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Interventions to mitigate the negative impact of stress on college students through resilience-building strategies are attracting considerable interest; however, there has been little discussion regarding the strategies college students readily use to build their resilience. This study (1) describes and identifies patterns of college students’ resilience-promoting behaviors and (2) examines the relationships of resilience-promoting strategies with trait resilience and well-being.

Objective: The purposes were to describe stressors and resilience behaviors of college students and examine the relationships among stressors, resilience, and well-being. Hypothesis: Resilience will modify the relationship between stressors and well-being. Participants: The sample included 1,010 college students, ages 18-26, from an urban Midwestern university. Methods: A secondary analysis of cross-sectional data from an anonymous survey was conducted using multiple regression and simple slopes analysis. Results: Resilience did not modify the relationship between stressors and well-being. Stressors ([beta] = -0.44, p < 0.0001) and resilience ([beta] = 0.33, p < 0.0001) accounted for 42% of the variance in well-being (adjusted R[superscript 2] = 0.42, F[subscript 2,999] = 365.98, p < 0.0001). The most frequently endorsed stressors were sleep problems, anxiety, and relationships. Conclusions: Stressors and resilience warrant special attention in the allocation of resources and development of programs to improve student well-being.

AbstractPurposeDesignMethodsFindingsImplicationsTo understand the scanxiety experience in pancreatic cancer (PC) survivors following curative surgical resection.A qualitative study with a hermeneutic phenomenological approach was used.Eighteen PC survivors participated. Data from in-depth, semi-structured interviews were analyzed and themes emerged from systematic line-by-line coding of the interview transcripts.Two key themes emerged: ‘the recurring cycle of scanxiety’ and ‘hope for lifelong remission’. Participants experienced similar patterns of scanxiety that impacted everyday life. Hope was an essential stabilizing component of the cancer-scan experience, and enabled participants to conceptualize a cure, despite the high likelihood of recurrent, incurable disease. A conceptual framework was developed to provide further insight.Everyday life is significantly affected during times of PC surveillance scans. This study enhances our understanding of the cancer-scan experience and provides a framework to guide care. [ABSTRACT FROM AUTHOR]

Virtual environments have the potential to be an important teaching tool for emotionally sensitive issues capable of producing a sense of presence, perspective-taking and introspection in users in a risk-free, rapid feedback experience. In designing such experiences, it is essential that users are regularly engaged in a collaborative design process. However, engaging in design, development, and evaluation can in itself provide a learning experience. Here, the authors present an approach to engaging children in the design, development and evaluation of a virtual learning environment, specifically a serious game, focused on inculcating empathy, ethical reasoning, and reflection for coping with bullying. It was demonstrated that children's involvement not only contributed to an improved virtual environment, but significantly engaging in the design process provided children with a novel and effective learning opportunity.

Background and Purpose: Because there are conflicting perspectives on the factor structure of the World Health Organization Quality of Life-BREF (WHOQOL-BREF) Questionnaire among college students, we evaluated the psychometric properties of the instrument in a sample of U.S. college students. Methods: We conducted secondary analysis of data collected from 1,138 undergraduate students from a large metropolitan university in the southeastern United States. Results: Confirmatory factor analysis did not support the original 4-factor structure. Based on exploratory factor analysis, three factors were retained and rotated using Varimax rotation, which accounted for 96% of the item variance. Coefficient alphas for the factors were: social/psychological health, 0.84; physical health, 0.81; and environment, 0.77. Sexual minorities had significantly lower scores on all factors than those who identified as heterosexuals. Conclusions: In this sample of college students, the WHOQOL-BREF was three-dimensional, and a significant amount of the item variance was explained. Lower quality of life scores of nonWhites and sexual minority college students point to a critical need that should be addressed. [ABSTRACT FROM AUTHOR]

This paper discusses leveraging design thinking techniques for involving children in serious game design in Japanese elementary schools. Our action research project approach accomplished two different goals: (1) to inculcate design thinking in pupils, and (2) to sensitize children on bullying victimization. Our approach uses a range of participatory design methods to distil design ideas from children and to support their design thinking aiming to boost children’s creative confidence and develop social and emotional skills. Key findings from our project are: (1) children made valuable design contributions including realistic bullying scenarios, language content, user interface design, storyline progression, character profiles, coping strategies etc., and (2) participatory design and design thinking stimulated ethical reasoning, reflection and empathy in children on bullying victimization. Our approach is unique in the current design thinking landscape, because it moves from designing “thing” (object) to designing “think” (bullying sensitization). Future research should focus on highlighting ways how participatory design and design thinking enrich and complement each other. The significance of our paper stems from the simple standpoint that those participating in a design should gain from participating in the design process. Takeaways for practitioners are: (1) building relationships with stakeholders, especially children, (2) empathy and user research techniques, (2) translating field data into usable insights, (3) idea-generation and rapid concept development, (4) product co-prototyping, (5) user engagement and co-creation, (6) multiple perspectives on effective communication.

