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Introduction: Emergency medical services (EMS) dispatchers have made efforts to determine whether patients are high risk for coronavirus disease 2019 (COVID-19) so that appropriate personal protective equipment (PPE) can be donned. A screening tool is valuable as the healthcare community balances protection of medical personnel and conservation of PPE. There is little existing literature on the efficacy of prehospital COVID-19 screening tools. The objective of this study was to determine the positive and negative predictive value of an emergency infectious disease surveillance tool for detecting COVID-19 patients and the impact of positive screening on PPE usage.  Methods: This study was a retrospective chart review of prehospital care reports and hospital electronic health records. We abstracted records for all 911 calls to an urban EMS from March 1–July 31, 2020 that had a documented positive screen for COVID-19 and/or had a positive COVID-19 test. The dispatch screen solicited information regarding travel, sick contacts, and high-risk symptoms. We reviewed charts to determine dispatch-screening results, the outcome of patients’ COVID-19 testing, and documentation of crew fidelity to PPE guidelines.  Results: The sample size was 263. The rate of positive COVID-19 tests for all-comers in the state of Massachusetts was 2.0%. The dispatch screen had a sensitivity of 74.9% (confidence interval [CI], 69.21-80.03) and a specificity of 67.7% (CI, 66.91-68.50). The positive predictive value was 4.5% (CI, 4.17-4.80), and the negative predictive value was 99.3% (CI, 99.09-99.40). The most common symptom that triggered a positive screen was shortness of breath (51.5% of calls). The most common high-risk population identified was skilled nursing facility patients (19.5%), but most positive tests did not belong to a high-risk population (58.1%). The EMS personnel were documented as wearing full PPE for the patient in 55.7% of encounters, not wearing PPE in 8.0% of encounters, and not documented in 27.9% of encounters. Conclusion: This dispatch-screening questionnaire has a high negative predictive value but moderate sensitivity and therefore should be used with some caution to guide EMS crews in their PPE usage. Clinical judgment is still essential and may supersede screening status.

How can we harness the power of innovation to support the development of our youth as empathic citizens, who are engaged with and informed about the world around them? The Citizen Discourse initiative is creating a unique platform to meet this goal.

Karen Gross, former president of Southern Vermont College and author of "Breakaway Learners: Strategies for Post-Secondary Success with At-Risk Students," writes of the impact the recent March for Our Lives at hundreds of locations around the globe had on her. As she stood in the middle of hundreds of thousands of protesters in Washington D.C., she wondered had we finally found a way to increase activism, to get more and more people of all ages and stages in life involved in the well-being of their communities? As Gross listened to the young speakers over the loudspeakers and later on television, she wondered: Have the voices of high school students (and some even younger students) been ignited such that their fire will expand? These young people from Parkland, Fla. and beyond, seem capable of spreading their energy, their eloquence and their belief that "enough is enough" in terms of gun violence. Can the efforts of these students to change gun laws to increase school safety be sustained? All of these questions bring the conversation in this article toward concerns about college campuses and Gross' worry about levels of student activism, spurred in part by efforts to eradicate sexual harassment and abuse. Here she wonders if students are truly engaging in the political process that other fundamental way: by exercising their right to vote? Gross goes on to suggest that a rating of "voting" percentages broadly defined speaks volumes about an institution. It bespeaks campus culture, campus involvement, campus priorities. It sends a message about how activism and political activity will be received and handled and supported. Gross closes by saying that in today's world, that's a pretty good reflection of citizenship and the role of educational institutions in preparing the leaders of tomorrow. Surely voting percentages are more important than the size of a college's endowment or other indicators we currently use to measure the quality of colleges.

Although rising student debt levels are frequently studied, very little attention has been paid to the lack of student financial literacy and its negative effects. The absence of financial management skills and accompanying low credit scores can increase debt, cause inadvertent defaults, and be harmful for both students and their institutions. For these reasons, one Northeastern law school designed, instituted, and studied a pilot financial literacy education course for its law students. This paper presents a detailed description of this course, which was offered on a one-credit, pass/fail basis over a two-day (14-hour) period. The study involved focus groups and a pre- and post-test questionnaire that was conducted to test its efficacy. The article also describes adaptations made to the course following the study and makes suggestions for course replication. As the study demonstrates, teaching financial literacy to students has measurable benefits, and the prospect of implementing a similar course in a variety of graduate and undergraduate settings merits serious attention. The article also describes avenues for important additional research, including on the longitudinal benefits of financial management education. (Contains 3 tables and 5 graphs.)

