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The COVID-19 pandemic negatively affected students’ mental health, increasing pre-existing psychosocial vulnerabilities. University students worldwide have presented differences in their mental health status; however, cross-country studies comparing students’ mental health during the pandemic are lacking.
Aims
To investigate potential differences between university students from Brazil and those from Germany with respect to (a) depressive symptoms and alcohol and drug consumption, (b) social and emotional aspects (loneliness, self-efficacy, perceived stress, social support and resilience) and (c) attitudes towards vaccination.
Method
Two online cross-sectional studies were conducted with university students during the COVID-19 pandemic in Brazil (November 2021 to March 2022) and in Germany (April to May 2022). Depressive symptoms, alcohol consumption, loneliness, self-efficacy, perceived stress, social support, resilience, sociodemographic information and attitudes towards vaccination were assessed. Data were analysed using univariate and bivariate models.
Results
The total sample comprised N = 7911 university students, with n = 2437 from Brazil and n = 5474 from Germany. Brazilian students presented significantly more depressive symptoms and suicidal thoughts, higher levels of perceived stress, higher frequency of drug or substance consumption, and lower levels of perceived social support and resilience than German students, whereas German students presented higher levels of loneliness than Brazilian students. A more favourable opinion towards vaccinations in general was found among Brazilian students compared with German students.
Conclusions
In both countries, low-threshold (online) counselling targeting university students is needed. The differences between the samples could indicate country and/or cultural differences which justify further research in this area.
Concern that self-harm and mental health conditions are increasing in university students may reflect widening access to higher education, existing population trends and/or stressors associated with this setting.
Aims
To compare population-level data on self-harm, neurodevelopmental and mental health conditions between university students and non-students with similar characteristics before and during enrolment.
Method
This cohort study linked electronic records from the Higher Education Statistics Agency for 2012–2018 to primary and secondary healthcare records. Students were undergraduates aged 18 to 24 years at university entry. Non-students were pseudo-randomly selected based on an equivalent age distribution. Logistic regressions were used to calculate odds ratios. Poisson regressions were used to calculate incidence rate ratios (IRR).
Results
The study included 96 760 students and 151 795 non-students. Being male, self-harm and mental health conditions recorded before university entry, and higher deprivation levels, resulted in lower odds of becoming a student and higher odds of drop-out from university. IRRs for self-harm, depression, anxiety, autism spectrum disorder (ASD), drug use and schizophrenia were lower for students. IRRs for self-harm, depression, attention-deficit hyperactivity disorder, ASD, alcohol use and schizophrenia increased more in students than in non-students over time. Older students experienced greater risk of self-harm and mental health conditions, whereas younger students were more at risk of alcohol use than non-student counterparts.
Conclusions
Mental health conditions in students are common and diverse. While at university, students require person-centred stepped care, integrated with local third-sector and healthcare services to address specific conditions.
Suicidal behaviours among students pose a significant public health concern, with mental health problems being well-established risk factors. However, the association between food insecurity (FIS) and suicidal behaviours remains understudied, particularly in Bangladesh. This study aimed to investigate the relationship between FIS and suicidal behaviours among Bangladeshi university students.
Design:
A cross-sectional survey using convenience sampling was conducted between August 2022 and September 2022. Information related to socio-demographics, mental health problems, FIS and related events and suicidal behaviours were collected. Chi-squared tests and multivariable logistic regression models, both unadjusted and adjusted, were employed to examine the relationship between FIS and suicidal behaviour.
Setting:
Six public universities in Bangladesh.
Participants:
This study included 1480 students from diverse academic disciplines.
Results:
A substantial proportion of respondents experienced FIS, with 75·5 % reporting low or very low food security. Students experiencing FIS had a significantly higher prevalence of suicidal ideation, plans and attempts compared with food-secure students (18·6 % v. 2·8 %, 8·7 % v. 0·8 % and 5·4 % v. 0·3 %, respectively; all P < 0·001). In addition, students who have personal debt and participate in food assistance programmes had a higher risk of suicidal behaviours.
Conclusions:
This study highlights the association between FIS and suicidal behaviours among university students. Targeted mental health screening, evaluation and interventions within universities may be crucial for addressing the needs of high-risk students facing FIS.
