Lansing Community College

As increased attention is placed on optimizing long-term outcomes of trauma patients by addressing mental health, little is known regarding the interplay of pre- and postinjury mental health on long-term financial and functional outcomes. Patients from 19 Level 1 and 2 trauma centers took part in serial surveys 1 to 24 months postdischarge. Preinjury mental health diagnoses were identified using trauma registry data and postinjury mental health symptoms from survey data. Outcomes included (1) health-related quality of life from the EuroQol-5D-5L and (2) elements of financial toxicity (e.g. medical debt, job/income loss, nonmedical bills, unaffordable care). Multivariable models were created, adjusting for patient, injury, and treatment factors, to evaluate the association of preinjury mental health diagnoses and postinjury mental health symptoms on health-related quality of life and financial toxicity. A total of 1,017 patients completed 1,297 surveys from July 2021 to December 2023, at a median of 6 months postinjury. Forty-six percent were female, the median age was 67.5 years, and 89% had blunt injuries. Thirty-two percent of patients had a preinjury mental health diagnosis, and 49% had self-reported mental health symptoms postdischarge. Patients with preinjury mental health diagnoses had higher odds of postinjury mental health symptoms (adjusted odds ratio, 3.6 [2.6-4.9]; p < 0.001); however, 55% of those with postinjury symptoms had no preinjury diagnosis. Postinjury symptoms alone were associated with worse health-related quality of life or financial toxicity. Notably, patients with new postinjury mental health symptoms (no preinjury mental health diagnosis) had the highest rate of foregone postinjury care because of costs (26% vs. 14%, p < 0.01). More than one-in-two patients had peri-injury mental health conditions, and patients with postinjury mental health symptoms experienced worse financial and functional outcomes. Addressing postinjury mental health may potentially improve long-term health-related quality of life of trauma survivors; however, efforts are needed to ensure that patients can afford the care needed for optimal health. Prognostic and Epidemiological; Level IV.

Settings where Emergency Medical Services (EMS) are provided to stabilize patients and transport them to locations better equipped to provide comprehensive care, "prehospital settings," are not frequently considered when designing packaged products. Packaging design is an understudied area, potentially impacting both healthcare provider behavior and patient outcomes. Our objectives were to: 1) describe difficulties associated with packaging in prehospital settings 2) investigate the coping strategies used by paramedics when difficulties occurred, and 3) assess the potential impacts these difficulties had on patient care. An online, cross-sectional survey was distributed via email using the National EMS Certification database maintained by the National Registry of Emergency Medical Technicians (NREMT) to a random sample of nationally-certified paramedics. Eligible respondents were aged 18 and older, employed as paramedics and had administered care in a prehospital setting within the previous 12 months. Survey items explored difficulties experienced and coping strategies used when difficulty was encountered identifying or opening medications and/or medical supplies. Descriptive statistics and logistic regression were calculated to analyse responses for trends. Of the 12,000 emails sent, 1,912 participants responded (response rate = 16%). After removing respondents who had not administered care within the past 12 months and partial surveys, data from 1,702 respondents were analysed. Nearly 20% of all respondents reported that they had experienced difficulties identifying (21.1%) or opening (20.5%) medications and identifying (17.0%) or opening (23.4%) medical supplies within the past year. Between 1.2% (identifying a medication) and 3.0% (opening supplies) of those included in the analysis indicated that reported difficulties had negatively impacted patient care. Common coping strategies reported to deal with difficulty opening included partner assistance, tool use (scissors, pens, and knives), and the use of teeth, all potential pathways for the transmission of microbes, conceivably further impacting outcomes. More thoughtfully designed packaging for prehospital settings has the potential to benefit both EMS providers and the patients that they care for.

