COVID-19 vaccine acceptance, hesitancy and resistancy among university students in France

Clinical Investigation Center, CHU Rouen, Normandie University, Rouen, France, CHU Rouen, Normandie University, Rouen, France, Rouen University Hospital, Normandie University, Rouen, FranceIntroduction. Young adults, specifically college students, are at risk of being infected with COVID-19 and transmitting the infection to others owing to their sense of invulnerability and can be a source of transmission to at-risk populations and could be the public acceptance of a new vaccine for COVID-19 developed within a short period remains uncertain despite the forthcoming availability. The objectives were to explore, among university students, the level of COVID-19 vaccine acceptance, hesitancy and resistancy and to determine the motivations and barriers, and the reasons that may change student vaccination decision making. Material and methods. An online cross-sectional study was conducted among students of a French university in January 2021 with questions about the intention to be vaccinated against COVID-19, the motivations and the barriers: ”Do you intend to be vaccinated against COVID-19 (when it is possible for you to do so)?” with the choice answers of: “Yes, absolutely”; “Yes, probably”; “No, probably not”; “No, certainly not” and “I don’t know”. Students reported the motivations or the reasons of hesitations with several possible answers. Results. A total of 3089 students were included, with a mean of age of 20.3 (SD=1.9). A total of 3089 students were included, with a mean of age of 20.3 (SD=1.9), and 71.4% were female. The self-estimated knowledge of conventional vaccines and COVID-19 vaccines was 5.9/10 (2.3) and 4.9/10 (2.3), respectively. Confidence in the efficacy and safety of conventional vaccines (excluding COVID-19 vaccines) was 8.0/10 (2.3) and 7.7/10 (2.3), respectively. To the question on the intention to vaccinate against the COVID-19, 58.0% of students reported that they would choose to have a vaccination, 17.0% reported that they would not and 25.0% were not sure. The main motivation for vaccine acceptance were “I don't want to transmit COVID-19 to others”, the main barrier for vaccine resistance or hesitancy were “I prefer to wait until I have more experience with these new vaccines”. Age, female gender, being in first three years of study, studied sciences courses and neither sciences nor healthcare courses were significantly associated with a higher risk of vaccine hesitancy or resistancy. Self-estimated knowledge of conventional vaccines and COVID-19 vaccines, and confidence in efficiency and safety of conventional vaccination were associated with a lower risk of vaccine hesitancy or resistancy. Conclusions. Our study shows that, in January 2021, before students have the opportunity to be vaccinated against COVID-19 in France, more than half of the students were vaccine acceptance, a quarter were hesitant, and one in five students were resistant. It is relevant to disseminate evidence-based interventions to promote COVID-19 vaccine acceptability for college students, especially for the students in neither sciences nor healthcare, as college students will soon be eligible to receive a COVID-19 vaccine. Preventive university medicine, campus-based student organizations, and college students could be consider designing educational programs and messaging that promotes behavioral confidence among college students to receive the COVID-19 vaccine

Severe pain management in the emergency department: patient pathway as a new factor associated with IV morphine prescription

BackgroundAcross the world, 25–29% of the population suffer from pain. Pain is the most frequent reason for an emergency department (ED) visit. This symptom is involved in approximately 70% of all ED visits. The effective management of acute pain with adequate analgesia remains a challenge, especially for severe pain. Intravenous (IV) morphine protocols are currently indicated. These protocols are based on patient-reported scores, most often after an immediate evaluation of pain intensity at triage. However, they are not systematically prescribed. This aspect could be explained by the fact that physicians individualize opioid pain management for each patient and each care pathway to determine the best benefit–risk balance. Few data are available regarding bedside organizational factors involved in this phenomenon.ObjectiveThis study aimed to analyze the organizational factors associated with no IV morphine prescription in a standardized context of opioid management in a tertiary-care ED.MethodsA 3-month prospective study with a case–control design was conducted in a French university hospital ED. This study focused on factors associated with protocol avoidance despite a visual analog scale (VAS) ≥60 or a numeric rating scale (NRS) ≥6 at triage. Pain components, physician characteristics, patient epidemiologic characteristics, and care pathways were considered. Qualitative variables (percentages) were compared using Fisher’s exact test or the chi-squared tests. Student’s t-test was used to compare continuous variables. The results were expressed as means with their standard deviation (SD). Factors associated with morphine avoidance were identified by logistic regression.ResultsA total of 204 patients were included in this study. A total of 46 cases (IV morphine) and 158 controls (IV morphine avoidance) were compared (3:1 ratio). Pain patterns and patient’s epidemiologic characteristics were not associated with an IV morphine prescription. Regarding NRS intervals, the results suggest a practice disconnected from the patient’s initial self-report. IV morphine avoidance was significantly associated with care pathways. A significant difference between the IV morphine group and the IV morphine avoidance group was observed for “self-referral” [adjusted odds ratio (aOR): 5.11, 95% CIs: 2.32–12.18, p < 0.0001] and patients’ trajectories (Fisher’s exact test; p < 0.0001), suggesting IV morphine avoidance in ambulatory pathways. In addition, “junior physician grade” was associated with IV morphine avoidance (aOR: 2.35, 95% CIs: 1.09–5.25, p = 0.03), but physician gender was not.ConclusionThis bedside case–control study highlights that IV morphine avoidance in the ED could be associated with ambulatory pathways. It confirms the decreased choice of “NRS-only” IV morphine protocols for all patients, including non-trauma patterns. Modern pain education should propose new tools for pain evaluation that integrate the heterogeneity of ED pathways

