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A growing number of studies have supported the use of unidimensional psychometric test instruments administered via the Internet; however, support for the use of multidimensional scales is weak. The present study compares paper and Internet administrations of the Multidimensional Health Locus of Control (MHLC) Scale (Wallston & Wallston, 1981). In terms of reliabilities and factor structures, the Internet data were found to be at least as good as the paper data. MHLC scores were comparable for paper and Internet administrations, although the Internet sample scored significantly lower on the Powerful Others subscale. Overall, the results show that administration of the MHLC Scale via the Internet can produce data comparable to that obtained by pen-and-paper methods. However, it is concluded that generalization of these findings beyond the psychometric test instrument and sampling procedures used here is not warranted.

Expressions of religious piety have been practiced in the Catholic Church as a response to plagues and pandemics. The faithful seek comfort in prayer and appeal to God and the saints for mercy and protection from illness and loss of life. In the Philippines, the veneration of sacred images and placing them outside the window of a house or a church is a religious expression known as "dungaw” (to look out). This paper discusses “dungaw” as a faith-response of Filipino Catholics during the COVID-19 pandemic. The study is an empirical phenomenology that consists of a literary review and interviews. This paper analyzed the significance of the religious expression “dungaw.” Four areas of inquiry were identified: (1) Views on the COVID-19 pandemic, (2) “Dungaw” and prayer life during the pandemic, (3) “Dungaw” as a religious expression, and (4) “Dungaw” and communal life. Results showed that Filipino Catholics utilized religion as a coping resource during turbulent times. Filipino Catholics also embodied traditional values to help repair the frayed social fabric during COVID-19.

Efforts to control and regulate alcohol has recently gained steam in Botswana. Inspired by a public health perspective, the government of Botswana has recently increased the alcohol tax levy, reduced the hours of operation for bars and increased penalties for alcohol-related offences to control alcohol-related harm. While these reforms have been central to policymaking, and caused some controversy, not much is known about the everyday experiences of alcohol consumers in Botswana. Drawing from semi-structured interviews (n = 40) collected amongst drinkers over a five-year period, this paper examines the everyday use of alcohol in Botswana. The analysis demonstrates that alcohol use constitutes an important part of leisure and night-time economy (NTE) activities in Botswana. It is a functional social activity that is used by people to take time away from the routines and pressures of daily life. More importantly, it is pleasurable to people, enhances sociability, and partaken as a form of transaction between men and women in bars. There is need for policy makers to consider the embodied experiences of alcohol use when designing alcohol interventions in Botswana.

There is ample evidence that exposure to Immigration and Customs Enforcement (ICE) activities could widen Latinas’ health disparities. Whether or not residing near an ICE detention center (IDC) further impacts their health is unknown. During nationwide increased ICE activities Latinas (N=45) attended an intervention at two separate sites: one near and another one far from an IDC. A focus group discussion and an interview were conducted using a grounded theory approach. Quantitative data were collected and analyzed. Participants residing near an IDC benefited less from the intervention and reported changes in anxiety levels and in mobility, and a sense of powerlessness. They also requested resources to respond to ICE overreach and broadcasting of their reality. Our results suggest that proximity to IDCs impacts immigrant communities and public health programming, which is inevitably embedded in political realities. These need to be addressed when providing much needed interventions. Supplementary Information The online version contains supplementary material available at 10.1007/s10903-021-01219-2.

Food contributes to an individual’s physical and mental well-being and expresses one’s cultural identity through preparation, sharing, and consumption (i.e., foodways). Inadequate access to cultural foods can create cultural stress and affect one’s identity and well-being. In particular, second-generation U.S. American student populations may have a higher risk for cultural stress due to being away from family, academic stress, environmental changes, and diminished financial stability to purchase cultural foods. Thus, an exploratory qualitative methodology was used to elicit information about second-generation U.S. Americans’ food experiences to identify how cultural foods play a role in individual identity and how individual well-being is influenced by the presence or lack of cultural foods. Sixteen semi-structured interviews were conducted with second-generation American students at the University of Nevada, Reno, who self-identified as a cultural or ethnic minority. A standard thematic analysis was conducted. The authors identified that cultural food security influenced the ability to practice foodways, which tied Second-generation American students to their cultural identities. The absence of foodways led to anxiety and depression among students, amplifying the feelings of identity degradation. Second-generation American students discussed that the ability to practice their foodways improved multiple well-being components and led to feelings of happiness, decreased stress, warmth, better digestion, and a sense of belonging, comfort, and safety. College populations continue to grow and become more diverse, and with the increasing Second-generation American students, it is essential to improve the access and availability of cultural foods to improve their overall well-being. (245/250 words). Supplementary Information The online version contains supplementary material available at 10.1007/s12571-020-01140-w.

Cultural background might influence knowledge and attitudes regarding autism, influencing willingness to interact. We studied whether beliefs, knowledge, contact, and attitude differed between the UK and Malaysia. With mediation analyses, we studied how these factors influenced willingness to interact. Autism was more often linked to food in the UK, and to upbringing in Malaysia. Knowledge, contact, and acceptance were greater in the UK. When excluding psychology students, Malaysian students were less willing to interact with autistic people. Knowledge and contact appeared to improve acceptance, but acceptance did not mediate the relation between country, beliefs, knowledge, and experience; and willingness to interact. Knowledge and contact regarding autism might improve acceptance in different cultures, but how acceptance could improve interaction is unclear.

This paper aims to clarify the role of culture as a public good that serves to preserve mental health. It tests the evolutionary hypothesis that cultural consumption triggers a microeconomic mechanism for the self-defense of mental health from uncertainty. The COVID-19 pandemic offers a natural experiment of cultural consumption under increased uncertainty. Using primary data from a pilot survey conducted online during the pandemic and applying Probit and Heckman selection models, the study analyzes levels of happiness and propensity to help others. The results suggest that past consumption of culture is associated with higher happiness levels during crises. Moreover, spontaneous cultural practices (such as group singing) during times of uncertainty are associated with an increase in the pro-social propensity to help others. These findings highlight culture as a tool for promoting mental health at the micro level and social capital resilience at the aggregate level.

There is a limited amount of empirical data available regarding the cultural and religious variation in perceptions about the age when young people should be regarded as competent to make decisions in health settings. A public survey of 400 adults from diverse religious and ethnic backgrounds was conducted in the UK and Spain. Attitudes were assessed using case vignettes. It was found that high religious practice was associated with recommending a higher age of consent for medical interventions. White British adults were more likely than Spanish adults to agree that younger adolescents should be allowed to consent to medical interventions. The study suggests that there is social, cultural and religious variation in adults' attitudes regarding the age when youngsters should consent to health interventions.

