Factors associated with stress among first-year undergraduate students attending an Australian university

Objective: The aim of this study was to examine the relationship between stress and various socio-demographic, health and behavioural factors among undergraduate students studying in an Australian university. Methods: A cross-sectional survey was carried out among firstyear undergraduate students studying at Griffith University. Participants were recruited from four different academic groups (N=728). The questionnaire used in this study comprised of three sections: socio-demographic information, stress scale and a food frequency questionnaire. K-means Cluster analysis was performed to identify the major dietary patterns and multinomial logistic regression analysis was used to examine the factors associated with stress. Results: Nearly 53% of the students had some degree of stress with 37.4% experiencing moderate to severe levels of stress. The factors most strongly associated with having mild or moderate/ severe stress levels included being in a relationship [OR =1.71, 95% CI (1.02-2.87) and OR=1.61, 95% CI (1.06-2.44)], studying a non-health related degree [OR=1.68, 95% CI (1.03-2.73) and OR=1.51, 95% CI (1.04-2.19)], working ≥ 21 hours per week [OR=2.12, 95% CI (1.02-4.40) and OR=2.21, 95% CI (1.32-3.67)], and engaging in an unhealthy dietary pattern [OR=2.67, 95% CI (1.25-5.72) and OR=2.76, 95% CI (1.47-5.16)]. Being a female [OR=1.84, 95% CI (1.25-2.72)], living in a shared accommodation [OR=0.52, 95% CI (0.27-0.98)], rarely exercising [OR=2.64, 95% CI (1.59-4.39)], having a body mass index (BMI) of 25 or over [OR=2.03, 95% CI (1.36-3.04)], and engaging in a dietary pattern that was low in protein, fruit and vegetables [OR=1.72, 95% CI (1.06-2.77)] were also associated with having moderate/severe stress levels. Conclusion: This study found that more than half of the undergraduate students had some levels of stress. Both mild and moderate/severe levels of stress were associated with sociodemographic characteristics, risky health behaviours and poor dietary patterns. Our findings reinforce the need to promote healthy behaviours among undergraduate university students in order to maintain good mental health.</p

Including Information on Overdiagnosis in Shared Decision Making : A Review of Prostate Cancer Screening Decision Aids

Publisher Copyright: © The Author(s) 2022.Background. Overdiagnosis is an accepted harm of cancer screening, but studies of prostate cancer screening decision aids have not examined provision of information important in communicating the risk of overdiagnosis, including overdiagnosis frequency, competing mortality risk, and the high prevalence of indolent cancers in the population. Methods. We undertook a comprehensive review of all publicly available decision aids for prostate cancer screening, published in (or translated to) the English language, without date restrictions. We included all decision aids from a recent systematic review and screened excluded studies to identify further relevant decision aids. We used a Google search to identify further decision aids not published in peer reviewed medical literature. Two reviewers independently screened the decision aids and extracted information on communication of overdiagnosis. Disagreements were resolved through discussion or by consulting a third author. Results. Forty-one decision aids were included out of the 80 records identified through the search. Most decision aids (n = 32, 79%) did not use the term overdiagnosis but included a description of it (n = 38, 92%). Few (n = 7, 17%) reported the frequency of overdiagnosis. Little more than half presented the benefits of prostate cancer screening before the harms (n = 22, 54%) and only 16, (39%) presented information on competing risks of mortality. Only 2 (n = 2, 5%) reported the prevalence of undiagnosed prostate cancer in the general population. Conclusion. Most patient decision aids for prostate cancer screening lacked important information on overdiagnosis. Specific guidance is needed on how to communicate the risks of overdiagnosis in decision aids, including appropriate content, terminology and graphical display. Most patient decision aids for prostate cancer screening lacks important information on overdiagnosis. Specific guidance is needed on how to communicate the risks of overdiagnosis.Peer reviewe

