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#ExpertSpotlight - Remembering the invasion of Grenada

The U.S. invasion of Grenada in 1983 stands as a key moment in Cold War history, reflecting the complex dynamics of American foreign policy in the Caribbean. Known as Operation Urgent Fury, this military action was a response to political instability on the island and perceived threats to U.S. citizens and interests. The invasion not only shaped Grenada’s future but also influenced global perceptions of U.S. interventionism, raising questions about sovereignty, international law, and regional geopolitics. The significance of this event continues to resonate, offering numerous story angles for journalists. Key sub-topics include: Cold War Geopolitics and U.S. Foreign Policy: Exploring the broader Cold War context, the U.S.’s strategic interests in the Caribbean, and how the invasion shaped subsequent American foreign policy decisions. Debates on Sovereignty and International Law: Investigating the legal and ethical implications of the invasion, including debates about military intervention, national sovereignty, and international diplomacy. Impact on Grenada’s Political and Social Landscape: Examining the long-term effects of the invasion on Grenada’s political stability, economy, and society, and how the event is remembered locally. Media Coverage and Public Opinion: Analyzing how the invasion was covered by the media at the time, the public’s reaction in the U.S. and globally, and how it shaped perceptions of U.S. military power. The Role of Regional Powers and Alliances: Looking at the involvement of regional organizations like the Organization of Eastern Caribbean States (OECS), and how the invasion impacted relationships between the U.S., Latin America, and the Caribbean. Lessons for Modern U.S. Military Interventions: Reflecting on the invasion’s legacy and what it teaches about the risks, justifications, and consequences of U.S. military interventions in other nations. As the anniversary of the U.S. invasion of Grenada approaches, this event offers an opportunity to revisit critical discussions on international intervention, geopolitical strategy, and the balance between national interests and global governance. Connect with an expert about the 1983  U.S. invasion of Grenada : To search our full list of experts visit www.expertfile.com Photo credit: Encyclopedia Britannica

ChristianaCare Honored for Emergency Nursing Excellence

ChristianaCare has earned the 2024 National Certification Champion Award for health systems from the Board of Certification for Emergency Nursing (BCEN), a leading authority in nursing specialty certification across the emergency care spectrum. ChristianaCare is the only national winner in its category. “ChristianaCare is honored to be named the BCEN National Certification Champion,” said Danielle Weber, DNP, MSM, RN-BC, NEA-BC, chief nurse executive at ChristianaCare. “This prestigious recognition speaks to the passion and dedication of our incredible nursing teams, guided by our values of love and excellence, who make the difference for patients during some of their worst moments, going above and beyond to deliver quality care.” “It’s a privilege to be a part of a team that is committed to nursing excellence, practicing at the top of their license through specialty certification,” Weber continued. “This award represents the culmination of years of focused attention by nursing leadership to promote and facilitate ED nurse certification coupled with a highly motivated and passionate nursing staff who are dedicated to their patients as well as their professional development. We are so proud of our certified nurses and their commitment to lifelong learning.” According to BCEN, nursing specialty certification independently validates a registered nurse’s advanced knowledge, clinical judgment and professionalism across an entire nursing specialty. Specialty board certification of nurses helps assure patients and their families that they are receiving the highest level of nursing care. A growing body of research links nursing specialty certification to improved patient care, safety and outcomes. “We congratulate ChristianaCare on its commitment to nursing excellence,” said BCEN CEO Janie Schumaker, MBA, BSN, RN, CEN, ICE-CCP, CENP, CPHQ, FABC. “The 2024 BCEN National Certification Champions show us how nursing specialty certification empowers nurses, elevates patient care and helps ensure communities of every size have access to advanced emergency and trauma care.” BCEN is an independent not-for-profit organization that offers nursing specialty certification programs for nurses across the emergency care spectrum. Over 50,000 registered nurses specializing in emergency, pediatric emergency, flight, critical care ground transport, trauma and burn nursing hold one or more BCEN certification.

