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National Secondary Education Campaign supplementary literature STD 11th

National Secondary Education Campaign supplementary literature STD 11th

The objective of the National Secondary Education Campaign (RSMA) is to expand and improve the standards of secondary education - Classes 9 to 10. National Secondary Education Campaign by specifying a secondary school (up to class 10) within an area of ​​5 km for each adjoining country. Will also take secondary education to the corner. The National Secondary Education Campaign (RMSA) is the latest initiative of the Government of India to achieve the goal of Universalization of Secondary Education (USE). in Indonesia, as schools were organized with the goal of creating Greater East Asia Co-Prosperity Sphere of influence. As a result, schools began training in military and physical drill that were anti-West oriented. It included indoctrination of Japanese culture and history. Students were required to raise the Japanese flag and bow to the Emperor every morning. The Japanese made schools less stratified; despite this, enrollment had shrunk by 30% for primary education and 90% for secondary education by 1945.[5]

Study quality is essential to generating meaningful results. Large and representative samples of the underlying population and sound statistical techniques during data analysis or sampling methodology can minimise selection bias. Exploring reasons for differential losses to follow-up could inform future studies. Wherever possible, a control group should be included to differentiate the Hawthorne effect from the effect of the intervention.143 Trials and impact designs can prevent or reduce confounding. Following checklists, like the one by the WHO mHealth Technical Evidence Review Group on mHealth innovations, is suggested and encouraged.144

Tobacco smoking is the cause of many preventable diseases and premature deaths in the UK and around the world. It poses enormous health- and non-health-related costs to the affected individuals, employers, and the society at large. The World Health Organization (WHO) estimates that, globally, smoking causes over US$500 billion in economic damage each year.

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DiscussionSummary of findingsOverall, digital innovations reported positive effects on key metrics. We noted a strong positive effect of digital innovations on clinic attendance rates (70%; 26/37), ART adherence (69%; 20/29), risk reduction behaviours (67%; 8/12) and self-care (100%; 2/2). SMS/phone calls were not able to reduce risky sexual behaviours; however, social media-based interventions, particularly interactive social media, were effective in reducing risky sexual behaviours. Acceptability was found to be high for all innovations. Feasibility estimates also remained high for all innovations, except for social media-based interventions, possibly due to a perceived lack of privacy and confidentiality. Combined innovations may thus offer promise in plugging this feasibility gap, with internet-based innovations compensating for limitations in SMS-only strategies and vice versa.While mHealth (SMS/phone calls only) innovations were highly effective in improving clinic attendance, ART adherence and turnaround time from testing to treatment, they did not report on other outcomes. It should be noted that SMS and phone calls alone failed to reduce risky sexual behaviours, which was not surprising as it is challenging to reduce risky behaviours with a prescriptive SMS alone. Population engagement is essential for risk reduction through qualitative research.While internet-based mHealth/eHealth innovations (social media, avatar-guided computer programs, mobile apps and soap opera videos) demonstrated positive evidence on impact metrics, not all studies reached statistical significance. Those that failed to report a statistically significant improvement in ART adherence had small sample sizes and were underpowered to detect these outcomes (n=76 vs n=240), and had less frequent sessions over a shorter evaluation period (2 sessions over 6 months vs 4 sessions over 9 months).102 107 For mobile applications, studies which reported significant effects recruited participants with varying level of adherence,104 110 compared with studies which had high adherence at baseline (≥95%) and did not show significance (due to smaller changes in effect). For social media-based campaigns, the two studies that did not reach statistical significance in reducing risky sexual behaviours lacked an interactive component and simply displayed educational material, while the study that showed significant effect engaged the participants by allowing them to contact professional cognitive behavioural therapists via live chat sessions.103 105 117 In terms of quality, confounding and selection bias were noted in observational and quasi-experimental studies, and loss to follow-up in some trials. Nevertheless, the overall validity of the findings from this review was not threatened by biases, as a large proportion of our data were derived from trials. While clinical trials were generally high quality, observational studies were medium to low quality.Consistent reporting of metrics was lacking, which prevented a comprehensive meta-analysis. Objectives, end points, metrics and measures are equally important in feasibility studies and must be well designed to generate high-quality evidence.Our review is an exhaustive assessment of the role of digital innovations in improving prevention and care for HIV/STIs. Our findings resonate with many smaller systematic reviews, which have separately evaluated individual components of digital innovation, such as SMS-based mHealth.22 23 130–137 Other systematic reviews evaluating social media-based interventions reported similar findings to ours, in improved testing uptake or improvements in sexual health.25–27 138 139 Our review makes a valuable addition to the growing body of evidence by highlighting the success of other interactive and engaging innovations such as avatar-guided computer programs, mobile apps, streamed soap opera videos and combined innovations. These integrated innovations and programs are gaining in popularity because of their power to engage rural and urban audiences at many levels.Designing combined innovations that are complementarity of various media, methods, platforms and messaging may deliver best results. This complementarity may also encourage participant engagement to improve prevention and care metrics and measures sustainably over time. Engagement is challenging when only one innovation (eg, mHealth SMS/phone calls only) is the sole focus, where boredom is likely.Caveats and implications for future researchThere are some caveats to considering design and evaluation of innovations. Future research needs to be focused on tailoring innovations to the context and population, and program objectives. Innovations aiming to reduce risky sexual behaviours could be interactive and tailored to the setting and population, with a deep understanding of patients’ needs and preferences.137 140 141 Any communication with patients could be customised for timing to avoid fatigue with its uptake. For example, patients may be more responsive to weekly versus daily SMS ART reminders.32 142 Study quality is essential to generating meaningful results. Large and representative samples of the underlying population and sound statistical techniques during data analysis or sampling methodology can minimise selection bias. Exploring reasons for differential losses to follow-up could inform future studies. Wherever possible, a control group should be included to differentiate the Hawthorne effect from the effect of the intervention.143 Trials and impact designs can prevent or reduce confounding. Following checklists, like the one by the WHO mHealth Technical Evidence Review Group on mHealth innovations, is suggested and encouraged.144 Objective measures (eg, HIV/STIs diagnosis, viral load) are desired in reporting of quantitative outcomes, over subjective self-reported data (eg, condom use, self-reported adherence). This could potentially reduce some biases (misclassification biases or desirability/recall biases) that are observed with subjective reporting.Qualitative data are rich and complement the understanding of all the contextual and population needs, and capture the dynamics of sustainability and change. They need to be integrated with quantitative data to provide a holistic picture of uptake of any digital innovation.Quality of digital data will merit from an improvement. Across studies, a lack of integrated online impact metrics in evaluating the success of innovations was evident. With continuously evolving digital media, inventing new ways to evaluate acceptability and feasibility becomes necessary. For example, some studies tracked online metrics via Google analytics.74 100 101 121–124 Synergy with industry powered metrics could be a new wave to measure success of digital innovations.To scale up proven innovations, a multistakeholder engagement is necessary. For that, data and metrics that appeal to all sections of stakeholders will be needed. In addition to improving the quality of randomised controlled trials and quasi-experimental impact studies, qualitative studies, cost-effectiveness studies and usability studies are also needed.Implications for policy and practiceIn consonance with other systematic reviews, evidence at scale and over time was scarce.138 This limits the projection of the long-term sustainability and cost-effectiveness of digital innovations. More evidence on scale-up, cost-savings and cost-effectiveness from Sub-Saharan Africa and Asia is needed. Future investments that incentivise both the development and evaluation of combined innovations by government and industry alike, and focus on sustainability of digital innovations with public and private partnerships, are urgently needed.

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