Home and School Pollutant Exposure, Respiratory Outcomes, and Influence of Historical Redlining.

BACKGROUND: The discriminatory and racist policy of historical redlining in the United States (U.S.) during the 1930s played a role in perpetuating contemporary environmental health disparities. OBJECTIVE: Our objectives were to determine associations between home and school pollutant exposure (fine particulate matter (PM2.5), nitrogen dioxide (NO2)) and respiratory outcomes (Composite Asthma Severity Index (CASI), lung function) among school-aged children with asthma and examine whether associations differed between children who resided and/or attended school in historically redlined compared to non-redlined neighborhoods. METHODS: Children ages 6 to 17 with moderate-to-severe asthma (N=240) from 9 U.S. cities were included. Combined home and school exposure to PM2.5 and NO2 was calculated based on geospatially assessed monthly averaged outdoor pollutant concentrations. Repeated measures of CASI and lung function were collected. RESULTS: Overall, 37.5% of children resided and/or attended schools in historically redlined neighborhoods. Children in historically redlined neighborhoods had greater exposure to NO2 (median: 15.4 vs 12.1 ppb) and closer distance to a highway (median: 0.86 vs 1.23 km), compared to those in non-redlined neighborhoods (p<0.01). Overall, PM2.5 was not associated with asthma severity or lung function. However, among children in redlined neighborhoods, higher PM2.5 was associated with worse asthma severity (p<0.005). No association was observed between pollutants and lung function or asthma severity among children in non-redlined neighborhoods (p>0.005). CONCLUSIONS: Our findings highlight the significance of historical redlining and current environmental health disparities among school-aged children with asthma, specifically, the environmental injustice of PM2.5 exposure and its associations with respiratory health.

Associations of school physical activity environment with comorbid obesity and myopia in children and adolescents: Findings from a Chinese national follow-up study.

BACKGROUND: Overweight and obesity (OWOB) and myopia have become two of the most important issues affecting the health of children and adolescents worldwide. Despite the recognition that the school physical activity (PA) environment is a critical factor for preventing and controlling overweight, obesity (OWOB), and myopia in children and adolescents, research on OWOB and myopia as a comorbidity remains unexplored, with evidence for effective strategies still being inconclusive. Hence, this study aimed to assess the prevalence and progression of comorbid OWOB/myopia and each condition alone, and to explore the association with school PA environment. METHODS: A total of 9814 children and adolescents aged 6-18 years were included from the Chinese National Survey on Students' Constitution and Health follow-up survey conducted from November 2019 to November 2020 in China. Anthropometric measurements, unaided distance vision acuity and non-cycloplegic refraction data were collected to assess OWOB and myopia, while eight indicators from questionnaires for children and adolescents aged 9-18 years were investigated to assess school PA environment. We calculated the one-year incidence and progression rates of comorbid OWOB/myopia, OWOB alone, and myopia alone. Mixed effect logistic regression was evaluated the association between school PA environment and incidence and progression of comorbid OWOB/myopia, OWOB, and myopia. RESULTS: The prevalence of comorbid OWOB/myopia increased from 11.1% in 2019 to 17.9% in 2020, and the incidence of comorbid OWOB/myopia was 10.9%. Children and adolescents experiencing an unfavorable school PA environment had a higher risk of the incidence of comorbid OWOB/myopia compared to a favorable school environment (OR = 1.85, 95% CI: 1.42-2.42). Similar findings were seen in the incidence of obesity (OR = 1.86, 95% CI: 1.26-2.75). Children and adolescents in an unfavorable school PA environment had a higher risk of myopia progression (OR = 1.29, 95% CI: 1.01-1.65). CONCLUSIONS: Obesity and myopia and their comorbidity have been serious among children and adolescents in China. A favorable school PA environment might mitigate the risk of comorbid OWOB/myopia, OWOB, and myopia progression.

Associations between a technical assistance model to build school organizational capacity and improvements in student perceptions of school climate.

