Search Results (325)

American universities have always reached beyond knowledge development. They are constituted through and often defenders of rights central to free and fair democracy. This article makes a novel case for reinvigorated commitments to democratic civic education, including a normative commitment to the dignity of all persons that is institutionalized through equality before the law. The analysis cuts through contemporary pieties of the left and right. The focus is US higher education, including relationships with governments, law, policy, and civil society, proceeding in six significant sections. After defining key terms and the plan of this paper, I clarify the relatively recent innovation of rights and their absence around the world. Rights are foundational for free and fair democracy. I then review critical moments among state, civil society, the rule of law, and higher education across US history, demonstrating that values commitments are essential to establishing basic freedoms for a functioning democracy. The legal and cultural architecture of the rights tradition also undergirds sacred ideals in higher education, including academic freedom and institutional autonomy. That analysis leads to two highly contested issues—national security and policing—to suggest how contemporary institutional patterns undermine progress on critical university goals: deepened insight and/or principled disagreement. Evidence indicates courses related to policing and its critiques are siloed within curricula, student self-selection and institutional socioeconomic sorting undermine potentially related democratic dialogue, and both connect to position campus discourse out of step with marginalized communities. These issues intersect with a key point of this article: individual rights and the formal, legal embrace of shared dignity require government entities. In the final sections, I focus on institutional-level recommendations for civic education that expands commitments to human dignity and the rule of law within a free and fair democracy. Full article

Objective: Patient safety culture (PSC) is a critical determinant of healthcare quality. This study aimed to assess the current status of PSC among healthcare workers at Kien An Hospital, Hai Phong, Vietnam, and identify associated factors. Methods: A cross-sectional survey was conducted using the 12-dimension hospital survey on patient safety culture (HSOPSC). A total of 324 healthcare professionals (physicians, nurses, and allied staff) participated. Data were analyzed using descriptive statistics and multivariable logistic regression. Results: The positive response rate (PRR) across the 12 dimensions of patient safety culture (PSC) varied widely. The highest positive perceptions were observed in “Teamwork within units” (98.5%) and “Teamwork across units” (98.1%). Conversely, severe vulnerabilities in psychological safety were identified, with “Communication Openness” recording the absolute lowest PRR at 25.9%, closely followed by “Non-punitive response to error” at 29.0%. Comparative analysis between professional strata revealed broad alignment across 11 dimensions, with the sole significant divergence occurring in “Feedback and communication about error”, where physicians reported a significantly higher PRR than nurses & allied staff (85.8% vs. 75.2%; p = 0.04). In the multivariable logistic regression model, age emerged as the single independent predictor of overall positive PSC; compared to early-career staff (<30 years), healthcare workers aged 30–40 years (AOR = 4.17, p = 0.02) and 40–50 years (AOR = 5.03, p = 0.02) had significantly higher odds of favorable safety perceptions. Conclusions: Healthcare workers at the study hospital exhibit exceptionally strong collaborative teamwork, yet low communication openness and the fear of a punitive environment remain critical systemic barriers to safety. Because safety culture challenges are macro-institutional and disproportionately impact junior personnel, interventions should shift away from role-specific policies. Instead, hospital leadership must prioritize establishing non-punitive reporting mechanisms, enhancing open dialogue, and designing targeted safety culture onboarding initiatives tailored specifically to the needs of early-career healthcare workers to foster continuous organizational learning. Full article

Biomolecular and multi-omics approaches have transformed archaeology and heritage science, yet they are still widely conceptualized as ancillary techniques that refine narratives built on artifacts, architecture, and texts. This Perspective argues instead for treating molecules as primary archaeological evidence with their own epistemic status, temporalities, and bias structure. Drawing on a corpus of multi-omics case studies from the central and eastern Mediterranean (chiefly Sicily, Malta, and Egypt), together with comparative material from the lower Danube, Polynesia, and the Andes, and engaging directly with the philosophy of science, we adopt a critical entity realism grounded in the practice of physical intervention on molecular entities, and we develop evidential reasoning chains that connect instrumental data to historical phenomena. From this grounding, we propose a six-dimensional epistemic framework: (1) redefinition of archaeological evidence; (2) molecular counter-archive against preservation bias; (3) polytemporality of molecular signals; (4) ethics and conservation as internal epistemic variables; (5) identity, boundaries, and connectivity in a molecular key; and (6) methodological pluralism and interpretive convergence. The framework has concrete implications for curatorial policies, sampling strategy, and data governance, and opens a productive dialogue between biomolecular heritage science and archaeological theory. Full article

