Search results for: career outcomes
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 3911

Search results for: career outcomes

3221 Shaping Students’ Futures: Evaluating Professors’ Effectiveness as Academic Advisors in Postsecondary Institutions

Authors: Mohamad Musa, Khaldoun Aldiabat, Chelsea McLellan

Abstract:

In higher education, academic advising and counseling are pivotal for guiding students towards successful academic and professional trajectories. Within this landscape, professors play a critical role as academic advisors, offering guidance and support to students navigating their educational journey. This study endeavors to delve into the effectiveness of professors in this capacity through a comprehensive quantitative survey. Amidst the research objectives lies a profound exploration of students' perceptions regarding professors' effectiveness as academic advisors. Additionally, the study aims to elucidate the nuanced strengths and limitations inherent in professors' advisory roles. Through meticulous examination, the research seeks to uncover the profound impact of professors' engagement on student academic accomplishments and contentment. Moreover, it will scrutinize the requisite qualifications, training, and support mechanisms necessary for professors to excel in advisory roles. Utilizing a quantitative survey methodology, this research will gather invaluable insights into students' perspectives on professors' advisory competencies. Rigorous statistical analysis of survey responses will illuminate the efficacy of professors as academic advisors. The survey instrument will intricately measure diverse dimensions such as students' satisfaction levels with advisory sessions, the perceived efficacy of advice rendered by professors, and the holistic influence of professors' involvement on academic triumphs. Anticipated outcomes encompass a meticulous quantitative evaluation of professors' efficacy in academic advisory roles. Moreover, the research endeavors to delineate areas of proficiency and areas necessitating refinement within professors' advisory practices. Through these efforts, the study aims to provide valuable insights that can inform strategies for enhancing professors' advisory practices and optimizing the support systems available to students in higher education institutions. The study seeks to go beyond surface-level evaluations by delving into the intricate relationship between professors' involvement in academic advising and student academic outcomes. By unraveling this complex interplay, the research endeavors to shed light on the mechanisms through which professors' guidance impacts students' academic success, satisfaction, and overall educational experience.

Keywords: academic advising, professors, effectiveness, quantitative survey, student outcomes

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3220 Food Effects and Food Choices: Aligning the Two for Better Health

Authors: John Monro, Suman Mishra

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Choosing foods for health benefits requires information that accurately represents the relative effectiveness of foods with respect to specific health end points, or with respect to responses leading to health outcomes. At present consumers must rely on nutrient composition data, and on health claims to guide them to healthy food choices. Nutrient information may be of limited usefulness because it does not reflect the effect of food structure and food component interactions – that is, whole food effects. Health claims demand stringent criteria that exclude most foods, even though most foods have properties through which they may contribute to positive health outcomes in a diet. In this presentation, we show how the functional efficacy of foods may be expressed in the same format as nutrients, with weight units, as virtual food components that allow a nutrition information panel to show not only what a food is, but also what it does. In the presentation, two body responses linked to well-being are considered – glycaemic response and colonic bulk – in order to illustrate the concept. We show how the nutrient information on available carbohydrates and dietary fibre values obtained by food analysis methods fail to provide information of the glycaemic potency or the colonic bulking potential of foods, because of failings in the methods and approach taken to food analysis. It is concluded that a category of food values that represent the functional efficacy of foods is required to accurately guide food choices for health.

Keywords: dietary fibre, glycaemic response, food values, food effects, health

Procedia PDF Downloads 497
3219 The Interactions among Motivation, Persistence, and Learning Abilities as They Relate to Academic Outcomes in Children

Authors: Rachelle M. Johnson, Jenna E. Finch

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Motivation, persistence, and learning disability status are all associated with academic performance, but to the author's knowledge, little research has been done on how these variables interact with one another and how that interaction looks different within children with and without learning disabilities. The present study's goal was to examine the role motivation and persistence play in the academic success of children with learning disabilities and how these variables interact. Measurements were made using surveys and direct cognitive assessments on each child. Analyses were run on student's scores in motivation, persistence, and ability to learn compared to other fifth grade students. In this study, learning ability was intended as a proxy for learning disabilities (LDs). This study included a nationally representative sample of over 8,000 fifth-grade children from across the United States. Multiple interactions were found among these variables of motivation, persistence, and motivation as they relate to academic achievement. The major finding of the study was the significant role motivation played in academic achievement. This study shows the importance of measuring the within-group. One key finding was that motivation was associated with academic success and was moderated by the other variables. The interaction results were different for math and reading outcomes, suggesting that reading and math success are different and should be addressed differently. This study shows the importance of measuring the within-group differences in levels of motivation to better understand the academic success of children with and without learning disabilities. This study's findings call for further investigation into motivation and the possible need for motivational intervention for students, especially those with learning disabilities

Keywords: academic achievement, learning disabilities, motivation, persistence

Procedia PDF Downloads 115
3218 The Role of Dialogue in Shared Leadership and Team Innovative Behavior Relationship

Authors: Ander Pomposo

Abstract:

Purpose: The aim of this study was to investigate the impact that dialogue has on the relationship between shared leadership and innovative behavior and the importance of dialogue in innovation. This study wants to contribute to the literature by providing theorists and researchers a better understanding of how to move forward in the studies of moderator variables in the relationship between shared leadership and team outcomes such as innovation. Methodology: A systematic review of the literature, originally adopted from the medical sciences but also used in management and leadership studies, was conducted to synthesize research in a systematic, transparent and reproducible manner. A final sample of 48 empirical studies was scientifically synthesized. Findings: Shared leadership gives a better solution to team management challenges and goes beyond the classical, hierarchical, or vertical leadership models based on the individual leader approach. One of the outcomes that emerge from shared leadership is team innovative behavior. To intensify the relationship between shared leadership and team innovative behavior, and understand when is more effective, the moderating effects of other variables in this relationship should be examined. This synthesis of the empirical studies revealed that dialogue is a moderator variable that has an impact on the relationship between shared leadership and team innovative behavior when leadership is understood as a relational process. Dialogue is an activity between at least two speech partners trying to fulfill a collective goal and is a way of living open to people and ideas through interaction. Dialogue is productive when team members engage relationally with one another. When this happens, participants are more likely to take responsibility for the tasks they are involved and for the relationships they have with others. In this relational engagement, participants are likely to establish high-quality connections with a high degree of generativity. This study suggests that organizations should facilitate the dialogue of team members in shared leadership which has a positive impact on innovation and offers a more adaptive framework for the leadership that is needed in teams working in complex work tasks. These results uncover the necessity of more research on the role that dialogue plays in contributing to important organizational outcomes such as innovation. Case studies describing both best practices and obstacles of dialogue in team innovative behavior are necessary to gain a more detailed insight into the field. It will be interesting to see how all these fields of research evolve and are implemented in dialogue practices in the organizations that use team-based structures to deal with uncertainty, fast-changing environments, globalization and increasingly complex work.

