Query: negative effects of online classes in health

title: Effects of the COVID 19 Pandemic on Obsessive Compulsive Symptoms Among University Students: Prospective Cohort Survey Study
abstract: The COVID 19 pandemic is associated with common mental health problems. However, evidence for the association between fear of COVID 19 and obsessive compulsive disorder (OCD) is limited.  This study aimed to examine if fear of negative events affects Yale Brown Obsessive Compulsive Scale (Y BOCS) scores in the context of a COVID 19 fear invoking environment.  All participants were medical university students and voluntarily completed three surveys via smartphone or computer. Survey 1 was conducted on February 8, 2020, following a 2 week long quarantine period without classes; survey 2 was conducted on March 25, 2020, when participants had been taking online courses for 2 weeks; and survey 3 was conducted on April 28, 2020, when no new cases had been reported for 2 weeks. The surveys comprised the Y BOCS and the Zung Self Rating Anxiety Scale (SAS) additional items included questions on demographics (age, gender, only child vs siblings, enrollment year, major) knowledge of COVID 19, and level of fear pertaining to COVID 19.  In survey 1, 11.3% of participants (1519/13,478) scored =16 on the Y BOCS (defined as possible OCD) In surveys 2 and 3, 3.6% (305/8162) and 3.5% (305/8511) of participants had scores indicative of possible OCD, respectively. The Y BOCS score, anxiety level, quarantine level, and intensity of fear were significantly lower at surveys 2 and 3 than at survey 1 (P<.001 for all) Compared to those with a lower Y BOCS score <16) participants with possible OCD expressed greater intensity of fear and had higher SAS standard scores (P<.001) The regression linear analysis indicated that intensity of fear was positively correlated to the rate of possible OCD and the average total scores for the Y BOCS in each survey (P<.001 for all) Multiple regressions showed that those with a higher intensity of fear, a higher anxiety level, of male gender, with sibling(s) and majoring in a nonmedicine discipline had a greater chance of having a higher Y BOCS score in all surveys. These results were redemonstrated in the 5827 participants who completed both surveys 1 and 2 and in the 4006 participants who completed all three surveys. Furthermore, in matched participants, the Y BOCS score was negatively correlated to changes in intensity of fear (r=0.74 for survey 2, P<.001; r=0.63 for survey 3, P=.006) Conclusions Our findings indicate that fear of COVID 19 was associated with a greater Y BOCS score, suggesting that an environment (COVID 19 pandemic) x psychology (fear and/or anxiety) interaction might be involved in OCD and that a fear of negative events might play a role in the etiology of OCD.

title: Views and anxiety levels of Turkish dental students during the COVID 19 pandemic
abstract: The novel coronavirus disease (COVID 19) has become an important public health problem that may have negative effects on psychological health.  This study aims to evaluate the views and anxiety levels of dental students during COVID 19.  A questionnaire consisting of COVID 19 and online education views was filled by the students of a dental faculty. For the determination of the anxiety levels, the participants completed Turkish versions of the state trait anxiety inventory (STAI) scales. The data was analyzed using descriptive analysis and parametric statistical tests. P 0.05 was accepted as significant.  A total of 249 dental students (154 females, 95 males) including 143 preclinical and 106 clinical students participated in the survey. Most students (81.1% stated that they were concerned that the classes would be held in groups, with the transition to face to face education. Most of the participants (69.9% stated that the idea of late graduation creates fear. Due to the COVID 19 pandemic, approximately a quarter of the students have the idea of changing professions. The continuity anxiety value of the group with the idea of changing the profession was statistically higher than the other groups (p 0.05)  The results of our study indicated that dental students in our study were anxious about COVID 19. Our results emphasize the need to create psychological support programs for dental students during and after the pandemic.