Large language models (LLMs) exhibit strong general conversational capabilities, yet their deployment in domain-specific service environments such as hospitality remains limited by the absence of emotionally grounded datasets and validated end-to-end system architectures. This paper presents HOSPIT-LLM, an EU-funded euROBIN Technology Exchange Program pilot, as a complete, integrated pilot pipeline for human-centered conversational AI in hotel reception scenarios. We deploy a multimodal hotel-terminal assistant in a real hotel reception, capturing synchronized dual-camera video and audio to collect authentic guest–staff interactions. Speech is transcribed using Whisper, and emotion is extracted from the corresponding video segments via DeepFace, producing 582 real Greek guest–receptionist exchange examples. The resulting data are classified into eight Standard Operating Procedure (SOP) categories. To address data scarcity, we augment the corpus with 1269 synthetic dialogues generated by eight diverse LLMs through the OpenRouter API, yielding a total of 1851 dialogue records with explicit emotion-token annotation. We fine-tune Qwen3.5-35B-A3B using Low-Rank Adaptation (LoRA) through a two-stage process: supervised fine-tuning (SFT) on an 888-example conversation pool and Simple Preference Optimization (SimPO) on a 1899-pair preference pool, each split 80/10/10 into training, validation, and test. The resulting model is integrated into an interactive hotel-terminal system combining YOLO-based person detection, face-recognition-driven guest personalization, Kokoro neural text-to-speech (TTS), and a multi-service orchestration layer connected to the hotel Property Management System (PMS). Evaluation combines standard text metrics, emotion-aware scoring, and a large-model judge. The results indicate targeted improvements in the rule-based contextual emotion-policy match and staff-emotion policy compliance compared to the base model, while general response-quality gains remain more modest. In particular, the rule-based contextual policy-match score improves from 0.614 to 0.901, while forbidden staff-emotion outputs decrease from 0.142 to 0.018. The deployed pilot demonstrates the practical integration of a personalized, emotion-aware LLM assistant in an interactive hotel-terminal setting; end-to-end latency and fully hotel-side edge deployment were not evaluated and are left for future work. HOSPIT-LLM provides a reproducible framework for multimodal dataset creation, preference-based fine-tuning, and deployment of human-centered AI systems. A mobile robotic embodiment is planned as future work. Full article

The Eastern Mediterranean has always been a space where religious traditions, geopolitical antagonisms, and migratory waves intersect, yet existing literature treats religious diplomacy, climate geopolitics, and the securitization of migration as separate fields, leaving a significant research gap for 2015–2025. Drawing on Appleby’s notion of the “ambivalence of the sacred,” this study proposes the Eastern Mediterranean as a “religious geopolitical zone”—a space in which Islamic and Christian institutions move simultaneously, rather than sequentially, between humanitarian dialogue and securitization under accelerating climate pressure. Combining Critical Geopolitics, Copenhagen School securitization theory, and Environmental Peacebuilding, it applies geopolitical discourse analysis to texts by the Vatican, Al-Azhar, the Ecumenical Patriarchate, Diyanet, and Sant’Egidio, together with UNHCR, IOM, and IPCC data. The analysis shows that religious rhetoric functions concurrently as a securitizing “speech-act” that legitimizes exclusionary policies through cultural nationalism and a foundation for humanitarian cooperation, as evidenced by the Sant’Egidio Humanitarian Corridors and the Vatican–Al-Azhar dialogue. Climate change likewise operates simultaneously as a material multiplier of tension and as a semiotic resource that either reinforces securitization or establishes a common moral basis for interfaith environmental action. The findings offer an analytical model that enriches securitization theory, Critical Geopolitics, and the religious diplomacy literature, with implications for actors seeking to move the region toward sustainable cooperation. Full article

Global environmental change, biodiversity loss, emerging infectious diseases, antimicrobial resistance, and widening social inequalities increasingly interact to create complex risks for human, animal, and ecosystem health. Although international One Health frameworks and funding mechanisms are essential, implementation at national and especially community levels often remains uneven, fragmented, and weakly evaluated. This Perspective presents a structured, reproducible networking model designed to strengthen community-level One Health implementation through voluntary global collaboration among civil society organisations. The model connects bottom-up community mobilisation with interdisciplinary scientific support, shared evaluation templates, and iterative learning cycles. It outlines a transparent process for identifying and engaging One Health-oriented organisations and for organising their collaboration through thematic Project Working Groups that support situation analysis, strategic planning, implementation, evaluation, and dissemination. The framework translates community action into seven intervention fields: surveillance and early warning, animal health and welfare, water/sanitation/hygiene, food safety and food systems, community awareness and education, environmental risks and ecosystem health, and multisectoral governance. By linking local practice to comparative synthesis, joint publication, and policy dialogue, the network aims to transform isolated initiatives into a coordinated learning system while preserving community and organisational autonomy. As a conceptual framework, the model is ready for empirical testing in diverse settings to assess feasibility, participation, and evaluation quality. Full article

