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Nearly 4,00,000 farmers committed suicide in India between 1995 and 2018. This translates into approximately 48 suicides every day. The majority of suicides were those from ‘backwarded’ castes including Dalit farmers. This ethnographic study on cotton farmer suicide reports narratives of surviving Dalit families. The results reveal that financial and moral debt when accrued within a web of family and caste-related relationships result in patterns of personal and familial humiliation, producing a profound sense of hopelessness in the Self. This loss of hope and pervasive humiliation is ‘cultivated’ by a cascade of decisions taken by others with little or no responsibility to the farmers and the land they hope to cultivate as they follow different cultural and financial logic. Suicide resolves the farmers’ humiliation and is a logical conclusion to the farmer’s distress, which results from a reconfiguration of agricultural spaces into socially toxic places, in turn framing a local panopticon. The current corona virus pandemic is likely to impact adversely on peoples who are culturally distanced.

Background & methods National protests in the summer of 2020 drew attention to the significant presence of police in marginalized communities. Recent social movements have called for substantial police reforms, including “defunding the police,” a phrase originating from a larger, historical abolition movement advocating that public investments be redirected away from the criminal justice system and into social services and health care. Although research has demonstrated the expansive role of police to respond a broad range of social problems and health emergencies, existing research has yet to fully explore the capacity for health insurance policy to influence rates of arrest in the population. To fill this gap, we examine the potential effect of Medicaid expansion under the Affordable Care Act (ACA) on arrests in 3,035 U.S. counties. We compare county-level arrests using FBI Uniform Crime Reporting (UCR) Program Data before and after Medicaid expansion in 2014–2016, relative to counties in non-expansion states. We use difference-in-differences (DID) models to estimate the change in arrests following Medicaid expansion for overall arrests, and violent, drug, and low-level arrests. Results Police arrests significantly declined following the expansion of Medicaid under the ACA. Medicaid expansion produced a 20–32% negative difference in overall arrests rates in the first three years. We observe the largest negative differences for drug arrests: we find a 25–41% negative difference in drug arrests in the three years following Medicaid expansion, compared to non-expansion counties. We observe a 19–29% negative difference in arrests for violence in the three years after Medicaid expansion, and a decrease in low-level arrests between 24–28% in expansion counties compared to non-expansion counties. Our main results for drug arrests are robust to multiple sensitivity analyses, including a state-level model. Conclusions Evidence in this paper suggests that expanded Medicaid insurance reduced police arrests, particularly drug-related arrests. Combined with research showing the harmful health consequences of chronic policing in disadvantaged communities, greater insurance coverage creates new avenues for individuals to seek care, receive treatment, and avoid criminalization. As police reform is high on the agenda at the local, state, and federal level, our paper supports the perspective that broad health policy reforms can meaningfully reduce contact with the criminal justice system under historic conditions of mass criminalization.

This study assesses the practices and views of Scottish dairy farmers relating to pasture-based and indoor systems. There are the debates about the environmental, economic and animal welfare implications of these systems. Indoor dairy farming is a contentious practice among the public. While this controversy is sometimes represented as a lack of public understanding, there is a need for more research on farmers’ views to facilitate discussion in the industry. A survey was posted to 909 dairy farmers in Scotland with questions about their grazing practices and attitudes to grazing and indoor systems. 254 surveys were completed, online and in paper form. There was a 26% response rate to the paper version of the survey. The results showed that 19% of respondents housed some or all the cows all year-round. 68% agreed or strongly agreed that cows should graze for part of the year and 51% agreed or strongly agreed that welfare was better if cows grazed for part of the year. These views coexisted with the view that management was more important than the type of system for determining profitability or welfare outcomes (83% and 82% strongly agree or agree respectively). Respondents whose system involved grazing and respondents who had spent longer in farming were moderately more likely to agree that cows should have access to pasture, and slightly less likely to agree that management was more important than system for determining welfare outcomes. The results indicate that the picture is more complicated than the public rejecting indoor dairy farming and those in the industry accepting it. The results showed that a majority preference for cows to graze co-existed with the view that management was more important than system. In terms of industry and policy recommendations, the research suggests that measures should be taken to safeguard farmers’ ability to graze through for instance research and advisory support on grazing; ensuring different systems are not penalised in the development of dairy sector environmental measures and recommendations; and potentially supply chains that financially rewards farmers for grazing.

This paper aims to identify the determinants of the length of stay (LoS) of international tourists in Norway. The paper reassesses the standard assumption related to tourists’ LoS; it refers to the travel industry’s current trends, and it postulates a more sustainable approach to analyzing tourists’ LoS at the destination level. The paper concludes with a series of recommendations. The data for this study were collected during 153 data collection days and among 5,300 travelers in Norway. The determinants of LoS were analyzed by means of an ordinary least squares (OLS) regression. The results indicate that tourists’ LoS is positively related to their age, interests (nature-based tourists), origin (German, Dutch tourists) and mode of travel organization (package tourists). A negative and significant effect on tourists’ LoS was found for tourists’ interests (urban-based tourists), spending, and origin (home market, long-haul tourists). No significant results were revealed for two covariates, namely, gender and repeat visitation.