Keywords: dialogue, innovation, leadership, shared leadership, team innovative behavior

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3217 Impact of Early Father Involvement on Middle Childhood Cognitive and Behavioral Outcomes

Authors: Jamel Slaughter

Abstract:

Father involvement across the development of a child has been linked to children’s psychological adjustment, fewer behavioral problems, and higher educational attainment. Conversely, there is much less research that highlights father involvement in relation to childhood development during early childhood period prior to preschool age (ages 1-3 years). Most research on fathers and child outcomes have been limited by its focus on the stages of adolescence, middle childhood, and infancy. This study examined the influence of father involvement, during the toddler stage, on 5th grade cognitive development, rule-breaking, and behavior outcomes measured by Child Behavior Checklist (CBCL) scores. Using data from the Early Head Start Research and Evaluation (EHSRE) Study, 1996-2010: United States, a total of 3,001 children and families were identified in 17 sites (cities), representing a diverse demographic sample. An independent samples t-test was run to compare cognitive development, aggressive, and rule-breaking behavior mean scores among children who had early continuous father involvement for the first 14 – 36 months to children who did not have early continuous father involvement for the first 14 – 36 months. Multiple linear regression was conducted to determine if continuous, or non-continuous father involvement (14 month-36 months), can be used to predict outcome scores on the Child Behavior Checklist in aggressive behavior, rule-breaking behavior, and cognitive development, at 5th grade. A statistically significant mean difference in cognitive development scores were found for children who had continuous father involvement (M=1.92, SD=2.41, t (1009) =2.81, p =.005, 95% CI=.146 to .828) compared to those who did not (M=2.60, SD=3.06, t (1009) =-2.38, p=.017, 95% CI= -1.08 to -.105). There was also a statistically significant mean difference in rule-breaking behavior scores between children who had early continuous father involvement (M=1.95, SD=2.33, t (1009) = 3.69, p <.001, 95% CI= .287 to .940), compared to those that did not (M=2.87, SD=2.93, t (1009) = -3.49, p =.001, 95% CI= -1.30 to -.364). No statistically significant difference was found in aggressive behavior scores. Multiple linear regression was performed using continuous father involvement to determine which has the largest relationship to rule-breaking behavior and cognitive development based on CBCL scores. Rule-breaking behavior was found to be significant (F (2, 1008) = 8.353, p<.001), with an R2 of .016. Cognitive development was also significant (F (2, 1008) = 4.44, p=.012), with an R2 of .009. Early continuous father involvement was a significant predictor of rule-breaking behavior and cognitive development at middle childhood. Findings suggest early continuous father involvement during the first 14 – 36 months of their children’s life, may lead to lower levels of rule-breaking behaviors and thought problems at 5th grade.

Keywords: cognitive development, early continuous father involvement, middle childhood, rule-breaking behavior

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3216 Discussion on Big Data and One of Its Early Training Application

Authors: Fulya Gokalp Yavuz, Mark Daniel Ward

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This study focuses on a contemporary and inevitable topic of Data Science and its exemplary application for early career building: Big Data and Leaving Learning Community (LLC). ‘Academia’ and ‘Industry’ have a common sense on the importance of Big Data. However, both of them are in a threat of missing the training on this interdisciplinary area. Some traditional teaching doctrines are far away being effective on Data Science. Practitioners needs some intuition and real-life examples how to apply new methods to data in size of terabytes. We simply explain the scope of Data Science training and exemplified its early stage application with LLC, which is a National Science Foundation (NSF) founded project under the supervision of Prof. Ward since 2014. Essentially, we aim to give some intuition for professors, researchers and practitioners to combine data science tools for comprehensive real-life examples with the guides of mentees’ feedback. As a result of discussing mentoring methods and computational challenges of Big Data, we intend to underline its potential with some more realization.

Keywords: Big Data, computation, mentoring, training

Procedia PDF Downloads 351
3215 Math and Religion in Arvo Pärt's Out of the Depths

Authors: Ismael Lins Patriota

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Arvo Pärt is an Estonian composer who started his musical career under the influence of twelve-tone music and dodecaphonism. From 1968 to 1976, he isolated himself to search for a new path as a composer. In this period, he converted to Russian orthodoxy and changed his composing to tintinnabuli, a musical technique combining triadic chords with simple melodies. The recent analysis of Pärt’s output demonstrates that mathematics remained an influence after the invention of tintinnabuli. The present discussion deals with the relationship between math and religion in his work Out of the Depths (1980), proposing a musical-text approach and examining the minimum elements of the piece, such as motives and sub-phrases, which is the main focus of this work, considering text patterns and the role of the organ, which also uses the tintinnabuli system. The analysis of these elements demonstrates that Pärt uses math as a formal element, and the composer combines musical parameters to execute a personal and innovative interpretation of the text.

Keywords: Arvo Pärt, Out of the Depths, math, religion, analysis

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3214 Renal Transplant, Pregnancy, and Complications: A Literature Review

Authors: Sara Iqbal

Abstract:

Introduction:Renal transplant is increasingly one of the most popular transplants within the UK; with an aging population along with obesity epidemic we are witnessing increasing rates of diabetes – one of the commonest indications for renal transplant. However, the demand is far greater than supply. Many donors are provided by women of child-bearing age; however the long-term effects are still uncertain. Aim:Determine pregnancy outcomes and complications of women of child-bearing age following renal donation. Methods: A review of the current available literature was preformed using MEDLINE and EMBASE up to 2014. Search criteria included key terms such as pregnancy outcome post-renal donor, pregnancy outcomes and complications. Relevant articles were selected based on pure methodological medical research, after careful analysis, they were recorded within this review. Results: Out of 1141 women involved in transplant studies, 574 pregnancies reported having donated a single-renal donor prior to pregnancy. Of which a staggering miscarriage rate 32.4% (n=186) was reported, amongst this other complications included gestational hypertension of 10% (n=59) and gestational diabetes 2.3% (n=13). Other significantly noted complications included chronic hypertension, low-birth weights, and pregnancy-related death. Conclusions: After unilateral renal donor transplant, haemodynamics change along with pregnancy, predisposing women to developing several complications compared to pregnancies with no history any renal-donor transplant. Despite this, further investigation is required in order to accurately determine the safety of renal-donors in women of child-bearing age.

Keywords: renal transplant, pregnancy, complications, medical and health sciences

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3213 Electronic Mentoring: How Can It Be Used with Teachers?

