Resilience and social support as protective factors against suicidal ideation among tertiary students during COVID-19: a cross-sectional study.

BACKGROUND: Suicidal ideation is a depression symptom which represents a key (cognitive) component of suicidality and plays an important role in suicide risk detection, intervention, and prevention. Despite existing research showing the importance of certain factors of depression symptoms and suicidal ideation, less is known about the interaction between the various risk and protective factors. The aim of the study was to examine whether living conditions characteristics and personal circumstances during the COVID-19 pandemic predicted the presence of depression symptoms and suicidal ideation among tertiary students and whether resilience and social support can mitigate the detrimental effects of difficult life circumstances. METHOD: A large online cross-sectional study was conducted in March 2021 among 4,645 Slovenian tertiary students. Hierarchical multiple regression and hierarchical logistic regression methods were used to assess and compare the effect of life circumstances variables, as opposed to resilience and social support, on depression symptoms and suicidal ideation. RESULTS: Female gender, single relationship status, living alone, a higher degree of household conflict, having a history of mental illness and chronic disease diagnosis were significant predictors of depression scores. All but gender were also predictors of suicidal ideation. Household conflict and a history of mental illness were the factors showing the strongest effect in both cases. On the other hand, social support and, in particular, resilience proved to be strong protective factors against depression symptoms and suicidal ideation. After accounting for one's resilience and social support, the explained variance in depression scores was more than doubled, while the harmful effect of household conflict and history of mental illness significantly decreased. CONCLUSIONS: The findings stress the importance of one's resilience and social support and explain why some people manage to maintain mental well-being despite finding themselves in difficult life circumstances, which was the case for many tertiary students during the COVID-19 pandemic. These insights may inform preventive efforts against developing suicidal ideation and may be used as support for the design and implementation of interventions for improving resilience and social support from childhood onward.

Three measures of internet use, social media use and video game playing as predictors of insomnia during the pandemic among students.

Existing research indicates that the relationship between digital technology use and insomnia can largely depend on which digital technology measure and which insomnia measure is considered. Data on 4261 Slovenian tertiary students was gathered through an online survey in February 2021, which included measures of depression and insomnia symptoms, as well as measures of internet, social media and video game use divided into three measurement levels (use, duration of use, addictive use). Regression analysis revealed an apparent effect of measurement level, where addictive use measures consistently outperformed other technology use measures in predicting insomnia. Regardless of measurement level, social media use seems to produce more risk for insomnia, compared to playing video games or general internet use for leisure purposes. Importantly, a single measure of depression symptoms explained more variance in insomnia than the nine measures of digital technology use combined, meaning that the effect of digital technology on sleep should not be overstated. Most of the effect of social media use on insomnia may in fact be explained by understanding users' depression symptoms. In case of gaming, a larger part of its effect on insomnia is independent of depression symptoms.

Ensuring Corporate Security and Its Strategic Communication in Healthcare Institutions in Slovenia.

Ensuring corporate security is an essential and critical component of any healthcare facility to provide safe services to its patients and employees. Healthcare facilities must employ a variety of strategies to ensure corporate security. This includes developing a comprehensive communication plan that defines the roles and responsibilities of the various stakeholders. The objective of our study was to present the concept of corporate security in healthcare institutions and in the Slovenian healthcare system, to highlight current threats in healthcare institutions in Slovenia, to describe the importance of strategic communication of corporate security in healthcare, and finally to define the current state of corporate security in Slovenian healthcare institutions in Slovenia. A survey was conducted and distributed to healthcare institutions in Slovenia to obtain results. A total of 154 healthcare stakeholders participated in our study. The results showed that corporate security is present in Slovenian healthcare facilities, but additional efforts are needed to improve it, especially considering the current challenges related to the measures taken after the COVID-19 epidemic and the shortage of healthcare personnel. The legal processes of corporate security in healthcare facilities comply with applicable laws and regulations to protect the interests of their patients and employees. Operational security processes are currently provided primarily by internal providers. There is a need for improvement, particularly in the training and education of staff, who play the most important role in ensuring safety. To effectively establish comprehensive corporate security, strategic communication with all stakeholders is essential to ensure that their security policies and procedures are properly implemented.

