Mental health of medical students: a cross-sectional study in Tehran

Medical students are subject to stress from sources related to medical training in addition to personal problems, resulting in significant mental distress. This study evaluates the scope of the problem in Tehran medical schools and sheds light on some of its associations. Students (604) of medicine from four medical schools in the city of Tehran responded to the Persian version of 28-item General Health Questionnaire (GHQ-28) in conjunction with a data collection sheet asking about age, sex, marital status, current training level, living place, grade point average in previous semester, and perceptions of their financial status. Of 602 students, 40.7% had mental distress (45.7% of female and 36.7% of male students). Distress was associated with being a woman (female to male odds ratio: 1.55) and very poor financial status (OR: 18.0).     

High fatigue and its associations with health and work related factors among female medical personnel at 54 hospitals in Zhuhai,China

The present study aimed to investigate the prevalence of fatigue and determine factors associated with fatigue in female medical personnel. Based on a cross-sectional study, a total of 1608 female medical personnel at 54 hospitals in Zhuhai, China were recruited by a multistage stratified cluster sampling method. The Symptoms Checklist-90-Revised and Chalder Fatigue Scale were used to assess psychiatric symptoms and fatigue, respectively. Data regarding demographic, health, and work related variables were also collected. Multivariate logistic regression model was constructed to determine the influencing factors of fatigue. Approximately 83% of participants had experienced fatigue in the past week. The risk of fatigue was higher in aged 30–39 years old than older or younger participants; Longer sleeping time predicted a lower prevalence of fatigue (OR = .35), while tense physician-patient relationship predicted a higher prevalence of fatigue (OR = 1.77). Depression (OR = 1.76) and anxiety (OR = 1.96) were found related to fatigue. Additionally, fatigue was associated with marital status, occupation, health related factors (exercise, regular diet, and health status), and work related factors (hospital rank and turnover intention). These study findings might facilitate development and implementation of targeted interventions and preventive measures.     

The prevalence and predictors of metabolically healthy obesity in obese rural population of China: a cross-sectional study

Till now, no evidence illustrates the prevalence and predictors of metabolically healthy obesity (MHO) in rural areas of China. The objective of this study was, firstly, to examine the prevalence of MHO in rural areas of China, and identify contributing determinants of MHO, Secondly, to comprehensively investigate to the different characteristics between MHO and metabolically unhealthy obesity (MUO). We conducted a population-based cross-sectional study of 2037 participants with obesity in rural Liaoning Province during 2012–2013. Obesity was defined as BMI ≥28 kg/m² and metabolically healthy was defined as not having the metabolic syndrome. The prevalence of MHO was 23.1%, and significantly decreased with advancing age in female group. However there was no significant tendency with advancing age in male group. Independent determinant factors for MHO were age <55 years (odds ratio [OR] 1.659; p = .001), non-current smoking (OR 1.397; p = .038), pre-menopause (OR 1.648; p = .030) and non-hyperuricemia (OR 2.317; p < .001), whereas race, gender, diet score, current drinking, marriage, sleep duration, hyperhomocysteinemia, levels of physical activity, annual income and educational status were not significant contributors. In conclusion, we found that age <55 years, non-current smoking, pre-menopause and non-hyperuricemia were identified as independent determinant factors for MHO in this population.     

The Relationship Between Religious Service Attendance and Coronary Heart Disease and Related Risk Factors in Saskatchewan, Canada

Research suggests that attending religious services could provide small yet important protective benefits against coronary heart disease (CHD) and CHD risk factors (e.g., diabetes, hypertension). The extent to which these benefits apply to Canada deserves study because approximately one-third of adult Canadians attend religious services at least monthly. Therefore, the objective of this study is to examine the association between frequency of religious service attendance and prevalence of (1) CHD, (2) diabetes, and (3) hypertension in Canada. We used the Saskatchewan sample (n = 5,442) of the Canadian Community Health Survey (CCHS-4.1) and built multivariable logistic regression models to evaluate associations between religious service attendance and self-reported CHD, diabetes, and hypertension. After controlling for demographic, socioeconomic and health behavior variables, the association between religious service attendance and prevalence of CHD was not significant (OR = 0.82; 95 % CI 0.61–1.11). However, persons who attended religious services more than once a week exhibited lower prevalence odds of diabetes (OR = 0.60; 95 % CI 0.45–0.80) and hypertension (OR = 0.82; 95 % CI 0.68–0.99) compared to persons who attended less than once a year. The findings of this study are the first to suggest religious service attendance may be associated with a lower prevalence of CHD risk factors in Canada.     

