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The contributors to this discussion were invited to submit comments, each from a different standpoint, on the paper by John Caldwell and Thomas Schindlmayr that appeared in the preceding issue of the journal. The invitation was issued with the approval of these authors, and the journal is grateful to them for allowing their paper to be used to generate debate on the issues they had raised. The discussion is followed by the authors' response to it.

PurposeThese authors sought to define the new roles and competencies required of administrative staff and faculty in the age of CBME.MethodA modified Delphi process was used to define the new CBME roles and competencies needed by faculty and administrative staff. We invited international experts in CBME (volunteers from the ICBME Collaborative email list), as well as faculty members and trainees identified via social media to help us determine the new competencies required of faculty and administrative staff in the CBME era.ResultsThirteen new roles were identified. The faculty-specific roles were: National Leader/Facilitator in CBME; Institutional/University lead for CBME; Assessment Process & Systems Designer; Local CBME Leads; CBME-specific Faculty Developers or Trainers; Competence Committee Chair; Competence Committee Faculty Member; Faculty Academic Coach/Advisor or Support Person; Frontline Assessor; Frontline Coach. The staff-specific roles were: Information Technology Lead; CBME Analytics/Data Support; Competence Committee Administrative Assistant.ConclusionsThe authors present a new set of faculty and staff roles that are relevant to the CBME context. While some of these new roles may be incorporated into existing roles, it may be prudent to examine how best to ensure that all of them are supported within all CBME contexts in some manner.

This paper analyses the sociocultural background, and the nature of the cultural legacy of the Portuguese, in the diffusion and promotion of football in Macau. The paper seeks to examine why men’s football in Macau’s remains poorly developed at domestic, regional and international levels. Many factors could explain this lack of development, ranging from the limited degree of organizational specialization inherited from the Portuguese administration, problems regarding implementing rules and tournament organization, the lack of sports facilities, and the tension between the national governing body and the national team athletes. Nevertheless, there has also been some important progress, such as the recruitment of young footballers and the inclusion of local Portuguese talented players. These developments are discussed in a multidisciplinary approach, based on academic literature and harnessing comprehensive documentary analysis derived from official documents and website information of sports associations. info:eu-repo/semantics/acceptedVersion

Ivan Efreaim Gozum,1 Harvey Gain Capulong,1 Jose Ma Gopez,1 Joseph Renus Galang2,3 1Center for Christian Formation and Praxis, Angeles University Foundation, Angeles City, 2009, Philippines; 2Graduate School, Angeles University Foundation, Angeles City, 2009, Philippines; 3Theology and Religious Education Department, De La Salle University, Manila, 0922, PhilippinesCorrespondence: Ivan Efreaim Gozum Email gozum.ivanefreaim@auf.edu.phBackground: This research investigates different approaches by cultural, religious and political groups in ensuring public health during the COVID-19 pandemic. During the pandemic, several methods were done by governments and healthcare institutions to mitigate the spread of the virus.Methods: This study uses content analysis, specifically a literature review, on existing online literature found in online journals, books, and reports relevant to the COVID-19 pandemic. The paper presents the available qualitative data including substantive findings as well as theoretical and methodological foundations relevant to the topic.Results: Culture, religion and the state have roles to play in ensuring public health during the COVID-19 pandemic. These three areas can help in mitigating the transmission of the virus, managing patients, and aiding the rollout of COVID-19 vaccines.Conclusion: This paper ends by suggesting that, in ensuring public health during the COVID-19 pandemic, a multidisciplinary approach, involving a concerted effort among culture, religion and the state, is necessary. This approach is also recommended for any public health crisis in the future.Keywords: COVID-19, multidisciplinary approach, culture, religion, state

There is a lacuna in the research about LGBTIQ+ people’s relationships to family, and in particular, their experiences of family violence and how these experiences vary for people who also identify as culturally and linguistically diverse (CALD). In this paper, we explore the impact of the 2017 Australian Marriage Equality vote on CALD LGBTIQ+ people residing in Greater Western Sydney (GWS), which is one of the most culturally and linguistically diverse areas of Australia, and where there was a significant ‘no’ vote. The 14-week campaign before the Marriage Equality vote resulted in significant social and individual trauma and damage to existing, fraught family relationships for LGBTIQ+ Australians (Ecker & Bennett, 2017). The findings from this research highlight that while CALD LGBTIQ+ people experience high levels of family violence at the time of coming out and during events such as the Marriage Equality vote, families are also an incredible source of support when CALD LGBTIQ+ are accepted by their families and wider communities. This paper documents the experiences of CALD LGBTIQ+ people’s relationships and reports on the findings from a survey with CALD LGBTIQ+ people in GWS.

The paper considers different ways of conceptualising the settings in which research takes place into children’s everyday uses of digital technologies at home. The terms ‘ecology’ and ‘context’ are widely used to describe such settings but may be less appropriate as the boundaries between ‘home’ and ‘technology’ become less distinct. The paper traces associations between ‘ecology’, ‘culture’ and ‘context’ and outlines some of the ways in which the increasing omnipresence and invisibility of technologies in the home prompt different ways of both thinking about the research setting and suitable methods for exploring children’s everyday lives. Using the Internet of Things as an illustration, it contests default understandings of context and discusses the need to reconsider our use of terminology so that it takes account of the methodological implications and its theoretical provenance.

Moral panics are central to social work policy and practice. Voluntary agencies and statutory bodies (including governments) create and sustain moral panics in order to raise awareness of, and win support for, their own understandings of social issues and problems. This is not a neutral enterprise; on the contrary, moral panics often have consequences that are negative, whether intended or unintended. Far from leading to greater social justice and a more equal society, they may reinforce stereotypes and lead to fearful, risk-averse practice. This paper discusses one such moral panic in 2013 that centred on the story of ‘Maria’, a Bulgarian Roma child living in Greece. The paper explores the meaning and use of the concept of moral panic before unpacking this case-study example in more detail. We argue that the moral panic over ‘Maria’ has much to tell us about ideas of welfare and protection, institutional racism and children and childhood, as well as the connections between ‘private troubles’ and ‘public issues’. We conclude that social work as a profession must stand up to complexity, and in doing so, be aware of its own role in relation to moral panics.