Is Trust in Information Sources Associated with Drug Use? A Population-Based Study.

Aim: Communication and information sources can play an important role when addressing drug use. The aim of this study is to assess the association of different levels of trust in information sources regarding drug use within different population groups. Methods: Data was gathered using a mixed methods approach, with an online survey and interviews. A structured questionnaire was designed for data collection using the methodology of the European Monitoring Centre for Drugs and Drug Addiction, with additional items measuring trust in the information sources. Results: In total 9,161 inhabitants of Slovenia aged 15-64 years and living in the private households completed the survey as part of this non-experimental quantitative study (response rate: 57%). A total of 20.7% of the participants reported having used cannabis or hashish at least once in their lives, 2.5% cocaine/crack cocaine and 0.4% heroin. Mean age of the first cannabis/hashish use was 19.59 years, cocaine/crack cocaine 22.73 years and heroin 20.63 years. The participants most value and trust the information sources regarding tobacco, alcohol and illicit drugs if it comes from healthcare workers or immediate family and other relatives, and put the least trust in the internet and television. Conclusions: The data show that drug users have less trust in the given information sources compared to the whole sample. The present research serves as evidence for development and implementation of targeted interventions, including communication activities and tools.

The influence of anxiety and fear of COVID-19 on vaccination hesitancy among postsecondary students.

The aim of the present study was to explore the influence of anxiety and fear of COVID-19 on vaccination hesitancy among Slovenian postsecondary students. A cross-sectional study using a set of previously tested instruments and ad hoc questions created by the authors was chosen as the method to gain insight into various health and sociodemographic aspects of Slovenian postsecondary students affected by the COVID-19-induced closures and suspensions of educational activities at tertiary educational institutions (N = 5999). Overall, 39.7% of participating students expressed an intention to get vaccinated at the first possible opportunity, whereas 29.2% expressed no intent to do so. The highest vaccine hesitancy was observed among prospective teachers (50.3%) and the lowest among prospective physicians (5,7%). When examining the role of anxiety and fear of COVID-19 on the Slovenian postsecondary students' intentions to get vaccinated the results of logistic regression showed that only fear of COVID-19 played a mild and significant role.

The Protective Role of Resilience in the Development of Social Media Addiction in Tertiary Students and Psychometric Properties of the Slovenian Bergen Social Media Addiction Scale (BSMAS).

With the onset of the COVID-19 pandemic, social media became one of the most utilized sources of information relating to the disease. With the increased reliance on social media, the risk of excessive use and the development of social media addiction emerges. The aim of the present study was to explore the psychometric properties of the Slovenian version of the Bergen Social Media Addiction Scale, and to explore how psychological resilience affects social media addiction symptoms directly and indirectly through symptoms of depression, anxiety and mental distress. A large online cross-sectional study was conducted in March 2021 among Slovenian tertiary students (N = 4868). The results showed the high reliability, unidimensionality and criterion validity of the Slovenian Bergen Social Media Addiction Scale. The proposed structural model fit the data well and showed a significant direct positive effect of depression and stress on social media addiction. Moreover, the majority of the negative effects of psychological resilience on social media addiction (87.2%) were indirect, through depression and stress symptoms, whereas resilience had a significantly smaller impact on social media addiction by reducing anxiety symptoms. The overall prevalence of social media addiction symptoms was 4.6%, with females exhibiting higher proportions than men. Additionally, female social media users reported a complete absence of social media addiction symptoms less often compared to males. Future research should further explore the mechanisms behind social media addiction, in order to gain a better understanding of the apparently different risk levels for both genders.

Compliance with Preventive Measures and COVID-19 Vaccination Intention among Medical and Other Healthcare Students.

