Catalyst Schools: The Catholic Ethos and Public Charter Schools

During the past decade, Catholic leaders have been exploring options to revitalize the faltering Catholic school system especially in urban centers. One route being explored by dioceses and religious orders is opening what have been called “religious charter schools.” Though not technically religious schools, they integrate many of the same values and pedagogical approaches as found in faith-based schools. In this article, the authors examined three Chicago public charter schools that are modeled on the successful San Miguel Schools, which are run by the Christian Brothers and are located in impoverished urban areas. After interviewing 40 participants, observing 20 classrooms, and reviewing archival documents, the authors described the challenges faced, tensions experienced, and lessons learned while transferring a Lasallian (Christian Brother) educational model into the public sector. Résumé Au cours des dix dernières années, les responsables catholiques ont cherché par quels moyens revitaliser les écoles catholiques en difficulté, notamment dans les centres urbains. L’une des voies explorées par les diocèses et congrégations religieuses consiste à ouvrir ce que l’on appelle des « écoles religieuses sous contrat ». Bien qu’il ne s’agisse pas véritablement d’écoles religieuses, elles intègrent un grand nombre des valeurs et approches pédagogiques que l’on trouve dans les écoles confessionnelles. Dans cet article, les auteurs ont examiné trois écoles publiques sous contrat à Chicago, qui ont pris comme modèle le succès des écoles de San Miguel, dirigées par les Frères des écoles chrétiennes et situées dans des secteurs urbains déshérités. Après avoir interviewé 40 participants, observé 20 salles de classe et examiné des documents d’archives, les auteurs ont décrit les difficultés à surmonter, les tensions ressenties et les enseignements retirés lorsqu’un modèle éducatif lassalien (les Frères des écoles chrétiennes) est transféré dans un établissement public. Resumen Durante la última década, líderes católicos han explorado opciones para revitalizar el defectuoso sistema escolar católico, especialmente en centros urbanos. Las diócesis y órdenes religiosas han explorado una ruta: abrir lo que se llaman “escuelas chárter religiosas”. Aunque técnicamente no son escuelas religiosas, integran muchos de los mismos valores y enfoques pedagógicos tal y como se encuentran en las escuelas religiosas. En el presente artículo, los autores examinan tres escuelas chárter públicas de Chicago que se basan en el modelo exitoso de las escuelas San Miguel, gestionadas por los Christian Brothers (Hermanos Cristianos) y situada en zonas urbanas pobres. Tras entrevistar a 40 participantes, observar 20 aulas y revisar documentos de archivo, los autores describen los retos a los que se enfrentaron, las tensiones que experimentaron y las lecciones que aprendieron al transferir un modelo educativo lasaliano (Hermanos Cristianos) al sector público

Trails and Physical Activity: A Review

To provide a synthesis of research on trails and physical activity from the public health, leisure sciences, urban planning, and transportation literatures. Methods: A search of databases was conducted to identify studies published between 1980 and 2008. Results: 52 studies were identified. The majority were cross-sectional (92*%) and published after 1999 (11%). The evidence for the effects of trails on physical activity was mixed among 3 intervention and 5 correlational studies. Correlates of trail use were examined in 13 studies. Several demographic (eg, race, education, income) and environmental factors (eg, land-use mix and distance to trail) were related to trail use. Evidence from 31 descriptive studies identified several facilitators and barriers to trail use. Economic studies (n = 5) examining trails in terms of health or recreational outcomes found trails are cost-effective and produce significant economic benefits. Conclusion: There is a growing btidy of evidence demonstrating important factors that should be considered in promoting trail use, yet the evidence for positive effects of trails on physical activity is limited. Further research is needed to evaluate the effects of trails on physical activity. In addition, trail studies that include children and youth, older adults, and racial and ethnic minorities are a research priority

Factorial validity of an abbreviated Neighborhood Environment Walkability Scale for seniors in the Nurses’ Health Study

