Antibiotic Resistance in Urinary Tract Infections in College Students

Abstract

Objective: To determine resistance to antibiotics of Escherichia coli in uncomplicated urinary tract infections (uUTIs) in female college students. Participants: Symptomatic patients presenting to a student health service from September 2008 to December 2009. Methods: Clean catch midstream urine samples were tested for urinalysis (UA) and culture and sensitivity. Results: Of 168 students enrolled in the study, 138 had positive UA, and 94 of these grew >100,000 colonies/mL of E. coli. Ampicillin resistance was 31.9%, trimethoprim-sulfamethoxazole (TMP-SMX) resistance 16.0%, ciprofloxacin resistance 4.3%, amoxicillin/clavulanate resistance 3.2%, and nitrofurantoin resistance 1.1%. The sensitivity of UA was 95.4% and the positive predictive value was 87.0% (p ≤ .001). Specificity was 77.5% and negative predictive value 92.9%. Conclusions: In healthy college women with uUTI symptoms, TMP-SMX should not be universally used for empirical therapy, whereas use of ciprofloxacin, amoxicillin/clavulanate, and nitrofurantoin are appropriate.     

College students,shared decision making,and the appropriate use of antibiotics for respiratory tract infections: A systematic literature review

ABSTRACT

Objective: This systematic review examines shared decision making to promote the appropriate use of antibiotics for college students with respiratory tract infections. Participants/Methods: CINAL, Cochrane, PubMed, EBSCO, and PsycNET were searched in October 2014 using the following criteria: English language, human subjects, peer-reviewed, shared decision making for respiratory tract infections, adult patients or college students, and antibiotic use for respiratory tract infections. Twelve articles were selected for final review. Results: College students and younger, more educated, adults prefer shared decision making. Shared decision making shows promise for decreasing antibiotic use for respiratory tract infections. Education, understanding, and provider-patient communication are important to the shared decision-making process. Conclusions: Shared decision making shows promise to promote the appropriate use of antibiotics for respiratory tract infections in college students and could be considered for future studies.     

Psychotropic Drug Use Among College Students: Patterns of Use,Misuse, and Medical Monitoring

Abstract

Objective: To assess whether college students who use psychotropic drugs are (1) aware of potential side effects, (2) appropriately monitored by prescribing physicians, and (3) taking medications as prescribed. Participants: Fifty-five college students, currently taking psychotropic medications, were recruited between Summer 2008 and Fall 2009. Methods: Participants were given interviews assessing (1) interactions with prescribing physicians, (2) patterns of psychotropic drug use, and (3) Diagnostic and Statistical Manual of Mental Disorders Fourth Edition (DSM-IV) substance use disorders. Results: Twenty-five percent of participants did not remember being assessed for suicidal ideation. A large number of participants took their medications in different quantities or frequencies than prescribed and 35% of participants met DSM criteria for substance dependence. Conclusions: Many students are misusing psychotropic medications and this misuse is not being communicated with prescribing physicians.     

Variables Affecting Patient Satisfaction with Health Care Services in the College Health Setting

Abstract

Patient satisfaction with health care services is an important factor in health care delivery. It will significantly influence whether or not a patient seeks medical care, complies with prescribed treatment, and/or maintains a continuing relationship with a medical practitioner.

A survey questionnaire, relating patient satisfaction with a number of variables identified through a literature review, was mailed to a random sample of 500 students utilizing Student Health Service (SHS) at Kent State University (KSU) during the five week study period. The data obtained would be utilized to help with planning future health care services and staff inservice education programs.

The findings of this survey indicate that patient satisfaction has a statistically significant correlation with perceived technical competence of the practitioner and perceived adequacy of the interpersonal aspects of the practitioner-patient relationship. A significant relationship did not exist between satisfaction and expectations the patient holds of the practitioner's role performance. A statistically significant relationship was found to exist between receiving health information/education related to diagnosis, prognosis, and treatment plan and satisfaction with health care services. This relationship did not hold for health information/education related to activity restrictions or preventive measures. The study also revealed that time waited during the medical care encounter was inversely related to satisfaction. Last, stepwise regression found that perceived technical competence of the practitioner was the most important variable influencing patient satisfaction with health care services.

This study provides data about factors important to personal satisfaction with health care services for a selected group of college students.     

Social connectedness and life satisfaction: Comparing mean levels for 2 undergraduate samples and testing for improvement based on brief counseling

ABSTRACT

Objectives: Comparing the mean levels of social connectedness and life satisfaction, and analyzing their relationship for 2 undergraduate samples, and testing for an increase in their means for a brief counseling sample. Participants: Between October 2013 and May 2015, 3 samples were collected: not-in-counseling (NIC; n = 941), initial counseling session (ICS; ie, triage session only; n = 168), and brief counseling (BC; ie, median of 4 additional counseling sessions; n = 28). Methods: Online surveys measuring demographic and background control variables, social connectedness, and life satisfaction. Results: NIC students exhibited higher social connectedness and life satisfaction than ICS students. Social connectedness significantly explained life satisfaction beyond controlled-for variables for both samples. There was a significant increase in social connectedness and life satisfaction for the BC sample. Conclusions: Social connectedness is an important antecedent of life satisfaction for undergraduates. Brief counseling can increase transition students' social connectedness and life satisfaction.     

Evaluation of a Web-Based Malaria Risk Reduction Game for Study Abroad Students

Abstract

Objective: Compare feedback strategies in 3 versions of an educational game. Participants: Study abroad students (N = 482) participated by playing the game and completing pregame/postgame surveys January–March 2010. Methods: This study employed an experimental design. Primary outcome measures were knowledge gain, player satisfaction, and risk perception. Results: One-third had previously traveled to a malaria-risk region, and two thirds planned to do so. Baseline malaria knowledge was low. Postgame knowledge and risk perception were significantly higher than pregame, irrespective of past travel status. The group that automatically received explanatory feedback following game decisions scored higher for mean knowledge gain, without differences in player satisfaction. Conclusions: The challenges of designing a feedback strategy to support Web-based learning make these results highly relevant to health educators developing interactive multimedia interventions. The increasing number of students traveling to higher-risk destinations demands attention. Both malaria-naive and malaria-experienced students would benefit from this approach to travel health education.

[An appendix to the article is featured as an online supplement at the publisher's Web site.]     

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.     

The Association of Campus Resources for Gay,Lesbian, and Bisexual Students With College Students' Condom Use

Abstract

The author and colleagues examined campus resources for gay, lesbian, and bisexual (GLB) students at 119 US colleges to determine how the presence of such resources affected sexually active students' condom use. A random sample of unmarried, sexually active college students surveyed in 1999 completed questionnaires. Condom use was compared across schools with different levels of GLB resources. Condom use rates, analyzed by sex and sex-partner groups, ranged from 32% to 52%. With additional college variables controlled for, GLB resources were positively associated with the proportion of sexually active students who used condoms (p < .001). This association existed primarily for students with only opposite-sex partners. The author's findings suggest that campus resources for GLB students may be associated with college students' condom use.