A Case of Genital Self-Mutilation in a Female-Symptom Choice and Meaning.

PubMed

Conde, Ema; Santos, Telma; Leite, Rita; Vicente, Carla; Figueiredo, António Mesquita

2017-08-18

Self-mutilation is understood as any willful gesture or alteration of the body tissue without a suicidal intent. The most common self-mutilating gestures are, to a great extent, those that are superficial or moderate, such as cuts, burns, or bites. The most severe, as is the case of genital self-mutilation (GSM), are extremely rare and, in most cases, observed in patients suffering from psychosis. Furthermore, they are mostly reported from a surgical standpoint. Here, we report the case of a 20-year-old female patient who resorted to the emergency department after having amputated her clitoris with surgical scissors. This dramatic gesture, coupled with the patient's narrative, prompted for differential diagnosis between a psychotic syndrome and a severe personality disorder. We propose that, despite the magnitude of the self-harm, it is possible to conceptualize this GSM within a disturbed personality with significant sexuality issues and, therefore, this case report aims to broaden the limits that have been associated with the self-mutilating gestures in borderline personality disorder.

Implications of Genital Mutilation at Autopsy.

PubMed

Byard, Roger W

2017-07-01

Given the potential significance of mutilation of the external genitalia in medicolegal fatalities, a review of the literature was undertaken to identify subcategories. Such mutilations may have been sustained sometime before death, around the time of death, or after death. The most common type of ante mortem genital mutilations involves cultural practices such as male circumcision. Less common male mutilations such as subincisions are tribally based. Female genital mutilation is found particularly in African, Middle Eastern, or Asian populations. Self-inflicted genital injuries are most common in males and may be related to attempts at suicide, or to self-harming practices. The latter have a strong association with psychiatric illnesses. Postmortem injuries may arise from animal predation or deliberate mutilation of a corpse. The latter may be associated with ante mortem genital injuries in sadistic homicides. The range of possible causes of genital mutilations in forensic cases necessitates extremely careful evaluation. © 2017 American Academy of Forensic Sciences.

Suicide attempts and self-injurious behaviours in adolescent and adult patients with borderline personality disorder.

PubMed

Goodman, Marianne; Tomas, Irene Alvarez; Temes, Christina M; Fitzmaurice, Garrett M; Aguirre, Blaise A; Zanarini, Mary C

2017-08-01

Prevalence data on self-mutilation and suicide attempts for adolescent borderline personality disorder (BPD) are currently not available. The purpose of this paper was to determine the frequency and methods of two forms of physically self-destructive acts (i.e. self-mutilation and suicide attempts) reported by adolescent borderline inpatients in one of the largest samples to date and to compare these results with a similarly diagnosed and assessed group of adult borderline inpatients. A total of 104 adolescent inpatients with BPD and 290 adult inpatients with BPD were interviewed about their lifetime history of physically self-destructive acts. The overall rates of self-mutilation (about 90%) and suicide attempts (about 75%) were similar during index admission for both adolescent and adult borderline patients. However, adolescents reported significantly higher rates of extreme levels of lifetime self-mutilation (e.g. >25 and >50 episodes) and cutting in particular, as compared with adult BPD. In contrast, borderline adults were significantly more likely to report a history of numerous (five or more) suicide attempts than adolescents with BPD. Self-mutilation and suicide attempts among adolescent borderline patients are prevalent and serious. Taken together, these results suggest that extreme levels of self-mutilation distinguish adolescent BPD from adults with BPD. Copyright © 2017 John Wiley & Sons, Ltd. Copyright © 2017 John Wiley & Sons, Ltd.

[Penile injury caused by a Moulinette. Result of autoerotic self-mutilation].

PubMed

Lehsnau, M

2007-07-01

Autoerotic manipulations of external male genitals resulting in mutilation with different degrees of severity are rare. We report the clinical case of a 12-year-old boy who injured his glans, left corpus cavernosum and corpus spongiosum with opened urethra as a consequence of autoerotic genital self-mutilation. According to our knowledge of the current literature this is the first description of autoerotic genital self-mutilation with a Moulinette. A Moulinette is a kitchen tool with an electric engine and an extremely fast rotary double knife, which is used to reduce food into small pieces, especially vegetables and fruits.

Anorexia, masochism, self-mutilation, and autoerotism: the spider mother.

PubMed

Lane, Robert C

2002-02-01

In summary, both self-mutilators and eating-disordered individuals come from dysfunctional homes with a very controlling mother and usually absent father. They often have a history of trauma. They are depressed and obsessive, attached to their mothers, who discourage attempts at emancipation. The symptoms serve the purpose of keeping them as little girls with negative feelings toward menstruation, sexual maturity, development, and femininity in general. These symptoms comprise self-destructive behavior in the service of removing sexual thoughts, temptation, and activities. Favazza (1987) included both eating disorders and self mutilation in his "deliberate self-harm syndrome." The symptoms, whether they be anorexic, bulimic, or a form of self-mutilation are seen as "autoerotic in nature and a substitute for normal masturbation" (Hull & Lane, 1988). Eating disorders and delicate self-mutilation are said to have "a cathartic, self-purifying, function in that they modulate states of anxiety, sexual tension, anger or dissociated emptiness, and they bring about a tremendous quasi-physical sense of relief" (Cross, 1993, p. 50). These patients' use of substitutes prevents maturation and growth as women, causing regression to pregenital phases with the use of pregenital defenses, and the demise of the demands of puberty and mature sexuality.

Female habitual self-mutilators.

PubMed

Favazza, A R; Conterio, K

1989-03-01

Data are presented on 240 female habitual self-mutilators. The typical subject is a 28-year-old Caucasian who first deliberately harmed herself at age 14. Skin cutting is her usual practice, but she has used other methods such as skin burning and self-hitting, and she has injured herself on at least 50 occasions. Her decision to self-mutilate is impulsive and results in temporary relief from symptoms such as racing thoughts, depersonalization, and marked anxiety. She now has or has had an eating disorder, and may be concerned about her drinking. She has been a heavy utilizer of medical and mental health services, although treatment generally has been unsatisfactory. In desperation over her inability to control her self-mutilative behavior this typical subject has attempted suicide by a drug overdose.

Self-Mutilation. ERIC/CASS Digest.

ERIC Educational Resources Information Center

Simpson, Chris

Self-mutilation has been most commonly seen as a diagnostic indicator for borderline personality disorder. However, practitioners have more recently observed self-harming behavior among those individuals diagnosed with bipolar disorder, obsessive-compulsive disorder, eating disorders, multiple personality disorder, borderline personality disorder,…

A novel technique for prevention of self-mutilation in three Harris' hawks (Parabuteo unicinctus).

PubMed

Smith, Stephen P; Forbes, Neil A

2009-03-01

Feather destructive behavior is an ever-increasing problem in captive birds of prey and any associated self-mutilation can be challenging to manage. This clinical report describes a noninvasive, nonpainful, temporary beak modification technique used to prevent self-mutilation in 3 Harris' hawks (Parabuteo unicinctus), when other methods and husbandry modifications had failed. The technique was successful in all 3 birds, and no adverse effects were observed. Further investigations are required to further evaluate if this beak modification technique causes any psychologic or physical stress to the avian patient.

[A case of complete self-mutilation of penis].

PubMed

Tomita, Masayuki; Maeda, Shigetaka; Kimura, Takahiro; Ikemoto, Isao; Oishi, Yukihiko

2002-04-01

Self-mutilation of the penis is extremely rare. A 69-year-old man was admitted after having amputated his own penis completely from its root. He had no history of psychiatric illness, but his physical condition on admission was abnormal. We performed urethrocutaneostomy, rather than replantation of the penis, because of the danger that he would reinjure himself. The patient was treated by a psychiatrist under a diagnosis of alcoholic dementia. To our knowledge, this is the 24th case of self-mutilation of the penis reported in the Japanese literature.

The role of impulsivity in self-mutilators, suicide ideators and suicide attempters - a study of 1265 male incarcerated individuals.

PubMed

Carli, Vladimir; Jovanović, Nikolina; Podlesek, Anja; Roy, Alec; Rihmer, Zoltan; Maggi, Stefania; Marusic, Dragan; Cesaro, Caterina; Marusic, Andrej; Sarchiapone, Marco

2010-06-01

We explored differences between high and low-impulsive incarcerated individuals in the context of lifetime self-mutilation, suicide ideation and suicide attempt. A total of 1265 males detained in Italian penitentiary institutions were studied between January 2006 and December 2008. The study raters were specifically trained to discriminate between suicide attempters, ideators and self-mutilators. Participants completed the Barratt Impulsivity Scale, Childhood Trauma Questionnaire (CTQ), Eysenck Personality Questionnaire (EPQ), Connor-Davidson Resilience Scale (CD-RISC), Brown-Goodwin Assessment for Lifetime History of Aggression (BGLHA) and Buss and Durkee Hostility Inventory (BDHI). Based on BIS 7 total score distribution, two extreme quarters - high-impulsive group (n=306) and low-impulsive group (n=285) - were compared. Over 42% of participants had lifetime suicide ideation, 13% attempted suicide and 17% were self-mutilators. High-impulsive subjects were younger, more often single and with more prominent psychoticism, extraversion, aggression, hostility and resilience capacity. They were more frequently diagnosed with substance use disorders and engaged in self-mutilating behaviour. There was no difference in the rate of suicide attempts between the two groups. Although high-impulsive subjects were more prone to suicidal behaviour, it was not predicted by higher impulsivity when other psychological variables were accounted for. Copyright 2010 Elsevier B.V. All rights reserved.

"A hideous torture on himself": madness and self-mutilation in Victorian literature.

PubMed

Chaney, Sarah

2011-12-01

This paper suggests that late nineteenth-century definitions of self-mutilation, a new category of psychiatric symptomatology, were heavily influenced by the use of self-injury as a rhetorical device in the novel, for the literary text held a high status in Victorian psychology. In exploring Dimmesdale's "self-mutilation" in The Scarlet Letter in conjunction with psychiatric case histories, the paper indicates a number of common techniques and themes in literary and psychiatric texts. As well as illuminating key elements of nineteenth-century conceptions of the self, and the relation of mind and body through ideas of madness, this exploration also serves to highlight the social commentary implicit in many Victorian medical texts. Late nineteenth-century England, like mid-century New England, required the individual to help himself and, simultaneously, others; personal charity and individual philanthropy were encouraged, while state intervention was often presented as dubious. In both novel and psychiatric text, self-mutilation is thus presented as the ultimate act of selfish preoccupation, particularly in cases on the "borderlands" of insanity.

Female genital mutilation among Iraqi Kurdish women: a cross-sectional study from Erbil city.

PubMed

Yasin, Berivan A; Al-Tawil, Namir G; Shabila, Nazar P; Al-Hadithi, Tariq S

2013-09-08

Iraqi Kurdistan region is one of the areas where female genital mutilation is reportedly widely practiced but inadequately studied. The aim of this study was to determine (i) the prevalence of female genital mutilation among Muslim Kurdish women in Erbil city, (ii) the patterns and types of female genital mutilation, (iii) the factors associated with this practice and (iv) women's knowledge and attitudes towards this practice. A cross-sectional study was conducted in the primary health care centers and the Maternity Teaching Hospital in Erbil city, involving 1987 women aged 15-49 years. Data were obtained about female genital mutilation status and knowledge and perception towards this practice. The participants were clinically examined to verify the self-reported female genital mutilation status. The self-reported prevalence of female genital mutilation was 70.3%, while it was 58.6% according to clinical examination of the women's genitalia. The most common type of female genital mutilation was type I (99.6%) and the most common age at which mutilation was performed was 4-7 years (60.2%). This practice was mostly performed by traditional birth attendants (72.5%). Only 6.4% of mutilated women reported having complications after mutilation, most commonly bleeding (3.6%). The practice was more reported among housewives (OR = 3.3), those women whose mothers were mutilated (OR = 15.1) or with unknown mutilation status (OR = 7.3) and those women whose fathers were illiterate (OR = 1.4) or could only read and write (OR = 1.6). The common reasons for practicing female genital mutilation were cultural tradition (46.7%) and dictate of religion (38.9%). Only 30% of the participants were aware about the health consequences of female genital mutilation. More than one third (36.6%) of the women support the practice and 34.5% have intention to mutilate their daughters. Prevalence of female genital mutilation among Muslim Kurdish women in Erbil city is very high; although, most cases are of type I. There is clear lack of knowledge about the health consequences of female genital mutilation and a relatively important segment of women support this practice. Custom or tradition and dictate of religion are the main reasons for this practice that need further in-depth exploration.

Female genital mutilation among Iraqi Kurdish women: a cross-sectional study from Erbil city

PubMed Central

2013-01-01

Background Iraqi Kurdistan region is one of the areas where female genital mutilation is reportedly widely practiced but inadequately studied. The aim of this study was to determine (i) the prevalence of female genital mutilation among Muslim Kurdish women in Erbil city, (ii) the patterns and types of female genital mutilation, (iii) the factors associated with this practice and (iv) women’s knowledge and attitudes towards this practice. Methods A cross-sectional study was conducted in the primary health care centers and the Maternity Teaching Hospital in Erbil city, involving 1987 women aged 15–49 years. Data were obtained about female genital mutilation status and knowledge and perception towards this practice. The participants were clinically examined to verify the self-reported female genital mutilation status. Results The self-reported prevalence of female genital mutilation was 70.3%, while it was 58.6% according to clinical examination of the women’s genitalia. The most common type of female genital mutilation was type I (99.6%) and the most common age at which mutilation was performed was 4–7 years (60.2%). This practice was mostly performed by traditional birth attendants (72.5%). Only 6.4% of mutilated women reported having complications after mutilation, most commonly bleeding (3.6%). The practice was more reported among housewives (OR = 3.3), those women whose mothers were mutilated (OR = 15.1) or with unknown mutilation status (OR = 7.3) and those women whose fathers were illiterate (OR = 1.4) or could only read and write (OR = 1.6). The common reasons for practicing female genital mutilation were cultural tradition (46.7%) and dictate of religion (38.9%). Only 30% of the participants were aware about the health consequences of female genital mutilation. More than one third (36.6%) of the women support the practice and 34.5% have intention to mutilate their daughters. Conclusions Prevalence of female genital mutilation among Muslim Kurdish women in Erbil city is very high; although, most cases are of type I. There is clear lack of knowledge about the health consequences of female genital mutilation and a relatively important segment of women support this practice. Custom or tradition and dictate of religion are the main reasons for this practice that need further in-depth exploration. PMID:24010850

Bullying behavior is related to suicide attempts but not to self-mutilation among psychiatric inpatient adolescents.

PubMed

Luukkonen, Anu-Helmi; Räsänen, Pirkko; Hakko, Helinä; Riala, Kaisa

2009-01-01

To investigate the association of bullying behavior with suicide attempts and self-mutilation among adolescents. The study sample consisted of 508 Finnish adolescents (age 12-17 years) admitted to psychiatric inpatient care between April 2001 and March 2006. DSM-IV psychiatric diagnoses and variables measuring suicidal behavior (i.e. suicide attempts and self-mutilation) and bullying behavior (i.e. a victim, a bully or a bully-victim) were obtained from the Schedule for Affective Disorder and Schizophrenia for School-Age Children Present and Lifetime (K-SADS-PL). Logistic regression analyses were conducted to examine the impact of being a victim, a bully or both a bully and a victim on suicide attempts and self-mutilation. After adjusting for age, school factors, family factors and psychiatric disorders, there was a higher risk of suicide attempts in girls who were victims of bullying (OR=2.07, CI=1.04-4.11, p=0.037) or who bullied others (OR=3.27, CI=1.08-9.95, p=0.037). Corresponding associations were not found for boys; nor was any association of bullying behavior with self-mutilation found among either sex. Among girls, being bullied or bullying others are both potential risk factors for suicidal behavior. Psychiatric assessment and treatment should thus be considered not only for victims of bullying, but also for bullies. Suicide-prevention programs should also routinely include interventions to reduce bullying. However, the generalization of our findings to all adolescents is limited because our study sample consisted of psychiatric adolescent patients. In addition, some of the possible findings might have remained statistically insignificant due to the small sample size among adolescents who had performed suicide attempts or self-mutilation. Copyright 2009 S. Karger AG, Basel.

Adolescents' Intentional Self-Mutilation

ERIC Educational Resources Information Center

Laskite, A.; Laskene, S.

2011-01-01

In Lithuania, suicide is among the top three causes of death; between twenty and thirty-three school-age children take their own lives every year, and the overwhelming majority of adolescents do not seek help in connection with situations that prompt them to engage in self-mutilation. Research indicates adolescents think that if more attention is…

Spinal osteosarcoma in a hedgehog with pedal self-mutilation.

PubMed

Rhody, Jeffrey L; Schiller, Chris A

2006-09-01

An African pygmy hedgehog (Atelerix albiventris) was diagnosed with osteosarcoma of vertebral origin with compression of the spinal cord and spinal nerves. The only presenting sign was a self-mutilation of rear feet. Additional diagnoses included a well-differentiated splenic hemangiosarcoma, an undifferentiated sarcoma of the ascending colon, and membranoproliferative glomerulonephritis.

Special Deveice as Aids in the Management of Child Self-Mutilation in the Lesch-Nyhan Syndrome

ERIC Educational Resources Information Center

Letts, R. M.; Hobson, Douglas A.

1975-01-01

A multidisciplinary team at a hospital special devices clinic designed multiple use wheelchair and car seats with unique tabletop or arm enclosures for two educable mentally retarded brothers (11 and 14-years-old) afflicted with Lesch-Nyhan syndrome, a purine metabolic disorder characterized by an insatiable urge for self-mutilation. (LH)

The Use of Biofeedback in Treating the Self-Mutilative Behaviors of a Child with Lesch-Nyhan Syndrome: A Pilot Study.

ERIC Educational Resources Information Center

Carmen, Jeffrey A.; And Others

The pilot study focused on the effective design of adaptive biofeedback equipment for use in the control of self-mutilating behaviors in individuals with Lesch-Nyhan syndrome, typically characterized by apasticity, mental retardation, and violent biting of the lips and fingers. Utilizing an electromyographic (EMG) monitor and a custom-designed…

Clinical characteristics of self-mutilating behavior in Turkish male subjects with antisocial personality disorder: relationship to psychopathy.

PubMed

Alpay Ates, M; Algul, Ayhan; Semiz, Umit B; Gecici, Omer; Basoglu, Cengiz; Ebrinc, Servet; Cetin, Mesut

2011-05-01

The aims of this study were to determine the characteristics of self-mutilation (SM) and examine the relationship between SM and psychopathy in male subjects with antisocial personality disorder (APD). APD diagnosis was established by the Structured Clinical Interview for DSM-III-R Axis II Disorders. Subjects (N = 116) were assessed using the Psychopathy Checklist-Revised and a semi-structured self-mutilation questionnaire form. In males with APD, the percentages of psychopathy and SM were 48.3% (N =56) and 96.6% (N = 112), respectively. There were positive correlations between severity of psychopathy and severity, number, and frequency of SM. Considerably high rates of SM and psychopathy were found in Turkish males with APD. The features of SM were associated with comorbidity of psychopathy. These results showed the importance of exploring the self-injurious behavior and psychopathy when diagnosed with APD.

Death by self-mutilation after oral cannabis consumption.

PubMed

Delteil, Clemence; Sastre, Caroline; Piercecchi, Marie-Dominique; Faget-Agius, Catherine; Deveaux, Marc; Kintz, Pascal; Devooght, Marc-Antoine; Leonetti, George; Bartoli, Christophe; Pélissier-Alicot, Anne-Laure

2018-01-01

Major self-mutilation (amputation, castration, self-inflicted eye injuries) is frequently associated with psychiatric disorders and/or substance abuse. A 35-year-old man presented with behavioral disturbances of sudden onset after oral cannabis consumption and major self-mutilation (attempted amputation of the right arm, self-enucleation of both eyes and impalement) which resulted in death. During the enquiry, four fragments of a substance resembling cannabis resin were seized at the victim's home. Autopsy confirmed that death was related to hemorrhage following the mutilations. Toxicological findings showed cannabinoids in femoral blood (tetrahydrocannabinol (THC) 13.5 ng/mL, 11-hydroxy-tetrahydrocannabinol (11-OH-THC) 4.1 ng/mL, 11-nor-9-carboxy-THC (THC-COOH) 14.7 ng/mL, cannabidiol (CBD) 1.3 ng/mL, cannabinol (CBN) 0.7 ng/mL). Cannabinoid concentrations in hair (1.5 cm brown hair strand/1 segment) were consistent with concentrations measured in chronic users (THC 137 pg/mg, 11-OH-THC 1 pg/mg, CBD 9 pg/mg, CBN 94 pg/mg). Analysis of the fragments seized confirmed that this was cannabis resin with high levels of THC (31-35%). We discuss the implications of oral consumption of cannabis with a very high THC content. Copyright © 2017 Elsevier B.V. All rights reserved.

Studies on Metabolism of 1,4-Dioxane

DTIC Science & Technology

2010-03-01

altered strength, and stereotypes or bizarre behavior (e.g., self mutilation, walking backwards). f. Study conduct. The study described will be...from dioxane in drinking water that is the foundation of the EPA drinking water risk assessment. V.3.3 Laboratory Animals: V.3.3.1 Genus and Species...stimuli, altered strength, and stereotypes or bizarre behavior (e.g., self mutilation, walking backwards). V.4.1.2.3 Paralytics: N/A V.4.1.3 Literature

Female genital mutilation/cutting type IV in Cambodia: a case report.

PubMed

Abdulcadir, Jasmine; Irion, Olivier; de Tejada, Begoña Martinez

2015-12-01

Nontherapeutic female genital modifications can cause short- and long-term consequences. Caregivers should promote women's self knowledge on genitals' anatomy and physiology, and psychophysical and sexual health. They should also inform on possible negative consequences of vulvar nontherapeutic alterations requested and avoid the medicalization of female genital mutilation.

Acute Inhalation Toxicity and Blood Absorption of 3-Nitro-1,2,4-Triazol-5-One (NTO) in Rats

DTIC Science & Technology

2013-09-16

strength, and stereotypes or bizarre behavior (e.g., self mutilation, walking backwards). In addition, rats exposed via the inhalation route of...species due to an historical and extensive database. V.3.3. Laboratory animals V.3.3.1 . Genus and Species: Rattus norvegicus V.3.3.2. Strain/Stock...or sensory stimuli, altered strength , and stereotypes or bizarre behavior (e.g., self mutilation, walking backwards). Observation and body weight

["Self-inflicted injuries"--psychiatric, forensic and insurance aspects (II)].

PubMed

Möllhoff, G; Schmidt, G

1999-03-01

German law distinguishes between attempted suicide which is not punishable and self-mutilation which is prohibited. This article describes the historical development of self-injurious behaviour, reviews the social, juridical, and ethical assessments of the past, and examines the statistical and biological results of current research. It relates observations from forensic medicine and psychiatry to specific clinical symptoms, toxicological circumstances, and social influences (stress incurred by everyday life, war, or imprisonment). Drawing on pertinent cases, it clarifies criminal and civil jurisdiction and emphasizes the importance of self-mutilation for private insurers. Intended for insurers, forensic scientists, and psychiatrists, recommendations concern the procedures to be followed in the examination, jurisdiction, and therapy involving cases of self-inflicted injuries.

The Relationship between Childhood Maltreatment and Emotional Dysregulation in Self Mutilation: An Investigation among Substance Dependent Patients

PubMed Central

KARAGÖZ, Başak; DAĞ, İhsan

2015-01-01

Introduction The present study aims to examine the role of emotion dysregulation and childhood maltreatment in self mutilation (SM) of substance dependent patients. Specifically, the present study examined whether emotion dysregulation and its dimensions, and childhood maltreatment and its dimensions were associated with SM. The relationship between emotion dysregulation and childhood maltreatment was also investigated. Methods The sample of study consisted of 55 alcohol dependent and 24 opiate dependent patients (n=79). Substance dependence was diagnosed by means of the Structured Clinical Interview for DSM-IV-TR (SCID-I), Turkish version. Childhood Trauma Questionnaire (CTQ) and Difficulties in Emotion Regulation Scale (DERS) were used. Results Findings indicated that substance dependents with SM and without SM were differentiated in terms of overall emotion dysregulation. Results also suggest the relevance of three specific dimensions of emotion dysregulation to SM: Difficulties engaging in goal-directed behaviors when experiencing negative emotions, difficulties controlling impulsive behaviors when experiencing negative emotions, and limited access to effective emotion regulation strategies. These dimensions were predicted from childhood emotional maltreatment and neglect. It is also revealed that substance dependents with SM had higher points than those without SM on emotional childhood maltreatment and neglect, physical childhood maltreatment. Conclusion Results were supported by the literature suggested that self-mutilation functions as a emotional regulation strategy. Findings also suggested that self- mutilation is related to early relationships take place in family environment in which individuals grow up. PMID:28360668

Self-inflicted testicular amputation in first lysergic acid diethylamide use.

PubMed

Blacha, Christian; Schmid, Markus M; Gahr, Maximilian; Freudenmann, Roland W; Plener, Paul L; Finter, Florian; Connemann, Bernhard J; Schönfeldt-Lecuona, Carlos

2013-01-01

Genital self-mutilation is a well-known phenomenon in patients with schizophrenia and has occasionally been described in patients with personality disorders or transsexuality. However, literature just provides few cases of genital self-mutilation related to the use of psychotropic substances. A previously mentally healthy man (age, 32 years) performed manual amputation of both testes after first use of lysergic acid diethylamide in combination with alcohol consumption. Follow-up examination 6 month after the event did not reveal the development of a psychiatric disorder. This report shows that a first and single use of lysergic acid diethylamide in combination with alcohol can cause intoxication with dramatic consequences.

Deliberate self-injury functions and their clinical correlates among adolescent psychiatric inpatients.

PubMed

Radziwiłłowicz, Wioletta; Lewandowska, Magdalena

2017-04-30

The aim of the study was to analyze the relationships between clinical variables (the severity of depression symptoms, feelings towards the body, dissociation, number and type of traumatic events) and deliberate self-injury functions. Moreover, we investigated whether the of group self-mutilating adolescents is internally diverse in terms of how important individual functions of self-mutilation are, and whether the subgroups singled out by these functions differ between each other in terms of clinical variables. The Inventory of Statements about Self-Injury was used. Characterizations of examined individuals and other research tools are included in our previous article (year, issue, pages). Associated with negative feelings towards the body are the functions of self-injuries (anti-dissociation, self-punishment) that can be described as interpersonal. High levels of depression symptoms (self-depreciation included) are mainly associated with the self-injury functions: self-punishment, anti-dissociation, establishing interpersonal boundaries. Affect regulation becomes more important as a function of self-inflicted injuries in cases of biological dysregulation and intense dissociative symptoms. The adolescents psychiatric inpatients are internally diverse in terms of dominant functions of self-injuries, which can be categorized into intra- and interpersonal. Intrapersonal functions dominate when an individual experiences severe depression, dissociative symptoms, and negative feelings towards the body. In cases of moderate intensity of depression, dissociative symptoms and negative feelings towards the body, both intrapersonal and interpersonal functions of self-mutilation are similarly important. Further research is required to explain the lowest severity of depression symptoms, dissociative symptoms and negative feelings towards the body co-occurs with no awareness of self-injuries functions.

Living on the edge: the current phenomenon of self-mutilation in adolescents.

PubMed

Derouin, Anne; Bravender, Terrill

2004-01-01

The purpose of this article is to share current knowledge about adolescent self-mutilation (SM), and to discuss treatment approaches for affected teens and young adults. One in eight American teenagers experiences depression or anxiety. The growing phenomenon of SM is a particularly worrisome coping mechanism used by teens and young adults to deal with stress and sadness. The incidence of SM is increasing, and might be fueled by current trends in music and media that highlight violent and self-injurious behaviors. SM represents a "cry for help" by adolescents who are suffering. Self-mutilators who repeatedly cut themselves with razors, scissors, knives, or sharp glass are not attempting suicide, but are seeking to relieve extreme anxiety, tension, or pain. Medical literature regarding SM is limited, and evidence-based treatment approaches have not been documented; however, early discovery of SM and the development of a multifaceted treatment approach that incorporates the child, family, and trusted practitioners could be instrumental in managing SM. There is hope that antidepressant medications may also be beneficial. Research is needed to identify successful treatment approaches, and to discover the best ways to educate teens, families, educators, and community leaders about the prevalence of SM in our youth.

Clitoral Reconstruction Using a Vaginal Graft After Female Genital Mutilation.

PubMed

Mañero, Ivan; Labanca, Trinidad

2018-04-01

Clitoral reconstruction after genital mutilation is a feasible and effective strategy to reduce clitoral pain, improve sexual pleasure, and restore vulvar appearance. We describe a novel surgical technique for clitorolabial reconstruction using a vaginal graft. We present a series of 32 consecutive women who underwent this procedure at Iván Mañero Clinic, Barcelona, Spain, and were prospectively followed. The total Female Sexual Function Index changed favorably from 16 before surgery to 29 after surgery (P<.05). Likewise, the Female Self-Image Genital Scale changed favorably from 11 to 23 (P<.05). Clitoral reconstruction after genital mutilation was associated with improved sexual function and genital aesthetic perception.

Self-mutilations in private-accident-insurance cases.

PubMed

Dotzauer, G; Iffland, R

1976-04-21

Self-inflicted injuries can be classified in groups. One group deals with the simulation of illness, another with the occurrence itself and the application of chemical, thermic or mechanical methods. One sector concerns self-mutilation, which, from a psychiatrist's point of view, is interesting. At this time we are more concerned with the problems of proving it. In wartime and even during military service in peace-time soldiers inflict mutilating injuries on themselves. They are motivated by the notion that they will gain benefit from their action. Economic gain plays a role in the case of people who have taken out private accident insurance: self mutilation to simulate the result of an accident. Our investigation into self-mutilation started with an analysis under the following aspects of 123 cases: age, sex, occupation, place of residence, place and time of deed, method employed (weapon used), localisation, single or multiple wound, direction of injury, position of fingers, nature of edges of wound. Whether or not an injury was suffered voluntarily or involuntarily can only be determined with the help of auxiliary facts. It must be clarified whether or not the information given by the injured person ties in with facts concerning the place where the injury was sustained, its position and its direction. The medico-legal expert should not interpret medical findings without relating them to the facts of the case. Indeed, he should start by examining the claimant's account of the accident. To some extent it almost requires the work of a general staff to compare the findings of a careful medical investigation with the injuries themselves. If the injury was inflicted by a certain tool information must be available regarding, for example, the "accident with the saw" together with an assessment of the wounds sustained (utilization of clinical material). Sometimes tests on corpses need to be carried out because these can provide information on mechanical and physical problems. When the direction of the wound is being clarified together with an appraisal of any traces found electron scanning and microscopic tests should also be incorporated into the examination in addition to medical and X-ray tests. At the slightest suspicion that a wound might have been self-inflicted appropriate tests should be carried out immediately. Conclusions should only be drawn by someone who has made an intensive study of this special field which is of such great forensic interest.

Main predictors for repetition of suicidal behaviour among women referred to a single public sector tertiary care hospital in Iran.

PubMed

Mostafazadeh, Babak; Farzaneh, Esmaeil

2017-09-01

To assess the main predictors for repetition of suicidal behaviour among women. This cross-sectional study was conducted at Loghman Hakim Hospital, Tehran, Iran, in 2014, and comprised women patients. The patients were divided into two groups, i.e. women repeating suicide and women without repeating suicide. Data was collected through a checklist and then analysed with SPSS 20. Of the 300 women, 121(40.3%) repeated suicide and 179(59.7%) did not. The overall mean age was 26.9±9.1 years (range: 14-80 years). High prevalence of psychological drug usage, alcohol use, history of self-mutilation (self-harm), psychotic disturbances, sexual relationships, as well as smoking and opium addition was revealed as major factors in repeated suicidal behaviour in women when compared with other women. The result of multivariate logistic regression model showed two factors of self-mutilation (odds ratio =2.692, p=0.002) and underlying psychotic disorders (odds ratio = 2.780, p<0.001) as main predictors of suicide in women. In this regard, demographic characteristics could not predict repeating suicidal attempts (p>0.05). The presence of underlying psychotic disorders and self-mutilation were main predictors for repetition of suicidal behaviour.

Unsweetened ice popsicles impart a positive feeling and reduce self-mutilation after paediatric dental treatment with local anaesthesia.

PubMed

Ram, Diana; Berson, Tamar; Moskovitz, Moti; Efrat, Jacob

2010-09-01

The purpose of the current study was to assess whether an unsweetened ice-popsicle imparts a positive feeling to children after dental treatment in which local anaesthesia is administered, and whether it reduces the tendency of children to self-mutilate (bite the lip, cheek or tongue) after the administration of local anaesthesia. Crossover study of 31 children aged 4-11 years old who needed similar dental treatments on both sides of the mandible or maxilla under local anaesthesia. At the end of each appointment the child received a toy or an ice-popsicle especially made for this study. Patients and parents answered a questionnaire regarding the children's behaviour and feeling immediately after the treatment, and 10 and 30 min after receiving the ice-popsicle or toy. Children who received ice-popsicles after dental treatment under local anaesthesia felt less discomfort and suffered less soft tissue trauma than they did when they received a toy. Reduction in soft tissue trauma was evident 10 min after receiving the ice-popsicles. Licking of an ice-popsicle after dental treatment with local anaesthesia reduces the feeling of discomfort and the biting of soft tissue and self- mutilation.

Cardiac arrest after anesthetic management in a patient with hereditary sensory autonomic neuropathy type IV.

PubMed

Ergül, Yakup; Ekici, Bariş; Keskin, Sabiha

2011-01-01

Hereditary sensory autonomic neuropathy type IV is a rare disorder with an autosomal recessive transmission and characterized by self-mutilation due to a lack in pain and heat sensation. Recurrent hyperpyrexia and anhydrosis are seen in patients as a result of a lack of sweat gland innervation. Self-mutilation and insensitivity to pain result in orthopedic complications and patients undergone recurrent surgical interventions with anesthesia. However, these patients are prone to perioperative complications such as hyperthermia, hypothermia, and cardiac complications like bradycardia and hypotension. We report a 5-year-old boy with hereditary sensory autonomic neuropathy type IV, developing hyperpyrexia and cardiac arrest after anesthesia.

Self-mutilation of the nose in a schizophrenic patient with Cotard syndrome.

PubMed

Ghaffari-Nejad, Alireza; Kerdegari, Mohammad; Reihani-Kermani, Hamed

2007-10-01

Cotard syndrome is a rare condition, which its main symptom is nihilistic delusion. Self-mutilation of the nose is also a rare condition, which has not been seen in schizophrenic patients with Cotard syndrome. A single case is presented here. A 32-year-old woman who was diagnosed as having schizophrenia and believed that she was dead, cut the tip of her nose. She had no guilt feeling and described her act as a cosmetic surgery. We try to explain how various symptoms that seem to be very far from each other could exist side by side. Misinterpretation of her face is suggested to be the starting point in her complex symptoms.

How Do Researchers Define Self-Injurious Behavior?

ERIC Educational Resources Information Center

Matson, Johnny L.; Turygin, Nicole C.

2012-01-01

Self-injurious behavior is commonly observed among persons with intellectual disabilities. However, a second parallel use of this term is used in the general mental health field for self-mutilation. The authors describe these two disorders and how they differ. Characteristics of what we refer to as repetitive self-injurious behavior among persons…

Bodywork: Self-Harm, Trauma, and Embodied Expressions of Pain

ERIC Educational Resources Information Center

Gurung, Kesherie

2018-01-01

Self-harm, or self-mutilation, is generally viewed in academic literature as a pathological act, usually born out of trauma and/or a psychological and personality defect. Individuals who engage in self-harm are usually seen as damaged, destructive, and pathological. While self-harm is not a desirable act, this paper argues through the narratives…

Self-Amputation in Two Non-Psychotic Patients.

PubMed

Rahmanian, Hamid; Petrou, Nikoletta A; Sarfraz, M Aamer

2015-09-01

Self-amputation, the extreme form of self-mutilation, is uncommon. The vast majority of cases are associated with psychosis, with a small number being assigned the controversial diagnosis of body identity integrity disorder. In this article, we report two cases of non-psychotic self-amputation and their similarities with a view to highlighting the risk factors and formulating an appropriate management plan.

Clinical Correlates and Repetition of Self-Harming Behaviors among Female Adolescent Victims of Sexual Abuse

ERIC Educational Resources Information Center

Cyr, Mireille; McDuff, Pierre; Wright, John; Theriault, Chantal; Cinq-Mars, Caroline

2005-01-01

This study investigated self-harming behaviors in 149 female adolescent victims of sexual abuse, first, by determining the rates of nine types of self-mutilating behavior at intake and nine months later and, second, by investigating comorbidity of clinical correlates associated with these behaviors. The adolescents were divided into three groups…

Mobilizing the Campuses against Self-Mutilation

ERIC Educational Resources Information Center

Eells, Gregory T.

2006-01-01

In this article, the author discusses self-injury, which is a strategy to manage painful emotions. Generally, it is not about attempting suicide. In addition, it operates in complex ways. One one level, it is a method of communicating feelings when the self-injurer lacks other skills with which to express them. On another level, it helps people…

Predictors for Self-Directed Aggression in Italian Prisoners include Externalizing Behaviors, Childhood Trauma and the Serotonin Transporter Gene Polymorphism 5-HTTLPR

PubMed Central

Gorodetsky, Elena; Carli, Vladimir; Sarchiapone, Marco; Roy, Alec; Goldman, David; Enoch, Mary-Anne

2016-01-01

Suicidal behavior and self-mutilation can be regarded as the expression of self-directed aggression and both are common in prison populations. We investigated the influence of externalizing behaviors, depressive symptoms, childhood trauma, 5-HTTLPR variants on self-directed aggression (N = 145) in a group of 702 male Italian prisoners. Participants were comprehensively evaluated, including for psychiatric disorders, impulsive traits, lifetime aggressive behavior (BGHA), hostility, violent behavior during incarceration, depressive symptomatology (HDRS), childhood trauma (CTQ). Logistic regression analysis revealed FDR corrected independent main effects of externalizing behaviors: BGHA (p=0.001), violent behavior in jail (p=0.007), extraversion (p=0.015); HDRS (p=0.0004), Axis I disorders (p=0.015), CTQ (p=0.004) and 5-HTTLPR genotype (p=0.02). Carriers of 5-HTTLPR high (LALA), intermediate (LALG, SLA) activity variants were more likely to have exhibited self-directed aggression relative to the low activity (LGLG, SLG, SS) variant: High/Low: OR = 2.3, 95% CI 1.27–4.68, p=0.007; Intermediate/Low: OR = 1.96, 95% CI 1.09–3.68, p=0.025. The CTQ main effect was driven by physical abuse. There was no interactive effect of 5-HTTLPR and CTQ. Secondary logistic regression analyses in (a) all suicide attempters (N = 88) and (b) all self-mutilators (N = 104), compared with controls revealed that in both groups, childhood trauma (p = 0.008-0.01), depression (p=0.0004-0.001) were strong predictors. BGHA, violent behavior in jail predicted self-mutilation (p=0.002) but not suicide attempts (p =0.1). This study was able to distinguish differing influences on self-directed aggression between groups of closely related predictor variables within the externalizing behavioral domain. 5-HTTLPR had an independent, variant dosage effect. PMID:27062586

A missense mutation in the CRBN gene that segregates with intellectual disability and self-mutilating behaviour in a consanguineous Saudi family

PubMed Central

Sheereen, Atia; Alaamery, Manal; Bawazeer, Shahad; Al Yafee, Yusra; Massadeh, Salam; Eyaid, Wafaa

2017-01-01

Background Autosomal-recessive non-syndromic intellectual disability (ARNS-ID) is an aetiologically heterogeneous disorder. Although little is known about the function of human cereblon (CRBN), its relationship to mild cognitive deficits suggests that it is involved in the basic processes of human memory and learning. Objectives We aim to identify the genetic cause of intellectual disability and self-mutilation in a consanguineous Saudi family with five affected members. Methods Clinical whole-exome sequencing was performed on the proband patient, and Sanger sequencing was done to validate and confirm segregation in other family members. Results A missense variant (c. 1171T>C) in the CRBN gene was identified in five individuals with severe intellectual disability (ID) in a consanguineous Saudi family. The homozygous variant was co-segregating in the family with the phenotype of severe ID, seizures and self-mutilating behaviour. The missense mutation (p.C391R) reported here results in the replacement of a conserved cysteine residue by an arginine in the CULT (cereblon domain of unknown activity, binding cellular ligands and thalidomide) domain of CRBN, which contains a zinc-binding site. Conclusions These findings thus contribute to a growing list of ID disorders caused by CRBN mutations, broaden the spectrum of phenotypes attributable to ARNS-ID and provide new insight into genotype–phenotype correlations between CRBN mutations and the aetiology of ARNS-ID. PMID:28143899

The coming of age of self-mutilation.

PubMed

Favazza, A R

1998-05-01

Self-mutilation (SM), the deliberate, nonsuicidal destruction of one's own body tissue, occurs in such culturally sanctioned practices as tattooing; body piercing; and healing, spiritual, and order-preserving rituals. As a symptom, it has typically been regarded as a manifestation of borderline behavior and misidentified as a suicide attempt. It has begun to attract mainstream media attention, and many more who suffer from it are expected to seek treatment. This review suggests that SM can best be understood as a morbid self-help effort providing rapid but temporary relief from feelings of depersonalization, guilt, rejection, and boredom as well as hallucinations, sexual preoccupations, and chaotic thoughts. Major SM includes infrequent acts such as eye enucleation and castration, commonly associated with psychosis and intoxication. Stereotypic SM includes such acts as head banging and self-biting most often accompanying Tourette's syndrome and severe mental retardation. Superficial/moderate SM includes compulsive acts such as trichotillomania and skin picking and such episodic acts as skin-cutting and burning, which evolve into an axis I syndrome of repetitive impulse dyscontrol with protean symptoms.

[Psychoanalysis of self injury].

PubMed

Plassmann, R

1995-08-02

Psychoanalytic aspects of diseases with self-inflicted mutilation (factitious diseases and Munchhausen syndrome) have been investigated increasingly within the last years in the setting of long term ambulatory and hospital treatments. The author describes in this report how these disease states may also be interpreted as equivalents of remembrance and can be understood as inadequate attempts for self assistance. He outlines possibilities for psychotherapy arising in view of this background.

Youth in crisis: dimensions of self-destructive conduct among adolescent prisoners.

PubMed

Johnson, R

1978-01-01

Self-mutilation and attempted suidcide among adolescent prisoners are explored in relation to concrete coping tests posed in prison and to self-esteem problems posed by failure of external (family) and internal (peer) support systems. Crisis sequences are traced using verbatim excerpts from interviews with self-destructive prisoners and conceptualized in terms of enduring adolescent needs and concerns. Some general observations regarding strategies of intervention with crisisprone prisoners are included.

Hereditary sensory and autosomal peripheral neuropathy-type IV: case series and review of literature.

PubMed

Ashwin, D P; Chandan, G D; Jasleen, Handa Kaur; Rajkumar, G C; Rudresh, K B; Prashanth, R

2015-06-01

Hereditary sensory and autonomic neuropathy (HSAN) IV is a rare autosomal recessive disorder which is characterized by a decrease in the number of myelinated and non-myelinated nerve fibers of peripheral nerves which causes diminished or absent pain sensation leading to increase in self-mutilative habits. A retrospective study of eight cases ranging from age group of 4 to 17 years for oral and digital signs and symptoms is presented. All the patients showed congenital insensitivity to pain and anhidrosis. Oral self-mutilations, such as autoextraction of teeth and severe bite injuries (with resultant scarring) of the finger tips and oral soft tissues (tongue, lip, and buccal mucosa) were found in most patients. Our study suggests that early diagnosis and specific treatment plan are important for prevention of characteristic of the oral as well as digital trauma associated with this disorder.

Predictors for self-directed aggression in Italian prisoners include externalizing behaviors, childhood trauma and the serotonin transporter gene polymorphism 5-HTTLPR.

PubMed

Gorodetsky, E; Carli, V; Sarchiapone, M; Roy, A; Goldman, D; Enoch, M-A

2016-06-01

Suicidal behavior and self-mutilation can be regarded as the expression of self-directed aggression and both are common in prison populations. We investigated the influence of externalizing behaviors, depressive symptoms, childhood trauma, 5-HTTLPR variants on self-directed aggression (N = 145) in a group of 702 male Italian prisoners. Participants were comprehensively evaluated, including for psychiatric disorders, impulsive traits, lifetime aggressive behavior [Brown-Goodwin Lifetime History of Aggression (BGHA)], hostility, violent behavior during incarceration, depressive symptomatology [Hamilton Depression Rating Scale (HDRS)], childhood trauma [Childhood Trauma Questionnaire (CTQ)]. Logistic regression analysis showed false discovery rate corrected independent main effects of externalizing behaviors: BGHA (P = 0.001), violent behavior in jail (P = 0.007), extraversion (P = 0.015); HDRS (P = 0.0004), Axis I disorders (P = 0.015), CTQ (P = 0.004) and 5-HTTLPR genotype (P = 0.02). Carriers of 5-HTTLPR high (LA LA ), intermediate (LA LG , SLA ) activity variants were more likely to have exhibited self-directed aggression relative to the low activity (LG LG , SLG , SS) variant: high/low: odds ratio (OR) = 2.3, 95% confidence interval (CI) 1.27-4.68, P = 0.007; intermediate/low: OR = 1.96, 95% CI 1.09-3.68, P = 0.025. The CTQ main effect was driven by physical abuse. There was no interactive effect of 5-HTTLPR and CTQ. Secondary logistic regression analyses in (1) all suicide attempters (N = 88) and (2) all self-mutilators (N = 104), compared with controls showed that in both groups, childhood trauma (P = 0.008-0.01), depression (P = 0.0004-0.001) were strong predictors. BGHA, violent behavior in jail predicted self-mutilation (P = 0.002) but not suicide attempts (P = 0.1). This study was able to distinguish differing influences on self-directed aggression between groups of closely related predictor variables within the externalizing behavioral domain. 5-HTTLPR had an independent, variant dosage effect. © 2016 John Wiley & Sons Ltd and International Behavioural and Neural Genetics Society.

Neuropsychiatric Disturbances, Self-Mutilation and Malingering in the French Armies during World War I: War Strain or Cowardice?

PubMed

Tatu, Laurent; Bogousslavsky, Julien

2016-01-01

Between 1914 and 1918, war strain appeared under a number of guises and affected, to varying extents, the majority of French soldiers. The most frequent form of war strain was war psychoneurosis, but war strain also induced more paroxystic disorders, such as acute episodes of terror, self-mutilation, induced illnesses and even suicide. Fear was the constant companion of soldiers of the Great War: soldiers were either able to tame it or overwhelmed by an uncontrollable fear. Nonetheless, over the course of the war, some aspects of fear were recognised as syndromes. The French health service poorly anticipated the major consequences of war strain, as with many other types of injuries. After the establishment of wartime neuropsychiatric centres, two main medical stances emerged: listening to soldiers empathetically on the one hand and applying more repressive management on the other. For many physicians, the psychological consequences of this first modern war were synonymous with malingering or cowardice in the face of duty. The stance of French military physicians in relation to their command was not unequivocal and remained ambivalent, swaying between medico-military collusion and empathy towards soldiers experiencing psychological distress. The ubiquity of suspected malingering modified the already porous borders between neuropsychiatric disorders and disobedience. Several war psychoneurotic soldiers were sentenced by councils of war for deserting their posts in the face of the enemy and were shot. Many soldiers suspected of self-mutilation or suffering from induced illnesses were also sentenced and executed without an expert assessment of their wound or their psychological state. © 2016 S. Karger AG, Basel.

A missense mutation in the CRBN gene that segregates with intellectual disability and self-mutilating behaviour in a consanguineous Saudi family.

PubMed

Sheereen, Atia; Alaamery, Manal; Bawazeer, Shahad; Al Yafee, Yusra; Massadeh, Salam; Eyaid, Wafaa

2017-04-01

Autosomal-recessive non-syndromic intellectual disability (ARNS-ID) is an aetiologically heterogeneous disorder. Although little is known about the function of human cereblon (CRBN), its relationship to mild cognitive deficits suggests that it is involved in the basic processes of human memory and learning. We aim to identify the genetic cause of intellectual disability and self-mutilation in a consanguineous Saudi family with five affected members. Clinical whole-exome sequencing was performed on the proband patient, and Sanger sequencing was done to validate and confirm segregation in other family members. A missense variant (c. 1171T>C) in the CRBN gene was identified in five individuals with severe intellectual disability (ID) in a consanguineous Saudi family. The homozygous variant was co-segregating in the family with the phenotype of severe ID, seizures and self-mutilating behaviour. The missense mutation (p.C391R) reported here results in the replacement of a conserved cysteine residue by an arginine in the CULT (cereblon domain of unknown activity, binding cellular ligands and thalidomide) domain of CRBN, which contains a zinc-binding site. These findings thus contribute to a growing list of ID disorders caused by CRBN mutations, broaden the spectrum of phenotypes attributable to ARNS-ID and provide new insight into genotype-phenotype correlations between CRBN mutations and the aetiology of ARNS-ID. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Violence against women.

PubMed

1995-04-01

Domestic violence constitutes historical behavior in accord with patriarchal systems. Family and domestic violence includes female infanticide, higher female mortality, female genital mutilation, bride burning, rape, wife battering, and early marriage. These practices are commonly integrated into values and beliefs. Women accept domestic violence in violation of their basic human rights due to social prejudice and low self esteem. Mothers who perpetuate female genital mutilation believe that they are acting in the best interests of the child by adhering to centuries-long traditions. Women who allow female infanticide or female abortion are motivated to do so in order to maintain the security of their marriage. Women are in unequal power relationships and submit to their own detriment. Negative attitudes against women are perpetuated through incorrect interpretations of religious principles and myths. Economic self-reliance gives women the courage to stand up against domestic violence. Empowerment through education and appropriate and protective legislation also gives women the means to fight violence. Nongovernmental organizations (NGOs) at the national, regional, and international levels are active in creating awareness of domestic violence and influencing policy change. The NGO Working Group on Traditional Practices and the Inter-African Committee have a 10-year history of fighting against practices such as female genital mutilation. In order to bring about change, there must be cooperative and joint action among governmental and inter-governmental groups and NGOs.

31 CFR 100.5 - Mutilated paper currency.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 31 Money and Finance: Treasury 1 2011-07-01 2011-07-01 false Mutilated paper currency. 100.5..., DEPARTMENT OF THE TREASURY EXCHANGE OF PAPER CURRENCY AND COIN Exchange of Mutilated Paper Currency § 100.5 Mutilated paper currency. (a) Lawfully held paper currency of the United States which has been mutilated...

Female Genital Mutilation: A Visual Reference and Learning Tool for Health Care Professionals.

PubMed

Abdulcadir, Jasmine; Catania, Lucrezia; Hindin, Michelle Jane; Say, Lale; Petignat, Patrick; Abdulcadir, Omar

2016-11-01

Female genital mutilation comprises all procedures that involve partial or total removal of the external female genitalia or injury to the female genital organs for nonmedical reasons. Health care providers for women and girls living with female genital mutilation have reported difficulties in recognizing, classifying, and recording female genital mutilation, which can adversely affect treatment of complications and discussions of the prevention of the practice in future generations. According to the World Health Organization, female genital mutilation is classified into four types, subdivided into subtypes. An agreed-upon classification of female genital mutilation is important for clinical practice, management, recording, and reporting, as well as for research on prevalence, trends, and consequences of female genital mutilation. We provide a visual reference and learning tool for health care professionals. The tool can be consulted by caregivers when unsure on the type of female genital mutilation diagnosed and used for training and surveys for monitoring the prevalence of female genital mutilation types and subtypes.

Using the Female Sexual Function Index (FSFI) to evaluate sexual function in women with genital mutilation undergoing surgical reconstruction: a pilot prospective study.

PubMed

Vital, Mathilde; de Visme, Sophie; Hanf, Matthieu; Philippe, Henri-Jean; Winer, Norbert; Wylomanski, Sophie

2016-07-01

Few prospective studies have evaluated sexual function in women with female genital mutilation by cutting (FGM/C) before and after clitoral reconstructive surgery, and none used a validated questionnaire. A validated questionnaire, the Female Sexual Function Index (FSFI) was used for the first time, to assess the impact of reconstructive surgery on sexual function in women with female genital mutilation/cutting (FGM/C) before and after clitoral reconstructive surgery. Women with FGM/C consulting at the Nantes University Hospital for clitoral reconstruction between 2013 and 2014 were prospectively included. All patients completed a questionnaire at inclusion, describing their social, demographic, and FGM/C characteristics. They were also asked to complete the FSFI as well as a questionnaire about clitoral sensations, symptoms of depression or anxiety, and self-esteem before and 3 and 6 months after the surgery. Paired Wilcoxon and McNemar tests were used to compare data. Of the 12 women included, 9 (75%) had type II mutilations. Results showed a global sexual dysfunction (median FSFI summary score=17) before surgery. Clitoral sensations were absent in 8 women (67%). Six months after surgery, all FSFI dimensions except lubrication had improved significantly (median FSFI summary score=29, P=0.009). Ten women had clitoral sensations, and 11 (92%) were satisfied with their surgery. This study shows that 6 months after clitoral reconstructive surgery, women reported a multidimensional positive improvement in their sexual function. The FSFI is a promising tool for routine standardized assessment of the sexual function of women with FGM/C for determining appropriate management and assessing it. Larger studies with validated questionnaires assessing self-esteem, depression, and body image are also needed to develop an integrative approach and to provide evidence-based recommendations about management of these women. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

In My Own Words.

ERIC Educational Resources Information Center

Terenzi, Nicole

1999-01-01

Describes one youth's account of her experiences with depression and recounts her earliest feelings of being an outsider. Remembers what it was like to be diagnosed with Attention-Deficit/Hyperactivity Disorder and to take Ritalin. Her experiences with self-mutilation in middle school eventually led to hospitalization and electroconvulsive…

Body dysmorphia, self-mutilation and the reconstructive surgeon.

PubMed

Chan, James Kwok-Kwan; Jones, Sophie M; Heywood, Anthony J

2011-01-01

Body dysmorphic disorder (BDD) is a disabling preoccupation with a slight or an imagined defect in appearance. It is recognised in some patients who present to the plastic surgeon requesting multiple cosmetic procedures. Very rarely, BDD patients may wish for amputation of a healthy limb and may even mutilate themselves deliberately in order to necessitate amputation. These patients pose a diagnostic challenge as BDD is uncommon and they are often uncooperative whilst appearing mentally sound. Furthermore, they raise difficult ethical and legal issues for the surgeon. Although there is some guidance for the management of BDD patients seeking elective amputation, there is currently none for the management of those who present in the emergency setting. Illustrated by the case of a man who, having failed to find a complicit surgeon, attempted self-amputation of the hand, we review the relevant ethical, legal and management issues with advice by the British Medical Association and General Medical Council. Copyright © 2010 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

Female genital mutilation and reporting duties for all clinical personnel.

PubMed

Cropp, Gabrielle; Armstrong, Jane

2016-07-01

Female genital mutilation is illegal. It is now mandatory for health-care professionals to report female genital mutilation to the police. Professionals caring for women and girls of all ages must understand how female genital mutilation presents, and what action to take.

Social Disorganization as a Critical Factor in "Crowding."

ERIC Educational Resources Information Center

McCain, Garvin; And Others

This paper discusses factors related to negative psychological and physiological reactions (i.e., violent deaths, psychiatric commitments, self-mutilations, attempted suicides, disciplinary infractions, etc.) to life in institutional environments such as prisons, schools, off-shore oil rigs, and homes for the aged. Factors discussed are: (1)…

Trauma due to Self-aggression in Patient with Waardenburg Syndrome associated with Congenital Anomalies.

PubMed

Marta, Sara Nader; Kawakami, Roberto Yoshio; Sgavioli, Claudia Almeida Prado Piccino; Correa, Ana Eliza; D'Árk de Oliveira El Kadre, Guaniara; Carvalho, Ricardo Sandri

2016-08-01

Waardenburg syndrome (WS) is an inherited autosomal dominant genetic disorder presenting variable penetrance and expressivity, with an estimated prevalence of 1:42,000. Clinical characteristics of WS include lateral displacement of the internal eye canthus, hyperplasia of the medial portion of the eyebrows, prominent and broad nasal base, congenital deafness, pigmentation of the iris and skin, and white forelock. A 24-year-old male patient, previously diagnosed with WS, was referred to the Special Needs Dental Clinic of Sacred Heart University, Bauru, Brazil. Parents reported that the patient was experiencing self-mutilation, particularly in the oral region. He presented multiple congenital anomalies, including anophthalmia, mental retardation, low-set ears, and leg deformities. Clinical oral examination revealed hypodontia, abnormalities in dental morphology, extensive dental caries, periodontal disease, and fistulae. Extensive scars on the tongue, lips, and hands caused by self-mutilation were also observed. In accordance with his family and neurologist, full-mouth extraction under general anesthesia was performed, especially considering his severe self-aggressive behavior and the necessity to be fed with soft-food diet due to his inability to chew. After the surgical procedure, a significant reduction in the patient's irritability and gain of weight were reported in the follow-ups of 30, 60, and 180 days.

31 CFR 100.5 - Mutilated paper currency.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 31 Money and Finance: Treasury 1 2010-07-01 2010-07-01 false Mutilated paper currency. 100.5 Section 100.5 Money and Finance: Treasury Regulations Relating to Money and Finance EXCHANGE OF PAPER CURRENCY AND COIN Exchange of Mutilated Paper Currency § 100.5 Mutilated paper currency. (a) Lawfully held...

Emotional and Behavioral Disturbances in Adolescents Involved in Witchcraft and Satanism.

ERIC Educational Resources Information Center

Burket, Roger C.; And Others

1994-01-01

Examined inpatient medical records of 157 consecutive adolescent admissions to private psychiatric hospital. Ten patients with interest in witchcraft and Satanism had significantly more diagnoses of identity disorder, alcohol abuse, and hallucinogen abuse. One-half reported history of self-mutilation. Found no significant difference in criminal…

40 CFR 795.250 - Developmental neurotoxicity screen.

Code of Federal Regulations, 2011 CFR

2011-07-01

... the tests when conducted at about the same age. (C) One male and one female shall be randomly selected... searching, compulsive biting or licking, self-mutilation, circling, and walking backwards. (C) The presence... reliability is required. At a minimum, the end points outlined in paragraph (c)(6)(ii) of this section shall...

40 CFR 795.250 - Developmental neurotoxicity screen.

Code of Federal Regulations, 2010 CFR

2010-07-01

... the tests when conducted at about the same age. (C) One male and one female shall be randomly selected... searching, compulsive biting or licking, self-mutilation, circling, and walking backwards. (C) The presence... reliability is required. At a minimum, the end points outlined in paragraph (c)(6)(ii) of this section shall...

Wave of mutilation: the cattle mutilation phenomenon of the 1970s.

PubMed

Goleman, Michael J

2011-01-01

During the 1970s many small-scale cattle ranchers across the Midwest reported finding their cattle mutilated. The episode, often dismissed as mass hysteria or sensationalized reporting, demonstrates the growing dissatisfaction of many ranchers concerning government intrusiveness and restrictive policies. These frustrations found a release in response to the mutilation phenomenon during which ranchers vented their anger by taking direct aim at the federal government. The turbulent economic conditions of the period paired with government interference in the cattle industry helped sustain the mutilation phenomenon as ranchers projected their fears and insecurities through the bizarre episode. The hostility ranchers showed toward the federal government during the mutilation scare presaged and helped provide the impetus for events such as the Sagebrush Rebellion. The mutilation phenomenon also underscores the pronounced effects of the libertarian movement of the 1960s that gave rise to the New Right and gained adherents across the West and Midwest.

Female genital mutilation: a hidden epidemic (statement from the European Academy of Paediatrics).

PubMed

Sauer, Pieter J J; Neubauer, David

2014-02-01

Female genital mutilation or female circumcision is frequently performed worldwide. It is estimated by the World Health Organisation that worldwide, 100-140 million girls and women currently have to live with the consequences of female genital mutilation. The article argues that the tradition is one of the causes, while another four possible reasons for undergoing such cruel mutilation of young girls exist. Today, there exists a classification of at least four different ways of such mutilation which has no health benefits, and it harms girls and women in many ways. Long-term consequences like recurrent urinary tract infections, dysmenorrhea, sexual problems, infertility and complications both for the mother and infant at delivery are mentioned. Female genital mutilation is a violation of the fundamental human rights, as well as a savage breach of the integrity and personality. The European Academy of Paediatrics advises its members to initiate appropriate counselling for parents and female adolescents regarding the risk of female genital mutilation and strongly condemns female genital mutilation and councils its members not to perform such procedures.

Aggravated loss of tooth structure.

PubMed

Barsby, M J

1989-09-01

Self-inflicted tooth modification other than ritual mutilation practised in some countries is a rare occurrence. The author reports a case of aggravated loss of tooth structure where a patient has contributed to loss of tooth structure by the novel method of adjusting his natural teeth with a 'knife'. Subsequent management of the case is discussed.

Sexual Abuse and the Problem of Embodiment.

ERIC Educational Resources Information Center

Young, Leslie

1992-01-01

Potential long-term effects of the trauma of severe sexual abuse on a child's sense of living in his/her body and in the world are explored. Trauma and dissociation are analyzed and linked to a posttraumatic sense of personal identity. Then dissociation, multiple personality disorder, eating disorders, somatization disorder, self-mutilation, and…

Towards a post-traumatic subtype of obsessive-compulsive disorder.

