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Student engagement and wellbeing over time at a higher education institution
Authors: Chris A. Boulton aff001; Emily Hughes aff002; Carmel Kent aff001; Joanne R. Smith aff002; Hywel T. P. Williams aff001
Authors place of work: Computer Science, University of Exeter, Exeter, United Kingdom aff001; School of Psychology, University of Exeter, Exeter, United Kingdom aff002
Published in the journal: PLoS ONE 14(11)
Category: Research Article
doi: https://doi.org/10.1371/journal.pone.0225770Summary
Student engagement is an important factor for learning outcomes in higher education. Engagement with learning at campus-based higher education institutions is difficult to quantify due to the variety of forms that engagement might take (e.g. lecture attendance, self-study, usage of online/digital systems). Meanwhile, there are increasing concerns about student wellbeing within higher education, but the relationship between engagement and wellbeing is not well understood. Here we analyse results from a longitudinal survey of undergraduate students at a campus-based university in the UK, aiming to understand how engagement and wellbeing vary dynamically during an academic term. The survey included multiple dimensions of student engagement and wellbeing, with a deliberate focus on self-report measures to capture students’ subjective experience. The results show a wide range of engagement with different systems and study activities, giving a broad view of student learning behaviour over time. Engagement and wellbeing vary during the term, with clear behavioural changes caused by assessments. Results indicate a positive interaction between engagement and happiness, with an unexpected negative relationship between engagement and academic outcomes. This study provides important insights into subjective aspects of the student experience and provides a contrast to the increasing focus on analysing educational processes using digital records.
Keywords:
Learning – Human learning – Behavior – Surveys – Motivation – Lectures – Teaching methods – Happiness
Introduction
Engagement with learning is believed to be an important factor in student success in higher education. Engagement has been defined in different ways in the literature [1], but is considered here to refer to the active commitment and purposeful effort expended by students towards all aspects of their learning, including both formal and informal activities [2]. Student engagement has been shown to be related to success in both online learning [3–5] and more traditional campus-based higher education settings [6–8]. However, engagement can be difficult to measure. In most studies of online-only education (e.g. [9–13]), student engagement is measured from the interactions a student has within a virtual learning environment (VLE). This may be a reasonable approach for digital-only contexts where a large proportion of learning activities occur through this channel. In contrast, in a traditional, face-to-face learning, university environment, VLE usage only captures one dimension of student learning activity and full engagement with learning is much harder to measure. The numerous and varied interactions students have with their learning programmes, including lectures, seminars, peer group discussions and ad hoc interactions with teaching staff, as well as other aspects of campus life such as participation in sports and student societies, are harder to record, requiring innovative methods for their capture [14, 15].
Exploration of the relationship between student engagement and success raises the important question of how “success” is defined. Most obviously, success relates to academic performance, such as final grades (e.g. [6–8, 16]), but success is also often discussed in terms of retention and completion of a course of learning (e.g. [7, 10, 13, 17–19]). It is important to consider that students may have different motivations for attending university, including, for example, social or sporting aims alongside conventional academic goals. Thus, in seeking to link engagement to success, there is value in adopting a more holistic view of student motivations and appropriate measures of outcomes. Furthermore, it is important to note that engagement and success, however measured, are dynamic and should be expected to vary within and between individuals over the duration of academic study.
There is increasing interest in learning analytics [20–25], which may use either static attributes of students (e.g. demographics, socioeconomic indicators, previous attainment) or dynamic attributes based on digital traces of learning behaviour to understand many aspects of the student experience, including student engagement. Traditionally, such studies have primarily made use of “found” data from institutional databases and “by-product” data from digital learning platforms. This kind of data, which is not collected for the purpose of pedagogical research, has limitations. The records that are collected institutionally tend to relate to either the administration of higher education (e.g., demographic data, recruitment/retention statistics) or to the core components of academic performance (e.g., grades, progression, completion). Data collected as the by-product of student learning activities on digital platforms such as VLEs (e.g. [8–10] only offers a partial view of a complex whole. For example, previous work that examined the relationship between academic performance and engagement at a traditional University found that VLE usage alone is a relatively poor predictor of academic performance in this context [8], while another study showed that VLE usage was a useful predictor of outcomes for online learning but not significant for face-to-face learning [9].
Dispositional learning analytics (see [26]), on the other hand, seeks to combine digital trace data (e.g., those generated by engagement in online learning activities) with learner data (e.g., dispositions, attitudes, and values assessed via self-report surveys). By doing so, recent research has found that learning dispositions (e.g., motivation, emotion, self-regulation) strongly and dynamically influence engagement and academic performance over time (e.g., [27–29]). In addition, this research suggests that the predictive value added by consideration of learner data might be time-dependent: learner data seems to play a critical role up until the point that feedback from assessment or online activities becomes available. This raises the possibility that whether incorporating learner dispositions into learning analytics models is useful depends on learning context (i.e., online only versus campus-based institutions).
Another limitation of learning analytics based solely on digital traces, is that these sources often cannot capture subjective aspects of student life, such as wellbeing and satisfaction, which are rarely routinely measured. Relationships between student engagement and wellbeing, or between wellbeing and success, have consequently been less well studied for higher education than that between engagement and success (but see [30, 31]). One project that has moved beyond by-product data and used deliberate collection of digital records to measure student behaviour and wellbeing is the StudentLife study at Dartmouth College in the USA [14]. This project supplied mobile phones to student participants in a term-long study that attempted to capture a multi-dimensional and longitudinal view of student behaviour. Findings used aspects of student life that had previously been inaccessible to researchers, including social interactions and physical activity patterns, to predict academic performance [16] and also to diagnose wellbeing issues [14, 32]. While the StudentLife study showed that deliberate data collection using digital methods can access important aspects of the subjective student experience, it does not address the difficulty of doing so using the kinds of by-product digital records and institutional data that are routinely collected and used as input into learning analytics.
The importance of student wellbeing for academic outcomes, and the relationships between wellbeing and engagement, remain open research questions for higher education. Wellbeing is a loosely defined concept that may include a number of different dimensions, including satisfaction, positive affect (e.g. enjoyment, gratitude, contentment) and negative affect (e.g. anger, sadness, worry) [33, 34]. Many studies have explored the relationship between wellbeing and academic performance, commonly finding a positive association, e.g. in US college undergraduates [35, 36] and among high school students [37]. The relationship between engagement and wellbeing is less well studied in higher education, but a positive association has been found in other working environments [34]. A recent government report on student mental health and wellbeing in UK universities found increasing incidence of mental illness, mental distress and low wellbeing [38]. The same study found that these negative wellbeing factors had a substantial harmful impact on student performance and course completion; by extension, students with positive wellbeing are likely to perform better and complete their studies. Another study by the UK Higher Education Academy focused on methods for promoting wellbeing in higher education, as well as identifying several pedagogical benefits [39].
Here we report on a longitudinal survey of student learning behaviours at a traditional campus-based university in the United Kingdom. Our survey was designed to capture multiple dimensions of student engagement and wellbeing over time, deliberately using self-report to look beyond digital traces and institutional records. An initial questionnaire included questions to characterise individual students on different dimensions including learning style and motivations for study. Subsequent waves captured student learning behaviours and engagement with a wide variety of learning systems (both offline and online) and activities, as well as their subjective feelings of satisfaction and wellbeing. The survey ran in 10 waves spanning a teaching semester, vacation and exam period, allowing observation of changes over time.
This study aims to complement the growing body of work that uses digital trace data to measure engagement, with a more subjective offline approach that captures a fuller representation of the student experience. Our research goals are to understand how engagement and wellbeing vary over time, as well as to determine a multidimensional view of student learning behaviours and patterns. Addressing these questions will make an important contribution to the academic study of student engagement and will help to identify other learning dispositions (e.g., engagement) that might be of value to combine with digital trace data in learning analytic models. Findings may also offer instrumental benefit by helping to guide institutional decision-making around interventions and student support.
Methods
Survey
The cohort for the survey consisted of 1st year and 2nd year undergraduate students at a research-intensive campus-based university in the United Kingdom. Students were invited to participate via emails containing a link to survey registration. In addition, recruitment booths were set up at the university’s main campus and researchers approached students to invite them to participate. Students were incentivised by entry into a prize draw to win gift vouchers for a well-known online retailer, with 10 prizes available in each wave. There were 10 waves in all. To incentivise continued participation, there was an additional final prize draw with larger prizes available to students who had completed 80% of surveys. Every participant explicitly gave their consent to their data being analysed for research purposes.
The survey ran from February to June 2017. Of the 10 waves, Waves 1–7 were released weekly during the Spring term, followed by a break for the Easter vacation period. Waves 8–10 were released fortnightly during the Summer term, which at this institution was mostly taken up with revision and examinations. Responses were received asynchronously, so although the survey was released in waves, we analyse the data over a continuous time interval spanning 19 weeks.
Our longitudinal survey consisted of a series of questions that students completed in every wave. To measure engagement with learning, we asked respondents to report their participation in each of 17 different learning activities (see Table 1), measured as the number of days in the past 7 days they had performed that activity. These activities were selected to represent the variety of online and offline activities, as well as social and academic activities, available to students at the university. To give context, we also asked respondents to report whether they had an assessment due in the past 7 days.
