Acceptability and proof of concept of internet-delivered treatment for depression, anxiety, and stress in university students: protocol for an open feasibility trial

BACKGROUND: In recent years, university counseling and mental health services have reported an increase in the number of clients seeking services and in yearly visits. This trend has been observed at many universities, indicating that behavioral and mental health issues pose significant problems for many college students. The aim of this study is to assess the acceptability and proof of concept of internet-delivered treatment for depression, anxiety, and stress for university students. METHODS/DESIGN: The study is an open feasibility trial of the SilverCloud programs for depression (Space from Depression), anxiety (Space from Anxiety), and stress (Space from Stress). All three are 8-module internet-delivered CBT (iCBT) intervention programs. Participants are assigned a supporter who provides weekly feedback on progress and exercises. Participants will complete the Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), and stress subscale of the Depression, Anxiety, Stress Scale-21 (DASS-21) as the outcome measures for the depression, anxiety, and stress interventions, respectively. Other outcomes include measures of acceptability of, and satisfaction, with the intervention. Data will be collected at baseline, 8 weeks and 3-month follow-up. DISCUSSION: It is anticipated that the study will inform the researchers and service personnel of the programs' potential to reduce depression, anxiety, and stress in a student population as well as the protocols to be employed in a future trial. In addition, it will provide insight into students' engagement with the programs, their user experience, and their satisfaction with the online delivery format

Supported internet-delivered cognitive behavioral therapy programs for depression, anxiety, and stress in university students: open, non-randomised trial of acceptability, effectiveness, and satisfaction

BACKGROUND: Many university campuses have limited mental health services that cannot cope with the high demand. One alternative is to use internet-delivered cognitive behavioral therapy (iCBT) as a way of tackling barriers such as lack of availability and scheduling issues. OBJECTIVE: This study aimed to assess feasibility, acceptability, effectiveness, and satisfaction of a supported iCBT intervention offering 3 programs on depression, anxiety, and stress to university students. The design was an open or nonrandomized feasibility trial. METHODS: Participants were recruited from 3 counseling centers at a large midwestern University in the United States. Those agreeing to take part chose 1 of 3 iCBT programs-Space from Depression, Space from Anxiety, or Space from Stress -all comprised 8 modules of media-rich interactive content. Participants were supported throughout the trial by a trained professional. The Patient Health Questionnaire 9 (PHQ-9), Generalized Anxiety Disorder 7 (GAD-7) questionnaire, and stress subscale of the Depression Anxiety and Stress Scale (DASS-21) were completed at baseline, 8 weeks, and 3-month follow-up. A Satisfaction With Treatment (SAT) questionnaire was completed at 8 weeks, and qualitative interviews were completed by a subsample of participants at 3 months. RESULTS: A total of 102 participants were recruited, with 52 choosing Space from Anxiety, 31 choosing Space from Depression, and 19 choosing Space from Stress. Mixed-effects models showed a significant decrease in symptoms of depression (F₄=6.36, P<.001), anxiety (F₄=7.97, P<.001), and stress (F₄=8.50, P<.001) over time across all 3 programs. The largest decreases in PHQ-9 scores at 8 weeks were among participants who chose the Space from Depression program (d=0.84); at 3 months, the largest decreases in PHQ-9 scores were among those who chose the Space from Stress program (d=0.74). The largest decreases in GAD-7 scores were among those who chose the Space from Anxiety program (d=0.74 at 8 weeks and d=0.94 at 3 months). The largest decrease in DASS-21 stress subscale scores was among those who chose the Space from Stress program (d=0.49 at 8 weeks and d=1.16 at 3 months). The mean time spent using the platform per session was 27.4 min (SD 33.8), and participants completed 53% (SD 37.6) of the total program content on average. Most (37/53, 69%) participants found the programs helpful or very helpful and liked the convenience and flexibility of the intervention. Qualitative interviews (n=14) indicated the intervention met students' expectations, and they saw it as a valuable complement to face-to-face treatment. CONCLUSIONS: The iCBT programs tested in our study appear to be feasible, acceptable, and effective in a university environment. Participants described the benefits of having a flexible, supported Web-based intervention available on campus. Larger trials should be conducted to further test the effectiveness of supported Web-based interventions that give students a choice of program depending on their symptom profile.Published versio

