"The fairer the better?" Use of potentially toxic skin bleaching products.

Background: Skin bleaching is a widespread phenomenon in spite of their potentially toxic health effects.Objectives: This study aimed to determine if such products are used in Sweden in particular by pregnant women, furthermore to explore immigrant women’s view skin bleaching.Methods: 455 pregnant women completed a questionnaire, which were statistically analysed. Focus groups and individual interviews were conducted with immigrant women, content analysis was used to assess the data.Results: Skin bleaching products were used by 2.6% of pregnant women, significantlly more by women born in non-European countries. Motivating factors were associated with the concept of beauty together with social and economic advantages. The women had low awareness of the potential health risks of the products. Regulations on the trade of skin bleaching products have not effectively reduced the availability of the products in Sweden nor the popularity of skin bleaching.Conclusion: There is need for further research especially among pregnant women and possible effects on newborns. Products should be tested for toxicity. Public health information should be developed and health care providers educated and aware of this practice, due to their potential negative health implications.Keywords: Skin bleaching; harmful practice; pregnanc

Factors shaping political priorities for violence against women-mitigation policies in Sri Lanka.

BACKGROUND: Although violence against women (VAW) is a global public health issue, its importance as a health issue is often unrecognized in legal and health policy documents. This paper uses Sri Lanka as a case study to explore the factors influencing the national policy response to VAW, particularly by the health sector. METHODS: A document based health policy analysis was conducted to examine current policy responses to VAW in Sri Lanka using the Shiffman and Smith (2007) policy analysis framework. RESULTS: The findings suggest that the networks and influences of various actors in Sri Lanka, and their ideas used to frame the issue of VAW, have been particularly important in shaping the nature of the policy response to date. The Ministry of Women and Child Affairs led the national response on VAW, but suffered from limited financial and political support. Results also suggest that there was low engagement by the health sector in the initial policy response to VAW in Sri Lanka, which focused primarily on criminal legislation, following global influences. Furthermore, a lack of empirical data on VAW has impeded its promotion as a health policy issue, despite financial support from international organisations enabling an initial health systems response by the Ministry of Health. Until a legal framework was established (2005), the political context provided limited opportunities for VAW to also be construed as a health issue. It was only then that the Ministry of Health got legitimacy to institutionalise VAW services. CONCLUSION: Nearly a decade later, a change in government has led to a new national plan on VAW, giving a clear role to the health sector in the fight against VAW. High-level political will, criminalisation of violence, coalesced women's groups advocating for legislative change, prevalence data, and financial support from influential institutions are all critical elements helping frame violence as a national public health issue

"The fairer the better?" Use of potentially toxic skin bleaching products.

Background: Skin bleaching is a widespread phenomenon in spite of their potentially toxic health effects. Objectives: This study aimed to determine if such products are used in Sweden in particular by pregnant women, furthermore to explore immigrant women\u2019s view skin bleaching. Methods: 455 pregnant women completed a questionnaire, which were statistically analysed. Focus groups and individual interviews were conducted with immigrant women, content analysis was used to assess the data. Results: Skin bleaching products were used by 2.6% of pregnant women, significantlly more by women born in non-European countries. Motivating factors were associated with the concept of beauty together with social and economic advantages. The women had low awareness of the potential health risks of the products. Regulations on the trade of skin bleaching products have not effectively reduced the availability of the products in Sweden nor the popularity of skin bleaching. Conclusion: There is need for further research especially among pregnant women and possible effects on newborns. Products should be tested for toxicity. Public health information should be developed and health care providers educated and aware of this practice, due to their potential negative health implications

