Mental Health Problems during the COVID-19 Pandemics and the Mitigation Effects of Exercise: A Longitudinal Study of College Students in China

Determining the Mental Status, Sleep Quality, and Eating Behaviors of University Students During the COVID-19 Pandemic: A Cross-Sectional Study

BACKGROUND

The COVID-19 pandemic has resulted in adverse effects on individuals' physical and mental health worldwide, with university students also being adversely affected by this process.

OBJECTIVES

This research aimed to determine the mental condition, sleep quality, and eating behaviors of university students during the COVID-19 process.

METHOD

This cross-sectional study was conducted with 1,065 university students. Study data were collected with an online questionnaire including a personal information form, the Depression Anxiety Stress Scale, the Pittsburgh Sleep Quality Index, and the Dutch Eating Behavior Scale.

RESULTS

Students' poor sleep quality was determined to be 69.5%. It was also determined that students' depression and stress levels were moderate that their anxiety levels were low, their eating behaviors were generally problematic, and more than half had poor sleep quality. In addition, eating disorders and poor sleep quality increased as depression, anxiety, and stress levels increased, and eating disorders increased as poor sleep quality increased (p < .05).

CONCLUSIONS

The results emphasize the importance of the strengthening of students' mental health, particularly by improving their sleep quality and eating habits. Evidence-based interventions regarding the effects of the pandemic should be made for students under the leadership of a psychiatric nurse, and effective strategies must be developed accordingly.

Effects of Changes in Frequency of Going Out during the COVID-19 Pandemic on ikigai (Sense of Purpose in Life) and Mental Health in Middle-Aged and Older Adults in Japan

To clarify whether changes in frequency of going out due to the COVID-19 pandemic affect ikigai (sense of purpose in life) and mental health in Japanese middle-aged and older adults. In a questionnaire survey mailed to 16,866 adults aged > 40 years in Japan in September 2020, 7,973 responses were received (response rate, 47.3%) in October 2020. Following exclusions, data from 6,978 individuals (50.6% female, mean age 67.8 ± 12.2 years) were available for analysis. Respondents were categorized based on changes in frequency of going out, reflecting changes in social and/or physical activity, during the pandemic compared with before it: the previously active group went out often before but less often during the pandemic; the remained active group continued going out often; and the inactive group continued not going out often. Whether these changes affected the respondents' ikigai and mental health was investigated. The previously active group had a significantly higher proportion of individuals with decreased ikigai during the pandemic than the other groups. Mental health score decreased in all groups during the pandemic, but more so in the previously active group (-3.21), followed by the inactive and then the remained active groups (-1.45 and -1.28, respectively). Previously active individuals showed the greatest decline in ikigai and mental health among the three groups. These findings suggest that continuing to engage in appropriate physical and social activities, including going out, while following appropriate infection control measures, even under restrictions, can help people maintain ikigai and mental health.

The Effect of Physical Activity on Sleep Quality Among Chinese College Students: The Chain Mediating Role of Stress and Smartphone Addiction During the COVID-19 Pandemic

Purpose

During the period of COVID-19 pandemic, the social restrictions and isolation exerted a significant impact on the sleep quality of Chinese college students. This study aims to delve into the influence of physical activity on the sleep quality of college students as well as the mediating roles of stress and smartphone addiction.

Materials and Methods

A cohort of 274 eligible college students (146 males and 128 females) were selected for the investigation. The International Physical Activity Questionnaire Short Form, Stress Perception Scale, Smartphone Addiction Scale, and Pittsburgh Sleep Quality Index were employed to assess the levels of physical activity, stress, smartphone addiction, and sleep quality among college students. For data analysis, descriptive statistics, correlation analysis, and chained mediation effect tests were performed sequentially.

Results

The findings revealed: (1) a significant negative correlation between physical activity and stress, smartphone addiction, and sleep quality among college students (r = -0.216, p < 0.001; r = -0.224, p < 0.001; r = -0.259, p < 0.001); (2) independent mediating roles of stress and smartphone addiction in the relationship between physical activity and sleep quality; and (3) chained mediating effects of stress and smartphone addiction in the association between physical activity and sleep quality.

Conclusion

This study deepens our comprehension of how physical activity augments the quality of slumber, concurrently emphasizing that mitigating stress levels and alleviating smartphone addiction constitute effective strategies for preventing sleep issues among college students.

Adolescents' attitudes, habits, identity and social support in relation to physical activity after the COVID-19 pandemic

This study focuses on adolescents' cognitive processes, behaviors and social support (SS) as they relate to physical activity (PA) before and after the pandemic. The aims of the study were: (1) to investigate the changes in adolescents' engagement in moderate and vigorous physical activity (MVPA), and examine the changes in PA-related attitudes and behaviors before and after the COVID-19 pandemic; (2) to analyze the correlations between the significant changes that were found, PA engagement, and SS. The survey targeted third-year middle school students of Italian nationality, attending male and female mixed classes, residents in urban, periphery and sub-urban areas, living in families with different incomes, and different habits of engaging in PA. A longitudinal study was developed using a standardized questionnaire. The questionnaire was administered in April-May 2023 to a sample of 952 students aged 11/14 residing in the Marche region in Central Italy. Increasing values were found in the post-COVID-19 phase for all the cognitive processes and attitudes, in particular, those regarding habits (0.66 vs 0.50, + 32%) and identity (0.70 vs 0.55, + 27%) related to PA. Significant correlations were found between these values and VPA engagement and between the values of the same indicators and SS (p < 0.01). The strongest relationship was found with the dimension of identity (r = 0.51; r = 054).

Prevalence and correlates of mental disorders among Chinese overseas students during the COVID-19: A multi-regional cross-sectional analysis

BACKGROUND

The global impact of the COVID-19 pandemic extends beyond physical health, significantly affecting mental health. Chinese overseas students are particularly susceptible to the adverse psychological effects of the pandemic. Understanding the prevalence and correlates of mental disorders in this population is essential for developing targeted interventions and support systems.

METHODS

Employing a snowball sampling technique, this study recruited Chinese overseas students from diverse regions. The 50-item Self-evaluation Table was utilized to assess the presence of mental disorders. Descriptive statistics, including percentages, 95% confidence intervals, means, and standard deviations, characterized the survey population. The chi-square test identified disparities among categorical variables, while logistic regression explored risk factors for mental disorders among Chinese overseas students.

RESULTS

Out of the total sample size of 10,864 Chinese overseas students, a staggering 7,090 (65.4%) met the diagnostic criteria for mental disorders. Furthermore, the degree of mental disorder varied significantly across different regions (p < 0.001), education levels (p < 0.05), the duration of anti-epidemic measures (p < 0.05), and age (p < 0.05), while no significant differences were observed in terms of gender (p > 0.05). Several risk factors contributing to the mental disorder burden among Chinese overseas students during the pandemic were identified, including the seriousness of the epidemic in their residential area, the apprehension of getting infected, anxieties regarding academic performance, the infection control policies implemented by the host government, preventive measures taken locally to counter the epidemic, and challenges encountered in returning to their home country.

CONCLUSION

Given the significant challenges in mental health faced by Chinese overseas students during the COVID-19 crisis, addressing their specific needs and implementing tailored measures is imperative. Future public health emergencies should consider the potential mental disorders and disease risks faced by Chinese overseas students. By providing comprehensive support and targeted interventions, policymakers, educational institutions, and healthcare providers can help mitigate the adverse psychological effects and promote the well-being of this vulnerable population.

The Role of Insomnia and Exercise in COVID-19 Worries for Psychological Distress in Hong Kong Chinese: A Moderated Mediation Model

OBJECTIVE

To examine the role of insomnia as a mediator between worrying and mental health and whether the association between worrying and insomnia is moderated by the levels of exercise frequency.

METHODS

A cross-sectional online survey was conducted during the fourth wave of the COVID-19 outbreak in Hong Kong (n = 988). Participants' insomnia, psychological distress, and exercise frequency were evaluated. A mediation analysis was performed to examine the direct effect of COVID-19 worries and their indirect effect through insomnia on psychological distress.

RESULTS

A significant indirect effect of COVID-19 worries through insomnia was found on psychological distress (beta = 0.18, SE = 0.02, 95% CI = 0.14-0.22, p < .001). The significant index of moderated mediation supported the moderating effect of exercise frequency on the indirect effect of COVID-19 worries on psychological distress (IMM = 0.06, SE = 0.02, 95% CI = 0.02-0.10, p = .006). The conditional indirect effects of insomnia on psychological distress were significant in individuals with mean and higher exercise frequency but not in those with lower exercise frequency.

CONCLUSION

COVID-19 worries increased psychological distress through the worsening of sleep, and such an array of COVID-19 worries on insomnia was moderated by exercise frequency. Engaging more frequent exercise could reduce insomnia in people with less COVID-19 worries.

