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This paper examines whether school COVID-19 policies influenced enrollment differently by student age and race/ethnicity. Unlike much prior research, we i) analyze enrollments for virtually the entire U.S. public school population for both the 2020-2021 and 2021-2022 school years, ii) compare enrollment trends within districts in order to isolate subgroup heterogeneity from district characteristics, and iii) account for district selection into preferred learning modes. Analyzing data on over 9,000 districts that serve more than 90% of public school students in the United States, we find enrollment responses to COVID policies differed notably. We find that White enrollments declined more than Black, Hispanic, and Asian enrollments in districts that started the 2020-2021 school year virtually, but in districts that started in-person the reverse was true: Non-White enrollments declined more than White enrollments. Moreover, Black, Hispanic, and Asian families responded more than White families to higher COVID-19 death rates in the months preceding the start of the 2021 school year. In 2021-2022, enrollment differences by the previous year's learning mode persisted. Racial/ethnic differences did not vary by whether the district required masking in classrooms. These findings are consistent with the greater risk faced by communities of color during the pandemic and demonstrate an additional source of disparate impact from COVID policies.

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In June 2019, New York State (NYS) adopted Senate Bill 2994A eliminating nonmedical vaccine exemptions from school entry laws. Since student noncompliance with the law required school exclusion, we sought to evaluate the law's effects on student enrollment and absenteeism, and school workloads related to its implementation. In November 2019, we sent an electronic survey to NYS (excluding New York City) schools. Due to the COVID-19 pandemic, outreach was curtailed in March 2020 with 525 (14%) of 3,759 eligible schools responding. To account for non-response, results were analyzed using inverse probability weighting. After weighting, 39% (95% CI: 34%, 44%) of schools reported enrollment changes and 31% (95% CI: 26%, 36%) of schools reported absenteeism related to the law. In addition, 95% (95% CI: 93%, 98%) of schools reported holding meetings and/or preparing correspondence about the law, spending a mean of 14 (95% CI: 11, 18) hours on these communication efforts. Schools in the highest pre-mandate nonmedical exemption tertile (vs. lowest) were more likely to report enrollment and absenteeism changes, and higher workloads. While our results should be interpreted with caution, changes in student enrollment, absenteeism, and school workloads may represent important considerations for policymakers planning similar legislation.

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Interrupted education of adolescent mothers remains a major concern, but limited evidence-based programming exists to support postpartum schooling of this group. This study aimed to better understand the factors that render some adolescent mothers vulnerable to school non-enrollment, and how to reduce these risks. Data from 1,046 adolescent and young mothers (10-24 years) from rural and urban communities in South Africa's Eastern Cape was obtained through a questionnaire containing validated and study-specific measures relating to sociodemographic characteristics, schooling, relationships, violence exposure, and health. Using latent class analysis, we explored emerging latent groups and their relationship to mothers' enrollment in school, college, or tertiary education. The analyses revealed three distinct groups of mothers: The 'most disadvantaged' subgroup (39%) experienced multiple risks, including food insecurity, living in informal housing, lacking positive relationships with their caregiver, and the highest distance to school; The 'disadvantaged' subgroup (44%) did not experience food insecurity whilst reporting better caregiver relationships and lower distance to school. However, this group still showed high probabilities of residing in informal housing and in communities that expose them to violence; A 'least disadvantaged' subgroup (17%) was largely unaffected by economic and community risks and experienced good caregiver relationships. Compared to the most disadvantaged mothers, the least disadvantaged mothers showed the highest probability of being enrolled in education (65% versus 45%). Adolescent motherhood can impede continued enrollment in education and individual-centered interventions alone might not be sufficient to mitigate the risks for non-enrollment. Services and provisions that address severe poverty and improve family relationships might provide an opportunity to positively influence schooling among adolescent mothers.

