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Objective: This review demonstrates that women who encounter the Australian criminal justice system include some of the most disadvantaged and mentally unwell people in society, particularly Aboriginal women. Women in custody are a heterogeneous group and have different psychosocial needs when compared to male prisoners. Conclusion: The approaches to female offending must address their significant psychosocial and mental health issues at every point of contact with the criminal justice system, be culturally informed and specifically address Indigenous overrepresentation. [ABSTRACT FROM AUTHOR]

Leisure has the potential to contribute to processes of colonization and decolonization. In this paper, we propose using trauma-informed practice as part of a decolonizing process in leisure service provision. While trauma-informed practice continues to have it critiques and limitations from a decolonizing perspective, its recognition of the widespread impact of trauma, the role colonization plays in this trauma, and the value it places on safety, trust, empowerment, collaboration, and practitioner humility and responsiveness may provide leisure professional guidance in decolonizing their practice. This paper presents a project involving Indigenous women, which incorporated aspects of TIP into the facilitation of an arts-based leisure workshop. Using poetic-representation—a method purposefully used to evoke and awaken emotions, the paper highlights experiences of challenge, discovery and release, and collective responsibility. Implications emphasize engaging in a conscious and deliberate process that incorporates arts-based leisure, aims to address colonization (e.g., trauma and oppressive systemic structures), and works towards social justice. [ABSTRACT FROM AUTHOR]

Background: Although it is generally believed that the femoral neck fracture is related to the femoral neck geometric parameters (FNGPs), the association between the risk of osteoporotic fracture of the femoral neck and FNGPs in native Chinese women is still unclear. Methods: A total of 374 female patients (mean age 70.2 ± 9.32 years) with osteoporotic fracture of the femoral neck, and 374 non-fracture control groups were completely matched with the case group according to the age ratio of 1:1. Using DXA bone densitometer to measured eight FNGPs: the outer diameter (OD), cross-sectional area (CSA), cortical thickness (CT), endocortical diameter (ED), buckling ratio (BR), section modulus (SM), cross-sectional moment of inertia (CSMI), and compressive strength index (CSI) at the narrowest point of the femoral neck. Results: Compared with the control group, the average values of OD (2.9%), ED (4.5%), and BR (26.1%) in the patient group significantly increased (p = 0.015 to < 0.001), while CSA (‒15.3%), CT (‒18.2%), SM (‒10.3%), CSMI (‒6.4%), and CSI (‒10.8%) significantly decreased (all p < 0.001). The prevalence of osteoporosis in the lumbar spine, femoral neck, and total hip was, respectively, 82%, 81%, and 65% in fracture patients. Cox proportional hazard model analysis showed that in the age adjusted model, the fracture hazard ratio (HR) of CSA, CT, BR, SM, and CSI significantly increased (HRs = 1.60‒8.33; 95% CI = 1.08‒16.6; all p < 0.001). In the model adjusted for age and femoral neck BMD, HRs of CT (HRs = 3.90‒8.03; 95% CI = 2.45‒15.1; all p < 0.001) and BR (HRs = 1.62‒2.60; 95% CI = 1.20‒5.44; all p < 0.001) were still significantly increased. Conclusion: These results suggest that the majority of osteoporotic fractures of the femoral neck of native Chinese women occur in patients with osteoporosis. CT thinning or BR increase of FNGPs may be independent predictors of fragility fracture of femoral neck in native Chinese women unrelated to BMD. [ABSTRACT FROM AUTHOR]

This collaborative paper explores the interconnections between climate change and the mental health and well‐being of Indigenous women in Western Canada. As the impacts of climate change intensify globally, vulnerable populations, particularly Indigenous communities, face disproportionate and multifaceted challenges. Centering on Indigenous women in Western Canada, this study explores how the climate crisis magnifies Indigenous communities' mental health disparities. Drawing from the Indigenist feminist research approach, the investigation focuses on Indigenous women's lived experiences, perceptions, and land‐based coping strategies amidst climate challenges, while simultaneously addressing the unique social, cultural, and historical factors influencing their mental health vulnerabilities within the context of climate change. The findings shed light on the complex relationships between environmental degradation, ongoing colonial impacts on traditional practices, and the mental well‐being of Indigenous women. Concluding with implications for policy and community‐led interventions, this research contributes to the discourse on the intersectionality of climate change impacts and mental health, particularly focusing on Indigenous women in Western Canada. [ABSTRACT FROM AUTHOR]

Faced with the violence produced by coloniality and the resistance woven by the multiplicity present in the body-territory of indigenous and black women. This article seeks to reflect on the contributions of the writings of the Tehêy de Pescaria do Conhecimento by indigenous teacher Dona Liça Pataxoop to the weaving of research committed to knowledge, ancestral memories and the body-territory of indigenous and black women. In this study, the act of "Tehêyá" is seen as a form of literacy for the political and subjective formation of the body-territory, as well as a methodological device for "sharpening our gaze", to think of alternatives that can connect the various worlds that have been fragmented by the Modern/Colonial System. We conclude that Tehêy de Pescaria do Conhecimento positions itself as an intersectional, embodied, localized and autobiographical way of knowing. These positions reaffirm ethical and methodological frameworks committed to the voices of the women of Abya Yala and also question the objectivity defended by the traditional sciences. [ABSTRACT FROM AUTHOR]

Simple Summary: The current evidence regarding Indigenous* women and breast cancer in Australia shows lower prevalence but higher mortality rates. There are a range of reasons for this, including co-morbidities, lack of access to health services and low health information fluency. Perhaps most importantly, breast cancer health policy and service delivery practice do not meet the needs of Indigenous women in Australia, according to Indigenous women. Talking and listening to Indigenous women about breast cancer highlight that the solutions to improve breast cancer outcomes are available and that they are not complex. Indigenous women must be involved in the improvement of policy and practice in order for these outcomes to improve. *Terminology: We respectfully refer to Aboriginal and Torres Strait Islander people as "Indigenous". In Australia, the incidence rate of breast cancer is lower in Indigenous* women than non-Indigenous women; however, the mortality rate is higher, with Indigenous women 1.2 times more likely to die from the disease. This paper provides practical and achievable solutions to improve health outcomes for Indigenous women with breast cancer in Australia. This research employed the Context–Mechanism–Outcome (CMO) framework to reveal potential mechanisms and contextual factors that influence breast cancer outcomes for Indigenous women, stratified into multiple levels, namely, micro (interpersonal), meso (systemic) and macro (policy) levels. The CMO framework allowed us to interpret evidence regarding Indigenous women and breast cancer and provides nine practical ways to improve health outcomes and survival rates. [ABSTRACT FROM AUTHOR]

