High rates of observed face mask use at Colorado universities align with students' opinions about masking and support the safety and viability of in-person higher education during the COVID-19 pandemic.

BACKGROUND: Over the course of the COVID-19 pandemic, colleges and universities have focused on creating policies, such as mask mandates, to minimize COVID-19 transmission both on their campuses and in the surrounding community. Adherence to and opinions about these policies remain largely unknown. METHODS: The Centers for Disease Control and Prevention (CDC) developed a cross-sectional study, the Mask Adherence and Surveillance at Colleges and Universities Project (MASCUP!), to objectively and inconspicuously measure rates of mask use at institutes of higher education via direct observation. From February 15 through April 11, 2021 the University of Colorado Boulder (CU, n = 2,808 observations) and Colorado State University Fort Collins (CSU, n = 3,225 observations) participated in MASCUP! along with 52 other institutes of higher education (n = 100,353 observations) spanning 21 states and the District of Columbia. Mask use was mandatory at both Colorado universities and student surveys were administered to assess student beliefs and attitudes. RESULTS: We found that 91.7%, 93.4%, and 90.8% of persons observed at indoor locations on campus wore a mask correctly at University of Colorado, Colorado State University, and across the 52 other schools, respectively. Student responses to questions about masking were in line with these observed rates of mask use where 92.9% of respondents at CU and 89.8% at CSU believe that wearing masks can protect the health of others. Both Colorado universities saw their largest surges in COVID-19 cases in the fall of 2020, with markedly lower case counts during the mask observation window in the spring of 2021. CONCLUSION: High levels of mask use at Colorado's two largest campuses aligned with rates observed at other institutes across the country. These high rates of use, coupled with positive student attitudes about mask use, demonstrate that masks were widely accepted and may have contributed to reduced COVID-19 case counts. This study supports an emerging body of literature substantiating masks as an effective, low-cost measure to reduce disease transmission and establishes masking (with proper education and promotion) as a viable tactic to reduce respiratory disease transmission on college campuses.

Observed Face Mask Use at Six Universities - United States, September-November 2020.

Approximately 41% of adults aged 18-24 years in the United States are enrolled in a college or university (1). Wearing a face mask can reduce transmission of SARS-CoV-2, the virus that causes coronavirus disease 2019 (COVID-19) (2), and many colleges and universities mandate mask use in public locations and outdoors when within six feet of others. Studies based on self-report have described mask use ranging from 69.1% to 86.1% among adults aged 18-29 years (3); however, more objective measures are needed. Direct observation by trained observers is the accepted standard for monitoring behaviors such as hand hygiene (4). In this investigation, direct observation was used to estimate the proportion of persons wearing masks and the proportion of persons wearing masks correctly (i.e., covering the nose and mouth and secured under the chin*) on campus and at nearby off-campus locations at six rural and suburban universities with mask mandates in the southern and western United States. Trained student observers recorded mask use for up to 8 weeks from fixed sites on campus and nearby. Among 17,200 observed persons, 85.5% wore masks, with 89.7% of those persons wearing the mask correctly (overall correct mask use: 76.7%). Among persons observed indoors, 91.7% wore masks correctly. The proportion correctly wearing masks indoors varied by mask type, from 96.8% for N95-type masks and 92.2% for cloth masks to 78.9% for bandanas, scarves, and similar face coverings. Observed indoor mask use was high at these six universities with mask mandates. Colleges and universities can use direct observation findings to tailor training and messaging toward increasing correct mask use.

Making the Most of Our Community Health Assessment by Developing a Framework for Evaluation.

The Health District of Northern Larimer County is a special district delivering community health programs and services in Northern Colorado. Since 1995, we have conducted a community health assessment (CHA) every 3 years. In 2015, we looked at our CHA process to see whether improvements could be made. We gathered information to understand recommended processes and potential impacts of CHA. We then developed a logic model to describe our CHA process and intended outcomes. The model outlined our CHA activities and impacts and informed our evaluation questions. We identified areas for process improvement, including our ability to analyze health inequities and effectively disseminate CHA data and findings. We recommend that others conducting a CHA evaluate their processes and impacts. Developing a logic model can be a first step toward creating an evaluation. While evaluation requires resources, we believe that the practice of CHA could greatly benefit from additional evaluation efforts.

Data for Community Health Assessment in Rural Colorado: A Comparison of Electronic Health Records to Public Health Surveys to Describe Childhood Obesity.

