Exploring student preferences for implementing a digital mental health intervention in a university setting: Qualitative study within a randomised controlled trial.

Objective: Digital interventions can be effective in preventing and treating common mental health conditions among university students. Incorporating student experiences and perspectives in the design and implementation of these programmes may improve uptake and engagement. This qualitative study explored university students' perspectives of a low-intensity video-based mental health intervention, their recommendations for implementing the programme in university settings, and their views and recommendations to address barriers to engagement. Methods: Participants (N = 115) were students (mean = 20.63 years, SD = 2.10) with elevated distress from 31 Australian universities drawn from a randomised controlled trial of the Uni Virtual Clinic-Lite (UVC-Lite). Data from students randomised to the intervention condition were collected via semi-structured interviews (n = 12) and open-ended questions during post-intervention surveys (n = 103). Data were analysed using content analysis. Results: Participants generally reported positive views of the intervention, and most felt it should be offered to students as a universal intervention. Multiple methods of disseminating the intervention were suggested, including through university counselling, official platforms (e.g. student support services) and informal channels (e.g. word-of-mouth promotion). Difficulty integrating the programme into everyday life, pre-existing beliefs about mental health and technology-related factors were highlighted as barriers to engagement. Conclusion: A low-intensity video-based mental health intervention was generally considered to be acceptable and appropriate for students with mild to moderate distress. Participants provided several suggestions to encourage uptake of the intervention and possible pathways to disseminate the intervention to students. The effectiveness of these should be examined in future trials.

Examining Demographic & Socio-Cultural Factors as Predictors of Alcohol Consumption Among African American Male College Students Attending an Urban Historically Black College and University.

Alcohol consumption among college students continues to be a significant public health concern for colleges and universities across the country. However, a preponderance of research primarily included White samples from predominantly white institutions. Unsurprisingly, this practice limits what is known regarding alcohol consumption among African American male college students on historically Black campuses. Notably, as a "rite of passages" from childhood to adulthood, early exposure to alcohol consumption has been viewed as a cultural norm in African American families. The negative consequences associated with alcohol abuse, early exposure to alcohol, and the prevalence of problem drinking among college students in general, mandated further research facilitating a better understanding of this public health concern on historically Black campuses. This study examined alcohol use among African American male college students, investigating relationships between demographics and socio-cultural factors as predictors of alcohol consumption among African American male college students who drink. A convenience sample of 94 students was used. A multiple regression was conducted to test whether demographics and socio-cultural factors were predictors of alcohol consumption. Findings from this study will advance social work research and stimulate discussions about substance abuse disparities among African American male college students who consume alcohol. Furthermore, this research highlights the public health issue, prompting the development of prevention and intervention programs aimed at addressing the social problem of alcohol consumption among African American male college students at historically Black universities.

Mentoring LGBT Students: Perspectives from Volunteers at a Taiwanese Buddhist University.

An increasing number of studies related to LGBT inclusion on university campuses have emerged over the past few years. While a number of these studies address complex challenges encountered in Western religious universities, very little research has investigated religious universities in Eastern, Sinophone communities. This study sheds light on a mentor system at a prominent Buddhist university in Taiwan to investigate mentors' understandings of and interactions with LGBT students. Through the use of both qualitative and quantitative measures, the researchers found very few mentors were even aware of interactions with LGBT students. A thematic analysis of focus group data found the mentors' understandings and attitudes could be classified into three distinct categories ranging from very supportive to unintentionally discriminatory. Overall, it seems Confucian values, rather than Buddhist doctrines, is a far more influential factor on mentors' understandings and attitudes toward LGBT individuals. In particular, conflicts between Confucian thought and LGBT inclusive practices may arise when individuals concurrently display a strong desire to help, Confucian understandings of "family," and very little understanding of gender or sexuality. Finally, this study offers recommendations for future research and universities.

Educational intervention on sexual violence to empower university students in developing healthy affective-sexual relationships.