Authors: Roberta Gentry

Abstract:

Electronic mentoring is defined as a relationship between a mentor and a mentee using computer mediated communication (CMC) that is intended to develop and improve mentee’s skills, confidence, and cultural understanding. This session will increase knowledge about electronic mentoring, its uses, and outcomes. The research behind electronic mentoring and descriptions of existing programs will also be shared.

Keywords: electronic mentoring, mentoring, beginning special educators, education

Procedia PDF Downloads 245
3212 Impact of Entrepreneurial Education on Entrepreneurial Success through Entrepreneurial Mindset, Professional Growth, and Innovation

Authors: Hummaira Qudsia Yousaf, Sidra Munawar

Abstract:

The study aims to examine in which way entrepreneurial education and attitude affect the entrepreneur’s success with the help of an entrepreneurial mindset, professional growth, and innovation. The target population was the entrepreneurs of successful startups in Pakistan. Data was gathered through an e-questionnaire, and 230 responses were analyzed using the partial least square structural equation modeling (PLS-SEM). Resultantly, entrepreneurial education is an essential component for the development of an entrepreneurial mindset. Also, an entrepreneurial attitude is responsible for the entrepreneurial mindset, which enhances professional growth. Moreover, the study highlighted that innovation is as necessary as mindset and education are for entrepreneurs. Furthermore, the findings confirmed that professional growth brings innovation to the success of entrepreneurs. This study provides proof of how entrepreneurial education and attitude influence pupils’ success in making entrepreneurs. This study extends the scope of education by incorporating predictors, such as professional growth, innovation, and entrepreneurial success. The study is unique due to the usage of innovative techniques for professional growth that ultimately bring career success.

Keywords: entrepreneurial education, entrepreneurial attitude, entrepreneurial mindset, professional growth, entrepreneurial success, innovation

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3211 Patient Outcomes Following Out-of-Hospital Cardiac Arrest

Authors: Scott Ashby, Emily Granger, Mark Connellan

Abstract:

Background: In-hospital management of Out-of-Hospital Cardiac Arrest (OHCA) is complex as the aetiologies are varied. Acute coronary angiography has been shown to improve outcomes for patients with coronary occlusion as the cause; however, these patients are difficult to identify. ECG results may help identify these patients, but the accuracy of this diagnostic test is under debate, and requires further investigation. Methods: Arrest and hospital management information was collated retrospectively for OHCA patients who presented to a single clinical site between 2009 and 2013. Angiography results were then collected and checked for significance with survival to discharge. The presence of a severe lesion (>70%) was then compared to categorised ECG findings, and the accuracy of the test was calculated. Results: 104 patients were included in this study, 44 survived to discharge, 52 died and 8 were transferred to other clinical sites. Angiography appears to significantly correlate with survival to discharge. ECG showed 54.8% sensitivity for detecting the presence of a severe lesion within the group that received angiography. A combined criterion including any ECG pathology showed 100% sensitivity and negative predictive value, however, a low specificity and positive predictive value. Conclusion: In the cohort investigated, ST elevation on ECG is not a sensitive enough screening test to be used to determine whether OHCA patients have coronary stenosis as the likely cause of their arrest, and more investigation into whether screening with a combined ECG criterion, or whether all patients should receive angiography routinely following OHCA is needed.

Keywords: out of hospital cardiac arrest, coronary angiography, resuscitation, emergency medicine

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3210 Quality of Life among Mothers of Children with Autism Spectrum Disorder in Saudi Arabia

Authors: Asma Alsaleh, Kara Makara

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Autistic spectrum disorder (ASD) is a neurodevelopmental condition characterized by difficulties with communication and interaction. Besides presenting challenges for the ASD individual, the condition can entail negative outcomes for those who care for them, most often mothers. While this issue has been studied substantially in Western society, less is known about how mothers in the Arab world are affected by raising an ASD child. This study sought to gain insights into this area by assessing quality of life and stress in mothers with (n = 25) and without (n = 25) ASD children in Riyadh (Saudi Arabia) by using, respectively, the World Health Organization Quality of Life Assessment-BREF (WHOQOL-BREF) and the Parenting Stress Index-Short Form (PSI-SF). Data pertaining to income and education were also attained to investigate how socioeconomic factors interact with the above-mentioned variables. The analysis revealed that total stress scores and scores on the individual subscales of the PSI-SF were significantly higher for the mothers with an ASD child compared to those without an ASD child, though the opposite was true of quality of life scores. Moreover, increased income was associated with increased quality of life and decreased stress. While there were not main effects of education, there were interactions between education, whether children were ASD or non-ASD, and the outcome variables. These results suggest that mothers of ASD children in an Arab culture are at increased risk of negative outcomes relative to mothers of typically developing children, and, therefore, this study may act as a foundation for the delivery of interventions to assist mothers in this position.

Keywords: autism, education, income, mothers, quality of life, stress

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3209 Towards a Doughnut Economy: The Role of Institutional Failure

Authors: Ghada El-Husseiny, Dina Yousri, Christian Richter

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Social services are often characterized by market failures, which justifies government intervention in the provision of these services. It is widely acknowledged that government intervention breeds corruption since resources are being transferred from one party to another. However, what is still being extensively studied is the magnitude of the negative impact of corruption on publicly provided services and development outcomes. Corruption has the power to hinder development and cripple our march towards the Sustainable Development Goals. Corruption diminishes the efficiency and effectiveness of public health and education spending and directly impacts the outcomes of these sectors. This paper empirically examines the impact of Institutional Failure on public sector services provision, with the sole purpose of studying the impact of corruption on SDG3 and 4; Good health and wellbeing and Quality education, respectively. The paper explores the effect of corruption on these goals from various perspectives and extends the analysis by examining if the impact of corruption on these goals differed when it accounted for the current corruption state. Using Pooled OLS(Ordinary Least Square) and Fixed effects panel estimation on 22 corrupt and 22 clean countries between 2000 and 2017. Results show that corruption in both corrupt and clean countries has a more severe impact on Health than the Education sector. In almost all specifications, corruption has an insignificant effect on School Enrollment rates but a significant effect on Infant Mortality rates. Results further indicate that, on average, a 1 point increase in the CPI(Consumer Price Index) can increase health expenditures by 0.116% in corrupt and clean countries. However, the fixed effects model indicates that the way Health and Education expenditures are determined in clean and corrupt countries are completely country-specific, in which corruption plays a minimal role. Moreover, the findings show that School Enrollment rates and Infant Mortality rates depend, to a large extent, on public spending. The most astounding results-driven is that corrupt countries, on average, have more effective and efficient healthcare expenditures. While some insights are provided as to why these results prevail, they should be further researched. All in all, corruption impedes development outcomes, and any Anti-corrupt policies taken will bring forth immense improvements and speed up the march towards sustainability.

