The research explores the escalation of the herder-farmer conflict in Nigeria to identify the significant patterns of escalation. Relying on a mixed-method analysis of secondary data and aligning with the analytical anchorage of dynamic systems theory, the research argues that the although Benue and Enugu observe the same herder-farmer the patterns of conflict escalation is neither similar, linear or recurrent. This research submits ethnoreligious antagonism, lawlessness, and exclusionary politics as reasons why the conflict escalated into widespread violence. Adding that each of these elements self- reinforces and influence each other to sustain a coordinated state of violence or maintain peace. It makes a case for pragmatic policies that captures the history and political, economic, and social interaction of states and local government.

No description available.

Yes / The National Early Warning Score (NEWS) is being replaced with NEWS2 which adds 3 points for new confusion or delirium. We estimated the impact of adding delirium on the number of medium/high level alerts that are triggers to escalate care. Methods Analysis of emergency medical admissions in two acute hospitals (York Hospital (YH) and Northern Lincolnshire and Goole NHS Foundation Trust hospitals (NH)) in England. Twenty per cent were randomly assigned to have delirium. Results The number of emergency admissions (YH: 35584; NH: 35795), mortality (YH: 5.7%; NH: 5.5%), index NEWS (YH: 2.5; NH: 2.1) and numbers of NEWS recorded (YH: 879193; NH: 884072) were similar in each hospital. The mean number of patients with medium level alerts per day increased from 55.3 (NEWS) to 69.5 (NEWS2), a 25.7% increase in YH and 64.1 (NEWS) to 77.4 (NEWS2), a 20.7% increase in NH. The mean number of patients with high level alerts per day increased from 27.3 (NEWS) to 34.4 (NEWS2), a 26.0% increase in YH and 29.9 (NEWS) to 37.7 (NEWS2), a 26.1% increase in NH. Conclusions The addition of delirium in NEWS2 will have a substantial increase in medium and high level alerts in hospitalised emergency medical patients. Rigorous evaluation of NEWS2 is required before widespread implementation because the extent to which staff can cope with this increase without adverse consequences remains unknown.

Many nurses are physically and verbally abused by the patients under their care, with those providing care to patients dealing with mental illness or addition being at particular risk. Leadership of the project site, an urban mental health treatment center, identified a need to provide additional education to improve their nursing staff's ability to work with combative patients and prevent escalation of violent behaviors. Albert Bandura's social cognitive theory and adaptation to the environment guided the development of this project to answer the question if an education program for nurses working with potentially combative patients will increase their knowledge of strategies to prevent escalation of violent behavior. The education program was developed using results from an extensive literature review and input from a team of local subject experts, who provided evaluation regarding their satisfaction with the planning process through the completion of an anonymous, 10 questions, Likert-type survey. All team members scored each question with a (5) strongly agree or (4) agree. Project deliverables handed over to the facility included the developed education program, an associated handout, a plan for later implementation, and plans for outcome evaluation through evaluation of learning. This project has the potential to achieve positive social change through less violent encounters between nurses and patients, contributing to an increased culture of safety.

At the beginning of the Continuation War in 1941, Finnish and German troops commenced a gradual escalation which resulted in swift successive victories against the Soviets. Yet, Finland´s Field Marshal Mannerheim unexpectedly turned his back on military rationality at Leningrad and Murmansk despite his knowledge of how vitally strategic the locations were to the Soviet war effort. Leningrad was encircled by German and Finnish forces and a successful siege was achievable, yet Mannerheim abruptly discontinued the offensive and chose to assume a stale war lasting until 1944. Likewise, Mannerheim withheld his troops from cutting off Murmansk Railway. These events beckon important inquiries regarding Mannerheim´s decision to de-escalate during successful offensives in a total war and presents a conundrum that few have to date examined holistically. As such, this thesis offers an alternative perspective to the current rational explanations of Finnish warfare in the Continuation War. This thesis discusses specific social processes of Finnish society that rationalist explanations overlook and applies the theory of constructivism to identify that normative factors can complement the prevailing rationalist explanations. This thesis further identifies how the social concepts of identity, shared culture and knowledge, and the norms of the Finnish people, and its leadership, contributed to Mannerheim’s decision to disregard military rationality and de-escalate. Lastly, this thesis determines that norms and ideas matter in war studies and future research should incorporate an interpretivist approach which contemplates social constructions and norms as alternative explanations in complex, multi-casual social phenomena like war.

