Tuberculosis screening for international students

Nonimmigrant, international students entering colleges in the United States are not required to undergo screening for tuberculosis (TB). Thirty-nine percent of active TB cases in the United States are in foreign-born individuals. In an effort to minimize the occurrence of active TB on a community campus with an increasing international student population, the college health service implemented a TB-screening policy for all newly enrolled international students. For the 1997/98 school year, 171 international students from 70 different countries enrolled in classes. Fifty-nine students (35%) screened for TB had a positive skin test (greater than 10 mm induration). Of those, 34 initiated isoniazid therapy, and 27 successfully completed the prescribed regimen under supervision of the campus health office.     

Cigarette Smoking Among Korean International College Students in the United States

Abstract

Objective and Participants: This study explored (1) the prevalence of cigarette smoking among South Korean international college students in the United States, (2) differences in smoking between on- and off-campus living arrangements, and (3) predictors of an increase in smoking over time in the United States Methods: An online survey was completed by 1,201 students at 52 4-year US universities (34% response rate). Results: The overall smoking prevalence was 43.5%. The smoking rate (29.0%) of female students was higher than that (4%) of female college students in South Korea. Sex, living place, living situation, length of stay as a student in the United States, home smoking rules, campus-wide tobacco-free policies, and levels of acculturative stress, anxiety, and depression were significantly associated with an increase in smoking (p < .05). Conclusions: Given the high smoking prevalence among the South Korean students on US college campuses, targeted prevention efforts for these students may be warranted.     

Man Up Monday: An integrated public health approach to increase sexually transmitted infection awareness and testing among male students at a midwest university

ABSTRACT

Objective: This campaign sought to (a) increase awareness of sexual health and chlamydia testing; (b) motivate students, particularly sexually active men who do not pursue regular sexually transmitted infection (STI) testing, to get tested; and (c) improve the capacity of the student health center to provide free chlamydia testing and treatment for all students. Participants: Students enrolled at a 4-year public research university (N = 333). Methods: Collaborative partnerships formed the foundation of a campus marketing and testing campaign, with treatment for students testing positive for chlamydia. Results: A total of 333 students were tested over 5 consecutive Mondays, showing a chlamydia incidence of 9.6%. The incidence for females and males were 8.6% and 10.8%, respectively. Conclusions: The campaign was effective in reaching men, an at-risk population not traditionally emphasized in STI testing.     

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.     

US college and university student health screening requirements for tuberculosis and vaccine-preventable diseases, 2012

ABSTRACT

Objective: Colleges are at risk for communicable disease outbreaks because of the high degree of person-to-person interactions and relatively crowded dormitory settings. This report describes the US college student health screening requirements among US resident and international students for tuberculosis (TB) and vaccine-preventable diseases (VPDs) as they relate to the American College Health Association (ACHA) guidelines. Methods/Participants: In April 2012, US college health administrators (N = 2,858) were sent online surveys to assess their respective school's TB screening and immunization requirements. Results: Surveys were completed by 308 (11%) schools. Most schools were aware of the ACHA immunization (78%) and TB screening (76%) guidelines. Schools reported having policies related to immunization screening (80.4%), immunization compliance (93%), TB screening (55%), and TB compliance (87%). Conclusion: Most colleges were following ACHA guidelines. However, there are opportunities for improvement to fully utilize the recommendations and prevent outbreaks of communicable diseases among students in colleges.     

An examination of ecological predictors of health literacy in black college students

Objective: Health literacy is a determinant of health, but disparities in health literacy persist. This study examined the influence of ecological factors on college students’ health literacy. Participants: During January 2016 a nonrandom sample of black undergraduate students (n = 298) aged 18–24 were recruited from enrollment lists at two urban universities in the Southeastern United States. Methods: Information on health literacy as well as numerous intrapersonal, social, and cultural-environment factors was obtained using an electronic questionnaire and then statistically modeled. Results: Ecological factors accounted for 28.7% of the variance in health literacy. In particular, reappraisal (B = 0.323, p < .001), suppression (B = ?0.289, p < .001), campus health education (B = 0.192, p < .05), campus tobacco culture (B = ?0.174, p < .05), and perceived norms (B = ?0.153, p < .05) directly predicted health literacy. Conclusions: Although intrapersonal factors influence health literacy, the sociocultural environment of college can also foster or hinder college students’ health literacy.     

