Happiness and health behaviours among university students from 24 low,middle and high income countries

The aim of this study was to examine health behaviours and happiness and associated factors in low, middle and high income countries. In a cross-sectional survey, 17 508 undergraduate university students (mean age 20.9, SD = 2. 8) from 25 universities in 24 countries across Asia, Africa and the Americas self-completed anonymous questionnaires. Results indicate that the overall happiness mean score among university students across 24 countries was 13.7 (range 4–20). Generally, the study found that university students from countries of the Caribbean, South America and sub-Saharan Africa had greater happiness scores than students from countries in North Africa and Asia. In multivariate linear regression analysis, better subjective socio-economic status, coming from an higher income country, higher social support, higher intrinsic religiosity, higher personal mastery, positive health behaviours (regular breakfast, adequate physical activity, habitual seatbelt use, regular dental check-ups, not having had an injury, not drinking and driving) and negative health behaviours (not having three or more servings of vegetables and eating red meat daily) were correlated with happiness. Improvement to the happiness of university students should consider regional differences in socio-economic environment.     

Factors associated with self-rated health status among university students from 26 low,middle and high income countries

The aim of this study was to investigate self-reported health status and associated factors in low, middle and high income countries. Using anonymous questionnaires, data were collected in a cross-sectional survey from 19 811 undergraduate university students (mean age=20.8, SD=2.8) from 27 universities in 26 countries across Asia, Africa and the Americas. Results indicate that the overall self-rated health status score was 3.0 (range 1–5). Generally, university students from study countries of the Caribbean, South America and North Africa, Near East and Central Asia had greater self-rated health status scores than students from study countries in Asia. In multivariate stepwise linear regression analysis, older age, coming from an upper middle income or high income country, higher personal control, better mental health (not having sleep problems, and having no or fewer PTSD symptoms), and having normal weight predicted better self-rated health status. Paradoxically, a poor healthy dietary score and low physical activity were also associated with better self-rated health status. In comparing self-rated health status across a large sample of students across many countries, associations were found between sociodemographic, psycho-social and health related variables and self-rated health status.     

Association between tobacco use,depression, and anxiety: A cross-national study among university students from 30 low- and middle-income countries

This study aimed to investigate the association between tobacco use and depression and anxiety in a cross-national study among university students from 30 predominantly low- and middle-income countries. Self-report survey data were collected from 23 073 university students (58.0% female), with a mean age of 20.8 years (SD = 2.5). Following logistic regression analyses, tobacco using university students were more likely to have depressive symptoms and anxiety (posttraumatic stress symptoms = PTSS) than non-tobacco using students. Gender stratified analysis found associations between tobacco use and depressive symptoms were stronger among women than men. The associations between tobacco use and anxiety (PTSD) symptoms were stronger among men than women. In this large cross-national study, current tobacco use was significantly associated with depression and anxiety (PTSD) symptoms. Tobacco use prevention efforts can help alleviating mental health problems among university students.     

Post-traumatic stress disorder and health risk behaviour among persons 15 years and older in South Africa

The aim of this study was to investigate the association between post-traumatic stress disorder (PTSD) and health risk behaviours among persons 15 years and older in South Africa. We analysed data from the South African National Health and Nutrition Examination Survey (SANHANES-1, 2012) (N = 15 201; mean age = 36.9 years, SD = 16.5; 2.1% with PSTD, 4.0% with partial PTSD). The survey included questions from validated measures of the following health risk behaviours: problem drinking, current tobacco use, physical activity, sedentary behaviour, vegetable consumption, and fast food and frequent soft drinks consumption. In adjusted logistic regression analysis, only self-reporting with PTSD was associated with problem drinking. The data did not yield significant association between PTSD status and any of the other health risk behaviours (tobacco use, low physical activity, and fast food consumption).     

Mental health correlates of HIV risk behaviour and STIs/HIV infection among university students from 22 low,middle and high income countries

The aim of this study was to determine mental health correlates of HIV risk behaviour and self-reported STIs/HIV infection among university students in 22 low, middle and high income countries. Data on mental health and HIV risk were collected from 16 567 undergraduate university students (mean age 20.9, SD = 2.9) from 23 universities in 22 countries across Asia, Africa and the Americas. Results indicate that overall 16.8% of the students had two or more sexual partners in the past 12 months, and among the sexually active, 73.7% had inconsistently used a condom in the past three months with their primary sexual partner, 3.2% had ever been diagnosed with a sexually transmitted infection (STI) and 0.6% had been diagnosed with HIV. In multivariate logistic regression poorer mental health and child abuse (physical and sexual) were associated with HIV risk behaviour, and child abuse (physical and sexual) was associated with STI and HIV positive diagnoses.     

