la mitad de los estudiantes se han graduado con rezago y cerca de un tercio hizo abandono de los estudios. La nota del examen de admisión parece ser un predictor en el comportamiento académico de los estudiantes: a mayor nota más posibilidades de graduarse y menos de abandonar la carrera.

Evasão acadêmica no curso de Odontologia de uma instituição pública e ações voltadas para mitigar o abandono discente / Evasión académica en la carrera de Odontología en una institución pública y acciones encaminadas a mitigar la deserción estudiantil / Academic evasion in the Dentistry course of a public institution and actions to mitigate student dropout

O estudo investigou aspectos da evasão e avaliou a satisfação de calouros no curso de Odontologia de uma instituição de ensino superior pública, além de relatar intervenções de combate ao abandono acadêmico desenvolvidas neste período. Trata-se de um estudo com uma fase observacional, transversal, descritiva, quanti-qualitativa, com aplicação de questionários; e outra intervencionista, com atividades voltadas ao combate à evasão. Foram entrevistados 74 alunos, matriculados no primeiro ano do curso, com idade entre 15 e 30 anos. Os dados foram expressos em frequências absoluta e percentual e analisados pelos testes exato de Fisher ou qui-quadrado de Pearson (p ≤0,05). Variáveis com associação significativa foram submetidas ao modelo de regressão logística multinomial (RLM). Observou-se que o grau de insatisfação com o curso foi maior entre os alunos com menor faixa etária (entre 15 e 20 anos) e menor renda familiar (até 2 salários mínimos). Além disso, cerca de 66% dos possíveis desistentes ainda não haviam vivenciado nenhum tipo de experiência prática odontológica, enquanto 69% dos que pretendem completar o curso já passaram por algum contato com vivências clínicas. A RLM revelou que a Odontologia não ser a primeira opção aumenta em 7,96 vezes a probabilidade de desistência do curso, independente do semestre. Observou-se, ainda, redução nos índices de evasão a medida em que intervenções (cerimônia do jaleco, visita clínica guiada e apadrinhamento de alunos calouros) foram realizadas. Conclui-se que asações implementadas para o combate de evasão no curso de Odontologia impactaram positivamente nos índices de abandono do curso nos semestres analisados (AU).

El estudio investigó aspectos de la evasión y evaluó la satisfacción de los estudiantes de primer año de la carrera de Odontología de una institución de enseñanza superior pública, además de relatar las intervenciones para combatir la deserción académica desarrolladas en ese período. Se trata de un estudio con fase observacional, transversal, descriptivo, cuantitativo y cualitativo, con aplicación de cuestionarios; y otra intervencionista, con actividades encaminadas a combatir la evasión. Fueron entrevistados 74 estudiantes, matriculados en el primer año de la carrera, con edades entre 15 y 30 años. Los datos se expresaron como frecuencias absolutas y porcentuales y se analizaron mediante la prueba exacta de Fisher o la prueba de chi-cuadrado de Pearson (p ≤0,05). Las variables con asociación significativa fueron sometidas al modelo de regresión logística multinomial (RLM). Se observóque el grado de insatisfacción con el curso fue mayor entre los estudiantes de menor franja etaria (entre 15 y 20 años) y menor renta familiar (hasta 2 salarios mínimos). Además, alrededor del 66% de los posibles desertores aún no habían tenido ningún tipo de experiencia práctica en odontología, mientras que el 69% de los que pretendían completar el curso ya habían tenido algúncontacto con experiencias clínicas. El RLM reveló que el hecho de no ser Odontología la primera opción aumenta en 7,96 veces la probabilidad de deserción de la carrera, independientemente del semestre. También hubo una reducción en las tasas de deserción a medida que se realizaron intervenciones (ceremonia de bata de laboratorio, visita clínica guiada y patrocinio de estudiantes de primer año). Se concluye que las acciones implementadas para combatir la deserción en la carrera de Odontología incidieron positivamente en las tasas de deserción de la carrera en los semestres analizados (AU).

