Results of a brief online group application of the unified protocol for the prevention of emotional disorders in university students: a pilot study with multiple baseline experimental design / Resultados de una aplicación grupal breve en línea del protocolo unificado para la prevención de trastornos emocionales en estudiantes universitarios: un estudio piloto con diseño experimental de línea base múltiple

Los trastornos emocionales (TEs) son los trastornos más comunes entre la población joven. El desarrollo de programas preventivos de los TEs es fundamental para evitar su posible aparición. Los programas de prevención transdiagnósticos podrían presentar una ventaja sobre los existentes para mejorar las estrategias de regulación emocional. Así, el objetivo de este estudio ha sido determinar la viabilidad y eficacia preliminar de un programa breve basado en el Protocolo Unificado (PU). El proyecto consistió en un estudio piloto utilizando un diseño experimental de línea base múltiple. Nueve estudiantes universitarios recibieron un programa de 5 sesiones basado en el PU en formato grupal online. Se encontraron diferencias significativas después de la intervención en la regulación de las emociones, el apoyo social percibido y la evitación, con tamaños del efecto moderados-grandes (r de Cohen = .49 - .59). Estas mejoras mostraron aumentos en los seguimientos al mes y a los 3 meses. Esos resultados están en línea con los que muestran que los programas preventivos transdiagnósticos breves podrían ser útiles para la prevención de los TEs en población universitaria.(AU)

Emotional disorders (EDs) are the most common disorders among the young population. The development of preventive programs for EDs is essential to avoid their possible appearance. Transdiagnostic prevention programs could present an advantage over existing ones to im-prove emotional regulation strategies. Thus, the objective of this study has been to determine the preliminary feasibility and effectiveness of a brief program based on the Unified Protocol (UP). The project consisted of a pilot study using a multiple baseline experimental design. Nine university students received a 5-session program based on the UP in online-group format. Significant differences were found after the intervention for emo-tion regulation, perceived social support and avoidance, with moderate-large effect sizes (Cohen's r= .49-.59). These improvements showed in-creases at 1-month and 3-month follow-ups. Those results are in line with those showing that brief transdiagnostic preventive programs could be use-ful for the prevention of EDs in the university population.(AU)

Narcissism, perfectionism, and self-promoting behavior on social networking sites among university students in Pakistan / Narcisismo, perfeccionismo y comportamiento de autopromoción en sitios de redes sociales entre estudiantes universitarios en Pakistán

Existe un debate considerable en la literatura sobre cómo el narcisismo predice diversos comportamientos asociados con la utilidad de los sitios de redes sociales, pero los investigadores han prestado menos atención a explorar los mediadores potenciales de esta relación. Con base en la literatura existente, anticipamos que el narcisismo predice comportamientos de autopromoción en los sitios de redes sociales. El estudio actual también investigó el papel mediador del perfeccionismo multidimensional entre el narcisismo y el comportamiento de autopromoción. Se recopiló un total de 605 cuestionarios completos de estudiantes de universidades de Rawalpindi e Islamabad, Pakistán, mediante un muestreo conveniente. El estudio utilizó el Inventario de Personalidad Narcisista (Ames et al., 2006), un cuestionario de desarrollo propio sobre comportamiento de autopromoción en sitios de redes sociales y la Escala de Perfeccionismo Multidimensional (Hewitt et al., 1991). Los hallazgos indicaron que las mujeres en comparación con los hombres y las solteras en comparación con las casadas obtuvieron puntuaciones más altas en narcisismo. Los niveles educativos más altos se asociaron con tasas más altas de narcisismo. Los resultados también sugieren que el narcisismo se correlaciona con el perfeccionismo orientado a uno mismo y, más significativamente, con el narcisismo orientado a los demás. El perfeccionismo orientado a uno mismo y a los demás medió significativamente la relación entre el narcisismo y el comportamiento de autopromoción en los sitios de redes sociales.(AU)