This article uses two case studies, a charitable foundation that provided dowries to orphans as well as efforts to fundraise for a convent for Indigenous women, to explore how philanthropy functioned in late colonial Oaxaca, Mexico. I argue that in both cases, gendered rhetoric proved essential for constructing compelling reasons for wealthy individuals to donate money. Additionally, both projects were intrinsically connected with material culture--ranging from the physical accoutrements of the lottery drawing to choose a dowry winner, to the geographic location and building structure of the convent. These material properties are still visible in Oaxaca today. [ABSTRACT FROM AUTHOR]

Objective: Community college transfer pathways are critical for advancing gender equity in STEM. Yet, community college students are often ignored within studies of women's participation in undergraduate computing. In a first effort to address this gap in the literature, this paper explores the composition of transfer-intending computing students over time (Study One) and gender differences in the characteristics and experiences of transfer-intending computing students (Study Two). Methods: This descriptive paper uses Center for Community College Student Engagement (CCCSE) survey data. Study One relies on a sample of nearly 30,000 transfer aspirants in computing across the United States between 2011 and 2019, allowing us to explore trends over time. Study Two examines a subset of over 9,000 students from the most recent survey cohort, providing a more nuanced snapshot of transfer-intending computing students. Descriptive statistics were used to examine how student experiences differ by gender and race/ethnicity. Results: Study One findings show that women's representation among transfer-intending computing students has declined over time. Study Two results reveal that, relative to men, women spend more time caregiving, commuting, studying, in student groups, and utilizing advising services, pointing to unique demands on women's time. We also identify significant differences in how Black and Indigenous women financed their college, relative to other women. Conclusions: While women are underrepresented among transfer-intending computing students, they represent a diverse group to support. We point to recommendations for policy and practice to support transfer-intending women in STEM and future research that considers intersectional identities among this diverse group. [ABSTRACT FROM AUTHOR]

In order to analyse how social movements build alternative futures, this article explores the relationship between prefigurative politics and utopianism. A case study of the 'Indigenous Women's Movement for Buen Vivir' in Argentina will reveal how movement members shape alternative futures, while taking into account how everyday life influences their approaches to the future. Empirical data collected in 2019 shows that members define the present day as a crises-ridden dystopian age, exemplified by the conflicts they face which emerge from the resource-based development model of global capitalism. Extractivist activities are understood as destroyers of the planet and therefore are viewed as an imminent threat to human existence. Hence, the members aim to make the future possible by (re)constructing a reciprocity with nature as well as one between humans and other-than-human beings, in short, to realize Buen Vivir. To unravel how prefigurative practices and utopian imaginations intersect and co-constitute each other, I focus on how Buen Vivir is experienced in the movement through horizontality, spirituality, and autonomy. These experiences are framed by the actors as pre-colonial practices that are reconstructed in the present, as they seek to decolonise capitalist modernity 'so that there is a future'. This understanding reflects a cyclical temporality that inspires a processual, non-linear view of social change, which accompanies the indigenous women's 'prefigurative walking'. Thus, the linking of prefiguration with utopianism helps us in grasping the role of imagination, hopes, and visions for future transformations in the process of building alternative futures. [ABSTRACT FROM AUTHOR]

I conducted fieldwork in Umoja village, Samburu County, Kenya and Chorrera County, Colombia. These countries have a history of gender violence against Indigenous women and this violence often continues into contemporary times. Conversations about contemporary violence against Indigenous women in Chorrera's educational spaces—high school or the workshops of the local Indigenous organization—during the post-conflict period are painful and uncomfortable for them. Thus, I introduced the experience of Umoja from Kenya as a memory device to analyze the violence against Indigenous women and their educational expectations in Chorrera. These dialogues prompted by Umoja's analysis in Chorrera reveals the simultaneous opportunities of Indigenous women's collective memory, resistance, and challenges to girls' and women's access to traditional and formal education. [ABSTRACT FROM AUTHOR]

The strawberry is connected to heart teachings for many Indigenous people. The strawberry plant produces beautiful things. However, when exploring the topic of Indigenous women and heart health, the focus of the conversation is most often around deficits. Indigenous women have diseases related to the heart at a higher proportion than both non-Indigenous women and Indigenous men. There is a lack of understanding specific nations' relationships to heart, and there is little to no research available specific to Mi'kmaw (adjective for a Mi'kmaq (First Nations people, Atlantic provinces, Canada, who call themselves L'nu) person) women and heart health. The focus of this Mi'kmaq research, which aligned with community-based participatory research, was to explore and gain a better understanding of what heart means to Mi'kmaw women on the west coast of Newfoundland, Canada. Four Mi'kmaw women joined the research and shared their experiences to co-create knowledge about heart health. This knowledge in turn shaped my understanding of nursing practice. [ABSTRACT FROM AUTHOR]

This essay employs the "Korean War minor" as a methodological lens to demonstrate the need for more Asian Americanist critique at the intersection of American childhood studies and empire studies. While scholars have shown how children and children's culture were central to advancing US Cold War policy at home and abroad, this body of research largely neglects to interrogate the centrality of whiteness to dominant constructions of children/childhood. Attending to childhood as a technology of racist, patriarchal, imperial power, I elucidate how the biopolitics of the Korean War produce juvenile Asian-raced and gendered bodies at the precarious boundaries of childhood, as not quite children but, rather, childlike. I grapple, in particular, with how to reclaim the "girl" from US military archives, as the rubric of the "boy-mascot" and "camptown woman" overdetermine and constrain how the girl is allowed to come into view. I develop and enact this decolonial practice of reclaiming the Korean War minor through an analysis of Nora Okja Keller's Fox Girl , a novel that is particularly invested in narrating the camptown girl into being. Fox Girl directs attention to the limits of a politics of childhood innocence and prompts a generative reconceptualization of childhood in relation to justice. [ABSTRACT FROM AUTHOR]

