Microbial Load of Chicken Shawerma and the Handlers’ Compliance with Food Safety Practices in Jordan

Background: Shawerma is a popular traditional food in the Eastern Mediterranean region. Aim: The aim of this study was to assess the shawerma handlers’ compliance with food safety practices and determine the microbial load and pathogenic organisms in the ready-to-eat chicken shawerma sandwiches in the restaurants of Amman, Jordan. Methods: This cross-sectional study used mixed methods including observational checklists to determine the compliance of food safety practices by 120 chicken shawerma handlers from 40 randomly selected restaurants in Amman. Additionally, pathogenic microorganisms were assessed by laboratory analysis in the ready-to-eat chicken shawerma sandwiches. Results: Only 2.5% and 10% complied, respectively, with separating knives and boards used for chicken from the ones used for vegetables. The compliance for maintaining proper temperatures for freezers and chillers were only 62% and 67%, respectively. As for hand-washing techniques and using disposable drying papers, the adherence was 5% and 7.5%, respectively. Laboratory analysis showed that 27.5% of the ready-to-eat shawerma had unacceptable levels of microorganisms. Conclusion: Our findings showed poor compliance of food safety practices in chicken shawerma restaurants of Amman. There is a need for capacity building and periodic evaluations of food handlers’ knowledge and practices within a comprehensive food safety program, carried out by qualified trainers. Keywords: chicken shawerma, food safety, Jorda

Female genital mutilation : Studies on primary and repeat female genital cutting

Background: Worldwide at least 130 million now living women and girls have undergone female genital mutilation (FGM), also called female genital cutting (FGC). Reinfibulation (RI) is a secondary form, mainly performed after delivery. In spite of documented complications, the procedures continue, and it seems essential to further reveal the underlying motives in order to increase the understanding of its persistency and to elucidate the encounter in maternity care after migration. Objectives: To explore FGC and RI in a country of origin, Sudan, and after immigration to Sweden. More specifically the objectives were: (I) to describe the perceptions and practice of FGC among rural Sudanese women and men's views; (II) to describe the prevalence of RI in hospital settings; (III) to elucidate knowledge, attitude and practice of FGC and RI in a rural setting in Sudan; (IV) to explore the experiences and perceptions of RI after delivery among Sudanese midwives; (V) to investigate the experiences of FGC and RI among Sudanese women and men; and (VI) to explore the experiences of FGC and the encounter with Swedish maternity care among women immigrants from Sudan, Somalia and Eritrea. Methods: These studies were conducted in El Gezira and in Khartoum State, Sudan, and in Sweden after immigration. The studies employed both qualitative and quantitative methods: (I) interview-administered questionnaires to 120 villagers; (II) participant observations and digital examination at 100 deliveries; (III) interview-administered questionnaires; (IV) nonparticipant observations and open-ended interviews; (V) focus groups and open-ended interviews; (VI) openended interviews. Results: (I) A high prevalence of FGC (100%) was stated among the respondents. Tradition and social importance were the main motives. The younger generation stated a change in practice, preferring the least severe form of FGC for their daughters. (II) 61% of the women included had undergone tightening vulvar operations after delivery, at the delivery wards, including women who had not been subjected to primary FGC. (III) Reinfibulation after delivery was widely practised and the main motives were social reason/tradition and alleged male sexual satisfaction. The younger generation of women described the midwife and older female relatives as being behind the decision. (IV) The midwives' motives for RI were to respond to the social requests and to benefit the women by increasing their beauty and value. (V) Women and men explained both negative health implications and perceived benefits of the practices. Both men and women were seen as victims of the consequences of the practices and blamed each other and the midwives for its persistence. (VI) The immigrant women's experienced suffering from being abandoned and mutilated, feeling vulnerable in the encounter with Swedish healthcare personnel, which led them to avoid seeking maternity care. Conclusion: This thesis indicates high prevalence of FGC and RI in settings in Sudan and health complications associated with the practices. The motives are not only social, sexual, traditional and economic, but also embrace normality, identity and power relations related to paternalism, maternalism and patriarchy. Deficient communication was demonstrated between women and men in Sudan and between women and midwives, both in Sudan and in Sweden. This thesis also shows that there is still a need of increased practical skills related to FGC among Swedish healthcare personnel and continuous training to meet culturally specific health needs

The successful factors of Swedish and Norwegian breastfeeding interventions programs as inspiration to promote breastfeeding internationally - presentation of the future joint project between Sweden and Norway

Findings from international research as well as from Sweden show that breastfeeding is important for infant health. Further there are still needs to continuously invest on the society level to promote the breastfeeding. Working together in international research collaborations can empower all partners involved.   The projects’ aims are to describe the successful factors of Swedish and Norwegian breastfeeding interventions programs on national level, and to elucidate the present situation and background of the present low rates of breastfeeding. Further the aim is to develop the Nordic breastfeeding model.     Data will be collected between September and December 2013 by individual and focus group interviews with obstetricians, midwifes, district nurses, paediatricians and voluntary breastfeeding advisers in both countries. Further the outcomes from the interviews will be used to creation of the questionnaire that will be tested and power analysis performed during the spring at 2014.   The findings will be used to promote breastfeeding and inspire other countries spatially high-income countries to focus on the benefits and importance of the breastfeeding to infant’s health

