Foundational Tenets Research Articles

Specificity in the Study of Mixed Emotions: A Theoretical Framework

Research on mixed emotions is yet to consider emotion-specificity, the idea that same-valenced emotions have distinctive characteristics and functions. We review two decades of research on mixed emotions, focusing on evidence for the occurrence of mixed emotions and the effects of mixed emotions on downstream outcomes. We then propose a novel theoretical framework of mixed-emotion-specificity with three foundational tenets: (a) Mixed emotions are distinguishable from single-valenced emotions and other mixed emotions based on their emotion-appraisal relationships; (b) Mixed emotions can further be characterized by four patterns that describe relationships between simultaneous appraisals or appraisals that are unique to mixed emotions; and (c) Carryover effects occur only on outcomes that are associated with the appraisal characteristics of mixed emotion. We outline how mixed-emotion-specific effects can be predicted based on the appraisal tendency framework. Temporal dynamics, the application of mixed-emotion-specificity to individual difference research, methodological issues, and future directions are also discussed.

Ansoff’s Strategic Turbulence Model: Why It’s Important to Marketing Strategy

The purpose of this paper is to briefly introduce the reader to Ansoffian strategy and the concepts of environmental turbulence and examine their impact on marketing strategy. The authors overlay Ansoff’s identification of turbulence levels to marketing strategy as a dynamic synergy of management processes and innovation which depends on a firm’s posturing to address marketing aggressiveness and environmental turbulence. 
 
 Within the environmental turbulence model, Ansoff puts forth that the third level is where marketing becomes a critical functional activity of strategic success and where customers and competitors are factors in the environmental turbulence. Advancing to levels four and five, firms must now integrate the latest technologies and processes required to facilitate and create innovation in response to a faster-moving, dynamic, and surpriseful environment. Ansoff described the changing turbulence levels as increasing unpredictability, novelty, and complex, especially when considering movement from his level four (exploring) turbulence level to a level five (creative and “surpriseful”). 
 
 When the environment shifts to the highest level of disruption-discontinuity where change is occurring faster and more surpriseful, a firm must adopt a heightened level of strategic aggressiveness into the organizational structure and rapidly adapt marketing postures and strategies to reposition the firm’s marketing mix to optimize opportunities and mitigate change threats. Through the lens of discontinuous environmental turbulence, the authors explore recent and extant research and unravel how new strategic marketing principles align with the foundational tenets of Ansoff’s strategic diagnosis and gap analysis methodology by analyzing the internal environment and comparing it to the external environment. Additionally, the researchers explore how the greater the “gap” between capabilities and marketing strategy, the more the firm needs to perform a realignment of itself to mitigate the impending effects of the environmental turbulence pressures.

Body Knowledge, Reproductive Anxiety, and "Paying the Rent" in Octavia E. Butler's "Bloodchild"

In this article, we read Octavia E. Butler's "Bloodchild" as a "paying the rent" story in which reproduction functions as the source of payment made by the Terrans to the Tlic. We use Jenkins's distinctions between "hierarchical body knowledge" and "intelligent body knowledge," which derive from Butler's conception of "body knowledge," to argue that the Tlic's reproduction anxiety results from a legacy of "hierarchical body knowledge" that persists in their approaches to and valuation of their Terran trade partners. The problem with hierarchical body knowledge, as Butler suggests in "Bloodchild," is that it fosters social stratification at the expense of survival and could lead both groups to one-up themselves to death. To avoid such a fate, the story suggests that both groups need to develop a symbiotic love for each other, a love rooted in one of the foundational tenets of intelligent body knowledge—that a body's survival value is more important than its social value.

