Thereby, EIDs pose huge threats to health care infrastructures everywhere due to unprepared infrastructures and poor immunity levels of population. It discusses how key role players, the hospital administrator, would play a big role in managing EID infections as well as strategies related to infection control. Such vital factors include resource allocation, implementation of policies, training, and building a culture for safety as well as working under an interdisciplinary approach. COVID-19 pandemics are best used as case studies both where successes (...) occurred and where infection prevention lacked. Findings point toward robust surveillance, real-time data analytics, and the emotional support required for the healthcare workers involved in combating EIDs. The work discusses the socio-economic implications of EIDs and the utmost need to adapt strategies at resource-poor settings. Adding their recommendations with proper training, technological adaptations, and well-defined policymaking, they can decrease the impact of EID. By including technology, teamwork, and psychological impacts, the hospital administrators can develop such healthcare systems that can take on future challenges. It is a transformational effort that proactive leadership and innovation can make to combat the global health threat. (shrink)

Differences That Matter challenges existing ways of theorising the relationship between feminism and postmodernism which ask 'is or should feminism be modern or postmodern?' Sara Ahmed suggests that postmodernism has been allowed to dictate feminist debates and calls instead for feminist theorists to speak (back) to postmodernism, rather than simply speak on (their relationship to) it. Such a 'speaking back' involves a refusal to position postmodernism as a generalisable condition of the world and requires closer readings of what postmodernism (...) is actually 'doing' in a variety of disciplinary contexts. Sara Ahmed hence examines constructions of postmodernism in relation to rights, ethics, subjectivity, authorship, meta-fiction and film. (shrink)

Most philosophers agree that causal knowledge is essential to decision-making: agents should choose from the available options those that probably cause the outcomes that they want. This book argues against this theory and in favour of evidential or Bayesian decision theory, which emphasises the symptomatic value of options over their causal role. It examines a variety of settings, including economic theory, quantum mechanics and philosophical thought-experiments, where causal knowledge seems to make a practical difference. The arguments make novel use of (...) machinery from other areas of philosophical inquiry, including first-person epistemology and the free will debate. The book also illustrates the applicability of decision theory itself to questions about the direction of time and the special epistemic status of agents. (shrink)

_The Promise of Happiness_ is a provocative cultural critique of the imperative to be happy. It asks what follows when we make our desires and even our own happiness conditional on the happiness of others: “I just want you to be happy”; “I’m happy if you’re happy.” Combining philosophy and feminist cultural studies, Sara Ahmed reveals the affective and moral work performed by the “happiness duty,” the expectation that we will be made happy by taking part in that which (...) is deemed good, and that by being happy ourselves, we will make others happy. Ahmed maintains that happiness is a promise that directs us toward certain life choices and away from others. Happiness is promised to those willing to live their lives in the right way. Ahmed draws on the intellectual history of happiness, from classical accounts of ethics as the good life, through seventeenth-century writings on affect and the passions, eighteenth-century debates on virtue and education, and nineteenth-century utilitarianism. She engages with feminist, antiracist, and queer critics who have shown how happiness is used to justify social oppression, and how challenging oppression causes unhappiness. Reading novels and films including_ Mrs. Dalloway_, _The Well of Loneliness_, _Bend It Like Beckham_, and _Children of Men_, Ahmed considers the plight of the figures who challenge and are challenged by the attribution of happiness to particular objects or social ideals: the feminist killjoy, the unhappy queer, the angry black woman, and the melancholic migrant. Through her readings she raises critical questions about the moral order imposed by the injunction to be happy. (shrink)

The primary and secondary sources of Islamic law often assume a binary distinction between ijtihād and taqlīd, ignoring a third level of engagement with the sources, which was conceptualized by some jurists as forming a distinct category. In this article I discuss the evolution of the terms ijtihād, taqlīd, and ittibāʿ, using a conceptual-historical approach. I argue that the use of taqlīd to mean “precedent-following” did not emerge as a technical term until after the time of al-Shāfiʿī. The distinction between (...) precedent-following and verifiable-following did not appear in legal discourse until the time of Aḥmad b. Ḥanbal. I also demonstrate that there were three approaches to these terms in legal discourse after the time of Ibn Ḥanbal, with three groups of jurists defining them in ways that advanced their different visions of law-making. I conclude with a discussion of the debate over the meanings of these terms in the eighteenth and nineteenth centuries. (shrink)

We show that it is impossible to define a substitution operator for arbitrary representable cylindric algebras that agrees in its basic properties with the notion of substitutions introduced for dimension complemented algebras.