Introduction: Sexual violence (SV) is frequent in universities, and a link has been demonstrated between SV and toxic substance use by university students in leisure settings. In Spain there is little scientific evidence in this regard, and SV prevention programmes are practically non-existent in Spanish universities. Objectives: To develop, implement, and evaluate an educational awareness-raising intervention regarding SV aimed at empowering university students to develop healthy affective-sexual relationships. Methods: Participatory action research intervention, implemented with a convenience sample of students recruited in a public university and qualitatively evaluated using a phenomenological approach. Results: The sample was composed of 22 women students, whose discourse revealed that SV acts are normalized in university leisure settings featured by the consumption of alcohol and other drugs. Post-intervention, the participants showed an increased understanding of SV, a heightened awareness of SV, and a greater capacity to identify SV acts. The intervention empowered the participants in terms of coping with SV situations and in raising awareness in their own social circles. Conclusions: The intervention changed the participants' attitudes and behaviours regarding SV, empowering them not only regarding their own affective-sexual relationships, but also in censoring attitudes and behaviours that foster SV, and in transmitting their acquired knowledge of SV in their social circles. Post-intervention, the participants considered themselves to be agents of social change in their environment and in terms of healthy affective-sexual relationships. Public contribution: University students participated in and evaluated an intervention that trained them to identify and to censor attitudes and behaviours that promote SV, empowered them as engines of social change, and showed them how to foster healthy affective-sexual relationships.

Africa must create centres of educational excellence for innovation and development.

This paper explores the following development questions that perplex most Africans: "Why do African countries rely on foreign companies and foreign experts for almost all our development projects? Why can't we build our own roads, process our own food, and mine our own minerals, oil, and gas? Why don't we have world-class hospitals and industries? How can we have so much natural wealth and yet be so poor? Why do we invent so little?" The answer lies in our failure to implement idea number two. There are two major ideas in educational policy. Idea number one is the obligation to educate all children because it is their fundamental human right as enshrined in the 1948 United Nations Declaration of Human Rights. Idea number two is the strategy of establishing and sustaining world class schools and universities for the education of the most highly gifted and highly talented citizens. Developed countries deploy both ideas aggressively. Underdeveloped countries in Africa have not implemented idea number two. Countries that have deployed idea number two have at least one university ranked among the top 200 in the world. The presence of great universities (top 200) in a country is a 21st century indicator of the presence of high levels of innovation, technology, development and wealth in that country. According to the three major rankings of world universities (Shanghai-ARWU, THE, and QS-topuniversities.com), none of the world's top 100 great universities is in Africa. Although Africa was a pioneer among the continents in innovations such as human language, domestication of fire, making of tools, invention of agriculture, development of writing, and creation of great centers of learning in ancient times, it has fallen behind other continents over the last 500 years and it has been disrupted by enslavement and colonization, and the structural adjustment programs (SAPs) of the IMF and the World Bank. Ancient African centers of innovation included the Ancient City of Benin and Timbuktu in Western Africa, the Kingdom of Kush and ancient Egypt in northern Africa, Axum in Eastern Africa, Mapungubwe and Great Zimbabwe in Southern Africa, and the Kingdom of Kongo in central-Africa. An African renaissance will only occur when we implement idea number two by establishing world class schools and at least one great university per African country.

Cet article explore les questions de développement suivantes qui intriguent la plupart des Africains : « Pourquoi les pays africains s'appuient-ils sur des entreprises et des experts étrangers pour presque tous nos projets de développement ? Pourquoi ne pouvons-nous pas construire nos propres routes, transformer nos propres aliments et extraire nos propres minéraux, pétrole et gaz ? Pourquoi n'avons-nous pas d'hôpitaux et d'industries de classe mondiale ? Comment pouvons-nous avoir autant de richesses naturelles et pourtant être si pauvres ? Pourquoi inventons-nous si peu ? La réponse réside dans notre échec à mettre en œuvre l'idée numéro deux. Il y a deux idées majeures en politique éducative. L'idée numéro un est l'obligation d'éduquer tous les enfants, car il s'agit de leur droit humain fondamental tel que consacré dans la Déclaration des droits de l'homme des Nations Unies de 1948. L'idée numéro deux est la stratégie consistant à créer et à maintenir des écoles et des universités de classe mondiale pour l'éducation des citoyens les plus doués et les plus talentueux. Les pays développés déploient ces deux idées de manière agressive. Les pays sous-développés d'Afrique n'ont pas mis en œuvre l'idée numéro deux. Les pays qui ont déployé l'idée numéro deux comptent au moins une université classée parmi les 200 meilleures au monde. La présence de grandes universités (les 200 meilleures) dans un pays est un indicateur du XXIe siècle de la présence de niveaux élevés d'innovation, de technologie, de développement et de richesse dans ce pays. Selon les trois principaux classements des universités mondiales (Shanghai-ARWU, THE et QS-topuniversities.com), aucune des 100 meilleures universités mondiales ne se trouve en Afrique. Bien que l'Afrique ait été un continent pionnier en matière d'innovations telles que le langage humain, la domestication du feu, la fabrication d'outils, l'invention de l'agriculture, le développement de l'écriture et la création de grands centres d'apprentissage dans l'Antiquité, elle a pris du retard sur les autres continents au fil du temps. Ces 500 dernières années ont été perturbées par l'esclavage et la colonisation, ainsi que par les programmes d'ajustement structurel (PAS) du FMI et de la Banque mondiale. Les anciens centres d'innovation de l'Afrique comprenaient l'ancienne ville du Bénin et Tombouctou en Afrique de l'Ouest, le royaume de Kouch et l'Égypte ancienne en Afrique du Nord, Axum en Afrique de l'Est, Mapungubwe et le Grand Zimbabwe en Afrique australe et le royaume de Kongo en Afrique centrale. . Une renaissance africaine ne se produira que lorsque nous mettrons en œuvre l'idée numéro deux en créant des écoles de classe mondiale et au moins une grande université par pays africain.