PubMed

Fontenelle, Leonardo F; Cocchi, Luca; Harrison, Ben J; Shavitt, Roseli G; do Rosário, Maria Conceição; Ferrão, Ygor A; de Mathis, Maria Alice; Cordioli, Aristides V; Yücel, Murat; Pantelis, Christos; Mari, Jair de Jesus; Miguel, Euripedes C; Torres, Albina R

2012-03-01

We evaluated whether traumatic events are associated with a distinctive pattern of socio-demographic and clinical features of obsessive-compulsive disorder (OCD). We compared socio-demographic and clinical features of 106 patients developing OCD after post-traumatic stress disorder (PTSD; termed post-traumatic OCD), 41 patients developing OCD before PTSD (pre-traumatic OCD), and 810 OCD patients without any history of PTSD (non-traumatic OCD) using multinomial logistic regression analysis. A later age at onset of OCD, self-mutilation disorder, history of suicide plans, panic disorder with agoraphobia, and compulsive buying disorder were independently related to post-traumatic OCD. In contrast, earlier age at OCD onset, alcohol-related disorders, contamination-washing symptoms, and self-mutilation disorder were all independently associated with pre-traumatic OCD. In addition, patients with post-traumatic OCD without a previous history of obsessive-compulsive symptoms (OCS) showed lower educational levels, greater rates of contamination-washing symptoms, and more severe miscellaneous symptoms as compared to post-traumatic OCD patients with a history of OCS. Copyright © 2011 Elsevier Ltd. All rights reserved.

Smoking synthetic marijuana leads to self-mutilation requiring bilateral amputations.

PubMed

Meijer, Karim A; Russo, Russell R; Adhvaryu, Dhaval V

2014-04-01

Synthetic cannabinoids have become a worldwide epidemic because they provide a sometimes legal, easily accessible, and presumably safe alternative to marijuana. Recently published reports have linked acute psychosis, myocardial infarctions, convulsions, self-harm, and even terrorist organizations to these designer substances. This case report outlines the first reported case of Black Diamond, a synthetic cannabis, leading to a self-inflicted burn to the bilateral upper extremities requiring a transradial amputation of the right arm and a toe transfer procedure of the left hand after loss of all digits. The patient presented to the emergency department with self-inflicted fourth-degree burns to the bilateral hands and forearms with second-degree burns of the face, for a total body surface area of 14.5%. The patient was found by firefighters with his hands aflame on his kitchen stove. With no previous medical or psychiatric history and collateral information to confirm the patient's mental status prior to use of Black Diamond, the patient's acute psychotic episode was attributed to Black Diamond. After multiple procedures and a lengthy recovery, the patient completed his post-graduate education and entered the professional world. As orthopedic surgeons, we should be involved in educating the public on the harm of these designer drugs, including self-mutilation. The popularity of synthetic drugs in the United States will continue to present a major challenge to all health care providers. Orthopedists are on the front lines of this epidemic because these drugs push patients into risky, traumatic behavior. Copyright 2014, SLACK Incorporated.

Female Genital Mutilation in Sierra Leone: Forms, Reliability of Reported Status, and Accuracy of Related Demographic and Health Survey Questions

PubMed Central

Grant, Donald S.; Berggren, Vanja

2013-01-01

Objective. To determine forms of female genital mutilation (FGM), assess consistency between self-reported and observed FGM status, and assess the accuracy of Demographic and Health Surveys (DHS) FGM questions in Sierra Leone. Methods. This cross-sectional study, conducted between October 2010 and April 2012, enrolled 558 females aged 12–47 from eleven antenatal clinics in northeast Sierra Leone. Data on demography, FGM status, and self-reported anatomical descriptions were collected. Genital inspection confirmed the occurrence and extent of cutting. Results. All participants reported FGM status; 4 refused genital inspection. Using the WHO classification of FGM, 31.7% had type Ib; 64.1% type IIb; and 4.2% type IIc. There was a high level of agreement between reported and observed FGM prevalence (81.2% and 81.4%, resp.). There was no correlation between DHS FGM responses and anatomic extent of cutting, as 2.7% reported pricking; 87.1% flesh removal; and 1.1% that genitalia was sewn closed. Conclusion. Types I and II are the main forms of FGM, with labia majora alterations in almost 5% of cases. Self-reports on FGM status could serve as a proxy measurement for FGM prevalence but not for FGM type. The DHS FGM questions are inaccurate for determining cutting extent. PMID:24204384

Clitoral keloids after female genital mutilation/cutting.

PubMed

Birge, Özer; Akbaş, Murat; Özbey, Ertuğrul Gazi; Adıyeke, Mehmet

2016-09-01

We aimed to describe the presentation of long-term complications of female genital mutilation/cutting and the surgical management of clitoral keloids secondary to female genital mutilation/cutting. Twenty-seven women who underwent surgery because of clitoral keloid between May 2014 and September 2015 in Sudan Nyala Turkish Hospital were evaluated in this retrospective descriptive case series study. The prevalence of type 1, type 2, and type 3 female genital mutilation/cutting were 3.7%, 22.2%, and 74.1%, respectively (type 1: 1/27, type 2: 6/27, and type 3: 20/27). All patients had long-term health problems (dysuria, chronic pelvic pain, vaginal discharge, and chronic pruritus) and sexual dysfunction. Keloids were removed by surgical excision. There were no postoperative complications in any patient. Although clitoral keloid lesions can be seen after any type of female genital mutilation/cutting, they usually develop after type 3 female genital mutilation/cutting. Most of these keloids were noticed after menarche. Keloids can be removed by surgical excision and this procedure can alleviate some long-term morbidities of female genital mutilation/cutting.

Clitoral keloids after female genital mutilation/cutting

PubMed Central

Birge, Özer; Akbaş, Murat; Özbey, Ertuğrul Gazi; Adıyeke, Mehmet

2016-01-01

We aimed to describe the presentation of long-term complications of female genital mutilation/cutting and the surgical management of clitoral keloids secondary to female genital mutilation/cutting. Twenty-seven women who underwent surgery because of clitoral keloid between May 2014 and September 2015 in Sudan Nyala Turkish Hospital were evaluated in this retrospective descriptive case series study. The prevalence of type 1, type 2, and type 3 female genital mutilation/cutting were 3.7%, 22.2%, and 74.1%, respectively (type 1: 1/27, type 2: 6/27, and type 3: 20/27). All patients had long-term health problems (dysuria, chronic pelvic pain, vaginal discharge, and chronic pruritus) and sexual dysfunction. Keloids were removed by surgical excision. There were no postoperative complications in any patient. Although clitoral keloid lesions can be seen after any type of female genital mutilation/cutting, they usually develop after type 3 female genital mutilation/cutting. Most of these keloids were noticed after menarche. Keloids can be removed by surgical excision and this procedure can alleviate some long-term morbidities of female genital mutilation/cutting. PMID:28913112

[Algorithm for the prevention of female genital mutilation. Case study from primary care].

PubMed

Alcón Belchí, Carolina; Jiménez Ruiz, Ismael; Pastor Bravo, María del Mar; Almansa Martínez, Pilar

2016-03-01

Create and implement a protocol for identifying and preventing female genital mutilation in a municipality of the Region of Murcia. A bibliographical review and significant databases were consulted for the creation of the algorithm performance. These include Cuiden, Dialnet, Medes, Medline, and other documentary sources of interest. The instrument for data collection was completed by interviewing parents of girls at risk. The multi-disciplinary team was formed; the female genital mutilation risk cases were collected, and were summoned to the nursing consulting room. Two girls had been mutilated, the rest were at risk of female genital mutilation, and in one case the risk was imminent. The algorithm designed guides practitioners in their performance, achieving an effective detection and prevention of genital mutilation of girls. This is a first approach to the development of a regional protocol. Copyright © 2015 Elsevier España, S.L.U. All rights reserved.

Is There a Specific Relationship between Childhood Sexual and Physical Abuse and Repeated Suicidal Behavior?

ERIC Educational Resources Information Center

Ystgaard, Mette; Hestetun, Ingebjorg; Loeb, Mitchell; Mehlum, Lars

2004-01-01

Objective: Studies show that childhood sexual and physical abuse predict repeated suicide attempts and self-mutilation. Little is known about the importance of sexual and physical abuse when compared to other severe childhood adversities with respect to chronic suicidal behavior. Method: Seventy-four subjects, 65% of whom were women, consecutively…

Sexual Function, Mental Well-being and Quality of Life among Kurdish Circumcised Women in Iran.

PubMed

Daneshkhah, Farzaneh; Allahverdipour, Hamid; Jahangiri, Leila; Andreeva, Tatiana

2017-09-01

Female genital mutilation is an intentional inhumane procedure that threatens girls and women's health. It is especially widespread in developing countries due to cultural, traditional and religious preferences. The aim of the current study was to investigate how circumcision affects women's sexual function. This cross-sectional study was conducted in the urban and rural area of Piranshahr County, Iran, in 2015 among convenience samples of 200 women, 15-49 yr old, who were applying to health care centers for receiving routine health care services. Data collection was conducted with the use of a self-administered written questionnaire to assess female sexual function, mental well-being, and quality of life. Significant differences were found between circumcised and non-circumcised women in total score of female sexual function index (FSFI) in domains of desire, arousal, vaginal moisture, orgasm, satisfaction, and pain [( P <0.001), MD(95%CI)=5.64(3.64 to 7.64)] and based on Hotelling's T-square, significant differences were found in dimensions of quality of life and FSFI. The revealed sexual dysfunction among mutilated women gives ground to require that public health systems take actions aimed at implementing special sexual education program to improve sexual functions of mutilated women and changing beliefs and social norms in the community level.

Defense Logistics Agency Disposition Services Needs to Improve Demilitarization Program Self-Assessment Evaluations - Redacted

DTIC Science & Technology

2016-12-20

Program Self -Assessment Evaluations I N T E G R I T Y  E F F I C I E N C Y  A C C O U N T A B I L I T Y  E X C E L L E N C E Mission Our mission...Project No. D2016-D000RD-0057.000) │ i Results in Brief Defense Logistics Agency Disposition Services Needs to Improve Demilitarization Program Self ...mutilation contractor3 in Holbrook, New York, the two sites we visited. However, for self -assessment evaluations4 at three DLA Centralized

Female genital mutilation/cutting in Italy: an enhanced estimation for first generation migrant women based on 2016 survey data.

PubMed

Ortensi, Livia Elisa; Farina, Patrizia; Leye, Els

2018-01-12

Migration flows of women from Female Genital Mutilation/Cutting practicing countries have generated a need for data on women potentially affected by Female Genital Mutilation/Cutting. This paper presents enhanced estimates for foreign-born women and asylum seekers in Italy in 2016, with the aim of supporting resource planning and policy making, and advancing the methodological debate on estimation methods. The estimates build on the most recent methodological development in Female Genital Mutilation/Cutting direct and indirect estimation for Female Genital Mutilation/Cutting non-practicing countries. Direct estimation of prevalence was performed for 9 communities using the results of the survey FGM-Prev, held in Italy in 2016. Prevalence for communities not involved in the FGM-Prev survey was estimated using to the 'extrapolation-of-FGM/C countries prevalence data method' with corrections according to the selection hypothesis. It is estimated that 60 to 80 thousand foreign-born women aged 15 and over with Female Genital Mutilation/Cutting are present in Italy in 2016. We also estimated the presence of around 11 to 13 thousand cut women aged 15 and over among asylum seekers to Italy in 2014-2016. Due to the long established presence of female migrants from some practicing communities Female Genital Mutilation/Cutting is emerging as an issue also among women aged 60 and over from selected communities. Female Genital Mutilation/Cutting is an additional source of concern for slightly more than 60% of women seeking asylum. Reliable estimates on Female Genital Mutilation/Cutting at country level are important for evidence-based policy making and service planning. This study suggests that indirect estimations cannot fully replace direct estimations, even if corrections for migrant socioeconomic selection can be implemented to reduce the bias.

Posttraumatic Stress Disorder Relapse and Clitoral Reconstruction After Female Genital Mutilation.

PubMed

Abdulcadir, Jasmine; Bianchi Demicheli, Francesco; Willame, Alexia; Recordon, Nathalie; Petignat, Patrick

2017-02-01

Evidence on clitoral reconstruction after female genital mutilation is lacking. A woman with female genital mutilation experiencing clitoral pain during sex consulted to undergo clitoral reconstruction. The surgery was complicated by a wound infection responsible for severe postoperative pain. Such genital pain made our patient recall the traumatic experience of genital mutilation and experience a relapse of posttraumatic stress disorder symptoms. She reported anxiety; spontaneous, intrusive recurrent memories of the cutting; hypervigilance; and depressed mood. We successfully treated the infection and posttraumatic stress disorder. At 6 months postsurgery, she reported no clitoral pain and improved sexual function. Genital pain after clitoral reconstruction may cause recall of memories of the genital mutilation. We recommend multidisciplinary comprehensive psychosexual care and adequate analgesia.

Female genital mutilation in Britain.

PubMed

Black, J A; Debelle, G D

1995-06-17

The practice of female genital mutilation predates the founding of both Christianity and Islam. Though largely confined among Muslims, the operation is also practiced in some Christian communities in Africa such that female genital mutilation takes place in various forms in more than twenty African countries, Oman, Yemen, the United Arab Emirates, and by some Muslims in Malaysia and Indonesia. In recent decades, ethnic groups which practice female genital mutilation have immigrated to Britain. The main groups are from Eritrea, Ethiopia, Somalia, and Yemen. In their own countries, an estimated 80% of women have had the operation. Female genital mutilation has been illegal in Britain since 1985, but it is practiced illegally or children are sent abroad to undergo the operation typically at age 7-9 years. It is a form of child abuse which poses special problems. The authors review the history of female genital mutilation and describe its medical complications. Assuming that the size of the population in Britain of ethnic groups which practice or favor female genital mutilation remains more or less unchanged, adaptation and acculturation will probably cause the practice to die out within a few generations. Meanwhile, there is much to be done. A conspiracy of silence exists in medical circles as well as widespread ignorance. Moreover, none of a number of well-known obstetric and pediatric textbooks mentions female genital mutilation, while the National Society for the Prevention of Cruelty to Children has neither information nor instructional material. It is high time that the problem was more widely and openly discussed.

A Novel 6.14 Mb Duplication of Chromosome 8p21 in a Patient with Autism and Self Mutilation

ERIC Educational Resources Information Center

Ozgen, Heval M.; Staal, Wouter G.; Barber, John C.; de Jonge, Maretha V.; Eleveld, Marc J.; Beemer, Frits A.; Hochstenbach, Ron; Poot, Martin

2009-01-01

Autism spectrum disorders (ASDs) are a group of neurodevelopmental disorders with a strong genetic etiology. Cytogenetic abnormalities have been detected in 5-10% of the patients with autism. In this study, we present the clinical, cytogenetic and array-comparative genomic hybridization (array-CGH) evaluation of a 13-year-old male with severe…

The Prevalence and Comorbidity between Delinquency, Drug Abuse, Suicide Attempts, Physical and Sexual Abuse, and Self-Mutilation among Delinquent Hispanic Females

ERIC Educational Resources Information Center

Cuellar, Jeanette; Curry, Theodore R.

2007-01-01

Representative data show that drug abuse, delinquency, and suicide attempts are major concerns among adolescent Hispanic females. Although comorbidity research indicates that such problems tend to be related to each other, this research largely neglects Hispanic females. Using data from presentence investigations on 141 Hispanic girls sentenced to…

31 CFR 306.113 - Cases not requiring bonds of indemnity.

Code of Federal Regulations, 2011 CFR

2011-07-01

... GOVERNING U.S. SECURITIES Relief for Loss, Theft, Destruction, Mutilation, or Defacement of Securities § 306... relief for the loss, theft, destruction, mutilation, or defacement of registered securities in any of the...: (a) If the loss, theft, destruction, mutilation, or defacement, as the case may be, occurred while...

Destruction of Knowledge: A Study of Journal Mutilation at a Large University Library.

ERIC Educational Resources Information Center

Constantinou, Constantia

1995-01-01

A study of 1264 incidents of journal mutilation at New York University indicates no relationship between the availability of indexing and abstracting services on CD-ROM databases and mutilation. Recommends posting warnings; raising awareness; providing adequate photocopiers, change, and vendor card machines; announcing closing time; encouraging…

7 CFR 1779.73 - Replacement of loss, theft, destruction, mutilation, or defacement of Loan Note Guarantee or...

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 12 2010-01-01 2010-01-01 false Replacement of loss, theft, destruction, mutilation..., theft, destruction, mutilation, or defacement of Loan Note Guarantee or Assignment Guarantee Agreement... circumstances of the loss, theft, or destruction of the Loan Note Guarantee or Assignment Guarantee Agreement...

7 CFR 1901.509 - Loss, theft, destruction, mutilation, or defacement of insured notes, insurance contracts, and...

Code of Federal Regulations, 2011 CFR

2011-01-01

... 7 Agriculture 12 2011-01-01 2011-01-01 false Loss, theft, destruction, mutilation, or defacement... Notes § 1901.509 Loss, theft, destruction, mutilation, or defacement of insured notes, insurance... different from the present address; the capacity of person certifying, if other than owner; the identity of...

Self-Inflicted Nailgun-Induced Penetrating Penile Injury: Case Report and Discussion.

PubMed

Hernandez, Jeremy Mark; Hamilton, David; Upadhye, Suneel

2017-05-01

Penetrating penile injuries occur mostly in industrial/work accidents, automobile accidents, or as a result of sexual curiosity and attempts at self-expression/mutilation. In this case report, the authors describe an accidental nailgun injury to the penis of a 46-year-old man. We discuss the management of such injuries in the emergency department, including the utility of a dorsal penile block for regional anesthesia. Although exceptionally rare, familiarity with penetrating lower urinary tract injuries may reduce their long-term repercussions on genitourinary and sexual health.

Sexual Function, Mental Well-being and Quality of Life among Kurdish Circumcised Women in Iran

PubMed Central

DANESHKHAH, Farzaneh; ALLAHVERDIPOUR, Hamid; JAHANGIRI, Leila; ANDREEVA, Tatiana

2017-01-01

Background: Female genital mutilation is an intentional inhumane procedure that threatens girls and women’s health. It is especially widespread in developing countries due to cultural, traditional and religious preferences. The aim of the current study was to investigate how circumcision affects women’s sexual function. Methods: This cross-sectional study was conducted in the urban and rural area of Piranshahr County, Iran, in 2015 among convenience samples of 200 women, 15–49 yr old, who were applying to health care centers for receiving routine health care services. Data collection was conducted with the use of a self-administered written questionnaire to assess female sexual function, mental well-being, and quality of life. Results: Significant differences were found between circumcised and non-circumcised women in total score of female sexual function index (FSFI) in domains of desire, arousal, vaginal moisture, orgasm, satisfaction, and pain [(P<0.001), MD(95%CI)=5.64(3.64 to 7.64)] and based on Hotelling’s T-square, significant differences were found in dimensions of quality of life and FSFI. Conclusion: The revealed sexual dysfunction among mutilated women gives ground to require that public health systems take actions aimed at implementing special sexual education program to improve sexual functions of mutilated women and changing beliefs and social norms in the community level. PMID:29026793

Female Genital Mutilation Reconstruction: A Preliminary Report.

PubMed

Chang, Catherine S; Low, David W; Percec, Ivona

2017-09-01

Female genital mutilation (FGM) is internationally recognized as a violation of human rights. Though rarely discussed, FGM is prevalent, affecting hundreds of millions of females worldwide. We believe that is important for plastic surgeons to be informed and prepared to address the surgical and emotional needs of these women. We present our experience on treatment of women subjected to FGM. Three consecutive patients were treated by our clitoral restoration procedure. The procedure involves conscious sedation and involves wide release of scar tissue around the labia majora and clitoris. Labial flaps are elevated and secured down to the periosteum and the clitoris is allowed to remucosalize. Three females with grade II mutilation were treated. The average age was 32.3-years-old and the average follow up was 305 days. All patients self-reported improved sexual function and decreased embarrassment with their partners. And all recommended the treatment to other women subjected to FGM. FGM is a violation of the basic rights of women and children. Plastic surgeons can help these women restore their physical and psychological sense of well-being by providing effective reconstructive options. Our goal is to raise awareness of this problem and describe a simple yet effective treatment for women that have been subject to FGM. 5. © 2017 The American Society for Aesthetic Plastic Surgery, Inc. Reprints and permission: journals.permissions@oup.com

Female genital mutilation and cosmetic surgery: regulating non-therapeutic body modification.

PubMed

Sheldon, Sally; Wilkinson, Stephen

1998-10-01

In the UK, female genital mutilation is unlawful, not only when performed on minors, but also when performed on adult women. The aim of our paper is to examine several arguments which have been advanced in support of this ban and to assess whether they are sufficient to justify banning female genital mutilation for competent, consenting women. We proceed by comparing female genital mutilation, which is banned, with cosmetic surgery, towards which the law has taken a very permissive stance. We then examine the main arguments for the prohibition of the former, assessing in each case both (a) whether the argument succeeds in justifying the ban and, if so, (b) whether a parallel argument would not also support a ban on the latter. We focus on the following arguments. Female genital mutilation should be unlawful because: (1) no woman could validly consent to it; (2) it is an oppressive and sexist practice; (3) it involves the intentional infliction of injury; (4) it causes offence. Our view is that arguments (3) and (4) are unsound and that, although arguments (1) and (2) may be sound, they support not only a ban on female genital mutilation, but also one on (some types of) cosmetic surgery. Hence, we conclude that the present legal situation in the UK is ethically unsustainable in one of the following ways. Either the ban on female genital mutilation is unjustified because arguments (1) and (2) are not in fact successful; or the law's permissive attitude towards cosmetic surgery is unjustified because arguments (1) and (2) are in fact successful and apply equally to female genital mutilation and (certain forms of) cosmetic surgery. The people of the countries where female genital mutilation is practised resent references to 'barbaric practices imposed on women by male-dominated primitive societies', especially when they look at the Western world and see women undergoing their own feminization rites intended to increase sexual desirability: medically dangerous forms of cosmetic plastic surgery, for instance....

7 CFR 1786.35 - Loss, theft, destruction, mutilation, or defacement of RUS guarantee.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 12 2010-01-01 2010-01-01 false Loss, theft, destruction, mutilation, or defacement... Loans Pursuant to Section 306(A) of the RE Act § 1786.35 Loss, theft, destruction, mutilation, or... circumstances of the loss, theft, or destruction of the guarantee; and (vi) The lender or holder, shall present...

7 CFR 1901.509 - Loss, theft, destruction, mutilation, or defacement of insured notes, insurance contracts, and...

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 12 2010-01-01 2010-01-01 false Loss, theft, destruction, mutilation, or defacement... Notes § 1901.509 Loss, theft, destruction, mutilation, or defacement of insured notes, insurance... writing. (iv) A full statement of circumstances of the loss, theft, or destruction of the note. (2) An...

Measurement of perceived functions of non-suicidal self-injury for Chinese adolescents.

PubMed

Leong, Choi Hong; Wu, Anise M S; Poon, Mary Man-Yee

2014-01-01

Due to the lack of validated assessment tools for motives of non-suicidal self-injury behaviors in the Chinese contexts, this study aims to evaluate the psychometric properties of the Chinese version of the Functional Assessment of Self-Mutilation (C-FASM). A total of 345 secondary school students (mean age = 11.41 years), who reported non-suicidal self-injury in the past year, voluntarily participated in the questionnaire survey. Confirmatory factor analysis results supported a second-order model of 4 motivational factors. The overall scale scores had significant correlations with depression, anxiety, impulsiveness, self-esteem, social support, and suicidal ideation. The internal consistency of the scale was also satisfactory. The C-FASM is a valid and reliable instrument for assessing non-suicidal self-injury among nonclinical Chinese adolescents.

Self-attempted labioplasty with elastic bands resulting in severe necrosis.

PubMed

Farahani, Farimah; Gentry, Adrienne; Lara-Torre, Eduardo; McCuin, Elizabeth

2015-04-01

Labial hypertrophy is protuberant labial tissue extending beyond the labia majora. Self-perception of poor cosmetic appearance is common in young patients and not necessarily pathologic. Labioplasty is indicated for patients with persistent symptoms including entrapment and painful intercourse. A 26-year-old woman presented with genital pain and foul odor after self-applying elastic bands to her labia minora. The bands were applied for a self-perceived abnormal appearance and lack of insurance for medical consultation. Surgical debridement and revision of the labia were performed using a straight vertical approach. Self-attempted labioplasty can result in necrosis and infection. Education and counseling of patients on the normal variants of labial anatomy and the recommended therapeutic methods will lead to better cosmetic results and prevent self-mutilation.

[Transference Focused Psychotherapy for Borderline-Adolescents in a Day Clinic Treatment Program].

PubMed

Krischer, Maya; Ponton-Rodriguez, Tamara; Gooran, Ghazal Rostami; Bender, Stephan

2017-07-01

Transference Focused Psychotherapy for Borderline-Adolescents in a Day Clinic Treatment Program This paper focuses on the concept of transference focused psychotherapy (TFP) modified for juvenile borderline patients. Adolescents with borderline developmental personality disorder (bpd) have an essential deficit in their personality structure that leads to oscillations in their self-esteem and in a "split" perception of the world. They suffer from a variety of symptoms and severe impairments on their own and their families' quality of life. Their fragmented perception of themselves and others make relationships almost unbearable for them. Relationships are mostly marked by severe anxiety of resentment and rejection. For these patients this causes intolerable trouble at school where every day conflicts take place. Self-mutilation and suicidal thoughts often seem the only way out. By now, there is an agreement that an early specialized assessment and treatment is necessary in order to stop the typical consequences of their self-mutilative and dysfunctional behavior. Still, in contrast to adult age, empirical evidence is missing which proves the effectiveness of treating adolescent borderline patients. In this paper we present a research project on the effectiveness of transference focused psychotherapy with adolescent borderline patients (TFP-A) in a day clinic setting, combining TFP with group skills training as known from dialectic behavior therapy (DBT). Furthermore, we give first results on analyzing the effectiveness of our day clinic treatment program based on TFP-A, focusing on improving core symptoms such as affective problems, aggressive behavior against self and others and interpersonal problems.

Maternal infibulation and obstetrical outcome in Djibouti.

PubMed

Minsart, Anne-Frederique; N'guyen, Thai-Son; Ali Hadji, Rachid; Caillet, Martin

2015-01-01

The objective of the present study was to assess the relation between female genital mutilation and obstetric outcome in an East African urban clinic with a standardized care, taking into account medical and socioeconomic status. This was a cohort study conducted in Djibouti between October 1, 2012 and April 30, 2014. Overall 643 mothers were interviewed and clinically assessed for the presence of female genital mutilation. The prevalence of obstetric complications by infibulation status was included in a multivariate stepwise regression model. Overall, 29 of 643 women did not have any form of mutilation (4.5%), as opposed to 238 of 643 women with infibulation (37.0%), 369 with type 2 (57.4%), and 7 with type 1 mutilation (1.1%).Women with a severe type of mutilation were more likely to have socio-economic and medical risk factors. After adjustment, the only outcome that was significantly related with infibulation was the presence of meconium-stained amniotic fluid with an odds ratio of 1.58 (1.10-2.27), p value=0.014. Infibulation was not related with excess perinatal morbidity in this setting with a very high prevalence of female genital mutilation, but future research should concentrate on the relation between infibulation and meconium.

Female genital mutilation.

PubMed

Ladjali, M; Rattray, T W; Walder, R J

1993-08-21

Female genital mutilation, also misleadingly known as female circumcision, is usually performed on girls ranging in from 1 week to puberty. Immediate physical complications include severe pain, shock, infection, bleeding, acute urinary infection, tetanus, and death. Longterm problems include chronic pain, difficulties with micturition and menstruation, pelvic infection leading to infertility, and prolonged and obstructed labor during childbirth. An estimated 80 million girls and women have undergone female genital mutilation. In Britain alone an estimated 10,000 girls are currently at risk. Religious, cultural, medical, and moral grounds rationalize the custom which is practiced primarily in sub-Saharan Africa, the Arab world, Malaysia, Indonesia, and among migrant populations in Western countries. According to WHO it is correlated with poverty, illiteracy, and the low status of women. Women who escape mutilation are not sought in marriage. WHO, the UN Population Fund, the UN Children's Fund, the International Planned Parenthood Federation, and the UN Convention on the Rights of the Child have issued declarations on the eradication of female genital mutilation. In Britain, local authorities have intervened to prevent parents from mutilating their daughters. In 1984, the Inter-African Committee Against Harmful Traditional Practices Affecting Women and Children was established to work toward eliminating female genital mutilation and other damaging customs. National committees in 26 African countries coordinate projects run by local people using theater, dance, music, and storytelling for communication. In Australia, Canada, Europe, and the US women have organized to prevent the practice among vulnerable migrants and refugees.

Attitudes towards female genital mutilation: an integrative review.

PubMed

Reig Alcaraz, M; Siles González, J; Solano Ruiz, C

2014-03-01

Immigration and globalization processes have contributed to the international dissemination of practices such as female genital mutilation. Between 100 and 400 million girls and women have been genitally mutilated, and every year 3 million girls are at risk of being subjected to female genital mutilation. The objective of this study was to describe the attitudes towards the practice of female genital mutilation in relation to different health systems and the factors that favour its discontinuation. An integrative review was performed of publications from the period 2006 to 2013 included in the MedLine, PubMed, LILACS, SciELO, CINAHL and CUIDEN databases. We selected 16 studies focusing on diverse contexts that assessed the attitudes of both men and women regarding the perpetuation of this practice. Ten corresponded to studies conducted in countries of residence. Several areas of investigation were explored (factors contributing to the continuation of female genital mutilation, factors contributing to its discontinuation, feelings about the health system). It is possible that the relevant studies may not have been included given the limitations of the literature review and the invisibility of the phenomenon studied. This review demonstrates the strong social pressure to which women are subjected as regards the practice of female genital mutilation. However, many other factors can contribute to eroding beliefs and arguments in favour of this practice, such as the globalization, culture and social environment of countries in the West. Nurses occupy an essential position in detecting and combating these practices. © 2013 International Council of Nurses.

GOJJAM ZONE, WESTERN AMHARA, ETHIOPIA.

PubMed

Andualem, Mulusew

2016-07-01

Female genital mutilation is one of the harmful traditional practices among women and girls. More than 130 million girls and women live today who have undergone female genital mutilation. In Ethiopia, a high prevalence (74.3% national and 68.5% in Amhara region) has been reported. This study was aimed to identify determinant factors of female genital mutilation practices in East Gojjam Zone, Western Amhara, Ethiopia community based cross sectional study was conducted among 730 women aged 15-49 years and having children < 5 years old in September, 2014. Data were collected using a pretested interviewer administered questionnaire. Descriptive statistics were used to describe study objectives, and bivariate and multivariate analysis to identify determinant factors to female genital mutilation. 718 women and 805 daughters participated in the study. FGM prevalence was 689 (96%) and 403 (49%) among women and daughters< 5 years of age, respectively. Type1 and type 2 FGMs were common and daughters <1 years of age exhibited 91% female genital mutilation. Daughters' age, parent education level, residence, women circumcision history, culture, health education, frequent health extension workers follow up and participation in anti FGM interventions were risk factors to female genital mutilation practice. Female genital mutilation practices continues to be a major problem to women and daughter <5 years of age in the study area. A number of factors were associated with FGM practices including daughters’ age, parent education level, residence, health education, culture, mothers circumcision history, frequent health extensions workers follow up and participation in anti FGM interventions were determinants to higher FGM practices.

Married women's negotiation for safer sexual intercourse in Kenya: Does experience of female genital mutilation matter?

PubMed

Chai, Xiangnan; Sano, Yujiro; Kansanga, Moses; Baada, Jemima; Antabe, Roger

2017-12-01

Married women's ability to negotiate for safer sex is important for HIV prevention in sub-Saharan Africa, including Kenya. Yet, its relationship to female genital mutilation is rarely explored, although female genital mutilation has been described as a social norm and marker of womanhood that can control women's sexuality. Drawing on the social normative influence theory, this study addressed this void in the literature. We analysed data from the 2014 Kenya Demographic and Health Survey using logistic regression. Our sample included 8,602 married women. Two indicators of safer sex, namely the ability to refuse sex and the ability to ask for condom use, were explored. We found that women who had undergone genital mutilation were significantly less likely to report that they can refuse sex (OR=0.87; p<.05) and that they can ask for condom use during sexual intercourse (OR=0.62; p<.001) than their counterparts who had not undergone genital mutilation, while controlling for theoretically relevant variables. Our findings indicate that the experience of female genital mutilation may influence married women's ability to negotiate for safer sex through gendered socialization and expectations. Based on these findings, several policy implications are suggested. For instance, culturally sensitive programmes are needed that target both married women who have undergone genital mutilation and their husbands to understand the importance of safer sexual practices within marriage. Copyright © 2017. Published by Elsevier B.V.

Crime in Nigeria: An Exploratory Analysis

DTIC Science & Technology

2012-11-02

and actual practice of Female Genital Mutilation and Cutting (FGM/C), early marriage, a substantial age gap between spouses (usually an older husband...prevention among 15-24 years-old, 2007 FGM: occurrence of Female Genital Mutilation /Cutting among daughters 15-49 yr old, 2007 Gender Parity... genital mutilation /cutting among 15-49 year old adults, 2007 AIDS Knowledge: Percentage with "comprehensive knowledge" of HIV/AIDS

Making the cut: The production of 'self-harm' in post-1945 Anglo-Saxon psychiatry.

PubMed

Millard, Chris

2013-04-01

'Deliberate self-harm', 'self-mutilation' and 'self-injury' are just some of the terms used to describe one of the most prominent issues in British mental health policy in recent years. This article demonstrates that contemporary literature on 'self-harm' produces this phenomenon (to varying extents) around two key characteristics. First, this behaviour is predominantly performed by those identified as female. Second, this behaviour primarily involves cutting the skin. These constitutive characteristics are traced back to a corpus of literature produced in the 1960s and 1970s in North American psychiatric inpatient institutions; analysis shows how pre-1960 works were substantially different. Finally, these gendered and behavioural assertions are shown to be the result of historically specific processes of exclusion and emphasis.

Perceived family and peer invalidation as predictors of adolescent suicidal behaviors and self-mutilation.

PubMed

Yen, Shirley; Kuehn, Kevin; Tezanos, Katherine; Weinstock, Lauren M; Solomon, Joel; Spirito, Anthony

2015-03-01

The present study investigates the longitudinal relationship between perceived family and peer invalidation and adolescent suicidal events (SE) and self-mutilation (SM) in a 6 month follow-up (f/u) study of adolescents admitted to an inpatient psychiatric unit for suicide risk. Adolescents (n=119) and their parent(s) were administered interviews and self-report assessments at baseline and at a 6 month f/u, with 99 (83%) completing both assessments. The Adolescent Longitudinal Interval Follow-Up Evaluation (A-LIFE) was modified to provide weekly ratings (baseline and each week of f/u) for perceived family and peer invalidation. Regression analyses examined whether: 1) Prospectively rated perceived family and peer invalidation at baseline predicted SE and SM during f/u; and 2) chronicity of perceived invalidation operationalized as proportion of weeks at moderate to high invalidation during f/u was associated with SE and SM during f/u. Multiple regression analyses, controlling for previously identified covariates, revealed that perceived family invalidation predicted SE over f/u for boys only and perceived peer invalidation predicted SM over f/u in the overall sample. This was the case for both baseline and f/u ratings of perceived invalidation. Our results demonstrate the adverse impact of perceived family and peer invalidation. Specifically, boys who experienced high perceived family invalidation were more likely to have an SE over f/u. Both boys and girls who experienced high perceived peer invalidation were more likely to engage in SM over f/u.

Nurses and requests for female genital mutilation: cultural rights versus human rights.

PubMed

Sala, R; Manara, D

2001-05-01

In this article we focus on female genital mutilation. We analyse this problem as one of the most important issues of multiculturalism, which is also coming to the attention of the public in Italy as a consequence of the growing number of immigrants from African countries. The fundamental problem is about the acceptability of this practice: can female genital mutilation be permitted and, if so, on what basis? We will try to cope with this as a genuine conflict between culture-relative values and universal values, such as human rights. Some attention will be drawn to Italian law. Finally, the impact on nurses of requests for genital mutilation will be described.

Surgical Treatment of Complication of Female Genital Mutilation in Pikine Hospital, Senegal.

PubMed

Diouf, Abdoul A; Diallo, Moussa; Mbodj, Aissatou; Gassama, Omar; Guèye, Mamour; Moreau, Jean C; Diouf, Alassane

2017-03-01

We share our experience on reconstructive for surgery female genital mutilation. This is a retrospective study of all cases of female genital mutilation surgery performed in Pikine National Hospital. We have reviewed the various indications and surgical techniques used. We collected 8 cases of clitoral cyst and 6 cases of closed vaginal opening. The surgery of clitoral cysts was to perform cystectomy followed by nymphoplasty. The closing of the vaginal opening required defibulation together with clitoroplasty according to the wishes of the patient. The anatomical and functional outcomes were satisfactory. Female genital mutilation surgery requires a good knowledge of vulvar anatomy. The various surgical indications must meet the expectations of patients to guarantee their satisfaction.

A family with autosomal dominant mutilating neuropathy not linked to either Charcot-Marie-Tooth disease type 2B (CMT2B) or hereditary sensory neuropathy type I (HSN I) loci.

PubMed

Bellone, Emilia; Rodolico, Carmelo; Toscano, Antonio; Di Maria, Emilio; Cassandrini, Denise; Pizzuti, Antonio; Pigullo, Simona; Mazzeo, Anna; Macaione, Vincenzo; Girlanda, Paolo; Vita, Giuseppe; Ajmar, Franco; Mandich, Paola

2002-03-01

Sensory loss and ulcero-mutilating features have been observed in hereditary sensory neuropathy type I and in hereditary motor and sensory neuropathy type IIB, also referred as Charcot-Marie-Tooth disease type 2B. To date two loci associated with ulcero-mutilating neuropathy have been described: CMT2B at 3q13-q22 and HSN I at 9q22.1-q22.3. We performed linkage analysis with chromosomal markers representing the hereditary sensory neuropathy type I and Charcot-Marie-Tooth disease type 2B loci on an Italian family with a severe distal sensory loss leading to an ulcero-mutilating peripheral neuropathy. Negative likelihood-of-odds scores excluded any evidence of linkage to both chromosome 3q13 and chromosome 9q22 markers, confirming the genetic heterogeneity of this clinical entity and the presence of a third locus responsible for ulcero-mutilating neuropathies.

Female genital mutilation in Iraqi Kurdistan: description and associated factors.

PubMed

Saleem, Rozhgar A; Othman, Nasih; Fattah, Fattah H; Hazim, Luma; Adnan, Berivan

2013-01-01

The high prevalence of female genital mutilation has been a concern in Iraqi Kurdistan. This study was undertaken to estimate its prevalence and describe factors associated with its occurrence. A cross-sectional survey was undertaken from March to April 2011 of females aged up to 20 years using interviews and clinical examination. The survey included 1,508 participants with mean age of 13.5 years (SD 5.6). Overall female genital mutilation prevalence was 23%, and the mean age at which it had been performed was 4.6 years (SD 2.4). Type I (partial or total removal of the clitoris) comprised 76% of those who had had female genital mutilation; in 79% of cases the decision to perform it was made by the mother; and in 54% of cases it was performed by traditional birth attendants/midwives. Women aged 16 years and over were more likely to have had female genital mutilation compared to children aged below 6 years (OR 11.9, p < .001). Children of uneducated mothers were eight times as likely to have had genital mutilation compared to children of mothers with over nine years of education (OR 8.0, p < .001). Among women aged 17 years and younger, 34% of those who were married had been circumcised versus 17% of those who were not married (p < .001). Participants residing in the northeast of Kurdistan region were more likely to have been circumcised. The study results show that female genital mutilation is a frequent practice in Iraqi Kurdistan. Attention and intervention is needed to address this aspect of the well-being of girls and women.

Eunuchs in contemporary society: characterizing men who are voluntarily castrated (part I).

PubMed

Johnson, Thomas W; Brett, Michelle A; Roberts, Lesley F; Wassersug, Richard J

2007-07-01

Some males desire to be emasculated for no medical reason. These individuals are often secretive about their desires and little is known about their background and motivation. We sought to characterize these modern eunuchs and to identify risk factors for genital self-mutilation or self-administered chemical castration. We posted a questionnaire on the Eunuch Archive ( http://www.eunuch.org) that was responded to by 135 voluntarily castrated males. Questionnaire data were supplemented by accompanying narrative responses and several personal interviews. Participants answered questionnaire items pertaining to their knowledge about androgen deprivation, the nature of their castration, and the length of time between initial presentation of castration paraphilia and castration. These questionnaire data allowed us to compare and contrast voluntary chemical and physical eunuchs. The physical castrations were largely premeditated, with an average of 18 years from the time that an individual developed interest in being a eunuch to the time of their actual castration. We identified four factors that may promote castration ideations: (i) abuse sustained during childhood, including parental threats of castration; (ii) homosexuality; (iii) exposure to animal castration during youth; and (iv) religious condemnation of sexuality. Chemical eunuchs were more likely to have sought castration for libido control or to advance transition from male to female (P < 0.05). Physical eunuchs had a nonsignificant tendency to have masochistic paraphilia involving genital mutilation in advance of their castration (P < 0.1). Both Body Integrity Identity Disorder and Gender Identity Disorders occur among those who self-identify as eunuch. We present evidence that the majority of self-identified voluntary eunuchs are not male-to-female transsexuals. Whereas the majority identify as male, many view themselves as in an alternate nonmale, nonfemale, gender space. We therefore suggest that male-to-eunuch is a valid transgender identity.

Key points for abolishing Female Genital Mutilation from the perspective of the men involved.

PubMed

Ruiz, Ismael Jiménez; Martínez, Pilar Almansa; Del Mar Pastor Bravo, María

2016-03-01

female Genital Mutilation is internationally considered an affront on human rights and an act of violence against women and young girls. Furthermore, it hierarchises and perpetuates inequality and denies the right to bodily and psychosocial integrity of women and young girls. to detect the key points for the abolition of Female Genital Mutilation as well as the necessary resources for its eradication. a qualitative methodology with an ethnonursing perspective, via semi-structured interviews, held both individually and in groups, in 21 men familiar with Female Genital Mutilation. through the voices of men familiar with this tradition, five key points are presented for its gradual eradication: sensitisation and awareness building, team action, abolition-promoting media, focusing action on rural areas and applying educational means before punitive ones. awareness-raising via the combined efforts of families, communities and governments, together with the promotion of health education programmes in demonstrating the complications derived from this practice, play a vital part in eradicating Female Genital Mutilation. Copyright © 2016 Elsevier Ltd. All rights reserved.

Evolution of external female genital mutilation: why do males harm their mates?

PubMed

Mouginot, Pierick; Uhl, Gabriele; Fromhage, Lutz

2017-11-01

Sperm competition may select for male reproductive traits that influence female mating or oviposition rate. These traits may induce fitness costs to the female; however, they may be costly for the males as well as any decrease in female fitness also affects male fitness. Male adaptations to sperm competition manipulate females by altering not only female behaviour or physiology, but also female morphology. In orb-weaving spiders, mating may entail mutilation of external structures of the female genitalia, which prevents genital coupling with subsequent males. Here, we present a game theoretical model showing that external female genital mutilation is favoured even under relatively high costs of mutilation, and that it is favoured by a high number of mate encounters per female and last-male sperm precedence.

Evolution of external female genital mutilation: why do males harm their mates?

PubMed Central

Uhl, Gabriele

2017-01-01

Sperm competition may select for male reproductive traits that influence female mating or oviposition rate. These traits may induce fitness costs to the female; however, they may be costly for the males as well as any decrease in female fitness also affects male fitness. Male adaptations to sperm competition manipulate females by altering not only female behaviour or physiology, but also female morphology. In orb-weaving spiders, mating may entail mutilation of external structures of the female genitalia, which prevents genital coupling with subsequent males. Here, we present a game theoretical model showing that external female genital mutilation is favoured even under relatively high costs of mutilation, and that it is favoured by a high number of mate encounters per female and last-male sperm precedence. PMID:29291104

Female genital mutilation in Djibouti.

PubMed

Martinelli, M; Ollé-Goig, J E

2012-12-01

The practice of female genital mutilation (we will use the latest definition adopted by WHO/UNFP: female genital mutilation/cutting or FGM/C) is still widespread in 28 African countries. The World Health Organisation (WHO) estimates that more than two million females undergo some form of genital mutilation every year. Its negative health impact and its ethical and human rights aspects have been discussed and attempts to eliminate it have been the objectives of several meetings promoted by national and international organisations thanks to an increased awareness related to FGM/C in those countries practicing it and also, maybe due to the number of Africans migrating to industrialized countries. We review the present situation in Djibouti, a small country in the Horn of Africa, where 98 % of the female population has suffered different forms of FGM/C.

[Hereditary sensory and autonomic neuropathy type IV: a report on two cases].

PubMed

Achouri, E; Gribaa, M; Bouguila, J; Haddad, S; Souayeh, N; Saad, A; Essoussi, A S

2011-04-01

Hereditary sensory and autonomic neuropathy type IV (HSAN IV) is a very rare autosomal recessive disorder characterized by recurrent episodes of unexplained fever, extensive anhidrosis, total insensitivity to pain, hypotonia, and mental retardation. The absence of urticarial reaction to intradermal injection of histamine is a sign of great diagnostic value, but this is common to all types of HSAN. The most frequent complications of this disease are corneal scarring, multiple fractures, joint deformities, osteomyelitis, and disabling self-mutilations. Malignant hyperthermia and sepsis are major causes of mortality. We relate the first observations of two Tunisian children with genetically confirmed HSAN IV. Our goal is to review the clinical aspects of this mysterious neuropathy and to emphasize the peculiarities of its management. These two patients are brothers from 1st-degree consanguineous parents (cousins) with no particular medical history. The 1st patient, the family's 1st child, presented in the 1st h of life with hypotonia and persistent fever, which was refractory to antipyretics. At the age of 8 months, the patient presented recurrent febrile seizures and developed significant self-mutilations of the fingers and tongue. He died 3 months later in a context of multivisceral failure from sepsis and malignant hyperthermia. The 2nd patient, currently aged 4 years, was born after a normal sister. He consulted in the neonatal period for a high fever. The diagnosis of HSAN IV was rapidly suspected and genetically confirmed. In fact, this patient is homozygous for the NTRK1 gene, whereas his sister and both parents are heterozygous. Special predispositions have been taken to improve the course of the disease such as air conditioning to control hyperthermia, a dental tray to reduce the injuries resulting from self-mutilation, regular moistening of the eyes to avoid corneal drying, and chlorpromazine to control hyperactivity and reduce injuries. The good progression with all these predispositions and others underlines the importance of appropriate multidisciplinary management and close monitoring of patients suffering from HSAN IV, especially during the first 3 years of life. Indeed, mortality, behavioral disorders, and mental retardation significantly decrease after this age. New curative treatments are expected in the next decade. Copyright © 2011. Published by Elsevier SAS.

Functions of nonsuicidal self-injury in Singapore adolescents: Implications for intervention.

PubMed

Ong, Say How; Tan, Augustine Chin Yeow; Liang, Wilfred Zhijian

2017-08-01

The functions of nonsuicidal self-injury (NSSI) and DSM-IV-TR diagnoses were examined in a sample of thirty ethnic adolescents followed up in a local child and adolescent psychiatric clinic in Singapore. The most commonly endorsed function of NSSI on the Functional Assessment of Self-Mutilation scale was Automatic Negative Reinforcement (A-NR) and the least being Social Negative Reinforcement (S-NR). Participants were more likely to be diagnosed as having Major Depression Disorder. Depressed adolescents did not differ from non-depressed counterparts in their endorsement of social reinforcement functions. The results suggest that specific psychosocial interventions may help address both automatic and social functions of NSSI in Singapore adolescents. Copyright © 2017 Elsevier B.V. All rights reserved.

Tobacco use among 10th grade students in Istanbul and related variables.

PubMed

Evren, Cuneyt; Evren, Bilge; Bozkurt, Muge

2014-04-01

Aim of this study was to determine prevalence of cigarette smoking and hookah use among 10th grade students in Istanbul, Turkey, and to compare sociodemographic, psychological and behavioral variables according to frequency of tobacco use. Cross-sectional online self-report survey conducted in 45 schools from the 15 districts in Istanbul/Turkey. The questionnaire included sections about demographic data, family characteristics, school life, psychological symptoms and use of substances including tobacco, hookah, alcohol, marijuana, volatiles, heroin, cocaine, non-prescribed legal tranquillizers (benzodiazepines, alprazolam etc.) and illegal tranquillizers (flunitrazepam). The analyses were conducted based on the 4957 subjects. Trial at least once in life is observed as 45.4% for hookah use and as 24.4% for cigarette use. Risk of hookah and cigarette use was significantly higher in male students than in female students. Frequency of tobacco use is related with various sociodemographic, psychological and behavioral variables. Our data also shows that using tobacco and alcohol increases the risk of all the other substances use and these effects are interrelated. The data suggest that there is a link between tobacco use and substance use, psychological, behavioral and social factors. There is also a strong association between tobacco use and suicidal behavior as well as self-mutilative, impulsive, hyperactive, delinquent, aggressive and behavioral problems. The illumination of these relationships may be relevant in prevention and management of tobacco use as well as important problems, such as substance use, impulsivity, hyperactivity, delinquent, aggressive self-mutilative and suicidal behavior among 10th grade students in Istanbul. Copyright © 2013 Elsevier B.V. All rights reserved.

For the sake of purity (and control). Female genital mutilation.

PubMed

Gilbert, D

1993-01-01

In 1973 approximately 1 million girls will be victimized by female genital mutilation (FGM), widely practiced in more than 20 African nations from Mauritania to the Ivory Coast in the west, to Egypt and North Tanzania in the east, as well as in Oman, Bahrain, North and South Yemen, and the United Arab Emirates. FGM takes place among the Moslem populations of the Philippines, Indonesia, and Malaysia and the Jewish Falashas in Ethiopia. FGM is practiced on babies just a few days old to girls right before marriage or young women pregnant with their first child. The most extreme mutilation is called infibulation. In Somalia, almost 100% of the women are infibulated, and so are more than 80% of the women in north and central Sudan. In Ethiopia/Eritrea, Mali, and Sierra Leone, 90% of the women have undergone some form of genital mutilation. The rate reaches 70% in Burkina Faso; 60% in Kenya, Gambia, and the Ivory Coast; and 50% in Senegal, Egypt, Guinea Bissau, and Nigeria. The mutilation often results in accumulation of menstrual blood and pelvic inflammatory disease often leading to infertility. Between 20% and 25% of infertility in Sudan has been attributed to female genital mutilation. The practice of FGM has existed for centuries, and some claim it originated in the Nile Valley during the Pharaonic era. On the other hand, Muslim countries like Iraq, Syria, and Tunisia do not practice FGM. The London Black Women's Health Action Project set up an educational network to prevent mutilations and to dispel the myth of religion about FGM. FORWARD convened the First Study Conference on Genital Mutilation of Girls in Europe in 1992 and deemed FGM a form of child abuse. Local campaigns in Africa, Asia, and the Arab world educate against FGM. The Inter-Africa Committee on Traditional Practices Affecting the Health of Women and Children, based in Addis Ababa, Ethiopia, has offices in more than 20 African nations to sensitize the public about the harmful effects of FGM. In Nigeria, the National Association of Nigerian Nurses and Midwives presents plays in the local markets about the complications of FGM.

[The voice of women subjected to female genital mutilation in the Region of Murcia (Spain)].

PubMed

Ballesteros Meseguer, Carmen; Almansa Martínez, Pilar; Pastor Bravo, María del Mar; Jiménez Ruiz, Ismael

2014-01-01

To explore the perceptions of a group of women who underwent female genital mutilation on the impact of this practice on their sexual and reproductive health. We performed a phenomenological qualitative study in a sample of 9 sub-Saharan Africa women, whose mean age was 30 years old and who had lived in Spain for 1 to 14 years. These women underwent genital mutilation in their countries of origin. Data was collected using a socio-demographic survey and an in-depth, structured personal interview. Subsequently, we performed a thematic discourse analysis. The discourses were grouped into four categories related to participants' perceptions of female genital mutilation. These categories were intimate relationships, pregnancy, childbirth, and social impact. The practice of female genital mutilation is maintained due to social and family pressure, transmitted from generation to generation and silenced by women themselves. This practice affects their sexual and reproductive health, as demonstrated by anorgasmia and dyspareunia. The women were satisfied with the healthcare received during pregnancy and childbirth. Nevertheless, most of them were not satisfied with family planning. Copyright © 2013 SESPAS. Published by Elsevier Espana. All rights reserved.

[Impact of female genital mutilation on the millennium goals].

PubMed

Ruiz, Ismael Jiménez; Martínez, María Pilar Almansa; Bravo, María Del Mar Pastor

2015-01-01

To relate the Female Genital Mutilation as a negative factor for the achievement of the Millennium Development Goals 1, 3, 4, 5 and 6. Data collection was through review literature review between in the years 2014 and 2015 in the databases Medline/PubMed, Web of Science, LILACS, SCIELO, Tesis Doctorales TESEO and in the webs of WOK, UNICEF, UNAF and WHO using the descriptors: female circumcision, millennium development goals, rights of women. Articles published between years 2010 y 2015, were included and finally 24 articles were selected. The Female Genital Mutilation is based on gender discrimination, and reinforces and encourages the circle of poverty. This practice causes physical complications that may affect the infant mortality and morbidity, complications in pregnancy and childbirth and there is a relationship between the practice and the transmission of human immunodeficiency virus. The fight against Female Genital Mutilation contributes to the achievement of five of the eight Millennium Goals.

Necrotizing sialometaplasia of tongue

PubMed Central

Randhawa, Tanu; Varghese, Ipe; Shameena, PM; Sudha, S; Nair, Resmi G

2009-01-01

Necrotizing sialometaplasia, is a benign inflammatory lesion primarily involving the minor salivary glands of the hard palate. The lesion often presents itself as a deep-seated palatal ulcer with clinical and histological features similar to those of a malignant neoplasm. Here we report a case of necrotizing sialometaplasia in a 40-year-old female, present on the lateral border of the tongue, mimicking squamous cell carcinoma, clinically. A correct diagnosis to avoid mutilant surgical treatments is essential, considering that it is a self-limiting disease. PMID:21886996

Restoring the smile: Inexpensive biologic restorations

PubMed Central

Mittal, Neeti P.

2014-01-01

Extensive breakdown of primary teeth to the cervical level and their loss in very young children is not uncommon. Owing to increasing concerns over self-appearance, due considerations to esthetic aspects in addition to restoring function are necessary aspects of rehabilitation of mutilated teeth to help children grow into a psychologically balanced personality. The present article describes rehabilitation of grossly decayed teeth with biologic restorations such as dentine posts, dentine post and core and biologic shell crown. This treatment modality provided a cost-effective esthetic solution. PMID:25097656

Stimulus appraisal modulates cardiac reactivity to briefly presented mutilation pictures.

PubMed

Mocaiber, Izabela; Perakakis, Pandelis; Pereira, Mirtes Garcia; Pinheiro, Walter Machado; Volchan, Eliane; de Oliveira, Letícia; Vila, Jaime

2011-09-01

Emotional reactions to threatening situations can be either advantageous for human adaptation or unfavorable for physical and mental health if sustained over prolonged periods of time. These contrasting effects mostly depend on the individual's capacity for emotion regulation. It has been shown, for example, that changing appraisal can alter the course of emotional processing. In the present study, the influence of stimulus appraisal over cardiac reactivity to briefly presented (200ms) mutilation pictures was tested in the context of an affective classification task. Heart rate and reaction time of twenty-four undergraduate students were monitored during the presentation of pictures (neutral or mutilated bodies) in successive blocks. In one condition (real), participants were told that the pictures depicted real events. In the other condition (fictitious), they were told that the pictures were taken from movie scenes. As expected, the results showed a more pronounced bradycardia to mutilation pictures, in comparison to neural pictures, in the real context. In the fictitious context, a significant attenuation of the emotional modulation (defensive bradycardia) was observed. However, this attenuation seemed to be transient because it was only observed in the first presentation block of the fictitious context. Reaction time to classify mutilation pictures, compared to neutral pictures, was slower in both contexts, reflecting the privileged processing of emotionally laden material. The present findings show that even briefly presented mutilation pictures elicit a differential cardiac reactivity and modulate behavioral performance. Importantly, changing stimulus appraisal attenuates the emotional modulation of cardiac reactivity (defensive bradycardia). Copyright © 2011 Elsevier B.V. All rights reserved.

7 CFR 1786.35 - Loss, theft, destruction, mutilation, or defacement of RUS guarantee.

Code of Federal Regulations, 2011 CFR

2011-01-01

... name and address of lender of record; (iii) Capacity of person certifying; (iv) Full identification of... Loans Pursuant to Section 306(A) of the RE Act § 1786.35 Loss, theft, destruction, mutilation, or...

Senegal: Background and U.S. Relations

DTIC Science & Technology

2012-02-20

press, and assembly; corruption and impunity; rape, domestic violence, sexual harassment of and discrimination against women; female genital mutilation ...Senegal’s Budget Process is Transparent [UNCLASSIFIED],” May 4, 2010. 23 The 1999 Penal Law outlawed domestic violence and female genital mutilation , and

Facts and controversies on female genital mutilation and Islam.

PubMed

Rouzi, Abdulrahim A

2013-02-01

Female genital mutilation (FGM) is a very ancient traditional and cultural ritual. Strategies and policies have been implemented to abandon this practice. However, despite commendable work, it is still prevalent, mainly in Muslim countries. FGM predates Islam. It is not mentioned in the Qur'an (the verbatim word of God in Islam). Muslim religious authorities agree that all types of mutilation, including FGM, are condemned. 'Sensitivity' to cultural traditions that erroneously associate FGM with Islam is misplaced. The principle of 'do no harm', endorsed by Islam, supersedes cultural practices, logically eliminating FGM from receiving any Islamic religious endorsement.

[Female genital mutilation meets Swedish health care. Female genital mutilation is one of many forms of discrimination of women in the world].

PubMed

Andersson, C

2001-05-16

About 27,000 women from countries in which female genital mutilation (FGM) is a common practice are presently living in Sweden. This means that FGM is a phenomenon that directly affects the Swedish health care system. Knowledge and understanding of the background, meaning and consequences of FGM are a prerequisite for effective prevention, proper clinical handling and supportive reception of the women. To avoid a stigmatizing reception it is also important to understand the situation of genitally mutilated women, and to become aware of the identity crisis many of them experience when they come to Sweden and lose their identity as "normal" women. It is essential to remember that female genital mutilation is one of many forms of discrimination affecting girls and women around the world. This discrimination knows no national or cultural borders and varies in expression and extent. In order to offer optimal care and reception of women who have been socialized into a gender role that is often seen as completely different from the gender role that Swedish society is said to embrace, it is of the utmost importance to first take a critical look beneath the veil of alleged gender equality of Swedish women.

A passion for castration: characterizing men who are fascinated with castration, but have not been castrated.

PubMed

Roberts, Lesley F; Brett, Michelle A; Johnson, Thomas W; Wassersug, Richard J

2008-07-01

A number of men have extreme castration ideations. Many only fantasize about castration; others actualize their fantasies. We wish to identify factors that distinguish those who merely fantasize about being castrated from those who are at the greatest risk of genital mutilation. Seven hundred thirty-one individuals, who were not castrated, responded to a survey posted on http://www.eunuch.org. We compared the responses of these "wannabes" to those of 92 men who were voluntarily castrated and responded to a companion survey. Main Outcome Measures. Respondents answered the questionnaire items relating to demographics, origin of interest in castration, and ambition toward eunuchdom. Two categories of wannabes emerged. A large proportion ( approximately 40%) of wannabes' interest in castration was singularly of a fetishistic nature, and these men appeared to be at a relatively low risk of irreversible genital mutilation. Approximately 20% of the men, however, appeared to be at great risk of genital mutilation. They showed a greater desire to reduce libido, change their genital appearance, transition out of male, and prevent sexually offensive behavior. Nineteen percent of all wannabes have attempted self-castration, yet only 10% have sought medical assistance. We identify several motivating factors for extreme castration ideations and provide a classification for reasons why some males desire orchiectomies. Castration ideations fall under several categories of the Diagnostic and Statistical Manual of Mental Disorders, 4th Ed. (DSM-IV), most notably a Gender Identity Disorder other than male-to-female (MtF) transsexual (i.e., male-to-eunuch) and a Body Identity Integrity Disorder. Physicians need to be aware of males who have strong desires for emasculation without a traditional MtF transsexual identity.

Facticious disorders in dermatology.

PubMed

Harth, Wolfgang; Taube, Klaus-Michael; Gieler, Uwe

2010-05-01

Facticious Disorders are self inflicted skin lesions and includes the creation of physical or psychiatric symptoms in oneself or other reference persons. In dermatology frequently, there are mechanical injuries by pressures, friction, occlusion, biting, cutting, stabbing, thermal burns or self-inflicted infections with wound-healing impairment, abscesses, mutilations or damages by acids and other toxic to the skin. The current classification differentiates between four groups: 1. Dermatitis artefacta syndrome in the narrower sense as unconscious/dissociated self-injury, 2. Dermatitis paraartefacta syndrome: Disorders of impulse control, often as manipulation of an existing specific dermatosis (often semi-conscious, admitted - self-injury), 3. Malingering: consciously simulated injuries and diseases to obtain material gain, 4. special forms, such as the Gardner Diamond Syndrome, Münchhausen Syndrome and Münchhausen-by-Proxy Syndrome. This categorization is helpful in understanding the different pathogenic mechanisms and the psychodynamics involved, as well as in developing various therapeutic avenues and determining the prognosis.

A qualitative study exploring how Somali women exposed to female genital mutilation experience and perceive antenatal and intrapartum care in England.

PubMed

Moxey, Jordan M; Jones, Laura L

2016-01-07

To explore how Somali women exposed to female genital mutilation experience and perceive antenatal and intrapartum care in England. We explored women's perceptions of deinfibulation, caesarean section and vaginal delivery; their experiences of care during pregnancy and labour; and factors that affect ability to access these services, in order to make recommendations about future practice. A descriptive, exploratory qualitative study using face-to-face semistructured interviews. Interviews were audio-recorded, transcribed and data were analysed using a thematic approach. An interpreter was used when required (n=3). Participants recruited from 2 community centres in Birmingham, England. Convenience and snowball sample of 10 Somali women resident in Birmingham, who had accessed antenatal care services in England within the past 5 years. 3 core themes were interpreted: (1) Experiences of female genital mutilation during life, pregnancy and labour: Female genital mutilation had a significant physical and psychological impact, influencing decisions to undergo deinfibulation or caesarean section. Women delayed deinfibulation until labour to avoid undergoing multiple operations if an episiotomy was anticipated. (2) Experience of care from midwives: Awareness of female genital mutilation from midwives led to open communication and stronger relationships with women, resulting in more positive experiences. (3) Adaptation to English life: Good language skills and social support networks enabled women to access these services, while unfavourable social factors (eg, inability to drive) impeded. Female genital mutilation impacts Somali women's experiences of antenatal and intrapartum care. This study suggests that midwives should routinely ask Somali women about female genital mutilation to encourage open communication and facilitate more positive experiences. As antenatal deinfibulation is unpopular, we should consider developing strategies to promote deinfibulation to non-pregnant women, to align with current guidelines. Women with unfavourable social factors may require additional support to improve access to English antenatal care services. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Urinary and genital tract obstruction as a complication of female genital mutilation: case report and literature review.

