Caught between relief and unease: How university students' well-being relates to their learning environment during the COVID-19 pandemic in the Netherlands.

Previous literature shows that university students are particularly vulnerable to psychological ill-being. Also throughout the COVID-19 pandemic, stressors ranging from uncertainty to disruption of social lives have influenced their well-being. Resilience as a psychological resource could help students deal with such crises. Furthermore, students' learning environment can substantially determine their well-being and resilience, by satisfying their basic psychological needs for autonomy, competence, and relatedness. The present study aims to longitudinally investigate students' well-being and resilience in relation to their learning environment. To this end, we interviewed six participants, of which two were university students, two university teachers, one study advisor, and one student psychologist. With a longitudinal interview study with four dates of measurement, spanning the pre to mid-COVID-19 pandemic period, we gathered commentary about the evolution of student well-being, resilience factors, and the effects of the learning environment. To analyse the interview data, we used thematic inductive and deductive coding. The participants confirmed the postulated stressors, but also positive consequences for student well-being, including resilience growth. Interviewees also reported a variety of resilience factors, both within the individual (e.g. social support) and within academia (e.g., impaired student-teacher relationship, diminished sense of belonging). Furthermore, the interview data indicate changes in teaching related to students' needs for autonomy, competence, and relatedness, which in turn have consequences for learning and engagement, including challenges, opportunities, and positive outcomes. These findings, connecting the learning environment to student well-being and resilience, may help reshape academic systems for the post-pandemic future.

A Phase I Trial of the Dual MET Kinase/OCT-2 Inhibitor OMO-1 in Metastatic Solid Malignancies Including MET Exon 14 Mutated Lung Cancer.

INTRODUCTION: Targeted therapy in non-small cell lung cancer (NSCLC) patients with mesenchymal epithelial transition (MET) exon 14 skipping mutations (METex14) and MET amplifications has improved patients' outcomes. The development of more potent MET kinase inhibitors could further benefit these patients. The aim of this trial is to determine the safety and recommended phase 2 dose (RP2D) of OMO-1 (an oral dual MET kinase/OCT-2 inhibitor) and to assess preliminary clinical efficacy in METex14-positive NSCLC and other MET-positive solid tumors. MATERIALS AND METHODS: This was a first-in-patient, open-label, multicenter study of OMO-1 in patients with locally advanced or metastatic solid malignancies. A standard 3 + 3 dose escalation design was utilized starting at a dose level of 100 mg BID continuously. Preliminary efficacy was investigated in patients with METex14-positive NSCLC, and MET amplified NSCLC and other solid tumors (MET basket). RESULTS: In the dose-escalation part, 24 patients were included in 5 dose levels ranging from 100 mg twice daily (BID) to 400 mg BID. Most common adverse events (≥ 20%) were nausea, fatigue, vomiting, increased blood creatinine, and headache. The RP2D was determined at 250 mg BID. In the expansion cohorts, 15 patients were included (10 in METex14-positive NSCLC cohort and 5 in MET basket cohort) and received either 200 or 250 mg BID. Eight out of the 10 patients with METex14 positive NSCLC had stable disease as the best response. CONCLUSION: OMO-1 was tolerated at the dose of 250 mg BID and shows initial signs of MET inhibition and anti-tumor activity in METex14 mutated NSCLC patients.

Through the Looking Glass: How the COVID-19 Pandemic Changed International Branch Campuses' Academic Experience and Home Campus Relationship.

This study examines how the COVID-19 pandemic has impacted the academic experience at international branch campuses (IBCs) and has changed the relationship between the IBC and the home campus. Semi-structured interviews with 26 leaders, academic staff, and students at seven IBCs in Malaysia revealed that the COVID-19 pandemic has changed the experience at IBCs in unique ways, including collaboration and communication with the home campus; increasing campus-specific resources for student wellbeing; and playing a larger role in student enrollment, recruitment, and mobility initiatives. Findings provide useful insights for higher education institutions (HEIs) engaged in transnational education (TNE).

A Conceptual Framework for Understanding Variability in Student Perceptions.