In the intersection of Indigenous tourism and gender, a pressing question arises: How can Indigenous women lead sustainability and gender equality in the tourism industry? To shed light on this issue, we conducted qualitative and case study research in the Amazonia region of Ecuador. Our study analysed the roles that Napo Runa women play in tourism development, their efforts to align tourism with their sustainability and gender equality goals, and the factors that shape these efforts. Our findings highlight the importance of focusing on the relationships that surround Indigenous women and recognizing the various forms of discrimination they face. We also found that Indigenous planning, led by Indigenous women, is a crucial tool for promoting more visible and empowered roles for Indigenous women in the tourism sector. The case study supports the argument that addressing gender inequality is a crucial first step toward sustainable business practices, especially in cases where women's economic participation is invisible and influenced by violence and gender discrimination. This research contributes to the work of scholars and practitioners aiming to advance sustainability and justice in the tourism industry. [ABSTRACT FROM AUTHOR]

The CONIAE (Confederation of Indigenous Nationalities of Ecuador) continuously critiques the global capitalist neoliberal structure. Similarly, this Indigenous critique is embodied in the projects studying the past in the Ecuadorian territory, particularly in the research of the gendered/sexual relations of the Enchaquirados during the pre-Hispanic period. This article builds upon this ethnohistorical research to show how these noncapitalist forms of economic, political, and gendered/sexual relationships continued to develop and evolve alternative forms of agency, livelihood and resistance. In Engabao (one of Ecuador's many rural coastal communities), like in the CONAIE'S discourse, these cultural alternatives to the capitalist system tie this historical past to an agent-filled resistant Indigenous political present. [ABSTRACT FROM AUTHOR]

Native women in Indigenous‐Western colonial entanglements are often portrayed as passive agents with little transformative social power in an otherwise dynamic landscape. However, Native women throughout the European colonial world many times controlled the most important resource required by European colonists: the knowledge and materials necessary to transform raw materials into "food." Their control over this invaluable resource provided Native women with avenues of power both within their own societies and in European colonies. Here, we explore constructions and perceptions of Native women's power during the period of sixteenth‐century Spanish expeditions into the Carolina Piedmont and mountains by reviewing documentary data from entradas led by Hernando de Soto and Juan Pardo, as well as archaeological data from the Indigenous town of Joara and the Spanish colonial outpost of Cuenca and Fort San Juan at the Berry site (31BK22), located near Morganton, North Carolina. Employing an Indigenous feminist framework, we argue that the power vested in Native women through their own societies, as well as by Spaniards through their dependence on them for survival, provided Native women with far greater agency and power in entanglements with Spanish colonists, and interactions with European colonists more broadly, than previously recognized. [ABSTRACT FROM AUTHOR]

In this paper, Indigenous and non-Indigenous scholars used a decolonial conversation framework to build a meaningful bridge between Indigenous and Western worldviews. Our decolonial conversations approach is a unique and transformative space where Indigenous and Western knowledge systems intersect, facilitating a rich exchange of valuable insights for fostering intercultural dialogue and breathing new ways of knowing and acting into Indigenous cultures. The decolonial conversation provides a platform for transmitting Indigenous knowledge and cultural practices across generations by uniting Indigenous land-based knowledge, community members, and Western researchers. Integrating Indigenous and Western knowledge systems in these environments fosters collaboration, dispels stereotypes, and forges partnerships grounded in reciprocity and trust. Through this collaborative process, traditional cultural camps emerge as potent catalysts for instilling cultural pride, fostering community resilience, and co-creating knowledge. This collaborative approach aligns with the broader objectives of decolonization and cultural revitalization. In our exploration following the decolonial learning conversation, we, comprising an Indigenous woman land-based educator and a racialized academic scholar, focused on the transformative potential and synergies realized by integrating these knowledge systems within the context of traditional cultural camps. [ABSTRACT FROM AUTHOR]

Cervical cancer, primarily caused by Human Papillomavirus (HPV) transmission through sexual contact, necessitates comprehensive strategies to combat its impact on women's health. Yet, certain underserved populations, such as low socioeconomic and ethnic minority groups, encounter barriers in accessing timely interventions and early diagnosis. This cross-sectional study was conducted with the aim of assessing HPV prevalence, genotype distribution, and co-infections among 280 adult women residing in a Colombian Indigenous Reserve within the Amazon region. The research adhered to a community-centric approach that respected cultural norms, native languages, and Indigenous authorities' permission. The study revealed an overall HPV infection prevalence of 31.1% (n = 87, 95% CI 25.7–36.8), with 22.5% (n = 63, 95% CI 17.7–27.8) of women infected by at least one high-risk HPV genotype and 15.0% (n = 42, 95% CI 11–19.7) infected by at least one LR genotype. These results align with the findings of other Colombian studies. Notable high-frequency genotypes included 16, 52, 66, 56, and 68, with the most common combinations being [66–52] and [66–58]. The study also assessed the prevalence of HPV vaccination, revealing a rate of 22.9%, lower than the national average. In vaccinated women, the prevalence of genotypes 16 and 18 was significantly reduced, as anticipated. Importantly, it was observed that 57.1% of all high-risk HPV infections could have been prevented with the use of the nonavalent vaccine. These findings underscore the critical need to enhance adherence to early cervical cancer detection and monitor positive cases to evaluate high-risk HPV persistence. Efforts should be directed toward continuing vaccination coverage against high-risk HPV 16 and 18 with the quadrivalent vaccine, while also striving to make the nonavalent vaccine accessible for inclusion in large-scale public health programs. Additionally, the study did not identify a specific pattern of co-infection. The study emphasizes the significance of adopting a locally tailored epidemiological approach to guide and promote cervical cancer prevention efforts in Indigenous communities. [ABSTRACT FROM AUTHOR]

This article discusses everyday spatial heritage practices in Rio de Janeiro's favelas. It focusses on the experiences of faveladas, Black and poor women residents of the favelas, as they build their houses and struggle for political memory in the city. Based on ethnographic fieldwork and photowalks conducted in 2011–2013 and 2018 with residents of the favelas of Pavão-Pavãozinho and Cantagalo (PPG), this article documents the insurgent heritage practices of 'women warriors' and analyses the ways in which these practices typify means of resistance to urban coloniality. I draw on theories by the Afro-Brazilian feminist scholars and activists Beatriz Nascimento on quilombos (maroon communities) and Lélia Gonzalez on 'Amefricanity', who recourse to black and indigenous women's Southern Atlantic experiences of oppression and forced migration and of resistance, to suggest the notion of 'Amefrican' heritage practices. The women warriors' spatial practices and resistance encompass curated favela heritage. They challenge prejudice against the favelas and Afro-Brazilians, thereby sustaining 'Amefrican' heritage practices and shaping Rio de Janeiro's cultural heritage and future, especially against contemporary processes of urban coloniality. [ABSTRACT FROM AUTHOR]

