Exam Period Research Articles

Considering interactive effects in the identification of influential regions with extremely rare variants via fixed bin approach.

In this study, we analyze the Genetic Analysis Workshop 18 (GAW18) data to identify regions of single-nucleotide polymorphisms (SNPs), which significantly influence hypertension status among individuals. We have studied the marginal impact of these regions on disease status in the past, but we extend the method to deal with environmental factors present in data collected over several exam periods. We consider the respective interactions between such traits as smoking status and age with the genetic information and hope to augment those genetic regions deemed influential marginally with those that contribute via an interactive effect. In particular, we focus only on rare variants and apply a procedure to combine signal among rare variants in a number of "fixed bins" along the chromosome. We extend the procedure in Agne et al [1] to incorporate environmental factors by dichotomizing subjects via traits such as smoking status and age, running the marginal procedure among each respective category (i.e., smokers or nonsmokers), and then combining their scores into a score for interaction. To avoid overlap of subjects, we examine each exam period individually. Out of a possible 629 fixed-bin regions in chromosome 3, we observe that 11 show up in multiple exam periods for gene-smoking score. Fifteen regions exhibit significance for multiple exam periods for gene-age score, with 4 regions deemed significant for all 3 exam periods. The procedure pinpoints SNPs in 8 "answer" genes, with 5 of these showing up as significant in multiple testing schemes (Gene-Smoking, Gene-Age for Exams 1, 2, and 3).

Barriers and facilitators to the uptake of voluntary medical male circumcision (VMMC) among adolescent boys in KwaZulu–Natal, South Africa

Epidemiological modelling has concluded that if voluntary medical male circumcision (VMMC) is scaled up in high HIV prevalence settings it would lead to a significant reduction in HIV incidence rates. Following the adoption of this evidence by the WHO, South Africa has embarked on an ambitious VMMC programme. However, South Africa still falls short of meeting VMMC targets, particularly in KwaZulu-Natal, the epicentre of the HIV/AIDS epidemic. A qualitative study was conducted in a high HIV prevalence district in KwaZulu-Natal to identify barriers and facilitators to the uptake of VMMC amongst adolescent boys. Focus group discussions with both circumcised and uncircumcised boys were conducted in 2012 and 2013. Analysis of the data was done using the framework approach and was guided by the Social Cognitive Theory focussing on both individual and interpersonal factors influencing VMMC uptake. Individual cognitive factors facilitating uptake included the belief that VMMC reduced the risk of HIV infection, led to better hygiene and improvement in sexual desirability and performance. Cognitive barriers related to the fear of HIV testing (and the subsequent result and stigmas), which preceded VMMC. Further barriers related to the pain associated with the procedure and adverse events. The need to abstain from sex during the six-week healing period was a further prohibiting factor for boys. Timing was crucial, as boys were reluctant to get circumcised when involved in sporting activities and during exam periods. Targeting adolescents for VMMC is successful when coupled with the correct messaging. Service providers need to take heed that demand creation activities need to focus on the benefits of VMMC for HIV risk reduction, as well as other non-HIV benefits. Timing of VMMC interventions needs to be considered when targeting school-going boys.

Aportaciones al estudio de la sostenibilidad bibliotecaria: las emisiones de CO2 del servicio de apertura de fin de semana de la biblioteca de la Universidad de Vigo

La Biblioteca de la Universidad de Vigo y la Oficina de Medio Ambiente llevaron a cabo un estudio sobre los impactos ambientales del servicio de aperturas en fin de semana de la biblioteca central durante el período de exámenes extraordinarios de julio de 2013.El estudio pone de manifiesto que las emisiones de gases de efecto invernadero (GEI) asociadas a las aperturas provienen sobre todo del consumo de energía eléctrica del edificio y de los desplazamientos de los usuarios hasta la biblioteca. Asimismo propone una metodología de cálculo de la huella ecológica de este tipo de servicio con objeto de facilitar la toma en consideración de los criterios de sostenibilidad en la programación y organización de este tipo de servicio.

