Thalassemia is a major health challenge in the United Arab Emirates (UAE), however previous studi... more Thalassemia is a major health challenge in the United Arab Emirates (UAE), however previous studies have focused on genetics and molecular characterisation while neglecting culture and society. In this commentary, we discuss how tradition and religion in the UAE (e.g. consanguinity, endogamy, illegality of abortion and in vitro fertilisation, adoption restrictions), and limited academic research, affect the prevention and management of the blood disorder. It is suggested that changing attitudes towards traditional marriage practices, education and awareness campaigns targeting families and young people, and earlier genetic testing, are culturally acceptable solutions to curbing the high incidence of thalassemia in the UAE.
Myanmar has more child soldiers than any other country but the literature on this subject disrega... more Myanmar has more child soldiers than any other country but the literature on this subject disregards their experiences. I analyse a first-hand account of child-soldiering in 2014 in the Kachin Independence Army (KIA), a non-state armed group in Kachin State, to understand motivations for associating with the armed group as well as the lived experience of being a child soldier. I critique claims made in the literature for their failure to appreciate agency and volition and positive experiences in accounts of passivity, innocence, and suffering. Most pertinently, the case study reveals ethnic heterogeneity and ethnicisation, challenging the portrayal of the KIA as an ethnic militia exclusively advocating for Kachin people, and bringing into question politicised ethnicity as the primary lens through which conflict in Myanmar is conventionally viewed. The limitations of Western child rights-based approaches in leveraging culturally sensitive analyses are also considered. This nuanced view of child-soldiering is a corrective to top-down political approaches to deciphering Myanmar’s conflict.
Descendants of indigenous people in the United States (Native Americans) are underrepresented in ... more Descendants of indigenous people in the United States (Native Americans) are underrepresented in happiness studies. The social-cognitive mechanisms involved in happiness are also poorly understood. Here we test a social-cognitive model for theorizing the happiness of Native Americans. Self-identified Native Americans (120 women, 59 men, aged 18-79 years) in the Phoenix, Arizona metropolitan area answered a survey which measured interdependent and independent self-construals, decision-making style (satisficing and maximizing), and subjective happiness. Relationships among these variables were examined using path analysis. For the participants' happiness, independent self-construal was relatively less important than interdependent self-construal, as social harmony and interdependence with others tend to be salient traditional Native American cultural values. However, in agreement with previous studies with Euro-American samples, subjective happiness was positively correlated with satisficing, and negatively correlated with maximizing, suggesting societal factors such as the availability of options and choices in the U.S. as possible influences. These findings contribute to the literature by revealing the basis of happiness in social-cognitive processes, and have important implications for understanding the happiness of an under-researched population.
Aim: The COVID-19 pandemic has disrupted the delivery of healthcare to vulnerable older adults, p... more Aim: The COVID-19 pandemic has disrupted the delivery of healthcare to vulnerable older adults, prompting the expansion of telemedicine usage. This study surveyed the acceptance of virtual medical consultations among older adults and caregivers within geriatric outpatient services in a tertiary hospital during the pandemic. Methods: A cross-sectional survey was conducted among caregivers and patients attending geriatric outpatient services in Kuala Lumpur, Malaysia. The survey measured the availability of equipment for virtual consultations, prior knowledge and experience of telemedicine, and willingness to consult geriatricians through virtual technology, using the Unified Theory of Acceptance and Use of Technology (UTAUT) scale. Results: A total of 197 caregivers and 42 older patients with a mean age of 54.28 (±13.22) and 75.62 (±7.32) years, respectively, completed the survey. One hundred and fifty-six (79.2%) of the caregivers were adult children accompanying patients. The mean UTAUT score was 65.97 (±13.71) out of 90, with 66.64 (±13.25) for caregivers and 62.79 (±15.44) for older adults, suggesting a high acceptance of adopting virtual consultations in lieu of face-to-face care. The independent predictors of acceptance of virtual consultation were : possession of an electronic device capable of video-communication, living with someone, living in a care home, weekly online banking usage, and perceived familiarity with virtual platforms. Conclusion: Caregivers and patients indicated a high level of acceptance of virtual medical consultations, which is likely facilitated by caregivers such as adult children or spouses at home or staff in care homes. To minimize the transmission of COVID-19 in a highly vulnerable group, virtual consultations are an acceptable alternative to face-to-face consultations for older people and their caregivers in our setting.