This study investigates the association of a broad set of variables with the ethical decision making of management accountants in Libya. Adopting a cross-sectional methodology, a questionnaire including four different ethical scenarios was used to gather data from 229 participants. For each scenario, ethical decision making was examined in terms of the recognition, judgment and intention stages of Rest’s model. A significant relationship was found between ethical recognition and ethical judgment and also between ethical judgment and ethical intention, but ethical (...) recognition did not significantly predict ethical intention—thus providing support for Rest’s model. Organizational variables, age and educational level yielded few significant results. The lack of significance for codes of ethics might reflect their relative lack of development in Libya, in which case Libyan companies should pay attention to their content and how they are supported, especially in the light of the under-development of the accounting profession in Libya. Few significant results were also found for gender, but where they were found, males showed more ethical characteristics than females. This unusual result reinforces the dangers of gender stereotyping in business. Personal moral philosophy and moral intensity dimensions were generally found to be significant predictors of the three stages of ethical decision making studied. One implication of this is to give more attention to ethics in accounting education, making the connections between accounting practice and Islam. Overall, this study not only adds to the available empirical evidence on factors affecting ethical decision making, notably examining three stages of Rest’s model, but also offers rare insights into the ethical views of practising management accountants and provides a benchmark for future studies of ethical decision making in Muslim majority countries and other parts of the developing world. (shrink)

The essay presents a novel counterexample to Causal Decision Theory (CDT). Its interest is that it generates a case in which CDT violates the very principles that motivated it in the first place. The essay argues that the objection applies to all extant formulations of CDT and that the only way out for that theory is a modification of it that entails incompatibilism. The essay invites the reader to find this consequence of CDT a reason to reject it.

Medieval Muslim scholars were challenged with squaring their conceptions of prophetic infallibility with reports that Muhammad disobeyed revelatory commands from God. The manner in which they rehabilitated the prophetic image in these cases had corresponding repercussions in the fields of jurisprudence, theology, and legal theory. The present article uses the case of Q. 8:67 to demonstrate the intertwined nature of the Islamic sciences and the stakes involved when delimiting the prophetic ability to err and/or disobey God.

Examinations form part of the assessment processes that constitute the basis for benchmarking individual educational progress, and must consequently fulfill credibility, reliability, and transparency standards in order to promote learning outcomes and ensure academic integrity. A randomly selected question examination is considered to be an effective solution to mitigate sharing of questions between students by addressing replicated inter-examination questions that compromise examination integrity and sequential intra- examination questions that compromise examination comprehensivity. In this study, a Monte Carlo approach was used (...) to design six examination schemes for the purpose of generating and evaluating 600 RSQEs in order to investigate the effects of RSQE design on replicated inter-examination and sequential and intra-examination questions. Results revealed that the number of randomly selected questions from the pool and the number of sub-pools inversely affected the replication and sequencing of the examination questions. Thus, by designing the RSQE in many sub-pools, in equivalence to the number of examination questions and selecting only one question from each sub-pool, and updating the sub-pools after each examination, the passing of information can be prevented, ensuring the integrity of the examinations. (shrink)

The YAP/TAZ family of transcriptional co‐activators drives cell proliferation in epithelial tissues and cancers. Yet, how YAP and TAZ are physiologically regulated remains unclear. Here we review recent reports that YAP and TAZ act primarily as sensors of epithelial cell polarity, being inhibited when cells differentiate an apical membrane domain, and being activated when cells contact the extracellular matrix via their basal membrane domain. Apical signalling occurs via the canonical Crumbs/CRB‐Hippo/MST‐Warts/LATS kinase cascade to phosphorylate and inhibit YAP/TAZ. Basal signalling occurs (...) via Integrins and Src family kinases to phosphorylate and activate YAP/TAZ. Thus, YAP/TAZ is localised to the nucleus in basal stem/progenitor cells and cytoplasm in differentiated squamous cells or columnar cells. In addition, other signals such as mechanical forces, tissue damage and possibly receptor tyrosine kinases (RTKs) can influence MST‐LATS or Src family kinase activity to modulate YAP/TAZ activity. (shrink)

This book offers for the first time a complete scholarly translation, commentary, and glossary in a modern European language of the logic section of Avicenna's very important compendium al-Naj=at.