COVID-19 stressful life events and mental health: Personality and coping styles as moderators

OBJECTIVE

To examine the role of COVID-19-specific stressful life events (SLE) in predicting depression, anxiety, and life satisfaction, and if personality traits (extraversion and neuroticism), and coping styles (problem-focused coping and avoidance coping) moderated these relations.

PARTICIPANTS

Data were collected from 371 college students (Mage = 20.59; SDage = 2.58) from one large university of the Mid-Atlantic region in the U.S.

METHODS

Participants completed an online survey measuring COVID-19 related stressful life events (adapted from a tool developed to measure stressful life events during the SARS pandemic; Costa et al., 2001; Main et al., 2011), personality (the Mini-Markers; Saucier, 1994), coping styles (by using a measure developed by Aldrige-Gerry et al., 2011), depression (PHQ-9; Kroenke et al., 2011), anxiety (GAD-7; Spitzer et al., 2006), and life satisfaction (Student's Life Satisfaction Scale, Huebner, 1996) between March 27th and April 27th, 2020.

RESULTS

Path analysis results showed that extraversion and avoidance coping style moderated the effects of SLE on depression and anxiety symptoms; neuroticism and avoidance coping style moderated the relation between SLE and life satisfaction. The moderation results also differed by gender.

CONCLUSIONS

These findings indicated that the COVID-19 pandemic had deleterious effects on college students' mental health, where extraversion emerged as a protective factor, while neuroticism and avoidance coping style were risk factors. These findings underscore the importance of paying special attention to college students' mental health needs and promoting appropriate coping strategies in the light of the current pandemic.

Longitudinal change in symptoms of depression, anxiety and post-traumatic stress disorder during the COVID-19 pandemic among Mexican college students

Longitudinal studies suggest the psychological difficulties precipitated by the COVID-19 pandemic have gradually declined, but our understanding of the factors that predict change in mental health is limited. We evaluated the mental health of Mexican college students during the early stage of the pandemic and 4 months later, as well as predictors of change in students' mental health. Participants were 648 students (71% women, Mage = 21.46) from a private University in Northern Mexico who completed online surveys from May 2020 to September 2020. Students' self-reported levels of mental health symptoms (depression, anxiety and post-traumatic stress disorder) significantly decreased from May to September. Poor physical health, more COVID-related worry and higher initial levels of peer social support predicted less change in psychological symptoms. On the other hand, more hours of sleep per night and a pre-existing mental health diagnosis predicted steeper decreases in symptoms. Findings suggest reductions in mental health difficulties that are consistent with theoretical frameworks of resilience among Mexican college students. In addition, results underscore the interplay between physical, psychological and social functioning, and the need for continued monitoring of mental health and intervention efforts that address physical health, sleep and pandemic-related worry in University settings.

COVID-19-Related Stressors and Psychophysical Health Conditions among Italian University Students: A Post Pandemic Insight

The COVID-19 medical emergency has ended worldwide, yet the psychological impact of these years of unprecedented changes on students' lives still needs to be deepened.

METHODS

This study aims to assess and compare COVID-19-related stressors (relationships and academic life; isolation; and fear of contagion) and psychophysical symptoms reported by 637 university students at three times, i.e., April 2020 (n = 197), April 2021 (n = 200), and April 2022 (n = 240). The impact of COVID-19-related stressors on psychophysical symptoms within each time was also tested.

RESULTS

In April 2022, perceived isolation and fear of contagion decreased from the peak registered in April 2021, but stress related to relationships and academic life remained high. An ongoing increase in psychophysical symptoms was found. More than 50% of students reported clinical levels of sleep disorders, depression, psychoticism, and interpersonal sensitivity. In April 2022, students still perceiving stress related to relationships and academic life and isolation were at risk for anxiety, somatization, and sleep disorders. Students still perceiving stress related to fear of contagion were also at risk for depression, obsessive-compulsive symptoms, and psychoticism.

CONCLUSION

The findings emphasized the long-lasting effects of COVID-19-related stress on students' psychophysical health. Interventions must aim at supporting students in dealing with the complex post-pandemic adjustment process.

Sleep quality and associated factors among university students in Africa: a systematic review and meta-analysis study

Background

Poor sleep quality significantly impacts academic performance in university students. However, inconsistent and inconclusive results were found in a study on sleep among university students in several African nations. Therefore, this study aimed to estimate the pooled prevalence and associated factors of poor sleep quality among university students in Africa.

Methods

The databases PubMed, Scopus, Cochrane Library, Science Direct, African Journal Online, and Google Scholar were searched to identify articles. A total of 35 primary articles from 11 African countries were assessed and included in this systematic review and meta-analysis. Data were extracted by using a Microsoft Excel spreadsheet and exported to STATA version 14 for analysis. The I2 test was used to assess the statistical heterogeneity. A random effect meta-analysis model was employed with 95% confidence intervals. Funnel plots analysis and Egger regression tests were used to check the presence of publication bias. A subgroup analysis and a sensitivity analysis were done.

Results

A total of 16,275 study participants from 35 studies were included in this meta-analysis and systematic review. The overall pooled prevalence of poor sleep quality among university students in Africa was 63.31% (95% CI: 56.91-65.71) I2 = 97.2. The subgroup analysis shows that the combined prevalence of poor sleep quality in East, North, West, and South Africa were 61.31 (95% CI: 56.91-65.71), 62.23 (95% CI: 54.07-70.39), 54.43 (95% CI: 47.39-61.48), and 69.59 (95% CI: 50.39-88.80) respectively. Being stressed (AOR= 2.39; 95% CI: 1.63 to 3.51), second academic year (AOR= 3.10; 95% CI: 2.30 to 4.19), use of the electronic device at bedtime (AOR= 3.97 95% CI: 2.38 to 6.61)) and having a comorbid chronic illness (AOR = 2.71; 95% CI: 1.08, 6.82) were factors significantly associated with poor sleep quality.

Conclusion

This study shows that there is a high prevalence of poor sleep quality among university students in Africa. Being stressed, in the second year, using electronic devices at bedtime, and having chronic illness were factors associated with poor sleep quality. Therefore, addressing contributing factors and implementing routine screenings are essential to reduce the burden of poor sleep quality.

Systematic Review Registration

https://www.crd.york.ac.uk/prospero/, identifier CRD42023493140.

Mobile phone addiction and insomnia among college students in China during the COVID-19 pandemic: a moderated mediation model

Background

Nowadays, it is widely acknowledged that mobile phone addiction is a risky factor for insomnia symptoms, but to date, people know little about the underlying relationship between them among undergraduates during the COVID-19 pandemic. The purpose of the present study was to examine the potential association between mobile phone addiction and insomnia, as well as the mediating role of social anxiety and the moderating role of physical activity.

Methods

Using the Mobile Phone Addiction Tendency Scale, Social Phobia Inventory, Physical Activity Rating Scale and Insomnia Severity Index, 301 eligible college students in China were investigated. For data analysis, descriptive analysis, correlation analysis, moderating effect test, moderating effect test were carried out in turn.

Results

The findings revealed a favorable correlation between mobile phone addiction, social anxiety and insomnia, as well as between social anxiety and insomnia. But physical activity was negatively correlated with social anxiety and mobile phone addiction, and social anxiety partially mediated the relationship between mobile phone addiction and insomnia. Additionally, physical activity played a significant moderating effect between mobile phone addiction and social anxiety.

Conclusion

This study advances the knowledge of how mobile phone addiction raises the likelihood of experiencing insomnia symptoms, and also implies that upping physical activity level could lessen the harmful impacts from mobile phone addiction.

Stigma towards mental illness, resilience, and help-seeking behaviours in undergraduate students in Hong Kong

AIM

Early interventions have great impact on reducing burden of mental illness. Young people are however the least likely to seek help for psychological issues. Resilience and stigma towards mental illness have been identified as contributing factors, although previous findings were mixed with potentially complex interaction with symptom severity. We investigated the relationship between stigma, resilience, depressive symptom severity, and help-seeking behaviours in undergraduate students in Hong Kong.

METHODS

A cross-sectional online survey was conducted among undergraduates from a university in Hong Kong (n = 945). The 21-item Stigma and Acceptance Scale, Connor-Davidson Resilience Scale, and the Patient Health Questionnaire-9 were used. History of help-seeking for psychological issues was self-reported. Path analysis was conducted to test a conceptual model of their relationships.

RESULTS

Among those with moderate-to-severe depressive symptoms (39.5%), only one-fourth had sought professional help. The path model showed that depressive symptom severity and stigma were positively associated with help-seeking behaviours, while resilience was negatively associated with help-seeking behaviours independently (all p < .001). Subgroup analyses showed differential contribution of stigma and resilience to a history of help-seeking in those with minimal-to-mild symptoms compared with moderate-to-severe symptoms.

