An Explanatory Sequential Mixed Methods Study of the School Leaders\u27 Role in Students\u27 Mathematics Achievement Through the Lens of Complexity Theory

Student achievement in the K-12 mathematics classroom is of concern to parents, teachers, and community leaders as complex modern technological innovations call for higher proficiency in problem solving and mathematically creative minds are necessary to fill the vital, higher-paying jobs of today and the future. School leaders are expected to make decisions that will measurably, and in some cases, dramatically, improve student achievement in mathematics. However, school leaders do not make decisions in isolation; rather, they make decisions as part of a complex adaptive system (CAS). There is limited research concerning content-specific school leadership and its effects on student achievement, particularly through the lens of complexity theory. This study focuses on the relationships between students’ mathematics achievement and the characteristics of school leaders, looks at the influences affecting the decisions and actions being made by school leaders, and then seeks to understand how a school leaders’ decisions and actions are associated with students’ mathematics achievement. A significant predictive model was found including evidence of interaction effects and multiplicative looping effects aligned with complexity theory. Distinctive patterns emerged between school leaders’ decisions and actions from schools who were performing higher than expected, about where expected, and lower than expected. Furthermore, result indicate that school leaders do play an indirect role in student mathematics achievement specifically through the ability to foster a shared vision of mathematics education in their respective schools

An Explanatory Sequential Mixed Methods Study of the School Leaders’ Role in Students’ Mathematics Achievement Through the Lens of Complexity Theory

School leaders are expected to make decisions that improve student mathematics achievement. However, one difficulty for school leaders has been the limited amount of research concerning content-specific (e.g., mathematics) school leadership and its effects on student achievement. School leaders do not make decisions in isolation; rather, they make decisions as part of a complex adaptive system (CAS), as proposed by complexity theory. The purpose of this study was to explore the role the school leader plays in students’ mathematics achievement through the lens of complexity theory. The researcher collected survey data from K-12 school leaders and conducted focus group interviews to answer the research questions. The researcher found a significant regression equation predicting the school-wide average SAGE mathematics proficiency scores based on several characteristics of the school leader and student demographics. Distinctive patterns emerged in the decisions and actions made by school leaders based on school-wide SAGE mathematics proficiency. Results suggest that the school leaders’ first role in promoting higher student mathematics achievement is to directly and indirectly facilitate a shared vision of mathematics education between stakeholders in the CAS. The school leader’s second role is to actively work to recruit and retain the highest quality teachers possible

The Role of Gender on the Associations Among Children’s Attitudes, Mathematics Knowledge, Digital Game Use, Perceptions of Affordances, and Achievement

This study explored associations among children’s prior attitudes, prior mathematics knowledge, and frequency of digital game use, with children’s perceptions of game affordances, and transfer to out-of-game performance when interacting with digital math games, with respect to gender. Participants were 187 children (ages 8–12). An SEM mediation path analysis using MPLUS software showed significant direct effects for all pathways for all children, and significant indirect effects on all pathways for male children and five of six pathways for female children. More favorable attitudes, prior math knowledge, and perception of the helping affordances were associated with increased posttest performance, while increased frequency of digital game use and stronger perception of the hindering affordances was associated with decreased posttest performance. The model showed stronger connections for male children between frequency of digital game use, prior mathematics knowledge, and hindering affordances to the posttest, while female children showed stronger connections between attitude and perception of helping affordances to the posttest

How Design Features in Digital Math Games Support Learning and Mathematics Connections

Current research shows that digital games can significantly enhance children’s learning. The purpose of this study was to examine how design features in 12 digital math games influenced children’s learning. The participants in this study were 193 children in Grades 2 through 6 (ages 8-12). During clinical interviews, children in the study completed pre-tests, interacted with digital math games, responded to questions about the digital math games, and completed post-tests. We recorded the interactions using two video perspectives that recorded children’s gameplay and responses to interviewers. We employed mixed methods to analyze the data and identify salient patterns in children’s experiences with the digital math games. The analysis revealed significant gains for 9 of the 12 digital games and most children were aware of the design features in the games. There were eight prominent categories of design features in the video data that supported learning and mathematics connections. Six categories focused on how the design features supported learning in the digital games. These categories included: accuracy feedback, unlimited/multiple attempts, information tutorials and hints, focused constraint, progressive levels, and game efficiency. Two categories were more specific to embodied cognition and action with the mathematics, and focused on how design features promoted mathematics connections. These categories included: linked representations and linked physical actions. The digital games in this study that did not include linked representations and opportunities for linked physical actions as design features did not produce significant gains. These results suggest the key role of mathematics-specific design features in the design of digital math games