How animal communities arrive at homogeneous behavioural preferences is a central question for studies of cultural evolution. Here, we investigated whether chimpanzees (Pan troglodytes) would relinquish a pre-existing behaviour to adopt an alternative demonstrated by an overwhelming majority of group mates; in other words, whether chimpanzees behave in a conformist manner. In each of five groups of chimpanzees (N = 37), one individual was trained on one method of opening a two-action puzzle box to obtain food, while the remaining individuals learned the alternative method. Over 5 h of open access to the apparatus in a group context, it was found that 4/5 ‘minority’ individuals explored the majority method and three of these used this new method in the majority of trials. Those that switched did so after observing only a small subset of their group, thereby not matching conventional definitions of conformity. In a further ‘Dyad’ condition, six pairs of chimpanzees were trained on alternative methods and then given access to the task together. Only one of these individuals ever switched method. The number of observations that individuals in the minority and Dyad individuals made of their untrained method was not found to influence whether or not they themselves switched to use it. In a final ‘Asocial’ condition, individuals (N = 10) did not receive social information and did not deviate from their first-learned method. We argue that these results demonstrate an important influence of social context upon prioritisation of social information over pre-existing methods, which can result in group homogeneity of behaviour. Electronic supplementary material The online version of this article (10.1007/s10071-018-1178-y) contains supplementary material, which is available to authorized users.

Almost one in four women in Cambodia is a victim of physical, emotional or sexual violence. The study aims to provide a comprehensive understanding of the ways in which Cambodians see its causes and effects and to identify and analyse the cultural forces that underpin and shape its landscape. An ethnographic study was carried out with 102 perpetrators and survivors of emotional, physical and sexual violence against women and 228 key informants from the Buddhist and healing sectors. Their views and experiences of it were recorded-the popular idioms expressed and the symptoms of distress experienced by survivors and perpetrators. From these results, the eight cultural forces, or cultural attractors, that are seen to propel a person to violence were identified. Violence stemmed from blighted endowment, or 'bad building' (sɑmnaaŋ mɨn lʔɑɑ) determined by deeds in a previous life (kam). Children with a vicious character (kmeeŋ kaac or doṣa-carita) might grow to be abusers, and particular birthmarks on boys were thought to be portents. Krʊəh, or mishap, especially when a female's horoscope predicted a zodiac house on the descent (riesəy), explained vulnerability to violence and its timing. Astrological incompatibility (kuu kam) was a risk factor. Lust, anger and ignorance, the 'Triple Poison', fuelled it. 'Entering the road to ruin' (apāyamuk), including alcohol abuse, womanising and gambling, triggered it. Confusion and loss of judgement (mohā) led to moral blindness (mo baŋ). These were the eight cultural attractors that shaped the landscape of violence against women. The cultural epigenesis of violence against women in Cambodia is an insight which can be used to build culturally responsive interventions and strengthen the primary prevention of violence against women. An understanding of the epigenesis of violence could strengthen the primary prevention of violence against women.

This paper compares the biofilter capacity and cost-effectiveness of blue mussels (Mytilus edulis) and seaweed for use in integrated multi-trophic aquaculture (IMTA) based on experiences in Ireland and Denmark. This comparison shows that weight for weight, mussels are a better biofilter than seaweed with regard to the amount of nitrogen assimilated. Furthermore, in optimized systems, areal requirement for mussels is similar to the cultivation of the same tonnage (1,000 t) of seaweed (approximately 8 ha). The cost-effectiveness of a mussel biofilter is a,not sign11-30 kg(-1) nitrogen (N) removed based on various examples compared to production costs of a,not sign209-672 removed and a,not sign1,013 kg(-1) N removed, respectively, for Laminaria digitata and Alaria esculenta from extrapolated laboratory and field trials. However, commercial seaweed (Saccharina latissima) producers claim that production costs are less than a,not sign10-38 kg(-1) N removed. These up-scaled and commercial figures make the seaweed cost competitive to mussels for removal of nitrogen. Disadvantages such as predators (e.g. eider ducks) and biofouling should also be taken into account before choice of biofilter is made. These drawbacks can reduce overall biofilter capacity and biomass value as a consequence of biomass spoilage or loss. However, disadvantages may be mitigated by seasonal choice of cultivation and harvest times. Cultivation technologies and harvesting methods may be improved together with breeding to improve the cost-efficiency of the biofilter, especially in the newer European seaweed cultivation. Furthermore, upscaling of IMTA to commercial proportions, other than the Danish example, would allow more real data on production costs and revenues.

Spirit possession is a common, worldwide phenomenon with dissociative features. Studies in Europe and the United States have revealed associations among psychoform and somatoform dissociation and (reported) potential traumatic events. The aim of this study was to explore the relationships among spirit possession, dissociative symptoms and reported potentially traumatizing events in Uganda. One hundred nineteen persons with spirit possession, diagnosed by traditional healers, were compared to a matched control group of 71 nonpossessed persons. Assessments included demographic items and measures of dissociation and potentially traumatizing events. Compared to the nonpossessed group, the possessed group reported more severe psychoform dissociation and somatoform dissociation and more potentially traumatizing events. The associations between these events and both types of dissociation were significant. Yet, consistent with the cultural perception of dissociative symptoms, the participants subjectively did not associate dissociative symptoms with potentially traumatizing events. In conclusion, spirit possession deserves more interest as a possible idiom of distress and a culture-specific expression of dissociation related to potential traumatizing events.

Killer cell immunoglobulin-like receptors (KIR) gene frequencies vary between populations and contribute to functional variation in immune responses to viruses, autoimmunity and reproductive success. This study describes the frequency distribution of 12 variable KIR genes and their HLA-C ligands in two Iranian populations who have lived for many generations in different environments: the Azerbaijanis at high altitude and the Jonobi people at sea level. The results are compared with those published for other human populations and a large group of English Caucasians. Differences were seen in KIR and HLA-C group frequencies, in linkage disequilibrium and inhibitory/activating KIR ratios between the groups. Similarities with geographically close populations in the frequencies of the KIR A and B haplotypes and KIR AA genotype reflected their common ancestry. The extreme variability of the KIR gene family and their HLA-C ligands is highlighted and their importance in defining differences between geographically and culturally isolated communities subject to different environmental pressures who come from the same ethnic grouping.

