Student Health Services

Iceland responsible fisheries Vottorðið staðfestir uppruna sjávarfangs frá íslensku hafsvaeði og ábyrga fiskveiðistjórnun (Sjávarútvegs-og landbúnaðarráðuneytið, e.d; Iceland Responsible Fisheries, e.d.). TÚN Vottorðið staðfestir lífraena vottun á íslenskum vörum (Vottunarstofan Tún, e.d.). Tékknesk gaeðavottorð KLASA Vottorðið gefur til kynna bestu matgaeði landbúnaðarvara sem framleiddar eru í Tékklandi. Vottorðið er gefið út af Landbúnaðarráðuneyti Tékklands (Klasa, e.d.). Czech BIO label Vottorðið staðfestir lífraena framleiðsluhaetti og er gefið út af Landbúnaðarráðuneyti Tékklands í samráði við Samtök lífraenna framleiðanda (PRO-BIO) (Ministry of Agriculture of the Czech Republic, e.d.-a, e.d.-c.

Iceland responsible fisheries Vottorðið staðfestir uppruna sjávarfangs frá íslensku hafsvaeði og ábyrga fiskveiðistjórnun (Sjávarútvegs-og landbúnaðarráðuneytið, e.d; Iceland Responsible Fisheries, e.d.). TÚN Vottorðið staðfestir lífraena vottun á íslenskum vörum (Vottunarstofan Tún, e.d.). Tékknesk gaeðavottorð KLASA Vottorðið gefur til kynna bestu matgaeði landbúnaðarvara sem framleiddar eru í Tékklandi. Vottorðið er gefið út af Landbúnaðarráðuneyti Tékklands (Klasa, e.d.). Czech BIO label Vottorðið staðfestir lífraena framleiðsluhaetti og er gefið út af Landbúnaðarráðuneyti Tékklands í samráði við Samtök lífraenna framleiðanda (PRO-BIO) (Ministry of Agriculture of the Czech Republic, e.d.-a, e.d.-c.

Community outbreaks of serogroup C invasive meningococcal disease are increasing in North America (L. H. Harrison, JAMA 273:419-421, 1995; L. A. Jackson, A. Schuchat, M. W. Reeves, and J. D. Wenger, JAMA 273:382-389, 1995; C. M. Whalen, J. C. Hockin, A. Ryan, and F. Ashton, JAMA 273:390-394). In a recent 15-month university outbreak, disease was linked to patronage of a specific campus-area bar, suggesting that aspects of a campus bar environment might promote meningococcal transmission (P. B. Imrey, L. A. Jackson, P. H. Ludwinski, et al., Am. J. Epidemiol., in press). To investigate this hypothesis, oropharyngeal carriage results from samples taken from 867 university health service clients and 85 campus-area bar employees during the last 3 months of the outbreak were analyzed to determine factors correlated with carriage of any strain of Neisseria meningitidis. Results were validated with data from samples from 344 health center clients and 211 campus bar employees taken 8 months ...

Aedes albopictus or “Asian tiger mosquito” is an invasive species consider the second most important Dengue vector. Due to Public Health relevance and the recent findings in several areas from Venezuela, we sampled in seven localities in the Carabobo State from June to August 2013. This is the first report of Aedes albopictus in four localities of Carabobo State associated to larvitraps and flower vases. This increases to 15 the number of occurrences in the country. This finding in urban areas of Carabobo represents a potentiality risk for arboviruses emergence and transmission, because that we recommended vector monitoring, entomological and epidemiological surveillance and the vectorial control in the country. This finding shows the importance of further studies of mosquito’s geographical distribution, arboviruses detection, vector ecological aspects, and their possible medical and epidemiological link with emerging and reemerging diseases.

The incidence of coital trauma in this study was 0.34% of the total gynaecological patients seen within the period. The mean age was 19.88+6.75, 45.8% of them were teenagers and 16.7% were prepubertal girls. Alleged rape was the commonest aetiological factor seen Conclusion: Coital injury in the society is not an uncommon occurrence but seldom reported and still poses a great challenge as regards to its prevention. Sex education, counseling and enforcement of stringent penalties to the perpetuators of rape will go a long way in reducing its occurrence.

