Therapeutic Assessment in a University Counseling Center: A Replicated Single-Case Time-Series Pilot Study.

In this study, we pilot tested Therapeutic Assessment (TA) in a university counseling center using a replicated single-case design to generate hypotheses on the effectiveness and applicability for this setting and population. We aimed to see whether TA could be an effective brief intervention to address students' presenting mental health concerns. Further, we explored whether different types of presenting concerns were associated with differential symptomatic improvement during the intervention. An independent clinician interviewed participants before the baseline period to develop individualized rating scales pertaining to their presenting concerns. Eight consecutive students accessing the counseling center enrolled in the study and rated their presenting problems across baseline, intervention, and follow-up periods. The intervention involved five TA sessions. The results suggested that TA is associated with statistically significant reductions in clients' symptoms in the context of a university counseling center. Idiographic trajectory analysis of participant data who experienced significant and insignificant change was used to test whether changes were associated with the onset of TA. The findings suggest TA might be more effective for certain presenting concerns than for others. The implications for the implementation of TA in university counseling centers is discussed.

University Student Health Services, Local Experience, and Emerging Needs: Bridging the Past With the Future.

University students' health and well-being is critical, especially in the aftermath of the coronavirus disease 2019 pandemic; however, a comprehensive and integrated approach in academic institutions remains neglected. In this context, the local experience from a pilot university-based Student Health Center at an urban campus in Greece is presented. Select health promotion and disease prevention screening and monitoring initiatives are summarized from the viewpoint of a Strengths, Weaknesses, Opportunities, and Threats analysis, with emerging health needs and policy implications. Long-term sustainability is feasible, only if synergies and close collaboration with other university units and local health authorities are developed. A post-pandemic call to action for intervention programs that integrate physical and mental health care, as well as raise awareness among university stakeholders and health policy makers, is issued. [Journal of Psychosocial Nursing and Mental Health Services, 61(3), 27-31.].

Performance of an Antigen-Based Test for Asymptomatic and Symptomatic SARS-CoV-2 Testing at Two University Campuses - Wisconsin, September-October 2020.

Antigen-based tests for SARS-CoV-2, the virus that causes coronavirus disease 2019 (COVID-19), are inexpensive and can return results within 15 minutes (1). Antigen tests have received Food and Drug Administration (FDA) Emergency Use Authorization (EUA) for use in asymptomatic and symptomatic persons within the first 5-12 days after symptom onset (2). These tests have been used at U.S. colleges and universities and other congregate settings (e.g., nursing homes and correctional and detention facilities), where serial testing of asymptomatic persons might facilitate early case identification (3-5). However, test performance data from symptomatic and asymptomatic persons are limited. This investigation evaluated performance of the Sofia SARS Antigen Fluorescent Immunoassay (FIA) (Quidel Corporation) compared with real-time reverse transcription-polymerase chain reaction (RT-PCR) for SARS-CoV-2 detection among asymptomatic and symptomatic persons at two universities in Wisconsin. During September 28-October 9, a total of 1,098 paired nasal swabs were tested using the Sofia SARS Antigen FIA and real-time RT-PCR. Virus culture was attempted on all antigen-positive or real-time RT-PCR-positive specimens. Among 871 (79%) paired swabs from asymptomatic participants, the antigen test sensitivity was 41.2%, specificity was 98.4%, and in this population the estimated positive predictive value (PPV) was 33.3%, and negative predictive value (NPV) was 98.8%. Antigen test performance was improved among 227 (21%) paired swabs from participants who reported one or more symptoms at specimen collection (sensitivity = 80.0%; specificity = 98.9%; PPV = 94.1%; NPV = 95.9%). Virus was isolated from 34 (46.6%) of 73 antigen-positive or real-time RT-PCR-positive nasal swab specimens, including two of 18 that were antigen-negative and real-time RT-PCR-positive (false-negatives). The advantages of antigen tests such as low cost and rapid turnaround might allow for rapid identification of infectious persons. However, these advantages need to be balanced against lower sensitivity and lower PPV, especially among asymptomatic persons. Confirmatory testing with an FDA-authorized nucleic acid amplification test (NAAT), such as RT-PCR, should be considered after negative antigen test results in symptomatic persons, and after positive antigen test results in asymptomatic persons (1).

