Search Results (93)

Background: University students’ mental health represents an increasing public health concern, particularly in STEM contexts characterized by high academic demands. Students living away from home, including international students, may face additional stressors related to relocation, social integration, and adaptation. This study examined how narrated academic experiences are associated with psychological and academic functioning among relocated STEM students. Methods: A cross-sectional convergent parallel mixed-methods study was conducted at an Italian STEM university (May–June 2024). An online survey was distributed to the entire accessible student population (33,336 invitations; 12,538 accesses; response rate = 37.6%). Analyses focused on relocated students who completed all relevant sections (N = 776; M age = 22.96). Quantitative measures assessed academic self-efficacy, burnout (Emotional Exhaustion; Cynicism), engagement (Vigor; Dedication), study program satisfaction, and perceived academic goal attainment. Open-ended responses underwent thematic analysis with a codebook approach and transformed into category count variables. Hierarchical regression models examined associations controlling for age, gender, and academic level. Results: Organizational and learning-related difficulties were the most frequent categories. Content categories explained additional variance across outcomes (ΔR² = 0.054–0.107). Teaching-related narratives were associated with higher burnout and lower engagement and satisfaction, whereas Positive narratives showed the opposite pattern. Conclusions: Institutional and pedagogical experiences are systematically associated with student well-being among relocated STEM students, highlighting modifiable targets for university-level mental health promotion strategies. Full article

Background/Objectives: Estimate the prevalence of myopia among children aged 6–17 years in county and rural areas across seven geographically diverse provinces of China, and identify demographic, behavioral, and geographic factors associated with myopia, with particular focus on urban–rural and ethnic differences. Methods: A multi-stage stratified cluster sampling design was employed. Seven provinces were randomly selected, one from each of seven geographical regions of China (Southeast, North, Central, South, Southwest, Northwest, and Northeast). In each province, one rural county was randomly chosen. Within each county, one urban survey site (county town) and one rural survey site (village) were selected. From each site, one primary school and one junior high school were included. In each school, approximately 20 ± 2 students per grade (grades 1–9) were recruited. Uncorrected visual acuity and non-cycloplegic autorefraction were measured. Multivariable generalized linear mixed models (GLMM) with random intercepts at the class level were used to identify factors associated with myopia, accounting for the cluster sampling design. Results: The overall myopia prevalence was 42.9% (urban 49.6%, rural 36.0%). In the multivariable GLMM, educational stage was the strongest risk factor (grades 7–9 vs. 1–3: OR = 5.54). A significant district × ethnicity interaction was found only for Mongolian children: rural residence was strongly protective (OR = 0.19) compared to Han (OR = 0.65), and the ethnic advantage disappeared in county towns. Only 14.2% of myopic students had adequate correction. Conclusions: In conclusion, myopia is highly prevalent and severely under-corrected in rural China. Educational pressure is the main risk factor, and the rural protective effect is strongest in Mongolians but erodes with urbanization. Urgent public health actions, including vision screening, affordable spectacles, and lifestyle preservation, are needed to address this growing burden. Full article

Background/Objectives: Digital media play an important role in the lives of contemporary adolescents. While associated with many benefits, they also pose risks to physical health related to prolonged screen time and non-ergonomic body posture. This study analyzed the frequency of self-reported physical complaints among Polish adolescents in relation to time spent on different screen-based activities. Methods: The study included 9083 students aged 13–17 who completed an online survey in March and April 2024 in schools located in western Poland (approximately 30% of the region’s student population). Physical symptoms selected from the HBSC-SCL instrument were analyzed and supplemented with neck or shoulder pain and eye strain. Results: Longer screen time was associated with more frequent occurrence of all analyzed complaints. A 5-item index ranging from 0 to 20 points was proposed, including headache, neck or shoulder pain, eye strain, dizziness, and problems falling asleep (mean 6.56 ± 5.15). The index showed reliability at the level of α = 0.744 and good model fit according to CFA (RMSEA = 0.025). In a multivariate linear regression model (R² = 0.153), after adjusting for age, gender, place of residence, and family affluence, the variability of this index was most strongly associated with time spent on social media (β = 0.40) and browsing websites (β = 0.30). Gender-specific models were also compared. Conclusions: The results confirm the co-occurrence of physical complaints during adolescence and a significant association between their severity and screen-based activities, particularly engagement in social media. Full article

