Income Inequality and the Odds of Online Gambling Among a Large Sample of Adolescents in Canada.

Consistent evidence points to the detrimental effects of income inequality on population health. Income inequality may be associated with online gambling, which is of concern since gambling is a risk factor for adverse mental health conditions, such as depression and suicide ideation. Thus, the overall objective of this study is to study the role of income inequality on the odds of participating in online gambling. Data from 74,501 students attending 136 schools participating in the 2018/2019 Cannabis, Obesity, Mental health, Physical activity, Alcohol, Smoking, and Sedentary behaviour (COMPASS) survey were used. The Gini coefficient was calculated based on school census divisions (CD) using the Canada 2016 Census linked with student data. We used multilevel modeling to explore the association between income inequality and self-reported participation in online gambling in the last 30 days, while controlling for individual- and area-level characteristics. We examined whether mental health (depressive and anxiety symptoms, psychosocial wellbeing), school connectedness, and access to mental health programs mediate this relationship. Adjusted analysis indicated that a standardized deviation (SD) unit increase in Gini coefficient (OR = 1.17, 95% CI 1.05, 1.30) was associated with increased odds of participating in online gambling. When stratified by gender, the association was significant only among males (OR = 1.12, 95% CI 1.03, 1.22). The relationship between higher income inequality and greater odds for online gambling may be mediated by depressive and anxiety symptoms, psychosocial well-being, and school connectedness. Evidence points to further health consequences, such as online gambling participation, stemming from exposure to income inequality.

Investigation of the Exposure of Schoolchildren to Ultrafine Particles (PM0.1) during the COVID-19 Pandemic in a Medium-Sized City in Indonesia.

The health risk of schoolchildren who were exposed to airborne fine and ultrafine particles (PM0.1) during the COVID-19 pandemic in the Jambi City (a medium-sized city in Sumatra Island), Indonesia was examined. A questionnaire survey was used to collect information on schoolchildren from selected schools and involved information on personal profiles; living conditions; daily activities and health status. Size-segregated ambient particulate matter (PM) in school environments was collected over a period of 24 h on weekdays and the weekend. The personal exposure of PM of eight selected schoolchildren from five schools was evaluated for a 12-h period during the daytime using a personal air sampler for PM0.1 particles. The schoolchildren spent their time mostly indoors (~88%), while the remaining ~12% was spent in traveling and outdoor activities. The average exposure level was 1.5~7.6 times higher than the outdoor level and it was particularly high for the PM0.1 fraction (4.8~7.6 times). Cooking was shown to be a key parameter that explains such a large increase in the exposure level. The PM0.1 had the largest total respiratory deposition doses (RDDs), particularly during light exercise. The high level of PM0.1 exposure by indoor sources potentially associated with health risks was shown to be important.

Universal Design in Primary Schools.

The Norwegian building code give an apparently clear framework for the implementation of universal design (UD) in public buildings. However, it seems that neither increased awareness of UD, nor compliance with building regulations can so far guarantee equal use. Statistics and inspections reveal that there still are shortcomings as regards accessibility for many groups. Children with reduced mobility or impaired vision are better cared for than students whose needs are less documented. There is still a necessity for understanding the needs of other groups, such as children with hearing impairments, or other sensory challenges, children with social anxieties and those within the autism spectrum. A key part of achieving UD should be a design process where users' needs are in focus. Based on recent research carried out by SINTEF Building and Infrastructure and funded by the Directorate for Children, Youth and Families, this paper presents 1) Examples of practices where primary and lower secondary schools have been designed within a framework of UD, and 2) Important drivers for universal design during the design process. Recommendations will be proposed for further development of standardized tools. Findings indicate that opportunities to challenge the minimum requirements for UD within a conventional design process are few without having a supportive and competent client. The regulations and standards do not necessarily ensure inclusion and equal use. Low understanding about what UD entails in terms of user knowledge and involvement may be one reason. Norwegian standards for UD do not appear to be in significant use. Tools for UD often appear as checklists, based on the building regulations. The examples show that effective collaboration between the client and the architect plays a central role in the UD of schools. Architects not only need tools to think about usability at all design levels, but the ability to collaborate with the client and users in every phase.

Association between the school physical activity environment, measured and self-reported student physical activity and active transport behaviours in Victoria, Australia.

