Search

ZusammenfassungEine zu geringe Impfbereitschaft zählt zu den größten globalen Gesundheitsgefahren und war in der COVID-19-Pandemie auch in Deutschland eine der großen Herausforderungen der öffentlichen Gesundheit. Die Identifikation potenzieller Einflussfaktoren auf das Impfverhalten ist deshalb für eine zielgruppengerechte Gesundheitskommunikation von großer Bedeutung. Studierende sind eine besonders wichtige Zielgruppe der Prävention und Gesundheitsförderung. Der Beitrag geht mit Hilfe einer Online-Befragung der Studierenden einer westdeutschen Universität (n = 1398) im Sommersemester 2021 den Fragen nach, inwieweit sich geimpfte und ungeimpfte Studierende mit hoher bzw. niedrigerer Impfintention hinsichtlich a) ihrer Medien- und Informationsnutzung und b) ihres Vertrauens in Medien und Informationsquellen in der COVID-19-Pandemie unterschieden. Die Ergebnisse zeigen z. T. deutliche Differenzen. Während geimpfte Studierende sich intensiver informierten und hierfür auch stärker auf klassische Medienangebote zurückgriifen, vertrauten insbesondere ungeimpfte Studierende mit niedrigerer Impfintention u. a. mehr auf alternative Nachrichtenseiten und Blogs.

BackgroundStudents were at an increased risk for elevated mental symptoms during the first year of the COVID-19 pandemic compared to pre-pandemic levels. As universities remained closed much longer than anticipated, the mental burden was expected to persist through the second year of the pandemic. The current study aimed to investigate the prevalence of mental distress from 2019 through 2021 and identify risk factors for elevated mental burden, focusing on gender.MethodsWe analyzed three cross-sectional online surveys among students at the University of Mainz, conducted in 2019 (n = 4,351), 2020 (n = 3,066), and 2021 (n = 1,438). Changes in the prevalence of depressive symptoms, anxiety, suicidal ideation, and loneliness were calculated using Pearson's chi-square tests and analyses of variance. Multiple linear regressions yielded associated risk factors.ResultsThe proportion of students with clinically relevant depressive symptoms was significantly higher during the pandemic (38.9% in 2020, and 40.7% in 2021), compared to pre-pandemic (29.0% in 2019). Similarly, more students reported suicidal ideation and generalized anxiety during the pandemic with a peak in the second pandemic year (2021). The level of loneliness was significantly higher in 2020, compared to 2019, and remained at a high level in 2021 (p < 0.001, ηp2 = 0.142). Female and diverse/open gender, being single, living alone, and being a first-year student were identified as risk factors associated with mental burden during the pandemic.DiscussionMental burdens remained elevated among students through the second year of the pandemic and were associated with socio-demographic risk factors and pandemic-related concerns. Future research should monitor recovery and evaluate the need for psychosocial support.

BackgroundThe present study aimed to (1) assess and compare sedentary time (ST) of university students before and during the COVID-19 pandemic, (2) examine risk groups with regard to ST and the “extent of change” in ST (from before to during the pandemic) in association with sociodemographic (gender, age), study-related (degree aspired to, field of study, semester), and pre-pandemic physical health-related [pre-pandemic physical activity (PA) and ST levels, pre-pandemic BMI class] variables, and (3) investigate whether the change in ST was predicted by these variables.MethodsTwo online surveys were conducted among students at the University of Mainz, Germany—the first in 2019 (before the pandemic) and the second in 2020 (during the pandemic). Participants of both surveys were included in a longitudinal sample. With the longitudinal sample's data, paired t-tests, single factor, and mixed analyses of variances were used to examine group differences in ST and the “extent of change” in ST. A linear regression analysis was computed to investigate the influence of the abovementioned sociodemographic, study-related, and pre-pandemic physical health-related variables on the change in ST.ResultsOf the N = 4,351 (pre-pandemic) and N = 3,066 (in-pandemic) participants of the online surveys, N = 443 entered the longitudinal sample. ST increased by 1.4 h/day to critical levels (≥8 h/day) in all subgroups analyzed—even among students who were highly physically active before the pandemic. Students with a low pre-pandemic ST had the largest increase in ST. Pre-pandemic PA level negatively predicted the change in ST.ConclusionEven during a global pandemic lockdown, individuals who were previously more physically active and had less ST showed more health-promoting behavior in terms of ST. Therefore, it can be stated that efforts to promote PA and reduce ST are always valuable. Since ST increased and was worryingly high in all subgroups analyzed, all university students should be targeted by multidimensional approaches to tackle ST and promote their health.