The contents of this article and the examples given and lessons proffered boil down to this: the need to ramp up positive role modeling. Role modeling isn't a part-time activity. It is a full-time obligation. To that end, parents and educators: (1) need to come up with strategies in advance that recognize that young people need ways to engage safely; (2) must involve students in the planning of these activities that are COVID-safe; (3) need to question where students are and anticipate their behavior by offering alternatives; (4) need to talk more to students about risks and about solutions and about feelings and double standards; and (5) shouldn't make punishment the best solution as it doesn't work; instead, provide alternatives.

With the growing number of colleges moving to online learning, the author has been asked: Can online learning incorporate trauma-responsive strategies? The short answer is yes. Current events, including the lack of an endpoint in terms of the pandemic, have heightened the stress that students, faculty and staff will feel when colleges and universities reopen. In the COVID-gap (the time between when educational institutions shut down to when they reopen in fall 2020) many students experienced trauma. So did faculty and staff. The trauma experienced was not uniform. This article lists a set of eleven strategies (not listed in order of importance) that can be deployed to ameliorate trauma symptomology in the context of online learning, remembering that all suggestions need to be adapted to the culture, location and climate in which learning is occurring.

There's been no shortage of suggestions for how to save the many small colleges that dot the landscape, especially in New England. Susan Dynarski, a well-respected professor who regularly comments insightfully on issues in higher education, suggested that perhaps the only places where COVID safety and education can coexist are rural small college campuses. The author can attest to their ability, with innovative thinking and bold leadership, to respond to COVID and offer in-person education. In this article, the author describes concrete ways small campuses can operate effectively and safely and with deep change. For those of who care about education, small colleges and student success, the pandemic may be the needed opening for enabling these institutions to remain a part of the educational landscape.

Whether and how campuses will reopen in fall 2020 has emerged as "the" key story in higher education during the COVID-19 pandemic. This essay is an effort to reflect on how reopeners can and should conduct risk management, which individuals need to be involved in the decision-making, and what personnel within the institution will oversee compliance on a go-forward basis. Eight steps for reopeners to consider are discussed.

Karen Gross is an author, educator and advisor on diverse issues along the educational pipeline. Her current research focuses on student success and the impact of trauma on learning, psychosocial development and health. Sadly, the issues on which she focuses have taken center stage with the coronavirus pandemic and the literally thousands of colleges (and schools) closing their brick-and-mortar campuses for the semester--if not longer. In this Q&A, "NEJHE" Executive Editor John O. Harney asks Gross about her work with at-risk students in the new age of trauma and the impact of the pandemic of higher education and the reopening of campuses when that occurs.

The spread of COVID-19, which happens easily in a campus setting, raises critical questions about what educational institutions can and should do. The raised issues are remarkably varied and call for all those involved in running institutions to approach these concerns thoughtfully and quickly, given the speed with which the virus is spreading, particularly in some states. Most of what is being written, according the author, focuses on the physical threats and risks of the coronavirus. However the physical protection of students has missed a focus on their psychological well-being and the traumatizing effect the threat of this virus can have--including re-triggering prior trauma. As some commentators have observed, there is a viral epidemic but also a fear pandemic. For the record, fear and anxiety and toxic stress produce trauma symptomology in some students and impair learning, social engagement and physical health (not from the virus itself). How higher education deals with the psychological impact of the COVID-19 situation is the critically important question for all educators, in addition to and side-by-side with the physical protections. One without the other will not help students. At the end of the day, according to the author, there needs to be both physical and mental well-being. Educators need to recognize first and then deal with the psychosocial impacts of the threat of the virus and school closings and disruptions on students. This requires understanding how the virus's threat can be traumatizing and lead to trauma symptomology. They also needs to be able to help students deal with their symptoms--not of the virus but of the trauma of the virus; and educators need to be able to see those symptoms--recognize them, deal with them, and ameliorate them.