Activitatea fizică la studenți: un studiu epidemiologic transversal în Republica Moldova și Franța

Université d’État de Médecine et de Pharmacie „Nicolae Testemițanu”, République de Moldavie, Unisversité de Rouen, FranceIntroduction. Physical activity is the key component of a student's healthy lifestyle, which is a fundamental factor contributing to academic success. The importance of physical activities during the study period is determined particularly by the student's working regime, which is often characterized by sedentary lifestyle, reduced mobility and constant working position. Material and methods. A cross-sectional epidemiological study (2017-2018) was carried out. The study sample consisted of 783 students, including 430 students from the Republic of Moldova and 353 students from France. The data collection was performed by using a questionnaire that was completed by each study participant online, in electronic form. Results. The mean body mass index (kg/m2) of students from Chisinau was 21.5±0.10 (ranging between 16.16 and 34.72) and of students from Rouen - 22.65±0.22 (15.75-43.76) (p<0.001). 43.9% students from Chisinau and 56.4% students from Rouen practice sport (p<0.001). Both men (98.5%) and women (98.4%) from Chisinau practice same-intensity physical activities, until sweating. A slightly more different situation was reported in students from Rouen, where only 88.8% of women exercise until sweating, compared to men – 93.1%. Conclusions. The results of the research showed a slightly significant difference among students from both countries, as well as in their gender distribution.Introducere. Activitatea fizică reprezintă una din componentele de bază ale unui stil de viață sănătos al unui student – un factor primordial, care contribuie la succesul academic. Importanța activităților fizice în perioada studiilor este determinată, în special, de faptul că regimul de lucru al studentului se caracterizează adesea prin sedentarism, mobilitate redusă sau poziţie de lucru invariabilă. Material și metode. A fost proiectat un studiu epidemiologic transversal (2017-2018), eșantionul de studiu fiind constituit din 783 studenți, dintre care 430 de respondenți din Republica Moldova și 353 - din Franța. Datele au fost colectate în baza unui formular cu întrebări, care a fost completat de către fiecare participant la studiu, în format electronic, în regim online. Rezultate. Valoarea medie a indicelui masei corporale (kg/m2) pentru studenții din Chișinău a constituit 21,5±0,10 (limitele cuprinse între 16,16 și 34,72), iar pentru studenții din Rouen - 22,65±0,22 (15,75-43,76) (p<0,001). Astfel, practică sportul: 43,9% studenți din Chișinău și 56,4% studenți din Rouen (p<0,001). Atât bărbații (98,5%), cât și femeile (98,4%) din Chișinău practică activitățile fizice cu aceeași intensitate, până la transpirație. O situație puțin mai deosebită atestându-se la studenții din Rouen, unde femeile fac exerciții fizice până la transpirație doar în 88,8% cazuri, în comparație cu bărbații – 93,1%. Concluzii. Rezultatele cercetării au arătat că diferențele au fost puțin semnificative atât după criteriul de gen, cât și la nivel de țări

Attention-deficit hyperactivity disorder and addictions (substance and behavioral): Prevalence and characteristics in a multicenter study in France

Aim The aim of this study is to determine the possible links between attention-deficit hyperactivity disorder (ADHD) and the presence of concomitant addictions with or without substance use in a French student population. Measures A battery of questionnaire measuring socioeconomic characteristics, university curriculum, ADHD (Wender Utah Rating Scale and Adult ADHD Self-Report Scale), substance consumptions (alcohol, tobacco, and cannabis), and behavioral addictions [(eating disorders (SCOFF)], Internet addiction (Internet Addiction Test), food addiction (Yale Food Addiction Scale), compulsive buying (Echeburua’s), and problem gambling (The Canadian Problem Gambling Index)] and measures of physical activity (Godin’s Leisure Time Exercise Questionnaire) was filled up by university students in Rouen and Nanterre in France. Results A total of 1,517 students were included (472 from Paris Nanterre and 1,042 from Rouen). The mean age was 20.6 years (SD = 3.6) and the sex ratio male to female was 0.46. The prevalence of ADHD among the students (current ADHD with a history of ADHD in childhood) was 5.6%. A quarter (25.7%) of students had already repeated their university curriculum, compared to 42.2% among the students with ADHD. Students with possible ADHD had repeated classes more often and believed to have a lower academic level than the students without ADHD. Significant differences were found as students with ADHD were less likely to succeed in their studies (repeated classes more often) than non-ADHD students, and considered their academic level to be lower. They also had significantly higher scores on substance (alcohol, cannabis, and tobacco) as well as behavioral addictions (gambling, compulsive buying disorder, eating disorders, and Internet addiction). Conclusion It seems essential to determine students’ problems and propose interventions adapted to students’ needs, in order to reduce the negative impact on their future academic and global successes