title: An App for Detecting Bullying of Nurses Using Convolutional Neural Networks and Web Based Computerized Adaptive Testing: Development and Usability Study
abstract: Workplace bullying has been measured in many studies to investigate its effects on mental health issues. However, none have used web based computerized adaptive testing (CAT) with bully classifications and convolutional neural networks (CNN) for reporting the extent of individual bullying in the workplace.  This study aims to build a model using CNN to develop an app for automatic detection and classification of nurse bullying levels, incorporated with online Rasch computerized adaptive testing, to help assess nurse bullying at an earlier stage.  We recruited 960 nurses working in a Taiwan Ch Mei hospital group to fill out the 22 item Negative Acts Questionnaire Revised (NAQ R) in August 2012. The k mean and the CNN were used as unsupervised and supervised learnings, respectively, for: (1) dividing nurses into three classes (n=918, 29, and 13 with suspicious mild, moderate, and severe extent of being bullied, respectively) and (2) building a bully prediction model to estimate 69 different parameters. Finally, data were separated into training and testing sets in a proportion of 70:30, where the former was used to predict the latter. We calculated the sensitivity, specificity, and receiver operating characteristic curve (area under the curve [AUC] along with the accuracy across studies for comparison. An app predicting the respondent bullying level was developed, involving the model's 69 estimated parameters and the online Rasch CAT module as a website assessment.  We observed that: (1) the 22 item model yields higher accuracy rates for three categories, with an accuracy of 94% for the total 960 cases, and accuracies of 99% (AUC 0.99; 95% CI 0.99 1.00) and 83% (AUC 0.94; 95% CI 0.82 0.99) for the lower and upper groups (cutoff points at 49 and 66 points) based on the 947 cases and 42 cases, respectively; and (2) the 700 case training set, with 95% accuracy, predicts the 260 case testing set reaching an accuracy of 97. Thus, a NAQ R app for nurses that predicts bullying level was successfully developed and demonstrated in this study.  The 22 item CNN model, combined with the Rasch online CAT, is recommended for improving the accuracy of the nurse NAQ R assessment. An app developed for helping nurses self assess workplace bullying at an early stage is required for application in the future.

title: Effects of Regular Classes in Outdoor Education Settings: A Systematic Review on Students' Learning, Social and Health Dimensions
abstract: Participants in Outdoor Education Programmes (OEPs) presumably benefit from these programmes in terms of their social and personal development, academic achievement and physical activity (PA) The aim of this systematic review was to identify studies about regular compulsory school and curriculum based OEPs, to categorise and evaluate reported outcomes, to assess the methodological quality, and to discuss possible benefits for students.  We searched online databases to identify English and German language peer reviewed journal articles that reported any outcomes on a student level. Two independent reviewers screened studies identified for eligibility and assessed the methodological quality.  Thirteen studies were included for analysis. Most studies used a case study design, the average number of participants was moderate (mean valued (M) 62.17; standard deviation (SD) 64.12) and the methodological quality was moderate on average for qualitative studies (M 0.52; SD 0.11) and low on average for quantitative studies (M 0.18; SD 0.42) Eight studies described outcomes in terms of social dimensions, seven studies in learning dimensions and four studies were subsumed under additional outcomes, i.e. PA and health. Eleven studies reported positive, one study positive as well as negative, and one study reported negative effects. PA and mental health as outcomes were underrepresented.  Tendencies were detected that regular compulsory school and curriculum based OEPs can promote students in respect of social, academic, physical and psychological dimensions. Very little is known concerning students' PA or mental health. We recommend conducting more quasi experimental design and longitudinal studies with a greater number of participants, and a high methodological quality to further investigate these tendencies.

title: Prevalence and Psychological Effects of Hateful Speech in Online College Communities
abstract: Hateful speech bears negative repercussions and is particularly damaging in college communities. The efforts to regulate hateful speech on college campuses pose vexing socio political problems, and the interventions to mitigate the effects require evaluating the pervasiveness of the phenomenon on campuses as well the impacts on students' psychological state.  Given the growing use of social media among college students, we target the above issues by studying the online aspect of hateful speech in a dataset of 6 million Reddit comments shared in 174 college communities. To quantify the prevelence of hateful speech in an online college community, we devise College Hate Index (CHX) Next, we examine its distribution across the categories of hateful speech,behavior, class, disability, ethnicity, gender, physical appearance, race, religion, andsexual orientation. We then employ a causal inference framework to study the psychological effects of hateful speech, particularly in the form of individuals' online stress expression. Finally, we characterize their psychological endurance to hateful speech by analyzing their language their discriminatory keyword use, and their personality traits.  We find that hateful speech is prevalent in college subreddits, and 25% of them show greater hateful speech than non college subreddits. We also find that the exposure to hate leads to greater stress expression. However, everybody exposed is not equally affected; some show lower psychological endurance than others. Low endurance individuals are more vulnerable to emotional outbursts, and are more neurotic than those with higher endurance.  Our work bears implications for policy making and intervention efforts to tackle the damaging effects of online hateful speech in colleges. From technological perspective, our work caters to mental health support provisions on college campuses, and to moderation efforts in online college communities. In addition, given the charged aspect of speech dilemma, we highlight the ethical implications of our work. Our work lays the foundation for studying the psychological impacts of hateful speech in online communities in general, and situated communities in particular (the ones that have both an offline and an online analog)

