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The safety of highly aggregated tourist crowds is a challenging and important issue. This paper not only provided a comprehensive analysis of the accidents of highly aggregated tourist crowds but also determined the occurrence mechanism and coping paths. Based on the analysis of multiple cases, we found that the variable status of highly aggregated tourist crowds was the result of the interaction of three main elements: multisource pressure, state mutations and management responses. A series of factors interact and result in accidents, and the lack of a management response or a low-quality management response is the root cause of such accidents. A high-quality management response is a basic safety precaution for highly aggregated tourist crowds. Therefore, forming a virtuous circle of multisource pressure, state mutations and management responses is an effective path for coping with accidents.

Background A pandemic of coronavirus disease 2019 (COVID-19) emerged and affected most of the world in early 2020. To inform effective public health measures we conducted a knowledge, attitude and practice (KAP) survey among a Hausa Muslim society in Nigeria in March 2020. Methods The study is an analytic cross-sectional survey with questionnaires administered to the general population including Health Care Workers (HCW) in Kano, Nigeria. Participants were recruited by convenience sampling following informed consent. The percentage of KAP scores were categorized as good and poor. Independent predictors of good knowledge of COVID 19 were ascertained using a binary logistic regression model. Results The questionnaire was administered among urban 32.8%, peri-urban dwellers 32.4%, and to online participants 34.8%. The peri-urban and urban participants were given paper questionnaires. There were 886 study participants with mean age 28.58yrs [SD:10.25] (Interquartile range [IQR]:22yrs–32yrs), males 55.4% with 57.3% having had or were in tertiary education. Most participants were students 40% and civil servants 20%. The overall mean [standard deviation (SD)] for knowledge, attitude and practice scores expressed in percentage was 65.38%[SD15.90], 71.45% [SD14.10], and 65.04% [SD17.02] respectively. Out of the respondents, 270(30.47%) had good knowledge (GK), 158(17.8%) had good attitude (GA), and 230(25.96%) had good practice (GP) using cut-off scores of 75%, 86.5%, and 75% respectively. Over 48% did not agree COVID-19 originated from animals while 60% perceived the pandemic to be due to God’s punishment. Also, 36% thought it was a man-made virus. When rating fear, most respondents [63.5%] had marked fear i.e. ≥ 7 out of 10 and 56% admitted to modifying their habits recently in fear of contracting the virus. As regards attitude to religious norms, 77.77% agreed on cancellation of the lesser pilgrimage as a measure to curb the spread of the disease while 23.64% admitted that greater pilgrimage (Hajj) should proceed despite the persistence of the ongoing pandemic. About 50% of the respondents insisted on attending Friday congregational prayers despite social distancing. One in four people still harbored stigma towards a person who has recovered from the virus. 28% felt some races are more at risk of the disease though 66% mentioned always practicing social distancing from persons coughing or sneezing. Almost 70% of respondents said they were willing to accept a vaccine with 39% saying they would be willing to pay for it if not publicly funded. In univariate analysis increasing age and having been ever married were associated with GK while tertiary education was associated with GA [Odds Ratio; 95% Confidence Interval] 2.66(1.79–3.95). Independent positive predictors of GK were those who were or had ever been married, those who had marked fear of COVID-19, and had modified their habits in the last three months. Those who had non-tertiary education and had the questionnaire administered as paper rather than online version had GK but age was not a predictor. Conclusion Knowledge of transmission and preventive measures should be improved in the general population cognizant of cultural norms and Islamic practices. The study highlights the importance of considering belief systems and perception in developing control measures against COVID-19.

Ebola Virus Disease in the Democratic Republic of Congo (DRC) was declared a public health emergency of international concern on July 17, 2019. The first case to cross the border into Uganda in June 2019 demonstrates the importance of better understanding border dynamics in a context of Ebola. This paper adopts a political economy approach to contextualize epidemic response programs conducted in moderate- and high-risk border districts in Uganda, through a qualitative study with 287 participants. To that end, our aim was to describe the historical underpinnings of the borderlands context; the role of livelihood strategies in constraining risk avoidance decisions; and the dynamics of trust in authority figures, including health workers. This paper reports that border communities are highly connected, for a variety of social and economic reasons. These daily realities are in direct opposition to guidance to limit travel during an active Ebola epidemic. We argue that an ability to limit movement is constrained by the economic need to seek livelihood strategies wherever that may be. Moreover, border regions are populated by communities with long-standing distrust in authority figures, particularly in fishing areas. This distrust spills over with consequences for Ebola prevention and control activities. This research indexes the importance of tailoring Ebola programming and policies to consider the political and economic dynamics of borderlands.

Evidence for specialised bone tools has recently been reported for the Middle Stone Age of North Africa [one], which complements similar finds of slightly younger age in South Africa [two, three]. However, until now scant reference has been made to lesser known tools also made of bone ('bone retouchers') that were employed specifically as intermediaries for working or refining stone artefacts, that are sometimes present in these assemblages. In this paper we describe 20 bone retouchers from the cave of Grotte des Pigeons at Taforalt in north-east Morocco. This is the largest stratified assemblage of bone retouchers from a North African MSA site, and the biggest single collection so far from the African Continent. A total of 18 bone retouchers was recovered in securely dated archaeological levels spanning a period from ~ 84.5 ka to 24 ka cal BP. A further two bone retouchers were found in a layer at the base of the deposits in association with Aterian artefacts dating to around 85,000 BP and so far represent the earliest evidence of this type of tool at Taforalt. In this paper we present a first, detailed description of the finds and trace the stages of their production, use and discard (chaîne opératoire). At the same time, we assess if there were diachronic changes in their form and function and, finally, explore their presence in relation to stone tools from the same occupation layers of the cave.

In the global context, health and the quality of life of people are adversely affected by either one or more types of chronic diseases. This paper investigates the differences in the level of income and expenditure between chronically-ill people and non-chronic population. Data were gathered from a national level survey conducted namely, the Household Income and Expenditure Survey (HIES) by the Department of Census and Statistics (DCS) of Sri Lanka. These data were statistically analysed with one-way and two-way ANOVA, to identify the factors that cause the differences among different groups. For the first time, this study makes an attempt using survey data, to examine the differences in the level of income and expenditure among chronically-ill people in Sri Lanka. Accordingly, the study discovered that married females who do not engage in any type of economic activity (being unemployed due to the disability associated with the respective chronic illness), in the age category of 40–65, having an educational level of tertiary education or below and living in the urban sector have a higher likelihood of suffering from chronic diseases. If workforce population is compelled to lose jobs, it can lead to income insecurity and impair their quality of lives. Under above findings, it is reasonable to assume that most health care expenses are out of pocket. Furthermore, the study infers that chronic illnesses have a statistically proven significant differences towards the income and expenditure level. This has caused due to the interaction of demographic and socio-economic characteristics associated with chronic illnesses. Considering private-public sector partnerships that enable affordable access to health care services for all as well as implementation of commercial insurance and community-based mutual services that help ease burden to the public, are vital when formulating effective policies and strategies related to the healthcare sector. Sri Lanka is making strong efforts to support its healthcare sector and public, which was affected by the coronavirus (COVID-19) in early 2020. Therefore, findings of this paper will be useful to gain insights on the differences of chronic illnesses towards the income and expenditure of chronically-ill patients in Sri Lanka.

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

While diaspora communities have become more critical of Female Genital Cutting (FGC), there are also trends of continuity. To explore the interplay between continuity and change, I designed a study among Somali migrants in Norway. A team of six Somali research assistants collected data from 72 male and female research participants between 16 and 57 years of age through in-depth interviews and focus group discussions. The aim of the study was to gather knowledge that could improve interventions among migrant populations. The study findings indicate that the experience of FGC as a practice in transition implies that people have to maneuver between different and partly contradictory social norms. The paper first discusses the contradiction between a strong negative attitude toward FGC and very low engagement. The lack of engagement is explained by the increased privatization of FGC and insecurities due to the transition and disempowerment with regard to challenging the FGC practices of relatives based in countries of origin. Second, the paper explores the contradiction between perceptions of FGC as a disappearing practice and the recognition of trends of continuation. Trends of continuation include those related to perceptions of risk during travel to countries of origin, resistance to defibulation, support for sunna circumcision and insecurities regarding the significance of FGC for marriageability. Thus, despite an almost universally negative attitude toward FGC in the form of infibulation, ongoing changes can, to some extent, hamper further change. This suggests that to ensure further progress in the abandonment of the practice, these complex and interconnected expectations must be addressed.