Essential Factors for a Healthy Microbiome: A Scoping Review

Recent discoveries of the purpose and potential of microbial interactions with humans have broad implications for our understanding of metabolism, immunity, the host–microbe genetic interactions. Bioavailability and bioaccessibility of phytonutrients in foods not only enrich microbial diversity in the lower human gastrointestinal tract (GIT) but also direct the functioning of the metagenome of the microbiota. Thus, healthy choices must include foods that contain nutrients that satisfy both the needs of humans and their microbes. Physical activity interventions at a moderate level of intensity have shown positive effects on metabolism and the microbiome, while intense training (\u3e70% VO2max) reduces diversity in the short term. The microbiome of elite endurance athletes is a robust producer of short-chain fatty acids. A lifestyle lacking activity is associated with the development of chronic disease, and experimental conditions simulating weightlessness in humans demonstrate loss of muscle mass occurring in conjunction with a decline in gut short-chain fatty acid (SCFA) production and the microbes that produce them. This review summarizes evidence addressing the relationship between the intestinal microbiome, diet, and physical activity. Data from the studies reviewed suggest that food choices and physical fitness in developed countries promote a resource “curse” dilemma for the microbiome and our health

Jamesian Women: A Readers Theatre Adaptation from Selected Novels of Henry James

The purpose of this study is to illustrate the power image of Henry James's female protagonists through a Readers Theatre adaptation of his novels, Daisy Miller, The Wings of the Dove, and The Portrait of a Lady. Chapter I includes an introduction and defines the purpose of the thesis. Chapter II briefly examines biographical information on James. Chapter III includes the analysis of the three selected novels in relation to preparation of a performance based script for Readers Theatre. In the Appendix is the Readers Theatre script with the inclusive transition and introductory material. The illustration of a typical Jamesian woman reveals a philosophic view of the human possibilities in freedom, power, and the destructive elements that limit an independent spirit

Perceptions of New Principal Mentoring Programs in a Large Urban School District

The principalship has changed significantly over the past 20 years. Today’s principals must be effective instructional leaders, managers of large facilities, and experts at analyzing data to successfully meet the accountability demands of high-stakes testing, along with state, and federal mandates. The primary purpose of this quantitative study was to examine how 43 first- and second-year sitting school principals perceived their mentoring experiences and the degree to which a principal mentoring program—offered by their large urban school district—was effective in building their leadership capacity. A second purpose of this inquiry was to understand these principals’ perceptions of the most beneficial aspects of the mentoring program. The study used quantitative data gathered via an online questionnaire distributed during Fall 2015. The results indicated that respondents perceived that the components of the large urban school-mentoring program were generally effective in training principal mentees to become highly-effective school leaders. This study enriches the literature on mentoring by providing the voices of first and second year school leaders to add depth to the characteristics of successful mentoring programs

2009 Alaska Health Workforce Vacancy Study

Alaska continues to experience health professional shortages. The state has long had a deficient “supply side” characterized by insufficient numbers of key health workers whose recruitment, retention, and training have been impeded by Alaska’s remoteness, harsh climate, rural isolation, low population density, and scarce training resources. Alaska is the only state without a pharmacy school and lacks its own dental and physical therapy schools as well. Health professional shortages can be decreased through the start of new training programs, the expansion of existing programs, and the improvement of the effectiveness of recruitment and retention efforts. However, strategic planning and the execution of such programs require valid and accurate data. To this end, stakeholders such as the Alaska Mental Health Trust Authority (AMHTA) and Alaskan's For Access to Health Care (ACCESS), along with schools and departments within the University of Alaska Anchorage (UAA), funded the Alaska Center for Rural Health-Alaska’s AHEC (ACRH) and the Institute of Social and Economic Research (ISER) to conduct a comprehensive health workforce study during winter and spring of 2009. This report highlights employers’ needs for employees to fill budgeted positions. This is different from a needs assessment that would take into account population demographics and disease incidence and prevalence. This health workforce study is an assessment of health manpower shortage based on budgeted staff positions and their vacancies in organizations throughout the state. Respondents included part-time positions, which resulted in our counting full-time equivalent (FTE) rather than individuals (“bodies”). In situations where a position was divided among more than one occupation (e.g., Dental Assistant and Billing Clerk), we asked the respondent to count the position under which they considered the position’s “primary occupation.” This was a point-in-time cross-sectional study. Recently filled vacancies or imminent vacancies were not counted. Positions filled by relief/temporary/locum/contract health workers were counted as vacancies only if these workers were temporarily filling a currently vacant, budgeted position. Due to budget and time constraints, we were not able to conduct a trend analysis that is a comparison of this study’s findings and the prior 2007 study. The key questions this study sought to answer were (1) How many budgeted positions, either full- or part-time, existed in organizations providing health services in Alaska? (2) How many of these budgeted positions were currently vacant? (3) What was the vacancy rate? (4) How many of the organizations that employ these occupations hired new graduates of training programs? (5) How many of the currently vacant budgeted positions (#2) could be filled by new graduates of training programs? (6) What were the mean and maximum length of time, expressed in months, that the vacancies have existed? (7) What were the principal, underlying causes of vacancies? The study was designed in consultation with an advisory group that included AMHTA, ACCESS, and UAA. The study targeted 93 health occupations. The unit of analysis was the employment site by organization type, which allowed for the allocation of positions and vacancies by geographic region. For each employer, we identified the staff person most knowledgeable about hiring and vacancies. In large organizations this meant that one employer might provide information about multiple sites and organization types; smaller employers were responsible for only a single site.Alaska Mental Health Trust Authority. Alaskan's for Access to Health Care. University of Alaska Fairbanks, Tanana Valley campus Telemedicine program. University of Alaska Anchorage, Community and Technical College. University of Alaska Anchorage, School of Nursing.Acknowledgements / Executive Summary / Table of Contents / Problem and Rationale / Methodology / Limitations of Study / Findings / Appendix A. List of Health Occupations / Appendix B. Health Workforce Surveys / Appendix C. Cover Letter Accompanying Survey Forms / Appendix D. Confidence Intervals for Positions, Vacancies, Number of Vacancies Filled with New Graduates, and Length of Longest Vacancy in Months / Appendix E. Tables of Samples and Estimates of Positions, Vacancies, Vacancy Rates, Number of Vacancies Filled with New Graduates, Mean and Maximum Length of Longest Vacancy in Months / Appendix F. Tables of Occupations Sorted By Estimates of Positions, Vacancies, Vacancy Rates, Number of Vacancies Filled with New Graduates, Mean and Maximum Length of Longest Vacancy in Month

