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1.
Proc Natl Acad Sci U S A ; 119(2)2022 01 11.
Artigo em Inglês | MEDLINE | ID: mdl-34969678

RESUMO

We consider epidemiological modeling for the design of COVID-19 interventions in university populations, which have seen significant outbreaks during the pandemic. A central challenge is sensitivity of predictions to input parameters coupled with uncertainty about these parameters. Nearly 2 y into the pandemic, parameter uncertainty remains because of changes in vaccination efficacy, viral variants, and mask mandates, and because universities' unique characteristics hinder translation from the general population: a high fraction of young people, who have higher rates of asymptomatic infection and social contact, as well as an enhanced ability to implement behavioral and testing interventions. We describe an epidemiological model that formed the basis for Cornell University's decision to reopen for in-person instruction in fall 2020 and supported the design of an asymptomatic screening program instituted concurrently to prevent viral spread. We demonstrate how the structure of these decisions allowed risk to be minimized despite parameter uncertainty leading to an inability to make accurate point estimates and how this generalizes to other university settings. We find that once-per-week asymptomatic screening of vaccinated undergraduate students provides substantial value against the Delta variant, even if all students are vaccinated, and that more targeted testing of the most social vaccinated students provides further value.


Assuntos
COVID-19/epidemiologia , Retorno à Escola/métodos , Infecções Assintomáticas/epidemiologia , COVID-19/diagnóstico , COVID-19/prevenção & controle , COVID-19/transmissão , Tomada de Decisões , Humanos , Programas de Rastreamento , SARS-CoV-2/isolamento & purificação , Incerteza , Estados Unidos/epidemiologia , Universidades , Vacinação
2.
Proc Natl Acad Sci U S A ; 118(42)2021 10 19.
Artigo em Inglês | MEDLINE | ID: mdl-34642247

RESUMO

This paper empirically examines how the opening of K-12 schools is associated with the spread of COVID-19 using county-level panel data in the United States. As preliminary evidence, our event-study analysis indicates that cases and deaths in counties with in-person or hybrid opening relative to those with remote opening substantially increased after the school opening date, especially for counties without any mask mandate for staff. Our main analysis uses a dynamic panel data model for case and death growth rates, where we control for dynamically evolving mitigation policies, past infection levels, and additive county-level and state-week "fixed" effects. This analysis shows that an increase in visits to both K-12 schools and colleges is associated with a subsequent increase in case and death growth rates. The estimates indicate that fully opening K-12 schools with in-person learning is associated with a 5 (SE = 2) percentage points increase in the growth rate of cases. We also find that the association of K-12 school visits or in-person school openings with case growth is stronger for counties that do not require staff to wear masks at schools. These findings support policies that promote masking and other precautionary measures at schools and giving vaccine priority to education workers.


Assuntos
COVID-19/epidemiologia , COVID-19/transmissão , Retorno à Escola/estatística & dados numéricos , COVID-19/mortalidade , COVID-19/prevenção & controle , Humanos , Máscaras , Modelos Estatísticos , SARS-CoV-2 , Instituições Acadêmicas , Viagem , Estados Unidos/epidemiologia
5.
Brasília, D.F.; OPAS; 2021-07-20.
Não convencional em Português | PAHO-IRIS | ID: phr2-54527

RESUMO

O objetivo desta lista de verificação é reforçar a conformidade e a adesão às medidas de saúde pública delineadas no documento recentemente atualizado Considerations for school-related public health measures in the context of COVID-19 [Considerações para medidas de saúde pública relacionadas a escolas no contexto da COVID-19], considerando-se principalmente as crianças menores de 18 anos em contextos educacionais e em escolas com recursos limitados. A lista de verificação foi elaborada de acordo com os princípios e as abordagens das escolas promotoras de saúde.7,8 Este documento destaca a importância da coordenação multinível (ou seja, nos níveis escolar, subnacional e nacional) e de abordagens participativas e cocriadas pelas várias partes interessadas (por exemplo, trabalhadores das escolas, professores, alunos e pais). Esta abordagem visa a otimizar o cumprimento das medidas sociais e de saúde pública baseadas nos contextos sociais e culturais, conforme descrito no documento Considerations for implementing and adjusting public health and social measures in the context of COVID-19 [Considerações para a implementação e ajuste de medidas sociais e de saúde pública no contexto da COVID-19].