Social jetlag negatively correlates with academic performance in undergraduates

Discrepancies between sleep timing on workdays and weekends, also known as social jetlag (SJL), affect the majority of the population and have been found to be associated with increased health risk and health-impairing behaviors. In this study, we explored the relationship between SJL and academic performance in a sample of undergraduates of the Semmelweis University. We assessed SJL and other sleep-related parameters with the Munich ChronoType Questionnaire (MCTQ) (n = 753). Academic performance was measured by the average grade based on weekly test results as well as scores acquired on the final test (n = 247). The average mid-sleep point on free days in the Hungarian sample fits well the regression line plotted for longitudes within the Central European Time Zone and chronotypes, confirming that sunlight has a major impact on chronotype. Multivariate analysis showed negative effect of SJL on the weekly average grade (p = 0.028, n = 247) during the lecture term with its highly regular teaching schedules, while this association disappeared in the exam period (p = 0.871, n = 247) when students had no scheduled obligations (lower SJL). We also analyzed the relationship between the time of the weekly tests and academic performance and found that students with later sleep times on free days achieved worse in the morning (p = 0.017, n = 129), while the inverse tendency was observed for the afternoon test-takers (p = 0.10, n = 118). We did not find significant association between academic performance and sleep duration or sleep debt on work days. Our data suggest that circadian misalignment can have a significant negative effect on academic performance. One possible reason for this misalignment is socially enforced sleep times.

Effect of a mindfulness program on stress, anxiety and depression in university students.

Two of the problems that currently affect a large proportion of university students are high levels of anxiety and stress experienced in different situations, which are particularly high during the first years of their degree and during exam periods. The present study aims to investigate whether mindfulness training can bring about significant changes in the manifestations of depression, anxiety, and stress of students when compared to another group undergoing a physical activity program and a control group. The sample consisted of 125 students from the Bachelor of Education Program. The measuring instrument used was the Abbreviated Scale of Depression, Anxiety and Stress (DASS-21). The results indicate that the effects of reducing the identified variables were higher for the mindfulness group than for the physical education group and for the control group F(2) = 5.91, p = .004, η2 = .106. The total scores for all variables related to the mindfulness group decreased significantly, including an important stress reduction t(29) = 2.95, p = .006, d = .667. Mindfulness exercises and some individual relaxing exercises involving Physical Education could help to reduce manifestations of stress and anxiety caused by exams in students.

Novel Solution Based on Face Recognition to Address Identity Theft and Cheating in Online Examination Systems

The main objective of this research is to provide a solution for online exam systems by using face recognition to authenticate learners for attending an online exam. More importantly, the system continuously (with short time intervals), checks for learner identity during the whole exam period to ensure that the learner who started the exam is the same one who continued until the end and prevent the possibility of cheating by looking at adjacent PC or reading from an external paper. The system will issue an early warning to the learners if suspicious behavior has been noticed by the system. The proposed system has been presented to eight e-learning instructors and experts in addition to 32 students to gather feedback and to study the impact and the benefit of such system in e-learning environment.

Somatic Symptoms Evoked by Exam Stress in University Students: The Role of Alexithymia, Neuroticism, Anxiety and Depression

