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Articles 4051 - 4080 of 659174
Full-Text Articles in Entire DC Network
The Cleansing Effect Of Technological Investment: An Empirical Analysis Of Episodic Labor Market Polarization (2000–2010), Adam Murphy
University Honors Theses
This paper investigates the episodic nature of labor market polarization in the United States between 2000 and 2010. While the Skill-Biased Technological Change (SBTC) framework may have successfully explained the rise of inequality in the 1980s, it struggled to account for the wage stagnation and hollowing out of the middle class that followed in the 1990s and 2000s. Utilizing Task-Biased Technological Change (TBTC) as a primary lens, this study examines how the codification of routine tasks allowed for the widespread substitution of middle-skill labor by technological capital. By synthesizing IPUMS-CPS occupational data with Bureau of Economic Analysis (BEA) investment statistics, …
Fundamentalist Disorientations For Queer Subjects: Narrative And Theory, Betty Canoso
Fundamentalist Disorientations For Queer Subjects: Narrative And Theory, Betty Canoso
University Honors Theses
This thesis examines disorientation experienced by queer people who were raised in high-cost fundamentalist Christianity–people like me. Disorientation is a philosophical concept useful for examining specific intersections of human experience, like queerness and fundamentalism. Philosophers such as Sara Ahmed (2006) and Ami Harbin (2016) have been exploring the intersection of queerness and disorientation. Psychologists, sociologists and researchers from other disciplines are analyzing the interrelatedness of queerness and religion, and disaffiliation and deconversion from high-cost or high-control religions is another ongoing area of interest. Yet, despite widespread interest in these concepts, few have looked at instances of disorientation as they pertain …
Who Keeps Us Safe? Youth Resistance And Security Regimes At The Neoliberal University, Arwen Hansell
Who Keeps Us Safe? Youth Resistance And Security Regimes At The Neoliberal University, Arwen Hansell
University Honors Theses
In a political climate shaped by surveillance, labor precarity, policing, and immigration enforcement, questions of (in)security increasingly organize everyday life. Governments justify security measures through the language of public safety, even as many people experience insecurity surrounding housing, healthcare, employment, and the future itself. Although critical security studies have examined policing, militarism, and surveillance extensively, youth are often overlooked as political actors despite their central role in social movements. This study addresses that gap by focusing on student labor organizers and activists navigating (in)security. Using collaborative ethnography, I conducted fieldwork at protests, labor organizing meetings, workshops, and demonstrations connected to …
Not Everyone Gets A Tree: Housing Values, Street Trees, And Equity In Portland, Matthew Moller
Not Everyone Gets A Tree: Housing Values, Street Trees, And Equity In Portland, Matthew Moller
University Honors Theses
Street trees are positively associated with Portland home sale prices, but exposure and capitalization are uneven by race/ethnic neighborhood context. Urban trees are ecological assets, but their economic and equity implications remain uneven. This thesis examines street-tree exposure and 2023 residential sale prices in Portland, Oregon (n = 6,414) using a mixed-methodology hedonic design. Ordinary least squares models measure inventoried street-tree counts within 20m, 50m, and 100m buffers together with structural controls and census-block racial and ethnic context. Trees are positively and significantly associated with logged prices at all radii, with scale-sensitive magnitudes and modestly better fit as wider buffers. …
Reconfiguring Dependency: China's Belt And Road Initiative And Development In Ethiopia And Nigeria, Alexander Freund
Reconfiguring Dependency: China's Belt And Road Initiative And Development In Ethiopia And Nigeria, Alexander Freund
University Honors Theses
This thesis examines China's Belt and Road Initiative (BRI) in Africa through the frameworks of dependency theory, postcolonial theory, and neo-colonialism. As China's global economic influence has expanded throughout the twenty-first century, the BRI has emerged as a major source of infrastructure financing and development across the Global South, particularly in Africa. While critics frequently portray the initiative as a form of "debt-trap diplomacy," supporters argue that Chinese investment offers an alternative to the neoliberal conditionality historically associated with Western-led International Financial Institutions (IFIs) such as the International Monetary Fund and World Bank. This study addresses two central research questions: …
The Scars Of Renewal: How The Legacy Of Urban Renewal Informs Community Response To Gentrification In San Francisco's Fillmore District, Christopher Hayes
