I present a possible worlds semantics for a hyperintensional belief revision operator, which reduces the logical idealization of cognitive agents affecting similar operators in doxastic and epistemic logics, as well as in standard AGM belief revision theory. (Revised) belief states are not closed under classical logical consequence; revising by inconsistent information does not perforce lead to trivialization; and revision can be subject to ‘framing effects’: logically or necessarily equivalent contents can lead to different revisions. Such results are obtained without resorting to non-classical logics, or to non-normal or impossible worlds semantics. The framework combines, instead, a standard semantics for propositional S5 with a simple mereology of contents. K after revision by Standard AGM belief revision theory imposes a high amount of idealization on cognitive agents who revise their beliefs in the light of new informationentclass1pt{minimaframing effects w iff Here B stands for the relevant (non-agent-indexed) cognitive state ; W. Cognitive agents know or believe all logical truths, know or believe all the logical consequences of what they know or believe, and never have inconsistent beliefs. It is widely agreed \docubases  more fine-grained than ordinary modal ones: when salva veritate as indexes in Works such as Spohn , SegerbeThe framing effect is but a special case of a broader fact: thought is hyperintensional. Our  mental states—believing, supposing, desiring, hoping, fearing—can treat logically or necessarily equivalent contents differently: Lois Lane can wish that Superman is in love with her without wishing that Clark Kent is in love with her, although (if Barcan Marcus and Kripke are right) it is metaphysically impossible for Superman to be other than Clark Kent. We can conceive that this paper, I aim at modeling agents whose belief revision processes are sensitive to framing effects; who can hold inconsistent beliefs without thereby believing everything; who are safe from various other forms of logical omniscience.paraconsistent logics for the management of inconsistent information: see Tanaka et al. In intentionality, that is, being about states of affairs, situations, or circumstances which make for their content. Arguably, it is precisely the aboutness of such intentional states that can account for many of their hyperintensional features: when we think that Another feature of the approach is its simplicity. It takes its cue from a single, plain insight: we should take at face value the view of beliefs as  representational mental states bearing B is understood, as we will see, as a variably strict quantifier over possible worlds with a content-containment requirement. It involves no model transformations, as it happens in dynamic epistemic logics such as van Benthem . We use frame for W is a set of possible worlds. contents. We should understand contents as the situations (the configurations of objects and properties) the formulas of about. In the metalanguage I use variables content fusion, a binary operation on (Idempotence) (Commutativity) (Associativity) We assume unrestricted fusion, that is, content parthood, (Reflexivity) (Antisymmetry) (Transitivity) Thus, atoms, contents with no proper parts ; but also that ee Hawke ) entailsmodelp is true at w, ‘(S(S(S(SB)  can be equivalently expressed using set-selection functions (as in Lewis B as:B) , w are assumed to be finite, the system satisfies Lewis’ Limit Assumption: the existence of a smallest such For the in Lewis  reformul(C1) (C2) (C3) (C4) Notice that we do not demand that w. w itself need not be among the innermost worlds, for the agent may have false beliefs.The system satisfies various conditions,Finally, logical consequence is defined the standard way, as truth preservation at all worlds of all models (based on our system of spheres generated by $—we will omit mentioning it each time). With For single-premise entailment, I write The logic induced by the semantics for the extensional operators is just classical propositional, with B operator is essentially non-monotonic. As we go through its features, thus, it will be worth comparingC, satisfies what, according to Gabbay  same belief.  displays the non-monotonic features of belief revision. Our operator is non-monotonic in this sense:and that the city has been annexed by Germany, you will not come to believe that he is in France.Content is preserved here, for in general if Countermodel let B), When, after revising by Notice that the inference fails for the right reason: although Countermodel let B), q and r fail at some Another disjunction-involving issue has to do with the fact that beliefs can be ‘nonprime’ due to indeterminacy in the information via which we revise. After being informed that Mike landed in New Zealand, you come to believe that he is either in the North Island or in the South Island, but you are not sure which one it is. Thus, you don’t believe him to be in either rather than the other. So we need, and we get:Here, too, the inference fails for the right reason. Content-inclusion works: when one believes that either Countermodel let I now come to interesting invalidities highlighting the hyperintensional features of belief revision in our models. To begin with, one’s coming to believe that The strict conditional is ‘irrelevant’, in the sense criticized in Anderson and Belnap , AndersoCountermodel let B), For similar reasons, what is strictly implied by what we come to believe after revision is not perforce believed in its turn—thus, the counterpart of Kraus et al. ’s Right Here, too, the failure happens for the right reason: although all the itself. This principle, which might be called Closure under Believed Implication, is valid:(CBI)[Proof let B), for all B) again, for all B), Things are different if, after revision, one comes to believe the strict implication under the same revision byB highlighted above, the inference would not be valid anymore if the revision input were allowed to change across the involved formulas). As remarked by Yablo , Next, also the counterpart of Kraus et al. ’s Left LAgain, failure of aboutness does the trick of differentiating necessarily equivalent contents. This invalidity allows a proper appreciation of framing effects in our semantics: after being informed that one’s probability of making it to the short list is 1 / 3, one believes that one should apply for the job. But, against such principles as AGM’s , In our framework, belief revision is not automatically trivialized by incoming inconsistent information. We already know that, via its content-preservation constraints, our belief revision has an element of relevance in the sense of relevant logics. Our S5-ish strict implication is ‘explosive’, something. In general Snow is white and not white is about snow’s being white, not about grass’ being purple).9Although there is no possible world where a contradiction is true, inconsistent information may still be about Countermodel : let B), For similar reasons, when we revise by (PEP)[Proof suppose B), these entail, respectively, (a) B) again, I close with some important validities warranted with the help of Condition C3 above.salva veritate as inputs for belief revision: when we revise by either, we come to have the same beliefs. This seems plausible. ‘Equivalents in plausibility’ are formulas B as a consequence of its variable strictness, C3 validates a kind of limited transitivity or Cut principle for belief revision:(CUT)[Proof suppose (a) B), B) again,B) again, B) again, While general transitivity fails for our (CM)[Proof suppose (a) B), B) again, B) again, we get C3 also validates a converse principle of Cautious Monotonicity:Cut and Cautious Monotonicity are defended in Board , p. 56, h Gabbay ’s minimaThis work was just an initial exploration of a simple formal set-up for hyperintensional belief revision that looks, in my view, promising: it preserves some good features of more standard approaches while overcoming some problems due to agent idealization, and achieves so by sticking to a fairly classical modal framework. The first obvious direction of further work would consist in coming up with a proof system sound and complete with respect to the above semantics, or variations thereof.A second direction would be to develop the set-up following the lines pursued in dynamic doxastic and epistemic logics such as Baltag and Solecki , Leitgeb11A third direction


With the continuous development of the internet and the explosive growth in data, big data technology has emerged. With its ongoing development and application, cloud computing technology provides better data storage and analysis. The development of cloud health care provides a more convenient and effective solution for health. Studying the evolution of knowledge and research hotspots in the field of cloud health care is increasingly important for medical informatics. Scholars in the medical informatics community need to understand the extent of the evolution of and possible trends in cloud health care research to inform their future research.Drawing on the cloud health care literature, this study aimed to describe the development and evolution of research themes in cloud health care through a knowledge map and common word analysis.A total of 2878 articles about cloud health care was retrieved from the Web of Science database. We used cybermetrics to analyze and visualize the keywords in these articles. We created a knowledge map to show the evolution of cloud health care research. We used co-word analysis to identify the hotspots and their evolution in cloud health care research.The evolution and development of cloud health care services are described. In 2007-2009 (Phase I), most scholars used cloud computing in the medical field mainly to reduce costs, and grid computing and cloud computing were the primary technologies. In 2010-2012 (Phase II), the security of cloud systems became of interest to scholars. In 2013-2015 (Phase III), medical informatization enabled big data for health services. In 2016-2017 (Phase IV), machine learning and mobile technologies were introduced to the medical field.Cloud health care research has been rapidly developing worldwide, and technologies used in cloud health research are simultaneously diverging and becoming smarter. Cloud–based mobile health, cloud–based smart health, and the security of cloud health data and systems are three possible trends in the future development of the cloud health care field. Through a computer network, cloud computing provides scalable, distributed computing solutions that greatly alleviate problems related with a lack of computing power in various fields . LargelyIn the area of health care, cloud computing has played an increasingly important role in providing storage and computing power for the massive volumes of data . In the Researchers and practitioners worldwide have extensively explored cloud health care. There are many studies in health care that are based on cloud computing. For example, He et al  developeDespite the abundant body of literature on cloud health care, little effort has been made to curate and refine the knowledge from the literature. First, there is a lack of understanding of the evolution of global knowledge on cloud health care. Second, research hotspots in cloud health care have not been identified. Third, the future trends in cloud health care are