Unrealistic Expectations Research Articles

From Campus to Career

Students undertaking professional degrees are often expected to step into the workplace fully formed, with unrealistic expectations around their experience and capabilities. Universities, facing an increasingly competitive market in a neoliberal context, are focused the student experience, attraction and retention metrics, as students demand return on their investment of money and time. Alongside this, criticism of work readiness and employability comes from graduates and the industries that need them. It is in this space that technology and innovation can offer simple, albeit disruptive ways of increasing the possibility of connecting tertiary students with industry partners to facilitate authentic learning. Early workplace experience, undertaken while still studying, provides both students and employers an opportunity to understand their respective needs within a temporary low risk and low stakes environment. A platform for connecting students with industry for paid employment experiences that sit outside the ubiquitous and often unpaid internships and practicums, offers authentic ways of preparing graduates for the workforce. It also has the potential to improve the way industry connects with the university enabling a richer experience for all; students, universities and industry partners.

Predictive Model to Evaluate University Students' Perception and Attitude Towards Artificial Intelligence

Artificial Intelligence is emerging as a transformative tool impacting various industries, including education As Artificial Intelligence continues to develop and gain prominence in classrooms, understanding how students perceive this integration and how it affects their educational experience becomes crucial. The aim of this research was to develop a model to predict the perception of students at Bolívar State University regarding the use and potentialities of Artificial Intelligence in the educational field. The methodology employed a factorial analysis, which represents the relationships among a set of variables. From this, a logistic regression was performed, generating an equation to identify predictors that allowed understanding student behavior based on specific characteristics such as attitude, perception, and satisfaction. As a technique for information gathering, a questionnaire composed of 25 items on a Likert scale was used, statistically validated with a Cronbach's alpha value of 0.925. The results of the model show that all covariates, except "Insecurity and fear of using artificial intelligence tools", are significant (p < 0.001). This suggests that the remaining variables are related to the dependent variable "Positive Perception of the Usefulness of Artificial Intelligence in Learning". It is concluded that students have limited knowledge about Artificial Intelligence, and this may cause them to have unrealistic expectations. Training can help students learn about AI and how to use it effectively and ethically. Received: 9 May 2024 / Accepted: 12 September 2024 / Published: 05 November 2024

A silent pandemic of violence against providers in obstetrics and gynecology: A mixed-methods study based on a global survey.

To quantify and qualify the experience of workplace violence (WPV) in a global sample of providers in obstetrics and gynecology (OBGYN). We performed a mixed-methods analysis on data from a global survey. Survey content was designed around categorical and open-ended questions in relation to WPV; the occurrence and character, the physical and psychological consequences, training and support structures, and perceived triggers of the experience of WPV. Quantitative data were analyzed using descriptive statistics and text data using mixed deductive-inductive content analysis. These data were integrated using convergent joint display. Between October 2023 and January 2024, survey responses were collected from 77 individual countries. Among the final sample, 764/1016 (75.2%) had experienced WPV, 699/1016 (68.8%) verbal, and 123/1016 (12.1%) physical violence. The violence affected physical health, psychological health, or job satisfaction for 106/764 (13.9%), 36/7642 (47.4%), and 222/764 (29.1%) of individuals respectively; 216/764 (28.3%) received support. Main WPV triggers were staff shortages, lack of security personnel, and long waiting times, identified by 38.8%, 37.5%, and 37.3% of respondents respectively. Qualitative data indicated that violence caused severe and long-lasting suffering. Catalysts for WPV were often reported as complex interplays between unmet or unrealistic expectations and insufficient resources. Lack of support for WPV was explained as violence being "part of the job" and a culture of assumed resilience among providers. WPV against OBGYN providers seems to be ubiquitous, arises from a complex interplay of factors, and causes significant injury while receiving insufficient mitigation and support.

Targeting the TNF and TNFR superfamilies in autoimmune disease and cancer.