Assuntos
COVID-19 , Coronavirus , Infecções por Coronavirus , Betacoronavirus , Saúde Pública , Retorno à Escola , Instituições Acadêmicas
6.
J Sch Health ; 91(5): 370-375, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-33768584

RESUMO

BACKGROUND: In fall 2020, all public K-12 schools reopened in broadly 3 learning models. The hybrid model was considered a mid-risk option compared with remote and in-person learning models. The current study assesses school-based coronavirus disease 2019 (COVID-19) spread in the early fall using a national data set. METHODS: We assess COVID-19 case growth rates from August 10 to October 14, 2020 based on a crowdsourcing data set from the National Education Association. The study follows a retrospective cohort design with the baseline exposures being 3 teaching models: remote learning only, hybrid, and in-person learning. To assess the consistency of our findings, we estimated the overall, as well as region-specific (Northeast, Midwest, South, and West) and poverty-specific (low, mid, and high) COVID-19 case-growth rates. In addition, we validated our study sample using another national sample survey data. RESULTS: The baseline was from 617 school districts in 48 states, where 47% of school districts were in hybrid, 13% were in remote, and 40% were in-person. Controlling for state-level risk and rural-urban difference, the case growth rates for remote and in-person were lower than the hybrid (odds ratio [OR]: 0.963, 95% confidence interval [CI]: 0.960-0.965 and OR: 0.986, 95% CI: 0.984-0.988, respectively). A consistent result was found among school districts in all 4 regions and each poverty level. CONCLUSIONS: Hybrid may not necessarily be the next logical option when transitioning from the remote to in-person learning models due to its consistent higher case growth rates than the other 2 learning models.


Assuntos
COVID-19/epidemiologia , Modelos Educacionais , Retorno à Escola/métodos , Adolescente , Criança , Surtos de Doenças/estatística & dados numéricos , Humanos , Estudos Retrospectivos , SARS-CoV-2 , Instituições Acadêmicas , Estudantes , Estados Unidos/epidemiologia
7.
J Sch Health ; 91(5): 376-383, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-33655549

RESUMO

BACKGROUND: During spring 2020, COVID-19 forced widespread United States school building closures in an unprecedented disruption for K-12 students and staff. Partnering with the American School Health Association (ASHA), we sought to identify areas of concern among school staff planning for school reopening with the goal of addressing gaps in resources and education. METHODS: This 16-item web-based survey was distributed via email to 7467 ASHA members from May to June 2020. Topics focused on 3 Whole School, Whole Community, Whole Child components: physical environment, health services, and mental health. Chi-square tests were used to identify differences in responses by school characteristics and school role on each survey item. RESULTS: A total of 375 respondents representing 45 states completed the survey. The majority were female (91.7%), white (83.4%) and non-Hispanic (92.2%), and school nurses (58.7%). Priority concerns were feasibility of social distancing (93.6%), resurgence of COVID-19 (92.8%), and the availability of health supplies (88.8%). CONCLUSION: Understanding staff concerns in the context of the Whole School, Whole Community, Whole Child model better positions the school community to address ongoing gaps and changing needs as schools continue to address COVID-19 complications.