University students are a unique population subgroup, who experience a life transition into adulthood, often marked by the establishment of unhealthy eating behaviours(1) which are associated with chronic disease risk factors, poor mental health and lower academic achievement(2). Data regarding the food skills/behaviours of university students is limited, but low cooking self- efficacy and food skills are potential barriers to healthy meal preparation(1). Nourished@Deakin is an online cooking program, co-designed by Deakin University students, that aims to inspire students to cook and eat healthier. It commenced in November 2021 and includes a series of blogs, recipes, and cooking videos, available to all Deakin students via a Deakin University blog site. To determine if accessing Nourished@Deakin improves food skill confidence, food intake, and nutrition knowledge, participants completed a short online survey before accessing Nourished@Deakin materials and then again four weeks after their first engagement. The survey included 31 questions regarding confidence related to a variety of food skills (eg. recipe following, reading food labels, meal planning); 2 questions regarding fruit/vegetable intake; 11 knowledge questions regarding the Australian Dietary Guidelines (ADGs); and 16 demographic questions. Pre/post surveys were compared using paired t tests (knowledge scores, fruit/veg serves) or McNemar extact test (proportions). A total of 108 students completed the pre-survey and 41 (mean (SD) age 27.0 (8.4) years; 63% female) also completed the post-survey. Of the 41 participants who completed both surveys, 42% were studying within the Faculty of Health and 16 (39%) were living in the family home with parents. Most (68%) were studying full time and 59% were employed part-time/casually. Three-quarters were domestic students, and 59% were undergraduate students. Following completion of Nourished@Deakin, there was a significant increase in the proportion of participants feeling confident in two of the 31 food skills (namely ‘meal planning’: 44% pre vs 63% post, P<0.05; and ‘growing fruit and/or vegetables at home’: 22% pre vs 44% post, P<0.05). Fruit intake increased from 1.6 serves/day pre-program to 1.9 serves/day post-program (P<0.05), but vegetable intake remained stable (2.5 serves/day pre and 2.6 serves/day post, P = 0.287). Before participating in Nourished@Deakin, 56% of participants correctly reported the recommended daily serves of fruit and 66% correctly reported it for vegetables. The mean ADG knowledge score was 8.2/9 and 49% of participants got all nine questions correct. There were no significant changes in any of the knowledge markers post-program. Over a relatively short period, Nourished@Deakin produced modest improvements in the self-reported confidence in some food skills and self-reported fruit intake. A revised program (incorporating a greater variety of recipes, additional blogs, and new videos) may encourage greater engagement and result in increased confidence and knowledge in other targeted areas.
In a rapidly changing academic-scientific context, it is essential to adapt new learning strategies that foster the acquisition of new knowledge and the development of skills in future professionals, such as interacting synergistically with disciplines outside their own to execute projects successfully and comprehensively. The adaptation is only possible thanks to the inter and transdisciplinarity that Astrobiology has promoted since its inception. We use the term transdisciplinary for education that integrates different disciplines in a way to build new knowledge and increase the student's knowledge and skills. For this reason, this study aimed to demonstrate that an astrobiological stratospheric balloon launch project cultivates transdisciplinary awareness in participants: undergraduate university students in Lima, Peru. The sample consisted of 15 students from the following disciplines: biology, genetics, chemical engineering, physics, industrial engineering, agri-food engineering, forestry engineering, electronics engineering, mechatronics engineering, geology, geological engineering, philosophy, social communication, audiovisual communication and education. Using a semi-structured in-depth interview technique, experts validated the questions from the Universidad Nacional Mayor de San Marcos, Peru, and a matrix of meaning was constructed to classify the responses, ultimately obtaining the categories: contribution, complementarity and quantity. The participants' responses were processed and analyzed with Chat-GPT 3.5, revealing unanimous agreement that each participant's discipline contributed to the success of the balloon launch. To complement the qualitative interpretation of the results, a quantitative measurement was conducted to minimize subjective biases. Additionally, they gained knowledge and insights into other unfamiliar study subjects, collaborated to improve process quality, shared and harmonized their ideas to implement comprehensive solutions, and affirmed that their university education is often isolated or strictly focused on their specialization. In conclusion, experiences where different areas of knowledge converge in praxis, have the potential to awaken new technical, cognitive and communication skills in the individuals involved, utilizing astrobiological resources to invigorate and strengthen collective learning.