There is considerable debate in the literature about how narcis-sism predicts various behaviors associated with the utility of social net-working sites, but researchers have paid less attention to exploring the po-tential mediators of this relationship.Based on the existing literature, we anticipated that narcissism predicts self-promoting behaviors on social networking sites. The current study also investigated the mediating role of multidimensional perfectionismbetween narcissism and self-promoting behavior. A total of 605 complete questionnaires weregathered fromstu-dents from universities from Rawalpindi and Islamabad, Pakistan using convenient sampling. The study used Narcissistic Personality Inventory (Ames et al., 2006), self-developed Self-promoting Behavior on social net-working sites questionnaire, and the Multidimensional Perfectionism Scale (Hewitt et al., 1991). Findings indicated that females as compared to males and single as comparedto married individuals scored higher on narcissism. Higher educational levels were associated with higher rates of narcissism. The results also suggestthat narcissism correlated with self-oriented per-fectionism, and more significantlywith others-oriented narcissism. Self-oriented and others-oriented perfectionism significantly mediated the rela-tionship between narcissism and self-promoting behavior on social net-working sites.(AU)

Effect of peer education on knowledge and frequency of smoking among high school students in disadvantaged districts: A quasi-experimental study.

OBJECTIVE: To evaluate the effectiveness of peer education on changing the knowledge and frequency of smoking of high school students. METHODS: The quasi-experimental study was conducted at the Vocational and Technical Anatolian High School, Turkey, during the 2021-22 academic year, and comprised students of either gender from the 9th to the 11th grade. After baseline assessment, training that blended peer education with the photovoice technique was administered between March 2021 and January 2022. Post-intervention assessment included smoking frequency, cigarette exposure and health literacy. Data was analysed using R version 4.0.5. RESULTS: Of the 465 students available, 395(84.95%) were part of the baseline assessment, while 434(93.3%) took the postintervention assessment. At the baseline, 365(93.8%) participants were males and 24(6.2%) were femaes. The overall median age was 15 years (interquartile range: 15-16 years). Post-training, smoking rate and indoor exposure to cigarette smoke among the students were statistically lower than the baseline values (p<0.05). The mean health literacy score postintervention was significantly higher than the baseline score (p<0.05). CONCLUSIONS: Photovoice combined with peer education seemed beneficial in terms of positive effect on smoking behaviour among youths.

Prevalence of depression, anxiety and stress and their risk and protective factors among secondary students in Rwanda during the first wave of COVID-19 pandemic.

INTRODUCTION: Compelling evidence shows that the COVID-19 pandemic has detrimental effects on the mental health of university students. However, little is known about the psychological distress experienced by students from high schools during the pandemic. This study, therefore, sought to examine the prevalence of depression, anxiety and stress and their associated factors among students from high schools in Rwanda. METHODS AND MATERIALS: A retrospective, cross-sectional study was conducted on 384 students randomly selected from high schools. Data were collected using standardized measures of mental disorders and their associated factors. Bivariate and multivariate analyses based on the odds ratio were used to indicate the associated factors of anxiety, depression, and stress. RESULTS: The results indicated that slightly above half of the participants (51%, n = 195) had clinically significant symptoms of depression, 30.3% (n = 116) had stress and 67.3% (n = 259) had anxiety. Our analyses identified several key risk factors associated with increased odds of these mental disorders. These include exposure to domestic violence, COVID-19 symptoms like cough and myalgia, eating twice per day, having one of the three mental disorders, gender, with females showing higher susceptibility, and direct contact with the people who positively tested covid-19. Conversely, protective factors such as heightened awareness about Covid-19, positive mental health, social support, eating three times, belonging to the third Ubudehe category, and a high resilience emerged as significant elements mitigating the risks of these mental health challenges within our sample. Intriguingly, religious affiliation emerged as a notable factor, with students affiliated with the Witness of Jehovah and Adventist denominations exhibited lower risks for depression and anxiety. CONCLUSION: Our findings highlighted a high prevalence of depression, anxiety, and stress among students from secondary schools. Interestingly, this study also revealed the associated risk and protective factors of depression, anxiety, and stress in Rwandan students in high schools. Therefore, mental health interventions targeting the impact of COVID-19 on students, as young people are needed.