A Student-to-Student Dental Outreach Program

Abstract

Objective: This study investigates the individual, interpersonal, and institutional level factors that are associated with overall mental health among college students. Participants: Data are from an online cross-sectional survey of 2,203 students currently enrolled at a large public university. Methods: Mental health was ascertained using a subcomponent of the RAND Medical Outcomes Study functioning and well-being measures developed by the RAND corporation. Stepwise regression was used to determine if self-reported measures of individual (ie, coping abilities), interpersonal (ie, intergroup awareness), and institutional (ie, campus climate/tension) level factors were associated with overall mental health, after controlling for demographic characteristics. Results: The combined effects of both individual and institutional level measures were associated with student mental health. In particular, limited coping abilities and a perceived racially tense campus climate contributed to the psychological distress of college students. Conclusions: Simultaneously addressing the individual and institutional level influences on mental health offers the most promising help for students.     

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.     

Education for Cross-Cultural Social Work Practice

Abstract

Little attention has been given to the needs of international and American social work students who are preparing for direct practice outside of the United States. A preliminary model of cross-cultural social work practice is described as the basis for a course in direct social work practice in international settings.     

Counseling Brazilian Undergraduate Students: 17 Years of a Campus Mental Health Service

Objective: The authors reviewed demographic and clinical characteristics of undergraduates at a Brazilian public university (UNICAMP) who visited the campus mental health service (SAPPE) and compared their demographics with those from all undergraduate students enrolled in the university. Participants: The authors looked at data from all undergraduates who sought counseling or mental health care at SAPPE over a 17-year period (N = 2,203; 1987-2004). Methods: They obtained this information from clinical charts and a UNICAMP database. Results: Women, students from other Brazilian states, students living in the campus residence hall, and students whose main source of income was a scholarship were overrepresented. Female student-clients complained about family conflicts more frequently than did their male counterparts, and male student-clients reported concern about poor academic performance more frequently than did their female counterparts. Conclusions: Sex, living in a university residential facility, and reliance on a scholarship grant were predictive of undergraduates' mental health-seeking behavior and pattern of complaints.     

Mental health and substance use of sexual minority college athletes

ABSTRACT

Objective: Assess the mental health and substance use of sexual minority collegiate student-athletes in the United States, as compared with heterosexual college students and heterosexual student-athletes. Participants: Undergraduate students (N = 196,872) who completed the American College Health Association's National College Health Assessment (Fall 2008–Fall 2012 administrations). Methods: Written cross-sectional survey. Results: Sexual minority student-athletes had a higher risk of experiencing mental health difficulties than their heterosexual athlete peers. There were no significant differences in mental health between sexual minority male athletes and nonathletes. Sexual minority female athletes appeared to fare better than nonathlete peers. Substance use was greater among sexual minority students (athlete and nonathlete) and was mediated by mental health. Conclusions: Participation in athletics does not appear to be associated with an elevated risk of negative mental health outcomes for sexual minority participants; however, there are disparities in mental health outcomes by sexual orientation regardless of athletics participation.     

A Systematic Review and Meta-analysis of the Acceptability and Effectiveness of University Smoke-Free Policies

Abstract

Objective: Systematically review studies of support for, and effectiveness of, university campuses’ smoke-free policies. Participants/Methods: A search was carried out for studies in English related to campus smoking bans through June 2013. Eligible studies had outcomes for student or faculty attitudes, or measures of smoking prevalence or secondhand smoke (SHS) exposure. Results: Nineteen eligible studies were identified, 18 from the United States and 1 from the United Kingdom. A meta-analysis found 58.94% (95% confidence interval [CI] [52.35%, 65.53%]) of students (12 studies) and 68.39% (95% CI [65.12%, 71.67%]) of faculty (7 studies) supported smoke-free policies. Both studies measuring student smoking prevalence indicated a postban reduction (16.5% to 12.8% after 1 year [p < .001] and 9.5% to 7.0% [p = .036] after 3 years). Only 5% of UK universities were smoke-free compared with 25% of US universities. Conclusions: A majority of students and faculty support smoke-free campus policies, which may reduce smoking and SHS exposure.     

Active Commuting Patterns at a Large,Midwestern College Campus

Abstract

Objective: To understand patterns and influences on active commuting (AC) behavior. Participants: Students and faculty/staff at a university campus. Methods: In April–May 2008, respondents answered an online survey about mode of travel to campus and influences on commuting decisions. Hierarchical regression analyses predicted variance in walking and biking using sets of demographic, psychological, and environmental variables. Results: Of 898 respondents, 55.7% were female, 457 were students (50.4%). Students reported more AC than faculty/staff. For students, the models explained 36.2% and 29.1% of the variance in walking and biking, respectively. Among faculty/staff, the models explained 45% and 25.8% of the variance in walking and biking. For all models, the psychological set explained the greatest amount of variance. Conclusions: With current economic and ecological concerns, AC should be considered a behavior to target for campus health promotion.     