Tab. 1. Learning activities included in the survey. Effort over the preceding week was assessed with two items assessed on a 5-point Likert scale (specifically, “How engaged were you with your studies?”; “How much effort did you put into your studies?”, 1 = not at all, 5 = very much). The mean response from each student was used to form a reliable scale (Pearson’s r = 0.78, p < .001). Well-being over the last week was assessed with four items that asked about happiness in general (e.g., “How happy did you feel about your life in general?”) and in relation to their programme of study (e.g., “How well do you feel you are doing in your course?”, 1 = not at all, 5 = very much). Responses were averaged to form a reliable scale (Cronbach’s α = 0.69).
In addition to the longitudinal survey questions, we also asked further questions in Wave 1 to determine their self-reported learning engagement style and motivation for attending university.
Engagement with learning was assessed with 10 items adapted from the Student Engagement in Schools Questionnaire (SESQ; [40]). Participants indicated the extent of their agreement with the statements on a 5-point Likert scale (1 = strongly disagree, 5 = strongly agree). Principal components analysis with varimax rotation extracted two factors, accounting for 53% of the variance. The first factor was characterised by the items assessing cognitive engagement (e.g., “When I study, I try to understand the material better by relating it to things I already know”), and items were averaged to form a cognitive engagement scale (α = 0.73). The second factor was characterised by the items assessing behavioural engagement (e.g., “In my modules, I work as hard as I can”), and items were averaged to form a behavioural engagement scale (α = 0.75).
Participants indicated their agreement with six different reasons for attending university (1 = not at all, 5 = very much). Principal components analysis with varimax rotation extracted two factors, accounting for 57% of the variance. The first factor was characterised by the items assessing social motivations (e.g., “To socialise with friends”), and items were averaged to form a social motivations scale (α = 0.62). The second factor was characterised by the items assessing academic motivations (e.g., “To get good grades”), and items were averaged to form an academic motivations scale (α = 0.48). The original survey is shown in Supplementary Information (S1 File).
The survey and following analysis were undertaken in accordance with the guidelines of the British Psychological Society. All participants provided informed consent prior to participation and were free to withdraw at any time without penalty. The survey and analysis received ethical approval from the University of Exeter Psychology Ethics Committee prior to commencement of data collection.
Analysis
Our analysis is based on both static and dynamic variables from the survey responses for each student. Static variables include the motivation and engagement style measurements that were calculated from Wave 1. An additional static variable was also used to measure student academic performance across the term in which the survey was conducted, using grade data from the university database; for this metric, a student grade variable was calculated as their credit-weighted average grade from all the modules they took during the term in which the survey was conducted. Dynamic variables include the engagement and wellbeing measurements recorded in every wave. To allow comparison between static variables and dynamic variables, we take the mean value for the dynamic variable (e.g., the mean number of days per week that a student participated in a learning activity, or their mean effort scale score). Correlations between variables are measured using the Pearson correlation coefficient and measure correlations between both the static and dynamic variables. In both cases, all data is used in the correlation measurement, such that there is one record per student who answered in Wave 1, and all the responses are used to calculate the correlation between the dynamic variables.
Dynamic variables were used to analyse trends in behaviour over time, such as trends in engagement and wellbeing. To allow analysis of trends across the whole cohort, we created time series for engagement and wellbeing variables using a moving average across all responses with a 7-day window size. To ensure robustness, we made sure there were at least 10 responses in each window for which a mean was calculated. Since counts were lower during vacation and examination periods, we restricted our trend analysis to term-time only. Trends in these time series were calculated using the Kendall rank correlation coefficient, which counts the proportion of concordant pairs (both xi >xj and yi>yj or xi<xj and yi<yj). Using time as one of the variables, this gives a measure of tendency in the range [–1,1], with a score of -1 if the time series is always decreasing, a score of +1 if the time series is always increasing, and a score of 0 if there is no overall trend.
Our analysis involved looking for differences in behaviour between sub-populations within our respondent cohort (e.g. splitting the cohort into those who did or did not have an assessment due each week). We present differences in the mean values between the two distributions and then use a Mann-Whitney U-test to determine if the distributions are significantly different. We use these non-parametric tests since the distributions of values are typically non-normal and vary in shape between different variables. We also have a small sample size once the distributions have been split. However, we still present the difference in mean values, rather than the difference in median values, since the discrete nature of our data (e.g., integer values in range 0–7, which for some variables have an inter-quartile range of 0 to 1) means that medians are sometimes too coarse-grained to show differences even where the distributions are significantly different.
Results
Survey response
Overall, we had responses from 175 unique students, 174 of which answered the Wave 1 survey including questions to determine engagement style and motivations. We had 1050 responses overall, giving an average of exactly 6 responses per student.
Fig 1 shows the number of responses received over time during the 19-week period that the survey was active. There is an expected decline in the number of responses over time as participants lose interest or for other reasons drop out of the cohort. Despite this, we still have a reasonably steady and high response rate during the Spring term (left of the grey shaded area). There is a significant drop off in survey participation during the Easter break (grey shaded area), before the response rate recovers during the Summer term, although not to the levels seen previously (right of great shaded area). The Summer term in our survey is dominated by revision and exams, which suggests we might see different student behaviour.
Fig. 1. Weekly counts of survey responses over time. Grey shaded region refers to the Easter break between semesters. Spring Term is to the left of the grey region, Summer Term to the right. Vertical dotted lines indicate the weeks in which a survey email was sent and a responder lottery was held to incentivise participation. Note that students could answer a survey wave in the following week, hence a lower amount of first-week responses is observed when compared to the 174 students that answered the first wave of the survey. Table 2 shows some demographics of our survey respondents (n = 175), compared to the entire student population (n = 15646). We find that our survey respondents are slightly biased towards being female and in their first year of study. The students who took the survey also have slightly higher marks than the student population. The number of students in the Life and Environmental Sciences college is greater than expected, with less representation of students from the Social Sciences and International Studies college and the Medical School. The low numbers from the Medical School reflect the fact that this School is based on a different campus to where physical recruitment of participants occurred.
Tab. 2. Demographic data for survey respondents and the student population for the 2016/17 academic year. Respondent characteristics
The Wave 1 survey included one-time questions intended to allow construction of engagement style and motivation scores for each individual student (see Methods). The distributions of these scores are shown in Fig 2. Due to the nature of these measurements, and the fact that they are only measured once, they make up part of our ‘static’ data and can be thought of as measuring a student’s underlying dispositions. They suggest that generally students reported slightly higher levels of behavioural engagement than cognitive engagement, although there was a bigger spread in behavioural engagement scores. Most of the students who responded to our survey reported higher academic motivation than social motivation for attending university.
Fig. 2. Distributions of scores of cognitive and behavioural engagement, and academic and social motivation from the Wave 1 survey responses. Relationships among student characteristics, average engagement and performance
Fig 3 shows the distributions of values from the longitudinal survey questions used to measure dynamic variables related to engagement with different learning activities and levels of student wellbeing. The plots show all responses from all students aggregated together, with the various learning activities ordered according to their mean usage level. The distributions suggest that activities that are most directly associated with learning (e.g. using the VLE, using the info app, using the Internet for learning, attending a teaching session) are used much more frequently than those that are not (e.g. using sports facilities, talking to a year representative, using SU facilities). This is consistent with the finding above that most students in the sample had stronger academic than social motivations for attending university. Distributions of scores on the “effort” and “happy” scales derived from the wellbeing questions asked each week (see Methods) show that both metrics have a broad absolute range but a relatively narrow interquartile range. These metrics cannot be usefully compared.
Fig. 3. The underlying survey questions were asked in all waves and as such these are dynamic variables. Plot shows minimum and maximum scores (dotted lines), the interquartile range (solid lines) and median values (points). For this analysis all student responses were pooled. Next, we related the various static variables to each other and to the mean values for the various dynamic variables for each student in our cohort. Table 3 shows (Spearman’s) correlations between static variables across the cohort for: engagement style, motivation, grades, wellbeing, and engagement levels. Statistical significance is indicated in Table 3; henceforth we only discuss correlations with statistical significance at level p<0.05, unless stated explicitly. For the dynamic variables, we use the mean reported level across all responses for each student. Grades are analysed using the average credit-weighted module grade from the term in which the survey was carried out (see Methods).
Tab. 3. Static correlations in the survey. We find relatively strong positive correlation (ρ = 0.36) between levels of the two engagement styles (behavioural and cognitive). Behavioural engagement is correlated positively with academic motivation for attending university (ρ = 0.15) but correlated negatively with social motivation (ρ = -0.22). Behavioural engagement is very strongly positively correlated with effort (ρ = 0.55) and positively correlated with grades (ρ = 0.24). Cognitive engagement, on the other hand, is not correlated with grades (ρ = 0.02) but is positively correlated with happiness (ρ = 0.30). Cognitive engagement is also often positively correlated with participation in the various learning activities, with several positive correlations: seeing a lecturer (ρ = 0.32); going to the library (ρ = 0.28); using social media for learning (ρ = 0.18); and using the Internet for learning (ρ = 0.24). Cognitive engagement is negatively correlated with viewing lecture recordings (ρ = -0.16). Interestingly, behavioural engagement was typically uncorrelated with participation in learning activities except negatively with attending scheduled teaching sessions (ρ = -0.16); and viewing lecture recordings (ρ = -0.17).
