The putative cannabinoid-secreting trichome of Trema micrantha (L.) Blume (Cannabaceae)

Trema, a genus of the popularly known Cannabaceae, has recently been the subject of cannabinoid bioprospection. T. micrantha is a tree with pharmacological potential widely used in folk medicine. It has two types of glandular trichomes, bulbous and filiform, spread throughout the plant body. Considering the proximity of this species to Cannabis sativa and Trema orientalis, species containing cannabinoids, the glandular trichomes of T. micrantha are also expected to be related to the secretion of these compounds. Thus, this study aims to detail the morphology of secretory trichomes during the synthesis, storing and release of metabolites in T. micrantha. We tested the proposition that they could be a putative type of cannabinoid-secreting gland. Pistillate and staminate flowers and leaves were collected and processed for ontogenic, histochemical, and ultrastructural analyses. Both types of glandular trichomes originate from a protodermal cell. They are putative cannabinoid-secreting sites because: (1) terpene-phenols and, more specifically, cannabinoids were detected in situ; (2) their secretory subcellular apparatus is consistent with that found in C. sativa: modified plastids, polyribosomes, an extensive rough endoplasmic reticulum, and a moniliform smooth endoplasmic reticulum. Plastids and smooth endoplasmic reticulum are involved in the synthesis of terpenes, while the rough endoplasmic reticulum acts in the phenolic synthesis. These substances cross the plasma membrane by exocytosis and are released outside the trichome through cuticle pores. The study of the cell biology of the putative cannabinoid glands can promote the advancement of prospecting for natural products in plants.

HIV knowledge and access to testing for people with and without disabilities in low- and middle-income countries: evidence from 37 Multiple Indicator Cluster Surveys

INTRODUCTION

Disability and HIV are intricately linked, as people with disabilities are at higher risk of contracting HIV, and living with HIV can lead to impairments and disability. Despite this well-established relationship, there remains limited internationally comparable evidence on HIV knowledge and access to testing for people with disabilities.

METHODS

We used cross-sectional data from 37 Multiple Indicator Cluster Surveys. Surveys were from six UNICEF regions, including East Asia and Pacific (n = 6), East and Central Asia (n = 7), Latin America and the Caribbean (n = 6), Middle East and North Africa (n = 4), South Asia (n = 2) and sub-Saharan Africa (n = 12). A total of 513,252 people were eligible for inclusion, including 24,695 (4.8%) people with disabilities. We examined risk ratios and 95% confidence intervals for key indicators on HIV knowledge and access to testing for people with disabilities by sex and country. We also conducted a meta-analysis to get a pooled estimate for each sex and indicator.

RESULTS

Men and women with disabilities were less likely to have comprehensive knowledge about HIV prevention (aRR: 0.74 [0.67, 0.81] and 0.75 [0.69, 0.83], respectively) and to know of a place to be tested for HIV (aRR: 0.95 [0.92, 0.99] and 0.94 [0.92, 0.97], respectively) compared to men and women without disabilities. Women with disabilities were also less likely to know how to prevent mother-to-child transmission (aRR: 0.87 [0.81, 0.93]) and ever have been tested for HIV (aRR: 0.90 [0.85, 0.94]).

CONCLUSIONS

Men and women with disabilities have lower overall HIV knowledge and in particular women with disabilities also indicate lower testing rates. Governments must include people with disabilities in HIV programmes by improving disability-inclusion and accessibility to HIV-related information, education and healthcare services.

Technology and the Situationist Challenge to Virtue Ethics

In this paper, I introduce a "promises and perils" framework for understanding the "soft" impacts of emerging technology, and argue for a eudaimonic conception of well-being. This eudaimonic conception of well-being, however, presupposes that we have something like stable character traits. I therefore defend this view from the "situationist challenge" and show that instead of viewing this challenge as a threat to well-being, we can incorporate it into how we think about living well with technology. Human beings are susceptible to situational influences and are often unaware of the ways that their social and technological environment influence not only their ability to do well, but even their ability to know whether they are doing well. Any theory that attempts to describe what it means for us to be doing well, then, needs to take these contextual features into account and bake them into a theory of human flourishing. By paying careful attention to these contextual factors, we can design systems that promote human flourishing.

Language Learning for People Living with Dementia and Their Caregivers: Feasibility and the Quality of Experience

BACKGROUND

A body of research from around the world has reported positive effects of bilingualism on cognitive ageing and dementia. However, little is known about whether foreign language learning could be applied as an intervention for people already living with dementia. Yet, before it is possible to determine the efficacy of language courses as an intervention for people living with dementia (PLWD), it is necessary to establish whether such an intervention is feasible. Our study explored this possibility.

METHODS

We conducted an exploratory study to examine the feasibility and tolerability of 2-week Italian beginner courses for PLWD in early stages and their family carers in two Scottish Dementia Resource Centres (DRCs). The courses were delivered by trained tutors from Lingo Flamingo, a social enterprise specialising in language teaching for older learners and learners with dementia. Twelve PLWD and seven carers participated in the study. Focus groups preceded and followed the courses. Additional post-course open interviews with the DRC managers were conducted, with a follow-up via telephone approximately one year later.

RESULTS

Qualitative content analysis resulted in 12 themes, 5 reflected in the interview schedule and 7 arising from the focus groups and interviews. Overall, the courses were perceived positively by PLWD, carers, and DRC managers, although a few logistically and linguistically challenging aspects were also mentioned. The courses were found to positively impact both the individual by increasing self-esteem and producing a sense of accomplishment as well as the group by creating a sense of community. Notably, no adverse effects (in particular no confusion or frustration) were reported.

CONCLUSION

The positive outcomes of our study open a novel avenue for future research to explore foreign language training in dementia as an intervention and its implications.

`It's not just linguistically, there's much more going on': The experiences and practices of bilingual paediatric speech and language therapists in the UK

BACKGROUND

Despite the high prevalence of bilingualism in the United Kingdom, few speech and language therapists (SLTs) are bilingual themselves. Most SLT research on bilingualism has generated knowledge to inform service delivery for bilingual clients, but few studies have investigated how being a bilingual SLT influences one's professional experiences and practices. Better understanding the unique positionality of bilingual SLTs can yield critical insights to meaningfully address issues of diversity, inclusion and equity in the profession.

AIMS

To investigate the experiences and practices of bilingual paediatric SLTs in the United Kingdom through the lens of Cultural-Historical Activity Theory-International Classification of Functioning, Disability and Health (CHAT-ICF), a new theoretical framework developed to conceptualise the activities of professionals working in the field of disability.

METHODS

In this qualitative study, 19 bilingual paediatric SLTs practising in the United Kingdom were interviewed individually. Participants were recruited through a snowball sampling strategy, and semi-structured interviews conducted online. The data were analysed using reflexive thematic analysis and following a hybrid inductive-deductive approach to map the results onto the CHAT-ICF framework.

RESULTS

Six overarching components of the CHAT-ICF framework hosted the 12 sub-themes identified to capture the experiences and practices of bilingual SLTs: (1) Subject (intersectionality); (2) Tools (language skills, education, clinical resources); (3) Rules (systemic barriers, sense of responsibility); (4) Community (sense of inclusion); (5) Division of labour (parents, colleagues); and (6) Practice (empathy with children, holistic mindset, flexible approaches). The use of the CHAT-ICF theoretical lens revealed two fundamental structural phenomena: (1) the distribution of sub-themes across many components of CHAT-ICF demonstrated that being a bilingual SLT is a multifactorial experience; and (2) the chain reactions between sub-themes illustrated the dynamic nature of bilingual SLTs' experiences which can be harnessed to challenge marginalisation and promote equity in the profession.