The Scars Of Renewal: How The Legacy Of Urban Renewal Informs Community Response To Gentrification In San Francisco's Fillmore District, Christopher Hayes
University Honors Theses
What is the disconnect between what the people living in the city say that they want, what the politicians say they're doing to address it, and where does that disconnect come from? Using a case study of San Francisco's Fillmore District, this study investigated discourses of gentrification in media coverage. As a historically Black neighborhood that was severely disrupted by post-World War II Urban Renewal programs, the Fillmore's story mirrors that of many other neighborhoods in the United States. Today, there are heated debates about how to move forward with development given this history and the declining numbers of African …
Ecological And Political Grief In College Students: Making Meaning In Uncertain Times, Kate Hlad
Ecological And Political Grief In College Students: Making Meaning In Uncertain Times, Kate Hlad
University Honors Theses
The study aims to explore grief experiences of college students in relation to world issues, namely ecological and political concerns and ways of making/finding meaning, hope, and purpose. To address a gap in research on manifestations of combined and multifaceted world grief experiences, qualitative research was conducted in the form of semi-structured interviews with 6 different college students. Common themes arose from the interviewees' grief experiences including hopelessness, overwhelm, anger, and changed future planning. Additionally, participants shared their experience finding community, engaging in creative pursuits, and taking action against oppressive systems in order to experience hope and purpose individually and …
"I Still Care About Her": Ambiguous Loss And Social Death In Substance-Affected Relationships, Margaret M. King
"I Still Care About Her": Ambiguous Loss And Social Death In Substance-Affected Relationships, Margaret M. King
University Honors Theses
Substance use creates a ripple effect, affecting the individual as well as their family members. The struggles associated with problematic substance use result in feelings of ambiguous loss towards the substance using individual, a type of loss in which a person is still living but either psychologically or physically unavailable. This research explores the experiences of ambiguous loss in college students with loved ones struggling with substance use, examining how they are thrust into caregiving roles, experience support, and find meaning within their loss. Seven semi-structured interviews were held with adult college students who identified as having a loved-one struggling …
Meeting The Needs: Examining The Response To Houselessness In Portland, Or, Miguel Angel Lopez Paz
Meeting The Needs: Examining The Response To Houselessness In Portland, Or, Miguel Angel Lopez Paz
University Honors Theses
All across the nation, there is an affordable housing crisis that has led to many people losing their homes. In this paper, This paper examines the current response to ending unsheltered homelessness in Portland, Oregon, and the ways that this response impacts the people it is intended to serve. The current mayor, Keith Wilson, ran his campaign with a plan to expand the number of shelter beds available. This plan has had mixed results as some people have been able to benefit, while others choose not to access shelters for various reasons. Besides opening more shelters, the city has another …
The Power Of Perception: Latine Threat Narratives And Immigration Control In The United States, Nina Gallo
The Power Of Perception: Latine Threat Narratives And Immigration Control In The United States, Nina Gallo
University Honors Theses
Despite America's rich history as a self-proclaimed "nation of immigrants," immigration policy in the United States has functioned as a tool of social control designed to systematically exclude and restrict groups of people that pose a perceived threat to national identity and safety. This perceived threat has effectively been communicated through harmful narratives that stratify immigrant communities from the rest of society. Through this framing, support for punitive immigration policies thrives. Currently, Latine immigrants and their families have been the target of discriminatory immigration policies and enforcement tactics. No work to date has synthesized the current state of the immigration …
School Counseling With Indigenous Students In Rural America: The Role Of A Counselor In Supporting An Indigenous Pedagogy Based Curriculum, Donovan Greene
School Counseling With Indigenous Students In Rural America: The Role Of A Counselor In Supporting An Indigenous Pedagogy Based Curriculum, Donovan Greene
University Honors Theses
Indigenous students are a huge population that are not fully supported by the school psychology field. This is primarily due to cognitive imperialism and the focus on a Western monoculture in education. This has led school psychologists and counselors feeling underprepared and lacking the tools to work with Indigenous students and as a result these students are harmed academically and in terms of their mental wellness. This essay opens with a literature review of scholarship on school counselors working with Indigenous students. To improve relations, I suggest implementing more culturally focused interventions. Unfortunately there is a lack of research on …
