Prevalence and correlates of depressive symptoms among matriculated university students in Singapore during Covid-19 pandemic: findings from a repeated cross-sectional analysis.

BACKGROUND: Depression is a common issue among university students and has been particularly exacerbated during the COVID-19 pandemic. However, limited research has specifically focused on depression among university entrants. OBJECTIVES: This study aimed to determine the prevalence of depression severity and identify associated factors during different phases of the COVID-19 pandemic using health screening questionnaires completed by matriculated university students in Singapore. METHODS: A repeated cross-sectional study was conducted at a public university in Singapore. Data from health screening questionnaires administered in 2020 and 2021, involving 15,630 newly enrolled university students, were analyzed. The questionnaires covered students' sociodemographic information, physical health status, own and family medical history, lifestyle behaviours, and the Patient Health Questionnaire (PHQ-9). The PHQ-9 was used to measure the severity of depressive symptoms, categorizing into moderate to severe depressive symptoms (MSDS), mild depressive symptoms (MDS), or no depressive symptom (NDS). Multinomial logistic regression was used to assess the sociodemographic, physical and behavioural correlates of depression. RESULTS: The prevalence of MSDS was 1% in both 2020 and 2021, while the rates for MDS were 1.93% in 2020 and 1.64% in 2021. In the 2020 cohort, male freshmen who reported better health had a lower likelihood of experiencing depression. Conversely, students of Malay ethnicity, those majoring in Engineering, those with multiple chronic diseases, monthly alcohol consumers, current smokers, and those with a family history of mental disorder had a higher likelihood of experiencing depression. Moreover, students who lived on-campus in the 2021 cohort were less likely to experience depression than those living off-campus. However, the associations between academic majors, alcohol consumption, and smoking with depression were not significant in the 2021 cohort. CONCLUSIONS: This study reported a low prevalence of both MSDS and MDS among university entrants in Singapore. The study further identified three categories of factors associated with depression: sociodemographic, physical, and behavioural. This study suggests policy interventions to enhance targeted social support that address each student group's specific requirements and susceptibilities. A more extensive and comprehensive study is warranted to assess the changes in student mental health status post-COVID-19 pandemic.

Knowledge and attitudes of medical and pharmacy university students regarding monkeypox: a multicenter, cross-sectional study in Vietnam.

BACKGROUND: In May 2022, monkeypox (mpox) suddenly reappeared and rapidly spread worldwide. This global outbreak was a public health emergency of international concern. This study investigated Vietnamese medical and pharmacy university students' knowledge and attitudes towards mpox. METHODS: This online cross-section survey was administered among students in four universities using a convenience sampling method. A semi-structured questionnaire was shared among students via a Google Forms link (quick-response code) in university amphitheaters at recess. Frequency (percentage) and mean (standard division) were used for descriptive statistics. Univariate and multivariate linear regression analyses were conducted to identify factors associated with students' mpox knowledge and attitudes. A p-value < 0.001 was considered statistical significance. RESULTS: A total of 1,848 students participated in this study (including 1,030 medical students and 818 pharmacy students). Their common sources for seeking mpox/health information included the Internet (89.7%) and mass media (64.2%). Students' average knowledge and attitude scores were 11.542 ± 3.910 (range: 0-23) and 30.301 ± 3.738 (range: 9-45), respectively. The average knowledge score of pharmacy students (12.139 ± 3.545) was significantly higher than that of medical students (11.067 ± 4.118) (p < 0.001). The average attitude score of the former (30.454 ± 3.787) was comparatively higher than that of the latter (30.181 ± 3.696), but this difference was insignificant (p = 0.111). Factors significantly associated with students' mpox knowledge and/or attitudes were their sex, age, year of study, residence, major, grade point average, type of university, seeking mpox information in the past, and using reliable sources to seek health information (p < 0.001). A positive correlation existed between students' knowledge and attitude scores (p < 0.001). CONCLUSIONS: Students' knowledge about mpox was relatively poor, while their attitudes were comparatively positive. Universities and relevant authorities should focus on the above factors and use multiple platforms and channels of communication to guarantee that trustworthy information about mpox can reach as many students as possible.