CONCLUSIONS

Stigma may be a barrier for help-seeking particularly in students with moderate-to-severe depression. Higher levels of resilience in young people may be protective and reduce the unnecessary seeking of professional help. Therefore, enhancing resilience among students in general, and reducing stigma and promoting help-seeking behaviours for those who have moderate-to-severe symptoms should be consider in parallel as strategies to enhance mental wellbeing of students.

Association of worker's mental health with changes in exercise time, going-out time, and screen time (TV time, internet time, and game time) before and after the COVID-19 pandemic: A cross-sectional study

The coronavirus disease 2019 (COVID-19) pandemic and government regulations have affected the daily lives and mental health of individuals worldwide. This study aimed to determine how much the change in time spent on exercise (exercise time), outdoor activities ("going-out" time), and screen usage (screen time) before and after the COVID-19 pandemic has affected mental health (depression, anxiety, and insomnia). In June 2021, during the third wave of the COVID-19 pandemic, a web-based, cross-sectional survey was conducted in Japan through an online research company. A total of 824 workers participated in this study. Depression, anxiety, and insomnia were assessed using the Patient Health Questionnaire-9, General Anxiety Disorder-7, and Insomnia Severity Index, respectively. The symptoms of depression were associated with age and decreased exercise time. Symptoms of anxiety were associated with not decreased going-out time. Symptoms of insomnia were associated with reduced exercise time. The results indicated that during the COVID-19 pandemic, an increase in exercise time could have prevented depression and insomnia. Similarly, a decrease in going-out time could have prevented anxiety. Furthermore, in the event of future outbreaks of unpredictable infections, such as COVID-19, decreased going out and increased exercise may help maintain mental health.

Psychological predictors of physical activity intensity among college students

Objective: The purpose of this study was to investigate the association of mental health, subjective well-being, and the impact of COVID-19 on quality of life with PA intensity among college students. Participants: The sample included 1262 college students from a large Midwestern research university (mean age = 21.5 ± 3.6 years). Methods: Participants voluntarily and anonymously completed the Qualtrics questionnaires which included the Patient Health Questionnaire -Anxiety and Depression Scale, the Satisfaction with Life Scale, the Impact of COVID-19 on Quality of Life (QoL) Scale, and the International Physical Activity Questionnaire. Results: Multiple linear regression models indicated that COVID-19 QoL and life satisfaction were significant predictors of the total, vigorous, and moderate PA (p's < .05). Life satisfaction was also a significant predictor of walking. Conclusion: Higher level satisfaction and lower impact of COVID-19 on quality of life were related to higher total, vigorous, and moderate PA levels.

Stress and emotion in a locked campus: the moderating effects of resilience and loneliness

The aim of this study is to investigate the dynamic relationship between Chinese students' emotions and stress during a strict lockdown period in a university setting and the context of a global pandemic. Dynamic structural equation modeling was used to investigate the moderating role of resilience and loneliness in this relationship. The participants consisted of 112 students. Based on loneliness and resilience measures and the intensive tracking of emotional stress over a 21-day period, the results of data analysis indicated that the students' overall levels of positive emotions were low and relatively independent of negative emotions. Negative emotions were significantly autoregressive and their baseline was closely related to the individual's overall feelings of stress and loneliness levels, fluctuating with feelings of stress. The results confirm the hypothesis that resilience helps to stabilize emotions. Individuals with low resilience may be more emotionally sensitive in confined environments, while receiving social support may help to alleviate low moods.

COVID-19 Pandemic: What We Have Learned on Stress, Technology Use, and Psychological Health Among University Students

Nowadays, the medical COVID-19 emergency is ending worldwide, whereas there is an increasing need to understand the marks and the lessons learned from over two years of unprecedented changes in all life domains. Recent research has highlighted growing rates of psychological suffering among the general population as well as among university students, who were yet well-recognized as a vulnerable population even before the pandemic. The present work drives from university students' experience, and it aims to provide an overview of the key dimensions to take into account, in terms of main risks, changes, challenges, and resources, to develop updated tailored research and interventions promoting psychological health conditions in the current time within and beyond the educational context/university students' population. Implications for research and interventions are highlighted and discussed.

Attachment, Resilience and Life Satisfaction of University Students in Cyprus after the Fourth Wave of COVID-19

The COVID-19 pandemic has given rise to a large-scale crisis that has also impacted the well-being and, more specifically, the life satisfaction of university students. Factors such as attachment dimensions and psychological resilience can provide us with a better understanding of students' life satisfaction levels during the recent pandemic. While previous literature has revealed a significant association between attachment dimensions, resilience, and life satisfaction, very few studies have attempted to address a more complex relationship among all three variables for university students, and even fewer have explored this topic during the COVID-19 pandemic. Therefore, the aim of the current study was to investigate the impact of attachment dimensions on university students' life satisfaction after the fourth wave of COVID-19 in Cyprus, with a focus on the mediating role of psychological resilience. The sample comprised 780 university students, consisting of 323 men and 457 women, aged between 18 and 61 years. Participants were recruited electronically, and after being directed to Google Forms, they completed the ECR-R for their attachment dimensions, the RES for psychological resilience, and the SWLS for life satisfaction. The results indicated significant correlations between attachment dimensions, psychological resilience, and life satisfaction. Notably, psychological resilience was found to partially mediate the relationship between attachment anxiety, as well as attachment avoidance, and life satisfaction. Specifically, attachment anxiety and avoidance negatively affected life satisfaction, partially due to lower levels of psychological resilience. These findings are discussed in relation to the existing literature, and implications for practice are provided.

Association between physical activity levels and anxiety or depression among college students in China during the COVID-19 pandemic: A meta-analysis

BACKGROUND

This meta-analysis aimed to investigate the links between the level of physical activity and the risk of anxiety or depression among college students in China during the Coronavirus Disease 2019 pandemic.

METHODS

Eligible studies were searched from the PubMed, Embase, and Web of Science databases. The associations between them were assessed with odd ratio (OR) and 95% confidence interval (CI). The heterogeneity of the included studies was evaluated and subgroup analysis was performed. Sensitivity analysis was executed using leave-one-out method. Publication bias of included studies was evaluated. Ten studies with moderate quality were included.

RESULTS

Physical activity levels of college students were associated with reduced risk of depression (OR [95%CI] = 0.69 [0.58, 0.82], P < .001) and anxiety (OR [95%CI] = 0.71 [0.62, 0.80], P < .001). The measurement scale of depression or anxiety and whether multi-factor correction was performed or not did not influence the pooled results. The pooled results of depression and anxiety were stable and were not significantly influenced by a single study. No publication bias was observed in the included studies reporting depression and anxiety.

CONCLUSION

The physical activity level of college students is negatively correlated with anxiety and depression in China during the pandemic. During the Coronavirus Disease 2019 pandemic, it is necessary to strengthen the construction of university physical education courses. As an organized form of physical activity, physical education classes are a necessary and effective way to increase physical activity among college students.

Impact of the COVID-19 Pandemic on the Professional Attitudes of Medical Students: A Pre-Post-Like Study

OBJECTIVE

This study assesses the difference in professional attitudes among medical students, both before and after coronavirus disease 2019 (COVID-19), and identifies the determinants closely associated with it, while providing precise and scientific evidence for implementing precision education on such professional attitudes.

METHODS

A pre-post-like study was conducted among medical students in 31 provinces in mainland China, from March 23, to April 19, 2021.

RESULTS

The proportion of medical students whose professional attitudes were disturbed after the COVID-19 pandemic, was significantly lower than before the COVID-19 pandemic (χ2 = 15.6216; P < 0.0001). Compared with the "undisturbed -undisturbed" group, the "undisturbed-disturbed" group showed that there was a 1.664-fold risk of professional attitudes disturbed as grade increased, 3.269-fold risk when others suggested they choose a medical career rather than their own desire, and 7.557-fold risk for students with COVID-19 in their family, relatives, or friends; while the "disturbed-undisturbed" group showed that students with internship experience for professional attitudes strengthened was 2.933-fold than those without internship experience.

CONCLUSIONS

The professional attitudes of medical students have been strengthened during the COVID-19 pandemic. The results provide evidence of the importance of education on professional attitudes among medical students during public health emergencies.