The first anti-tumour necrosis factor (TNF) monoclonal antibody, infliximab (Remicade), celebrated its 25th anniversary of FDA approval in 2023. Inhibitors of TNF have since proved clinically efficacious at reducing inflammation associated with several autoimmune diseases, including rheumatoid arthritis, psoriasis and Crohn's disease. The success of TNF inhibitors raised unrealistic expectations for targeting other members of the TNF superfamily (TNFSF) of ligands and their receptors, with difficulties in part related to their more limited, variable expression and potential redundancy. However, there has been a resurgence of interest and investment, with many of these cytokines or their cognate receptors now under clinical investigation as targets for modulation of autoimmune and inflammatory diseases, as well as cancer. This Review assesses TNFSF-targeted biologics currently in clinical development for immune system-related diseases, highlighting ongoing challenges and future directions.

From Teacher Beliefs to Practices: Unpacking the Benefits and Barriers of Extensive Reading Programmes in Macau Secondary Schools

Extensive reading entails language learners’ independent reading of abundant materials suitable for their proficiency levels. Previous studies have revealed extensive reading as effective for improving various aspects of second language (L2) proficiency. However, many Macau secondary schools have cancelled or reduced their extensive reading programmes (ERPs), prompting the need for a qualitative study to comprehend these modifications. In this case study, five L2 English teachers from different Macau secondary schools shared their beliefs and practices during semi-structured interviews. Qualitative content analysis of the interview transcripts revealed all teachers supported incorporating extensive reading in their respective English curriculums; they believed students’ engagement in ERPs enhanced reading fluency and comprehension, vocabulary knowledge, and L2 learning motivation and confidence. However, the teachers also believed restricted time and unengaged students hindered the ERPs. The schools’ possible misinterpretations of extensive reading and their potentially unrealistic expectations regarding short-term returns against limited investment in extensive reading may have contributed to the abandonment or reduction of ERPs. To engage students in ERPs, schools should allow students to choose their own reading materials, reduce the emphasis on extensive reading tests, incorporate more intrinsic and extrinsic motivators, and consider combining extensive reading with reading strategy instruction.

Pharmaceutical Advertising and Public Perceptions in Saudi Arabia

Introduction: As the pharmaceutical advertising landscape evolves with digital advancements, this study examines public awareness and perceptions of medication advertisements in Saudi Arabia. It focuses on the effects of regulatory frameworks and evaluates how they influence public understanding and attitudes toward these advertisements. Method: A cross-sectional study was conducted using an electronic survey in Saudi Arabia in December 2023. The survey was distributed on social media platforms and reached a diverse sample of 440 participants. It covered public perception and attitudes toward drug advertisements, knowledge of regulatory laws, and preferences regarding advertising mediums. Results: Out of the 440 participants in the study, who were primarily employees with bachelor’s degrees, there was a clear awareness of drug advertisements. The average age of the group was 33 years, and a significant portion (71.1%) held a bachelor’s degree, with 51.1% being employed. The findings revealed that 25.5% of participants frequently noticed drug ads, while 22.7% saw them very often. Although many found the ads informative, there were significant concerns about unrealistic expectations and the risk of overmedication; 89.8% believed the ads set unrealistic expectations about the effectiveness of medications. Additionally, 60.7% thought that celebrity endorsements might mislead the audience, and 91.1% felt that ads should provide more detailed information about potential risks and side effects. Regarding preferred advertising platforms, mobile apps and websites were favored (47%), followed closely by social media (46.4%). A striking 93.2% of participants believed that drug ads on social media should be subject to stricter regulations, and 96.4% wanted more proactive monitoring of online advertising. Many also reported using other sources, such as medical review sites, to verify medication information. Conclusions: Pharmaceutical advertising in Saudi Arabia must balance ethical transparency with educational value. The influence of digital platforms underscores the necessity for stricter regulation and accurate information dissemination. A collaborative approach is essential to align advertising practices with public health interests and regulatory standards.

The production and utility of evidence synthesis during the COVID-19 pandemic in Canada: perspectives of evidence synthesis producers

