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Aims: This study aims to document and understand the benefits of underserved youths' successful involvement in an after-school music program (ASMP)., Methods: The contents of semi-structured, individual interviews with 11 alumni and five staff members of an ASMP were coded and analyzed using inductive Thematic Analysis., Results: Alumni identified several positive program characteristics as most influential (e.g., consistency, opportunity, exposure), and described the program's favorable impact at a personal (e.g., identity development), relational (e.g., improving social skills), and musical level (e.g., acquiring performance skills). Staff members identified similar program characteristics as crucial for the success of the program and singled out their personal, relational, and social motivations as important dimensions that bring about the program's impact., Conclusions: The study highlights the value of musical experiences and after-school resources for a group of underserved youth who would otherwise not be exposed to them due to socioeconomic barriers and inequities in opportunities., (© 2019 Wiley Periodicals, Inc.)

Background: The primary purpose of this study was to determine which physical activity (PA) opportunity elicits the most moderate to vigorous PA (MVPA) in after-school programs. This study used a 3-group cross-over design in which participants were exposed to 3 variations of activity structures: free play, organized, or a mixture., Methods: PA was measured using ActiGraph GT3X+ accelerometers. All data were transformed into percentage of time spent sedentary or in MVPA. Repeated-measures mixed-effects models were used to examine differences in MVPA and sedentary among the 3 activity sessions. Participants included 197 unique children, aged 5-12 years, and were 53% male and 55% white., Results: Statistically significant differences were observed in the percentage of time boys spent in MVPA during free play and mixed compared with organized only sessions (35.8% and 34.8% vs 29.4%). No significant difference was observed in the percentage of time girls spent in MVPA during free play compared with organized or mixed (27.2% and 26.1% vs 26.1%). Both boys and girls experienced ∼10% less time sedentary during free play compared with the others., Conclusion: Offering free play during PA opportunities can help children attain as much if not more MVPA compared with only offering organized, adult-led games.

Objectives: Despite the relationship between physical activity (PA) and learning outcomes, the school system has not been able to support the inclusion of PA throughout the day. A solution to this problem integrates PA into the academic classroom. The objective of this review is to determine the impact of active classrooms compared to traditional sedentary classrooms on educational outcomes of school-aged children., Design: We searched ERIC, PubMed, PsychINFO, and Web of Science, reference lists of included studies for randomised controlled studies. Independent reviewers screened the texts of potentially eligible studies and assessed the risk of bias. Data were pooled using random-effects models on standardized mean differences., Results: This review identified 25 studies examining educational outcomes, including approximately 6,181 students. Risk of bias was assessed as either some or high risk of bias for most of the studies and outcomes. Pooled data from 20 studies and 842 participants measuring academic performance shows a small positive effect of active classrooms compared with traditional, sedentary classrooms (SMD = 0.28, 95% CI: 0.09 to 0.47)., Conclusions: Physically active classrooms may slightly improve academic achievement compared to the traditional sedentary lessons. Future research is needed to ensure that studies are adequately powered, employ appropriate methods of randomization, and measure a wide range of important student outcomes across the full spectrum of the school-age., Competing Interests: The authors have declared that no competing interests exist.

Recent study shows that 617 million children and adolescents-or six out of 10 globally- are not acquiring minimum levels in literacy and mathematics, indicating the magnitude of the learning acquisition problem. For children with disabilities in context of conflict, the situation is arguably even worse: the literature shows that they face difficulties to access the education system due to multiple barriers, and when they do access, they are not learning. Our paper examines if an active education policy promoting inclusion since 2005 in Afghanistan, a protracted crisis context, has been effective. Using two cross sectional household surveys carried out eight years apart (2005-2013), our study shows that access to school and literacy did not improve between 2005 and 2013 for children and youth with disabilities. Both access and literacy outcomes were worse for girls with disabilities, those with a mental, learning or associated disability and those living in household where the head was uneducated. Finally, odds of being mentally distressed significantly declined between 2005 and 2013 indicating that schools might play a protective role for children with disabilities in Afghanistan. Our findings suggest that a multilevel multi-pronged adaptation of the existing system to improve the learning experience and promote children's resilience, particularly for children with disabilities, in conflict context such as Afghanistan, is required., Competing Interests: The authors have declared that no competing interests exist.

Supporting the implementation of school food and nutrition policies is an international priority to encourage healthier eating among children and youth. Schools are an important intervention setting to promote childhood nutrition, and many jurisdictions have adopted policies, guidelines, and programs to modify the school nutrition environment and promote healthier eating. The purpose of this study was to explore the association between perceived adequacy of facilities or equipment and capacity of staff to support policy implementation with food availability and policy adherence in the province of Nova Scotia (NS), Canada, one of the first regions in Canada to launch a comprehensive school food and nutrition policy (SFNP). A cross-sectional online survey was conducted in 2014-2015 to provide a current-state assessment of policy implementation and adherence. Adequacy and capacity for food policy implementation was used to assess policy adherence through the availability of prohibited 'minimum' nutrition foods. An exploratory factor analysis was conducted on a selection of available foods, and 'slow'- and 'quick'-service food composition measures were dichotomized for food availability. Schools with above-average perceived adequacy and capacity for policy implementation had greater odds (OR = 3.62, CI = 1.56, 8.40) of adhering to a lunch policy, while schools that adhered to a snack and lunch policy had lower odds (OR = 0.48, CI = 0.23, 1.01 and OR = 0.18, CI = 0.08, 0.41) of serving quick-service foods. This study identified the need for appropriate adequacy of facilities or equipment and capacity of staff for policy implementation to ensure policy adherence and improve the school food environment. These findings highlight the relationship between school food and nutrition policies, suggesting that better supporting their implementation could increase the likelihood of their success.

Objective: Recovery Colleges are widespread, with little empirical research on their key components. This study aimed to characterize key components of Recovery Colleges and to develop and evaluate a developmental checklist and a quantitative fidelity measure., Methods: Key components were identified through a systematized literature review, international expert consultation ( n = 77), and semistructured interviews with Recovery College managers across England ( n = 10). A checklist was developed and refined through semistructured interviews with Recovery College students, trainers, and managers ( n = 44) in 3 sites. A fidelity measure was adapted from the checklist and evaluated with Recovery College managers ( n = 39, 52%), clinicians providing psychoeducational courses ( n = 11), and adult education lecturers ( n = 10)., Results: Twelve components were identified, comprising 7 nonmodifiable components (Valuing Equality, Learning, Tailored to the Student, Coproduction of the Recovery College, Social Connectedness, Community Focus, and Commitment to Recovery) and 5 modifiable components (Available to All, Location, Distinctiveness of Course Content, Strengths Based, and Progressive). The checklist has service user student, peer trainer, and manager versions. The fidelity measure meets scaling assumptions and demonstrates adequate internal consistency (0.72), test-retest reliability (0.60), content validity, and discriminant validity., Conclusions: Coproduction and an orientation to adult learning should be the highest priority in developing Recovery Colleges. The creation of the first theory-based empirically evaluated developmental checklist and fidelity measure (both downloadable at researchintorecovery.com/recollect ) for Recovery Colleges will help service users understand what Recovery Colleges offer, will inform decision making by clinicians and commissioners about Recovery Colleges, and will enable formal evaluation of their impact on students.

