Higher Dietary Inflammatory Index Scores Are Associated With Stress and Anxiety in Dormitory-Residing Female University Students in the United Arab Emirates.

Dormitory-residing university students are at-risk of mental health problems related to unhealthy diets. The purpose of this study was to assess the association between dietary inflammatory potential and mental health of dormitory-residing female university students. This cross-sectional study was comprised of 260 undergraduate females residing in dormitories of the largest university in United Arab Emirates during Spring 2019. The Energy-adjusted Dietary Inflammatory Index (E-DIITM) scores calculated from 37 food parameters were derived from two 24-h dietary recalls. The logistic regression analysis was used to estimate odds ratios (ORs) and 95% CIs for the E-DII score in relation to depression, anxiety, and stress. The E-DII scores (mean = 2.98 ± 1.17) were categorized into: tertile 1 (-1.96-2.62), tertile 2 (2.63-3.52), and tertile 3 (3.53-5.60), representing less to more proinflammatory diets. Students in the E-DII tertile 3 had significantly higher depression, anxiety, and stress scores. The logistic regression analysis showed that each point increase in the E-DII score was associated with symptoms of stress (OR = 1.41; 95% CI: 1.12-1.77; p = 0.003) and anxiety (OR = 1.35; 95% CI: 1.07-1.69; p = 0.01). Relative to students in the E-DII tertile 1, those students in the E-DII tertile 3 were more likely to be at higher risk of stress and anxiety ORE-DIItertile3vs1 = 2.89 (1.44-5.79) and 2.88 (1.49-5.56), respectively. Overall, stress and anxiety were associated with proinflammatory diets in dormitory-residing female university students, suggesting the need for targeted interventions to increase the anti-inflammatory capacity of diet and improve mental wellbeing in students on university campuses.

Factors that affect student engagement in online learning in health professions education.

BACKGROUND: Student engagement is vital in achieving learning outcomes and improving students' motivation, involvement, and attitudes toward learning. The aim of this study was to identify the factors that affect student engagement in online learning in medical and health science colleges. METHODS: A cross-sectional study was conducted among medical and health science students and faculty in May 2020. The Online Engagement Strategies Questionnaire was e-mailed to 370 students and 102 faculty members. The SPSS statistical software was used for the statistical analysis. Exploratory factor analysis was performed to identify the factors that affected the students' engagement in online learning. Composite scores were calculated for factors, separately for the student and faculty responses. Descriptive statistical analysis was performed for the student and faculty responses. RESULTS: The response rates of the students and faculty were 85.1% and 74.1%, respectively. The mean ages of the students and faculty were 20.6 and 44.6 years, respectively. Eighty-five percent of the faculty (n = 51) and 88.3% (n = 278) of the students found that the use of technology in proper communication was an important strategy to engage students in online learning. The factor analysis revealed agreement between the students and faculty regarding the factors that support student engagement in online learning. Techno-pedagogical skills were considered very important for faculty and important for students. For both faculty and students, self-directed learning skills were important, and peer-assisted learning (PAL) was fair symmetry. Nevertheless, collaborative learning (CL) was fairly symmetry to students and important to faculty. CONCLUSION: To enhance student engagement in online learning, faculty members should consider improving their techno-pedagogical skills. Moreover, by incorporating self-directed learning, CL and PAL will support student engagement. Finally, faculty development, updating of course design, and institutional policies are all required to support online learning.

Bridging the Gap in Online Learning Anxiety Among Different Generations in Health Professions Education.

OBJECTIVES: This study aimed to examine the effects of an individual's generation group on anxiety related to online learning among students and online learning and teaching activities among faculty. METHODS: This cross-sectional study was conducted at the University of Sharjah, Sharjah, United Arab Emirates, in April 2020 using the Online Course Anxiety Scale. The questionnaires were sent to 370 undergraduate students and 81 faculty members via email and the responses were stratified by generation. Descriptive statistics and an independent sample t-test was used to compare the mean scores of online learning anxiety with gender and previous experience among faculty and students. RESULTS: A total of 358 students and 70 faculty members completed the questionnaire (response rate: 96.8% and 86.4%, respectively). Only 5.7% of the faculty (compared to 54.7% of the students) enjoyed browsing internet resources during online learning. Among the faculty, 75.7% experienced anxiety during online teaching compared to 37.7% of students. Of the faculty, 92.3% of baby boomers felt anxious compared to 70.5% and 76.9% of X and Y generations, respectively. CONCLUSION: While students of Generations Z and Y enjoyed browsing the internet during online learning, the Generation Z students were anxious during online discussions and concerned about the misinterpretation of their written communication. Anxiety among faculty members was related to confusion regarding the use of the internet and computers and misinterpretations of text-based messages.

