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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

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.

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.

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.

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.

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.

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.

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 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.

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.

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...

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 .

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

This paper explores religious perceptions of disasters and their implications for post-disaster processes of religious and cultural change. Based on ethnographic fieldwork in post-tsunami Samoa, this study investigates how people in two tsunami-affected villages make sense of the tsunami, its causes and impact based on different Christian understandings: the tsunami as divine punishment or as a sign of the Second Coming. I argue that these different perceptions of the tsunami are used in bringing about or opposing religious and cultural change based on different ideals of continuity and change.

American Indian (AI) adolescents living on reservations report much higher substance use rates compared to other youth yet there are few effective prevention interventions developed for them. This paper presents findings from formative research undertaken to guide adaptation for AI youth of a prevention intervention, Be Under Your Own Influence (BUYOI), previously found to be effective in reducing substance use among middle-school youth. We conducted focus groups with 7(th) graders, the primary target audience, and photovoice with 11(th) graders, the role models who would help deliver the campaign, to inform surface and deep structure adaptation. Both age groups noted the pervasiveness of substance use on the reservation and indicated that this posed a major challenge to being drug and alcohol free. Students also described aspects of their community that tied to signs of social disorganization. However, these youth have much in common with other youth, including high future aspirations, involvement in activities and hobbies, and influence from family and friends. At the same time, there were important differences in the experiences, environment, and values of these AI youth, including emphasis on different types of activities, a more collectivist cultural orientation, tribal identity and pride, and the importance of extended families.

Background The World Health Organization highlights that patient safety interventions are not lacking but that the local context affects their successful implementation. Increasing attention is being paid to patient safety in Mainland China, yet few studies focus on patient safety in organizations with mixed cultures. This paper evaluates the current patient safety culture in an experimental Chinese hospital with a Hong Kong hospital management culture, and it aims to explore the application of Hong Kong’s patient safety strategies in the context of Mainland China. Methods A quantitative survey of 307 hospital staff members was conducted using the Hospital Survey on Patient Safety Culture questionnaire. The findings were compared with a similar study on general Chinese hospitals and were appraised with reference to the Manchester Patient Safety Framework. Results Lower scores were observed among participants with the following characteristics: males, doctors, those with more work experience, those with higher education, and those from the general practice and otolaryngology departments. However, the case study hospital achieved better scores in management expectations, actions and support for patient safety, incident reporting and communication, and teamwork within units. Its weaknesses were related to non-punitive responses to errors, teamwork across units, and staffing. Conclusions The case study hospital contributes to a changing patient safety culture in Mainland China, yet its patient safety culture remains mostly bureaucratic. Further efforts could be made to deepen the staff’s patient safety culture mind-set, to realize a “bottom-up” approach to cultural change, to build up a comprehensive and integrated incident management system, and to improve team building and staffing for patient safety., Video abstract

This study explores what South African township youth presented as significant elements in their identity shaping. The youth participants were invited to take photographs and engage in reflective writing to explain the significance of what they had photographed. The theoretical framework is post modern and post apartheid views of identity, where language is the medium for expressing experiences, feelings and identity. We used a methodological framework of participatory research, in which participants engage in the process of research actively by reflecting on the lives of their own or their communities. Thirteen previously disadvantaged Grade 11 students took photos every day for a week. After which the students selected their most significant photos to write their narratives. This paper focuses on the texts that the students wrote to explain their photographs. The students’ photos and texts showed that democracy, family, present context and culture, have most influence on young people's lives.

