Sleep and Perceived Stress: An Exploratory Mediation Analysis of the Role of Self-Control and Resilience among University Students.

BACKGROUND: High levels of stress are frequent in university education, and a lack of sleep has been reported to make students more vulnerable to stress. The mechanisms through which sleep harms students have not been sufficiently clarified; therefore, this study aimed to explore the mediating role of self-control and resilience in the relationship between sleep quality and duration and perceived stress. METHODS: Of 32 first-year college students, 21 (78%) were women, with a mean age of 18.47 (±0.84). They responded to a self-administered survey that included questions on stress, resilience, and sleep quality and recorded their daily sleep duration using a wristband for six days. RESULTS: Perceived stress was significantly correlated with resilience (r = -0.63), self-control (r = -0.46), sleep duration (r = -0.35), and lower sleep quality (r = 0.57). Path analysis revealed that self-control and resilience were partially mediated by sleep quality (R2 = 0.62; p < 0.01) and completely mediated by sleep duration (R2 = 0.46; p < 0.01). In both models, self-control had a direct effect on resilience and had a good-fit index. CONCLUSION: Being resilient seems to play a mediating role in the relationship between sleep and perceived stress; this ability can be favored by self-control, which is directly influenced by sleep.

Generaciones centenial y milenial: actitudes hacia la sexualidad / The Centennial and Millennial generations: Attitudes towards sexuality / Gerações centennial e millennial: atitudes em relação à sexualidade

Resumen (analítico) El objetivo general fue conocer las actitudes hacia la sexualidad de estudiantes universitarios de las generaciones milenial y centenial. Como objetivo específico se validó un cuestionario de actitudes. Se siguió una metodología no experimental, transversal, con análisis descriptivo de respuestas de 402 estudiantes (69.1% mujeres, 30.9% hombres), con una media de edad de 20.8 años (DE 2.07). Resultaron actitudes favorables hacia: expresiones sexuales homosexuales y transexuales, eliminación de roles de género, uso del condón y re-chazo hacia la violencia en redes sociales. Se presentaron actitudes desfavorables hacia el amor y actitudes indecisas hacia las relaciones casuales. Concluimos que el conocimiento de las actitudes es fundamental en el diseño y la ejecución de políticas de salud pública dirigidas a promover y preservar la salud sexual de las generaciones actuales.

Abstract (analytical) The general objective of this study was to identify attitudes towards sexuality held by university students pertaining to the millennial and centennial generations. An attitudes questionnaire was validated as a specific objective. A non-experimental, cross-sectional methodology was followed, involving a descriptive analysis of 402 students' responses (69.1% women, 30.9% men) with a mean age of 20.8 years (SD 2.07). Favorable attitudes were found towards: homosexual and transexual expressions of sexuality, elimination of gender roles, condom use and rejection of violence in social networks. There were unfavorable attitudes toward love and marriage and a lack of definition towards casual relationships. The authors conclude that knowledge of attitudes is essential for the design and implementation of public health policies aimed at promoting and preserving the sexual health of current generations.

Resumo (analítico) O objetivo geral foi conhecer as atitudes face à sexualidade de estudantes universitários das gerações millennial e centennial, tendo como objetivo específico validar um questionário de atitudes. Foi seguida uma metodologia não experimental, transversal, com análise descritiva das respostas de 402 alunos (69.1% mulheres, 30.9 % homens), com uma média de idade de 20.8 anos (DP 2.07). Atitudes favoráveis foram encontradas em relação a: expressões sexuais homossexuais e transexuais, eliminação de papéis de gênero, uso de preservativo e repulsa face à violência nas redes sociais. Simultaneamente, atitudes desfavoráveis foram encontradas em relação ao amor e ao casamento e atitudes indefinidas em relação aos relacionamentos casuais. Concluímos que o conhecimento das atitudes é essencial na formulação e implementação de políticas públicas de saúde dirigidas a promover e preservar a saúde sexual das gerações atuais.

Validation of the 10-item resilience scale with Mexican college students. / Validación de la escala de resiliencia de 10 ítems en universitarios mexicanos.

