Well-Being amongst College Students during COVID-19 Pandemic: Evidence from a Developing Country.

College students face unique challenges that the consequences of COVID-19 might aggravate. To explore the pandemic's consequences on college students' well-being, we conducted an online survey with 634 students from a private university in Cali, Colombia. The study sought to assess students' well-being due to COVID-19, and to explore the mediating effects of optimism, gratitude, and emotional closeness on college students' well-being. Results showed that COVID-19 affected students' mental health and well-being. Being optimistic and grateful mediated with life satisfaction and happiness. Optimism, emotional closeness, and gratitude also mediated the negative effect of fear of infection and the pandemic's impact on students' academic performance. The results of this analysis will promote discussion of the implementation of coping strategies to help students thrive, promote resilience, and contribute to students' well-being and better mental health.

Cost-effectiveness analysis of VECTOS software for the control of diseases transmitted by Aedes aegypti in two Colombian municipalities / [Análisis de costo-efectividad del uso del programa VECTOS en el control rutinario de enfermedades transmitidas por Aedes aegypti en dos municipios de Santander, Colombia].

Introduction: Diseases transmitted by Aedes aegypti are considered a public health problem. VECTOS is a novel software for the integration of vector control strategies. Objective: To assess the cost-effectiveness of the use of VECTOS in the routine control programs of diseases transmitted by A. aegypti in the municipality of San Juan de Girón (Santander). Materials and methods: We conducted a cost-effectiveness analysis using a decision analysis model from the perspective of the local health authorities. We considered the use of the VECTOS software in the routine control activities in the municipality of San Juan de Girón during 2016 as the treatment group while the routine control in the municipality of Floridablanca, where VECTOS is not implemented, was considered as the comparator. We calculated the incremental cost-effectiveness ratio (ICER) taking as effectiveness measure the disability-adjusted life years (DALY). Results: VECTOS was cost-effective at a rate of USD$ 660,4 savings per each DALY avoided compared to the routine control in Floridablanca. The probabilistic model showed that the system was cost-effective in 70% of the 10.000 iterations for a threshold between 1 to 3 GDP per capita. Conclusions: VECTOS software as implemented in the municipality of San Juan de Girón is highly cost-effective and could be used in other municipalities in the country where diseases transmitted by A. aegypti are endemic.

Introducción. Las enfermedades transmitidas por Aedes aegypti son un problema de salud pública. VECTOS es un programa novedoso de integración de estrategias de control de vectores. Objetivo. Evaluar el costo-efectividad del uso del VECTOS en los programas de control rutinario de enfermedades transmitidas por el vector Aedes aegypti en el municipio de San Juan de Girón (Santander). Materiales y métodos. Se evaluó el costo-efectividad del programa empleando un modelo de análisis de decisiones desde la perspectiva de las autoridades locales de salud. Se estudió la integración de las estrategias de control de vectores mediante el programa VECTOS utilizado en el municipio de San Juan de Girón durante el 2016, con el control rutinario llevado a cabo sin VECTOS en el municipio de Floridablanca. Se calculó la razón incremental del costo-efectividad (RICE), usando como medida de efectividad los años de vida ajustados por discapacidad (AVAD). Resultados. El uso del programa VECTOS fue rentable a una tasa de ahorro de USD$660,4 por cada AVAD evitado en comparación con el control de rutina en Floridablanca. El modelo probabilístico indicó que el sistema fue costo-efectivo en el 70 % de las 10.000 iteraciones para un umbral entre 1 y 3 PIB per cápita. Conclusiones. El programa VECTOS fue muy costo-efectivo en el municipio de San Juan de Girón. Su uso puede adoptarse en otros municipios del país donde las enfermedades transmitidas por A. aegypti son endémicas.

Análisis de costo-efectividad del uso del programa VECTOS en el control rutinario de enfermedades transmitidas por Aedes aegypti en dos municipios de Santander, Colombia / Cost-effectiveness analysis of VECTOS software for the control of diseases transmitted by Aedes aegypti in two Colombian municipalities

Introducción. Las enfermedades transmitidas por Aedes aegypti son un problema de salud pública. VECTOS es un programa novedoso de integración de estrategias de control de vectores. Objetivo. Evaluar el costo-efectividad del uso del VECTOS en los programas de control rutinario de enfermedades transmitidas por el vector Aedes aegypti en el municipio de San Juan de Girón (Santander). Materiales y métodos. Se evaluó el costo-efectividad del programa empleando un modelo de análisis de decisiones desde la perspectiva de las autoridades locales de salud. Se estudió la integración de las estrategias de control de vectores mediante el programa VECTOS utilizado en el municipio de San Juan de Girón durante el 2016, con el control rutinario llevado a cabo sin VECTOS en el municipio de Floridablanca. Se calculó la razón incremental del costo-efectividad (RICE), usando como medida de efectividad los años de vida ajustados por discapacidad (AVAD). Resultados. El uso del programa VECTOS fue rentable a una tasa de ahorro de USD$ 660,4 por cada AVAD evitado en comparación con el control de rutina en Floridablanca. El modelo probabilístico indicó que el sistema fue costo-efectivo en el 70 % de las 10.000 iteraciones para un umbral entre 1 y 3 PIB per cápita. Conclusiones. El programa VECTOS fue muy costo-efectivo en el municipio de San Juan de Girón. Su uso puede adoptarse en otros municipios del país donde las enfermedades transmitidas por A. aegypti son endémicas.