Long-Covid And Cognition, Mychael Bruce
Long-Covid And Cognition, Mychael Bruce
Dissertations
COVID-19 is an evolving virus that can harm the body’s respiratory and cardiovascular systems. Directly related to COVID-19 are individuals who do not recover from their initial infection, making them long haulers. Long-COVID is transitioning from a range of isolated phenomena to higher prevalence rates in patients who contracted COVID-19. Many individuals report issues with cognitive function, referred to as ‘brain fog’, that affect memory, attention, and even language skills. This literature review addresses the available research on Long-COVID and how persistent infection correlates with cognitive difficulties. It aims to explain the neurobiology of Long-COVID and how Long-COVID interacts within …
Evaluation Of Neuroplastic Changes In Psychological Intervention And Contemporary Treatments Of Depression, Taylor Severance
Evaluation Of Neuroplastic Changes In Psychological Intervention And Contemporary Treatments Of Depression, Taylor Severance
Dissertations
Major depressive disorder is one of the most prevalent mental health disorders worldwide. There is a vast range of treatment options for depression, with varying levels of effectiveness. Recent treatments for depression have expanded, increasing alternative treatments, and it is unknown which treatments have the largest impact on depression. This research was designed to examine the treatments of depression, with a focus on psychotherapy and contemporary treatments such as ketamine, psilocybin, and transcranial magnetic stimulation. A literature review was conducted to assess treatment outcomes and neuroplastic changes in these interventions, as well as combinations of the interventions. Data were evaluated …
Exercise Therapy For Mood Disorders In Retiring/Former Athletes, Christian Antos
Exercise Therapy For Mood Disorders In Retiring/Former Athletes, Christian Antos
Dissertations
This dissertation examined the potential integration of exercise therapy and psychotherapy as a treatment approach for mood-related difficulties experienced by former elite athletes during the transition out of competitive sport. Retirement from athletics is often associated with significant biopsychosocial challenges, including disruptions in identity, healthy routines, social support, and emotional well-being. Existing literature suggests that exercise may serve as an effective adjunctive intervention for improving mood and overall psychological functioning, though limited research has explored its application among retiring athletes within psychotherapeutic contexts. This literature review synthesized current research related to athletic retirement, neurobiological mechanisms associated with physical activity, and …
Youth Social And Emotional Development Through Sports: Skyhawks Insight, Jeremy Vincent, Michelle Van Beek
Youth Social And Emotional Development Through Sports: Skyhawks Insight, Jeremy Vincent, Michelle Van Beek
Journal of Youth Development
This study examines the impact of Skyhawks Sports Academy camps on youth participants’ social-emotional learning (SEL) competencies using an intrinsic case study approach incorporating both quantitative and qualitative methods. Quantitative data were gathered through SEL competency surveys and observations of coaches and qualitative data through semi-structured interviews with past and current Skyhawks coaches. A paired samples t-test analysis of the quantitative data revealed statistically significant changes in three SEL competencies: social awareness and self-management showed growth, while relationship skills declined. However, significant changes were not discovered in all categories; therefore, the null hypothesis was accepted. The observational data (scored using …
Uplifting Youth Voice Through Multi‑Level Features To Make A Splash For Positive Youth Development, Sylvia Y. Gutierrez, Kellie A. Walters, Jayne A, Fulkerson, Nancy Sherwood, Eydie Kramer-Kostecka
Uplifting Youth Voice Through Multi‑Level Features To Make A Splash For Positive Youth Development, Sylvia Y. Gutierrez, Kellie A. Walters, Jayne A, Fulkerson, Nancy Sherwood, Eydie Kramer-Kostecka
Journal of Youth Development
This study explored how a multicomponent health promotion program for pre-adolescent girls could be adapted to support positive youth development across diverse cultural and community contexts. In summer 2022, trained research staff conducted six focus groups with 27 girls from urban and rural communities in the Midwestern United States. Participants reviewed the original program curriculum and provided feedback on program activities, structure, relationships, and implementation strategies. Sessions were audio recorded, transcribed verbatim, and analyzed thematically using qualitative software and manual review. Girls provided feedback on multiple program components, resulting in 12 themes aligned with eight established features of positive developmental …