Analyzing the Influence of Ambiguity Tolerance on Grammar Acquisition in EFL Learners Across Face-to-Face, Blended, and Flipped Learning Environments.

In the realm of language education, the influence of learners' personality traits on their educational outcomes within novel instructional frameworks has gained prominence, prompting an exploration into the effects of ambiguity tolerance on grammar acquisition among English as a Foreign Language (EFL) students. This study investigates the impact of learners' personality traits on their learning outcomes in innovative instructional models, such as flipped and blended classes. A sample of 120 EFL students was divided into four comparative groups and two control groups based on their proficiency and ambiguity tolerance (AT) scores. The study utilized a Learning Management System (LMS) to deliver instruction to the different groups. The blended group received a combination of online and face-to-face instruction, while the flipped group received online instruction using the flipped approach. The control group received only face-to-face instruction. After a semester of instruction, a posttest on grammar learning was administered. The findings showed that the blended group performed better than the flipped and face-to-face groups in terms of grammar learning. The study also found no significant differences in grammar learning between high AT and low AT participants in the flipped and blended classes. However, high AT students in the face-to-face class demonstrated higher levels of success in grammar learning compared to low AT students.

Providing sexual health care for international students in Australia: a qualitative study of a general practice team approach.

Background Provision of culturally responsive sexual health care for international students is important, given the large numbers of international students in Australia and known lower levels of health literacy among this cohort. Team-based care in general practice has the potential to provide this care. Methods A qualitative study that developed and evaluated a team-based model of care for female, Mandarin-speaking, international students in a university-based general practice. The model involved patients attending a consultation with a Mandarin-speaking nurse with advanced skills in sexual health who provided education and preventive health advice, followed by a consultation with a GP. Evaluation of the model explored patient and healthcare worker experiences using a survey and a focus group of patients, and interviews with healthcare workers. Data were analysed using a general inductive approach. Results The consultation model was evaluated with 12 patients and seven GPs. Five patients participated in a focus group following the consultation. Survey results showed high levels of patient satisfaction with the model. This was confirmed via the focus group findings. Healthcare workers found the model useful for providing sexual health care for this cohort of patients and were satisfied with the team approach to patient care. Conclusions A team-based approach to providing sexual health care for international students was satisfactory to patients, GPs and the practice nurse. The challenge is providing this type of model in Australian general practice under the current funding model.

Association between bullying, childhood adversities and social capital among adolescents.

This study aims to analyze the association between bullying behaviors, adverse childhood experiences and social capital in late adolescence. Secondary school students aged 15-19 of a metropolitan region of Brazil were recruited for a sectional epidemiological survey, with a sample of 2,281 students, stratified by municipality of school location. Descriptive and inferential statistics were performed from three instruments: Olweus Bully/Victim Questionnaire, Childhood Adversity History Questionnaire and Integrated Questionnaire to Measure Social Capital, in adapted versions. The results showed that the factors associated with bullying victims were gender and adversity in childhood. The factors associated to bullying aggressors were gender, childhood adversities, and cognitive social capital. And the factors associated with bullying aggressor-victims were gender, childhood adversities, and cognitive social capital. It is concluded that bullying is associated with adversity in childhood and also with cognitive social capital and they point out the need to address the causes of violence in order to provide a healthy and safe development for children and adolescents, preventing negative outcomes for physical and mental health.

Cerina: cognitive-behavioural therapy-based mobile application for managing GAD symptoms among Ulster University Students in Northern Ireland - a protocol for a pilot feasibility randomised controlled trial.