Zusammenfassung Ziel der Studie Internetsucht ist eine Verhaltensstörung, von welcher v. a. Jugendliche und junge Erwachsene, unter ihnen auch Studierende an Hochschulen betroffen sind. Die COVID-19 Pandemie führte aufgrund der Maßnahmen zu ihrer Eindämmung zu starken Einbußen sozialer Beziehungen, Studium und Freizeitaktivitäten der Studierenden. Diese Studie untersuchte, wie hoch die Prävalenz der Internetsucht unter Studierenden vor und während der COVID-19 Pandemie ausfällt und welche soziodemografischen (Geschlecht, Fachgruppe) und Gesundheitsfaktoren (Depressionssymptome, Einsamkeit, Ängste, Impulsivität) mit Internetsuchtsymptomen assoziiert sind. Methodik In der vorliegenden Studie nahmen 2 Stichproben der Studierenden der Johannes Gutenberg-Universität Mainz im Sommer 2019 (N=4351) vor und im Sommer 2020 (N=3066) während der COVID-19 Pandemie im Rahmen des Modellvorhabens „Healthy Campus Mainz-gesund studieren“ zur Prävention und Gesundheitsförderung zu verschiedenen Gesundheitsthemen und Studienbedingungen an Online-Umfragen teil. Es wurde die Prävalenz von Internetsucht erhoben und mittels logistischer Regression Zusammenhänge mit Geschlecht, Depressionssymptomen, Einsamkeit, Ängsten und Impulsivität analysiert. Ergebnisse Die Prävalenz der Internetsucht lag 2019 bei 3,9% und lag 2020 signifikant höher bei 7,8%. Während 2019 männliches Geschlecht noch mit Internetsucht assoziiert war (OR2019=0,685, p Schlussfolgerung Studierende stellen eine gefährdete Gruppe für Internetsucht dar. Während der COVID-19 Pandemie trat die Symptomatik deutlich häufiger auf als noch ein Jahr zuvor. Es müssen unbedingt geeignete Präventions- und Interventionsangebote für Studierende implementiert werden, die sowohl Internetsucht, aber auch damit einhergehende Probleme wie Depression und Einsamkeit in den Blick nehmen.

BackgroundPhysical inactivity and sedentary behavior are modifiable risk factors for an unhealthy lifestyle in university students. The aim of this study was to identify subgroups among German university students with an increased risk for unhealthy behavior. For this purpose, differences in physical activity and sedentary behavior with respect to sociodemographic and study related factors were examined.MethodsA total of 4,351 students participated in an online survey. The amount of physical activity (metabolic equivalent of task-min/week) and the sitting time (h/day) were assessed using the German short form of the International Physical Activity Questionnaire. Differences in gender and age as well as field of study, targeted degree and study semester were analyzed using a single factorial ANOVA with Tukey correction or a Welch-ANOVA with Games-Howell correction.ResultsFor physical activity, significant differences were found for gender (F(2, 80.46) = 17.79, p < 0.001, ηp2 = 0.009), for field of study (F(5, 1738.09) = 7.41, p < 0.001, ηp2 = 0.01), and for study semester (F(1, 948.12) = 5.53, p < 0.05, ηp2 =0.001), but not for age and targeted degree (p > 0.05). For sedentary behavior, significant differences were found for field of study (F(5, 3816) = 5.69, p < 0.001, ηp2 = 0.01) and targeted degree (F(3, 3868) = 3.94, p < 0.01, ηp2 = 0.003), but not for gender, age and study semester (p > 0.05).ConclusionFemale students, students enrolled in “natural sciences, mathematics and informatics” and first year students appear to have an increased risk of an unhealthy lifestyle. Future research should identify barriers to and incentives of physical activity as well as reasons for high amounts of SB in sub-populations of university students. Suitable prevention and intervention programs are necessary.

Vaccination hesitancy has been a major challenge for health authorities and societies during the COVID-19 pandemic. The general determinants of vaccination intentions and behavior include sociodemographic and health-related, psychological, and communication-related factors, with varying relevance for different types of vaccinations, countries, and target groups. The predictors of university students’ COVID-19 vaccination behavior have not been sufficiently studied. Using a German university as an example and based on an online survey of 1398 university students, we investigated factors related to (a) the likelihood of vaccination against COVID-19 and (b) vaccination intention among those who had not been vaccinated by summer of 2021. Psychological factors showed high relevance. Field of study, trust in, and use of certain media and information channels were found to be important determinants of students’ vaccination decision. Our findings can help better understand university students’ vaccination behavior to develop and implement tailored strategies and campaigns.