Investigation of Gambling Behavior, Self-Confidence and Psychological Resilience Levels of University Students.

The aim of this study is to examine the relationship between gambling behavior, self-confidence, and psychological resilience levels among university students. Additionally, the study aims to investigate the relationship between gambling behavior and socio-demographic variables. This descriptive and cross-sectional study was conducted between April and June 2023. The research employed a questionnaire, the Brief Psychological Resilience Scale, the South Oaks Gambling Screen (SOGS), and the Self-Confidence Scale. The study was carried out online, reaching 229 students through Google Forms. According to the SOGS scores, 4.8% of the students are at risk of gambling addiction. Male students have statistically significantly higher SOGS scores than female students. The SOGS score is significantly higher in working students, smokers, and alcohol drinkers (p < 0.05). No statistically significant relationship was found between the students' SOGS scores and the self- confidence scale (p = 0.637) and the brief resilience scale (p = 0.675). It is thought that training should be given to risky groups in order to prevent gambling behavior. In addition, it is thought that supporting university students to be active in different arts and sports fields may have a positive effect on preventing and reducing addictions.

The impact of an online educational game on breast cancer awareness among university female students, Malaysia: a pilot study.

BACKGROUND: Breast cancer is one of the world's most prevalent cancer and the most common type of cancer in Malaysia. Interestingly, breast cancer in young women is more aggressive compared to older women and the survival rate among these groups of individuals is poor. Thus, breast cancer awareness is essential among young women as early detection is possible and treatment will be effective during which the disease is curable. Hence, the purpose of this study is to design and evaluate the impact of an educational game on breast cancer awareness among female university students in Malaysia. METHODS: This is a one-group pre-and post-intervention pilot study. It was conducted in Private and public higher education institutions around Malaysia. An online education game was created and used as the intervention. A self-administered questionnaire was administered to the participants during the pre-and post-intervention test to evaluate the online educational game on breast cancer awareness. RESULTS: A total of 52 responses were collected. The mean age of the participants was 21.98 (SD = 1.896) years. The findings showed a statistically significant median increase (p < 0.05) in breast cancer knowledge scores among participants in the post-intervention. A median increase in breast cancer knowledge score of 6 was shown when participants were exposed to the online education game (24.00) compared to before they were exposed to it (17.00). CONCLUSION: Using online educational games effectively raised awareness of breast cancer among university students. Online games can be used as a health educational tool to promote awareness of a topic of interest, as digital games can be accessed easily, game content can be tailored made or updated, and improve participant engagement in learning.

The Impact of the COVID-19 Pandemic on the Mental Health of First-Year Undergraduate Students Studying at a Major Canadian University: A Successive Cohort Study.

OBJECTIVE: To examine the impact of the COVID-19 pandemic on first year undergraduate student mental health. METHODS: As part of the Queen's University U-Flourish Student Well-Being and Academic Success study, three successive cohorts of students entering undergraduate studies in 2018 (pre-pandemic), 2019 (transitional), and 2020 (during pandemic) completed electronic surveys at entry and completion of first year. Validated self-report measures were used to assess mental health status including symptom levels of anxiety, depression, and insomnia, self-harm and frequency of substance use. Propensity matching and multivariable log-binomial regression were used in comparisons of mental health indicators across the cohorts. RESULTS: Clinically significant symptoms of depression, anxiety, insomnia, and self-harm were reported more frequently in the 2020-2021 cohort, coincident with remote learning and pandemic restrictions. In female students, screen positive rates for anxiety and depression, and suicidal ideation increased from about one-third to just under one-half in association with the pandemic (χ2, p < .01), while increases in mental health concerns were less pronounced among males. Among females, increases in clinically significant symptoms over first year appeared greatest during the pandemic year, while striking decreases in alcohol consumption in both females and males were reported in that same year. Studying under pandemic conditions had a negative impact on student well-being, social relationships and school connectedness, quality of learning experience, leisure activities, and optimism about future prospects. CONCLUSIONS: Mental health concerns including anxiety, depression and sleep problems increased in first year students during the pandemic, especially among females, while alcohol use declined. These findings highlight the negative mental health impact associated with studying under pandemic restrictions involving remote learning and social distancing.

