Pragmatic Model Research Articles

Você + 2SG in Cabindan Portuguese (Angola): Two effects of language contact

This article describes the system of address forms in Cabindan Portuguese (Angola), particularly the widespread use of você (largely displacing both o senhor and tu) and the formation of a paradigm that –only if our interest is diachronic– can be characterized as hybrid. This paradigm is marked by the combination of the independent(/oblique) pronoun você with at least some forms derived from the tu-paradigm (object clitics, possessives, and, to a much lesser extent, verb endings). Additionally, it is proposed that the adaptative success of both features was, to some extent, determined by Kikongo, a continuum of genetically and typologically related Bantu languages, which provides structural and pragmatic models that seem to have been transferred to Portuguese in the usage of bilingual speakers. Finally, it is suggested that these features might be particularly well represented within the Romania Bantu, i.e. the Bantu-influenced areas of the Romance-speaking world.

Could bibliometrics reveal top science and technology achievements and researchers? The case for evaluatology-based science and technology evaluation

By utilizing statistical methods to analyze bibliographic data, bibliometrics faces inherent limitations in identifying the most significant science and technology achievements and researchers. To overcome this challenge, we present an evaluatology-based science and technology evaluation methodology. At the heart of this approach lies the concept of an extended evaluation condition, encompassing nine crucial components derived from a field. We define four relationships that illustrate the connections among various achievements based on their mapped extended EC components, as well as their temporal and citation links. Within a relationship under an extended evaluation condition, evaluators can effectively compare these achievements by carefully addressing the influence of confounding variables. We establish a real-world evaluation system encompassing an entire collection of achievements, each of which is mapped to several components of an extended EC. Within a specific field like chip technology or open source, we construct a perfect evaluation model that can accurately trace the evolution and development of all achievements in terms of four relationships based on the real-world evaluation system. Building upon the foundation of the perfect evaluation model, we put forth four-round rules to eliminate non-significant achievements by utilizing four relationships. This process allows us to establish a pragmatic evaluation model that effectively captures the essential achievements, serving as a curated collection of the top N achievements within a specific field during a specific timeframe. We present a case study on the top 100 Chip achievements to demonstrate the effectiveness of our science and technology evaluatology. The case study highlights its practical application and efficacy in identifying significant achievements and researchers that otherwise can not be identified by using bibliometrics.

Unlocking the potential of electric and hybrid tractors via sensitivity and techno-economic analysis

The majority of agricultural vehicles in use today still rely on diesel-based propulsion, a major source of air pollution. Electrification is seen as a potential solution for decarbonizing these off-road vehicles but is hampered by higher upfront costs in energy storage and charging infrastructure. To better quantify these barriers, this paper proposes a techno-economic tool that can assist farmers in evaluating the total costs of ownership of electric and hybrid tractors. A pragmatic simulation model of the tractor is developed to predict the annual energy/fuel consumption and NOx emissions, while an economic model estimates the total acquisition, operation, and maintenance costs. For managing the energy in hybrid tractors, a new power split strategy based on model predictive control is developed, allowing the designer to balance energy efficiency and NOx emissions, while taking into account operational constraints of the electric powertrain. Additionally, we propose novel decision maps that allow farmers to quickly identify operating regions (in term of average load and yearly working time) where the deployment of electric/hybrid tractors is economically viable. To account for variability in the tractor’s operational conditions, we conduct both a deterministic sensitivity analysis with multi-parameter variation and a stochastic analysis of the total cost of ownership. The tool is validated with different mission profiles based on data from a California farm. The results show that, compared to diesel powertrains, electric tractors are more cost-effective for light-duty farming activities (engine loads less than 20%). On the other hand, hybrid powertrains are more economical for medium-duty tasks, where engine loads range from 20% to 60%.

A Pragmatic Study of Media Disinformation: Yemeni Conflict as a Representative

The concept of disinformation is widely spread in media discourse, particularly in relation to the Yemeni conflict. The study examines the impact of media coverage on shaping an unfavorable disinformation among the population by Al-Hadath satellite channel. Regarding the channel, it exhibits hostility towards the Houthi government in Yemen and shows support for the opposing party. In terms of linguistic means, the study aims to examine media disinformation in order to identify the pragmatic tools employed to fabricate this disinformation and deceive the audience with a false version of the truth. The data under scrutiny represent selected an interview and a news report that are broadcasted by Al-Hadath satellite channel. The study adopts two models to examine media disinformation: the first one is an ideological (Van Dijk, 1998), aiming at investigating ideology behind media disinformation while the second is an eclectic pragmatic model, including Levinson (1983) and Yule (1996), aiming at analyzing the pragmatic strategies, particularly the types and triggers of presuppositions. Ultimately, the study concludes that the media discourse of Al-Hadath satellite channel addressing the Yemeni conflict is disinforming, as it seeks to vilify the Houthi government and create a negative impression of them among the public by highlighting fabricated negative features. Keywords: Pragmatics; media; disinformation; presupposition; Yemeni conflict.

