WorldWideScience

Sample records for surrounding female circumcision

  1. Female circumcision: persistence amid conflict.

    Science.gov (United States)

    Douglas, J H

    1998-01-01

    The continuing practice of female circumcision (removal of varying degrees of external genitalia) was perhaps the most emotional issue discussed at the Ninth International Congress on Women's Health Issues, held in June in Alexandria, Egypt. The results of two studies presented at the Congress have resulted to an argument. Others view female circumcision as a traditional folk practice, similar to scarring of the skin or elongation of the lips among certain African tribes and should not be subjected to "cultural imperialism" from abroad. Instead, the procedure could best be eradicated through focused education--telling patients that it is not required by Islam and that it can be detrimental to health. However, this suggestion was hotly debated by members of the audience who insisted that female circumcision should be considered as a form of child abuse and thus properly addressed as a political issue.

  2. Psychosocial and sexual aspects of female circumcision

    OpenAIRE

    S. Abdel-Azim

    2013-01-01

    Sexual behavior is a result of interaction of biology and psychology. Sexual excitement of the female can be triggered by stimulation of erotogenic areas; part of which is the clitoris. Female circumcision is done to minimize sexual desire and to preserve virginity. This procedure can lead to psychological trauma to the child; with anxiety, panic attacks and sense of humiliation. Cultural traditions and social pressures can affect as well the unexcised girl. Female circumcision can reduce fem...

  3. Reflections on Female Circumcision Discourse in Hargeysa ...

    African Journals Online (AJOL)

    AJRH Managing Editor

    This study aimed to explore diverse discourses on female circumcision and the relationship between discourses .... 'Halalays' has the stem halal in Arabic – referring to what is permitted in ...... Strand T, Norsk rikskringkasting. Suaads reise: en.

  4. What's wrong with female circumcision?

    Science.gov (United States)

    Nelson, D

    1994-03-16

    Why should the multicultural society of Canada outlaw female genital mutilation (FGM) as proposed by federal Justice Minister Allan Rock or allow avoidance of the procedure to be a legitimate reason for gaining refugee status? Is this anti-FGM position simply an ethnocentric stance that would be called racism in other circumstances? Canadian objections to FGM can not arise from objections about mutilation of a child's sexual organs because male circumcision is legal in Canada, although it, too, is medically questionable. Perhaps Rock is being patriarchal in reserving his concern for females. In Somali culture, women determine the nature and extent of FGM, so Rock may simply be exhibiting his inability to understand other cultures. On the other hand, it is politically incorrect for Canadian government workers to criticize other cultures, and immigrants are assured that their values and beliefs will be accommodated in Canada. Thus, polygamy among Somali immigrants is ignored. The question is why should FGM be a major exception and invoke efforts at repression instead of a respect for diversity.

  5. Bodily integrity and male and female circumcision.

    NARCIS (Netherlands)

    Dekkers, W.J.M.; Hoffer, C.; Wils, J.P.

    2005-01-01

    This paper explores the ambiguous notion of bodily integrity, focusing on male and female circumcision. In the empirical part of the study we describe and analyse the various meanings that are given to the notion of bodily integrity by people in their daily lives. In the philosophical part we

  6. A STUDY OF FEMALE CIRCUMCISION AMONG THE ISOKO TRIBE ...

    African Journals Online (AJOL)

    drclement

    2009-12-01

    Dec 1, 2009 ... women's health, sexuality and fertility. Objective: To ... them showed a high significant rate of circumcision (66%) ... female genital cutting by its critics) has been practiced ..... mutilation is falling, indicating that it has decreasing ...

  7. Female circumcision and child mortality in urban Somalia.

    Science.gov (United States)

    Mohamud, O A

    1991-01-01

    In Somalia, a demographer analyzed urban data obtained from the Family Health Survey to examine the effect female circumcision has on child mortality and the mechanism of that effect. Girls undergo female circumcision between 5-12 years old in Somalia. Since sunni circumcision (removal of the clitoral prepuce and tip of the clitoris) and clitoridectomy (removal of the entire clitoris) did not affect child mortality, he used them as the reference group. Infibulation (entire removal of the clitoris and of the labia minora and majora with the remains of the labia majora being sewn together allowing only a small opening for passage of urine) did affect child mortality. Female children who underwent infibulation and whose mothers most likely also underwent infibulation experienced higher mortality (13-72%) than those from other circumcised mothers. Female mortality exceeded male mortality indicating possible son preference. Mothers with clitoridectomy or infibulation had significantly higher infant mortality than those with sunni circumcision with the strongest effects during the neonatal period (95% and 42% higher mortality, respectively; p=.01). The effect of female circumcision on child mortality decreased with increased child's age. This higher than expected mortality among women with clitoridectomy may have been because women with infibulation had more stillbirths which were not counted as births. The exposed vagina of clitoridectomized women is more likely to be infected resulting in high risk of stillbirths and premature births than the closed vagina of infibulated women. The researcher suggested that the policies promoting education and consciousness raising may eventually eradicate female circumcision. This longterm campaign should use mass media, senior women of high status, and respected religious leaders. Legislation prohibiting this practice would only drive it underground under unsanitary conditions. Demographers should no longer ignore female circumcision

  8. Post-female-circumcision clitoral epidermal inclusion cyst: a case ...

    African Journals Online (AJOL)

    Keywords: complication, epidermal inclusion cyst, female circumcision. Pediatric Urology Division, Department of Urology, ... transplantation of the epidermis into the subcutaneous tissue with subsequent proliferation of epidermal ... The evolution of the practice of FGM, from being performed by traditional birth attendants to.

  9. Trends in Female Circumcision Between 1933 And 2003 in Osun ...

    African Journals Online (AJOL)

    1174 female live births to 413 women were included in the analysis. 52.4% of all females were circumcised. The prevalence dropped from 64.9% during the period 1933-60 to 25.7% for the period 2000–2003. For first order births, the corresponding rates were 58.8% and 25.0%. The decline for first-born females comes a ...

  10. Circumcision

    Science.gov (United States)

    ... the hospital. According to the American Academy of Pediatrics (AAP), there are medical benefits and risks to circumcision. Possible benefits include a lower risk of urinary tract infections, penile cancer, and sexually transmitted diseases. There is ...

  11. Psychosocial and sexual aspects of female circumcision

    African Journals Online (AJOL)

    S. Abdel-Azim

    Sexual behavior is a result of interaction of biology and psychology. Sexual excitement of the female can be triggered by stimulation of erotogenic areas; part of which is the clitoris. Female ... Cultural traditions and social pressures can.

  12. Khitan Perempuan: Who Speaks for the Indonesian Female Circumcision?

    Directory of Open Access Journals (Sweden)

    Bočko Vesna

    2016-12-01

    Full Text Available Throughout the paper the author focuses on the ritual of female circumcision in Indonesian Java, more specifically in the city of Yogyakarta. By the help of fieldwork and academic literature she examines this not merely taboo but also legally forbidden practice in the biggest Muslim country in the world. Female circumcision (FC in Java and Indonesia in general is considered as a daily practice going hand in hand with tradition. The author puts to the foreground the form of circumcision performed in Yogyakarta and its classification as a symbolic and less invasive one. She explains the history of this ritual in the archipelago, national and international regulations and guidelines, analyzes the role of different authorities (state, religious leaders and NGO’s on the persistence/abundance of FC and as a consequence its ‘globalized’ form (medicalizetion of FC. The author learns and emphasizes that this is a practice taken for granted, whose origin is little known to the interlocutors (the executors and participants of the ritual and that the existing literature on the subject is insufficient. For such research a careful approach is of key importance and the author frequently utilizes the help of cultural relativism, reductionism and the use of narrative.

  13. Female circumcision in non-Muslim females in Africa

    African Journals Online (AJOL)

    W.R. Elseesy

    he had overloaded the shape of the body with useless growths. However, if... we ... women in the perfect form, and no one has the right to cut a part of his or her body. ... [4] Wallerstein E. Circumcision: the uniquely American enigma. Reprint.

  14. Circumcision

    Science.gov (United States)

    ... in the United States, Canada, Africa, and the Middle East than in Asia, South America, Central America, and most of Europe, where it's uncommon. Parents who choose circumcision often do so based on religious beliefs, concerns about hygiene, or cultural or social reasons, such as the ...

  15. The relation of female circumcision to sexual behavior in Kenya and Nigeria.

    Science.gov (United States)

    Mpofu, Sibonginkosi; Odimegwu, Clifford; De Wet, Nicole; Adedini, Sunday; Akinyemi, Joshua

    2017-08-01

    One of the reasons for the perpetuation of female circumcision is that it controls female sexuality. In this study, the authors examined the relationship between female circumcision and the sexual behavior of women in Kenya and Nigeria. Data on women who were aware of circumcision and were circumcised were extracted from the Kenya Demographic and Health Survey of 2008-09 as well as the Nigeria Demographic and Health Survey of 2008. The sample size was 7,344 for Kenya and 16,294 for Nigeria. The outcome variables were age at first intercourse and total lifetime number of sexual partners. The study hypothesis was that women who were circumcised were less likely to have initiated sex early and to have only one sex partner. Cox proportional hazards regression and Poisson regression were used to examine the relations of female circumcision and other selected variables to sexual behavior. No association was observed between female circumcision and the outcomes for sexual behavior of women in Kenya and Nigeria. The argument of sexual chastity is insufficient to sustain the perpetuation of female circumcision.

  16. Reconciling female genital circumcision with universal human rights.

    Science.gov (United States)

    Gordon, John-Stewart

    2017-09-18

    One of the most challenging issues in cross-cultural bioethics concerns the long-standing socio-cultural practice of female genital circumcision (FGC), which is prevalent in many African countries and the Middle East as well as in some Asian and Western countries. It is commonly assumed that FGC, in all its versions, constitutes a gross violation of the universal human rights of health, physical integrity, and individual autonomy and hence should be abolished. This article, however, suggests a mediating approach according to which one form of FGC, the removal of the clitoris foreskin, can be made compatible with the high demands of universal human rights. The argument presupposes the idea that human rights are not absolutist by nature but can be framed in a meaningful, culturally sensitive way. It proposes important limiting conditions that must be met for the practice of FGC to be considered in accordance with the human rights agenda. © 2017 John Wiley & Sons Ltd.

  17. Reconciling international human rights and cultural relativism: the case of female circumcision.

    Science.gov (United States)

    James, Stephen A

    1994-01-01

    How can we reconcile, in a non-ethnocentric fashion, the enforcement of international, universal human rights standards with the protection of cultural diversity? Examining this question, taking the controversy over female circumcision as a case study, this article will try to bridge the gap between the traditional anthropological view that human rights are non-existent -- or completely relativised to particular cultures -- and the view of Western naturalistic philosophers (including Lockeian philosophers in the natural rights tradition, and Aquinas and neo-Thomists in the natural law tradition) that they are universal -- simply derived from a basic human nature we all share. After briefly defending a universalist conception of human rights, the article will provide a critique of female circumcision as a human rights violation by three principal means: by an internal critique of the practice using the condoning cultures' own functionalist criteria; by identifying supra-national norms the cultures subscribe to which conflict with the practice; and by the identification of traditional and novel values in the cultures, conducive to those norms. Through this analysis, it will be seen that cultural survival, diversity and flourishing need not be incompatible with upholding international, universal human rights standards.

  18. When female circumcision comes to the West: attitudes toward the practice among Somali Immigrants in Oslo.

    Science.gov (United States)

    Gele, Abdi A; Johansen, Elise B; Sundby, Johanne

    2012-08-27

    Female circumcision (FC) has lifelong adverse social and health consequences for women, and its abolition will not only enhance the health of children and women, but also promote gender equality. Like many other Western countries, Norway hosts a large proportion of immigrants from FC-practicing countries, though primarily from Somalia, which is the country with the highest prevalence of FC in the world. A behavioral change by the practicing communities has the best chance to successfully and sustainably eliminate this practice. However, FC prevention programs require a behavioral surveillance that monitors the process of change, with this being the first quantitative study since the major migration of the Somali community to Norway began in 1991 to investigate whether or not Somali immigrants' attitudes toward the practice has improved in favor of its abandonment. A cross-sectional study using a respondent-driven sampling (RDS) was conducted in Oslo from April to June of 2011. A sample of 214 persons was interviewed, using structured questionnaires. The results show that 70% of Somalis in Oslo support the discontinuation of all forms of FC compared to 30% who support its continuation, with the latter group more likely to be people who lived in Norway ≤ 4 years. Of the 10 girls who came to Norway at the age of ≤ 7 years, only one was circumcised, though whether the circumcision occurred before or after the girl's arrival in Norway remains unclear. The perception that FC is required by religion was the sole factor to be significantly associated with an ongoing support of FC. The study reveals that Somalis in Oslo demonstrate a trend to abandon this practice over time. Nevertheless, the 30% of the people who still support its continuation, and who are primarily newly arrived immigrants, require a targeted intervention that is implemented in the early phase of the immigrants' arrival.

  19. When female circumcision comes to the West: Attitudes toward the practice among Somali Immigrants in Oslo

    Directory of Open Access Journals (Sweden)

    Gele Abdi A

    2012-08-01

    Full Text Available Abstract Background Female circumcision (FC has lifelong adverse social and health consequences for women, and its abolition will not only enhance the health of children and women, but also promote gender equality. Like many other Western countries, Norway hosts a large proportion of immigrants from FC-practicing countries, though primarily from Somalia, which is the country with the highest prevalence of FC in the world. A behavioral change by the practicing communities has the best chance to successfully and sustainably eliminate this practice. However, FC prevention programs require a behavioral surveillance that monitors the process of change, with this being the first quantitative study since the major migration of the Somali community to Norway began in 1991 to investigate whether or not Somali immigrants’ attitudes toward the practice has improved in favor of its abandonment. Methods A cross-sectional study using a respondent-driven sampling (RDS was conducted in Oslo from April to June of 2011. A sample of 214 persons was interviewed, using structured questionnaires. Results The results show that 70% of Somalis in Oslo support the discontinuation of all forms of FC compared to 30% who support its continuation, with the latter group more likely to be people who lived in Norway ≤ 4 years. Of the 10 girls who came to Norway at the age of ≤ 7 years, only one was circumcised, though whether the circumcision occurred before or after the girl’s arrival in Norway remains unclear. The perception that FC is required by religion was the sole factor to be significantly associated with an ongoing support of FC. Conclusion The study reveals that Somalis in Oslo demonstrate a trend to abandon this practice over time. Nevertheless, the 30% of the people who still support its continuation, and who are primarily newly arrived immigrants, require a targeted intervention that is implemented in the early phase of the immigrants’ arrival.

  20. Male circumcision for HIV prevention: female risk compensatory behaviour in South Africa.

    Science.gov (United States)

    Greevy, Clare; King, Rebecca; Haffejee, Firoza

    2018-05-20

    South Africa promotes male circumcision (MC) as an HIV prevention method and implemented a national plan to scale-up MC in the country from 2012 to 2016. Literature has suggested that female risk compensatory behaviours (RCBs) are occurring in countries where these programmes have been implemented. Behaviours such as decreased condom use, concurrent sexual partners and sexual activity during the circumcision wound-healing period have the potential to jeopardise the campaigns' objectives. Literature has shown that directly providing women with MC information results in correct knowledge however, previous studies have not directly sought women's views and ideas on engagement with the information. This study aims to identify and explore female RCBs in relation to MC campaigns in South Africa, and to identify interventions that would result in greater female involvement in the campaigns. Snowball sampling was used to conduct twelve qualitative vignette-facilitated semi-structured interviews with women residing in a municipal housing estate in Durban, Kwa-Zulu Natal, South Africa. Interviews were audio-recorded, verbatim transcribed and analysed using framework analysis. MC knowledge and understanding varied, with some participants mistaking MC as direct HIV protection for females. Despite a lack in knowledge, the majority of women did not report signs of RCBs. Even with a lack of evidence of RCBs, misinterpretation of the MC protective effect has the potential to lead to RCBs; a concept acknowledged in the literature. Several women expressed that MC campaigns are directed to males only and expressed a keenness to be more involved. Suggested interventions include couple counselling and female information sessions in community clinics. Exploring women's attitude towards involvement in MC campaigns fills in a research knowledge gap that is important to international health, as women have a vital role to play in reducing the transmission of HIV.

  1. Attitudes toward female circumcision among Somali immigrants in Oslo: a qualitative study

    Directory of Open Access Journals (Sweden)

    Gele AA

    2012-01-01

    Full Text Available Abdi A Gele1,2, Bernadette Kumar3, Karin Harsløf Hjelde3, Johanne Sundby21The Department of Social Science, Oslo University College, 2Section for International Health, Department of General Practice and Community Medicine, University of Oslo, 3Norwegian Center for Minority Health Research, Oslo, NorwayAbstract: Due to its negative impact on public health, female circumcision (FC has gained increased attention from international communities and the Norwegian public in recent decades. In 1995, the Norwegian government outlawed the practice and simultaneously developed a package of measures aimed at preventing and ultimately eradicating FC in Norway. Like many other Western countries, immigrants of Somali descent constitute the largest immigrant group in Norway from countries with FC traditions. Although this immigrant group is often perceived as a cultural society that supports FC generally as a practice, there appears to be a lack of studies that explore the impact of acculturation and the Western social context on Somali immigrants’ attitudes toward the practice. Against this background, this paper explores the attitudes of Somalis living in Oslo, Norway to the practice of FC. Findings from this qualitative study indicate that Somalis in Oslo have, to a large extent, changed their attitude toward the practice. This was proven by the presence in Oslo of a large number of Somali parents who left their daughters uncut as well as Somali girls, boys, men, and women who attribute being uncircumcised a high status. This study adds to the knowledge of the process of abandonment of FC among immigrants in the Western countries. The study highlights the success that has been achieved in improving attitudes toward the practice of the Somali community in Oslo, Norway, as well as emerging challenges that need to be addressed further.Keywords: female circumcision, attitude, behavior, immigrants, Somalis

  2. Comparative study of meanings, beliefs, and practices of female circumcision among three Nigerian tribes in the United States and Nigeria.

    Science.gov (United States)

    Anuforo, Prisca O; Oyedele, Lola; Pacquiao, Dula F

    2004-04-01

    The study was conducted to gain insight into the meanings, beliefs, and practices of female circumcision among three Nigerian tribes in the United States and Nigeria. Participant-observations occurred in three sites in Nigeria (Ibadan, Lagos, and Owerri) and in Essex County, New Jersey (Newark, Irvington, and East Orange). A total of 50 informants included adult males and females from the three main Nigerian ethnic tribes: Igbo, Yoruba, and Hausa. Leininger's culture care theory of diversity and universality was the study framework. Findings revealed existence of similarities and differences in the cultural meanings, beliefs, and practices among the tribes. Religion, education, and occupation were significant factors influencing informants' attitudes toward continuation of the practice. Government-sponsored public education and influence by the media were found to increase informants' awareness of complications of female circumcision. Changes in attitudes toward the practice and use of alternative practices were evident.

  3. Have we made progress in Somalia after 30 years of interventions? Attitudes toward female circumcision among people in the Hargeisa district.

    Science.gov (United States)

    Gele, Abdi A; Bø, Bente P; Sundby, Johanne

    2013-03-27

    Female circumcision is a major public health problem that largely contributes to the ill-health of women and their children globally. Accordingly, the international community is committed to take all possible measures to abolish the practice that is internationally considered to be absolutely intolerable. While the practice is a social tradition shared by people in 28 African countries, there is no country on earth where FC is more prevalent than in Somalia. Yet, since the early 1990s, there is no quantitative study that has investigated whether the perception towards the practice among Somali men and women in Somalia has improved or not. Thus, this cross-sectional quantitative study examines the attitudes toward the practice among people in Hargeisa, Somalia. A cross-sectional study of 215 randomly selected persons, including both men and women, was conducted in Hargeisa, Somalia from July to September of 2011. Participants were interviewed using structured questionnaires, with questions including the circumcision status of the female participants, the type of circumcision, if one has the intention to circumcise his/her daughter, whether one supports the continuation or discontinuation of the practice and men's perceptions toward having an uncircumcised woman as a wife. The findings show that 97% of the study's participants were circumcised with no age differences. Of this, 81% were subjected to Type 3, while 16% were subjected to either Type 1 or 2 and only 3% were left uncircumcised. Approximately 85% of the respondents had intention to circumcise their daughters, with 13% were planning the most radical form. Among men, 96% preferred to marry circumcised women, whereas overall, 90% of respondents supported the continuation of the practice. The vast majority of the study's respondents had a good knowledge of the negative health effects of female circumcision. In multivariate logistic regressions, with an adjustment for all other important variables, female

  4. Attitudes toward female circumcision among Somali immigrants in Oslo: a qualitative study.

    Science.gov (United States)

    Gele, Abdi A; Kumar, Bernadette; Hjelde, Karin Harsløf; Sundby, Johanne

    2012-01-01

    Due to its negative impact on public health, female circumcision (FC) has gained increased attention from international communities and the Norwegian public in recent decades. In 1995, the Norwegian government outlawed the practice and simultaneously developed a package of measures aimed at preventing and ultimately eradicating FC in Norway. Like many other Western countries, immigrants of Somali descent constitute the largest immigrant group in Norway from countries with FC traditions. Although this immigrant group is often perceived as a cultural society that supports FC generally as a practice, there appears to be a lack of studies that explore the impact of acculturation and the Western social context on Somali immigrants' attitudes toward the practice. Against this background, this paper explores the attitudes of Somalis living in Oslo, Norway to the practice of FC. Findings from this qualitative study indicate that Somalis in Oslo have, to a large extent, changed their attitude toward the practice. This was proven by the presence in Oslo of a large number of Somali parents who left their daughters uncut as well as Somali girls, boys, men, and women who attribute being uncircumcised a high status. This study adds to the knowledge of the process of abandonment of FC among immigrants in the Western countries. The study highlights the success that has been achieved in improving attitudes toward the practice of the Somali community in Oslo, Norway, as well as emerging challenges that need to be addressed further.

  5. Reproductive health profile and circumcision of females in the Hali semi-urban region, Saudi Arabia: A community-based cross-sectional survey.

    Science.gov (United States)

    Milaat, Waleed Abdullah; Ibrahim, Nahla Khamis; Albar, Hussain Mohammed

    2018-01-01

    Improving the reproductive health of females has be.come the focus of the developmental efforts of many nations. To identify the reproductive health style of married females, and to determine the prevalence and predictors of circumcision among girls aged less than or equal 18 years in Hali semi-urban region. A cross-sectional household survey SETTING: Houses in Hali, Al-Qunfudhah governorate, western Saudi Arabia during 2017. A multistage systematic cluster random sampling method was used to select participants. A validated questionnaire was used in interviewing the head of the selected houses. Reproductive health profile of women, and circumcision of girls. 365 households. Reproductive life starts early in the Hali region as 41.4% of women are married at or before 18 years of age. Consanguinity was recorded in 57.0% of houses. The prevalence of grand multiparity (GMP) was 54.7%; it was significantly associated with current maternal age, age at marriage, low educational levels of both parents and husbands with non-professional jobs. Current use of birth control methods was reported by 28.9% of families, and oral contraceptives (OCs) were the commonest method. Contraceptive use was significantly associated with higher educational levels of both parents and with women having professional work. The prevalence of circumcision was 80.3%. Circumcision was most frequent (59.4%) at age 7 years or less, and almost always done by doctors (91.4%). Hemorrhage (2.9%) and fever (2.3%) were the minimal recorded complications. Girls with higher parental education, enough income, no parental consanguinity, and whose mothers married at an older age had slightly lower rates of circumcision, but the difference was without statistical significance. The pattern of early female marriage, high consanguinity, GMP, low contraceptive use, and a high frequency of circumcision in girls was apparent in Hali. Public health education and legislative policies are needed. Recall bias may affect the

  6. Libertarianism and circumcision.

    Science.gov (United States)

    Testa, Patrick; Block, Walter E

    2014-06-01

    Despite the millenniums-old tradition in Abrahamic circles of removing the foreskin of a penis at birth, the involuntary and aggressive practice of circumcision must not be made an exception to the natural, negative right to self-ownership-a birthright which should prevent a parent from physically harming a child from the moment of birth going forward. This paper will present a natural rights argument against the practice of male child circumcision, while also looking into some of the potential physical and psychological consequences of the practice. It will compare the practice with that of female circumcision, which is banned in developed nations but still practiced in the third world, as well as other forms of aggressive action, some once-prevalent, while disputing arguments made for parental ownership of the child, religious expression, cultural tradition, cleanliness, cosmetics, and conformity.

  7. Libertarianism and Circumcision

    Directory of Open Access Journals (Sweden)

    Patrick Testa

    2014-06-01

    Full Text Available Despite the millenniums-old tradition in Abrahamic circles of removing the foreskin of a penis at birth, the involuntary and aggressive practice of circumcision must not be made an exception to the natural, negative right to self-ownership—a birthright which should prevent a parent from physically harming a child from the moment of birth going forward. This paper will present a natural rights argument against the practice of male child circumcision, while also looking into some of the potential physical and psychological consequences of the practice. It will compare the practice with that of female circumcision, which is banned in developed nations but still practiced in the third world, as well as other forms of aggressive action, some once-prevalent, while disputing arguments made for parental ownership of the child, religious expression, cultural tradition, cleanliness, cosmetics, and conformity.

  8. Libertarianism and circumcision

    Science.gov (United States)

    Testa, Patrick; Block, Walter E.

    2014-01-01

    Despite the millenniums-old tradition in Abrahamic circles of removing the foreskin of a penis at birth, the involuntary and aggressive practice of circumcision must not be made an exception to the natural, negative right to self-ownership—a birthright which should prevent a parent from physically harming a child from the moment of birth going forward. This paper will present a natural rights argument against the practice of male child circumcision, while also looking into some of the potential physical and psychological consequences of the practice. It will compare the practice with that of female circumcision, which is banned in developed nations but still practiced in the third world, as well as other forms of aggressive action, some once-prevalent, while disputing arguments made for parental ownership of the child, religious expression, cultural tradition, cleanliness, cosmetics, and conformity. PMID:24987720

  9. Circumcision (Male)

    Science.gov (United States)

    ... can also be a matter of family tradition, personal hygiene or preventive health care. For others, however, circumcision ... can also be a matter of family tradition, personal hygiene or preventive health care. Sometimes there's a medical ...

  10. Attitudes toward Female Circumcision among Men and Women in Two Districts in Somalia: Is It Time to Rethink Our Eradication Strategy in Somalia?

    Directory of Open Access Journals (Sweden)

    Abdi A. Gele

    2013-01-01

    Full Text Available Somalia has the highest global prevalence (98% of female circumcision (FC, and, despite a long history of abandonment efforts, it is not clear as to whether or not these programmes have changed people’s positive attitudes toward the practice. Against this background, this paper explores the attitudes of Somalis living in Hargeisa and Galkayo districts to the practice of FC. Methods. A purposive sampling of 24 Somalis, including activists and practitioners, men and women, was conducted in Somalia. Unstructured interviews were employed to explore the participants' knowledge of FC, their attitudes toward the continuation/discontinuation of the practice, and the type they want to continue or not to continue. Result. The findings of this qualitative study indicate that there is a strong resistance towards the abandonment of the practice in Somalia. The support for the continuation of Sunna circumcision is widespread, while there is a quite large rejection of Pharaonic circumcision. Conclusion. Therefore, since the “zero tolerance policy” has failed to change people’s support for the continuation of the practice in Somalia, programmes that promote the pinch of the clitoral skin and verbal alteration of status, with the goal of leading to total abandonment of FC, should be considered for the Somali context.

  11. Narratives of newly circumcised men in Malawi

    African Journals Online (AJOL)

    public space where female health providers can participate, even for men coming from ... United Nations Programme on HIV and AIDS (UNAIDS) recommended ..... keep male circumcision a secret or out of females' purview is beyond the ...

  12. Is female circumcision evolving or dissolving in Norway? A qualitative study on attitudes toward the practice among young Somalis in the Oslo area.

    Science.gov (United States)

    Gele, Abdi A; Sagbakken, Mette; Kumar, Bernadette

    2015-01-01

    Female genital mutilation or female circumcision (FC) is increasingly visible on the global health and development agenda - both as a matter of social justice and equality for women and as a research priority. Norway is one of the global nations hosting a large number of immigrants from FC-practicing countries, the majority from Somalia. To help counteract this practice, Norway has adopted a multifaceted policy approach that employs one of the toughest measures against FC in the world. However, little is known about the impact of Norway's approach on the attitudes toward the practice among traditional FC-practicing communities in Norway. Against this background, this qualitative study explores the attitudes toward FC among young Somalis between the ages of 16 to 22 living in the Oslo and Akershus regions of Norway. Findings indicate that young Somalis in the Oslo area have, to a large extent, changed their attitude toward the practice. This was shown by the participants' support and sympathy toward criminalization of FC in Norway, which they believed was an important step toward saving young girls from the harmful consequences of FC. Most of the uncircumcised girls see their uncircumcised status as being normal, whereas they see circumcised girls as survivors of violence and injustice. Moreover, the fact that male participants prefer a marriage to uncircumcised girls is a strong condition for change, since if uncut girls are seen as marriageable then parents are unlikely to want to circumcise them. As newly arrived immigrants continue to have positive attitudes toward the practice, knowledge of FC should be integrated into introduction program classes that immigrants attend shortly after their residence permit is granted. This study adds to the knowledge of the process of the abandonment of FC among immigrants in Western countries.

  13. The Factor Related to Mother’s Motivations in Carrying out the Circumcision of the Female Children in a Teuk Jawo Village Baiturrahman Sub District, Banda Aceh in 2014

    Directory of Open Access Journals (Sweden)

    Marniati

    2018-01-01

    Full Text Available Circumcision is the activity carried out to remove the partial foreskin of penis. The preliminary survey result of 15 mothers that were carried out the circumcision to their female children mention that 7 mothers carried out the circumcision because of the culture/tradition from generation to the generation, 5 mothers brought their children because of the family supports. There are 121 female children that are 0 – 5 years old in Ateuk Jawo Village. The objective of this research is to detect the factors that affect the mothers’ motivations in carrying out the circumcision to female children in Ateuk Jawo Village, Baiturrahman Sub District, Banda Aceh. The methodology used in this research is analytical descriptive with 121 population of people. The samples in this research are 55 people. The sampling technique is purposive sampling. The data was collected by distributing the questionnaires. This research was conducted in Ateuk Jawa Village, Baiturrahman Sub Village, Banda Aceh on July 2014. The results of this research mention that Chi –Square tests show that from 28 respondents who chose the culture were not affected to the low motivations of the mothers in carrying the circumcision, there were 16 respondents (57.1% with the value of p = = 0.003 (p <0.05. From the 32 respondents who chose the family supports were higher affected of the mothers’ motivations, there were 26 respondents (81.2% with the value of p= 0.004 (p < 0.05. The last was from the 25 respondents who chose the religion factor were the most affected of the mothers’ motivations, there are 21 respondents (84%, with the value of p = 0.010 (p <0.05.This research concluded that there are the relations among culture, family supports and religions factor that were affected the mothers’ motivations in carrying out the female children circumcision. It is recommended to the pregnant women to improve the knowledge about the circumcision to their female children later.

  14. Circumcision: Pros and cons

    Directory of Open Access Journals (Sweden)

    Burgu Berk

    2010-01-01

    Full Text Available Circumcision is possibly the most frequently performed elective surgical procedure in men. It can simply be described as the excision of the preputium. There have been several studies about the association between circumcision and urinary tract infections (UTI. Many studies have demonstrated that the frequency of UTI increase in uncircumcised males, especially in the first year of life. This review discusses the embryology of the preputium, epidemiology, indications, complications and benefits of circumcision, as well as operation and anesthesiology techniques. It especially examines the association between UTI and circumcision and the importance of circumcision in congenital urinary system anomalies. In addition, this review examines the associations between circumcision and sexually transmitted diseases, including HIV, and the protective role of circumcision on penile cancer.

  15. Evaluation of the safety of the Taraklamp male circumcision device ...

    African Journals Online (AJOL)

    Background: Male circumcision has been proved to be an effective additional means of preventing transmission of the HIV virus from females to males in heterosexual relationships with efficacy of up to 60%. Many methods and devices for adult male circumcision have now been developed. However, there are still concerns ...

  16. Circumcision in Australia: prevalence and effects on sexual health.

    Science.gov (United States)

    Richters, Juliet; Smith, Anthony M A; de Visser, Richard O; Grulich, Andrew E; Rissel, Christopher E

    2006-08-01

    The results from a telephone survey in 2001-02 of a probability sample of Australian households including 10,173 men aged 16-59 (response rate 69.4%) are used to assess the prevalence of circumcision across social groups in Australia and examine lifetime history of sexually transmissible infection (STI), sexual difficulties in the last year, sexual practices including masturbation, and sexual attitudes. More than half (59%) of the men were circumcised. Circumcision was less common among younger men (32% aged practices at last sexual encounter with a female partner or in masturbation alone. Circumcised men had somewhat more liberal sexual attitudes. Neonatal circumcision was routine in Australia until the 1970s. It appears not to be associated with significant protective or harmful sexual health outcomes. This study provides no evidence about the effects on sexual sensitivity.

  17. Exploring drivers for safe male circumcision: Experiences with health education and understanding of partial HIV protection among newly circumcised men in Wakiso, Uganda.

    Directory of Open Access Journals (Sweden)

    Simon P S Kibira

    Full Text Available About 2.5 million men have voluntarily been circumcised since Uganda started implementing the WHO recommendation to scale up safe male circumcision to reduce HIV transmission. This study sought to understand what influences men's circumcision decisions, their experiences with health education at health facilities and their knowledge of partial HIV risk reduction in Wakiso district.Data were collected in May and June 2015 at five public health facilities in Wakiso District. Twenty-five in-depth interviews were held with adult safe male circumcision clients. Data were analysed using thematic network analysis.Safe male circumcision decisions were mainly influenced by sexual partners, a perceived need to reduce the risk of HIV/STIs, community pressure and other benefits like hygiene. Sexual partners directly requested men to circumcise or indirectly influenced them in varied ways. Health education at facilities mainly focused on the surgical procedure, circumcision benefits especially HIV risk reduction, wound care and time to resumption of sex, with less focus on post-circumcision sexual behaviour. Five men reported no health education. All men reported that circumcision only reduces and does not eliminate HIV risk, and could mention ways it protects, although some extended the benefit to direct protection for women and prevention of other STIs. Five men thought social marketing messages were 'misleading' and feared risk compensation within the community.Participants reported positive community perception about safe male circumcision campaigns, influencing men to seek services and enabling female partners to impact this decision-making process. However, there seemed to be gaps in safe male circumcision health education, although all participants correctly understood that circumcision offers only partial protection from HIV. Standard health education procedures, if followed at health facilities offering safe male circumcision, would ensure all

  18. Debunking myths about female circumcision

    African Journals Online (AJOL)

    Catherine deVries

    as well as in many parts of Asia and Latin America, educational opportunities for women and ... own body is assumed, and there are few residual cultural beliefs or activities that cause direct ... sive traditional behaviors that damage their physical and emotional health and sometimes risk their lives. Genital cutting is one such.

  19. Complications of Circumcision

    Directory of Open Access Journals (Sweden)

    Aaron J. Krill

    2011-01-01

    Full Text Available In the United States, circumcision is a commonly performed procedure. It is a relatively safe procedure with a low overall complication rate. Most complications are minor and can be managed easily. Though uncommon, complications of circumcision do represent a significant percentage of cases seen by pediatric urologists. Often they require surgical correction that results in a significant cost to the health care system. Severe complications are quite rare, but death has been reported as a result in some cases. A thorough and complete preoperative evaluation, focusing on bleeding history and birth history, is imperative. Proper selection of patients based on age and anatomic considerations as well as proper sterile surgical technique are critical to prevent future circumcision-related adverse events.

  20. [Ethics and ritual circumcision].

    Science.gov (United States)

    Castagnola, C; Faix, A

    2014-12-01

    Circumcision dates back to ancient times, nowadays, this ritual is practiced mainly in the context of Jewish and Muslim religions. The purpose of this article is to give urologists elements of reflection on the act according to the ethical principles of autonomy, beneficence, non-maleficence and justice. According to a Kantian vision, priority should be given to the respect and wishes of the individuals. In contrast, for the utilitarian theory, circumcision can be justified by a contribution to the happiness of the majority of community members at the expense of a given few. In the event of a request for ritual circumcision, urologists find themselves in the middle, uncomfortable for some, questioning the ethics of its meaning. The main pitfall for the surgeon remains in respecting the child's autonomy. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  1. Circumcision revision in male children

    Directory of Open Access Journals (Sweden)

    Mohammed A. Al-Ghazo

    2006-08-01

    Full Text Available OBJECTIVE: To determine indications for circumcision revision and to identify the specialty of the person who performed unsatisfactory primary circumcision. MATERIALS AND METHODS: The authors reviewed medical records of 52 cases that underwent circumcision revision over a 6-year period (1998 to 2004. Sleeve surgical technique was used for revision in patients with redundant foreskin or concealed penis, penoplasty for partial or complete degloving of the penis and meatotomy for external meatal stenosis. The mean age of children was 32 months (range 6 months to 9 years. RESULTS: Most of unsatisfactory primary circumcisions (86.7% were performed by laymen. All patients who underwent circumcision revision had good to excellent cosmetic results. CONCLUSION: Primary circumcision performed by laymen carry a high complication rate and serious complications may occur. A period of training and direct supervision by physicians is required before allowing laymen to perform circumcision independently.

  2. Why do male patients request circumcisions?

    African Journals Online (AJOL)

    The history of circumcision ... In South Africa, cultural circumcision is often regarded as the only way to attain full adulthood, and consequently ... under some non-circumcising tribes, ..... battering in Zulu society [dissertation] University.

  3. Late complications of circumcision

    African Journals Online (AJOL)

    Freud [17] considers the meatal orifice to be abnormally small if the anteroposterior diameter is 3 mm or less. Williams [18] regarded the stenosis as secondary to ulceration. Most of the acquired cases of phimosis after circumcision are because of very little foreskin removed at operation, with the infection at the circumcized ...

  4. The effects of circumcision on the penis microbiome.

    Directory of Open Access Journals (Sweden)

    Lance B Price

    2010-01-01

    Full Text Available Circumcision is associated with significant reductions in HIV, HSV-2 and HPV infections among men and significant reductions in bacterial vaginosis among their female partners.We assessed the penile (coronal sulci microbiota in 12 HIV-negative Ugandan men before and after circumcision. Microbiota were characterized using sequence-tagged 16S rRNA gene pyrosequencing targeting the V3-V4 hypervariable regions. Taxonomic classification was performed using the RDP Naïve Bayesian Classifier. Among the 42 unique bacterial families identified, Pseudomonadaceae and Oxalobactericeae were the most abundant irrespective of circumcision status. Circumcision was associated with a significant change in the overall microbiota (PerMANOVA p = 0.007 and with a significant decrease in putative anaerobic bacterial families (Wilcoxon Signed-Rank test p = 0.014. Specifically, two families-Clostridiales Family XI (p = 0.006 and Prevotellaceae (p = 0.006-were uniquely abundant before circumcision. Within these families we identified a number of anaerobic genera previously associated with bacterial vaginosis including: Anaerococcus spp., Finegoldia spp., Peptoniphilus spp., and Prevotella spp.The anoxic microenvironment of the subpreputial space may support pro-inflammatory anaerobes that can activate Langerhans cells to present HIV to CD4 cells in draining lymph nodes. Thus, the reduction in putative anaerobic bacteria after circumcision may play a role in protection from HIV and other sexually transmitted diseases.