Loneliness: Its correlates and associations with health risk behaviours among university students in 25 countries

The aim of this cross-national study was to assess factors associated with loneliness and to determine the degree to which loneliness affects health status and risk behaviours among university students. Data were collected from 17 886 university students in 25 countries (females = 58.6%, from Africa = 33.5%). In multivariable logistic regression, loneliness was predicted by lower family wealth, living in a low or lower middle income country, and antecedent childhood. Moreover, psychosocial factors of perceived lack of control, low organised religious activity, high non-organised religious activity, high intrinsic religiosity, and low social support were associated with loneliness. Lonely students were also likely to self-report poor subjective health status, sleeping problems, short sleep duration, tobacco use, heavy internet use, aggressive behaviour, injury, and sexual risk behaviour. University students with loneliness may be assisted by preventive health interventions aimed at enhancing their subjective well-being.     

Self-efficacy for health-related behaviour change in patients with TIA or minor ischemic stroke

Abstract

Objective: To assess levels of self-efficacy for health-related behaviour change and its correlates in patients with TIA or ischemic stroke.

Methods: In this prospective cohort study, 92 patients with TIA or ischemic stroke completed questionnaires on self-efficacy for health-related behaviour change and fear, social support and depressive symptoms. Relations between fear, social support, depressive symptoms, cognitive impairment, vascular risk factors and history and demographic characteristics and low-self-efficacy were studied with univariable and multivariable logistic regression.

Results: Median total self-efficacy score at baseline was 4 (IQR 4–5). Older age (OR 1.05, 95% CI 1.01–1.09), depressive symptoms (OR 1.09, 95% CI 1.03–1.16), presence of vascular history (OR 2.42, 95% CI 0.97–6.03), higher BMI (OR 1.15, 95% CI 1.01–1.30), fear (OR 1.06, 95% CI 1.01–1.12) and low physical activity (OR 1.49, 95% CI 1.01–2.21) were significantly associated with low self-efficacy.

Conclusion: Patients with recent TIA or ischemic stroke report high self-efficacy scores for health-related behaviour change. Age, vascular history, more depressive symptoms, higher BMI, less physical activity and fear were correlates of low self-efficacy levels.

Practice implications: These correlates should be taken into account in the development of interventions to support patients in health behaviour change after TIA or ischemic stroke.     

Mindfulness,General Trust,and Social Support Among Trauma-Exposed College Students

The purpose of the present study was to examine whether mindfulness predicts general trust and social support among trauma-exposed college students, as well as to examine the potential moderating effect of posttraumatic stress on these relationships. Participants consisted of 536 trauma-exposed college students attending a public university in the southeast United States. After controlling for PTSD symptoms and type of trauma, mindfulness was positively associated with general trust and social support at low and mean levels of PTSD symptomatology; however, the relationships between mindfulness and these variables were nonsignificant at high levels of PTSD symptomatology.     

Parental involvement and health risk behaviours among school-going adolescents in six African countries

The aim of this study was to assess the association between parental involvement (support and monitoring) and health risk behaviours among adolescents in six African countries. Data were from the cross-sectional Global School-Based Student Health Survey (GSHS) which sampled a total of 16 587 adolescents (mean age 14.6 years, SD = 1.6) from 2009 to 2013. In multivariable regression analyses, adjusted for relevant variables, higher levels of parental involvement were negatively associated with substance use (smoking, other tobacco use, drunkenness and illicit drug use) and violence (being bullied, in a physical fight), injury and truancy. Only high-level parental involvement was associated with use of contraception at most recent sex. Interventions for reducing various health risk behaviours should consider the positive impact of parental involvement.     

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.     

The impact of AIDS/sex education by schools or family doctors on Hong Kong Chinese adolescents

Despite the rapid increases of HIV and sexually transmitted infections (STIs) in East Asia, the sex-related knowledge among Chinese adolescents is limited and the standard of sex education is both variable and inconsistent in Hong Kong. The aim of this study is to review the overall effectiveness of the school-based or doctor-based sexual health education currently provided for Hong Kong adolescents. In 1999 - 2000, a large survey on youth risk behaviours was carried out among 15 - 18-year-old students from 21 secondary schools. Of the 8,039 questionnaires, 377 students (4.7%) admitted sexual experience. Multiple logistic regression showed that students who had received school AIDS education were found to be less likely to have sexual intercourse in the past 3 months (odds ratio, OR 0.5; 95% confidence interval, CI 0.3 - 0.9) or use drugs or alcohol before the previous intercourse (OR 0.5; 95% CI 0.3 - 0.9). They were twice as likely to discuss emotional (95% CI 1.4 - 4.0) or puberty issues (95% CI 1.1 - 3.0). Although not statistically significant, sex education by family doctors showed a similar pattern. This result provides the strongest available evidence that school-based sex education programmes can modify sexual behaviour, which, in turn, reduces risk among Chinese students.     