Psychosocial factors associated with sickness absence in employees at a federal public university.

Introduction: There is a need to understand which factors are associated with sickness absence in the context of public service in order to guide efforts to prevent illness in workers. Objectives: We investigated whether lifestyle, locus of health control, work-related stress, and self-perception of physical and mental health are associated with sickness absence from a biopsychosocial perspective. Methods: This is a cross-sectional study using an online questionnaire and the participants comprised 898 employees at a federal university. The assessment included instruments on sociodemographic and occupational characteristics, sickness absence, lifestyle (FANTASTIC Lifestyle scale), locus of control (Multidimensional Health Locus of Control Scale), workrelated stress (Health Safety Executive), and physical and mental health (Short-Form Health Survey 12 - version 2). A Poisson regression model was constructed using Generalized Estimating Equations to identify the variables associated with sickness absence, with a p ≤ 0.05 significance level. Results: We found that work-related stress, locus of control, physical and mental health, administrative or technical job role, female gender, and longer service time at the institution were associated with a higher number of days absent from work due to illness (for all associations, p < 0.001). Conclusions: The present study contributes to the literature by offering additional data on sickness absence in the context of Brazilian public university employees.

Introdução: É necessário compreender quais fatores estão associados ao absenteísmo-doença no contexto do serviço público para direcionar a prevenção do adoecimento em trabalhadores. Objetivos: Foi investigado se estilo de vida, lócus de controle da saúde, estresse relacionado ao trabalho e autopercepção de saúde física e mental estão associados com absenteísmodoença, a partir de uma perspectiva biopsicossocial. Métodos: Trata-se de um estudo transversal por meio de questionário online. Participaram 898 servidores públicos de uma universidade federal. Utilizaram-se cinco instrumentos: um questionário de características sociodemográficas e ocupacionais; a escala FANTASTIC Lifestyle, para avaliação do estilo de vida; a escala Multidimensional Health Locus of Control Scale, que avalia lócus de controle da saúde; as diretrizes do Health and Safety Executive, para avaliação do estresse relacionado ao trabalho; e o Short-Form Health Survey 12 - version 2, para avaliação da saúde física e mental. Para identificar as variáveis associadas ao absenteísmo-doença, foi empregado o modelo de regressão de Poisson através de equações de estimativas generalizadas, sendo considerado o nível de significância p ≤ 0,05. Resultados: Apontou-se que maior estresse relacionado ao trabalho, lócus de controle da saúde, pior autopercepção de saúde física e mental, técnicos administrativos, gênero feminino e maior tempo de serviço na instituição se associam com mais dias de ausência ao trabalho por motivo de doença (para todas as associações: p < 0,001). Conclusões: O presente estudo contribui com a literatura ao oferecer dados adicionais sobre absenteísmo-doença no contexto de serviço público universitário brasileiro.

Quality of life among home office-based university administrative personnel.