INTRODUCTION: University students are one of the most vulnerable populations for anxiety disorders worldwide. In Northern Ireland, anxiety disorders appear to be more common among the university student population due to the population demographics across the region. Despite the need, these students show less inclination to access the widely available on-campus well-being services and other external professional services. Digital cognitive-behavioural therapy (CBT) aims to bridge this gap between the need for psychological help and access to it. However, challenges such as limited reach, low adoption, implementation barriers and poor long-term maintenance are mainstay issues resulting in reduced uptake of digital CBT. As a result, the potential impact of digital CBT is currently restricted. The proposed intervention 'Cerina' is a scalable CBT-based mobile app with an interactive user interface that can be implemented in university settings if found to be feasible and effective. METHODS AND ANALYSIS: The study is a single-blind pilot feasibility randomised controlled trial aiming to test the feasibility and preliminary effects of Cerina in reducing Generalised Anxiety Disorder (GAD) symptoms. Participants are 90 Ulster University students aged 18 and above with self-reported GAD symptoms. They will be allocated to two conditions: treatment (ie, access to Cerina for 6 weeks) and a wait-list control group (ie, optional on-campus well-being services for 6 weeks). Participants in the wait-list will access Cerina 6 weeks after their randomisation and participants in both conditions will be assessed at baseline, at 3 (mid-assessment) and 6 weeks (postassessment). The primary outcome is the feasibility of Cerina (ie, adherence to the intervention, its usability and the potential to deliver a full trial in the future). The secondary outcomes include generalised anxiety, depression, worry and quality of life. Additionally, participants in both conditions will be invited to semistructured interviews for process evaluation. ETHICS AND DISSEMINATION: Ethical approval for the study has been granted by the Ulster University Research Ethics Committee (ID: FCPSY-22-084). The results of the study will be disseminated through publications in scientific articles and presentations at relevant conferences and/or public events. TRIAL REGISTRATION NUMBER: NCT06146530.

Does chubby can get lower grades than skinny Sophie? Using an intersectional approach to uncover grading bias in German secondary schools.

We aim to uncover grading bias by gender, socio-economic status, ethnic/migration background as well as body weight in the German secondary school system. Following an intersectional approach, we test whether-controlling for ability-students receive different grades depending on (the specific combination of) ascriptive characteristics. Using data from the fourth starting cohort (SC4, 13.0.0, first survey in year 9 in 2010) of the National Educational Panel Study (NEPS) consisting of more than 14,000 ninth graders, we compute the predicted differences in grades for the different groups of students depending on whether they are a boy or a girl, whether they are obese/overweight or not, their socio-economic status (SES) and ethnic background. We rely on a grade equation approach, assuming that discrepancies between observed grades and achievement as measured in standardised tests are evidence of biased grading. We control for two different competence tests-the Domain General Cognitive Functions (DGCF) and a standardised domain-specific competence test-as objective measures of ability as well as secondary school track. Even after controlling for different personality and behavioural traits-the "big five", the Strengths and Difficulties Questionnaire (SDQ), the Sick, Control, One, Fat and Food (SCOFF), health satisfaction and class retention-substantial differentials in grading across almost all factors and subjects remain. To account for the fact that many students may face bias on multiple grounds, we then compare the differences in predicted grades for groups with overlapping (dis)advantaging characteristics (e.g. low SES overweight Turkish boy vs a high SES non-overweight majority girl), while controlling for the objective ability measures. Significant differentials in grades are found in almost all cases, with the largest effect sizes for the subject German. We also compute models including all 2-way or 4-way interactions between the four axes of inequality and find the main effects largely unchanged. On the whole our findings are indicative of widespread additive intersectional effects of gender, social and ethnic origin as well as body weight on grading bias.

Knowledge, attitude and practices towards oral health among secondary school students in Huye district, Rwanda.

