Risk For Poor Academic Performance Research Articles

Exploring the intersections of college student poverty, grief, and racial/ethnic identity: a scoping review protocol

BackgroundCollege students who experience the negative impact of poverty, such as food, financial, and housing insecurity, are at higher risk for poor academic performance. One recent study examined grief in a college student sample and found students with a diverse racial or ethnic background were more likely to experience prolonged grief disorder, however, did not examine poverty in their sample. To date, no known reviews have examined poverty by racial and ethnic identity and the experience of grief due to the death of a family member or friend, and no reviews have examined how these three factors relate to interventions designed to support student academic performance and degree completion.MethodsOur aim is to map the primary literature reporting on college students of any age who identify or are identified as non-white racial or ethnic groups who experience poverty and grief due to the death of a family member or friend. The mapping strategy includes extracting the various types of interventional support of academic performance and degree completion delivered from campus or community services in any geographic setting worldwide. We will conduct our scoping review with guidance from the latest version of the JBI Manual for Evidence Synthesis. Utilizing the framework as outlined by Arksey and O’Malley, we will conduct our scoping review with Arksey’s five stages: (1) identifying the research question, (2) identifying relevant studies, (3) study selection, (4) charting the data, and (5) collating, summarizing, and reporting the results. For transparency and reproducibility, we will adhere to the PRISMA reporting guidelines.DiscussionThe purpose of this scoping review is to map the primary literature reporting college students, regardless of their age, who belong to non-white racial or ethnic groups and face poverty and grief resulting from the loss of a family member or friend. This analysis includes mapping the various types of intervention and support available both on and off campus, in any global setting, with the aim of enhancing academic performance and facilitating degree completion. The results of this review may inform the further research needed in this area to help prevent poor academic performance and dropout for many vulnerable college students. The results may be of value, particularly to college administrators developing prevention and interventional programs to support college student success.Systematic review registrationOpen Science Framework (https://osf.io/enuwt).

Lower academic performance among children with perinatal HIV exposure in Botswana.

Studies have reported a higher risk of suboptimal neurodevelopment among children who are HIV-exposed uninfected (HEU) compared to children HIV-unexposed uninfected (HUU). Actual academic performance among school-aged children by HIV exposure status has not been studied. Academic performance in Mathematics, Science, English, Setswana and overall among children enrolled in the Botswana-based FLOURISH study who were attending public primary school and ranging in age from 7.1 to 14.6 years were compared by HIV exposure status using a Cochran-Mantel-Haenszel test. Lower academic performance was defined as a grade of "C" or lower (≤60%). Unadjusted and adjusted logistic regression models were fit to assess for an association between HIV exposure and lower academic performance. Between April 2021 and December 2022, 398 children attending public primary school enrolled in the FLOURSH study, 307 (77%) were HEU. Median age was 9.4 years (IQR 8.9-10.2). Only 17.9% of children HEU were breastfeed versus 100% of children HUU. Among children HEU, 80.3% had foetal exposure to three-drug antiretroviral treatment, 18.7% to zidovudine only and 1.0% had no antiretroviral exposure. Caregivers of children HEU were older compared to caregivers of children HUU (median 42 vs. 36 years) and more likely to have no or primary education only (15.0% vs. 1.1%). In unadjusted analyses, children HEU were more likely to have lower overall academic performance compared to their children HUU (odds ratio [OR]: 1.96 [95% confidence interval (CI): 1.16, 3.30]), and lower performance in Mathematics, Science and English. The association was attenuated after adjustment for maternal education, caregiver income, breastfeeding, low birth weight and child sex (aOR: 1.86 [95% CI: 0.78, 4.43]). In this Botswana-based cohort, primary school academic performance was lower among children HEU compared to children HUU. Biological and socio-demographic factors, including child sex, appear to contribute to this difference. Further research is needed to identify modifiable contributors, develop screening tools to identify the risk of poor academic performance and design interventions to mitigate risk.

Stress, Grit, Satisfaction With Life, and Remediation of Prelicensure Nursing Students.

