text:
Adverse birth outcomes and its associated factors among women who delivered in North Wollo zone, northeast Ethiopia: a facility based cross-sectional study
Eskeziaw Abebe Kassahun1,
Habtamu Dessie Mitku2 &
Mikiyas Amare Getu3
Pregnancy is a happy time for women and their families although it can also a period of concern and anxiety, for some women, lose their babies during early or late pregnancy, give birth earlier than the expected date or face low birth weight. Therefore, this study aimed to assess the prevalence of adverse birth outcomes and associated factors among women who delivered in the North Wollo zone, northeast Ethiopia.
The prevalence of adverse birth outcomes among women who delivered in North Wollo zone was 31. 8%. Living in rural area (AOR = 1.8; 95% CI 1.13, 2.78), age ≥ 34 years (AOR = 2.2; 95% CI 1.21, 4.05), mid-upper-arm circumference < 23 cm (AOR = 3.1; 95% CI 1.90, 4.94), multigravida women (AOR = 1.8; 95% CI 1.08, 3.06), lack of antenatal care visit (AOR = 2.1; 95% CI 1.02, 4.40) and complications during pregnancy (AOR = 2.1; 95% CI 1.23, 3.55) were significantly associated with adverse birth outcomes. The prevalence of adverse birth outcomes was high and is a major public health problem in Ethiopia particularly in the study area. Hence, increasing the access to health institutions, developing strategies to prevent and treat complications, and providing focused antenatal care follow-up for pregnant women is recommended.
Pregnancy is usually a happy time for most women and their families although it can also be a period of concern and anxiety, for some women lose their babies during early or late pregnancy and delivery earlier than the expected date or face low birth weight [1].
Adverse birth outcomes are common health problems in developing countries [2] and incur significant health consequences on infants, and emotional and economic costs on families, and communities across the world, particularly in resource-limited settings where health systems and access to and utilization of health services are weak [3,4,5].
Globally, preterm birth is the leading cause of neonatal deaths which is contributing to 35% of the world's neonatal mortality. It's also the leading cause of disability and ill health later in life. Out of 7.6 million deaths of under-five children, 17% are due to prematurity [6]. Each year, 15 million babies are preterm birth and more than one million dies [7]. As a result, many of the survivors face physical and neurological problems and, the onset of communicable and non-communicable diseases or educational disabilities [7, 8] for life. More than 60% of the preterm births take place in South Asia and Sub-Saharan Africa [7]. According to the Ethiopian profile of preterm and low-birth weight prevention and care report, 320,000 babies are born in each year of which 24,400 die at the age of less than 5 years due to direct complications of preterm birth [9].
Low-birth-weight babies experience growth retardation and inhibited cognitive developments, besides, to severe health problems from immediately after birth to later life [10, 11].
Globally, more than 20 million infants (15.5% of all births) are born with low birth weight, 95.6% of them in developing countries. Around 15% of low-birth-weight occurs in Sub-Saharan Africa [12]. According to the 2016 Ethiopian Demographic and Health Survey (EDHS) report, 13% of infants weighed less than 2.5 kg at birth [13].
Worldwide, over 2.6 million deliveries are stillbirths 98% of which occur in low and middle-income countries. About 60% of the stillbirths are in rural areas, and more than half occur among conflict and emergency zones [14, 15].
Although the Ethiopian government has developed strategy and plan to improve the wellbeing of mothers and children [16], the level of adverse birth outcomes are a major public health problem in areas such as Shire, Tigray, (22.6%) [17], Gondar (23%) [18], and Hosanna, (24.5%) [19]. Consequently, the mortality rate of neonates, infants, and under five-children has been 29, 48, and 67 per 1000 live births, respectively [13]. Therefore, this study aimed to assess the prevalence of adverse birth outcomes and associated factors among women who delivered in the health institutions of North Wollo.
Study design and settings
An institution based cross-sectional study was conducted on 462 delivered mothers from March 2017 to June 2018. North Wollo zone is found 521 km from Addis Ababa, the capital of Ethiopia. It has 65 health centers and 3 hospitals. According to the 2017 Zonal Health Administrative Office report, 65 health centers gave delivery services to 600 women, while the three hospitals served 60 women per week. About 24% of the women were of childbearing age.
Sample size and sampling procedures
All women who delivered in North Wollo zone health institutions were included in the study. However, women who gave birth with unknown last normal menstrual period (LNMP) or who had no a reliable ultrasonography results and severely ill were excluded. The required sample size was calculated using the single population proportion formula by considering the proportion of adverse birth outcomes as 22.7% taken from a previous study in Gondar [20], a 95% confidence interval (CI), 4% margin of error (d) and 10% non-response rate; the final sample was 462 women. First, the health institutions were stratified into hospitals and health centers. Then, by the random sampling method and rule of thumb (20%), thirteen health centers and one hospital were selected. Finally, using the systematic random sampling method and proportional allocation to each selected health institution, 462 women were selected and interviewed.
Adverse birth outcomes
A baby is said to be preterm, if born before 37 completed weeks of gestation but after 28 weeks of gestation or low birth weight, if its birth weight is below 2500 g and stillbirth, if the infant died in the womb or during intrapartum period after 28 weeks of gestation [21]. If a woman met at least one of the above conditions, it is considered as an adverse birth outcome.
Data collection tools and techniques
Data was collected through pretested and structured interviewer-administered questionnaire. It was first prepared in English and translated to Amharic (the local language), and back-translated to English again. A total of 28 data collectors (BSc. in Midwifery) were involved in the data collection process. The purposes and objectives of the study were clearly explained to participants before data collection.
Data quality controls
The questionnaire was pretested on 24 women in Kobo primary hospital out of the study area. Twenty-eight data collectors were selected from the selected health institutions. Interviewers received a total of 15 days of intensive training before data collection. During data collection, any personal identifiers were not recorded.
Data processing and analysis
After the data collection, data was entered in EpiData 3.10 and exported to SPSS version 20 for analysis. Both bivariable and multivariable logistic regression analysis were carried out to identify factors associated with adverse birth outcomes. In bivariate logistic regression analysis, variables with p-value less than 20% were considered into the multivariable analysis to control the possible effect of confounders. Adjusted odds ratio (AOR) with a 95% confidence interval (CI) was calculated to see the strength and significant association. Variables having a p-value less than 0.05 in the multivariable logistic regression analysis were considered as statistically significant.
Sociodemographic and economic characteristics
A total of 462 women were interviewed, which makes a response rate of 100%. The majority (76.8%) of the women were in the age range of 20–34 years. About 61.9 and 93.5% of women lived in urban areas and married, respectively. Moreover, 26.4% of women were illiterate and 38.7% were farmers (Table 1).
Table 1 Sociodemographic, medical and behavioral characteristics of respondents in North Wollo zone, northeast Ethiopia, 2017 (n = 462)
Obstetrics characteristics
The majority (91%) of women had an ANC follow-up. Of those, 20.7, 69.3 and 10% of women started ANC visit during the first, second and third trimester of pregnancy, respectively (Table 2).
Table 2 Obstetrics characteristics of women delivered in North Wollo zone health institutions, northeast Ethiopia, 2017 (n = 462)
Prevalence of adverse birth outcomes
The overall prevalence of adverse birth outcomes was 31. 8% (95% CI 27.6%, 36.1%). Of those, one-fifth (19.5%) were low birth weight, while 13.2% were preterm and 7.8% stillbirths.
Factors contributing to adverse birth outcomes
Both bivariable and multivariable logistic regression analyses were done to see the effects of the selected variables on adverse birth outcomes. As it is shown in Table 3, residence, age, mother's education, MUAC, gravidity, ANC visits and complications during pregnancy had significant associations with adverse birth outcomes in the bivariable analysis. However, in the multivariable logistic regression analysis residence, age, MUAC, gravidity, ANC visit and complications during pregnancy were significantly and independently associated with adverse birth outcomes. Accordingly, the odds of having adverse birth outcomes increased by 80% (AOR = 1.8; 95% CI 1.13, 2.78) among women who lived in a rural area as compared with women who lived in an urban area. The likelihood of encountering adverse birth outcomes was 2.2 times (AOR = 2.2; 95% CI 1.21, 4.05) higher among women aged ≥ 34 years compared to women aged 20–34 years. Moreover, the odds of developing adverse birth outcomes among women whose MUAC was less than 23 cm were 3 times (AOR = 3.1; 95% CI 1.90, 4.94) higher compared to women whose MUAC was ≥ 23 cm.
Table 3 Bivariable and multivariable analyses of adverse birth outcomes of women delivered in North Wollo zone health institutions, northeast Ethiopia, 2017
In this study, the higher odds of developing adverse birth outcomes were also observed among multigravida (AOR = 1.8; 95% CI 1.08, 3.06) than primigravida women. Likewise, the odds of exhibited adverse birth outcomes among women with complications during pregnancy were 3 times (AOR = 3.1, 95% CI 1.90, 4.94) higher compared to those of their counterparts (Table 3).
This study was conducted to assess the prevalence and factors associated with adverse birth outcomes among women who delivered in North Wollo zone health institutions, northeast Ethiopia. The overall prevalence of adverse birth outcomes was found to be 31.8% (95% CI 27.6%, 36.1%). This finding is higher than those of studies conducted in Gondar (23%) [18], Hosanna Town (24.5%) [19], Suhul Hospital, Tigray (22.6%) [17], Tanzania (18%) [22], and China (23.5%) [23]. The possible reason for the difference might be variations in the areas of studies. For instance, the studies in Gondar, Hosanna and Suhul hospitals were hospital-based unlike this study which was also conducted at health centers. Commonly, health centers are located in a rural area to provide services to rural women who are usually unemployed, overworked and have poor access to antenatal care, labor, and delivery services. Furthermore, methodological [24] and socio-economic [24, 25] variations may explain the differences in adverse birth outcomes in Ethiopia on one hand and Tanzania, Ghana and China on the other hand.
Women who live in rural areas are unemployed and less informed about pregnancy, labor and delivery. Moreover, cultural or traditional taboos have a great effect on the nutritional status of women through the prohibition of essential foods and or drinks, are commonly practiced in rural areas, such women are more likely to develop adverse birth outcomes than urban dwellers. Our finding is similar to those of studies reported in Gamo Gofa [26], China [23] and Hosana town [19].
In this study, women ≥ 34 years of age were at higher risk of encountering adverse birth outcomes. This is supported by other findings in China [23]. Perhaps because of the advanced maternal age result in adverse pregnancy outcomes [27, 28].
Women with a Mid Upper Arm Circumference (MUAC) less 23 cm were three times more likely to have adverse birth outcomes than women with MUAC ≥ 23 cm. This result is in agreement with those of other studies in Dessie [29]. That is because MUAC less than 23 cm might be related to maternal undernutrition which affects the fetus in the womb. Poor nutrition during child and adulthood might persist in the offspring, too.
Multigravida women were twice as likely to develop adverse birth outcomes than primigravida women. This finding is supported by other studies in Tigray [17] and Gamo Gofa [26]. This might be due to the socioeconomic burden which increases the sharing of food among family members.
Women who did not attend ANC were more likely to have adverse birth outcomes when compared to those who used the service. This finding is in line with those of studies in Dessie [29], Gondar [18] and Tanzania [22]. This might be because attending antenatal care helps women to have an awareness of the danger signs during pregnancy, delivery and postnatal period. It also improves health-seeking behavior, orients women on potential complications, birth readiness and help them to identify pregnancy-related problems.
Unrecognized and untreated pregnancy-related health problems put women and their fetus at risk of many problems. In this study, women with complications during pregnancy were more likely to have adverse birth outcomes. Again, this study is consistent with other studies in Dessie [29] and Hosanna town [19].
This study revealed that the prevalence of the adverse birth outcomes in North Wollo zone was 31.8%. Residence, age, gravidity, Mid Upper Arm Circumference (MUAC), antenatal care (ANC) and pregnancy complications were mainly associated with adverse birth outcomes. Therefore, increasing the accessibility of health institutions, developing strategies and policies to prevent, diagnose and treat complications before and during pregnancy are recommended. Creating and raising awareness of women on the effect of pregnancy at an advanced age, and providing timely and focused antenatal care (ANC) follow up to all pregnant women are very important to minimize the problem.
Being a cross-sectional study design attempt to our work did not establish the possible temporal relationship between dependent and independent variables. Besides, recall bias in finding out the gestational age of pregnant women was not ruled out.
Due to ethical restrictions and privacy concerns, a dataset is available upon request from the author Eskeziaw Abebe: eskeziaw02@gmail.com.
inter quartile range
PIH:
pregnancy induced hypertension
PPH:
post-partum hemorrhage
PROM:
premature rapture of membrane
SPSS:
Statistical Package for Social Sciences
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The authors have special gratitude for all the study participants for their valuable information. We would like also to thank Woldia University for material support. Finally, the authors appreciation for data collectors for their valuable contribution in data collection activities.
This study was funded by Woldia University that was not involved in the design of the study, data collection, analysis and interpretation.
Department of Midwifery, Faculty of Health Sciences, Woldia University, Woldia, Ethiopia
Eskeziaw Abebe Kassahun
Department of Statistics, Faculty of Natural and Computational Sciences, Woldia University, Woldia, Ethiopia
Habtamu Dessie Mitku
Department of Nursing, Faculty of Health Sciences, Woldia University, Woldia, Ethiopia
Mikiyas Amare Getu
EAK developed the idea of the study, acquired the research proposal, carried out statistical analysis and draft the manuscript. EAK, HDM and MAG facilitated data collection, participated in the design of the study, statistical analyses and critically reviewed the manuscript. All authors read and approved the final manuscript.
Correspondence to Eskeziaw Abebe Kassahun.
Ethical approval was obtained from the Faculty of Health Sciences, Woldia University. Data was collected after getting written informed consent from women whose ages were 18 years and above. A written informed consent was taken from legal guardians for those study participants who were less than 18 years of age. Additionally, assent was secured from participants aged below 18 years. Participants' names or other personal identifications were not written on the questionnaire during data collection.
Kassahun, E.A., Mitku, H.D. & Getu, M.A. Adverse birth outcomes and its associated factors among women who delivered in North Wollo zone, northeast Ethiopia: a facility based cross-sectional study. BMC Res Notes 12, 357 (2019). https://doi.org/10.1186/s13104-019-4387-9
Preterm birth
Low birth weight
North Wollo zone