In this special issue of Anatolia, we explore a number of new trends and products related to cultural tourism, searching for a deeper understanding of how culture is becoming a central factor of attraction in tourism. Contributed papers deal with a number of on-going trends in cultural tourism, including the importance of heritage valuing for sustainability of destinations, the raising wave of religious travels in Arab countries recently opening to tourism, or the analysis of interactions between cultural visitors and local residents This work was supported by Groups of Excellence Program of Fundación Séneca, Science and Technology Agency of the Region of Murcia [project number 19884/GERM/15]

From research in central Chhattisgarh, this paper interprets the bearing that healthcare beliefs and practices may have in shaping maternal and child nutrition both in the light of biomedical recommendations and within the context and constraints of a rural village setting. It contends that health beliefs and practices that are at variance from biomedical recommendations appear to have few consequences for gestational nutrition and for child health in relation to pregnancy. In the postpartum however, health ideas at variance from biomedical recommendations appear to have an important bearing on maternal nutrition and infant feeding, and may put mothers and children at risk of nutritional deficiency. Maternal 'eating down' following a surgical procedure such as a caesarean delivery or tubectomy is especially noteworthy, since food intake quantity is reduced over an extended time frame. While caring practices are influenced by cultural formulations, they also reflect, perhaps, adaptations to health risks.

In this paper we use narrative analysis to consider how the discursive resources that come with living 'in between' countries and cultures unfold in personal stories. We do this by presenting a close analysis of two transcripts drawn from a study about the vulnerability to HIV faced by Chinese immigrants to Canada. Our goal is to illustrate the application of narrative analysis and highlight the contributions it can make to conceptualising how transnationalism becomes consequential in accounts of intimate life. In narrative terms, transnationalism lends each life situation dual or multiple interpretive frameworks. Migrants from China to Canada situate their personal stories in relation to social and cultural norms and features of both nations. Yet, as our analysis makes apparent, 'Canada' and 'China' do not carry singular or consistent meanings in migrants' stories. Attention to the role of stories in self-making allows us to better understand why transnational contexts appear as they do in narrative accounts, and responds to calls for more accurate mappings of the interface between transnationalism and the subject. Attention to how stories are 'put together' shows that transnational discursive resources are assembled in ways that bolster, and also undermine, entitlements to safe and equitable intimate relationships.

The paper will examine the intersection between Sangh Parivar activities, Christianity, and indigenous religions in relation to the state of Nagaland. I will argue that the discourse of ‘religion and culture’ is used strategically by Sangh Parivar activists to assimilate disparate tribal groups and to envision a Hindu nation. In particular, I will show how Sangh activists attempt to encapsulate Christianity within the larger territorial and civilisational space of Hindutva (Hinduness). In this process, the idea of Hindutva is visualised as a nationalist concept, not a theocratic or religious one (Cohen 2002: 26). I will argue that the boundaries between Hindutva as cultural nationalism and its religious underpinnings are usefully maintained in the context of Nagaland because they allow Sangh activists to reconstitute the limits of Christianity and incorporate it into Hindu civilisation on their own terms.

This paper explores the dynamics of change in meaning-making about female genital cutting among migrants from Somalia and Sudan residing in Norway. In both countries, female genital cutting is almost universal, and most women are subjected to the most extensive form - infibulation - which entails the physical closure of the vulva. This closure must later be re-opened, or defibulated, to enable sexual intercourse and childbirth. Defibulation can also ease other negative health consequences of the practice. In Norway, surgical defibulation is provided on demand by the public health services, also beyond the traditional contexts of marriage and childbirth. This study explores experiences and perceptions of premarital defibulation. It explores whether Somali and Sudanese men and women understand defibulation as a purely medical issue or whether their use of the services is also affected by the cultural meaning of infibulation. This study analyses data from in-depth interviews with 36 women and men of Somali and Sudanese origin as well as participant observation conducted in various settings during 2014-2015. It reports that although all of the informants displayed negative attitudes towards infibulation, cultural meanings associated with virginity and virtue constitute a significant barrier to the uptake of premarital defibulation.