Food insecurity was negatively associated with adherence to the "fruits, vegetables, and foods rich in animal protein" dietary pattern among university students' households: the 2018 Mexican National Household Survey.

BACKGROUND: University students are often affected by food insecurity (FI) and this situation has been associated with low consumption of fruit/vegetables and high intake of added sugars and sweet drinks. However, there needs to be more evidence on the association between FI and dietary patterns (DPs), assessing the overall diet and allowing analysis of commonly consumed food combinations. We aimed to analyze the association between FI and DPs in university students' households. METHODS: We used data from 7659 university student households from the 2018 Mexican National Household Income and Expenditure Survey (ENIGH, for its acronym in Spanish). We obtained FI levels (mild, moderate, and severe) using the validated Mexican Food Security Scale (EMSA, Spanish acronym). Two DPs were identified by principal component analysis based on the weekly frequency of consumption of 12 food groups. Multivariate logistic regression adjusted by university student and household's characteristics was applied. RESULTS: Compared to food security, households with mild-FI (OR:0.34; 95%CI:0.30, 0.40), moderate-FI (OR:0.20; 95%CI:0.16, 0.24) or severe-FI (OR:0.14; 95%CI:0.11, 0.19) were less likely to adhere to the dietary pattern "Fruits, vegetables and foods rich in animal protein" (fruits, vegetables, meat, fish or seafood, dairy products, and starchy vegetables). In addition, people with severe-FI (OR:0.51; 95% CI:0.34, 0.76) were also less likely to adhere to the dietary pattern "Traditional-Westernized" (pulses, oils or fats, sugar, sweets, industrialized drinks, foods made from corn/maize, wheat, rice, oats or bran, coffee, tea and eggs). CONCLUSIONS: In these households FI impairs the ability to consume a healthy dietary pattern (fruits/vegetables and foods rich in animal protein). In addition, the intake of foods typical of the Mexican food culture reflecting the local Western dietary pattern is compromised in households with severe-FI.

Fear of detachment from mobile phone: nomophobia and suicidality among Malaysian university students before and during the COVID-19 pandemic.

The attachment to mobile devices during the COVID-19 pandemic has led to the possibility of increased nomophobia, which is the intense fear of losing access to one's mobile device. Therefore, this study aimed to determine if nomophobia was independently associated with suicidality before and during the COVID-19 pandemic among university students in Malaysia. This cross-sectional study had two-time points in data collection: one year before and one year into the COVID-19 pandemic. N = 806 university students aged ≥ 18 years completed an online questionnaire comprising the Nomophobia Questionnaire, Multidimensional Scale of Perceived Social Support, and the Suicidal Behaviors Questionnaire-Revised. A multiple logistic regression (controlling for gender, age, and social support) was conducted to determine the association between nomophobia and suicidality before and during the COVID-19 pandemic. The prevalence of severe nomophobia before and during the COVID-19 pandemic was 15.7% and 35.6% respectively. The level of nomophobia was significantly higher during the COVID-19 pandemic compared to pre-pandemic. Pre-pandemic, there were no significant associations. During the pandemic, participants with moderate (aOR 3.09, 95% CI [1.14-8.40], p = .027) and severe (aOR 3.57, 95% CI [1.25-10.20], p = .018) nomophobia had higher odds of suicide plan. During the pandemic, moderate and severe nomophobia were independently associated with more than three times higher odds for a lifetime suicide plan. Our study findings carry implications for the well-being of university students.

The relationship between fear of COVID-19 and psychological resilience according to personality traits of university students: A PATH analysis.