Psychometric Properties of the Greek Inventory of the Dimensions of Emerging Adulthood (IDEA): University Student Perceptions of Developmental Features

Emerging adulthood, the transitional period from adolescence to adulthood, differs demographically and is associated with the cultural and socioeconomical environment one lives in. Its key dimensions have been explored in many countries including the USA through the IDEA instrument (Reifman et al. in J Youth Dev 2(1):1–12, 2007). Five dimensions have been identified and associated with specific items. In this paper, we aim to measure the psychometric properties of the IDEA used to measure key developmental features associated with emerging adulthood in Greece. A total of 592 University Humanity and Science students, both male (29.3 %) and female (70.7 %), aged 18–30 years were asked to complete a questionnaire battery including the IDEA and a set of demographic questions. We used structural equation modeling to identify factors underlying the IDEA. We identified three factors, which we named “Identity exploration/Feeling in-between,” “Experimentation/Possibilities/Self-focused” and “Negativity/Instability.” The first two factors appeared to be more prominent in our sample, while evidence of negativity and instability was limited among the study participants. Further analyses assessed the impact of demographic characteristics of participants on the above three factors. Age, gender and type of studies appeared to exert some influence on the perception of main features of emerging adulthood. Further research linking the criteria to the developmental features characterizing this distinct age group is required in order to unveil the intricacies of the phenomena of emerging adulthood in Greece.     

Attitudes Toward Religion Scale: development and initial psychometric evaluation among Chinese college students

The Attitudes Toward Religion Scale (ATRS) was developed to access the level of interest in and position toward the five state-approved religions in China. Data were analysed across two samples of Chinese college students. With Sample 1 (N = 278), exploratory factor analyses were used to select the 10 ATRS items corresponding to two factors: Interest and Position. With Sample 2, confirmatory factor analyses (N = 270) cross-validated the two-factor oblique model as well as a bifactor model. Cronbach alphas of ATRS subscale scores in the two samples ranged from .75 to .85. ATRS-Interest and Position were both positively associated with number of close relationships with religious people. In addition, negative attitudes toward religion was associated with being religiously proselytised by strangers. Moreover, female students reported more favourable attitudes toward religion compared to their male counterparts. The overall results support ATRS as a psychometrically strong and promising measure.     

Associations Between Mixed-Gender Friendships,Gender Reference Group Identity and Substance Use in College Students

We investigated the associations between same-gender friendship, gender reference group identity, and substance use in college students (54 % male, M age?=?19.23, SD?=?1.23) from the northeastern United States using an online survey. Male students reported greater weekly marijuana, but not alcohol use than female students. Regression analyses revealed that having a greater proportion of same-gender friendships was associated with greater weekly alcohol use for male students and lesser weekly alcohol and marijuana use for female students. Gender reference group identity was negatively associated with weekly marijuana use for male and female students. For female students, gender reference group identity mediated the association between proportion of same-gender friendships and weekly marijuana use. Our study highlights the importance of considering the social context (e.g., the gender of friends) and individual variables relating to gender (e.g. gender reference group identity) in substance use research. Our findings fit within social constructionist models of social development that suggest participation in gendered contexts (e.g., same-gender or other-gender-peer contexts) over time cue gender-typed behaviors such as using marijuana.     

Childhood and Adolescent Victimization and Perpetration of Sexual Coercion by Male and Female University Students

This study examines the extent to which male and female university students use verbal sexual coercion and physically forced sex on a dating partner and tests a theoretical model that specifies that corporal punishment, minor forms of neglect by parents, and sexual abuse increase the probability of sexually coercing and sexually assaulting a partner, and that this relationship is partly mediated by antisocial traits and behavior. A path analysis using multinomial logistic regression was used to test the fit of the model to a convenience sample of 13,877 students in 32 nations. Both male and female students perpetrate sexual coercion, but the rates are higher for males. For both men and women, each of the three forms of prior victimization studied were associated with an increased probability of antisocial behavior, which in turn was associated with an increased probability of verbally coercing and physically forcing sex. Most of the direct paths from victimization to sexual coercion were also statistically significant. Because relatively mild victimization such as corporal punishment and seemingly innocuous forms of neglect are highly prevalent, steps to reduce their prevalence could be an import step in primary prevention of sexual coercion.     

