Health Parameters of University Students After Pandemic Isolation

Study Overview
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Brief Summary
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The COVID-19 pandemic caused by the SARS-CoV-2 coronavirus represents threats to global health and economy. The high pathogenesis of SARS-CoV-2 extent that the Mexican government declared a national health emergency, agreeing to take extraordinary measures such as the suspension of non-essential work, including the suspension of academic activities at all levels, in order to minimize the dispersion and transmission of the virus and its consequences. Several previously reported quarantine evaluations have shown that psychological stress reactions can arise from the experience of physical and social isolation, so the current global threat of isolation has shaken the usual practices of the general population, including young people, and resulting in the modification of their academic, labor and social dynamics. The usual behavior in this phenomenon establishes that greater social isolation is associated with less satisfaction with life, higher levels of depression and lower levels of psychological well-being or performance as well as changes in diet. Understanding the factors related to coping with COVID-19 is essential to issue guidance on health in the student population, for that, the present proposal intends to evaluate changes in health parameters derived from the resumption of academic activities in person for a year in university students of health sciences area.

Detailed Description
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The severe acute respiratory syndrome coronavirus (SARS-CoV-2) caused an outbreak of pneumonia of unknown origin in late December 2019, causing coronavirus disease 19 (COVID-19). After its high contagion capacity, a couple of weeks later the World Health Organization declared COVID-19 an international public security emergency, and by March 2020 it was officially declared a pandemic (World Health Organization, 2020) . The rapid increase in the number of cases of infection and deaths from COVID-19 forced national governments to take extreme control and prevention measures. In Mexico, the community health strategy was defined in the National Day of Healthy Distance, where the main guidelines included avoiding inter-personal contagion through confinement, forcing the suspension of all non-essential activities, which included the suspension of academic activities at all levels (Official Gazette of the Federation, 2020). Although the measures that were taken to mitigate the spread of the disease are obtaining favorable results with respect to the transmission of the virus, but the modification of the academic, work, food and social dynamics are having an unprecedented impact on biological, psychological and social health of the population (Prowse et al., 2021). In this sense, maintaining and promoting the physical and mental health of the population is a challenge that transcends the individual level and demands actions at the local, national and global levels (Gruber et al., 2021). Social isolation is a multidimensional event that contemplates both the quantity, as well as the inadequate quality of interactions with other people, including those not only in the family environment, but also at the community level. Social isolation has been studied mainly in older adults derived from their retirement or low mobility, however, the current global threat of isolation has shaken the usual practices of the general population, including young people and resulting in the modification of their academic, labor and social dynamics (Clair et al., 2021). The usual behavior in this phenomenon establishes that greater social isolation is associated with lower life satisfaction, higher levels of depression and lower levels of psychological well-being or performance (Liu et al., 2020) as well as changes in diet (dos Santos et al., 2021). The invitation to social isolation contemplated in the strategy of the Mexican government promoted the decrease in the level of physical activity in individuals during the last two years, while eating patterns were substantially modified by emotional and economic phenomena associated witheach person. These levels of physical activity associated with food choices (voluntary or conditioned) have been shown to negatively affect health (Martínez-Vázquez et al., 2021). The lifestyle of university students prior to isolation due to the pandemic was already considered a risk factor for developing chronic non-communicable diseases, due to poor dietary intake, a low level of physical activity and a high level of sedentary lifestyle (Bertrand et al ., 2021). Isolation has been shown to decrease physical activity levels and develop poor eating habits in North American university students, specifically in a study that included 125 participants, of which only 16% met the Canadian criteria for physical activity a week before of the pandemic, only 9.6% continued to comply with them during isolation. Furthermore, of the participants who did not meet the physical activity requirements, 55% showed a significant decrease in physical activity levels (Bertrand et al., 2021). In response to the confinement due to the pandemic, clinically significant results have been reported regarding the presence of mental health problems such as acute stress and anguish in university students of health sciences area (Li et al., 2020). This phenomenon has been attributed to the fact that students of health sciences area have a greater knowledge of COVID-19 (according to the general population), the risks associated with contracting it, symptoms and its possible social impact, for which may be more susceptible to develop mental health problems during the period of confinement (Liu et al., 2020). In addition to confinement and physical inactivity, instability in the national economy contributes substantially to the genesis of mental health effects, such as fear, stress, and anxiety. The interplay between emotions and eating (referred to as emotional eating) has been addressed before, with evidence that changes in food intake are consistently the primary response during altered mental states (Reichenberg et al., 2018).

Official Title
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Evaluation of Mental Health, Sleep Quality, Level of Physical Activity, Food Intake, and Body Composition Before and After One Year of Face-to-face Academic Activities in University Students

Conditions
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Mental Health Wellness 1, Sedentary Behavior

Intervention / Treatment
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* Behavioral: In person academic activities


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Health Sciences Students Informed consent sign Exclusion Criteria: Fail a course by absences No assistance to evaluations

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 25 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| In person academic activities group<br>University students of health sciences area returning to in person academic activities in Mexico. All unviersity students will return to in person academic activities in March, 2022, for that reason a limitation is that it is no possible to have a control group (Nobody is goint to continue in virtual academic activities). | Behavioral: In person academic activities<br>* All participants will perform academic activities in person from March to December, 2022<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Depression | Patient Health Questionnaire (PHQ-7) | March-December, 2022 | 
| Physical activity | International Physical Activity Questionnaire (IPAQ, short form) | March-December, 2022 | 
| Body fat percentage | Air Displacement Pletismography | March-December, 2022 | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Anxiety | General Anxiety Disorder 7 Questionnaire (GAD-7) | March-December, 2022 | 
| Sleep Quality | Pittsburgh Sleep Quality Index (PSQI) | March-December, 2022 | 
| Body Mass Index | Body Weight and Body Mass Evaluation | March-December, 2022 | 
| Waist to hip ratio | Waist and hip girths | March-December, 2022 | 
| Food intake | 24 hour recalls | March-December, 2022 | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Anxiety, Depression, Body composition, Food intake