Depression and suicide ideation among students accessing campus health care.

Depression and suicide are of increasing concern on college campuses. This article presents data from the College Health Intervention Projects on the frequency of depression and suicide ideation among 1,622 college students who accessed primary care services in 4 university clinics in the Midwest, Northwest, and Canada. Students completed the Beck Depression Inventory and other measures related to exercise patterns, alcohol use, sensation seeking, and violence. The frequency of depression was similar for men (25%) and women (26%). Thought of suicide was higher for men (13%) than women (10%). Tobacco use, emotional abuse, and unwanted sexual encounters were all associated with screening positive for depression. "Days of exercise per week" was inversely associated with screening positive for depression. Because the majority of students access campus-based student health centers, medical providers can serve a key role in early identification and intervention. With every 4th student reporting symptoms of depression and every 10th student having suicidal thoughts, such interventions are needed.

Condom use in heavy drinking college students: the importance of always using condoms.

OBJECTIVE: The authors examined whether alcohol use decreased condom use. PARTICIPANTS: The subjects were heavy-drinking students on 5 different college campuses. METHODS: A face-to-face interview, administered between November of 2004 and February of 2007, gathered information about condom use, alcohol use, and other behaviors. Multivariate logistic regression was used to assess predictors of condom use. RESULTS: Of the 1715 participants, 64% reported that they did not always use condoms. Male students who drank heavily were less likely to always use condoms (adjusted odds ratio [AOR] 0.61). Participants with more sexual partners used condoms less when drinking (AOR 1.93 for men, 1.45 for women). CONCLUSIONS: Many students do not use condoms consistently, especially those who drink heavily or have multiple sexual partners. Clinicians at student health need to encourage all students to use condoms every time they have intercourse.

Sufficiently important difference for common cold: severity reduction.

PURPOSE: We undertook a study to estimate the sufficiently important difference (SID) for the common cold. The SID is the smallest benefit that an intervention would require to justify costs and risks. METHODS: Benefit-harm tradeoff interviews (in-person and telephone) assessed SID in terms of overall severity reduction using evidence-based simple-language scenarios for 4 common cold treatments: vitamin C, the herbal medicine echinacea, zinc lozenges, and the unlicensed antiviral pleconaril. RESULTS: Response patterns to the 4 scenarios in the telephone and in-person samples were not statistically distinguishable and were merged for most analyses. The scenario based on vitamin C led to a mean SID of 25% (95% confidence interval [CI] 0.23-0.27). For the echinacea-based scenario, mean SID was 32% (95% CI, 0.30-0.34). For the zinc-based scenario, mean SID was 47% (95% CI, 0.43-0.51). The scenario based on preliminary antiviral trials provided a mean SID of 57% (95% CI, 0.53-0.61). Multivariate analyses suggested that (1) between-scenario differences were substantive and reproducible in the 2 samples, (2) presence or severity of illness did not predict SID, and (3) SID was not influenced by age, sex, tobacco use, ethnicity, income, or education. Despite consistencies supporting the model and methods, response patterns were diverse, with wide spreads of individual SID values within and among treatment scenarios. CONCLUSIONS: Depending on treatment specifics, people want an on-average 25% to 57% reduction in overall illness severity to justify costs and risks of popular cold treatments. Randomized trial evidence does not support benefits this large. This model and these methods should be further developed for use in other disease entities.