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Benjamin Fitzgerald
Neiman Marcus's Lana Todorovich on the year of optimizing its omnichannel approach
What a difference a year makes. In the case of Neiman Marcus, two years is night and day. In May 2020, the upscale Dallas-based retailer founded in 1907 filed for Chapter 11, citing the pandemic store closures as the final straw.
Fast-forward to May 2021, as everyday activities and in-person events came back to life thanks to the widespread adoption of the Covid-19 vaccines, Neiman's kicked off a series of highly produced pop-up experiences that have defined its path forward fueled by a $600 million investment in its retail strategy.
Now, just over 13 months, the store has hosted over 3,200 events that have helped draw its clientele back where the retail pundits said they would never go again: the physical store.
FashionNetwork.com spoke to Neiman Marcus president and chief merchandising officer Lana Todorovich about the department store chain's strategy of belief in IRL (in real life) experiences and integrated omnichannel platform, the silver lining behind the closures, and its continued legacy of supporting emerging talents.
Lana Todorovich - Neiman Marcus Group
"We were the lonely voice saying we wanted to invest $300 Million in our physical stores at a time when that wasn't a popular statement," said Todorovich in a video meeting on the eve of their latest activation with Burberry.
"The pandemic was about digital, but now we are focusing on the stores on top of the investments we were making in digital, developing our Connect platform, and acquiring Stylyze. The digital foundation was there for us, so we focused on the stores too." (Stylyze is a machine-learning, cloud-based SaaS platform Neiman Marcus style advisors use in their toolkit for remote selling).
Todorovich revealed that Neiman's has a third channel for sales engagement beyond in-store and online purchases. Its Connect platform, which pairs shoppers with a personal style advisor online, was born directly out of the pandemic store closures, and the concept took hold.
"We were on the forefront of remote selling, which was born out of necessity during the shutdowns," she said, explaining the genesis of Connect, which had millions of engagements within a few weeks. (Today, that figure has reached 9 million emails or text messages sent to customers from associates).
The multi-faceted omnichannel gave the retailer a "clear vision that customers shop in an eco-system between channels," according to the executive. Data supports this approach as stats show those who shop online versus just in-store spend twelve times the amount as those who just shop in the store.
That said, the retailer knew that once its clients came back in-person post after the first phase pandemic, they wanted a fresh start.
"We recognized the desire to connect differently," she said. The first prominent activation, an experiential pop-up with the Prada beach collection, crystallized their instinct to provide a new 'retail-tainment' environment. Todorovich described the pop-up, including LED screens depicting waves crashing onto a beach, natural sand on the floor, models posing as lifeguards, and a gelato station. "It felt like you were at the beach. Everyone invited to the opening came and lingered after to chat, engage, or even hug each other," she recalled.
The Prada Beach Pop-Up was followed up this year with the Prada Tropico event in San Francisco and the Prada Coast pop-up at the NorthPark store pictured here - Neiman Marcus
"I spoke to Marcelo Noschese of Prada a few minutes ago, and we talked about that moment. It felt like a joyful way to come back to shopping, life, fashion, and relationships, all of that," she shared. "We knew we were on to something, and we tapped into that with the customers craving human connection and interaction."
From there, the brand embarked on several notable experiences, such as the Loewe X Paula's Ibiza activation in the Beverly Hills store and the Tyler the Creator Golf le Fleur event that also took place there. Others included an ice-skating rink in the Dallas NorthPark store with Maison Francis Kurkdijan and the Balmain X Barbie experience that drove home the digital connection and the success of the over-the-top collaborations.
"We had that foundation, but this took to a new level of sentiment with the Prada event, and we built upon that by doubling the size of events to accommodate demand," she continued, noting that event yielded seven figures after just a few days at one location.
It was the beginning of the trend to amplify events. For example, in the past quarter, Neiman Marcus has had over 1,000 events—think trunk shows, personal appearances, beauty launches, masterclasses, and more. The investment is paying off digitally too. The hot pink-bathed Balmain event generated 192 million impressions in January 2021, and the featured video on Instagram became the most-watched in Neiman Marcus' social media history. Furthermore, customer demand online for Balmain tripled on the days leading up to, during, and after the event.
Its latest project with Burberry—chosen to be in the retailer's Atlanta store based on its top performer status of the British brand helmed by Riccardo Tisci—debuted on June 17 and boasts wrapping the entire exterior of the store in a pattern made from the new TB logo and classic plaid motif.
Todorovich says product exclusivity is also crucial. "There was a bit of a frenzy with the Barbie collection. One hundred percent of the collectible bags sold with the entire capsule selling through seventy percent within a week," she confirmed, adding online sales contribute to sell-through. On June 20th, the Valentino Escape pop-up was unveiled with fifty exclusive vacation-ready styles that used retro 60s and 70s prints from the Roman couture house.
The Burberry X Neiman Marcus activation in Atlanta - Neiman Marcus
From a content perspective, the installations also pay off. For instance, the Balmain pop-up editorial story was also number one in January when the pop-up took place. "We hosted ten pop-up experiences over the last twelve months, which collectively garnered 500 million impressions. The digital component supports the in-person events."
While major brands and budgets may direct these more significant events, Neiman's is still committed to supporting the little guy.
"Neiman's has a history of discovering and nurturing talent," Todorovich reminds. Indeed, a young Christian Dior won the prestigious The Neiman Marcus Award for Distinguished Service in the Field of Fashion award in 1947. Coco Chanel owes her 1954 comeback to the tony retailer who supported her return. (She would also win the store's prize in 1957).
Recently they hosted a launch event for Salon 1884, a new ready-to-wear designer by multi-discipline artist Andrea Mary Marshall. They also will carry the collection of fellow Texan Bach Mai, who designed for Maison Margiela under John Galliano, among others who debuted a collection during the last NYFW.
"He's from Houston. He said something interesting at our last meeting. Tom Ford, Brandon Maxwell, and designers from Texas uniquely understand this idea of American glamour and how to show fashion in a special way," said Todorovich, noting Mai's evening dresses are part of an important category for the retailer. Another eveningwear label from Italy sold after being featured in the Resort catalog.
Other young labels Neiman's is currently excited about include buzzy New York designer Peter Do; Italian-made sustainable vegan shoe brand, Piferi; the edgy Japanese streetwear brand Mastermind; and Lebanese eveningwear Monot, who was picked up after a Paris debut in September 2021.
The president also mentioned that nine Neiman Marcus stores, including the New York City area store in Paramus, New Jersey, are getting remodeled as part of the retail investment.
"Fashion is at the heart of our business," she said. "It's not the sprinkles on the top of other things but the core of what we do. We are very busy [delivering luxury product curation]. We are having so much fun."