not understood. After a decade of exploration, it is important to understand the current status of cloud health care research and how it will develop in the future. Therefore, drawing on the cloud health care literature, this study aimed to identify the development and evolution of research themes in cloud health care through a knowledge map and common word analysis.This article contributes to the cloud computing medical research community by summarizing research achievements and identifying new frontiers of research. Literature about science and technology represents one of the most comprehensive and concrete manifestations of scientific research results. It is an important tool for researchers to exchange ideas and communicate research findings. Electronic journal databases have made it possible and convenient to find and collect a large amount of literature . In-deptThe rest of the paper is organized as follows: presentation of data and research methods and tools; reporting of the findings from the knowledge evolutionary analysis, co-word analysis, and sudden word analysis of the cloud health care literature; and a discussion of the implications to cloud health care research.The Web of Science, developed by US Thomson Scientific, includes three cited libraries: Science Citation Index, Social Sciences Citation Index, and Arts & Humanities Citation Index. It also includes two chemical databases: Current Chemical Reactions and Index Chemicus . It contThis study used the following as data sources: Science Citation Index Expanded, Conference Proceedings Citation Index-Science, Current Chemical Reactions Expanded, and Index Chemicus. On August 14, 2017, we retrieved relevant articles published between 2007 and 2017. In this paper, the following two search types were used with the “AND” relationship in the advanced search method: TS =   and TS = (“cloud comput *” OR “SaaS” OR “PaaS” OR “IaaS” OR ##), where “##” represents more than 11 keywords related to cloud computing. The search returned 2878 articles; the types included “proceedings paper,” “article,” and nine other types. According to the search results, articles related to cloud health care were scarce before 2010. At the beginning of 2010, the number of related articles began to rapidly increase. By 2016, the number of articles had increased by nearly 10 times that in 2010 . TherefoTo establish a sequential word network, the bibliographic information was divided into four periods: 2007-2009 (Phase I), 2010-2012 (Phase II), 2013-2015 (Phase III), and 2016-2017 (Phase IV). Terms synonymous with different forms of the term were replaced. For example, “Internet of Things” uniformly replaced “IoT” and “internet of things.” Subsequently, a symmetric co-occurrence matrix was generated by counting the co-occurrences of the two keywords. The data in the diagonal cell was treated as the key word frequency, and the value of the non-diagonal cell was the common word frequency [This study used keywords to analyze the relevant research articles about cloud health care. Keywords are the core concepts in the study of natural language forms. Keywords can be used to distinguish the contexts and methods of research articles. Therefore, multiple time series of keywords extracted from research papers in a certain field can reveal the development and trend of research in that field . For staTo visualize the evolution of keywords in cloud health care, we used NEViewer . The datIn this study, we used SATI to extract keywords and get a 100-by-100 co-occurrence matrix of high-frequency words in each phase. The co-occurrence matrix was the basis for further analysis. SATI is an article title statistical analysis tool with four functions: title format conversion, field information extraction, entry frequency statistics, and knowledge matrix construction . SubsequNEViewer functions include topic clustering and community division. It can be applied to the analysis of evolutionary processes of many complex networks such as social network evolution, knowledge network evolution, enterprise network evolution, and human network evolution. The processed file was imported into NEViewer for Blondel community detection processing, and the evolving situation of foreign hotspot communities in various periods is shown in The evolution of the knowledge network includes the generation, disappearance, division, and merger of knowledge. The evolutionary manifold of NEViewer can vividly show the process of extinction, differentiation, and integration of hotspot community evolution. Using “Cloud Computing” as an example, from Phase I to Phase II, “mining” differentiated into “Cloud Computing” and “Internet.” From Phase II to Phase III, “Cloud Computing” differentiated into “Security” and “Mobile health.” Mobile health became a new research hotspot in Phase III. From Phase III to Phase IV, “Cloud Computing” differentiated into “Cloud” and “Security” as well as “Hadoop” and “Analytics,” among others. This shows that the research scope of cloud computing in the medical field is constantly expanding and deepening. Meanwhile, “Mobile health” merged with “Cloud Computing” and “Cloud.” In addition, from Phase I to Phase II, “Cloud Computing” differentiated into “Internet of Things” and “mobile cloud computing.” From Phase II to Phase III, “Internet of Things” merged with “mobile.” From Phase III to Phase IV, “mobile” merged again with “Cloud Computing.” Therefore, the evolution and development of the cloud health care field was firmly centered on cloud computing.As a refined way to express a subject in academic publications, the correlation between keywords can reveal the inherent relationship of knowledge in the academic field, to a certain extent. Co-word analysis is similar to co-citation or co-occurrence analysis  and is cWe constructed co-word matrices by keywords and their co-occurrence relationships and then mapped them to a co-word network. The distance between the nodes in the network reflects the relationship between the topic content. The co-word network, when combined with time, can reflect the evolutionary trend of the scientific literature and the development process of the entire discipline. The co-occurrence and evolution analyses of the keywords can highlight updates in scientific research topics and capture the patterns of knowledge production.Co-word analysis has been applied in various fields of research. This paper explores the main research directions and hotspots in the cloud health care field in the four phases from 2007 to 2017 through common word analysis and discusses the trends for future development.The size of the node characterizes betweenness of the keywords. The larger the nodes, the more the keywords are related to each other and the more likely it is to expand to the keywords of other research topics . As showWatson et al  developeMedical technology is indispensable to modern medicine. However, in the case of an influx of data, it becomes very expensive and complex and therefore inaccessible. Therefore, in Phase I, most scholars applied cloud computing to the medical field mainly to solve high-cost problems. In recent years, cloud computing has accelerated the construction of medical information resources, realized the sharing of information resources, improved the service level of medical institutions, and reduced the cost of building medical information systems.If a node in a network has strong relationships with other nodes, it has high centrality and is very important in the network. In Phase II, “Cloud Computing” had the highest level of betweenness and occupied an important position, becoming the largest bridge among the other research hotspots. In addition, the levels of betweenness of “Cloud” and “Healthcare” were also strong. The emergence of “Healthcare” shows that the research topics in the field of medicine were extensively explored and that other emerging research points are likely to be expanded through those topics. Studying the high-frequency keywords in a certain field helps to determine the context development, hotspots, and trends. As shown in During this period, radiology led the promotion of technology development, such as cloud computing, in the medical field, which might be attributed to the relatively rich IT-related knowledge of radiologists. Krestin et al  reportedIn view of this, compared with Phase I, in which scholars focused on expanding data volumes and high costs using grid computing, cloud computing, and other technologies, Phase II saw scholars paying attention to system security issues. Implementing cloud computing in the day-to-day medical operations has many benefits. However, health care organizations and employees have encountered resistance to this modern technology due to patient data privacy and security issues. To take full advantage of the power of cloud computing, comprehensive and secure solutions for cloud processing are needed. Nguyen et al  introduc, the betweenness of “Cloud Computing” remained at the top of the list. However, its drop from the previous higher ranking might be related to the emergence of bridges such as “Internet of Things” and “big data” in this phase, which weakened the role of “Cloud computing” as a liaison.In Phase III, “Cloud Computing” had the strongest betweenness, followed by “Cloud,” “Healthcare,” “Internet of Things,” “big data,” “Security,” and “eHealth.” As shown in Figure 5With the rapid development of computer science and IT, health care informatization has been widely implemented, generating massive volumes of data in health care and health management. The development and application of big data in health care play an important role in promoting medical and health services and the development of healthy industries . In the More specifically, scholars have proposed algorithms and architectures to address efficiency and security issues. Nakagawa et al  proposedeHealth is an emerging area at the intersection of medical informatics, public health, and commerce. It involves health services and information provided or enhanced through the internet and related technologies. With the rapid development in such fields as cloud computing and big data, more extensive research attention will occur for eHealth. At present, the widespread application of electronic health records has led to the rapid accumulation of medical data. Big data analytics can extract this knowledge to improve the quality of health care, which is also an important reason for the rise of “big data” as a keyword in the co-word network . In addiAs shown in In this phase, machine learning gradually drew health care scholars’ attention. As an example, natural language processing has been used to structure electronic health records . ClassifIn Europe, the United States, and other countries, the mobile health business has moved into the service phase. For example, portable sensing terminals that measure parameters such as electrocardiograms, blood glucose levels, and blood pressure have provided convenient methods for both doctors and patients. With the rise of the mobile internet, medical health applications such as Chunyu Doctor, Baidu, and Pomelo are increasingly used by the general public. As a result, mobile health and mobile medical services have become hotspots among scholars worldwide. Witbrodt and Sunderam  proposedTo further understand the research hotspots throughout all the studied years, we analyzed