Organizational capacity building-the process of developing leadership, collecting and analyzing data, building buy-in, and implementing programming-is foundational to effectively changing schools, and frequently relies on technical assistance. This study employed a quasi-experimental, repeated measured design to evaluate the role of technical assistance provided through Safe School Certification model in improving school climate. Schools worked through an eight-element framework, using data from a sample of six middle and high schools in Washington, D.C. that completed data collection in all years of the evaluation. Students in schools receiving technical assistance for implementing the SSC Framework had more positive changes in perceptions of school climate than students in schools that did not receive support, but those differences were small. The results from this study offer limited evidence that providing schools with technical assistance to improve organizational capacity is associated with more positive student perceptions of school climate.

The factors associated with contraceptive use among young female students in rural Guinea / Facteurs associés à l'utilisation des méthodes contraceptives chez les jeunes filles élèves en milieu rural guinéen

Introduction: The low use of modern contraceptive methods by young girls is a real public health problem in sub-Saharan Africa, especially among young female students living in rural areas. The purpose of this study was to analyze the factors associated with contraceptive use among young female students in rural Guinea. Method: This was an analytical cross-sectional study including 607 students from 10 secondary schools in the rural district of Kankan, Guinea. Results: A total of 607 female students were interviewed and included in this study. They had an average age of 17.3 ± 1.7 years, 50.9% were in junior high school, and 49.1% were in high school. During our survey period, 67.7% of the girls reported being sexually active, while only 24.4% were on modern contraception. In the bivariate analysis, factors such as age, religion, school level, having heard of contraception, and having had sexual intercourse were statistically associated with contraceptive use. In the multivariate analysis, factors such as age (OR = 2.1; CI = 1.1­3.8), religion (OR = 5.1; CI = 2.8­9.5), and having had sexual intercourse (OR = 2.2; CI = 1.4­3.5) remained statistically associated with the use of contraceptive methods among young female students. Conclusion: Our study highlights the need to increase awareness of, and access to, contraceptive methods in schools in order to improve contraceptive practice and, in turn, to reduce the frequency of unwanted and early pregnancies among young female students in rural areas of Guinea.

Introduction: La faible utilisation des méthodes contraceptives modernes par les jeunes filles constitue un véritable problème de santé publique en Afrique subsaharienne, en particulier chez les jeunes filles élèves et résidant en milieu rural. Cette étude visait à analyser les facteurs associés à l'utilisation des méthodes contraceptives chez les jeunes filles élèves en milieu rural guinéen. Méthodes: Il s'agissait d'une étude transversale analytique incluant 607 élèves de 10 écoles secondaires du district rural de Kankan en Guinée. Résultats: Au total, 607 jeunes filles élèves ont été interrogées et incluses dans cette étude. Leur moyenne d'âge était de 17,3 ± 1,7 ans, 50,9 % d'entre elles fréquentaient le collège et 49,1 % le lycée. Pendant notre période d'enquête, 67,7 % des jeunes filles ont déclaré être sexuellement actives alors que seules 24,4 % étaient sous contraception moderne. En analyse bivariée, les facteurs comme l'âge, la religion, le niveau scolaire, avoir déjà entendu parler de contraception et avoir déjà eu un rapport sexuel étaient statistiquement associés à l'utilisation de méthodes contraceptives. En analyse multivariée, les facteurs comme l'âge (RCa = 2,1 ; IC = 1,1-3,8), la religion (RCa = 5,1 ; IC = 2,8-9,5) et avoir déjà eu un rapport sexuel (RCa = 2,2 ; IC = 1,4-3,5) restaient statistiquement associés à l'utilisation de méthodes contraceptives chez les jeunes filles en milieu scolaire. Conclusion: Notre étude souligne le besoin de renforcer la sensibilisation et l'accès aux méthodes contraceptives en milieu scolaire en vue d'améliorer la pratique contraceptive, et par ricochet réduire la fréquence des grossesses non désirées et précoces chez les jeunes filles élèves en milieu rural guinéen.

Ultra-processed food consumption is associated with variations in daily routines in elementary schoolchildren during the COVID-19 pandemic in Chile.