PURPOSE: The purpose of the current research was to identify the influence of university students' personality traits on their fear of COVID-19 and psychological resilience levels. DESIGN AND METHODS: A cross-sectional trial was completed with 690 students. Descriptive statistics and correlations were calculated, and a path analysis was employed with the objective of assessing the model fit and investigating direct and indirect impacts. FINDINGS: Among personality traits, conscientiousness and neuroticism were observed to affect fear of COVID-19, and conscientiousness, neuroticism, and openness to experience had an effect on psychological resilience. The tested model has a good fit and explains the direct effects of the study variables. PRACTICE IMPLICATIONS: Nurses should improve university students' psychological resilience by supporting them with protective and improving factors. The role of the psychiatric nurse is important in providing conscious and need-oriented support in extraordinary events such as pandemics.

Impact of educational intervention regarding COVID-19 on knowledge, attitude, and practice of students before dental school re-opening.

BACKGROUND AND AIM: Lack of knowledge on COVID-19 among people and healthcare staff significantly impacts late management and its rapid transmission. Dental students must be aware of the exact preventive instructions due to their close contact with patients and clinical work in the dental setting during the pandemic. This interventional study aimed to investigate the effectiveness of designed educational content regarding COVID-19 on Iranian dental students' knowledge, attitudes, and practices at Alborz University of medical sciences. MATERIALS AND METHODS: A total of 88 dental students were investigated in this study. Educational content was designed based on the clinical guidelines regarding COVID-19 in dentistry. The content was presented to dental students as a three-hour webinar. In addition, the online, validated questionnaire was obtained from the students as pre, post, and follow-up surveys. RESULTS: A statistically significant difference between students' knowledge, attitudes, and practices were obtained before and after the intervention and the follow-up survey. 48.58% improvement in knowledge score, 6.37% in attitudes, and 17% in practice scores were observed. CONCLUSION: Although this educational intervention significantly improved the knowledge, attitude, and practice of dental students, additional education and clinical training are mandatory for effective and safe dental practice management in future crises.

Perceived academic challenges of Jewish and Arab undergraduates during the first wave of COVID-19.

This study examined differences between Arab and Jewish undergraduate students in their perceived academic challenges, COVID-19-related concerns, perceived social support and trust in the university and the government. It also examined factors associated with perceived academic challenges and the moderating role of trust in the university in the associations between COVID-19-related concerns and perceived academic challenges. The sample consisted of 2751 students: 2291 (83%) Jewish, 398 (15%) Arab and 61 (2%) 'other'. Arab students reported higher COVID-19-related concerns and perceived academic challenges, and lower levels of perceived social support and trust in university and government than did Jewish students. Both Jewish and Arab students identified COVID-19-related concerns as a stress-vulnerability factor for perceived academic challenges, whereas perceived social support and trust in the university were identified as resources for perceived academic challenges. No support was found for the role of trust in government in the face of perceived academic challenges nor for the moderating role of trust in the university in the associations between COVID-19-related concerns and perceived academic challenges. In conclusion, the need of Arab students for emotional and academic support needs to be acknowledged as part of the efforts to promote academic success during the pandemic.

Accommodation environments and student mental health in the UK: the role of relational spaces.

BACKGROUND: Despite Universities UK emphasising a "whole university approach" to improve mental health and wellbeing, quantitative research exploring the role of accommodation environments in student mental health is limited. AIM: To explore the effects of physical and social structures on university student mental health in the UK. METHODS: Using a cross-sectional sample of newly acquainted student residents living in shared accommodation in North West England (n = 904), this study sought to investigate how accommodation environments influence students' mental health with a focus on the concept of relational spaces. RESULTS: Within the milieu of university accommodation, a low sense of belonging and feeling uncomfortable were associated with higher levels of depression, anxiety, and loneliness. Poor relationships with fellow residents and not using communal areas were associated with higher levels of depression and loneliness, whilst sharing cooking with others was associated with higher levels of depression and anxiety. CONCLUSIONS: For students to flourish in their new homes, accommodation providers must consider relational wellbeing, making places that foster a sense of belonging where students feel sufficiently connected to others. As empowering communities and promoting community cohesion is central to health and wellbeing promotion, greater efforts need to be made to consider relational aspects of space and wellbeing in the design and stewardship of student accommodation.