and summarized the keywords of 2007-2017. The identification and tracking of research frontiers can inform researchers of the evolution of research topics, forecast the development of research, and identify problems that need to be further explored . Chen beIn Phase II, most of the sudden words were also high-frequency keywords in that period. This indicates rapid development of the cloud health care field during this phase. Emerging keywords such as “Electronic health record,” “Personal Health Record,” and “DICOM” suggest that storage technology was used to solve the problem of data expansion that came with the adoption of personal health records and digital medical images. For example, Fernández-Cardeñosa et al  proposedIn Phase III, “big data” was the most frequent sudden word. As aforementioned, the use of big data and other technologies increased in the medical industry during this phase. In addition, “Mobile health,” “mobile computing,” and “mobile cloud” started to emerge. Mobile internet is the product of a combination of mobile communications and the internet. Mobile internet technology is a new technology for high-speed wireless connectivity to mobile devices such as laptops, tablets, and smartphones . Since 2In Phase IV, keywords such as “machine learning,” “fog computing,” and “smart cities” started to appear. As already mentioned, in this phase, machine learning began to be of interest to medical scholars. Machine learning technologies provide effective support for medical data mining to improve the efficiency and quality of data recording and application. The concept of fog computing was first proposed in 2011. Fog computing is a distributed computing infrastructure for the IoT that extends computing power and data analytics applications to the “edge of the network.” It enables customers to gain instant insights through connectivity by analyzing and managing data locally. Tayeb et al  summarizIn this study, we conducted a bibliometric analysis using NEVeiwer, SATI, UCINET, and NetDraw of 2878 articles collected from the Web of Science database. The results show that the evolution and development of cloud health care services are closely linked with “Cloud Computing.” The primary keywords were “Cloud Computing,” “Cloud,” “Healthcare,” “Internet of Things,” “Security,” “eHealth,” “big data,” “computing,” “Privacy,” and “mobile cloud computing.” Through the keyword analysis, we summarized the major research hotspots and directions in each phase. In Phase I, most scholars used cloud computing mainly to save costs in the medical field, and the technologies in use were primarily grid computing and cloud computing. In Phase II, scholars began to pay attention to the security of cloud systems, including patient data privacy and security issues. In Phase III, health and medical informatization created big data for health and medical services, and the IoT also developed rapidly. In Phase IV, machine learning and mobile technologies were introduced to the medical field. This study provides not only important references to understand the development of science to inform future research and identify research questions in the field in general but also information to guide practitioners in terms of technological changes and developments in the medical industry. While cloud computing, IoT, and big data have become technical hotspots in this field, electronic health, mobile health, and smart health have developed as main branches.Emerging information technologies can provide technical support and solve many of the current problems faced by the health care industry as medical data become more heterogeneous, big, and noisy. Through the knowledge evolution analysis, keyword co-occurrence analysis, and sudden word analysis, we identified three trends for the future development of the cloud health care field.First, cloud computing in health care mainly focuses on saving costs and improving computing efficiency. Some scholars have applied distributed storage and computing to health care systems, demonstrating that cloud computing can enhance the performance of health care systems and increase the satisfaction with smart health care applications and services ,64,65. TSecond, the results show that research hotspots such as “Mobile health,” “mobile computing,” and “mobile cloud” emerged in the second phase. Mobile cloud computing is the combination of mobile internet and cloud computing. The mobile applications of today place higher demands on battery capacity, computing power, storage capacity, and mobile terminal security. Therefore, mobile cloud computing has grown rapidly to meet these needs. Mobile cloud computing technology has been used in health applications to address issues such as limited storage and processing capabilities of mobile devices, interoperability, and availability of electronic medical records ,67. In aFinally, security and privacy issues always accompany data. With the continuing popularization of emerging technologies, security in the medical field has drawn increasing attention. To ensure the security of cloud health data and the system, there are many challenges to overcome, including big data computing ethics, secure computing in a distributed programming framework, trustworthiness in remote data computing, multigranular access control, and trustworthiness of data sources and data channels.This study has some limitations. Because cloud health care is an emerging field, the amount of data available for retrieval was relatively limited, which might have impacted the analysis. Second, only keyword evolution was analyzed, and we did not consider other aspects of the evolutionary analysis. These should be addressed in future studies.


Exercise and a healthy diet can improve the quality of life and prognosis of prostate cancer survivors, but there have been limited studies on the feasibility of web-based lifestyle interventions in this population.This study aims to develop a data-driven grounded theory of web-based engagement by prostate cancer survivors based on their experience in the Community of Wellness, a 12-week randomized clinical trial designed to support healthy diet and exercise habits.TrueNTH’s Community of Wellness was a four-arm pilot study of men with prostate cancer (N=202) who received progressive levels of behavioral support . The primary aim of the study is to determine the feasibility and estimate the effects on behaviors (results reported in a separate paper). Following the 12-week intervention, we invited participants to participate in 4 focus groups, one for each intervention level. In this report, we used grounded theory analyses including open, axial, and selective coding to generate codes and themes from the focus group transcripts. Categories were refined across levels using embodied categorization and constant comparative methods.In total, 20 men with prostate cancer participated in the focus groups: 5, 4, 5, and 6 men in levels 1, 2, 3, and 4, respectively. Participants converged on 5 common factors influencing engagement with the intervention: environment , motivation , preparedness , program design , and program support . Each of these factors influenced the survivors’ long-term impressions and habits. We proposed a grounded theory associating these constructs to describe the components contributing to the intuitiveness of a web-based lifestyle intervention.These analyses suggest that web-based lifestyle interventions are more intuitive when we optimize participants’ technology and health literacy; tailor interface design, content, and feedback; and leverage key motivators  and environmental factors . Together, these grounded theory–based efforts may improve engagement with web-based interventions designed to support prostate cancer survivorship. Prostate cancer is the most common cancer among men in the United States, with more than 190,000 new diagnoses expected in 2020 -8 in addavoid inactivity  like that because, like I said, I’m doing something on my own already and I’m pretty satisfied with it. But that’s just my feeling about it.Participant 3, level 3, aged 65 years, years since diagnosis not reportedParticipants reflected on the various components of the program and suggested improvements.Comments about how participants hoped communications would be used and how they might be improved:As I’m looking at this, I’m a little embarrassed to say I didn’t find this on the website. Maybe one of the messages would have been really helpful to remind me to look here.Participant 2, level 3, aged 68 years, 3 years since diagnosisI think it would have been nice to have some kind of a general email once in a while every few weeks or more often, just about this whole thing. You know, kind of reminding us what’s available to us and maybe asking for feedback even then, as human to human.Participant 1, level 3, aged 75 years, 7 years since diagnosisSo I guess the question I have is when you say “coach,” I’m not clear. Because is the coach acting as the expert, in terms of information? Or are they acting in terms of holding us accountable and giving us that position. So I’m not really...I guess that’s the question, are they there to be the expert role or are they there to be the coach?Participant 6, level 4, aged 56 years, 1 year since diagnosisWhen receiving the text messages, they came from different numbers...if I was to keep them, I had to kind of keep this whole catalog of texts from different phone numbers. So, if it’s possible to standardize the messaging from one sourced number, it would be easier to just have a ready reference for all the information that was provided...I think they’re worthy of keeping.Participant 6, level 4, aged 56 years, 1 year since diagnosisParticipants discussed the program materials :...again, if I think about different diet programs, they give you the ability to find creative substitutes and creative, not just recipes but be able to say I’m looking for some creative alternatives for when I’m lunch on the go or something like that.Participant 1, level 1, aged 65 years, years since diagnosis unknownI’ve mastered the ability to print almost anything displayed on a website. So, I don't need to have a mailing. If it's available on the website and I wanted it in print, I can make that happen.Participant 3, level 2, aged 79 years, 24 years since diagnosisI found [the Fitbit] very unhelpful. Number one, I don't know how to read it, and it was hard to put on with one hand.Participant 4, level 3, aged 84 years, 8 years since diagnosisYeah I think the Fitbit is a little behind. I think as I’d mentioned, the Oura is probably a better route to take. It’s just on your fingers. You don’t have to worry about it...And to the activities that it doesn’t auto-recognize or automatically sync on, you do have to go in there, as you would with any other wearable tech, you do have to go in and kind of manipulate that and add that to it.Participant 6, level 4, aged 56 years, 1 year since diagnosisParticipants of all levels commented on their desire for increased customization and flexibility—many participants mentioned that their engagement in various aspects of the program would have changed if messaging delivery or content was customized:If we were talking about things that were targeted based on my activity on the site or my filters or my preferences I might say more often but if it’s just more general type information, weekly [text message