Sexual Coercion Among Students at the University of Cape Coast,Ghana

Sexual coercion refers to strategies that result in an individual engaging in sexual activity against his or her will. Ecological factors influence the way sexual interactions occur; however, the relationship between these factors and sexual coercion has not been explored among university students in Ghana. The purpose of this study was to examine sexual coercion among university students in Ghana by specifically examining individual-level factors (age, gender, sexual debut, age differential with first partner, being in an intimate relationship, history of abortion, and past experiences with transactional sex) and the experience of forced and coerced sex. Residential students at the University of Cape Coast were invited to participate and completed a survey on a tablet computer. Questions included demographics; sexual and reproductive health experiences and knowledge; and attitudes and experiences with abortion. Bivariate and multivariate analyses were used to examine individual-level factors associated with experiences of sexual coercion and forced sex. There were 480 females and 556 males that completed the survey; 26.3 and 16.4% reported having had intercourse either because they were forced or coerced, or when they were “very unwilling”. These students were more likely to be female (OR 3.5), to have had an abortion (OR 2.9), and to have engaged in transactional sex (OR 1.9). Many University of Cape Coast students are experiencing forced or coerced sex. Programs targeting both female and male students as both victims and perpetrators of sexual violence in this population are sorely needed. Primary prevention of sexual violence is one promising field.     

Associations of depression,anxiety and PTSD with neurological disability and cognitive impairment in survivors of moyamoya disease

Depression, anxiety and posttraumatic stress disorder (PTSD) are common complications of cerebrovascular diseases. However, they were seldom explored in Moyamoya Disease (MMD) survivors. In this study, we measured the prevalence of depression, anxiety and PTSD in MMD survivors. We evaluated the association of mental disorders with neurological disability and cognitive impairment, and further find out the independent protective and risk factors of neurological disability and cognitive impairment. In MMD survivors, the prevalence of these three mental disorders is high, 46.7% for depression, 50% for anxiety and 47.5% for PTSD. Anxiety and PTSD were significantly associated with more severe neurological disability (p = 0.039 and < 0.001); depression and anxiety were significantly associated with greater cognitive deficiency (p = 0.004 and 0.002). We further found PTSD was the only risk factor associated with neurological disability, and the corresponding odds ratio (OR) and 95% confidence interval (CI) was 81.74 (9.91–674.17); depression and anxiety were risk factors associated with cognitive impairment, and the corresponding OR and 95%CI were 2.73 (1.10–6.81) and 3.37 (1.29–8.78). Therefore, these three mental disorders were associated with more severe neurological disability and greater cognitive deficiency in MMD survivors.     

Associations between multiple health risk behaviors and mental health among Chinese college students

Although there is substantial evidence that health risk behaviors increase risks of premature morbidity and mortality, little is known about the multiple health risk behaviors in Chinese college students. Here, we investigated the prevalence of multiple health risk behaviors and its relation to mental health among Chinese college students. A cross-sectional study was conducted in Wuhan, China from May to June 2012. The students reported their health risk behaviors using self-administered questionnaires. Depression and anxiety were assessed using the self-rating depression scale and self-rating anxiety scale, respectively. A total of 2422 college students (1433 males) aged 19.7 ± 1.2 years were participated in the study. The prevalence of physical inactivity, sleep disturbance, poor dietary behavior, Internet addiction disorder (IAD), frequent alcohol use and current smoking was 62.0, 42.6, 29.8, 22.3, 11.6 and 9.3%, respectively. Significantly increased risks for depression and anxiety were found among students with frequent alcohol use, sleep disturbance, poor dietary behavior and IAD. Two-step cluster analysis identified two different clusters. Participants in the cluster with more unhealthy behaviors showed significantly increased risk for depression (odds ratio (OR): 2.21; 95% confidence interval (CI): 1.83, 2.67) and anxiety (OR: 2.32; 95%CI: 1.85, 2.92). This study indicates that a relatively high prevalence of multiple health risk behaviors was found among Chinese college students. Furthermore, the clustering of health risk behaviors was significantly associated with increased risks for depression and anxiety.     

