Who attends out-of-hours general practice appointments? Analysis of a patient cohort accessing new out-of-hours units.

Objectives: This report describes the patients who used additional out-of-hours (OOH) appointments offered through a UK scheme intended to increase patient access to primary care by extending OOH provision.

Design: Cohort study and survey data.

Setting: OOH appointments offered in four units in one region in England (October 2015 to November 2016).

Stress and type 2 diabetes: a review of how stress contributes to the development of type 2 diabetes.

Current policy and research around type 2 diabetes (T2D) interventions largely invoke a behavioral model. We suggest that activation of the physiologic stress response (PSR) from chronic exposure to stressors, low socioeconomic status (SES), severe mental health problems, or aggressive behavior increases the risk of T2D. This article is a comprehensive review of the literature on the link between T2D and psychosocial factors focusing on prospective studies of the risk for developing diabetes.

Socioeconomic status and the risk of depression among U.K. higher education students.

Background: Many university students experience some symptoms of depression during the course of their studies but there is evidence that students from less advantaged backgrounds may be more vulnerable.

Methods: The study was a cross-sectional online survey of 923 undergraduate students attending 6 U.K.

A systematic review of studies of depression prevalence in university students.

Background: Depression is a common health problem, ranking third after cardiac and respiratory diseases as a major cause of disability. There is evidence to suggest that university students are at higher risk of depression, despite being a socially advantaged population, but the reported rates have shown wide variability across settings.

Purpose: To explore the prevalence of depression in university students.

Reliability of a shortened version of the Zagazig Depression Scale and prevalence of depression in an Egyptian university student sample.

Background: There is some evidence that university students are at higher risk of depression; but rates have been found to vary widely across different countries, and there have been few surveys in representative samples. This study was carried out to assess the reliability of the Arabic-language Zagazig Depression Scale (ZDS) in a sample of Egyptian university students and to use the ZDS to assess the prevalence of depression.

Methods: The study was a cross-sectional survey of a representative sample of 988 undergraduate students from Assiut University, Egypt (response rate, 82.

Analysis of an Egyptian study on the socioeconomic distribution of depressive symptoms among undergraduates.

Background: Worldwide population surveys show that prevalence of mental disorders in developing countries was as common as in industrialized countries. College life is an important stage in every person's life; unfortunately, it may be the time to experience depression for the first time. Latterly, there has been a steady increase in the number of university students diagnosed and treated as depressed patients.

Establishing the reliability and validity of the Zagazig Depression Scale in a UK student population: an online pilot study.

Background: It is thought that depressive disorders will be the second leading cause of disability worldwide by 2020. Recently, there is a steady increase in the number of university students diagnosed and treated as depression patients. It can be assumed that depression is a serious mental health problem for university students because it affects all age groups of the students either younger or older equally.

Evaluation of inter-pandemic influenza vaccine effectiveness during eight consecutive winter seasons in England and Wales in patients with cardiovascular risk factors.

We evaluated the effectiveness of inactivated influenza vaccine in persons aged ≥45 years with co-morbidities (including essential hypertension) likely to have prompted consideration of prophylactic statin therapy. Using case-control analyses, we measured the impact of vaccination on General Practitioner (GP) reported new episodes of illness for clinically diagnosed influenza-like illness (ILI) and total acute respiratory infection (TARI) during eight consecutive winters, adjusting for potential confounders using multivariable techniques. Although the study failed to demonstrate the effectiveness of influenza vaccine, we identified important potential confounding related to a greater likelihood of vaccinees than non-vaccinees to consult with a GP for respiratory infections.

Manifestations of tuberculosis stigma within the healthcare system: the case of Sekondi-Takoradi Metropolitan district in Ghana.

Objectives: To explore the manifestations of tuberculosis (TB) stigma within the healthcare system.

Method: Twenty-one individual interviews (16 females and 5 males) and six focus groups (1 with health managers, 1 with staff providing services for TB patients, and 4 with general staff) were conducted among healthcare workers (HCWs) and the generated data analysed using grounded theory principles and procedures.

Results: TB stigma manifests in three broad and inter-related ways within the healthcare system: behaviour towards TB patients; attitudes towards TB work; and administrative procedures and policies of healthcare mangers.

Levels and confounders of morning cortisol collected from adolescents in a naturalistic (school) setting.

Salivary cortisol is widely used in research but little is known about the typical, or expected, functioning of the HPA-axis in adolescents in naturalistic settings, nor whether the extensive array of confounders documented in the literature is applicable in this situation. In a school-based study, 2995 15-year-old pupils provided two saliva samples, 30 min apart, in morning sessions timed to capture peak cortisol decline. The collection protocol was a balance between the large sample size obtainable in a school situation and a limited number of samples, constrained by the school timetable.

Compared to whom? An investigation of the relative health comparisons of well people.

Objectives: Responses to the self-reported health (SRH) question, "In general how would you rate your health? Excellent, very good, good, fair or poor", have been repeatedly demonstrated to predict mortality. Survival curves plotted for each response category show that the likelihood of death increases in a stepped fashion with each progressively negative response category and the relationship persists for up to 12 years following initial measurement. To whom do people compare themselves when answering the self-reported health question?

Methods: Twenty-one interviews with people who selected the better-health response choices (i.