Background/Objectives: Medical devices are essential to modern healthcare, but their adoption is often driven by regulatory conformity, clinical enthusiasm, procurement pressures and vendor-led innovation rather than systematic evaluation of comparative value. CE marking and related regulatory mechanisms are necessary for market access; however, they do not determine whether a device improves patient-related outcomes compared with existing alternatives, whether its benefits justify its total costs, or whether it can be implemented safely in routine care. This narrative review examines why medical devices require a dedicated life-cycle health technology assessment (HTA) approach and proposes an operational framework linking assessment to adoption, evidence generation, reassessment and disinvestment. Methods: A structured targeted search covered peer-reviewed literature and policy or institutional documents addressing HTA, medical devices, regulation, economic evaluation, real-world evidence, hospital-based HTA, procurement digital and AI-enabled devices, patient involvement and post-market reassessment. Results: Medical devices differ from pharmaceuticals through user dependence, learning curves, procedure dependence, short product life cycles, incremental modification, heterogeneous comparators, limited randomized evidence and hidden life-cycle costs. These features create clinical, economic, organizational and implementation uncertainty after market entry. The proposed model specifies six linked phases: horizon scanning and early dialogue, pre-adoption appraisal, an explicit adoption decision, controlled implementation, real-world monitoring and scheduled or trigger-based reassessment leading to continuation, scale-up, restriction, or disinvestment. Practical constraints include fragmented data infrastructure, the cost of maintaining registries and residual confounding in real-world evidence. Conclusions: Medical device HTA should move beyond one-time pre-adoption assessment toward a decision-linked life-cycle model that integrates comparative value, patient and public involvement, procurement, implementation governance, real-world evidence, version monitoring, reassessment and disinvestment. This approach can support responsible innovation, patient safety, transparent procurement and sustainable health-system value. Full article

Scholarship on civic engagement and democratic culture has long emphasized dialogue, inclusion, and the recognition of marginalized voices, yet the legal and civic status of individuals with disabilities—particularly those with Down syndrome—remains insufficiently examined within this literature. This article addresses that gap by exploring how civic education and civic engagement, as supported by law at public universities, can better account for disability as a matter of democratic membership, dignity, and participation. Drawing on historical and contemporary analysis, the article examines the persistence and transformation of eugenic narratives supported by law as one underappreciated mechanism through which exclusion and devaluation continue to shape civic life. Historically, eugenic ideas influenced law, culture, and public policy by normalizing hierarchies based on health, appearance, and perceived ability. Contemporary forms of such reasoning, while often less explicit, continue to surface across legal and cultural divides, raising important questions for civic education and public deliberation. By situating disability within broader debates about civic inclusion, empathy, and democratic formation at institutions supported by law, this article argues for a more robust and balanced paradigm of civic engagement—one that critically confronts exclusionary narratives while affirming the civic agency, legal rights, and perspectives of individuals with disabilities, including those with Down syndrome and with respect to comprehensive considerations in prenatal contexts. Full article

This paper examines how sequenced cross-border health initiatives may contribute to confidence-building and, ultimately, serve as catalyst toward more coherent cross-border migration-related governance in North Africa. Using a practice-based case study approach, it analyzes a series of regional processes implemented in 2024 and 2025 by the International Organization for Migration (IOM), in collaboration with the WHO Regional Office for the Eastern Mediterranean (WHO EMRO) and Africa CDC, including two technical workshops in Tunis, a sub-regional simulation exercise in Cairo, and a Mediterranean Forum. The analysis draws on process documentation, institutional outputs, and the authors’ direct involvement in these initiatives to trace how repeated technical engagement supported procedural alignment and the gradual building of confidence for cross-border collaboration. Key outputs included a draft operational plan, a technical white paper, and regional policy recommendations. The paper argues that, in politically sensitive migration settings, cross-border health cooperation—jointly engaging ministries of health, interior, and foreign affairs—can provide an entry point for dialogue, joint problem-solving, and confidence-building across countries and sectors, thereby enhancing collaborative governance. While such collaboration does not directly determine migration policy, it may contribute to health diplomacy efforts that foster a more coherent governance environment capable of supporting safer, more orderly, and better-coordinated migration processes. Although several operational questions remain unresolved and more studies are need it, this paper seeks to open further dialogue and encourage new evidence and reflection on the potential role of health as a catalyst for collaborative governance and confidence-building between countries. Full article