The study investigated aspects of evasion and evaluated the satisfaction of freshmen in the Dentistry course at a public higher education institution, in addition to reporting interventions to combat academic dropout developed during this period. This is astudy with an observational, cross-sectional, descriptive, quantitative and qualitative phase, with the application of questionnaires; and another interventionist, with activities aimed at combating evasion. 74 students were interviewed, enrolled in the first year of the course, aged between 15 and 30 years old. Data were expressed as absolute and percentage frequencies and analyzed using Fisher's exact test or Pearson's chi-square test (p ≤0.05). Variables with significant association were submitted to the multinomial logistic regression model (RLM). It was observed that the degree of dissatisfaction with the course was higher among students with a lower age group (between 15 and 20 years old) and lower family income (up to 2 minimum wages). In addition, around 66% of possible dropouts had not yet had any kind of practical dental experience, while 69% of those intending to complete the course had already had some contact with clinical experiences. The RLM revealed that Dentistry not being the first option increases the probability of dropping out of the course by 7.96 times, regardless of the semester. There was also a reduction in dropout rates as interventions were carried out (lab coat ceremony, guided clinical visit and sponsorship of freshman students)were performed. It is concluded that the actions implemented to combat dropout in the Dentistry course had a positive impact on the dropout rates of the course in the analyzed semesters (AU).

Toxic stress and disconnection from work and school among youth in Detroit.

This study explores toxic stress and youth disconnection from work and school using data from the Detroit Jobs for Michigan's Graduates (JMG) program. A secondary cross-sectional analysis was conducted using a program census of 1934 youth participating in JMG between 2014 and 2019. Youth with criminal justice contact, parenting responsibilities, and toxic stress barriers showed the greatest disparity in graduating or become employed following participation in the JMG program. Youth without toxic stress-aligned barriers were 1.87 times the odds more likely of successful program outcomes when controlling for program enrollment year, program type, Detroit residency, gender, and age. Toxic stress is associated with disconnection from education and employment before and after participation in the JMG program. This indicates that expanding trauma-informed systems and community approaches in youth-serving programs can play a role in mitigating the impact of toxic stress exposure on connection to opportunity for Detroit youth.

Effectiveness of the Sista2Sista programme in improving HIV and other sexual and reproductive health outcomes among vulnerable adolescent girls and young women in Zimbabwe.

Background: In Zimbabwe, adolescent girls and young women (AGYW) experience high rates of HIV and other sexual and reproductive health challenges. In 2013, the Zimbabwe Ministry of Health and Child Care partnered with the United Nations Population Fund to implement the Sista2Sista programme, a structured peer group intervention aimed at improving health outcomes among vulnerable in- and out-of-school AGYW.Methods: Programme data was analysed for 91 612 AGYW aged 10-24 years old who participated in Sista2Sista from 2013 to 2019. Logistic regression was used to determine odds ratios (OR) and evaluate programme exposure as a factor in a set of defined variables.Results: 58 471 AGYW (63.82%) graduated from the Sista2Sista programme by completing at least 30 of 40 exercises. Graduates were more likely to take an HIV test (2.78 OR 95% CI 2.52-3.10), less likely to get married (0.63 OR 95% CI 0.55-0.73) and less likely to drop out of school (0.60 OR 95% CI 0.53-0.69). At higher thresholds of programme completion, additional positive outcomes were observed. Participants who completed all 40 exercises were more likely to return to school (1.41 OR 95% CI 1.18-1.69), more likely to use contraception (1.38 OR 95% CI 1.21-1.56), more likely to report sexual abuse (1.76 OR 95% CI 1.17-2.66), and less likely to become pregnant as adolescents (0.41 OR 95% CI 0.24-0.72). Individual counselling improved the likelihood of programme graduation.Conclusions: The Sista2Sista programme had a positive effect on HIV and other sexual health outcomes among vulnerable AGYW in Zimbabwe. Strategies to improve graduation rates should be explored.

Completion and attrition of nursing PhD students of the 2001 to 2010 matriculating cohorts.