CONCLUSION & IMPLICATIONS

This is the first qualitative study to date to provide in-depth insights into the experiences and practices of bilingual SLTs in the United Kingdom. These insights can be mobilised to inform the meaningful inclusion of bilingual SLTs in workforce planning efforts and service development. Recommendations include using intersectional lenses, providing cultural and anti-racism awareness training to SLTs, developing more diverse clinical resources and flexible approaches for bilingual families, valuing bilingualism in recruitment processes and increasing accountability at the leadership level. Research giving voice to bilingual SLTs, and other underrepresented demographics in the SLT workforce, can catalyse action to promote a more diverse and inclusive profession in line with the Royal College of Speech and Language Therapists' strategic vision 2022-2027.

WHAT THIS PAPER ADDS

What is already known on the subject Most research on bilingualism in speech and language therapy is focused on issues related to service provision and delivery for bilingual clients with little consideration for bilingual speech and language therapists' (SLTs) unique positionality. A few survey studies have shown that bilingual SLTs report significantly higher competency and greater confidence when working with clients who speak multiple languages, but there are significant gaps in understanding how bilingualism impacts other aspects of their professional experiences. What this paper adds to existing knowledge This is the first study to provide in-depth insights into the experiences and practices of bilingual SLTs in the United Kingdom. We show that being bilingual profoundly impacts many aspects of their professional experiences, including their clinical identity, skillset, sense of inclusion in the workplace, work relationships and clinical approaches. Bilingual SLTs expressed developing trust relationships with bilingual families and adopting flexible approaches to account for their clients' environmental factors, all of which can contribute to more equitable SLT services. This study also makes a novel contribution by proposing and using the Cultural-Historical Activity Theory-International Classification of Functioning, Disability and Health (CHAT-ICF) framework to conceptualise and investigate SLTs' experiences and practices. What are the potential or actual clinical implications of this work? This study provides evidence-based recommendations to inform progress towards the Royal College of Speech and Language Therapists' strategic vision 2022-2027 and the diversification of the profession. Actions to support bilingual SLTs and diversify the profession include shifting a rigid mindset of linguistic and cultural `competence' to self-growth and awareness, developing more diverse clinical resources and flexible approaches for bilingual families, valuing bilingualism in SLT recruitment processes and career progression and increasing accountability and leadership around issues of diversity in the workplace. The novel CHAT-ICF framework has the potential to be used to support therapists' reflexivity in their practice or structure audits of rehabilitation services. Intersectionality theories and transformative processes can catalyse positive change in clinical services and research around bilingualism.

The technology of polychrome glazed ceramics in Ifriqiya: new data from the site of Chimtou

Ifriqiya (roughly Tunisia and eastern Algeria) is believed to have played a significant role in the diffusion of ceramic glazed technologies into other regions of the Western Mediterranean. However, due to limited analysis on North African glazed ceramics, its role in technology transfer remains poorly understood. This paper uses SEM-EDS and petrographic analyses to understand the technology employed in the production of Tunisian ceramics through the study of 30 polychrome glazed ceramics from a medieval settlement at the site of Chimtou (ancient Simitthus), Tunisia, dated to the late ninth-twelfth century. The results show that these are lead-rich glazes with varying contents of alkalis, coloured with copper, iron and manganese oxide and applied over a calcareous body. Opaque glazes were obtained using cassiterite crystals as opacifier or by adding crushed quartz. The use of lead stannate as a colourant and opacifier in one light yellow glaze raises questions about the mechanisms of introduction of tin opacification technology in North Africa. Scrap metal seems to have been used as a source of lead for the glazes; while iron slag was probably used as a source of iron to colour the glaze in one sample, pointing to a cross-craft interaction between glazemaking and metallurgy.

Supplementary information

The online version contains supplementary material available at 10.1007/s12520-024-01974-x.

Isotopic biographies reveal horse rearing and trading networks in medieval London

This paper reports a high-resolution isotopic study of medieval horse mobility, revealing their origins and in-life mobility both regionally and internationally. The animals were found in an unusual horse cemetery site found within the City of Westminster, London, England. Enamel strontium, oxygen, and carbon isotope analysis of 15 individuals provides information about likely place of birth, diet, and mobility during the first approximately 5 years of life. Results show that at least seven horses originated outside of Britain in relatively cold climates, potentially in Scandinavia or the Western Alps. Ancient DNA sexing data indicate no consistent sex-specific mobility patterning, although three of the five females came from exceptionally highly radiogenic regions. Another female with low mobility is suggested to be a sedentary broodmare. Our results provide direct and unprecedented evidence for a variety of horse movement and trading practices in the Middle Ages and highlight the importance of international trade in securing high-quality horses for medieval London elites.

Nourishing food, clean air and exercise: medical debates over environment and polar hygiene on Robert Falcon Scott's British National Antarctic expedition, 1901-1904

The late nineteenth and early twentieth century saw dramatic new developments in climatic medicine, particularly the institutionalisation of thinking about tropical hygiene. There were also more limited efforts to understand how hygiene theories should be applied in a polar environment. Studying the British National Antarctic Expedition (1901-1904), led by Robert Falcon Scott, helps us understand how these practices had both similarities and differences from applications of hygiene in other contexts. The expedition offers unique insights into debates about hygiene, environment, and health because of the important, and well documented, role that medics, naval officers and scientists played in organising logistical arrangements for the journey to Antarctica. In analysing the writings of expedition members and organisers, this paper examines the ways that the universal tools of hygiene theories were applied and developed in a polar environment. Many of the most acute threats seemed to come not from the outside environment but from the explorers' supplies and equipment. There was general agreement on many issues. Yet the expedition's organisers, medics and leadership had numerous arguments about the best way to preserve or restore health. These disagreements were the product of both competing medical theories about the cause of disease and the importance of embodied (and somewhat subjective) observations in establishing the safety of foods, atmospheres and environments in this period.

COVID-19 vaccine refusal as unfair free-riding

Contributions to COVID-19 vaccination programmes promise valuable collective goods. They can support public and individual health by creating herd immunity and taking the pressure off overwhelmed public health services; support freedom of movement by enabling governments to remove restrictive lockdown policies; and improve economic and social well-being by allowing businesses, schools, and other essential public services to re-open. The vaccinated can contribute to the production of these goods. The unvaccinated, who benefit from, but who do not contribute to these goods can be morally criticised as free-riders. In this paper defends the claim that in the case of COVID-19, the unvaccinated are unfair free-riders. I defend the claim against two objections. First, that they are not unfair free-riders because they lack the subjective attitudes and intentions of free-riders; second, that although the unvaccinated may be free-riders, their free-riding is not unfair.

Psychiatric epidemiology and the Chicago School of Sociology

This article explores the Chicago School of Sociology's influence on psychiatric epidemiology. While the Chicago School text usually associated with psychiatric epidemiology is the 1939 book by Faris and Dunham, it is important to acknowledge the influence of earlier Chicago School projects during the 1920s. These projects, tackling everything from homelessness and delinquency to the ghetto and suicide, provided models not only for Faris and Dunham, but also for numerous methodological and theoretical insights for the social psychiatry projects that would emerge after World War II. The social sciences and the humanities still have important roles to play in informing contemporary approaches to psychiatric epidemiology and deriving ways to tackle the socio-economic problems that contribute to mental illness.

Ancient and modern DNA track temporal and spatial population dynamics in the European fallow deer since the Eemian interglacial

Anthropogenic factors have impacted the diversity and evolutionary trajectory of various species. This can be through factors such as pressure on population size or range, habitat fragmentation, or extensive manipulation and translocation. Here we use time-calibrated data to better understand the pattern and processes of evolution in the heavily manipulated European fallow deer (Dama dama). During the Pleistocene, fallow deer had a broad distribution across Europe and were found as far north as Britain during the Eemian interglacial. The last glacial period saw fallow deer retreat to southern refugia and they did not disperse north afterwards. Their recolonisation was mediated by people and, from northern Europe and the British Isles, fallow deer were transported around the world. We use ancient and modern mitochondrial DNA (mtDNA) and mitogenomic data from Eemian Britain to assess the pattern of change in distribution and lineage structure across Europe over time. We find founder effects and mixed lineages in the northern populations, and stability over time for populations in southern Europe. The Eemian sample was most similar to a lineage currently in Italy, suggesting an early establishment of the relevant refuge. We consider the implications for the integration of anthropogenic and natural processes towards a better understanding of the evolution of fallow deer in Europe.