Introduction: Diseases transmitted by Aedes aegypti are considered a public health problem. VECTOS is a novel software for the integration of vector control strategies. Objective: To assess the cost-effectiveness of the use of VECTOS in the routine control programs of diseases transmitted by A. aegypti in the municipality of San Juan de Girón (Santander). Materials and methods: We conducted a cost-effectiveness analysis using a decision analysis model from the perspective of the local health authorities. We considered the use of the VECTOS software in the routine control activities in the municipality of San Juan de Girón during 2016 as the treatment group while the routine control in the municipality of Floridablanca, where VECTOS is not implemented, was considered as the comparator. We calculated the incremental cost-effectiveness ratio (ICER) taking as effectiveness measure the disability-adjusted life years (DALY). Results: VECTOS was cost-effective at a rate of USD$ 660,4 savings per each DALY avoided compared to the routine control in Floridablanca. The probabilistic model showed that the system was cost-effective in 70% of the 10.000 iterations for a threshold between 1 to 3 GDP per capita. Conclusions: VECTOS software as implemented in the municipality of San Juan de Girón is highly cost-effective and could be used in other municipalities in the country where diseases transmitted by A. aegypti are endemic.

Academic Well-Being and Structural Characteristics of Peer Networks in School.

Peer networks at school and students' position in these networks can influence their academic well-being. We study here individual students' network position (isolation, popularity, social activity) and peer network structures at the school level (centralization, density, clustering, school connectedness) and their relations to students' academic well-being (school burnout, SB; schoolwork engagement, SE). Classroom surveys for 14-16-year-olds (N = 11,015) were conducted in six European cities (SILNE survey). Students were asked to nominate up to five schoolmates with whom they preferred to do schoolwork. SB and SE correlated negatively (-0.32; p < 0.0001). Students had on average 3.4 incoming (popularity; range 0-5) and 3.4 outgoing (social activity; 0-5) social ties. Percentage of isolated students was 1.4. Students' network position was associated weakly with academic well-being-popular students had less SB and higher SE, and socially active students had higher SE. School-level peer networks showed high clustering and school connectedness, but low density and low centralization. Clustering was associated with higher SB. Low centralization and high school connectedness protected from SB. Dense networks supported SE as did high average school connectedness. Correlations between these network indicators and academic well-being were, however, low. Our study showed that both students' network position and network characteristics at the school level can influence adolescents' academic well-being.

Budget impact analysis of the adoption of new hypertension guidelines in Colombia.

BACKGROUND: Hypertension represents a high burden of disease in different healthcare systems. Recent guideline published in 2017 by the American Heart Association and the American College of Cardiology has generated a debate between clinicians and policymakers due to the lowering of diagnosis threshold and the subsequent increase of the prevalence and healthcare costs. No empirical research exists addressing the question about the pressure on healthcare costs generated by new standards. This study aims to quantify the impact on the hypertension diagnosis and treatment costs for healthcare system using the new hypertension guideline. METHODS: We conducted a budget impact analysis from a Colombian healthcare payer's perspective with a 3-year time horizon (2018-2020), in which we estimated the difference in total medical care costs between previous hypertension cut-off points (140/90 mmHg) and new guideline cut-off points (130/80 mmHg). RESULTS: Our results show that the impact of the adoption of the new hypertension guideline would represent a decrease close to 22% in total annual high blood pressure costs in Colombia. This reduction is mainly driven by a lower number of cardiovascular complications. It is worth noting that these results should be taken with caution due to local available data. CONCLUSIONS: A high-middle income country such as Colombia should carry out an exhaustive revision of the recommendations of the new hypertension guideline, due to its high probability of saving medical treatment costs for the healthcare system.

School smoking policies and educational inequalities in smoking behaviour of adolescents aged 14-17 years in Europe.

BACKGROUND: Studies on the effects of school smoking policies are inconclusive and there is no research on whether the effects of school policies vary by educational level. We examined the association between school smoking policies and smoking behaviour among adolescents aged 14-17 years in Europe and assessed educational inequalities in these associations. METHODS: Data on 10,325 adolescents from 50 schools in six European cities were obtained from the 2013 SILNE survey. We measured student perceived policy, staff reported policy and its three subscales: regulations, communication and sanctions. The association between school policies and smoking outcomes (daily smoking and smoking on school premises) was adjusted for individual characteristics and for parental smoking. We tested interaction between school policies and educational level. RESULTS: Daily smoking was not associated with school smoking policies (eg, OR total policy=1.04, 95% CI 0.93 to 1.16 and OR student perceived policy=1.04, 95% CI 0.98 to 1.10). Smoking on school premises was less prevalent in schools with stronger staff reported total policy (OR=0.71, 95% CI 0.53 to 0.96). Other policy variables were also negatively associated with smoking on school premises, but not significantly (eg, OR student perceived policy=0.89, 95% CI 0.78 to 1.02). Associations between policy and smoking on school premises tended to be stronger in those with a low educational level, but none of the interactions tested were statistically significant. CONCLUSIONS: Our results suggest that school smoking policies may not have a direct effect on daily smoking but may reduce smoking on the school premises. We found no clear evidence for the effects of school policies to differ by educational level.