Background: Using validated measures of individuals’ perceptions of their neighborhood built environment is important for accurately estimating effects on physical activity. However, no studies to date have examined the factorial validity of a measure of perceived neighborhood environment among older adults in the United States. The purpose of this measurement study was to test the factorial validity of a version of the Abbreviated Neighborhood Environment Walkability Scale (NEWS-A) modified for seniors in the Nurses’ Health Study (NHS). Findings: A random sample of 2,920 female nurses (mean age = 73 ± 7 years) in the NHS cohort from California, Massachusetts, and Pennsylvania completed a 36-item modified NEWS-A for seniors. Confirmatory factor analyses were conducted to test measurement models for both the modified NEWS-A for seniors and the original NEWS-A. Internal consistency within factors was examined using Cronbach’s alpha. The hypothesized 7-factor measurement model was a poor fit for the modified NEWS-A for seniors. Overall, the best-fitting measurement model was the original 6-factor solution to the NEWS-A. Factors were correlated and internally consistent. Conclusions: This study provided support for the construct validity of the original NEWS-A for assessing perceptions of neighborhood environments in older women in the United States

Factorial Invariance of the Abbreviated Neighborhood Environment Walkability Scale among Senior Women in the Nurses’ Health Study Cohort

The purpose of this study was to examine the factorial invariance of the Abbreviated Neighborhood Environment Walkability Scale (NEWS-A) across subgroups based on demographic, health-related, behavioral, and environmental characteristics among Nurses’ Health Study participants (N = 2,919; age M = 73.0, SD = 6.9 years) living in California, Massachusetts, and Pennsylvania. A series of multi-group confirmatory factor analyses were conducted to evaluate increasingly restrictive hypotheses of factorial invariance. Factorial invariance was supported across age, walking limitations, and neighborhood walking. Only partial scalar invariance was supported across state residence and neighborhood population density. This evidence provides support for using the NEWS-A with older women of different ages, who have different degrees of walking limitations, and who engage in different amounts of neighborhood walking. Partial scalar invariance suggests that researchers should be cautious when using the NEWS-A to compare older adults living in different states and neighborhoods with different levels of population density

Relationships Between the Built Environment and Walking and Weight Status Among Older Women in Three U.S. States

There are few studies of built environment associations with physical activity and weight status among older women in large geographic areas that use individual residential buffers to define environmental exposures. Among 23,434 women (70.0±6.9 years; range = 57-85) in 3 states, relationships between objective built environment variables and meeting physical activity recommendations via walking and weight status were examined. Differences in associations by population density and state were explored in stratified models. Population density (odds ratio (OR)=1.04 [1.02,1.07]), intersection density (ORs=1.18-1.28), and facility density (ORs=1.01-1.53) were positively associated with walking. Density of physical activity facilities was inversely associated with overweight/obesity (OR=0.69 [0.49, 0.96]). The strongest associations between facility density variables and both outcomes were found among women from higher population density areas. There was no clear pattern of differences in associations across states. Among older women, relationships between accessible facilities and walking may be most important in more densely populated settings

Neurodevelopmental and Epilepsy Phenotypes in Individuals With Missense Variants in the Voltage-Sensing and Pore Domains of KCNH5

