Suchergebnisse

1. Methodological issues in social research: Experience from the 21st century -- 2. An active partner in disgraceful context: research, surveillance and risk in the Chittagong Hill Tracts -- 3. Researching Garo Death Rites (reprint with revision) -- 4. Negotiating the tyrannies of fieldwork in Africa: A Nigerian experience -- 5. Trial by fire: Reflections on fieldwork in Nagaland, Northeast India. 6. Encounters in the field: The influence of emotions on data -- 7. Developing relationships over many years: Under investigated but important types of qualitative Research -- 8. Sick in the Field: Illness and inter-being encounters in anthropological fieldwork -- 9. At the organ bazaar of Bangladesh: In search of kidney sellers (reprint with revision). 10. "Can we talk about surrogacy?" Legal precariousness and the perils of qualitative research in the biomedical Context -- 11. Qualitative 'fieldwork' in health geographic research: self-reports from Bangladesh -- 12. Adolescent drug abuse in Connecticut private high schools: Zero tolerance, contextual peer Influence, and deterrence effectiveness -- 13. Researchers' dilemmas and challenges in qualitative fieldwork with climate-vulnerable communities -- 14. Risks and challenges in fieldwork on gender-based violence: Identity, social taboo and culture -- 15. Rethinking ethnographic research as 'gendered and en-casted labour': Reflections from researching caste and partition-induced forced-migration in a non-metropolitan city of West Bengal -- 16. Photovoice as a method for women's empowerment in domestic violence: a reflexive account -- 17. Working with opposite gender: Experience of doing fieldwork among rural women in Bangladesh -- 18. Between an activist and academic: Contested (re)positioning in refugee research -- 19. Moving research methods to the field: Challenges and Lessons learned across African contexts -- 20. Entry, access, bans and returns: Reflections on positionality in field research on Central Asia's ethnic minorities -- 21. Doing ethnography on sexuality among Young Men in Dhaka, Bangladesh: How Has Reflexivity Helped? - 22. A native anthropologist's positionality of being insider/outsider: A reflective account of doing ethnographic research in Nepal -- 23. Recruitment of participants from vulnerable groups for social research: Challenges and solutions -- 24. Navigating Archival Readings of Rural Technology -- 25. Challenges of social research: Way forward.

How did mothers transform from parents of secondary importance in the colonies to having their multiple and complex roles connected to the well-being of the nation? In the first comprehensive history of motherhood in the United States, Jodi Vandenberg-Daves explores how tensions over the maternal role have been part and parcel of the development of American society. Modern Motherhood travels through redefinitions of motherhood over time, as mothers encountered a growing cadre of medical and psychological experts, increased their labor force participation, gained the right to vote, agitated for more resources to perform their maternal duties, and demonstrated their vast resourcefulness in providing for and nurturing their families. Navigating rigid gender role prescriptions and a crescendo of mother-blame by the middle of the twentieth century, mothers continued to innovate new ways to combine labor force participation and domestic responsibilities. By the 1960s, they were poised to challenge male expertise, in areas ranging from welfare and abortion rights to childbirth practices and the confinement of women to maternal roles. In the twenty-first century, Americans continue to struggle with maternal contradictions, as we pit an idealized role for mothers in children's development against the social and economic realities of privatized caregiving, a paltry public policy structure, and mothers' extensive employment outside the home. Building on decades of scholarship and spanning a wide range of topics, Vandenberg-Daves tells an inclusive tale of African American, Native American, Asian American, working class, rural, and other hitherto ignored families, exploring sources ranging from sermons, medical advice, diaries and letters to the speeches of impassioned maternal activists. Chapter topics include: inventing a new role for mothers; contradictions of moral motherhood; medicalizing the maternal body; science, expertise, and advice to mothers; uplifting and controlling mothers; modern reproduction; mothers' resilience and adaptation; the middle-class wife and mother; mother power and mother angst; and mothers' changing lives and continuous caregiving. While the discussion has been part of all eras of American history, the discussion of the meaning of modern motherhood is far from over