The two types of motivation (academic and social) are not significantly correlated with each other (ρ = 0.14), but social motivation is correlated negatively with grades (ρ = -0.25). Academic motivation is significantly correlated with wellbeing scales for both effort (ρ = 0.28) and happiness (ρ = 0.29), whereas social motivation is not. Regarding participation in learning activities, the pattern of correlations makes intuitive sense. Academic motivation is weakly positively correlated with two academic activities: info app usage (ρ = 0.22); and VLE usage (ρ = 0.23). Social motivation is positively correlated with one core academic activity, attending a teaching session (ρ = 0.26), but is also positively correlated with several activities that are less directly academic and have a social aspect: working with friends (ρ = 0.19), using sports facilities (ρ = 0.46), using retail facilities (ρ = 0.23), using catering facilities (ρ = 0.23), using social media for learning (ρ = 0.21), and attending clubs or societies (ρ = 0.36).
It is interesting to note that the only significant correlations between student academic performance (measured by average grades) and levels of participation in learning activities are negative. Perhaps less surprising are negative correlations between grades and participation in “social” activities: using retail facilities (ρ = -0.22); and using catering facilities (ρ = -0.32). It is hard to explain the negative correlations between grades and attending a teaching session (ρ = -0.17). We return to this topic in the Discussion.
The wellbeing scales (effort and happiness) are positively correlated with each other (ρ = 0.30): students who put in more effort report greater happiness. Effort is positively correlated with several non-compulsory learning activities: using the VLE (ρ = 0.27); going to the library (ρ = 0.31); using career services (ρ = 0.30); using social media for learning (ρ = 0.36); and using the Internet for learning (ρ = 0.50). Effort is also positively correlated with using retail facilities (ρ = 0.27), perhaps suggesting more time spent on campus. Happiness is uncorrelated with core learning activities but is positively correlated with more social activities: using SU facilities (ρ = 0.28); and going to clubs or societies (ρ = 0.36).
Table 3 shows many positive correlations between levels of participation in various learning activities. Without listing all the pairwise relationships here, we find that 50% of activity pairs are significantly positively correlated, with no activity pairs negatively correlated. This suggests that students who engage more with learning do so in a holistic manner, with raised participation across a variety of learning activities.
Temporal trends and correlations
Next, we consider trends or changes in behaviour during the Spring term (Fig 4), looking first at time series of reported participation levels for each learning activity (see Methods). Since we use a moving average to give robust values, and since survey response rate falls outside term time, we restrict our analysis to the period within the Spring term (Waves 1–7, prior to the grey shaded area in Fig 1). We use a moving average equal to one week (7 days) and when doing this, the lowest number of responses in any window is 17 (on the last day of term), suggesting the plotted values are reliable. Apart from the final two days of term, all the windows have 38 or more responses within them. Trends are calculated using Kendall’s tau correlation coefficient (see Methods). For ease of viewing, we have split the learning activities into ‘Online’ learning activities (Fig 4a), ‘Offline’ learning activities (Fig 4b) and ‘Other’ activities (Fig 4c). We also plot time series for wellbeing variables (Fig 4d).
Fig. 4. Trends in dynamic variables (engagement and wellbeing scores) over the term. Time series are calculated as a moving average using data from all students. Trends and significance are calculated using Kendall’s tau correlation coefficient. There is a general downward trend in participation with learning activities over the Spring term. Of the ‘Online’ systems (Fig 4a), all of them have a significantly downward trend as the term goes on: using the VLE (τ = -0.72); using the info app (τ = -0.65); using the Internet for learning (τ = -0.85); using social media for learning (τ = -0.67); and accessing lecture recordings (τ = -0.47). Three of the ‘Offline’ systems also decrease over the term (Fig 4b): attending teaching sessions (τ = -0.91); accessing the library (τ = -0.20); viewing past exams (τ = -0.56). Since teaching activities are scheduled with a roughly uniform density throughout the term, the downward trend in engagement with learning activities is notable. A similar trend is seen for many of the ‘Other’ activities (Fig 4c): going to clubs or societies (τ = -0.70); using the sports facilities (τ = -0.32); using retail facilities (τ = -0.83); using catering facilities (τ = -0.63); talking to a year rep (τ = -0.49); using SU facilities (τ = -0.68). There are no learning activities that show an increase in participation over the term.
Looking at trends in the wellbeing variables over the term, we see that effort increases slightly but not significantly (τ = 0.10). However, happiness increases significantly (τ = 0.36), suggesting that students report greater happiness as the term progresses. We cannot say whether this increase in self-reported happiness is related to the concurrent decrease in engagement, though it is tempting to speculate.
Table 4 shows correlations between the dynamic variables measuring participation in learning activities and wellbeing. This analysis shows whether there are temporal associations between levels of participation in different activities (e.g., if a student does more of one activity, does this correspond to more engagement in other activities). The striking observation in this analysis is that nearly all pairwise relationships between dynamic variables show significant positive correlations, with a small number of exceptions. This indicates a pattern whereby student learning activity varies holistically; students may be more or less active, but when they are active, they are active across a wide range of activities and behaviours. Again, the two wellbeing scales are correlated with each other (ρ = 0.37). Overall, 83% of the pairwise relationships between learning activities show a positive correlation over time (compared to 50% for the averaged data shown in Table 3). We find two significant negative correlations: between viewing past exam papers and visiting a lecturer (ρ = -0.08) and attending a teaching session (ρ = -0.13). This is most likely because Table 4 uses time-resolved information and is affected by the switch between attendance at scheduled teaching sessions during the Spring term and using past exams to revise for upcoming exams during the Summer term.
Tab. 4. Dynamic correlations in the survey. Impact of assessments on engagement and wellbeing
To determine the impact of assessments (e.g., coursework, class tests, final exams, etc.) on student engagement and wellbeing, we split our dataset into “assessment week” responses (those responses where the student answered that there was an assessment due in the 7-day reporting period) and “non-assessment week” responses (where no assessments were due). Note that “assessment weeks” are temporally heterogeneous and specific to the individual; that is, the assessment/non-assessment weeks are not temporally correlated across the cohort. This rules out effects from globally correlated hidden variables such as, for example, campus wide events, external media stories, etc. For each set of responses, we create distributions for each dynamic variable and then measure the differences between these distributions using the difference in means and Mann-Whitney U-tests (see Methods). Results are shown in Fig 5. The bars in Fig 5 plot the difference in mean values for each distribution, with positive differences referring to increased participation in assessment weeks. Bar colours indicate whether the difference between the distributions is statistically significant according to the Mann-Whitney U-test.
Fig. 5. Differences in (upper panel) participation levels for different learning activities and (lower panel) wellbeing for responses from assessment and non-assessment weeks. Bars show the difference in mean values for reported score distributions for (upper panel) participation in each learning activity measured in days, or (lower panel) levels of effort and happiness on scale 1–5. Positive values indicate an increase in assessment weeks. Bar colours indicate statistical significance for the difference between distributions calculated from a Mann-Whitney U-test (blue—significant positive difference, red—significant negative difference, white—not significant). Fig 5 (upper panel) shows the mean difference for assessment weeks and non-assessment weeks in the reported number of days of participation in each learning activity. We find increased participation in all learning activities during assessment weeks, except using career services, which had significantly less usage when an assessment was due. Of the activities with increased participation, 9 of the 15 increases were significant. Interestingly, increased participation in assessment weeks extends across a mix of activity types; for example, there is greater attendance at clubs and societies when assessments are due. Overall, the analysis suggests there is higher engagement with most learning activities when assessments are due.
We also look for differences in the wellbeing variables of effort and happiness between assessment weeks and non-assessment weeks (Fig 5, lower panel). We find that there is a significant increase in the effort levels students report when an assessment is due. There is also, perhaps surprisingly, a slight increase in happiness, although this is not significant.
Relationships between behaviour and wellbeing
To explore the relationship between engagement with learning activities and reported wellbeing, we again split our dataset, this time into sets of responses where the student reported high/low levels of effort and high/low levels of happiness for that week. Since both variables are measured on an integer scale from 1 (low) to 5 (high), we use a threshold of 3 to split the cohort in each case, creating datasets for those who responded below 3 and those who reported 3 or above. This gives comparator sets for students who report “high effort” or “low effort” and students who report “happy” or “not happy”. Results are shown in Fig 6.
Fig. 6. Differences in participation levels for (left panel) high effort students vs low effort students, and (right panel) happy students vs unhappy students. Bars show the difference in mean scores (in days) from the distributions of participation levels for different learning activities. Positive values indicate higher participation by the (left) high effort and right (happy) students. Bar colour indicates significant differences between the distributions according to a Mann-Whitney U-test (blue—significant positive difference, red—significant negative difference, white—not significant). As expected, we find that 16 of the 17 learning activities show higher mean participation levels by high effort students, and for 10 of these the difference between the distributions is significant (Fig 6, left panel). Happy students have higher mean participation levels in all activities that students who are not happy (Fig 6, right panel). However, these differences are generally smaller than those for high vs low effort groups. When comparing the left and right panels in Fig 6, there is a significant increase in going to the Sports Park and using catering facilities for happier students, whereas rates of viewing past exams are only significantly increased for high effort students.