Background: Tobacco smoking and tattooing interact in multiple ways because they are risk factors... more Background: Tobacco smoking and tattooing interact in multiple ways because they are risk factors to health and share social determinants and meanings (e.g. deviance). Existing research is limited and reliant on non-generalizable samples in Europe and the United States. Addiction studies on religious Chinese are scarce. In this study, we investigated the embeddedness of smoking in tattooing and tattoo-associated contextual factors in a representative sample of Chinese Buddhist adolescents. Method: Latent class analyses based on smoking, tattooing, and tattoo norms were conducted on survey data from 1322 Chinese Dai students (aged 15–19 years, 41.2% females) in seven middle schools in Xishuangbanna, Yunnan Province, China. Subgroup membership was subsequently examined in terms of associations with religiosity, spirituality, and traditionalist tattoo esthetics. Results: Three subgroups with different patterns of cooccurring smoking and tattooing were detected. Tattoo norms—especially peer norms—were found to be distinguishable indicators between subgroups. Traditionalist tattoo esthetics was associated with the lowest smoking-tattooing comorbidity subgroup. Religiosity and spirituality showed sporadic associations with subgroup memberships. Conclusions: The results demonstrate the complexity of smoking-tattooing comorbidity and the importance of a culturally contextualized understanding of addiction. Greater smoking-tattooing comorbidity among adolescents with higher levels of religiosity and spirituality highlights the limitations of Eurocentric views of addiction. The role of tattoo esthetics suggests that body-related visual information can contribute to substance use. Further studies are needed on religious Chinese, a population overlooked in the literature.
Free-roaming cats negatively affect wildlife, human health, and society, and anthropogenic food s... more Free-roaming cats negatively affect wildlife, human health, and society, and anthropogenic food sources partly maintain their populations. There is a dearth of theory-informed interventions to change people’s beliefs about feeding animals. Here, we outline a behavioural change intervention protocol to modify Malaysians’ key beliefs (i.e. the most influential beliefs) about feeding free-roaming cats. Our protocol serves as a novel, timely, and potentially valuable tool for addressing a significant conservation and societal issue. The Theory of Planned Behaviour is the theoretical framework of the intervention, underpinning its targets (i.e. behavioural beliefs, normative beliefs), content, delivery, and evaluation. The prescriptive intervention consists of one full-day workshop (duration=5h) with three sessions each attempting to alter one key belief using behavioural change strategies. A two-armed parallel-group prospective-cluster randomised controlled trial will be used to evaluat...
Objectives: Most of the world's areca nut users reside in south and southeast Asia, but research ... more Objectives: Most of the world's areca nut users reside in south and southeast Asia, but research is scarce. We examine areca nut use among Dai, a Chinese ethnic minority, and its implications. Results: The history, common knowledge, traditional medical applications, social functions, and changing epidemiology of areca nut use are reviewed. Importantly, areca nut use is embedded in complex social meanings and practices, and is changing as long-standing customs are being shaped by new fashions. Its declining popularity among Dai has important implications for the management of substance misuse, as changing contextual factors such as customs and social norms have been more important than interventions or policies and laws. Conclusions/Importance: The findings contribute to future strategies to curb the consumption of areca nut, and also help to explain unsuccessful control in China of other substances such as tobacco which overlooked social context. It is imperative that health professionals and researchers engage with the culture, health beliefs, and society of specific populations to formulate culturally appropriate and innovative oral health strategies.