reminders] would probably be good.Participant 1, level 1, aged 65 years, years since diagnosis unknown...as I recall, the prescription was developed based on a questionnaire that I had submitted to you prior to the beginning or at the beginning of the study. So it at least purported to be specific recommendations to the lifestyle and concerns that I as an individual had in that sense. If that’s correct, then it might be helpful to have the opportunity to periodically develop a new prescription to answer the same questionnaire submitted...it would be helpful maybe every six months or so to give participants the opportunity to complete the questionnaire again with updated information and develop a new prescription.Participant 3, level 2, aged 79 years, 24 years since diagnosisI’ve had a couple bouts with heart failure, so right now I’m on a salt-free diet and it would be helpful to me to be a little more specific as to what I can eat and what I can’t eat regarding that particular restriction.Participant 4, level 3, aged 84 years, 8 years since diagnosisBut I think that his idea of having more flexibility is a good one. Being able to tailor it to your particular lifestyle would be beneficial as well.Participant 3, level 3, aged 65 years, years since diagnosis not reportedYeah, and I think [the text messages] were pretty good, even as generic as they were, just to be a reminder and motivator.Participant 2, level 4, 53 years old, 1 year since diagnosisThe participants commented on the benefits of tailored immediate feedback for meeting their lifestyle goals:I like [the surveys] because the feedback was immediate and I could put it in and just right away I knew where I was, where I stood as far as doing good or not doing good and I liked that process.Participant 2, level 2, aged 66 years, 1 year since diagnosisI thought it was useful. Like I said, it’s kind of a dialogue. It tells you whether you’re doing what you should be doing or not, to get the feedback, immediate feedback.Participant 5, level 4, aged 78 years, 16 years since diagnosisI think if [the website] worked in tandem with the coaching process, maybe there would be more visibility on. And so, in terms of that being helpful, yes, I think either you go in, you look, you work with your coach, you see there’s a dip...if you convert that sole tool from an extrinsic motivator to more of an intrinsic motivator when you're working with somebody to help you see the benefit of moving through your exercise regime and getting stronger. Right? And so, I think it would work well if you paired it with the coaching process.Participant 6, level 4, aged 56 years, 1 year since diagnosisParticipants communicated their expectations of various types of support from the web-based program.Participants from all levels provided suggestions on how to improve the educational component of the intervention:What I did like about this particular site and participation in this was I felt like I was getting consistent information across diet, diagnosis, symptoms, side effects, and so forth.Participant 1, level 1, aged 65 years, years since diagnosis unknownI guess you could put more links in to connect us to information. I mean there’s stuff I have to go searching for on the internet anyway, but you put that information in the stuff that you send to us it might save us a little time...Anything about the disease and its cure. I mean the amount of information available on the internet about prostate, it’s almost like drinking out of a fire hydrant. If there’s anything special that...you want to make people aware of, that would be good.Participant 5, level 1, aged 80 years, 8 years since diagnosisAnyway, I’d like to see if there was someplace, if I had question, the food and the exercise, if somewhere I could easily go to another website or get these studies that prove [inaudible] is good to prevent cancer. You’re just telling us...I’m following it. You’re just telling us don’t do this, do this, this, this, this. Without any resources to back it. I’m not seeing the...studies or how extensive [a] study was.Participant 1, level 2, aged 73 years, years since diagnosis not reportedBeing a non-cooking person which I’m trying to change...I wasn’t sure what a cruciferous vegetable was when we started, so just having a list of cruciferous vegetables...So I was just looking for additional resources. In some cases, some ideas in terms of cooking or putting food together, some of those I shared with my wife, some of them were just looked at. You know, when you say, “Eat more fish.” It’s not really about eating more fish, it was about eating more salmon and related fish in terms of oils. So that type of stuff helped.Participant 2, level 3, aged 68 years, 3 years since diagnosisSo, the internet is full of information. Some of it really helpful, some of it really pretty horrid. As part of the resource would be some direction in terms of, “Here’s some places you can go to get some really good information about this that might be outside OHSU [Oregon Health and Sciences University]...”Participant 2, level 3, aged 68 years, 3 years since diagnosisWell as I’m looking at it now, it seems to mostly like recipes and things like that. I would be much more interested in technical information about cancer or exercise or something of that sort.Participant 5, level 4, aged 78 years, 16 years since diagnosisI was actually drawn to the diet piece. There was actually some very helpful and not helpful bits of information, like the gentleman that raised the topic of tomatoes. I went down that path and incorporated tomatoes, cooked tomatoes, some ripened tomatoes, all the different types of salsa. Things that really made the meal at some points. And so I thought that was really helpful.Participant 6, level 4, aged 56 years, 1 year since diagnosisParticipants wanted someone who genuinely cared about their progress available to answer questions and provide support:Just a couple thoughts on coaches. I think it’s definitely helpful to have more of a personal interaction. You know, with the coach giving reminders, as opposed to having an email message kind of a reminder coming from a program. You know, if you have that more personal...Someone that’s interested in what you’re accomplishing, I think that’s a better motivator.Participant 1, level 4, aged 56 years, years since diagnosis not reportedThe promise of a coach is somebody who can celebrate with you when you’ve reached your goals...and can also listen to you when you’re struggling and be empathetic.Participant 2, level 4, aged 53 years, 1 year since diagnosisIdeally, the coach should provide both functions. He should have deep expertise and be a motivator, just like a football coach.Participant 5, level 4, aged 78 years, 16 years since diagnosisAn overwhelming majority of participants appreciated having others with similar experiences to relate with:...when I was first diagnosed with prostate cancer, I went to a local support group of meetings and it was really terrific. The ability to interchange information, there’s no substitute for it as far as I'm concerned and if there was a way you could enable that I’d be all for it.Participant 5, level 1, aged 80 years, 8 years since diagnosisI think [Community of Wellness] is perfect because there’s so many different...some people are doing active surveillance, some people are doing radiation, some people are just...there’s so many different things but does anybody have the real answer of what worked for them or what is working for you, that’s hard to do.Participant 4, level 1, aged 71 years, 1 year since diagnosis[Community of Wellness] is just a way to interact with people who are going through the same thing, and sometimes get support and sometimes receive it through that kind of community.Participant 1, level 3, aged 75 years, 7 years since diagnosisOne of the things I really liked about [Community of Wellness] was that I felt like I was part of a community. Not only was it in the name, but it was nice to feel like there was some help more than just going to the doctor. So that was very valuable to me. Obviously, there were a lot of benefits that I got from it. You know, maybe they’ll come out during the discussion. I just thought it was really good being a part of something that at least acknowledged, “Hey, we’re alive. We have cancer, but somehow, we’re getting through it,” and that sort of thing was emotionally quite beneficial.Participant 1, level 3, aged 75 years, 7 years since diagnosisIdeally, lifestyle interventions help participants develop lifelong habits. In this quotation, one participant offers his thoughts on the long-term impacts of this intervention. This quotation and others reflect the participants’ impressions of the program; these impressions add to their collective experiences with technology and health:six months later...I have really changed. [The program] kind of kicked it off. But if I look back from where I am right now, and what I’m eating now, and how I’m eating, it’s dramatically different than how I was before I entered the program, and even when I finished the program because I continued on that trajectory, and been able to really, to do that. So, I think as far as coaching goes, everybody’s different. And I’m not sure that the program’s long enough to be able to really drive the kind of...You know, to be able to see the sustained change, or even get to the sustained change, maybe.Participant 2, level 4, aged 53 years, 1 year since diagnosisEach code generated in this study represents a unique mechanism for designing a more intuitive, web-based lifestyle intervention for prostate cancer survivors. By addressing the environment, we may transform factors that already exist in participants’ lives as obstacles to reinforcing factors for improved engagement with the web-based program. By addressing participants’ motivation, we may improve our ability to tailor web content and web-based communications. Understanding participants’ preconceived attitudes based on past encounters with the health care system will allow us to actively address concerns and improve program adherence. We may influence preparedness when we assess and consider each participant’s unique level of health and technological literacy, readiness to change, and trust and bolster these whenever possible through program content. Program design and program support are the most easily affected; we can increase intuitiveness through tailored communication, materials, and feedback, providing quality educational content, serving as allies, and generating community.Noting the ways in which certain codes presented in the different intervention levels helped contextualize feedback. For example, participants in level 1, who received only web access to educational content, requested more communication, whereas participants in levels 2 to 4, who received increasing levels of behavioral support, provided details on ways in which the multiple forms of communication they received might be tailored. Participants in levels 3 and 4 received more types of behavior support and were also more likely to request more instructions or reminders orienting them to the program, as their interventions had more components. Conversely, some codes were commonly expressed across groups, such as competing priorities, readiness for change, flexibility, education, and community.The relationships among these codes  may resuMen with prostate