What makes labour and birth traumatic? A survey of intrapartum ‘hotspots’

Evidence suggests between 1% and 6% of women develop post-traumatic stress disorder (PTSD) after childbirth. ‘Hotspots’ are moments of extreme distress during traumatising events that are implicated in symptoms of PTSD. This cross-sectional internet survey of hotspots examined (1) the content of intrapartum hotspots and (2) whether particular events, cognitions or emotions during hotspots are related to PTSD. Women (N?=?675) who experienced a difficult or traumatic birth completed a questionnaire composed of a validated measure of PTSD, questions concerning the existence of hotspots, and a newly developed measure of emotions and cognitions during hotspots. The majority of women (67.4%) reported at least one hotspot during birth and 52.9% had re-experiencing symptoms of these hotspots. Women were more likely to have PTSD if hotspots involved fear and lack of control (odds ratio (OR) 1.30, 95% CI 1.17–1.43) or intrapartum dissociation (OR 1.12, 95% CI 1.05–1.19). Risk of PTSD was higher if hotspots concerned interpersonal difficulties (OR 4.34, 95% CI 2.15–8.77) or obstetric complications (OR 3.35, 95% CI 1.64–6.87) compared to complications with the baby.     

Predictor Variables of PTSD Symptoms in School Victimization: A Retrospective Study with College Students

The literature has indicated that school victimization might favor the development of posttraumatic stress disorder (PTSD) symptoms. However, few studies have shown which variables are important in this process. This study aimed to investigate the relationship between explanatory variables (individual characteristics and aversive school experiences), and the development of PTSD symptoms, using an ordinal logistic regression model. To this end, 691 students of a public university situated in the state of São Paulo, Brazil, with a mean age of 21.1 years responded to a Brazilian version of the retrospective instrument Student Alienation and Trauma Survey–R (SATS–R). Significant variables for the regression model were age, duration of the worst school experience and subsequent discomfort, and relational and verbal violence victimization. In general, the greater the discomfort experienced by the student, the longer the duration of the worst school experience, the older the student and the more verbal and relational victimization episodes experienced, the greater the possibility of displaying clinically significant symptoms of PTSD.     

Religious coping,general coping strategies,perceived social support,PTSD symptoms,resilience, and posttraumatic growth among survivors of the 2010 earthquake in Haiti

This study examines the relationships between coping strategies, perceived social support, resilience, PTSD symptoms, and posttraumatic growth (PTG) in a sample of 256 survivors of the 2010 Haiti earthquake. The results of the bivariate analysis suggested a significant positive correlation between PTG and resilience, PTSD symptoms, perceived social support, positive religious coping, and active coping. There was a significant positive relationship between perceived social support and resilience and between resilience and active coping. PTSD symptoms were positively correlated with both positive and negative religious coping. Results of the multiple regression analysis indicated that positive religious coping, active coping, perceived social support, resilience, and PTSD symptoms accounted for 34% of the variance in the participants’ PTG. The strongest predictor of PTG was positive religious coping, followed by active coping, perceived social support, resilience, PTSD symptoms, and negative religious coping. Implications and recommendations for future research were discussed.     

Social orientations and adolescent health behaviours in Hungary

Adolescent health behaviours are influenced by a variety of social factors, including social orientations, such as social comparison or competitiveness. The main goal of the present study was to investigate the role that these social orientations might play in health behaviours (both health‐impairing and health‐promoting). Data were collected from high school students (N = 548; ages 14–20 years; 39.9% males) in two counties of the Southern Plain Region of Hungary. The self‐administered questionnaires contained items on sociodemographics, such as age, sex, parental schooling, and socioeconomic status (SES) self‐assessment; school achievement, health behaviours, competitiveness and social comparison. Multiple regression analyses suggest that those who scored higher on competitiveness engaged in more substance use, a pattern that was not present for health‐promoting behaviours. Social comparison, however, was associated with lower levels of substance use. In addition, in relation to health‐impairing behaviours, both competitiveness and social comparison interacted with sex; both social orientation variables proved to be more important for boys. Social comparison also contributed to health‐promoting behaviours among boys. Findings support the idea that the role of social orientations, such as competitiveness and social comparison, can be quite different depending on sex and the nature of the health behaviour. While competitiveness may act as a risk factor for substance use among boys, social comparison may act as a protection. It appears that social orientations play less of a role in girls' health‐related behaviours. More focus is needed on gender differences in influences on adolescents' health‐related behaviours.     