Background: Good oral health knowledge is considered to be crucial for health-related practices and better oral hygiene. Objective: This study was aimed to assess knowledge, attitudes and practices towards oral health among secondary student in Huye district. Methods: A cross-sectional survey was conducted with 386 students from public secondary schools with advanced level. Boarding secondary schools were excluded. Stratified Clustering sampling technique was used for selecting study participants. A closed ended questionnaire was used for collecting data. Results were found on the basis of percentage and frequency using SPSS 21.0 version. Results: The majority of participants, 222 (57.5%) were female and 164 (42.5%) were male. The majority of the participants, 168 (43.5%) were between 15-17 years old. Out of the total population of students 1.8% had good knowledge, 56.2% had average knowledge and 42% had poor knowledge about oral health. Moreover, 56.2% had negative and 43.8% had positive oral health attitudes and overall practice towards oral hygiene of students showed that 74.6 % had poor practice and 24.4% had good practices. Conclusion: Oral hygiene has to be long life practice and oral health education have to be included as part of the school environment.

Knowledge, attitudes and practices about air pollution and its health effects in 6th to 11th-grade students in Colombia: a cross-sectional study.

Introduction: Globally, air pollution is the leading environmental cause of disease and premature death. Raising awareness through environmental education and adequate communication on air quality could reduce the adverse effects. We aimed to assess the knowledge, attitudes, and practices (KAP) regarding air pollution and health and determine the factors associated with these KAP in children and adolescents. Methods: In 2019-2020, a cross-sectional study was conducted on 6th-11th grade high school students in five municipalities in Colombia. Variables collected included: age, sex, private or public school, any medical history, emergency room visits due to respiratory symptoms in the last year, and whether students played sports. The main exposure was the School Environmental Project. The outcomes were the KAP scale [0% (the lowest score) to 100% (the highest score)]. The factors associated with KAP levels were evaluated with independent mixed regressions due to the multilevel structure of the study (level 1: student; level 2: school), and the exponential coefficients (95% confidence interval-CI) were reported. Results: Among 1,676 students included, 53.8% were females. The median knowledge score about air pollution and its health effects was 33.8% (IQR: 24.0-44.9), 38.6% knew the air quality index, 30.9% knew the air quality alerts that occurred twice a year in these municipalities and 5.3% had high self-perceived knowledge. Positive attitudes, pro-environmental practices, being female, grade level, attending a private school, having respiratory diseases, and the school environmental project importance were associated with higher knowledge scores. The median attitudes score was 78.6% (IQR: 71.4-92.9). Pro-environmental attitudes were associated with knowledge-increasing, being female, attending a private school, and the school environmental project. The median pro-environmental practices score was 28.6% (IQR: 28.6-42.9). During air quality alerts, 11.6% had worn masks, 19% had reduced the opening time of windows and 15.9% avoided leaving home. Pro-environmental practices were associated with knowledge-increasing and attitudes-increasing, and lower practices with higher grade levels, visiting a doctor in the last year, and practicing sports. Discussion: Children and adolescents have low knowledge scores and inadequate pro-environmental practices scores regarding air pollution. However, they demonstrate positive attitudes towards alternative solutions and express important concerns about the planet's future.

Awareness, attitudes and perceptions of students towards leisure noise in Durban, South Africa.

BACKGROUND:  Young adults are exposed to high noise levels in leisure venues, which increases their risk of hearing loss, and can affect their quality of life. OBJECTIVES:  The aim of this study was to describe the young adults' awareness, attitudes and perceptions towards leisure noise at a university in South Africa. METHOD:  A descriptive cross-sectional study design with quantitative methods of data was considered for this study. Students from first to fourth years in the Education Department of a local university in Durban, South Africa, who were aged 18 years old - 25 years old were invited to participate in an online survey. RESULTS:  Of the 462 participants, most had a general awareness on noise and hearing loss but lacked knowledge on the negative effect of loud noise, with 95.2% using personal listening devices, followed by visiting restaurants and gyms, and 48.3% being unsure if noise can damage hearing permanently. They were unaware of methods to reduce their exposure to noise. A significant relationship between awareness of noise and attitudes (p = 0.029) indicated that the higher the level of awareness regarding leisure noise, the better their attitude and behaviour, thus the lower the risk of hearing loss. CONCLUSION:  The results highlight the need for implementing the World Health Organization (WHO) noise regulations and providing education for this age group to prevent irreversible hearing loss through exposure to leisure noise.Contribution: A national study is recommended to increase research evidence.