PURPOSE: To examine completion and attrition of students in nursing PhD programs. METHODS: Total 5,391 students who matriculated into nursing PhD programs in 2001 to 2010 were selected from the AACN database. FINDINGS: The completion rate of the students was 74.2% and the attrition rate was 22.7%. On average, it took 5.7 years for the students to graduate and 3.7 years for the students who left without graduating to drop out. The mean age at matriculation and graduation was 42.4 and 47.5, respectively. Male students, part-time students, students of post-baccalaureate programs, students who were not faculty or held a part-time faculty position, students of the 2001 to 2010 matriculation cohorts, and students in PhD programs with 25% or more of the courses taught online were more likely to experience attrition. CONCLUSION: The study findings provide useful information for the nursing education community to better address the issue of nursing PhD shortage.

Identifying factors that predict attrition among first year physiotherapy students: a retrospective analysis.

BACKGROUND: A number of first year students leave physiotherapy programmes every year. A high attrition rate has implications for the student and the academic institution. OBJECTIVES: To report the rate of attrition among first year physiotherapy students, and to identify contributing factor. DESIGN: Retrospective analysis. SETTING: University. PARTICIPANTS: Electronic student records for enrolled students 2010 to 2013. MEASURES: Independent variables; gender, age at entry, mode of admission, place of residence, ethnicity, fee status, level of education, disability, whether a student obtained a B in A level Biology, and whether a student repeated A level examinations. Logistic regression analysis was conducted to identify the relationship between independent variables and drop-out (failure to continue to the second year). RESULTS: Data from 338 students were included in the analysis. The percentage drop-out was 17%; 38 students (11%) failed, and 20 students (6%) withdrew voluntarily. Black and Asian students had greater odds of drop-out for any reason (Odds Ratio (OR): 6.23; 95% Confidence Interval (CI) 1.79 to 21.63, and OR: 6.43; 95% CI: 3.03 to 13.68 respectively), and due to failure (OR: 5.50, 95% CI: 1.27 to 23.70, and OR: 7.19; 95% CI: 3.02 to 17.08, respectively) compared to white British students. Students who lived off-campus were more likely to withdraw from the programme irrespective of ethnicity (OR: 4.65; 95% CI: 1.41 to 15.34). CONCLUSION: A significant number of students from ethnic minority backgrounds failed to progress. Specific strategies to retain students from ethnic minority backgrounds should be implemented. Students who live off-campus may be at high risk of drop-out; reasons for this should be investigated.

Mind the gap: The relationship between liminality, learning and leaving in pre-registration nurse education.

Attrition refers to students leaving programmes of study before completion. This is an important topic area; there is a current global shortage of nurses, and it is widely reported that nursing is in crisis. Nurse education in the United Kingdom has changed substantially in the past fifty years, gradually moving from work-based apprentice style training to an 'all graduate entry' profession. There is a plethora of literature reporting attrition both in the UK and worldwide. It is clear that regardless of the education model, attrition from pre-registration programmes is a long-standing problem which has attracted much attention. The educative process of learning to be a nurse can be likened to a 'rite of passage', or perhaps a series of rites of passage. Rites of passage were first articulated by anthropologists, van Gennep and Turner. Van Gennep and Turner argued that as people make 'transitions', often via 'rites of passage' they pass through an in-between phase described as 'liminal'. This paper explores aspects of liminality in nurse education and examines the potential relationship with attrition. The paper concludes by suggesting that although liminality could be considered a risk factor for attrition, exploitation of the concept may offer opportunities to enhance learning.

Sources of prescription opioids and tranquilizers for misuse among U.S. young adults: differences between high school dropouts and graduates and associations with adverse outcomes.

Background and Objectives: Prior research has identified that sources of prescription drugs for misuse vary based on educational attainment, which is important as certain sources are associated with adverse outcomes. The current research addressed limitations of the extant literature by creating distinct categories of push factors for high school dropout (e.g., negative school performance/experiences), pull factors for high school dropout (e.g., starting a family or getting a job), and high school graduates who did not attend college.Methods: Using data from the 2009-2014 National Survey on Drug Use and Health, prevalence of sources were estimated and design-based multivariable logistic regression investigated the association between sources and educational attainment. Additionally, multivariable logistic regression assessed the associations between sources and adverse outcomes (i.e., substance use, substance use disorders, and mental health) separately for each educational category.Results: College respondents were more likely to report "physician" and free from "friend/relative" and less likely to report "purchased" as sources. For most educational categories, "purchasing" prescription drugs was associated with adverse outcomes. Additionally, "theft/fake" prescription emerged as a source associated with adverse outcomes for college respondents, while "friend/relative" was associated with adverse outcomes for high school graduates that did not go on to college.Conclusions: This research has important clinical implications as it identified young adults with a college education as being less likely to obtain prescription drugs from sources known to be associated with adverse outcomes. It also highlighted how associations between sources and adverse outcomes vary based on educational attainment.

