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Background Understanding the frequency of violence experienced by female sex workers (FSWs) and how violence contributes to HIV transmission can help improve HIV programs. Methods Using recent recommendations for modelling structural factors and associated causal pathways, we developed a HIV transmission dynamic model for FSWs and their clients in Mombasa, Kenya, mechanistically representing three types of violence (sexual violence, SV; physical violence, PV; police assault and arrest, PAA). Each type of violence affects HIV transmission through key mediators (condom non-use, HIV testing). We parameterized the model using data from a cross-sectional study of FSWs aged 15–24 recruited from a systematic geographical mapping sampling frame in Mombasa, Kenya (Cheuk E et al., Frontiers in Reproductive Health 2(7), 2020). Using this model, calibrated (and cross-validated) to HIV epidemiological and violence outcomes, we estimated the incidence of violence episodes, the contribution of violence to the HIV epidemic measured by the transmission population-attributable fraction, and the potential impact of possible violence interventions. Results The median estimated incidence of PAA in 2023 among FSWs who had not previously experienced that type of violence was 0.20 (95% credible interval: 0.17–0.22) per person-year (ppy), about double the incidence of SV and PV (0.10 (0.09–0.11), 0.11 (0.09–0.12), respectively). The incidence of violence was higher among FSWs who had previously experienced violence: the incidence of recurrent PV was 2.65 (1.82–3.37) ppy, while the incidence of recurrent SV and PAA were 1.26 (0.80–1.67) and 1.37 (0.94–1.74 ppy, respectively. In this setting, we estimated that a median of 35.3% (3.4–55.8%) infections in FSWs and clients combined over the next 10 years may be due to all types of violence (and mediators), mainly through reduced condom use in FSWs who have ever experienced SV (34.6% (2.4–55.5%)). Interventions that prevent future violence without mitigating the effects of past violence may only prevent 8.8% (0.8–14.0%) infections over 10 years. Conclusions FSWs in Mombasa experience violence frequently. In this population, we find that addressing sexual violence, including mitigating the effects of past violence, is potentially important in reducing HIV transmission in this population. However, the wide uncertainty range shows longitudinal studies are needed to strengthen the evidence of the influence of violence on HIV risk behavior. We find that the recommendations for modelling structural factors provide a useful framework for describing the model.

Background A disco matanga , or “disco funeral,” is a celebration of a decedent’s life that is culturally important in parts Africa, often involving overnight travel and alcohol consumption. These are known risk factors for HIV, which is prevalent in many areas where disco matanga is practiced. However, the contribution of disco matanga to HIV transmission is not well-understood. We used agent-based network modeling to estimate how disco matanga impacted HIV transmission, and to explore the impact of relevant biomedical, biobehavioral, and structural interventions to reduce HIV risk. Methods We adapted EMOD-HIV, a previously validated network-based model of HIV in the Nyanza region of Kenya, to incorporate disco matanga assumptions informed by literature review. Occurrence of disco matanga was modeled to occur following any death in the population. We compared past HIV incidence (1980–2024) with and without incorporating disco matanga , and future HIV incidence (2025–2050) with different interventions for disco matanga attendees: (1) biomedical (HIV prophylaxis), (2) biobehavioral (reduction in condomless sex partners), (3) structural (female empowerment to avoid unwanted sex). We estimated HIV infections and deaths averted in the overall population, with sensitivity analysis around intervention uptake. Results Over 1980–2024, disco matanga contributed 7.8% (95% CI: 5.5–9.3%) of all HIV infections, an effect that peaked at 9.9% (95% CI: 6.4–12.0%) in the year 2004, coinciding with a peak in all-cause mortality due to HIV/AIDS. Biomedical prevention at disco matanga could avert up to 9.7% (95% CI: 8.9–10.5%) of adult HIV infections and 2.3% (95% CI: 1.9–2.6%) of deaths; biobehavioral 2.9% (95% CI: 2.1–3.6%) of infections and 0.9% (95% CI: 0.6–1.2%) of deaths; and structural 1.2% (95% CI: 0.5–1.8%) of infections and 0.5% (95% CI: 0.2–0.7%) of deaths. Results were highly sensitive to intervention uptake. Conclusions We conducted the first modeling study, to our knowledge, simulating the interactions between disco matanga , HIV/AIDS, and intervention options. We found that biomedical, biobehavioral, or structural interventions implemented during disco matanga could substantially reduce HIV transmission and mortality in the Nyanza region. Research is needed to understand the feasibility and acceptability of HIV interventions tailored to local cultural practices.