COVID-19 vaccination intent in university students and influencing factors: An analytical cross-sectional.

OBJECTIVE: To determine coronavirus disease-2019 vaccination intent and factors influencing the decision among university students. METHODS: The analytical cross-sectional study was conducted from 25 January - 25 February 2021 at a state university in Mugla, Turkey, and comprised undergraduate students. Data was collected using a self-designed questionnaire through Google Forms. Factors affecting vaccination intent were identified using multinomial logistic models. Data was analysed using SPSS 22. RESULTS: Of the 1069 subjects, 629(58.8%) were females and 440(41.2%) were males. The overall mean age of the sample was 21.34±2.99. Overall, 712(66.6%) students were enrolled in health-related fields, and 357(33.4%) were pursuing non-medical degrees. Besides, 578(54.1%) students intended to have the vaccine. While 458(64.3%) of the subjects studying health-related subjects intended to have the vaccine, only 120(33.8%) in other academic streams said they would get vaccinated. Students who had had the disease or had been in contact with someone who had it 102(33%) were more likely to believe that the vaccine was safe. Smoking, having a flu vaccine in the past, and having a coronavirus disease-2019 test were the factors influencing the intent to have the vaccination (p<0.05). CONCLUSIONS: Having had a flu vaccine in the past, social media use, history of, or exposure to, coronavirus disease-2019 and enrolment in health-related programme of studies were the factors influencing the vaccination intent of the students.

Functional Food Consumption and Its Associated Factors among University Students in Malaysia during COVID-19 Pandemic.

Background: In the current situation of COVID-19, dietary intake that incorporates functional foods may potentially be a preventive measure for defence against viral infection. This study aimed to determine the consumption of functional foods and its associated factors among university students during COVID-19. Methods: This was a cross-sectional study conducted among 284 Malaysian university students in Kuala Lumpur, Malaysia. An online self-administered questionnaire was employed to assess subjects' nutrition knowledge, dietary habits, attitude towards functional foods, recognition and consumption of functional food products. Results: Out of 284 respondents, 41.9% had poor level of nutrition knowledge and 57% had moderate level of functional food-related attitude, with seven types of functional foods consumed on average (57.0%). Binary logistic regression showed that university students who consumed fruits at least three times per day (aOR = 11.18; 95% CI: 1.46, 80.17), salty snacks (aOR = 2.90; 95% CI: 1.43, 5.86), soft drinks/sugar-sweetened beverages (SSB) (aOR = 3.12; 95% CI: 1.53, 5.26) and pure juice (aOR = 2.80; 95% CI: 1.48, 5.30) were more likely to consume functional foods during COVID-19 (P < 0.05). Conclusion: The findings could provide information to public and private sectors in terms of creating a supportive environment to encourage and promote the awareness and consumption of functional foods and their associated health benefits.

Nutritional quality and carbon footprint of university students' diets: results from the EHU12/24 study.

OBJECTIVE: To evaluate diets in terms of nutritional characteristics and quality from the perspectives of health, greenhouse gas emissions (GHGE) and possible associations with each other in a representative sample of students at a public university. DESIGN: Cross-sectional. Dietary intake was evaluated with a validated FFQ, and diet quality was assessed through the Healthy Eating Index (HEI-2010) and MedDietScore (MDS). GHGE data were obtained from the literature. In addition, sex, socio-economic status (SES) and body fat (BF) status were analysed as covariates. SETTING: Basque Autonomous Community, Spain. PARTICIPANTS: Totally, 26 165 healthy adults aged 18-28 years. RESULTS: Student diets were characterised by low consumption of carbohydrates (38·72 % of total energy intake (TEI)) and a high intake of lipids (39·08 % of TEI). Over half of the participants had low dietary quality. The low-emitting diets were more likely to be consumed by subjects with low HEI-2010 scores (ß: 0·039 kg eCO2/1000 kcal/d) and high MDS scores (ß: -0·023 kg eCO2/1000 kcal/d), after controlling for sex, SES and BF status. Both the low-emitting and healthy diets were more likely to be consumed by women and by those with normal BF percentage. CONCLUSIONS: UPV/EHU university students' diets were characterised by moderate quality from a nutritional perspective and moderate variation in the size of carbon footprints. In this population, diets of the highest quality were not always those with the lowest diet-related GHGE; this relationship depended in part on the constructs and scoring criteria of diet quality indices used.