AbstractIntroductionSouth African men face a substantial burden of HIV and are less likely to test for HIV and initiate antiretroviral therapy if tested positive and more likely to die from AIDS‐related causes than women. In addition to condoms and circumcision, guidelines provide for the use of daily oral pre‐exposure prophylaxis (PrEP) as an HIV prevention intervention for any men who recognize their need and request PrEP. However, heterosexual men have not been a focus of PrEP programmes, and since its introduction, there is limited literature on PrEP use among men in South Africa. This study explores the experiences, motivators and barriers to oral PrEP use among heterosexual men accessing primary healthcare services in South Africa.MethodsThis study forms part of a mixed‐methods implementation science study aimed at generating evidence for oral PrEP introduction and conducted in primary healthcare clinics in South Africa since 2018. Men aged ≥15 years who initiated oral PrEP and enrolled in a parent cohort study were purposefully invited to participate in an in‐depth interview (IDI). Between March 2020 and May 2022, 30 men participated in IDIs exploring their motivators for PrEP use, and experiences with accessing health services. Interviews were audio recorded, transcribed and analysed thematically.ResultsThe final analysis included 28 heterosexual men (18–56 years old). Motivations to initiate PrEP included fear of acquiring HIV, self‐perceived vulnerability to HIV and mistrust in relationships; health systems factors which motivated PrEP use included the influence of healthcare providers, educational materials and mobile services. Perceived reduction in HIV vulnerability and changing proximity to partners were reasons for PrEP discontinuation. Side effects, daily‐pill burden and stigma were noted as challenges to PrEP use. Health system barriers to PrEP use included limited PrEP availability, school and work demands, and inconsistent mobile clinic schedules.ConclusionsOur study reports on the experiences of heterosexual men accessing oral PrEP in real‐world settings and contributes to the limited literature among this population. We highlight multiple levels which could be strengthened to improve men's PrEP use, including individual support, education among partners and communities, and addressing health system barriers to access.

Violence against women, in particular, the crime of rape has reached epidemic status in South Africa. Rape constitutes a gross violation of the victim's dignity, privacy, and person. It also intrudes upon the commitment between another man and the woman who is the victim to keep the intimacies of their bodily affections exclusively for one another. Rape is not only an act of contempt for the woman who is its victim but is also an act of contempt for the man or woman that she will choose or has chosen to commit herself. Rape is an act of violence, not only upon the woman who is its immediate victim, but towards the concept of family. The family is the granite cornerstone of society. Rape, by its definition, is the intentional, unlawful act of sexual penetration with a victim without their consent. The conundrum arises where a victim is confronted by a group of perpetrators but is only raped by one of them. Can the crime of rape be imputed to the other perpetrators who only watched and did not participate? The common purpose doctrine, a form of liability under South African common law, has been one of the few available measures which effectively addresses joint criminal ventures carried out by gangs. However, whether a conviction on a charge of rape on the doctrine of common purpose is legally competent has been the centre of legal debate. The main argument levelled against the imposition of liability for rape based on common purpose is that rape can only be committed through the instrumentality of an accused's own body or part thereof, and not through the instrumentality of another. This paper seeks to discuss the effect of including the crime of rape in the doctrine of common purpose. The authors firstly discuss the doctrine of common purpose and rape. Thereafter, a discussion of the current legislative framework in South Africa follows as well as an analysis of the German criminal legal system. Finally, this paper seeks to advance and endorse the judgment handed down by the Constitutional Court in the case of ...

