Lifting Universal Masking in Schools - Covid-19 Incidence among Students and Staff.

BACKGROUND: In February 2022, Massachusetts rescinded a statewide universal masking policy in public schools, and many Massachusetts school districts lifted masking requirements during the subsequent weeks. In the greater Boston area, only two school districts - the Boston and neighboring Chelsea districts - sustained masking requirements through June 2022. The staggered lifting of masking requirements provided an opportunity to examine the effect of universal masking policies on the incidence of coronavirus disease 2019 (Covid-19) in schools. METHODS: We used a difference-in-differences analysis for staggered policy implementation to compare the incidence of Covid-19 among students and staff in school districts in the greater Boston area that lifted masking requirements with the incidence in districts that sustained masking requirements during the 2021-2022 school year. Characteristics of the school districts were also compared. RESULTS: Before the statewide masking policy was rescinded, trends in the incidence of Covid-19 were similar across school districts. During the 15 weeks after the statewide masking policy was rescinded, the lifting of masking requirements was associated with an additional 44.9 cases per 1000 students and staff (95% confidence interval, 32.6 to 57.1), which corresponded to an estimated 11,901 cases and to 29.4% of the cases in all districts during that time. Districts that chose to sustain masking requirements longer tended to have school buildings that were older and in worse condition and to have more students per classroom than districts that chose to lift masking requirements earlier. In addition, these districts had higher percentages of low-income students, students with disabilities, and students who were English-language learners, as well as higher percentages of Black and Latinx students and staff. Our results support universal masking as an important strategy for reducing Covid-19 incidence in schools and loss of in-person school days. As such, we believe that universal masking may be especially useful for mitigating effects of structural racism in schools, including potential deepening of educational inequities. CONCLUSIONS: Among school districts in the greater Boston area, the lifting of masking requirements was associated with an additional 44.9 Covid-19 cases per 1000 students and staff during the 15 weeks after the statewide masking policy was rescinded.

Addressing College Food Insecurity: An Assessment of Federal Legislation Before and During Coronavirus Disease-2019.

Research conducted before coronavirus disease-2019 illustrated high rates of food insecurity among college students. The pandemic has likely increased student food insecurity because of factors like unemployment and closure of campus resources, and many students cannot access federal food assistance because of long-standing student restrictions. This perspective reviews federal legislation on college food insecurity introduced in the 116th legislative session (2019-2020) immediately before coronavirus disease-2019 in the US, as well as pandemic-related stimulus bills and their implications for future policies and practice. Food insecurity promises to become more pressing as colleges try to reopen and the country grapples with economic recovery.

The Bell Has Rung: Answering the Door for Student-Athlete Concussion Issues in the National Collegiate Athletic Association.

This Note examines the NCAA's unwillingness to enforce the requirement that all NCAA institutions must implement a concussion management plan; the NCAA's refusal to apply its appropriate enforcement mechanism when member institutions violate their concussion management plans, which are instituted in order to protect student-athletes from concussions; how both of these failures result in more concussions and a higher probability of debilitating long-term effects; and solutions to remedy this grave injustice. Part II describes what a concussion is, the long-term effects of concussions, the NCAA's management of concussions, and lawsuits challenging the NCAA in relation to concussions. Part III analyzes the inefficiencies of the NCAA in its management of concussions, the previous and current lawsuits' failure to stimulate change within the NCAA, and the proposed solutions that will help create a safe environment for student-athletes.

National Analysis of State Health Policies on Students' Right to Self-Carry and Self-Administer Asthma Inhalers at School.

BACKGROUND: Asthma has no known cure, and though manageable, it disrupts the everyday lives of over 6 million US children. Because children spend more than half of their waking hours in school, students must be able to carry and administer their inhaler at school to manage their asthma. METHODS: This policy paper is a comprehensive review of all 50 states and the District of Columbia's laws and policies for the self-carry and administration of quick-relief asthma inhalers among children in prekindergarten through 12th grade. RESULTS: All states permit students to carry and administer their inhalers at school, although each state differs in their development and implementation of policies for asthma self-management at school. This review examines how states regulate self-carry policies by looking at policy development, regulated school systems, relevant stakeholders, required medical records, and school liability. CONCLUSIONS: Each state's laws have nuances that create gray areas, increasing the potential of misinterpreted or incorrectly implemented policies for asthma self-management at school. As a result, children may not have immediate access to their inhaler for symptom management or in an emergency. State policymakers should reform current laws to remove barriers for students to carry and use inhalers at school.