How College Students Communicatively Manage Uncertainty about University Health Services.

Despite university health services' critical role in addressing students' health, students frequently underutilize on-campus healthcare, in part due to uncertainty. This study used Uncertainty Management Theory and 41 interviews with college students and health center staff and providers to uncover the types of health services uncertainty students experienced and how students used communication to manage uncertainty. Students experienced institutional uncertainty pertaining to services, logistics, and quality-of-care. Participants who viewed this uncertainty negatively sought to reduce it via passive- and experiential-information seeking. Students who appraised uncertainty neutrally or positively maintained it by ignoring or avoiding information. Other students increased uncertainty by seeking second opinions. Findings suggest that promoting health services year-round and incentivizing patient referrals may help students manage both uncertainty and their health.

Understanding barriers to prescription retrieval and attitudes toward mental health medications at a university student health services pharmacy.

OBJECTIVES: To describe barriers affecting college students' ability to retrieve prescription medications for mental health conditions from a community pharmacy embedded within a student health center on a university campus and then describe beliefs and attitudes toward the use of those medications. METHODS: We conducted a cross-sectional study of college students who were prescribed a medication(s) for a mental health condition(s) and left the medication(s) unclaimed at the pharmacy for at least 5 days. Eligible participants were identified through routine reminder telephone calls and then provided a link to an online survey via e-mail. The survey collected information on demographics, prescription retrieval barriers, and medication beliefs and attitudes using 2 validated questionnaires. Data were summarized using descriptive statistics and scoring methods specific to the validated questionnaires. RESULTS: A total of 83 e-mails were distributed with 46 usable responses received (55.4% response rate). Participants were undergraduate students (n = 38, 82.6%) and most frequently prescribed a medication(s) for depression (n = 21, 45.7%) or anxiety (n = 16, 34.8%). Forgetting to pick up their medication was the most commonly cited reason for prescription nonretrieval (n = 32, 69.6%) followed by limited pharmacy hours (n = 21, 45.7%). Participants generally viewed the necessity of their medication(s) as outweighing their concerns about their medication(s), and they generally viewed themselves as medication adherent. CONCLUSIONS: University students taking medications for mental health conditions identified forgetfulness and limited pharmacy hours as the most common reasons for not retrieving prescriptions. Students generally viewed their medication(s) as necessary and themselves as medication adherent, suggesting that attitudes and beliefs may play a smaller role in medication use behaviors in this population. Future research is needed to develop and evaluate interventions that improve medication adherence in college students, potentially focused on reminder-based interventions.

Dynamic changes in generalized anxiety and depression during counseling.

Comorbidity of generalized anxiety and depression is common in clinical populations. Understanding how change in generalized anxiety and depression are related during counseling may help improve treatment. College student data (N = 51,922) from university and college counseling centers across the United States were used to examine relationships between change in generalized anxiety and depression across 12 counseling sessions using bivariate dual change score models. Results suggested greater improvement in depression was related to greater improvement in generalized anxiety across sessions, but greater improvement in generalized anxiety was related to less improvement in depression across sessions. This same pattern of results generalized to individuals who attended counseling with concerns in anxiety only, depression only, and both anxiety and depression. Although there were general improvements in generalized anxiety and depression across counseling sessions, greater improvement in depression at earlier sessions appeared to be a leading indicator of greater improvement in generalized anxiety at later sessions. Implications and future directions are discussed. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Showcasing Nursing Leadership and Contributions to a University's COVID-19 Student Contact Tracing Process.

The COVID-19 pandemic was an unprecedented event that impacted every segment of healthcare, including universities preparing healthcare professionals. Instituting processes to coordinate student return to campus and ongoing COVID-19 testing and contract tracing challenged university campuses, but also brought opportunities for collaboration. This article reports on the experiences of one nonprofit private higher education university in management of the COVID-19 testing and contact tracing that were led by school of nursing faculty and nursing leadership.