This article reflects on the changes in the way of organizing the most traditional celebration of the patron saint of the Remanso quilombola community in Chapada Diamantina (Bahia): the São Francisco das Chagas party, celebrated annually. The text presents the context of the party in order to reveal the specific forms of resistance that culminate in a process of politicization of its agents. It is an experience that reveals the emergence of unique knowledge and practices, subject to disputes, absence of support and denial of rights and which are linked to other local ways of celebrating: Marujada Quilombola do Remanso and Caruru ceremonies dedicated to Saints Cosme and Damião. With these three moments as central to the analysis, the article points to identity celebrations as important spaces for the construction of policies and mediation, emphasizing their organization process and the performance of women at the base of decision-making, in the organization and in the conduct of rituals. When looking at the senses of these three ways of celebrating, we have a historical invisibility and vulnerabilities that cross a daily life whose power is affirmed from its identity base, Jarê, a religion of African origin exclusive to the Lavras Diamantinas region, where the Remanso community is located. ; Este artigo reflete sobre as transformações no modo de organização da festa mais tradicional da comunidade quilombola do Remanso na Chapada Diamantina (Bahia): a festa de São Francisco das Chagas, celebrada anualmente. O texto apresenta o contexto da festa de modo a revelar as formas próprias de resistência que culminam em um processo de politização dos seus agentes. Trata-se de uma experiência que revela a emergência de um saber e práticas singulares, sujeitas a disputas, ausência de apoio e negação de direitos e que se articulam com outras formas locais de festejar: a Marujada Quilombola do Remanso e as cerimônias de Caruru dedicadas aos santos Cosme e Damião. Tendo estes três momentos como centrais na análise, o artigo ...

Este trabajo explora y desarrolla algunas nuevas y viejas dimensiones de lo que se conoce como" la guerra por las vacas ". A propósito de un documento puntano inédito y de otras dos fuentes poco o nada conocidas, enfocamos la escena del conflicto en el centro- oeste de las pampas a la vez que introducimos matices interesantes en las relaciones sociales interétnicas que pudieron haber agudizado la dimensión del conflicto significativamente en toda el área: el acoso sexual a las mujeres indias libres por parte de los "vaqueros" que recogían ganado cimarrón. Además, penetramos en las relaciones entre criollos puntanos y aucas trasandinos a la vez que revisamos una aguda estereotipia hacia los pampas unívocamente acusados de asesinos de vaqueros. Para entender estas actitudes intentamos explorar el escenario histórico intra e interétnico diferencial entre el Reino de Chile y las gobernaciones del sur del virreinato así como el impacto que sobre estas relaciones pudo haber tenido la trata de esclavos africanos legalizada en 1702. ; This paper explores and develops old and new dimensions ofwhat is known as "the war for the cows" ("la guerra por las vacas"). According to an unpublished documentfrom the province of San Luis and other hule known sources, we focus the scene of conflict on the western central pampas where interesting new shades arefound in the inter-ethnic social relationships including the sexual harassment offree lndian women by the wlúte "vaqueros ", gatherers ofrun away caule in the heart of lndian te rritory. The "tidy" relationships between San Luis ' 'criollos' and Auca /ndians from across the Andes are also considered and the strong stereotype which associates the Pampa /ndians as murderers of vaqueros, is revised. In arder to understand these attitudes we explore the different intra and interethnic historical relationships between the Kingdom ofChile and the southern governments of the Vice royalty, as well as the impact that the legalization of African slavery in 1702 might have had on these relationships. ; Sociedad Argentina de Antropología

BACKGROUND: Disease and mortality burdens of unhealthy lifestyle behaviours are often reported. In contrast, the positive narrative around the burdens that an existing behaviour have averted is rarely acknowledged. We aimed to estimate the prevented fraction for the population (PFP) for premature mortality averted by physical activity on a global scale. METHODS: In this descriptive study, we obtained previously published data on physical activity prevalence (2001–16) and relative risks of all-cause mortality for 168 countries. We combined the data in Monte-Carlo simulations to estimate country-specific, mean PFP values, corresponding to percentage of mortality averted, and their 95% CIs. High prevented fractions indicated an increased proportion of deaths averted due to physical activity. Using mortality data for all people in a country aged 40–74 years, we estimated the number of premature deaths averted for all adults and by gender. We present the median and range of the prevented fractions globally, by WHO region, and by World Bank income classification. FINDINGS: The global median PFP was 15·0% (range 6·6–20·5), conservatively equating to 3·9 million (95% CI 2·5–5·6) premature deaths averted annually. The African region had the highest median prevented fraction (16·6% [range 12·1–20·5]) and the Americas had the lowest (13·1% [10·8–16·6]). Low-income countries tended to have higher prevented fractions (group median 17·9% [12·3–20·5]) than high-income countries (14·1% [6·6–17·8]). Globally, the median prevented fraction was higher for men (16·0% [7·8–20·7] than women (14·1% [5·0–20·4]). INTERPRETATION: Existing physical activity prevalence has contributed to averting premature mortality across all countries. PFP has utility as an advocacy tool to promote healthy lifestyle behaviours. By making the case of what has been achieved, the prevented fraction can show the value of current investment and services, which might be conducive to political support. FUNDING: UK Medical Research Council, British Heart ...