Es alta la prevalencia de mala calidad del sueño en estudiantes universitarios, especialmente de medicina. Los disturbios del dormir repercuten de manera negativa en la salud mental, física y en la calidad de vida. El objetivo es evaluar la calidad del dormir e insomnio y su asociación con el rendimiento académico, en estudiantes de medicina de una universidad pública del Caribe Colombiano. Estudio transversal, realizado en estudiantes de primero a décimo semestre de medicina de la Universidad de Cartagena, Colombia. Se aplicó formulario de datos socio demográfico y académico, así como la Escala de Insomnio de Atenas y el índice de calidad de sueño de Pittsburgh. Puntuación de Atenas > 5 indica insomnio y Pittsburgh >5: malos dormidores. Participación voluntaria, estratificada por sexo y semestre. Los datos fueron analizados con Epi-Info 7. Valor de p<0.05 estadísticamente significativo. Participaron 210 estudiantes. Edad: 19.7±2.0. Varones: 49.0%, procedentes de Cartagena:...

What is already known about this topic? There are exceptionally limited data that assessed prescribers' adherence to allergen immunotherapy labeling guidelines. What does this article add to our knowledge? This study highlights poor adherence to allergen immunotherapy extract vials labeling guidelines and notes this as a potential function of the number of years in practice. How does this study impact current management guidelines? This study highlights the potential for adverse events that could result from nonadherence to allergen immunotherapy extract vial labeling guidelines and raises questions about reasons of nonadherence and ways to best implement practice guidelines. BACKGROUND: Little is known about the adherence rate to allergen immunotherapy (AIT) labeling guidelines.

Meslek, kişinin yaşamını devam ettirmek için yerine getirmesi gereken, eğitim, çalışma, bilgi birikimi ile bireyin yeteneğini kullanarak ortaya koyduğu uğraşıdır. 1 Meslek tercihi ise kişinin birçok meslek arasından kendisine en yakın hissettiği ve yerine getirebileceğine inandığı mesleki uygulamaları içeren ve manevi olarak üst seviyede doyuma ulaşabileceğini düşündüğü bir alanı tercih etmesidir. 2 Kişinin ge-

We report a series of dermatitis cases caused by the staphilinid beetles, Paederusfuscipes Curtis, among university students staying in the residential college in Puncak Alam, Selangor, Malaysia from 1 January to 31 December 2010. A total of 360 cases (6.0%) were recorded in the Student Health Center throughout the year; the majority of patients stayed at a hostel near an oil palm plantation. Skin symptoms included erythema, edema, vesicular papules, painful blisters, burning sensation, pruritus, hyper pigmentation and peeling of skin. The commonly involved sites were the face, neck, shoulders and arms. Most students noticed the symptoms upon awakening in the morning. The patients were treated with fusidic acid cream and the symptoms resolved within 5 days. These beetles are nocturnally active and enter the room whenever a light source is available. The unintentional crushing of these beetles during sleep causes the release of its hemolymph (paederin) which is the cause of the derma...

The New Jersey Collegiate Substance Abuse Program (NJCSAP) provided intensive substance abuse treatment to college students requiring treatment for severe substance use disorders. This study reports the progress of students who received 6 months of treatment at NJCSAP and participated in a research evaluation of the program. Overall, 74.5% of participants who completed the follow-up were abstinent at the 6-month assessment. Including participants who did not complete the follow-up as users yielded a 52.6% rate of abstinence. Students who completed the follow-up experienced decreases in the number of current psychiatric diagnoses met, depressive symptomatology, alcohol and drug problem severity, and family and psychiatric problem severity over the 6 month period. Most students rated the program components as vet), or moderately helpful and most were attending AA at the 6-month assessment. Results are compared to findings from other programs for adolescents and young adults. Copyright