OBJECTIVE: To assess the association between child ultra-processed food (UPF) consumption and home-school learning environment characteristics during school closures due to the COVID-19 pandemic in schoolchildren with low- and middle income in Chile. DESIGN: Cross-sectional. UPF consumption was collected using the Nova screener. We apply the structured days hypothesis (SDH) to assess home-school learning environment characteristics with three constructs that summarised school preparedness for online teaching and learning, school closure difficulties for caregivers and child routine. We explored associations between child UPF consumption and home-school environment characteristics using multivariate linear regression analyses after controlling for child demographic and school characteristics. SETTING: Low- and middle-income neighbourhoods in southeastern Santiago, Chile. PARTICIPANTS: Children from the Food Environment Chilean Cohort (n 428, 8-10 years old). RESULTS: Based on the Nova score, child mean consumption of UPF was 4·3 (sd 1·9) groups. We found a statistically significant negative association between child routine for eating, play and study and child UPF consumption when we adjusted for child sociodemographic (model 1: ß = -0·19, (95 % CI -0·40, 0·02)) and school characteristics (model 2: ß = -0·20, (95 % CI -0·41, 0·00)). Associations between school preparedness for online teaching or school closure difficulties and UPF were not statistically significant. CONCLUSIONS: Variations in child routines during the COVID-19 pandemic were negatively associated with UPF intake in schoolchildren with low- and middle income. Our findings are consistent with the SDH, suggesting the school environment helps regulate eating behaviours. Future research should evaluate what happens when children return to in-person classes at school.

Alcohol norms and alcohol intake among high school students.

AIMS: To analyse whether parental alcohol norms were associated with the alcohol intake of high school students and whether this association persisted across different levels of alcohol intake in school and trustful communication with parents. METHODS: This was a cross-sectional study among 70,544 high school students (mean age 18 years) participating in the Danish National Youth Study 2014. We examined the associations between parental alcohol norms and individual alcohol intake as the number of drinks at the most recent school party and the frequency of binge drinking in the last 30 days using negative binomial regression. We then performed joint analyses of parental alcohol norms and alcohol intake at school level, and parental alcohol norms and trustful communication with parents. RESULTS: The mean intake of alcohol at the most recent school party was 9.9 units of alcohol for boys and 7.6 units of alcohol for girls. A total of 36.2% of boys and 24.7% of girls were binge drinking frequently (more than four occasions in the last month). Lenient parental alcohol norms and a low level of trustful communication with parents were associated with a higher intake at the most recent school party and with the frequency of binge drinking. Joint analyses showed that these associations persisted across different levels of school level alcohol intake and levels of trustful communication with parents. CONCLUSIONS: Among high school students, parental alcohol norms were strongly associated with alcohol intake and consistently so across different levels of school level alcohol intake and level of trustful communication with parents. This indicates that the role of parents in preventing excessive drinking is important, even in older adolescents.

Rhinitis in Japanese students - associations with window pane condensation, recent indoor painting, wooden home and dog allergen at school.

We studied risk factors for rhinitis in Japanese homes and schools. A questionnaire was sent to students in four schools (12-15 y age), 1048 (99.2%) participated. Crowdedness and furry pet allergens were measured in their classrooms. Household environment data was collected by a questionnaire. Risk factors were identified by multi-level logistic regression with mutual adjustment. The prevalence of current rhinitis was 60.3%, current rhinoconjunctivitis 24.4% and weekly rhinitis 29.5%. Window condensation (AORs1.69-1.90) and indoor painting (AORs1.72-1.76) at home were associated with rhinitis. The association between painting and rhinitis was stronger in girls (interaction p = 0.002) and in wooden homes (interaction p = 0.05). Dog allergen (Can f 1) in classroom air was associated with rhinitis (p = 0.04). In conclusion, window pane condensation and indoor painting can be household risk factors for rhinitis and dog allergen may be a risk factor in Japanese schools. Girls can be more sensitive to emissions from indoor paint than boys.

Effects of school environment on depression among Black and White adolescents.