Coloration in Flow: The Potential of In Situ Coloration of Casein Fibers to Mitigate Environmental Impact of Traditional Dyeing Methods

The environmental impact of the textiles and food industries can no longer be ignored, and while combining natural protein-based fibers with natural colorants, each derived from food waste, has the potential to offer increased sustainability based on a circular economy, it fails to address other environmentally detrimental textile production steps, such as coloration. This work explores the potential of a new, novel method for in situ coloration of regenerated protein fibers using an anthocyanin-based natural dye, used within the wet-spinning process, to reduce the environmental impact of the dyeing process. It is observed that similar or improved dye sorption and much improved 3D sustainability metrics (energy and material intensity) can be achieved through dyeing of casein fibers in flow, with higher color strength (K/Sλmax = 2.5) observed under milder conditions (room temperature, 10 s) compared to conventional dyeing (K/Sλmax = 1.0 at 40 °C, 30 min; K/Sλmax = 2.7 at 80 °C, 30 min). Energy intensity calculations show conventional dyeing requires 1.7-5.0 MJ kg-1 fiber, depending on the dyeing temperature for experiments performed in this paper and up to 13.4 MJ kg-1 fiber for examples in the literature. Using coloration in flow, energy intensity is negligible showcasing a vast improvement in energy-based metrics. The in situ experimental method showed a material intensity of 10.2 compared to 21.2 of the conventional method explored and up to 40.2 for examples in the literature, making the process in flow far less material intensive than conventional coloration methods, with additional potential for further material savings due to the recycling potential of the dyebath, which does not require auxiliary dyeing chemicals. Space time yield calculations showed that the productivity of the proposed method in flow is much higher (182.4 g L-1 h-1) compared to the conventional batch process (33.3-60.0 g L-1 h-1).

Potential factors contributing to observed sex differences in virtual-reality-induced sickness

Virtual reality (VR) technology has been widely adopted for several professional and recreational applications. Despite rapid innovation in hardware and software, one of the long prevailing issues for end users of VR is the experience of VR sickness. Females experience stronger VR sickness compared to males, and previous research has linked susceptibility to VR sickness to the menstrual cycle (Munafo et al., Exp Brain Res 235(3):889-901). Here we investigated the female versus male experience in VR sickness while playing an immersive VR game, comparing days of the menstrual cycle when hormones peak: day 15 (ovulation-peak estrogen) and day 22 (mid-luteal phase-peak progesterone). We found that immersion duration was greater in the second session than the first, and discomfort was lessened, suggesting a powerful adaptation with repeated exposure. Due to the estrogen levels changing along with the exposure, there was no clear independent impact of that; note, though, that there was a significant difference between self-report and physiological measures implying that GSR is potentially an unreliable measure of motion sickness. Although prior work found a delay over 2 days between session would not allow adaptation and habituation to reduce VR sickness susceptibility, we found that a week delay has potential success.

Youth-led co-production of mental health promotion in Pakistan: intergenerational influences

Youth with mental health needs face barriers in seeking and accessing help, especially in resource-constrained settings in Majority World Countries. Community engagement is thus important for mental health promotion, particularly in addressing stigma. Engagement can be enhanced by involving peer educators and by relating to intergenerational experiences in the sociocultural context of the community. The aim of this study was to explore how intergenerational experiences and perspectives can inform the co-production of youth-led mental health promotion in a Majority World Country, Pakistan. We recruited 11 families (one grandmother, mother and granddaughter in each family) as advisers from two disadvantaged areas of Karachi, and 14 peer educators. Training for peer educators included seminars, experiential activities, three participatory workshops with family advisers and supervision. A sub-sample of family advisers and peer educators attended four focus groups, and peer educators completed reflective diaries following each activity. Data were integrated and subjected to thematic codebook analysis. The three themes related to enabling and hindering factors towards co-production of mental health promotion, incorporation of intergenerational resilience and cascading knowledge to communities. The findings highlighted potential benefits of youth-led mental health promotion that contextualizes intergenerational experiences for those communities. Peer educator roles should be supported by training, and mental health promotion should be integrated within local service systems.

Consent-GPT: is it ethical to delegate procedural consent to conversational AI?

Obtaining informed consent from patients prior to a medical or surgical procedure is a fundamental part of safe and ethical clinical practice. Currently, it is routine for a significant part of the consent process to be delegated to members of the clinical team not performing the procedure (eg, junior doctors). However, it is common for consent-taking delegates to lack sufficient time and clinical knowledge to adequately promote patient autonomy and informed decision-making. Such problems might be addressed in a number of ways. One possible solution to this clinical dilemma is through the use of conversational artificial intelligence using large language models (LLMs). There is considerable interest in the potential benefits of such models in medicine. For delegated procedural consent, LLM could improve patients' access to the relevant procedural information and therefore enhance informed decision-making.In this paper, we first outline a hypothetical example of delegation of consent to LLMs prior to surgery. We then discuss existing clinical guidelines for consent delegation and some of the ways in which current practice may fail to meet the ethical purposes of informed consent. We outline and discuss the ethical implications of delegating consent to LLMs in medicine concluding that at least in certain clinical situations, the benefits of LLMs potentially far outweigh those of current practices.

Investigating environmental effects on phonology using diachronic models

Previous work has proposed various mechanisms by which the environment may affect the emergence of linguistic features. For example, dry air may cause careful control of pitch to be more effortful, and so affect the emergence of linguistic distinctions that rely on pitch such as lexical tone or vowel inventories. Criticisms of these proposals point out that there are both historical and geographic confounds that need to be controlled for. We take a causal inference approach to this problem to design the most detailed test of the theory to date. We analyse languages from the Bantu language family, using a prior geographic-phylogenetic tree of relationships to establish where and when languages were spoken. This is combined with estimates of humidity for those times and places, taken from historical climate models. We then estimate the strength of causal relationships in a causal path model, controlling for various influences of inheritance and borrowing. We find no evidence to support the previous claims that humidity affects the emergence of lexical tone. This study shows how using causal inference approaches lets us test complex causal claims about the cultural evolution of language.

Advances in the characterisation and identification of mastic (Pistacia sp.) resin in archaeological samples by GC-QToF-MS

The optimisation and application of an analytical method based on gas chromatography coupled to quadrupole time-of-flight mass spectrometry (GC-QToF-MS) is proposed for the first time for the characterisation and identification of mastic (Pistacia sp.) resin in archaeological samples. The GC-QToF-MS method demonstrated higher sensitivity compared to single quadrupole GC-MS and enabled enhanced structural elucidation power to be exploited, particularly due to the high mass resolution and accuracy, the possibility to use standard and low ionisation energies as well as its tandem MS capabilities. The heat-induced degradation of the resin was also studied in open air conditions, showing that 28-norolean-17-en-3-one forms upon heating, but then progressively degrades. This makes it a reliable marker for heating of Pistacia resin; however, the lack of detection does not imply that the resin was not heated. These observations were used to interpret the results of a large number of archaeological samples containing Pistacia resin in different formulations, from various archaeological contexts and exposed to different environmental conditions. Lumps of relatively pure resin found in marine waterlogged conditions (Uluburun shipwreck, Turkey), residues on ceramics from Sai Island (Nubia, Sudan) as well as varnish and coating layers on Egyptian coffins from the collections of the British Museum (London, UK) and Fitzwilliam Museum (Cambridge, UK) were analysed to understand what the molecular profiles reveal about the use of the resin. The results showed that the resin was often mixed with a drying or semi-drying oil in ancient varnish formulations, thus suggesting that oil was used as a medium to dissolve the resin, which would have been impossible to apply as a layer using simple heat. These new observations significantly add to our understanding of ancient Egyptian technology and provide museum scientists and conservators with key information to accurately identify Pistacia resin and preserve objects containing it.