University life is a critical period for establishing healthy eating habits and attitudes. However, university students are at risk of developing poor eating habits due to various factors, including economic conditions, academic stress and lack of information about nutritional concepts. Poor diet quality leads to malnutrition or overnutrition, increasing the risk of preventable diseases. Food environments on university campuses also play a significant role in shaping the dietary habits of students, with the availability of and accessibility to healthy food options being important factors influencing food choices and overall diet quality. Disordered eating habits and body dissatisfaction are prevalent among university students and can lead to eating disorders. Income and living arrangements also influence dietary habits, with low household income and living alone being associated with unhealthy eating habits. This study is a narrative review that aimed to address nutritional issues and eating behaviours, specifically among university students. We investigated the eating behaviours of university students, including their dietary patterns, food choices and food environments. The objective of this review was to provide insights into the nutritional issues and eating behaviours of university students, with the aim of identifying target areas for intervention to improve the overall health and wellbeing among college students. University food environments need to be restructured to promote healthy eating, including the availability, accessibility, affordability and labelling of healthy foods, and policies to limit the availability of unhealthy foods and drinks on campus.
Self-harm is a significant problem in university students because of its association with emotional distress, physical harm, broader mental health issues and potential suicidality. Research suggests that fewer than half of students who have self-harmed seek professional help when at university.
Aims
This study aimed to explore the help-seeking journeys of university students who had engaged in self-harm, to identify perceived facilitators and barriers to securing both formal and informal support.
Method
Participants comprised 12 students who had self-harmed during their university tenure. Engaging in two semi-structured interviews over the academic year, they shared insights into their help-seeking behaviours and proposed enhancements to local services. Data underwent reflexive thematic analysis within a critical realist framework.
Results
The analysis identified four themes: ‘The initial university phase poses the greatest challenge’, ‘Perceived criteria for “valid” mental health problems’, ‘Evading external judgements, concerns and consequences’ and ‘The pivotal role of treatment options and flexibility in recovery’.
Conclusions
Students felt isolated and misunderstood, which amplified self-harming tendencies and diminished inclinations for help-seeking. A prevalent belief was that for self-harm to be deemed ‘valid’, it must manifest with a certain severity; however, concurrent fears existed around the ramifications of perceived excessive severity. Participants expressed a desire for streamlined pathways to mental health resources, encompassing both university and external mental health services. Insights from this study could guide future research and inform current service paradigms within academic and healthcare systems.
Grieve et al. (2022) tested the effects of an intervention designed to reduce perfectionism. Contrary to their hypotheses, the intervention reduced both perfectionism and excellencism. Furthermore, excellencism positively correlated with negative outcomes (e.g. anxiety).
Aims:
A theory-driven framework (with five hypothetical scenarios) is proposed to reconsider how we interpret the effectiveness of interventions designed to reduce perfectionism. Our goal was to offer a constructive reinterpretation of the results of Grieve et al. (2022) using our new framework derived from the Model of Excellencism and Perfectionism.
Method:
Secondary data analyses using the experimental and correlational results are published in the randomized control trial of Grieve et al. (2022).
Results:
Our re-examination of the results reveals that excellencism was reduced by a smaller extent (approximately 25% less) than perfectionism. Based on our framework, such a ratio provides conclusive evidence for the effectiveness of this intervention. Students entered the intervention as perfectionists and they ended up somewhere between the zones of excellence striving and non-perfectionism. Furthermore, our multivariate re-analysis of the bivariate correlations indicates that excellence strivers experienced better adjustment (lower anxiety, depression, stress, body-related acceptance, and higher self-compassion) compared with perfectionists.
Conclusion:
Future interventions should target the reduction of perfectionism and the maintenance of excellencism because excellencism relates to desirable outcomes. Our secondary data analysis was needed to inform researchers and practitioners about an alternative interpretation of Grieve and colleagues’ findings. Future interventions to reduce perfectionism should closely monitor excellencism and follow the interpretational guidelines advanced in this article.
Sleep problems associated with poor mental health and academic outcomes may have been exacerbated by the COVID-19 pandemic.
Aims
To describe sleep in undergraduate students during the COVID-19 pandemic.