Exploring the experiences of school-going children with HIV in Eswatini: A qualitative inquiry.

BACKGROUND:  Infection by human immunodeficiency virus (HIV) is a major disease in children, affecting an estimated 1.8 million children and adolescents worldwide. Eswatini has the highest prevalence of HIV in the world. Only 76% of children in Eswatini are on anti-retroviral treatment. AIM:  This study aimed to gain an in-depth understanding of the lived experience of school-going children with HIV in Eswatini. Being aware of these children's experiences can assist schools in supporting them. SETTING:  The study was conducted in four primary health care facilities in Eswatini. METHODS:  Employing a qualitative, exploratory, descriptive research design, 12 school-going children with HIV were interviewed through semi-structured face-to-face interviews. The data were coded, categorised and clustered into themes and sub-themes using Georgi's data analysis. Ethical considerations and measures to ensure trustworthiness were adhered to throughout the study. RESULTS:  The findings revealed three themes: Experiences after HIV disclosure, experience of disclosure and discrimination, and experience of desire to fulfil educational needs. Six sub-themes were identified: A feeling of sadness and worry relating to knowledge of HIV diagnosis, a desire to disclose their status to their teachers but not to their peers, a need for protection against discrimination, a desire to learn, illness affecting their learning and expectation for teachers to be supportive in their educational needs.Conclusion and contribution: The findings of the study guided recommendations that may assist, the Eswatini Ministry of Health, schools, parents and caregivers, and siblings to support school-going children with HIV.

Effectiveness of Group Health Education on "Perceived Stress" among High-School Children of Kolar: A Cluster Randomized Controlled Trial.

BACKGROUND: Adolescents are exposed to various psycho-physiological stressors due to rapid changes in their bodies along with increased academic pressure, peer pressure, and pressures from other sources of society. Group health education sessions in schools could have a positive outcome in not only the way they perceive stress but also tackle it efficiently. OBJECTIVE: The objective of the study was to assess the effectiveness of group health education intervention on "perceived stress" among the high school children of Kolar. MATERIALS AND METHODS: An open-label cluster randomized controlled trial was conducted among high school students (8th, 9th, and 10th standard) in selected English Medium Schools of Kolar Taluk. The study was conducted in three phases spanning 5 months of duration. Phase I included baseline data collection wherein "perceived stress" level was captured using the Perceived Stress Scale (PSS) 10 questionnaire. Phase II was the interventional phase in the form of group health education sessions. Phase III was end-line assessment. RESULTS: Before the intervention, 6.2%, 92.4%, and 1.5% of the students had mild, moderate, and severe stress, respectively, in the intervention group. After the intervention in the intervention group, about 57.9% had mild stress, 42.1% had moderate stress, and none had severe stress. The difference in difference analysis (DID) showed that the mean PSS scores in the intervention group changed by -8.84 while in the control group by 0.40. CONCLUSION: Group health education delivered was effective in reducing the perceived stress levels among high school children and it is a feasible and acceptable intervention for stress in school-going adolescent children.

Research on the influencing factors of promoting flipped classroom teaching based on the integrated UTAUT model and learning engagement theory.

With the rapid advancement of educational technology, the flipped classroom approach has garnered considerable attention owing to its potential for enhancing students' learning capabilities. This research delves into the flipped classroom teaching methodology, employing the Unified Theory of Acceptance and Use of Technology (UTAUT), learning engagement theory, and the 4C skills (comprising communication, collaboration, creativity, and critical thinking) to investigate its effects on learning capabilities. The research surveyed 413 students from three universities in Jiangxi Province, employing stratified random sampling. SPSS 24.0 and Amos were used for structural equation modeling and hypothesis testing analysis. The findings indicate that: (1) Performance expectancy, effort expectancy, and peer influence significantly enhance students' learning engagement in the flipped classroom. (2) Students' learning engagement in the flipped classroom notably promotes their learning capabilities. (3) Performance expectancy, effort expectancy, and peer influence can significantly boost learning capabilities by increasing learning engagement. (4) Personality traits significantly moderate the effect of peer influence on learning engagement, highlighting the crucial role of individual differences in learning. (5) The level of students' learning engagement is differentially influenced by performance expectancy and peer influence across various academic disciplines. Ultimately, this research provides valuable insights for educational policymakers and guides improvements in teaching practices, collectively advancing educational quality and equity.