Background: COVID-19 accentuated an evergreen dilemma in evidence-informed policy making: the imperative to synthesise the best available evidence with limited time to produce high quality synthesis. The pandemic prompted the adaptation of evidence synthesis practices to match the urgency of the crisis, and heightened demand by policy makers, while maintaining a focus on quality. This study documents the response to these challenges from the perspectives of those who produced evidence syntheses in Canada. Methods: A qualitative phenomenological study was conducted between October 2022 and January 2023. Data collection included interviews with 22 participants within 19 organisations across seven provinces. A thematic analysis was performed and reported narratively. Results: Evidence synthesis producers in Canada adapted in response to the demands of different types of requests during the pandemic. Participants described several key challenges in responding to end-users, in which a lack of knowledge of evidence synthesis processes and products prompted difficult questions and unrealistic expectations. They responded to the needs of evidence synthesis requestors by creating custom syntheses, utilising rapid review methodologies, emphasising limitations and incorporating recommendations into syntheses. Discussion and conclusion: The evidence synthesis field was able to adapt to pandemic challenges in valuable ways. Still, this experience accentuates disconnects between producers and users, including differing views on the purpose, methods, limitations and implementation of synthesis findings.

Machine Learning, Deep Learning, Artificial Intelligence and Aesthetic Plastic Surgery: A Qualitative Systematic Review.

This systematic review aims to assess the use of machine learning, deep learning, and artificial intelligence in aesthetic plastic surgery. This qualitative systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses reporting guideline. To analyze quality risk-of-bias assessment of all included articles, we used the ROBINS-I tool for non-randomized studies. We searched for studies with the following MeSH terms: Machine Learning OR Deep Learning OR Artificial intelligence AND Plastic surgery on MEDLINE/PubMed, EMBASE, and Cochrane Library, from inception until July 2024 without any filter applied. A total of 2,148 studies were screened and 41 were fully reviewed. We conducted article extraction, screening, and full text review using the rayyan tool. Eighteen studies were ultimately included in this review, describing the use of machine learning, deep learning and artificial intelligence in aesthetic plastic surgery. All studies were published from 2019 to 2024. Articles varied regarding the population studied, type of machine learning (ML), Deep Learning Model (DLM), Artificial Intelligence (AI) used, and aesthetic plastic surgery type. Of the eighteen studies, we included the following aesthetic plastic surgeries: augmentation mastopexy, breast augmentation, reduction mammoplasty, rhinoplasty, facial rejuvenation surgery, including facelift surgery; blepharoplasty, and body contouring. Image-based with AI, ML, and DLMs algorithms were used in these studies to improve human decision-making and identified factors associated with postoperative complications. AI, ML, and DL algorithms offer immense potential to transform the aesthetic plastic surgery field. By meticulously analyzing patient data, these technologies may, in the future, help optimize treatment plans, predict potential complications, and more clearly elucidate patient concerns, improving their ability to make informed decisions. The drawback, as with preoperative surgical simulation, is that patients may see an AI-generated image that is to their liking, but impossible to achieve; great care is needed when using such tools in order to not create unrealistic expectations. Ultimately, the old plastic surgery adage of ''under-promise and over-deliver'' will continue to hold true, at least for the foreseeable future. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 . Study registration A review protocol for this systematic review was registered at PROSPERO CRD42024567461.

The Cosmetic Readiness Questionnaire (CRQ): Validation of a Pre-Operative Psychological Screening Tool for Aesthetic Procedures.

Several psychological risk factors are associated with patient dissatisfaction with aesthetic procedures, such as body dysmorphic disorder (BDD), unmanaged mental health concerns or unrealistic expectations. Identifying these risks via preoperative screening may protect patients from adverse psychological outcomes and provide reputational or legal protection for practitioners. This study aimed to further develop and validate the Cosmetic Readiness Questionnaire (CRQ), a comprehensive psychological screening tool to assess patient suitability for surgical and non-surgical aesthetic procedures. The CRQ was validated across two studies in clinical contexts, examining structural and construct validity in a sample of 8031 individuals who completed the CRQ as part of routine clinical care. In a further sample (n = 574), criterion validity was explored through the relationship between the CRQ and dissatisfaction with past aesthetic treatments. Risk category cut-off scores were developed. Results supported the reliability and validity of a five-factor CRQ which measures Body Dysmorphia, Psychological Distress, Self-Criticism, Unrealistic Expectations and Lack of Openness. High scorers on the CRQ were 78% more likely to report dissatisfaction with a past cosmetic procedure than low scorers. The CRQ is a comprehensive and valid screening measure to identify patients who may require further psychological assessment or additional support prior to aesthetic treatment. Instructions are provided on how to implement the CRQ in clinical practice.