Addressing the problems of bullying in schools, this paper presents a novel and highly innovative pedagogical approach, building on the immersive power of virtual role-play. Educational role-play is widely accepted as a powerful instrument to change attitudes and behaviour, but faces some difficulties and disadvantages when applied to sensitive social issues in the classroom. This paper shows how the FearNot! software application, developed within the scope of the EU-funded projects VICTEC (Virtual ICT with Empathic Characters) and eCIRCUS (Education through Characters with emotional-Intelligence and Role-playing Capabilities that Understand Social interaction) uses virtual role-play and autonomous agents to provide children aged eight to eleven years of age with the opportunity to visit a virtual school environment populated by 3D animated synthetic characters that engage in bullying episodes. The characters' actions and the storyline are created as improvised dramas by use of emergent narrative, resulting in unscripted and highly believable interaction experiences for the learner. While the students are spectators to the bullying episodes that unfold among the FearNot! characters, the victimised character starts a conversation with the student in between the episodes, describing their experiences with bullying and how they feel as a result to it, and asking the student for advice. The aim of this approach and particularly of this interaction sequence in between the virtual bullying episodes is to sensitise primary school students to the potential problems that victims of persistent aggressive behaviour are facing: By triggering an empathic relationship between learners and characters, learners understand and vicariously feel into the plight of the victimised character. Empirical evidence from bullying research implies that bullies are regularly reinforced by bystanders that witness the bullying and turn their attention to it, but do not actively intervene to end it (Craig & Pepler 1996; Lean 1998; Salmivalli 1999; Hawkins et al. 2001). Hence, this intervention strategy targets these bystanders to stand up to the bully and help the victim, due to their heightened awareness and sensitivity to the grave consequences victims face. Preliminary evaluation results indicate that the children were willing to immerse themselves in the virtual drama and that they empathically engage with the characters, attributing a range of emotions to the characters depending on the events that happen within the respective scenario. An ongoing long-term intervention in school in the UK and Germany covers several interactions with the software over a ten week period of time.

Perioperative nurse engagement and certification are associated with a culture of safety, which is crucial in perioperative environments. Therefore, examining relationships between engagement, the practice environment, and certification is warranted. The purposes of this study were to examine the relationships between the perioperative practice environment and reported nurse engagement, determine differences in engagement based on certification, and identify facilitators and barriers to attaining and sustaining certification. In this multiphase mixed‐methods study, we used a convenience sample of perioperative nurses (N = 379) to examine relationships between engagement, the practice environment, and certification. Qualitative interviews were conducted (n = 15) to supplement the quantitative findings. Leadership support (β = 0.23, P =.001) and nursing foundations for quality care (β = 0.21, P =.01) were significant predictors of engagement. Certified nurses did not have significantly higher mean engagement scores when compared with noncertified peers. Qualitative interviews corroborated the findings. [ABSTRACT FROM AUTHOR]

Cigarette smoking is common among pregnant women with substance use disorders (SUD) and may contribute to more adverse health consequences for the infant than alcohol and illicit drug use. However, most studies focused on stopping illicit drug use and paid little attention to cigarette smoking in pregnant women with SUD. To identify predictors of current smoking among pregnant women with SUD, given past-month psychological distress, alcohol use and illicit drug use, the receipt of past-year mental health and substance use treatment controlling for potential confounders. Secondary analysis of cross-sectional data from the National Survey on Drug Use and Health (NSDUH) 2015–2019 was conducted. The NSDUH included 3,540 pregnant women aged 18–44 years; among them were 195 lifetime smokers with SUD. Multiple logistic regression modeling was used to examine the probability of prenatal smoking. Sixty-one percent of pregnant women with SUD reported current cigarette smoking. The likelihood of prenatal smoking increased with a higher level of past-month psychological distress (Adjusted Odds Ratio [AOR] 1.14; 95% Confidence Interval [CI]: 1.02–1.28), past-month illicit drug use (AOR: 5.68; 95% CI: 1.59–20.21), and past-year substance use treatment receipt (AOR: 5.73; 95% CI: 1.88–17.45). The receipt of substance use treatment markedly increased the probability of smoking in pregnant women with SUD. Treatment and policy initiatives are required to address and integrate cigarette smoking within other substance use treatment modalities for pregnant women with SUD. [ABSTRACT FROM AUTHOR]