Background and Objectives KCNH5 encodes the voltage-gated potassium channel EAG2/Kv10.2. We aimed to delineate the neurodevelopmental and epilepsy phenotypic spectrum associated with de novo KCNH5 variants.Methods We screened 893 individuals with developmental and epileptic encephalopathies for KCNH5 variants using targeted or exome sequencing. Additional individuals with KCNH5 variants were identified through an international collaboration. Clinical history, EEG, and imaging data were analyzed; seizure types and epilepsy syndromes were classified. We included 3 previously published individuals including additional phenotypic details.Results We report a cohort of 17 patients, including 9 with a recurrent de novo missense variant p.Arg327His, 4 with a recurrent missense variant p.Arg333His, and 4 additional novel missense variants. All variants were located in or near the functionally critical voltage-sensing or pore domains, absent in the general population, and classified as pathogenic or likely pathogenic using the American College of Medical Genetics and Genomics criteria. All individuals presented with epilepsy with a median seizure onset at 6 months. They had a wide range of seizure types, including focal and generalized seizures. Cognitive outcomes ranged from normal intellect to profound impairment. Individuals with the recurrent p.Arg333His variant had a self-limited drug-responsive focal or generalized epilepsy and normal intellect, whereas the recurrent p.Arg327His variant was associated with infantile-onset DEE. Two individuals with variants in the pore domain were more severely affected, with a neonatal-onset movement disorder, early-infantile DEE, profound disability, and childhood death.Discussion We describe a cohort of 17 individuals with pathogenic or likely pathogenic missense variants in the voltage-sensing and pore domains of Kv10.2, including 14 previously unreported individuals. We present evidence for a putative emerging genotype-phenotype correlation with a spectrum of epilepsy and cognitive outcomes. Overall, we expand the role of EAG proteins in human disease and establish KCNH5 as implicated in a spectrum of neurodevelopmental disorders and epilepsy.</p

Global burden of 288 causes of death and life expectancy decomposition in 204 countries and territories and 811 subnational locations, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