cancer find themselves in an era of seemingly limitless access to medical information via the web. Technological advances impact their daily lives, and as technology and health care delivery are increasingly intertwined, their ability to maintain health may inevitably be influenced by their willingness to engage with technological interfaces ,45. We lWe used the grounded theory methodology because no comprehensive theory of web interventions for behavior change in prostate cancer survivors has been developed before. This methodologic approach is a strength because data-driven open coding is most equipped to interrogate the inherent assumptions held by study participants and researchers alike . Anotherusability engineering, where the usability of a system is defined by (1) learnability, (2) efficiency, (3) memorability, (4) low error rate, and (5) satisfaction. Usability heavily overlaps with intuitiveness, although we believe intuitiveness emphasizes tailoring and program responsiveness, shifting the burden of anticipation on program designers rather than program users. The interest in temporal and user tailoring beyond usability is also illustrated by the growing literature on just in time adaptive interventions, which are designed to adapt according to changes in an individual’s contexts over time. These interventions provide the most appropriate and timely support to their users ; their applications in health promotion are of particular interest [An intuitive, web-based interface is not a novel concept. In 1993, Nielsen  coined tinterest .Our findings suggest that intuitiveness will likely depend on both the context and the intended user. This qualitative study elucidates some of the key areas that can be optimized for intuitive use of an internet-based lifestyle intervention among well-educated, White prostate cancer survivors. Although we used a grounded theory approach and generated data-driven codes, many of the resulting codes and their relationships to one another  are corrReadiness to change is supported by the transtheoretical model stages of change  [The environment code  is corroborated by the idea of a multilevel intervention based on the social ecological model. The social ecological model by Bronfenbrenner and Morris suggests that the individual is enveloped and influenced by interpersonal, organizational, community, and public policy networks . Readineination) . The ideination) . Finallyination) , which dLimitations of the study include the small subgroup sample size and lack of a theoretical sampling process parallel to the analyses. Overall, 10% (20/200) of eligible men were both interested and available to participate in the focus groups at the scheduled times. Although the smaller sample size is acceptable as our objectives were to explore themes using a grounded theory approach, this introduces a possible selection bias. In addition, not all participants fully participated in the web intervention as indicated, and the focus groups took place a median of 7 months after the interventions. Some men participated in multiple TrueNTH programs or were involved in other clinical trials. Although the longer follow-up period and competing priorities contributed valuable, realistic insight into the participants’ lasting impressions and their habit formation, participants may not have recalled all the details of the intervention. In addition, although this was a multi-institutional study, the participants’ experiences may primarily reflect viewpoints of educated, White men in the West and Mountain regions of the United States, where there may be disproportionately greater exposure to technology and overall better physical activity rates . The lacOur study demonstrates that a web-based lifestyle intervention for men with prostate cancer can become intuitive and encourage adherence. These include addressing technological and health literacy, motivation, and environmental factors. In addition, flexible and transparent web design, integration of key stakeholders , and effective coaching may improve the usability and intuitiveness of a web-based intervention to support prostate cancer survivorship. Men with prostate cancer tend to be older, have comorbidities, and balance multiple priorities; this may limit their ability to engage with a web-based lifestyle platform. A web intervention’s potential to affect long-term change will depend on the intuitiveness of its components, allowing integration within an individual’s daily life . This grounded theory–based analysis may help guide future web intervention designs for cancer survivors. The convergence of our findings with well-established theories in public health suggests that certain aspects of our theory are broadly applicable to lifestyle intervention design, although this will require further study.


It is only recently that written sources of local knowledge on plants are not being ignored by scholars as not belonging to “traditional” knowledge. Ethnobotanical texts, however, if they at all focus on knowledge from written sources, hardly ever pay any attention to the actual processes of interaction with written texts and illustrations. During our research, we examined people’s interactions with texts, illustrations, and herbarium specimens of plants they collect or are familiar with. We focused on a small community of Shiri people in the mountainous village and in the lowland settlements in the Republic of Daghestan, Russia. In the paper, we address the following questions: how do Shiri people interact with illustrations, written text, and herbaria specimens? How is this interaction influenced by the practice of plant collection? What are the methodological implications of the ways people interact with illustrations, texts, and herbaria specimens?Our research was based on long-term ethnographic fieldwork: co-designing of a booklet showing edible plants people collect in Shiri, semi-structured interviews, and video-recordings, and observing interactions between people and text/illustrations/voucher specimens.We identified three kinds of interactions between individuals and text/illustrations: “text-wayfaring”—predominantly a bodily interaction between an individual and illustrations and text; “fact/spelling checking”—predominantly discursive and information focused; “between wayfaring and fact-checking”—the mix of the two. Using the idea of textual poaching, as well as the knowledge-making approach, we show that the mode of interaction with text/illustrations influences what is acquired, and how. This process influences readers’ LEK. The mere presence of an information in the text available to people does not imply that they will acquire it, make use of it, and change their LEK. Photographs and pressed specimens of locally known plants are often not (or only partly) recognized by the interlocutors. Video-recording is essential for analyzing the above mentioned interactions.In ethnobotanical research, it is important to pay more attention to people’s interaction with their sources of knowledge, including text and illustrations. The discursive part of LEK is more easily influenced by written sources. The practice of plant collection is not as easily influenced. Ethnobotanists function in a particular context and are embedded in discourses oriented towards conservation of bio-cultural diversity that value heritage as such, so it is important to be aware of one’s positionality. A methodology that relies on showing pressed specimens or photographs to interlocutors may be a very misleading way of collecting ethnobotanical data. Written sources of local knowledge on plants were often ignored by scholars as not belonging to LEK  or TEK During our research, we examined the interaction of people with texts and illustrations of plants they collect or are familiar with. We focused on a small community of Shiri people living in the mountainous Shiri village and in the lowland settlements and towns  situated along the Caspian coast in Daghestan. Along with the people from the community, we collected the edible plant specimens , then coDaghestan is Russia’s southernmost and the most ethnically and linguistically diverse republic, a considerable part of which belongs to the Caucasus Biodiversity HotSpot. Most Daghestanis are Sunni Muslims. The Shiri village is located in the mountains in the Dakhadaevsky region. People in Shiri speak a distinct language that belongs to the Kubachi subgroup of Dargi languages, and it has not been documented until recentlyEdible plants are important for the elderly and middle-aged Shiri people due to their taste values and their role in forming identity and social relations (for more see ), ratherReciprocity and engaging with the community resulted in the booklets brought back to the community. Bringing written materials to the researched community may raise controversies. One of such controversies derives from the idea that TEK is seen as based only on the knowledge transmitted from one generation to the next (cf. ). In thoemic perception of knowledge as being traditional should be taken into account , but it is the fact that this knowledge is made and re-made, and that it is important for the communityunt (cf. ). It wasunt (cf. ).It is also important to mention that we had other goals than for example   using small cameras placed on a table or a tripod, so it did not intimidate them. We also noted occasional comments from the other 31 individuals. All of our informants were non-specialists in plant knowledge. The age range was from mid 30s to 90s. Most of them, therefore, received their (at least) elementary education still in the Soviet times (a fact important for the knowledge-making). It is worth mentioning here that, as of 2018, we knew all the Shiri people very well, which allowed great levels of trust and naturalness during the video-recording of their interactions with the booklets, with each other, and with us. In this respect, our methodology was quite specific and, we believe, cannot be randomly applied in other contexts.lingua-franca in Daghestan. The older inhabitants used the mix of Russian and ShiriExpression of consent was required before each interview and it was obtained verbally. The main language of research was RussianFirst, we will present the results and discussion regarding types of interaction with text and illustrations, then we will present methodological implications.Knowledge about plants was important for all of our interlocutors, even those who have little practice in plant collection. Local plants were a part of their identity and constituted an important part of social relations . Basing duc’armura , ʡaˤʁʷamura (Cerastium davuricum Fisch. ex Spreng.), guržinakːʷi (Oberna multifida (Adams) Ikonn.) , they also made a “cutting” gesture when they came to the root which, when asked later, they considered unnecessary/not-useful. Compared to our other interlocutors, they put the booklet away relatively quickly. They were surprised when they heard us discuss the section “Uses in Shiri” with the men present in the room. Three of our interlocutors commented: “we know this anyway.”Patimat (in her 70s) and Malaykat (in her 40s), who had vast knowledge on plant collection, were happy to receive the booklet in 2017, but they did not read it; they just browsed through it looking at the illustrations and plant names , it grows in all conditions, it just grows like… Look, there is a word ‘sporish’ (in Russian: quarrels)—he says in a lecturing tone. – it just quarrels with nature, you can even trample on it, it is a very life-loving plant.”  