Impacts of the COVID-19 pandemic on early pregnancy outcomes among women undergoing frozen-thawed embryo transfer: a retrospective cohort study

The effect of COVID-19 pandemic on early pregnancy outcomes among women undergoing frozen-thawed embryo transfer (FET) remains unclear. We aimed to evaluate whether early pregnancy outcomes were altered in patients undergoing FET during the pandemic. In this retrospective cohort study, women conceived through FET in 2016-2021 from two hospitals in China were included. The early pregnancy outcomes were compared using Logistic regression model, including biochemical pregnancy rate (BPR), clinical pregnancy rate (CPR), and early pregnancy loss rate (EPLR). A total of 16,669 (67.2%) and 6,113 (26.8%) FET cycles enrolled before and during the pandemic, respectively. Univariate analyses showed that women undergoing FET during the pandemic had significantly increased BPR (72.9% vs. 69.7%) and CPR (59.5% vs. 55.0%), and significantly decreased EPLR (13.7% vs. 16.7%) compared to pre-pandemic (all P < 0.001). Moreover, after adjustment, the results were in accordance with univariate analysis for CPR [adjusted OR (95%CI) = 1.08 (1.01-1.14)] and EPLR [adjusted OR (95%CI) = 0.82 (0.73-0.91)], while the statistical significance between BPR and the pandemic disappeared. In summary, women conceived by FET did not have a reduced possibility of clinical pregnancy and a higher risk of early pregnancy loss during the pandemic compared with the pre-pandemic.

US college student mental health and COVID-19: Comparing pre-pandemic and pandemic timepoints

OBJECTIVE

To assess mental health in US undergraduates during COVID-19; to identify key pandemic-related stressors, perceived control, and coping and their associations with mental health.

PARTICIPANTS

Data collected from a sample of undergraduates in April 2020 (N = 312) were compared to data collected in Spring 2017 (N = 362).

METHODS

Online measures of depression, anxiety, and stress symptoms and perceived control and coping (both samples); pandemic-related stressors and perceived benefits (April 2020).

RESULTS

Depression and stress symptoms were higher in April 2020 than in 2017. Most students reported perceiving at least some pandemic-related benefits. Top-rated stressors involved missing seeing friends and school-related stressors. Perceived control and approach coping were lower during the pandemic but related to better mental health; avoidant coping was higher during the pandemic and related to poorer mental health.

CONCLUSIONS

Findings can inform campuses regarding how to improve student mental health during COVID and beyond.

Relationship between Fear of COVID-19, Intolerance of Uncertainty, and Coping Strategies on University Students' Mental Health

BACKGROUND

the mental health of students was particularly affected by the COVID-19 pandemic. The present study therefore examined the relationships between anxiety and depressive symptoms, eating-related problems, coping, fear of COVID-19, and intolerance of uncertainty.

METHODS

2139 French students of 54 universities were recruited in the different regions of France during a French lockdown (between 21 April and 3 May 2021). Six variables were measured: fear of COVID-19, intolerance of uncertainty, coping, anxiety and depressive symptoms, and eating-related problems. To explore the directions of the relationships between our variables of interest, we calculated a directed acyclic graph.

RESULTS

our data highlighted the central roles of intolerance of uncertainty in students' anxiety and depressive symptoms, and the direct role of prospective intolerance of uncertainty on eating-related problems.

CONCLUSIONS

these findings indicate that intolerance of uncertainty should be targeted by interventions designed to help students with high levels of anxiety, depressive symptoms, and/or eating-related problems.

Exploring the Impact of the COVID-19 Pandemic on Academic Burnout Among Nursing College Students in China: A Web-Based Survey

BACKGROUND The COVID-19 pandemic has brought changes and challenges to nursing students. However, little is known about the prevalence of academic burnout among nursing students in this challenging circumstance. This study aimed to assess nursing student academic burnout and its influencing factors. MATERIAL AND METHODS We conducted a sample survey of a 4-year undergraduate nursing university in Wuhu, Anhui Province, China. The social-demographic information questionnaire, Academic Burnout Scale, Connor-Davidson Resilience Scale, Impact of Event Scale-6, Patient Health Questionnaire-2, and Professional Identity Scale were used. Stepwise multiple linear regression was used to clarify the relationship among sociodemographic characteristics, resilience, and academic burnout. RESULTS Of all the study participants, 51.30% had a certain degree of academic burnout. Academic year, satisfaction with specialty, satisfaction with online learning, professional identity, and psychological resilience were negatively correlated with academic burnout among nursing students. Depression was positively correlated with academic burnout. CONCLUSIONS Nursing students had a high degree of academic burnout. Academic year, satisfaction with specialty, satisfaction with online learning, professional identity, and psychological resilience were protective factors that reduced nursing students' academic burnout.

COVID-19-Evidence of the Impact of Literacy and Salutogenic Behaviours in Positive Mental Health: A Cross-Sectional Study

Positive mental health is defined as the ability to perceive and interpret the context of a situation and to adapt to it whenever necessary. Considering the pandemic situation, identifying the factors that may have the greatest impact on quality of life and consequently, on positive mental health is paramount. The objective of this study was to assess the impact of health literacy on the adoption of behaviours that promote positive mental health during COVID-19. A descriptive, cross-sectional and correlational study was conducted on a sample of 770 patients using a questionnaire for sociodemographic characterization, the Positive Mental Health Questionnaire and the Mental Health Knowledge Questionnaire. Concerning health-promoting behaviours, those who sleep enough hours, exercise regularly, eat healthy and are more aware of mental health promotion activities, or have greater mental health literacy, have higher positive mental health scores. Thus, having more knowledge of mental health and adopting health-promoting behaviours improve positive mental health.

Changes in Quality of Life, Sleep, and Physical Activity During COVID-19: A Longitudinal Study of Adolescent Athletes

CONTEXT

The abrupt cessation of school and sport participation during the COVID-19 pandemic may have negative implications for adolescent mental health.

OBJECTIVES

To (1) compare mental, physical, and social health and behaviors during pandemic-related stay-at-home mandates with the same measures collected 1 to 2 years earlier and (2) evaluate the relationships between physical activity and sleep during the pandemic and changes in anxiety, fatigue, and peer relationships between assessment times.

DESIGN

Cohort study.

SETTING

Pediatric sports medicine center.

PATIENTS OR OTHER PARTICIPANTS

A total of 39 high school athletes (25 adolescent girls, 14 adolescent boys; age = 16.2 ± 0.9 years).

MAIN OUTCOME MEASURE(S)

Patient-Reported Outcome Measurement System anxiety, fatigue, and peer relationships short forms and the Pittsburgh Sleep Quality Index were completed twice (initial assessment in May 2018 or 2019, follow-up assessment in May or June 2020). Frequency and duration of physical activity and frequency of interaction with other individuals (family, peers, sport coaches, etc) were self-reported at follow-up assessment for the 2 weeks before school or sport closure and the 2 weeks before questionnaire completion.

RESULTS

Higher levels of anxiety (5.5 ± 4.0 versus 3.6 ± 3.4 points; P = .003) and fatigue (5.4 ± 3.7 versus 2.3 ± 2.5 points; P < .001) and worse sleep quality (6.6 ± 2.9 versus 4.3 ± 2.3 points; P < .001) were observed during the pandemic compared with previous assessments. Reductions in physical activity were noted between assessments (exercise duration: 86.4 ± 41.0 versus 53.8 ± 30.0 minutes; P < .001). Sleep quality but not physical activity during the pandemic predicted changes in fatigue (P = .03, β = 0.44 [95% CI = 0.06, 0.83]) and peer relationships (P = .01, β = -0.65 [95% CI = -1.16, -0.15]) from initial to follow-up assessment.

CONCLUSIONS

Mental and physical health declined during stay-at-home mandates compared with assessments 1 to 2 years earlier. Physical activity behaviors and sources of social interaction underwent changes after school and sport cessation. Sleep quality may have provided some protection against declining adolescent mental health during the pandemic, although this relationship requires further investigation.

Gender-Based Analysis of the Association Between Mental Health, Sleep Quality, Aggression, and Physical Activity Among University Students During the COVID-19 Outbreak

COVID-19 has spread throughout the world, resulting in significant morbidity, mortality, and negative psychological effects among general population. However, university students are particularly vulnerable in terms of mental health. The present study evaluated the association between mental health, quality of sleep, aggression, and physical activity in university students in Mexico after 1 year of dealing with the COVID-19 pandemic in Mexico, including a gender-sensitive analysis. Participants (935 university students) completed an online questionnaire which collected information regarding demographic data, psychological distress (IES-R scale), depression, anxiety, and stress (DASS-21), aggressiveness Buss-Perry Aggressive Questionnaire, sleep quality (PSQI) and physical activity (IPAQ-S). Findings showed that female students showed significantly higher scores in psychological distress, anxiety, stress scores and sleep quality, as compared to male students. By contrast, male students showed significantly higher scores on aggressiveness than female students. In addition, on physical activity, females performed significantly higher MET-min/week on moderate and high levels. Finally, liner regression model accounted for approximately 73.5% of the variance in DASS-21 scores, with the body mass index, IES-R, Pittsburgh Sleep Quality Index, and IPAQ subscales, emerging as significant individual (positive) predictors. Therefore, the pandemic affected female and male students differently. Female students reported more psychological distress, anxiety, and stress while male students reported higher aggressiveness. The differences observed may be due to physiological differences, the response to stress, and differences in sensitivity to life events.