Objective: School-aged children are a risk group in terms of accidents and injuries, and these factors may be the primary causes of death in children. Teachers have important roles in preventing accidents and injuries and giving first aid. The purpose of this research was to identify situations in which teachers most frequently encounter the need to administer first aid to children and whether the teachers performed the correct application in these events., Methods: This descriptive study was conducted with 331 teachers in a city in the Central Anatolia Region. The study was approved by the local ethics committee and the participants., Results: Of the 45.3% teachers educating children ages 6 to 15 years, 81.0% of the teachers were familiar with first aid, but only 23.0% claimed to have an adequate knowledge. In the previous year, situations that had required first aid included epistaxis (75.2%), abdominal pain (49.2%), and vomiting (39.2%). The study also investigated any accidents and injuries occurring, their causes, and the teachers' interventions following the accidents and injuries. It was found that teachers had information about first aid, but they did not trust themselves enough to practice it., Conclusion: Understanding the causes of accidents and injuries, finding preventive measures, and updating teachers' knowledge about this subject are important to provide a safe educational environment. (Disaster Med Public Health Preparedness. 2019;13:456-462).

Purpose of Review: This review summarizes the latest scientific evidence on determinants and interventions to promote water consumption among adolescents., Recent Findings: We identified 15 studies on determinants of water consumption and 11 interventions to promote water consumption among adolescents. Determinants of adolescent's water consumption included individual (e.g., physiological, demographic, psychological, and behavioral variables), social (e.g., peer influence), and environmental (e.g., availability of water at school/home, warm weather) ones and school policies. Interventions with both educational/behavioral and legislative/environmental components seem the most promising to promote water consumption among adolescents. To our knowledge, this is the first review integrating the results on both determinants of, and interventions to promote, water consumption among adolescents. Gaps in the scientific literature were identified and recommendations to improve future studies were given. Promoting water consumption among adolescents could be a promising avenue to lower obesity and promote early acquisition of healthy dietary habits.

Inclusive policies that attend to sexual orientation and gender identity (SOGI) are associated with more supportive school environments for lesbian, gay, bisexual, and transgender (LGBT) youth. We use the 2013-2015 California Healthy Kids Survey (n = 113,148) matched with principal reports of school policies from the 2014 California School Health Profiles to examine differential effects of SOGI-focused policies for LGB and transgender youth. SOGI-focused policies had a direct association with less truancy, and moderated the association between sexual orientation/gender identity and other school outcomes. SOGI-focused policies were associated with more positive experiences and perceptions of school climate for LGB youth and, to a lesser extent, transgender youth. Findings underscore the importance of inclusive policies, especially those that address the unique needs of transgender students., (Copyright © 2019. Published by Elsevier Ltd.)

Background: Transgender and gender nonbinary adolescents experience high rates of peer victimization, but the prevalence of sexual assault in this population has not been established. Some schools restrict transgender and nonbinary students from using restrooms and locker rooms that match their gender identity, with unknown effects on sexual assault risk. We tested whether these restrictions were associated with the 12-month prevalence of sexual assault victimization., Methods: Survey responses were analyzed from 3673 transgender and nonbinary US adolescents in grades 7 through 12 who participated in the cross-sectional 2017 LGBTQ Teen Study. We estimated the association between school restroom and locker room restrictions and sexual assault, adjusting for potential social and behavioral confounders, using logistic regression. We also tested potential mediators., Results: The 12-month prevalence of sexual assault was 26.5% among transgender boys, 27.0% among nonbinary youth assigned female at birth, 18.5% among transgender girls, and 17.6% among nonbinary youth assigned male at birth. Youth whose restroom and locker room use was restricted were more likely to experience sexual assault compared with those without restrictions, with risk ratios of 1.26 (95% confidence interval [CI]: 1.02-1.52) in transgender boys, 1.42 (95% CI: 1.10-1.78) in nonbinary youth assigned female at birth, and 2.49 (95% CI: 1.11-4.28) in transgender girls. Restrictions were not associated with sexual assault among nonbinary youth assigned male at birth., Conclusions: Pediatricians should be aware that sexual assault is highly prevalent in transgender and nonbinary youth and that restrictive school restroom and locker room policies may be associated with risk., Competing Interests: POTENTIAL CONFLICT OF INTEREST: Mr Murchison participated in survey development and data collection for the LGBTQ Teen Study as an employee of the Human Rights Campaign Foundation; the other authors have indicated they have no potential conflicts of interest to disclose., (Copyright © 2019 by the American Academy of Pediatrics.)

Objective: The Healthy Food and Drink Policy was implemented in Western Australian government schools in 2007. The aim of the present study was to assess the compliance of Western Australian school canteen menus with the policy a decade after its introduction., Design: The traffic-light system that underpins the Healthy Food and Drink Policy categorises foods and drinks into three groups: 'green' healthy items, 'amber' items that should be selected carefully and 'red' items that lack nutritional value. Canteen menus were collected online and each menu item was coded as a green, amber or red choice., Setting: Western Australia.ParticipantsOnline canteen menus from 136 primary and secondary government schools., Results: The majority of audited school menus met policy requirements to include ≥60 % green items (84 %) and ≤40 % amber items (90 %), but only 52 % completely excluded red items. Overall, approximately half (48 %) of school canteen menus met all three traffic-light targets. On average, 70 % of the menu items were green, 28 % were amber and 2 % were red. Primary-school canteen menus were more likely than those from secondary schools to meet the requirements of the policy., Conclusions: While the sampled Western Australian government school canteen menus were highly compliant with most of the requirements of the Healthy Food and Drink Policy, many offered red foods and/or drinks. Providing all schools with further education about identifying red items and offering additional services to secondary schools may help improve compliance rates.

Background : Few studies have examined school physical activity policies to assess dose-response on student outcomes. The purpose of this study was to evaluate the association between health-promoting physical activity policies in elementary schools and physical activity behavior. Methods : In this cross-sectional study, physical activity was assessed using self-report measures in fourth-grade students in Texas (N = 1958, x  = 9.66 y) from the School Physical Activity and Nutrition (SPAN) survey. School policies were assessed using the number of health-promoting policies in place taken from the SPAN School Health Survey with principals and their proxies. Multiple linear regressions adjusted for student- and school-level confounders and school clustering were performed. Results : School physical activity policies were significantly associated with student-level physical activity behavior ( P  < .05), even after controlling for the student- and school-level confounding variables. The interactions between physical activity policy-by-economic disadvantage ( P  < .01) and between physical activity policy-by-geographic strata ( P  < .01) were both significant, with stronger direct effects of policies on student physical activity for economically disadvantaged schools and major urban schools. Conclusion : Results from this study provide evidence for the importance of school-based health policies and practices in potentially reducing health disparities, especially in low-income and urban schools.