In the land now known as Brazil, Indigenous women were responsible for cultivating and preparing a tuberous root called mandioca (cassava). Following the arrival of Europeans in 1500, mandioca replaced wheat bread to become the staple carbohydrate in settlers' diets. Travellers' accounts between 1500 and 1550 describe how Indigenous women taught settlers to prepare the tubers for consumption through the use of special tools and processes of soaking, drying and pulverizing. However, with the arrival of the Jesuits, European sources began to elide or problematize knowledge among Indigenous women that did not cohere with Christian normative values. By the mid seventeenth century, naturalists were no longer acknowledging the original female informants who had taught Europeans how to identify and cultivate the plant. In line with recent scholarship on the history of science and medicine in colonial contexts, a close reading of the sources reflects the importance of Indigenous knowledges to imperial expansion, on the one hand, and the interactive nature of cross-cultural knowledge sharing that became hidden by early modern European epistemological practices. Drawing on a broad body of colonial documentation, this article examines how European representations of the cultivation of mandioca identified, exploited, assimilated, suppressed and, finally, alienated Indigenous women's knowledges from their original holders between 1500 and 1650. [ABSTRACT FROM AUTHOR]

Aim: This study aims to map intimate partner violence evidence among indigenous women and explore the prevalence, social and systemic factors contributing to this occurrence. Methods: This is a scoping review following the steps recommended by the JBI. We searched the MEDLINE/PubMed®, Web of Science™, Embase, CINAHL and LILACS databases on March 2023. Studies that addressed the intimate partner violence topic among indigenous women and risk factors, without time and language limitations, were included. Detailed information was extracted, standardized by JBI. Results: Twenty studies of different designs were included, all published in English, between 2004 and 2022. A high intimate partner violence prevalence among indigenous women was identified, associated with a great diversity of risk factors. Conclusion: The great diversity of identified factors associated with its occurrence shows the complexity of this problem and the vulnerability of indigenous women. Summary statement: What is already known about this topic? Intimate partner violence is a serious social and public health problem.Worldwide, a third of women aged between 15 and 49 who have a partner have already experience or are experiencing intimate partner violence.One in three women experience intimate partner violence during their lifetime. What this paper adds? The study presents intimate partner violence prevalence among indigenous women based on evidence.The study explores the social and systemic factors that contribute to this prevalence. The implications of this paper: Nurses are necessary agents not only in providing care but also in articulating and developing strategies to deal with violence, especially intimate partner violence.In nurses' work with indigenous health, it is essential to understand the health–disease process in a broader way, including the ethnic–cultural aspects.The study points out that embracing, understanding and respecting cultural diversity and social support are aspects to be considered in prevention, protection and health promotion strategies for these women. [ABSTRACT FROM AUTHOR]

This paper looks at the migration of women from Bangladesh to the Middle East as short‐term migrants, mainly for work in the domestic care sector as domestic workers, housekeepers, nannies, cooks, etc. This group accounts for about 15 per cent of the total short‐term migration cohort. They face particular challenges around not only the precarity of their employment but also in navigating a series of patriarchal norms in both Bangladesh and the destination countries in the Middle East. The paper will build on the work of Deniz Kandiyoti and her seminal work on patriarchal bargains. This paper will explore the challenges women face in migrating to the Middle East: in their decision to migrate, their experiences abroad, and on return and reintegration into Bangladesh society and their home life, and how these are determined by a series of patriarchal bargains both in Bangladesh and the destination country. [ABSTRACT FROM AUTHOR]

Purpose: To develop a culturally-tailored American Indian/Alaska Native (AI/AN) women's Facebook group supporting opioid recovery as an adjunct to medication. Design: Community-based, qualitative approach. Setting: Minnesota, U.S. Participants: AI/AN women in opioid recovery, interested parties, and a Community Advisory Committee (CAC) of AI/AN women with lived experience, health care providers, and community members. Intervention: We developed evidence-based content focusing on stress/trauma and substance use, mindfulness, responding to triggers, and supportive community resources. Additional content centered on AI/AN culture was also selected. Method: Interviews were conducted by two women, then transcribed and coded using content analysis with NVivo software. Results were presented to CAC for further content refinement. Results: CAC members (n = 10) guided study methods, intervention development, and dissemination activities. 14 AI/AN women (mean age 36.4 years; mean 6.7 months opioid abstinence) and 12 interested parties (7 men, 5 women) were receptive to an AI/AN gender-specific Facebook group, preferring content with AI/AN people and/or text resonating with AI/AN culture (e.g., Native traditions, family, personal stories, historical trauma). Recommendations included (1) protect confidentiality, (2) retain positivity, (3) incorporate resources and exercises to build coping skills, and (4) moderators should be authentic and relatable to build trust. Conclusions: Our approach provides a model for developing culturally tailored, appealing and effective social media interventions to support AI/AN women in recovery from opioid use disorder. [ABSTRACT FROM AUTHOR]

