The Association Between Mental Health and Acute Infectious Illness Among a National Sample of 18- to 24-Year-Old College Students

Poor mental health is associated with physical illness, but this association is poorly characterized among college students. Objective and Participants: Using American College Health Association-National College Health Assessment data, the authors characterized poor mental health (depression, anxiety, negative affect) and examined the relationship between poor mental health and acute infectious illnesses (bronchitis, ear infection, sinusitis, strep throat) among 47,202 US college students. Methods: The authors used frequency and cross-tabulation analyses to characterize mental health and determine univariate associations among variables. They used binary logistic regression to determine the association between poor mental health and acute infectious illness, controlling for research-derived covariates. Results: The prevalence of acute infectious illness ranged from 8% to 29%. The prevalence of anxiety and depression ranged from 12% to 20%, respectively. Depression, anxiety, and exhaustion were associated with acute infectious illness across all dependent measures, with odds ratios ranging from .56 to .91. Conclusions: Poor mental health is associated with acute infectious illness among college students.     

The Effect of Mixing Events on the Dynamics of pH1N1 Outbreaks at Small Residential Colleges

Abstract

Objective: The authors examine the dynamics and the impact of all-campus events on pH1N1 spread at Bates College in fall 2009, with comparisons to 3 other campuses. Participants: Students (N = 285) presented or called in to the Bates Health Center with symptoms consistent with influenza-like illness. Methods: Health Center staff at Bates collected data on the outbreak; data from other colleges are from Web sites and journal articles. Data were analyzed using a mathematical model for influenza. Results: Bates held 2 vaccine clinics mid-outbreak. The data are consistent with the hypothesis that the vaccine clinics may have altered routine student interactions, facilitating transmission of pH1N1 among students who otherwise might not have encountered each other. Conclusion: The vaccine clinics, held when vaccine became available, were too late to halt transmission. The disruptions to campus rhythms due to the vaccine clinics may instead have contributed to pH1N1 spread.     

Rapid response to a college outbreak of meningococcal serogroup B disease: Nation's first widespread use of bivalent rLP2086 vaccine

Objective: To outline the reasoning behind use of bivalent rLP2086 in a Rhode Island college meningococcal B disease outbreak, highlighting the timeline from outbreak declaration to vaccination clinic, emphasizing that these two time points are <3 days apart. Participants: Staff, faculty, and students at College X eligible for vaccination. Methods: An outbreak response was initiated, advantages/disadvantages of available MenB vaccines were discussed, and a vaccination clinic was coordinated. Results: Bivalent rLP2086 was chosen as the vaccination intervention. We achieved a 94% coverage rate for the first dose. To date, this intervention has prevented further cases of Neisseria meningitidis serogroup B disease at College X. Conclusions: The close, efficient collaboration of public health stakeholders and College X led 94% of the eligible population to be safely vaccinated with at least one dose of bivalent rLP2086. This outbreak marked the first time bivalent rLP2086 was effectively used as an intervention response.     

Incremental Change: The Pace of Progress in Health

Abstract

In a prospective study of acute diarrheal illness among college students, during one academic year, the incidence of Campylobacter enteritis was 5.57 per 1,000. Approximately 17% of all patients with acute diarrheal illness had Campylobacter enteritis. Campylobacter enteritis is briefly discussed. The value of the stool wet-mount examination is emphasized. It can serve as a guide to which stools to culture and often can lead to a presumptive diagnosis of Campylobacter enteritis. Student health center labs are urged to perform stool wet-mount exams and to provide cultures for isolating the Campylobacter organism.     

Managing Helicobacter pylori in college health,with special considerations for international students

ABSTRACT

Objective: Helicobacter pylori infection is the major cause of dyspepsia, peptic ulcer disease, and gastric cancer. This paper will make specific recommendations for a diagnostic and treatment strategy tailored to the international student population. Participants/Methods: This paper is a case report and narrative review based on recent international epidemiologic studies and consensus conference recommendations identified in MEDLINE. Results: In the nations (mostly Asian) that send the largest number of students to the United States, the prevalence of H. pylori is generally 60% to 80%, whereas the prevalence in the United States is about 25%. The patterns of antibiotic resistance in those countries are also different than that in the general US population. Conclusions: Health care providers should have a higher index of suspicion for Helicobacter infection among international students with dyspepsia and need to use a different treatment regimen than is standard for the general US population.     