title: Negative Impacts From the Shift to Online Learning During the COVID 19 Crisis: Evidence from a Statewide Community College System
abstract: The COVID 19 pandemic led to an abrupt shift from in person to virtual instruction in Spring 2020. Using a difference in differences framework that leverages within course variation on whether students started their Spring 2020 courses in person or online, we estimate the impact of this shift on the academic performance of Virginia's community college students. We find that the shift to virtual instruction resulted in a 6.7 percentage point decrease in course completion, driven by increases in both course withdrawal and failure. Faculty experience teaching a course online did not mitigate the negative effects of moving to virtual instruction. Acknowledgements We are grateful for our partnership with the Virginia Community College System and in particular Dr. Catherine Finnegan. We thank Alex Smith for valuable conversations and feedback. Any errors are our own.  The COVID 19 health crisis has led to one of the largest disruptions in the history of American higher education. Beginning in March 2020, tens of millions of college students who were enrolled in in person courses abruptly had to shift to online learning. While some course instructors had experience teaching online, many faculty had to pivot into online teaching for the first time, often using relatively rudimentary technology (e.g. Zoom conferencing) to deliver instruction and engage students. Prior research demonstrates that health and economic disruptions can have substantial effects on students' achievement and educational attainment. For instance, children born during the 1918 Influenza Pandemic received significantly fewer years of education as compared to their older siblings (Parman, 2015) More recently, students exposed to hotter learning environments through a combination of extreme temperatures and insufficient air conditioning in schools, perform worse academically (Park et al, 2020) The economic downturn from the Great Recession reduced the math and English Language Arts achievement of elementary and middle aged students (Shores and Steinberg, 2017) and negative economic shocks arising from local area job losses during adolescence can have long term educational and mental health implications, particularly among lower income populations (Ananat et al, 2017) While several papers demonstrate that economic downturns affect college enrollments, institutional expenditures, and students' choice of college majors (Barr and Turner, 2013; Barr and Turner, 2015; Betts and McFarland, 1995; Ersoy, 2020; Long, 2014) there has been less research on how downturns affect student success in higher education. Descriptively, students who initially enrolled in college during the Great Recession were less likely to graduate compared to earlier and more recent cohorts (Shapiro et al, 2016) however, this trend is likely driven in large part by compositional changes in the student population during this time. There are various reasons why the broader COVID 19 crisis and the ensuing abrupt shift to online learning may have led to worse negative outcomes for students. Based on a survey administered to college students in April 2020, Aucejo et al (2020) report that 13% of students report delaying graduation and 40% lost a job, job offer or internship due to the pandemic. Low income students were much more likely to report having delayed graduation. Additionally, students may have been dealing directly with health challenges associated with COVID 19 infection, or have had family members who became sick. Many students were among the tens of millions of Americans who lost their jobs during Spring 2020, or may have had family members lose employment; the stress of these job losses may have reduced the cognitive bandwidth and attention students could devote to class (Shah, Shafir, and Mullainathan, 2015) Increased child care responsibilities may have detracted from time adult students could invest in their college course work. Research to date on the efficacy of online versus in person learning suggests that students tend to fare worse in online classes. Randomized studies which assigned students to either in person or online learning have shown online learning to have negative impacts on course performance (Figlio, Rush and Yin 2013; Alpert, Couch and Harmon 2016) Additional studies which employ quasi experimental methods find that online learning decreases course completion, final grade and enrollment persistence, and increases in course repetition (Xu and Jaggars 2011; Xu and Jaggars 2013; Hart, Friedman, and Hill 2016; Bettinger et al. 2017) At the same time, there are several reasons why the sudden shift to online learning may not have negatively affected student outcomes, or why the magnitude of this effect may have been not as profound as some might expect. For instance, the combined shift to online learning, remote work, and even job loss may have substantially increased the time available to students to invest in their courses. Forward thinking students who anticipate the importance of additional training or education in a potentially transformed post COVID economy may have renewed their efforts toward earning a credential. Students may have had additional access to asynchronous course materials to support their learning and exam preparation. Many colleges implemented emergency grading policies which could have reduced the effort required from students to pass their courses and make further progress towards their degree. Since the shift to online courses happened well into the Spring 2020 semester, negative impacts on student learning could also be mitigated by the opportunity to create relationships in person prior to the switch and therefore had a higher degree of "social presence" which is associated with better outcomes in online learning (Liu, Gomez, and Yen, 2009) Finally, most of the prior research on the efficacy of online learning has estimated local treatment effects or average treatment effects (from RCTs) that may not generalize beyond the experimental setting. These studies may not capture the relative impact of online versus in person education in the COVID 19 context, which induced an effectively population level shift to online education. Isolating the effect of the abrupt shift to online learning on student outcomes is challenging, given the lack of variation in the timing over which most colleges and universities shifted to online, and because of the parallel health, economic, and child care challenges that could have also affected students' academic success. In this paper, we use a difference in differences estimation strategy, exploiting variation in whether students were enrolled in in person or online classes at the start of the Spring 2020 semester, to produce the first causal estimates we know of on the impact of the sudden shift to online learning as a result of COVID 19. More specifically, we compare changes in course completion rates along two dimensions: (1) in person versus online courses; (2) Spring 2020 versus recent comparison terms. We classify students enrolled in in person courses at the start of the Spring 2020 as "treated" i.e. they experienced the sudden shift to virtual instruction. We estimate our models with course fixed effects to respectively control for differences in student outcomes occurring across courses. We estimate the impact of abruptly shifting to online using student level data from the Virginia Community College System, which enrolls approximately 250,000 students per year, on numerous dimensions is broadly representative of open access institutions across the country, and which had a broad slate of online course offerings prior to COVID 19. Our analyses yield several primary results. The move from in person to virtual instruction resulted in a 6.7 percentage point decrease in course completion. This translates to a 8.5 percent decrease when compared to the pre COVID course completion rate for in person students of 79.4 percent. This decrease in course completion was due to a relative increase in both course withdrawal (5.2 pp) and course failure (1.4 pp) We find very similar point estimates when we estimate models separately for instructors teaching both modalities versus only one modality, suggesting that faculty experience teaching a given course online does not mitigate the negative effects of students abruptly switching to online instruction. The negative impacts are largest for students with lower GPAs or no prior credit accumulation. Our paper makes several contributions. First, our analyses are the first we are aware of that estimate the causal effect of the abrupt shift to online instruction stemming from the COVID 19 crisis on students' academic performance in the Spring 2020 semester. Our results make concrete the tradeoff in terms of student performance from abruptly shifting from in person to online instruction that may arise if, during future semesters, higher education administrators need to cancel in person classes because of COVID 19 resurgences or other future disruptions. The diminished performance in online courses that we estimate could be weighed alongside the costs of continuing in person, such as increased health risks to students, faculty, or staff, or the cost of investments in personal protective equipment. Our results moreover indicate that educators may need to invest additional resources to structure online learning environments that more closely resemble in person instruction, such as having synchronous class meeting times, and building in additional opportunities for faculty and student engagement. Second, we make the novel contribution of demonstrating that declines in student performance stemming from disruptions are not solely a function of economic, health, or familial challenges that students experience outside of the classroom, or a function in overall shifts in institutional resources, and are also influenced by changes in course delivery and p