Abandono escolar en medicina: análisis de tres promociones / School dropout in Medicine: analysis of three generations

INTRODUCCIÓN: El abandono escolar representa desde hace años uno de los grandes problemas a los que se enfrenta la educación en México, principalmente a nivel superior y en licenciaturas de alta exigencia académica como es el caso de medicina. SUJETOS Y MÉTODOS: Se realizó un análisis cuantitativo de tres promociones de la licenciatura de médico cirujano de la Universidad Nacional Autónoma de México con el fin de comparar el abandono escolar según sexo y promoción. RESULTADOS: Se observó que el primer año de la licenciatura de médico cirujano es donde se presenta un mayor porcentaje de abandono escolar (77%), con un predominio de población femenina y abandono definitivo. CONCLUSIÓN: Se estudió el comportamiento estudiantil de la licenciatura de Médico Cirujano para replantear métodos y estrategias institucionales en términos de abandono escolar

INTRODUCTION: For years, school dropout has represented one of the greatest problems that education in Mexico faces, mainly at the higher level and in highly demanding academic degrees such as Medicine. SUBJECTS AND METHODS: We carried out a quantitative analysis of three generations enrolled in Medicine Bachelor of the UNAM's School of Medicine in order to compare school dropouts by sex and generation. RESULTS: It was observed that the Medicine Bachelor's first year is where the highest percentage of school dropouts (77%) occurs, with a predominance of female population and definitive dropout. CONCLUSION: Medicine Bachelor's student behavior was studied to rethink institutional methods and strategies focused on scholar dropout

[Massive online course "Sexual and reproductive health": changes in knowledge, desertion, disapproval and satisfaction] / Curso masivo en línea "Salud sexual y reproductiva": cambios en conocimientos, deserción, reprobación y satisfacción

OBJECTIVE: To present global results of the dropout and failure and satisfaction of the Massive Open Online Course (MOOC) users, as well as changes in knowledge and practices of personnel registered in "Sexual and Reproductive Health and Prevention of adolescent pregnancy". MATERIALS AND METHODS: Using 45 549 records, we adjust logistic regression models to find associations between variables of dropout and failure. RESULTS: 57.8% of people completed the course and 15.1% failure. Logistic models show that age and position are associated with both dropout and failure. CONCLUSIONS: The MOOC is useful to improve knowledge and skills of health personnel. It is necessary to expand the coverage to professionals who deal with adolescent population, in order to improve sexual and reproductive health and prevent teenage pregnancies.

OBJETIVO: Presentar resultados globales de la deserción, reprobación y satisfacción de los usuarios del Curso Masivo en Línea Abierto (MOOC, por sus siglas en inglés), así como los cambios en conocimientos y prácticas del personal de salud inscrito al MOOC "Salud sexual y reproductiva y prevención del embarazo en adolescentes". MATERIAL Y MÉTODOS: Se analizaron 45 549 registros y se ajustaron modelos de regresión logística para la deserción y reprobación del curso. RESULTADOS: Finalizó el curso 57.8% de los usuarios, mientras que 15.1% reprobó. Los modelos logísticos muestran que la edad y el cargo ocupado se asocian tanto con la deserción como con la reprobación. CONCLUSIONES: El MOOC es una herramienta útil para generar mejoras en conocimientos y competencias. Es necesario ampliar la cobertura a profesionales que tienen trato con población adolescente, con el fin de mejorar la salud sexual y reproductiva y prevenir embarazos en la adolescencia.