redpajama_set_name: RedPajamaCommonCrawl


text:
IWM Moses, Harry Baker, Lindsay Evans, David William Temple, Owen Wade "Tony Waggott, Maisie Williams, Thomas Rheidol "Rhei"
Ardherne, Eustace "Houdini" Bower-Leighton, Lieutenant Colonel British Army, Auxiliary Territorial Service British Army, Camp, British Army, Durham Light Infantry British Army, Durham Light Infantry, 1st Battalion British Army, General Service Corps British Army, Royal Army Ordnance Corps British Army, Royal Artillery British Army, Royal Artillery, Searchlight Regt, 54, Bty 411 British Army, Welch Regiment, 1st/5th Battalion British Army, Women's Royal Army Corps Cotton, Corporal Davies, Captain Davies, Sergeant Dunning, Hilda Evans, David William Gare, Norman German Prisoner of War Camp, Stalag IV A German Prisoner of War Camp, Stalag XI A Gower, Charlie Heslop (Major) Jackson, Colonel Matthews (Sergeant) McCorseland (Colonel) Rippon, Bandmaster Sheriff (Captain) Stafford (Captain) Sutcliffe (Private) Temple, Owen Wade "Tony
Donnington, Shropshire, England, UK GB, England Nottingham, Nottinghamshire, England, UK Old Dalby, Leicestershire, England, UK Aldershot, Hampshire Alexandria, Egypt Baron, Oise, France Bayeux, Calvados, France Beeston, Nottinghamshire, England, UK Blackdown Camp, Surrey, England, UK Brancepeth, County Durham, England, UK CN CN & Shanghai CN & Shanghaikwan CN & Tientsin Caen, Calvados, France Canterbury, Kent, England, UK Castle Howard, Yorkshire, England, UK Cheltenham, Gloucestershire, England, UK Cheux, Calvados, Normandy, France Chilwell, Nottingham, Nottinghamshire, England, UK Clacton-on-Sea, Essex, England, UK Colchester, Essex, England, UK DE DE & Halle DE & Moosburg Darlington, County Durham, England, UK Durham, County Durham, England, UK EG EG & Cairo
Donnington, Shropshire, England, UK
Williams, Thomas Rheidol "Rhei" (Oral history)
IWM (Production company) Baker, Lindsay (recorder) Williams, Thomas Rheidol "Rhei" (interviewee/speaker)
Evans, David William (Oral history)
IWM (Production company) Moses, Harry (recorder) Evans, David William (interviewee/speaker)
Temple, Owen Wade "Tony (Oral history)
IWM (Production company) Moses, Harry (recorder) Temple, Owen Wade "Tony (interviewee/speaker)
Waggott, Maisie (Oral history)
IWM (Production company) Moses, Harry (recorder) Waggott, Maisie (interviewee/speaker)


UK citizens are not currently required to obtain a visa to travel to Peru. We do not anticipate that Brexit will affect the visa process, but we will be in touch should this change.
In order to sign-up for Morocco you will need to pay your registration fee of £390. You will then be given an option to select a fundraising target. You can reduce your fundraising target by paying what we call a flexi-payment.


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France's Digital Agenda
December 7, 2021 at 10:00 am to 11:00 am
Data and Privacy Digital Innovation Initiative Emerging technology France Internet freedom
On January 1, France will assume the rotating presidency of the Council of the European Union, with a wide-ranging agenda on digital sector regulation.
On January 1, France will assume the rotating presidency of the Council of the European Union, with a wide-ranging agenda on digital sector regulation. As the EU aims for greater digital sovereignty, the Digital Markets Act and Digital Services Act – both slated to pass in 2022 - will be at the top of France's legislative priorities. At the same time, the EU and US are working more closely on digital regulation, following the first meeting of the Trade and Technology Council (TTC) earlier this year. France's vision for the next stage of Europe's digital agenda will have long-term implications for transatlantic cooperation. What are the French government's priorities as it assumes a leading role in digital policymaking, and what can we expect during its presidency?
Stéphane Distinguin, Founder and CEO, FABERNOVEL
Alice Pannier, Research Fellow and Head, Geopolitics of Technology Program, French Institute of International Relations
Alexandra Reeve Givens, President and CEO, Center for Democracy & Technology
Alina Polyakova, President and CEO, Center for European Policy Analysis
Divided Digital Europe: The Continent Connects at Different Speeds
July 13, 2022 at 10:00 am to 11:00 am
France's Digital Ambitions: A Conversation with H.E. Henri Verdier
Digital Innovation Initiative