Lean Startup Teori (LST) har kommit att växa i popularitet inom entreprenörskap världen över. LST är en teori som för startup- företag skall minska kostnader och tid samt för entreprenörer skapa en arbetsprocess som underlättar beslutsfattande. I denna studie har länkar mellan problematik inom beslutsfattande (overconfidence, prospektteori, gloriaeffekten samt escalation of commitment) och LST undersökts genom semistrukturerade intervjuer med entreprenörer i Sverige. Vidare har generella lärdomar från de olika fallen  undersökts för att belysa fördelar och svagheter inom LST. Då pionjärer inom LST hävdat att teorin lämpar sig inom alla  sektorer och branscher har även detta  påstående granskats. Studien fann att LST- processer motverkar de negativa effekterna associerade med overconfidence och  gloriaeffekten men kan inte hantera de  problem som introduceras i samband med prospektteori samt escalation of commitment. Vidare når studien slutsatsen att LST kräver en fit med varje enskilt startup - företag och fungerar bäst inom branscher och industrier som har låga inträdesbarriärer form av kapitalkrav. / Lean Startup theory (LST) has been growing in popularity in entrepreneurship worldwide. LST is a theory for startup companies to reduce costs and time, and for entrepreneurs to create a process that eases decision-making. In this study, links betweenproblems of decision making (overconfidence, prospect theory, the halo effect and escalation of commitment) and LST has been examined through semi-structured interviews with  entrepreneurs in Sweden. Furthermore, general lessons from the cases has been studied to illustrate advantages and  weaknesses of LST. As pioneers of LST argue that the theory is suitable for all  sectors and industries, this claim has also been examined. The study found that LST processes counteract the negative effects associated with overconfidence and the halo effect, but cannot handle the problems that areintroduced in conjunction with the  prospect theory and escalation of  commitment. Furthermore, the study reaches the conclusion that LST requires a fit with each startup company, and functions best in sectors and industries where the entry barrier of capital requirement is low.

Escalation of commitment is an individual's persistent behavior at sustaining commitment to an original decision or course of action. Although researchers have found that personality impacts escalation of commitment behavior, this study addressed a gap in escalation of commitment behavior regarding personality in higher education, which has consistently been ignored. Building on the self-justification theory, this study was an investigation of (a) whether perceived self-efficacy and dispositional optimism individually predicted escalation of commitment behavior; and (b) whether perceived self-efficacy and dispositional optimism jointly predicted escalation of commitment behavior after controlling for age, gender, ethnicity, socioeconomic status, and tenure. Hierarchical regression was performed using a sample of 76 participants from a community college in Minnesota. Results suggested that only perceived self-efficacy will predict leaders' escalation of commitment behavior and not dispositional optimism. The result of this study has implications for positive social change by aiding effective leadership decision making, enabling better screening and recruiting process, and allowing organizations to develop specific training and intervention programs that will help educational leaders utilize their positive attributes appropriately.

The complex interaction between predators and their prey is rarely preserved in the fossil record. However, predation of marine mollusks by drilling gastropods leaves a diagnostic hole in the shell of the prey, possibly allowing for quantitative analysis of this ecological interaction. Drilling frequency, as measured in marine mollusks both in the Modern and fossil record, has been heralded as a potential opportunity to quantify these ecological interactions and use these values in the testing of hypotheses. This study employed the collection, tallying, and analysis of bulk samples derived from shelly deposits on 45 Modern beaches along the contiguous coast of the southeast United States (Virginia Beach, VA to Port Isabella, TX). The tallying scheme allowed for pooling and reduction of the data to compare drilling frequencies at several taxonomic and geographic scales. In addition, multivariate clustering analyses was used to generate groups of similar taxonomic abundances for direct comparison. Understanding potential spatial variation in the natural environment is paramount to using quantified values of drilling frequency in temporal and spatial studies in the fossil record. Calculated drilling frequencies for bulk (location) samples ranged from 0 to over 100%. Similar ranges of drilling frequency were observed in more finely defined taxonomic groups. Calculated drilling frequency was higher in the Carolinian province as compared to the Gulf-Louisianian and Virginian provinces. No correlation between drilling frequency and latitude was observed at any scale. An area of substantially increased drilling frequency was observed along the Carolina coast, at the ecotone between the Carolinian and Virginian provinces, suggesting that some environmental condition is present and responsible for the local increase in drilling frequency. Finally, little attention has been paid to sampling techniques and their subsequent impact on the analysis of drilling frequency. As the bulk samples represent aggregate accumulations of shells from a myriad of environments, this introduces pronounced variation in the analysis that has not been previously accounted for. Statistically, much larger abundances of specimens in individual taxa, approaching 450 values for bivalves, are needed to effectively constrain this variability.