ObjectiveThe etiology of somatization is incompletely understood, but could be elucidated by models of psychosocial stress. Academic exam stress has effectively been applied as a naturalistic stress model, however its effect on somatization symptoms according to ICD-10 and DSM-IV criteria has not been reported so far. Baseline associations between somatization and personality traits, such as alexithymia, have been studied exhaustively. Nevertheless, it is largely unknown if personality traits have an explanatory value for stress induced somatization.MethodsThis longitudinal, quasi-experimental study assessed the effects of university exams on somatization — and the reversal of effects after an exam-free period. Repeated-observations were obtained within 150 students, measuring symptom intensity before, during and after an exam period, according to the Screening for Somatoform Symptoms 7-day (SOMS-7d). Additionally, self-reports on health status were used to differentiate between medically explained and medically unexplained symptoms. Alexithymia, neuroticism, trait-anxiety and baseline depression were surveyed using the Toronto-Alexithymia Scale (TAS-20), the Big-Five Personality Interview (NEO-FFI), the State Trait Anxiety Inventory (STAI) and Beck’s Depression Inventory (BDI-II). These traits were competitively tested for their ability to explain somatization increases under exam stress.ResultsSomatization significantly increased across a wide range of symptoms under exam stress, while health reports pointed towards a reduction in acute infections and injuries. Neuroticism, alexithymia, trait anxiety and depression explained variance in somatization at baseline, but only neuroticism was associated with symptom increases under exam stress.ConclusionExam stress is an effective psychosocial stress model inducing somatization. A comprehensive quantitative description of bodily symptoms under exam stress is supplied. The results do not support the stress-alexithymia hypothesis, but favor neuroticism as a personality trait of importance for somatization.

Taking Hold and Letting Go of the Life Ladder

Taking Hold and Letting Go of the Life Ladder

Determination of the effect of stress on the salivary cortisol level among sample of university students having myofacial pain

Background: Psychological stress is considered the major etiological factor precipitating myofacial pain and temporomandibular disorders.It is known that stress induce various adaptational responses of physiologic systems. The process includes increase in the activity of the hypothalamic-pituitary-adrenal axis which promotes cortisol secretion. Salivary cortisol has been used as a measure of free circulating cortisol levels.The use of salivary biomarkers has gained increased popularity since collecting samples is non-invasive and painless. The aim of thisstudy was to evaluate the level of cortisol in saliva among sample of university students having myofacial pain, during the final exam period and whether this finding could have a significant value as a symptomatic psychobiological marker. Materials and Methods: Ninety eight (98) university students were enrolled in this study. Fifty(50) were with myofacial pain (symptomatic) and forty eight (48) were without myofacial pain (asymptomatic) as a control group.Each student with myofacial pain was examined according to Research Diagnostic Criteria for Temporomandibular Disorders. Saliva sample were collected from each subject before final examination and three months later for biochemical analysis of cortisolusing ELISA test. Results: A highly significant difference in salivary cortisol level between the two periods for both the study and control groups, and a non-significant difference between the two groups in before examination period. A negative association has been observed between the level of salivary cortisol and severity of pain and a highly significant improvement of pain between the final examination periods and three months later. Conclusions: Dental students perceived a higher level of stress prior to the final exam was associated with raised salivary cortisol levels which could be considered as a useful non-invasive biomarker for measuring acute stress.

P 136. The influence of academic stress on cortical plasticity

Medical education is perceived as stressful. The purpose of this study was to explore the possible effect of academic examination stress on cortical long-term potentiation (LTP)-like plasticity in a group of university students. The study included nine healthy medical students (males: mean age 30.2 ± 4.3 SE) and was conducted during a major exam period (stressed) and 5 weeks later after the exams (non-stressed). Facilitatory associative plasticity was induced by paired associative stimulation (PAS) in the human motor cortex (PAS-25 protocol). In addition, students were required to fill the Perceived Stress Scale 10 (PSS) questionnaire. Sixty minutes after PAS-25 induction protocol, students showed lower amounts of potentiation during the exam period compared with after the exams ( p = 0.039). The average PSS score significantly higher during the “stressed” period ( P = 0.024). LTP-like plasticity showed an inverse correlation with the perceived stress. Academic stress appears to affect LTP-like plasticity in students. Deficit in attention and impairment of N -methyl- d -aspartate receptor-dependent neural plasticity associated with stress might underlie our findings. Larger scale studies are needed to address the interrelationship between LTP-like plasticity and academic performance.