Stress and poor academic performance often lead to high levels of nursing school attrition. To explore nursing students' perceived stress, grit, and satisfaction with life, and assess the effectiveness of a remediation program for students at risk for poor academic performance. Perceived stress, grit, and satisfaction with life were measured, and the effect of remediation given to at-risk students was studied. Examination and psychometric scores were compared between remediation and nonremediation groups. The remediation group had higher levels of perceived stress and a lower satisfaction with life compared with the rest of the cohort. Remediation significantly improved examination scores of at-risk students although scores remained lower than those among nonremediation students. Perceived stress and grit scores were high in nursing students, and satisfaction varied among age groups. Remediation based on metacognitive theory significantly improved at-risk students' examination scores.

The association between child abuse and poor academic performance in public primary schools in urban Sudan

IntroductionChild abuse, sometimes referred to as child abuse and neglect, includes all forms of physical and emotional ill-treatment, sexual abuse, neglect, and exploitation that results in actual or potential harm to the child’s health, development or dignity. Child abuse with all its forms is under reported globally in developed and developing countries. The extent of the problem is difficult to ascertain since most of the victims remain silent thus, assessing its prevalence and effects on children is crucial.ObjectivesTo assess the association between child abuse with poor school performance considering related variables including family instability, home environment, and school environment.MethodsThis study included 504 participants: 168 cases and 336 controls. Controls were matched for age and gender. Both groups were tested for marital or family instability, home environment, school environment, peer and teacher maltreatment using bi-variate analysis. Test of significance of the result was estimated by confidence interval. Quantification of each factor effect and the interrelationships between all factors that affect academic performance was calculated using multivariate analysis by multiple logistic regressions.ResultsAfter controlling for confounding factors using a multivariate analysis model, the following was found: a significant increase in the risk of poor academic performance in children who were subjected to maternal physical neglect compared with children who were not (OR= 3.106: CI 95%=1.875-5.147), and in children subjected to maternal emotional neglect compared with children who were not (OR= 1.968: CI 95% = 1.200- 3.226). No association was found between maternal emotional/verbal or physical abuse and poor academic performance.There is a significant increase in the risk of poor academic performance in children subjected to paternal emotional verbal abuse compared with children who were not (OR= 4.534: CI 95% = 1.833 - 11.214), but the result illustrated no association between paternal physical abuse and poor academic performance.ConclusionsThe risk of poor academic performance is significantly higher in children exposed to frequent parental conflicts or physical abuse from teachers compared with children who were not. There is a significant increase in the risk of poor academic performance in children who experienced maternal physical and emotional neglect and paternal emotional/ verbal abuse. Higher levels of parental education, feeling safe at home, and feeling happy may be protective factors.Disclosure of InterestNone Declared

Social determinants of neurocognitive and academic performance in sickle cell disease.

Sickle cell disease (SCD) is associated with poor neurocognitive outcomes due to biomedical and psychosocial factors. The aims of this study were to investigate associations between household and neighborhood socioeconomic status (SES) with cognitive and academic outcomes in SCD and to determine if these relationships were modified by sickle genotype, fetal hemoglobin, or age. We prospectively recruited patients to complete a battery of neurocognitive and academic measures. Household SES was measured using the Barratt Simplified Measure of Social Status, a composite index of parent education and occupation. The Social Vulnerability Index was used to classify individuals based on social vulnerabilities at the neighborhood level. Overall, 299 patients between the ages of 4 and 18 (mean=11.4, standard deviation=4.3) years diagnosed with SCD (57% SS/SB0 -thalassemia) completed testing. Stepwise multivariate models demonstrated that patients with low social vulnerability (i.e., high SES) at the neighborhood level displayed intelligence and math scores that were 4.70 and 7.64 points higher than those living in areas with moderate social vulnerability, respectively (p<.05). Reading performance did not differ based on neighborhood SES; however, the effect of neighborhood SES was dependent on age, such that older participants living in neighborhoods with moderate or high levels of social vulnerability displayed poorer reading scores than those with low social vulnerability (p<.05). This study identified patients with SCD at higher risk of poor academic performance based on SES. Interventions addressing academic difficulties should be offered to all children with SCD, but should be emergently offered to this subpopulation.