The purpose of this paper was to highlight the importance of cultural influence in understanding hearing-help seeking and hearing-aid uptake.Information on audiological services in different countries and 'theories related to cross-culture' is presented, followed by a general discussion.Twenty-seven relevant literature reviews on hearing impairment, cross-cultural studies, and the health psychology model and others as secondary resources.Despite the adverse consequences of hearing impairment and the significant potential benefits of audiological rehabilitation, only a small number of those with hearing impairment seek professional help and take up appropriate rehabilitation. Therefore, hearing help-seeking and hearing-aid uptake has recently become the hot topic for clinicians and researchers. Previous research has identified many contributing factors for hearing help-seeking with self-reported hearing disability being one of the main factors. Although significant differences in help-seeking and hearing-aid adoption rates have been reported across countries in population studies, limited literature on the influence of cross-cultural factors in this area calls for an immediate need for research.This paper highlights the importance of psychological models and cross-cultural research in the area of hearing help-seeking and hearing-aid uptake, and consequently some directions for future research are proposed.

Our starting point in this conceptual paper is the assumption that place-based approaches can contribute to the sustainable development of communities and regions. In order to enhance sustainable development, adaptations to vulnerabilities and unsustainability require a more place-based approach, using local resources, people’s capacities and the distinctiveness of places for sustainable development. Our aim is to understand how processes of sustainable place-shaping are influenced by human values, rooted in culture. Culture is constructed and plays a mediating role between people and their environment, influencing people’s intentions, way of life, sense of place, practices, norms and rules. In its variety, culture is one of the sources as well as an outcome of distinctiveness between places. Transformation to sustainability is not only driven by practices and political structures, but also by beliefs, values, worldviews and paradigms that influence attitudes and actions. The paper shows how values have been interpreted in different ways in various bodies of literature, as abstract principles and in an instrumental way. Values are not self-standing concepts but are intertwined, context-determined, culturally varied and connected to how we see our self and how we perceive our environment. It is argued that development and engagement of participants’ values can build co-creative capacity in place-based development aimed at sustainability. A distinction is made between an economic, intentional and symbolic approach. A value-oriented approach can provide a more in-depth insight into what people appreciate, feel responsible for and are willing to commit to in the context of their place.

This paper examines the beliefs and practices that constitute gender among Gypsy-Traveller women and then attempts to discern the consequences that flow from these. It analyses gender ideology and expectations among women and the shared investment in the moral identity attached to being a good Gypsy-Traveller wife. The paper argues that 'Gypsy-Traveller woman' cannot be understood as an identity that stands apart from gender and racial oppression. It is within this context that the tension between change and permanence in gender relations is played out. It argues that the maintenance of cultural taboos embodied and symbolised in the surveillance of womens' bodies is an important issue that problematises the construction of Gypsy-Traveller women. It posits that the appeal to morality may represent as much an avoidance of anxiety as a defence of marked gendered divisions within Gypsy-Traveller society. The paper suggests that the demands of cultural survival play a significant role in framing the degree to which women are willing or able to challenge the status quo.

The paper deals with the national reputation programmes of Denmark and Norway in the period 2005–2010. The first section demonstrates how national reputation management emerged as a part of the globalization discourse and illustrates its hybrid character. The paper then gives a short overview of the two approaches, nation branding and public diplomacy. In the next section, national reputation management efforts in Denmark and Norway are compared according to three variables: how they were launched in response to globalization, the role of consultants, and the countries’ different institutional settings. The article concludes with a discussion of how the elements of national reputation management interact in the initiatives of the two countries and how this relates to the general change in the relationship between nation-states on the global scene. The paper concludes that Norway and Denmark represent two different variations of a new, hybrid national reputation management. In the Norwegian case, the political and cultural spheres infiltrated the commercial sphere, while in Denmark, the commercial sphere infiltrated the cultural and political spheres

This paper evaluates the connecting fabric between gendered violence and human rights through the dire lenses of widowhood rites in Oshimili-North Local Government Area in Delta State, Nigeria. This evaluation stems from the Sustainable Development Goal-5 whose aim is the eradication of all forms of discrimination against women as well as harmful practices. Hinged on the theories of cultural relativism and universalism, the paper provides information on the existence of dehumanizing cultural practices related with widowhood rites despite the enactment of human rights instruments that are expected to address this form of discrimination targeted mostly against women. In-depth interviews were conducted among widows who voluntarily shared their experiences. Findings show widows’ acceptability of widowhood practices despite their educational and financial status notwithstanding. Also worthy of note is that women are perpetrators of these widowhood rites and they ensure its strict compliance among other widows. It recommends the dire need of the Nigerian government to domesticate the global rights regime into its legal framework, education of the populace through the interpretation, appropriation and the reconstructing of these transnational discourses into the indigenous and ensure that, effective monitoring mechanisms are in place to guarantee the effective protection of this vulnerable population.

Organ donation is constructed in the UK as a public responsibility, but more particularly as an obligation for members of minority ethnic communities. This paper draws attention to the ways in which 'ethnicity' has been made problematic by the allocation practices of transplant medicine, health promotion discourses and policy developments. Taken together, they have served to culturalise and racialise the procurement of organs. As the problem of organ donation is as much made inside medicine as outside it, this paper argues greater attention ought to be paid to these institutional practices and processes. Drawing on ethnographic work in the north of England, and with a specific focus on the organ consent encounter, this paper shows how categories of ethnicity in organ transplantation are an outcome of biopolitical and institutional practices. It argues that organ donation is best thought of, less as a discrete temporally-bounded act of decision-making, and more as a set of variegated situated practices that, in all manner of ways, problematically produce the publics that transplant medicine has come to rely upon so profoundly.