Impact of resilience on college student mental health during COVID-19

OBJECTIVE

The aim of this study was to investigate how the COVID-19 pandemic impacted college student mental health and alcohol use and to determine how resilience could alleviate negative outcomes.

PARTICIPANTS

Students attending an Appalachian university during spring 2020 were surveyed shortly after on-campus activities stopped.

METHODS

Survey items included resilience, demographics, self-rated health, and depression symptoms, anxiety symptoms, and alcohol use before and since COVID-19.

RESULTS

There was a significant increase in prevalence of severe depression, severe anxiety, and high stress, and a significant decrease in prevalence high risk for problem drinking before and since COVID-19. Four separate standard least squares regression models were conducted with each of the dependent variables. Self-rated health was the strongest predictor for changes in depression, anxiety, and stress in each of the models, displaying a negative relationship.

CONCLUSIONS

Universities should prepare students using resilience training and provide employment and other resources to mitigate effects of stressful situations.

Impact of COVID-19 on Lifestyle Habits and Emotional State of Childhood Cancer Survivors and Their Parents

OBJECTIVE

The COVID-19 pandemic and associated social distancing measures affected the physical and emotional state of children and parents worldwide. Survivors of childhood cancer may be particularly vulnerable to these effects. We aimed to evaluate the lifestyle habits and emotional states of childhood cancer survivors and their parents during the COVID-19 outbreak.

METHODS

Lifestyle habits and emotional distress were assessed in 43 childhood cancer survivors (aged 8-21 years) and their parents before and during the COVID-19 lockdown, using the PROMIS anxiety and depression modules and the "Mabat Youth" questionnaire.

RESULTS

Most parents (80.5%) reported eating more family meals during home confinement compared to their usual routine. Patients' physical activity levels did not change significantly during confinement, leisure-related screen time nearly doubled (p < 0.001), and sleep duration increased (p = 0.006). Anxiety levels of children (p = 0.045) and parents (p = 0.02) increased during confinement compared to pre-pandemic levels, with no significant changes in depression levels.

CONCLUSIONS

Contrary to concerns regarding lifestyle habits during the COVID-19 lockdown, eating behaviors of childhood cancer survivors improved, sleep duration increased, and physical activity remained unchanged. Still, screen time increased significantly. Parents of childhood cancer survivors reported higher anxiety levels for themselves and their children during home confinement. Our findings may assist medical and psycho-social teams in guiding parents of cancer survivors during similar circumstances in the future.

Health-related behavioral changes during the COVID-19 pandemic. A comparison between cohorts of French and Italian university students

This cross-sectional observational study compares the health behaviors of university students in France and Italy, examining how their choices and lifestyles were affected by the COVID-19 pandemic with the aim of contributing to the development of adequate public health and higher education institutions interventions. The French cohort was investigated between January and February 2022, while the Italian cohort was examined between March and April 2022. In both contexts, data were collected through web surveys using institutional directories of university degree programs. Data were collected using standardized tools, validated and recovered in full or partial form. The tool used consisted of three specific sections (general experience, eating habits, physical activity), to which a fourth, dedicated to describing the sociographic picture of the respondents, was added. It was found that the pandemic mainly affected the mental health and sense of well-being of young people in both countries. The pandemic altered dietary habits (41.8% of the French subjects and 38.3% of the Italians declared an increasing of their food intake), alcohol consumption (9.0% of the Italian respondents and 4.0% of the French respondents reported an increased alcohol consumption), propensity to smoke (among the French 85.3% subjects remained non-smokers versus 65.3% of the Italian subjects), sleep quality (25.7% of Italian students 16.6% of French students experienced a decline in the quality of their sleep), and physical activity levels (the percentage of physically active French subjects rose to 72.4%, whereas among Italian students, it dropped to 68,4%). The results emphasize the need for the implementation of relational and psychological interventions, even digital, to face the consequences of social isolation and negative changes in everyday behaviors due to the restrictions during the COVID-19 pandemic.

Physical activity, sleep, and mental health during the COVID-19 pandemic: A one-year longitudinal study of Spanish university students

The objective of this longitudinal study was to analyze changes in physical activity, sedentary time, sleep, anxiety, mood, and perceived health as a result of COVID-19 pandemic in a cohort of Spanish university students, both during the home confinement and one year after. Additionally, we analyzed the associations between physical activity, sedentary time, and other measured parameters. Data were collected through two online questionnaires that included the International Physical Activity Questionnaire-Short Form, the Pittsburgh Sleep Quality Index, and self-reported anxiety, mood, and perceived health levels before, during and one year after home confinement. Participants reported decreased physical activity, increased sedentary time, and deterioration in sleep quality and perceived health during confinement. Most parameters had improved one year later; however, the participants still reported less physical activity, more sedentary time, and deterioration in sleep quality and perceived health compared to before confinement. Men reported greater reduction of physical activity during home confinement than women. In contrast, women reported reduced physical activity one year after confinement, whereas men reported increased activity. Participants reported higher anxiety and worse mood both during and one year post-confinement compared to pre-confinement, with women reporting higher levels of anxiety than men. Sports science students were closer to regaining pre-pandemic levels of physical activity one year post-confinement than students in other disciplines. Sleep, anxiety, and mood were worse among students with obesity compared to students in other BMI categories. Overall, increased physical activity and decreased sedentary time were associated with less anxiety and better sleep, mood, and perceived health during and one year post-confinement. In conclusion, our results demonstrate that physical activity, sedentary behavior, sleep, anxiety, mood, and perceived health were disrupted one year after home confinement. Higher levels of physical activity and lower sedentary time were associated with preserved sleep and mental health during the pandemic.

Comparison of prevalence of depression symptoms and history of suicidality in students of medical schools and other study programmes of Charles University

OBJECTIVES

Medical students represent a group of undergraduate students who are exposed to specific risk factors that may lead to the onset of depression and the occurrence of suicidal ideation. The aim of the article is to present information about the prevalence of symptoms of depression in medical students of different faculties at Charles University, Prague, compared to other students of this university.

METHODS

We used a standardized Beck's Inventory scale II (BDI-II) with added specific questions electronically distributed to undergraduate students of the full-time forms of study of all faculties of Charles University. The data collection was anonymous and took place in December 2020. The data were statistically assessed in relation to the occurrence of moderate and severe depression using univariate and multivariable analysis.

RESULTS

Moderate and severe depression rate (MSDR) was recorded in 19.6% of medical school students, who returned the questionnaire, compared to 23.4% of students of other faculties (p = 0.001) of Charles University in Prague. Differences in MSDR among students of different faculties of medicine of Charles University were not statistically significant. The total number of previous suicide attempts among respondents was 542, of which 115 were medical students, with the lifetime prevalence of suicide attempts among all students participating in the study 6.96% and in medical students of Charles University 5.73%.

CONCLUSIONS

The findings of our study highlight the need for systematic, accessible and timely assistance to university students, both in terms of prevention and early intervention, which can take place at the university level and within the mental healthcare system.

The impact of COVID-19 on students' anxiety and its clarification: a systematic review

Introduction

Since the emergence of COVID-19 in 2019, every country in the world has been affected to varying degrees. Long-term psychological pressure and anxiety will inevitably damage the physical and mental health of students. This study aimed to examine the effects of the COVID-19 pandemic on students who experienced stress and anxiety and to clarify which intervention was more effective.

Methods

A comprehensive literature search was conducted between January 2020 and December 2022 using online databases such as PubMed, Web of Science, Scopus, and Google Scholar by using the following keywords in combination: "COVID-19," "stress," "anxiety," "depression," and "intervention." The retrieved literature was screened and reviewed.

Results

A total of 2,924 articles were retrieved using subject and keyword searches. After screening through the titles and abstracts, 18 related studies were retained. Their review revealed that: (1) most studies did not use medication to control stress and anxiety; (2) the standard methods used to reduce stress and anxiety were religion, psychological counseling, learning more about COVID-19 through the media, online mindfulness courses, improving sleep quality, and physical exercise; (3) the most effective interventions were physical activity and raising awareness about COVID-19 through the media and online mindfulness programs. However, some studies show that physical activity cannot directly relieve psychological stress and anxiety.

Conclusion

Limited interventions are effective, but learning more about COVID-19 and using active coping strategies may help reduce stress and anxiety. The implications of COVID-19 are also discussed.