Third-Grade Academic Performance and Episodes of Cardiac Care Among Children with Congenital Heart Defects.

Children with congenital heart defects (CHDs) are at risk for poor academic performance. The degree to which receipt of health care services is associated with adverse academic outcomes is not known. We examined the association between episodes of cardiac care and third-grade performance in children with CHD. We identified subjects between 1/1/2008 and 4/30/2012 among 5 centers in North Carolina. We classified children by CHD type and linked subjects to the state educational records. Any inpatient or outpatient cardiac encounter on a date of service was considered an encounter. We calculated the number of encounters by adding the number of inpatient or outpatient cardiac visits prior to the date of the end-of-grade (EOG) tests. We estimated the odds of failing third-grade reading or math EOG tests by episodes of care stratified at the 50th percentile, controlling for CHD type, maternal education, sex, race/ethnicity, birth weight, and gestational age. A total of 184 children had third-grade EOG scores linked to health care records. The median number of episodes of care was 4 (range: 1-60). Those with visits ˃ 50th percentile (> 4 encounters/year over the 4.3year observation period) had 2.09 (95% CI 1.04, 4.21) greater odds of failing the math EOG compared to those ≤ 50th percentile (1-4 encounters). The third-grade math score declined by 1.5 points (P < 0.008) for every 10 episodes of care. There was no association of episodes of care on third-grade reading performance. Children with CHD with > 4 episodes of cardiac care/year may be at risk for delays in third-grade academic performance. Strategies to minimize school absenteeism may improve academic success in this population.

Perception of Cognitive Functions and Academic Performance in Chilean Public Schools.

Understanding the perception that students have about their own cognitive processes is a key aspect that allows for a deeper assimilation of the different factors that affect school performance. However, there is limited evidence explaining the link between students’ perception of their own cognitive functions and their academic performance. The objective of this study was to analyze the association between perception of cognitive functions, such as memory, processing speed, attention, execution of complex tasks and nervousness, and academic performance in Chilean schoolchildren from the province of Biobio. A cross-sectional analytic design was conducted. The sample consisted of 590 elementary school students (12 ± 1.3 years old; 48.3% female) from Chilean public schools. The academic performance was measured by means of the accumulated final grades in the language, mathematics, physical education and health subjects, and the grade point average (GPA) of each student. Moreover, a survey to measure the cognitive functions of the participants was applied. The results show that 20.3% of the students perceived themselves as very nervous and 16.8% felt distracted. Differences in marks were observed in all the measured subjects, as well as in GPAs, depending on the perception of cognitive functions. Thus, the students with low to moderate perceptions of their cognitive functions received lower marks than those who reported a high perception. These results were consistent after a multivariate analysis adjusted for a socio-educational variables model. In conclusion, one in five public school students in the Biobío Region of Chile expressed a low perception of their cognitive functions, which is consistent with their weaker school performance. Therefore, it is believed that integrating curricular activity and cognitive work could potentially boost the perception of said functions, and thus reduce the risk of poor academic performance.

Association between mental health and academic performance among university undergraduates: The interacting role of lifestyle behaviors.

Impaired mental health status tends to be associated with poor academic performance, but few prospective studies have examined the association between mental health and academic performance among undergraduates while considering the interacting roles of multiple lifestyle behaviors. A total of 1823 Japanese undergraduate students (67% men) were followed up for 4years. Their mental health status was measured by the six-item Kessler Psychological Distress Scale (K6). We defined poor academic performance as a grade point average (GPA)<2.0. Cox proportional hazards models were used to determine the relationship between the students' mental health status and the incident risk of poor academic performance. Our analyses revealed that impaired mental health status in the first semester of university study significantly predicted an increased incident risk of poor academic performance during the overall undergraduate period. This association remained significant when the health lifestyle behaviors were adjusted, and the hazard ratio (95% confidence interval) for poor academic performance was 1.62 (1.18-2.23). This significant association disappeared in the low-lifestyle-behavior-risk group. Impaired mental health status in the first semester significantly predicts an increased incident risk of poor academic performance during the undergraduate period.