The Impact of Knowledge, Anxiety and Fear on Psychological Distress during COVID-19 among Residents of the United Arab Emirates.

Objectives: COVID-19 has become a global concern, affecting both physical and mental health. In this study, we measured knowledge, fear, anxiety, and psychological distress related to COVID-19 among residents of the United Arab Emirates (UAE). Methods: A total of 1053 adult participants completed a Web-based cross-sectional survey. Results: Our data revealed 75.7% of the sample to be knowledgeable about COVID-19, 15.3% had experienced anxiety and 50.4%, psychological distress about COVID-19. Being knowledgeable about COVID-19 was significantly associated with having spent one to 2 hours reading about COVID-19. There was also an association between being knowledgeable about COVID-19 and low levels of anxiety and psychological distress. Psychological distress was associated with a history of mental illness (76.2%), anxiety (85.1%), and fear of COVID-19 (21±6.6). Age, history of mental illness (OR = 3.70, 95% CI = 2.35-5.82, p < .001), and COVID-19 anxiety (OR = 2.48, 95% CI = 1.48-4.13, p < .001) and fear (OR = 1.17, 95% CI = 1.14-1.20, p < .001) were risk factors for psychological distress. Conclusion: Our results showed significant psychological distress in the UAE population. Providing pre-recorded workshops and continuous telemedicine on biopsychosocial perspectives of COVID-19 may enhance the COVID-19 insight and reduce the COVID-19 anxiety and psychological distress.

Satisfaction with online learning in the new normal: perspective of students and faculty at medical and health sciences colleges.

Online learning has become the new normal in many medical and health science schools worldwide, courtesy of COVID-19. Satisfaction with online learning is a significant aspect of promoting successful educational processes. This study aimed to identify factors affecting student and faculty satisfaction with online learning during the new normal. Online questionnaires were emailed to students (n = 370) and faculty (n = 81) involved in online learning during the pandemic. The questionnaires included closed- and open-ended questions and were organised into two parts: socio-demographic information and satisfaction with online learning. Descriptive statistics were used to analyse the responses to the satisfaction scales. Students' and faculty responses to the open-ended questions were analysed using the thematic analysis method. The response rate was 97.8% for students and 86.4% for faculty. Overall satisfaction among students was 41.3% compared to 74.3% for faculty. The highest areas of satisfaction for students were communication and flexibility, whereas 92.9% of faculty were satisfied with students' enthusiasm for online learning. Technical problems led to reduced student satisfaction, while faculty were hampered by the higher workload and the required time to prepare the teaching and assessment materials. Study-load and workload, enhancing engagement, and technical issues (SWEET) were the themes that emerged from the thematic analysis as affecting student and faculty satisfaction. Adopting a combination synchronous and asynchronous approach, incorporating different applications to engage students, and timely feedback are imperative to increasing student satisfaction, while institutional support and organisational policy could enhance faculty satisfaction.

Knowledge, Anxiety, Fear, and Psychological Distress About COVID-19 Among University Students in the United Arab Emirates.

Background: Fear of infection, the epidemic situation, unexpected lockdown, and implementation of online classes are most likely affecting the psychological well-being of students during the COVID-19 pandemic. Therefore, this study aims to assess the level of knowledge, anxiety, and psychological distress concerning COVID-19 and their association with fear, gender, age, history of mental illness, time spent reading about COVID-19, program of study, and type of dwelling among students in the United Arab Emirates (UAE). Methods and Materials: In this cross-sectional study, 433 students participated in a web-based survey. These were students at the University of Sharjah, coming from all the emirates of the UAE. Demographic scale, COVID-19 knowledge, anxiety, fear, and psychological distress scales were used to screen these problems. Results: Of the 433 students, 278 (64.2%) were male and 155 (35.8%) were female. Overall, 353 (81.5%) exhibited adequate knowledge of COVID-19. Sixty-nine (15.9%) of students were anxious and 221 (51%) were in psychological distress. Students who exhibited anxiety concerning COVID-19 anxiety (odds ratio [OR]: 2.98) and fear (OR: 1.27), and who spent more than 4 h reading about COVID-19 (OR: 11.20) were more psychologically distressed. Students with a history of mental illness showed adequate knowledge of COVID-19; however, they were more psychologically distressed (OR: 5.93). Older students were less likely to have psychological distress (OR: 0.87). Conclusion: Students possess adequate knowledge concerning COVID-19; however, they are psychologically distressed. Age, dwelling status, history of mental illness, anxiety, and fear significantly predicted psychological distress. Frequent web-based workshops that include insight, guidance, online counseling, scheduled activity, and coping mechanisms for COVID-19 are highly recommended. The authors discuss the implications for future research and provide recommendations for students and educational institutions.