Introduction Programmatic assessment is an approach to assessment aimed at optimizing the learning and decision function of assessment. It involves a set of key principles and ground rules that are important for its design and implementation. However, despite its intuitive appeal, its implementation remains a challenge. The purpose of this paper is to gain a better understanding of the factors that affect the implementation process of programmatic assessment and how specific implementation challenges are managed across different programs. Methods An explanatory multiple case (collective) approach was used for this study. We identified 6 medical programs that had implemented programmatic assessment with variation regarding health profession disciplines, level of education and geographic location. We conducted interviews with a key faculty member from each of the programs and analyzed the data using inductive thematic analysis. Results We identified two major factors in managing the challenges and complexity of the implementation process: knowledge brokers and a strategic opportunistic approach. Knowledge brokers were the people who drove and designed the implementation process acting by translating evidence into practice allowing for real-time management of the complex processes of implementation. These knowledge brokers used a 'strategic opportunistic' or agile approach to recognize new opportunities, secure leadership support, adapt to the context and take advantage of the unexpected. Engaging in an overall curriculum reform process was a critical factor for a successful implementation of programmatic assessment. Discussion The study contributes to the understanding of the intricacies of implementation processes of programmatic assessment across different institutions. Managing opportunities, adaptive planning, awareness of context, were all critical aspects of thinking strategically and opportunistically in the implementation of programmatic assessment. Future research is needed to provide a more in-depth understanding of values and beliefs that underpin the assessment culture of an organization, and how such values may affect implementation.

The paper describes findings from an ethnographic study exploring understandings of love and intimacy amongst young heterosexual middle-class Indians of Gujarati origin in the UK and India. A two-site comparative study was used to enable an understanding of how social and economic contexts shape cultural constructions of intimate relationships and sexuality. Focusing on attitudes to 'love at first sight', this paper shows that, for Indian participants, love based on physical attraction denotes a lesser kind of love. A relationship based on 'physical love' is not expected to last, since it has been formed without regard to family and status concerns. Even couples who meet outside of the arranged marriage system demonstrate the quality of their love by not having sex with one another before marriage. In the UK, however, participants view love as properly spontaneous. Love at first sight is considered desirable and demonstrates how the relationship must be based on love only, without any concern for (for example) material gain. This spontaneous love entails both physical attraction and emotional connection - an early transition to sex, usually before marriage, was seen as both desirable and inevitable.

This paper explores how local people in a province in southern Thailand perceive the practice of male and female genital cutting. In order to understand the importance placed on these practices, a comparison is drawn between the two and also between the male circumcision and the Buddhist ordination of monks as rites of passage. Discourses on the exposure or concealment of male and female bodies, respectively, witness to the relevance of both the local political-historical context and biomedical hegemony to gendered bodies. The comparisons evince the need to reflect upon the theoretical and ethical implications of studying genital cutting and focusing exclusively on one of the two practices rather than, as this paper claims to be necessary, considering them as inextricably connected.

This paper intends to provide a brief overview of different ethical aspects related to the provision of mental health care to marginalized populations. The paper will have a particular focus on eth...

Although South Africa's total fertility rate is one of the lowest in sub-Saharan Africa, high rates of early childbearing remain a concern. Most teenage pregnancies occur among poor black and coloured South Africans. The majority of these pregnancies are said to be unwanted and unplanned and the teenager's relationships, unstable. Becoming a mother during one's teenage years is perceived to be socially, economically and physically deleterious for the teenager and her baby. This paper presents ethnographic data collected over a five-year period in the South African township of Nyanga East in the Western Cape. It draws attention to the circumstances that surround teenage pregnancy and discusses reactions to teenage pregnancies in this community. Findings highlight that despite the negative perception of teenage pregnancy within the township, particular social and cultural circumstances provided fertile ground for its occurrence. Furthermore, the paper argues that in this particular community the management of a teenage pregnancy played a functional and critical role in maintaining and reproducing social norms and ideals regarding intergenerational relationships, which ultimately ensured that the rates of early childbearing remained high.

HIV prevention discourses concern lives, the protection of bodily rights and people's active involvement in the policies and programmes that affect them. HIV prevention discourses also create lives, relying upon the deployment of normative sexual identities at the same time as they invite complex and fluid youth identities to embody the norms of prevention. This paper examines a particular HIV prevention text that is available to teachers in the Western Cape province of South Africa to support the implementation of the national Life Orientation programme. Rather than considering this text as a neutral 'scaffold' upon which teachers and students add cultural meanings, it is important to interrogate the ways in which texts rely upon and reiterate particular discursive constructions of the youth sexual subject. This paper argues that the text deploys a particular discursive framework in order to construct a 'normal' (and hetero) sexuality that validates, rather than questions, social constructions of masculine privilege within heterosexuality. This is achieved through the deployment of a scientific expertise of sexuality; the mobilisation of a valued hetero/homosexual binary to create a 'safe' heterosexuality; the normalisation of bourgeois sexuality through the ideology of marriage; and the naturalisation of heterosexual masculine and feminine identities.

