Evaluation of two study demands-resources-based interventions: a randomized controlled trial.

Introduction: Higher education students experience significant levels of exhaustion in their studies, yet there are limited evidence-based support programs available. Therefore, this study evaluated a novel intervention approach by testing the effectiveness of two online interventions based on the study demands-resources framework. These interventions aimed to balance demands and resources. Derived from the theoretical assumptions of the framework, we hypothesized that the interventions would increase study and personal resources, engagement, and study crafting, and decrease study demands, exhaustion, and self-undermining. Additionally, we hypothesized that demands and resources would mediate the effects of the intervention on engagement, exhaustion, study crafting, and self-undermining. Methods: Conducted as a randomized controlled trial with a waitlist control group (n = 71), the study involved participants in two intervention groups who engaged with the interventions for 2 weeks. Intervention group 1 (n = 64) focused on adapting demands, while intervention group 2 (n = 70) focused on increasing resources. The design allowed for a comparison of the effectiveness of these different approaches. Participants completed questionnaires before and after the intervention, and at a 5-week follow-up. Results: Results of the analyses of variance with repeated measures revealed that the interventions had significant positive effects on the personal resource mindfulness, two study crafting strategies, self-undermining, and exhaustion. Notably, intervention group 2 exhibited more positive outcomes. The hypothesized mediation effects through mindfulness were partially supported. Discussion: The study demonstrates the considerable potential of interventions based on the study demands-resources framework for higher education institutions in supporting student well-being.

Immunophenotyping in routine clinical practice for predicting treatment response and adverse events in patients with MS.

Background: Recent studies proposed cellular immunoprofiling as a surrogate for predicting treatment response and/or stratifying the occurrence of adverse events (AEs) in persons with multiple sclerosis (pwMS). However, applicability in real-world circumstances is not sufficiently addressed. Objective: We aimed to explore whether standard routine clinical leukocyte phenotyping before treatment initiation could help stratify patients according to treatment response or AEs in a real-world MS cohort. Methods: In this retrospective study, 150 pwMS were included, who had been newly initiated on a disease-modifying drug (DMD) and had been assessed for standard immunophenotyping before DMD initiation (baseline) and at least once during the following year. Multivariate models were used to assess an association of immune subsets and the association between immune cell profiles regarding treatment response and AEs. Results: We found that the composition of T cell subsets was associated with relapse activity, as an increased proportion of CD8+ lymphocytes at baseline indicated a higher likelihood of subsequent relapse (about 9% per 1% increase in CD8+ proportion of all CD3+ cells). This was particularly driven by patients receiving anti-CD20 therapy, where also EDSS worsening was associated with a higher number of CD8+ cells at baseline (3% increase per 10 cells). In the overall cohort, an increase in the proportion of NK cells was associated with a higher risk of EDSS worsening (5% per 1% increase). Occurrence of AEs was associated with a higher percentage of T cells and a lower number of percentual NKT cells at baseline. Conclusion: Immune cell profiles are associated with treatment response and the occurrence of AEs in pwMS. Hence, immunophenotyping may serve as a valuable biomarker to enable individually tailored treatment strategies in pwMS.

Study Crafting and Self-Undermining in Higher Education Students: A Weekly Diary Study on the Antecedents.

The aim of the current study is to validate the adaptation of the job demands-resources theory to the study context. In addition, we introduce the concepts study crafting and self-undermining to the study demands-resources framework by examining the mediating role of engagement and exhaustion in the relationship between study characteristics and study crafting and self-undermining. Over four consecutive weeks, 205 higher education students answered a questionnaire about their weekly study demands and resources, their well-being (i.e., engagement, exhaustion), and their study crafting and self-undermining behaviors. Multilevel structural equation modeling (controlling for autoregressors of mediators and dependent variables from the previous week) demonstrated a positive relationship between study resources and study crafting mediated by engagement, as well as a positive relationship between study demands and self-undermining mediated by exhaustion. Our findings show that even short-term fluctuations in study characteristics affect students' well-being and, in turn, their proactive and dysfunctional behaviors. Accordingly, universities should provide a resource-rich study environment and limit study demands as much as possible. Furthermore, our results demonstrate that students can also actively influence their study environment themselves.

Work stressors and resources in a Swiss orthopedic clinic and their relationship with employees' health and the patient orientation of employees.

QUESTIONS UNDER STUDY: At present, the health service system is under pressure to reduce costs. This situation is associated with risks for the health of the employees themselves, as well as for the quality of treatment and care. The aim of the study was to investigate stressors and resources which are present in the interactions of employees with patients at an orthopaedic clinic of a Swiss cantonal hospital and to analyse their relationship to the health of employees and their patient orientation. METHODS: A questionnaire was administered to 162 employees of different occupational groups at the clinic (including physicians, nurses and secretaries). In order to investigate the relationships between working conditions, employee health and the patient orientation of employees, correlations were calculated and regression analyses were conducted. RESULTS: The results of the study demonstrate that working conditions in the interaction with patients indeed predict health problems, as well as quality of health services provided. Especially stressors in the form of barriers to patient-oriented work are significant predictors of emotional exhaustion, aversion to patients, physical complaints and a (lower) patient orientation of employees. CONCLUSIONS: The results of the investigation of the clinic in question led to the formation of health circles, including the participation of different occupational groups, and to the introduction of measures for reducing stressors in the interaction with patients.