BACKGROUND Regular, detailed reporting on population health by underlying cause of death is fundamental for public health decision making. Cause-specific estimates of mortality and the subsequent effects on life expectancy worldwide are valuable metrics to gauge progress in reducing mortality rates. These estimates are particularly important following large-scale mortality spikes, such as the COVID-19 pandemic. When systematically analysed, mortality rates and life expectancy allow comparisons of the consequences of causes of death globally and over time, providing a nuanced understanding of the effect of these causes on global populations. METHODS The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 cause-of-death analysis estimated mortality and years of life lost (YLLs) from 288 causes of death by age-sex-location-year in 204 countries and territories and 811 subnational locations for each year from 1990 until 2021. The analysis used 56 604 data sources, including data from vital registration and verbal autopsy as well as surveys, censuses, surveillance systems, and cancer registries, among others. As with previous GBD rounds, cause-specific death rates for most causes were estimated using the Cause of Death Ensemble model-a modelling tool developed for GBD to assess the out-of-sample predictive validity of different statistical models and covariate permutations and combine those results to produce cause-specific mortality estimates-with alternative strategies adapted to model causes with insufficient data, substantial changes in reporting over the study period, or unusual epidemiology. YLLs were computed as the product of the number of deaths for each cause-age-sex-location-year and the standard life expectancy at each age. As part of the modelling process, uncertainty intervals (UIs) were generated using the 2·5th and 97·5th percentiles from a 1000-draw distribution for each metric. We decomposed life expectancy by cause of death, location, and year to show cause-specific effects on life expectancy from 1990 to 2021. We also used the coefficient of variation and the fraction of population affected by 90% of deaths to highlight concentrations of mortality. Findings are reported in counts and age-standardised rates. Methodological improvements for cause-of-death estimates in GBD 2021 include the expansion of under-5-years age group to include four new age groups, enhanced methods to account for stochastic variation of sparse data, and the inclusion of COVID-19 and other pandemic-related mortality-which includes excess mortality associated with the pandemic, excluding COVID-19, lower respiratory infections, measles, malaria, and pertussis. For this analysis, 199 new country-years of vital registration cause-of-death data, 5 country-years of surveillance data, 21 country-years of verbal autopsy data, and 94 country-years of other data types were added to those used in previous GBD rounds. FINDINGS The leading causes of age-standardised deaths globally were the same in 2019 as they were in 1990; in descending order, these were, ischaemic heart disease, stroke, chronic obstructive pulmonary disease, and lower respiratory infections. In 2021, however, COVID-19 replaced stroke as the second-leading age-standardised cause of death, with 94·0 deaths (95% UI 89·2-100·0) per 100 000 population. The COVID-19 pandemic shifted the rankings of the leading five causes, lowering stroke to the third-leading and chronic obstructive pulmonary disease to the fourth-leading position. In 2021, the highest age-standardised death rates from COVID-19 occurred in sub-Saharan Africa (271·0 deaths [250·1-290·7] per 100 000 population) and Latin America and the Caribbean (195·4 deaths [182·1-211·4] per 100 000 population). The lowest age-standardised death rates from COVID-19 were in the high-income super-region (48·1 deaths [47·4-48·8] per 100 000 population) and southeast Asia, east Asia, and Oceania (23·2 deaths [16·3-37·2] per 100 000 population). Globally, life expectancy steadily improved between 1990 and 2019 for 18 of the 22 investigated causes. Decomposition of global and regional life expectancy showed the positive effect that reductions in deaths from enteric infections, lower respiratory infections, stroke, and neonatal deaths, among others have contributed to improved survival over the study period. However, a net reduction of 1·6 years occurred in global life expectancy between 2019 and 2021, primarily due to increased death rates from COVID-19 and other pandemic-related mortality. Life expectancy was highly variable between super-regions over the study period, with southeast Asia, east Asia, and Oceania gaining 8·3 years (6·7-9·9) overall, while having the smallest reduction in life expectancy due to COVID-19 (0·4 years). The largest reduction in life expectancy due to COVID-19 occurred in Latin America and the Caribbean (3·6 years). Additionally, 53 of the 288 causes of death were highly concentrated in locations with less than 50% of the global population as of 2021, and these causes of death became progressively more concentrated since 1990, when only 44 causes showed this pattern. The concentration phenomenon is discussed heuristically with respect to enteric and lower respiratory infections, malaria, HIV/AIDS, neonatal disorders, tuberculosis, and measles. INTERPRETATION Long-standing gains in life expectancy and reductions in many of the leading causes of death have been disrupted by the COVID-19 pandemic, the adverse effects of which were spread unevenly among populations. Despite the pandemic, there has been continued progress in combatting several notable causes of death, leading to improved global life expectancy over the study period. Each of the seven GBD super-regions showed an overall improvement from 1990 and 2021, obscuring the negative effect in the years of the pandemic. Additionally, our findings regarding regional variation in causes of death driving increases in life expectancy hold clear policy utility. Analyses of shifting mortality trends reveal that several causes, once widespread globally, are now increasingly concentrated geographically. These changes in mortality concentration, alongside further investigation of changing risks, interventions, and relevant policy, present an important opportunity to deepen our understanding of mortality-reduction strategies. Examining patterns in mortality concentration might reveal areas where successful public health interventions have been implemented. Translating these successes to locations where certain causes of death remain entrenched can inform policies that work to improve life expectancy for people everywhere. FUNDING Bill & Melinda Gates Foundation

Tests and development of perceived and objective built environment measures for physical activity research