The relationship between ethnicity and health is attracting increasing attention in international health research. Different measures are used to operationalise the concept of ethnicity. Presently, self-definition of ethnicity seems to gain favour. In contrast, in the Netherlands, the use of country of birth criteria have been widely accepted as a basis for the identification of ethnic groups. In this paper, we will discuss its advantages as well as its limitations and the solutions to these limitations from the Dutch perspective with a special focus on survey studies. The country of birth indicator has the advantage of being objective and stable, allowing for comparisons over time and between studies. Inclusion of parental country of birth provides an additional advantage for identifying the second-generation ethnic groups. The main criticisms of this indicator seem to refer to its validity. The basis for this criticism is, firstly, the argument that people who are born in the same country might have a different ethnic background. In the Dutch context, this limitation can be addressed by the employment of additional indicators such as geographical origin, language, and self-identified ethnic group. Secondly, the country of birth classification has been criticised for not covering all dimensions of ethnicity, such as culture and ethnic identity. We demonstrate in this paper how this criticism can be addressed by the use of additional indicators. In conclusion, in the Dutch context, country of birth can be considered a useful indicator for ethnicity if complemented with additional indicators to, first, compensate for the drawbacks in certain conditions, and second, shed light on the mechanisms underlying the association between ethnicity and health.

Over the course of the past three decades, there has been a significant increase of research on the social and cultural dimensions of sexuality. This paper reviews three major phases in the development of this work. In the first phase, work focusing on the social construction of sexual experience developed an important critique of the biomedical and sexological approaches that had dominated the field over much of the twentieth century. In the second phase, increasingly detailed studies of sexual life were developed which highlighted the cross-cultural diversity of sexual cultures, sexual identities and sexual communities. In the most recent phase, there has been a growing recognition of the complex relationship between culture and power, and increasing attention to the political and economic dimensions of sexuality. In spite of the significant conceptual and methodological advances that have taken place over time, however, it is also possible to identify a number of important questions that have not yet been adequately addressed and that may have been precluded by some of the perspectives that have come to dominate the field. The paper ends by focusing on the silences and invisibilities that continue to characterize this field of research and the challenges that must still be confronted in seeking to expand our understanding of these issues.

Despite recent reports that there is increasing condom use, generally resistance to condom use is still high. This paper focuses on factors inhibiting condom use and explores issues of responsibility for safe sex practices to prevent infection among a group of 14 South African male soldiers. Military men are particularly vulnerable to HIV because of their working conditions; for example, working far from home and being among communities where they have greater economic and political power, as well as in relation to their identities and sexualities as men, and how that is exaggerated by the institutional framework of the military. The data in this paper were drawn from a larger qualitative study exploring a group of military men’s narratives on their masculinity, sexuality, sexual relationships and HIV/AIDS. Semi-structured interviews were the main data collection method, and the interview transcripts were analysed primarily through interpretive discourse analysis. Findings of this study show that most participants used the socially desirable discourse that safe sex practices (specifically condom use) should be everybody’s responsibility. However, there was also the discourse of the ‘other’ responsible person, which was linked to gender, race, ethnicity, education and rank. The paper concludes with a recommendation that tackling HIV in the military needs to involve the rigorous examination of social factors such as gender, race and ethnicity.

This paper describes and introduces lesbians' lives and the relevant research in China's Mainland. The first part shows the slow development of lesbian culture in the form of literature, films and documentaries. Although lesbians' lives were reflected more or less in modern literature, the "true" lesbian novel was published only recently. Relevant films and documentaries were never shown to the public in China. Lesbian culture is still unevenly developed and remains negligible. The first part also describes lesbian research in the field of literature, psychiatry and sociology. The relevant research in literature is relatively systematic and rich, while that in psychiatry is fraught with discrimination and that in sociology is relatively weak. The second part presents the observation and analysis of lesbian Internet communities. It deals with lesbians' self-identity, role differentiation, sentiments and sexuality. Among them, role differentiation plays an important part in lesbians' lives though few researchers have studied it. Most lesbian organizations founded on the strength of Internet communication lack experience and resources and have little influence on the masses. Some lesbians are accepted by the public, but in return, they compromise to some popular values. This is extremely disadvantageous to those who are unwilling to give in. At the end of the paper, the first author expresses her future plan that she will continue her study on lesbian culture under the help of Internet observation and various activities. doi:10.1300/J155v10n03_08.

This paper is confined to a discussion of some of the possible harm and problems that came about as a result of the psychosocial interventions that were carried out in the post-tsunami phase. It also discusses some of the coordination activities that were carried out. It is accepted that there were many psychosocial initiatives that were well planned and were very useful to the community; however, this paper does not discuss those projects. It is mainly based on the experience gathered from working in the East coast of Sri Lanka for over five years and also from being involved in post-tsunami coordination work that was done with over 60 different organizations in Batticaloa, Sri Lanka. Experiences from the neighbouring Ampara and Trincomalee districts are also included.

This paper discusses the tsunami disaster in Sri Lanka with special reference to Buddhism, which is the majority religion in the island. The role of religious beliefs and of religion in general in strengthening coping skills is well known. Buddhism, with its specific views on the human condition and its use of psychological strategies, is almost unique among world religions. The Buddhist responses to the tsunami have been discussed widely, if largely informally, in Sri Lanka, and many concepts and practices have been highlighted and focused on. This paper provides an overview of the relationship between culture and traumatic experiences, with a brief discussion of the role of religion in mental health. It then goes on to explore some relevant Buddhist concepts and practices which can be used in clinical settings.

This paper explores dialectics of entrepreneurship and cultural consumption in the backpacker tourist enclave of 'Foreigner's Lane' in Dali, Yunnan Province, PR China, focusing on the role of ethnic identities and their representation. The discussion uses the performance metaphor to conceptualise tourism as a carefully staged act and illustrates the context of authentification. The paper focuses on the activities of local entrepreneurs and their construction of 'exotic Otherness' that reflects the preconceptions and demands of identity obsessed backpacker travellers. It is argued that the agency of local entrepreneurs undermine traditional notions of cultural producers as passive victims commodified by the globalised tourism complex.

The ability to interpret collected data across international mental health communities often proves to be difficult. The following paper reports on the use and appropriateness of focus group methodology in helping to clarify issues that could help substantiate data collection and comparison across different cultures and regions. Field tests of the focus group methodology were undertaken in different regions and this paper describes an overview of the final field test in Sofia, Bulgaria. The findings and experiences with utilizing this methodology were incorporated in subsequent data collections.