Background During the Coronavirus Disease 2019 (COVID-19) pandemic, the number of consultations and diagnoses in primary care and referrals to specialist care declined substantially compared to prepandemic levels. Beyond deferral of elective non-COVID-19 care by healthcare providers, it is unclear to what extent healthcare avoidance by community-dwelling individuals contributed to this decline in routine healthcare utilisation. Moreover, it is uncertain which specific symptoms were left unheeded by patients and which determinants predispose to healthcare avoidance in the general population. In this cross-sectional study, we assessed prevalence of healthcare avoidance during the pandemic from a patient perspective, including symptoms that were left unheeded, as well as determinants of healthcare avoidance. Methods and findings On April 20, 2020, a paper COVID-19 survey addressing healthcare utilisation, socioeconomic factors, mental and physical health, medication use, and COVID-19–specific symptoms was sent out to 8,732 participants from the population-based Rotterdam Study (response rate 73%). All questionnaires were returned before July 10, 2020. By hand, prevalence of healthcare avoidance was subsequently verified through free text analysis of medical records of general practitioners. Odds ratios (ORs) for avoidance were determined using logistic regression models, adjusted for age, sex, and history of chronic diseases. We found that 1,142 of 5,656 included participants (20.2%) reported having avoided healthcare. Of those, 414 participants (36.3%) reported symptoms that potentially warranted urgent evaluation, including limb weakness (13.6%), palpitations (10.8%), and chest pain (10.2%). Determinants related to avoidance were older age (adjusted OR 1.14 [95% confidence interval (CI) 1.08 to 1.21]), female sex (1.58 [1.38 to 1.82]), low educational level (primary education versus higher vocational/university 1.21 [1.01 to 1.46), poor self-appreciated health (per level decrease 2.00 [1.80 to 2.22]), unemployment (versus employed 2.29 [1.54 to 3.39]), smoking (1.34 [1.08 to 1.65]), concern about contracting COVID-19 (per level increase 1.28 [1.19 to 1.38]) and symptoms of depression (per point increase 1.13 [1.11 to 1.14]) and anxiety (per point increase 1.16 [1.14 to 1.18]). Study limitations included uncertainty about (perceived) severity of the reported symptoms and potentially limited generalisability given the ethnically homogeneous study population. Conclusions In this population-based cross-sectional study, 1 in 5 individuals avoided healthcare during lockdown in the COVID-19 pandemic, often for potentially urgent symptoms. Healthcare avoidance was strongly associated with female sex, fragile self-appreciated health, and high levels of depression and anxiety. These results emphasise the need for targeted public education urging these vulnerable patients to timely seek medical care for their symptoms to mitigate major health consequences., Marije J. Splinter and colleagues assess the prevalence of healthcare avoidance during the COIVD-19 pandemic and investigate related determinants, Author summary Why was this study done? ➢ During the Coronavirus Disease 2019 (COVID-19) pandemic, consultation rates in both primary and specialist care declined compared to prepandemic levels, which can partially be attributed to the postponement or cancellation of elective and nonurgent medical care. ➢ It is unclear to what extent these declines in consultation rates could be related to healthcare avoidance by patients in the general population. ➢ To evaluate the collateral health damage of the COVID-19 pandemic, it is important to not only assess the prevalence of healthcare avoidance, but also for what symptoms healthcare was avoided and which determinants are associated with this behaviour. What did the researchers do and find? ➢ We sent out a paper questionnaire to 8,732 participants of the population-based Rotterdam Study containing several COVID-19–related subjects, such as healthcare utilisation, work status, mental and physical health, and concerns about contracting COVID-19. ➢ About 6,241 participants (73%) returned the questionnaire, of whom 5,656 participants (90.6%) were included in our analyses. We found that 1,142 of them (20.2%) avoided healthcare during the COVID-19 pandemic, often for symptoms that might have needed urgent medical evaluation, such as limb weakness (13.6%), palpitations (10.8%), and chest pain (10.2%). ➢ Determinants that were most strongly associated with healthcare avoidance were female sex, poor self-appreciated health, and high levels of depression and anxiety. What do these findings mean? ➢ The results of this population-based study suggest that healthcare avoidance contributed to the decline in consultation rates during the COVID-19 pandemic. Importantly, our findings suggest that this behaviour may be associated with certain vulnerable groups within the population. ➢ These findings should be interpreted in light of the limitations of this study, which include that the actual severity of the symptoms that were reported by participants is unknown, since they were not medically evaluated when they experienced these symptoms. ➢ The findings of this study can be used to develop policy interventions targeted to vulnerable individuals who may be more likely to exhibit healthcare avoiding behaviours.

The scientific evaluation of tourism resources provides the basic conditions for the rational development and utilization of tourism resources, which is significant for the sustainable development of tourism. On the basis of obtaining a large sample of tourism resource data, this study constructed an evaluation index system of regional tourism resources from four aspects: quantity, type, grade, and a combination of regional tourism resources, taking the township scale as the spatial evaluation unit. The combination weighting method was used to evaluate the grade of tourism resources in each township, and the hierarchical clustering method and spatial autocorrelation method were used to analyze the spatial patterns of the tourism resource values. On the basis of the evaluation’s results and spatial pattern analysis, this paper analyzed the influencing factors of tourism resource patterns and puts forward a tourism development model suitable for Hainan tourism development. The results showed that the overall value of tourism resources on Hainan Island was low, and the spatial pattern was obviously different, showing that the northern piedmont plain area was higher than the southern hilly area, and the east coast area was higher than the west coast area. Based on the analysis of quantity density, type abundance, grade advantage, and spatial combination, the tourism resource values of Hainan Island was divided into four combination areas: the first area was diversity and good combination, the second area was large quantity and good combination, the third area was diversity and high-quality resources, and the fourth area was large quantity. In addition, from the analysis of the spatial agglomeration effect, the phenomena of high and low agglomerations of tourism resource values were obvious. Finally, this paper puts forward a tourism development model for Hainan Island by grading, classification, and zoning. The results of this study can determine the time sequence and mode of regional tourism resources development and provide spatial implications and suggestions for regional tourism planning and management.

Enterprises acquire heterogeneous knowledge through external knowledge search and adapt to the change of external environment, which is of great significance to enterprise breakthrough innovation. This paper takes the innovation ecosystem as the boundary of the research paradigm. Based on innovation ecosystem theory, knowledge management theory and enterprise innovation theory, this paper constructs a moderated mediation model of the enterprise knowledge search, knowledge integration and breakthrough innovation under the characteristics of innovation ecosystem network. This model is tested on the survey data of 344 technology enterprise and manufacturing industries including R&D departments in the Beijing-Tianjin-Hebei region. The research results show that: knowledge integration plays part of the intermediary role between knowledge search and enterprise breakthrough innovation; the larger the network scale, the stronger the network connection, the stronger the intermediary role of knowledge integration on the relationship between knowledge search and enterprise breakthrough innovation. The research results reveal the important role of the innovation ecosystem in enterprise breakthrough innovation. At the same time, the research on knowledge search and enterprise breakthrough innovation should consider the network characteristics of innovation ecosystem and the ability of enterprise knowledge integration.

This paper critiques the research article “Exploring the Development of ‘Interest’ in Learning English as a Foreign/Second Language” written by Tan Bee Tin (2013) and mainly analyzes its strengths and weaknesses. Tin (2013) argued that the previous notions for motivation in foreign/ second language learning were considered as inadequate and claimed a new concept from a cognitive perspective. This review paper recognizes the problems Tin (2013) put forward in previous studies on learning interests, but points out that the solutions she described in her research article cannot well fill the gap.

Background Self-management is a promising approach to improve quality of life after stroke. However, evidence for the appropriateness and effectiveness of self-management for stroke survivors with aphasia is limited. This article reports on the process used to develop a supported self-management intervention for stroke survivors with aphasia (SSWA) using co-production and behaviour change theory. Preparatory research included systematic reviews, and qualitative interviews and focus groups with SSWA, family members and speech and language therapists (SLTs). Materials and methods We conducted six, 2 hour long intervention development workshops with key stakeholders. The workshops were informed by principles of co-production and the intervention development process outlined by the Behaviour Change Wheel (BCW). We also incorporated the findings of our preparatory research within workshops. Each workshop included an introduction, 1–2 co-production tasks and time for feedback at the end of the session. Data were analysed on an ongoing basis so that findings could be used to feed in to subsequent workshops and intervention development. Results Workshop participants (n = 12) included; SSWA (n = 5), family members (n = 3) and SLTs (n = 4). Together, participants engaged with accessible and participatory co-production tasks which aligned with the BCW framework. Participants engaged in discussion to define self-management in behavioural terms (behavioural diagnosis) and to identify what needed to change to support self-management. Participant’s co-produced solutions for supporting self-management and discussed options to implement these in practice. Prototype materials were generated by the research team and evaluated by participants. Intervention functions and behaviour change techniques (BCTs) were mapped to the solutions generated by participants by the research team, after the final workshop. A supported self-management intervention for SSWA was developed which will be delivered by SLTs through community stroke services. Conclusions This paper reports the process we used to integrate co-production work with behaviour change theory to develop a complex self-management intervention. This is of relevance for researchers looking to harness the strengths of co-production methods and theory in intervention design. Future research will feasibility test the supported self-management intervention developed. This paper provides transparency to our intervention development process which will help others to better interpret the findings of our feasibility work.