INTRODUCTION: The purpose of this study is to evaluate compliance with preventive measures and COVID-19 vaccination acceptance among Slovenian students of healthcare and medicine, identify the predictive socio-demographic factors, establish the possible causes, and propose vaccination strategies and programs in response to the findings. METHODS: Data were collected using an online survey as part of a large cross-sectional study of full-time students engaged in higher-level study. The survey took place between 9 February and 8 March 2021. RESULTS: A total of 56.3% of medical and other healthcare students surveyed expressed their intention to receive the vaccine at the earliest opportunity, 22.4% said that they would do so at a later date and 21.3% said that they did not intend to get vaccinated. The medical students surveyed showed a greater readiness to get vaccinated at the earliest opportunity than those studying other healthcare disciplines, men more than women, and single persons more than those in a relationship. Students attending a vocational college, professional higher education or university study program (Bologna first cycle) showed less readiness than other students to get vaccinated as soon as they were able. CONCLUSION: Our research found that 56.3% of those studying health-related subjects intended to get vaccinated at the earliest opportunity. There were significant differences between medical and other healthcare students, as well as differences resulting from the level of higher education study being undertaken. In addition, the conclusions show that there needs to be a strengthening of communication with students regarding COVID-19 and the importance of vaccination. Lessons that we learned in this pandemic should prepare us for the future. Clearer and more effective communication and education in the future regarding the importance of vaccination is the most effective way of preventing communicable diseases.

Perceived Satisfaction with Online Study during COVID-19 Lockdown Correlates Positively with Resilience and Negatively with Anxiety, Depression, and Stress among Slovenian Postsecondary Students.

BACKGROUND: The purpose of this study is to fill the research gap regarding the influence of satisfaction with distance learning on the correlates of mental health during the COVID-19 pandemic. METHODS: An online cross-sectional study was conducted in February and March 2021, involving 4661 postsecondary students. Five validated instruments-PHQ-9 (depression), GAD-7 (anxiety), PSS-4 (stress), CD-RISC-10 (resilience) and SAT-5 (satisfaction with online study)-were used in the present study. FINDINGS: The correlations between anxiety, depression, and stress were so high that they were almost inextricably linked. Both satisfaction with online learning and psychological resilience were negatively correlated with anxiety, depression, and stress. Satisfaction with online learning was also negatively correlated with psychological resilience. Females showed higher levels of vulnerability to anxiety, depression, and stress, and exhibited lower levels of psychological resilience than males. CONCLUSION: Home-based distance-learning during the COVID-19-induced lockdown had a significant impact on students' mental health. Low satisfaction with distance learning can lead to the development of anxiety and depression symptoms, increase stress, and decrease the psychological resilience of postsecondary students; therefore, it is critical that educational institutions focus on implementing interventions that promote students' satisfaction with distance learning, and their psychological resilience, to protect their mental health.

Influence of Forced Online Distance Education During the COVID-19 Pandemic on the Perceived Stress of Postsecondary Students: Cross-sectional Study.

BACKGROUND: One of the most significant changes in the majority of postsecondary educational institutions was the closure of those institutions and the shift of educational activities to online distance learning formats as a result of the COVID-19 pandemic. Closure combined with forced online distance education (FODE) was a cure with many side effects, 1 of them being the effect on students' mental health and, more specifically, levels of stress. Due to the novelty of the situation, there have been no studies so far designed to link satisfaction with online study, feelings toward the study obligations, and stress among students. OBJECTIVE: The aim of the study is to assess the perceived stress of Slovenian postsecondary students in order to identify the online study-related factors affecting or acting as a covariate during the COVID-19 lockdown. METHODS: Data collection was conducted through a self-reported survey as part of a large cross-sectional study based on data collected from postsecondary students from a number of higher educational institutions. The random sample consisted of 4455 individuals. The Perceived Stress Scale (PSS-4), Satisfaction with Online Study Scale (SAT-5), and Feelings Towards Study Obligations Scale (FETSOS) were used to assess the constructs and the relations observed within the study. RESULTS: The results indicate that more than half of all respondents reported high levels of stress. The difference in the reported levels of perceived stress between genders were statistically significant (N=4454, F2=56.719, P<.001, Cohen d=0.35). Overall, the results suggest that a decline in the motivation to study, the quality of internet and mobile connections, and the presence of distracting factors in the study space were the 3 main factors related to the students' negative emotions as associated with the timeliness, performance, and quality of the study obligations. Furthermore, the results show that the level of satisfaction with online study affected stress such that the higher the satisfaction, the lower the stress. Moreover, the more positive feelings connected with the timeliness, performance, and quality of the study obligations that the students felt, the more satisfaction they reported with online study and, thus indirectly, lower stress and less negative feelings. CONCLUSIONS: The findings of this study call for implementing structures and measures targeted at stress reduction, working conditions, and pedagogy with regard to FODE.