BACKGROUND: Resilience is the ability to emerge strengthened in an adverse scenario. One population that suffer constant stress are doctors and medical students, which is why it is necessary to have validated instruments to assess resilience. OBJECTIVE: To evaluate the validity and reliability parameters of the 10-item resilience scale, Connor-Davidson (CD-RISC-10), in a Mexican university sample. MATERIAL AND METHODS: A sample of 1333 first-year medical students who agreed to participate in the study was evaluated; sample selection was for convenience, with an average age of 18 years (standard deviation: 1.4 years; 17-39 years). CD-RISC-10 scale was applied to the sample. In a sub-sample, Mexican resilience scale (RESI-M) was applied to assess convergent validity; the Beck Anxiety Inventory and the Beck Depression Inventory were used to divergent validity. RESULTS: A factorial analysis was performed with a factor that explains 96.245 of the total variances. The internal consistency of the scale presented a Cronbach's alpha of 0.935. The test-retest was r = 0.521, p = 0.01; the correlation with the RESI-M was moderate (r = 0.61, p = 0.0001). The correlation with the Beck Anxiety Inventory was r = −0.214 (p < 0.05) and with the Beck Depression Inventory, r = −199, p < 0.05). CONCLUSIONS: The 10-item Spanish version of the Connor and Davidson CD-RISC had adequate psychometric properties to estimate resilience in medical university students.

INTRODUCCIÓN: La resiliencia es la capacidad de salir fortalecido en un escenario adverso. Una población que sufre estrés constante es la de los médicos y los estudiantes de medicina, por lo que es necesario contar con instrumentos validados para evaluar la resiliencia. OBJETIVO: Evaluar los parámetros de validez y confiabilidad de la escala de resiliencia de 10 ítems Connor-Davidson (CD-RISC-10) en una muestra universitaria mexicana. MATERIAL Y MÉTODOS: Se evaluó una muestra de 1333 estudiantes de primer año de Medicina. La selección fue por conveniencia, con una media de edad de 18 años (desviación estándar: 1.4 años; rango: 17-39 años). A la muestra se le aplicó la escala CD-RISC-10. En una submuestra se aplicó escala de resiliencia mexicana (RESI-M) para evaluar la validez convergente; para la validez divergente se utilizaron el Inventario de Ansiedad de Beck y el Inventario de Depresión de Beck. RESULTADOS: Se hizo un análisis factorial con un factor que explica el 96.245 de la varianza total. La consistencia interna de la escala presentó un alfa de Cronbach de 0.935. La prueba test-retest fue de r = 0.521 (p = 0.01) y la correlación con la RESI-M fue moderada, con r = 0.61 (p = 0.0001). La correlación con el Inventario de Ansiedad de Beck fue r = -0.214 (p < 0.05) y con el Inventario de Depresión de Beck fue r = -199 (p < 0.05). CONCLUSIÓN: La versión en español de la CD-RISC-10 presenta adecuadas propiedades psicométricas para estimar la resiliencia en estudiantes universitarios de medicina.

[Academic performance in first year medical students: an explanatory multivariate model]. / El rendimiento académico en el primer año de la carrera de médico cirujano: modelo multivariado explicativo.

INTRODUCTION: Current education is focused in intellectual, affective, and ethical aspects, thus acknowledging their significance in students´ metacognition. Nowadays, it is known that an adequate and motivating environment together with a positive attitude towards studies is fundamental to induce learning. Medical students are under multiple stressful, academic, personal, and vocational situations. OBJECTIVE: To identify psychosocial, vocational, and academic variables of 2010-2011 first year medical students at UNAM that may help predict their academic performance. MATERIAL AND METHODS: Academic surveys of psychological and vocational factors were applied; an academic follow-up was carried out to obtain a multivariate model. The data were analyzed considering descriptive, comparative, correlative, and predictive statistics. RESULTS: The main variables that affect students´ academic performance are related to previous knowledge and to psychological variables. CONCLUSIONS: The results show the significance of implementing institutional programs to support students throughout their college adaptation.

Síntomas depresivos y rendimiento escolar en estudiantes de Medicina / Depressive symptoms and academic performance in medical students

The prevalence of depression among medical students is significantly higher than that from the general population or other undergraduate students and can result in dropping out, in such a way that the growing number of students who have dropped due to their poor performance or their vocational indecision could be related to the presence of this condition. Objective and methodology To identify if the depressive symptoms presented by medical students from first year were associated with poor performance. The study included 774 medical students in their first year (66.4% female, 33.6% male, average age: 18.6 ± 1.7 years). The Beck Inventory for Depression and the SCL90 (Symptom-CheckList) depression subscale were used. Statistical analysis. Descriptive analyzes were performed, χ2, Student t test and logistic regression. Results The percentage of students with depressive symptoms was 23% (male 12.3%, women 28.4%), with a significant difference in depressive symptoms between women and men medical students (OR=2.8). 68% of students who had depressive symptoms failed a subject, which was a risk of disapproval of 2.4 times compared with those without such symptomatology. The variables sex and depressive symptomatology were found to be factors related to poor academic performance, with an increased risk for students with symptoms (OR=2.2, 95% CI=1.56-3.20). Conclusions Depressive symptomatology is an important risk factor for failing a subject or having a poor academic performance.