The objective of the paper is to diagnose organisational culture of selected universities and analyse its impact on the innovation processes within them. The subject matter of the study was organisational culture and innovation at universities. The subjects were four selected universities in Poland, Austria, Germany, and Ukraine. The paper provided a definition of organisational culture and its typology. It further discussed the organisational culture of universities and the relationships between organisational culture and innovativeness. The literature review provided foundations for building a model for the formation of a type of organisational culture at universities that is innovation-friendly, which is the added value of the paper. It offers actions worth taking to shape innovation-friendly culture at universities. It is particularly important during difficult time of changing labour market, when universities greatly impact the attitudes of young people. The knowledge of how to shape innovation-friendly organisational culture at universities is necessary for academia to profile future employees in times of continuous changes. To investigate the relationship between organisational culture and the innovativeness of universities, we designed an original survey questionnaire [S1 File]. Organisational culture was diagnosed with the Organizational Culture Assessment Instrument by K.S. Cameron and R.E. Quinn. The analyses were conducted in Dell Statistica v. 13.1 (StatSoft Polska). We normalised data from the Likert rating scale using Kaufman’s and Rousseeuw’s formula. We used Spearman’s correlation coefficient and Kendall’s W to calculate correlations. The research shows that the investigated Polish and Austrian universities are dominated by hierarchy and market cultures. On the other hand, the German and Ukrainian universities host all cultures, but clan and adhocracy dominate there. Moreover, the analyses demonstrated that although the adhocracy culture was the least visible in the investigated organisations, it contributes to university innovativeness the most. The conclusions were used to build a model for promoting innovation-friendly organisational culture at universities. The model contains answers to the research questions. In addition, it offers guidelines for shaping organisational culture to bolster innovation at universities. The research identified relationships between organisational culture and university innovativeness and components that create innovation opportunities at universities as its contribution to management theory. When applied in practice, the guidelines can help form the university’s organisational culture bottom-up.

Traffic congestion continues to be a persistent problem throughout the world. As vehicle-to-vehicle communication develops, there is an opportunity of using cooperation among close proximity vehicles to tackle the congestion problem. The intuition is that if vehicles could cooperate opportunistically when they come close enough to each other, they could, in effect, spread themselves out among alternative routes so that vehicles do not all jam up on the same roads. Our previous work proposed a decentralized multiagent based vehicular congestion management algorithm entitled Congestion Avoidance and Route Allocation using Virtual Agent Negotiation (CARAVAN), wherein the vehicles acting as intelligent agents perform cooperative route allocation using inter-vehicular communication. This paper focuses on evaluating the practical applicability of this approach by testing its robustness and performance (in terms of travel time reduction), across variations in: (a) environmental parameters such as road network topology and configuration; (b) algorithmic parameters such as vehicle agent preferences and route cost/preference multipliers; and (c) agent-related parameters such as equipped/non-equipped vehicles and compliant/non-compliant agents. Overall, the results demonstrate the adaptability and robustness of the decentralized cooperative vehicles approach to providing global travel time reduction using simple local coordination strategies.

In a city of high vehicular traffic like Cairo, in some neighborhoods simple social activities were usually practiced in enclosed places. The outbreak of the Covid-19 pandemic has somehow turned the corner in the street life of Cairo as the livability of the urban public spaces enhanced. Residents of Cairo were widely seen using every well-maintained public space they could find. This paper aims to explore the emerging questions concerning Covid-19 and its effect on the city. How did Covid-19 help in bringing residents of Cairo back to the streets? What kind of street activities were introduced during the pandemic and what are the reasons behind them? What are the effects of these novel activities on both the people and the city? Basing on relevant international literature, this research will provide a comparative analysis between urban public life in the streets of Cairo before and during the pandemic. The research adopts a case study qualitative approach for a selected neighborhood in Cairo. It relies on observations, focus group discussions and in-depth interviews with residents from the district. Findings indicate that enclosed commercial and recreational facilities, and vehicular domination in the streets have taken life away from the city before the lockdown period. During the pandemic people have acquired new habits which gave life back to the streets. The flow of the main social stream has a very important role in shaping the street life. As a result of these new circumstances the physical and psychological health of the residents were maintained, new social ties were created and their sense of belonging has been enhanced.

Resumen Este artículo de investigación tiene como objetivo identificar las concepciones sobre la didáctica de la filosofía considerada como una didáctica disciplinar con un objeto propio de estudio, en los documentos escritos de los programas de las universidades acreditadas en alta calidad para el año 2018 en Colombia, que orientan esta misma asignatura en sus currículos. Para este propósito se analizó el discurso escrito de cinco documentos provistos por las mismas universidades participantes, a través de un enfoque cualitativo y bajo un tipo de estudio basado en el análisis documental. Solo se tuvieron en cuenta dos secciones de la totalidad de la estructura de los programas: objetivos y justificación. Los resultados indican que hay una tendencia a ver en la didáctica de la filosofía un elemento metodológico; es decir, una perspectiva clásica que se tiene sobre la didáctica. Se desconocen, así, elementos como el aprendizaje y el pensamiento crítico que han hecho de este concepto un campo de estudio más amplio. De esta forma, se concluye que debe haber una mayor preocupación desde la didáctica específica de la filosofía por integrar este tipo de procesos a su dinámica epistemológica, de manera que los procesos educativos en este ámbito no se sitúen exclusivamente en el qué enseñar; sino, a su vez, en el cómo se aprende. Abstract This research article attempts to identify the existing conceptions about the Didactics of Philosophy considered like a Disciplinary Didactics with an object of study in the syllabi of high-quality and accredited universities in the year 2018, in Colombia. To do that, a qualitative approach with a documentary analysis was undertaken in this article, only considering two sections in said syllabi: objectives and rationale sections. Results suggest there is a trend towards viewing the Didactics of Philosophy as a methodological element closely linked to a traditional view of didactics ignoring other important elements such as learning and critical thinking considered in contemporary perspectives. In the end, this paper leads to conclude that Didactics of Philosophy should have a greater concern for the integration of those processes to its epistemology in order to focus not only on what to teach but also on how to learn. Resumo Este artigo de pesquisa tem como objetivo identificar os conceitos da didática da filosofia, considerada disciplinar com seu próprio objeto de estudo, nos documentos dos programas das universidades credenciadas em alta qualidade para o ano de 2018 na Colômbia que orientam essa disciplina em seus currículos. Para tanto, analisou-se o discurso escrito de cinco documentos fornecidos pelas universidades participantes, através de uma abordagem qualitativa e sob um tipo de estudo baseado na análise documental. Apenas duas seções de toda a estrutura do programa foram consideradas: objetivos e justificativa. Os resultados indicam que há uma tendência a ver na didática da filosofia um elemento metodológico, sendo essa uma perspectiva clássica que é adotada na didática. Isso ignora elementos como o aprendizado e o pensamento crítico que tornaram esse conceito um campo de estudo mais amplo. Dessa forma, conclui-se que é preciso uma maior preocupação da didática específica da filosofia em integrar esse tipo de processo em sua dinâmica epistemológica, de tal maneira que os processos educacionais nesse campo não se localizem exclusivamente no que ensinar; mas, por sua vez, na maneira como aprendem.