Developing a strategy to scale up place-based arts initiatives that support mental health and wellbeing: A realist evaluation of 'Arts for the Blues'

Place-based arts initiatives are regarded as rooted in local need and as having capacity to engage local assets. However, many place-based arts initiatives remain poorly funded and short-lived, receiving little attention on how to scale up and sustain their activities. In this study we make a unique contribution to knowledge about scaling up place-based arts initiatives that support mental health and wellbeing through focusing on the example of 'Arts for the Blues', an arts-based psychological group intervention designed to reduce depression and improve wellbeing amongst primary care mental health service users in deprived communities. Methodologically, we used realist evaluation to refine the study's theoretical assumptions about scaling up, drawing on the lived and professional experiences of 225 diverse stakeholders' and frontline staff through a series of focus groups and evaluation questions at two stakeholders' events and four training days. Based on our findings, we recommend that to scale up place-based arts initiatives which support mental health and wellbeing: (i) the initiative needs to be adaptable, clear, collaborative, evidence-based, personalised and transformative; (ii) the organisation has to have a relevant need, have an understanding of the arts, has to have resources, inspiration and commitment from staff members, relevant skillsets and help from outside the organisation; (iii) at a policy level it is important to pay attention to attitude shifts towards the arts, meet rules, guidelines and standards expected from services, highlight gaps in provision, seek out early intervention and treatment options, and consider service delivery changes. The presence of champions at a local level and buy-in from managers, local leaders and policy makers are also needed alongside actively seeking to implement arts initiatives in different settings across geographical spread. Our theoretically-based and experientially-refined study provides the first ever scaling up framework developed for place-based arts initiatives that support the mental health and wellbeing, offering opportunities for spread and adoption of such projects in different organisational contexts, locally, nationally and internationally.

Authority and medical expertise: Arthur Conan Doyle in The Idler

Arthur Conan Doyle's medical and writing careers intertwined and his work has a history of being read in the light of his medical expertise. He wrote at a time when the professionalisation and specialisation of medicine had resulted in an increasing distance between the profession and the public, yet general practitioners relied financially on maintaining good relationships with their patients and popular medical journalism proliferated. A variety of contrasting voices often disseminated narratives of medical science. These conflicting developments raised questions of authority and expertise in relation to the construction of medicine in the popular imagination: how is knowledge constructed? Who should disseminate it? How and by whom is authority conferred? How can the general population judge experts in medical science? These are questions explored more widely in Conan Doyle's writing as he examines the relationship between expertise and authority. In the early 1890s, Conan Doyle wrote for the popular, mass-market periodical The Idler: An Illustrated Magazine His contributions to it address these questions of authority and expertise for a lay audience. First establishing the medical context of doctor/patient relationships in which these questions arose, this article undertakes a close reading of these mostly rarely studied single-issue stories and articles as a means of ascertaining how Conan Doyle and his illustrators identified the relationship between competing narratives, expertise and authority. It argues that rather than maintaining a distance between public and professional, Conan Doyle's illustrated work demonstrates to his readers that there are ways to successfully navigate the appearance of authority and recognise expertise as they confront entangled representations of advances in medical science.

"Sometimers, Alzheimer's? I love that! That's definitely me": Readers' Responses to Fictional Dementia Narratives

This article presents findings from an interdisciplinary project which invited readers to experience the impact of dementia via fictional characters' narratives. Combining methods from critical gerontology and literary linguistics-a field that examines the language of literature-we undertook an empirical reader response study of dementia fiction. We constructed a large corpus of dementia fiction; selecting 12 extracts, each containing first-hand, focalized accounts of fictional characters' experiences of living with dementia. Readers (31) were purposively sampled for 4 separate reading groups-student social workers (9); general public (9); family carers (6); and people with dementia (7). Over 6 weeks they engaged in separate, facilitated, on-line group discussions of extracts. Discussions were independently coded using ATLAS.ti. Although readers from all 4 groups reported that fictional characters drew them into the internal life of someone with dementia, some carers questioned whether fictional characters' experiences were plausible. Readers with dementia recognized themselves in the extracts; viewing fictional characters as eloquent envoys of their lived experiences of diagnosis, social isolation, loss of language, and use of humor. Fictional characters offer an entry point for understanding contrasts in caregiver and care-receiver experiences of dementia. Fictional characters are potentially useful for moving dementia narratives beyond monstrous cultural metaphors and onto a disability-based rights agenda.

Multiproxy bioarchaeological data reveals interplay between growth, diet and population dynamics across the transition to farming in the central Mediterranean

The transition to farming brought on a series of important changes in human society, lifestyle, diet and health. The human bioarchaeology of the agricultural transition has received much attention, however, relatively few studies have directly tested the interrelationship between individual lifestyle factors and their implications for understanding life history changes among the first farmers. We investigate the interplay between skeletal growth, diet, physical activity and population size across 30,000 years in the central Mediterranean through a 'big data' cross-analysis of osteological data related to stature (n = 361), body mass (n = 334) and long bone biomechanics (n = 481), carbon (δ13C) and nitrogen (δ15N) stable isotopes (n = 1986 human, n = 475 animal) and radiocarbon dates (n = 5263). We present the observed trends on a continuous timescale in order to avoid grouping our data into assigned 'time periods', thus achieving greater resolution and chronological control over our analysis. The results identify important changes in human life history strategies associated with the first farmers, but also highlight the long-term nature of these trends in the millennia either side of the agricultural transition. The integration of these different data is an important step towards disentangling the complex relationship between demography, diet and health, and reconstruct life history changes within a southern European context. We believe the methodological approach adopted here has broader global implications for bioarchaeological studies of human adaptation more generally.

"Work with us… to make it more accessible". What women with intellectual disabilities want from infant-feeding health resources: an exploratory study

BACKGROUND

More women with intellectual disabilities are becoming mothers but fewer are known to breastfeed compared with other women. Women with intellectual disabilities are entitled to accessible antenatal and infant feeding information, yet are rarely asked for their views on available resources. This article reports on the final stage of a UK project exploring how women with intellectual disabilities are supported to make infant feeding decisions. The wider project includes a scoping review and interviews with healthcare professionals, here we focus on the voices of the women themselves.

METHODS

Four women with an intellectual disability participated in a focus group where they were asked to give their views on the accessibility of currently available infant feeding resources and on alternative representations of infant feeding. All were interested in women's health issues, including infant feeding. Photo-elicitation was used to gather views on videos, bespoke 'Easy Read' material and several alternative representations of infant feeding. A transcription of the discussion was thematically analysed whilst a critical visual analysis was undertaken of the women's preferred images/resources. The study took place in Bristol, UK, during 2022.

RESULTS

Two themes were identified from the group discussion: 'The desire for choice' and 'How easy is 'Easy Read'?' The desire for choice was expressed in terms through agreements and disagreements about preferred imagery, differing tastes, and reasons for these preferences. We identified a challenge to 'Easy Read' as a default standard and concerns that some forms of 'Easy Read' can confuse rather than inform. Critical visual analysis identified the importance of the story and social setting of the preferred infant feeding image.

CONCLUSIONS

Findings suggest a need for a suite of resources, avoiding the one-size-fits-all approach, including people with an intellectual disability at every stage of the design and production process. Resources should recognise and embrace differences in terms of understanding, visual literacy and cultural taste, as well as being freely available to support women with intellectual disabilities to make informed infant feeding decisions. An accessible film was co-produced, to disseminate the findings from all three stages of the completed project.