Objective-Colleges are at risk for communicable disease outbreaks because of the high degree of person-to-person interactions and relatively crowded dormitory settings. This report describes the U.S. college student health screening requirements among U.S. resident and international students for tuberculosis (TB) and vaccine-preventable diseases (VPD) as it relates to the American College Health Association (ACHA) Guidelines. Methods/Participants-In April 2012, U.S. college health administrators (N=2858) were sent online surveys to assess their respective school's TB screening and immunization requirements. Results-Surveys were completed by 308 (11%) schools. Most schools were aware of the ACHA immunization (78%) and TB screening (76%) guidelines. Schools reported having policies related to immunization screening (80.4%), immunization compliance (93%), TB screening (55%), and TB compliance (87%). Conclusion-Most colleges were following ACHA guidelines. However, there are opportunities for improvement to fully utilize the recommendations and prevent outbreaks of communicable diseases among students in colleges.

Strengths-based approaches leveraging the strengths and interests of autistic students are increasingly recognised as important to meeting their school-related needs. A scoping review exploring elements contributing to strengths-based approaches for autistic students in schools was undertaken. Eighteen articles were identified, with results conceptualised according to the Bioecological Model of Development. One personal (strengths and interests), six microsystem (specialised instructions, curriculum integration, curriculum differentiation, common interests with peers, reciprocal roles and adult involvement), three mesosystem (matching resources and activities, real-life learning experiences and benefiting all students), and three exosystem (cost-effective and timesaving, collaboration with colleagues and parents and teachers' attitude and knowledge) elements were identified. Findings highlight the interrelatedness of the elements contributing to strengths-based approaches for autistic students, which can be used to aid in the development of more inclusive school environments.

Objectives: To determine if medication reminding via smartphone app increases adherence to antidepressant medications in college students. Participants: College students (N D 57) enrolled at a state-funded institution who had a current prescription for an antidepressant and regularly used a smartphone device. Methods: Participants were randomized to either a reminder group or a control group. Both groups were asked to complete a survey and undergo a manual pill count at the beginning of the study and 30 days later. Results: There was a strong trend suggesting that the use of a medication reminder app was beneficial for adherence to antidepressant medication regimens. Factors influencing medication adherence in college students included health beliefs, use of illicit drugs, and type of professional care received. Conclusions: Use of a medication reminder may increase adherence to antidepressant medications in college students.

The start of university is presented as a crucial stage in the life of the student. If, on the one hand, it is a period of increased autonomy and freedom, on the other, it is a period that also increases the sense of responsibility and self discipline. In this study, based on a quantitative approach, we identified the main risk situations experienced by freshmen at the University of Evora, by applying a questionnaire developed for this purpose and the Beck inventory. Key findings are highlighted, such as the consumption of harmful substances (tobacco, alcohol and illicit drugs), whose values exceed the average population. The consumption of alcoholic beverages begins early and is continuous and excessive. Also, the presence of symptoms compatible with dysphoria and depression is noted in about 9% of students. Self-medication practices were found in 58.7% of the freshmen. Our findings reveal the need for preventive intervention by health professionals, due to these young people's...

OBJECTIVES To summarise survey results for the quality of medical students' personal health care, characterise the results according to the demographics and career orientations of the students, and evaluate the relationship between the perceived quality of health care received and the degree of emphasis on prevention in the health care provided. METHODS We carried out a cross-sectional study with 2316 medical students in the class of 2003 from 16 medical schools, surveyed at 3 points during their training. We used a self-administered questionnaire designed to assess personal health care and related variables in medical students. The majority (92%) reported receiving health care that was at least good, but only a minority (23%) said they received excellent health care. Half had a regular doctor. Health care quality was rated more highly at Year 1 orientation than at later timepoints by students who had a regular personal doctor, and especially by those with personal doctors who emphasised prevention. CONCLUSIONS The majority of medical students perceived that they had received health care that was good or better, but most did not believe it was excellent. As the provision of preventive care is important to students, increasing the amount of preventive care provided to students may both increase their personal satisfaction with their health care and model good clinical preventive practices for them.