Online virtual museum tours combine museum authority and an academic approach with the diversity and interactivity of online resources; such tours have become an essential resource for online scientific research and education. Many important museums around the world are developing this type of online service. Comprehensive evaluation of such tours is, however, urgently needed to ensure effectiveness. This paper establishes a heuristic evaluation scale based on the literature. Taking the online virtual tour of the Exhibition of Architecture of the Forbidden City as a case study, confirmatory factor analysis was then carried out to improve the scale. Interviews were conducted to discuss and analyze the research results. The developed evaluation scale has four dimensions: authenticity, interaction, navigation, and learning. The results from the case study showed, first, that the exhibition had visual authenticity, but the behavioral authenticity was insufficient; second, the exhibition was generally interactive, but this aspect could be improved by enriching the links; third, the lack of effective navigation design for the exhibit was the main factor affecting experience quality. Fourth, the exhibition was informative and supported learning, but needs further improvement to the quantity and quality of information provided. Finally, the interviews revealed that the online exhibition did not entirely support people of different ages and abilities, so it needs further improvement to be wholly inclusive.

Visual Question Answering (VQA) is a learning task that combines computer vision with natural language processing. In VQA, it is important to understand the alignment between visual concepts and linguistic semantics. In this paper, we proposed a Pre-training Model Based on Parallel Cross-Modality Fusion Layer (P-PCFL) to learn the fine-grained relationship between vision and language. The P-PCFL model is composed of three Encoders: Object Encoder, Language Encoder, and Parallel Cross-Modality Fusion Encoder, with Transformer as the core. We use four different Pre-training missions, namely, Cross-Modality Mask Language Modeling, Cross-Modality Mask Region Modeling, Image-Text Matching, and Image-Text Q&A, to pre-train the P-PCFL model and improve its reasoning and universality, which help to learn the relationship between Intra-modality and Inter-modality. Experimental results on the platform of Visual Question Answering dataset VQA v2.0 show that the Pre-trained P-PCFL model has a good effect after fine-tuning the parameters. In addition, we also conduct ablation experiments and provide some results of Attention visualization to verify the effectiveness of P-PCFL model.

ObjectiveSex disparity is a major societal issue. The aim of this paper was to describe changes in the representation of women among speakers of the American Psychiatric Association (APA) annual meeting over 10 years, between 2009 and 2019 and to compare them to changes in the proportion of women among American psychiatrists.MethodsData were collected from the programs of the APA annual meetings of 2009 and 2019, and from the Association of American Medical Colleges. Descriptive and comparative statistical analyses were performed.ResultsThere were 1,138 distinct speakers at the 2009 conference and 1,784 at the 2019 conference. The number of distinct female speakers increased from 413 (36.3%) to 813 (45.6%). The proportion of female speakers at the meetings was almost equivalent to the proportion of women in the American psychiatrists' workforce. The number of female chairs increased from 158 (39.6%) to 322 (46.4%). There were 38 female speakers in child and adolescent psychiatry in 2009 (51.4% of 74 speakers) and 74 in 2019 (51.0% of 155 speakers).ConclusionsThe representation of women at the APA annual meetings increased between 2009 and 2019. At the same time, the growth in the percentage of women in the American psychiatrists' workforce was slower. The APA appears to promote female representation during its annual meetings.

Social media represent an important source of news for many users. They are, however, affected by misinformation and they might be playing a role in the growth of political polarization. In this paper, we create an agent based model to investigate how policing content and backlash on social media (i.e. conflict) can lead to an increase in polarization for both users and news sources. Our model is an advancement over previously proposed models because it allows us to study the polarization of both users and news sources, the evolution of the audience connections between users and sources, and it makes more realistic assumptions about the starting conditions of the system. We find that the tendency of users and sources to avoid policing, backlash and conflict in general can increase polarization online. Specifically polarization comes from the ease of sharing political posts, intolerance for opposing points of view causing backlash and policing, and volatility in changing one’s opinion when faced with new information. On the other hand, it seems that the integrity of a news source in trying to resist the backlash and policing has little effect.

Using microdata from the Chinese General Social Survey (CGSS 2010), this paper investigates whether there are green returns to education in China, where educational attainment promotes pro-environmental attitudes and behaviors. We establish causality by exploiting the exogenous variation induced by the implementation of the Compulsory Schooling Law (CSL) in China. We find evidence that educational attainment is associated with higher levels of pro-environmental attitudes and behaviors, and these estimates are robust to various robustness checks. Further analysis reveals that the acquisition of environmental knowledge is the channel that drives the effect of education on pro-environmental attitudes and behaviors. Finally, the effects of education are heterogeneous across individuals.

The Monitoring and Analysis Centre for the fight against money laundering is a valid financial information body which is responsible for collecting, analysing and providing financial information and conducting international exchanges of financial information for relevant undertakings. By constructing the analysis of the monitoring of the local and foreign currency and of the data transmission subsystem in the plan for the transitional period against In the light of the above, the Commission will continue to monitor the implementation of the acquis in the light of the progress made in implementing the acquis future new systems. The purpose of this paper is to study the research and implementation of the security control of the anti-money laundering monitoring and analysis system. This article studies the application of decision tree analysis technology in the anti-money laundering monitoring system of insurance companies to achieve the purpose of improving the anti-money laundering monitoring technology and capabilities of insurance companies. The emergence of data mining technology provides a new system solution for anti-money laundering monitoring. For insurance anti-money laundering, how to find potential money laundering cases in suspicious and large surrender transactions is key. The experimental data show that the decision tree method is the best predictor of the customer category between the insurance application and the surrender days. The decision tree analysis technology has greatly improved the security monitoring capabilities of the insurance in the anti-money laundering monitoring system. Experimental data shows that the security control capabilities of the anti-money laundering monitoring and analysis system make the accuracy of the entire model reach 95%, the accuracy of large and suspicious transactions reaches 88.6%, and the correct classification of customers is about 99.6%.

This paper proposes a multiple criteria group decision making with individual preferences (MCGDM-IP) to address the robot selection problem (RSP). Four objective criteria elicitation approaches, namely, Shannon entropy approach, CRITIC approach, distance-based approach, and ideal-point approach, are proposed to indicate individual decision makers. A preliminary group decision matrix is therefore formulated. Both preferential differences representing the preference degrees among different robots, and preferential priorities representing the favorite ranking of robots for each individual decision maker, are analyzed to propose a revised group decision matrix. A satisfaction index is developed to manifest the merits of the proposed MCGDM-IP. An illustrative example using the data drawn from previous literature is conducted to indicate the effectiveness and validity of MCGDM-IP. The results demonstrate that the MCGDM-IP could generate a more satisfactory scheme to evaluate and select industrial robots, with an improvement of group satisfactory level as 2.12%.

Motivated by the two-decade-long scientific debate over the existence of the ego-depletion effect, our paper contributes to exploring the scope conditions of ego-depletion theory. Specifically, in a randomized experiment, we depleted students’ self-control with a cognitively demanding task that required students’ effort. We measured the effect of depleted self-control on a subsequent task that required self-control to not engage in fraudulent cheating behavior—measured with an incentivized dice-roll task—and tested ego-depletion in a large-scale preregistered field experiment that was similar to real-life situations. We hypothesized that treated students would cheat more. The data confirms the hypothesis and provides causal evidence of the ego-depletion effect. Our results provide new insights into the scope conditions of ego-depletion theory, contribute methodological information for future research, and offer practical guidance for educational policy.