  5. Male circumcision significantly reduces prevalence and load of genital anaerobic bacteria.

    Science.gov (United States)

    Liu, Cindy M; Hungate, Bruce A; Tobian, Aaron A R; Serwadda, David; Ravel, Jacques; Lester, Richard; Kigozi, Godfrey; Aziz, Maliha; Galiwango, Ronald M; Nalugoda, Fred; Contente-Cuomo, Tania L; Wawer, Maria J; Keim, Paul; Gray, Ronald H; Price, Lance B

    2013-04-16

    Male circumcision reduces female-to-male HIV transmission. Hypothesized mechanisms for this protective effect include decreased HIV target cell recruitment and activation due to changes in the penis microbiome. We compared the coronal sulcus microbiota of men from a group of uncircumcised controls (n = 77) and from a circumcised intervention group (n = 79) at enrollment and year 1 follow-up in a randomized circumcision trial in Rakai, Uganda. We characterized microbiota using16S rRNA gene-based quantitative PCR (qPCR) and pyrosequencing, log response ratio (LRR), Bayesian classification, nonmetric multidimensional scaling (nMDS), and permutational multivariate analysis of variance (PerMANOVA). At baseline, men in both study arms had comparable coronal sulcus microbiota; however, by year 1, circumcision decreased the total bacterial load and reduced microbiota biodiversity. Specifically, the prevalence and absolute abundance of 12 anaerobic bacterial taxa decreased significantly in the circumcised men. While aerobic bacterial taxa also increased postcircumcision, these gains were minor. The reduction in anaerobes may partly account for the effects of circumcision on reduced HIV acquisition. The bacterial changes identified in this study may play an important role in the HIV risk reduction conferred by male circumcision. Decreasing the load of specific anaerobes could reduce HIV target cell recruitment to the foreskin. Understanding the mechanisms that underlie the benefits of male circumcision could help to identify new intervention strategies for decreasing HIV transmission, applicable to populations with high HIV prevalence where male circumcision is culturally less acceptable.

  6. BRAND LOYALTY OF FEMALE CONSUMERS - STUDY CARRIED IN SFÂNTU GHEORGHE AND THE SURROUNDING AREAS

    Directory of Open Access Journals (Sweden)

    Erika KULCSÁR

    2011-01-01

    Full Text Available Today, the role of women in society has significantly changed, they work as men so they have their own income that they can spend as they wish and as necessary. We need to pay particular importance to consumer behaviour of female and as such it should be treated as a particular segment. This paper aims to study the simultaneous effects - based on data from quantitative marketing research – that the independent variables generate on the dependent variable. The variables introduced in the analysis of variance are: How often do you drink coffee /tea every day?, Age, Income, Last graduated school. We applied the hi square test we in order to analyze the links between two variables measured with nominal scale. The variables analyzed are: Do you always buy the some brand and The highest level of education achieved.

  7. An exploration of the knowledge, attitudes and beliefs of Xhosa men concerning traditional circumcision.

    Science.gov (United States)

    Froneman, Salome; Kapp, Paul A

    2017-10-13

    The practice of traditional circumcision is associated with considerable morbidity and mortality, yet there is a paucity of literature that provides an understanding of the cultural values that influence men to choose traditional rather than medical circumcision.The aim of this study was to better understand the culture surrounding traditional circumcision, with a view to addressing morbidity and mortality rates associated with the Xhosa male initiation rituals.We explored Xhosa men's perceptions regarding the need for the risks and the social pressure to undergo traditional circumcision, the impact of non-initiation or failed initiation and the perceived barriers to obtaining medical help for the complications of traditional circumcisions. Individual in-depth interviews were conducted with 10 purposively sampled teenagers and adult men. The interviews were recorded, translated, transcribed and analysed using the framework method. Traditional circumcision was seen as essential to Xhosa culture. Participants rationalised many reasons for participating, including personal growth and development, family and peer pressure, independence and knowledge gained, a connection with ancestors and initiation into manhood. Despite publicity of the dangers of traditional circumcision and the hardships they have to endure, most young men still saw this process as necessary and worthwhile. Traditional initiation and circumcision are here to stay. The majority of boys still trust the elders and supernatural processes to guide them. However, some participants welcomed government initiatives to reduce human error causing unnecessary death and suffering. Current systems to prevent morbidity and mortality are insufficient and should be prioritised.

  8. German law on circumcision and its debate: how an ethical and legal issue turned political.

    Science.gov (United States)

    Aurenque, Diana; Wiesing, Urban

    2015-03-01

    The article aims to illuminate the recent debate in Germany about the legitimacy of circumcision for religious reasons. The aim is both to evaluate the new German law allowing religious circumcision, and to outline the resulting conflict between the surrounding ethical and legal issues. We first elucidate the diversity of legal and medical views on religious circumcision in Germany. Next we examine to what extent invasive and irreversible physical interventions on infant boys unable to given their consent should be carried out for non-medical reasons. To this end, the potential benefits and harms of circumcision for non-medical reasons are compared. We argue that circumcision does not provide any benefits for the 'child as a child' and poses only risks to boys. We then set out to clarify and analyse political (rather than ethical) justifications of the new circumcision law. We demonstrate through this analysis how the circumcision debate in Germany has been transformed from a legal and ethical problem into a political issue, due at least in part to Germany's unique historical context. Although such a particular political sensibility is entirely comprehensible, it raises particular problems when it comes to framing and responding to medical ethical issues - as in the case of religious circumcision. © 2013 John Wiley & Sons Ltd.

  9. Circumcision Is Unethical and Unlawful.

    Science.gov (United States)

    Svoboda, J Steven; Adler, Peter W; Van Howe, Robert S

    2016-06-01

    The foreskin is a complex structure that protects and moisturizes the head of the penis, and, being the most densely innervated and sensitive portion of the penis, is essential to providing the complete sexual response. Circumcision-the removal of this structure-is non-therapeutic, painful, irreversible surgery that also risks serious physical injury, psychological sequelae, and death. Men rarely volunteer for it, and increasingly circumcised men are expressing their resentment about it.Circumcision is usually performed for religious, cultural and personal reasons. Early claims about its medical benefits have been proven false. The American Academy of Pediatrics and the Centers for Disease Prevention and Control have made many scientifically untenable claims promoting circumcision that run counter to the consensus of Western medical organizations.Circumcision violates the cardinal principles of medical ethics, to respect autonomy (self-determination), to do good, to do no harm, and to be just. Without a clear medical indication, circumcision must be deferred until the child can provide his own fully informed consent.In 2012, a German court held that circumcision constitutes criminal assault. Under existing United States law and international human rights declarations as well, circumcision already violates boys› absolute rights to equal protection, bodily integrity, autonomy, and freedom to choose their own religion. A physician has a legal duty to protect children from unnecessary interventions. Physicians who obtain parental permission through spurious claims or omissions, or rely on the American Academy of Pediatrics' position, also risk liability for misleading parents about circumcision. © 2016 American Society of Law, Medicine & Ethics.

  10. The Cost of Medicaid Savings: The Potential Detrimental Public Health Impact of Neonatal Circumcision Defunding

    Directory of Open Access Journals (Sweden)

    Annie L. Andrews

    2012-01-01

    Full Text Available Objective. To project the increased incidence of HIV and subsequent costs resulting from the expected decreased rate of circumcision due to Medicaid defunding in one southeastern state. Methods. Using 2009 South Carolina (SC Medicaid birth cohort (n=29,316, we calculated expected heterosexually acquired HIV cases at current circumcision rates. To calculate age/race/gender specific HIV incidence rates, we used 2009 South Carolina Department of Health and Environmental Control reported gender and race specific HIV cases, CDC reported age distribution of HIV cases, and 2009 S.C. population data. Accounting for current circumcision rates, we calculated the change in incidence of heterosexually acquired HIV assuming circumcision provides 60% protection against HIV transmission to males and 46% protection against male to female transmission. Published lifetime cost of HIV was used to calculate the cost of additional HIV cases. Results. Assuming Medicaid circumcision rates decrease from current nationally reported levels to zero secondary to defunding, we project an additional 55 male cases of HIV and 47 female cases of HIV among this birth cohort. The total cost discounted to time of infection of these additional HIV cases is $20,924,400 for male cases and $17,711,400 for female cases. The cost to circumcise males in this birth cohort at currently reported rates is $4,856,000. Conclusions. For every year of decreased circumcision rates due to Medicaid defunding, we project over 100 additional HIV cases and $30,000,000 in net medical costs.

  11. Do the Benefits of Male Circumcision Outweigh the Risks? A Critique of the Proposed CDC Guidelines.

    Science.gov (United States)

    Earp, Brian D

    2015-01-01

    The Centers for Disease Control and Prevention (CDC) have announced a set of provisional guidelines concerning male circumcision, in which they suggest that the benefits of the surgery outweigh the risks. I offer a critique of the CDC position. Among other concerns, I suggest that the CDC relies more heavily than is warranted on studies from Sub-Saharan Africa that neither translate well to North American populations nor to circumcisions performed before an age of sexual debut; that it employs an inadequate conception of risk in its benefit vs. risk analysis; that it fails to consider the anatomy and functions of the penile prepuce (i.e., the part of the penis that is removed by circumcision); that it underestimates the adverse consequences associated with circumcision by focusing on short-term surgical complications rather than long-term harms; that it portrays both the risks and benefits of circumcision in a misleading manner, thereby undermining the possibility of obtaining informed consent; that it evinces a superficial and selective analysis of the literature on sexual outcomes associated with circumcision; and that it gives less attention than is desirable to ethical issues surrounding autonomy and bodily integrity. I conclude that circumcision before an age of consent is not an appropriate health-promotion strategy.

  12. Circumcision of male children for reduction of future risk for HIV: acceptability among HIV serodiscordant couples in Kampala, Uganda.

    Directory of Open Access Journals (Sweden)

    Kenneth K Mugwanya

    Full Text Available The ultimate success of medical male circumcision for HIV prevention may depend on targeting male infants and children as well as adults, in order to maximally reduce new HIV infections into the future.We conducted a cross-sectional study among heterosexual HIV serodiscordant couples (a population at high risk for HIV transmission attending a research clinic in Kampala, Uganda on perceptions and attitudes about medical circumcision for male children for HIV prevention. Correlates of willingness to circumcise male children were assessed using generalized estimating equations methods.318 HIV serodiscordant couples were interviewed, 51.3% in which the female partner was HIV uninfected. Most couples were married and cohabiting, and almost 50% had at least one uncircumcised male child of ≤18 years of age. Overall, 90.2% of male partners and 94.6% of female partners expressed interest in medical circumcision for their male children for reduction of future risk for HIV infection, including 79.9% of men and 87.6% of women who had an uncircumcised male child. Among both men and women, those who were knowledgeable that circumcision reduces men's risk for HIV (adjusted prevalence ratio [APR] 1.34 and 1.14 and those who had discussed the HIV prevention effects of medical circumcision with their partner (APR 1.08 and 1.07 were significantly (p≤0.05 more likely to be interested in male child circumcision for HIV prevention. Among men, those who were circumcised (APR 1.09, p = 0.004 and those who were HIV seropositive (APR 1.09, p = 0.03 were also more likely to be interested in child circumcision for HIV prevention.A high proportion of men and women in Ugandan heterosexual HIV serodiscordant partnerships were willing to have their male children circumcised for eventual HIV prevention benefits. Engaging both parents may increase interest in medical male circumcision for HIV prevention.

  13. Discourses of masculinity, femininity and sexuality in Uganda's Stand Proud, Get Circumcised campaign.

    Science.gov (United States)

    Rudrum, Sarah; Oliffe, John L; Benoit, Cecilia

    2017-02-01

    This paper analyses discourses of masculinity, femininity and sexuality in Stand Proud, Get Circumcised, a public health campaign promoting circumcision as an HIV-prevention strategy in Uganda. The campaign includes posters highlighting the positive reactions of women to circumcised men, and is intended to support the national rollout of voluntary medical male circumcision. We offer a critical discourse analysis of representations of masculinity, femininity and sexuality in relation to HIV prevention. The campaign materials have a playful feel and, in contrast to ABC (Abstain, Be faithful, Use condoms) campaigns, acknowledge the potential for pre-marital and extra-marital sex. However, these posters exploit male anxieties about appearance and performance, drawing on hegemonic masculinity to promote circumcision as an idealised body aesthetic. Positioning women as the campaign's face reasserts a message that women are the custodians of family health and simultaneously perpetuates a norm of estrangement between men and their health. The wives' slogan, 'we have less chance of getting HIV', is misleading, because circumcision only directly prevents female-to-male HIV transmission. Reaffirming hegemonic notions of appearance- and performance-based heterosexual masculinity reproduces existing unsafe norms about masculinity, femininity and sexuality. In selling male circumcision, the posters fail to promote an overall HIV-prevention message.

  14. Circumcision ceremonies at the Ottoman palace.

    Science.gov (United States)

    Sari, N; Büyükünal, S N; Zülfikar, B

    1996-07-01

    Circumcision is widely practiced in all Islamic countries. Festivities pertaining to circumcision vary according to the regions and civilizations. In this report, circumcision festivities at the Ottoman Palace and the socioeconomic importance of the tradition are presented. The Ottoman circumcision technique is discussed, as are the miniature paintings, in manuscript, written on the occasion of the circumcision of the sons of the Sultans. Because these festivities involved the participation of all classes of the society and all professions they contributed to social and technical progress and led to developments in art, music, sports, and ideas.

  15. Cultural change after migration: Circumcision of girls in Western migrant communities.

    Science.gov (United States)

    Johnsdotter, Sara; Essén, Birgitta

    2016-04-01

    This paper reviews the current knowledge on cultural change after migration in the practice of female circumcision, also named genital cutting or mutilation. Explorative studies show trends of radical change of this practice, especially the most extensive form of its kind (type III or the 'Pharaonic' type). The widespread interpretation that Islam would require circumcision of girls is questioned when, for example, Somalis meet other Muslim migrants, such as Arab Muslims, who do not circumcise their daughters. The few criminal court cases for circumcision of girls that have taken place in Western countries corroborate the conclusion that substantial change in the practice has occurred among migrants. In this literature review, an absence of reports is identified from healthcare providers who have witnessed circumcision after migration. Concurrently, a substantial knowledge exists on how to take care of already circumcised women and girls, and there is a system of recommendations in place regarding best practices for prevention. There is a great potential for healthcare providers to encourage this development towards general abandonment of circumcision of girls. The challenge for the future is how to incorporate culturally sensitive efforts of prevention on the one hand, and the examination of suspicious cases of illegal circumcision on the other. We recommend using--in a cautious way--the existing routines for identifying child abuse in general. Experiences from African contexts show that failure to generate significant change of the harmful practices/tradition may be due to the lack of multidisciplinary collaboration in different sectors of the society. In Western societies, the tendency toward abandonment of the practice could be reinforced by professionals who work toward better inclusion of men and women originally from countries where circumcision is practised. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

  16. Circumcision weeks: making circumcision part of routine training ...

    African Journals Online (AJOL)

    2010-07-26

    Jul 26, 2010 ... The average age of the patients was 20, and generally, they elected to have medical circumcision ... Senior Family Physician, Pretoria West Hospital, Department of Family Medicine, University of Pretoria ... inverse relationship between prostate cancer and male ..... [homepage on the Internet]. c2010.

  17. Decline in male circumcision in South Korea.

    Science.gov (United States)

    Kim, DaiSik; Koo, Sung-Ae; Pang, Myung-Geol

    2012-12-11

    To investigate the changing circumcision rate in South Korea in the last decade and to propose underlying causes for this change, in the context of the present fluctuating world-wide trends in circumcision. From 2009 to 2011, 3,296 South Korean males (or their parents) aged 0-64 years were asked about their circumcision status, their age at circumcision, and their information level regarding circumcision. We employed non-probability sampling considering the sensitive questions on the study theme. Currently the age-standardized circumcision rate for South Korean males aged 14-29 is found to be 75.8%. In an earlier study performed in 2002, the rate for the same age group was 86.3%. Of particular interest, males aged 14-16 show a circumcision rate of 56.4%, while the same age group 10 years ago displayed a much higher percentage, at 88.4%. In addition, the extraordinarily high circumcision rate of 95.2% found 10 years ago for the 17-19 age group is now reduced to 74.4%. Interestingly, of the circumcised males, the percentage circumcised in the last decade was only 25.2%; i.e., the majority of the currently circumcised males had undergone the operation prior to 2002, indicating that the actual change in the last decade is far greater. Consistent with this conjecture, the 2002 survey showed that the majority of circumcised males (75.7%) had undergone the operation in the decade prior to that point. Focusing on the flagship age group of 14-16, this drop suggests that, considering the population structure of Korean males, approximately one million fewer circumcision operations have been performed in the last decade relative to the case of non-decline. This decline is strongly correlated with the information available through internet, newspapers, lectures, books, and television: within the circumcised population, both the patients and their parents had less prior knowledge regarding circumcision, other than information obtained from person to person by oral communication

  18. Bupivacaine versus lidocaine analgesia for neonatal circumcision

    OpenAIRE

    Stolik-Dollberg, Orit C; Dollberg, Shaul

    2005-01-01

    Abstract Background Analgesia for neonatal circumcision was recently advocated for every male infant, and its use is considered essential by the American Academy of Pediatrics. We compared the post-operative analgesic quality of bupivacaine to that of lidocaine for achieving dorsal penile nerve block (DPNB) when performing neonatal circumcision. Methods Data were obtained from 38 neonates following neonatal circumcision. The infants had received DPNB analgesia with either lidocaine or bupivac...

  19. Perceptions about medical male circumcision and sexual behaviours of adults in rural Uganda: a cross sectional study.

    Science.gov (United States)

    Mukama, Trasias; Ndejjo, Rawlance; Musinguzi, Geofrey; Musoke, David

    2015-01-01

    Medical male circumcision is currently recognized as an additional important HIV preventive intervention to reduce the risk of heterosexually acquired HIV infection in men. However, sexual behaviours after medical circumcision can potentially reduce the expected benefits of the practice. This study explored the perceptions about medical male circumcision and sexual behaviours of adults in Kayunga district, Uganda. A cross-sectional study was carried out among 393 respondents using a semi structured questionnaire. In addition, four focus group discussions were conducted. Quantitative data was analysed using STATA 12. Univariate, bivariate and multivariate analyses were carried out. Qualitative data was analysed thematically. The study established various perceptions about medical male circumcision and sexual behaviours. Majority 247 (64.5%) did not perceive circumcision as a practice that can lead men to have multiple sexual partners. Males were 3 times more likely to think that circumcision would lead to having multiple sexual partners than females (AOR=2.99, CI: 1.93-4.61). Only 89 (23.2%) believed that circumcision would lead to complacency and compromise the use of condoms to prevent against infection with HIV. Respondents who had education above primary were less likely to think that circumcision would compromise the use of condoms (AOR=0.49, CI: 0.31- 0.79). The perception that circumcised youths were less likely to abstain from sexual intercourse was less held among those with education above primary (AOR=0.58, CI: 0.37-0.91) and those older than 30 years (AOR=0.59, CI: 0.38-0.92). There were gaps in knowledge and negative perceptions about MMC in the study community. Measures are needed to avert the negative perceptions by equipping communities with sufficient, accurate and consistent information about medical male circumcision and sexual behaviour.

  20. The Islamic view on female circumcision

    African Journals Online (AJOL)

    Ali Gomaa

    Muslim societies, the truth is that the Muslim woman has been liberated for centuries under Islamic rule. What is ... equity envisioned by Islam in the social relations between men and women. ..... Educational establishments and media, for.

  1. The Islamic view on female circumcision

    Directory of Open Access Journals (Sweden)

    Ali Gomaa

    2013-09-01

    The fundamental principle is that both men and women are honored members of creation, possessing equality with respect to spirituality and worship. Following from this spiritual and legal equality is the equity envisioned by Islam in the social relations between men and women. Socially, the relationship between them is one of complementarity, and not of competition. As the Qur’an says, “And in no wise covet those things in which Allah Hath bestowed His gifts More freely on some of you than on others: To men is allotted what they earn, and to women what they earn: But ask Allah of His bounty”. From this follows the concept of social equity, and not identity. This standpoint maintains the distinction between men as men, and women as women, a distinction which has come under attack from some materialist philosophies. Either of the two genders fulfills its role in life in accordance with its natural specificities and responsibilities.

  2. False beliefs predict increased circumcision satisfaction in a sample of US American men.

    Science.gov (United States)

    Earp, Brian D; Sardi, Lauren M; Jellison, William A

    2017-12-06

    Critics of non-therapeutic male and female childhood genital cutting claim that such cutting is harmful. It is therefore puzzling that 'circumcised' women and men do not typically regard themselves as having been harmed by the cutting, notwithstanding the loss of sensitive, prima facie valuable tissue. For female genital cutting (FGC), a commonly proposed solution to this puzzle is that women who had part(s) of their vulvae removed before sexual debut 'do not know what they are missing' and may 'justify' their genitally-altered state by adopting false beliefs about the benefits of FGC, while simultaneously stigmatising unmodified genitalia as unattractive or unclean. Might a similar phenomenon apply to neonatally circumcised men? In this survey of 999 US American men, greater endorsement of false beliefs concerning circumcision and penile anatomy predicted greater satisfaction with being circumcised, while among genitally intact men, the opposite trend occurred: greater endorsement of false beliefs predicted less satisfaction with being genitally intact. These findings provide tentative support for the hypothesis that the lack-of-harm reported by many circumcised men, like the lack-of-harm reported by their female counterparts in societies that practice FGC, may be related to holding inaccurate beliefs concerning unaltered genitalia and the consequences of childhood genital modification.

  3. Circumcision policy: A psychosocial perspective.

    Science.gov (United States)

    Goldman, Ronald

    2004-11-01

    The debate about the advisability of circumcision in English-speaking countries has typically focused on the potential health factors. The position statements of committees from national medical organizations are expected to be evidence-based; however, the contentiousness of the ongoing debate suggests that other factors are involved. Various potential factors related to psychology, sociology, religion and culture may also underlie policy decisions. These factors could affect the values and attitudes of medical committee members, the process of evaluating the medical literature and the medical literature itself. Although medical professionals highly value rationality, it can be difficult to conduct a rational and objective evaluation of an emotional and controversial topic such as circumcision. A negotiated compromise between polarized committee factions could introduce additional psychosocial factors. These possibilities are speculative, not conclusive. It is recommended that an open discussion of psychosocial factors take place and that the potential biases of committee members be recognized.

  4. The impact of female genital cutting on health of newly married women.

    Science.gov (United States)

    Elnashar, A; Abdelhady, R

    2007-06-01

    To detect the rate of female genital cutting among a sample of newly married women in Benha city, and make a comparison between circumcised and non-circumcised women regarding long-term health problems. Randomly selected (264) newly married women were the subjects of this work. Circumcised group constitutes 75.8% of the sample. All non-circumcised women were living in an urban area. Dysmenorrhea was more common among circumcised rather than non-circumcised, with statistically significant difference (Pwomen. Obstetric problems such as tears, episiotomy and consequently distressed babies were more events among circumcised mothers with statistical significance. Circumcised females had significant mental problems such as somatization, anxiety and phobia (Pwomen's life particularly the time of consummation of marriage and the time of childbirth.

  5. Prevalence and acceptability of male circumcision in South Africa ...

    African Journals Online (AJOL)

    ... groups and having heard of the HIV protective effect of male circumcision were significant predictors for male circumcision acceptability, and among women with a non-circumcised sexual partner, Black African and Coloured population groups and higher education were predictors for male circumcision acceptability.

  6. Key considerations in scaling up male circumcision in Tanzania ...

    African Journals Online (AJOL)

    Three hundred and thirteen (313) PO responded to a self-administered questionnaire that comprised of socio-demographic characteristics, reasons for not circumcising, perceptions regarding circumcision, methods of enhancing male circumcision, communication means and barriers to promote circumcision. This was ...

  7. Bupivacaine versus lidocaine analgesia for neonatal circumcision

    Directory of Open Access Journals (Sweden)

    Stolik-Dollberg Orit C

    2005-05-01

    Full Text Available Abstract Background Analgesia for neonatal circumcision was recently advocated for every male infant, and its use is considered essential by the American Academy of Pediatrics. We compared the post-operative analgesic quality of bupivacaine to that of lidocaine for achieving dorsal penile nerve block (DPNB when performing neonatal circumcision. Methods Data were obtained from 38 neonates following neonatal circumcision. The infants had received DPNB analgesia with either lidocaine or bupivacaine. The outcome variable was the administration by the parents of acetaminophen during the ensuing 24 hours. Results Seventeen infants received lidocaine and 19 received bupivacaine DPNB. Ten infants in the lidocaine group (59% were given acetaminophen following circumcision compared to only 3 (16% in the bupivacaine group (P 2 = 20.6; P = 0.006. Conclusion DPNB with bupivacaine for neonatal circumcision apparently confers better analgesia than lidocaine as judged by the requirement of acetaminophen over the ensuing 24-hour period.

  8. Female genital mutilation and its effects: Implications for counselling ...

    African Journals Online (AJOL)

    This study tried to establish if there is any relationship between promiscuity and FGM, if circumcised females suffer depression more than the uncircumcised females and, if circumcised females have less difficulty than their uncircumcised counterparts in becoming sexually aroused and attaining orgasm. Three null ...

  9. Association between male circumcision and women's biomedical health outcomes: a systematic review.

    Science.gov (United States)

    Grund, Jonathan M; Bryant, Tyler S; Jackson, Inimfon; Curran, Kelly; Bock, Naomi; Toledo, Carlos; Taliano, Joanna; Zhou, Sheng; Del Campo, Jorge Martin; Yang, Ling; Kivumbi, Apollo; Li, Peizi; Pals, Sherri; Davis, Stephanie M

    2017-11-01

    Male circumcision reduces men's risk of acquiring HIV and some sexually transmitted infections from heterosexual exposure, and is essential for HIV prevention in sub-Saharan Africa. Studies have also investigated associations between male circumcision and risk of acquisition of HIV and sexually transmitted infections in women. We aimed to review all evidence on associations between male circumcision and women's health outcomes to benefit women's health programmes. In this systematic review we searched for peer-reviewed and grey literature publications reporting associations between male circumcision and women's health outcomes up to April 11, 2016. All biomedical (not psychological or social) outcomes in all study types were included. Searches were not restricted by year of publication, or to sub-Saharan Africa. Publications without primary data and not in English were excluded. We extracted data and assessed evidence on each outcome as high, medium, or low consistency on the basis of agreement between publications; outcomes found in fewer than three publications were indeterminate consistency. 60 publications were included in our assessment. High-consistency evidence was found for five outcomes, with male circumcision protecting against cervical cancer, cervical dysplasia, herpes simplex virus type 2, chlamydia, and syphilis. Medium-consistency evidence was found for male circumcision protecting against human papillomavirus and low-risk human papillomavirus. Although the evidence shows a protective association with HIV, it was categorised as low consistency, because one trial showed an increased risk to female partners of HIV-infected men resuming sex early after male circumcision. Seven outcomes including HIV had low-consistency evidence and six were indeterminate. Scale-up of male circumcision in sub-Saharan Africa has public health implications for several outcomes in women. Evidence that female partners are at decreased risk of several diseases is highly

  10. Implications of male circumcision for women in Papua New Guinea: a transformational grounded theory study.

    Science.gov (United States)

    Redman-MacLaren, Michelle; Mills, Jane; Tommbe, Rachael; MacLaren, David; Speare, Rick; McBride, William J H

    2017-07-27

    Male circumcision reduces the risk of female-to-male transmission of human immunodeficiency virus (HIV) and is being explored for HIV prevention in Papua New Guinea (PNG). PNG has a concentrated HIV epidemic which is largely heterosexually transmitted. There are a diverse range of male circumcision and penile modification practices across PNG. Exploring the implications of male circumcision for women in PNG is important to inform evidence-based health policy that will result in positive, intended consequences. The transformational grounded theory study incorporated participatory action research and decolonizing methodologies. In Phase One, an existing data set from a male circumcision study of 861 male and 519 female participants was theoretically sampled and analyzed for women's understanding and experience of male circumcision. In Phase Two of the study, primary data were co-generated with 64 women in seven interpretive focus group discussions and 11 semi-structured interviews to develop a theoretical model of the processes used by women to manage the outcomes of male circumcision. In Phase Three participants assisted to refine the developing transformational grounded theory and identify actions required to improve health. Many women know a lot about male circumcision and penile modification and the consequences for themselves, their families and communities. Their ability to act on this knowledge is determined by numerous social, cultural and economic factors. A transformational grounded theory was developed with connecting categories of: Women Know a Lot, Increasing Knowledge; Increasing Options; and Acting on Choices. Properties and dimensions of each category are represented in the model, along with the intervening condition of Safety. The condition of Safety contextualises the overarching lived realty for women in PNG, enables the inclusion of men in the transformational grounded theory model, and helps to explain relationships between men and women. The

  11. General Practitioner Knowledge Levels About Circumcision

    Directory of Open Access Journals (Sweden)

    Levent Cankorkmaz

    2011-09-01

    Full Text Available Objective: This study was carried out to investigate knowledge levels of general practitioners and their thoughts about circumcision in Middle Anatolia.Materials and Methods: This descriptive and cross-sectional study was carried out with 247 general practitioners working in Sivas. A questionnaire was prepared by the authors using previous reports. Questionnaires were sent to subjects by post. One hundred and seventy eight general practitioners (57 women, 121 men responded and were included in the study. For statistical analysis, Chi-square test was used and p<0.05 value was accepted as significant.Results: 42.1% of subjects believed that circumcision should be performed between 2 and 6 years of age. 2.2% of subjects declared that circumcision could be done at home and 7.3% believed that the location of the operation is not important. 9.6% of subjects believed that the person who performs the circumcision does not have to be a doctor. 21.3% of subjects believed that circumcision could be performed without anesthesia during the newborn period because of undeveloped pain sensation. Conclusion: This study demonstrated that general practitioners, who are the most easily accessible health staff for information about health, do not have updated information about the way to perform circumcision and its necessity. Therefore, it is concluded that education programs about circumcision for general practitioners must be continued and updated.

  12. Religious circumcision, invasive rites, neutrality and equality: bearing the burdens and consequences of belief.

    Science.gov (United States)

    Johnson, Matthew Thomas

    2013-07-01

    The decision of the German regional court in Cologne on 26 June 2012 to prohibit the circumcision of minors is important insofar as it recognises the qualitative similarities between the practice and other prohibited invasive rites, such as female genital cutting. However, recognition of similarity poses serious questions with regard to liberal public policy, specifically with regard to the exceptionalist treatment demanded by certain circumcising groups. In this paper, I seek to advance egalitarian means of dealing with invasive rites which take seriously cultural diversity, minimise harm and place responsibility for the burdens and consequences of beliefs upon those who promote practices.

  13. Women's beliefs about male circumcision, HIV prevention, and sexual behaviors in Kisumu, Kenya.

    Directory of Open Access Journals (Sweden)

    Thomas H Riess

    Full Text Available It is important to understand how women's sexual practices may be influenced by male circumcision (MC as an HIV prevention effort. Women's beliefs about MC and sexual behaviour will likely influence the scale-up and uptake of medical MC. We conducted qualitative interviews with 30 sexually active women in Kisumu, Kenya. Women discussed MC related to perceived health benefits, condom use, sexual behaviour, knowledge of susceptibility to HIV and sexually transmitted infections (STIs, circumcision preference, and influence on circumcision uptake. Respondents had a good understanding of the partial protection of MC for acquisition of HIV for men. Women perceived circumcised men as cleaner, carrying fewer diseases, and taking more time to reach ejaculation. Male's circumcision status is a salient factor for women's sexual decision making, including partner choice, and condom use. It will be important that educational information affirms that MC provides only partial protection against female to male transmission of HIV and some STIs; that other HIV and STI prevention methods such as condoms need to be used in conjunction with MC; that MC does not preclude a man from having HIV; and that couples should develop plans for not having sex while the man is healing.

  14. Factors influencing Chinese male's willingness to undergo circumcision: a cross-sectional study in western China.

    Directory of Open Access Journals (Sweden)

    Xiaobo Yang

    Full Text Available BACKGROUND: Male circumcision (MC has been shown to reduce the risk of female to male transmission of HIV. The goal of this survey was to explore the acceptability of MC among the Chinese and to identify factors associated with circumcision preference. METHODS: A cross-sectional survey was conducted between September 2009 and December 2010. We interviewed 2,219 male community participants, from three high HIV prevalence provinces in western China. A structured questionnaire was used to collect data on MC knowledge, willingness to accept MC, reasons to accept or refuse MC, and sexual behaviors and health. For those who refused MC, a health education intervention providing information on the benefits of circumcision was conducted. We used multiple logistic regression models to identify factors associated with the acceptability of MC. RESULTS: Of the respondents (n = 2,219, 44.6% (989/2,219 reported they would accept MC for the following reasons: promotion of female partners' hygiene (60.3%, redundant foreskin (59.4%, prevention of penile cancer (50.2%, enhanced sexual pleasure (41.4%, and protection against HIV and STDs (34.2%. The multivariable logistic regression showed that five factors were associated with MC willingness: long foreskin (OR = 15.98, residing in Xinjiang province (OR = 3.69, being younger than 25 (OR = 1.60, knowing hazards of redundant foreskin (OR = 1.78, and having a friend who underwent circumcision (OR = 1.36. CONCLUSION: The acceptability of male circumcision was high among the general population in China. Our study elucidates the factors associated with circumcision preference and suggests that more health education campaigns about positive health effects are necessary to increase the MC rate in China.

  15. Comparison of post circumcision complications and wound

    International Nuclear Information System (INIS)

    Malik, S.; Ahmad, S.A.; Habib, A.

    2015-01-01

    The objective of this study is to compare the frequency of post circumcision complications like bleeding and infection along with wound healing in infants by conventional open method and the bone-cutter method. Study Design: Randomized controlled trial. Place and Duration of Study: Combined Military Hospital and Military Hospital Rawalpindi, from March 2009 to March 2010. Patients and Methods: A total of 400 patients were included in the study that underwent circumcision. Patients were randomly allotted to either group A in whom the circumcision was done with conventional open technique (n = 200) or to group B, in whom circumcision was done with bone-cutter (n = 200). Patients were followed up in the surgical OPD after 5 days for assessment and earlier in case of any complication. Outcomes were measured by absence or presence of infection, post operative bleeding and cosmetic acceptance by the parents. Results: Comparison between the two groups showed that the bleeding rate was 8% in group A and 7% in group B (p = 0.704). Infection rate was 6% in group A and 5% in group B (p = 0.661). Delayed wound healing was seen in 4% of circumcisions in group A as opposed to 2% in group B ( p = 0.241). Conclusion: Complication is a part of any surgical procedure. So is the case with circumcision however no significant difference was found between the two procedures in terms of bleeding, infection, trauma to the glans and the cosmetic outcome. (author)

  16. Understanding the partial protection of male circumcision for HIV prevention among women in Iringa Region, Tanzania: an ethnomedical model.

    Science.gov (United States)

    Layer, Erica H; Beckham, Sarah W; Momburi, Romani B; Kennedy, Caitlin E

    2013-08-01

    Communicating the partial efficacy of male circumcision for HIV prevention is challenging. Understanding how people conceptualize risk can help programs communicate messages in a way that is understandable to local communities. This article explores women's ethnomedical model of disease transmission related to male circumcision in Iringa Region, Tanzania. We conducted in-depth interviews (IDIs) with 32 female partners of male circumcision clients and focus group discussions (FGDs) with married (n=3) and unmarried (n=3) women from November 2011 to February 2012. Interviews were digitally recorded, transcribed, and translated into English, and codes were developed based on emerging themes. While women understand that circumcised men are still at risk of HIV, risk is perceived to be low as long as both partners avoid abrasions during sexual intercourse and the man's penis is kept clean. Women said that HIV transmission only occurs when both partners have abrasions on their genitalia and mixing of blood occurs. Abrasions are thought to be the result of friction from fast or dry sex and are more likely to occur with uncircumcised men; thus, HIV can be prevented if a man is circumcised and couples have gentle, lubricated sex. In addition, women reported that the foreskin traps particles of sexually transmitted infections (STIs) including HIV, which can easily be passed on to female partners. In contrast, circumcised men are viewed as being able to clean themselves of disease particles and, therefore, do not easily acquire diseases or transmit them to female partners. These findings align with the scientific understanding of increased HIV risk associated with abrasions or microflora in the foreskin; however, the ethnomedical model differs from scientific understanding in that disease transmission can in fact occur without either of these conditions. Programs can build upon these findings to better convey risks along with the benefits of male circumcision.

  17. - 1 - Key considerations in scaling up male circumcision in Tanzania ...

    African Journals Online (AJOL)

    circumcision, communication means and barriers to promote circumcision. ... Other recommendations include use of public media, seminars at work and .... to the conduct of this study ethical clearance was obtained from the ethics committee.

  18. The ethical concerns of using medical male circumcision in HIV

    African Journals Online (AJOL)

    that medical male circumcision raises ethical questions among implementers .... the 'adult-adult model' which facilitates effective communication between the .... HIV prevention through the media, men from non-circumcising societies could ...

  19. Acceptability of medical male circumcision among traidtionally non ...

    African Journals Online (AJOL)

    IMTU Medical Journal ... Background: Male circumcision (MC) can reduce men's risk of contracting Sexually Transmitted Infections (STIs) ... non-circumcising males accessing health care in Makambako Hospital, Njombe Region, Tanzania.

  20. Parental circumcision preferences and early outcome of plastibell circumcision in a Nigerian tertiary hospital.

    Science.gov (United States)

    Ekwunife, Okechukwu Hyginus; Ugwu, Jideofor Okechukwu; Okoli, Chinedu C; Modekwe, Victor Ifeanyichukwu; Osuigwe, Andrew N

    2015-01-01

    Parents are central in decisions and choices concerning circumcision of their male children and plastibell circumcision is a widely practiced technique. This study determined parental preferences for male neonatal and infant circumcisions and evaluate the early outcomes of plastibell circumcisions in a tertiary centre. This is a prospective study on consecutive male neonates and infants who were brought for circumcisions at Nnamdi Azikiwe University Teaching Hospital Nnewi, South-East Nigeria and their respective parents between January 2012 and December 2012. Data on demography, parental choices and early outcome of plastibell circumcision were obtained and analysed. A total of 337 requests for circumcisions were made for boys with age range of 2-140 days. Culture and religion were the most common reasons for circumcision requests in 200 (59.3%) and 122 (36.2%), respectively, other reasons were medical, cosmesis, to reduce promiscuity and just to follow the norm. Most parents, 249 (73.9%) preferred the procedure to be performed on the 8 th day and 88.7% would like the doctors to perform the procedure while 84.6% preferred the plastibell method. Among those who had circumcision, 114 complied with follow-up schedules and there were complications in 22 (19.3%) patients. Parents assessed the early outcome as excellent, very good, good and poor in 30.7%, 45.6%, 18.4% and 5.3% of the patients, respectively. Parents request for male circumcision in our environment is largely for cultural and religious reasons; and prefer the procedure to be performed by a physician. Plastibell method is well known and preferred and its outcome is acceptable by most parents.