BackgroundAccording to the literature, the conditions of studying and living as well as the psychological, social and health behavior-related variables, which were strongly related to pharmacological neuroenhancement (PN) before the pandemic, significantly changed during the pandemic. For this reason, it is expected that the prevalence of PN among university students is higher during the pandemic compared to before the pandemic. Therefore, the present study aimed to investigate and compare the prevalence of PN among university students before and during the COVID-19-pandemic.MethodsThree online surveys assessing the 12-month prevalence of PN were conducted among university students at the University of Mainz, Germany. The first survey took place in summer term 2019 (before the pandemic), the second in summer term 2020 (during the first German lockdown), and the third in summer term 2021 (after the second German lockdown). Pearson's chi-square test was used to test whether the 12-month prevalence of PN differed significantly between the three surveys.ResultsThe 12-month prevalence of PN was 10.4% in 2019, 11.3% in 2020, and 8.0% in 2021. Chi-square tests revealed no statistical difference in the prevalence of PN between 2019 and 2020. Overall, the use of PN was lower in 2021 compared to 2019 (p < 0.0001) as well as in comparison to 2020 (p = 0.001). Only the use of cannabis slightly increased from 2019 to 2020 (7.1 vs. 8.3%) and decreased in 2021 (5.4%). At all three time points, cannabis was the most commonly used substance for the purpose of PN. Consequently, the results suggest that the prevalence of PN was highly intertwined with the prevalence of cannabis use for PN.DiscussionThe decrease in the prevalence of PN of around three percentage points in 2021 compared to the previous years was a surprising finding. It may be mainly due to the decrease in the prevalence of cannabis for the purpose of PN. However, the fairly high prevalence of PN of around 8% in 2021 is still an important finding that demonstrates that there is still an urgent need for prevention initiatives among university students to combat the use of PN.

Aiming to develop and implement intervention strategies targeting pharmacological neuroenhancement (PN) among university students more specifically, we i) assessed the prevalence of PN among German university students, ii) identified potential sociodemographic and study-related risk groups, and iii), investigated sociodemographic, psychological, study-related psychosocial, general psychosocial and health behavior related factors predicting the 12-month prevalence of PN. Therefore, a cross-sectional online survey was administered to all students of the University of Mainz, Germany. A binary logistic regression with stepwise inclusion of the five variable groups was performed to predict PN.A total of N = 4,351 students participated in the survey of which N = 3,984 answered the question with regard to PN. Of these, 10.4% had used one substance for PN at least once in the past 12 months. The regression revealed 13 variables that were significantly related to the 12-month prevalence of PN.Specifically, the group of health behavior variables had the strongest influence on the explained variance of PN. Therefore, an approach to the prevention of PN should be multifactorial so that it addresses social conditions, as well as education on substance use and healthy behaviors in terms of non-pharmacological strategies as alternatives of PN.

Aiming to develop and implement intervention strategies targeting pharmacological neuroenhancement (PN) among university students more specifically, we (1) assessed the prevalence of PN among German university students, (2) identified potential sociodemographic and study-related risk groups, and (3) investigated sociodemographic, psychological, study-related psychosocial, general psychosocial and health behavior related factors predicting the 12-month prevalence of PN. Therefore, a cross-sectional online survey was administered to students of the University of Mainz, Germany. A binary logistic regression with stepwise inclusion of the five variable groups was performed to predict PN. A total number of 4351 students out of 31,213 registered students (13.9%) participated in the survey, of whichN = 3984 answered the question concerning PN. Of these, 10.4% had used one substance for PN at least once in the past 12 months. The regression analysis revealed 13 variables that were significantly related to the 12-month prevalence of PN. Specifically, the group of health behavior related variables showed the strongest relationship with PN. Therefore, an approach to the prevention of PN should be multifactorial so that it addresses social conditions, as well as education on substance use and healthy behaviors in terms of non-pharmacological strategies as alternatives of PN.