Beyond The Page: Transmedia Storytelling To Promote Gedsi Among Youth, Clara Evi Candrayuli Citraningtyas, Gita Widya Laksmini Soerjoatmodjo, Isti Utami, - Supriyanto, Slamet Budiharjo
Beyond The Page: Transmedia Storytelling To Promote Gedsi Among Youth, Clara Evi Candrayuli Citraningtyas, Gita Widya Laksmini Soerjoatmodjo, Isti Utami, - Supriyanto, Slamet Budiharjo
Journal of Youth Development
This article presents the results of an applied experimental study aimed at evaluating the effectiveness of a transmedia storytelling approach in increasing youth understanding and awareness of gender equality, disability, and social inclusion (GEDSI) issues. The study involved 198 young people aged 17–25 years who were randomly divided into control and experimental groups, with a pre- and post-test design to measure changes in attitudes and understanding. The intervention was done to the experimental group through a series of participatory activities: transmedia storytelling modules, quizzes, participatory games, and focus group discussion. The results showed an increase in GEDSI understanding and awareness …
How Adults Can Bridge The Trust Gap With Youth, Dana Mitra, Ghadir Al Saghir, Ashley Boat, Jerusha O. Conner, Samantha Holquist
How Adults Can Bridge The Trust Gap With Youth, Dana Mitra, Ghadir Al Saghir, Ashley Boat, Jerusha O. Conner, Samantha Holquist
Journal of Youth Development
Research has established positive relationships and trust as cornerstones for successful youth-adult partnerships (YAPs), yet limited work addresses how to sustain struggling partnerships, particularly in low-trust environments. Using an explanatory, sequential mixed-methods design, this study first quantitatively affirmed the importance of strong teacher-student relationships as precursors for the formation of classroom YAPs (known here as Student Voice Partnerships or SVPs). Subsequent qualitative data explains that youth define these relationships through the lens of trust, actively assessing adults to determine their trustworthiness—a process aligning with concepts of discernment and calculation. Drawing on organizational trust and relational resilience frameworks, this study offers …
Afterschool Program Attendance And Academic Outcomesin A Vermont District, Hans W. Cabra Hernandez
Afterschool Program Attendance And Academic Outcomesin A Vermont District, Hans W. Cabra Hernandez
Journal of Youth Development
Afterschool programs can bridge opportunity gaps by providing children with venues for learning and cultivating socioemotional skills. This paper examines the relationship between attendance in afterschool programs in a Vermont school district and two academic outcomes (the Scholastic Reading Inventory/SRI and the EasyCMB math test) using cross-sectional data from Spring 2018. Using multivariate regression analysis, this study found a positive association between afterschool program attendance and academic achievement on these tests. Moreover, the findings indicate the persistence of socioeconomic academic disparities. While the study’s design does not permit causal claims, the results suggest that afterschool programs are a valuable resource …
Relationships Matter: External Factors Influence High School Completion Among Black Young Adults, L. B. Simmons, Shawn Jones, Sepideh S. Soheilian, Chelsea Williams
Relationships Matter: External Factors Influence High School Completion Among Black Young Adults, L. B. Simmons, Shawn Jones, Sepideh S. Soheilian, Chelsea Williams
Journal of Youth Development
To identify whether and how contextual (i.e., spiritual, educational, and cultural contexts) and relational (i.e., physical and psychological caregiving) resilience influence high school completion among Black young adults, the team conducted logistic regression and moderation analyses. The interaction between contextual resilience and relational resilience revealed that at higher levels of relational resilience, increased contextual resilience is associated with an increased likelihood of high school completion. Importantly, the findings also suggest that at lower levels of relational resilience, increased contextual resilience is associated with a decreased likelihood of high school completion among Black young adults. Themes emerging from this study highlight …
4‑H Efforts Toward Demographic Representation, 1980–2025: A State‑Of‑The‑Art Review (Part 1), Jeremy Elliott-Engel, Jeff Wayne Howard
4‑H Efforts Toward Demographic Representation, 1980–2025: A State‑Of‑The‑Art Review (Part 1), Jeremy Elliott-Engel, Jeff Wayne Howard
Journal of Youth Development