PubMed

Okwudili, Obi Anselm; Chukwudi, Onoh Robinson

2012-01-01

Female genital mutilation (FGM) is the partial or total removal of the female external genitalia or other deliberate injury to the female genital organs, either for cultural or non-therapeutic reasons. This barbaric act is accompanied by a variety of complications ranging from hemorrhage, fracture, infective complications, gynetresia, with its attendant sexual and obstetric difficulties, and death. A 23-year-old girl, with urinary and genital tract obstruction following female genital mutilation(infibulation) is presented. She was managed by elective defibulation, with a satisfactory outcome. Robust health education strategies are needed for the eradication of FGM.

Urinary and Genital Tract Obstruction as a Complication of Female Genital Mutilation: Case Report and Literature Review

PubMed Central

Okwudili, Obi Anselm; Chukwudi, Onoh Robinson

2012-01-01

Female genital mutilation (FGM) is the partial or total removal of the female external genitalia or other deliberate injury to the female genital organs, either for cultural or non-therapeutic reasons. This barbaric act is accompanied by a variety of complications ranging from hemorrhage, fracture, infective complications, gynetresia, with its attendant sexual and obstetric difficulties, and death. A 23-year-old girl, with urinary and genital tract obstruction following female genital mutilation(infibulation) is presented. She was managed by elective defibulation, with a satisfactory outcome. Robust health education strategies are needed for the eradication of FGM. PMID:23066470

Should we prevent non-therapeutic mutilation and extreme body modification?

PubMed

Schramme, Thomas

2008-01-01

In this paper, I discuss several arguments against non-therapeutic mutilation. Interventions into bodily integrity, which do not serve a therapeutic purpose and are not regarded as aesthetically acceptable by the majority, e.g. tongue splitting, branding and flesh stapling, are now practised, but, however, are still seen as a kind of 'aberration' that ought not to be allowed. I reject several arguments for a possible ban on these body modifications. I find the common pathologisation of body modifications, Kant's argument of duties to oneself and the objection from irrationality all wanting. In conclusion, I see no convincing support for prohibition of voluntary mutilations.

The Amazons and an analysis of breast mutilation from a plastic surgeon's perspective.

PubMed

Karacalar, Ahmet

2007-03-01

The Amazon philosophy has been increasing in popularity because of the evolving status of women in society. Many references point to Themiscrya on the southern coast of the Black Sea in Anatolia as the Amazon homeland. The primary objective of this article is to discuss the different femininity of the Amazons and their breast mutilation from the perspective of a plastic surgeon who has been living in this region that the Amazons inhabited. Findings from archaeology, linguistics, anthropology, medicine, history, psychology, and the fine arts were integrated. The hypotheses that have been proposed to explain the method of breast mutilation include amputation, cauterization, breast searing, and breast pinching. It is generally believed that the primary purpose was to facilitate the efficient use of a bow. Another explanation would be that breast mutilation was performed for medical reasons, including the prevention of breast pain, the development of a tender lump, or cancer. There is another school of thought on this involving religious and sociological reasons that breast mutilation was a badge of honor for warrior women and a sign that a woman had become a real warrior and a sacrifice to Artemis as a sign of service. Much indirect proof and archaeological evidence point to their historical existence. The Amazons, who lived in an autonomous and original social model, changed their image and function to suit the needs of the society and the times.

Hereditary sensory and autonomic neuropathy type IV and orthopaedic complications.

PubMed

Kim, W; Guinot, A; Marleix, S; Chapuis, M; Fraisse, B; Violas, P

2013-11-01

Hereditary sensory and autonomic neuropathy type IV (HSAN-IV) is a very rare autosomal recessive disorder characterized by recurrent episodes of unexplained fever, extensive anhidrosis, total insensitivity to pain, hypotonia, and mental retardation. The most frequent complications of this disease are corneal scarring, multiple fractures, joint deformities, osteomyelitis, and disabling self-mutilations. We reported the case of a 12-year-old boy. The goal was to discuss our decision-making and compare this case with cases described in the literature. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

31 CFR 306.111 - Procedure for applying for relief.

Code of Federal Regulations, 2010 CFR

2010-07-01

... GOVERNING U.S. SECURITIES Relief for Loss, Theft, Destruction, Mutilation, or Defacement of Securities § 306.111 Procedure for applying for relief. Prompt report of the loss, theft, destruction, mutilation or... some other person, the capacity in which he represents the owner. (b) The identity of the security by...

31 CFR 306.111 - Procedure for applying for relief.

Code of Federal Regulations, 2011 CFR

2011-07-01

.... SECURITIES Relief for Loss, Theft, Destruction, Mutilation, or Defacement of Securities § 306.111 Procedure for applying for relief. Prompt report of the loss, theft, destruction, mutilation or defacement of a... person, the capacity in which he represents the owner. (b) The identity of the security by title of loan...

Pornography, Human Mutilation and Psychological Dysfunction.

ERIC Educational Resources Information Center

Shaughnessy, Michael F.

Pornography is widely available and inevitably linked to crime and abnormal behavior. Social scientists must be concerned with the long-term effects on consenting adults and children and adolescents of exposure to pornography and human mutilation. An experiment in which a treatment group is exposed to pornography and a control group is exposed…

Mothers' Perceptions of Female Genital Mutilation

ERIC Educational Resources Information Center

Ahanonu, E. L.; Victor, O.

2014-01-01

The practice of female genital mutilation (FGM) is widespread in Nigeria. This study was conducted to assess the perceptions of FGM among mothers at a primary healthcare centre in Lagos, Nigeria. A convenience sample of 95 mothers completed the pre-tested, semi-structured questionnaires. Data analysis was carried out using descriptive statistics…

7 CFR 3575.73 - Replacement of loss, theft, destruction, mutilation, or defacement of Loan Note Guarantee or...

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 15 2010-01-01 2010-01-01 false Replacement of loss, theft, destruction, mutilation... AGRICULTURE GENERAL Community Programs Guaranteed Loans § 3575.73 Replacement of loss, theft, destruction... circumstances of the loss, theft, or destruction of the Loan Note Guarantee or Assignment Guarantee Agreement...

31 CFR 306.113 - Cases not requiring bonds of indemnity.

Code of Federal Regulations, 2010 CFR

2010-07-01

... the security was in the custody or control of the United States, or a duly authorized agent thereof... GOVERNING U.S. SECURITIES Relief for Loss, Theft, Destruction, Mutilation, or Defacement of Securities § 306... relief for the loss, theft, destruction, mutilation, or defacement of registered securities in any of the...

Google Books Mutilates the Printed Past

ERIC Educational Resources Information Center

Musto, Ronald G.

2009-01-01

In this article, the author discusses a mutilation that he has encountered involving Google Book Search. That massive text-digitization project, working in collaboration with several of the world's most important library collections, has now made available, in both PDF and text view, tens of thousands of 19th-century titles while it awaits the…

Female Genital Mutilation: Proposals for Change. Minority Rights Group International Report. [Revised].

ERIC Educational Resources Information Center

Dorkenoo, Efua; Elworthy, Scilla

In Africa today, women's voices are being raised against female genital mutilation. Inspired by the United Nations Decade for Women, this report seeks to present information in a logical, coherent manner to stimulate support for eradication of the practice. It describes steps African governments, Western states, and international agencies can take…

Autosomal recessive mutilating sensory neuropathy with spastic paraplegia maps to chromosome 5p15.31-14.1.

PubMed

Bouhouche, Ahmed; Benomar, Ali; Bouslam, Naima; Ouazzani, Reda; Chkili, Taïeb; Yahyaoui, Mohamed

2006-02-01

Autosomal recessive ulcero-mutilating neuropathy with spastic paraplegia is a very rare disease since only few cases were described up to date. We report in this study a consanguineous Moroccan family with four affected males with this syndrome. The disease onset was in early infancy, with spastic paraplegia and sensory loss leading to mutilating acropathy. Electrophysiological studies revealed a severe axonal sensory neuropathy, magnetic resonance imaging ruled out compression of spinal cord and biological investigations showed decreased levels of Apo B, total cholesterol and triglycerides. A genomewide search was conducted in this family and linkage was found to chromosome 5p. Analysis of recombination events and LOD score calculation map the responsible gene in a 25 cM genetic interval between markers D5S2054 and D5S648. A maximum LOD score value of 3.92 was obtained for all markers located in this candidate interval. This study establishes the presence of a locus for autosomal recessive mutilating sensory neuropathy with spastic paraplegia on chromosome 5p15.31-14.1.

Management of female genital mutilation in Djibouti: the Peltier General hospital experience.

PubMed

Collinet, P; Stien, L; Vinatier, D; Leroy, J L

2002-11-01

Female genital mutilation (FGM) is still performed on 98% of Djiboutian women. Infibulation (FGM type 3) is the most widely used method of FGM in Djibouti. Even though this operation is mutilating, illegal and sometimes results in death, it is still practiced at approximately the same rate as in the past. Mass immigration of African women to Europe, Canada, Australia and the United States in the past decade has brought the problems of FGM to these countries. Female genital mutilation is a problem unfamiliar to most Western obstetrician-gynecologists. A tight infibulation can be a high risk for the mother and fetus if not handled by a skilled operator. It can lead to an unnecessary cesarean section as a result of the fear of handling infibulated women. Therefore, Western physicians need to be informed. The aim of this article was to share our experience of FGM. It will focus on FGM in Djibouti, its types, epidemiology and health consequences. It will present the management of obstetric and gynecologic complications and discuss medico-legal and health service measures to combat these dangerous and unnecessary practices

Mutation in the epsilon subunit of the cytosolic chaperonin-containing t-complex peptide-1 (Cct5) gene causes autosomal recessive mutilating sensory neuropathy with spastic paraplegia.

PubMed

Bouhouche, A; Benomar, A; Bouslam, N; Chkili, T; Yahyaoui, M

2006-05-01

Mutilating sensory neuropathy with spastic paraplegia is a very rare disease with both autosomal dominant and recessive modes of inheritance. We previously mapped the locus of the autosomal recessive form to a 25 cM interval between markers D5S2048 and D5S648 on chromosome 5p. In this candidate interval, the Cct5 gene encoding the epsilon subunit of the cytosolic chaperonin-containing t-complex peptide-1 (CCT) was the most obvious candidate gene since mutation in the Cct4 gene encoding the CCT delta subunit has been reported to be associated with autosomal recessive mutilating sensory neuropathy in mutilated foot (mf) rat mutant. A consanguineous Moroccan family with four patients displaying mutilating sensory neuropathy associated with spastic paraplegia was investigated. To identify the disease causing gene, the 11 coding exons of the Cct5 gene were screened for mutations by direct sequencing in all family members including the four patients, parents, and six at risk relatives. Sequence analysis of the Cct5 gene revealed a missense A492G mutation in exon 4 that results in the substitution of a highly conserved histidine for arginine amino acid 147. Interestingly, R147 was absent in 384 control matched chromosomes tested. This is the first disease causing mutation that has been identified in the human CCT subunit genes; the mf rat mutant could serve as an animal model for studying these chaperonopathies.

FEMALE GENITAL MUTILATION: ARE WE WINNING?

PubMed

Makinde, O N; Elusiyan, J B E; Adeyemi, A B; Taiwo, O T

2012-06-01

For more than 25 years, efforts have been geared towards curtailing the practice of female genital mutilation (FGM) in countries like Nigeria. This study was designed to see if all these efforts have made any impact in reducing the prevalence of FGM appreciably in the south-West of Nigeria. To determine the prevalence of female genital mutilation and profiling the trends of FGM affected patients. A prospective study based on direct observation of the external genitalia by health-care workers . Five hundred and sixty five females less than 15 years of age. The children emergency and gynaecological wards of the Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria from 1st of January to December 31s 2007. Forty one point nine percent of the patients examined had female genital mutilation, 93.2% of these had the procedure before attaining the age of one year. Type 2 FGM predominated (58.22%). The procedure was performed predominantly (64.6%) by traditional birth attendants. The decision to have the procedure done was influenced in 78% of cases by mothers and grandmothers. In 35.4% of cases, there were immediate and short term complications. Demands of tradition predominated (59.1%) as the most important reason for the practice of female genital mutilation. The practice of FGM appears to be still highly prevalent and resistant to change probably due to deep rooted socio-cultural factors. Strategies such as public education campaigns highlighting its negative impact on health and disregard for human rights should be evolved.

39 CFR 762.41 - Advice of non-receipt or loss, destruction, or mutilation.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 39 Postal Service 1 2011-07-01 2011-07-01 false Advice of non-receipt or loss, destruction, or..., Mutilated, and Defaced Disbursement Postal Money Orders § 762.41 Advice of non-receipt or loss, destruction... purpose for which it was issued, giving, if possible, its date, number, and amount, and requesting that...

39 CFR 762.41 - Advice of non-receipt or loss, destruction, or mutilation.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 39 Postal Service 1 2010-07-01 2010-07-01 false Advice of non-receipt or loss, destruction, or..., Mutilated, and Defaced Disbursement Postal Money Orders § 762.41 Advice of non-receipt or loss, destruction... purpose for which it was issued, giving, if possible, its date, number, and amount, and requesting that...

[Fatal female genital mutilation in a 10-year-old girl].

PubMed

Sow, A; Diagne, G; Keita, Y; Sow, O; Ndiath, A; Ouattara, A; Sarr, M-L; Sylla, A; Moreira, C

2017-10-01

Female genital mutilation (FGM) comprises all procedures involving partial or total removal of the external genitalia and/or any other procedures affecting the female genitalia, for cultural or religious reasons or for nontherapeutic purposes in general. FGM is responsible for a number of short-, medium-, and long-term complications that can engage the vital and functional prognosis, especially in African countries. We report on a case in a 10-year-old girl who underwent genital mutilation, a traditional type of total excision during the neonatal period. She was followed for urethral meatus stenosis, which then was complicated by obstructive chronic kidney failure and urinary sepsis, whose progression was fatal. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

Prevalence and functions of non-suicidal self-injury in Spanish adolescents.

PubMed

Calvete, Esther; Orue, Izaskun; Aizpuru, Leire; Brotherton, Hardin

2015-01-01

This study examined the prevalence, characteristics and functions of Non-suicidal Self-injury (NSSI) among Spanish adolescents. The sample consisted of 1,864 adolescents aged between 12 and 19 years (Mean Age = 15.32, SD = 1.97, 51.45% girls). The participants completed a modified version of the self-report scale Functional Assessment of Self-Mutilation (FASM; Lloyd, Kelley, & Hope, 1997) to assess rates and methods of NSSI used during the last 12 months. They also indicated the functions of NSSI. NSSI behaviors are common among Spanish adolescents. More than half of the sample showed such behavior in the past year, and 32.2% had carried out severe NSSI behaviors. The functions of NSSI were examined by using confirmatory factor analyses. Results supported a hierarchical model consisting of two second-order factors: automatic reinforcement, which explained both positive and negative automatic reinforcement, and social reinforcement, which explained both positive and negative social reinforcement. These dimensions are critical to understand the factors that maintain NSSI behavior and have implications for treatments.

[Significance of bad habits in orthodontics].

PubMed

Tarján, Ildikó

2002-08-01

The author is concerned with the etiological role of bad habits in the development. Disturbances caused by pacifier habits, finger sucking, various forms of swallowing habits and their therapeutical possibilities are discussed. The role of mouth breathing, nail biting, bruxism and self-mutilation in development of anomalies and their therapy are also mentioned. The attention is called to the fact that dentists have responsibility and task to diagnose as early as can be the oral bad habits and that the adequate therapy in time in co-operation with other specialists helping the child get out of bad habits, preventing the development of severe anomaly.

38 CFR 10.24 - Payment of death claim on lost, destroyed or mutilated adjusted service certificate with bond.

Code of Federal Regulations, 2010 CFR

2010-07-01

... section 501 of the World War Adjusted Compensation Act, is deceased, and if, after receipt by the veteran... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Payment of death claim on lost, destroyed or mutilated adjusted service certificate with bond. 10.24 Section 10.24 Pensions...

38 CFR 10.24 - Payment of death claim on lost, destroyed or mutilated adjusted service certificate with bond.

Code of Federal Regulations, 2012 CFR

2012-07-01

... section 501 of the World War Adjusted Compensation Act, is deceased, and if, after receipt by the veteran... 38 Pensions, Bonuses, and Veterans' Relief 1 2012-07-01 2012-07-01 false Payment of death claim on lost, destroyed or mutilated adjusted service certificate with bond. 10.24 Section 10.24 Pensions...

38 CFR 10.24 - Payment of death claim on lost, destroyed or mutilated adjusted service certificate with bond.

Code of Federal Regulations, 2011 CFR

2011-07-01

... section 501 of the World War Adjusted Compensation Act, is deceased, and if, after receipt by the veteran... 38 Pensions, Bonuses, and Veterans' Relief 1 2011-07-01 2011-07-01 false Payment of death claim on lost, destroyed or mutilated adjusted service certificate with bond. 10.24 Section 10.24 Pensions...

38 CFR 10.24 - Payment of death claim on lost, destroyed or mutilated adjusted service certificate with bond.

Code of Federal Regulations, 2014 CFR

2014-07-01

... section 501 of the World War Adjusted Compensation Act, is deceased, and if, after receipt by the veteran... 38 Pensions, Bonuses, and Veterans' Relief 1 2014-07-01 2014-07-01 false Payment of death claim on lost, destroyed or mutilated adjusted service certificate with bond. 10.24 Section 10.24 Pensions...

38 CFR 10.24 - Payment of death claim on lost, destroyed or mutilated adjusted service certificate with bond.

Code of Federal Regulations, 2013 CFR

2013-07-01

... section 501 of the World War Adjusted Compensation Act, is deceased, and if, after receipt by the veteran... 38 Pensions, Bonuses, and Veterans' Relief 1 2013-07-01 2013-07-01 false Payment of death claim on lost, destroyed or mutilated adjusted service certificate with bond. 10.24 Section 10.24 Pensions...

Male genital mutilation in the high-mountain goblin spider, Unicorn catleyi.

PubMed

Izquierdo, Matías A; Rubio, Gonzalo D

2011-01-01

Male genital mutilation is a common mechanism by which males reduce sperm competition by plugging female insemination ducts with different parts of its own genital system. This behavior is frequent in many spider families but is uncommon in Haplogynae. The reproductive biology of Dysderoidea is not well studied and the data is fragmentary; male genital mutilation has been reported only for one species of Oonopidae. This study provides evidence of male genital mutilation in Unicorn catleyi Platnick and Brescovit (Araneae: Oonopidae). Pieces of the embolus were found in the female posterior receptaculum. This behavior is a strategy used by the males in order to guarantee their paternity and not for escape from female attacks as has been reported for other species of Araneae, since cannibalism is unlikely in this species. The presence of embolus in the posterior receptaculum suggests this is the first place where sperm is received. The similarity of the female genitalia of U. catleyi to those of Orsolobidae, along with sclerotization of the seminal duct in the male copulatory bulb that is also present in Orchestina, Xiombarg, and Orsolobidae, provide strong evidence of the basal position of this genus in the family Oonopidae.

Male Genital Mutilation in the High-Mountain Goblin Spider, Unicorn catleyi

PubMed Central

Izquierdo, Matías A.; Rubio, Gonzalo D.

2011-01-01

Male genital mutilation is a common mechanism by which males reduce sperm competition by plugging female insemination ducts with different parts of its own genital system. This behavior is frequent in many spider families but is uncommon in Haplogynae. The reproductive biology of Dysderoidea is not well studied and the data is fragmentary; male genital mutilation has been reported only for one species of Oonopidae. This study provides evidence of male genital mutilation in Unicorn catleyi Platnick and Brescovit (Araneae: Oonopidae). Pieces of the embolus were found in the female posterior receptaculum. This behavior is a strategy used by the males in order to guarantee their paternity and not for escape from female attacks as has been reported for other species of Araneae, since cannibalism is unlikely in this species. The presence of embolus in the posterior receptaculum suggests this is the first place where sperm is received. The similarity of the female genitalia of U. catleyi to those of Orsolobidae, along with sclerotization of the seminal duct in the male copulatory bulb that is also present in Orchestina, Xiombarg, and Orsolobidae, provide strong evidence of the basal position of this genus in the family Oonopidae. PMID:22225476

Stop female genital mutilation: appeal to the international dermatologic community.

PubMed

Morrone, Aldo; Hercogova, Jana; Lotti, Torello

2002-05-01

Female genital mutilation (FGM) is a traditional cultural practice, but also a form of violence against girls, which affects their lives as adult women. FGM comprises a wide range of procedures: the excision of the prepuce; the partial or total excision of the clitoris (clitoridectomy) and labia; or the stitching and narrowing of the vaginal orifice (infibulation). The number of girls and women who have been subjected to FGM is estimated at around 137 million worldwide and 2 million girls per year are considered at risk. Most females who have undergone mutilation live in 28 African countries. Globalization and international migration have brought an increased presence of circumcised women in Europe and developed countries. Healthcare specialists need to be made aware and trained in the physical, psychosexual, and cultural aspects and effects of FGM and in the response to the needs of genitally mutilated women. Health education programs targeted at immigrant communities should include information on sexuality, FGM, and reproduction. Moreover, healthcare workers should both discourage women from performing FGM on their daughters and receive information on codes of conduct and existing laws. The aim is the total eradication of all forms of FGM.

Female Genital Mutilation in Sudan.

PubMed

Elduma, Adel Hussein

2018-02-15

Female genital mutilation or female circumcision (FGM) is a serious health problem in Sudan. This procedure is harmful to women and causes many complications during pregnancy and childbirth. This study aims to determine the female genital mutilation (FGM) and its associated factors in Sudan. Data from Sudan Multiple Indicator Cluster Survey (MICS - UNICEF) was used in this research. The survey was carried out in 2014 and included women aged between 14 - 49 years. A logistic regression model was used to find an association between dependent and independent variables. Total numbers of 21947 women were included in the survey and out of the 6249 (28.5 %) from urban and 15698 (71.5%) from rural areas. The prevalence of female circumcision was 89%. Women who had circumcised daughters were 32.1 %. The highest prevalence of FGM was reported from South Kordofan state with 7.8%, and lowest was in Red Sea state (7.6%). A significant association was observed between circumcised women and their marital status, daughter circumcision, and the level of education. The practice of female genital mutilation is spread all over the country. Poor women with low level of education are at high risk for this phenomenon. More efforts have to be provided to end this dangerous practice.

Woman experiencing gynecologic surgery: coping with the changes imposed by surgery 1

PubMed Central

Silva, Carolina de Mendonça Coutinho e; Vargens, Octavio Muniz da Costa

2016-01-01

ABSTRACT Objectives: to describe the feelings and perceptions resulting from gynecologic surgery by women and analyze how they experience the changes caused by the surgery. Method: a qualitative, descriptive and exploratory study, which had Symbolic Interactionism and Grounded Theory as its theoretical framework. Participants of the study: 13 women submitted to surgery: Total Abdominal Hysterectomy, Total Abdominal Hysterectomy with bilateral Adnexectomy, Wertheim-Meigs surgery, Oophorectomy, Salpingectomy, Mastectomy, Quadrantectomy and Tracheloplasty. Individual interviews were conducted, recorded and analyzed according to the comparative analysis technique of the Grounded Theory. Results: from the data two categories emerged - Perceiving a different body and feeling as a different person and; building the meaning of mutilation. The changes experienced make women build new meanings and change the perception of themselves and their social environment. From the interaction with their inner self, occurred a reflection on relationships, the difference in their body and themselves, the functions it performs and the harm caused by the surgery. Conclusions: the participants felt like different women; the mutilation developed in concrete feelings, due the loss of the organ, and in abstract, linked to the impact of social identity and female functionality. The importance of the nurse establishing a multidimensional care, to identify the needs that go beyond the biological body is perceived. PMID:27579935

Female genital mutilations - a testimony.

PubMed

Youssouf, Samia

2013-02-01

In Djibouti, the prevalence of female genital mutilations (FGMs) amounts to 98% and the practice is still in use. When I left, in 1999, I knew I would involve myself in the fight against FGMs and I describe here the outcome of an obstacle course of more than ten years duration. This paper is written on behalf of innumerable women, who could give you a similar account.

Interleukin-15 receptor blockade in non-human primate kidney transplantation.

PubMed

Haustein, Silke; Kwun, Jean; Fechner, John; Kayaoglu, Ayhan; Faure, Jean-Pierre; Roenneburg, Drew; Torrealba, Jose; Knechtle, Stuart J

2010-04-27

Interleukin (IL)-15 is a chemotactic factor to T cells. It induces proliferation and promotes survival of activated T cells. IL-15 receptor blockade in mouse cardiac and islet allotransplant models has led to long-term engraftment and a regulatory T-cell environment. This study investigated the efficacy of IL-15 receptor blockade using Mut-IL-15/Fc in an outbred non-human primate model of renal allotransplantation. Male cynomolgus macaque donor-recipient pairs were selected based on ABO typing, major histocompatibility complex class I typing, and carboxy-fluorescein diacetate succinimidyl ester-based mixed lymphocyte responses. Once animals were assigned to one of six treatment groups, they underwent renal transplantation and bilateral native nephrectomy. Serum creatinine level was monitored twice weekly and as indicated, and protocol biopsies were performed. Rejection was defined as a increase in serum creatinine to 1.5 mg/dL or higher and was confirmed histologically. Complete blood counts and flow cytometric analyses were performed periodically posttransplant; pharmacokinetic parameters of Mut-IL-15/Fc were assessed. Compared with control animals, Mut-IL-15/Fc-treated animals did not demonstrate increased graft survival despite adequate serum levels of Mut-IL-15/Fc. Flow cytometric analysis of white blood cell subgroups demonstrated a decrease in CD8 T-cell and natural killer cell numbers, although this did not reach statistical significance. Interestingly, two animals receiving Mut-IL-15/Fc developed infectious complications, but no infection was seen in control animals. Renal pathology varied widely. Peritransplant IL-15 receptor blockade does not prolong allograft survival in non-human primate renal transplantation; however, it reduces the number of CD8 T cells and natural killer cells in the peripheral blood.

Female Genital Mutilation in Sudan

PubMed Central

Elduma, Adel Hussein

2018-01-01

BACKGROUND: Female genital mutilation or female circumcision (FGM) is a serious health problem in Sudan. This procedure is harmful to women and causes many complications during pregnancy and childbirth. OBJECTIVE: This study aims to determine the female genital mutilation (FGM) and its associated factors in Sudan. SUBJECTS AND METHODS: Data from Sudan Multiple Indicator Cluster Survey (MICS - UNICEF) was used in this research. The survey was carried out in 2014 and included women aged between 14 – 49 years. A logistic regression model was used to find an association between dependent and independent variables. RESULT: Total numbers of 21947 women were included in the survey and out of the 6249 (28.5 %) from urban and 15698 (71.5%) from rural areas. The prevalence of female circumcision was 89%. Women who had circumcised daughters were 32.1 %. The highest prevalence of FGM was reported from South Kordofan state with 7.8%, and lowest was in Red Sea state (7.6%). A significant association was observed between circumcised women and their marital status, daughter circumcision, and the level of education. CONCLUSION: The practice of female genital mutilation is spread all over the country. Poor women with low level of education are at high risk for this phenomenon. More efforts have to be provided to end this dangerous practice. PMID:29531618

Ulcerative Dermatitis in C57BL/6 Mice Exhibits an Oxidative Stress Response Consistent with Normal Wound Healing

PubMed Central

Williams, Lisa K; Csaki, Lauren S; Cantor, Rita M; Reue, Karen; Lawson, Greg W

2012-01-01

Ulcerative dermatitis (UD) is a common syndrome of unknown etiology that results in profound morbidity in C57BL/6 mice and lines on a C57BL/6 background. The lesions are due to severe pruritus-induced self-trauma, progressing from superficial excoriations to deep ulcerations. UD may be behavioral in origin, with ulcerative lesions resulting from self-mutilating behavior in response to unresolved inflammation or compulsion. Alternatively, abnormal oxidative damage may be a mechanism underlying UD. To evaluate whether UD behaves similarly to normal wounds, consistent with a secondary self-inflicted lesion, or is a distinct disorder with abnormal wound response, we evaluated expression levels of genes representing various arms of the oxidative stress response pathway UD-affected and unwounded C57BL/6J mice. No evidence indicated that UD wounds have a defect in the oxidative stress response. Our findings are consistent with an understanding of C57BL/6 UD lesions as typical rather than atypical wounds. PMID:22776048

FGMReview: design of a knowledge management tool on female genital mutilation.

PubMed

Martínez Pérez, Guillermo; Turetsky, Risa

2015-11-01

Web-based literature search engines may not be user-friendly for some readers searching for information on female genital mutilation. This is a traditional practice that has no health benefits, and about 140 million girls and women worldwide have undergone it. In 2012, the website FGMReview was created with the aim to offer a user-friendly, accessible, scalable, and innovative knowledge management tool specialized in female genital mutilation. The design of this website was guided by a conceptual model based on the use of benchmarking techniques and requirements engineering, an area of knowledge from the computer informatics field, influenced by the Transcultural Nursing model. The purpose of this article is to describe this conceptual model. Nurses and other health care providers can use this conceptual model to guide their methodological approach to design and launch other eHealth projects. © The Author(s) 2014.

Reconstructive surgery after female genital mutilation: a prospective cohort study.

PubMed

Foldès, Pierre; Cuzin, Béatrice; Andro, Armelle

2012-07-14

Women who have undergone female genital mutilation rarely have access to the reconstructive surgery that is now available. Our objective was to assess the immediate and long-term outcomes of this surgery. Between 1998 and 2009, we included consecutive patients with female genital mutilation aged 18 years or older who had consulted a urologist at Poissy-St Germain Hospital, France. We used the WHO classification to prospectively include patients with type II or type III mutilation. The skin covering the stump was resected to reveal the clitoris. The suspensory ligament was then sectioned to mobilise the stump, the scar tissue was removed from the exposed portion and the glans was brought into a normal position. All patients answered a questionnaire at entry about their characteristics, expectations, and preoperative clitoris pleasure and pain, measured on a 5-point scale. Those patients who returned at 1 year for follow-up were questioned about clitoris pain and functionality. We compared data from the 1-year group with the total group of patients who had surgery. We operated on 2938 women with a mean age of 29·2 (SD 7·77 years; age at excision 6·1, SD 3·5 years). Mali, Senegal, and Ivory Coast were the main countries of origin, but 564 patients had undergone female genital mutilation in France. The 1-year follow-up visit was attended by 866 patients (29%). Expectations before surgery were identity recovery for 2933 patients (99%), improved sex life for 2378 patients (81%), and pain reduction for 847 patients (29%). At 1-year follow-up, 363 women (42%) had a hoodless glans, 239 (28%) had a normal clitoris, 210 (24%) had a visible projection, 51 (6%) had a palpable projection, and three (0·4%) had no change. Most patients reported an improvement, or at least no worsening, in pain (821 of 840 patients) and clitoral pleasure (815 of 834 patients). At 1 year, 430 (51%) of 841 women experienced orgasms. Immediate complications after surgery (haematoma, suture failure, moderate fever) were noted in 155 (5%) of the 2938 patients, and 108 (4%) were briefly re-admitted to hospital. Reconstructive surgery after female genital mutilation seems to be associated with reduced pain and restored pleasure. It needs to be made more readily available in developed countries by training surgeons. French Urological Association. Copyright © 2012 Elsevier Ltd. All rights reserved.

Mutilating Procedures, Management Practices, and Housing Conditions That May Affect the Welfare of Farm Animals: Implications for Welfare Research

PubMed Central

Nordquist, Rebecca E.; van der Staay, Franz Josef; van Eerdenburg, Frank J. C. M.; Velkers, Francisca C.; Fijn, Lisa; Arndt, Saskia S.

2017-01-01

Simple summary Intensive farming systems are confronted with a number of animal welfare issues such as injuries from horns in cattle and feather pecking in poultry. To solve these problems, mutilating procedures, such as dehorning in cattle and goats and beak trimming in laying hens, are applied routinely. These and other procedures such as early maternal separation, overcrowding, and barren housing conditions impair animal welfare. Scientific underpinning of the efficacy of these interventions and management practices is poor. We advocate that all stakeholders, in particular animal scientists and veterinarians, take the lead in evaluating common, putative mutilating and welfare reducing procedures and management practices to develop better, scientifically supported alternatives, focused on adaptation of the environment to the animals, to ensure uncompromised animal welfare. Abstract A number of mutilating procedures, such as dehorning in cattle and goats and beak trimming in laying hens, are common in farm animal husbandry systems in an attempt to prevent or solve problems, such as injuries from horns or feather pecking. These procedures and other practices, such as early maternal separation, overcrowding, and barren housing conditions, raise concerns about animal welfare. Efforts to ensure or improve animal welfare involve adapting the animal to its environment, i.e., by selective breeding (e.g., by selecting “robust” animals) adapting the environment to the animal (e.g., by developing social housing systems in which aggressive encounters are reduced to a minimum), or both. We propose adapting the environment to the animals by improving management practices and housing conditions, and by abandoning mutilating procedures. This approach requires the active involvement of all stakeholders: veterinarians and animal scientists, the industrial farming sector, the food processing and supply chain, and consumers of animal-derived products. Although scientific evidence about the welfare effects of current practices in farming such as mutilating procedures, management practices, and housing conditions is steadily growing, the gain in knowledge needs a boost through more scientific research. Considering the huge number of animals whose welfare is affected, all possible effort must be made to improve their welfare as quickly as possible in order to ban welfare-compromising procedures and practices as soon as possible. PMID:28230800

Mutilation, deception, and sex changes.

PubMed Central

Lavin, M

1987-01-01

The paper considers and rejects two arguments against the performance of sexual reassignment surgery. First, it is argued that the operation is not mutilating, but functionally enabling. Second, it is argued that the operation is not objectionably deceptive, since, if there is such a thing as our 'real sex', we do not know (ordinarily) what it is. The paper is also intended to shed light on what our sexual identity is and on what matters in sexual relations. PMID:3612700

Dealing with the fear of mutilation in the donation discussion.

PubMed

Verble, M; Worth, J

1999-03-01

Fear of mutilation is a significant barrier to organ and tissue donation. It constitutes an example of Mystical Thinking and may be seen as an exemplar of animal learning or, more specifically, as a representation of the "blood phobia." As such the fear is not amenable to conventional public education efforts. Cognitive and behavioral techniques used in treating other types of phobias should be studied as a way to remove this barrier to donation.

Female genital mutilation among mothers and daughters in Harar, eastern Ethiopia.

PubMed

Oljira, Teshome; Assefa, Nega; Dessie, Yadeta

2016-12-01

To assess the practice of female genital mutilation (FGM) among mothers and daughters, and to investigate sociodemographic factors influencing the practice of FGM in Harar, Ethiopia. A community-based cross-sectional study was conducted among women aged 15 years or older who had at least one living daughter younger than 12 years via the Harar Health and Demographic Surveillance System 2013. Data were collected through face-to-face interviews. The practice of FGM was compared between mothers and their daughters. Whether the daughter had undergone FGM was included as an outcome variable in bivariate and multivariate analyses. Among 842 mothers, 669 (79.5%) reported that they had undergone FGM themselves, and 160 (19.0%) that their daughter had undergone FGM. Traditional practitioners were said to be the major performers of FGM by 151 (94.4%) mothers. Mothers whose daughter was mutilated mentioned social acceptance (144 [90.0%] women) and better marriage prospects (96 [60.0%]) as the major benefits. Genital mutilation of daughters was significantly associated with maternal age, education to grade 1-4, and FGM experience. Amhara ethnic origin was significantly associated with a reduced likelihood of FGM among daughters. Over one generation, the incidence of FGM has reduced. Increasing advocacy against FGM and enforcement of law should be emphasized. Copyright © 2016 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

Pleasure and orgasm in women with Female Genital Mutilation/Cutting (FGM/C).

PubMed

Catania, Lucrezia; Abdulcadir, Omar; Puppo, Vincenzo; Verde, Jole Baldaro; Abdulcadir, Jasmine; Abdulcadir, Dalmar

2007-11-01

Female genital mutilation/cutting (FGM/C) violates human rights. FGM/C women's sexuality is not well known and often it is neglected by gynecologists, urologists, and sexologists. In mutilated/cut women, some fundamental structures for orgasm have not been excised. The aim of this report is to describe and analyze the results of four investigations on sexual functioning in different groups of cut women. semistructured interviews and the Female Sexual Function Index (FSFI). 137 adult women affected by different types of FGM/C; 58 young FGM/C ladies living in the West; 57 infibulated women; 15 infibulated women after the operation of defibulation. The group of 137 women, affected by different types of FGM/C, reported orgasm in almost 86%, always 69.23%; 58 mutilated young women reported orgasm in 91.43%, always 8.57%; after defibulation 14 out of 15 infibulated women reported orgasm; the group of 57 infibulated women investigated with the FSFI questionnaire showed significant differences between group of study and an equivalent group of control in desire, arousal, orgasm, and satisfaction with mean scores higher in the group of mutilated women. No significant differences were observed between the two groups in lubrication and pain. Embryology, anatomy, and physiology of female erectile organs are neglected in specialist textbooks. In infibulated women, some erectile structures fundamental for orgasm have not been excised. Cultural influence can change the perception of pleasure, as well as social acceptance. Every woman has the right to have sexual health and to feel sexual pleasure for full psychophysical well-being of the person. In accordance with other research, the present study reports that FGM/C women can also have the possibility of reaching an orgasm. Therefore, FGM/C women with sexual dysfunctions can and must be cured; they have the right to have an appropriate sexual therapy.

Daughters at Risk of Female Genital Mutilation: Examining the Determinants of Mothers’ Intentions to Allow Their Daughters to Undergo Female Genital Mutilation

PubMed Central

Pashaei, Tahereh; Ponnet, Koen; Moeeni, Maryam; Khazaee-pool, Maryam; Majlessi, Fereshteh

2016-01-01

Female genital mutilation (FGM) is still a common practice in many countries in Africa and the Middle East. Understanding the determinants of FGM can lead to more active interventions to prevent this harmful practice. The goal of this study is to explore factors associated with FGM behavior among Iranian mothers and their daughters. Based on Ajzen’s theory of planned behavior, we examined the predictive value of attitudes, subjective norms, perceived behavioral control and several socio-demographic variables in relation to mothers’ intentions to mutilate their daughters. A paper-and-pencil survey was conducted among 300 mothers (mean age = 33.20, SD = 9.09) who had at least one daughter and who lived in Ravansar, a county in Kermanshah Province in Iran. Structural equation modeling was used to investigate the relationships among the study variables. Our results indicate that attitude is the strongest predictor of mothers’ intentions to allow their daughters to undergo FGM, followed by subjective norms. Compared to younger mothers, older mothers have more positive attitudes toward FGM, perceive themselves as having more control over their behavior and demonstrate a greater intention to allow their daughter to undergo FGM. Furthermore, we found that less educated mothers and mothers living in rural areas had more positive attitudes toward FGM and feel more social pressure to allow FGM. The model accounts for 93 percent of the variance in the mothers’ intentions to allow their daughters to undergo FGM. Intervention programs that want to decrease FGM might focus primarily on converting mothers’ neutral or positive feelings toward FGM into negative attitudes and on alleviating the perceived social pressure to mutilate one’s daughter. Based on our findings, we provide recommendations about how to curtail mothers’ intentions to allow their daughters to undergo FGM. PMID:27031613

Surgical reconstruction in female genital mutilation

PubMed Central

Gültekin, İsmail Burak; Altınboğa, Orhan; Dur, Rıza; Kara, Osman Fadıl; Küçüközkan, Tuncay

2016-01-01

Female genital mutilation (FGM) is an unusual condition for our country. However, an increase in FGM in future days can be predicted with the increasing numbers of exchange students coming from African countries, migration of refugees and socioeconomic relations with the African countries. We want to share our experience of two FGM victims admitted to our clinic with the request of reconstructive vulvar surgery before their marriage. Both women had WHO Type III FGM. Physical examination findings and surgical reconstruction techniques were presented. PMID:27274899

Female genital mutilation: when a cultural practice generates clinical and ethical dilemmas.

PubMed

Gibeau, A M

1998-01-01

Female genital mutilation (FGM) is of growing concern to health care providers in the United States and Canada as more women from countries where the procedure is practiced emigrate to North America. An introduction to the demographics of FGM, including prevalence rates, is a necessary antecedent for understanding the cultural rationales for this widespread practice. Considering the health consequences of this practice promotes questions about legal and ethical aspects of care as North Americans approach FGM from their own individual cultural frameworks.

Concern mounts over female genital mutilation.

PubMed

Jones, J

2000-07-29

According to estimates by the WHO, up to 140 million girls and women have undergone female genital mutilation (FGM), and each year another 2 million are thought to be at risk of it. Most girls who undergo this ritual live in Africa and to a lesser extent in Asia and the Middle East. However, there has been an increasing occurrence of genital mutilations among migrants from these countries who have settled in the US, Europe, and Australia. Although some countries prohibit the practice, evidence suggests that these laws are defied. In the UK, Baroness Ruth Rendell, the prime mover behind a cross-party parliament inquiry into FGM is convinced that some health professionals are still carrying out the operation on request. To this effect, she is advocating some prosecutions under the 1985 act. Rendell is also pressing for resources to be put into education and awareness campaigns for girls and women to have an informed choice as to whether to submit to the procedure or not.

Emotional influences on locomotor behavior.

PubMed

Naugle, Kelly M; Joyner, Jessica; Hass, Chris J; Janelle, Christopher M

2010-12-01

Emotional responses to appetitive and aversive stimuli motivate approach and avoidance behaviors essential for survival. The purpose of the current study was to determine the impact of specific emotional stimuli on forward, approach-oriented locomotion. Steady state walking was assessed while participants walked toward pictures varying in emotional content (erotic, happy people, attack, mutilation, contamination, and neutral). Step length and step velocity were calculated for the first two steps following picture onset. Exposure to the mutilation and contamination pictures shortened the lengths of step one and step two compared to the erotic pictures. Additionally, step velocity was greater during exposure to the erotic pictures compared to (1) the contamination and mutilation pictures for step one and (2) all other picture categories for step two. These findings suggest that locomotion is facilitated when walking toward approach-oriented emotional stimuli but compromised when walking toward aversive emotional stimuli. The data extend our understanding of fundamental interactions among motivational orientations, emotional reactions, and resultant actions. Theoretical and practical implications are discussed. Copyright © 2010 Elsevier Ltd. All rights reserved.

Intervention of the hospital midwife in the case of a pregnant women who had undergone female genital mutilation. A case study.

PubMed

Díaz-Jiménez, Désirée; Rodríguez-Villalón, Marta; Moreno-Dueñas, María Begoña

Female genital mutilation, condemned by all UN member countries has spread throughout the world as a result of migratory flows and is practiced under the guise of a custom, tradition or culture. In Spain, it is punishable as a personal injury offence under the current penal code. A clinical case study reviewedthe main actions of the midwife in this kind of injury in a pregnant woman during labour. The data collected from the physical examination and the midwife's assessment according to the Virginia Henderson model are presented and a complete care plan developed. From the case it can be concluded that in the hospital area, midwives can and should reinforce and complete the work with these women and their families, of informing, educating and reinforcing the decision not to mutilate. This work should have been started in, the health centre. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

fMRI responses to pictures of mutilation and contamination.

PubMed

Schienle, Anne; Schäfer, Axel; Hermann, Andrea; Walter, Bertram; Stark, Rudolf; Vaitl, Dieter

2006-01-30

Findings from several functional magnetic resonance imaging (fMRI) studies implicate the existence of a distinct neural disgust substrate, whereas others support the idea of distributed and integrative brain systems involved in emotional processing. In the present fMRI experiment 12 healthy females viewed pictures from four emotion categories. Two categories were disgust-relevant and depicted contamination or mutilation. The other scenes showed attacks (fear) or were affectively neutral. The two types of disgust elicitors received comparable ratings for disgust, fear and arousal. Both were associated with activation of the occipitotemporal cortex, the amygdala, and the orbitofrontal cortex; insula activity was nonsignificant in the two disgust conditions. Mutilation scenes induced greater inferior parietal activity than contamination scenes, which might mirror their greater capacity to capture attention. Our results are in disagreement with the idea of selective disgust processing at the insula. They point to a network of brain regions involved in the decoding of stimulus salience and the regulation of attention.

Autonomic markers of emotional processing: skin sympathetic nerve activity in humans during exposure to emotionally charged images.

PubMed

Brown, Rachael; James, Cheree; Henderson, Luke A; Macefield, Vaughan G

2012-01-01

The sympathetic innervation of the skin primarily subserves thermoregulation, but the system has also been commandeered as a means of expressing emotion. While it is known that the level of skin sympathetic nerve activity (SSNA) is affected by anxiety, the majority of emotional studies have utilized the galvanic skin response as a means of inferring increases in SSNA. The purpose of the present study was to characterize the changes in SSNA when showing subjects neutral or emotionally charged images from the International Affective Picture System (IAPS). SSNA was recorded via tungsten microelectrodes inserted into cutaneous fascicles of the common peroneal nerve in ten subjects. Neutral images, positively charged images (erotica) or negatively charged images (mutilation) were presented in blocks of fifteen images of a specific type, each block lasting 2 min. Images of erotica or mutilation were presented in a quasi-random fashion, each block following a block of neutral images. Both images of erotica or images of mutilation caused significant increases in SSNA, but the increases in SSNA were greater for mutilation. The increases in SSNA were often coupled with sweat release and cutaneous vasoconstriction; however, these markers were not always consistent with the SSNA increases. We conclude that SSNA, comprising cutaneous vasoconstrictor and sudomotor activity, increases with both positively charged and negatively charged emotional images. Measurement of SSNA provides a more comprehensive assessment of sympathetic outflow to the skin than does the use of sweat release alone as a marker of emotional processing.

Searching for "voices": feminism, anthropology, and the global debate over female genital operations.

PubMed

Walley, C J

1997-08-01

This article lays the groundwork for a feminist and anthropological political response to female genital "operations" that transcends the current debate over the phenomenon, which is couched in terms of cultural relativism or of politically-informed outrage. After an introduction, the study considers the politics involved in assigning a name to the procedure and explains the author's reason for choosing female genital "operation" over the more commonly used "circumcision," "mutilation," or "torture." In the next section, clitoridectomy is contextualized through a recounting of the circumstances under which the procedure was performed in the western Kenyan village of Kikhome in 1988. This discussion focuses on the ceremonies surrounding the circumcisions of young men and women, the author's attempts to discover how the young women involved really felt about the tradition, and a review of the anthropological literature on the significance and impact of these practices. The analysis then examines the international controversy surrounding female genital mutilation and provides an overview of the colonial discourse on female genital mutilation in Africa to expose 1) the origins of justifications for colonial dominance in the dominance of non-Western women by non-Western men and 2) the fact that use of cultural arguments that fuse women and tradition can support culturally-defined power relationships. The article concludes with a consideration of who is qualified to speak out against female genital mutilation given the fact that all women and all debates are the products of longstanding, tenacious power relationships.

Mutilating Procedures, Management Practices, and Housing Conditions That May Affect the Welfare of Farm Animals: Implications for Welfare Research.

PubMed

Nordquist, Rebecca E; van der Staay, Franz Josef; van Eerdenburg, Frank J C M; Velkers, Francisca C; Fijn, Lisa; Arndt, Saskia S

2017-02-21

A number of mutilating procedures, such as dehorning in cattle and goats and beak trimming in laying hens, are common in farm animal husbandry systems in an attempt to prevent or solve problems, such as injuries from horns or feather pecking. These procedures and other practices, such as early maternal separation, overcrowding, and barren housing conditions, raise concerns about animal welfare. Efforts to ensure or improve animal welfare involve adapting the animal to its environment, i.e., by selective breeding (e.g., by selecting "robust" animals) adapting the environment to the animal (e.g., by developing social housing systems in which aggressive encounters are reduced to a minimum), or both. We propose adapting the environment to the animals by improving management practices and housing conditions, and by abandoning mutilating procedures. This approach requires the active involvement of all stakeholders: veterinarians and animal scientists, the industrial farming sector, the food processing and supply chain, and consumers of animal-derived products. Although scientific evidence about the welfare effects of current practices in farming such as mutilating procedures, management practices, and housing conditions is steadily growing, the gain in knowledge needs a boost through more scientific research. Considering the huge number of animals whose welfare is affected, all possible effort must be made to improve their welfare as quickly as possible in order to ban welfare-compromising procedures and practices as soon as possible.

Molecular-genetic correlates of self-harming behaviors in eating-disordered women: findings from a combined Canadian-German sample.

PubMed

Steiger, Howard; Fichter, Manfred; Bruce, Kenneth R; Joober, Ridha; Badawi, Ghislaine; Richardson, Jodie; Groleau, Patricia; Ramos, Cinthia; Israel, Mimi; Bondy, Brigitta; Quadflieg, Norbert; Bachetzky, Nadine

2011-01-15

Across populations, findings suggest that rates of self-mutilation, suicidal acts, and other self-harming behaviors (SHBs) may be influenced by polymorphisms that code for activity of the serotonin transporter (e.g., 5HTTLPR) and the enzyme, monoamine oxidase A (e.g., MAOAuVNTR). SHBs being common in patients with Eating Disorders (EDs), we evaluated (in a large sample of eating-disordered women) relationships between triallelic 5HTTLPR and MAOAuVNTR variants, on the one hand, and SHBs, on the other. We had 399 eating-disordered women report on eating symptoms and lifetime history of SHBs, and provide blood samples for genotyping. Individuals carrying high-function MAOAuVNTR alleles reported a history of SHBs about twice as often as did carriers of low-function alleles. We obtained no comparable main effect of 5HTTLPR, or MAOAuVNTR×5HTTLPR interaction effect. Genetic variations did not predict severity of eating symptoms. As in other populations, our findings link the MAOAuVNTR high-function alleles with increased risk of self-directed harm in bulimic females. We discuss theoretical and clinical ramifications of our results. Copyright © 2010 Elsevier Inc. All rights reserved.

[Automutilation with indistinct underlying disease--difficulties of care in the community].

PubMed

Gehb, Iris; Reuhl, Joachim; Volk, Stephan; Urban, Reinhard

2009-11-01

Self-mutilation is well-known in various psychiatric diseases and represents a challenge for forensic pathologists as regards the differentiation of accidental versus self-inflicted injuries, especially when a criminal charge is likely to emerge. A case of extraordinarily severe self-inflicted injuries is presented as well as the related implications concerning clinical and ambulatory care for patients, whose underlying motivation remains unknown. A 60 year-old worker exhibited an open scull fracture and 14 abdominal wounds with protrusion of small intestine, from which a part of 160 cm length was completely removed beforehand. The patient claimed the wounds having been caused accidentally. When examined by a psychiatrist, disturbances in orientation, unrest and ill concentration were found, but no symptoms related to psychosis, depression or suicidal behaviour. Although the need for more detailed examination seemed to be clearly evident, the medical authorities did not take action. Consequently, no further psychiatric treatment was initiated. The implications of this case on the background of the literature are discussed. Georg Thieme Verlag KG Stuttgart.New York.

Oral manifestations, dental management, and a rare homozygous mutation of the PRDM12 gene in a boy with hereditary sensory and autonomic neuropathy type VIII: a case report and review of the literature.

PubMed

Elhennawy, Karim; Reda, Seif; Finke, Christian; Graul-Neumann, Luitgard; Jost-Brinkmann, Paul-Georg; Bartzela, Theodosia

2017-08-15

Hereditary sensory and autonomic neuropathy type VIII is a rare autosomal recessive inherited disorder. Chen et al. recently identified the causative gene and characterized biallelic mutations in the PR domain-containing protein 12 gene, which plays a role in the development of pain-sensing nerve cells. Our patient's family was included in Chen and colleagues' study. We performed a literature review of the PubMed library (January 1985 to December 2016) on hereditary sensory and autonomic neuropathy type I to VIII genetic disorders and their orofacial manifestations. This case report is the first to describe the oral manifestations, and their treatment, of the recently discovered hereditary sensory and autonomic neuropathy type VIII in the medical and dental literature. We report on the oral manifestations and dental management of an 8-month-old white boy with hereditary sensory and autonomic neuropathy-VIII over a period of 16 years. Our patient was homozygous for a mutation of PR domain-containing protein 12 gene and was characterized by insensitivity to pain and thermal stimuli, self-mutilation behavior, reduced sweat and tear production, absence of corneal reflexes, and multiple skin and bone infections. Oral manifestations included premature loss of teeth, associated with dental traumata and self-mutilation, severe soft tissue injuries, dental caries and submucosal abscesses, hypomineralization of primary teeth, and mandibular osteomyelitis. The lack of scientific knowledge on hereditary sensory and autonomic neuropathy due to the rarity of the disease often results in a delay in diagnosis, which is of substantial importance for the prevention of many complications and symptoms. Interdisciplinary work of specialized medical and dental teams and development of a standardized treatment protocols are essential for the management of the disease. There are many knowledge gaps concerning the management of patients with hereditary sensory and autonomic neuropathy-VIII, therefore more research on an international basis is needed.

Clitoral reconstruction after female genital mutilation/cutting: case studies.

PubMed

Abdulcadir, Jasmine; Rodriguez, Maria I; Petignat, Patrick; Say, Lale

2015-01-01

Clitoral reconstruction following female genital mutilation/cutting (FGM/C) is a new surgical technique reported to be a feasible and effective strategy to reduce clitoral pain, improve sexual pleasure, and restore a vulvar appearance similar to uncircumcised women. However, data on safety, care offered, and evaluation of sexual and pain outcomes are still limited. This study aims to present the care offered and clinical outcomes of two women who received multidisciplinary care, including psychosexual treatment, with clitoral reconstruction. We report their long-term outcomes, and the histology of the removed periclitoral fibrosis. We report the cases of two women with FGM/C types II and III who requested clitoral reconstruction for different reasons. One woman hoped to improve her chronic vulvar pain, as well as improve her sexual response. The other woman requested surgery due to a desire to reverse a procedure that was performed without her consent, and a wish to have a genital appearance similar to non infibulated women. They both underwent psychosexual evaluation and therapy and surgery. The histology of the periclitoral fibrosis removed during surgery was analyzed. At 1-year postoperatively, the first woman reported complete disappearance of vulvar pain and improved sexual pleasure, including orgasm. Our second patient also described improved sexuality at 1-year follow-up (increased sexual desire, lubrication, vulvar pleasure, and sensitiveness), which she attributed to a better self body image and confidence. Both women reported feeling satisfied, happy, and more beautiful. We show a positive outcome in pain reduction and improved sexual function, self body image, and gender after psychosexual therapy and clitoral reconstruction. More evidence is needed about clitoral reconstruction to develop guidelines on best practices. Until research is conducted that rigorously evaluates clitoral reconstruction for its impact on pain and sexuality, we advise always offering a multidisciplinary care, including sexual therapy before and after the surgery. © 2014 International Society for Sexual Medicine The World Health Organization retains copyright and all other rights in the manuscript of this article as submitted for publication.

Self- and other-directed forms of violence and their relationship with lifetime DSM-5 psychiatric disorders: Results from the National Epidemiologic Survey on Alcohol Related Conditions-III (NESARC-III).

PubMed

Harford, Thomas C; Chen, Chiung M; Kerridge, Bradley T; Grant, Bridget F

2018-04-01

A combined history of violence toward self and others has been reported in clinical and incarcerated populations. Psychiatric disorders have been implicated as risk factors. This study examines the lifetime prevalence of this combined violence in the general population and its associations with DSM-5 psychiatric disorders in comparison with other- and self-directed violence. Data from the National Epidemiologic Survey on Alcohol and Related Conditions-III (NESARC-III) were analyzed, including 36,309 U.S. adults ages 18 and older. Violent behavior was defined by suicide attempts; recurrent suicidal behavior; gestures, threats, or self-mutilating behavior (self-directed); and multiple items of violence toward others (other-directed) in four categories: none, self-directed only, other-directed only, and combined self-/other-directed. Multinomial logistic regression examined these violence categories in association with sociodemographics and lifetime DSM-5 psychiatric disorders. Results show that approximately 18.1% of adults reported violent behavior, including self-directed only (4.4%), other-directed only (10.9%), and combined self- and other-directed violence (2.8%). DSM-5 psychiatric disorders significantly associated with the violence typology include alcohol, tobacco, cannabis, and other drug use disorders; mood disorders; posttraumatic stress disorder; and schizotypal, antisocial, and borderline personality disorders. Findings extend the clinical literature regarding the co-occurrence of self- and other-directed violent behaviors to the general population. Copyright © 2017 Elsevier B.V. All rights reserved.

Homicides with corpse dismemberment in the material collected by the Department of Forensic Medicine, Krakow, Poland.

PubMed

Konopka, Tomasz; Bolechała, Filip; Strona, Marcin; Kopacz, Paweł

2016-01-01

Aim of the study: To determine the circumstances which can be useful for offenders profiling in homicide cases with victim's body dismemberment. Material and methods: Study of all homicide cases with victim's corpse dismemberment examined in Krakow Department of Forensic Medicine over the last 50 years. Results: Within the past 50 years, a total number of 30 cases of homicides with dismembered bodies were examined in Krakow. 22 cases represent defensive mutilations performed by offender, 3 cases can be classified as offensive muti-lations and 3 cases represent aggressive mutilations - decapitation as a method of committing homicide. In this period the only 1 case of necrophilic mutilations was examined, when the body was dismembered without murder. In most cases the background of homicide was the family conflict, 6 was cause of mental illness of perpetrator and in 3 was sexual motive. Only in 3 cases (from 25 when the offender was known) perpetrator kill a stranger. In the other the offender belonged to the family or friends of the victim. In all cases where the perpetrator was determined, homicide and dismemberment was performed in his place of residence. The findings of the Police investigations indicate that in most cases homicides were not planned, occurred under the influence of emotion, only two have been previously scheduled. Conclusions: Homicides with corpses dismemberment usually are committed by offenders who is in close relationship with victim (family or friend). Dismemberment is almost always performed in the same place as murder - home of perpetrator. This type of homicide usually is not planned.

Gender equality and human rights approaches to female genital mutilation: a review of international human rights norms and standards.

PubMed

Khosla, Rajat; Banerjee, Joya; Chou, Doris; Say, Lale; Fried, Susana T

2017-05-12

Two hundred million girls and women in the world are estimated to have undergone female genital mutilation (FGM), and another 15 million girls are at risk of experiencing it by 2020 in high prevalence countries (UNICEF, 2016. Female genital mutilation/cutting: a global concern. 2016). Despite decades of concerted efforts to eradicate or abandon the practice, and the increased need for clear guidance on the treatment and care of women who have undergone FGM, present efforts have not yet been able to effectively curb the number of women and girls subjected to this practice (UNICEF. Female genital mutilation/cutting: a statistical overview and exploration of the dynamics of change. 2013), nor are they sufficient to respond to health needs of millions of women and girls living with FGM. International efforts to address FGM have thus far focused primarily on preventing the practice, with less attention to treating associated health complications, caring for survivors, and engaging health care providers as key stakeholders. Recognizing this imperative, WHO developed guidelines on management of health complications of FGM. In this paper, based on foundational research for the development of WHO's guidelines, we situate the practice of FGM as a rights violation in the context of international and national policy and efforts, and explore the role of health providers in upholding health-related human rights of women at girls who are survivors, or who are at risk. Findings are based on a literature review of relevant international human rights treaties and UN Treaty Monitoring Bodies.

Reconstructive surgery for female genital mutilation starts sexual functioning in Sudanese woman: a case report.

PubMed

Fazari, Atif B E; Berg, Rigmor C; Mohammed, Wafaa A; Gailii, Enas B; Elmusharaf, Khalifa

2013-11-01

Female genital mutilation (FGM) involves the partial or complete removal of the external female genitalia and/or other injury to the female genital organs whether for cultural or other nontherapeutic reasons. The study aims to describe the method of and findings from reconstructive surgery for FGM victims. We present a case of a 24-year-old Sudanese female, who had undergone ritual FGM type III as a young girl. She had suffered from a large, vulval mass for the last 6 years and came to the clinic because of apareunia. We performed mass excision and reconstructive surgery of the mutilated genital tissue. The giant mass was successfully removed. Remaining genital tissues were approximated and sutured, with hemostasis assured for the reconstructed organs on each side. Reconstructive surgery for women who suffer sexual consequences from FGM is feasible, with a high degree of client acceptance and satisfaction. It restores some of women's natural genital anatomy, and offers the potential for improved female sexuality. © 2013 International Society for Sexual Medicine.

Traumatic Penile Injury: From Circumcision Injury to Penile Amputation

PubMed Central

Park, Jae Young; Song, Yun Seob

2014-01-01

The treatment of external genitalia trauma is diverse according to the nature of trauma and injured anatomic site. The classification of trauma is important to establish a strategy of treatment; however, to date there has been less effort to make a classification for trauma of external genitalia. The classification of external trauma in male could be established by the nature of injury mechanism or anatomic site: accidental versus self-mutilation injury and penis versus penis plus scrotum or perineum. Accidental injury covers large portion of external genitalia trauma because of high prevalence and severity of this disease. The aim of this study is to summarize the mechanism and treatment of the traumatic injury of penis. This study is the first review describing the issue. PMID:25250318

THE USE OF THE LIGASURE™ DEVICE FOR SCROTAL ABLATION IN MARSUPIALS.

