Deadlines make you productive, but what do they do to your motivation? Trajectories in quantity and quality of motivation and study activities among university students as exams approach.

Introduction: Recent research has emphasized that achievement motivation is context-sensitive and varies within individual students. Ubiquitous temporal landmarks such as exams or deadlines are evident contextual factors that could systematically explain variation in motivation. Indeed, research has consistently found that university students increase their study efforts as exams come closer in time, indicating increasing study motivation. However, changes in study motivation for a specific exam as it comes closer have rarely been investigated. Instead, research on developmental changes in expectancy and value beliefs has consistently founds that achievement motivation declines over a semester. Surprisingly, declining motivation thus apparently coincides with increasing study efforts for end-of-semester exams. Methods: The present research investigates this apparent contradiction by assessing how exam-specific motivation and study behavior change under equal methodological conditions as an exam draws closer. Using parallel growth curve models, we examine changes in expectancy-value beliefs, performance approach and avoidance motivation and study behavior as well as motivational want- and should-conflicts among 96 students over eight weekly measurement points. Results and discussion: Results show that students study more for their exam as it comes closer and increase their use of surface learning strategies more rapidly than their use of deep learning strategies. However, even exam-specific expectancy and attainment value beliefs decline while performance-avoidance motivation increases over time, indicating that students increasingly study out of fear to fail as exams come closer. Consistent with these findings, students' experience of should conflicts decreases while their want conflicts increase over time. We discuss several possible mechanisms underlying our findings in addition to potential theoretical consequences and suggest future research opportunities to better understand students' changes in situative motivation and study behavior in the context of temporal landmarks.

Diagnosis and treatment of MPN in real life: exploratory and retrospective chart review including 960 MPN patients diagnosed with ET or MF in Germany.

PURPOSE: The WHO 2016 re-classification of myeloproliferative neoplasms resulted in a separation of essential thrombocythemia (ET) from the pre-fibrotic and fibrotic (overt) phases of primary myelofibrosis (MF). This study reports on a chart review conducted to evaluate the real life approach regarding clinical characteristics, diagnostic assessment, risk stratification and treatment decisions for MPN patients classified as ET or MF after implementation of the WHO 2016 classification. METHODS: In this retrospective chart review, 31 office-based hematologists/oncologists and primary care centers in Germany participated between April 2021 and May 2022. Physicians reported available data obtained from patient charts via paper-pencil based survey (secondary use of data). Patient features were evaluated using descriptive analysis, also including diagnostic assessment, therapeutic strategies and risk stratification. RESULTS: Data of 960 MPN patients diagnosed with essential thrombocythemia (ET) (n = 495) or myelofibrosis (MF) (n = 465) after implementation of the revised 2016 WHO classification of myeloid neoplasms was collected from the patient charts. While they met at least one minor WHO-criteria for primary myelofibrosis, 39.8% of those diagnosed with ET did not have histological BM testing at diagnosis. 63.4% of patients who were classified as having MF, however, did not obtain an early prognostic risk assessment. More than 50% of MF patients showed characteristics consistent with the pre-fibrotic phase, which was emphasized by the frequent use of cytoreductive therapy. Hydroxyurea was the most frequently used cytoreductive medication in 84.7% of ET and 53.1% of MF patients. While both ET and MF cohorts showed cardiovascular risk factors in more than 2/3 of the cases, the use of platelet inhibitors or anticoagulants varied between 56.8% in ET and 38.1% in MF patients. CONCLUSIONS: Improved histopathologic diagnostics, dynamic risk stratification including genetic risk factors for cases of suspected ET and MF are recommended for precise risk assessment and therapeutic stratification according to WHO criteria.

University students' profiles of burnout symptoms amid the COVID-19 pandemic in Germany and their relation to concurrent study behavior and experiences.

Burnout symptoms are prevalent among university students. This study examined students' understudied profiles of burnout symptoms and their relation to procrastination, dropout intentions, and study- and life satisfaction. We used cross-sectional data from two online-studies conducted in Germany in April 2020 amid the COVID-19 pandemic (N study1 = 597, N study2 = 857). Latent profile analyses indicated three profiles in both studies: (1) well-functioning, (2) moderately exhausted-inefficacious, and (3) burned-out. Most students belonged to Profiles 1 and 2 with low to moderate burnout symptoms. Students in Profile 3 reported the highest symptoms, most procrastination, strongest dropout intentions, and lowest study- and life satisfaction. The distinct profiles broaden knowledge about intra-individual differences in students' burnout experiences and underpin the need for tailored interventions.