While the school environment is critical for adolescents' psychological development, how the school environment influences depression among different racial groups has not been fully explored. This study aims to identify the effects of the school environment (school connectedness, school climates, trouble with peers and teachers) on depressive symptoms among Black and White adolescents. It also compares how the effects of school environments differ between Black and White adolescents. This study analyzed wave 6 of the Fragile Families and Child Well-being Study, a longitudinal birth cohort study in 20 major cities across the United States. Almost three-fourth (73.39%) of the adolescents were Black, and 26.61% were White. About half (50.46%) of the adolescents were females, and the mean age of adolescents was 15.39. Multiple regression analysis showed that higher school connectedness and less frequent troubles with teachers were associated with lower depression among Black adolescents. In contrast, only school connectedness was associated with depression among White adolescents. Higher school connectedness was associated with lower depressive symptoms for both Black and White adolescents. However, the magnitude of the effects of school connectedness was found to be statistically weaker among Black adolescents. These findings suggest a need for creating a racially equitable school environment that makes every student feel more connected to their schools, especially Black students.

Evaluation of Primary School Health Environment in Ido/Osi Local Government Area, Ekiti State, Nigeria.

BACKGROUND: School environment entails the sum total of the physical, biological, social, and emotional environment within which members of the school community operate. It is essential to make the school environment healthy to promote and protect the health of school pupils as well as their safety. This study aimed at finding the level of implementation of a Healthy School Environment (HSE) in Ido/Osi Local Government Area (LGA) of Ekiti State. METHODOLOGY: A cross-sectional descriptive study carried out among 48 private and 19 public primary schools using a standardised checklist and direct observation. RESULTS: The teacher-to-pupil ratio was 1:16 in public schools and 1:10 in private schools. The leading source of water in 47.8% of the schools was well water. Most, 97%, of the schools practiced open dumping of refuse. Private schools had more school buildings with strong walls and good roofs with doors and windows which provided adequate ventilation compared to the public schools (p- 0.001). No school was located close to an industrial area, however, none had a safety patrol team. Only 34.3% of schools had a fence and 31.3% had terrains prone to flooding. Only 3% of the schools, all private schools, attained the minimum acceptable score on the school environment. CONCLUSION: The status of school environment was poor in the study location and school ownership did not make any much impact as there was no difference in the situations of school environment between public and private schools.

CONTEXTE: L'environnement scolaire est l'ensemble des conditions physiques, biologiques, sociales et émotionnelles dans lesquelles évoluent les membres de la communauté scolaire. Il est essentiel de rendre l'environnement scolaire sain afin de promouvoir et de protéger la santé des élèves ainsi que leur sécurité. Cette étude visait à déterminer le niveau de mise en œuvre de l'environnement scolaire sain (HSE) dans la zone de gouvernement local (LGA) d'Ido/Osi de l'État d'Ekiti. MÉTHODOLOGIE: Une étude descriptive transversale a été menée dans 48 écoles primaires privées et 19 écoles primaires publiques à l'aide d'une liste de contrôle standardisée et d'une observation directe. RÉSULTATS: Le ratio enseignant/élèves était de 1:16 dans les écoles publiques et de 1:10 dans les écoles privées. La principale source d'eau dans 47,8 % des écoles était l'eau de puits. La plupart des écoles (97%) pratiquaient le dépôt d'ordures à l'air libre. Les écoles privées avaient plus de bâtiments scolaires avec des murs solides et de bons toits avec des portes et des fenêtres qui fournissaient une ventilation adéquate par rapport aux écoles publiques (p- 0.001). Aucune école n'était située à proximité d'une zone industrielle, mais aucune ne disposait d'une équipe de patrouille de sécurité. Seules 34,3 % des écoles disposaient d'une clôture et 31,3 % étaient situées sur des terrains inondables. Seules 3 % des écoles, toutes privées, ont atteint le score minimum acceptable en matière d'environnement scolaire. CONCLUSION: L'état de l'environnement scolaire était médiocre dans la région étudiée et la propriété de l'école n'avait pas beaucoup d'impact car il n'y avait pas de différence dans la situation de l'environnement scolaire entre les écoles publiques et les écoles privées. Mots-clés: État d'Ekiti, Environnement sain, Gouvernement Local, Nigeria, École Primaire, Environnement Scolaire.

What is the impact of structural and cultural factors and interventions within educational settings on promoting positive mental health and preventing poor mental health: a systematic review.