PubMed

Cusack, Lara; Cutler, Daniel; Mayer, Joerg

2017-03-01

Five sugar gliders ( Petaurus breviceps ), ranging in age from 3 mo to 3.5 yr of age, and one opossum ( Didelphis virginianus ), age 4.5 mo, presented for elective orchiectomy and scrotal ablation. The LigaSure™ device was safely used for orchiectomy and scrotal ablation in both species. Surgical time with the LigaSure was approximately 4 sec. No grooming of the incision site or self-mutilation was seen in the first 72 hr postoperatively. One sugar glider required postoperative wound care approximately 10 days postoperatively following incision-site grooming by a conspecific. The LigaSure provides a rapid, technologically simple and safe surgical technique for scrotal ablation and orchiectomy in the marsupial patient that minimizes surgical, anesthetic, and recovery times.

Educating about female genital mutilation.

PubMed

Holmes, Victoria; Farrington, Rebecca; Mulongo, Peggy

2017-01-01

Female genital mutilation (FGM) is illegal in the UK but nevertheless practised in some immigrant communities. Effective educational approaches are required to inform policy and to direct resources, often in the voluntary sector. The opinions in this article arise from discussions with professionals and members of FGM-practising communities. We highlight the importance of sharing experiences and expertise across health and social care professionals as well as working in partnership with culturally sensitive Non-Governmental Organisations. Enlisting the support of men and religious leaders is crucial to breaking down barriers in male-dominated communities and dispelling myths about FGM being a 'requirement' of faith.

Borderline Personality and Externalized Aggression

PubMed Central

Sansone, Lori A.

2012-01-01

Individuals with borderline personality disorder are diagnostically and clinically characterized by self-harm behavior, as indicated by the criterion in the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision, “recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior.” However, individuals with borderline personality disorder can display externalized aggressive behavior, as well. In an area characterized by considerably less research, empirical evidence indicates that individuals with borderline personality disorder may exhibit physical violence toward partners, physical violence toward known but nonintimate individuals, criminal behaviors that embody externalized violence (e.g., property damage), and, on very rare occasion, murderous behavior (either of family members or anonymous others through serial killing). Given this under-researched area, there are probably other types of externalized aggressive behaviors that have not been empirically revealed. However, externalized aggressive behaviors in individuals with borderline personality disorder clearly exist and need to be assessed in both psychiatric and primary care settings in an effort to promote safety of medical personnel and effective patient management. PMID:22567607

Clinical vampirism. A presentation of 3 cases and a re-evaluation of Haigh, the 'acid-bath murderer'.

PubMed

Hemphill, R E; Zabow, T

1983-02-19

Clinical vampirism is named after the mythical vampire, and is a recognizable, although rare, clinical entity characterized by periodic compulsive blood-drinking, affinity with the dead and uncertain identity. It is hypothetically the expression of an inherited archaic myth, the act of taking blood being a ritual that gives temporary relief. From ancient times vampirists have given substance to belief in the existence of supernatural vampires. Four vampirists, including Haigh, the 'acid-bath murderer', are described. From childhood they cut themselves, drank their own, exogenous human or animal blood to relieve a craving, dreamed of blood-shed, associated with the dead, and had a changing identity. They were intelligent, with no family mental or social pathology. Some self-cutters are auto-vampirists; females are not likely to assault others for blood, but males are potentially dangerous. Vampirism may be a cause of unpredictable repeated assault and murder, and should be looked for in violent criminals who are self-mutilators. No specific treatment is known.

Severe complications in wound healing and fracture treatment in two brothers with congenital insensitivity to pain with anhidrosis.

PubMed

Rapp, Marion; Spiegler, Juliane; Härtel, Christoph; Gillessen-Kaesbach, Gabrielle; Kaiser, Martin M

2013-01-01

Congenital insensitivity to pain with anhidrosis is an autosomal recessive disorder caused by mutations in the neurotrophic tyrosine receptor kinase 1 (NTRK1) gene, which encodes the receptor for nerve growth factor. We report the clinical and radiological pitfalls in the diagnosis and treatment of two brothers, aged 5 and 8 years, with congenital insensitivity to pain with anhidrosis, the older brother having a proven NTRK1 mutation. In the neonatal period, both presented with recurrent episodes of fever of unknown origin, but their clinical problems changed later. In addition to severe mental retardation and self-harming behaviour, the older brother developed recurrent nonbacterial destructive infections of both the calcaneus and later the talus. No immunodeficiency was found. The younger brother had three complex fractures with a long history of healing problems: overwhelming production of callus, osteomyelitis and movement restrictions. He has less mental retardation than his older brother and shows no self-mutilation.

Why alternative teenagers self-harm: exploring the link between non-suicidal self-injury, attempted suicide and adolescent identity

PubMed Central

2014-01-01

Background The term ‘self-harm’ encompasses both attempted suicide and non-suicidal self-injury (NSSI). Specific adolescent subpopulations such as ethnic or sexual minorities, and more controversially, those who identify as ‘Alternative’ (Goth, Emo) have been proposed as being more likely to self-harm, while other groups such as ‘Jocks’ are linked with protective coping behaviours (for example exercise). NSSI has autonomic (it reduces negative emotions) and social (it communicates distress or facilitates group ‘bonding’) functions. This study explores the links between such aspects of self-harm, primarily NSSI, and youth subculture. Methods An anonymous survey was carried out of 452 15 year old German school students. Measures included: identification with different youth cultures, i.e. Alternative (Goth, Emo, Punk), Nerd (academic) or Jock (athletic); social background, e.g. socioeconomic status; and experience of victimisation. Self-harm (suicide and NSSI) was assessed using Self-harm Behavior Questionnaire and the Functional Assessment of Self-Mutilation (FASM). Results An “Alternative” identity was directly (r ≈ 0.3) and a “Jock” identity inversely (r ≈ -0.1) correlated with self-harm. “Alternative” teenagers self-injured more frequently (NSSI 45.5% vs. 18.8%), repeatedly self-injured, and were 4–8 times more likely to attempt suicide (even after adjusting for social background) than their non-Alternative peers. They were also more likely to self-injure for autonomic, communicative and social reasons than other adolescents. Conclusions About half of ‘Alternative’ adolescents’ self-injure, primarily to regulate emotions and communicate distress. However, a minority self-injure to reinforce their group identity, i.e. ‘To feel more a part of a group’. PMID:24885081

Why alternative teenagers self-harm: exploring the link between non-suicidal self-injury, attempted suicide and adolescent identity.

PubMed

Young, Robert; Sproeber, Nina; Groschwitz, Rebecca C; Preiss, Marthe; Plener, Paul L

2014-05-22

The term 'self-harm' encompasses both attempted suicide and non-suicidal self-injury (NSSI). Specific adolescent subpopulations such as ethnic or sexual minorities, and more controversially, those who identify as 'Alternative' (Goth, Emo) have been proposed as being more likely to self-harm, while other groups such as 'Jocks' are linked with protective coping behaviours (for example exercise). NSSI has autonomic (it reduces negative emotions) and social (it communicates distress or facilitates group 'bonding') functions. This study explores the links between such aspects of self-harm, primarily NSSI, and youth subculture. An anonymous survey was carried out of 452 15 year old German school students. Measures included: identification with different youth cultures, i.e. Alternative (Goth, Emo, Punk), Nerd (academic) or Jock (athletic); social background, e.g. socioeconomic status; and experience of victimisation. Self-harm (suicide and NSSI) was assessed using Self-harm Behavior Questionnaire and the Functional Assessment of Self-Mutilation (FASM). An "Alternative" identity was directly (r ≈ 0.3) and a "Jock" identity inversely (r ≈ -0.1) correlated with self-harm. "Alternative" teenagers self-injured more frequently (NSSI 45.5% vs. 18.8%), repeatedly self-injured, and were 4-8 times more likely to attempt suicide (even after adjusting for social background) than their non-Alternative peers. They were also more likely to self-injure for autonomic, communicative and social reasons than other adolescents. About half of 'Alternative' adolescents' self-injure, primarily to regulate emotions and communicate distress. However, a minority self-injure to reinforce their group identity, i.e. 'To feel more a part of a group'.

Fitting a hand-glove prosthesis to enhance the reconstructed mutilated hand.

PubMed

Leow, M E; Kour, A K; Pereira, B P; Pho, R W

1998-03-01

Microsurgical reconstruction of the severely mutilated hand aimed at improving prehensile functions often does not address the esthetic aspects of the hand. The poor appearance of the reconstructed hand affects its active display and use. A hand-glove prosthesis may be prescribed in this instance to enhance the overall form and function of the mutilated hand. We reviewed 16 cases of mutilating hand injuries in which surgical reconstructions were performed and the patients were subsequently fitted with a hand-glove prosthesis to augment the outcome. An improved appearance was achieved in all patients fitted with the prosthesis. The patients' sense of confidence was also enhanced, which in turn promoted the active and open use of the reconstructed hands. While prescribed primarily to improve the appearance of the reconstructed hands, these prostheses were documented to enhance the physical hand functions in 11 cases by increasing the span of the hand and providing an opposable post and a palmar base for holding and for anchorage. The prosthesis enhanced assistive functions of the reconstructed hands and freed the contralateral normal hand for use in bimanual activities, such as holding a wallet and taking out money, supporting a note pad for writing, and holding a plate at buffet receptions. At the 18-month follow-up visit, 13 (87%) of the patients continued to use their prosthesis. Wear and tear were problems associated with the frequent use of the prosthesis. The expected life span of the prosthesis with daily use ranged from 2 to 3 years. All the patients acknowledged that the prosthesis played a role in their rehabilitation and that it helped them to overcome the initial psychological trauma and to come to terms with their physical loss.

To mutilate in the name of Jehovah or Allah: legitimization of male and female circumcision.

PubMed

Abu-Sahlieh, S A

1994-01-01

Female circumcison is practised in Sudan, Somalia, Egypt and a few other Arab and Muslim countries. It has triggered a passionate public debate in the West. This debate has found somewhat of an echo in the Arab and Muslim world, but some Muslim religious circles such as Al-Azhar (Egypt), the most important Islamic centre in the world, try to justify it on the basis of sunnah (that is, to conform with the tradition of the prophet Mohammed). Male circumcision is practised by all Muslims and Jews and also by some Christians in Egypt, in the United States and Canada). For different reasons, the debate on this topic is still taboo in Western and in Arab and Muslim countries. The object of this study is to define the role of Islamic law and Muslim religious leaders in female and male circumcision. On purpose, it avoids any use of the word 'Islam', and concentrates on the written sources of Islamic law and the opinions of contemporary Arab authors, mostly of Egyptian origin. Juridical logic cannot acknowledge the distinction between female and male circumcision, both being the mutilation of healthy organs which is damaging to the physical integrity of the child, whatever the underlying religious motivations. Furthermore, both practices violate the Koran: 'Our Lord, You did not create all this in vain' (3:191), and '[He] perfected everything He created' (32:7). In our opinion, a god who demands that his believers be mutilated and branded on their genitals the same as cattle, is a god of questionable ethics. To mutilate children, boys or girls, under the pretext that it is for their own good, shows the influence of cynicism and fanaticism.

A survey of Australian midwives' knowledge, experience, and training needs in relation to female genital mutilation.

PubMed

Turkmani, Sabera; Homer, Caroline; Varol, Nesrin; Dawson, Angela

2018-02-01

Female genital mutilation (FGM) involves partial or total removal of the external female genitalia or any other injury for non-medical reasons. Due to international migration patterns, health professionals in high income countries are increasingly caring for women with FGM. Few studies explored the knowledge and skills of midwives in high income countries. To explore the knowledge, experience and needs of midwives in relation to the care of women with FGM. An online self-administered descriptive survey was designed and advertised through the Australian College of Midwives' website. Of the 198 midwives (24%) did not know the correct classification of FGM. Almost half of the respondents (48%) reported they had not received FGM training during their midwifery education. Midwives (8%) had been asked, or knew of others who had been asked to perform FGM in Australia. Many midwives were not clear about the law or health data related to FGM and were not aware of referral paths for affected women. As frontline providers, midwives must have appropriate up-to-date clinical skills and knowledge to ensure they are able to provide women with FGM the care they need and deserve. Midwives have a critical role to play in the collection of FGM related data to assist with health service planning and to prevent FGM by working closely with women and communities they serve to educate and advocate for its abandonment. Therefore, addressing educational gaps and training needs are key strategies to deliver optimal quality of care. Copyright © 2017 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

Disease activity in and quality of life of patients with psoriatic arthritis mutilans: the Nordic PAM Study.

PubMed

Lindqvist, U; Gudbjornsson, B; Iversen, L; Laasonen, L; Ejstrup, L; Ternowitz, T; Ståhle, M

2017-11-01

To describe the social status and health-related quality of life of patients with psoriatic arthritis mutilans (PAM) in the Nordic countries. Patients with at least one mutilated joint confirmed by radiology were studied. Disease activity involving joints and skin, physician-assessed disease activity, and patient's education and work status were recorded. Data from the 36-item Short Form Health Survey, Health Assessment Questionnaire and Dermatology Life Quality Index questionnaire were gathered and correlated with disease duration, pain, and general well-being (visual analogue scale). The controls were 58 Swedish patients with long-standing psoriatic arthritis sine PAM. Sixty-seven patients were included. Patients with PAM had a protracted disease history (33 ± 14 years) and disease onset at a relatively early age (30 ± 12 years). Overall inflammatory activity at inclusion was mild to moderate. The mean number of mutilated joints was 8.2 and gross deformity was found in 16% of patients. Forty per cent were treated with biological and 32% with conventional synthetic disease-modifying anti-rheumatic drugs. Forty-two per cent had retired early or were on sick leave. Impaired functional capacity with little or no ability to perform self-care or everyday tasks was reported by 21% of the patients. Patients between 45 and 60 years of age reported the most impaired quality of life in comparison to the control group. PAM seriously affects social functioning. Whether early recognition of PAM and new forms of therapy can improve disease outcome and quality of life remains to be studied.

Skeletal Fixation in a Mutilated Hand.

PubMed

Bhardwaj, Praveen; Sankaran, Ajeesh; Sabapathy, S Raja

2016-11-01

Hand fracture fixation in mutilating injuries is characterized by multiple challenges due to possible skeletal disorganization and concomitant severe injury of soft tissue structures. The effects of skeletal disruption are best analyzed as divided into specific locales in the hand: radial, ulnar, proximal, and distal. Functional consequences of injuries in each of these regions are discussed. Although a variety of implants are now in vogue, K-wire fixation has stood the test of time and is especially useful in multiple fracture situations. Segmental bone loss is quite common in such injuries, which can be safely reconstructed in a staged manner. Copyright © 2016 Elsevier Inc. All rights reserved.

Female genital mutilation in Greece.

PubMed

Vrachnis, N; Salakos, N; Iavazzo, C; Iliodromiti, Z; Bakalianou, K; Kouiroukidou, P; Creatsas, G

2012-01-01

The number of migrants and refugees with a female genital mutilation (FGM) living in Greece is rising. This study explores the characteristics and psychosexual issues of women with FGM who were examined in the 2nd Department of Obstetrics and Gynecology, University of Athens Medical School, Greece during the year 2009. The women were asked to fill out an anonymous questionnaire asking for demographic data, obstetric history, current complaints, and psychosexual problems. The results are presented and discussed, as FGM is a new reality for Greece. Healthcare providers have to familiarize themselves with issues related to FGM and improve their skills in transcultural care, so as to manage and support women with FGM adequately.

Female genital mutilation: a urology focus.

PubMed

Clarke, Elinor

2016-10-13

Female genital mutilation (FGM) is a collective term for the deliberate alteration, removal and cutting of the female genitalia. It has no known health benefits and can have negative physical and psychological consequences. The number of women and girls in the UK that are affected by FGM is unknown. Recent NHS data suggested that FGM has been evident (declared or observed) in women who have accessed health care; however, there are gaps in knowledge and a limited evidence base on the health consequences of FGM. This article explores the urological complications experienced by women who have undergone this practice, and the effects this can have on their health and wellbeing.

A systematic review of doctors' experiences and needs to support the care of women with female genital mutilation.

PubMed

Dawson, Angela; Homer, Caroline S E; Turkmani, Sabera; Black, Kirsten; Varol, Nesrin

2015-10-01

Female genital mutilation (FGM) involves partial or complete removal of the external female genitalia or other injury for non-therapeutic reasons. Little is known about the knowledge and skills of doctors who care for affected women and their practice in relation to FGM. To examine the FGM experiences and educational needs of doctors. A structured search of five bibliographic databases was undertaken to identify peer-reviewed research literature published in English between 2004 and 2014 using the keywords "female genital mutilation," "medical," "doctors," "education," and "training." Observational, quasi-experimental, and non-experimental descriptive studies were suitable for inclusion. A narrative synthesis of the study findings was undertaken and themes were identified. Ten papers were included in the review, three of which were from low-income countries. The analysis identified three themes: knowledge and attitudes, FGM-related medical practices, and education and training. There is a need for improved education and training to build knowledge and skills, and to change attitudes concerning the medicalization of FGM and reinfibulation. Copyright © 2015 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

Emotion dysregulation as a mechanism linking child maltreatment exposure and self-harm behaviors in adolescents.

PubMed

Peh, Chao Xu; Shahwan, Shazana; Fauziana, Restria; Mahesh, Mithila V; Sambasivam, Rajeswari; Zhang, YunJue; Ong, Say How; Chong, Siow Ann; Subramaniam, Mythily

2017-05-01

Although child maltreatment exposure is a recognized risk factor for self-harm, mechanisms underlying this relationship remain unclear. Self-harm may function as a compensatory strategy to regulate distressing emotions. This cross-sectional study examines if emotion dysregulation mediates between the severity of maltreatment exposure and self-harm, adjusting for demographic variables and depressive symptoms. Participants were 108 adolescent patients recruited from a psychiatric hospital in Singapore (mean age 17.0 years, SD=1.65; 59.3% female). Study measures included the Childhood Trauma Questionnaire (CTQ-SF), Functional Assessment of Self-Mutilation (FASM), Difficulties in Emotion Regulation Scale (DERS), and the Patient Health Questionnaire (PHQ-8). Path analysis was conducted to examine the direct and indirect effects of maltreatment exposure on self-harm via emotion dysregulation, controlling for demographic variables and depressive symptoms. Indirect effects were tested using bootstrapped confidence intervals (CI). Results showed that self-harm was highly prevalent in our sample (75.9%). Emotion dysregulation and depressive symptoms were found to be associated with higher self-harm frequency. In addition, results from path analysis showed that the association between the severity of maltreatment exposure and self-harm frequency was significantly mediated by emotion dysregulation B=0.07, p<0.05, 95% CI [0.02, 0.16]. Thus, emotion dysregulation may be a proximal mechanism linking maltreatment exposure and adolescent self-harm. Notably, self-harm may represent maladaptive attempts to manage emotion dysregulation that may have resulted from maltreatment. Findings from the study have implications for the prevention and treatment of self-harm in maltreated youth. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

Female genital mutilation and pregnancy: associated risks.

PubMed

Gayle, Claudine; Rymer, Janice

2016-09-22

Female genital mutilation (FGM) is a traditional practice that has no medical benefit and severe health consequences for girls and women. This article discusses the risks to patients who are pregnant and have had FGM. It will describe urinary tract infections caused by FGM, and how this condition increases the risk of preterm labour and delivery. It will also address the difficulty in vaginal examinations that can be caused by FGM and instances when this can delay diagnosis and treatment. In addition, it will explore a number of intrapartum risks caused by FGM and the role of deinfibulation in pregnancy. Finally, it will look at the link between maternal and fetal morbidity and mortality, and FGM.

Knowledge, attitude, and experience of health professionals of female genital mutilation (FGM): A qualitative study in Iraqi Kurdistan Region.

PubMed

Shabila, Nazar P; Ahmed, Hamdia M; Safari, Kolsoom

2017-11-01

We aimed to assess the knowledge, attitude, and experience of health professionals of female genital mutilation (FGM). The study involved content analysis of semistructured interviews with 21 health professionals. The participants had poor knowledge regarding different aspects of FGM including its types, prevalence, and complications as well as the existing legislation that prohibits FGM. They believed that FGM is mainly practiced for religious reasons and to reduce sexual desire/arousal. Health professionals are apparently not involved in performing FGM, and they do not support its continuation. Health professionals can take a leading role in raising the awareness of women and combating FGM.

Research gaps in the care of women with female genital mutilation: an analysis.

PubMed

Abdulcadir, J; Rodriguez, M I; Say, L

2015-02-01

Female genital mutilation (FGM) includes procedures involving the partial or total removal of the external female genitals for non-therapeutic reasons. They can have negative psychosexual and health consequences that need specific care. In this paper, we review some key knowledge gaps in the clinical care of women with FGM, focusing on obstetric outcomes, surgical interventions (defibulation and clitoral reconstruction), and the skills and training of healthcare professionals involved in the prevention and management of FGM. We identify research priorities to improve the evidence necessary to establish guidelines for the best multidisciplinary care, communication, and prevention, and to improve health-promotion measures for women with FGM. © 2014 Royal College of Obstetricians and Gynaecologists.

[Male perceptions of sequelae associated with female genital mutilation].

PubMed

Jiménez-Ruiz, Ismael; Almansa Martínez, Pilar; Pastor Bravo, María Del Mar

2016-01-01

To explore men's knowledge of the negative consequences of female genital mutilation (FGM) to women's health in countries where this practice is performed. A qualitative methodology was used with an ethnomethodological approach. Both individual and group semi-structured interviews concerning FGM were conducted with 25 men, selected by triple sampling. A study presentation letter was provided to participants, together with an informed consent declaration. Permission was also procured to record the interviews in audio format. Data analysis was performed using the Atlas Ti7 software. Those participants against FGM are aware of the range of complications this practice can cause, being able to identify physical, obstetric, psychological, sexuality and social consequences in women subjected to FGM. However, those men who are in favour display a general ignorance of the problems resulting from this practice. Participants from countries where FGM is performed who are against this practice are more aware of the negative consequences than those who claim to be in favour. The design of awareness-raising programmes and other tools to combat female genital mutilation must highlight the implications for women's and girls' health, and include family-targeted campaigns which involve men in the process of eradicating this practice. Copyright © 2016 SESPAS. Published by Elsevier Espana. All rights reserved.

Bilateral corneal perforations and autoproptosis as self-induced manifestations of ocular Munchausen's syndrome.

PubMed

Lin, Joseph L; Servat, J Javier; Bernardino, Carlo R; Goldberg, Robert A; Levin, Flora

2012-08-01

To report a patient with bilateral corneal perforations and autoproptosis in a case of ocular Munchausen's syndrome. Case report. A 26-year-old white male referred to the oculoplastics service with one month history of decreased vision bilaterally and painful right eye. Multiple eyelid scars and right corneal opacity were noted. The patient was previously seen at another institution for rapid loss of vision in both eyes. An orbit decompression among many procedures failed to controlled extreme pain and proptosis. Resolution of proptosis, stabilization of vision, pain resolution. Three weeks after enucleation of the right eye was offered, patient presented with spontaneous left ruptured globe. After multiple episodes of self-mutilation and infections, both eyes were exenterated. Munchausen syndrome can be seen with ophthalmic manifestations and should be considered in the differential diagnosis when ocular abnormalities cannot be explained after a thorough evaluation. Recognition of this psychiatric disease is not only important for correct medical diagnosis and treatment, but also essential in protecting the patients from unnecessary invasive and aggressive medical procedures.

Clozapine in borderline personality disorder: a review of the evidence.

PubMed

Beri, Anand; Boydell, Jane

2014-05-01

Borderline personality disorder (BPD) is a serious mental disorder that is difficult to treat. Possible targets for pharmacotherapy include affective symptoms, cognitive disturbances, and impulsive, self-injurious behaviors. Although many of the medications tested for treatment of BPD have been demonstrated to be useful, no clear pharmacologic treatment has emerged. Clozapine is one of the medications that has been evaluated for the treatment of severe BPD. The aim of this review is to summarize the evidence examining the effectiveness of clozapine in the treatment of BPD. A comprehensive search of the health science databases PubMed, EMBASE, CINAHL, PsycINFO, Web of Science, Cochrane Library, and Google Scholar was performed for studies describing the use of clozapine in the treatment of BPD. After the initial search, no randomized controlled trials evaluating the effectiveness of clozapine in BPD were identified. Therefore, case reports and case series were reviewed, with 12 articles selected for final review. This review suggests that clozapine may be a beneficial treatment option for BPD especially in controlling symptom severity, psychotic symptoms, impulsivity, self-mutilation, number of days on enhanced observation, use of restraint, and overall functioning.

Female Genital Mutilation/Cutting among Women of Somali and Kurdish Origin in Finland.

PubMed

Koukkula, Mimmi; Keskimäki, Ilmo; Koponen, Päivikki; Mölsä, Mulki; Klemetti, Reija

2016-09-01

The tradition of female genital mutilation/cutting (FGM/C) has spread in Europe as a result of immigration. Although it is known to have negative health impacts, the exact prevalence of FGM/C and its health effects in Finland are unknown. This study explores the prevalence of FGM/C, the sociodemographic characteristics associated with it, and its health effects among women of Somali and Kurdish origin in Finland. Data were obtained from the Migrant Health and Well Being Study carried out in 2010-2012. This study uses data from interviews with Somali (N = 165) and Kurdish origin (N = 224) women. The participation rate was 37 percent for Somali and 54 percent for Kurdish origin women. The prevalence of FGM/C was 69 percent among those of Somali origin and 32 percent among those of Kurdish origin. Having no education and older age were significantly associated with FGM/C, as was marriage amongst women of Somali origin, and the practice of Islam among women of Kurdish origin. Reporting good self-perceived health was more common among women without FGM/C. Outpatient visits to medical doctors were less common among women of Somali origin with FGM/C, compared with women without FGM/C. About 26 percent of Somali origin and 39 percent of Kurdish origin women with FGM/C reported reproductive or other health problems because of FGM/C. FGM/C is more common in Finland than previously assumed, particularly among women of Kurdish origin. Women with FGM/C need improved access to culturally competent health services to address the health impacts of FGM/C. Education and outreach to immigrant communities to prevent future FGM/C are also urgently needed. © 2016 Wiley Periodicals, Inc.

Effects of female genital mutilation/cutting on the sexual function of Sudanese women: a cross-sectional study.

PubMed

Rouzi, Abdulrahim A; Berg, Rigmor C; Sahly, Nora; Alkafy, Susan; Alzaban, Faten; Abduljabbar, Hassan

2017-07-01

Female genital mutilation/cutting (FGM/C) is a cultural practice that involves several types of removal or other injury to the external female genitalia for nonmedical reasons. Although much international research has focused on the health consequences of the practice, little is known about sexual functioning among women with various types of FGM/C. To assess the impact of FGM/C on the sexual functioning of Sudanese women. This is a cross-sectional study conducted at Doctor Erfan and Bagedo Hospital, Jeddah, Saudi Arabia. Eligible women completed a survey and a clinical examination, which documented and verified women's type of FGM/C. The main outcome measure was female sexual function, as assessed by the Arabic Female Sexual Function Index. A total of 107 eligible women completed the survey and the gynecological examination, which revealed that 39% of the women had FGM/C Type I, 25% had Type II, and 36% had Type III. Reliability of self-report of the type of FGM/C was low, with underreporting of the extent of the procedure. The results showed that 92.5% of the women scored lower than the Arabic Female Sexual Function Index cut-off point for sexual dysfunction. The multivariable regression analyses showed that sexual dysfunction was significantly greater with more extensive type of FGM/C, across all sexual function domains (desire, arousal, lubrication, orgasm, satisfaction, and pain) and overall. The study documents that a substantial proportion of women subjected to FGM/C experience sexual dysfunction. It shows that the anatomical extent of FGM/C is related to the severity of sexual dysfunction. Copyright © 2017 Elsevier Inc. All rights reserved.

Effect of female genital mutilation/cutting; types I and II on sexual function: case-controlled study.

PubMed

Ismail, Sahar A; Abbas, Ahmad M; Habib, Dina; Morsy, Hanan; Saleh, Medhat A; Bahloul, Mustafa

2017-08-30

The existing literature is contradictory regarding effects of female genital mutilation/cutting (FGM/C) on sexual functions. The aim of this study was to explore the impact of type I and II FGM/C on sexual function of Egyptian women. We recruited 197 cut women and 197 control women from those visiting Assiut University hospitals for different reasons. We asked each woman to fill the Arabic female sexual function index (FSFI) (a self reported 19-item questionnaire assessing the main domains of female sexual function). Genital Examination was done to confirm the type of FGM. Female sexual dysfunction (FSD) was found in 83.8% of FGM/C cases in contrast to 64.5% of the control. The total FSFI score in the FGM/C group (19.82 ± 7.1) was significantly lower than in the control group (23.34 ± 8.1). Concerning the types of FGM/C, type 73.6% of cases had type I and 26.4% had type II. Type I FGM/C was performed mainly by physicians (62.1%) while type II was performed mainly by midwives (44.4%). FSD was found in 83.4% of FGM/C I cases and in 84.6% of FGM/C II cases. There was no statistically significant difference between the two types of FGM/C as regards total and individual domain scores except for the pain domain. There were significantly lower total and individual domain scores in both FGM/C types except for the desire domain compared to control. In this study, FGM/C was associated with reduced scores of FSFI on all domains scores, and among both types I and II, both were associated with sexual dysfunction.

32 CFR 2001.47 - Destruction.

Code of Federal Regulations, 2010 CFR

2010-07-01

... prescribed by agency heads. The methods and equipment used to routinely destroy classified information include burning, cross-cut shredding, wet-pulping, melting, mutilation, chemical decomposition or...

Sexual abuse and the problem of embodiment.

PubMed

Young, L

1992-01-01

In this paper, trauma, sexual abuse, and some of the potential resulting long-term effects, are explored in terms of the problem of embodiment and the formation of personal identity and psychological integrity. That is, what effect does severe sexual abuse have on an individual's, particularly a child's, sense of living in his or her body and, by extension, living in the world? First, trauma and dissociation are analyzed and linked to the development and maintenance of a "posttraumatic" sense of personal identity. Then, several disorders associated with sexual abuse--dissociation, multiple personality disorder, eating disorders, somatization disorder, self-mutilation, suicide, and suicide attempts--are examined in terms of their phenomenological coherence and relation to the problem of embodiment. This conceptual framework may be of use to clinicians and researchers assessing and treating the survivors of sexual abuse.

["My body belongs to me"--cultural history and psychology of piercings and tattoos].

PubMed

Stirn, A

2007-02-01

At present tattoos and piercings can no longer be regarded as destructive acts of self mutilation practized by fringe groups. Body modifications (BMs) are found in virtually all preindustrial cultures and have their roots in ancient myths and magical rituals. The prevalence of tattoos and piercings in the German population is 8.5% and 6.8%, respectively. Unemployed young men and young women who do not live in a firm partnership show particularly high prevalences. The incidence of BMs correlates positively with the personality trait "sensation seeking", particularly in young women. BMs often serve to express individuality and identity, and they also reflect changed attitude towards the human body and body art as well as following fashion trends. However, BMs can also provide valuable diagnostic indications for identity search and risk taking behaviour.

Changes in EEG alpha power to different disgust elicitors: the specificity of mutilations.

PubMed

Sarlo, Michela; Buodo, Giulia; Poli, Silvia; Palomba, Daniela

2005-07-15

It is unclear in the literature whether the various disgust elicitors are differentially processed by the brain and/or able to elicit distinct psychophysiological response patterns. On the other hand, disgusting stimuli depicting mutilations have been proved to elicit a distinct autonomic response pattern and to demand greater attentional resources, as compared with other unpleasant visual stimuli. In this EEG study, 34 participants viewed 4 film-clips depicting surgery, cockroach invasion, human attack and neutral landscape during EEG recording, and then rated the clips for valence, arousal and the basic emotions. Independent of location, the highest cortical activation was found during the viewing of the surgery scene. Moreover, the above activation was prominent over the right posterior regions.

A Tradition in Transition: Factors Perpetuating and Hindering the Continuance of Female Genital Mutilation/Cutting (FGM/C) Summarized in a Systematic Review

PubMed Central

Berg, Rigmor C.; Denison, Eva

2013-01-01

Understanding the forces underpinning female genital mutilation/cutting (FGM/C) is a necessary first step to prevent the continuation of a practice that is associated with health complications and human rights violations. To this end, a systematic review of 21 studies was conducted. Based on this review, the authors reveal six key factors that underpin FGM/C: cultural tradition, sexual morals, marriageability, religion, health benefits, and male sexual enjoyment. There were four key factors perceived to hinder FGM/C: health consequences, it is not a religious requirement, it is illegal, and the host society discourse rejects FGM/C. The results show that FGM/C appears to be a tradition in transition. PMID:23489149

Setting up a clinic to assess children and young people for female genital mutilation.

PubMed

Hodes, Deborah; Creighton, Sarah M

2017-02-01

It is now mandatory for health, social care professionals and teachers to report to the police all under-18s where female genital mutilation (FGM) has been disclosed by the child or where physical signs of FGM are seen. Such referrals are likely to result in a request for medical examination. New multiagency statutory guidance sets out instructions for physical examination but provides no details how services should be set-up. This review gives practical guidance learnt from the first year of the UK's only dedicated children's FGM service. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Providing information about the consequences of female genital mutilation to healthcare providers caring for women and girls living with female genital mutilation: A systematic review.

PubMed

Oringanje, Chioma M; Okoro, Anthony; Nwankwo, Ogonna N; Meremikwu, Martin M

2017-02-01

The persistence of female genital mutilation (FGM) in some countries, despite an overall decline in the prevalence of the practice, calls for improvement in the capacity of healthcare workers and institutions to provide optimal care for this population. To determine the impact of providing information on FGM and its consequences to healthcare providers on their attitudes toward FGM, and quality of care and patient satisfaction. The following major databases were searched from inception to August 2015: Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, SCOPUS, Web of Science, and ClinicalTrials.gov, without language restrictions. Controlled studies were included based on use of objective measures. Two team members independently screened and collected data. Relative risks and proportions were calculated and evidence assessed using the GRADE (Grade of Recommendation, Assessment, Development and Evaluation) approach. One study was identified. Based on this study there was no evidence to suggest change in healthcare provider outcomes after the intervention. Despite a comprehensive search, only one study of low methodological quality was included. This precludes a definitive conclusion regarding the impact of providing information on FGM to healthcare providers. More research is needed. CRD42015024570. © 2017 International Federation of Gynecology and Obstetrics. The World Health Organization retains copyright and all other rights in the manuscript of this article as submitted for publication.

Behavioral modulation by mutilation pictures in women.

PubMed

Pereira, M G; Volchan, E; Oliveira, L; Machado-Pinheiro, W; Rodrigues, J A; Nepomuceno, F V P; Pessoa, L

2004-03-01

Previous studies have shown that women are more emotionally expressive than men. It is unclear, however, if women are also more susceptible to the emotional modulation of behavior imposed by an affective stimulus. To investigate this issue, we devised a task in which female subjects performed six sequential trials of visual target detection following the presentation of emotional (mutilation and erotic) or neutral pictures (domestic utensils and objects) and compared the data obtained in the present study with those described in a previous study with male subjects. The experiment consisted of three blocks of 24 pictures and each block had an approximate duration of 4 min. Our sample consisted of 36 subjects (age range: 18 to 26 years) and each subject performed all blocks. Trials following the presentation of mutilation pictures (283 ms) had significantly slower reaction times than those following neutral (270 ms) pictures. None of the trials in the "pleasant block" (271 ms) was significantly different from those in the "neutral block". The increase in reaction time observed in the unpleasant block may be related in part to the activation of motivational systems leading to an avoidance behavior. The interference effect observed in this study was similar to the pattern previously described for men. Thus, although women may be more emotionally expressive, they were not more reactive to aversive stimuli than men, as measured by emotional interference in a simple reaction time task.

Female genital mutilation and monandry in an orb-web spider

PubMed Central

2016-01-01

Monandry, in which a female has only one mating partner during the reproductive period, is established when a female spontaneously refrains from re-mating, or when a partner male interferes with the attempts of a female to mate again. In the latter case, however, females often have countermeasures against males, which may explain why polyandry is ubiquitous. Here, I demonstrate that the genital appendage, or scape, of the female orb-web spider (Cyclosa argenteoalba) is injured after her first mating, possibly by her first male partner. This female genital mutilation (FGM) permanently precludes copulation, and females appear to have no countermeasures. FGM is considered to confer a strong advantage to males in sexual conflicts over the number of female matings, and it may widely occur in spiders. PMID:26911338

Female genital mutilation and monandry in an orb-web spider.

PubMed

Nakata, Kensuke

2016-02-01

Monandry, in which a female has only one mating partner during the reproductive period, is established when a female spontaneously refrains from re-mating, or when a partner male interferes with the attempts of a female to mate again. In the latter case, however, females often have countermeasures against males, which may explain why polyandry is ubiquitous. Here, I demonstrate that the genital appendage, or scape, of the female orb-web spider (Cyclosa argenteoalba) is injured after her first mating, possibly by her first male partner. This female genital mutilation (FGM) permanently precludes copulation, and females appear to have no countermeasures. FGM is considered to confer a strong advantage to males in sexual conflicts over the number of female matings, and it may widely occur in spiders. © 2016 The Author(s).

Female Genital Mutilation

MedlinePlus

... of being rejected by the community, are strong motivations to perpetuate the practice. In some communities, FGM ... of being rejected by the community, are strong motivations to perpetuate the practice. In some communities, FGM ...

Delusional disorders in dermatology: a brief review.

PubMed

Robles, David T; Romm, Sharon; Combs, Heidi; Olson, Jonathan; Kirby, Phil

2008-06-15

There are several unique psychiatric disorders that are likely to present to a dermatologist because of their accompanying skin complaints. Delusions of parasitosis (DP) is a fixed, false belief of parasitic infestation that may lead patients to compulsively self-mutilate while attempting to remove the non-existent parasites. Morgellons disease is a controversial condition characterized by a fixed belief that fibers that are imbedded or extruding from the skin; this condition is likely in the spectrum of DP. Body dysmorphic disorder (BDD) is a preoccupation with an imagined defect in appearance that causes significant distress and is associated with time consuming rituals, isolation, depression, and increased risk of suicide. Olfactory reference syndrome (ORS) is a preoccupation with body odor leading to the stigmata of shame, embarrassment, and social isolation. This brief review examines each of these conditions and their management because any one of them may present to a dermatologist.

Oral manifestations and prosthetic rehabilitation in hereditary sensory and autonomic neuropathy (HSAN)type IV: a case report.

PubMed

Ofluoglu, Duygu; Altin, Nazli; Yaman, Elif; Tuna İnce, Elif Bahar; Aytepe, Zeynep; Tanyeri, Hakki

2016-01-01

Hereditary sensory and autonomic neuropathies (HSAN) are rare genetic syndromes of unknown etiology. They are seen in early childhood and are categorized into six different types by their symptoms. HSAN type 4 demonstrates autosomal recessive transmission pattern, with such major characteristics as loss of sense of pain, self-mutilation, anhydrosis and mental retardation. Sympathetic innervations are deficient despite the existence of sweat glands. Sufferers are hypotonic without any tendon reflexes, and neuro-motor development is retarded. In some cases tactile sensation and vibration may be intact. Biting injuries due to lack of pain sensation cause laceration, ulceration and scarring of the tongue, lips and other parts of oral mucosa. Tooth luxation and severe dental attrition have been observed. This case report presents oral and dental findings, surgical treatments and prosthetic rehabilitation of an 11- year-old boy with HSAN type 4.

[The male genital in legal medicine].

PubMed

Albrecht, K; Schultheiss, D

2006-02-01

Pathomorphological findings for the male genital are an exception among forensic cases. In earlier publications they were usually published as individual cases. A significant percentage are the so-called fertility- and potency medical certificates, which are usually commissioned for doubtful paternity cases. Old forensic writings about genital injuries distinguish--apart from the necessity of a complete dissection--between "deadly as such" and "accidentally deadly" injuries. Another group consists of reports about self-inflicted genital mutilation, e.g. among prison inmates or soldiers of the last world wars to become an invalid. When it was necessary to identify a corpse, e.g. in cases of progressive decomposition, Merkel recommended in 1945 the representation of the so-called "Schnepfenkopf" (snipe head; colliculus seminalis) in the lesser pelvis. In this article a medical and forensic review of forensically relevant findings of the male genital is presented and illustrated with historical cases.

The pathophysiology, medical management, and dental implications of autism.

PubMed

Friedlander, Arthur H; Yagiela, John A; Paterno, Victoria I; Mahler, Michael E

2003-09-01

Autism is a lifelong, severe, developmental disorder that appears initially in infancy and early childhood and impairs the acquisition of some of the most important skills in human life. The disease is characterized by impaired social interactions, verbal and nonverbal communication deficiencies, limited activities and interest, and repetitive behaviors. Often accompanying the disorder are behavioral disturbances, such as self-mutilation and aggression, psychiatric symptoms, and seizures, which necessitate the administration of multiple medications to help the affected individual participate effectively in the educational and rehabilitative process. Dentists caring for these people must be familiar with the manifestations of the disease and its associated features so that they can garner the maximum level of cooperation. They must also be familiar with the medications used to treat the associated features of the disorder because many of these pharmaceuticals cause untoward orofacial and systemic reactions and may precipitate adverse interactions with dental therapeutic agents.

How repeated 15-minute assertiveness training sessions reduce wrist cutting in patients with borderline personality disorder.

PubMed

Hayakawa, Masaya

2009-01-01

The aim of this work was to examine a possible treatment for patients with borderline personality disorder who have wrist-cutting syndrome, a condition characterized by repeated, superficial wrist cutting in a non-suicidal fashion. Within the current healthcare system in Japan, the average amount of time a doctor can spend with a psychiatric outpatient is about 8 to 15 minutes. We, therefore, examined whether repeated 15-minute psychotherapy sessions to improve patient assertiveness would be effective for reducing wrist cutting and possibly other forms of self-mutilation. We treated 13 patients diagnosed with borderline personality disorder and wrist-cutting syndrome with assertiveness training during 15-minute, biweekly therapy sessions over a course of one to four years. At the conclusion of psychotherapeutic treatment, 69% of outpatients showed a statistically significant reduction in wrist-cutting behavior.

[Patient motivation--an essential therapeutic tool].

PubMed

Neuber, M; Joist, A; Probst, A

1998-05-01

A deciding factor for the future functioning of a hand with a mutilating hand injury is the self-motivation that the patient brings with him to rehabilitation. This is illustrated in the case of a guitar teacher who returned to his career after subtotal and total finger amputation of his left hand (used for gripping chords). With consistent exercise on his instrument he compensated for the functional deficits of his hand and won a law suit against his employer who denied that he had the physical ability to play the classical guitar. It is more clear than ever that an injured person is jointly responsible, through self-motivation in the working process, for more-or-less complete rehabilitation. It is not uncommon in a system of job-sharing in which several members of the health service (surgeons, physiotherapists, social workers, general practitioners) must co-ordinate their work, for the patient--if he does not involve himself--to fall by the wayside. It is shown how inherent and rewarding it can be to support the patient in his desire to return to work. Apart from that, we hope that this example will be an encouragement to those similarly affected.

Attitudes and awareness of female genital mutilation: a questionnaire-based study in a Kenyan hospital.

PubMed

Livermore, L; Monteiro, R; Rymer, J

2007-11-01

There are considerable efforts in Kenya to increase awareness of the issues and health risks associated with female genital mutilation (FGM) through educational programmes. The Kenyan government formally outlawed FGM in 2001. This questionnaire-based study aimed to explore attitudes and awareness of FGM in Kenya with particular reference to the law, health complications and educational programmes. A significant decline in the prevalence of FGM was demonstrated and awareness of health complications of FGM shown to be the main factor causing this trend. The need for further efforts to eradicate the practice and the importance of religion and culture in shaping social attitudes was evident. The outlawing of FGM was considered a positive advance but may have the detrimental effect of deterring women from seeking medical assistance for complications relating to FGM.

[Treatment of a serious autistic disorder in a child with Naltrexone in an oral suspension form].

PubMed

Desjardins, S; Doyen, C; Contejean, Y; Kaye, K; Paubel, P

2009-04-01

CLINICAL BACKGROUND: Autism is a developmental disorder that is usually diagnosed in early childhood. According to ICD-10 criteria, autism can be characterized by delays in language skills, by impaired social interaction, verbal or non-verbal communication and by repetitive, stereotyped or severely restricted activities and interests. The causes of autism are not yet elucidated, but both genetics and environment seem to play a role in 10 to 25% of autism cases. Several biochemical abnormalities, such as impairment of serotoninergic, catecholinergic, dopaminergic, and opioid systems have been reported. Autism therapies are designed to treat symptoms, and medication can be associated with psychoeducational and environmental interventions. Generally, the medications that are currently used are not intended for autism, and must be used with caution and selected according to the type and intensity of symptoms. The most common medication consists of psychotropic therapies by administration of dopaminergic and/or serotoninergic receptor antagonists (haloperidol, risperidone, clomipramine). Several drugs, such as anxiolytics (buspirone), mood stabilisers (lithium, sodium valproate), vitamins (vitamins B6, B12) or opioid antagonists (naltrexone) can be prescribed, in second intention, in cases of severe behavioural disorders. The prescription of opioid antagonists is based on the possible implication of an opioid system disorder observed in some cases. Nevertheless, several clinical studies reveal its variable effectiveness. Naltrexone is a competitive antagonist of opioid receptors OPRM1, OPRD1 and OPRK1. In France, this drug is prescribed for treating opioid and alcohol dependence. Moreover, several studies describe naltrexone as a possible treatment of autistic children in cases of developmental disorder and hyperactivity. In the Child and Adolescent Psychopathology Department of Sainte-Anne's Hospital, autistic children benefit from a multidisciplinary treatment program that sometimes includes the administration of psychotropic medication. One of these children presented with a severe autistic disorder according to the Childhood Autism Rating Scale (CARS). Considering ICD-10 criteria, he benefited from a multidisciplinary program, associating cognitive psychotherapy, psychomotor rehabilitation, speech therapy and educational intervention. However, persistent sleep disorder and motor instability led to successive prescriptions of several different psychotropic drugs. Initial treatment by thioridazine (10mg per day) followed by propericiazine (2.5mg per day) improved sleep, but was not efficient in reducing self-mutilating behaviour. A new treatment by risperidone (from 0.5mg to 1.5mg per day) was therefore chosen; however it lost its efficacy after five months. Finally, an anxiolytic (cyamemazine) and a thymoregulator (sodium valproate) were successively tried without yielding any clinical improvement. Owing to the persistence of communication difficulties, major instability, self-mutilating behaviour and heteroaggressiveness, treatment with naltrexone was subsequently chosen with parental consent. In France, naltrexone hydrochloride is only available in tablet form (Nalorex 50mg and Revia 50mg), which is not adapted to children at the efficient dose. Consequently, an oral suspension form marketed in Spain (Antaxone 50mg) was imported, having obtained the Afssaps' (the French drug administration) authorisation for its temporary use. The Connors and Nisonger scales were used as outcome measures of behavioural symptom change. The Conners scale is used to assess attention deficit and hyperactivity, whereas the Nisonger scale analyses social skills and behaviour disorders in children and adolescents with mental retardation. The onset of treatment, at a dose of 1mg/kg/day, led to a transitory increase in negative behaviour. However, a dose of 0.75mg/kg per day subsequently led to significant improvements, as shown by outcome measurements. Self-mutilating behaviour disappeared completely. Certain side effects were observed, namely transitory sedation at the beginning of treatment and moderate constipation. This clinical case confirms that treatment of a serious autistic disorder in children using Naltrexone in oral suspension form is a potentially interesting therapeutic alternative for treating behavioural symptoms resistant to classical drug therapy.

11 CFR 7.16 - Miscellaneous statutory provisions.

Code of Federal Regulations, 2011 CFR

2011-01-01

... employee of the Commission and of the Government. In particular, the attention of employees is directed to... Government matter. (k) The prohibition of 18 U.S.C. 2071 against mutilating or destroying a public record. (l...

Senegal: Background and U.S. Relations

DTIC Science & Technology

2010-08-16

boys, often separated from their families, receive religious instruction.33 The 1999 Penal Law outlawed domestic violence and female genital ... mutilation ; however, implementation has reportedly been uneven, and both are widespread.34 Human rights organizations have criticized

31 CFR 315.25 - General.

Code of Federal Regulations, 2010 CFR

2010-07-01

... OF THE TREASURY BUREAU OF THE PUBLIC DEBT REGULATIONS GOVERNING U.S. SAVINGS BONDS, SERIES A, B, C, D, E, F, G, H, J, AND K, AND U.S. SAVINGS NOTES Relief for Loss, Theft, Destruction, Mutilation...

77 FR 4083 - Departmental Offices; Submission for OMB Review, Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2012-01-26

... portions of notes are missing. DATES: Written comments should be received on or before March 26, 2012 to be... substantial portions are missing from the notes presented to the Treasury for redemption. Treasury's Mutilated...

7 CFR 52.3761 - Defects.

Code of Federal Regulations, 2010 CFR

2010-01-01

... PROCESSED FRUITS AND VEGETABLES, PROCESSED PRODUCTS THEREOF, AND CERTAIN OTHER PROCESSED FOOD PRODUCTS 1... harmless extraneous vegetable material, stems, and portions thereof, blemishes, wrinkles, mutilated olives... these two axes exceeds 45 degrees. (5) Harmless extraneous vegetable material. Harmless extraneous...

Female genital mutilation/cutting: changes and trends in knowledge, attitudes, and practices among health care professionals in The Gambia

PubMed Central

Kaplan Marcusán, Adriana; Riba Singla, Laura; Laye, Mass; Secka, Dodou M; Utzet, Mireia; Le Charles, Marie-Alix

2016-01-01

Background Female genital mutilation/cutting (FGM/C) is a harmful traditional practice that affects two out of three girls in The Gambia, seriously threatening their life and well-being with severe health consequences. By tracking the reference values established in former research conducted between 2009 and 2011, the objectives of this study are to explore trends and to measure and assess changes in knowledge, attitudes, and practices regarding FGM/C among health care professionals (HCPs) in The Gambia. Methods A cross-sectional descriptive study was designed to collect and analyze data from an overall stratified sample consisting of 1,288 HCPs including health professionals and students throughout the six regions of The Gambia. Data were collected by the implementation of a self-administered written knowledge, attitudes, and practices questionnaire between 2012 and 2014. Results The results of this study showed that 76.4% of HCPs are eager to abandon FGM/C, and 71.6% of them regard it as a harmful practice with negative consequences on life and health. HCPs reported more knowledge and favorable attitudes towards FGM/C abandonment, being better able to identify the practice, more aware of its health complications, and more concerned in their essential role as social agents of change. However, 25.4% of HCPs still embraced the continuation of the practice, 24.4% expressed intention of subjecting their own daughters to it, and 10.5% declared to have performed it within their professional praxis. Conclusion Findings confirm progress in knowledge and attitudes regarding FGM/C among HCPs, who are better skilled to understand and manage the consequences. Nevertheless, discrepancies between information, intention, and behavior unveil resistance in practice and proves that FGM/C medicalization is increasing. Thus, there is an urgent need to support HCPs in the integration of FGM/C preventive interventions within the public health system, to address arguments favoring medicalization, and to use data to design appropriate strategies. PMID:27110140

Epidemiology, Regional Characteristics, Knowledge, and Attitude Toward Female Genital Mutilation/Cutting in Southern Iran.

PubMed

Dehghankhalili, Maryam; Fallahi, Soghra; Mahmudi, Forugh; Ghaffarpasand, Fariborz; Shahrzad, Mohammad Esmaeil; Taghavi, Mohsen; Fereydooni Asl, Marjan

2015-07-01

Female genital mutilation/cutting (FGM/C), also known as female circumcision, is an ancient traditional procedure that involves partial or total removal of the female external genitalia for nonmedical reasons. Although it is well described in African and some Arabic countries, data from Iran are scarce. To describe the epidemiology, regional characteristics, knowledge, and attitude toward FGM/C in Southern Iran. This cross-sectional study was conducted during a 36-month period from 2010 to 2013 in Hormozgan, a southern province of Iran near the Persian Gulf. We included 780 women in six major rural areas of the province who referred to healthcare centers for vaccination, midwifery, or family planning services. All participants underwent complete pelvic examination to determine the type of FGM. The questionnaire consisted of several sections such as demographic and baseline characteristics, and two self-report sections addressing the knowledge and attitude toward FGM/C and its complications. Baseline sociodemographic characteristics including age, educational level, marital status, religion, and nationality were the independent variables. Among the participants, 535 (68.5%) had undergone FGM/C. FGM/C was associated with higher age (P = 0.002), Afghan nationality (P = 0.003), Sunni Islam as religion (P = 0.019), illiteracy (P < 0.001), and family history of FGM/C in mother (P < 0.001), sister (P < 0.001), and grandmother (P < 0.001). Ancient traditions in the area (57.1%) were mentioned as the most important factor leading to FMG/C. Urinary tract infection was the most common reported complication (60.4%). FGM/C is a common practice in rural areas of Southern Iran. It is associated with increased age, illiteracy, Sunni Islam religion, Afghan nationality, and positive family history. Lack of knowledge toward FGM/C is the main cause of its high prevalence and continuation in the area. © 2015 International Society for Sexual Medicine.

The relationship between female genital mutilation and HIV transmission in sub-Saharan Africa.

PubMed

Olaniran, Abimbola A

2013-12-01

Female genital mutilation (FGM) is an age-old practice that has since been linked with many health problems. This review aims to highlight some of the controversies trailing the relationship between FGM and HIV transmission in sub-Saharan Africa. A literature search was conducted on the subject matter. This was done using articles published in English while limiting the geographical coverage to sub-Saharan Africa. Three themes were noted. These themes include: Direct causal link between FGM and HIV transmission; indirect causal link between FGM and HIV transmission and a negative or no association between FGM and HIV transmission. While many of the arguments are within scientific reasoning, the researches supporting the views seem to lack the necessary objectivity. This study underscored the need for a more objective lens in viewing and conducting research on the relationship between FGM and HIV transmission in sub-Saharan Africa.

Female genital mutilation/cutting: risk management and strategies for social workers and health care professionals

PubMed Central

Costello, Susan

2015-01-01

Female genital mutilation/cutting (FGM/C) is a traditional practice originating in Africa. Its worst forms cause irreparable harm to girls and women and have no medical justification. Based on a literature review of global responses to FGM/C and conversations with Australian women who migrated from FGM/C practicing countries, this paper provides some background on FGM/C and its epidemiology, outlining its prevalence, types, and health risks and complications for women and girls. It discusses risk-prevention strategies, first, for health practitioners in identifying, screening, and supporting women affected by FGM/C and, second, for welfare and social workers and health care professionals to identify, work with, and prevent girls from being cut. Consistent with international trends in addressing the risks of FGM/C, the paper suggests practice responses for coordinated responses between professionals, communities from practicing countries, and governments of different countries. PMID:26719732

Female genital mutilation: the role of medical professional organizations.

PubMed

Bazi, Tony

2017-04-01

Female genital mutilation (FGM) refers to alteration of the external genitalia of girls without medical benefit. It is estimated by United Nations agencies that 200 million living girls and women have been subjected to different forms of FGM worldwide. Despite the criminalization of the procedure in the vast majority of countries where it is practiced, the decline in the incidence of this ritual is far from satisfactory. Immediate and long-term ill effects are well documented. Most publications of relevance originate from countries outside the map of FGM. In addition, there are major gaps in research related to this issue, considering the magnitude of the problem. International medical organizations and societies should assume their responsibility by providing a platform to professionals engaged in the prevention and treatment of the consequences of FGM, especially those living in the communities where the practice is endemic.

Medicalized Female Genital Mutilation/Cutting: Contentious Practices and Persistent Debates.

PubMed

Kimani, Samuel; Shell-Duncan, Bettina

2018-01-01

Female genital cutting/mutilation (FGM/C) performed by health care professionals (medicalization) and reduced severity of cutting have been advanced as strategies for minimizing health risks, sparking acrimonious ongoing debates. This study summarizes key debates and critically assesses supporting evidence. While medicalization is concentrated in Africa, health professionals worldwide have faced requests to perform FGM/C. Whether medicalization is hindering the decline of FGM/C is unclear. Factors motivating medicalization include, but are not limited to, safety concerns. Involvement of health professionals in advocacy to end FGM/C can address both the supply and demand side of medicalization, but raises ethical concerns regarding dual loyalty. Ongoing debates need to address competing rights claims. Polarizing debates have brought little resolution. We call for a focus on common goals of protecting the health and welfare of girls living in communities where FGM/C is upheld and encourage more informed and open dialog.

Surgical or medical interventions for female genital mutilation.

PubMed

Smith, Helen; Stein, Karin

2017-02-01

Deinfibulation can prevent or treat gynecological and obstetric complications in women living with type III female genital mutilation (FGM), and subsequently improve childbirth outcomes. Recently published WHO guidelines recommend use of deinfibulation in both circumstances. However, to really impact practice, evidence-based guidance needs to be matched with evidence-based implementation strategies. This qualitative evidence synthesis provides information on the factors that facilitate or act as barriers to use of deinfibulation, and the context and conditions that are necessary for implementing the procedure, including healthcare providers' knowledge and experience, the service delivery environment, as well as broader health system contexts. This information is of great value for policy makers and others considering this as an option for better clinical care of women living with FGM. © 2017 International Federation of Gynecology and Obstetrics. The World Health Organization retains copyright and all other rights in the manuscript of this article as submitted for publication.

Correction of a mutilated dentition with mini-implants as anchorage.

PubMed

Hyun, Jae-Man; Kim, Tae-Woo

2010-11-01

The patient was an adolescent boy, aged 15.6 years, with a mutilated dentition. He had extrusion of the maxillary left first molar because of loss of the mandibular first molar and lingual tilting and rotation of the mandibular second molars. Both left and right second molars were in scissors-bite that was more severe on the left side. By using mini-implants and a TPA with hooks, a 3-mm intrusion was successfully made on the maxillary left first molar. This provided room for mesial movement of the mandibular left second molar. The second molar was protracted into the space of the missing first molar, and the mandibular left third molar was positioned in place of the second molar. The second molars scissors-bite was corrected. Active treatment took 45 months, and the treatment result remained stable 2 years after debonding. Copyright © 2010 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.

Profiles in the offending process of nonserial sexual murderers.

PubMed

Beauregard, Eric; Proulx, Jean

2002-08-01

The aim of this study was to investigate specific pathways in the offending processes of nonserial sexual murderers and to examine possible relationships with different precrime, per-crime, and postcrime factors. Included in this study were 36 offenders who have committed at least one sexual murder against a female victim and they were classified using cluster analysis. Participants using the sadistic pathway planned their offenses and used physical restraints during the offenses. Furthermore, they mutilated and humiliated their victims. Finally, they hid the bodies of the victims. Participants using the anger pathway had not premeditated the homicide. Mutilation, humiliation, and physical restraints were less predominant with these participants than with those using the sadistic pathway. Moreover, these offenders were more likely to leave the bodies at the crime scenes after the killings occurred. These two profiles are compared with empirical studies addressing sexual homicide.

Dissociating motivational direction and affective valence: specific emotions alter central motor processes.

PubMed

Coombes, Stephen A; Cauraugh, James H; Janelle, Christopher M

2007-11-01

We aimed to clarify the relation between affective valence and motivational direction by specifying how central and peripheral components of extension movements are altered according to specific unpleasant affective states. As predicted, premotor reaction time was quicker for extension movements initiated during exposure to attack than for extension movements initiated during exposure to all other valence categories (mutilation, erotic couples, opposite-sex nudes, neutral humans, household objects, blank). Exposure to erotic couples and mutilations yielded greater peak force than exposure to images of attack, neutral humans, and household objects. Finally, motor reaction time and peak electromyographic amplitude were not altered by valence. These findings indicate that unpleasant states do not unilaterally prime withdrawal movements, and that the quick execution of extension movements during exposure to threatening images is due to rapid premotor, rather than motor, reaction time. Collectively, our findings support the call for dissociating motivational direction and affective valence.

Securing Paternity by Mutilating Female Genitalia in Spiders.

PubMed

Mouginot, Pierick; Prügel, Josepha; Thom, Ulrike; Steinhoff, Philip O M; Kupryjanowicz, Janusz; Uhl, Gabriele

2015-11-16

Competition between males and their sperm over access to females and their eggs has resulted in manifold ways by which males try to secure paternity, ranging from physically guarding the female after mating to reducing her receptivity or her attractiveness to subsequent males by transferring manipulative substances or by mechanically sealing the female reproductive tract with a copulatory plug. Copulations may also result in internal damage of the female genitalia; however, this is not considered as a direct adaptation against sperm competition but as a collateral effect. Here, we present a drastic and direct mechanism for securing paternity: the removal of coupling structures on female genitalia by males. In the orb-weaving spider Larinia jeskovi males remove the scapus, a crucial coupling device on the female external genital region. Reconstruction of the coupling mechanism using micro-CT-scanned mating pairs revealed that several sclerites of the male genitalia interact to break off the scapus. Once it is removed, remating cannot occur due to mechanical coupling difficulties. In the field, male-inflicted genital damage is very prevalent since all female L. jeskovi were found to be mutilated at the end of the mating season. External genital mutilation is an overlooked but widely spread phenomenon since 80 additional spider species were found for which male genital manipulation can be suspected. Interlocking genitalia provide an evolutionary platform for the rapid evolution of this highly effective mechanism to secure paternity, and we suspect that other animal groups with interlocking genital structures might reveal similarly drastic male adaptations. Copyright © 2015 Elsevier Ltd. All rights reserved.

The Late Positive Potential (LPP) in Response to Varying Types of Emotional and Cigarette Stimuli in Smokers: A Content Comparison

PubMed Central

Minnix, Jennifer A.; Versace, Francesco; Robinson, Jason D.; Lam, Cho Y.; Engelmann, Jeffrey M.; Cui, Yong; Brown, Victoria L.; Cinciripini, Paul M.