Intimate partner abuse (IPA) is a public health crisis that disproportionately impacts indigenous women. We know little about rates and correlates of IPA victimization (IPAV) and abuse directed at one's partner (ADP) among indigenous women caregivers (people who take care of children). The purpose of the current study was to address this critical gap in the literature. Participants were 44 indigenous women caregivers in the United States in a current relationship who completed a survey. Most women reported IPAV and ADP experiences in the past 6 months, and IPAV and ADP abuse directed at partner were positively associated. Further, IPAV was positively associated with adverse childhood experiences (ACEs), participants' engagement in harsh parenting, and depressive symptoms. IPAV was negatively associated with age, income, indigenous cultural identity, and social support. ADP was positively associated with ACEs, harsh parenting, and depressive symptoms. ADP was negatively associated with age and income. ADP was not associated with indigenous cultural identity and social support. These data suggest the urgency with which efforts are needed to prevent and respond to IPA among indigenous women caregivers, especially those who are younger and of lower income, and that culturally grounded initiatives that seek to build social support may be especially impactful. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to determine the factors associated with negative birth experience in Peruvian Quechua‐speaking indigenous women in the context of contagion due to COVID‐19. Methods: This was a cross‐sectional study, with 142 women from the Olleros community (Huaraz‐Peru, 3336 m a.s.l.), whose birth occurred between November 2020 and December 2021. Two questionnaires were applied between January and June 2022, prior voluntary informed consent and approval by an ethics committee. The SPSS program version 24 and the odds ratio (OR) were used with 95% confidence interval (CI). Results: A total of 62.7% of women (89/142) had a negative birth experience. The main factors associated were hospital and biosafety factors, highlighting the restriction to choose the position during birth (OR = 15.64, CI: 1.89–128.99, P = 0.001), care of women in a language other than Quechua (OR = 5.86, CI: 1.51–22.76, P = 0.005) and fear of health personnel when approaching women due to COVID‐19 (OR = 10.61, CI: 3.94–28.56, P < 0.001). Conclusion: Hospital and biosafety factors are associated with negative birth experience in Peruvian Quechua‐speaking indigenous women, with less emphasis on sociodemographic and obstetric factors. The results found show that, in the case of this research, the negative birth experience is not only due to the restrictions imposed by COVID‐19 pandemic, but also to the limited application of the intercultural approach in Peru, where the opinion of women is not taken into account. In this sense, intervention actions are required through health policies with an intercultural approach that involve the active participation of women. Synopsis: There are hospital and biosafety factors associated with negative birth experience in Peruvian Quechua‐speaking women, due to restrictions by COVID‐19 and to limited application of intercultural approach. [ABSTRACT FROM AUTHOR]

AbstractThis paper examines contextual dynamics shaping the development of trust in the management of indigenous tourism. It focuses in particular on the role of women’s leadership in fostering community autonomy and a sense of community, which is argued to be key to building trusting relations essential to sustaining the tourism enterprise. Based on empirical fieldwork with the Pataxó Jaqueira community of Porto Seguro, Brazil involving document analysis, participant observation and interviews, the paper shows how trust, tradition and culturally embedded indigenous leadership capacities interact when seeking to develop and deliver tourism that meets community needs. The data show how investing in cultural resources builds social capital and reinforces the credibility women’s leadership, which is then leveraged to challenge patriarchal gender norms. Moreover, it identifies mechanisms of trust development and maintenance between entrepreneurial indigenous women and other community stakeholders, stressing the impacts of the women’s capacity for openness, solidarity and risk taking. The article thus provides contextualised and historically-informed, socio-cultural insights regarding the intersections of gender, trust and traditions in shaping sustainable indigenous tourism. [ABSTRACT FROM AUTHOR]

Background: Literature on barriers and facilitators for early detection of Breast Cancer (BC) among indigenous women is very scarce. This study aimed to identify barriers and facilitators for BC early diagnosis as perceived by women of the otomí ethnic group in Mexico. Methods: We performed an exploratory qualitative study. Data was collected in 2021 through three focus group interviews with 19 otomí women. The interview transcripts were analyzed using the constant comparison method and guided by a conceptual framework that integrates the Social Ecological Model (SEM), the Health Belief Model and the Institute of Medicine's Healthcare Quality Framework. Results: Barriers and facilitators were identified at several levels of the SEM. Among the main barriers reported by the study participants were: beliefs about illness, cancer stigma, cultural gender norms, access barriers to medical care, and mistreatment and discrimination by health care personnel. Our participants perceived as facilitators: information provided by doctors, social support, perceived severity of the disease and perceived benefits of seeking care for breast symptoms. Conclusions: Healthcare policies need to be responsive to the particular barriers faced by indigenous women in order to improve their participation in early detection and early help-seeking of care for breast symptoms. Measures to prevent and eradicate all forms of discrimination in healthcare are required to improve the quality of healthcare provided and the trust of the indigenous population in healthcare practitioners. [ABSTRACT FROM AUTHOR]

The word "sovereignty" implies "freedom from external control" and is synonymous with the terms autonomy, self-determination, and independence. That is, at least, how Merriam-Webster defines the term and how the Supreme Court treated Native Americans through the careful development of over 200 years of case law. The current bench of the Supreme Court, however, had a different perception of how the relationship between federal, state, and tribal governments should function. In its decision in Oklahoma v. Castro-Huerta, the majority decided the state now has authority to prosecute crimes traditionally reserved for the federal government. This decision incorrectly frames the jurisdictional dispute as one of preemption, whereas the correct analysis would follow well established precedent that promised tribes would remain sovereign and free from state interference. This Comment analyzes the majority opinion's flawed legal reasoning by evaluating the clear line of case law that was impliedly overruled without proper justification. This Comment maintains that this ruling fundamentally ignores the principle of tribal sovereignty, explores the negative impact it will have on Native rights, and proposes that states should invest resources into tribal communities rather than encroaching on their sovereignty. As support for this proposal, this Comment explores how tribal communities will face an increase in safety concerns and suffer potentially deadly consequences due to jurisdictional disputes. This Comment also supports its proposition to keep prosecutorial power in the hands of federal and tribal governments who prioritize unique concerns to Native peoples by analyzing the treatment of murdered and missing Indigenous women and girls. [ABSTRACT FROM AUTHOR]

In this article I examine the responses of Ngöbe indigenous women to experiences of gender violence, aided by concepts from Mesoamerican cosmology and the concept of agency as a practice of belonging (Weir, 2013). Emphasis is placed on responses to gender violence that rely on the connection to the Ngöbe identity and the renegotiation of relationships within the community and with external institutions. I also highlight the aspirations of indigenous Ngöbe women to ensure a full experience of their culture and their beliefs for themselves and for future generations. The empirical data comes from the ethnographic fieldwork in a Ngöbe indigenous community in southern Costa Rica undertaken during 2015 and 2016. In this article I conclude that women's substantive connection with their identity can reinforce their status in the community and expand the scope of their actions and as a result impact on the possibility of generating safe spaces for themselves and for other women in the community. Likewise, women have managed to establish and maintain supportive networks that offer spaces of protection. In the context of these networks, they have begun to renegotiate and reconfigure prevalent forms of relationship in the community and with external institutions. By setting these processes in motion, they promote respect for women's dignity and improve the well-being of the whole community. [ABSTRACT FROM AUTHOR]

