American University of Kuwait

Purpose This study examines how statutory governance reforms requiring CEO-chair role separation reconfigure top executive relationships. Drawing on social exchange and triadic interaction theory, the authors analyze how formal structural mandates interact with informal leadership bonds to influence trust, loyalty, authority and cohesion among the CEO, executive chair and members of the top management team. The authors explore how senior executives negotiate continuity and change in their relationships while adapting to global governance norms and balancing local relational traditions with international accountability and legitimacy expectations.Design/methodology/approach The authors pursued a revelatory case study in an emerging markets context with rare access into an emerging market multinational corporation that transitioned from CEO-chair duality to separate roles following regulatory reform. Data collection included 22 semi-structured interviews with the CEO, chair and all TMT members; over 450 hours of site visits; observations of meetings; and internal documents. The authors categorized and coded data thematically and structured their approach conceptually around an emergent triadic social exchange theory and methodologically to capture interdependencies across CEO-chair-TMT interactions.Findings Formal governance reforms reshaped executive role definitions but did not eliminate longstanding informal ties. Trust, loyalty and familial-style bonds persisted, influencing triadic dynamics in ways that sometimes reinforced and sometimes undermined formal structures. The executive chair exerted disproportionate influence, while prior TMT membership constrained the legitimacy of the new CEO. Triadic configurations highlighted asymmetries of power, mutual dependence and relational cohesion, showing how persistent socioemotional connections mediate formal institutional change.Research limitations/implications The study derives from a single firm in one emerging market regulatory context, limiting broad generalizability. Nevertheless, findings extend social exchange theory by applying a triadic lens to governance reform, moving beyond dyadic models of CEO-chair or CEO-TMT relations. Future research should explore multi-actor interactions across different governance systems, industries and regions and consider the inclusion of boards, additional heterogeneity dimensions and comparative institutional frameworks.Practical implications For boards and policymakers, findings underscore that mandating role separation alone does not guarantee stronger accountability or independence. Informal ties, often culturally embedded, can sustain influence and blur authority lines even after reform. Effective governance, therefore, requires not only formal structural compliance but also careful attention to relational dynamics among executives. Practitioners should proactively manage transitions, clarify expectations and cultivate balanced trust to ensure that role reconfiguration achieves both oversight and collaboration goals.Social implications The authors highlight how institutional reforms aimed at enhancing transparency and accountability intersect with relational traditions in emerging markets. By demonstrating how executives rely on personal trust and quasi-familial loyalty to navigate structural changes, the authors show the continuing salience of social capital in organizational governance. Findings encourage policymakers to consider cultural embeddedness when designing reforms, ensuring that governance frameworks accommodate both global legitimacy demands and local relational practices without creating unanticipated tensions.Originality/value The authors advance understanding of governance by applying a triadic social exchange perspective to the CEO-chair-TMT constellation, involving multple triadic groupings of the CEO, chair and individual members of the TMT. The authors show how formal governance reforms intersect with informal executive bonds to create hybrid relational structures. Through rare empirical access to elite leadership in an emerging market multinational, the authors contribute novel theoretical, contextual and practical insights to the governance literature. This study informs both scholars and practitioners seeking to understand the relational undercurrents of governance reforms in globalizing firms.

BackgroundPharmaceutical care can be improved via mobile health (mHealth) applications (apps); however, the engagement of these apps depends on healthcare providers' acceptance. Thus, identifying barriers and facilitators to utilizing mHealth apps is needed to develop and facilitate their use.ObjectiveThe objective of this research was to investigate the various elements that influence the acceptability and utilization of mHealth apps in the delivery of pharmaceutical care services, as perceived by pharmacists working in the government health sector of Kuwait.MethodsA cross-sectional survey was conducted, and the results were used in the mobile health technology acceptance model (m-TAM) to measure the behavioral intentions of pharmacists with regard to the acceptance and use of mHealth apps.ResultsMultiple elements influence the behavioral intention of pharmacists to use mHealth apps, including Compatibility (CO), Performance Expectancy (PE), Personal Innovativeness (PI) and Effort Expectancy (EE) were statistically significant predictors. The mediating role of PE was found to be statistically significant in the link between CO and BI and in the association between EE and BI. The substantial mediation effects of Effort Expectancy (EE) and Performance Expectancy (PE) were seen in the three associations between job-related mental demands (MA) and burnout (BI), professional identity (PI) and burnout (BI), and perceived social support at work (PSA) and Behavioural Intention (BI). The results further demonstrate that EE substantially mediates the connections between MA and PE, MSE and PE, PI and PE, and PSA and PE.ConclusionsThese results suggest that the acceptance of mHealth apps by pharmacists in Kuwait is multifaceted and requires evaluating a chain of effects. As a result, developing apps that provide pharmaceutical care requires consideration of each one of these factors. Results can direct policymakers and stakeholders in their efforts to implement mHealth in Kuwait.