Current and emerging developments in subseasonal to decadal prediction

Weather and climate variations of subseasonal to decadal timescales can have enormous social, economic and environmental impacts, making skillful predictions on these timescales a valuable tool for decision makers. As such, there is a growing interest in the scientific, operational and applications communities in developing forecasts to improve our foreknowledge of extreme events. On subseasonal to seasonal (S2S) timescales, these include high-impact meteorological events such as tropical cyclones, extratropical storms, floods, droughts, and heat and cold waves. On seasonal to decadal (S2D) timescales, while the focus remains broadly similar (e.g., on precipitation, surface and upper ocean temperatures and their effects on the probabilities of high-impact meteorological events), understanding the roles of internal and externally-forced variability such as anthropogenic warming in forecasts also becomes important. The S2S and S2D communities share common scientific and technical challenges. These include forecast initialization and ensemble generation; initialization shock and drift; understanding the onset of model systematic errors; bias correct, calibration and forecast quality assessment; model resolution; atmosphere-ocean coupling; sources and expectations for predictability; and linking research, operational forecasting, and end user needs. In September 2018 a coordinated pair of international conferences, framed by the above challenges, was organized jointly by the World Climate Research Programme (WCRP) and the World Weather Research Prograame (WWRP). These conferences surveyed the state of S2S and S2D prediction, ongoing research, and future needs, providing an ideal basis for synthesizing current and emerging developments in these areas that promise to enhance future operational services. This article provides such a synthesis

Telling lives : children's stories of hope, loss, love, and violence in Aotearoa/New Zealand : a thesis presented in partial fulfillment of the requirements for the degree of Doctor of Philosophy in Social Anthropology at Massey University, Palmerston North, New Zealand

This is a descriptive, exploratory study of children’s experiences and understandings of domestic violence in the Manawatu region of Aotearoa/New Zealand. It responds to the historical absence of children in anthropological research and in studies of domestic violence. The research is based on data gathered through group activities and discussions with children, five to twelve years old, in a domestic violence education and support group. A series of life history interviews was also undertaken. The study uncovers a myriad of ways that children make sense of domestic violence; incorporate their experiences of domestic violence into their identities; and manipulate, adapt, disrupt, or reproduce cultural knowledge about domestic violence in their own lives and relationships. Special focus is given to the role of helping or compassionate social relationships in children’s lives, not only for the physical safety of children but also for their ability to cope with domestic violence and bounce back from other hardships in life. The children’s narratives shared in this study have practical implications for domestic violence service delivery in New Zealand, as well as applied research with children more generally. The study also highlights children’s capacities for powerful observations, insights, and critical analysis. The thesis itself incorporates many different modes of data (re-)presentation, including poetry, drama, vignettes, and experiments with narrative voice and researcher reflexivity. The use of these literary forms helps to weave multiple perspectives into the thesis, allowing participants to speak for themselves. It also assists in producing an engaging and accessible account of children’s lives, which shows or represents lived experience, an alternative to the large number of statistical analyses that exist in the literature on domestic violence

How are private medical colleges collaborating with the National TB Control Programme in Nepal, a qualitative study

Background: Tuberculosis (TB) is an enduring public health problem in Nepal. This study aimed to uncover the experiences and attitudes of health workers at Private medical colleges (PMCs) towards the National TB Control Programme (NTP). Methods: Strategic and convenience sampling were used to identify health personnel participating in TB care at PMCs affiliated to Kathmandu University. Three focus group interviews were held with 19 participants. Audio recordings of the discussions were transcribed, and thematic analysis was conducted. Results: The PMCs treat many TB patients and regularly refer patients to DOTS clinics for treatment, but the PMCs don’t feel well integrated into the NTP. There are gaps between the NTP programmes/ guidelines and clinical realities, and the PMCs would like to participate in developing national guidelines and the NTP`s monitoring and evaluation initiatives. There is also a lack of communication within and between levels. Clear lines of management and responsibility, and more training of staff at all levels, are wanted. Conclusion: Increased involvement of PMCs in national TB control activities is important to improve TB care. Clearer guidelines from the government about the involvement of PMCs in TB control are also needed, as is better collaboration between the NTP and PMCs

Feasibility of Participatory Theater Workshops to Increase Staff Awareness of and Readiness to Respond to Abuse in Health Care: A Qualitative Study of a Pilot Intervention Using Forum Play among Sri Lankan Health Care Providers