The school shooting will eventually land on college campuses in the invisible backpacks of students. Regrettably, most colleges are not trauma-informed nor trauma-responsive. And folks will be shocked when these students struggle or barely stay in school or drop out or stop out. Their learning, their memories, their engagement can all be impacted. It's time to see the trauma around us and how it affects education. And we need educators who can and will be ready, willing and able to be trauma-responsive at the university level.

There have been articles about the competitiveness of elite colleges and universities and the need to provide courses or partial courses or seminars in failure. The idea is legitimizing failure; it happens to everyone after all. But, since some college students have never experienced failure, the colleges need to include instruction on how to fail. Some even provide certificates of failure at the beginning or end of the courses. In this article, Karen Gross explains why certificates of failure are unwelcome recognition since failure is evident in lives being lived, and especially since the focus of certificates of failure applies to such a narrow segment of college students who have been surrounded by failure of every sort from food scarcity, parental absence, incarceration, addiction, and homelessness.

The events surrounding Brett Kavanaugh's confirmation to the Supreme Court will have an effect of college campuses--and not just in the near term. Campuses will be brimming over with concerns about how people treat each other, how people engage with each other, how people of different views can respond to each other and how we form attachments to another person or to people in general with truth and trust. The author offers two suggestions, which can be adapted and molded to particular campuses, for how to address these issues campuswide.

A hitherto unidentified early modern inscription in an illuminated Anglo-Norman Apocalypse manuscript owned by the Wormsley Estate (Buckinghamshire) is here demonstrated to be a stanza from "Content and Rich," a moralizing lyric written by the Jesuit priest and martyr Robert Southwell (ca. 1561–95). In three parts, this essay explores the nature of solitude as prompted by this happy placement of Southwell's lines praising conscience within a medieval French metrical translation of the Book of Revelation. The first part considers how the medieval manuscript glosses the Renaissance poem, proposing that the eschatological setting changes the seemingly anodyne "Content and Rich" into a charged justification for the controversial defense strategy known as equivocation. The second part, inspired by the Wormsley manuscript's evidence of early modern engagement with medieval books, investigates Southwell's reading of Bernard of Clairvaux (1090–1153) while awaiting execution. The final section reverses the relationship outlined in the first, using the early modern annotation to explicate the medieval Apocalypse manuscript. Southwell's verses celebrating inner tranquility challenge readers to imagine if there may be such a condition as eschatological solitude. All three of these meditations on finding Southwell in the Apocalypse underscore the profound paradox that contented solitude is not solitary. [ABSTRACT FROM AUTHOR]

Few question the difficulties of being a college or university president in today's era. The work of college and university presidencies is getting harder not easier with the passage of time. In this article, the author discusses how leadership in higher education is due for a change. She offers and discusses a solution of co-presidency.

In times of financial distress, the communication strategies of leaders of institutions of higher education are often flawed. This is because the best approaches to helping a campus deal with financial woes are counter-intuitive and require an understanding of money as a language. But bankruptcy law, financial counseling, psychology, and behavioral economics have lessons to teach that are transportable to an educational setting. Leaders who reevaluate how to think, talk and write about financial issues can improve how a campus responds to necessary but unpleasant fiscal decisions, as well as avoid mistakes that make matters worse. This article identifies several strategies that college and university presidents can deploy that will make these trying times easier to navigate. The provided "pointers" focus on the value of pausing, pondering, and partnering and describe the steps leaders can take to improve their capacity to speak money's complex language.

How to foster wise decision-making generally and among young people in particular has been the subject of numerous studies. Professionals working in the field of student life struggle to accomplish two goals on campus: foster quality decision-making and curb irresponsible behavior. Given the range of choices confronting college students, it is no small wonder that college presidents have many sleepless nights worrying about the safety of the students in their charge. For "breakaway students," complex decisions arise long before college begins--indeed the choice to go to college itself is only one example of making a remarkable and positive choice. For breakaway students' access to and success in college to occur, good decision-making needs to start early and often. Educators can help students build an architecture of better choice, in part by making deliberate what may now be done without much thought.