Mental health (MH) difficulties are on the increase among children and young people (CYP). Evidence has shown that educational settings contain both risk and protective factors for MH. This review investigated which structural and cultural factors and interventions within educational settings promote positive MH and prevent poor MH in 4-18 year olds. Searches were conducted in PsychINFO, Embase, ERIC, ASSIA and British Education Index, and reference lists from key studies and relevant systematic reviews were hand-searched. Intervention, cohort, and qualitative studies were included. Of the 62 included papers, 36 examined cultural factors (30 social/relational and six value-related) while 12 studies examined structural factors (eight organisational and four physical) and 14 studies examined multiple factors. There was strong evidence for the impact of positive classroom management techniques, access to physical activity, and peer mentoring on student MH. Studies examining the impact of positive school culture, teacher training in MH and parent involvement in school MH activities also found predominantly positive results for student MH, albeit the evidence was of lower quality or from a low number of studies. Few studies explicitly examined the impact of interventions on MH inequalities; those that did indicated limited if any reduction to inequalities. A very small number of studies suggested that interventions targeting those at risk of poor MH due to socioeconomic factors could successfully improve wellbeing and reduce depression, anxiety and behavioural problems. Studies exploring the effect of management and leadership strategies within schools, policies, and aspects of the physical environment other than green space were scarce or absent in the literature. This review highlights the need to consider the ways in which educational settings are organised, the culture that is created and the physical space in order to improve the MH of CYP.

What factors influence implementation of whole-school interventions aiming to promote student commitment to school to prevent substance use and violence? Systematic review and synthesis of process evaluations.

BACKGROUND: Whole-school interventions go beyond classroom health education to modify the school environment to promote health. A sub-set aim to promote student commitment to school to reduce substance use and violence (outcomes associated with low commitment). It is unclear what factors influence implementation of such interventions. METHODS: We conducted a systematic review including synthesis of evidence from process evaluations examining what factors affect implementation. Meta-ethnographic synthesis was informed by May's General Theory of Implementation. RESULTS: Sixteen reports, covering 13 studies and 10 interventions were included in our synthesis. In terms of May's concept of 'sense-making', we found that school staff were more likely to understand what was required in implementing an intervention when provided with good-quality materials and support. Staff could sometimes wilfully or unintentionally misinterpret interventions. In terms of May's concept of 'cognitive participation', whereby staff commit to implementation, we found that lack of intervention adaptability could in particular undermine implementation of whole-school elements. Interventions providing local data were reported as helping build staff commitment. School leaders were more likely to commit to an intervention addressing an issue they already intended to tackle. Collaborative planning groups were reported as useful in ensuring staff 'collective action' (May's term for working together) to enact interventions. Collective action was also promoted by the presence of sufficient time, leadership and relationships. Implementation of whole-school interventions took time to build. Considering May's concept of 'reflexive monitoring' (formal or informal review of progress), this was important in assessing and enhancing implementation. 'Quick wins' could help maintain collective impetus to implement further intervention activities. CONCLUSION: We identified novel factors influencing implementation of whole-school elements such as: local adaptability of interventions; providing local data to build commitment; interventions addressing an issue already on school leaders' agenda; collaborative planning groups; and 'reflexive monitoring' as an explicit intervention component.

Social alienation of adolescents with obesity in classrooms: A multilevel approach.

INTRODUCTION: Adolescents with obesity are more likely to be isolated by peers, but whether they also choose to disengage from their peers remains unclear. METHODS: This study examined a sample of 646 adolescents between the age of 13 and 16 across 34 classrooms in 3 junior high schools in Taiwan, with data collected from May to June 2019. The sociometric network nomination method assessed peer relationships, such as unpopularity, unsociability, and alienation. Multilevel models were applied to explore the extent to which the class-level prevalence of overweight and obesity and peer support moderate the relationship between student-level obesity and peer relationships. RESULTS: Overall, students with obesity were more likely to experience unpopularity, unsociability, and alienation from their peers in classroom settings (adjusted odds ratio [AOR] = 1.904, 2.208, 2.777, p < .05). Regardless of their obesity status, students in high classroom peer support were less likely to report unsociability (AOR = 0.124, p < .05). No cross-level interactions were observed, indicating that students with obesity did not experience a reduction of peer rejection in high peer support classrooms. Neither did obese students in classrooms with higher rates of overweight and obesity. CONCLUSIONS: Students with obesity were more likely to experience interpersonal problems. Classroom peer support can increase peer acceptance for typical students but has no beneficial influence on adolescents with weight problems. Classroom peer support needs to be directed to become adequate support for students with obesity.