Student achievement prediction using deep neural network from multi-source campus data

Finding students at high risk of poor academic performance as early as possible plays an important role in improving education quality. To do so, most existing studies have used the traditional machine learning algorithms to predict students’ achievement based on their behavior data, from which behavior features are extracted manually thanks to expert experience and knowledge. However, owing to an increase in the varieties and overall volume of behavioral data, it has become more and more challenging to identify high-quality handcrafted features. In this paper, we propose an end-to-end deep learning model that automatically extracts features from students’ multi-source heterogeneous behavior data to predict academic performance. The key innovation of this model is that it uses long short-term memory networks to capture inherent time-series features for each type of behavior, and it takes two-dimensional convolutional networks to extract correlation features among different behaviors. We conducted experiments with four types of daily behavior data from students of the university in Beijing. The experimental results demonstrate that the proposed deep model method outperforms several machine learning algorithms.

Early Hydroxyurea Use May be Neuroprotective in Children with Sickle Cell Anemia

Introduction: The neurologic changes of sickle cell anemia (SCA) are particularly devastating and include acute stroke, silent infarctions, and cerebral hypoxemia that together result in cumulative damage and significant neurocognitive deficits. Executive functioning and attention are the most commonly reported deficits with individuals with SCA scoring on average ten points lower on measures of full scale intelligence compared to matched unaffected controls, translating to poor academic achievement and later job attainment. Hydroxyurea is the standard-of-care in patients with SCA with a growing body of evidence suggesting a role in neuroprotection. However, although encouraging, until now, the only studies have involved children who began hydroxyurea in grade school, well after the onset of SCA-related neurocognitive decline. Beginning in 2014, Cincinnati Children's Hospital Medical Center (CCHMC) began treating children with SCA as young as six months with hydroxyurea; these children have had few SCA-related complications and offer a unique population to evaluate the effects of the early introduction of hydroxyurea on neurocognition.Methods: We completed a cross-sectional analysis of the neurocognitive status of our SCA population. Children at least three years old with SCA were enrolled in two cohorts: 1) children with SCA (HbSS and HbS-B 0thalassemia genotypes) who began hydroxyurea before age five years and 2) children with SCA who did not qualify for the first cohort (either on hydroxyurea or chronic transfusions (CTT)). Unaffected controls (siblings of patients with SCA or children seen in the CCHMC primary care clinic) were matched to each patient with early hydroxyurea use by age, race, and sex. All participants completed the NIH Toolbox: Cognition Battery, a shortened neuropsychological evaluation administered using a handheld tablet in the clinical setting, requiring 15-30 minutes. The mean score is 100 and standard deviation 15. We also obtained academic history, demographic variables, and laboratory values for SCA patients.Our overall objective was to compare the neurocognitive status of children with SCA who initiated hydroxyurea before age five years to an unaffected, matched sibling and community control cohort and to historically treated patients followed at the CCHMC sickle cell clinic in order to assess whether the beneficial effects of hydroxyurea extend to neuroprotection.Results: We enrolled 29 patients into the early hydroxyurea SCA group with 24 matched unaffected controls (early hydroxyurea group: mean age 7.2 +/-3.2 years, 52% female). The SCA cohort who initiated disease modifying treatment later in life included 20 patients (mean age 16 +/-5.1 years, 70% female) (Table 1). There were no differences in age, gender, patient education, maternal education, and Area Deprivation Index (ADI, a marker of socioeconomic status) between the early hydroxyurea SCA and control cohorts (Table 1). In the SCA cohort initiating treatment later in life, 5 patients received hydroxyurea, 13 were on CTT for reasons other than for stroke prophylaxis, and 2 received no therapy. The early hydroxyurea use patients and controls scored no differently on the composite cognition score (86 +/-13 versus 88 +/-12, p = 0.6), while the early hydroxyurea patients scored significantly higher than the SCA cohort treated later in life on the composite cognition (versus 77 +/-14, p = 0.03) (Table 2). On a linear regression model, age (p = 0.004) and patient years of education (p = 0.04) were significantly correlated with the composite cognition score when considering all cohorts. When limited to only patients with SCA on hydroxyurea, age (p = 0.005) and patient education (p = 0.002) remained significant, while maternal educational attainment below high school (p = 0.07), hemoglobin (p = 0.07), and fetal hemoglobin (p = 0.07) approached significance.Conclusions: Due to challenges with social determinants of health, children with SCA are already at risk for poor academic performance with early and recurrent “silent” hypoxic events further exacerbating these challenges. If started early in life and maintained through the important early years of brain development, hydroxyurea may be neuroprotective for children with SCA. These data provide further evidence to support the universal prescription of hydroxyurea beginning in the first years of life for all children with SCA. [Display omitted] DisclosuresNo relevant conflicts of interest to declare.