2013-01-01

Identifying neural mechanisms associated with addiction has substantially improved the overall understanding of addictive processes. Indeed, research suggests that drug-associated cues may take advantage of neural mechanisms originally intended for emotional processing of stimuli relevant to survival. In this study, we investigated cortical responses to several categories of emotional cues (erotic, romance, pleasant objects, mutilation, sadness, unpleasant objects) as well as two types of smoking-related cues (people smoking and cigarette-related objects). We recorded ERPs from 180 smokers prior to their participation in a smoking cessation clinical trial and assessed emotional salience by measuring the amplitude of the late positive potential (LPP; 400 to 600 ms after picture onset). As expected, emotional and cigarette-related pictures prompted a significantly larger LPP than neutral pictures. The amplitude of the LPP increased as a function of picture arousal level, with high-arousing erotic and mutilation pictures showing the largest response in contrast to low-arousing pleasant and unpleasant objects, which showed the smallest response (other than neutral). Compared to females, male participants showed larger LPPs for high-arousing erotic and mutilation pictures. However, unlike emotional pictures, no difference was noted for the LPP between cigarette stimuli containing people versus those containing only objects, suggesting that in contrast to emotional objects, cigarette-related objects are highly relevant for smokers. We also compared the smokers to a small (N=40), convenience sample of never-smokers. We found that never-smokers had significantly smaller LPPs in response to erotic and cigarette stimuli containing only objects compared to smokers. PMID:23643564

A study of deliberate self-harm and its repetition among patients presenting to an emergency department.

PubMed

Yip, Paul S F; Hawton, Keith; Liu, Kayuet; Liu, Kwong-Sun; Ng, Pauline W L; Kam, Pui-Man; Law, Yik-Wa; Wong, Tai-Wai

2011-01-01

Marked differences have been found in the characteristics of people dying by suicide in Western and Asian countries. However, there is less information available on possible differences for deliberate self-harm (DSH). To compare the characteristics of people presenting to hospital in Hong Kong and Oxford (UK) with DSH, and to assess the outcome of those persons in Hong Kong. A sample of DSH patients admitted to the accident and emergency (A&E) department of a regional hospital in Hong Kong was assessed and followed up 6 months later to assess the risk of repetition of DSH, and was then compared with such patients in Oxford. The majority of patients in Hong Kong were female (male:female ratio of 1:2.4), young (59% were under 35), and had used self-poisoning (78%). Over one-third were single (37%) and one-fourth unemployed (26%). About half (49%) scored in the high or very high categories of the Beck's Suicide Intent Scale, considerably more so than in Oxford; 44.6% of patients defaulted psychiatric outpatient service during the 6-month follow-up period. The repetition rate within the following 6 months was 16.7%. The number of self-reported adverse life problems, history of childhood sexual and physical abuse, and repetitive self-mutilation were shown to be the factors most strongly correlated with the risk of re-attempt. Alcohol problems were much lower than in Oxford. The findings show that DSH patients in Hong Kong show some marked differences compared to those in Oxford. Implications for the prevention of repeated DSH in Hong Kong are discussed.

38 CFR 10.2 - Evidence required of loss, destruction or mutilation of adjusted service certificate.

Code of Federal Regulations, 2010 CFR

2010-07-01

... an adjusted service certificate issued pursuant to the provisions of section 501 of the World War... to payment thereon and witnessed by at least two persons who shall state, under oath that they...

42 CFR 424.350 - Replacement of checks that are lost, stolen, defaced, mutilated, destroyed, or paid on forged...

Code of Federal Regulations, 2011 CFR

2011-10-01

... CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE... investigation and settlement of claims in connection with Treasury checks issued on behalf of CMS. (2) Action by...

An Interdisciplinary Approach in Rehabilitation of an Adult Mutilated Dentition with Multiple Missing Permanent Teeth--A Case Report.

PubMed

Agrawal, Sarvesh; Jose, Nidhin Philip; Bandi, Rohan S; Jain, Nimit; Rodrigues, Shobha J

2015-01-01

Adult orthodontics has been an area of increasing focus in recent times. Comprehensive treatment of adults is more challenging due to a myriad of problems that coexist in an adult that makes treatment planning more challenging. A large number of individuals seek dental care because of aesthetic reasons, that is, the desire to look more attractive by improving their smiles. The role an attractive smile plays on a person's self-image and confidence cannot be overemphasized. Evaluating and treating patients for the purpose of smile design often involves a multi-discipline approach. Achieving an ideal smile may require orthodontics, orthognathic surgery, periodontal therapy, including soft tissue repositioning and bone re-contouring, cosmetic dentistry, and plastic surgery. This aesthetic approach to patient care produces the best dental and dental-facial beauty. This paper describes a case report in which an orthodontist, an endodontist, and a prosthodontist worked as a team to improve the patients smile and confidence.

Atypical hereditary sensory and autonomic neuropathy type IV with neither mental retardation nor pain insensitivity.

PubMed

Jung, Chae Lim; Ki, Chang-Seok; Kim, Byoung Joon; Lee, Jong-Hyuck; Sung, Ki-Sun; Kim, Jong-Won; Park, Youn-Soo

2013-12-01

Hereditary sensory and autonomic neuropathy type IV is an autosomal recessive disorder characterized by severe mental retardation and self-mutilation-related complications. Recently, we investigated a 16-year-old Korean boy with normal intelligence. He had preserved pain sensation but was suspected of having hereditary sensory and autonomic neuropathy type IV because of the recurrent bone fractures and painless joint destruction in the absence of any predisposing medical conditions. Genetic analysis of the NTRK1 gene revealed compound heterozygous mutations including c.851-33T>A and c.2303C>T (p.Pro768Leu) in the NTRK1 gene. The p.Pro768Leu mutation has been identified in 2 Japanese patients with a mild phenotype. Therefore, although it is rare, hereditary sensory and autonomic neuropathy type IV should be considered in patients with recurrent bone fractures and painless joint destruction who do not have any predisposing conditions even when they do not have typical clinical features such as mental retardation or pain insensitivity.

From genotype to phenotype; clinical variability in Lesch-Nyhan disease. The role of epigenetics.

PubMed

Trigueros Genao, M; Torres, R J

2014-11-01

Lesch-Nyhan disease is a rare genetic disease characterized by a deficiency in the function of the enzyme hypoxanthine-guanine phosphoribosyltransferase (HGPRT). Patients affected by this disease experience hyperuricemia, motor disorders, mental retardation and, in the most severe cases, self-mutilation. Its clinical manifestations depend on the enzymatic activity of HGPRT, which is classically linked to the type of alteration in the HGPRT gene. More than 400 mutations of this gene have been found. At present, one of the controversial aspects of the disease is the relationship between the genotype and phenotype; cases have been described lacking a mutation, such as the patient presented in this article, as well as families who despite sharing the same genetic defect show disorders with differing severity. Epigenetic processes, which modify the genetic expression without changing the sequence of the deoxyribonucleic acid (DNA), could explain the clinical variability observed in this disease. Copyright © 2014 Elsevier España, S.L.U. All rights reserved.

An atypical case of SCN9A mutation presenting with global motor delay and a severe pain disorder.

PubMed

Meijer, Inge Anita; Vanasse, Michel; Nizard, Sonia; Robitaille, Yves; Rossignol, Elsa

2014-01-01

Erythromelalgia due to heterozygous gain-of-function SCN9A mutations usually presents as a pure sensory-autonomic disorder characterized by recurrent episodes of burning pain and redness of the extremities. We describe a patient with an unusual phenotypic presentation of gross motor delay, childhood-onset erythromelalgia, extreme visceral pain episodes, hypesthesia, and self-mutilation. The investigation of the patient's motor delay included various biochemical analyses, a comparative genomic hybridization array (CGH), electromyogram (EMG), and muscle biopsy. Once erythromelalgia was suspected clinically, the SCN9A gene was sequenced. The EMG, CGH, and biochemical tests were negative. The biopsy showed an axonal neuropathy and neurogenic atrophy. Sequencing of SCN9A revealed a heterozygous missense mutation in exon 7; p.I234T. This is a case of global motor delay and erythromelalgia associated with SCN9A. The motor delay may be attributed to the extreme pain episodes or to a developmental perturbation of proprioceptive inputs. Copyright © 2013 Wiley Periodicals, Inc.

Prospective Prediction of Juvenile Homicide/Attempted Homicide among Early-Onset Juvenile Offenders

PubMed Central

Baglivio, Michael T.; Wolff, Kevin T.

2017-01-01

While homicide perpetrated by juveniles is a relatively rare occurrence, between 2010 and 2014, approximately 7%–8% of all murders involved a juvenile offender. Unfortunately, few studies have prospectively examined the predictors of homicide offending, with none examining first-time murder among a sample of adjudicated male and female youth. The current study employed data on 5908 juvenile offenders (70% male, 45% Black) first arrested at the age of 12 or younger to prospectively examine predictors of an arrest for homicide/attempted homicide by the age of 18. Among these early-onset offenders, males, Black youth, those living in households with family members with a history of mental illness, those engaging in self-mutilation, and those with elevated levels of anger/aggression (all measured by age 13) were more likely to be arrested for homicide/attempted homicide by age 18. These findings add to the scant scientific literature on the predictors of homicide, and illustrate potential avenues for intervention. PMID:28212340

Prospective Prediction of Juvenile Homicide/Attempted Homicide among Early-Onset Juvenile Offenders.

PubMed

Baglivio, Michael T; Wolff, Kevin T

2017-02-16

While homicide perpetrated by juveniles is a relatively rare occurrence, between 2010 and 2014, approximately 7%-8% of all murders involved a juvenile offender. Unfortunately, few studies have prospectively examined the predictors of homicide offending, with none examining first-time murder among a sample of adjudicated male and female youth. The current study employed data on 5908 juvenile offenders (70% male, 45% Black) first arrested at the age of 12 or younger to prospectively examine predictors of an arrest for homicide/attempted homicide by the age of 18. Among these early-onset offenders, males, Black youth, those living in households with family members with a history of mental illness, those engaging in self-mutilation, and those with elevated levels of anger/aggression (all measured by age 13) were more likely to be arrested for homicide/attempted homicide by age 18. These findings add to the scant scientific literature on the predictors of homicide, and illustrate potential avenues for intervention.

Opiate sensitivity test in patients with stereotypic movement disorder and trichotillomania.

PubMed

Frecska, Ede; Arato, Mihaly

2002-06-01

Preliminary data about the therapeutic effect of opiate receptor manipulation in self-injurious behavior (SIB) suggest that endogenous opioid mechanisms may have a pathophysiological role in that condition and their involvement may be dependent on the severity of the SIB. The aim of this study was to use fentanyl-induced prolactin response as an opiate receptor sensitivity test in patients with stereotypic movement disorder (SMD) manifesting SIB (skin picking). Healthy volunteers and trichotillomanic patients were enrolled as comparison subjects. Individuals with trichotillomania (TTM) manifest repetitive, less serious self-mutilation (hair pulling) and are classified under different DSM-IV category than SMD. Therefore, they were considered as patient controls. Ten healthy subjects received 0.05 mg/70 kg and another 10 were given 0.1 mg/70 kg dose of fentanyl intravenously in the AM hours. Five of them had placebo trials. A dose of 0.05 mg/70 kg fentanyl was administered to patients with SMD (n = 10) and TTM (n = 12). Serial blood sampling was performed for prolactin measurements. Fentanyl elevated plasma prolactin in a dose-dependent manner. Patients with skin picking, but not with hair pulling, showed significantly increased responses. This finding supports the involvement of endogenous opioids in the pathomechanism of serious SIB.

47 CFR 13.17 - Replacement license.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 47 Telecommunication 1 2010-10-01 2010-10-01 false Replacement license. 13.17 Section 13.17 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL COMMERCIAL RADIO OPERATORS General § 13.17 Replacement license. (a) Each licensee or permittee whose original document is lost, mutilated, or destroyed must...

International Population Assistance and Family Planning Programs: Issues for Congress

DTIC Science & Technology

2006-06-06

AIDS; ! restoration of maternal health care in locations hit by natural disasters; ! elimination of female genital mutilation ; and ! access by...particularly through the Administrative Procedure Law enacted in October 1990. Chinese authorities have termed female infanticide an “intolerable crime” that

42 CFR 424.352 - Intermediary and carrier checks that are lost, stolen, defaced, mutilated, destroyed or paid on...

Code of Federal Regulations, 2010 CFR

2010-10-01

... the check and other pertinent information (such as a claim form, affidavit or questionnaire to be... the claim form, questionnaire or affidavit) that the endorsement is not the payee's. (3) The claim...

14 CFR 47.49 - Replacement of Certificate.

Code of Federal Regulations, 2011 CFR

2011-01-01

... AIRCRAFT REGISTRATION Certificates of Aircraft Registration § 47.49 Replacement of Certificate. (a) If the original Certificate of Aircraft Registration, AC Form 8050-3, is lost, stolen, or mutilated, the... owner. (b) The registered owner may request a temporary Certificate of Aircraft Registration pending...

14 CFR 47.49 - Replacement of Certificate.

Code of Federal Regulations, 2012 CFR

2012-01-01

... AIRCRAFT REGISTRATION Certificates of Aircraft Registration § 47.49 Replacement of Certificate. (a) If the original Certificate of Aircraft Registration, AC Form 8050-3, is lost, stolen, or mutilated, the... owner. (b) The registered owner may request a temporary Certificate of Aircraft Registration pending...

14 CFR 47.49 - Replacement of Certificate.

Code of Federal Regulations, 2014 CFR

2014-01-01

... AIRCRAFT REGISTRATION Certificates of Aircraft Registration § 47.49 Replacement of Certificate. (a) If the original Certificate of Aircraft Registration, AC Form 8050-3, is lost, stolen, or mutilated, the... owner. (b) The registered owner may request a temporary Certificate of Aircraft Registration pending...

14 CFR 47.49 - Replacement of Certificate.

Code of Federal Regulations, 2013 CFR

2013-01-01

... AIRCRAFT REGISTRATION Certificates of Aircraft Registration § 47.49 Replacement of Certificate. (a) If the original Certificate of Aircraft Registration, AC Form 8050-3, is lost, stolen, or mutilated, the... owner. (b) The registered owner may request a temporary Certificate of Aircraft Registration pending...

Prevalence of female genital mutilation among female infants in Kano, Northern Nigeria.

PubMed

Garba, I D; Muhammed, Z; Abubakar, I S; Yakasai, I A

2012-08-01

To determine the prevalence and type of female genital mutilation (FGM) among female infants, reasons and attitude of the mothers to the practice. A cross sectional descriptive study. Tertiary centre in Kano Northern Nigeria. A Pretested questionnaire was administered for mothers of female infants presenting for routine immunization in Aminu Kano Teaching Hospital (AKTH). A total of 250 questionnaires were administered, but only 200 were properly filled and this was used for the analysis. Prevalence and type of FGM, reason for and attitude of mothers towards FGM. Twenty-six infants had FGM during the period of study, giving a prevalence rate of 13 %. The mean age at cutting was 8 days ± 7.3. The commonest type of FGM was type I accounting for 96.2 % of the cases. Tradition/culture was the commonest reason for mutilation accounting for 73.1 %, other reasons included; religious in 11.5 %, hygienic in 11.5 % and to preserve virginity in 3.8 %. Traditional barbers were the commonest operators in 80.8 % of cases, followed by the nurse/midwife in 15.4 % of cases. The fathers were the main decision makers in 46.2 %, followed by both parents in 26.9 % and grandparents in 15.4 % of the cases. 84 % of mothers were not in support of the practice. Thirteen percent of the clients would circumcise all their daughters. Forty-eight percent of the clients were of the opinion that FGM cause harm to the victims. Four percent of those whose daughters were yet to be circumcised will do so later. Female genital cutting is still practiced in our environment. Educational enlightenment is fundamental in changing public opinion as well as in offering reasonable alternative to FGM. Campaign against the practice of FGM should be encouraged to eradicate its practice.

Female genital mutilation: knowledge, attitude and practices of Flemish midwives.

PubMed

Cappon, Sien; L'Ecluse, Charlotte; Clays, Els; Tency, Inge; Leye, Els

2015-03-01

health professionals in Belgium are confronted with female genital mutilation (FGM). To date, no survey to assess knowledge, attitudes and practices on FGM was conducted among midwives in the Northern region of Belgium. the objective of this study was to assess the knowledge, attitude and practices of Flemish midwives regarding female genital mutilation (FGM). we used a quantitative design, using KAP study (semi-structured questionnaire). labour wards, maternity wards and maternal intensive care units (MIC) in 56 hospitals in Flemish region of Belgium. 820 midwives, actively working in labour wards, maternity wards and maternal intensive care units (MIC). 820 valid questionnaires (40.9%) were returned. More than 15% of the respondents were recently confronted with FGM. They were mostly faced with the psychological and sexual complications caused by FGM. Few respondents were aware of existing guidelines regarding FGM in their hospitals (3.5%). The results also showed that only 20.2% was aware of the exact content of the law. The majority of midwives condemned the harmful traditional practice: FGM was experienced as a form of violence against women or a violation of human rights. Only 25.9% declared that FGM forms a part of their midwifery program. The vast majority of respondents (92.5%) indicated a need for more information on the subject. this study indicated that midwives in Flanders are confronted with FGM and its complications and highlighted the gaps in the knowledge of Flemish midwives regarding FGM. This may interfere with the provision of adequate care and prevention of FGM for the new-born daughter. there is an important need for appropriate training of (student)midwives concerning FGM as well as for the development and dissemination of clear guidelines in Flemish hospitals. Copyright © 2014 Elsevier Ltd. All rights reserved.

The late positive potential (LPP) in response to varying types of emotional and cigarette stimuli in smokers: a content comparison.

PubMed

Minnix, Jennifer A; Versace, Francesco; Robinson, Jason D; Lam, Cho Y; Engelmann, Jeffrey M; Cui, Yong; Brown, Victoria L; Cinciripini, Paul M

2013-07-01

Identifying neural mechanisms associated with addiction has substantially improved the overall understanding of addictive processes. Indeed, research suggests that drug-associated cues may take advantage of neural mechanisms originally intended for emotional processing of stimuli relevant to survival. In this study, we investigated cortical responses to several categories of emotional cues (erotic, romance, pleasant objects, mutilation, sadness, and unpleasant objects) as well as two types of smoking-related cues (people smoking and cigarette-related objects). We recorded ERPs from 180 smokers prior to their participation in a smoking cessation clinical trial and assessed emotional salience by measuring the amplitude of the late positive potential (LPP; 400 to 600 ms after picture onset). As expected, emotional and cigarette-related pictures prompted a significantly larger LPP than neutral pictures. The amplitude of the LPP increased as a function of picture arousal level, with high-arousing erotic and mutilation pictures showing the largest response in contrast to low-arousing pleasant and unpleasant objects, which showed the smallest response (other than neutral). Compared to females, male participants showed larger LPPs for high-arousing erotic and mutilation pictures. However, unlike emotional pictures, no difference was noted for the LPP between cigarette stimuli containing people versus those containing only objects, suggesting that in contrast to emotional objects, cigarette-related objects are highly relevant for smokers. We also compared the smokers to a small (N=40), convenience sample of never-smokers. We found that never-smokers had significantly smaller LPPs in response to erotic and cigarette stimuli containing only objects compared to smokers. Copyright © 2013 Elsevier B.V. All rights reserved.

In Search of Insight.

ERIC Educational Resources Information Center

Kaplan, Craig A.; Simon, Herbert A.

1990-01-01

Attaining the insight needed to solve the Mutilated Checkerboard problem, which requires discovery of an effective problem representation (EPR), is described. Performance on insight problems can be predicted from the availability of generators and constraints in the search for an EPR. Data for 23 undergraduates were analyzed. (TJH)

The Deterministic Origins of Sexism.

ERIC Educational Resources Information Center

Perry, Melissa J.; Albee, George W.

1998-01-01

Discusses the physical, sexual, and psychological ramifications of biological determinism using examples from the global status of women's health, the continuation of female genital mutilation, and the history of sexist beliefs in psychology that serve a social control function of creating and defining women's psychopathology. (Author/SLD)

Ethnofederalism and the Accommodation of Ethnic Minorities in Burma: United They Stand

DTIC Science & Technology

2013-06-01

perform that role. The two defining criteria are thus met, but with significant limitations. 3. Stepan’s Variables Stepan offers more concrete ...rights book, Suffering in Silence, published in 2000. Rape, burnt villages, confiscated food stores, mutilated livestock, and indiscriminate

14 CFR 47.49 - Replacement of Certificate.

Code of Federal Regulations, 2010 CFR

2010-01-01

... AIRCRAFT REGISTRATION Certificates of Aircraft Registration § 47.49 Replacement of Certificate. (a) If a Certificate of Aircraft Registration is lost, stolen, or mutilated, the holder of the Certificate of Aircraft Registration may apply to the FAA Aircraft Registry for a duplicate certificate, accompanying his application...

Controversial issues: female genital mutilation.

PubMed

Richards, D

2000-01-01

As immigrant women from African countries enter the U.S., Canada, Australia, and Western Europe, western health care providers are beginning to see patients affected by the cultural practice of Female Genital Mutilation (FGM). Unfamiliar with the practice, either medically or culturally, these providers are turning to medical librarians for information. Complicating the issue are the strong negative feelings most western health care workers have about FGM, which appears to them to be both barbaric and cruel. These feelings may conflict strongly with those of their immigrant patients, who regard the practice as normal and desirable. Both medical and cultural information are needed for the professional to provide treatment of medical conditions, while also establishing a good relationship with the FGM affected patient. This article identifies and describes the most important refereed journal article databases, available now over the Internet, providing both medical and cultural information on FGM, and the most useful Web sites for health professionals, librarians, and interested laypersons who need information about this difficult multicultural issue.

Female genital mutilation: Australian law, policy and practical challenges for doctors.

PubMed

Mathews, Ben

2011-02-07

The issue of whether medical practitioners should perform "ritual nicks" as a method of meeting demand for female genital mutilation (FGM) has recently been debated in the United States and Australia. Due to increasing numbers of people arriving and settling in Australia from African nations in which FGM is customary, demand for FGM in Australia is present and may be increasing. Australian law clearly prohibits performance of any type of FGM. FGM is also prohibited by the most recent policy of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG). For legal, medical and social reasons, the RANZCOG policy is sound, and medical practitioners should not administer FGM in any form. Development of an evidence base regarding incidence of and attitudes towards FGM, and the need for post-FGM treatment, would help inform sound policy and practical responses. Strategies adopted in African nations to abolish FGM may assist in refining educational and supportive efforts.

Type I female genital mutilation: a cause of completely closed vagina.

PubMed

Rouzi, Abdulrahim A; Sahly, Nora; Alhachim, Estabraq; Abduljabbar, Hassan

2014-09-01

Female genital mutilation (FGM) ranges in severity from a nick of the clitoris to partial or total removal of the external genitalia. Sexual complications after FGM include sexual dysfunction, difficult intercourse, and dyspareunia. We report a case of Type I FGM presenting as complete vaginal closure and urinary retention. A 16-year-old adolescent was referred for obliterated vagina and urinary retention. She had recurrent urinary tract infections, difficulty in voiding, and cyclic hematuria. At the age of 1 year she had been taken by her mother to a pediatric surgeon to have a Type I FGM procedure. On examination, the urethral meatus and vaginal orifices were completely closed by the FGM scar. She underwent uneventful surgical opening of the vagina. A normal vaginal orifice was created and normal flow of urine and menses occurred. Type I FGM can present as complete vaginal closure and urinary retention. Proper diagnosis and treatment are of paramount importance. © 2014 International Society for Sexual Medicine.

Dismantling the man-made myths upholding female genital mutilation.

PubMed

Jiménez Ruiz, Ismael; Almansa Martínez, Pilar; Alcón Belchí, Carolina

2017-05-01

Female genital mutilation (FGM) is internationally considered an affront to human rights and an act of violence against women and young girls. Furthermore, it hierarchizes and perpetuates inequality and denies women and girls the right to physical and psychosexual integrity. The aim of this study is to detect the weak points and false premises underlying male justification of FGM and to present demythologization as a health education tool. We used a qualitative methodology with an ethonursing focus via semistructured individual and group interviews in 25 men associated with FGM. Our results found that nine myths and their mythologization are presented through the masculine voices of those associated with this tradition. These myths are used as justification by men and women in order to uphold the practice of FGM. Demythologization as a nursing intervention based on reorienting or restructuring models of cultural care allows us to work against the false premises making up the myths which act to protect this tradition.

In defence of genital autonomy for children.

PubMed

Earp, Brian D

2016-03-01

Arora and Jacobs (2016) assume that liberal societies should tolerate non-therapeutic infant male circumcision, and argue that it follows from this that they should similarly tolerate-or even encourage-what the authors regard as 'de minimis' forms of female genital mutilation (as defined by the World Health Organization). In this commentary, I argue that many serious problems would be likely to follow from a policy of increased tolerance for female genital mutilation, and that it may therefore be time to consider a less tolerant attitude toward non-therapeutic infant male circumcision. Ultimately, I suggest that children of whatever sex or gender should be free from having healthy parts of their most intimate sexual organs either damaged or removed, before they can understand what is at stake in such an intervention and agree to it themselves. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

8 CFR 264.1 - Registration and fingerprinting.

Code of Federal Regulations, 2010 CFR

2010-01-01

... mutilated card; (C) To change a name or other biographic data. (ii) Fee. An I-695 application must be... be submitted with the application. (C) Evidence of name or other biographic change. An I-695... of competent jurisdiction, changing the applicant's name, or with the applicant's marriage...

Actinomycotic abscess of the anterior abdominal wall: a case report and literature review.

PubMed

Pitot, D; De Moor, V; Demetter, P; Place, S; Gelin, M; El Nakadi, I

2008-01-01

Actinomycosis is a rare, chronic, suppurative, pseudotumoral illness caused by an anaerobic gram positive organism usually Actinomyces israelii which can mimick a tumoral pathology leading to a mutilating surgical resection. We report a case of abdominal actinomycosis and a literature review.

Self-inflicted finger injury in individuals with spinal cord injury: an analysis of 5 cases.

PubMed

Frost, Frederick S; Mukkamala, Sridevi; Covington, Edward

2008-01-01

To describe the occurrence of finger autophagia in 5 persons with traumatic spinal cord injury and to present a discussion of putative causes and potential treatments. Minor self-mutilating actions, such as nail biting and hair pulling, are common in humans and usually benign. In some circumstances, these behaviors are associated with obsessive-compulsive personality traits. In humans, self-injurious biting behaviors are well described in the setting of mental retardation and psychosis and in persons with Lesch-Nyhan syndrome. Rare cases of human autophagia in persons with intact cognition have been reported, most commonly in the setting of acquired nervous system lesions. After spinal cord injury, it has been suggested that this behavior constitutes a human variant of animal autotomy and a response to neuropathic pain. Case presentation narrative. Photographic and radiological study, administration of Yale-Brown Obsessive-Compulsive Scale (YBOCS). In 5 patients with complete tetraplegia, pain in the hands was present in only one instance. The severity of autoamputation varied from minor to extreme. In all cases, damage was confined to analgesic body parts. In 3 cases, autophagia behavior was discovered in progress. Treatments included pharmacotherapy, counseling, and behavioral therapy, with mixed results. All patients were intelligent, willing to discuss their issues, and able to identify conditions of stress and isolation in their lives. Mild preinjury obsessive-compulsive behaviors, such as nail biting, were universal. On the YBOCS, only 1 patient scored in a range indicative of mild obsessive-compulsive symptomatology. This group exhibited heterogeneous medical, social, and cultural characteristics. A link between pain and self-injurious behavior could not be demonstrated. This behavior may be viewed as an extreme variant of nail biting, with potential ominous complications. Treatment strategies have been employed with mixed results.

The relationship of suicide attempt history with childhood abuse and neglect, alexithymia and temperament and character dimensions of personality in substance dependents.

PubMed

Evren, Cuneyt; Evren, Bilge

2006-01-01

The aim of this study was to evaluate the prevalence of suicide in Turkish male substance dependents, and to investigate the relationship of suicide attempt history with childhood abuse and neglect, alexithymia, and temperament and character dimensions of personality. Participants were 154 consecutively admitted male substance dependents. Patients were investigated with the Childhood Abuse and Neglect Questionnaire, Toronto Alexithymia Scale (TAS-20) and Temperament and Character Inventory (TCI). Among substance-dependent patients, 28.6% was considered a group with suicide attempt history (SAH). Current age was lower and rate of being single was higher in the group with SAH. There were no significant differences between groups in terms of employment, educational status and duration of education. Rates of physical, emotional abuse and neglect, self-mutilation and being alexithymic were higher and ages at first substance use and regular substance use were lower in the group with SAH. Mean scores of "difficulty in identifying feelings" (DIF) and "difficulty in describing feelings" (DDF) subscale EOT of the TAS-20 were higher in the SAH group. Among temperament and character dimensions of the TCI, only "Self-directedness" and "Cooperativeness" were lower in SAH and there were no significant differences between groups in terms of other subscales. Age and Self-directedness score of TCI were determinants for suicide attempt. In particular, young drug users with low Self-directedness scores could be the target population in order to prevent suicidal behavior. This study also suggests that in substance-dependent patients, in the background of all suicidal behavior, childhood abuse and neglect must be evaluated.

4 CFR 202.3 - Prohibitions against misuse of seal.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 4 Accounts 1 2010-01-01 2010-01-01 false Prohibitions against misuse of seal. 202.3 Section 202.3 Accounts RECOVERY ACCOUNTABILITY AND TRANSPARENCY BOARD OFFICIAL SEAL § 202.3 Prohibitions against misuse of seal. (a) Falsely making, forging, counterfeiting, mutilating, or altering the Board seal or...

4 CFR 202.3 - Prohibitions against misuse of seal.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 4 Accounts 1 2011-01-01 2011-01-01 false Prohibitions against misuse of seal. 202.3 Section 202.3 Accounts RECOVERY ACCOUNTABILITY AND TRANSPARENCY BOARD OFFICIAL SEAL § 202.3 Prohibitions against misuse of seal. (a) Falsely making, forging, counterfeiting, mutilating, or altering the Board seal or...

31 CFR 100.8 - Packaging of mutilated currency.

Code of Federal Regulations, 2010 CFR

2010-07-01

... disturb the fragments more than is absolutely necessary. (b) If the currency is brittle or inclined to fall apart, pack it carefully in cotton and box it as found, without disturbing the fragments, if... therein, if possible, in order to prevent further deterioration of the fragments or from their being lost...

7 CFR 52.808 - Freedom from defects.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 2 2010-01-01 2010-01-01 false Freedom from defects. 52.808 Section 52.808... Quality § 52.808 Freedom from defects. (a) General. The factor of freedom from defects refers to the degree of freedom from harmless extraneous material, mutilated cherries, and cherries blemished by scab...

A Mind/Brain/Matter Model Consistent with Quantum Physics and UFO phenomena

DTIC Science & Technology

1979-01-01

precognitive nightmares indicating the horror of the Armageddon to come, and these nightmarish paranormal mutilations reveal the true nature of our times...strange, precognitive dreams that were foisted upon a king, nor was it foolish to interpret strange aerial phenomena in terms oi serious threats looming

76 FR 41764 - Atlantic Coastal Fisheries Cooperative Management Act Provisions; General Provisions for Domestic...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-15

... scientists and the fishing industry, to help them understand the settlement and location of larval lobsters... vessels from the following Federal American lobster regulation: Mutilation requirement within American lobster management Area 3. The researchers propose to collect a pleopod (small swimmerettes located on the...

39 CFR 762.43 - Issuance of substitute disbursement postal money order.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 39 Postal Service 1 2013-07-01 2013-07-01 false Issuance of substitute disbursement postal money...; DISBURSEMENT POSTAL MONEY ORDERS DISBURSEMENT POSTAL MONEY ORDERS Issuance of Substitutes for Lost, Destroyed, Mutilated, and Defaced Disbursement Postal Money Orders § 762.43 Issuance of substitute disbursement postal...

39 CFR 762.43 - Issuance of substitute disbursement postal money order.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 39 Postal Service 1 2014-07-01 2014-07-01 false Issuance of substitute disbursement postal money...; DISBURSEMENT POSTAL MONEY ORDERS DISBURSEMENT POSTAL MONEY ORDERS Issuance of Substitutes for Lost, Destroyed, Mutilated, and Defaced Disbursement Postal Money Orders § 762.43 Issuance of substitute disbursement postal...

39 CFR 762.43 - Issuance of substitute disbursement postal money order.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 39 Postal Service 1 2012-07-01 2012-07-01 false Issuance of substitute disbursement postal money...; DISBURSEMENT POSTAL MONEY ORDERS DISBURSEMENT POSTAL MONEY ORDERS Issuance of Substitutes for Lost, Destroyed, Mutilated, and Defaced Disbursement Postal Money Orders § 762.43 Issuance of substitute disbursement postal...

39 CFR 762.43 - Issuance of substitute disbursement postal money order.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 39 Postal Service 1 2011-07-01 2011-07-01 false Issuance of substitute disbursement postal money...; DISBURSEMENT POSTAL MONEY ORDERS DISBURSEMENT POSTAL MONEY ORDERS Issuance of Substitutes for Lost, Destroyed, Mutilated, and Defaced Disbursement Postal Money Orders § 762.43 Issuance of substitute disbursement postal...

39 CFR 762.43 - Issuance of substitute disbursement postal money order.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 39 Postal Service 1 2010-07-01 2010-07-01 false Issuance of substitute disbursement postal money...; DISBURSEMENT POSTAL MONEY ORDERS DISBURSEMENT POSTAL MONEY ORDERS Issuance of Substitutes for Lost, Destroyed, Mutilated, and Defaced Disbursement Postal Money Orders § 762.43 Issuance of substitute disbursement postal...

31 CFR 309.12 - Relief on account of loss, theft or destruction, etc.

Code of Federal Regulations, 2011 CFR

2011-07-01

..., theft, destruction, mutilation or defacement of Treasury bills may be given only under the authority of... bills, immediate advice, with a full description of the bill or bills involved, should be sent to the... be given, instructions and necessary blank forms will be furnished. ...

31 CFR 309.12 - Relief on account of loss, theft or destruction, etc.

Code of Federal Regulations, 2010 CFR

2010-07-01

..., theft, destruction, mutilation or defacement of Treasury bills may be given only under the authority of... bills, immediate advice, with a full description of the bill or bills involved, should be sent to the... be given, instructions and necessary blank forms will be furnished. ...

7 CFR 52.3761 - Defects.

Code of Federal Regulations, 2011 CFR

2011-01-01

... harmless extraneous vegetable material, stems, and portions thereof, blemishes, wrinkles, mutilated olives... to olives pitted along an axis other than the stem-flower axis. A defect is a unit where the angle of.... (12) Stem means a stem that measures 3 mm or more from the shoulder of the olive. Stems are classified...

7 CFR 52.3761 - Defects.

Code of Federal Regulations, 2012 CFR

2012-01-01

... harmless extraneous vegetable material, stems, and portions thereof, blemishes, wrinkles, mutilated olives... to olives pitted along an axis other than the stem-flower axis. A defect is a unit where the angle of.... (12) Stem means a stem that measures 3 mm or more from the shoulder of the olive. Stems are classified...

78 FR 61352 - Agency Information Collection Activities; Proposed Collection; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2013-10-03

... will be considered before the FTC submits a request for Office of Management and Budget (OMB) review of... information collection, the destruction, mutilation, alteration, or falsification of documentary evidence... documents requested, as each will entail various levels of management and/or support staff among many...

31 CFR 100.6 - Destroyed paper currency.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 31 Money and Finance: Treasury 1 2010-07-01 2010-07-01 false Destroyed paper currency. 100.6 Section 100.6 Money and Finance: Treasury Regulations Relating to Money and Finance EXCHANGE OF PAPER CURRENCY AND COIN Exchange of Mutilated Paper Currency § 100.6 Destroyed paper currency. No relief will be...

Mutilating lawn mower injuries in children.

PubMed

Ross, P M; Schwentker, E P; Bryan, H

1976-08-02

Serious injuries from riding power mowers were sustained by 18 children. Eleven children were passangers on the mower and fell into its path. The injuries required an extensive number of hospitalizations and reconstructive procedures. Fifteen patients suffered considerable residual deformities. Operating riding power mowers in the vicinity of children must be actively discouraged.

Transsexualism: An Issue of Sex-Role Stereotyping.

ERIC Educational Resources Information Center

Raymond, Janice

Transsexualism offers a unique perspective on gender identity, sex-role stereotyping, and sex differences in a patriarchal society. It is also an important medical ethical issue which raises questions of bodily mutilation and integrity, nature versus technology, medical research priorities, unnecessary surgery, and the medical model, as well as…

Psychoactive "bath salts" intoxication with methylenedioxypyrovalerone.

PubMed

Ross, Edward A; Reisfield, Gary M; Watson, Mary C; Chronister, Chris W; Goldberger, Bruce A

2012-09-01

Abuse of the psychoactive "designer drug" methylenedioxypyrovalerone (MDPV) has become a serious international public health concern because of the severity of its physical and behavioral toxicities. MDPV is the primary ingredient in so-called "bath salts," labeled as such to avoid criminal prosecution and has only been classified recently as a controlled substance in the United States and some other countries. However, it remains a danger because of illegal sources, including the Internet. MDPV is a synthetic, cathinone-derivative, central nervous system stimulant and is taken to produce a cocaine- or methamphetamine-like high. Administered via oral ingestion, nasal insufflation, smoking, intravenous or intramuscular methods, or the rectum, the intoxication lasts 6 to 8 hours and has high addictive potential. Overdoses are characterized by profound toxicities, causing increased attention by emergency department and law enforcement personnel. Physical manifestations range from tachycardia, hypertension, arrhythmias, hyperthermia, sweating, rhabdomyolysis, and seizures to those as severe as stroke, cerebral edema, cardiorespiratory collapse, myocardial infarction, and death. Behavioral effects include panic attacks, anxiety, agitation, severe paranoia, hallucinations, psychosis, suicidal ideation, self-mutilation, and behavior that is aggressive, violent, and self-destructive. Treatment is principally supportive and focuses on counteracting the sympathetic overstimulation, including sedation with intravenous benzodiazepines, seizure-prevention measures, intravenous fluids, close (eg, intensive care unit) monitoring, and restraints to prevent harm to self or others. Clinical presentation is often complicated by coingestion of other psychoactive substances that may alter the treatment approach. Clinicians need to be especially vigilant in that MDPV is not detected by routine drug screens and overdoses can be life-threatening. Copyright © 2012 Elsevier Inc. All rights reserved.

8 CFR 103.7 - Fees.

Code of Federal Regulations, 2010 CFR

2010-01-01

..., remittance may be made by bank international money order or foreign draft drawn on a financial institution in... petition for school certification—$1,700, plus a site visit fee of $655 for each location listed on the..., mutilated, or destroyed, or for a change in name—$290. Form I-94.For issuance of Arrival/Departure Record at...

A Dishonorable Killing

ERIC Educational Resources Information Center

Lum, Lydia

2006-01-01

The brutal slaying in 1955 of Emmett Till by at least two White Southerners shocked and outraged the country. Published photos of the Black teenager's mutilated body on the covers of Jet and The Chicago Defender galvanized the civil rights movement, especially in the South. A sadly similar crime in Hawaii 23 years earlier also led residents of…

42 CFR 424.350 - Replacement of checks that are lost, stolen, defaced, mutilated, destroyed, or paid on forged...

Code of Federal Regulations, 2010 CFR

2010-10-01

... CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM CONDITIONS FOR MEDICARE PAYMENT Replacement and Reclamation of Medicare Payments § 424.350... investigation and settlement of claims in connection with Treasury checks issued on behalf of CMS. (2) Action by...

36 CFR § 702.10 - Protection of property.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 36 Parks, Forests, and Public Property 3 2013-07-01 2012-07-01 true Protection of property. § 702.10 Section § 702.10 Parks, Forests, and Public Property LIBRARY OF CONGRESS CONDUCT ON LIBRARY..., mutilate, tear, or destroy library materials, or any portion thereof, shall be punished by a fine of not...

32 CFR 11.6 - Crimes and elements.

Code of Federal Regulations, 2010 CFR

2010-07-01

... must be a direct result of the substance's effect or effects on the human body (e.g., asphyxiation...) The accused caused serious injury to the body or health of one or more persons; (B) The accused... of the body, and serious damage to internal organs. (13) Mutilation or maiming—(i) Elements. (A) The...

32 CFR 11.6 - Crimes and elements.

Code of Federal Regulations, 2011 CFR

2011-07-01

... must be a direct result of the substance's effect or effects on the human body (e.g., asphyxiation...) The accused caused serious injury to the body or health of one or more persons; (B) The accused... of the body, and serious damage to internal organs. (13) Mutilation or maiming—(i) Elements. (A) The...

International Year of the Family 1994: Family and Gender Equity in Education.

ERIC Educational Resources Information Center

Hildebrand, Verna

1994-01-01

Advances 14 general propositions on family and gender equity that seek to promote gender equality; an end to female genital mutilation; an awareness of sexually transmitted diseases; responsible parenthood and parent education; healthy gender relations; compulsory education for both sexes; and acceptance of unmarried or divorced adults, single…

31 CFR 100.6 - Destroyed paper currency.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 31 Money and Finance: Treasury 1 2011-07-01 2011-07-01 false Destroyed paper currency. 100.6..., DEPARTMENT OF THE TREASURY EXCHANGE OF PAPER CURRENCY AND COIN Exchange of Mutilated Paper Currency § 100.6 Destroyed paper currency. No relief will be granted on account of lawfully held paper currency of the United...

[Sociocultural aspects of albinism in Sub-Saharan Africa: mutilations and ritual murders committed in east Africa (Burundi and Tanzania)].

PubMed

Aquaron, R; Djatou, M; Kamdem, L

2009-10-01

This report presents an overview of the many sociocultural prejudices confronting albinos and their parents in Sub-Saharan Africa at each stage of life (infancy, adolescence, and adulthood). The birth of an albino child to two black parents has always been an enigma for African peoples. French-speaking and English-speaking populations in Central, East and South African countries have invented numerous myths to account for this event. Albinos are believed to possess good and evil magical powers. On the white magic side, some organs are believed to confer luck, health, and prosperity. For this reason albinos in Tanzania and Burundi are still in 2008 prey to ritual murders and mutilations to obtain various body parts such as arms, legs, and genitals for preparation of amulets. This barbaric and iniquitous practice has been severely condemned by authorities in both countries as well as by the European Parliament. To end these atrocities disseminating accurate medical information explaining the genetic basis of albinism will be necessary to eliminate ignorance and superstition.

Severe mutilation of a Critically Endangered Taiwanese humpback dolphin Sousa chinensis taiwanensis by fishing gear.

PubMed

Wang, John Y; Araújo-Wang, Claryana

2017-03-21

Direct observations of the causes of injuries to cetaceans are rare events. For very small and declining populations, such events may be even less likely to be observed because of the few individuals that remain. A long-term monitoring program using photographic identification of individuals resulted in the documentation of an individual Taiwanese humpback dolphin Sousa chinensis taiwanensis that survived a harmful interaction with fishing gear. An adult female that was accompanied by a young calf sustained massive damage to several tissue types on her dorsal surface. From the injuries, it is clear that the animal had suffered intense trauma that likely caused pain for several months as the fishing gear sliced through its dorsal hump and fin. Given the incredible mutilation, the animal is likely compromised at some level and probably continues to experience ongoing pain. This case, along with observations of other individuals in this population bearing serious injuries or being entangled in fishing gear, is direct evidence that the impacts of local fisheries on this subspecies are almost certainly unsustainable.

Psychological and counselling interventions for female genital mutilation.

PubMed

Smith, Helen; Stein, Karin

2017-02-01

Women and girls living with female genital mutilation (FGM) are more likely to experience psychological problems than women without FGM. As well as psychological support, this population may need additional care when seeking surgical interventions to correct complications of FGM. Recent WHO guidelines recommend cognitive behavioral therapy for women and girls experiencing anxiety disorders, depression, or post-traumatic stress disorder. The guidelines also suggest that preoperative counselling for deinfibulation, and psychological support alongside surgical interventions, can help women manage the physiological and psychological changes following surgery. This synthesis summarizes evidence on women's values and preferences, and the context and conditions that may be required to provide psychological and counselling interventions. Understanding women's views, their own ways of coping, as well social and cultural factors that influence women's mental well-being, may help identify the types of interventions this population needs at different times and stages of their lives. © 2017 International Federation of Gynecology and Obstetrics. The World Health Organization retains copyright and all other rights in the manuscript of this article as submitted for publication.

Mutilation of the uvula among Bedouins of the South Sinai.

PubMed

Nathan, H; Hershkovitz, I; Arensburg, B; Kobyliansky, Y; Goldschmidt-Nathan, M

1982-07-01

Mutilation of the uvula, as practiced by various tribes of Bedouins in the South Sinai, was discovered while carrying out anthropological studies in the area. Partial or total amputation of the uvula is performed on both boys and girls during the first or second year of life, as a ritual custom. Anatomical changes in the soft palate due to the uvulectomy in 115 subjects are described. The remnant of the uvula (scar) was classified according to size as: very large, large, medium, small, trace or none. A notch or kind of cleft of the palate, as a result of the uvulectomy, was considered the most extreme degree of extirpation. The majority (47%) were of small size and a notch was found in 9.6%. Changes in shape and symmetry of the arches of the palate as a result of the uvulectomy are also described. These changes are explained on the basis of the anatomical structure of the palate and uvula. The possible effects of the uvulectomy on health in general and on speech in particular are discussed.

Health information interventions for female genital mutilation.

PubMed

Smith, Helen; Stein, Karin

2017-02-01

Providing information and education to women and girls living with female genital mutilation (FGM) could be an important influence on their healthcare-seeking behavior. Healthcare providers also need adequate knowledge and skills to provide good quality care to this population. Recent WHO guidelines on managing health complications from FGM contain best practice statements for health education and information interventions for women and providers. This qualitative evidence synthesis summarizes the values and preferences of girls and women living with FGM, and healthcare providers, together with other evidence on the context and conditions of these interventions. The synthesis highlights that healthcare providers lack skills and training to manage women, and women are concerned about the lack of discussion about FGM with providers. There is a need for more training for providers, and further research to understand how health information interventions may be perceived or experienced by women living with FGM in different contexts. © 2017 International Federation of Gynecology and Obstetrics. The World Health Organization retains copyright and all other rights in the manuscript of this article as submitted for publication.

Addressing Female Genital Mutilation/Cutting (FGM/C) in the Era of Clitoral Reconstruction: Plastic Surgery.

PubMed

Sigurjonsson, Hannes; Jordal, Malin

2018-01-01

The aim of this review is to give an overview of the recent evidence on clitoral reconstruction and other relevant reconstructive plastic surgery measures after female genital mutilation/cutting (FGM/C). Recent publications present refinements and modifications of the surgical technique of clitoral reconstruction along with reconstruction of the labia majora and clitoral hood. Novel approaches with reposition of the clitoral nerve, anchoring of the labia majora, fat grafting, and full thickness mucosa grafts have been introduced. The current evidence on outcomes of clitoral reconstruction shows potential benefits. However, there is a risk of postoperative complications and a negative outcome. Experts in the field advocate for a multidisciplinary approach including psychosexual counseling and health education with or without subsequent clitoral reconstructive surgery. The evolution of reconstructive treatment for women with FGM/C is expanding, however at a slow rate. The scarcity of evidence on clitoral reconstruction halters availability of clinical guidelines and consensus regarding best practice. Clitoral reconstruction should be provided by multidisciplinary referral centers in a research setting with long-term follow-up on outcomes of postoperative morbidity and possible benefits.

Supportive psychotherapy or client education alongside surgical procedures to correct complications of female genital mutilation: A systematic review.

PubMed

Abayomi, Olukayode; Chibuzor, Moriam T; Okusanya, Babasola O; Esu, Ekpereonne; Odey, Edward; Meremikwu, Martin M

2017-02-01

Supportive psychotherapy, in individual or group settings, may help improve surgical outcomes for women and girls living with female genital mutilation (FGM). To assess whether supportive psychotherapy given alongside surgical procedures to correct complications of FGM improves clinical outcomes. We searched major databases including CENTRAL, Medline, African Index Medicus, SCOPUS, PsycINFO, and others. There were no language restrictions. We checked the reference lists of retrieved studies for additional reports of relevant studies. We included studies of girls and women living with any type of FGM who received supportive psychotherapy or client education sessions alongside any surgical procedure to correct health complications from FGM. Two team members independently screened studies for eligibility. There were no eligible studies identified. There is no direct evidence for the benefits or harms of supportive psychotherapy alongside surgical procedures for women and girls living with FGM. Research evidence is urgently needed to guide clinical practice. 42015024639. © 2017 International Federation of Gynecology and Obstetrics. The World Health Organization retains copyright and all other rights in the manuscript of this article as submitted for publication.

Female Genital Mutilation Is a Violation of Reproductive Rights of Women: Implications for Health Workers.

PubMed

Jungari, Suresh Banayya

2016-02-01

Female genital mutilation (FGM) comprises all procedures that involve partial or total removal of the external female genitalia or other injury to the female genital organs for nonmedical reasons. This coercive practice is still prevalent in many parts of the world, in both developed and developing countries. However, FGM is more prevalent in African countries and some Asian countries. In this study, an attempt has been made to understand the prevalence and practice of FGM worldwide and its adverse effects on women's reproductive health. To fulfill the study objectives, the author collected evidence from various studies conducted by international agencies. Many studies found that FGM has no health benefits; is mostly carried out on girls before they reach the age of 15 years; can cause severe bleeding, infections, psychological illness, and infertility; and, most important, can have serious consequences during childbirth. The practice is mainly governed by the traditions and cultures of the communities without having any scientific or medical benefit. In conclusion, FGM is a practice that violates the human and reproductive rights of women.

Emotional sensitization highlights the attentional bias in blood-injection-injury phobics: an ERP study.

PubMed

Sarlo, Michela; Buodo, Giulia; Devigili, Andrea; Munafò, Marianna; Palomba, Daniela

2011-02-18

The presence of an attentional bias towards disorder-related stimuli has not been consistently demonstrated in blood phobics. The present study was aimed at investigating whether or not an attentional bias, as measured by event-related potentials (ERPs), could be highlighted in blood phobics by inducing cognitive-emotional sensitization through the repetitive presentation of different disorder-related pictures. The mean amplitudes of the N100, P200, P300 and late positive potentials to picture onset were assessed along with subjective ratings of valence and arousal in 13 blood phobics and 12 healthy controls. Blood phobics, but not controls, showed a linear increase of subjective arousal over time, suggesting that cognitive-emotional sensitization did occur. The analysis of cortical responses showed larger N100 and smaller late positive potentials in phobics than in controls in response to mutilations. These findings suggest that cognitive-emotional sensitization induced an attentional bias in blood phobics during picture viewing, involving early selective encoding and late cognitive avoidance of disorder-related stimuli depicting mutilations. © 2010 Elsevier Ireland Ltd. All rights reserved.

Vincristine-induced central neurotoxicity in a collie homozygous for the ABCB1Δ mutation.

PubMed

Krugman, L; Bryan, J N; Mealey, K L; Chen, A

2012-03-01

A six-year-old, neutered, female collie was presented to an oncology specialty service after developing tetraparesis and self-mutilation that progressively worsened while receiving chemotherapy for lymphoma. Neurologic examination revealed ataxia, paresis and diminished conscious proprioception in all limbs with entire spinal reflexes. Magnetic resonance imaging of the brain and spinal cord was normal. Electromyography of the limbs ruled out a vincristine-induced peripheral neuropathy. Cerebrospinal fluid analysis and cerebrospinal fluid and serum testing for Neospora and Toxoplasma were normal. Results of MDR1 genotyping revealed that the dog was homozygous for the ABCB1-1Δ (MDR1) mutation. This clinical presentation strongly resembled the effects seen from inadvertent intrathecal administration of vincristine in humans. Dogs that are homozygous for the ABCB1-1Δ (MDR1) mutation should not receive standard dosages of chemotherapy drugs known to be eliminated by P-glycoprotein, the gene product of ABCB1. Testing for this mutation is strongly recommended before chemotherapy initiation for at-risk breeds. © 2011 British Small Animal Veterinary Association.

The neuropathology, medical management and dental implications of autism.

PubMed

Friedlander, Arthur H; Yagiela, John A; Paterno, Victoria I; Mahler, Michael E

2006-11-01

A paucity of information exists in the dental literature about autism and its dental implications. The authors conducted a MEDLINE search for the period 2000 through 2006, using the term "autism," with the aim of defining the condition's clinical manifestations, dental and medical treatment and dental implications. Autism is a severe developmental brain disorder that appears in infancy, persists throughout life, and is characterized by impaired social interaction, abnormalities in communication (both verbal and nonverbal) and restricted interests. Often accompanying the disorder are behavioral disturbances - such as self-mutilation, aggression, psychiatric symptoms and seizures - that necessitate the administration of multiple medications to help the affected person participate effectively in the educational and rehabilitative process. Dentists caring for people with autism must be familiar with the manifestations of the disease and its associated features so that they can garner the maximum level of patient cooperation. They also must be familiar with the medications used to treat the associated features of the disorder because many of them cause untoward orofacial and systemic reactions and may precipitate adverse interactions with dental therapeutic agents.

Wiedemann-Steiner Syndrome With 2 Novel KMT2A Mutations.

PubMed

Min Ko, Jung; Cho, Jae So; Yoo, Yongjin; Seo, Jieun; Choi, Murim; Chae, Jong-Hee; Lee, Hye-Ran; Cho, Tae-Joon

2017-02-01

Wiedemann-Steiner syndrome is a rare genetic disorder characterized by short stature, hairy elbows, facial dysmorphism, and developmental delay. It can also be accompanied by musculoskeletal anomalies such as muscular hypotonia and small hands and feet. Mutations in the KMT2A gene have only recently been identified as the cause of Wiedemann-Steiner syndrome; therefore, only 16 patients from 15 families have been described, and new phenotypic features continue to be added. In this report, we describe 2 newly identified patients with Wiedemann-Steiner syndrome who presented with variable severity. One girl exhibited developmental dysplasia of the hip and fibromatosis colli accompanied by other clinical features, including facial dysmorphism, hypertrichosis, patent ductus arteriosus, growth retardation, and borderline intellectual disability. The other patient, a boy, showed severe developmental retardation with automatic self-mutilation, facial dysmorphism, and hypertrichosis at a later age. Exome sequencing analysis of these patients and their parents revealed a de novo nonsense mutation, p.Gln1978*, of KMT2A in the former, and a missense mutation, p.Gly1168Asp, in the latter, which molecularly confirmed the diagnosis of Wiedemann-Steiner syndrome.

Prevalence and predictors of female genital mutilation among infants in a semi urban community in northern Nigeria.

PubMed

Ashimi, Adewale O; Amole, Taiwo G; Iliyasu, Zubairu

2015-12-01

To determine the prevalence, predictors, of female genital mutilation (FGM) among infants and ascertain if their mothers knew what was done to them in Birnin Kudu northern Nigeria. Cross sectional study which utilised a pretested interviewer administered semi-structured questionnaire to assess occurrence of FGM with physical examination of the infants. Logistic regression analysis was used to assess the relative effect of determinants, after adjusting for other predictor variables. Of the 450 infants, 215(47.8%) (95% Confidence Interval [CI]: 43.1%-52.5%) had experienced one form of FGM. The ages at genital mutilation ranged from 1 to 50 days with a median of 4 days and interquartile range of 7 days. Maternal occupation, education and religion and type of facility accessed were significantly associated with occurrence of FGM in infants (p ≤ 0.05). After controlling for confounders, having a mother without formal education [AOR = 6.39 and 95% CI = 3.99-10.23] (p = 0.001) and one who was employed [Adjusted odds ratio (AOR) = 2.89 and 95% CI = 1.66-5.03] (p = 0.001) increased the likelihood of infant FGM remarkably while utilising tertiary institution for health care reduced the risk by about half [AOR = 0.49 and 95% CI = 0.26-0.92] (p = 0.03). Of the 215 infants that had undergone FGM, there was correlation between the reported and the observed forms of FGM in 16 (7.4%) of the cases. The prevalence of FGM is high with mothers' educational status, type of health facility utilised and occupational status being predictors of FGM among infants in Birnin Kudu. Majority of the mothers are not aware of what was done. Strategies aimed at discouraging this dangerous practice in the community should include female education, involvement of the men as husbands, fathers, traditional and religious leaders. Copyright © 2015 Elsevier B.V. All rights reserved.

Management of painful clitoral neuroma after female genital mutilation/cutting.

PubMed

Abdulcadir, Jasmine; Tille, Jean-Christophe; Petignat, Patrick

2017-02-08

Traumatic neuromas are the result of regenerative disorganized proliferation of the proximal portion of lesioned nerves. They can exist in any anatomical site and are responsible for neuropathic pain. Post-traumatic neuromas of the clitoris have been described as an uncommon consequence of female genital mutilation/cutting (FGM/C). FGM/C involves partial or total removal of the female genital organs for non-therapeutic reasons. It can involve cutting of the clitoris and can cause psychological, sexual, and physical complications. We aimed to evaluate the symptoms and management of women presenting with a clitoral neuroma after female genital mutilation/cutting (FGM/C). We identified women who attended our specialized clinic for women with FGM/C who were diagnosed with a traumatic neuroma of the clitoris between April 1, 2010 and June 30, 2016. We reviewed their medical files and collected socio-demographic, clinical, surgical, and histopathological information. Seven women were diagnosed with clitoral neuroma. Six attended our clinic to undergo clitoral reconstruction, and three of these suffered from clitoral pain. The peri-clitoral fibrosis was removed during clitoral reconstruction, which revealed neuroma of the clitoris in all six subjects. Pain was ameliorated after surgery. The seventh woman presented with a visible and palpable painful clitoral mass diagnosed as a neuroma. Excision of the mass ameliorated the pain. Sexual function improved in five women. One was not sexually active, and one had not yet resumed sex. Post-traumatic clitoral neuroma can be a consequence of FGM/C. It can cause clitoral pain or be asymptomatic. In the case of pain symptoms, effective treatment is neuroma surgical excision, which can be performed during clitoral reconstruction. Surgery should be considered as part of multidisciplinary care. The efficacy of neuroma excision alone or during clitoral reconstruction to treat clitoral pain should be further assessed among symptomatic women.

[Clinical efficacy of partial resection of puborectalis combined with mutilation of internal anal sphincter in the treatment of puborectalis syndrome with high anal pressure].

PubMed

Ye, Hui; Liu, Weicheng; Qian, Qun; Liu, Zhisu; Jiang, Congqing; Zheng, Keyan; Qin, Qianbo; Ding, Zhao; Gong, Zhilin

2017-03-25

To explore the efficacy of partial resection of puborectalis combined with mutilation of internal anal sphincter(IAS) in the treatment of puborectalis syndrome with high anal pressure. Twenty-five cases of puborectalis syndrome with high anal resting pressure in the preoperative examination received the operation of partial resection of puborectalis combined with mutilation of IAS in Zhongnan Hospital of Wuhan University between January 2013 and May 2015. The position of puborectalis was confirmed by touching with the exposure under the transfixion device, and a transverse incision was made by electrotome between 3 and 5 o'clock direction of puborectalis, then partial puborectalis was lifted by vessel clamp at 5 o'clock direction, and about 0.5 cm of muscular tissue was resected. Between 8 to 10 o'clock direction of anal tube, about 1 cm length of transverse incision was made by electrotome, then partial IAS was lifted by vessel clamp and cut off. Preoperative and postoperative 3-month anorectal manometry and defecography were carried out. Wexner constipation score and Cleveland Clinic incontinence score were implemented before surgery and 3, 6, 12 months after operation. This study was registered in the Chinese Clinical Trial Registry (registration number: ChiCTR-ORB-16007695). Of the 25 cases, 18 were male and 7 were female, the average age was 55 years old and the average course of disease was 9 years. Compared with pre-operation, the postoperative 3-month anal resting pressure and maximal squeeze pressure were significantly decreased [(53.56±9.05) mmHg vs. (92.44±7.06) mmHg, (142.80±20.35) mmHg vs. (210.88±20.56) mmHg, respectively, both P=0.000]; anorectal angulation at resting state and forced defecation state increased significantly [(102.32±4.96)degree vs. (95.88±4.01)degree, (117.88±5.95)degree vs. (89.52±3.25)degree, respectively, both P=0.000]. Wexner constipation score of postoperative 3-month, 6-month, 12-month (8.28±3.91, 7.40±3.64 and 8.04±4.74) was significantly lower than the preoperative score (16.00±3.69, all P<0.05), while the score was not significantly different among 3 time points after operation (P>0.05). Cleveland Clinic incontinence score was 0 at postoperative 6 and 12 months, and revealed 20 cases were effective among all the surgical patients(80%). Partial resection of puborectalis combined with mutilation of internal anal sphincter can effectively reduce anal pressure and improve symptoms of outlet obstruction, which is an effective method in the treatment of puborectalis syndrome with high anal pressure.

Mutilating Data and Discarding Variance: The Dangers of Dichotomizing Continuous Variables.

ERIC Educational Resources Information Center

Kroff, Michael W.

This paper reviews issues involved in converting continuous variables to nominal variables to be used in the OVA techniques. The literature dealing with the dangers of dichotomizing continuous variables is reviewed. First, the assumptions invoked by OVA analyses are reviewed in addition to concerns regarding the loss of variance and a reduction in…

The Marketing of Education in a Coordinated Decentralised Context: Alfred P. Sloan Revisited.

ERIC Educational Resources Information Center

Watkins, Peter E.

This paper argues that a useful way of analyzing the current moves to locate education within a decentralized framework of schools competing for educational consumers is to return to the founders of managerialism. In particular, this paper suggests that by returning to the point of production, the "mutilated rationality" (Habermas) of…

Children in Africa: Key Statistics on Child Survival, Protection and Development

ERIC Educational Resources Information Center

UNICEF, 2014

2014-01-01

This report presents key statistics relating to: (1) child malnutrition in Africa; (2) HIV/AIDS and Malaria in Africa; (3) child marriage, birth registration and Female Genital Mutilation/Cutting (FGM/C); (4) education in Africa; (5) child mortality in Africa; (6) Drinking water and sanitation in Africa; and (7) maternal health in Africa.…

46 CFR 167.43-20 - Shipboard inspections.

Code of Federal Regulations, 2014 CFR

2014-10-01

... SHIPS Work Vests § 167.43-20 Shipboard inspections. (a) Each work vest shall be subject to examination... vest is found not to be in a serviceable condition, then such work vest shall be removed from the vessel. If a work vest is beyond repair, it shall be destroyed or mutilated in the presence of a marine...