Muslims constitute a growing proportion of the African-American population. This paper explores the health practices, health behaviors, and code of ethics as informed by the Islamic religion within the context of African-American Muslim women's lives. An overview of the history of Islam in the world, and in the U.S., the main Islamic tenets, and the socio-cultural context of African-American Muslim women provides the broad framework for this paper. This information will be helpful in meeting the health needs of African-American Islamic women, within an outreach/community health promotion setting, within a clinical/hospital setting, or within a home care setting.

This chapter will show that the term "drag" in drag queen has a different meaning, history and value to the term "drag" in drag king. By exposing this basic, yet fundamental, difference this paper will expose the problems inherent in the assumption of parity between the two forms of drag. An exposition of how camp has been used to comprehend and theorise drag queens will facilitating an understanding of the parasitic interrelationship between camp and drag queen performances, while a critique of "Towards a Butch-Femme Aesthetic," by Sue Ellen Case, will point out the problematic assumptions made about camp when attributed to a cultural location different to the drag queen. By interrogating the historical, cultural and theoretical similarities and differences between drag kings, butches, drag queens and femmes this paper will expose the flawed assumption that camp can be attributed to all of the above without proviso, and hence expose why drag has a fundamentally different contextual meaning for kings and queens. This chapter will conclude by examining the work of both Judith Halberstam and Biddy Martin and the practical examples of drag king and queen performances provided at the UK drag contest held at The Fridge in Brixton, London on 23 June 1999.

Decreasing the number of homeless drug users is one of the main characteristics of inner city drugs policy. The present study selected an urban-ethnographic perspective (the subculture theory) in order to explore why one drug user is homeless and another 7 not, and to attempt to describe and define the homeless and their immediate social environment. These issues were formulated into the following research questions: 1. What are the sociodemographic characteristics of homeless drug users in Rotterdam, and do they differ from domiciled drug users? 2. What are their living conditions? 3. What are the reasons for being homeless? 4. Does the period of homelessness play a role in the need to change one's lifestyle? Five research methods were employed for this study: a literature search, interviews with key persons, field notes from community fieldworkers, a survey among drug users (n = 204), and photographic reports from six homeless users. Data were collected in 1998/1999. The results document that in our study population there were more women, more illegal persons, and more foreigners than among domiciled drug users, and that the homeless group used heroin and cocaine on more days. A large proportion of the homeless users had no identity papers and no health insurance. This did not, however, lead to more self-reported sickness or a higher prevalence of infectious diseases compared with nonhomeless drug users. Easily accessible (low threshold) social care centers and assistance are very important. Few of the homeless had voluntarily chosen a homeless life-most describe an event that was a trigger for their homelessness. The average duration of being homeless was 17 months, and the longer someone had been homeless the less inclined they were to change their situation. This paper also discusses policymaking implications.

Despite making tremendous progress in education since independence to become a leader in literacy in Africa, Zimbabwe lags behind other nations in providing special programming for its gifted children and youths. Not only do gifted and talented students exist in Zimbabwean schools and colleges, giftedness has also been confirmed in research on indigenous cultures. This paper discusses a number of issues characterizing the discourse of gifted education in Zimbabwe. In this discourse, the paper examines indigenous conceptions of giftedness, types of giftedness valued, local beliefs about giftedness, challenges involved in educating gifted students and critical findings in local research on gifted education in Zimbabwe. The paper is informed by a number of studies conducted by this writer and other researchers on gifted education in Zimbabwe. Future directions for gifted education research in Zimbabwe are highlighted.

The objective of this paper is to understand the intended sexual and condom behaviour patterns among teenage higher secondary school students in India. To achieve this, variables including perceived norms, perceived peer group norms, risk behaviour patterns, perceived chances of getting AIDS and relevant sociodemographic variables were regressed on intended sexual behaviour. Regression of actual sexual behaviour was carried out with perceived norms, perceived peer group norms and intended sexual behaviour as the independent variables. In this paper a conceptual model has been framed based on the theory of reasoned action, health belief model and self-efficacy theory. Cumulative scores are computed for perceived norms, perceived peer group norms, risk behaviour patterns, opinion on handling condoms and perceived chances of getting AIDS. Along with these variables, possible confounding variables such as age, gender, type of family, mother's education and father's education were considered for their effect on intended sexual and condom behaviour. The results revealed that perceived norms and perceived peer group norms showed significant association with intended sexual behaviour and actual sexual behaviour and that children of more highly educated parents are less likely to engage in sexual activities in their adolescent years.

The publication of "Myths of Neuropsychology" (Dodrill, 1997) has stimulated three responses, each of which takes issue with points in the original publication. These three responses especially address Myth #4 ("Above-average performances on neuropsychological tests are expected when intellectual abilities are above average") and to a lesser degree Myth #1 ("We have a good knowledge of the constructs that our tests measure"). The present paper reviews the thoughts and new data which these colleagues have provided in response to the original paper, and it also presents additional data bearing on the issues at hand. Based on the composite of information now available, it is conceded that Myth #4 was not accurately worded in the original paper. This was a mistake, and an alternate wording for Myth #4 is offered. Other changes in the original publication do not appear to be required. In order to resolve many of the issues at hand and thereby advance our profession, research in a number of areas is needed, many of which are specifically identified in the present paper.