A Cross Sectional Study on Knowledge, Beliefs and Psychosocial Predictors of Shisha Smoking among University Students in Sharjah, United Arab Emirates

Background: Smoking is now prohibited in all educational institutions and other public places in the United Arab Emirates (UAE), but shisha smoking is considered as one of the major problems among the students population. This study aimed to identify the (a) prevalence of ever shisha, current shisha and shisha dependency smokers among university students in the University of Sharjah (UOS), (b) knowledge and belief differences among ever shisha, current shisha as well as shisha dependency smoking students, (c) relationship between precipitating factors and shisha dependency and (d) precipitating factors (stimulation, handling, pleasure, tension reduction, addiction (dependency), automatism (habit) and social interaction, parents smoking behavior, knowledge and beliefs about smoking predict shisha dependency among students in UOS. Materials and Methods: In this cross sectional study, 633 students participated from UOS, UAE. Knowledge and Belief scale, Modified Reason for Smoking Scale and Fagerstrom Test for Nicotine Dependence (FTND) were used to measure knowledge, beliefs, shisha dependency and predictive factors of smoking behavior among undergraduate students in UOS. Results: Nearly103 (16.3%) of students were addictive to shisha smoking based on FTND. Students had adequate knowledge that smoking led to cardiac problems; however, their knowledge about the other consequences of smoking was inadequate and believed that smoking was not harmful. There was a significant positive relationship between addiction, pleasure, social interaction, habit, parental smoking behavior and shisha dependency behavior among current shisha dependency students. Habit, addiction, pleasure, social interaction and parental smoking were the predictors of shisha smoking dependency among this population. Step wise multiple regressions showed that social interaction was the highest significant predictor for shisha dependency behavior. Conclusions: Hence, there is a need to enhance the knowledge and modify irrational beliefs about shisha smoking as these students possess inadequate knowledge about consequences of shisha smoking.

Effects of a combination of non-pharmaceutical psychological interventions on dental anxiety.

BACKGROUND: Dental anxiety is a common problem associated with poorer oral health. Managing anxiety is key to improving oral health of patients with dental anxiety. The present pilot study therefore investigated dental anxiety prevalence among patients visiting a university dental clinic. We further examined the effect of combined psychological interventions on anxiety or concern towards dental treatment procedures before treatment, after treatment, and at follow-up. METHODS: In this prospective pilot study, patients seeking restorative treatment were screened for dental anxiety and dental concern about treatment using the Dental Anxiety Scale-Revised (DAS-R) and Dental Concern Assessment (DCA) questionnaires. Participants with a DAS-R score of 9 or above were randomly assigned to an experimental or control group. The patients in the experimental group received two psycho-logical interventions (psychoeducation and progressive muscular relaxation) prior to dental treatment. Dur-ing treatment, patients received another psychological intervention (music distraction). No psychological interventions were given to control patients. DAS-R and DCA scores were used to assess dental anxiety and concern, respectively, before treatment, after treatment, and at follow-up. Nonparametric tests were used for intergroup and intragroup statistical analyses. RESULTS: Out of 64 patients surveyed, 33 (51.6%) had experienced dental anxiety. Of those, 2 were exclud-ed, and 31 patients with a mean ± SD age of 41.2 ± 15.9 y completed the study. No intergroup differences in dental anxiety were found in terms of pretreatment, posttreatment, and follow-up treatment. The mean rank value of the dental anxiety score was less in the experimental group (13.53) than the control group (18.31), albeit not significant. More specifically, differences (Kruskal-Wallis %2 = 14.82, P = 0.001, effect size = 0.33) were found in the experimental group for pretreatment, posttreatment, and follow-up treatment levels of dental anxiety for extraction (P = 0.01), injection (P = 0.02), and sound/vibration of the drill (P = 0.00). No significant intragroup differences between pretreatment, posttreatment, and follow-up treatment were found in the control group. CONCLUSIONS: The combined brief psychological interventions reduced dental anxiety. RELEVANCE FOR PATIENTS: The psychological interventions of the present study could be applied right before or during dental treatment to reduce the dental anxiety of patients. However, additional research involving larger groups is needed to replicate the results of this pilot study.

