Background: There is currently very limited information on the nature and prevalence of post-COVID-19 symptoms after hospital discharge. Methods: A purposive sample of 100 survivors discharged from a large University hospital were assessed 4 to 8 weeks after discharge by a multidisciplinary team of rehabilitation professionals using a specialist telephone screening tool designed to capture symptoms and impact on daily life. EQ-5D-5L telephone version was also completed. Results: Participants were between 29 and 71 days (mean 48 days) postdischarge from hospital. Thirty-two participants required treatment in intensive care unit (ICU group) and 68 were managed in hospital wards without needing ICU care (ward group). New illness-related fatigue was the most common reported symptom by 72% participants in ICU group and 60.3% in ward group. The next most common symptoms were breathlessness (65.6% in ICU group and 42.6% in ward group) and psychological distress (46.9% in ICU group and 23.5% in ward group). There was a clinically significant drop in EQ5D in 68.8% in ICU group and in 45.6% in ward group. Conclusions: This is the first study from the United Kingdom reporting on postdischarge symptoms. We recommend planning rehabilitation services to manage these symptoms appropriately and maximize the functional return of COVID-19 survivors.
This paper explores two key norms that underpin intimate partner violence in Rwanda: men's roles as economic providers and decision-making authorities in the household. It describes the political, legal and socio-economic factors affecting these norms and how they create opportunities and barriers to 'undoing' restrictive gender norms. Findings are drawn from an evaluation of Inadshyikirwa, an intimate partner violence prevention programme operating in Rwanda. Across three intervention sectors, 24 focus groups were conducted with unmarried and married men and women residing in intervention communities. Thirty interviews with couples and nine interviews with opinion leaders were conducted before they completed programme training designed to shift gender norms underlying intimate partner violence. The data indicate a strong awareness of and accountability to Rwandan laws and policies supporting women's economic empowerment and decision-making, alongside persisting traditional notions of men as household heads and primary breadwinners. Transgression of these norms could be accommodated in some circumstances, especially those involving economic necessity. The data also identified increasing recognition of the value of a more equitable partnership model. Findings highlight the importance of carefully assessing cracks in the existing gender order that can be exploited to support gender equality and non-violence.
This paper explores the relationship between changes in individual beliefs and behaviours, couple relationship dynamics and gender normsand how interventions can influence these. It draws on longitudinal qualitative research with heterosexual couples who participated in the Indashyikirwa programme in Rwanda. The couples followed a curriculum designed to improve relationship skills and reduce the gender-inequitable beliefs, behaviours and norms that underpin intimate partner violence. Qualitative findings show that the programme resulted in moderate, but significant, positive 'shifts' in individual beliefs and behaviours, couple relationship dynamics and levels of inequality -increasing men's engagement in domestic duties, women's participation in household decision making, and women's access to economic resources. They also suggest which parts of the couples' curriculum were most effective in catalysing these changes. However, the data also show that these 'shifts' occurred without fully transforming deeply-entrenched beliefs and norms around gender roles and male authority over economic resources. The paper suggests that the persistence of these beliefs and norms constrained the extent of changes among couplesand could potentially constrain their longevity and act as an obstacle to longer-term, larger-scale changes in gender inequalities and violence.
This article considers the relationship between education, conflict, and peacebuilding in Rwanda. First, it examines the role that education played in the lead-up to the 1994 genocide, discussing whether and how the low levels of educational attainment, inequalities of access, curricular content, and teaching methods contributed to the conditions for violence. It then looks at approaches to rebuilding the education sector since 1994. Despite significant progress, for example in widening access and achieving gender parity at primary level, three significant challenges remain. First, educational opportunity continues to be unequal in the post-primary sector, with disparities of access between rich and poor, a severe lack of alternative and non-formal educational opportunities, and some ethnic dimensions to the disparities. Second, tensions remain over history teaching due to government attempts to impose a single ''official'' narrative of Rwanda's history. Finally, teaching methods remain largely teacher-centred, with little open debate and teaching of critical thinking skills. The article cautions that, despite progress, some dimensions of Rwanda's current education policy and practice may continue to exacerbate tensions. It concludes by outlining some future priorities and urges the Rwandan government and its international development partners to more rigorously assess the potential impact of education policies on fragile social relations, and to embrace opportunities for education to play a more central role in peacebuilding in Rwanda.
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