Depressive symptoms in higher education students during the COVID-19 pandemic: the role of containment measures

Background Students are a vulnerable group for the indirect impact of the COVID-19 pandemic, particularly their mental health. This paper examined the cross-national variation in students’ depressive symptoms and whether this can be related to the various protective measures implemented in response to the initial stage of the COVID-19 outbreak. Methods Student data stem from the COVID-19 International Student Well-being Study, covering 26 countries during the first wave of the COVID-19 pandemic. Country-level data on government responses to the COVID-19 pandemic were retrieved from the Oxford COVID-19 Tracker. Multilevel analyses were performed to estimate the impact of the containment and economic support measures on students’ depressive symptoms (n = 78 312). Results School and workplace closures, and stay-at-home restrictions were positively related to students’ depressive symptoms during the COVID-19 pandemic, while none of the economic support measures significantly related to depressive symptoms. Countries’ scores on the index of these containment measures explained 1.5% of the cross-national variation in students’ depressive symptoms (5.3%). This containment index’s effect was stable, even when controlling for the economic support index, students’ characteristics, and countries’ epidemiological context and economic conditions. Conclusions Our findings raise concerns about the potential adverse effects of existing containment measures (especially the closure of schools and workplaces and stay-at-home restrictions) on students’ mental health

Identification and Characterization of Human Observational Studies in Nutritional Epidemiology on Gut Microbiomics for Joint Data Analysis

In any research field, data access and data integration are major challenges that even large, well-established consortia face. Although data sharing initiatives are increasing, joint data analyses on nutrition and microbiomics in health and disease are still scarce. We aimed to identify observational studies with data on nutrition and gut microbiome composition from the Intestinal Microbiomics (INTIMIC) Knowledge Platform following the findable, accessible, interoperable, and reusable (FAIR) principles. An adapted template from the European Nutritional Phenotype Assessment and Data Sharing Initiative (ENPADASI) consortium was used to collect microbiome-specific information and other related factors. In total, 23 studies (17 longitudinal and 6 cross-sectional) were identified from Italy (7), Germany (6), Netherlands (3), Spain (2), Belgium (1), and France (1) or multiple countries (3). Of these, 21 studies collected information on both dietary intake (24 h dietary recall, food frequency questionnaire (FFQ), or Food Records) and gut microbiome. All studies collected stool samples. The most often used sequencing platform was Illumina MiSeq, and the preferred hypervariable regions of the 16S rRNA gene were V3-V4 or V4. The combination of datasets will allow for sufficiently powered investigations to increase the knowledge and understanding of the relationship between food and gut microbiome in health and disease

The Impact of COVID-19 Lockdown on Health Behaviors among Students of a French University

This study aimed to determine the changes in health behaviors among students of a French university during the COVID-19 lockdown. An online retrospective survey was distributed to Rouen-Normandy University students at the end of the COVID-19 lockdown (13th March–11th May 2020). Voluntary university students were included. Data collected were on socio-demographics, academic environment, COVID19 concerns, tobacco smoking, binge drinking, cannabis use, and physical activity in the periods before and during COVID-19 lockdown. The survey was completed by 3671 university students (mean age 20.9 ± 2.47 years, 72.9% female). Significantly favorable changes between the periods before and during COVID-19 were reported for tobacco smoking (18.5% vs. 14.8%), binge drinking (35.9% vs. 9.3%) and cannabis use (5.6% vs. 3.2%) and unfavorable changes for moderate (79.4% vs. 67.9%) and vigorous physical activity (62.5% vs. 59.1%). After logistic regression, factors associated with unfavorable changes in tobacco smoking and with favorable changes in vigorous physical activity were the worry of not validating the academic year and stress related to changes in the mode of teaching, respectively. For each health behavior, unfavorable changes were associated with higher depression levels, and male gender. Then as a decrease, mainly in binge drinking was observed during the COVID-19 lockdown, care must be taken to prevent university students from resuming binge drinking after the end of the lockdown. Health-promotion strategies directed at adopting or maintaining positive mental health and promoting physical activity should be developed for university students to better manage future lockdown periods

Database Burnout Rouen and Paris Nanterre (France) n=1134

Burnout Data of 1134 university students in Franc