Increasing rates of autism spectrum disorder (ASD) and younger age at diagnosis pose a challenge to preschool intervention systems. In Sweden, most young autistic children receive intervention service in community-based preschool programs, but no tool is yet available to assess the quality of the preschool learning environment. This study adapted the Autism Program Environment Rating Scale Preschool/Elementary to Swedish community context (APERS-P-SE). Following translation and a multistep modification process, independent experts rated the content validity of the adaptation. Findings indicate high cross-cultural validity of the adapted APERS-P-SE. The cultural adaption process of the APERS-P-SE highlights similarities and differences between the American and Swedish preschool systems and their impact on early ASD intervention.

Background: Heavy schoolbags and their adverse musculoskeletal effects are a cause of great concern. Parents' awareness and knowledge about this are crucial to prevent such health problems. Thus, this study aimed to assess parents' perceptions, knowledge, and attitudes regarding children's schoolbags and related musculoskeletal health., Methods: A cross-sectional study was conducted targeting parents with children of school age. In January 2015, a self-administered, validated questionnaire was distributed to all participants, consisting of questions about their awareness, knowledge, and attitude regarding the negative effects of carrying inappropriate schoolbags on children's musculoskeletal health., Result: A total of 616 parents (284 fathers and 332 mothers) completed the questionnaire (response rate of 100%). A total of 247 (87.3%) fathers and 301 (90.9%) mothers knew that carrying heavy schoolbags produces back problems. However, only 105 (36.9%) fathers and 107 (37.6%) mothers knew that incorrect schoolbag weight and inadequate way to carry it may impede the normal alignment and growth of the spine. Only 107 (37.6%) fathers and 96 (28.9%) mothers knew the ideal weight of the schoolbag, while 49.6% of fathers and 42.8% of mothers did not check their children's schoolbags for unnecessary contents., Conclusion: Awareness of parents about the consequences of heavy schoolbags and correct use is still limited and suboptimal. Educational sessions for parents and awareness campaigns may help to reduce the prevalence of musculoskeletal health problems among children.

Acquiring literacy in English as a foreign language (EFL) is important for language development. However, many students enter middle school without adequate EFL literacy skills. This may indicate a gap between EFL literacy instruction theory and the classroom practice that is occurring in elementary school classrooms. The aim of this study was to explore the components of EFL literacy instruction as perceived by teachers. The study investigated whether perceptions of classroom practices are theoretically based, thus shedding light on the gap between EFL literacy theory and practice. The participants were 167 EFL elementary school teachers, who submitted anonymous online questionnaires regarding their reported EFL teaching in year one, two, three, four, and five of elementary school. The research was based on the five pillars of literacy instruction for English as a first language (National Reading Panel, 2000) and additional EFL components (August & Shanahan, 2006). Results of this study showed that EFL teachers expressed views that may indicate a gap between teachers' practices and most cutting-edge research. The study concluded that providing EFL elementary school teachers with theoretical knowledge may lead to more productive literacy programs and may improve classroom practices.

Objectives: To examine the association between parental disengagement in childhood and adolescent gun carrying and determine whether this association is accounted for by externalizing problems and affiliation with delinquent peers during early adolescence., Methods: The sample included 503 boys (55.7% African American, 40.6% white, 3.7% other) recruited from first-grade classrooms in Pittsburgh public schools. Multi-informant assessments were conducted regularly (semiannually then annually) from approximately ages 7.5 to 20 years. Latent factors were constructed by using parent-reported parental disengagement (ie, poor parental involvement, poor parent-son communication, poor parent-son relationship quality) collected from ages 7.5 to 10 years, youth-reported peer delinquency from ages 10.5 to 13 years, and teacher-reported externalizing problems from ages 10.5 to 13 years. The outcome was youth-reported gun carrying from ages 14 to 20 years., Results: Twenty percent of individuals sampled reported carrying a gun during adolescence. Childhood parental disengagement was significantly associated with adolescent gun carrying (β = .22; 95% confidence interval: 0.08 to 0.36). Furthermore, the association between parental disengagement and gun carrying was partially mediated through peer delinquency and externalizing problems during early adolescence. The 2 indirect paths accounted for ∼29% of the total effect of parental disengagement., Conclusions: Boys exposed to poorer parental engagement during childhood are more likely to affiliate with delinquent peers and exhibit externalizing problems during early adolescence, which (in turn) increases their risk of carrying a firearm in later adolescence. This suggests that gun violence prevention efforts with children should work to enhance aspects of parental engagement., Competing Interests: POTENTIAL CONFLICT OF INTEREST: The authors have indicated they have no potential conflicts of interest to disclose., (Copyright © 2019 by the American Academy of Pediatrics.)

Background & Objective: Canadian Ministries of Health and Education across all provinces aim to support and maximize the mental and physical health of students to ensure their ability to fulfill their academic potential. Chronic sleep loss affects all of these domains. However, tools to optimize youth sleep are generally lacking., Methods: This manuscript explains the rationale for the integration of sleep health education into schools, describes the barriers to sleep health education, outlines efforts made to address them in Canada, and discusses future directions for sleep health education in Canada., Results: There is unequivocal evidence that sleep plays critical roles in achieving the key goals to which Canadian schools are committed. Sleep restriction and poor sleep habits resulting from hectic, demanding, unbalanced lifestyles; pressure for academic success; participation in extracurricular activities; and the low priority given to sleep over competing activities are prevalent in Canadian youth of all ages and may significantly impair their learning, well-being, and health. Attempts to integrate sleep health education into school curricula meet with multiple barriers. Some of these barriers can be overcome by using community-based participation to develop and implement school-based sleep health education programs., Conclusion: Successful school-based sleep health promotion programs hold the promise of having a long-lasting positive impact on students' physical and mental health, academic performance and daytime functioning., (Copyright © 2019 Elsevier B.V. All rights reserved.)

Teacher self-efficacy is critical because it predicts teachers' future behavior and impacts teacher turnover. Most teachers begin their career with moderate to high self-efficacy for teaching, but often experience a sharp decline during the first year of teaching. After the first year, their self-efficacy begins to increase but rarely rises to the level it was prior to beginning teaching. Therefore, examining first-year teachers' self-efficacy is extremely important. Previous research generally depicts teachers as a homogeneous group, relying on variable-centered approaches and including self-efficacy as a scaling score, which may not be applicable at the individual level. Simply extending findings from the variable-centered analyses is insufficient. Therefore, the purpose of the present study is to examine the heterogeneous profiles of first-year teachers' self-efficacy from the 2011-2012 Schools and Staffing Survey and to investigate how self-efficacy profiles are related to teacher training at the individual level. Using latent class analyses, we found three statistically distinctive classes within self-efficacy: high, moderate, and low. Regardless of teaching assignments, teachers who completed reading content courses during preparation programs and received discipline-specific mentoring during their first year dominated a higher level of self-efficacy. We conclude that these two factors are essential to preparing and retaining high-quality teachers.