Curso masivo en línea "Salud sexual y reproductiva": cambios en conocimientos, deserción, reprobación y satisfacción / Massive online course "Sexual and reproductive health": changes in knowledge, desertion, disapproval and satisfaction

Resumen Objetivo: Presentar resultados globales de la deserción, reprobación y satisfacción de los usuarios del Curso Masivo en Línea Abierto (MOOC, por sus siglas en inglés), así como los cambios en conocimientos y prácticas del personal de salud inscrito al MOOC "Salud sexual y reproductiva y prevención del embarazo en adolescentes". Material y métodos: Se analizaron 45 549 registros y se ajustaron modelos de regresión logística para la deserción y reprobación del curso. Resultados: Finalizó el curso 57.8% de los usuarios, mientras que 15.1% reprobó. Los modelos logísticos muestran que la edad y el cargo ocupado se asocian tanto con la deserción como con la reprobación. Conclusiones: El MOOC es una herramienta útil para generar mejoras en conocimientos y competencias. Es necesario ampliar la cobertura a profesionales que tienen trato con población adolescente, con el fin de mejorar la salud sexual y reproductiva y prevenir embarazos en la adolescencia.

Abstract Objective: To present global results of the dropout and failure and satisfaction of the Massive Open Online Course (MOOC) users, as well as changes in knowledge and practices of personnel registered in "Sexual and Reproductive Health and Prevention of adolescent pregnancy". Materials and methods: Using 45 549 records, we adjust logistic regression models to find associations between variables of dropout and failure. Results: 57.8% of people completed the course and 15.1% failure. Logistic models show that age and position are associated with both dropout and failure. Conclusions: The MOOC is useful to improve knowledge and skills of health personnel. It is necessary to expand the coverage to professionals who deal with adolescent population, in order to improve sexual and reproductive health and prevent teenage pregnancies.

Long-term Cognitive, Psychological, and Health Outcomes Associated With Child Abuse and Neglect.

Potential long-lasting adverse effects of child maltreatment have been widely reported, although little is known about the distinctive long-term impact of differing types of maltreatment. Our objective for this special article is to integrate findings from the Mater-University of Queensland Study of Pregnancy, a longitudinal prenatal cohort study spanning 2 decades. We compare and contrast the associations of specific types of maltreatment with long-term cognitive, psychological, addiction, sexual health, and physical health outcomes assessed in up to 5200 offspring at 14 and/or 21 years of age. Overall, psychological maltreatment (emotional abuse and/or neglect) was associated with the greatest number of adverse outcomes in almost all areas of assessment. Sexual abuse was associated with early sexual debut and youth pregnancy, attention problems, posttraumatic stress disorder symptoms, and depression, although associations were not specific for sexual abuse. Physical abuse was associated with externalizing behavior problems, delinquency, and drug abuse. Neglect, but not emotional abuse, was associated with having multiple sexual partners, cannabis abuse and/or dependence, and experiencing visual hallucinations. Emotional abuse, but not neglect, revealed increased odds for psychosis, injecting-drug use, experiencing harassment later in life, pregnancy miscarriage, and reporting asthma symptoms. Significant cognitive delays and educational failure were seen for both abuse and neglect during adolescence and adulthood. In conclusion, child maltreatment, particularly emotional abuse and neglect, is associated with a wide range of long-term adverse health and developmental outcomes. A renewed focus on prevention and early intervention strategies, especially related to psychological maltreatment, will be required to address these challenges in the future.

The Effect of the Medicaid Expansion on Dropout Rates.

BACKGROUND: This study investigates how the Medicaid Expansion of the Affordable Care Act affected state high school dropout rates. METHODS: This study relies on a differences-in-differences estimation strategy that is common in program evaluation, especially in education. This method replicates in a regression framework a classic pre-test post-test comparison group quasi-experimental design. The analysis is conducted at the state level, which reduces the precision of the estimates. RESULTS: States that adopted the Medicaid Expansion had a 0.658 percentage point greater reduction in dropout rates than non-Expansion states in the year of Medicaid implementation. A back-of-the-envelope calculation suggests that if all the remaining non-Expansion states adopted Medicaid, there would be a decrease of over 92,500 youths who drop out of high school, representing a drop of 11.2% in the number of dropouts in these states. CONCLUSION: The Medicaid Expansion of the Affordable Care Act is more than just a health insurance program; it is a dropout prevention program.