Keywords: corruption, education, health, public spending, sustainable development

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3208 Antioxidant Mediated Neuroprotective Effects of Allium Cepa Extract Against Ischemia Reperfusion Induced Cognitive Dysfunction and Brain Damage in Mice

Authors: Jaspal Rana, Varinder Singh

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Oxidative stress has been identified as an underlying cause of ischemia-reperfusion (IR) related cognitive dysfunction and brain damage. Therefore, antioxidant based therapies to treat IR injury are being investigated. Allium cepa L. (onion) is used as culinary medicine and is documented to have marked antioxidant effects. Hence, the present study was designed to evaluate the effect of A. cepa outer scale extract (ACE) against IR induced cognition and biochemical deficit in mice. ACE was prepared by maceration with 70% methanol and fractionated into ethylacetate and aqueous fractions. Bilateral common carotid artery occlusion for 10 min, followed by 24 h reperfusion, was used to induce cerebral IR injury. Following IR injury, ACE (100 and 200 mg/kg) was administered orally to animals for 7 days once daily. Behavioral outcomes (memory and sensorimotor functions) were evaluated using Morris water maze and neurological severity score. Cerebral infarct size, brain thiobarbituric acid reactive species, reduced glutathione, and superoxide dismutase activity were also determined. Treatment with ACE significantly ameliorated IR mediated deterioration of memory and sensorimotor functions and rose in brain oxidative stress in animals. The results of the present investigation revealed that ACE improved functional outcomes after cerebral IR injury which may be attributed to its antioxidant properties.

Keywords: allium cepa, cerebral ischemia, memory, sensorimotor

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3207 Access to the Community and Needed Supports among People with Physical Disabilities Receiving Long-Term Services and Supports in the United States

Authors: Stephanie Giordano, Eric Lam, Rosa Plasencia

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An important piece of active aging is ensuring people have the right support to meet individual needs. Using NCI-AD data, we will look at measures of satisfaction with community access and needed services among people with physical disabilities receiving LTSS in the US. National Core Indicators—Aging and Disabilities (NCI-AD) is a voluntary effort by State Medicaid, aging, and disability agencies across the US to measure and track their own performance. NCI-AD uses a standardized survey – the Adult Consumer Survey (ACS), to hear directly from people receiving services about the quality of services and supports they receive. Data from the 2018-19 ACS found that compared to people without a physical disability, those with a physical disability were more likely to make choices about the services they receive, including when and how often they receive those services. Yet people with a physical disability were less likely to report they get enough assistance with everyday activities (e.g., shopping, housework, and taking medications) and self-care (e.g., dressing or bathing) and more likely to report that services and supports do not fully meet their needs and goals. A further breakdown by age shows that people 40-65 years old with a physical disability experienced even greater barriers to being as active in the community as they would like to be, indicating a need to better support people as they age with or into a disability. We will explore how these and other outcomes were affected by COVID-19, take a closer look at outcomes by demographics (e.g., race/ethnicity, gender, and mental health diagnoses) and discuss implications on the future needs of service systems.

Keywords: quality-of-life, long-term services and supports, person-centered, community

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3206 Work Related Outcomes of Perceived Authentic Leadership: Moderating Role of Organizational Structures

Authors: Aisha Zubair, Anila Kamal

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Leadership styles and practices greatly influence the organizational effectiveness and productivity. It also plays an important role in employees’ experiences of positive emotions at workplace and creative work behaviors. Authentic leadership as a newly emerging concept has been found as a significant predictor of various desirable work related outcomes. However, leadership practices and its work related outcomes, to a great extent, are determined by the very nature of the organizational structures (tall and flat). Tall organizations are characterized by multiple hierarchical layers with predominant vertical communication patterns, and narrow span of control; while flat organizations are featured by few layers of management employing both horizontal and vertical communication styles, and wide span of control. Therefore, the present study was undertaken to determine the work related outcomes of perceived authentic leadership; that is work related flow and creative work behavior among employees of flat and tall organizations. Moreover, it was also intended to determine the moderating role of organizational structure (flat and tall) in the relationship between perceived authentic leadership with work related flow and creative work behavior. In this regard, two types of companies have been considered; that is, banks as a form of tall organizational structure with multiple hierarchical structures while software companies have been considered as flat organizations with minimal layers of management. Respondents (N = 1180) were full time regular employees of marketing departments of banks (600) and software companies (580) including both men and women with age range of 22-52 years (M = 33.24; SD = 7.81). Confirmatory Factor Analysis yielded factor structures of measures of work related flow and creative work behavior in accordance to the theoretical models. However, model of authentic leadership exhibited variation in terms of two items which were not included in the final measure of the perceived authentic leadership. Results showed that perceived authentic leadership was positively associated with work related flow and creative work behavior. Likewise, work related flow was positively aligned with creative work behavior. Furthermore, type of organizational structure significantly moderated the relationship of perceived authentic leadership with work related flow and creative work behavior. Results of independent sample t-test showed that employees working in flat organization reflected better perceptions of authentic leadership; higher work related flow and elevated levels of creative work behavior as compared to those working in tall organizations. It was also found that employees with extended job experience and more job duration in the same organization displayed better perceptions of authentic leadership, reported more work related flow and augmented levels of creative work behavior. Findings of the present study distinctively highlighted the similarities as well as differences in the interactions of major constructs which function differentially in the context of tall (banks) and flat (software companies) organizations. Implications of the present study for employees and management as well as future recommendations were also discussed.

Keywords: creative work behavior, organizational structure, perceived authentic leadership, work related flow

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3205 Tip-Apex Distance as a Long-Term Risk Factor for Hospital Readmission Following Intramedullary Fixation of Intertrochanteric Fractures