As the Covid-19 pandemic sweeps across the globe, news reports are publicising political claims a... more As the Covid-19 pandemic sweeps across the globe, news reports are publicising political claims about accountability for the crisis, conspiracy theories, cover-ups, misinformation, public health responses, and vulnerabilities in societies. President Donald Trump and senior officials in the Chinese Government have
In this study, we analyzed identity construction among young smokers in China, with three interco... more In this study, we analyzed identity construction among young smokers in China, with three interconnected objectives: to theorize the turning points and career trajectory of smoking initiation; to account for their characteristics with interactionist processes; and to critically evaluate the applicability of classic typologies of identity change by Becker and Strauss. In-depth interviews with 24 late adolescents (ages 18–19) revealed a smoking initiation career path of four interconnected turning points, each characterized by interactionist processes. Smoker peers played a key role in facilitating overall career progression, and shame avoidance was crucial to their social dynamics. We also conclude that classic studies of turning points in general, and substance use specifically, are sufficiently broad and flexible to elucidate tobacco smoker identity construction in China, and facilitate a comparison of commonality and divergence among different “becoming” identities. The implications of these findings for tobacco control in China are discussed.
People's beliefs about feeding stray cats require investigation. Previous studies were based on a... more People's beliefs about feeding stray cats require investigation. Previous studies were based on assumptions about sample homogeneity, potentially obscuring within-group and background differences in beliefs. A latent class analysis was conducted on
Little information has been reported about the welfare and management of free-roaming animals in ... more Little information has been reported about the welfare and management of free-roaming animals in Middle Eastern countries. Here we describe a case study of free-roaming cat (Felis catus) management policies in two universities in Beirut, Lebanon whereby cats are immensely valued for their presence and the benefits they bring to students and employees. Guided by concern for animal welfare, the innovative, humane approaches by the universities include arranging adoptions, discouraging pet abandonment, food provision, health monitoring, nurturing a social responsibility consciousness among young people, formal endorsement of animal rights and humane treatment in student conduct expectations, sterilization, and veterinary care. The policies serve as blueprint for universities and other institutions across the globe to adopt proactive approaches to free-roaming cat management as well take responsibility for the welfare of all animals on campus (rather than only for ethical conduct in use of animals in scientific research). They also inspire students, as the next generation, to safeguard animals and the environment.
Journal of Child and Adolescent Substance Abuse, 2019
This study investigates smoking intention, nicotine dependence, and mindfulness among Dai Lue ado... more This study investigates smoking intention, nicotine dependence, and mindfulness among Dai Lue adolescents (N ¼ 1322, ages ¼ 14-18), an understudied Buddhist ethnic minority in China. Based on the Theory of Planned Behavior (TPB), mindfulness showed a negative association with smoking intention. However, for participants with nicotine dependence, the mindfulness-intention association diminished, while volitional processes remained salient. Results from this study contribute to debates in the literature regarding habit versus planned behavior, and provide empirical support for integrating mindfulness into the TPB. The cognitive pathways identified could be targeted in anti-smoking interventions to curb the high prevalence of smoking among Dai Lue adolescents.
In this article, we report our research on Dai Lue in a rural area of Xishuangbanna, revealing ho... more In this article, we report our research on Dai Lue in a rural area of Xishuangbanna, revealing how their tattoos have become an emblem of the self or an interiority cultivated through outer appearance, acted out and contested on people's bodies as parchments for society's discourses. China's version of modernisation and nationstate building has underpinned shifting tattoo designs and subjectivities. Tattooing among younger people was different to their elders, as they were less inclined to practise it for a sense of belonging and conformity to Dai Lue and, instead, did so to stand out from and within their ethnic group, expressing a more individual and volitional self-a profound cultural change which also pervades many other aspects of their lives. We also show how popular discourses in China concerning the nation and ethnic minorities are being embodied and visually performed by Dai Lue through their tattoos, albeit creatively and not homogeneously. Our findings call for a more inclusive national story line in China which moves beyond simple stereotypes of ethnic categories currently popular in society to appreciate the complexity of peoples' lives. Our study also updates the literature on tattooing among Dai Lue which, hitherto, was limited to descriptions in Chinese texts of old tattoo designs and rituals in isolation from society and politics.