Ask the Expert: Understand the latest on COVID-19 and mpox

As the university physician at Michigan State, Michael Brown advises the president and other leaders on major health policy or programs that impact life on campus or education abroad programs. He is also chair of the Department of Emergency Medicine in the MSU College of Human Medicine. Here, Brown shares the latest guidance about two viruses that are making news — COVID-19 and mpox, which was formerly called monkeypox. Is COVID-19 changing? COVID-19 will be with us for years to come. It seems to come and go in waves and now, it’s surging again across the United States. We’re seeing more cases, but the number of severe cases is much lower than the peaks we saw during the height of the pandemic. This is good news. Just a small fraction of the people who get COVID-19 actually become sick enough to go to the emergency department. We have to keep that in perspective. How can people stay healthy? The virus does mutate — that’s what viruses do — and a couple recent variants have become predominant. Ideally, the next vaccine will target the latest prevalent variants. I expect the Food and Drug Administration to release a new vaccine very soon, and I definitely will be in line to get one when it’s available. In fact, I highly encourage everyone to get a vaccine this fall. The effectiveness peaks about four weeks after you receive it and lasts at least four to six months — maybe longer. The people who are most protected are those who have had a bout of COVID-19, built up their immunity and received a vaccine. This combination is the best protection from getting an illness that’s severe enough to send you to the hospital. What symptoms are associated with this strain of COVID-19? The symptoms are much like what we’ve seen from COVID-19 in the past. It is an upper respiratory illness, so you may have a sore throat, congestion and a cough, but there can be other symptoms like headache. Some people experience nausea, vomiting or diarrhea. Fever and muscle aches are also common. What if someone tests positive for COVID-19? False positives are very rare with COVID-19 tests so if you get a positive result, you should take care of yourself and protect those around you. The Centers for Disease Control and Prevention recommend that you stay home and wear a mask around others. You should also treat your symptoms, stay hydrated and take acetaminophen for fever and muscle aches. After 24 hours of feeling better and being fever-free (with no acetaminophen), you can go out in public. It’s advised that you wear a mask for an additional five days to protect people who are vulnerable. And what about mpox? Mpox is a viral disease largely found in the Democratic Republic of the Congo in Central Africa. The people there are accustomed to living with it. But it mutates, and we have seen a change in the disease patterns in the past few years. One of the new variants is more severe and is now spreading in the Congo region. It has become a critical situation there, but we have not seen the more severe variant here in the United States. Mpox is not as transmissible as COVID-19 because it requires close contact — usually intimate contact or other close physical proximity like sharing a towel. Symptoms include a rash that may start on the face or genital area along with fever and body aches. A vaccine is available, and an experimental drug can be prescribed as treatment. The World Health Organization has asked developed countries like the United States to assist with research to better understand the new variant. Looking to know more - we can help. Michael Brown is available to speak with media - simply connect with Dalin Clark now to arrange an interview today.

The History of Hezbollah

Hezbollah, a powerful political and militant group based in Lebanon, has played a significant role in Middle Eastern politics since its formation in the early 1980s. Understanding the group’s origins, its political evolution, and its regional and global implications is critical in analyzing ongoing conflicts and power dynamics in the region. Hezbollah’s influence extends beyond its militant activities, affecting everything from political governance in Lebanon to its role in broader geopolitical struggles. As global attention often focuses on Middle Eastern stability, the history of Hezbollah provides rich context for journalists to explore various angles on its lasting impact. Here are several story angles that highlight Hezbollah's far-reaching influence: Origins and ideological foundations: Investigate Hezbollah's roots during the Lebanese Civil War, its ideological ties to the Iranian Revolution, and its early activities in resistance movements against Israel. Hezbollah’s role in Lebanese politics: Explore how Hezbollah transformed from a militant group into a major political player, examining its impact on Lebanon's government, elections, and power structure. Regional and international influence: Analyze Hezbollah’s relationships with Iran and Syria, its involvement in the Syrian Civil War, and its role in shaping regional alliances and rivalries in the Middle East. Hezbollah’s military evolution and conflicts with Israel: Provide an in-depth look at the group’s military capabilities, its tactics, and its key confrontations with Israel, including the 2006 Lebanon War. Terrorism designations and global reactions: Investigate Hezbollah’s designation as a terrorist organization by various countries, the group's response, and the wider international community's stance on its activities. Connect with an expert about the the  History of Hezbollah: To search our full list of experts visit www.expertfile.com Photo Credit: Council on Foreign Relations

AU study shows participation in civil society groups lowers suicide rates

A new study by Lance Hunter, PhD, professor of social science in Augusta University’s Pamplin College of Arts, Humanities, and Social Sciences, reveals a direct link between voluntary involvement in civil social groups and a lower risk of suicide. In the study, published in Cross-Cultural Research, Hunter looked at data gathered from 2000 to 2019 from 156 countries with varying levels of development from Africa, Asia, Australia, Europe, North America and South America and found that participation in civil society groups, both political and non-political, may produce positive social and psychological benefits that are associated with lower suicide rates. September is National Suicide Prevention Month, during which mental health advocates, prevention organizations and other community groups promote suicide prevention awareness. “The greater the voluntary participation in civil society groups within the country, the lower the suicide rates are for that country,” said Hunter. “Voluntary civil society participation is a great way for people to connect with other individuals with similar interests and possibly find meaning and purpose to some degree. That in turn decreases feelings of social isolation, which can decrease the likelihood of suicidality or suicide.” Based on the research, he noted that social isolation is a major factor in suicide ideation and attempted suicide but it’s not the only factor. “It is important to note there are many psychological, biological, social and mental health factors that can contribute to suicide risk. Civil society participation and social isolation are just two factors among many that can affect suicidality,” said Hunter. Meredith Rausch, PhD, associate professor in the College of Education and Human Development’s Department of Research, Counseling and Curriculum, said research shows ideation and deaths by suicide in the United States tend to rise between February and April and again in August and September. “I have found the change in seasons often leads to people feeling overwhelmed when it comes to thinking about enduring another season,” said Rausch. “While the advent of spring or autumn may seem enjoyable or hopeful to some people, others find it to represent an entirely new season and the idea of experiencing that is exhausting.” Rausch also notes it’s important to note how these times of the year also coincide with the academic year, causing an increase in bullying, frustration with academics or other negative experiences for school-aged children. According to a 2023 study by the World Health Organization, more than 700,000 people worldwide die each year by suicide, and suicide is the fourth-leading cause of death among people 15 to 29 years old. Interested in learning more - let us help. Lance Hunter, PhD, is available to speak with media about this important topic - simply click on his icon to arrange an interview today.