The combination of wearable sensor systems and artificial intelligence (AI) is revolutionizing the personalized healthcare landscape through intelligent, ongoing, and context-aware monitoring. This project introduces VitaSense-AI, an innovative smart vest that can provide real-time physiological information for early detection of health anomalies. It provides multiple biosensor measurements consisting of electrocardiogram (ECG), heart rate, oxygen saturation (SpO2), respiratory rate, skin temperature, and galvanic skin response (GSR), allowing assessment of cardiovascular and stress-related issues. Additionally, motion and environmental sensors track posture, movement, air quality, humidity, and ambient temperature, providing context for interpretation of physiological data. Using a microcontroller for the main processing unit, data is acquired and sent wirelessly using Bluetooth to a mobile application, thereby providing users with real-time monitoring of their physiological parameters. The user will have the ability to set threshold values for each of the parameters using the mobile application, allowing the application to generate alerts when an abnormal condition is detected. Additionally, the system can be connected to a personal computer for communication with Open AI services to assist the user with health recommendations and situation assessments based on user-specific input (age and gender). This communication will also assist users in determining their normal threshold range for each parameter, which can then be set into the mobile application. Since the mobile application will be responsible for notifying the user when an abnormal condition is detected, the system will not rely on Wi-Fi, thus increasing the system response time, timely notification of the user with less latency. Possible implications for health monitoring at home of VitaSense-AI differs from traditional wearable devices because it will continue to learn and adapt to each individual’s physiological baselines, allowing for reliable, personalized biofeedback on individual health. The proposed VitaSense-AI system will allow very accurate measurements, be efficient in energy consumption, and be user-friendly, thus leading to long-term, noninvasive health care monitoring. The system will monitor healthcare in an intelligent, proactive, and scalable manner as a result of the combination of multiple modalities of sensing, adaptive AI analytics, and an ergonomic design. The VitaSense-AI system will support the real-time monitoring of vital sign tracking for someone in order to detect anomalies, to accurately and reliably assess health. This innovative system will represent a significant progression of next generation wearable health technologies to facilitate preventive diagnostics and aid personalized medical decision making. Implementing the hardware part of the system is completed but the software part is still under progress. Thus, the real results, system response, OpenAI recommendations will be all evaluated at the final phase.

This paper examines the impact of air pollution on stock market performance, emphasizing geopolitical risk as a mediator. It explores how air pollution's health effects disrupt investor behavior and financial market dynamics, with geopolitical risk bridging the relationship between air quality, emissions policies, and stock performance, thus highlighting the interplay between environmental and financial systems. This study employs the Vector Error Correction Model (VECM) to analyze both short-term and long-term dynamics among the regressors. Using updated data from A-share listed firms on the Shanghai Composite Index, covering the period 2012–2021, the analysis is supported by rigorous stationarity and cointegration tests to ensure the robustness and reliability of the findings. The long-term results indicate that air pollution and geopolitical risk significantly influence stock yield volatility, with deviations from equilibrium gradually corrected over time. In the short term, there is a significant Granger causality between stock yield and both air pollution and geopolitical risk, highlighting their combined impact on stock market performance. The study shows that air quality index negatively affects stock yield by depressing investor sentiment and driving irrational behaviors, emphasizing its role as both a social challenge and a key driver of financial market stability and economic development.

This study examines how cloud microphysical parameterizations in the Weather Research and Forecasting (WRF) model influence the simulation of rainfall over Kuwait during November 2018, with particular focus on the extreme event of 14 November. The WRF model was configured at 4-km resolution and dynamically downscaled from the Community Climate System Model version 4 (CCSM4) to evaluate the performance of four bulk microphysics schemes: WSM6, Lin, Thompson, and Morrison. Model output was evaluated against observations from the Kuwait Automatic Weather Station (29.22°N, 47.96°E) using cumulative and distributional rainfall characteristics, event-scale analysis, and standard statistical metrics (RMSE, MAE, bias, and correlation). All schemes reproduced the timing of rainfall events, while notable differences were found in simulated rainfall intensity. WSM6 produced rainfall amounts closest to observations, with the lowest error values and a small positive bias. Lin showed moderate overestimation, Thompson produced larger overestimation during heavy-rain periods, and Morrison consistently underestimated rainfall totals. For the 14 November event, which recorded 79.0 mm at the station, simulated totals ranged from 55.6 to 91.6 mm across the schemes, indicating that inter-scheme differences were dominated by rainfall magnitude rather than timing. These results highlight the sensitivity of convection-permitting rainfall simulations in arid regions to microphysical formulation. Evaluation using additional events and seasons is needed to assess whether these results extend beyond the period examined.