Background/Objectives: Knowledge of plant-based diets is gaining increasing significance in adolescents due to the growing popularity of vegetarian and vegan dietary patterns. To date, there has been limited research examining the level of awareness and understanding of these diets among secondary school students, as well as the factors influencing their knowledge. The aim of the study was to determine the prevalence of plant-based diets and to assess knowledge regarding these dietary patterns among high school students, as well as to identify factors associated with both diet adherence and achieving sufficient nutritional knowledge. Methods: A cross-sectional study was conducted among 341 high school students. Data were collected using a self-administered paper questionnaire that included demographic information, self-reported body weight and height, adherence to plant-based diets, and knowledge of vegetarian and vegan nutrition. Nutritional knowledge was assessed using a structured 19-item questionnaire (25 scorable items) and verified for reliability (test–retest, Krippendorff’s alpha = 0.88). Based on a 25-point scale, a score of >60% (16–25 points) was categorized as ‘sufficient’ knowledge. Statistical analyses included the chi-square test, Mann–Whitney and Kruskal–Wallis non-parametric tests, and multivariable logistic regression to estimate adjusted odds ratios (aOR) for factors associated with sufficient knowledge. Results: The prevalence of plant-based diets in the study group was 16.1% (n = 55), with a significantly higher frequency observed among female students and those with sufficient nutritional knowledge. The majority of students (81.2%) achieved sufficient knowledge. Higher scores were observed among female students, those in higher grade levels, and those individuals adhering to plant-based diets (p < 0.05). Multivariate regression analysis indicated that male sex (aOR = 0.38 compared to females), higher grade level (aOR = 3.66 for grade 3 vs. grade 1; aOR = 3.62 for grade 4 vs. grade 1), residence in a rural area (aOR = 0.50), and non-adherence to a plant-based diet (aOR = 0.32) were independently associated with sufficient knowledge. Conclusions: The majority of high school students demonstrate sufficient knowledge regarding plant-based diets, with significant variations associated with sex, grade level, place of residence, and experience with plant-based diets. These findings underscore the need for targeted educational interventions, particularly among male students, those in lower grade levels, and individuals residing in rural areas. Full article

Air pollution is one of the major environmental challenges threatening global sustainable development and human health. The World Health Organization identifies it as a critical factor contributing to non-communicable diseases and inequality, especially in vulnerable populations such as children. The findings highlight the negative effects of environmental degradation on physical health and underline the urgent need to incorporate health metrics, such as children’s fitness, into sustainability monitoring frameworks and public policies aiming at cleaner and healthier urban environments. The aim of this study was to examine the association between ambient particulate pollution and cardiorespiratory fitness in school-aged children from two rural villages in southern Spain characterised by relatively higher and lower levels of particulate matter. A total of 938 children (primary and secondary school levels) participated in a naturalistic pre–post study design. Cardiorespiratory fitness was assessed using the 6 min walk test, where maximal oxygen uptake (VO₂max) was estimated. Assessments were conducted before and after a period characterised by unfavourable air-quality conditions in the higher-pollution village. The students were assigned by convenience into an experimental [n = 476 (EG)] and a control group [n = 462 (CG)]. The t-test, repeated measures analysis and MANOVA test were used in order to report differences within and between groups, as well as time-points and academic levels. The significance level was set at p < 0.05. Significant differences between groups were reported within the pre-test period, showing elevated pre-test values in the CG compared to the EG. The EG showed a higher pre–post difference in estimated VO₂max compared to the CG for primary education level (16.19%, ES(d) = 0.91 vs. 3.07%, ES(d) = 0.26; p < 0.001, respectively); secondary education (EG: 12.29%, ES = 0.91 vs. CG: 1.69, ES(d) = 0.16); and the whole population (EG: 14.72%, ES = 0.91 vs. CG: 2.84, ES = 0.25). It seems that the environmental context, and specifically the air pollution in the area of residence, may be an important factor to consider in relation to the assessment of physical fitness in the school-aged youth population. Full article