  1. Parental circumcision preferences and early outcome of plastibell circumcision in a Nigerian tertiary hospital

    Directory of Open Access Journals (Sweden)

    Okechukwu Hyginus Ekwunife

    2015-01-01

    Full Text Available Background: Parents are central in decisions and choices concerning circumcision of their male children and plastibell circumcision is a widely practiced technique. This study determined parental preferences for male neonatal and infant circumcisions and evaluate the early outcomes of plastibell circumcisions in a tertiary centre. Patients and Methods: This is a prospective study on consecutive male neonates and infants who were brought for circumcisions at Nnamdi Azikiwe University Teaching Hospital Nnewi, South-East Nigeria and their respective parents between January 2012 and December 2012. Data on demography, parental choices and early outcome of plastibell circumcision were obtained and analysed. Results: A total of 337 requests for circumcisions were made for boys with age range of 2-140 days. Culture and religion were the most common reasons for circumcision requests in 200 (59.3% and 122 (36.2%, respectively, other reasons were medical, cosmesis, to reduce promiscuity and just to follow the norm. Most parents, 249 (73.9% preferred the procedure to be performed on the 8 th day and 88.7% would like the doctors to perform the procedure while 84.6% preferred the plastibell method. Among those who had circumcision, 114 complied with follow-up schedules and there were complications in 22 (19.3% patients. Parents assessed the early outcome as excellent, very good, good and poor in 30.7%, 45.6%, 18.4% and 5.3% of the patients, respectively. Conclusion: Parents request for male circumcision in our environment is largely for cultural and religious reasons; and prefer the procedure to be performed by a physician. Plastibell method is well known and preferred and its outcome is acceptable by most parents.

  2. Circumcision

    Science.gov (United States)

    ... have an increased risk of certain conditions, including: Cancer of the penis Certain sexually transmitted diseases, including HIV Infections of ... 2016:chap 40. Review Date 10/18/2017 Updated by: Neil K. Kaneshiro, MD, MHA, Clinical Professor ...

  3. Early infant male circumcision for human immunodeficiency virus ...

    African Journals Online (AJOL)

    Prudence Jarrett

    2014-06-24

    Jun 24, 2014 ... This article may be used for research, teaching, and private study purposes. ... circumcision, although knowledge of the comparative risks and benefits of EIMC to adult circumcision was .... ation and willingness of parents to circumcise their sons. .... When this child is older, like my brothers they are refusing.

  4. Why do male patients request circumcisions? | Engelbrecht | South ...

    African Journals Online (AJOL)

    Background: Circumcision has been performed for centuries. The popularity of the procedure waxed and waned during the ages. In South Africa, cultural circumcision is often regarded as the only way to attain full adulthood, and consequently many patients request circumcision by medical personnel. The aim of this study ...

  5. Rapid, minimally invasive adult voluntary male circumcision: A ...

    African Journals Online (AJOL)

    Background. Voluntary medical male circumcision (VMMC) is a priority HIV preventive intervention. To facilitate VMMC scale-up, the World Health Organization is seeking circumcision techniques that are faster, easier, and safer than open surgical methods. Objective. To compare open surgical circumcision with suturing v.

  6. Allocation of healthcare dollars: analysis of nonneonatal circumcisions in Florida.

    Science.gov (United States)

    Gutwein, Luke G; Alvarez, Juan F; Gutwein, Jenny L; Kays, David W; Islam, Saleem

    2013-09-01

    Circumcision remains a controversial operation. Most procedures are performed in the neonatal period and avoid general anesthesia. Legislation driven by policy statements from the American Academy of Pediatrics led to significant changes in circumcisions in Florida with a shift to nonneonatal procedures as a result of costs. We sought to study the prevalence and financial implications of nonneonatal circumcisions in Florida. A retrospective population study was performed using the Florida Agency for Health Care Administration outpatient procedure database. We queried for patients 0 to 17 years of age undergoing circumcision between 2003 and 2008. Demographics, charges, and insurance status were analyzed. From 2003 to 2008, 31,741 outpatient circumcisions were performed. Publicly funded circumcisions accounted for 17,537 charging the state $6,263 on average for each circumcision at an expense of $111.8 million for the 5-year time period analyzed. Publicly funded circumcision procedures increased more than sixfold (P < 0.0001) than those covered by private insurance. Black circumcision procedures increased 77.3 per cent, whereas white circumcisions increased 28.7 per cent. There has been a significant increase in the number of nonneonatal circumcisions performed. This has resulted in an increase in economic health care. Public funding of neonatal circumcision could result in significant cost savings and avoid potential complications of general anesthesia.

  7. High rate of adverse events following circumcision of young male ...

    African Journals Online (AJOL)

    (94) refusing circumcision by the TK technique; 34 men were randomised to the FG group and 35 to the TK group, and 32 and 24 patients were circumcised by the FG and TK methods respectively, of whom 29 and 19 respectively attended the post-circumcision visit. All 12 adverse event sheets corresponded to the TK group ...

  8. Ritual male infant circumcision and human rights.

    Science.gov (United States)

    Jacobs, Allan J; Arora, Kavita Shah

    2015-01-01

    Opponents of male circumcision have increasingly used human rights positions to articulate their viewpoint. We characterize the meaning of the term "human rights." We discuss these human rights arguments with special attention to the claims of rights to an open future and to bodily integrity. We offer a three-part test under which a parental decision might be considered an unacceptable violation of a child's right. The test considers the impact of the practice on society, the impact of the practice on the individual, and the likelihood of adverse impact. Infant circumcision is permissible under this test. We conclude that infant circumcision may be proscribed as violating local norms, even though it does not violate human rights.

  9. [Shang Ring circumcision versus conventional circumcision for redundant prepuce or phimosis: a meta analysis].

    Science.gov (United States)

    Xiao, Er-Long; Ding, Hui; Li, Yong-Qian; Wang, Zhi-Ping

    2013-10-01

    To compare the effect and safety of Shang Ring circumcision with those of conventional circumcision in the treatment of redundant prepuce or phimosis. We retrieved the randomized controlled trials on Shang Ring circumcision and conventional circumcision for the treatment of redundant prepuce or phimosis published at home and abroad. Relevant data were selected according to the Cochrane Handbook for Systematic Reviews by two reviewers after quality evaluation of the included trials, and the statistical software RevMan 5.0 was used for meta analysis. Totally 8 randomized controlled trials with 2277 cases were included in this study. Compared with conventional circumcision, Shang Ring circumcision showed a shorter operation time (SMD = -5.82, 95% CI [ -7.39, -4.24], PSMD = -3.28, 95% CI [ -3.47, -3.09], Pinfection (OR = 0.44, 95% CI [0.26, 0.72], P=0.001), lower rate of postoperative bleeding (OR =0.05, 95% CI [0.02, 0.12], PSMD = -3.32, 95% CI [ -3.50, -3.14], PSMD = -3.28, 95% CI [ - 3.47, - 3.00], P<0.00001), but longer wound healing time (OR=1.46, 95% CI [1.03, 1.90], P<0.00001). In comparison with conventional circumcision, Shang Ring circumcision has the advantages of shorter operation time, fewer complications, mild pain, and higher rate of satisfaction with the postoperative penile appearance. However, more high-quality randomized controlled trials with large samples are required to lend further support to our findings.

  10. Smart Surroundings

    NARCIS (Netherlands)

    Havinga, Paul J.M.; Jansen, P.G.; Lijding, M.E.M.; Scholten, Johan

    2004-01-01

    Ambient systems are networked embedded systems integrated with everyday environments and supporting people in their activities. These systems will create a Smart Surrounding for people to facilitate and enrich daily life and increase productivity at work. Such systems will be quite different from

  11. Experience of Using Amniotic Membrane After Circumcision

    International Nuclear Information System (INIS)

    Manjas, Menkher; Ismal; Efmansyah, Dody

    2002-01-01

    It is compulsory, for boys to undergone circumcision before getting adult in Moslem region. It can be done by General Surgeon, General Practitioner, Nurse, Midwife or Quack. The place to carry out the circumcision can be inside or outside hospital. The utmost problems are injections, point for secondary wound covering and delay of using underpants. To overcome those problem amniotic membranes can be used as wound covering, based on : they are soft, easy to shape wound surface, satisfactory adhesive properties, good elasticity and sufficient, transparency which allows wound control without redressing of the wound. From January until December 1999, 165 boys at an age between 6-10 years, which have been carried out circumcision, were evaluated. Radiation sterilized lyophilized amniotic membranes were used in this work as wound covering Result show that amniotic membrane gave a good result in wound healing. All the patients observed, showed early mobilization as well as early using underpants. There is no different result between circumcision which had been done either inside or out hospital, carried out by surgeon or non-surgeon

  12. Improving voluntary medical male circumcision standards ...

    African Journals Online (AJOL)

    Voluntary medical male circumcision (VMMC) has been demonstrated to reduce the transmission of HIV by 60%. Scaling up VMMC services requires that they be of high quality, socially accepted, and effective. We evaluated an intervention aimed at improving VMMC standards adherence and patient follow-up rates in nine ...

  13. Ketamine-propofol sedation in circumcision

    Directory of Open Access Journals (Sweden)

    Handan Gulec

    2015-10-01

    Full Text Available ABSTRACTBACKGROUND AND OBJECTIVE: To compare the therapeutic effects of ketamine alone or ketamine plus propofol on analgesia, sedation, recovery time, side effects in premedicated children with midazolam-ketamine-atropin who are prepared circumcision operation.METHODS: 60 American Society of Anaesthesiologists physical status I-II children, aged between 3 and 9 years, undergoing circumcision operations under sedation were recruited according to a randomize and double-blind institutional review board-approved protocol. Patients were randomized into two groups via sealed envelope assignment. Both groups were administered a mixture of midazolam 0.05 mg/kg + ketamine 3 mg/kg + atropine 0.02 mg/kg intramuscularly in the presence of parents in the pre-operative holding area. Patients were induced with propofol-ketamine in Group I or ketamine alone in Group II.RESULTS: In the between-group comparisons, age, weight, initial systolic blood pressure, a difference in terms of the initial pulse rate was observed (p > 0.050. Initial diastolic blood pressure and subsequent serial measurements of 5, 10, 15, 20th min, systolic blood pressure, diastolic blood pressure and pulse rate in ketamine group were significantly higher (p < 0.050.CONCLUSION: Propofol-ketamine (Ketofol provided better sedation quality and hemodynamy than ketamine alone in pediatric circumcision operations. We did not observe significant complications during sedation in these two groups. Therefore, ketofol appears to be an effective and safe sedation method for circumcision operation.

  14. Achieving the HIV Prevention Impact of Voluntary Medical Male Circumcision: Lessons and Challenges for Managing Programs

    Science.gov (United States)

    Sgaier, Sema K.; Reed, Jason B.; Thomas, Anne; Njeuhmeli, Emmanuel

    2014-01-01

    Voluntary medical male circumcision (VMMC) is capable of reducing the risk of sexual transmission of HIV from females to males by approximately 60%. In 2007, the WHO and the Joint United Nations Programme on HIV/AIDS (UNAIDS) recommended making VMMC part of a comprehensive HIV prevention package in countries with a generalized HIV epidemic and low rates of male circumcision. Modeling studies undertaken in 2009–2011 estimated that circumcising 80% of adult males in 14 priority countries in Eastern and Southern Africa within five years, and sustaining coverage levels thereafter, could avert 3.4 million HIV infections within 15 years and save US$16.5 billion in treatment costs. In response, WHO/UNAIDS launched the Joint Strategic Action Framework for accelerating the scale-up of VMMC for HIV prevention in Southern and Eastern Africa, calling for 80% coverage of adult male circumcision by 2016. While VMMC programs have grown dramatically since inception, they appear unlikely to reach this goal. This review provides an overview of findings from the PLOS Collection “Voluntary Medical Male Circumcision for HIV Prevention: Improving Quality, Efficiency, Cost Effectiveness, and Demand for Services during an Accelerated Scale-up.” The use of devices for VMMC is also explored. We propose emphasizing management solutions to help VMMC programs in the priority countries achieve the desired impact of averting the greatest possible number of HIV infections. Our recommendations include advocating for prioritization and funding of VMMC, increasing strategic targeting to achieve the goal of reducing HIV incidence, focusing on programmatic efficiency, exploring the role of new technologies, rethinking demand creation, strengthening data use for decision-making, improving governments' program management capacity, strategizing for sustainability, and maintaining a flexible scale-up strategy informed by a strong monitoring, learning, and evaluation platform. PMID:24800840

  15. Rapid, minimally invasive adult voluntary male circumcision: A ...

    African Journals Online (AJOL)

    To compare conventional open surgical circumcision with suturing to a minimally invasive technique using a single-use-only disposable instrument (Unicirc) plus tissue adhesive. This technique completes the circumcision at the time of surgery, and requires no further visits for device removal. We hypothesised that the new ...

  16. Safety of a disposable male circumcision kit. results from a ...

    African Journals Online (AJOL)

    ... disposable instruments, consumables and pharmaceutical products needed to perform one single male circumcision among young male adults according to the most common technique used in South Africa (the Forceps Guided technique). The objective of this study was to evaluate the safety of this new circumcision kit.

  17. Swazi men's perception of the protective effect of male circumcision ...

    African Journals Online (AJOL)

    about the protective effect of circumcision against STIs including HIV, and its implication to the mass MC strategy. .... In addition, permission to conduct the study was also granted by the FLAS Research and Evaluation Unit. ..... Willingness to be circumcised for preventing HIV among Chinese men who have sex with men.

  18. A comparison of risky sexual behaviours between circumcised and ...

    African Journals Online (AJOL)

    though male circumcision coupled with preventive behaviour reduces this risk. Objective: To compare the factors associated with risky sexual behaviour among circumcised and uncircumcised men in Bo- tswana. Methods: Nationally representative data from the Botswana AIDS Impact Survey III were used. A sample of 313 ...

  19. Does circumcision alter the periurethral uropathogenic bacterial flora

    African Journals Online (AJOL)

    Background: The aim of this study was to assess the pattern of periurethral bacterial flora in uncircumcised boys and to evaluate the effect of circumcision on alteration of periurethral uropathogenic bacterial flora. Materials and Methods: Pattern of periurethral bacterial flora before and after circumcision was studied ...

  20. The effect of circumcision on young adult sexual function

    Directory of Open Access Journals (Sweden)

    Ming-Hsin Yang

    2014-06-01

    Full Text Available Whether sexual function is affected by circumcision is a subject of considerable debate among advocate and opponent opinions. We analyzed the sexual function of young men, and the differences between those who were uncircumcised and circumcised, in Taiwan. A total of 506 patients who received circumcision between January 2009 and March 2011 at the urology department in our center were enrolled. Before circumcision, the patients' sexual performances were evaluated using the International Index of Erectile Function-5 (IIEF-5, and the Brief Male Sexual Function Inventory (BMSFI questionnaires. They were evaluated using the questionnaires again, after a postoperative interval of 90 days. Furthermore, intravaginal ejaculation latency times (IELT of the patients were also measured. The IELT and scores in five main domains of the BMSFI, and IIEF, before and after circumcision, were analyzed. A total of 442 patients were available for follow up. The mean age was 25.14 ± 4.46 years (range = 19–35 years. The differences in the BMSFI scores were statistically significant (p < 0.001, especially in increasing sex drive after circumcision (p < 0.001. The IIEF-5 score showed no statistically difference before and after circumcision (p = 0.141. However, after the circumcision, the participants had more erection confidence (p < 0.001, more difficulty in maintaining erections in completing intercourse (p = 0.01, and showed lower IELT scores (p = 0.06. The sexual performance, especially with regards to sex drive and mental erection confidence, seemed to have improved among the patients after circumcision. Our findings may help urologists to better counsel young men receiving circumcisions.

  1. The impact of electrocautery method on post-operative bleeding complications after non-newborn circumcision and revision circumcision.

    Science.gov (United States)

    Harty, Niall J; Nelson, Caleb P; Cendron, Marc; Turner, Shaunna; Borer, Joseph G

    2013-10-01

    We evaluated post-operative bleeding complications in non-newborns following use of monopolar versus bipolar electrocautery for circumcision or revision circumcision. We retrospectively reviewed sequentially performed cases of circumcision and revision circumcision performed by nine pediatric urologists at our institution from 2005 to 2010. In order to incorporate both the monopolar and bipolar electrocautery experience for a single surgeon employing bipolar technique, sequential cases from 2002 to 2010 were reviewed. Variables assessed included age, procedure, method of electrocautery, skin approximation and dressing, and bleeding complications. 1810 patients that underwent either circumcision or revision circumcision were reviewed. Complete data was available for 1617 patients. Age at operation was a mean 3.7 ± 4.9 yrs and median 1.5 yrs. Return for bleeding complication for all surgeons, was 2/336 (0.6%) for bipolar and 28/1281 (2.2%) for monopolar (p = 0.0545). For the single surgeon using bipolar technique, returns were 2/336 (0.6%) for bipolar and 5/309 (1.6%) for monopolar (p = 0.2133). Returns per procedure type were 1/200 (0.5%) bipolar and 24/844 (2.8%) monopolar for primary circumcision (p = 0.0513), and 1/136 (0.7%) bipolar and 4/437 (0.9%) monopolar (p = 0.84) for revision. Four of 1617 (0.2%) patients returned to the operating room [4/1281 (0.3%) monopolar (p = 0.31)]. There was no difference in return to the operating room for circumcision versus revision. Return for bleeding complications after circumcision and revision circumcision occurred more frequently after monopolar electrocautery compared to bipolar. However, there was no significant difference between the two electrocautery methods. Either form of electrocautery appears to be effective for this common pediatric urologic procedure. Copyright © 2012 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.

  2. Does circumcision alter the periurethral uropathogenic bacterial flora

    Directory of Open Access Journals (Sweden)

    Mushtaq Ahmad Laway

    2012-01-01

    Full Text Available Background: The aim of this study was to assess the pattern of periurethral bacterial flora in uncircumcised boys and to evaluate the effect of circumcision on alteration of periurethral uropathogenic bacterial flora. Materials and Methods: Pattern of periurethral bacterial flora before and after circumcision was studied prospectively in 124 boys. The results were analysed to compare change in bacterial colonisation before and after circumcision. Results: The age range was 6 weeks to 96 months. Most (94.3% of the boys had religious indication and 5.7% had medical indication for circumcision. E. coli, Proteus and Klebsiella were most common periurethral bacterial flora in uncircumcised subjects. Coagulase-negative staphylococcus and Staphylococcus aureus was most common periurethral bacterial flora in circumcised subjects. In 66.1% of circumcised subjects, no bacteria were grown from periurethral region. Conclusion: We conclude that presence of prepuce is associated with great quantity of periurethral bacteria, greater likelihood of the presence of high concentration of uropathogens and high incidence of urinary tract infection (UTI. This study provides circumstantial evidence supporting the idea that early circumcision may be beneficial for prevention of UTI.

  3. Surgical reimplantation of penile glans amputation in children during circumcision

    Directory of Open Access Journals (Sweden)

    Bouassida Khaireddine

    2014-01-01

    Full Text Available Circumcision is one of the oldest and most commonly performed surgical procedures. Unfortunately, various complications may occur during circumcision, ranging from trivial to tragic such as penile amputation which is a serious complication and a challenging injury to treat. We describe two cases of non-microsurgical successful reattachment of a distal penile glans which were amputated during circumcision. In the first case, a 5-year-old child underwent circumcision by an urologist under local anesthesia. In the second one, a 3-year-old child underwent circumcision by a general practitioner who used to make circumcision. In this article, the literature is reviewed; results and potential complications of this surgery are also discussed. Glans sensation was present, early morning erection was maintained, and there was an erectile response during penile manipulation in both cases. Although circumcision is not technically difficult, it should be taken seriously. The use of microsurgical reattachment is not always possible, especially in pediatric cases; it also requires special equipment and training.

  4. Low acceptability of medical male circumcision as an HIV/AIDS prevention intervention within a South African community that practises traditional circumcision.

    Science.gov (United States)

    Mark, Daniella; Middelkoop, Keren; Black, Samantha; Roux, Surita; Fleurs, Llewellyn; Wood, Robin; Bekker, Linda-Gail

    2012-05-23

    Traditional circumcision is practised among some indigenous tribes in South Africa (SA) such as the Xhosa. Recent experimental evidence has demonstrated the benefits of male circumcision for the prevention of HIV infection in heterosexual men. The acceptability of circumcision as a biomedical intervention mirroring an ingrained cultural practice, as well as the age and extent of the procedure, are poorly understood. Men aged 15 - 42 years were recruited in a peri-urban settlement near Cape Town. Participants completed an interviewer-administered questionnaire assessing self-reported circumcision status, context and reasons for previous or planned circumcision, and willingness to undergo medical circumcision for themselves or their sons. Results were confirmed by clinical examination. The most recent HIV test result was compared with circumcision status. Of the 199 men enrolled, 148 (74%) reported being traditionally circumcised; of the 51 not circumcised, 50 were planning the traditional procedure. Among men self-reporting circumcision, 40 (27%) had some or all of the foreskin remaining. The median age at traditional circumcision was 21 years (interquartile range 19 - 22 years). While knowledge of the preventive benefit of circumcision was reported by 128 men (66%), most were unwilling to undergo medical circumcision or allow their sons to do so, because of religion/culture, notions of manhood, and social disapproval. Almost all men in this study had undergone or were planning to undergo traditional circumcision and were largely opposed to the medically performed procedure. In the majority, traditional circumcision had occurred after the mean age of sexual debut and almost a quarter were found to have only partial foreskin removal. To ensure optimal HIV prevention benefits, strategies to facilitate complete foreskin removal prior to sexual debut within traditional circumcision practices require further attention.

  5. Bleeding and Blood Disorders in Clients of Voluntary Medical Male Circumcision for HIV Prevention - Eastern and Southern Africa, 2015-2016.

    Science.gov (United States)

    Hinkle, Lawrence E; Toledo, Carlos; Grund, Jonathan M; Byams, Vanessa R; Bock, Naomi; Ridzon, Renee; Cooney, Caroline; Njeuhmeli, Emmanuel; Thomas, Anne G; Odhiambo, Jacob; Odoyo-June, Elijah; Talam, Norah; Matchere, Faustin; Msungama, Wezi; Nyirenda, Rose; Odek, James; Come, Jotamo; Canda, Marcos; Wei, Stanley; Bere, Alfred; Bonnecwe, Collen; Choge, Isaac Ang'Ang'A; Martin, Enilda; Loykissoonlal, Dayanund; Lija, Gissenge J I; Mlanga, Erick; Simbeye, Daimon; Alamo, Stella; Kabuye, Geoffrey; Lubwama, Joseph; Wamai, Nafuna; Chituwo, Omega; Sinyangwe, George; Zulu, James Exnobert; Ajayi, Charles A; Balachandra, Shirish; Mandisarisa, John; Xaba, Sinokuthemba; Davis, Stephanie M

    2018-03-23

    Male circumcision reduces the risk for female-to-male human immunodeficiency virus (HIV) transmission by approximately 60% (1) and has become a key component of global HIV prevention programs in countries in Eastern and Southern Africa where HIV prevalence is high and circumcision coverage is low. Through September 2017, the President's Emergency Plan for AIDS Relief (PEPFAR) had supported 15.2 million voluntary medical male circumcisions (VMMCs) in 14 priority countries in Eastern and Southern Africa (2). Like any surgical intervention, VMMC carries a risk for complications or adverse events. Adverse events during circumcision of males aged ≥10 years occur in 0.5% to 8% of procedures, though the majority of adverse events are mild (3,4). To monitor safety and service quality, PEPFAR tracks and reports qualifying notifiable adverse events. Data reported from eight country VMMC programs during 2015-2016 revealed that bleeding resulting in hospitalization for ≥3 days was the most commonly reported qualifying adverse event. In several cases, the bleeding adverse event revealed a previously undiagnosed or undisclosed bleeding disorder. Bleeding adverse events in men with potential bleeding disorders are serious and can be fatal. Strategies to improve precircumcision screening and performance of circumcisions on clients at risk in settings where blood products are available are recommended to reduce the occurrence of these adverse events or mitigate their effects (5).

  6. [Circumcision: what do we cut when we are cutting?].

    Science.gov (United States)

    Calcagno, C

    2007-01-01

    The term circumcision refers to partial or complete excision of the foreskin. There are three types of circumcision: ritual circumcision, performed for religious practice, as a rite of passage, usually during neonatal or transpubertal age; prophylactic circumcision, as preventive measure against future potential diseases; therapeutic circumcision, performed because of an evident pathology of the foreskin with clear medical indications. The investigation on the meaning of the ritual circumcision goes beyond the boundaries of the present paper; we are referring to anthropological literature to better understand its origin and reasons. Prophylactic circumcision spread among English-speaking peoples in the nineteenth century as a means against masturbation. In the twentieth century prevention against cancer, urinary infections, sexually transmitted diseases and, eventually, AIDS took over. The controversy about prophylactic circumcision is increasing nowadays in the United States whereas in the other English-speaking countries the procedure has almost disappeared and this represents what Edward Wallerstein calls "the uniquely American medical enigma". There are many interpretations for prophylactic circumcision and its lasting success in the United States. Each explanation probably hits the target only partially because this procedure takes its roots in the cultural history of the above mentioned country and in the relation with its puritan origins. Therapeutic circumcision is performed because of a clear and evident pathology of the prepuce. The embryological development of the prepuce is completed at the sixteenth week of pregnancy. At birth, this tissue covers the glans without an apparent plane of cleavage and should be defined as 'non-retractile prepuce' instead of 'phymosis'. The prepuce in its free development becomes completely retractile at puberty. These evolutionary concepts about prepuce have been described by Douglas Gairdner in 1948 and Jacob Oster in

  7. ORIGINAL ARTICLES Male circumcision and its relationship to HIV ...

    African Journals Online (AJOL)

    2008-10-09

    Oct 9, 2008 ... The notion that male circumcision could be protective against HIV infection ..... to finally gain acceptance of their masculinity by other Xhosa men.14 ... Prevalence, Behavioural Risks and Mass Media Household Survey 2002.

  8. Editorial: The Islamic view on female circumcision | Goma | African ...

    African Journals Online (AJOL)

    The history of Islam had not itself been previously confronted with what is now called “women's issues,”despite the great diversity in customs and cultures among Muslims over the centuries. As a result of theirencounter with the West, however, and its particular history during the Dark Ages, calls for the liberationof women ...

  9. Female genital mutilation : Conditions of decline

    NARCIS (Netherlands)

    Caldwell, JC; Orubuloye, IO; Caldwell, P

    Female genital mutilation (or female circumcision) has been experienced by over 100 million women in sub-Saharan Africa and the Nile valley Efforts to suppress the practice were made in the earlier decades of the present century, especially by missionaries in Kenya in the 1920s and early 1930s.

  10. Paediatric sutureless circumcision-an alternative to the standard technique.

    LENUS (Irish Health Repository)

    2012-01-31

    INTRODUCTION: Circumcision is one of the most commonly performed surgical procedures in male children. A range of surgical techniques exist for this commonly performed procedure. The aim of this study is to assess the safety, functional outcome and cosmetic appearance of a sutureless circumcision technique. METHODS: Over a 9-year period, 502 consecutive primary sutureless circumcisions were performed by a single surgeon. All 502 cases were entered prospectively into a database including all relevant clinical details and a review was performed. The technique used to perform the sutureless circumcision is a modification of the standard sleeve technique with the use of a bipolar diathermy and the application of 2-octyl cyanoacrylate (2-OCA) to approximate the tissue edges. RESULTS: All boys in this study were pre-pubescent and the ages ranged from 6 months to 12 years (mean age 3.5 years). All patients had this procedure performed as a day case and under general anaesthetic. Complications included: haemorrhage (2.2%), haematoma (1.4%), wound infection (4%), allergic reaction (0.2%) and wound dehiscence (0.8%). Only 9 (1.8%) parents or patients were dissatisfied with the cosmetic appearance. CONCLUSION: The use of 2-OCA as a tissue adhesive for sutureless circumcisions is an alternative to the standard suture technique. The use of this tissue adhesive, 2-OCA, results in comparable complication rates to the standard circumcision technique and results in excellent post-operative cosmetic satisfaction.

  11. "If You Are Not Circumcised, I Cannot Say Yes": The Role of Women in Promoting the Uptake of Voluntary Medical Male Circumcision in Tanzania.

    Directory of Open Access Journals (Sweden)

    Haika Osaki

    Full Text Available Voluntary Medical Male Circumcision (VMMC for HIV prevention in Tanzania was introduced by the Ministry of Health and Social Welfare in 2010 as part of the national HIV prevention strategy. A qualitative study was conducted prior to a cluster randomized trial which tested effective strategies to increase VMMC up take among men aged ≥20 years. During the formative qualitative study, we conducted in-depth interviews with circumcised males (n = 14, uncircumcised males (n = 16, and participatory group discussions (n = 20 with men and women aged 20-49 years in Njombe and Tabora regions of Tanzania. Participants reported that mothers and female partners have an important influence on men's decisions to seek VMMC both directly by denying sex, and indirectly through discussion, advice and providing information on VMMC to uncircumcised partners and sons. Our findings suggest that in Tanzania and potentially other settings, an expanded role for women in VMMC communication strategies could increase adult male uptake of VMMC services.

  12. Knowledge, attitudes and perceptions of pharmacy and nursing students towards male circumcision and HIV in a KwaZulu-Natal University, South Africa

    Directory of Open Access Journals (Sweden)

    Panjasaram V. Naidoo

    2012-07-01

    Full Text Available Background: Male circumcision is currently being promoted in South Africa as a HumanImmunodeficiency Virus (HIV prevention method. Effective implementation requires thathealthcare providers should believe in the procedure’s efficacy and should possess a positiveattitude. A study was undertaken amongst pharmacy and nursing students with differentobjectives.Objectives: To ascertain students’ knowledge, attitudes and perceptions regarding malecircumcision and (HIV prevention.Method: A descriptive cross-sectional study using anonymous questionnaires was undertakenamongst 4th year pharmacy and nursing students studying at a university in KwaZulu-Natal,after obtaining their consent. Data were captured and analysed using SPSS version 15.Results: A response rate of 83.18% and a mean knowledge score of 66.43% with relativelypositive attitudes (62.7 were obtained; 85.4% of the respondents felt that promoting malecircumcision is appropriate, with all Muslim students (n < 11 supporting the promotion ofmale circumcision. Even though all Muslim students supported male circumcision, only 3students were willing to perform the procedure if adequately trained (p < 0.03. The majorityof the female students were unwilling to perform the procedure (p < 0.005. A third of therespondents indicated that male circumcision would both undermine existing protectivebehaviours and strategies as well as increase riskier sexual behaviour. Over 54% of therespondents believed that the South African Health System would be able to cope with themassive male circumcision drive. The majority of the respondents favoured the procedure tobe done at birth. Pain was cited as the most important reason for not wanting to be circumcised.Conclusion: Pharmacy and nursing students have a moderate knowledge of male circumcisionand HIV prevention with relatively positive attitudes. The majority felt that promoting malecircumcision is appropriate and should be encouraged.

  13. Male circumcision does not result in inferior perceived male sexual function - a systematic review

    DEFF Research Database (Denmark)

    Shabanzadeh, Daniel Mønsted; Düring, Signe; Frimodt-Møller, Cai

    2016-01-01

    -B). Following non-medical circumcision, no inferior sexual function was reported (A-B). Following medical circumcision, most outcomes were comparable (B); however, problems in obtaining an orgasm were increased (C) and erectile dysfunction was reported with inconsistency (D). A younger age at circumcision...

  14. Early Resumption of Sex following Voluntary Medical Male Circumcision amongst School-Going Males.

    Directory of Open Access Journals (Sweden)

    Gavin George

    Full Text Available Voluntary medical male circumcision is an integral part of the South African government's response to the HIV and AIDS epidemic. Following circumcision, it is recommended that patients abstain from sexual activity for six weeks, as sex may increase the risk of female-to-male HIV transmission and prolong the healing period. This paper investigates the resumption of sexual activity during the healing period among a cohort of school-going males in the KwaZulu-Natal province of South Africa. The analysis for this paper compares two groups of sexually active school-going males: the first group reported having sex during the healing period (n = 40 and the second group (n = 98 reported no sex during the healing period (mean age: 17.7, SD: 1.7.The results show that 29% (n = 40 of young males (mean age: 17.9, SD: 1.8 who were previously sexually active, resumed sexual activity during the healing period, had on average two partners and used condoms inconsistently. In addition, those males that engage in sexual activity during the healing period were less inclined to practice safe sex in the future (AOR = 0.055, p = 0.002 than the group of males who reported no sex during the healing period. These findings suggest that a significant proportion of young males may currently and in the future, subject themselves to high levels of risk for contracting HIV post circumcision. Education, as part of a VMMC campaign, must emphasize the high risk of HIV transmission for both the males their partners during the healing period.

  15. Complications of traditional circumcision amongst young Xhosa males seen at St Lucy’s Hospital, Tsolo, Eastern Cape, South Africa

    Directory of Open Access Journals (Sweden)

    Ugochukwu Anike

    2013-05-01

    Conclusion: Genital sepsis was the most common complication of traditional male circumcision.Complications were related to the circumciser, advanced age of the patient and place of circumcision. Thereis need for training of the traditional circumcisers on safe techniques and use of hygienic practices in orderto reduce the complications identified in this study.

  16. The British Royal Family’s Circumcision Tradition

    Directory of Open Access Journals (Sweden)

    Robert Darby

    2013-10-01

    Full Text Available The birth of Prince William’s son in July 2013 was the occasion for an outpouring of media speculation about the fate of the royal baby’s foreskin. The possibility that he might be circumcised was connected to a purported tradition of circumcision within the British royal family, said to be have been initiated either by Queen Victoria or by George I. In this article, we trace the origins and evolution of these stories and assess their validity. Our conclusion is that belief in a royal circumcision tradition derives from the reported circumcision of Prince Charles by the mohel Jacob Snowman in 1948, and the efforts of the British Israelite movement to concoct a “lost tribes of Israel” origin for the British race. These elements merged into a fully developed narrative that was widely disseminated from the late 1990s. The initially separate claim that the tradition was imported from Hanover by George I can be sourced precisely to 2012. We further show that these stories are inventions, and that the royal family circumcision tradition should be regarded as a classic instance of a contemporary legend or urban myth.

  17. The evolutionary saga of circumcision from a religious perspective.

    Science.gov (United States)

    Raveenthiran, Venkatachalam

    2018-03-08

    Circumcision is the oldest surgical operation known to mankind. It probably originated as a less radical form of genital mutilation inflicted on prisoners of war. Over time it was adopted by the Egyptian priesthood and nobility, perhaps inspired by the mythology of Osiris. In turn, circumcision became part of the Jewish and Muslim religious cultures. In contrast, ancient Greeks valued an intact prepuce, as evident from the nude figures of Renaissance art. In the 19th century, circumcision was touted as a treatment for excessive masturbation, seizures, epilepsy, and paraplegia. Adoption of the procedure by medical science was almost akin to a religious belief. By the mid-20th century, it was widely performed on male infants on the pretext of phimosis when the prepuce was not retractable. In 1949, Gairdner documented that the tight prepuce of infants gradually becomes retractile as childhood progresses. Thus, childhood circumcision solely for non-retractile prepuce is unnecessary, which is the foundation for modern anti-circumcision movements. Copyright © 2018 Elsevier Inc. All rights reserved.

  18. [Ethical Evaluation of Non-Therapeutic Male Circumcision].

    Science.gov (United States)

    İzgi, M Cumhur

    2015-01-01

    Elective circumcision for nonmedical reasons is a surgical approach which is historically long standing and accepted as the most performed procedure. The necessity of the procedure is usually for religious and traditional reasons alongside some medical ground related benefits to enable its social acceptability. The discussion of the subject from the aspect of ethics becomes necessary as there is no consensus about the benefits or harmfulness of nonmedical circumcision. Fundamental ethical discussions about circumcision, which contradicts legal acceptance criteria of any medical application, are related to the basic concepts of the existence of an individual such as sovereignty, the loss of bodily integrity, and privacy. The recent legal processes and the fact that the European Council and the American Academy of Pediatrics have put the issue on their agenda have increased the necessity of these ethical evaluations. The responsibility of consideration and evaluation of ethical permission of every circumcision procedure, besides discussing the necessity of circumcision for improvement and protection of health rests on the shoulders of the physicians because the dignity and intellectual identity of the profession require so.

  19. Is traditional male circumcision effective as an HIV prevention strategy? Evidence from Lesotho.

    Directory of Open Access Journals (Sweden)

    Elisa M Maffioli

    Full Text Available In many developing countries, male circumcision has been promoted as an effective HIV prevention strategy, and medical randomized controlled trials have indeed shown a causal link. However, there is limited empirical evidence to support this conclusion in countries where individuals can voluntary opt for different types of circumcision. The present study considers male circumcision in Lesotho, where HIV prevalence is among the highest in the world (23%. Here, men can opt for one of two types of circumcision: traditional male circumcision in initiation schools, or the medical option in health clinics. This paper investigates whether the former has medical effects on individual HIV status that are as beneficial as those shown for the latter. Controlling for the potential individual behavioral response after the operation, it was found that circumcision performed in initiation schools wholly offset the medical benefits of the surgical procedure. This supports anecdotal evidence that the operation performed by traditional circumcisers does not have the same protective effect against HIV transmission as the medical operation. No evidence of "disinhibition" behavior among circumcised men was found, nor differential risky sexual behavior among men circumcised, traditionally or medically. Considering that, in Lesotho, traditional male circumcision is undertaken by more than 90% of circumcised men, the findings highlight the need for further research into how the operation in initiation schools is performed and its medical benefits.

  20. The Cost of Voluntary Medical Male Circumcision in South Africa.

    Directory of Open Access Journals (Sweden)

    Michel Tchuenche

    Full Text Available Given compelling evidence associating voluntary medical male circumcision (VMMC with men's reduced HIV acquisition through heterosexual intercourse, South Africa in 2010 began scaling up VMMC. To project the resources needed to complete 4.3 million circumcisions between 2010 and 2016, we (1 estimated the unit cost to provide VMMC; (2 assessed cost drivers and cost variances across eight provinces and VMMC service delivery modes; and (3 evaluated the costs associated with mobilize and motivate men and boys to access VMMC services. Cost data were systematically collected and analyzed using a provider's perspective from 33 Government and PEPFAR-supported (U.S. President's Emergency Plan for AIDS Relief urban, rural, and peri-urban VMMC facilities. The cost per circumcision performed in 2014 was US$132 (R1,431: higher in public hospitals (US$158 [R1,710] than in health centers and clinics (US$121 [R1,309]. There was no substantial difference between the cost at fixed circumcision sites and fixed sites that also offer outreach services. Direct labor costs could be reduced by 17% with task shifting from doctors to professional nurses; this could have saved as much as $15 million (R163.20 million in 2015, when the goal was 1.6 million circumcisions. About $14.2 million (R154 million was spent on medical male circumcision demand creation in South Africa in 2014-primarily on personnel, including community mobilizers (36%, and on small and mass media promotions (35%. Calculating the unit cost of VMMC demand creation was daunting, because data on the denominator (number of people reached with demand creation messages or number of people seeking VMMC as a result of demand creation were not available. Because there are no "dose-response" data on demand creation ($X in demand creation will result in an additional Z% increase in VMMC clients, research is needed to determine the appropriate amount and allocation of demand creation resources.

