Clinical Assessment of Subjective Visual and Haptic Vertical Norms in Healthy Adults.

BACKGROUND AND OBJECTIVE: Accurate verticality perception is essential for daily life activities, such as correctly estimating object orientation in space. This study established normative data for the subjective visual vertical (SVV) and subjective haptic vertical (SHV) using the portable and self-constructable modified Bucket test and Rotating-Column test. Additionally, the contribution of age, sex, and starting position of the line/ column on SVV and SHV accuracy were evaluated. METHOD: This study, part of the PRECISE project (ClinicalTrials.gov ID NCT05978596), was conducted following the STROBE guidelines. Healthy adults without visual/neurological/vestibular disorders were recruited. Subjective visual vertical and SHV accuracy were described in terms of constant errors (i.e., mean deviation from 0° [true vertical] respecting its direction), unsigned errors (i.e., mean deviation from 0° irrespective of direction), and variability (i.e., intra-individual standard deviation). RESULTS: Sixty participants were evaluated (mean age: 41.14 [SD = 16.74] years). Subjective visual vertical constant errors between -2.82° and 2.90°, unsigned errors up to 2.15°, and variability up to 1.61° are considered normal. Subjective haptic vertical constant errors ranged from -6.94° to 8.18°, unsigned errors up to 6.66° and variability up to 4.25°. Higher ages led to higher SVV unsigned errors and variability. SHV variability was higher in females compared to males. Certain starting positions led to higher SVV and SHV constants and SVV unsigned errors. DISCUSSION: Normative data are provided for affordable, self-constructable, and portable SVV and SHV tools. These norms are consistent with more sophisticated equipment and can be used to distinguish between normal and abnormal values.

Assessment of natural radioactivity levels and hazard indicators in Tarakeshwor Municipality, Nepal through in-situ technique and multivariate analysis.

The evaluation of primordial radionuclide concentrations in rapidly urbanized and concrete-laden areas through the importation of construction materials from various regions of Nepal is both important and essential. This study utilized a portable gamma-ray spectrometer (PGIS 2) to analyze the distribution of three natural radionuclides: uranium (238U), thorium (232Th), and potassium (40K) in Tarakeshwor Municipality, Kathmandu, Nepal. The measured dose rates ranged from 70.22 nSv hr-1 to 163.66 nSv hr-1, with an average of 124.65±20.29 nSv hr-1, surpassing the global average of 59 nSv hr-1. The activity concentrations of 40K, 238U, and 232Th exceeded global averages, indicating relatively higher natural radioactivity concentrations in the region. Specifically, the average values for 40K, 238U, and 232Th were 935.26±172.30 Bq kg-1, 80.47±15.53 Bq kg-1, and 80.44±18.58 Bq kg-1, respectively. The calculated radium equivalent (Raeq) ranged from 132.26 to 351.22 Bq kg-1, and the annual gonadal equivalent dose (AGED) varied from 372.61 to 1028.81 µSv yr-1. The annual effective dose rates for indoor and outdoor environments were 0.54±0.09 mSv yr-1 and 0.15±0.03 mSv yr-1, respectively, both exceeding the global average. The representative level index (RLI) within the study area averaged 1.96±0.32, indicating an elevated radiation risk. The excess lifetime cancer risk (ELCR) values for outdoor and indoor environments were 0.52×10-3 ±0.09 ×10-3 and 1.87 ×10-3 ±0.31×10-3, respectively, surpassing the world average. Additionally, external hazard indices (Hex) ranged from 0.36 to 0.59, while internal hazard indices (Hin) ranged from 0.38 to 1.20, both indicating values higher than UNSCEAR recommendations. These findings underscore the necessity for further experimental analysis employing ex-situ equipment. The data generated in this study can provide a valuable baseline for future assessments and interventions in radiation risk management guidelines within the country.

A scoping review of neuropsychological assessment for Asian Indians in the United States - research and clinical recommendations.