Authors: Brandon Knopp, Matthew Harris

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Purpose: Tip-apex distance (TAD) has long been discussed as a metric for determining risk of failure in the fixation of peritrochanteric fractures. TAD measurements over 25 millimeters (mm) have been associated with higher rates of screw cut out and other complications in the first several months after surgery. However, there is limited evidence for the efficacy of this measurement in predicting the long-term risk of negative outcomes following hip fixation surgery. The purpose of our study was to investigate risk factors including TAD for hospital readmission, loss of pre-injury ambulation and development of complications within 1 year after hip fixation surgery. Methods: A retrospective review of proximal hip fractures treated with single screw intramedullary devices between 2016 and 2020 was performed at a 327-bed regional medical center. Patients included had a postoperative follow-up of at least 12 months or surgery-related complications developing within that time. Results: 44 of the 67 patients in this study met the inclusion criteria with adequate follow-up post-surgery. There was a total of 10 males (22.7%) and 34 females (77.3%) meeting inclusion criteria with a mean age of 82.1 (± 12.3) at the time of surgery. The average TAD in our study population was 19.57mm and the average 1-year readmission rate was 15.9%. 3 out of 6 patients (50%) with a TAD > 25mm were readmitted within one year due to surgery-related complications. In contrast, 3 out of 38 patients (7.9%) with a TAD < 25mm were readmitted within one year due to surgery-related complications (p=0.0254). Individual TAD measurements, averaging 22.05mm in patients readmitted within 1 year of surgery and 19.18mm in patients not readmitted within 1 year of surgery, were not significantly different between the two groups (p=0.2113). Conclusions: Our data indicate a significant improvement in hospital readmission rates up to one year after hip fixation surgery in patients with a TAD < 25mm with a decrease in readmissions of over 40% (50% vs 7.9%). This result builds upon past investigations by extending the follow-up time to 1 year after surgery and utilizing hospital readmissions as a metric for surgical success. With the well-documented physical and financial costs of hospital readmission after hip surgery, our study highlights a reduction of TAD < 25mm as an effective method of improving patient outcomes and reducing financial costs to patients and medical institutions. No relationship was found between TAD measurements and secondary outcomes, including loss of pre-injury ambulation and development of complications.

Keywords: hip fractures, hip reductions, readmission rates, open reduction internal fixation

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3204 The Lacuna in Understanding of Forensic Science amongst Law Practitioners in India

Authors: Poulomi Bhadra, Manjushree Palit, Sanjeev P. Sahni

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Forensic science uses all branches of science for criminal investigation and trial and has increasingly emerged as an important tool in the administration of justice. However, the growth and development of this field in India has not been as rapid or widespread as compared to the more developed Western countries. For successful administration of justice, it is important that all agencies involved in law enforcement adopt an inter-professional approach towards forensic science, which is presently lacking. In light of the alarmingly high average acquittal rate in India, this study aims to examine the lack of understanding and appreciation of the importance and scope of forensic evidence and expert opinions amongst law professionals such as lawyers and judges. Based on a study of trial court cases from Delhi and surrounding areas, the study underline the areas in forensics where the criminal justice system has noticeably erred. Using this information, the authors examine the extent of forensic understanding amongst legal professionals and attempt to conclusively identify the areas in which they need further appraisal. A cross-sectional study done using a structured questionnaire was conducted amongst law professionals across age, gender, type and years of experience in court, to determine their understanding of DNA, fingerprints and other interdisciplinary scientific materials used as forensic evidence. In our study, we understand the levels of understanding amongst lawyers with regards to DNA and fingerprint evidence, and how it affects trial outcomes. We also aim to understand the factors that prevent credible and advanced awareness amongst legal personnel, amongst others. The survey identified the areas in modern and advanced forensics, such as forensic entomology, anthropology, cybercrime etc., in which Indian legal professionals are yet to attain a functional understanding. It also brings to light, what is commonly termed as the ‘CSI-effect’ in the Western courtrooms, and provides scope to study the existence of this phenomenon and its effects on the Indian courts and their judgements. This study highlighted the prevalence of unchallenged expert testimony presented by the prosecution in criminal trials and impressed upon the judicial system the need for independent analysis and evaluation of the scientist’s data and/or testimony by the defense. Overall, this study aims to define a clearer and rigid understanding of why legal professionals should have basic understanding of the interdisciplinary nature of forensic sciences. Based on the aforementioned findings, the author suggests various measures by which judges and lawyers might obtain an extensive knowledge of the advances and promising potentialities of forensic science. This includes promoting a forensic curriculum in legal studies at Bachelor’s and Master’s level as well as in mid-career professional courses. Formation of forensic-legal consultancies, in consultation with the Department of Justice, will not only assist in training police, military and law personnel but will also encourage legal research in this field. These suggestions also aim to bridge the communication gap that presently exists between law practitioners, forensic scientists and the general community’s awareness of the criminal justice system.

Keywords: forensic science, Indian legal professionals, interdisciplinary awareness, legal education

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3203 Ubiquitous Learning Environments in Higher Education: A Scoping Literature Review

Authors: Mari A. Virtanen, Elina Haavisto, Eeva Liikanen, Maria Kääriäinen

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Ubiquitous learning and the use of ubiquitous learning environments herald a new era in higher education. Ubiquitous environments fuse together authentic learning situations and digital learning spaces where students can seamlessly immerse themselves into the learning process. Definitions of ubiquitous learning are wide and vary in the previous literature and learning environments are not systemically described. The aim of this scoping review was to identify the criteria and the use of ubiquitous learning environments in higher education contexts. The objective was to provide a clear scope and a wide view for this research area. The original studies were collected from nine electronic databases. Seven publications in total were defined as eligible and included in the final review. An inductive content analysis was used for the data analysis. The reviewed publications described the use of ubiquitous learning environments (ULE) in higher education. Components, contents and outcomes varied between studies, but there were also many similarities. In these studies, the concept of ubiquitousness was defined as context-awareness, embeddedness, content-personalization, location-based, interactivity and flexibility and these were supported by using smart devices, wireless networks and sensing technologies. Contents varied between studies and were customized to specific uses. Measured outcomes in these studies were focused on multiple aspects as learning effectiveness, cost-effectiveness, satisfaction, and usefulness. This study provides a clear scope for ULE used in higher education. It also raises the need for transparent development and publication processes, and for practical implications of ubiquitous learning environments.

Keywords: higher education, learning environment, scoping review, ubiquitous learning, u-learning

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3202 Locus of Control and Self-Esteem as Predictors of Maternal and Child Healthcare Services Utilization in Nigeria

Authors: Josephine Aikpitanyi, Friday Okonofua, Lorrettantoimo, Sandy Tubeuf

Abstract:

Every day, 800 women die from conditions related to pregnancy and childbirth, resulting in an estimated 300,000 maternal deaths worldwide per year. Over 99 percent of all maternal deaths occur in developing countries, with more than half of them occurring in sub-Saharan Africa. Nigeria being the most populous nation in sub-Saharan Africa bears a significant burden of worsening maternal and child health outcomes with a maternal mortality rate of 917 per 100,000 live births and child mortality rate of 117 per 1,000 live births. While several studies have documented that financial barriers disproportionately discourage poor women from seeking needed maternal and child healthcare, other studies have indicated otherwise. Evidence shows that there are instances where health facilities with skilled healthcare providers exist, and yet maternal, and child health outcomes remain abysmally low, indicating the presence of non-cognitive and behavioural factors that may affect the utilization of healthcare services. This study investigated the influence of locus of control and self-esteem on utilization of maternal and child healthcare services in Nigeria. Specifically, it explored the differences in utilization of antenatal care, skilled birth care, postnatal care, and child vaccination by women having an internal and external locus of control and women having high and low self-esteem. We collected information on non-cognitive traits of 1411 randomly selected women, along with information on utilization of the various indicators of maternal and child healthcare. Estimating logistic regression models for various components of healthcare services utilization, we found that women’s internal locus of control was a significant predictor of utilization of antenatal care, skilled birth care, and completion of child vaccination. We also found that having high self-esteem was a significant predictor of utilization of antenatal care, postnatal care, and completion of child vaccination after adjusting for other control variables. By improving our understanding of non-cognitive traits as possible barriers to maternal and child healthcare utilization, our findings offer important insights for enhancing participant engagement in intervention programs that are initiated to improve maternal and child health outcomes in low-and-middle-income countries.