‘True Champions and Incredible Patriots’

n the United States, a championship-winning sports team’s ceremonial visit to the White House has become a familiar tradition. Beginning nearly a century ago when Calvin Coolidge invited the Washington Senators to celebrate their second American League Pennant in 1924, the White House visit has evolved into such a common occurrence that we tend to take it for granted as a public relations ploy for the political elites and sports darlings of the moment, ultimately bearing little consequence for either. Yet the rhetorical strategies involved in these events reveal shifting understandings of sports’ role in American culture along with interrelated anxieties about what defines the United St ates as a nation. Especially in the context of a turbulent and divisive social climate under President Trump, the ceremonial White House visit has become an unlikely stage for displaying overarching ideological tensions. The controversies surrounding Trump’s invitations and disinvitations, as well as players’ acceptances and rejections, illuminate the inherently political dimensions of sport as athletes conform to, negotiate, or in many cases subvert societal expectations. Mounting disruptions of an enduring White House ritual have initiated a dialogue about leaders hip, honor, and freedom, foundational tenets of the US and the office that represents it.

Assessing Fluid Intolerance with Doppler Ultrasonography: A Physiological Framework.

Ultrasonography is becoming the favored hemodynamic monitoring utensil of emergentologists, anesthesiologists and intensivists. While the roles of ultrasound grow and evolve, many clinical applications of ultrasound stem from qualitative, image-based protocols, especially for diagnosing and managing circulatory failure. Often, these algorithms imply or suggest treatment. For example, intravenous fluids are opted for or against based upon ultrasonographic signs of preload and estimation of the left ventricular ejection fraction. Though appealing, image-based algorithms skirt some foundational tenets of cardiac physiology; namely, (1) the relationship between cardiac filling and stroke volume varies considerably in the critically ill, (2) the correlation between cardiac filling and total vascular volume is poor and (3) the ejection fraction is not purely an appraisal of cardiac function but rather a measure of coupling between the ventricle and the arterial load. Therefore, management decisions could be enhanced by quantitative approaches, enabled by Doppler ultrasonography. Both fluid ‘responsiveness’ and ‘tolerance’ are evaluated by Doppler ultrasound, but the physiological relationship between these constructs is nebulous. Accordingly, it is argued that the link between them is founded upon the Frank–Starling–Sarnoff relationship and that this framework helps direct future ultrasound protocols, explains seemingly discordant findings and steers new routes of enquiry.

Enhancing the Imago Dei: Can a Christian Be a Transhumanist?

Abstract Transhumanism is an ideology that embraces the use of various forms of biotechnology to enhance human beings toward the emergence of a “posthuman” kind. In this article, I contrast some of the foundational tenets of Transhumanism with those of Christianity, primarily focusing on their respective anthropologies—that is, their diverse understandings of whether there is an essential nature shared by all human persons and, if so, whether certain features of human nature may be intentionally altered in ways that contribute toward how each views human flourishing. A central point of difference concerns Transhumanists’ aim of attaining “substrate independence” for the human mind, such that one’s consciousness could be uploaded into a cybernetic environment. Christian anthropology, on the other hand, considers embodiment, with its characteristics of vulnerability and finitude, to be an essential feature of human nature—hence, Christians’ belief in bodily resurrection. Despite Christianity and Transhumanism having fundamental differences, I contend that Christians may support moderate forms of enhancement oriented toward supporting our flourishing as living, sentient, social, and rational animals.

Can Family Medicine's Counterculture History Help Shape an Anti-Racist Future?

Family medicine prides itself on community engagement and has embraced its counterculture roots. After the racial and social reckoning of 2020, including the COVID-19 pandemic and the Black Lives Matters movement, family medicine, as a specialty, must embrace anti-racism as a core value to meet community needs. This article reflects on the foundational tenets of family medicine's origin. It highlights the current disparities regarding professional representation while offering equitable, intentional, and collaborative approaches to move toward and achieve anti-racism within the specialty, medical education, and the community.