Illness uncertainty and illness intrusiveness as predictors of depressive and anxious symptomology in college students with chronic illnesses

Objective: To examine predictors of psychological functioning in college students with chronic illnesses. Participants: Participants (N = 1413) included 364 students with self-reported diagnoses of asthma or allergies, 148 students with other chronic illnesses (eg, epilepsy, type 1 diabetes), and 901 healthy students. Data were collected between November 2013 and May 2015. Methods: Participants completed online measures of psychosocial functioning, including illness uncertainty, illness intrusiveness, depression, and anxiety. Results: Students with chronic illnesses other than asthma or allergies evidenced the greatest levels of anxious (p <. 05), but not depressive symptomology. Additionally, this group reported greater illness uncertainty and intrusiveness (p <. 05) compared to their peers. Uncertainty and intrusiveness independently predicted depressive and anxious symptoms for students in both illness groups. Conclusions: Compared to peers with asthma or allergies, college students with other chronic illnesses reported higher levels of anxious symptoms. Illness uncertainty and intrusiveness appear to be predictors of psychological distress, regardless of illness.     

Klebsiella pneumonia liver abscess syndrome: Case presentation to a college student health clinic

ABSTRACT

The authors describe a case of Klebsiella pneumoniae liver abscess (KPLA) in a student presenting to a university student health center. The authors also provide a review of KPLA and invasive Klebsiella pneumoniae liver abscess syndrome (IKPLAS), including epidemiology, common clinical manifestations, standard diagnostic work-up, management options, and potential complications.     

Prevalence of Sufficient Physical Activity Among Parents Attending a University

Objective: The benefits of regular physical activity are well documented. However, approximately half of all university students are insufficiently active, and no research to date exists on the activity behavior of university students who are also parents. Participants and Methods: Using an adapted version of the Godin Leisure Time Exercise Questionnaire (ie, the Physical Activity Prevalence Questionnaire), the authors examined the prevalence of sufficient physical activity among 245 parent students from 6 faculties and 12 programs. Results: Half (49.5%) of the students who were not parents (n = 90) were sufficiently physically active, compared with 16% of students who were parents (n = 3, p < .002). The authors found that 33.3% of parents and 13% of nonparents limited their activity level as a result of illness or injury (p < .05). Conclusions: Most parent students in this study were insufficiently active and at potential risk for the negative health consequences of inactivity. This is a grossly understudied population, and researchers must conduct further studies to understand what can be done to facilitate physical activity among this potentially vulnerable group of students.     

The Nurse Practitioner: History,Current Conflicts,and Future Survival

Abstract

“A Community-Based Outbreak of Infection With Penicillin-Resistant Neisseria Gonorrhoeae Not Producing Penicillinase (Chromosomally Mediated Resistance),” HAWAZIN FARUKI, et al. From February through November of 1983, 199 cases of penicillin-resistant Neisseria gonorrhoeae infection were identified in a localized epidemic in Durham, North Carolina. The isolates did not produce beta-lactamase but were usually resistant to penicillin (minimum inhibitory concentration, 2.0 to 4.0 μg per milliliter), and 15 of 16 patients treated with 4.8 million units of penicillin G procaine plus 1.0g of probenecid did not respond to therapy. Recognition of the outbreak was impeded by a lack of routine surveillance for resistance other than that mediated by beta-lactamase. All epidemic isolates had a single serotype, auxotype, and antibiotic-susceptibility profile. The outbreak was halted by changing the treatment for all patients and their contacts to spectinomycin, and by intensive epidemiologic case-finding efforts. The emergence of such resistant strains poses potential major public health problems and indicates a need for reassessment of current surveillance procedures. (New England Journal of Medicine 1985;313:607–11.)

