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Personal motivation is a key factor in the service of foster care, impending both on the welfare of the child and on the satisfaction of the carer. This paper explores the benefits, challenges and dilemmas involved in the job of professional (i.e. state-supported) foster carer in Romania–a country where the issue of child protection has drawn a great deal of international attention over the last thirty years. The principal hypothesis concerns whether the benefits, challenges and dilemmas identified by foster carers are influenced by the factors that led to their taking up this kind of work. Quantitative research was conducted using a questionnaire as the main tool. The paper takes a descriptive, cross-sectional and multifactorial approach. Sampling was carried out by self-selecting method, and the study involved 51 participants. The research project identified a statistically significant variation in the challenges and dilemmas reported by foster carers. Thus, the results of the study show that the majority of the carers indicate a primarily intrinsic motivation for their work. By way of conclusion, it is argued that social workers, operating in collaboration with multidisciplinary teams, can offer carers support in managing more difficult periods in the child–carer relationship, thus enhancing the sustainability of the foster care service. [ABSTRACT FROM AUTHOR]

Background: The prevalence of intimate partner violence (IPV) is high (54%) in Bangladesh. Moreover, female garment workers report higher rates of IPV and are also vulnerable to workplace violence (WPV). Experience of violence puts women at increased risk of developing depressive symptoms, which are related with low self-esteem, lower life satisfaction and lower productivity. To our knowledge, there has been no previous research on depression among female garment workers and its connections to IPV and WPV in Bangladesh. This paper aims to address this gap by studying the relationship of IPV, WPV and depression among female garment workers. Methods: The data for this paper comes from a cross-sectional survey of female garment workers (n = 800) conducted as baseline survey of a quasi-experimental study known as HERrespect. Survey data were collected during September-December, 2016 among randomly selected female garment workers from eight garment factories in and around Dhaka city. Structural equation modelling was conducted to explore the relationship among IPV, WPV and depression. Results: The findings show high rates of any IPV (69%); WPV (73%, experienced or witnessed) and depressive symptomatology (40%) among female garment workers. The analysis of pathways shows that IPV impacts a woman’s experience of WPV and work related stress leading to the development of depression; while WPV had direct and mediated pathways to depression. Experience of controlling by their husband leads to WPV and increased work related stress, and thus leads to depression. It also reveals that a worker’s ability to mobilize resources in emergency, however, increased self-esteem and reduced work related stress. Conclusion: This study shows the pathways through which experience of IPV and WPV lead to development of depressive symptoms among female garment workers. The link between women’s ability to mobilize resources with self-esteem and work related stress indicates the need for socio-economic empowerment of women and may suggest that combined intervention to address IPV and women’s empowerment could be successful in dealing with WPV and mental health. [ABSTRACT FROM AUTHOR]

Objective: There is a need for structure to achieve functional patient engagement within mental healthcare organizations, and for clarification on how to proceed on a strategic level. The aim of this paper is to shed light on the implementation of a strategic organizational structure for patient engagement in mental health by examining why and how to implement a structure, the organizational and environmental factors that facilitate or limit the process, and the perceived consequences of the implementation. Method: This paper evaluates the implementation of a strategic committee for patient engagement in a mental healthcare organization in Montreal (Quebec, Canada). The research was designed as a qualitative single case study using a deductive approach by means of a conceptual framework. Data sources consisted in ten semi-structured interviews, three focus groups, and organizational documents. Results: The strategic committee for patient engagement was implemented as a means to formalize patient partner participation, following the introduction of a vision of full citizenship. Important aspects of its implementation included its composition and role, the elaboration of a framework for patient partner participation, and finally, ongoing application and evaluation of the framework. Several facilitating factors were identified, including executive management support, leadership, and a vision behind the participation. Limiting factors mainly consisted of resistance towards patient participation and the existence of stigma. Consequences included increased and improved patient engagement, as well as reduced stigma within the organization. Conclusion: This study shows that the implementation of a strategic organizational structure for patient engagement is comprehensive. It further shows the importance of a vision and an articulate leadership involving several actors. Further research is needed regarding the impact of this type of strategic structure on a clinical level. [ABSTRACT FROM AUTHOR]

Objective: To explore intersections of social determinants of maternal healthcare utilization using the Classification and Regression Trees (CART) algorithm which is a machine-learning method used to construct prediction models. Methods: Institutional review board approval for this study was granted from Public Health Service—Ethical Review Board (PHS-ERB) and from the Health Ministry Screening Committee (HMSC) facilitated by Indian Council for Medical Research (ICMR). IRB review and approval for the current analyses was obtained from University of California, San Diego. Cross-sectional data were collected from women with children aged 0–11 months (n = 5,565) from rural households in 25 districts of Uttar Pradesh, India. Participants were surveyed on maternal healthcare utilization including registration of pregnancy (model-1), receipt of antenatal care (ANC) during pregnancy (model-2), and delivery at health facilities (model -3). Social determinants of health including wealth, social group, literacy, religion, and early age at marriage were captured during the survey. The Classification and Regression Tree (CART) algorithm was used to explore intersections of social determinants of healthcare utilization. Results: CART analyses highlight the intersections, particularly of wealth and literacy, in maternal healthcare utilization in Uttar Pradesh. Model-1 documents that women who are poorer, illiterate and Muslim are less likely to have their pregnancies registered (71.4% vs. 86.0% in the overall sample). Model-2 documents that poorer, illiterate women had the lowest ANC coverage (37.7% vs 45% in the overall sample). Model-3, developed for deliveries at health facilities, highlighted that illiterate and poor women have the lowest representation among facility deliveries (59.6% vs. 69% in the overall sample). Conclusion: This paper explores the interactions between determinants of maternal healthcare utilization indicators. The findings in this paper highlights that the interaction of wealth and literacy can play a very strong role in accentuating or diminishing healthcare utilization among women. The study also reveals that religion and women’s age at marriage also interact with wealth and literacy to create substantial disparities in utilization. The study provides insights into the effect of intersections of determinants, and highlights the importance of using a more nuanced understanding of the impact of co-occurring forms of marginalization to effectively tackle inequities in healthcare utilization. [ABSTRACT FROM AUTHOR]

This paper describes the process of adapting the Stanford Coreference resolution module to the Basque language, taking into account the characteristics of the language. The module has been integrated in a linguistic analysis pipeline obtaining an end-to-end coreference resolution system for the Basque language. The adaptation process explained can benefit and facilitate other languages with similar characteristics in the implementation of their coreference resolution systems. During the experimentation phase, we have demonstrated that language-specific features have a noteworthy effect on coreference resolution, obtaining a gain in CoNLL score of 7.07 with respect to the baseline system. We have also analysed the effect that preprocessing has in coreference resolution, comparing the results obtained with automatic mentions versus gold mentions. When gold mentions are provided, the results increase 11.5 points in CoNLL score in comparison with results obtained when automatic mentions are used. The contribution of each sieve is analysed concluding that morphology is essential for agglutinative languages to obtain good performance in coreference resolution. Finally, an error analysis of the coreference resolution system is presented which have revealed our system’s weak points and help to determine the improvements of the system. As a result of the error analysis, we have enriched the Basque coreference resolution adding new two sieves, obtaining an improvement of 0.24 points in CoNLL F1 when automatic mentions are used and of 0.39 points when the gold mentions are provided. [ABSTRACT FROM AUTHOR]

Empirical studies show that discrimination by identity found in offline markets also prevails online. This paper reveal that in a competitive market, buyers that intend to discriminate exist but they are prevented from influencing the market outcome. To this end, we construct a field experiment on eBay, where half of the sellers disclose their names in their usernames while the other half do not. eBay, however, automatically discloses the seller’s names to the buyer after the auction. In the anonymous auctions, winning bidders thus learn the identity of the seller after the auction ends, and here we find buyers to discriminate against sellers with foreign-sounding names by leaving them feedback less often. However, there is no such discrimination in feedback provision when the seller name was known to the buyer before the auction. When bidders know the names of the sellers, the bidders with animus towards individuals with specific names can select out of auctions from these sellers, leaving winners that do not discriminate. One would expect that the auctions of for example sellers with foreign-sounding names would receive fewer bidders and thus lower auction prices. However, we observe no such differences: there are no statistically significant differences in the number of bids or auction prices received by sellers with foreign or domestic sounding names. [ABSTRACT FROM AUTHOR]