GASTRIC ADENOCARCINOMA MASQUERADING AS CHRONIC COUGH

TOPIC: Pulmonary Manifestations of Systemic Disease TYPE: Medical Student/Resident Case Reports INTRODUCTION: Chronic cough in adults is defined by cough lasting for at least eight weeks in duration. It remains one of the most common symptoms encountered in ambulatory care, largely attributed to Upper Airway Cough Syndrome (UACS), Asthma, Non-asthmatic Eosinophilic Bronchitis (NAEB), or Gastroesophageal Reflux Disease (GERD). Other less common etiologies shouldn't be overlooked, such as those disorders which stimulate cough receptors. These receptors are located throughout the body including the gastrointestinal tract;irritation of any of these can trigger the vagal-mediated afferent limb of the cough reflex arc. We present the case of a patient with gastric cancer with an initial complaint of three months of cough with associated dyspnea. CASE PRESENTATION: A 33-year-old male with a medical history of obstructive sleep apnea, prior tobacco use, and GERD presented with a three month history of dry cough, fatigue, and dyspnea. Previous primary care visits were conducted via telehealth amid the COVID-19 pandemic, where he was empirically treated with therapies for UACS, asthma, and reflux disease without improvement. His physical exam and chest radiograph were unremarkable. Pulmonary function tests were not obtained secondary to profound coughing with forced exhalation maneuvers. On further questioning, he endorsed early satiety, 10-pound weight loss, and a family history of stomach cancer. CT of the chest demonstrated questionable gastric thickening, retroperitoneal lymphadenopathy surrounding the mesenteric root, a nine millimeter lytic lucency along the right periphery of the 11th thoracic vertebral body, and subtle diffuse peripheral tree-in-bud pulmonary opacities. Bronchoscopy with lavage, brushings, and endobronchial biopsies were negative for infection, granulomas, or malignancy. Upper endoscopy revealed a laterally spreading lesion with central ulceration in the gastric cardia, with biopsy consistent with poorly differentiated gastric adenocarcinoma. Stage IV disease was confirmed by retroperitoneal lymph node sampling. DISCUSSION: Gastric cancer represents 1.4% of all new cancer cases annually in the U.S., most frequently in the sixth decade of life in those with multiple risk factors. Our patient presented nearly three decades earlier with a chronic cough which is exceedingly rare. Plausible risk factors for our patient include male sex, Hispanic ethnicity, obesity, prior tobacco use, and familial predisposition. Early symptoms are equivocal but usually include abdominal pain and weight loss. Respiratory symptoms generally portend late-stage metastasis to the lungs or pulmonary embolism, which our patient did not exhibit. CONCLUSIONS: While UACS, Asthma, NAEB, and GERD remain the most conceivable etiologies of chronic cough, fully investigating all red flag symptoms during patient encounters, with consideration of uncommon causes, endure as foundational tenets of chronic cough evaluation. REFERENCE #1: Irwin RS, French CL, Chang AB, Altman KW, CHEST Expert Cough Panel*. Classification of cough as a symptom in adults and management algorithms: chest guideline and expert panel report. Chest. 2018;153(1):196-209. REFERENCE #2: Kou A, Patel JK, Adetula I, Frunzi J. Gastric cancer presenting as persistent pneumonia: an unusual case report. Cureus. Published online March 21, 2021. REFERENCE #3: Polverino M, Polverino F, Fasolino M, Ando F, Alfieri A, De Blasio F. Anatomy and neuro-pathophysiology of the cough reflex arc. Multidiscip Respir Med. 2012;7(1):5. DISCLOSURES: No relevant relationships by Patrick Kicker, source=Web Response No relevant relationships by Ashley Soler Acevedo, source=Web Response

'We're both here to do a job and that's all that matters': Cisgender correctional officer recruit reflections within an unsettled correctional prison culture.

Reflecting on new trans prisoner placement policies within Canadian federal prisons, in light of recent changes instigated under the Canadian Liberal Trudeau government, we provide knowledge from cisgender correctional officer (CO) recruits regarding these policy changes and underscore their views of working with officers who identify as transgender. Canada's new policies recognize the presence of trans prisoners and create new protocols accordingly, simultaneously challenging some of the foundational tenets of the carceral system. While overwhelming support exists from cisgender recruits for their trans colleagues, support among a relative minority of COs is contingent upon notions like safety and security grounded in a dominantly cisgender prison culture; a culture we situate within the wider context of an unsettled correctional prison culture.