Discussion
In planning this research, we expected to find different patterns of engagement among students, such as individuals showing more engagement with certain systems and less with others. This might be driven by students’ personal preferences (e.g., [27, 28]) or by the teaching activities prescribed and/or preferred by different disciplines and programmes (see e.g. [8, 41]). Instead we find that students who are engaged with learning tend to be engaged with all learning activities and systems; engagement appears to be a holistic phenomenon (Tables 3 and 4). The only exception to this pattern is a negative correlation between attending scheduled teaching sessions and viewing past exam papers. This might be explained by the separation (for most students) of learning and revision, with exam papers used for revision after scheduled teaching has finished. The strong correlation between all forms of engagement with learning has possible instrumental value for the design of systems to monitor student engagement, since it suggests that engagement could be effectively tracked using only a subset of engagement metrics as indicators. Monitoring of engagement might be used to identify anomalies or changes in behaviour of individuals, for example, to assist tutors in providing support and pastoral care. Indeed, the predictive analytics project at Nottingham Trent University (NTU Student Dashboard), which calculates engagement scores based on five online resources (VLE access, library usage, attendance, assignment submissions, and card swipes), has identified a positive relationship between student engagement and both progression and attainment. Moreover, this information, when communicated to students and staff, has been used to provide more targeted support to students from pastoral tutors (see [42]).
A feature of our survey design is the ability to measure variables at a campus-based university that would otherwise be difficult to access. Of the 17 learning activities recorded by our survey, only four could be tracked digitally with current methods (VLE, info app, past exam views and recorded lecture viewing), with the rest not routinely measured. Furthermore, this study provides temporally resolved data on student wellbeing, giving the opportunity to explore relationships between engagement and wellbeing.
Engagement and wellbeing are shown in this study to be positively related. Looking longitudinally across the survey (Table 4), we find 13 forms of engagement were positively (and significantly) correlated with at least one of the wellbeing variables, either effort or happiness. Reasonably, one could suggest a possible feedback loop where increasing engagement increases academic performance, which in turn increases wellbeing (happiness and grades are correlated; Table 4), which then increases engagement. Alternatively, students with greater background levels of wellbeing may be more likely to engage with learning (see also [30, 31]). This study cannot separate these potential mechanisms, since it only shows correlation and cannot assign causality.
The responses to our survey show a broad sample of student engagement at the university where the study was based. The survey was widely advertised and contains responses from students across all disciplines. However, in common with most survey studies, it relies on voluntary participation and we had no control over who would participate (see also [43]). This may introduce bias into our results. For example, we find that the students who responded scored much higher on academic motivation than on social motivation (Fig 2), but this may be an artefact of self-selection bias in the sample of survey respondents, such that academically motivated students who are engaged with learning were more likely to participate (see also [43, 44]). Indeed, analysis of the demographic data of respondents suggests that certain disciplines were over-sampled. This might limit the generalizability of our findings to the whole cohort, given that there are likely to be disciplinary differences in the extent to which students are expected to engage with various learning systems (see [8]). Furthermore, since this study was based at a single university in the UK, it may not represent students at other universities in the UK or worldwide. We encourage other researchers to repeat our study at other institutions in order to consolidate our findings. We make our survey design available in the Supplementary Information (S1 File) to facilitate this.
Another caveat to our results is that differences between student workloads associated with different learning activities are not considered. In previous work, we have shown that the amount of observed VLE usage differs between different disciplines [8], explained by the differing requirements of different disciplines, programmes and modules. For example, a humanities student is likely to have a balance of learning activities that differs from an engineering student, with resulting variation in the time they spend on the VLE. In addition, the number of scheduled lectures and other contact hours will differ between disciplines, with students taking STEM subjects typically having more contact hours than those taking arts or humanities subjects which require more self-study. It is possible that these differences might affect some of our findings. For example, the correlation between attending scheduled teaching sessions and student happiness might be influenced by the fraction of sessions attended, rather than the absolute number; a student who attends 100% of 4 scheduled sessions might be happier than a student who attends 50% of 8 scheduled sessions, even though the number of attended sessions remains the same. This kind of difference might mask or confound some relationships, so it is possible that a study sample stratified on discipline or programme would give a more nuanced picture of the relationships between engagement and wellbeing. With a larger sample size, we would have been able to create disciplinary subsets of students to explore this aspect, but our sample size did not permit this here.
One interesting dimension of student engagement that we are yet to explore within our survey is how well students predict their own usage of various learning systems; that is, do they accurately report their usage of digital tools? Results given here are based on student self-report rather than documented usage of different systems. In general, students might mis-report their behaviour either by mistake or deliberately, for whatever reason. If self-reported data in the current survey are inaccurate, it might raise the interesting question of whether some students systematically under - or over-report their levels of engagement with learning, and whether students who misreport perform better or worse academically (see [45, 46]). We will return to this question in future work. If self-report and documented data (where available) do not agree, it raises the question of which sources show a more accurate picture of student behaviour and which are more important in relation to student wellbeing.
We can only speculate why there is an observed decrease in engagement during the academic term. It could be because students like to get ahead at the start of term and work harder or engage more to do this. The larger drop off in engagement at the end of term may be due to students having assessments that are not due until after the break and therefore not needing to work as much as they do during the middle of term. The rise in reported effort during the term (although not statistically significant) is interesting in relation to the decrease in reported engagement. The observed increase in happiness towards the end of term seems to be robust but is hard to explain; we speculate that perhaps students become happier as they start to receive assessment outcomes, or maybe they are simply looking forward to the end of term. This may be at odds with the correlations between engagement and wellbeing discussed previously. However, we believe that the correlations are picking out individual student behaviours, whereas these trends reflect the whole population.
Our research identified strong differences in behaviour between students who have an assessment due and those who do not. This gives us confidence that our survey can identify meaningful results, despite the limited sample size. We also find strong differences in behaviour between those students who feel engaged as well as happy. Finding that students who are happy are engaging more is an important result for our understanding of student wellbeing. Coupled with mechanisms to routinely measure engagement, it could assist tutors to identify students who are suffering with poor wellbeing and might benefit from intervention or greater support.
Supporting information
S1 File [pdf]
Questions used in survey completed by participants.
Zdroje
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- Barriers to integration of bioinformatics into undergraduate life sciences education: A national study of US life sciences faculty uncover significant barriers to integrating bioinformatics into undergraduate instruction
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- Being there: A scoping review of grief support training in medical education
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- Effect of self-rated health status on functioning difficulties among older adults in Ghana: Coarsened exact matching method of analysis of the World Health Organization’s study on global AGEing and adult health, Wave 2
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- Effect of community based health education on knowledge and attitude towards iron and folic acid supplementation among pregnant women in Kiambu County, Kenya: A quasi experimental study
- Implementation and effectiveness of non-specialist mediated interventions for children with Autism Spectrum Disorder: A systematic review and meta-analysis
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- The nonlinear effect of financial and fiscal policies on poverty alleviation in China—An empirical analysis of Chinese 382 impoverished counties with PSTR models
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- Live observation of the oviposition process in Daphnia magna
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- Differences in clinical features of cluster headache between drinkers and nondrinkers in Japan