Yanbu, on the Red Sea, is an affluent Saudi Arabian industrial city of modest size. Substantial effort has been spent to balance environmental quality, especially air pollution, and industrial development. We have analyzed six years of observations of criteria pollutants O3, SO2, particles (PM2.5 and PM10) and the known ozone precursors-volatile organic compounds (VOCs) and nitrogen oxides (NOx). The results suggest frequent VOC-limited conditions in which ozone concentrations increase with decreasing NOx and with increasing VOCs when NOx is plentiful. For the remaining circumstances ozone has a complex non-linear relationship with the VOCs. The interactions between these factors at Yanbu cause measurable impacts on air pollution including the weekend effect in which ozone concentrations stay the same or even increase despite significantly lower emissions of the precursors on the weekends. Air pollution was lower during the Eids (al-Fitr and al-Adha), Ramadan and the Hajj periods. During Ramadan, there were substantial night time emissions as the cycle everyday living is almost reversed between night and day. The exceedances of air pollution standards were evaluated using criteria from the U.S. Environmental Protection Agency (EPA), World Health Organization (WHO), the Saudi Presidency of Meteorology and Environment (PME) and the Royal Commission Environmental Regulations (RCER). The latter are stricter standards set just for Yanbu and Jubail. For the fine particles (PM2.5), an analysis of the winds showed a major impact from desert dust. This effect had to be taken into account but still left many occasions when standards were exceeded. Fewer exceedances were found for SO2, and fewer still for ozone. The paper presents a comprehensive view of air quality at this isolated desert urban environment.Frequent VOC-limited conditions are found at Yanbu in Saudi Arabia that increase ozone pollution if NOx is are reduced. In this desert environment, increased nightlife produces the highest levels of VOCs and NOx at night rather than the day. The effects increase during Ramadan. Fine particles peak twice a day-the morning peak is caused by traffic and increases with decreasing wind, potentially representing health concerns, but the larger afternoon peak is caused by the wind, and it increases with increasing wind speeds. These features suggest that exposure to pollutants must be redefined for such an environment.

Made available in DSpace on 2018-11-26T17:28:16Z (GMT). No. of bitstreams: 0 Previous issue date: 2017-06-01 It is acknowledged that knowledge and knowledge bases are an important part of coach and athlete learning and that the coach - athlete relationship is crucial to knowledge created, shared and used. This said knowledge about nutrition as constructed by elite gymnasts would seem particularly important in a culture long associated with weight control practices and disordered eating. This paper provides an insight into the ways that 10 Brazilian Olympic gymnasts construct ideas pertaining to nutritional knowledge across generational periods (between 1980 and 2004) where significant organisational change in Women's Artistic Gymnastics in Brazil occurred and included the introduction of dieticians. Drawing upon different knowledge types and paying attention to the coaching context, the life histories of 10 Olympic gymnasts were used to open a window on knowledge construction pertaining to nutrition by three generations of gymnasts. The findings draw attention to two main illustrative themes. Firstly, coaches' personal knowledge, whilst perceived as incomplete by gymnasts, reinforced a narrative of weight loss for gymnasts regardless of generation. Secondly, the younger generations of gymnasts perceived that the introduction of dieticians into structured provision enabled them to use better structured knowledge, and with it a sense of increased autonomy and corporeal learning via the construction of tacit embodied knowledge leading to healthier practices. Reflections are given to the role of the coach, dieticians and pedagogical actions, and the continued reshaping of knowledge in elite gymnastics. Cardiff Metropolitan Univ, Cardiff Sch Sport, Cyncoed Campus,Cyncoed Rd, Cardiff CF23 6XD, S Glam, Wales State Univ Sao Paulo, Dept Phys Educ, Rio Claro, Brazil Univ Estadual Campinas, Fac Phys Educ, Exercise Physiol Lab, Campinas, SP, Brazil State Univ Sao Paulo, Dept Phys Educ, Rio Claro, Brazil