Objective: There is an increasing focus on understanding health disparities among various cultural groups in the United States. The need for heterogeneity in norms and test stimuli across ethnically diverse individuals are being increasingly recognized. However, to date it remains unknown whether and to what extent differences in cognitive norms and tests exist in Asian Indians, a fast-growing population in the U.S. It is essential to understand these differences to improve diagnostic accuracy and provide timely and appropriate clinical care. Method: In this study, we conducted a scoping review of available cognitive tests that were normed, developed, or adapted for Asian Indians living in the U.S. Results: The results suggested a paucity of norms and tests specifically examining cognition in this community. Conclusions: Based on the findings, we provide suggestions for research directions focusing on the development of culturally sensitive neuropsychological tools, normative data representative of this demographic, and interventions addressing healthcare access barriers. Overall, this review provides readers with relevant clinical information to immediately enhance patient care as well as provide actionable items in research to improve the future utility of neuropsychology for Asian Indians in the United States.

Subjective Well-Being Population Norms and Inequalities in Hungary: A Large Cross-Sectional, Internet-Based Survey.

OBJECTIVES: This study aimed to provide subjective well-being (SWB) population norms in Hungary and explore the contribution of explanatory factors of SWB inequality among the Hungarian adult general population. METHODS: The data originated from a large representative internet-based cross-sectional survey in Hungary, which was conducted in 2020. We applied validated multi-item instruments for measuring SWB, namely Satisfaction With Life Scale (SWLS) and World Health Organization-Five Well-Being Index (WHO-5). Multiple linear regressions were used to examine the relationship between demographic-socioeconomic-health status and both well-being instruments. The concentration index (CI) was used to measure the degree of income-related inequality in well-being. RESULTS: A total of 2001 respondents were enrolled with the means ± SD WHO-5 scores and SWLS scores of 0.51 ± 0.21 and 0.51 ± 0.23, respectively. Higher household income, higher educational level, better general health status, and absence of chronic morbidity were significant positive predictors for both WHO-5 and SWLS scores. The CI of WHO-5 scores was lower than that of SWLS scores in the total sample (0.0480 vs 0.0861) and in subgroups by gender (male, 0.0584 vs 0.1035; female, 0.0302 vs 0.0726). The positive CI values implied a slight pro-rich SWB inequality in this population. The regression analyses showed a positive association of SWB with having a higher household income and a better general health status. CONCLUSIONS: This is the first representative study in Hungary to compare population norm of 2 well-being instruments and analyze well-being inequality. Slight pro-rich inequality was found consistently with both SWB measures. Our findings support the need for health and social policies that effectively tackle inequalities in Hungary.

Misperception of peer beliefs reinforces inequitable gender norms among Tanzanian men.

Gender role ideology, i.e. beliefs about how genders should behave, is shaped by social learning. Accordingly, if perceptions about the beliefs of others are inaccurate this may impact trajectories of cultural change. Consistent with this premise, recent studies report evidence of a tendency to overestimate peer support for inequitable gender norms, especially among men, and that correcting apparent 'norm misperception' promotes transitions to relatively egalitarian beliefs. However, supporting evidence largely relies on self-report measures vulnerable to social desirability bias. Consequently, observed patterns may reflect researcher measurement error rather than participant misperception. Addressing this shortcoming, we examine men's gender role ideology using both conventional self-reported and a novel wife-reported measure of men's beliefs in an urbanising community in Tanzania. We confirm that participants overestimate peer support for gender inequity. However, the latter measure, which we argue more accurately captures men's true beliefs, implies that this tendency is relatively modest in magnitude and scope. Overestimation was most pronounced among men holding relatively inequitable beliefs, consistent with misperception of peer beliefs reinforcing inequitable norms. Furthermore, older and poorly educated men overestimated peer support for gender inequity the most, suggesting that outdated and limited social information contribute to norm misperception in this context.