Background: Against a backdrop of more than four decades of war, conflict and insecurity, Afghanistan is recognised as suffering from endemic violence and children are exposed to multiple forms of violence, including at the family and school levels. This paper presents the results of an evaluation of school-based peace education and a community-based intervention to change harmful social norms and practices related to gender and the use of violence in conflict resolution, implemented in Afghanistan with the aim of reducing violence against and between children. Methods: The evaluation consisted of a cross-sectional, interrupted time series design with three data collection points over 12 months. Data was collected from students in 11 secondary schools (seven girls’ and four boys’ schools) in Jawzjan province of Afghanistan, with a total of 361 boys and 373 girls sampled at endline. All children were interviewed with a questionnaire developed for the study. Key outcomes included children’s experience of peer violence (both perpetration and victimization) at school, corporal punishment both at home and at school, and observation of family violence. Other outcomes included children’s gender equitable attitudes, attitudes towards child punishment, depression and school performance. Results: Between baseline and endline evaluation points, there were significant reductions in various forms of violence at the school level, including both boys’ and girls’ past month experience of peer violence victimization, peer violence perpetration, and corporal punishment by teachers. There were also significant reductions in boys’ and girls’ experience of corporal punishment at home and observation of family violence, with a particularly strong effect observed among girls. Both boys and girls had significantly more equitable gender attitudes and significantly less violence-supportive attitudes in relation to children’s punishment, and significantly fewer symptoms of depression. Girls’ school attendance was also significantly higher at endline. Discussion: To our knowledge this is the first time that a peace education program has been evaluated in Afghanistan, with or without a community intervention to change harmful social norms and practices related to gender and the use of violence for conflict resolution. The evaluation suggests that the intervention may have led to a reduction in various forms of violence, including children’s peer violence, corporal punishment of children both at school and at home, and in children’s reports of domestic violence against women at the household level. [ABSTRACT FROM AUTHOR]

This paper aims to describe the prevalent forms of intimate partner violence (IPV), and the factors associated with IPV among women and men living in the two migrant communities of Baglung district, Nepal. 357 adult women and men were enrolled following a family model, interviewing young married women with daughter-in-law status in the home, their husbands, and mothers-in-law and fathers-in-laws using an electronic questionnaire. Random effects regression modelling compared men and women, as well as young married women with daughter-in-law status and older women with mothers-in-law with status. 28.6% of women had ever experienced physical and/or sexual violence by an intimate partner compared to 18.2% of men ever perpetrated these forms of violence against their wives. Being older, male controlling behaviour and poor relations with husband increased women’s IPV in their lifetime while perceptions that the mother-in-law is kind were protective. Being ashamed of being unemployed and childhood trauma were associated with men perpetrating IPV in their lifetime. Borrowing money or food increased young married women’s lifetime IPV risk while mother-in-law cruelty and male control increased older married women’s lifetime IPV exposure. Factors associated with IPV in the past year among men were being younger, job seeking, experiences of childhood trauma and depression exposure among men while difficulty accessing money for emergencies, holding inequitable gender attitudes, and depression was associated with women’s increased IPV exposure. Unemployment stress, holding inequitable gender attitudes and mother-in-law kindness were associated with young women’s increased IPV risk and hunger, mother-in-law cruelty and depression with older women’s IPV risk. There is a need to critically challenge harmful social and gender norms by using approaches that are sensitive to young married women’s position and unequal gender relations in the family. IPV prevention interventions need to employ a holistic approach that combines changing social and gender norms and improving socioeconomic conditions of women living in migrant communities. [ABSTRACT FROM AUTHOR]

Recent study shows that 617 million children and adolescents–or six out of 10 globally- are not acquiring minimum levels in literacy and mathematics, indicating the magnitude of the learning acquisition problem. For children with disabilities in context of conflict, the situation is arguably even worse: the literature shows that they face difficulties to access the education system due to multiple barriers, and when they do access, they are not learning. Our paper examines if an active education policy promoting inclusion since 2005 in Afghanistan, a protracted crisis context, has been effective. Using two cross sectional household surveys carried out eight years apart (2005–2013), our study shows that access to school and literacy did not improve between 2005 and 2013 for children and youth with disabilities. Both access and literacy outcomes were worse for girls with disabilities, those with a mental, learning or associated disability and those living in household where the head was uneducated. Finally, odds of being mentally distressed significantly declined between 2005 and 2013 indicating that schools might play a protective role for children with disabilities in Afghanistan. Our findings suggest that a multilevel multi-pronged adaptation of the existing system to improve the learning experience and promote children’s resilience, particularly for children with disabilities, in conflict context such as Afghanistan, is required. [ABSTRACT FROM AUTHOR]

Background: A community’s cultural beliefs, attitudes and discourse can affect their responses in surveys. Knowledge of these cultural factors and how to comply with them or adjust for them during data collection can improve data quality. Objective: This study describes implications of features of Gambian culture related to women’s reproductive health, and mortality, when collecting data in surveys. Methods: 13 in-depth interviews of female interviewers and a focus group discussion among male interviewers were conducted in two rural health and demographic surveillance systems as well as three key informant interviews in three regions in The Gambia. Results: From the fieldworker’s viewpoint, questions relating to reproduction were best asked by women as culturally pregnancies should be concealed, and menstruation is considered a sensitive topic. Gambians were reluctant to speak about decedents and the Fula did not like to be counted, potentially affecting estimation of mortality. Asking about siblings proved problematic among the Fula and Serahule communities. Proposals made to overcome these challenges were that culturally-appropriate metaphors and symbols should be used to discuss sensitive matters and to enumerating births/deaths singly instead of collecting summary totals, which had threatening connotations. This was as opposed to training interviewers to ask standardised and precise verbatim questions. Contribution: This paper presents indigenous Gambian solutions by fieldworkers to culturally sensitive topics when collecting pregnancy outcomes and mortality data in demographic and health surveys. For researchers collecting maternal mortality data, it highlights the potential shortcomings of the sibling history methodology. [ABSTRACT FROM AUTHOR]

Background: Due to changes in Polish society resulting from a significant inflow of immigrants to Poland, the need to develop the cultural competences of various professional groups who have contact with immigrants in their work has increased. These groups should include healthcare professionals, especially because of the significant increase in the number of culturally diverse patients. Therefore, medical education in Poland has had to rapidly adapt to this novel situation. For instance, the teaching process should be now more focused on the development and evaluation of the cultural competences of prospective health care workers. However, there is still a lack of standardized, valid and reliable instruments to assess cross-cultural competences among healthcare professionals. The purpose of the present paper was to describe, for the first time, the translation, adaptation, and psychometric evaluation of the Polish version of the Cross-Cultural Competence Inventory. Methods: Across two studies, we examined psychometric properties of the Cross-Cultural Competence Inventory (CCCI) such as reliability (i.e. internal consistency, test-retest reliability, factor structure) and validity (i.e. theoretical, criteria, convergent). In the first study, 408 participants (75% were healthcare professionals) completed the Polish version of the CCCI and the Positive/Negative Attitude Towards Culturally Divergent People Questionnaire. In the second study, 317 participants (97% were healthcare professionals) completed the CCCI twice, with an interval of at least 22 days. In addition, across two study sessions, participants completed questionnaires constructed to measure (a) cultural intelligence, (b) need for cognitive closure, (c) emphatic sensitiveness, (d) emotional intelligence, (e) self-esteem, (f) social desirability, and (g) personality. Finally, to additionally examine the theoretical validity, 36 professional cross-cultural competence trainers completed the CCCI during a one-session study. Results: Our findings confirm the reliability and validity of the CCCI. More precisely, in study 1 we proved the theoretical validity and reliability (i.e. internal consistency) of the CCCI. While the assumed structure did not fit the data well, all items were significantly related to the general factor, thus providing strong support for the usage of the total score of the CCCI. In study 2, we additionally estimated the test-retest reliability and theoretical, criterion and convergent validity. Across two studies we were able to successfully confirm these psychometric properties. The reliability was satisfactory and ranged from .83 to .86. We also observed a high and significant positive correlation between CCCI and the Cultural Intelligence Scale, which measures a concept similar to the one measured by CCCI. In addition, a significant relationship between intercultural competences (CCCI) and other variables such as personality, empathic sensitivity, emotional intelligence, self-esteem (positive correlations) and the need for cognitive closure (mainly negative correlation) were demonstrated. Conclusions: The obtained results support the usage of the CCCI questionnaire in scientific research, such as, for example, among healthcare professionals (nurses, doctors) and students of medical fields (nursing, medicine). [ABSTRACT FROM AUTHOR]