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- A deep learning reconstruction framework for X-ray computed tomography with incomplete data
- Integrating interconception care in preventive child health care services: The Healthy Pregnancy 4 All program
- The prognostic significance of tumor-infiltrating lymphocytes assessment with hematoxylin and eosin sections in resected primary lung adenocarcinoma
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- Salt or fish (or salted fish)? The Bronze Age specialised sites along the Tyrrhenian coast of Central Italy: New insights from Caprolace settlement
- Pragmatic language dysfunction in systemic lupus erythematosus patients: Results from a single center Italian study
- Association between cerebral atrophy and osteoporotic vertebral compression fractures
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- The association between psychological distress and angina pectoris: A population-based study
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- Psychological and physiological effects of applying self-control to the mobile phone
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- Modulating transcription through development of semi-synthetic yeast core promoters
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- The role of stigma in the acceptance and disclosure of HIV among recently diagnosed men who have sex with men in Australia: A qualitative study
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- Questioning the lasting effect of galvanic vestibular stimulation on postural control
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- The clinicopathological significance of Thrombospondin-4 expression in the tumor microenvironment of gastric cancer
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- Identifying resurrection genes through the differentially expressed genes between Selaginella tamariscina (Beauv.) spring and Selaginella moellendorffii Hieron under drought stress
- Impact of hemodialysis on the concentrations of sodium and potassium during infusion of sodium thiosulfate using an In Vitro hemodialysis model
- Minimal effects of oyster aquaculture on local water quality: Examples from southern Chesapeake Bay
- Suboptimal infant and young child feeding practices in rural Boucle du Mouhoun, Burkina Faso: Findings from a cross-sectional population-based survey
- High salinity tolerance of invasive blue catfish suggests potential for further range expansion in the Chesapeake Bay region
- From waste to food: Optimising the breakdown of oil palm waste to provide substrate for insects farmed as animal feed
- Quantitative assessment of interstitial lung disease in Sjögren’s syndrome
- Comparative efficacy of tenofovir and entecavir in nucleos(t)ide analogue-naive chronic hepatitis B: A systematic review and meta-analysis
- Reference ranges for ultrasonographic renal dimensions as functions of age and body indices: A retrospective observational study in Taiwan
- Finding phrases: On the role of co-verbal facial information in learning word order in infancy
- Mathematical modeling reveals the factors involved in the phenomena of cancer stem cells stabilization
- Effects of forest management and roe deer impact on a mountain forest development in the Italian Apennines: A modelling approach using LANDIS-II
- Evaluation of comprehensive improvement for mild and moderate soil salinization in arid zone
- Efficacy, acceptability and feasibility of daily text-messaging in promoting glycaemic control and other clinical outcomes in a low-resource setting of South Africa: A randomised controlled trial
- Magnitude and associated factors of postpartum depression among women in Nekemte town, East Wollega zone, west Ethiopia, 2019: A community-based study
- Comparison of continuous wave and cold lateral condensation filling techniques in 3D printed simulated C-shape canals instrumented with Reciproc Blue or Hyflex EDM
- Effect of caffeine on neuromuscular function following eccentric-based exercise
- AtUBL5 regulates growth and development through pre-mRNA splicing in Arabidopsis thaliana
- The gut microbiome of freshwater Unionidae mussels is determined by host species and is selectively retained from filtered seston
- Alcohol consumption and survival after breast cancer diagnosis in Japanese women: A prospective patient cohort study
- Selection of reference genes for normalization of cranberry (Vaccinium macrocarpon Ait.) gene expression under different experimental conditions
- The household economic costs associated with depression symptoms: A cross-sectional household study conducted in the North West province of South Africa
- Increased cell size, structural complexity and migration of cancer cells acquiring fibroblast organelles by cell-projection pumping
- Acute low- compared to high-load resistance training to failure results in greater energy expenditure during exercise in healthy young men
- Impact of body mass index and metabolically unhealthy status on mortality in the Japanese general population: The JMS cohort study
- Characterization of two thermophilic cellulases from Talaromyces leycettanus JCM12802 and their synergistic action on cellulose hydrolysis
- Ecohydrology of urban trees under passive and active irrigation in a semiarid city
- Cyclosporine A eyedrops with self-nanoemulsifying drug delivery systems have improved physicochemical properties and efficacy against dry eye disease in a murine dry eye model
- LFastqC: A lossless non-reference-based FASTQ compressor
- Highly accurate prediction of flammability limits of chemical compounds using novel integrated hybrid models
- Nonsteroidal anti-inflammatory drugs and acetaminophen ameliorate muscular mechanical hyperalgesia developed after lengthening contractions via cyclooxygenase-2 independent mechanisms in rats
- A popular Indian clove-based mosquito repellent is less effective against Culex quinquefasciatus and Aedes aegypti than DEET
- Yeasts affect tolerance of Drosophila melanogaster to food substrate with high NaCl concentration
- The effect of climate change on cholera disease: The road ahead using artificial neural network
- Grit (effortful persistence) can be measured with a short scale, shows little variation across socio-demographic subgroups, and is associated with career success and career engagement
- Micro-dislodgement during transcatheter aortic valve implantation with a contemporary self-expandable prosthesis
- Improving the antimicrobial efficacy against resistant Staphylococcus aureus by a combined use of conjugated oligoelectrolytes
- Kin discrimination and outer membrane exchange in Myxococcus xanthus: Experimental analysis of a natural population
- Inflammatory cell infiltrates, hypoxia, vascularization, pentraxin 3 and osteoprotegerin in abdominal aortic aneurysms – A quantitative histological study
- Effects of virtual reality rehabilitation training on gait and balance in patients with Parkinson's disease: A systematic review
- Serum miR-33a is associated with steatosis and inflammation in patients with non-alcoholic fatty liver disease after liver transplantation
- Association between housing tenure and self-rated health in Japan: Findings from a nationwide cross-sectional survey
- Investigation of biochemical and physiological parameters of the newborn Saiga antelope (Saiga tatarica) in Gansu Province, China
- One-year follow-up of changes in refraction and aberrations induced by corneal incision
- Evaluation of upper limb superficial venous percussion as a sign of anatomical location and venous permeability. A comparative study of superficial venous percussion to ultrasound findings on non-renal patients and on chronic kidney disease patients
- An assessment of the Dutch experience with health insurers acting as healthcare advisors
- Perception of potential harm and benefits of HIV vaccine trial participation: A qualitative study from urban Tanzania
- Veterans with Gulf War Illness exhibit distinct respiratory patterns during maximal cardiopulmonary exercise
- Deep brain stimulation restores the glutamatergic and GABAergic synaptic transmission and plasticity to normal levels in kindled rats
- Metformin strongly affects transcriptome of peripheral blood cells in healthy individuals
- Cranberry extracts promote growth of Bacteroidaceae and decrease abundance of Enterobacteriaceae in a human gut simulator model
- Long-term retention on antiretroviral therapy among infants, children, adolescents and adults in Malawi: A cohort study
- Histochemical quantification of collagen content in articular cartilage
- Optogenetically transduced human ES cell-derived neural progenitors and their neuronal progenies: Phenotypic characterization and responses to optical stimulation
- Ion torrent high throughput mitochondrial genome sequencing (HTMGS)
- Outpatient antibiotic prescription rate and pattern in the private sector in India: Evidence from medical audit data
- Acute Influenza A virus outbreak in an enzootic infected sow herd: Impact on viral dynamics, genetic and antigenic variability and effect of maternally derived antibodies and vaccination
- Prevalence and correlates of low serum calcium in late pregnancy: A cross sectional study in the Nkongsamba Regional Hospital; Littoral Region of Cameroon
- Home-cage monitoring ascertains signatures of ictal and interictal behavior in mouse models of generalized seizures
- CRISPR/Cas9 gene editing in the West Nile Virus vector, Culex quinquefasciatus Say
- Genetic susceptibility to angiotensin-converting enzyme-inhibitor induced angioedema: A systematic review and evaluation of methodological approaches
- Proton pump inhibitor use increases the risk of peritonitis in peritoneal dialysis patients
- Comparative distribution of extended-spectrum beta-lactamase–producing Escherichia coli from urine infections and environmental waters
- Sex differences in thigh muscle volumes, sprint performance and mechanical properties in national-level sprinters
- Maternal serum and cord blood leptin concentrations at delivery
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- Intolerance of uncertainty fuels depressive symptoms through rumination: Cross-sectional and longitudinal studies
- Monitoring exercise-induced muscle damage indicators and myoelectric activity during two weeks of knee extensor exercise training in young and old men
- Can adoption of pollution prevention techniques reduce pollution substitution?