This study adds to the international literature on the assessment of the effectiveness of psychotherapies delivered by university counseling centers. The present study evaluated the effectiveness of psychotherapy in 226 students (179 women, 47 men; M age = 24.8 yr., SD = 4.0) who started psychotherapy treatment at the counseling service of the University of Bologna, Italy, between January 2008 and October 2010. The Symptom Questionnaire (SQ) was completed twice, before and after the psychotherapeutic treatment. Significant improvements were observed after therapy in all the SQ dimensions' scores, indicating the effectiveness of the therapy in reducing the students' distress.

This study evaluated efforts of secondary schools to prevent unintended pregnancy among students and their reactions to pregnant students before and after delivery. A cross-sectional survey of 46 teachers in three public and two private schools in Anambra state, Nigeria was carried out. Information was collected using self-administered questionnaire. Of all the teachers in the study, 87% reported unintended pregnancies among students in the previous 3 years. Expulsion (43%) and suspension (28%) were the most common reactions. Private schools were more likely to expel pregnant students than public schools. Following the delivery of their babies, 43% discontinued their education in the same school, whereas 37% continued their education in a different school. Counselling was given before suspension or expulsion in 4% of public schools and 15% of private schools. Majority of the schools (61%) did not have sex education as part of their schools' curriculum. Students should be re-admi...

Objective: To determine the aetiological bacterial agents of urinary tract infections, within communities in Kenyatta University, and current resistance levels to commonly available therapeutic agents. Design: Cross-sectional survey research design.

This study evaluates a new stress management course for medical students offered through the Occupational Health Unit, Royal Free Hospital, London. It was offered to students in their first clinical year, which has been shown to be a highly stressful time. The course took place over 3 weeks, with one 2-hour session each week. Students completed questionnaires about mood, attitudes and causes of stress at the beginning of the year, and again one year later. The uptake of this optional course was 17%. Attendees, compared with non-attendees, were more anxious, less satisfied with themselves and their life, and perceived both work and outside functioning to be poorer. Over this first clinical year, non-attendees became sigmficantly more dissatisfied at work and increasingly perceived their functioning at work and outside to be poorer whilst attendees showed no such deterioration over the year. Attendees completed the questionnaires before and after the course, and at two time points prior to starting the course when on the waiting list. Improvements in reported work functioning were found after the course, and this change was significant compared with the waiting list controls. These results are consistent with the attendees' own reports that they found the course helpful. These results show that stress management provides long-term protective effects as well as short-term benefits.

Use of synthetic marijuana (also known as spice, K2, aroma, and eclipse ) is often viewed by young people as harmless recreation. Until recently, the substance was freely available in U.S. convenience stores and head shops, and it is still available via the Internet. Emerging evidence shows a wide range of responses to the drug, including paranoia, aggressive behavior, anxiety, and short-term memory deficits. Synthetic cannabinoids are not currently detectable via standard toxicology tests. Recognition and management of synthetic cannabinoid use are discussed.

Objective: This study reviews an initiative to educate providers on pediatric cancer survivor care and to establish a cancer survivor registry in a college health center. Participants: Participants were University of Georgia (UGA) college health providers. Methods: Providers attended lectures on survivor care and were encouraged to register on Cancer SurvivorLink. Changes in provider familiarity and practice were measured using baseline and follow-up surveys. A survivor registry was created using health entrance forms and medical records abstraction. Results: Twenty-four providers registered on SurvivorLink, and 16 completed both surveys. Familiarity with survivor care (p D .003) and a survivor health care plan (p D .016) increased. Likelihood to deliver survivor care increased (p D .01). UGA follows 95 survivors; 71 diagnosed at < 21 years. Among survivors diagnosed at < 21 years, 91% reported their diagnosis on entrance forms. Conclusions: Through education and optimization of health informatics, college health centers can identify and provide survivor care to this medically vulnerable population.