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2018 Big 12 Preview: Sooners Team To Beat Again
Posted on August 8, 2018 by SportsBook Review - OKTC
The Oklahoma Sooners captured the Big 12 title and got their ticket punched to the College Football Playoff last season before they fell in double overtime to Georgia in the semifinal matchup. Let's check out this year's edition of the Sooners as well as the other Big 12 squads and see what the oddsmakers are dealing as well.
Oklahoma Sooners (2017 record: 12-2, Reg Season Wins 10 ½ U-155, Big 12 Title +132, National Championship +2600) – The Sooners have claimed the Big 12 title three years running and this season doesn't appear as though there will be any shift in the landscape. Yes, Oklahoma suffered a huge loss with the departure of Baker Mayfield as the No. 1 overall pick in the draft as well as the departures of massive tackle Orlando Brown and tight end Mark Andrews. However, the offensive line remains solid, Rodney Anderson is one of the nation's best running backs and new quarterback Kyler Murray is mobile and effective enough at hitting his targets. This edition of the Sooners may not be as dangerous as the 2017 squad but appears more talented than the rest in the Big 12.
Texas (2017 record: 7-6, Reg Season Wins 8 ½ O-135, Big 12 Title +325, National Championship +5000) – The Longhorns increased their win total by two last season, which included a bowl win over Missouri. This will be head coach Tom Herman's second season at the helm and expectations are high both for his program and sophomore quarterback Sam Ehlinger. Factor in a boost in the backfield from U of California transfer running back Tre Watson and Texas will be a dangerous opponent for any team coming to Austin.
TCU (2017 record: 11-3, Reg Season Wins 7 ½ O-145, Big 12 Title +725, National Championship +17,500) – The Frogs are loaded up at the skill positions with sophomore Jalen Reagor as the lead dog in the receiving corps after coming off a 2017 campaign that saw him catch eight touchdown passes as a true freshman. Junior Darius Anderson will return to chew up yards and break the plane of the end zone as he did eight times last season. It will be up to new starting signal caller Shawn Robinson to harness his weapons and get the offense to run. We believe he can.
Oklahoma State (2017 record: 10-3, Reg Season Wins 7 ½ O-160, Big 12 Title +730, National Championship +25,000) – A quick check over to our friends at Sportsbook Review, our go-to sports betting site that features, among other things gambling related, up to the minute odds from the best online sportsbooks tells us that the Cowboys are likely to regress from their 10-win season of 2017. Quarterback Mason Rudolph and receiver James Washington were a devastating pass/catch combination last year, but they are now Pittsburgh Steelers and nobody will fill that void on the Oklahoma State roster this season.
West Virginia (2017 record: 7-6, Reg Season Wins 7 ½ U-125, Big 12 Title +825, National Championship +13,000) – Although many accomplished players are champing at the bit for a crack at the NFL, there are some who return for another season to hone their skills and elevate their status at next season's draft. The Mountaineers have three such athletes returning with quarterback Will Grier, left tackle Yodny Cajuste, and All-American wideout David Sills. However, on the defensive side of the ball, West Virginia has sustained defections with Lamonte McDougle and Adam Shuler on the defensive line while the injury bug has already bitten hard on linebackers Quondarius Qualls and Brendan Ferns, both out with ACL tears. The offense better dazzle because the defense is suspect.
Iowa State (2017 record: 8-5, Reg Season Wins 6 ½ O-120, Big 12 Title +2700, National Championship +75,000) – The Cyclones lost standout wideout Allen Lazard as a tall target for returning quarterback Kyle Kempt but the offense is expected to be solid with David Montgomery and sophomore Kene Nwangwu leading the way in the backfield and a deep bench of receivers for Kempt to target. The defense should at least maintain what was a vast improvement last year over a lackluster 2016 edition. Iowa State could surprise again this season behind rising coach Matt Campbell.
Kansas State (2017 record: 8-5, Reg Season Wins 6 ½ O-120, Big 12 Title +3000, National Championship +40,000) – This is a big transition year for the Wildcats with a pair of new coordinators as well as a mass exodus of starters from last season. The offensive backfield looks talented and deep but the quarterback situation is uncertain and the receiving corps is in flux. The offensive line is a strength, but the defense will have to be revamped. Looks like a bridge season for the Cats.
Texas Tech (2017 record: 6-7, Reg Season Wins 6 ½ U-145, Big 12 Title +4000, National Championship +200,000) – The only thing Texas Tech can count on offense begins and ends on the line. Other than that, this is an offense that will have to fake it 'til they make it. The defense, on the other hand, returns nine starters which is a huge boost for a team that may have difficulty scoring points.
Baylor (2017 record: 1-11, Reg Season Wins 5 ½ O-145, Big 12 Title +6000, National Championship +200,000) – Sophomore Charlie Brewer will lead the Bears offense on a team that was devastated by injuries last year which led to a dismal 1-11 season. Most will look at Baylor's record in '17 and immediately dismiss them as a punching bag in 2018. But if the walking wounded of last year stay healthy this year then we could see a Cinderella in the making.
Kansas (2017 record: 1-11, Reg Season Wins 3 ½ U-220, Big 12 Title +80,000, National Championship +200,000) – How many days until basketball season?


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Home / Blog / Bioelectronic medicine applications and future prospects
Bioelectronic Medicine: Applications and Future Prospects
Healthcare industry during the past few decades has witnessed phenomenal growth and improvement due to technological advancement and innovation. The hospital management, medical devices & equipment, pharmaceutical products, and surgical procedures all have gone under tremendous up-gradation and improvement.
Bioelectronic Medicine is one such emerging domain in the healthcare industry which is likely to impact the lives of people all over the world in the upcoming years. Bioelectronic Medicine might seem like a novel approach; however, its concept has been in use since the 1960s when it was used as an electrical stimulation or artificial pacemaker.
Bioelectronic Medicine is a compiled effort produced by the intersection of computing, bioengineering, molecular Medicine and neuroscience. Bioelectronic Medicine is helpful in diagnosis and treating diseases & disabilities.
What is the concept behind Bioelectronic Medicine?
To treat any disease, numerous approaches and novel therapies are under evaluation and development. But for this a detailed understanding of the molecular mechanism of disease is imperative. The drugs target the molecular structure in the body, usually a protein, associated with the disease, to produce desired therapeutic results.
However, there are always chances that these drugs may off-target the molecules and result in side effects. Under and over-doses of drugs are a common problem that may cause serious complications.
To overcome these challenges and provide customised treatment for the disease, Bioelectronic Medicine is being used by healthcare professionals.
Bioelectronic Medicine is based on the concept of neural control of biological processes or systems that causes diseases or disability.
Whenever there is an injury, the brain receives and sends signals to the vagus nerve. However, in the case of chronic diseases such as rheumatoid arthritis, the process of relaying the information gets hampered. But by implanting tiny electronic devices, the targets can be delivered to the vagus nerve.
A study by Koopman FA, et al. reported that rheumatoid arthritis patients implanted with vagus nerve stimulator efficiently activated inflammatory reflex and hence showed significant improvement in easing the symptoms.
To treat the disease a medical device is developed that will control or regulate the specific neural circuit which causes the disease. So basically instead of drugs, electrons are used as a treatment option. Bioelectronic Medicines can address the disease and disability in a more effective and efficient way than the drugs can do.
Why is Bioelectronic Medicine important?
Today's drug applications are designed to work on the entire nerve of the affected area, while Bioelectronic Medicine is likely to detect and treat the specific nerve fibre which causes a wide range of disorders. So the ultimate aim of Bioelectronic Medicine is to provide a biocompatible and miniaturized device that can detect and treat the desired nerve in a precise manner.
GE Global Research (the research and development division of General Electric) is working on Bioelectronic Medicine Therapy for Targeted Neuromodulation. The aim of the research is to target the dysfunctions nervous system which is supposed to be the main contributing element of the disease. With this, the Bioelectronic Medicines are likely to treat chronic diseases and disorders such as Arthritis, IBS and diabetes.
SetPoint Medical is currently working on Bioelectronic Medicine to treat rheumatoid arthritis and Crohn's diseases, for this the company has conducted early clinical studies.
Similarly, various other companies are working on Bioelectronic Medicine to treat the disease like retinal implants, cochlear implants, cardiac rhythm management etc.
Bioelectronic Medicine and its future prospects
Bioelectronic Medicine has tremendous potential and offers enormous opportunities to replace traditional pharmaceutical Medicines.
Bioelectronic Medicine has gained significant attention from large Pharmaceutical players and medical device manufacturers in recent time. Companies are investing in Bioelectronic Medicine research in order to gain profit and advantage from the potential and untapped market.
Some of the key companies in the Bioelectronic Medicine industry include Galvani Bioelectronics, Medtronic, Bright Medical Ltd, EnteroMedics Inc., Nevro Corp., Abbott, Boston Scientific Corporation, and many others.
Similarly from the consumer's prospects, the development in Bioelectronic Medicine is going to be equally beneficial and remunerative for them also. Consumers are likely to get better and newer treatment options which may get cost-effective in future with large scale production and improved medical care with fewer side effects.
Bioelectronic Medicine
Bioelectronic Medicine Applications
Bioelectronic Medicine Market
Boston Scientific Corporation
Bright Medical Ltd
Crohn's Diseases
EnteroMedics Inc.
Galvani Bioelectronics
GE Global Research
Nevro Corp.
SetPoint Medical
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Apathy Quotes. Apathy Quotes from BrainyQuote, an extensive collection of quotations by famous authors, celebrities, and newsmakers.
Apathy Sayings And Apathy Quotes. Apathy Sayings and Quotes. Below you will find our collection of inspirational, wise, and humorous old apathy quotes, apathy sayings, and apathy proverbs, collected over the years from a variety of sources.
Apathy Quotes otes. Political apathy is the luxury of an affluent society where the majority does not feel threatened and people's basic needs are met. Under such circumstances, apathy is understandable, predictable, and perhaps even rational.
ThinkExist.com. "Some people confuse acceptance with apathy, but there's all the difference in the world. Apathy fails to distinguish between what can and what cannot be helped; acceptance makes that distinction.


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Q: Create a TRIGGER/EVENT in PHP/MS SQL 2008 I need to write an Insert on table A which will automatically insert a value into table A after every 24 hours if there's no data for that day. How would I go around writing this? Below is my code. It runs well but doesn't insert anything into the table.
Declare @incidentlevel varchar(50)
set @incidentlevel = 'free'

If exists (Select * from TABLE1 where date = (SELECT CONVERT(VARCHAR(10), GETDATE(), 101)) AND incidentlevel = '')

BEGIN
INSERT INTO TABLE1 (incidentlevel) VALUES (@incidentlevel)
SELECT * FROM TABLE1
WHERE date = (SELECT CONVERT(VARCHAR(10), GETDATE(), 101))

END;

I'm developing this in PHP/MSSQL 2008.
Thanks in advance.