Mechanisms behind gender transformative approaches targeting adolescent pregnancy in low- and middle-income countries: a realist synthesis protocol.

INTRODUCTION: Adolescent pregnancy is defined as pregnancy at the age of 19 or below. Pregnancy and childbirth complications are the most significant cause of death among 15-19-year-old girls. Several studies have indicated that inequitable gender norms can increase the vulnerability of adolescent girls, including violence exposure, early marriage, and adolescent pregnancy. To address these disparities, gender transformative approaches aim to challenge and transform restrictive gender norms, roles, and relations through targeted interventions, promoting progressive changes. This realist review aims to synthesise existing evidence from a broad range of data sources to understand how, why, for whom, and in what contexts gender transformative approaches succeed in reducing adolescent pregnancy in low- and middle-income countries. METHOD AND ANALYSIS: We employ a five-step realist synthesis approach: (1) clarify the scope of review and assessment of published literature, (2) development of initial programme theories, (3) systematic search for evidence, (4) development of refined programme theories, and (5) expert feedback and dissemination of results. This protocol presents the results of the first three steps and provides details of the next steps. We extracted data from 18 studies and outlined eight initial programme theories on how gender transformative approaches targeting adolescent pregnancy work in the first three steps. These steps were guided by experts in the field of sexual and reproductive health, implementation science, and realist methodology. As a next step, we will systematically search evidence from electronic databases and grey literature to identify additional studies eligible to refine the initial programme theories. Finally, we will propose refined programme theories that explain how gender transformative approaches work, why, for whom, and under which circumstances. ETHICS AND DISSEMINATION: Ethics approval is not required because the included studies are published articles and other policy and intervention reports. Key results will be shared with the broader audience via academic papers in open-access journals, conferences, and policy recommendations. The protocol for this realist review is registered in PROSPERO (CRD42023398293).

Health-related quality of life measured using the EQ-5D-3L: iranian population norms.

BACKGROUND: Normative values are valuable for comparing a specific population with the general population, making them particularly useful in disease burden studies and cost-effectiveness analysis. The objective of this study was to estimate HRQoL normative values for the EQ-5D measure in Iran. METHODS: The analysis was performed using a sample (n = 27,704) of the Iranian adult population, which was extracted from a nationwide survey conducted in 2021. Participants assessed their health-related quality of life using the EQ-5D-3 L instrument and a visual analogue scale (EQ VAS). Multivariable regression analyses were performed to examine the relationships between utility scores, EQ VAS scores, and various socio-demographic factors. RESULTS: The mean utility and EQ VAS scores of the total sample were 0.87 (95% CI: 0.86, 0.88) and 72.9 (95% CI: 72.7, 73.1), respectively. Almost half of the respondents (46.8%) reported a health state without any problems. The most prevalent problems were pain/discomfort (38.3%) and anxiety/depression (35.2%). Furthermore, EQ-5D values and EQ VAS scores were associated with gender, age, employment status, education level, marital status, and chronic illness. CONCLUSIONS: This study provided normative values for the general population in Iran. Policymakers and researchers can use these values as a reference for population norms in economic assessments and studies focusing on the population's health.

Radionuclides distribution and radiation hazards assessment of black sand separation plant's minerals: a case study.

This study assessed the radioactivity levels and associated risks in the black sand-separated products obtained from the black sand separation plant in Delta, Egypt. A total of sixteen samples were taken from hot spots during and after the separation process. These include water samples and other samples that represent monazite, rutile, zircon, granite, ilmenite, and silica products. The hot spots included the area where the ore was stored. The activity concentrations of 232 T h , 226 R a , and 40 K were determined in these samples using a p-type HPGe detector. Based on gamma spectrometric analysis, samples of rutile, zircon, and monazite had the highest amounts of radioactivity because they contained the highest NORM's activity concentrations. In addition, it indicated that the radiological hazard indices of the collected samples were higher than the average world limits for sand texture. These findings suggest that the black sand separation process reveals potential risks to human health and the environment, and therefore, appropriate measures need to be taken to mitigate these risks, especially for the safety of the workers on-site. Reducing the risk associated with those sites should be controlled by implementing the recommendations declared for the series of International Basic Safety Standards of the International Atomic Energy Agency (GSR) Part 3, as affirmed in Document No. 103 of 2007 by the International Commission on Radiological Protection (ICRP) as will be presented in the paper body.