This research paper aims to understand the effects of time spent in domestic work, including childcare, on women’s mental health in Ghana. The paper adopted a triangulation convergence mixed methods approach. The quantitative information was sourced from two waves (2009/ 2014) of the Ghana Socioeconomic Panel Survey (GSEPS) while qualitative information was obtained from in-depth interviews with couples and key informants from five (5) regions, representing diverse ethnic backgrounds, in Ghana. Employing fixed effects regressions and a multinomial logistic regression model with fixed effects, we find that domestic work contributes to poorer mental health outcomes among women. These results are consistent, even when we correct for potential self-selectivity of women into domestic work. We also examine whether the relationship is differentiated between women of higher and lower socioeconomic status. We find that women from wealthier households who spend increasing time in domestic work have higher odds of mental distress. These results are supported by the qualitative data- women indicate increasing stress levels from domestic work and while some husbands acknowledge the situation of their overburdened wives and make attempts, however minor, to help, others cite social norms and cultural expectations that act as a deterrent to men’s assistance with domestic work. Efforts should be made to lessen the effects of social and cultural norms which continue to encourage gendered distributions of domestic work. This may be done through increased education, sensitization and general re-socialization of both men and women about the need for more egalitarian divisions of household work.

Sexual violence against women and girls is a major public health problem globally and in South Africa. Although young men have been identified as an important risk group for prevention interventions, scant attention have been given to this age cohort in low and middle-income countries. There is strong evidence that perpetration starts early and increasing attention is being drawn to Higher Education Institutions (HEIs) as settings for prevention interventions. The main objective of this study was to adapt the One Man Can Intervention for use with male university students in residences and develop materials for implementation. This paper presents the qualitative findings of the adaptation process of the One Man Can Intervention with 15 young male student leaders at a HEI in South Africa. The same participants who started in the study, participated throughout. Only five of the 15 participants were located and participated in the interviews six months post intervention. The results show the emergence of a six-hour session adapted intervention that addresses key drivers of violence against women and girls (VAWG). Critical engagement and dialogue on sexual violence is shown to shift key norms on gender equality, on being a man and reflection on their role in preventing sexual violence. This paper contributes to the field where much learning, refining and improvement of prevention interventions for VAWG are ongoing.

Introduction Homebirths are common in low and middle income countries and are associated with poor child survival. We assessed the feasibility of using smartphones by village health workers for pregnancy registration and the effectiveness of health text messages (SMS) sent to pregnant women through village health workers in reducing homebirths in rural Uganda. Methods A non-randomised intervention study was undertaken in 26 villages. In the intervention arm, village health workers registered pregnant women (n = 262) in 13 villages using a smartphone app (doForm) and paper forms and gestation age-timed SMS were sent through village health workers to the pregnant women. In 13 control villages, (n = 263) pregnant women were registered on paper forms only and no SMS was sent. The main outcome was place of birth measured through a self-report. Logistic regression with generalised estimating equations was used to explore the effect of the intervention. Results Comparing 795 corresponding data fields on phone and paper revealed that numeric variable fields were 86%-95% similar while text fields were 38%-48% similar. Of the 525 pregnant women followed, 83 (15.8%) delivered at home. In the adjusted analysis, the intervention was associated with lower odds of homebirths [AOR = 0.38, 95%CI (0.15–0.97)]. Muslim religion [AOR = 4.0, 95%CI (1.72–9.34)], primary or no maternal education [AOR = 2.51, 95%CI (1.00–6.35)] and health facility distance ≥ 2 km [AOR = 2.26, 95%CI (0.95–5.40)] were independently associated with homebirths. Conclusion Village health workers can register pregnant women at home using phones and relay gestation age specific SMS to them to effectively reduce homebirths.

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

This paper reports the impact of a major life event-death-on the physical, psychological and social well-being of the deceased's close friends. We utilised data from a large longitudinal survey covering a period of 14 years (2002-2015) consisting a cohort of 26,515 individuals in Australia, of whom 9,586 had experienced the death of at least one close friend. This longitudinal cohort dataset comprises responses to the SF-36 (health related quality of life measure) and allowed for analysis of the short and longer-term impacts of bereavement. In order to manage the heterogeneity of the socio-demographics of respondents who did/not experience a death event, we use a new and robust approach known as the Entropy Balancing method to construct a set of weights applied to the bereaved group and the control group (the group that did not experience death). This approach enables us to match the two groups so that the distribution of socio-demographic variables between the two groups are balanced. These variables included gender, age, marital status, ethnicity, personality traits, religion, relative socio-economic disadvantage, economic resources, and education and occupation and where they resided. The data show, for the first time, a range of negative and enduring consequences experienced by people following the death of a close friend. Significant adverse physical and psychological well-being, poorer mental health and social functioning occur up to four years following bereavement. Bereaved females experienced a sharper fall in vitality, suffered greater deterioration in mental health, impaired emotional and social functioning than the male counterparts up to four years after the death. The data show that the level of social connectedness plays an important role in bereavement outcomes. Specifically, we found that less socially active respondents experienced a longer deterioration in physical and psychological health. Finally, we found evidence that the death of a close friend lowered the respondent's satisfaction with their health. Since death of friends is a universal phenomenon, we conclude the paper by reflecting on the need to recognise the death of a close friend as a substantial experience, and to offer support and services to address this disenfranchised grief. Recognising bereaved friends as a group experiencing adverse outcomes can be used internationally to prompt health and psychological services to assist this specific group, noting that there may be substantial longevity to the negative sequelae of the death of a friend. Facilitating bereaved people's support networks may be a fruitful approach to minimising these negative outcomes.

Background Over the last decade, implementation research and a science of global health delivery have emerged as important vehicles to improve the effectiveness of interventions. Efforts to control neglected tropical diseases (NTD) operate in challenging circumstances and with marginalized populations, making attention to context-specific details particularly relevant. Socio-anthropological insights have much to offer a science of NTD delivery. In this paper, an accessible and actionable framework for understanding NTD intervention effectiveness, based on socio-anthropological research, is presented and its utility for program planning and monitoring and evaluation is outlined. Methodology/Principal findings The framework was developed inductively by comparatively analyzing three rapid ethnographic studies undertaken in Eastern Africa (2010–2013) on three different large-scale NTD interventions: rabies elimination in Tanzania, sleeping sickness control in Uganda and the prevention of parasitic worms in Zambia. The framework includes five “intervention domains” where the effectiveness of these interventions was negotiated and determined at the local level. This involves: 1) the terrain of intervention (including seasonality and geographical variability); 2) community agency (including local knowledge, risk perceptions, behaviors, leadership and social pressure); 3) the strategies and incentives of field staff (skills, motivations, capabilities and support); 4) the socio-materiality of technology (characteristics of intervention tools and the adoption process itself); and 5) the governance of interventions (policy narratives, available expertise, bureaucracy, politics and the utilization of knowledge). The paper illustrates the importance of each of these domains by drawing on the case study research, presenting lessons learnt and practical recommendations for how such insights could improve intervention delivery. Conclusions/Significance To help close the gap between efficacy and effectiveness in NTD programs, it is important that field staff: 1) generate meaningful knowledge about contextual factors; 2) use this knowledge to tailor field strategies; and 3) create routine mechanisms to account for the dynamic process of implementation itself. The framework presented here offers a simple analytical tool to strengthen these knowledge-to-action relationships existing project planning tools, drawing on the insights of socio-anthropology., Author summary Many efficacious tools exist to control NTDs, but effectively moving these tools and approaches from the boardroom to the village is a complicated socio-political process. In the era of Sustainable Development Goals, global health has become more focused on improving the delivery of existing interventions. Greater attention to implementation research, including the value of social science perspectives, has followed in an effort to build a science of global health delivery. This paper presents an accessible and actionable socio-anthropological framework for understanding the effectiveness factors of NTD interventions. The framework was developed by comparatively analyzing three large-scale NTD interventions in Eastern Africa: rabies elimination in Tanzania, sleeping sickness control in Uganda and the prevention of parasitic worms in Zambia. The framework includes five “intervention domains” where the effectiveness of these interventions was determined: 1) the terrain of intervention; 2) community agency; 3) the strategies and incentives of field staff; 4) the socio-materiality of technology; and 5) the governance of interventions. The paper illustrates the importance of each of these domains, presenting lessons learnt and practical recommendations. As a flexible analytical tool, the framework could be integrated into the planning and implementation process itself, bringing the insights of socio-anthropological approaches into an emerging science of NTD delivery.