Background In parts of Africa, women who become widowed lose housing, bank accounts, and other property and must re-marry to avoid extreme poverty. To re-marry, some women are required to undergo widow “cleansing”—condomless sex with a man who removes “impurities” ascribed to her from her husband’s death—and are “inherited” as a wife of a brother-in-law. This study explores how HIV biomedical and structural interventions could reduce HIV-related harms associated with these practices. Methods We adapted EMOD-HIV, an HIV agent-based network transmission model previously calibrated and validated for the Nyanza region of western Kenya. Building on the model’s pre-existing configuration of marriages, mortality, and widowhood, we added widow cleansing and wife inheritance with assumptions based on literature. Modeled HIV prevalence among inherited widows was validated to match observed data. We modeled the effect of widowed women, cleansers, and inheritors receiving biomedical HIV interventions (testing, treatment for those tested positive, and 1 year of pre-exposure prophylaxis (PrEP) initiated at cleansing for those tested negative) with or without structural interventions (female empowerment). We modeled low (30%) and high (70%) intervention uptake and reported HIV outcomes including cumulative infections over 2025–2050. Results Modeled HIV prevalence among inherited widowed women was 59.8% (95% CI: 59.5–60.2%), comparable to observed prevalence of 64.1% (95% CI: 63.2–65.4%). Among all widowed women, biomedical interventions averted 2.0% (95% CI: 1.3–2.6%) of HIV infections with low uptake and 2.6% (95% CI: 2.0–3.2%) with high uptake. Combined biomedical and structural interventions averted 7.8% (95% CI: 7.2–8.4%) of HIV infections with low uptake and 16.1% (95% CI: 15.5–16.6%) with high uptake. Impacts were smaller for men, e.g., high-uptake structural and biomedical interventions averted 1.8% (95% CI: 1.5–2.2%) of infections among cleansers and 2.7% (95% CI: 2.4–3.0%) among inheritors. Conclusions Widowed women are a vulnerable population with extremely high HIV prevalence. Combined biomedical and structural interventions focused on the practice of widow cleansing and wife inheritance have the potential to avert up to one-quarter of HIV infections among widowed women, and a smaller proportion among men participating in these practices.

Background Binge drinking, inequitable gender norms and sexual risk behaviour are closely interlinked. This study aims to model the potential effect of alcohol counselling interventions (in men and women) and gender-transformative interventions (in men) as strategies to reduce HIV transmission. Methods We developed an agent-based model of HIV and other sexually transmitted infections, allowing for effects of binge drinking on sexual risk behaviour, and effects of inequitable gender norms (in men) on sexual risk behaviour and binge drinking. The model was applied to South Africa and was calibrated using data from randomized controlled trials of alcohol counselling interventions ( n  = 9) and gender-transformative interventions ( n  = 4) in sub-Saharan Africa. The model was also calibrated to South African data on alcohol consumption and acceptance of inequitable gender norms. Binge drinking was defined as five or more drinks on a single day, in the last month. Results Binge drinking is estimated to be highly prevalent in South Africa (54% in men and 35% in women, in 2021), and over the 2000–2021 period 54% (95% CI: 34–74%) of new HIV infections occurred in binge drinkers. Binge drinking accounted for 6.8% of new HIV infections (0.0–32.1%) over the same period, which was mediated mainly by an effect of binge drinking in women on engaging in casual sex. Inequitable gender norms accounted for 17.5% of incident HIV infections (0.0–68.3%), which was mediated mainly by an effect of inequitable gender norms on male partner concurrency. A multi-session alcohol counselling intervention that reaches all binge drinkers would reduce HIV incidence by 1.2% (0.0–2.5%) over a 5-year period, while a community-based gender-transformative intervention would reduce incidence by 3.2% (0.8–7.2%) or by 7.3% (0.6–21.2%) if there was no waning of intervention impact. Conclusions Although binge drinking and inequitable gender norms contribute substantially to HIV transmission in South Africa, recently-trialled alcohol counselling and gender-transformative interventions are likely to have only modest effects on HIV incidence. Further innovation in developing locally-relevant interventions to address binge drinking and inequitable gender norms is needed.