BACKGROUND: Environments within schools including the physical, social-cultural and policy/practice environments have the potential to influence children's physical activity (PA) behaviours and weight status. This Australian first study comprehensively examined the association(s) of physical, social-cultural and policy/practice environments with PA, active transport (AT) and weight status among regional primary school children. METHODS: Data were from two childhood obesity monitoring systems in regional Victoria, Australia. Measured height and weight were collected from students in Year 2 (aged approx. 7-8 years), Year 4 (9-10 years), and Year 6 (11-12 years). Self-reported PA behaviour, including AT were collected from students in Year 4 and 6 and a sub-sample wore an ActiGraph (wGT3X-BT) accelerometer for 7-days. A school physical activity environment audit was completed by the school principal and responses were used to calculate school physical activity environment scores (PAES) and active transport environment scores (ATES). Mixed effects logistic regression was used to assess the relationship between the proportion of students meeting the PA guidelines (≥60mins/day of moderate-to-vigorous PA) and PAES tertiles (low, medium, high) and those using AT and school ATES tertiles, controlling for gender, school size/type and socioeconomic composition. RESULTS: The analysed sample included 54/146 (37%) schools and 3360/5376 (64%) students. In stratified analysis, girls in schools with a medium PAES score were more likely to meet the objectively measured PA guideline compared to low PAES score (OR 2.3, 95%CI 1.27, 4.16). Similarly, students in schools with a medium or high ATES score had higher odds of self-reported AT (medium OR 3.15, 95%CI 1.67, 5.94; high OR 3.71, 95%CI: 1.80, 7.64). No association between PAES or ATES and weight status were observed. Self-reported AT among boys (OR 1.59, 95%CI 1.19, 2.13) and girls (OR 1.56, 95%CI 1.08, 2.27) was associated with higher odds of meeting self-reported PA guidelines on all 7-days than those who did not report using AT. CONCLUSIONS: In this study of regional Victorian primary schools, PA environments were only associated with girls' adherence to PA guidelines. School AT environments were strongly associated with students' AT behaviours and with increased likelihood of students being physically active.

School food offer at lunchtime: assessing the validity and reliability of a web-based questionnaire.

OBJECTIVES: To develop and validate a web-based self-diagnostic questionnaire on school food service offer aimed at food service managers (FSM) by: (i) identifying relevant indicators of school food offer, developing a questionnaire and validating the concept using an expert panel; (ii) validating the questions by comparing the FSM's responses with observations by dietitians and (iii) undergoing a qualitative evaluation of the tool through direct observation and short interviews. DESIGN: Mixed methods. SETTING: Quebec, Canada. PARTICIPANTS: Nine experts validated the theoretical constructs and indicators on which the questionnaire was based. Inter-rater reliability tests were conducted with thirty-nine FSM, who then participated in interviews about platform functionality satisfaction. Twenty school stakeholders participated in the survey pertaining to their use of the personalised report. RESULTS: The questionnaire focused on the main school food service's lunchtime offer and comprised twenty-six questions. The overall strength of agreement was good, and all questions' strengths of agreement were fair to excellent except for one question. Qualitative data reached saturation and showed that navigation through the questionnaire was fluid. Improvements were suggested to increase user-friendliness and simplicity of both the platform and questionnaire. Results from the survey showed that all respondents were either satisfied or very satisfied with their personalised report. CONCLUSIONS: We successfully developed and validated a web-based self-diagnostic questionnaire. The final version facilitates knowledge mobilisation with school stakeholders and offers a new opportunity for the assessment and surveillance of school food offer.

Disentangling individual, school, and neighborhood effects on screen time among adolescents and young adults in the United States.

OBJECTIVES: To examine the association between individual, neighborhood, and school-level influences on individual screen time among adolescents and young adults (AYAs) in the National Longitudinal Study of Adolescent to Adult Health. METHODS: We classified screen time continuously as self-reported total hours per week of television, videos, and video/computer games at baseline and categorical as extended screen time (≥14 h per week). We fit cross-classified multilevel models (CCMM) to examine to examine the individual-, school- and neighborhood-level demographic and socioeconomic factors associated with screen time. Models were fit using MLwiN with Bayesian estimation procedures. RESULTS: AYAs reported an average of 22.8 (SD = 19.4) and 21.9 (SD = 20.3) hours of screen time, respectively. At the individual level, younger age, male sex, Black/multiracial race, receipt of public assistance, and lower parental education were associated with higher screen time. At the school level, being out of session (i.e., school and national holidays including summer), having a higher proportion of non-White students, and having a lower proportion of parents with a college education were associated with higher individual screen time. CONCLUSIONS: We found that individual-level factors most influence youth screen time, with smaller contributions from school factors.

Understanding School-Aged Childhood Obesity of Body Mass Index: Application of the Social-Ecological Framework.