Implementing and Evaluating Environmental and Policy Interventions for Promoting Physical Activity in Rural Schools.

BACKGROUND: Schools are an important setting for improving behaviors associated with obesity, including physical activity. However, within schools there is often a tension between spending time on activities promoting academic achievement and those promoting physical activity. METHODS: A community-based intervention provided administrators and teachers with a training on evidence-based public health and then collaborated with them to identify and implement environmental (walking track) and local school policy interventions (brain breaks). The evaluation included conducting in-depth interviews and SOPLAY observations to assess the facilitators and barriers and impact of the dissemination of environmental and policy changes. RESULTS: Individual, organizational, intervention, and contextual factors influenced dissemination. Teachers reported that brain breaks increased student focus and engagement with classroom material and decreased student behavioral problems. Students decreased sedentary behavior and increased vigorous behavior. Of the 4 schools, 2 increased walking. CONCLUSIONS: Active dissemination of environmental and policy interventions by engaging school administrators and teachers in planning and implementation shows potential for increasing physical activity in rural school settings.

Delaying Middle School and High School Start Times Promotes Student Health and Performance: An American Academy of Sleep Medicine Position Statement.

ABSTRACT: During adolescence, internal circadian rhythms and biological sleep drive change to result in later sleep and wake times. As a result of these changes, early middle school and high school start times curtail sleep, hamper a student's preparedness to learn, negatively impact physical and mental health, and impair driving safety. Furthermore, a growing body of evidence shows that delaying school start times positively impacts student achievement, health, and safety. Public awareness of the hazards of early school start times and the benefits of later start times are largely unappreciated. As a result, the American Academy of Sleep Medicine is calling on communities, school boards, and educational institutions to implement start times of 8:30 AM or later for middle schools and high schools to ensure that every student arrives at school healthy, awake, alert, and ready to learn.

Exposure and vulnerability of California kindergarteners to intentionally unvaccinated children.

Widespread vaccination coverage among children is responsible for reducing or eliminating 14 serious childhood diseases in the United States. Despite this success, some parents remain concerned about the health effects of vaccines, and choose to keep their children unvaccinated. When population rates of vaccinations remain high enough, even unvaccinated children are protected because everyone around them is immune (so-called "herd immunity"). But clusters of unvaccinated children may threaten herd immunity and lead to increasing outbreaks of preventable diseases. This Issue Brief summarizes a new study that investigates the extent of such clustering, and quantifies the exposure of all California kindergartners to their intentionally unvaccinated schoolmates.

Should college campuses become tobacco free without an enforcement plan?

Tobacco-free campuses are a great public health initiative. Healthy People 2020 and Healthy Campus 2020 address tobacco use and young adults including college students. Sources indicate that of the more than 6,000 colleges and universities in the United States, less than 800 are either smoke free or tobacco free. An increasing number of college campus policy makers in the United States are implementing smoke-free or tobacco-free policies, including procedures for violators of these policies. However, without a clearly defined and actionable enforcement component, these policies serve little purpose. This has become a policy enforcement issue that campus leaders should address. Should colleges and universities become tobacco free, if enforcement is not implemented? College and university administrators should demonstrate leadership by having violators of tobacco-free campus policies held to the same standard as those who violate other policies.

Assessment of college and university campus tobacco-free policies in North Carolina.

OBJECTIVE: To develop a reliable and efficient method for assessing prevalence and strength of college/university tobacco-related policies. PARTICIPANTS: North Carolina (NC) public universities, community colleges, and private colleges/universities (N = 110). METHODS: A census of policies using campus handbooks and Web sites was conducted in March 2011. RESULTS: The rating tool is reliable and valid. Ninety-nine percent of NC college/university campuses are smoke-free in all indoor areas. The majority (94/110 [85%]) of colleges and universities regulate smoking and/or tobacco in some or all outdoor areas. Less than 20% of campuses had restrictions for industry marketing, promotion, and sales. CONCLUSIONS: Clean indoor air policies are present at all but 1 NC college/university campus, and a growing number have enacted broad outdoor limits to protect students, faculty, and staff from secondhand smoke. Policy census approaches across all other states would quantify the national tobacco-free college campus policy environment and facilitate adoption of tobacco-free campus policies.