A: I finally resolved it with Job using SQL Server Agent. Thank you all for pointing me in the right direction.

redpajama_set_name: RedPajamaStackExchange


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The Last Ask — A Look Back At Obama's Parting Request, One Year Ago Today
It came as no surprise that an outgoing president would make the obligatory noises about "the peaceful transfer of power from one freely elected president to the next," as President Obama did in his final speech, delivered in Chicago one year ago today. It was a theme used to quell fears and stifle protest, to give Trump "a chance to govern," as both President Obama and Vice President Biden put it after the election, and it was offered as the reason former presidents and other politicians would overcome their appreciable dismay at the election's outcome and attend the inauguration ceremony on the 20th.
Remember? You could not turn on a television, open a newspaper, or click on a mainstream news site in mid-January of 2017 without being told that on inauguration day we were going to witness power's peaceful transfer. Very few people making these presentations went much further, at least publicly, to distinguish succession from transition, or talk in a serious way about power, how it is peacefully transferred, or to raise the questions of legitimacy and political authority that attend the transfer of power.
Those questions were, however, hanging in the air, like the dark clouds that would gather over the Mall on inauguration day, and over the past year, with the Mueller investigation and the current president's daily demonstrations of unfitness for office, they have only grown more urgent and important. Considerations of power that were once the preserve of political theorists are now millions of people's daily, top-of-mind concerns — as they should have been all along.
Obama's Chicago speech did little to dispel the doubts and fears people had, and still have, about his successor; and it did not directly address the big question on nearly everyone's mind that day, and every day since the 2016 election: what is to be done? After the abortive and misguided recount effort in November, the shameful but predictable acquiescence of the electoral college in December, and the first signs of trouble on the Russian front, the hope in early January was that the president would say or do something (what?) to change the course events had taken, or he would make some kind — any kind! — of intervention or call to action.
But this is precisely what Obama did not do. He talked about the forces threatening American democracy (income inequality, racial division, political polarization) which had brought us to this ugly juncture. He celebrated "the power of ordinary Americans" to bring about change, "to get involved, get engaged, and come together to demand it," and the "power" (the word echoes throughout the speech) "our participation, and the choices we make" give to the Constitution. All this talk about the power of the people might have amounted to a kind of preemptive bid, made before the upcoming official ceremony transferred executive power to the loser of the popular vote. But the president never made that bid explicit, and turned deliberately away from asking people to take action.
In fact, when Obama presented the peaceful transfer of power as a "hallmark of our democracy," and the remark elicited boos and shouts of "No!" — cries of resistance, threats of upheaval — he quieted them ("no, no, no, no, no"). By the fifth refusal, the crowd had backed down. What else could he have done? What would have happened had he assented, publicly, to that No!? Or if he had simply stepped back from the podium and let the tide of emotion roll over the crowd?
Over the past year I have often thought about how much hung in the balance at that moment, and how with a gentle reprimand the president took the crowd right back into the flow of his speech. He stumbled just a little after all those impromptu "nos," but recovered balance by using his index finger to guide him through the phrase on the prompter: "the peaceful transfer of power." Regaining his composure, he kept the crowd in check – and they applauded him. (We cannot imagine his successor doing the same, or even trying; it is much easier to imagine him inciting a riot.) He said he was stepping down to rejoin us as a citizen, but he had not yet let go of the reins. By the end of the speech, when the president issued his final charge or made what he called his "final ask," the audience was roaring:
My fellow Americans, it has been the honor of my life to serve you. I won't stop. In fact, I will be right there with you, as a citizen, for all my remaining days.
But for now whether you are young or whether you are young at heart, I do have one final ask of you as your president — the same thing I asked when you took a chance on me eight years ago.
I am asking you to believe. Not in my ability to bring about change — but in yours.
I am asking you to hold fast to that faith written into our founding documents; that idea whispered by slaves and abolitionists; that spirit sung by immigrants and homesteaders and those who marched for justice; that creed reaffirmed by those who planted flags from foreign battlefields to the surface of the moon; a creed at the core of every American whose story is not yet written:
Yes, we can.
The delivery was a little flatter than it had been in previous years. But who could not have been impressed, at the very least, by the rhetorical consistency the president had managed to achieve over the course of two terms in office? History rarely allows anyone — let alone a president — this measure of consistency, and the election in November of 2016 had marked nothing less than a violent historical rupture. This final ask didn't acknowledge the cataclysm. It returned, instead, to familiar themes, central to Obama's own biography, and situated the eight years of Obama's presidency on the arc, or what he called "the long sweep," of history that bends toward justice. This last ask was also a tell — one last public demonstration of President Obama's leadership style. It took the form of a soft directive.
Thank you for everything. My last ask is the same as my first. I'm asking you to believe—not in my ability to create change, but in yours.
— President Obama (@POTUS44) January 11, 2017
One year on, however, it's difficult to say where this parting request, and the end of Obama's presidency, left us. Was this last ask anything more than a feel-good exhortation? The president asked us not to do something, but simply to believe in our ability to do something. That might have been as far as he could go, there on that public platform, with emotions still raw from the election; and of course there's a decent argument to be made that taking ourselves seriously as historical actors, people with the "ability" to bring about change, might be essential to disposing us to do anything at all.
At the same time, "Yes, we can" does not necessarily mean we will, or we ought, or even that we are doing what we can. There is a good distance to travel from believing in oneself as a person capable of doing to the doing itself. Setting intentions, planning projects, coordinating with others, anticipating consequences — all that still only takes us to the edge of action, as the Community Organizer in Chief must know. The great risk of political action comes when we apply power, when we move from can to will. Asking people to believe they can act, but not asking them to do anything in particular, might keep them temporarily from incurring that risk and rushing into the breach, but it also makes action seem like a distant possibility, not an urgent necessity.
We should hardly have expected the president to call for resistance, even if he shared the sense that something — but what, exactly? — had to be done. What he promised instead was redemption. The two could not be less different. If redemption assures us that We Shall Overcome, Someday, resistance plants its feet firmly in the present and declares, We Shall Not Be Moved. Resistance is mounted out of necessity. Strikes, sit downs, shutdowns, blockades, riots, raids — these actions were not always or primarily animated by some great faith in just outcomes, though that faith may have arisen in the course of the fight or helped sustain the fighters. People have made many gains by refusing and resisting power's encroachments, by saying No, You Cannot long before they were able to believe in Yes, We Can. In many cases, things just become so intolerable, the long train of abuses and usurpations, as the Declaration has it, become so unbearable, that ordinary people feel they must stand their ground and resist.
We are living in that kind of moment. The current political crisis demands more than faith. We have to get to work. We should do so with the understanding that resistance, as the very word suggests, will help us push back against the forces intent on destroying the American democratic order, but it is not the extent or end of our power. It is, rather, the limit of theirs. This distinction matters, even though we are still in the thick of the fray. It invites us to think about near- and long-term commitments, and the nature of our power.
Our power is not at all like the power of command that was transferred — I won't say peacefully, given all the damage that has already been done — from one office holder to the other last January. It's another kind of power. It's the power we confer upon each other, not through official ceremonies but through the rituals of everyday life; it's power we hold together, not just as individual rights holders with claims and grievances, but in the first person plural, as a "we."
We realize and renew our power when we gather or assemble publicly. We may not have the power to issue directives or orders, but as the president reminded us, we can make demands – of those who hold political power (by voting, marching, practicing civil disobedience, and so on) and, just as importantly, of each other. We can deliberate what to do, coordinate efforts, and hold each other mutually accountable. There's power in all of that – some power, maybe not enough all by itself to get us to the other side of this crisis, but some; and we have not done nearly enough to develop it, test its limits or discover its possibilities. (Instead, we have built and continue to prop up organizations and institutions that require its surrender.) Ultimately, it's the power we need to govern ourselves responsibly and vigilantly, after we have put an end to current abuses and usurpations.
What should we do? This wasn't the question for the outgoing president to put to us, but one for us to put to ourselves, and in this form: in the first person plural, and with that modal verb should (or ought) to highlight obligations and responsibilities, or right action. There's not one answer to this question, or an end to its deliberation; nor will there be one solution to the crisis, such as the Mueller investigation, a medical diagnosis, the emoluments clause, the 25th Amendment. None of those things alone will do it, because "it" goes (way) beyond removing an abusive and corrupt authoritarian and his cronies from power. " It" is up to us, because ultimately it comes down to reclaiming and realizing self-governance.
Every refusal, however small, to yield to authoritarian attention-stealing, rule-breaking and administrative sabotage will help safeguard our authority to govern ourselves, just as every act of decency and respect, no matter how small, will count as a victory against the moral coarsening we have undergone over the past year. Obama himself made this last point a couple of weeks ago in an end-of-year, schmaltzy Twitter thread of "stories that remind us what's best about America" and demonstrate that "each of us can make a difference, and all of us ought to try." Yes, we ought.
This entry was posted in Ask Is A Verb, Language, Leadership, Louis V. Galdieri's Blog, The Power of Asking and tagged 25th Amendment, acting, action, ask, ask is a verb, asking, authoritarianism, belief, can, citizenship, civil society, collaboration, crisis, deliberation, doing, final ask, impeachment, institutional sabotage, last ask, leadership, leadership style, management style, mutual accountability, no, norms, Obama, oratory, ordinary, ought, peaceful transfer of power, political crisis, power, President Obama, public life, public speaking, redemption, refusal, resistance, responsibility, rhetoric, rule breaking, rules, saying no, self-governance, self-organizing, social compact, strikes, succession, the power of asking, The Resistance, transfer of power, unfit, valediction on January 10, 2018 by lvgaldieri.