PREDICTORS OF SEXUAL SATISFACTION: AN INTERNATIONAL STUDY.

The aim of this cross-cultural study was to examine predictors of sexual satisfaction. For the present analysis, we used a large-scale sample database that included 8821 individuals from 4 countries. All participants completed the same questionnaires, which were designed to capture numerous important variables that have been shown to correlate with sexual satisfaction. According to our results, predictors of sexual satisfaction were classified into four general categories (demographic factors, psychological factors, sociocultural factors, and pathophysiological factors). Our international study found statistically significantly higher satisfaction among homosexual participants, participants aged 18 to 23 years, those with a higher level of education, in a relationship, with a current sexual partner, in a current partnered (unmarried) relationship, and without a diagnosed sexual or mental disorder. At the same time, we found that the correlation between sexual satisfaction and the different predictors varieed considerably across countries, which calls for further research.

Public opinion on the eligibility of health care for migrants and refugees in Slovenia.

BACKGROUND: Worldwide, more than 200 million people have left their home country, and international migration from the Middle East to Europe is increasing. The journey and the poor living conditions cause numerous health problems. Migrants show significant differences in lifestyle, health beliefs and risk factors compared with native populations and this can impact access to health systems and participation in prevention programmes. AIMS: Our aim was to measure the attitude of survey participants to migrants and to define up to what level migrants are entitled to health care from the viewpoint of Slovenian citizens. METHODS: This survey was carried out in January 2019 and included 311 respondents. We applied a quantitative, nonexperimental sampling method. We used a structured survey questionnaire based on an overview, a national survey on the experiences of patients in hospitals and user satisfaction with medical services of basic health care at the primary level. RESULTS: A large proportion of the respondents agreed that migrants should receive emergency or full health care provision, that there is no need to limit their health rights and that they do not feel that their own rights are compromised by the rights of migrants. Over 80% agreed with health protection for women and for children. CONCLUSION: The findings offer a basis for supplementing the existing, or designing a new, model of health care provision for migrants in Slovenia, focusing on the provision of health protection and care as a fundamental human right.

Need for comprehensive management of frailty at an individual level: European perspective from the advantage joint action on frailty.

OBJECTIVES: ADVANTAGE Joint Action is a large collaborative project co-founded by the European Commission and its Member States to build a common understanding of frailty for Member States on which to base a common management approach for older people who are frail or at risk of developing frailty. One of the key objectives of the project is presented in this paper; how to manage frailty at the individual level. METHODS: A systematic review of the literature was conducted, including grey literature and good practices when possible. RESULTS: The management of frailty should be directed towards comprehensive and holistic treatment in multiple and related fields. Prevention requires a multifaceted approach addressing factors that have resonance across the individual's life course. Comprehensive geriatric assessment to diagnose the condition and plan a personalized multidomain treatment increases better outcomes. Multicomponent exercise programmes, adequate protein and vitamin D intake, when insufficient, and reduction in polypharmacy and inadequate prescription, are the most effective strategies found in the literature to manage frailty effectively. CONCLUSION: Frailty can be effectively prevented and managed with a multidomain intervention strategy based on comprehensive geriatric assessment.