Objective: This study reviews an initiative to educate providers on pediatric cancer survivor care and to establish a cancer survivor registry in a college health center. Participants: Participants were University of Georgia (UGA) college health providers. Methods: Providers attended lectures on survivor care and were encouraged to register on Cancer SurvivorLink. Changes in provider familiarity and practice were measured using baseline and follow-up surveys. A survivor registry was created using health entrance forms and medical records abstraction. Results: Twenty-four providers registered on SurvivorLink, and 16 completed both surveys. Familiarity with survivor care (p D .003) and a survivor health care plan (p D .016) increased. Likelihood to deliver survivor care increased (p D .01). UGA follows 95 survivors; 71 diagnosed at < 21 years. Among survivors diagnosed at < 21 years, 91% reported their diagnosis on entrance forms. Conclusions: Through education and optimization of health informatics, college health centers can identify and provide survivor care to this medically vulnerable population.

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The purpose of this study was to test brief counseling impact on four outcomes. Two outcomes, self-esteem and social connectedness, were more typical for a University Counseling Center (UCC) to address. However, two other outcomes were more related to a university's academic mission, i.e., recommending the university and active alumnus intent. Using a longitudinal sample of 60 matched non-urgent undergraduate clients at a UCC, brief counseling increased all four outcomes: social connectedness, self-esteem, recommending the university, and active alumnus intent. For this study, brief counseling was defined as a median of three counseling sessions after intake (range 1 to 8) over a median period of six weeks (range 4 to 10 weeks). In addition, these scale means were compared to a control group of business undergraduates not in counseling. The counseled sample at Time 2 compared favorably to the non-counseled sample on recommending the university and active alumnus intent. To better support its students' success and university enrollments, UCCs need to consider new avenues to promote their advocacy by gathering data more directly connected to a university's mission.

Chlamydia trachomatis (CT) screening programs have been established in educational settings in many countries during the past 2 decades. However, recent evidence suggests that high uptake of screening and management (treatment, partner notification, and retesting for reinfection) improves program effectiveness. We conducted a systematic review to understand the screening strategies, the extent of screening conducted, and uptake of management strategies in educational settings. Screening studies in educational settings were identified through a systematic search of published literature from 2005 to 2011. We identified 27 studies describing 30 screening programs in the United States/Canada (n = 10), Europe (n = 8), Australia/New Zealand (n = 5), and Asia (n = 4). Most studies targeted both male and female students (74%). Classroom-based strategies resulted in 21,117 testes overall (4 programs), followed by opportunistic screening during routine health examination (n = 13,470; 5 progra...

ABS TRACT Objective: It was aimed to reveal professional awareness
levels of the students studying in undergraduate physiotherapy technician programs with this study. Material and Methods: Research was
carried out with 275 undergraduate physiotherapy technician program
students from two separate vocational schools. Data of the study were
collected by online questionnaire with 25 questions that inquired about
the demographic information and professional awareness of the participants. Data were evaluated at 95% confidence interval and p<0.05 significance level. Results: 76% of the students participating in the study
were women and all participants’ average age was 20.06±2.00. In line
with the reports of participants, it was seen that they had information
about duties and responsibilities of the physiotherapy technician, they
made research in their choice of profession, and they knew the title they
would hold. It was determined that students preferred physiotherapy technician because of their own wishes and interest in health or the opportunity to transfer to different undergraduate programs. It was determined
that the type of high school graduated from and gender affect students'
knowledge level about their professional duties and responsibilities
(p<0.05). On the other hand, it was observed that the physiotherapy technician students were confused about duties and responsibilities of the
physiotherapist’s profession. Conclusion: A subject that includes the
professional authorities and responsibilities of physiotherapy technicians
should be included in the course curriculum. Knowing the occupation
descriptions of other occupational groups in the interdisciplinary system
can contribute to increasing professional awareness and preventing professional ethics violations in physiotherapy technician candidates.