A reassessment of graduation modeling for policy design

A vast and diverse literature estimates graduation chances using logistic models set in an arbitrary timeframe, where a graduation indicator is checked at a conventional point in time and associated with covariates measured at some date. Survival models emerged over time as a robust alternative, for being able to estimate time-to-degree and time-varying effects of predictors. This paper reconsiders the effectiveness of both modeling approaches in addressing policy-relevant questions, particularly in light of the increasingly automated and algorithm-based educational policies. We find that both methods exhibit blind spots and limitations, but that adopting a simple pragmatic approach logistic models can achieve a comparable level of effectiveness at depicting graduation dynamics while also being capable of answering questions that are problematic for survival models. We exploit a unique dataset and the nature of discrete-time survival models as combinations of logistic regressions run at different times to illustrate how arbitrary timeframes impact the estimates of a logistic model of graduation. Conversely, we illustrate how separately running and analyzing all the distinct logistic regressions provides insights that are unlikely to come from a survival model.

An Analysis of Pragmatic Presuppositions in Political Newspaper Articles

This study investigates the underlying presuppositions present in a newspaper article published in The Telegraph, a British daily. The newspaper article is authored by Con Coughlin, the foreign and defense editor of the newspaper. This article critiques the Russian war, characterizing it as an unjust conflict aimed at countering Islamic radicals who are carrying out attacks on Russia. The study seeks to examine the various types and triggers of presuppositions employed in the essay to accurately depict and illustrate Putin's misguided military campaign. An eclectic pragmatic model is utilized to examine the types and triggers of presuppositions in the selected article. Finally, the study concludes that the Telegraph mainly depend on lexical and existential presuppositions, with a minor role of structural presuppositions, to convey thoughts in the process of vilifying Russia.

Grief is the price we pay for love: Emotions disclosed by Chinese mourners in online memorial platform

The present paper undertakes an in-depth analysis of the messages within the ‘Grief-expressing’ section of the online memorial platform ‘Heavenly Remembrance.’ Utilizing Grounded Theory alongside a mixed-methods approach incorporating both qualitative and quantitative methodologies, this study delves into the emotional categories and referential features in the online discourse of Chinese mourners, drawing upon the Affective Lexicon Ontology. The findings of this study reveal that: firstly, the expressions of Chinese online mourners demonstrate a remarkable diversity and complexity, encompassing a spectrum of emotional categories characterized by both positive and negative attributes. This highlights the capacity of online memorial platforms to provide inclusive spaces for emotional disclosure, thereby facilitating the transformation of traditionally singular and concentrated grief into more personalized and varied emotional experiences. Secondly, the emotional disclosure of Chinese online mourners is directed towards the self, the deceased and the community respectively. Notably, there appears to be a trend over time towards a gradual transition in emotional expression from predominantly negative to increasingly positive, as well as from predominantly individual-focused to more collective-oriented expressions. In light of this, the study also attempts to explain the motivations behind such grief disclosure through the Motivation Model of Pragmatics, thereby theoretically contributing to the research on discourse and emotion in the Chinese mourning context and offering a new perspective on the emotional dynamics of individuals experiencing bereavement in online context.

Review of Chen (2022): Toward a Motivation Model of Pragmatics

Review of Chen (2022): Toward a Motivation Model of Pragmatics

Reducing asthma attacks in disadvantaged school children with asthma: study protocol for a type 2 hybrid implementation-effectiveness trial (Better Asthma Control for Kids, BACK)