Stephen Pearlman, M.D., Honored for Excellence in Neonatology Education

Stephen Pearlman, M.D., MSHQS, will receive the 2024 Avroy Fanaroff Neonatal Education Award at the American Academy of Pediatrics’ annual meeting in September. This honor, presented by the AAP’s section on Neonatal-Perinatal Medicine, recognizes an educator who makes outstanding contributions in neonatal-perinatal medicine for health care students, professionals or the public. Pearlman, an expert in neonatology, intensive care and pediatrics, is clinical effectiveness officer for acute care at ChristianaCare. He is also professor of pediatrics at Sidney Kimmel College of Medicine at Thomas Jefferson University. “Stephen is deeply committed to excellence in neonatal education and the highest quality care,” said Kert Anzilotti, M.D.,MBA, system chief medical officer at ChristianaCare. “As a faculty member, physician and leader, he continues to make a lasting impact at ChristianaCare and beyond with his pioneering initiatives in quality improvement and safety in health care.” A faculty member for almost 40 years, Pearlman has served ChristianaCare in clinical, educational and administrative roles. Among them, he was chair of the Pediatric and Neonatal Safety Committee, director of Neonatal Quality Improvement, associate director of Neonatology and director of Pediatric Medical Education. Pearlman has led initiatives that have been spotlighted by the federal government as exemplars of how to improve safety at health systems. He developed an innovative quality-improvement curriculum for neonatal fellows, which the Organization of Neonatal-Perinatal Training Program Directors adopted. “I’m passionate about educating clinicians about ways to improve the quality of patient care, so it’s humbling to receive this recognition,” Pearlman said. “I am honored to have been selected as a recipient of this award.” Pearlman is also an associate editor of Quality Improvement for the Journal of Perinatology and an executive committee member of the American Academy of Pediatrics’ Perinatal Section.

Forbes Ranks ChristianaCare Among America’s Best Employers for Women in 2024

ChristianaCare has been recognized as one of America’s Best Employers for Women by Forbes for 2024, marking the first time the company has received this prestigious recognition. In a survey of 150,000 women working for companies of at least 1,000 employees in the U.S., ChristianaCare ranked 150 on the list of 600 employers that were recognized. “This important recognition is a testament to our culture and the remarkable women who have chosen to build meaningful careers at ChristianaCare,” said Chris Cowan, MEd, FABC, ChristianaCare’s Chief Human Resources Officer. “Empowering women to succeed is integral to our culture and strengthens our organization. Together, we’ll continue to advance equity and inclusion in the workplace while transforming health and clinical care.” Forbes partnered with market research firm Statista, which surveyed employees on various aspects such as workplace environment, growth opportunities, compensation, diversity, parental leave, schedule flexibility and family assistance. ChristianaCare continues to cultivate a strong, inclusive, and diverse culture for women inside and outside the company by investing in professional development through its Women’s Employee Network (WEN) and providing a comprehensive benefits package that includes various flexible leave options for employees, including at least 12 weeks of paid parental leave. “Receiving this recognition from Forbes is an honor,” said Pamela Ridgeway, MBA, MA, SPHR, chief diversity officer and vice president of Talent and Acquisition at ChristianaCare. “In addition to offering workplace benefits such as paid maternity and paternity leave, ChristianaCare is firmly committed to empowering and advancing talented individuals within the workplace. Receiving this award for the first time signifies our unwavering dedication to ensuring that every individual has a voice and feels truly valued within our organization.” The Forbes recognition follows other national recognitions of ChristianaCare’s commitment to an inclusive workplace. Earlier this year, Forbes ranked ChristianaCare as one of the best employers for diversity in the U.S. Additionally, Forbes ranked ChristianaCare as the top health care employer for veterans in the United States. Both ChristianaCare’s Wilmington Hospital and Christiana Hospital have been named Leaders in LGBTQIA+ Healthcare Equality since 2012.

Expert Insight: Training Innovative AI to Provide Expert Guidance on Prescription Medications

