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This chapter uses a dataset of heights calculated from the femurs of skeletal remains to explore the development of stature in England across the last two millennia. We find that heights increased during the Roman period and then steadily fell during the “Dark Ages” in the early medieval period. At the turn of the first millennium, heights grew rapidly, but after 1200 they started to decline coinciding with the agricultural depression, the Great Famine, and the Black Death. Then they recovered to reach a plateau which they maintained for almost 300 years, before falling on the eve of industrialization. The data show that average heights in England in the early nineteenth century were comparable to those in Roman times, and that average heights reported between 1400 and 1700 were similar to those of the twentieth century. This chapter also discusses the association of heights across time with some potential determinants and correlates (real wages, inequality, food supply, climate change, and expectation of life), showing that in the long run heights change with these variables, and that in certain periods, notably the thirteenth and fourteenth centuries, the associations are observable over the shorter run as well. We also examine potential biases surrounding the use of skeletal remains.

This chapter describes the approach to sustainable rail passenger rolling stock in terms of interior passive safety requirements within the European market. It is intended to give the background and logistical approach for the future introduction of a standard as an aid for the design and validation of the interiors of passenger rail vehicles. Also discussed is the acceptance of the proposed European-based standard into the regulatory system of the technical specifications for interoperability. Methodologies for design assessment and validation will be discussed. This chapter is intended to encourage an acceptance of the standard for interior passive safety as a realistic and cost-effective method of improving rail vehicle safety in terms of the passenger interfaces with the rail stock interior.

This study illuminates the experiences of adults diagnosed with autism spectrum disorders (ASDs) and intellectual disabilities (IDs) and their challenges and successes in receiving quality healthcare services. Individuals with developmental disabilities often experience health issues associated with aging at earlier ages and at higher rates than the general population. This population has a higher incidence of chronic health conditions that require regular medical attention.

The intent of this project was to learn directly from adults and their caregivers how well healthcare providers understand autism, explore their experience with how well their care is coordinated between primary healthcare and other specialty services, and identify factors which could impact access to care and to discover what other barriers which may potentially influence health outcomes for ASD adult.

A qualitative study conducted with semi-structured interviews with 12 adults diagnosed with ASD and/or their guardians/caregivers.

Some of the adults interviewed experienced negative health outcomes and suboptimal relationships with healthcare providers; others seemed to have positive relationships. Clinical and communications accommodations were necessary to make healthcare provision more comfortable. Barriers to accessing healthcare services existed in many forms.

The healthcare needs of the growing population adults diagnosed with ASD/ID are anticipated to be significant. This challenge is further exacerbated given there are few trained healthcare providers who are prepared or dedicated to serve this population. Continuing to build awareness of the health needs of the ASD/ID adult population is critical.

This project is highly innovative as it is the first attempt to understand how the adult autism population accesses care and perceives their healthcare interactions. This study serves as a starting point to suggest new opportunities for further research for this growing population.

Purpose – A study of the origins of socioeconomic complexity at the agropastoral site of Jachakala in the eastern altiplano of Oruro, Bolivia with pre-Tiwanaku and Tiwanaku-contemporary components (ca. AD 150–1100). It uses faunal remains to explore differential access to subsistence resources.

Methodology/approach – Synchronic and diachronic analyses of camelid faunal remains from the multicomponent highland Bolivian site of Jachakala are used to explore access to cuts of meat of variable meat utility value among three areas of the village community. The merits of interzonal analyses, rather than inter-household comparisons, are argued as well.

Findings – Differential access to cuts of camelid meat among residents of Jachakala indicate early and sustained wealth differences beyond those typical of a subsistence-oriented economy. This is significant in part because of the clear absence of political elites at the site who might have controlled or directed resource distributions.

Research limitations/implications – This study suggests the origins of socioeconomic complexity can be divorced from the development of a political elite, providing a comparative case study for archaeologists interested in similar issues elsewhere.

Originality/value – This approach to the origins of complexity focuses not on agricultural resources or control over the production or distribution of craft or exotic trade goods, but rather on animal remains. Using faunal remains as a proxy for wealth, not just protein or pastoralism, this case study contributes to discussions about incipient complexity.

