Digital learning in higher education expanded rapidly after the COVID-19 pandemic, yet evidence on its impact on well-being in academia remains limited. To date, no comprehensive synthesis has examined well-being outcomes in post-pandemic, digitally mediated higher education . This scoping review synthesises research on student andstaff well-being in digital, post-pandemichigher education . Systematic searches were conducted in Medline, Scopus, Web of Science, and ERIC (2021–2025). Two reviewers independently screened studies and extracted data. Findings were synthesised narratively. Seven cross-sectional studies involving 3,744 students met inclusion criteria; no eligible studies on teaching staff were identified. Most studies reported moderate stress, depression, and anxiety, with insomnia and burnout ranging from low to moderate. Well-being was associated with learning preferences, digital tool satisfaction, institutional support, and traits such as self-management. Common barriers included assessment-related stress, digital fatigue, social isolation, and infrastructure limitations. Post-pandemic digital education is associated with moderate psychological and emotional burden among students, shaped by individual and contextual factors. The absence of staff-focused research represents a significant structural gap in the literature. Institutions should adopt strategies to support well-being in digital settings, and future research must address diverse digital formats and prioritise the well-being of both students and teaching staff.

Nature-based adventure activity has become increasingly popular due to its positive impact on well-being. Activities, such as mountaineering, often incorporate thrill components and require tourists to master physical and technical skills. Guides can play a key role in improving tourists' experience and promoting environmental consciousness. This study investigated the impact of guiding on tourist's experience and pro-environmental attitudes, along with identifying sociodemographic and psychological profiles of visitors hiring guides in a natural park. An ex-post-facto design was conducted on a 2 x 2-factor framework (guided versus non-guided mountaineering; pre- versus post-activity). On-site questionnaires assessed psychological aspects, pro-environmental attitudes and sociodemographic factors related to tourism behavior. Nature-based activity enhanced pro-environmental attitudes, and guiding mitigated perceived difficulty and risk. A sociodemographic profile relying on attitudes, group size, technical preparedness, and age achieved 85% discriminant capacity between guided and non-guided mountaineers. A psychological profile, relying on perceived difficulty, ecological values, and risk avoidance, distinguished guided from non-guided mountaineers (64% discriminant capacity). The results emphasize profiling mountaineers' characteristics to enhance visitor experience, preserve natural areas, and highlight the benefits of guiding for long-term sustainability. The conclusions of this study are geographically limited, highlighting the need for further research in diverse environments.

Introduction: During Covid-19, high prevalence of distress was reported among students, suggesting that they may be at higher risk than the general population of developing psychological disorders in confinement situations. Methods: We conducted a systematic search of four databases (PsycINFO, PubMed, SCOPUS, and Web of Science) for articles published from January 2020 to May 2022. Risk of bias was assessed using the Joanna Briggs Institute (JBI) checklist. Random effects meta-analyses of the reported proportions of college students with clinically significant symptoms of anxiety, depression and stress were carried out, and between-studies heterogeneity was also analysed. Results: 73 studies (N=209.761) were included for meta-analysis. The estimated proportion of college students with clinically significant short-term symptoms was 34% for anxiety (95% CI [29%,39%]; I 2 =99.75%), 38% for depression (95% CI [33%,44%; I 2 = 99.71%), and 54% for stress (95% CI [46%,62%]; I 2 = 99.57%). The estimated proportion of college students with clinically significant long-term symptoms was 37% for anxiety (95% CI [32%,42%]; I 2 = 97.92%), 31% for depression (95% CI [23%,41%]; I 2 = 99.49%) and 41% for stress (95% CI [25%,59%]; I 2 = 99.29%) were found. Several methodological and sociodemographic moderators accounted for heterogeneity in the observed prevalences. Limitations: The heterogeneity of study findings suggest that the results should be interpreted with caution. Conclusion: The current evidence shows that approximately one-third of college students experienced distress, further where we can infer that there was no evidence of a worsening in mental health derived from a cumulative effect during the pandemic. PROSPERO: CRD420222233036.