Background: Limited data exist describing supportive care management, laboratory abnormalities and outcomes in patients with Ebola virus disease (EVD) in West Africa. We report data which constitute the first description of the provision of enhanced EVD case management protocols in a West African setting. Methods: Demographic, clinical and laboratory data were collected by retrospective review of clinical and laboratory records of patients with confirmed EVD admitted between 5 November 2014 and 30 June 2015. Results: A total of 44 EVD patients were admitted (median age 37 years (range 17–63), 32/44 healthcare workers), and excluding those evacuated, the case fatality rate was 49% (95% CI 33%–65%). No pregnant women were admitted. At admission 9/44 had stage 1 disease (fever and constitutional symptoms only), 12/44 had stage 2 disease (presence of diarrhoea and/or vomiting) and 23/44 had stage 3 disease (presence of diarrhoea and/or vomiting with organ failure), with case fatality rates of 11% (95% CI 1%–58%), 27% (95% CI 6%–61%), and 70% (95% CI 47%–87%) respectively (p = 0.009). Haemorrhage occurred in 17/41 (41%) patients. The majority (21/40) of patients had hypokalaemia with hyperkalaemia occurring in 12/40 patients. Acute kidney injury (AKI) occurred in 20/40 patients, with 14/20 (70%, 95% CI 46%–88%) dying, compared to 5/20 (25%, 95% CI 9%–49%) dying who did not have AKI (p = 0.01). Ebola virus (EBOV) PCR cycle threshold value at baseline was mean 20.3 (SD 4.3) in fatal cases and 24.8 (SD 5.5) in survivors (p = 0.007). Mean national early warning score (NEWS) at admission was 5.5 (SD 4.4) in fatal cases and 3.0 (SD 1.9) in survivors (p = 0.02). Central venous catheters were placed in 37/41 patients and intravenous fluid administered to 40/41 patients (median duration of 5 days). Faecal management systems were inserted in 21/41 patients, urinary catheters placed in 27/41 and blood component therapy administered to 20/41 patients. Conclusions: EVD is commonly associated life-threatening electrolyte imbalance ...

Bereket Kefale,1 Yitayish Damtie,1 Melaku Yalew,1 Bezawit Adane,2 Mastewal Arefaynie1 1Department of Reproductive and Family Health, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia; 2Department of Biostatistics and Epidemiology, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, EthiopiaCorrespondence: Bereket KefaleDepartment of Reproductive and Family Health, School of Public Health, College of Medicine and Health Sciences, Wollo University, PO Box: 1145, Dessie, EthiopiaTel +251933807117Fax +251331190586Email bereketkefale398@gmail.comBackground: HIV/AIDS has been a big public health problem in sub-Saharan African countries including Ethiopia. Comprehensive knowledge is a basis for the prevention, control and treatment of HIV/AIDS. Several studies were focused only on the individual-level characteristics. However, comprehensive knowledge of HIV/AIDS is a multi-factorial understanding on a different level. Thus, the aim of this study was to identify the individual- and community-level factors that determine comprehensive knowledge of HIV/AIDS in Ethiopia.Methods: This study used data from the 2016 Ethiopian Demographic and Health Survey (EDHS). A total of 25,927 (weighted) people aged 15– 49 years were included in the study. A two-stage stratified cluster was used. Data were analyzed using Stata version 14. Multilevel mixed effect logistic regression was used to identify predictors of comprehensive knowledge on HIV/AIDS.Results: Various individual- and community-level factors were associated with comprehensive knowledge of HIV/AIDS. From individual-level factors such as sex (male), educational status (educated), media exposure, and ever been tested for HIV, and from community-level factors such as place of residence (urban) and region (developed region) were predictors of comprehensive knowledge of HIV/AIDS.Conclusion: Both individual- and community-level factors were identified as predictors of comprehensive knowledge of HIV/AIDS. The government should design strategies to address the HIV/AIDS knowledge gaps among women and other underprivileged population sub-groups.Keywords: predictors, comprehensive knowledge, HIV/AIDS, multi-level analysis, Ethiopia