7275 Diverse Reasons for Discontinuing Gender Affirming Hormone Therapy

Abstract Disclosure: A. Jain: None. M.S. Irwig: None. Many Transgender and Gender Diverse (TGD) individuals take Gender Affirming Hormone Therapy (GAHT). A study that included 264 adults [67% assigned male at birth (AMAB)] in Georgia found that 2% (n=5) discontinued GAHT over a follow-up period of 64 months. Reasons identified were change in gender identity (n=2), financial barriers (n=2) and venous thrombosis (n=1). Discontinuation was temporary for 2 and permanent for 2. Here we describe the reasons why four TGD individuals discontinued GAHT. Case Descriptions: Patient 1, AMAB, came out as gay as a teenager. In his mid 30s he became unhappy which he attributed to a conflict between religion and his sexual orientation and failed relationships. He thought that changing his sex would solve his problems. He took injectable estrogen for 3-4 years. He subsequently underwent multiple gender-affirmation surgeries including facial feminization surgery, breast implants, an orchiectomy and vaginoplasty. Immediately following the breast implant surgery he had regrets and wanted them removed. He also regretted the vaginoplasty. He stopped estrogen following the bottom surgery. In his 40s he stated that he would like to detransition as he sees himself "as a fake" when looking in the mirror. Patient 2 was assigned female at birth. Puberty was associated with discomfort from having a large chest. In his late 20s he began injectable testosterone which he took for three years. He then decided to take a two year break as he was frustrated that he had not achieved the desired results and because he was still not able to pass as a man. He resumed testosterone two years ago and underwent top surgery. Patient 3, AMAB, knew from a young age that he was transgender. He took estrogen and an antiandrogen for > 5 years and underwent an orchiectomy and vaginoplasty. He was pleased with the results from the GAHT and surgeries. He presented as a woman for many years. A few years ago, however, he awoke one day with the thought that God wanted him to be a man. He decided to detransition and presented to the endocrinology clinic to start testosterone therapy. Patient 4, AMAB, began GAHT in her late 30s. She discontinued GAHT 4 years later due to lack of results (feminization, larger breasts, wider hips and a more curvy figure). She presented to the endocrinology clinic 2 years later, wanting to resume GAHT. Conclusion: In addition to the reasons identified by Gupta et al for discontinuation of GAHT, we also identified unrealistic expectations, not achieving the desired results and perceived conflict between religion and gender identity. Endocrinologists should be aware of the possibility of discontinuation of GAHT and know how to manage any potential complications such as hypogonadism that may arise. Reference: Gupta P et al. J Clin Endocrinol Metab. 2023. Presentation: 6/2/2024

Why Is Caries Prevention in Children So Difficult? A Narrative Opinion.

Caries is among the most common non-communicable diseases worldwide, yet it is commonly described as preventable. Caries prevention is, however, difficult and complex, since the disease has strong social, parental, behavioral, political, medical/genetic, and psychological elements, and the payment models are targeted at traditional conservative care. The aim of this paper is to discuss some key issues that make caries prevention in children be perceived as "difficult": i) the communication gap between researchers and clinicians, creating unrealistic expectations of intervention efficacy; ii) the skewed distribution of caries and the problem of reaching children with the highest need; iii) limited access to care, which is a threat to oral health, in particular in low-socioeconomic-status, underserviced, and remote communities; and iv) the need to adopt behavior change models to affect the modifiable risk factors that are shared with other non-communicable diseases. Dentists cannot simply rely on fluoride exposure; proper education and training in caries risk assessment, behavior change models targeted at oral hygiene and sugar intake, and collaboration with primary healthcare and local school authorities are avenues that aid in caries prevention and reduce the uneven burden of the disease. Online education and mobile apps may help to promote oral health in areas with shortages of dental work force.

Assessing Personality Risks profile in Prosthodontics Patients: A Delphi-Driven Classification Approach.

