Food and mental health: relationship between food and perceived stress and depressive symptoms among university students in the United Kingdom.

AIMS: The current study assessed, by university and sex, the association between nutritional behaviour (twelve independent variables), and stress and depressive symptoms (dependent variables) in a sample from three UK countries. METHODS: A cross-sectional survey was undertaken among undergraduates enrolled across seven universities in England, Wales and Northern Ireland (N = 3,706). Self-administered questionnaires included a 12-item food frequency questionnaire, Cohen's Perceived Stress Scale and modified Beck Depression Inventory. Sex and university comparisons were undertaken. Univariable and multivariable regression analyses were computed for each of the two outcomes--perceived stress and depressive symptoms. RESULTS: The frequencies of consuming of the various food groups differed by university and sex, as did depressive symptoms and perceived stress. Multivariable regression analyses indicated that consuming 'unhealthy' foods (e.g. sweets, cookies, snacks, fast food) was significantly positively associated with perceived stress (females only) and depressive symptoms (both males and females). Conversely, consuming 'healthy' foods (e.g. fresh fruits, salads, cooked vegetables) was significantly negatively associated with perceived stress and depressive symptoms scores for both sexes. There was significant negative association between consuming fish/sea food and depressive symptoms among males only. For males and for females, consuming lemonade/soft drinks, meat/sausage products, dairy/dairy products, and cereal/cereal products were not associated with either perceived stress or depressive symptoms. CONCLUSIONS: The associations between consuming 'unhealthy' foods and higher depressive symptoms and perceived stress among male and female students as well as the associations between consuming 'healthy' foods and lower depressive symptoms and perceived stress among male and female students in three UK countries suggest that interventions to reduce depressive symptoms and stress among students could also result in the consumption of healthier foods and/or vice versa.

What Makes People With Chronic Illnesses Discontinue Treatment? A Practice Theory Informed Analysis of Adherence to Treatment among Patients With Drug-Resistant Tuberculosis in Pakistan.

BACKGROUND: Non-adherence to treatment is a frequently observed phenomenon amongst those on long-term treatment for chronic illnesses. This qualitative study draws upon the tenets of 'practice theory' to reveal what shapes patients' ability to adhere to the demanding treatment for drug-resistant tuberculosis (DR-TB) at three treatment sites in Khyber-Pakhtunkhwa (KP) province of Pakistan. METHODS: This qualitative study involved observation of service provision over a period of nine months of stay at, and embedment within the three treatment sites and in-depth interviews with 13 service providers and 22 patients who became non-adherent to their treatment. RESULTS: Consistent with the extensive research based on the barriers and facilitator approach, both patients, and providers in our study also talked of patients' doubts about diagnosis and treatment efficacy, side-effects of drugs, economic constraints, unreliable disbursements of monetary incentive, attitude of providers and co-morbidities as reasons for non-adherence to treatment. Applying a practice theory perspective yielded more contextualised insights; inadequate help with patients' physical complaints, unempathetic responses to their queries, and failure to provide essential information, created conditions which hindered the establishment and maintenance of the 'practice' of adhering to treatment. These supply-side gaps created confusion, bred resentment, and exacerbated pre-existing distrust of public health services among patients, and ultimately drove them to disengage with the TB services and stop their treatment. CONCLUSION: We argue that the lack of supply-side 'responsiveness' to patient needs beyond the provision of a few material inputs is what is lacking in the existing DR-TB program in Pakistan. We conclude that unless Pakistan's TB program explicitly engages with these supply side, system level gaps, patients will continue to struggle to adhere to their treatments and the TB program will continue to lose patients. Conceptually, we make a case for reimagining the act of adherence (or not) to long-term treatment as a 'Practice.'

Health promoting behaviours and lifestyle characteristics of students at seven universities in the UK.

AIMS: University students' wellbeing and health promoting and damaging behaviours are important and comprise many parameters. The purpose of this study was to assess a range of health behaviours and lifestyle characteristics of 3,706 undergraduate students from seven universities in England, Wales and Northern Ireland. We compared differences in these parameters between males and females, and across the participating universities. METHODS: A self-administered questionnaire assessed socio-demographic information (e.g., gender, age), nutrition, dietary intake and food consumption patterns, as well as the importance of healthy eating, three levels of physical activity, restful sleep, tobacco smoking, use of illicit substance (recreational drugs), frequency of binge drinking and problem drinking. The data was collected in 2007-2008. RESULTS: While females generally reported lower use of tobacco, illicit substances and alcohol (binge drinking/problem drinking) and consumed more fruits and vegetables, male students had a higher level of physical activity, consumed less sweets and had more restful sleep. When lifestyle characteristics of students were compared between the different universities we observed some 'clustering' of the parameters under study, whereby favourable health practices would be exhibited at some universities; and conversely, the clustering of less favourable practices exhibited at other participating sites. CONCLUSIONS: We conclude that only a minority of students exhibited positive health practices above recommended levels and the level of binge drinking and problem drinking was high. This calls for increased awareness of university administrators, leaders and policy makers to the risky health habits of their students. The observed clustering effects also indicate the need for local (university-specific) health profiles as basis and guidance for relevant health promotion programmes at universities.