The COVID-19 pandemic led to a shutdown of universities in Germany. In a longitudinal design, we compared mental health (depression, anxiety, somatic complaints) of university students in Germany before (June to August 2019) and in the course of the COVID-19 pandemic (June 2020) and determined the impact of pandemic-related stress and loneliness on students’ mental health in self-report online surveys. We investigated 443 participants (mean age 22.8 years), among them 77% female, and 10.4% medical students. A small increase of depression mean scores was observed (F(1,420) = 5.21; p = .023), anxiety and somatic complaints have not significantly changed. There was a medium increase in loneliness from pre-pandemic scores to the pandemic situation (F(1,423) = 30.56; p

The immunosuppressive medications used in organ transplant recipients (OTRs) to prevent allograft rejection are associated with an increased incidence of skin cancer in this population. Several classes of immunosuppressive agents exist, and the selection of which medication to use varies by organ type and with time. The tumorigenic potential and relative effects of different immunosuppressive medications on skin cancer risk have been studied. This article reviewed the history of the immunosuppressive agents and their mechanisms of action. A summary of the current literature on the relationship between skin cancer and the different immunosuppressives were included. Guidelines for management of OTRs in dermatologic practice were discussed.

Objectives To assess how the surgical skills of residents are taught and evaluated within dermatology residency programs in the United States; to assess which surgical techniques training directors and residents consider important for residents to perform or at least understand by the end of residency training. Methods A 126-question survey was sent to all 106 of the US dermatology residency programs accredited by the Accreditation Council for Graduate Medical Education. Contact was initially made via e-mail. Surveys were addressed to the program director, surgical training director, and chief resident of each program. A follow-up survey was mailed to nonresponders. Results Ninety-five surveys were returned representing 71 (67%) of 106 programs. Eighty-nine percent of programs (n=63) reported having a formal curriculum in dermatologic surgery. Among programs represented, 97% (n=69) taught surgical skills in the procedure room, 84% (n=57) used pigs’ feet, and fewer than 10% (n=6) used human cadavers. Ninety-four percent of programs (n=61) scheduled surgical lectures; two thirds (n=41) formally assigned surgical reading, and over half (n=36) used Web-based lectures to teach skills. To assess training, most programs (86%; n=50) used subjective global evaluation at the end of a surgery rotation. Fewer than 30% (n=15) discussed specific objectives prior to the rotation. Only about 25% of programs (n=17) reported the use of written or oral examinations to assess resident surgery skills. Traditional biopsy and simple surgical procedures were reported as most important to know and perform. Interest by both faculty members and residents in more advanced surgical techniques was more limited and variable. Cosmetic surgery techniques were most likely to be viewed as unimportant. Conclusions Most dermatology programs teach surgical skills by traditional apprenticeship methods supplemented by work in pigs’ feet laboratory classes and regularly scheduled lectures. Skill assessment is mainly done through subjective means. Almost all respondents thought that basic biopsy and excisional skills were essential for residents to know and perform. More complex surgical techniques and the use of lasers were considered less important. Cosmetic techniques were those most frequently viewed as unimportant.

Importance Detailed information regarding perioperative risk and adverse events associated with Mohs micrographic surgery (MMS) can guide clinical management. Much of the data regarding complications of MMS are anecdotal or report findings from single centers or single events. Objectives To quantify adverse events associated with MMS and detect differences relevant to safety. Design, Setting, and Participants Multicenter prospective inception cohort study of 21 private and 2 institutional US ambulatory referral centers for MMS. Participants were a consecutive sample of patients presenting with MMS for 35 weeks at each center, with staggered start times. Exposure Mohs micrographic surgery. Main Outcomes and Measures Intraoperative and postoperative minor and serious adverse events. Results Among 20 821 MMS procedures, 149 adverse events (0.72%), including 4 serious events (0.02%), and no deaths were reported. Common adverse events reported were infections (61.1%), dehiscence and partial or full necrosis (20.1%), and bleeding and hematoma (15.4%). Most bleeding and wound-healing complications occurred in patients receiving anticoagulation therapy. Use of some antiseptics and antibiotics and sterile gloves during MMS were associated with modest reduction of risk for adverse events. Conclusions and Relevance Mohs micrographic surgery is safe, with a very low rate of adverse events, an exceedingly low rate of serious adverse events, and an undetectable mortality rate. Common complications include infections, followed by impaired wound healing and bleeding. Bleeding and wound-healing issues are often associated with preexisting anticoagulation therapy, which is nonetheless managed safely during MMS. We are not certain whether the small effects seen with the use of sterile gloves and antiseptics and antibiotics are clinically significant and whether wide-scale practice changes would be cost-effective given the small risk reductions.