Relationship between sleep habits and academic performance in university Nursing students

BackgroundSleep disorders are composed of a group of diseases of increasing prevalence and with social-health implications to be considered a public health problem. Sleep habits and specific sleep behaviors have an influence on the academic success of students. However, the characteristics of sleep and sleep habits of university students as predictors of poor academic performance have been scarcely analyzed. In the present study, we aimed to investigate sleep habits and their influence on academic performance in a cohort of Nursing Degree students.MethodsThis was a cross-sectional and observational study. An anonymous and self-administered questionnaire was used, including different scales such as the ‘Morningness and Eveningness scale’, an author-generated sleep habit questionnaire, and certain variables aimed at studying the socio-familial and academic aspects of the Nursing students. The association of sleep habits and other variables with poor academic performance was investigated by logistic regression. The internal consistency and homogeneity of the ‘sleep habits questionnaire’ was assessed with the Cronbach’s alpha test.ResultsOverall, 401 students (mean age of 22.1 ± 4.9 years, 74.8 % females) from the Nursing Degree were included. The homogeneity of the ‘sleep habits questionnaire’ was appropriate (Cronbach’s alpha = 0.710). Nursing students were characterized by an evening chronotype (20.2 %) and a short sleep pattern. 30.4 % of the Nursing students had bad sleep habits. Regarding the academic performance, 47.9 % of the students showed a poor one. On multivariate logistic regression analysis, a short sleep pattern (adjusted OR = 1.53, 95 % CI 1.01–2.34), bad sleep habits (aOR = 1.76, 95 % CI 1.11–2.79), and age < 25 years (aOR = 2.27, 95 % CI 1.30–3.98) were independently associated with a higher probability of poor academic performance.ConclusionsAlmost 1/3 of the Nursing students were identified as having bad sleep habits, and these students were characterized by an evening chronotype and a short sleep pattern. A short sleep pattern, bad sleep habits, and age < 25 years, were independently associated with a higher risk of poor academic performance. This requires multifactorial approaches and the involvement of all the associated actors: teachers, academic institutions, health institutions, and the people in charge in university residences, among others.

Alcohol and substance use among first-year students at the University of Nairobi, Kenya: Prevalence and patterns.

ObjectiveIncrease in alcohol and substance use among college students is a global public health concern. It is associated with the risk of alcohol and substance use disorders to the individual concerned and public health problems to their family and society. Among students there is also the risk of poor academic performance, taking longer to complete their studies or dropping out of university.This study determined the prevalence and patterns of alcohol and substance use of students at the entry to the university.MethodA total of 406 (50.7% male) students were interviewed using the Assessment of Smoking and Substance Involvement Test (ASSIST) and the Alcohol Use Disorder Identification Tool (AUDIT). Bivariate logistic regression analyses were used to examine associations between substance use and students' socio-demographic characteristics. Multivariate logistic regression analysis was conducted to examine the predictors of the lifetime and current alcohol and substance use.ResultsLifetime and current alcohol and substance use prevalence were 103 (25%) and 83 (20%) respectively. Currently frequently used substances were alcohol 69 (22%), cannabis 33 (8%) and tobacco 28 (7%). Poly-substance use was reported by 48 (13%) respondents, the main combinations being cannabis, tobacco, and alcohol. Students living in private hostels were four times more likely to be current substance users compared with those living on campus (OR = 4.7, 95% CI: 2.0, 10.9).ConclusionA quarter of the study respondents consumed alcohol and/or substances at the entry to university pushing the case for early intervention strategies to delay initiation of alcohol and substance use and to reduce the associated harmful consequences.