In the first study, a commonly used measure of perceived neighborhood environment walkability was tested for factorial invariance by demographic, behavioral, and environmental factors. A sample of 2,919 Nurses\u27 Health Study participants (mean age=73.0 ± 6.9 years) in California, Massachusetts, and Pennsylvania completed mailed surveys in 2008. In a series of multi-group confirmatory factor analyses, invariance was tested by age, presence of walking limitations, frequency of neighborhood walking, population density within a buffer around home, and state of residence. Several measurement model fit indices were examined, including change in the comparative fit index (Delta CFI), to evaluate four increasingly restrictive hypotheses of configural, metric, scalar, and residual invariance. All levels of invariance by age, walking limitations, and neighborhood walking were supported (Delta CFI less than -.01). However, there was a lack of support for scalar invariance by state and population density (Delta CFI = -.02 and -.05, respectively). The sources of scalar non-invariance were identified in two subscales, infrastructure for walking and access to destinations. Overall, evidence for the invariance of the measure of perceived neighborhood environment walkability provides support for its use in older women of different ages, with different degrees of walking limitations, and frequency of neighborhood walking. However, the finding of partial scalar invariance, suggests that researchers should be cautious when examining certain neighborhood environment subscales among residents living in different states and areas with varied levels of population density. In the second study, novel methods in a geographic information system were examined for assessing daily lifespace and built environment exposure and their relation to daily physical activity. Analyses were conducted with an existing data set of global positioning system (GPS) and accelerometer data collected from 148 adult trail users (mean age 43.9 ± 12.9 years, 72.7% white, 51.4% female) in Massachusetts in 2004-2005. Geographic location and physical activity data were collected simultaneously for a period of one to four days. Daily lifespace (i.e., geographic area individuals circulate within during a given day) of 448 days of monitoring were assessed using three geographic information system (GIS) approaches, convex hull polygon, standard deviational ellipse, and line-based buffer. Comparisons were made between the three GIS approaches in the measures of lifespace area and length, population density, land use mix, and greenness and their associations with demographic characteristics of participants and daily moderate-to-vigorous physical activity (MVPA). Variation in lifespace characteristics was also examined by weekend and weekday. Spatial and built environment characteristics of daily lifespaces were strongly correlated (R = .76 to .99) between the three approaches and also yielded similar patterns of associations with individual demographic factors, weekend days, and physical activity. Male gender, white race and weekend days were associated with lower land use mix, lower population density, and higher greenness in daily lifespaces. Male gender and white race were also associated with longer length of lifespace in kilometers. Land use mix and population density were positively associated with MVPA, and greenness was inversely associated with MVPA. The findings from these two studies provide evidence for the utility of novel statistical and geographic information systems methods to test and develop measures of both the perceived and objective built environment. Major strengths of this study included: 1) invariance tests of a commonly used perceived built environment measure across three states and in older women; 2) development of daily built environment measures that account for the spatial and temporal dynamics of human movement; and 3) examination of relationships between daily built environment exposures and objective daily MVPA. (Abstract shortened by UMI.

Spatial clustering of physical activity and obesity in relation to built environment factors among older women in three U.S. states

Background: Identifying spatial clusters of chronic diseases has been conducted over the past several decades. More recently these approaches have been applied to physical activity and obesity. However, few studies have investigated built environment characteristics in relation to these spatial clusters. This study’s aims were to detect spatial clusters of physical activity and obesity, examine whether the geographic distribution of covariates affects clusters, and compare built environment characteristics inside and outside clusters. Methods: In 2004, Nurses’ Health Study participants from California, Massachusetts, and Pennsylvania completed survey items on physical activity (N = 22,599) and weight-status (N = 19,448). The spatial scan statistic was utilized to detect spatial clustering of higher and lower likelihood of obesity and meeting physical activity recommendations via walking. Clustering analyses and tests that adjusted for socio-demographic and health-related variables were conducted. Neighborhood built environment characteristics for participants inside and outside spatial clusters were compared. Results: Seven clusters of physical activity were identified in California and Massachusetts. Two clusters of obesity were identified in Pennsylvania. Overall, adjusting for socio-demographic and health-related covariates had little effect on the size or location of clusters in the three states with a few exceptions. For instance, adjusting for husband’s education fully accounted for physical activity clusters in California. In California and Massachusetts, population density, intersection density, and diversity and density of facilities in two higher physical activity clusters were significantly greater than in neighborhoods outside of clusters. In contrast, in two other higher physical activity clusters in California and Massachusetts, population density, diversity of facilities, and density of facilities were significantly lower than in areas outside of clusters. In Pennsylvania, population density, intersection density, diversity of facilities, and certain types of facility density inside obesity clusters were significantly lower compared to areas outside the clusters. Conclusions: Spatial clustering techniques can identify high and low risk areas for physical activity and obesity. Although covariates significantly differed inside and outside the clusters, patterns of differences were mostly inconsistent. The findings from these spatial analyses could eventually facilitate the design and implementation of more resource-efficient, geographically targeted interventions for both physical activity and obesity