Food insecurity (FI) may lead to lower academic achievement, yet college students with inadequate food underutilize campus food pantries. This research aimed to identify predictors of academic success among pantry shoppers (PSs) to inform outreach. Data from AY 2021–2022 (N = 847) and 2022–2023 (N = 951) were derived from swipes of student identification cards, merged with university student-provided data, and de-identified. Multiple regression, logistic regression, and Least Absolute Shrinkage and Selection Operator (LASSO) were employed to create and validate models using Machine Learning. Grade Point Averages (GPAs) were compared by two-sample t tests. The PSs demonstrated higher GPAs in the fall term than non-pantry shoppers (p = 0.04). Validation of the models indicated strong performance. Multiple regression yielded a low prediction error (0.05), and logistic regression achieved 71% accuracy (AUC = 0.776). LASSO identified positive predictors of academic success, including graduate and honors status, junior and senior classification, females, international residency, and frequency of pantry shopping. Negative predictors included part-time status, first-year status, Black or Hispanic ethnicity, and Pell Grant eligibility. Findings underscore the complex interplay between sociodemographic and academic factors that should be considered when planning pantry outreach programs and highlight the need for standardized measures of student pantry utilization, which may aid resource allocation and sustainability. Full article

Background/Objectives: Insomnia is common among adolescents and is associated with emotional, behavioral, and academic difficulties. Although high rates have been reported globally, evidence in Latin America—particularly in Peru—remains limited and heterogeneous. Many previous studies relied on small samples, descriptive designs, omitted key psychosocial variables, or were conducted during early pandemic waves, despite the rise in sleep disturbances following COVID-19 restrictions. This study aimed to estimate the prevalence of insomnia and identify associated factors among adolescents in northern Peru. Methods: An analytical cross-sectional study was conducted using secondary data from students attending five schools in Lambayeque, Peru. Insomnia was assessed using the Insomnia Severity Index (ISI). Sociodemographic, psychosocial, behavioral, and health-related variables—including self-esteem, family dysfunction, eating disorders, acne severity, mental health help-seeking, and digital behavior—were evaluated. Generalized linear models estimated prevalence ratios (PRs) and 95% confidence intervals (CIs). Results: Among 1313 adolescents (54.3% male; mean age 14.6 years), the prevalence of insomnia was 38.9% (95% CI: 36.1–41.5). In adjusted analyses, insomnia was associated with urban residence, non-Catholic religion, seeking mental health support, high social media use, internet use of 6–10 h/day, low self-esteem, eating disorders, greater acne severity, and experiencing the death of a family member due to COVID-19. Conclusions: Nearly four in ten adolescents reported insomnia, influenced by sociodemographic, psychosocial, and lifestyle-related factors. These findings provide updated post-pandemic evidence for the Peruvian context and highlight the multifactorial nature of adolescent insomnia. Further research is needed to clarify causal pathways and understand the long-term mental health implications of large-scale stressors such as the COVID-19 pandemic. Full article

Background: Nonsteroidal anti-inflammatory drugs (NSAIDs) are among the most commonly used analgesics. However, their inappropriate or excessive use may lead to serious adverse effects. The aim of the study was to analyze behavioral patterns and attitudes toward the use of over-the-counter (OTC) NSAIDs, as well as the perception of risks associated with their use. Methods: A cross-sectional survey was conducted among 567 respondents. An anonymous questionnaire consisting of 26 items was used, addressing sociodemographic characteristics, frequency of reading drug information leaflets, frequency of NSAID use, and awareness of potential adverse effects associated with these medications. Results: The demographic factors significantly influenced NSAID-related behaviors. Women were significantly more likely than men to read drug information leaflets and reported more frequent use of OTC NSAIDs. Older respondents exhibited greater adherence to the principles of responsible NSAID use. Higher educational attainment was associated with more frequent and attentive reading of drug information leaflets. Urban residents reported higher median frequencies of NSAID use, whereas students demonstrated greater awareness of potential NSAID adverse effects compared with non-students. Conclusions: The results reveal complex patterns of NSAID consumption and underscore the need for implementing targeted public health interventions. Full article