Introduction: The integration of remote work into higher education institutions has led to increased administrative activities and has affected quality of life, especially at work. Objectives: To verify the influence of income on the quality of life and quality of work life of administrative personnel of a higher education institution who worked remotely during the COVID-19 pandemic. Methods: This descriptive cross-sectional study included 18 employees who worked via home office in the teaching, research, and/or extension sectors of a public university in Bahia, Brazil. Data were collected through an online questionnaires regarding sociodemographic data, quality of life (36-item Short-Form Health Survey), and quality of work life (Total Quality of Work Life). Results: Older employees had higher income. Higher income was associated with higher quality of life scores for physical, emotional, and mental health, while lower income was associated with better scores for interpersonal relationships and work hours. There was a high prevalence of COVID-19 infection. Quality of life and quality of work life were considered worse than in the pre-pandemic period. Conclusions: Income influenced several aspects of quality of life and quality of work life (physical, emotional, and mental health, as well as interpersonal relationships and work hours) among university administrative personnel who worked remotely working during the COVID-19 pandemic.

Introdução: A implementação do trabalho remoto nas instituições de ensino superior tem provocado um aumento nas atividades administrativas e causado diversos efeitos na qualidade de vida, sobretudo em relação ao trabalho. Objetivos: Verificar a influência da renda na qualidade de vida e na qualidade de vida no trabalho dos servidores técnicos administrativos de uma instituição de ensino superior em home office durante a pandemia da covid-19. Métodos: Tratou-se de um estudo transversal descritivo com 18 servidores técnicos administrativos em home office, lotados nos setores de ensino, pesquisa e/ou extensão de uma universidade pública no estado da Bahia, Brasil. Os dados foram coletados por meio de um questionário on-line no qual se investigou dados sociodemográficos, a qualidade de vida (Short-Form Health Survey) e a qualidade de vida no trabalho (Total Quality of Work Life). Resultados: Os técnicos administrativos mais velhos possuíam maior renda. A maior renda esteve associada a melhores escores na qualidade de vida para os aspectos físicos, emocionais e de saúde mental, enquanto aqueles com menor renda obtiveram melhores escores na qualidade de vida no trabalho para os aspectos relações interpessoais e jornada de trabalho. Houve elevada prevalência de contaminação pela covid-19, e a qualidade de vida e a qualidade de vida no trabalho foram consideradas piores em comparação ao período pré-pandemia. Conclusões: A renda influencia em aspectos físicos, emocionais e de saúde mental, bem como em aspectos de relações interpessoais e jornada de trabalho, impactando a qualidade de vida e a qualidade de vida no trabalho de técnicos administrativos em home office durante a pandemia da covid-19.

Exploring the need for sexually transmitted infection education among university student athletes in Saskatchewan.

Background: Sexually transmitted infections (STIs) are common in young adults in Canada and their prevalence is rising. Assessing sexual health knowledge among young adults is essential for developing effective STI education strategies. However, there is limited research on the sexual health knowledge of Canadian university athletes, who have increased risks of STIs. Objective: To determine perceived and objective levels of knowledge on STIs among university athletes and their preferred methods of knowledge translation regarding sexual health information. Methods: U SPORTS athletes at the University of Saskatchewan and the University of Regina were invited to complete an electronic survey between January-March 2022. Participants completed the Sexual Transmitted Disease Knowledge Questionnaire (STD-KQ) and self-reported their confidence in their answers. Participants were asked about testing beliefs, where they receive their sexual health information and their preferred format for STI information delivery. Results: One hundred participants completed the survey (14% response rate). Participants had a median composite self-reported STI knowledge score of 2.8 out of 5 (interquartile range [IQR]: 2.4-3.6). The median participant scored 12 out of 27 (44%) on the STD-KQ (IQR: 8-17). Sixty-seven percent of participants received sexual health information from a physician. Sixty-one percent of participants believed embarrassment may prevent them from getting tested or screened. The three most popular methods of health information sharing were online modules (34%), in-person lectures/conferences (24%) and self-paced videos (20%). Conclusion: This study highlighted that STI knowledge is limited in university athletes. Comprehensive online educational interventions may be effective at improving knowledge.

Evaluation of the psychometric properties of the homophobia scale in religious-based university students in Indonesia.