  1. Swazi men's perception of the protective effect of male circumcision ...

    African Journals Online (AJOL)

    The relatively low uptake of circumcision does not necessarily imply failure of the strategy but rather a natural selection of the most relevant and at-risk portion of the population. It is recommended that more effort be put towards correcting misconceptions and convincing those who still hold a negative perception about the ...

  2. Voluntary medical male circumcision for HIV prevention in fishing ...

    African Journals Online (AJOL)

    Local beliefs and practices about voluntary medical male circumcision (VMMC) may influence uptake and effectiveness. Data were gathered through interviews with 40 people from four ethnically mixed fishing communities in Uganda. Some men believed that wound healing could be promoted by contact with vaginal fluids ...

  3. Impact of male circumcision on HIV risk compensation through the ...

    African Journals Online (AJOL)

    Conclusions: We conclude that male circumcision does not impede condom use. Condom use is impeded by low level of education, marriage, drunkenness, and misconceptions regarding ART. We recommend the emphasis of consistent condom use targeting people with low education, those in marriage, users of alcohol, ...

  4. Addressing legal and policy barriers to male circumcision for ...

    African Journals Online (AJOL)

    We are of the view that the framework does confer protection for adolescent boys while enabling access to male circumcision; however, we identify ambiguities and tensions that exist between the Children's Act, regulations and national guidelines. We recommend reform to further enable access by this vulnerable group to ...

  5. Post-Circumcision Urethro-Cutaneous Fistula: The Key to ...

    African Journals Online (AJOL)

    After incision and development of skin flaps the urethra was closed, a layer of dartos fascia interposed, followed by closure of the skin, all with 6/0 Vicryl. A compression dressing was applied, and the catheter was left in for 5-7 days. Results: The boys ranged in age between 5 and 12 years, and had undergone circumcision ...

  6. Factors associated with parental intent not to circumcise daughters ...

    African Journals Online (AJOL)

    This study explored intention of parents not to circumcise daughters in Enugu State, Nigeria using theory of planned behavior (TPB) as a framework. A survey of 1345 parents was carried out using structured questionnaire with FGM question items based on TPB constructs of attitude, subjective norm (SN), perceived ...

  7. Addressing legal and policy barriers to male circumcision for ...

    African Journals Online (AJOL)

    guidelines, which address medical male circumcision performed under local anaesthetic. ... we identify ambiguities and tensions that exist between the Children's Act, regulations and national guidelines. We recommend reform to ..... 474. http://dx.doi.org/10.1136/medethics-2012-101229. 6. South Africa. Children's Act No.

  8. Effects of Adult Male Circumcision on Premature Ejaculation: Results from a Prospective Study in China

    Directory of Open Access Journals (Sweden)

    Jingjing Gao

    2015-01-01

    Full Text Available The purpose of this study is to investigate the effects of adult male circumcision on premature ejaculation (PE. Therefore, between December 2009 and March 2014, a total of 575 circumcised men and 623 uncircumcised men (control group were evaluated. Detailed evaluations (including circumcision and control groups on PE were conducted before circumcision and at the 3-, 6-, 9-, and 12-month follow-up visits after circumcision. Self-estimated intravaginal ejaculatory latency time (IELT, Patient-Reported Outcome measures, and 5-item version of the International Index of Erectile Function were used to measure the ejaculatory and erectile function for all subjects. The results showed that, during the one-year follow-up, men after circumcision experienced higher IELT and better scores of control over ejaculation, satisfaction with sexual intercourse, and severity of PE than men before circumcision (P<0.001 for all. Similarly, when compared with the control group, the circumcised men reported significantly improved IELT, control over ejaculation, and satisfaction with sexual intercourse (P<0.001 for all. These findings suggested that circumcision might have positive effects on IELT, ejaculatory control, sexual satisfaction, and PE severity. In addition, circumcision was significantly associated with the development of PE.

  9. Male circumcision and HIV prevention: current knowledge and future research directions.

    Science.gov (United States)

    Bailey, R C; Plummer, F A; Moses, S

    2001-11-01

    Over the past decade, numerous epidemiological studies have reported a significant association between lack of male circumcision and risk for HIV infection, leading to recommendations for male circumcision to be added to the armamentarium of effective HIV prevention strategies. We review the epidemiological data from studies that have investigated this association, including ecological, cross-sectional/case-control, and prospective studies. We discuss problematic issues in interpreting the epidemiological data, including the presence of other sexually transmitted infections, age of circumcision, and potential confounders such as religion, cultural practices, and genital hygiene. In addition, we review studies of biological mechanisms by which the presence of the foreskin may increase HIV susceptibility, data on risks associated with the circumcision procedure, and available data on the acceptability and feasibility of introducing male circumcision in societies where it is traditionally not practised. Although the evidence in support of male circumcision as an effective HIV prevention measure is compelling, residual confounding in observational studies cannot be excluded. Taken together with concerns over the potential disinhibiting effect of male circumcision on risk behaviour, and safety of the circumcision procedure, randomised trials of male circumcision to prevent HIV infection are recommended. An individual's choice to undergo male circumcision or a community's decision to promote the practice should be made in the light of the best available scientific evidence. More knowledge is required to assist individuals and communities in making those decisions. We conclude with recommendations for future research.

  10. Perceptions of HIV and Safe Male Circumcision in High HIV Prevalence Fishing Communities on Lake Victoria, Uganda.

    Directory of Open Access Journals (Sweden)

    Paul E Nevin

    Full Text Available In 2010, the Uganda Ministry of Health introduced its Safe Male Circumcision (SMC strategy for HIV prevention with the goal of providing 4.2 million voluntary medical male circumcisions by 2015. Fishing communities, where HIV prevalence is approximately 3-5 times higher than the national average, have been identified as a key population needing targeted HIV prevention services by the National HIV Prevention Strategy. This study aimed to understand perceptions of HIV and identify potential barriers and facilitators to SMC in fishing communities along Lake Victoria.We conducted 8 focus group discussions, stratified by sex and age, with 67 purposefully sampled participants in 4 communities in Kalangala District, Uganda.There was universal knowledge of the availability of SMC services, but males reported high uptake in the community while females indicated that it is low. Improved hygiene, disease prevention, and improved sexual performance and desirability were reported facilitators. Barriers included a perceived increase in SMC recipients' physiological libido, post-surgical abstinence, lost income during convalescence, and lengthier recovery due to occupational hazards. Both males and females reported concerns about spousal fidelity during post-SMC abstinence. Reported misconceptions and community-held cultural beliefs include fear that foreskins are sold after their removal, the belief that a SMC recipient's first sexual partner after the procedure should not be his spouse, and the belief that vaginal fluids aid circumcision wound healing.Previous outreach efforts have effectively reached these remote communities, where availability and health benefits of SMC are widely understood. However, community-specific intervention strategies are needed to address the barriers identified in this study. We recommend the development of targeted counseling, outreach, and communication strategies to address barriers, misconceptions, and community-held beliefs

  11. [Acceptability of male circumcision among male miners in Baise of Guangxi].

    Science.gov (United States)

    Luo, Hao; Liang, Xu; Chen, Jian; Yang, Xiao-bo; Jiang, Jun-jun; Deng, Wei; Zou, Yun-feng; Wei, Bo; Zhang, Zhi-yong; Liu, Zhi-hao; Liang, Hao

    2011-06-01

    To investigate the acceptability of male circumcision among male miners in Baise, Guangxi, China. A questionnaire-based survey on the willingness to be circumcised (WTC) and its influential factors were conducted among Guangxi male miners recruited by random cluster sampling. Of 569 subjects who were surveyed, 143 (25.13%) expressed their willingness to be circumcised. Univariate analysis showed that marital status, education level, and the awareness of the hazards of phimosis and redundant prepuce and reasons for circumcision were significantly different between WTC group and the non-WTC group (all Pminers WTC. Male miners in this area have low WTC. Education on the basic knowledge of acquired immunodeficiency syndrome and circumcision may help promote the application of circumcision.

  12. The Association Between Male Circumcision and Condom Use Behavior – a Meta-Analysis

    DEFF Research Database (Denmark)

    Kabwama, Steven Ndugwa; Ssewanyana, Derrick; Berg-Beckhoff, Gabriele

    2018-01-01

    Introduction: The protective benefit of male circumcision against spreading HIV is well established. Aim: The objective of this Meta-analysis was to investigate behavioral risk compensation measured as the change in condom use behavior in light of knowledge of the benefits of circumcision. Material...... does not influence condom use behavior in the medium and short term. Keywords: Condom use, behavioral change, circumcision, sexual health....... and Methods: A systematic search was conducted from 6 bibliographic databases for studies that quantitatively assessed a link between male circumcision and condom use behavior. Pooled odd ratios (OR) of condom use during any sexual activity were generated from three cohort studies and two Randomized Control...

  13. Circumcision in Australia: further evidence on its effects on sexual health and wellbeing.

    Science.gov (United States)

    Ferris, Jason A; Richters, Juliet; Pitts, Marian K; Shelley, Julia M; Simpson, Judy M; Ryall, Richard; Smith, Anthony M A

    2010-04-01

    To report on the prevalence and demographic variation in circumcision in Australia and examine sexual health outcomes in comparison with earlier research. A representative household sample of 4,290 Australian men aged 16-64 years completed a computer-assisted telephone interview including questions on circumcision status, demographic variables, reported lifetime experience of selected sexually transmissible infections (STIs), experience of sexual difficulties in the previous 12 months, masturbation, and sexual practices at last heterosexual encounter. More than half the men (58%) were circumcised. Circumcision was less common (33%) among men under 30 and more common (66%) among those born in Australia. After adjustment for age and number of partners, circumcision was unrelated to STI history except for non-specific urethritis (higher among circumcised men, OR=2.11, plack of circumcision and erection difficulties was detected. After correction for age, circumcised men were somewhat more likely to have masturbated alone in the previous 12 months (OR=1.20, p=0.02). Circumcision appears to have minimal protective effects on sexual health in Australia. © 2010 The Authors. Journal Compilation © 2010 Public Health Association of Australia.

  14. Rationalization of indigenous male circumcision as a sacred religious custom: health beliefs of Xhosa men in South Africa.

    Science.gov (United States)

    Mavundla, Thandisizwe Redford; Netswera, Fulufelo Godfrey; Bottoman, Brian; Toth, Ferenc

    2009-10-01

    This article presents research findings based on the meaning of indigenous circumcision to Xhosa men in South Africa. In South Africa, male circumcision is a rite of passage from adolescence to adulthood. The country has experienced serious problems associated with the practice of this rite ranging from dehydration to death in the traditional "bush" circumcision schools. A qualitative, endogenous research "How do you experience having a son who is undergoing the circumcision rite?" The study revealed cultural circumcision as a "sacred religious practice" with five themes, namely (a) readiness of Xhosa families to engage in the circumcision ritual, (b) the act of circumcision and preparation for manhood, (c) the importance of symbolic purity during the circumcision ritual, (d) celebrating acquired manhood, and (5) aspects of manhood and the rejection of clinical care. Secondary to this are health promotion recommendations made for individuals involved in this ritual.

  15. Towards a solution concerning female genital mutilation? An approach from within according to Islamic legal opinions

    Directory of Open Access Journals (Sweden)

    Jens Kutscher

    2011-01-01

    Full Text Available Female circumcision is a tradition that is widespread and not restricted to predominantly Muslim countries. It is prevalent among all religious groups in many parts of Africa and Western Asia, whether they are Coptic Christians, Ethiopian Jews, or Arab Muslims. Female genital cutting or—more to the point—female genital mutilation (FGM, generally referred to as circumcision, occurs in at least five different forms. Circumcision is essentially a powerful bodily sign of the human—male and female—covenant with God. In the Quran it is reaffirmed in sura al-Nahl and quoted as example in the fatwas endorsing circumcision. It seems to be true that men are hardly involved in the actual decision in favour of female genital cutting. A man should not interfere in the decision of women to be circumcised. It is practiced and transmitted among women and midwives. Only sometimes is a (male or female physician involved. On the basis of Islamic normativity, mirrored in fatwas, this paper aims to examine a very ambivalent approach concerning female genital mutilation.

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

    NARCIS (Netherlands)

    Sauer, Pieter J. J.; Neubauer, David

    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

  17. Community and Healthcare Providers' Perspectives on Male Circumcision: A Multi-Centric Qualitative Study in India

    Science.gov (United States)

    Sahay, Seema; Nagarajan, Karikalan; Mehendale, Sanjay; Deb, Sibnath; Gupta, Abhilasha; Bharat, Shalini; Bhatt, Shripad; Kumar, Athokpam Bijesh; Kanthe, Vidisha; Sinha, Anju; Chandhiok, Nomita

    2014-01-01

    Background Although male circumcision (MC) is recommended as an HIV prevention option, the religious, cultural and biomedical dimensions of its feasibility, acceptability and practice in India have not been explored till date. This study explores beliefs, experiences and understanding of the community and healthcare providers (HCPs) about adult MC as an HIV prevention option in India. Methods This qualitative study covered 134 in-depth interviews from Belgaum, Kolkata, Meerut and Mumbai cities of India. Of these, 62 respondents were the members of circumcising (CC)/non-circumcising communities (NCC); including medically and traditionally circumcised men, parents of circumcised children, spouses of circumcised men, and religious clerics. Additionally, 58 registered healthcare providers (RHCPs) such as general and pediatric surgeons, pediatricians, skin and venereal disease specialists, general practitioners, and operation theatre nurses were interviewed. Fourteen traditional circumcisers were also interviewed. The data were coded and analyzed in QSR NUD*IST ver. 6.0. The study has not explored the participants' views about neonatal versus adult circumcision. Results Members of CC/NCC, traditional circumcisers and RCHPs expressed sharp religious sensitivities around the issue of MC. Six themes emerged: Male circumcision as the religious rite; Multiple meanings of MC: MC for ‘religious identity/privilege/sacrifice’ or ‘hygiene’; MC inflicts pain and cost; Medical indications outweigh faith; Hesitation exists in accepting ‘foreign’ evidence supporting MC; and communication is the key for acceptance of MCs. Medical indications could make members of NCC accept MC following appropriate counseling. Majority of the RHCPs demanded local in-country evidence. Conclusion HCPs must educate high-risk groups regarding the preventive and therapeutic role of MC. Communities need to discuss and create new social norms about male circumcision for better societal acceptance

  18. Community and healthcare providers' perspectives on male circumcision: a multi-centric qualitative study in India.

    Directory of Open Access Journals (Sweden)

    Seema Sahay

    Full Text Available Although male circumcision (MC is recommended as an HIV prevention option, the religious, cultural and biomedical dimensions of its feasibility, acceptability and practice in India have not been explored till date. This study explores beliefs, experiences and understanding of the community and healthcare providers (HCPs about adult MC as an HIV prevention option in India.This qualitative study covered 134 in-depth interviews from Belgaum, Kolkata, Meerut and Mumbai cities of India. Of these, 62 respondents were the members of circumcising (CC/non-circumcising communities (NCC; including medically and traditionally circumcised men, parents of circumcised children, spouses of circumcised men, and religious clerics. Additionally, 58 registered healthcare providers (RHCPs such as general and pediatric surgeons, pediatricians, skin and venereal disease specialists, general practitioners, and operation theatre nurses were interviewed. Fourteen traditional circumcisers were also interviewed. The data were coded and analyzed in QSR NUD*IST ver. 6.0. The study has not explored the participants' views about neonatal versus adult circumcision.Members of CC/NCC, traditional circumcisers and RCHPs expressed sharp religious sensitivities around the issue of MC. Six themes emerged: Male circumcision as the religious rite; Multiple meanings of MC: MC for 'religious identity/privilege/sacrifice' or 'hygiene'; MC inflicts pain and cost; Medical indications outweigh faith; Hesitation exists in accepting 'foreign' evidence supporting MC; and communication is the key for acceptance of MCs. Medical indications could make members of NCC accept MC following appropriate counseling. Majority of the RHCPs demanded local in-country evidence.HCPs must educate high-risk groups regarding the preventive and therapeutic role of MC. Communities need to discuss and create new social norms about male circumcision for better societal acceptance especially among the NCC. Feasibility

  19. Male circumcision: care practices and attitudes in a Muslim community of western Nepal

    Directory of Open Access Journals (Sweden)

    Mohan Paudel

    2011-03-01

    Full Text Available

    Abstract:
    Background: Male circumcision is a removal of the foreskin of the glans penis. There are medical, ritual and religious reasons for male circumcision. The purpose of this study is to explore the current practices, perceptions, future recommendations and health seeking behavior during and after performing male circumcision in a Muslim community of western Nepal. Method: A total of 64 households were sampled by a simple random sampling method. Information was collected using semi-structured questionnaires and focus group discussions. Result: Circumcision was practiced among all Muslim households and the main reason was religious rite and ritual. It was the traditional circumciser, locally known as hazam, who circumcised all male children in the community. Interestingly, in only 5 % of the household children had been circumcised using modern medicines. The rest of the households, i.e. 95%, relied on traditional healing systems, the use of local herbs and homemade ointments (mainly the suspension of ghee and ash.A Non-sterilized knife was the main surgical instrument used during circumcision. The wound healing after circumcision was much longer, even up to 90 days or more. Conclusions: Circumcision is a practice that is still largely carried out outside the domain of the formal health care system in this community. It demands a design of service delivery models from health policy makers in the Ministry of Health, thus bringing circumcision within formal health care systems in those communities. It deserves an urgent attention to provide safe, culturally acceptable and sustainable services from health institutions.

  20. Cost-effectiveness of newborn circumcision in reducing lifetime HIV risk among U.S. males.

    Directory of Open Access Journals (Sweden)

    Stephanie L Sansom

    Full Text Available BACKGROUND: HIV incidence was substantially lower among circumcised versus uncircumcised heterosexual African men in three clinical trials. Based on those findings, we modeled the potential effect of newborn male circumcision on a U.S. male's lifetime risk of HIV, including associated costs and quality-adjusted life-years saved. METHODOLOGY/PRINCIPAL FINDINGS: Given published estimates of U.S. males' lifetime HIV risk, we calculated the fraction of lifetime risk attributable to heterosexual behavior from 2005-2006 HIV surveillance data. We assumed 60% efficacy of circumcision in reducing heterosexually-acquired HIV over a lifetime, and varied efficacy in sensitivity analyses. We calculated differences in lifetime HIV risk, expected HIV treatment costs and quality-adjusted life years (QALYs among circumcised versus uncircumcised males. The main outcome measure was cost per HIV-related QALY saved. Circumcision reduced the lifetime HIV risk among all males by 15.7% in the base case analysis, ranging from 7.9% for white males to 20.9% for black males. Newborn circumcision was a cost-saving HIV prevention intervention for all, black and Hispanic males. The net cost of newborn circumcision per QALY saved was $87,792 for white males. Results were most sensitive to the discount rate, and circumcision efficacy and cost. CONCLUSIONS/SIGNIFICANCE: Newborn circumcision resulted in lower expected HIV-related treatment costs and a slight increase in QALYs. It reduced the 1.87% lifetime risk of HIV among all males by about 16%. The effect varied substantially by race and ethnicity. Racial and ethnic groups who could benefit the most from circumcision may have least access to it due to insurance coverage and state Medicaid policies, and these financial barriers should be addressed. More data on the long-term protective effect of circumcision on heterosexual males as well as on its efficacy in preventing HIV among MSM would be useful.

  1. 'It brought joy in my home as in the area of my wife.' How recently circumcised adult men ascribe value to and make sense of male circumcision

    DEFF Research Database (Denmark)

    Lundsby, Katrine; Dræbel, Tania; Wolf Meyrowitsch, Dan

    2012-01-01

    The present study used a phenomenological approach to explore the everyday-life experiences of male circumcision (MC) and to learn how recently circumcised men ascribe value to and make sense of MC. Thirteen recently circumcised Zambian men were identified through the snowball technique...... that in addition to emphasising the HIV protective effect of MC, MC promotion should also highlight the social, sexual and romantic values perceived and experienced by the interviewees of this study; (3) the analysis reveals potentially harmful misconceptions about the health benefits of MC, demonstrating...

  2. Attitudes, Beliefs and Predictors of Male Circumcision Promotion among Medical University Students in a Traditionally Non-Circumcising Region

    Directory of Open Access Journals (Sweden)

    Maria Ganczak

    2017-09-01

    Full Text Available Objective: To evaluate the beliefs of medical university students regarding male circumcision (MC, as well as attitudes and the predictors of its promotion in the case of adults at risk of HIV. Methods: A cross-sectional survey was conducted between 2013–2016 at the Medical University in Szczecin, Poland, among final year Polish/foreign students from Northern Europe, using a standardized questionnaire. Results: There were 539 participants, median age 25 years, 40.8% males, and 66.8% were Polish nationals. The MC rate was 16.7%. Regarding HIV/AIDS knowledge, 66.6% of the students scored more than 75%; and, 34.2% knew that MC reduces the risk of HIV infection. One in eleven respondents (9.1% believed that circumcised men felt more intense sexual pleasure. More than half of the respondents (54.8% declared that they would recommend MC to adult patients at risk for HIV. The belief that circumcised men felt more intense sexual pleasure, and knowledge on MC regarding HIV risk reduction was associated with greater odds of recommending adult MC (OR = 3.35 and OR = 2.13, respectively. Conclusions: Poor knowledge of its benefits and a low willingness to promote the procedure—strongly dependent on personal beliefs—suggest that medical students may need additional training to help them to discuss MC more openly with adult men at risk for HIV infection. Knowledge may be an effective tool when making decisions regarding MC promotion.

  3. The prevalence of an excessive prepuce and the effects of distal circumcision on premature ejaculation

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    Luigi Gallo

    2017-06-01

    Conclusions: An excessive prepuce is very common in patients affected by PE. Although accepted by only 13% of our patients, distal circumcision was shown to be a very effective surgical treatment for definitive treatment of PE. We therefore recommend assessing patients complaining of lifelong PE for an excessive prepuce and if they have an excessive prepuce to suggest that they undergo distal circumcision.

  4. Histological Correlates of Penile Sexual Sensation: Does Circumcision Make a Difference?

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    Guy Cox, MA, DPhil

    2015-06-01

    Conclusion: Based on histological findings and correlates of sexual function, loss of the prepuce by circumcision would appear to have no adverse effect on sexual pleasure. Our evaluation supports overall findings from physiological measurements and survey data. Cox G, Krieger JN, and Morris BJ. Histological correlates of penile sexual sensation: Does circumcision make a difference? Sex Med 2015;3:76–85.

  5. Modeling the population-level effects of male circumcision as an HIV-preventive measure: a gendered perspective.

    Directory of Open Access Journals (Sweden)

    Jonathan Dushoff

    Full Text Available BACKGROUND: Evidence from biological, epidemiological, and controlled intervention studies has demonstrated that male circumcision (MC protects males from HIV infection, and MC is now advocated as a public-health intervention against HIV. MC provides direct protection only to men, but is expected to provide indirect protection to women at risk of acquiring HIV from heterosexual transmission. How such indirect protection interacts with the possibility that MC campaigns will lead to behavior changes, however, is not yet well understood. Our objective here is to investigate the link between individual-level effects of MC campaigns and long-term population-level outcomes resulting from disease dynamics, looking at both genders separately, over a broad range of parameters. METHODS AND FINDINGS: We use simple mathematical models of heterosexual transmission to investigate the potential effects of a circumcision scale-up, combined with possible associated behavioral disinhibition. We examine patterns in expected long-term prevalence using a simple equilibrium model based on transmission factors, and validate our results with ODE-based simulations, focusing on the link between effects on females and those on males.We find that the long-term population-level effects on females and males are not strongly linked: there are many possible ways in which an intervention which reduces prevalence in males might nonetheless increase prevalence in females. CONCLUSIONS: Since an intervention that reduces long-term male prevalence could nonetheless increase long-term female prevalence, MC campaigns should explicitly consider both the short-term and long-term effects of MC interventions on females. Our findings strongly underline the importance of pairing MC programs with education, support programs and HIV testing and counseling, together with other prevention measures.

  6. Dangerous to mix: culture and politics in a traditional circumcision in South Africa.

    Science.gov (United States)

    Banwari, Meel

    2015-03-01

    Traditional circumcision (initiation) is an integral part of the Xhosa speaking communities. Circumcision is the first step towards manhood. It involves a number of cultural, religious, legal and ethical issues, which in terms of the constitution of the Republic of South Africa, are rights that must be protected. To highlight the problem of circumcision related death in South Africa. This case report examines a 16- year boy who had died as result of botched circumcision by an unqualified traditional surgeon. He kept the boy in his custody despite his serious illness. He applied a tight bandage to control the bleeding, resulting in gangrene of the penis followed by septicemia. The histories, postmortem findings, cause of death and medico- legal and social aspects have been discussed in this manuscript. There are unacceptable deaths related with circumcision in South Africa. The right to life cannot be sacrificed at the altar of culture and politics.

  7. The when and how of male circumcision and the risk of HIV

    DEFF Research Database (Denmark)

    Rasmussen, Dlama Nggida; Wejse, Christian; Larsen, Olav

    2016-01-01

    Introduction: Male circumcision (MC) reduces the risk of HIV, and this risk reduction may be modified by socio-cultural factors such as the timing and method (medical and traditional) of circumcision. Understanding regional variations in circumcision practices and their relationship to HIV...... is crucial and can increase insight into the HIV epidemic in Africa. Methods: We used data from two retrospective HIV surveys conducted in Guinea- Bissau from 1993 to 1996 (1996 cohort) and from 2004 to 2007 (2006 cohort). Multivariate logistical models were used to investigate the relationships between HIV...... risk and circumcision status, timing, method of circumcision, and socio-demographic factors. Results: MC was protective against HIV infection in both cohorts, with adjusted odds ratios (AORs) of 0.28 (95% CI 0.12-0.66) and 0.30 (95% CI 0.09-0.93), respectively. We observed that post-pubertal (≥13 years...

  8. HIV risk perception and behavior among medically and traditionally circumcised males in South Africa.

    Science.gov (United States)

    Zungu, N P; Simbayi, L C; Mabaso, M; Evans, M; Zuma, K; Ncitakalo, N; Sifunda, S

    2016-04-26

    In South Africa, voluntary medical male circumcision (VMMC) has recently been implemented as a strategy for reducing the risk of heterosexual HIV acquisition among men. However, there is some concern that VMMC may lead to low risk perception and more risky sexual behavior. This study investigated HIV risk perception and risk behaviors among men who have undergone either VMMC or traditional male circumcision (TMC) compared to those that had not been circumcised. Data collected from the 2012 South African national population-based household survey for males aged 15 years and older were analyzed using bivariate and multivariate multinomial logistic regression, and relative risk ratios (RRRs) with 95 % confidence interval (CI) were used to assess factors associated with each type of circumcision relative no circumcision. Of the 11,086 males that indicated that they were circumcised or not, 19.5 % (95 % CI: 17.9-21.4) were medically circumcised, 27.2 % (95 % CI: 24.7-29.8) were traditionally circumcised and 53.3 % (95 % CI: 50.9-55.6) were not circumcised. In the final multivariate models, relative to uncircumcised males, males who reported VMMC were significantly more likely to have had more than two sexual partners (RRR = 1.67, p = 0.009), and males who reported TMC were significantly less likely to be low risk alcohol users (RRR = 0.72, p risk for HIV infection associated with multiple sexual partners and alcohol abuse following circumcision.

  9. HIV risk perception and behavior among medically and traditionally circumcised males in South Africa

    Directory of Open Access Journals (Sweden)

    N. P. Zungu

    2016-04-01

    Full Text Available Abstract Background In South Africa, voluntary medical male circumcision (VMMC has recently been implemented as a strategy for reducing the risk of heterosexual HIV acquisition among men. However, there is some concern that VMMC may lead to low risk perception and more risky sexual behavior. This study investigated HIV risk perception and risk behaviors among men who have undergone either VMMC or traditional male circumcision (TMC compared to those that had not been circumcised. Methods Data collected from the 2012 South African national population-based household survey for males aged 15 years and older were analyzed using bivariate and multivariate multinomial logistic regression, and relative risk ratios (RRRs with 95 % confidence interval (CI were used to assess factors associated with each type of circumcision relative no circumcision. Results Of the 11,086 males that indicated that they were circumcised or not, 19.5 % (95 % CI: 17.9–21.4 were medically circumcised, 27.2 % (95 % CI: 24.7–29.8 were traditionally circumcised and 53.3 % (95 % CI: 50.9–55.6 were not circumcised. In the final multivariate models, relative to uncircumcised males, males who reported VMMC were significantly more likely to have had more than two sexual partners (RRR = 1.67, p = 0.009, and males who reported TMC were significantly less likely to be low risk alcohol users (RRR = 0.72, p < 0.001. Conclusion There is a need to strengthen and improve the quality of the counselling component of VMMC with the focus on education about the real and present risk for HIV infection associated with multiple sexual partners and alcohol abuse following circumcision.

  10. Impact of Female Genital Mutilation on Sexual Functioning, Self ...

    African Journals Online (AJOL)

    Impact of Female Genital Mutilation on Sexual Functioning, Self-Esteem and Marital Instability of Women in Ajegunle. ... Awareness about the adverse consequences of FGM should be intensified and psychological treatment especially post-traumatic stress disorder intervention for circumcised women is recommended.

  11. Knowledge, attitude and practice of female genital mutilation among ...

    African Journals Online (AJOL)

    Background: Female genital mutilation (FGM) is a harmful traditional practice that is deeply rooted in Africa. It has been outlawed in Bayelsa state of Nigeria but there is evidence that its performance by traditional circumcisers and health professionals continues. Aim: The study aimed to determine the knowledge, attitude ...

  12. Male circumcision decreases penile sensitivity as measured in a large cohort.

    Science.gov (United States)

    Bronselaer, Guy A; Schober, Justine M; Meyer-Bahlburg, Heino F L; T'Sjoen, Guy; Vlietinck, Robert; Hoebeke, Piet B

    2013-05-01

    WHAT'S KNOWN ON THE SUBJECT? AND WHAT DOES THE STUDY ADD?: The sensitivity of the foreskin and its importance in erogenous sensitivity is widely debated and controversial. This is part of the actual public debate on circumcision for non-medical reason. Today some studies on the effect of circumcision on sexual function are available. However they vary widely in outcome. The present study shows in a large cohort of men, based on self-assessment, that the foreskin has erogenous sensitivity. It is shown that the foreskin is more sensitive than the uncircumcised glans mucosa, which means that after circumcision genital sensitivity is lost. In the debate on clitoral surgery the proven loss of sensitivity has been the strongest argument to change medical practice. In the present study there is strong evidence on the erogenous sensitivity of the foreskin. This knowledge hopefully can help doctors and patients in their decision on circumcision for non-medical reason. To test the hypothesis that sensitivity of the foreskin is a substantial part of male penile sensitivity. To determine the effects of male circumcision on penile sensitivity in a large sample. The study aimed at a sample size of ≈1000 men. Given the intimate nature of the questions and the intended large sample size, the authors decided to create an online survey. Respondents were recruited by means of leaflets and advertising. The analysis sample consisted of 1059 uncircumcised and 310 circumcised men. For the glans penis, circumcised men reported decreased sexual pleasure and lower orgasm intensity. They also stated more effort was required to achieve orgasm, and a higher percentage of them experienced unusual sensations (burning, prickling, itching, or tingling and numbness of the glans penis). For the penile shaft a higher percentage of circumcised men described discomfort and pain, numbness and unusual sensations. In comparison to men circumcised before puberty, men circumcised during adolescence or

  13. Combination Analgesia for Neonatal Circumcision: A Randomized Controlled Trial.

    Science.gov (United States)

    Sharara-Chami, Rana; Lakissian, Zavi; Charafeddine, Lama; Milad, Nadine; El-Hout, Yaser

    2017-12-01

    There is no consensus on the most effective pain management for neonatal circumcision. We sought to compare different modalities. This is a double-blinded randomized controlled trial comparing 3 combination analgesics used during circumcision (EMLA + sucrose; EMLA + sucrose + dorsal penile nerve block [DPNB]; EMLA + sucrose + ring block [RB]) with the traditional topical analgesic cream EMLA alone. The trial was set in the normal nursery of a teaching hospital. The sample included 70 healthy male newborns, randomly assigned to intervention and control groups at a 2:1 ratio. Infants were videotaped (face and torso) during the procedure for assessment of pain by 2 blinded, independent reviewers. The primary outcome measure is the Neonatal Infant Pain Scale score. Secondary outcomes include heart rate, oxygen saturation, and crying time. Neonatal Infant Pain Scale scores were significantly lower in the intervention groups (EMLA + sucrose, mean [SD]: 3.1 [1.33]; EMLA + sucrose + DPNB: 3 [1.33]; EMLA + sucrose + RB: 2.45 [1.27]) compared with the control (5.5 [0.53]). Between-group analyses showed RB + EMLA + sucrose to be significantly more effective than EMLA + sucrose; EMLA + sucrose + DPNB ( P = .009 and P = .002, respectively). Interrater reliability was κ = 0.843. Significant increase in heart rate (139.27 [9.63] to 163 [13.23] beats per minute) and crying time (5.78 [6.4] to 45.37 [12.39] seconds) were noted in the EMLA group. During neonatal circumcision in boys, the most effective analgesia is RB combined with oral sucrose and EMLA cream. Copyright © 2017 by the American Academy of Pediatrics.

  14. Male Circumcision and STI Acquisition in Britain: Evidence from a National Probability Sample Survey.

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    Virginia Homfray

    Full Text Available It is well-established that male circumcision reduces acquisition of HIV, herpes simplex virus 2, chancroid, and syphilis. However, the effect on the acquisition of non-ulcerative sexually transmitted infections (STIs remains unclear. We examined the relationship between circumcision and biological measures of three STIs: human papillomavirus (HPV, Chlamydia trachomatis and Mycoplasma genitalium.A probability sample survey of 15,162 men and women aged 16-74 years (including 4,060 men aged 16-44 years was carried out in Britain between 2010 and 2012. Participants completed a computer-assisted personal interview, including a computer-assisted self-interview, which asked about experience of STI diagnoses, and circumcision. Additionally, 1,850 urine samples from sexually-experienced men aged 16-44 years were collected and tested for STIs. Multivariable logistic regression was used to calculate adjusted odds ratios (AOR to quantify associations between circumcision and i self-reporting any STI diagnosis and ii presence of STIs in urine, in men aged 16-44 years, adjusting for key socio-demographic and sexual behavioural factors.The prevalence of circumcision in sexually-experienced men aged 16-44 years was 17.4% (95%CI 16.0-19.0. There was no association between circumcision and reporting any previous STI diagnoses, and specifically previous chlamydia or genital warts. However, circumcised men were less likely to have any HPV type (AOR 0.26, 95% confidence interval (CI 0.13-0.50 including high-risk HPV types (HPV-16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59 and/or 68 (AOR 0.14, 95% CI 0.05-0.40 detected in urine.Circumcised men had reduced odds of HPV detection in urine. These findings have implications for improving the precision of models of STI transmission in populations with different circumcision prevalence and in designing interventions to reduce STI acquisition.

  15. Circumcision status and incident herpes simplex virus type 2 infection, genital ulcer disease, and HIV infection

    Science.gov (United States)

    Mehta, Supriya D.; Moses, Stephen; Parker, Corette B.; Agot, Kawango; Maclean, Ian; Bailey, Robert C.

    2013-01-01

    Objective We assessed the protective effect of medical male circumcision (MMC) against HIV, herpes simplex virus type 2 (HSV-2), and genital ulcer disease (GUD) incidence. Design Two thousand, seven hundred and eighty-seven men aged 18–24 years living in Kisumu, Kenya were randomly assigned to circumcision (n=1391) or delayed circumcision (n =1393) and assessed by HIV and HSV-2 testing and medical examinations during follow-ups at 1, 3, 6, 12, 18, and 24 months. Methods Cox regression estimated the risk ratio of each outcome (incident HIV, GUD, HSV-2) for circumcision status and multivariable models estimated HIV risk associated with HSV-2, GUD, and circumcision status as time-varying covariates. Results HIV incidence was 1.42 per 100 person-years. Circumcision was 62% protective against HIV [risk ratio =0.38; 95% confidence interval (CI) 0.22–0.67] and did not change when controlling for HSV-2 and GUD (risk ratio =0.39; 95% CI 0.23–0.69). GUD incidence was halved among circumcised men (risk ratio =0.52; 95% CI 0.37–0.73). HSV-2 incidence did not differ by circumcision status (risk ratio =0.94; 95% CI 0.70–1.25). In the multivariable model, HIV seroconversions were tripled (risk ratio =3.44; 95% CI 1.52–7.80) among men with incident HSV-2 and seven times greater (risk ratio =6.98; 95% CI 3.50–13.9) for men with GUD. Conclusion Contrary to findings from the South African and Ugandan trials, the protective effect of MMC against HIV was independent of GUD and HSV-2, and MMC had no effect on HSV-2 incidence. Determining the causes of GUD is necessary to reduce associated HIV risk and to understand how circumcision confers protection against GUD and HIV PMID:22382150

  16. Examining the association between male circumcision and sexual function: evidence from a British probability survey.

    Science.gov (United States)

    Homfray, Virginia; Tanton, Clare; Mitchell, Kirstin R; Miller, Robert F; Field, Nigel; Macdowall, Wendy; Wellings, Kaye; Sonnenberg, Pam; Johnson, Anne M; Mercer, Catherine H

    2015-07-17

    Despite biological advantages of male circumcision in reducing HIV/sexually transmitted infection acquisition, concern is often expressed that it may reduce sexual enjoyment and function. We examine the association between circumcision and sexual function among sexually active men in Britain using data from Britain's third National Survey of Sexual Attitudes and Lifestyles (Natsal-3). Natsal-3 asked about circumcision and included a validated measure of sexual function, the Natsal-SF, which takes into account not only sexual difficulties but also the relationship context and overall level of satisfaction. A stratified probability survey of 6293 men and 8869 women aged 16-74 years, resident in Britain, undertaken 2010-2012, using computer-assisted face-to-face interviewing with computer-assisted self-interview for the more sensitive questions. Logistic regression was used to calculate odds ratios (ORs) to examine the association between reporting male circumcision and aspects of sexual function among sexually active men (n = 4816). The prevalence of male circumcision in Britain was 20.7% [95% confidence interval (CI): 19.3-21.8]. There was no association between male circumcision and, being in the lowest quintile of scores for the Natsal-SF, an indicator of poorer sexual function (adjusted OR: 0.95, 95% CI: 0.76-1.18). Circumcised men were as likely as uncircumcised men to report the specific sexual difficulties asked about in Natsal-3, except that a larger proportion of circumcised men reported erectile difficulties. This association was of borderline statistical significance after adjusting for age and relationship status (adjusted OR: 1.27, 95% CI: 0.99-1.63). Data from a large, nationally representative British survey suggest that circumcision is not associated with men's overall sexual function at a population level.

  17. American Society for Pain Management Nursing (ASPMN) position statement: male infant circumcision pain management.

    Science.gov (United States)

    O'Conner-Von, Susan; Turner, Helen N

    2013-12-01

    The ASPMN strongly recommends that infants who are being circumcised must receive optimal pain management. ‘‘If a decision for circumcision is made, procedural analgesia should be provided’’ (AAP, 1999, p. 691). Therefore, it is the position of the ASPMN that optimal pain management must be provided throughout the circumcision process. Furthermore, parents must be prepared for the procedure and educated about infant pain assessment. They must also be informed of pharmacologic and integrative pain management therapies that are appropriate before, during, and after the procedure.