Method
This longitudinal analysis included data from 9523 students over 4 years (2018–2022), associated with different pandemic phases. Students completed a biannual survey assessing risk factors, mental health symptoms and lifestyle, using validated measures. Sleep was assessed with the Sleep Condition Indicator (SCI-8). Propensity weights and multivariable log-binomial regressions were used to compare sleep in four successive first-year cohorts. Linear mixed-effects models were used to examine changes in sleep over academic semesters and years.
Results
There was an overall decrease in average SCI-8 scores, indicating worsening sleep across academic years (average change −0.42 per year; P-trend < 0.001), and an increase in probable insomnia at university entry (range 18.1–29.7%; P-trend < 0.001) before and up to the peak of the pandemic. Sleep improved somewhat in autumn 2021, when restrictions loosened. Students commonly reported daytime sleep problems, including mood, energy, relationships (36–48%) and concentration, productivity, and daytime sleepiness (54–66%). There was a consistent pattern of worsening sleep over the academic year. Probable insomnia was associated with increased cannabis use and passive screen time, and reduced recreation and exercise.
Conclusions
Sleep difficulties are common and persistent in students, were amplified by the pandemic and worsen over the academic year. Given the importance of sleep for well-being and academic success, a preventive focus on sleep hygiene, healthy lifestyle and low-intensity sleep interventions seems justified.
Energy drinks gained popularity after the launch of Red Bull in 1997. Different brands are now available and young adults mainly consume these drinks. This study assesses the knowledge, attitude, and perception of energy drink consumption among university students in Jordan. A validated online survey was used to collect the required data, extracted from Google Forms into an Excel spreadsheet and statistically analysed using Statistical Package for Social Sciences version 24.0. A nationally representative sample of university students with a mean age of 22⋅2 ± 3⋅9 years (n 749) was obtained. The participating students demonstrated a neutral level of knowledge about energy drinks, as the mean score of knowledge = 7⋅1 ± 2⋅2 (out of 12), with 66 % (n 498) of them having consumed energy drinks and experienced their effects. Generally, the study's participants demonstrated a neutral attitude towards energy drinks and 70⋅5 % (n 528) acknowledged that energy drinks increase activity, but more than 70 % of them believed that energy drinks have harmful side effects. It was found that there is a significant (P-value <0⋅5) positive correlation between knowledge score and female gender, studying a medical major, and monthly income. The main reasons for consuming energy drinks were reported to be: to stay awake for longer, help study, and become more energetic. There is a need for more structured awareness campaigns to warn students about the possible side effects of these products in order to reduce the consumption and popularity of these drinks among students.
University students face vast mental health challenges, and both attitudinal and structural barriers to seeking care. Embedding interventions in college courses is one solution. Acceptance and commitment therapy (ACT) is an ideal candidate intervention given its emphasis on values, context, and skill building from a transdiagnostic perspective. This study embedded a brief ACT intervention in a required freshman seminar that was delivered by trained but unlicensed graduate students. In two class sessions of the freshman seminar taught by the same instructor, one session was randomly assigned to receive the course as usual, and one session received the ACT intervention. ACT content was delivered to all students in the intervention course on five consecutive weekly class periods. Students in both classes who chose to participate in the study completed assessments before and after the intervention and at follow-up. There were no significant changes with tests that were run, including non-parametric tests given the small sample sizes. Descriptively, the intervention group had slight improvements in wellbeing and mindfulness and decreases in distress, and the control group had worsened wellbeing, mindfulness and distress. A moderate portion of intervention group students enjoyed the intervention and indicated use of ACT skills, particularly mindfulness. Results suggest that this classroom-based intervention was feasible and acceptable, but further study should occur given small sample sizes. Future work should continue course-based ACT interventions, and should also explore potential applications of student training to deliver interventions given the shortage of mental health providers on college campuses.
Key learning aims
(1) Can acceptance and commitment therapy content and skills be integrated into an existing freshman seminar curriculum?
(2) Can acceptance and commitment therapy improve wellbeing and decrease distress amongst college students?
(3) How will students engage with and practise acceptance and commitment therapy skills outside of the context of session delivery?