Women globally experience mistreatment by health providers during childbirth. Researchers have identified strategies to counteract this type of abuse in health care, but few have been evaluated. We used a theater technique, Forum Play, in a brief training intervention to increase awareness of abuse in health care and promote taking action to reduce or prevent it. The intervention was implemented in four workshops with 50 participating physicians and nurses from three hospitals in Colombo, Sri Lanka. This article reports the views of 23 workshop participants who also took part in four focus group discussions on the acceptability and feasibility of the method. The participants reported that the intervention method stimulated dialogue and critical reflection and increased their awareness of the everyday nature of abuses experienced by patients. Participants appreciated the participatory format of Forum Play, which allowed them to re-enact scenarios they had experienced and rehearse realistic actions to improve patient care in these situations. Structural factors were reported as limitations to the effectiveness of the intervention, including under-developed systems for protecting patient rights and reporting health provider abuses. Nonetheless, the study indicates the acceptability and feasibility of a theater-based training intervention for reducing the mistreatment of patients by health care providers in Sri Lanka

Perceptions on the sexual harassment of female nurses in a state hospital in Sri Lanka : a qualitative study

Background: Sexual harassment occurs within the nursing profession globally, challenging the health and safety of nurses and the quality and efficiency of health systems. In Sri Lanka, no studies have explored this issue in the health sector; however, female employees face sexual harassment in other workplace settings. Objective: To explore female nurses' perceptions of workplace sexual harassment in a large state hospital in Sri Lanka. Methods: This is a qualitative study conducted in an urban, mainly Buddhist and Singhalese context. We invited all female senior and ward nurses working in the hospital to participate in the study. We conducted individual in-depth interviews with four senior nurses and focus group discussions with 29 nurses in three groups. Results: The nurses described a variety of perceived forms of sexual harassment in the hospital. They discussed patient-perpetrated incidents as the most threatening and the clearest to identify compared with incidents involving doctors and other co-workers. There was significant ambiguity regarding sexual consent and coercion in relationships between female nurses and male doctors, which were described as holding potential for exploitation or harassment. The nurses reported that typical reactions to sexual harassment were passive. Alternatively, they described encountering inaction or victim blaming when they attempted to formally report incidents. They perceived that workplace sexual harassment has contributed to negative societal attitudes about the nursing profession and discussed various informal strategies, such as working in teams, to protect themselves from sexual harassment in the hospital. Conclusions: Sexual harassment was a perceived workplace concern for nurses in this hospital. To develop effective local prevention and intervention responses, further research is required to determine the magnitude of the problem and explore differences in responses to and consequences of sexual harassment based on perpetrator type and intent, and personal vulnerabilities of the victims, among other factors

‘Violence exists to show manhood’: Nepali men’s views on domestic violence – a qualitative study

Background: There is significant evidence of the prevalence and factors associated with domestic violence in high and low-income country settings. However, men’s views on domestic violence are still understudied and have never been reported in Nepali society. Objective: The aim of the study was to explore Nepali men’s perceptions regarding domestic violence in their communities. Method: The authors undertook a qualitative study using focus group discussions. Results: Sixty-six married men, considered they were responsible for upholding family discipline and physically demonstrating their masculinity, and they suggested that violence was a mean for achieving this. Men’s frustration when unable to fulfil their family’s expectations or material needs, and cultural attitudes that precluded interference in other families’ lives, were perceived as factors contributing to domestic violence. The men held the opinion that women also perpetrated domestic violence. Some men were reluctant to accept domestic violence as a norm in Nepali families and were aware of recent changes in societal expectations regarding gender roles. Conclusion: Overall, the Nepali men who participated in the study held different and sometimes opposing views on domestic violence, ranging from violence justified as a necessity for family discipline, uneasy acceptance that violence was commonplace in families, to definite opposition to the use of domestic violence. The study’s findings provide information for identifying points of intervention for violence-prevention efforts and strategies to alter the social and cultural norms that lead to acceptance of domestic violenc