and Marat (in his 30s) were browsing through the booklet in Marat’s house in Izberbash.zveroboy,” said Rabadan with confidence reading the heading and looking at the photograph (zveroboy is the Russian folk name for Hypericum sp.)“It is not zveroboy, they just took the photo like this”—argues Marat, making a gesture to suggest that the photo was taken from above. “These are zveroboy flowers, just photographed from here.”—he adds.“No, it is qːaˤnala čutni ).“It looks like a shrub here.”—says Rabadan. “And a half of it is missing”—he adds Fig. . 2). He “Shulum (Mentha aquatica L.), is also not clear here. At this time (as in the picture), it is already too old”—said Marat turning the page. In his opinion, the illustrations of plants in the booklet should be “as they look when they are collected”, as otherwise it may be confusing.pocher . Kirksey uses the following metaphor: “At the Multispecies Salon, panelists poached each other’s papers, like chefs “poach” pears, using red wine and honey to intensify and transform the flavour of the fruit.” ) ʡaˤʁʷamura (Cerastium davuricum Fisch. ex Spreng.) specimen from our herbaria collection and traced the contour of the plant with her finger. Then (to our dismay) she took its leaf in between her fingers and started rubbing it, asking: “What is this?” “Did we collect it? Hmm.” Cerastium davuricum Fisch. ex Spreng. was among the most important plants collected in Shiri, it was considered unique. That is why we initially thought that we collected the wrong specimen, but ʡaˤʁʷamura collected in the following days also turned out to be Cerastium davuricum Fisch. ex Spreng. Shiri people with less experience had even more trouble recognizing pressed herbaria specimens . In theens . Our inAnother methodological implication concerns the gender of interlocutors and researchers. In most cases, the most knowledgeable individuals in regard to plants were the women. However, in the presence of men, out of respect they did not demonstrate their plant knowledge unless explicitly asked by men or by us. Men often consulted them in regard to plant names. Men watching the booklets were more self-assured and ready to contest the female researchers’ authorityThe last methodological implication concerns video-recording. We realized that methodology based on video-recording was indispensable for this research to be successful. It enabled us to analyze details of bodily interactions with booklets which could otherwise be omitted. This kind of methodology is, however, not possible without long-term stays and great levels of trust between the interlocutors and the researcher.In ethnobotanical research, it is important to pay more attention to people’s interactions with their sources of knowledge, including text and illustrations. Without scrutinizing these interactions, it is hard to fully understand the influence of sources of knowledge on people’s LEK. What is more, ignoring parts of the social context may lead to misunderstanding of the processes of knowledge-making. This is why we shall not reject written sources of knowledge, because only by using them we can acquire a better understanding of what LEK is.emic perception of traditionality of knowledge is crucial for us.Ethnobotanists, as researchers, function in a particular context, and are embedded in discourses oriented towards bio-cultural-diversity conservation, and value heritage as such . InstituWritten text (as observed in the example of interaction with booklets and narratives about them) influences people’s discursive knowledge, but does not influence praxis of plant collection and usage. Shiri people were more interested in just having booklets than reading/using them, so the influence of the booklet on their plant knowledge was effectively negligible. Although they wanted to know the medicinal properties from the official pharmacopoeia, and the uses in other parts of the world (or the former USSR), this knowledge was rather regarded as purely informational—to be collected, but not practised.Methodology that relies on showing pressed specimens or photographs to interlocutors ), m), m45]))


Well-being is a heterogeneous idea with inconsistent applicability to real-world circumstances. In this article, I explore A’uwẽ (Xavante) notions of social well-being from an ethnographic perspective. My data indicate many members of this Indigenous group understand wellness to involve not only health and harmony, but also certain modes of strife and inequality that are also viewed as desirable. A’uwẽ understandings of social wellness, including linkages to the environment, suggest that a broader and more locally contingent concept of social well-being than is evident in mainstream literature would benefit transcultural health efforts and policy involving Indigenous and other culturally distinct communities. Well-being, a seemingly common-sense concept closely allied with health, defies attempts at definition, qualification, and quantification in transcultural perspective. Rooted in the apparently simple condition of being well, it is a heterogeneous idea that provokes intriguing questions about its applicability to plural real-world circumstances, the role of disciplinary boundaries in framing its meanings, and how to reconcile myriad quantitative indicators that purport to capture its essential dimensions. Such a seemingly simple term provokes widely diverse academic interpretations in part because it involves multiple and often divergent facets that reach well beyond mainstream quality of life measures into other arenas, including social life as locally understood.The constellation of ideas coded with the term well-being come from a variety of disciplines including philosophy, psychology, economics, sociology, epidemiology, and public health. They include both “subjective” and “objective” definitions, which are distinguished by how they engage with individual perception versus external verifiability . They maAll academic fields contributing to the well-being discussion have their own epistemological assumptions about appropriate methods for producing knowledge, most of which are very different from anthropology’s. Among the unique contributions of ethnographic studies are robust and holistic approaches that prioritize the diversity of local understandings. Ethnographic approaches ask how different cultures engage their own concepts of wellness and what work others need to do to understand them. Thus, they tend to focus on aspects at the subjective, eudaimonic, and qualitative ends of the spectra. They also show greater interest in sociocultural than individualistic dimensions of well-being, while recognizing that these dimensions overlap and engage one another .Psychologists have argued that well-being is social and cultural as much as it is individual . SimilarThe study group included four principal A’uwẽ communities located in the Pimentel Barbosa Indigenous Land, State of Mato Grosso, Central Brazil, a region of cerrados or tropical savannas known for their exceptional but threatened biodiversity . BetweenI begin this article with a profile of my late adoptive A’uwẽ grandfather Antônio (Ru’wẽ’warazu’ata) and how his unique life and personality illustrate some of the dilemmas and solutions involved in assessing well-being from anthropological, public health, and other academic frameworks. I met Antônio as soon as I first arrived at Pimentel Barbosa in 2004 and came to know him by working with him in his gardens, accompanying him on hunts, and whiling the time away in conversations about any number of topics.Antônio was an agriculturist, a hunter, a fisher, and often a collector of fruit, roles closely linked to his identity as a husband, father, and grandfather, who proudly cared for his family along with his wives and his mother-in-law. Acquiring game meat and fish were mostly his domain as the senior male member of this small group of household caretakers. He was a determined and knowledgeable hunter, one of the last in the study communities to use a bow and arrows.Antônio had not adopted the conservationist language acquired by several younger A’uwẽ men while living in metropolitan cities and engaging with national and international environmental conservation agencies. Antônio worked on nearby ranches in the 1970s but had otherwise remained a resident of local A’uwẽ communities. His concern for the local environment was tangible and passionate, guided by his interest in obtaining resources from it over the long term. His understanding of how to preserve the landscape for the future was based on his life experience of extracting resources from it before, during, and after largescale encroachment and circumscription by cattle and monoculture agricultural ranches. He spoke to me about the landscape in very pragmatic terms, which communicated a strong sense of place, but without resorting to characterizations of it in animistic terms .Among the first to invite me to accompany him for a day clearing weeds in his garden, he also was one of the first hunters to give me the opportunity to shadow him on group hunts, which were a special interest of mine ; 2015. Otepé’tede’Wa), which are an important component of the ceremonial complex that makes up the rites of initiation of girls and boys into novitiate adulthood (wai’a’rada) during spiritual rituals, giving advice and critique to the younger individuals who were now responsible for carrying them out. In secret, he was the senior owner of a series of heritable prerogatives that he employed for the benefit of his family and the community at large. I considered Antônio to exemplify social well-being in this A’uwẽ community.Antônio and his wives, with the assistance of his mother-in-law, cared for their fourteen rowdy children with all the love, pride, and hard work one could imagine. In community ceremonial life, he performed an essential role as the elder owner and leader of the Tebe (Fish) ceremonies  looked after me in his own individual caring ways. His concern for me as a guest in the community was not exceptional for him (it was for me) and illustrated A’uwẽ capacities for creating special affective bonds with non-A’uwẽ who show an interest in their community and well-being. Among the ways they did this was including outsiders in adoptive families, and thereby exogamous moieties, as well as age sets, and thereby age set moieties, in order to orient them socially to the whole of society and give A’uwẽ residents a basis for approaching them properly in socially proximate or distant ways, or with culturally appropriate affinity or antagonism.Antônio’s and other’s interest in outsiders spoke to me about their concern with their own families’, communities’, and ethnic group’s welfare in a rapidly changing world of territorial circumscription, market insertion, transcultural engagement, biomedical healthcare services, and social media. By engaging outsiders like myself, these elders sought to enhance their community’s sovereignty amid upheaval in diverse realms. This sovereignty derived from building knowledge and networks beyond the community that could reinforce internal sources of resilience. As has been mentioned elsewhere, in many ways we are “their” anthropologists rather than the other way around .Antônio died after