"Lady Lucy's Quest" (Shires Press) is a story about a feisty young girl in the Middle Ages who wants to become a Knight of the Round Table. The initial reaction of her family, the townspeople, and the knights is, stated simply, "no way." But Lucy perseveres and meets the three challenges of knighthood presented to her, albeit in unusual, intriguing, and unexpected ways. The book is illustrated by two high school seniors at The Emma Willard School (New York) as their senior year project. Ji Woo Jasmine Shin and So Young Yang, with the help of their art teacher, Lindsey Slaughter, worked to animate Lucy. Both student illustrators are immigrants from Korea and understand Lucy's story and her need to pursue a dream. They created moving, remarkable scenes to make Lucy's story come alive.

The academic literature is clear: students with a college degree earn more and lead healthier, more productive lives than their non-degree counterparts. Moreover, the early weeks on campus profoundly affect the likelihood of students persisting through to graduation. With its significant enrollment of first-generation and underrepresented students, Southern Vermont College (SVC) took a new road to meet the challenge of first-semester (and first-year) retention. Many variables impact student retention: (1) academic offerings; (2) residential programming; and (3) the overall culture of the institution. New students need to feel part of the institution and connect to one another, to faculty and to the campus community. To establish connectivity on campus, SVC focused on two strategies: (1) connecting with students "before" they arrive on campus; and (2) intentionally linking pre-orientation initiatives with both orientation and events planned for students during the semester. Rather than one-time events arranged by Academic Affairs or Student Life, SVC aimed to create a quilt of events during a 12-week period. SVC's retention work, the authors believed, had to be "of a piece," by linking typically disparate activities through shared themes, teamwork and coordination among departments. In this article, the authors describe their new approaches for first-semester retention and report on the results. (Contains 1 table.)

In his best-selling book, "Deep Economy," Bill McKibben comments on the benefits of "small" education. Smaller institutions, he argues, resemble farmers' markets--one gets wonderful and quality seasonal food from people he knows and trusts. But, one cannot get everything there that he may want precisely when he wants it. Given personal preferences and differences among people, they need both large universities and small colleges--just as they need both supermarkets/mega stores and farmers markets/niche boutiques and everything in-between. So, what are those benefits of small colleges that justify and support their continued role on the college landscape? These are: (1) personalization; (2) choice; (3) navigation; and (4) early engagement.

The words "truth," "transparency," and "trust" recently have taken on renewed importance in higher education. The reporting and handling of sexual assaults, athletic cheating scandals, Muslim student deaths, the intrusion into the admissions process by college/university presidents forcing acceptance of new students who are politically connected, and fraternity hazing, among other inappropriate activities, have run headlong into efforts to determine the truth, demonstrate institutional transparency, and establish and maintain trust among the wide range of stakeholders. Education leaders and campuses must build trust. College presidents know that if they lose the trust of their boards, their faculty, government officials and sometimes their students, their jobs are at risk. Of late, too many presidents have lost their positions because the trust others held in them was eroded beyond repair. In this article, Karen Gross suggests that while university and college presidents need not be flawless, they must ferret out--and often quickly--what is fact and what is fiction. They must spend the time to think through the words they use to describe volatile situations, and above all else, own the truth, whether it is good or bad. Gross goes on to say that judging from current events, trust on campuses is eroding, including in leaders and within the student population. She emphasizes that without trust the connectivity so central to the creation of community and the capacity to learn and take risks diminishes. She concludes by asserting that educators need to spend more time rebuilding and valuing trust, not just divining and sharing truth.

The author illustrates the influence of Virgil's epic poem Aeneid on Boccaccio's De Casibus Illustrium Virorum by bringing out the similarities in the structure and theme.

U.S. Sen. Elizabeth Warren has had concerns about student debt for decades. Her recent solution seeks to redistribute tax revenue from the richest Americans to enable students to refinance their postgraduation indebtedness; this would allow students to benefit from the low interest rates in today's financial markets. The Massachusetts Democrat is right in noting that the inability of students to refinance--as opposed to consolidate--debt takes away a valuable tool in the repayment arsenal. Senator Warren's Robin Hood-esque proposal relies on private-sector dollars to enable refinancing. Warren thinks the burden should fall instead to the federal government to be a better lender with better products and better terms, and to colleges and universities to be better partners, particularly in lowering default rates and matching repayment options with graduates' needs. That would be good policy, better ensuring that students and graduates can thrive in the workplace and in their local communities. Warren feels that is, after all, what we hope education provides: insurance that our future is in good hands.