  18. Evaluation of pain management interventions for neonatal circumcision pain.

    Science.gov (United States)

    Joyce, B A; Keck, J F; Gerkensmeyer, J

    2001-01-01

    The purpose of the study was to determine the efficacy of music and eutectic mixture of local anesthetics (EMLA) on pain responses of neonates undergoing circumcision. A randomized, double-blind experimental design was used with 23 neonates. Pain response was measured using an observational pain intensity rating scale and the physiologic parameters of heart rate, respiratory rate, oxygen saturation levels, salivary cortisol levels, and length of cry. Each infant's state was examined for a potential contribution to the pain response. Infant state, salivary cortisol levels, and respiratory rates were not significant. Pain ratings had considerable variability for all treatment conditions, but both single treatment groups had less pain by the end of the procedure. The heart rate was significantly lower for the EMLA group and remained stable for the music group. Oxygen saturation differences were statistically significant for the music group (P =.02) and approached significance for the EMLA group. Preliminary support was provided for the efficacy of EMLA and music to contribute to the pain relief of neonates undergoing circumcision. Further study is warranted. Neonates deserve interventions that will provide them with a less painful start in life.

  19. Glanular hypospadias management with modified circumcision and firlit procedure

    International Nuclear Information System (INIS)

    Iqbal, N.; Hussain, I.; Cheema, M.A.; Akhter, S.

    2017-01-01

    Objective: To document the results of using simple technique of Firlit procedure with modified circumcision for treatment of glanular hypospadias. Study Design: Descriptive case series. Place and Duration of Study: Department of Urology, Shifa International Hospital, Islamabad, from January 2011 till May 2017. Methodology: The subjects included pediatric patients who underwent repair of glanular hypospadias by using modified circumcision and Firlit procedure. Patients were analyzed for operative time, age, hospital stay, and peroperative and postoperative complications. Chart review was done for collection of data on specified proforma. Results: There were 73 patients with mean age of 1.81 +-0.92 years. Children were discharged on the same day. None of them needed catheterization and dressing. Temporary dressing was used for mild bleeding immediate post op in 13 (17.80%) cases only. Postoperative complication such as urinary retention, fever, severe pain, or urinary tract infection were not seen in children. Meatal stenosis was not seen on a 2-24 months' follow-up. Satisfactory urine stream and good cosmesis was noted by the parents. Conclusion: The Firlit technique for the repair of glanular hypospadias was simple and satisfactory in terms of urine stream and cosmesis with minimal complications. (author)

  20. Use of a disposable circumcision suture device versus conventional circumcision: a systematic review and meta-analysis

    Directory of Open Access Journals (Sweden)

    Zhong-Chao Huo

    2017-01-01

    Full Text Available This systematic review assessed the safety and efficacy of the disposable circumcision suture device (DCSD and conventional circumcision (CC in the treatment of redundant prepuce and phimosis. Two independent reviewers conducted a literature search for randomized controlled trials (RCTs using the DCSD and CC for the treatment of redundant prepuce or phimosis in China and abroad. Nine RCTs (1898 cases were included. Compared with the CC group, the DCSD group had a shorter operative time (standardized mean difference [SMD] = −21.44; 95% confidence intervals [95% CIs] [−25.08, −17.79]; P < 0.00001, shorter wound healing time (SMD = −3.66; 95% CI [−5.46, −1.85]; P < 0.0001, less intraoperative blood loss (SMD = −9.64; 95% CI [−11.37, −7.90]; P < 0.00001, better cosmetic penile appearance (odds ratio [OR] =8.77; 95% CI [5.90, 13.02]; P < 0.00001, lower intraoperative pain score, lower 24-h postoperative pain score, lower incidence of infection, less incision edema, and fewer adverse events. There were no differences between the CC and DCSD groups in the incidences of dehiscence, or hematoma. The results of this meta-analysis indicate that the DCSD appears to be safer and more effective than CC. However, additional high-quality RCTs with larger study populations are needed.

  1. Use of a disposable circumcision suture device versus conventional circumcision: a systematic review and meta-analysis.

    Science.gov (United States)

    Huo, Zhong-Chao; Liu, Gang; Li, Xiao-Yan; Liu, Fei; Fan, Wen-Ju; Guan, Ru-Hua; Li, Pei-Feng; Mo, De-Yang; He, Yong-Zhi

    2017-01-01

    This systematic review assessed the safety and efficacy of the disposable circumcision suture device (DCSD) and conventional circumcision (CC) in the treatment of redundant prepuce and phimosis. Two independent reviewers conducted a literature search for randomized controlled trials (RCTs) using the DCSD and CC for the treatment of redundant prepuce or phimosis in China and abroad. Nine RCTs (1898 cases) were included. Compared with the CC group, the DCSD group had a shorter operative time (standardized mean difference [SMD] = -21.44; 95% confidence intervals [95% CIs] [-25.08, -17.79]; P SMD = -3.66; 95% CI [-5.46, -1.85]; P SMD = -9.64; 95% CI [-11.37, -7.90]; P infection, less incision edema, and fewer adverse events. There were no differences between the CC and DCSD groups in the incidences of dehiscence, or hematoma. The results of this meta-analysis indicate that the DCSD appears to be safer and more effective than CC. However, additional high-quality RCTs with larger study populations are needed.

  2. Ischemia of the glans penis following circumcision: case report and revision of the literature

    Directory of Open Access Journals (Sweden)

    Pietro Pepe

    2015-03-01

    Full Text Available Ischemic complications of the glans penis are rare and commonly result from trauma, inadvertent administration of vasoconstrictive solutions, diabetes mellitus, circumcision and vasculitis; we refer about a young man with severe ischemia of the glans penis following circumcision. The patient had undergone circumcision 5 days before in a surgery department under local anesthesia (1% mepivacaine hydrochloride. The patient noticed a brownish color and edema of the glans penis at 24 h after he opened the wound dressing, but arrived to our hospital only 5 days after circumcision because these findings had progressed. Physical examination revealed the black color or necrotic appearance of the glans penis, and edema on the dorsal penile skin. The patient underwent antibiotic, antiplatatelet, corticosteroid and iperbaric therapy achieving a complete restitutio ad integrum.

  3. Citizenship in a time of HIV: Understanding medical adult male circumcision in South Africa.

    Science.gov (United States)

    Howard-Payne, Lynlee; Bowman, Brett

    2018-05-01

    Medical adult male circumcision has been shown to offer men significant protection against HIV infection during peno-vaginal sex. This has resulted in calls for a national roll-out of medical adult male circumcision in South Africa, a rights-based constitutional democracy. This article explores the ways that the potential tensions between this call to circumcise as a practice of good health citizenship and the guaranteed right to bodily integrity are negotiated in interviews with 30 urban-based men in Johannesburg. The results suggest that despite its demonstrable biological efficacy, these tensions may paralyse decision- and policy-makers in grappling with the potential scaling up of medical adult male circumcision for HIV prevention in South Africa.

  4. Ischemia of the glans penis following circumcision: case report and revision of the literature.

    Science.gov (United States)

    Pepe, Pietro; Pietropaolo, Francesco; Candiano, Giuseppe; Pennisi, Michele

    2015-03-31

    Ischemic complications of the glans penis are rare and commonly result from trauma, inadvertent administration of vasoconstrictive solutions, diabetes mellitus, circumcision and vasculitis; we refer about a young man with severe ischemia of the glans penis following circumcision. The patient had undergone circumcision 5 days before in a surgery department under local anesthesia (1% mepivacaine hydrochloride). The patient noticed a brownish color and edema of the glans penis at 24 h after he opened the wound dressing, but arrived to our hospital only 5 days after circumcision because these findings had progressed. Physical examination revealed the black color or necrotic appearance of the glans penis, and edema on the dorsal penile skin. The patient underwent antibiotic, antiplatatelet, corticosteroid and iperbaric therapy achieving a complete restitutio ad integrum.

  5. On-site comprehensive curriculum to teach reproductive health to female adolescents in Kenya.

    Science.gov (United States)

    Gaughran, Margaret; Asgary, Ramin

    2014-04-01

    Rates of sexually transmitted infections (STIs) and unplanned pregnancy are high in Kenya, and limited reproductive health education exists in schools. We designed and implemented a 6-week reproductive health curriculum in Laikipia District, Kenya, in 2011, which included didactic sessions, educational games, and open discussions. We applied a mixed quantitative and qualitative methods to evaluate this curriculum including a comprehensive 35-item survey to assess pre- and post-training knowledge, attitudes, and practices of female teenagers regarding STIs/HIV and family planning using paired t-test as well as complementary focus groups (n=42) and individual interviews (n=20). Average age for 42 female teenagers was 16.5 (± 1.31) years. Pre-test questionnaires revealed lack of knowledge about different types of STIs, specifically chlamydia, but adequate knowledge of basic contraception including abstinence and condom use. By the conclusion of the study, we observed improvement in following educational domains: general knowledge of HIV/AIDS (85% ± 7.5% to 94% ± 5.6%) (pmasturbation and its perceived consequences, and issues surrounding female circumcision. Important misconceptions and gaps in reproductive practices were identified and addressed using a mixed methods approach. Despite prior basic knowledge and positive attitudes on STI prevention and family planning, complementary teaching approaches were instrumental in improving overall knowledge of STIs other than HIV as well as family planning. The curriculum was feasible, well received, and achieved its educational goals.

  6. Male Circumcision for HIV Prevention in South Africa: Addressing HIV and Gender Relations

    OpenAIRE

    Fischer-Nielsen, Sara; Møller, Sabrah

    2011-01-01

    The thesis scrutinizes how gender relations and women’s and men’s control of sexual health are influenced by the intervention of male circumcision for HIV prevention in South Africa. The analytical framework combines the theory of therapeutic citizenship, post-development theory and gender theory. We argue that the individual man’s choice to circumcise is being challenged by international HIV prevention methods emphasizing men’s responsibility in HIV prevention. In South Africa, current chang...

  7. Penile measurements in Tanzanian males: guiding circumcision device design and supply forecasting.

    Science.gov (United States)

    Chrouser, Kristin; Bazant, Eva; Jin, Linda; Kileo, Baldwin; Plotkin, Marya; Adamu, Tigistu; Curran, Kelly; Koshuma, Sifuni

    2013-08-01

    Voluntary medical male circumcision decreases the risk in males of HIV infection through heterosexual intercourse by about 60% in clinical trials and 73% at post-trial followup. In 2007 WHO and the Joint United Nations Programme on HIV/AIDS (UNAIDS) recommended that countries with a low circumcision rate and high HIV prevalence expand voluntary medical male circumcision programs as part of a national HIV prevention strategy. Devices for adult/adolescent male circumcision could accelerate the pace of scaling up voluntary medical male circumcision. Detailed penile measurements of African males are required for device development and supply size forecasting. Consenting males undergoing voluntary medical male circumcision at 3 health facilities in the Iringa region, Tanzania, underwent measurement of the penile glans, shaft and foreskin. Age, Tanner stage, height and weight were recorded. Measurements were analyzed by age categories. Correlations of penile parameters with height, weight and body mass index were calculated. In 253 Tanzanian males 10 to 47 years old mean ± SD penile length in adults was 11.5 ± 1.6 cm, mean shaft circumference was 8.7 ± 0.9 cm and mean glans circumference was 8.8 ± 0.9 cm. As expected, given the variability of puberty, measurements in younger males varied significantly. Glans circumference highly correlated with height (r = 0.80) and weight (r = 0.81, each p <0.001). Stretched foreskin diameter moderately correlated with height (r = 0.68) and weight (r = 0.71, each p <0.001). Our descriptive study provides penile measurements of males who sought voluntary medical male circumcision services in Iringa, Tanzania. To our knowledge this is the first study in a sub-Saharan African population that provides sufficiently detailed glans and foreskin dimensions to inform voluntary medical male circumcision device development and size forecasting. Copyright © 2013 American Urological Association Education and Research, Inc. Published by Elsevier

  8. Readiness of health facilities to deliver safe male circumcision services in Tanzania: a descriptive study

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    Frank Felix Mosha

    2013-03-01

    Full Text Available Assessing the readiness of health facilities to deliver safe male circumcision services is more important in sub-Saharan Africa because of the inadequacy state of health facilities in many ways. The World Health Organization recommends that only facilities equipped with available trained staff, capable to perform at least minor surgery, able to offer minimum MC package and appropriate equipment for resuscitation, and compliant with requirements for sterilization and infection control should be allowed to deliver safe circumcision services. A cross-sectional study using quantitative data collection technique was conducted to assess the readiness of the health facilities to deliver safe circumcision services in selected districts of Tanzania. All hospitals, health centres and 30% of all dispensaries in these districts were selected to participate in the study. Face-toface questionnaires were administered to the heads of the health facilities and to health practitioners. Overall, 49/69 (59% of the facilities visited provided circumcision services and only 46/203 (24% of the health practitioners performed circumcision procedures. These were mainly assistant medical officers and clinical officers. The vast majority – 190/203 (95% – of the health practitioners require additional training prior to providing circumcision services. Most facilities – 63/69 (91% – had all basic supplies (gloves, basin, chlorine and waste disposal necessary for infection prevention, 44/69 (65% provided condoms, HIV counselling and testing, and sexuallytransmitted infections services, while 62/69 (90% had the capability to perform at least minor surgery. However, only 25/69 (36% and 15/69 (22% of the facilities had functioning sterilization equipment and appropriate resuscitation equipment, respectively. There is readiness for roll out of circumcision services; however, more practitioners need to be trained on circumcision procedures, demand forecasting

  9. Somatosensory evoked potentials assess the efficacy of circumcision for premature ejaculation.

    Science.gov (United States)

    Xia, J-D; Jiang, H-S; Zhu, L-L; Zhang, Z; Chen, H; Dai, Y-T

    2016-07-01

    To assess the efficacy and mechanism of circumcision in the treatment of premature ejaculation (PE) with redundant prepuce, we enrolled a total of 81 PE patients who received circumcision. The patients' ejaculatory ability and sexual performances were evaluated before and after circumcision by using questionnaires (Intravaginal ejaculation latency time (IELT), Chinese Index of PE with 5 questions (CIPE-5) and International Index of Erectile function- 5 (IIEF-5)). Furthermore, somatosensory evoked potentials (SEPs) including dorsal nerve (DNSEP) and glans penis (GPSEP) of the patients were also measured. The mean IELTs of preoperation and post operation were 1.10±0.55 and 2.48±2.03 min, respectively (PIELT after operation was 2.16 min, compared with the baseline 1.07 min before the operation, the fold increase of the IELT was 2.02. Compared with the uncircumcised status, scores of CIPE-5 showed a significant increase after circumcision (P<0.001). The mean latencies (and amplitudes) of GPSEP and DNSEP were 38.1±4.0 ms (3.0±1.9 uV) and 40.5±3.4 ms (2.8±1.6 uV) before circumcision, respectively; and 42.8±3.3 ms (2.8±1.6 uV) and 40.5±4.1 ms (2.4±1.2 uV) in the follow-up end point after circumcision. Only the latencies of GPSEP showed significant prolongation before and after circumcision (P<0.001). The ejaculation time improvement after circumcision is so small, and equal to placebo response, therefore it could not be interpreted as a therapeutic method in men with PE.

  10. Christians' cut: popular religion and the global health campaign for medical male circumcision in Swaziland.

    Science.gov (United States)

    Golomski, Casey; Nyawo, Sonene

    2017-08-01

    Swaziland faces one of the worst HIV epidemics in the world and is a site for the current global health campaign in sub-Saharan Africa to medically circumcise the majority of the male population. Given that Swaziland is also majority Christian, how does the most popular religion influence acceptance, rejection or understandings of medical male circumcision? This article considers interpretive differences by Christians across the Kingdom's three ecumenical organisations, showing how a diverse group people singly glossed as 'Christian' in most public health acceptability studies critically rejected the procedure in unity, but not uniformly. Participants saw medical male circumcision's promotion and messaging as offensive and circumspect, and medical male circumcision as confounding gendered expectations and sexualised ideas of the body in Swazi Culture. Pentecostal-charismatic churches were seen as more likely to accept medical male circumcision, while traditionalist African Independent Churches rejected the operation. The procedure was widely understood to be a personal choice, in line with New Testament-inspired commitments to metaphorical circumcision as a way of receiving God's grace.

  11. Traditional male circumcision-related fatalities in the Mthatha area of South Africa.

    Science.gov (United States)

    Meel, B L

    2010-10-01

    Traditional male circumcision is still widely practised by the Xhosa population throughout South Africa. Male circumcision is carried out mainly during summer and winter seasons. This is a retrospective record review of the male circumcision-related fatalities at Mthatha General Hospital during 2005 and 2006. The purpose of this study is to highlight the problem of circumcision-related deaths in the Mthatha area of South Africa. Twenty-five deaths related to traditional circumcisions were recorded over the period. The common causes of deaths were septicaemia (9 patients; 36%), pneumonia (5; 20%), dehydration (3; 12%), assault (3; 12%), thromboembolism (2; 8%), gangrene (2; 8%) and congestive heart failure (1; 4%). All fatalities were among black Africans with a median age of 17.56 (SD = 2.56) years. In seven deaths (28%) the young men came from the Libode District. The youngest victim was 12 years old. Most of the deaths (13; 52%) occurred in July 2006. The mortality associated with traditional male circumcision in the Mthatha area of South Africa is alarming.

  12. Neonatal circumcision in severe haemophilia: a survey of paediatric haematologists at United States Hemophilia Treatment Centers.

    Science.gov (United States)

    Kearney, S; Sharathkumar, A; Rodriguez, V; Chitlur, M; Valentino, L; Boggio, L; Gill, J

    2015-01-01

    Neonatal circumcision in patients with severe haemophilia has not been well studied. We performed a survey of paediatric haematologists from Hemophilia Treatment Centers (HTC) across the United States to better understand the attitudes toward and management of neonatal circumcision in haemophilia patients. Response rate to our survey was 40% (n = 64/159). Thirty-eight percent of respondents (n = 24) said that they would allow this procedure in the newborn period but in many cases this was against medical advice. The most reported concern regarding neonatal circumcision in haemophilia patients was the risk of development of an inhibitor (n = 25; 39%) followed by the concern for bleeding (n = 22; 34%) and issues related to vascular access in the neonate (n = 11; 17%). All respondents recommended at least one preprocedure dose of factor replacement. Twenty-two percent (n = 14) of respondents did not use more than one dose of factor replacement but 32% (n = 21) used 1-2 postoperative doses. The remainder of paediatric haematologists surveyed recommended between 3-5 (16%; n = 10) and 6-10 (3%, n = 2) additional days postoperatively. There was wide variation in both techniques of circumcision as well as adjuvant haemostatic agents used. Only 22% of respondents said that they had an established protocol for management of circumcision in the newborn haemophilia patient. These survey results highlight the need for evidence-based guidelines regarding the optimal management of circumcision in neonates with severe haemophilia. © 2014 John Wiley & Sons Ltd.

  13. Male circumcision as strategy for HIV prevention and sexually transmitted diseases. The potential role of traditional birth attendants in neonatal male circumcision.

    Science.gov (United States)

    Dini, Catia

    2010-01-01

    In developing countries, it would be advisable to give priority to human immunodeficiency virus (HIV) prevention strategies, because of the high mortality caused by the rapid spread of the pandemic. Furthermore, HIV prevention could contribute to the mitigation of tuberculosis (TB) propagation, which is tightly correlated to acquired immune deficiency syndrome (AIDS). As demonstrated, male circumcision (MC) confers protection against HIV and sexually transmitted diseases (STD). The suggested strategy considers the neonatal MC advantageous, since it is safer, feasible, culturally more acceptable and less costly than adult MC. This approach is based on the assumption that, if newborn males are circumcised, within the next 15-20 years the sexually active population will be almost entirely circumcised and, consequently, the HIV transmission will be reduced. The employment of retrained traditional birth attendants is considered in order to implement the MC after the child birth and to facilitate its acceptance in those contexts where it is not traditionally performed.

  14. Male circumcision as strategy for HIV prevention and sexually transmitted diseases: the potential role of traditional birth attendants in neonatal male circumcision

    Directory of Open Access Journals (Sweden)

    Catia Dini

    2010-12-01

    Full Text Available In developing countries, it would be advisable to give priority to human immunodeficiency virus (HIV prevention strategies, because of the high mortality caused by the rapid spread of the pandemic. Furthermore, HIV prevention could contribute to the mitigation of tuberculosis (TB propagation, which is tightly correlated to acquired immune deficiency syndrome (AIDS. As demonstrated, male circumcision (MC confers protection against HIV and sexually transmitted diseases (STD. The suggested strategy considers the neonatal MC advantageous, since it is safer, feasible, culturally more acceptable and less costly than adult MC. This approach is based on the assumption that, if newborn males are circumcised, within the next 15-20 years the sexually active population will be almost entirely circumcised and, consequently, the HIV transmission will be reduced. The employment of retrained traditional birth attendants is considered in order to implement the MC after the child birth and to facilitate its acceptance in those contexts where it is not traditionally performed.

  15. Modeling Costs and Impacts of Introducing Early Infant Male Circumcision for Long-Term Sustainability of the Voluntary Medical Male Circumcision Program.

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    Emmanuel Njeuhmeli

    Full Text Available Voluntary medical male circumcision (VMMC has been shown to be an effective prevention strategy against HIV infection in males [1-3]. Since 2007, the President's Emergency Plan for AIDS Relief (PEPFAR has supported VMMC programs in 14 priority countries in Africa. Today several of these countries are preparing to transition their VMMC programs from a scale-up and expansion phase to a maintenance phase. As they do so, they must consider the best approaches to sustain high levels of male circumcision in the population. The two alternatives under consideration are circumcising adolescents 10-14 years old over the long term or integrating early infant male circumcision (EIMC into maternal and child health programs. The paper presents an analysis, using the Decision Makers Program Planning Tool, Version 2.0 (DMPPT 2.0, of the estimated cost and impact of introducing EIMC into existing VMMC programs in several countries in eastern and southern Africa. Limited cost data exist for the implementation of EIMC, but preliminary studies, such as the one detailed in Mangenah, et al. [4-5], suggest that the cost of EIMC may be less than that of adolescent and adult male circumcision. If this is the case, then adding EIMC to the VMMC program will increase the number of circumcisions that need to be performed but will not increase the total cost of the program over the long term. In addition, we found that a delayed or slow start-up of EIMC would not substantially reduce the impact of adding it to the program or increase cumulative long-term costs, which should make introduction of EIMC more feasible and attractive to countries contemplating such a program innovation.

  16. Voluntary medical male circumcision: an HIV prevention priority for PEPFAR.

    Science.gov (United States)

    Reed, Jason Bailey; Njeuhmeli, Emmanuel; Thomas, Anne Goldzier; Bacon, Melanie C; Bailey, Robert; Cherutich, Peter; Curran, Kelly; Dickson, Kim; Farley, Tim; Hankins, Catherine; Hatzold, Karin; Justman, Jessica; Mwandi, Zebedee; Nkinsi, Luke; Ridzon, Renee; Ryan, Caroline; Bock, Naomi

    2012-08-15

    As the science demonstrating strong evidence for voluntary medical male circumcision (VMMC) for HIV prevention has evolved, the President's Emergency Plan for AIDS Relief (PEPFAR) has collaborated with international agencies, donors, and partner country governments supporting VMMC programming. Mathematical models forecast that quickly reaching a large number of uncircumcised men with VMMC in strategically chosen populations may dramatically reduce community-level HIV incidence and save billions of dollars in HIV care and treatment costs. Because VMMC is a 1-time procedure that confers life-long partial protection against HIV, programs for adult men are vital short-term investments with long-term benefits. VMMC also provides a unique opportunity to reach boys and men with HIV testing and counseling services and referrals for other HIV services, including treatment. After formal recommendations by WHO in 2007, priority countries have pursued expansion of VMMC. More than 1 million males have received VMMC thus far, with the most notable successes coming from Kenya's Nyanza Province. However, a myriad of necessary cultural, political, and ethical considerations have moderated the pace of overall success. Because many millions more uncircumcised men would benefit from VMMC services now, US President Barack Obama committed PEPFAR to provide 4.7 million males with VMMC by 2014. Innovative circumcision methods-such as medical devices that remove the foreskin without injected anesthesia and/or sutures-are being rigorously evaluated. Incorporation of safe innovations into surgical VMMC programs may provide the opportunity to reach more men more quickly with services and dramatically reduce HIV incidence for all.

  17. Female genital mutilation.

    Science.gov (United States)

    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.

  18. Acceptability of early infant male circumcision among chinese parents: strategy implications of HIV prevention for china

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    Pan Lianjun

    2012-09-01

    Full Text Available Abstract Background Recent evidence has confirmed that circumcision can be performed as a preventive strategy for HIV and early infant male circumcision (EIMC is regarded to be safer than circumcision in adulthood; however, limited data are available in the literature about EIMC in China. Therefore, the present study was designed to determine the willingness and attitudes of Chinese parents on newborn male circumcision so as to provide data for exploring the feasibility of implementing EIMC as an HIV prevention strategy in China. Methods Simple random sampling was used to draw participants from parents who had a newborn son delivered at Nanjing Maternity and Child Health Care Hospital, which is affiliated to Nanjing Medical University, between March and December 2010. A questionnaire was used to determine general medical knowledge or information about circumcision, attitudes about EIMC, and level of decision-making on circumcision for the newborn son. Results Data derived from 558 responses were analyzed and the ratio of respondents was 56.3% for fathers and 43.6% for mothers. Of the respondents, 34.4% agreed to circumcise their newborn son, and the level of agreement was 3.25 ± 1.17 (range, 1–5 with “1” being “reluctantly agree” and “5” being “very strongly agree”. The major reason for EIMC was for health (44.8%, followed by doctor’s advice (31.2%. The major reason not to agree to EIMC was concern about pain (50.5%, followed by the risk of the procedure (23.5%. Conclusion The willingness and acceptability of EIMC in China is low and the parents of newborn sons are usually not very affirmative when making a decision on such a procedure, suggesting that significant effort will be needed if EIMC is to be implemented as an HIV prevention strategy for China.

  19. The emerging trend of self-circumcision and the need to define cause: Case report of a 21 year-old male

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    Ronald Kintu-Luwaga

    2016-01-01

    Conclusion: Cases of self-circumcision continue to emerge. There is need to report all cases, explore and manage the possible causes. The stigma uncircumcised males face among circumcised peers may be an important cause. Public health education and improved access to voluntary medical male circumcision services may help to prevent this practice.

  20. The Consideration of Socioeconomic Determinants in Prevention of Traditional Male Circumcision Deaths and Complications.

    Science.gov (United States)

    Douglas, Mbuyiselo; Hongoro, Charles

    2018-05-01

    The responsiveness to socioeconomic determinants is perceived as highly crucial in preventing the high mortality and morbidity rates of traditional male circumcision initiates in the Eastern Cape, a province in South Africa. The study sought to describe social determinants and explore economic determinants related to traditional circumcision of boys from 12 to 18 years of age in Libode rural communities in Eastern Cape Province. From the results of a descriptive cross-sectional survey ( n = 1,036), 956 (92.2%) boys preferred traditional male circumcision because of associated social determinants which included the variables for the attainment of social manhood values and benefits; 403 (38.9%) wanted to attain community respect; 347 (33.5%) wanted the accepted traditional male circumcision for hygienic purposes. The findings from the exploratory focus group discussions were revolving around variables associated with poverty, unemployment, and illegal actions to gain money. The three negative economic determinants were yielded as themes: (a) commercialization and profitmaking, (b) poverty and unemployment, (c) taking health risk for cheaper practices, and the last theme was the (d) actions suggested to prevent the problem. The study concluded with discussion and recommendations based on a developed strategic circumcision health promotion program which is considerate of socioeconomic determinants.

  1. Exposé of fallacious claims that male circumcision will increase HIV infections in Africa

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    Brian J. Morris

    2011-09-01

    Full Text Available Despite over two decades of extensive research showing that male circumcision protects against heterosexual acquisition of HIV in men, and that includes findings from large randomized controlled trials leading to acceptance by the WHO/UNAIDS and the Cochrane Committee, opponents of circumcision continue to generate specious arguments to the contrary. In a recent issue of the Journal of Public Health in Africa, Van Howe and Storms claim that male circumcision will increase HIV infections in Africa. Here we review the statements they use in support of their thesis and show that there is no scientific basis to such an assertion. We also evaluate the statistics used and show that when these data are properly analyzed the results lead to a contrary conclusion affirming the major role of male circumcision in protecting against HIV infection in Africa. Researchers, policy makers and the wider community should rely on balanced scholarship when assessing scientific evidence. We trust that our assessment may help refute the claims by Van Howe and Storms, and provide reassurance on the importance of circumcision for HIV prevention.

  2. Safe male circumcision in Botswana: tension between traditional practices and biomedical marketing.

    Science.gov (United States)

    Katisi, Masego; Daniel, Marguerite

    2015-01-01

    Botswana has been running Safe Male Circumcision (SMC) since 2009 and has not yet met its target. Donors like the US Centers for Disease Control and Prevention and Africa Comprehensive HIV/AIDS Partnership (funded by the Gates Foundation) in collaboration with Botswana's Ministry of Health have invested much to encourage HIV-negative men to circumcise. Demand creation strategies make use of media and celebrities. The objective of this paper is to explore responses to SMC in relation to circumcision as part of traditional initiation practices. More specifically, we present the views of two communities in Botswana on SMC consultation processes, implementation procedures and campaign strategies. The methods used include participant observation, in-depth interviews with key stakeholders (donors, implementers and Ministry officials), community leaders and men in the community. We observe that consultation with traditional leaders was done in a seemingly superficial, non-participatory manner. While SMC implementers reported pressure to deliver numbers to the World Health Organization, traditional leaders promoted circumcision through their routine traditional initiation ceremonies at breaks of two-year intervals. There were conflicting views on public SMC demand creation campaigns in relation to the traditional secrecy of circumcision. In conclusion, initial cooperation of local chiefs and elders turned into resistance.

  3. [Medieval scenes of ritual circumcision as a reflection of sociopolitical circumstances].

    Science.gov (United States)

    Pust, R A; Drost, C; Willerding, H; Bschleipfer, T

    2005-03-01

    Ritual circumcision in males is regarded as one of the oldest surgical procedures. Whereas their medieval illustrations are mostly interpreted within a religious context, this study tries to prove the influence of the political and social situation of the above-mentioned period.Selected iconography of ritual male circumcision in the Middle Ages from Germany, France, Italy, and the Byzantine Empire was critically examined. Special attention was paid to the stained glass windows recently returned to St. Mary's Church in Frankfurt/Oder, where circumcision of the so-called Antichrist is also shown. Up to now we could not find any medical historical information about this subject. Clerical fine art of the fifteenth and sixteenth centuries shows more frequently than before illustrations of ritual circumcision, which evidently demonstrate the political, economic, and social tensions and controversies of that period. In many cases this iconography indicates a rejection of this old Jewish tradition and its confessors. Also the stained glass image of the Antichrist posthetomy could be interpreted as criticism or aversion.This study expands our approach to medieval illustrations of ritual circumcision that have hitherto mostly been interpreted in religious terms. The influence of changing political and social situations in the Middle Ages is evident.

  4. Response to Vogelstein: How the 2012 AAP Task Force on circumcision went wrong.

    Science.gov (United States)

    Van Howe, Robert S

    2018-01-01

    Vogelstein cautions medical organizations against jumping into the fray of controversial issues, yet proffers the 2012 American Academy of Pediatrics' Task Force policy position on infant male circumcision as 'an appropriate use of position-statements.' Only a scratch below the surface of this policy statement uncovers the Task Force's failure to consider Vogelstein's many caveats. The Task Force supported the cultural practice by putting undeserved emphasis on questionable scientific data, while ignoring or underplaying the importance of valid contrary scientific data. Without any effort to quantitatively assess the risk/benefit balance, the Task Force concluded the benefits of circumcision outweighed the risks, while acknowledging that the incidence of risks was unknown. This Task Force differed from other Academy policy-forming panels by ignoring the Academy's standard quality measures and by not appointing members with extensive research experience, extensive publications, or recognized expertise directly related to this topic. Despite nearly 100 publications available at the time addressing the substantial ethical issues associated with infant male circumcision, the Task Force chose to ignore the ethical controversy. They merely stated, with minimal justification, the opinion of one of the Task Force members that the practice of infant male circumcision is morally permissible. The release of the report has fostered an explosion of academic discussion on the ethics of infant male circumcision with a number of national medical organizations now decrying the practice as a human rights violation. © 2017 John Wiley & Sons Ltd.

  5. Efficient and equitable HIV prevention: A case study of male circumcision in South Africa

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    Verguet Stéphane

    2013-01-01

    Full Text Available Abstract Background We determine efficient, equitable and mixed efficient-equitable allocations of a male circumcision (MC intervention reducing female to male HIV transmission in South Africa (SA, as a case study of an efficiency-equity framework for resource allocation in HIV prevention. Methods We present a mathematical model developed with epidemiological and cost data from the nine provinces of SA. The hypothetical one-year-long MC intervention with a budget of US$ 10 million targeted adult men 15–49 years of age in SA. The intervention was evaluated according to two criteria: an efficiency criterion, which focused on maximizing the number of HIV infections averted by the intervention, and an equity criterion (defined geographically, which focused on maximizing the chance that each male adult individual had access to the intervention regardless of his province. Results A purely efficient intervention would prevent 4,008 HIV infections over a year. In the meantime, a purely equitable intervention would avert 3,198 infections, which represents a 20% reduction in infection outcome as compared to the purely efficient scenario. A half efficient-half equitable scenario would prevent 3,749 infections, that is, a 6% reduction in infection outcome as compared to the purely efficient scenario. Conclusions This paper provides a framework for resource allocation in the health sector which incorporates a simple equity metric in addition to efficiency. In the specific context of SA with a MC intervention for the prevention of HIV, incorporation of geographical equity only slightly reduces the overall efficiency of the intervention.

  6. Willingness of men who have sex with men (MSM in the United States to be circumcised as adults to reduce the risk of HIV infection.

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    Elin B Begley

    Full Text Available BACKGROUND: Circumcision reduces HIV acquisition among heterosexual men in Africa, but it is unclear if circumcision may reduce HIV acquisition among men who have sex with men (MSM in the United States, or whether MSM would be willing to be circumcised if recommended. METHODS: We interviewed presumed-HIV negative MSM at gay pride events in 2006. We asked uncircumcised respondents about willingness to be circumcised if it were proven to reduce risk of HIV among MSM and perceived barriers to circumcision. Multivariate logistic regression was used to identify covariates associated with willingness to be circumcised. RESULTS: Of 780 MSM, 133 (17% were uncircumcised. Of these, 71 (53% were willing to be circumcised. Willingness was associated with black race (exact odds ratio [OR]: 3.4, 95% confidence interval [CI]: 1.3-9.8, non-injection drug use (OR: 6.1, 95% CI: 1.8-23.7 and perceived reduced risk of penile cancer (OR: 4.7, 95% CI: 2.0-11.9. The most commonly endorsed concerns about circumcision were post-surgical pain and wound infection. CONCLUSIONS: Over half of uncircumcised MSM, especially black MSM, expressed willingness to be circumcised. Perceived risks and benefits of circumcision should be a part of educational materials if circumcision is recommended for MSM in the United States.

  7. Does male circumcision affect sexual function, sensitivity, or satisfaction?--a systematic review.

    Science.gov (United States)

    Morris, Brian J; Krieger, John N

    2013-11-01

    Circumcision of males is commonly carried out worldwide for reasons of health, medical need, esthetics, tradition, or religion. Whether circumcision impairs or improves male sexual function or pleasure is controversial. The study aims to conduct a systematic review of the scientific literature. A systematic review of published articles retrieved using keyword searches of the PubMed, EMBASE, and Cochrane databases was performed. The main outcome measure is the assessment of findings in publications reporting original data relevant to the search terms and rating of quality of each study based on established criteria. Searches identified 2,675 publications describing the effects of male circumcision on aspects of male sexual function, sensitivity, sensation, or satisfaction. Of these, 36 met our inclusion criteria of containing original data. Those studies reported a total of 40,473 men, including 19,542 uncircumcised and 20,931 circumcised. Rated by the Scottish Intercollegiate Guidelines Network grading system, 2 were 1++ (high quality randomized controlled trials) and 34 were case-control or cohort studies (11 high quality: 2++; 10 well-conducted: 2+; 13 low quality: 2-). The 1++, 2++, and 2+ studies uniformly found that circumcision had no overall adverse effect on penile sensitivity, sexual arousal, sexual sensation, erectile function, premature ejaculation, ejaculatory latency, orgasm difficulties, sexual satisfaction, pleasure, or pain during penetration. Support for these conclusions was provided by a meta-analysis. Impairment in one or more parameters was reported in 10 of the 13 studies rated as 2-. These lower-quality studies contained flaws in study design (11), selection of cases and/or controls (5), statistical analysis (4), and/or data interpretation (6); five had multiple problems. The highest-quality studies suggest that medical male circumcision has no adverse effect on sexual function, sensitivity, sexual sensation, or satisfaction. © 2013

  8. Factors contributing to the low uptake of medical male circumcision in Mutare Rural District, Zimbabwe

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    Irene O. Chiringa

    2016-05-01

    Full Text Available Background: Medical male circumcision (MMC has become a significant dimension of HIV prevention interventions, after the results of three randomised controlled trials in Uganda, South Africa and Kenya demonstrated that circumcision has a protective effect against contracting HIV of up to 60%. Following recommendations by the World Health Organization, Zimbabwe in 2009 adopted voluntary MMC as an additional HIV prevention strategy to the existing ABC behaviour change model. Purpose: The purpose of this study is thus to investigate the factors contributing to the low uptake of MMC. Methods: The study was a quantitative cross-sectional survey conducted in Mutare rural district, Zimbabwe. Questionnaires with open- and closed-ended questions were administered to the eligible respondents. The target population were male participants aged 15–29 who met the inclusion criteria. The households were systematically selected with a sample size of 234. Statistical Package for the Social Sciences was used to analyse the data. Results: Socioculturally, circumcised men are viewed as worthless (37%, shameful (30% and are tainted as promiscuous (20%, psychological factors reported were infection and delayed healing (39%, being ashamed and dehumanised (58%, stigmatised and discriminated (40.2% and fear of having an erection during treatment period (89.7% whilst socio-economic factors were not having time, as it will take their time from work (58% and complications may arise leading to spending money on treatment (84%. Conclusion: Knowledge deficits regarding male medical circumcision lead to low uptake, education on male medical circumcision and its benefits. Comprehensive sexual health education should target men and dispel negative attitudes related to the use of health services. Keywords: Factors, Low uptake, Medical Male Circumcision (MMC

  9. Acceptability of early infant male circumcision as an HIV prevention intervention in Zimbabwe: a qualitative perspective.