Thalassemia is a major health challenge in the United Arab Emirates (UAE), however previous studi... more Thalassemia is a major health challenge in the United Arab Emirates (UAE), however previous studies have focused on genetics and molecular characterisation while neglecting culture and society. In this commentary, we discuss how tradition and religion in the UAE (e.g. consanguinity, endogamy, illegality of abortion and in vitro fertilisation, adoption restrictions), and limited academic research, affect the prevention and management of the blood disorder. It is suggested that changing attitudes towards traditional marriage practices, education and awareness campaigns targeting families and young people, and earlier genetic testing, are culturally acceptable solutions to curbing the high incidence of thalassemia in the UAE.
Myanmar has more child soldiers than any other country but the literature on this subject disrega... more Myanmar has more child soldiers than any other country but the literature on this subject disregards their experiences. I analyse a first-hand account of child-soldiering in 2014 in the Kachin Independence Army (KIA), a non-state armed group in Kachin State, to understand motivations for associating with the armed group as well as the lived experience of being a child soldier. I critique claims made in the literature for their failure to appreciate agency and volition and positive experiences in accounts of passivity, innocence, and suffering. Most pertinently, the case study reveals ethnic heterogeneity and ethnicisation, challenging the portrayal of the KIA as an ethnic militia exclusively advocating for Kachin people, and bringing into question politicised ethnicity as the primary lens through which conflict in Myanmar is conventionally viewed. The limitations of Western child rights-based approaches in leveraging culturally sensitive analyses are also considered. This nuanced view of child-soldiering is a corrective to top-down political approaches to deciphering Myanmar’s conflict.
Descendants of indigenous people in the United States (Native Americans) are underrepresented in ... more Descendants of indigenous people in the United States (Native Americans) are underrepresented in happiness studies. The social-cognitive mechanisms involved in happiness are also poorly understood. Here we test a social-cognitive model for theorizing the happiness of Native Americans. Self-identified Native Americans (120 women, 59 men, aged 18-79 years) in the Phoenix, Arizona metropolitan area answered a survey which measured interdependent and independent self-construals, decision-making style (satisficing and maximizing), and subjective happiness. Relationships among these variables were examined using path analysis. For the participants' happiness, independent self-construal was relatively less important than interdependent self-construal, as social harmony and interdependence with others tend to be salient traditional Native American cultural values. However, in agreement with previous studies with Euro-American samples, subjective happiness was positively correlated with satisficing, and negatively correlated with maximizing, suggesting societal factors such as the availability of options and choices in the U.S. as possible influences. These findings contribute to the literature by revealing the basis of happiness in social-cognitive processes, and have important implications for understanding the happiness of an under-researched population.
Aim: The COVID-19 pandemic has disrupted the delivery of healthcare to vulnerable older adults, p... more Aim: The COVID-19 pandemic has disrupted the delivery of healthcare to vulnerable older adults, prompting the expansion of telemedicine usage. This study surveyed the acceptance of virtual medical consultations among older adults and caregivers within geriatric outpatient services in a tertiary hospital during the pandemic. Methods: A cross-sectional survey was conducted among caregivers and patients attending geriatric outpatient services in Kuala Lumpur, Malaysia. The survey measured the availability of equipment for virtual consultations, prior knowledge and experience of telemedicine, and willingness to consult geriatricians through virtual technology, using the Unified Theory of Acceptance and Use of Technology (UTAUT) scale. Results: A total of 197 caregivers and 42 older patients with a mean age of 54.28 (±13.22) and 75.62 (±7.32) years, respectively, completed the survey. One hundred and fifty-six (79.2%) of the caregivers were adult children accompanying patients. The mean UTAUT score was 65.97 (±13.71) out of 90, with 66.64 (±13.25) for caregivers and 62.79 (±15.44) for older adults, suggesting a high acceptance of adopting virtual consultations in lieu of face-to-face care. The independent predictors of acceptance of virtual consultation were : possession of an electronic device capable of video-communication, living with someone, living in a care home, weekly online banking usage, and perceived familiarity with virtual platforms. Conclusion: Caregivers and patients indicated a high level of acceptance of virtual medical consultations, which is likely facilitated by caregivers such as adult children or spouses at home or staff in care homes. To minimize the transmission of COVID-19 in a highly vulnerable group, virtual consultations are an acceptable alternative to face-to-face consultations for older people and their caregivers in our setting.