Keywords: behavioural economics, health-seeking behaviour, locus of control and self-esteem, maternal and child healthcare, non-cognitive traits, and healthcare utilization

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3201 Evaluation of the Trauma System in a District Hospital Setting in Ireland

Authors: Ahmeda Ali, Mary Codd, Susan Brundage

Abstract:

Importance: This research focuses on devising and improving Health Service Executive (HSE) policy and legislation and therefore improving patient trauma care and outcomes in Ireland. Objectives: The study measures components of the Trauma System in the district hospital setting of the Cavan/Monaghan Hospital Group (CMHG), HSE, Ireland, and uses the collected data to identify the strengths and weaknesses of the CMHG Trauma System organisation, to include governance, injury data, prevention and quality improvement, scene care and facility-based care, and rehabilitation. The information will be made available to local policy makers to provide objective situational analysis to assist in future trauma service planning and service provision. Design, setting and participants: From 28 April to May 28, 2016 a cross-sectional survey using World Health Organisation (WHO) Trauma System Assessment Tool (TSAT) was conducted among healthcare professionals directly involved in the level III trauma system of CMHG. Main outcomes: Identification of the strengths and weaknesses of the Trauma System of CMHG. Results: The participants who reported inadequate funding for pre hospital (62.3%) and facility based trauma care at CMHG (52.5%) were high. Thirty four (55.7%) respondents reported that a national trauma registry (TARN) exists but electronic health records are still not used in trauma care. Twenty one respondents (34.4%) reported that there are system wide protocols for determining patient destination and adequate, comprehensive legislation governing the use of ambulances was enforced, however, there is a lack of a reliable advisory service. Over 40% of the respondents reported uncertainty of the injury prevention programmes available in Ireland; as well as the allocated government funding for injury and violence prevention. Conclusions: The results of this study contributed to a comprehensive assessment of the trauma system organisation. The major findings of the study identified three fundamental areas: the inadequate funding at CMHG, the QI techniques and corrective strategies used, and the unfamiliarity of existing prevention strategies. The findings direct the need for further research to guide future development of the trauma system at CMHG (and in Ireland as a whole) in order to maximise best practice and to improve functional and life outcomes.

Keywords: trauma, education, management, system

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3200 Effect of Parenting Style on Aggression and Empathy in Children Between the Age of 10-12

Authors: Debangana Mukherjee

Abstract:

This study delves into the pivotal role of parenting styles in shaping the development of aggression and empathy in children aged 10 to 12. Using a sample of 300 school students, we employed self-assessment questionnaires and scales to investigate correlations between parenting styles—authoritative, authoritarian, permissive, and neglectful—and behavioural traits, focusing on aggression and empathy as primary outcomes. The findings underscore the intricate relationships between parenting styles, aggressive behaviours, and empathetic tendencies. Notably, certain parenting approaches demonstrated strong correlations with specific behavioural outcomes. For instance, authoritarian parenting showed associations with increased aggression and reduced empathy, while authoritative parenting exhibited the opposite trend. These correlations emphasize the potential impact of parenting styles on children's behavioural development during this critical transitional phase. However, this study is limited by its correlational nature, which does not imply causation. The complexities of human behaviour, the limited scope of analysis, and the need for further research into causative relationships and cultural influences call for a nuanced understanding of these dynamics. Moving forward, longitudinal studies, causality investigations, consideration of cultural diversity, and exploration of additional variables could enrich our understanding of the interplay between parenting styles, empathy, and aggression. Validating these findings across diverse populations and refining interventions could pave the way for nurturing healthy behavioural development in children.

Keywords: aggression, correlational nature, empathy, longitudinal studies, parenting style

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3199 Pattern Discovery from Student Feedback: Identifying Factors to Improve Student Emotions in Learning

Authors: Angelina A. Tzacheva, Jaishree Ranganathan

Abstract:

Interest in (STEM) Science Technology Engineering Mathematics education especially Computer Science education has seen a drastic increase across the country. This fuels effort towards recruiting and admitting a diverse population of students. Thus the changing conditions in terms of the student population, diversity and the expected teaching and learning outcomes give the platform for use of Innovative Teaching models and technologies. It is necessary that these methods adapted should also concentrate on raising quality of such innovations and have positive impact on student learning. Light-Weight Team is an Active Learning Pedagogy, which is considered to be low-stake activity and has very little or no direct impact on student grades. Emotion plays a major role in student’s motivation to learning. In this work we use the student feedback data with emotion classification using surveys at a public research institution in the United States. We use Actionable Pattern Discovery method for this purpose. Actionable patterns are patterns that provide suggestions in the form of rules to help the user achieve better outcomes. The proposed method provides meaningful insight in terms of changes that can be incorporated in the Light-Weight team activities, resources utilized in the course. The results suggest how to enhance student emotions to a more positive state, in particular focuses on the emotions ‘Trust’ and ‘Joy’.

Keywords: actionable pattern discovery, education, emotion, data mining

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3198 Engineering Topology of Construction Ecology in Urban Environments: Suez Canal Economic Zone

Authors: Moustafa Osman Mohammed

Abstract:

Integration sustainability outcomes give attention to construction ecology in the design review of urban environments to comply with Earth’s System that is composed of integral parts of the (i.e., physical, chemical and biological components). Naturally, exchange patterns of industrial ecology have consistent and periodic cycles to preserve energy flows and materials in Earth’s System. When engineering topology is affecting internal and external processes in system networks, it postulated the valence of the first-level spatial outcome (i.e., project compatibility success). These instrumentalities are dependent on relating the second-level outcome (i.e., participant security satisfaction). Construction ecology approach feedback energy from resources flows between biotic and abiotic in the entire Earth’s ecosystems. These spatial outcomes are providing an innovation, as entails a wide range of interactions to state, regulate and feedback “topology” to flow as “interdisciplinary equilibrium” of ecosystems. The interrelation dynamics of ecosystems are performing a process in a certain location within an appropriate time for characterizing their unique structure in “equilibrium patterns”, such as biosphere and collecting a composite structure of many distributed feedback flows. These interdisciplinary systems regulate their dynamics within complex structures. These dynamic mechanisms of the ecosystem regulate physical and chemical properties to enable a gradual and prolonged incremental pattern to develop a stable structure. The engineering topology of construction ecology for integration sustainability outcomes offers an interesting tool for ecologists and engineers in the simulation paradigm as an initial form of development structure within compatible computer software. This approach argues from ecology, resource savings, static load design, financial other pragmatic reasons, while an artistic/architectural perspective, these are not decisive. The paper described an attempt to unify analytic and analogical spatial modeling in developing urban environments as a relational setting, using optimization software and applied as an example of integrated industrial ecology where the construction process is based on a topology optimization approach.