“Primary Tubal Infertility in Relation to the Use of an Intrauterine Device,” JANET R. DALING, et al. Women who use an intrauterine device (IUD) are at increased risk of acute pelvic inflammatory disease, but the relation of the IUD to subsequent infertility is not established. We interviewed 159 nulligravid women with tubal infertility to determine their prior use of an IUD. Their reponses were compared with those of a matched group who conceived their first child at the time the infertile women started trying to become pregnant. The risk of primary tubal infertility in women who had ever used an IUD was 2.6 times that in women who had never used one (95 per cent confidence interval, 1.3 to 5.2). The observed difference between cases and controls was not uniform for different types of IUD. The relative risk associated with use of a Dalkon Shield was 6.8 (1.8 to 25.2), and that associated with use of either a Lippes Loop or Saf-T-Coil IUD was 3.2 (0.9 to 12.0). The smallest elevation in risk was found among users of copper-containing IUDs (relative risk, 1.9 [0.9 to 4.0] for all women who had ever used a copper-containing IUD). The relative risk for women who used only a copper-containing IUD was 1.3 (0.6 to 3.0).

We conclude that use of the Dalkon Shield (and possibly of plastic IUDs other than those that contain copper) can lead to infertility in nulligravid women. (New England Journal of Medicine 1985;312:937–41.)     

Over-the-Counter Medication and Herbal or Dietary Supplement Use in College: Dose Frequency and Relationship to Self-Reported Distress

Objective: A growing number of researchers have examined the use of over-the-counter (OTC) medications and herbal or dietary supplements among college students. There is concern about the efficacy and safety of these products, particularly because students appear to use them at a higher rate than does the general public. Participants and Methods: The authors administered surveys to college students (N = 201) to assess the frequency of use in the past week. Results: A substantial percentage reported using OTC medications (74.1%), herbal or dietary supplements (70.6%), or both concurrently (61.2%). Dose frequency of OTC medications was the best predictor of self-reported emotional distress in the past week. Higher doses of products containing pseudoephedrine or valerian were associated with self-reported anxiety. Conclusions: These data further reflect an increasing trend toward self-medication among college students. Investigators must conduct reliability and validity studies to evaluate the clinical utility of the measurement tool developed in this study.     

Specificity of the Tuberculin Skin Test and the T-SPOT.TB Assay Among Students in a Low–Tuberculosis Incidence Setting

Abstract

Objective: Interferon-γ release assays (IGRAs) are an important tool for detecting latent Mycobacterium tuberculosis infection (LTBI). Insufficient data exist about IGRA specificity in college health centers, most of which screen students for LTBI using the tuberculin skin test (TST). Participants: Students at a low–TB incidence college health center. Methods: TST and T-SPOT.TB were performed on prospectively recruited students. TB exposure risk was assessed using a questionnaire: Those at low risk were assumed to not have LTBI in order to calculate test specificity. Results: Of 184 students enrolled, 143 had results available for both TST and T-SPOT.TB. Agreement of the tests was 97% (kappa statistic 0.717; 95% confidence interval, 0.399–1.00). Among 124 low-risk students, specificity for TST and T-SPOT.TB were 98.4% and 100%, respectively. Conclusions: T-SPOT.TB specificity was high among low-risk students. Additional studies such as cost-effectiveness analyses using T-SPOT.TB as a single or confirmatory test to TST are needed to contribute to LTBI screening policy decisions.     

Help Seeking and Treatment Use Among Suicidal College Students

Abstract

Objectives: Many suicidal college students do not receive mental health treatment, and the reasons for this are not fully understood. This study examines how attitudes, beliefs, and social network factors relate to help seeking among suicidal students. Participants: A random sample of 8,487 undergraduate and graduate students from 15 US universities participated. Methods: A Web-based survey administered in spring 2009 examined correlates of mental health service utilization among students reporting serious thoughts of suicide in the previous year (n = 543). Results: Correlates of treatment use included perceived need, beliefs that treatment is effective, contact with service users, lower personal stigma, higher perceived stigma, fewer positive relationships, and sexual minority or Caucasian identity. Conclusions: Help seeking among suicidal students is associated with a range of personal and social network factors. Campus strategies to enhance help seeking should be tailored to address identified facilitators and barriers to treatment use among target populations.     

Lyme Disease: A Case Report

Abstract

Using a needs-assessment technique called story-boarding to determine characteristics of health promotion and wellness among university students is discussed. Storyboarding allows students to work together as they generate ideas and eliminates the territorial defensiveness that often occurs when new ideas are suggested. Sixteen graduate students in a health education teaching methods course demonstrated the use of the technique to identify characteristics of wellness for university students. In addition, they identified content areas and outlined key programs, services, personal habits, and skills useful for enhancing university students' wellness.     