Assuntos
Ambiente Construído , COVID-19/prevenção & controle , Saúde Mental , Retorno à Escola/normas , Serviços de Saúde Escolar , Instituições Acadêmicas/estatística & dados numéricos , Adulto , Feminino , Humanos , Masculino , Inquéritos e Questionários , Estados Unidos
9.
Artigo em Inglês | MEDLINE | ID: mdl-33499409

RESUMO

The current wave and future trend of the novel coronavirus disease 2019 (COVID-19) has triggered public uncertainty, causing unbearable psychological pressure on people. A cross-sectional online questionnaire was conducted among back-to-school students in Wuhan from 31 August 2020, to 14 September 2020, by using convenience sampling. A total of 1017 participants voluntarily provided sociodemographic characteristics and accomplished the following scales: the Intolerance of Uncertainty Scale (IUS-12), the Social Support Scale (SSQ), the Generalized Anxiety Disorder Scale (GAD-7), the Patient Health Questionnaire-9 (PHQ-9), and the Insomnia Severity Index-7 (ISI-7). Results revealed that the levels of anxiety, depression, and insomnia were moderate, moderate and subthreshold, respectively. A one-way multivariate analysis of variance indicated that those with different attitudes toward the trajectory of the COVID-19 epidemic in China showed significantly different results in anxiety and depression (p < 0.001). Moderation modeling implicated that social support significantly moderated the predictive relationship between intolerance of uncertainty and mental health variables including anxiety and depression, but failed on insomnia. Findings indicate that back-to-school students in Wuhan experience mental health problems and improving social support measures could buffer the effect of intolerance of uncertainty with respect to COVID-19 on mental health.


Assuntos
COVID-19/psicologia , Saúde Mental , Retorno à Escola , Apoio Social , Estudantes/psicologia , Incerteza , Adolescente , Adulto , Ansiedade/epidemiologia , China/epidemiologia , Estudos Transversais , Depressão/epidemiologia , Feminino , Humanos , Masculino , Instituições Acadêmicas , Inquéritos e Questionários , Adulto Jovem
10.
Clin J Sport Med ; 31(6): e406-e413, 2021 11 01.
Artigo em Inglês | MEDLINE | ID: mdl-31876794

RESUMO

OBJECTIVE: The need to have a pediatric-specific concussion management protocol on Return to School (RTS) and Return to Activity (RTA) after concussion has been recognized internationally. The first step to evaluate the protocol effectiveness is to establish whether children and youth are adhering to these recommendations. The objective of this study was to explore the prevalence and predictors of adherence to RTS and RTA concussion management protocols for children/youth. DESIGN: A prospective cohort of children/youth with concussion. SETTING: Childhood Disability Research Centre. PARTICIPANTS: One hundred thirty-nine children/youth aged 5 to 18 years, diagnosed with concussion and symptomatic upon enrollment, were followed for up to 6 months. Primary recruitment occurred from a Children's Hospital Emergency Department. INTERVENTION: Provision of RTS/RTA guidelines. MAIN OUTCOME MEASURES: Measurement of adherence came from multiple sources, including the child's and parent's knowledge of protocols, research personnel evaluations, and self-reported stages of RTS/RTA and Post-Concussion Symptom Scale (PCSS) scores. RESULTS: Spearman correlations and logistic regression were used, investigating the relationship between PCSS and progression of protocols and determining predictors of adherence. Significant negative associations between total PCSS score and stage of RTS/RTA protocols were found. Fifty-three percent and 56% of the participants adhered to the RTS and RTA protocols, respectively. CONCLUSIONS: Children's knowledge of protocols and total PCSS scores significantly predicted adherence to RTS/RTA and may be the most important factors in predicting adherence during recovery from concussion.


Assuntos
Traumatismos em Atletas , Concussão Encefálica , Síndrome Pós-Concussão , Adolescente , Criança , Estudos de Coortes , Humanos , Estudos Prospectivos , Retorno à Escola
11.
Rev Environ Health ; 36(1): 27-37, 2021 Mar 26.
Artigo em Inglês | MEDLINE | ID: mdl-33001857

RESUMO

In the midst of the COVID-19 pandemic, United States (U.S.) educational institutions must weigh incomplete scientific evidence to inform decisions about how best to re-open schools without sacrificing public health. While many communities face surging case numbers, others are experiencing case plateaus or even decreasing numbers. Simultaneously, some U.S. school systems face immense infrastructure challenges and resource constraints, while others are better positioned to resume face-to-face instruction. In this review, we first examine potential engineering controls to reduce SARS-CoV-2 exposures; we then present processes whereby local decision-makers can identify and partner with scientists, faculty, students, parents, public health officials, and others to determine the controls most appropriate for their communities. While no solution completely eliminates risks of SARS-CoV-2 exposure and illness, this mini-review discusses engaged decision and communication processes that incorporate current scientific knowledge, school district constraints, local tolerance for health risk, and community priorities to help guide schools in selecting and implementing re-opening strategies that are acceptable, feasible, and context-specific.