This study aims to evaluate the psychometric properties of the homophobia scale in students attending religion-based universities in Indonesia. This research is important as homosexuality is a controversial issue in the country and is still a topic of debate. The Homophobia Scale is a tool that assesses attitudes towards homosexuality through 17 items measuring positive affirmation, negative cognition, and the perceived threat of homosexual behavior. The scale was adapted for the Indonesian context, which is predominantly religious, based on The Heterosexual Attitudes Towards Homosexuality (HATH) Scale and Items, originally translated by bilingual experts. The translated scale was then reviewed for content by psychologists and communication experts, and field-tested for reliability and validity. Data from 327 students aged 18-35 from both state and private religion-based universities were analyzed using Rasch model analyses, including principal component analysis (PCA), reliability analysis, and differential item functioning (DIF) assessment. The study found that the homophobia scale accounted for 42.4 % of the raw variance, indicating its unidimensionality. The scale demonstrated an acceptable level of personal reliability and excellent reliability for individual items. Results revealed significant demographic effects, with age and study program showing more differential item functioning (DIF). Male students were more tolerant towards homosexuals than females. Additionally, students at state universities tended to be more tolerant but held negative views of homosexuality when associated with AIDS. In conclusion, the homophobia scale assessed in this study exhibits promising construct validity and sufficient psychometric properties. The findings indicate that negative stigma towards homosexuals and homophobia still persist among students at religion-based universities in Indonesia, despite limited interaction with homosexuals.

Evaluating the efficiency of online course resource allocation in universities of China.

Curriculum is the core element of talent cultivation in universities, and its quality directly determines that of the talent cultivation. However, the efficiency of online course resource allocation in universities of China is unacceptable, and the corresponding driving mechanisms are unclear. Based on the data of iCourses platform for a top university (H University) of China, this paper develops the DEA-Malmquist index and Tobit regression model to evaluate the efficiency of university online course resource allocation and explore its main influencing factors. The empirical results indicate that, first of all, humanities and social sciences outperform natural sciences in the resource allocation efficiency of online courses. Compared with non-national premium online courses, the resource investment redundancy of national premium online courses appears relatively lower. Secondly, from the perspective of temporal changes, the total factor productivity of online course resource allocation generally has a downward trend. The innovation effect of technological progress is more significant, while the catch-up effect of technical efficiency is clearly insufficient. Scale efficiency is the main factor hindering its improvement. Finally, in terms of the factors affecting the efficiency of online course resource allocation, teachers' research guidance capability, teaching research skills, and the number of courses offered have significantly positive impact.

University Food Environment Assessment Methods and Their Implications: Protocol for a Systematic Review.

BACKGROUND: While the retail food environment has been well studied, research surrounding the university food environment is still emerging. Existing research suggests that university food environments can influence behavioral outcomes such as students' dietary choices, which may be maintained long-term. Despite a growing interest in assessing university food environments, there is no standardized tool for completing this task. How researchers define "healthy" when assessing university food environments needs to be clarified. This paper describes the protocol for systematically reviewing literature involving university food environment assessments. OBJECTIVE: This paper aimed to describe the protocol for a systematic review of the assessments of university food environments. The review will summarize previously used tools or methods and their implications. METHODS: Electronic databases, including PubMed (NLM), Cochrane Library (Wiley), Web of Science (Clarivate), APA PsycINFO (EBSCO), CINAHL (Cumulative Index to Nursing & Allied Health) Complete (EBSCO), ProQuest Nursing and Allied Health, and Google Scholar were searched for papers published between 2012 and 2022 using combinations of related medical subject headings terms and keywords. The electronic databases were supplemented by reviewing the reference list for all included papers and systematic reviews returned with our search results. The review will include all study types, including randomized controlled trials, observational studies, and other pre-post designs. Papers that examine at least 1 aspect of the university food environment, such as cafeterias, campus convenience stores, and vending machines, were considered for inclusion. A total of 2 reviewers will independently screen titles and abstracts, complete a full-text review, extract data, and perform a quality assessment of included papers, with a third reviewer resolving any conflicts. The Quality Assessment for Diverse Studies (QuADS) tool was used to determine the methodological quality of selected studies. A narrative and tabular summary of the findings were presented. There will not be a meta-analysis due to the methodological heterogeneity of the included papers. RESULTS: The initial queries of 4502 records have been executed, and papers have been screened for inclusion. Data extractions were completed in December 2023. The results of the review were accepted for publication in May 2024. The systematic review generated from this protocol will offer evidence for using different assessment tools to examine the campus food environment. CONCLUSIONS: This systematic review will summarize the tools and methods used to assess university food environments where many emerging adults spend a significant part of their young adult lives. The findings will highlight variations in practice and how "healthy" has been defined globally. This review will provide an understanding of this unique organizational food environment with implications for practice and policy. TRIAL REGISTRATION: PROSPERO CRD42023398073; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=398073. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/54955.