The effects of brief individual cognitive behavioural therapy for depression and homesickness among international students in Malaysia.

BACKGROUND: Students who go to other countries for higher education face various psychological problems, particularly homesickness and depression. The objectives of this study were to: (a) identify differences between students who did and did not receive brief individual cognitive behavioural therapy (CBT) for depression to reduce homesickness; (b) identify whether brief individual CBT for depression reduces the level of homesickness in students between pre-, post- and follow-up assessment; and (c) compare the scores of students experiencing only homesickness and those experiencing both homesickness and depression. METHOD: The sample consisted of 520 first-year undergraduate international students. The experimental group contained students who were diagnosed with depression and homesickness and received seven sessions of brief individual CBT for depression to reduce homesickness. The control group contained students who were diagnosed with depression and homesickness and received one session of advice and suggestions. The comparison group contained students who experienced only homesickness and did not receive any interventions. The study used the comparison group to determine if an interaction effect existed between students experiencing only homesickness and students experiencing both homesickness and depression. RESULTS: Students who received brief individual CBT displayed a significant reduction in their homesickness and depression scores compared to the scores of students in the control group. Students who experienced only homesickness exhibited a significant reduction in the scores on homesickness in the post-assessment compared to the control group's post-assessment homesickness scores. LIMITATION: The results of this study cannot be generalized as data were collected from three universities in Malaysia. The follow-up assessment was conducted six months after the post-assessment, which also limits generalizability beyond six months. CONCLUSION: Overall, homesickness is considered a normal reaction. Brief individual CBT for depression is effective in reducing homesickness and depression among international students.

The Prevalence and Inter-Relationship of Negative Body Image Perception, Depression and Susceptibility to Eating Disorders among Female Medical Undergraduate Students.

INTRODUCTION: Female students are thought to be more negatively impacted by body image ideals and often more susceptible to various eating related disorders compared to men. A previous study using a sample of female students in Malaysia did not identify whether the increase in susceptibility to eating disorders can be explained by the level of body image acceptance. AIM: To identify the prevalence of depression and susceptibility to eating disorders among a sample of 206 female students in one of the private universities in Malaysia and explore the relationship between depression, body image and susceptibility to eating disorders. In addition, this study aimed to determine whether depression is a mediator between body image and susceptibility to eating disorders among female college students. MATERIALS AND METHODS: The Body Image Acceptance and Action Questionnaire were used to assess body image acceptance, the Patient Health Questionnaire to measure depression and the Eating Attitude Test- 26 was used to assess susceptibility to eating disorders. RESULTS: The results showed that 65.5% (n=135) of the students were depressed and 6.3% (n=13) were susceptible to eating disorders. There was a significant positive relationship between depression and eating disorders and a negative relationship between body image and depression as well as between body image and eating disorder. Further, the regression model showed that depression was partially mediating the effect of body image on eating disorders. CONCLUSION: Body image and depression contribute to eating disorders and treating depression could reduce susceptibility to eating disorders.

The effectiveness of psychoeducation and systematic desensitization to reduce test anxiety among first-year pharmacy students.

OBJECTIVE: To analyze the effect of psychological intervention on reducing performance anxiety and the consequences of the intervention on first-year pharmacy students. METHODS: In this experimental study, 236 first-year undergraduate pharmacy students from a private university in Malaysia were approached between weeks 5 and 7 of their first semester to participate in the study. The completed responses for the Westside Test Anxiety Scale (WTAS), the Kessler Perceived Distress Scale (PDS), and the Academic Motivation Scale (AMS) were received from 225 students. Out of 225 students, 42 exhibited moderate to high test anxiety according to the WTAS (score ranging from 30 to 39) and were randomly placed into either an experiment group (n=21) or a waiting list control group (n=21). RESULTS: The prevalence of test anxiety among pharmacy students in this study was lower compared to other university students in previous studies. The present study's anxiety management of psychoeducation and systematic education for test anxiety reduced lack of motivation and psychological distress and improved grade point average (GPA). CONCLUSION: Psychological intervention helped significantly reduce scores of test anxiety, psychological distress, and lack of motivation, and it helped improve students' GPA.