A new wave of medications meant to treat Type II diabetes is grabbing headlines around the world for their ability to help people lose a significant amount of weight. They are called GLP-1 receptor agonists. By mimicking a glucagon-like peptide (GLP) naturally released by the body during digestion, they not only lower blood sugar but also slow digestion and increase the sense of fullness after eating. The two big names in GLP-1 agonists are Ozempic and Wegovy, and both are a form of semaglutide. Another medication, tirzepatide, is sold as Mounjaro and Zepbound. It is also a glucose-dependent insulinotropic polypeptide (GIP) agonist as well as GLP-1. Physicians have been prescribing semaglutide and tirzepatide with increasing frequency. However, both medications come with a host of side effects, including nausea and stomach pain, and are not suitable for every patient. Many clinics and physicians do not have immediate access to expert second opinions, as do the physicians at Emory Healthcare. Creating a Digital Twin That lack of an expert is one of the reasons Karl Kuhnert, professor in the practice of organization and management at Emory University’s Goizueta Business School, is using artificial intelligence to capture the expertise of physicians like Caroline Collins MD through the Tacit Object Modeler™, or TOM. By using TOM, developed by Merlynn Intelligence Technologies, Kuhnert and Collins can create her “decision-making digital twin.” This allows Collins to reveal her expertise as a primary care physician with Emory Healthcare and an Assistant Professor at Emory School of Medicine, where she has been leading the field in integrating lifestyle medicine into clinical practices and education. Traditional AI, like ChatGPT, uses massive amount of data points to predict outcomes using what’s known as explicit knowledge. But it isn’t necessarily learning as it goes. According to Kuhnert, TOM has been designed to learn how an expert, like Collins, decides whether or not to prescribe a drug like semaglutide to a patient. Wisdom or tacit knowledge is intuitive and rooted in experience and context. It is hard to communicate, and usually resides only in the expert’s mind. TOM’s ability to “peek into the expert’s mind makes it a compelling technology for accessing wisdom.” “Objective or explicit knowledge is known and can be shared with others,” says Kuhnert. "For example, ChatGPT uses explicit knowledge in its answers. It’s not creating something new. It may be new to you as you read it, but somebody, somewhere, before you, has created it. It’s understood as coming from some source." Karl Kuhnert “Tacit knowledge is subjective wisdom. Experts offer this, and we use their tacit know-how, their implicit knowledge, to make their decisions. If it were objective, everyone could do it. This is why we hire experts: They see things and know things others don’t; they see around corners.” Mimicking the Mind of a Medical Expert Teaching TOM to see around the corners requires Collins to work with the AI over the course of a few days. “Essentially what I do is I sit down with, in this case, a physician, and ask them, ‘What are thinking about when you make this decision?'” says Kuhnert. “The layperson might think that there are hundreds of variables in making a medical decision like this. With the expert’s tacit knowledge and experience, it is usually between seven and twelve variables. They decide based on these critical variables,” he says. "These experts have so much experience, they can cut away a lot of the noise around a decision and get right to the point and ask, ‘What am I looking at?’" Karl Kuhnert As TOM learns, it presents Collins with more and different scenarios for prescribing semaglutide. As she makes decisions, it remembers the variables present during her decision-making process. “Obviously, some variables are going to be more important than other variables. Certain combinations are going to be challenging,” says Collins. “Sometimes there are going to be some variables where I think, yes, this patient needs a GLP-1. Then there may be some variables where I think, no, this person really doesn’t need that. And which ones are going to win out? That’s really where TOM is valuable. It can say, okay, when in these difficult circumstances where there are conflicting variables, which one will ultimately be most important in making that decision?” The Process: Trusting AI After working with TOM for several hours, Collins will have reacted to enough scenarios for TOM to learn to make her decision. The Twin will need to demonstrate that it can replicate her decision-making with acceptable accuracy—high 90s to 100 percent. Once there, Collins’ Twin is ready to use. “I think it’s important to have concordance between what I would say in a situation and then what my digital twin would say in a situation because that’s our ultimate goal is to have an AI algorithm that can duplicate what my recommendation would be given these circumstances for a patient,” Collins says. “So, someone, whether that be an insurance company, or a patient themselves or another provider, would be able to consult TOM, and in essence, me, and say, in this scenario, would you prescribe a GLP-1 or not given this specific patient’s situation?” The patient’s current health and family history are critical when deciding whether or not to prescribe semaglutide. For example, according to Novo Nordisk, the makers of Ozempic, the drug should not be prescribed to patients with a history of problems with the pancreas or kidneys or with a family history of thyroid cancer. Those are just the start of a list of reasons why a patient may or may not be a good candidate for the medication. Kuhnert says, “What we’re learning is that there are so many primary care physicians right now that if you come in with a BMI over 25 and are prediabetic, you’re going to get (a prescription). But there’s much more data around this to suggest that there are people who are health marginalized, and they can’t do this. They should not have this (medication). It’s got to be distributed to people who can tolerate it and are safe.” Accessing the Digital Twin on TOM Collins’s digital twin could be available via something as easy to access as an iPhone app. “Part of my job is to provide the latest information to primary care physicians. Now, I can do this in a way that is very powerful for primary care physicians to go on their phones and put it in. It’s pretty remarkable, according to Colllins.” It is also transparent and importantly sourced information. Any physician using a digital twin created with TOM will know exactly whose expertise they are accessing, so anyone asking for a second opinion from Colllins will know they are using an expert physician from Emory University. In addition to patient safety, there are a number of ways TOM can be useful to the healthcare industry when prescribing medications like semaglutide. This includes interfacing with insurance companies and the prior approval process, often lengthy and handled by non-physician staff. “Why is a non-expert at an insurance company determining whether a patient needs a medication or not? Would it be better to have an expert?” says Collins. “I’m an expert in internal medicine and lifestyle medicine. So, I help people not only lose weight, but