The Danube is promoted as a pan-European river, what can be justified for instance by the vast range of its drainage basin, covering 19 countries on both sides of the historical border diving Eastern and Western Europe. Differentiation of imaginations of Danube course from the perspective of 7 European cities, based on research covering 1577 respondents, conducted between 2005–2007 and 2016–2018 has been presented in the paper. Maps presenting the generalized imagination of river course have been generated for each city. It has been proved that in spite of substantial political, economical and symbolical importance of this river for big part of Europe, the course of Danube remains unknown for inhabitants of its Western part, in parallel to more correct recognition of the river by students from Eastern Europe. It has been shown that the perception does not change despite the progressing integration processes.

School closures due to the COVID-19 global pandemic are likely to have a range of negative consequences spanning the domains of child development, education and health, in addition to the widening of inequalities and inequities. Research is required to improve understanding of the impact of school closures on the education, health and wellbeing of pupils and school staff, the challenges posed during reopening and importantly to identify how countries can ensure a safe return to education and to inform policy. This qualitative study aimed to reflect on the experience of primary school staff (pupils aged 3-11) in Wales regarding school closures and the initial reopening of schools and to identify recommendations for the future. A total of 208 school staff completed a national online survey through the HAPPEN primary school network, consisting of questions about school closures, the phased reopening of schools and a return to full-time education. Thematic analysis of survey responses identified five recommendations; (i) prioritise the health and wellbeing of pupils and staff. This includes more focus on wellbeing activities and less focus on attainment/assessments and protecting staff breaks to promote workplace wellbeing; (ii) focus on enabling parental engagement and support. Introduce support sessions for parents and include regular check ins during periods of home learning; (iii) improve digital competence amongst pupils, teachers and parents. Ensure the provision of equipment and training in building digital skills. Offer a combination of paper-based and digital home learning activities; (iv) consider opportunities for smaller class sizes and additional staffing. Ensure support is directed to need whilst providing pastoral care; and (v) improve the mechanism of communication between schools and families, and between government and schools. Ensure that schools receive advance notice of local or national changes in guidance.

Background Digital health (DH) and the benefits of related services are fairly well understood. However, it still is critical to map the digital health care landscape including the key elements that define it as an ecosystem. Particularly, knowing the perspectives of citizens on this digital transformation is an important angle to capture. In this review we aim to analyze the relevant studies to identify how DH is understood and experienced by Australian citizens and what they may require from DH platforms. Materials and methods A scoping literature review was conducted across several electronic databases (ACM Digital Library, OVID, PubMed, Scopus, IEEE, Science Direct, SAGE), as well as grey literature. Additionally, citation mining was conducted to identify further relevant studies. Identified studies were subjected to eligibility criteria and the final set of articles was independently reviewed, analyzed, discussed and interpreted by three reviewers. Results Of 3811 articles, 98 articles met the inclusion criteria with research-based articles–as opposed to review articles or white papers– comprising the largest proportion (72%) of the selected literature. The qualitative analysis of the literature revealed five key elements that capture the essence of the digital health ecosystem interventions from the viewpoint of the Australian citizens. The identified elements were “consumer/user”, “health care”, “technology”, “use and usability”, “data and information”. These elements were further found to be associated with 127 subcategories. Conclusions This study is the first of its kind to analyze and synthesize the relevant literature on DH ecosystems from the citizens’ perspective. Through the lens of two research questions, this study defines the key components that were found crucial to understanding citizens’ experiences with DH. This understanding lays a strong foundation for designing and fostering DH ecosystem. The results provide a solid ground for empirical testing.

As precision oncology has evolved, patients and their families have become more involved in efforts to access these treatments via fundraising and campaigning that take place outside of the larger cancer charities. In this paper, we explore the solidarities, networks, and emotional work of the UK-based access advocates, drawing on the stories of nine advocates, which included interviews and content analyses of their social media posts and coverage of their case in news, commentary, and fundraising websites. We consider the emotional and knowledge work of building networks that spanned consumerist and activist agendas, forged individual and collective goals, and orientations toward the public, private, and third sectors as part of securing support and access. Through these various practices, the actors we have studied cultivated personal advantage and solidarities with other patients and advocates, and in so doing engaged in self and collective advocacy alongside and beyond mainstream cancer charities.

In this paper, we presentautopsych, a novel online tool that allows school assessment experts, test developers, and researchers to perform routine psychometric analyses and equating of student test data and to examine the effect of student demographic and group conditions on student test performance. The app extends current open-source software by providing (1) extensive embedded result narration and summaries for written reports, (2) improved handling of partial credit data via customizable item-person Wright maps, (3) customizable item- and person-flagging systems, (4) item-response theory model constraints and controls, (5) many-facets Rasch analysis to examine item bias, (6) Rasch fixed item equating for mapping student ability across test forms, (7) tabbed spreadsheet outputs and immediate options for secondary data analysis, (8) customizable graphical color schemes, (9) extended ANOVA analysis for examining group differences, and (10) inter-rater reliability analyses for the verifying the consistency of rater scoring systems. We present the app’s architecture and functionalities and test its performance with simulated and real-world small-, medium-, and large-scale assessment data. Implications and planned future developments are also discussed.

The diversified management ability of the non-family members in the top management teams (TMTs) can significantly increase the research and development (R&D) investment of the family firms. However, existing studies focus on family characteristics. To bridge the gap, this study explored the R&D investment propensity for family firms from the perspective of non-family members’ participation in TMTs. Based on the upper echelons and the socioemotional wealth theory, this paper incorporated the non-economic goals that influence strategic decisions on family firms into the analytical framework. According to the questionnaire data of Chinese private enterprises, the Tobit regression model was used to analyze the influence of family members on R&D investment decisions under non-economic goal orientations. The results indicated that the preference for control and influence among family members weakens the positive effect of non-family managers on R&D investment, while the preferences for status perception and social responsibility strengthen the positive effect.

In this paper, we assume that the supply chain for new energy vehicles (NEVs) consists of a manufacturer and N parts suppliers, considering that the R&D investment of both manufacturer and suppliers will affect the market demand of NEVs and NEVs credit, we construct decentralized and centralized decision-making models under the dual-credit policy to study the R&D investment strategy of supply chain enterprises. Furthermore, considering that suppliers can form alliances, we establish bargaining game models under the conditions of the non-alliance and alliance of suppliers, and discuss the coordination strategy for the NEVs supply chain. It is found that, under the dual-credit policy, the higher the credit coefficient of technology improvement, the higher the transaction price of credits, and the higher the R&D investment of supply chain. Dual-credit policy can effectively encourage NEVs supply chain to increase R&D investment, improve NEV technology level, and improve the profit of supply chain. Under the dual-credit policy, the increment profit distribution strategy based on a bargaining game model can coordinate the NEVs supply chain. When suppliers separately negotiate with the manufacturer, bringing the negotiation sequence forward, the supplier can get more profits. However, as the manufacturer has the right to determine the negotiation sequence, the supplier can only get the profit of the last round of negotiation, and the manufacturer can get excess profit. Forming a suppliers alliance can solve this problem effectively, and increase the profit of all suppliers when the alliance`s negotiating power is improved to a certain threshold.