Since colonisation, Australia’s criminal apparatus has targeted people on the basis of race and class through changing modes of legal control. This article explores two examples of collective resistance to this. In 2019, Sisters Inside’s FreeHer campaign enlisted community members to pay for the freedom of Aboriginal women imprisoned for non-payment of fines in Western Australia. Simultaneously, in the United States, bail funds enabled people to free those imprisoned due to inability to afford cash bail. In both examples, by paying for the freedom of strangers, the community inserts itself into otherwise opaque criminal processes, challenging the very reason for a person’s incarceration and disrupting the rhetorical divide between the community and the criminalised. Through the framework of demosprudence (ie, collective citizen mobilisations which are democracy-enhancing) and prison abolition, this article demonstrates the capacity for these forms of participatory resistance to contribute to transformative social and legal change. [ABSTRACT FROM AUTHOR]

This essay recovers the newspaper writings of the Omaha journalist Susette Bright Eyes La Flesche as the first Indigenous woman to publish about the 1890 Wounded Knee Massacre. Her eyewitness accounts challenge mainstream histories of the massacre that focus largely on frontier violence and Indigenous death by rewriting Wounded Knee as a place of Indigenous resilience and of an Indigenous community bound together by the rights and responsibilities of kinship. By prioritizing the stories of surviving Indigenous women and girls, Bright Eyes’s reporting speaks to and becomes a precedent for ongoing acts and discourses of Indigenous activism, feminism, resurgence, and selfdetermination. [ABSTRACT FROM AUTHOR]

Foreign aid plays a critical role in actualising pro-women outcomes in the Global South. However, there is a paucity of research on how gender and political ideology inform gender-oriented foreign aid to sub-Saharan countries. This study examines how gender and political ideology inform the trends of women-focused foreign aid donations from Australia, Canada, Finland, and Germany to sub-Saharan African nations from 2002 to 2016. During this period, government leaders and ministers in the donor countries were from different genders and political ideologies. The study reveals that female heads of government gave more women-focused aid to sub-Saharan Africa than male heads of government. The study also found that right-wing heads of government allocated more women-focused assistance to sub-Saharan Africa than left-wing politicians. This study points to the importance of the active role of female heads of government in effectively mainstreaming and furthering the idea of gender equality on a global scale. [ABSTRACT FROM AUTHOR]

The aim of this study is to defamiliarize Gayatri Spivak's pessimistic approach regarding the condition of the subaltern as a female subject. Spivak's subaltern, misrepresented by the male-dominated West and the male-dominated East and therefore not belonging to any particular social group, has no history and cannot speak for herself. The position of the subaltern woman is examined based on Buchi Emecheta's Kehinde (1994), which deals with the circular migration of the eponymous character - Kehinde - from Nigeria to England, back to Nigeria and then back to England. The novel explores the binary between the self and the other of the subaltern woman in relation to the native and host cultures. To this end, the study uses several postcolonial concepts by Homi K. Bhabha, discussed at length in his book The Location of Culture (1994), such as mimicry, liminality, appropriation, and ambivalence, which, in its turn, conceptualises the position of the Nigerian subaltern woman in relation to cultural difference. The study foregrounds the validity of the popular woman theory known as African feminism, which specifically addresses the situation of African women. This approach also makes it possible to redefine the traditional concept of femininity in Nigerian culture. The study shows how cultural difference affects the growing consciousness of the subaltern woman, which ultimately helps her to become an independent person. The study concludes that, unlike Spivak's subaltern, the Nigerian subaltern creates her own space from which she can speak for herself in the male-dominated society. [ABSTRACT FROM AUTHOR]

As early as 1989, Kimberlé Crenshaw had proposed investigating the interconnection between gender and ethnic identities, especially in her work about black identities. Subsequently, many scholars have extended investigation of the interconnection to the field of Indigenous studies. However, most studies focus on women's suffering, rather than their active engagement in the process of anti-colonial resistance and Indigenous identity formation. Despite painful colonial histories—including displacement and assimilation—Indigenous peoples have resisted and survived and have been revived. Indigenous women played a crucial part in these processes, but their contributions were often neglected or forgotten. Through analyses of two renowned post-colonial films— Seediq Bale (dir. Wei Te-sheng, 2011) from Taiwan and Utu (dir. Geoff Murphy, 1983) from New Zealand—this essay explores how Seediq and Maori women showed great strength in Austronesian indigenous people's resistance to colonialism and in their campaign to rewrite history. [ABSTRACT FROM AUTHOR]

Maylei Blackwell's book, "Scales of Resistance: Indigenous Women's Transborder Activism," explores the activism of Indigenous women in Mexico and the Latin American Indigenous diaspora. Blackwell's methodology draws from oral histories, ethnography, and community-based digital storytelling to analyze how these women organize and create new spaces of participation and consciousness. The book engages with theories of Indigenous feminisms, critical Indigenous studies, transnational social movements, and more. Blackwell's personal investment in her relationships with activists is evident throughout the book, providing a reading experience that counters feelings of loneliness. [Extracted from the article]

Background: Indigenous women are vulnerable to cervical cancer. Screening is a strategy to reduce the burden of the disease. Objective: To evaluate the prevalence profile of cervical cancer screening cytological results in Brazilian indigenous women by age and frequency of tests compared to non-indigenous women. Methods: A cross-sectional study evaluating the prevalences of screening test results in indigenous women assisted in the Brazilian Amazon from 2007 to 2019 (3,231 tests), compared to non-indigenous women (698,415 tests). The main outcome was the cytological result. Other variables were frequency, age groups, and population. The frequency was categorized as "1st test", the first test performed by the women in their lifetime, or "screening test," tests from women who had previously participated in screening. Analyzes were based on prevalences by age group and population. We used Prevalence Ratios (PR) and 95% Confidence Intervals for risks and linear regression for trends. Results: Data from the 1st test showed a higher prevalence of Low-grade Squamous Intraepithelial Lesion (LSIL) in indigenous women. Peaks were observed in indigenous under 25, 35 to 39, 45 to 49, and 60 to 64. The prevalence of High-grade Squamous Intraepithelial Lesion or more severe (HSIL+) was low in both groups in women younger than 25. The indigenous HSIL+ prevalence curve showed a rapid increase, reaching peaks in women from 25 to 34 years, following a slight decrease and a plateau. In screening tests, HSIL+ was more prevalent in indigenous from 25 to 39 (PR 4.0,2.3;6.8) and 40 to 64 (PR 3.8,1.6;9.0). In indigenous, the PR of HSIL+ results in screening tests over 1st tests showed no screening effect in all age groups. In non-indigenous, there was a significant effect toward protection in the age groups over 25. Conclusion: This screening study of indigenous women from diverse ethnicities showed a higher prevalence of cytological LSIL and HSIl+ than in non-indigenous women. The protective screening effect in reducing HSIL+ prevalence was not observed in indigenous. [ABSTRACT FROM AUTHOR]