also help people change their behaviors to optimize their health. My take on GLP-1 medications is not that everyone needs them, it’s that they need to be utilized in a meaningful way, so patients will get benefit, given risks and benefits for these medications.” The Power of a Second Opinion Getting second, and sometimes third, opinions is a common practice among physicians and patients both. When a patient presents symptoms to their primary care physician, that physician may have studied the possible disease in school but isn’t necessarily an expert. In a community like Emory Healthcare, the experts are readily available, like Collins. She often serves as a second opinion for her colleagues and others around the country. “What we’re providing folks is more of a second opinion. Because we want this actually to work alongside someone, you can look at this opinion that this expert gave, and now, based on sourced information, you can choose. This person may be one of the best in the country, if not the world, in making this decision. But we’re not replacing people here. We’re not dislocating people with this technology. We need people. We need today’s and tomorrow’s experts as well,” according to Kuhnert. But also, you now have the ability to take an Emory physician’s diagnosing capabilities to physicians in rural areas and make use of this information, this knowledge, this decision, and how they make this decision. We have people here that could really help these small hospitals across the country. Caroline Collin MD Rural Americans have significant health disparities when compared to those living in urban centers. They are more likely to die from heart disease, cancer, injury, chronic respiratory disease, and stroke. Rural areas are finding primary care physicians in short supply, and patients in rural areas are 64 percent less likely to have access to medical specialists for needed referrals. Smaller communities might not have immediate access to experts like a rheumatologist, for example. In addition, patients in more rural areas might not have the means of transportation to get to a specialist, nor have the financial means to pay for specialized visits for a diagnosis. Collins posits that internal medicine generalists might suspect a diagnosis but want to confirm before prescribing a course of treatment. “If I have a patient for whom I am trying to answer a specific question, ‘Does this patient have lupus?’, for instance. I’m not going to be able to diagnose this person with lupus. I can suspect it, but I’m going to ask a rheumatologist. Let’s say I’m in a community where unfortunately, we don’t have a rheumatologist. The patient can’t see a rheumatologist. That’s a real scenario that’s happening in the United States right now. But now I can ask the digital twin acting as a rheumatologist, given these variables, ‘Does this patient have lupus?’ And the digital twin could give me a second opinion.” Sometimes, those experts are incredibly busy and might not have the physical availability for a full consult. In this case, someone could use TOM to create the digital twin of that expert. This allows them to give advice and second opinions to a wider range of fellow physicians. As Kuhnert says, TOM is not designed or intended to be a substitute for a physician. It should only work alongside one. Collins agreed, saying, “This doesn’t take the place of a provider in actual clinical decision-making. That’s where I think someone could use it inappropriately and could get patients into trouble. You still have to have a person there with clinical decision-making capacity to take on additional variables that TOM can’t yet do. And so that’s why it’s a second opinion.” “We’re not there yet in AI says Collins. We have to be really careful about having AI make actual medical decisions for people without someone there to say, ‘Wait a minute, does this make sense?’” AI Implications in the Classroom and Beyond Because organizations use TOM to create digital twins of their experts, the public cannot use the twins to shop for willing doctors. “We don’t want gaming the system,” says Collins. “We don’t want doctor shopping. What we want is a person there who can utilize AI in a meaningful way – not in a dangerous way. I think we’ll eventually get there where we can have AI making clinical decisions. But I don’t think I’d feel comfortable with that yet.” The implications of using decision-making digital twins in healthcare reach far beyond a second opinion for prescription drugs. Kuhnert sees it as an integral part of the future of medical school classrooms at Emory. In the past, teaching case studies have come from books, journals, and papers. Now, they could come alive in the classroom with AI simulation programs like TOM. "I think this would be great for teaching residents. Imagine that we could create a simulation and put this in a classroom, have (the students) do the simulation, and then have the physician come in and talk about how she makes her decisions." Karl Kuhnert “And then these residents could take this decision, and now it’s theirs. They can keep it with them. It would be awesome to have a library of critical health decisions made in Emory hospitals,” Kuhnert says. Collins agreed. “We do a lot of case teaching in the medical school. I teach both residents and medical students at Emory School of Medicine. This would be a really great tool to say, okay, given these set of circumstances, what decision would you make for this patient? Then, you could see what the expert’s decision would have been. That could be a great way to see if you are actually in lockstep with the decision-making process that you’re supposed to be learning.” Kuhnert sees decision-making twins moving beyond the healthcare system and into other arenas like the courtroom, public safety, and financial industries and has been working with other experts to digitize their knowledge in those fields. "The way to think about this is: say there is a subjective decision that gets made that has significant ramifications for that company and maybe for the community. What would it mean if I could digitize experts and make it available to other people who need an expert or an expert’s decision-making?" Karl Kuhnert “You think about how many people aren’t available. Maybe you have a physician who’s not available. You have executives who are not available. Often expertise resides in the minds of just a few people in an organization,” says Kuhnert. “Pursuing the use of technologies like TOM takes the concept of the digital human expert from simple task automation to subjective human decision-making support and will expand the idea of a digital expert into something beyond our current capabilities,” Kuhnert says. “I wanted to show that we could digitize very subjective decisions in such areas as ethical and clinical decision-making. In the near future, we will all learn from the wisdom codified in decision-making digital twins. Why not learn from the best? There is a lot of good work to do.” Karl Kuhnert is a Professor in the Practice of Organization & Management and Associate Professor of Psychiatry, School of Medicine and Senior Faculty Fellow of the Emory Ethics Center. If you're looking to connect with Karl to know more - simply click on his icon now to arrange a time to talk today.