Land tenure and tenure security are among the most important factors determining the viability and success of Reducing Emissions from Deforestation and Forest Degradation (REDD+) initiatives. The premise of the present paper is that territorial conflicts lead to forest loss and compromise the successful implementation of REDD+. Within this context, the main objectives of this paper are to (i) document, relying on participatory methods, the extent to which land conflicts drive deforestation and (ii) reflect on the legal context of REDD+ examining if, from an Indigenous perspective, it offers tools to resolve such conflicts. We used the Upper Bayano Watershed in eastern Panama as a case study of complex land tenure dynamics, and their effects on forest conservation in the context of REDD+. Combining a range of participatory methods including participatory mapping and forest carbon stock assessment, we estimated the consequences of land invasions on forest carbon stocks. Our analysis shows that invasions of Indigenous territories amounted to 27.6% of the total deforestation for the period of 2001-2014. The situation is of paramount concern in the Embera territory of Majé where 95.4% of total deforestation was caused by colonist invaders. Using and validating the maps made freely available by the Global Forest Change initiative of the University of Maryland, we then developed a reference level for the watershed and carried out a back of the envelop estimation of likely REDD+ revenue, showing its potential to bring much needed income to Indigenous communities striving to protect their forest estate. Our analysis of current legislation in Panama highlights confusion and important legal voids and emphasizes the strong links between land tenure, carbon ownership, and territorial invasions. The options and shortcoming of implementing REDD+ in Indigenous territories is discussed in the conclusion taking our legal review into account.

The Million Dollar List (MDL, online at http://www.milliondollarlist.org) is a compilation of publicly announced charitable donations of $1 million or more from across the United States since 2000; as of December 2016, the database contains close to 80,000 gifts made by U.S. individuals, corporations, foundations, and other grant-making nonprofit organizations. This paper discusses the unique value of the Million Dollar List and provides unique insights to key questions such as: How does distance affect giving? How do networks impact million-dollar-plus gifts? Understanding the geospatial and temporal dimensions of philanthropy can assist researchers and policymakers to better understand the role of private funding in innovation and discovery. Moreover, the results from the paper emphasize the importance of philanthropy for fueling research and development in science, the arts, environment, and health. The paper also includes the limitations of the presented analyses and promising future work.

International audience; There appears to be little doubt as to the existence of an intentional technological resolve to produce convergent tools during the Middle Palaeolithic. However, the use of these pieces as pointed tools is still subject to debate: i.e., handheld tool vs. hafted tool. Present-day technological analysis has begun to apply new methodologies in order to quantify shape variability and to decipher the role of the morphology of these pieces in relation to function; for instance, geometric morphometric analyses have recently been applied with successful results. This paper presents a study of this type of analysis on 37 convergent tools from level Ga of Payre site (France), dated to MIS 8-7. These pieces are non-standardized knapping products produced by discoidal and orthogonal core technologies. Moreover, macro-wear studies attest to various activities on diverse materials with no evidence of hafting or projectile use. The aim of this paper is to test the geometric morphometric approach on non-standardized artefacts applying the Elliptical Fourier analysis (EFA) to 3D contours and to assess the potential relationship between size and shape, technology and function. This study is innovative in that it is the first time that this method, considered to be a valuable complement for describing technological and functional attributes, is applied to 3D contours of lithic products. Our results show that this methodology ensures a very good degree of accuracy in describing shape variations of the sharp edges of technologically non-standardized convergent tools. EFA on 3D contours indicates variations in deviations of the outline along the third dimension (i.e., dorso-ventrally) and yields quantitative and insightful information on the actual shape variations of tools. Several statistically significant relationships are found between shape variation and use-wear attributes, though the results emphasize the large variability of the shape of the convergent tools, which, in general, does not show a strong direct association with technological features and function. This is in good agreement with the technological context of this chronological period, characterized by a wide diversity of non-standardized tools adapted to multipurpose functions for varied subsistence activities.

BACKGROUND: Migrant workers in the United States have extremely poor health. This paper aims to identify ways in which the social context of migrant farm workers affects their health and health care. METHODS AND FINDINGS: This qualitative study employs participant observation and interviews on farms and in clinics throughout 15 months of migration with a group of indigenous Triqui Mexicans in the western US and Mexico. Study participants include more than 130 farm workers and 30 clinicians. Data are analyzed utilizing grounded theory, accompanied by theories of structural violence, symbolic violence, and the clinical gaze. The study reveals that farm working and housing conditions are organized according to ethnicity and citizenship. This hierarchy determines health disparities, with undocumented indigenous Mexicans having the worst health. Yet, each group is understood to deserve its place in the hierarchy, migrant farm workers often being blamed for their own sicknesses. CONCLUSIONS: Structural racism and anti-immigrant practices determine the poor working conditions, living conditions, and health of migrant workers. Subtle racism serves to reduce awareness of this social context for all involved, including clinicians. The paper concludes with strategies toward improving migrant health in four areas: health disparities research, clinical interactions with migrant laborers, medical education, and policy making.

Dedicated inpatient care for eating disorders has profound impact on patients' embodied practices and lived realities. Analyses of inpatients' accounts have shown that participants endorse complex and conflicting attitudes toward their experiences in eating disorders wards, yet the apparent ambivalence that characterizes inpatient experiences has not been subject to critical examination. This paper examines the narrated experiences of 13 participants (12 women and one man; age 18–38 years at first interview) with past or present anorexia nervosa, bulimia nervosa, or eating disorder not otherwise specified, who had been hospitalized in an inpatient eating disorders ward for adults in central Israel. The interviews, which took place in 2005–2006, and again in 2011, were part of a larger longitudinal study exploring the subjective experiences of eating disorders and recovery among Israeli adults. Employing qualitative analysis, this study finds that the participants' accounts were concerned with dynamics of difference and belonging, as they played out in various aspects of inpatient care, including diagnosis, treatment, relationships with fellow patients and staff, and everyday life in hospital. Notably, participants simultaneously defined themselves as connected to, but also distinct from, the eating disordered others who formed their reference group at the ward. Through negotiating a protectively ambivalent positioning, participants recognized their eating disordered identities and connected with others on the ward, while also asserting their non-disordered individuality and distancing themselves from the potential dangers posed by ‘excessive’ belonging. The paper suggests that this ambivalent positioning can usefully be understood through the anthropological concept of liminality: being both a part of and apart from one's community.

Background The Wolbachia strategy aims to manipulate mosquito populations to make them incapable of transmitting dengue viruses between people. To test its efficacy, this strategy requires field trials. Public consultation and engagement are recognized as critical to the future success of these programs, but questions remain regarding how to proceed. This paper reports on a case study where social research was used to design a community engagement framework for a new dengue control method, at a potential release site in central Vietnam. Methodology/Principal Findings The approach described here, draws on an anthropological methodology and uses both qualitative and quantitative methods to design an engagement framework tailored to the concerns, expectations, and socio-political setting of a potential trial release site for Wolbachia-infected Aedes aegypti mosquitoes. The process, research activities, key findings and how these were responded to are described. Safety of the method to humans and the environment was the most common and significant concern, followed by efficacy and impact on local lives. Residents expected to be fully informed and engaged about the science, the project, its safety, the release and who would be responsible should something go wrong. They desired a level of engagement that included regular updates and authorization from government and at least one member of every household at the release site. Conclusions/Significance Results demonstrate that social research can provide important and reliable insights into public concerns and expectations at a potential release site, as well as guidance on how these might be addressed. Findings support the argument that using research to develop more targeted, engagement frameworks can lead to more sensitive, thorough, culturally comprehensible and therefore ethical consultation processes. This approach has now been used successfully to seek public input and eventually support for releases Wolbachia-infected mosquitoes, in two different international settings - Australia and Vietnam., Author Summary In recent years, a number of new strategies using novel technologies for the control of dengue fever control have emerged. These strategies are notably different from their predecessors and not without controversy. Many also require open release field trials to test their efficacy. Public consultation and engagement are recognized as critical to the future success of these programs, but questions remain regarding how to proceed. In this paper we describe an approach to public engagement that uses social research to design an engagement framework and communication materials tailored to the concerns, expectations, and socio-political setting of potential trial release sites. This approach was developed and implemented in Australia (2008–2010) where the first publicly supported field trials occurred January 2011. We report here on the implementation of this approach in Vietnam (2009–2010) where the second release will occur in 2014. This paper describes the process, research activities, outcomes and key findings from the Vietnamese field site. It highlights key public concerns and expectations about engagement and authorization and shows how these were used to develop a more targeted, culturally appropriate and comprehensible engagement framework and communication materials. The paper demonstrates the viability of this approach to community engagement for new dengue control strategies, in a ‘developing’ country context.