This document is a bibliography that includes a wide range of academic sources related to various topics in British Columbia. The sources cover subjects such as indigenous languages, leadership, feminism, fisheries, international relations, climate change, tourism, healthcare, colonialism, cultural identity, intergenerational memory, energy futures, nursing experiences, electric vehicle adoption, women's advocacy, mental health support, urban policing, Indigenous healthcare, labor history, and literary analysis. The bibliography provides a diverse range of perspectives and research topics for library patrons conducting research on specific subjects in British Columbia. [Extracted from the article]

How can a society be democratic when a section of its population is deprived or barred from participating in decision‐making platforms because of their gender? How can we talk about equality and freedom when the Naga society in Northeast India is marred by the fact that a few affluent sections of the population – those who are male – have the prerogative? Can egalitarianism be imagined while Indigenous customs and laws give freedom and authority to the people in decision‐making roles, are largely prohibitive, and fail to promote egalitarianism? The Naga society in Northeast India is fiercely patriarchal, where gender roles and responsibilities are defined according to norms that restrict women's roles in the social and political arena. [ABSTRACT FROM AUTHOR]

This article underlines another aspect of New Age spirituality developed in Mexico: although emerging from the Global North, it is also a matrix that gives value to those elements excluded by modernity and produces decolonial critiques and deconstructions from the Global South. The authors analyse four strands of neo-Mexican spirituality in which the decolonial perspective is corroborated: (1) the rise of post-national ethnic nations; (2) the criticism of patriarchy and the emergence of ecofeminist spiritualities; (3) the critique of capitalism and the alternatives of sustainable economy; and (4) the consumption of sacred plants and medicines as a spot where the struggle of indigenous ontologies and modern epistemologies takes place. [ABSTRACT FROM AUTHOR]

With music album Isqun , nine in Quechua and meaning mirror of the soul, Quechua singer Renata Flores aims to trace the journey of Indigenous women from the Andes in Peruvian history: the Inca era, colonialism, independence, and Republic. Combining sounds of the Andean countryside and the beats of Latin rap, trap, and hip-hop, her nine songs written in Quechua and Spanish represent a decolonial turn towards undoing westernized epistemologies of knowledge. This article explores Flores's potential contributions to decolonial feminism through the lens of Gloria Anzaldúa's theoretical framework of Nepantla (in-between), María Lugones's fractured locus, and Catherine Walsh's decolonial insurgency. The author argues that Flores's feminist ch'ixi+art music and songs "Chañan Cori Coca," "Beatriz Clara Coya," "María Parado de Bellido," and "Rita Puma Justo" not only reclaim spaces for the language of Quechua in contemporary Peru, but also contribute to remapping Indigenous women's herstories of resistance, disobedience, survivance, and empowerment. Ultimately this article illustrates how Flores's feminist decolonial pedagogies of interweaving memorias cortas and memorias largas denote an action of creation and intervention, opening paths to resignify historically excluded Indigenous women in Peru. [ABSTRACT FROM AUTHOR]

The most prominent social effects of the drug war in Mexico are the criminalization of poverty and increased rates of feminicide. Feminist academics and community leaders have been developing and working hand in hand to find the most appropriate methods to document gender-based violence and feminicide to shed light on the impunity that hides the systemic dismissal of women's lives. This essay presents a critical analysis of my own positionality as a feminist and academic ally in building a collaborative research alliance with indigenous women leaders who are politically engaged in the production of knowledge from an intersectional perspective that adequately reflects the matrix of violence that affects the lives of indigenous women in urban and rural areas. This process has been fruitful and promising, although it has also entailed challenges and contradictions arising from disparate meanings of gender justice and the lack of encounter of feminist/indigenous politics of resistance. [ABSTRACT FROM AUTHOR]

Menstrual cycle has a significant impact on women's health from different perspectives, both physically and psychologically. The assessment of menstrual-related distress is of pivotal clinical interest, especially in women with chronic exposure to abnormal bleeding or pain. The Menstrual Distress Questionnaire (MEDI-Q) is a new tool originally developed in Italian that comprehensively evaluates menstrual-related distress. To validate the English version of the MEDI-Q in an English-speaking population. The study consisted of two phases: an initial translation phase of the original Italian version of the MEDI-Q, and a data collection phase to validate the new English version among 288 native English-speaking women. The English version of MEDI-Q showed excellent psychometric properties, with high internal consistency (Cronbach's alpha = 0.84) and test-retest reliability (intraclass correlation coefficient = 0.95). Construct validity was supported by significant correlations between MEDI-Q scores and scores on measures of psychological distress and premenstrual symptoms. The English version of the MEDI-Q is a valid and reliable instrument for the assessment of menstrual distress and its impact on psychological well-being. This tool can be utilized in research and clinical settings to comprehensively investigate the impact of menstruation on various populations, identify and monitor menstruation-related disorders promptly and effectively, and to evaluate the effectiveness of targeted treatments for menstrual distress. [ABSTRACT FROM AUTHOR]

This study examines how three Native women politicians were portrayed in Native newspapers. The analysis found striking differences in how national Native media cover women politicians compared with prior findings in mainstream newspapers. The data illustrate the influence of Indigenous standpoint theory on the journalistic norms of Native media and its distinct lack of gendered politics, revealing significant prioritization of policy over personal and contrasts in the coverage amount and tone for conservative women politicians. [ABSTRACT FROM AUTHOR]

While the global rates of intimate partner violence (IPV) for Indigenous women have been acknowledged as substantial, few studies have incorporated an analysis of the impacts of colonization in the context of IPV. This secondary mixed-methods analysis explored the experiences of 40 Indigenous women from the Canadian prairie provinces who were abused by their intimate partners. The women discussed the impact of colonization, including the use of residential schools, to break down family life, spiritual beliefs, and languages, at times linking this to IPV. Of the 40 women, 38 described male partners as the abusers and two identified female abusive partners. Consistent with the literature, many of the male partners physically assaulted the respondents so severely that the women were injured and were at risk of death. Almost half of the men (47.4%) used sexually coercive strategies and/or sexually assaulted the women. Implications include the importance of professionals considering the broader historical experiences and possible trauma of Indigenous women who seek assistance for IPV from abusive partners. [ABSTRACT FROM AUTHOR]