Emotions of the pandemic: phenomenological perspectives

This article provides an introduction to the special issue "Emotions of the Pandemic: Phenomenological Perspectives". We begin by outlining how phenomenological research can illuminate various forms of emotional experience associated with the exceptional circumstances of the COVID-19 pandemic. In addition, we propose that a consideration of pandemic experience, in all its complexity and diversity, has the potential to yield wider-ranging phenomenological insights. We go on to discuss the thirteen contributions that follow, identifying common themes and points of complementarity.

The Alchemical Oedipus: Re-Visioning the Myth

The Oedipus myth is foundational to depth psychology due to Freud's use of Sophocles' play Oedipus Rex in the creation of psychoanalysis. But analytical psychology's engagement with the myth has been limited despite the importance Jung also places upon it. The absence of a developed Jungian response to Oedipus means the myth's psychologically constructive elements have been overlooked in favour of reductive Freudian interpretations. I examine whether analytical psychology can fruitfully re-engage with Oedipus by reinterpreting his story as a paternal rebirth. This is achieved by reincorporating those parts of the myth that occur before and after the period portrayed in Oedipus Rex. Such a move reintegrates Oedipus' father, King Laius, into the story and unveils important parallels with the alchemical trope of the king's renewal by his son. Using Jung's method of amplification, Oedipus is recast as Laius' redeemer and identified with the archetype of psychological wholeness, the Self. The contention is that such an understanding of Oedipus supports a clearer recognition of the potentially generative quality of human suffering, restoring to the myth the quality of moral instruction it possessed in antiquity.

Development of novel parameters for characterising scale morphology of wool fibre and its correlation with dye diffusion coefficient of acid dye

This paper reports the development of novel surface parameters which can be used to characterise the scale structure of wool fibres obtained from different breeds. Scanning electron microscopy and subsequent image analysis technique were used to study wool fibres from Leicester, Dartmoor, Ryeland and Herdwick breeds of sheep. Novel scale parameters related to wool fibre's effective chemical diffusion pathway were developed. Namely, the total scale perimeter per 100 µm fibre length and scale perimeter index, which is the total scale perimeter per 100 µm length divided by the fibre diameter. Wool fibres obtained from different breeds showed significant differences in their scale pattern with the change in fibre diameter. The scale perimeter per 100 µm length increased with the fibre diameter and showed a polynomial correlation. It was also demonstrated that an increase in the diameter of the wool fibre resulted in an increase in the apparent dye diffusion coefficient, which contrasts the established theory that finer fibres are associated with a higher dyeing rate. The increase in effective diffusion pathway (total scale perimeter per 100 µm) for the wool fibres (among different breeds) resulted in a higher dye diffusion rate at the initial phase of dyeing (liquor to surface).

Modelling arts professionals' wellbeing and career intentions within the context of COVID-19

The COVID-19 pandemic had a substantial effect on the creative and cultural industries in the United Kingdom (UK), as seen in our first snapshot of the HEartS Professional Survey (April-June 2020, Phase 1, N = 358). By analysing data collected one year later (April-May 2021, Phase 2, N = 685), the aims of the current study are to trace the contributors to (1) arts professionals' mental and social wellbeing and (2) their expectations of staying in the arts. Findings show that artists continued to experience challenges in terms of finances, and mental and social wellbeing. Over half of the respondents reported financial hardship (59%), and over two thirds reported being lonelier (64%) and having increased anxiety (71%) than before the pandemic. Hierarchical multiple linear regression models, using the Mental Health Continuum-Short Form, Center for Epidemiologic Studies Depression Scale, Social Connectedness Scale, and Three-Item Loneliness Scale as outcome variables, indicate that perceived financial hardship continued to be associated with higher depression and loneliness scores. As in our first study, more physical activity before lockdown was associated with higher wellbeing and social connectedness scores, and higher self-rated health scores were associated with higher wellbeing and lower depression scores. Similarly, increases in physical activity during lockdown, as well as older age, were still associated with higher wellbeing and social connectedness scores and with lower depression and loneliness scores. An ordinal logistic regression model indicated three contributors to artists' professional expectations of remaining in the arts: greater proportion of income from the arts pre-pandemic, continued maintenance of skills, and greater proportion of freelance work. The results suggest that the wellbeing patterns observed at the start of the pandemic remained consistent a year on. They point to possible strategies to support wellbeing and underline the importance of finances for expectations of remaining in arts professions.

Situating commercial determinants of health in their historical context: a qualitative study of sugar-sweetened beverages in Jamaica

BACKGROUND

Non-communicable diseases (NCDs) are the leading cause of mortality across the Caribbean and similar regions. Structural determinants include a marked increase in the dependency on food imports, and the proliferation of processed foods, including sugar-sweetened beverages (SSBs). We focused on Jamaica as a case study and the health challenge of SSBs, and situated contemporary actions, experiences and policies within their historical context to investigate underlying drivers of commercial determinants of health and attempts to counter them. We asked: how can a historical perspective of the drivers of high level SSB consumption in Jamaica contribute to an enhanced understanding of the context of public health policies aimed at reducing their intake?

METHODS

An ethnographic approach with remote data collection included online semi-structured interviews and workshops with 22 local experts and practitioners of health, agriculture and nutrition in Jamaica and attending relevant regional public webinars on SSBs and NCD action in the Caribbean. Our analysis was situated within a review of historical studies of Caribbean food economies with focus on the twentieth century. Jamaican and UK-based researchers collected and ethnographically analysed the data, and discussed findings with the wider transdisciplinary team.

RESULTS

We emphasise three key areas in which historical events have shaped contextual factors of SSB consumption. Trade privileged sugar as a cash crop over food production during Jamaica's long colonial history, and trade deregulation since the 1980s through structural adjustment opened markets to transnational companies. These changes increased Jamaican receptiveness to the mass advertisement and marketing of these companies, whilst long-standing power imbalances hampered taxation and regulation in contemporary public health actions. Civil society efforts were important for promoting structural changes to curb overconsumption of SSBs and decentring such entrenched power relations.

CONCLUSION

The contemporary challenge of SSBs in Jamaica is a poignant case study of commercial determinants of health and the important context of global market-driven economies and the involvement of private sector interests in public health policies and governance. Historically contextualising these determinants is paramount to making sense of the sugar ecology in Jamaica today and can help elucidate entrenched power dynamics and their key actors.

Too humble for words

It's widely held that a lack of intellectual humility is part of the reason why flagrantly unjustified beliefs proliferate. In this paper, I argue that an excess of humility also plays a role in allowing for the spread of misinformation. Citing experimental evidence, I show that inducing intellectual humility causes people inappropriately to lower their confidence in beliefs that are actually justified for them. In these cases, they manifest epistemic humility in ways that make them epistemically worse off. I argue that epistemic humility may fail to promote better beliefs because it functions for us against the background of our individualistic theory of responsible epistemic agency: until we reject such theories, intellectual humility is as much a problem as a solution to epistemic ills. Virtue epistemology is inadequate as a response to unjustified beliefs if it does not look beyond the virtues to our background beliefs.

Place attachment and perception of climate change as a threat in rural and urban areas

Climate change is a global threat to ecosystems and the people that depend on them. However, the perceived threat of climate change may vary spatially. Previous research suggests that inhabitants in rural areas show higher levels of place attachment (associating meaning with a specific place) than urbanites, possibly because rural people depend more directly on their local environment. This can shape perceptions and behaviours, such as enhanced willingness to engage in landscape preservation. Here we ask if it also makes rural people perceive climate change as a greater threat, using a representative sample of 1,071 survey respondents from across the United Kingdom (UK) to provide first-order insights. We found that, whilst indicators of place attachment were indeed more frequent in rural areas, the perceived threat of climate change in the most rural locations was lower. We discuss possible explanations for this pattern (including lower levels of awareness of the anthropogenic causes of climate change, lessened first-hand experiences of climate change impacts due to higher levels of regulating ecosystem services, and higher levels of resilience in rural areas related to a closer relationship with nature), and call for further research to investigate this.

