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AbstractThe normalization of gender-based violence (GBV) consists of all those cultural beliefs and values that sustain, justify, or minimize GBV perpetration. Acknowledging the lack of instruments addressing the normalization of GBV and its constitutive sociocultural dimensions, this article presents the conceptual development and initial validation of the Normalization of gender-based violence against women scale. This 18-item instrument could be used to assess the normalization of violence against women in GBV survivors of various cultural contexts. The scale has been developed through a sizeable mixed-methods study. This paper reports the qualitative portion of the study that allowed the development of the instrument and assessment of its content and face validity. In particular, the method section details the process by which the assessed scale's domain has been identified through an expert panel workshop, the analysis of GBV survivor's interviews, and the review of existing scales. The assessment of face and content validity, trough expert judges' evaluation and Cognitive Interviewing, is presented. This instrument is the first normalization scale developed by a multicultural team for use with violence survivors. The techniques used to construct this scale aimed to capture cultural aspects of normalization that might be shared across women from diverse groups. Therefore, its use could enable social or health care providers worldwide to program or evaluate the effectiveness of interventions to contrast GBV by promoting a clearer understanding of cultural and social norms that sustain the acceptance and normalization of violence.

Sexual harassment against female migrant domestic workers is a public health problem, which remains hidden and largely underreported. The current paper presents the results of a qualitative research study on sexually victimized migrant domestic workers in four European countries (Austria, Cyprus, Greece, and Sweden). The study aimed at exploring the profile and experiences of victimised individuals. Data were gathered via 66 semi-structured interviews with victimised female migrant domestic workers. Key findings of the current study indicate that the victims: (a) were usually undocumented and had low local language skills; (b) identified domestic work as the only way into the labour market; (c) suffered primarily psychological, economic, and social consequences; (d) had poor social support networks; (e) were poorly connected to governmental support services. This is the first study to explore this hidden problem via direct contact with victims. Addressing barriers of migrants' social integration seems important. Better regulation and monitoring of this low-skilled occupation could minimise risks for vulnerable employees.

Abstract Background European countries are increasingly adopting systems of self –care support (SMS) for long term conditions which focus on enhancing individual, competencies, skills, behaviour and lifestyle changes. To date the focus of policy for engendering greater self- management in the population has been focused in the main on the actions and motivations of individuals. Less attention has been paid to how the broader influences relevant to SMS policy and practice such as those related to food production, distribution and consumption and the structural aspects and economics relating to physical exercise and governance of health care delivery systems might be implicated in the populations ability to self- manage. This study aimed to identify key informants operating with knowledge of both policy and practice related to SMS in order to explore how these influences are seen to impact on the self-management support environment for diabetes type 2. Methods Ninety semi-structured interviews were conducted with key stakeholder informants in Bulgaria, Spain, Greece, Norway, Netherlands and UK. Interviews were transcribed and analysed using thematic and textual analysis. Results Stakeholders in the six countries identified a range of influences which shaped diabetes self-management (SM). The infrastructure and culture for supporting self- management practice is viewed as driven by political decision-makers, the socio-economic and policy environment, and the ethos and delivery of chronic illness management in formal health care systems. Three key themes emerged during the analysis of data. These were 1) social environmental influences on diabetes self-management 2) reluctance or inability of policy makers to regulate processes and environments related to chronic illness management 3) the focus of healthcare system governance and gaps in provision of self-management support (SMS). Nuances in the salience and content of these themes between partner countries related to the presence and articulation ofdedicated prevention and self- management policies, behavioural interventions in primary care, drug company involvement and the impact of measures resulting .

Background European countries are increasingly adopting systems of self –care support (SMS) for long term conditions which focus on enhancing individual, competencies, skills, behaviour and lifestyle changes. To date the focus of policy for engendering greater self- management in the population has been focused in the main on the actions and motivations of individuals. Less attention has been paid to how the broader influences relevant to SMS policy and practice such as those related to food production, distribution and consumption and the structural aspects and economics relating to physical exercise and governance of health care delivery systems might be implicated in the populations ability to self- manage. This study aimed to identify key informants operating with knowledge of both policy and practice related to SMS in order to explore how these influences are seen to impact on the self-management support environment for diabetes type 2. Methods Ninety semi-structured interviews were conducted with key stakeholder informants in Bulgaria, Spain, Greece, Norway, Netherlands and UK. Interviews were transcribed and analysed using thematic and textual analysis. Results Stakeholders in the six countries identified a range of influences which shaped diabetes self-management (SM). The infrastructure and culture for supporting self- management practice is viewed as driven by political decision-makers, the socio-economic and policy environment, and the ethos and delivery of chronic illness management in formal health care systems. Three key themes emerged during the analysis of data. These were 1) social environmental influences on diabetes self-management 2) reluctance or inability of policy makers to regulate processes and environments related to chronic illness management 3) the focus of healthcare system governance and gaps in provision of self-management support (SMS). Nuances in the salience and content of these themes between partner countries related to the presence and articulation ofdedicated prevention and self- management policies, behavioural interventions in primary care, drug company involvement and the impact of measures resulting from economic crises, and differences between countries with higher versus lower social welfare support and public spending on shaping illness management. Conclusions The results suggest reasons for giving increasing prominence to meso level influences as a means of rebalancing and improving the effectiveness of implementing an agenda for SMS. There is a need to acknowledge the greater economic and policy challenging environment operating in some countries which act as a source of inequality between countries in addressing SMS for chronic illness management and impacts on people's capacity to undertake self-care activities.

Background European countries are increasingly adopting systems of self –care support (SMS) for long term conditions which focus on enhancing individual, competencies, skills, behaviour and lifestyle changes. To date the focus of policy for engendering greater self- management in the population has been focused in the main on the actions and motivations of individuals. Less attention has been paid to how the broader influences relevant to SMS policy and practice such as those related to food production, distribution and consumption and the structural aspects and economics relating to physical exercise and governance of health care delivery systems might be implicated in the populations ability to self- manage. This study aimed to identify key informants operating with knowledge of both policy and practice related to SMS in order to explore how these influences are seen to impact on the self-management support environment for diabetes type 2. Methods Ninety semi-structured interviews were conducted with key stakeholder informants in Bulgaria, Spain, Greece, Norway, Netherlands and UK. Interviews were transcribed and analysed using thematic and textual analysis. Results Stakeholders in the six countries identified a range of influences which shaped diabetes self-management (SM). The infrastructure and culture for supporting self- management practice is viewed as driven by political decision-makers, the socio-economic and policy environment, and the ethos and delivery of chronic illness management in formal health care systems. Three key themes emerged during the analysis of data. These were 1) social environmental influences on diabetes self-management 2) reluctance or inability of policy makers to regulate processes and environments related to chronic illness management 3) the focus of healthcare system governance and gaps in provision of self-management support (SMS). Nuances in the salience and content of these themes between partner countries related to the presence and articulation ofdedicated prevention and self- management policies, behavioural interventions in primary care, drug company involvement and the impact of measures resulting from economic crises, and differences between countries with higher versus lower social welfare support and public spending on shaping illness management. Conclusions The results suggest reasons for giving increasing prominence to meso level influences as a means of rebalancing and improving the effectiveness of implementing an agenda for SMS. There is a need to acknowledge the greater economic and policy challenging environment operating in some countries which act as a source of inequality between countries in addressing SMS for chronic illness management and impacts on people's capacity to undertake self-care activities.