When Lily Says "No"
Always take no for an answer is a cardinal rule of asking, I wrote in my first post on this theme. It's a version of the golden rule that's especially worth bearing in mind when making plans to collaborate or act with others, or just talking about what we are going to do.
While giving someone an order might be a way to delegate authority and raise her stature in a group, asking recognizes the authority and standing she already has. According this basic respect takes precedence over extracting promises and concessions or getting to yes in a conversation or negotiation, and unless another person can say "no" and have that answer heeded, she will never really be able to say "we". "No" marks the spot where you stop and we begin.
In other words, taking no for an answer is not just about respecting others, but about respecting and caring for how things are between us (the theme of a post I wrote earlier this week) and for the sense of us we have. That sense of us is how we make up and maintain the social world together. When we ask someone to do something, or ask what we are going to do, we openly acknowledge that there is — or can be — a "we," not just you and I, but a plural first person. Asking creates an opening. It puts us out in the open.
The philosopher Margaret Gilbert seems to be heading in this same direction when she remarks in passing: "successfully questioning someone involves entering a joint commitment with that person."
Take a moment to consider the example she offers. Bob addresses Lily with the question, "Shall we dance?" And Lily answers, "Yes, lets!" From this point on, the usual Gilbertian scenario unfolds. Having expressed their readiness to enter a joint commitment — indicating "that all is in order as far as one's own will is concerned" — Bob and Lily are now jointly committed to dance together.
Once they start dancing, or, actually, even before that, once Lily has said yes and as she rises from her seat, each will have to answer to the other in the event one of them violates the joint commitment, or at least Lily would be justified in complaining if Bob were to drag his feet, go outside for a smoke, or give in to sultry Melissa, who is beckoning with her eyes from the other side of the room.
Unfortunately, Gilbert never elaborates on what "successfully questioning someone" entails, or what might make it different from unsuccessfully questioning someone. On the surface, it looks as if Bob "successfully" questions Lily here because she says "yes" to his request: she accepts his invitation to dance. Bob and Lily have therefore reached an explicit agreement. But let's not confuse successfully questioning someone with getting to yes, or confuse getting to yes with reaching an agreement. (It's worth noting that for Gilbert, joint commitments don't always entail explicit agreements. The way Gilbert puts it is: "everyday agreements can be understood as constituted by…joint commitments" [her emphasis]).
What if Lily says "no"? What if she rolls her eyes, or sticks her nose in the air? In that case, has something like an agreement been reached?
Maybe. As long as Bob takes Lily's no for an answer, we can say he and Lily have agreed not to dance. Of course, Bob might not like our putting it that way. He might say he failed to get Lily to dance with him, but that might also go to show that he was not prepared to take no for an answer and regarded Lily's consent as the only acceptable outcome. We might do better if we were to characterize Bob's questioning Lily in terms of Lily's responsiveness — on that score, both yes and no would count as success — or if we think about what Bob's asking Lily to dance and Lily's refusal puts between them, how it constitutes them as a plural subject.
Though not committed to dance together, Bob and Lily are not done with each other or free of shared commitments after Lily says "no." In a very important way, their relationship has just begun. When one person addresses or flags the attention of another, with a question or a nod, the squeak of a chair or a sneeze, they "jointly commit to recognizing as a body that the two of them are co-present," Gilbert writes. People mutually recognize each other in this way all the time, on queues and in coffee shops, in bookstore aisles and on city sidewalks. Here we are, a "we". Asking helps get us there.
So even if Lily politely refuses Bob with a "no thank you," or rudely brushes him off, Bob can take solace in the thought that he has successfully questioned Lily. Bob's failed bid to dance with Lily commits Lily and Bob to recognize that the two of them are co-present, there in the dance hall. Bob and Lily now have a sense of us, even if Lily will never dance with Bob, and that sense — that relationship — will endure.
With that enduring sense of us between them, Bob and Lily are now jointly committed to Lily's refusal as well. So if Bob were to order Lily or insist that she dance with him, or grab her by the arm and drag her to the dance floor, coercing her, Lily has every right to complain. And if the next time Bob saw Lily he were to pretend that she never refused him at the dance, he would be doing Lily wrong.
This entry was posted in Ask Is A Verb, Louis V. Galdieri's Blog, The Power of Asking and tagged ask, asking, care, co-presence, coercion, collaboration, complaint, consent, dancing, joint commitment, leadership, Margaret Gilbert, moral claims, mutual accountability, mutual recognition, no, non-coercion, non-coercive leadership, non-coercive power, power, power of asking, power relations, the power of asking on March 18, 2016 by lvgaldieri.
Serious Conversations, 8
… as opposed to psychopaths… RT @SquishTalks: Good Leaders are Conversationalists http://t.co/nv39xI1o2d
— stuart chittenden (@chittenden) April 28, 2015
There's a serious aspect to what Stuart jokingly says here. Philip Pettit and Michael Smith put a finger on it in their discussion of what they call "the conversational stance" in "Freedom in Belief and Desire" [pdf].
When we engage in serious conversation about what to believe or do, Pettit and Smith observe, we assume, among other things, that our interlocutor can, and will, change her beliefs (about the way things are) and evaluations (about what to do) in light of evidence. We assume, further, that she will adjust her desires and assess her plan of action in light of these evaluations. (So, they will go on to argue, we hold her responsible as a free thinker and as someone possessed of free will.) Otherwise, there is no point in having the conversation, and there might even be reason to fear that we are involved with a zombie or psychopath:
Were you to think that your interlocutor lacked the dispositions to register and respond to the demands of the norms governing evaluations that you both countenance, and lacked them even in the provisoed measure allowed, you would either have to put his evaluative understanding or commitment in serious question or you would have to regard him as something close to a zombie or a psychopath. How could your interlocutor agree that doing such and such is irrational, so you will ask, but not see that the prescription applies to him? Or, if he does admit it applies to him, how could he fail to adjust his desires and actions accordingly? In particular, how could he fail to do these things, when the failure is not to be explained by reference to familiar obstacles [such as fetishes and obsessions, disabling moods and passions]? The only answer available would seem to be that he is not seriously or sincerely involved in the business of practical evaluation, or that if he is, then he is not reliably attuned to the practical values in question. In either case, you lose solid grounds for authorizing him as a conversational interlocutor. You must cease to see any point in conducting a conversation that is supposed to bear on how he should behave.
This entry was posted in Ask Is A Verb, Language, Leadership, Readings, The Power of Asking and tagged ask is a verb, asking, conversation, conversational stance, evaluations, freedom, Freedom in Belief and Desire, leaders, leadership, Michael Smith, norms, Pettit and Smith, Philip Pettit, practical deliberation, practical evaluation, psychopaths, responsiblity, serious conversations, Stuart Chittenden, the power of asking, zombies on April 29, 2015 by lvgaldieri.
In these notes on serious conversations, I keep circling back, it seems, to two ideas: first, that what makes a conversation serious is not its subject matter or tone, but the stance of its participants toward each other; and, second, that the conversational stance requires that we confer a certain authority on our interlocutors, or (to put it another way) recognize that they have standing to address us.
While other kinds of authority — title, rank, role — are of secondary importance, and can sometimes even get in the way, this moral authority or standing is fundamental. It does not have to be earned, proven or ratified by reference to some person, written instrument or record of accomplishment outside the conversation or by institutional set up. It is constituted and realized in the relationship you and I have — or, if that is just too clunky, let's say it is the relationship you and I have; and it is sufficient authority for a serious conversation because it makes us mutually accountable to each other.
Where this equal human stature (or dignity) is respected (and appreciated), it can be a source of power: not just the power of one over another, but the power to make claims or demands of each other, or to ask and answer, and this power of asking is essential if we are going to deliberate in earnest about our situation or collaborate on something new.
The conversational stance allows for genuine co-creation, because it's not founded on subordination or one person ordering the other about. And the capacity for co-creation, the creative power that we share, only increases as we include more people in the circle of the conversation. (Of course there are limits: the research on group size and social complexity Dunbar summarizes suggests the circle probably should not widen beyond 150 people.)
I've tried to capture this thought in a simple rule: the power of asking will always be greater than the power of command.
That's the basic position.
Another way to put the same thought might be in terms of the mechanics of ordering versus asking: whereas in the former we have one person directing the will of another, as we might address a short-order cook, in the latter we direct each other's wills, so that we are, to stick with the metaphor, chefs in our own kitchen.
Of course the usual caveat applies about too many cooks spoiling the broth, I guess, but let's also remember that people have different talents, training and competencies, and we can worry about how to order and organize ourselves once it comes to the actual cooking. Right now we're just having a conversation.
Let's also acknowledge, while we're at it, that short-order cooks are models of industrial-era efficiency (but no longer efficient enough for the post-industrial fast food kitchen); gains in co-creativity can and probably will translate to losses in short-term efficiency.
Some concessions on one side or the other will probably have to be made, but too often the proponents of efficiency win without any argument, and people start giving orders or setting out plans for what's to be done before the conversation even has a chance to get started. That's when all the real power goes out of the room.
This entry was posted in Ask Is A Verb, The Power of Asking and tagged accountability, agile, agility, asking, authority, autonomy, co-creativity, co-deliberation, collaboration, command and control, conversation, conversational stance, creativity, decisions, deliberation, dignity, efficiency, hierarchy, human dignity, innovation, leadership, mutual accountability, non-coercive leadership, orders, power, power of asking, self-organizing systems, standing, stature on January 28, 2015 by lvgaldieri.