This paper aims to identify specific personality traits that could potentially undermine the overall satisfaction of the patient with the prosthodontic treatment. A literature review was conducted to identify the personality traits (PT) relevant to patients requiring dental treatment. Later, a Delphi process was employed to classify the selected PT into risk levels to prosthodontic treatment satisfaction, ultimately leading to the development of a personality risk profile (PRP) proposal. The expert panel consisted of specialists with over ten years of practice. The Delphi process involved three rounds of evaluation and consensus building. Twenty-six PT associated with dental treatment satisfaction were identified. Following the three rounds of the Delphi method, a consensus was achieved, resulting in the classification of these PT into three PRP, as follows: Low Risk (cooperative, understanding, compliant, trusting, concerned about their health, willing, thankful, and responsible), Moderate Risk (Insecure, Over-informed, Demanding, Appearance-obsessed, and Pessimistic), and High Risk (mistrustful, skeptical, unwilling, defiant attitude, unrealistic expectations, neglectful, treatment resistant, patient refers negatively about other dentists, violent, irresponsible, idealise the dentist, and controller). This study identified and categorized PT that have the potential to adversely impact prosthodontics treatment satisfaction. Through this PRP proposal, dental professionals can recognize these patients before initiating prosthodontic interventions.

The 6 Biggest Mistakes Leaders Make When Motivating Employees

Abstract: This article examines key factors that demotivate employees based on research in organizational psychology and leadership theory. It identifies a lack of feedback and praise, unclear or misaligned goals, limited autonomy and decision-making power, insufficient opportunities for skills development and growth, unrealistic workload expectations, and poor communication as universal demotivators across organizational contexts. Specific examples from the automotive industry illustrate how these issues negatively impact motivation. The article maintains that while individualized approaches are needed, certain demotivating behaviors should be avoided, such as not providing regular performance feedback or recognition. It advocates for goal setting, autonomy-enhancing problem solving, targeted skills training programs, reasonable workload calibration, and transparent communication as evidence-based ways to meaningfully boost employee engagement. The conclusion reiterates that leadership equipped with motivation science can focus on empowering rather than discouraging employees through these best practices.

More than Half Underemployed: Developing Talent for Meaningful Work

This article examines the problem of underemployment among recent college graduates and proposes strategies for organizations and institutions of higher education to work individually and collaboratively to address this issue. According to recent data, over 55% of 2020 graduates were underemployed within six months due to factors like economic disruption from the pandemic, skills mismatches, unrealistic graduate expectations, and rising education costs. Long-term impacts of underemployment include lower lifetime earnings and wasted talent. The article suggests organizational approaches like internships, clear communication of needs, bridging roles, and mentorship to develop talent and connect graduates to careers. For institutions, recommendations include experiential learning, career education, industry advisory boards, and robust career services. Finally, the article proposes collaborative models such as curriculum partnerships with employers, employer-embedded teaching, shared talent databases, and joint roundtables to fully tackle graduate underemployment through multi-stakeholder cooperation.

Different patterns of endorsement of intensive mothering beliefs: Associations with parenting guilt and parental burnout.

The unrealistic expectations rooted in intensive mothering beliefs can negatively impact maternal well-being. The present study investigates associations between intensive mothering beliefs, parenting guilt, and parental burnout using a person-centered approach. We first examined whether different profiles of mothers exist based on their endorsement of the five subbeliefs of the Intensive Parenting Attitudes Questionnaire. We then tested associations between these profiles and parenting guilt and parental burnout and whether mothers' demographic characteristics predicted profile membership. Using data from 291 mothers (61% White, 15% Black/African American) with at least one child under 6 years old, we identified four profiles of mothers. Two distinct patterns of intensive mothering endorsement emerged: mothers who exhibited consistent levels of endorsement across the five subbeliefs (i.e., high endorsement, moderate endorsement, and low endorsement) and mothers who were characterized by higher endorsement on fulfillment, stimulation, and child-centered but lower endorsement on essentialism and challenging (i.e., selective endorsement). Profile membership contributed to differences in parenting guilt and parental burnout. Parenting guilt was the highest in the profile characterized by the high levels of endorsement across all five subbeliefs (high endorsement) and was significantly higher than low endorsement. Parental burnout was the lowest in the selective endorsement and was significantly lower than in the high endorsement and moderate endorsement. These results highlight the heterogeneity of subscribing to intensive mothering beliefs and suggest that magnitude and patterns of endorsement of intensive mothering beliefs differentially contribute to parenting-related well-being. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Dɛnkyɛm: Identity Development and Negotiation Among 1.5-Generation Ghanaian American Millennials