title: Online gaming in relation to negative consequences and ill health among adolescents
abstract: Playing online computer games is one of the most common leisure activities among adolescents. However, frequent computer related activities have been suggested to be a new health risk factor associated with psychosomatic and physical complaints. The present study examined online gaming time and motives for playing, in relation to depression, musculoskeletal symptoms and psychosomatic symptoms.  A total of 7,757 Swedish adolescents aged 13 18 years completed a voluntary, anonymous questionnaire during class hours that included questions about demographic background, depressive symptoms, musculoskeletal symptoms, psychosomatic symptoms and gaming habits.  Increased gaming time on weekdays elevated the odds for depression, musculoskeletal symptoms and psychosomatic symptoms. However, the effects of time spent gaming were further explained by motives for playing. Gaming on weekdays for more than five hours a day, in combination with escape motives, revealed the highest odds for depression symptoms (OR 5.335, p 0.001) musculoskeletal symptoms (OR 2.614, p 0.001) and psychosomatic symptoms (OR 4.814, p 0.001) The increases in odds for depression symptoms, musculoskeletal symptoms and psychosomatic symptoms were less obvious among weekend gamers.  Motives for playing was the dominant factor in relation to depression, musculoskeletal symptoms and psychosomatic symptoms, whereas the time factor was of less importance. Online gaming motives may identify problem gamers in need of intervention to reduce their unhealthy gaming behaviour. Further research on health issues in relation to online gaming should consider the combined effects of time spent gaming and gaming motives.