BACKGROUND/OBJECTIVES:The main objective of the present study is to assess the short-term effects of Forest Bathing (FB) conducted in a Mediterranean forest on individuals with fibromyalgia (FM) and/or chronic fatigue syndrome/myalgia encephalomyelitis (CFS/ME) on perceived pain, fatigue, state anxiety, positive and negative affect, mood states, and state mindfulness. METHODS:A total of 44 participants with FM and/or CSF/ME agreed to participate in this study. The FB session consisted of a 3 km silent walk, lasting three hours and guided by a specialized psychologist and a mountain guide to guarantee the safety of the activity. Paired-sample t-tests were used to analyze the pre-post changes in perceived pain, fatigue, state anxiety, positive and negative affect, mood states, and mindfulness. RESULTS:All reported variables but self-reported pain showed statistically significant pre-post variations after the FB session. Particularly, large-to-very-large improvements in positive and negative affect, state anxiety, tension, depression, anger, and vigor were found. Small-to-moderate effect sizes for fatigue, friendliness, and state mindfulness were also reported. CONCLUSIONS:This study provides preliminary evidence of the short-term benefits of FB in individuals with FM and/or CFS/ME, especially on state anxiety and negative affect.

The widespread availability of pornography due to the digital shift raises concerns about its impact on adolescents and young adults' sexual behavior. Based on Social Learning Theory, this study examined the associations among gender, pornography exposure, sexual knowledge, attitudes, and practices in Spanish youth. A sample of 263 adolescents and young adults in Barcelona completed an online questionnaire assessing these variables. Results showed males, those with lower sexual knowledge, younger age of exposure, and frequent viewers of certain content were more likely to replicate behaviors from pornography. The study emphasizes the need for early sexual and digital literacy education.

El bienestar disminuido y la alta angustia entre doctorandos son preocupaciones crecientes en educación superior e investigación. El objetivo de la presente investigación fue analizar y contrastar características sociodemográficas, indicadores de bienestar y malestar emocional en estudiantes de doctorado mexicanos y españoles. Este estudio observacional y transversal analizó características sociodemográficas, bienestar y malestar emocional en 351 estudiantes de doctorado (192 mexicanos y 159 españoles) mediante un cuestionario en línea. Los doctorandos en España enfrentan mayores desafíos emocionales y psicológicos que sus pares mexicanos, con menores puntuaciones en bienestar y mayores en malestar emocional. Asimismo, ser estudiante internacional y la edad aparecieron como factores de riesgo para el desarrollo de problemas de salud mental. Los resultados muestran diferencias en la salud mental en función del país, sugiriendo que el entorno académico y las características culturales y académicas podrían influir en el bienestar de sus doctorandos y su personal investigador en formación.

Objective: Surgical repair remains the standard treatment for severe mitral regurgitation (MR) due to mitral prolapse. Minimally-invasive mitral valve surgery (MIMVS) has been increasingly performed but still is the minority, with lack of solid evidence on its superiority over conventional surgery. Our objectives were to compare the results of MIMVS and conventional surgery. Methods: Retrospective review of all patients treated in our center with degenerative severe MR (November 2011 – May 2020). Patients with previous mitral surgery and those requiring concomitant procedures other than atrial fibrillation ablation were excluded. Two groups were compared: MIMVS (minimally invasive surgery) and Open (full median sternotomy), in a cohort of matched (1:1; nearest neighbor) pairs using propensity score (PS) methods. Results: 286 consecutive patients met the inclusion criteria (MIMVS:183, Open:103). There were no significant differences preoperatively, except for lower age, NYHA III-IV and EuroSCOREII in the MIMVS group. In both groups, around 40% of patients presented with anterior or bileaflet prolapse, with no differences in repair techniques used. After PS matching, a cohort of 93 matched pairs was selected and all basal differences were balanced. Comparisons showed that despite bypass and cross-clamp times were higher (+32 and +21m; p<0.001), MIMVS presented shorter mechanical ventilation (0 vs. 6h; p<0.01), ICU stay (1.8 vs. 2.5d; p=0.02), higher hemoglobin (11 vs. 10mg/dL; p<0.02) and less renal failure (1 vs. 8%; p:0.03). There were no differences in mortality, repair rate or MR grade at discharge. During follow-up (median 2.8 years), there were no significant differences in the degree of recurrent MR and reoperation. Conclusions: Surgical repair of mitral prolapse is possible in most cases with low perioperative morbimortality and excellent mid-term results. MIMVS can be performed without compromising perioperative outcomes, repair rate and durability, while providing shorter ICU and mechanical ventilation duration, less blood loss and renal failure.

