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

Operational Techniques for Dealing with Long Eclipses During the MMS Extended Mission

Launch window design for the Magnetospheric Multiscale (MMS) mission ensured that no excessive eclipses would be encountered during the prime mission. However, no orbit solutions exist that satisfy the eclipse constraints indefinitely: most extended mission years contain 1-3 eclipses long enough to potentially damage either the spacecraft or its scientific instruments. Two steps were taken to improve the situation. Firstly, raising apogee radius from 25 to 29.34 Earth radii altered the Sun-Earth-MMS phasing, so efficiently achieving reductions in the long eclipse durations. These maneuvers were performed early this year, in preparation for the first pair of long eclipses in August 2019. Secondly, a set of operational steps were taken around the time of the eclipses to help maintain spacecraft and instrument temperatures while preventing power load shedding. These operational steps included raising key onboard temperatures through adjusting the spacecraft attitude to tilt the instrument deck towards the Sun, and engaging select heaters prior to going into eclipses. In addition, all scientific instruments were turned off, as well as high-power, non-critical spacecraft systems, to conserve energy.These steps each came with trade-offs which will be discussed in the paper. Finally, the results that were obtained when the spacecraft experienced the first extremely long eclipses will be discussed, as will lessons learned for future long eclipses

Vertical Jump Performance as a Discriminator of Playing Ability in Collegiate Female Soccer Players

Previous studies have assessed the importance of physical characteristics to soccer playing ability by comparing performance-based outcomes between starters and non-starters. Starters are often considered the most skilled players on the team. These players get more playing time than non-starters and have been shown to achieve higher performance outcomes on intermittent fitness tests. However, it remains unclear whether starters can achieve higher performance outcomes on a countermovement vertical jump. PURPOSE: The purpose of this study was to investigate the efficacy of countermovement vertical jump height and peak power to discriminate between starters and non-starters in collegiate female soccer. METHODS: Twenty-seven collegiate female soccer players (age = 19.56 ± 1.28 years; height = 164.26 ± 5.74 cm; body mass = 66.65 ± 8.43 kg) were recruited to participate in the present study. All testing was completed during the 2021 preseason training period. The players were classified as starters (n = 12) or non-starters (n = 15) according to their average number of minutes played per game during the subsequent exhibition season. Each participant reported to the laboratory for a single visit where they performed three countermovement vertical jump tests on a jump mat. For each jump, participants stood on the mat with feet shoulder width apart and hands positioned on the hips. Participants were not allowed to take any steps prior to performing the vertical jump and a quick descending quarter-squat countermovement was allowed before the ascending takeoff phase. The participants were instructed to jump as explosively as possible with both feet at the same time and land on the jump mat in the starting position. Vertical jump height (cm) was estimated from the flight time recorded by the jump mat. Peak power output was estimated using a previously validated regression equation: peak power (W) = 51.9 × vertical jump height (cm) + 48.9 × body mass (kg) - 2007. Independent samples t-tests were used to compare vertical jump height and peak power between the starting and non-starting groups. RESULTS: Vertical jump height was significantly greater (P = 0.039) for the starters (38.60 ± 6.11 cm) compared to the non-starters (34.43 ± 3.75 cm). There was no significant difference (P = 0.448) between the starters (3076.72 ± 331.98 W) and non-starters (3182.23 ± 369.67 W) for peak power. CONCLUSION: These findings suggest that vertical jump height is an effective measure for discriminating between starters and non-starters in collegiate female soccer. Vertical jump characteristics are critical to a player’s performance on the field. Because the starters in this study were able to jump higher than the non-starters, vertical jump height may be an important parameter for identifying players with a high degree of soccer playing ability