Paws for a Study Break: Running an Animal-Assisted Therapy Program at the Gerstein Science Information Centre

The Gerstein Science Information Centre is the Science and Health Sciences library serving the University of Toronto community. As the second largest library on campus, Gerstein is a mecca for studying and can accommodate 1100 students. Research has shown that high levels of stress, anxiety, depression, and other mental health disorders are prevalent among both medical students and the student population as a whole. In recent years, Gerstein staff members have seen evidence of the rising levels of student stress in their dealings with the public while providing reference and research help. Animal-assisted therapy (AAT) is often used in hospital and rehabilitation settings and, most recently, to help young children learn to read by providing a stress-free learning environment in public libraries and schools. Studies on animal-assisted therapy have shown that AAT decreases blood pressure, cortisol, and reduces anxiety overall. In response to these findings, staff at Gerstein decided to implement an AAT program, “Paws for a Study Break,” comprised of several sessions when a therapy dog and her handler would visit the library to hold ‘office hours’ and give students a break from their studying during the Winter 2012 exam period. Through a total of six visits of ninety minutes each, 417 visitors were received. Best practices and lessons learned are discussed, including steps involved in coordination of the event, working with volunteers, publicity avenues, dealing with media requests, costs involved, and evaluation techniques. Based on the completed evaluation forms, the response to the therapy dog program at Gerstein was overwhelmingly positive; students were very appreciative, and there are plans underway to repeat this program on an ongoing basis.

Sleep timing is more important than sleep length or quality for medical school performance

Overwhelming evidence supports the importance of sleep for memory consolidation. Medical students are often deprived of sufficient sleep due to large amounts of clinical duties and university load, we therefore investigated how study and sleep habits influence university performance. We performed a questionnaire-based study with 31 medical students of the University of Munich (second and third clinical semesters; surgery and internal medicine). The students kept a diary (in 30-min bins) on their daily schedules (times when they studied by themselves, attended classes, slept, worked on their thesis, or worked to earn money). The project design involved three 2-wk periods (A: during the semester; B: directly before the exam period—pre-exam; C: during the subsequent semester break). Besides the diaries, students completed once questionnaires about their sleep quality (Pittsburgh Sleep Quality Index [PSQI]), their chronotype (Munich Chronotype Questionnaire [MCTQ]), and their academic history (previous grades, including the previously achieved preclinical board exam [PBE]). Analysis revealed significant correlations between the actual sleep behavior during the semester (MSdiary; mid-sleep point averaged from the sleep diaries) during the pre-exam period and the achieved grade (p = 0.002) as well as between the grades of the currently taken exam and the PBE (p = 0.002). A regression analysis with MSdiary pre-exam and PBE as predictors in a model explained 42.7% of the variance of the exam grade (effect size 0.745). Interestingly, MSdiary—especially during the pre-exam period—was the strongest predictor for the currently achieved grade, along with the preclinical board exam as a covariate, whereas the chronotype did not significantly influence the exam grade.

Protein and lipid oxidative damage in healthy students during and after exam stress

Oxidative damage at cellular level is thought to be one of the mechanisms in the pathogenesis of psychological stress (anxiety). The aim of this study was to investigate lipid and protein oxidative damage in exam anxiety conditions. Blood samples were collected in two stages (during the exam period and post vacation) from 51 healthy female students after responding to Beck Anxiety Inventory (BAI) and test anxiety questionnaire. Protein carbonyl, total thiol and malondialdehyde (MDA) levels were determined in serum. Participants reported significantly higher levels of subjective anxiety during the exam period than post vacation. Also the level of total thiol was significantly lower during the exam period compared with post vacation (p<0.001). Meanwhile, protein carbonyl and MDA levels during the exams were significantly higher than those in post-exam period (p<0.01). During the exam period, there was a negative correlation between serum total thiol levels and the severity of anxiety (r=−0.45, p<0.01). A significant positive correlation between the changes in serum protein carbonyl and MDA levels, also between those markers and anxiety score was found during the exam period. The high level of protein carbonyl and MDA, also low level of total thiol during the exam period demonstrated an oxidative damage to proteins and lipids in stress conditions. Our results suggest that oxidative damage to cellular compounds may be one of the mechanisms involved in the pathogenesis of anxiety.