- The association between self-efficacy and self-management behaviors among Chinese patients with type 2 diabetes
- Poly-arginine-18 peptides do not exacerbate bleeding, or improve functional outcomes following collagenase-induced intracerebral hemorrhage in the rat
- Affective disorders in the elderly in different European countries: Results from the MentDis_ICF65+ study
- Evaluation of forearm vascular resistance during orthostatic stress: Velocity is proportional to flow and size doesn’t matter
- Proton pencil minibeam irradiation of an in-vivo mouse ear model spares healthy tissue dependent on beam size
- Maternal stress in Shank3ex4-9 mice increases pup-directed care and alters brain white matter in male offspring
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- Exploiting open source 3D printer architecture for laboratory robotics to automate high-throughput time-lapse imaging for analytical microbiology
- Long non-coding RNAs and latent HIV – A search for novel targets for latency reversal
- Clinical characteristics of neonatal fulminant necrotizing enterocolitis in a tertiary Children's hospital in the last 10 years
- Effects of neuromuscular electrical stimulation training on muscle size in collegiate track and field athletes
- Adaptive fuzzy flow rate control considering multifractal traffic modeling and 5G communications
- Evaluation of four commercial tests for detecting ceftiofur in waste milk bulk tank samples
- A smart tele-cytology point-of-care platform for oral cancer screening
- Vasopressin SNP pain factors and stress in sickle cell disease
- Carbonate production of Micronesian reefs suppressed by thermal anomalies and Acanthaster as sea-level rises
- Microbial metabolisms in an abyssal ferromanganese crust from the Takuyo-Daigo Seamount as revealed by metagenomics
- Incidence of chronic kidney disease hospitalisations and mortality in Espírito Santo between 1996 to 2017
- The impact of short-term machine perfusion on the risk of cancer recurrence after rat liver transplantation with donors after circulatory death
- Proteomic profiling of the thrombin-activated canine platelet secretome (CAPS)
- Blood metal levels and serum testosterone concentrations in male and female children and adolescents: NHANES 2011–2012
- The effects of prolonged single night session of videogaming on sleep and declarative memory
- Diversity, distribution and dynamics of large trees across an old-growth lowland tropical rain forest landscape
- Mapping developmental QTL for plant height in soybean [Glycine max (L.) Merr.] using a four-way recombinant inbred line population
- Vaginal ring acceptability and related preferences among women in low- and middle-income countries: A systematic review and narrative synthesis
- UM171 induces a homeostatic inflammatory-detoxification response supporting human HSC self-renewal
- Positive selection and precipitation effects on the mitochondrial NADH dehydrogenase subunit 6 gene in brown hares (Lepus europaeus) under a phylogeographic perspective
- Evaluation of Minimum Inhibitory Concentrations for 154 Mycoplasma synoviae isolates from Italy collected during 2012-2017
- Enhancement of antibiotics antimicrobial activity due to the silver nanoparticles impact on the cell membrane
- Correction: Smoking, alcohol use disorder and tuberculosis treatment outcomes: A dual co-morbidity burden that cannot be ignored
- Correction: Effect of corruption on perceived difficulties in healthcare access in sub-Saharan Africa
- Knowledge-based best of breed approach for automated detection of clinical events based on German free text digital hospital discharge letters
- Importance of thorough tissue and cellular level characterization of targeted drugs in the evaluation of pharmacodynamic effects
- Integrated value-chain and risk assessment of Pig-Related Zoonoses in Ghana
- Failed sperm retrieval from severely oligospermic or non-obstructive azoospermic patients on oocyte retrieval day: Emergent oocyte cryopreservation is a feasible strategy
- Cassava yield traits predicted by genomic selection methods
- Verification of hub genes in the expression profile of aortic dissection
- Pig farmers’ willingness to pay for management strategies to reduce aggression between pigs
- Metabolomic response of Euglena gracilis and its bleached mutant strain to light
- Diagnostic value of ASVS for insulinoma localization: A systematic review and meta-analysis
- Newly educated care managers’ experiences of providing care for persons with stress-related mental disorders in the clinical primary care context
- Real-time telemetry monitoring of oxygen in the central complex of freely-walking Gromphadorhina portentosa
- Qualification programmes for immigrant health professionals: A systematic review
- An analytical model to minimize the latency in healthcare internet-of-things in fog computing environment
- Grain filling of early-season rice cultivars grown under mechanical transplanting
- Intercalation of small molecules into DNA in chromatin is primarily controlled by superhelical constraint
- Correlative evidence for co-regulation of phosphorus and carbon exchanges with symbiotic fungus in the arbuscular mycorrhizal Medicago truncatula
- How to design a dose-finding study on combined agents: Choice of design and development of R functions
- Altered expression of Notch1 in Alzheimer's disease
- The ZJU index is a powerful surrogate marker for NAFLD in severely obese North American women
- Trunk velocity-dependent Light Touch reduces postural sway during standing
- Evaluation of cytological diagnostic accuracy for canine splenic neoplasms: An investigation in 78 cases using STARD guidelines
- Trade-offs in motivating volunteer effort: Experimental evidence on voluntary contributions to science
- Does caching strategy vary with microclimate in endangered Mt. Graham red squirrels?
- Assessment of energy expenditure during high intensity cycling and running using a heart rate and activity monitor in young active adults
- Evaluating rectal swab collection method for gut microbiome analysis in the common marmoset (Callithrix jacchus)
- Implementation of a screening, brief intervention and referral to treatment programme for risky substance use in South African emergency centres: A mixed methods evaluation study
- Can the CalproQuest predict a positive Calprotectin test? A prospective diagnostic study
- The calcium sensor OsCBL1 modulates nitrate signaling to regulate seedling growth in rice
- Acceptability of and treatment preferences for recurrent bacterial vaginosis—Topical lactic acid gel or oral metronidazole antibiotic: Qualitative findings from the VITA trial
- Mathematical determination of the HIV-1 matrix shell structure and its impact on the biology of HIV-1
- Contingent negative variation during a modified cueing task in simulated driving
- CAMDI interacts with the human memory-associated protein KIBRA and regulates AMPAR cell surface expression and cognition
- Effect of feeding patterns on growth and nutritional status of children aged 0-24 months: A Chinese cohort study
- A fecal sequel: Testing the limits of a genetic assay for bat species identification
- Measuring the impact of chronic conditions and associated multimorbidity on health-related quality of life in the general population in Hong Kong SAR, China: A cross-sectional study
- Short and long-term clinical effectiveness and cost-effectiveness of a late-phase community-based balance and gait exercise program following hip fracture. The EVA-Hip Randomised Controlled Trial
- Vaccine cold chain in general practices: A prospective study in 75 refrigerators (Keep Cool study)
- Brazilian norms for the Bank of Standardized Stimuli (BOSS)
- Distinct varieties of aesthetic chills in response to multimedia
- Interaction between apolipoprotein E genotype and hypertension on cognitive function in older women in the Nurses’ Health Study
- Correction: Resistance profile of the HIV-1 maturation inhibitor GSK3532795 in vitro and in a clinical study
- New formulation of the Gompertz equation to describe the kinetics of untreated tumors
- Development of visual perception of others’ actions: Children’s judgment of lifted weight
- Retrospective comparative analysis of intraocular lens calculation formulas after hyperopic refractive surgery
- Human vitreous concentrations of citicoline following topical application of citicoline 2% ophthalmic solution
- Development and validation of exhaled breath condensate microRNAs to identify and endotype asthma in children
- Arthroscopic release for frozen shoulder: Does the timing of intervention and diabetes affect outcome?
- Risk factors affecting dairy cattle protective grouping behavior, commonly known as bunching, against Stomoxys calcitrans (L.) on California dairies
- Acceleration of chemical shift encoding-based water fat MRI for liver proton density fat fraction and T2* mapping using compressed sensing
- Characterisation and microbial community analysis of lipid utilising microorganisms for biogas formation
- Sexuality in male partners of women with fibromyalgia syndrome: A qualitative study
- Exploring optimization strategies for improving explicit water models: Rigid n-point model and polarizable model based on Drude oscillator
- Artificial insemination with fresh, liquid stored and frozen thawed semen in dromedary camels
- Moving into an urban drug scene among people who use drugs in Vancouver, Canada: Latent class growth analysis
- Numerical study on the start and unstart phenomena in a scramjet inlet-isolator model
- Effects of dietary supplementation with apple peel powder on the growth, blood and liver parameters, and transcriptome of genetically improved farmed tilapia (GIFT, Oreochromis niloticus)
- Urban growth simulation in different scenarios using the SLEUTH model: A case study of Hefei, East China
- Chronic bronchitis without airflow obstruction, asthma and rhinitis are differently associated with cardiovascular risk factors and diseases
- Factors associated with medication adherence among people with diabetes mellitus in poor urban areas of Cambodia: A cross-sectional study
- Mammary microbiome of lactating organic dairy cows varies by time, tissue site, and infection status
- Force field generalization and the internal representation of motor learning
- Polyphenism of visual and chemical secondary sexually-selected wing traits in the butterfly Bicyclus anynana: How different is the intermediate phenotype?
- Minimal genetic differentiation of the malaria vector Nyssorhynchus darlingi associated with forest cover level in Amazonian Brazil
- The impact of leisure activities on older adults’ cognitive function, physical function, and mental health
- scafSLICR: A MATLAB-based slicing algorithm to enable 3D-printing of tissue engineering scaffolds with heterogeneous porous microarchitecture
- Association of serum leptin and adiponectin concentrations with echocardiographic parameters and pathophysiological states in patients with cardiovascular disease receiving cardiovascular surgery
- Operation of cognitive memory inhibition in adults with Down syndrome: Effects of maintenance load and material
- Influences on surgical antimicrobial prophylaxis decision making by surgical craft groups, anaesthetists, pharmacists and nurses in public and private hospitals
- Post-treatment Lyme disease symptoms score: Developing a new tool for research
- Expression of Concern: The Role of the RACK1 Ortholog Cpc2p in Modulating Pheromone-Induced Cell Cycle Arrest in Fission Yeast
- Equine bronchial fibroblasts enhance proliferation and differentiation of primary equine bronchial epithelial cells co-cultured under air-liquid interface
- Investigating cooperation with robotic peers
- Synthesis, purification and crystallization of a putative critical bulge of HAR1 RNA
- Prosthetic push-off power in trans-tibial amputee level ground walking: A systematic review
- A case study of the use of verbal reports for talent identification purposes in soccer: A Messi affair!