'When I came to university, that's when the real shift came': alcohol and belonging in English higher education.

While young people's alcohol consumption has fallen sharply in the United Kingdom and other high-income countries, universities remain places where heavy drinking is routine and normative. Drawing on interviews with undergraduate students, this article explores how heavy drinking is part of how students negotiate a sense of belonging and form personal relationships. Theoretical work on belonging and relationality is used to make sense of students' encounters with alcohol. Consistent with the decline in youth drinking, several interviewees had limited experience of heavy drinking prior to university, and some were not interested in taking it up. After describing how heavy drinking facilitates belonging in certain spaces of student life, we examine the strategies of non- and low-drinking students in navigating these spaces. Attending to their strategies suggests that becoming known as 'social persons' is key to negotiating belonging without drinking heavily. We conclude by considering how universities might better accommodate the desire for belonging for the increasingly large proportion of students with limited experience of or desire for alcohol by creating opportunities for students to form personal relationships in ways that do not involve alcohol or where alcohol is peripheral to the activity.

[A healthy lifestyle of students is a resource for preserving the health of the working-age population in the near future].

The issues of acceptance and support of a healthy lifestyle by various social and age groups of the population, especially among the younger generation and youth, through the pursuit of physical, mental and social well-being remain relevant. Educational organizations, including universities, are important actors in this direction, since their students will soon become leaders in society, decision makers, as well as parents of tomorrow. According to scientists, a weak attitude towards sports, lack of time for physical education lead to a vicious circle of focusing on intellectual education, high knowledge scores, low physical abilities and physical fitness. It is emphasized that universities should have organizational systems for managing educational materials, teaching staff, as well as technologies to improve learning processes through a technology platform. Universities are strategic places to launch a wellness campaign and «have conversations¼ about healthy lifestyles and sustainable development.

Minimally Invasive Coronary Artery Bypass Grafting in a Low-Risk Asian Cohort: A Propensity-Score Matched Study.

INTRODUCTION: Minimally invasive coronary artery bypass grafting (MICS CABG) offers a new paradigm in coronary revascularization. This study aims to compare the outcomes of MICS CABG with those of conventional median sternotomy CABG (MS CABG) within a growing minimally invasive cardiac surgical program in Singapore. METHODS: Propensity matching produced 111 patient pairs who underwent MICS CABG or MS CABG between January 2009 and February 2020 at the National University Heart Centre, Singapore. Minimally invasive direct coronary artery bypass surgery patients were matched to single- or double-graft MS CABG patients (Group 1). Multivessel MICS CABG patients were matched to MS CABG patients with equal number of grafts (Group 2). RESULTS: Overall, MICS CABG patients experienced shorter postoperative length of stay (P<0.071). In Group 2, procedural duration (P<0.001) was longer among MICS CABG patients, but it did not translate to adverse postoperative events. Postoperative outcomes, including 30-day mortality, reopening for bleeding, new onset atrial fibrillation as well as neurological, pulmonary, renal, and infectious complications were comparable between MICS and MS CABG groups. CONCLUSION: MICS CABG is a safe and effective approach for surgical revascularization of coronary artery disease and trends toward a reduction in hospital stay.

Intersectionality and Gender-Based Violence: An Empirical Multi-Level Examination of Prevalence and Frequency in Universities and Research Organizations.

This article provides a multilevel intersectional analysis of the prevalence and frequency of gender-based violence within universities and other research organizations in Europe. Results show not only the high prevalence of gender-based violence in this context, but also that in contrast to the prevailing discourse, that gender-based violence is not solely a "women's problem", but also a structural issue impacting diverse identities. Data on frequency show that physical and sexual violence usually occurs as isolated incidents, whereas psychological violence and harassment are often repeated.

Effectiveness of Unguided Internet-Based Cognitive Behavioral Therapy for Subthreshold Social Anxiety Disorder in Adolescents and Young Adults: Multicenter Randomized Controlled Trial.