Background: Tobacco smoking and tattooing interact in multiple ways because they are risk factors... more Background: Tobacco smoking and tattooing interact in multiple ways because they are risk factors to health and share social determinants and meanings (e.g. deviance). Existing research is limited and reliant on non-generalizable samples in Europe and the United States. Addiction studies on religious Chinese are scarce. In this study, we investigated the embeddedness of smoking in tattooing and tattoo-associated contextual factors in a representative sample of Chinese Buddhist adolescents. Method: Latent class analyses based on smoking, tattooing, and tattoo norms were conducted on survey data from 1322 Chinese Dai students (aged 15–19 years, 41.2% females) in seven middle schools in Xishuangbanna, Yunnan Province, China. Subgroup membership was subsequently examined in terms of associations with religiosity, spirituality, and traditionalist tattoo esthetics. Results: Three subgroups with different patterns of cooccurring smoking and tattooing were detected. Tattoo norms—especially peer norms—were found to be distinguishable indicators between subgroups. Traditionalist tattoo esthetics was associated with the lowest smoking-tattooing comorbidity subgroup. Religiosity and spirituality showed sporadic associations with subgroup memberships. Conclusions: The results demonstrate the complexity of smoking-tattooing comorbidity and the importance of a culturally contextualized understanding of addiction. Greater smoking-tattooing comorbidity among adolescents with higher levels of religiosity and spirituality highlights the limitations of Eurocentric views of addiction. The role of tattoo esthetics suggests that body-related visual information can contribute to substance use. Further studies are needed on religious Chinese, a population overlooked in the literature.
Free-roaming cats negatively affect wildlife, human health, and society, and anthropogenic food s... more Free-roaming cats negatively affect wildlife, human health, and society, and anthropogenic food sources partly maintain their populations. There is a dearth of theory-informed interventions to change people’s beliefs about feeding animals. Here, we outline a behavioural change intervention protocol to modify Malaysians’ key beliefs (i.e. the most influential beliefs) about feeding free-roaming cats. Our protocol serves as a novel, timely, and potentially valuable tool for addressing a significant conservation and societal issue. The Theory of Planned Behaviour is the theoretical framework of the intervention, underpinning its targets (i.e. behavioural beliefs, normative beliefs), content, delivery, and evaluation. The prescriptive intervention consists of one full-day workshop (duration=5h) with three sessions each attempting to alter one key belief using behavioural change strategies. A two-armed parallel-group prospective-cluster randomised controlled trial will be used to evaluat...
Objectives: Most of the world's areca nut users reside in south and southeast Asia, but research ... more Objectives: Most of the world's areca nut users reside in south and southeast Asia, but research is scarce. We examine areca nut use among Dai, a Chinese ethnic minority, and its implications. Results: The history, common knowledge, traditional medical applications, social functions, and changing epidemiology of areca nut use are reviewed. Importantly, areca nut use is embedded in complex social meanings and practices, and is changing as long-standing customs are being shaped by new fashions. Its declining popularity among Dai has important implications for the management of substance misuse, as changing contextual factors such as customs and social norms have been more important than interventions or policies and laws. Conclusions/Importance: The findings contribute to future strategies to curb the consumption of areca nut, and also help to explain unsuccessful control in China of other substances such as tobacco which overlooked social context. It is imperative that health professionals and researchers engage with the culture, health beliefs, and society of specific populations to formulate culturally appropriate and innovative oral health strategies.