Background: Numerous studies have reported on the epidemiology of hand, foot and mouth disease (HFMD) reinfection and its potential influencing factors; however, findings regarding reinfection rates as well as determinants such as gender, age, residence, and pathogens remain inconsistent. Due to this heterogeneity in reported outcomes, a comprehensive systematic review and meta-analysis are warranted to consolidate existing evidence. Methods: Effect estimates were expressed as reinfection rates, odds ratio (OR)/hazard ratio (HR) and 95% confidence intervals (CI). When necessary, data were converted to ensure consistency across comparison groups. Results: A thorough search was carried out using the predetermined literature retrieval approach across the PubMed, Web of Science, and Embase databases. Finally, 9 articles met the inclusion criteria and were included in this study. The results indicated that the overall reinfection rate for HFMD was 4.1% (95% CI: 2.0–6.2%). Males compared to females (overall effect = 1.256, 95% CI: 1.176–1.341), younger compared to older children (overall effect = 2.972, 95% CI: 1.512–5.843), scattered children compared to students (overall effect: 4.017, 95% CI: 1.560–10.344), and enterovirus 71 (EV71) compared to non-EV71 enteroviruses (overall effect = 0.71, 95% CI: 0.59–0.86) were associated with the HFMD reinfection. Conclusions: The overall HFMD reinfection rate was 4.1% (95% CI: 2.0–6.2%). Male, younger age, kindergarten children, and infection with non-EV71 enteroviruses (compared to EV71), were identified as significant risk factors for recurrent HFMD. Targeted intervention strategies should be developed for these high-risk populations to effectively reduce the incidence of reinfection. Full article

This study examines the underrepresentation of women in STEMM (Science, Technology, Engineering, Mathematics, and Medicine) within Peruvian public universities and identifies factors associated with women’s program choice. A cross-sectional survey was administered to first-term students across three public institutions spanning Peru’s Highlands, Coast, and Amazon regions. Data from 1142 students (145 women) were used for descriptive analysis of segregation, while an inferential sample (N = 152; 76 STEMM, 76 non-STEMM) was used for modeling. The instrument was an adapted “University Students’ Questionnaire on STEM Studies in Higher Education (QSTEMHE)” (Cronbach’s α = 0.89). Descriptive statistics and a penalized (Firth) binary logistic regression were used to evaluate sociodemographic, contextual/experiential, and motivational predictors of enrolling in a STEMM major. The cross-sectional design limits causal inference, and perception data are subject to self-report biases. Women accounted for 12.7% of STEMM enrolment overall, with pronounced horizontal segregation: engineering programs frequently recorded critically low female participation (≈3–5% in Civil, Mechanical, and Computer Engineering), whereas Medicine and Sanitary Engineering showed comparatively higher representation (27–38%). Perception data indicated that STEMM students more strongly rejected gender–ability stereotypes than non-STEMM peers, although a substantial proportion still reported constraining gender expectations and rigid household roles. In the penalized regression, Prior Interest in STEM (OR = 7.76; p = 0.018) and Motivation: Opportunities (OR = 2.24; p = 0.0001) significantly increased the probability of choosing STEMM. Crucially, Ethnicity emerged as a significant barrier: identifying as ‘Quechua’ (OR = 0.19; p = 0.0004) or ‘Other(s)’ (OR = 0.16; p = 0.011) significantly decreased this likelihood. Age, area of residence, and Motivation: Altruism was not significant. Findings support early, gender-responsive career guidance, mentoring, addressing intersectional ethnic barriers, and targeted financial aid to strengthen women’s participation and retention in STEMM. Full article