Decoding Hierarchies in Business: When is Having a Boss a Benefit for an Organization?

Most companies around the world have a leader, whether that title is a President, CEO, or Founder. There’s almost always someone at the very top of a corporate food chain, and from that position down, the company is structured hierarchically, with multiple levels of leadership supervising other employees. It’s a structure with which most people in the working world are familiar, and it dates back as long as one can remember. The word itself—leader—dates back to as far as the 12th Century and is derived from the Old English word “laedere,” or one who leads. But in 2001, a group of software engineers developed the Agile Workflow Methodology, a project development process that puts a priority on egalitarian teamwork and individual independence in searching for solutions. A number of businesses are trying to embrace a flatter internal structure, like the agile workflow. But is it necessarily the best way to develop business processes? That’s the question posed by researchers, including Goizueta Business School’s Özgecan Koçak, associate professor of organization and management, and fellow researchers Daniel A. Levinthal and Phanish Puranam in their recently published paper on organizational hierarchies. “Realistically, we don’t see a lot of non-hierarchical organizations,” says Koçak. “But there is actually a big push to have less hierarchy in organizations.” "Part of it is due to the demotivating effects of working in authoritarian workplaces. People don’t necessarily like to have a boss. We place value in being more egalitarian, more participatory." Özgecan Koçak, Associate Professor of Organization & Management “So there is some push to try and design organizations with flatter hierarchies. That is specifically so in the context of knowledge-based work, and especially in the context of discovery and search.” Decoding Organizational Dynamics While the idea of an egalitarian workplace is attractive to many people, Koçak and her colleagues wanted to know if, or when, hierarchies were actually beneficial to the health of organizations. They developed a computational agent-based model, or simulation, to explore the relationships between structures of influence and organizational adaptation. The groups in the simulation mimicked real business team structures and consisted of two types of teams. In the first type, one agent had influence over the beliefs of rest of the team. For the second type, no one individual had any influence over the beliefs of the team. The hierarchical team vs. the flat structured team. “When you do simulations, you want to make sure that your findings are robust to those kinds of things like the scale of the group, or the how fast the agents are learning and so forth,” says Koçak. "What’s innovative about this particular simulation is that all the agents are learning from their environment. They are learning through trial and error. They are trying out different alternatives and finding out their value." Özgecan Koçak Koçak is very clear that the hierarchies in the simulation are not exactly like hierarchies in a business organization. Every agent was purposefully made to be the same without any difference in wisdom or knowledge. “It’s really nothing like the kinds of hierarchies you would see in organizations where there is somebody who has a corner office, or somebody who is has a management title, or somebody’s making more than the others. In the simulation, it’s nothing to do with those distributional aspects or control, and nobody has the ability to control what others do in (the simulation). All control comes through influence of beliefs.” Speed vs. Optimal Solutions What they found in the simulation was that while both teams solved the same problems presented to them, they achieved different results at different speeds. "We find that hierarchical teams don’t necessarily find the best solution, but they find the good enough solution in the shorter term. So if you are looking at the really long term, crowds do better. The crowds where individuals are all learning separately, they find the best solution in the long run, even though they are not learning from each other." Özgecan Koçak For example, teams of scientists looking for cures or innovative treatments for diseases work best with a flat structure. Each individual works on their own timeline, with their own search methodologies. The team only comes together for status updates or to discuss their projects without necessarily getting influence or direction from colleagues. The long-term success of the result is more important in some cases than the speed at which they arrive to their conclusion. That won’t work for an organization that answers to a board of directors or shareholders. Such parties want to see rapid results that will quickly impact the bottom line of the company. This is why the agile methodology is not beneficial to large-scale corporations. Koçak says, “When you try to think about an entire organization, not just teams, it gets more complicated. If you have many people in an organization, you can’t have everybody just be on the same team. And then you have to worry about how to coordinate the efforts of multiple teams. "That’s the big question for scaling up agile. We know that the agile methodology works pretty well at the team level. However, when firms try to scale it up applied to the entire organization, then you have more coordination problems." Özgecan Koçak Özgecan Koçak (pronounced as ohz-gay-john ko-chuck) is associate professor of Organization & Management at Emory University’s Goizueta Business School. If you're looking to know more about this topic or connect with Özgecan for an interview - simply click on her icon today

Small Changes Can Save Lives: How a Police Officer’s First Words Can Transform Communities