ObjectivesThis paper examines the ethnic and gender differentials in high blood pressure (HBP), diabetes, coronary heart disease (CHD), arthritis and asthma among older people in Malaysia, and how these diseases along with other factors affect self-rated health. Differentials in the prevalence of non-communicable diseases among older people are examined in the context of socio-cultural perspectives in multi-ethnic Malaysia.MethodsData for this paper are obtained from the 2004 Malaysian Population and Family Survey. The survey covered a nationally representative sample of 3,406 persons aged 50 and over, comprising three main ethnic groups (Malays, Chinese and Indians) and all other indigenous groups. Bivariate analyses and hierarchical logistic regression were used in the analyses.ResultsArthritis was the most common non-communicable disease (NCD), followed by HBP, diabetes, asthma and CHD. Older females were more likely than males to have arthritis and HBP, but males were more likely to have asthma. Diabetes and CHD were most prevalent among Indians, while arthritis and HBP were most prevalent among the Indigenous groups. Older people were more likely to report poor health if they suffered from NCD, especially CHD. Controlling for socio-economic, health and lifestyle factors, Chinese were least likely to report poor health, whereas Indians and Indigenous people were more likely to do so. Chinese that had HBP were more likely to report poor health compared to other ethnic groups with the same disease. Among those with arthritis, Indians were more likely to report poor health.ConclusionPerceived health status and prevalence of arthritis, HBP, diabetes, asthma and CHD varied widely across ethnic groups. Promotion of healthy lifestyle, early detection and timely intervention of NCDs affecting different ethnic groups and gender with socio-cultural orientations would go a long way in alleviating the debilitating effects of the common NCDs among older people.

Background In recent years, new strategies aimed at reducing the capacity of mosquito vectors to transmit dengue fever have emerged. As with earlier control methods, they will have to be employed in a diverse range of communities across the globe and into the main settings for disease transmission, the homes, businesses and public buildings of residents in dengue-affected areas. However, these strategies are notably different from previous methods and draw on technologies that are not without controversy. Public engagement and authorization are critical to the future success of these programs. Methodology/Principal Findings This paper reports on an Australian case study where long-term social research was used to enable participation and the design of an engagement strategy tailored specifically to the sociopolitical setting of a potential trial release site of Wolbachia-infected Aedes aegytpi mosquitoes. Central themes of the social research, methods used and conclusions drawn are briefly described. Results indicate that different communities are likely to have divergent expectations, concerns and cultural sensibilities with regard to participation, engagement and authorization. Conclusions/Significance The findings show that a range of issues need to be understood and taken into account to enable sensitive, ethical and effective engagement when seeking public support for new dengue control methods., Author Summary A number of new strategies are emerging to combat dengue fever. Many are notably different from earlier methods and not without controversy. Public participation, engagement, enablement and authorization are recognized as critical to the success of field trials and future use and acceptability of new strategies. It is well established in cultural anthropology and public health that interventions often fail because of a lack of understanding of the local context, lay knowledge of the disease, and community, local or regional expectations around engagement. In this paper we demonstrate the critical importance of using long-term social research to address these issues and to design engagement strategies and communication materials that are tailored specifically to the needs, expectations and concerns of residents at a potential release site. We report on the results of an extensive and systematic social research and engagement program undertaken in the two years prior to the first successful release of Wolbachia-infected Aedes aegypti mosquitoes in Cairns, northern Australia.

International audience; Mass graves are usually key historical markers with strong incentive for archeological investigations. The identification of individuals buried in mass graves has long benefitted from traditional historical, archaeological, anthropological and paleopathological techniques. The addition of novel methods including genetic, genomic and isotopic geochemistry have renewed interest in solving unidentified mass graves. In this study, we demonstrate that the combined use of these techniques allows the identification of the individuals found in two Breton historical mass graves, where one method alone would not have revealed the importance of this discovery. The skeletons likely belong to soldiers from the two enemy armies who fought during a major event of Breton history: the siege of Rennes in 1491, which ended by the wedding of the Duchess of Brittany with the King of France and signaled the end of the independence of the region. Our study highlights the value of interdisciplinary approaches with a particular emphasis on increasingly accurate isotopic markers. The development of the sulfur isoscape and testing of the triple isotope geographic assignment are detailed in a companion paper [13].

Nineteen broken and complete bone fish hooks and six grooved stones recovered from the Epipaleolithic site of Jordan River Dureijat in the Hula Valley of Israel represent the largest collection of fishing technology from the Epipaleolithic and Paleolithic periods. Although Jordan River Dureijat was occupied throughout the Epipaleolithic (~20–10 kya the fish hooks appear only at the later stage of this period (15,000–12,000 cal BP). This paper presents a multidimensional study of the hooks, grooved stones, site context, and the fish assemblage from macro and micro perspectives following technological, use wear, residue and zooarchaeological approaches. The study of the fish hooks reveals significant variability in hook size, shape and feature type and provides the first evidence that several landmark innovations in fishing technology were already in use at this early date. These include inner and outer barbs, a variety of line attachment techniques including knobs, grooves and adhesives and some of the earliest evidence for artificial lures. Wear on the grooved stones is consistent with their use as sinkers while plant fibers recovered from the grooves of one hook shank and one stone suggest the use of fishing line. This together with associations between the grooved stones and hooks in the same archaeological layers, suggests the emergence of a sophisticated line and hook technology. The complexity of this technology is highlighted by the multiple steps required to manufacture each component and combine them into an integrated system. The appearance of such technology in the Levantine Epipaleolithic record reflects a deep knowledge of fish behavior and ecology. This coincides with significant larger-scale patterns in subsistence evolution, namely broad spectrum foraging, which is an important first signal of the beginning of the transition to agriculture in this region.

The province of Sindh reported the first COVID-19 case in Pakistan on 26th February 2020. The Government of Sindh has employed numerous control measures to limit its spread. However, for low-and middle-income countries such as Pakistan, the management protocols for controlling a pandemic are not always as definitive as they would be in other developed nations. Given the dire socio-economic conditions of Sindh, continuation of province-wise lockdowns may inadvertently cause a potential economic breakdown. By using a data driven SEIR modelling framework, this paper describes the evolution of the epidemic projections because of government control measures. The data from reported COVID-19 prevalence and google mobility is used to parameterize the model at different time points. These time points correspond to the government’s call for advice on the prerequisite actions required to curtail the spread of COVID-19 in Sindh. Our model predicted the epidemic peak to occur by 18th June 2020 with approximately 3500 reported cases at that peak, this projection correlated with the actual recorded peak during the first wave of the disease in Sindh. The impact of the governmental control actions and religious ceremonies on the epidemic profile during this first wave of COVID-19 are clearly reflected in the model outcomes through variations in the epidemic peaks. We also report these variations by displaying the trajectory of the epidemics had the control measures been guided differently; the epidemic peak may have occurred as early as the end of May 2020 with approximately 5000 reported cases per day had there been no control measures and as late as August 2020 with only around 2000 cases at the peak had the lockdown continued, nearly flattening the epidemic curve.