Keywords: construction ecology, industrial ecology, urban topology, environmental planning

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3197 Survey Study of Key Motivations and Drivers for Students to Enroll in Online Programs of Study

Authors: Tina Stavredes

Abstract:

Increasingly borderless learning opportunities including online learning are expanding. Singapore University of Social Science (SUSS) conducted research in February of 2017 to determine the level of consumer interest in undertaking a completely online distance learning degree program across three countries in the Asian Pacific region. The target audience was potential bachelor degree and post-degree students from Malaysia, Indonesia, and Vietnam. The results gathered were used to assess the market size and ascertain the business potential of online degree programs in Malaysia, Indonesia and Vietnam. Secondly, the results were used to determine the most receptive markets to prioritise entry and identify the most receptive student segments. In order to achieve the key outcomes, the key points of understanding were as follows: -Motivations for higher education & factors that influence the choice of institution, -Interest in online learning, -Interest in online learning from a Singapore university relative to other foreign institutions, -Key drivers and barriers of interest in online learning. An online survey was conducted from from 7th Feb 2017 to 27th Feb 2017 amongst n=600 respondents aged 21yo-45yo, who have a basic command of English, A-level qualifications and above, and who have an intent to further their education in the next 12 months. Key findings from the study regarding enrolling in an online program include the need for a marriage between intrinsic and extrinsic motivation factors and the flexibility and support offered in an online program. Overall, there was a high interest for online learning. Survey participants stated they are intrinsically motivated to learn because of their interest in the program of study and the need for extrinsic rewards including opportunities for employment or salary increment in their current job. Seven out of ten survey participants reported they are motivated to further their education and expand their knowledge to become more employable. Eight in ten claims that the feasibility of furthering their education depends on cost and maintaining a work-life balance. The top 2 programs of interest are business and information and communication technology. They describe their choice of university as a marriage of both motivational and feasibility factors including cost, choice, quality of support facilities, and the reputation of the institution. Survey participants reported flexibility as important and stated that appropriate support assures and grows their intent to enrol in an online program. Respondents also reported the importance of being able to work while studying as the main perceived advantage of online learning. Factors related to the choice of an online university emphasized the quality of support services. Despite concerns, overall there was a high interest for online learning. One in two expressed strong intent to enrol in an online programme of study. However, unfamiliarity with online learning is a concern including the concern with the lack of face-to-face interactions. Overall, the findings demonstrated an interest in online learning. A main driver was the ability to earn a recognised degree while still being able to be with the family and the ability to achieve a ‘better’ early career growth.

Keywords: distance education, student motivations, online learning, online student needs

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3196 Effect of Parenting Style on Aggression and Empathy in Children Between the Ages of 10-12

Authors: Debangana Mukherjee

Abstract:

This study delves into the pivotal role of parenting styles in shaping the development of aggression and empathy in children aged 10 to 12. Using a sample of 300 school students, we employed self-assessment questionnaires and scales to investigate correlations between parenting styles—authoritative, authoritarian, permissive, and neglectful—and behavioural traits, focusing on aggression and empathy as primary outcomes. The findings underscore the intricate relationships between parenting styles, aggressive behaviours, and empathetic tendencies. Notably, certain parenting approaches demonstrated strong correlations with specific behavioural outcomes. For instance, authoritarian parenting showed associations with increased aggression and reduced empathy, while authoritative parenting exhibited the opposite trend. These correlations emphasize the potential impact of parenting styles on children's behavioural development during this critical transitional phase. However, this study is limited by its correlational nature, which does not imply causation. The complexities of human behaviour, the limited scope of analysis, and the need for further research into causative relationships and cultural influences call for a nuanced understanding of these dynamics. Moving forward, longitudinal studies, causality investigations, consideration of cultural diversity, and exploration of additional variables could enrich our understanding of the interplay between parenting styles, empathy, and aggression. Validating these findings across diverse populations and refining interventions could pave the way for nurturing healthy behavioural development in children.

Keywords: aggression, correlational nature, empathy, longitudinal studies, parenting style

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3195 Outcomes Following Overcorrecting Minus Lens Therapy for Intermittent Distance Exotropia

Authors: Alasdair Warwick, Luna Dhir

Abstract:

Aim: To ascertain the efficacy of overcorrecting minus lens therapy in intermittent distance exotropia. Methods: Retrospective audit of all intermittent distance exotropia patients seen in the Chelsea and Westminster Hospital pediatric eye clinic between 1st January 2014 and 1st March 2016. Change in LogMAR visual acuity, stereopsis, near and distance angles of deviation, as well as the proportions of patients converting to exophoria or undergoing strabismus surgery, were recorded. Results: 22 patients were identified, 45% male, mean age 5 years (range 0.6 to 18.5 years). The median overminus prescription was -1.0 dioptres (range -0.5 to -1.75 dioptres) and mean follow-up was 15 months (range 3 to 54 months). Visual acuity, near and distance angles of deviation improved but were not statistically significant: -0.15 LogMAR, -0.2 prism dioptres and -1.2 prism dioptres respectively (p>0.05). However, a significant change in stereopsis was observed: -74'' (p<0.01). 27% underwent strabismus surgery and 36% converted to exophoria whilst wearing their overminus prescription. Conclusions: Overcorrecting minus lens therapy is an effective therapy for intermittent distance exotropia. There was no deterioration in visual acuity and a significant improvement in stereopsis was seen in our cohort, with many patients converting to an exophoria. The proportion of patients requiring strabismus surgery was comparable to other studies. Further, follow-up is needed to ascertain long-term outcomes.