Complex IT outsourcing relationships aptitude several benefits such as increased cost likelihood and lowered costs, higher scalability and flexibility upon demand. However, by virtue of its complexity, the complex outsourcing typically necessitates the interactions among various stakeholders from diverse regions and cultures, making it significantly more challenging to manage than traditional outsourcing. Furthermore, when compared to other types of outsourcing, complex outsourcing is extremely difficult because it necessitates a variety of control and coordination mechanisms for project management, which proportionally increases the risk of project failure. In order to overcome the failure of projects in complex outsourcing relationships, there is a need of robust systematic research to identify the key challenges and practices in this area. Therefore, this research implements systematic literature review as a research method and works as a pioneer attempt to accomplish the aforementioned objectives. Upon furnishing the SLR results, the authors identified 11 major challenges with 67 practices in hand from a total of 85 papers. Based on these findings, the authors intend to construct a comprehensive framework in the future by incorporating robust methodologies such as AHP and fuzzy logic, among others. Qatar National Library and Qatar University - grant No. IRCC- 2021-010.

Men are underrepresented in family planning (FP) research, and despite the widespread promotion of FP through mass media, there is no systematic evaluation on how mass media exposure influences their FP knowledge, attitudes and behavior. Using Demographic and Health Survey (DHS) data from 31 countries in Sub-Saharan Africa (SSA), collected between 2010 and 2019, this paper examines the associations between three types of traditional mass media (radio, television and print) with FP knowledge, attitudes and method choices among reproductive age men in SSA, relative to other socio-cultural factors. Estimates to quantify the relative contribution of each type of mass media, relative to other evidence-based socio-cultural influences on FP outcomes, were derived using the Shorrocks-Shapley decomposition. Radio exposure had the largest impact on FP knowledge, attitudes and method choice, accounting for 26.1% of the variance in FP knowledge, followed by Television (21.4%) and education attainment (20.7%). Mass media exposure had relatively minimal impact on FP method choice, and between the three types of mass media, television (8%) had the largest influence on FP method choice. Print media had comparatively lesser impact on FP knowledge (8%), attitudes (6.2%) and method choice (3.2%). Findings suggest that mass media exposure has positive influences on FP knowledge, attitudes and method choice but its influence on FP knowledge, attitudes and method choice is smaller relative to other socio-cultural factors such as education, household wealth and marital status. As such, efforts to increase FP uptake in Sub-Saharan Africa should take into consideration the impact of these socio-cultural economic factors.

Emotions at work have long been identified as critical signals of work motivations, status, and attitudes, and as predictors of various work-related outcomes. When more and more employees work remotely, these emotional signals of workers become harder to observe through daily, face-to-face communications. The use of online platforms to communicate and collaborate at work provides an alternative channel to monitor the emotions of workers. This paper studies how emojis, as non-verbal cues in online communications, can be used for such purposes and how the emotional signals in emoji usage can be used to predict future behavior of workers. In particular, we present how the developers on GitHub use emojis in their work-related activities. We show that developers have diverse patterns of emoji usage, which can be related to their working status including activity levels, types of work, types of communications, time management, and other behavioral patterns. Developers who use emojis in their posts are significantly less likely to dropout from the online work platform. Surprisingly, solely using emoji usage as features, standard machine learning models can predict future dropouts of developers at a satisfactory accuracy. Features related to the general use and the emotions of emojis appear to be important factors, while they do not rule out paths through other purposes of emoji use.

In the aftermath of shock events, policy responses tend to be crafted under significant time constraints and high levels of uncertainty. The extent to which individuals comply with different policy designs can further influence how effective the policy responses are and how equitably their impacts are distributed in the population. Tools which allow policymakers to model different crisis trajectories, policy responses, and behavioral scenariosex antecan provide crucial timely support in the decision-making process. Set in the context of COVID-19 shelter in place policies, in this paper we present the COVID-19 Policy Evaluation (CoPE) tool, which is an agent-based modeling framework that enables researchers and policymakers to anticipate the relative impacts of policy decisions. Specifically, this framework illuminates the extent to which policy design features and behavioral responsiveness influence the efficacy and equity of policy responses to shock events. We show that while an early policy response can be highly effective, the impact of the timing is moderated by other aspects of policy design such as duration and targeting of the policy, as well as societal aspects such as trust and compliance among the population. More importantly, we show that even policies that are more effective overall can have disproportionate impacts on vulnerable populations. By disaggregating the impact of different policy design elements on different population groups, we provide an additional tool for policymakers to use in the design of targeted strategies for disproportionately affected populations.

In this paper, a general class of estimators is proposed for estimating the finite population mean for sensitive variable, in the presence of measurement error and non-response in simple random sampling. Expressions for bias and mean square error up to first order of approximation, are derived. Impact of measurement errors is examined using real data sets, including the survey conducted at Quaid-i-Azam University, Islamabad. Simulated data sets are also used to observe the performance of the proposed estimators in comparison to some other estimators. We obtain the empirical bias and MSE values for the proposed and the competing estimators.

This paper sought to understand the extent to which, and how individuals use personal or collective language when asked to articulate sense of place from a collective perspective. Understanding a collective sense of place could illuminate place-based connections in natural resource industries, where it is as groups or as institutions that organizations interact with the environment rather than as individuals. While there are well known methods for collecting information about sense of place at the individual level, there is a gap in understanding the best method to collect information at a collective level. We examined the use of key-informant interviews as a method to understand collective sense of place. In Bocas del Toro, Panama, ecotourism and environmentally based organizations are becoming more prolific due to abundant natural resources, making it an interesting case study for understanding sense of place from an organizational perspective. The use of personal and collective language is examined though in-depth semi-structured interviews from 15 environmentally-oriented organizations with a total of 17 interviews. This study specifically examined whether and how key informants, when prompted to speak for their organization, spoke collectively, reflecting a collective perspective versus their own. Methods included both quantitative analysis of personal versus collective language use frequency, and qualitative examinations of how individuals used personal versus collective language. Our results indicated no difference in the frequency with which individuals use personal versus collective language. We found that how individuals situated their perspectives into an organization reflects a complex personal and collective point of view reflecting five themes of personal versus collective language use: 1) sole personal perspective, 2) sole collective perspective, 3) distinction between collective and personal perspective; 4) organization perspective with insertion of “I think”; and 5) personal and collective perspective about organization and greater community. Our research identifies a previously undiscussed potential bias of key informant interviews. These findings have implications for how researchers approach collecting information beyond the individual level.