BackgroundAsthma is a leading cause of children’s hospitalizations, emergency department visits, and missed school days. Our school-based asthma intervention has reduced asthma exacerbations for children experiencing health disparities in the Denver Metropolitan Area, due partly to addressing care coordination for asthma and social determinants of health (SDOH), such as access to healthcare and medications. Limited dissemination of school-based asthma programs has occurred in other metropolitan and rural areas of Colorado. We formed and engaged community advisory boards in socioeconomically diverse regions of Colorado to develop two implementation strategy packages for delivering our school-based asthma intervention — now termed “Better Asthma Control for Kids (BACK)" — with tailoring to regional priorities, needs and resources.MethodsIn this proposed type 2 hybrid implementation-effectiveness trial, where the primary goal is equitable reach to families to reduce asthma disparities, we will compare two different packages of implementation strategies to deliver BACK across four Colorado regions. The two implementation packages to be compared are: 1) standard set of implementation strategies including Tailor and Adapt to context, Facilitation and Training termed, BACK-Standard (BACK-S); 2) BACK-S plus an enhanced implementation strategy, that incorporates network weaving with community partners and consumer engagement with school families, termed BACK-Enhanced (BACK-E). Our evaluation will be guided by the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework, including its Pragmatic Robust Implementation Sustainability Model (PRISM) determinants of implementation outcomes. Our central hypothesis is that our BACK-E implementation strategy will have significantly greater reach to eligible children/families than BACK-S (primary outcome) and that both BACK-E and BACK-S groups will have significantly reduced asthma exacerbation rates (“attacks”) and improved asthma control as compared to usual care.DiscussionWe expect both the BACK-S and BACK-E strategy packages will accelerate dissemination of our BACK program across the state – the comparative impact of BACK-S vs. BACK-E on reach and other RE-AIM outcomes may inform strategy selection for scaling BACK and other effective school-based programs to address chronic illness disparities.Trial registrationClinicaltrials.gov identifier: NCT06003569, registered on August 22, 2023, https://classic.clinicaltrials.gov/ct2/show/NCT06003569.

Stronger together: Implementing patient-reported symptom tool in routine cancer care in diverse Asia—A multi-national pilot feasibility study (PROMiSE-Pilot).

TPS180 Background: Patients diagnosed with cancer often experience disease or treatment-related symptoms, which can be under-elicited and under-appreciated by clinicians during time-poor consultations. This is particularly challenging in Asia where structural disparities in healthcare access mean oncology services are often under-resourced. Five oncologists from Thailand, India, Singapore, Philippines and Australia formed a working group as part of ASCO Asia-Pacific Leadership Development Program (LDP-AP). Systematic symptom monitoring using patient-reported outcomes measures (PROM) was identified as a potential solution to improve care in diverse Asian settings. PROM has demonstrated improved outcomes in Western settings but its utility in resource limited Asian contexts is less well established. A study was developed to evaluate the feasibility of implementing PROM in routine outpatient care across diverse cultural contexts in Asia. Methods: PROMiSE-Pilot is a prospective, multi-centre, feasibility study of integrating PROM in routine outpatient care across Asia. The Edmonton Symptom Assessment Scale questionnaire (ESAS-r) was selected as the PROM tool. Clinicians in 4 hospitals in Singapore, Manila, Bangkok and Hyderabad will be invited to participate, and their patients will be invited to complete the ESAS-r on paper before each visit. The primary aim is to evaluate if proportion of patients who complete ≥5 of 10 items on ESAS-r is ≥85% (Clopper Pearson). Secondary aims include assessing proportion who complete ≥8 and all 10 items and perceived utility of ESAS-r evaluated through surveys adapted to measure patient and clinician satisfaction. Site-specific patient, clinician, administrative barriers and facilitators will be studied. A pragmatic approach to context-specific implementation was adopted with each site developing its own process map for delivering the pilot and adapting to local patient demographics (e.g. low literacy), cultural contexts and resources. Translated versions of ESAS-r were acquired where necessary. Recruitment commenced in March 2024 following ethics approval at 2 sites. 87 patient encounters have been captured from 5 participating clinicians in Singapore. 5 clinicians have agreed to participate in Bangkok. Target recruitment is 200 encounters per site. Multi-centre data will be presented at the Breakthrough congress. Clinicians from ASCO LDP-AP identified PROM as a low-cost but potentially high-value approach to improving quality of care in resource limited settings in Asia. Understanding the feasibility of such a tool is vital prior to consideration of wider scale adoption by stakeholders. This co-developed multi-national pilot additionally demonstrates the value of collaboration, our strength in diversity and a pragmatic model for investigator-initiated studies in Asia.