46 CFR 167.43-20 - Shipboard inspections.

Code of Federal Regulations, 2011 CFR

2011-10-01

... SHIPS Work Vests § 167.43-20 Shipboard inspections. (a) Each work vest shall be subject to examination... vest is found not to be in a serviceable condition, then such work vest shall be removed from the vessel. If a work vest is beyond repair, it shall be destroyed or mutilated in the presence of a marine...

46 CFR 167.43-20 - Shipboard inspections.

Code of Federal Regulations, 2013 CFR

2013-10-01

... SHIPS Work Vests § 167.43-20 Shipboard inspections. (a) Each work vest shall be subject to examination... vest is found not to be in a serviceable condition, then such work vest shall be removed from the vessel. If a work vest is beyond repair, it shall be destroyed or mutilated in the presence of a marine...

46 CFR 167.43-20 - Shipboard inspections.

Code of Federal Regulations, 2010 CFR

2010-10-01

... SHIPS Work Vests § 167.43-20 Shipboard inspections. (a) Each work vest shall be subject to examination... vest is found not to be in a serviceable condition, then such work vest shall be removed from the vessel. If a work vest is beyond repair, it shall be destroyed or mutilated in the presence of a marine...

46 CFR 167.43-20 - Shipboard inspections.

Code of Federal Regulations, 2012 CFR

2012-10-01

... SHIPS Work Vests § 167.43-20 Shipboard inspections. (a) Each work vest shall be subject to examination... vest is found not to be in a serviceable condition, then such work vest shall be removed from the vessel. If a work vest is beyond repair, it shall be destroyed or mutilated in the presence of a marine...

31 CFR 315.26 - Application for relief-after receipt of bond.

Code of Federal Regulations, 2010 CFR

2010-07-01

... (Continued) FISCAL SERVICE, DEPARTMENT OF THE TREASURY BUREAU OF THE PUBLIC DEBT REGULATIONS GOVERNING U.S. SAVINGS BONDS, SERIES A, B, C, D, E, F, G, H, J, AND K, AND U.S. SAVINGS NOTES Relief for Loss, Theft... of a mutilated bond should be submitted to the Bureau. (d) Execution of claims application. The...

Causes and Prevention of Theft and Mutilation in a High School Library Media Center: A Survey of Students' Attitudes and Practices.

ERIC Educational Resources Information Center

Baine, Martha S.

1993-01-01

Reports on a survey of high school students' attitudes toward the destruction of materials in their school library media center. The association of rule breaking with grade level, reasons for the behavior, willingness to report violators, and respondents' preferred preventative measures (e.g., improved photocopying services) are discussed.…

Assessment of Disgust Sensitivity in Children with an Age-Downward Version of the Disgust Emotion Scale

ERIC Educational Resources Information Center

Muris, Peter; Huijding, Jorg; Mayer, Birgit; Langkamp, Marit; Reyhan, Ela; Olatunji, Bunmi

2012-01-01

The present study examined the psychometric properties of the Disgust Emotion Scale for Children (DES-C). Principal components analysis of the DES-C data revealed five factors reflecting disgust toward (a) rotting foods, (b) injection and blood, (c) odors, (d) mutilation and death, and (e) animals, which were largely in keeping with the intended…

[Psychological care of patients with head and neck cancer].

PubMed

Moya, Mélanie

2015-09-01

Treatments for head and neck cancers are generally complex and debilitating. Surgery, often mutilating, profoundly affects the relationship between oneself and others and causes verbal communication, breathing and swallowing difficulties. The functional and aesthetic sequelae are a constant reminder to the patient of the disease and make them conscious of their appearance. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

A retrospective analysis of 34 potentially missed cases of female genital mutilation in the emergency department.

PubMed

Fawcett, Richard John; Kernohan, George

2017-09-12

To discover if healthcare professionals working within an ED are able to make a diagnosis of female genital mutilation (FGM) in those patients who have previously undergone the procedure and report it as per UK law. A retrospective analysis of patients' notes who were assigned an FGM code during the period of May 2015 to August 2016. Single-centre, large UK major trauma centre offering a tertiary FGM clinic. Any woman coded during the study period as having undergone FGM. Number of FGM cases identified by the ED. Mean age, presenting complaint, discharge diagnosis, genitourinary exam and defibulation status. 34 patients were identified as having undergone FGM, 19 had previously attended ED and none had their FGM identified during their ED attendance. The age range of those identified was 23 to 40 years. None had undergone defibulation. This study demonstrates that the identification of FGM victims by an ED is very poor, and more work needs to be done to increase awareness of the subject by front-line staff. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Canine Gouging: A Taboo Resurfacing in Migrant Urban Population.

PubMed

Noman, Anila Virani; Wong, Ferranti; Pawar, Ravikiran Ramakrishna

2015-01-01

Cosmopolitan cities have become a pool of migrants from different parts of the world, who carry their cultural beliefs and superstitions with them around the globe. Canine gouging is a kind of infant oral mutilation (IOM) which is widely practiced among rural population of Africa where the primary tooth bud of the deciduous canine is enucleated. The belief is that the life threatening illnesses in children like vomiting, diarrhoea, and fevers are caused by worms which infest on tooth buds. This case report is of a 15-year-old Somalian born boy, who presented at the dental institute with intermittent pain in his lower right permanent canine which was associated with a discharging intra oral buccal sinus. The tooth was endodontically treated and then restored with composite. General dental practitioners need to be vigilant when encountered with tooth presenting unusual morphology, unilateral missing tooth, and shift in the midline due to early loss of deciduous/permanent canines. Identification of any such dental mutilation practice will need further counselling of the individual and family members. It is the duty of every dental professional to educate and safeguard the oral and dental health of general public.

Egyptian government broadens ban on female genital mutilation.

PubMed

1996-01-01

An estimated 70-90% of girls in Egypt are subjected to female genital mutilation (FGM) before reaching puberty. Many Egyptians believe the practice to be ordained by Islam. Whether this is true, however, remains an issue of debate among Muslim scholars. Some Egyptian Christians also secure FGM for their girls. Egyptian law prohibits anyone without medical training from performing FGM, and any physician or health worker who causes permanent damage to a girl may face 3-10 years of hard labor. However, the law is frequently ignored, especially in rural areas, where village barbers and midwives perform the operations. In October 1995, Egyptian state hospitals were banned from performing FGM. Egypt has since broadened its ban to bar all health care workers in both state-run hospitals and private clinics from performing the procedure. No health care worker affiliated with the Ministry of Health is therefore allowed to perform FGM. Almost all Egyptian doctors are affiliated with the Ministry. While this recent move by the Health Minister is laudable, it remains to be seen whether he can enforce it. The secretary-general of the Egyptian Organization for Human Rights has urged parliament to enact legislation criminalizing FGM.

The issue of reinfibulation.

PubMed

Serour, Gamal I

2010-05-01

Reinfibulation is resuturing after delivery or gynecological procedures of the incised scar tissue resulting from infibulation. Despite the global fight against female genital mutilation/cutting (FGM/C), reinfibulation of previously mutilated or circumcised women is still performed in various countries around the world. A good estimate of the prevalence of reinfibulation is difficult to obtain, but it can be inferred that 6.5-10.4million women are likely to have been reinfibulated worldwide. Women who undergo reinfibulation have little influence on the decision-making and are usually persuaded by the midwife or birth attendant to undergo the procedure immediately following labor or gynecological operation. Although medicalization of reinfibulation may reduce its immediate risks, it has no effect on the incidence of long-term risks. Reinfibulation is performed mainly for the financial benefit of the operator, and cultural values that have been perpetuated for generations. Reinfibulation has no benefits and is associated with complications for the woman and the unborn child. Its medicalization violates the medical code of ethics and should be abandoned. International and national efforts should be combined to eradicate this practice. Copyright 2010 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

Vulvar Epidermoid Cyst and Type 2 Radical Genital Mutilation

PubMed Central

Birge, Ozer; Ozbey, Ertugrul Gazi; Arslan, Deniz; Erkan, Mustafa Melih; Demir, Feyza; Akgor, Utku

2015-01-01

About 100 million women are estimated to be circumcised globally. Various rates of complications have been encountered, especially after circumcision, such as bleeding, infection, shock, menstrual irregularity, difficulty in urination or common urinary tract infections, inguinal pain, difficulty in sexual intercourse, and genital circumcision scar especially at the vulvar region, and cystic or solid character mass in short and long term. Furthermore, the maternal-fetal morbidity and mortality increase due to bleeding and fistula, which develop after prolonged labor, travail, and difficult labors. Our aim in this paper was to discuss a 42-year-old multiparous female case who had undergone type 2 radical genital mutilation (circumcision) when she was 7 years of age, along with the literature, which has been evaluated for the gradually growing mass at the left inguinal canal region in the last 10 years and diagnosed as epidermoid inclusion cyst developing secondary to postcircumcision surgical ground trauma, since there was no other case found in the literature search that had been circumcised at such an early age and developing after circumcision at such advanced age, and, therefore, this is suggested to be the first case on this subject. PMID:26682078

Addressing female genital mutilation in Europe: a scoping review of approaches to participation, prevention, protection, and provision of services.

PubMed

Baillot, Helen; Murray, Nina; Connelly, Elaine; Howard, Natasha

2018-02-08

Public and policy attention to female genital mutilation (FGM) in diaspora communities has increased in Europe, but research remains limited and misinformation abounds. As a first step to addressing these issues, this study explored FGM prevention and response interventions in Europe, using a scoping literature review and key informant interviews. A scoping study design was selected, using Arksey and O'Malley's six-stage scoping framework to review identified sources. Key informant interviews were used to inform and add depth to literature findings. Findings were summarised thematically, guided by the Scottish Government's '4Ps' framework for tackling violence against women (i.e. participation, prevention, protection, providing services). Seventy literature sources, of 1095 screened, plus 16 individual and 3 group interview sources were included. Several countries have developed promising interventions supporting FGM resistance and recovery. However, gaps remain including community participation, professional knowledge and linkages, and evaluation of approaches. This scoping review is an initial attempt to describe available primary evidence on European initiatives responding to FGM. Further research is required to determine whether interventions are effective, while policy and practice development must be shaped and driven by the experiences, needs, and views of affected communities.

Infant oral mutilation - a child protection issue?

PubMed

Girgis, S; Gollings, J; Longhurst, R; Cheng, L

2016-04-01

Infant oral mutilation (IOM) is a primitive traditional practice involving the 'gouging out' of an infant's healthy primary tooth germs. This can lead to transmission of blood-borne diseases such as HIV/ AIDS, septicaemia and death. Other complications include eradication and/ or malformation of the child's permanent dentition. IOM is usually performed by village healers in low income countries as an accepted remedy for common childhood illness. The gingival swelling of the unerupted teeth is mistakenly thought to indicate the presence of 'tooth worms'. Crude methods to remove these are employed using unsterile tools. IOM has been reported in many African countries. More recently, some immigrants living in high income countries, such as the UK, have shown signs of IOM. Our aim is to raise awareness among clinicians about the existence of IOM practice being carried out among respective African immigrant groups. We encourage clinicians, particularly those working with paediatric patients to inform parents and carers of children with a history of IOM about the risks and consequences. As part of child safeguarding policies, dental practitioners and health care professionals should intervene if they are aware of any perceived plan that IOM is to be carried out in the future.

Female genital mutilation as sexual disability: perceptions of women and their spouses in Akure, Ondo State, Nigeria.

PubMed

Owojuyigbe, Michael; Bolorunduro, Miracle-Eunice; Busari, Dauda

2017-05-01

Disability encompasses the limitations on an individual's basic physical activities, and the consequent social oppressions such individual faces in society. In this regard, the limitation on the use of some parts of the genitals in a patriarchal system is considered a form of disability. This paper describes the perceptions of and the coping mechanisms employed by affected couples dealing with the consequences of female genital mutilation (FGM) as a form of sexual disability. Cultural Libertarianism was employed as a theoretical framework. The paper presents the results of a descriptive cross-sectional study conducted in Akure, Ondo State, Nigeria, with 10 male and 12 female respondents purposively selected through a snowball sampling for in-depth interviews. The findings present the justifications provided for the practice of FGM, and victims' perceptions of how it affects their sexual relations. Furthermore, it highlights coping strategies employed by affected women and their spouses. The study shows that the disabling consequence of FGM is largely sexual in nature, leading to traumatic experiences and negative beliefs about sex, and requiring a myriad of coping strategies employed by the disabled women, and their spouses, which may have its own implications for marital and sexual bliss.

Female genital mutilation/cutting in Africa.

PubMed

Odukogbe, Akin-Tunde A; Afolabi, Bosede B; Bello, Oluwasomidoyin O; Adeyanju, Ayodeji S

2017-04-01

Female genital mutilation/cutting (FGM/C) is a traditional practice in which the external female genitalia is partially or totally incised or excised for a non-therapeutic reason, usually without the consent of the individual. FGM/C is common in Africa with varying prevalence in different countries, though the incidence is reducing because it is considered a human rights issue with tremendous advocacy for its elimination by mainly nongovernmental organizations. It is mainly underreported in many countries in Africa especially where it has been declared illegal. FGM/C is often performed by a nonmedical practitioner with the aim of fulfilling religious or cultural rites and sometimes for economic benefits with the resultant acute, intermediate and late complications. It is sometimes performed by medical practitioners when it is speciously believed that its medicalization reduces the complications associated with the practice. The sensitivity of FGM/C is amplified when compared to male circumcision and voluntary alterations of the female external genitalia like piercing and tattooing as similar practices. The magnitude of the physical and psychosocial consequences of FGM/C outweighs the presumed benefits of the procedures highlighting the need for improvement of the multiple preventive measures by all the stakeholders and in all the sectors.

Interventions for healthcare providers to improve treatment and prevention of female genital mutilation: a systematic review.

PubMed

Balfour, Julie; Abdulcadir, Jasmine; Say, Lale; Hindin, Michelle J

2016-08-19

Studies on healthcare providers' awareness, knowledge and attitudes regarding female genital mutilation (FGM) have shown a lack of awareness of the prevalence, diagnosis, and management of FGM. Our objective was to systematically review the literature on interventions improving healthcare providers' capacities of prevention and treatment of FGM. Systematic review of the published and grey literature on interventions aimed at improving healthcare providers' capacities of prevention and treatment of FGM (1995-2015). Outcomes observed were knowledge and attitudes about FGM, medicalization, and prevention. Only two studies met our inclusion criteria. They reported on educational interventions aimed at increasing caregivers' knowledge on FGM. One was conducted with 59 providers, in Mali; the other one with 11 certified nurse-midwives in the United States. The studies report basic statistics regarding the improvement of healthcare professionals' knowledge, attitude on FGM and medicalization of the practice. Neither conducted multivariable analysis nor evaluated the training effects on the quality of the care offered, the clinical outcomes and the satisfaction of women attended, and prevention. As health care providers are essential in prevention and treatment of FGM, developing effective interventions is crucial.

Prioritizing and synthesizing evidence to improve the health care of girls and women living with female genital mutilation: An overview of the process.

PubMed

Stein, Karin; Hindin, Michelle J; Chou, Doris; Say, Lale

2017-02-01

Female genital mutilation (FGM) constitutes a harmful traditional practice that can have a profound impact on the health and well-being of girls and women who undergo the procedure. In recent years, due to international migration, healthcare providers worldwide are increasingly confronted with the need to provide adequate health care to this population. Recognizing this situation the WHO recently developed the first evidence-based guidelines on the management of health complications from FGM. To inform the guideline recommendations, an expert-driven, two-step process was conducted. The first step consisted of developing and ranking a list of priority research questions for the evidence retrieval. The second step involved conducting a series of systematic reviews and qualitative data syntheses. In the present paper, we first provide the methodology used in the development and ranking of the research questions (step 1) and then detail the common methodology for each of the systematic reviews and qualitative evidence syntheses (step 2). © 2017 International Federation of Gynecology and Obstetrics. The World Health Organization retains copyright and all other rights in the manuscript of this article as submitted for publication.

Psychological impact of female genital mutilation among adolescent Egyptian girls: a cross-sectional study.

PubMed

Ahmed, Magdy R; Shaaban, Mohamed M; Meky, Heba K; Amin Arafa, Mohamed E; Mohamed, Tamer Y; Gharib, Waleed F; Ahmed, Abeer B

2017-08-01

Worldwide, at least 200 million women and girls have undergone female genital mutilation (FGM). The medical and sexual consequences have been documented, but the psychological impact has not been studied to the same extent. The aim of this study was to explore the relationship between FGM and psychiatric problems among adolescent girls. A total of 204 girls, aged 14-19 years, were included in a cross-sectional study conducted at Suez Canal University Hospitals. All participants completed an Arabic-validated, structured questionnaire covering nine symptom scales. Sociodemographic data were also collected. Main outcome measures were the prevalence of psychiatric problems among adolescent girls who had undergone FGM. Overall, 66.2% of girls had undergone FGM. The percentage in rural areas was 91.8%, compared with 43.0% in urban areas. There were no significant differences between the FGM and non-FGM groups as regards religion, educational and socioeconomic levels. FGM girls had a significantly higher level of psychological problems with regard to somatisation, depression, anxiety, phobic anxiety and hostility compared with non-FGM girls (p < .0001). FGM is a traumatic experience that may leave a lasting psychological mark and a negative impact on the psychological status of affected girls.

Female genital mutilation/cutting in Africa

PubMed Central

Afolabi, Bosede B.; Bello, Oluwasomidoyin O.; Adeyanju, Ayodeji S.

2017-01-01

Female genital mutilation/cutting (FGM/C) is a traditional practice in which the external female genitalia is partially or totally incised or excised for a non-therapeutic reason, usually without the consent of the individual. FGM/C is common in Africa with varying prevalence in different countries, though the incidence is reducing because it is considered a human rights issue with tremendous advocacy for its elimination by mainly nongovernmental organizations. It is mainly underreported in many countries in Africa especially where it has been declared illegal. FGM/C is often performed by a nonmedical practitioner with the aim of fulfilling religious or cultural rites and sometimes for economic benefits with the resultant acute, intermediate and late complications. It is sometimes performed by medical practitioners when it is speciously believed that its medicalization reduces the complications associated with the practice. The sensitivity of FGM/C is amplified when compared to male circumcision and voluntary alterations of the female external genitalia like piercing and tattooing as similar practices. The magnitude of the physical and psychosocial consequences of FGM/C outweighs the presumed benefits of the procedures highlighting the need for improvement of the multiple preventive measures by all the stakeholders and in all the sectors. PMID:28540220

A systematic review of the evidence on clitoral reconstruction after female genital mutilation/cutting.

PubMed

Abdulcadir, Jasmine; Rodriguez, Maria I; Say, Lale

2015-05-01

Clitoral reconstruction is a new surgical technique for women who have undergone female genital mutilation/cutting (FGM/C). To review evidence on the safety and efficacy of clitoral reconstruction. PubMed and Cochrane databases were searched for articles published in any language from database inception until May 2014. Search terms related to FGM/C and clitoral reconstruction were used in various combinations. Studies of any design that reported on safety or clinical outcomes (e.g. appearance, pain, sexual response, or patient satisfaction) associated with clitoral reconstruction after FGM/C were included. Evidence was summarized and systematically assessed via a standard data abstraction form. Four of 269 identified articles were included. They were fair to poor in quality. Summary measures could not be computed owing to heterogeneity. The studies reported on immediate surgical complications, clitoral appearance, dyspareunia or chronic pain, and clitoral function postoperatively via non-standardized scales. Women who request clitoral reconstruction should be informed about the scarcity of evidence available. Additional research is needed on the safety and efficacy of the procedure to identify both long-term outcomes and which women might benefit. Copyright © 2015 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

Missed opportunities for diagnosis of female genital mutilation.

PubMed

Abdulcadir, Jasmine; Dugerdil, Adeline; Boulvain, Michel; Yaron, Michal; Margairaz, Christiane; Irion, Olivier; Petignat, Patrick

2014-06-01

To investigate missed opportunities for diagnosing female genital mutilation (FGM) at an obstetrics and gynecology (OB/GYN) department in Switzerland. In a retrospective study, we included 129 consecutive women with FGM who attended the FGM outpatient clinic at the Department of Gynecology and Obstetrics at the University Hospitals of Geneva between 2010 and 2012. The medical files of all women who had undergone at least 1 previous gynecologic exam performed by an OB/GYN doctor or a midwife at the study institution were reviewed. The type of FGM reported in the files was considered correct if it corresponded to that reported by the specialized gynecologist at the FGM clinic, according to WHO classification. In 48 (37.2%) cases, FGM was not mentioned in the medical file. In 34 (26.4%) women, the diagnosis was correct. FGM was identified but erroneously classified in 28 (21.7%) cases. There were no factors (women's characteristics or FGM type) associated with missed diagnosis. Opportunities to identify FGM are frequently missed. Measures should be taken to improve FGM diagnosis and care. Copyright © 2014 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

Suicide in Inmates in Nazis and Soviet Concentration Camps: Historical Overview and Critique

PubMed Central

López-Muñoz, Francisco; Cuerda-Galindo, Esther

2016-01-01

Living conditions in concentration camps were harsh and often inhumane, leading many prisoners to commit suicide. We have reviewed this topic in Nazi concentration camps (KL), Soviet special camps, and gulags, providing some preliminary data for our research. Data show that the incidence of suicide in Nazi KL could be up to 30 times higher than the general population and was also much higher than in Soviet special camps (maybe due to more favorable conditions for prisoners and the abolishment of death penalty), while available data on Soviet gulags are contradictory. However, data interpretation is very controversial, because, for example, the Nazi KL authorities used to cover-up the murder victims as suicides. Most of the suicides were committed in the first years of imprisonment, and the method of suicide most commonly used was hanging, although other methods included cutting blood vessels, poisoning, contact with electrified wire, or starvation. It is possible to differentiate two behaviors when committing suicide; impulsive behavior (contact with electrified barbed wire fences) or premeditated suicide (hanging up or through poison). In Soviet special camps, possible motives for suicides could include feelings of guilt for crimes committed, fear of punishment, and a misguided understanding of honor on the eve of criminal trials. Self-destructive behaviors, such as self-mutilation in gulag camps or prisoners who let themselves die, have been widely reported. Committing suicide in concentration camps was a common practice, although precise data may be impossible to obtain. PMID:27303312

Self-Inflicted Finger Injury in Individuals With Spinal Cord Injury: An Analysis of 5 Cases

PubMed Central

Frost, Frederick S; Mukkamala, Sridevi; Covington, Edward

2008-01-01

Objective: To describe the occurrence of finger autophagia in 5 persons with traumatic spinal cord injury and to present a discussion of putative causes and potential treatments. Background: Minor self-mutilating actions, such as nail biting and hair pulling, are common in humans and usually benign. In some circumstances, these behaviors are associated with obsessive-compulsive personality traits. In humans, self-injurious biting behaviors are well described in the setting of mental retardation and psychosis and in persons with Lesch-Nyhan syndrome. Rare cases of human autophagia in persons with intact cognition have been reported, most commonly in the setting of acquired nervous system lesions. After spinal cord injury, it has been suggested that this behavior constitutes a human variant of animal autotomy and a response to neuropathic pain. Design: Case presentation narrative. Main Outcome Measures: Photographic and radiological study, administration of Yale-Brown Obsessive-Compulsive Scale (YBOCS). Findings: In 5 patients with complete tetraplegia, pain in the hands was present in only one instance. The severity of autoamputation varied from minor to extreme. In all cases, damage was confined to analgesic body parts. In 3 cases, autophagia behavior was discovered in progress. Treatments included pharmacotherapy, counseling, and behavioral therapy, with mixed results. All patients were intelligent, willing to discuss their issues, and able to identify conditions of stress and isolation in their lives. Mild preinjury obsessive-compulsive behaviors, such as nail biting, were universal. On the YBOCS, only 1 patient scored in a range indicative of mild obsessive-compulsive symptomatology. Conclusions: This group exhibited heterogeneous medical, social, and cultural characteristics. A link between pain and self-injurious behavior could not be demonstrated. This behavior may be viewed as an extreme variant of nail biting, with potential ominous complications. Treatment strategies have been employed with mixed results. PMID:18533422

Combat and peacekeeping operations in relation to prevalence of mental disorders and perceived need for mental health care: findings from a large representative sample of military personnel.

PubMed

Sareen, Jitender; Cox, Brian J; Afifi, Tracie O; Stein, Murray B; Belik, Shay-Lee; Meadows, Graham; Asmundson, Gordon J G

2007-07-01

Although military personnel are trained for combat and peacekeeping operations, accumulating evidence indicates that deployment-related exposure to traumatic events is associated with mental health problems and mental health service use. To examine the relationships between combat and peacekeeping operations and the prevalence of mental disorders, self-perceived need for mental health care, mental health service use, and suicidality. Cross-sectional, population-based survey. Canadian military. A total of 8441 currently active military personnel (aged 16-54 years). The DSM-IV mental disorders (major depressive disorder, posttraumatic stress disorder, generalized anxiety disorder, panic disorder, social phobia, and alcohol dependence) were assessed using the World Mental Health version of the World Health Organization Composite International Diagnostic Interview, a fully structured lay-administered psychiatric interview. The survey included validated measures of self-perceived need for mental health treatment, mental health service use, and suicidal ideation. Lifetime exposure to peacekeeping and combat operations and witnessing atrocities or massacres (ie, mutilated bodies or mass killings) were assessed. The prevalences of any past-year mental disorder assessed in the survey and self-perceived need for care were 14.9% and 23.2%, respectively. Most individuals meeting the criteria for a mental disorder diagnosis did not use any mental health services. Deployment to combat operations and witnessing atrocities were associated with increased prevalence of mental disorders and perceived need for care. After adjusting for the effects of exposure to combat and witnessing atrocities, deployment to peacekeeping operations was not associated with increased prevalence of mental disorders. This is the first study to use a representative sample of active military personnel to examine the relationship between deployment-related experiences and mental health problems. It provides evidence of a positive association between combat exposure and witnessing atrocities and mental disorders and self-perceived need for treatment.

Identification of individual foothill yellow-legged frogs (Rana boylii) using chin pattern photographs: a non-invasive and effective method for small population studies

Treesearch

K.R. Marlow; K.D. Wiseman; Clara Wheeler; J.E.  Drennan; R.E.  Jackman

2016-01-01

The ability to identify individual animals is a valuable tool in the study of amphibian population dynamics, movement ecology, social behavior, and habitat use. Numerous methods of marking amphibians have been employed including the use of passive integrated transponder (PIT) tags, radio-transmitters, elastomers, branding, and mutilation techniques such as toe...

Tanzania: Background and Current Conditions

DTIC Science & Technology

2010-12-08

movement of refugees. Societal violence against women and persons with albinism and women persisted. Female genital mutilation (FGM), especially of...Zanzibar /islands over 99% Muslim Literacy: Male, 77.5%; Female , 66.2% (2003) Under-5 Mortality: 165 deaths/1,000 live births HIV/AIDS adult...infection rate: 6.2% (2007) Life Expectancy, years at birth: Male, 50.5 Female , 53.5 (2009 est.) Sources: CIA World Factbook 2010. Tanzania

Tanzania: Background and Current Conditions

DTIC Science & Technology

2010-07-23

persons with albinism and women persisted. Female genital mutilation (FGM), especially of young girls, continued to be practiced. Trafficking in...35%; Zanzibar /islands over 99% Muslim Literacy: Male, 77.5%; Female , 66.2% (2003) Under-5 Mortality: 165 deaths/1,000 live births HIV/AIDS adult...infection rate: 6.2% (2007) Life Expectancy, years at birth: Male, 50.5 Female , 53.5 (2009 est.) Sources: CIA World Factbook 2010. Tanzania

Egypt: Background and U.S. Relations

DTIC Science & Technology

2006-06-14

genital mutilation (FGM) remained a serious problem due to widespread cultural acceptance, despite the government’s attempts to eliminate the practice... female ) Unemployment Rate: 15%-20% (est.) External Debt: (as % of GDP) $33 billion 37.8% Source: U.S. Central Intelligence Agency World Factbook 2005. CRS...group’s members have been detained. In May 2005, female Kefaya activists accused Egyptian police officers of sexually assaulting female protesters

African, male attitudes on female genital mutilation: an Australian survey.

PubMed

Shahid, Usama; Rane, Ajay

2017-11-01

Female genital mutilation (FGM) is a traditional practice where female genital organs are altered for non-medical reasons. The custom is outlawed in Australia and associated with an array of medical consequences. Due to the recent influx of migrants from regions endemic to FGM, the practice is becoming a growing concern locally. This federal government funded study aimed to elicit the poorly understood perceptions that young, Sub-Saharan African, migrant males residing in Townsville, Australia have on FGM. Through piloted questionnaires we found that amongst the 67 participants, 23.9% believed that FGM should be allowed under Australian Law. The independent predictors of supportive attitudes in favour of FGM were having resided in Australia for five or less years (p = .016, 95% CI 0.99-8.09) and coming from a basic educational background (high school or TAFE) (p = .003, 95% CI 1.3-12.4). This study also found that participant perceptions on FGM were amenable to change through educational interventional strategies. Impact statement Female genital mutilation (FGM) is a traditional practice where female genital organs are altered for non-medical reasons. The role that males play in the continuation of this outlawed practice remains poorly understood. No research has ever been conducted in Australia looking at the perception that young, migrant males have on FGM. Several European-based studies have examined the perceptions of older, poorly educated, migrant male cohorts. Generally, these studies show that the attitudinal support for FGM and intention to practice remains relatively high amongst these cohorts. This study examined the attitudes of a young, Sub-Saharan African, migrant, male cohort residing in Australia. This adds to the literature base by establishing the perceptions and associated socio-demographic variables of this unique and influential subset of the migrant population. This directly facilitates the development of interventional strategies against FGM by highlighting those most likely to have an attitudinal support in favour of FGM. Consequentially, this 'at risk' group can be more effectively focussed on interventional programmes and be further investigated in larger scale studies.

Fluidity of the Subsyndromal Phenomenology of Borderline Personality Disorder Over 16 Years of Prospective Follow-Up.

PubMed

Zanarini, Mary C; Frankenburg, Frances R; Reich, D Bradford; Fitzmaurice, Garrett M

2016-07-01

The purpose of this study was to determine the cumulative rates of 2- and 4-year remission, and the recurrences that follow them, of 24 symptoms of borderline personality disorder over 16 years of prospective follow-up. A total of 290 inpatients meeting rigorous criteria for borderline personality disorder and 72 axis II comparison subjects were assessed during their index admission using a series of semistructured diagnostic interviews. The same instruments were readministered at eight contiguous 2-year time periods. The 12 acute symptoms (e.g., self-mutilation, help-seeking suicide attempts) of borderline personality disorder were more likely to remit for a period of 2 years and for a period of 4 years than the 12 temperamental symptoms (e.g., chronic anger/frequent angry acts, intolerance of aloneness) of this disorder. They were also less likely to recur after a remission lasting 2 years or a remission lasting 4 years. Taken together, the symptoms of borderline personality disorder are quite fluid, with remissions and recurrences being common. However, the more clinically urgent acute symptoms of borderline personality disorder seem to have a better prognosis than the less turbulent temperamental symptoms of the disorder.

Fluidity of the Subsyndromal Phenomenology of Borderline Personality Disorder over 16 Years of Prospective Follow-up

PubMed Central

Zanarini, Mary C.; Frankenburg, Frances R.; Reich, D. Bradford; Fitzmaurice, Garrett M.

2016-01-01

Objective The purpose of this study was to determine the cumulative rates of two and four-year remission, and the recurrences that follow them, of 24 symptoms of borderline personality disorder over 16 years of prospective follow-up. Method 290 inpatients meeting rigorous criteria for borderline personality disorder and 72 axis II comparison subjects were assessed during their index admission using a series of semistructured diagnostic interviews. The same instruments were readministered at eight contiguous two-year time periods. Results The 12 acute symptoms (e.g., self-mutilation, help-seeking suicide attempts) of borderline personality disorder were more likely to remit for a period of two years and for a period of four years than the 12 temperamental symptoms (e.g., chronic anger/frequent angry acts, intolerance of aloneness) of this disorder. They were also less likely to recur after a remission lasting two years or a remission lasting four years. Conclusions Taken together, the symptoms of borderline personality disorder are quite fluid, with remissions and recurrences being common. However, the more clinically urgent acute symptoms of borderline personality disorder seem to have a better prognosis than the less turbulent temperamental symptoms of the disorder. PMID:26869248

Solvothermal one-step synthesis of Ni-Al layered double hydroxide/carbon nanotube/reduced graphene oxide sheet ternary nanocomposite with ultrahigh capacitance for supercapacitors.

PubMed

Yang, Wanlu; Gao, Zan; Wang, Jun; Ma, Jing; Zhang, Milin; Liu, Lianhe

2013-06-26

A Ni-Al layered double hydroxide (LDH), mutil-wall carbon nanotube (CNT), and reduced graphene oxide sheet (GNS) ternary nanocomposite electrode material has been developed by a facile one-step ethanol solvothermal method. The obtained LDH/CNT/GNS composite displayed a three-dimensional (3D) architecture with flowerlike Ni-Al LDH/CNT nanocrystallites gradually self-assembled on GNS nanosheets. GNS was used as building blocks to construct 3D nanostructure, and the LDH/CNT nanoflowers in turn separated the two-dimensional (2D) GNS sheets, which preserved the high surface area of GNSs. Furthermore, the generated porous networks with a narrow pore size distribution in the LDH/CNT/GNS composite were also demonstrated by the N2 adsorption/desorption experiment. Such morphology would be favorable to improve the mass transfer and electrochemical action of the electrode. As supercapacitor electrode material, the LDH/CNT/GNS hybrid exhibited excellent electrochemical performance, including ultrahigh specific capacitance (1562 F/g at 5 mA/cm(2)), excellent rate capability, and long-term cycling performance, which could be a promising energy storage/conversion material for supercapacitor application.

Total Hip Arthroplasty in an Inveterate Femoral Neck Fracture in a Patient with Congenital Insensitivity to Pain with Anhidrosis.

PubMed

Dagnino, Augusto; Ursino, Nicola; Ripamonti, Carlo A M; Fiorentini, Carlo E; Scelsi, Michele; D'Ambrosi, Riccardo; Portinaro, Nicola M

2017-12-01

Congenital insensitivity to pain with anhidrosis (CIPA) is an extremely rare disorder characterized by autonomic and sensory nerves malfunction with insensitivity to both deep and superficial painful stimuli, inability to sweat and produce tears, and mild to moderate mental retardation with self-mutilating behavior. Related consequences of inveterate musculoskeletal injuries represent a major issue for these patients, since pain cannot act as a protection mechanism. For the same reason, the patients are at risk during postoperative rehabilitation, which should be taken into account when selecting an orthopaedic implant. To our knowledge, only one case of total hip arthroplasty has been reported in the literature to date. A 21-year-old Caucasian male patient affected with CIPA arrived at our attention complaining about a functional limitation of the left hip. No history of trauma was reported. The X-rays showed an inveterate femoral neck fracture with a severe necrosis and resorption of the femoral head. We decided to perform a total hip arthroplasty with a cemented stem and a cemented dual mobility cup. The postoperative course and rehabilitation were satisfactory, with excellent clinical results, measured with the Harris Hip Score at 1 year.

Total Hip Arthroplasty in an Inveterate Femoral Neck Fracture in a Patient with Congenital Insensitivity to Pain with Anhidrosis

PubMed Central

Dagnino, Augusto; Ursino, Nicola; Ripamonti, Carlo A. M.; Fiorentini, Carlo E.; Scelsi, Michele; D'Ambrosi, Riccardo; Portinaro, Nicola M.

2017-01-01

Congenital insensitivity to pain with anhidrosis (CIPA) is an extremely rare disorder characterized by autonomic and sensory nerves malfunction with insensitivity to both deep and superficial painful stimuli, inability to sweat and produce tears, and mild to moderate mental retardation with self-mutilating behavior. Related consequences of inveterate musculoskeletal injuries represent a major issue for these patients, since pain cannot act as a protection mechanism. For the same reason, the patients are at risk during postoperative rehabilitation, which should be taken into account when selecting an orthopaedic implant. To our knowledge, only one case of total hip arthroplasty has been reported in the literature to date. A 21-year-old Caucasian male patient affected with CIPA arrived at our attention complaining about a functional limitation of the left hip. No history of trauma was reported. The X-rays showed an inveterate femoral neck fracture with a severe necrosis and resorption of the femoral head. We decided to perform a total hip arthroplasty with a cemented stem and a cemented dual mobility cup. The postoperative course and rehabilitation were satisfactory, with excellent clinical results, measured with the Harris Hip Score at 1 year. PMID:29270564

Allotransplanted DRG neurons or Schwann cells affect functional recovery in a rodent model of sciatic nerve injury.

PubMed

Dayawansa, Samantha; Wang, Ernest W; Liu, Weimin; Markman, John D; Gelbard, Harris A; Huang, Jason H

2014-11-01

In this study, the functional recoveries of Sprague-Dawley rats following repair of a complete sciatic nerve transection using allotransplanted dorsal root ganglion (DRG) neurons or Schwann cells were examined using a number of outcome measures. Four groups were compared: (1) repair with a nerve guide conduit seeded with allotransplanted Schwann cells harvested from Wistar rats, (2) repair with a nerve guide conduit seeded with DRG neurons, (3) repair with solely a nerve guide conduit, and (4) sham-surgery animals where the sciatic nerve was left intact. The results corroborated our previous reported histology findings and measures of immunogenicity. The Wistar-DRG-treated group achieved the best recovery, significantly outperforming both the Wistar-Schwann group and the nerve guide conduit group in the Von Frey assay of touch response (P < 0.05). Additionally, Wistar-DRG and Wistar-Schwann seeded repairs showed lower frequency and severity in an autotomy measure of the self-mutilation of the injured leg because of neuralgia. These results suggest that in complete peripheral nerve transections, surgical repair using nerve guide conduits with allotransplanted DRG and Schwann cells may improve recovery, especially DRG neurons, which elicit less of an immune response.

A Fully Implanted Drug Delivery System for Peripheral Nerve Blocks in Behaving Animals

PubMed Central

Pohlmeyer, Eric A.; Jordon, Luke R.; Kim, Peter; Miller, Lee E.

2009-01-01

Inhibiting peripheral nerve function can be useful for many studies of the nervous system or motor control. Accomplishing this in a temporary fashion in animal models by using peripheral nerve blocks permits studies of the immediate effects of the loss, and/or any resulting short-term changes and adaptations in behavior or motor control, while avoiding the complications commonly associated with permanent lesions, such as sores or self-mutilation. We have developed a method of quickly and repeatedly inducing temporary, controlled motor deficits in rhesus macaque monkeys via a chronically implanted drug delivery system. This assembly consists of a nerve cuff and a subdermal injection dome, and has proved effective for delivering local anesthetics directly to peripheral nerves for many months. Using this assembly for median and ulnar nerve blocks routinely resulted in over 80% losses in hand and wrist strength for rhesus monkeys. The assembly was also effective for inducing ambulatory motor deficits in rabbits through blocks of the sciatic nerve. Interestingly, while standard anesthetics were sufficient for the rabbit nerve blocks, the inclusion of epinephrine was essential for achieving significant motor blockade in the monkeys. PMID:19524613

Manipulation tactics of patients with neurotic disorders in everyday life and during therapy.

PubMed

Mandal, Eugenia; Horak, Adam

2016-01-01

The objective of the study was to examine the repertoire and intensity of manipulation tactics of neurotic patients in everyday life and during therapy, as well as diagnosing the intensity of Machiavellianism in neurotic patients. There were 111 study subjects: 44 patients with diagnosed neurotic disorders, 44 people from the control group and 23 therapists. The manipulation tactics were measured by means of survey methods of E. Mandal and D. Kocur and Machiavellianism was measured using the MACH-IV scale of M. Christi and F. Geis. In comparison to people from the control group, the patients were more willing to use manipulation tactics such as guilt induction, threatening to break up the relationship, and self-mutilation but less willing to use supplication/begging. The intensity of tendency to undertake manipulation was higher in everyday life than during therapy. The Machiavellianism of patients was positively correlated with the tendency to employ manipulation tactics. Differences within the scope of general Machiavellianism between the patients and the control group were not noted. The manipulation tactics of neurotic patients are of morbid nature. They are related to anxiety, feeling of guilt and hostility. The tendency to manipulate correlates with Machiavellianism.

"Your feet's too big": an inquiry into psychological and symbolic meanings of the foot.

PubMed

Zerbe, K J

1985-01-01

The foot is a highly cathected appendage that is commonly singled out as the brunt of humorous or derisive remarks, as if it embodies repugnance and disgust. Attitudes toward the foot are overdetermined, bearing the imprint of man's early linguistic patterns and individual dynamics. This article suggests that feet are symbolic because they bear the feelings derived from earlier separations, good and bad object representations, collective memories, and genital representations. The foot's role as symbol of both the male and female genitals, repository of badness, symbol of passivity, initiator of movement, and site of self-mutilation have been briefly reviewed. As Fats Waller rhapsodizes that the "feet's too big," he finds a convenient way to displace his symbiotic and erotic anxieties vis-à-vis women. Similarly, patients who come for psychiatric treatment and psychotherapy frequently make references to their feet or use them in specific ways. An understanding of this type of communication can often provide insight into individual dynamics and enhance treatment. The weight placed on these communications depends, of course, on the vicissitudes of the previous therapeutic work as well as on the particular problems of the patient.

United Nations Impact on Child Soldier Use in Eastern Democratic Republic of the Congo: 1999-2007

DTIC Science & Technology

2008-12-12

control typically included terror techniques such as cannibalism, maiming and mutilation , rape of women and children, and forced recruitment and...was that none of the children interviewed were female . The demobilization of girl-soldiers was particularly confounding. Despite the definition of...Clemensac acknowledged the unique and troubling nature of female child soldiers and their endurance of sexual violence as an unanswered shortcoming

Trafficking in Persons: U.S. Policy and Issues for Congress

DTIC Science & Technology

2008-01-10

domestic violence; sexual assault; abusive sexual contact; prostitution; sexual exploitation; female genital mutilation ; being held hostage; peonage...countries in the region are destination points for low-skilled workers, both male and female , from South and Southeast Asia who migrate willingly to work...through FY2004, HHS certified 1,076 people; 94% of the victims were female .87 CRS-29 87 (...continued) Department of Labor, Department of Homeland

Trafficking in Persons: U.S. Policy and Issues for Congress

DTIC Science & Technology

2010-02-18

incest; domestic violence; sexual assault; abusive sexual contact; prostitution; sexual exploitation; female genital mutilation ; being held hostage...approximately 600,000 to 800,000 people are trafficked across borders each year—80% of whom are female and up to 50% of whom are minors.7 If...documentation. They are often aided by corrupt police and migration officials. Female traffickers reportedly play a more prominent role in TIP than in other

Building Partnership Capacity at the Ministerial Level to Improve Gender Equality

DTIC Science & Technology

2014-06-13

rape, sexual slavery, enforced prostitution , forced sterilization and the forced termination of pregnancies, and mutilations – and the ways in which...40% of all Liberian women were raped. Loss of family forces women to depend on men and may lead to rape, forced marriage, prostitution , domestic...differs from the Iraq and Afghanistan experiences, this nevertheless provides U.S. strategists with an opportunity to begin diffusing problematic gender

Counselling for deinfibulation among women with type III female genital mutilation: A systematic review.

PubMed

Bello, Segun; Ogugbue, Miriam; Chibuzor, Moriam; Okomo, Uduak; Meremikwu, Martin M

2017-02-01

Counselling is a routine practice done before deinfibulation in women with type III female genital mutilation (FGM). However, cultural and social pressures, in addition to maladaptation to the changes in the body post deinfibulation, cause some women to choose to be reinfibulated after being deinfibulated. To conduct a systematic review of the impact of counselling prior to deinfibulation on patient satisfaction, marital satisfaction, and rate of requests for reinfibulation among women living with type III FGM. The secondary aim was to assess the impact of male partner involvement in counselling on patient satisfaction, marital satisfaction, and rate of requests for reinfibulation. Major databases including Cochrane Central Register of Controlled Trials, Medline, SCOPUS, and ClinicalTrials.gov were searched until August 2015. Studies comparing women with type III FGM who received counselling before deinfibulation versus no counselling were included. Two team members independently screened and collected data. No eligible studies were identified. There is no evidence to conclude that counselling before deinfibulation influences patients' satisfaction with overall quality of care or rates of request for reinfibulation. CRD42015024675. © 2017 International Federation of Gynecology and Obstetrics. The World Health Organization retains copyright and all other rights in the manuscript of this article as submitted for publication.

Diseased, maimed, mutilated: categorizations of disability and an ugly law in late nineteenth-century Chicago.

PubMed

Coco, Adrienne Phelps

2010-01-01

The article places Chicago's "ugly" law—an 1881 municipal ordinance that fined "any person who is diseased, maimed, mutilated or in any way deformed so as to be an unsightly or disgusting object" for appearing in public—within the context of late nineteenth-century imaginings of disability. Drawing on the framework of disability studies, this paper demonstrates that nineteenth-century understandings of disability had little to do with the impairments of individuals but instead were tied to the status of the person with the disability. Examining the role of disabled people as workers, as bodies and as charity recipients reveals the hierarchies of disability in late nineteenth-century Chicago and demonstrates who the ugly law intended to restrict and, just as importantly, who it did not. While the law appears to be a blanket indictment of all physically disabled people, multiple sources indicate that the public expected disabled veterans, workers, and freak show performers to occupy the public realm; they therefore cannot be the intended objects of the ordinance. Instead, Chicago's ugly law was one of many pieces of legislation enacted in the wake of the panic of 1873 that attempted to eradicate street begging in general by specifically targeting beggars with disabilities.

The Obstetric Consequences of Female Genital Mutilation/Cutting: A Systematic Review and Meta-Analysis

PubMed Central

Berg, Rigmor C.; Underland, Vigdis

2013-01-01

Various forms of female genital mutilation/cutting (FGM/C) have been performed for millennia and continue to be prevalent in parts of Africa. Although the health consequences following FGM/C have been broadly investigated, divergent study results have called into question whether FGM/C is associated with obstetric consequences. To clarify the present state of empirical research, we conducted a systematic review of the scientific literature and quantitative meta-analyses of the obstetric consequences of FGM/C. We included 44 primary studies, of which 28 were comparative, involving almost 3 million participants. The methodological study quality was generally low, but several studies reported the same outcome and were sufficiently similar to warrant pooling of effect sizes in meta-analyses. The meta-analyses results showed that prolonged labor, obstetric lacerations, instrumental delivery, obstetric hemorrhage, and difficult delivery are markedly associated with FGM/C, indicating that FGM/C is a factor in their occurrence and significantly increases the risk of delivery complications. There was no significant difference in risk with respect to cesarean section and episiotomy. These results can make up the background documentation for health promotion and health care decisions that inform work to reduce the prevalence of FGM/C and improve the quality of services related to the consequences of FGM/C. PMID:23878544

The ongoing violence against women: Female Genital Mutilation/Cutting.

PubMed

Muteshi, Jacinta K; Miller, Suellen; Belizán, José M

2016-04-18

Female Genital Mutilation/Cutting (FGM/C) comprises different practices involving cutting, pricking, removing and sometimes sewing up external female genitalia for non-medical reasons. The practice of FGM/C is highly concentrated in a band of African countries from the Atlantic coast to the Horn of Africa, in areas of the Middle East such as Iraq and Yemen, and in some countries in Asia like Indonesia. Girls exposed to FGM/C are at risk of immediate physical consequences such as severe pain, bleeding, and shock, difficulty in passing urine and faeces, and sepsis. Long-term consequences can include chronic pain and infections. FGM/C is a deeply entrenched social norm, perpetrated by families for a variety of reasons, but the results are harmful. FGM/C is a human rights issue that affects girls and women worldwide. The practice is decreasing, due to intensive advocacy activities of international, national, and grassroots agencies. An adolescent girl today is about a third less likely to be cut than 30 years ago. However, the rates of abandonment are not high enough, and change is not happening as rapidly as necessary. Multiple interventions have been implemented, but the evidence base on what works is lacking. We in reproductive health must work harder to find strategies to help communities and families abandon these harmful practices.

Attitudes toward organ donation in rural areas of southeastern Spain.

PubMed

Conesa, C; Ríos, A; Ramírez, P; Cantéras, M; Rodríguez, M M; Parrilla, P

2006-04-01

Rural areas present a worse attitude toward organ donation. However, the factors conditioning this attitude are not well known. Our aim was to determine the profile of the population opposed to donation in rural areas. A random sample stratified by age and sex was obtained from municipalities with less than 10,000 inhabitants. Attitudes toward donation were assessed by a questionnaire which evaluated variables that may influence these attitudes. A descriptive statistical study used the Student t test and chi-square test as well as a logistic regression analysis. Among 181 respondents, 63% were in favor of donation and 37% against or undecided. Among the reasons to be against donation were rejection of body mutilation (43%) and fear of apparent death (41%). The psychosocial variables against donation were age >or=44 years, primary education or below, no previous experience with donation, no prosocial activities, an unfavorable opinion of the partner, and fear of corpse mutilation. The variables persisting in the multivariate analysis were level of education, previous experience, prosocial activities, and fear of corpse manipulation. Among the rural population the profile of a person opposed to donation was someone older than 44 years, with a low level of education and no previous experience with donation, who does not participate in prosocial activities and is opposed to corpse manipulation.

Regulation of sexual development in the basal termite Cryptotermes secundus: mutilation, pheromonal manipulation or honest signal?

PubMed

Korb, Judith

2005-01-01

Social insect colonies are not the harmonious entities they were once considered. Considerable conflicts exist between colony members, as has been shown for Hymenoptera. For termites, similar studies are lacking, but aggressive manipulations have been claimed to regulate sexual development, and even to account for the evolution of workers. This study on a basal termite, Cryptotermes secundus (Kalotermitidae), suggests that the importance of aggressive manipulations in termites has been overemphasized. Wing-bud mutilations, a means proposed to regulate the development of dispersing sexuals (alates), seem to be artifacts of handling conditions that cause disturbance. Aggressive behaviors never occurred unless colonies were disturbed. Theoretical considerations further showed that the potential for intense conflict among termite nestmates is low compared to hymenopteran societies. Strong conflicts are only expected to occur over the replacement of natal reproductives that died, while less intense conflicts should exist over the development into alates when food in the colony becomes limiting. Accordingly, intracolonial aggressive interactions over replacement are common, whereas nestmates seem to manipulate alate development via proctodeal feeding when food resources decline. However, the latter is rather an honest signal than a manipulation because only the most competent prospective dispersers can impede the development of nestmates.

Deinfibulation for treating urologic complications of type III female genital mutilation: A systematic review.

PubMed

Effa, Emmanuel; Ojo, Olumuyiwa; Ihesie, Austin; Meremikwu, Martin M

2017-02-01

Women and girls who have undergone type III female genital mutilation (FGM) may suffer urologic complications such as recurrent urinary tract infections, obstruction, stones, and incontinence. To assess the effectiveness of deinfibulation for preventing and treating urologic complications in women and girls living with FGM. The following major databases were searched from inception to August 2015: Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, SCOPUS, Web of Science, and ClinicalTrials.gov without language restrictions. Randomized controlled studies (RCTs) or observational studies with controls were considered. We screened the results of the search independently for potentially relevant studies and applied inclusion and exclusion criteria for the full texts of the relevant studies. No RCTs were found. We found three case reports and a retrospective case review, all of which were excluded. There is no evidence on the use of deinfibulation to improve urologic complications among women with type III FGM. Current clinical practice may be informed by anecdotal evidence from case reports. Appropriate RCTs and observational studies with comparison groups in countries where FGM is common are needed. PROSPERO registration: CRD42015024901. © 2017 International Federation of Gynecology and Obstetrics. The World Health Organization retains copyright and all other rights in the manuscript of this article as submitted for publication.

The timing of female genital mutilation and the role of contralateral palpal insertions in the spider Cyclosa argenteoalba.

PubMed

Nakata, Kensuke

2017-11-01

Some male spiders exhibit female genital mutilation behaviour (FGM) by removing the female genital appendage (scape) to control the mating frequency of females. Female spiders have two, i.e. right and left, genital openings connected with separate spermathecae into which males transfer sperm successively using one pedipalp (secondary genitalia) at a time. Thus, males must complete at least two palpal insertions to fill both spermathecae, before FGM. The present study examined whether (i) scape removal is only associated with the second palpal insertion (one-action hypothesis) or (ii) two contralateral palpal insertions facilitate FGM, with each insertion cutting the basal part of the scape halfway (two-actions hypothesis). Experiments in which females were replaced after a male had made the first insertion did not support the one-action hypothesis, because scapes remained intact after the newly introduced virgin females received their first palpal insertion, which was the second insertion by the males. In comparison, mating experiments using two half-eunuchs (i.e. one of the palps of each male had been manually removed, forcing them to fill female spermatheca on one side only) supported the two-actions hypothesis. FGM was more frequent in females that received two contralateral palpal insertions than in females that received ipsilateral insertions.

The timing of female genital mutilation and the role of contralateral palpal insertions in the spider Cyclosa argenteoalba

PubMed Central

2017-01-01

Some male spiders exhibit female genital mutilation behaviour (FGM) by removing the female genital appendage (scape) to control the mating frequency of females. Female spiders have two, i.e. right and left, genital openings connected with separate spermathecae into which males transfer sperm successively using one pedipalp (secondary genitalia) at a time. Thus, males must complete at least two palpal insertions to fill both spermathecae, before FGM. The present study examined whether (i) scape removal is only associated with the second palpal insertion (one-action hypothesis) or (ii) two contralateral palpal insertions facilitate FGM, with each insertion cutting the basal part of the scape halfway (two-actions hypothesis). Experiments in which females were replaced after a male had made the first insertion did not support the one-action hypothesis, because scapes remained intact after the newly introduced virgin females received their first palpal insertion, which was the second insertion by the males. In comparison, mating experiments using two half-eunuchs (i.e. one of the palps of each male had been manually removed, forcing them to fill female spermatheca on one side only) supported the two-actions hypothesis. FGM was more frequent in females that received two contralateral palpal insertions than in females that received ipsilateral insertions. PMID:29291078

[Patients' rights of the deceased and related problems in Hungarian law].

PubMed

Kereszty, Eva Margit

2012-03-04

In the Hungarian law, non-burial interventions on cadavers are regulated only by the health law and, therefore, other scientific examinations are theoretically not allowed. Only the international ethical code of museums is used in certain cases. Numerous cultures consider this practice as the mutilation of the cadaver. Beyond this and the criminal forms of mutilation, the medical interventions (trial and training) are also appropriate to hurt the dignity of the dead. As a counterweight, the consent of the patient or his/her relatives is needed for post-mortem interventions. This study presents the Hungarian legislation in which the deceased is a 'patient', and the special enforcement of patients' rights takes place in relation to the body. The relatives have many rights concerning autopsy, and the anatomy institutes are also regulated. The presumption of opting-out is used for organ harvesting; objection is accepted only from the patient. Medical data of the deceased are strictly protected, but there are no obstacles to the interests of the relatives. Graduate and postgraduate medical education pays only little attention to these issues, and the legislation is not in line with the present expectations and possibilities, so that it would be advisable to reconsider the full spectrum of the problem.

Female genital mutilation and efforts to achieve Millennium Development Goals 3, 4, and 5 in southeast Nigeria.

PubMed

Lawani, Lucky O; Onyebuchi, Azubuike K; Iyoke, Chukwuemeka A; Okeke, Nwabunike E

2014-05-01

To determine the prevalence of female genital mutilation (FGM), the common forms of FGM, reasons for the practice, associated obstetric outcomes, and how these have affected efforts to achieve Millennium Development Goals (MDGs) 3, 4, and 5 in southeast Nigeria. A prospective descriptive study of parturients in southeast Nigeria was conducted from January to December 2012. All primigravid women attending delivery services at 2 health institutions during the study period were recruited, examined, and classified using the 2008 WHO classification for FGM. The mean age of the 516 participants was 27.24±4.80 years and most (66.3%) had undergone FGM. Type II FGM was the most common form, accounting for 59.6% of cases. Most FGM procedures were performed in infancy (97.1%) and for cultural reasons (60.8%). Women who had undergone FGM had significantly higher risk for episiotomy, perineal tear, hemorrhage, cesarean delivery, neonatal resuscitation, fresh stillbirth/early neonatal death, and longer hospitalization, with higher risk ratios associated with higher degrees of FGM. FGM is still a common practice in southeast Nigeria, where its association with adverse reproductive outcomes militates against efforts to achieve MDGs 3, 4, and 5. Copyright © 2014 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

Directed Evolution of Carbonyl Reductase from Rhodosporidium toruloides and Its Application in Stereoselective Synthesis of tert-Butyl (3R,5S)-6-Chloro-3,5-dihydroxyhexanoate.

PubMed

Liu, Zhi-Qiang; Wu, Lin; Zhang, Xiao-Jian; Xue, Ya-Ping; Zheng, Yu-Guo

2017-05-10

tert-Butyl (3R,5S)-6-chloro-3,5-dihydroxyhexanoate ((3R,5S)-CDHH) is a key intermediate of atorvastatin and rosuvastatin synthesis. Carbonyl reductase RtSCR9 from Rhodosporidium toruloides exhibited excellent activity toward tert-butyl (S)-6-chloro-5-hydroxy-3-oxohexanoate ((S)-CHOH). For the activity of RtSCR9 to be improved, random mutagenesis and site-saturation mutagenesis were performed. Three positive mutants were obtained (mut-Gln95Asp, mut-Ile144Lys, and mut-Phe156Gln). These mutants exhibited 1.94-, 3.03-, and 1.61-fold and 1.93-, 3.15-, and 1.97-fold improvement in the specific activity and k cat /K m , respectively. Asymmetric reduction of (S)-CHOH by mut-Ile144Lys coupled with glucose dehydrogenase was conducted. The yield and enantiomeric excess of (3R,5S)-CDHH reached 98 and 99%, respectively, after 8 h bioconversion in a single batch reaction with 1 M (S)-CHOH, and the space-time yield reached 542.83 mmol L -1 h -1 g -1 wet cell weight. This study presents a new carbonyl reductase for efficient synthesis of (3R,5S)-CDHH.

The Applicability of Behaviour Change in Intervention Programmes Targeted at Ending Female Genital Mutilation in the EU: Integrating Social Cognitive and Community Level Approaches

PubMed Central

Brown, Katherine; Barrett, Hazel

2013-01-01

With increased migration, female genital mutilation (FGM) also referred to as female circumcision or female genital cutting is no longer restricted to Africa, the Middle East, and Asia. The European Parliament estimates that up to half a million women living in the EU have been subjected to FGM, with a further 180,000 at risk. Aware of the limited success of campaigns addressing FGM, the World Health Organization recommended a behavioural change approach be implemented in order to end FGM. To date, however, little progress has been made in adopting a behaviour change approach in strategies aimed at ending FGM. Based on research undertaken as part of the EU's Daphne III programme, which researched FGM intervention programmes linked to African communities in the EU (REPLACE), this paper argues that behaviour change has not been implemented due to a lack of understanding relating to the application of the two broad categories of behaviour change approach: individualistic decision-theoretic and community-change game-theoretic approaches, and how they may be integrated to aid our understanding and the development of future intervention strategies. We therefore discuss how these can be integrated and implemented using community-based participatory action research methods with affected communities. PMID:23983698

Treatment of intra-oral injection phobia: a randomized delayed intervention controlled trial among Norwegian 10- to 16-year-olds.

PubMed

Berge, Karin G; Agdal, Maren Lillehaug; Vika, Margrethe; Skeie, Marit Slåttelid

2017-05-01

To evaluate the effect of five sessions of cognitive behavioural therapy (CBT) for 10- to 16-year-olds with intra-oral injection phobia. This was a randomized delayed intervention controlled trial in 67 patients, fulfilling the DSM-5 criteria for specific phobia. All patients received the same CBT performed by dentists specially trained in CBT. The patients were randomly assigned to either an immediate treatment group (ITG) (34 patients) or a waitlist-control group (WCG) (33 patients). The WCG was put on a waitlist for 5 weeks. After treatment, all patients were combined for post-treatment analyses. Assessments including the psychometric self-report scales Intra-oral injection fear scale (IOIF-s), Children's Fear Survey Schedule-Dental Subscale (CFSS-DS), Injection Phobia Scale for children (IS-c) and Mutilation Questionnaire for children (MQ-c) and a behavioural avoidance test (BAT) followed by a questionnaire on cognitions during the BAT, occurred pre-, post-treatment/waitlist and at a 1-year follow-up. CBT had a significant effect compared to no treatment (WCG). After treatment, the scores on the psychometric self-report scales were significantly reduced and higher levels in the BAT were achieved. The results were maintained at 1-year follow-up. Of the 67 patients, 70.1% received intra-oral injections during CBT treatment, whereas 69.4% of those completing the CBT, in need for further dental treatment, managed to receive the necessary intra-oral injections at their regular dentist. The 10- to 16-year-olds diagnosed with intra-oral injection phobia benefitted positively on CBT performed by specially trained dentists.

Disorders as undifferentiated selfobject formations: treatment of a multidisordered patient.

PubMed

Rowe, Crayton E

2014-06-01

This paper offers a new understanding of disorders as undifferentiated selfobject formations. A treatment example of a multipledisordered patient is presented to illustrate how disorders diminished as a result of this understanding. This paper highlights the developmental importance of the undifferentiated selfobject and suggests that early interruptions of this discovery experience that take place during the infant's positive moments of freedom and enthusiasm are traumatic. If they go beyond the tolerance of the infant, they can be imprinted as unconscious core traumatic experiences. They remain as implicit memories that can act as warnings of repetitions of the trauma that occurred at the time of freedom and enthusiasm in the act of discovering. It can be suggested that the threat of repetitions of the traumatic loss is associated with these positive moments of discovery. This threat directs the needed self-sustaining undifferentiated selfobject discovery experience away from the positive, thereby leaving the posttraumatic effects of the loss as the focus of discovery. This focus leads to destructive preoccupations and obsessions that are considered disorders such as depression, suicidal thinking, self-mutilation, and eating disorders. Once patients understand the importance of the undifferentiated selfobject discovery need, the delinking of the undifferentiated selfobject from the negative preoccupations takes place. As a result, disorders diminish, and patients begin to consider positive possibilities for their lives. This paper suggests that early interferences in the development of the undifferentiated selfobject lead to the formation of disorders. A treatment of a multidisordered patient is presented to illustrate how this understanding was central to the diminishing of the disorders.