The purpose of this research was to study the etiology of teacher knowledge about and factors that influence implementation of evidence-based reading and writing interventions at the upper elementary grade levels. Five data sources are used in this study: first, we used teacher surveys about their pre-service preparation on reading comprehension and literacy practices gathered during a recent cluster randomized control trial on a reading comprehension intervention conducted with 280 fourth and fifth-grade teachers and their classroom students. We also conducted focus group interviews with 43% of the teachers and observed 90% of the teachers once during the implementation years. For writing, we used data collected from 32 teachers during a 3-year design project for a teacher-led computer-supported writing intervention. We also collected data from groups of school administrators using structured interviews during both studies. Finally, we conducted an artifact review of school curricula and posted professional development (PD) plans. Our results show that in both reading comprehension and writing, all teachers reported not receiving sound evidence-based pre-service preparation and they were not currently employing any evidence-based approaches. Most teachers reported using the basal reading series with very little variation from the lesson scope and sequence. Teachers and administrators frequently reported that skills were being taught in isolation (e.g., skill of the week is summarizing) and that writing was neglected. The interviews showed very interesting patterns of curricula decision-making by school administrators and these findings were further confirmed through the artifact reviews. Based on these results, we recommend that any review of teacher practices focus also on administrator decision-making and school level factors that are driving what happens in the classrooms. The review showed that the teachers themselves do not feel empowered to learn and deliver evidence-based literacy practices and feel constrained by the system.

In the USA, many states have adopted response to intervention or multi-tiered systems of supports to provide early intervention. However, there is considerable variability in how states and schools implement RTI. Teachers are responsible for using student data from RTI to inform instructional decisions for students with or at risk for dyslexia, so it is necessary to understand the knowledge they have about the structure of RTI in their individual schools. This study reviews the results of an exploratory factor analysis of a survey aimed at measuring teachers' knowledge about RTI implementation and their understanding of RTI implementation within their school. The 52-item survey was administered online to 139 general and special education teachers. The three final factors from this factor analytic work were (1) Teacher Knowledge about Tier 1 Implementation, (2) Teacher Knowledge about Leadership and School Systems, and (3) Teacher Knowledge about Data-Based Decision Making. Factor determinacy scores demonstrated that the survey had high internal consistency. On average, teachers' survey scores were higher on the first two factors and slightly lower on the third factor. Implications of the findings for teachers of students with learning disabilities, including dyslexia, and directions for future research were discussed.

Policy actions to improve the nutritional environment include the provision of official food service guidelines. This study aimed to examine compliance with food service guidelines for hot meals as well as self-evaluated focus on food waste reduction across settings, i.e., elementary schools, upper secondary schools and workplaces, and different canteen characteristics. The same five criteria for hot meals were applied for all settings with regard to serving of fruit and vegetables, fish, wholegrain product and high fat meat and dairy products. A self-administered questionnaire survey was conducted as a cross-sectional study among 680 Danish canteens. Canteens having a high degree of organic food procurement were more likely to comply with the five criteria for hot meals combined (OR 2.00 (Cl 1.13,3.53)). Also, the use of organic food together with having a meal policy was associated with reported focus on food waste reduction (OR 1.91 (CI 1.12,3.25) and 1.84 (Cl 1.31,2.59), respectively). Compliance with individual criteria varied across settings with elementary schools being more likely to comply with criteria on, e.g., maximum serving of non-wholegrain products, whereas workplaces were more likely to comply with criteria on, e.g., minimum fruit and vegetable content and serving of fish. In addition, specific characteristics, e.g., serving system, were found to predict compliance with some of the criteria. These findings highlight the need to address differences in canteen characteristics when planning implementation support for both guideline and food waste reduction initiatives.

As the United States becomes more diverse, the ways in which mainstream institutions recognize and address race and ethnicity will be increasingly important. Here, we show that one novel and salient characteristic of an institutional environment, that is, whether a school emphasizes the value of racial and ethnic diversity, predicts better cardiometabolic health among adolescents of color. Using a diverse sample of adolescents who attend more than 100 different schools in predominantly urban locations, we find that when schools emphasize the value of diversity (operationalized as mentioning diversity in their mission statements), students of color, but not white students, have lower values on a composite of five biomarkers of inflammation, have less insulin resistance and compensatory β-cell activity, and have fewer metabolic syndrome signs and score lower on a continuous metabolic syndrome composite. These results suggest that institutions that emphasize diversity may play an unacknowledged role in protecting the health of people of color and, thus, may be a site for future interventions to reduce health disparities., Competing Interests: The authors declare no conflict of interest.

Terrorist attacks and mass shootings often involve youth. Knowledge is needed on how this may impact their health and functioning. This study investigates perceived academic performance and school wellbeing in 237 terror-exposed survivors of the Utøya youth camp attack according to their sociodemographic characteristics, health and mental health service (MHS) utilization. Semi-structured interviews were conducted after 4-5 and 14-15 months. The year following the attack, 143 (61%) survivors reported impaired academic performance and 66 (29%) impaired school wellbeing. Female survivors more often reported impaired performance. Non-Norwegian origin, being financially disadvantaged and less social support were associated with impaired wellbeing. Sleep problems, posttraumatic stress, anxiety/depression, somatic symptoms, and lower life satisfaction were associated with both impaired performance and impaired wellbeing. Survivors who had received MHS were more likely to report impaired or improved academic performance and school wellbeing. Higher age and posttraumatic stress reactions were associated with impaired academic performance after multivariate logistic regression adjustments for gender, somatic symptoms and social support. When additionally adjusting for impaired school wellbeing, age and impaired wellbeing were associated with impaired performance. Only posttraumatic stress reactions were associated with impaired wellbeing after similar adjustments. Non-Norwegian origin and being financially disadvantaged were not significantly associated with impaired wellbeing after adjusting for posttraumatic stress reactions, age and gender. Our findings demonstrate how a terrorist attack can considerably deteriorate young survivors' performance and wellbeing at school, which is associated with poorer health. Consequently, it is important to provide appropriate school support, and coordinate MHS with follow-up at school.

Executive function (EF), its importance for scholastic achievement and the question of whether or not EF is malleable, have become a topic of intense interest. Education or schooling is often seen as effective approaches to enhance EF due to the specific school-related requirements as compared to kindergarten or pre-school. However, no study to date has investigated whether targeted training focusing on those domains might be comparable with regular schooling in improving EF and fluid intelligence (Gf). The aim of the present study was to replicate and extend the previously demonstrated schooling effects on EF by using a school-cutoff design, and to further investigate whether a theoretically motivated intervention targeting specific EF, i.e., working memory (WM) or inhibitory control (IC), could achieve comparable effects with schooling in both, WM and IC, as well as Gf. 91 6-year-old kindergarteners and first-graders with similar chronological age participated the study. We compared the performance of a first-grade schooling group with that of two kindergarten training groups as well as a business-as-usual kindergarten control group. Participants were assessed in WM, IC and Gf at baseline, immediately after the intervention (posttest), as well as 3 months after training completion (follow-up). The results showed that the schooling group indeed outperformed the kindergarten groups at baseline in several cognitive tasks. Furthermore, both the WM and IC training showed pronounced gains in the trained tasks, as well as varying degrees of improvement in non-trained outcome measures. Most importantly, both training groups achieved comparable performance with the schooling group, which was especially apparent in Gf at follow-up. Our findings provide further evidence for the malleability of EF demonstrating that both, long-term and short-term interventions can facilitate the acquisition of those important skills, and as such, our work has important implications for educational practice., (© 2018 John Wiley & Sons Ltd.)