Previous studies have reported that adolescents were at higher risk for mental health disorders during and after the COVID-19 pandemic due to the characteristics of their developmental period and to the impact of social and mobility restrictions on their daily routines. In response to these reports, we designed, implemented, and evaluated the impact of a brief positive psychological intervention in a high school setting to increase adolescents’ psychological well-being during the COVID-19 pandemic. A pre-post experimental study was conducted to compare the levels of anxiety, academic motivation, and performance changes in an experimental and control group. A final sample of 148 students from two Spanish high schools of the Catalan region participated in the study ( M ag e = 12.45; 48% female). Results showed that participants in the experimental group reported a reduction in anxiety and an increase in global motivation levels compared to the control group. Regression analyses also revealed that the intervention was a significant predictor of reduced anxiety, increased motivation, and fewer failed subjects, while high anxiety predicted decreased performance and reduced motivation. These findings suggest that brief positive psychological interventions implemented in high school classrooms could be a cost-effective and systemic preventive measure for increasing adolescents’ psychological well-being and strengthening their general mental health both during and after periods of pandemic restrictions.

We assessed the cross-cultural role of Time Perspective (TP) tendencies [Past Positive (PP), Past Negative (PN), Present Hedonistic (PH), Present Fatalistic (PF), and Future (F)], the Deviation from a Balanced Time Perspective (DBTP) profile, the Deviation from a Negative Time Perspective (DNTP) profile, and mindfulness on life satisfaction (LS). The sample consisted of psychology undergraduate students (N = 867, M AGE = 20.19, SD = 3.417) in four countries: USA, Spain, Poland and Japan. We used a 17-item short version of the Zimbardo Time Perspective Inventory (ZTPI), the Mindful Attention Awareness Scale (MAAS), and the Satisfaction with Life Scale (SWLS) in all countries. For ensuring measurement invariance, we conducted pairwise CFAs for the ZTPI-17, MAAS and SWLS. Regression analyses showed that PN predicted decreased LS in Poland and Japan. PP predicted increased LS in Spain. F predicted increased LS in Poland. DNTP predicted decreased LS in Poland. Mindfulness predicted decreased LS in Japan and increased LS in USA, Spain and Poland. Moreover, mediation analyses revealed that the DBTP partially mediated the relationship between mindfulness and LS in Spain and USA. The DNTP partially mediated the relationship between mindfulness and LS in Spain, Poland and Japan (opposite direction). The findings suggest that the association of TP, mindfulness and LS differs across the investigated countries as a function of culture.

We conducted this study to explore the efficacy and safety of laparoscopic radical cystectomy (LRC) and robot-assisted radical cystectomy (RARC) for bladder cancer (BC).We searched the PubMed, Embase, Cochrane Library and Web of Science databases for studies on LRC and RARC treatment of BC from the time of the databases creation to May 1, 2022. We extracted data and used Stata 16.0 for calculation and statistical analyses.Thirteen studies with 1509 patients were included. Meta-analysis showed no statistically significant differences (P > 0.05) between RARC and LRC in terms of operative time (weighted mean difference [WMD] = 14.48; 95% confidence interval [CI][-2.49, 31.44], P = 0.001), estimated intraoperative blood loss (WMD = −4.23; 95% CI [-81.48, 73.01], P = 0.001), intraoperative blood transfusion (odds ratio [OR] = 0.7; 95% CI [0.39, 1.27]; P = 0.011), positive surgical margins (OR = 1.21; 95% CI [0.61, 2.03]; P = 0.855), time to regular diet, length of hospital stay (WMD = 0.37, 95% CI [-1.73, 2.46]; P = 0.001), postoperative hospital days (WMD = −0.52; 95% CI [-1.15, 0.11], P = 0.359), intraoperative complications, 30- day postoperative complications, and 90- day postoperative complications. However the RARC lymph node yield was higher than that of LRC (WMD = 1.87; 95% CI [0.74, 2.99], P = 0.147).Our study showed that LRC and RARC have similar efficacy and safety profiles for the treatment of muscle invasive bladder cancer.

Planned overlapping surgery can improve efficiency, reduce costs and help manage long waiting lists, yet this practice has been questioned due to patient safety concerns. A systematic review and meta-analysis were performed to answer the question: (1) Are there any differences in the risk of post-operative adverse outcomes and (2) are there any differences in length of stay or length of surgery, in elective total hip arthroplasty (THA) and total knee arthroplasty (TKA) performed either as non-overlapping surgery (NOS) or overlapping surgery (OS).A systematic search of literature in the databases of MEDLINE, PubMed, Embase and Cochrane from dates of inception was performed. All studies published in English were included. Risk of Bias in Non-randomised Studies–of Interventions (ROBINS-I) and the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) framework were utilised. Relative risk (RR) was used for dichotomous outcomes, while mean difference (MD) was used for continuous variables, with 95% confidence intervals. Alpha was set at 0.05.A total of nine studies with 120,625 patients were included for analyses. There were no statistically significant differences for overall rates of post-operative complications, dislocations, fractures, infections, readmissions or revision surgery nor with length of stay or length of surgery (p > 0.05). Patient characteristics between groups were similar (p > 0.05).There were no differences in post-operative adverse outcomes for elective orthopaedic THA and TKA performed as NOS when compared to OS. Operating schedules for OS in elective lower limb arthroplasty appear to be safe, given appropriate patient selection processes and may be a useful method to improve hospital efficiency. Informed consent and pre-operative patient education should remain paramount.IV.