Graph Annotations in Modeling Complex Network Topologies

The coarsest approximation of the structure of a complex network, such as the Internet, is a simple undirected unweighted graph. This approximation, however, loses too much detail. In reality, objects represented by vertices and edges in such a graph possess some non-trivial internal structure that varies across and differentiates among distinct types of links or nodes. In this work, we abstract such additional information as network annotations. We introduce a network topology modeling framework that treats annotations as an extended correlation profile of a network. Assuming we have this profile measured for a given network, we present an algorithm to rescale it in order to construct networks of varying size that still reproduce the original measured annotation profile. Using this methodology, we accurately capture the network properties essential for realistic simulations of network applications and protocols, or any other simulations involving complex network topologies, including modeling and simulation of network evolution. We apply our approach to the Autonomous System (AS) topology of the Internet annotated with business relationships between ASs. This topology captures the large-scale structure of the Internet. In depth understanding of this structure and tools to model it are cornerstones of research on future Internet architectures and designs. We find that our techniques are able to accurately capture the structure of annotation correlations within this topology, thus reproducing a number of its important properties in synthetically-generated random graphs

Digital terrain analysis reveals new insights into the topographic context of Australian Aboriginal stone arrangements

Satellite-derived surface elevation models are an important resource for landscape archaeological studies. Digital elevation data is useful for classifying land features, characterizing terrain morphology, and discriminating the geomorphic context of archaeological phenomena. This paper shows how remotely sensed elevation data obtained from the Japan Aerospace Exploration Agency's Advanced Land Observing Satellite was integrated with local land system spatial data to digitally classify the topographic slope position of seven broad land classes. The motivation of our research was to employ an objective method that would allow researchers to geomorphometrically discriminate the topographic context of Aboriginal stone arrangements, an important archaeological site type in the Pilbara region of northwest Australia. The resulting digital terrain model demonstrates that stone arrangement sites are strongly correlated with upper topographic land features, a finding that contradicts previous site recordings and fundamentally changes our understanding of where stone arrangement sites are likely to have been constructed. The outcome of this research provides investigators with a stronger foundation for testing hypotheses and developing archaeological models. To some degree, our results also hint at the possible functions of stone arrangements, which have largely remained enigmatic to researchers

Diagnostic accuracy of the Depression subscale of the Hospital Anxiety and Depression Scale (HADS-D) for detecting major depression : protocol for a systematic review and individual patient data meta-analyses

INTRODUCTION: The Depression subscale of the Hospital Anxiety and Depression Scale (HADS-D) has been recommended for depression screening in medically ill patients. Many existing HADS-D studies have used exploratory methods to select optimal cut-offs. Often, these studies report results from a small range of cut-off thresholds; cut-offs with more favourable accuracy results are more likely to be reported than others with worse accuracy estimates. When published data are combined in meta-analyses, selective reporting may generate biased summary estimates. Individual patient data (IPD) meta-analyses can address this problem by estimating accuracy with data from all studies for all relevant cut-off scores. In addition, a predictive algorithm can be generated to estimate the probability that a patient has depression based on a HADS-D score and clinical characteristics rather than dichotomous screening classification alone. The primary objectives of our IPD meta-analyses are to determine the diagnostic accuracy of the HADS-D to detect major depression among adults across all potentially relevant cut-off scores and to generate a predictive algorithm for individual patients. We are already aware of over 100 eligible studies, and more may be identified with our comprehensive search. METHODS AND ANALYSIS: Data sources will include MEDLINE, MEDLINE In-Process & Other Non-Indexed Citations, PsycINFO and Web of Science. Eligible studies will have datasets where patients are assessed for major depression based on a validated structured or semistructured clinical interview and complete the HADS-D within 2 weeks (before or after). Risk of bias will be assessed with the Quality Assessment of Diagnostic Accuracy Studies-2 tool. Bivariate random-effects meta-analysis will be conducted for the full range of plausible cut-off values, and a predictive algorithm for individual patients will be generated. ETHICS AND DISSEMINATION: The findings of this study will be of interest to stakeholders involved in research, clinical practice and policy

Towards an understanding of quality and inclusivity in human‐environment experiences