Racism as social determinant of health significantly affects Indigenous women's maternal healthcare access. This study uses Jones' 'Three Levels of Racism' theory and an intersectional lens to explore how racism shapes the experience of maternal health care access among Garo Indigenous women in Bangladesh. Semi-structured interviews were conducted with 24 women of diverse backgrounds and pregnancy statuses using snowball sampling. Thematic analysis, incorporating inductive and deductive approaches, was employed for data analysis. The findings reveal a significant deviation from Jones' theory regarding the level of internalized racism within the specific context of Garo Indigenous women's experiences. Jones' theory usually focuses on how racism is internalized due to institutional and personally-mediated factors. On the contrary, this study uncovers a unique theme: 'women agency.' This theme emerges as a robust response among the Garo Indigenous women to their encounters with institutional and personally-mediated racism, highlighting their cultural resistance and resilience. The findings suggest that the complex relationship between these two forms of racism contributes to the strengthening of agency among Garo Indigenous women. Their agency stems from avoiding hospitals that disrespect their culture, manifesting their cultural resistance practice against the encountered racism at the institutional and relational levels. To increase biomedical healthcare access among Garo Indigenous women, it is recommended to address racism through intercultural competency training with the 'cultural safety' 'cultural humility' approach. This approach would foster inclusivity and empowerment, recognizing the agency of Garo women in healthcare decisions. Additionally, it would facilitate constructive dialogues between clinicians and Garo Indigenous women, acknowledging the shared experiences of racism within the latter group. [ABSTRACT FROM AUTHOR]

This article focuses on Indigenous women’s narrative and storytelling tradition and its relation to decolonial ecologies. It argues that Indigenous women’s narratives, both written and orally transmitted, constitute sites of defiance to the eco-social structures of settler colonialism and imperialism. Drawing on the case of Palestine, the article reveals that ‘zoocentric environmentalism,’ as represented by an Israeli installation at the Venice Biennale, incarnates the material and symbolic constituents of Zionist blooming enterprise. That is, such presumed forms of progressive ‘non-anthropocentric’ engagements with ecological calamities unveil the historical continuity of the Zionist project that aims to erase Indigenous Palestinians and their multigenerational, more-than-human place thought. To counter universalising environmental projects and their inherent colonial violence, the article engages with place-based stories of a Palestinian woman’s novella; more-than-human ancestral knowledge shared by Palestinian women elders; and a visual-media project showing Palestinian refugee women returning to their ancestral villages. The article’s overall aim is to advance an Indigenous situated approach to decolonising today’s environmentalism and to centre Palestine in the wider social and cultural geography debate on Indigeneity, decolonial ecologies, and storytelling. [ABSTRACT FROM AUTHOR]

Customs and values within Indigenous communities form the basis of customary behavior in understanding human conduct, particularly in the context of Balinese indigenous women's behavior as guardians of tradition in an empirical approach to legal anthropology. This means that the legal norms used to observe the behaviors of Balinese indigenous women as custodians of indigenous traditions within the frame of cultural relativism represent legal realities apparent in legal situations or any legal events that genuinely occur within the indigenous community, as manifestations of the indigenous women's behaviors in preserving sacred traditions. This is based on an empirical approach to Legal Anthropology. Whether acknowledged or not by the indigenous community, the empirical approach to cultural relativism fundamentally holds a social and cultural value system that can serve as the social capital of the nation. The community's attitudes and behaviors rooted in tradition are guided by values believed to be true, exemplifying the traditional values and cultures passed down through generations and perceived as instruments for social control and religious values that guide human life, manifesting the preservation of local cultural relativism among the local indigenous community. Indigenous communities in these regions become the focal research site with the hope of safeguarding traditional values as a reinforcement of customary practices, the culture, and the traditions of the local indigenous community, which embody the manifestation of protected local wisdom governed by regional customary laws. The methodological approach utilized involves the Empirical Approach of Legal Anthropology linked with the theory of cultural relativism, leading to the conclusion that the approach involves field observations, interviews with research informants, and analyzing primary, secondary, and tertiary data sources through the lens of cultural relativism concerning the behaviors of indigenous women based on an empirical approach within the context of indigenous customary law. [ABSTRACT FROM AUTHOR]

Introduction. During the coronavirus (SARS-Cov-2) pandemic, restrictive measures were implemented to reduce contagion. However, severely decreasing social interaction also negatively impacted the economy, particularly that of indigenous groups. Objective. This article seeks to understand the emotional distress identified by a group of indigenous women residents, as well as their self-care practices, during the COVID-19 pandemic in Mexico City. Method. A digital qualitative study was undertaken since the fieldwork was conducted in person and online, using various Internet platforms, which served as a field scenario, data collection tool and a means of continuous connection with subjects. Results. Anecdotal records were obtained from the subjects, who identified categorizations in the collective organization of the indigenous group, which became a support network for mobilizing official material resources. Information was also obtained on the way the women engaged in the self-care of their emotional distress in a range of ways with a sense of immediacy, through physical, spiritual, herbal, and psychological resources. They observed how women managed to cope with their situation and continue caring for and supporting their families to enable them to get by, distinguishing between those who were providers and those who were dependent on another provider. Discussion and conclusion. The pandemic, together with social restrictions, created stressful situations, causing various emotional problems among the indigenous collective. Nevertheless, their capacity for self-management and self-care enabled them to cope with these conditions in the midst of structural contexts of violence, poverty, and social exclusion. [ABSTRACT FROM AUTHOR]

Introduction: In 2016, 5,712 American Indian/Alaskan Native (AI/AN) women and girls were reported missing in the United States. In Canada, 4% of the population is Indigenous, yet Indigenous females represent 50% of all sex trafficking victims. This systematic mixed-studies review examined the effects of Missing and Murdered Indigenous Women and Girls (MMIWG) to define a role for nurses. Methods: We used five databases with keywords, inclusion criteria, and the Mixed Methods Appraisal Tool. Results: Findings of 22 papers discuss: (a) demographic data; (b) factors that increase vulnerability of AI/AN women; and (c) how nurses can decrease the prevalence of MMIW. Discussion: Nurses are the first provider patients see when accessing care. Increasing knowledge about the impact of violence against AI/AN women and girls is the first step in identifying measures needed to address this public health concern. [ABSTRACT FROM AUTHOR]