Alcohol use and family-related factors among Spanish university students: the unHicos project.

BACKGROUND: During adolescence and youth there are relevant changes in the consolidation, gain or loss of consumption habits and lifestyles and the family factors has a fundamental role to development these habits. The study of the consumption of toxins, such as alcohol intake, is crucial at this stage due to the repercussions that said consumption presents in adulthood. Therefore, the objective of our study was to evaluate the associations between alcohol consumption patterns and related family factors (family functioning, family history of alcohol consumption) in Spanish university students. METHODS: Observational, descriptive, cross-sectional, multicenter study, carried out in first-year university students from 11 Spanish universities. Through an online questionnaire, alcohol consumption (risky consumption and intensive consumption or binge drinking), family functioning and history of alcohol in the family were evaluated. Risky alcohol consumption and binge drinking were assessed using the AUDIT test, and family functioning was assessed using the family APGAR questionnaire. A descriptive analysis of the data was performed, as well as the Chi-Square test and Student's T-Test, and non-conditional logistic regression models were carried out to examine this association. RESULTS: The prevalence of risky alcohol consumption identified in the 10,167 respondents was 16.9% (95% CI = 16.2-17.6), and that of BD was 48.8% (95% CI = 47.9-48.8). There is a significant association between risky alcohol consumption and family functioning in students of both sexes, with greater consumption in the face of severe dysfunctional support (men OR = 1.72; p < 0.001 and women OR = 1.74; p < 0.001) and family history of consumption (p = 0.005). Regarding the binge drinking pattern, no statistically significant differences were observed. CONCLUSIONS: Risky alcohol consumption in university students is associated with dysfunctional family support, unlike the binge drinking pattern, where there is no such association. The findings of this study show the importance of creating prevention programs focused on the family approach in university students, which include alcohol screening in the population with a family history of this substance, and greater social support from health services.

Knowledge, attitudes, and practices of university students regarding COVID-19: a cross-sectional study in Vietnam.

OBJECTIVE: This cross-sectional study investigated the knowledge, attitudes, and practices (KAP) of Vietnamese university students regarding COVID-19. METHODS: A validated questionnaire (Cronbach's alpha = 0.71) was used to survey 1,025 students. A convenience sampling method was used for recruiting students from April to May 2022. The Wilcoxon rank-sum test and the Kruskal-Wallis rank-sum test/Dunn test for multiple comparisons were employed to compare students' KAP scores between two groups and among three groups or more, respectively. Factors associated with students' COVID-19 KAP scores were determined via univariate and multivariate linear regression models. Variables in the multivariate linear regression models were chosen using the Bayesian Model Averaging method in R software version 4.2.0. RESULTS: A majority of students had good knowledge (75.61%), positive attitudes (98.24%), and good practices toward COVID-19 (94.93%). Regarding the COVID-19 knowledge, the proportions of students who knew that mosquito bites and exposure to/eating wild animals would not lead to COVID-19 infection were not high (47.22 and 34.34%, respectively). More importantly, 70.34% of students thought that vitamins and minerals could help prevent or cure COVID-19. Antibiotics were the first choice for COVID-19 treatment of 438 students (42.73%). Nearly half of students (48.0%) bought antibiotics to keep at home in case of COVID-19 infection. The average KAP scores of medical students (19.97 ± 3.99, 45.10 ± 3.94, 9.72 ± 1.78) and females (18.67 ± 4.44, 44.79 ± 3.79, 9.36 ± 1.84) were significantly higher than those of non-medical students (16.48 ± 4.37, 43.33 ± 4.03, 8.68 ± 1.87) and males (17.01 ± 4.55, 42.79 ± 4.39, 8.77 ± 1.97), respectively (p < 0.001). Older students were more likely to have good knowledge and practices than the younger ones (p < 0.001). In addition, students using websites of the World Health Organization/the Ministry of Health and scientific articles to seek COVID-19 information were significantly associated with higher KAP scores when compared with those not using these sources (p < 0.001, p < 0.001, and p = 0.00139, respectively). CONCLUSION: Students' KAP scores significantly varied by age, sex, major, and sources of COVID-19 information. Although many students had sufficient knowledge, positive attitudes, and good preventive practices toward COVID-19, additional education and training strategies are paramount, especially for non-medical students and males.