Purpose: To provide an overview of binge drinking in college-aged women and to suggest strategies for nurse practitioners (NPs) to assist women in preventing the negative consequences associated with this behavior. Data sources: Original research articles and comprehensive review articles identified through Medline, CINAHL, and OVID databases. Conclusions: Researchers have shown that the rates of binge drinking in college-aged women are increasing, which places these women at increased risk for the long-term complications associated with alcohol use. Implications for practice: NPs must be aware of this phenomenon and carefully screen women for high-risk alcohol use. Prevention strategies are reviewed and include the use of brief motivational interviews delivered during individual client encounters as well as through Web-based programs.

Alcohol use disorders and their related consequences continue to be among the nation's most prevalent and persistent healthcare problems across the lifespan. The vast majority of treatment facilities for substance use disorders in the United States report using some form of 12-step facilitation to help direct their patients to mutual help groups such as Alcoholics Anonymous (AA). Yet, many students in various healthcare disciplines may lack familiarity and direct experience with this readily accessible and potentially lifesaving, low-cost resource. AA has a long-standing tradition of extending an open invitation to professionals and providing educational materials about this worldwide program of recovery. The purpose of this article is to describe an experiential, interdisciplinary approach that has been used to teach undergraduate psychology students about AA. Associated activities included (a) selected readings, (b) attendance at an open AA meeting, (c) the formulation of thoughtful questions by the students, and (d) a single, interactive didactic session. Undergraduate psychology students responded positively when principles of experiential learning were applied to educational activities related to AA.

This study examined data collected on over 5,000 clients seen by 71 therapists over a 6-year period in a University Counseling Center. Clients were given the Outcome Questionnaire-45 (OQ-45) on a session-bysession basis to track their treatment response. Data were also collected on therapists' theoretical orientation, years of experience, gender, and type of training. Data were analyzed using hierarchical linear modeling (HLM) to see if general therapist traits (i.e., theoretical orientation, type of training) accounted for differences in clients' rate of improvement. Data were then analyzed, again using HLM with therapists as a fixed effect, to compare individual therapists to see if there were significant differences in the efficiency of treatment. In addition, pre-minus posttest OQ-45 scores were examined to see if there were differences in the overall outcome of clients. There was a significant amount of variation among therapists' clients' rates of improvement. Therapist feedback reports were generated to summarize client outcome for individual providers in contrast to center averages and in an attempt to improve client outcome.

Context: Medical organizations have recommended that administrators, parents, and community leaders explore every opportunity to make interscholastic athletic programs safe for participation, including employing athletic trainers at practices and competitive events. Objective: To determine the overall level of medical services provided for secondary school-aged athletes at high school athletic events in a rural southern state, to evaluate the employment of athletic trainers in the provision of medical services in secondary schools, and to compare athletic training medical services provided at athletic events among schools of various sizes. Design: Cross-sectional study. Setting: Questionnaires were sent to administrators at 199 secondary schools. Patients or Other Participants: A total of 144 administrators, including interscholastic athletic directors and school principals, from 199 secondary schools participated (72% response rate). Main Outcome Measure(s): Participants completed the Self-Appraisal Checklist for Health Supervision in Scholastic Athletic Programs from the American Academy of Pediatrics, which has been demonstrated to be valid and reliable. The Kruskal-Wallis and Mann-Whitney tests were used to measure differences in groups. Results: We found differences in cumulative scores when measuring between institutional classifications (P~.05). Cumulative scores for the Event Coverage section of the instrument ranged from 80.5 to 109.6 out of a total possible score of 126. We also found differences in several factors identified in the Event Coverage section (P~.05). Conclusions: The number of coaching staff certified in cardiopulmonary resuscitation or first aid was minimal. Most schools did not have a plan for providing minimal emergency equipment, ice, or water for visiting teams. We found that 88% (n = 7) of the 8 essential Event Coverage components that the American Academy of Pediatrics deems important were not addressed by schools represented in our study.