Body weight and weight perception among African and Caribbean university students: Correlation with depression symptoms

The aim of the study was to investigate the association between body weight, weight perception, and depressive symptoms in African and Caribbean university students. In a cross-sectional survey the total sample included 4 964 undergraduate university students (mean age 21.8, SD = 3.4, age range = 18-30 years) from five African and three Caribbean countries. Data on the students’ actual and perceived body weight, as well as depression symptoms, were collected. In logistic regression, perceived rather than measured overweight predicted depressive symptoms in male students with normal weight. For female students, perceived overweight predicted depression symptoms regardless of actual body weight. Male students who overestimated their body weight were at greater risk of depressive symptoms. Body weight self-perceptions appear to influence experience of mood disorder among African and Caribbean country students.     

Childhood physical and sexual abuse,and adult health risk behaviours among university students from 24 countries in Africa,the Americas and Asia

The goal of this study was to retrospectively estimate the prevalence of childhood physical abuse (CPA) and childhood sexual abuse (CSA) in relation to experience of adult violence, poor mental health, addictive behaviour and sexual risk behaviour among university students from 24 countries in Africa, the Americas and Asia. In a cross-sectional survey, data were collected from 18 404 undergraduate university students (mean age 20.7, SD = 2.9, age range of 16–30 years) from 24 countries. Overall, 5.0%, 2.6% and 1.2% of the students reported childhood physical abuse, childhood sexual abuse and childhood physical and sexual abuse, respectively. In the logistic regression models, adjusting for age, sex, study year, family wealth, and country, having experienced CPA and CSA was associated with increased odds of having any adult violence (physical and sexual partner violence victimisation. Having been in a physical fight, and weapon carrying), any poor mental health (post-traumatic stress disorder, depression symptoms and sleeping problems), addictive behaviour (tobacco use, binge drinking, frequent gambling and obesity) and sexual risk-taking was higher with a self-reported history of CPA and CSA.     

Attachment,Social Support,Resilience and Posttraumatic Stress Disorder Symptoms in Chinese Adults Living with HIV/AIDS

The present study aimed to examine the effects of attachment, social support and resilience on posttraumatic stress disorder (PTSD) symptoms in people living with HIV/AIDS. One hundred fifty-two HIV+ adults in China were investigated. The results suggested that attachment anxiety had a significant direct effect on PTSD symptoms and impacted PTSD symptoms indirectly though associations with social support and resilience. Attachment avoidance could also be considered a distal risk factor of PTSD symptoms via the mediation of social support and resilience. The findings highlight the importance of identifying trauma and PTSD symptoms in people affected by HIV/AIDS and suggest that people with attachment anxiety and low social support resources might be at high risk for PTSD.     

Depressive symptoms, social support, and personal health behaviors in young men and women.

This study investigated the relationship of depressive symptoms, social support, and a range of personal health behaviors in 2,091 male and 3,438 female university students from 16 countries. Depressive symptoms and social support were measured using the short Beck Depression Inventory and the Social Support Questionnaire; 9 personal health behaviors were also assessed. After the authors took age, social support, and clustering by country into account, depressive symptoms were significantly associated with lack of physical activity, not eating breakfast, irregular sleep hours, and not using a seat belt in both men and women, and additionally with smoking, not eating fruit, and not using sunscreen among women. Low social support was independently associated with low alcohol consumption, lack of physical activity, irregular sleep hours, and not using a seat belt in men and women. Bidirectional causal pathways are likely to link health behaviors with depressed mood.     

Prevalence and social and health correlates of insomnia symptoms among middle-and older-age persons in rural South Africa

This study investigated the prevalence and social and health correlates of insomnia symptoms among middle-and older-adults in rural South Africa. We analysed baseline survey data from the Health and Aging in Africa: A Longitudinal Study of an INDEPTH community in South Africa (HAALSI) (N = 5 059; females = 53.6%; largely African Shangaan/Tsonga-speaking). In all, 8.0% of the adults had three insomnia symptoms, 8.9% of participants had difficulty initiating sleep, 13.6% had difficulty in sleep maintenance, and 6.5% had poor sleep quality. In adjusted logistic regression, lower education, perceived unsafe neighbourhood, poorer self-rated health status, vision difficulty, pain, depressive symptoms, and posttraumatic stress disorder (PTSD) symptoms increased the odds of having insomnia symptoms. Insomnia symptoms are common in middle-and older-age adults in rural South Africa, and various risk factors were identified. This can help in improving insomnia prevention treatment in this population.