Mobile version of the Battery for the Assessment of Auditory Sensorimotor and Timing Abilities (BAASTA): Implementation and adult norms.

Timing and rhythm abilities are complex and multidimensional skills that are highly widespread in the general population. This complexity can be partly captured by the Battery for the Assessment of Auditory Sensorimotor and Timing Abilities (BAASTA). The battery, consisting of four perceptual and five sensorimotor tests (finger-tapping), has been used in healthy adults and in clinical populations (e.g., Parkinson's disease, ADHD, developmental dyslexia, stuttering), and shows sensitivity to individual differences and impairment. However, major limitations for the generalized use of this tool are the lack of reliable and standardized norms and of a version of the battery that can be used outside the lab. To circumvent these caveats, we put forward a new version of BAASTA on a tablet device capable of ensuring lab-equivalent measurements of timing and rhythm abilities. We present normative data obtained with this version of BAASTA from over 100 healthy adults between the ages of 18 and 87 years in a test-retest protocol. Moreover, we propose a new composite score to summarize beat-based rhythm capacities, the Beat Tracking Index (BTI), with close to excellent test-retest reliability. BTI derives from two BAASTA tests (beat alignment, paced tapping), and offers a swift and practical way of measuring rhythmic abilities when research imposes strong time constraints. This mobile BAASTA implementation is more inclusive and far-reaching, while opening new possibilities for reliable remote testing of rhythmic abilities by leveraging accessible and cost-efficient technologies.

Assessment of radiological hazards from radioactivity natural of cement used in Dwellings in Rio de Janeiro, Brazil.

Brazil is the fourth largest cement consumer in the world and the largest producer in Latin America, around 1.3% of global production. The main inputs in the manufacture of cement are limestone and clay. Few studies have been carried out in the country on the risk of these materials used in civil construction. Therefore, the objective of this present work is to evaluate the radiological danger that they can present to society. Gamma spectrometry analysis on 16 samples of different brands of cement used as construction material in Rio de Janeiro (Brazil) was performed in this study, using an HPGe detector and the Genie 2000 data acquisition software. Samples were set to count for an accumulation time of 14,400 s (4 h) and all measurements were corrected to eliminate background and backscattering. Activity concentrations are determined for 226Ra was from (41.2 ± 1.6 to 174.9 ± 3.9) Bq kg-1, 232Th was from (15.7 ± 0.5 to 43.1 ± 0.7) Bq kg-1 and 40K was from (82.6 ± 7.2 to 254 ± 17) Bq kg-1. To assess radiological health risks: mean values of Radium Activity Equivalent 150.0 ± 3.4 Bq kg-1, Annual Gonadal Dose Equivalent 468 ± 11 µSv year-1 and Lifetime Excess Cancer Risk (ELCR) 2.42 ± 0.06 were calculated. Total Absorbed Dose Rates ranged from 72.2 ± 1.7 to 225.1 ± 5.2 nGy h-1. The damage to collective health was also estimated from the annual effective dose rates with an estimated total cost of damage to health of US$ 130 million. Values are generally within global limits reported by UNSCEAR.

Sexual Violence in Later Life: A Widespread and Growing Yet Hidden Public Health Issue.