- Transgenerational deep sequencing revealed hypermethylation of hippocampal mGluR1 gene with altered mRNA expression of mGluR5 and mGluR3 associated with behavioral changes in Sprague Dawley rats with history of prolonged febrile seizure
- Obesity is associated with an impaired survival in lymphoma patients undergoing autologous stem cell transplantation
- Periodontal disease: Repercussions in pregnant woman and newborn health—A cohort study
- Origins of Chinese reindeer (Rangifer tarandus) based on mitochondrial DNA analyses
- Regional, racial, gender, and tumor biology disparities in breast cancer survival rates in Africa: A systematic review and meta-analysis
- How effective are films in inducing positive and negative emotional states? A meta-analysis
- 3D nanostructural characterisation of grain boundaries in atom probe data utilising machine learning methods
- An outbreak of tuberculosis in a middle school in Henan, China: Epidemiology and risk factors
- Initial clinical radiological findings and staging to predict prognosis of primary hepatic angiosarcoma: A retrospective analysis
- A new early Eocene deperetellid tapiroid illuminates the origin of Deperetellidae and the pattern of premolar molarization in Perissodactyla
- Longevity and marginal bone loss of narrow-diameter implants supporting single crowns: A systematic review
- Impact of UVC-sustained recirculating air filtration on airborne bacteria and dust in a pig facility
- Cold-related Florida manatee mortality in relation to air and water temperatures
- Conceptual fluency in inductive reasoning
- Clinical outcomes and treatment patterns among Medicare patients with nonvalvular atrial fibrillation (NVAF) and chronic kidney disease
- Improvements in the learnability of smartphone haptic interfaces for visually impaired users
- Role of the malic enzyme in metabolism of the halotolerant methanotroph Methylotuvimicrobium alcaliphilum 20Z
- Cyclic loading test study on a new cast-in-situ insulated sandwich concrete wall
- Natural compounds as angiogenic enzyme thymidine phosphorylase inhibitors: In vitro biochemical inhibition, mechanistic, and in silico modeling studies
- Analysis of virulence potential of Escherichia coli O145 isolated from cattle feces and hide samples based on whole genome sequencing
- Pre-clinical medical student reflections on implicit bias: Implications for learning and teaching
- Prognostic significance of non-sustained ventricular tachycardia on stored electrograms in pacemaker recipients
- Determinants of preterm birth among mothers who gave birth at public hospitals in the Amhara region, Ethiopia: A case-control study
- Real-world evidence of the effectiveness of ombitasvir-paritaprevir/r ± dasabuvir ± ribavirin in patients monoinfected with chronic hepatitis C or coinfected with human immunodeficiency virus-1 in Spain
- Unique transcriptomic landscapes identified in idiopathic spontaneous and infection related preterm births compared to normal term births
- Restrained expansion of the recall germinal center response as biomarker of protection for influenza vaccination in mice
- Arabidopsis TRM5 encodes a nuclear-localised bifunctional tRNA guanine and inosine-N1-methyltransferase that is important for growth
- Achievement of weight loss in patients with overweight during dietetic treatment in primary health care
- Autophagy deficiency exacerbates colitis through excessive oxidative stress and MAPK signaling pathway activation
- The impacts of parity on lung function data (LFD) of healthy females aged 40 years and more issued from an upper middle income country (Algeria): A comparative study
- Reorganization of spatial configurations in visual working memory: A matter of set size?
- Unravelling travellers’ route choice behaviour at full-scale urban network by focusing on representative OD pairs in computer experiments
- Evaluating the higher-order structure of the Profile of Emotional Competence (PEC): Confirmatory factor analysis and Bayesian structural equation modeling
- HIV prevalence and correlated factors among male clients of female sex workers in a border region of China
- Next generation sequencing and RNA-seq characterization of adipose tissue in the Nile crocodile (Crocodylus niloticus) in South Africa: Possible mechanism(s) of pathogenesis and pathophysiology of pansteatitis
- Association between advanced maternal age and maternal and neonatal morbidity: A cross-sectional study on a Spanish population
- Ethnic differences in the prevalence, socioeconomic and health related risk factors of knee pain and osteoarthritis symptoms in older Malaysians
- Increasing knowledge of HIV status in a country with high HIV testing coverage: Results from the Botswana Combination Prevention Project
- Friends with benefits: The effects of vegetative shading on plant survival in a green roof environment
- Comparison of the fecal, cecal, and mucus microbiome in male and female mice after TNBS-induced colitis
- Identifying candidate diagnostic markers for early stage of non-small cell lung cancer
- Complex alternative splicing of human Endonuclease V mRNA, but evidence for only a single protein isoform
- Correction: KML001 Induces Apoptosis and Autophagic Cell Death in Prostate Cancer Cells via Oxidative Stress Pathway
- Unique developmental trajectories of risk behaviors in adolescence and associated outcomes in young adulthood
- Enhanced fibrinolysis detection in a natural occurring canine model with intracavitary effusions: Comparison and degree of agreement between thromboelastometry and FDPs, D-dimer and fibrinogen concentrations
- Overexpression of Saussurea involucrata dehydrin gene SiDHN promotes cold and drought tolerance in transgenic tomato plants
- Foxtail millet (Setaria italica (L.) P. Beauv) CIPKs are responsive to ABA and abiotic stresses
- Autonomous drone hunter operating by deep learning and all-onboard computations in GPS-denied environments
- Heterogeneity Diffusion Imaging of gliomas: Initial experience and validation
- Frequency cluster formation and slow oscillations in neural populations with plasticity
- DHP23002 as a next generation oral paclitaxel formulation for pancreatic cancer therapy
- Diagnostic accuracy of SOX11 immunohistochemistry in mantle cell lymphoma: A meta-analysis
- Analytical solution to swing equations in power grids
- Pathways to conspiracy: The social and linguistic precursors of involvement in Reddit’s conspiracy theory forum
- Spatiotemporally random and diverse grid cell spike patterns contribute to the transformation of grid cell to place cell in a neural network model
- Empathic concern and personal distress depend on situational but not dispositional factors
- Who is more susceptible to job stressors and resources? Sensory-processing sensitivity as a personal resource and vulnerability factor
- Cost-effectiveness of integrating postpartum antiretroviral therapy and infant care into maternal & child health services in South Africa
- A substitution mutation in a conserved domain of mammalian acetate-dependent acetyl CoA synthetase 2 results in destabilized protein and impaired HIF-2 signaling
- One step at a time: Physical activity is linked to positive interpretations of ambiguity
- Calreticulin regulates vascular endothelial growth factor-A mRNA stability in gastric cancer cells
- Evaluation of various methods of selection of B. subtilis strains capable of secreting surface-active compounds
- Association between US Pharmacopeia (USP) monograph standards, generic entry and prescription drug costs
- Molecular characterisation of the synovial fluid microbiome in rheumatoid arthritis patients and healthy control subjects
- On sorption hysteresis in wood: Separating hysteresis in cell wall water and capillary water in the full moisture range
- Inbreeding, Allee effects and stochasticity might be sufficient to account for Neanderthal extinction
- Reliability and construct validity of the stepping-forward affordance perception test for fall risk assessment in community-dwelling older adults
- Socioeconomic determinants of nutritional status among ‘Baiga’ tribal children In Balaghat district of Madhya Pradesh: A qualitative study
- Study on characteristics of fire plume in building facade window under lateral blow
- ‘When you talk to someone in a bad way or always put her under pressure, it is actually worse than beating her’: Conceptions and experiences of emotional intimate partner violence in Rwanda and South Africa
- Effects of 6-mercaptopurine in pressure overload induced right heart failure
- The association between haemoglobin levels in the first 20 weeks of pregnancy and pregnancy outcomes
- Implementation and evaluation of an antimicrobial stewardship programme in companion animal clinics: A stepped-wedge design intervention study
- Factors associated with persistently high-cost health care utilization for musculoskeletal pain
- Nitrogen and chlorophyll status determination in durum wheat as influenced by fertilization and soil management: Preliminary results
- Effect of repeated in vivo microCT imaging on the properties of the mouse tibia
- Coupling environment and physiology to predict effects of climate change on the taxonomic and functional diversity of fish assemblages in the Murray-Darling Basin, Australia
- Hematology and plasma biochemistries in the Blanding’s turtle (Emydoidea blandingii) in Lake County, Illinois
- CRISPR-Cas influences the acquisition of antibiotic resistance in Klebsiella pneumoniae
- Phosphorylation-dependent activity-based conformational changes in P21-activated kinase family members and screening of novel ATP competitive inhibitors
- Antidepressant prescriptions, discontinuation, depression and perinatal outcomes, including breastfeeding: A population cohort analysis
- Why men with a low-risk prostate cancer select and stay on active surveillance: A qualitative study
- Imported severe malaria and risk factors for intensive care: A single-centre retrospective analysis
- Combined treatment (image-guided thrombectomy and endovascular therapy with open femoral access) for acute lower limb ischemia: Clinical efficacy and outcomes
- Low-latency single channel real-time neural spike sorting system based on template matching
- Quantifying the scale effect in geospatial big data using semi-variograms
- Paper-and-pencil versus computerized administration mode: Comparison of data quality and risk behavior prevalence estimates in the European school Survey Project on Alcohol and other Drugs (ESPAD)
- Regression adjusted colocalisation colour mapping (RACC): A novel biological visual analysis method for qualitative colocalisation analysis of 3D fluorescence micrographs
- Ostrich eggshell bead diameter in the Holocene: Regional variation with the spread of herding in eastern and southern Africa
- Spatial and temporal variations in female size at maturity of a Southern Rock Lobster (Jasus edwardsii) population: A likely response to climate change
- Inactive USP14 and inactive UCHL5 cause accumulation of distinct ubiquitinated proteins in mammalian cells
- Training rhesus macaques to take daily oral antiretroviral therapy for preclinical evaluation of HIV prevention and treatment strategies