Mental health and academic performance: a study on selection and causation effects from childhood to early adulthood

PurposeAn inverse relationship between mental health and academic achievement is a well-known phenomenon in the scientific literature. However, how and when this association develops is not fully understood and there is a lack of longitudinal, population-based studies on young children. Early intervention is important if associations are to be found already during childhood. The aim of the present study was to investigate the development of the association between mental health and academic performance during different developmental periods of childhood and adolescence.MethodsData from a longitudinal birth cohort study of 1700 children were used. Child mental health was assessed through mother’s reports at age 3, and self-reports at age 12 and 20. Academic performance was assessed through teacher reports on educational results at age 12 and final grades from compulsory school (age 15–16) and upper secondary school (age 18–19). The association between mental health and academic performance was assessed through regression models.ResultsThe results indicate that social selection mechanisms are present in all three periods studied. Behavioral and emotional problems at age 3 were associated with performing below grade at age 12. Similarly, mental health problems at age 12 were associated with lack of complete final grades from compulsory school and non-eligibility to higher education. Academic performance at ages 15 and 19 did not increase the risk for mental health problems at age 20.ConclusionMental health problems in early childhood and adolescence increase the risk for poor academic performance, indicating the need for awareness and treatment to provide fair opportunities to education.

Congenital amusia and academic performance among Colombian university students.

Congenital amusia is a rare neurogenetic and neuropsychological condition which hinders the ability to recognize variations in all aspects of a musical piece. Although previous studies have determined the prevalence of congenital amusia in the general population, few have studied its presence among university students. Findings regarding the association between this condition and academic performance are equivocal, although evidence suggests that musical training improves scholastic achievement. We conducted a cross-sectional study on a sample of 383 university students, all pursuing health-related degrees, comparing their class rank with their performance on the BRAMS Online Test for amusia. We found a prevalence of 0.52% for pitch-based amusia. When applying the Off-Scale test failure criterion for the definition of amusia in our sample, we found a prevalence of 4.4%. Logistic models showed an increase in risk of poor academic performance (lowest quartile) in subjects who failed the off-scale test (Odds Ratio: 7.14 95% CI 2.59-19.6) and who met any of the described definitions of amusia (Odds Ratio: 4.89 95% CI 2.24-10.7). Both musical training and self-report of musical ability significantly affected test results. Although musical education shows some effect over academic performance, further studies are required to determine if this is due to differential effects in subjects with and without amusia.

Associations between demographic factors and the academic trajectories of medical students in Japan.

BackgroundGroup-based trajectory modeling is a useful tool for categorizing students’ academic trajectories and their determinants. Using insights gained from the analyses, we can identify students at risk for poor academic performance and monitor them to provide support. To date, studies investigating the associations between demographic factors and academic performance trajectories among medical students are scarce. The study objective was to examine the associations between demographic factors and academic performance trajectories in medical students using group-based trajectory modeling.MethodsParticipants included all medical students admitted to Tokyo Medical and Dental University in Japan in 2013 and 2014 (n = 202). Academic performance was evaluated by biannual grade point average (GPA) scores in preclinical years. We used group-based trajectory modeling to categorize students into GPA trajectories. Multinomial logistic regression was used to examine the association between the odds of being in a certain GPA trajectory group and demographic factors such as high school type, high school geographical area, admission test type, high school graduation year, whether the student was a biology major, and sex.ResultsStudents’ GPA trajectories were classified into four trajectory groups as well as another group that consisted of students who withdrew or repeated years. We found that students whose high school geographical area was outside the National Capital Region were 7.2 times more likely to withdraw or repeat years in comparison with students whose school was inside the National Capital Region (OR: 7.21, 95% CI: 1.87, 27.76). In addition, admission test type, high school graduation year, and sex were associated with GPA trajectories.ConclusionsHigh school geographical area, admission test type, high school graduation year, and sex were associated with GPA trajectories. These findings provide important insights into identifying students at risk for poor academic performance and strategies for monitoring them to provide adequate and timely support.