Abstract Engaging Early Engineering Students (EEES): A Fourth Year ReportEarly “leavers” from engineering programs typically fall into one of two overlapping categories:(a) those who leave because of academic difficulties and (b) those who leave because they findthe educational environment of early engineering to be hostile and/or not engaging. This paperdescribes an NSF STEP project, EEES, that is a suite of four articulated programs. EEES isdesigned to ease the transition of high school students into engineering undergraduate programs,and, by making the transition smoother, to increase the retention rate of early engineeringstudents. Analysis of internal statistics revealed key courses that are pivotal in promotingretention: early mathematics courses, first term physics, and a computational tools-for-problem-solving course; the students in those courses are the specific targets of EEES.The EEES project is a collaborative effort between the College of Engineering at and . EEES consists of four content subprograms: (a) aprogram to provide formative assessments in the key courses with follow-on “bootstrapping”tutorials, (b) a supplemental instruction program initially patterned after the Kansas City model,(c) a program to directly engage engineering faculty with early engineering students, and (d) aprogram to develop and exploit course material from one key course to another thereby enablinga “program view” by our students instead of the more typical “course silo view”. Our effort isnot a conglomeration of the four independent subprojects; rather EEES is a system of fourinterrelated, articulated programs.The project goal for EEES is to raise the matriculation-to-graduation rate in our College ofEngineering by ten percentage points. Earlier, we reported on reasoned methods to determineretention rate, a surprisingly complex problem. In addition to making good progress towards ourproject goal, we have set the problem of determining (a) the relative contribution of our each ofour projects to our retention goal and (b) the overall contribution of our project to retention in anenvironment that is constantly changing. In addition to our four content programs, our dataassembly and analysis goals are housed in an infrastructure program within EEES that is focusedspecifically on data management and analysis. The ultimate goals of credit assignment depend onmore complete data sets than we currently have. But intermediate data analysis is promising.In September, 2012, we completed the fourth year of our five year project. In this paper wepresent a summary of our results to date, including our data handling and analysis methodology.We report on both direct and indirect assessment metrics we have developed for assessment. Ourmethods have been mixed: both qualitative and quantitative. Our report is one year past “mid-term” for our project, and reports on the data and analyses supplied to NSF for our project’sSTEP third year review.

Abstract The Successes and Challenges of Supplemental Instruction as a Component of an NSF STEP Project to Engage Early Engineering StudentsIn recent years there has been a noticeable decline in the number of STEM students nationwide.Specifically, there is a high loss rate of early engineering students in the first half of their degreeprograms. The early “leavers” typically fall into two categories (i) those that are facingacademic probation and (ii) those that perceive the education environment of early engineeringas hostile and not engaging (Bernold, Spurlin et.al., 2007; Seymour, 2002; Seymour and Hewitt,1997). Undergraduate engineering enrollment has declined substantially over the last decade atthe College of Engineering at a large Midwestern university. The downturn can be attributedpartly to the rapid decline of the American automobile and manufacturing industry, a traditionalmainstay for the local economy.In 2008, a five-year NSF STEP grant (STEM Talent Expansion Program) was awarded tosupport a partnership between the Colleges of Engineering and Natural Science at the university,and a nearby community college. The project is titled Engaging Early Engineering Students(EEES). A primary goal of EEES is to increase retention at the College of Engineering and inturn increase the number of degree recipients. The EEES project functions through thesynergistic operation of four components designed to maximize student engagement with boththe college and the learning process. The components are (i) Connector faculty; (ii)Supplemental Instruction; (iii) Course cross linkages; and (iv) Early intervention.The primary objective of this paper is to describe the successes and challenges encounteredduring the first two and a half years of the Supplemental Instruction segment of the EEESproject. Supplemental Instruction (SI) is an internationally recognized peer-tutoring program thatintegrates course content with active student learning in the form of peer facilitated studysessions. This approach to peer to peer learning has shown that participating students makegreater gains than those achieved by classmates competing with each other or studying alone(Bok, 2006). Additionally, group learning has demonstrated benefits essential to creating a morewelcoming educational environment, including helping to integrate students into academic life,teaching effective collaboration methods, and reducing prejudice (Bok).This paper will include (i) a description of the implementation process of SI at the College ofEngineering; (ii) the roles of the various partners in the SI program; (iii) early signs of successand the evaluation methods used to measure them; and (iv) adjustments made to maximizeprogram resources, including the creation of combined subject sessions to increase attendanceand demonstrate the interconnectedness of subject material. Quantitative and qualitative methodswere used to acquire data on the impact of SI, including the students who attend the studysessions, as well as the peer leaders who facilitate them. In addition, the paper will highlight theSI program in relation to student development theory in the context of engineering education.

Abstract Drawing on systems theory, this chapter uses two different institutional examples to demonstrate the benefits of combining gateway‐course improvement initiatives with other student success efforts so that the combined approach makes the whole greater than the simple sum of the pieces.

This investigation explores scholarly communication business models in American Library Association (ALA) division peer-reviewed academic journals. Previous studies reveal the numerous issues organizations and publishers face in the academic publishing environment. Through an analysis of documented procedures, policies, and finances of five ALA division journals, we compare business and access models. We conclude that some ALA divisions prioritize the costs associated with changing business models, including hard-to-estimate costs such as the labor of volunteers. For other divisions, the financial aspects are less important than maintaining core values, such as those defined in ALA’s Core Values in Librarianship.