The goal of this study is to evaluate university students’ perceptions of tap water safety and water filter use and determine how these perceptions and behaviours affect water and sugar-sweetened beverage intake.
Design:
Cross-sectional; online survey conducted in Fall 2021.
Setting:
A large, public Midwestern university in the USA.
Participants:
Seven-hundred ninety-three university students.
Results:
Students who experienced food insecurity, were on a Pell grant, were first-generation college students or were racial/ethnic minorities were less likely to trust tap water safety. Tap water filtration behaviour also varied by age and race/ethnicity. Students who did not agree with the statement ‘my local tap water is safe to drink’ had lower odds of consuming ≥ 3 cups of total water per day (OR = 0·45, 95 % CI: 0·32, 0·62), lower odds of consuming tap water ≥ 3 times/d (OR = 0·46, 95 % CI: 0·34, 0·64), higher odds of drinking bottled water ≥ 1 time per day (OR = 1·80, 95 % CI: 1·22, 2·66) and higher odds of drinking SSB ≥ 1 time per day (OR = 1·47, 95 % CI: 1·01, 2·14) than those who agreed. Students who always or sometimes filtered their tap water had lower odds of consuming ≥ 3 cups of total water per day (OR = 0·59, 95 % CI: 0·39, 0·90) than students who never filtered their tap water.
Conclusions:
Tap water perceptions and behaviours affect tap and bottled water and SSB intake among university students. Tap water perceptions and behaviours in this demographic provide important context for university programming promoting healthy beverage initiatives.
Mental disorders are common among university students. In the face of a large treatment gap, resource constraints and low uptake of traditional in-person psychotherapy services by students, there has been interest in the role that digital mental health solutions could play in meeting students’ mental health needs. This study is a cross-sectional, qualitative inquiry into university students’ experiences of an online group cognitive behavioural therapy (GCBT) intervention. A total of 125 respondents who had participated in an online GCBT intervention completed a qualitative questionnaire, and 12 participated in in-depth interviews. The findings provide insights into how the context in which the intervention took place, students’ need for and expectations about the intervention; and the online format impacted their engagement and perception of its utility. The findings of this study also suggest that, while online GCBT can capitalise on some of the strengths of both digital and in-person approaches to mental health programming, it also suffers from some of the weaknesses of both digital delivery and those associated with in-person therapies.
The protective effect of the Mediterranean Diet (MeDi) is undisputed. However, adherence to MeDi has decreased in recent years, particularly in young people. The aim of this study was to evaluate adherence to MeDi in medical students and to assess the influence of knowledge acquisition as well as other factors on dietary compliance.
Design:
A cross-sectional study was conducted on medical students. The data were obtained through anonymous surveys that collected demographic characteristics, medical history, alcohol and tobacco consumption, physical activity and adherence to MeDi – using 14-point Mediterranean Diet Adherence Score (MEDAS) –. Adherence to MeDi and related factors were evaluated by univariate and multivariable analysis.
Participants:
Medical students from the first to the sixth year of the 2018–2019 academic year.
Setting:
The study was conducted at the university of Las Palmas de Gran Canaria.
Results:
Of 589 respondents (73 % women) mean aged 22 years (range 18–39), 58·9 % showed good adherence to MeDi. Adherence was significantly associated with age (P = 0·017) but not with sex or the presence of comorbidities. Independently, adherence to MeDi was higher in last academic courses (OR = 2·1; 95 % CI = 1·3, 3·2; P = 0·001), in those who consumed alcohol more frequently (OR = 1·5; 95 % CI = 1·0, 2·1; P = 0·039) and in those who practiced more exercise (OR = 1·5; 95 % CI = 1·2, 1·9; P < 0·001).
Conclusions:
Half of all medical students did not have a good adherence to MeDi. Adherence was higher at older age in higher academic years and related to greater physical activity. It would be convenient to quantify dietary knowledge as well as implement nutritional educational programmes, favouring a healthy lifestyle.