Six ways to get a grip on leveraging the expertise of Instructional Design and Technology professionals.

We underutilize the knowledge and skills of Instructional Design and Technology (IDT) professionals, despite the frequent challenges in implementing learning technologies in medical education. This is largely due to a lack of understanding among stakeholders regarding the expertise of IDT professionals and their role in technology implementation processes. We seek to improve technology implementation outcomes by explaining the IDT field’s foundational tenets of a systems perspective and disciplined approach, clarifying the role that IDT professionals can play in educational technology initiatives, and providing guidance on how to foster productive collaborations in pursuit of effective technology-enhanced learning.

The Case for Holistic Review in Communication Sciences and Disorders Admissions

Purpose: The purpose of this article is to review the foundational tenets and current evidence regarding holistic review for graduate admissions that can be applied specifically to the field of communication sciences and disorders (CSD). Holistic review represents a paradigm shift from expecting the best students as those with the highest academic metrics to those who are a best fit with the mission, values, and goals of any program. This shift may be challenging for widespread adoption by the CSD field. It requires reconsideration of long-standing traditions and beliefs about admissions criteria, and a strong definition of what makes a successful student and future practitioner. Conclusions: A comprehensive exploration of current knowledge around holistic review and faculty perceptions or hesitations could inform future policies, create a unified effort across the fields of speech-language pathology and audiology, and inspire collaborative work among graduate programs. We have the opportunity to facilitate changes that will ultimately result in a workforce that reflects the world in which we live and the populations we serve. Graduate CSD programs must be training students who are both academically successful and who provide culturally sensitive, responsive, and competent clinical care.

The dynamics of food shopping behavior: Exploring travel patterns in low-income Detroit neighborhoods experiencing extreme disinvestment using agent-based modeling.

Only a handful of studies have leveraged agent-based models (ABMs) to examine public health outcomes and policy interventions associated with uneven urban food environments. While providing keen insights about the role of ABMs in studying urban food environments, these studies underutilize real-world data on individual behavior in their models. This study provides a unique contribution to the ABM and food access literature by utilizing survey data to develop an empirically-rich spatially-explicit ABM of food access. This model is used to simulate and scrutinize individual travel behavior associated with accessing food in low-income neighborhoods experiencing disinvestment in Detroit (Michigan), U.S. In particular, the relationship between trip frequencies, mode of travel, store choice, and distances traveled among individuals grouped into strata based on selected sociodemographic characteristics, including household income and age, is examined. Results reveal a diversified picture of not only how income and age shape food shopping travel but also the different thresholds of tolerance for non-motorized travel to stores. Younger and poorer population subgroups have a higher propensity to utilize non-motorized travel for shopping than older and wealthier subgroups. While all groups tend to travel considerable distances outside their immediate local food environment, different sociodemographic groups maintain unique spatial patterns of grocery-shopping behavior throughout the city and the suburbs. Overall, these results challenge foundational tenets in urban planning and design, regarding the specific characteristics necessary in the built environment to facilitate accessibility to urban amenities, such as grocery stores. In neighborhoods experiencing disinvestment, sociodemographic conditions play a more important role than the built environment in shaping food accessibility and ultimately travel behavior.

The development and future of occupational science: A budding occupational scientist’s reflections and assertions about the discipline

ABSTRACT As occupational science moves beyond 30 years as an academic discipline, reviewing its genesis and development is important in envisioning its future as a continually relevant, socially responsive discipline that addresses globally concerning issues. My positionality in writing this article is as a budding occupational scientist who has experience as an occupational therapy practitioner and educator, offering a multi-varied lens through which I am beginning to see and process concepts about the discipline. Thus, I reflect on aspects of the historical development of occupational science, offering my perspectives on the context that supported its genesis and identifying four foundational tenets that I perceive to have underpinned the science’s initial historical contributions. Then, pre-existing published literature forms the basis for an overview of where and how occupational science has developed globally and supports my thoughts about the relationship of occupational science to occupational therapy and its potential impact on continued disciplinary growth and maturation. A compilation of already established concepts guides my commentary on how research and theory development should study and measure occupation in a transformative and socially responsible way, how language factors have influenced expansion and incorporation of occupational science globally, the role of interdisciplinarity in shaping knowledge generation, and the influence of teaching and learning on the education of future generations of scientists. Finally, a synthesis of views from the literature shapes my recommendations for future disciplinary growth and societal contribution.