The COVID-19 pandemic and mental health in Kazakhstan

The COVID-19 pandemic had significant impacts on mental health. We examined factors associated with symptoms of depression and anxiety during the COVID-19 pandemic in Kazakhstan. We surveyed 991 adults in Kazakhstan in July 2021 using multistage stratified sampling. Depression and anxiety were measured with the Patient Health Questionnaire-4. We conducted logistic regression to assess associations between depression and anxiety and sociobehavioral factors. Overall, 12.01% reported depressive symptoms and 8.38% anxiety. Higher likelihood of depression was associated with being female (AOR: 1.64; 95% CI [1.05, 2.55]), having experience with COVID-19 in the social environment (AOR: 1.85; 95% CI [1.1-3.14]), experiencing food insecurity (AOR: 1.80; 95% CI [1.11-2.89]), increased family conflict (AOR: 2.43; 95% CI [1.32-4.48]) and impaired healthcare access (AOR: 2.41; 95% CI [1.32-4.41]). Higher likelihood of anxiety was associated with being female (AOR: 3.43; 95% CI [1.91-6.15]), increased family conflict (AOR: 2.22; 95% CI [1.11-4.44]) and impaired healthcare access (AOR: 2.63; 95% CI [1.36-5.12]). Multiple factors were associated with mental health in Kazakhstan during the COVID-19 pandemic. Further research is needed to determine the extent to which these factors and their associated mental health outcomes may persist.

Physical activity and mental health in children and youth during COVID-19: a systematic review and meta-analysis

BACKGROUND

The coronavirus disease (COVID-19) and universal mitigation strategies have fundamentally affected peoples' lives worldwide, particularly during the first two years of the pandemic. Reductions in physical activity (PA) and increased mental health (MH) problems among children and youth have been observed. This systematic review and meta-analysis investigated the relationship between physical activity (PA) and mental health (MH) among children and youth during the COVID-19 pandemic.

METHODS

Four electronic databases (EMBASE, PsycINFO, PubMed, and Web of Science) were systematically searched to identify studies that (1) examined the relationship between PA and MH among children and youth (aged 2-24 years old) and (2) were published in peer-reviewed journals in English between January 2020 and December 2021. Relationships between PA and two MH aspects (i.e., negative and positive psychological responses) among children and youth at different age ranges and those with disabilities or chronic conditions (DCC) were synthesized. Meta-analyses were also performed for eligible studies to determine the pooled effect size.

RESULTS

A total of 58 studies were eventually included for variable categorization, with 32 eligible for meta-analyses. Our synthesis results showed that greater PA participation was strongly related to lower negative psychological responses (i.e., anxiety, depression, stress, insomnia, fatigue, and mental health problems) and higher positive psychological responses (i.e., general well-being and vigor) in children and youth during COVID-19. The pattern and strength of relations between PA and MH outcomes varied across age ranges and health conditions, with preschoolers and those with DCC receiving less attention in the existing research. Meta-analysis results showed that the magnitude of associations of PA with negative (Fisher's z = - 0.198, p < 0.001) and positive (Fisher's z = 0.170, p < 0.001) psychological responses among children and youth was weak. These results were linked to age of participants, study quality, and reporting of PA-related information.

CONCLUSIONS

PA participation and MH among children and youth deteriorated during the COVID-19 pandemic and were closely associated with each other. For the post-COVID-19 era, additional research on age- and health condition-specific relationships between PA and MH outcomes from a comprehensive perspective is warranted. (Word count: 344 words).

A randomized controlled trial examining a Tranquil sitting intervention compatible with Confucian values

Introduction

During the COVID-19 pandemic in China, the silent management (Lockdown) policy has caused severe sleep problems for university students. Long-term isolation may further deteriorate sleep quality, and it requires practical interventions. Today in mental and sleep health, interventions based on Buddhist, Taoist and Confucian ethics have been proven effective in reducing cognition and sleep disorders. However, such interventions also have limitations. They tend to focus on peace of mind or some technical means with the main direction of symptom improvement but neglect the mundane activities of daily life.

Methods

We conducted an innovative tranquil sitting intervention program based on the Chinese Confucian value of the "tranquility and reverence" method, integrating various intervention techniques traditionally recognized as effective for achieving more lasting mental health and sleep quality. This study aims to assess the effectiveness and feasibility of a tranquil sitting intervention in improving sleep problems in isolated university students. Using a randomized control trial (RCT), the participants in the intervention program (n = 35) practiced the tranquil sitting intervention program for ten weeks. They had their PSQI scores measured at the pre-experimental, post-test, and 1-month follow-up time points and compared to the control group (n = 35).

Results

The participants who received the tranquil sitting intervention had significantly better sleep quality than the control group, with moderate to large effect sizes in the middle and late stages. The instructor may challenge the intervention group at the beginning of the tranquil sitting technique. However, the improvement in sleep quality was significant after fully mastering the method.

Discussion

The intervention program in this study emphasized the importance of "tranquility" and showed the same sleep improvement as in other traditional interventions. In conclusion, this intervention is a feasible and promising new approach to improving sleep quality among youths.

Psychological distress among healthcare students in Poland from COVID-19 to war on Ukraine: a cross-sectional exploratory study

Objectives

Healthcare students went through a rough time in March 2022 due to extreme changes in the educational system (moving from online to stationary learning) and Ukrainian-Russian war circumstances. Our study aims to update knowledge about psychological distress and its impact on healthcare students in Poland after two years of the COVID-19 pandemic, followed by intense and political instability in Europe.

Methods

We conducted a cross-sectional study on healthcare students from Poznan University of Medical Sciences, Poland, from March to April 2022. The questionnaire included subjective retrospective 5-point Likert-scales ratings of anxiety, stress, and depression and self-reported information on various psychological distress predictors.

Results

The anxiety levels at the beginning of the COVID-19 pandemic were higher than in April 2022. There was no significant reduction in stress and depression. Females had higher initial anxiety levels than post-pandemic levels. Higher reported levels of anxiety, stress, and depression were significantly correlated with political instability in Eastern Europe (Spearman r_anxiety = 0.178, r_stress = 0.169, r_depression = 0.154, p ≤ 0.001, respectively). The concern about moving towards online education showed a significant association only with stress level (r_stress = 0.099, p = 0.034). We also observed a positive correlation between anxiety, stress, and depression and deteriorating sleep quality (Spearman r_anxiety,=0.325, r_stress = 0.410, r_depression = 0.440, p < 0.001), the feeling of worsening relationships with family and peers (r_anxiety = 0.325, r_stress = 0.343, r_depression = 0.379, p < 0.001), and the sense of loss of efficient time management (r_anxiety = 0.321, r_stress = 0.345, r_depression = 0.410, p < 0.001).

Conclusion

Throughout the progression of the Ukrainian war and the COVID-19 pandemic, females reported improved (lower levels) levels of anxiety. Nevertheless, the current levels of self-reported anxiety post-pandemic remain alarming, while stress and depression levels remained unchanged. Mental, psychological, and social support activities are required for healthcare students, especially those away from their families. Time management, academic performance, and coping skills in relation to the additional stressors of war and the global pandemic require further research in this group of students.

Implications of the COVID-19 Pandemic for the Well-Being of Emerging Adult Populations: A Synthesis of Findings From the COVID-19 Eating and Activity Over Time (C-EAT) Study

Research addressing the impact of the COVID-19 pandemic on psychosocial well-being and health behavior is accumulating; however, implications for emerging adult populations are underexplored. This manuscript synthesizes findings from a mixed-methods study of well-being, eating and activity behaviors, and food insecurity among a diverse, longitudinal cohort of emerging adults. The review includes findings from 11 original studies that involved collecting online surveys from 720 emerging adults and in-depth, virtual interviews with 33 respondents who were food insecure. Findings indicated the pandemic had widespread impacts on well-being. Population groups at greatest risk for poor outcomes included women; those who identified as Black, Indigenous, or a Person of Color; persons in households of low socioeconomic status; parents of young children; and persons who previously experienced mental health challenges or weight stigma. Further research will be needed to evaluate efforts to improve the well-being of emerging adults in the aftermath of the pandemic.