Obsidian, originating from the Rocky Mountains and the West, was an exotic exchange commodity in Eastern North America that was often deposited in elaborate caches and burials associated with Middle Woodland era Hopewell and later complexes. In earlier times, obsidian is found only rarely. In this paper we report two obsidian flakes recovered from a now submerged paleolandscape beneath Lake Huron that are conclusively attributed to the Wagontire obsidian source in central Oregon; a distance of more than 4,000 km. These specimens, dating to ~ 9,000 BP, represent the earliest and most distant reported occurrence of obsidian in eastern North America.

The emergence of a new tech elite in Silicon Valley and beyond raises questions about the economic reach, political influence, and social importance of this group. How do these inordinately influential people think about the world and about our common future? In this paper, we test a) whether members of the tech elite share a common, meritocratic view of the world, b) whether they have a “mission” for the future, and c) how they view democracy as a political system. Our data set consists of information about the 100 richest people in the tech world, according to Forbes, and rests on their published pronouncements on Twitter, as well as on their statements on the websites of their philanthropic endeavors. Automated “bag-of-words” text and sentiment analyses reveal that the tech elite has a more meritocratic view of the world than the general US Twitter-using population. The tech elite also frequently promise to “make the world a better place,” but they do not differ from other extremely wealthy people in this respect. However, their relationship to democracy is contradictory. Based on these results, we conclude that the tech elite may be thought of as a “class for itself” in Marx’s sense—a social group that shares particular views of the world, which in this case means meritocratic, missionary, and inconsistent democratic ideology.

With the in-depth development of globalization, individuals are increasingly embedded in a culturally diverse environment. Effective communication and management ability (Cultural Intelligence) of employees in this type of diverse and heterogeneous environment impacts behavior and performance, affecting the sustainable innovation ability of organizations. Researchers have not yet fully assessed the impact of individuals’ cross-cultural management ability on sustainable innovation. Using Cultural Intelligence Theory and Trait Activation Theory, this paper discusses the influence of individual cultural intelligence on sustainable innovation behavior. The results showed that employees’ cultural intelligence positively affected their sustainable innovation behavior. Employee knowledge sharing plays an mediating role between intelligence and behavior. Differences in organizational culture have a negative moderating effect on the impact of employees’ cultural intelligence on knowledge sharing and sustainable innovation behaviors. The research results provide theoretical guidance for managing organizational cultural diversity and advancing cultural intelligence and sustainable innovation behaviors among employees.

Background The present study aims to estimate the prevalence and correlates of multimorbidity among women aged 15–49 years in India. Additionally, the population attributable risk for multi-morbidity in reference to those women who smoke tobacco, chew tobacco, and consume alcohol is estimated. Methods The data was derived from the National Family Health Survey which was conducted in 2015–16. The effective sample size for the present paper 699,686 women aged 15–49 years in India. Descriptive statistics along with bivariate analysis were used to do the preliminary analysis. Additionally, binary logistic regression analysis was used to fulfil the objectives. Results About 1.6% of women had multimorbidity in India. The prevalence of multimorbidity was high among women from southern region of India. Women who smoke tobacco, chew tobacco and consume alcohol had 87% [AOR: 1.87CI: 1.65, 2.10], 18% [AOR: 1.18; CI: 1.10, 1.26] and 18% [AOR: 1.18; CI: 1.04, 1.33] significantly higher likelihood to suffer from multi-morbidity than their counterparts respectively. Population Attributable Risk for women who smoke tobacco was 1.2% (p Conclusion The findings indicate the important role of lifestyle and behavioural factors such as smoking and chewing tobacco and consuming alcohol in the prevalence of multimorbidity among adult Indian women. The subgroups identified as at increased risk in the present study can be targeted while making policies and health decisions and appropriate comorbidity management can be implemented.

BackgroundIn response to the Coronavirus disease-19 (COVID-19) pandemic, in-patient units in hospitals around the world have altered their patient care routines and Infection Prevention and Control (IPC) practices. Our interdisciplinary team of applied Human Factors (HF), ethnography, and IPC experts assisted one Unit, normally serving general surgical and orthopedic patients, as it rapidly converted to deliver COVID-19-specific care. This paper describes the conversion experience of the Unit, and outlines broader lessons for other acute care teams faced with similar issues.MethodsWe deployed walkthroughs, simulations, and ethnography to identify important safety gaps in care delivery processes on the Unit. These interventions were undertaken using interdisciplinary theories of implementation that combined systems-level HF perspectives, ethnographic approaches, and individual-level IPC perspectives. Timely recommendations were developed and delivered to Unit staff for feedback and implementation.ResultsWe describe three interventions on the Unit: 1) the de-cluttering and re-organization of personal protective equipment (PPE); 2) the reconfiguring of designated ‘dirty’ tray tables and supplies; and 3) the redesign of handling pathways for ‘dirty’ linens and laundry. Each of these interventions was implemented to varying degrees, but all contributed to discussions of safety and IPC implementation that extended beyond the Unit and into the operations of the broader hospital.ConclusionsLeveraging our team’s interdisciplinary expertise and blended approaches to implementation, the interventions assisted in the Unit’s rapid conversion towards providing COVID-19-specific care. The deployment and implementation of the interventions highlight the potential of collaboration between HF, ethnography, and IPC experts to support frontline healthcare delivery under pandemic conditions in an effort to minimize nosocomial transmission potential in the acute healthcare setting.

Predictive models have become an integral part of archaeological research, particularly in the discovery of new archaeological sites. In this paper, we apply predictive modeling to map high potential Pleistocene archaeological locales on the island of Cyprus in the Eastern Mediterranean. The model delineates landscape characteristics that denote areas with high potential to unearth Pleistocene archaeology while at the same time highlighting localities that should be excluded. The predictive model was employed in surface surveys to systematically access high probability locales on Cyprus. A number of newly identified localities suggests that the true density of mobile hunter-gatherer sites on Cyprus is seriously underestimated in current narratives. By adding new data to this modest corpus of early insular sites, we are able to contribute to debates regarding island colonisation and the role of coastal environments in human dispersals to new territories. Introduction Predicting locales of past human activity Regional setting - Archaeological background Materials and methods - Variables - Data - The model - Field methodology Results - Regional - Local - Field survey results Discussion: Modelling the Pleistocene exploitation of Cyprus Conclusions

Assisted Reproductive Technology (ART) is increasingly becoming a viable option for infertile couples in Ghana. There exists significant literature that explores the gender, legal, religious and socio-cultural implications of ART usage. In this paper, we expand the discourse on the nexus between religion and ART usage by looking at how the former is used as a frame of reference in the decision-making process, as well as how it is employed to explain treatment successes and failures. Irrespective of religious orientation, there was a general acceptance of ART by participants in the study-with exceptions only when it came to some aspects of the procedure. Even here, participants’ desperate desire to have children, tended to engender some accommodation of procedures they were uncomfortable with because of their religious beliefs. Thus, in contrast to some studies that suggest religion as interfering with ART use, we posit that religion is not an inhibiting factor to ART usage. On the contrary, it is an enabling factor, engendering the agentic attitude of participants to find a solution to their infertility in ART; as well as providing the strength to endure the physical and emotional discomfort associated with the biomedical process of conception and childbirth. In this context, religion thus provides participants with a frame of reference to navigate the spaces between decision-making, treatment processes and outcomes, and attributions of responsibility for the outcomes whatever they may be.

