Int. J. Environ. Res. Public Health 2010, 7 13 suggests. For instance, taking the relationship between physical activity and school achievement in children as a parallel example, increased activity levels might be related to increased self-esteem, which could be expected to improve classroom behaviour as well as academic performance [67]. It might be that alcohol binge drinking might operate in the opposite direction. Moreover, recent reports found the first direct evidence that short-term binge drinking can generate evident cerebral dysfunction undetectable by behavioural measures alone. The observed latency abnormalities, similar to those observed in long-term alcoholism, comprise an electrophysiological marker of slowed cerebral activity associated with binge drinking [70]. Moreover, the importance of the college context has been shown, where heavy drinking does in fact predict student attrition [71]. Indeed in a nationally representative sample of college and university students in the USA, alcohol use was rated as one of the top 10 hindrances to students‘ academic performance [72]. Problematic drinking during college has been identified to have an effect on several individual-level outcomes e.g., alcohol use disorder in students may result in visuospatial deficits [73]. An interesting finding was related to the multiple indicators of student achievement that the present study mobilized. Table 2 showed that many of the health/ wellbeing, demographic and satisfaction variables we explored were associated with particular achievement indicator/s but not with the others. This suggested that caution needs to be exercised when researchers and practitioners select a given outcome measure of student achievement, and where possible, it could be beneficial to employ more than one outcome of student achievement. Further, even though the accomplished grade (module mark) is seen as an objective measure, it could still be viewed as subjective as it is also dependent on the teacher/s who mark the student‘s assignment and allocate a grade to the student‘s coursework. Despite this, such indicators that employ the accomplished grade (module mark) of pupil/student achievement have been widely used, as an isolated marker, in order to gauge academic performance [20,28,40,42-44]. If one compares the three models of outcomes of educational achievement with each other (Table 2), it becomes compelling that the educational outcome ―importance of good grades‖ could be best explained by the covariates used in the model (only 3 covariates did not reach statistical significance). Conversely, the outcome ―performance reltaive to peers‖ showed fewer associations with the covariates (6 non-significant results); and ―module mark‖the least (7 non-significant results). In agreement, the amount of variance of educational achievement that is explained by the three models decreased from 21% to 9%. Although this does not verify our conceptual framework, it provides support for the framework as depicted in Figure 1, assuming that the importance of good grades is mediating the influence of health and health behaviours on educational achievement. All the three models showed significant or at least almost significant associations between the three measures of academic achievement, again indicating support to the reciprocal relationships between importance of good grades and educational achievement as suggested in our conceptual framework. Financial restrictions place pressure on students, as many of them are forced to work besides studying. This represents a ‗double burden‘ with potentially harmful effects on educational achievements. In our sample, more than 30% of students perceived his/her income as insufficient. Our findings suggested that satisfaction with income was correlated with better educational achievement in terms of performance compared to peers. Income insufficiency could be a main reason where students are obliged to study part time. For instance, many nursing students are working [74,75], usually citing