Background: In most recent large efficacy trials of barrier contraceptive methods, a high proportion of participants withdrew before the intended end of follow-up. The objective of this analysis was to explore characteristics of participants who failed to complete seven months of planned participation in a trial of spermicide efficacy. Methods: Trial participants were expected to use the assigned spermicide for contraception for 7 months or until pregnancy occurred. In bivariable and multivariable analyses, we assessed the associations between failure to complete the trial and 17 pre-specified baseline characteristics. In addition, among women who participated for at least 6 weeks, we evaluated the relationships between failure to complete, various features of their first 6 weeks of experience with the spermicide, and characteristics of the study centers and population. Results: Of the 1514 participants in this analysis, 635 (42%) failed to complete the study for reasons other than pregnancy. Women were significantly less likely to complete if they were younger or unmarried, had intercourse at least 8 times per month, or were enrolled at a university center or at a center that enrolled fewer than 4 participants per month. Noncompliance with study procedures in the first 6 weeks was also associated with subsequent early withdrawal, but

CONTEXT Doctors do not follow guidance when managing their own health and illness. This behaviour may start at medical school. This study aimed to investigate whether inappropriate responses to illness are an issue for medical students and, if so, to identify the determinants of students' responses to illness. METHODS We undertook a qualitative study using framework analysis to explore the views of medical students at two UK medical schools. RESULTS Eight focus groups carried out with 35 medical students identified four main themes in students' cognitions about their intended behaviour: not using usual patient pathways; informal consultation; self-treatment, and keeping going when ill. The reasons or assumptions underlying these beliefs referred to: time and resources, including wider issues such as responsibility to colleagues; stigma and attitudes of others including regulatory bodies; beliefs about themselves in terms of taking on the patient role and issues relating to coping and self-sufficiency; the behaviour and attitudes of peers; patient safety considerations; patients' views about sick doctors; barriers to accessing care; the ease of self-care, and uncertainty about ability to self-care. CONCLUSIONS Many different factors related to medical students' beliefs about illness. Conflicts occur among student needs to be seen as competent and dedicated to medicine, to protect personal privacy, to maintain convenience, and to seek care appropriately in order to be fair on colleagues and protect the public. These conflicts were complicated by perceptions of the system, peers and doctors as unsupportive of ill health except by facilitating informal access to care. Beliefs underlying intentions are similar between doctors and medical students, but further research is needed to fully determine how and when these beliefs are formed.

This study examined data collected on over 5,000 clients seen by 71 therapists over a 6-year period in a University Counseling Center. Clients were given the Outcome Questionnaire-45 (OQ-45) on a session-bysession basis to track their treatment response. Data were also collected on therapists' theoretical orientation, years of experience, gender, and type of training. Data were analyzed using hierarchical linear modeling (HLM) to see if general therapist traits (i.e., theoretical orientation, type of training) accounted for differences in clients' rate of improvement. Data were then analyzed, again using HLM with therapists as a fixed effect, to compare individual therapists to see if there were significant differences in the efficiency of treatment. In addition, pre-minus posttest OQ-45 scores were examined to see if there were differences in the overall outcome of clients. There was a significant amount of variation among therapists' clients' rates of improvement. Therapist feedback reports were generated to summarize client outcome for individual providers in contrast to center averages and in an attempt to improve client outcome.

This study adds to the international literature on the assessment of the effectiveness of psychotherapies delivered by university counseling centers. The present study evaluated the effectiveness of psychotherapy in 226 students (179 women, 47 men; M age = 24.8 yr., SD = 4.0) who started psychotherapy treatment at the counseling service of the University of Bologna, Italy, between January 2008 and October 2010. The Symptom Questionnaire (SQ) was completed twice, before and after the psychotherapeutic treatment. Significant improvements were observed after therapy in all the SQ dimensions&#39; scores, indicating the effectiveness of the therapy in reducing the students&#39; distress.