We advance binational link-tracing sampling design, an innovative data collection methodology for sampling from transnational social fields, i.e., transnational networks embedding migrants and non-migrants. This paper shows the practical challenges of such a design, the representativeness of the samples and the qualities of the resulted networks. We performed 303 face-to-face structured interviews on sociodemographic variables, migration trajectories and personal networks of people living in a Romanian migration sending community (D\^ambovi\c{t}a) and in a migration receiving Spanish town (Castell\'on), simultaneously in both sites. Inter-connecting the personal networks, we built a multi-layered complex network structure embedding 4,855 nominated people, 5,477 directed ties (nominations) and 2,540 edges. Results indicate that the participants' unique identification is a particularly difficult challenge, the representativeness of the data is not optimal (homophily on observed attributes was detected in the nomination patterns), and the relational and attribute data allow to explore the social organization of the Romanian migrant enclave in Castell\'on, as well as its connectivity to other places. Furthermore, we provide methodological suggestions for improving link-tracing sampling from transnational networks of migration. Our research contributes to the emerging efforts of applying social network analysis to the study of international migration., Comment: 37 pages, 8 figures

Interpreting human behavioral patterns during the Middle Paleolithic in the Levant is crucial for better understanding the dispersals and evolution of Homo sapiens and their possible interactions with other hominin groups. Here, we reconstruct the technological behavior, focusing on the centripetal Levallois method at Nesher Ramla karst sinkhole, Israel. Nesher Ramla karst sinkhole is dated to the Marine Isotope stages (MIS) 6 and 5 and represents one of the oldest occurrences of the centripetal Levallois reduction strategy in the Near East. The Levallois centripetal technology is often seen as a marker of human dispersals and adaptations in the Middle Paleolithic/Middle Stone Age of Africa and the Near East. This technology is documented in East African sites as early as 300 kya and in the Levant as early as 130 kya. However, the degree of similarity between African and Levantine centripetal technology and whether it originates from the same source remain under debate. In this paper, we focus on describing the lithic organization at Unit III of Nesher Ramla (dated to MIS 5), which is dominated by the centripetal Levallois method in association with other reduction sequences. Both preferential and recurrent centripetal Levallois modes were used at the site to produce oval and rectangular flakes. Other minor reduction sequences include unidirectional convergent method for Levallois points production and a specific method for the manufacture of naturally backed knives. The lithic data from Unit III of Nesher Ramla is further used in inter-site comparisons suggesting that the mid-Middle Paleolithic sites in the Near East possess common technological characteristics, especially the use of the centripetal Levallois method as predominant reduction strategy. This trend differs from what is usually observed in Africa and Europe, where the centripetal Levallois method is modestly represented during MIS 5 and is accompanied by other, more dominant, reduction strategies.

All relevant data are within the manuscript and its Supporting Information files. Lithic material inventories and basic analyses may be consulted in the Field Season Reports that the Orce Research Team delivers yearly to Junta de Andalucia, which are freely available by request. The studied material is preserved in the Archaeological and Ethnographical Museum of Granada (Andalucía, Spain)., The lithic assemblage of Barranco León (BL), attributed to the Oldowan techno-complex, contributes valuable information to reconstruct behavioral patterning of the first hominins to disperse into Western Europe. This archaic stone tool assemblage comprises two, very different groups of tools, made from distinct raw materials. On the one hand, a small-sized toolkit knapped from Jurassic flint, comprising intensively exploited cores and small-sized flakes and fragments and, on the other hand, a large-sized limestone toolkit that is mainly linked to percussive activities. In recent years, the limestone macro-tools have been the center of particular attention, leading to a re-evaluation of their role in the assemblage. Main results bring to light strict hominin selective processes, mainly concerning the quality of the limestone and the morphology of the cobbles, in relation to their use-patterning. In addition to the variety of traces of percussion identified on the limestone tools, recurrences have recently been documented in their positioning and in the morphology of the active surfaces. Coupled with experimental work, this data has contributed to formulating hypothesis about the range of uses for these tools, beyond stone knapping and butchery, for activities such as: wood-working or tendon and meat tenderizing. The abundance of hammerstones, as well as the presence of heavy-duty scrapers, are special features recognized for the limestone component of the Barranco Leo´n assemblage. This paper presents, for the first time, another characteristic of the assemblage: the presence of polyhedral and, especially, subspheroid morphologies, virtually unknown in the European context for this timeframe. We present an analysis of these tools, combining qualitative evaluation of the raw materials, diacritical study, 3D geometric morphometric analysis of facet angles and an evaluation of the type and position of percussive traces; opening up the discussion of the late Oldowan beyond the African context., This research has been funded by the Junta de Andalucía, Consejería de Educación, Cultura y Deporte: Orce Research Project “Primeras ocupaciones humanas y contexto paleoecológico a partir de los depósitos pliopleistocenos de la cuenca Guadix-Baza: zona arqueolo´gica de la Cuenca de Orce (Granada, España), 2017–2020”; "Presencia humana y contexto paleoecológico en la cuenca continental de Guadix-Baza. Estudio e interpretacio´n a partir de los depósitos Plio-Pleistocénicos de Orce. Granada. España" B120489SV18BC, 2012-16; "Primeras ocupaciones humanas del Pleistoceno inferior de la cuenca de Guadix-Baza (Granada, España)" B090678SVI8BC, 2009-11; MICINN (no feder) "Estudio de las dispersiones faunísticas y humanas durante el Pleistoceno inferior en la cuenca mediterránea.", CGL2016-80975-P, 2017- 19; the Spanish government Ministerio de Ciencia, Innovación y Universidades (MICINN-FEDER) code CGL2016-80975-P, and the Generalitat de Catalunya Research Group 2017SGR 859. “Comportamiento ecosocial de los homínidos de la Sierra de Atapuerca durante el Cuaternario V”, MICINN-FEDER PGC2018-093925-B-C32 and the Generalitat de Catalunya, AGAUR agency, SGR 859 and SGR 1040. Gerda Henkel Foundation (AZ 32/V/ 19, Lower Paleolithic Spheroids Project (LPSP) is assuring continuity in this line of research. ST is beneficiary of the Provincia Autonoma di Bolzano (Italy) post-master scholarship. AB has been funded from the European Union’s Horizon 2020 research and innovation programme under the Marie Sklodowska-Curie Action grant agreement PREKARN nº702584. The research of DB, JMV, & RSR is funded by CERCA Programme/Generalitat de Catalunya. JMJA belongs to the Research Group HUM-607.

The current paper presents three studies, which suggest that perceiving one’s nation as transgenerational (TG) is related to a differentiation in the evaluation of ethnically German diaspora migrants and ethnically non-German (‘foreign’) migrants. First, we find that unlike ‘classical’ concepts such as right-wing authoritarianism (RWA), social dominance orientation (SDO), and hierarchic self-interest (HSI), TG explains differences in derogatory sentiments expressed towards diaspora and ‘foreign’ migrants. Second, TG is differentially related to positive emotions and behavioral intentions expressed towards these two groups of migrants. Lastly, results indicate that people who perceive the ingroup as TG require ‘foreign’ migrants to fulfill more criteria that make them eligible for citizenship and are thereby more exclusionist than people who include only the current generation into their concept of national identity. The social implications of these findings in face of the so-called refugee crisis in Germany and the wider European Union are discussed.

Indirect questioning techniques such as the crosswise model aim to control for socially desirable responding in surveys on sensitive personal attributes. Recently, the extended crosswise model has been proposed as an improvement over the original crosswise model. It offers all of the advantages of the original crosswise model while also enabling the detection of systematic response biases. We applied the extended crosswise model to a new sensitive attribute, campus islamophobia, and present the first experimental investigation including an extended crosswise model, and a direct questioning control condition, respectively. In a paper-pencil questionnaire, we surveyed 1,361 German university students using either a direct question or the extended crosswise model. We found that the extended crosswise model provided a good model fit, indicating no systematic response bias and allowing for a pooling of the data of both groups of the extended crosswise model. Moreover, the extended crosswise model yielded significantly higher estimates of campus Islamophobia than a direct question. This result could either indicate that the extended crosswise model was successful in controlling for social desirability, or that response biases such as false positives or careless responding have inflated the estimate, which cannot be decided on the basis of the available data. Our findings highlight the importance of detecting response biases in surveys implementing indirect questioning techniques.

This paper studies the spatial and time series patterns of religious liberty across countries and estimates its effect on measures of human flourishing. First, while there are significant cross-country differences in religious liberty, it has declined in the past decade across countries, particularly among countries that rank higher in economic freedom. Second, countries with greater religious liberty nonetheless exhibit greater levels of economic freedom, particularly property rights. Third, using micro-data across over 150 countries in the world between 2006 and 2018, increases in religious freedom are associated with robust increases in measures of human flourishing even after controlling for time-invariant characteristics across space and time and a wide array of time-varying country-specific factors, such as economic activity and institutional quality. Fourth, these improvements in well-being are primarily driven by improvements in civil liberties, such as women empowerment and freedom of expression.