Background: Emergent evidence suggests a positive school climate may be a promising population-level intervention to promote academic achievement and student well-being. However, researchers have called for expanding the school climate evidence-base to better describe how the construct is associated with student outcomes. The purpose of this study was to determine the associations between 10 school climate domains and academic achievement among middle and high school students., Methods: ANOVAs were used to analyze survey data from 6-12 grade students in a Mid-Atlantic US state (n = 2405, response rate: middle school = 82.4%, 50.5% female; high school = 62.5%, 56.1% female)., Results: Significant main effects were found for all school climate domains and varied between middle and high school students apart from academic support. Effect sizes ranged from small to medium, with academic support demonstrating the strongest effects among both middle and high school students., Conclusions: Findings suggest school climate is associated with academic achievement for both middle and high school students. Correctly identifying the role of key aspects of school climate by grade-level may provide improved and developmentally appropriate recommendations for the delivery of instruction and school-based interventions that promote positive school well-being and student performance., (© 2019, American School Health Association.)

Purpose The purpose of this paper is to describe a collaborative service learning experience (SLE) which was part of the degree requirements of the Public Health Nutrition Graduate Program at the University of Tennessee. The SLE was collaboratively developed by the University of Tennessee's maternal and child health (MCH) nutrition leadership education and training (NLET) Program Director and the Knox County Health Department's healthy weight program manager. Description The SLE was a semester long project that included instructional time and fieldwork. Coursework focused on development of a community nutrition needs assessment, how to interpret and analyze assessment data, and how to use assessment data for program planning and policy development. Fieldwork consisted of interacting with an interprofessional team, assessing the nutrition environment at two afterschool sites, conducting a plate waste study to determine the amount of food consumed by children at the sites' dinner meals, interpreting and analyzing data, and developing and presenting recommendations for improvement. Assessment Trainees successfully completed all aspects of the SLE. They completed a community needs assessment of the neighborhoods surrounding the two afterschool program sites, conducted nutrition environment audits, including meal observations, and measured and analyzed plate waste from dinner meals served at the sites. Using the data gathered and collected, they prepared suggestions for nutrition environment improvements and policy development for community partners. Conclusion The SLE allowed trainees to develop MCH competencies and professional skills required in public health nutrition, while providing valuable data that subsequently was used to establish nutrition-related policies and interventions.

Background: In the United States, the National School Lunch Program (NSLP) is the healthiest lunch option for students, yet participation is suboptimal and fruit and vegetable waste remains high. Improving school meal convenience, engaging teachers in the school-lunch program, and enhancing the cafeteria environment are promising strategies to improve participation and dietary intake, yet little evidence is available on their impact., Methods/design: The Multi-Pronged Intervention to Increase Secondary Student Participation in School Lunch (MPI) is a 3-year quasi-experimental study in a large urban school district in California. A total of 24 middle and high schools participated in the study: half received the intervention and half served as controls. The intervention consisted of additional school lunch points of sale (vending machines and mobile carts), a school meal outreach program for teachers, and cafeteria redesigns. School meal participation, student-reported fruit and vegetable consumption, and school lunch plate waste were assessed at baseline and in years 1 and 2 of the intervention. Change in meal participation and fruit and vegetable consumption were compared between intervention and control arms to determine the impact of the intervention on school meal participation and dietary intake., Discussion: This study is positioned to provide evidence on the feasibility and efficacy of a multi-level intervention to increase school meal participation and consumption of fruits and vegetables., (Copyright © 2019 Elsevier Inc. All rights reserved.)

Objectives We examined biologic and social determinants of school readiness in an urban population and whether childcare altered these associations. Methods A retrospective cohort study was conducted using school readiness data linked to birth certificates of first-time kindergarten students (n = 39,463) in a large, urban public-school district during 2002-2012. Multivariate linear regression models compared mean readiness scores (MRS) for students born low birthweight (LBW) or preterm (PTB) and by childcare type, adjusting for other student and parent risk factors. Results MRSs for moderately LBW (1000-2499 g), extremely LBW (< 1000 g), moderately PTB (28-36 weeks), early-term (37-38 weeks) and post-term (42 + weeks) students were significantly lower than scores for their normal weight or full-term peers, adjusting for childcare type and other student and parent characteristics. Childcare was an important predictor of MRSs. MRSs were highest for district prekindergarten (PK) students and for students of mothers with greater years of education. Conclusions for Practice Social and biologic differences in MRSs for children entering school in a large urban public-school district suggest the need for greater attention to family and child health backgrounds. Increased enrollment in formal childcare may improve school readiness in these settings.

The scope of this article is to analyze the accreditation criteria of the studies that evaluated actions of health promotion and risk factor prevention of Health Promoting Schools (HPS). A systematic review was conducted based on the recommendations proposed in the "Preferred Reporting Items for Systematic Reviews and Meta-Analyses (Prisma)" protocol of articles that assessed HPS in the following databases: SciELO, Lilacs, Medline, PubMed and Portal Capes. From the analysis of the three pillars for accreditation of HPS, three of the studies analyzed did not include all the criteria for certification as HPS on the "Planning Process" and "Health Promotion Activities Developed" pillars. The schools cited in these studies perform health education, prevention and/or health promotion activities, however, it is misleading to refer to themselves as HPS. The main challenges for implementation, development and continuity of HPS were identified as being intersectionality and insufficient financial and qualified human resources. HPS need to be certified and submitted to an ongoing evaluation process. It is also suggested the topic of health promotion be included in the syllabuses of training courses of health education teachers and other health education professionals.

An investigation has been carried out to examine the impact of different levels of classroom noise on adolescents' performance on reading and vocabulary-learning tasks. A total of 976 English high school pupils (564 aged 11 to 13 years and 412 aged 14 to 16 years) completed reading tasks on laptop computers while exposed to different levels of classroom noise played through headphones. The tasks consisted of reading science texts, which were followed by multiple-choice questions probing comprehension and word learning. Number of questions attempted, times taken to read the texts and to answer questions were recorded, as well as correct answers to different types of question. The study consisted of two similar experiments, the first comparing performance in classroom noise at levels of 50 and 70 dB L Aeq ; and the second at levels of 50 and 64 dB L Aeq . The results showed that the performance of all pupils was significantly negatively affected in the 70 dB L Aeq condition, for the number of questions attempted and the accuracy of answers to factual and word learning questions. It was harder to discern effects at 64 dB L Aeq , this level of noise having a detrimental effect upon the older pupils only.

Introduction: Future orientation (FO) refers to individuals' beliefs and feelings about their future. Earlier research has primarily investigated correlates of FO at the individual and family level, but it seems likely that FO is also shaped by other central agents or institutions, such as the school. Earlier studies have found positive associations between "school effectiveness" and student performance, and negative associations in relation to e.g., bullying, delinquency, and health risk behaviors. The current study investigated three teacher-reported features of school effectiveness - school leadership, teacher cooperation and consensus, and school ethos - and their links with student-reported FO., Methods: Survey data were collected in 2016 among 5131 students (aged 17-18 years) and 1061 teachers in 46 upper secondary schools in Stockholm, Sweden, and merged with school-level register data. Two-level binary logistic regression analyses were performed., Results: The analyses showed that higher teacher ratings of school leadership and school ethos were associated with a greater likelihood of reporting an optimistic FO among students. Teacher cooperation and consensus was however not associated with students' FO., Conclusion: The findings indicate that the school environment contributes to shaping students' beliefs about their future. Thus, enhancing features of school effectiveness may be a way of promoting a positive development and brighter objective future prospects for the young, via pathways such as good student-teacher relations and academic motivation and achievement., (Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.)