Il s’agit d’essayer de penser un « entre-deux » entre les travaux novateurs de Gilbert Durand sur l’imaginaire et les conceptualisations sémiotiques de la signification. Bien que Durand semble rejeter toute forme d’« explication sémiologique » des images-symboles, sa conception de l’imaginaire est régie par une sémiosis et une rationalité spécifiques qui permettent d’entrevoir, même si l’intersection n’implique pas forcément la fusion, les contours d’un « entre-deux » entre son « archétypologie » et la sémiotique. This paper try to imagine (...) a “In-between” from the semiotic conceptualizations of the significance to the innovative work of Gilbert Durand on the imaginary. Although Durand seems to reject any form of “semiological explanation” of the image-symbols, his conception of imaginary is governed by a specific semiosis and rationality which make it possible to foresee, even if the intersection does not inevitably imply fusion, contours of a “In-between” between his “archetypology” and semiotics. (shrink)

The risk of cigarette smoking plays a pivotal role in increasing the incidence rates of lung cancer. This paper sheds new light on modeling the impact of cigarette smoking on lung cancer evolution, especially genetic instability and the number of gene mutations in the genome of stem cells. To handle this issue, we have set up stochastic multi-stage models to fit the data set of the probabilities of current and former smokers from the Nurses’ Health Study cohort of females and (...) the Health Professionals Follow up Study cohort of men. Throughout this paper, we consider both mutation rates and clonal expansion rates as parameters in each compartment. For current and former smokers, three-driver mutations are most likely to take place in the progression of lung cancer under smoking risk. For current smokers, our findings reveal that two to sixteen gene mutations are required to obtain a cancerous cell among men and women in US. Moreover, two to six cancer-mutations are available in the pathway to lung cancer among former smokers who have quit smoking for more than ten years for both male and female patients. This highlights that cigarette smoking stimulates the number of driver mutations during lung tumorigenesis in both sexes. It is very crucial to examine the role of cigarette smoking in determining whether genomic instability is an early stage or late stage in the process of lung carcinogenesis. (shrink)

In _Willful Subjects_ Sara Ahmed explores willfulness as a charge often made by some against others. One history of will is a history of attempts to eliminate willfulness from the will. Delving into philosophical and literary texts, Ahmed examines the relation between will and willfulness, ill will and good will, and the particular will and general will. Her reflections shed light on how will is embedded in a political and cultural landscape, how it is embodied, and how will (...) and willfulness are socially mediated. Attentive to the wayward, the wandering, and the deviant, Ahmed considers how willfulness is taken up by those who have received its charge. Grounded in feminist, queer, and antiracist politics, her sui generis analysis of the willful subject, the figure who wills wrongly or wills too much, suggests that willfulness might be required to recover from the attempt at its elimination. (shrink)

Introduction: find your way -- Orientations toward objects -- Sexual orientation -- The orient and other others -- Conclusion: disorientation and queer objects.

Buildings energy consumption is growing gradually and put away around 40% of total energy use. Predicting heating and cooling loads of a building in the initial phase of the design to find out optimal solutions amongst different designs is very important, as ell as in the operating phase after the building has been finished for efficient energy. In this study, an artificial neural network model was designed and developed for predicting heating and cooling loads of a building based on a (...) dataset for building energy performance. The main factors for input variables are: relative compactness, roof area, overall height, surface area, glazing are a, wall area, glazing area distribution of a building, orientation, and the output variables: heating and cooling loads of the building. The dataset used for training are the data published in the literature for various 768 residential buildings. The model was trained and validated, most important factors affecting heating load and cooling load are identified, and the accuracy for the validation was 99.60%. (shrink)

Drawing on social exchange theory, this study examines a mechanism, namely organizational social capital, through which self-sacrificial leadership is related to two types of employee behaviours: organizational citizenship behaviours and counterproductive behaviours. The results of two different studies in Egypt showed that self-sacrificial leadership is positively related to OSC which, in turn, is positively related to OCBs and negatively related to CPBs. Overall, the findings suggest that self-sacrificial leaders are more likely to achieve desirable employee behaviours through improving the quality (...) of social relationships among employees. (shrink)