[Student Health Service : anchoring health education in the students' curriculum]. / Service sanitaire des étudiants en santé : ancrer l'éducation pour la santé dans le cursus des étudiants.

INTRODUCTION: Established in France since 2018, the Student Health Service aims to train students to become actors in health education. METHODS AND RESULTS: A teaching system lasting the equivalent of six weeks full-time has been set up in the third year of medical school in Rennes. The aim is for students to develop the skills needed to carry out interventions based on a project approach, with a variety of audiences, on priority public health themes.New pedagogical approaches have been developed to integrate learning about health promotion and health education into the medical curriculum. Innovations have been implemented: work on the educational posture, tutoring of third-year students by medical interns, a forum for simulation of concrete actions under the supervision of a dual thematic and population-based expertise. Beyond the acquisition of knowledge, the training aims to encourage a reflective approach and is based on peer education.The 240 students of the faculty prepare their project in trinomials throughout the academic year. Their activities take place over ten half-days in more than a hundred establishments in the faculty subdivision and enable them to work with approximately 10,000 people per year. DISCUSSION: Education and health promotion now occupies a central place in the training of third-year students, an essential condition for the sustainable acquisition of this field of expertise by future health professionals.

Service sanitaire des étudiants en santé : ancrer l'éducation pour la santé dans le cursus des étudiants.

INTRODUCTION: Established in France since 2018, the Student Health Service aims to train students to become actors in health education. METHODS AND RESULTS: A teaching system lasting the equivalent of six weeks full-time has been set up in the third year of medical school in Rennes. The aim is for students to develop the skills needed to carry out interventions based on a project approach, with a variety of audiences, on priority public health themes.New pedagogical approaches have been developed to integrate learning about health promotion and health education into the medical curriculum. Innovations have been implemented: work on the educational posture, tutoring of third-year students by medical interns, a forum for simulation of concrete actions under the supervision of a dual thematic and population-based expertise. Beyond the acquisition of knowledge, the training aims to encourage a reflective approach and is based on peer education.The 240 students of the faculty prepare their project in trinomials throughout the academic year. Their activities take place over ten half-days in more than a hundred establishments in the faculty subdivision and enable them to work with approximately 10,000 people per year. DISCUSSION: Education and health promotion now occupies a central place in the training of third-year students, an essential condition for the sustainable acquisition of this field of expertise by future health professionals.

[The university health service: Role of a mental health nurse]. / Apport d'une infirmière dédiée à la santé mentale au sein d'un service de santé universitaire.

University health services have been serving students for many years. During this very particular health crisis, they are actively caring for the health of their population, including psychological health. Nursing skills are essential here.

Patients Are Willing to Wait for Rapid Sexually Transmitted Infection Results in a University Student Health Clinic.

We examined the acceptability and feasibility of using a 30-minute chlamydia/gonorrhea test in a student health clinical setting. One hundred eight students were enrolled and 89.4% were willing to wait up to 20 minutes beyond the conclusion of their routine visit. The average amount of time added per clinic visit was less than 11 minutes. Patient and staff satisfaction were high.

Sexual Assault, Alcohol Use, and Gender of Sexual Partners Among Cisgender Women Seeking Care at US College Health Centers, 2015-2018.

Objectives. To assess differences by gender of sexual partner in the association between sexual assault and alcohol use among women seeking care in college health centers.Methods. This longitudinal study comprised 1578 women aged 18 to 24 years visiting 28 college health centers in Pennsylvania and West Virginia from 2015 to 2018. We used multilevel logistic regression and negative binomial regression, testing for interactions of gender of sexual partners, sexual assault, and prevalence and frequency of alcohol use and binge drinking.Results. Sexual assault was reported by 87.3% of women who had sex with women or with women and men (WSWM), 68.2% of women who had sex with men only (WSM), and 47.5% of women with no penetrative sexual partners. The relative associations between sexual assault and alcohol outcomes were smaller for WSWM (prevalence: odds ratios from 0.04 to 0.06; frequency: incidence rate ratios [IRRs] from 0.24 to 0.43) and larger for women who had no penetrative sexual partners (IRRs from 1.55 to 2.63), compared with WSM.Conclusions. Alcohol use patterns among women who have experienced sexual assault differ by gender of sexual partners.