The main purpose of this study was to evaluate medication use patterns (i.e., dose escalation, medication adherence, persistence, and switching) of rheumatoid arthritis (RA) patients on etanercept (ETN), infliximab (IFX) or adalimumab (ADA) and the associated healthcare utilization costs using Texas Medicaid data. Study participants were Medicaid beneficiaries (18-63 years) with an RA diagnosis (ICD-9-CM code 714.0x) who had no claim for a biologic agent in the 6-month pre-index period (July 1, 2003 - Dec 31, 2010). The index date was the first date when the patient had the first fill for any of the study TNF inhibitors (ETN, ADA or IFX) within the study identification period (Jan 1, 2004 – Aug 31, 2010). Data were extracted from July 1, 2003 to August 31, 2011. Prescription and medical claims were analyzed over an 18-month study period (i.e., 6-month pre-index and 12-month post-index periods). The primary study outcomes were adherence, persistence, dose escalation, switching and cost (i.e., total healthcare, RA-related and TNF inhibitor therapy cost). The study covariates were demographic factors (age, gender, race/ethnicity), pre-index use of other RA-related medications (pain, glucocorticoids and disease modifying antirheumatic drugs), total number of non-study RA-related medications used at index, pre-index RA and non-RA related visits, pre-index healthcare utilization cost and Charlson Comorbidity Index score. Conditional regression analyses, which accounts for matched samples, were used to address the study objectives. After propensity score matching, 822 patients (n=274/group) comprised the final sample. The mean age (±SD) was 48.9(±9.8) years, and the majority of the subjects were between 45 and 63 years (69.2%), Hispanic (53.7%) and female (88.0%). Compared to patients on ETN, the odds of having a dose escalation were ≈ 5 [Odds Ratio= 4.605 [95% CI= 1.605-12.677], p=0.0031] and ≈ 8 [Odds Ratio=7.520, [95% CI= 2.461-22.983], p=0.0004] times higher for IFX and ADA patients, respectively, while controlling for other variables in the model. Compared to ETN, patients on IFX (p=0.0171) were more adherent while adherence was comparable with patients on ADA (p=0.1144). Compared to patients on ETN, the odds of being adherent (MPR ≥ 80%) to IFX was ≈ 2 times higher [Odds Ratio= 2.437, [95% CI=1.592-3.731], p < 0.0001] while controlling for other variables in the model. Persistence to index TNF inhibitor therapy and likelihood to switch or discontinue index TNF inhibitor therapy were comparable among the 3 study groups. In addition, the duration of medication use (i.e., persistence) prior to switching or discontinuation of index therapy was comparable among the 3 study groups. Furthermore, for each of the cost variables (total healthcare, RA-related and TNF inhibitor therapy cost), costs incurred by patients on ETN were significantly lower (p < 0.01) than those incurred by ADA patients but significantly higher (p < 0.01) than those incurred by IFX patients. Finally, a positive and significant relationship (p < 0.0001) was found between RA-related healthcare cost, adherence and persistence to TNF inhibitor therapies. In conclusion, ETN was associated with lower rates of dose escalation compared to ADA or IFX. However, adherence was better and associated healthcare costs were lower with IFX. Clinicians should endeavor to work with each individual patient to identify patient-specific factors responsible for poor medication use behaviors with TNF-inhibitor therapies. Reducing the impact of these factors and improving adherence should be included as a major part of the treatment plan for each RA patient. RA patients need to be adequately educated on the importance of adhering and persisting to their TNF-inhibitor therapy as poor medication adherence/persistence negatively impacts the RA disease process. / text

ABSTRACT THE IMPACT OF MOTIVATION AND CONFLICT ESCALATION ON THE FIVE ZONE MODEL FOR PREFERRED CONFLICT HANDLING AND MANAGERIAL DECISION MAKING BY DEWEY WILSON TODD JULY 2005 Committee Chairmen: Dr. Peter Zhang and Dr. Craig Hill Major Department: Managerial Sciences (Decision Sciences) The Todd-Cambridge Preferred Conflict-Handling Mode (PCHM) Instrument is an example of a two-dimensional, five zone model, similar to the Thomas-Kilmann Conflict Mode Instrument, used to explain how individuals deal with situations in which their desires are in conflict with another individual or group. The instrument, developed for this research, was based on the Managerial Grid (Van de Vliert & Kabanoff, 1990). The two variables in the PCHM model are Assertiveness and Cooperativeness. Two additional interacting, independent variables (Motivation and Conflict Escalation) were posited to affect a sudden change in subject action under situations wherein there are different views of recommended decisions. The third variable being explored by this research is “Motivation”. This represents a measure of one’s degree of attachment with respect to a decision. Motivation may originate in compensation, personal regard or an emotional attachment. The primary theory was that while assertiveness and cooperativeness may be statistically uncorrelated, although interdependent for the purposes of categorization (Van de Vliert & Kabanoff, 1990), motivation creates an interaction effect with the other two variables and can be shown by inserting either a negative or positive motivational vignette between two administrations of the PCHM instrument. In other words, when one is highly motivated on a decision component there will be a predictable change in PCHM. Five of ten hypotheses were supported (null rejected) in investigating the effect of motivation. The fourth variable explored was “Conflict Escalation” – also introduced in the form of a vignette. The purpose was to determine the effect on PCHM when a normal group decision making environment suddenly intensified in conflict. Individuals are classified according to the five preference categories, with one primary preference generally emerging. The research question here was, “…as conflict escalates, does the dominant preference score of the individual change significantly?” This could potentially affect communication and make participants more disparate. In two of the five hypotheses, this theory was supported. The conclusion was that, although PCHM has traditionally been considered static, it can be affected suddenly and with a degree of predictability. This can be evidenced through motivation and conflict escalation.