Supporting students with hay fever during the exam period

Supporting students with hay fever during the exam period

Tweaking and Tweeting: Exploring Twitter for Nonmedical Use of a Psychostimulant Drug (Adderall) Among College Students

BackgroundAdderall is the most commonly abused prescription stimulant among college students. Social media provides a real-time avenue for monitoring public health, specifically for this population.ObjectiveThis study explores discussion of Adderall on Twitter to identify variations in volume around college exam periods, differences across sets of colleges and universities, and commonly mentioned side effects and co-ingested substances.MethodsPublic-facing Twitter status messages containing the term “Adderall” were monitored from November 2011 to May 2012. Tweets were examined for mention of side effects and other commonly abused substances. Tweets from likely students containing GPS data were identified with clusters of nearby colleges and universities for regional comparison.Results213,633 tweets from 132,099 unique user accounts mentioned “Adderall.” The number of Adderall tweets peaked during traditional college and university final exam periods. Rates of Adderall tweeters were highest among college and university clusters in the northeast and south regions of the United States. 27,473 (12.9%) mentioned an alternative motive (eg, study aid) in the same tweet. The most common substances mentioned with Adderall were alcohol (4.8%) and stimulants (4.7%), and the most common side effects were sleep deprivation (5.0%) and loss of appetite (2.6%).ConclusionsTwitter posts confirm the use of Adderall as a study aid among college students. Adderall discussions through social media such as Twitter may contribute to normative behavior regarding its abuse.

Association of whole grain intake and longitudinal changes in abdominal adiposity in the Framingham Heart Study

Longitudinal studies on the association of whole grain (WG) intake and abdominal adiposity are scarce. We examined the longitudinal association between WG intake and annualized changes in waist circumference (WC) in the Framingham Heart Study (FHS) Offspring adults. WC was measured approximately every 4 years over a median of 14 years of follow‐up. WG intake (g/d) was estimated by FFQ and calculated with and without added bran and germ. Repeated measures models, with data from 4 exam periods (n=11,372 observations), were used to examine associations between WG intake and annualized changes in WC. After adjustment for time‐varying and invariant demographic and lifestyle factors (including WC at the beginning of each exam interval), greater WG intake was associated with less annualized gain in WC. Adults who consumed more whole grains daily (median intake of 39 g/d) gained less abdominal fat per year (0.63 ± 0.04 cm gain in WC) than those who consumed fewer whole grains (median intake of 4 g/d) (0.79± 0.04 cm gain in WC). The inverse association between WG intake and change in WC was stronger in normal weight adults. The association remained significant after further adjusting for lipid‐lowering and blood pressure medications and diabetes. Based on these findings, a randomized trial is warranted to examine whether incorporating WG foods in the diet helps to mitigate gains in abdominal adiposity over time.Grant Funding Source: The National Institute of Health/National Heart, Lung, and Blood Institute (Contract N01‐HC‐25195), the United States Department of Agriculture (USDA agreement No. 58–1950‐7–707) and the General Mills Bell Institute of Health and Nutrition

Self-Esteem Instability Moderates Psychopathological Scarring: Support for a Malleable Self Hypothesis

Shahar and Henrich (2010) hypothesized and found that depressive scarring, that is, depression's effect on personality and the self (Lewinsohn, Steinmetz, Larson, & Franklin, 1981) is particularly pronounced when the self-concept is malleable. We provided an additional test for this hypothesis by examining the moderating effect of self-esteem instability, a marker of self-concept malleability, on depressive versus psychopathological scarring. As part of a larger study, freshmen (N = 104) were assessed as to their self-esteem level and stability, and psychopathological symptoms, before and after their first exam period. General psychopathology predicted a decrease in self-esteem, only among participants with elevated self-esteem instability. In addition, the test-retest correlation of self-esteem was weaker among participants with higher baseline levels of self-esteem instability. Results are consistent with the malleability hypothesis and with the construct validity of self-esteem instability.