As the Covid-19 pandemic sweeps across the globe, news reports are publicising political claims a... more As the Covid-19 pandemic sweeps across the globe, news reports are publicising political claims about accountability for the crisis, conspiracy theories, cover-ups, misinformation, public health responses, and vulnerabilities in societies. President Donald Trump and senior officials in the Chinese Government have
In this study, we analyzed identity construction among young smokers in China, with three interco... more In this study, we analyzed identity construction among young smokers in China, with three interconnected objectives: to theorize the turning points and career trajectory of smoking initiation; to account for their characteristics with interactionist processes; and to critically evaluate the applicability of classic typologies of identity change by Becker and Strauss. In-depth interviews with 24 late adolescents (ages 18–19) revealed a smoking initiation career path of four interconnected turning points, each characterized by interactionist processes. Smoker peers played a key role in facilitating overall career progression, and shame avoidance was crucial to their social dynamics. We also conclude that classic studies of turning points in general, and substance use specifically, are sufficiently broad and flexible to elucidate tobacco smoker identity construction in China, and facilitate a comparison of commonality and divergence among different “becoming” identities. The implications of these findings for tobacco control in China are discussed.
People's beliefs about feeding stray cats require investigation. Previous studies were based on a... more People's beliefs about feeding stray cats require investigation. Previous studies were based on assumptions about sample homogeneity, potentially obscuring within-group and background differences in beliefs. A latent class analysis was conducted on
Little information has been reported about the welfare and management of free-roaming animals in ... more Little information has been reported about the welfare and management of free-roaming animals in Middle Eastern countries. Here we describe a case study of free-roaming cat (Felis catus) management policies in two universities in Beirut, Lebanon whereby cats are immensely valued for their presence and the benefits they bring to students and employees. Guided by concern for animal welfare, the innovative, humane approaches by the universities include arranging adoptions, discouraging pet abandonment, food provision, health monitoring, nurturing a social responsibility consciousness among young people, formal endorsement of animal rights and humane treatment in student conduct expectations, sterilization, and veterinary care. The policies serve as blueprint for universities and other institutions across the globe to adopt proactive approaches to free-roaming cat management as well take responsibility for the welfare of all animals on campus (rather than only for ethical conduct in use of animals in scientific research). They also inspire students, as the next generation, to safeguard animals and the environment.
Journal of Child and Adolescent Substance Abuse, 2019
This study investigates smoking intention, nicotine dependence, and mindfulness among Dai Lue ado... more This study investigates smoking intention, nicotine dependence, and mindfulness among Dai Lue adolescents (N ¼ 1322, ages ¼ 14-18), an understudied Buddhist ethnic minority in China. Based on the Theory of Planned Behavior (TPB), mindfulness showed a negative association with smoking intention. However, for participants with nicotine dependence, the mindfulness-intention association diminished, while volitional processes remained salient. Results from this study contribute to debates in the literature regarding habit versus planned behavior, and provide empirical support for integrating mindfulness into the TPB. The cognitive pathways identified could be targeted in anti-smoking interventions to curb the high prevalence of smoking among Dai Lue adolescents.
In this article, we report our research on Dai Lue in a rural area of Xishuangbanna, revealing ho... more In this article, we report our research on Dai Lue in a rural area of Xishuangbanna, revealing how their tattoos have become an emblem of the self or an interiority cultivated through outer appearance, acted out and contested on people's bodies as parchments for society's discourses. China's version of modernisation and nationstate building has underpinned shifting tattoo designs and subjectivities. Tattooing among younger people was different to their elders, as they were less inclined to practise it for a sense of belonging and conformity to Dai Lue and, instead, did so to stand out from and within their ethnic group, expressing a more individual and volitional self-a profound cultural change which also pervades many other aspects of their lives. We also show how popular discourses in China concerning the nation and ethnic minorities are being embodied and visually performed by Dai Lue through their tattoos, albeit creatively and not homogeneously. Our findings call for a more inclusive national story line in China which moves beyond simple stereotypes of ethnic categories currently popular in society to appreciate the complexity of peoples' lives. Our study also updates the literature on tattooing among Dai Lue which, hitherto, was limited to descriptions in Chinese texts of old tattoo designs and rituals in isolation from society and politics.
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Papers by Gareth Davey