CONTEXT AND OBJECTIVE: Client characterization is an important step in evaluating the services offered by campus counseling and mental health centers and in their further planning and development. The objectives here were to describe reported complaints and demographics among students who sought counseling/mental healthcare at a Brazilian campus mental health service over a 17-year period and to compare these characteristics with those of the general university student body. DESIGN AND SETTING: Retrospective study at the Psychological and Psychiatric Service for Students (SAPPE), Universidade Estadual de Campinas (Unicamp). METHODS: The participants were all of the 2,194 students who sought counseling/mental health care at SAPPE from 1987 to 2004. Information was obtained from clients’ clinical charts. Unicamp’s database was consulted for general information on its students. RESULTS: The findings indicated overrepresentation, among the clients, of undergraduates, female students, st...

Background: Prevention of depression is a priority to reduce its global disease burden. Targeting specific risk factors, such as rumination, may improve prevention. Rumination-focused Cognitive Behavioral Therapy (RFCBT) was developed to specifically target depressive rumination. Objective: The primary objective of this study was to test whether guided Web-based RFCBT (i-RFCBT) would prevent the incidence of major depression relative to usual care in UK university students. The secondary objective was to test the feasibility and estimated effect sizes of unguided i-RFCBT. Methods: To address the primary objective, a phase III randomized controlled trial was designed and powered to compare high risk university students (N=235), selected with elevated worry/rumination, recruited via an open access website in response to circulars within universities and internet advertisements, randomized to receive either guided i-RFCBT (interactive Web-based RFCBT, supported by asynchronous written Web-based support from qualified therapists) or usual care control. To address the secondary objective, participants were also randomized to an adjunct arm of unguided (self-administered) i-RFCBT. The primary outcome was the onset of a major depressive episode over 15 months, assessed with structured diagnostic interviews at 3 (postintervention), 6, and 15 months post randomization, conducted by telephone, blind to the condition. Secondary outcomes of symptoms of depression and anxiety and levels of worry and rumination were self-assessed through questionnaires at baseline and the same follow-up intervals. Results: Participants were randomized to guided i-RFCBT (n=82), unguided i-RFCBT (n=76), or usual care (n=77). Guided i-RFCBT reduced the risk of depression by 34% relative to usual care (hazard ratio [HR] 0.66, 95% CI 0.35 to 1.25; P=.20). Participants with higher levels of baseline stress benefited most from the intervention (HR 0.43, 95% CI 0.21 to 0.87; P=.02). Significant improvements in rumination, worry, and depressive symptoms were found in the short-to-medium term. Of the 6 modules, guided participants completed a mean of 3.46 modules (SD 2.25), with 46% (38/82) being compliant (completing ≥4 modules). Similar effect sizes and compliance rates were found for unguided i-RFCBT. Conclusions: Guided i-RFCBT can reduce the onset of depression in high-risk young people reporting high levels of worry/rumination and stress. The feasibility study argues for formally testing unguided i-RFCBT for prevention: if the observed effect sizes are robustly replicated in a phase III trial, it has potential as a scalable prevention intervention.

Objective. To determine factors influencing Doctor of Pharmacy (PharmD) students' selection of advanced pharmacy practice experiences (APPEs) in one school of pharmacy. Methods. In their final year, PharmD students are required to complete a minimum of 1440 hours of experiential education, including ambulatory, community, inpatient general medicine, and hospital/ health system APPEs, and elective APPEs. Third-year (P3) and fourth-year (P4) PharmD students were invited to complete an anonymous online survey to determine what factors impacted their decision process when selecting their required experiences. Students selected up to five factors that most influenced their selection of APPEs. Factors included areas of interest, size of institution, location, future employment, preceptor reputation, rotation hours, faculty rotation, non-faculty rotation, peer recommendation, cost/housing, level of difficulty, size of institution, and whether the site offered a residency program. Results. Of the 143 students enrolled, 100% responded to the survey. Students in both classes (71 P3 and 72 P4 students) selected location as the number one factor that influenced their decision when selecting required APPEs. Cost/housing was the second most important factor overall for P3 students, while peer recommendation was the second most important factor overall for P4 students. Conclusion. Location was the driving factor behind P3 and P4 pharmacy students' selection of APPE sites. Schools should consider establishing more APPE sites that offer housing to reduce cost. Further research into the factors that influence ranking on APPE electives is warranted.