Background: Nutrition outcomes among young children in Nigeria are among the worse globally. Mother’s limited knowledge about food choices, feeding, and health care seeking practices contributes significantly to negative nutrition outcomes for children in most developing countries. Much less is known about the relationship between mother’s nutrition-related knowledge and child nutritional outcomes in rural Nigeria. This paper investigates therefore: (i) the association of mother’s nutrition-related knowledge with nutrition outcomes of young children living in rural Nigeria, where access to education is limited, and (ii) whether mother’s education has a complementary effect on such knowledge in producing positive child nutrition outcomes in such settings. Methods: Using the Demographic and Health Survey data for Nigeria, we employ both descriptive and regression analyses approaches in analyzing the study’s objectives. In particular, we apply ordinary least square (OLS) to investigate the association of mother’s nutrition-related knowledge with child HAZ and WHZ while controlling for maternal, child, household and regional characteristics. An index was constructed for mother’s nutrition-related knowledge using information on dietary practices, disease treatment and prevention, child immunization, and family planning. Results: We found that mother’s knowledge is independently and positively associated with HAZ and WHZ scores in young children. Higher levels of mother’s education, typically above primary, have a significant, positive association with child HAZ and WHZ scores. We argue that mother’s knowledge of health and nutrition may substitute for education in reducing undernutrition in young children among populations with limited access to formal education. However, the present level of mother’s education in rural Nigeria appears insufficient to reinforce knowledge in producing better nutrition outcomes for children. Conclusions: This study suggests promotion of out-of-school (informal) education, such as adult literacy and numeracy classes where women without formal education can gain health and nutrition knowledge, and practices that could enhance child nutrition outcomes in Nigeria. [ABSTRACT FROM AUTHOR]

We propose an agent-based model leading to a decrease or an increase of hostility between agents after a major cultural threat such as a terrorist attack. The model is inspired from the Terror Management Theory and the Social Judgement Theory. An agent has a cultural identity defined through its acceptance segments about each of three different cultural worldviews (i.e., Atheist, Muslim, Christian) of the considered society. An agent’s acceptance segment is composed from its acceptable positions toward a cultural worldview, including its most acceptable position. An agent forms an attitude about another agent depending on the similarity between their cultural identities. When a terrorist attack is perpetrated in the name of an extreme cultural identity, the negatively perceived agents from this extreme cultural identity point of view tend to decrease the width of their acceptance segments in order to differentiate themselves more from the threatening cultural identity. We generated a set of populations with cultural identities compatible with data from a survey on attitudes among a large sample representative of the population of France; we then simulated the reaction of these agents facing a terrorist attack from Muslim extremists. For most populations, the average attitude toward Muslims becomes more negative. However, for some specific populations, we noticed the opposite effect as the average attitude of the population toward Muslims becomes less negative. In these populations, the Muslim agents strongly differentiate themselves from the terrorists’ extreme cultural identity, and the other agents are aware of these changes. These reactions are due to particular properties of their cultural identities that are identified in this paper. [ABSTRACT FROM AUTHOR]

Attitudes and beliefs about menstruation can place restrictions on menstruating women and girls, limiting their ability to fully participate in community life, education and employment. This paper presents evidence on menstruation-related beliefs contributing to restrictive practices in Papua New Guinea (PNG), Solomon Islands (SI) and Fiji. Focus group discussions and interviews were undertaken with 307 adolescent girls, women and men in a rural and urban site in each country. Data were analysed using an inductive thematic approach. Participants described a range of attitudes and beliefs that restrict the behaviour of menstruating women and girls. Themes include the belief that menstrual blood is ‘dirty’; that when menstruating, girls and women can bring ‘bad luck’ to men; secrecy and shame associated with menstruation; and beliefs about the impact of certain behaviours on menstruation and health. Restrictive practices were more frequently reported in PNG and SI than Fiji, and more common in rural compared with urban sites. Some restrictions, such as avoidance of household chores, were perceived as desirable or driven by women themselves. However participants identified other restrictions, such as not being able to attend church or hygienically wash menstrual hygiene materials, as unwanted, in some cases impacting on participation in school, work and community life. Education initiatives guided by women and girls, implemented by local stakeholders and grounded in a sound understanding of specific contexts are needed to address discriminatory attitudes and beliefs that contribute to unwanted restrictions, and to support enabling attitudes and beliefs regarding menstruation. [ABSTRACT FROM AUTHOR]

In this paper, I examine whether inducing gender/professional identity compatibility prior to a self-advocacy negotiation, may enhance women’s assertiveness in a compensation negotiation and mitigate potential social backlash concerns for assertiveness. In two experimental lab studies where women negotiated with a male counterpart as sellers and job candidates, I found evidence supporting the causal link between state gender/profession identity integration and higher levels of assertiveness in women’s self-advocacy compensation negotiations. [ABSTRACT FROM AUTHOR]

Background: Violence against women by an intimate partner (DV) is a serious public health and human rights issue. Attitudes justifying DV strongly predict its perpetration and victimisation. This paper presents gendered ecological analyses of the societal acceptance of DV in 49 low- and middle-income countries (LMICs) across geographical regions. Methods and findings: We utilised data from 49 Demographic and Health Surveys conducted between 2005 and 2017, United Nations Statistics and topic-specific meta-databases. DV acceptance was measured as the justification of ‘wife-beating’ in at least one of five circumstances, and by the summative scale. Stepwise multiple linear regression examined country-level social, economic and political empowerment predictors of societal acceptance of DV amongst women, men, and the aggregate gender difference. Women were more likely than men to justify DV in Sub-Saharan Africa and South (east) Asia with societal acceptance of DV being more widespread in these regions compared with Latin America, the Caribbean, Central/West Asia and Europe. Political conflict and limited economic rights for women were associated with higher levels of DV acceptance amongst women and men. Men in more democratic countries were less likely to justify DV. Amongst women, higher national female literacy rates predicted lower levels of justification. There were higher levels of DV acceptance amongst women and a wider aggregate gender difference in countries with a larger representation of women in national parliament. Conclusion: Justification of DV is widespread amongst women and men in LMICs with acceptance rates varying across countries and regions. Gender differences in the impact of contextual factors on DV acceptance supports a gendered approach to national-level interventions. Our findings highlight the need for tailored interventions targeting DV acceptance in conflict-impacted societies. The emphasis of inter(national) policies on the ‘empowerment’ domains of widely-used gender (in)equality indices need to be coupled with strategies tackling discriminatory gender norms. [ABSTRACT FROM AUTHOR]

This paper examines social class-based differences in influence in online review contexts. We explore four mechanisms for how a review writer’s social class may affect readers’ evaluations of the organization. First, we argue that, via a “contagion” process, organizations reviewed by higher-class individuals will be evaluated more positively than organizations reviewed by lower-class individuals. Second, we expect that higher-class reviewers will be seen as more knowledgeable; thus, their opinions will be more influential in shaping others’ opinions. Third, we expect that reviewers will be seen more influential when they review organizations that match their social class. Fourth, we expect people to be more influenced by those who share their own class background. A large-scale observational study of reviews (N = 1,234,665) from finds support for the contagion, the organization-reviewer social class matching, and the reviewer-participant social matching hypotheses, but disconfirms the hypothesis that higher-class reviewers are always treated as having more expertise. Two experimental studies (N = 354 and N = 638) demonstrate that reviewer class plays a causal role in both a contagion process and in an assumption of higher-class knowledge process, but do not provide evidence for the reviewer-participant social matching hypothesis. [ABSTRACT FROM AUTHOR]