Britt Nestor knew something needed to change. Nestor is a police officer in North Carolina. Unlike many in her field, who recite interview-ready responses about wanting to be a police officer since childhood, Nestor admits that her arrival to the field of law enforcement was a serendipitous one. Told by teachers to start rehearsing the line “do you want fries with that?” while in high school, Nestor went to college to prove them wrong—and even graduated with a 3.9 GPA solely to prove those same people wrong—but she had absolutely no idea what to do next. When a local police department offered to put her through the police academy, her first thought was, “absolutely not.” “And here I am,” says Nestor, 12 years into her career, working in Special Victims Investigations as an Internet Crimes Against Children detective. A Calling to Serve Community Brittany Nestor, New Blue Co-Founder and President Though she’d initially joined on a whim, Nestor stuck around and endured many growing pains, tasting some of the problematic elements of police culture firsthand. As a woman, there was particular pressure to prove herself; she resisted calling for back-up on dangerous calls for fear of being regarded as weak, and tried out for and joined the SWAT team to demonstrate her mettle. "It took time to realize I didn’t need to make the most arrests or get the most drugs and guns to be a good cop. What was important was recognizing that I was uniquely positioned and given opportunities every single shift to make a difference in people’s lives—that is what I wanted to focus on." Britt Nestor Nestor found she took great pleasure in interacting with different kinds of people all day. She’s deeply fond of her community, where she is also a youth basketball coach. One of her greatest joys is being on call or working an event and hearing someone hail her from the crowd by yelling, “hey, coach!” When she landed in the Juvenile Investigations Unit, Nestor truly felt she’d found her calling. Still, what she’d witnessed in her profession and in the news weighed on her. And she’s not alone; while there is continued debate on the urgency and extent of changes needed, 89% percent of people are in favor of police reform, according to a CBS/YouGov poll. A few weeks after George Floyd’s murder in 2020, Nestor’s colleague Andy Saunders called her and told her they had to do something. It felt like the tipping point. “I knew he was right. I needed to stop wishing and hoping police would do better and start making it happen.” Andy Saunders, New Blue Co-Founder and CEO That conversation was the spark that grew into New Blue. Founded in 2020, New Blue strives to reform the U.S. Criminal Justice system by uniting reform-minded police officers and community allies. The organization focuses on incubating crowd-sourced solutions from officers themselves, encouraging those in the field to speak up about what they think could improve relations between officers and the communities they serve. “Over the years I’ve had so many ideas—often addressing problems brought to light by community members—that could have made us better. But my voice was lost. I didn’t have much support from the police force standing behind me. This is where New Blue makes the difference; it’s the network of fellows, alumni, partners, mentors, and instructors I’d needed in the past.” Nestor and Saunders had valuable pieces of the puzzle as experienced law enforcement professionals, yet they knew they needed additional tools. What are the ethical guidelines around experimenting with new policing tactics? What does success look like, and how could they measure it? The Research Lens Over 400 miles away, another spark found kindling; like Nestor, Assistant Professor of Organization & Management Andrea Dittmann’s passion for making the world a better place is palpable. Also, like Nestor, it was an avid conversation with a colleague—Kyle Dobson—that helped bring a profound interest in police reform into focus. Dittmann, whose academic career began in psychology and statistics, came to this field by way of a burgeoning interest in the need for research-informed policy. Much of her research explores the ways in which socioeconomic disparities play out in the work environment, and—more broadly—how discrepancies of power shape dynamics in organizations of all kinds. When people imagine research in the business sector, law enforcement is unlikely to crop up in their mind. Indeed, Dittmann cites the fields of criminal justice and social work as being the traditional patrons of police research, both of which are more likely to examine the police force from the top down. Andrea Dittmann Dittmann, however, is a micro-oriented researcher, which means she assesses organizations from the bottom up; she examines the small, lesser-studied everyday habits that come to represent an organization’s values. “We have a social psychology bent; we tend to focus on individual processes, or interpersonal interactions,” says Dittmann. She regards her work and that of her colleagues as a complementary perspective to help build upon the literature already available. Where Dittmann has eyes on the infantry level experience of the battleground, other researchers are observing from a bird’s eye view. Together, these angles can help complete the picture. And while the “office” of a police officer may look very different from what most of us see every day, the police force is—at the end of the day—an organization: “Like all organizations, they have a unique culture and specific goals or tasks that their employees need to engage in on a day-to-day basis to be effective at their jobs,” says Dittmann. Theory Meets Practice Kyle Dobson, Postdoctoral Researcher at The University of Texas at Austin What Dittmann and Dobson needed next was a police department willing to work with them, a feat easier said than done. Enter Britt Nestor and New Blue. "Kyle and I could instantly tell we had met people with the same goals and approach to reforming policing from within." Andrea Dittmann Dittmann was not surprised by the time it took to get permission to work with active officers. “Initially, many officers were distrustful of researchers. Often what they’re seeing in the news are researchers coming in, telling them all the problems that they have, and leaving. We had to reassure them that we weren’t going to leave them high and dry. If we find a problem, we’re going to tell you about it, and we’ll work on building a solution with you. And of course, we don’t assume that we have all the answers, which is why we emphasize developing research ideas through embedding ourselves in police organizations through ride-alongs and interviews.” After observing the same officers over years, they’re able to build rapport in ways that permit open conversations. Dittmann and Dobson now have research running in many pockets across the country, including Atlanta, Baltimore, Chicago, Washington, D.C. and parts of Texas. The Rise of Community-Oriented Policing For many police departments across the nation, there is a strong push to build closer and better relationships with the communities they serve. This often translates to police officers being encouraged to engage with citizens informally and outside the context of enforcing the law. If police spent more time chatting with people at a public park or at a café, they’d have a better chance to build rapport and foster a collective sense of community caretaking—or so the thinking goes. Such work is often assigned to a particular unit within the police force. This is the fundamental principle behind community-oriented policing: a cop is part of the community, not outside or above it. This approach is not without controversy, as many would argue that the public is better served by police officers interacting with citizens less, not more. In light of the many high-profile instances of police brutality leaving names like Breonna Taylor and George Floyd echoing in the public’s ears, their reticence to support increased police-to-citizen interaction is understandable. “Sometimes when I discuss this research, people say, ‘I just don’t think that officers should approach community members at all, because that’s how things escalate.’ Kyle and I acknowledge that’s a very important debate and has its merits.” As micro-oriented researchers, however, Dittmann and Dobson forgo advocating for or dismissing broad policy. They begin with the environment handed to them and work backward. “The present and immediate reality is that there are officers on the street, and they’re having these interactions every day. So what can we do now to make those interactions go more smoothly? What constitutes a positive interaction with a police officer, and what does it look like in the field?” Good Intentions Gone Awry To find out, they pulled data through a variety of experiments, including live interactions, video studies and online experiments, relying heavily on observation of such police-to-citizen interactions. "What we wanted to do is observe the heterogeneity of police interactions and see if there’s anything that officers are already doing that seems to be working out in the field, and if we can ‘bottle that up’ and turn that into a scalable finding." Andrea Dittmann Dittmann and her colleagues quickly discovered a significant discrepancy between some police officers’ perceived outcome of their interactions with citizens and what those citizens reported to researchers post-interaction. “An officer would come back to us and they’d say it went great. Like, ‘I did what I was supposed to do, I made that really positive connection.’ And then we’d go to the community members, and we’d hear a very different story: ‘Why the heck did that officer just come up to me, I’m just trying to have a picnic in the park with my family, did I do something wrong?’” Community members reported feeling confused, harassed, or—at the worst end of the spectrum—threatened. The vast majority—around 75% of citizens—reported being anxious from the very beginning of the interaction. It’s not hard to imagine how an officer approaching you apropos of nothing may stir anxious thoughts: have I done something wrong? Is there trouble in the area? The situation put the cognitive burden on the citizen to figure out why they were being approached. The Transformational Potential of the “Transparency Statement” And yet, they also observed officers (“super star” police officers, as Dittmann refers to them) who seemed to be especially gifted at cultivating better responses from community members. What made the difference? “They would explain themselves right from the start and say something like, ‘Hey, I’m officer so-and-so. The reason I’m out here today is because I’m part of this new community policing unit. We’re trying to get to know the community and to better understand the issues that you’re facing.’ And that was the lightbulb moment for me and Kyle: the difference here is that some of these officers are explaining themselves very clearly, making their benevolent intention for the interaction known right from the start of the conversation.” Dittmann and her colleagues have coined this phenomenon the “transparency statement.” Using a tool called the Linguistic Inquiry & Word Count software and natural language processing tools, the research team was able to analyze transcripts of the conversations and tease out subconscious cues about the civilians’ emotional state, in addition to collecting surveys from them after the encounter. Some results jumped out quickly, like the fact that those people whose conversation with an officer began with a transparency statement had significantly longer conversations with them. The team also employed ambulatory physiological sensors, or sensors worn on the wrist that measure skin conductivity and, by proxy, sympathetic nervous system arousal. From this data, a pattern quickly emerged: citizens’ skin conductance levels piqued early after a transparency statement (while this can be a sign of stress, in this context researchers determined it to reflect “active engagement” in the conversation) and then recovered to baseline levels faster than in the control group, a pattern indicative of positive social interaction. Timing, too, is of the essence: according to the study, “many patrol officers typically made transparency statements only after trust had been compromised.” Stated simply, the interest police officers showed in them was “perceived as harassment” if context wasn’t provided first. Overall, the effect was profound: citizens who were greeted with the transparency statement were “less than half as likely to report threatened emotions.” In fact, according to the study, “twice as many community members reported feeling inspired by the end of the interaction.” What’s more, they found that civilians of color and those from lower socioeconomic backgrounds —who may reasonably be expected to have a lower baseline level of trust of law enforcement—“may profit more from greater transparency.” Talk, it turns out, is not so cheap after all. Corporate Offices, Clinics, and Classrooms The implications of this research may also extend beyond the particulars of the police force. The sticky dynamics that form between power discrepancies are replicated in many environments: the classroom, between teachers and students; the office, between managers and employees; even the clinic, between medical doctors and patients. In any of these cases, a person with authority—perceived or enforceable—may try to build relationships and ask well-meaning questions that make people anxious if misunderstood. Is my boss checking in on me because she’s disappointed in my performance? Is the doctor being nice because they’re preparing me for bad news? “We believe that, with calibration to the specific dynamics of different work environments, transparency statements could have the potential to ease tense conversations across power disparities in contexts beyond policing,” says Dittmann. More Research, Action, and Optimism What could this mean for policing down the road? Imagine a future where most of the community has a positive relationship with law enforcement and there is mutual trust. "I often heard from family and friends that they’d trust the police more ‘if they were all like you.’ I can hear myself saying, ‘There are lots of police just like me!’ and I truly believe that. I believe that so many officers love people and want to serve their communities—and I believe a lot of them struggle with the same things I do. They want to see our profession do better!" Britt Nestor “When I get a new case and I meet the survivor, and they’re old enough to talk with me, I always explain to them, ‘I work for you. How cool is that?’ And I truly believe this: I work for these kids and their families.” The implications run deep; a citizen may be more likely to reach out to police officers about issues in their community before they become larger problems. An officer who is not on edge may be less likely to react with force. Dittmann is quick to acknowledge that while the results of the transparency statement are very promising, they are just one piece of a very large story with a long and loaded history. Too many communities are under supported and overpoliced; it would be denying the gravity and complexity of the issue to suggest that there is any silver bullet solution, especially one so simple. More must be done to prevent the dynamics that lead to police violence to begin with. “There’s a common narrative in the media these days that it’s too late, there’s nothing that officers can do,” says Dittmann. Yet Dittmann places value on continued research, action and optimism. When a simple act on the intervention side of affairs has such profound implications, and is not expensive or difficult to implement, one can’t help but see potential. “Our next step now is to develop training on transparency statements, potentially for entire agencies,” says Dittmann. “If all the officers in the agency are interacting with transparency statements, then we see this bottom-up approach, with strong potential to scale. If every interaction you have with an officer in your community starts out with that transparency statement, and then goes smoothly, now we’re kind of getting to a place where we can hopefully talk about better relations, more trust in the community, at a higher, more holistic, level.” While the road ahead is long and uncertain, Dittmann’s optimism is boosted by one aspect of her findings: those community members who reported feeling inspired after speaking with police officers who made their benevolent intentions clear. "That was really powerful for me and Kyle. That’s what gets me out of bed in the morning. It’s worth trying to move the needle, even just a little bit." Andrea Dittmann Looking to know more?  Andrea Dittman is available to speak with media about this important research. Simply click on her icon now to arrange an interview today.