European Collaborative and Interprofessional Capability Framework for Prevention and Management of Frailty-a consensus process supported by the Joint Action for Frailty Prevention (ADVANTAGE) and the European Geriatric Medicine Society (EuGMS).

BACKGROUND: Interprofessional collaborative practice (ICP) is currently recommended for the delivery of high-quality integrated care for older people. Frailty prevention and management are key elements to be tackled on a multi-professional level. AIM: This study aims to develop a consensus-based European multi-professional capability framework for frailty prevention and management. METHODS: Using a modified Delphi technique, a consensus-based framework of knowledge, skills and attitudes for all professions involved in the care pathway of older people was developed within two consultation rounds. The template for the process was derived from competency frameworks collected in a comprehensive approach from EU-funded projects of the European Commission (EC) supported best practice models for health workforce development. RESULTS: The agreed framework consists of 25 items structured in 4 domains of capabilities. Content covers the understanding about frailty, skills for screening and assessment as well as management procedures for every profession involved. The majority of items focused on interprofessional collaboration, communication and person-centred care planning. DISCUSSION: This framework facilitates clarification of professionals' roles and standardizes procedures for cross-sectional care processes. Despite a lack of evidence for educational interventions, health workforce development remains an important aspect of quality assurance in health care systems. CONCLUSIONS: The multi-professional capability framework for frailty prevention and management incorporated interprofessional collaborative practice, consistent with current recommendations by the World Health Organization, Science Advice for Policy by European Academies and the European Commission.

Management of Frailty at Individual Level: Narrative Review of Physical Activity from the European Perspective of Joint Action on Frailty - JA Advantage.

INTRODUCTION: This paper aimed to review the effect of physical activity and exercise in frail older persons. As the process which leads to frailty and disability can be slowed down or even completely reversed, it can be appropriate for early interventions. METHODOLOGY: A literature search was conducted in the following databases: PubMed, Cochrane, Embase, Cinahl and UpToDate. The criterion in selecting the literature was that articles were published from 2002 to 2017. From 620,043 initial hits, 25 publications were selected. RESULTS: Physical activity and exercise in frail elderly are effective and relatively safe and may reverse frailty. CONCLUSION: Different exercise interventions in frail elderly persons can increase strength and power, improve balance and reduce fall incidence resulting in greater quality of life. From this perspective, physical exercise interventions should become daily routine in frail elderly persons.

Non-Medical Use of Novel Synthetic Opioids: A New Challenge to Public Health.

Background: In the last decade there has been a progressive increase in the use of new psychoactive substances (NPSs) that are not yet under international control. In particular, novel synthetic opioids (NSOs) have reappeared on the recreational drug market in the last few years. As a result, the use of NSOs has increased rapidly. This poses an emerging and demanding challenge to public health. Aim: To raise awareness among clinicians and other professionals about NPSs, especially NSOs, to summarize current knowledge about pharmacological properties, forms of NSO on the market, pattern of use, effects and consequences of use. Methods: An electronic search was carried out on the Medline/PubMed and Google Scholar databases to find selected search terms. Results: Some NPSs are already controlled, while others can be legally sold directly on the drug market (mainly via internet, less so by drug dealers) or be used as precursors for the synthesis of other designer drugs that mimic the psychoactive effects of controlled substances. Potential side-effects of NSOs include miosis, sedation, respiratory depression, hypothermia, inhibition of gastrointestinal propulsion, death (from opioid overdose). Conclusions: The severity of the opioid crisis has intensified with the introduction of highly potent NSOs on the drug market. As long as addicts are dying from overdose or similar causes, there is something more constructive to do than waiting for addicts to overdose on heroin at a place located near a remedy, as if to say, within reach of naloxone.

The role of nutrition in ageing: A narrative review from the perspective of the European joint action on frailty - ADVANTAGE JA.