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The connection between women's education and infant mortality is one of the most consistent and powerful relationships established in public health. A large body of cross-national research highlights the benefits of women's access to education, especially for improving population health in developing countries. However, most of this literature assumes the relationship is uniform across cases. In this study, we revisit the education-health link using a distributional approach. To do so, we conduct a series of unconditional quantile regression analyses that estimate the impact of female secondary school enrollment on infant mortality rates across 153 countries from 1970 to 2016. This technique allows for the possibility that the relationship between education and health may vary across the distribution of mortality. Indeed, results show that the education advantage is distribution-specific. We find that the expected benefits of women's education are limited to the middle of the distribution where infant mortality rates range from about 11 to 55 deaths per 1000 live births. However, we find no significant effect where mortality is comparatively low or high. Both consistent with and contradictory to prior research, these findings provide a more nuanced picture of how women's access to education relates to global health inequalities.

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In recent years, biomass energy tends to be one of the important sources of renewable energy in the world. The main objective of current research is to evaluate the impact of biomass energy on the economic growth of NEXT-11 economies. The data used in "the study is based on panel data of NEXT-11 covering the period 1990 to 2019. The included variables are GDP, biomass energy (BE) school enrollment gross ratio (SEGR; trade openness (TO; population growth (PG; and CO2 emission (CO2)." For estimation, this study applied the fully modified ordinary least square (FMOLS) and dynamic ordinary least square (DOLS) approaches. The results of FMOLS and DOLS analysis indicate a statistically significant and positive relationship among all the variables in our sample of nations. According to the findings, an increase in biomass energy use tends to positively affect economic growth. To meet the challenge of global warming, these countries need to increase their technical development and inventions as well as they need to improve biomass energy use.

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Objective: To investigate effects of school race/ethnic enrollment on mental health in early adolescence by examining both race/ethnic density (percent non-Latinx [NL] White enrollment) and diversity (range/size of all race/ethnic groups enrolled). Variation by student race/ethnic identity is examined as minority stressors are uniquely experienced by race/ethnic minority students. Design: Longitudinal cohort from a broader mental health study. Setting: Fourteen schools in Texas (2011-2015). Participants: Sixth-grade participants (mean age 11.5 years) linked to publicly available data about their school (N=389). Main Outcome Measures: Self-reported depressive-anxious symptoms over a two-year period. Methods: Generalized estimating equations tested main effects of density/diversity on depressive-anxious symptoms across student-reported race/ethnic identity, adjusting for student/school factors. Owing to statistically significant Latinx-group differences by acculturative stress, four unique identities were generated: NL-Black, low-stress Latinx, high-stress Latinx, and NL-White-referent. Points of convergence of student mental health profiles across density/diversity were explored. Results: A significant interaction between density and student race/ethnicity was found (P<.01), with NL-Black and low-stress Latinx vs NL-White students experiencing higher symptoms over the two-year period, net of covariates. In contrast, greater diversity was associated with higher symptoms, net of controls (P<.05). A marginally significant interaction (P=.06) revealed fewer symptoms for high-stress Latinx vs NL-White students. At about 25%, NL-White density and diversity of .5-.6, all students experienced similar mental health profiles. Conclusions: Greater NL-White density increases mental health risk for NL-Black and low-stress Latinx students, while school diversity lowers risk for high-stress Latinx students. These findings demonstrate how educational settings may produce or lessen minority stress.

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Following the Syrian conflict that began in 2011, Lebanon received more than one million refugees including 44,000 Palestinian refugees from Syria (PRS). PRS children were integrated into existing schools run by the United Nations Relief and Works Agency (UNRWA). Despite efforts by UNRWA to integrate the newly displaced into its services in Lebanon, only 58% of 6-18-year-old PRS children were enrolled in school in 2014. Informed by ecological systems theory, we examined the role of parental characteristics in determining school enrollment among PRS children following displacement into Lebanon. Utilizing data from the 2014 UNRWA Vulnerability Assessment (N = 12,378 6-18-year-old children), we specified crude and adjusted logistic regression models to predict child school non-enrollment including a set of variables on head of family characteristics (gender, age, education, and presence/absence of chronic disease) and post-displacement household characteristics (crowding, wealth, camp residence, region, and type of dwelling). The results show that, adjusting for household characteristics, a child living in a family whose head has secondary education or higher is more likely to be enrolled in school compared to one living in a family headed by someone with less than secondary education. Parental education remains the strongest predictor of child school enrollment despite displacement-related household disadvantage. To break the cycle of intergenerational educational disadvantage, it is critical for UNRWA to proactively design school retention programs for PRS children living in families whose head had limited access to education. Supplementary Information: The online version contains supplementary material available at 10.1007/s12134-020-00793-y.