The research on male homosexuality and alternative sexual cultures among Latin American men is one of the richest sources of data and cross-cultural analysis on sexuality, sexual identities and sexual communities anywhere in the world. New research includes not only an ongoing concern to describe the distinct contours of different social and cultural constructions of sexual identity (a concern that has been evident in this field for 3 decades), but also a concern to describe the complex process of social, cultural, economic and political change taking place in sexual cultures throughout the region. Numerous papers now document the dilemmas confronted--and the creative solutions that have been invented--by Latino American men in response to the HIV/AIDS epidemic, and the emerging struggles for sexual rights and sexual-determination that can now be seen emerging in major urban centers throughout the region. These papers demonstrate the limitations of the dominant North American models of behavior change in response to AIDS by carefully uncovering the culturally articulated worlds of intimacy and desire that such models ignore, pointing the way toward a culturally constituted prevention practice as the only possible route to health promotion--possibly among all marginalized and vulnerable populations.

There have been more than 160 wars and armed conflicts since 1945, almost all in the Third World, and more than 50 currently. More than 90% of these are internal rather than between sovereign states. There has been a sixfold increase in the number of war refugees worldwide since 1970, who now number 1% of the global population. Ninety per cent of all casualties are civilians. A key element of modern political violence is the creation of states of terror to penetrate the entire fabric of grassroots social relations as a means of control. The valued institutions and ways of life of whole populations are routinely targeted for destruction. In the 1980s many such wars were played out on a terrain of subsistence economies. The back-drop is of environmental degradation, poverty, embedded social injustice, pressure on the nation-state, a global rise in food insecurity and a widening gulf between the wealthiest 20% and the poorest 20% in the world. The World Health Organization is warning of a health catastrophe, with life expectancy in the world's poorest countries falling by the year 2000 and one-third of the world's children undernourished. Understanding a complex and evolving set of causes and effects surrounding war is a considerable challenge to the international humanitarian field, not least the health professions. In recent years there has been a burgeoning interest in the psychological impact of the atrocities of war, and in trauma programmes based on Western psychological concepts and techniques. This individualistic focus risks neglecting the core issue: the role of a social world, invariably targeted in war and yet still embodying the capacity of survivor populations to manage their suffering, adapt and recover on a collective basis. Using the example of Mozambique, Guatemala and others, this paper will discuss the way in which contemporary war damages social and cultural forms, and the range of traditions, values and understandings which these carry. However, society and culture also engage actively with war, with changes in the social order that may come to outlast the violence itself. This paper will also pinpoint the quest for justice as an issue that may distinguish the subjective experience of war from those that arise after peacetime or natural disasters. The work of anthropologists, sociologists, historians and poets in both West and Third World, allied to the voices of survivors themselves, can help the humanitarian field to acquire a more richly textured understanding of the range of responses to war and atrocity, and outcomes over time.

This paper explores the relationship between workforce competence, migration, and quality improvement in the Asia-Pacific through analysis of Early Childhood Education (ECE) policy texts from three East Asia Summit countries. Content (word level) analysis of salient policy texts was undertaken to address two questions: How are culture and diversity conceptualized in these texts? How are diverse educators positioned in these texts? We show that, despite differing historical trajectories of ECE, policy frameworks in all three countries fail to sufficiently acknowledge the potential contribution of migrant educators to quality improvement initiatives. We conclude by calling for greater attention to workforce mobility and diversity in ECE policies, and for further research into the untapped competence of migrant educators.

This paper examines the role of Mexican philosopher, José Vasconcelos, in consolidating mestizaje (racial and cultural mixture) as the national ideology through a textual analysis of his essay, “La raza cósmica” (The Cosmic Race), his educational magazine, “El Maestro” (The Teacher), and other writings. The paper takes on a historical approach to explore how Vasconcelos’ ideas on mixture circulated within the culture at large, influenced the eugenics and education movements, and helped shape the politics of race, culture, and social engineering in early twentieth-century Mexico in order to account for what persists in the present.

Data from several national studies lead to divergent conclusions regarding trends in illicit drug use in the United States. Two major population studies point to a downturn in drug use dating to the late 1970s. However, a study of drug-related deaths and hospital emergency room visits shows increases in these events in recent years. Studies also show drug use, especially cocaine, continuing to increase among criminals. Additionally, drugs were identified as the most important problem facing the nation in a Gallup poll conducted during the summer of 1989. This paper offers some possible explanations for the divergent trends. Most notably, we suggest that methodological differences in the studies being compared, and lags between trends in the general population and certain subgroups, account for most of the variation in the trend estimates. The paper concludes that illicit drug use is decreasing in the United States.

Sociologists and psychologists now agree on the significance of belonging to the experience of loneliness. Yet to date, this is unevenly reflected in both survey instruments and qualitative inquiry where the focus is mostly on belongingness attributed to social connectivity, social support, intimate social bonds and interpersonal relationships. While these are very important, recent work on belonging itself has stressed the significance of much wider bases of belonging, including place, temporality, memory, mobilities, generation, culture, labour processes, kinship systems, residential arrangements, settlement patterns, the public sphere and more-than-human factors. Drawing on evidence from sociology and other disciplines in the humanities and social sciences, this paper brings these insights together for the first time in order to develop a deeper consideration of belonging for loneliness research, and especially to identify further sources of variation in loneliness. In this article we will concentrate on kinship, cultural, spatial, temporal and generational bases of belonging, which while discrete are also often interrelated and linked to wider social structural developments associated with individualism and neoliberalism. We argue that this research is a necessary foundation for the “all-of-government” strategies on loneliness that are just beginning to gain favour and traction through their consideration of individual and structural solutions. Refereed/Peer-reviewed

This paper argues that Joseph Ratzinger is a theologian with the stature of a Church Doctor, notwithstanding the fact that he did not develop a theological system in the manner of other ‘big name’ theologians of the twentieth century such as Karl Barth, Karl Rahner and Hans Urs von Balthasar. The author argues that it is Ratzinger’s manner of responding to the contemporary crisis in fundamental theology that is his outstanding intellectual contribution to the life of the Church, along with his effect of a Christocentric turn in magisterial theology and his defence of beauty within his theology of culture.

The paper discusses differences in IT ethics perceptions and behavior of college students. The study is one of the few that examine multicultural differences in IT ethics on a convenience sample of...