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    Webster Mavhu

    Full Text Available BACKGROUND: Early infant male circumcision (EIMC is simpler, safer and more cost-effective than adult circumcision. In sub-Saharan Africa, there are concerns about acceptability of EIMC which could affect uptake. In 2009 a quantitative survey of 2,746 rural Zimbabweans (aged 18-44 indicated that 60% of women and 58% of men would be willing to have their newborn son circumcised. Willingness was associated with knowledge of HIV and male circumcision. This qualitative study was conducted to better understand this issue. METHODS: In 2010, 24 group discussions were held across Zimbabwe with participants from seven ethnic groups. Additionally, key informant interviews were held with private paediatricians who offer EIMC (n = 2 plus one traditional leader. Discussions were audio-recorded, transcribed, translated into English (where necessary, coded using NVivo 8 and analysed using grounded theory principles. RESULTS: Knowledge of the procedure was poor. Despite this, acceptability of EIMC was high among parents from most ethnic groups. Discussions suggested that fathers would make the ultimate decision regarding EIMC although mothers and extended family can have (often covert influence. Participants' concerns centred on: safety, motive behind free service provision plus handling and disposal of the discarded foreskin. Older men from the dominant traditionally circumcising population strongly opposed EIMC, arguing that it separates circumcision from adolescent initiation, as well as allowing women (mothers to nurse the wound, considered taboo. CONCLUSIONS: EIMC is likely to be an acceptable HIV prevention intervention for most populations in Zimbabwe, if barriers to uptake are appropriately addressed and fathers are specifically targeted by the programme.

  10. Infant male circumcision and the autonomy of the child: two ethical questions.

    Science.gov (United States)

    McMath, Akim

    2015-08-01

    Routine neonatal circumcision--the non-therapeutic circumcision of infant males--has generated considerable ethical controversy. In this article, I suggest that much of the disagreement results from conflicting ideas about the autonomy of the child. I examine two questions about autonomy. First, I ask whether we should be realists or idealists about the future autonomous choices of the child-that is, whether we should account for the fact that the child may not make the best choices in future, or whether we should assume that his future choices will reflect his best interests. Second, I ask whether the child has a right to autonomy with respect to circumcision, an interest in autonomy or neither--that is, whether respect for autonomy overrides considerations of interests, whether it counts as one interest among many or whether it counts for nothing. In response to the first question, I argue that we should be idealists when evaluating the child's own interests, but realists when evaluating public health justifications for circumcision. In response to the second question, I argue that the child has an interest in deciding whether or not to be circumcised, insofar as the decision is more likely to reflect his actual interests and his own values. Finally, I show how these findings may help to resolve some particular disputes over the ethics of infant male circumcision. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  11. Complication rate after circumcision in a paediatric surgical setting should not be neglected

    DEFF Research Database (Denmark)

    Thorup, Jørgen; Thorup, Sebastian Cortes; Ifaoui, Inge Botker Rasmussen

    2013-01-01

    INTRODUCTION: As a consequence of the discussion on whether the health benefits of newborn male circumcision outweigh the risks and the discrepancies in reported figures of complications, we evaluated our results from a paediatric surgical department. MATERIAL AND METHODS: Patient file data from......: Parents should be counselled and be required to provide informed consent that any health benefits of childhood circumcision do not outweigh the reported complication rate and that therefore they should weigh the health benefits against the risks in light of their religious, cultural and personal...

  12. Evaluation of a safer male circumcision training programme for traditional surgeons and nurses in the Eastern Cape, South Africa.

    Science.gov (United States)

    Peltzer, Karl; Nqeketo, Ayanda; Petros, George; Kanta, Xola

    2008-06-18

    Training designed to improve circumcision knowledge, attitude and practice was delivered over 5 days to 34 traditional surgeons and 49 traditional nurses in the Eastern Cape, South Africa. Training included the following topics: initiation rites; statutory regulation of traditional male circumcision and initiation into Manhood (TCIM); structure and function of the male sex organs; procedure of safe circumcision, infection control; sexually transmitted infections (STIs); HIV/AIDS; infection control measures; aftercare of the initiate including after care of the circumcision wound and initiate as a whole; detection and early management of common complications of circumcision; nutrition and fluid management; code of conduct and ethics; and sexual health education. The evaluation of the training consisted of a prospective assessment of knowledge and attitude immediately prior to and after training. Significant improvement in knowledge and/or attitudes was observed in legal aspects, STI, HIV and environmental aspects, attitudes in terms of improved collaboration with biomedical health care providers, normal and abnormal anatomy and physiology, sexually transmitted infections and including HIV, circumcision practice and aftercare of initiates. We concluded that safer circumcision training can be successfully delivered to traditional surgeons and nurses.

  13. 'Not men enough to rule!': politicization of ethnicities and forcible circumcision of Luo men during the postelection violence in Kenya.

    Science.gov (United States)

    Ahlberg, Beth Maina; Njoroge, Kezia Muthoni

    2013-10-01

    As a contribution to ongoing research addressing sexual violence in war and conflict situations in the Democratic Republic of Congo, Kenya and Rwanda, this paper argues that the way sexual violence intersects with other markers of identity, including ethnicity and class, is not clearly articulated. Male circumcision has been popularized, as a public health strategy for prevention of HIV transmission, although evidence of its efficacy is disputable and insufficient attention has been given to the social and cultural implications of male circumcision. This paper draws from media reporting and the material supporting the prosecutor at the International Criminal Court case against four Kenyans accused of crimes against humanity, to explore the postelection violence, especially forcible male circumcision. During the postelection violence in Kenya, women were, as in other conflict situations, raped. In addition, men largely from the Luo ethnic group were forcibly circumcised. Male circumcision among the Gikuyu people is a rite of passage, but when forced upon the Luo men, it was also associated with cases of castration and other forms of genital mutilation. The aim appears to have been to humiliate and terrorize not just the individual men, but their entire communities. The paper examines male circumcision and questions why a ritual that has marked a life-course transition for inculcating ethical analysis of the self and others, became a tool of violence against men from an ethnic group where male circumcision is not a cultural practice. The paper then reviews the persistence and change in the ritual and more specifically, how male circumcision has become, not just a sexual health risk, but, contrary to the emerging health discourse and more significantly, a politicized ethnic tool and a status symbol among the Gikuyu elite. In the view of the way male circumcision was perpetrated in Kenya, we argue it should be considered as sexual violence, with far

  14. Prevalence and risk factors for female sexual dysfunction among Egyptian women.

    Science.gov (United States)

    Ibrahim, Zakia Mahdy; Ahmed, Magdy Refaat; Sayed Ahmed, Waleed Ali

    2013-06-01

    To assess sexual function among married women and determine associated risk factors for sexual dysfunction. Cross-sectional hospital-based study involving 509 non-pregnant married females 20-59 years old who were enrolled into the study after approval of the ethics committee. The study population was recruited among women attending gynecology outpatient clinic or their relatives visiting inpatients of obstetrics and gynecology department at Suez Canal University Hospital. Female and male partner-related data were collected using an interview questionnaire. Sexual dysfunction was assessed using female sexual function index (FSFI). Mean female age was 39.5 years. About half of the participants were premenopausal (48.7 %). Most of the females were circumcised (71.7 %). Desire and Orgasm domains were the most affected with 52.8 % of the participants having sexual dysfunction. Total FSFI score of ≤26.55 was the cutoff value for diagnosis of FSD and female age, postmenopausal status, duration of marriage, circumcision, partner's age, and the presence of male sexual dysfunction were found to be significant associated factors with FSD. FSD is highly prevalent in Egypt and orgasm and desire scores were the most affected domains. Several personal (female age, postmenopausal status, duration of marriage and circumcision) and male partner (age, and the presence of sexual dysfunction) factors were significantly associated.

  15. Determinants of Male Circumcision for HIV/AIDS Prevention in East ...

    African Journals Online (AJOL)

    AJRH Managing Editor

    perceived health and sexual benefits and desire to conform to social norms7. Findings of earlier studies in Uganda revealed that reasons for MC were mainly associated with culture and religion12,13,14, although HIV prevention benefits are still realized. Ethnicity is a significant predictor of Male Circumcision (MC) in ...

  16. An exploration of the knowledge, attitudes and beliefs of Xhosa men concerning traditional circumcision

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    Salome Froneman

    2017-10-01

    Conclusion: Traditional initiation and circumcision are here to stay. The majority of boys still trust the elders and supernatural processes to guide them. However, some participants welcomed government initiatives to reduce human error causing unnecessary death and suffering. Current systems to prevent morbidity and mortality are insufficient and should be prioritised.

  17. Male Circumcision and HIV/AIDS Risk – Analysis of the Scientific ...

    African Journals Online (AJOL)

    ra

    ABSTRACT. Objective: The aim of this review was to evaluate the scientific evidence supporting the hypo- thesis that male circumcision reduces the risk of HIV infection and consequently the incidence of acquired immunodeficiency syndrome (AIDS). Patients and Methods: We performed a literature search of the major ...

  18. After Cologne: male circumcision and the law. Parental right, religious liberty or criminal assault?

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    Merkel, Reinhard; Putzke, Holm

    2013-07-01

    Non-therapeutic circumcision violates boys' right to bodily integrity as well as to self-determination. There is neither any verifiable medical advantage connected with the intervention nor is it painless nor without significant risks. Possible negative consequences for the psychosexual development of circumcised boys (due to substantial loss of highly erogenous tissue) have not yet been sufficiently explored, but appear to ensue in a significant number of cases. According to standard legal criteria, these considerations would normally entail that the operation be deemed an 'impermissible risk'-neither justifiable on grounds of parental rights nor of religious liberty: as with any other freedom right, these end where another person's body begins. Nevertheless, after a resounding decision by a Cologne district court that non-therapeutic circumcision constitutes bodily assault, the German legislature responded by enacting a new statute expressly designed to permit male circumcision even outside of medical settings. We first criticise the normative foundations upon which such a legal concession seems to rest, and then analyse two major flaws in the new German law which we consider emblematic of the difficulty that any legal attempt to protect medically irrelevant genital cutting is bound to face.

  19. Universelle kramper og respirationsstop som komplikation i forbindelse med lokalanalgesi ved circumcision

    DEFF Research Database (Denmark)

    Heiberg, Ida Louise; Nebrich, Lars; Pedersen, Pernille

    2015-01-01

    We present two cases in which two boys of four weeks and four and a half months, respectively, experienced seizures and respiratory insufficiency as complications to the local anaesthesia administered for ritual circumcision. They both needed intubation and anticonvulsive therapy and acquired...

  20. Reasons for the low uptake of adult male circumcision for the ...

    African Journals Online (AJOL)

    Swaziland is currently experiencing the worst impact of HIV and AIDS of any country in the world. In an effort to curb further spread of the virus, the country adopted mass male circumcision (MC) as recommended by the World Health Organization in 2007. Despite intense campaigns to promote the procedure over the past ...

  1. Assessment of the Effect of Male Circumcision on HIV Infection and ...

    African Journals Online (AJOL)

    samson

    Sub-Saharan Africa was conducted to assess the protective effect of male circumcision from HIV .... world and contains most of the least developed ... List of 18 Demographic Health Surveys Included in the Analysis. ... tion and economical status), access to mass media. (frequency of watching television, listening radio and.

  2. Circumscribing the Body Politic : Circumcision, Religious Freedom and Identity in Europe

    NARCIS (Netherlands)

    McIvor, Méadhbh

    2018-01-01

    In February 2018, Icelandic Member of Parliament Silja Dögg Gunnarsdóttir made international news by proposing a bill that would criminalise the circumcision of male children for non-medical reasons. The bill, which is supported by the ruling Progressive Party and Left-Green coalition, has sparked

  3. Complication rate after circumcision in a paediatric surgical setting should not be neglected

    DEFF Research Database (Denmark)

    Thorup, Jørgen; Thorup, Sebastian Cortes; Ifaoui, Inge Botker Rasmussen

    2013-01-01

    : Parents should be counselled and be required to provide informed consent that any health benefits of childhood circumcision do not outweigh the reported complication rate and that therefore they should weigh the health benefits against the risks in light of their religious, cultural and personal...

  4. Cultural bias in the AAP's 2012 Technical Report and Policy Statement on male circumcision.

    Science.gov (United States)

    Frisch, Morten; Aigrain, Yves; Barauskas, Vidmantas; Bjarnason, Ragnar; Boddy, Su-Anna; Czauderna, Piotr; de Gier, Robert P E; de Jong, Tom P V M; Fasching, Günter; Fetter, Willem; Gahr, Manfred; Graugaard, Christian; Greisen, Gorm; Gunnarsdottir, Anna; Hartmann, Wolfram; Havranek, Petr; Hitchcock, Rowena; Huddart, Simon; Janson, Staffan; Jaszczak, Poul; Kupferschmid, Christoph; Lahdes-Vasama, Tuija; Lindahl, Harry; MacDonald, Noni; Markestad, Trond; Märtson, Matis; Nordhov, Solveig Marianne; Pälve, Heikki; Petersons, Aigars; Quinn, Feargal; Qvist, Niels; Rosmundsson, Thrainn; Saxen, Harri; Söder, Olle; Stehr, Maximilian; von Loewenich, Volker C H; Wallander, Johan; Wijnen, Rene

    2013-04-01

    The American Academy of Pediatrics recently released its new Technical Report and Policy Statement on male circumcision, concluding that current evidence indicates that the health benefits of newborn male circumcision outweigh the risks. The technical report is based on the scrutiny of a large number of complex scientific articles. Therefore, while striving for objectivity, the conclusions drawn by the 8 task force members reflect what these individual physicians perceived as trustworthy evidence. Seen from the outside, cultural bias reflecting the normality of nontherapeutic male circumcision in the United States seems obvious, and the report's conclusions are different from those reached by physicians in other parts of the Western world, including Europe, Canada, and Australia. In this commentary, a different view is presented by non-US-based physicians and representatives of general medical associations and societies for pediatrics, pediatric surgery, and pediatric urology in Northern Europe. To these authors, only 1 of the arguments put forward by the American Academy of Pediatrics has some theoretical relevance in relation to infant male circumcision; namely, the possible protection against urinary tract infections in infant boys, which can easily be treated with antibiotics without tissue loss. The other claimed health benefits, including protection against HIV/AIDS, genital herpes, genital warts, and penile cancer, are questionable, weak, and likely to have little public health relevance in a Western context, and they do not represent compelling reasons for surgery before boys are old enough to decide for themselves.

  5. Determinants of Male Circumcision for HIV/AIDS Prevention in East ...

    African Journals Online (AJOL)

    Safe Male Circumcision (SMC) is one the effective strategies for reducing HIV transmission. The paper examines factors associated with SMC for HIV prevention, based on 4,979 males from East Central Uganda. Data were analysed using chi-squared tests and multinomial logistic regression. Older males aged 31 years ...

  6. Traditional male circumcision in Uganda: a qualitative focus group discussion analysis.

    Science.gov (United States)

    Sabet Sarvestani, Amir; Bufumbo, Leonard; Geiger, James D; Sienko, Kathleen H

    2012-01-01

    The growing body of evidence attesting to the effectiveness of clinical male circumcision in the prevention of HIV/AIDS transmission is prompting the majority of sub-Saharan African governments to move towards the adoption of voluntary medical male circumcision (VMMC). Even though it is recommended to consider collaboration with traditional male circumcision (TMC) providers when planning for VMMC, there is limited knowledge available about the TMC landscape and traditional beliefs. During 2010-11 over 25 focus group discussions (FGDs) were held with clan leaders, traditional cutters, and their assistants to understand the practice of TMC in four ethnic groups in Uganda. Cultural significance and cost were among the primary reasons cited for preferring TMC over VMMC. Ethnic groups in western Uganda circumcised boys at younger ages and encountered lower rates of TMC related adverse events compared to ethnic groups in eastern Uganda. Cutting styles and post-cut care also differed among the four groups. The use of a single razor blade per candidate instead of the traditional knife was identified as an important and recent change. Participants in the focus groups expressed interest in learning about methods to reduce adverse events. This work reaffirmed the strong cultural significance of TMC within Ugandan ethnic groups. Outcomes suggest that there is an opportunity to evaluate the involvement of local communities that still perform TMC in the national VMMC roll-out plan by devising safer, more effective procedures through innovative approaches.

  7. Male circumcision for HIV prevention: current evidence and implementation in sub-Saharan Africa

    Science.gov (United States)

    2011-01-01

    Heterosexual exposure accounts for most HIV transmission in sub-Saharan Africa, and this mode, as a proportion of new infections, is escalating globally. The scientific evidence accumulated over more than 20 years shows that among the strategies advocated during this period for HIV prevention, male circumcision is one of, if not, the most efficacious epidemiologically, as well as cost-wise. Despite this, and recommendation of the procedure by global policy makers, national implementation has been slow. Additionally, some are not convinced of the protective effect of male circumcision and there are also reports, unsupported by evidence, that non-sex-related drivers play a major role in HIV transmission in sub-Saharan Africa. Here, we provide a critical evaluation of the state of the current evidence for male circumcision in reducing HIV infection in light of established transmission drivers, provide an update on programmes now in place in this region, and explain why policies based on established scientific evidence should be prioritized. We conclude that the evidence supports the need to accelerate the implementation of medical male circumcision programmes for HIV prevention in generalized heterosexual epidemics, as well as in countering the growing heterosexual transmission in countries where HIV prevalence is presently low. PMID:22014096

  8. International efforts on abandoning female genital mutilation

    Directory of Open Access Journals (Sweden)

    E. Edouard

    2013-09-01

    Full Text Available Female genital mutilation (FGM, sometimes referred to as female circumcision or female genital cutting, is a harmful cultural practice without any known health benefit. Its short-term and long-term health risks have led to numerous initiatives toward its eradication at international and local levels, over the last two decades. While major challenges remain and millions of girls and women are still at risk of being subjected to FGM, there is growing evidence that interventions that take into account the social dynamics that perpetuate FGM are yielding positive results toward its reduction. Well-recognized as a human rights violation in international treaties, the elimination of female genital mutilation requires ongoing interventions through cross-sectoral approaches that address attitudinal, cultural and behavioral change.

  9. Factors associated with the acceptability of male circumcision among men in Jamaica.

    Directory of Open Access Journals (Sweden)

    Melonie M Walcott

    Full Text Available To determine the prevalence of male circumcision (MC among men in the western region of Jamaica, and to identify factors associated with acceptability of MC for self, infants (<1 year and older sons (1-17 years.A cross-sectional, interviewer-administered questionnaire survey of 549 men aged 19-54 years was conducted in the western region of Jamaica. The survey included questions about the acceptance of MC for self, infants, and sons before and after an information session about the benefits of MC in preventing HIV/STI transmission. Logistic regression models were used to identify factors that were associated with acceptability of MC. Adjusted odds ratios (AOR and 95% confidence intervals (CI were calculated from the models.Fourteen percent of the men reported that they were circumcised. In the multivariable model, which adjusted for age, education, religion and income, there were increased odds of accepting MC for infants/sons among uncircumcised men who accepted MC for self (AOR=8.1; 95% CI = 4.1-15.9, believed they would experience more pleasure during sex if circumcised (AOR=4.0; 95% CI = 2.0-8.2, and reported having no concerns regarding MC (AOR=3.0; 95% CI = 1.8-4.8. Similarly, uncircumcised men who reported no concerns about MC or who believed that they would experience more pleasure during sex if circumcised were more likely to accept MC for self.Providing men with information about MC increased acceptance of MC for self, infants (<17 years and sons (1-17 years. Since targeted education on the benefits of male circumcision for prevention of HIV/STI can be effective in increasing acceptability of MC, health professionals should be trained, and willing to discuss MC with men in healthcare facilities and in the community.

  10. Scaling-up voluntary medical male circumcision - what have we learned?

    Science.gov (United States)

    Ledikwe, Jenny H; Nyanga, Robert O; Hagon, Jaclyn; Grignon, Jessica S; Mpofu, Mulamuli; Semo, Bazghina-Werq

    2014-01-01

    In 2007, the World Health Organization (WHO) and the joint United Nations agency program on HIV/AIDS (UNAIDS) recommended voluntary medical male circumcision (VMMC) as an add-on strategy for HIV prevention. Fourteen priority countries were tasked with scaling-up VMMC services to 80% of HIV-negative men aged 15-49 years by 2016, representing a combined target of 20 million circumcisions. By December 2012, approximately 3 million procedures had been conducted. Within the following year, there was marked improvement in the pace of the scale-up. During 2013, the total number of circumcisions performed nearly doubled, with approximately 6 million total circumcisions conducted by the end of the year, reaching 30% of the initial target. The purpose of this review article was to apply a systems thinking approach, using the WHO health systems building blocks as a framework to examine the factors influencing the scale-up of the VMMC programs from 2008-2013. Facilitators that accelerated the VMMC program scale-up included: country ownership; sustained political will; service delivery efficiencies, such as task shifting and task sharing; use of outreach and mobile services; disposable, prepackaged VMMC kits; external funding; and a standardized set of indicators for VMMC. A low demand for the procedure has been a major barrier to achieving circumcision targets, while weak supply chain management systems and the lack of adequate financial resources with a heavy reliance on donor support have also adversely affected scale-up. Health systems strengthening initiatives and innovations have progressively improved VMMC service delivery, but an understanding of the contextual barriers and the facilitators of demand for the procedure is critical in reaching targets. There is a need for countries implementing VMMC programs to share their experiences more frequently to identify and to enhance best practices by other programs.

  11. Modeling the Impact of Uganda's Safe Male Circumcision Program: Implications for Age and Regional Targeting.

    Science.gov (United States)

    Kripke, Katharine; Vazzano, Andrea; Kirungi, William; Musinguzi, Joshua; Opio, Alex; Ssempebwa, Rhobbinah; Nakawunde, Susan; Kyobutungi, Sheila; Akao, Juliet N; Magala, Fred; Mwidu, George; Castor, Delivette; Njeuhmeli, Emmanuel

    2016-01-01

    Uganda aims to provide safe male circumcision (SMC) to 80% of men ages 15-49 by 2016. To date, only 2 million men have received SMC of the 4.2 million men required. In response to age and regional trends in SMC uptake, the country sought to re-examine its targets with respect to age and subnational region, to assess the program's progress, and to refine the implementation approach. The Decision Makers' Program Planning Tool, Version 2.0 (DMPPT 2.0), was used in conjunction with incidence projections from the Spectrum/AIDS Impact Module (AIM) to conduct this analysis. Population, births, deaths, and HIV incidence and prevalence were used to populate the model. Baseline male circumcision prevalence was derived from the 2011 AIDS Indicator Survey. Uganda can achieve the most immediate impact on HIV incidence by circumcising men ages 20-34. This group will also require the fewest circumcisions for each HIV infection averted. Focusing on men ages 10-19 will offer the greatest impact over a 15-year period, while focusing on men ages 15-34 offers the most cost-effective strategy over the same period. A regional analysis showed little variation in cost-effectiveness of scaling up SMC across eight regions. Scale-up is cost-saving in all regions. There is geographic variability in program progress, highlighting two regions with low baseline rates of circumcision where additional efforts will be needed. Focusing SMC efforts on specific age groups and regions may help to accelerate Uganda's SMC program progress. Policy makers in Uganda have already used model outputs in planning efforts, proposing males ages 10-34 as a priority group for SMC in the 2014 application to the Global Fund's new funding model. As scale-up continues, the country should also consider a greater effort to expand SMC in regions with low MC prevalence.

  12. Modeling the Impact of Uganda's Safe Male Circumcision Program: Implications for Age and Regional Targeting.

    Directory of Open Access Journals (Sweden)

    Katharine Kripke

    Full Text Available Uganda aims to provide safe male circumcision (SMC to 80% of men ages 15-49 by 2016. To date, only 2 million men have received SMC of the 4.2 million men required. In response to age and regional trends in SMC uptake, the country sought to re-examine its targets with respect to age and subnational region, to assess the program's progress, and to refine the implementation approach.The Decision Makers' Program Planning Tool, Version 2.0 (DMPPT 2.0, was used in conjunction with incidence projections from the Spectrum/AIDS Impact Module (AIM to conduct this analysis. Population, births, deaths, and HIV incidence and prevalence were used to populate the model. Baseline male circumcision prevalence was derived from the 2011 AIDS Indicator Survey. Uganda can achieve the most immediate impact on HIV incidence by circumcising men ages 20-34. This group will also require the fewest circumcisions for each HIV infection averted. Focusing on men ages 10-19 will offer the greatest impact over a 15-year period, while focusing on men ages 15-34 offers the most cost-effective strategy over the same period. A regional analysis showed little variation in cost-effectiveness of scaling up SMC across eight regions. Scale-up is cost-saving in all regions. There is geographic variability in program progress, highlighting two regions with low baseline rates of circumcision where additional efforts will be needed.Focusing SMC efforts on specific age groups and regions may help to accelerate Uganda's SMC program progress. Policy makers in Uganda have already used model outputs in planning efforts, proposing males ages 10-34 as a priority group for SMC in the 2014 application to the Global Fund's new funding model. As scale-up continues, the country should also consider a greater effort to expand SMC in regions with low MC prevalence.

  13. Male circumcision and risk of syphilis, chancroid, and genital herpes: a systematic review and meta-analysis.

    Science.gov (United States)

    Weiss, H A; Thomas, S L; Munabi, S K; Hayes, R J

    2006-04-01

    Male circumcision is associated with reduced risk of HIV infection. This may be partly because of a protective effect of circumcision on other sexually transmitted infections (STI), especially those causing genital ulcers, but evidence for such protection is unclear. Our objective was to conduct a systematic review and meta-analyses of the associations between male circumcision and infection with herpes simplex virus type 2 (HSV-2), Treponema pallidum, or Haemophilus ducreyi. Electronic databases (1950-2004) were searched using keywords and text terms for herpes simplex, syphilis, chancroid, ulcerative sexually transmitted diseases, or their causative agents, in conjunction with terms to identify epidemiological studies. References of key articles were hand searched, and data were extracted using standardised forms. Random effects models were used to summarise relative risk (RR) where appropriate. 26 articles met the inclusion criteria. Most syphilis studies reported a substantially reduced risk among circumcised men (summary RR = 0.67, 95% confidence interval (CI) 0.54 to 0.83), although there was significant between study heterogeneity (p = 0.01). The reduced risk of HSV-2 infection was of borderline statistical significance (summary RR = 0.88, 95% CI 0.77 to 1.01). Circumcised men were at lower risk of chancroid in six of seven studies (individual study RRs: 0.12 to 1.11). This first systematic review of male circumcision and ulcerative STI strongly indicates that circumcised men are at lower risk of chancroid and syphilis. There is less association with HSV-2. Potential male circumcision interventions to reduce HIV in high risk populations may provide additional benefit by protecting against other STI.

  14. Male circumcision and risk of syphilis, chancroid, and genital herpes: a systematic review and meta‐analysis

    Science.gov (United States)

    Weiss, H A; Thomas, S L; Munabi, S K; Hayes, R J

    2006-01-01

    Objectives Male circumcision is associated with reduced risk of HIV infection. This may be partly because of a protective effect of circumcision on other sexually transmitted infections (STI), especially those causing genital ulcers, but evidence for such protection is unclear. Our objective was to conduct a systematic review and meta‐analyses of the associations between male circumcision and infection with herpes simplex virus type 2 (HSV‐2), Treponema pallidum, or Haemophilus ducreyi. Methods Electronic databases (1950–2004) were searched using keywords and text terms for herpes simplex, syphilis, chancroid, ulcerative sexually transmitted diseases, or their causative agents, in conjunction with terms to identify epidemiological studies. References of key articles were hand searched, and data were extracted using standardised forms. Random effects models were used to summarise relative risk (RR) where appropriate. Results 26 articles met the inclusion criteria. Most syphilis studies reported a substantially reduced risk among circumcised men (summary RR = 0.67, 95% confidence interval (CI) 0.54 to 0.83), although there was significant between study heterogeneity (p = 0.01). The reduced risk of HSV‐2 infection was of borderline statistical significance (summary RR = 0.88, 95% CI 0.77 to 1.01). Circumcised men were at lower risk of chancroid in six of seven studies (individual study RRs: 0.12 to 1.11). Conclusions This first systematic review of male circumcision and ulcerative STI strongly indicates that circumcised men are at lower risk of chancroid and syphilis. There is less association with HSV‐2. Potential male circumcision interventions to reduce HIV in high risk populations may provide additional benefit by protecting against other STI. PMID:16581731

  15. Circumstances surrounding aneurysmal subarachnoid hemorrhage

    NARCIS (Netherlands)

    Schievink, W. I.; Karemaker, J. M.; Hageman, L. M.; van der Werf, D. J.

    1989-01-01

    The circumstances surrounding aneurysmal subarachnoid hemorrhage were investigated in a group of 500 consecutive patients admitted to a neurosurgical center. Subarachnoid hemorrhage occurred during stressful events in 42.8% of the patients, during nonstrenuous activities in 34.4%, and during rest or

  16. Ability and willingness to pay for voluntary medical male circumcision: a cross-sectional survey in Kisumu County, Kenya.

    Science.gov (United States)

    Wandei, Stephen; Nangami, Mabel; Egesa, Omar

    2016-01-01

    Voluntary medical male circumcision is one of the most effective measures in preventing male acquisition of HIV during heterosexual intercourse. In Kenya, the voluntary medical male circumcision programme was launched in the year 2008 as part of a comprehensive national HIV prevention strategy. With the global challenge of funding HIV intervention programs, the sustainability of the programme beyond the donor periods need to be assessed. The purpose of this study was to determine the household ability and willingness to pay for voluntary medical male circumcision as an alternative method of funding the programme. The findings show that 62.2% of the households were "able" to pay for medical circumcision. However, 60.4% of them were not "willing" to pay for the service regardless of the cost. The findings indicate that ability to pay is not a significant predictor of willingness to pay for voluntary medical male circumcision within Kisumu County. Knowledge on the role of medical circumcision is a more important factor in determining willingness to pay for the service.

  17. Voluntary Medical Male Circumcision: Logistics, Commodities, and Waste Management Requirements for Scale-Up of Services

    Science.gov (United States)

    Edgil, Dianna; Stankard, Petra; Forsythe, Steven; Rech, Dino; Chrouser, Kristin; Adamu, Tigistu; Sakallah, Sameer; Thomas, Anne Goldzier; Albertini, Jennifer; Stanton, David; Dickson, Kim Eva; Njeuhmeli, Emmanuel

    2011-01-01

    Background The global HIV prevention community is implementing voluntary medical male circumcision (VMMC) programs across eastern and southern Africa, with a goal of reaching 80% coverage in adult males by 2015. Successful implementation will depend on the accessibility of commodities essential for VMMC programming and the appropriate allocation of resources to support the VMMC supply chain. For this, the United States President’s Emergency Plan for AIDS Relief, in collaboration with the World Health Organization and the Joint United Nations Programme on HIV/AIDS, has developed a standard list of commodities for VMMC programs. Methods and Findings This list of commodities was used to inform program planning for a 1-y program to circumcise 152,000 adult men in Swaziland. During this process, additional key commodities were identified, expanding the standard list to include commodities for waste management, HIV counseling and testing, and the treatment of sexually transmitted infections. The approximate costs for the procurement of commodities, management of a supply chain, and waste disposal, were determined for the VMMC program in Swaziland using current market prices of goods and services. Previous costing studies of VMMC programs did not capture supply chain costs, nor the full range of commodities needed for VMMC program implementation or waste management. Our calculations indicate that depending upon the volume of services provided, supply chain and waste management, including commodities and associated labor, contribute between US$58.92 and US$73.57 to the cost of performing one adult male circumcision in Swaziland. Conclusions Experience with the VMMC program in Swaziland indicates that supply chain and waste management add approximately US$60 per circumcision, nearly doubling the total per procedure cost estimated previously; these additional costs are used to inform the estimate of per procedure costs modeled by Njeuhmeli et al. in “Voluntary Medical

  18. Voluntary medical male circumcision: logistics, commodities, and waste management requirements for scale-up of services.

    Directory of Open Access Journals (Sweden)

    Dianna Edgil

    2011-11-01

    Full Text Available BACKGROUND: The global HIV prevention community is implementing voluntary medical male circumcision (VMMC programs across eastern and southern Africa, with a goal of reaching 80% coverage in adult males by 2015. Successful implementation will depend on the accessibility of commodities essential for VMMC programming and the appropriate allocation of resources to support the VMMC supply chain. For this, the United States President's Emergency Plan for AIDS Relief, in collaboration with the World Health Organization and the Joint United Nations Programme on HIV/AIDS, has developed a standard list of commodities for VMMC programs. METHODS AND FINDINGS: This list of commodities was used to inform program planning for a 1-y program to circumcise 152,000 adult men in Swaziland. During this process, additional key commodities were identified, expanding the standard list to include commodities for waste management, HIV counseling and testing, and the treatment of sexually transmitted infections. The approximate costs for the procurement of commodities, management of a supply chain, and waste disposal, were determined for the VMMC program in Swaziland using current market prices of goods and services. Previous costing studies of VMMC programs did not capture supply chain costs, nor the full range of commodities needed for VMMC program implementation or waste management. Our calculations indicate that depending upon the volume of services provided, supply chain and waste management, including commodities and associated labor, contribute between US$58.92 and US$73.57 to the cost of performing one adult male circumcision in Swaziland. CONCLUSIONS: Experience with the VMMC program in Swaziland indicates that supply chain and waste management add approximately US$60 per circumcision, nearly doubling the total per procedure cost estimated previously; these additional costs are used to inform the estimate of per procedure costs modeled by Njeuhmeli et al. in

  19. Voluntary medical male circumcision: logistics, commodities, and waste management requirements for scale-up of services.

    Science.gov (United States)

    Edgil, Dianna; Stankard, Petra; Forsythe, Steven; Rech, Dino; Chrouser, Kristin; Adamu, Tigistu; Sakallah, Sameer; Thomas, Anne Goldzier; Albertini, Jennifer; Stanton, David; Dickson, Kim Eva; Njeuhmeli, Emmanuel

    2011-11-01

    The global HIV prevention community is implementing voluntary medical male circumcision (VMMC) programs across eastern and southern Africa, with a goal of reaching 80% coverage in adult males by 2015. Successful implementation will depend on the accessibility of commodities essential for VMMC programming and the appropriate allocation of resources to support the VMMC supply chain. For this, the United States President's Emergency Plan for AIDS Relief, in collaboration with the World Health Organization and the Joint United Nations Programme on HIV/AIDS, has developed a standard list of commodities for VMMC programs. This list of commodities was used to inform program planning for a 1-y program to circumcise 152,000 adult men in Swaziland. During this process, additional key commodities were identified, expanding the standard list to include commodities for waste management, HIV counseling and testing, and the treatment of sexually transmitted infections. The approximate costs for the procurement of commodities, management of a supply chain, and waste disposal, were determined for the VMMC program in Swaziland using current market prices of goods and services. Previous costing studies of VMMC programs did not capture supply chain costs, nor the full range of commodities needed for VMMC program implementation or waste management. Our calculations indicate that depending upon the volume of services provided, supply chain and waste management, including commodities and associated labor, contribute between US$58.92 and US$73.57 to the cost of performing one adult male circumcision in Swaziland. Experience with the VMMC program in Swaziland indicates that supply chain and waste management add approximately US$60 per circumcision, nearly doubling the total per procedure cost estimated previously; these additional costs are used to inform the estimate of per procedure costs modeled by Njeuhmeli et al. in "Voluntary Medical Male Circumcision: Modeling the Impact and Cost of

  20. Relations between circumcision status, sexually transmitted infection history, and HIV serostatus among a national sample of men who have sex with men in the United States.

    Science.gov (United States)

    Jozkowski, Kristen; Rosenberger, Joshua G; Schick, Vanessa; Herbenick, Debby; Novak, David S; Reece, Michael

    2010-08-01

    Circumcision's potential link to HIV/sexually transmitted infections (STI) has been at the center of recent global public health debates. However, data related to circumcision and sexual health remain limited, with most research focused on heterosexual men. This study sought to assess behavioral differences among a large sample of circumcised and noncircumcised men who have sex with men (MSM) in the United States. Data were collected from 26,257 U.S. MSM through an online survey. Measures included circumcision status, health indicators, HIV/STI screening and diagnosis, sexual behaviors, and condom use. Bivariate and regression analyses were conducted to determine differences between HIV/STI status, sexual behaviors, and condom use among circumcised and noncircumcised men. Circumcision status did not significantly predict HIV testing (p > 0.05), or HIV serostatus (p > 0.05), and there were no significant differences based on circumcision status for most STI diagnosis [syphilis, gonorrhea, chlamydia, human papilloma virus (HPV)]. Being noncircumcised was predictive of herpes-2 diagnosis, however, condom use mediated this relationship. These data provide one of the first large national assessments of circumcision among MSM. While being noncircumcised did not increase the likelihood of HIV and most STI infections, results indicated that circumcision was associated with higher rates of condom use, suggesting that those who promote condoms among MSM may need to better understand condom-related behaviors and attitudes among noncircumcised men to enhance the extent to which they are willing to use condoms consistently.

  1. Not a surgical vaccine: there is no case for boosting infant male circumcision to combat heterosexual transmission of HIV in Australia.

    Science.gov (United States)

    Darby, Robert; Van Howe, Robert

    2011-10-01

    To conduct a critical review of recent proposals that widespread circumcision of male infants be introduced in Australia as a means of combating heterosexually transmitted HIV infection. These arguments are evaluated in terms of their logic, coherence and fidelity to the principles of evidence-based medicine; the extent to which they take account of the evidence for circumcision having a protective effect against HIV and the practicality of circumcision as an HIV control strategy; the extent of its applicability to the specifics of Australia's HIV epidemic; the benefits, harms and risks of circumcision; and the associated human rights, bioethical and legal issues. Our conclusion is that such proposals ignore doubts about the robustness of the evidence from the African random-controlled trials as to the protective effect of circumcision and the practical value of circumcision as a means of HIV control; misrepresent the nature of Australia's HIV epidemic and exaggerate the relevance of the African random-controlled trials findings to it; underestimate the risks and harm of circumcision; and ignore questions of medical ethics and human rights. The notion of circumcision as a 'surgical vaccine' is criticised as polemical and unscientific. Circumcision of infants or other minors has no place among HIV control measures in the Australian and New Zealand context; proposals such as these should be rejected. © 2011 The Authors. ANZJPH © 2011 Public Health Association of Australia.

  2. FEMALE GENITAL MUTILATION

    African Journals Online (AJOL)

    local and systemic infection, abscess and ulcer formation, septicaemia ... the girl's legs are then bound together from ankles to hips, and she is immobilised for 10 to ... circumcised woman's sexual desire is usually not affected by the procedure ...

  3. Nontherapeutic Circumcision of Minors as an Ethically Problematic Form of Iatrogenic Injury.

    Science.gov (United States)

    Svoboda, J Steven

    2017-08-01

    Nontherapeutic circumcision (NTC) of male infants and boys is a common but misunderstood form of iatrogenic injury that causes harm by removing functional tissue that has known erogenous, protective, and immunological properties, regardless of whether the surgery generates complications. I argue that the loss of the foreskin itself should be counted, clinically and morally, as a harm in evaluating NTC; that a comparison of benefits and risks is not ethically sufficient in an analysis of a nontherapeutic procedure performed on patients unable to provide informed consent; and that circumcision violates clinicians' imperatives to respect patients' autonomy, to do good, to do no harm, and to be just. When due consideration is given to these values, the balance of factors suggests that NTC should be deferred until the affected person can perform his own cost-benefit analysis, applying his mature, informed preferences and values. © 2017 American Medical Association. All Rights Reserved.