Background: Despite the known benefits of a physically active lifestyle, there are few examples of interventions that have been successfully implemented at a population level over a long period of time. One such example is The Daily Mile, a school based physical activity initiative, where a teacher takes their class out daily during class time for a short bout of ambulatory activity. At one school, this activity appears has been sustained over a long period (6 years), has the whole school participating and is now incorporated into its daily routine. The aim of this paper was to understand how The Daily Mile was implemented in primary schools and to assess factors associated with its successful implementation. Methods: Semi-structured interviews with school staff who had a significant role in implementing The Daily Mile were conducted at four primary schools in central Scotland. Interviews were digitally recorded and transcribed verbatim. Data were analysed using thematic analysis and descriptive analysis and interpretation of data undertaken. Details regarding the school grounds and facilities were also noted during the interviews. Results: Having simple core intervention components, flexible delivery that supports teacher autonomy and being adaptable to suit the specific primary school context appear to be key aspects of The Daily Mile that are related to its implementation success. Other factors relating to how The Daily Mile was developed, trialled and rolled out might also have contributed towards its successful implementation. Conclusion: The Daily Mile appears to have several factors which may relate to its implementation success. These are important considerations for others looking to implement The Daily Mile effectively in their primary school or in other contexts. [ABSTRACT FROM AUTHOR]

Although health provider racial/ethnic bias has the potential to influence health outcomes and inequities, research within health education and training contexts remains limited. This paper reports findings from an anonymous web-based study examining racial/ethnic bias amongst final year medical students in Aotearoa/New Zealand. Data from 302 students (34% of all eligible final year medical students) were collected in two waves in 2014 and 2015 as part of the Bias and Decision Making in Medicine (BDMM) study. Two chronic disease vignettes, two implicit bias measures, and measures of explicit bias were used to assess racial/ethnic bias towards New Zealand European and Māori (indigenous) peoples. Medical students demonstrated implicit pro-New Zealand European racial/ethnic bias on average, and bias towards viewing New Zealand European patients as more compliant relative to Māori. Explicit pro-New Zealand European racial/ethnic bias was less evident, but apparent for measures of ethnic preference, relative warmth, and beliefs about the compliance and competence of Māori patients relative to New Zealand European patients. In addition, racial/ethnic bias appeared to be associated with some measures of medical student beliefs about individual patients by ethnicity when responding to a mental health vignette. Patterning of racial/ethnic bias by student characteristics was not consistent, with the exception of some associations between student ethnicity, socioeconomic background, and racial/ethnic bias. This is the first study of its kind with a health professional population in Aotearoa/New Zealand, representing an important contribution to further understanding and addressing current health inequities between Māori and New Zealand European populations. [ABSTRACT FROM AUTHOR]

Abstract: Wealthy schools appoint better qualified teachers, less wealthy schools under qualified teachers. Added to this mix is a powerful teacher’s union whose policies attempt to entrench the job security of teachers in the less wealthy schools irrespective of whether they can teach their subjects or not. Can one isolate these effects from that of other socio-demographic factors that may also be affecting the performance of students when they enrol for a degree at the University of KwaZulu-Natal (UKZN)? An outcome variable that subtracts the number of courses that have been failed from the number of courses that have been passed, dividing this by the total number of years that they have spent studying for a particular degree will be used as a response variable for this paper. Objectives: The system of secondary education in South Africa is highly polarized. On the one hand, we have a group of mainly Black African students, forming about 80% of the total student population, that come from a vastly under-resourced rural or township based community. On the other hand, we have a group of predominantly White and Indian students who are able to attend a far better resourced set of private schools. Added to this mix, we have 240,000 of South Africa’s total number of 390,000 primary and secondary school teachers who belong to a powerful teacher’s union which enjoys a strong political alliance with the ruling party in South Africa. With most of their union members teaching in the less wealthy schools in South Africa, `school background’ now includes a politically motivated component that focuses on teacher self–interest rather than the education of the child. What sort of effect does school background have on the performance of students when they enter an institution of higher learning? More importantly, can one isolate the effect of school background from that of other possibly confounding factors such as gender, financial aid and the receipt of some form of residence based accommodation that will also impact on their performance while at university? Method: A total of 6,183 students enrolling for a degree at the University of KwaZulu-Natal (UKZN) over the period 2008 to 2012 were used a dataset for this study. Permission to use this dataset was given by the Teaching and Learning Office at UKZN. The database that was used for this study was obtained from the Division of Management Information (DMI) office at UKZN. The percentage based marks that students have managed to record for Mathematics, English, Biology and Accounting in their school leaving exams together with some other important but observable socio-economic factors were included in a regression model to determine how students will perform at UKZN. Socio-economic variables relating to gender, race and whether they have receivd some form of financial aid or residence based accommodation while studying at university were also included as predictor variables in our regression based model structure. Results and Conclusions: An interaction effect associated with being a Black African student who has been privileged enough to attend a quintile five school was found to be significant. A main effect associated with being able to attend a more privileged quintile 5 school however was found to be nonsignificant even after an adjustment has been made for gender, race, the receipt of some form of financial aid and residence based accommodation. Given that UKZN already has a number of bridging programs in place that target students who have come from a less privileged background, for university based policymakers, this result may help to justify the targeted selection of Black African students from the less privileged schools that is taking place. Because some of the disparity in matric performance that we are observing may also be associated with teacher competency and the protective influence of a powerful teacher’s union, this paper may also help to highlight some of the economic costs related with having under-prepared students. “A mind is a terrible thing to waste”–United Negro College Fund. [ABSTRACT FROM AUTHOR]

When disaster events capture global attention users of Twitter form transient interest communities that disseminate information and other messages online. This paper examines content related to Typhoon Haiyan (locally known as Yolanda) as it hit the Philippines and triggered international humanitarian response and media attention. It reveals how Twitter conversations about disasters evolve over time, showing an issue attention cycle on a social media platform. The paper examines different functions of Twitter and the information hubs that drive and sustain conversation about the event. Content analysis shows that the majority of tweets contain information about the typhoon or its damage, and disaster relief activities. There are differences in types of content between the most retweeted messages and posts that are original tweets. Original tweets are more likely to come from ordinary users, who are more likely to tweet emotions, messages of support, and political content compared with official sources and key information hubs that include news organizations, aid organization, and celebrities. Original tweets reveal use of the site beyond information to relief coordination and response. [ABSTRACT FROM AUTHOR]

With the booming development of evacuation simulation software, developing an extensive database in indoor scenarios for evacuation models is imperative. In this paper, we conduct a qualitative and quantitative analysis of the collected videotapes and aim to provide a complete and unitary database of pedestrians’ earthquake emergency response behaviors in indoor scenarios, including human-environment interactions. Using the qualitative analysis method, we extract keyword groups and keywords that code the response modes of pedestrians and construct a general decision flowchart using chronological organization. Using the quantitative analysis method, we analyze data on the delay time, evacuation speed, evacuation route and emergency exit choices. Furthermore, we study the effect of classroom layout on emergency evacuation. The database for indoor scenarios provides reliable input parameters and allows the construction of real and effective constraints for use in software and mathematical models. The database can also be used to validate the accuracy of evacuation models. [ABSTRACT FROM AUTHOR]

Background: Bangladesh reports one of the highest rates of intimate partner violence (IPV) in the world. Despite wide recognition of IPV as an important public health and human rights issue, evidence for IPV prevention is still inadequate. Lack of guidance on effective IPV prevention in Bangladesh resulted in targeting only women in most of the programmes. Methods: This paper assesses impact of SAFE, a 20-month intervention (March 2012 to October 2013) in slums of Dhaka on IPV and tests effectiveness of female only groups vs. no groups; and female + male groups vs. female only groups on IPV in the community using a three-arm cluster randomized controlled trial. SAFE’s core activities included interactive group sessions, community mobilisation, and services. The last two activities were common across arms. Findings: Regression analyses (female survey: baseline n = 2,666; endline n = 2,670) showed no effect of SAFE on IPV against women aged 15–29. However, sub-group analyses demonstrated 21% risk reduction of physical IPV against adolescent girls aged 15–19 in the female + male group intervention arm. A consistent reduction in sexual violence was observed in both female and female + male arms for both groups of women, but the results were not statistically significant. Interpretation: The findings emphasise the importance of combining male and female interventions for reducing physical IPV against adolescent girls. Implications for future research have been discussed. [ABSTRACT FROM AUTHOR]