Seni Helah dan Perbahasan Belanjawan 2024: Analisis Pragmatik

The integrity of the administration of any governmentlargely depends on relevant and clear financial policies, for instance, Short-Term Plans or Annual Budgets. Periodically, the Annual Budget, the most important component of Parliamentary discourse, will be tabled for discussion, either to gain support or face criticism in both Houses of Representatives. Certainly, discussions and debates require politicians to master the art of rhetoric, analysis, and inference to navigate the dynamics of political legitimacy. For this purpose, the important document known as the Hansard serves as a substantial source, recording the strategies and art of Evasive Language in challenging-defending policies, addressing-mitigating issues, and strengthening-undermining the image that determines the integrity of the legitimacy of both the Governmentand and Opposition. However, previous corpus studies by Hansard on the topic of Evasive Response have focused only on the structural forms of debate. Therefore, employing three Pragmatic models, namely Harris’s Framework of Respons (1991), Thomas’s Notion of Implicator (1995), and Claymen’s Dimension of Resistance (2012), this qualitative study aims to analyse more complex, intense, and natural debate sessions, specifically the policy debate on the 2024 Budget. The findings reveal that all three types of Responses have some distinctive features, and their selection correlates with the scale of their impact on the image of the Government-Opposition. In addition, adhering to the Gricean Maxims (1975), the configuration of Evasive Language behavior is more easily defined and justified. Lastly, the discourse background at the policy level is more heterogeneous, thereby enriching the performative nature of Evasive Language.

A national evaluation of Project Cautioning And Relationship Abuse ('CARA') awareness raising workshops for first time offenders of domestic violence and abuse: protocol for a concurrent mixed-methods evaluation design.

Interventions related to the perpetration of Domestic Violence and Abuse (DVA) have gained traction over the past several years, in response to dissatisfaction by victims, an inadequate response from the criminal justice system, increased demand on police time and a lack of rehabilitative responses to the perpetration of domestic abuse. The CARA model is a conditional diversionary caution, offered by police for first time offenders of 'standard' or 'medium risk' domestic abuse, that engages perpetrators in awareness raising workshops and signposts them onto further services. Although quasi-experimental studies have indicated that CARA showed promise at reducing reoffending, the CARA model has yet to be evaluated nationally and there is no qualitative evidence related to understanding or learning about the lived experience of perpetrators and victims as they engage with the intervention. Using a concurrent pragmatic mixed methods design model we will undertake a national evaluation of CARA by triangulating quantitative data from up to nine police forces, and routine data from service providers, with qualitative data from workshop participants, victims and professional stakeholders to: (1) understand the long-term impact of CARA implementation on DVA reoffending and engagement with services and (2) explore perceptions and experiences of both delivery and receipt of CARA. We will use qualitative methodologies that draw on interpretivist and phenomenological perspectives, as well as quantitative methodologies using interrupted time series models, Poisson regression models, Geo mapping and a cost benefits analysis. Where currently the CARA model is being introduced as a national option for standard risk first-time offending, we will engage with policymakers and academics nationally in the live debate on its effectiveness and suitability during its roll-out. Ethical approval was approved by the University of Southampton on the 1 st June 2022 (Ref: ERGO ID: 71818.A1).

From Disposable Education to Acting in the World as a Human in the Time of AI

This contribution presents two perspectives: one based on AI expertise and the other on the importance of knowledge as human knowledge. The later focuses on the purpose of education by revisiting Alexander von Humboldt’s concept of Bildung as the main purpose of education. Resisting the shifting to radically pragmatic models of education, without Bildung, in recent decades, in the Global North which develops a system of disposable education that focuses on training a workforce for the market. Concerned by the production of disposable knowledge and assessments, with the sole goal of achieving good grades and securing employment, we see Generative AI, as mirroring this functionalist and economist vision of society, revealing strongly the limits of this paradigm. This article first explains how automatic learning, the foundation of generative AI, works. Second, we shall discuss human deep learning, as opposed to surface learning showing how it is required to develop as a person in the Bildung perspective. Third, we highlight this first intuition that AI reveals the functioning of our societies and move beyond, with an art of questioning in philosophy.

A Theory of Thinking and Interpersonal Communication

ABSTRACT This article explores the psychology behind thinking and communicating, subsequently proposing a pragmatic model for improving these processes. It begins from the consideration that we all operate very limited cognitive “machines”: in an average lifetime, the human brain can theoretically store up to 0.0000084% (8.4×10⁻⁸) and consciously process some 0.0000000000512% (5.12×10⁻¹³) of the (digital) information that was ever created, captured or replicated by humans. Such a dismally low ratio between human cognitive capacities on the one side, and the total amount of existing information on the other means that thinking and communicating—especially on “difficult” topics such as warfare, politics or religion—usually involves unilateral or hypolateral thinking. This is defined as people’s general tendency to ignore most of the existing information on any topic; to specialize only on information immediately available and; to use cognitive strategies and other cognitive meta-mechanisms to simplify thinking processes. On the basis of these considerations, the article proposes: (1) a logical proof of why most of our “objective” knowledge is in fact built from emotions and intentions, rather than from rationality and ontological proofs—suggesting that our “inner world” is the ultimate driver of the “outer world” as we perceive it; and (2) a model of hyperlateral or omnilateral thinking, whereby we consciously follow a technique to become aware of the existence of a multitude of perspectives on any one topic, a necessary precondition for meaningful thinking and communication to happen.