  4. Vitamin K deficiency bleeding and early infant male circumcision in Africa.

    Science.gov (United States)

    Plank, Rebeca M; Steinmetz, Tara; Sokal, David C; Shearer, Martin J; Data, Santorino

    2013-08-01

    Early infant (1-60 days of life) male circumcision is being trialed in Africa as a human immunodeficiency virus prevention strategy. Postcircumcision bleeding is particularly concerning where most infants are breastfed, and thus these infants are at increased risk of vitamin K deficiency bleeding. During a circumcision trial, one infant bled for 90 minutes postprocedure. After discovering he had not received standard prophylactic vitamin K, we gave 2 mg phytomenadione (vitamin K1) intramuscularly; bleeding stopped within 30 minutes. Vitamin K's extremely rapid action is not commonly appreciated. Neonatal vitamin K has been shown to be cost-effective. To increase availability and promote awareness of its importance, especially in low-resource settings where blood products and transfusions are limited, vitamin K should be included in the World Health Organization's Model List of Essential Medicines for Children.

  5. Community and Healthcare Providers' Perspectives on Male Circumcision: A Multi-Centric Qualitative Study in India

    OpenAIRE

    Sahay, Seema; Nagarajan, Karikalan; Mehendale, Sanjay; Deb, Sibnath; Gupta, Abhilasha; Bharat, Shalini; Bhatt, Shripad; Kumar, Athokpam Bijesh; Kanthe, Vidisha; Sinha, Anju; Chandhiok, Nomita

    2014-01-01

    Background Although male circumcision (MC) is recommended as an HIV prevention option, the religious, cultural and biomedical dimensions of its feasibility, acceptability and practice in India have not been explored till date. This study explores beliefs, experiences and understanding of the community and healthcare providers (HCPs) about adult MC as an HIV prevention option in India. Methods This qualitative study covered 134 in-depth interviews from Belgaum, Kolkata, Meerut and Mumbai citie...

  6. Factors Associated with Knowledge of and Willingness for Adult Male Circumcision in Changsha, China.

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    Mingqiang Zeng

    Full Text Available Male circumcision (MC has been shown to reduce the risk of male genital diseases. MC is not commonly practiced among Chinese males and little is known about the factors associated with their knowledge of and willingness for MC. This study was to explore the knowledge regarding the foreskin among Chinese males and to identify factors associated with their willingness to undergo circumcision.A total of 237 patients with redundant prepuce/phimosis were interviewed through face-to-face interviews. The items on the questionnaire included: demographics, an objective scale assessing knowledge about the foreskin, willingness to have MC, the attitudes of sexual partners and doctors toward redundant prepuce/phimosis, and the approaches that patients used to acquire knowledge regarding the prepuce. Univariate analysis and multiple logistic regression analysis were performed to identify factors that are associated with willingness to be circumcised (WTC.A total of 212 patients completed the interview. Multivariable logistic regression showed that three factors were significantly associated with WTC: being married (OR = 0.43, perceiving redundant prepuce/phimosis as a disease (OR = 1.93, and if a patient's partner supported MC (OR = 1.39. 58% (n = 122 had received information about the foreskin from another party: 18% (n = 37 from school, 8% (n = 17 from family, 17% (n = 36 from friends, 27% (n = 57 from health care providers. About 4% (n = 8 believed that their partners disliked their redundant prepuce/phimosis. 20% (n = 42 had received doctors' advice to undergo circumcision.Knowledge about the foreskin was low among Chinese males. Our study elucidates the factors associated with WTC and suggests that more education of the population about the foreskin can help improve the recognition of a correctible abnormality and help patients assess the potential role of MC in their health.

  7. Histological Correlates of Penile Sexual Sensation: Does Circumcision Make a Difference?

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    Guy Cox, MA, DPhil; John N. Krieger, MD; Brian J. Morris, DSc, PhD

    2015-01-01

    Introduction: The question of whether removal of sensory receptors in the prepuce by circumcision affects sensitivity and/or sexual pleasure is often debated. Aims: To examine histological correlates relevant to penile sensitivity and sexual pleasure. Methods: Systematic review of the scientific literature on penile structures that might affect sensitivity and sexual sensation. Articles were included if they contained original data on human male penile histology or anatomy. Individual a...

  8. Male Circumcision and Risk of HIV Acquisition among Men who have Sex with Men from the United States and Peru

    Science.gov (United States)

    Sánchez, Jorge; Sal y Rosas, Victor G.; Hughes, James P.; Baeten, Jared M.; Fuchs, Jonathan; Buchbinder, Susan P.; Koblin, Beryl A.; Casapia, Martín; Ortiz, Abner; Celum, Connie

    2011-01-01

    Objectives To assess the association between male circumcision, insertive anal sex practices, and HIV acquisition in a cohort of men who have sex with men (MSM). Methods Data were from 1824 HSV-2 seropositive, HIV seronegative MSM, 1362 (75%) from Peru and 462 (25%) from the US, who participated in a randomized placebo controlled trial of HSV-2 suppression for HIV prevention (HPTN 039). Circumcision status was determined by examination at enrollment. HIV testing was done every three months for up to 18 months. Partner-specific sexual behavior for up to the last three partners during the previous three months was analyzed. Results There was no significant association between male circumcision and HIV acquisition in univariate analysis (RR=0.84, 95% CI 0.50–1.42). In a pre-specified multivariate analysis that assumed a linear relationship between the proportion of insertive acts and effect of circumcision on HIV acquisition, the interaction between circumcision and proportion of insertive acts was not significant (p=0.11). In an exploratory analysis that categorized behavior with recent partners by proportion of insertive acts (<60% or ≥60% insertive acts), circumcision was associated with a non-statistically significant 69% reduction in the risk of HIV acquisition (RR=0.31, 95% CI 0.06–1.51) among men who reported ≥60% of insertive acts with recent male partners. Conclusion Circumcision does not have a significant protective effect against HIV acquisition among MSM from Peru and US, although there may be reduced risk for men who are primarily insertive with their male partners. This association needs to be investigated across diverse cohorts of MSM. PMID:21099672

  9. Correlates of male circumcision in Eastern and Southern African countries: establishing a baseline prior to VMMC Scale-up.

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    Khai Hoan Tram

    Full Text Available BACKGROUND: Despite the importance of male circumcision (MC prevalence to HIV prevention efforts in Eastern and Southern Africa, there has been no systematic analysis on the correlates of male circumcision. This analysis identifies correlates of MC in 12 countries in the region with available data. METHODS: Data from the male questionnaire of DHS surveys collected between 2006-2011 in Ethiopia, Kenya, Lesotho, Malawi, Mozambique, Namibia, Rwanda, Swaziland, Tanzania, Uganda, Zambia, and Zimbabwe were analyzed. The dependent variable was self-reported male circumcision status. Independent variables included age, education, wealth quintile, place of residence, ethnicity, religion and region. Bivariate and multivariate analyses were conducted separately for each country. RESULTS: MC prevalence ranged from 8.2 percent in Swaziland to 92.2 percent in Ethiopia. Bivariate analyses showed a consistent positive association between age (being older and male circumcision. Education, wealth quintile, and place of residence were either not significantly related or differed in the direction of the relationship by country. Multivariate logistic regression showed three variables consistently associated with MC status: age (being older, religion (being Muslim and ethnicity. DISCUSSION: These data were collected prior to the scale-up of voluntary medical male circumcision (VMMC programs in 11 of the 12 countries. As the VMMC scale-up intensifies in countries across Eastern and Southern Africa, the correlates of VMMC are likely to change, with (younger age and education emerging as key correlates of VMMC performed in medical settings. The centuries-long tradition among Muslims to circumcise should continue to favor MC among this group. Non-circumcising ethnicities may become more open to MC if promoted as a health practice for decreasing HIV risk.

  10. Male genital representation in paleolithic art: erection and circumcision before history.

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    Angulo, Javier C; García-Díez, Marcos

    2009-07-01

    To report on the likely existing evidence about the practice of circumcision in prehistory, or at least a culture of foreskin retraction, and also the meaning of erection in Paleolithic minds. The origin of the ritual of circumcision has been lost in time. Similarly, the primitive anthropologic meaning of erection is undefined. We studied the archeologic and artistic evidence regarding human representations performed during the Upper Paleolithic period, 38,000 to 11,000 years BCE, in Europe, with a focus on genital male representations in portable and rock art. Drawings, engravings, and sculptures displaying humans are relatively scarce, and death. Therefore, erection could be understood as a phenomenon related to the shamanic transit between life and death. The erection in Paleolithic art is explicitly represented in almost all the figures defined as unequivocally male that have survived to the present and in many objects of portable art. Circumcision and/or foreskin retraction of the penis are present in most of the works.

  11. Opportunity's Surroundings on Sol 1818

    Science.gov (United States)

    2009-01-01

    NASA's Mars Exploration Rover Opportunity used its navigation camera to take the images combined into this full-circle view of the rover's surroundings during the 1,818th Martian day, or sol, of Opportunity's surface mission (March 5, 2009). South is at the center; north at both ends. The rover had driven 80.3 meters (263 feet) southward earlier on that sol. Tracks from the drive recede northward in this view. The terrain in this portion of Mars' Meridiani Planum region includes dark-toned sand ripples and lighter-toned bedrock. This view is presented as a cylindrical projection with geometric seam correction.

  12. HIV prevalence is strongly associated with geographical variations in male circumcision and foreskin cutting in Papua New Guinea: an ecological study.

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    MacLaren, David J; McBride, W John H; Kelly, Gerard C; Muller, Reinhold; Tommbe, Rachael; Kaldor, John M; Vallely, Andrew J

    2015-11-01

    To examine the correlation between HIV prevalence and male circumcision and other foreskin cutting practices across the four regions of Papua New Guinea (PNG). An ecological substudy using unique data from an interdisciplinary research programme to evaluate the acceptability, sociocultural context and public health impact of male circumcision for HIV prevention in PNG. Published data describing (a) self-reported circumcision status by region from the 'Acceptability and Feasibility of Male Circumcision for HIV prevention in PNG' study and (b) HIV prevalence by region from PNG National Department of Health were used to correlate male circumcision and other foreskin cutting practices and HIV prevalence. Maps were constructed to visually represent variations across the four regions of PNG. Regions of PNG with the highest HIV prevalence had the lowest prevalence of male circumcision and other forms of foreskin cutting and vice versa. Male circumcision and dorsal longitudinal cuts were strongly associated with HIV prevalence and able to explain 99% of the observed geographical variability in HIV prevalence in PNG (pPNG appears to be closely correlated with the regional distribution of male circumcision and dorsal longitudinal foreskin cuts. Further research is warranted to investigate causality of this correlation as well as the potential of dorsal longitudinal cuts to confer protection against HIV acquisition in heterosexual men. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  13. Comparison of local anesthetic effects of lidocaine versus tramadol and effect of child anxiety on pain level in circumcision procedure.

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    Polat, Fazli; Tuncel, Altug; Balci, Melih; Aslan, Yilmaz; Sacan, Ozlem; Kisa, Cebrail; Kayali, Mustafa; Atan, Ali

    2013-10-01

    To compare the local anesthetic effects of tramadol hydrochloride with those of lidocaine in circumcision procedures. We also investigated the effect of child anxiety on pain level. A total of 70 children were included in this study. The children were randomized into 3 groups. Group 1 (n = 26) received lidocaine hydrochloride + epinephrine and they underwent circumcision using Ali's clamp(®). Group 2 (n = 35) received lidocaine hydrochloride + epinephrine and group 3 (n = 12) 5% tramadol. The last two groups underwent conventional circumcision. The mean anxiety score was 22.6. We did not find significant differences in terms of anxiety score among the groups (p = 0.761). When the pain scores of the groups during injection were compared, it was found that there were no significant differences. However, the pain score of the third group was significantly high when it was compared with the first and second group 2 and 10 min after injection. In the correlation analysis, we found a positive correlation between children's anxiety scores and the pain degree during injection (r = 0.373, p = 0.001). Tramadol may not provide effective local anesthesia in male circumcision. The child's anxiety before the circumcision seems to have a negative effect on pain level. Copyright © 2012 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.

  14. Rates of Complications After Newborn Circumcision in a Well-Baby Nursery, Special Care Nursery, and Neonatal Intensive Care Unit.

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    Srinivasan, Mythili; Hamvas, Corrine; Coplen, Douglas

    2015-10-01

    To determine rates of complications after newborn circumcision by performing a retrospective chart review of patients circumcised at a well-baby nursery, neonatal intensive care units (NICU), and special care nursery (SCN) from 2007 to 2012. A total of 5129 babies (73%) were circumcised at the well-baby nursery and 1909 babies (27%) at the NICU and SCN. Forty-seven patients (0.67%, 95% CI 0.49% to 0.89%) had circumcision-related complications: 5 (0.07%) patients with acute and 42 (0.6%) with late complications. Babies in the NICU/SCN had increased odds of complication (OR 4.00, 95% CI 2.23 to 7.19) compared with those in well-baby nursery. There were increased odds of complications in babies with Caucasian ethnicity (OR 2.60, 95% CI 1.48 to 4.89) compared with African American babies and in babies with private insurance (OR 4.0, 95% CI 2.1 to 7.5) compared with nonprivate insurance. The rates of complications after newborn circumcisions were low. Babies in the NICU/SCN had increased odds of complication. © The Author(s) 2015.

  15. Male circumcision at different ages in Rwanda: a cost-effectiveness study.

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    Agnes Binagwaho

    2010-01-01

    Full Text Available BACKGROUND: There is strong evidence showing that male circumcision (MC reduces HIV infection and other sexually transmitted infections (STIs. In Rwanda, where adult HIV prevalence is 3%, MC is not a traditional practice. The Rwanda National AIDS Commission modelled cost and effects of MC at different ages to inform policy and programmatic decisions in relation to introducing MC. This study was necessary because the MC debate in Southern Africa has focused primarily on MC for adults. Further, this is the first time, to our knowledge, that a cost-effectiveness study on MC has been carried out in a country where HIV prevalence is below 5%. METHODS AND FINDINGS: A cost-effectiveness model was developed and applied to three hypothetical cohorts in Rwanda: newborns, adolescents, and adult men. Effectiveness was defined as the number of HIV infections averted, and was calculated as the product of the number of people susceptible to HIV infection in the cohort, the HIV incidence rate at different ages, and the protective effect of MC; discounted back to the year of circumcision and summed over the life expectancy of the circumcised person. Direct costs were based on interviews with experienced health care providers to determine inputs involved in the procedure (from consumables to staff time and related prices. Other costs included training, patient counselling, treatment of adverse events, and promotion campaigns, and they were adjusted for the averted lifetime cost of health care (antiretroviral therapy [ART], opportunistic infection [OI], laboratory tests. One-way sensitivity analysis was performed by varying the main inputs of the model, and thresholds were calculated at which each intervention is no longer cost-saving and at which an intervention costs more than one gross domestic product (GDP per capita per life-year gained. RESULTS: Neonatal MC is less expensive than adolescent and adult MC (US$15 instead of US$59 per procedure and is cost

  16. The perceptions on male circumcision as a preventive measure against HIV infection and considerations in scaling up of the services: a qualitative study among police officers in Dar es Salaam, Tanzania

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    Tarimo Edith AM

    2012-07-01

    Full Text Available Abstract Background In recent randomized controlled trials, male circumcision has been proven to complement the available biomedical interventions in decreasing HIV transmission from infected women to uninfected men. Consequently, Tanzania is striving to scale-up safe medical male circumcision to reduce HIV transmission. However, there is a need to investigate the perceptions of male circumcision in Tanzania using specific populations. The purpose of the present study was to assess the perceptions of male circumcision in a cohort of police officers that also served as a source of volunteers for a phase I/II HIV vaccine (HIVIS-03 trial in Dar es Salaam, Tanzania. Methods In-depth interviews with 24 men and 10 women were conducted. Content analysis informed by the socio-ecological model was used to analyze the data. Results Informants perceived male circumcision as a health-promoting practice that may prevent HIV transmission and other sexually transmitted infections. They reported male circumcision promotes sexual pleasure, confidence and hygiene or sexual cleanliness. They added that it is a religious ritual and a cultural practice that enhances the recognition of manhood in the community. However, informants were concerned about the cost involved in male circumcision and cleanliness of instruments used in medical and traditional male circumcision. They also expressed confusion about the shame of undergoing circumcision at an advanced age and pain that could emanate after circumcision. The participants advocated for health policies that promote medical male circumcision at childhood, specifically along with the vaccination program. Conclusions The perceived benefit of male circumcision as a preventive strategy to HIV and other sexually transmitted infections is important. However, there is a need to ensure that male circumcision is conducted under hygienic conditions. Integrating male circumcision service in the routine childhood vaccination

  17. Opportunity's Surroundings on Sol 1687

    Science.gov (United States)

    2009-01-01

    NASA's Mars Exploration Rover Opportunity used its navigation camera to take the images combined into this 360-degree view of the rover's surroundings on the 1,687th Martian day, or sol, of its surface mission (Oct. 22, 2008). Opportunity had driven 133 meters (436 feet) that sol, crossing sand ripples up to about 10 centimeters (4 inches) tall. The tracks visible in the foreground are in the east-northeast direction. Opportunity's position on Sol 1687 was about 300 meters southwest of Victoria Crater. The rover was beginning a long trek toward a much larger crater, Endeavour, about 12 kilometers (7 miles) to the southeast. This view is presented as a cylindrical projection with geometric seam correction.

  18. Opportunity's Surroundings on Sol 1798

    Science.gov (United States)

    2009-01-01

    NASA's Mars Exploration Rover Opportunity used its navigation camera to take the images combined into this 180-degree view of the rover's surroundings during the 1,798th Martian day, or sol, of Opportunity's surface mission (Feb. 13, 2009). North is on top. The rover had driven 111 meters (364 feet) southward on the preceding sol. Tracks from that drive recede northward in this view. For scale, the distance between the parallel wheel tracks is about 1 meter (about 40 inches). The terrain in this portion of Mars' Meridiani Planum region includes dark-toned sand ripples and lighter-toned bedrock. This view is presented as a cylindrical projection with geometric seam correction.

  19. Factors associated with the take-up of voluntary medical male circumcision amongst learners in rural KwaZulu-Natal.

    Science.gov (United States)

    George, Gavin; Govender, Kaymarlin; Beckett, Sean; Montague, Carl; Frohlich, Janet

    2017-09-01

    Voluntary medical male circumcision (VMMC) is an integral part of South Africa's HIV prevention programme. School-going males, in particular, are considered a cost-effective target population. However, ambitious policy targets have not been achieved due to the plateau in demand for VMMC. This study documents the factors influencing demand for VMMC amongst school-going males. Data were collected from 750 learners (251 circumcised and 499 uncircumcised) from 42 secondary schools in KwaZulu-Natal, South Africa. There was a positive association between the perceived benefit of VMMC and the likelihood of undergoing circumcision (AOR: 1.41, p = 0.01). There was a negative association between self-efficacy to use condoms and likelihood of undergoing VMMC (AOR: 0.75, p concern, learners who were confident in their ability to access condoms and t use a condom with their partner were less likely to undergo VMMC.

  20. Acceptability of Male Circumcision among College Students in Medical Universities in Western China: A Cross-Sectional Study.

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    Junjun Jiang

    Full Text Available Male circumcision (MC has been shown to reduce the risk of female to male transmission of HIV. The goal of this survey was to explore MC's acceptability and the factors associated with MC among college students in medical universities in western China.A cross-sectional study was carried out in three provinces in western China (Guangxi, Chongqing and Xinjiang to assess the acceptability of MC as well as to discover factors associated with the acceptability among college students in medical universities. A total of 1,790 uncircumcised male students from three medical universities were enrolled in this study. In addition, 150 students who had undergone MC were also enrolled in the survey, and they participated in in-depth interviews.Of all the uncircumcised participants (n = 1,790, 55.2% (n = 988 were willing to accept MC. Among those who accepted MC, 67.3% thought that MC could improve their sexual partners' hygiene, 46.3% believed that HIV and sexually transmitted diseases (STDs could be partially prevented by MC. The multivariable logistic regression indicates that MC's acceptability was associated with three factors: the redundant foreskin (OR = 10.171, 95% CI = 7.629-13.559, knowing the hazard of having a redundant foreskin (OR = 1.597, 95% CI = 1.097-2.323, and enhancing sexual pleasure (OR = 1.628, 95% CI = 1.312-2.021. The in-depth interviews for subjects who had undergone MC showed that the major reason for having MC was the redundant foreskin (87.3%, followed by the benefits and the fewer complications of having MC done. In addition, most of these participants (65.3% said that the MC could enhance sexual satisfaction.MC's acceptance among college students in medical universities is higher than it is among other populations in western China. An implementation of an MC programme among this population is feasible in the future.

  1. Impact of male circumcision on the HIV epidemic in Papua New Guinea: a country with extensive foreskin cutting practices.

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    Richard T Gray

    Full Text Available The degree to which adult medical male circumcision (MC programs can reduce new HIV infections in a moderate HIV prevalence country like Papua New Guinea (PNG are uncertain especially given the widespread prevalence of longitudinal foreskin cuts among adult males. We estimated the likely impact of a medical MC intervention in PNG using a mathematical model of HIV transmission. The model was age-structured and incorporated separate components for sex, rural/urban, men who have sex with men and female sex workers. Country-specific data of the prevalence of foreskin cuts, sexually transmitted infections, condom usage, and the acceptability of MC were obtained by our group through related studies. If longitudinal foreskin cutting has a protective efficacy of 20% compared to 60% for MC, then providing MC to 20% of uncut males from 2012 would require 376,000 procedures, avert 7,900 HIV infections by 2032, and require 143 MC per averted infection. Targeting uncut urban youths would achieve the most cost effective returns of 54 MC per HIV infection averted. These numbers of MC required to avert an HIV infection change little even with coverage up to 80% of men. The greater the protective efficacy of longitudinal foreskin cuts against HIV acquisition, the less impact MC interventions will have. Dependent on this efficacy, increasing condom use could have a much greater impact with a 10 percentage point increase averting 18,400 infections over this same period. MC programs could be effective in reducing HIV infections in PNG, particularly in high prevalence populations. However the overall impact is highly dependent on the protective efficacy of existing longitudinal foreskin cutting in preventing HIV.

  2. Binaural Rendering in MPEG Surround

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    Kristofer Kjörling

    2008-04-01

    Full Text Available This paper describes novel methods for evoking a multichannel audio experience over stereo headphones. In contrast to the conventional convolution-based approach where, for example, five input channels are filtered using ten head-related transfer functions, the current approach is based on a parametric representation of the multichannel signal, along with either a parametric representation of the head-related transfer functions or a reduced set of head-related transfer functions. An audio scene with multiple virtual sound sources is represented by a mono or a stereo downmix signal of all sound source signals, accompanied by certain statistical (spatial properties. These statistical properties of the sound sources are either combined with statistical properties of head-related transfer functions to estimate “binaural parameters” that represent the perceptually relevant aspects of the auditory scene or used to create a limited set of combined head-related transfer functions that can be applied directly on the downmix signal. Subsequently, a binaural rendering stage reinstates the statistical properties of the sound sources by applying the estimated binaural parameters or the reduced set of combined head-related transfer functions directly on the downmix. If combined with parametric multichannel audio coders such as MPEG Surround, the proposed methods are advantageous over conventional methods in terms of perceived quality and computational complexity.

  3. Rural female adolescence: Indian scenario.

    Science.gov (United States)

    Kumari, R

    1995-01-01

    This article describes the life conditions of female adolescents in India and issues such as health, discrimination in nutrition and literacy, child labor, early marriage, juvenile delinquency, and violence against girls in rural areas of India. Data are obtained from interview samples conducted among 12 villages in north India. Female adolescents suffer from a variety of poverty-ridden village life conditions: caste oppression, lack of facilities, malnutrition, educational backwardness, early marriage, domestic burden, and gender neglect. Girls carry a heavy work burden. Adolescence in rural areas is marked by the onset of puberty and the thrust into adulthood. Girls have no independent authority to control their sexuality or reproduction. Girls are expected to get married and produce children. Control of female sexuality is shifted from the father to the husband. There is a strong push to marry girls soon after menstruation, due to the burden of imposing strict restrictions on female sexuality, the desire to reduce the burden of financial support, and the need to ensure social security for daughters. Girls may not go out alone or stay outside after dark. Many rural parents fear that education and freedom would ruin their daughter. Girls develop a low self-image. Rural villages have poor sanitation, toilet facilities, and drainage systems. Girls are ignorant of health and sex education and lack access to education. The neglect of female children includes malnutrition, sex bias, and early marriage. In 1981, almost 4 out of every 100 girls had to work. 5.527 million girls 5-14 years old were child laborers. Girls are veiled, footbound, circumcised, and burnt by dowry hungry in-laws. Female delinquents are subjected to sexual harassment and sometime to sexual abuse while in custody. Cows are treated better in rural India than women. Gender disparity is caused by the perpetuation of patriarchal masculine values.

  4. Rural Zulu women's knowledge of and attitudes towards medical male circumcision.

    Science.gov (United States)

    Ikwegbue, Joseph N; Ross, Andrew; Ogbonnaya, Harbor

    2015-03-31

    Medical male circumcision (MMC) is a key strategy in the South African HIV infection prevention package. Women may have a potentially powerful role in supporting such a strategy. Circumcision is not a traditional part of Zulu society, and Zulu women may have limited knowledge and ambivalent or negative attitudes towards MMC. This study employs quantitative data to expand insight into rural Zulu women's knowledge of and attitudes towards MMC, and is important as women could potentially yield a powerful positive or negative influence over the decisions of their partners and sons. A hospital-based antenatal clinic in rural KwaZulu-Natal. Participants were 590 pregnant, mostly isiZulu-speaking women. Data on their knowledge of and attitude towards MMC were collected using a questionnaire and were analysed descriptively. The majority of the women supported MMC; however, knowledge of the potential benefits was generally poor. Most would encourage their partners and sons to undergo MMC. The preferred place for the procedure was a hospital. Zulu participants supported MMC and would support their partners and children being circumcised. Knowledge around potential benefits was worryingly poor, and further research into disseminating information is essential. The findings highlight the need for an expanded campaign of health education for women, and innovative means are suggested to enhance information accessibility. Reasons for preferring that MMC be carried out in hospital need to be explored further.

  5. Rural Zulu women’s knowledge of and attitudes towards medical male circumcision

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    Joseph N. Ikwegbue

    2015-03-01

    Full Text Available Background: Medical male circumcision (MMC is a key strategy in the South African HIV infection prevention package. Women may have a potentially powerful role in supporting such a strategy. Circumcision is not a traditional part of Zulu society, and Zulu women may have limited knowledge and ambivalent or negative attitudes towards MMC. Aim: This study employs quantitative data to expand insight into rural Zulu women’s knowledge of and attitudes towards MMC, and is important as women could potentially yield a powerful positive or negative influence over the decisions of their partners and sons. Setting: A hospital-based antenatal clinic in rural KwaZulu-Natal. Methods: Participants were 590 pregnant, mostly isiZulu-speaking women. Data on their knowledge of and attitude towards MMC were collected using a questionnaire and were analysed descriptively. Results: The majority of the women supported MMC; however, knowledge of the potential benefits was generally poor. Most would encourage their partners and sons to undergo MMC. The preferred place for the procedure was a hospital. Conclusion: Zulu participants supported MMC and would support their partners and children being circumcised. Knowledge around potential benefits was worryingly poor, and further research into disseminating information is essential. The findings highlight the need for an expanded campaign of health education for women, and innovative means are suggested to enhance information accessibility. Reasons for preferring that MMC be carried out in hospital need to be explored further.

  6. Neonatal facial coding system scores and spectral characteristics of infant crying during newborn circumcision.

    Science.gov (United States)

    Lehr, Victoria Tutag; Zeskind, Philip Sanford; Ofenstein, John P; Cepeda, Eugene; Warrier, Indulekha; Aranda, J V

    2007-06-01

    To determine the relations between Neonatal Facial Coding System (NFCS) scores and measures of infant crying during newborn circumcision. Video and audio recordings were made of infant facial activity and cry sounds, respectively, during the lysis phase of circumcisions of 44 healthy term males (analgesia before circumcision. NFCS scores were determined by blinded assistant from video recordings of facial activity. Measures of infant crying were determined via spectrum analysis of audio recordings by a blinded, independent researcher. Pearson product-moment correlations were used to examine relationship between NFCS scores and measures of crying. Principal component factor analysis detected dimensions underlying related measures of crying. Factor scores from a factor analysis were used in stepwise linear regression to predict NFCS scores. Higher NFCS scores correlated with lower peak fundamental frequency of crying (P<0.01) and with higher amplitudes of crying at peak fundamental frequency and dominant frequency and in overall cry sample (P<0.01). The factor analysis showed 3 significant orthogonal dimensions underlying measures of crying: Power and Velocity (amplitude and rapidity), Pitch of Crying (frequency characteristics), and Infant Arousal (turbulence and intensity) accounting for 42.3%, 17.8%, and 14.6% of variance, respectively. A regression analysis showed all 3 factor scores accounted for significant and separate portions of variance (P<0.001). The best predictor of NFCS score was Power and Velocity (P<0.002), followed by Infant Arousal (P<0.002), and Pitch of Crying (P<0.007). These data provide some of the first known evidence linking specific measures of infant crying with an independent, validated measure of pain.

  7. A prospective evaluation of plastibell® circumcision in older children

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    Jose Murillo Bastos Netto

    2013-07-01

    Full Text Available Introduction and Objective Circumcision is one of the oldest surgical procedures and one of the most frequently performed worldwide. It can be done by many different techniques. This prospective series presents the results of Plastibell® circumcision in children older than 2 years of age, evaluating surgical duration, immediate and late complications, time for plastic device separation and factors associated with it. Materials and Methods We prospectively analyzed 119 children submitted to Plastic Device Circumcision with Plastibell® by only one surgeon from December 2009 to June 2011. In all cases the surgery was done under general anesthesia associated with dorsal penile nerve block. Before surgery length of the penis and latero-lateral diameter of the glans were measured. Surgical duration, time of Plastibell® separation and use of analgesic medication in the post-operative period were evaluated. Patients were followed on days 15, 45, 90 and 120 after surgery. Results Age at surgery varied from 2 to 12.5 (5.9 ± 2.9 years old. Mean surgical time was 3.7 ± 2.0 minutes (1.9 to 9 minutes. Time for plastic device separation ranged from 6 to 26 days (mean: 16 ± 4.2 days, being 14.8 days for children younger than 5 years of age and 17.4 days for those older than 5 years of age (p < 0.0001. The diameter of the Plastibell® does not interfered in separations time (p = 0,484. Late complications occurred in 32 (26.8% subjects, being the great majority of low clinical significance, especially prepucial adherences, edema of the mucosa and discrete hypertrophy of the scar, all resolving with clinical treatment. One patient still using diaper had meatus stenosis and in one case the Plastibell® device stayed between the glans and the prepuce and needed to be removed manually. conclusions Circumcision using a plastic device is a safe, quick and an easy technique with low complications, that when occur are of low clinical importance and of easy

  8. The potential impact of male circumcision on HIV in Sub-Saharan Africa.

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    Brian G Williams

    2006-07-01

    Full Text Available A randomized controlled trial (RCT has shown that male circumcision (MC reduces sexual transmission of HIV from women to men by 60% (32%-76%; 95% CI offering an intervention of proven efficacy for reducing the sexual spread of HIV. We explore the implications of this finding for the promotion of MC as a public health intervention to control HIV in sub-Saharan Africa.Using dynamical simulation models we consider the impact of MC on the relative prevalence of HIV in men and women and in circumcised and uncircumcised men. Using country level data on HIV prevalence and MC, we estimate the impact of increasing MC coverage on HIV incidence, HIV prevalence, and HIV-related deaths over the next ten, twenty, and thirty years in sub-Saharan Africa. Assuming that full coverage of MC is achieved over the next ten years, we consider three scenarios in which the reduction in transmission is given by the best estimate and the upper and lower 95% confidence limits of the reduction in transmission observed in the RCT. MC could avert 2.0 (1.1-3.8 million new HIV infections and 0.3 (0.1-0.5 million deaths over the next ten years in sub-Saharan Africa. In the ten years after that, it could avert a further 3.7 (1.9-7.5 million new HIV infections and 2.7 (1.5-5.3 million deaths, with about one quarter of all the incident cases prevented and the deaths averted occurring in South Africa. We show that a MC will increase the proportion of infected people who are women from about 52% to 58%; b where there is homogenous mixing but not all men are circumcised, the prevalence of infection in circumcised men is likely to be about 80% of that in uncircumcised men; c MC is equivalent to an intervention, such as a vaccine or increased condom use, that reduces transmission in both directions by 37%.This analysis is based on the result of just one RCT, but if the results of that trial are confirmed we suggest that MC could substantially reduce the burden of HIV in Africa

  9. Awareness and predictors of female genital mutilation/cutting among young health advocates

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    Abolfotouh SM

    2015-02-01

    Full Text Available Sherif M Abolfotouh,1,2 Ahmed Z Ebrahim,1,3 Mostafa A Abolfotouh4 On Behalf of IFMSA-Egypt 1IFMSA-Egypt, Alexandria, Egypt; 2Oulu University Hospital, Oulu, Finland; 3Alexandria Faculty of Medicine, Alexandria, Egypt; 4King Abdullah International Medical Research Center (KAIMRC, King Saud bin-Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia Abstract: The act of female genital mutilation/cutting (FGM/C is considered internationally as a violent act against girls and women and a violation of their human rights. This study sought to assess the awareness and predictors of FGM/C in young Egyptian health advocates. A cross-sectional study of 600 medical students from a total of 2,500 members of the International Federation of Medical Students’ Associations (IFMSA-Egypt, across all Egyptian medical schools, was conducted using a previously validated online Google survey. The overall prevalence of circumcision was 14.7/100 female students, with a significantly higher prevalence in students from rural areas (25% than in non-rural areas (10.8%, P=0.001, and in those residing in Upper (southern Egypt (20.6% than in Lower (northern Egypt (8.7%, P=0.003. The students’ mean percentage score for knowledge about the negative health consequences of FGM/C was 53.50±29.07, reflecting a modest level of knowledge; only 30.5% had a good level of knowledge. The mean percentage score for the overall attitude toward discontinuation of the practice of FGM/C was 76.29±17.93, reflecting a neutral attitude; 58.7% had a favorable attitude/norms toward discontinuation of the practice. Of circumcised students, approximately one-half (46.8% were unwilling to have their daughters circumcised, and 60% reported no harm from being circumcised. After controlling for confounders, a negative attitude toward FGM/C was significantly (P<0.001 in all cases associated with male sex, residency in Upper Egypt, rural origin, previous circumcision, and the preclinical

  10. Male circumcision for HIV prevention in Papua New Guinea: a summary of research evidence and recommendations for public health following a national policy forum.

    Science.gov (United States)

    Vallely, A; MacLaren, D J; Kaleva, W; Millan, J; Tommbe, R; Marape, W; Manineng, C; Buchanan, H; Amos, A; Frank, R; Kelly, A; Kupul, M; Aeno, H; Trowalle, E; John, L N; Redman-Maclaren, M L; Ryan, C; Browne, K; Tynan, A; Hill, P S; Gray, R T; Murray, J; Wilson, D P; Law, G; Siba, P; McBride, W J H; Farley, T; Kaldor, J M

    2011-01-01

    In 2005, a clinical trial in South Africa found that circumcision of young men could reduce their risk of acquiring HIV (human immunodeficiency virus) infection by over 60%. In the following year, two more trials in Africa confirmed this finding, leading the World Health Organization to recommend male circumcision as a public health strategy for HIV prevention in high-incidence countries. In order to inform public health policy in Papua New Guinea (PNG), two major research projects were initiated with the goals of investigating the status of penile cutting practices and assessing understandings, acceptability, feasibility and cost-effectiveness of male circumcision for HIV prevention. In addition, behavioural surveillance surveys systematically asked questions on penile cutting practices and an ethnographic literature review informed historical perspectives of penile cutting in PNG. Key findings from these research activities were presented at a National Policy Forum on Male Circumcision for HIV Prevention held in Port Moresby in November 2011. The Forum made three key recommendations: (1) the formation of a joint National Department of HealthlNational AIDS Council Secretariat Policy Committee on male circumcision; (2) the establishment of an integrated harm reduction program; and (3) that future policy on wide-scale roll-out of male circumcision for HIV prevention in PNG be informed by a combination of data from (a) male circumcision intervention pilot programs and (b) research on the potential protective effect of other forms of penile cutting.

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

    Science.gov (United States)

    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.

  12. The emerging trend of self-circumcision and the need to define cause: Case report of a 21 year-old male.

    Science.gov (United States)

    Kintu-Luwaga, Ronald

    2016-01-01

    Male circumcision is traditionally carried out by ascribed practitioners, so self-circumcision is very rare. It is intriguing why the victims should not seek available modern health care. This article highlights another case of self-circumcision, the related causes, complications and their management. The gradual increase in numbers is contributing to the surgical disease burden. A 21year old male circumcised himself using a razor-blade 13days prior to presentation at the hospital. He attributes this to reluctance to have him circumcised. He sustained extensive penile skin denudation of 7cm in length, severe bleeding and pain. He lives close to traditionally-circumcising communities and was once chided by peers for being uncircumcised. He had no evidence of psychosis. He did not use any medications during the procedure. He was managed with analgesics, antibiotics and surgical reconstruction. He was discharged on the second post-operative day and subsequently recovered fully. Such patients face a variety of complications, both the immediate and long term. Some are fatal especially those with systemic effects including haemorrhagic shock and septicaemia associated with gangrene. Timely referral to specialist surgeons is critical, as well as thorough review and control of the causes prompting this practice. Cases of self-circumcision continue to emerge. There is need to report all cases, explore and manage the possible causes. The stigma uncircumcised males face among circumcised peers may be an important cause. Public health education and improved access to voluntary medical male circumcision services may help to prevent this practice. Copyright © 2016 The Author(s). Published by Elsevier Ltd.. All rights reserved.

  13. Time to complete wound healing in HIV-positive and HIV-negative men following medical male circumcision in Kisumu, Kenya: a prospective cohort study.

    Directory of Open Access Journals (Sweden)

    John H Rogers

    Full Text Available While voluntary medical male circumcision (VMMC has been shown to be protective against HIV-acquisition, the procedure may place men and their partners at risk of HIV infection in the period following circumcision if sex is resumed before the wound is healed. This prospective cohort study evaluates post-circumcision wound healing to determine whether the 42-day post-circumcision abstinence period, recommended by the World Health Organization and adopted by VMMC programs, is optimal.Men were circumcised by forceps-guided method and their post-circumcision wounds examined weekly for seven weeks and at 12 weeks. Time to complete healing was recorded in completed weeks since circumcision, and its associations with baseline covariates were assessed by Kaplan-Meier methods and Cox Proportional Hazard Models. A total of 215 HIV-negative and 108 HIV-positive men aged 18-35 years (median 26, IQR 23-30 were enrolled. 97.1% of scheduled follow-up visits were completed. At week 4, 59.3% of HIV-positive men and 70.4% of age-matched HIV-negative men were healed. At week 6, these percentages rose to 93.4% in HIV-positive men and 92.6% in age-matched HIV-negative men. There was no difference in the hazard of healing between 108 HIV-positive and 108 age-matched HIV-negative men (HR 0.91 95% CI 0.70-1.20. Early post-operative infection was associated with delayed healing in both HIV-positive and HIV-negative men (HR 0.48 95% CI 0.23-1.00.Our results indicate that the WHO recommendation for 42-days post-circumcision sexual abstinence should be maintained for both HIV-positive and HIV-negative men. It is important to stress condom use upon resumption of sex in all men undergoing circumcision.