Intimate partner violence (IPV) has significant impacts on mental health. Community-focused interventions have shown promising results for addressing IPV in low-income countries, however, little is known about the implications of these interventions for women’s mental wellbeing. This paper analyses data from a community-focused policy intervention in Rwanda collected in 2013–14, including focus group discussions and in-depth interviews with community members (n = 59). Our findings point to three ways in which these community members responded to IPV: (1) reconciling couples experiencing violence, (2) engaging community support through raising cases of IPV during community discussions, (3) navigating resources for women experiencing IPV, including police, social services and legal support. These community responses support women experiencing violence by helping them access available resources and by engaging in community discussions. However, assistance is largely only offered to married women and responses tend to focus exclusively on physical rather than psychological or emotional forms of violence. Drawing on Campbell and Burgess’s (2012) framework for ‘community mental health competence’, we interrogate the potential implications of these responses for the mental wellbeing of women affected by violence. We conclude by drawing attention to the gendered nature of community responses to IPV and the potential impacts this may have for the mental health of women experiencing IPV. [ABSTRACT FROM AUTHOR]

In recent years, major global institutions have amplified their efforts to address intimate partner violence (IPV) against women—a global health and human rights violation affecting 15–71% of reproductive aged women over their lifetimes. Still, some scholars remain concerned about the validity of instruments used for IPV assessment in population-based studies. In this paper, we conducted two validation analyses using novel data from 450 women-men dyads across nine villages in Northern Tanzania. , we examined the level of inter-partner agreement in reporting of men’s physical, sexual, emotional and economic IPV against women in the last three and twelve months prior to the survey, ever in the relationship, and during pregnancy. , we conducted a convergent validity analysis to compare the relative efficacy of men’s self-reports of perpetration and women’s of victimization as a valid indicator of IPV against Tanzanian women using logistic regression models with village-level clustered errors. We found that, for every violence type across the recall periods of the last three months, the last twelve months and ever in the relationship, at least one in three couples disagreed about IPV occurrences in the relationship. Couples’ agreement about physical, sexual and economic IPV during pregnancy was high with 86–93% of couples reporting concordantly. Also, men’s self-reported perpetration had statistically significant associations with at least as many validated risk factors as had women’s self-reported victimization. This finding suggests that men’s self-reports are at least as valid as women’s as an indicator of IPV against women in Northern Tanzania. We recommend more validation studies are conducted in low-income countries, and that data on relationship factors affecting IPV reports and reporting are made available along with data on IPV occurrences. Keywords: Intimate partner violence; measurement; validity; survey research; Tanzania. [ABSTRACT FROM AUTHOR]

This paper deals with the skills related to the early reading acquisition in two countries that share language. Traditionally on reading readiness research there is a great interest to find out what factors affect early reading ability, but differ from other academic skills that affect general school learnings. Furthermore, it is also known how the influence of pre-reading variables in two countries with the same language, affect the development of the reading. On the other hand, several studies have examined what skills are related to reading readiness (phonological awareness, alphabetic awareness, naming speed, linguistic skills, metalinguistic knowledge and basic cognitive processes), but there are no studies showing whether countries can also influence the development of these skills.Our main objective in this study was to establish whether there were differences in the degree of acquisition of these skills between Spanish (119 children) and Peruvian (128 children), five years old children assessed in their own countries and after controlling Economic, Social and Cultural Status (ESCS). The results show that there are significant differences in the degree of acquisition of these skills between these two samples. It's especially relevant, in these results, that the main predictor in a regression study was the country of origin, explaining a higher percentage of variance than other variables such as age differences, in months, or gender. These findings corroborate the results obtained in other studies with migrant population. [ABSTRACT FROM AUTHOR]

Background: Child peer violence is a global problem and seriously impacts children’s physical and psychological health, and their education outcomes. There are few research studies on children’s peer violence available in South Asian countries, particularly in Afghanistan. This paper describes the prevalence of children’s peer violence perpetration and victimization and associated factors among school children in Afghanistan. Methods: A total of 770 children were recruited into a baseline study conducted as part of an intervention evaluation in 11 schools (seven girls’ and four boys’ schools). All children were interviewed with a questionnaire developed for the study. The main outcome is a three-level peer violence variable consisting of (a) no violence, (b) victimization only, or (c) perpetration (with or without victimization). Peer violence victimization was measured through the Multidimensional Peer-Victimization Scale, and peer violence perpetration was measured through an adjusted version of the same scale with wording changed to measure perpetration. Results: 49.7% of boys and 43.3% of girls reported having experienced more than one instance of violence victimization in the past month, and 31.7% of boys and 17.6% of girls disclosed perpetration of more than one instance of violence in the past month, with considerable overlap found between experience of victimization and perpetration, particularly among boys. Multinomial models of factors associated with peer violence show that for boys, food insecurity was associated with perpetration of peer violence but not with victimization, and experiencing corporal punishment at school in the last month was significantly associated with both peer victimization and perpetration. For girls, food insecurity, more depressive symptoms and experiencing any beating at home were associated with both violence victimization and perpetration. Having a disability was associated with victimization only, and having witnessed their father fighting and experiencing any kind of corporal punishment were associated with peer violence perpetration only. Discussion: Peer violence in Afghanistan is linked to food insecurity, exposure of children to witnessing family violence, and children’s experience of physical violence at home and corporal punishment at school. School-based settings provide an important platform for interventions to reduce and prevent peer violence; however, such interventions may benefit from broader violence-prevention initiatives conducted at the community level. [ABSTRACT FROM AUTHOR]

Context: Ambivalence in pregnancy intentions is well-documented in sub-Saharan African (SSA) settings and has been associated with inconsistent use of contraception, thereby exposing women using contraception to the possibility of unintended pregnancies. A better understanding of the potential role for client counseling interventions in enabling women to achieve their pregnancy intentions is essential for aiding program efforts to reduce unintended pregnancies. Objective: To measure ambivalence in pregnancy intentions longitudinally and determine its association with the quality of care received, controlling for demographic, socio-economic and contextual factors among a cohort of family planning (FP) clients in Kenya. Methods: This paper uses data drawn from a prospective cohort study of FP clients to investigate the relationship between the quality of care received during FP service delivery and the decisiveness of their pregnancy intentions over time. The study tests the hypothesis that higher quality of care enables women to be less ambivalent about their pregnancy intentions. Binary logistic regression with random effects and multinomial logistic regression were used to assess the predictive effect of the quality of care received by a woman on the decisiveness or ambivalence of her pregnancy intentions, and on any shifts in ambivalence over time, controlling for background characteristics. The study recruited 1,957 women aged 15–49 years attending twelve family planning clinics in four counties in Central Kenya; of these, 1,053 women were observed for four rounds of data collection over a period of 24 months and form the sample for analysis. Findings: A substantial proportion (43%) of women expressed ambivalence about their intentions to become pregnant at some point during the study period, while over half (57%) remained unequivocal throughout the study. Almost one third of women (31%) shifted from being unequivocal to ambivalent and 12% shifted from ambivalence to being unequivocal. Women experiencing higher quality of care have lower odds of ever expressing ambivalence and higher odds of remaining unequivocal over time, net of other factors. Quality of care was not associated with a shift in ambivalence over time. Conclusion: FP programs offering higher quality of care are likely to support women to be more decisive in their pregnancy intentions. Improving the quality of care can contribute to reduced ambivalence and consequently reduced likelihood of unintended pregnancy among contraceptive users. This study provides further evidence of the benefits gained through providing high quality services. Trial registration: ClinicalTrials.gov [ABSTRACT FROM AUTHOR]