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Background: This paper explores how implementation and refinement of an early intervention (EI) program for children with delayed development was informed by an iterative, intentional and structured process of measurement. Providing access to early intervention therapy for children in rural areas of India is challenging due to a lack of rehabilitation therapists and programs. Following a biopsychosocial framework and principles of community-based rehabilitation, a non-governmental organization, Amar Seva Sangam (ASSA), overcame those barriers by designing a digital technology supported EI program in rural Tamil Nadu, India. Program objectives included providing service access; supporting program engagement, child development and school enrollment; and positioning the intervention for scale-up. This paper contributes to a growing body of literature on how program design and implementation can be informed through a cyclical process of data collection, analysis, reflection, and adaptation. Methods: Through several strands of data collection, the design and implementation of the EI program was adapted and improved. This included qualitative data from focus groups and interviews with caregivers and service providers, and a mobile application that collected and monitored longitudinal quantitative data, including program engagement rates, developmental progression, caregiver outcomes, and school enrollment status. Results: Measurements throughout the program informed decision-making by identifying facilitators and barriers to service providers' quality of work-life, family program engagement, and school enrollment. Consultation with key stakeholders, including caregivers and service providers, and data driven decision making led to continual program changes that improved service provider quality of work-life, program engagement and school enrollment. These changes included addressing gender-related work challenges for service providers; forming caregiver support networks; introducing psychological counseling for caregivers; providing medical consultations and assistive devices; creating community awareness programs; improving access to therapy services; focusing on caregiver education, motivation and support; and advocacy for accessibility in schools. Conclusion: The process of using evidence-informed and stakeholder driven adaptations to the early intervention program, led to improved service provider quality of work-life, greater program engagement, improved school enrollment and positioned the intervention for scale-up, providing lessons that may be beneficial in other contexts.

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BACKGROUND: Access to washroom facilities and a place to dispose of menstrual waste are prerequisites for optimal menstrual hygiene management in schools. Like other low- and middle-income countries, Bangladeshi schools lack facilities for girls to change and dispose of their menstrual absorbents. We explored existing systems for disposing of menstrual absorbent wastes in urban and rural schools of Bangladesh and assessed the feasibility and acceptability of alternative disposal options. METHODS: We explored how girls dispose of their menstrual products, identified girls' preferences and choices for a disposal system and piloted four disposal options in four different schools. We then implemented one preferred option in four additional schools. We explored girls', teachers', and janitors' perspectives and evaluated the acceptability, feasibility, and potential for sustainability of the piloted disposal system. RESULTS: Barriers to optimal menstrual hygiene management included lack of functional toilets and private locations for changing menstrual products, and limited options for disposal. Girls, teachers, and janitors preferred and ranked the chute disposal system as their first choice, because it has large capacity (765 L), is relatively durable, requires less maintenance, and will take longer time to fill. During implementation of the chute disposal system in four schools, girls, teachers, and janitors reported positive changes in toilet cleanliness and menstrual products disposal resulting from the intervention. CONCLUSIONS: The chute disposal system for menstrual products is a durable option that does not require frequent emptying or regular maintenance, and is accepted by schoolgirls and janitors alike, and can improve conditions for menstrual hygiene management in schools. However, regular supervision, motivation of girls to correctly dispose of their products, and a long-term maintenance and management plan for the system are necessary.