In this paper, we take a fresh look at the magnitude of the trade-off between caring informally for a parent and paid work. We adopt a simultaneous approach with a primary focus on how hours of car...

Background. Pharmaceutical communication is an essential component of pharmaceutical health care, optimally ensuring patients understand the proper administration and side effects of their medications. Communication can often be complicated by language and culture, but with pharmaceuticals, misunderstandings can prove particularly harmful. In Nunavut, to ensure the preservation and revitalization of Inuit languages, the Inuit Language Protection Act and Official Languages Act were passed requiring that all public and private sector essential services offer verbal and written communication in Inuit languages (Inuktitut and Inuinnaqtun) by 2012. Methods. While the legislation mandates compliance, policy implementation for pharmaceutical services is problematic. Not a single pharmacist in Nunavut is fluent in either of the Inuit languages. Pharmacists have indicated challenges in formally translating written documentation into Inuit languages based on concerns for patient safety. These challenges of negotiating the joint requirements of language legislation and patient safety have resulted in pharmacies using verbal on-site translation as a tenuous solution regardless of its many limitations. Results. The complex issues of pharmaceutical health care and communication among the Inuit of Nunavut are best examined through multimethod research to encompass a wide range of perspectives. This methodology combines the richness of ethnographic data, the targeted depth of interviews with key informants and the breadth of cross-Canada policy and financial analyses. Conclusions. The analysis of this information would provide valuable insights into the current relationships between health care providers, pharmacists and Inuit patients and suggest future directions for policy that will improve the efficacy of pharmaceuticals and health care spending for the Inuit in Canada. Keywords: drugs; prescription; medication; remote; delivery; culture; counselling; communication; language (Published: 5 August 2013) This paper is part of Supplement 1, 2013, ICCH15 Proceedings . More papers from this Supplement can be found here . Citation: Int J Circumpolar Health 2013, 72 : 21409 - http://dx.doi.org/10.3402/ijch.v72i0.21409

Background. Little is known about the burden of heart failure among indigenous populations, including Native Hawaiians (NH). Recent concerns about genetic research in the NH community resonate with similar concerns raised by American Indian, Alaskan Native and Canadian First Nations communities and have raised questions about the best way to proceed with studies involving biological specimens. Objective. To help us plan a study to investigate disparities in heart failure incidence and outcomes in a NH community, we performed a qualitative study to examine the community’s expectations for heart failure research that includes the collection of biological specimens. Methods. Eighty-five NH with a personal or family history of heart failure, who lived in a geographically isolated community in the state of Hawai‘i participated in 1 of 16 semi-structured interviews. Interviews were conducted in a standard manner, with open-ended questions designed to explore their expectations for a heart failure research study that included the collection of biological specimens. Interviews were analyzed thematically through iterative readings and coding. Results. Four key themes regarding heart failure research with the use of biological specimens characterized their expectations: (a) Need to foster trust between investigator and community; (b) Establish a partnership with the community to identify needs and goals; (c) Need for mutual benefit to investigator and community; (d) Identification of a key voice to represent the community. Participants expressed strong support for research. However, the strength of that support was directly related to the strength of the relationship between the research team and the community. The collection of biological specimens for genetic analyses was not an explicit concern or barrier per se. Conclusions. It appears feasible to conduct a heart failure research study that includes the collection of biological samples. However, success will likely require addressing the community’s expectations, including the need for a long-term partnership built on trust and mutual benefit, and a key voice to represent the community. Keywords: Native Hawaiian; qualitative; heart failure; biological specimens; interviews; screening (Published: 5 August 2013) This paper is part of Supplement 1, 2013, ICCH15 Proceedings . More papers from this Supplement can be found here . Citation: Int J Circumpolar Health 2013, 72 : 21346 - http://dx.doi.org/10.3402/ijch.v72i0.21346

Background. Multiple climatic, environmental and socio-economic pressures have accumulated to the point where they interfere with the ability of remote rural Alaska Native communities to achieve food security with locally harvestable food resources. The harvest of wild foods has been the historical norm, but most Alaska Native villages are transitioning to a cash economy, with increasing reliance on industrially produced, storebought foods, and with less reliable access to and reliance on wild, country foods. While commercially available market foods provide one measure of food security, the availability and quality of market foods are subject to the vagaries and vulnerabilities of the global food system; access is dependent on one’s ability to pay, is limited to what is available on the shelves of small rural stores, and, store-bought foods do not fulfill the important roles that traditional country foods play in rural communities and cultures. Country food access is also constrained by rising prices of fuel and equipment, a federal and state regulatory framework that sometimes hinders rather than helps rural subsistence users who need to access traditional food resources, a regulatory framework that is often not responsive to changes in climate, weather and seasonality, and a shifting knowledge base in younger generations about how to effectively harvest, process and store wild foods. Objective. The general objective is to provide a framework for understanding the social, cultural, ecological and political dimensions of rural Alaska Native food security, and to provide information on the current trends in rural Alaska Native food systems. Design. This research is based on our long-term ethnographic, subsistence and food systems work in coastal and interior Alaska. This includes research about the land mammal harvest, the Yukon River and coastal fisheries, community and village gardens, small livestock production and red meat systems that are scaled appropriately to village size and capacity, and food-system intervention strategies designed to rebuild local and rural foodsheds and to restore individual and community health. Results. The contemporary cultural, economic and nutrition transition has severe consequences for the health of people and for the viability of rural communities, and in ways that are not well tracked by the conventional food security methodologies and frameworks. This article expands the discussion of food security and is premised on a holistic model that integrates the social, cultural, ecological, psychological and biomedical aspects of individual and community health. Conclusion. We propose a new direction for food-system design that prioritizes the management of placebased food portfolios above the more conventional management of individual resources, one with a commitment to as much local and regional food production and/or harvest for local and regional consumption as is possible, and to community self-reliance and health for rural Alaska Natives. Keywords: food security; Alaskan food systems; community health and well-being; food portfolios (Published: 5 August 2013) This paper is part of Supplement 1, 2013, ICCH15 Proceedings . More papers from this Supplement can be found here . Citation: Int J Circumpolar Health 2013, 72 : 21560 - http://dx.doi.org/10.3402/ijch.v72i0.21560