Using the photovoice method to advocate for change to a campus smoking policy.

OBJECTIVE: The authors used the photovoice method as a strategy for empowering students to advocate for change of a campus smoking policy. PARTICIPANTS: Participants included 49 college students and 160 photo-exhibit attendees during spring 2011. METHODS: Students were trained in the use of the photovoice method and a public exhibit was used to educate the campus community and advocate for change. RESULTS: The photovoice initiative resulted in an effective platform for students to successfully advocate for the relocation of ashtrays that were in violation of the policy and for the elicitation of future advocacy targets. CONCLUSIONS: The photovoice project provided a platform for students to have their views heard by campus community members and policymakers. The project served as a useful tool for grassroots student advocacy. Those interested in addressing campus health policy issues may want to consider conducting a photovoice project similar to the one described in this article.

Young, black, and connected: Facebook usage among African American college students.

This article examines the extent and intensity of Facebook usage among African American college students and investigates their reasons for using Facebook. As expected, 98% of students in the survey had a Facebook account, and a large number of Facebook "friends." Younger users spent significantly more time on Facebook than older ones. Our findings underscore the importance of cultural influence for African American online users. Displaying photographs and personal interests on Facebook signals racial identity among African American college students. Personality traits, such as self-esteem, trust in people, satisfaction with university life, and racial identity, were not significant predictors on the time spent on Facebook.

Social energy and racial segregation in the university context.

OBJECTIVES: Universities often promote their diversity as a selling point, but are students of different races at these universities integrated socially? Using theories on social energy, I examine racial segregation among university students. METHODS: Quantitative data were collected on student residence patterns and social groupings formed at lunch tables at a case study university. In addition, interviews were conducted with 25 students. RESULTS: Students are substantially more segregated than chance predicts. Blacks and Hispanics are particularly segregated. Interviews reveal that these students spend large amounts of social energy coping with prejudice and discrimination as well as functioning in a student culture they find unwelcoming and foreign. CONCLUSIONS: Social energy drains on minority students from discrimination and an unwelcoming campus culture reduce energy left for interracial interaction, making these racial groups more segregated. The study highlights the need for understanding segregation as a function of the interaction of out-group preferences, in-group preferences, and the larger social context.

Concurrent validity of the Learning and Study Strategies Inventory (LASSI): a study of African American precollege students.

Concurrent validation procedures were employed, using a sample of African American precollege students, to determine the extent to which scale scores obtained from the first edition of the Learning and Study Strategies Inventory (LASSI) were appropriate for diagnostic purposes. Data analysis revealed that 2 of the 10 LASSI scales (i.e., Anxiety and Test Strategies) significantly correlated with a measure of academic ability. These results suggested that scores obtained from these LASSI scales may provide valid assessments of African American precollege students' academic aptitude. Implications for teachers, school counselors, and developmental studies professionals were discussed.

Travelling home for treatment and EU patients' rights to care abroad: results of a survey among German students at Maastricht University.

Empirical evidence on patient mobility in Europe is lacking despite widespread legal, policy and media attention which the phenomenon attracts. This paper presents quantitative data on the health care seeking behaviour of German students at Maastricht University in the Netherlands. A cross-sectional survey design was applied with a mixed-methods approach including open and closed questions. Questionnaire items were based on a theoretical model of patient mobility and input from focus group discussions with German students living in Maastricht. 235 valid surveys were completed, representing ca. 8% of the target population. Data collection took place in Oct-Dec 2010. Of respondents who received medical care over the last two years, 97% returned to Germany; of these, 76% travelled to their home city for medical treatment. 72% received care only in Germany, i.e. not even once in Maastricht. Distance partly influenced whether students travelled to Germany, returned home or stayed in Maastricht, and the type of care accessed. Key motivations were familiarity with home providers/system, and reimbursement issues. In the context of the new EU Directive on patients' rights, the findings call into question whether Europeans use entitlements to cross-border care and what the real potential of patient mobility is. The results demonstrate the existence and magnitude of return movements as a sub-group of patient mobility.