Academic exam stress and depressive mood are associated with reductions in exhaled nitric oxide in healthy individuals

Nitric oxide (NO) has beneficial effects on cardiovascular and immune health. Stress and depression have been linked to a reduction in serum NO. In this study, we examined the effect of academic exam stress on the fraction of NO in exhaled air (FeNO) and spirometric lung function in 41 healthy college students. Participants completed assessments at mid-semester as well as in the early and late phase of an academic exam period. Negative affect, depressive mood, and salivary cortisol were elevated during exams, whereas FeNO and lung function decreased. Higher depressive mood was associated with lower FeNO, whereas higher negative affect was associated higher FeNO across time. These findings provide initial evidence that depression and prolonged stress can alter FeNO and lung function in healthy individuals, which could have adverse consequences for cardiovascular, airway, and immune health.

Effect of the Examination Stress on Periodontal Health Status and Salivary IL - 1β among Iraqi Dental Students

Background: Periodontal diseases (PD) are common chronic inflammatory diseases caused by pathogenic microorganisms colonizing the gingival area and inducing local and systemic elevations of pro-inflammatory cytokines resulting in tissue destruction by a destructive inflammatory process. Stress was considered as one of the important risk factors that cause many inflammatory diseases including PD. The purpose of this study wasto determines and compares clinical periodontal parameters (PLI, GI and BOP), stress level and salivary IL-1? level among dental students before, during and after mid-year exam, also to find the correlation among stress, IL-1? and clinical periodontal parameters. Materials and methods: The sample was consisted of 24 dental students; 12 male and 12 female aged (21-23) years, theywere examined in this follow up study at three main periods; first period at least one month before mid-year exam (Period I), second period during mid-year exam (Period II) and third period at least one month after mid-year exam (Period III). DASS-21 was used to measure stress level in all periods. Saliva samples were collected to determine the salivary IL-1? level by ELISA. Clinical periodontal parameters were recorded at four sites per tooth. Results: The means of all clinical periodontal parameters were higher in the period II than in the periods I and III with highly significant differencesat (P ? 0.01). As well as, the means concentrations of salivary IL-1? were higher in the period II than in the periods I and III with highly significant differencesat (P ? 0.01). Also, by using Pearson's Correlation Coefficient, stress shows highly significant strong correlation with IL-1? and clinical periodontal parametersat (P ? 0.01). Conclusions: The results of this study provided strong evidence of association between examination stress and PD, where dental students during mid-year exam have higher levels of stress, clinical periodontal parameters and salivary IL-1? as compared with before and after mid-year exam periods.

Sleepless in Macao: Factors Associated with Sleep Behaviour and Sleep Duration among Children in Public and Private Schools

To evaluate the associations of socioeconomic class (middle and lower) with sleep behaviour, two public and two private primary schools were randomly selected in three district areas (out of seven) in Macao, China. The sleep be- haviour of these children (primary grades one to six) was examined with a validated, locally developed questionnaire. In all, 756(83.3%) of the 908 questionnaires were completed and returned, 330(43.7%) for girls and 426(56.3%) for boys. Only 142(19.9%) children reached the recommended standard of 10 hours of daily sleep on weekdays that were not during an exam period. Thus, 571(80.1%) did not get the required sleep (x 2 = 9.748; degrees of freedom (df) = 1; P = 0.002). The situation was even worse in exam periods during weekdays, with 626 (87.6%; x 2 = 19.406; df = 1; P = 0.000) children not obtaining 10 hours of sleep during that time. These results show that improper sleep behaviour in Macao children is associ- ated with stressed school workload, bedtime difficulty, and environmental factors. Early intervention on these factors might help the children to establish adequate sleep habits.