Sexual violence in later life and related trauma have been identified as a growing yet preventable public health crises, which disproportionately impact women. Research is limited and is continuing to emerge in this area, along with implications for addressing healthcare disparities, primarily among older women. In this paper, the prevalence of sexual violence in later life will be explored, along with survivor characteristics as they relate to structural inequality and health disparities. Consequences of sexual violence in later life will be explored as well, with implications for healthcare workers, focused on pressing needs for research, practice, policy and education at individual, relational, organizational and societal levels.

Assessment of NORMs (238U, 232Th, 40K) and radiation hazard indices in Beldih apatite mine region of Purulia district, West Bengal, India.

The radiation arising from naturally occurring radioactive materials (NORMs) is the foremost contributor to the collective dose received by the global population. The present study aims to measure the natural background radiation level and the associated gamma radiation dose in air in the Beldih apatite mine region of Purulia district, India. This study is primarily focused on the determination of 238U, 232Th and 40K activities in the sub-surface soil of the study area. The measurements were carried out using a High Purity Germanium (HPGe) detector-based gamma-ray spectrometer with a relative efficiency of 80%. To achieve uniformity in exposure estimations, radium equivalent activity has been calculated. Additionally, the internal hazard index, external hazard index, radioactivity level index and gamma dose rates have been evaluated to estimate the radiation hazard levels in the study area. The comparison of obtained concentrations and hazard indices with global data (UNSCEAR. (2008). Sources, effects and risks of ionizing radiation. United nations scientific committee on the effects of atomic radiation (report to the general assembly, with Annexes).) suggests that this region lies in a relatively high background radiation zone.

Assessment of radioactivity level and associated radiological hazard in riverbed samples within industrial areas.

Terrestrial gamma radiation is one of the major outdoor radiation exposures to the general public that varies substantially based on the type and geological properties of the soil. The objective of this study is to evaluate the naturally occurring radioactive materials (NORMs) distribution and assess the hazard parameters in the riverbank soil within various industrial zones in the densely populated Dhaka and Chattogram cities of Bangladesh. The mean activities of 226Ra (37 ± 3), 232Th (58 ± 4), and 40K (1129 ± 18) Bqkg-1 in the assessed soil samples were found to be slightly higher than the world average values 32, 35, and 420 Bqkg-1, respectively. The mean radium equivalent activity (207.49 Bqkg-1) and the external and internal hazard indices were within the recommended limits of 370 Bqkg-1 and <1, respectively. The mean absorbed dose rate (99.47 nGyhr-1), annual effective dose (0.12 mSva-1), ELCR (4.27 × 10-4), and gamma level index (1.58) exceeded the world average values 59 nGyhr-1, 0.07 mSva-1, 2.9 × 10-4, and 1 respectively. However, the studied areas are safe from a radiological viewpoint with no radiation health hazard to the people. The results of this study can be utilized to produce factual baseline data for future studies.

When norm change hurts.

Applied cultural evolution includes any effort to mobilize social learning and cultural evolution to promote behaviour change. Social tipping is one version of this idea based on conformity and coordination. Conformity and coordination can reinforce a harmful social norm, but they can also accelerate change from a harmful norm to a beneficial alternative. Perhaps unfortunately, the link between the size of an intervention and social tipping is complex in heterogeneous populations. A small intervention targeted at one segment of society can induce tipping better than a large intervention targeted at a different segment. We develop and examine two models showing that the link between social tipping and social welfare is also complex in heterogeneous populations. An intervention strategy that creates persistent miscoordination, exactly the opposite of tipping, can lead to higher social welfare than another strategy that leads to tipping. We show that the potential benefits of miscoordination often hinge specifically on the preferences of people most resistant to behaviour change. Altogether, ordinary forms of heterogeneity complicate applied cultural evolution considerably. Heterogeneity weakens both the link between the size of a social planner's intervention and behaviour change and the link between behaviour change and the well-being of society. This article is part of the theme issue 'Social norm change: drivers and consequences'.

Adolescent sexual and reproductive health and rights for ethnic minority girls in Vietnam.