An Examination of Children’s Learning Progression Shifts While Using Touch Screen Virtual Manipulative Mathematics Apps

The purpose of this study was to examine shifts in young children\u27s learning progression levels while they interacted with virtual manipulative mathematics apps on touch-screen devices. A total of 100 children participated in six mathematics learning sequences while using 18 virtual manipulative mathematics touch-screen apps during clinical interviews. Researchers developed a micro-scoring tool to analyze video data from two camera sources (i.e., GoPro camera, wall-mounted camera). Our results showed that it is possible to document evidence of shifts in children\u27s learning progressions while they are interacting with mathematics apps on touch-screen devices. Our results also indicated patterns in the children\u27s interactions that were related to the shifts in their learning progression levels. These results suggest that an open-ended number of tasks with a variety of representations and tasks at varying levels of difficulty led to children refining their understanding and shaping their concept image of mathematical ideas resulting in incremental shifts in learning. The results of this study have important implications about how mathematical tasks in touch-screen apps may prompt children\u27s incremental learning progression shifts to occur, and thereby promote opportunities for learning. We propose that design features in mathematics apps can be created to support and encourage these learning shifts

Developing a model Fracture Liaison Service consultation with patients, carers and clinicians: a Delphi survey to inform content of the iFraP complex consultation intervention

Summary Fracture Liaison Services are recommended to deliver best practice in secondary fracture prevention. This modified Delphi survey, as part of the iFraP (Improving uptake of Fracture Prevention drug Treatments) study, provides consensus regarding tasks for clinicians in a model Fracture Liaison Service consultation. Purpose The clinical consultation is of pivotal importance in addressing barriers to treatment adherence. The aim of this study was to agree to the content of the ‘model Fracture Liaison Service (FLS) consultation’ within the iFraP (Improving uptake of Fracture Prevention drug Treatments) study. Methods A Delphi survey was co-designed with patients and clinical stakeholders using an evidence synthesis of current guidelines and content from frameworks and theories of shared decision-making, communication and medicine adherence. Patients with osteoporosis and/or fragility fractures, their carers, FLS clinicians and osteoporosis specialists were sent three rounds of the Delphi survey. Participants were presented with potential consultation content and asked to rate their perception of the importance of each statement on a 5-point Likert scale and to suggest new statements (Round 1). Lowest rated statements were removed or amended after Rounds 1 and 2. In Round 3, participants were asked whether each statement was ‘essential’ and percentage agreement calculated; the study team subsequently determined the threshold for essential content. Results Seventy-two, 49 and 52 patients, carers and clinicians responded to Rounds 1, 2 and 3 respectively. One hundred twenty-two statements were considered. By Round 3, consensus was reached, with 81 statements deemed essential within FLS consultations, relating to greeting/introductions; gathering information; considering therapeutic options; eliciting patient perceptions; establishing shared decision-making preferences; sharing information about osteoporosis and treatments; checking understanding/summarising; and signposting next steps. Conclusions This Delphi consensus exercise has summarised for the first time patient/carer and clinician consensus regarding clearly defined tasks for clinicians in a model FLS consultation

Society and Learning Research Priority Area - Research share September 2021

The session, held in September 2021, is an introduction to the work of Society and Leaning Research Priority Area (RPA), in which we examine the nature and role of the RPA as well as the ways in which it supports research in the university. The largest part of the event is an opportunity for staff to share a slide on their research, including the focus of the work, ongoing and potential projects, and opportunities for others to get involved

Global patient outcomes after elective surgery: prospective cohort study in 27 low-, middle- and high-income countries.