The current study sought to build upon research on cognitive behavioral therapy (CBT) as the first-line treatment for depressed youth by investigating the effects of the various components of a CBT treatment on changes in depressive symptoms in young female participants. Female participants 9-14 years of age (n = 40; M age = 10.58 years) with a diagnosis of a depressive disorder from the CBT-only treatment condition of a larger randomized clinical trial were included in the current study. Participants engaged in a 20-session, 11-week, school-based CBT group intervention (ACTION Treatment; Stark et al., 2006). Depressive symptoms were assessed pre- and posttreatment, and intervention components were coded based on review of audio recordings of treatment sessions. Data were examined using two-level mixed-effects models using hierarchical linear modeling with full maximum likelihood estimation. Results indicated that higher quality behavioral intervention components were associated with greater improvement in posttreatment depression scores, higher quality cognitive intervention components were marginally associated with worsening posttreatment depression scores, and relational intervention components were not associated with depression outcome. Age significantly moderated the relationships between intervention components and depression outcome, with younger female participants benefiting most from higher quality behavioral and relational intervention components. These findings provide preliminary evidence about the differential impact of CBT components on depression treatment outcome for young female participants, with consideration of age as a moderator. This study highlights the importance of continuing to dismantle CBT treatment components for youth depression, as such findings can be used to design more potent, developmentally tailored interventions.

Evidence supports the utility of measurement-based care (MBC) to improve youth mental health outcomes, but clinicians rarely engage in MBC practices. Digital measurement feedback systems (MFS) may reflect a feasible strategy to support MBC adoption and sustainment. This pilot study was initiated to evaluate the impact of a MFS and brief consultation supports to facilitate MBC uptake and sustainment among mental health clinicians in the education sector, the most common mental health service delivery setting for youth. Following an initial training in MBC, 14 clinicians were randomized to either a digital MFS and brief consultation supports or control. Baseline ratings of MBC attitudes, skill, and use were collected. In addition, daily assessment ratings tracked 2 core MBC practices (i.e., assessment tool administration, provision of feedback) over a 6-month follow-up period. Clinicians in the MFS condition demonstrated rapid increases in both MBC practices, whereas the control group did not significantly change. For clinicians in the MFS group, consultation effects were significant for feedback and approached significance for administration. Over the follow-up period, average decreases in the current study were moderate with only 1 of the 2 outcome variables (administration) decreasing significantly. Inspection of individual clinician trajectories revealed substantial within-group trend variation. MFS may represent an effective MBC implementation strategy beyond initial training, although individual clinician response is variable. Identifying feasible and impactful implementation strategies is critical given the ability of MBC to support precision health care.

A positive school climate has been found to support mental and physical health, academic achievement and social adjustment among youth. However, links between school climate and brain structure have not been investigated to date. In this study, we investigated whether school climate was associated with executive function (EF) and brain structure (cortical thickness and surface area) in children and adolescents. We further examined whether these links varied as a function of socioeconomic background. Participants who ranged from 9 to 18 years of age (N = 108) completed EF tasks and a high-resolution, 3-Tesla, T1-weighted magnetic resonance imaging (MRI) scan. Overall school climate, academic support, and family socioeconomic background were assessed using questionnaires. Higher academic support was associated with greater EF task performance and increased global cortical thickness. Additionally, academic support moderated the association between family income and EF, such that children from lower income families performed similarly to their more advantaged peers on EF tasks in the context of positive academic support. This work is the first to link school climate to brain structure and contributes to the growing body of evidence suggesting that academic support may be an important protective factor in the context of socioeconomic disadvantage., (© 2018 John Wiley & Sons Ltd.)

Background: Mexico approved mandatory nutrient-based standards for foods sold in schools in 2011. The aim of this study was to analyse the association between compliance with nutrition standards for foods sold in schools and children's school snacks., Methods: Data came from three surveys representative of Mexican elementary schools in 13 states and their students (2012, 2013 and 2015); n = 645 children from N = 99 different schools. Information on foods sold in schools and snacks consumed by children was collected through direct observation. Compliance with the standards was defined as the proportion of foods sold in school which met nutrition criteria established by the standards. Snacks were classified as healthy if they contained at least one fruit or vegetable and had no sugar-sweetened beverages. Robust logistic regression models for cross-sectional and repeated surveys aggregated at the school-level were fitted to quantify the association between school compliance with standards and healthy snacks., Results: On average across waves 27% of foods sold complied with nutrition standards; 18% of children consumed a healthy snack. For snacks purchased in school, a 10% increase in school compliance with the standards was associated with a 32% increase in the odds of a healthy snack (OR = 1.32; 95%CI 1.09,1.61); no association was observed for snacks brought from home. The odds of a healthy snack increased over time in schools where compliance with the standards improved (OR = 3.89; 95%CI 1.47,10.31) but not in those where compliance remained constant or decreased., Conclusions: Only a small proportion of children are eating healthy snacks in school. School compliance with standards increases the likelihood of a healthy snack if it is bought at school. Our findings support better implementation of the standards and additional strategies to enhance the policy to achieve its aim of reducing childhood obesity.

Importance: Although school environments are thought to influence health behaviors, experimental data assessing causality are lacking, and which aspects of school environments may be most important for adolescent health are unknown., Objective: To test whether exposure to high-performing schools is associated with risky adolescent health behaviors., Design, Setting, and Participants: This natural experiment used admission lotteries, which mimic random assignment, to estimate the association of school environments and adolescent health. A survey of 1270 students who applied to at least 1 of 5 high-performing public charter schools in low-income minority communities in Los Angeles, California. Schools had an academic performance ranked in the top tertile of Los Angeles County public high schools, applicants outnumbered available seats by at least 50, and an admissions lottery was used. Participants included lottery winners (intervention group [n = 694]) and lottery losers (control group [n = 576]) from the end of 8th grade and beginning of 9th grade through the end of 11th grade. Intention-to-treat (ITT) and instrumental variable techniques estimated the association of winning the lottery and attending high-performing schools with health behaviors and whether the association varied by sex. Data were collected from March 11, 2013, through February 22, 2017, and analyzed from October 1, 2017, through July 1, 2018., Exposures: Schools were considered high performing if they placed in the top tercile of public high schools in LA County on 2012 state standardized tests. Most students attended that same school for 3 years (9th-11th grades)., Main Outcomes and Measures: Primary self-reported outcomes were 30-day and high-risk self-reported marijuana use. Additional health outcomes included 30-day alcohol use, alcohol misuse, ever being in a fight, ever having sex, and past-year delinquency. Potential intermediate factors (time studying, truancy, school mobility, school culture, school order, teacher support for college, and proportion of substance-using peers in students' social networks) were also examined., Results: Among the 1270 participating students (52.6% female; mean [SD] age at enrollment, 14.3 [0.5] years), ITT analysis showed that the intervention group reported less marijuana misuse than the control group (mean marijuana misuse score, 0.46 vs 0.71), as well as fewer substance-using peers (9.6% vs 12.7%), more time studying (mean, 2.63 vs 2.49 hours), less truancy (84.3% vs 77.3% with no truancy), greater teacher support for college (mean scores, 7.20 vs 7.02), more orderly schools (mean order score, 7.06 vs 6.83), and less school mobility (21.4% vs 28.4%) (all P < .05). Stratified analyses suggest that among boys, intervention participants had significantly lower marijuana use (mean misuse score, 0.43 vs 0.88; difference, -0.45; 95% CI, -0.78 to -0.13) and alcohol misuse (mean misuse score, 0.52 vs 0.97; difference, -0.44; 95% CI, -0.80 to -0.09) scores compared with control participants, whereas no significant health outcomes were noted for girls., Conclusions and Relevance: This natural experiment provides evidence that school environments can improve risky behaviors for low-income minority adolescents.