Gender differences in the relationships between sleep disturbances and academic performance among nursing students: A cross-sectional study

BackgroundSleep disturbances, such as insomnia, excessive daytime sleepiness, and poor-quality sleep, are common among nursing students and are closely linked with academic performance. ObjectivesTo examine the prevalence of sleep disturbances and academic performances in male and female nursing students and to determine gender-specific effects on the relationship between sleep disturbances and academic performance. DesignA cross-sectional study design was adopted. SettingsThis study was conducted in a school of nursing in Indonesia. ParticipantsA total of 492 undergraduate students (103 males and 389 females) were included. MethodsData pertaining to the biosociodemographic characteristics, Pittsburgh Sleep Quality Index, Insomnia Severity Index, Epworth Sleepiness Scale, Morningness-Eveningness Questionnaire, and Beck Depression Inventory were collected from July 1, 2018 to September 30, 2018. Academic performance was measured using grade point average of the academic year 2017–2018. A multivariate logistic regression model was used for data analyses. ResultsThe prevalence of poor sleep quality, insomnia, and daytime sleepiness was 66.0%, 45.6%, and 24.3%, respectively, in male nursing students and 71.5%, 52.4%, and 28.8%, respectively, in female nursing students. For circadian rhythm preferences, 66% male and 51.7% female nursing students were categorized as intermediate- and morning-type people, respectively. Insomnia was the only variable among sleep disturbances that significantly correlated with the risk of poor academic performance in female nursing students even after adjustment of covariates. ConclusionsSleep disturbances were highly prevalent among female and male nursing students, and insomnia was substantially associated with poor academic performance in female nursing students. Identifying sleep disturbances among nursing students and designing effective interventions to specifically target them are required to improve academic performance of female nursing students.

The association between sleep problems and academic performance in primary school-aged children: Findings from a Norwegian longitudinal population-based study.

The purpose of this study was to examine the longitudinal association between concurrent, transitory and persistent difficulties initiating and maintaining sleep (DIMS) on academic performance in children in a. longitudinal child-cohort (N = 3986) targeting school-aged children when they were 7–9 years (T1) and 11–13 years (T2) old, whilst controlling for mental health problems. DIMS were parent-reported at T1 and T2 and academic performance teacher-reported at T2. Mental health was based on child self-report at T2 using the Strength and Difficulties Questionnaire (SDQ). In all, 10.6% (n = 423) of the children had poor school performance at T2. These had more symptoms of externalizing and internalizing mental health problems (p. < 001) compared to their peers at T2. A logistic regression analysis showed that both concurrent DIMS (at T2, but not at T1) and persistent DIMS (at both T1 and T2) was associated with elevated risk of poor academic performance. After controlling for mental health problems, only persistent DIMS was associated with increased risk of poor academic performance. Transitory DIMS (DIMS at T1 but not at T2) did not increase the risk of later poor academic performance. A mediation analysis also revealed that the association between DIMS and poor school performance was mediated by mental health problems, in addition to an overall significant direct relative effect of DIMS on poor school performance in the persistent DIMS group. These findings support the notion that sleep problems in children are associated with impaired academic performance, and extends past findings demonstrating that sleep problems may not increase the risk of poor academic performance unless they persist over time. The negative effects of persistent sleep problems suggest that more emphasis should be put on preventive interventions of sleep problems in school-aged children.