Adolescents' expectancy-value profiles in school context: The impact of self-directed learning intervals.

INTRODUCTION: Using the situated expectancy-value theory, it becomes possible to explain motivational functioning across alternating learning conditions not only at a particular moment but also over time. The situated expectancy-value theory provides evidence for the critical role of context. The present research examines how adolescents' success expectancies, task values, and effort develop when the conditions of the academic environment change. It also evaluates whether adolescents adopt more adaptive expectancy-value profiles in response to the need-based nature of self-directed learning as an extension of regular instruction. Within the self-directed learning approach under investigation, adolescents take responsibility for their own learning processes. METHODS: The present research offers insights into the expectancy-value profiles of 754 German adolescents (Mage = 13.56; SD = 1.2; 49.4% female). A four-wave study was used to examine perceptions of self-efficacy, intrinsic value, utility value, and effort. Latent profile analyses and latent transition analyses were employed. RESULTS: Notably, the results provide evidence that expanding instruction via self-directed learning intervals that occur for 1 week per semester contributes to more favorable expectancy-value profiles within a student's favorite subject. A mixed profile (highly confident, hardly interested) disappeared. Instead, success expectations aligned more closely with adolescents' task values and effort. All profiles settled at a higher level. CONCLUSIONS: The findings indicate that instruction that is expanded via self-directed learning intervals has positive consequences for motivational profiles over time. An initial self-directed learning episode led to a shift to more interested profile groups. The continuation of a positive trend even after a self-directed learning interval indicates that adolescents are able to continually adapt their learning to their needs during teacher-directed instruction. This study provides clues about how to design curricula in a way that counteracts the downward trend in students' motivation to learn.

[Mindfulness as a prevention tool in addiction]. / La pleine conscience comme outil de prévention en addictologie.

The development of psychosocial skills in children is considered an important element in the promotion of health and well-being. Mindfulness meditation in schools is a promising start in managing emotions and preventing addictions. A report from an addiction nurse on the experience of children in the fourth and fifth grades.

Asthma symptoms and respiratory infections in Malaysian students-associations with ethnicity and chemical exposure at home and school.

Little is known on respiratory effects of indoor chemicals in the tropics. We investigated associations between asthma and respiratory infections in Malaysian students and chemical exposure at home and at school. Moreover, we investigated differences in home environment between the three main ethnic groups in Malaysia (Malay, Chinese, Indian). Totally, 462 students from 8 junior high schools in Johor Bahru participated (96% participation rate). The students answered a questionnaire on health and home environment. Climate, carbon dioxide (CO2), volatile organic compounds (VOC), formaldehyde and nitrogen dioxide (NO2) were measured inside and outside the schools. Multilevel logistic regression was applied to study associations between exposure and health. Totally 4.8% were smokers, 10.3% had wheeze, 9.3% current asthma, and had 18.8% any respiratory infection in the past 3 months. Malay students had more dampness or mould (p < 0.001), more environmental tobacco smoke (ETS) (p < 0.001) and more cats (p < 0.001) at home as compared to Chinese or Indian students. Wheeze was associated with ethnicity (p = 0.02; lower in Indian), atopy (p = 0.002), current smoking (p = 0.02) and recent indoor painting at home (p = 0.03). Current asthma was associated with ethnicity (p = 0.001; lower in Chinese) and para-dichlorobenzene in classroom air (p = 0.008). Respiratory infections were related to atopy (p = 0.002), ethylbenzene (p = 0.02) and para-dichlorobenzene (p = 0.01) in classroom air. Para-dichlorobenzene is used in Asia against insects. In conclusion, chemical emissions from recent indoor painting at home can increase the risk of wheeze. In schools, para-dichlorobenzene can increase the risk of current asthma and respiratory infections while ethylbenzene can increase the risk of respiratory infections.

