Implementation and Performance of a Point-of-Care COVID-19 Test Program in 4,000 California Schools.

OBJECTIVE: To evaluate the feasibility and accuracy of an unprecedented COVID-19 antigen testing program in schools, which required a healthcare provider order, laboratory director, a Clinical Laboratory Improvement Amendments (CLIA) certificate of waiver, as well as training of school personnel. STUDY DESIGN: Descriptive report of a point-of-care, school-based antigen testing program in California from 8/1/2021 through 5/30/2022, in which participants grades K-12 self-swabbed and school personnel performed testing. Participants included 944,009 students, personnel, and community members from 4,022 California K-12 schools. Outcomes measured include sensitivity and specificity (with polymerase chain reaction [PCR] as comparator), of the Abbott BinaxNOW™ antigen test, number of tests performed, and active infections identified. RESULTS: Of 102,022 paired PCR/antigen tests, the overall sensitivity and specificity for the antigen test was 81.2% (95%CI:80.5%-81.8%) and 99.6% (95%CI:99.5%-99.6%), respectively using cycle threshold (Ct) values <30. During January through March 2022, the highest prevalence period, the positive predictive value (PPV) of antigen testing was 94.7% and the negative predictive value was 94.2%. Overall, 4,022 school sites were enrolled and 3,987,840 million antigen tests were performed on 944,009 individuals. A total of 162,927 positive antigen tests were reported in 135,163 individuals (14.3% of persons tested). CONCLUSIONS: Rapidly implementing a school-based testing program in thousands of schools is feasible. Self-swabbing and testing by school personnel can yield accurate results. On-site COVID-19 testing is no longer necessary in schools, but this model provides a framework for future infectious disease threats.

Surveillance Methods Used to Detect, Characterize, and Monitor the COVID-19 Pandemic in Rocky Mountain Tribal Communities.

OBJECTIVE: Data were essential to public health decision-making during the COVID-19 pandemic, yet no single data source was adequate for Tribes in Montana and Wyoming. We outlined data access, availability, and limitations for COVID-19 pandemic surveillance response to improve future data exchange. MATERIALS AND METHODS: The Rocky Mountain Tribal Epidemiology Center (RMTEC) used various data sources to deliver data on the number of COVID-19 cases, deaths, and vaccinations at local, state, and regional levels to inform Tribes in Montana and Wyoming. RMTEC reviewed state, federal, and public datasets and then attached a score to each dataset for completeness of demographic information, including race, geographic level, and refresh rate. RESULTS: The RMTEC COVID-19 response team shared data weekly on the number of COVID-19 cases, deaths, and vaccinations distributed and the percentage of the population vaccinated with Tribal health departments in Montana and Wyoming. The Indian Health Service Epidemiology Data Mart dataset scored the highest (24 of 30), followed by datasets from Montana (18 of 30) and Wyoming (22 of 30). Publicly available datasets scored low largely due to data aggregation across larger geographic areas and lack of demographic variables. PRACTICE IMPLICATIONS: The absence of data on race and ethnicity from publicly available data and lack of access to real-time data limited RMTEC's ability to provide Tribal-specific updates on COVID-19 cases, deaths, and vaccinations to Tribal health departments. RMTEC should be fully funded to provide the necessary resources for data management and the capacity to respond to data requests from Tribal health departments and their programs to address current and future pandemics. Federal and state agencies should also be educated on Tribal Epidemiology Centers' public health authority status to improve access to infectious disease data among those agencies.

U.S. College Students' Marijuana Information Sources, Confidence in Knowledge, and Objective Knowledge.

In recent years, marijuana use on U.S. college campuses reached the highest point while the perceptions of risk and social disapproval registered the lowest since the early 1980s. However, little attention has been paid to the sources of the marijuana-related messages and their relationships with marijuana knowledge and confidence in knowledge, proximate protective/risk factors. To fill this gap, a convenience sample of students (N = 249) on a campus located in a U.S. recreational marijuana legal state were surveyed to identify their marijuana information sources and explore the relationships among the sources, confidence in marijuana knowledge, and objective knowledge. Peers/media were the most important sources and they were used more than other sources. Use of peers/media sources was related to lower health knowledge and higher confidence in knowledge. Although students named parents and education/science sources as important, these were less frequently used than siblings, the sources they named as the least important. This study advanced our understanding of the various sources of marijuana information used by U.S. college students and the relationships between the information sources and confidence in knowledge and objective knowledge, two emerging risk/protective factors in the era of marijuana deregulation.

Youth assets and alcohol-related problems among male and female youth: Results from a longitudinal cohort study.

Youth who experience alcohol-related problems are at increased risk for developing alcohol dependence. Identifying factors associated with adolescent alcohol-related problems is essential, but most studies have focused on risk factors or a limited number of protective factors, with little attention to sex differences. We assessed the prospective association between 17 assets and alcohol-related problems among male and female youth. A 4-year cohort study with 1, 111 youth living in randomly-selected census tracts in the Oklahoma City Metropolitan Area was conducted. Follow-up for the current study began at wave 2 (2004/2005; N = 1079). Seventeen assets at the individual-, family-, and community-levels were measured. Five questions documented alcohol-related problems in the past 12 months. Generalized linear mixed models evaluated the prospective influence of assets on alcohol-related problems, separately for males and females. Models controlled for age, race/ethnicity, family structure, and parental income. Overall, females had more assets than males, but the protective influence of assets on alcohol-related problems over time was stronger for males. Six assets uniquely protected males (responsible choices [AOR = 0.58, 95% CI = 0.36-0.94], educational aspirations [AOR = 0.54, 95% CI = 0.31-0.93], parental monitoring [AOR = 0.41, 95% CI = 0.27-0.64], community involvement [AOR = 0.57, 95% CI = 0.34-0.97], use of time for groups/sports [AOR = 0.64, 95% CI = 0.42-0.97], and school connectedness [AOR = 0.51, 95% CI = 0.34-0.77]), and 3 uniquely protected females (general self-confidence [AOR = 0.62, 95% CI = 0.40-0.96], good health practices [AOR = 0.67, 95% CI = 0.47-0.95], and relationship with mother [AOR = 0.53, 95% CI = 0.36-0.80]). Strengthening youth assets across multiple domains may decrease alcohol-related problems for both males and females; however, gender-specific approaches to asset building are also warranted.

Timing and duration of European larch growing season along altitudinal gradients in the Swiss Alps.

The 2007 European larch (Larix decidua Mill.) growing season was monitored along two elevational transects in the Lötschental valley in the Swiss Alps. Phenological observations and weekly microcore sampling of 28 larch trees were conducted between April and October 2007 at seven study sites regularly spaced from 1350 to 2150 m a.s.l. on northwest- and southeast-facing slopes. The developmental stages of nearly 75,000 individual cells assessed on 1200 thin sections were used to investigate the links between the trees' thermal regimes and growth phases including the beginning and ending of cell enlargement, wall thickening and maturation of the stem wood. Needles appeared approximately 3-4 weeks earlier than stem growth. The duration of ring formation lasted from mid-May to the end of October, with the length of the growing season decreasing along elevation from 137 to 101 days. The onset of the different growing seasons changed by 3-4 days per 100 m elevation; the ending of the growing season, however, appeared minimally related to altitude. If associated with the monitored altitudinal lapse rate of -0.5 degrees C per 100 m, these results translate into a lengthening of the growing season by approximately 7 days per degree Celsius. This study provides new data on the timing and duration of basic growth processes and contributes to quantification of the impacts of global warming on tree growth and productivity.