Towards a health promoting university: descriptive findings on health, wellbeing and academic performance amongst university students in Australia.

BACKGROUND: Universities are increasingly recognised as institutions where health and wellbeing can be promoted to maximise academic outcomes, career transitions, and lifelong positive health behaviours. There is concern about the mental health of university students and other factors which affect academic outcomes particularly for subgroups such as international students. There are few cohort studies of the breadth of issues that can impact on mental health and academic outcomes for both local and international students. We conducted a baseline prevalence survey of students at a large Australian university covering health, academic, and social determinants of wellbeing. The purpose was to inform the university's new student health and wellbeing framework with a view to follow-up to determine predictors of mental ill-health and academic outcomes in the subsequent year. In this paper we present the baseline prevalence data and report on selected mental health and health care access issues for local and international students. METHODS: The entire university population as of April 2019 of over 56,375 students aged 18 or above were invited to complete the online survey. Questions explored eight domains: demographic characteristics, general health and wellbeing, mental health, risk taking behaviours, psychosocial stressors, learning and academic factors, social and cultural environment, and awareness of and access to health and wellbeing services. Records of academic results were also accessed and matched with survey data for a large subset of students providing consent. RESULTS: Fourteen thousand eight hundred eighty (26.4%) students commenced our survey and were representative of the entire student population on demographic characteristics. Three quarters were aged between 18 to 25 years and one third were international students. Eighty-five percent consented to access of their academic records. Similar proportions of local and international students experienced symptoms of a depression or anxiety disorder, however international students were less aware of and less likely to access available health services both inside and external to the university. We also reported on the prevalence of: general lifestyle factors (diet, exercise, amount of daily sleep); risk-taking behaviours (including alcohol, tobacco and other drug use; unprotected sexual activity); psychosocial stressors (financial, intimate partner violence, discrimination, academic stressors, acculturative stress); subjects failed; resilience; social supports; social media use; and health services accessed online. CONCLUSIONS: This rigorous and comprehensive examination of the health status of local and international students in an Australian university student population establishes the prevalence of mental health issues and other psychosocial determinants of health and wellbeing, along with academic performance. This study will inform a university-wide student wellbeing framework to guide health and wellbeing promotion and is a baseline for a 12-month follow-up of the cohort in 2020 during the COVID-19 pandemic.

Water pipe smoking among public versus private university students in Ankara, Turkey: an online survey.