Higher education plays a crucial role in equipping citizens to tackle contemporary socio-ecological challenges. However, little research has examined how different generations of university students understand socioecological transitions, or the implications of these differences for sustainability education. This study compares the perceptions of older learners (aged 55–70) enrolled in the ‘Classrooms of Experience’ programme with those of undergraduate students (aged 18–28) from the Faculty of Economics and Business at the University of the Basque Country (UPV/EHU). Qualitative data were collected from approximately 250 participants during the 2023/24 and 2024/25 academic years. The data were analysed using the Grid Elaboration Method and the IRaMuTeQ (Version 0.8 Alpha 7) text analysis tool to identify semantic structures, symbolic associations and patterns of meaning across the two age groups. The findings reveal significant generational differences in understanding socioecological transitions. Older learners tend to frame transitions as regulated processes linked to institutional action, public policy, welfare, and quality of life. In contrast, younger students interpret socioecological transitions as responses to interconnected ecological and social crises, emphasising socioecological justice, responsibility, sustainability, and technological innovation as key drivers of transformation. These results suggest the coexistence of complementary yet distinct socioecological imaginaries within the university context. The study highlights the pedagogical value of intergenerational dialogue and learning in higher education. By bringing together diverse perspectives on sustainability, universities can promote more critical, reflective, and transformative educational processes that are capable of addressing the complex challenges of contemporary socioecological transitions. Full article

Universities are increasingly expected to contribute not only to teaching and research, but also to public-sector innovation, regional development, and digitally enabled governance. This article examines how higher education institutions organize that contribution by comparing two university-based transfer architectures: Smart-EDU Hub @ SNSPA in Bucharest and the distributed transfer portfolio of RheinMain University of Applied Sciences and Arts (HSRM). Using a qualitative comparative case-study design based on the document analysis of internal strategy and regulatory documents, institutional webpages, and European policy frameworks, the study analyzes the mission framing, organizational form, program architecture, trust infra-structure, and scaling logic. The documentary analysis indicates that Smart-EDU Hub is formally presented and institutionally organized as a centralized, branded, mission-led platform that bundles conferences, courses, projects, visiting scholars, and publication channels under a recognizable public-facing identity. HSRM, by contrast, is documented as a distributed transfer portfolio linking transfer strategy, dialogue formats, digitally supported teaching, administrative digitalization, continuing education, and AI support services. The comparison should therefore be read as an analysis of formal and publicly documented transfer architectures, not as an evaluation of actual institutional performance, stakeholder experience, or societal impact. The article contributes to Administrative Sciences by conceptualizing university transfer for smart governance as a public-management and governance-design problem. It develops an analytical hybrid transfer-architecture framework in which a visible hub is combined with distributed specialist nodes, shared quality assurance, and explicit safeguards for ethics, cybersecurity, and trustworthy AI. Full article

Practice-oriented or practice-based research is growing in popularity in the social, built environment and health fields for its important role in driving transformative changes at policy, programme/service and practice levels. As planning is a practice with performative characteristics occurring in a socio-political-legal context, practice-oriented research has been utilised to inform and help shape change. However, to be truly effective, practice-oriented research must be connected to day-to-day practices. In this article, we present our experience of using a Community of Practice (CoP)—that brings together people with shared interests and professions—to exchange learning and experiences and to help create knowledge to advance professional practice. In our case, we established a Community of Practice of Planners (CoPP) to help translate stage one findings into tailored knowledge resources to open up a dialogue and raise awareness on Planning for Disability Equity and Inclusion. In this article, we describe the method of CoP, how it works, including our reflections and learnings. We suggest that CoP are an underutilised method in planning practice and research. We argue that the CoP approach should be in a researcher and planner’s toolbox for more transformative progress in equity and inclusion in planning. Full article