Factors associated with antibiotic prescribing for acute bronchitis at a university health center.

BACKGROUND: Antibiotics are not indicated for treating acute bronchitis cases, yet up to 70% of adult acute bronchitis medical visits in the USA result in an antibiotic prescription. Reducing unnecessary antibiotic prescribing for acute bronchitis is a key antibiotic stewardship goal set forth by the Centers for Disease Control and Prevention. Understanding what factors influence prescribing for bronchitis cases can inform antimicrobial stewardship initiatives. The goal of this study was to identify factors associated with antibiotic prescribing at a high-volume student health center at a large US university. The Pennsylvania State University Health Services offers on-campus medical care to a population of over 40,000 students and receives over 50,000 visits every year. METHODS: We conducted a retrospective chart review of acute bronchitis visits for the 2015-2016 academic year and used a multivariate logistic regression analysis to identify variables associated with antibiotic prescribing. RESULTS: Findings during lung exams increased the likelihood of an antibiotic prescription (rales OR 13.95, 95% CI 3.31-80.73; rhonchi OR 5.50, 95% CI 3.08-10.00; percussion abnormality OR 13.02, 95% CI 4.00-50.09). Individual clinicians had dramatically different rates of prescribing (OR range 0.03-12.3). Male patients were more likely than female patients to be prescribed antibiotics (OR 1.68, 95% CI 1.17-2.41). Patients who reported longer duration since the onset of symptoms were slightly more likely to receive prescriptions (OR 1.04 per day, 95% CI 1.03-1.06), as were patients who reported worsening symptoms (OR 1.78, 95% CI 1.03-3.10). Visits with diagnoses or symptoms associated with viral infections or allergies were less likely to result in prescriptions (upper respiratory tract infection (URI) diagnosis OR 0.33, 95% CI 0.18-0.58; sneezing OR 0.39, 95% CI 0.17-0.86; vomiting OR 0.31, 95% CI 0.10-0.83). An exam finding of anterior cervical lymphadenopathy was associated with antibiotic prescribing (tender OR 3.85, 95% CI 1.70-8.83; general OR 2.63, 95% CI 1.25-5.54). CONCLUSIONS: Suspicious findings during lung examinations (rales, rhonchi, percussion abnormality) and individual healthcare providers were important factors influencing antibiotic prescribing rates for acute bronchitis visits. Patient gender, worsening symptoms, duration of illness, symptoms associated with viral infections or allergies, and anterior cervical lymphadenopathy also influenced prescribing rates.

Reducing overprescribing of antibiotics for suspected urinary tract infections in a health sciences campus student health service.

AIMS: Recommendations for the management of women with suspected uncomplicated lower urinary tract infections (UTIs) include presumptive antibiotics with or without obtaining a urine culture (UCx). However, with increasing antibiotic resistance, efforts to decrease antibiotic usage are vital. Therefore, the objective of this study was to determine if the presumptive treatment of women with suspected uncomplicated UTIs is contributing to unnecessary antibiotic usage. METHODS: We retrospectively reviewed all nonpregnant female patients presenting to our student health services clinic with UTI symptoms from December 2016 to May 2017 who had UCx sent. Clinical information, symptoms, office urine dip, and UCx results were reviewed. Patients with positive and negative UCx were compared. RESULTS: A total of 67 patients were included for analysis. Presenting symptoms included dysuria (59/60, 98%), frequency (41/45, 91%), and urgency (27/27, 100%). Office urine dip was performed on 33 of 67 (49%) patients. Dips were positive for leukocytes (88%), blood (79%), and nitrites (18%). All patients in the study were prescribed antibiotics, most commonly nitrofurantoin (82%). Culture results were negative in 29 of 67 (43%). There were no significant differences in duration of symptoms, presenting symptoms, or urine dip results between patients with a negative UCx and those with a positive UCx. CONCLUSIONS: In our study, we found a significant negative UCx rate in women with symptoms of uncomplicated UTI, representing a cohort of patients who were exposed to antibiotics unnecessarily. In addition, we found no difference in presenting symptoms or urine dip results to help distinguish patients with a positive UCx.