The depth of brand engagement funnel: dimensionalizing interaction in social media brand communities

Purpose This paper aims to contribute to the augmenting literature on consumer brand engagement (CBE) in social media brand communities (SMBCs) by offering the model of the depth of brand engagement funnel (DOBEF). The model is intended to complement the multi-dimensional conceptualization of CBE in the extant consumer behaviour literature and to critically address some of its foundational tenets. Design/methodology/approach A computer-mediated discourse analytic (CMDA) approach is adopted while using a mixed methods research design whereby qualitative data are quantified with a view to enhancing the robustness of the interpretive procedure. The data comprise 170 UGC posts stemming from three fast-moving consumer goods brands’ SMBC threads. Additionally, a netnographic approach is adopted in data collection, while data analysis/synthesis proceeds with the application of the laddering technique with the aid of the computer-aided qualitative discourse analytic CAQDAS software atlas.ti. Findings The bulk of user-generated content (UGC) in the scrutinized brand initiated thematic threads were found to be relevant, albeit negatively valenced or lacking in relevance altogether. This behavioural response pattern to brand initiated themes poses significant constraints to the level and quality of CBE. Multi-dimensional engagement across the DOBEF’s strata was found to be scarce, while engagement diminishes gravely as the upper layers of the model are reached. Research limitations/implications By conducting analyses on coded data alongside DOBEF’s strata, rather than treating consumer comments as raw data, the narrowing down of the semantic focus of posted comments in a thread-specific fashion is enabled, thus meeting the narrow contextualization criterion that is lacking from various studies in the extant literature. Practical implications By shifting focus in identifying CBE levels in SMBCs from attitudinal/behavioural antecedents/outcomes towards the content of the interaction, a nuanced perspective is offered as regards the depth of interaction, while addressing posted comments not only in terms of valencing, but even more importantly of valorization. Social implications By attending closely to incidents of negative brand engagement, and by dimensionalizing engagement along the funnel’s strata, a more nuanced understanding of territories where brand communities contribute to the dilution, rather than the enhancement of brand equity was obtained. Originality/value This is the first paper that discusses engagement on the grounds of deeply-laden consumer axiologies and the degree to which these are congruent with specific brand initiated thematic threads in SMBCs. It is anticipated that the discourse analytic (DA) approach that is adopted here will instigate further research that attends to UGC in a small-data, highly context-specific, rather than a big-data vein.