The tension between corporate growth and sustainability is a common governance dilemma faced by transitional economies in their green development. This study incorporates corporate ESG performance and its potential influencing factors into the analysis framework and constructs a theoretical model to capture the relationship between China’s National Demonstration Base policy for Mass Entrepreneurship and Innovation (MEI) and corporate ESG performance, based on the framework that integrates resource enablement, reputation accumulation and information governance. Leveraging the quasi-natural experiment provided by China’s National Demonstration Program for Mass Entrepreneurship and Innovation (MEI), this study systematically evaluates the impact of China’s demonstration policy on corporate ESG performance, drawing on data from A-share listed companies spanning 2010 to 2024. The study finds that the demonstration policy significantly improves enterprise ESG performance, which remains robust after a series of robustness tests. The mechanism test reveals that the policy promotes firms’ green technology innovation by lowering innovation costs, facilitates the accumulation of social reputational capital by incentivizing charitable donations, and compels improvements in information disclosure quality by strengthening market-oriented oversight. Heterogeneity analysis shows that the policy effects are more prominent among heavy polluting industries, large-scale enterprises and firms at the mature stage. Moreover, industry competition intensity and digital transformation have a positive moderating effect on the policy effects. This paper enriches the theoretical dialogue between institutional innovation policy and enterprise sustainable development, providing empirical evidence for the development of a collaborative ESG governance mechanism characterized by an active government and an efficient market. Full article

Background: The retention of Clinical Research Associates (CRAs) is critical for the integrity and sustainability of clinical trials in South Africa, an emerging hub for global clinical research. High CRA turnover threatens trial quality, data continuity, and site relationships, yet the context-specific drivers of turnover within the South African clinical research landscape remain poorly understood. This study explores the factors influencing job satisfaction and turnover intentions among CRAs to inform targeted retention strategies. Methods: A qualitative, interpretivist study was conducted using semi-structured interviews. Twelve CRAs with experience in South African Contract Research Organizations (CROs) were sampled on LinkedIn using purposive sampling. Data were analyzed iteratively using thematic analysis within Atlas.ti 26.0.1.33961 software, guided by Herzberg’s Two-Factor Theory and Mobley’s Turnover Model. Results: The analysis revealed a complex model of turnover drivers. Compensation was the most salient factor, operating not only as a hygiene factor but also as a direct motivator for job mobility in a competitive market. Unsustainable workload and a culture stigmatizing discussions of overload were key push factors. Intrinsic motivators were equally decisive: misalignment with therapeutic area preferences caused profound dissatisfaction, while alignment fostered engagement. Career growth manifested dual pathways: ambition for vertical progression and a redefined search for horizontal growth into roles offering greater work-life flexibility. Conclusions: CRA turnover is driven by an interplay of extrinsic pressures and intrinsic motivational deficits. To enhance retention, managers must adopt a multi-pronged strategy: implement market-competitive, well-being-oriented compensation; foster a culture that supports open workload dialogue; create transparent career architectures with dual progression tracks; and facilitate internal mobility across therapeutic areas. This study provides a foundational framework for developing context-sensitive retention policies, thereby contributing to the stability and quality of clinical research in South Africa. Full article

Indigenous students continue to experience persistent educational inequities shaped by colonial histories, assimilationist schooling structures, and the marginalization of Indigenous knowledge systems. Although social–emotional learning (SEL) is widely promoted as foundational to student well-being and academic success, dominant SEL frameworks often reflect Eurocentric assumptions that overlook Indigenous understandings of relationality, land, identity, healing, and collective responsibility. In alignment with Sustainable Development Goal 4 (SDG 4), this study examines how SEL and teacher professional development can be reimagined through Indigenous and Local Knowledge (ILK). Using a qualitative collaborative ethnographic design integrated with a structured literature synthesis, the study drew on two years of community-engaged research involving collaborative focus group dialogues, community interactions, and sustained relational engagement with Native teachers, Elders, cultural leaders, and community practitioners (N = 20). Thematic analysis revealed five interrelated themes: culturally grounded SEL frameworks, structural barriers and equity-driven strategies, culture as prevention and healing, schoolwide conditions that sustain belonging and identity, and alignment between Indigenous-centered SEL and SDG 4. Findings highlight the importance of cultural identity, ceremony, storytelling, Elder mentorship, talking circles, land-based learning, relational accountability, and community partnerships in supporting meaningful SEL. The findings also reveal tensions between Indigenous relational approaches to SEL and dominant educational systems shaped by standardization, accountability pressures, and assimilationist schooling structures. The study advances a conceptual model showing how Indigenous-centered SEL, mediated through relational teacher professional development, can support culturally sustaining, healing-centered, equity-oriented, and sovereignty-affirming educational outcomes aligned with SDG 4. In addition to contributing to SEL scholarship, the study offers implications for teacher education, educational policy, and school leadership seeking to advance culturally sustaining and community-responsive educational systems. Full article