Who is more important in stigmatization, family or friends?

INTRODUCTION: Although the knowledge about epilepsy is rapidly increasing, the rate of stigmatization still remains high among patients. Since stigmatization is a condition that reduces the quality of life of patients and adversely affects the treatment response, it is very important to reveal the contributing factors. In this study, it was aimed to investigate which of the current social support resources of the patients are related to stigmatization, whether the support received from family or friends and a special person. MATERIALS AND METHODS: A total of 60 patients with epilepsy (30 males and 30 females) were included in the study. Sociodemographic data form, stigma scale of epilepsy, and multidimensional scale of perceived social support were administered to all participants. RESULTS: Duration of education from sociodemographic variables and duration of epilepsy from clinical variables were associated with stigma scores (for each other, p < 0.01). While a negative correlation was determined between friend support, special person support scores, and total social support score and stigma scores (p < 0.01, p < 0.001, p < 0.01, respectively), no significant relationship was detected between family support score and stigma score. CONCLUSIONS: The findings of the study show that the support of a friend and a special person may be more important than the family support in patients with epilepsy. When evaluating these patients, questioning the type and adequacy of social support that they receive and taking necessary interventions (such as forming peer support groups) may be helpful in reducing the perceived stigmatization.

Incidence of seizure exacerbation and injury related to football participation in people with epilepsy.

INTRODUCTION: There is scant evidence to quantify the risk of contact sports such as football to patients with epilepsy. This retrospective review was performed to evaluate the incidence of injuries or seizure exacerbation related to football participation in patients with epilepsy. METHODS: Between the years 1994 and 2004, 157,709 consecutive clinic notes were searched for mention of "football" and "epilepsy" or "seizure". Resulting notes were reviewed to quantify the number of seizure exacerbations and the number of injuries in this cohort. RESULTS: Seven of 44 subjects with epilepsy (15.9%) experienced injury while playing football. Four of 32 (12.5%) patients experienced seizure exacerbation during a time when they were concurrently participating in football though 3 of these patients stopped taking or were weaned off of their antiepileptic drugs (AEDs). One in 32 patients with epilepsy (3.1%) had an exacerbation of seizures while playing football and consistently taking AEDs. CONCLUSION: The risk of injury and seizure exacerbation due to participation in football for patients with epilepsy is low. Clinicians should use their best judgment in deciding whether contact sports increase risks for a particular patient based on individual seizure frequency, concurrent neurological and medical issues, and medication adverse effects.

Engaging male students with mental health support: a qualitative focus group study.

BACKGROUND: Males are less likely to seek help for mental health difficulties compared to females. Despite considerable interest, a paucity of evidence-based solutions exists to address this. Concerns about students' mental health has led to the United Kingdom's Department of Education to make this a priority. Studies have shown that male students hold more negative attitudes towards the use of psychological services compared to female students and are less likely to seek help. A major concern is that male students make up 69% of university suicides, which is often associated with lower rates of help-seeking. This focus group study therefore sought to identify potential approaches that would be relevant to improving mental health help-seeking in male students. METHODS: Three focus groups comprising of 24 male students at a London University were conducted. Participants were asked questions exploring: the barriers to seeking help, what would encourage help-seeking, how an appropriate intervention should be designed, and how to publicise this intervention to male students. Thematic analysis was conducted to evaluate participants responses. RESULTS: Five distinct themes were identified. These were: 1) protecting male vulnerability, 2) providing a masculine narrative of help-seeking, 3) differences over intervention format, 4) difficulty knowing when and how to seek help, and 5) strategies to sensitively engage male students. CONCLUSIONS: These themes represent important considerations that can be used, together with the existing literature about male help-seeking, to develop more male friendly interventions that are suitable for male students. This could help improve help-seeking attitudes and the uptake of mental health interventions for male students experiencing emotional distress.