COVID-19: Academic, Financial, and Mental Health Challenges Faced by International Students in the United States Due to the Pandemic

Background and objective Many international students often face challenges regarding their mental health, finances, and academics. The coronavirus disease 2019 (COVID-19) outbreak may have presented unprecedented challenges to many foreign students in these aspects. Our study examined the academic, financial, and mental health challenges encountered by international students residing in the United States due to the COVID-19 pandemic. It also examined the association between the mental health of the respondents and the academic and financial challenges they encountered. Method The study involved international students enrolled at Texas A&M University, who identified themselves as non-US citizens or non-permanent residents. We conducted a cross-sectional study by using Qualtrics® to explore the three domains of the study. Questions included in previous studies were modified to assess the academic and financial status while the Patient Health Questionnaire-4 (PHQ-4) score was used to assess the mental health of the respondents. We presented descriptive statistics for all domains and used an ordered logistic regression to further analyze the effect of the other domains on the mental health of the respondents. Results Of the 281 respondents, the majority (79%) experienced challenges with online classes; 91% reported having negative emotions and some students (24%) lost funding due to the pandemic. The inability to pay bills resulted in a three-fold increase in the likelihood of reporting higher mental distress [adjusted odds ratios (aOR): 3.051, 95% CI: 1.665-5.591; p<0.001], and experiencing academic challenges led to a seven-fold increase in the likelihood of reporting higher mental distress (aOR: 7.236, 95% CI: 3.168-12.530; p<0.001). Conclusion The COVID-19 pandemic posed a major challenge to international students and its impact on the mental health of the participants was aggravated by concurrent academic and financial hardships.

Multiscale Geographically Weighted Regression in the Investigation of Local COVID-19 Anomalies Based on Population Age Structure in Poland

A growing number of various studies focusing on different aspects of the COVID-19 pandemic are emerging as the pandemic continues. Three variables that are most commonly used to describe the course of the COVID-19 pandemic worldwide are the number of confirmed SARS-CoV-2 cases, the number of confirmed COVID-19 deaths, and the number of COVID-19 vaccine doses administered. In this paper, using the multiscale geographically weighted regression, an analysis of the interrelationships between the number of confirmed SARS-CoV-2 cases, the number of confirmed COVID-19 deaths, and the number of COVID-19 vaccine doses administered were conducted. Furthermore, using maps of the local R² estimates, it was possible to visualize how the relations between the explanatory variables and the dependent variables vary across the study area. Thus, analysis of the influence of demographic factors described by the age structure and gender breakdown of the population over the course of the COVID-19 pandemic was performed. This allowed the identification of local anomalies in the course of the COVID-19 pandemic. Analyses were carried out for the area of Poland. The results obtained may be useful for local authorities in developing strategies to further counter the pandemic.

Sleep and Lifestyle Habits of Medical and Non-Medical Students during the COVID-19 Lockdown

It has been shown that the measures of social distancing and lockdown might have had negative effects on the physical and mental health of the population. We aim to investigate the sleep and lifestyle habits as well as the mood of Croatian medical (MS) and non-medical students (NMS) during the COVID-19 lockdown. The cross-sectional study included 1163 students (21.6% male), whose lifestyle and sleep habits and mood before and during the lockdown were assessed with an online questionnaire. The shift towards later bedtimes was more pronounced among NMS (~65 min) compared to MS (~38 min), while the shift toward later wake-up times was similar in both MS (~111 min) and NMS (~112 min). All students reported more frequent difficulty in falling asleep, night-time awakenings and insomnia (p < 0.001) during lockdown. A higher proportion of MS reported being less tired and less anxious during lockdown compared to pre-lockdown (p < 0.001). Both student groups experienced unpleasant moods and were less content during lockdown compared to the pre-lockdown period (p < 0.001). Our results emphasize the need for the promotion of healthy habits in the youth population. However, the co-appearance of prolonged and delayed sleep times along with decreased tiredness and anxiety among MS during lockdown reveals their significant workload during pre-lockdown and that even subtle changes in their day schedule might contribute to the well-being of MS.

How do university students perceive the educational transition in the COVID-19 era: A cross-sectional study from 15 Arab countries

Background and Aims

The viral agent of the novel coronavirus disease 2019 (COVID-19) continues to spread worldwide, leading to a global pandemic. this may negatively affect students' mental health who have to maintain their learning efforts. Therefore, we aimed to assess students' perceptions of the online learning programs designed for university students in Arab countries during the COVID-19 pandemic.

Methods

This cross-sectional study was conducted on university students using a self-administered online questionnaire in 15 Arab countries, including 6779 participants. The actual sample size was calculated using the EpiInfo program calculator. The validated, piloted questionnaire assessed the effectiveness of internet-based distance learning applications used in these countries during the pandemic. The SPSS version 22 was used.

Results

Among the 6779 participants, 26.2% believed that their teachers diversify learning methods, 22.0% thought that their teachers were able to treat the weakness the students have, and 30.7% agreed that their teachers efficiently communicate with them through COVID-19 internet-based learning process. Around 33% of students participated in lectures effectively, 47.4% submitted their homework within accepted deadlines, and 28.6% thought that their colleagues did not cheat during exams and homework. Around 31.3% of students believed that online-based learning had a role in directing them towards research, and 29.9% and 28.9%, respectively, believed that online learning had a role in developing analytical thinking and synthesis skills. Participants reported many suggestions to enhance the process of internet-based distance learning in the future.

Conclusion

Our study suggests that online-based distance learning in Arab countries still needs more improvement as students still are more inclined toward face-to-face teaching. However, exploring the factors that influence students' perceptions of e-learning is vital for improving the quality of online-based distance learning. We recommend exploring the perceptions of educators regarding their experience towards online-based distance learning during COVID-19 lockdown.

The mental health of international university students from China during the COVID-19 pandemic and the protective effect of social support: A longitudinal study

BACKGROUND

During the COVID-19 pandemic Chinese international students were reported to experience racism, food security issues and social isolation. However, no study has investigated the prevalence of these issues and the potential for worsening mental health in this population group during the pandemic. Therefore, this study aimed to examine the effect of this pandemic on the mental health of Chinese international students living in Australia and China, and the protective effect of social support.

METHODS

Data were extracted from a survey of Australian university students (April-June 2019) and follow-up during the pandemic (Sept-Oct 2020). The prevalence of anxiety, major depression and pandemic-related stressors was reported. Multivariable logistic regression was used to assess the association between country of residence, social support (baseline/follow-up), and follow-up self-reported mental health.

RESULTS

With the pandemic, there was a substantial increase in the prevalence of anxiety (24.7 % vs 45.7 %) and major depression (22.1 % vs 43.8 %). Major depression was less likely to be reported by international students in China (34.8 %) than in Australia (46.3 %). Students with high social support during the pandemic were less likely to report major depression (Adjusted OR:0.15 [95 % CI 0.06,0.34]), although this effect was not observed longitudinally (Adjusted OR:1.03 [95 % CI 0.58,1.83]).

LIMITATION

Post pandemic improvement in mental health cannot be assessed.

CONCLUSION

The pandemic appeared to have had a strong negative effect on Chinese international university students' mental health. Those living in Australia were more likely to experience poorer mental health, highlighting the need for increased support to this group.

The relationship between physical activity pre COVID-19 pandemic with mental health, depression, and anxiety in COVID-19 patients: a cross-sectional study

Purpose

Covid-19 pandemic has gained a growing trend and affected mental health in several aspects. Physical activity guidelines was strongly associated with a reduced risk for severe COVID-19 outcomes among infected adults. The purpose of this study was to evaluate the association between physical activity pre COVID-19 pandemic with mental health, depression, and anxiety in COVID-19 patients.

Methods

206 hospitalized patients diagnosed with covid-19 (140 male and 66 female, aged 34.5 ± 12) were selected and completed physical activity questionnaire (IPAQ) and hospital anxiety and depression questionnaire (HADS). For physical activity status assessment, a self-completed IPAQ questionnaire was taken and patients were divided into: (1) low active, (2) moderate active and (3) high active groups according to their physical activity experience. One-way ANOVA test was recruited and Tukey post hoc test was taken to assess difference among means. Pearson correlation was used to evaluate the association between physical activity level and mental health status (p < 0.05).

Results

The results from this study showed that anxiety and depression was significantly higher in low active patients (p = 0.001) and there was a negative correlation between physical activity level and HADS (p = 0.001). However, patients with high physical activity pre COVID-19 pandemic have a lowest levels of anxiety and depression compare to other groups (p < 0.001).

Conclusion

It seems that adequate physical activity as a part of a healthy lifestyle may have a beneficial effect on mental health during the current outbreak of covid-19. Therefore, it is suggested that we perform exercise training every day to preconditioning effects.