Why students feel competent in the classroom: A qualitative content analysis of students' views.

This qualitative study aimed to identify and to systematize factors that contribute to students' competence satisfaction in class from students' perspectives. Based on self-determination theory as our primary theoretical background, we conducted episodic interviews with 25 high school students. A combined deductive-inductive qualitative content analysis approach was applied. As our key finding, we revealed different teaching factors within and beyond self-determination theory (i.e., structure, autonomy support, relatedness support, mastery goal structure, perceived error climate, teaching quality, teachers' reference norm orientations) as well as additional factors (e.g., students' motivation and engagement, peer climate and reciprocal peer support) that contributed to students' competence satisfaction in class from the students' points of view. This study contributes to existing research on why students' competence satisfaction arises in class by complementing it with an integrative, explorative, and student-oriented perspective.

Study satisfaction among university students during the COVID-19 pandemic: Longitudinal development and personal-contextual predictors.

The COVID-19 pandemic challenges the well-being and academic success of many students. Yet, little is known about students' study satisfaction during the COVID-19 pandemic, a multilayered construct which accounts for students' subjective cognitive well-being and academic success. Besides, previous studies on study satisfaction are mostly cross-sectional and hardly consider the distinct subdimensions of this construct. Therefore, our main goal in this study was to shed light on the understudied development of the subdimensions of study satisfaction (i.e., satisfaction with study content, conditions of studying, and coping with study-related stress) in two semesters amid the COVID-19 pandemic. Additionally, we examined how particular personal (i.e., gender, age, GPA, intrinsic motivation, motivational cost, and academic procrastination) and contextual (i.e., loneliness) factors are related to these subdimensions. We conducted two panel studies with convenience and purposeful samples of university students in Germany (N study1 = 837; N study2 = 719). Participants responded online to questions on each of the subdimensions of study satisfaction at the beginning, middle, and end of each semester but responded to measures of personal and contextual factors only at the beginning of each semester. In both studies, manifest growth curve models indicated a decrease in all subdimensions of study satisfaction as the semester progressed. Generally, gender (male) and intrinsic motivation were positive predictors but age (younger students), motivational cost, and loneliness were negative predictors of different subdimensions of study satisfaction - particularly satisfaction with study content. Overall, motivational costs and loneliness were the most consistent predictors of all subdimensions of study satisfaction across both studies. Our findings provide support for the understanding that study satisfaction could diminish in the face of challenging situations such as in this pandemic. The present study also highlights certain personal and contextual factors that relate to study satisfaction and calls for intensive research into the multidimensional construct of study satisfaction.

Context Stability in Habit Building Increases Automaticity and Goal Attainment.

In this paper, we investigate the effects of context stability on automaticity and goal attainment in intentional habit building. We used hierarchical growth curve modeling and multilevel mediation to test our hypotheses on two datasets. In Study 1, N = 95 university students (N = 2,482 habit repetitions) built new study habits over a period of 6 weeks with manipulated context stability. One group was instructed to constantly vary the context of their habit repetitions by changing rooms and times and the other group was instructed to keep the context of habit performance stable. In Study 2, N = 308 habits (N = 2,368 habit repetitions) from N = 218 users of a published habit building app were analyzed without manipulating but measuring context stability. We found the same pattern in both datasets: Context stability predicted more automaticity and higher habit repetition goal attainment. We also found that the effect of context stability on habit repetition goal attainment was partially mediated by automaticity in both datasets. These results show that context does not only act as a trigger for habit instigation but also has an ongoing effect on habit execution.

Self-Efficacy in Habit Building: How General and Habit-Specific Self-Efficacy Influence Behavioral Automatization and Motivational Interference.

In this article, we investigate the role of self-efficacy (SE) in intentional habit building. We analyzed event sampling data from a habit building app we created that helps define and track habit data. We used hierarchical growth curve modeling and multilevel mediation to test our hypotheses. In a first study, N = 91 university students built new study habits over a period of 6 weeks in a controlled study. We found that the trait-like (Level 2) general self-efficacy predicted automaticity (i.e., habit strength) but not the experience of motivational interference (MI). In a second study with real user data, N = 265 idiographic habits have been analyzed. The specific SE associated with these habits - habit-specific self-efficacy (Level 1, HSE) - was measured during habit formation. We found that lagged HSE predicted automaticity and that lagged automaticity predicted HSE, indicating a positive feedback mechanism in habit building. Furthermore, we found that lagged HSE predicted less MI during habit performance. A multilevel mediation analysis showed significant effects of lagged HSE (Level 1) and aggregated HSE (Level 2) on MI, which were both partially mediated by automaticity. These results show the importance of defining the specificity of SE beliefs and how they interact with automaticity in the habit building process.