Introduction Quality antenatal care is a window of opportunity for improving maternal and neonatal outcomes. Numerous studies have shown a positive effect of women empowerment on improved coverage of maternal and reproductive health services, including antenatal care (ANC). However, there is scarce evidence on the association between women’s empowerment and improved ANC services both in terms of coverage and quality. Addressing this gap, this paper examines the relationship between multi-dimensional measures of women empowerment on utilization of quality ANC (service coverage and consultation) in Pakistan. Methods We used Pakistan Demographic and Health Survey 2017–18 (PDHS) data which comprises of 6,602 currently married women aged between 15–49 years who had a live birth in the past five years preceding the survey. Our exposure variables were three-dimensional measures of women empowerment (social independence, decision making, and attitude towards domestic violence), and our outcome variables were quality of antenatal coverage [i.e. a composite binary measure based on skilled ANC (trained professional), timeliness (1st ANC visit during first trimester), sufficiency of ANC visits (4 or more)] and quality of ANC consultation (i.e. receiving at least 7 or more essential antenatal components out of 8). Data were analysed in Stata 16.0 software. Descriptive statistics were used to describe sample characteristics and binary logistic regression was employed to assess the association between empowerment and quality of antenatal care. Results We found that 41.4% of the women received quality ANC coverage and 30.6% received quality ANC consultations during pregnancy. After controlling for a number of socio-economic and demographic factors, all three measures of women’s empowerment independently showed a positive relationship with both outcomes. Women with high autonomy (i.e. strongly opposed the notion of violence) in the domain of attitude to violence are 1.66 (95% CI 1.30–2.10) and 1.45 (95% CI 1.19–1.75) and times more likely to receive antenatal coverage and quality ANC consultations respectively, compared with women who ranked low on attitude to violence. Women who enjoy high social independence had 1.87 (95% CI 1.44–2.43) and 2.78 (95% CI 2.04–3.79) higher odds of quality antenatal coverage and consultations respectively, as compared with their counterparts. Similarly, women who had high autonomy in household decision making 1.98 (95% CI 1.60–2.44) and 1.56 (95% CI 2.17–1.91) were more likely to receive quality antenatal coverage and consultation respectively, as compared to women who possess low autonomy in household decision making. Conclusion The quality of ANC coverage and consultation with service provider is considerably low in Pakistan. Women’s empowerment related to social independence, gendered beliefs about violence, and decision-making have an independent positive association with the utilisation of quality antenatal care. Thus, efforts directed towards empowering women could be an effective strategy to improve utilisation of quality antenatal care in Pakistan.

Critical thinking is a requisite skill for college success, employability, and conducive active civic participation. Empirical studies have noted to the low achievement of Arab students on critical thinking assessments. Insufficient endeavors have attempted to propose effective interventions enhancing critical thinking abilities among Arab students. The current analysis provides a preliminary overview of a special course designed to improve critical thinking skills among Arab college students. Results indicated a great improvement in all areas of critical thinking including explanation of information, identification of strategies, implementing solutions, and formulating logical inferences. Students’ scores on a critical thinking assessment increased from sufficient to good as a result of participating in the program. The gains are consistent after controlling for gender, major, class seniority, and nationality. Notwithstanding these promising results, this paper is limited in several respects including the choice of critical thinking assessments represented by two questions, the highly contextualized setting making it difficult to be replicated, and the convenient sampling strategy used to recruit participants. This set of limitations, however, does not discourage proactive attempts like designing special courses to enhance students’ critical thinking acquisition in the Middle East.

Little is known in Aotearoa New Zealand about experiences of homelessness amongst Takatāpui/LGBTIQ+ identifying people, despite growing international literature regarding LGBTIQ+ homelessness. Using data from semi-structured interviews with eight people who identified as Takatāpui/LGBTIQ+ and had experienced homelessness, this paper explores their experiences prior to becoming homeless. These experiences are placed into the categories of: the pervasiveness of instability (especially in regards to family relationships, finances, and housing), having to grow up fast due to social and material conditions, experiences of looking for housing in stressed markets, and systems failures that resulted in a lack of autonomy. These results show that instability and systems failures are key contributors to Takatāpui/LGBTIQ+ people becoming homeless in Aotearoa New Zealand.

Happiness levels often fluctuate from one day to the next, and an exogenous shock such as a pandemic can likely disrupt pre-existing happiness dynamics. This paper fits a Marko Switching Dynamic Regression Model (MSDR) to better understand the dynamic patterns of happiness levels before and during a pandemic. The estimated parameters from the MSDR model include each state’s mean and duration, volatility and transition probabilities. Once these parameters have been estimated, we use the one-step method to predict the unobserved states’ evolution over time. This gives us unique insights into the evolution of happiness. Furthermore, as maximising happiness is a policy priority, we determine the factors that can contribute to the probability of increasing happiness levels. We empirically test these models using New Zealand’s daily happiness data for May 2019 –November 2020. The results show that New Zealand seems to have two regimes, an unhappy and happy regime. In 2019 the happy regime dominated; thus, the probability of being unhappy in the next time period (day) occurred less frequently, whereas the opposite is true for 2020. The higher frequency of time periods with a probability of being unhappy in 2020 mostly correspond to pandemic events. Lastly, we find the factors positively and significantly related to the probability of being happy after lockdown to be jobseeker support payments and international travel. On the other hand, lack of mobility is significantly and negatively related to the probability of being happy.

Earlier findings suggest that men with daughters make judgments and decisions somewhat in line with those made by women. In this paper, we attempt to extend those findings, by testing how gender and parenting daughters affect judgments of the appropriateness of investing in and working for morally controversial companies (“sin stocks”). To do so, in Study 1 (N = 634) we investigate whether women judge the prospect of investing in sin stocks more harshly than men do, and test the hypothesis that men with daughters judge such investments less favorably than other men. In Study 2 (N = 782), we investigate the willingness to work in morally controversial companies at a significant wage premium. Results show that—for men—parenting daughters yields harsher evaluations of sin stocks, but no evidence that it lowers the propensity to work in such companies. This contrasts to the effect of gender: women reliably judge both investment and employment in morally controversial companies more harshly than men do. We suggest that an aversion towards morally controversial companies might be a partial determinant of the gender gap in wages.

Disparity in suicide rates across various metropolitan areas in the US is growing. Besides personal genomics and pre-existing mental health conditions affecting individual-level suicidal behaviors, contextual factors are also instrumental in determining region-/community-level suicide risk. However, there is a lack of quantitative approach to model the complex associations and interplays of the socio-environmental factors with the regional suicide rates. In this paper, we propose a holistic data-driven framework to model the associations of socio-environmental factors (demographic, socio-economic, and climate) with the suicide rates, and compare the key socio-environmental determinants of suicides across the large and medium/small metros of the vulnerable US states, leveraging a suite of advanced statistical learning algorithms. We found that random forest outperforms all the other models in terms of both in-sample goodness-of-fit and out-of-sample predictive accuracy, which is then used for statistical inferencing. Overall, our findings show that there is a significant difference in the relationships of socio-environmental factors with the suicide rates across the large and medium/small metropolitan areas of the vulnerable US states. Particularly, suicides in medium/small metros are more sensitive to socio-economic and demographic factors, while that in large metros are more sensitive to climatic factors. Our results also indicate that non-Hispanics, native Hawaiian or Pacific islanders, and adolescents aged 15-29 years, residing in the large metropolitan areas, are more vulnerable to suicides compared to those living in the medium/small metropolitan areas. We also observe that higher temperatures are positively associated with higher suicide rates, with large metros being more sensitive to such association compared to that of the medium/small metros. Our proposed data-driven framework underscores the future opportunities of using big data analytics in analyzing the complex associations of socio-environmental factors and inform policy actions accordingly.