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There is no national immunization policy in the United States, and the strictness of regulations allowing vaccine exemption for school attendance varies greatly by state. Despite substantial evidence on the safety and health benefits of immunization, there has been a recent upsurge in skepticism amongst parents regarding vaccine safety and efficacy for their children. To measure the effect of strictness of immunization policy on enrollment rates for school aged children, we utilize fixed effects regression. We construct a panel of data on county level enrollment rate and county characteristics from the American Community Survey, and utilize a recently validated measure of state vaccination policy effectiveness to identify level of strictness amongst states. Given the positive effects early education has for a child's future, paired with the importance of public health, understanding these outcomes may be of interest to policymakers. We find that as children exit the 3-and 4-year-old age cohort and enter the 5-to 9-year-old cohort, stricter vaccination policy has a positive effect on overall enrollment and, specifically, public school enrollment. We also find that female 3-and 4-year-olds' enrollment is more negatively affected by policy strictness than their male counterpart's.

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INTRODUCTION: This systematic literature review provides evidence concerning the association of school race/ethnic composition in mental health outcomes among adolescents (ages 11-17 years). A range of mental health outcomes were assessed (e.g., internalizing behaviors, psychotic symptoms) in order to broadly capture the relationship between school context on mental health and psychological wellbeing. METHODS: A search across six databases from 1990 to 2018 resulted in 13 articles from three countries (United States, United Kingdom, and the Netherlands) that met inclusion criteria following a two step review of titles/abstracts and full-text. RESULTS: The existing research on school race/ethnic composition and mental health point to two distinct measures of school composition: density-the proportion of one race/ethnic group enrolled in a school, and diversity-an index capturing the range and size of all race/ethnic groups enrolled in a school. Overall, higher same race/ethnic peer density was associated with better mental health for all adolescents. In contrast, there was no overall strong evidence of mental health advantage in schools with increased diversity. CONCLUSIONS: Theoretical and methodological considerations for future research towards strengthening causal inference, and implications for policies and practices concerning the mental health of adolescent-aged students are discussed.

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BACKGROUND: Survival rates of children with congenital heart disease (CHD) have increased significantly in the decade. There is now increased interest in the long-term outcome and quality of life of these children. AIMS: To assess the educational achievement of patients with CHD in Germany. STUDY DESIGN: Cross-sectional study using an online survey. The recruitment of study participants was carried out via the database of the German National Register for Congenital Heart Defects (NRCHD). SUBJECTS: Patients born between 1992 and 2011 were enrolled in the study. For 2609 study participants (female = 1870 (71.7%); 1072 (41.1%) patients; 1537 (58.9%) parents), who participated in the survey, detailed information regarding the underlying CHD diagnosis and clinical data was available. OUTCOME MEASURES: Age at enrollment, secondary school form, school year repetition, school degree. RESULTS: The large majority of study participants were enrolled at a conventional elementary school (83.4%) and started school at the age of 6 years or below (73.3%). In total 45.7% of graduated study participants graduated with the qualification necessary to study at any university. In terms of analysis of the different CHD severity subgroups 57.3% of patients with a mild CHD, 47.5% with a moderate CHD and only 35.1% suffering from a severe CHD attained a high school diploma. CONCLUSIONS: In our study, the majority of participating CHD patients had a standard school career. These initial results are of great importance to affected families and treating physicians as they show that, in general, a normal school career is possible for all CHD patients.

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The "5-to-7-year shift" refers to the remarkable improvements observed in children's cognitive abilities during this age range, particularly in their ability to exert control over their attention and behavior-that is, their executive functioning. As this shift coincides with school entry, the extent to which it is driven by brain maturation or by exposure to formal schooling is unclear. In this longitudinal study, we followed 5-year-olds born close to the official cutoff date for entry into first grade and compared those who subsequently entered first grade that year with those who remained in kindergarten, which is more play oriented. The first graders made larger improvements in accuracy on an executive-function test over the year than did the kindergartners. In an independent functional MRI task, we found that the first graders, compared with the kindergartners, exhibited a greater increase in activation of right posterior parietal cortex, a region previously implicated in sustained attention; increased activation in this region was correlated with the improvement in accuracy. These results reveal how the environmental context of formal schooling shapes brain mechanisms underlying improved focus on cognitively demanding tasks.