To examine the relationship that athletes establish with their bodies within sport and through their transitions out of sport, with a special focus on risk, injury and pain.

This chapter is an explanatory review of the literature focusing on the embodied and sensory experiences of athletes as they depart sport.

This chapter explores definitions and conceptualizations of the retirement process, highlights how the body is experienced during the sporting exit (as fragile and out of control) and makes connections between how bodily breakdown during sporting exits impacts an athlete’s sense of self and identity.

Through practical recommendations, this chapter highlights some of the ways in which psycho-education and an expanded focus on the body could be useful to athletes as they attempt to reconcile their new lives and bodies post-sport.

Developments in the social neurosciences over the past two decades have rendered problematic the main knowledge elicitation techniques currently in use by strategy researchers, as a basis for revealing actors’ mental representations of strategic knowledge. Extant elicitation techniques were advanced during an era when cognitive scientists and organizational researchers alike were preoccupied with the basic information of processing limitations of decision makers and means of addressing them, predicated on an outmoded conception of strategists as affect-free, cognitive misers. The need to adapt these techniques to enable the investigation of the emotional content and structure of actors’ mental representations is now a pressing priority for the advancement of theory, research, and practice pertaining to several interrelated areas of strategic management, from dynamic capabilities development, to upper echelons theory, to strategic consensus formation. Accordingly, in this chapter, we report the findings of two studies that investigated the feasibility of adapting the repertory grid, a robust method, widely known and well used in strategic management, for this purpose. Study 1 elicited a series of commonly mentioned strategic issues (the elements) from a sample of senior managers similar in composition to the sample recruited to the second study. Study 2 participants evaluated the elements elicited in Study 1 in relation to a series of researcher-supplied bipolar attributes (the constructs), based on the well-known affective circumplex model of human emotions. In line with expectations, a series of vector-based multivariate analyses revealed a number of interesting similarities and variations among participants in terms of the basic structure and emotional salience of the issues under consideration.

Medical uncertainty is recognized as a critical issue in the sociology of diagnosis and medical sociology more generally, but a neglected focus of this concern is the question of patient decision making. Using a mixed methods approach that draws upon autoethnographic accounts and third-party interviews, we aim to illuminate the dilemmas of patient decision making in the face of uncertainty. How do patients and supportive caregivers go about navigating this state of affairs? What types of patient–doctor/healthcare professional relationships hinder or enhance effective patient decision making? These are the themes we explore in this study by following patients through the sequence of experiencing symptoms, seeking a diagnosis, evaluating treatment protocols, and receiving treatments. In general, three genres of culturally available narratives are revealed in the data: strategic, technoluxe, and unbearable health narratives.

Purpose – This chapter argues that health care is best conceptualized as a complex adaptive system. Sustainable health care depends on harnessing the complexity of the system by building aligned purpose, flexible pathways to connect people, knowledge and resources, and the capacity for self-organization.

Design/methodology/approach – The case study of the Southern California Region of Kaiser Permanente is based on three years of interviews and archival data collection examining the system's transformational change that began in 2004 and has been aimed at building a sustainable health care system with the guiding principles of value and prevention. The case focuses primarily on the medical care delivery system designed by the Southern California Permanente Medical Group, the capabilities that have been built into the system to continually improve the quality of care and the outcomes of the system, and the results that have been achieved.

Findings – During the period from 2004 to 2011, the region improved significantly in slowing cost acceleration by significantly improving medical care. The implementation of an electronic medical records system and its integration with other clinical information technology systems have enabled: (1) truly integrated, well defined, and easily navigated care delivery systems that are based on evidence; (2) upstream focus on prevention, disease control, patient education, and population health; and (3) management accountability and organizational improvement systems based on transparency of data and feedback. Physician leadership and partnering with the region's administrative and hospital leadership have been critical change enablers.

Originality/value – Embracing the complexity of the system has led to the crafting of pathways and linkages that enable patients to move through the system to flexibly and efficiently connect to the knowledge and resources required to optimize their health. This requires continual self-organization based on well-defined roles and connections. Previous health care improvement approaches have stressed initiatives and organizational changes that may further fragment the health care system.