Antenatal care (ANC) contacts have long been considered a critical component of the continuum of care for a pregnant mother along with the newborn baby. The latest maternal mortality survey in Bangladesh suggests that progress in reducing maternal mortality has stalled as only 37% of pregnant women have attended at least four ANC contacts. This paper aims to determine what factors are associated with ANC contacts for women in Bangladesh. We analysed the data, provided by Bangladesh demographic and health survey 2014, covering a nationally representative sample of 17,863 ever married women aged 15-49 years. A two-stage stratified cluster sampling was used to collect the data. Data derived from 4,475 mothers who gave birth in the three years preceding the survey. Descriptive, inferential, and multivariate statistical techniques were used to analyse the data. An overall 78.4% of women had ANC contacts, but the WHO recommended ≥8 ANC contacts and ANC contacts by qualified doctors were only 8% for each. The logistic regression analysis revealed that division, maternal age, women's education, husband's education, wealth index and media exposure were associated with the ANC contacts. Likewise, place of residence, women's education, religion, and wealth index were also found to be associated with the WHO recommended ANC contacts. Furthermore, the husband's education, division, religion and husband's employment showed significant associations with ANC contacts by qualified doctors. However, Bangladeshi women in general revealed an unsatisfactory level of ANC contacts, the WHO recommended as well as ANC contacts by qualified doctors. In order to improve the situation, it is necessary to follow the most recent ANC contacts recommended by the WHO and to contact the qualified doctors. Moreover, an improvement in education as well as access to information along with an increase of transports, care centres and reduction of service costs would see an improvement of ANC contacts in Bangladesh.

There is a significant number of funerary contexts for the Early Neolithic in the Iberian Peninsula, and the body of information is much larger for the Late Neolithic. In contrast, the archaeological information available for the period in between (ca. 4800-4400/4200 cal BC) is scarce. This period, generally called Middle Neolithic, is the least well-known of the peninsular Neolithic sequence, and at present there is no specific synthesis on this topic at the peninsular scale. In 2017, an exceptional funerary context was discovered at Dehesilla Cave (Sierra de Cádiz, Southern Iberian Peninsula), providing radiocarbon dates which place it at the beginning of this little-known Middle Neolithic period, specifically between ca. 4800–4550 cal BC. Locus 2 is a deposition constituted by two adult human skulls and the skeleton of a very young sheep/goat, associated with stone structures and a hearth, and a number of pots, stone and bone tools and charred plant remains. The objectives of this paper are, firstly, to present the new archaeological context documented at Dehesilla Cave, supported by a wide range of data provided by interdisciplinary methods. The dataset is diverse in nature: stratigraphic, osteological, isotopic, zoological, artifactual, botanical and radiocarbon results are presented together. Secondly, to place this finding within the general context of the contemporaneous sites known in the Iberian Peninsula through a systematic review of the available evidence. This enables not only the formulation of explanations of the singular new context, but also to infer the possible ritual funerary behaviours and practices in the 5th millennium cal BC in the Iberian Peninsula.

The retouching and resharpening of lithic tools during their production and maintenance leads to the production of large numbers of small flakes and chips known as microdebitage. Standard analytical approaches to this material involves the mapping of microartefact densities to identify activity areas, and the creation of techno-typologies to characterise the form of retouch flakes from different types of tools. Whilst use-wear analysis is a common approach to the analysis of tools, it has been applied much less commonly to microdebitage. This paper contends that the use-wear analysis of microdebitage holds great potential for identifying activity areas on archaeological sites, representing a relatively unexplored analytical resource within microartefact assemblages. In order to test the range of factors that affect the identification of use-wear traces on small retouch flakes, a blind test consisting of 40 retouch flakes was conducted. The results show that wear traces can be identified with comparable levels of accuracy to those reported for historic blind tests of standard lithic tools suggesting that the use-wear analysis of retouch flakes can be a useful analytical tool in understanding site function, and in increasing sample sizes in cases where assemblages contain few tools., BC Grant Number: 328642 Funder: European Commission FP7 Marie Curie Actions Intra-European Fellowship programme - Grant Number: AH/N007506/1 Funder: Arts and Humanities Research Council (UK) - Grant Number: HAR2016-75201-P Funder: Ministry of Science and Innovation, Spain - Grant Number: AH/L503939/1 Funder: Arts and Humanities Research Council (UK) through the South West and Wales Doctoral Training

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

This paper uses data from a community cross-sectional survey to examine the factors that are associated with justification of physical violence against women. Results indicate that respondents who were married at the time of the survey were less likely (OR = 0.29; CI = 0.17–0.52) to agree that it is justified for a man to physically assault his partner that their counterparts who were single. The likelihood to justify physical violence was less likely to happen among respondents with primary education (OR = 0.49; CI = 0.39–0.62), secondary education (OR = 0.40; CI = 0.31–0.53) and vocation or tertiary education (OR = 0.28; CI = 0.19–0.41) than among respondents with no education. Protestants were less likely (OR = 0.77; CI = 0.64–0.94) to justify physical violence than the Catholics. Respondents who were not formally employed were more likely (OR = 1.66; CI = 1.32–2.08) to justify physical violence than their counterparts who were in formal employment in the last three months preceding the survey. Respondents who agreed that it is okay for a man to control his partner’s movements (OR = 1.27; CI = 1.04–1.55), it is okay for a man to have sex with his wife anytime (OR = 2.28; CI = 1.87–2.78), alcohol is the main reason for violence against women (OR = 1.67; CI = 1.33–2.10), men need sex more than women (OR = 1.57; CI = 1.23–1.99) and women know where to obtain support in case of violence (OR = 1.42; CI = 1.00–2.02) were more likely to justify physical violence than respondents who disagreed. The likelihood to justify physical violence was less among respondents who agreed that: violence is not the only way to deal with disagreements (OR = 0.54; CI = 0.33–0.86), it is possible for men to stop violence (OR = 0.62; CI = 0.47–0.82) and it is acceptable for a woman to ask her partner to use a condom (OR = 0.61; CI = 0.51–0.73) than their counterparts who disagreed. There is need to increase investment in social norms change programmes in order to strengthen contestation of tolerance of physical violence among men and women in Uganda.

The Aceramic Neolithic site of Ganj Dareh (Kermanshah, Iran) is arguably one of the most significant sites for enhancing our understanding of goat domestication and the onset of sedentism. Despite its central importance, it has proven difficult to obtain contextually reliable data from it and integrate the site in regional syntheses because it was never published in full after excavations ceased in 1974. This paper presents the Ganj Dareh archive at Université de Montréal and shows how the documentation and artifacts it comprises still offer a great deal of useful information about the site. In particular, we 1) present the first stratigraphic profile for the site, which reveals a more complex depositional history than Smith’s five-level sequence; 2) reveal the presence of two possible pre-agricultural levels (H-01 and P-01); 3) explore the spatial organization of different levels; 4) explain possible discrepancies in the radiocarbon dates from the site; 5) show some differences in lithic technological organization in levels H-01 and P-01 suggestive of higher degrees of residential mobility than subsequent phases of occupation at the site; and 6) reanalyze the burial data to broaden our understanding of Aceramic Neolithic mortuary practices in the Zagros. These data help refine our understanding of Ganj Dareh’s depositional and occupational history and recenter it as a key site to improve our understanding the Neolithization process in the Middle East.

BackgroundsAccurate measurement and suitable strategies facilitate people regulate their sadness in an effective manner. Regulating or mitigating negative emotions, particularly sadness, is crucial mainly because constant negative emotions may lead to psychological disorders, such as depression and anxiety. This paper presents an overview of sadness regulation strategies and related measurement.MethodUpon adhering to five-step scoping review, this study combed through articles that looked into sadness regulation retrieved from eight databases.ResultsAs a result of reviewing 40 selected articles, 110 strategies were identified to regulate emotions, particularly sadness. Some of the most commonly reported strategies include expressive suppression, cognitive reappraisal, distraction, seeking social or emotional support, and rumination. The four types of measures emerged from the review are self-reported, informant report (parents or peers), open-ended questions, and emotion regulation instructions. Notably, most studies had tested psychometric properties using Cronbach’s alpha alone, while only a handful had assessed validity (construct and factorial validity) and reliability (Cronbach’s alpha or test-retest) based on responses captured from questionnaire survey.ConclusionSeveral sadness regulation strategies appeared to vary based on gender, age, and use of strategy. Despite the general measurement of emotion regulation, only one measure was developed to measure sadness regulation exclusively for children. Future studies may develop a comprehensive battery of measures to assess sadness regulation using multi-component method.