Background Emerging data suggest that problem/pathological gambling may be highly prevalent among Asian-Pacific Islanders (APIs) and that can be a major concern to their communities. Methods This study surveyed problem/pathological gambling knowledge, attitudes, and perceived community impact of problem gambling among self-identified male and female APIs and non-APIs attending one of two API community events in Los Angeles County. Results Unexpectedly, our results indicated no effect for ethnicity with regards to ratings of problem/pathological gambling knowledge, community impact, or consequences. However, a gender effect with women reporting less problem/pathological-gambling-related knowledge than men, regardless of ethnicity was found. Over 40% of all respondents reported that problem/pathological gambling impacted their communities ‘a lot’, and the ratings for the impact of problem/pathological gambling was equal to ratings for other significant public health issues like diabetes, depression, drug abuse, and alcohol abuse. Discussion Based on these results, it is recommended that evidence-based legislation support the development of culturally-relevant prevention and intervention programs for problem/pathological gambling in Los Angeles County.

Establishing triage is necessary in mass casualty events. If the concept of triage itself is easy, its application in the field encounters many difficulties at times unforseen. MSF offers a list of the main obstacles encountered when establishing an efficient triage system.

HIV and AIDS have posed various medical, nutritional, social and economic problems, female-headed households being the most affected. Poor nutritional knowledge and dietary practices common among the most affected households significantly contribute to the rapid progression of HIV. However, very little data exist concerning these aspects of nutrition among women living with HIV and AIDS in resource-limited settings, such as Uganda. The aim of the study was to investigate the gaps in nutritional knowledge, attitudes, and practices and their relationship with sociodemographic characteristics in an urban population of women living with HIV and AIDS in Uganda. In total, 133 women living with HIV were interviewed using a pretested questionnaire. Most (89.5%) women reported being trained on the importance of nutrition for people living with HIV and AIDS (PLWHA) and believed that it is very important to consume a balanced diet (99.5%). On the contrary, only 21.8% consumed at least three meals per day and 39.8% at least six food-groups. They also reported higher dependency on starchy staples while foods of animal origin and fruits that play vital immunity and protective roles were inadequately consumed. Results of bivariate analysis indicated that consumption of a diversified diet was significantly associated with access to food-aid (p=0.006), possibly because access to food-aid reportedly enhances the ability of the household to access other food items. However, much is still needed to understand the drug-food interaction and dietary diversification and enhance proper dietary practices through sustainable projects that ensure increased access to food. Support groups of the PLWHA are a good vehicle for communication of nutrition information and implementation of nutrition-related projects.

This article reports the results of a qualitative study conducted in two villages of Matlab to explore the cultural dimensions of depression. Participants included adult men and women with and without a history of depressive episode (n=42), formal and informal healthcare providers (n=6), and caregivers (n=2). Adults (n=10) with a history of depressive episode were selected from a 2005 survey conducted by ICDDR,B. A case vignette was used for eliciting local terms for depression, perceived causes, impact, and treatments. Hardly anyone recognized the term bishonnota (literal translation of depression) used in the past survey. The participants thought that the vignette was about chinta rog (worry illness), and they spoke of somatic symptoms in relation to this condition. When explored further, they mentioned sadness and psychological complaints. Men felt that it affected them more while women felt the opposite. They associated chinta rog with poverty and social issues with impacts on marriage, work, and education. From their responses, it seemed that they preferred a psychosocial framework attributing the cause to thoughts and emotions, resulting from social causes. Commonly-suggested treatments were more income, better relationships, and tablets. Former health providers were often the first choice for help-seeking. The study hopes to 'culturally inform' the formal healthcare providers and programme planners.

Following the work of Hellman, this paper examines homosexism (the stigmatisation of non-penetrative sexual activities of men who have sex with men as non-sexual practices) in relation to hegemony, masculinity, and sexuality theories. In doing so, it discusses the function of sides, men who have sex with men but do not engage in penetrative sexual practices, in relation to the maintenance of established, normative, and damaging notions of masculinities. The central question this paper addresses is what the significance of the stigmatisation of sides is. In addressing this question, the potential of sides to facilitate and inhibit normative hegemonic structures is considered while more in-depth research is deemed necessary. The aim of this paper is to extend the discussion on homosexism, acknowledge non-penetrative sexual practices as legitimate forms of sexual expression, and encourage further scholarly research that focuses on the potential of sides to challenge and subvert established normative understandings of genders and sexualities, as well as the power structures that are involved in the construction of such understandings.

International audience; It is well known that entrepreneurship plays a key role in economic development; however, its cultural underpinnings remain a marginal field of study. This paper is an attempt to fill this gap. The development trend of the oil-rich United Arab Emirates (“UAE”) is at the heart of debates surrounding the effects of culture on economic choices and outcomes. In order to move away from an oil-based economy and provide private sector jobs for its growing number of nationals, the UAE has promoted and implemented diversification strategies over the last 20 years. Yet, less than 2% of the private sector workforce is composed of UAE nationals. The latter prefer working in the public sector because of better salary and working conditions. This paper seeks to explain the cultural foundations of the lack of entrepreneurship among UAE nationals. It conducts a survey among students from United Arab Emirates University and tests the determinants of their entrepreneurial intentions. It shows that the students’ culture is holistic and rather hostile to entrepreneurship. Such disinterest is stronger because of fear of stigmatization associated with business failure and because of social prestige associated with public sector jobs. Our results not only confirm the cultural specificity of Rentier States but also invite the launching of educational programs aimed at modifying students’ beliefs over entrepreneurship. Such cultural change seems inevitable in the context of a transition from an oil-based to a knowledge-based economy.; Les sciences économiques contemporaines ont redonné toute sa place à l’activité des entrepreneurs dans leur explication du développement. Les raisons des différentiels d’activité entrepreneuriale d’un pays à l’autre reste, en revanche, l’objet d’importants débats. Parmi ces raisons, il y a la culture. Cet article étudie sur la base d’une enquête menée auprès d’étudiants des Émirats Arabes Unis ("EAU") l’effet de la culture sur le désir d’entreprendre, de créer son entreprise. Le cas des EAU est emblématique de ces pays riches en ressource naturel mais qui pour préparer l’après pétrole s’interroge sur l’absence de classe entrepreneuriale et ses risques pour la soutenabilité de la croissance économique à long terme. Afin de s'éloigner d'une économie de rente et fournir aux nationaux des emplois dans le secteur privé, les EAU ont promu et mis en œuvre des stratégies de diversification au cours des 20 dernières années. Pourtant, moins de 2 % de la main-d'œuvre du secteur privé est composée de citoyens des EAU. Ces derniers préfèrent travailler dans le secteur public en raison des meilleures conditions de travail et de plus hauts salaires. A l’origine de ce désintérêt des émiratis pour l’entrepreneuriat il y a une culture singulière. L’enquête faite auprès des étudiants de l’université des EAU montre que la culture des étudiants est holistique et plutôt hostile à l'esprit d'entreprise. Ce désintérêt est d’autant plus prégnant que ces étudiants craignent d’être stigmatisés par leurs proches s’ils échouent et préfèrent le prestige social associé aux emplois publics. Ces résultats confirment non seulement la spécificité culturelle des Etats Rentier mais invitent également à lancer des programmes éducatifs visant à modifier les croyances des étudiants afin de les rendre plus réceptifs aux projets entrepreneuriaux. Un tel changement culturel est probablement vital dans le contexte de la transition d'une économie basée sur le pétrole à une économie fondée sur la connaissance.