Forging National Identity: Journey from Economic Struggles to Cultural Harmony

After gaining independence from colonial rule, faced a complex domestic situation. To avoid religious and cultural conflicts among its diverse ethnic groups, the government adopted a multicultural governance approach for multi-ethnic management, supplemented by a supranational identity governance strategy, which maintained social harmony and stability. In this process, the political system ensured a basic balance of power among ethnic groups, a pragmatic economic development model met the survival needs of various ethnicities, and a liberal cultural environment preserved the historical heritage of each group. However, harmonious Singapore still falls short of becoming a true nation-state. To achieve the goal of nation-building, the Singaporean government has begun to emphasize cultural identity and seeks to foster a sense of being "Singaporean." With English as the lingua franca, Singaporeans can communicate in a common language, the preservation of historical buildings retains a shared cultural memory, and efforts to promote "shared values" are gradually fostering national identity among citizens.

A geospatial analysis of local intermediate snail host distributions provides insight into schistosomiasis risk within under-sampled areas of southern Lake Malawi

BackgroundAlong the southern shoreline of Lake Malawi, the incidence of schistosomiasis is increasing with snails of the genera Bulinus and Biomphalaria transmitting urogenital and intestinal schistosomiasis, respectively. Since the underlying distribution of snails is partially known, often being focal, developing pragmatic spatial models that interpolate snail information across under-sampled regions is required to understand and assess current and future risk of schistosomiasis.MethodsA secondary geospatial analysis of recently collected malacological and environmental survey data was undertaken. Using a Bayesian Poisson latent Gaussian process model, abundance data were fitted for Bulinus and Biomphalaria. Interpolating the abundance of snails along the shoreline (given their relative distance along the shoreline) was achieved by smoothing, using extracted environmental rainfall, land surface temperature (LST), evapotranspiration, normalised difference vegetation index (NDVI) and soil type covariate data for all predicted locations. Our adopted model used a combination of two-dimensional (2D) and one dimensional (1D) mapping.ResultsA significant association between normalised difference vegetation index (NDVI) and abundance of Bulinus spp. was detected (log risk ratio − 0.83, 95% CrI − 1.57, − 0.09). A qualitatively similar association was found between NDVI and Biomphalaria sp. but was not statistically significant (log risk ratio − 1.42, 95% CrI − 3.09, 0.10). Analyses of all other environmental data were considered non-significant.ConclusionsThe spatial range in which interpolation of snail distributions is possible appears < 10km owing to fine-scale biotic and abiotic heterogeneities. The forthcoming challenge is to refine geospatial sampling frameworks with future opportunities to map schistosomiasis within actual or predicted snail distributions. In so doing, this would better reveal local environmental transmission possibilities.Graphical

How does pornography change desires? A pragmatic account

Abstract Rae Langton and Caroline West famously argue that pornography operates like a language game, in that it introduces certain views about women into the common ground via presupposition accommodation. While this pragmatic model explains how pornography has the potential to change its viewers’ beliefs, it leaves open how pornography changes people's desires. Our aim in this paper is to show how Langton and West's discourse-theoretic account of pornography can be refined to close this lacuna. Using tools from recent developments in discourse theory, we propose that pornography issues implicit directives, and thereby introduces bouletic components into the discourse.

Evaluation of a New Adolescent Social Communication Assessment: The Transition Pragmatics Interview.