Meaning in life: One link in the chain from religiousness to well-being

Meaning in life has been identified as a potential mediator of the link between religiousness and psychological health. The authors tested this hypothesis in 2 studies, using multiple methods and measures of religiousness and well-being. In the studies, meaning in life mediated the relation between religiousness and life satisfaction (Study 1A), as well as self-esteem and optimism (Study 1B). In addition, using an experience sampling method, the authors found that meaning in life also mediated the relation between daily religious behaviors and well-being (Study 2). The authors discuss these findings and suggest that meaning in life may be an effective conduit through which counselors and clients can discuss &quot;ultimate&quot; matters, even when they do not share similar perspectives on religion

Backward Compatibility Effects in Younger and Older Adults

In many dual-task situations, responses to the second of two tasks are slowed when the time between tasks is short. The response-selection bottleneck model of dual-task performance accounts for this phenomenon by assuming that central processing of the second task is blocked by a bottleneck until central processing of Task 1 is complete. This assumption could be called into question if it could be demonstrated that the response to Task 2 affected the central processing of Task 1, a backward response compatibility effect. Such effects are well-established in younger adults. Backward compatibility effects in older (as well as younger) adults were explored in two experiments. The first experiment found clear backward response compatibility effects for younger adults but no evidence of them for older adults. The second experiment explored backward stimulus compatibility and found similar effects in both younger and older adults. Evidence possibly consistent with some pre-bottleneck processing of Task 2 central stages also was found in the second experiment in both age groups. For younger adults, the results provide further evidence falsifying the claim of an immutable response selection bottleneck. For older adults, the evidence suggested that Task 2 affects Task 1 when there is stimulus compatibility but not when there is response compatibility

Human Resources Strategies & Lessons Learned During the COVID-19 Pandemic: A Literature Review

The novel coronavirus (COVID-19) pandemic has been the most devastating public health crisis since the Spanish flu pandemic of 1918-1920. COVID-19 has impacted every human being and operational system throughout the land. The pandemic has caused challenging times for businesses, financial markets, government agencies, and academia. One area frequently overlooked is COVID-19’s impact implications for workplaces, working practices, and Human Resource Management (HRM) operationalization. This literature review aims to identify best practices implemented for the sustainability of Human Resources (HR) functions and the survival of institutions in the age of a dynamic public health crisis. This is an effective approach to better understand the disruptions caused by COVID-19 on HRM and examine how this pandemic has impacted organizations. The findings obtained focus on four main pillars: (1) recruitment, retention, and the Great Resignation, (2) employee well-being and wellness, (3) remote work options, practices, and professionalism, and (4) HR practitioners' leadership development. These have continued to be salient themes interwoven throughout many articles. These findings suggest that talent and having the most experienced, operationalized, and professional individuals as part of one’s organization are paramount to its success. Upskilling is imperative, and all stakeholders must be open to the inevitability of change as change is constant