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Ragging is an initiation ritual practiced in Sri Lankan universities for generations, although research is scarce. This practice has several adverse consequences such as physical, psychological, and behavioral effects and increased university dropouts. The aim of this study was to investigate the prevalence of different types of ragging: emotional/verbal, physical and sexual ragging, self-perceived health consequences, help-seeking behavior, and factors associated with the experience of ragging. A cross-sectional study was conducted among 623, second- and third-year students from the medical, and technology faculties in Jaffna University. Bivariate associations were assessed using chi-squared tests. Logistic regression was used to evaluate factors associated with any type of ragging. Ragging was experienced by 59% of the students, emotional/verbal ragging being the most common. A total of 54% of students suffered one or more health consequences and mainly sought help from friends and family, with few seeking formal help. Factors associated with any type of ragging were faculty and year of study. This study emphasizes the urgent need to address this public health problem. It is important that there are adequate student support services, planning and implementation of effective interventions, as well as ensuring that existing policies are strengthened, to reduce or eliminate ragging in Sri Lanka.

Supplemental material, sj-docx-1-nmi-10.1177_11786388211047056 for Rural and Urban Correlates of Stunting Among Under-Five Children in Sierra Leone: A 2019 Nationwide Cross-Sectional Survey by Quraish Sserwanja, Kassim Kamara, Linet M Mutisya, Milton W Musaba and Shirin Ziaei in Nutrition and Metabolic Insights

The consequences of maternal experience of Domestic Violence (DV) on their children&rsquo, s cardio-metabolic risk factors are unclear. We aimed to assess if maternal exposure to any or a specific form of DV (i.e., physical, sexual, emotional and controlling behaviors) before and after childbirth was associated with their children&rsquo, s lipid biomarkers at the age of 10 years. A current observational sub-study of a larger MINIMat trial included a cohort of 1167 mothers and their children. The conflict tactic scale was used to record women&rsquo, s experience of lifetime DV before and after childbirth at week 30 of pregnancy and at a 10-year follow up, respectively. Five ml of fasting blood sample was collected from the children to evaluate their lipid profile. Children of women who experienced any DV before childbirth had lower Apo A (&beta, adj &minus, 0.04, 95% CI: &minus, 0.08, &minus, 0.01). Women who experienced physical DV both before and after childbirth had children with higher triglycerides (&beta, adj 0.07, 95% CI: 0.01, 0.14). Children whose mother experienced sexual DV before birth had lower Apo A (&beta, 0.05, 0.01) and High Density Lipoprotein (HDL) (&beta, 0.10, &minus, 0.01) as well as higher Low Density Lipoprotein (LDL) (&beta, adj 0.17, 95% CI: 0.05, 0.29) and LDL/HDL (&beta, 0.24, 95% CI: 0.11, 0.38). However, levels of LDL (&beta, 0.17, 0.28, &minus, 0.06), LDL/HDL (&beta, 0.12, 0.25, &minus, 0.00) and cholesterol (&beta, 0.13, 0.02) were lower among the children of mothers who experienced controlling behavior after childbirth. Results from the current study suggest that maternal experience of physical or sexual DV might negatively affect their children&rsquo, s lipid profile at the age of 10 years.

Background: Women from low-income settings have higher risk of maternal near miss (MNM) and suboptimal care than natives in high-income countries. Iran is the second largest host country for Afghan refugees in the world. Our aim was to investigate whether care quality for MNM differed between Iranians and Afghans and identify potential preventable attributes of MNM. Methods: An MNM audit study was conducted from 2012 to 2014 at three university hospitals in Tehran. Auditors evaluated the quality of care by reviewing the hospital records of 76 MNM cases (54 Iranians, 22 Afghans) and considering additional input from interviews with patients and professionals. Main outcomes were frequency of suboptimal care and the preventable attributes of MNM. Crude and adjusted odds ratios with confidence intervals for the independent predictors were examined. Results: Afghan MNM faced suboptimal care more frequently than Iranians after adjusting for educational level, family income, and insurance status. Above two-thirds (71%, 54/76) of MNM cases were potentially avoidable. Preventable factors were mostly provider-related (85%, 46/54), but patient-(31%, 17/54) and health system-related factors (26%, 14/54) were also important. Delayed recognition, misdiagnosis, inappropriate care plan, delays in care-seeking, and costly care services were the main potentially preventable attributes of MNM. Conclusions: Afghan mothers faced inequality in obstetric care. Suboptimal care was provided in a majority of preventable near-miss events. Improving obstetric practice and targeting migrants' specific needs during pregnancy may avert near-miss outcomes. The manuscript of this paper is part of the thesis Beyond ‘Cesarean Overuse’: Hospital-Based Audits of Obstetric Care and Maternal Near Miss in Tehran, Iran http://uu.diva-portal.org/smash/record.jsf?pid=diva2:1049158

The importance of women’s status for child nutrition has recently been recognized. However, pathways through which women’s status can affect their caretaking practices and child nutrition have not been fully determined. The aim of this thesis was to evaluate associations between aspects of women’s status – including exposure to domestic violence and level of autonomy and social support – with their level of stress, feeding practices and child nutritional status in two different cultural settings: Bangladesh and Nicaragua. Data were acquired from population-based studies. For Study I we used data from the Bangladesh 2007 Demographic and Health Survey, and Study II was embedded in the 2009 Health and Demographic Surveillance System conducted in Los Cuatro Santos, rural Nicaragua. Studies III and IV were part of the MINIMat study, conducted in rural Bangladesh. In-person interviews were conducted and validated questionnaires were used in each of the studies. Anthropometric characteristics of the children were recorded based on standardized World Health Organization techniques. In Bangladesh, we found women with lifetime experience of domestic violence to be more likely to report emotional distress during pregnancy, cease exclusive breastfeeding before 6 months and have a stunted child. Further, we found a negative association between experience of domestic violence and duration of excusive breastfeeding to be mitigated with breastfeeding counseling. In Nicaragua, a lower level of maternal autonomy was associated with more appropriate breastfeeding practices such as higher odds of exclusive breastfeeding and longer continuation of breastfeeding. Further, a maternal lower level of social support was associated with better child nutritional status. In conclusion, this investigation showed that different dimensions of women’s status were associated with their feeding practices and child nutritional status and also revealed that the strength and direction of these associations may vary by the child’s age, setting and other contextual factors. These findings suggest that women’s status might have an important public health impact on child health and its role should be considered in programs and policies aiming to improve child health and nutrition.