Purpose Based on sociotechnical systems theory, social (human) and technological sub-systems in an organization should be taken in account when making strategic decisions and designed to fit the demands of the environment for organizational effectiveness. Yet there is very limited information in literature on whether employees are well equipped with indispensable (human) skills to prepare them combating challenges caused by advanced technology. The purpose of this study is to empirically investigate employees’ human skills that are critical for success in the Age of Robots and Artificial Intelligence from human resource development’s perspective. Design/methodology/approach A questionnaire was developed for the purpose of this exploratory study. A total of 422 US Midwest employees were surveyed on their human skills level that are critical for success in the Industry 4.0 transformation. Findings In general, the respondents could perform all the measured human skills (which can be categorized into social skillset and decision-making skillset) more than adequate but may vary by education level and gender. To strengthen one’s human skills, organizations may begin with facilitating employees on relationship building to create a support system and a strong sense of belonging, which will promote their social sensitivity and collaboration skill development, as well as decision-making skillset. Originality/value The findings of this study can be used for techno-structural interventions and employee development programs. This study highlights the importance of investigating human skills to cope with the changing nature of work and make upskilling more feasible and flexible for workers to be robot-proof.

Summary Schools provide an important setting for health promotion and health education. In countries where health education is not a specific subject, it is typically undertaken by teachers in health-integrating subjects such as biology, home economics or physical education. More ambitious and holistic frameworks and whole school approaches such as health promoting schools have been considered best practice for the past three decades. Recently, more attention has been given to policy initiatives integrating health activities into school curriculum time. This paper discusses potentials and challenges of school-based health promotion applying an ‘add-in’ approach, that integrates health activities into teachers’ curricular obligations without taking time away from them, based on a presentation of three Danish cases. This may serve as a supplement to health promotion activities that have been initiated over and above the day-to-day teaching (add-on). We contend that an ‘add-in’ approach to school health promotion provides a potential win–win situation where both health and core education stand to gain; makes it possible to reach a wider range of schools; mobilizes additional resources for health promotion; and leads to more sustainable activities. However, potential limitations including not addressing structural aspects of health promotion and reliance on a relatively limited evidence base should also be considered.

Background Including structural determinants (e.g. criminalisation, stigma, inequitable gender norms) in dynamic HIV transmission models is important to help quantify their population-level impacts and guide implementation of effective interventions that reduce the burden of HIV and inequalities thereof. However, evidence-based modelling of structural determinants is challenging partly due to a limited understanding of their causal pathways and few empirical estimates of their effects on HIV acquisition and transmission. Methods We conducted a scoping review of dynamic HIV transmission modelling studies that evaluated the impacts of structural determinants, published up to August 28, 2023, using Ovid Embase and Medline online databases. We appraised studies on how models represented exposure to structural determinants and causal pathways. Building on this, we developed a new methodological framework and recommendations to support the incorporation of structural determinants in transmission dynamics models and their analyses. We discuss the data and analyses that could strengthen the evidence used to inform these models. Results We identified 17 HIV modelling studies that represented structural determinants and/or interventions, including incarceration of people who inject drugs (number of studies [ n ] = 5), violence against women ( n  = 3), HIV stigma ( n  = 1), and housing instability ( n  = 1), among others ( n  = 7). Most studies ( n  = 10) modelled exposures dynamically. Almost half (8/17 studies) represented multiple exposure histories (e.g. current, recent, non-recent exposure). Structural determinants were often assumed to influence HIV indirectly by influencing mediators such as contact patterns, condom use, and antiretroviral therapy use. However, causal pathways’ assumptions were sometimes simple, with few mediators explicitly represented in the model, and largely based on cross-sectional associations. Although most studies calibrated models using HIV epidemiological data, less than half (7/17) also fitted or cross-validated to data on the prevalence, frequency, or effects of exposure to structural determinants. Conclusions Mathematical models can play a crucial role in elucidating the population-level impacts of structural determinants and interventions on HIV. We recommend the next generation of models reflect exposure to structural determinants dynamically and mechanistically, and reproduce the key causal pathways, based on longitudinal evidence of links between structural determinants, mediators, and HIV. This would improve the validity and usefulness of predictions of the impacts of structural determinants and interventions.