Callous-Unemotional Traits and Academic Performance in Secondary School Students: Examining the Moderating Effect of Gender

Callous-unemotional (CU) traits and male gender are both known risk factors for poor academic outcomes in children and adolescents. However, despite gender differences in CU trait severity, comorbid difficulties and correlates of CU traits, research has yet to examine whether the CU traits and male gender may work together to increase risk for poor academic performance. That is, whether boys high in CU traits perform more poorly across academic disciplines than girls high in these traits. This study therefore aimed to investigate i) the relationships between CU traits, student gender and English, Science and Math grades, and ii) whether gender moderates the association between CU traits and academic outcomes. Participants were 437 children aged 11 to 14 years (mean age 12.50 years; 49% girls; 85% White) attending a state secondary school in England. Students reported on CU traits and externalizing problems and their English, Math and Science grades were gathered from school records. Using hierarchical linear modelling, CU traits were found to be significantly related to lower English, Math and Science grades when controlling for age, gender, sociodemographic disadvantage and externalizing problems. CU traits were significantly related to lower Science grades for boys but not girls. However, gender did not moderate the association between CU traits for English or Math grades. Findings enhance our understanding of how child characteristics may interact to increase the likelihood of poor school outcomes, and therefore help us to identify youth at-risk for poor academic performance.

Clinical Practice Guidelines for the management of depression in children and adolescents.

Over the last half century, it is now well established that depression can occur at any age, and it has been documented as early as infancy. In terms of epidemiology, different studies which have evaluated the prevalence of depression in children and adolescents suggest that the prevalence varies according to the different age groups. Prevalence figures reported for infants vary from 0.5% to 3% in clinic population, whereas in preschool children, the prevalence rate for major depression (1.4%) has been reported to be higher than depression not otherwise specified (0.7%) and dysthymia (0.6%). Studies done in community settings suggest the prevalence of depression in children to range from 0.4% to 2.5% and among adolescents to be from 0.4% to 8.3%. Lifetime prevalence through adolescence is considered to be as high as 20%. Prior to puberty, depression is known to have equal gender representation; however, among adolescents, the male: female ratio is 1:2. Over the years, it has also been understood that depression in children and adolescents is a chronic and relapsing condition, which does not remits spontaneously and hence, there is a need to identify and treat the same at the earliest to reduce its long-term negative consequences. Childhood depression has been shown to lead to an increased risk of poor academic performance, impaired social functioning, suicidal behavior, homicidal ideation, and alcohol/substance abuse. It is also associated with an increased risk of recurrent depressive episodes. Unfortunately, a major proportion of depression in children and adolescents is underdiagnosed and undertreated.

Abstract 16919: Third Grade Academic Performance and Episodes of Care Among Children With Congenital Heart Defects

Introduction: Children with Congenital Heart Defects (CHD) may be at risk for poor academic performance in elementary school. Cumulative episodes of care among children with CHD may impact neurocognitive outcomes. We examined the association between the number of episodes of care and third-grade academic performance among children with CHD. Methods: We identified children with CHD from electronic medical records between 1/1/2008 and 12/31/2013 among five North Carolina (NC) tertiary care centers. We classified children by CHD type (severe disease, shunt lesion, valve disease, other) and matched subjects to the NC Department of Public Instruction educational records. We calculated the number of episodes of care by adding inpatient and outpatient visits from the EMR in the follow up period prior to administering the EOG. We estimated the odds of failing third-grade reading or math end of grade (EOG) tests among children with CHD who had episodes of care &gt;50 th percentile compared to children ≤50 th percentile using logistic regression controlling for maternal education, race/ethnicity, and gestational age. We also estimated the average change in the developmental scale score using linear regression for the same comparison group. The inability to demonstrate proficiency in NC grade level standards was considered a failing score. Results: A total of 425 children with CHD had third-grade EOG scores. Of these, 57% were male and 45% of children had a severe CHD, 30% had a shunt lesion, and 21% had valve disease. The median number of episodes of care was 4 (range: 1-60). Children with number of visits above the 50 th percentile (&gt;4 visits) had 2.09 (95% CI: 1.04,4.21) greater odds of failing the math EOG compared to children at or below the 50 th percentile (1-4 visits). The third- grade math developmental scale score declined by 1.54 points (p&lt;0.008) for every 10 episodes of care. There was no statistically significant effect of episodes of care on third grade reading performance. Conclusions: Children with CHD in NC with number of episodes of care above the 50 th percentile, may be at risk for delays in third-grade academic performance. Additional services may be required to improve academic success in this population.