title: [Development and evaluation of online aging and health management education for undergraduate students]
abstract: The purpose of this study was to develop online aging and health management education for undergraduate students and to evaluate its effects analyzing the differences in knowledge and attitude toward aging and the elderly.  An Online aging and health management education program was established through analysis, planning, content framing and production, program application, and evaluation stages. The study sample consisted of 98 undergraduate students in one university in D city. The instruments used were FAQ I for knowledge of aging and a 20 item semantic differential scale for attitude toward aging and the elderly.  The results of this study were as follows. First, undergraduate students' knowledge level was low and attitudes were negative at the baseline. Second, after the class, knowledge scores improved significantly from 14.44 to 20.12. In addition, the attitudes toward elderly and aging changed from negative to a more positive way showing a 23.57 point difference.  This study shows that the online aging and health management education program was an effective educational method to improve knowledge and attitude of aging for the young generation such as college students.

title: Testing the effects of a message framing intervention on intentions towards hearing loss prevention in adolescents.
abstract: Adolescent hearing loss is a public health problem that has eluded effective intervention. A persuasive message strategy was tested for its effectiveness on adolescents' intention to listen to music at a reduced volume. The messages manipulated both type of message frame [positive consequences of listening to music at a reduced volume (gain framed) versus negative consequences of not listening to music at a reduced volume (loss framed) and type of temporal context (short term versus long term consequences) Participants were recruited from four vocational and secondary education schools in the Netherlands and message exposure took place online during class hours. Two weeks prior to message exposure, adolescents provided data on intention and risk perception towards hearing loss and use of (digital) music players. After message exposure, 194 adolescents (mean age 14.71 years, SD 1.00, 37.8% males) provided immediate follow up data on intention. Results revealed that intention to listen to music at a reduced volume increased in those exposed to a loss framed message with short term consequences. No changes were found in the other conditions. Messages that emphasize negative short term consequences of not listening to music at a moderate volume have the ability to influence adolescents' intention towards hearing loss prevention.

title: Evaluating COVID 19 Public Health Messaging in Italy: Self Reported Compliance and Growing Mental Health Concerns
abstract: The COVID 19 death rate in Italy continues to climb, surpassing that in every other country. We implement one of the first nationally representative surveys about this unprecedented public health crisis and use it to evaluate the Italian government's public health efforts and citizen responses.  (1) Public health messaging is being heard. At this point, the Italian people understand how to keep themselves and others safe from the SARS Cov 2 virus. This is true for all population groups we studied, with the partial exception of slightly lower compliance among young adults. Remarkably, even those who do not trust the government, and those who think the government has been untruthful about the crisis mostly believe the public health message and claim to be acting in accordance. (2) The quarantine is beginning to have serious negative effects on the population's mental health. Policy Recommendations: Public health messaging is being heard and understood. The focus now should move from explaining that citizens should stay at home to what they can do at home. We need interventions that make staying at home and following public health protocols more desirable, or possibly even fun. These interventions could include virtual social interactions, such as online social reading activities, classes, exercise routines, among others all designed to reduce the boredom of being socially isolated for long periods of time and to increase the attractiveness of following public health recommendations. Interventions like these will grow in importance as the crisis wears on around the world, and staying inside wears on people.