While research suggests that schools can foster active citizenship among youth, studies have not tested whether ethnic minority youth may benefit differently from school experiences than ethnic majority youth. In this study of 219 students (138 German majority and 81 Turkish-origin minority; M age  = 18.26; 55% females), we examined the association between different experiences at school and 4 indicators of youth active citizenship, controlling for various socio-demographic characteristics. Although value of social studies was associated with three out of four active citizenship indicators among both ethnic groups, the effects of the other school-related variables on active citizenship were moderated by ethnicity. Specifically, indicators of classroom climate, such as open classroom climate and classroom community, were only associated with greater active citizenship among Turkish-minority youth, while participatory factors, such as engagement in school decisions, were only associated with active citizenship among native German youth., (© 2016 International Union of Psychological Science.)

Background/aim: Occupational therapists are commonly referred children who find reduced social competence a barrier to participation in school activities. Little is known about the social skills expected of children at school and the thinking strategies children use during social interactions. This study aimed to investigate the social skills expected of children during school-based learning activities in the current NSW K-6 Syllabuses and the types of cognitive strategies expected during social interactions., Methods: A qualitative text-based approach was adopted to explore the range of social skills expected of children at school. A content analysis of text-based data was used to identify specific social skills represented in the current NSW K-6 Syllabuses and the types of cognitive strategies required. Cognitive strategy use items from the PRPP System of Task Analysis were used to identify expected ways of thinking that related to social competence outcomes as stated in the Syllabus., Results: Findings revealed a high number of social skills represented in expected learning outcomes for all six subjects included in the analysis. Four categories representing expected social behaviours across the syllabuses were identified: intrapersonal skills: communication by language; interpersonal skills and responding to others. Each desired social competence phrase embedded within syllabus objectives aligned with at least one item from the PRPP System of Task Analysis. The highest representation of expected strategy use was items from Recall (memory) and Planning (problem solving and evaluating) Quadrants., Conclusion: Investigation into the types of cognitive strategies embedded within Syllabus objectives which relate to social competence can assist therapists more accurately target social skills and associated cognitive strategies required for occupational performance at school. Findings from the study support the use of the PRPP System of Task Analysis for identifying and addressing cognitive strategy use during occupational therapy assessment and intervention., (© 2018 Occupational Therapy Australia.)

Sub-Saharan Africa carries a high burden of the HIV epidemic, with young adults being particularly affected. Well-designed school-based HIV prevention interventions can contribute to establishing protective behaviour. The aim of this study was to explore the needs of primary school students and teachers in the region of Kagera, Tanzania, regarding an HIV prevention intervention in the primary school setting. The needs assessment was structured according to the PRECEDE component of the PRECEDE-PROCEED model. Qualitative data was collected in six focus group discussions with primary school students and teachers. Key informant interviews with seven experts were conducted. We employed qualitative content analysis to analyse data in MAXQDA. The findings suggest that teachers need to be adequately trained to provide HIV and sex education and to support HIV-positive students. Enabling structural factors, such as an appropriate syllabus, are required. Stigmatization has been reported a major barrier to HIV prevention in schools. Teachers and students identified a more trustful relationship between each other as well as to legal guardians of children as a basis for HIV prevention. These findings will inform the development of a tailored HIV prevention intervention., (� The Author(s) 2018. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.)

Ratings are present in many areas of assessment including peer review of research proposals and journal articles, teacher observations, university admissions and selection of new hires. One feature present in any rating process with multiple raters is that different raters often assign different scores to the same assessee, with the potential for bias and inconsistencies related to rater or assessee covariates. This paper analyzes disparities in ratings of internal and external applicants to teaching positions using applicant data from Spokane Public Schools. We first test for biases in rating while accounting for measures of teacher applicant qualifications and quality. Then, we develop model-based inter-rater reliability (IRR) estimates that allow us to account for various sources of measurement error, the hierarchical structure of the data, and to test whether covariates, such as applicant status, moderate IRR. We find that applicants external to the district receive lower ratings for job applications compared to internal applicants. This gap in ratings remains significant even after including measures of qualifications and quality such as experience, state licensure scores, or estimated teacher value added. With model-based IRR, we further show that consistency between raters is significantly lower when rating external applicants. We conclude the paper by discussing policy implications and possible applications of our model-based IRR estimate for hiring and selection practices in and out of the teacher labor market., Competing Interests: The authors have declared that no competing interests exist.

Background: In Norway, for several dental conditions, a substantial part of treatment costs are reimbursed by the National Insurance Scheme. Ideally, the probability of receiving subsidized dental care (SDC) should be independent of social determinants of health, such as education, so that dental services are accessible to everyone independent of their social status., Objective: The main objective of this study was to estimate the causal effect of education on the probability of receiving SDC in the adult Norwegian population., Research Design: During the period 1960-1972, all municipalities in Norway were required to increase the number of compulsory years of education from 7 to 9 years. This education reform was used to create exogenous variation in the education variable. Since municipalities implemented the reform at different times, we have both cross-sectional and time series variation in the reform instrument. Thus we were able to estimate the effect of education on the probability of receiving SDC by controlling for municipality fixed effects and trend variables., Subjects: This study included all Norwegian adults, born during the period of 1947-1958., Measures: Information about education (number of years), whether the individuals had received SDC, place of residence (municipality) was collected., Results: The probability of receiving SDC was found to increase by 2 percentage points per additional year of education., Conclusion: People with the most resources benefit the most from a universal welfare scheme that is addressed to reach everybody. We suggest providing information about the subsidy scheme in a way that is easily available and understandable to all individuals, independent of their level of education.

Background: Schools are particularly vulnerable to pests, but integrated pest management (IPM) can address pest problems. This study describes IPM policies and practices and the extent to which they are associated with school characteristics., Methods: We analyzed data from the 2014 School Health Policies and Practices Study, a nationally representative survey of schools in the United States (N = 568, response rate = 69%). Pairwise comparisons assessed differences in pest prevention strategies by school characteristics., Results: Nationwide, 55.3% of schools conducted campus-wide inspections for pests at least monthly; 35.6% of schools notified staff, students, and families prior to each application of pesticides; and 56.1% of schools required custodial or maintenance staff to receive training on pest management practices that limit the use of pesticides. During the 12 months before the study, 46.5% of schools almost always or always used spot treatments and baiting rather than widespread applications of pesticides, and 36.8% of schools almost always or always marked indoor and outdoor areas that had been treated with pesticides. No clear pattern emerged for school characteristics associated with IPM policies and practices., Conclusions: The variation in implementation of IPM-related policies and practices suggest opportunities for targeted education among school staff about IPM principles., (Published 2018. This article is a U.S. Government work and is in the public domain in the USA.)