Effect of a Single Session of a Yogic Meditation Technique on Cognitive Performance in Medical Students: A Randomized Crossover Trial

Medical students confront enormous academic, psychosocial, and existential stress throughout their training, leading to a cascade of consequences both physically and psychologically. The declined cognitive function of these students interferes in their academic performance and excellence. The purpose of this study was to examine the effectiveness of a yogic meditation technique, mind sound resonance technique (MSRT), on cognitive functions of University Medical students in a randomized, two-way crossover study. In total, 42 healthy volunteers of both genders (5 males and 37 females) with mean age of 19.44 ± 1.31 years were recruited from a medical college in South India, based on the inclusion and exclusion criteria. A 10-day orientation in the technique of MSRT was given to all the recruited subjects after which each subject underwent both MSRT and supine rest (SR) sessions. All participants were randomized in a 1:1 ratio to receive a session of either MSRT or SR. After a day of washout, participants crossed over to receive the alternative intervention. The cognitive functions were assessed using 2 paper-pencil tasks called Digit Letter Substitution Test (DLST) and Six-Letter Cancelation Task (SLCT), before and immediately after both sessions. Both the groups showed significant improvement in net attempt of both DLST and SLCT, but the magnitude of change was more in the MSRT group than in the SR group. The MSRT group demonstrated significantly enhanced net scores in both SLCT (p < 0.001) and DLST (p < 0.001). The result of the present study suggests that a single session of MSRT, a Mind–Body Practice, may positively impact the performance in cognitive tasks by the University Medical Students.     

Health-related Quality of Life, Marital Satisfaction, and Social Support in Medical Staff in Iran

Quality of life is a subjective and multidimensional concept that includes all aspects of an individual’s life. Many investigations indicate that marital satisfaction is an important determinant of quality of life and social support affects both marital satisfaction and quality of life. Since medical staff face job stressors in their everyday life, in the present cross-sectional study, the relationships between quality of life, marital satisfaction, and social support in medical staff in Tehran were analyzed. Data collection was performed in 653 medical staff using socio-demographic questions, the SF-36 questionnaire, the ENRICH Marital Satisfaction Inventory, and the Social Support Questionnaire. The results revealed that men reported significantly higher quality of life and marital satisfaction than women, but there was no gender difference in social support. The quality of life and marital satisfaction domains were found to be differentially correlated among male and female participants. All domains of marital satisfaction were found to be significantly associated with the “vitality” and “mental health” domains among females and “physical functioning” domain in the male. Also, social support was associated with almost all quality of life domains in both sexes. The multiple regression analyses indicated that all the study variables combined with socio-demographic factors can explain between 12 % and 28 % of the variance in quality of life domains. Therefore, focusing on these factors could be an effective approach to improve quality of life in medical staff as a group with a stressful job.     

The Relationship Between Trust-in-God,Positive and Negative Affect,and Hope

We aimed to test the relationships between Trust-in-God, positive and negative affect, and feelings of hope. A sample of university students (N = 282, 50 % female) completed the Positive and Negative Affect Schedule, the Adult Dispositional Hope Scale, and a Persian measure of Trust-in-God for Muslims. The results of a series of hierarchical regression analyses indicated that Trust-in-God was positively associated with participants’ scores for hope and positive affect but was negatively associated with their scores for negative affect. The results support the relationship between Trust-in-God and indices of mental health.     

Predicting Relationship of Smoking Behavior Among Male Saudi Arabian College Students Related to Their Religious Practice

This study describes the relationships of smoking behavior among a sample of male college students in Kingdom of Saudi Arabia (KSA) to their religious practice, parents’ smoking behaviors and attitudes, peers’ smoking behaviors and attitudes, and knowledge about the dangers of smoking. A 49-item questionnaire was developed and pilot tested in KSA. This questionnaire was completed during the academic year 2013 by 715 undergraduate male students at the King Saud University in Riyadh. 29.8 % of the students were smokers (13.8 % cigarette smokers, 7.3 % sheesha smokers, and 27 % cigarette and sheesha smokers). Students in the College of Education were much more likely to be smokers than the students in the College of Science. The differences between the College of Education and the College of Science was statistically significant (χ² = 16.864. df = 1, p = .001). Logistic regression analysis suggested that students who were more faithful in their practice of Islam were 15 % less likely to smoke. Students who were more knowledgeable about the dangers of smoking were 8 % less likely to smoke. The logistic analysis identified peers (friends) as the most powerful factor in predicting smoking. The four-factor model had an overall classification accuracy of 78 %. The need to understand more fully the dynamics of peer relations among Saudi Arabian males as a basis for developing tobacco education/prevention programs. Prevention programs will need to include education and changes in the college level or earlier in KSA.     

