Alcohol Drinking in University Students Matters for Their Self-Rated Health Status: A Cross-sectional Study in Three European Countries.

BACKGROUND: Alcohol drinking was linked to self-rated health in different populations, but the observed association was inconsistent. We studied the association among university students across three European countries with different patterns of drinking. METHODS: We analyzed data from three universities, one from each country: Germany (beer dominant), Bulgaria (wine dominant), and Poland (unclassified among youths, spirits dominant in adults) (N = 2103). Frequency of drinking and problem drinking (≥2 positive responses on CAGE-scale), on the one side, and self-rated health, caring for one's own health, and worsening of health since the last year, on the other side, were assessed by means of self-administered questionnaire. The association between alcohol- (independent) and health-related (dependent) variables was evaluated by means of logistic regression, adjusting for country and sex. RESULTS: Poor self-rated health and worsened health since previous year were associated with problem drinking {odds ratio 1.82 [95% confidence interval (CI) 1.21-2.73] and 1.61 (95% CI 1.17-2.21), respectively}, but not with a higher frequency of drinking. In contrast, not caring for one's own health was associated with frequent drinking [1.40 (95% CI 1.10-1.78)], but not with problem drinking [1.25 (95% CI 0.95-1.63)]. The results were consistent across the studied countries and for both sexes. CONCLUSION: The health status of university students was associated with problem drinking. A high frequency of drinking was associated with the lack of care of own health, but it was not associated with current health status. These associations were independent of the predominant pattern of drinking across the studied countries.

Depressive symptoms and perceived burdens related to being a student: Survey in three European countries.

BACKGROUND: Despite a high prevalence of depressive symptoms among university students, few studies have examined how this mental health problem is associated with perceived stress and perceived burdens related to being a student. METHODS: We conducted a cross-sectional study of 2,103 first year students from one western (Germany), one central (Poland), and one south-eastern European country (Bulgaria). The self-administered questionnaires included the modified Beck Depression Inventory and Cohen's Perceived Stress Scale. A 13 item scale measured perceived burdens related to being a student with four subscales: "Course work", "Relationships", "Isolation", and "Future". RESULTS: Depressive symptoms were highly prevalent in all three countries (M-BDI >/=35: 34% in Poland, 39% in Bulgaria, and 23% in Germany). Students felt more burdened by course work and bad job prospects ("Future") than by relationship problems or by feelings of isolation. The perceived burdens subscales "Future", "Relationship" and "Isolation" remained associated with depressive symptoms after adjusting for perceived stress, which displayed a strong association with depressive symptoms. The association between perceived stress and depressive symptoms differed by gender. These findings were similar in all three countries. CONCLUSION: Perceived burdens related to studying are positively associated with higher depression scores among students, not only by mediation through perceived stress but also directly. While the strong association between perceived stress and depressive symptoms suggests the need for interventions that improve stress management, perceived burdens should also be addressed.

Prevalence of depressive symptoms in university students from Germany, Denmark, Poland and Bulgaria.

BACKGROUND: Previous research indicated a higher prevalence of depressive symptoms among students from Eastern European countries than students from Western European countries. This difference was thought to be linked to political and economic instabilities resulting from political changes in the early 1990s. We investigated whether these differences persist 15 years later. METHODS: Using data from a general health survey among first year students (N = 2,651) from two Western (Germany and Denmark) and two Eastern European countries (Poland and Bulgaria), our analysis was restricted to 2,146 students below 23 years of age. Depressive symptoms were measured using the Modified Beck Depression Inventory (M-BDI). The recommended cut-off point of the M-BDI for depression screening in the general population is a score of > or =35. Perceived income sufficiency was measured on a four-point scale from "totally sufficient" to "not sufficient at all". Analysis of variance and logistic regression were performed to assess the differences in depressive symptoms between countries adjusting for income sufficiency. RESULTS: Depressive symptoms were more prevalent in Eastern European than Western European countries (M-BDI scores of > or =35 in Germany 26.7%/22.8%, in Denmark 24.9%/12.1%, in Poland 45.5%/27.3%, in Bulgaria 42.9%/33.8% for female and male students, respectively). There was an association between income perceived as insufficient and higher levels of depressive symptoms, but it did not differ across the countries. Adjusting for perceived income sufficiency had little effect on differences in the prevalence of depressive symptoms across countries. CONCLUSIONS: The difference in prevalence of depressive symptoms in university students from Eastern and Western European countries persists 15 years after political changes have taken place and cannot be explained by differences in perceived sufficiency of income.

Promoting public health: benefits and challenges of a Europeanwide research consortium on student health.

AIMS: The purpose of this paper is to highlight some of the benefits and challenges when undertaking research across several countries comprising diverse ethnic, lingual and historically different communities. METHODS: Literature review and experiences of the researchers who participated in the Students' Health Inquiry, as regards the benefits and the challenges that can emerge when conducting collaborative research. The Delphi technique was employed to reach consensus on and prioritise the emerging challenges and suggested solutions. RESULTS: Challenges of research consortia include the preparatory work before the study, the ownership of the data and dissemination of results, as well as methodological, financial, operational, and structural challenges. These are described, each challenge is further broken down in its subcomponents, examples are given, and potential solutions are suggested. CONCLUSIONS: If challenges can be prevented or solved, the benefits of research consortia include greater generalisability of findings, and more comprehensive understanding of the issues than would be possible with a single-site study. There is also an increased probability to bring about policy changes and programmatic adjustments. Cross-national research consortia can contribute to reduction in the inequality of resources and research opportunities in the collaborating countries. Research consortia deserve the attention of funding agencies. They are capable of bringing about synergies that result from working collaboratively together of large multi-disciplinary team of investigators who share their strengths, disciplines and expertise in order to bear on the same research issue in multiple countries and diverse populations.

Nurses' involvement in international research collaborations.

Nurses are becoming increasingly involved in collaborative international research teams. This article describes a European-wide research consortium that is implementing research across Europe. The experiences of members of a cross-national research consortium and some of the challenges are discussed. Cross-national research consortia should pay attention to preparatory, methodological, financial, operational and structural challenges. Ownership of data and dissemination of research findings are also explored. Consortia need to find a balance between a consistent organisational structure and communication styles, and respecting the differences between members of the consortium.