Early Modern Theatre and the Figure of Disability by Genevieve Love

Reviewed by: Early Modern Theatre and the Figure of Disability by Genevieve Love Jarred Wiehe EARLY MODERN THEATRE AND THE FIGURE OF DISABILITY. By Genevieve Love. Arden Studies in Early Modern Drama series. London: Bloomsbury Arden Shakespeare, 2019; pp. 224. Two of the foundational tenets of disability studies are resisting the use of disability and illness as metaphor (Susan Sontag) and resisting using disability as a “narrative prosthesis,” a narrative device that either overburdens the disabled body with meaning or hollows it out as a storytelling tool (David T. Mitchell and Sharon L. Snyder). Such formulations create stigmas and myths around disability while placing disability in service of something else (often to show that able-bodiedness is the baseline, natural, and normal state of the body). When attending to disability in premodern literature and culture, metaphor and narrative prosthesis become critical pitfalls as scholars are pulled either to consider disability as discourse and rhetoric or try to recover how “real” disabled people lived in the past. Thankfully, there are a number of studies that avoid these pitfalls, often by directly challenging them. Elizabeth Bearden’s Monstrous Kinds and Jason Farr’s Novel Bodies, for instance, weigh the differences between the real and the discursive. Collections like Allison P. Hobgood and David Houston Wood’s Recovering Disability in Early Modern England, Helen Deutsch and Felicity Nussbaum’s Defects: Engendering the Modern Body, and Chris Mounsey’s The Idea of Disability in the Eighteenth Century ask scholars to think through similar theoretical cruxes. Genevieve Love’s Early Modern Theatre and the Figure of Disability may be added to this list, as it deftly highlights and narrates these tensions—between real and representative, material and discursive, metaphor and lived experience. Love thinks deliberately and specifically about disability figurations, and this choice opens up an exciting conversation about theatre, mimesis, the stage versus the page, and finally, the way we write about theatre history. By foregrounding theatre and theatrical meaning-making, Love moves early modern disability studies into a new space. One of the valuable contributions of this work is simply that it makes visible disability’s saturation through early modern theatricality. As Love notes, “exploration of disability’s privileged relationship to literary representation began, in disability studies, with the novel, or at any rate with narrative fiction” (10). Alongside the reminder that, indeed, theatre and disability have a shared history, Love makes a more provocative claim: that disability is the way early modern England understood theatrical meaning-making. She writes that “prosthetic disabled characters parade the being of theatrical persons, and animate dramatic textual forms” (37). In other words, prosthetic performances show audiences how the actor is different from the role, and how the form of drama makes meaning on and through bodies. To illustrate how the theatre made use of “disabled characters as figures for theatrical representation” (30), Love explores the work that the characters Cripple (The Fair Maid of the Exchange) and Stump (A Larum for London) do not only in their respective plays’ plotting but also for the theatre itself. She sees these two roles as jointly constituting “a particular kind of theatrical analogy-machine” (22), varying in their operations but yoked together by the way they mediate how actors relate to their roles through the binaries of excess/lack, similarity/difference, horizontal/vertical movement, standing/stopping, past/present, and domestic/foreign (71). This monograph is important both for performance studies scholars and for literary historians of disability—beginning with Love’s theoretically savvy introduction, which synthesizes disability and performance theory. Despite her claim that her work is “[g]rounded in neither a historicist nor a disability studies methodology” (6), Love signals her theoretical positioning by attending up front to disability as metaphor and narrative prosthesis. This is a smart move since, as her title makes clear, she is centering figures of disability, which necessarily require attention to metaphor and prosthesis. She writes that “[m]y focus on figuration would seem to fly in the face of much disability studies scholarship, which over the past twenty years or so has introduced a variety of ethical critiques of disability as metaphor” (8). However, Love’s deft rendering of key concepts from...

The Common Ground of Open Access and Interdisciplinarity

In recent years, Open Access and interdisciplinarity have emerged as two prevalent trends in academia. Although seemingly separate pursuits with separate literature, goals, and advocates, there are significant interconnections between these two movements that have largely gone unnoticed. This paper provides a philosophical inquiry into the unexplored relationship between these two trends and makes the case that there is an intrinsic affinity between Open Access and interdisciplinarity and, as such, concludes that all interdisciplinary research, to remain true to the foundational tenets of interdisciplinarity, ought to be Open Access.

Tracing the contribution of childhood studies: Maintaining momentum while navigating tensions

Over recent decades, the evolving field of childhood studies has contributed significantly to the theorisation of childhood and to research seeking to understand children’s lives and experiences in different contexts. This article traces some of the key theoretical developments within childhood studies by means of a scoping study of peer-reviewed, scholarly journals and books published between 2010 and 2018. The aim of the review was to explore the theoretical and empirical contributions of childhood studies beyond its early foundational tenets. A number of emerging tensions were identified and these are explored in this article.