Assessment of CO2 and aerosol (PM2.5, PM10, UFP) concentrations during the reopening of schools in the COVID-19 pandemic: The case of a metropolitan area in Central-Southern Spain.

Public health authorities have been paramount in guaranteeing that adequate fresh air ventilation is promoted in classrooms to avoid SARS-CoV-2 transmission in educational environments. In this work it was aimed to assess ventilation conditions (carbon dioxide, CO2) and suspended particulate matter (PM2.5, PM10 and UFP) levels in 19 classrooms - including preschool, primary and secondary education - located in the metropolitan area of Ciudad Real, Central-Southern Spain, during the school's reopening (from September 30th until October 27th, 2020) after about 7 months of lockdown due to COVID-19 pandemic. The classrooms that presented the worst indoor environmental conditions, according to the highest peak of concentration obtained, were particularly explored to identify the possible influencing factors and respective opportunities for improvement. Briefly, findings suggested that although ventilation promoted through opening windows and doors according to official recommendations is guaranteeing adequate ventilation conditions in most of the studied classrooms, thus minimizing the risk of SARS-CoV-2 airborne transmission, a total of 5 (26%) surveyed classrooms were found to exceed the recommended CO2 concentration limit value (700 ppm). In general, preschool rooms were the educational environments that registered better ventilation conditions, while secondary classrooms exhibited the highest peak and average CO2 concentrations. In turn, for PM2.5, PM10 and UFP, the concentrations assessed in preschools were, on average about 2-fold greater than the levels obtained in both primary and secondary classrooms. In fact, the indoor PM2.5 and PM10 concentrations substantially exceeded the recommended limits of 8hr-exposure, established by WHO, in 63% and 32% of the surveyed classrooms, respectively. Overall, it is expected that the findings presented in this study will assist the establishment of evidence-based measures (namely based on ensuring proper ventilation rates and air filtration) to mitigate preventable environmental harm in public school buildings, mainly at local and national levels.

A cross-sectional study of the impact of school neighbourhood on children obesity and body composition.

Schools' neighbourhoods provide an important environmental context that may influence the risk of obesity among children. The aim of this study was to assess the effect of neighbourhood surrounding schools on obesity and body composition in schoolchildren. Data on 845 children aged 7 to 12 years old from 20 primary schools were considered. Anthropometric measurements and bioelectrical impedance analysis were performed to assess body mass index (BMI) and characterize body composition. Land use characteristics were quantified within a 500-m buffer zone around schools. Mixed-effect models measured the effects of school neighbourhood on obesity and body composition. The results showed a tendency between green urban areas around schools and lower values of BMI and better body composition parameters compared with built areas, being BMI z-scores CDC, and body fat percentage significantly higher in-built than in green urban areas (ß = 0.48, 95% CI 0.05; 0.90, and ß = 2.56, 95% CI 0.39; 4.73, respectively).Conclusion: Our findings suggest that the school neighbourhood has an effect on BMI and body fat percentage in schoolchildren. These results may contribute to the creation of healthier cities and help reduce health expenses by focusing on prevention programmes towards the expansion of green spaces. What is Known: • Living in greener areas has been associated with healthy weight outcomes and to the lower impact of obesogenic urban environments. • The school environment may be especially important for youth health outcomes. What is New: • Neighbourhoods around schools may affect child health, specifically the development of obesity. • The presence of urban green areas around school may promote a framework of lifestyle or behaviours conducive to achieving a healthy weight.

Implementation of a regulatory food policy to reduce availability of energy-dense foods in Costa Rican high schools.