There has been significant progress in improved adolescent sexual and reproductive health and rights (ASRHR) for girls across low- to- middle-income countries (LMICs). However, progress has been uneven, and disparities persistent across and within countries. For example, Vietnam is one of only nine countries to have achieved the 2015 maternal mortality rate (MMR) target of the Millennium Development Goals (MDGs) as a nation, but for some sub-populations, progress has been much slower, and MMR is more than twice that the national average. Ensuring equity is a current focus of the Sustainable Development Goals (SDGs) agenda that seeks to Leave No One Behind. This paper explores some of these inequities and potential drivers for ethnic minority adolescent girls in Vietnam, with a specific focus on the Tay community, the largest ethnic minority group in Vietnam. This paper highlights the challenges to progress, including areas where there is still limited evidence about the range of socio-cultural factors that may determine sexual and reproductive health outcomes for Tay adolescent girls. In the era of the SDGs, Vietnam's national policy platforms and current aid architecture provide a solid basis on which to build research, policy and practice investments that improve the health of adolescent ethnic minority girls in Vietnam.

Social norms, diffusion, and women's risk of intimate partner violence in Nepal: Impact assessment of a social and behavior Change communication intervention (Change Starts at home).

Introduction: Intimate partner violence (IPV) is a significant public health, human rights, and development issue. While existing evidence posits that addressing social norms is key to IPV prevention, successful IPV interventions that include a norms approach are limited in number and methodological rigor and rarely include a formal investigation of the diffusion of intervention impact. We contribute novel findings to this intellectual and programmatic space with evidence on a social and behavior change communication (SBCC) intervention (Change Starts at Home) in Nepal designed to prevent IPV and shift social norms towards greater gender equity. Methods: Participants included 442 married women across 13 communities assessed at three timepoints: before intervention (baseline), at the completion of the core couple's curriculum and edutainment (midline), and at the conclusion of the diffusion curriculum (endline). Generalized estimating equations with propensity-score adjustments were used to determine change in outcomes at midline and endline for two intervention conditions (direct beneficiary, N = 173; and resident of the intervention community, (N = 178) relative to control (N = 91). Results: IPV victimization significantly decreased in both intervention conditions at midline, with larger reductions in direct beneficiaries. At endline, direct beneficiaries had sustained reduction in IPV relative to control participants. Positive injunctive norms also significantly improved by midline for both intervention groups, whereas improvements in descriptive norms for intervention groups were matched by improvements in the control group at both midline and endline. Several secondary outcomes showed significant improvements for both intervention groups at midline and/or endline, including in-law violence, financial decision-making, communication, and relationship quality, with additional improvements for the direct beneficiaries in attitudes, leadership, GBV advocacy, and diffusion. Conclusion: This study sheds light on the effectiveness of the Change intervention, the role of addressing social norms in IPV prevention efforts, and the benefits of organized diffusion.

A qualitative assessment of the impact of a community-embedded intervention on beneficiaries' attitudes and beliefs about adolescent sexual reproductive health in Ebonyi State, Southeast, Nigeria.