Reactions of adolescent cyber bystanders toward different victims of cyberbullying: the role of parental rearing behaviors.

BACKGROUND: Group-based situations are common settings for cyberbullying, making bystander responses crucial in combating this issue. This study investigated how adolescent bystanders respond to various victims, including family members, friends, teachers, and celebrities. This study also examined how different parenting styles influenced children's cyber bystander involvement. METHODS: This study employed data from a cross-sectional school survey covering 1,716 adolescents aged 13-18 years from public and vocational schools in China collected in 2022. Logistic regression analyses were conducted to measure demographic characteristics, cyberbullying experiences, and parental rearing behaviors in predicting bystander reactions. RESULTS: The findings showed that middle school students preferred to "ask for help" while high school students tended to choose "call the police" when witnessing cyberbullying incidents. Bystanders growing up with parental rejection and overprotection, having previous cyberbullying victimization experiences, where the victims were disliked by them, exhibited fewer defensive reactions. CONCLUSIONS: This study has implications for future research and practices involving parental involvement in cyber bystander interventions, which could provide implications for future practice in designing specific intervention programs for cyberbullying bystander behavior. Future research and interventions against cyberbullying may provide individualized training including parents' positive parenting skills and parent-child interactions.

The effect of physical exercise on social adaptability in Chinese middle school students: The mediating role of social anxiety.

The purpose of this study was to explore the effect of physical exercise on the social adaptability of middle school students and further analyze the mediating role of social anxiety. A total of 1056 middle school students from 6 middle schools in Sichuan, China, voluntarily participated in the survey. The Physical Activity Rating Scale (PARS-3), Social Anxiety Subscale of the Self-Consciousness Scale, and Social Adaptability Scale were used in this study. The data obtained in this study were processed by SPSS 19.0 and Process 3.0. The results showed that physical exercise could positively predict social adaptability (b = 0.08, P < .05), and social anxiety played a mediation role between physical exercise and social adaptability (indirect effect = 0.11, 95% confidence interval = 0.066-0.150). Some practical implications have been discussed on the physical exercise intervention for promoting social adaptability in middle school students.

Knowledge, attitudes, practice, and public health education demand regarding PARI prevention: a cross-sectional study among Chinese undergraduates.

Objectives: The purpose of this study was to assess the level of knowledge, attitudes, and practices (KAP) of university students in China regarding the need for PARI and public health education. Methods: A cross-sectional online and offline survey was conducted in China website through Wenjuanxing and in different cities such as Changsha Hunan Province, Shanghai, Chongqing and in different public scenarios, such as hospitals, universities, and commercial venues between September 1 and September 7, 2023, using a 28-question questionnaire designed and reviewed by multidisciplinary experts. Results: A total of 4,096 respondents were recruited for this study, with 3,957 valid questionnaires. The mean knowledge score was 1.84 ± 0.52, the mean attitude score was 2.12 ± 0.51, and the mean practice score was 3.18 ± 0.55. Regression analyses found that: region, grade, school, and weekly anaerobic exercise time were influences on the knowledge score; region, grade, school, and weekly anaerobic exercise time were influences on the attitude score; region, grade, school attended, weekly anaerobic exercise time and weekly anaerobic exercise time as influences on the practice score. Subgroup analyses revealed that undergraduates from southern regions and 985 schools had higher knowledge attitude scores and lower practice scores. As the grade level increased, the knowledge and attitude scores showed a V-shaped trend and the behavior scores showed an inverted V-shaped trend. Correlation analysis found a positive correlation between knowledge and attitude scores, and a negative correlation between both and behavior, respectively. The public health education needs survey found that undergraduate students generally preferred guided instruction methods and content centered on the RICE principles, they preferred learning through books and pamphlets, and they were happy to see relevant content promoted in the campus environment. Conclusion: This study shows that Chinese undergraduate students have less knowledge, neutral attitudes, and good behaviors regarding PARI prevention. Special attention should be paid to meeting the needs of undergraduate students for public health education to equip them with relevant knowledge so that they can better behave in PARI prevention.