'Maternal Request' Caesarean Sections and Medical Necessity

Currently, many women who are expecting to give birth have no option but to attempt vaginal delivery, since access to elective planned caesarean sections (PCS) in the absence of what is deemed to constitute ‘clinical need’ is variable. In this paper, we argue that PCS should be routinely offered to women who are expecting to give birth, and that the risks and benefits of PCS as compared with planned vaginal delivery should be discussed with them. Currently, discussions of elective PCS arise in the context of what are called ‘Maternal Request Caesarean Sections’ (MRCS) and there is a good deal of support for the position that women who request PCS without clinical indication should be provided with them. Our argument goes further than support for acceding to requests for MRCS: we submit that healthcare practitioners caring for women with uncomplicated pregnancies have a positive duty to inform them of the option of PCS as opposed to assuming vaginal delivery as a default, and to provide (or arrange for the provision of) PCS if that is the woman's preferred manner of delivery.

What makes a health system good? From cost-effectiveness analysis to ethical improvement in health systems

Fair allocation of scarce healthcare resources has been much studied within philosophy and bioethics, but analysis has focused on a narrow range of cases. The Covid-19 pandemic provided significant new challenges, making powerfully visible the extent to which health systems can be fragile, and how scarcities within crucial elements of interlinked care pathways can lead to cascading failures. Health system resilience, while previously a key topic in global health, can now be seen to be a vital concern in high-income countries too. Unfortunately, mainstream philosophical approaches to the ethics of rationing and prioritisation provide little guidance for these new problems of scarcity. Indeed, the cascading failures were arguably exacerbated by earlier attempts to make health systems leaner and more efficient. This paper argues that health systems should move from simple and atomistic approaches to measuring effectiveness to approaches that are holistic both in focusing on performance at the level of the health system as a whole, and also in incorporating a wider range of ethical concerns in thinking about what makes a health system good.

A Foundation for a "Cheerful Society": The Korean War and the Rise of Psychiatry

One of the most remarkable medical achievements of the Korean War was the development of psychiatry. During the Korean War, soldiers and prisoners of war (POWs) experienced "gross stress reaction" and manifested poor concentration and memory as well as clinical depression and social alienation. Rest and relaxation rotations served as the primary treatment for their conditions. Civilians also bore the brunt of the war's effects. Delusions of grandeur and megalomania appear to have been common among Koreans, but there were few mental health facilities to provide treatment and care. Out of the furnace of war, psychiatry emerged as a newly specialized field, and in the 1950s, Korea became the very place where military psychiatry training under the U.S. military laid the groundwork for civilian psychiatry. This essay aims to enrich the study of mental illness during and after the Korean War by providing a more detailed picture of the mental problems experienced not only by veterans and POWs, but also by civilians in Korea. Examining mental health issues from this period is challenging due to the scarcity of resources for delving into the minds of the civilians involved. Taking military psychiatry as a starting point, this essay goes beyond existing scholarship to discuss psychiatry-related responses to the Korean War, including the influence of military psychiatry on civilian psychiatry, the endeavors of medical professionals and government policies, and contemporary expressions of mental distress during and after the war.

Unstable Expansion: The Development of the Military Medical Evacuation Chain in Korea, 1948-1953

This research examines the expansion and characteristics of the Korean Army's chain of medical evacuation in 1948-1953. The most important goal of the chain of medical evacuation was to conserve fighting strength, which cannot be achieved only by sending the sick and wounded to the rear for treatment. It was more important to maintain as many mission-capable wounded soldiers on the frontline. Therefore, triage for conserving strength was the priority in the evacuation process, and military doctors conducting triage played a significant role. Focusing on military doctors, this article studies the instability of the Korean Army's medical evacuation chain. Although Korea was liberated from Japanese colonial rule in August 1945, Korea had no army or army medical services. With the support of KMAG, the Korean Army was able to build a nationwide evacuation chain during the Korean War. However, the expansion of the medical evacuation chain resulted in instability. At the heart of the instability was manpower, rather than organization and transportation. Koreans had almost no experience with the military medical services before 1948, and during the Korean War, most doctors, who had been conscripted after the outbreak of the war, were not trained as military doctors. Therefore, the Korean Army had no other choice but to conduct medical evacuations using mobilized civilian doctors who were not sufficiently trained as military doctors. The escalating war revealed the problems of civilian doctors in military uniforms. Unlike the goal of the chain of medical evacuation, they easily evacuated patients and were reluctant to release patients to return to their duties. Korean Army doctors who were not sufficiently trained as military doctors struggled between the goals of military medical services and those of medical care. Consequently, the military doctors and the instability of the medical evacuation chain during the Korean War reflect the fundamental tension between war and medicine.

A data-based participatory approach for health equity and digital inclusion: prioritizing stakeholders

This article starts from the premise that projects informed by data science can address social concerns, beyond prioritizing the design of efficient products or services. How can we bring the stakeholders and their situated realities back into the picture? It is argued that data-based, participatory interventions can improve health equity and digital inclusion while avoiding the pitfalls of top-down, technocratic methods. A participatory framework puts users, patients and citizens as stakeholders at the centre of the process, and can offer complex, sustainable benefits, which go beyond simply the experience of participation or the development of an innovative design solution. A significant benefit for example is the development of skills, which should not be seen as a by-product of the participatory processes, but a central element of empowering marginalized or excluded communities to participate in public life. By drawing from different examples in various domains, the article discusses what can be learnt from implementations of schemes using data science for social good, human-centric design, arts and wellbeing, to argue for a data-centric, creative and participatory approach to address health equity and digital inclusion in tandem.

Measuring real-time cognitive engagement in remote audiences

Responses to arts and entertainment media offer a valuable window into human behaviour. Many individuals worldwide spend the vast majority of their leisure time engaging with video content at home. However, there are few ways to study engagement and attention in this natural home viewing context. We used motion-tracking of the head via a web-camera to measure real-time cognitive engagement in 132 individuals while they watched 30 min of streamed theatre content at home. Head movement was negatively associated with engagement across a constellation of measures. Individuals who moved less reported feeling more engaged and immersed, evaluated the performance as more engaging, and were more likely to express interest in watching further. Our results demonstrate the value of in-home remote motion tracking as a low-cost, scalable metric of cognitive engagement, which can be used to collect audience behaviour data in a natural setting.

Developing home cleaning intervention through community engagement to reduce infections and antimicrobial resistance in Ghanaian homes

Globally Antimicrobial Resistance (AMR) constitutes a health crisis, particularly in developing countries, where infectious disease are commonly fatal. There is clear evidence for microbial exposure and infection transmission within the home. Personal and environmental hygiene are the best ways of reducing household infections thus decreasing the need for antibiotics and consequently diminishing AMR. Despite this being an obvious step, research efforts to understand the home environment and its impact on AMR, cleaning and possible interventions on household cleaning are limited. We combined design and microbiology methods in an innovative mixed-method approach. A traditional survey design (n = 240), a design ethnography (n = 12), a co-design workshop and a pre-intervention microbiological dust sample analysis was undertaken to provide insights for codesign workshops in which new cleaning practices might be developed to minimise any AMR bacteria present in the household environments located in the Greater Accra Region of Ghana. Microbiological analysis of household dust showed that 36.6% of bacterial isolates detected were found to carry at least one resistance to the panel of antibiotics tested. Four scenarios were generated from an economic segmentation of the survey data. 50 ethnographic insights were 'presented' and descriptions of 12 bacteria species that showed resistance to one or more antibiotics (representing 176 bacterial isolates that showed resistance to one or more antibiotics found in the dust samples) were presented to the participants in a codesign workshop. An intervention, a new regime of cleaning practices agreed through the co-design workshop and practiced for thirty days, was made in (n = 7) households. The high prevalence of multidrug resistance observed in this study indicate the need for antibiotics surveillance program, not only in hospital settings but also in the household environment. There is, thus, an urgent need for targeting of interventions at the household level. Activating knowledge through community engagement in the research helps in increasing public perception and breaking down the scientist-public barrier.