Background. Alaska Native (AN) college students experience higher attrition rates than their non-Native peers. Understanding the factors that contribute to quality of life (‘‘what makes life good’’) for AN students will help inform supportive programs that are congruent with their culture and college life experiences. Objectives. Co-develop a conceptual model and a measure of quality of life (QOL) that reflects the experiences of AN college students. Methods. Six focus groups were conducted with 26 AN college students. Within a communityacademic partnership, interactive data collection activities, co-analysis workgroup sessions and an interactive findings forum ensured a participant-driven research process. Findings. Students identified and operationally defined eight QOL domains (values, culture and traditions, spirituality, relationships, basic needs, health, learning and leisure). The metaphor of a tree visually illustrates how the domains values, culture and traditions and spirituality form the roots to the other domains that appear to branch out as students navigate the dual worldviews of Native and Western ways of living. Conclusions. The eight QOL domains and their items identified during focus groups were integrated into a visual model and an objective QOL measure. The hope is to provide a useful tool for developing and evaluating university-based programs and services aimed toward promoting a positive QOL and academic success for AN students. Keywords: quality of life; Alaska Native; college students; community-based participatory research (Published: 5 August 2013) This paper is part of Supplement 1, 2013, ICCH15 Proceedings . More papers from this Supplement can be found here . Citation: Int J Circumpolar Health 2013, 72 : 21180 - http://dx.doi.org/10.3402/ijch.v72i0.21180

Background: Experiencing domestic violence is considered a chronic and stressful life event. A theoretical framework of coping strategies can be used to understand how women deal with domestic violence. Traditional values strongly influenced by religious teachings that interpret men as the leaders of women play an important role in the lives of Javanese women, where women are obliged to obey their husbands. Little is known about how sociocultural and psychosocial contexts influence the ways in which women cope with domestic violence. Objective: Our study aimed to deepen our understanding of how rural Javanese women cope with domestic violence. Our objective was to explore how the sociocultural context influences coping dynamics of women survivors of domestic violence in rural Purworejo. Design: A phenomenological approach was used to transform lived experiences into textual expressions of the coping dynamics of women survivors of domestic violence. Results: Experiencing chronic violence ruined the women’s personal lives because of the associated physical, mental, psychosocial, and financial impairments. These chronic stressors led women to access external and internal resources to form coping strategies. Both external and internal factors prompted conflicting impulses to seek support, that is, to escape versus remain in the relationship. This strong tension led to a coping strategy that implied a long-term process of moving between actively opposing the violence and surrendering or tolerating the situation, resembling an elastic band that stretches in and out. Conclusions: Women survivors in Purworejo face a lack of institutional support and tend to have traditional beliefs that hamper their potential to stop the abuse. Although the women in this study were educated and economically independent, they still had difficulty mobilizing internal and external support to end the abuse, partly due to internalized gender norms. Keywords: domestic violence; coping; lived experience; Indonesia (Published: 2 January 2013) Citation: Glob Health Action 2013, 6 : 18894 - http://dx.doi.org/10.3402/gha.v6i0.18894 This paper is part of the Cluster Gender and health . More papers from this cluster can be found here and here .

Handedness ontogenesis is still under debate in science. This systematic review analyzed articles regarding the theories and basis of handedness formation, highlighting the historical knowledge path that this literature underwent. Cochrane Library, LILACS, Web of Sciences, Science Direct and PubMed databases were searched. This review included review studies with handedness as the main topic. Only papers written in English with analyses exclusively in neurotypical humans (any age range) were included. Different approaches (genetic, neural, social, and behavioural) were reviewed in light of growing evidence, summarizing the current state of the art. Genetic and environmental/social impacts are common points in most of the reviews, each given more or less importance, depending on the author and theory proposed. Multifactorial, developmental approaches to handedness formation seem to be the most up to date view of the phenomenon. Different control mechanisms between hemisphere and neural asymmetries are also contributing factors to handedness formation.

This paper draws on qualitative research in Jiwaka Province, in the highlands of Papua New Guinea (PNG), to examine the changing nature of marriage in that context. In particular, it examines how changes in the practice of brideprice have been associated with an increase in intimate partner violence. Violence, a relational process, is to be understood in the context of the customary unequal power relations between men and women. It is argued that men in the highlands of PNG see any gain in power for women as a loss for themselves, and so actively resist it. Men who see their power over women challenged resort to the discourse of brideprice, arguing that the payment of brideprice gives them absolute authority over wives. A good understanding of the norms that sanction violence is a vital step in developing interventions to prevent violence.

This work was supported by Arts and Humanities Research Council: [Grant Number AH/L00495X/1]. Despite its undoubted importance to policy makers and practitioners, cultural value remains a highly contested concept. Empirical work in the area has, meanwhile, been hampered by the use of a unidimensional framework of cultural value. The understanding of word-of-mouth (WOM) communication behaviour related to cultural values has consequently been limited. The purpose of this paper is to develop cultural value segments using a multidimensional value framework to enable a profile to be developed of the WOM behaviour (both online and offline) of each segment. A typology with four distinct segments of cultural consumer, each exhibiting different combinations of cultural values and of WOM communication preferences. The study thereby challenges the orthodoxy of value creation and transmission in cultural settings. Practical recommendations include the use of market segmentation based on multidimensional value ‘constellations’: not only to achieve better audience development but also to encourage wider value communication through word of mouth. Postprint