BACKGROUND: Social anxiety disorder (SAD) is a common mental disorder in adolescents and young adults. Early intervention and support could help prevent the development of full-blown SAD. Considering that adolescents with social anxiety symptoms do not prefer face-to-face sessions due to their fear of communicating with therapists, internet-based cognitive behavioral therapy (ICBT) was implemented. OBJECTIVE: This study aimed to examine the effectiveness of complete self-help ICBT for subthreshold SAD in high school and college students with no history of mental disorders. METHODS: A multicenter randomized controlled trial designed to demonstrate the objective was conducted from December 2022 to October 2023. Participants were students enrolled at 6 universities and 1 high school. The intervention was a complete self-help ICBT and consisted of 10 text-based sessions that taught cognitive behavioral therapy techniques for social anxiety in youths and young adults. The comparison was a no-treatment condition (control group), which was randomly assigned in a 1:1 ratio by a computer program. A total of 2 psychological scales were used to assess the severity of social anxiety, and 1 psychological scale each was used to measure symptoms of depression, general anxiety, and quality of life. RESULTS: In total, 77 students were enrolled as study participants. Through the randomization procedure, 38 participants were included in the intervention group, and 39 patients were included in the control group. Results from the analysis of covariance with depression as covariates showed that the participants in the intervention group had significantly reduced symptoms of social anxiety, depression, and general anxiety compared to the control group. The response rate was 61% (19/31) in the intervention group and 24% (9/38) in the control group: odds ratio (OR) 4.97 (95% CI 1.61-16.53; P=.003) in the Fisher exact test. The recovery rate was 68% (21/31) in the intervention group and 34% (13/38) in the control group: OR 3.95 (95% CI 1.32-12.56; P=.008). The OR for the remission ratio was 2.01 (95% CI 0.64-6.60; P=.20) and for the risk of worsening was 0.23 (95% CI 0.002-1.33; P=.10), but no significant difference was observed. CONCLUSIONS: The results of this randomized controlled trial show that fully unguided ICBT improves subthreshold SAD in adolescents and young adults. Interpretation of the effectiveness in preventing SAD that meets the diagnostic criteria is limited by sample size and the follow-up period. Future studies should include more extended observations and larger sample sizes in high-risk populations. TRIAL REGISTRATION: UMIN-CTR UMIN000050064; https://center6.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000057035.

Towards context-independent indicators for an unbiased assessment of environmental sustainability in higher education: An application to Italian universities.

Higher education institutes (HEIs) are important drivers for the development and implementation of best practices for environmental sustainability. However, reliable indicators are needed to objectively evaluate the environmental performance of HEIs and their policies. The present paper aims at identifying suitable indicators for unbiased comparisons among different HEIs and for the identification of temporal trends in terms of environmental sustainability performance. At this aim, sustainability reports made publicly available by 24 Italian HEIs over a 10-year period were considered. Normalization of sustainability variables such as the annual electrical and thermal energy consumptions, related greenhouse gas emissions, and water consumption, against context-specific factors such as the number of users of each university, latitude, illuminance, heating degree days (HDDs) and cooling degree days allowed identifying the actual possible disturbance of the same variables. HDDs were found to positively affect the thermal energy consumption and the related CO2 emissions. Based on this, a novel indicator was formulated where the actual value of thermal energy consumption and the related CO2 emissions are divided not only by the number of users but also by the HDDs of the HEIs' locations. Indeed, this is a remarkable finding that, prior to confirmation with data from world HEIs, could be implemented in world university green ranking systems for improved and less biased sustainability assessments.

Cultural adaptation of a self-review tool for health promoting universities in Bulgaria.

Introduction: The Health Promoting University initiative is unknown in Bulgaria, and the health promotion potential of Bulgarian universities has not been studied. In order to examine it, a suitable instrument is needed. The UK Healthy Universities Network provides an accessible Self-Review-Tool (SRT). Aim: To present the process of cultural adaptation of the SRT in Bulgarian language. Methods: The standardized WHO methodology for cultural adaptation of instruments was followed in four stages: (1) Two language translations of the instrument into Bulgarian were made; (2) An expert Delphi discussion reached a consensus on specific health promoting (HP) terms, followed by a backward translation; (3) Pilot testing of the tool among university community representatives was conducted through a survey among a small sample, with independent responses to the SRT questionnaire followed by cognitive interviews; (4) Final revision of the instrument. Results: Ten public health experts reached a consensus on the name of the initiative and various HP terms. Ten other respondents pre-tested the tool. Difficulties in responding the SRT concerned the meaning of some HP terms, complex words, the system of answers, limited applicability of some statements. Changes were made to 61 of the total 68 elements in the SRT. Conclusion: All stages of the cultural adaptation were important for the final result. The adapted Bulgarian version of the SRT would be useful to Bulgarian universities that want to make a clear commitment to improving the health of their university community and the wider society.