BACKGROUND: As global initiatives increase patient access to surgical treatments, there remains a need to understand the adverse effects of surgery and define appropriate levels of perioperative care. METHODS: We designed a prospective international 7-day cohort study of outcomes following elective adult inpatient surgery in 27 countries. The primary outcome was in-hospital complications. Secondary outcomes were death following a complication (failure to rescue) and death in hospital. Process measures were admission to critical care immediately after surgery or to treat a complication and duration of hospital stay. A single definition of critical care was used for all countries. RESULTS: A total of 474 hospitals in 19 high-, 7 middle- and 1 low-income country were included in the primary analysis. Data included 44 814 patients with a median hospital stay of 4 (range 2-7) days. A total of 7508 patients (16.8%) developed one or more postoperative complication and 207 died (0.5%). The overall mortality among patients who developed complications was 2.8%. Mortality following complications ranged from 2.4% for pulmonary embolism to 43.9% for cardiac arrest. A total of 4360 (9.7%) patients were admitted to a critical care unit as routine immediately after surgery, of whom 2198 (50.4%) developed a complication, with 105 (2.4%) deaths. A total of 1233 patients (16.4%) were admitted to a critical care unit to treat complications, with 119 (9.7%) deaths. Despite lower baseline risk, outcomes were similar in low- and middle-income compared with high-income countries. CONCLUSIONS: Poor patient outcomes are common after inpatient surgery. Global initiatives to increase access to surgical treatments should also address the need for safe perioperative care. STUDY REGISTRATION: ISRCTN5181700

Basic science232. Certolizumab pegol prevents pro-inflammatory alterations in endothelial cell function

Background: Cardiovascular disease is a major comorbidity of rheumatoid arthritis (RA) and a leading cause of death. Chronic systemic inflammation involving tumour necrosis factor alpha (TNF) could contribute to endothelial activation and atherogenesis. A number of anti-TNF therapies are in current use for the treatment of RA, including certolizumab pegol (CZP), (Cimzia ®; UCB, Belgium). Anti-TNF therapy has been associated with reduced clinical cardiovascular disease risk and ameliorated vascular function in RA patients. However, the specific effects of TNF inhibitors on endothelial cell function are largely unknown. Our aim was to investigate the mechanisms underpinning CZP effects on TNF-activated human endothelial cells. Methods: Human aortic endothelial cells (HAoECs) were cultured in vitro and exposed to a) TNF alone, b) TNF plus CZP, or c) neither agent. Microarray analysis was used to examine the transcriptional profile of cells treated for 6 hrs and quantitative polymerase chain reaction (qPCR) analysed gene expression at 1, 3, 6 and 24 hrs. NF-κB localization and IκB degradation were investigated using immunocytochemistry, high content analysis and western blotting. Flow cytometry was conducted to detect microparticle release from HAoECs. Results: Transcriptional profiling revealed that while TNF alone had strong effects on endothelial gene expression, TNF and CZP in combination produced a global gene expression pattern similar to untreated control. The two most highly up-regulated genes in response to TNF treatment were adhesion molecules E-selectin and VCAM-1 (q 0.2 compared to control; p > 0.05 compared to TNF alone). The NF-κB pathway was confirmed as a downstream target of TNF-induced HAoEC activation, via nuclear translocation of NF-κB and degradation of IκB, effects which were abolished by treatment with CZP. In addition, flow cytometry detected an increased production of endothelial microparticles in TNF-activated HAoECs, which was prevented by treatment with CZP. Conclusions: We have found at a cellular level that a clinically available TNF inhibitor, CZP reduces the expression of adhesion molecule expression, and prevents TNF-induced activation of the NF-κB pathway. Furthermore, CZP prevents the production of microparticles by activated endothelial cells. This could be central to the prevention of inflammatory environments underlying these conditions and measurement of microparticles has potential as a novel prognostic marker for future cardiovascular events in this patient group. Disclosure statement: Y.A. received a research grant from UCB. I.B. received a research grant from UCB. S.H. received a research grant from UCB. All other authors have declared no conflicts of interes