In order to understand the prevalence of school-aged childhood obesity in the United States and suggest better methods to prevent and treat the public health problem, we examined it with significant and identifiable factors within the social-ecological model. To investigate the association between social-ecological factors and child obesity/overweight (BMI), we used the 5th wave of the Fragile Families and Child Wellbeing Study. The dataset included information on 9-year-old children. The sample size for our study was 2054. We utilized multiple normal distributions for missing values and the Ordinary Least Square regression analysis. Black and Hispanic children were more likely to be obese/overweight than White children; children with higher physical activity were negatively associated with higher obesity; older mothers were more likely to be associated with children's obesity; family structure was also significantly related to the likelihood of childhood obesity; finally, school environment was significantly associated with child obesity. To combat childhood obesity, more school physical activities should be implemented, such as increasing physical education opportunities as well as building more sizable playgrounds and accessible recreation facilities at school and in communities. School environments also should be pleasant and safe for children. Health practitioners need to assess home environments to intervene for children's health.

Human exposure to NO2 in school and office indoor environments.

BACKGROUND: Although nitrogen dioxide (NO2) is one of the most common air pollutants encountered indoors, and extensive literature has examined the link between NO2 exposure and duration causing adverse respiratory effects in susceptible populations, information about global and local exposure to NO2 in different indoor environments is limited. To synthesize the existing knowledge, this review analyzes the magnitude of and the trends in global and local exposure to NO2 in schools and offices, and the factors that control exposure. METHODS: For the literature review, Web of Science, SCOPUS, Google Scholar, and PubMed were searched using 42 search terms and their combinations to identify manuscripts, reports, and directives published between 1971 and 2019. The search was then extended to the reference lists of relevant articles. RESULTS: The calculated median, as well as the mean, concentration of NO2 in school (median 21.1 µg/m3; mean 29.4 µg/m3) and office settings (median 22.7 µg/m3; mean 25.1 µg/m3) was well below the World Health Organization (WHO) guideline of 40 µg/m3 for the annual mean NO2 concentration. However, a large range of average concentrations of NO2 were reported, from 6.00 to 68.5 µg/m3 and from 3.40 to 56.5 µg/m3 for school and office environments, respectively, indicating situations where the WHO guidelines are exceeded. Outdoor levels of NO2 are a reliable predictor of indoor NO2 levels across seasons, with mean and median Indoor/Outdoor (I/O) ratios of 0.9 and 0.7 in school and 0.9 and 0.8 in office environments, respectively. The absence of major indoor NO2 emission sources and NO2 sinks, including chemical reactions and deposition, are the reasons for lower indoor NO2 concentrations. During the winter, outdoor NO2 concentrations are generally higher than during the summer. In addition, various building and indoor environment characteristics, such as type of ventilation, air exchange rates, airtightness of the envelope, furnishing and surface characteristics of the building, location of the building (urban versus suburban and proximity to traffic routes), as well as occupants' behavior (such as opening windows), have been statistically significantly associated with indoor NO2 levels in school and office environments. CONCLUSIONS: Indoor exposure to NO2 from the infiltration of ambient air can be significant in urban areas, and in the case of high traffic volume. Although reducing transportation emissions is challenging, there are several easier means to reduce indoor NO2 concentrations, including a ventilation strategy with suitable filters; location planning of new schools, classrooms, and ventilating windows or intakes; traffic planning (location and density); and reducing the use of NO2-releasing indoor sources.

Keeping Students Out of Harm's Way: Reducing Risks of Educator Sexual Misconduct.

Sexual misconduct by school staff, which we refer to as educator sexual misconduct (ESM), is a serious and damaging violation of the trust that parents and students put in the educational system. After reviewing the prevalence and consequences of ESM for all parties involved, the authors propose standards of practice based on the Situational Crime Prevention framework to prevent sexual abuse by altering the environment and reducing opportunities for offending. The strategies offered in this paper can help create a comprehensive approach to reducing sexual victimization of students by staff. The standards serve as an operational framework for prevention and reduce the likelihood of ESM and institutional legal liability. The seven standards include safe screening and hiring practices for staff, codes of conduct, ensuring safe environments, staff-student communication policy (including electronic communication), training staff, parents and students, monitoring and supervision, along with reporting questionable conduct. By implementing these standards, educational institutions can help ensure better protection of children from ESM.

Human exposure to ozone in school and office indoor environments.