Smoking in school-aged adolescents: design of a social network survey in six European countries.

BACKGROUND: In Western countries, smoking accounts for a large share of socio-economic inequalities in health. As smoking initiation occurs around the age of 13, it is likely that school context and social networks at school play a role in the origin of such inequalities. So far, there has been little generic explanation of how social ties at school contribute to socio-economic inequalities in smoking. The SILNE (Smoking Inequalities - Learning from Natural Experiments) survey was designed to test the hypothesis that a combination of peer effect, homophilous social ties, and school context may explain how smoking inequalities are magnified at school - a theory known as network-induced inequality. In this paper, the survey theory and design are presented. FINDINGS: The social network survey was carried out in 2013 in six medium-sized European cities with average incomes similar to the national average: Namur (Belgium), Tampere (Finland), Hannover (Germany), Latina (Italy), Amersfoort (The Netherlands), and Coimbra (Portugal). In each city, 6 to 8 schools were selected in a stratified sampling procedure. In each school, two grades in secondary education, corresponding to 14-16-year-olds, were selected. All adolescents in these two grades were invited to participate in the survey. Social ties were reported using the roster approach, in which each adolescent had to nominate up to 5 friends from a directory. The survey collected information from 11,015 adolescents in 50 schools, out of a total of 13,870 registered adolescents, yielding a participation rate of 79%. The SILNE survey yielded 57,094 social ties, 86.7% of which referred to friends who also participated in the survey. DISCUSSION: The SILNE survey was designed to measure the association between adolescents' social ties at school, their socio-economic background, and their smoking behaviour. Two difficulties were encountered, however: legal privacy constraints made it impossible to apply the same parental consent procedure in all countries, leading to somewhat lower participation rates in two cities: Hannover and Latina. It was also difficult to match the 6 cities in terms of both age and type of education. The SILNE survey provided a comparable database for the study of smoking inequalities across European cities from a social network perspective.

Alcohol drinking among college students: college responsibility for personal troubles.

BACKGROUND: One young adult in two has entered university education in Western countries. Many of these young students will be exposed, during this transitional period, to substantial changes in living arrangements, socialisation groups, and social activities. This kind of transition is often associated with risky behaviour such as excessive alcohol consumption. So far, however, there is little evidence about the social determinants of alcohol consumption among college students. We set out to explore how college environmental factors shape college students' drinking behaviour. METHODS: In May 2010 a web questionnaire was sent to all bachelor and master students registered with an important Belgian university; 7,015 students participated (participation = 39%). The survey looked at drinking behaviour, social involvement, college environmental factors, drinking norms, and positive drinking consequences. RESULTS: On average each student had 1.7 drinks a day and 2.8 episodes of abusive drinking a month. We found that the more a student was exposed to college environmental factors, the greater the risk of heavy, frequent, and abusive drinking. Alcohol consumption increased for students living on campus, living in a dormitory with a higher number of room-mates, and having been in the University for a long spell. Most such environmental factors were explained by social involvement, such as participation to the student folklore, pre-partying, and normative expectations. CONCLUSIONS: Educational and college authorities need to acknowledge universities' responsibility in relation to their students' drinking behaviour and to commit themselves to support an environment of responsible drinking.

Fiscal decentralisation and infant mortality rate: the Colombian case.

There is a paucity of research analysing the influence of fiscal decentralisation on health outcomes. Colombia is an interesting case study, as health expenditure there has been decentralising since 1993, leading to an improvement in health care insurance. However, it is unclear whether fiscal decentralisation has improved population health. We assess the effect of fiscal decentralisation of health expenditure on infant mortality rates in Colombia. Infant mortality rates for 1080 municipalities over a 10-year period (1998-2007) were related to fiscal decentralisation by using an unbalanced fixed-effect regression model with robust errors. Fiscal decentralisation was measured as the locally controlled health expenditure as a proportion of total health expenditure. We also evaluated the effect of transfers from central government and municipal institutional capacity. In addition, we compared the effect of fiscal decentralisation at different levels of municipal poverty. Fiscal decentralisation decreased infant mortality rates (the elasticity was equal to -0.06). However, this effect was stronger in non-poor municipalities (-0.12) than poor ones (-0.081). We conclude that decentralising the fiscal allocation of responsibilities to municipalities decreased infant mortality rates. However, this improved health outcome effect depended greatly on the socio-economic conditions of the localities. The policy instrument used by the Health Minister to evaluate municipal institutional capacity in the health sector needs to be revised.