Background: When the Zika virus outbreak became a global health emergency in early 2016, the scientific community responded with an increased output of Zika-related research. This upsurge in research naturally made its way into academic journals along with editorials, news, and reports. However, it is not yet known how or whether these scholarly communications were distributed to the populations most affected by Zika. Methodology/Principal findings: To understand how scientific outputs about Zika reached global and local audiences, we collected Tweets and Facebook posts that linked to Zika-related research in the first six months of 2016. Using a language detection algorithm, we found that up to 90% of Twitter and 76% of Facebook posts are in English. However, when none of the authors of the scholarly article are from English-speaking countries, posts on both social media are less likely to be in English. The effect is most pronounced on Facebook, where the likelihood of posting in English is between 11 and 16% lower when none of the authors are from English-speaking countries, as compared to when some or all are. Similarly, posts about papers written with a Brazilian author are 13% more likely to be in Portuguese on Facebook than when made on Twitter. Conclusions/Significance: Our main conclusion is that scholarly communication on Twitter and Facebook of Zika-related research is dominated by English, despite Brazil being the epicenter of the Zika epidemic. This result suggests that scholarly findings about the Zika virus are unlikely to be distributed directly to relevant populations through these popular online mediums. Nevertheless, there are differences between platforms. Compared to Twitter, scholarly communication on Facebook is more likely to be in the language of an author’s country. The Zika outbreak provides a useful case-study for understanding how scientific outputs are communicated to relevant populations. Our results suggest that Facebook is a more effective channel than Twitter, if communication is desired to be in the native language of the affected country. Further research should explore how local media—such as governmental websites, newspapers and magazines, as well as television and radio—disseminate scholarly publication. [ABSTRACT FROM AUTHOR]

It is difficult to know whether different dimensions of trust have different effects on local residents’ acceptance of nuclear power plants (NPPs). In previous research such trust has been considered as a single dimensional concept. This paper divides trust into goodwill trust and competence trust, and we explore the ways in which trust affects acceptance of NPPs through structural equation modeling. A survey of 491 people was conducted in Haiyan County, China, where the Qinshan nuclear power plant is located. We find that goodwill trust is significantly correlated with competence trust, and each can indirectly promote residents’ acceptance of NPPs but by different paths. Goodwill trust improves acceptance of NPPs by decreasing risk perception, while competence trust improves acceptance of NPPs by increasing benefit perception. However, the associations between goodwill trust and benefit perception, competence trust and risk perception, are not significant. [ABSTRACT FROM AUTHOR]

Bangladesh is a culturally conservative nation with limited freedom for women. A number of studies have evaluated intimate partner violence (IPV) and spousal physical violence in Bangladesh; however, the views of women have been rarely discussed in a quantitative manner. Three nationwide surveys in Bangladesh (2007, 2011, and 2014) were analyzed in this study to characterize the most vulnerable households, where women themselves accepted spousal physical violence as a general norm. 31.3%, 31.9% and 28.7% women in the surveys found justification for physical violence in household in 2007, 2011 and 2014 respectively. The binary logistic model showed wealth index, education of both women and their partner, religion, geographical division, decision making freedom and marital age as significant household contributors for women’s perspective in all the three years. Women in rich households and the highly educated were found to be 40% and 50% less likely to accept domestic physical violence compared to the poorest and illiterate women. Similarly, women who got married before 18 years were 20% more likely accept physical violence in the family as a norm. Apart from these particular groups (richest, highly educated and married after 18 years), other groups had around 30% acceptance rate of household violence. For any successful attempt to reduce spousal physical violence in the traditional patriarchal society of Bangladesh, interventions must target the most vulnerable households and the geographical areas where women experience spousal violence. Although this paper focuses on women’s attitudes, it is important that any intervention scheme should be devised to target both men and women. [ABSTRACT FROM AUTHOR]

Self-rated health (SRH) accounts comprehensively for many health domains. The aim of this paper was to investigate time trends and associations between age-comparative self-rated health and some known determinants in a general population aged 24–34 years. Population-based cross-sectional surveys were performed in 1990, 1994, 1999, 2004, 2009 and 2014 in Northern Sweden. Out of 3500 invited persons, 1811 responded. Comparative SRH was measured on a three-grade ordinal scale by the question: “How would you assess your general health condition compared to persons of your own age?” with the alternatives “better/worse/similar”. Over the period 1990 to 2014, the percentage of women rating comparative SRH as “worse” increased steadily, from 8.5% in 1990 reaching 20% in 2014 (p for trend 0.007). Among men, this pattern was almost the opposite, with increasing proportions rating “better” (p for trend <0.000). Time trends for physical activity in leisure time; length of education; Body Mass Index; anxiety; depressive emotions and satisfaction with economy showed a similar pattern for men and women. Factors that might contribute to the development of time trends for comparative SRH are discussed. [ABSTRACT FROM AUTHOR]

This paper aimed to investigate the role of parental education in child disability in China. We used nationally representative data from China’s National Sample Survey on Disability, iterated twice, in 1987 and 2006, with data of 764,718 children aged 0–14 years. Logit models were used for statistical analysis. Results showed that the prevalence of child disability was significantly associated with each parent’s education. Maternal education was more important than paternal education in child disability in both surveys. The analysis of marginal effect indicated a one-year increase in maternal and paternal schooling led to an average decrease of 0.121% and 0.091% in the probability of child disability in 1987, and 19 years later, these figures had dwindled to 0.091% and 0.072%, respectively. [ABSTRACT FROM AUTHOR]

Fish consumption in Mexico is considered low (around 12 kg per person per year) and non-homogeneously distributed across the country. One of the reasons for this situation is the scarcity of wholesale selling sites. In this context, the Mercado del Mar (MM), located in Guadalajara city, Jalisco, is the second biggest wholesale fish market in Mexico, with a distribution of about 500 tons per day and a variety of about 350 different species of fish. In this paper, we argue that MM has accumulated social capital, which is formed from two main resources: buyer and seller relationships, and reputation. Specifically, the MM manages a broad and intensive interaction among business actors and the already achieved reputation allows the MM to adapt to market changes. To validate our hypotheses, an empirical study was conducted in 2015 by means of interviews to fish wholesalers in the MM and a sample of their suppliers and buyers. For simplicity we have only considered fresh water fish. We have followed snow-ball sampling as the survey strategy. Results show that the MM has responded to fish market dynamics organizing a complex network of buyers and suppliers whose relationships can be explained in the form of strong and weak ties. At the same time, reputation has been the central resource to build this social capital and also gives place to market transactions. Additionally, the strategic position of Guadalajara city and the well-connected routes have facilitated fish bulking and distribution in the region. [ABSTRACT FROM AUTHOR]

Background: The population of Ghana is increasingly becoming urbanized with about 70% of the estimated 27 million people living in urban and peri-urban areas. Nonetheless, eight out of the ten regions in Ghana remain predominantly rural where only 32% of the national health sector workforce works. Moreover, the rural-urban disparities in the density of health tutors (staff responsible for pre-service training of health professionals) are enormous. This paper explores perceived needs of health tutors in rural and urban health training institutions in Ghana. Methods: This is a descriptive qualitative study conducted in the Greater Accra and Northern regions of Ghana. The Study used the deductive thematic and sub-thematic analysis approaches. Five health training institutions were randomly sampled, and 72 tutors engaged in separate focus group discussions with an average size of 14 participants per group in each training institution. Results: Perceived rural-urban disparities among health tutors were found in the payment of extra duty allowances; school infrastructure including libraries and internet connectivity; staff accommodation; and opportunities for scholarships and higher education. Health tutors in rural areas generally expressed more frustration with these work conditions than those in urban areas. Conclusions: There is the need to initiate and sustain work incentives that promote motivation of rural health tutors to control ongoing rural-urban migration of qualified staff. It is recommended the following incentives be prioritized to promote retention of qualified health tutors in rural health training schools: payment of research, book and rural allowances; early promotion of rural staff; prioritizing rural tutors for scholarships, and introduction of national best health tutor awards. [ABSTRACT FROM AUTHOR]