BACKGROUND: Although it is recognized that ozone causes acute and chronic health effects and that even trace amounts of ozone are potentially deleterious to human health, information about global and local exposures to ozone in different indoor environments is limited. To synthesize the existing knowledge, this review analyzes the magnitude of and the trends in global and local exposure to ozone in schools and offices and the factors controlling the exposures. METHODS: In conducting the literature review, Web of Science, SCOPUS, Google Scholar, and PubMed were searched using 38 search terms and their combinations to identify manuscripts, reports, and directives published between 1973 and 2018. The search was then extended to the reference lists of relevant articles. RESULTS: The calculated median concentration of ozone both in school (8.50 µg/m3) and office (9.04 µg/m3) settings was well below the WHO guideline value of 100 µg/m3 as a maximum 8 h mean concentration. However, a large range of average concentrations of ozone was reported, from 0.8-114 µg/m3 and from 0 to 96.8 µg/m3 for school and office environments, respectively, indicating situations where the WHO values are exceeded. Outdoor ozone penetrating into the indoor environment is the main source of indoor ozone, with median I/O ratios of 0.21 and 0.29 in school and office environments, respectively. The absence of major indoor ozone sources and ozone sinks, including gas-phase reactions and deposition, are the reasons for lower indoor than outdoor ozone concentrations. However, there are indoor sources of ozone that are of significance in certain indoor environments, including printers, photocopiers, and many other devices and appliances designed for indoor use (e.g., air cleaners), that release ozone either intentionally or unintentionally. Due to significantly elevated outdoor ozone concentrations during summer, summer indoor concentrations are typically elevated. In addition, the age of a building and various housing aspects (carpeting, air conditioning, window fans, and window openings) have been significantly associated with indoor ozone levels. CONCLUSIONS: The existing means for reducing ozone and ozone reaction products in school and office settings are as follows: 1) reduce penetration of outdoor ozone indoors by filtering ozone from the supply air; 2) limit the use of printers, photocopiers, and other devices and appliances that emit ozone indoors; 3) limit gas-phase reactions by limiting the use of materials and products (e.g. cleaning chemicals) the emissions of which react with ozone.

School Nurses' Experiences and Perceptions of Healthy Eating School Environments.

School nurses provide health promotion and health services within schools, as healthy children have a greater potential for optimal learning. One of the school nurses' role is in encouraging healthy eating and increasing the availability of fruits and vegetables in the school. The purpose of this study was to explore and describe school nurses' perceptions of their role in promoting increased fruit and vegetable consumption in the school setting. One avenue to increased availability of fruits and vegetables in schools is Farm to School programs mandated by the Federal government to improve the health of school children. School nurses are optimally positioned to work with Farm to School programs to promote healthy eating. A secondary aim was to explore school nurses' knowledge, experiences and/or perceptions of the Farm to School program to promote fruit and vegetable consumption in the school setting. Three themes emerged from the focus groups: If There Were More of Me, I Could Do More; Food Environment in Schools; School Nurses Promote Health. School nurses reported that they addressed health issues more broadly in their roles as educator, collaborator, advocate and modeling healthy behaviors. Most of the participants knew of Farm to School programs, but only two school nurses worked in schools that participated in the program. Consequently, the participants reported having little or no experiences with the Farm to School programs.

Percepción de cualidades restauradoras de los espacios escolares de bachillerato en la ciudad de Xalapa, México / Perceived restorativeness in school spaces of high schools in Xalapa City, México / Percepção de qualidades restauradoras dos espaços escolares de ensino médio na cidade de Xalapa, México

El presente estudio se llevó a cabo con estudiantes de centros educativos de nivel bachillerato en Xalapa, México, y tuvo el objetivo de identificar y comparar las cualidades restauradoras percibidas en sus espacios escolares de acuerdo con la Teoría de la Restauración de la Atención. Se trabajó con una muestra no probabilística de 706 estudiantes de siete bachilleratos. Se recopilaron datos mediante una encuesta sociodemográfica y la Escala del Potencial Restaurador de los Espacios Escolares (EPREE).Los resultados mostraron que las áreas verdes de las escuelas eran los espacios de descanso con mayores cualidades restauradoras, y que los lugares de descanso favoritos poseían más cualidades restauradoras que los no favoritos. Los alumnos varones, los de más edad y aquellos cuya madre (jefe de familia) tenía niveles inferiores de estudios reportaron una percepción más positiva de los espacios escolares. Las escuelas más grandes y con áreas verdes fueron mejor valoradas en las dimensiones de fascinación, posibilidad de estar alejado, y extensión. Los resultados confirmaron las propuestas centrales de la teoría de la restauración de la atención en el contexto de los espacios escolares.