<b><i>Background:</i></b> The Dutch multi-ethnic Healthy Life in an Urban Setting study recently showed that alcohol consumption was lower in ethnic minority groups than those of Dutch origin, but that binge drinking in drinkers of Turkish and Moroccan origin was relatively high. The aim of the current study is to examine factors that may contribute to the differences in drinking patterns and how they relate to the relationship between drinking patterns and alcohol dependence (AD) across ethnic groups. <b><i>Methods:</i></b> The rate of last year alcohol use, alcohol use patterns and AD was assessed in 4,635 Dutch, 4,317 Moroccan, 4,036 Turkish, 2,459 Ghanaian, 4,426 African Surinamese and 3,357 South-Asian Surinamese participants (both men and women) born in Amsterdam, the Netherlands. <b><i>Results:</i></b> Compared to the Dutch, the prevalence of (regular) drinking is substantially lower in all ethnic minority groups and regular drinkers among most ethnic minority groups have a lower adjusted risk to develop binge drinking and AD than the Dutch. For the prevalence of regular drinking, the ethnic differences are bigger than for the prevalence of current drinking. However, regular drinkers of Moroccan origin have a risk similar to the Dutch to develop binge drinking and AD; a finding that could not be explained by group differences in age, sex, religiosity, perceived discrimination, depression or guilt feelings about drinking. <b><i>Discussion:</i></b> The prevalence data show that current drinking is lower and that regular drinking is much lower in ethnic minorities and – with the exception of those of Moroccan origin – ethnic minority regular drinkers also have a significant lower risk to develop binge drinking or AD than regular drinkers of Dutch origin. This implies that the magnitude of problematic alcohol use is substantially smaller in ethnic minorities than in the ethnic Dutch population of Amsterdam. Unfortunately, no explanation was found for the special risk situation of regular drinkers of Moroccan origin.

TF is funded by the Wellcome Trust (104480/Z/14/Z) and the UK Ministry of Defence. ; Background: Limited data exist describing supportive care management, laboratory abnormalities and outcomes in patients with EVD (Ebola virus disease) in West Africa. We report data which constitute the first description of the provision of enhanced EVD case management protocols in a West African setting. Methods: Demographic, clinical and laboratory data were collected by retrospective review of clinical and laboratory records of patients with confirmed EVD admitted between 5 November 2014 and 30 June 2015. Results: A total of 44 EVD cases were admitted (median age 37 years (range 17-63), 32/44 healthcare workers), and excluding those evacuated, the case fatality rate was 49% (95% CI 33-65%). No pregnant women were admitted. At admission 9/44 had stage 1 disease (fever and constitutional symptoms only), 12/44 stage 2 disease (presence of diarrhoea and/or vomiting) and 23/44 had stage 3 disease (presence of diarrhoea and/or vomiting with organ failure), with case fatality rates of 11% (95% CI 1-58%), 27% (95% CI 6-61%), and 70% (95% CI 47-87%) respectively (p=0.009). Haemorrhage occurred in 17/41 (41%) patients. The majority (21/40) of patients had hypokalaemia with hyperkalaemia occurring in 12/40 patients. Acute Kidney Injury (AKI) occurred in 20/40 patients, with 14/20 (70%, 95% CI 46-88%) dying, compared to 5/20 (25%, 95% CI 9-49%) dying who did not have AKI (p=0.01). Ebola virus (EBOV) PCR cycle threshold value at baseline was mean 20.3 (SD 4.3) in fatal cases and 24.8 (SD 5.5) in survivors (p=0.007). Mean National Early Warning Score (NEWS) at admission was 5.5 (SD 4.4) in fatal cases and 3.0 (SD 1.9) in survivors (p=0.02). Central venous catheters were placed in 37/41 patients and intravenous fluid administered to 40/41 patients (median duration of 5 days). Faecal management systems were inserted in 21/41 patients, urinary catheters placed in 27/41 and blood component therapy administered to 20/41 patients. Conclusions: ...