Exploring the potential for children to act on antimicrobial resistance in Nepal: Valuable insights from secondary analysis of qualitative data

This study explores the perceived roles of children in antimicrobial resistance (AMR) in two sites across Nepal. AMR is a global challenge and underpinned by many complex behavioural drivers including how antimicrobial medicines are sourced and used. Because of this social dynamic, several research groups are using community engagement (CE) approaches to understand AMR at community level. However, most data negate the importance of children in behaviours linked to, and potentially driving AMR. In this study, authors apply secondary analysis methods to 10 transcripts representing the views of 23 adults engaged in an AMR-focused film-making project. By focusing on participants' reference to children, we reveal that antimicrobial usage and adherence to health providers' messages can be influenced by the age of the patient. Secondly that children are involved in some of the behaviours which are known to drive antimicrobial resistance such as purchasing over-the-counter antibiotic drugs. Finally, community members discuss that, with careful creation of resources, AMR could be meaningfully presented in educational settings with a view to children acting as agents of change around AMR-driving behaviours. Findings suggest that age-inclusive community engagement projects could be effective in tackling AMR at community level in Nepal and other low resource settings.

The harm principle, personal identity and identity-relative paternalism

Is it ethical for doctors or courts to prevent patients from making choices that will cause significant harm to themselves in the future? According to an important liberal principle the only justification for infringing the liberty of an individual is to prevent harm to others; harm to the self does not suffice.In this paper, I explore Derek Parfit's arguments that blur the sharp line between harm to self and others. I analyse cases of treatment refusal by capacitous patients and describe different forms of paternalism arising from a reductionist view of personal identity. I outline an Identity Relative Paternalistic Intervention Principle for determining when we should disallow refusal of treatment where the harm will be accrued by a future self, and consider objections including vagueness and non-identity.Identity relative paternalism does not always justify intervention to prevent harm to future selves. However, there is a stronger ethical case for doing so than is often recognised.

'All in good faith?' An ethno-historical analysis of local faith actors' involvement in the delivery of mental health interventions in northern Uganda

Faith actors have become increasingly significant in the field of global mental health, through their inclusion in the delivery of psychosocial support in humanitarian settings. This inclusion remains empirically underexplored. We explore historical and contemporary activities of local faith actors in responding to mental disquiet in northern Uganda. Given pre-existing roles, we question what it means when humanitarians draw on faith actors to deliver mental health and psychosocial support (MHPSS) in conflict-affected settings. We argue for a recognition of faith actors as agents operating within a therapeutic marketplace, which on occasion links suffering to social inequality and exclusion. We show, moreover, that the formal inclusion of Christian actors within MHPSS may not equate to the enforcement of rights-based values at the core of international ideas of protection.

Choosing the best apple: counselling leaflets and technologies of communication in the history of reproduction

Historians have shown how the establishment of human genetic counselling in West Germany was characterised by several sociohistorical factors, in particular the impact of the legacies of Nazi biopolitics. These accounts have reconstructed continuities on an intellectual level which delayed a turn towards non-directive approaches, emphasising individual (emotional) well-being and voluntariness, and instead have prolonged a discourse that defined disability as an economic and social burden. However, while the distinct legacies of eugenics and racial hygienics are well researched, other factors that constituted counselling encounters, such as the ways of communicating reproduction and material objects' roles in transformations of concepts, actors and their relations, have not been examined in detail. Drawing on the archives of a Marburg-based charity, this paper aimed to reconstruct these factors at the example of the production and circulation of a major family planning leaflet, Our Child Shall Be Healthy, developed ca 1977. In doing so, I want to suggest that connections between science, politics and economy were a key element in technologies of communicating reproduction. This essay approaches counselling as a communicative practice that was in continual productive engagement with different concepts of reproductive health. First, it argues that the communicative and paper technologies used in counselling interactions in West Germany changed in the aftermath of the worldwide thalidomide tragedy. Second, it argues that a novel approach to reproductive health emerged that focused on individual decision making as the basis of prosperity and emotional well-being. Taking a family planning leaflet as a site for reconstructing how people of different organisations, with different stakes and expertise converged in the design of a counselling encounter, this paper targets the crossroads of economic, political and scientific activities in the history of communicating reproductive health and reproductive risks.

Exacerbating Pre-Existing Vulnerabilities: an Analysis of the Effects of the COVID-19 Pandemic on Human Trafficking in Sudan

COVID-19 has caused far-reaching humanitarian challenges. Amongst the emerging impacts of the pandemic is on the dynamics of human trafficking. This paper presents findings from a multi-methods study interrogating the impacts of COVID-19 on human trafficking in Sudan-a critical source, destination, and transit country. The analysis combines a systematic evidence review, semi-structured interviews, and a focus group with survivors, conducted between January and May of 2021. We find key risks have been exacerbated, and simultaneously, critical infrastructure for identifying victims, providing support, and ensuring accountability of perpetrators has been impeded. Centrally, the co-occurrence of the pandemic and the democratic transition undercut the institutional and governance capacity, limiting the anti-trafficking response and exposing already vulnerable groups to increased risks of human trafficking. Findings point to increased vulnerabilities for individuals with one or more of the following identities: migrants, refugees, females, and informal labourers.

Caring Under Fire Across Three Continents: The Hadfield-Spears Ambulance, 1941-1945

During the Second World War, the Hadfield Spears ambulance took care of around 22,000 wounded and/or sick patients across three continents. This article analyses how military attacks and instances of violence impacted on the psychological, emotional and physical health of those attending the wounded within this mobile unit. While historiography of allied medicine develops apace, analysis of the Free French health service remains rare. Yet the history of the Hadfield Spears ambulance provides a fascinating window into the neglected issue of attacks on healthcare in wartime, as well as a fresh scope for combining macro and micro perspectives. The deployment of both approaches suggests potent ways to connect intimate responses to attacks to broader histories of allied frictions and cooperation. Crucially, it offers rich insights into the development of a transnational 'ethos of stoicism', which helped to sustain the hospital's community, in a fraught allied diplomatic context.

Record DNA: reconceptualising digital records as the future evidence base

A major issue facing society is the extent to which the usability of the digital evidence base is at risk because, in the digital era, the concept of the record has been eroded. The nature and reality of a record are no longer agreed. Addressing the challenges that the digital presents for managing records and assuring their future usability is not one that records and archives scholars and professionals can tackle alone. This article argues that this is a 'grand challenge' which requires a broad range of perspectives and expertise and convergence research to resolve. It discusses findings from an international multidisciplinary research network established to critically explore, through a grounded theory approach, the nature of a digital record and the implications of the digital era for the usability and functionality of the future evidence base. A series of different visions of a digital record emerged alongside a wide-ranging set of research questions that form the basis of an agenda for future collaborative (convergence) research.