Psychological problems and psychosocial predictors of cigarette smoking behavior among undergraduate students in Malaysia.

BACKGROUND: Cigarette smokers have their own motivation and justification to smoke. For example, smoking reduces their stress or enhances their pleasure. This study aimed to identify the (a) prevalence of cigarette smokers among undergraduates in Malaysia, (b) gender differences in nicotine dependence among current smokers, (c) differences in psychological problems (depression, anxiety and stress) based on the status of smoking cigarettes (current, former and non-smokers) and (d) extent to which precipitating factors (tension reduction, addiction, automatism, handling, social interaction, pleasure, and stimulation) predict the smoking behavior among current smokers. MATERIALS AND METHODS: In this study 780 undergraduate students participated from a private university in Kuala Lumpur and Selangor state in Malaysia. The Depression, Stress and Anxiety Scale, Modified Reason for Smoking Scale and Fagerstrom Nicotine Dependence Test were used to measure psychological problems, predictors of smoking behavior and nicotine dependency among current smokers. RESULTS: The results showed that 14.7%(n=106) of the students were smokers. Current smokers exhibited more psychological problems (depression, anxiety and stress) compared to former and non-smokers. Addiction, tension reduction, pleasure and automatism were predictors of smoking behavior among the current smoking students. Step wise regression analysis showed that smoking behavior was highly predicted by nicotine dependency or addiction. Smoking students were motivated to smoke cigarettes as they believed that it reduced their tension and enhance pleasure. CONCLUSIONS: Hence, there is a need for health promotion and anti-tobacco prevention as cigarette smokers experience more psychological problems. Nicotine dependency or addition was one of the major causes for smoking behavior among the student population in Malaysia.

A randomized control study of psychological intervention to reduce anxiety, amotivation and psychological distress among medical students.

BACKGROUND: Test anxiety aggravates psychological distress and reduces the motivation among graduate students. This study aimed to identify psychological intervention for test anxiety, which reduces the level of psychological distress, amotivation and increases the intrinsic and extrinsic motivation among medical students. MATERIALS AND METHODS: Westside test anxiety scale, Kessler Perceived Stress Scale and Academic Motivation Scale were used to measure test anxiety, psychological distress and motivation on 436 1(st) year medical students. Out of 436 students, 74 students who exhibited moderate to high test anxiety were randomly divided into either experimental or waiting list group. In this true randomized experimental study, 32 participants from the intervention group received five sessions of psychological intervention consist of psychoeducation, relaxation therapy and systematic desensitization. Thirty-three students from waiting list received one session of advice and suggestions. RESULTS: After received psychological intervention participants from the intervention group experienced less anxiety, psychological distress, and amotivation (P < 0.01) and high intrinsic and extrinsic motivation (P < 0.01) in the postassessment compared with their preassessment scores. CONCLUSION: Overall psychological intervention is effective to reduce anxiety scores and its related variables.

Medical students' experience of and reaction to stress: the role of depression and anxiety.

BACKGROUND: Medical school is recognized as a stressful environment that often has a negative effect on students' academic performance, physical health, and psychosocial well-being. Previous studies have not identified differences between depressed and nondepressed and anxious and nonanxious medical students' experiences of stress or their reactions to stressors. The present study aimed to identify the prevalence of depression and anxiety among a sample of 358 medical students attending a private university in Malaysia and to examine differences according to participants' gender, year of study, and stage of training (preclinical and clinical). Additionally, this study examined the extent to which stress predicts depression and anxiety, differences between depressed and nondepressed medical students' experiences of and reactions to stressors, and differences between anxious and nonanxious medical students' experiences of and reactions to stressors. METHODS: The Student Life Stress Inventory was used to measure stress and reaction to stressors and the Depression, Anxiety, and Stress Scale was used to measure depression and anxiety. RESULTS: The results showed that 44% (n = 158) of the students were anxious and 34.9% (n = 125) were depressed. More female students exhibited anxiety compared to male students. Stress is a predictor for depression and anxiety. A significant difference was found between depressed and nondepressed and anxious and nonanxious students' experience of stressors due to frustration, change, and their emotional reaction to stressors. CONCLUSION: Overall, depressed and anxious students were found to experience more stress and react differently to stressors compared to nondepressed and nonanxious students.