This thesis shows the effects of political correctness, social justice and diversity on contemporary Marvel comics. The main part of the work is divided into two parts: The analysis of the traditonal and the contemporary presentation of minorities and women in Marvel comics. The first part deals with the time of the inception of the industry to the year of 2011 which marked the beginning of big changes in the medium. Comic books like the Black Panther, the first African American superhero, and the X-Men, the first minorities (called "mutants") were analyzed. The ways Marvel presented those characters, as well as their roles in the shared Universe they were in, are studied. In order to fully analyze their characteristics and importance, some of the more prominent, both early and newer comic books, are looked at in depth. The message they sent to the reader is also taken into consideration. The second part of the thesis follows the same pattern. Comic books from the year of 2011 and up to the present day and all the sudden changes promtped by political correcntess and social justice are analzyed. The comic books studied are Thor, Iron Man and America Chavez. ; U ovom diplomskom radu prikazuje se utjecaj političke korektnosti, socijalne pravde i raznolikosti na Marvelove stripove suvremenog doba. Glavni dio rada podijeljen je na dva dijela: Analiza tradicionalnog i suvremenog prikaza manjina i žena u Marvelovim stripovima. Prvi dio bavi se vremenskim razdobljem od osnutka industrije pa sve do 2011. godine koja se uzima kao početak velikih promjena na stripovskoj sceni. U tom dijelu analiziraju se stripovi prvog afroameričkog superjunaka Black Panthera te stripovi koji su se bavili prikazom prvih manjina u društvu (nazivani "mutantima") popularno zvanih kao X-Men. Proučavaju se načini na koji je Marvel prikazao te likove i kakvu su ulogu isti imali u zajedničkom svijetu u kojem su stvoreni. Kako bi se detaljno analizirale njihove karakteristike i važnosti tih junaka pobliže se analiziraju neki od njihovih prvih, ali ...

IntroductionHIV in the United States is concentrated in the South, an impoverished region with marked health disparities and high rates of incarceration, particularly among African Americans. In the Deep South state of Alabama, a policy directive to reduce prison overcrowding has diverted large numbers of convicted felons to community supervision. Probation and parole offices have yet to provide the HIV education and testing services that are offered in state prisons. This study sought to implement on‐site HIV services for probationers and parolees through an intersectoral programme involving law enforcement, university and HIV agency employees. The three main objectives were to (1) involve probation/parole officers in planning, execution and assessment of the programme, (2) provide HIV education to the officers and (3) offer voluntary pretest HIV counselling and testing to probationers and parolees.MethodsThe partnered programme was conducted between October and December 2015. Offenders who were recently sentenced to probation ("new offenders"), received HIV education during orientation. Offenders already under supervision prior to the programme ("current offenders") learned about the on‐site services during scheduled office visits. Outcomes were measured through officer assessments, informal feedback and uptake of HIV services among offenders.ResultsA total of 86 new and 249 current offenders reported during the programme (N=335). Almost one‐third (31.4%) of new offenders sought HIV testing, while only 3.2% of current offenders were screened for HIV. Refusals among current offenders invoked monogamy, time pressures, being tested in prison, fear of positive test results and concerns about being labelled as gay or unfaithful to women partners. Officers rated the programme as worthwhile and feasible to implement at other offices.ConclusionsThe partnership approach ensured support from law enforcement and intersectoral cooperation throughout the programme. HIV training for officers reduced discomfort over HIV and fostered their willingness to be active agents for referral to HIV services. Voluntary testing was enhanced by the HIV employee's educational role, particularly during orientation sessions for new offenders. The almost one‐third success rate in HIV testing among new offenders suggests that future efforts should concentrate on this group in order to maximize participation at the probation and parole office.