This state-of-the-art review synthesizes 45 years of scholarship (1980–2025) to assess how effectively the 4-H program has worked to serve a demographically representative youth population. Drawing on academic and gray literature (n=99) sources, the review traces 4-H’s evolution from its segregated land grant origins to contemporary efforts focused on access, equity, inclusion, and belonging. It documents progress in culturally responsive programming and national diversity, equity, inclusion (DEI) initiatives while highlighting persistent disparities in participation and benefit distribution. The review identifies effective strategies, enduring structural barriers, and areas where research and practice remain limited, offering a comprehensive foundation for understanding 4-H’s …
Relationships Matter: External Factors Influence High School Completion Among Black Young Adults, L. Blair Simmons, Shawn Ct Jones, Sepideh S. Soheilian, Chelsea D. Williams
Relationships Matter: External Factors Influence High School Completion Among Black Young Adults, L. Blair Simmons, Shawn Ct Jones, Sepideh S. Soheilian, Chelsea D. Williams
Journal of Youth Development
To identify whether and how contextual (i.e., spiritual, educational, and cultural contexts) and relational (i.e., physical and psychological caregiving) resilience influence high school completion among Black young adults, the team conducted logistic regression and moderation analyses. The interaction between contextual resilience and relational resilience revealed that at higher levels of relational resilience, increased contextual resilience is associated with an increased likelihood of high school completion. Importantly, the findings also suggest that at lower levels of relational resilience, increased contextual resilience is associated with a decreased likelihood of high school completion among Black young adults. Themes emerging from this study highlight …
Youth Engagement With Rural School & Community Institutions: Implications For Future Orientation, Hannah Falcone, Cindy L. Hartman, Jayson Seaman, Andrew D. Coppens, Kate Moscouver
Youth Engagement With Rural School & Community Institutions: Implications For Future Orientation, Hannah Falcone, Cindy L. Hartman, Jayson Seaman, Andrew D. Coppens, Kate Moscouver
Journal of Youth Development
Rural youth in the United States have long demonstrated a consistent pattern of outmigration from their rural communities, often driven by aspirations for higher education and specialized careers available elsewhere. This qualitative study explores the positive youth development (PYD) experiences of youth in rural New Hampshire, focusing on how schools, community engagement, work, and experiences in nature shape their development and future orientation. Eighteen youth ages 14–19 participated in online interviews. Data were analyzed using both inductive and deductive strategies, including the application of the Developmental Systems Model of PYD. Four key themes emerged: (a) rural schools are a central …
Table Of Contents, Journal Of Youth Development
Table Of Contents, Journal Of Youth Development
Journal of Youth Development
No abstract provided.
Fostering Developmentally Nurturant Relationships To Promote Character And Thriving: Perspectives Of Program Practitioners In Rural South Africa, Jonathan M. Tirrell, Alexa Hasse, Margaret Mackin, Elizabeth Dowling, Kirsten Olander, Roya Abbasi-Asl, Katherine Mcconnel, Thobeka Kwela, Raah Msimango, Justine Mccarthy-Martin, Tyler Howard, Angela Larkan, Richard Lerner
Fostering Developmentally Nurturant Relationships To Promote Character And Thriving: Perspectives Of Program Practitioners In Rural South Africa, Jonathan M. Tirrell, Alexa Hasse, Margaret Mackin, Elizabeth Dowling, Kirsten Olander, Roya Abbasi-Asl, Katherine Mcconnel, Thobeka Kwela, Raah Msimango, Justine Mccarthy-Martin, Tyler Howard, Angela Larkan, Richard Lerner
Journal of Youth Development
Developmentally nurturant relationships are fundamental to enabling children to thrive across contexts, including homes, schools, and communities. Such relationships are also a central feature of effective positive youth development (PYD) programming. As strengths-based PYD programs are increasingly being adopted in majority-world countries, a better understanding of how to foster and promote developmentally nurturant relationships is needed. As part of the Thanda Study of Character and Health, we interviewed 15 program practitioners about their understandings of and approaches to fostering developmentally nurturant relationships with children enrolled in Thanda programs in rural KwaZulu-Natal, South Africa. Phenomenological analysis indicated that practitioners’ understanding of …
Disrupting The Time Space Continuum: Time Travel As Methodological Practice For Building Evaluation Capacity, Linetta Alexander
Disrupting The Time Space Continuum: Time Travel As Methodological Practice For Building Evaluation Capacity, Linetta Alexander
The Foundation Review
Dominant Western ideology limits our understanding of and engagement with time, representing it as a linear two-dimensional arrow that moves forward in one direction from the past to the future. Viewing the past, present, and future as distinct and disconnected phases can hinder the growth and improvement of organizations working on building their evaluation capacity.