OBJECTIVES The clinical importance of optimal post-repair mitral valve diastolic performance is increasingly being recognized. The haemodynamic effect of a partial annuloplasty band implantation, in comparison to a full ring, remains insufficiently explored.METHODS Patients undergoing mitral valve repair for pure degenerative disease between 2011 and 2019 at 2 experienced heart valve centres were eligible for inclusion. Exclusion criteria were concomitant procedures other than tricuspid valve repair and ablation procedures for atrial fibrillation. Pre-discharge and follow-up echocardiograms (1-4 years after surgery) were analysed to assess haemodynamic mitral valve performance.RESULTS Of 535 patients meeting the inclusion criteria, 364 (68.0%) patients underwent full annuloplasty ring and 171 (31.0%) partial band implantation. On predischarge echocardiogram, post-repair mitral valve gradient and area did not differ between groups [2.89 mmHg (IQR 2.26-3.72) vs 2.60 mmHg (IQR 1.91-3.55), P = 0.19 and 1.98 cm2 (IQR 1.66-2.46) vs 2.03 cm2 (IQR 1.55-3.06), P = 0.15]. However, multivariable linear regression analysis demonstrated band annuloplasty as a determinant of larger valve area (coefficient 0.467 cm2, standard error 0.105, P < 0.001). On multivariable analysis, no significant impact on post-repair gradient was observed (-0.370 mmHg, standard error 0.167, P = 0.36). At follow-up, the differences between groups disappeared and multivariable regression analysis failed to demonstrate a significant impact of annuloplasty device type on mitral valve gradient (coefficient -0.095 mmHg, standard error 0.171, P = 1.00) or area (coefficient -0.085 cm2, standard error 0.120, P = 1.00). These results were confirmed with a linear mixed model analysis.CONCLUSIONS Partial band annuloplasty was related to an improved haemodynamic profile directly after valve repair for degenerative disease but the effect was short-lived. Our results suggest that the type of annuloplasty device has no durable impact on diastolic valve performance. Surgical mitral valve repair is the gold standard treatment for degenerative valve disease with excellent clinical outcomes [1].

University students constitute a population that is highly vulnerable to developing mental health problems, such as distress. The role of different variables associated with the development of states of stress has been studied in order to identify potential risk and protective factors. This study explored whether mindfulness, self-compassion, and experiential avoidance, while controlling for specific sociodemographic and academic variables, were potential significant protective or risk factors explaining perceived stress in a sample of 589 Spanish university students (81.2% female, age range 18-48 years). A hierarchical multiple regression analysis was performed using an exploratory cross-sectional design. Higher experiential avoidance, lower self-compassion, lower mindfulness, not perceiving family support, higher total study hours per week, having a partner (vs. being single), being female (vs. being male), and being older were significantly associated with higher levels of perceived stress. In conclusion, perceived stress in our sample was positively associated with experiential avoidance, which could be regarded as a potential psychological risk variable. In contrast, perceived stress was negatively correlated with self-compassion and mindfulness, which, in turn, could be seen as protective factors. Accordingly, it is concluded that programmes aimed at reducing stress and at improving well-being among university students should include experiential avoidance, self-compassion, and mindfulness as therapeutic targets.

Forest bathing (FB) has evidenced positive effects on individuals’ mental health and well-being, but its benefits have mainly been studied in Asian biomes. The present study aimed to evaluate whether its benefits are also generalisable to other forests and biomes of the world, such as the Mediterranean. Eighty-six healthy adults of the general population were assessed before and after a FB near Barcelona (Spain) during the COVID-19 pandemic. A control-hiking group of participants was also analysed to contrast the FB effects on anxiety, affect, mood states and mindfulness. Results show that the guided practice of FB in Mediterranean-Catalan forests increases mindfulness states and positive affect and reduces anxiety and negative affect, with effect sizes being large to very large. Hiking also induced significant changes in all variables tested, but FB showed higher effect sizes. An exploratory analysis also revealed a different profile of the FB participants compared to the hiking practitioners, being highly educated women living in urban areas and with lower basal levels of psychological well-being. Accordingly, it is concluded that both Mediterranean FB and hiking (to a lesser degree) might be cost-effective strategies to promote and restore psychological well-being after the COVID-19 pandemic and to promote sustainable tourism in Mediterranean biomes of the European forested and protected areas.