Palimpsests of Themselves is an intervention in current discussions about the fate of philosophy in postclassical Islamic intellectual history. It takes up the most advanced logic textbook of Muslim South Asia, The Ladder of the Sciences, as a case study and engages its legacy in three ways. In addition to presenting the first full translation and extended commentary in English, Asad Q. Ahmed offers detailed assessments of the technical contributions of the work, explores the social and institutional settings of (...) the vast commentarial response it elicited, and develops a theory of the philosophical commentary that is internal to the tradition. The technical, social, and theoretical approaches to the commentarial text complicate presuppositions upon which questions of Islam's intellectual decline are erected. As such, Ahmed offers a unique and powerful opportunity to understand the transmission of knowledge across the Islamic world. (shrink)

This discussion note examines a recent argument for the principle that any counterfactual with true components is itself true. That argument rests upon two widely accepted principles of counterfactual logic to which the paper presents counterexamples. The conclusion speculates briefly upon the wider lessons that philosophers should draw from these examples for the semantics of counterfactuals.

We consider countable so‐called rich subsemigroups of ; each such semigroup T gives a variety CPEAT that is axiomatizable by a finite schema of equations taken in a countable subsignature of that of ω‐dimensional cylindric‐polyadic algebras with equality where substitutions are restricted to maps in T. It is shown that for any such T, if and only if is representable as a concrete set algebra of ω‐ary relations. The operations in the signature are set‐theoretically interpreted like in polyadic equality set (...) algebras, but such operations are relativized to a union of cartesian spaces that are not necessarily disjoint. This is a form of guarding semantics. We show that CPEAT is canonical and atom‐canonical. Imposing an extra condition on T, we prove that atomic algebras in CPEAT are completely representable and that CPEAT has the super amalgamation property. If T is rich and finitely represented, it is shown that CPEAT is term definitionally equivalent to a finitely axiomatizable Sahlqvist variety. Such semigroups exist. This can be regarded as a solution to the central finitizability problem in algebraic logic for first order logic with equality if we do not insist on full fledged commutativity of quantifiers. The finite dimensional case is approached from the view point of guarded and clique guarded (relativized) semantics of fragments of first order logic using finitely many variables. Both positive and negative results are presented. (shrink)

Generative Artificial Intelligence (AI) tools produce hallucinations exposing developers and users to a myriad of liabilities in courts. Given the absence of strict laws and regulations structuring how Generative AI content interact with potential allegations of defamation, libel, and slander, judges and attorneys are left with the semiotics of the fragmented articles and rules in each system attempting to settle such cases. The endless interpretations of written and non-verbal signs in the law across the world constitutes a new realm for (...) legal semiotics in the area of Generative AI and defamation. The present analysis examines existing civil liability articles in the Jordanian code to shed light on the litigation and defenses afforded in the defamation realm with respect to Generative AI content. The key finding is that like other countries, civil codes in Jordan are outdated concerning Generative AI content opening a plethora of liability scenarios in libel or slander cases. More importantly, the exercise of semiotic interpretation generates several defenses salvaging users and developers under strict sets of conditions. In sum, new amendments and updated legislative frameworks are needed to protect the healthy development of Generative AI while preserving citizens from damaging defamation, libel, and slander. (shrink)

BackgroundBreaking bad news to mothers whose children has disability is an important role of physicians. There has been considerable speculation about the inevitability of parental dissatisfaction with how they are informed of their child’s disability. Egyptian mothers’ preferences for how to be told the bad news about their child’s disability has not been investigated adequately. The objective of this study was to elicit Egyptian mothers’ preferences for how to be told the bad news about their child’s disability.MethodsMothers of 100 infants (...) recently diagnosed with Down syndrome were interviewed regarding their preferences for how to be told bad news. Mothers were recruited through outpatient clinics of the Pediatric Genetics Department at Fayoum University Hospital (located 90 km southwest of Cairo, Egypt) from January to June 2011.Results and discussionQuestionnaire analyses revealed nine themes of parental preferences for how to be told information difficult to hear. Mothers affirmed previously reported recommendations for conveying bad medical news to parents, including being told early, being told of others with a similar condition, and being informed of the prognosis.ConclusionsMothers affirmed communication themes previously discussed in the literature, such as being told early, and being informed of the prognosis. Although more research is needed in this important area, we hope that our findings will stimulate future search and help health care providers in different societies establish guidelines for effectively communicating bad news. (shrink)