BACKGROUND: Water pipe smoking has become a global public health problem as its popularity increased over time, especially among youth. The objective of our study was to estimate water pipe tobacco smoking prevalence and to assess socioeconomic factors associated with ever water pipe smoking by public and private university students in Ankara, Turkey. METHODS: This descriptive study was based on a survey conducted among public (n=2685) and private (n=2485) university students via an online questionnaire on demographics and water pipe consumption patterns. For every student in the sample, a socioeconomic status index was calculated using principal component analysis. Binary logistic regressions for the outcome variable of ever-using water pipe yielded estimates of adjusted odds ratios (aORs) for the associated factors such as the respondent's age, gender, university type, and socioeconomic status. RESULTS: The prevalence of ever use of water pipe was 69.1% (95% CI: 67.2-70.9%) among private and 59.1% (95% CI: 57.2-60.9%) among public university students. A substantial share of ever users were current users (25.5% in private versus 21.6% in public, p=0.008). On average, private university students had higher socioeconomic status than public university students (for example, access to a car (51.7% versus 35.8%, p=0.008), financial support from family (71.5% versus 65.1%, p<0.001)), also demonstrated by a higher socioeconomic status index. Being a private university student (aOR 1.57, 95% CI: 1.38-1.79), older (aORs 1.50 to 2.39, p<0.001), male (aOR 2.36, 95% CI:2.06-2.70), as well as having greater financial resources, such as having access to a car (aOR 1.24, 95% CI:1.07-1.42), or having income support from family (aOR 1.32, 95% CI:1.13-1.54), were associated with ever-using water pipe. A higher SES index was significantly associated with higher odds of ever using water pipe among both private (aOR 1.13, 95% CI:1.06,1.20) and public university (aOR 1.12, 95% CI:1.06,1.19) students. CONCLUSIONS: Water pipe smoking was common in both public and private universities; however, private university students had higher odds of ever using water pipe. There is an urgent need to implement evidence-based interventions, taking into account the socioeconomic status of young adults, to prevent them from water pipe smoking.

Differences in digital health literacy and future anxiety between health care and other university students in England during the COVID-19 pandemic.

BACKGROUND: This study investigates university students' digital health literacy and web-based information-seeking behaviours during the early stages of the COVID-19 pandemic in England. It compares undergraduate and postgraduate students in non-health related subjects with health care students, many of whom were preparing for, or working in, frontline roles. The survey was conducted as part of a wider study by the COVID-HL research consortium. METHODS: A cross-sectional study was conducted among n = 691 university students aged ≥18 years from 25 universities across England using an adapted digital survey developed by COVID-HL. Data were collected regarding sociodemographic characteristics and specific measures drawn from the Future Anxiety Scale and the Digital Health Literacy Instrument (DHLI). These had been adapted for use in an English setting and to the specific context of the COVID-19 pandemic. Other data collected included students' anxiety or worries about the future using the Dark Future Scale as well as behaviours in online information-seeking. Data were analysed using correlations to test for relationships between constructs and also between group comparisons to test for differences between students studying health and non-health related subjects. RESULTS: Across digital health literacy dimensions, there was no significant difference between students studying health-related subjects and other students. Health care students did report greater difficulties in relation to how to behave online. They also relied less on public body sources for information about the pandemic. A significant difference was found between the two student populations in relation to their anxiety about the future with health care students reporting fewer fears about the future. CONCLUSIONS: Although digital health literacy is well developed in university students, a significant proportion of students still face difficulties with evaluating online information which may frustrate public health efforts. This could be addressed by ensuring health students' curriculum in particular encompasses digital health literacy.

Development and proposed evaluation of an eHealth learning tool for undergraduate university students in Ireland.

Undergraduate university students are at a critical stage of development in terms of their academic, social, psychological and behavioural health. Patterns established during these formative years can last a lifetime. eHealth tools have the potential to be engaging, convenient and accessible to a wide range of students by providing health information and enhancing the uptake of positive health behaviours. The 'Healthy Trinity Online Tool' (H-TOT) was developed in collaboration with students and a transdisciplinary team with decades of experience between them in terms of research, clinical responsibility and service delivery. Developmental steps undertaken included: a literature review to formulate the topic content choices; a survey of students to check the relevance and suitability of topics identified; and, the tacit experience of the development team. This co-design model led to the development of content encompassing academic life, healthy eating, physical activity, mood, financial matters, alcohol, tobacco, drugs and relaxation. Qualitative focus groups were subsequently conducted for in-depth exploration of the usage and functionality of H-TOT. The theoretical underpinnings include the locus of control and social cognitive theory. Evidence-based behavioural change techniques are embedded throughout. During early pre-piloting of H-TOT, the team identified and solved content functionality problems. The tone of the content was also revised to ensure it was non-judgemental. To make the H-TOT as interactive as possible, video scenarios were included and all content was audio-recorded to allow playback for students with visual or learning difficulties. Evaluation plans for the pilot year of H-TOT are outlined.