The literature suggests that a whole-institution culture of academic integrity is needed in order to prevent academic integrity breaches. It is also suggested that the national cultures and individual backgrounds of academic staff and students can impact on their propensity to breach academic integrity policies and on their uptake of initiatives aimed at enhancing academic culture. Much research has been conducted on academic integrity related to culture in the western world including the behaviours of international students, and some work has been conducted in various Asian contexts. However, little is known about how national culture and religion affect academic integrity in eastern countries with a Muslim majority. This paper presents a synthesis of the literature related to academic integrity and culture in regions where Muslims are the majority. An integrative literature review was carried out. Keywords were used to search and to collect academic integrity related research published from 2010 to 2020. The literature reviewed revealed that academics in countries with a Muslim majority faced challenges related to their local cultures, which included social and religious perceptions and practices. However, they were also able to draw upon some national and religious practices that supported and enhanced academic integrity. This paper concludes with recommendations for incorporating these positive cultural factors into an academic integrity framework for policy and practice appropriate for Muslim contexts.

Education is in the core of societal change in all its different forms-from kindergartens to vocational schools and lifelong learning. Education-understood as goal-oriented personal movement-re-structures personal lives both inside school and outside the school. This special issue stems from the Cultural Psychology of Education (Marsico Culture & Psychology, 21(4), 445-454, 2015a, b, Journal for the Study of Education and Development, 40(4), 754-781, 2017)-a new approach to the field of education that examines how educational experience is culturally organized. This special issue is focused on the work of schooling as a crucial scientific arena to investigate. It is the follow up of an international workshop host by the Centre for Cultural Psychology (at Aalborg University, Demark) that was very thought provoking and from where several outcomes came out. Some of them are the papers here presented that tried to illuminate the different dimensions of the educational context in the East and West society with specific attention to the Chinese and Scandinavian educational practices. The dialogue between Chinese, European and North American scholars offered a complex view of the current educational challenges in the age of globalization. In this paper I try to focus on some of the most debated and challenging aspects in educational psychology worldwide: diversity, values and practical usability of psychology at school. I re-read these "hot topics" with the help of the themes developed by the authors of this special issue and in light of Cultural Psychology of Education. Then, I conclude by proposing a new agenda for the education of the future.

In this paper, we provide an overview of our ongoing project in the Genetics and Human Agency Initiative sponsored by the John Templeton Foundation. Our project focuses on the ways that lay beliefs about the heritability of virtue influence reasoning about the nature of virtue, parenting behaviors, and the development of virtue in children. First, we provide philosophical perspectives on the nature of virtue and suggest that viewing virtue as a malleable skill may have important advantages. Next, we review theory and research that highlights the ways that lay heritability beliefs potentially undermine conceptualizations of virtue as a malleable skill. Finally, we discuss how lay heritability beliefs might ultimately affect parent-child interactions and child virtue development. The paper thus provides a brief description our project's theoretical foundation and a general look at the empirical questions it will tackle.

Built heritage faces increasing pressures and threats from development and change in the contemporary world, a situation that frequently results in compromise or loss of historic fabric and its associated values. This paper examines how Heritage Impact Assessment (HIA) methodology specifically addresses and mitigates threats to built heritage within an overall sustainable development framework. The methodology will be explained and examples will be given from across Asia of HIA applications to the urban and rural built environment to illustrate how this can be achieved. These case studies reflect a variety of ways in which development and heritage come into conflict and have been selected to show how versatile and adaptable HIA can be as a tool for finding balance and solutions. HIA is an approach rooted in a balanced and sustainable relationship between ‘the needs of the present and future generations and the legacy from the past’ (UNESCO 2011). The paper also illuminates some of the basic assumptions on which HIA functions and some of the contradictions that often arise when the methodology is applied to real world problems.

Ontological issues have a bad reputation within mainstream psychology. This paper, however, is an attempt to argue that ontological reflection may play an important role in the development of cultural psychology. A cross-reading of two recent papers on the subject (Mammen & Mironenko, Integrative Psychological and Behavioral Science, 49(4), 681-713, 2015; Simao Integrative Psychological and Behavioral Science, 50, 568-585, 2016), aimed at characterizing their respective approaches to ontological issues, sets the stage for a presentation of Cornelius Castoriadis' ontological reflections. On this basis, a dialogue is initiated with E.E. Boesch's Symbolic Activity Theory that could contribute to a more refined understanding of human psychological functioning in its full complexity.

The purpose of this research is to investigate the relationship between innovation and human capital investment, and to show how the implementation of these two concepts leads to economic development. A case study was conducted in Jordan with one-to-one, in-depth expert interviews to obtain the information needed to answer the research questions; in addition, a focus group of ten final year undergraduate students (about to enter the educated workforce) experts offered their thoughts and ideas to identify how youth today relate to this research and its findings. The findings identified four main pillars required to support economic development and achieve a competitive advantage using the country’s human capital: Habilitation, Opportunity, Power Distance, and Entrepreneurship (HOPE). The findings also indicated that Jordanian culture is highly germane to all four pillars, which can encourage innovative human capital and ensure economic development. This paper is important to the Jordanian community and the Arab world in general, which lacks awareness of the importance of human capital in socio-economic development; the study helps understand innovation and economic development in the region. This paper explores the relationship between innovation and human capital investment, and shows how this combination will lead to the development of Jordanian culture and the economy.