The present research applies Michel Foucault's perspectives on discipline and punishment to Steve Hamilton's novel The Lock Artist, exploring the criminal subjectivity of the protagonist beyond the binary of good and evil. Through textual analysis, the study examines the norms, upbringing, and circumstances that shape the protagonist's identity as a deviant and criminal. The research also investigates the role of confession as a tool of the modern state in altering the subjectivity of its subjects. The findings suggest that deviance and (...) illegality are social constructs, created and maintained by power structures. The study highlights how society defines deviance and the state defines illegality, leading individuals down a path of criminalization. This research provides insight into the ways power operates to shape an individual’s subjectivity, particularly in relation to criminality, and offers a critical analysis of the ways the modern state exercises control over its subjects. For useful explanation and analysis of criminal subjectivity, Michel Foucault’s book ‘discipline and punishment’ has been referred. This article discusses the norms, upbringing, and circumstances of the protagonist and tries to explore his subjectivity as a criminal beyond the paradigm of good and evil. It elaborates those factors which constitute his identity as a deviant and then as a criminal. Also, this research discusses the role of confession as a tool of the modern state to alter the subjectivity of its subject. (shrink)

Résumé L’histoire récente montre que les deuxièmes générations rencontrent aussi un problème d’intégration. Les immigrations post-coloniales sont maintenant mondialisées, et les quartiers dortoirs d’immigration sont devenus des places de commerce cosmopolites. L’espace public dans lequel se meut l’immigration s’est différencié. L’émigré devient l’immigré, la famille se regroupe. La nouvelle génération veut incarner la tradition et n’a plus peur de marquer l’espace public des signes ostentatoires d’une présence singulière.

The proposed work describes an approach for segmentation of activated sludge flocs from the microscopic images for monitoring wastewater treatment. The morphological features of flocs and filaments are related to the state of an activated sludge wastewater treatment plant and must be monitored for proper functioning. Hence, image processing and analysis could be a time-saving monitoring tool. To address this challenge, we propose a novel framework involving a multiphase edge detection algorithm based on information theory. The proposed framework is evaluated (...) and scrutinized critically considering the artifacts found in the photographs tested. To evaluate the segmentations, gold approximation of estimated truth images is created. In addition, the performance was subjectively evaluated for its potential for segmenting activated sludge images. Experimental results show that the proposed framework exhibits the good results and demonstrates its effectiveness. (shrink)

"The Uncertain Science" argues that sociology has not freed itself from the influence of philosophy, and specifically from the search for certainty. This "foundationalism" which is characteristic of Western thought has influenced both the method adopted by sociologists, and their research practices. The authors criticize sociology for its formalism, arguing that this blunts the radicalism of its project. To regain the radical and critical edge implicit in sociology, it is necessary to adopt a comparative and historical approach which interprets social (...) science as part of societal learning. In the first part of the book the authors trace formalism to central positions in Western philosophy and examine its impact on historiography, evolutionary social thought and positivist sociology. In the second part they examine the tensions between formalism and social theory in the work of Levi Strauss and Habermas. In part three they compare modernization theory to more recent descussions of "modernity" and "postmodernity", and show the elements of continuity between these apparently contrary positions. This book should be of interest to undergraduates in sociology and philosophy. (shrink)

This book explores policy innovation for same-sex couples throughout the Americas and includes same-sex marriage legislation, civil unions, and other new developments for same-sex couples throughout the Americas at both national and sub-national levels. This scholarship is innovative because though much has been written regarding developments in North America, there is very little work dealing with recent developments in the rest of the Americas.

The purpose of this paper is to analyze the meaning and scope of social responsibility in a state-owned enterprise. Is corporate social responsibility (CSR) a meaningful concept for a state-owned enterprise, as opposed to a privately-owned corporation, given that it is created with social as well as economic aims? To try to answer to this question, the case of Sonatrach, an Algerian oil company, is examined. The lack of statistical data does not allow an assessment of CSR actions undertaken by (...) this company since 2004. The analysis identifies two main obstacles to the effectiveness of CSR in state-owned enterprises: (a) the system of internal governance ischaracterized by a lack of control; (b) the competitive and social environment is characterized by a partial application of the logic of the market, which does not allow the optimal allocation of means. (shrink)