The importance of sociocultural constructs as influences on cancer attitudes and screening has been established in the literature. This paper reports on the efforts to explore alternatives to sociocultural constructs previously associated with African-American cancer screening, but with low acceptance among community members or incomplete measurement (empowerment and collectivism) and develop a measure for a recently identified construct of interest (privacy). We report preliminary psychometric data on these sociocultural scales and their associations with cancer attitudes. African-Americans (N = 1021), 50-75 years of age participated in this study. Participants were identified via a listed sample and completed a telephone survey administered via call center. Sociocultural attitudes were assessed using items identified through computerized database searches, reviewed by advisory panels, edited and tested using cognitive response strategies. Cancer screening pros and cons, cancer worry, perceived cancer risk, colorectal cancer (CRC) screening subjective norms, and perceived self-efficacy for colorectal cancer screening (CRCS) were also assessed. Confirmatory factor analyses and multivariate analyses were conducted to provide support for the validity of the constructs and to understand the associations among the selected sociocultural constructs (empowerment, collectivism, and privacy) and cancer beliefs and attitudes (CRC perceived benefits and barriers, perceived risks, subjective norms, and perceived behavioral control/self-efficacy). Consistent with the literature, the factor analytic model (RMSEA for the model was .062; 90% CI: .060-.065) provided support for the empowerment, collectivism, and privacy constructs. The modified collectivism and privacy scales had acceptable reliability. The privacy scale demonstrated the strongest associations with measures of cancer beliefs and attitudes. The implication of the findings and need for further scale development activities is discussed.

The purpose of this paper is to explicate a change model for caregivers of persons with dementia to assist them in facilitating meals in the home, at community-based programs and in institutional settings. Building on a Social Ecological Model, the C3P Model-Change the Person, Change the People, Change the Place offers a clear method to adapt care strategies to foster independence while providing appropriate support as the person with dementia cognitively and functionally declines. Meals are highly embedded within a culture and are ritualized events within a family requiring an individualized approach when modifications are needed.

Current international debates and policies on safe motherhood mainly propose biomedical interventions to reduce the risks during pregnancy and delivery. Yet, the conceptualisations of risk that underlie this framework may not correspond with local perceptions of reproductive dangers; consequently, hospital services may remain underutilised. Inspired by a growing body of anthropological literature exploring local fertility-related fears, and drawing on 15 months of fieldwork, this paper describes ideas about risky reproduction and practices of pregnancy protection in a Cameroonian village. It shows that social and supernatural threats to fertility are deemed more significant than the physical threats of fertility stressed at the (inter)national level. To protect their pregnancies from those social and supernatural influences, however, women take very physical measures. It is in this respect that biomedical interventions, physical in their very nature, do connect to local methods of pregnancy management. Furthermore, some pregnant women purposefully deploy hospital care in an attempt to reduce relational uncertainties. Explicit attention to the intersections of the social and the physical, and of the supernatural and the biomedical, furthers anthropological knowledge on fertility management and offers a starting point for more culturally sensitive safe motherhood interventions.

This paper explores notions of fatherhood and their linkages to fertility desires and intentions among a treatment-naïve cohort of Xhosa-speaking male key informants living with HIV, aged 20-53 in Cape Town, South Africa. Analysis is based on an initial 27, and 20 follow-up, interviews with men who were part of a study that assessed the acceptability of safer conception and alternative parenting strategies among men and women newly diagnosed with HIV to inform an intervention. Grounded theory analysis revealed themes related to the cultural imperative of biologically-connected fatherhood. Certain safer-conception strategies aimed at minimising the risk of HIV transmission were perceived as threats to paternity. These findings suggest that understanding of social and cultural beliefs related to notions of paternity and fatherhood may inform the implementation of acceptable safer-conception options for HIV-positive men and their infected and uninfected female partners in a high-HIV prevalence, low-resource setting.

This paper explores the new event in the Olympic Movement, the Youth Olympic Games (YOG) in Innsbruck, Austria, in 2012, and examines the similarities and differences between the winter editions of the YOG and the Olympic Games (OG). The qualitative case study utilised a stakeholder approach and revealed four main groupings that differed in relative salience as compared to the OG: the host core stakeholders, international core stakeholders, sponsors and media, and parents and other stakeholders. From an external perspective, the YOG had the general ‘look-and-feel’ of the OG, despite their smaller size and relatively lesser involvement by sponsors and the media. However, this may have helped showcase the Olympic Movement tenets like those presented in the Culture and Education Programme. The YOG were thus closer to the Olympic ideals than the OG. We further discuss this and other paradoxes and disconnects requiring further debate and analysis.