Investigating Disparities by Sex and LGBTQ Identity: A Content Analysis of Sexual Health Information on College Student Health Center Websites.

Student Health Centers (SHCs) are important resources on U.S. college campuses. In light of recent calls for creating more opportunities for health care services to young men and sexual/gender minorities, this content analytic study evaluated how sexual health information and resources are communicated on SHC websites. Utilizing a stratified random sample of 400 U.S. colleges/universities, we assessed how often sexual health is explicitly labeled for particular groups, the types of sexual health topics on SHC websites, the depth of sexual health information, and the sexual health resources offered on SHC websites. Our findings revealed that women's health webpages far outnumbered men's health webpages, sexual health topics were more common on women's health webpages, and sexual health topics were covered at greater depth on women's health webpages compared to men's health webpages. Similar disparities were found for sexual/gender minorities. General sexual health webpages on SHC websites addressed significantly more sexual health topics in greater depth and offered more sexual health resources than LGBTQ health webpages. The practical implications for college student health and potential health disparities are discussed.

A Retrospective Study of Students Referred to a Psychiatric Clinic at a College Counseling Center in Appalachia.

OBJECTIVES: This study describes the clinical problems and psychiatric diagnoses of college students who sought services at a student counseling clinic and were subsequently referred for evaluation by a psychiatrist. Several important psychiatric problems present before leaving for college that could mandate the selection of a college with psychiatric services at the university or nearby community. This study confirms the importance of having psychiatric consultation available in addition to the range of counseling services found in a campus mental health clinic. METHODS: We conducted a retrospective chart review of 150 patients who were referred for psychiatric care from an on-campus mental health clinic at an Appalachian university (Marshall University). Demographic and clinical data were collected, entered into SPSS version 24, and analyzed. RESULTS: The most common diagnosis was that of a depressive disorder (76.7%). The next most common was an anxiety disorder (60.7%). In addition, 43.3% of students had suicidal ideation within 1 month preceding their appointment with the psychiatrist, 24% had attempted suicide at least once in their life, and 36% had a history of nonsuicidal self-harm. Almost 81% had prior psychiatric diagnoses, and of those, 22% had a history of inpatient psychiatric care. CONCLUSIONS: These results indicate that this student sample referred for psychiatric treatment has significant psychiatric illness. Our findings also confirm the need for the availability of psychiatric consultation as a part of college mental health services. Those students most in need of psychiatric consultation had almost all received psychiatric treatment and almost half had suicidal ideation in the month preceding the appointment with the psychiatrist. The specific problems that may lead a student applying to college to take into consideration the availability of psychiatric services include a previous psychiatric hospitalization, previous suicidal ideation that had already come to the attention of a mental health professional, or a previous diagnosis of depressive disorder or anxiety disorder.

The effect of implementing the partners for change outcome management system in a nationwide student counseling service.

The aims of the present study were to investigate the effect of implementing the Partners for Change Outcome Management System (PCOMS) in the Danish Student Counseling Service and to explore both between-condition moderators and within-condition predictors of outcomes. The study was a nonrandomized controlled study, comparing the outcome of individual and group student counseling for 634 PCOMS clients to that of 740 clients having started treatment as usual (TAU) 2 years before the PCOMS data collection began. The primary outcome measure was the Global Severity Index on the Symptom Checklist 90-Revised. Main analyses were conducted with multilevel models on the intention-to-treat sample. The results demonstrated no effect of the PCOMS compared with the TAU condition, neither for the primary outcome nor for the number of dropouts or clients experiencing deterioration. The PCOMS effect was not predicted by the counselors' adherence to the PCOMS protocol. Because the counselor level explained less than 1% of the variance in outcome, the counselor factors (i.e., attitude to feedback, reactions to negative feedback, and deliberate practice) were not analyzed as predictors. In conclusion, this study does not align with previous studies finding a positive effect of the PCOMS in counseling settings. However, all previous studies relied on the PCOMS Outcome Rating Scale as the only measure of outcome, maybe indicating a measure-specific effect. (PsycINFO Database Record (c) 2019 APA, all rights reserved).