The extent to which an unforeseen biotic disturbance can challenge timber expectations

Forest pathogens are one of the key drivers of the dynamics and diversity of forested landscapes, contributing to structural and compositional complexity at multiple scales in space and time. Growth and yield models help guide forest management decisions but the roles of abiotic and biotic disturbance agents including pathogens are often overlooked. In our study of mid-rotation spruce plantations in northwest British Columbia (BC), Canada, we examine the influence of tomentosus root disease on the oldest managed stands in a previously unmanaged landscape allowing us to witness pathogen expression in a first rotation setting over the longest duration available. Our 10 one-hectare stem-mapped plots capture the spatial variability of root disease expression and their large size, coupled with their random selection without any prior knowledge of the pathogen, make our study unique. We found tomentosus root disease accounted for nearly 90% of both the number and the volume of spruce trees that died and that the incidence of the disease more than doubled over a 16-year period from stand age ~30–46. The volume growth of trees that were initially healthy but became infected was 17% less than that of the trees that remained healthy, while the volume growth of trees that were infected since plot establishment was 28% less than that of trees that remained healthy. We found a weak relationship between infected stumps from the previous stand and the condition of trees surrounding those stumps at age 30, but more critically we found a similarly weak relationship between infected trees at age 30 and the condition of the neighbouring trees 16 years later. Using the growth and yield model TASS II v2.7.75, we found model projections of spruce volume exceeded measured plot volume by an average of 30.5%. TASS is based on the same foundational tenets that are the dominant paradigm in forestry where the prediction of forest growth is based on the assessment of site index (dominant stand height and age), Eichhorn’s rule (which implies that when the dominant tree height is known, stand yield can be easily estimated now and then projected into the future), and the thinning response hypothesis. Our results reflect the influential role of a forest pathogen that is operating on a different scale and following a different set of rules. This, in combination with the unexpected behaviour of the forest pathogen itself, represents a multifaceted challenge in forecasting forest growth.

Toward a pluralistic conception of resilience

Abstract The concept of resilience occupies an increasingly prominent position within contemporary efforts to confront many of modernity’s most pressing challenges, including global environmental change, famine, infrastructure, poverty, and terrorism, to name but a few. Received views of resilience span a broad conceptual and theoretical terrain, with a diverse range of application domains and settings. In this paper, we identify several foundational tenets—dealing primarily with intent/intentionality and uncertainty—that are seen to underlie a number of recent accounts of resilience, and we explore the implications of these tenets for ongoing attempts to articulate the rudiments of an overarching resilience paradigm. Firstly, we explore the complemental nature of risk and resilience, looking, initially, at the role that linearity assumptions play in numerous resilience frameworks found in the literature. We then explore the limitations of these assumptions for efforts directed at modeling risk and resilience in complex domains. These discussions are then used to motivate a pluralistic conception of resilience, drawing inspiration and content from a broad range of sources and empirical domains, including information, network, and decision theories. Secondly, we sketch the rudiments of a framework for engineered resilience, the primary focus of which is the exploration of the fundamental challenges that system design and system performance pose for resilience managers. The conception of engineered resilience set forth here also considers how challenges concerning time and predictability should factor explicitly into the formal schemes that are used to represent and model resilience. Finally, we conclude with a summary of our findings, and we provide a brief sketch of possible future research directions.

Hurdles to the Development of the “Surgical Home” in the Low-Resource World

This chapter assesses the current state of practice of anesthesia in a low-resourced hospital and the hurdles envisaged in the development of perioperative surgical home, PSH, at the Komfo Anokye Teaching Hospital, KATH in Ghana. In the PSH model, the patient’s experience of care is coordinated by a Director of Perioperative Services, additional Surgical Home Leadership, and supportive personnel, which constitute an interdisciplinary team. KATH is yet to establish working structures that provide a solid foundation that would make implementation of this model possible. Foundational tenets of the PSH being operating room (OR) managers or directors, interdisciplinary teamwork, well-oriented and motivated staff, appreciation of the key roles of the anesthetist by both patients and surgeons among others are either not well established or nonexistent currently at KATH. While KATH has the basic infrastructure and personnel compared to other low-resourced countries for delivery of safe anesthesia, there exist several important limitations to the successful establishment of the PSH practice. Besides having to operate currently on limited funding, the necessary interdepartmental cohesion and acceptance of the anesthetist to lead any such model present an important hurdle to be surmounted.