Student perceptions using surveys are frequently used to measure student perceptions of teachers' teaching quality in secondary and higher education. Research shows that the variance in student perceptions exists within a class and between countries. However, the influence of individual- and cultural-level factors on the variance of student perceptions is less well studied. More insights are needed to understand the mechanisms underlying the variance in student perceptions in-depth. Insights into determinants of student perceptions of teaching quality could become valuable toward understanding school-related outcomes. A conceptual framework is put forward in this study to enhance our understanding of manifestations of student perceptions of teaching quality. It is suggested that value orientations at the individual- and cultural-level as well as social desirability may play a role in understanding student perceptions of teaching quality. Understanding students' individual and collective perceptions of teaching quality can contribute to teachers' sense-making of their student evaluations. It is argued that this understanding could contribute to enhancing the development of teaching quality and ultimately education quality.

Platelet-Therapeutics to Improve Tissue Regeneration and Wound Healing-Physiological Background and Methods of Preparation.

Besides their function in primary hemostasis, platelets are critically involved in the physiological steps leading to wound healing and tissue repair. For this purpose, platelets have a complex set of receptors allowing the recognition, binding, and manipulation of extracellular structures and the detection of pathogens and tissue damage. Intracellular vesicles contain a huge set of mediators that can be released to the extracellular space to coordinate the action of platelets as other cell types for tissue repair. Therapeutically, the most frequent use of platelets is the intravenous application of platelet concentrates in case of thrombocytopenia or thrombocytopathy. However, there is increasing evidence that the local application of platelet-rich concentrates and platelet-rich fibrin can improve wound healing and tissue repair in various settings in medicine and dentistry. For the therapeutic use of platelets in wound healing, several preparations are available in clinical practice. In the present study we discuss the physiology and the cellular mechanisms of platelets in hemostasis and wound repair, the methods used for the preparation of platelet-rich concentrates and platelet-rich fibrin, and highlight some examples of the therapeutic use in medicine and dentistry.

Clot Retraction: Cellular Mechanisms and Inhibitors, Measuring Methods, and Clinical Implications.

Platelets have important functions in hemostasis. Best investigated is the aggregation of platelets for primary hemostasis and their role as the surface for coagulation leading to fibrin- and clot-formation. Importantly, the function of platelets does not end with clot formation. Instead, platelets are responsible for clot retraction through the concerted action of the activated αIIbß3 receptors on the surface of filopodia and the platelet's contractile apparatus binding and pulling at the fibrin strands. Meanwhile, the signal transduction events leading to clot retraction have been investigated thoroughly, and several targets to inhibit clot retraction have been demonstrated. Clot retraction is a physiologically important mechanism allowing: (1) the close contact of platelets in primary hemostasis, easing platelet aggregation and intercellular communication, (2) the reduction of wound size, (3) the compaction of red blood cells to a polyhedrocyte infection-barrier, and (4) reperfusion in case of thrombosis. Several methods have been developed to measure clot retraction that have been based on either the measurement of clot volume or platelet forces. Concerning the importance of clot retraction in inborn diseases, the failure of clot retraction in Glanzmann thrombasthenia is characterized by a bleeding phenotype. Concerning acquired diseases, altered clot retraction has been demonstrated in patients with coronary heart disease, stroke, bronchial asthma, uremia, lupus erythematodes, and other diseases. However, more studies on the diagnostic and prognostic value of clot retraction with methods that have to be standardized are necessary.

Do bleaching gels affect the stability of the masking and caries-arresting effects of caries infiltration-in vitro.