Biologising the problems of reading has a long tradition. However, modern and non-invasive techniques, like functional magnetic resonance imaging (fMRI), that allow the mapping of changes in brain hemodynamic that corresponds to mental operations, boosted a wave of new research on the subject. This paper traces the history of treating a problem in teaching/learning as a disease-like condition. It also examines the beliefs of professionals in relation to dyslexia, and how they are biased by published research and the imbalance between biological and educational perspectives in published research. Overall, the educational perspective is underrepresented in published research about dyslexia, while the biological perspective is overrepresented. This is puzzling since to date biological perspectives have not produced any effective interventions for dyslexia, and almost all major claims for the biological view remain unproven. Nevertheless, biological models have a great influence on the beliefs of practitioner...

This paper discusses the limitations of previous research on race, ethnicity, culture, and substance use. The study offers the following recommendations for future research in this area: (1) move beyond simple comparisons of mutually exclusive groups, (2) focus on the meaning of an ethnic label to the individual, (3) consider the complex interactions between an individual's cultural identity and the cultural context, (4) understand and acknowledge the researcher's inherent biases, and (5) translate research findings into practice and policy change.

HIV/AIDS is devastating sub-Saharan Africa with great impact in the rural communities. Though prevention is the mainstay of various responses to the epidemic, communication strategies used to influence risk perception and motivate behavior change are culturally inappropriate, hence the lack of success. The bulk of prevention efforts target the 15-49 age group, resulting in limited knowledge and understanding of HIV/AIDS in adults over age 50 who are considered at a lower or no risk of infection. This paper addresses older adults as a key segment of the population in HIV/AIDS prevention given the increasing number that is living with the disease or newly infected. Many older adults are also caregivers of those infected and affected by the disease. As cultural, social, political, and opinion leaders in rural Kenya, older adults are in a position to influence attitudes and behaviors of their community members, but they have not been involved in the current intervention strategies. Through application of a participatory and culture-centered approach, the study sought views of older adults on the factors contributing to the epidemic in rural Kenya and their opinions on effective prevention strategies that are culturally appropriate. Several recommendations are made for a culture-specific HIV/AIDS prevention intervention for rural Kenya.

Previous studies have identified several factors to be associated with physical activity (PA) among African-Americans, e.g., demographic and health-related characteristics. Formative studies suggest a link between sociocultural factors and PA among ethnic minorities; yet, it is unclear whether these factors play a role in PA among African-Americans. This paper explores the association of selected sociocultural characteristics with self-reported PA by gender among African-American adults, taking into account demographic and health-related characteristics.Data from the baseline survey of a colorectal cancer communication intervention trial were used. Participants included 446 African-American men and women, aged 45-75 years. Self-report data were collected on demographics, health-related characteristics, selected sociocultural constructs (e.g., ethnic identity, religiosity, collectivism, and medical mistrust), and PA. PA was categorized as meeting or not meeting recommended levels; recommended levels were defined as participating in vigorous PA for 20 minutes/day for at least three days/week or moderate PA for 30 minutes/day for at least five days/week or a minimum of 600 MET-minutes/week in at least five days. Chi-square and multivariate logistic regression models were used to characterize the association between the selected sociocultural constructs and PA among men and women, after adjusting for demographic and health-related characteristics.Most participants reported some PA but only 59% were found to be meeting recommended levels. Univariate analyses revealed that high collectivist attitudes were associated with meeting recommended PA (OR = 1.74), particularly for women (OR = 1.81). In multivariate analyses, high collectivist attitudes were significantly associated with meeting PA recommendations among men (OR = 1.87); while high religiosity and high collectivism were significant among women (OR = 1.87 and 1.85, respectively).Few of the selected sociocultural characteristics were found to be associated with meeting recommended PA levels. Further study is needed to understand the association of these characteristics with PA among African-Americans.