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Estimating the effects of international migration on left-behind children's educational attainment is complicated by the potential offsetting effects of fathers' absences and household remittances. Most research has not separated these aspects of international migration on children's human capital outcomes. We address this deficiency by using instrumental variables to isolate the effects of fathers' international migration absences from international household remittances on student enrollment and grade progression in Guatemala. Results indicate that fathers' absences and household international remittances are negatively related to enrollment, providing evidence for a culture of migration effect. For students who remain in school, household international remittances neutralize the harmful influence of fathers' absences on grade progression.

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PURPOSE: The purpose of the study was to identify risk factors and time trends for sexual experience and sexual debut in rural Uganda. METHODS: Using population-based, longitudinal data from 15- to 19-year olds in Rakai, Uganda, we examined temporal trends in the prevalence of sexual experience and potential risk factors for sexual experience (n = 31,517 person-round observations) using logistic regression. We then identified factors associated with initiation of sex between survey rounds, using Poisson regression to estimate incidence rate ratios (IRR; n = 5,126 person-year observations). RESULTS: Sexual experience was more common among adolescent women than men. The prevalence of sexual experience rose for most age-gender groups after 1994 and then declined after 2002. Factors associated with higher prevalence of sexual experience (without adjustment for other factors) included age, not enrolled in school, orphanhood, lower socioeconomic status, and drinking alcohol in the past 30 days; similar factors were associated with initiation of sex. Factors independently associated with initiation of sex included older age, nonenrollment in school (IRR = 1.7 for women and 1.8 for men), alcohol use (IRR = 1.3 for women and men), and being a double orphan among men (IRR = 1.2). Sexual experience began to decline around 2000, whereas increases in school enrollment began as early as 1994 and declines in orphanhood occurred after 2004 (as antiretroviral therapy became available). CONCLUSIONS: Sexual experience among youth in Rakai was associated with social factors particularly school enrollment. Changes in these social factors also appear to influence change over time in sexual experience.

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Achieving universal primary education is one of the Millennium Development Goals. In low- and middle-income developing countries (LMIC), child labor may be a barrier. Few multi-country, controlled studies of the relations between different kinds of child labor and schooling are available. This study employs 186,795 families with 7- to 14-year-old children in 30 LMIC to explore relations of children's work outside the home, family work, and household chores with school enrollment. Significant negative relations emerged between each form of child labor and school enrollment, but relations were more consistent for family work and household chores than work outside the home. All relations were moderated by country and sometimes by gender. These differentiated findings have nuanced policy implications.

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OBJECTIVE: College and university administrators have expressed concern that adoption of tobacco-free policies may reduce applications and enrollment. This study examines adoption and implementation of 100% tobacco-free campus policies by institutions of higher education on applications and enrollment. PARTICIPANTS: North Carolina private colleges and universities and public community colleges. Analysis was conducted in 2011. METHODS: Student enrollment and application data were analyzed by campus type to determine (a) if there was a difference in student applications and enrollment before and after policy implementation, and (b) if there was a difference in student applications and enrollment for campuses with versus without a policy. RESULTS: No significant differences were found in student enrollment or applications when comparing years prior to and following policy implementation or when comparing with institutions without 100% tobacco-free campus policies. CONCLUSIONS: The authors found no evidence that 100% tobacco-free policy adoption had an impact on student enrollment or applications.