As a part of a larger qualitative study to understand HIV-risk factors and impacts on people living with HIV (PLHIV) (52 women and 40 men) in Belu and Yogyakarta, Indonesia, this paper reports the influences of cultural practices and religious beliefs on sexual relationships and behaviours of participants as contributors for HIV transmission. This study was conducted from June to December 2020. Data collection was conducted using one-one-one in-depth interviews. Participants were recruited using the snowball sampling technique. Data analysis was guided by a qualitative data analysis framework. The findings showed that cultural practices in Belu related to the use of bride wealth, managing spousal disputes, marriage, and condom use, influenced spousal relationships and sexual behaviours or practices which contributed to HIV transmission. Javanese cultural practices and expectation of an ‘ideal wife’, Islamic religious beliefs about expected husband-wife relationships, forbidden premarital sex, and the participants’ individual interpretation of their religious beliefs about condom use spousal sexual relations, also influenced spousal sexual relations and behaviours, which supported HIV transmission among the participants. The findings indicate the need for HIV education programs that address cultural practices and religious beliefs for community members and population groups to enhance their understanding about HIV, condom use, and how cultural practices and religious beliefs play a role in HIV transmission. The findings also indicate the need for involvement of religious leaders in HIV education programs to bring insights to people and help them interpret their religious beliefs in health promoting ways. Future studies that explore different aspects of culture and religion which may contribute to HIV transmission are recommended.

Background The relationship between migration and fertility has vexed demographers for years. One issue missing in the literature is the lack of careful temporal consideration of when women migrate and specifically, the extent to which they do either before or after live births. Objective Here, we opt for a more appropriate methodological approach to help remedy the complexity of the temporal aspect of migration and childbirth processes: regression models using the episode-splitting method. Methods This paper applies a rarely used methodological approach (episode-splitting) in the literature of migration-fertility relationship to investigate how internal in-migration is associated with inter-birth intervals among women in Cotonou, the largest city of Benin. Data comes from the 2017–2018 Benin Demographic and Health Survey (DHS) of women aged 15–49. Estimates from exponential regression models with episode-splitting were compared to estimates from exponential regression models without episode-splitting approach. Sensitivity analysis was also conducted to determine the robustness of the comparison between the two methods. Akaike Information Criteria (AIC) and Bayesian Information Criteria (BIC) were used to identify the method that provides models with best fit. Results The results from (standard) exponential regression models without episode-splitting show that there is no significant association between migration and interbirth transition rate. However, significant associations between migration and interbirth transition rate emerge after applying the episode splitting method. The hazard ratios (HR) of the transition to the next live birth are higher among migrant women than among nonmigrant women. This trend is persistent even after 10 years spent in Cotonou by migrant women. Conclusion Exponential regression models with episode-splitting were of better fit than exponential regression models without episode-splitting. Sensitivity analysis conducted seems to confirm that models with episode-splitting produce estimates that are accurate, reliable and superior to models without episode-splitting. The results suggest a long-run process adaptation of migrants to lower fertility behaviours in Cotonou and are therefore consistent with the socialization hypothesis.

IntroductionViolence against medical staff has been prevalent in China over the past two decades. Although Chinese authorities have released many laws and regulations to protect medical staff from violence since 2011, the legal approach alone is unlikely to resolve this complex issue. In particular, several cases of violence against medical staff in China have caused great media sensation.MethodThis paper proposes an integrated model that combines the environmental stimuli theory, broken windows theory, and rational choice theory. It adopts the fuzzy set qualitative comparative analysis (fsQCA) to untangle the causal relationship between violence against medical staff, media sensation, and judicial judgment. We examined reports of medical violence on media and news websites from January 1, 2010, to January 31, 2020, and selected 50 cases with detailed information for this study.ResultsThe results show that each condition is not sufficient for the absence ofjudicial judgment, but when combined, they are conducive to the outcome. The conditions ofhospital level,medical cost, andmedia sensationplay important roles. The providers, patients, and environmental factors are indicators of inadequate or lack ofjudicial judgment, which corresponds to previous expectations.ConclusionsThe integrated model greatly enriches the extant theories and literature, and also yields implications for preventing violence against medical staff in China. We suggest that sustainable and innovative healthcare reform should be initiated. For example, public hospitals should remain the cornerstone of national public health security. Medical staff in public hospitals must be regarded as “civil servants”. Therefore, the current legal system should be improved. The media should objectively report events concerning medical staff and improve public healthcare knowledge.

This paper examines the impact of rural e-commerce development on rural households’ digital credit behavior at the micro-level by using a multivariate Probit model and propensity score matching method with rural residents in the China Family Panel Studies (CFPS) database. Specifically, we examine the complementary or substitution relationship between digital credit and traditional bank credit and the impact of participation in e-commerce on the scale of digital credit of rural households. The empirical results show that there is a substitution relationship between digital credit and traditional bank credit. Participation in e-commerce has a positive impact on the scale of digital credit and the full scale of credit obtained by farmers, with an increase of $0.922 million and $37.49 million in the scale of digital credit and real credit received by farmers who participate in e-commerce, respectively, compared with those who do not participate in e-commerce. Further tests revealed that the difference in capital endowment was an essential reason for the disparity in the size of digital credit received among e-commerce farmers.

Background Aboriginal language interpreters are under-utilised in healthcare in northern Australia. Self-discharge from hospital is an adverse outcome occurring at high rates among Aboriginal people, with poor communication thought to be a contributor. We previously reported increased Aboriginal interpreter uptake and decreased rates of self-discharge during implementation of a 12-month hospital-based intervention. Interrupted time-series analysis showed sudden increase and up-trending improvement in interpreter use, and a corresponding decrease in self-discharge rates, during a 12-month intervention period (April 2018—March 2019) compared with a 24-month baseline period (April 2016 –March 2018). This paper aims to investigate reasons for these outcomes and explore a potential causal association between study activities and outcomes. Methods The study was implemented at the tertiary referral hospital in northern Australia. We used the Template for Intervention Description and Replication (TIDieR) as a framework to describe intervention components according to what, how, where, when, how much, tailoring, modifications and reach. Components of the study intervention were: employment of an Aboriginal Interpreter Coordinator, ‘Working with Interpreters’ training for healthcare providers, and championing of interpreter use by doctors. We evaluated the relative importance of intervention components according to TIDieR descriptors in relation to outcomes. Activities independent of the study that may have affected study findings were reviewed. The relationship between proportion of hospital separations among Aboriginal people ending in self-discharge and numbers of Aboriginal interpreter bookings made during April 2016-March 2019 was tested using linear regression. ‘Working with Interpreters’ training sessions were undertaken at a regional hospital as well as the tertiary hospital. Training evaluation comprised an anonymous online survey before the training, immediately after and then at six to eight months. Survey data from the sites were pooled for analysis. Results Employment of the Aboriginal Interpreter Coordinator was deemed the most important component of the intervention, based on reach compared to the other components, and timing of the changes in outcomes in relation to the employment period of the coordinator. There was an inverse association between interpreter bookings and self-discharge rate among Aboriginal inpatients throughout the baseline and intervention period (p = 0.02). This association, the timing of changes and assessment of intercurrent activities at the hospital indicated that the study intervention was likely to be casually related to the measured outcomes. Conclusions Communication in healthcare can be improved through targeted strategies, with associated improvements in patient outcomes. Health services with high interpreter needs would benefit from employing an interpreter coordinator.