Keywords: exotropia, overcorrecting minus lens, refraction, strabismus

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3194 A Clear Language Is Essential: A Qualitative Exploration of Doctor-Patient Health Interaction in Jordan

Authors: Etaf Khlaed Haroun Alkhlaifat

Abstract:

When doctors and patients do not share the same first language, language barriers may exist, which may have negative effects on the quality of communication and care provided. Doctors’ use of medical jargon and patients’ inability to fully express their illness, to a potential loss of relevant information can often create misunderstanding. This study sought to examine the extent to which a lack of “common” language represents one of the linguistic obstacles that may adversely influence the quality of healthcare services in Jordan. Communication Accommodation Theory (CAT) was used to interpret the phenomena under study. Doctors (n=9) and patients (n=18) were observed and interviewed in natural Jordanian medical settings. A thematic qualitative approach was employed to analyse the data. The preliminary findings of the study revealed that most doctors appeared to have a good sense of appropriate ways to break through communication barriers by changing medical terminologies or jargons into lay terms. However, for some, there were two main challenges: 1) the use of medical jargon in explaining medication and side effects and 2) the lack of patients’ knowledge in providing a full explanation about their illnesses. The study revealed that language barriers adversely affect health outcomes for patients with limited fluency in the English language. It argues that it is doctors’ responsibility to guarantee mutual understanding, educate patients on their condition and improve their health outcomes.

Keywords: communication accommodation theory, doctor-patient interaction, language barrier, medical jargon, misunderstanding

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3193 The Impact of the COVID-19 Pandemic on the Armenian Higher Education System: Challenges аnd Perspectives

Authors: Armine Vahanyan

Abstract:

Humanity has been still coping with the new COVID-19 pandemic. Healthcare providers, economists, psychologists, and other specialists speak about the impact of the virus on different spheres of our life. In the list of similar discussions, the impact of pandemics on global education is of utmost importance. Ideally, providing quality education services should be crucial, and the ways education programs are being adapted will determine the success or failure of the service providers. The paper aims to summarize the research touching upon the current situation of higher education in Armenia. The research includes data from official reports, surveys among education leads, faculty, and students, as well as personal observations and consideration. Through descriptive analysis, the findings of the research are being presented from various aspects. Interim results of the research unveiled two major issues in the sector of higher education in Armenia. On the one hand, the entire compulsory digitization of instruction, assessment, and grading has evoked serious gaps related to the lack of technical competencies. There is an urgent need for professional development programs that will address most of the concerns due to the shift to the online instruction mode. On the other hand, online teaching and learning require revision and adaptation of the existing curricula. Given that the content of certain programs may not be compromised, the teaching methods, the assignments, and evaluation require profound transformation, which will still be in line with course learning outcomes and student learning outcomes. The given paper focuses on the ways the mentioned issues are being addressed in Armenia. The extent of commitment for changes and adaptability to the new situation varies from the government-funded and private universities. In particular, the paper compares and contrasts activities and measures taken at the Armenian State Pedagogical University and the American University of Armenia. Thus, the Pedagogical University focused on the use of Google Classroom as the only means for teaching and learning as well as adopted the compulsory synchronous instruction mode. The American University, on the contrary, kept practicing the academic freedom, enabling both synchronous and asynchronous instruction modes, ensuring alignment of the course learning outcomes and student learning outcomes. The State University utilized the assignments and assessment, which would work for the on-campus instruction mode, while the American university employed a variety of assignments applicable for online teaching mode. The latter has suggested the utilization of multiple apps, internet sources, and online library access for a better online instant. Discussions with faculty through online forums and/or professional development workshops also facilitate restructuring and adaptation of the courses. Finally, the paper will synthesize the results of the undertaken research and will outline the e-learning perspectives and opportunities boosted by the known devastating healthcare issue.

Keywords: assessment, compulsory digitization of education services, online teaching, instruction mode, program restructuring

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3192 Factors Affecting Early Antibiotic Delivery in Open Tibial Shaft Fractures

Authors: William Elnemer, Nauman Hussain, Samir Al-Ali, Henry Shu, Diane Ghanem, Babar Shafiq

Abstract:

Introduction: The incidence of infection in open tibial shaft injuries varies depending on the severity of the injury, with rates ranging from 1.8% for Gustilo-Anderson type I to 42.9% for type IIIB fractures. The timely administration of antibiotics upon presentation to the emergency department (ED) is an essential component of fracture management, and evidence indicates that prompt delivery of antibiotics is associated with improved outcomes. The objective of this study is to identify factors that contribute to the expedient administration of antibiotics. Methods: This is a retrospective study of open tibial shaft fractures at an academic Level I trauma center. Current Procedural Terminology (CPT) codes identified all patients treated for open tibial shaft fractures between 2015 and 2021. Open fractures were identified by reviewing ED and provider notes, and with ballistic fractures were considered open. Chart reviews were performed to extract demographics, fracture characteristics, postoperative outcomes, time to operative room, time to antibiotic order, and delivery. Univariate statistical analysis compared patients who received early antibiotics (EA), which were delivered within one hour of ED presentation, and those who received late antibiotics (LA), which were delivered outside of one hour of ED presentation. A multivariate analysis was performed to investigate patient, fracture, and transport/ED characteristics contributing to faster delivery of antibiotics. The multivariate analysis included the dependent variables: ballistic fracture, activation of Delta Trauma, Gustilo-Andersen (Type III vs. Type I and II), AO-OTA Classification (Type C vs. Type A and B), arrival between 7 am and 11 pm, and arrival via Emergency Medical Services (EMS) or walk-in. Results: Seventy ED patients with open tibial shaft fractures were identified. Of these, 39 patients (55.7%) received EA, while 31 patients (44.3%) received LA. Univariate analysis shows that the arrival via EMS as opposed to walk-in (97.4% vs. 74.2%, respectively, p = 0.01) and activation of Delta Trauma (89.7% vs. 51.6%, respectively, p < 0.001) was significantly higher in the EA group vs. the LA group. Additionally, EA cases had significantly shorter intervals between the antibiotic order and delivery when compared to LA cases (0.02 hours vs. 0.35 hours, p = 0.007). No other significant differences were found in terms of postoperative outcomes or fracture characteristics. Multivariate analysis shows that a Delta Trauma Response, arrival via EMS, and presentation between 7 am and 11 pm were independent predictors of a shorter time to antibiotic administration (Odds Ratio = 11.9, 30.7, and 5.4, p = 0.001, 0.016, and 0.013, respectively). Discussion: Earlier antibiotic delivery is associated with arrival to the ED between 7 am and 11 pm, arrival via EMS, and a coordinated Delta Trauma activation. Our findings indicate that in cases where administering antibiotics is critical to achieving positive outcomes, it is advisable to employ a coordinated Delta Trauma response. Hospital personnel should be attentive to the rapid administration of antibiotics to patients with open fractures who arrive via walk-in or during late-night hours.

Keywords: antibiotics, emergency department, fracture management, open tibial shaft fractures, orthopaedic surgery, time to or, trauma fractures

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