several years of major paralysis resulting from a stroke. His last years of life were filled with deep emotion as he tried but could no longer communicate well verbally with his loved ones and friends, including myself. Although his family cared for him attentively and close friends visited regularly, his wheelchair broke repeatedly, his clothes fell into a state of disrepair, and his evident desire to be close to other people went insufficiently attended as community life continued without his usual active participation. When his wheelchair worked, he spent much of his time in front of his house, where he could see the entire community plaza and all the activities that occurred there. When his wheelchair was broken, which was often, he spent most of his days in his kitchen annex behind the house, where he could enjoy the company of members of his extended family household and other visitors as they came and went.His suffering could be easily interrupted with the pleasure of a friendly visit, a warm hand on his knee, a hug, or a cathartic cry with someone close. Antônio was ill, but he was also well in so many ways. His health was poor, but his depth of feeling and connection with others was rich and full until he died. Whereas some scientific or popular formulations of well-being might characterize him as disadvantaged, I understood his degree of wellness to be very high despite his stroke sequelae. This was because his A’uwẽ relatives and peers saw him as the same loving person who abundantly contributed to his family and community with all the responsibility and care that are expected of a husband, father, grandfather, elder, and ceremonial prerogative owner. In his final years, his person was not defined exclusively by his paralysis, but also by his life-long successes, contributions, and affections.Antônio’s example illustrates why I am led by my ethnographic data to focus on well-being as construed very openly, especially including many social aspects of wellness besides physical and mental health . Health I am not the first to call for a broad ethnographic understanding of well-being. For example, wahöimanazé) by A’uwẽ people. I do not intend for these terms to imply religious conservatism specifically or to suggest any negative connotations such as antiprogressive thinking. Nor do I mean to suggest that culture is static, although some A’uwẽ perspectives of tradition involve ideas about an idealized past.Within A’uwẽ communities, overwhelming support exists for the maintenance of certain challenging customary rites of passage, especially those related to two age group systems closely intertwined with social and ethnic identity, as described below. Thus, most A’uwẽ support cultural traditionalism in at least some contexts, even if younger people’s attentions are not particularly directed towards the preservation of all other customs. I use the terms traditionalism and traditionalist to capture emergent emic notions of contemporary advocacy of culture and customs considered “traditional”  of individuals that pass through age grades (phases of life) by means of collective public rituals. In other words, age grades are formalized through their occupation by sequential age sets, which occurs ceremoniously for members of an age set at the same time . In the Interestingly, this same format applies to two distinct age group systems, one which applies both to men and women and is considered by the A’uwẽ to have a secular focus, and one which includes only male members and is considered fundamentally spiritual in nature. Although the first of these two systems involves both women and men, through the male-only pre-initiate house experience (up to approximately five-year residence in symbolic isolation from the community) it engenders special relationships of camaraderie between male age set peers and their mentors . The second is a secret men’s cult and cannot be discussed in detail with women or outsiders. Nor may its secret activities and contents be published in this article. These social configurations are important examples of culturally appropriate expressions of differentiation and ranking contributing to a thoroughly plural social tapestry of contrasts between people that is fundamental to traditionalist perspectives of how a good life is lived ; 2010.My pre-initiate male interviewees affirmed enthusiastically that their experience in the pre-initiate house  was unchI interpreted these seemingly contradictory narratives as deriving from the simultaneous fallibility of the individuals engaged in these age group systems  and the irreproachability of the social arrangements  perpetuated through the generations. Thus, the social configurations involved in mentorship remain intrinsically good and beautiful, while the individuals involved in them may fall short of expectations. These irreproachable social arrangements are an excellent example of traditionalist values that are similarly shared by younger and older people. As I mentioned above, boys take great pride in asserting that their experiences in the pre-initiate house were unchanged from the past. Notably, all boys opt to live with their secular age set peers away from home for up to about five years rather than stay at home, even though A’uwẽ notions of child autonomy  give theI interpret the near universal enthusiasm to participate in age group system activities, especially diverse public ceremonies and rituals and excursions into the forest by mentors and their protégés, as indication that these social arrangements are an expressive focus of A’uwẽ traditionalism, anchored in the interests of the entire population, including women and men of diverse ages. Furthermore, they are widely understood to represent the only proper and good way of creating men from boys, contributing substantively to notions of ethnic belonging. Thus, it is my ethnographic understanding that these age group systems are examples of traditionalist social configurations amply believed to promote well-being among the population, both for those who participate publicly and those who help prepare behind the scenes and watch.By joining a coed secular age set and living in the all-male pre-initiate house for years before advancing to novitiate adulthood, a boy is assuming his responsibility to do the internal and external work required to become a respectful and responsible adult who provides for his family and participates appropriately in the community. By identifying with her secular age set, assisting pre-initiates thatch their shelter, and participating in ceremonies recently opened to females , a womanAge group systems are not the only example of social well-being expressed through traditionalism. Other examples include weddings (and associated wedding hunts), secret female knowledge regarding wild root vegetables, pregnancy and birthing practices, children’s play activities, men’s councils, and many more. What is unique about age group systems is the pervasive manner in which they condition the human experience from childhood to old age, thereby providing social bearings for all but the youngest living individuals, and women in the case of the spiritual age group system. Age group systems are ubiquitous aspects of daily social interaction through which meaning is constructed between individuals and groups of individuals (such as age sets and moieties).… has been viewed variously as happiness, satisfaction, enjoyment, contentment; and engagement and fulfilment, or a combination of these and other hedonic and eudaimonic factors. Well-being is also viewed as a process, something we do together, and as sense-making, rather than just a state of being. It is acknowledged that in life as a whole there will be periods of ill-being, and that these may add richness to life. It has also been recognized that well-being and the environment are intimately interconnected. Certainly, well-being is seen to be complex and multifaceted, and may take different forms.According to Haworth and Hart (2007:1), well-being: Based on my ethnographic experience with the A’uwẽ, I identify with this characterization of well-being because it focusses on process and “sense-making,” as well as interconnectedness with such factors as the environment. Antônio’s sadness at the end of his life did not negate the fullness of his lifelong experience or cancel out his degree of contentment for having raised many children, hunted and gardened to provide them with food, and passed along secret knowledge to them. It did not undo the rich pleasure he expressed when reconnecting with those who had shared his life of generosity and goodwill. It did not betray his community’s respect for his years of ceremonial leadership and caring for his ceremonial protégés. In these ways, Antônio exemplified several A’uwẽ ways of “well-living” and “well-dying” (McGillivray 2007:29).Based on these ethnographic observations, I seek to move beyond individualistic hedonic concepts of happiness, health, and wellness towards an understanding of A’uwẽ well-being as involving social notions of quality and richness of community life. I focus on aspects of social life, such as the age set systems, which my ethnographic research suggests many A’uwẽ understand to promote “the quality of their relationships with each other and the world, which, ideally, contribute to a deep and ensuring sense of intrinsic worth and existential certainty” (Eckersley 2011:633).Wellness, well-being, living well, and good living are but a few of the popular academic terms for the intersection of factors that contribute to quality of life. Too often these concepts are reduced to oversimplified indicators of vital statistics, food security, socioeconomic status, developmental indices, health conditions, access to public services, happiness, psychological satisfaction, or social capital , “beautiful” (ĩwe), “beautiful to see” (ĩ’madö’öze), and “respect” or “modesty” (danhisé). These terms are not unlike those proposed for the Gê group Mebêngôkre-Xikrin, for whom goodness and respect configure into notions of well-being . Examples such as this suggest the importance of robust A’uwẽ ideas like “suffering together” for peoples’ perceptions of good living. This viewpoint forefronts what is considered “‘good’ in the sense that it is meaningful and judged well by other people in accordance with social principles” :31. I agI also agree with Prilleltensky and Prilleltensky (2007:57) that “contrary to prevalent notions that well-being is a personal issue, … it is also relational, organizational and communal.” While individuals may experience or share aspects of well-being, it is as communities and societies that they collectively construct shared notions of well-being. This is not to say that people agree on everything, but rather that they have the potential to share meaning through common experiences and viewpoints. My A’uwẽ friends are a heterogeneous group of people who also agree on many things, among them some aspects of what contributes to good living and satisfaction in life. Many of them explicitly recognize the distinction between individual and community values and understand that their representations of social wellness are influenced by different factors when speaking as a community representative as opposed to an individual resident. These stances may differ slightly or substantially, but do not imply contradiction.A’uwẽ social arrangements, such