BACKGROUND AND PURPOSE: There is sufficient evidence that nutrition and frailty status are related. In order to deliver quality management of frail and pre-frail patients, clinicians and dieticians should understand the role of nutrition in the concept of frailty. This study examines the role of nutrition in ageing in general, malnutrition and the risk of frailty, individual nutritional factors as the risk factors of frailty and lastly nutritional interventions that have a significant role in frailty. METHODS: A literature search was conducted in the following databases: PubMed, Cochrane, Embase, Cinahl and UpToDate. The criterion in selecting the literature was that articles were published between 2002 and 2017. From 39,885 initial hits, 28 publications were selected. RESULTS: Malnutrition or being at risk of malnutrition increases the risk of frailty and its consequences. With regard to the importance of recognizing malnutrition and the risk of malnutrition, the Mini Nutritional Assessment is a validated tool with acceptable sensitivity/specificity to be used for screening and assessment. Frail patients who are at an elevated risk of falls and fractures need Vitamin D supplementation. The promotion of a Mediterranean diet and a protein intake of at least 1-1.2 g per kilogram of body weight per day is beneficial. CONCLUSIONS: One of the main variable risk factors for the development of frailty can be unsuitable nourishment and there is evidence that nutrition and frailty status are related. Successful comprehensive management of frailty requires a balanced healthy nutrition at all ages, preferably in combination with physical activity.

Management of Frailty at Individual Level - Clinical Management: Systematic Literature Review.

INTRODUCTION: To deliver quality management of a frail individual, a clinician should understand the concept of frailty, be aware of its epidemiology and be able to screen for frailty and assess it when it is present, and, finally, to recommend successful interventions. METHODOLOGY: A systematic literature search was conducted in the following databases: PubMed, Cochrane, Embase, Cinahl and UpToDate. The criterion in selecting the literature was that articles were published in the period from 2002 to 2017. From 67432 initial hits, 27 publications were selected. RESULTS: Useful interventions to address frailty are supplementation of vitamin D, proper nutrition, multicomponent training, home-based physiotherapy and comprehensive geriatric assessment, particularly when performed in geriatric wards. CONCLUSION: Comprehensive geriatric assessment is an effective way to decrease frailty status especially when performed in geriatric wards. Multicomponent physical training and multidimensional interventions (physical training, nutrition, vitamin D supplementation and cognitive training) are effective measures to reduce frailty.

Prevalence of Violence Toward Community Nurses: A Questionnaire Survey.

Violence toward nursing staff occurs frequently, particularly in intensive care units and closed or intensive psychiatric facilities, which have been studied previously. However, violence toward community nurses has not been investigated. The purpose of this study was to explore the frequency of violence toward community nurses in Slovenia. More than 56% of study respondents were verbally abused by their patients during the past year. More than 42% of all cases of horizontal violence were directed at community nurses.

Prevalence of violence towards nursing staff in Slovenian nursing homes.

INTRODUCTION: The purpose of this research was to identify the prevalence of violence towards nursing staff in Slovenian nursing homes. METHODS: For the purpose of this study, a non-experimental sampling method was employed, using a structured questionnaire as a data collection instrument (n=527). The contents of the questionnaire proved valid and reliable, with a high enough degree of internal consistency (Cronbach Alpha minimum 0.82). RESULTS: The nursing staffs working in nursing homes for senior citizens are at high risk of violence. In the last year, the employees were most often faced with verbal violence (71.7%), physical violence (63.8%) and sexual violence (35.5%). 35.5% of employees suffered injuries at their working place. During aggressive outbursts of nursing home residents, employees particularly experience vulnerability, fear and insecurity. CONCLUSION: There is a need for a comprehensive approach to tackle workplace violence. Some psychiatric health care facilities have already introduced certain measures in this field, and reduction of workplace violence proves that it is possible to reduce aggressive outbursts of patients. After conducting further quantitative research, which would expose detailed characteristics and the background of such violence, it would be sensible to develop similar measures in the field of health care in nursing homes.