PARENTS 'VIEW OF INFLUENCE IN THE PRE-SCHOOL

Denna studie syftar till att synliggöra föräldrars syn på olika samverkansformer inom förskolan med fokus på föräldrainflytande. Ett kvalitativt angreppssätt har använts för att genomföra studien. Resultatet visar att föräldrar med annat modersmål än svenska upplever utmaningar med att ha inflytande om regler och rutiner på grund av språkliga och kulturella skillnader. Mammor känner sig mer inkluderade i barnens utbildning och känner fler möjligheter till att ha inflytande än pappor. Föräldrarna vill ha inflytande i barnens utbildning till viss del men genom olika samverkansformer. Vilka samverkansformer de föredrar kan relateras till personlighet. En viss maktstruktur finns och strukturen har betydelse för föräldrarnas inflytande. Studien är tolkad utifrån Foucaults maktperspektiv. Enligt Foucault är det utformandet av rutiner, förutbestämda regler och normer som skapar maktrelationer. Slutsatsen är att föräldrars personlighet, kön och modersmål samt styrkan i relationer är betydande för deras möjlighet till inflytande

PARENTS 'VIEW OF INFLUENCE IN THE PRE-SCHOOL

Denna studie syftar till att synliggöra föräldrars syn på olika samverkansformer inom förskolan med fokus på föräldrainflytande. Ett kvalitativt angreppssätt har använts för att genomföra studien. Resultatet visar att föräldrar med annat modersmål än svenska upplever utmaningar med att ha inflytande om regler och rutiner på grund av språkliga och kulturella skillnader. Mammor känner sig mer inkluderade i barnens utbildning och känner fler möjligheter till att ha inflytande än pappor. Föräldrarna vill ha inflytande i barnens utbildning till viss del men genom olika samverkansformer. Vilka samverkansformer de föredrar kan relateras till personlighet. En viss maktstruktur finns och strukturen har betydelse för föräldrarnas inflytande. Studien är tolkad utifrån Foucaults maktperspektiv. Enligt Foucault är det utformandet av rutiner, förutbestämda regler och normer som skapar maktrelationer. Slutsatsen är att föräldrars personlighet, kön och modersmål samt styrkan i relationer är betydande för deras möjlighet till inflytande

'There's something in their eyes' - Child Health Services nurses' experiences of identifying signs of postpartum depression in non-Swedish-speaking immigrant mothers

BACKGROUND: Due to the current world situation, Sweden has one of the highest asylum applications within the European Union. Immigrant mothers, specifically those who have immigrated during the last ten years and do not speak the language of the new country, are found to be at particular risk of being effected by postpartum depression.AIM: In this study, we elucidate Swedish Child Health Services nurses' experiences of identifying signs of postpartum depression in non-Swedish-speaking immigrant mothers.METHODS: Latent content analysis was used when analysing data material from 13 research interviews.RESULTS: Being able to interpret a non-Swedish-speaking immigrant mother's mood required establishing and constant deepening of a transcultural caring relationship, the use of cultural knowledge to perceive signs of postpartum depression from observations and interactions and to rely on intuition.CONCLUSION: There are both challenges and key factors for success in interpreting the mood of non-Swedish-speaking immigrant mothers.IMPLICATIONS: This study provides information to healthcare professionals about challenges with adapting the screening with the Edinburgh Postnatal Depression Scale to immigrant mothers not speaking the language of residence. Tacit knowledge and cultural competence among healthcare personnel are invaluable assets when interpreting mental health in this vulnerable group of mothers

Caring for undernourished patients in an orthopaedic setting.

This study elucidates the nursing of undernourished patients as experienced by eight registered clinical nurses and five nursing assistants by using content analysis. The participants' narratives describe the inner perspective of caring for undernourished patients, known in Sweden as ;the thin ones'. Categories identified were: frustration in nursing, joy in nursing and that undernourishment is taboo. The taboo was narrated as feelings of guilt and shame. Frustration in nursing could be seen as feeling stressed, exposed, lonely, powerless, helpless, and being torn between demands and needs. Joy in nursing was experienced when creating a trusting relationship, promoting pleasure in the meal situation and working with respect for each individual's life-style and context of life. Understanding staff members' views is important when implementing guidelines as well as in the teaching situation in order to identify where staff stand with regard to knowledge and attitudes

Perceptions and experiences of female genital mutilation after immigration to Sweden: An explorative study

Aim: The aim of this study is to explore how women from part of the world where female genital mutilation (FGM) is normative perceive and experience FGM after immigrating to Sweden. Method: Interviews were conducted with eight women from Djibouti, Eritrea, Ethiopia and Somalia. The data were analyzed using qualitative content analysis. Results: The women's feelings were ambivalent: though they opposed FGM, on the one hand, because of its negative effects on health, they acknowledged the practice's positive cultural aspects on the other hand. The themes that emerged from the interviews are the role of FGM in ensuring virginity and protecting a family's honor, its role in avoiding shame and enhancing purity, social pressure experienced after immigration, an understanding of FGM as a symbol of the country of origin, and support for changing the tradition. Conclusion: These findings indicate that women originating from communities where FGM is normative live in a context in which the practice is viewed as an important aspect of life even after immigration. More research concerning this complex and deeply rooted cultural issue is recommended. (C) 2013 Elsevier B.V. All rights reserved