OBJECTIVE: To assess the extent to which mandatory Guidelines to improve the school food environment were being implemented in Costa Rican high schools and to explore the perspectives of key policy actors towards the Guidelines. DESIGN: Semi-structured interviews and site observations. Interviews were recorded, transcribed verbatim and imported to NVivo 12 for analysis. Inductive and deductive themes were identified, and elements of the RE-AIM framework and the social process framework were used when classifying these themes. SETTING: Sixteen public high schools in San José, Costa Rica. PARTICIPANTS: High school principal and kiosk concessionaires. RESULTS: Products that did not adhere to the Guidelines were still widely available in schools, and amongst the most prevalent challenges to implementation that emerged from our interviews, were a lack of understanding of the policy content, a lack of monitoring and accountability, and competing values amongst actors which affected their views on the role that the school must have in offering a healthy food environment. CONCLUSION: Most products offered in high schools did not meet the criteria required by the mandatory Guidelines, and several contextual factors were found to influence implementation. Strengthening the implementation of the Costa Rican Guidelines will require further actions at the governmental and school levels.

Determinants of student's physical activity: a 12-month follow-up study in Ningxia province.

BACKGROUND: Physical activity has many health benefits for children and adolescents. However, the prevalence of physical inactivity in school-aged children and adolescents remains high in China. Many factors impact the levels of moderate and vigorous physical activity (MVPA) among students. This study investigated the factors associated with students' MVPA levels and the determinants of changes in their MVPA behaviour. METHODS: This is a longitudinal study with a 12-month follow-up. The study samples were obtained from 2016 and 2017 Physical Activity and Fitness in China-The Youth Study, and they included 1597 students (aged 9-18 years) from 31 primary, junior high, and high schools in Ningxia Province. Factors related to the individual (Age, Sex, BMI and attitude to PA), school (school exercise facility, PE class, teacher support, PA time and PA environment) and neighbourhood (free skill training, sport events, sport organization, sport facility) factors were measured via questionnaire at baseline and after 12 months. Multiple logistic regression was performed to examine the factors that impact students' MVPA level and the determinants of changes in students' MVPA behaviour. RESULTS: There was no difference in students' MVPA levels between 2016 and 2017. Boys were more physically active than girls at baseline (RR 1.55, 95% CI 1.10, 2.20). Neighbourhood factors associated students' MVPA levels were significant, but all of these factors (neighbourhood sport events, organizations, facilities, etc.) were removed from the longitudinal model. Individual and school factors were important for students' MVPA maintenance and positive development (e.g., gender, attitude, school PE class and PA time). CONCLUSIONS: In conclusion, both neighbourhood and school factors may affect students' MVPA, but school appears to plays a more critical role in maintaining and promoting students' MVPA levels. In addition, individual factors may be more important than school and neighbourhood factors in influencing students' MVPA levels. Our research demonstrates that students' attitudes towards PA and school factors should be considered targets for future intervention programmes to promote MVPA. More education programmes may help enhance students' attitudes towards PA, but more studies with large samples and objective assessments are needed to explore the determinants of MVPA.

A supportive school environment may reduce the risk of non-medical prescription opioid use due to impaired mental health among students.

Canada is in the midst of an ongoing, escalating opioid crisis, with significant impacts on adolescents and young adults. Accordingly, mental health impairment was examined as a risk factor for non-medical prescription opioid use (NMPOU) among high school students. In addition, the moderating effects of the school environment, in terms of the availability of mental health services and substance use policies, were characterized. Self-reported, cross-sectional data were obtained from the COMPASS study, including 61,239 students (grades 9-12) in 121 secondary schools across Canada. Current and lifetime NMPOU were ascertained. Categorical indicators of mental health impairment and school environment were derived. The main analytical strategy encompassed hierarchal multilevel logistic regression, including the addition of interaction terms to characterize the moderation effects. Current and lifetime NMPOU were reported by 5.8% and 7.2% of the students, respectively. After adjusting for confounders, students in the highest quintile of mental health impairment had odds ratios (OR) of 2.60 (95% confidence interval [CI] 2.29-2.95) and 2.96 (95% CI 2.64-3.33) for current and lifetime NMPOU, respectively when compared to students in the lowest quintile of mental health impairment. A significant interaction between mental health impairment and school environment indicated relatively lower risks of NMPOU in students from schools that provide more mental health services and have stricter substance use policies. Mental health impairment increased the risk of NMPOU, but the associations were moderated by the school environment. These findings underscore the importance of mental health services and substance use regulations in schools.