This paper sets out to present a novel construal of one of the notions of Vygotskian cultural-historical theory viz., zone of proximal development (ZPD) drawing upon dynamic systems theory. The principal thesis maintains that ZDP is an emergent and dynamic system which is engendered by a dialectical concatenation of psychogenesic and sociogenesic facets of human development over time. It is reasoned that Vygotskian cultural-historical theory of human development, by invoking dialectical logic, has transcended Cartesian substance dualism and in turn has proffered a monistic and process-anchored ontology for emerging becoming of human consciousness. Likewise, it is contended that dynamic systems theory, having assumed fluent flux of reality with a capital R as its ontological axiom, entails a consilience of cognitive and contextual conceptual schemes to describe, explain, and optimize human development. The paper concludes by drawing some interpretive conclusions in regard to ZPD from dynamic systems theory perspective. peerReviewed

Christian Smith’s paper “The Incoherence of ‘Culture’ in American Sociology” is a valuable provocation that can prompt us to reflect on the role of concepts and on the role of agreement on the definition of concepts in scientific research. In this comment paper, I raise questions about Smith’s empirical expectation that sociologists should agree on a concept of culture based on debates in the sociology of science. I also suggest that in terms of the future agenda for the sociology of culture, we should distinguish between dialogue and clarification on the one hand, which I agree is needed, and standardization on the other hand, which seems incompatible with open-minded empirical research. Rather than work on agreement on what culture is, we might work on clarifying relevant distinctions among dimensions of culture.

Background This paper aims to examine the health care contexts shaping perinatal survival in remote mountain villages of Nepal. Health care is provided through health services to a primary health care level—comprising district hospital, village health facilities and community-based health services. The paper discusses the implications for future policies and practice to improve health access and outcomes related to perinatal health. The study was conducted in two remote mountain villages in one of the most remote and disadvantaged mountain districts of Nepal. The district is reported to rank as the country’s lowest on the Human Development Index and to have the worst child survival rates. The two villages provided a diversity of socio-cultural and health service contexts within a highly disadvantaged region. Methods The study findings are based on a qualitative study of 42 interviews with women and their families who had experienced perinatal deaths. These interviews were supplemented with 20 interviews with health service providers, female health volunteers, local stakeholders, traditional healers and other support staff. The data were analysed by employing an inductive thematic analysis technique. Results Three key themes emerged from the study related to health care delivery contexts: (1) Primary health care approach: low focus on engagement and empowerment; (2) Quality of care: poor acceptance, feeling unsafe and uncomfortable in health facilities; and (3) Health governance: failures in delivering health services during pregnancy and childbirth. Conclusions The continuing high perinatal mortality rates in the mountains of Nepal are not being addressed due to declining standards in the primary health care approach, health providers’ professional misbehaviour, local health governance failures, and the lack of cultural acceptance of formalised care by the local communities. In order to further accelerate perinatal survival in the region, policy makers and programme implementers need to immediately address these contextual factors at local health service delivery points. Electronic supplementary material The online version of this article (10.1186/s41043-018-0148-y) contains supplementary material, which is available to authorized users.

Background In recent years, Ireland has experienced a large-scale, outward migration of doctors. This presents a challenge for national policy makers and workforce planners seeking to build a self-sufficient medical workforce that trains and retains enough doctors to meet demand. Although, traditionally, medical migration has been considered beneficial to the Irish health system, austerity has brought a greater level of uncertainty to the health system and, with it, a need to reappraise the professional culture of migration and its impact on the Irish health system. Methods This paper illustrates how a culture of migration informs career and migration plans. It draws on quantitative data—registration and migration data from source and destination countries—and qualitative data—in-depth interviews with 50 doctors who had undertaken postgraduate medical training in Ireland. Results Of 50 respondents, 42 highlighted the importance of migration. The culture of medical migration rests on two assumptions—that international training/experience is beneficial to all doctors and that those who emigrate will return to Ireland with additional skills and experience. This assumption of return is challenged by a new generation of doctors whose professional lives have been shaped by globalisation and by austerity. Global comparisons reveal the comparatively poor working conditions, training and career opportunities in Ireland and the relative attractiveness of a permanent career abroad. Conclusion In light of these changes, there is a need to critically appraise the culture of medical migration to determine if and in what circumstances migration is appropriate to the needs of the Irish health system. The paper considers the need to reappraise the culture of medical migration and the widespread emigration that it promotes.

Background The World Health Organization recently made a recommendation supporting ‘culturally-appropriate’ maternity care services to improve maternal and newborn health. This recommendation results, in part, from a systematic review we conducted, which showed that interventions to provide culturally-appropriate maternity care have largely improved women’s use of skilled maternity care. Factors relating to the implementation of these interventions can have implications for their success. This paper examines stakeholders’ perspectives and experiences of these interventions, and facilitators and barriers to implementation; and concludes with how they relate to the effects of the interventions on care-seeking outcomes. Methods We based our analysis on 15 papers included in the systematic review. To extract, collate and organise data on the context and conditions from each paper, we adapted the SURE (Supporting the Use of Research Evidence) framework that lists categories of factors that could influence implementation. We considered information from the background and discussion sections of papers included in the systematic review, as well as cost data and qualitative data when included. Results Women’s and other stakeholders’ perspectives on the interventions were generally positive. Four key themes emerged in our analysis of facilitators and barriers to implementation. Firstly, interventions must consider broader economic, geographical and social factors that affect ethnic minority groups’ access to services, alongside providing culturally-appropriate care. Secondly, community participation is important in understanding problems with existing services and potential solutions from the community perspective, and in the development and implementation of interventions. Thirdly, respectful, person-centred care should be at the core of these interventions. Finally, cohesiveness is essential between the culturally-appropriate service and other health care providers encountered by women and their families along the continuum of care through pregnancy until after birth. Conclusion Several important factors should be considered and addressed when implementing interventions to provide culturally-appropriate care. These factors reflect more general goals on the international agenda of improving access to skilled maternity care; providing high-quality, respectful care; and community participation.

The question of whether individuals retain interests or can be harmed after death is highly contentious, particularly within the context of deceased organ retrieval, retention and use. This paper argues that posthumous interests and/or harms can and do exist in the Konkomba (and wider Ghanaian) traditional setting through the concept of ancestorship, a reputational concept of immense cultural and existential significance in this setting. I adopt Joel Feinberg's account of harms as a setback to interests. The paper argues that a socio-culturally sensitive regulatory framework does not necessarily exclude the donation of (deceased) human biomaterials for transplant and science research. Indeed, when customary values are explored with open-mindedness and sensitivity it may be shown that such donation can form part of the important customs of some communities in this jurisdiction. Accordingly, a context-appropriate governance framework could utilise the cultural value of ancestorship as an incentive to encourage organ donation in the Ghanaian traditional setting.