PurposeThe uptake of reprocessed construction materials (RCMs) derived from demolition waste (DW) is limited, which questions the long-term sustainability of DW reverse logistics (RL). To address this gap, the current study focused on identifying informational and structural interventions to promote the uptake of RCMs among Australian construction professionals (CPs).Design/methodology/approachFollowing a qualitative research approach with thirty-one semi-structured interviews, the study explored potential interventions that can drive broader RCM usage. The study's strength lies in the in-depth qualitative insights gathered through extensive interviews with CPs experienced in using RCMs.FindingsSixteen informational and structural interventions to promote the uptake of RCMs were identified and mapped against the industry levels at which they should be implemented. RCM suppliers should focus on improving material quality, supply and marketing while minimising material costs. Governments should encourage using RCMs through incentivisation, supportive legislation and approval processes. The significance of awareness building and research was also recognised, which requires the collective efforts of suppliers, governmental and non-governmental bodies and educational institutes.Originality/valueDespite the talk around sustainable consumption, the actual walk towards this is limited from a construction perspective, as seen through the low uptake of RCMs. This study attempts to bridge this mismatch by outlining informational and structural interventions that would drive CPs to walk the talk and use RCMs for construction applications. While most studies on DW RL have focused on improving waste recovery processes, this study takes a less-trodden path and explores the potential for developing markets for RCMs.

Objective: One of the fundamental chal­lenges in research on, and the practice of, anti-racism is helping people open their minds to new possibilities and new ways of thinking.Design: This commentary illustrates how art can help people unlearn misinformation and narrow ways of thinking while enhanc­ing flexibility that allows people to think cre­atively about efforts to eliminate or mitigate the health effects of racism.Results: Historically, art has been a critical foundation of the history of protest and struggle to achieve equity in the United States and across the globe. Whether music, poems, paintings or other forms of creative expression, art has been at the core of efforts to express emotion, communicate difficult concepts, spur action and change what seems impossible. Art has been particularly important in illustrating and helping to facilitate how people understand what racism is, how it feels to experience privilege or oppression and exploring the implications of policies and practices that affect health indirectly or directly. Yet, art remains underutilized in anti-racism educa­tion, training and organizing efforts within public health. This commentary includes several arts-based examples to illustrate how art can facilitate insights, observations and strategies to address racism and achieve health equity.Conclusion: Art can be an important tool to facilitate moving past intellectual arguments that seek to explain, justify and excuse racism. Art may be particularly important in efforts to illuminate how racism operates in organizational or institutional contexts and to communicate hope, resilience, and strength amid what seems impossible. Ethn Dis. 2020;30(3):373-380; doi:10.18865/ed.30.3.373

Fintech services are changing traditional financial services due to the fourth industrial revolution's focus on digital transformation. Fintech success drives economic growth, technological advancement, and industrialization. Indian financial technology companies have received much attention in anticipation of such a result, but their performance has fallen short. This empirical paper investigates organizational development interventions' effects on business performance in the fintech sector in Chennai cityhood interventions and organisational performance in Chennai fintech firms were studied descriptively. Simple random sampling and structural equation modelling test 410 respondents' hypotheses. According to the empirical findings, techno structural, team development, HRM, and strategic interventions significantly impact with a fintech firm's success. It emphasizes the importance of HRM interventions for boosting market share and revenue in fintech businesses.HR managers should concentrate more on individual interventions, such as mentoring and counselling, to effectively guide, clarify, and counsel employees about various organizational issues. These interventions require a cautious and systematic approach. Organizational development strategies help the study understand fintech firms' performance. OD practitioners can help managers organize and share this information with employees to boost productivity. Little research focuses on organizational development interventions and firms' performance. Moreover, recent studies have attempted to generate solutions to various FinTech problems. This study presents a comprehensive theoretical framework to evaluate the relationship between team development, strategic, techno-structural, process, HRM, and fintech sector organizational performance.