Background: Sleep disorders, particularly insomnia, represent a significant health concern in medical education. Neuroticism, characterized by emotional instability and stress reactivity, shows cross-sectional associations with sleep disturbances in healthcare trainees. Limited research examines these relationships among South Asian medical students. This cross-sectional study investigated insomnia symptom prevalence, personality correlates, and environmental factors among Pakistani medical students. Methods: We conducted a cross-sectional study among 364 undergraduate medical and dental students in Peshawar, Pakistan (June–November 2024). Data collection occurred during examination months. Data collection employed validated instruments: the Insomnia Severity Index (ISI) and the NEO Five-Factor Inventory neuroticism subscale (NEO-FFI-12). Statistical analyses included Pearson correlations, chi-square tests, and multivariate regression with interaction terms. Results: Among 364 participants (mean age 21.3 ± 2.3 years, 52.2% female), 47.0% reported severe insomnia symptoms (ISI 22–28), with 89.0% experiencing at least subthreshold symptoms (ISI ≥ 8) during the 2-week assessment period. These prevalence rates reflect symptom severity over a 2-week period during examination months and do not represent clinical diagnoses of chronic insomnia disorder, which requires ≥3 months of symptoms with clinical confirmation. High neuroticism (NEO-FFI ≥ 37) characterized 59.8% of students. Multivariate regression revealed a robust cross-sectional association between neuroticism and insomnia symptom severity (β = 0.239, 95% CI [0.173, 0.305], standardized β = 0.342, p < 0.001) and may reflect measurement during peak examination stress rather than stable trait-outcome relationships. Hostel residents showed non-significantly higher clinical insomnia prevalence than day scholars (75.9% vs. 67.5%, p = 0.081). Clinical-year students demonstrated significantly lower insomnia severity than pre-clinical students (β = −1.271, p < 0.001), a finding that contradicts assumptions about increasing stress through training progression. The neuroticism × living arrangement interaction was non-significant (p = 0.118); however, post hoc power analysis indicated the study was underpowered to detect small moderation effects, making this finding inconclusive. Conclusions: This study documents high insomnia symptom severity during a 2-week assessment period in Pakistani medical students, with a robust cross-sectional association with neuroticism. However, these findings must be interpreted within the constraints of the cross-sectional design, which cannot establish temporal precedence or causality between neuroticism and insomnia symptoms. These symptom prevalence rates likely reflect a combination of chronic sleep disorders and transient examination-related stress. Living arrangements showed small, non-significant associations with insomnia. The observed association between neuroticism and insomnia may be partially mediated or confounded by unmeasured variables, including academic stress, psychiatric comorbidities, substance use, and other sleep disorders. Findings suggest potential benefits from interventions addressing cognitive-emotional factors, though comprehensive diagnostic assessment is needed to distinguish chronic insomnia disorder from transient, stress-related sleep difficulties. Longitudinal research with objective sleep measures, structured psychiatric assessment, and systematic confounder evaluation is essential to establish causal relationships and intervention efficacy in this population. Full article

This study examines the financial behavior of university students in Economics, Business Administration, and Accounting in Tegucigalpa, Honduras, using the FB–13 instrument. Exploratory and confirmatory factor analyses validate a three-dimensional structure: (1) financial planning and control, (2) savings and financial preparation, and (3) fulfillment of obligations, with high internal consistency (α = 0.915), supporting its psychometric robustness in Latin American academic contexts. Based on a sample of 714 students with diversity in gender, age, work experience, and parental status, the analyses confirmed that the FB–13 model best fits a three-factor structure. Significant correlations were identified between financial behavior and experiential variables such as age, work experience, and parenthood, while traditional sociodemographic attributes such as gender, residence, marital status, employment, and educational level showed limited associations. These findings suggest that personal experiences have a greater influence on the configuration of financial practices than conventional demographic categories. The study acknowledges limitations related to cross-sectional design, non-probabilistic sampling, and self-reported data, yet these do not diminish its contributions. By validating the FB–13 in Honduras, the research offers comparative evidence and promotes cultural diversity in financial behavior literature. Future research should move toward longitudinal and qualitative studies that explore the role of family dynamics, work contexts, and personal aspirations in responsible financial behaviors. Full article