This paper reports in part on a major study, carried out in 2013, in which data were collected from university senior executives and academics in the five university business schools in the North East of England: it focuses on the quantitative findings produced. Whilst prima facie evidence would suggest that universities are strategically embedding and integrating third stream strategies alongside first and second stream activities, a critical analysis of the research data revealed that this was clearly not the case. Empirical evidence from the research indicates that there are strategic failings in universities. This research contributes to the existing literature which highlights the academic pressures in embedding the third stream in higher education institutions.

Objectives: Identification of health-related risk behaviors associated with well-being in college students is essential to guide the development of health promotion strategies for this population. The purposes were to evaluate well-being among undergraduate students and to identify health-related risk behaviors that predict well-being in this population. Methods: A cross-sectional Web-based survey of undergraduate students was conducted at a metropolitan university in the Southeast United States. A total of 568 students responded (response rate 14.2%). Data were collected on health-related risk behaviors using the National College Health Assessment II. Results: Controlling demographic characteristics, the best predictive model included physical activity, current tobacco user, depression, ever received mental health services, and sleep quality, which was the strongest predictor (ß = 0.45, p < 0.001). This model explained 35% of the variance in well-being. Conclusions: Interventions that promote sleep quality among college students may be most beneficial in improving well-being.

Providing opportunities for children to engage with intercultural learning has frequently focused on exposure to the ritual, celebrations and festivals of cultures, with the view that such experiences will result in greater acceptance of cultural differences. Intercultural conflict is often avoided, bringing as it does particular pedagogical, ethical and political dilemmas of which cultures we place in conflict in the multicultural classroom. In this paper we discuss an alternative approach, providing children with an interactive learning experience with synthetic cultures and characters. The agent architecture developed to enable intelligent agents to exhibit culturally appropriate affect and behaviours is outlined. MIXER, an experiential learning application developed for 9-11 year old children on intercultural conflict is described, highlighting the learning goals and approaches. A school-based evaluation of MIXER with 144 UK children is presented. Children demonstrated high levels of comprehension, engagement and enjoyment of MIXER, with MIXER contributing to near and far transfer, supporting children's cognitive, emotional and behavioural learning and stimulating discussion and debate about how to resolve conflict.

Purpose: This paper aims to briefly outline the seamless evaluation approach and its application during an evaluation of ORIENT, a serious game aimed at young adults. Design/methodology/approach: In this paper, the authors detail a unobtrusive, embedded evaluation approach that occurs within the game context, adding value and entertainment to the player experience whilst accumulating useful data for the development team. Findings: The key result from this study was that during the "seamless evaluation" approach, users were unaware that they had been participating in an evaluation, with instruments enhancing rather than detracting from the in-role game experience. Practical implications: This approach, seamless evaluation, was devised in response to player expectations, perspectives and requirements, recognising that in the evaluation of games the whole process of interaction including its evaluation must be enjoyable and fun for the user. Originality/value: Through using seamless evaluation, the authors created an evaluation completely embedded within the "magic circle" of an in-game experience that added value to the user experience whilst also yielding relevant results for the development team. (Contains 3 figures and 2 tables.)

The purpose of this study was to test the reliability and validity of an acanthosis nigricans (AN) screening tool for use in elementary school-age children of different ethnic groups. Cross-sectional data were collected via observation of 288, 5- to 12-year-old school-age children. Three nurse clinicians used a 0-4 grade AN screening tool to rate each child's level of AN independently. AN was consistently and appropriately identified in elementary school-age children from different ethnic groups. All clinicians were within one grade 98% of the time. Substantial agreement among raters was found (kappa statistic = 0.822, p [less than or equal to] 0.001), indicating similar interpretation and reproducibility of the AN screening tool. There was more consistent detection of grade four AN regardless of the children's sex, body mass index, or ethnic group. The AN screening tool is easy to use and reliable for use with elementary school-age children of various ethnic groups. (Contains 2 tables and 2 figures.)