This study evaluated the psychometric functioning of a new criterion-referenced assessment of adolescent social communication, the Transition Pragmatics Interview (TPI), based on the synthesis model of pragmatics. Two ways of interpreting item difficulty were explored: (a) as a function of the synthesis model elements of social communication ability that items were designed to assess, and (b) as a function of the developmental level required for a successful response based on an adapted situational-discourse-semantics (SDS) model (Norris & Hoffman, 1993). Thirty-seven participants aged 14-22 years completed the TPI. Responses were analyzed using Rasch analysis to evaluate the functioning of the scale and to determine item difficulty. Items were coded for the SDS developmental level required for an adequate response. The mean Rasch item difficulty for items at each SDS developmental level was analyzed for the five adapted SDS domains. Consistent with the first approach for interpreting item difficulty, TPI items varied in difficulty as a function of the element of social communication they were designed to assess (p < .001). Interpreting item difficulty based on the adapted SDS model was not supported: Items requiring higher SDS developmental levels were not more difficult than those requiring less (p = .55). The TPI responses fit the Rasch model, supporting the TPI as a unidimensional measure and supporting the use of all items together to compute a single number that summarizes the level of social communication for each examinee. The item ordering from least to most difficult was consistent with prior findings on adolescent social communication development. https://doi.org/10.23641/asha.26018545.

The prognostic importance of traumatic axonal injury on early MRI: the Trondheim TAI-MRI grading and quantitative models.

We analysed magnetic resonance imaging (MRI) findings after traumatic brain injury (TBI) aiming to improve the grading of traumatic axonal injury (TAI) to better reflect the outcome. Four-hundred sixty-three patients (8-70 years) with mild (n = 158), moderate (n = 129), or severe (n = 176) TBI and early MRI were prospectively included. TAI presence, numbers, and volumes at predefined locations were registered on fluid-attenuated inversion recovery (FLAIR) and diffusion-weighted imaging, and presence and numbers on T2*GRE/SWI. Presence and volumes of contusions were registered on FLAIR. We assessed the outcome with the Glasgow Outcome Scale Extended. Multivariable logistic and elastic-net regression analyses were performed. The presence of TAI differed between mild (6%), moderate (70%), and severe TBI (95%). In severe TBI, bilateral TAI in mesencephalon or thalami and bilateral TAI in pons predicted worse outcomes and were defined as the worst grades (4 and 5, respectively) in the Trondheim TAI-MRI grading. The Trondheim TAI-MRI grading performed better than the standard TAI grading in severe TBI (pseudo-R2 0.19 vs. 0.16). In moderate-severe TBI, quantitative models including both FLAIR volume of TAI and contusions performed best (pseudo-R2 0.19-0.21). In patients with mild TBI or Glasgow Coma Scale (GCS) score 13, models with the volume of contusions performed best (pseudo-R2 0.25-0.26). We propose the Trondheim TAI-MRI grading (grades 1-5) with bilateral TAI in mesencephalon or thalami, and bilateral TAI in pons as the worst grades. The predictive value was highest for the quantitative models including FLAIR volume of TAI and contusions (GCS score <13) or FLAIR volume of contusions (GCS score ≥ 13), which emphasise artificial intelligence as a potentially important future tool. The Trondheim TAI-MRI grading reflects patient outcomes better in severe TBI than today's standard TAI grading and can be implemented after external validation. The prognostic importance of volumetric models is promising for future use of artificial intelligence technologies. Traumatic axonal injury (TAI) is an important injury type in all TBI severities. Studies demonstrating which MRI findings that can serve as future biomarkers are highly warranted. This study proposes the most optimal MRI models for predicting patient outcome at 6 months after TBI; one updated pragmatic model and a volumetric model. The Trondheim TAI-MRI grading, in severe TBI, reflects patient outcome better than today's standard grading of TAI and the prognostic importance of volumetric models in all severities of TBI is promising for future use of AI.

How to talk about dying? The development of an evidence-based model for communication with patients in their last days of life and their family caregivers

ObjectiveTo help healthcare professionals (HCP) act with more confidence when communicating about approaching death, we sought to develop a communication model for HCP to facilitate conversations with dying patients and family caregivers (FC) in nonemergency situations. MethodsWe used a four-phase integrative approach: (1) creation of a preliminary model based on a systematic literature review and expert knowledge, (2) review of the model draft by international palliative care experts, (3) review by key stakeholders, and (4) final appraisal by communication experts. ResultsAfter the clinical recognition of dying, the communication model provides a structure and practical communication aids for navigating the conversation based on three phases. It describes the content and relational level as core dimensions of effective conversations about approaching death and highlights the importance of HCP self-awareness and self-care when caring for the dying. ConclusionBased on systematic involvement of key stakeholders, the model supports clinicians navigating challenging conversations about approaching death with dying patients and their FC successfully and with more confidence. InnovationThis study expands the theoretical basis for communication about approaching death and offers a pragmatic model for educational interventions and clinical use.