Risk factors associated with multi-drug-resistant Acinetobacter baumannii nosocomial infections at a tertiary care hospital in Makkah, Saudi Arabia - a matched case-control study.

Objective To determine risk factors for multi-drug-resistant Acinetobacter baumannii (MDR-AB) nosocomial infections in intensive care units in a tertiary care hospital, Makkah, Saudi Arabia. Methods We performed a hospital-based, matched case-control study in patients who were admitted to Al Noor Specialist Hospital between 1 January 2012 and 31 August 2012. The study included cases of A. baumannii nosocomial infection and controls without infection. Controls were matched to cases by age and ward of admission. Results The most frequent site of infection was the respiratory tract (77.3%). Susceptibility to antimicrobial MDR-AB was 92.0% for ceftazidime and ciprofloxacin, while it was 83.3% for imipenem, 83.0% for trimethoprim, 79.0% for amikacin, and 72.7% for gentamicin. Multiple logistic regression of risk factors showed that immunosuppression (OR = 2.9; 95% CI 1.5-5.6; p = 0.002), clinical outcome (OR = 0.4; 95% CI 0.3-0.9; p = 0.01), invasive procedures (OR = 7.9; 95% CI 1.8-34.2; p = 0.002), a central venous catheter (OR = 2.9; 95% CI 1.5-5.6; p = 0.000), and an endotracheal tube (OR = 3.4; 95% CI 1.6-7.3; p = 0.001) were associated with MDR-AB. Conclusions Acinetobacter nosocomial infections are associated with admission to the ICU (Intensive care unit) and exposure to invasive procedures.

Feeling healthy? A survey of physical and psychological wellbeing of students from seven universities in the UK.

University students' physical and psychological health and wellbeing are important and comprise many variables. This study assessed perceived health status in addition to a range of physical and psychological wellbeing indicators of 3,706 undergraduate students from seven universities in England, Wales and Northern Ireland. We compared differences in these variables across males and females, and across the participating universities. The data was collected in 2007-2008. A self-administered questionnaire assessed socio-demographic information (e.g., gender, age), self-reported physical and psychological health data, as well as questions on health awareness, health service use, social support, burdens and stressors and university study related questions. While females generally reported more health problems and psychological burdens, male students felt that they received/had fewer persons to depend on for social support. The comparisons of health and wellbeing variables across the different universities suggested some evidence of 'clustering' of the variables under study, whereby favourable situations would be exhibited by a cluster of the variables that is encountered at some universities; and conversely, the clustering of less favourable variables as exhibited at other universities. We conclude that the level of health complaints and psychological problems/burdens is relatively high and calls for increased awareness of university administrators, leaders and policy makers to the health and well-being needs of their students. The observed clustering effects also indicated the need for local (university-specific) health and wellbeing profiles as basis and guidance for relevant health promotion programmes at universities.

Does the association between depressive symptomatology and physical activity depend on body image perception? A survey of students from seven universities in the UK.

This cross-sectional study assessed the association between depression and PA in university students of both genders and the role of body image perception as a potential effect modifier. Undergraduate students (N = 3706) from seven universities in the UK completed a self-administered questionnaire that assessed sociodemographic information; a range of health, health behaviour and health awareness related factors; the modified version of Beck's Depression Inventory (M-BDI); educational achievement, and different levels of physical activity (PA), such as moderate PA (at least 5 days per week moderate exercise of at least 30 minutes), and vigorous PA (at least 3 days per week vigorous exercise of at least 20 minutes). Only 12.4% of the sample achieved the international recommended level for moderate PA, and 33.1% achieved the recommendations for vigorous PA. Both moderate and vigorous PA were inversely related to the M-BDI score. Physically active students, regardless of the type of PA, were significantly more likely to perceive their health as good, to have higher health awareness, to perform strengthening exercises, and to be males. The stratified analyses indicated that the association between depression and PA differed by body image. In students perceiving their body image as 'just right', moderate (>4th percentile) and high (>5th percentile) M-BDI scores were inversely related to vigorous PA. However, in students who perceived their body image as 'overweight', the inverse association was only significant in those with high M-BDI scores. We conclude that the positive effect of PA on depression could be down modulated by the negative impact of a 'distorted' body image on depression. The practical implications of these findings are that PA programmes targeting persons with depressive symptoms should include effective components to enhance body image perception.