- Left ventricular structural and functional changes in Friedreich ataxia – Relationship with body size, sex, age and genetic severity
- Magnitude and factors associated with anemia among pregnant women attending antenatal care in Bench Maji, Keffa and Sheka zones of public hospitals, Southwest, Ethiopia, 2018: A cross -sectional study
- Effectiveness of telerehabilitation in the management of adults with stroke: A systematic review
- Hydrogen sulphide-induced hypometabolism in human-sized porcine kidneys
- Correction: Comparison of the molecular properties of retinitis pigmentosa P23H and N15S amino acid replacements in rhodopsin
- Retraction: Regulation of gastric smooth muscle contraction via Ca2+-dependent and Ca2+-independent actin polymerization
- Evaluation of neutral oral contrast agents for assessment of the small bowel at abdominal staging CT
- Blood type and breed-associated differences in cell marker expression on equine bone marrow-derived mesenchymal stem cells including major histocompatibility complex class II antigen expression
- Induced abortion and future use of IVF treatment; A nationwide register study
- Psychosocial determinants of sustained maternal functional impairment: Longitudinal findings from a pregnancy-birth cohort study in rural Pakistan
- Measurement of finger joint angle using stretchable carbon nanotube strain sensor
- Determinants of mortality among patients with drug-resistant tuberculosis in northern Nigeria
- Drugs modulating stochastic gene expression affect the erythroid differentiation process
- Efficacy of UB0316, a multi-strain probiotic formulation in patients with type 2 diabetes mellitus: A double blind, randomized, placebo controlled study
- Prognostic value of des-γ-carboxy prothrombin in patients with hepatocellular carcinoma treated with transarterial chemotherapy: A systematic review and meta-analysis
- Avermectin induces the oxidative stress, genotoxicity, and immunological responses in the Chinese Mitten Crab, Eriocheir sinensis
- Antibiotic use in mandarin production (Citrus reticulata Blanco) in major mandarin-producing areas in Thailand: A survey assessment
- Application of CPI cutoff value based on parentage testing of duos and trios typed by four autosomal kits
- Correction: Good and Bad in the Hands of Politicians: Spontaneous Gestures during Positive and Negative Speech
- Adolescents with worse levels of oral health literacy have more cavitated carious lesions
- Effective methods for the inactivation of Francisella tularensis
- Detection of early-stage Alzheimer’s pathology using blood-based autoantibody biomarkers in elderly hip fracture repair patients
- Correlation between internal pudendal artery stenosis and erectile dysfunction in patients with suspected coronary artery disease
- Analysis of HER2 genomic binding in breast cancer cells identifies a global role in direct gene regulation
- Population productivity of shovelnose rays: Inferring the potential for recovery
- Correction: Long-term clinical outcomes in a cohort of patients with solitary plasmacytoma treated in the modern era
- Effects of tetracycline on myocardial infarct size in obese rats with chemically-induced colitis
- Mineral absorption is an enriched pathway in a brain region of restless legs syndrome patients with reduced MEIS1 expression
- Changes in weight and body composition across five years at university: A prospective observational study
- Adeno-associated virus-mediated expression of human butyrylcholinesterase to treat organophosphate poisoning
- Effects of insulin signaling on mouse taste cell proliferation
- Patient-level cost of home- and facility-based child pneumonia treatment in Suba Sub County, Kenya
- TAP: A static analysis model for PHP vulnerabilities based on token and deep learning technology
- Cost-effectiveness of QuantiFERON-TB Gold In-Tube versus tuberculin skin test for diagnosis and treatment of Latent Tuberculosis Infection in primary health care workers in Brazil
- Multifaceted intervention for the prevention and management of musculoskeletal pain in nursing staff: Results of a cluster randomized controlled trial
- Changes over time in creatinine clearance and comparison of emergent adverse events for HIV-positive adults receiving standard doses (300 mg/day) of lamivudine-containing antiretroviral therapy with baseline creatinine clearance of 30–49 vs ≥50 mL/min
- Population dynamics of foxes during restricted-area culling in Britain: Advancing understanding through state-space modelling of culling records
- Impacts of experimental advisory exit speed sign on traffic speeds for freeway exit ramp
- In-hospital outcomes and 30-day readmission rates among ischemic and hemorrhagic stroke patients with delirium
- Monitoring quality indicators for the Xpert MTB/RIF molecular assay in Ethiopia
- Delivering genes across the blood-brain barrier: LY6A, a novel cellular receptor for AAV-PHP.B capsids
- Correction: Using remote sensing to detect whale strandings in remote areas: The case of sei whales mass mortality in Chilean Patagonia
- Comparison of the inoculum size effects of antibiotics on IMP-6 β-lactamase-producing Enterobacteriaceae co-harboring plasmid-mediated quinolone resistance genes
- Contrast-enhanced computed tomography findings of canine primary renal tumors including renal cell carcinoma, lymphoma, and hemangiosarcoma
- Non-invasive in vivo imaging of UCP1 expression in live mice via near-infrared fluorescent protein iRFP720
- Overexpression of pink1 or parkin in indirect flight muscles promotes mitochondrial proteostasis and extends lifespan in Drosophila melanogaster
- Fiber stiffness, pore size and adhesion control migratory phenotype of MDA-MB-231 cells in collagen gels
- Comparison of two experimental ARDS models in pigs using electrical impedance tomography
- Are primary school children attending full-day school still engaged in sports clubs?
- Stroke risks in women with dysmenorrhea by age and stroke subtype
- Changes in patterns of mortality rates and years of life lost due to firearms in the United States, 1999 to 2016: A joinpoint analysis
- In vitro modeling of Batrachochytrium dendrobatidis infection of the amphibian skin
- Development and validation of LC-MS/MS method for imatinib and norimatinib monitoring by finger-prick DBS in gastrointestinal stromal tumor patients
- Correction: Habitat disturbance and the organization of bacterial communities in Neotropical hematophagous arthropods
- Characterisation of early metazoan secretion through associated signal peptidase complex subunits, prohormone convertases and carboxypeptidases of the marine sponge (Amphimedon queenslandica)
- Time trends between 2002 and 2017 in correlates of self-reported sitting time in European adults
- Performance of patient acuity rating by rapid response team nurses for predicting short-term prognosis
- Changes in HbA1c during the first six years after the diagnosis of Type 2 diabetes mellitus predict long-term microvascular outcomes
- Correction: Antimicrobial resistance genotypes and phenotypes of Campylobacter jejuni isolated in Italy from humans, birds from wild and urban habitats, and poultry
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- Correction: A 1D computer model of the arterial circulation in horses: An important resource for studying global interactions between heart and vessels under normal and pathological conditions
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- Correction: Identifying performance benchmarks and determinants for reproductive performance and calf survival using a longitudinal field study of cow-calf herds in western Canada
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- Correction: Interspecific Phylogenic Relationships within Genus Melilotus Based on Nuclear and Chloroplast DNA
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- Correction: KETOS: Clinical decision support and machine learning as a service – A training and deployment platform based on Docker, OMOP-CDM, and FHIR Web Services
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- Complete Chloroplast Genomes of Vachellia nilotica and Senegalia senegal: Comparative Genomics and Phylogenomic Placement in a New Generic System
- Retraction: Over-Expression of Superoxide Dismutase Ameliorates Cr(VI) Induced Adverse Effects via Modulating Cellular Immune System of Drosophila melanogaster
- Effect of pre-season training phase on anthropometric, hormonal and fitness parameters in young soccer players
- Exosomes from conditioned media of bone marrow-derived mesenchymal stem cells promote bone regeneration by enhancing angiogenesis
- Outcome of patients with heart failure after transcatheter aortic valve implantation
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- Appropriate empirical antibiotic therapy and mortality: Conflicting data explained by residual confounding
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- Telbivudine on IgG-associated hypergammaglobulinemia and TGF-β1 hyperactivity in hepatitis B virus-related liver cirrhosis
- Correction: Axial variation of deoxyhemoglobin density as a source of the low-frequency time lag structure in blood oxygenation level-dependent signals
- Correction: Mobile health-based physical activity intervention for individuals with spinal cord injury in the community: A pilot study
- Retraction: Placental expression of CD100, CD72 and CD45 is dysregulated in human miscarriage
- Correction: Use of IoT sensing and occupant surveys for determining the resilience of buildings to forest fire generated PM2.5
- Correction: The modulation of facial mimicry by attachment tendencies and their underlying affiliation motives in 3-year-olds: An EMG study
- Correction: Cognitive impairment in multiple sclerosis: An exploratory analysis of environmental and lifestyle risk factors
- Discovering novel disease comorbidities using electronic medical records
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- Epidemiology and antimicrobial resistance of methicillin-resistant Staphylococcus aureus isolates colonizing pigs with different exposure to antibiotics
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- A strategy to identify protein-N-myristoylation-dependent phosphorylation reactions of cellular proteins by using Phos-tag SDS-PAGE
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- Correction: Change in larval fish assemblage in a USA east coast estuary estimated from twenty-six years of fixed weekly sampling
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- Correction: A review of the elusive bicolored iris Snouted Treefrogs (Anura: Hylidae:Scinax uruguayus group)
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- Correction: Population-based dementia prediction model using Korean public health examination data: A cohort study
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- Correction: Use of validated objective methods of locomotion characteristics and weight distribution for evaluating the efficacy of ketoprofen for alleviating pain in cows with limb pathologies
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- Correction: Transcriptome profiling of mouse brain and lung under Dip2a regulation using RNA-sequencing
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