To the Edge of the Gap with Satya Nadella
It's hard to believe that the people around Microsoft CEO Satya Nadella did not prepare him for a question about the pay gap at the Grace Hopper Celebration of Women in Computing conference, and even harder to believe that they would advise him to tell women to stop asking for a raise and place their "faith," instead, in "karma." Nadella must have gone off script, or lost his talking points on the way to Phoenix. He tried to backpedal on Twitter later in the day, but by then the damage was done.
Was inarticulate re how women should ask for raise. Our industry must close gender pay gap so a raise is not needed because of a bias #GHC14
— Satya Nadella (@satyanadella) October 9, 2014
There is a transcript of the mess here. Nadella starts by talking about the inefficiencies of "HR systems" and ends up endorsing a corporate caste system, in which karma determines station. He advises talented women that the arc of Microsoft universe is long, but bends toward justice: they should keep the faith, keep working and just keep quiet about the whole equal pay thing.
Today, he's repented, in an email to Microsoft employees: "if you think you deserve a raise, just ask for it." He's also committed, he says, to closing the pay gap at Microsoft. The trouble is, telling women they should "just ask" for raises may indicate that the CEO has found a formula that will allow him to remove his foot from his mouth, but it isn't going to solve the problem.
In fact, research by the organization Catalyst — which I've written about in another post — shows that while the system may reward men in roughly the way Nadella describes, giving them "the right raises as [they] go along," it does not so reward women; and when women ask for raises, their requests go unmet. It's hard to have faith in a system like that.
The whole incident brings me back, of course, to my ongoing interest in the power of asking, which is the power in question here.
"Just ask" sounds like permission; but permission does not necessarily entail power. What's fascinating about the Catalyst research on what happens when women ask for raises is that it clearly shows that the power of asking is a power we have to confer on others: it's the power we give the other to make claims (or demands) on us.
We confer that power when we recognize the other's status as a second person, or — to put it another way — when we recognize in them an authority equal to our own.
Respect that authority, and we are mutually accountable to each other. Disrespect or disregard it, and we deny others the status of persons, make them instruments of our will or means to our ends. We dehumanize them, or fail to acknowledge them as fully human.
Of course, respect of this fundamental order is not something Nadella can institute at Microsoft by tweeting about "bias," emailing his apologies or by executive fiat. But a good place to start the broader conversation about closing the pay gap (at Microsoft, in the tech industry or throughout the business world) might be to see it, and approach it and address it as a basic power gap that only true respect for persons can bridge.
This entry was posted in Business and Society, Comment, Leadership, The CEO, The Power of Asking and tagged asking, Catalyst, Catalyst.org, corporate culture, corporate governance, Darwall, dignity, equal pay, gender pay gap, Grace Hopper Celebration of Women in Computing, leadership, Microsoft, mutual accountability, pay gap, power, power gap, respect, respect for persons, Satya Nadella, second person standpoint, the power of asking on October 10, 2014 by lvgaldieri.
The sculptor Richard Serra tells the following story about a Charles Mingus session at San Francisco's Jazz Workshop, sometime around 1956.
The performance was in the afternoon and there was a fan on. It was really loud and Mingus was going through his set and they were recording, and the bartender turned off the fan. Mingus had an apoplectic fit. He jumped over the bar and practically throttled the guy. 'That fan was one of my instruments,' he said. And it made me think, as someone who wanted to be an artist, that you had to pay attention all the time to everything that was going on, because everything was of potential use, if you could see the potential.
Place matters, whether you are playing music, making a sculpture or — as I like to remind people — simply having a conversation. From Mingus, Serra learned "to pay attention to everything that was going on," and that ambient attention or awareness of place has figured prominently in Serra's own art, which frequently involves creating site-specific, large-scale sculptures that both fit with and alter their surroundings. Place furnishes the sculptor with context, material and ideas: everything is of "potential use, if you..see the potential". Place can be both potent and useful, a power and a utility. For Serra, it's all a matter of paying attention.
Richard Serra creates large-scale, site-specific sculptures that draw on and amplify the power of place.
How, then, might we tap the power of place and put it to use when it comes to serious conversations? How do we pay attention to the place we are and how does that attention get repaid?
This is a vast topic, so for now I want to set out a few markers, just to get the discussion started.
First and most obviously, place situates the participants. We can talk about place in this basic sense as the setting of a conversation — not merely a location, site or spot; the setting is more like a scene in which we are the actors. I am not entirely sure about the theatrical metaphor (which is inescapable when we talk about place as a scene or setting): I don't mean to imply that conversations are performances for the benefit of anyone other than the interlocutors, that they require an audience, or that the place has the temporary and artificial qualities of a stage or set, put up or constructed for the sake of staging a conversation. That all sounds too contrived, and it implies a grand designer or author behind the scenes. Of course every conversation involves some element of make believe and there is a performative aspect to all conversation, but we ought to imagine an unscripted play, spontaneous or at least unplanned, in which the actors themselves are sole authors and creators — an improvisation.
Place sets conditions and defines limits: this is where we are, not over there, not elsewhere, maybe not even where we most want to be, but here. Limits imply presence, a here and now, and it's up to us to recognize and attend to that. Our attention registers the basic obligation we have to one another, which is simply to be in this place (and in this conversation). The word 'obligation' here shouldn't be misleading or mistaken for mandate or coercion: when a conversation is serious, we are not under any compulsion. We claim each other's attention. It makes sense, then, to talk about place as a space of commitment, a setting to which we can both lay claim and which permits us to make some simple claims: stay and talk awhile; listen to me; help me understand what you are saying. As I've said before, you can't just walk away or start playing hula hoops and I can't take part if I am whistling Dixie or daydreaming of someplace far away. This place is not just incidentally a backdrop for our conversation and our conversation is not a backdrop for some other action that will define or disrupt the place; our mutual presence here commits us jointly to the conversation. Attending to place helps us respect and keep that commitment.
Place creates new possibilities in the conversation, as participants discover and avail themselves of their situation in all sorts of ways. This is close to what Richard Serra is getting at when he talks about paying attention to everything that's going on — a noisy fan, the voices of children playing nearby, the smell and feel of the lush green grass, the roar of traffic or the flow of a nearby stream, a tweeting bird or a passing cyclist, the wail of sirens or the approach of the police, the patter of the rain, the creak of the wood as we settle on a rough-hewn bench. The important point here is that in conversation we experience a place from the inside and in company with others. To keep company is to be a participant, not merely an observer of the place, looking in or looking on from the outside. Our conversation is what's going on there — or at least one of the most important things going on.
Place is intrinsic to the unfolding of conversation, the warp to its woof; and to an appreciable extent, place and conversation may be indistinguishable — especially once things get going. Or it might be easier just to say conversation is the place we create between us. It's not a question of your place or mine. It's ours.
This entry was posted in Ask Is A Verb, Language, Leadership, Louis V. Galdieri's Blog, The Power of Asking and tagged Charles Mingus, coercion, collaboration, conversation, ethics, improvisation, jazz, joint commitment, language, leadership, leading, Margaret Gilbert, mutual accountability, non-coercive power, obligation, place, power, Richard Serra, sense of place, serious conversations on May 28, 2014 by lvgaldieri.
"For me, music has no leader"
In 1997, Ornette Coleman was in Paris to play at La Villette, and sat down for an interview with French philosopher Jacques Derrida. The interview was the subject of a thoughtful piece by Richard Brody in the New Yorker a few years ago, but I came across it only this morning. This part of the exchange especially resonates with me, as it has to do with conversations without a leader (an idea I've been exploring in some of my posts on the power of asking).
On the one hand, Coleman has throughout his career had to dispel the notion that in playing free jazz, "I just picked up my saxophone and played whatever was going through my head, without following any rule, but that wasn't true." He struggled, on the other hand, with the hierarchical, bureaucratic rigidity of the New York Philharmonic, where he had to submit a composition "to the person in charge of scores…to be sure the Philharmonic wouldn't be disturbed." He works according to another model — a conversation in which no one is "in charge," but in which the participants can rely on a "framework" (usually, but not always, provided by the piano).
Here is Timothy S. Murphy's translation:
OC: For the Philharmonic I had to write out parts for each instrument, photocopy them, then go see the person in charge of scores. But with jazz groups, I compose and I give the parts to the musicians in rehearsal. What's really shocking in improvised music is that despite its name, most musicians use a framework [trame] as a basis for improvising. I've just a recorded a CD with a European musician, Joachim Kuhn, and the music I wrote to play with him, that we recorded in August 1996, has two characteristics: it's totally improvised, but at the same time it follows the laws and rules of European structure. And yet, when you hear it, it has a completely improvised feel [air].
JD: First the musician reads the framework, then brings his own touch to it.
OC: Yes, the idea is that two or three people can have a conversation with sounds, without trying to dominate it or lead it. What I mean is that you have to be…intelligent, I suppose that's the word. In improvised music, I think the musicians are trying to reassemble an emotional or intellectual puzzle, in any case a puzzle in which the instruments give the tone. It's primarily the piano that has served at all times as the framework in music, but it's no longer indispensable and, in fact, the commercial aspect of music is very uncertain. Commercial music is not necessarily more accessible, but it is limited.
JD: When you begin to rehearse, is everything ready, written, or do you leave space for the unforeseen?
OC: Let's suppose that we're in the process of playing and you hear something that you think could be improved: you could tell me, "You should try this." For me, music has no leader.
JD: What do you think of the relationship between the precise event that constitutes the concert and pre-written music or improvised music? Do you think that pre-written music prevents the event from taking place?