CONTEXT: Community-level data are necessary to inform community health assessments and to plan for appropriate interventions. However, data derived from public health surveys may be limited or unavailable in rural locations. OBJECTIVE: We compared 2 sources of data for community health assessment in rural Colorado, electronic health records (EHRs) and routine public health surveys. DESIGN: Comparison of cross-sectional measures of childhood/youth obesity prevalence and data quality. SETTING: Two rural Colorado counties, La Plata and Prowers. PARTICIPANTS: The EHR cohort comprised patients 2 to 19 years of age who underwent a visit with the largest health care provider in each county. These data included sex, age, weight, height, race, ethnicity, and insurance status. Public health survey data were obtained from 2 surveys, the Colorado Child Health Survey (2-14 years of age) and the Healthy Kids Colorado Survey (15-19 years of age) and included caregiver and self-reported height and weight estimates. MAIN OUTCOME MEASURES: We calculated body mass index percentile for each patient and survey respondent and determined overweight/obesity prevalence by county. We evaluated data source quality indicators according to a rubric developed for this analysis. RESULTS: The EHR sample captured approximately 35% (n = 3965) and 70% (n = 2219) of all children living in La Plata and Prowers Counties, respectively. The EHR prevalence estimates of overweight/obesity were greater in precision than survey data in both counties among children 2 to 14 years of age. In addition, the EHR data were more timely and geographically representative than survey data and provided directly measured height and weight. Conversely, survey data were easier to access and more demographically representative of the overall population. CONCLUSIONS: Electronic health records describing the prevalence of obesity among children/youth living in rural Colorado may complement public health survey data for community health assessment and health improvement planning.

Cardiovascular changes during daily torpor in the laboratory mouse.

The laboratory mouse is a facultative daily heterotherm in that it experiences bouts of torpor under caloric restriction. Mice are the most frequently studied laboratory mammal, and often, genetically modified mice are used to investigate many physiological functions related to weight loss and caloric intake. As such, research documenting the cardiovascular changes during fasting-induced torpor in mice is warranted. In the current study, C57BL/6 mice were implanted either with EKG/temperature telemeters or blood pressure telemeters. Upon fasting and exposure to an ambient temperature (T(a)) of 19 degrees C, mice entered torpor bouts as assessed by core body temperature (T(b)). Core T(b) fell from 36.6 +/- 0.2 degrees C to a minimum of 25.9 +/- 0.9 degrees C during the fast, with a concomitant fall in heart rate from 607 +/- 12 beats per minute (bpm) to a minimum of 158 +/- 20 bpm. Below a core T(b) of 31 degrees C, heart rate fell exponentially with T(b), and the Q(10) was 2.61 +/- 0.18. Further, mice implanted with blood pressure telemeters exhibited similar heart rate and activity profiles as those implanted with EKG/temperature telemeters, and the fall in heart rate and core T(b) during entrance into torpor was paralleled by a fall in blood pressure. The minimum systolic, mean, and diastolic blood pressures of torpid mice were 62.3 +/- 10.2, 51.9 +/- 9.2, 41.0 +/- 7.5 mmHg, respectively. Torpid mice had a significantly lower heart rate (25-35%) than when euthermic at mean arterial pressures from 75 to 100 mmHg, suggesting that total peripheral resistance is elevated during torpor. These data provide new and significant insight into the cardiovascular adjustments that occur in torpid mice.

Effect of Online Training on Antenatal Physical Activity Counseling.

Objective: The objective of this study was to test the effect of an online education intervention on providers' attitudes, beliefs, knowledge, and practices pertaining to antenatal physical activity. Study design: A sample of 181 providers (ie, obstetricians, family medicine physicians, and certified nurse-midwives) was directed to view an online training on antenatal physical activity guidelines, counseling methods, and resources. Providers completed surveys before and 12 weeks after viewing the educational website material. Repeated-measures analyses were conducted to examine the effects of the online education. Results: A total of 164 providers (87.2%) completed baseline and follow-up surveys. After viewing the online training, participants more strongly agreed that it was their responsibility to encourage engagement in antenatal physical activity (P = .02) and believed that women would follow their advice about beginning antenatal physical activity (P = .01). Viewing the website material facilitated an increased confidence in ability to effectively talk with overweight and obese women about physical activity (P = .04) and more frequent advising to begin a moderate-intensity physical activity program for sedentary women (P = .02). Knowledge on antenatal physical activity guidelines also improved. Conclusion: Findings suggest that online educational interventions may be an effective tool in altering providers' knowledge and practices pertaining to antenatal physical activity.

The full expression of fasting-induced torpor requires beta 3-adrenergic receptor signaling.

Torpor, a controlled rapid drop in metabolic rate and body temperature (Tb), is a hypometabolic adaptation to stressful environmental conditions, which occurs in many small mammals, marsupials, and birds. To date, signaling pathways required for torpor have not been identified. We examined the role of the sympathetic nervous system (SNS) in mediating the torpor adaptation to fasting by telemetrically monitoring the Tb of dopamine beta-hydroxylase knock-out (Dbh-/-) mice, which lack the ability to produce the SNS transmitters, norepinephrine (NE), and epinephrine. Control (Dbh+/-) mice readily reduced serum leptin levels and entered torpor after a fast in a cool environment. In contrast, Dbh-/- mice failed to reduce serum leptin and enter torpor under fasting conditions, whereas restoration of peripheral but not central NE lowered serum leptin levels and rescued the torpor response. Torpor was expressed in fasted Dbh-/- mice immediately after administration of either the nonselective beta-adrenergic receptor agonist isoproterenol or the beta3-adrenergic receptor (AR)-specific agonist CL 316243 [disodium (RR)-5-[2-[[2-(3-chlorophenyl)-2-hydroxyethyl]-amino]propyl]-1,3-benzodioxazole-2,2-dicarboxylate], but not after administration of beta1, beta2, or alpha1 agonists. Importantly, the beta3-specific antagonist SR 59230A [3-(2-ethylphenoxy)-1-[(1,S)-1,2,3,4-tetrahydronapth-1-ylamino]-2S-2-propanol oxalate] severely blunted fasting-induced torpor in control mice, whereas other AR antagonists were ineffective. These results define a critical role of peripheral SNS activity at beta3-AR-containing tissues in the torpor adaptation to limited energy availability and cool ambient temperature.