La prevalencia de depresión en estudiantes de medicina es significativamente más alta que la presentada en la población general o en estudiantes de otras licenciaturas y puede dar como resultado el abandono de los estudios, de tal manera que el creciente número de estudiantes que han sido dados de baja debido a su mal rendimiento o a sus indecisiones vocacionales pudiera tener relación con la presencia de este padecimiento. Objetivo y metodología Identificar si los síntomas depresivos que presentaban los estudiantes de primer año de la licenciatura de Médico Cirujano estaban asociados con un bajo rendimiento. Participaron 774 estudiantes del primer año de la carrera de Médico Cirujano (66.4% mujeres, 33.6% hombres; media de edad: 18.6 ± 1.7 años). Se utilizó el Inventario de Beck para Depresión y la subescala de Depresión del SCL90 (Symptom Check-List). Análisis estadístico. Se realizaron análisis descriptivos, χ², t de Student y regresión logística. Resultados El porcentaje de estudiantes con síntomas depresivos fue de 23% (hombres 12.3%, mujeres 28.4%), con una diferencia significativa en la presencia de síntomas depresivos entre mujeres y hombres estudiantes de medicina (OR=2.8). El 68% de los alumnos que tenían síntomas depresivos reprobaron alguna materia, lo que supuso un mayor riesgo de reprobación de 2.4 veces, comparados con quienes no tenían dicha sintomatología. Las variables sexo y sintomatología depresiva resultaron ser factores relacionados con el bajo rendimiento escolar, con un riesgo mayor para los estudiantes con síntomas (OR=2.2, IC95%=1.56-3.20). Conclusiones La sintomatología depresiva es un factor de riesgo importante para reprobar alguna asignatura o tener un bajo rendimiento escolar.

[Sleep deprivation effects on cognitive, psychomotor skills and its relationship with personal characteristics of resident doctors]. / Efectos de la privación de sueño en las habilidades cognitivas, psicomotoras y su relación con las características personales de los médicos residentes.

BACKGROUND: In countries such as United States and European Nations changes have been proposed regarding to duty and academic structure of specialists in training, this implies adjustments in the norms concerning the number of hours a week that residents work. The main argument which has underpinned such transformations is based on the assumption that excessive working hours (more than 16 hours uninterrupted) cause cognitive and psychomotor disorders in residents. OBJECTIVE: To evaluate the association between sleep deprivation and cognitive and psychomotor skills of a sample of residents of different specialties of Medicine. METHODS: Longitudinal study with measurements pre and post shifts, in 31 residents of Medicine. The measured variables were: cognitive and psychomotor skills, demographic data and conditions of the shift, quality of sleep and psychopathology. RESULTS: 81% residents showed detriment in at least one of the tests, however, in psychomotor skills significant different results were found in CPR maneuvers between pre and post shift with an improvement in scores. CONCLUSIONS: Sleep deprivation causes detriment of cognitive and psychomotor skills. While our results can't be generalized, they may constitute a precedent for possible changes in the working hours of medical residencies.

Antecedentes: en países como Estados Unidos y las naciones europeas se han propuesto cambios a la estructura asistencial y académica de los médicos especialistas en formación que proponen transformaciones a las normas relativas al número de horas que trabajan a la semana los residentes. El argumento principal que sustenta esas transformaciones se basa en el supuesto de que las horas de trabajo excesivas (más de 16 horas ininterrumpidas) provocan alteraciones cognitivas y psicomotrices en los residentes. Objetivo: evaluar la asociación entre la privación de sueño y las habilidades cognitivas y psicomotoras de una muestra de residentes de diferentes especialidades médicas. Material y métodos: estudio longitudinal, con mediciones pre y post guardia, en 31 residentes de Medicina. Se midieron las variables de: habilidades cognitivas y psicomotoras, datos sociodemográficos y de condiciones de guardia, calidad de sueño y psicopatología. resultados: 81% de los residentes tuvo detrimento en, al menos, una de las pruebas realizadas; sin embargo, en los resultados de las habilidades psicomotoras y en la maniobra de reanimación cardiopulmonar básica se encontró una diferencia significativa en los momentos pre y post guardia con mejoría en las puntuaciones. Conclusiones: la privación de sueño disminuye las habilidades cognitivas y psicomotoras. Si bien nuestros resultados no son generalizables, pueden constituir un precedente para fundamentar posibles cambios referentes a las guardias en las residencias médicas.