App-Based Habit Building Reduces Motivational Impairments During Studying - An Event Sampling Study.

In this app-based event sampling study, we observed the intentional formation of new study habits. A sample of 91 university students defined individual study habits and logged data over 6 weeks on motivational conflict, motivational interference (MI) and automaticity of behavior after each habit repetition using an app on their phone. The app was specifically created for this study and gave feedback on habit automaticity. A total of N = 2,574 habit repetitions have been generated and were analyzed using multilevel modeling. The results suggest that (1) app-based intentional habit building works, as automaticity of behavior could be predicted by habit repetition, (2) motivational impairments during studying can be reduced by building habits, as want conflicts and MI decreased with automaticity, and (3) trait self-control supports studying indirectly by fostering habit building rather than directly by suppressing impulses during the activity, as self-control predicted automaticity, but not motivational impairments during the habit execution. The effect of self-control on automaticity of the new study habit was fully mediated by the general automaticity of the students' other study habits (general study habit strength). This study showcases an app-guided genesis of new study habits and its beneficial motivational effects for learning behavior.

"I'll stop procrastinating now!" Fostering specific processes of self-regulated learning to reduce academic procrastination.

Academic procrastination is considered to be a result of self-regulation failure having detrimental effects on students' well-being and academic performance. In the present study, we developed and evaluated a group training that aimed to reduce academic procrastination. We based the training on a cyclical process model of self-regulated learning, thus, focusing on improving deficient processes of self-regulated learning among academic procrastinators (e.g., time management, dealing with distractions). The training comprised five sessions and took place once a week for 90 min in groups of no more than 10 students. Overall, 106 students completed the training. We evaluated the training using a comprehensive control group design with repeated measures (three points of measurement); the control group was trained after the intervention group's training. The results showed that our training was successful. The trained intervention group significantly reduced academic procrastination and improved specific processes of self-regulated learning (e.g., time management, concentration), whereas the untrained control group showed no change regarding these variables. After the control group had also been trained, the control group also showed the expected favorable changes. The students rated the training overall as good and found it recommendable for procrastinating friends. Hence, fostering self-regulatory processes in our intervention was a successful attempt to support students in reducing academic procrastination. The evaluation of the training encourages us to adapt the training for different groups of procrastinators.

Testing Is More Desirable When It Is Adaptive and Still Desirable When Compared to Note-Taking.

Testing is a well-established desirable difficulty. Yet there are still some open issues regarding the benefits of testing that need to be addressed. First, the possibility to increase its benefits by adapting the sequence of test questions to the learners' level of knowledge has scarcely been explored. In view of theories that emphasize the benefits of adapting learning tasks to learner knowledge, it is reasonable to assume that the common practice of providing all learners with the same test questions is not optimal. Second, it is an open question as to whether the testing effect prevails if stronger control conditions than the typical restudy condition are used. We addressed these issues in an experiment with N = 200 university students who were randomly assigned to (a) adaptive testing, (b) non-adaptive testing, or note-taking (c) without or (d) with focus guidance. In an initial study phase, all participants watched an e-lecture. Afterward, they processed its content according to their assigned conditions. One week later, all learners took a posttest. As main results, we found that adaptive testing yielded higher learning outcomes than non-adaptive testing. These benefits were mediated by the adaptive learners' higher testing performance and lower perceived cognitive demand during testing. Furthermore, we found that both testing groups outperformed the note-taking groups. Jointly, our results show that the benefits of testing can be enhanced by adapting the sequence of test questions to learners' knowledge and that testing can be more effective than note-taking.

Altered treatment of chronic lymphocytic leukemia in Germany during the last decade.

Chronic lymphocytic leukemia (CLL) is the most common subtype of adult leukemia in the western world. We here report a nationwide survey monitoring the treatment decisions concerning CLL patients in Germany in 2011 and compare treatment trends to sequential surveys performed previously during the last decade. The rate of patients diagnosed in early stages (Binet A/B) notably increased (2006: 66 %, 2009: 71 %, 2011: 77 %) over the years. From 2006 to 2009, the most frequent applied regime switched from chlorambucil to fludarabine containing regimes (2006 chlorambucil: 32 %, 2009: 14 %, fludarabine 2006: 23 %, 2009: 37 %). In 2011, the combination of rituximab with bendamustine (31 %) was most frequent used followed by the rituximab-fludarabine-cyclophosphamide (22 %) regime. Further, immune-chemotherapies were administered significantly more often over the observation period (2006: 15 %, 2011: 73 %). Taken together, this data reflects the change of treatment strategies over the last decade in clinical reality.