Cigarette Smoking and Cessation Among Trade or Technical School Students in Texas

Although students enrolled in trade or technical colleges are at an elevated risk for tobacco use, virtually no information exists regarding their smoking behaviors. Objective and Participants: In the present study, the authors examined (1) the prevalence of smoking and quitting among 617 students in 2 trade or technical colleges in East Texas and (2) on-campus media exposure to antitobacco messages. Methods: Students voluntary completed the 42-item Texas Trade and Technical School Tobacco Survey during a required introductory-level class. Results: Of the participating students, 34% reported past-30-day smoking (current smoking). Of current smokers, 74% reported a previous quit attempt and 64% wanted to quit before graduation. Although most current smokers expressed a desire to quit smoking, the antitobacco message they were least likely to see on campus was that regarding how to quit. Current smokers cited their own health as the most likely reason to quit smoking, and most reported wanting to quit on their own, without the use of resources. However, of the 9 listed resources, students were most likely to report the possible use of medication. Conclusions: Given that most smoking students desire to quit smoking—and that they are enrolled in trade or technical schools for an extended period of time—additional research should examine how successful interventions can be delivered at the trade or technical school itself.     

'Land of the free'? Circulating human rights and narrated lives in the United States

Abstract

In the 50 years during which human rights has gained an international currency, personal narratives have become one of the most potent vehicles for advancing human rights claims. This is particularly true in the United States where personal narratives attesting to human rights violations frequently gain wide exposure through mass publication and publicity, media circulation, and global information flows. This article explores the circulation of human rights narratives in the United States, examining some of the ways that stories enter into public discourse through published life narratives, television talk shows, news reports, campus lectures and publicity tours, websites, and the like, and are taken up by popular and academic audiences, spurring debates within the fields of legal and political theory, international relations, religion, morality and ethics, often far removed from the originating event or site of human rights violation. The article considers the many intended and unintended effects of this circulation on storytellers, their audiences, and the campaigns they represent.     

Utilizing International Clinical Practice to Build Inter-Cultural Sensitivity in Social Work Students

ABSTRACT

This paper describes an international clinical internship that uses a developmental model to build inter-cultural sensitivity in baccalaureate social work students. The paper analyzes the stages students go through as they struggle to develop a bi-cultural professional perspective. This model adheres to the position that cross cultural practice in a multicultural world not only conforms to the emerging picture of life in the United States, but is also in accord with the values of social work.     

Using the wellness inventory to assess health and well-being in college students at the end of the semester

Abstract

Objective: The authors examined the end of semester outcomes (December, 2017) on the Wellness Inventory and demographics among college students taking a Physical Education (PED 101) course at a university in the southeast United States. Participants: College students were assessed at the end of the semester for health and well-being outcomes according to the Wellness Inventory. Results: Results showed that there were few gender or age differences for the dimensions of well-being. However, there were significant differences for most of the dimensions of health and well-being between frequent exercisers and infrequent exercisers. There were also significant differences between students who reported being in excellent health versus students who reported being in fair or poor health. Conclusions: Consistent exercise throughout the week may play a role in overall health and well-being. The results from this study warrant further investigation into the relationship between the exercise frequency and the dimensions of health and well-being.     

Undergraduate students survey their peers on mental health: Perspectives and strategies for improving college counseling center outreach

Abstract

Objective: The purpose of the study was to examine student perspectives about college mental health including the primary mental health issues affecting students, common college student stressors, student awareness of campus mental health resources, and mental health topics students want more information about. Participants: Participants were 822 undergraduate and graduate students enrolled in a private university. The study was conducted during September 2016. Methods: As part of a public health course in program planning, undergraduate students surveyed their peers about their experience with mental health and mental health resources. Results: Stress was perceived as the largest mental health issue. Students most wanted more information about school/work/life balance followed by stress management. Electronic newsletters, social media, and on-campus seminars were the top strategies that students suggested as ways to reach them. Conclusions: The results provide student perspectives on mental health that may be useful in developing effective outreach efforts.     

Status of personal health requirement for graduation at institutions of higher education in the United States

Objective: The purpose of this study was to examine the proportion of higher education institutions in the United States that require a personal health course (PHC) for graduation and to describe the nature of such requirements. Participants: This study included a random sample of public and private institutions of higher education (IHE) with undergraduate programs within the United States (N = 310). Data were collected between September 2014 and May 2015. Methods: University catalogs were accessed from the institutions' public Web sites to determine whether a PHC was offered, and whether it was exclusively or optionally required for graduation. Results: The majority (55.8%) of the sample offered at least 1 PHC, with only 10% exclusively requiring the course and an additional 10% optionally required the course. Conclusions: Although the utility of undergraduate students completing a PHC is clear, the majority of institutions do not require such a course for degree conferral.