Overuse of medications in low- and middle-income countries: a scoping review

OBJECTIVE: To identify and summarize the evidence about the extent of overuse of medications in low- and middle-income countries, its drivers, consequences and potential solutions. METHODS: We conducted a scoping review by searching the databases PubMed®, Embase®, APA PsycINFO® and Global Index Medicus using a combination of MeSH terms and free text words around overuse of medications and overtreatment. We included studies in any language published before 25 October 2021 that reported on the extent of overuse, its drivers, consequences and solutions. FINDINGS: We screened 3489 unique records and included 367 studies reporting on over 5.1 million prescriptions across 80 low- and middle-income countries – with studies from 58.6% (17/29) of all low-, 62.0% (31/50) of all lower-middle- and 60.0% (33/55) of all upper-middle-income countries. Of the included studies, 307 (83.7%) reported on the extent of overuse of medications, with estimates ranging from 7.3% to 98.2% (interquartile range: 30.2–64.5). Commonly overused classes included antimicrobials, psychotropic drugs, proton pump inhibitors and antihypertensive drugs. Drivers included limited knowledge of harms of overuse, polypharmacy, poor regulation and financial influences. Consequences were patient harm and cost. Only 11.4% (42/367) of studies evaluated solutions, which included regulatory reforms, educational, deprescribing and audit–feedback initiatives. CONCLUSION: Growing evidence suggests overuse of medications is widespread within low- and middle-income countries, across multiple drug classes, with few data of solutions from randomized trials. Opportunities exist to build collaborations to rigorously develop and evaluate potential solutions to reduce overuse of medications

A rare anomaly of the human spleen with nine notches associated with multiple accessory spleens:A case study, hypothesis on origin and review of clinical significance

In humans, the spleen is the body’s largest secondary lymphoid organ and filterer of blood. The trabeculated structure of the spleen, which is formed in its early embryonic development, provides its three-dimensional framework designed to remove senescent erythrocytes and eliminate blood-borne microorganisms and/or dubious antigens. At a later date this lobulated framework can develop into notches which usually manifest along its anterior (superior) border. This study addresses the clinical significance and developmental basis of both numerous notches and multiple accessory spleens observed in a male human cadaver. The nine notches were all observed on the anterior and inferior borders, whilst the accessory spleens numbered four, with two localized at the splenic hilum and the other two upon the splenorenal and splenocolic ligaments respectively. In the present study, we propose an aetiological origin for the anomalous multi-notches and accessory spleens, which will provide primary benefit for surgeons and radiologists because of clinical significance.Full Tex

Including Information on Overdiagnosis in Shared Decision Making : A Review of Prostate Cancer Screening Decision Aids

Publisher Copyright: © The Author(s) 2022.Background. Overdiagnosis is an accepted harm of cancer screening, but studies of prostate cancer screening decision aids have not examined provision of information important in communicating the risk of overdiagnosis, including overdiagnosis frequency, competing mortality risk, and the high prevalence of indolent cancers in the population. Methods. We undertook a comprehensive review of all publicly available decision aids for prostate cancer screening, published in (or translated to) the English language, without date restrictions. We included all decision aids from a recent systematic review and screened excluded studies to identify further relevant decision aids. We used a Google search to identify further decision aids not published in peer reviewed medical literature. Two reviewers independently screened the decision aids and extracted information on communication of overdiagnosis. Disagreements were resolved through discussion or by consulting a third author. Results. Forty-one decision aids were included out of the 80 records identified through the search. Most decision aids (n = 32, 79%) did not use the term overdiagnosis but included a description of it (n = 38, 92%). Few (n = 7, 17%) reported the frequency of overdiagnosis. Little more than half presented the benefits of prostate cancer screening before the harms (n = 22, 54%) and only 16, (39%) presented information on competing risks of mortality. Only 2 (n = 2, 5%) reported the prevalence of undiagnosed prostate cancer in the general population. Conclusion. Most patient decision aids for prostate cancer screening lacked important information on overdiagnosis. Specific guidance is needed on how to communicate the risks of overdiagnosis in decision aids, including appropriate content, terminology and graphical display. Most patient decision aids for prostate cancer screening lacks important information on overdiagnosis. Specific guidance is needed on how to communicate the risks of overdiagnosis.Peer reviewe