No abstract

The rock-cut tomb of Bolores in the Portuguese Estremadura dates primarily to the Late Neolithic/Copper Age (2800-2600 BC) and, in a series of recent excavations, has yielded thousands of fragmented, commingled human bone specimens. The primary goals of the present study were to determine the minimum number of individuals interred in the tomb and to analyse spatial patterns in fragmentation intensity to identify natural and anthropogenic taphonomic processes. To investigate these research questions, the authors employed a simplified version of an established method in zooarchaeology to the study of human remains. Human bone specimens were recorded by the presence of osteological landmarks rather than the zones used in similar studies. This recording system allowed for calculation of the minimum number of individuals (further refined through dental analysis) and generated the NISPs (Numbers of Identified Specimens), minimum number of elements, fragment counts and landmarks sums essential to the conjoining and fragmentation studies. Fragmentation analysis led to the identification of four possible use areas in the tomb: two for primary inhumations and two for secondary deposits created by cleaning out the burial chambers at Bolores. We found that the application of multiple zooarchaeological methods to the study of commingled human remains has the potential to provide a more fine-grained understanding of site biography and taphonomy than human osteological methods alone.

Background Vaccine hesitancy could undermine the effectiveness of COVID-19 vaccination programs. Knowledge about people’s lived experiences regarding COVID-19 vaccination can enhance vaccine promotion and increase uptake. Aim To use COVID-19 vaccine trial participants’ experiences to identify key themes in the lived experience of vaccination early in the vaccine approval and distribution process. Methods We interviewed 31 participants in the Iowa City, Iowa US site of the Pfizer/BioNTech COVID-19 vaccine phase 3 clinical trial. While trial participation differs from clinical receipt of an approved vaccine in key ways, it offers the first view of people’s lived experiences of potentially receiving a COVID-19 vaccine. The trial context is also useful since decision-making about vaccination and medical research participation often involve similar hopes and concerns, and because the public appears to view even approved COVID-19 vaccines as experimental given their novelty. Semi-structured interviews addressed subjects’ experiences, including decision-making and telling others about their trial participation. We analyzed verbatim transcripts of these interviews thematically and identified common themes relevant for vaccination decision-making. Results Participants across demographic groups, including age, sex/gender, race/ethnicity, and political affiliation, described largely similar experiences. Key motivations for participation included ending the pandemic/restoring normalcy, protecting oneself and others, doing one’s duty, promoting/modeling vaccination, and expressing aspects of identity like being a helper, career-related motivations, and support of science/vaccines. Participants often felt uniquely qualified to help via trial participation due to personal attributes like health, sex/gender or race/ethnicity. They reported hearing concerns about side effects and the speed and politicization of vaccine development. Participants responded by normalizing and contextualizing side effects, de-politicizing vaccine development, and explaining how the rapid development process was nevertheless safe. Conclusion These findings regarding participants’ reported motivations for trial participation and interactions with concerned others can be incorporated into COVID-19 vaccine promotion messaging aimed at similar populations.

IntroductionApproximately 38% of haemodialysis patients carry Staphylococcus aureus in their noses, and carriers have a nearly four-fold increased risk of S. aureus access-related bloodstream infections (BSIs) compared with non-carriers. Our objective is to determine the clinical efficacy and effectiveness of a novel intervention using nasal povidone-iodine (PVI) to prevent BSIs among patients in haemodialysis units. We will survey patients and conduct qualitative interviews with healthcare workers to identify barriers and facilitators to implementing the intervention.Methods and analysisWe will perform an open-label, stepped-wedge cluster randomised trial to assess the effectiveness of nasal PVI compared with standard care. Sixteen outpatient haemodialysis units will participate in the study. The 3-year trial period will be divided into a 4-month baseline period and eight additional 4-month time blocks. The primary outcome of the study will be S. aureus BSI, defined as a S. aureus positive blood culture collected in the outpatient setting or within one calendar day after a hospital admission. The study team will evaluate characteristics of individual patients and the clusters by exposure status (control or intervention) to assess the balance between groups, and calculate descriptive statistics such as average responses separately for control and intervention survey questions.Ethics and disseminationThis study has received IRB approval from all study sites. A Data Safety and Monitoring Board will monitor this multicentre clinical trial. We will present our results at international meetings. The study team will publish findings in peer-reviewed journals and make each accepted peer-reviewed manuscript publicly available.Trial registration numberNCT04210505.

This article examines how staff and patients worked to reconcile the rhythms of the body with those of gender‐normative health care bureaucracy in a U.S. Midwest gender‐affirming health clinic. Drawing from observations of clinical appointments and routine bureaucratic practice, as well as debriefing interviews with transgender and gender‐expansive patients, this article applies Laura Bear's theory of “time‐maps” and a new materialist approach to bodily agency that recognizes the variability of the body's responses to gender‐affirming health care. This evidence demonstrates how health care staff and patients’ labor practices structured patients’ abilities to embody their plans for medical transition. Anticipating the varied trajectories bodies take during medical transition can interrupt the reproduction of harmful cultural assumptions about sex difference in U.S. health care bureaucracy.