The present study examined how the pre-war debate of the US decision to invade Iraq (in March 2003) was discursively constructed in the US/British mainstream newspaper opinion/editorial (op/ed) argumentation. Drawing on theoretical insights from critical discourse analysis and argumentation theory, I problematised the fallacious discussion used in the pro-war op/eds to build up a ‘moral/legal case’ for war on Iraq based on adversarial (rather than dialogical) argumentation. The proponents of war deployed ‘instrumental rationality’ (ends-justify-means reasoning), ‘ethical necessity’ (Bush’s ‘Preemption Doctrine’) (...) and ‘humanitarian virtue’ (the bombing of Iraq to ‘save’ Iraqis from Saddam’s pestilent tyranny) to justify the pending invasion of Iraq. Their arguments intertextually resonated with Bush administration’s ‘war on terror’ rhetoric in a way that created a form of indexical association through ‘recontextualisation’. The type of arguments marshalled by the pro-war op/ed commentators uncritically bolstered the set of US official ‘truth claims’ and ‘presuppositions’. (shrink)

OBJECTIVES: To compare the practices of local research ethics committees and the time they take to obtain ethical approval for a multi-centre study. DESIGN: A retrospective analysis of outcome of applications for a multi-centre study to local research ethics committees. SETTING: Thirty-six local research ethics committees covering 38 district health authorities in England. MAIN MEASURES: Response of chairmen and women, the time required to obtain approval, and questions asked in application forms. RESULTS: We received replies from all 36 chairmen contacted: (...) four (11%) granted their approval, and 32 (89%) required our proposal to be considered by their local research ethics committee. Three committees asked us to attend their meetings. The application was approved by all 36 local research ethics committees but the time to obtain ethical approval varied between six to 208 days. One third of the committees did not approve the project within three months, and three took longer than six months. There was considerable variation in the issues raised by local research ethics committees and none conformed exactly to the Royal College of Physicians' guidelines. CONCLUSION: Obtaining ethical approval for a multi-centre study is time-consuming. There is much diversity in the practice of local research ethics committees. Our data support the recommendation for a central or regional review body of multi-centre studies which will be acceptable to all local research ethics committees. (shrink)

The best-known argument for Evidential Decision Theory (EDT) is the ‘Why ain’cha rich?’ challenge to rival Causal Decision Theory (CDT). The basis for this challenge is that in Newcomb-like situations, acts that conform to EDT may be known in advance to have the better return than acts that conform to CDT. Frank Arntzenius has recently proposed an ingenious counter argument, based on an example in which, he claims, it is predictable in advance that acts that conform to EDT will do (...) less well than acts that conform to CDT. We raise two objections to Arntzenius’s example. We argue, first, that the example is subtly incoherent, in a way that undermines its effectiveness against EDT; and, second, that the example relies on calculating the average return over an inappropriate population of acts. (shrink)

Shifting laws and regulations increasingly displace the centrality of women's health concerns in the provision of abortion services. This is exemplified by the growing presence of deceptive Crisis Pregnancy Centers alongside new informed consent laws designed to dissuade women from seeking abortions. Litigation on informed consent is further complicated in the clinical context due to the increased mobilization of facts – such as the gestational age or sonogram of the fetus – delivered with the intent to dissuade women from accessing (...) abortion. In other words, factual information utilized for ideological purpose. To preserve a woman's autonomy and decision-making capacity, there must be a concerted effort on the part of legislators and courts to place a woman's health at the center of abortion law and policy. (shrink)

Hospital administrators play an essential role in the implementation of Antibiotic Stewardship Programs, which is instrumental in the fight against antimicrobial resistance. The foundation and sustenance of such programs has been made possible through leadership; this is through interdisciplinary collaboration that is done with policy formulation and stewardship inclusion into the institutional systems. Indeed, it is immense strength where ID physicians and clinical pharmacists with special training proactively involve themselves in the program. Beyond that, the accreditation standards that incorporate ASPs (...) really enhance compliance and institutional commitment. Obstacles to movement include an absence of resources, unwilling prescriber, and other competing health conditions for priority. To achieve such success, the hospital administrators must ensure adequate staffing, proper utilization of advanced technologies, and instillation of accountability through focused education and participation. Besides the reduction of resistance, ASPs contribute to such improvements in patient outcomes, efficient consumption of resources, and significant reductions in costs. As this narrative review indicates, leadership at the hospital level plays an important role in augmenting antibiotic stewardship. Addressing major barriers, along with strategic implementation, means that administrators may play an important role in further maximizing effectiveness while truly adding to the world-wide effort against antimicrobial resistance. (shrink)