In the healthcare sector, race, ethnicity and religion have become an increasingly important factor in terms of patient care due to an increasingly diverse population. Health agencies at a national and local level produce a number of guides to raise awareness of cultural issues among healthcare professionals and hospitals may implement additional non-medical services, such as the provision of specific types of food and dress to patients or the hiring of chaplains, to accommodate the needs of patients with religious requirements. However, in an attempt to address the spiritual, cultural and religious needs of patients healthcare providers often assume that ethnic minority groups are homogenous blocks of people with similar needs and fail to recognize that a diverse range of views and practices exist within specific groups themselves. This paper describes the example of the Sikh community and the provision of palliative care in hospitals and hospices. Although, the majority of patients classifying themselves as Sikhs have a shared language and history, they can also be divided on a number of lines such as caste affiliation, degree of assimilation in the west, educational level and whether baptized or not, all of which influence their beliefs and practices and hence impact on their needs from a health provider. Given that it is unfeasible for health providers to have knowledge of the multitude of views within specific religious and ethnic communities and accounting for the tight fiscal constraints of healthcare budgets, this paper concludes by raising the question whether healthcare providers should step away from catering for religious and cultural needs that do not directly affect treatment outcomes, and instead put the onus on individual communities to provide resources to meet spiritual, cultural and religious needs of patients.

BACKGROUND: Open defecation is widely practiced in India. To improve sanitation and promote better health, the Government of India (GOI) has instituted large scale sanitation programmes supporting construction of public and institutional toilets and extending financial subsidies for poor families in rural areas for building individual household latrines. Nevertheless, many household latrines in rural India, built with government subsidies and the facilitation and support of non-government organizations (NGO), remain unused. Literature on social, cultural and behavioural aspects that constrain latrine adoption and use in rural India is limited. This paper examines defecation patterns of different groups of people in rural areas of Odisha state in India to identify causes and determinants of latrine non-use, with a special focus on government-subsidized latrine owners, and shortcomings in household sanitation infrastructure built with government subsidies. METHODS: An exploratory study using qualitative methods was conducted in rural communities in Odisha state. Methods used were focus group discussions (FGDs), and observations of latrines and interviews with their owners. FGDs were held with frontline NGO sanitation program staff, and with community members, separately by caste, gender, latrine type, and age group. Data were analysed using a thematic framework and approach. RESULTS: Government subsidized latrines were mostly found unfinished. Many counted as complete per government standards for disbursement of financial subsidies to contracted NGOs were not accepted by their owners and termed as 'incomplete'. These latrines lacked a roof, door, adequate walls and any provision for water supply in or near the cabin, whereas rural people had elaborate processes of cleansing with water post defecation, making presence of a nearby water source important. Habits, socialising, sanitation rituals and daily routines varying with caste, gender, marital status, age and lifestyle, also hindered the adoption of latrines. Interest in constructing latrines was observed among male heads for their female members especially a newlywed daughter-in-law, reflecting concerns for their privacy, security, and convenience. This paper elaborates on these different factors. CONCLUSIONS: Findings show that providing infrastructure does not ensure use when there are significant and culturally engrained behavioural barriers to using latrines. Future sanitation programmes in rural India need to focus on understanding and addressing these behavioural barriers.

The insignia worn by the British and Commonwealth Armed Services are rich in symbolism and meaning to the corps and regiments that wear them. Originally, before the adoption of national uniforms pre-1700s, there was little to distinguish friend from foe. To overcome that problem, certainly in battle, it was common practice to wear some sort of distinctive emblem, such as a sprig of a native plant. This then developed, in the reign of Charles II, to the custom of individual regiments or corps adopting devices and designs of their 'colours', through to modern cap and collar badges.On the centenary of the Royal Army Dental Corps, this paper gives some insight into those designs adopted by the Royal and Commonwealth Dental Corps, when a distinct service of dental care was recognised. They give a fascinating insight into the adoption and amalgamation of both national and dental symbols. The Dental Corps, separate from Army Medical Corps, went on to develop the vital provision of dental healthcare, both in the field and at home.

This paper analyses the nature of the relationship between risk and responsibility. Since neither the concept of risk nor the concept of responsibility has an unequivocal definition, it is obvious that there is no single interpretation of their relationship. After introducing the different meanings of responsibility used in this paper, we analyse four conceptions of risk. This allows us to make their link with responsibility explicit and to determine if a shift in the connection between risk and responsibility can be outlined. (1) In the engineer's paradigm, the quantitative conception of risk does not include any concept of responsibility. Their relationship is indirect, the locus of responsibility being risk management. (2) In Mary Douglas' cultural theory, risks are constructed through the responsibilities they engage. (3) Rayner and (4) Wolff go further by integrating forms of responsibility in the definition of risk itself. Analysis of these four frameworks shows that the concepts of risk and responsibility are increasingly intertwined. This tendency is reinforced by increasing public awareness and a call for the integration of a moral dimension in risk management. Therefore, we suggest that a form of virtue-responsibility should also be integrated in the concept of risk.

Subjective probabilities play a significant role in the assessment of evidence: in other words, our background knowledge, or pre-trial beliefs, cannot be set aside when new evidence is being evaluated. Focusing on homeopathy, this paper investigates the nature of pre-trial beliefs in clinical trials. It asks whether pre-trial beliefs of the sort normally held only by those who are sympathetic to homeopathy can legitimately be disregarded in those trials. The paper addresses several surprisingly unsuccessful attempts to provide a satisfactory justification for ignoring the pre-trial beliefs of the homeopathic community. The ensuing diagnosis of the difficulties here emphasizes that the reason the arguments for choosing the pre-trial beliefs of the conventional community seem insufficient is not the arguments per se. It is rather that there is no cogent argument for choosing the conventional stance which would at the same time rationally persuade a member of the homeopathic community. The paper concludes that, once we understand that this is the predicament, there is no genuine reason to doubt the reasoning that leads us to reject the pre-trial beliefs of the homeopathic community.