Introduction: Inconsistency in the time trade-off (TTO) task in EQ-5D-5L occurs when a respondent gives a higher value to a logically worse health state, the occurrence of inconsistency compromises the quality of the data. It is not yet clear which factors are associated with individual level inconsistency. Relating inconsistency to the characteristics of the respondent, interviewer, and the interview process could be helpful in understanding the causes of inconsistency. The objective of this paper is to discover the factors associated with individual level inconsistencies. Methods: Twenty interviewers interviewed 1,296 respondents and each respondent valued 10 health states using the EQ-VT platform in 5 cities in China. At the respondent level, inconsistency was identified in terms of severity and quantity and related to the respondent’s background characteristics, the time and iterations spent on the wheelchair example task, and the formal TTO tasks, using multilevel multinomial regression analyses. Interviewers’ impact on inconsistencies was analyzed using single level multinomial regression analyses. Results: In the full dataset, slight inconsistency was more related to the interview process (Time spent on TTO task: RRR = 1.246 with 95%CI: 1.076,1.441; time spent on Wheelchair example: RRR = 0.815 with 95%CI:0.699,0.952) while severe inconsistency was more related to respondent’s gender (Gender: RRR = 2.347 with 95%CI:1.429,3.855). One Interviewer (Interviewer 7: RRR = 7.335 with 95%CI:1.908,28.195) and interviewer’s experience (Sequence: RRR = 0.511 with 95%CI:0.385,0.678) in general showed strong influence over inconsistency in the TTO task. Conclusion: In conclusion, logical inconsistency in the valuation of EQ-5D-5L health states is associated not only with respondents’ characteristics but also with interviewers’ performance and the interview process. The role of interviewers and the importance of interviewer training may be more crucial than hitherto believed. This finding could be generalizable to other interviewer-administered health-state valuation study. [ABSTRACT FROM AUTHOR]

Objective: Heroin use in the United States has reached epidemic proportions. The objective of this paper is to estimate the annual societal cost of heroin use disorder in the United States in 2015 US dollars. Methods: An analytic model was created that included incarceration and crime; treatment for heroin use disorder; chronic infectious diseases (HIV, Hepatitis B, Hepatitis C, and Tuberculosis) and their treatments; treatment of neonatal abstinence syndrome; lost productivity; and death by heroin overdose. Results: Using literature-based estimates to populate the model, the cost of heroin use disorder was estimated to be $51.2 billion in 2015 US dollars ($50,799 per heroin user). One-way sensitivity analyses showed that overall cost estimates were sensitive to the number of heroin users, cost of HCV treatment, and cost of incarcerating heroin users. Conclusion: The annual cost of heroin use disorder to society in the United States emphasizes the need for sustained investment in healthcare and non-healthcare related strategies that reduce the likelihood of abuse and provide care and support for users to overcome the disorder. [ABSTRACT FROM AUTHOR]

Remote Internet voting places the control and secrecy of the immediate voting environment on the shoulder of the individual voter but it also turns voting into yet another on-line activity thus endangering the well-known social nature of voting and possibly reducing the crucial sense of civic duty that is important for a healthy democracy. There is however a complete lack of evidence to what degree this actually materializes once electronic voting is introduced. This paper uses individual level log data on Internet voting in Estonian elections between 2013–2015 to inspect if Internet voting retains the social nature of the voting act. We do so by examining if Internet voting in groups takes place and what implications it has for voting speed. We find strong evidence of e-voting in pairs. Same aged male-female pairs seem to be voting in close proximity to each other, consistent with spouses or partners voting together. Also, female-female and female-male pairs with large age differences seem to be voting together, consistent with a parent voting with an adult aged offspring. With regards to voting speed we see the second vote in a vote pair being considerably faster than the first vote, again indicating a shared voting act. We end with a discussion of how the onset of electronic voting does not make elections less social, but does make vote secrecy more a choice rather than a requirement. [ABSTRACT FROM AUTHOR]

Background: Exposure to armed conflict and/or war have been linked to an increase in intimate partner violence (IPV) against women. A substantial body of work has focused on non-partner rape and sexual violence in war and post-war contexts, but research about IPV is limited, particularly in Asian settings. This paper presents the finding of a study conducted in the Eastern Province of Sri Lanka. The study explored women’s experiences of and responses to IPV as well as how health and social service providers perceive the problem. It also explored the IPV-related services and supports available after the end of a 30-year civil war. Method: We conducted in-depth, qualitative interviews with 15 women who had experienced IPV and 15 service providers who were knowledgeable about IPV in the Eastern Province of Sri Lanka. Interviews were translated into English, coded and organized using NVivo8, and analyzed using inductive thematic analysis. Results: Participants described IPV as a widespread but hidden problem. Women had experienced various forms of abusive and controlling behaviours, some of which reflect the reality of living in the post-war context. The psychological effects of IPV were common, but were often attributed to war-related trauma. Some men used violence to control women and to reinstate power when their gender roles were reversed or challenged due to war and post-war changes in livelihoods. While some service providers perceived an increase in awareness about IPV and more services to address it, this was discordant with women’s fears, feelings of oppression, and perception of a lack of redress from IPV within a highly militarized and ethnically-polarized society. Most women did not consider leaving an abusive relationship to be an option, due to realistic fears about their vulnerability to community violence, the widespread social norms that would cast them as outsiders, and the limited availability of related services and supports. Implications: These findings revealed the need for more research about IPV in post-war contexts. Women’s experiences in such contexts are influenced and may be masked by a complex set of factors that intersect to produce IPV and entrap women in violence. A more nuanced understanding of the context-specific issues that shape women’s experiences of IPV- and community responses to it—is needed to develop more comprehensive solutions that are relevant to the local context. [ABSTRACT FROM AUTHOR]

The Health Literacy Questionnaire (HLQ), developed in Australia in 2012 using a ‘validity-driven’ approach, has been rapidly adopted and is being applied in many countries and languages. It is a multidimensional measure comprising nine distinct domains that may be used for surveys, needs assessment, evaluation and outcomes assessment as well as for informing service improvement and the development of interventions. The aim of this paper is to describe the German translation of the HLQ and to present the results of the validation of the culturally adapted version. The HLQ comprises 44 items, which were translated and culturally adapted to the German context. This study uses data collected from a sample of 1,058 persons with chronic conditions. Statistical analyses include descriptive and confirmatory factor analyses. In one-factor congeneric models, all scales demonstrated good fit after few model adjustments. In a single, highly restrictive nine-factor model (no cross-loadings, no correlated errors) replication of the original English-language version was achieved with fit indices and psychometric properties similar to the original HLQ. Reliability for all scales was excellent, with a Cronbach’s Alpha of at least 0.77. High to very high correlations between some HLQ factors were observed, suggesting that higher order factors may be present. Our rigorous development and validation protocol, as well as strict adaptation processes, have generated a remarkable reproduction of the HLQ in German. The results of this validation provide evidence that the HLQ is robust and can be recommended for use in German-speaking populations. Trial Registration: German Clinical Trial Registration (DRKS): . Registered 23 March 2011. [ABSTRACT FROM AUTHOR]

Background: Immigration often results in changes in family dynamics, and within this process of dynamic relational adjustment youth can be conceptualised as contested sites of culture and associated intergenerational conflicts. This paper considers the experiences of migrant youth in Greater Western Sydney, New South Wales, Australia using conflict as a useful lens through which to view issues of migrant youth identity and their sense of social connectedness, belonging, and agency. The aim of this study was twofold: 1) to explore how migrant youth cope with acculturative stress and intergenerational conflicts, and 2) to better understand the systemic and family-related factors that facilitate positive settlement experiences for migrant youth. Methods: A total of 14 focus group discussions, comprising 164 people, were carried out in Greater Western Sydney, New South Wales, Australia. These focus groups targeted newly arrived migrant parents and young adults (aged 18–24) of African, Burmese, Nepalese, Indian, Afghani, Bangladeshi and Iraqi backgrounds. Each focus group was 1.5 hours in duration and was conducted by a team of three people (an experienced facilitator, an accredited interpreter/bilingual worker, and a note taker). Data were collected using a standard interview schedule, and an accredited interpreter/bilingual worker asked the questions in the appropriate language and translated participant responses into English. Results: The findings highlight how youth in new migrant families become contested sites of culture as they try to balance integration into the new culture while maintaining their originating country’s cultural values. Two themes and four subthemes emerged from the analysis: Intergenerational acculturation gap (loss of family capital and intergenerational conflicts); and factors that successfully protected positive family values while still allowing young people to integrate (the legal system that disarm authoritarian parenting practices and family rules; and parental use of children’s increased knowledge of the new environment to navigate their new environment). Migrant families conceptualised family capital as the social solidarity, influence, and control governing obligations and expectations, intergenerational knowledge transmission and information flow, social norms, and cultural identity. The loss of family capital was characterised by children’s refusal to associate with or meet family members, preferring to be alone in their rooms and private space. Migrant youth find themselves caught between and negotiating two cultures, with unwanted negative consequences at the family level in the form of intergenerational conflicts. The new found freedom among children and their rapid transition into the Australian society gives children an increased sense of agency, which in turn threatens parental authority, allowing children to exercise three forms of power: increased assertiveness due to legal protection of children against any corporal punishment; and English language fluency and greater understanding of the functioning of Australian social institutions. Conclusion: Our findings suggest the need for an inter-generational approach to healthy family dynamics within migrant communities when dealing with youth negotiating the complexity and sensitivity of forging their cultural identity. [ABSTRACT FROM AUTHOR]