This is the dataset of the online survey PSY-COVID in its third wave (2022) used in the study "Psychometric properties of the Perceived Stress Scale-4 (PSS-4) in Colombians with university education". It contains data provided by 1,911 Colombians with university studies. The data set contains data on sociodemographic variables (age, gender, status, economic and employment) and clinical variables (stress, depression, anxiety, resilience, post-traumatic growth).

This is the dataset from the PSY-COVID-1 online survey in its first wave (may-september 2020) employed in the study "predictive factors of mental adjustment of health personnel during the first wave of the COVID-19 pandemic: An international survey". It contains data provided by 16221 heatlh workers from 22 countries and a age-gender and country matched sample of 16221 people from general population. Dataset contains data about these domains: Behavioural changes and adaptation during the pandemic, behaviours and their determinants facing the SARS-CoV-2 contagion, mental health (anxiety, depression, somatization, posttraumatic growth), social and physical context of lockdown/confinement during the first wave of the pandemic, personal dispositional variables (personality, resilience, loneliness) and sociodemographical variables.

The containment measures in the face of the COVID-19 epidemic have posed a notable challenge for formal teaching-learning processes, which have had to be adapted to a context of health security. An active learning program, MOTEMO-OUTDOOR was tested on a sample of 273 university undergraduate students. A within-subjects design was carried out with an adaptation of the four discussion seminars to three formats: face-to-face synchronous indoor (in a classroom), face-to-face synchronous outdoor (in a green space) and virtual asynchronous at home. Each student was assigned to the indoor (2 seminars) and outdoor (2 seminars) conditions, and a subsample (n = 30) also participated in the virtual context in application of the university's COVID lockdown protocols. The impact of the experience was evaluated in 6 dimensions (learning experience, evaluative impact, hedonic experience, technical conditions, environmental conditions and security against COVID-19). The exploratory factor analysis revealed a structure of two higher-order factors, called learning experience and learning conditions.The results relative to the general sample revealed a higher learning experience in the outdoor compared to the indoor context, being the dimension of hedonic experience the one that supposes the greatest difference between both.In contrast, the outdoor context presented better scores in learning conditions, with the component of environmental conditions being the one that supposed a greater difference between both.The analysis of the subsample revealed the absence of differences in the learning experience between the face-to-face vs. virtual contexts, despite the fact that the latter had better scores in the learning context factor with moderate effect sizes. It is concluded that this adaptation through active methodologies to an outdoor context and a virtual context, allows to overcome part of the technical and environmental limitations and improves health security perception, guaranteeing the learning experience, and thus provide with versatility the teaching-learning processes in a higher education context.

BACKGROUND:Long-term follow-up studies in patients with borderline personality disorder (BPD) consistently show persistent impairment in psychosocial adjustment, although symptoms tend to decrease over time. Consequently, it might be better to deemphasize symptom-oriented interventions and instead promote interventions that incorporate patient perspectives on recovery. In this study we aimed to examine the feasibility and acceptability of a novel intervention (dialectical behavioral therapy combined with positive psychology and contextual-based skills) in the clinical treatment of long-lasting BPD difficulties. METHODS:This was a qualitative study. We developed an initial 8-week group intervention for long-lasting BPD. Upon completion of the 8-week program, the participants were asked to participate in a group discussion to provide feedback. Based on that feedback, the intervention protocol was modified and then offered to a second group of patients, who also provided feedback. The protocol was revised again and administered to a third group. A total of 32 patients participated in the group interventions; of these, 20 provided feedback in the qualitative study. The main outcome measure was acceptability. RESULTS:The following overarching themes emerged from the group interviews: helpful, unhelpful and neutral practices; internal/external barriers; facilitators; and effects. Participants reported difficulties in imagining an optimal future and self-compassion. By contrast, positive skills were associated with an increase in positive emotions. The main internal barrier was facing difficult emotions. The main external barriers were language-related issues. The group format was perceived as a facilitator to success. Dropout rates, which were assessed as an additional measure of acceptability, decreased substantially in each successive group, from 60 to 40% and finally 20%. CONCLUSIONS:The intervention was feasible to implement in the clinical setting and participants rated the final set of skills highly. Most of the skills were considered useful. Participant feedback was invaluable to improve the intervention, as evidenced by the large increase in the retention rate from 40 to 80%. Randomized clinical trials are needed to test the efficacy of this intervention in promoting well-being in participants with long-lasting BPD.