The focus of this paper is the intercultural process through which Open Mole and trauma-related mental illnesses are brought together in the postconflict mental health encounter. In this paper, I explore the historical dimension of this process by reviewing the history of Open Mole, and the ways in which it has been interpreted, acted on, and objectified by external observers over the last half-century. Moving into Liberia's recent war and postconflict period, I examine the process by which Open Mole is transformed from a culture-bound disorder into a local idiom of trauma, and how it has become a gateway diagnosis of PTSD-related mental illnesses, and consider how it is produced as an objectified experience of psychiatric disorder in clinical humanitarian contexts. By studying how Open Mole is transformed in the humanitarian encounter, I address the structure and teleology of the humanitarian encounter and challenge some of the foundational assumptions about cultural sensitivity and community-based mental health care in postconflict settings that are prevalent in scholarship and practice today.

The purpose of this paper is to integrate the literature on family and social ties among older ethnic minority men and women with the literature on chronic illness self-care among elders in these groups, in order to increase understanding of social influences on self-care behavior, raise questions for future research, and inform culturally appropriate interventions to maximize the health-promoting potential of social relationships. The paper presents demographic and chronic illness prevalence information, and then summarizes literature about patterns of chronic illness self-care behaviors for older African-Americans, Latinos, Asian-Americans, and American Indians in the U.S. For each group, the sociological literature about residential, cultural, and socioeconomic patterns, family lives, and other social ties is then reviewed, and the self-care literature that has accounted for these patterns is discussed. Finally, six themes are outlined and related questions are identified to further illuminate the social context of older adults' chronic illness self-care.

This paper provides an analytical model representing four polar ethical approaches drawn from the main ethical positions suggested by the philosophical, psychological, and socio-economic literature. Moreover, it develops the model in order to obtain rankings of the four approaches in terms of happiness and, consequently, to provide insights into which ethical approach should best be adopted by each individual, according to his characteristics (income level, in developed countries (DCs) or in less developed countries (LDCs), aspiration level): some dynamics are also predicted, if the Golden and the Copper Rules are applied. Finally, this paper provides insights into which ethical approach should best be adopted by each society, according to its characteristics (DCs or LDCs, social distribution of aspiration levels), by predicting happiness levels in alternative countries, according to the prevailing ethics, and by comparing these predictions with the observed happiness levels, thus providing an empirical test of the analytical model: some dynamics are again predicted, with non-Protestant DCs moving to higher, and Protestant DCs towards lower, happiness levels (conditioned to the per capita income), due to the increasing and decreasing rejection of the Golden and Copper Rules, respectively, and with LDCs moving to lower (conditioned to the increasing per capita income) in the short-run and higher happiness levels in the long run, by establishing and entertaining conditions that set clear incentives for moral behaviour, in order to increase and decrease the adoption of the Golden and Copper Rules, respectively.

A wide variety of countries are seeking to attract international medical students. This could be due to the fact that their universities not only receive the economic benefit from these students, but also because they recognise the issues of cultural diversity and pedagogical practice. This review paper draws on literature to understand more fully the learning process of Asian international students. Whereas views on learning are different across cultures, medical school teachers must understand how Asian international students learn based on their culture. Two general themes emerged from the literature review: firstly culture's influence on learning and secondly memorisation versus understanding, both of which relate to the learning process of Asian international students. This study shows that Asian international students have a different approach to learning, which is not just about rote learning. Changes in attitudes towards Asian international students may stimulate the internationalisation of a more culturally sensitive form of medical education. The paper suggests further work on the area of appreciative thinking in order to identify the epistemological and ontological dimensions for a flexible approach to learning.

The papers in this special section of CMP explore new terrain in the cultural shaping of traumatic experience. The authors describe nightmares occurring in association with trauma across diverse settings. The innovative ethnographic work presented in these papers circles around basic questions about dreams and nightmares. What kind of experiences are nightmares? To what extent does their function, form and content follow from the neurobiology of dreaming? Put another way, what accounts for the admixture of biology, personal experience and cultural content in dreams? More specifically, in the case of nightmares related to trauma, how much of their content follows from the neurophenomenology of dreaming, how much reflects specific trauma memories and experiences and how much is a result of the dreamer’s imagination and interpretation operating either during the dream experience itself or on later recollection and recounting to others? Answers to these questions are crucial for any understanding of the potential links between dreams and trauma exposure and have clinical relevance for those seeking to understand and assist patients suffering from recurrent nightmares.

Bioethics, the term now usually standing in for Biomedical Ethics, is a field of medical anthropological engagement. While many anthropologists and other social scientists work with bioethicists and physicians, this paper instead takes Bioethics as a topic of cultural research from the perspective of Cultural Bioethics and Interpretive Medical Anthropology. Application of useful findings of vintage anthropological research in cultural anthropology and the anthropology of religion and an interpretive lens reveal a field without a single origin or unified methodology. The paper suggests the appropriateness of a literal meaning of current conceptual commonality of the term Bioethics: that the term does in fact refer to a plurality of distinct enterprises with distinct origins and, hence, justifications.

Dreams have been central in the birth and evolution of psychoanalysis. This paper explores the remarkable story of the relationship between dreams and psychoanalysis as a modern version of the long history of dreams in most healing traditions. But psychoanalysis seems to have turned away from dreams as central inspiration in a way parallel to the general culture's turn away from dreams and the reality of inner life. Yet modern postindustrial culture is transfixed by a version of "dream life" in ways just beginning to be understood (e.g., in the transformation of ancient interest in the inner screen to the external screen). Working with dreams in psychoanalytic psychotherapy was a creative and revolutionary act for our forebears. It is even more so today, in ways that are discussed in this paper.

In this paper, we describe the value and philosophy of lifeworld-led care. Our purpose is to give a philosophically coherent foundation for lifeworld-led care and its core value as a humanising force that moderates technological progress. We begin by indicating the timeliness of these concerns within the current context of citizen-oriented, participative approaches to healthcare. We believe that this context is in need of a deepening philosophy if it is not to succumb to the discourses of mere consumerism. We thus revisit the potential of Husserl's notion of the lifeworld and how lifeworld-led care could provide important ideas and values that are central to the humanisation of healthcare practice. This framework provides a synthesis of the main arguments of the paper and is finally expressed in a model of lifeworld-led care that includes its core value, core perspectives, relevant indicative methodologies and main benefits. The model is offered as a potentially broad-based approach for integrating many existing practices and trends. In the spirit of Husserl's interest in both commonality and variation, we highlight the central, less contestable foundations of lifeworld-led care, without constraining the possible varieties of confluent practices.