In contrast to Western notions of time, Indigenous cultures of the Americas and Africa understand the interconnectedness of all aspects of being, that our experiences are more cyclical, where birth leads to death and death to rebirth. The Sankofa principle, rooted in Akan philosophy, states …
Public Attitudes Toward Cascade Genetic Screening In The United States, Hadley Stevens Smith, Emilie S Zoltick, Madison R Hickingbotham, Emily S Bonkowski, Stacey Pereira, Tara A Lavelle, David L Veenstra, Amy L Mcguire, Katherine E Bonini, Leila Jamal
Public Attitudes Toward Cascade Genetic Screening In The United States, Hadley Stevens Smith, Emilie S Zoltick, Madison R Hickingbotham, Emily S Bonkowski, Stacey Pereira, Tara A Lavelle, David L Veenstra, Amy L Mcguire, Katherine E Bonini, Leila Jamal
Center for Medical Ethics and Health Policy Staff Publications
Introduction: After a patient receives genetic test results that indicate an actionable health condition, cascade genetic screening (CGS) is the process of evaluating the patient's relatives for a potentially elevated genetic risk of disease. The United States primarily relies on patients to communicate with their relatives, resulting in suboptimal rates of risk communication, familial genetic testing uptake, and risk-reducing interventions. There is ongoing debate about whether and how best to inform relatives of a potentially increased genetic risk.
Methods: We conducted a nationally representative survey of US adults to assess attitudes toward informing at-risk relatives, acceptability of system-mediated communication, and …
The Political Economy Of Mandatory Disclosure: A Literature Review, Hao Liang, Hanyu Zhang
The Political Economy Of Mandatory Disclosure: A Literature Review, Hao Liang, Hanyu Zhang
Research Collection Lee Kong Chian School Of Business
Reviewing the literature on mandatory corporate disclosure from a political economy perspective, we synthesize the classic justifications for disclosure regulations while emphasizing why voluntary disclosure often fails to achieve socially efficient transparency. We also highlight how legal institutions, enforcement capacity, and political forces shape the design, credibility, and effectiveness of disclosure mandates. Drawing on evidence from international and China-focused studies, we review empirical findings on how mandatory disclosure affects investor protection, information environments, and firm behavior, showing that similar reporting rules yield different outcomes across institutional settings. We further extend the discussion to ESG and climate-related disclosure to examine emerging …
Public Acceptance Of Meat-Reduction Policies Across Cultures: Comparing Singapore And Switzerland, Bianca Wassmann, Shu Tian Ng, Mark Chong, Angela K. Y. Leung, Michael Siegrist
Public Acceptance Of Meat-Reduction Policies Across Cultures: Comparing Singapore And Switzerland, Bianca Wassmann, Shu Tian Ng, Mark Chong, Angela K. Y. Leung, Michael Siegrist
Research Collection Lee Kong Chian School Of Business
Purpose – As meat-reduction policies are discussed across the globe, many are met with public resistance. Cultural values may help explain this pushback, yet their role in shaping support for food policy remains poorly understood. This study is the first to apply cultural cognition theory to food policy by examining how cultural worldviews shape the acceptance of meat-reduction interventions in Singapore and Switzerland—two economically developed countries with contrasting cultural profiles. Design/methodology/approach – In an online survey, participants (Singapore: n = 357; Switzerland: n = 495) rated their acceptance of 11 meat-reduction interventions (e.g. taxes, subsidies, labelling). We then analysed to …
Rethinking Ethics For An Era Of Trusted Computational Tools, Kristin M Kostick-Quenet, Meghan Hurley, John Herrington, Eric A Storch
Rethinking Ethics For An Era Of Trusted Computational Tools, Kristin M Kostick-Quenet, Meghan Hurley, John Herrington, Eric A Storch
Center for Medical Ethics and Health Policy Staff Publications
Computer perception (CP) technologies are poised to deliver near real-time behavioral insights with high precision. As technical barriers recede, our field's ethical focus must shift from "Can we trust the data?" to "Should we use it here, and how?" We propose a contextual ethics framework that: (1) defines the appropriate scope of CP integration; (2) advocates codesigned roadmaps to manage expectations and epistemic conflict; (3) expands evaluation beyond performance metrics to humanistic outcomes; and (4) anticipates future high performance systems to safeguard dignity, empathy, and shared decision-making in clinical care.