OBJECTIVES: The aim of this study was to evaluate the influence of different bleaching gels on the masking and caries-arresting effects of infiltrated and non-infiltrated stained artificial enamel caries lesions. MATERIALS AND METHODS: Bovine enamel specimens (n = 240) with each two sound areas (SI and SC) and each two lesions (DI and DC) were infiltrated (DI and SI), stained (1:1 red wine-coffee mixture,70 days), and randomly distributed in six groups to be bleached with the following materials: 6%HP (HP-6), 16%CP (CP-16), 35%HP (HP-35), 40%HP (HP-40), and no bleaching (NBl,NBl-NBr). Subsequently, specimens were pH-cycled (28 days, 6 × 60 min demineralization/day) and all groups except NBl-NBr were brushed with toothpaste slurry (1.100 ppm, 2×/day, 10 s). Differences in colorimetric values (ΔL, ΔE) and integrated mineral loss (ΔΔZ) between baseline, infiltration, staining, bleaching, and pH cycling were calculated using photographic and transversal microradiographic images. RESULTS: At baseline, significant visible color differences between DI and SC were observed (ΔEbaseline = 12.2; p < 0.001; ANCOVA). After infiltration, these differences decreased significantly (ΔEinfiltration = 3.8; p < 0.001). Staining decreased and bleaching increased ΔL values significantly (p ≤ 0.001). No significant difference in ΔΔE was observed between before staining and after bleaching (ΔEbleaching = 4.3; p = 0.308) and between the bleaching agents (p = 1.000; ANCOVA). pH-cycling did not affect colorimetric values (ΔEpH-cycling = 4.0; p = 1.000). For DI, no significant change in ΔZ during in vitro period was observed (p ≥ 0.063; paired t test). CONCLUSIONS: Under the conditions chosen, the tested materials could satisfactorily bleach infiltrated and non-infiltrated stained enamel. Furthermore, bleaching did not affect the caries-arresting effect of the infiltration. CLINICAL RELEVANCE: The present study indicates that bleaching is a viable way to satisfactorily recover the appearance of discolored sound enamel and infiltrated lesions.

Perspectives of bereaved partners of lung cancer patients on the role of mindfulness in dying and grieving: A qualitative study.

BACKGROUND: Mindfulness-Based Stress Reduction (MBSR) has been shown to reduce psychological distress in cancer patients but not their partners. Whether MBSR can support patients and partners in coping with the dying and grieving process is less well examined. AIM: We aimed to gain more insight in the role of mindfulness in the dying and grieving process from the perspective of the partner after the patient's death. DESIGN: As part of a pilot study or subsequent randomized controlled trial, partners had participated together with the patient in MBSR. After the patient's death partners were invited for qualitative in-depth interviews. Data from the interviews was analyzed using the grounded theory approach. SETTING/PARTICIPANTS: Interviews were conducted with 11 partners in their homes, on average 11 months after the patient's death (SD = 7.8). RESULTS: Mindfulness helped couples to allow and regulate difficult thoughts and feelings, which in turn helped them to accept the patient's impending death. It also facilitated them to enjoy things together and communicate more openly. For a few couples, however, participation was physically too burdensome or emotionally too confrontational. During the partners' grieving process, mindfulness helped allowing difficult thoughts and feelings, and taking the time to grieve, which helped them to take good care of themselves, giving them faith in the future. CONCLUSION: The present study showed that MBSR can facilitate lung cancer patients and their partners in accepting the forthcoming death and openly communicating about this, which can support a peaceful death and healthy grieving process.

'When They Struggle, I Cannot Sleep Well Either': Perceptions and Interactions Surrounding University Student and Teacher Well-Being.

A wealth of evidence has indicated that both students and teachers experience high levels of stress, burnout, and ultimately compromised well-being in the university context. Although numerous studies have investigated well-being among university students, and other studies have addressed well-being among university teachers, these lines of research are often conducted in isolation from one another. This is surprising, as the importance of considering reciprocal links between students and teachers has been suggested in several empirical studies. Additionally, when researching well-being in academia, the conceptualizations tend to differ from study-to-study. The present research therefore investigated how students and teachers conceptualize well-being at the university based on their personal experiences, as well as how student and teacher well-being interact. To examine this, six university students (50% female), and ten teachers (50% female) from Germany and the Netherlands participated in semi-structured interviews. Qualitative analysis using a multistage coding process revealed detailed insights concerning students' and teachers' perceptions of well-being that coincided with positive psychology, resilience, multifaceted, and basic psychological need fulfillment approaches. Moreover, an interaction between students' and teachers' well-being became apparent, including several factors such as the student-teacher relationship that in turn, contributed to both population's well-being. The present findings lend evidence toward a more coherent conceptualization of well-being and are discussed in terms of suggestions for initiatives that simultaneously support both populations, for example, through the student-teacher relationship.

Mindfulness-Based Cognitive Therapy for Cancer Patients Delivered via Internet: Qualitative Study of Patient and Therapist Barriers and Facilitators.