Many professors are interested in providing science outreach to local K-12 students, but may not have the time or resources needed to create an engaging presentation. The American Physiological Society supports outreach initiatives through programs such as the Physiology Understanding (PhUn) Week. Building on these activities, it was desired to create and assess an immersive and engaging Outreach Program in a disadvantaged K-12 student population. Three distinct modules were created on cardiovascular physiology, respiratory physiology, and oral health. All resources for these modules underwent peer review and publication, allowing other professors to easily execute their own outreach programming. The outreach modules were presented to 288 students in 3rd, 5th, 6th, and 7th grade classes. Implementation of the modules resulted in significant increases in student content knowledge, ranging from 32 to 57% improvement ( P < 0.001, dependent t-test), with an average increase of 46%. K-12 science teachers reported that the program was at an appropriate educational level, increased students' enthusiasm for science, and increased students' exposure to science careers. Additionally, the presenters of the Outreach Program were perceived to be enthusiastic, knowledgeable, and proficient at interacting with the students. On open-response survey items, the science teachers indicated a high level of satisfaction with the program and an enthusiasm for continued collaborations. These results indicate the importance of organized and interactive science activities for the success of a new Outreach Program.

The goal of the current study was to validate a new measure of the friendship self-disclosure process that assesses the likelihood of disclosing a negative peer experience and expectations for friends' responses to disclosure (EFRD) of this experience. Participants for Study 1 were 572 adolescents (age M = 14.82; 53% female; 66% Caucasian) from a public school sample who completed the self-disclosure survey and a measures of depressive symptoms at one time point. Participants of Study 2 comprised 180 obese adolescents (age M = 12.78; 67% female; 58% African American) from an urban children's hospital. The obese sample completed the self-disclosure survey, as well as measures of friendship quality, peer victimization, and depressive symptoms at two time points, 6 months apart. For both studies, 3 dimensions of EFRD were examined: protection, blame, and negative responses. Each EFRD dimension was replicated across 2 samples, over time, and had good interitem reliability as well as convergent and discriminant validity. In Study 2, high rates of expected negativity (only for boys) and blame (for boys and girls) predicted increases in depressive symptoms. In addition, victimization led to increases in depression for obese adolescents who expected little in the way of protective responses from their friends. In contrast, changes in depression were not predictable from victimization for those who expected friends to use protective responses. EFRD are clearly important mechanisms in the self-disclosure process that may serve to protect against changes in adjustment in response to negative peer experiences, such as peer victimization.

Background: In 2006, United States public schools participating in federal school meal programs were required to adopt school wellness policies. The effect of these policies on school nutrition environments is well documented; however, evaluation of physical activity policies has received less investigation. We aimed to evaluate how district wellness policies aligned to practice for physical activity implementation in 40 schools with high obesity rates (>24%)., Methods: Wellness policies were evaluated using the validated Wellness School Assessment Tool (WellSAT). Concurrently, schools completed the validated Alliance for a Healthier Generation's Healthy Schools Program (HSP) self-assessment to evaluate physical activity practices. Overall, 13 of 20 physical activity measures from WellSAT and 12 of 13 physical activity measures from HSP were aligned to match policy with practice., Results: Most policy items scored 0 or 1, indicating either 'no mention in the policy' or 'containing weak or vague language'. Corresponding HSP results indicated that school physical activity practices are 'not in place' or 'under development'. A strong, positive, correlation (r = 0.92, P < 0.001) indicated that a significant relationship exists between policy and implementation., Conclusions: Results indicate that most districts currently have weak policies regarding physical activity, limiting the potential to positively influence school-based physical activity.

As the Norwegian society, and thereby the kindergartens, have become more multicultural, the need for cultivating teachers capable of operating in an ever diversified and global world is highlighted as an important educational strategy within teacher education. The purpose of the specific intercultural program in kindergarten teacher education discussed in this article refers to competences needed as a professional teacher in a multicultural kindergarten. Teachers often have various assumptions and beliefs taken for granted. Therefore, reflexivity appears in intercultural education as a crucial asset. However, the article argues that the notion of self-contemplation and self-reflection that can give the subject freedom as a thinking being needs to be challenged. Questioning beliefs and assumptions includes an examination of one's emotional experiences, values and perspectives. This examination can threaten one's core beliefs and create powerful feelings such as anger, shame or resentment. Introducing the concept of disorienting dilemmas, the article problematizes the rationalist intellectual orientation in teacher education and discusses the need to focus on intercultural experiences as sensuous, intellectual and affective. The article illustrates some disorienting dilemmas with narratives from students who have attended the program. Finally, the article considers the conditions and pedagogical means that might support a more holistic approach to learning in intercultural experiences.

The aim of this paper is to point the Environmental Health (EH) profession in South Africa in the direction of their neglected function. The health inspection of initiation schools is one of the abandoned responsibility of EH profession in South Africa. This is due to fear of interfering with the traditional value systems and thus resulting in significant non-compliance to EH norms and standards. Little information is available on the compliance rate of EH requirements in the African traditional initiation schools. South African National Department of Health states that EHPs have an obligation to protect the health, safety and well-being of citizens from the environmental determinants, and this is achieved through enforcing the health requirements. In terms of the norms and standards for EH, health education in initiation schools should form an integral part of monitoring and evaluation, and this is found under the health surveillance of premises. The main argument raised by this paper is negligence of EHPs to conduct EH inspections at the Basotho male initiation schools and to promote health in support of the constitution of South Africa. Negligence of EHPs to perform their duties result in deaths and fatal injuries among initiates and this indicates the need for health promotion and EH research in the Basotho male initiation schools.

The need of tuning into speech in noisy and reverberant classrooms is a challenge for good speech communication and literacy development at school. Reading development can be compromised if children are exposed to inadequate acoustics, especially those with poor neural processing in speech discrimination. This work reports preliminary results on the influence of classroom acoustics on the reading speed of 94 Italian second-graders. Speech clarity (C50) was found to be significantly correlated with all the investigated reading tasks, while no significant correlations were found with reverberation time.

Earlier identification of executive deficits in preschool children using an ecological approach would give more scope for intervention. The Preschool Executive Task Assessment (PETA) was developed to resemble an everyday age-appropriate task in order to examine the self-direction and integration of executive functions during a multistep task. It was designed so that performance can be evaluated in a microanalytic way and so individualized feedback and support can be easily communicated. The utility of the PETA was assessed with 166 three-to five-year olds. Results showed improved performance with increasing age and verbal intellectual quotient as well as good task reliability and utility. Evidence for influence of socioeconomic status, gender, and use of self-talk was also observed. Clinical applications and future directions of this novel measure are discussed.