Multi-stakeholder platforms (MSPs) are seen as a promising vehicle to achieve agricultural development impacts. By increasing collaboration, exchange of knowledge and influence mediation among farmers, researchers and other stakeholders, MSPs supposedly enhance their ‘capacity to innovate’ and contribute to the ‘scaling of innovations’. The objective of this paper is to explore the capacity to innovate and scaling potential of three MSPs in Burundi, Rwanda and the South Kivu province located in the eastern part of Democratic Republic of Congo (DRC). In order to do this, we apply Social Network Analysis and Exponential Random Graph Modelling (ERGM) to investigate the structural properties of the collaborative, knowledge exchange and influence networks of these MSPs and compared them against value propositions derived from the innovation network literature. Results demonstrate a number of mismatches between collaboration, knowledge exchange and influence networks for effective innovation and scaling processes in all three countries: NGOs and private sector are respectively over- and under-represented in the MSP networks. Linkages between local and higher levels are weak, and influential organisations (e.g., high-level government actors) are often not part of the MSP or are not actively linked to by other organisations. Organisations with a central position in the knowledge network are more sought out for collaboration. The scaling of innovations is primarily between the same type of organisations across different administrative levels, but not between different types of organisations. The results illustrate the potential of Social Network Analysis and ERGMs to identify the strengths and limitations of MSPs in terms of achieving development impacts. [ABSTRACT FROM AUTHOR]

This paper examines the effects of maternal autonomy on child schooling outcomes in Ethiopia using a nationally representative Ethiopian Demographic and Health survey for 2011. The empirical strategy uses a Hurdle Negative Binomial Regression model to estimate years of schooling. An ordered probit model is also estimated to examine age grade distortion using a trichotomous dependent variable that captures three states of child schooling. The large sample size and the range of questions available in this dataset allow us to explore the influence of individual and household level social, economic and cultural factors on child schooling. The analysis finds statistically significant effects of maternal autonomy variables on child schooling in Ethiopia. The roles of maternal autonomy and other household-level factors on child schooling are important issues in Ethiopia, where health and education outcomes are poor for large segments of the population. [ABSTRACT FROM AUTHOR]

Due to the context-sensitive nature of entrepreneurial orientation (EO), it is imperative to in-depth explore the EO-performance mechanism in China at its critical, specific stage of economic reform. Under the context of “reverse internationalization” by Chinese global startup original equipment manufacturers (OEMs), this paper aims to manifest the unique links and complicated interrelationships between the individual EO dimensions and firm performance. Using structural equation modeling, we found that during reverse internationalization, proactiveness is positively related to performance; risk taking is not statistically associated with performance; innovativeness is negatively related to performance. The proactiveness-performance relationship is mediated by Strategic flexibility and moderated by social networking relationships. The dynamic and complex institutional setting, coupled with the issues of overcapacity and rising labor cost in China may explain why our distinctive results occur. This research advances the understanding of how contingent factors (social network relationships and strategic flexibility) facilitate entrepreneurial firms to break down institutional barriers and reap the most from EO. It brings new insights into how Chinese global startup OEMs draw on EO to undertake reverse internationalization, responding the calls for unraveling the heterogeneous characteristics of EO sub-dimensions and for more contextually-embedded treatment of EO-performance associations. [ABSTRACT FROM AUTHOR]

Based on our site investigation conducted in 2013, we found that the pedestrian red light crossing at the midblock connecting the campus of Southwest University and living area was low, where most of pedestrians are university students and staff. This paper reports a supplementary work applying the Theory of Planned Behaviour (TPB) to identify any psychological differences toward pedestrian red light crossing between university students and their peers. Three social groups participated in the investigation. The first group is the university students in Grade one (Group 1), the other two groups are their previous senior middle school classmates who are now working full time (Group 2) or who are now out of work and school (Group 3). The statistical results indicated The TPB components accounted for 42.9%, 55.3% and 55.4% of the variance of red signal crossing intention for Group 1, Group 2 and Group 3 in the depicted road crossing scenario. The data also showed that there are obvious differences among the participants’ responses to “refrain from crossing” between university students and others, and the subsequent regression analysis revealed the ability to “refrain from crossing” played the most important role in the intention of red light crossing in the depicted scenario. [ABSTRACT FROM AUTHOR]

Whereas past wolf management in the United States was restricted to recovery, managers must now contend with publicly contentious post-recovery issues including regulated hunting seasons. Understanding stakeholder concerns associated with hunting can inform stakeholder engagement, communication, and policy development and evaluation. Social identity theory (SIT) has been used to understand how groups interact, why they conflict, and how collaboration may be achieved. Applying SIT to stakeholder conflicts about wolf hunting may help delineate groups according to their concern about, support for or opposition to the policy choice of hunting wolves. Our objective was to assess concerns about hunting as a tool to resolve conflict in Michigan, using SIT as a framework. We used a mixed-modal sampling approach (e.g., paper, Internet) with wolf hunting-related public meeting participants in March 2013. Survey questions focused on 12 concerns previously identified as associated with hunting as a management tool to resolve conflict. Respondents (n  =  666) cared greatly about wolves but were divided over hunting wolves. Wolf conflicts, use of science in policy decisions, and maintaining a wolf population were the highest ranked concerns. Principle components analysis reduced concerns into three factors that explained 50.7% of total variance; concerns crystallized over justifications for hunting. General linear models revealed a lack of geographic influence on care, fear and support for hunting related to wolves. These findings challenge assumptions about regional differences and suggest a strong role for social identity in driving dichotomized public perceptions in wildlife management. [ABSTRACT FROM AUTHOR]

Objectives: Fertility desires require new understanding in a context of expanding access to antiretroviral therapy for people living with HIV/AIDS in Sub-Saharan Africa. This paper studies the fertility desires and their rationales, of slum-dwelling Kenyan men and women living with HIV/AIDS who know their serostatus, but have different antiretroviral therapy treatment statuses. It addresses two research questions: How do people living with HIV/AIDS consider their future fertility? What factors contribute to an explanation of fertility desires among people living with HIV/AIDS. Methods: A mixed methods study (survey [n = 513] and in-depth interviews [n = 41]) with adults living with HIV/AIDS living in Nairobi slums was conducted in 2010. Regression analyses assess independent relationships between fertility desires and socio-demographic factors. Analyses of in-depth interviews are used to interpret the statistical analyses of fertility desires. Results: Our analyses show that fertility desires are complex and ambivalent, reflecting tensions between familial and societal pressures to have children versus pressures for HIV (re-)infection prevention. More than a third (34%) of men and women living with HIV expressed future fertility desires; however, this is significantly lower than in the general population. Factors independently associated with desiring a child among people living with HIV/AIDS were age, sex, number of surviving children, social support and household wealth of the respondent. Discussion: Increasing access to ART is changing the context of future childbearing for people living with HIV/AIDS. Prevailing values mean that, for many people living with HIV/AIDS, having children is seen as necessary for a “normal” and healthy adult life. However, the social rewards of childbearing conflict with moral imperatives of HIV prevention, presenting dilemmas about the “proper” reproductive behaviour of people living with HIV/AIDS. The health policy and service delivery implications of these findings are explored. [ABSTRACT FROM AUTHOR]