BACKGROUND: The number of patients living with cancer is growing, and a substantial number of patients suffer from psychological distress. Mindfulness-based interventions (MBIs) seem effective in alleviating psychological distress. Unfortunately, several cancer patients find it difficult, if not impossible, to attend a group-based course. Internet-based MBIs (eMBIs) such as Internet-based mindfulness-based cognitive therapy (eMBCT) may offer solutions. However, it is yet to be studied what facilitators and barriers cancer patients experience during eMBCT. OBJECTIVE: This study aimed to explore facilitators and barriers of individual asynchronous therapist-assisted eMBCT as experienced by both patients and therapists. METHODS: Patients with heterogeneous cancer diagnoses suffering from psychological distress were offered eMBCT. This 9-week intervention mirrored the group-based MBCT protocol and included weekly asynchronous written therapist feedback. Patients were granted access to a website that contained the eMBCT protocol and a secured inbox, and they were asked to practice and fill out diaries on which the therapist provided feedback. In total, 31 patients participated in an individual posttreatment interview on experienced facilitators and barriers during eMBCT. Moreover, eight therapists were interviewed. The data were analyzed with qualitative content analysis to identify barriers and facilitators in eMBCT. RESULTS: Both patients and therapists mentioned four overarching themes as facilitators and barriers: treatment setting (the individual and Internet-based nature of the treatment), treatment format (how the treatment and its guidance were organized and delivered), role of the therapist, and individual patient characteristics. CONCLUSIONS: The eMBCT provided flexibility in when, where, and how patients and therapists engage in MBCT. Future studies should assess how different eMBCT designs could further improve barriers that were found.

Mindfulness-based stress reduction for breast cancer patients: a mixed method study on what patients experience as a suitable stage to participate.

PURPOSE: Breast cancer is associated with high levels of psychological distress. Mindfulness-based stress reduction (MBSR) has proven to be effective in reducing distress in cancer patients. In several studies, patients who are currently undergoing somatic anticancer treatment are excluded from participating in MBSR. Little is known about what would be the most suitable stage of disease to offer MBSR. We examined whether stage of disease facilitated and/or hindered participation in MBSR for breast cancer patients. METHOD: A mixed method design was used. Self-report questionnaires on psychological distress (HADS) and quality of life (EORTC QLQ-C30) were administered before and after MBSR. Five focus groups and three semi-structured individual interviews were conducted. Qualitative data were analyzed with the constant comparative method in order to develop a grounded theory. RESULTS: Sixty-four females participated in MBSR. In 52 patients who completed the questionnaires, psychological distress improved significantly. Qualitative data showed that participating in MBSR both during and after anticancer treatment has specific advantages and disadvantages. Interestingly, being emotionally ready to take part in MBSR seems equally important as physical ability. Informing patients at an early stage seemed to strengthen autonomy and self-management skills. CONCLUSIONS: In contrast to the common practice to tailoring the timing of MBSR to physical impairments or demands of the anticancer treatment, our findings revealed that emotional readiness is equally important to take into account. These findings might support professionals in their choices whether and when to inform and refer patients to MBSR.

A qualitative study on mindfulness-based stress reduction for breast cancer patients: how women experience participating with fellow patients.

PURPOSE: Peer support groups for cancer patients show mixed findings regarding effectiveness on psychological wellbeing. When embedded in a psychosocial intervention, such as mindfulness-based stress reduction (MBSR), peer support might be of more benefit to participants. This study is a qualitative exploration of how women with breast cancer experience the possible benefits and impediments of participating with fellow patients in an MBSR training. METHODS: Five focus groups (n = 37) and three individual interviews (n = 3) were conducted with breast cancer patients who participated in MBSR. The qualitative data were analysed with the constant comparative method in order to develop a grounded theory. RESULTS: We could identify a process where at the start of MBSR, patients experienced anticipatory fear for facing the suffering of fellow patients, especially for those who could not be cured anymore. In most women, this fear gradually subsided during the first two sessions. The atmosphere in the MBSR training was experienced as safe and supportive, providing a context where participants could connect with and trust one another. In turn, this facilitated participants to learn from one another. CONCLUSIONS: Our findings do not only show that the peer group facilitates the learning process in MBSR, but the MBSR also seemed to provide an atmosphere that promotes the experienced social support in participants. In addition, the results emphasize the importance for mindfulness teachers to acknowledge and explore the fear for facing fellow patients in the group. Future research should examine whether the results are generalizable to patients with other cancer types.