Prevalence of Insomnia and Its Psychosocial Correlates Among College Students in Hong Kong

Abstract

Objective: This study examined the prevalence of insomnia and its psychosocial correlates among college students in Hong Kong. Participants: A total of 529 Hong Kong college students participated in the study. Methods: Participants completed a self-reported questionnaire that included the Pittsburgh Sleep Quality Index (PSQI), the Revised Life Orientation Test, the Perceived Stress Scale, and the Beck Depression Inventory, and questions about sociodemographic and lifestyle factors. A PSQI global score equal to or greater than 5 indicated insomnia. Results: Results indicated that 68.6% of the participants were insomniacs. Adjusted regression analyses revealed that optimism, stress, and depression significantly predicted insomnia (p < .01). Conclusions: These results suggest that insomnia is very common among Hong Kong college students and associated with other psychosocial factors. This study provides preliminary data on sleep quality and risk factors for insomnia, which may be used to guide sleep hygiene promotion and intervention among college students.     

Look Again: Research,Uncertainty, and Understanding

Abstract

An outbreak of measles (rubeola) occurred on the Bloomington campus of Indiana University in February 1983, resulting in 179 clinically diagnosed cases. An aggressive, voluntary immunization program followed by the possibility of sanctions against nonimmunized students returning to campus after spring break resulted in 23,000 vaccinations, with other students submitting verifications of previous history of disease or live-vaccine immunization.

The factors that may have contributed to the outbreak were less natural immunity in this age group, absence of school legislation when these individuals were entering school, and use of killed vaccine which did not provide immunity.     

Meningococcal serogroup B outbreak response University of Wisconsin-Madison

A meningococcal serogroup B (MenB) outbreak at a large public university prompted an emergency response to immunize undergraduates. Objective: To report on a successful meningococcal serogroup B (MenB) vaccine clinic response at a large public university. Methods: We assembled the team leaders to write this case report. Results: Activation of the emergency plan and points of dispensing required cooperation of many units on campus under the leadership of university health officials with support from Centers for Disease Control and Prevention, state division of public health and the city-county health department. Significant efforts to provide consistent messages to students and parents regarding the outbreak and the availability of the MenB vaccines were made. Volunteers were recruited to staff the clinics alongside university healthcare providers. Over 22,000 doses of vaccine were administered. Conclusion: We report our experience and lessons learned which may be helpful to universities in preventing and responding to disease outbreaks.     

Rural-urban differences in college students’ cardiovascular risk perceptions

Abstract

Objective: To examine rural-urban differences in college students’ cardiovascular risk perceptions. Participants: College students in rural (n?=?61) and urban (n?=?57) Kentucky counties were recruited from November 2012 to May 2014. Methods: This was a secondary data analysis of a cross-sectional study examining rural-urban differences in cardiovascular risk factors. Students rated their risk for developing high blood pressure, diabetes, high cholesterol, heart disease, having a stroke, and gaining excess weight. Chi-square and logistic regression were used for data analysis. Results: Rural students had lower odds of perceived high risk for developing high blood pressure compared to urban students (odds ratio (OR): 0.32, 95% CI: 0.11–0.96) after adjusting for race, sex, and body mass index. This association was not observed after adjusting for healthcare access variables. No other significant differences were observed. Conclusions: Efforts to raise perceived risk for developing hypertension among rural college students may be warranted.     

Knowledge,Beliefs, and Behaviors: Examining Human Papillomavirus–Related Gender Differences Among African American College Students

Abstract

Objective: Given recent approval for administration of a human papillomavirus (HPV) vaccine to men, it is important to assess the HPV-related perspectives of men and women. The purpose of this study was to examine gender differences in HPV knowledge, beliefs, and vaccine acceptance among college students attending 3 historically black colleges/universities in the Southeast. Participants and Methods: A nonprobability sample of 575 students completed a self-report questionnaire. Results: Males were significantly less likely to have heard of HPV, scored lower in HPV knowledge, were less likely to perceive HPV health outcomes as severe and that there was a benefit to vaccinate, reported fewer cues for vaccine acceptance, and perceived more barriers to vaccination compared to females (all p < .05). Conclusions: The gender disparities demonstrated in this study highlight the need to increase HPV-related communication/education to include men and to extend HPV research to a broader segment of the college population.