OC: No, I don't know if it's true for language, but in jazz you can take a very old piece and do another version of it. What's exciting is the memory that you bring to the present. What you're talking about, the form that metamorphoses into other forms, I think it's something healthy, but very rare.
JD: Perhaps you will agree with me on the fact that the very concept of improvisation verges upon reading, since what we understand by improvisation is the creation of something new, yet something which doesn't exclude the pre-written framework that makes it possible.
OC: That's true.
This entry was posted in Ask Is A Verb, Language, Louis V. Galdieri's Blog, The Power of Asking and tagged framework, hierarchy, improvisation, Jacques Derrida, jazz, joint commitment, leaderless, leaders, leadership, music, non-coercion, non-coercive leadership, non-coercive power, organizational hierarchy, Ornette Coleman, rules, serious conversations on May 14, 2014 by lvgaldieri.
So far in these notes on serious conversations I've talked about questions of authority and trust as well as the joint commitments conversations entail. What little I've managed to say may not amount to more than the observation that what makes a conversation "serious" has less to do with subject matter than with the mutual obligations of its participants and their disposition toward the activity of conversation.
Let me spell that out a little more. In order for a conversation to be serious, all parties would have to enter freely into it. So a police interrogation or a dressing down at work are not very likely to qualify as serious conversation, though I wouldn't rule out the possibility that they might become serious if things were to take an unexpected turn. Joint commitment can't be coerced; and while it's possible that one party in a conversation might officially be in charge of things, by election, contract or appointment, all parties have to be vested with equal authority in the conversation — or have equal standing to make claims of others, despite differences in title, social stature, organizational standing, etc. To put it another way, all parties in a serious conversation are mutually accountable to each other.
In subsequent posts I hope I can explore this basic position a little more and strengthen it — or, if need be, abandon it in favor of something more compelling. Right now I want to be clear that while serious conversation requires parity, it's still possible to lead a serious conversation, so long as leading the conversation does not violate the covenant or commitment the participants have made. It all comes down to how one leads, and it's possible — it's very easy — to mislead a conversation: it happens all the time.
For example, someone might insist on getting to the point. A rule of serious conversation applies here: the point is almost beside the point.
The primary point of any conversation, which takes precedence over any insight, conclusion or plan for action the conversation might eventually yield, is that we have jointly committed to do something together — namely, have a conversation. That commitment will entail obligations to each other, some of which we can enumerate right at the outset, because we know, roughly, what conversation will require: e.g., you can't suddenly walk away, or I can't start singing "la la la" while you are talking or patronize you or coerce you into agreement. Others might become apparent only as the conversation wends its way, and neither of us can really know where the conversation will lead — unless, of course, one of us is being disingenuous or duplicitous, in which case the conversation is a sham.
When people insist we get to the point, they are not just short-circuiting the conversation; their efforts to control or wrap up the conversation risk foreclosing on claims we might make or unmet obligations we might have to each other as participants.
This is why, by the way, it's important to be tolerant of meandering turns the conversation might take and of what I call verbal fidgeting and others call throat clearing: all the little tics and tacks we use before we actually get around to saying anything definite. Verbal fidgeting — "like," "I mean," "so…" "you know," etc. — in conversation can be an annoyance, but it isn't just noise; and noise-to-signal ratio is not the best metaphor for conversation.
Fidgeting can indicate that someone is uncomfortable with silence, which is worth attending to, because it might tell us the person isn't listening or feels nervous and doesn't know how to sit with the restlessness that being with others sometimes involves. But fidgeting can also help coordinate the conversation and the being together that conversation entails, bringing others in, building bridges, redirecting attention. At the very least it can help us get to know the habits and manners of the others with whom we're speaking, and conversation happens where those habits and manners — those styles — meet.
This entry was posted in Language, Leadership, The Power of Asking and tagged asking, authority, coercion, collaboration, context, contextualization, contextualization cues, conversation, fidgeting, getting to the point, joint commitment, leadership, leading, mutual accountability, non-coercion, non-coercive power, obligation, power, serious conversations, seriousness, the point, the power of asking, trust, verbal fidgeting on March 9, 2014 by lvgaldieri.
Nora [after a short silence]. Isn't there one thing that strikes you as strange in our sitting here like this?
Helmer. What is that?
Nora. We have been married now eight years. Does it not occur to you that this is the first time we two, you and I, husband and wife, have had a serious conversation?
Helmer. What do you mean by 'serious'?
Nora. In all these eight years–longer than that–from the very beginning of our acquaintance, we have never exchanged a word on any serious subject.
Helmer. Was it likely that I would be continually and forever telling you about worries that you could not help me to bear?
Nora. I am not speaking about business matters. I say that we have never sat down in earnest together to try and get at the bottom of anything.
-Ibsen, A Doll's House, Act 3
Preoccupations may be harder to escape than promises. I went to see a performance of A Doll's House last night at the Harvey Theater, and this exchange between Nora and Torvald in the final act of Ibsen's play reminded me of my pledge to say something more about serious conversations. (My first effort to make good on this pledge is here.).
There's an important point here that I don't want to overlook. A serious conversation requires something more than a serious subject to discuss. It may not have anything to do with the things we take seriously: business matters, for example. Well before we consider things, or the topic at hand, we have to sit down "seriously together" — alvor sammen, as Nora puts it to her husband Torvald in Ibsen's Norwegian.
Of course, Torvald Helmer's "honor" will not survive the serious conversation he and his wife have. The respect Nora ultimately demands — the claim she makes on Torvald and on herself — will destroy their marriage and upset the bourgeois respectability of the Helmer household, or show it for the sham that it is. Torvald should have known: to sit down seriously together is always more about honoring the other than safeguarding personal honor. Or at least it's a matter of honoring the joint commitment to have a serious conversation.
Torvald (Dominic Rowan) and Nora (Hattie Morahan) are about to have their first serious conversation in the BAM Harvey Theater production of Ibsen's A Doll's House.
I'm using "joint commitment" here in Margaret Gilbert's sense — a commitment by two or more people as a body or plural subject, a we, to some act or activity: a walk or a conversation, for instance. For Gilbert, these joint commitments are commonplace associations by which we make up "the social world, the world of conversations, friendships, marriages, sports teams, discussion groups, religious orders, partisans, citizens and so on."
In entering and living up to joint commitments, we share agency with others, and all parties are obligated — have a duty — to act in accordance with the commitment. "If our acting together, our conventions, and other central aspects of our lives together involve our jointly committing ourselves in one way or another, then our lives together are run through with obligations to one another and rights against each other, with the correlative standing to insist on various actions and rebuke for non-performance."
To read the essays collected in Gilbert's Joint Commitment (Oxford, 2013) is to appreciate above all how often and how effortlessly we enter into these joint commitments, just as a matter of course, and to be reminded that assumptions of trust, respect and mutual accountability infuse our everyday social experience.
These are all the issues that come to the surface when Torvald and Nora sit down seriously together, for the first time, to have their serious conversation. Whether we commit jointly to take a walk together (to use Gilbert's favorite example) or have a conversation about work or a stifling marriage, what makes the activity serious is that we are on equal footing and mutually obligated to one another. Acknowledge that, honor it, and we have started to take one another seriously; deny it, or cover it up with patronizing gestures or power grabs, and we are probably heading for crisis or failure.
This entry was posted in Ask Is A Verb, Language, Leadership, Louis V. Galdieri's Blog, The Power of Asking and tagged A Doll's House, ask, ask is a verb, asking, claims, commitment, conversation, honor, Ibsen, joint commitment, leadership, Margaret Gilbert, mutual accountability, non-coercive power, obligations, power, power relations, respect, rights, serious conversations, seriousness, the power of asking, trust on March 7, 2014 by lvgaldieri.
The New Collaboration
"Collaboration" enters the English language in the latter half of the nineteenth century, from French. The OED notes that the word applies especially to literary, artistic and scientific work.
The spike in usage during and immediately after the Second World War comes as no surprise. In a second French import, the words "collaborate," "collaborator," and "collaboration" figure prominently in accounts of quislingism or collusion with the authorities and occupying forces.
But what explains the surge in usage from the mid-1980s on? Nothing very French at all. Instead, during this period, the American business world rehabilitates the word.
The word "collaboration" has now shed many of its sinister associations, and it's become so commonplace that we no longer consider it pretentious or even wrongheaded to elevate the doings of the workplace to a level of human achievement and excellence formerly reserved for intellectual and artistic endeavor.
In the process, we have lost sight of just how rare, intellectually trying and emotionally fraught truly collaborative work can be.
The special working relationships forged by composers and librettists, scientists and illustrators, dancers and musicians, writers and photographers, etc., are usually not made to last; but while they last, they offer collaborators a chance to accomplish something that they could never accomplish if left to themselves.
Now, however, we are regularly asked to believe that collaboration can be something people do every day, on the job. How is that going to happen?
You obviously can't mandate collaboration: "'lets force people to collaborate.' Sounds really dumb, doesn't it?" business consultant Daniel Mezick asked just the other day. Dumb — or downright totalitarian. It's equally senseless to expect collaborative behavior where people are getting bossed around, or promote collaboration while leaving powers of command and organizational hierarchy intact.
Misguided efforts to institutionalize collaboration can also crush creative resistance and penalize rule-breaking — the very essence of successful collaboration — or at least reign in and stifle creative individuals who excel when they disregard protocol and go it alone.
This entry was posted in Language, Leadership, Louis V. Galdieri's Blog, The Power of Asking and tagged collaboration, collaborative behavior, creativity, Daniel Mezick, Google NGram, leadership, non-coercive leadership, non-coercive power, organizational development, power, resistance, the power of asking, words on February 19, 2014 by lvgaldieri.