PLAY HANDS PROTECTIVE GLOVES: TECHNICAL NOTE ON DESIGN AND CONCEPT.

PubMed

Houston-Hicks, Michele; Lura, Derek J; Highsmith, M Jason

2016-09-01

Cerebral Palsy (CP) is the leading cause of childhood motor disability, with a global incidence of 1.6 to 2.5/1,000 live births. Approximately 23% of children with CP are dependent upon assistive technologies. Some children with developmental disabilities have self-injurious behaviors such as finger biting but also have therapeutic needs. The purpose of this technical note is to describe design considerations for a protective glove and finger covering that maintains finger dexterity for children who exhibit finger and hand chewing (dermatophagia) and require therapeutic range of motion and may benefit from sensory stimulation resulting from constant contact between glove and skin. Protecting Little and Adolescent Youth (PLAY) Hands are protective gloves for children with developmental disorders such as CP who injure themselves by biting their hands due to pain or sensory issues. PLAY Hands will be cosmetically appealing gloves that provide therapeutic warmth, tactile sensory feedback, range of motion for donning/ doffing, and protection to maximize function and quality of life for families of children with developmental disorders. The technology is either a per-finger protective orthosis or an entire glove solution designed from durable 3D-printed biodegradable/bioabsorbable materials such as thermoplastics. PLAY Hands represent a series of protective hand wear interventions in the areas of self-mutilating behavior, kinematics, and sensation. They will be made available in a range of protective iterations from single- or multi-digit finger orthoses to a basic glove design to a more structurally robust and protective iteration. To improve the quality of life for patients and caregivers, they are conceptualized to be cosmetically appealing, protective, and therapeutic.

Psychosocial impact of scars due to cutaneous leishmaniasis on high school students in Errachidia province, Morocco.

PubMed

Bennis, Issam; Thys, Séverine; Filali, Hind; De Brouwere, Vincent; Sahibi, Hamid; Boelaert, Marleen

2017-04-07

In Morocco, cutaneous leishmaniasis (CL) is usually known to be a slowly healing localized skin disease, but in some cases, it can lead to mutilating scars. The outbreak of CL due to Leishmania major in the Errachidia province in southeastern Morocco between 2008 and 2010 left many adolescents with permanent scar tissue on the face or other exposed body parts. We studied the psychosocial impact of CL on these young people. In 2015 we conducted a cross-sectional survey among high-school students living in boarding schools in two CL-endemic areas of Errachidia: Rissani and Tinejdad. A self-administered questionnaire elicited responses about general knowledge of CL and related scars. An open-ended question focused on the possible psychosocial effects associated with these scars. The quantitative data were analyzed with Epi Info™ and the text data with NVivo software. Almost 20% of 448 respondents reported they had experienced a CL lesion and 87% said it could possibly or definitely lead to psychological consequences. The text analysis showed that girls more often than boys expanded on the negative psychological effects of CL. The students considered CL as "dangerous", "serious", and "deathly", and said it sometimes led to extreme suicidal ideations. The burden of CL in this age group is not negligible. The indelible CL scars lead to self-stigma and social stigma, and the emergence of negative psychological effects in this age group. While some students accepted their CL scars and related suffering as their "destiny", others were eagerly demanding protective measures against CL and treatment for the scars.

The Johns Hopkins RTR Consortium: A Collaborative Approach to Advance Translational Science and Standardize Clinical Monitoring of Restorative Transplantation

DTIC Science & Technology

2015-10-01

that belatacept is highly effective as a biologic agent in maintaining allograft survival without the need for conventional high dose calcineurin... tissue , these injuries are not only mutilating, but frequently result in permanent disfigurement and morbidity. For many devastating combat and...II; n=3) TASK 4. Determine impact of peritransplant belatacept treatment to allow for allograft survival with low-dose (sub-therapeutic) CNI

A Question of Ethics

DTIC Science & Technology

1996-01-01

tation by multinational corporations, public justice policies, and th e environment .” Several months later, that colleague came to Sommers and...standards that every culture can appeal to, then how can we say that some - thing is amiss in Brazil, where men are not prose ­ cuted for mutilating...universal maxim—would be best for all people. That is, if everyone did it, it would be best for everyone. The categorical imperative is a fine, rational

Operation Iraqi Freedom: Strategies, Approaches, Results, and Issues for Congress

DTIC Science & Technology

2008-12-15

The New York Times, February 23, 2008; Lolita Baldor, “Gates: Turkey Raid Won’t Solve Problems,” Washington Post, February 23, 2008; Yochi Dreazen...In April 2004, the unofficial release of graphic photos of apparent detainee abuse at Abu Ghraib generated shock and horror among people inside and...who were driving through Fallujah, were ambushed and killed—and then their bodies were mutilated and hung from a bridge. Photos of that grisly

Pay phone receiver cord injuries to the hand.

PubMed

Lesavoy, M A; Meals, R A

1984-11-01

Pay phone receiver cord injuries to the hand have been identified in five hands of three patients. These injuries occur when the individual tries to violently jerk the receiver from the main unit of the telephone by the metal sheathed cord. This flexible metal sheath then becomes uncoiled and exposes very sharp edges on which hands can be severely lacerated and mutilated. Identification of and experiences with these types of injuries are discussed.

Voluntary Genital Ablations: Contrasting the Cutters and Their Clients

PubMed Central

Jackowich, Robyn A; Vale, Rachel; Vale, Kayla; Wassersug, Richard J; Johnson, Thomas W

2014-01-01

Introduction Some healthy males voluntarily seek castration without a recognized medical need. There are currently no standards of care for these individuals, which cause many of them to obtain surgery outside of a licensed medical setting. We seek to understand who performs these surgeries. Aim This study aims to characterize individuals who perform or assist in genital ablations outside of the healthcare system. Methods A cross-sectional Internet survey posted on eunuch.org received 2,871 responses. We identified individuals who had performed or assisted in human castrations (“cutters”; n = 98) and compared this group with all other survey respondents (n = 2,773), who had not assisted in castrations. Next we compared the cutters with the voluntary eunuchs. Lastly, because many of the cutters have themselves been castrated, we also divided the physically castrated population (n = 278) into cutters (n = 44) and noncutters (n = 234) and compared them. Main Outcome Measures Self-reported questionnaires were used to collect demographic information, gender identity and presentation, selected childhood experiences, and history of aggressive behaviors, self-harming behaviors, and hospitalization. Results Distinguishing characteristics of cutters included: (i) presenting themselves as very masculine, (ii) having had their longest sexual relationship with a man, (iii) growing up on a farm, (iv) witnessing animal castrations, (v) having a history of sexually inappropriate behavior, (vi) having been threatened with genital mutilation as a child, (vii) having a history of self-harm, (viii) being raised in a devoutly Christian household, (ix) having had an underground castration themselves, and (x) having body piercings and/or tattoos. Conclusions This study may help identify individuals who are at risk of performing illegal castrations. That information may help healthcare providers protect individuals with extreme castration ideations from injuring themselves or others. Jackowich RA, Vale R, Vale K, Wassersug RJ, and Johnson TW. Voluntary genital ablations: Contrasting the cutters and their clients. Sex Med 2014;2:121–132. PMID:25356309

Bibliometric analysis of literature on female genital mutilation: (1930 - 2015).

PubMed

Sweileh, Waleed M

2016-10-10

Female genital mutilation/cutting (FGM/C) is a common harmful traditional practice in many communities in Africa and to a lesser extent in Middle East and other regions in the world. In order to better understand publishing on this topic, we conducted a bibliometric study on FGM/C. Bibliometric analyses can be used as an indicator of the extent of interaction of researchers, health authorities, and communities with a particular health issue. Scopus database was used to retrieve data on FGM/C. Keywords used were "female genital mutilation", "female genital circumcision", "female genital cutting" and "female circumcision". Specifically, the number of publications, top productive countries and institutions, highly cited articles, citation analysis, co-authorships, international collaboration, role of African countries, top active authors, and journals involved in publishing articles on FGM/C were reviewed and analyzed. We indirectly assessed the impact of publications using total number of citations received, average number of citations per article, Hirsch-index, percentage of highly cited articles, and journal's impact factor. One thousand and thirty-five publications on FGM/C were retrieved. The h-index of retrieved articles was 37. A steep rise in number of publications was noticed in mid-1990s and again in 2012. More than half of retrieved articles were published from 2006 - 2015. A total of 65 countries contributed. The top ten productive countries included ones from Northern America, Europe and Africa. Nigeria and Egypt were the most active African countries in FGM/C publications. At least nine African academic institutions were actively involved on FGM/C publications. Articles on FGM/C that received the highest number of citations were those that focused on negative physical and psychosexual consequences of FGM/C. Journal topic areas were obstetrics/gynecology, public health, and psychological sociology. Collaboration between African and European countries on FGM/C research was evident. Bibliometric analysis reveals that research publications on FGM/C have been increasing since the l970s, with collaboration between African and Western countries, and articles are being published in higher impact journals, not only obstetrics, but also public health and social sciences. FGM/C research can be helpful to international health agencies and governments not only to document negative outcomes, but also to identify best practices, and to note gaps in implementation and practice.

An exploration of attitudes towards female genital mutilation (FGM) in men and women accessing FGM clinical services in London: a pilot study.

PubMed

Larsson, Martina; Cohen, Pollyanna; Hann, Gayle; Creighton, Sarah M; Hodes, Deborah

2018-03-21

This pilot study researched the attitudes towards and the knowledge of female genital mutilation (FGM) in adult women with FGM and their partners. The participant population consisted of English-speaking women and men over 18 years old attending specialist FGM clinics in two London hospitals. The participants completed a questionnaire on the attitudes and the knowledge of FGM, which were adapted with permission from the United Nations Children's Fund and the United States Agency for International Development household surveys. 54 participants (51 women, 3 men) took part in the surveys. 89% of participants thought that FGM should be stopped (95%CI: 0.81-0.97) and 72% said they knew FGM is illegal in the United Kingdom (UK). 15% reported that FGM caused no danger, or were unaware of any danger to women's health. This study demonstrates the opposition to FGM by participants, but some lack of knowledge regarding the legal and health implications. The exploration of attitudes in diaspora community groups is often cited as key to safeguarding girls from FGM. This is one of the first UK studies of individuals from FGM-practising communities, and we recommend use of the study questionnaires for a multicentre, cross-community study. Impact statement What is already known about this subject? Women and children are affected by female genital mutilation (FGM) globally and in the United Kingdom (UK). The majority of knowledge on practices and the attitudes towards FGM comes from UNICEF and USAID research in Africa and there is scant data on FGM practices in diaspora communities in the UK. What do the results of this study add? This study provides an appropriate questionnaire and protocol for use in community-based national research to improve healthcare for women by collecting up-to-date data on the attitudes towards FGM among the members of FGM-practising communities in the UK. What are the implications of these findings for clinical practice and further research? The implications of the results of this study are that health professionals need to understand that patients do not always know the law on FGM, even after a consultation. Health and social care professionals are placed in a unique position to work with community members to educate men and women to end FGM.

Male responsibility and maternal morbidity: a cross-sectional study in two Nigerian states.

PubMed

Andersson, Neil; Omer, Khalid; Caldwell, Dawn; Dambam, Mohammed Musa; Maikudi, Ahmed Yahya; Effiong, Bassey; Ikpi, Edet; Udofia, Etuk; Khan, Amir; Ansari, Umaira; Ansari, Noor; Hamel, Candyce

2011-12-21

Nigeria continues to have high rates of maternal morbidity and mortality. This is partly associated with lack of adequate obstetric care, partly with high risks in pregnancy, including heavy work. We examined actionable risk factors and underlying determinants at community level in Bauchi and Cross River States of Nigeria, including several related to male responsibility in pregnancy. In 2009, field teams visited a stratified (urban/rural) last stage random sample of 180 enumeration areas drawn from the most recent censuses in each of Bauchi and Cross River states. A structured questionnaire administered in face-to-face interviews with women aged 15-49 years documented education, income, recent birth history, knowledge and attitudes related to safe birth, and deliveries in the last three years. Closed questions covered female genital mutilation, intimate partner violence (IPV) in the last year, IPV during the last pregnancy, work during the last pregnancy, and support during pregnancy. The outcome was complications in pregnancy and delivery (eclampsia, sepsis, bleeding) among survivors of childbirth in the last three years. We adjusted bivariate and multivariate analysis for clustering. The most consistent and prominent of 28 candidate risk factors and underlying determinants for non-fatal maternal morbidity was intimate partner violence (IPV) during pregnancy (ORa 2.15, 95%CIca 1.43-3.24 in Bauchi and ORa 1.5, 95%CI 1.20-2.03 in Cross River). Other spouse-related factors in the multivariate model included not discussing pregnancy with the spouse and, independently, IPV in the last year. Shortage of food in the last week was a factor in both Bauchi (ORa 1.66, 95%CIca 1.22-2.26) and Cross River (ORa 1.32, 95%CIca 1.15-1.53). Female genital mutilation was a factor among less well to do Bauchi women (ORa 2.1, 95%CIca 1.39-3.17) and all Cross River women (ORa 1.23, 95%CIca 1.1-1.5). Enhancing clinical protocols and skills can only benefit women in Nigeria and elsewhere. But the violence women experience throughout their lives--genital mutilation, domestic violence, and steep power gradients--is accentuated through pregnancy and childbirth, when women are most vulnerable. IPV especially in pregnancy, women's fear of husbands or partners and not discussing pregnancy are all within men's capacity to change.

[The transsexualism syndrome: clinical aspects and therapeutic prospects].

PubMed

Gallarda, T; Amado, I; Coussinoux, S; Poirier, M F; Cordier, B; Olié, J P

1997-01-01

The prevalence rate of transsexualism varies from 1 to 50,000, to 1 to 100,000. Although it remains an infrequent affliction, transsexualism generates usually major suffering and may be responsible of many complications like suicide, self-mutilations, affective disorders and social disabilities. Since the first descriptions of Esquirol in the nineteenth, the medical community has always been questioned on medical, legal, social or ethical aspects of transsexualism. The aetiology of the trouble is still unknown. In the absence of biological marker, the syndrome of transsexualism can be defined only with clinical criteria. The main differential diagnosis are sexual ambiguities and psychotic disorders. For the specialists, satisfying the patients demand of a surgical and social reassignment still remains the only way to improve their clinical condition and avoid the onset of many dramatic complications. Without any treatment, the evolution of the trouble is chronic, without remission. Longitudinal studies of transsexual patients with a five year follow-up demonstrated subjective improvement in two thirds of the patients and don't find either higher rates of suicides nor psychotic decompensations after surgery and hormonotherapy. Clinical and neuropsychological studies of sexually differentiated cognitive abilities of transsexual patients, before and after hormonotherapy, could allow us in improving the understanding of sexual differences of the brain.

Current Concepts of Hyperuricemia and Gout

PubMed Central

Klinenberg, James R.

1969-01-01

Recent studies have confirmed that gout is an inborn error of metabolism. It has now become evident that the hyperuricemia associated with gout might occur either due to overproduction of uric acid, underexcretion of uric acid or a combination of these processes. Furthermore, patients with excessive purine synthesis may have a specific enzyme defect resulting in altered feedback inhibition of purine synthesis. A neurological disease manifest by mental retardation, choreo-athetosis, aggressive behavior, lip-biting and self-mutilation and associated with decidedly increased purine biosynthesis serves as a prototype of this kind of disorder. Other defects in regulation of purine biosynthesis have been postulated but their existence not yet confirmed. It has been demonstrated that urate crystals which are deposited from hyperuricemic body fluids set up an acute inflammatory reaction by means of a variety of chemical mediators. Thus, acute gouty arthritis is now recognized as an example of “crystal induced” synovitis. The treatment of gout consists of (1) the control of acute gouty attacks, and (2) the maintenance of normal serum uric acid concentrations. This latter may be achieved either with uricosuric drugs or with xanthine oxidase inhibition. With these principles in mind, it is now possible to avoid many of the severe crippling effects of gout and to restore the vast majority of gouty patients to useful and productive lives. PMID:5773483

Feather-picking psittacines: histopathology and species trends.

PubMed

Garner, M M; Clubb, S L; Mitchell, M A; Brown, L

2008-05-01

Histologic findings are described for 408 feather-picking or self-mutilating psittacines with the use of biopsies from clinically affected and unaffected skin. Inflammatory skin disease was diagnosed in 210 birds, and traumatic skin disease was diagnosed in 198 birds. Criteria used for the diagnosis of inflammatory skin disease included the presence of perivascular inflammation in the superficial or deep dermis of clinically affected and unaffected sites. The primary histologic criteria for the diagnosis of traumatic skin disease were superficial dermal scarring with or without inflammation in the affected sites and an absence of inflammation in the unaffected sites. The inflammatory cells associated with the lesions were typically lymphocytes and occasionally plasma cells, histiocytes, and granulocytes. A preponderance of inflammatory skin disease was seen in macaws (Ara spp.) and Amazon parrots (Amazona spp.). A preponderance of traumatic skin disease was seen in cockatoos (Cacatua spp.) and African grey parrots (Psittacus erithacus). The prevalence of each was approximately equal in several other species, including conures (Aratinga and Pyrrhura spp.), eclectus parrots (Eclectus roratus), quaker parrots (Myiopsitta monachus), cockatiels (Nymphicus hollandicus), parakeets (Cyanorhamphus and Psittacula spp.), and caiques (Pionites spp.). No geographic or gender-based trends were identified. These findings could be helpful for identifying and treating birds with feather-picking disorders.

[Dental loss in a rural population and the goals established for the World Health Organization].

PubMed

Saliba, Nemre Adas; Moimaz, Suzely Adas Saliba; Saliba, Orlando; Tiano, Ana Valéria Pagliari

2010-06-01

This study aimed to report the dental loss in a rural population, evaluating the contribution of socioeconomic and behavioral variables and comparing the results with the goals of the World Health Organization (WHO) for 2000 and 2010. A total of 473 residents had been examined using the methodology, codes and criteria according to WHO guidelines. The results were processed using the Epibuco program and the chi-square test (p<0.05) were used to compare the number of teeth lost with the variables studied. From the total of people examined, 17.8% were total edentulous as well as 8% and 50.9% of the examined of the age groups of 35 to 44 and 65 to 74 years-old, respectively. Initiating precociously in his population, the dental loss advanced considerably with the age, being the situation much distant of the goals established by WHO for 2010. Chi-square test revealed statistically significant differences among the number of teeth lost by the interviewed with 35 years-old or more in relation to education level, housing and self-perception of the speak quality. The development of oral health attention programs becomes necessary, in order to reduce the actual damages and to prevent the continuity of this trend of mutilation.

Operation Iraqi Freedom: Strategies, Approaches, Results, and Issues for Congress

DTIC Science & Technology

2008-09-22

Tavernise, “Turkish Troops Enter Iraq in Pursuit of Kurdish Militants,” The New York Times, February 23, 2008; Lolita Baldor, “Gates: Turkey Raid Won’t...unofficial release of graphic photos of apparent detainee abuse at Abu Ghraib generated shock and horror among people inside and outside Iraq. Some...were mutilated and hung from a bridge. Photos of that grisly aftermath were rapidly CRS-66 232 The Iraq Governing Council (IGC) was a critical part of

Operation Iraqi Freedom: Strategies, Approaches, Results, and Issues for Congress

DTIC Science & Technology

2008-03-28

23, 2008; Lolita Baldor, “Gates: Turkey Raid Won’t Solve Problems,” Washington Post, February 23, 2008; Yochi Dreazen, “U.S. Knew of Turkey’s Plan...release of graphic photos of apparent detainee abuse at Abu Ghraib generated shock and horror among people inside and outside Iraq. Some observers have...Blackwater, who were driving through Fallujah, were ambushed and killed — and then their bodies were mutilated and hung from a bridge. Photos of that

The Law of War: Can 20th-Century Standards Apply to the Global War on Terrorism?

DTIC Science & Technology

2005-01-01

perpetrated by Kenyans against Kenyans, were accompanied by reports of greater instances of oathing and intimidation, maiming of cattle on European...or mutilated (some so severely they were permanently maimed), 200 huts destroyed by fire, and 1,000 cattle maimed (usually by having the tendons of...examples where security forces castrated detainees, forced them to engage in acts of sodomy, and, to use her words, “Perpetrated similar horrifying acts

OLMSTED SYNDROME: REPORT OF TWO CASES

PubMed Central

Tharini, G K; Hema, N; Jayakumar, S; Parveen, B

2011-01-01

Olmsted syndrome is an uncommon genetic disorder with symmetrical, diffuse, transgredient, mutilating palmoplantar keratoderma and periorificial hyperkeratosis. Olmsted syndrome in a female patient is particularly rare, and we report two unrelated female patients of Olmsted syndrome, who presented with perioral hyperkeratosis and palmoplantar keratoderma. One of our patients also had woolly hair from birth and flexion contracture of a digit, while the other had pseudoainhum. There was no cardiac involvement. Hence, the diagnosis of Olmsted syndrome was made. PMID:22121289

The role of men in abandonment of female genital mutilation: a systematic review.

PubMed

Varol, Nesrin; Turkmani, Sabera; Black, Kirsten; Hall, John; Dawson, Angela

2015-10-08

Men in their roles as fathers, husbands, community and religious leaders may play a pivotal part in the continuation of female genital mutilation (FGM). However, the research on their views of FGM and their potential role in its abandonment are not well described. We undertook a systematic review of all publications between 2004 and 2014 that explored men's attitudes, beliefs, and behaviours in regards to FGM, as well as their ideas about FGM prevention and abandonment. We included twenty peer-reviewed articles from 15 countries in the analysis. Analysis revealed ambiguity of men's wishes in regards to the continuation of FGM. Many men wished to abandon this practice because of the physical and psychosexual complications to both women and men. Social obligation and the silent culture between the sexes were posited as major obstacles for change. Support for abandonment was influenced by notions of social obligation, religion, education, ethnicity, urban living, migration, and understanding of the negative sequelae of FGM. The strongest influence was education. The level of education of men was one of the most important indicators for men's support for abandonment of FGM. Social obligation and the lack of dialogue between men and women were two key issues that men acknowledged as barriers to abandonment. Advocacy by men and collaboration between men and women's health and community programs may be important steps forward in the abandonment process.

Evidence to inform education, training and supportive work environments for midwives involved in the care of women with female genital mutilation: a review of global experience.

PubMed

Dawson, Angela; Turkmani, Sabera; Fray, Shairon; Nanayakkara, Susie; Varol, Nesrin; Homer, Caroline

2015-01-01

to identify how midwives in low and middle income countries (LMIC) and high income countries (HIC) care for women with female genital mutilation (FGM), their perceived challenges and what professional development and workplace strategies might better support midwives to provide appropriate quality care. an integrative review involving a narrative synthesis of the literature was undertaken to include peer reviewed research literature published between 2004 and 2014. 10 papers were included in the review, two from LMIC and eight from HIC. A lack of technical knowledge and limited cultural competency was identified, as well as socio-cultural challenges in the abandonment process of the practice, particularly in LMIC settings. Training in the area of FGM was limited. One study reported the outcomes of an education initiative that was found to be beneficial. professional education and training, a working environment supported by guidelines and responsive policy and community education, are necessary to enable midwives to improve the care of women with FGM and advocate against the practice. improved opportunities for midwives to learn about FGM and receive advice and support, alongside opportunities for collaborative practice in contexts that enable the effective reporting of FGM to authorities, may be beneficial and require further investigation. Copyright © 2014 Elsevier Ltd. All rights reserved.

Female genital mutilation reversal: a general approach.

PubMed

Anand, Mallika; Stanhope, Todd J; Occhino, John A

2014-07-01

Female genital mutilation (FGM) is a violation of human rights; yet, more than 100 million females are estimated to have undergone the procedure worldwide. There is an increased need for physician education in treating FGM. Female pelvic surgeons have a unique opportunity to treat this population of patients. Here, we depict the classification of FGM and a general approach to FGM reversal. We specifically address the procedure of type III FGM reversal, or defibulation. In this video, we first highlight the importance of the problem of FGM. Next, we present the classification of FGM using an original, simple, schematic diagram highlighting they key anatomic structures involved in the four types of FGM. We then present a simple case of reversal of type III FGM, a procedure also known as defibulation. After depicting the surgical procedure, we discuss clinical results and summarize key principles of the defibulation procedure. Our patient was a 25-year-old woman who had undergone type III FGM as a child in Somalia. She desired restoration of vaginal function. We performed a reversal, and her postoperative course was uncomplicated. By 6 weeks postoperatively, she was able to engage in sexual intercourse without dyspareunia. FGM is a problem at the doorsteps of female pelvic medicine and reconstructive surgery. Our video demonstrates a basic surgical approach that can be applied to simple cases of type III FGM presenting to the female pelvic surgeon.

Violence against African migrant women living in Turin: clinical and forensic evaluation.

PubMed

Castagna, Paola; Ricciardelli, Rossana; Piazza, Federica; Mattutino, Grazia; Pattarino, Beatrice; Canavese, Antonella; Gino, Sarah

2018-07-01

The phenomenon of migration is often related to violence and exploitation. Data collection in conflict-affected countries is hard and complicated by the lack of literature, especially on the health of migrant female victims of violence. The aim of our study has been to realise a clinical and forensic evaluation on African female migrant's global health through their admissions to the Rape Centre "Soccorso Violenza Sessuale" at Sant'Anna Hospital in Turin. In our sample, we considered several aspects such as place where the violence occurred, number and the identity of the perpetrators, use of physical restraint instruments and/or substances, kidnapping, prostitution under duress, abuses, pregnancies and outcomes, injuries and complained symptoms, female genital mutilation, and sexually transmitted diseases. The sample consisted of 143 women, of which 136 were victims of violence. In 72.8% of the episodes, the perpetrator of violence was an unknown subject. Of the women, 58.8% reported being abused in Libya, 92.6% were victims of sexual violence, and 30.2% became pregnant after sexual abuse. The physical examination of the sample showed that 34.6% of women had at least a scar and that 12.5% reported a female genital mutilation. This is the first database on health of African female migrants in Turin area collecting data on migration, violence, and physical and psychological effects of abuse.

[Excision: the new prohibition that divides the society. Press review: Senegal].

PubMed

1999-12-01

Approximately 700,000 women in Senegal have suffered female genital mutilation (FGM). Now, following a vote upon legislation banning FGM, public opinion in the country over the practice is more divided than ever. The practitioners of FGM are not taking the law seriously, while politicians hesitate to openly condemn the practice, which still occurs widely in rural zones. Most of the 140 parliamentarians do not believe that laws alone can successfully end FGM in Senegal. Some deputies and feminists believe that several years of sensitization on the issue will be needed to effectively reduce the frequency with which FGM is practiced. Only optimists believe FGM will disappear on its own. The debate threatens to resurface in some areas during the year 2000 presidential election. One deputy from the governing party, originally from southern Senegal, states that he dares not tell his constituency that the president himself created the anti-FGM legislation, especially when locally elected leaders finance villages¿ FGM-related celebrations. According to a scholar of the Koran, FGM is an Islamic practice, but it is not taught in the Koran. FGM is therefore a cultural practice borne from individual choice. In Kolda, 650 km south of Dakar, the practitioners of such mutilation argue that they would rather be imprisoned than abandon the practice they consider to be an immutable component of their cultural history.

Surgical and nonsurgical interventions for vulvar and clitoral pain in girls and women living with female genital mutilation: A systematic review.

PubMed

Ezebialu, Ifeanyichukwu; Okafo, Obiamaka; Oringanje, Chukwudi; Ogbonna, Udoezuo; Udoh, Ekong; Odey, Friday; Meremikwu, Martin M

2017-02-01

Vulvar and clitoral pain are known complications of female genital mutilation (FGM). Several interventions have been used to treat these conditions. This review focuses on surgical and nonsurgical interventions to improve vulvar and clitoral pain in women living with FGM. To evaluate the impact of nonsurgical and surgical interventions for alleviating vulvar and clitoral pain in women living with any type of FGM and to assess the associated adverse events. The search included the following major databases: Cochrane Central Register for Controlled Trials (CENTRAL), MEDLINE, Scopus, Web of Science, and ClinicalTrials.gov. These were searched from inception until August 10, 2015 without any language restrictions. Study designs included randomized controlled trials, cluster randomized trials, nonrandomized trials, cohort studies, case-control studies, controlled before-and-after studies, historical control studies, and interrupted time series with reported data comparing outcomes among women with FGM who were treated for clitoral or vulvar pain with either surgical or nonsurgical interventions. Two team members independently screened studies for eligibility. No studies were included. Limited information exists on management of vulvar and clitoral pain in women living with FGM. This constitutes an important area for further research. CRD42015024521. © 2017 International Federation of Gynecology and Obstetrics.The World Health Organization retains copyright and all other rights in the manuscript of this article as submitted for publication.

Female Genital Mutilation as a Concern for Special Operations and Tactical Emergency Medical Support Medics.

PubMed

Wittich, Arthur C

Female genital mutilation (FGM), frequently called female genital cutting or female circumcision, is the intentional disfigurement of the external genitalia in young girls and women for the purpose of reducing libido and ensuring premarital virginity. This traditional, nontherapeutic procedure to suppress libido and prevent sexual intercourse before marriage has been pervasive in Northern Africa, the Middle East, and the Arabian peninsula for over 2,500 years. FGM permanently destroys the genital anatomy while frequently causing multiple and serious complications. The International Federation of Gynecology and Obstetrics proposed a classification system of FGM according to the specific genital anatomy removed and the extensiveness of genital disfigurement. Although it has been ruled illegal in most countries, FGM continues to be performed worldwide. With African, Asian, and Middle Eastern immigration to the United States and Europe, western countries are experiencing FGM in regions where these immigrants have concentrated. As deployments of Special Operations Forces (SOF) increase to regions in which FGM is pervasive, and as African, Asian, and Middle Eastern immigration to the United States increases, SOF and Tactical Emergency Medical Support (TEMS) medics will necessarily be called upon to evaluate and treat complications resulting from FGM. The purpose of this article is to educate SOF/TEMS medical personnel about the history, geographic regions, classification of procedures, complications, and medical treatment of patients with FGM. 2017.

Antepartum or intrapartum deinfibulation for childbirth in women with type III female genital mutilation: A systematic review and meta-analysis.

PubMed

Esu, Ekpereonne; Udo, Atim; Okusanya, Babasola O; Agamse, David; Meremikwu, Martin M

2017-02-01

There remains no consensus on the best timing of deinfibulation in women with type III female genital mutilation (FGM). To conduct a systematic review of the effects of antepartum or intrapartum deinfibulation on childbirth outcomes in women with type III FGM. The following major databases were searched: Cochrane Central Register for Controlled Trials (CENTRAL), MEDLINE, Scopus, Web of Science, and ClinicalTrials.gov, from inception until August 2015 without any language restrictions. Studies of pregnant women or girls with type III FGM who were deinfibulated antepartum or intrapartum were included. Two team members independently screened and collected data. Quality of evidence was assessed using GRADE. Summary odds ratios and proportions were calculated when possible. There is no evidence of a significant difference between antepartum and intrapartum deinfibulation for obstetric outcomes such as duration of labor, perineal lacerations, episiotomies, postpartum hemorrhage, and cesarean deliveries. Outcomes in women living with type III FGM and those who have undergone deinfibulation were not statistically different; however, trends show a benefit for deinfibulation. All studies were underpowered to detect statistical differences. Larger studies are required to have full confidence in these findings. CRD42015024464. © 2017 International Federation of Gynecology and Obstetrics. The World Health Organization retains copyright and all other rights in the manuscript of this article as submitted for publication.

Sexual counselling for treating or preventing sexual dysfunction in women living with female genital mutilation: A systematic review.

PubMed

Okomo, Uduak; Ogugbue, Miriam; Inyang, Elizabeth; Meremikwu, Martin M

2017-02-01

Female sexual dysfunction is the persistent or recurring decrease in sexual desire or arousal, the difficulty or inability to achieve an orgasm, and/or the feeling of pain during sexual intercourse. Impaired sexual function can occur with all types of female genital mutilation (FGM) owing to the structural changes, pain, or traumatic memories associated with the procedure. To conduct a systematic review of randomized and nonrandomized studies into the effects of sexual counseling with or without genital lubricants on the sexual function of women living with FGM. Cochrane Central Register of Controlled Trials, MEDLINE, African Index Medicus, SCOPUS, LILACS, CINAHL, ClinicalTrials.gov, Pan African Clinical Trials Registry, and other databases were searched to August 2015. The reference lists of retrieved studies were checked for reports of additional studies, and lead authors contacted for additional data. Studies of girls and women living with any type of FGM who received counselling interventions for sexual dysfunction were included. No relevant studies that addressed the objective of the review were identified. Despite a comprehensive search, the authors could not find evidence of the effects of sexual counseling on the sexual function of women living with FGM. Studies assessing this intervention are needed. CRD42015024593. © 2017 International Federation of Gynecology and Obstetrics. The World Health Organization retains copyright and all other rights in the manuscript of this article as submitted for publication.

Obstetric care of women with female genital mutilation attending a specialized clinic in a tertiary center.

PubMed

Abdulcadir, Jasmine; Dugerdil, Adeline; Yaron, Michal; Irion, Olivier; Boulvain, Michel

2016-02-01

To study the obstetric outcomes of women attending a specialized clinic for women with female genital mutilation (FGM). The medical charts of women with FGM who consecutively attended a specialized clinic between 2010 and 2012 were reviewed retrospectively. The present study focused on women attending for obstetric reasons. The outcome measures were type of delivery, reason for cesarean delivery or assisted delivery, blood loss, episiotomy, perineal tear, duration of the second stage of labor, postpartum complications, weight of the neonate, and Apgar score. Outcomes were compared between women with FGM type III who underwent defibulation, and patients with FGM type I and II. The clinic was attended by 129 women, 84 perinatally. Obstetric outcomes were similar to average outcomes for women without FGM presenting at the same department and in Switzerland generally. Specifically, 20 women had a cesarean delivery. An assisted delivery was performed for 18 patients; among these, only eight had experienced obstructed labor. No statistically significant differences were found for the outcome measures when women with FGM type III were compared to FGM type I and II. Routine obstetric follow-up combined with specialized care for women with FGM, including defibulation, can avoid inappropriate obstetric practices and reduce obstetric complications known to be associated with FGM. Copyright © 2015 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

Female sexual dysfunction in female genital mutilation.

PubMed

Elneil, Sohier

2016-01-01

Female genital mutilation (FGM), otherwise known as female genital cutting (FGC), is currently very topical and has become a significant global political issue. The impact of FGM on the lives of women and girls is enormous, as it often affects both their psychology and physical being. Among the complications that are often under-reported and not always acknowledged is female sexual dysfunction (FSD). FSD presents with a complex of symptoms including lack of libido, arousability and orgasm. This often occurs in tandem with chronic urogenital pain and anatomical disruption due to perineal scarring.To treat FSD in FGM each woman needs specifically directed holistic care, geared to her individual case. This may include psychological support, physiotherapy and, on occasion, reconstructive surgery. In many cases the situation is complicated by symptoms of chronic pelvic pain, which can make treatment increasingly difficult as this issue needs a defined multidisciplinary approach for its effective management in its own right. The problems suffered by women with FGM are wholly preventable, as the practice need not happen. The current global momentum to address the social, cultural, economic and medical issues of FGM is being supported by communities, governments, non-governmental agencies (NGOs) and healthcare providers. It is only by working together that the practice can be abolished and women and girls may be free from this practice and its associated consequences. © The Author(s) 2016.

Female genital mutilation/cutting: will it continue?

PubMed

Mohammed, Ghada F; Hassan, Magdy M; Eyada, Moustafa M

2014-11-01

Female genital mutilation/cutting (FGM/C) is a prevalent, deeply rooted traditional practice in Egypt. Specification of the motives behind the continuation of FGM/C in Egyptian community and evaluation of the sexual function in women with FGM/C. This cross-sectional study, involved 2,106 sexually active female participants with FGM/C. Full history-taking and general examination to evaluate the type of FGM/C were conducted. Sexual function was assessed by using the Female Sexual Function Index (FSFI) questionnaire. Enumerate and specify the motivational factors and its percent among the participants. The correlation between FGM/C and FSFI domain scores was done with Pearson's correlation. Tradition, cleanliness, and virginity were the most common motives empowering the continuation of FGM/C (100%), followed by men's wish, esthetic factors, marriage, and religion factors (45.2-100%). Type I FGM/C was the most common, followed by type II. There was only negative correlation between the type II FGM/C and sexual satisfaction. No statistically significant difference between type I and non-FGM/C was found. FGM/C remains high. A variety of socio-cultural myths, religious misbelievers, and hygienic and esthetic concerns were behind the FGM/C. Overall, a large proportion of the participants supported the continuation of FGM/C in spite of adverse effect and sexual dysfunction associated with FGM/C. © 2014 International Society for Sexual Medicine.

Are obstetric outcomes affected by female genital mutilation?

PubMed

Balachandran, Aswini A; Duvalla, Swapna; Sultan, Abdul H; Thakar, Ranee

2018-03-01

Female genital mutilation (FGM) has been associated with adverse obstetric and neonatal outcomes, such as postpartum haemorrhage (PPH), perineal trauma, genital fistulae, obstructed labour and stillbirth. The prevalence of FGM has increased in the UK over the last decade. There are currently no studies available that have explored the obstetric impact of FGM in the UK. The aim of our study was to investigate the obstetric and neonatal outcomes of women with FGM when compared with the general population. We conducted a retrospective case-control study of consecutive pregnant women with FGM over a 5-year period between 1 January 2009 and 31 December 2013. Each woman with FGM was matched for age, ethnicity, parity and gestation with subsequent patients without FGM (control cohort) over the same 5-year period. Outcomes assessed were mode of delivery, duration of labour, estimated blood loss, analgaesia, perineal trauma and foetal outcomes. A total of 242 eligible women (121 FGM, 121 control) were identified for the study. There was a significant increase in the use of episiotomy in the FGM group (p = 0.009) and a significant increase in minor PPH in the control group during caesarean sections (p = 0.0001). There were no differences in all other obstetric and neonatal parameters. In our unit, FGM was not associated with an increased incidence of adverse obstetric and foetal morbidity or mortality.

Cognitive behavioral therapy for post-traumatic stress disorder, depression, or anxiety disorders in women and girls living with female genital mutilation: A systematic review.

PubMed

Adelufosi, Adegoke; Edet, Bassey; Arikpo, Dachi; Aquaisua, Ememobong; Meremikwu, Martin M

2017-02-01

Female genital mutilation (FGM) is associated with psychological consequences such as post-traumatic stress disorder (PSTD), depression, and anxiety disorders. Cognitive behavioral therapy (CBT), an empirically supported form of psychotherapy, may be an effective treatment for these psychological sequelae of FGM. To assess the effectiveness of CBT among individuals living with any type of FGM and diagnosed to have PTSD, depression, or anxiety disorders. CENTRAL, Medline, African Index Medicus, SCOPUS, PILOTS, POPLINE, PsycINFO, WHOLIS, LILACS, ERIC, NYAM Library, CINAHL, Web of Science were searched from inception up to August 10, 2015. Both randomized and nonrandomized studies comparing the efficacy of CBT to other forms of interventions for PTSD, depression, or anxiety disorders in individuals with FGM, were systematically reviewed. We did not identify any studies with eligible design that addressed the objective of the review. There are no included studies. Future studies need to look beyond establishing the prevalence and correlates of FGM to conducting well-designed, randomized controlled studies or well-designed interventional observational studies for the management of the psychological consequences of women and girls living with FGM. CRD42015024458. © 2017 International Federation of Gynecology and Obstetrics. The World Health Organization retains copyright and all other rights in the manuscript of this article as submitted for publication.

Providing information to improve body image and care-seeking behavior of women and girls living with female genital mutilation: A systematic review and meta-analysis.

PubMed

Esu, Ekpereonne; Okoye, Ifeyinwa; Arikpo, Iwara; Ejemot-Nwadiaro, Regina; Meremikwu, Martin M

2017-02-01

Female genital mutilation (FGM) has become recognized worldwide as an extreme form of violation of the human rights of girls and women. Strategies have been employed to curb the practice. To conduct a systematic review of randomized and nonrandomized studies of the effects of providing educational interventions on the body image and care-seeking behavior of girls and women living with FGM with the view to ending the practice. CENTRAL, MEDLINE, and other databases were searched up to August 10, 2015 without any language restrictions. Studies that provided education to women and/or girls living with any type of FGM or residing in countries where FGM is predominantly practiced were included. Two authors independently screened and collected data. We summarized dichotomous outcomes using odds ratios and evidence was assessed using the GRADE system (Grading of Recommendations Assessment, Development, and Evaluation). Educational interventions resulted in fewer women recommending FGM for their daughters and also reduced the incidence of FGM cases among daughters of women who received the educational interventions. These findings need to be validated with large randomized trials. 42015024637. © 2017 International Federation of Gynecology and Obstetrics. The World Health Organization retains copyright and all other rights in the manuscript of this article as submitted for publication.

Injured bodies, damaged lives: experiences and narratives of Kenyan women with obstetric fistula and Female Genital Mutilation/Cutting.

PubMed

Mwanri, Lillian; Gatwiri, Glory Joy

2017-03-14

It is well acknowledged that Female Genital Mutilation/Cutting (FGM/C/C) leads to medical, psychological and sociocultural sequels. Over 200 million cases of FGM/C exist globally, and in Kenya alone, a total of 12,418,000 (28%) of women have undergone FGM/C, making the practice not only a significant national, but also a global health catastrophe. FGM/C is rooted in patriarchal and traditional cultures as a communal experience signifying a transition from girlhood to womanhood. The conversations surrounding FGM/C have been complicated by the involvement of women themselves in perpetuating the practice. A qualitative inquiry employing face-to-face, one-on-one, in-depth semi-structured interviews was used in a study that included 30 women living with obstetric fistulas in Kenya. Using the Social Network Framework and a feminist analysis we present stories of Kenyan women who had developed obstetric fistulas following prolonged and obstructed childbirth. Of the 30 participants, three women reported that health care workers informed them that FGM/C was one of the contributing factors to their prolonged and obstructed childbirth. They reported serious obstetric complications including: the development of obstetric fistulas, lowered libido, poor quality of life and maternal and child health outcomes, including death. Fistula and subsequent loss of bodily functionalities such as uncontrollable leakage of body wastes, was reported by the women to result in rejection by spouses, families, friends and communities. Rejection further led to depression, loss of work, increased sense of apathy, lowered self-esteem and image, as well as loss of identity and communal sociocultural cohesion. FGM/C is practised in traditional, patriarchal communities across Africa. Although the practice aims to bind community members and to celebrate a rite of passage; it may lead to harmful health and social consequences. Some women with fistula report their fistula was caused by FGM/C. Concerted efforts which embrace feminist understandings of society, as well as multi-sectoral, multidisciplinary and community development approaches need to be employed to address FGM/C, and to possibly reduce cases of obstetric fistulas in Kenya and beyond. Both government and non-government organisations need to be involved in making legislative, gender sensitive policies that protect women from FGM/C. In addition, the policy makers need to be in the front line to improve the lives of women who endured the consequences of FGM/C.

Transnational Organized Crime and Conflict: Strategic Implications for the Military

DTIC Science & Technology

2002-01-01

Publishing Company, 1999), 25-26. 22 Shelley, 4-5. 23 U.S. Bureau of the Census, Statistical Abstract of the United States: 2000 (1 1 th edition ) (Washington...34Lonefighter," Aisa Week, 30 November 2001, 28. 49 Joel R. San Juan and Al Maradz Jalim, "Jolo Folk Massacre 6 Rangers; Troops Beheaded, Mutilated...of Justice Programs, Bureau of Justice Statistics, 2001. Espinosa-Robles, Raissa. "Lonefighter." Aisa Week, 30 November 2001, 28. Farah, Douglas. "Al

Autosomal recessive type II hereditary motor and sensory neuropathy with acrodystrophy.

PubMed

Thomas, P K; Claus, D; King, R H

1999-02-01

A family is described with presumed autosomal recessive inheritance in which three siblings developed a progressive neuropathy that combined limb weakness and severe distal sensory loss leading to prominent mutilating changes. Electrophysiological and nerve biopsy findings indicated an axonopathy. The disorder is therefore classifiable as type II hereditary motor and sensory neuropathy (HMSN II). The clinical features differ from those reported in previously described cases of autosomal recessive HMSN II. This disorder may therefore represent a new variant.

Embolization as the treatment for a life-threatening mandibular arteriovenous malformation.

PubMed

Loureiro, Caio Cesar de Souza; Falchet, Paula Cristina Felix; Gavranich, João; Lobo Leandro, Luiz Fernando

2010-03-01

Mandibular arteriovenous malformation is a severe vascular pathological condition that may lead to life-threatening hemorrhages. In child and teenaged patients, a conservative treatment is preferred to avoid profuse blood loss and/or mutilating alterations in the still-growing patients' face. The aim of this article was to present a case of an 11-year-old boy with an arteriovenous malformation involving the left mandible and treated by means of endovascular embolization with direct lesional delivery of N-butyl-cyanoacrylate glue through transfemoral catheterization.

Further information on the prehistoric representations of human hands in the cave of Gargas

PubMed Central

Hooper, Alex

1980-01-01

This paper amends and adds recent information to Paul A. Janssens' earlier article on the prehistoric paintings of human hands in the cave of Gargas, France.1 Possible diagnoses for the deficiencies found in many of the hand pictures, and some non-medical theories of explanation, are reviewed. It is concluded that the hands used as stencils were mutilated and that the images were deliberately placed within the cave and were not the by-products of some other activity. PMID:6990130

Automation and Agitation: Today's Junior College Student--D.N.F.S.M.B.* (*Do Not Fold, Spindle, Mutilate, or Bend); Conference for Chief Administrators of Student Personnel (Pacific Grove, California, January 10-12, 1968).

ERIC Educational Resources Information Center

California Junior Coll. Association, Sacramento. Committee on Guidance and Student Personnel.

After a keynote speech on how the dean of students can help bridge the gap between students and the trustees, legislators, and the supporting community, the conferees discussed automated registration--how to provide it with an acceptable master schedule, its many advantages, and a few problems. As for student activism, understanding must work both…

The impact of ebinyo, a form of dental mutilation, on the malocclusion status in Uganda.

PubMed

Bataringaya, Aisha; Ferguson, Maurice; Lalloo, Ratilal

2005-09-01

The practice of extraction of ebinyo or false teeth is based on the belief that the rubbing of herbs on the gum (in the region of the canine) or the removal of the primary and/or permanent canine tooth buds will lead to the relief of childhood fevers and diarrhoea. The reported prevalence of this practice in Uganda and neighbouring countries is varied. A survey carried out in Kampala to determine the occlusal traits of fourteen-year-old children offered an opportunity to assess the effects of ebinyo (a dental mutilation based on local customs and superstitions) on the occlusal status of the sample population. 402 children aged fourteen years were examined according to the criteria of the Federation Dentaire Internationale Commission on Classification and Statistics for Oral Conditions method for measuring occlusal traits (COCSTOC-MOT) proposed by Baume et al. (1973). The most common dental anomaly was teeth missing due to extraction or trauma. Canines (28%) and mandibular first molars (28%) exhibited the highest frequency. Missing canines were four times more common in girls than boys, and three times greater in the maxilla than the mandible. Canines also accounted for 12.8% of the malformed teeth observed in the study. The results of this study show that the practice of ebinyo, although carried out early in the life of the child, can impact on the occlusal status in the permanent dentition years later.

A description of female genital mutilation and force-feeding practices in Mauritania: implications for the protection of child rights and health.

PubMed

Ouldzeidoune, Nacerdine; Keating, Joseph; Bertrand, Jane; Rice, Janet

2013-01-01

To establish the prevalence of female genital mutilation (FGM) and force feeding (gavage) practices among children in Mauritania; to investigate factors related to FGM and gavage practices and attitude in Mauritania; and to explore implications related to the protection of children's rights and welfare. Data from the Mauritania 2000-2001 DHS were used in this analysis. Data were collected from men and women about their attitude toward the continuation of FGM and gavage; women only were asked if they ever experienced one of these practices. Chi-square statistics were used to investigate differences in attitude and practice of FGM and gavage by demographic characteristics. Binary logistic regression was used to identify socio-demographic factors related to FGM and gavage outcomes. The overall prevalence of FGM was 77% but varied depending on ethnicity. The majority of both female and male respondents favored the continuation of the practice (64% and 70%, respectively). Almost a quarter (23%) of women reported being force fed as a child and 32% of women and 29% of men approved the continuation of the practice. Gavage is almost exclusively practiced among Arabs. The practice of both FGM and gavage is ongoing, although the prevalence and attitude towards both appears to vary as a function of ethnicity, wealth, education, marital status, and age. Contextually relevant intervention and enforcement strategies are needed to challenge these cultural norms and protect the rights and welfare of children in Mauritania.

Management of type III female genital mutilation in Birmingham, UK: a retrospective audit.

PubMed

Paliwal, Priya; Ali, Sarah; Bradshaw, Sally; Hughes, Alison; Jolly, Kate

2014-03-01

to audit clinical management of women with type III female genital mutilation (FGM) according to local guidelines. Secondary objectives were to describe the population that uses the service and compare obstetric outcomes of intrapartum deinfibulation and antenatal deinfibulation. retrospective audit. a hospital midwifery-led FGM specialist service in Birmingham, UK. 253 women with type III FGM who gave birth between January 2008 and December 2009 METHODS: retrospective case analysis using patient records. proportion of women managed according to locally agreed criteria for the management of FGM; obstetric outcomes including perineal tears, episiotomy rates, estimated blood loss, infant APGAR scores and indications for caesarean section. 91 (36%) women booked into antenatal care after 16 weeks gestation. Only 26 (10.3%) were managed fully according to guidelines. The area with poorest performance was child protection, where the presence of normal genitalia was documented in only 52 (38.8%) of medical notes following birth of a female infant. The majority of women (214, 84.6%) had been deinfibulated in a previous pregnancy. Of the 39 infibulated at booking, only 9 (23.1%) were deinfibulated antenatally, the rest opted for intrapartum deinfibulation. Women who had intrapartum deinfibulation had a higher average blood loss and more tears than those deinfibulated antenatally, although this was not statistically significant. alternative systems should be considered to improve documentation of child protection related information. Further research is needed to confirm or refute the adverse findings among those that delayed deinfibulation. Copyright © 2013 Elsevier Ltd. All rights reserved.

Deinfibulation for preventing or treating complications in women living with type III female genital mutilation: A systematic review and meta-analysis.

PubMed

Okusanya, Babasola O; Oduwole, Olabisi; Nwachuku, Nuria; Meremikwu, Martin M

2017-02-01

Deinfibulation is a surgical procedure carried out to re-open the vaginal introitus of women living with type III female genital mutilation (FGM). To assess the impact of deinfibulation on gynecologic or obstetric outcomes by comparing women who were deinfibulated with women with type III FGM or women without FGM. Major databases including CENTRAL, MEDLINE, and Scopus were searched until August 2015. We included nonrandomized studies that compared obstetric outcomes of women with deinfibulation, type III FGM (not deinfibulated during labor), and no FGM. Quality of evidence was determined following the GRADE methodology. Summary measures were calculated using odds ratios at 95% confidence intervals. We found no randomized controlled trials. We included four case-control studies. The quality of evidence was very low. Compared with women with type III FGM at delivery, deinfibulated women had a significant reduction in the risk of having a cesarean delivery or postpartum hemorrhage. Compared with women without FGM, deinfibulated women had a similar risk of episiotomy, cesarean delivery, vaginal lacerations, postpartum hemorrhage, and blood loss at vaginal delivery. The length of second stage of labor, mean maternal hospital stay, and Apgar scores less than 7 were also comparable. Low-quality evidence suggests deinfibulation improves birth outcomes for women with type III FGM. CRD42015024466. © 2017 International Federation of Gynecology and Obstetrics. The World Health Organization retains copyright and all other rights in the manuscript of this article as submitted for publication.

Crossing borders: discussing the evidence relating to the mental health needs of women exposed to female genital mutilation.

PubMed

Mulongo, Peggy; McAndrew, Sue; Hollins Martin, Caroline

2014-08-01

The terms 'Female Circumcision' (FC), 'FG Cutting' (FGC) and 'FG Mutilation' (FGM) refer to procedures involving the partial or total removal of the external female genitalia for non-medical reasons. In practicing countries, FGC/FC is more widely used, as it is believed to be inoffensive, providing more impartial ways of discussing the practice. Positive beliefs about FC/FGC include virginity, marriage prospects, family reputation, or passage to adulthood. Regardless of terminology, the practice exists in at least 28 African counties, and a few Asian and Middle Eastern countries. In Western society, FGM is considered a breach of human rights, being outlawed in a number of countries. With immigration trends, FGC is now prominent in Western society among practicing communities. While the past decade has seen an increase in studies and recommendations for health-care support related to the physical health consequences of FGM, little is known about the psychological impact and its management. For many girls and women, FGC is a traumatic practice, transforming it to FGM and affecting their mental health. This discussion paper focuses on evidence relating to the mental health consequences of FGM, therapeutic interventions, and the mental health nurse's role in addressing the needs of this group of women. © 2014 The Authors. International Journal of Mental Health Nursing published by Wiley Publishing Asia Pty Ltd on behalf of Australian College of Mental Health Nurses Inc.

Estimating the prevalence of female genital mutilation in Portugal.

PubMed

Teixeira, A L; Lisboa, M

2016-10-01

Due to globalized migratory processes, female genital mutilation/cutting (FGM/C) has spread to other countries, including countries in Europe, where, with a few exceptions, it remains a concealed problem. To the authors' knowledge, this is the first national extensive study to estimate the prevalence of FGM/C in Portugal. Prevalence estimation. Using extrapolation of country-of-origin prevalence data and the 2011 Census data, this study estimated: the prevalence of FGM/C in Portugal among women of reproductive age (15-49 years) and among all women aged ≥15 years; and the number of girls aged <15 years living in Portugal who have undergone or will probably undergo FGM/C. It is estimated that 6576 women aged ≥15 years living in Portugal have undergone FGM/C, with cases distributed unevenly throughout the national territory. In addition, it is estimated that 1830 girls aged <15 years living in Portugal have undergone or are likely to undergo FGM/C. This study estimated that more than 6000 women living in Portugal have undergone FGM/C, and many girls remain at risk. These two groups need different types of interventions. Awareness of the number and geographical dispersion of cases of FGM/C will enable more informed and targeted definition of public health policies for protection of females who have undergone or are at risk of undergoing FGM/C. Copyright © 2016 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Sexual homicide: Brief review of the literature and case report involving rape, genital mutilation and human arson.

PubMed

Karakasi, Maria-Valeria; Vasilikos, Epameinondas; Voultsos, Polichronis; Vlachaki, Aikaterini; Pavlidis, Pavlos

2017-02-01

The objective of the current paper is to report a new case of sexual murder involving human arson and summarize the literature on the phenomenon of sexual homicide. The present case study is unprecedented in Greece and a rarity in international literature due to the fact that the victim suffered genital mutilation and incineration while still alive. The evaluation consisted of 176 articles; 53 were reviewed by the authors. The results revealed sparse, but significant, research findings. The authors discuss the limitations regarding research, incidence of the phenomenon, crime-scene patterns, offender characteristics (killing methods, motive inferences, sociodemographic data, classifications, psychopathology, modus operandi), and victim selection. The incidence of the phenomenon is unclear (1-4%) due to non-standardized criteria. It is an expression of displaced anger or sexual sadism and/or a way to elude detection (ancillary benefit). Most offenders (in their first kill) and victims were in their late 20s to early 30s and belong to Caucasian populations. Personal weapons were commonly used against women, strangulation is the prevalent killing method against children, and firearms against men. Most of the sexual homicide perpetrators are non-psychotic at the time of the attack, but experience personality pathology, primitive defenses, pathological object relations, and withdrawal into fantasy in order to deal with social isolation. Copyright © 2016 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

Female Genital Mutilation in Kenya: are young men allies in social change programmes?

PubMed

Brown, Eleanor; Mwangi-Powell, Faith; Jerotich, Miriam; le May, Victoria

2016-05-01

The Girl Summit held in 2014 aimed to mobilise greater effort to end Female Genital Mutilation (FGM) within a generation, building on a global movement which viewed the practice as a severe form of violence against women and girls and a violation of their rights. The UN, among others, endorse "comprehensive" strategies to end FGM, including legalistic measures, social protection and social communications. FGM is a sensitive issue and difficult to research, and rapid ethnographic methods can use existing relations of trust within social networks to explore attitudes towards predominant social norms which posit FGM as a social necessity. This study used Participatory Ethnographic Evaluation Research (PEER) to understand young men's (18-25 years) perceptions of FGM, demand for FGM among future spouses, and perceptions of efforts to end FGM in a small town in West Pokot, Kenya, where FGM is reported to be high (between 85% to 96%). Twelve PEER researchers were recruited, who conducted two interviews with their friends, generating a total of 72 narrative interviews. The majority of young men who viewed themselves as having a "modern" outlook and with aspirations to marry "educated" women were more likely not to support FGM. Our findings show that young men viewed themselves as valuable allies in ending FGM, but that voicing their opposition to the practice was often difficult. More efforts are needed by multi-stakeholders - campaigners, government and local leaders - to create an enabling environment to voice that opposition. Copyright © 2016 Elsevier Inc. All rights reserved.

Midwives' experiences of caring for women with female genital mutilation: Insights and ways forward for practice in Australia.

PubMed

Dawson, A J; Turkmani, S; Varol, N; Nanayakkara, S; Sullivan, E; Homer, C S E

2015-09-01

Female genital mutilation (FGM) has serious health consequences, including adverse obstetric outcomes and significant physical, sexual and psychosocial complications for girls and women. Migration to Australia of women with FGM from high-prevalence countries requires relevant expertise to provide women and girls with FGM with specialised health care. Midwives, as the primary providers of women during pregnancy and childbirth, are critical to the provision of this high quality care. To provide insight into midwives' views of, and experiences working with, women affected by FGM. A descriptive qualitative study was undertaken using focus group discussions with midwives from four purposively selected antenatal clinics and birthing units in three hospitals in urban New South Wales. The transcripts were analysed thematically. Midwives demonstrated knowledge and recalled skills in caring for women with FGM. However, many lacked confidence in these areas. Participants expressed fear and a lack of experience caring for women with FGM. Midwives described practice issues, including the development of rapport with women, working with interpreters, misunderstandings about the culture of women, inexperience with associated clinical procedures and a lack of knowledge about FGM types and data collection. Midwives require education, training and supportive supervision to improve their skills and confidence when caring for women with FGM. Community outreach through improved antenatal and postnatal home visitation can improve the continuity of care provided to women with FGM. Copyright © 2015 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

Repeated dose 28-day oral toxicity study of DEAE-Dextran in mice: An advancement in safety chemotherapeutics.

PubMed

Bakrania, Anita K; Variya, Bhavesh C; Madan, Prem; Patel, Snehal S

2017-08-01

Cancer has emerged as a global threat with challenges for safe chemotherapeutics. Most of the currently available anti-cancer drugs exhibit significant toxicity. Amongst novel agents, interferons have exhibited anti-proliferative and cytoprotective roles. However, due to stability drawbacks of interferons, we have identified an interferon inducer DEAE-Dextran, which resolves the stability issues. Based on the previous history of toxicity pertaining to the current chemotherapeutic agents, it is equally essential to determine the safety of DEAE-Dextran. In the present study, repeated dose 28 day oral toxicity of DEAE-Dextran has been evaluated in accordance to OECD-407. We found absence of any CNS behavioral changes related to self-mutilation, walking backwards, aggressiveness on handling or tonic-clonic seizures during the 28 day study. Neither the motor activity nor grip strength was altered during the treatment duration with DEAE-Dextran implying absence of any effect on the skeletal muscles. Interestingly, we also found that treatment with DEAE-Dextran did not present any significant cardiac, hepatic, renal, gastrointestinal, lymphatic or reproductive system toxicity or alteration in the body's normal physiology based upon the various organ function tests. Henceforth, it may be concluded that DEAE-Dextran is a safe anti-cancer agent devoid of any sub-acute toxicity. Copyright © 2017 Elsevier Inc. All rights reserved.

Successful Second Microsurgical Replantation for Amputated Penis.

PubMed

Fujiki, Masahide; Ozaki, Mine; Kai, Akiko; Takushima, Akihiko; Harii, Kiyonori

2017-09-01

Penile amputation is a rare emergency, but the best method for its repair is required due to the organ's functional and societal role. Since the first successful microsurgical replantation of the amputated penis, microsurgical techniques have matured and become the standard treatment for the penile replantation. However, the successful second microsurgical replantation for amputated penis has been rarely reported. We present the case of a 40-year-old man with schizophrenia who had a past history of penile self-mutilation and successful replantation at another hospital 2 years ago. After stopping oral medication for schizophrenia, he again cut his penis with a kitchen knife. We successfully replanted the amputated penis by anastomosing both circumflex arteries, the superficial dorsal vein, and the deep dorsal vein using microsurgical techniques. Postoperatively, the foreskin of the replanted penis gradually developed partial necrosis, requiring surgical debridement. The aesthetic and functional results were satisfactory and retrograde urethrography showed no evidence of leakage and stricture of the urethra. Although skin necrosis after penile replantation has been reported as an unavoidable process owing to the nature of injury, the rate would be higher after secondary replantation because of scar formation due to the previous operation. Therefore, our case of successful secondary replantation suggests that skin necrosis would be a predictable postoperative complication and the debridement timing of the devitalized foreskin should be closely monitored, and also secondary amputation is not a contraindication of replantation.

[How dangerous are "mouse trap projectile traps"?].

PubMed

Schyma, C; Placidi, P

1994-01-01

The authors research by experiments to define the potency of wounding of a special mouse trap which belongs to the spring-guns. Besides the regular assigned 9 mm blank cartridge also the 9 x 17 mm "green" cattle stunning cartridge is tested. Shots were made on soap, cotton and skin on different conditions. As result the authors found that by close range shots (up to 1 cm) by the blank cartridge badly healing wounds are caused. The 600 Joule cattle stunning cartridge is able to mutilate the hand by contact shots.

[Hand reconstruction by microsurgical free toe transfer].