Assuntos
COVID-19/epidemiologia , COVID-19/prevenção & controle , Comunicação , Retorno à Escola , Participação dos Interessados , COVID-19/transmissão , Controle de Doenças Transmissíveis/métodos , Controle de Doenças Transmissíveis/organização & administração , Controle de Doenças Transmissíveis/estatística & dados numéricos , Humanos , Saúde Pública , Retorno à Escola/organização & administração , Risco , SARS-CoV-2 , Estados Unidos/epidemiologia
14.
Headache ; 61(1): 190-201, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-33382459

RESUMO

OBJECTIVE: To equip clinicians with recommendations specific to concerns related to the novel coronavirus disease 2019 (COVID-19), which impact the physical, emotional, and social health of youth with headache disorders. BACKGROUND: COVID-19 has affected societies on a global scale including children and youth with chronic headache disorders. Many concerns are predicted to arise in the 2020-2021 school year, whether classes are conducted in-person or virtually. METHODS: Clinical impressions were combined with a review of the literature, although limited due to the recent nature of this issue. RESULTS: We describe recommendations to support caregivers and youth as they face changes expected with the return to school in the fall of 2020. CONCLUSION: Although there are significant concerns for caregivers and youth with migraine given the context of changes related to the pandemic, there are many recommendations that can help minimize exacerbations of the physical, emotional, and social health of youth with chronic migraine.


Assuntos
COVID-19 , Transtornos de Enxaqueca , Retorno à Escola , Adolescente , Criança , Feminino , Humanos , Masculino , SARS-CoV-2
15.
Pediatr Transplant ; 25(1): e13791, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-33202076

RESUMO

Pediatric recipients of life-saving organ transplants are living longer, with improved graft and overall survivals. After successful transplant, children are encouraged to return to "normal life," with school attendance and participation in age-appropriate physical activities. This transition may cause stress to the recipients, parents, teachers, and other participating caregivers and staff. Planning for school reentry and assuring education for and open lines of communication with the school staff can help alleviate some of this discomfort and ease the process for the patient and the family. Cardiovascular disease has emerged as the leading cause of death in survivors of pediatric transplantation and is contributed to by modifiable risk factors such as obesity, hypertension, and the MS. Physical activity is a proven tool in decreasing surrogate markers of this risk. Sports participation is an important way to promote an enjoyment of physical activity that can ideally persist into adulthood, but conflicting advice and opinions exist regarding type and participation in physical activity. Moreover, specific recommendations are likely not applicable to all recipients, as certain degrees of rehabilitation may be needed depending on degree and length of illness. In general, a program of rehabilitation and increased physical activity has been shown to be safe and effective for most pediatric transplant recipients. Focusing on optimizing the "normal" childhood activities of going to school and participating in sports can improve the physical, social, cognitive, and mental health outcomes of this population after transplant and should be prioritized.


Assuntos
Estilo de Vida Saudável , Educação Física e Treinamento , Retorno à Escola , Esportes , Transplantados , Adolescente , Criança , Humanos , Fatores de Risco
16.
J Sch Health ; 91(1): 3-8, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-33140434