This study examined the mediating role of civic skill-acts and direct associations of group identity on intentions to engage in peaceful or radical protest actions (i.e., activism or radicalism intentions respectively). A sample of 526 university students in Hong Kong was surveyed. The findings suggested that political identity complementarily mediated the relationship between joining political activities and radicalism intentions. Religious identity and ethnic/racial identity each have an indirect-only mediation to activism as well as radicalism intentions when mediated by community activities and responding activities respectively. Finally, political identity and economic identity each have direct-only mediations to activism intentions respectively. These results suggest that although group identity and civic skill-acts uniquely contribute to protest intentions, the inter-relationship is complicated by the type of group identity, civic skill-act, and protest activity studied. Recommendations for future studies are discussed in light of the findings.
The high prevalence of mental health problems among university students poses a challenge when developing effective interventions, with digital technologies emerging as a potential resource to address this problem. The inclusion of student input in the design and development of such interventions is critical to improving their impact. This study contributed to the initial phase of a research project that aims to adapt and evaluate the feasibility and acceptability of an early intervention for anxiety and depression based on digital technologies for university students. Three participatory workshops were conducted with 13 university students in Chile to inquire about the features and content that a mental health mobile app should include to meet their needs and preferences. The workshop transcripts were analysed using inductive thematic analysis. The results of this study highlight the value of modifications such as the personalisation of some features of the app. The students recommended incorporating topics related to university life and the possibility of contacting a mental health professional, as well as the inclusion of peer interaction or other forms of support.
The bacterium Neisseria meningitidis causes life-threatening disease worldwide, typically with a clinical presentation of sepsis or meningitis, but can be carried asymptomatically as part of the normal human oropharyngeal microbiota. The aim of this study was to examine N. meningitidis carriage with regard to prevalence, risk factors for carriage, distribution of meningococcal lineages and persistence of meningococcal carriage. Throat samples and data from a self-reported questionnaire were obtained from 2744 university students (median age: 23 years) at a university in Sweden on four occasions during a 12-month period. Meningococcal isolates were characterised using whole-genome sequencing. The carriage rate among the students was 9.1% (319/3488; 95% CI 8.2–10.1). Factors associated with higher carriage rate were age ≤22 years, previous tonsillectomy, cigarette smoking, drinking alcohol and attending parties, pubs and clubs. Female gender and sharing a household with children aged 0–9 years were associated with lower carriage. The most frequent genogroups were capsule null locus (cnl), group B and group Y and the most commonly identified clonal complexes (cc) were cc198 and cc23. Persistent carriage with the same meningococcal strain for 12 months was observed in two students. Follow-up times exceeding 12 months are recommended for future studies investigating long-term carriage of N. meningitidis.
In the last decade, the increased complexity of, and levels of access to, financial products and services, together with rising household debt and the funding of an ageing population, have prompted the State to place increased focus on financial education, with the dual objectives of regulating to enhance market efficiency and mitigating social welfare issues attributed to poor financial decisions. Financial literacy is crucial for young adults as they embark on life events involving major expenditure and debt, particularly for university students who have already accrued a debt based on Higher Education contribution scheme liability and who are making labour market decisions. This paper investigates the determining factors of personal financial literacy levels among a sample of university students at different stages of study and across diverse study areas including business, education, arts, humanities and the sciences; with some interesting findings for policy makers. It also provides indicative evidence of students’ preferred method of learning more about personal finance to facilitate the effective design of personal financial literacy programs.
This cross-sectional study aimed to examine factors potentially associated with psychological distress among undergraduate students during the coronavirus disease 2019 pandemic in Japan.
Methods:
We analyzed data of 958 undergraduates (median age 20 y; 56.8% women) from a Web-based, self-administered questionnaire survey conducted from August to September 2020. Prevalence ratios (PRs) for psychological distress defined as 5 points or over of the Kessler Psychological Distress Scale (K6) were calculated by Poisson regression models.
Results:
The proportion of psychological distress was 40.0%. In the mutually-adjusted model, the following were significantly associated with psychological distress: decreases in household income to 50-99% of the prepandemic amount compared with no change (PR = 1.48), newly experiencing unpaid wages compared with no experience (PR = 1.44), insufficient money to buy necessities compared with no shortage (PR = 1.45), receiving a student loan or scholarship compared with none (PR = 1.27), and communication 1 to 3 times a month compared with at least once a week (PR = 1.22). In contrast, school closure during the pandemic compared with no closure was inversely associated with psychological distress (PR = 0.78).
Conclusions:
Among undergraduate students in Japan, economic difficulties significantly predicted psychological distress.