Psychosocial Predictors of Weight Loss among American Indian and Alaska Native Participants in a Diabetes Prevention Translational Project.

The association of psychosocial factors (psychological distress, coping skills, family support, trauma exposure, and spirituality) with initial weight and weight loss among American Indians and Alaska Natives (AI/ANs) in a diabetes prevention translational project was investigated. Participants (n = 3,135) were confirmed as prediabetic and subsequently enrolled in the Special Diabetes Program for Indians Diabetes Prevention (SDPI-DP) demonstration project implemented at 36 Indian health care programs. Measures were obtained at baseline and after completing a 16-session educational curriculum focusing on weight loss through behavioral changes. At baseline, psychological distress and negative family support were linked to greater weight, whereas cultural spirituality was correlated with lower weight. Furthermore, psychological distress and negative family support predicted less weight loss, and positive family support predicted greater weight loss, over the course of the intervention. These bivariate relationships between psychosocial factors and weight remained statistically significant within a multivariate model, after controlling for sociodemographic characteristics. Conversely, coping skills and trauma exposure were not significantly associated with baseline weight or change in weight. These findings demonstrate the influence of psychosocial factors on weight loss in AI/AN communities and have substantial implications for incorporating adjunctive intervention components.

Maximal lactate steady state declines during the aging process.

Increased participation of aged individuals in athletics warrants basic research focused on delineating age-related changes in performance variables. On the basis of potential age-related declines in aerobic enzyme activities and a shift in the expression of myosin heavy chain (MHC) isoforms, we hypothesized that maximal lactate steady-state (MLSS) exercise intensity would be altered as a function of age. Three age groups [young athletes (YA), 25.9 +/- 1.0 yr, middle-age athletes (MA), 43.2 +/- 1.0 yr, and older athletes (OA), 64.6 +/- 2.7 yr] of male, competitive cyclists and triathletes matched for training intensity and duration were studied. Subjects performed a maximal O2 consumption (V(o2 max)) test followed by a series of 30-min exercise trials to determine MLSS. A muscle biopsy of the vastus lateralis was procured on a separate visit. There were differences (P < 0.05) in V(o2 max) among all age groups (YA = 67.7 +/- 1.2 ml x kg-1x min-1, MA = 56.0 +/- 2.6 ml x kg-1x min-1, OA = 47.0 +/- 2.6 ml x kg-1 x min-1). When expressed as a percentage of V(o2 max), there was also an age-related decrease (P < 0.05) in the relative MLSS exercise intensity (YA = 80.8 +/- 0.9%, MA = 76.1 +/- 1.4%, OA = 69.9 +/- 1.5%). There were no significant age-related changes in citrate synthase activity or MHC isoform profile. The hypothesis is supported as there is an age-related decline in MLSS exercise intensity in athletes matched for training intensity and duration. Although type I MHC isoform, combined with age, is helpful in predicting (r = 0.76, P < 0.05) relative MLSS intensity, it does not explain the age-related decline in MLSS.

Exploring the impact of the 2008 global food crisis on food security among vulnerable households in rural South Africa.

Recurring food crises endanger the livelihoods of millions of households in developing countries around the globe. Owing to the importance of this issue, we explore recent changes in food security between the years 2004 and 2010 in a rural district in Northeastern South Africa. Our study window spans the time of the 2008 global food crises and allows the investigation of its impacts on rural South African populations. Grounded in the sustainable livelihood framework, we examine differences in food security trajectories among vulnerable sub populations. A unique panel data set of 8,147 households, provided by the Agincourt Health and Demographic Surveillance System (Agincourt HDSS), allows us to employ a longitudinal multilevel modeling approach to estimate adjusted growth curves for the differential change in food security across time. We observe an overall improvement in food security that leveled off after 2008, most likely resulting from the global food crisis. In addition, we discover significant differences in food security trajectories for various sub populations. For example, female-headed households and those living in areas with better access to natural resources differentially improved their food security situation, compared to male-headed households and those households with lower levels of natural resource access. However, former Mozambican refugees witnessed a decline in food security. Therefore, poverty alleviation programs for the Agincourt region should work to improve the food security of vulnerable households, such as former Mozambican refugees.