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CONTEXT: There is enough documented evidence to prove the benefits of early and appropriate initiation of education among children with cerebral palsy (CP). AIM: To find out the proportion of children with CP who are enrolled for some kind of formal education and to study the determinants of the same. SETTING AND DESIGN: This cross sectional study was done among children, attending the special clinics at government medical college, Thiruvananthapuram. MATERIALS AND METHODS: Children between 3 and 12 years of age diagnosed with CP were subjects for the study. STATISTICAL ANALYSIS USED: Enrollment for any form of formal education was the major outcome variable. The factors associated with initiation of formal education were tested using Chi-square test or Fischer's exact test. Independent association of each factor was evaluated through binary logistic Regression analysis. RESULTS AND CONCLUSIONS: The mean (SD) age of the children (n = 86) was 5.7 (2.3) years with forty-six (53.5%) of them being girls. Diplegia was the commonest limb abnormality found. Fifty-two (60.5%) children were undergoing some kind of schooling. Those children who were less dependent physically and those who had achieved better language development were regular school goers. After binary logistic regression the ability of a child to speak in sentences (P = 0.008) and ambulatory level of the child (P = 0.019) were factors which favored, whereas delay in attaining the adaptive developmental milestone of transferring objects from one hand to another (P = 0.014) was found to be detrimental for school enrollment.

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sta dissertação de mestrado teve o objetivo de investigar os motivos que levaram os pais de crianças com autismo e deficiência intelectual associada a matricularem seus filhos na educação infantil em escolas de educação especial. Para atender o objetivo proposto, esta pesquisa apresenta um panorama da educação infantil no Brasil, com destaque para a questão da educação especial, abordando as suas ambiguidades presentes nas normas e legislação, além de discutir a respeito da falta de consenso e fragilidade na conceituação e caracterização do autismo e da deficiência intelectual. Foram realizadas entrevistas com pais de crianças com autismo e deficiência intelectual associada, que frequentaram a educação infantil em escola de educação especial. O que se observou nas entrevistas foi que os pais buscaram inicialmente a escola regular para seus filhos, mas devido às dificuldades encontradas, acabaram escolhendo por retirá-los da escola regular e matriculá-los em escolas privadas de educação especial, por acreditarem que estas escolas podem oferecer melhores condições para o processo de escolarização de seus filhos. Ao analisarmos os relatos dos pais à luz da Teoria Critica da Sociedade, levantamos alguns indícios de que a escola de educação especial muitas vezes aparece como a melhor possibilidade de escolarização para crianças com autismo de e deficiência intelectual associada, logo, esta escolha dos pais apresenta uma coerência. No entanto, não houve resistência e enfrentamento dos pais ao se depararem com as dificuldades na inclusão de seus filhos nas escolas de ensino regular, o que indica uma atitude de adaptação destes pais em relação aos limites impostos à escolarização de seus filhos com autismo e deficiência intelectual associada.(AU)

This dissertation aimed to investigate the reasons that parents of children with autism and intellectual disability associated with enrolling their children in early childhood education in special education schools. To meet the proposed objective, this research presents an overview of early childhood education in Brazil, highlighting the issue of special education, approaching their present ambiguity in the rules and legislation, and to discuss about the fragility and lack of consensus in the conceptualization and characterization of autism and intellectual disabilities. Interviews were conducted with parents of children with autism and intellectual disability associated with, who attended early childhood education in special education school. What was observed in the interviews was that parents initially sought a mainstream school for their children, but due to difficulties, just by choosing to remove them from regular school and enroll them in private schools for special education because they believe that these schools may offer better conditions for the process of schooling of their children. When analyzing the parental reports in the light of Critical Theory of Society, lifted some evidence that the special education school often appears as the best possible education for children with autism and intellectual disability associated, so that parental choice has consistency. However, there was no resistance and coping of parents faced with the difficulties in including their children in mainstream schools, which indicates an attitude adjustment of parents in relation to limits on the schooling of their children with autism and disabilities associated intellectual.(AU)

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There are some issues concerning the domains of “attitude” and “habit” which are indispensable for medical students, such as motivation for problem-based learning and acquiring skills for smooth communication with medical staff and patients. In addition, some well-known limitations exist in medical education in these domains. Kochi Medical School has introduced an admissions-office (attitude-evaluation) system for enrollment selection to assess the abilities that applicants have acquired through experiences since birth. Although this system has a very short history, a follow-up survey 1 year after admission strongly suggests that this type of entrance examination system based on attitude evaluation is effective.