Ghanaian immigrants are largely ignored in U.S.-based scholarship. Within this qualitative study, I explored the experiences of 1.5-generation Ghanaian American millennials with the purpose of understanding how they create, negotiate, and re-create identities. Using a phenomenological approach, I examined the experiences of eight individuals to specifically understand the creation and negotiation of national, ethnic, and racial identities in public and private spaces. I argue that the 1.5-generation is uniquely socially positioned and forced to code-switch and adapt based on age, race, and nationality, all while still learning to adjust to living in the U.S. The findings suggest that many individuals of this generation had unrealistic expectations of what life in the United States was like, which made the initial transition difficult. Participants also discussed a common theme of bullying at school and a distinct difference between their home life and public life. Racialization was the most challenging aspect of life participants faced as it related to their adjustment to mainstream U.S. society and revealed complex layers that are involved in identity development and negotiation. I close with suggestions for future research and implications for practice for scholars, policymakers, and community members.

Rethinking multi‐site studies in social and personality psychology: Can the cross‐indigenous approach remedy common cross‐cultural vulnerabilities?

AbstractThe cross‐indigenous approach is introduced as a framework for conducting multi‐site studies. The cross‐indigenous approach is a simultaneous multi‐emic approach to studying psychological and social phenomena across cultures which intends to mitigate vulnerabilities commonly found in typical cross‐cultural studies done in social and personality psychology including methodological artifacts introduced when instruments, protocols, or research design do not work as expected across target cultures, and the unrealistic expectation of construct equivalence across sites. The article discusses ways to carry out a cross‐indigenous project which aims to be a principled way of making comparisons across cultures, aiming to stake out what are unique, what are shared and what are universals across populations, to explain psychological and social processes through culture‐sensitive and naturalistic methods.

Does community of inquiry really matter in understanding online learning? A confirmed perspective using mixed method

AbstractHigh dropout rates in online courses, caused by potential factors such as financial issues, low motivation and poor self‐regulation among learners, pose a significant challenge to the sustainable development of online education. Therefore, continuance of online courses has become a critical topic in both the academic and practical fields. By combining the Community of Inquiry framework (CoI) with Expectation‐Confirmation Theory, this study introduces three new constructs—confirmed teaching presence (CTP), confirmed cognitive presence (CCP) and confirmed social presence (CSP)—into the research model to understand how confirmed expectations towards CoI determine online learners' course continuance intention. Utilizing a mixed‐methods approach, the study conducted quantitative analysis on 409 learner surveys using partial least squares (PLS), followed by semi‐structured interviews, which revealed the depth and breadth of the confirmed CoI expectations on learners' willingness to continue learning. Specifically, the quantitative results uncovered the differential effects of CTP, CCP and CSP on learners' course continuance intentions by elucidating the internal mechanisms. The interviews provided deeper insights by illuminating online learners' initial expectations as well as their pre‐course and post‐course expectations. The findings of the study not only provide evidence of the crucial role of confirmed expectations in shaping online learners' course continuance intention but also offer actionable recommendations for improving online course design and fostering lifelong learning. Practitioner notesWhat is already known about this topic Online courses have expanded in scale and attracted a large number of learners in recent years, the large base of online learners has brought tremendous and unprecedented challenges to online course development. A high dropout rate is especially considered as a severe issue for online course development. The issue of learners' continuance intention was often explored from a technological perspective and at the platform level by using Information system (IS) theories. The community of inquiry (CoI) framework was extensively utilized as a theoretical basis for understanding online learning experiences and its three elements—teaching, cognitive and social presences—have long been deemed as major antecedents that influence learners' online learning behaviours and intentions. What this paper adds This paper integrated the community of inquiry (CoI) framework with Expectation confirmation theory and proposed three new variables: confirmed teaching presence (CTP), confirmed cognitive presence (CCP) and confirmed social presence (CSP). The study reveals the internal mechanisms by which the three confirmed expectations impact online learners' courses continuance intention. This implies that different confirmed expectations may have varying effects on online learners' learning behaviour. This research collects data from multiple sources to comprehensively explore online learners' expectations and perceptions. It also sheds light on the importance of learners' actual participation in the learning process for predicting their behavioural intentions. Implications for practice and/or policy The finding that learners' confirmed expectations impact their online course continuance intention conveys an important message to course practitioners: exaggerated or false claims for the online course must be avoided to prevent students from forming unrealistic expectations. Improving online learners' course completion rate cannot be hinged upon simply and blindly fostering and extending the three presences. Instead, knowing learners' confirmed expectations of the three presences allows course practitioners to reconsider and organize the important course elements. The research reveals the distinct role that each confirmed presence plays in promoting online learners' course continuance intention and, meanwhile, expands the understanding of learners' learning needs and experiences. Practitioners could make timely and appropriate strategies based on these to better motivate course learners' engagement and retention.