RESUMO

BACKGROUND: Amid the COVID-19 pandemic, there is a need to understand caregiver preferences for their children's instructional format for the start of the 2020 to 2021 academic year. The purpose of the current study was to assess caregiver preferences for on-campus versus virtual learning at home during the fall and factors associated with these preferences. METHODS: Participants were caregivers of 4436 children and adolescents who were enrolled in pre-kindergarten through high school at a large, public school district in Texas. Caregivers were asked to complete an anonymous, online survey about their initial preferences for their student's back to the school learning environment. RESULTS: Caregivers of high- and middle-school students were more likely to endorse a preference for an on-campus/virtual hybrid instructional format and less likely to endorse a preference for a traditional, face-to-face instructional format compared to caregivers of elementary school students. Regardless of the school level, concerns about child health and safety were the factor most strongly associated with caregiver preferences for on-campus versus virtual learning at home during the fall. CONCLUSIONS: These data highlight the importance of school re-opening plans offering virtual options and addressing caregiver concerns about children's health and safety amid the COVID-19 pandemic.


Assuntos
COVID-19/epidemiologia , Cuidadores/psicologia , Pais/psicologia , Retorno à Escola/organização & administração , Adolescente , Criança , Saúde da Criança/normas , Pré-Escolar , Feminino , Humanos , Masculino , Pandemias , Retorno à Escola/normas , SARS-CoV-2 , Fatores Socioeconômicos , Texas/epidemiologia
18.
J Head Trauma Rehabil ; 36(2): E89-E96, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-32769832

RESUMO

BACKGROUND: Many children who experience a traumatic brain injury (TBI) return to school without receiving needed support services. OBJECTIVE: To identify services received and predictors of formal special education services (ie, Individualized Education Plan [IEP]) for students with TBI 1 year after returning to school. SETTING AND PARTICIPANTS: A total of 74 students with TBI recruited from children's hospitals in Colorado, Ohio, and Oregon. DESIGN: Secondary analysis of previously reported randomized control trials with surveys completed by caregivers when students returned to school (T1) and 1 year later (T2). This study reports data collected at T2. RESULTS: While 45% of students with TBI reported an IEP 1 year after returning to school, nearly 50% of students received informal or no services. Male students, those who sustained a severe TBI, and students whose parents reported domain-specific concerns were more likely to receive special education services at 1 year. In a multivariate model, sex remained the only significant predictor of IEP services at T2. CONCLUSIONS: Females and students with less severe or less visible deficits were less likely to receive special education services. While transition services may help students obtain special education for the first year after TBI, identifying students with TBI who have subtle or later-developing deficits remains a challenge.


Assuntos
Lesões Encefálicas Traumáticas , Retorno à Escola , Lesões Encefálicas Traumáticas/diagnóstico , Lesões Encefálicas Traumáticas/epidemiologia , Lesões Encefálicas Traumáticas/terapia , Criança , Feminino , Humanos , Masculino , Pais , Instituições Acadêmicas , Estudantes
19.
Lima; OPS; 2021. (OPS/PER/21-0003).
em Espanhol | PAHO-IRIS | ID: phr2-54908

RESUMO

En este segundo cuento, continúa la historia de Gloria, la profesora de Susanita, quien se enfrenta al reto de recibirla nuevamente en el aula después de su tratamiento de cáncer. Gloria acompaña y orienta a Susanita y a los estudiantes para adaptarse a esta situación, fortaleciendo los lazos entre compañeros y ayudando a su continuidad académica. El colegio, por su parte, realiza los ajustes necesarios para favorecer la reincorporación de Susanita.


Assuntos
Neoplasias , Sistemas de Apoio Psicossocial , Cuidado da Criança , Saúde da Criança , Socialização , Retorno à Escola , América , Peru
20.
Lima; OPS; 2021. (OPS/PER/21-0005).
em Espanhol | PAHO-IRIS | ID: phr2-54907

RESUMO

Se trata de una profesora, llamada Gloria, que se enfrenta a una situación nueva: Susanita, su alumna, tiene cáncer. Gloria va aprendiendo a manejarlo, trabajando en equipo con el colegio, padres y especialistas; respondiendo a las dudas de los alumnos e incentivándolos a que continúen en contacto con Susanita.


Assuntos
Neoplasias , Sistemas de Apoio Psicossocial , Cuidado da Criança , Saúde da Criança , Retorno à Escola , América , Peru
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