The Role of Patient Religiosity in the Evaluation and Treatment Outcomes for Chronic HCV Infection

To determine the influence of patient religiosity on the outcome of treatment of hepatitis C infection, a prospective, blinded, cohort study was performed on hepatitis C-infected patients categorized as ‘higher religiosity’ and ‘lower religiosity’ based on responses to a religiosity questionnaire. Comparisons were made between high and low religiosity patients on demographics, pre-treatment laboratory values, and response to treatment. Eighty-seven patients with complete questionnaires were placed in either higher (38) or lower (49) religiosity cohort. The patients (60% female) were ethnically diverse: African-American 39%; Hispanic 31%; white 29%. African-American race (P = 0.001) and female gender (P = 0.026) were associated with higher religiosity. The frequency of being offered treatment, accepting treatment, and completing treatment was similar in both religiosity cohorts (P = 0.234, 0.809, 0.367). Fifty-six patients completed the 24- or 48-week treatment with peginterferon and ribavirin. Depression was more frequent in the low religiosity group (38.2% vs. 4.6%, P = 0.005). Sustained viral response rate at 3–6-month post-therapy was similar in the higher (50%) and lower (57.6%) religiosity cohorts (P = 0.580; n = 55). Logistic regression modeling revealed that males having higher religiosity gave greater odds of SVR than those with lower religiosity (OR 21.3; 95% CI 1.1–403.9). The level of religiosity did not affect the decision to begin treatment for chronic HCV infection and was not associated with a better treatment outcome. A higher level of religiosity was associated with less depression among patients.     

Sleep duration and health correlates among university students in 26 countries

The aim of this study was to investigate sleep duration and its health correlates in university students from 26 low-, middle- and high-income countries. Using anonymous questionnaires and anthropometric measurements, data were collected from 19417 undergraduate university students (mean age 20.8, SD = 2.8) from 27 universities from 26 countries across Asia, Africa and the Americas. Results indicate that the average number of self-reported hours of sleep was 7.07 (CI = 7.04–7.09), with the prevalence of reporting ≤6, 7–8, and ≥9?h sleep duration of 39.2, 46.9, and 13.9%, respectively. Multinomial logistic regression found that sociodemographic variables, health risk behaviour and health status variables were found to be associated with short and long sleep duration.     

Predictors of General Self-Efficacy and Self-Esteem in Occupational Therapy Students: A Cross-Sectional Study

A national survey reported college students showed higher risk of mental health problems than the general population. Using self-efficacy and self-esteem as indicators of mental health, this study explores sociodemographic, relational, educational, and work factors associated with these outcomes. A sample of 148 occupational therapy students in Norway participated, and data were analyzed with multiple linear regression. Factors associated with positive self-efficacy and self-esteem were higher general satisfaction with the education program, amount of time spent on self-study, and being male. Implications are attention toward female students' self-perceptions, improving the learning environment, and encouraging students to do more self-study.     

Factor analysis of a Venezuelan fear survey schedule

A Fear Survey Schedule, developed for use by university students in Venezuela, was administered to 871 first-year students at the Simón Bolivar University, Caracas, and subjected to several analyses to identify its factorial structure. Five factors were identified in the male group: Fear of aversive interpersonal events; of Violence and physical assault; of Loss of self-control; of Injuries and surgical operations; and of Animals and insects. Seven factors were identified in the female group, four of them coincided with the male group: Fear of interpersonal events; of Animals and insects; of Injuries and surgery; of Responsibility; of Death and physical threats; of Doctors and hospitals; of Violence and physical assault. The results were compared to those obtained with similar fear surveys of North American and Israeli University students.