Co-occurrence of problematic facebook and video game use: prevalence and association with mental health disorders among adolescents.

INTRODUCTION: The rapid proliferation of technology and its impact on adolescents' lives have raised concerns about addictive behaviors and its potential consequences, including behavioral and mental health problems. This study investigates the prevalence and risk factors associated with the co-occurrence of Problematic Facebook Use and Problematic Video game Use among Tunisian adolescents. METHODOLOGY: We conducted a cross-sectional study in the urban area of Sousse governorate in Tunisia during the 2018/2019 school year. We selected a representative sample of high school students enrolled in public educational institutions in Sousse. Data collection was performed through a self-administered structured questionnaire, which gathered information on sociodemographic characteristics, lifestyle behaviors, and mental health disorders. Problematic Facebook Use was assessed using the validated Arabic version of the Bergen Scale, while Problematic Video Game Use was measured using the 21-point Lemmens Scale, which was translated into Arabic. Statistical analysis was carried out using the SPSS program (version 20). RESULTS: We enrolled a total of 1342 high school students in our study, of whom, 63.2% were female with a mean age of 17.5 ± 1.44 years. The prevalence of Problematic Facebook Use and Problematic Video Game Use was  28.3% and  13% respectively. Regarding the co-occurrence of the two problematic behaviors, 31.3% of participants faced a singular addictive behavior, either related to problematic Facebook or video game use, while 5% had both addictive behaviors simultaneously. In a multivariate analysis, risk factors for the co-occurrence of Problematic Facebook and Video Game Use, in decreasing order of significance, included severe depression (AOR = 4.527; p = 0.003), anxiety (AOR = 4.216; p = 0.001), male gender (AOR = 4.130; p < 0.001), problematic internet use (AOR = 3.477; p = 0.006), as well as moderate depression (AOR = 3.048; p = 0.007). CONCLUSION: Our study found that Problematic Facebook and Video Game Use were prevalent among Tunisian adolescents. The co-occurrence of these disorders is strongly linked to male gender, problematic internet use, depression, and anxiety disorders. These findings underscore the urgency of implementing tailored and effective awareness and prevention programs to address these emerging challenges.

Being able to think when caught in the maelstrom - how adolescents used mindfulness when facing exams.

PURPOSE: Research indicates that exam anxiety may decline with mindfulness-based interventions but there is a lack of research on adolescents' accounts of the processes involved. We explored high-school students' descriptions of how they perceived and applied mindfulness in managing anxiety-inducing thoughts related to academic performance following an 8-week Mindfulness-Based Stress Reduction (MBSR) course. METHOD: Post-course individual semi-structured interviews with 22 high school students (2 males, mean age 17.8 years) were transcribed verbatim and analysed using reflexive thematic analysis. RESULTS: The analyses identified six themes: (1) Noticing and attending to the attention-binding "maelstrom" of anxious thoughts and feelings (2) Attending to the breath to cope with the maelstrom, (3) "removing" and "getting rid of" anxious thoughts (4) Being able to "think" (5) awareness of more helpful thoughts, and (6) Agency and control. The findings are discussed in light of the Buddhist notion of "unwholesome thoughts" and the distinction between thought suppression and the use of breathing as a benign distraction. We propose that mindfulness encompasses both a receptive, nonjudgmental awareness and an active, intentional redirection of attention. CONCLUSION: Mindfulness training aided participants by enhancing their capacity to disengage from fear-engaging thoughts, thereby maintaining them within their window of tolerance and facilitating cognitive processing.