Background The increased risk of suicidal behaviour among Turkish women living in Europe and Turkey is a serious public health problem. This study compares and synthesises the empirical evidence of demographic, social, psychological and interpersonal characteristics and precipitating factors in the suicides and attempted suicides of Turkish women in Europe and Turkey. Methods We systematically searched eight databases (PsycINFO, PubMed, Med Line, Web of Science, Smart Cat, Safety Lit, BASE and Ulakbim), using search terms in English, Turkish, German and Dutch, as well as the reference lists of the retrieved papers. We extracted data on countries/regions, population characteristics, sample characteristics, recruitment, method of data collection, type of suicidal behaviour (suicide or attempted suicide) and precipitating factors and characteristics. The results were qualitatively synthesised. Results We retrieved nine studies on attempted suicide in Europe (from Germany, Switzerland and the Netherlands), 17 studies on attempted suicide in Turkey and 10 studies on suicide in Turkey (36 in total). Overall, we found similar precipitating factors and characteristics of attempted suicide and suicide in Turkey and Europe, including socio-demographic factors (young age and not being enrolled in the labour market), poverty and, to some extent, mental illness. Moreover, conflicts with family or spouses and violence against women, including so-called honour violence, were particularly common for women living in or originating from traditional areas in Turkey. Conclusion The framework of intersectionality is relevant to understanding our results, because structural inequalities in gender roles, gender role expectations as well as power imbalances among socio-economic classes collectively impact the suicidal behaviour of Turkish women. Moreover, the importance of violence against women points to the cultural continuity of the patriarchal and oppressive structures of Europe and Turkey. Suicide prevention efforts should address cultural attitudes underlying violence against women and girls through community education programmes, cultural and gender-sensitive care provision and jurisdiction.

Since the inception of the National Programme for Family Planning, messages on family planning (FP) have been promoted across India using different mass media platforms. Mass media plays an important role in disseminating important information among the masses, such as how reversible modern methods give women more reproductive choices than opting for permanent methods that limit their child-bearing capacity. Mass media can provide a continuous flow of information and motivation to deter women from discontinuing the methods they have opted for. However, very few studies have been conducted on this issue, especially using recently available data. This study particularly focuses on exposure to mass media and the use of reversible modern methods of family planning among married women in India. The data for this study was obtained from the National Family Health Survey (2015–16) on currently married women aged 15–49 years. The association of reversible modern method use with media exposure variables was examined, controlling for a set of independent variables from multiple levels—individual, district, state, and region. The findings from this study showed that television was the most important medium for disseminating information on FP among married women in India. Spatial analysis revealed that some districts in the north, parts of the northeast, and Kerala in South India lacked any television exposure. The results from the decomposition analysis showed that mass media exposure was associated with a 14% increase in the use of reversible modern methods. Results from the multilevel analyses showed that exposure to TV along with other media (AOR 1.57 95% CI 1.49–1.65) and exposure to FP messages through different media (AOR 1.22 95% CI 1.12–1.32) had a significant positive effect on the use of reversible modern methods even when various individual, district, state, and regional-level factors were controlled. The findings of this paper provide evidence supporting the use of mass media to promote and increase awareness of voluntary contraceptive use in India. An increase in mass media exposure coupled with improvement in coverage and services of the FP program can significantly increase the use of reversible modern methods in a cost-effective yet efficient manner among women in need of FP services.

In criminological research the relationship between religion and delinquency has received great attention. Religiosity has been shown to be a protective factor for violent behaviour, drug use and other types of crime. In contrast, the relationship between religion and extremism was rarely investigated and then almost exclusively in relation to Islamist extremism. This paper presents results of a youth survey on extremism in Switzerland. A total of 8317 young people in ten cantons were interviewed about right-wing, left-wing and Islamist extremism. The study allows in a unique way to analyse religion, religiosity and religious attitudes in relation to three forms of extremist attitudes. The results show that religion is an important influencing factor of extremism, but religious affiliation and religiosity are less important than specific religious attitudes such as religious tolerance and religious exclusivity.

Background This paper aimed to explore various factors associated with the use of sanitary napkins among adolescent girls in Uttar Pradesh and Bihar. Methods The study uses information from the Understanding the Lives of Adolescents and Young Adults (UDAYA) project survey conducted in Uttar Pradesh and Bihar in 2016. The study sample consisted of 14,625 adolescent girls aged 10–19 years. The study sample was selected using a multi-stage systematic sampling design. Multilevel logistic regression (MLR) was used to identify the individual and community level factors associated with the use of sanitary napkins. Results The results revealed a wide variation in sanitary napkins’ use across the socio-economic and demographic factors. The use of sanitary napkins was significantly higher among girls with 8–9 (53.2%) and 10 and more (75.4%) years of schooling compared to those who had no formal education (26.4%). The use of sanitary napkins was higher among adolescent girls who were not engaged in paid work (54.7%) than those who did any paid job (40.8%). Adolescent girls reporting frequent exposure to mass media (OR = 2.10), belonging to the richest wealth quintile (OR = 3.76), and whose mothers had 10 or more years of education (OR = 2.29) had a higher propensity to use sanitary napkins than their counterparts. We did not find a significant role of community-level education of mothers on the menstrual hygiene practices of adolescents. Conclusion Ensuring that adolescent girls have access to hygienic means to manage their menses is critical from a public health perspective and in enabling them to realize their full potential. Programs to enhance menstrual hygiene are warranted. These programs should involve mothers, who are an important source of knowledge about menstrual hygiene. Facilitating girls’ access to education may also produce tangible menstrual hygiene benefits.

BackgroundThe patients that experience adverse events are in the best position to report them, only if they were empowered to do so. Systematic community engagement and support to patients in a rural setting to monitor any potential harm from medicines should provide evidence for patient safety.MethodsThis paper describes an uncontrolled before and after study aimed at assessing the effect of a community engagement strategy, the Community Dialogues and Sensitization (CDS) intervention between January and April 2017, on the knowledge, attitude and practice of reporting adverse drug events by community members in the two eastern Ugandan districts. A representative cross-sectional baseline household survey was done prior to the intervention in September 2016 (n=1034) and the end-line survey (n=827) in July 2017.ResultsAfter implementation of the CDS intervention, there was an overall 20% (95% CI=16- 25) increase in awareness about adverse drug events in the community. The young people (15- 24 years) demonstrated a 41% (95% CI =31-52) increase and the un-educated showed a 50% (95% CI=37-63) increase in awareness about adverse drug events. The attitudes towards reporting increased overall by 5% in response to whether there was a need to report ADEs (95% CI =3-7). An overall 115% (95% CI =137-217) increase in the population that had ever experienced ADEs was also reported.ConclusionOur evaluation shows that the CDS intervention increases knowledge, improves attitudes by catalyzing discussions among community members and health workers on health issues and monitoring safety of medicines.

In this paper, we explore gender norms held by men and women that might contribute to male perpetration of intimate partner violence (IPV) in Ghana. This qualitative research was conducted at the pre-intervention stage of a cluster randomized controlled trial. Our intervention uses community-based action teams to change social norms on gender and violence. Focus group discussions and in-depth interviews were conducted within communities. We found that male perpetrated IPV is a common phenomenon within the study communities, yet it is complex and experienced differently depending on the context. A woman's non-compliance with gender norms provided context for the male partner to enforce societal conformity through IPV. Also, male partners' misbehavior (e.g. alcohol abuse) may exacerbate IPV. Whereas the former is socially acceptable, the latter may be contested. Victims may challenge/counteract IPV using varying tactics (e.g. threats), which were mainly directed toward male partners' immoral behavior. We conclude that there is a need to assess IPV with key considerations for female agency, as some victims may respond with violence. Moreover, some communities have the tendency to demonstrate more gender-equitable attitudes regarding male perpetration of IPV, as indicated by laws instituted by some traditional leaders to deter perpetrators. These are key learnings that can inform the design and delivery of various interventions that seek to address IPV.