BACKGROUND: Adolescents and their communities in Ebonyi State, Nigeria have poor attitudes and beliefs towards adolescent sexual and reproductive health (SRH). This paper reports on the effects of a community-embedded intervention that focused on creating positive changes in the attitudes and beliefs of adolescents and community members to enhance adolescents' access to SRH information and services. METHODS: This study adopted the Qualitative Impact Assessment approach to evaluate the changes in attitudes and beliefs about the SRH of adolescents from the perspectives of the beneficiaries of a community-embedded intervention namely, adolescents, parents, school teachers, and community leaders. The intervention was implemented in six local government areas in Ebonyi State, southeast Nigeria and the evaluation was undertaken four months after the implementation of the interventions commenced. Eighteen (18) interviews were conducted with 82 intervention beneficiaries including: (i) six in-depth interviews with school teachers; (ii) two sex-disaggregated FGDs with parents; (iii) two sex-disaggregated FGDs with community leaders; and (iv) eight sex-disaggregated FGDs with in school and out of school adolescents. A thematic analysis of data was performed with the aid of NVivo software, version 12. RESULTS: The community-embedded intervention led to changes in individual attitudes and beliefs, as well as changes in community norms and values concerning adolescent SRH. Adolescents reported that following the community-embedded SRH intervention, they have become more comfortable discussing openly SRH issues with their peers, and they could more easily approach their parents and initiate SRH discussions. The parents of adolescents reported that following the intervention, they have become more willing to discuss sensitive SRH issues with adolescents, and frequently make out time to do so. It was also reported that parents no longer use euphemisms to describe sexual body parts, and community leaders now believe that it is all right to discuss SRH with adolescents. Hence, initiating or having SRH discussions with adolescents is no longer misconceived as encouraging sex, and menstruation in unmarried adolescents is no longer viewed as a sign of promiscuity. Respondents also highlighted changes in community norms of, (i) gendered parental communication of SRH matters, as both mothers and fathers have started discussing SRH issues with their adolescent boys and girls; and (ii) public shaming and discipline of pregnant teenage girls are on the decline. CONCLUSION: The community-based intervention had a positive impact on individual attitudes and beliefs, as well as community and societal values and norms about adolescent SRH. Interventions that take into account community norms and values regarding adolescent SRH should be prioritized to enable the achievement of the SRH-related target of SDG 3.

Adolescents face significant sexual and reproductive health (SRH) challenges which makes it difficult for them to access and utilize SRH services as a result of negative community norms and values. These norms discourage discussions relating to sex and sexuality in Nigeria because sexuality matters are regarded as taboo for young people, and sex is regarded as sacred and the exclusive reserve of the married. This qualitative study explored the views of adolescents, parents, and community leaders on the impact of a community-based intervention on their attitudes and beliefs concerning SRH issues. Using focus group discussions, the community members described the impact of the intervention on the beliefs and attitudes of adolescents, parents/guardians, and the community. Following the SRH intervention, parents started to make out time to discuss SRH issues with adolescents. They became more approachable and willing to discuss sensitive SRH issues with adolescents. Both mothers and fathers started to take up the role of communicating SRH matter with their adolescent boys and girls. Adolescents also started initiating SRH discussions with parents and could openly discuss SRH issues with their peers. In the community, adolescent girls were no longer publicly shamed for engaging in pre-marital sex. There were changes in community leaders' attitudes to teenage pregnancy and they no longer misconceive adolescent SRH issues. Considering the positive changes in individual attitudes, social values, and norms, there is a need for the community-embedded SRH intervention to be sustained and scaled up to other parts of the state by program managers.

Did Descriptive and Prescriptive Norms About Gender Equality at Home Change During the COVID-19 Pandemic? A Cross-National Investigation.

Using data from 15 countries, this article investigates whether descriptive and prescriptive gender norms concerning housework and child care (domestic work) changed after the onset of the COVID-19 pandemic. Results of a total of 8,343 participants (M = 19.95, SD = 1.68) from two comparable student samples suggest that descriptive norms about unpaid domestic work have been affected by the pandemic, with individuals seeing mothers' relative to fathers' share of housework and child care as even larger. Moderation analyses revealed that the effect of the pandemic on descriptive norms about child care decreased with countries' increasing levels of gender equality; countries with stronger gender inequality showed a larger difference between pre- and post-pandemic. This study documents a shift in descriptive norms and discusses implications for gender equality-emphasizing the importance of addressing the additional challenges that mothers face during health-related crises.

"I always felt like I wasn't supposed to be there". An international qualitative study of fathers' engagement in family healthcare during transition to fatherhood.