The connection between the AIDS epidemic and the efflorescence of religious 'enthusiasm' (construed in both classical and contemporary senses) in Africa in recent decades is best understood, this paper argues, by reference to a concept of 'spiritual insecurity'. The article offers a general description of the condition of spiritual insecurity and argues that it is best studied within a relational realist paradigm. The article presents a critique of the concept of 'belief' as commonly used in the social science of religion, arguing instead for an opening of the study of social relations to include the universe of relations within which people experience the world, including their relations with entities such as spiritual beings that might otherwise be considered virtual.

Integrating HIV prevention into substance abuse counselling is recommended to ameliorate the health outcomes of men who have sex with men. However, culture-based countertransferences (CBCs) may hamper this effort. Using a case illustration, this paper will explain the manifestation of CBCs held among substance abuse counsellors and how they hinder counsellors’ work with men who have sex with men. The following CBCs will be explored: distancing, topic avoidance, heteronormativity, assumptions and denying client strengths. These CBCs allow counsellors to avoid discussions about sexual practices and curtail HIV prevention counselling, while undermining the counsellor-client relationship. Based on the empirical literature on HIV and substance abuse prevention with men who have sex with men, we provide recommendations to help counsellors overcome CBCs and integrate HIV prevention consistently with men who are in treatment for substance abuse.

Central Asia has experienced a rapid increase in HIV. HIV interventions and prevention programmes are needed that adequately appreciate and account for the ways that ongoing cultural, political, and economic changes in this region affect HIV risk reduction efforts. Drawing on relevant literature, this paper provides a contextual foundation to better understand the impact of context on HIV risk behaviour in the countries of Central Asia and to begin the conversation on the contextual factors of Islam and polygamy.

This paper examines the relationship between bridewealth, socio-demographics, and sexual and reproductive practices among a group of women in Harare, Zimbabwe. The study sample was recruited as part of a six-month safety trial of the diaphragm and a microbicide, between August 2004 and April 2005 in Harare, Zimbabwe. Women underwent two screening visits: first, women completed a demographic and behavioral interviewer-administered questionnaire which included questions on bridewealth; at the second visit, women were offered HIV testing and counseling. Our results included: 417 women were married (currently or in the past) and almost half had had bridewealth negotiated as part of the marriage process. In multivariate analyses, women who were married with bridewealth had more years of education (OR 1.17, 95%CI 1.03-1.32), a higher age of coital debut (OR 1.37, 95%CI 1.09-1.71), and increased likelihood of having ever used male condoms (OR 1.54, 95%CI 1.01-2.37) compared with women who had been married without bridewealth. Bridewealth may be a relevant area of traditional culture to further examine in relation to HIV risk, for its potential association with co-factors that can reduce risk of HIV infection among women in Southern Africa.

This article has been published in the journal, History of European Ideas[© Elsevier]. The definitive version is available at http://dx.doi.org/10.1016/j.histeuroideas.2009.06.001 Journal URL: http://www.sciencedirect.com/science/journal/01916599 In this paper I attempt to situate the expression of the secular culture of the Enlightenment in the Greek context into the broader intellectual and spiritual tradition defined by the Greek language. The analysis points at the breaks introduced into this tradition by the Enlightenment (in historical and geographical conceptions, in scientific and political thought and in the understanding of the classics) but it also argues that despite its novelty the Enlightenment shared a considerable heritage with the broader Orthodox religious culture into which it was transmitted in Southeastern Europe. This point is illustrated by reference to biographical evidence, supplied by the life histories of three important exponents of the Enlightenment writing in Greek (E. Voulgaris, Iosipos Moisiodax and N. Doukas). The complex relation between the Enlightenment and earlier Greek intellectual traditions is underlined in conclusion.