Telehealth Readiness of Healthcare Providers during COVID-19 Pandemic in Saudi Arabia

Objective: This study aimed to assess and explore the telehealth readiness of healthcare providers in Saudi Arabia. Methods: This descriptive cross-sectional survey was conducted in a government healthcare facility in Saudi Arabia between August and October 2020. The Telehealth Readiness Assessment (TRA) tool was used. Results: A total of 372 healthcare providers participated in this study. Their mean age was 35.5 years (SD = 10.46). The majority of respondents were female (65.6%), nurses (68.0%), married (60.2%), and non-Saudi nationals (64.2%). The analysis shows that healthcare providers generally had moderate-to-high telehealth readiness. Of the five domains, financial contributions had the lowest rating among nurses and physicians, 63.4% and 66.1%, respectively. Gender (β = 7.64, p = 0.001), years of experience in the organization (β = 11.75, p = 0.001), and years of experience in the profession (β = 10.04, p = 0.023) predicted the telehealth readiness of healthcare providers. Conclusion: The telehealth readiness of healthcare providers in Saudi Arabia showed moderate to high levels. The COVID-19 pandemic poses a catastrophic threat to both patients and healthcare providers. Assessing telehealth readiness should include both patients and healthcare provider factors. A better understanding of the factors of organizational readiness, particularly healthcare providers, could help avoid costly implementation errors.

Social jetlag and quality of life among nursing students during the COVID-19 pandemic: a cross-sectional study

BACKGROUND

Amid drastic changes in the educational environment and continued substitution of in-person learning with online learning owing to the COVID-19 pandemic, it is important to analyze the predictors of quality of life among nursing students to devise strategies to enhance their quality of life. This study aimed to identify the predictors of nursing students' quality of life during the COVID-19 pandemic, focusing on social jetlag.

METHODS

In this cross-sectional study, data were collected from 198 Korean nursing students in 2021, using an online survey. Chronotype, social jetlag, depression symptoms, and quality of life were assessed using the Korean version of the Morningness-Eveningness Questionnaire, Munich Chronotype Questionnaire, Center for Epidemiological Studies Depression Scale, and World Health Organization Quality of Life Scale abbreviated version, respectively. Multiple regression analyses were performed to identify the predictors of quality of life.

RESULTS

Factors affecting participants' quality of life were age (β = - 0.19, p = .003), subjective health status (β = 0.21, p = .001), social jetlag (β = - 0.17, p = .013), and depression symptoms (β = - 0.33, p < .001). These variables accounted for 27.8% of the variance in quality of life.

CONCLUSION

As the COVID-19 pandemic continues, the social jetlag of nursing students has decreased compared to before the pandemic. Nevertheless, the results showed that mental health issues such as depression affect their quality of life. Therefore, it is necessary to devise strategies to support students' ability to adapt to the rapidly changing educational environment and promote their mental and physical health.

Assessment of the Level of Physical Activity and Mood in Students after a Year of Study in a Mixed Mode in the Conditions of Restrictions Resulting from the Pandemic

The COVID-19 pandemic has forced social isolation affecting all areas of life. It also affected the functioning of schools and universities. Many countries have introduced full or partial distance learning. The aim of the study was to assess the level of physical activity and student mood of the Faculty of Physiotherapy of the Academy of Physical Education in Wrocław (Poland) and students of the Faculty of Health of the ODISSE University in Brussels (Belgium) after a year of the study conducted in a mixed mode due to contact restrictions resulting from the COVID-19 pandemic and checking which of the analyzed factors increases the risk of depression to the greatest extent.

MATERIAL AND METHODS

297 students from the 2nd to 4th year of full-time studies took part in the observation. The academic year 2020/2021 was assessed. Physical activity was assessed using the Global Physical Activity Questionnaire (GPAQ) recommended for this type of analysis by WHO. The GPAQ questionnaire enables the assessment of activity performed at work, movement, and leisure time and assesses the time of sitting or resting in a supine position. The Beck Depression Inventory was used to assess mental health. The subjects also completed a questionnaire concerning selected somatic features and describing their living conditions in the previous year.

RESULTS

In the group of Polish students, classes conducted in a completely remote mode accounted for about 50%, while in the group of Belgian students, about 75%. In the described period, 19% of students from Poland and 22% of students from Belgium were infected with COVID-19. The median of the results of the Beck Depression Scale in both groups was lower than 12 points (7 points in the AWF group and 8 points in the ODISSE group, respectively). A detailed analysis showed that in both study groups, more than 30% of students received results showing a depressed mood. A total of 19% of the surveyed students of the University of Physical Education and 27% of the ODISSE students were characterized by a result indicating mild depression. The results of the GPAQ questionnaire show that the total physical activity, including work/study, recreation, and mobility was 16.5 h a week for students from Poland and 7.4 h a week for students from Belgium.

CONCLUSIONS

Both groups of subjects reached all the thresholds recommended by the WHO as a sufficient level of weekly physical activity. A group of students of the Faculty of Physiotherapy of the University of Physical Education in Wrocław was characterized by more than twice as high (statistically significant) level of weekly physical activity as compared to the group of participants from the ODISSE University in Brussels. In both study groups, more than 30% of students experienced a lowered mood of varying intensity. It is necessary to monitor the mental state of students and, in the event of obtaining control results at a similar level, to implement psychological assistance for willing participants.

The relations between COVID-19 stress, social connectedness, and mental health: a longitudinal investigation comparing Chinese and American college students

College students in the U.S. and China have faced significant challenges during COVID-19. Data were collected from 120 Amerian students (Mage = 19.48, SDage = 1.30) and 119 Chinese students (Mage = 18.61, SDage = 0.91) in November, 2019 and March, 2020 to examine risk and protective factors for mental health (depression, anxiety, life satisfaction) during the pandemic, and potential cultural and gender differences. Results indicated that the frequency and impact of COVID-19-related stressful life events predicted deterioration of mental health over time, while social connectedness before the pandemic buffered the negative impact of COVID-19 stressful life events on life satisfaction. Chinese students reported higher levels of social connectedness and larger impact of COVID-19-related stressful life events, but lower frequency of stressful life events than American students. Stressful life events and social connectedness predicted mental health outcomes similarly for Chinese and American students. Gender differences were identified. Females reported more stressful life events, higher levels of depression, anxiety and less life satisfaction during COVID-19 than males. In addition, the frequency of stressful life events had a stronger impact on depression and anxiety for females compared with males. It is important to implement prevention and intervention programs to promote social connections and wellbeing among college students, especially among female students.

Pre- and Post-Pandemic (COVID-19) Mental Health of International Students: Data from a Longitudinal Study

Purpose

International students are highly vulnerable to the risk of mental health worsening before and during the pandemic (COVID-19). This study investigated international students' mental health pre- and post-pandemic (COVID-19).

Methods

It is a longitudinal study, and data were collected online, pre-pandemic (N = 470) and during the pandemic (N = 420). Using a random sampling technique, a self-administered questionnaire was used to measure mental health, including depression and anxiety.

Results

Findings show that international students' mental health was good in pre-pandemic. Meanwhile, international students were found to be more depressed and anxious during the pandemic. Findings also investigated that in the pre-pandemic phase, young students' and mainly females' mental health was worsened.

Conclusion

This study concluded that students' mental problems are alarming, so the university should provide psychological services for the student's mental health. Post-pandemic is leaving long-lasting psychological effects and will require further investigation.

Relationship between Locomotive Syndrome and Musculoskeletal Pain and Generalized Joint Laxity in Young Chinese Adults

This study aims to investigate the prevalence of locomotive syndrome (LS) and to examine the relationship of LS with musculoskeletal symptoms (pain, generalized joint laxity (GJL)) in young Chinese adults. Our study population (n = 157; mean age of 19.8 ± 1.2 years) comprises college student residents at Tsinghua University in Beijing, China. Three screening methods were used to evaluate LS: 25-question Geriatric Locomotive Function Scale (GLFS-25), a two-step test, and a stand-up test. Musculoskeletal pain was assessed by self-report and visual analog scale (VAS), and joint body laxity was evaluated using the GJL test. The prevalence of LS was 21.7% of all participants. Musculoskeletal pain affected 77.8% of the college students with LS and was strongly associated with LS. A total of 55.0% of college students with LS had four or more site joints that were positive for GJL, and higher scores of GJL were associated with a higher prevalence rate of LS. Young Chinese college students have a relatively high prevalence of LS, and musculoskeletal pain and GJL were significantly related to LS. The present results suggest that we need early screening of musculoskeletal symptoms and LS health education in young adults to prevent the mobility limitations of LS in the future.

The correlation between physical inactivity and students' health based on data mining and related influencing factors

The sedentary behavior among college students has become one of the most important factors affecting the development of physical and mental health. Chronic lack of physical activity may lead to health problems such as decreased physical fitness, and increased psychological disorders. In the post-epidemic era, it is necessary for college students to have a strong immune system, and a strong body cannot be achieved without regular leisure physical activity. Therefore, it is necessary to explore the relationship between relevant health factors and physical activity. This paper presents an optimized COM-B model. And the experimental results show that the optimized model is well applied in describing the current situation of physical activity participation among college students, analyzing the distribution characteristics of socio-demographic variables related to physical activity, and exploring the correlation between physical activity and the subhealth status of college students.