Palliative treatment of colorectal cancer with secondary metastasis resection in Germany - impact of the multidisciplinary treatment approach on prognosis and cost: the Northern Bavaria IVOPAK I Project.

PURPOSE: The aim of this study was to evaluate the quality of care and interdisciplinary cooperation in the palliative treatment of colorectal cancer (CRC), including the associated costs. PATIENTS AND METHODS: 103 patients were enrolled from 13 institutions to reflect the existing clinical treatment reality and costs of palliative CRC treatment. We present the clinical outcome of the patients and compare the results obtained in the 3 centers with double-figure recruitment numbers (centers A, B, and C). RESULTS: First-line treatment with 5-fluorouracil monotherapy was applied in exceptional cases. The regular treatment method comprised either an irinotecan- (30%) or an oxaliplatin-based regimen (32%). Biological agents were added to the treatment of 33 patients (32%). The median overall survival (OS) of the total patient collective was 25 months. The OS differed significantly in 2 out of the 3 centers, ranging between 27 and 11 months. Secondary metastasis resections were performed in 26% of the total patient collective. The center with the most favorable outcome results also had the lowest costs for palliative treatment and care, including the lowest drug costs. CONCLUSION: A combined chemotherapy treatment was the rule. Concerning biological agents, a significant lack of their application in first-line treatment and the quality of interdisciplinary cooperation have to be addressed.

Reciprocal relationships between value orientation and motivational interference during studying and leisure.

BACKGROUND: Motivational interference is defined as the amount of impairment in a target activity due to the incentives of a non-chosen attractive alternative. The amount to which pupils experience motivational interference while studying or while performing a leisure activity in a school-leisure conflict situation is seen as depending on the values they attach to achievement and well-being. At the same time, values may also be effects of frequent experience of motivational interference in the respective areas. AIMS: The study is aimed at investigating the reciprocal relationship between personal value orientations and the experience of motivational interference during studying and leisure. SAMPLE: A total of 363 pupils (sixth to eighth graders at the time of first measurement) completed the same questionnaire twice in a 2-year interval. METHOD: The questionnaire included measures of achievement and well-being value orientation and the experience of motivational interference during studying and during leisure in school-leisure conflicts. For this, two scenarios were created. In regression analyses, achievement and well-being value orientations as well as their interaction terms were used as predictors for experience of motivational interference at t(2) while controlling for experience of motivational interference at t(1), and vice versa. Additionally in path models, these relations were tested in an integrative way. RESULTS: Pupils' achievement value orientations were connected to differential changes in experiencing motivational interference during leisure and during studying in one scenario but only for pupils low or medium in well-being value orientation. Conversely, experience of motivational interference at t(1) was related to changes in value orientations 2 years later. High motivational interference during studying led to an increase in well-being value orientation, while high motivational interference during leisure was followed by a decrease in well-being value orientation and an increase in achievement value orientation. Overall, path models supported these results. CONCLUSIONS: The results are discussed in terms of value change and are linked to self-control and motivation research.

Individual values, learning routines and academic procrastination.

BACKGROUND: Academic procrastination, the tendency to postpone learning activities, is regarded as a consequence of postmodern values that are prominent in post-industrialized societies. When students strive for leisure goals and have no structured routines for academic tasks, delaying strenuous learning activities becomes probable. AIMS: The model tested in this study posits that postmodern value orientations are positively related to procrastination and to a lack of daily routines concerning the performance of academic activities. In contrast, modern values are negatively related to procrastination and positively to learning routines. Academic procrastination, in-turn, should be associated with the tendency to prefer leisure activities to schoolwork in case of conflicts between these two life domains. SAMPLE: Seven hundred and four students from 6th and 8th grade with a mean age of 13.5 years participated in the study. The sample included students from all tracks of the German educational system. METHOD: Students completed a questionnaire containing two value prototypes as well as scales on learning routines and procrastination. Decisions in motivational conflicts were measured using two vignettes. RESULTS AND CONCLUSIONS: Results from structural equation modelling supported the proposed model for the whole sample as well as for each school track. A planned course of the day can prevent procrastination and foster decisions for academic tasks in case of conflicts. Students' learning takes place within a societal context and reflects the values held in the respective culture.