AbstractAs calls grow for relational approaches to nature and wellbeing research that consider reciprocity in human‐environment interactions, the concept of affordances is gaining importance as a useful way of thinking about nature experiences. Affordances provide a framework to enable individualised conceptions of nature by focusing on what is functionally meaningful to people. However, affordance thinking is currently limited in its ability to help us understand how peoples' background, culture and circumstances shape interactions with nature ‐ a critical issue with respect to inclusivity and the under‐representation of some sections of society. Bourdieu's theory of practice is a well‐established set of ‘thinking tools’ which potentially help addresses these influences. It examines how our social environment may pattern our practices, attitudes, and perceptions. In this paper, we review the various applications of affordances before providing an overview of how Bourdieu's concepts of habitus, capital and field can complement, and be integrated with, affordance thinking for novel applications to greenspace research. Bridging these areas of thinking will facilitate development of a more intersectional and complete understanding of nature experiences, including the quality and inclusivity of green and natural spaces.</jats:p

Simulating Heliospheric and Solar Particle Diffusion using the Parker Spiral Geometry

Cosmic Ray transport in curved background magnetic fields is investigated using numerical Monte-Carlo simulation techniques. Special emphasis is laid on the Solar system, where the curvature of the magnetic field can be described in terms of the Parker spiral. Using such geometries, parallel and perpendicular diffusion coefficients have to be re-defined using the arc length of the field lines as the parallel displacement and the distance between field lines as the perpendicular displacement. Furthermore, the turbulent magnetic field is incorporated using a WKB approach for the field strength. Using a test-particle simulation, the diffusion coefficients are then calculated by averaging over a large number of particles starting at the same radial distance from the Sun and over a large number of turbulence realizations, thus enabling one to infer the effects due to the curvature of the magnetic fields and associated drift motions.Comment: accepted for publication at Journal of Geophysical Research - Space Physic

Evaluating the Quality of Research into a Single Prognostic Biomarker: A Systematic Review and Meta-analysis of 83 Studies of C-Reactive Protein in Stable Coronary Artery Disease

Background Systematic evaluations of the quality of research on a single prognostic biomarker are rare. We sought to evaluate the quality of prognostic research evidence for the association of C-reactive protein (CRP) with fatal and nonfatal events among patients with stable coronary disease. Methods and Findings We searched MEDLINE (1966 to 2009) and EMBASE (1980 to 2009) and selected prospective studies of patients with stable coronary disease, reporting a relative risk for the association of CRP with death and nonfatal cardiovascular events. We included 83 studies, reporting 61,684 patients and 6,485 outcome events. No study reported a prespecified statistical analysis protocol; only two studies reported the time elapsed (in months or years) between initial presentation of symptomatic coronary disease and inclusion in the study. Studies reported a median of seven items (of 17) from the REMARK reporting guidelines, with no evidence of change over time. The pooled relative risk for the top versus bottom third of CRP distribution was 1.97 (95% confidence interval [CI] 1.78–2.17), with substantial heterogeneity (I2 = 79.5). Only 13 studies adjusted for conventional risk factors (age, sex, smoking, obesity, diabetes, and low-density lipoprotein [LDL] cholesterol) and these had a relative risk of 1.65 (95% CI 1.39–1.96), I2 = 33.7. Studies reported ten different ways of comparing CRP values, with weaker relative risks for those based on continuous measures. Adjusting for publication bias (for which there was strong evidence, Egger's p<0.001) using a validated method reduced the relative risk to 1.19 (95% CI 1.13–1.25). Only two studies reported a measure of discrimination (c-statistic). In 20 studies the detection rate for subsequent events could be calculated and was 31% for a 10% false positive rate, and the calculated pooled c-statistic was 0.61 (0.57–0.66). Conclusion Multiple types of reporting bias, and publication bias, make the magnitude of any independent association between CRP and prognosis among patients with stable coronary disease sufficiently uncertain that no clinical practice recommendations can be made. Publication of prespecified statistical analytic protocols and prospective registration of studies, among other measures, might help improve the quality of prognostic biomarker research