PubMed

Stamate, T; Budurcă, A R; Hermeziu, Oana

2003-01-01

Reconstruction of complex hand mutilations with multi-digital or thumb amputations are best treated with microsurgical toe transfers. We present the results of the first 15 cases operated by the first author, of which 12 are thumb reconstructions (6 great toe and 6 second toe transfers) and 3 long fingers reconstructions with combined second and third toe transfers. There were no microsurgical complications. Cortical integration and functional integration was achieved for all transferred toes, with discriminatory sensibility (m2PD between 5 and 13 mm) and active mobility range between 30 and 60 degrees.

Female genital mutilation in the Sudan: survey of the attitude of Khartoum university students towards this practice.

PubMed

Herieka, E; Dhar, J

2003-06-01

Female genital mutilation (FGM) or female circumcision is the removal of variable amounts of tissue from the female external genitalia. It is practised all over the world on very young girls. This study was conducted in Sudan where FGM is a criminal offence and not a religious dictate. We assessed the knowledge, attitudes, and perceptions of this practice among Khartoum university students and compared the differences between male and female student responses. An anonymised detailed questionnaire was distributed among the university students. In addition to the participant's age, marital status, course studying, details regarding their attitude, knowledge of the practice of FGM, and their own experiences were collected. Of the 500 questionnaires distributed, 414 (82.8%) were returned from 192 (46%) females and 222 (54%) males. 109 (56.8%) of the female respondents were themselves circumcised.18.8% of the male students and 9.4% of the female students thought FGM was recommended by their religion. Only 90 (46.9%) female students compared with 133 (59.9%) male students thought FGM was illegal. Though 16 (8.3%) female respondents thought FGM would increase their chances of marriage, the majority, 166 (74.8%), of the male students would prefer a non-circumcised female. This study shows that 109 (56.8%) female university students who responded were circumcised. Confusing religious messages and ambiguous laws seem to be responsible for the continuation of this practice. The study highlights the partnership that needs to be established between religious leaders and educationalists to end this medieval practice.

A multidisciplinary approach to clitoral reconstruction after female genital mutilation: the crucial role of counselling.

PubMed

De Schrijver, Lotte; Leye, Els; Merckx, Mireille

2016-08-01

Female genital mutilation (FGM) is becoming more widely seen in the West, due to immigration and population movement. Health services are being confronted with the need to provide care for women with FGM. One of the more recent trends is the provision of clitoral reconstruction. It remains unclear, however, what constitutes good practice with regard to this type of surgery. Based on a keynote presentation about reconstructive clitoral surgery, we briefly discuss the possible consequences of FGM and the findings from recent publications on clitoral reconstruction. Recognising individual differences in women, we suggest a multidisciplinary counselling model to provide appropriate care for women requesting clitoral reconstruction. The literature shows that FGM influences physical, mental and sexual health. Clitoral reconstructive surgery can lead to an increase in sexual satisfaction and orgasm in some, but not all, women. A multidisciplinary approach would enable a more satisfactory and individually tailored approach to care. The multidisciplinary team should consist of a midwife, a gynaecological surgeon, a psychologist-psychotherapist, a sexologist and a social worker. Comprehensive health counselling should be the common thread in this model of care. Our proposed care pathway starts with taking a thorough history, followed by medical, psychological and sexological consultations. Women with FGM requesting clitoral reconstruction might primarily be looking to improve their sexual life, to recover their identity and to reduce pain. Surgery may not always be the right answer. Thorough counselling that includes medical, psychological and sexual advice is therefore necessary as part of a multidisciplinary approach.

Using multilevel growth curve modeling to examine emotional modulation of temporal summation of pain (TS-pain) and the nociceptive flexion reflex (TS-NFR).

PubMed

Rhudy, Jamie L; Martin, Satin L; Terry, Ellen L; Delventura, Jennifer L; Kerr, Kara L; Palit, Shreela

2012-11-01

Emotion can modulate pain and spinal nociception, and correlational data suggest that cognitive-emotional processes can facilitate wind-up-like phenomena (ie, temporal summation of pain). However, there have been no experimental studies that manipulated emotion to determine whether within-subject changes in emotion influence temporal summation of pain (TS-pain) and the nociceptive flexion reflex (TS-NFR, a physiological measure of spinal nociception). The present study presented a series of emotionally charged pictures (mutilation, neutral, erotic) during which electric stimuli at 2 Hz were delivered to the sural nerve to evoke TS-pain and TS-NFR. Participants (n=46 healthy; 32 female) were asked to rate their emotional reactions to pictures as a manipulation check. Pain outcomes were analyzed using statistically powerful multilevel growth curve models. Results indicated that emotional state was effectively manipulated. Further, emotion modulated the overall level of pain and NFR; pain and NFR were highest during mutilation and lowest during erotic pictures. Although pain and NFR both summated in response to the 2-Hz stimulation series, the magnitude of pain summation (TS-pain) and NFR summation (TS-NFR) was not modulated by picture-viewing. These results imply that, at least in healthy humans, within-subject changes in emotions do not promote central sensitization via amplification of temporal summation. However, future studies are needed to determine whether these findings generalize to clinical populations (eg, chronic pain). Copyright © 2012 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.

Emotional modulation of pain and spinal nociception in fibromyalgia

PubMed Central

Rhudy, Jamie L.; DelVentura, Jennifer L.; Terry, Ellen L.; Bartley, Emily J.; Olech, Ewa; Palit, Shreela; Kerr, Kara L.

2013-01-01

Fibromyalgia (FM) is characterized by widespread pain, as well as affective disturbance (e.g., depression). Given that emotional processes are known to modulate pain, a disruption of emotion and emotional modulation of pain and nociception may contribute to FM. The present study used a well-validated affective picture-viewing paradigm to study emotional processing and emotional modulation of pain and spinal nociception. Participants were 18 individuals with FM, 18 individuals with rheumatoid arthritis (RA), and 19 healthy pain-free controls (HC). Mutilation, neutral, and erotic pictures were presented in four blocks; two blocks assessed only physiological-emotional reactions (i.e., pleasure/arousal ratings, corrugator EMG, startle modulation, skin conductance) in the absence of pain and two blocks assessed emotional reactivity and emotional modulation of pain and the nociceptive flexion reflex (NFR, a physiological measure of spinal nociception) evoked by suprathreshold electric stimulations over the sural nerve. In general, mutilation pictures elicited displeasure, corrugator activity, subjective arousal, and sympathetic activation, whereas erotic pictures elicited pleasure, subjective arousal, and sympathetic activation. However, FM was associated with deficits in appetitive activation (e.g., reduced pleasure/arousal to erotica). Moreover, emotional modulation of pain was observed in HC and RA, but not FM, even though all three groups evidenced modulation of NFR. Additionally, NFR thresholds were not lower in the FM group, indicating a lack of spinal sensitization. Together, these results suggest that FM is associated with a disruption of supraspinal processes associated with positive affect and emotional modulation of pain, but not brain-to-spinal cord circuitry that modulates spinal nociceptive processes. PMID:23622762

A descriptive study on evaluation of bio-medical waste management in a tertiary care public hospital of North India

PubMed Central

2014-01-01

Background Proper management of Biomedical waste (BMW) generated in a healthcare facility is one of the most important functions of a healthcare worker (HCW) as its improper management not only poses risk to human beings and environment, but may also invite legal action against HCW as well as hospital administration. This study was carried out to evaluate quality of BMW management in 1100-bedded hospital attached to a tertiary care public institute in North India. Methods A checklist, including 29 parameters related to various functions to be carried out at source of generation by a HCW for BMW management was prepared by researcher and used after validation to record observations in all the 70 areas of hospital. A total of 6 visits were made to each area and mean percentage score was calculated for each area and each category of waste management. Results It was found that summated mean percentage score of ‘Treatment Room of Wards’, which were used exclusively by resident doctors, was significantly lower than Operation Theatres (p value: 0.033) and ‘Central Waste Collection Points of Wards’ (p value: 0.018) for the function of ‘mutilation of recyclable waste’ and it was significantly lower than all other areas (p value: 0.006 to 0.017) for the function of ‘disinfection of waste’. Conclusion It is concluded that more emphasis needs to be laid on ‘mutilation of recyclable waste’ and disinfection of waste’ by HCWs especially resident doctors. PMID:24742274

A Description of Female Genital Mutilation and Force-Feeding Practices in Mauritania: Implications for the Protection of Child Rights and Health

PubMed Central

Ouldzeidoune, Nacerdine; Keating, Joseph; Bertrand, Jane; Rice, Janet

2013-01-01

Objectives To establish the prevalence of female genital mutilation (FGM) and force feeding (gavage) practices among children in Mauritania; to investigate factors related to FGM and gavage practices and attitude in Mauritania; and to explore implications related to the protection of children’s rights and welfare. Methods Data from the Mauritania 2000–2001 DHS were used in this analysis. Data were collected from men and women about their attitude toward the continuation of FGM and gavage; women only were asked if they ever experienced one of these practices. Chi-square statistics were used to investigate differences in attitude and practice of FGM and gavage by demographic characteristics. Binary logistic regression was used to identify socio-demographic factors related to FGM and gavage outcomes. Findings The overall prevalence of FGM was 77% but varied depending on ethnicity. The majority of both female and male respondents favored the continuation of the practice (64% and 70%, respectively). Almost a quarter (23%) of women reported being force fed as a child and 32% of women and 29% of men approved the continuation of the practice. Gavage is almost exclusively practiced among Arabs. Conclusion The practice of both FGM and gavage is ongoing, although the prevalence and attitude towards both appears to vary as a function of ethnicity, wealth, education, marital status, and age. Contextually relevant intervention and enforcement strategies are needed to challenge these cultural norms and protect the rights and welfare of children in Mauritania. PMID:23593257

I knew how it feels but couldn't save my daughter; testimony of an Ethiopian mother on female genital mutilation/cutting.

PubMed

Adinew, Yohannes Mehretie; Mekete, Beza Tamirat

2017-12-01

World Health Organization defines female genital mutilation/cutting as all procedures that involve partial or total removal of the external female genitalia, or other injury to the female genital organs for non-medical reasons. The practice is common in Ethiopia, especially among Somali (99%) ethnic groups. Even though FGM/C is labeled illegal practice according to the revised 2005 Penal Code of the country, the practice is still responsible for misery of many girls in Ethiopia. This personal testimony is presented using woman's own words. Data were collected through in-depth interview with a woman at Gursum health center, Somali regional state, eastern Ethiopia on June 19/2016. The interview was conducted in a private environment and original names were changed to overcome ethical concerns. Informed written consent was obtained from the participant prior to data collection. The interview was audio-taped using a digital voice recorder, later transcribed and translated verbatim from the local language, Amharic to English. The study participant described a range of experiences she had during her own and her daughter's circumcision. Three themes emerged from the woman's description: womanhood, social pressure and stigmatization of uncircumcised women and uncertain future. Even though the national prevalence may show a decline, FGM/C is still practiced underground. Thus, anti-FGM/C interventions shall take in to account elders influence and incorporate a human rights approach rather than relying merely on the dire health consequences. Further exploration of the determinants of FGM/C on a wider scale is recommended.

Clinical indications for cesarean delivery among women living with female genital mutilation.

PubMed

Rodriguez, Maria I; Say, Lale; Abdulcadir, Jasmine; Hindin, Michelle J

2017-10-01

To compare primary indications for cesarean delivery among patients with different female genital mutilation (FGM) status. The present secondary analysis included data from women who underwent trial of labor resulting in cesarean delivery at 28 obstetric centers in six African countries between November 1, 2001, and March 31, 2003. Associations between cesarean delivery indications and FGM status were assessed using descriptive statistics and multivariable multinomial logistic regression. Data from 1659 women (480 patients with no type of FGM and 1179 patients with FGM [any type]) were included; cesarean delivery indications were collapsed into five categories (fetal indications, maternal factors, stage 1 arrest, stage 2 arrest, and other). The incidence of a clear medical indication for cesarean delivery did not differ between the groups (P=0.320). Among patients without a clear indication for cesarean delivery, women with FGM were more likely to have undergone cesarean delivery for maternal factors (adjusted relative risk ratio [aRRR] 3.92, 95% confidence interval [CI] 1.3-11.71), stage 1 arrest (aRRR 7.74, 95% CI 1.33-45.07), stage 2 arrest (aRRR 6.63, 95% CI 3.74-11.73), or other factors (aRRR 2.41, 95% CI 1.04-5.60) rather than fetal factors compared with women who had no type of FGM. Among women with unclear medical indications, FGM was associated with cesarean delivery being performed for maternal factors or arrest disorders. © 2017 World Health Organization; licensed by John Wiley & Sons Ltd on behalf of International Federation of Gynecology and Obstetrics.

Multidisciplinary approach to the management of children with female genital mutilation (FGM) or suspected FGM: service description and case series.

PubMed

Creighton, Sarah M; Dear, Joanna; de Campos, Claudia; Williams, Louise; Hodes, Deborah

2016-02-29

To describe the first dedicated clinic in the UK for children with suspected or confirmed female genital mutilation (FGM) including referral patterns, clinical findings and subsequent management. A prospective study of all children seen in a dedicated multidisciplinary FGM clinic for children over a 1-year period. Patients aged under 18 years referred for clinical assessment or for a second opinion on Digital Versatile Disc (DVD) images. Data were collected on reasons for referral, demography, genital examination findings including FGM type, and clinical recommendations. 38 children were referred of whom 18 (47%) had confirmed FGM; most frequently type 4 (61%). Social care and police referred 78% of cases. According to UK law FGM had been performed illegally in three cases. Anonymous information given to the police led to the referral of six children, none of whom had had FGM. Mandatory reporting and increased media attention may increase the numbers of referrals of children with suspected FGM. This patient group have complex needs and management in a dedicated multidisciplinary service is essential. Paediatricians and gynaecologists should have the skills to carry out the consultation and detect all types of FGM including type 4 which was the most common type seen in this series. This is the first dedicated FGM service for children in the UK and similar clinics in high-prevalence areas should be established. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Mothers' factors associated with female genital mutilation in daughters in the Iraqi Kurdistan Region.

PubMed

Shabila, Nazar P

2017-03-01

An important proactive factor for the continuation of female genital mutilation (FGM) is tradition and customs inherited in the family from mothers to daughters. Therefore, the aim of this study was to determine mothers' factors associated with the occurrence of FGM among their daughters. The datasets from the Iraq Multiple Indicator Cluster Survey 2011, on 5,184 women aged 15 to 49 years having at least one daughter, was used. Multivariate analysis based on a binary logistic regression model was applied. Mothers' age (adjusted odds ratio [aOR] = 8.18 at ages 25-34 years, aOR = 22.64 at ages 35-44 years, and aOR = 29.78 at ages 45-49 years, compared to the age group 15-24 years), educational level (aOR = 0.52 for primary education, aOR = 0.26 for secondary education, and aOR = 0.03 for higher education compared to uneducated), employment status (aOR = 0.55 for women having office work compared with unemployed), FGM status (aOR = 27.44 for circumcised mothers compared to uncircumcised), the governorate of residence (aOR = 18.73 for Suleimaniya and aOR = 33.23 for Erbil compared with Dohuk), and the wealth index of the household (aOR = 0.55 for richest group compared to the poorest) were significantly associated with the occurrence of FGM in daughters. Strategies aimed at preventing this harmful practice in the Iraqi Kurdistan Region should include female education and empowerment.

Coping and chronic psychosocial consequences of female genital mutilation in The Netherlands.

PubMed

Vloeberghs, Erick; van der Kwaak, Anke; Knipscheer, Jeroen; van den Muijsenbergh, Maria

2012-01-01

The study presented in this article explored psychosocial and relational problems of African immigrant women in The Netherlands who underwent female genital mutilation/cutting (FGM/C), the causes they attribute to these problems--in particular, their opinions about the relationship between these problems and their circumcision--and the way they cope with these health complaints. This mixed-methods study used standardised questionnaires as well as in-depth interviews among a purposive sample of 66 women who had migrated from Somalia, Sudan, Eritrea, Ethiopia or Sierra Leone to The Netherlands. Data were collected by ethnically similar female interviewers; interviews were coded and analysed by two independent researchers. One in six respondents suffered from post-traumatic stress disorder (PTSD), and one-third reported symptoms related to depression or anxiety. The negative feelings caused by FGM/C became more prominent during childbirth or when suffering from physical problems. Migration to the Netherlands led to a shift in how women perceive FGM, making them more aware of the negative consequences of FGM. Many women felt ashamed to be examined by a physician and avoided visiting doctors who did not conceal their astonishment about the FGM. FGM/C had a lifelong impact on the majority of the women participating in the study, causing chronic mental and psychosocial problems. Migration made women who underwent FGM/C more aware of their condition. Three types of women could be distinguished according to their coping style: the adaptives, the disempowered and the traumatised. Health care providers should become more aware of their problems and more sensitive in addressing them.

Estimates of first-generation women and girls with female genital mutilation in the European Union, Norway and Switzerland.

PubMed

Van Baelen, Luk; Ortensi, Livia; Leye, Els

2016-12-01

Female genital mutilation (FGM) is the practice of partial or total removal of female genitalia for non-medical reasons. The procedure has no known health benefits but can cause serious immediate and long-term obstetric, gynaecological and sexual health problems. Health workers in Europe are often unaware of the consequences of FGM and lack the knowledge to treat women adequately. Our goal was to estimate the number of first-generation girls and women in the European Union, Norway and Switzerland who have undergone FGM. Before migration from FGM-practicing countries began, FGM was an unknown phenomenon in Europe. Secondary analysis of data from the 2011 EU census and extrapolation from age-specific FGM prevalence rates in the immigrants' home countries to these data were used to provide our estimates. Estimates based on census and other demographic data were compared to our results for Belgium. In 2011 over half a million first-generation women and girls in the EU, Norway and Switzerland had undergone FGM before immigration. One in two was living in the UK or France, one in two was born in East-Africa. For the first time, scientific evidence gives a reliable estimate of the number of first-generation women and girls in Europe coming from countries where FGM is practiced. The use of census data proves reliable for policy makers to guide their actions, e.g., regarding training needs for health workers who might be confronted with women who have undergone FGM, or the need for reconstructive surgery.

Global Threats to Child Safety.

PubMed

Mace, Sharon E

2016-02-01

Children have rights, as enumerated in the Declaration of the Rights of the Child, and need protection from violence, exploitation, and abuse. Global threats to child safety exist. These threats include lack of basic needs (food, clean water, sanitation), maltreatment, abandonment, child labor, child marriage, female genital mutilation, child trafficking, disasters, and armed conflicts/wars. Recent disasters and armed conflicts have led to a record number of displaced people especially children and their families. Strategies and specific programs can be developed and implemented for eliminating threats to the safety of children. Copyright © 2016 Elsevier Inc. All rights reserved.

Prosthodontic management of worn dentition in pediatric patient with complete overlay dentures: a case report

PubMed Central

Rastogi, Jyoti; Jain, Chandni; Singh, Harkanwal Preet

2012-01-01

Overlay complete dentures are simple, reversible and economical treatment modality for patients with congenital or acquired disorders that severely affect the tooth development. It satisfies both the esthetic and functional demands where the extraction of teeth is not generally indicated. In pediatric patients, the overlay dentures establish a relatively stable occlusion that improves patient's tolerance to the future treatment procedures for worn dentition. This clinical report highlights the imperative need of appropriate treatment strategy and application of maxillary and mandibular overlay dentures in a pediatric patient who suffered from congenitally mutilated and worn dentition. PMID:23236577

Breast reconstruction with anatomical implants: A review of indications and techniques based on current literature.

PubMed

Gardani, Marco; Bertozzi, Nicolò; Grieco, Michele Pio; Pesce, Marianna; Simonacci, Francesco; Santi, PierLuigi; Raposio, Edoardo

2017-09-01

One important modality of breast cancer therapy is surgical treatment, which has become increasingly less mutilating over the last century. Breast reconstruction has become an integrated part of breast cancer treatment due to long-term psychosexual health factors and its importance for breast cancer survivors. Both autogenous tissue-based and implant-based reconstruction provides satisfactory reconstructive options due to better surgeon awareness of "the ideal breast size", although each has its own advantages and disadvantages. An overview of the current options in breast reconstruction is presented in this article.

Reasons for and Experiences With Surgical Interventions for Female Genital Mutilation/Cutting (FGM/C): A Systematic Review.

PubMed

Berg, Rigmor C; Taraldsen, Sølvi; Said, Maryan A; Sørbye, Ingvil Krarup; Vangen, Siri

2017-08-01

Because female genital mutilation/cutting (FGM/C) leads to changes in normal genital anatomy and functionality, women are increasingly seeking surgical interventions for their FGM/C-related concerns. To conduct a systematic review of empirical quantitative and qualitative research on interventions for women with FGM/C-related complications. We conducted systematic searches up to May 2016 in 16 databases to obtain references from different disciplines. We accepted all study designs consisting of girls and women who had been subjected to FGM/C and that examined a reparative intervention for a FGM/C-related concern. We screened the titles, abstracts, and full texts of retrieved records for relevance. Then, we assessed the methodologic quality of the included studies and extracted and synthesized the study data. All outcomes were included. Of 3,726 retrieved references, 71 studies including 7,291 women were eligible for inclusion. We identified three different types of surgical intervention: defibulation or surgical separation of fused labia, excision of a cyst with or without some form of reconstruction, and clitoral or clitoral-labial reconstruction. Reasons for seeking surgical interventions consisted of functional complaints, sexual aspirations, esthetic aspirations, and identity recovery. The most common reasons for defibulation were a desire for improved sexual pleasure, vaginal appearance, and functioning. For cyst excision, cystic swelling was the main reason for seeking excision; for reconstruction, the main reason was to recover identity. Data on women's experiences with a surgical intervention are sparse, but we found that women reported easier births after defibulation. Our findings also suggested that most women were satisfied with defibulation (overall satisfaction = 50-100%), typically because of improvements in their sexual lives. Conversely, the results suggested that defibulation had low social acceptance and that the procedure created distress in some women who disliked the new appearance of their genitalia. Most women were satisfied with clitoral reconstruction, but approximately one third were dissatisfied with or perceived a worsening in the esthetic look. The information health care professionals give to women who seek surgical interventions for FGM/C should detail the intervention options available and what women can realistically expect from such interventions. The systematic review was conducted in accordance with guidelines, but there is a slight possibility that studies were missed. There are some data on women's motivations for surgery for FGM/C-related concerns, but little is known about whether women are satisfied with the surgery, and experiences appear mixed. Berg RC, Taraldsen S, Said MA, et al. Reasons for and Experiences With Surgical Interventions for Female Genital Mutilation/Cutting (FGM/C): A Systematic Review. J Sex Med 2017;14:977-990. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

MUTILS - a set of efficient modeling tools for multi-core CPUs implemented in MEX

NASA Astrophysics Data System (ADS)

Krotkiewski, Marcin; Dabrowski, Marcin

2013-04-01

The need for computational performance is common in scientific applications, and in particular in numerical simulations, where high resolution models require efficient processing of large amounts of data. Especially in the context of geological problems the need to increase the model resolution to resolve physical and geometrical complexities seems to have no limits. Alas, the performance of new generations of CPUs does not improve any longer by simply increasing clock speeds. Current industrial trends are to increase the number of computational cores. As a result, parallel implementations are required in order to fully utilize the potential of new processors, and to study more complex models. We target simulations on small to medium scale shared memory computers: laptops and desktop PCs with ~8 CPU cores and up to tens of GB of memory to high-end servers with ~50 CPU cores and hundereds of GB of memory. In this setting MATLAB is often the environment of choice for scientists that want to implement their own models with little effort. It is a useful general purpose mathematical software package, but due to its versatility some of its functionality is not as efficient as it could be. In particular, the challanges of modern multi-core architectures are not fully addressed. We have developed MILAMIN 2 - an efficient FEM modeling environment written in native MATLAB. Amongst others, MILAMIN provides functions to define model geometry, generate and convert structured and unstructured meshes (also through interfaces to external mesh generators), compute element and system matrices, apply boundary conditions, solve the system of linear equations, address non-linear and transient problems, and perform post-processing. MILAMIN strives to combine the ease of code development and the computational efficiency. Where possible, the code is optimized and/or parallelized within the MATLAB framework. Native MATLAB is augmented with the MUTILS library - a set of MEX functions that implement the computationally intensive, performance critical parts of the code, which we have identified to be bottlenecks. Here, we discuss the functionality and performance of the MUTILS library. Currently, it includes: 1. time and memory efficient assembly of sparse matrices for FEM simulations 2. parallel sparse matrix - vector product with optimizations speficic to symmetric matrices and multiple degrees of freedom per node 3. parallel point in triangle location and point in tetrahedron location for unstructured, adaptive 2D and 3D meshes (useful for 'marker in cell' type of methods) 4. parallel FEM interpolation for 2D and 3D meshes of elements of different types and orders, and for different number of degrees of freedom per node 5. a stand-alone, MEX implementation of the Conjugate Gradients iterative solver 6. interface to METIS graph partitioning and a fast implementation of RCM reordering

Irreversible muscle damage in bodybuilding due to long-term intramuscular oil injection.

PubMed

Banke, I J; Prodinger, P M; Waldt, S; Weirich, G; Holzapfel, B M; Gradinger, R; Rechl, H

2012-10-01

Intramuscular oil injections generating slowly degrading oil-based depots represent a controversial subject in bodybuilding and fitness. However they seem to be commonly reported in a large number of non-medical reports, movies and application protocols for 'site-injections'. Surprisingly the impact of long-term (ab)use on the musculature as well as potential side-effects compromising health and sports ability are lacking in the medical literature. We present the case of a 40 year old male semi-professional bodybuilder with systemic infection and painful reddened swellings of the right upper arm forcing him to discontinue weightlifting. Over the last 8 years he daily self-injected sterilized sesame seed oil at numerous intramuscular locations for the purpose of massive muscle building. Whole body MRI showed more than 100 intramuscular rather than subcutaneous oil cysts and loss of normal muscle anatomy. 2-step septic surgery of the right upper arm revealed pus-filled cystic scar tissue with the near-complete absence of normal muscle. MRI 1 year later revealed the absence of relevant muscle regeneration. Persistent pain and inability to perform normal weight training were evident for at least 3 years post-surgery. This alarming finding indicating irreversible muscle mutilation may hopefully discourage people interested in bodybuilding and fitness from oil-injections. The impact of such chronic tissue stress on other diseases like malignancy remains to be determined. © Georg Thieme Verlag KG Stuttgart · New York.

[Female migrants in the health care system. Health care utilisation, access barriers and health promotion strategies].

PubMed

Wimmer-Puchinger, B; Wolf, H; Engleder, A

2006-09-01

Due to the evident interaction between social factors and health, migrants are exposed to specific risk factors and access barriers to health services. Some examples are the lower education level, the low social position and/or the insufficient language skills. This concept is further elaborated in the multi-factorial impacts of health literacy. Female migrants often experience additional discrimination because of their gender. Despite the lack of representative data, consistent studies show that female migrants do not regularly take advantage of health care prevention and present themselves with higher degrees of stress. The current "inadequate health care" manifests itself in a lack of care in the areas of prevention and health education and an abundance in the context of medication and diagnostic procedures. To meet these demands and to further reduce barriers, in particular language barriers, specific strategies for this target group involving both politics and the health care system have to be developed. Besides the employment of interpreters with a native cultural background and the distribution of information booklets, it is an important strategy to reduce structural obstacles such as cultural diversity. To contact these women in their living environment should help to increase their self-determined health promotion. Selected models of good practice in Austria with regard to the themes of FGM (female genital mutilation), violence, heart disease and breast cancer are presented to highlight the specific health situation and risk factors of female migrants as well as successful strategies to confront them.

Factors That Condition the Attitude Toward Living Related Kidney Donation Among Santiago of Cuba's Population.

PubMed

Ríos, A; López-Navas, A I; Sánchez, Á; Martínez-Alarcón, L; Ayala, M A; Garrido, G; Sebastián, M J; Ramis, G; Hernández, A M; Ramírez, P; Parrilla, P

2018-03-01

Living kidney donation is currently the most important kidney donor source in Latin America, and it is necessary to further increase its rates. To analyze the attitude toward living kidney donation among the Santiago de Cuba's population and to determine the sociopersonal factors with which it is associated. The population over 15 years old residing in Santiago de Cuba, stratified by sex and age, was screened. The "PCID-LKD Ríos" attitude questionnaire toward living kidney donation was administered to a random selection of the people surveyed according to the stratification and the census data. The completion was anonymized and self-administered. Verbal consent was obtained. The study was completed by 445 people, of whom the 86% (n = 389) were in favor of living related kidney donation. This attitude is associated with the level of education (P < .001); previous experience with organ donation (P = .006); attitude toward cadaveric organ donation (P < .001); carrying out of prosocial activities (P = .010); discussion of the issue with the family (P < .001) and the significant other (P < .001); concern about mutilation after donation (P = .001); religious beliefs (P = .001); and assessment of the risk of living kidney donation (P < .001). In the multivariate study, the following variables persisted: (1) level of education; (2) attitude of cadaveric donation; (3) carrying out of prosocial activities; and (4) risk assessment of living donation. Living related donation is very well accepted among the Santiago de Cuba's population. Copyright © 2017 Elsevier Inc. All rights reserved.

Factors That Affect the Attitudes of the Bolivian Population in Spain With Regard to Organ Donation for Transplant.

PubMed

Ríos, A; López-Navas, A I; Sánchez, Á; Ayala, M A; Garrido, G; Sebastián, M J; Martínez-Alarcó, L; Ramis, G; Hernández, A M; Ramírez, P; Parrilla, P

2018-03-01

The Bolivian population is an emerging Latin American immigrant group in Spain, several of whom have been transplanted or are awaiting transplant. We aimed to assess attitudes toward organ donation among Bolivians currently residing in Spain. The population screened was born in Bolivia but living in Spain, stratified by gender and age. The appraisal tool used was a questionnaire that assesses attitudes toward organ donation for transplant ("PCID-DTO Ríos"). Support from immigration associations in Spain was needed for advice on locations of potential respondents. Survey participation was anonymized and the questionnaire was self-administered. Verbal consent was obtained before participation. There were 206 respondents: 49% (n = 101) in favor of donating their organs after death; 21% (n = 44) against donation; and 30% (n = 61) undecided. Their attitudes were found to be associated with level of education (P = .008), previous experience with donation and transplant (P = .011), concern regarding mutilation after donation (P = .002), knowing the attitude of their religion toward transplant (P = .001), the opinion of their partner (P < .001), and the possibility of needing a future transplant (P = .050). In the multivariate study, the main factor was having a partner in favor of organ donation (odds ratio = 16.129; P = .003). Attitudes toward organ donation among Bolivians residing in Spain are far more negative compared with rest of the Spanish population, due to various factors. Copyright © 2017 Elsevier Inc. All rights reserved.

[The prevalence of suicide attempts among children and adolescents].

PubMed

Woźniak, Ewelina; Talarowska, Monika; Orzechowska, Agata; Florkowski, Antoni; Gałecki, Piotr

2013-03-01

Suicide is the act of a fatal outcome. People who think about suicide perceive death as a way to avoid problems. Suicide attempts by children and young people likely to arise from the fact that the identified single or co-occurring mental disorders. was to illustrate the suicide problem, which is increasingly frequent attempts to take their own life for children and youth. Its main objective is to determine the prevalence and determinants of suicide attempts made by young people. The study group consisted of patients Babinski Hospital in Lodz. The study included 18 patients, 9 boys and 9 girls. Research methodology is based on the stories of young patients diseases. In order to verify the prevalence of trial and / or thoughts, suicidal tendencies among children and adolescents, was used as a research,tool - a survey of its own design. The survey consists of 21 questions about basic information on the state of social, physical and mental patients. Subjective verification made disseminate ideas, trends and / or suicide attempts among children and adolescents in most reflects the actual collection of information gathered by various authors. Children coming from families reconstructed and largely incomplete exhibit suicidal behavior. The main risk factors indicating the attempt on his own life are mental disorders: depression and behavioral disorders. Family situation of young people: conflicts between the father and the mother, violence, physical / mental, has a significant effect on the risk of an attempt on his own life. Superficial self-mutilation, is the main way to make a suicide bombing.

Epidemiological study of acute poisoning in children: a 5-year retrospective study in the Paediatric University Hospital in Białystok, Poland.

PubMed

Pawłowicz, Urszula; Wasilewska, Anna; Olański, Witold; Stefanowicz, Marta

2013-09-01

Poisoning among children and youths in the northeastern part of Poland accounted for 25% of the total number of patients admitted to the Hospital Emergency Department of the Paediatric University Hospital of Białystok. We hypothesise that the epidemiology of poisoned paediatric patients admitted is related to increase in 'designer drugs' (mainly amphetamine- and ecstasy-like psychostimulants, hallucinogens and synthetic cannabinoids ('spice') intake, which became popular 5 years ago in our country. A retrospective chart review of medical records of 489 patients admitted due to poisoning in the 5-year period (2006-2010). The data included: age, sex, place of residence, nature of the substance, causes of poisoning, former use of psychoactive stimulants, accompanying self-mutilation and injuries and length of hospitalisation. Categorical variables were expressed as percentages, and continuous variables as mean and SD. The data were collected in a Microsoft Excel database. Statistical analysis was performed using the Statistical Programme for Social Sciences. Out of 2176 hospitalised children, 489 were admitted because of poisoning. Out of these, 244 (49.9%) were hospitalised due to intoxication by alcohol. Only eight children used designer drugs. The mean age of all patients in our group was 12.86±5.04 years, of which 52.4% were male. Poisoning was intentional in 75.5%, and accidental in 24.5% of cases. Appearance of 'designer drugs' had no significant impact on the number and epidemiology of poisonings in our group.

High fear of intra-oral injections: prevalence and relationship to dental fear and dental avoidance among 10- to 16-yr-old children.

PubMed

Berge, Karin G; Agdal, Maren L; Vika, Margrethe; Skeie, Marit S

2016-12-01

The present study aimed to: (i) estimate the prevalence of self-reported high fear of intra-oral injections, high blood-injury fear, and injection fear; (ii) explore the overlap between high fear of intra-oral injections and high fear of dental treatment; and (iii) evaluate the possible consequence of high fear of intra-oral injections in terms of avoidance of dental care. The sample included 1,441 subjects, 10- to 16-yr of age, attending elementary schools in a county of Norway. Data were collected using questionnaires that were completed in classrooms. The survey instruments used were the Intra-Oral Injection Fear-scale, the Children's Fear Survey Schedule-Dental Subscale, the Injection Phobia scale for children, and the Mutilation Questionnaire for children. In total, 13.9% of the children reported high intra-oral injection fear. A strong association was found between fear of intra-oral injections and dental fear. When an intra-oral injection was needed, 10.6% would avoid dental treatment. In multiple regression analysis, high intra-oral injection fear was found to be associated with avoidance of dental treatment (OR = 6.52; 95% CI: 3.99-10.67). It was concluded that high fear of intra-oral injections was prevalent and might lead to avoidance of necessary dental treatment. Hence, intra-oral injection fear should be addressed before treatment of dental fear. © 2016 Eur J Oral Sci.

“When the pain won’t wane it's mainly in the brain”

PubMed Central

Pawl, Ron

2013-01-01

Chronic pain syndromes either have no underlying organic explanation, or include patients whose chronic pain complaints (without focal deficits or significant radiographic findings) were not alleviated by surgery (in 80% of cases). Patients with chronic pain typically “turn off” members of the medical community; they are often “written off” as malingerers or psychiatric cases. The Minnesota Multiphasic Personality Inventory often shows elevations on the hysteria and hypochondriasis scales; together these constitute somatization defined as patients converting emotional distress into bodily complaints. Depression, anxiety, and borderline personality disorders are also often encountered. Secondary gain also plays a critical role in patients with chronic pain syndromes (e.g., includes avoiding onerous tasks/work, or rewards opioid-seeking behaviors). Tertiary gain pertains to the physicians’ financial rewards for administering ineffective and repeated treatment of these patients, while validating for the patient that there is truly something organically wrong with them. Self-mutilation (part of Munchausen Syndrome/Fictitious Disorders) also brings these chronic pain patients to the attention of the medical community. They are also often involved in the legal system (e.g., workmen's compensation or tort action) that in the United States, unfortunately financially rewards “pain and suffering.” The main purpose of this commentary is to reeducate spinal surgeons about the pitfalls of operating on patients with chronic pain syndromes in the absence of significant neurological deficits or radiographic findings, as such “last ditch surgery” invariably fails. PMID:23878768

Trait-aggressiveness and impulsivity: role of psychological resilience and childhood trauma in a sample of male prisoners.

PubMed

Carli, Vladimir; Mandelli, Laura; Zaninotto, Leonardo; Alberti, Siegfried; Roy, Alec; Serretti, Alessandro; Sarchiapone, Marco

2014-01-01

One of the major challenges for research in the field of human aggression is the need to define the role of personality and trait-like dimensions, such as impulsivity and aggressiveness, in predisposing to violent behavior. 1) To determine whether trait- aggressiveness and impulsivity may be associated with socio-demographic, clinical and crime history variables in a sample of male prisoners; 2) to detect any association of those traits with measures of early traumatic experiences and current resilience traits. A sample of male prisoners (n = 1356) underwent the Brown-Goodwin Assessment for Lifetime History of Aggression (BGLHA) and the Barratt Impulsivity Scale (BIS). Axis I psychiatric disorders were also assessed. Early traumatic experiences and psychological resilience were detected respectively by the Childhood Trauma Questionnaire (CTQ) and the Connor-Davidson Resilience Scale (CD-RISC). Two non-linear logistic regression models were performed to test for the best predictors of trait-aggressiveness and impulsivity. Subjects with a history of substance use disorders and self-mutilation reported both higher BGLHA and BIS scores. Axis I disorders and suicide attempts were associated with aggressiveness, but not to impulsivity. A consistent correlation was found between BGLHA scores and early traumatic experiences. Resilience was positively correlated to impulsivity but not to aggressiveness scores. Our results support the view that aggressiveness and impulsivity are two different, albeit related trait-like dimensions of personality, having a different relationship with resilience, and, inferentially, a different impact over the development of psychiatric disorders.

Correlation of intact sensibility and neuropathic pain-related behaviors in eight inbred and outbred rat strains and selection lines.

PubMed

Shir, Y; Zeltser, R; Vatine, J J; Carmi, G; Belfer, I; Zangen, A; Overstreet, D; Raber, P; Seltzer, Z

2001-02-01

In some rat strains, total hindpaw denervation triggers autotomy, a behavior of self mutilation presumably related to neuropathic pain. Partial sciatic ligation (PSL) in rats produces tactile allodynia and heat hyperalgesia but not autotomy. Our aims in this study were to examine: (1) whether sensibility of intact rats to noxious and non-noxious stimuli is strain-dependent; (2) whether sensibility of intact rats could predict levels of autotomy, or of allodynia and hyperalgesia in the PSL model; and (3) whether autotomy levels are correlated with levels of allodynia or hyperalgesia. Here we report that in two inbred rat strains (Lewis and Fisher 344), two outbred rat strains (Sabra and Sprague-Dawley) and four selection lines of rats (Genetically Epilepsy-Prone Rats, High Autotomy, Low Autotomy and Flinders Sensitive Line), tactile sensitivity and response duration to noxious heat of intact animals were strain-dependent. Levels of autotomy following hindpaw denervation and of allodynia and hyperalgesia in the PSL model were also strain-dependent. Thus, these traits are determined in part by genetic factors. Sensory sensibility of intact rats was not correlated with levels of autotomy following total denervation, or allodynia and hyperalgesia following partial denervation. We suggest that preoperative sensibility of intact rats is not a predictor of levels of neuropathic disorders following nerve injury. Likewise, no correlation was found between autotomy, allodynia and hyperalgesia, suggesting that neuropathic pain behaviors triggered by nerve injury of different etiologies are mediated by differing mechanisms.

Psychiatric comorbidity among patients with gender identity disorder.

PubMed

Hoshiai, Masahiko; Matsumoto, Yosuke; Sato, Toshiki; Ohnishi, Masaru; Okabe, Nobuyuki; Kishimoto, Yuki; Terada, Seishi; Kuroda, Shigetoshi

2010-10-01

Psychiatric comorbidity and mental instability seem to be important unfavorable prognostic factors for long-term psychosocial adjustment in gender identity disorder (GID). However, psychiatric comorbidity in patients with GID has rarely been assessed. In this study, we investigated the psychiatric comorbidity and life events of patients with GID in Japan. A total of 603 consecutive patients were evaluated independently by at least two senior psychiatrists at the GID clinic using clinical information and results of examinations. Using DSM-IV criteria, 579 patients (96.0%) were diagnosed with GID. Among the GID patients, 349 (60.3%) were the female-to-male (FTM) type, and 230 (39.7%) were the male-to-female (MTF) type. Current psychiatric comorbidity was 19.1% (44/230) among MTF patients and 12.0% (42/349) among FTM patients. The lifetime positive history of suicidal ideation and self mutilation was 76.1% and 31.7% among MTF patients, and 71.9% and 32.7% among FTM patients. Among current psychiatric diagnoses, adjustment disorder (6.7%, 38/579) and anxiety disorder (3.6%, 21/579) were relatively frequent. Mood disorder was the third most frequent (1.4%, 8/579). Comparison with previous reports on the psychiatric comorbidity among GID patients revealed that the majority of GID patients had no psychiatric comorbidity. GID is a diagnostic entity in its own right, not necessarily associated with severe comorbid psychological findings. © 2010 The Authors. Journal compilation © 2010 Japanese Society of Psychiatry and Neurology.

Pediatric and Adolescent Gynecology in Europe: Clinical Services, Standards of Care, and Training.

PubMed

Richmond, Anna; Priyanka, Sweta; Mahmood, Tahir; MacDougall, Jane; Wood, Paul

2016-06-01

To identify current clinical services and training available across Europe within pediatric and adolescent gynecology (PAG) and establish the extent to which PAG services meet current European Board and College of Obstetrics and Gynecology (EBCOG) standards. Quantitative and qualitative questionnaire. European countries that are members of the EBCOG and the European Association of Pediatric and Adolescent Gynecology. Thirty-six countries that were approached beginning in September 2013; data were obtained from 27 countries. Questionnaires with 28 stems were sent to clinical leaders in 36 European countries. National society, national standards, legislation for female genital mutilation, protocols for transition to adult services, human papilloma virus vaccination programs, sex and contraception education, safeguarding, clinical leads for PAG, delivery of PAG services, and training available for PAG. Of 36 countries, 27 responded. Seventy-seven percent had a national PAG society but only 44% had national standards in PAG. There was agreement that PAG cases should be multidisciplinary but not all have clinical networks in place to facilitate this. Human papilloma virus programs are available in some European countries and not all have legislation against female genital mutilation. A significant proportion of cases continue to be seen in adult gynecology clinics as opposed to designated PAG clinics with only 41% with processes to transfer patients into adult care. In this article we provide a framework to explore areas for improvement within PAG services and training across Europe. The EBCOG standards of care are not being adhered to in many countries because processes and clinical networks are not in place to facilitate them. Crown Copyright © 2015. Published by Elsevier Inc. All rights reserved.

Genes for hereditary sensory and autonomic neuropathies: a genotype–phenotype correlation

PubMed Central

Rotthier, Annelies; Baets, Jonathan; Vriendt, Els De; Jacobs, An; Auer-Grumbach, Michaela; Lévy, Nicolas; Bonello-Palot, Nathalie; Kilic, Sara Sebnem; Weis, Joachim; Nascimento, Andrés; Swinkels, Marielle; Kruyt, Moyo C.; Jordanova, Albena; De Jonghe, Peter

2009-01-01

Hereditary sensory and autonomic neuropathies (HSAN) are clinically and genetically heterogeneous disorders characterized by axonal atrophy and degeneration, exclusively or predominantly affecting the sensory and autonomic neurons. So far, disease-associated mutations have been identified in seven genes: two genes for autosomal dominant (SPTLC1 and RAB7) and five genes for autosomal recessive forms of HSAN (WNK1/HSN2, NTRK1, NGFB, CCT5 and IKBKAP). We performed a systematic mutation screening of the coding sequences of six of these genes on a cohort of 100 familial and isolated patients diagnosed with HSAN. In addition, we screened the functional candidate gene NGFR (p75/NTR) encoding the nerve growth factor receptor. We identified disease-causing mutations in SPTLC1, RAB7, WNK1/HSN2 and NTRK1 in 19 patients, of which three mutations have not previously been reported. The phenotypes associated with mutations in NTRK1 and WNK1/HSN2 typically consisted of congenital insensitivity to pain and anhidrosis, and early-onset ulcero-mutilating sensory neuropathy, respectively. RAB7 mutations were only found in patients with a Charcot-Marie-Tooth type 2B (CMT2B) phenotype, an axonal sensory-motor neuropathy with pronounced ulcero-mutilations. In SPTLC1, we detected a novel mutation (S331F) corresponding to a previously unknown severe and early-onset HSAN phenotype. No mutations were found in NGFB, CCT5 and NGFR. Overall disease-associated mutations were found in 19% of the studied patient group, suggesting that additional genes are associated with HSAN. Our genotype–phenotype correlation study broadens the spectrum of HSAN and provides additional insights for molecular and clinical diagnosis. PMID:19651702

Genes for hereditary sensory and autonomic neuropathies: a genotype-phenotype correlation.

PubMed

Rotthier, Annelies; Baets, Jonathan; De Vriendt, Els; Jacobs, An; Auer-Grumbach, Michaela; Lévy, Nicolas; Bonello-Palot, Nathalie; Kilic, Sara Sebnem; Weis, Joachim; Nascimento, Andrés; Swinkels, Marielle; Kruyt, Moyo C; Jordanova, Albena; De Jonghe, Peter; Timmerman, Vincent

2009-10-01

Hereditary sensory and autonomic neuropathies (HSAN) are clinically and genetically heterogeneous disorders characterized by axonal atrophy and degeneration, exclusively or predominantly affecting the sensory and autonomic neurons. So far, disease-associated mutations have been identified in seven genes: two genes for autosomal dominant (SPTLC1 and RAB7) and five genes for autosomal recessive forms of HSAN (WNK1/HSN2, NTRK1, NGFB, CCT5 and IKBKAP). We performed a systematic mutation screening of the coding sequences of six of these genes on a cohort of 100 familial and isolated patients diagnosed with HSAN. In addition, we screened the functional candidate gene NGFR (p75/NTR) encoding the nerve growth factor receptor. We identified disease-causing mutations in SPTLC1, RAB7, WNK1/HSN2 and NTRK1 in 19 patients, of which three mutations have not previously been reported. The phenotypes associated with mutations in NTRK1 and WNK1/HSN2 typically consisted of congenital insensitivity to pain and anhidrosis, and early-onset ulcero-mutilating sensory neuropathy, respectively. RAB7 mutations were only found in patients with a Charcot-Marie-Tooth type 2B (CMT2B) phenotype, an axonal sensory-motor neuropathy with pronounced ulcero-mutilations. In SPTLC1, we detected a novel mutation (S331F) corresponding to a previously unknown severe and early-onset HSAN phenotype. No mutations were found in NGFB, CCT5 and NGFR. Overall disease-associated mutations were found in 19% of the studied patient group, suggesting that additional genes are associated with HSAN. Our genotype-phenotype correlation study broadens the spectrum of HSAN and provides additional insights for molecular and clinical diagnosis.

Effectiveness of health education as an intervention designed to prevent female genital mutilation/cutting (FGM/C): a systematic review.

PubMed

Waigwa, Susan; Doos, Lucy; Bradbury-Jones, Caroline; Taylor, Julie

2018-04-12

Female Genital Mutilation/Cutting (FGM/C) is a harmful practice that violates the human rights of women and girls. Despite global efforts to restrict the practice, there have been few reports on major positive changes to the problem. Health education interventions have been successful in preventing various health conditions and promoting service use. They have also been regarded as promising interventions for preventing FGM/C. The objective of this systematic review is to synthesise findings of studies about effectiveness of health education as an intervention to prevent FGM/C. The electronic databases searched were MEDLINE, EMBASE, Cochrane library, Web of Science, Psych INFO, CINAHL and ASSIA. Our search included papers published in the English language without date limits. Study quality was assessed using the Mixed Methods Appraisal Tool (MMAT). A predesigned data recording form was used to extract data from the included studies which were summarised by comparing similar themes. Twelve out of 359 individual studies met our inclusion criteria. Seven studies were quantitative, three were qualitative and two used mixed methods. Six studies tested before and after the interventions, four studies assessed the effectiveness of previous interventions used by different research teams and two studies endorsed the intervention. Four main factors emerged and were associated with facilitating or hindering the effectiveness of health education interventions: sociodemographic factors; socioeconomic factors; traditions and beliefs; and intervention strategy, structure and delivery. It is vital to target factors associated with facilitating or hindering the effectiveness of health education for FGM/C. This increases the possibility of effective, collective change in behaviour and attitude which leads to the sustainable prevention of FGM/C and ultimately the improved reproductive health and well-being of individuals and communities.

A new challenge for Africa: to reduce maternal mortality by half over the next decade.

PubMed

Ladjali, M

1989-04-01

This publication reviews the 1989 conference on safe motherhood in Niamey, Niger. Statistics regarding the situation in Africa reveal that 150,000 of the 1/2 million yearly maternal deaths worldwide occur in Africa, and 1 woman in 20 risks dying of pregnancy-related causes. Other maternal deaths are distributed as follows: 300,000 in South and West Asia, 34,000 in Latin America, 12,000 in East Asia and 6000 in all developed countries. The main causes of maternal deaths in Africa were identified as medical factors, among them lack of access to family planning, and socioeconomic and cultural factors, such as sexual discrimination against women and inferior social status. African girls are weaned earlier, receive a lower caloric intake, and work 4 times as long as boys. African women work 2490 hours per year, compared to 1400 hours for men. In a discussion of traditional practices related to maternal and child health, early marriage and genital mutilation, which are perpetuated by illiteracy, were deemed dangerous. The need for non-medical strategies and actions to improve the status of women, recognize their economic role and give them equal opportunities was acknowledged. Fertility control was identified as a determining factor in helping to reinforce these strategies, as unwanted pregnancies increase the risk of maternal death through abortion attempts. An important aspect of the conference was the identification of women as full-time partners of the health services rather than passive beneficiaries. Participants called for a reduction in women's domestic workload and the abolition of genital mutilation. They also agreed to promote exchange of information between African governments on research and positive developments. The World Bank called for more incisive efforts to reduce infant mortality and for population issues to be included in the economic debate.

Do Termites Avoid Carcasses? Behavioral Responses Depend on the Nature of the Carcasses

PubMed Central

Neoh, Kok-Boon; Yeap, Beng-Keok; Tsunoda, Kunio; Yoshimura, Tsuyoshi; Lee, Chow-Yang

2012-01-01

Background Undertaking behavior is a significant adaptation to social life in enclosed nests. Workers are known to remove dead colony members from the nest. Such behavior prevents the spread of pathogens that may be detrimental to a colony. To date, little is known about the ethological aspects of how termites deal with carcasses. Methodology and Principal Findings In this study, we tested the responses to carcasses of four species from different subterranean termite taxa: Coptotermes formosanus Shiraki and Reticulitermes speratus (Kolbe) (lower termites) and Microcerotermes crassus Snyder and Globitermes sulphureus Haviland (higher termites). We also used different types of carcasses (freshly killed, 1-, 3-, and 7-day-old, and oven-killed carcasses) and mutilated nestmates to investigate whether the termites exhibited any behavioral responses that were specific to carcasses in certain conditions. Some behavioral responses were performed specifically on certain types of carcasses or mutilated termites. C. formosanus and R. speratus exhibited the following behaviors: (1) the frequency and time spent in antennating, grooming, and carcass removal of freshly killed, 1-day-old, and oven-killed carcasses were high, but these behaviors decreased as the carcasses aged; (2) the termites repeatedly crawled under the aging carcass piles; and (3) only newly dead termites were consumed as a food source. In contrast, M. crassus and G. sulphureus workers performed relatively few behavioral acts. Our results cast a new light on the previous notion that termites are necrophobic in nature. Conclusion We conclude that the behavioral response towards carcasses depends largely on the nature of the carcasses and termite species, and the response is more complex than was previously thought. Such behavioral responses likely are associated with the threat posed to the colony by the carcasses and the feeding habits and nesting ecology of a given species. PMID:22558452

Female genital mutilation in children presenting to Australian paediatricians

PubMed Central

Zurynski, Yvonne; Sureshkumar, Premala; Cherian, Sarah; Deverell, Marie; Elliott, Elizabeth J

2017-01-01

Objective The WHO reports that female genital mutilation/cutting (FGM/C) is an ancient cultural practice prevalent in many countries. FGM/C has been reported among women resident in Australia. Our paper provides the first description of FGM/C in Australian children. Design Cross-sectional survey conducted in April–June 2014. Setting Paediatricians and other child health specialists recruited through the Australian Paediatric Surveillance Unit were asked to report children aged <18 years with FGM/C seen in the last 5 years, and to provide data for demographics, FGM/C type, complications and referral for each case. Participants Of 1311 eligible paediatricians/child health specialists, 1003 (76.5%) responded. Results Twenty-three (2.3%) respondents had seen 59 children with FGM/C and provided detailed data for 31. Most (89.7%) were identified during refugee screening and were born in Africa. Three (10.3%) were born in Australia: two had FGM/C in Australia and one in Indonesia. All parents were born overseas, mainly Africa (98.1%). Ten children had WHO FGM/C type I, five type II, five type III and six type IV. Complications in eight children included recurrent genitourinary infections, menstrual, sexual, fertility and psychological problems. Nineteen children (82.6%) were referred to obstetrics/gynaecology: 16 (69.9%) to social work and 13 (56.5%) to child protection. Conclusions This study confirms that FGM/C is seen in paediatric clinical practice within Australia. Paediatricians need cultural awareness, education and resources to help them identify children with FGM/C and/or at risk of FGM/C, to enable appropriate referral and counselling of children, families and communities to assist in the prevention of this practice. PMID:28082321

Thirty-year trends in the prevalence and severity of female genital mutilation: a comparison of 22 countries

PubMed Central

Heymann, Jody

2017-01-01

Introduction Female genital mutilation (FGM) harms women’s health and well-being and is widely considered a violation of human rights. The United Nations has called for elimination of the practice by 2030. Methods We used household survey data to measure trends in the prevalence of FGM in 22 countries. We also examined trends in the severity of the practice by measuring changes in the prevalence of flesh removal, infibulation and symbolic ‘nicking’ of the genitals. We evaluated the extent to which measurement error may have influenced our estimates by observing the consistency of reports for the same birth cohorts over successive survey waves. Results The prevalence of all types of FGM fell in 17 of 22 countries we examined. The vast majority of women who undergo FGM have flesh removed from their genitals, likely corresponding to the partial or total removal of the clitoris and labia. Infibulation is still practised throughout much of sub-Saharan Africa. Its prevalence has declined in most countries, but in Chad, Mali and Sierra Leone the prevalence has increased by 2–8 percentage points over 30 years. Symbolic nicking of the genitals is relatively rare but becoming more common in Burkina Faso, Chad, Guinea and Mali. Conclusion FGM is becoming less common over time, but it remains a pervasive practice in some countries: more than half of women in 7 of the 22 countries we examined still experience FGM. The severity of the procedures has not changed substantially over time. Rigorous evaluation of interventions aimed at eliminating or reducing the harms associated with the practice is needed. PMID:29225952

Virility, pleasure and female genital mutilation/cutting. A qualitative study of perceptions and experiences of medicalized defibulation among Somali and Sudanese migrants in Norway.

PubMed

Johansen, R Elise B

2017-02-10

The most pervasive form of female genital mutilation/cutting-infibulation-involves the almost complete closure of the vaginal orifice by cutting and closing the labia to create a skin seal. A small opening remains for the passage of urine and menstrual blood. This physical closure has to be re-opened-defibulated-later in life. When they marry, a partial opening is made to enable sexual intercourse. The husband commonly uses his penis to create this opening. In some settings, a circumciser or traditional midwife opens the infibulated scar with a knife or razor blade. Later, during childbirth, a further opening is necessary to make room for the child's passage. In Norway, public health services provide surgical defibulation, which is less risky and painful than traditional forms of defibulation. This paper explores the perceptions and experiences of surgical defibulation among migrants in Norway and investigates whether surgical defibulation is an accepted medicalization of a traditional procedure or instead challenges the cultural underpinnings of infibulation. Data derived from in-depth interviews with 36 women and men of Somali and Sudanese origin and with 30 service providers, as well as participant observations in various settings from 2014-15, were thematically analyzed. The study findings indicate that, despite negative attitudes towards infibulation, its cultural meaning in relation to virility and sexual pleasure constitutes a barrier to the acceptance of medicalized defibulation. As sexual concerns regarding virility and male sexual pleasure constitute a barrier to the uptake of medicalized defibulation, health care providers need to address sexual concerns when discussing treatment for complications in infibulated women. Furthermore, campaigns and counselling against this practice also need to tackle these sexual concerns.

Emotional modulation of pain and spinal nociception in fibromyalgia.

PubMed

Rhudy, Jamie L; DelVentura, Jennifer L; Terry, Ellen L; Bartley, Emily J; Olech, Ewa; Palit, Shreela; Kerr, Kara L

2013-07-01

Fibromyalgia (FM) is characterized by widespread pain, as well as affective disturbance (eg, depression). Given that emotional processes are known to modulate pain, a disruption of emotion and emotional modulation of pain and nociception may contribute to FM. The present study used a well-validated affective picture-viewing paradigm to study emotional processing and emotional modulation of pain and spinal nociception. Participants were 18 individuals with FM, 18 individuals with rheumatoid arthritis (RA), and 19 healthy pain-free controls (HC). Mutilation, neutral, and erotic pictures were presented in 4 blocks; 2 blocks assessed only physiological-emotional reactions (ie, pleasure/arousal ratings, corrugator electromyography, startle modulation, skin conductance) in the absence of pain, and 2 blocks assessed emotional reactivity and emotional modulation of pain and the nociceptive flexion reflex (NFR, a physiological measure of spinal nociception) evoked by suprathreshold electric stimulations over the sural nerve. In general, mutilation pictures elicited displeasure, corrugator activity, subjective arousal, and sympathetic activation, whereas erotic pictures elicited pleasure, subjective arousal, and sympathetic activation. However, FM was associated with deficits in appetitive activation (eg, reduced pleasure/arousal to erotica). Moreover, emotional modulation of pain was observed in HC and RA, but not FM, even though all 3 groups evidenced modulation of NFR. Additionally, NFR thresholds were not lower in the FM group, indicating a lack of spinal sensitization. Together, these results suggest that FM is associated with a disruption of supraspinal processes associated with positive affect and emotional modulation of pain, but not brain-to-spinal cord circuitry that modulates spinal nociceptive processes. Copyright © 2013 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.

Female Genital Mutilation/Cutting in the United States: Updated Estimates of Women and Girls at Risk, 2012

PubMed Central

Stupp, Paul; Okoroh, Ekwutosi; Besera, Ghenet; Goodman, David; Danel, Isabella

2016-01-01

Objectives In 1996, the U.S. Congress passed legislation making female genital mutilation/cutting (FGM/C) illegal in the United States. CDC published the first estimates of the number of women and girls at risk for FGM/C in 1997. Since 2012, various constituencies have again raised concerns about the practice in the United States. We updated an earlier estimate of the number of women and girls in the United States who were at risk for FGM/C or its consequences. Methods We estimated the number of women and girls who were at risk for undergoing FGM/C or its consequences in 2012 by applying country-specific prevalence of FGM/C to the estimated number of women and girls living in the United States who were born in that country or who lived with a parent born in that country. Results Approximately 513,000 women and girls in the United States were at risk for FGM/C or its consequences in 2012, which was more than three times higher than the earlier estimate, based on 1990 data. The increase in the number of women and girls younger than 18 years of age at risk for FGM/C was more than four times that of previous estimates. Conclusion The estimated increase was wholly a result of rapid growth in the number of immigrants from FGM/C-practicing countries living in the United States and not from increases in FGM/C prevalence in those countries. Scientifically valid information regarding whether women or their daughters have actually undergone FGM/C and related information that can contribute to efforts to prevent the practice in the United States and provide needed health services to women who have undergone FGM/C are needed. PMID:26957669

Female Genital Mutilation/Cutting in the United States: Updated Estimates of Women and Girls at Risk, 2012.

PubMed

Goldberg, Howard; Stupp, Paul; Okoroh, Ekwutosi; Besera, Ghenet; Goodman, David; Danel, Isabella

2016-01-01

In 1996, the U.S. Congress passed legislation making female genital mutilation/cutting (FGM/C) illegal in the United States. CDC published the first estimates of the number of women and girls at risk for FGM/C in 1997. Since 2012, various constituencies have again raised concerns about the practice in the United States. We updated an earlier estimate of the number of women and girls in the United States who were at risk for FGM/C or its consequences. We estimated the number of women and girls who were at risk for undergoing FGM/C or its consequences in 2012 by applying country-specific prevalence of FGM/C to the estimated number of women and girls living in the United States who were born in that country or who lived with a parent born in that country. Approximately 513,000 women and girls in the United States were at risk for FGM/C or its consequences in 2012, which was more than three times higher than the earlier estimate, based on 1990 data. The increase in the number of women and girls younger than 18 years of age at risk for FGM/C was more than four times that of previous estimates. The estimated increase was wholly a result of rapid growth in the number of immigrants from FGM/C-practicing countries living in the United States and not from increases in FGM/C prevalence in those countries. Scientifically valid information regarding whether women or their daughters have actually undergone FGM/C and related information that can contribute to efforts to prevent the practice in the United States and provide needed health services to women who have undergone FGM/C are needed.

Cultural circumcision in EU public hospitals--an ethical discussion.

PubMed

Brusa, Margherita; Barilan, Y Michael

2009-10-01

The paper explores the ethical aspects of introducing cultural circumcision of children into the EU public health system. We reject commonplace arguments against circumcision: considerations of good medical practice, justice, bodily integrity, autonomy and the analogy from female genital mutilation. From the unique structure of patient-medicine interaction, we argue that the incorporation of cultural circumcision into EU public health services is a kind of medicalization, which does not fit the ethos of universal healthcare. However, we support a utilitarian argument that finds hospital based circumcision safer than non-medicalized alternatives. The argument concerning medicalization and the utilitarian argument both rely on preliminary empirical data, which depend on future validation