The present study was carried out with high school students from Xalapa, Mexico. Its aim was to identify and compare the perceived restorativeness in their school environments according to the attention restoration theory. This work is based on a non-probabilistic sample of 706 students from seven high schools. All data were compiled by a sociodemographic survey and the Scale of the Restorative Potential of School Spaces (EPREE, for its the Spanish acronym). The results proved that green areas were the rest spaces with major restorative qualities and that the students' favorite rest places possessed more restorative qualities than other places. Males, older pupils and those whose mother (head of the family) had a lower educational level reported a more positive perception of the school spaces. The largest schools with green areas obtained a higher evaluation for their dimensions of fascination, being away and extent. The results confirmed the main propositions of the attention restoration theory.

Este artigo foi realizado com estudantes de centros educativos de ensino médio em Xalapa (México) e teve como objetivo identificar e comparar as qualidades restauradoras percebidas em seus espaços escolares de acordo com a Teoria da Restauração da Atenção. Trabalhou-se com uma amostra não probabilística de 706 estudantes de sete turmas de ensino médio. Coletaramse dados mediante uma enquete sociodemográfica e a Escala do Potencial Restaurador dos Espaços Escolares (EPREE). Os resultados mostraram que as áreas verdes dos centros eram os espaços de descanso com maiores qualidades restauradoras e que os lugares de descanso preferidos pelos estudantes possuíam mais qualidades restauradoras do que os não preferidos. Os estudantes do gênero masculino, os de mais idade e aqueles cuja mãe (cabeça de família) tinha níveis inferiores de escolaridade relataram uma percepção mais positiva dos espaços escolares. Os maiores centros e com áreas verdes tiveram melhores avaliações nas dimensões de fascinação, possibilidade de estar isolado e extensão. Os resultados confirmaram as propostas centrais da Teoria da Restauração da Atenção no contexto dos espaços escolares.

Quantile regression analyses of associated factors for body mass index in Korean adolescents.

OBJECTIVES: This study examined the influence of home and school environments, and individual health-risk behaviours on body weight outcomes in Korean adolescents. STUDY DESIGN: This was a cross-sectional observational study. METHODS: Quantile regression models to explore heterogeneity in the association of specific factors with body mass index (BMI) over the entire conditional BMI distribution was used. A nationally representative web-based survey for youths was used. RESULTS: Paternal education level of college or more education was associated with lower BMI for girls, whereas college or more education of mothers was associated with higher BMI for boys; for both, the magnitude of association became larger at the upper quantiles of the conditional BMI distribution. Girls with good family economic status were more likely to have higher BMIs than those with average family economic status, particularly at the upper quantile of the conditional BMI distribution. Attending a co-ed school was associated with lower BMI for both genders with a larger association at the upper quantiles. Substantial screen time for TV watching, video games, or internet surfing was associated with a higher BMI with a larger association at the upper quantiles for both girls and boys. Dental prevention was negatively associated with BMI, whereas suicide consideration was positively associated with BMIs of both genders with a larger association at a higher quantile. CONCLUSIONS: These findings suggest that interventions aimed at behavioural changes and positive parental roles are needed to effectively address high adolescent BMI.

Using cross-classified multilevel models to disentangle school and neighborhood effects: an example focusing on smoking behaviors among adolescents in the United States.

BACKGROUND: Despite much interest in understanding the influence of contexts on health, most research has focused on one context at a time, ignoring the reality that individuals have simultaneous memberships in multiple settings. METHOD: Using the example of smoking behavior among adolescents in the National Longitudinal Study of Adolescent Health, we applied cross-classified multilevel modeling (CCMM) to examine fixed and random effects for schools and neighborhoods. We compared the CCMM results with those obtained from a traditional multilevel model (MLM) focused on either the school and neighborhood separately. RESULTS: In the MLMs, 5.2% of the variation in smoking was due to differences between neighborhoods (when schools were ignored) and 6.3% of the variation in smoking was due to differences between schools (when neighborhoods were ignored). However in the CCMM examining neighborhood and school variation simultaneously, the neighborhood-level variation was reduced to 0.4%. CONCLUSION: Results suggest that using MLM, instead of CCMM, could lead to overestimating the importance of certain contexts and could ultimately lead to targeting interventions or policies to the wrong settings.

The sexual maltreatment of students with disabilities in American school settings.

This study presents results from the first nationwide survey of students with disabilities who were sexually maltreated in American schools. The Web survey results, which were mostly provided by caregivers, parents/guardians, and professional advocates, illuminate the types of sexual maltreatment committed, the characteristics of the victims and the abusers, where in the school setting the maltreatment occurred, the manner in which the maltreatment was reported, and the school's response to the maltreatment. More than two-thirds of the maltreated students experienced at least one form of contact sexual maltreatment, and fully 35% of all incidences of maltreatment occurred more than 10 times. The majority of the incidences of maltreatment were committed by school personnel.