OBJECTIVE: Engagement of fathers in family health services confers benefits for the health and wellbeing of the whole family. The childbirth continuum is traditionally considered a feminine event, however, commensurate with the changing paradigm of gender equity in family healthcare worldwide, the role of fathers is in transformation. The aim of the study is to explore father's perceptions and experiences of healthcare engagement during pregnancy and early infant care. DESIGN: Qualitative free-text questions were embedded in a large multi-country, cross-sectional survey, to explored fathers' attendance, participation, and experience of health care during appointments with their pregnant partner and/or baby. SETTING AND PARTICIPANTS: Expectant and new fathers were recruited through Prolific®, an international paid online survey platform. FINDINGS: Qualitative responses (n=889) were provided by fathers from 28 countries, with experiences of a range of contexts and models of care; 46.8% of whose partners were pregnant and 53.2% had given birth since 2020. The findings suggest that although most fathers wanted to attend and participate in maternity and early parenting-related healthcare, multiple barriers were identified at the individual father, organisational context, and societal levels. Fathers reported negative social factors such as gender bias and restrictive gender norms as barriers to their healthcare engagement. In contrast, factors that enabled fathers to overcome barriers included the fathers' feelings of confidence in their partner's autonomy and decision-making skills, trusted professional relationships with clinicians, and clinicians with good interpersonal skills. KEY CONCLUSIONS: Multiple barriers restrict the participation of fathers in healthcare for childbearing and early parenting. Knowledge of these barriers can inform healthcare redesign to include more successful engagement strategies for fathers, to benefit fathers, mothers, and infants alike. IMPLICATIONS FOR PRACTICE: Health professionals consulting with the mother, father and infant triad are ideally placed to address the healthcare needs of both parents. Early engagement of fathers in family health care by use of inclusive interpersonal skills and the development of a trusted relationship has potential to improve paternal mental health, and may be associated with benefits for the health, wellbeing and safety of the whole family.

Factors that influence the intent to pursue a master's degree: evidence from Shandong Province, China.

Introduction: In recent years, the pursuit of a master's degree has become a social phenomenon of wide concern. It is essential to understand why large number of students choose to pursue master's degree. This study aims to empirically analyze the factors that influence the intent to pursue a master's degree. Method: Based on the extended theory of planned behavior, this study conducts a questionnaire survey of university students in Shandong Province, which has had the highest number of people taking the postgraduate entrance examination in China for several years. A total of 440 questionnaires were finally collected, including 417 valid questionnaires. And then ordinary least squares (OLS) regression was used to analyze the factors that influence the intent to pursue a master's degree. Results: In general, the intent to pursue a master's degree is positively influenced by attitude (ß = 0.161, p < 0.01) and subjective norms (ß = 0.208, p < 0.01), and negatively influenced by risk perception (ß = -0.084, p < 0.05). Compared with male students, female students' intent is more likely to be influenced by risk perception (ß = -0.144, p < 0.05) and social factors (ß = 0.140, p < 0.05). The intent of upperclass students tends to be positively influenced by perceived behavioral control (ß = 0.125, p < 0.05), whereas the negative impact of risk perception (ß = -0.219, p < 0.05) on the intent is significant for underclass students. The intent of students in rural areas are more sensitive to risk perception (ß = -0.194, p < 0.01) than those of students in cities. In private universities, social factors (ß = 0.445, p < 0.05) significantly affect the intent to pursue a master's degree. In ordinary public universities, the intent of students is more likely to be influenced by risk perception (ß = -0.082, p < 0.05). Conclusion: The study is helpful to strengthen the understanding of the influencing factors of the intent to pursue a master's degree. In general, the intent to pursue a master's degree is mainly influenced by attitude, subjective norms and risk perception. Moreover, the influencing factors vary among different groups (e.g., female vs. male, rural areas vs. cities). Furthermore, attitude, subjective norms, perceived behavioral control, risk perception, and social factors have greater impacts on the intent of students from low-income households than those from high-income households. This study can provide policy implications for universities to take targeted educational measures to encourage students to make a choice that suits their own development after graduation.