Prehistoric pathways to Anthropocene adaptation: Evidence from the Red River Delta, Vietnam

Over the past twenty years, government advisory bodies have placed increasing emphasis on the need for adaptive measures in response to the effects of human-induced climate change. Integrated Assessment Models (IAMs), which incorporate macroeconomic and climate variables, feature prominently in advisory content, though they rarely draw on data from outside strictly constrained hypothetical systems. This has led to assertions that they are not well-suited to approximate complex systemic human-environment processes. Modular, interdisciplinary approaches have offered a way to address this shortcoming; however, beyond climate records, prehistoric data continue to be under-utilised in developing such models. In this paper we highlight the contribution that archaeology and palaeoecology can make to the development of the next generation IAMs that are expected to enhance provision for more local and pro-active adaptations to future climate change. We present data from one of Southeast Asia's most heavily developed river deltas: the Red River (Song Hong) Delta, in Vietnam and localised analysis from the Tràng An Landscape Complex World Heritage Site, on the delta's southern margin. Comparison is made between Shared Socio-economic Pathways (SSP) 5-8.5 and SSP2-4.5 emission projection models and the Mid-Holocene inundation of the Red River Basin. We highlight the value to taking a scientific long view of coastal evolution through an illustrative set of eight research foci where palaeo-data can bring new and localised empirical data to bear on future risk management planning. We proceed to demonstrate the applicability of palaeoenvironmental, zooarchaeological and historical evidence to management and the development of sustainable conservation strategies using Tràng An as a case study. In so doing, we further highlight the importance of knowledge exchange between scientific, corporate, non-governmental, local, and state stakeholders to achieve tangible results on the ground.

The role of social vulnerability in improving interventions for neglected zoonotic diseases: The example of Kyasanur Forest Disease in India

Forest-based communities manage many risks to health and socio-economic welfare including the increasing threat of emerging zoonoses that are expected to disproportionately affect poor and marginalised groups, and further impair their precarious livelihoods, particularly in Low-and-Middle Income (LMIC) settings. Yet, there is a relative dearth of empirical research on the vulnerability and adaptation pathways of poor and marginalised groups facing emerging zoonoses. Drawing on a survey of 229 households and a series of key-informant interviews in the Western Ghats, we examine the factors affecting vulnerability of smallholder and tribal households to Kyasanur Forest Disease (KFD), an often-fatal tick-borne viral haemorrhagic fever endemic in south India. Specifically, we investigate how different socio-demographic and institutional factors interact to shape KFD vulnerability and the strategies employed by households to adapt to disease consequences. Although surveyed households generally perceived KFD as an important health issue in the study region, there was variability in concern about contracting the disease. Overall results showed that poor access to land (AOR = 0.373, 95% CI: 0.152-0.916), being at or below the poverty line (AOR = 0.253, 95% CI: 0.094-0.685) and being headed by an older person (AOR = 1.038, 95% CI: 1.006-1.071) were all significant determinants of perceived KFD vulnerability. Furthermore, KFD vulnerability is also modulated by important extra-household factors including proximity to private hospitals (AOR = 3.281, 95% CI: 1.220-8.820), main roads (AOR = 2.144, 95% CI: 1.215-3.783) and study location (AOR = 0.226, 95% CI: 0.690-0.743). Our findings highlight how homogenous characterisation of smallholder and tribal communities and the 'techno-oriented' approach of existing interventions may further marginalise the most vulnerable and exacerbate existing inequalities. These findings are important for designing context-specific and appropriate health interventions (including the prioritisation of awareness raising, knowledge networks, livelihood diversification) that enhances the resilience of at-risk social groups within the KFD context. More broadly, our findings highlight how a focus on social vulnerability can help national and international health planners improve health interventions and prioritise among diseases with respect to neglected endemic zoonoses.

Sr analyses from only known Scandinavian cremation cemetery in Britain illuminate early Viking journey with horse and dog across the North Sea

The barrow cemetery at Heath Wood, Derbyshire, is the only known Viking cremation cemetery in the British Isles. It dates to the late ninth century and is associated with the over-wintering of the Viking Great Army at nearby Repton in AD 873-4. Only the cremated remains of three humans and of a few animals are still available for research. Using strontium content and isotope ratios of these three people and three animals-a horse, a dog and a possible pig-this paper investigates the individuals' residential origins. The results demonstrate that strontium isotope ratios of one of the adults and the non-adult are compatible with a local origin, while the other adult and all three animals are not. In conjunction with the archaeological context, the strontium isotope ratios indicate that these individuals most likely originated from the area of the Baltic Shield-and that they died soon after arrival in Britain. This discovery constitutes the first solid scientific evidence that Scandinavians crossed the North Sea with horses, dogs and other animals as early as the ninth century AD.

Deepfakes, Fake Barns, and Knowledge from Videos

Recent develops in AI technology have led to increasingly sophisticated forms of video manipulation. One such form has been the advent of deepfakes. Deepfakes are AI-generated videos that typically depict people doing and saying things they never did. In this paper, I demonstrate that there is a close structural relationship between deepfakes and more traditional fake barn cases in epistemology. Specifically, I argue that deepfakes generate an analogous degree of epistemic risk to that which is found in traditional cases. Given that barn cases have posed a long-standing challenge for virtue-theoretic accounts of knowledge, I consider whether a similar challenge extends to deepfakes. In doing so, I consider how Duncan Pritchard's recent anti-risk virtue epistemology meets the challenge. While Pritchard's account avoids problems in traditional barn cases, I claim that it leads to local scepticism about knowledge from online videos in the case of deepfakes. I end by considering how two alternative virtue-theoretic approaches might vindicate our epistemic dependence on videos in an increasingly digital world.

A Sartrean analysis of pandemic shaming

In this paper, we analyse the particular phenomena of COVID-19 pandemic shaming. We examine Sartre's account of the undifferentiated other in the experience of 'the look', and his insistence on shame as a foundational relational affect, in order to give a robust theoretical frame to understand how pandemic shaming circulated both online and offline, in targeted and diffuse manners. We focus on two features of pandemic shaming. First, we draw attention to the structural necessity of an audience in acts of pandemic shaming, where the shamer acts on behalf of a community of others, the audience, to perform and enforce a set of standards, values or norms. We turn to the we-experience and collective emotions literature and discuss how the shamer believes themselves to be 'speaking' on behalf of a community who share their outrage along with their values. Second, we discuss how the presumption of a collective emotion was frequently mistaken in acts of pandemic shaming, where shaming frequently led to shame backlashes, where the audience revealed themselves not to share the emotion and values of the shamer, consequently shaming the shamer. We argue that Jean-Paul Sartre's voyeur example is usefully illustrative of the tripartite structure of (1) shamed, (2) shamer and (3) shamer of the shamer that occurs in iterative processes of pandemic shaming, which are accompanied by shaming backlashes. We conclude by reflecting on the socio-historical context for Sartre's accounts of shame and 'the look', namely the German occupation of Paris and Sartre's experience of the French Resistance movement, and how these yield a particular socio-historical framing that makes evident how the extraordinary pseudo-wartime conditions of COVID-19 rendered atmospheres of distrust and suspicion prevalent.

Meaninglessness and monotony in pandemic boredom

Boredom is an affective experience that can involve pervasive feelings of meaninglessness, emptiness, restlessness, frustration, weariness and indifference, as well as the slowing down of time. An increasing focus of research in many disciplines, interest in boredom has been intensified by the recent Covid-19 pandemic, where social distancing measures have induced both a widespread loss of meaning and a significant disturbance of temporal experience. This article explores the philosophical significance of this aversive experience of 'pandemic boredom.' Using Heidegger's work as a unique vantage point, this article draws on survey data collected by researchers in an ongoing project titled 'Experiences of Social Distancing During the Covid-19 Pandemic' to give an original phenomenological interpretation of the meaninglessness and monotony of pandemic boredom. On a Heideggerian interpretation, pandemic boredom involves either a situative confrontation with relative meaninglessness that upholds our absorption in the everyday world, or an existential confrontation with absolute meaninglessness that forces us to take up the question of our existence. Arguing that boredom during the pandemic makes this distinction difficult to sustain, I consider some of the ways in which pandemic boredom might be seen to expose and then exceed the distinctive methodological limitations of Heidegger's philosophical interpretation of boredom.