as age group organizations and agamous and exogamous moieties, are emblematic dimensions of how A’uwẽ understand their own society and social values. They are more than anthropological constructions, being explicit dimensions of how A’uwẽ understand their own social identities, and essential to how they conceive of their unique ethnic identity. Furthermore, they are keystone components of traditionalism in contemporary A’uwẽ society, dovetailing with A’uwẽ notions of social wellness and good living.Recent research into well-being in Amazonian societies has emphasized diverse dimensions, some of which align better than others with my approach to A’uwẽ well-being. While these characterizations are similar in some respects to A’uwẽ notions of well-being, they lack a central aspect of my ethnographic argument, which is that some A’uwẽ constructions of social well-being involve certain modes of strife, opposition, and hierarchy, which are also viewed as good and proper. This point was well captured by Gordon, who made a similar argument for the Mebêngôkre-Xikrin, another Gê-speaking group, among whom differentiated social forms of resource and ceremonial goods ownership contribute to ethical and aesthetic concepts about what is “a good, beautiful and correct way life” (Gordon 2016:210). This author also suggests that among the Mebêngôkre-Xikrin, notions of well-being entail the maintenance of pervasive social differentiation, which is linked to ceremonial and other kinds of property. The A’uwẽ case is similar, where the expectation for “good” social relations involves age-related ranking, distinct prerogative ownerships by kin groups, and differentiated social roles in diverse aspects of ceremonial and every day social life. Gordon also expresses reservations about the universal applicability of the equivalence of conviviality and social well-being in Amazonia, which coincides well with my approach, whereby I highlight that A’uwẽ consider certain culturally appropriate and traditional forms of differentiation and ranking to be essential to living well.The association between cultural traditionalism and well-being has been observed among Indigenous peoples elsewhere. For example, a study showed that among Aboriginal Australians, “attachment to traditional culture is found to be associated with enhanced outcomes across a range of socio-economic indicators” :315. ForWhat form should an ethnographic study of well-being take to avoid the pitfalls of ethnocentric yardsticks and comparisons ? There iThe approach I take here is to discuss well-being within a society on its own terms, as I understand it, without emphasis on quantifiable measures for external comparison. Another way of characterizing my approach is as an exploration of subaltern epistemologies of well-being in an A’uwẽ community. Thus, I avoid overemphasis on absolute standards of quality of life, such as psychological, socioeconomic, or demographic measures. My attention is directed towards social  rather tWell-being is more than an individual or internal state of being. One’s environment may also contribute to one’s wellness, happiness, and quality of life. This environment may be one’s social and physical surroundings, including everything from physical housing and sanitation conditions to home or community life and one’s greater urban or rural setting, including access to “natural” and cultural resources present in a local landscape . From anThe cerrado tropical savannah ecological landscape is not the only kind of environment one might address when discussing A’uwẽ well-being, but it is an often-overlooked dimension that was borne out in my research as central to well-being for many individuals and for communities more generally. Not only is the environment, understood as an anthropogenic landscape, a topic of frequent discussion with regard to self-provisioning and sustainable resource use, but it is considered a key link in communities’ abilities to meet social needs for gifts of collected, hunted, or cultivated foods on certain ceremonial occasions, which are some of life’s most important events. Game meat is given by grooms to brides’ households to formalize their weddings. Collected wild root vegetables and maize loaves are given by spiritual initiates to their spiritual singers, mentors who guide them in spiritual matters, during spiritual ceremonies. The link between environment, subsistence, and well-being among the A’uwẽ recalls the North American Cree, among whom well-being is less associated with health and disease and more closely aligned with the presence of game animals, food sovereignty, and maintenance of traditional values, including religious practices and native language use . In anotPrevious literature on the connection between well-being and the environment has focused on several themes that I do not prioritize specifically for the A’uwẽ for being outside the scope of this article or discordant with A’uwẽ ways of engaging the environment. Some studies emphasize the role of ecological services, landscape resources, and biodiversity on the economic quality of life or health of individuals . Others I find several other approaches to the well-being/environment nexus more useful for the A’uwẽ case. For example, rowedi), spiritual ceremony (wai’a), animal (abazé), and plant (ĩ’re). This is not to say that the A’uwẽ are necessarily an exception to the tendency for Indigenous peoples to not categorically separate human society from the non-human landscape, but rather to suggest that they may not fit neatly into such relational schemata as they have been characterized previously. Currently, they have sophisticated concepts of the non-human environment as an anthropogenic place  and cultural resource  that deserves conservation to ensure its resources remain abundant for future generations  may be read by some as improvements mitigating against unwellness. At the same time, maintenance of social and environmental traditionalism may be interpreted as a source of ethnobiological resilience and strength, and therefore a source of wellness. From an anthropological point of view, just as suffering does not contradict well-being, neither does environmental change, for it is often precisely when conservation is needed that communities rally to preserve it . FurtherAntônio demonstrated the irreducibility and ambiguous nature of well-being when individual health and the social experience of wellness might be at odds with one another . He alsoMy reading of A’uwẽ understandings of well-being direct me towards an analytical framework of social wellness as a heterogeneous process constructed by communities through shared understandings of forms of interpersonal relations potentially involving both pleasure and strife that are considered good and appropriate, being understood to accrue benefits for individuals, communities, and environments. This approach has the potential to rebalance debates about transcultural well-being indicators by redirecting attention to the emic societal contexts within and through which experiences of wellness and unwellness occur. This need has been well established for Aboriginal and Torres Strait Islander peoples and similar principles likely apply to Indigenous and other traditional peoples elsewhere . From a Underlying the ethnographic stories told in this article is the reality that not all youths share with their elders identical ideas about what behaviors are socially desirable and thereby contribute to living a good life. Younger women no longer abide being struck on their legs with wooden rods by their male mentors to test their strength. Younger contemporary fathers-in-law often invite their sons-in-law to disregard long established A’uwẽ conventions of expressing respect through avoidance behavior. Youths tend to prefer to purchase store-bought foods rather than grow, collect, hunt, and fish local foods that are preferred by many elders as important to a healthful diet and most valued as gifts of reciprocity between relatives and neighbors. Nevertheless, certain cultural events serve to anchor almost everyone’s perspectives regarding traditionalism and its linkages to well-being.For example, the excitement of weddings motivates even those youths who are most repelled by the idea of hunting to enthusiastically participate in large group hunting expeditions undertaken to acquire ample quantities of game meat for the groom to deliver as a present to the doorstep of his parents-in-law’s house. They thereby learn hunting techniques and gain the capacity to provide sustenance for their families. Even young agnostics regarding A’uwẽ spirituality participate in each and every spiritual ritual, a challenging task, in order to lend their peers support and solidarity. With time, and their advancement through the spiritual ranks, they tend to become believers and gain capacities to heal their family members of disease and injury. Rites of passage into novitiate and mature adulthood are festive occasions in which the entire population participates in one way or another. They are occasions for previously unruly children to demonstrate respect for elders and commitment to their secular age set and age set moiety. These youths assume such responsibilities with solemnity and dedication, striving to demonstrate to the community their intentions to be good daughters and sons, mentors, children-in-law, spouses, and parents. In each of these examples, the appeal of participating in certain community social events brought youths into closer alignment with their elders in their perspectives of how to live well. Although what A’uwẽ understand to be traditional may change through time, certain social expressions of traditionalism unify otherwise disparate points of view and bring people together in their understandings of well-being and health.In this article, I have sought to provide an ethnographic justification for a broader understanding of social aspects of well-being than is usually evident in mainstream multidisciplinary well-being literature. My argument only addresses a slice of the diverse considerations involved in a comprehensive treatment of well-being, which also include physical, mental, and spiritual dimensions, among others. Besides physical health, social configurations and relations were the dimensions that my A’uwẽ family, friends, consultants, and interlocutors emphasized the most in their conversations with me, making them ethnographically salient dimensions in my research. They also stood out as the aspects of well-being that most reflected A’uwẽ emphasis on local community, which is central to how they understand identity. Academic and policy attention to this perspective of well-being will contribute to an alignment with diverse local sociocultural realities, opening of space for two-way intercultural dialogue, and thereby also to the decolonialization of science and healthcare. A broad understanding of social well-being may also have concrete health impacts in diverse transcultural contexts, beyond Indigenous and culturally distinct peoples illustrated by the A’uwẽ case. For many localized and virtual communities impacted by adverse health events, such as Covid-19, forced migration, natural disaster, and economic crisis, restoring well-being requires more complex and holistic understandings of wellness to address non-physical sequelae, including restoring collective social well-being.