Stratified University Strategies: The Shaping of Institutional Legitimacy in a Global Perspective

Globalizing forces have both transformed the higher education sector and made it increasingly homogenous. Growing similarities among universities have been attributed to isomorphic pressures to ensure and/or enhance legitimacy by imitating higher education institutions that are perceived as successful internationally, particularly universities that are highly ranked globally (Cantwell & Kauppinen, 2014; DiMaggio and Powell, 1983). In this study, we compared the strategic plans of 78 high-ranked, low-ranked, and unranked universities in 33 countries in 9 regions of the world. In analyzing the plans of these 78 universities, the study explored patterns of similarity and difference in universities' strategic positioning according to Suchman's (1995) 3 types of legitimacy: cognitive, pragmatic, and moral. We found evidence of stratified university strategies in a global higher education landscape that varied by institutional status. In offering a corrective to neoinstitutional theory, we suggest that patterns of globalization are mediated by status-based differences in aspirational behavior (Riesman, 1958) and "old institutional" forces (Stinchcombe, 1997) that contribute to differently situated universities pursuing new paths in seeking to build external legitimacy.18 month embargo; published online: 13 Sep 2018This item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at [email protected]

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

International Student Mobility in Africa: The Case of Egypt

International educational migration continues to increase (OECD, 2016). After the Second World War, student migration was predominantly unidirectional, from developing countries, to the core nations (Altbach, 2004). Recent studies, however, show that there is a shift in this migration patter due to the emergence of regional educational hubs (Jon, Lee, & Byun, 2013; Lee, 2014). Previous research has examined some educational hubs around the globe (Cantwell & Lee, 2009; Jon et al., 2013; Kondakci, 2011; Lee & Sehoole, 2015) but there is dearth of information on this significant trend in North Africa and the Middle East. Egypt was chosen for this study because it attracts the highest number of international students in the region (Huisman, Adelman, Hsieh, Shams, and Wilkins, 2012). Our study explores international student “orientations”—dispositions, experiences and expectations—toward studying in Egypt (Cantwell, Luca, & Lee, 2009). Data collection included twenty-three semi-structured interviews with international students from sixteen different countries attending three Egyptian universities, and examination of pertinent books and documents. The decision-making process of international students to study abroad varied by students’ degree choice. All regional and non-regional international undergraduate students chose the host country, Egypt, before the institution. Non-regional international graduate students gave selection of institution, host country, and the critical time in Egypt’s history as responsible for their choice. Reasons for selecting Egypt as a host nation included its historical, social, cultural, and educational significance and the perception that Egypt is a safe country in which to live, study, and travel, safer than other countries in the region. The study also provides evidence that students’ region of origin, degree program, and institution attended mattered in their international educational experience. For instance, regional international students sensed neo-national sentiments within their institutions. It was also evident that degree-seeking, regional and non-regional international graduate students considered attaining a degree from Egypt superior to earning the same degree from their home countries. Finally, the study also offers recommendations for policy practices for the betterment of international student experiences in Egypt

Marketing to International Students: Presentation of University Self in Geopolitical Space

Amidst public calls for greater internationalization, universities are marketing to international students. We explore how universities in regional hubs (Lee & Schoole, 2015) enact "dramaturgical performances" (Goffman, 1959), presenting images of themselves in geopolitical space. We find: (1) bifurcated marketing strategies to distinct student audiences; (2) differences between public and private universities in featuring lifestyle or academic issues, and higher education as a private or a public good, as in "academic capitalism" (Slaughter & Rhoades, 2004); & (3) distinctive positioning of universities by type and region in their local/national/regional space, highlighting the possibility of alternatives to dominant Anglo-American internationalization models.This item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at [email protected]

MALAT1 and MEG3 genes expression in non-alcoholic fatty liver disease in type 2 diabetes mellitus patients: a case-control study

ABSTRACTAim of the study This study aims to investigate the nonalcoholic fatty liver disease (NAFLD) serum molecular profile among individuals diagnosed with type 2 diabetes (T2DM).Methods In this observational case-control investigation, 120 participants were included and subdivided forming 4 different groups as follows: group І: NAFLD non diabetic individuals, group ІІ: T2DM without NAFLD patients, group III: NAFLD diabetic patients and group IV: healthy control. MALAT1 and MEG3 expression in serum from all groups was measured.Results Expression of MALAT1 was upregulated in NAFLD and diabetic patients (p = 0.037 and 0.033 respectively). The cutoff value was determined for MALAT1 expression in NAFLD and diabetic by the ROC curve and was > 0.54 and > 0.67 respectively. By multivariate analysis, the only reliable indicator for MALAT1 expression in NAFLD and diabetics was determined to be ESR. Furthermore, we found that NAFLD patients showed greater MEG3 expression than those with T2DM (p = 0.033).Conclusion Expression of MALAT1 was upregulated in NAFLD and T2DM indicating that it might be an early diagnostic marker for both diseases and helps in the development of novel therapeutic agents. Moreover, MEG3 expression was higher among NAFLD patients than those NAFLD patients with T2DM, which suggests the feasibility of decreased MEG3 expression could be a viable predictive biomarker for early T2DM detection among NAFLD-diagnosed patients

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Background: Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods: This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was coprioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low-middle-income countries. Results: In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of 'single-use' consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low-middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion: This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high- and low-middle-income countries