Eating Disorders, particularly anorexia and bulimia, are of immense contemporary importance and interest. News stories depicting the tragic effects of eating disorders command wide attention. Almost everybody in society has been touched by eating disorders in one way or another, and contemporary obsession with body image and diet fuels fascination with this problem. It is unclear why people develop eating disorders. Clinical and sociological studies have provided important information relating to the relational systems in which eating disorders are mainly found. This paper shows that their explanations are not conclusive and points out that the reasons why people develop eating disorders should not be found in the dysfunctional interactions occurring in both familial and social systems, but in the moral beliefs that underlie these interactions. Eating disorders are impossible to understand or explain, unless they are viewed in the light of these beliefs. A moral logic, that is a way of thinking of interpersonal relations in moral terms, gives shape to and justifies the clinical condition, and finds consistent expression in abnormal eating behaviour. The analysis offered here is not mainstream either in philosophy (eating disorders are in fact seldom the subject of philosophical investigation) or in clinical psychology (the methods of philosophical analysis are in fact seldom utilised in clinical psychology). However, this paper offers a important contribution to the understanding of such a dramatic and widespread condition, bringing to light the deepest reasons, which are moral in nature, that contribute to the explanation of this complex phenomenon.

Background: The rise of genomic studies in Africa – not least due to projects funded under H3Africa – is associated with the development of a small number of biorepositories across Africa. For the ultimate success of these biorepositories, the creation of cell lines including those from selected H3Africa samples would be beneficial. In this paper, we map ethical challenges in the creation of cell lines. Discussion: The first challenge we identified relates to the moral status of cells living in culture. There is no doubt that cells in culture are alive, and the question is how this characteristic is relevant to ethical decision-making. The second challenge relates to the fact that cells in culture are a source of cell products and mitochondrial DNA. In combination with other technologies, cells in culture could also be used to grow human tissue. Whilst on the one hand, this feature increases the potential utility of the sample and promotes science, on the other it also enables further scientific work that may not have been specifically consented to or approved. The third challenge relates to ownership over samples, particularly in cases where cell lines are created by a biobank, and in a different country than where samples were collected. Relevant questions here concern the export of samples, approval of secondary use and the acceptability of commercialisation. A fourth challenge relates to perceptions of blood and bodily integrity, which may be particularly relevant for African research participants from certain cultures or backgrounds. Finally, we discuss challenges around informed consent and ethical review. Summary: In this paper, we sought to map the myriad of ethical challenges that need to be considered prior to making cell line creation a reality in the H3Africa project. Considering the relative novelty of this practice in Africa, such challenges will need to be considered, discussed and potentially be resolved before cell line creation in Africa becomes financially feasible and sustainable. We suggest that discussions need to be undertaken between stakeholders internationally, considering the international character of the H3Africa project. We also map out avenues for empirical research.

This paper analyses culture as a determinant of technology adoption in a developing country. While the literature discusses the influence of culture upon economic growth, little attention has been paid to the mechanisms at the micro level. Therefore, we postulate that culture plays a crucial role in hindering or fostering the diffusion of innovation, a key trigger of the engine of growth. This empirical study uses the Ethiopia Rural Household Survey to disentangle between individual cultural traits, namely, ethnicity and religion, and the cultural homogeneity of the environment as co-determinants of fertiliser adoption. To examine our hypotheses, we apply a multivariate survival model for clustered and correlated observations to account for time and location effects. The results reveal significant differences in the probability of adopting fertiliser among cultural groups. Moreover, habits and social norms, proxied by ethnicity, provide a better explanation for the role of culture, than religious beliefs, as usually posited in the literature. Also, the cultural environment turns out tobe a decisive trigger. The probability of adoption is higher in rural societies with a homogeneous ethnic environment but distinct religious variety.

This paper tries to shed a fresh light on the use of several key terms in traditional Chinese medicine (and philosophy) related to the theory of so-called systematic correspondence. Drawing on some influential works in Chinese science and civilization (e.g., Marcel Granet, Joseph Needham, Nathan Sivin), the paper argues that the idea of rhythm, properly defined, should become an organizing idea in studying the traditions of Chinese thinking and practice in medicine as well as in general. Rhythmicity is not periodicity (though they are inseparable from one another) and the idea of rhythm is more useful (than for example the notion of correspondence) for medical anthropology. The paper is divided into three parts: 1) the idea of rhythm in some key terms of traditional Chinese medicine, 2) the Chinese theory of resonance versus the idea of rhythm, and 3) the relation of resonance, rhythm and ecstatic experiences with respect to medical anthropology. An acquaintance with the arguments of my previous article in these pages will be helpful but not necessary for the present paper.

Agrarian rural dwellers in Nigeria produce about 95% of locally grown food commodities. The low accessibility to and affordability of orthodox medicine by rural dwellers and their need to keep healthy to be economically productive, have led to their dependence on traditional medicine. This paper posits an increasing acceptance of traditional medicine country-wide and advanced reasons for this trend. The fact that traditional medicine practitioners' concept of disease is on a wider plane vis-à-vis orthodox medicine practitioners' has culminated in some socio-cultural and magico-religious practices observed in preparation and use of plant medicines for farmers' health management. Possible scientific reasons were advanced for some of these practices to show the nexus between traditional medicine and orthodox medicine. The paper concludes that the psychological aspect of traditional medicine are reflected in its socio-cultural and magico-religious practices and suggests that government should fund research into traditional medicine to identify components of it that can be integrated into the national health system.

Strong disciplinary academic fragmentation and sectoral division in policies lead to problems regarding the management of landscapes. As a result, there is a focus on the preservation and development of either cultural or natural landscapes. We argue that framing landscapes as “natural” or “cultural” will not help sustainable management. The goal of this paper is to show that even what is referred to as nature, virtually always features an intricate combination of physical geography, biology, and cultural history. It provides an analytical framework that visualizes the three forces at play in physical landscapes. Therefore, we introduce a diachronic triangular approach to study and manage landscapes from a holistic point of view, allowing an exchange of different perspectives. To test this approach, we have applied our model to a diachronic case study on Wadden Sea salt marshes. That area has been influenced by physical-geographical, biological, and cultural landscape forces, which are still visible in the landscape to a large extent. By placing different landscape zones in the triangular concept for different time periods, we can identify and visualize these driving forces through time for this specific landscape. These all play their specific roles in the appearance of the landscape over time in a close mutual interconnection. More importantly, we show that the diverse and complex interplay between these forces makes the current-day landscape what it is. We therefore conclude that the diachronic triangular approach provides a conceptual tool to define and operationalize landscape management in the Wadden Sea area. We welcome similar approaches in other landscapes to assess the usefulness of the diachronic triangular landscape approach.