Fantasies and Fallacies of ‘Aesthetic’ Instagrammers

AbstractThe influence of Instagram, as a social media platform, in shaping perceptions of aesthetic surgery cannot be understated. The idea of a more “aesthetic” self cultivates a desire for cosmetic enhancements. This article underscores the profound impact of Instagram on aesthetic surgery, shedding light on both its fantasies and fallacies. Instagram, a medium for dissemination of content, often blurs the lines between fantasy and reality. Although the intent is to transfer credible information from the provider to the consumer, Instagram often contributes to the distortion of one's self-image and creates unrealistic expectations. Moreover, the glamorization of aesthetic surgery as a fast, effortless fix, often by commercially run enterprises, leads to misconceptions and impulsive decision-making. These fallacies are further compounded by the increase of misinformation and deceptive practices, presenting ethical challenges for influencers and surgeons alike. This study explores the ethical responsibilities of these “Aesthetic Instagrammers,” emphasizing the necessity for transparency and ethical guidelines, while analyzing all the social media stakeholders and providing suggestions for better engagement.

Understanding Digital Dementia and Cognitive Impact in the Current Era of the Internet: A Review.

Dementia encompasses symptoms resulting from brain damage that impairs cognitive functions, surpassing natural aging effects. This condition affects emotional regulation, behavior, and motivation while preserving consciousness. Dr. Manfred Spitzer coined the term 'digital dementia,' highlighting the cognitive decline associated with excessive reliance on digital devices such as smartphones and Google, potentially exacerbating attention deficit hyperactivity disorder (ADHD) and memory loss. This condition mirrors terms like 'digital amnesia' and 'the Google Effect,' highlighting the brain's tendency to offload peripheral information, leading to panic and forgetfulness. Spitzer's book, Digital Dementia, focuses on gaming effects on children and has thus popularized the term. Teenagers are known to use electronic devices regularly, correlating with rising cognitive impairments. The advent of the internet's fifth generation (5G) has transformed technology use, impacting mental health treatments and clinical practices globally. Digital media's influence on the developing brain encompasses motor skills, language, and cognition. Excessive digital media use in young adults correlates with lower cognitive empathy, affecting interpersonal understanding and facial recognition. Studies link heavy reliance on web-based media to decreased white matter integrity, crucial for language skills. Adolescents may be more vulnerable to anxiety and unrealistic expectations due to digital media overuse. Digital media overuse impacts brain development, especially cognitive and inhibitory control, attention, memory, and reasoning, essential for adapting to dynamic environments. Early exposure to fast-paced media can impair motor skills, spatial awareness, problem-solving, and language learning. Neuroimaging studies reveal that environmental factors like screen usage affect brain networks controlling social-emotional behavior and executive functions. Overreliance on smartphones diminishes gray matter in key brain regions, affecting cognitive and emotional regulation. The internet generation, characterized by advancements such as Web 3.0, introduces artificial intelligence and semantic web technologies, reshaping digital content processing. The neurobiological basis of digital dementia involves changes in the brain structure and function, with excessive screen exposure linked to cognitive impairments. Neuroplasticity, or the brain's adaptability, plays a role in cognitive decline from digital media overuse. Early childhood and adolescent brain development stages exhibit significant plasticity, influencing cognitive trajectories. Addressing digital dementia requires strategies to reduce screen time, promote cognitive exercises, and enhance awareness. Parents should regulate children's screen usage, encourage digital detox periods, and substitute screen time with other activities. Cognitive training programs such as Cogmed (Neural Assembly Int AB, Stockholm, SWE) and CogniFit (San Francisco, CA, USA) can improve memory and attention in older adults. Promoting balanced technology use and educating on the risks of excessive digital media consumption is crucial for maintaining cognitive health in the digital age.