How can subordinated identity groups organize for political change while avoiding self-descriptions that exclude or marginalize some of their members? How can "queers," or "women," or "African Americans" mobilize politically without stipulating an idealized vision of their members that excludes or stigmatizes the practices or self-understandings of some who might travel under those very names? This dissertation examines, at a theoretical level, how identity-based groups can make justice claims without specifying what constitutes the identity or submitting to identity's normative force.Whereas critics of identity politics, such as Judith Butler, Patricia Hill Collins, and José Esteban Muñoz, examine how identity controls and constrains individual subjects, this project examines identity's regulatory effects on collective subjects mobilized for political action. The engagement with poststructuralist theory and the focus on mobilization, not just social collectivities, differentiates this dissertation's concerns from thinkers such as Anthony Appiah, Nancy Fraser, and Iris Marion Young. And while many feminist, queer, and critical race theorists focus exclusively on specific identities, this dissertation analyzes how our understanding of identity itself shapes political membership and mobilization across a wide range of identities and projects.This dissertation revisits the extensively explored terrain of normalization and control through identity categories, but focuses specifically on identity constituted in collective political action. It begins by using the movement for marriage equality to illustrate how otherwise emancipatory and egalitarian identity-based political projects can subordinate and stigmatize some of their members in the quest for freedom and equality through idealized visions of membership. Then it explores alternative political formulations of identity that might avoid such injuries. Using feminist and queer theory to extend and transform work by Jürgen Habermas and the later Ludwig Wittgenstein, it refigures an identity-based political group as itself a coalition rather than a homogenous entity. Revisiting the decision in Obergefell v. Hodges, the 2015 Supreme Court decision validating same-sex marriage, it shows how treating identity as a coalition could relieve the social pity, indeed pathologization, of homosexuals living outside of marriage featured in the Majority decision.

IntroductionCigarette smoking remains a significant health risk for Veterans. Increased understanding of factors that influence the tobacco cessation referral process within Veterans Affairs medical facilities is useful for enhancing utilization of smoking cessation treatment. The present study examined the association of demographic and health variables with whether smokers accepted referral for medication and/or tobacco cessation clinic.MethodsElectronic medical record data (2011-2013) were obtained for a sample of US military Veterans who accepted cessation assistance from their health care provider. Demographic and diagnostic variables were examined to identify predictors of the types of assistance accepted (medication only, clinic referral only, or both).ResultsThe sample includes 2941 Veterans, 10.3% female, 19.9% African American, 10.7% Hispanic, and 57.9% non-Hispanic white. Veterans averaged of 50.69 years of age (SD = 14.01), 31.5% had a substance use disorder diagnosis and 54.1% had a psychiatric diagnosis. Demographic and diagnostic information was compared across types of assistance accepted. Significant differences were found between those who accepted medications only and those who accepted either clinic referral or both medication and clinic referral. Veterans in the latter two categories were younger and more likely to have a psychiatric diagnosis than those accepting medication only. Women Veterans were significantly more likely than men to accept clinic referral plus medication. However, in contrast to men, almost none of the variables examined were associated with the type of assistance accepted by women.ConclusionThese findings indicate significant gender differences in influences on accepting assistance for smoking cessation among Veterans.ImplicationsExisting research identifies factors associated with unassisted quitting. However, little is known regarding the referral process, which is critical in connecting smokers with treatment. The present work is unique in employing electronic medical record data to examine factors associated with accepting different types of smoking cessation treatment referrals. This study represents an initial effort to elucidate the smoking cessation treatment referral process. These findings highlight the need to examine sex specific influences on smoking cessation treatment utilization and the importance of focusing on smokers with psychiatric disorders.