The primary goal of Transportation systems is to provide transportation accessibility to opportunities. Equitable access to essential destinations encompassing social, recreational, educational, and civic opportunities needs to be more consistent across different social groups. This study evaluates the disparities in social justice using social equity as a measure of transit access and walk access to non-work amenities. These non-work amenities include grocery stores, personal services, retail outlets, recreational venues, entertainment centers, and healthcare facilities in the U.S. Logistic regression models are developed using the 2017 National Community Livability Survey data. The results indicate regressive public transit access for socially disadvantaged groups, including older citizens, non-drivers, Medicare/Medicaid beneficiaries, and non-metropolitan residents. Walk access inequities similarly affect older individuals, non-drivers, the physically disabled, the unemployed, students, women, and non-metropolitan residents. This research emphasizes the importance of addressing transit and walk-access inequities to non-work amenities within transportation systems. By acknowledging the disparities in transportation equity, decision-makers and communities can foster more inclusive and equitable access to essential destinations, thereby promoting social cohesion and overall community well-being. Full article

Background/Objectives: Family meetings (FMs) are clinical encounters in a structured space between the patient, family members, and care teams. Healthcare professionals (HPs) often lack formal training in conducting FMs. The scoping review aims to provide an overview of the available research evidence on FMs’ education for HPs. Methods: We searched MEDLINE, Embase, CINAHL, PsycINFO, and Scopus. The PCC (Population-Concept-Context) framework was used to define inclusion criteria: educational intervention on FMs aimed at HPs in all settings of care and students of medicine and nursing sciences treating adult patients with oncological and non-oncological diseases. Results: The search retrieved 1017 articles, of which 26 were eligible. The training had as its primary aims the development of communication skills and curriculum development/evaluation. For the most part, palliative care physicians served as trainers, while medical students and residents represented a major part of trainees, underscoring a focus on early-career learners. FM training is mainly provided in the American countries and intensive care settings. Role-play or simulation was the most common teaching method. Pre- and post-interventional designs were the most common, with few studies incorporating longitudinal follow-up to assess skill retention. Quantitative and qualitative methodologies were used to evaluate interventions. Conclusions: The training topics are related to advanced communication, but there is a lack of an interprofessional perspective and long-term assessment of the skills learned. It is necessary to consider different family types as subjects of communication. Full article

Background/Objectives: Fear of terrorism can impact psychological functioning and behavior even without direct exposure. Little is known about how anticipatory terrorism fears manifest among nursing students in European contexts. This study assessed terrorism catastrophizing among Croatian nursing students and examined sociodemographic predictors. Methods: A cross-sectional correlational study was conducted between October and December 2024 among 348 nursing students, using the validated Terrorism Catastrophizing Scale (TCS). Behavioral and habitual changes related to the terrorism threat were also measured. Non-parametric tests and bootstrapped regression analyses (1000 resamples) explored associations with sociodemographic variables. Results: Mean TCS score was 38.4 ± 8.0, indicating moderate catastrophizing, with subscale means of 16.8 (Helplessness), 11.7 (Rumination), and 9.8 (Magnification). Female students scored higher across all TCS measures (p < 0.001). Employment was associated with greater catastrophizing and behavioral changes, while urban residence was linked to fewer habitual and overall behavioral modifications. Higher income was associated with lower magnification. TCS scores correlated moderately with behavioral changes (rs = 0.27, p < 0.001). Non-parametric tests (Mann–Whitney U, Kruskal–Wallis, Spearman correlation) were applied due to non-normal distributions. Conclusions: Terrorism catastrophizing in this population is moderate and influenced by gender, employment, and residential context. Findings suggest targeted mental health support and tailored risk communication strategies may benefit nursing students in similar low-risk settings. Full article