  14. Estimating the resources needed and savings anticipated from roll-out of adult male circumcision in sub-Saharan Africa

    NARCIS (Netherlands)

    B. Auvert (Bertran); E. Marseille (Elliot); E.L. Korenromp (Eline); J. Lloyd-Smith (James); R. Sitta (Remi); D. Taljaard (Dirk); C. Pretorius (Carel); B. Williams (Brian); J.G. Kahn (James)

    2008-01-01

    textabstractBackground: Trials in Africa indicate that medical adult male circumcision (MAMC) reduces the risk of HIV by 60%. MAMC may avert 2 to 8 million HIV infections over 20 years in sub-Saharan Africa and cost less than treating those who would have been infected. This paper estimates the

  15. Embodiment without bodies? Analysis of embodiment in US-based pro-breastfeeding and anti-male circumcision movements.

    Science.gov (United States)

    Newman, Harmony D; Carpenter, Laura M

    2014-06-01

    This article uses the cases of pro-breastfeeding and anti-circumcision activism to complicate the prevailing conceptualisation of embodiment in research on embodied health movements (EHMs). Whereas most EHM activists draw on their own bodily experiences, in the breastfeeding and circumcision movements, embodiment by proxy is common. Activists use embodiment as a strategy but draw on physical sensations that they imagine for other people's bodies, rather than on those they experience themselves. Pro-breastfeeding activists, who seldom disclose whether they were themselves breastfed, target mothers, encouraging them to breastfeed rather than to formula feed their children in order to reduce their child's risk of disease. Anti-circumcision activists, only some of whom are circumcised men, urge parents to leave their sons' penises intact in order to avoid illness and disfigurement and to preserve the sons' rights to make their own informed decisions as adults. In both movements activists use embodiment as a persuasive strategy even though they themselves do not necessarily embody the risks of the negative health outcomes with which they are concerned. Future research on EHMs should reconceptualise EHMs to include embodiment by proxy and examine whether this important phenomenon systematically affects movement strategies and outcomes.

  16. Learning that circumcision is protective against HIV: risk compensation among men and women in Cape Town, South Africa.

    Science.gov (United States)

    Maughan-Brown, Brendan; Venkataramani, Atheendar S

    2012-01-01

    We examined whether knowledge of the HIV-protective benefits of male circumcision (MC) led to risk compensating behavior in a traditionally circumcising population in South Africa. We extend the current literature by examining risk compensation among women, which has hitherto been unexplored. We used data on Xhosa men and women from the 2009 Cape Area Panel Study. Respondents were asked if they had heard that MC reduces a man's risk of contracting HIV, about their perceived risk of contracting HIV, and condom use. For each gender group we assessed whether risk perception and condom use differed by knowledge of the protective benefits of MC using bivariate and then multivariate models controlling for demographic characteristics, HIV knowledge/beliefs, and previous sexual behaviors. In a further check for confounding, we used data from the 2005 wave to assess whether individuals who would eventually become informed about the protective benefits of circumcision were already different in terms of HIV risk perception and condom use. 34% of men (n=453) and 27% of women (n=690) had heard that circumcision reduces a man's risk of HIV infection. Informed men perceived slightly higher risk of contracting HIV and were more likely to use condoms at last sex (pwomen perceived lower HIV risk (pwomen but not men. Further attention should be paid to the role of new information regarding MC, and drivers of HIV risk more broadly, in modulating sexual behavior among women.

  17. Infant circumcision: the last stand for the dead dogma of parental (sovereignal) rights.

    Science.gov (United States)

    Van Howe, Robert S

    2013-07-01

    J S Mill used the term 'dead dogma' to describe a belief that has gone unquestioned for so long and to such a degree that people have little idea why they accept it or why they continue to believe it. When wives and children were considered chattel, it made sense for the head of a household to have a 'sovereignal right' to do as he wished with his property. Now that women and children are considered to have the full complement of human rights and slavery has been abolished, it is no longer acceptable for someone to have a 'right' to completely control the life of another human being. Revealingly, parental rights tend to be invoked only when parents want to do something that is arguably not in their child's best interest. Infant male circumcision is a case in point. Instead of parental rights, I claim that parents have an obligation to protect their children's rights as well as to preserve the future options of those children so far as possible. In this essay, it is argued that the notion that parents have a right to make decisions concerning their children's bodies and minds-irrespective of the child's best interests-is a dead dogma. The ramifications of this argument for the circumcision debate are then spelled out and discussed.

  18. Male circumcision and penis enhancement in Southeast Asia: matters of pain and pleasure.

    Science.gov (United States)

    Hull, T H; Budiharsana, M

    2001-11-01

    This paper reviews some uniquely male sexual health concerns in Southeast Asia, with particular attention to Indonesia. These include various forms of male circumcision, different types of 'penis enhancement' carried out across the region and the use of dry sex by women. These practices appear to be motivated by specific notions of sexual pleasure, based on indigenous gender constructs. Although they may or may not pose a serious public health problem, as markers of misguided or exploitative gender relations they do reveal important aspects of social psychology related to sexuality and sexual health. Male circumcision provides an ideal opportunity to consider male reproductive health needs and risks in Indonesia, Malaysia and the Philippines. Practices that involve cutting the male genitals need to be addressed in ways that stress the importance of sexual relationships based on mutual respect and open communication. Penis implants and inserts and other penis augmentation devices, as well as dry sex practices, are potentially dangerous to both men and women, and of questionable value in bringing pleasure to either, and should be discouraged.

  19. Pre-emptive penile ring block with sucrose analgesia reduces pain response to neonatal circumcision.

    Science.gov (United States)

    Roman-Rodriguez, Christian F; Toussaint, Thomas; Sherlock, Douglas J; Fogel, Joshua; Hsu, Chaur-Dong

    2014-04-01

    To compare retrospective use of oral sucrose (SUC) vs oral sucrose plus lidocaine ring block (SUC + RB) in the management of pain during neonatal circumcision. A retrospective review of medical records of newborns circumcised using the "Neonatal Infant Pain Scale" was done. With regard to pain, the SUC group had a significantly greater percentage of those with pain than the SUC + RB group at 1 minute (77.7% vs 69.4%; P = .01) and 5 minutes (65.7% vs 55.7%; P = .004). There was no significant pain difference at 30 minutes. In the multivariate logistic regression analyses, those in the SUC group had significantly greater odds for pain at 1 minute than those in the SUC + RB group (odds ratio 1.45, 95% confidence interval 1.04-2.02; P = .03). No significant difference was noted at 5 minutes. Each of the SUC and SUC + RB groups had significant decreases in pain percentages at 5 minutes and 30 minutes (P analgesia. In addition, for post-term neonates, we recommend greater focus on pain levels, including considering higher dosages of pain medications. Copyright © 2014 Elsevier Inc. All rights reserved.

  20. Female genital cutting.

    Science.gov (United States)

    Perron, Liette; Senikas, Vyta; Burnett, Margaret; Davis, Victoria

    2013-11-01

    To strengthen the national framework for care of adolescents and women affected by female genital cutting (FGC) in Canada by providing health care professionals with: (1) information intended to strengthen their knowledge and understanding of the practice; (2) directions with regard to the legal issues related to the practice; (3) clinical guidelines for the management of obstetric and gynaecological care, including FGC related complications; and (4) guidance on the provision of culturally competent care to adolescents and women with FGC. Published literature was retrieved through searches of PubMed, CINAHL, and The Cochrane Library in September 2010 using appropriate controlled vocabulary (e.g., Circumcision, Female) and keywords (e.g., female genital mutilation, clitoridectomy, infibulation). We also searched Social Science Abstracts, Sociological Abstracts, Gender Studies Database, and ProQuest Dissertations and Theses in 2010 and 2011. There were no date or language restrictions. Searches were updated on a regular basis and incorporated in the guideline to December 2011. Grey (unpublished) literature was identified through searching the websites of health technology assessment and health technology-related agencies, clinical practice guideline collections, clinical trial registries, and national and international medical specialty societies. The quality of evidence in this document was rated using the criteria described in the Report of the Canadian Task Force on Preventive Health Care (Table 1). Summary Statements 1. Female genital cutting is internationally recognized as a harmful practice and a violation of girls' and women's rights to life, physical integrity, and health. (II-3) 2. The immediate and long-term health risks and complications of female genital cutting can be serious and life threatening. (II-3) 3. Female genital cutting continues to be practised in many countries, particularly in sub-Saharan Africa, Egypt, and Sudan. (II-3) 4. Global migration

  1. Male circumcision for HIV prevention - a cross-sectional study on awareness among young people and adults in rural Uganda

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    Hizaamu Ramadhan NB

    2010-04-01

    Full Text Available Abstract Background Medical male circumcision is now part of a comprehensive approach to HIV prevention. It has been shown that awareness of the protective effect of male circumcision leads to high acceptability towards the introduction of medical male circumcision services within countries. The objective of this survey was to identify factors determining awareness of male circumcision for HIV prevention. Methods We interviewed 452 participants (267 adults >24 years of age; 185 youths 14-24 years living in three rural Ugandan districts in 2008. Using a standardized questionnaire, we assessed socio-demographic parameters, awareness of MC for HIV prevention, general beliefs/attitudes regarding MC and MC status. Determinants for awareness of MC for HIV prevention were examined with multiple logistic regression models. Results Out of all adults, 52.1% were male (mean ± SD age 39.8 ± 11 years, of whom 39.1% reported to be circumcised. Out of all youths, 58.4% were male (18.4 ± 2.5, 35.0% circumcised. Adults were more aware of MC for HIV prevention than youths (87.1% vs. 76.5%; p = 0.004. In adults, awareness was increased with higher educational level compared to no school: primary school (adjusted OR 9.32; 95%CI 1.80-48.11, secondary (5.04; 1.01-25.25, tertiary (9.91; 0.76-129.18, university education (8.03; 0.59-109.95. Younger age and male sex were further significant determinants of increased awareness, but not marital status, religion, district, ethnicity, employment status, and circumcision status. In youths, we found a borderline statistically significant decrease of awareness of MC for HIV prevention with higher educational level, but not with any other socio-demographic factors. Conclusions Particularly Ugandans with low education, youths, and women, playing an important role in decision-making of MC for their partners and sons, should be increasingly targeted by information campaigns about positive health effects of MC.

  2. Age Differences in Perceptions of and Motivations for Voluntary Medical Male Circumcision Among Adolescents in South Africa, Tanzania, and Zimbabwe.

    Science.gov (United States)

    Patel, Eshan U; Kaufman, Michelle R; Dam, Kim H; Van Lith, Lynn M; Hatzold, Karin; Marcell, Arik V; Mavhu, Webster; Kahabuka, Catherine; Mahlasela, Lusanda; Njeuhmeli, Emmanuel; Seifert Ahanda, Kim; Ncube, Getrude; Lija, Gissenge; Bonnecwe, Collen; Tobian, Aaron A R

    2018-04-03

    The World Health Organization (WHO) and the Joint United Nations Programme on HIV/AIDS (UNAIDS) have set a Fast-Track goal to achieve 90% coverage of voluntary medical male circumcision (VMMC) among boys and men aged 10-29 years in priority settings by 2021. We aimed to identify age-specific facilitators of VMMC uptake among adolescents. Younger (aged 10-14 years; n = 967) and older (aged 15-19 years; n = 559) male adolescents completed structured interviews about perceptions of and motivations for VMMC before receiving VMMC counseling at 14 service provision sites across South Africa, Tanzania, and Zimbabwe. Adjusted prevalence ratios (aPRs) were estimated using multivariable modified Poisson regression models with generalized estimating equations and robust standard errors. The majority of adolescents reported a strong desire for VMMC. Compared with older adolescents, younger adolescents were less likely to cite protection against human immunodeficiency virus (HIV) or other sexually transmitted infections (aPR, 0.77; 95% confidence interval [CI], .66-.91) and hygienic reasons (aPR, 0.55; 95% CI, .39-.77) as their motivation to undergo VMMC but were more likely to report being motivated by advice from others (aPR, 1.88; 95% CI, 1.54-2.29). Although most adolescents believed that undergoing VMMC was a normative behavior, younger adolescents were less likely to perceive higher descriptive norms (aPR, 0.79; .71-.89), injunctive norms (aPR, 0.86; 95% CI, .73-1.00), or anticipated stigma for being uncircumcised (aPR, 0.79; 95% CI, .68-.90). Younger adolescents were also less likely than older adolescents to correctly cite that VMMC offers men and boys partial HIV protection (aPR, 0.73; 95% CI, .65-.82). Irrespective of age, adolescents' main concern about undergoing VMMC was pain (aPR, 0.95; 95% CI, .87-1.04). Among younger adolescents, fear of pain was negatively associated with desire for VMMC (aPR, 0.89; 95% CI, .83-.96). Age-specific strategies are important to

  3. Awareness and predictors of female genital mutilation/cutting among young health advocates.

    Science.gov (United States)

    Abolfotouh, Sherif M; Ebrahim, Ahmed Z; Abolfotouh, Mostafa A

    2015-01-01

    The act of female genital mutilation/cutting (FGM/C) is considered internationally as a violent act against girls and women and a violation of their human rights. This study sought to assess the awareness and predictors of FGM/C in young Egyptian health advocates. A cross-sectional study of 600 medical students from a total of 2,500 members of the International Federation of Medical Students' Associations (IFMSA)-Egypt, across all Egyptian medical schools, was conducted using a previously validated online Google survey. The overall prevalence of circumcision was 14.7/100 female students, with a significantly higher prevalence in students from rural areas (25%) than in non-rural areas (10.8%, P=0.001), and in those residing in Upper (southern) Egypt (20.6%) than in Lower (northern) Egypt (8.7%, P=0.003). The students' mean percentage score for knowledge about the negative health consequences of FGM/C was 53.50±29.07, reflecting a modest level of knowledge; only 30.5% had a good level of knowledge. The mean percentage score for the overall attitude toward discontinuation of the practice of FGM/C was 76.29±17.93, reflecting a neutral attitude; 58.7% had a favorable attitude/norms toward discontinuation of the practice. Of circumcised students, approximately one-half (46.8%) were unwilling to have their daughters circumcised, and 60% reported no harm from being circumcised. After controlling for confounders, a negative attitude toward FGM/C was significantly (Pdrive a change in attitude toward discontinuation of this harmful practice.

  4. Modeling the Impact of Uganda’s Safe Male Circumcision Program: Implications for Age and Regional Targeting

    Science.gov (United States)

    Kripke, Katharine; Vazzano, Andrea; Kirungi, William; Musinguzi, Joshua; Opio, Alex; Ssempebwa, Rhobbinah; Nakawunde, Susan; Kyobutungi, Sheila; Akao, Juliet N.; Magala, Fred; Mwidu, George; Castor, Delivette

    2016-01-01

    Background Uganda aims to provide safe male circumcision (SMC) to 80% of men ages 15–49 by 2016. To date, only 2 million men have received SMC of the 4.2 million men required. In response to age and regional trends in SMC uptake, the country sought to re-examine its targets with respect to age and subnational region, to assess the program’s progress, and to refine the implementation approach. Methods and Findings The Decision Makers’ Program Planning Tool, Version 2.0 (DMPPT 2.0), was used in conjunction with incidence projections from the Spectrum/AIDS Impact Module (AIM) to conduct this analysis. Population, births, deaths, and HIV incidence and prevalence were used to populate the model. Baseline male circumcision prevalence was derived from the 2011 AIDS Indicator Survey. Uganda can achieve the most immediate impact on HIV incidence by circumcising men ages 20–34. This group will also require the fewest circumcisions for each HIV infection averted. Focusing on men ages 10–19 will offer the greatest impact over a 15-year period, while focusing on men ages 15–34 offers the most cost-effective strategy over the same period. A regional analysis showed little variation in cost-effectiveness of scaling up SMC across eight regions. Scale-up is cost-saving in all regions. There is geographic variability in program progress, highlighting two regions with low baseline rates of circumcision where additional efforts will be needed. Conclusion Focusing SMC efforts on specific age groups and regions may help to accelerate Uganda’s SMC program progress. Policy makers in Uganda have already used model outputs in planning efforts, proposing males ages 10–34 as a priority group for SMC in the 2014 application to the Global Fund’s new funding model. As scale-up continues, the country should also consider a greater effort to expand SMC in regions with low MC prevalence. PMID:27410234

  5. Symptoms of Posttraumatic Stress Disorder After Ritual Female Genital Surgery Among Bedouin in Israel: Myth or Reality?

    Science.gov (United States)

    Applebaum, Julia; Cohen, Hagit; Matar, Michael; Abu Rabia, Yones; Kaplan, Zeev

    2008-01-01

    Objective: Ritual female genital surgery (RFGS), or female circumcision, is common among certain ethnic groups in Asia and Africa and describes a range of practices involving complete or partial removal of the female external genitalia for nonmedical reasons. Several studies in African populations, in which more severe forms of RFGS are performed, reported an increased prevalence of posttraumatic stress disorder and other psychiatric syndromes among circumcised women than among uncircumcised controls. Among the Bedouin population in southern Israel, RFGS has become a symbolic operation without major mutilation. However, in a study performed in 1999, Bedouin women after RFGS reported difficulties in mother-daughter relationships and trust. This pilot study assessed the mental health of Bedouin women from southern Israel after RFGS compared to age-matched controls without RFGS. Method: The psychological impact of RFGS was assessed in 19 circumcised Bedouin women compared to 18 age-matched controls. The Post Traumatic Stress Disorder Scale, Symptom Checklist, Impact of Event Scale, and a demographics and background questionnaire were used to assess traumatization and psychiatric illnesses. The study was conducted from March to July 2007. Results: No statistically significant differences were found between the 2 groups. Conclusions: The prevailing procedure of RFGS among the Bedouin population of southern Israel had no apparent effect on mental health. PMID:19287554

  6. Acceptability of Condoms, Circumcision and PrEP among Young Black Men Who Have Sex with Men: A Descriptive Study Based on Effectiveness and Cost

    Directory of Open Access Journals (Sweden)

    Richard A. Crosby

    2014-02-01

    Full Text Available The current study examined and compared the willingness of young Black men who have sex with men (YBMSM to accept pre-exposure prophylaxis (PrEP, adult male circumcision, and condoms for reducing their risk of HIV acquisition. The majority (67% reported unprotected receptive anal sex in the last six months. About three-quarters (71% would accept using PrEP if it was 100% effective. Cost influenced PrEP acceptance with 19% indicating acceptance at $100 per month co-pay. Of those not circumcised, 50% indicated willingness if circumcision was 100% effective. Acceptance of circumcision decreased markedly to 17% with co-pays of $100. About 73% of men were willing to use condoms if they were 100% effective and 50% indicated a willingness at the cost of $10 per month. The findings suggest that condom use promotion strategies should remain at the forefront of public health efforts to control HIV incidence among YBMSM.

  7. Implementation of Adolescent-Friendly Voluntary Medical Male Circumcision Using a School Based Recruitment Program in Rural KwaZulu-Natal, South Africa

    OpenAIRE

    Montague, Carl; Ngcobo, Nelisiwe; Mahlase, Gethwana; Frohlich, Janet; Pillay, Cheryl; Yende-Zuma, Nonhlanhla; Humphries, Hilton; Dellar, Rachael; Naidoo, Kogieleum; Karim, Quarraisha Abdool

    2014-01-01

    BACKGROUND: Epidemiological data from South Africa demonstrate that risk of human immunodeficiency virus (HIV) infection in males increases dramatically after adolescence. Targeting adolescent HIV-negative males may be an efficient and cost-effective means of maximising the established HIV prevention benefits of voluntary medical male circumcision (VMMC) in high HIV prevalence-, low circumcision practice-settings. This study assessed the feasibility of recruiting male high school students for...

  8. Risk compensation is not associated with male circumcision in Kisumu, Kenya: a multi-faceted assessment of men enrolled in a randomized controlled trial.

    Directory of Open Access Journals (Sweden)

    Christine L Mattson

    2008-06-01

    Full Text Available Three randomized controlled trials (RCTs have confirmed that male circumcision (MC significantly reduces acquisition of HIV-1 infection among men. The objective of this study was to perform a comprehensive, prospective evaluation of risk compensation, comparing circumcised versus uncircumcised controls in a sample of RCT participants.Between March 2004 and September 2005, we systematically recruited men enrolled in a RCT of MC in Kenya. Detailed sexual histories were taken using a modified Timeline Followback approach at baseline, 6, and 12 months. Participants provided permission to obtain circumcision status and laboratory results from the RCT. We evaluated circumcised and uncircumcised men's sexual behavior using an 18-item risk propensity score and acquisition of incident infections of gonorrhea, chlamydia, and trichomoniasis. Of 1780 eligible RCT participants, 1319 enrolled (response rate = 74%. At the baseline RCT visit, men who enrolled in the sub-study reported the same sexual behaviors as men who did not. We found a significant reduction in sexual risk behavior among both circumcised and uncircumcised men from baseline to 6 (p<0.01 and 12 (p = 0.05 months post-enrollment. Longitudinal analyses indicated no statistically significant differences between sexual risk propensity scores or in incident infections of gonorrhea, chlamydia, and trichomoniasis between circumcised and uncircumcised men. These results are based on the most comprehensive analysis of risk compensation yet done.In the context of a RCT, circumcision did not result in increased HIV risk behavior. Continued monitoring and evaluation of risk compensation associated with circumcision is needed as evidence supporting its' efficacy is disseminated and MC is widely promoted for HIV prevention.

  9. Covering the Last Kilometer: Using GIS to Scale-Up Voluntary Medical Male Circumcision Services in Iringa and Njombe Regions, Tanzania

    Science.gov (United States)

    Mahler, Hally; Plotkin, Marya; Kulindwa, Yusuph; Greenberg, Seth; Mlanga, Erick; Njeuhmeli, Emmanuel; Lija, Gissenje

    2015-01-01

    Background: Based on the established protective effect of voluntary medical male circumcision (VMMC) in reducing female-to-male HIV transmission, Tanzania's Ministry of Health and Social Welfare (MOHSW) embarked on the scale-up of VMMC services in 2009. The Maternal and Child Health Integrated Project (MCHIP) supported the MOHSW to roll out VMMC services in Iringa and Njombe, 2 regions of Tanzania with among the highest HIV and lowest circumcision prevalence. With ambitious targets of reaching 264,990 males aged 10–34 years with VMMC in 5 years, efficient and innovative program approaches were necessary. Program Description: Outreach campaigns, in which mobile teams set up temporary services in facilities or non-facility settings, are used to reach lesser-served areas with VMMC. In 2012, MCHIP began using geographic information systems (GIS) to strategically plan the location of outreach campaigns. MCHIP gathered geocoded data on variables such as roads, road conditions, catchment population, staffing, and infrastructure for every health facility in Iringa and Njombe. These data were uploaded to a central database and overlaid with various demographic and service delivery data in order to identify the VMMC needs of the 2 regions. Findings: MCHIP used the interactive digital maps as decision-making tools to extend mobile VMMC outreach to “the last kilometer.” As of September 2014, the MOHSW with MCHIP support provided VMMC to 267,917 men, 259,144 of whom were men were aged 10–34 years, an achievement of 98% of the target of eligible males in Iringa and Njombe. The project reached substantially more men through rural dispensaries and non-health care facilities each successive year after GIS was introduced in 2012, jumping from 48% of VMMCs performed in rural areas in fiscal year 2011 to 88% in fiscal year 2012 and to 93% by the end of the project in 2014. Conclusion: GIS was an effective tool for making strategic decisions about where to prioritize VMMC

  10. Covering the Last Kilometer: Using GIS to Scale-Up Voluntary Medical Male Circumcision Services in Iringa and Njombe Regions, Tanzania.

    Science.gov (United States)

    Mahler, Hally; Searle, Sarah; Plotkin, Marya; Kulindwa, Yusuph; Greenberg, Seth; Mlanga, Erick; Njeuhmeli, Emmanuel; Lija, Gissenje

    2015-09-01

    Based on the established protective effect of voluntary medical male circumcision (VMMC) in reducing female-to-male HIV transmission, Tanzania's Ministry of Health and Social Welfare (MOHSW) embarked on the scale-up of VMMC services in 2009. The Maternal and Child Health Integrated Project (MCHIP) supported the MOHSW to roll out VMMC services in Iringa and Njombe, 2 regions of Tanzania with among the highest HIV and lowest circumcision prevalence. With ambitious targets of reaching 264,990 males aged 10-34 years with VMMC in 5 years, efficient and innovative program approaches were necessary. Outreach campaigns, in which mobile teams set up temporary services in facilities or non-facility settings, are used to reach lesser-served areas with VMMC. In 2012, MCHIP began using geographic information systems (GIS) to strategically plan the location of outreach campaigns. MCHIP gathered geocoded data on variables such as roads, road conditions, catchment population, staffing, and infrastructure for every health facility in Iringa and Njombe. These data were uploaded to a central database and overlaid with various demographic and service delivery data in order to identify the VMMC needs of the 2 regions. MCHIP used the interactive digital maps as decision-making tools to extend mobile VMMC outreach to "the last kilometer." As of September 2014, the MOHSW with MCHIP support provided VMMC to 267,917 men, 259,144 of whom were men were aged 10-34 years, an achievement of 98% of the target of eligible males in Iringa and Njombe. The project reached substantially more men through rural dispensaries and non-health care facilities each successive year after GIS was introduced in 2012, jumping from 48% of VMMCs performed in rural areas in fiscal year 2011 to 88% in fiscal year 2012 and to 93% by the end of the project in 2014. GIS was an effective tool for making strategic decisions about where to prioritize VMMC service delivery, particularly for mobile and outreach services

  11. Early infant male circumcision: Systematic review, risk-benefit analysis, and progress in policy.

    Science.gov (United States)

    Morris, Brian J; Kennedy, Sean E; Wodak, Alex D; Mindel, Adrian; Golovsky, David; Schrieber, Leslie; Lumbers, Eugenie R; Handelsman, David J; Ziegler, John B

    2017-02-08

    To determine whether recent evidence-based United States policies on male circumcision (MC) apply to comparable Anglophone countries, Australia and New Zealand. Articles in 2005 through 2015 were retrieved from PubMed using the keyword "circumcision" together with 36 relevant subtopics. A further PubMed search was performed for articles published in 2016. Searches of the EMBASE and Cochrane databases did not yield additional citable articles. Articles were assessed for quality and those rated 2+ and above according to the Scottish Intercollegiate Grading System were studied further. The most relevant and representative of the topic were included. Bibliographies were examined to retrieve further key references. Randomized controlled trials, recent high quality systematic reviews or meta-analyses (level 1++ or 1+ evidence) were prioritized for inclusion. A risk-benefit analysis of articles rated for quality was performed. For efficiency and reliability, recent randomized controlled trials, meta-analyses, high quality systematic reviews and large well-designed studies were used if available. Internet searches were conducted for other relevant information, including policies and Australian data on claims under Medicare for MC. Evidence-based policy statements by the American Academy of Pediatrics (AAP) and the Centers for Disease Control and Prevention (CDC) support infant and later age male circumcision (MC) as a desirable public health measure. Our systematic review of relevant literature over the past decade yielded 140 journal articles that met our inclusion criteria. Together, these showed that early infant MC confers immediate and lifelong benefits by protecting against urinary tract infections having potential adverse long-term renal effects, phimosis that causes difficult and painful erections and "ballooning" during urination, inflammatory skin conditions, inferior penile hygiene, candidiasis, various sexually transmissible infections in both sexes, genital

  12. Informing the scaling up of voluntary medical male circumcision efforts through the use of theory of reasoned action: survey findings among uncircumcised young men in Swaziland.

    Science.gov (United States)

    Gurman, Tilly A; Dhillon, Preeti; Greene, Jessica L; Makadzange, Panganai; Khumlao, Philisiwe; Shekhar, Navendu

    2015-04-01

    Assessing predictors of intention to circumcise can help to identify effective strategies for increasing uptake of voluntary medical male circumcision (VMMC). Grounded in the theory of reasoned action (TRA), the current study of uncircumcised males ages 13-29 in Swaziland (N = 1,257) employed multivariate logistic regression to determine predictors of VMMC intention. The strongest predictors were strongly disagreeing/disagreeing that sex was more painful for a circumcised man (odds ratio [OR] = 4.37; p = < .007), a Christian man should not get circumcised (OR = 2.47; p < .001), and circumcision makes penetration more painful and difficult (OR = 2.44; p = .007). Several beliefs about enhanced sexual performance, normative beliefs (parents, sexual partner, and friends), and non-TRA-related factors (e.g., importance of plowing season to daily schedule) were also statistically significant predictors. TRA proved a useful theory to explore young men's intention to circumcise and can help inform interventions aimed at increasing uptake of VMMC.

  13. A preliminary study of the sensory distribution of the penile dorsal and ventral nerves: implications for effective penile block for circumcision.

    LENUS (Irish Health Repository)

    Long, Ronan M

    2012-01-31

    OBJECTIVE: To determine the sensory innervation of the penis, as regional anaesthesia is often used either for postoperative analgesia or as the sole anaesthetic technique for circumcision. Since first described in 1978 the dorsal penile nerve block has become the standard technique, but some blocks are ineffective; a better understanding of the sensory innervation of the penis might improve the efficacy of the dorsal penile block technique. PATIENTS AND METHODS: In 13 men undergoing circumcision with local anaesthetic, cutaneous sensation was tested before and after infiltration of the dorsal aspect of the penis, and then again after infiltration of the ventral aspect. The area of anaesthesia was mapped using pin-prick sensation. RESULTS: Ten of the 13 patients showed a similar pattern of sensory distribution. After the dorsal block, the dorsal aspect of the shaft of the penis and glans penis became insensate. The ventral aspect of the shaft remained sensate up to and including the frenulum. After successful ventral infiltration all sensate areas became insensate and circumcision proceeded. In one case the frenulum and distal ventral foreskin was anaesthetized after the dorsal block and ventral infiltration was not required. No patient experienced pain during circumcision. CONCLUSION: For consistently successful regional anaesthesia of the foreskin in circumcision, a dorsal block must be used. This should be combined with ventral infiltration at the site of incision. This method will avoid inconsistencies and allow pain-free circumcision using local anaesthesia in most men.

  14. Comparative efficacy and safety of different circumcisions for patients with redundant prepuce or phimosis: A network meta-analysis.

    Science.gov (United States)

    Huang, Chuiguo; Song, Pan; Xu, Changbao; Wang, Ruofan; Wei, Lei; Zhao, Xinghua

    2017-07-01

    Phimosis and redundant prepuce are defined as the inability of the foreskin to be retracted behind the glans penis in uncircumcised males. To synthesize the evidence and provide the hierarchies of different circumcisions for phimosis and redundant prepuce, we performed an overall network meta-analysis (NMA) based on their comparative efficacy and safety. Electronic databases including PubMed, Embase, Wan Fang, VIP, CNKI and CBM database were researched from randomized controlled trials (RCTs) for redundant prepuce or phimosis. We conducted the direct and indirect comparisons by aggregate data drug information system (ADDIS) software. Moreover, consistency models were applied to assess the differences among the male circumcision practices, and the ranks based on probabilities of intervention for the different endpoints were performed. Node-splitting analysis was used to test inconsistency. Eighteen RCTs were included with 6179 participants. Compared with the conventional circumcision(CC), two new styles of circumcisions, the disposable circumcision suture device(DCSD) and Shang Ring circumcision(SRC), provided significantly shorter operation time[DCSD: standardized mean difference (SMD) = -20.60, 95% credible interval(CI) (-23.38, -17.82); SRC: SMD = -19.16, 95%CI (-21.86, -16.52)], shorter wound healing time [DCSD:SMD = -4.19, 95%CI (-8.24,-0.04); SRC: SMD = 4.55, 95%CI (1.62, 7.57); ] and better postoperative penile appearance [DCSD: odds ratios odds ratios (OR) = 11.42, 95%CI (3.60, 37.68); SRC: OR = 3.85,95%CI (1.29, 12.79)]. Additionally, DCSD showed a lower adverse events rate than other two treatments. However, no significant difference was shown in all surgeries for 24 h postoperative pain score. Node-splitting analysis showed that no significant inconsistency was existed (P > 0.05). Based on the results of NMA, DCSD may be a most effective and safest choice for phimosis and redundant prepuce. DCSD has the advantages of a shorter operation

  15. Informed consent and registry-based research - the case of the Danish circumcision registry

    DEFF Research Database (Denmark)

    Ploug, Thomas; Holm, Søren

    2017-01-01

    Background: Research into personal health data holds great potential not only for improved treatment but also for economic growth. In these years many countries are developing policies aimed at facilitating such research often under the banner of 'big data'. A central point of debate is whether...... the secondary use of health data requires informed consent if the data is anonymised. In 2013 the Danish Minister of Health established a new register collecting data about all ritual male childhood circumcisions in Denmark. The main purpose of the register was to enable future research into the consequences......) polarised research, and that a person may therefore have a strong and legitimate interest in deciding whether or not such data should be collected and/or used in research. This casts doubt on the claim that the requirement of informed consent could and should be waived for all types of secondary research...

  16. Voluntary medical male circumcision: an introduction to the cost, impact, and challenges of accelerated scaling up.

    Directory of Open Access Journals (Sweden)

    Catherine Hankins

    2011-11-01

    Full Text Available Scaling up voluntary medical male circumcision (VMMC for HIV prevention is cost saving and creates fiscal space in the future that otherwise would have been encumbered by antiretroviral treatment costs. An investment of US$1,500,000,000 between 2011 and 2015 to achieve 80% coverage in 13 priority countries in southern and eastern Africa will result in net savings of US$16,500,000,000. Strong political leadership, country ownership, and stakeholder engagement, along with effective demand creation, community mobilisation, and human resource deployment, are essential. This collection of articles on determining the cost and impact of VMMC for HIV prevention signposts the way forward to scaling up VMMC service delivery safely and efficiently to reap individual- and population-level benefits.

  17. Safety, effectiveness and acceptability of the PrePex device for adult male circumcision in Kenya.

    Directory of Open Access Journals (Sweden)

    Paul J Feldblum

    Full Text Available To assess the safety, effectiveness and acceptability of the PrePex device for adult medical male circumcision (MMC in routine service delivery in Kenya.We enrolled 427 men ages 18-49 at one fixed and two outreach clinics. Procedures were performed by trained clinical officers and nurses. The first 50 enrollees were scheduled for six follow-up visits, and remaining men were followed at Days 7 and 42. We recorded adverse events (AEs and time to complete healing, and interviewed men about acceptability and pain.Placement and removal procedures each averaged between 3 and 4 minutes. Self-reported pain was minimal during placement but was fleetingly intense during removal. The rate of moderate/severe AEs was 5.9% overall (95% confidence interval [CI] 3.8%-8.5%, all of which resolved without sequelae. AEs included 5 device displacements, 2 spontaneous foreskin detachments, and 9 cases of insufficient foreskin removal. Surgical completion of MMC was required for 9 men (2.1%. Among the closely monitored first 50 participants, the probability of complete healing by Day 42 was 0.44 (95% CI 0.30-0.58, and 0.90 by Day 56. A large majority of men was favorable about their MMC procedure and would recommend PrePex to friends and family.The PrePex device was effective for MMC in Kenya, and well-accepted. The AE rate was higher than reported for surgical procedures there, or in previous PrePex studies. Healing time is longer than following surgical circumcision. Provider experience and clearer counseling on post-placement and post-removal care should lead to lower AE rates.ClinicalTrials.gov NCT01711411.

  18. Removal of foreskin remnants in circumcised adults for treatment of premature ejaculation

    Directory of Open Access Journals (Sweden)

    Mohammad Reza Namavar

    2011-01-01

    Full Text Available Background and Aim : Premature ejaculation (PE is the most prevalent sexual dysfunction in every country. There are many types of treatment, but the main limitation of medical treatment for premature ejaculation is recurrence after withdrawal of medicine. The prepuce is a specific erogenous zone that contains a rich and complex network of nerves. Circumcision radically desensitizes the penis, but incomplete circumcision may cause premature ejaculation. We evaluate the effect of removal of foreskin remnants in adults on PE. Materials and Methods : The sensitive area of penile skin and the remaining parts of foreskin in adult men were recognized in 47 selective patients. Under local anesthesia, the remnant parts of foreskin were incised and removed. They were asked to fill the investigating questionnaire about the changes of intravaginal latency ejaculatory time (IVELT, patients and their sexual partners′ satisfaction with sexual life, control over ejaculation, and penile sensitivity, before and after treatment. Results : There were no signs of inflammation and no serious adverse reactions in all cases after operation. IVELT significantly increased from 64.25 before surgery to 731.49 sec after surgery (P<0.001. The percentage of postoperative satisfaction in both the patient and his partner significantly increased (P<0.001. After surgery, 95.7% of men had better control over their ejaculation. This surgery significantly decreased sensitivity of penis (P<0.001, but it did not change glans penis insensitivity. Conclusions : These results indicate that removal of foreskin remnants in adults is an effective modality in selective patients of PE.

  19. Estimating Client Out-of-Pocket Costs for Accessing Voluntary Medical Male Circumcision in South Africa.

    Directory of Open Access Journals (Sweden)

    Michel Tchuenche

    Full Text Available In 2010, South Africa launched a countrywide effort to scale up its voluntary medical male circumcision (VMMC program on the basis of compelling evidence that circumcision reduces men's risk of acquiring HIV through heterosexual intercourse. Even though VMMC is free there, clients can incur indirect out-of-pocket costs (for example transportation cost or foregone income. Because these costs can be barriers to increasing the uptake of VMMC services, we assessed them from a client perspective, to inform VMMC demand creation policies. Costs (calculated using a bottom-up approach and demographic data were systematically collected through 190 interviews conducted in 2015 with VMMC clients or (for minors their caregivers at 25 VMMC facilities supported by the government and the President's Emergency Plan for AIDS Relief in eight of South Africa's nine provinces. The average age of VMMC clients was 22 years and nearly 92% were under 35 years of age. The largest reported out-of-pocket expenditure was transportation, at an average of US$9.20 (R 100. Only eight clients (4% reported lost days of work. Indirect expenditures were childcare costs (one client and miscellaneous items such as food or medicine (20 clients. Given competing household expense priorities, spending US$9.20 (R100 per person on transportation to access VMMC services could be a significant burden on clients and households, and a barrier to South Africa's efforts to create demand for VMMC. Thus, we recommend a more focused analysis of clients' transportation costs to access VMMC services.

  20. Effectiveness of and Financial Returns to Voluntary Medical Male Circumcision for HIV Prevention in South Africa: An Incremental Cost-Effectiveness Analysis.

    Directory of Open Access Journals (Sweden)

    Markus Haacker

    2016-05-01

    Full Text Available Empirical studies and population-level policy simulations show the importance of voluntary medical male circumcision (VMMC in generalized epidemics. This paper complements available scenario-based studies (projecting costs and outcomes over some policy period, typically spanning decades by adopting an incremental approach-analyzing the expected consequences of circumcising one male individual with specific characteristics in a specific year. This approach yields more precise estimates of VMMC's cost-effectiveness and identifies the outcomes of current investments in VMMC (e.g., within a fiscal budget period rather than of investments spread over the entire policy period.The model has three components. We adapted the ASSA2008 model, a demographic and epidemiological model of the HIV epidemic in South Africa, to analyze the impact of one VMMC on HIV incidence over time and across the population. A costing module tracked the costs of VMMC and the resulting financial savings owing to reduced HIV incidence over time. Then, we used several financial indicators to assess the cost-effectiveness of and financial return on investments in VMMC. One circumcision of a young man up to age 20 prevents on average over 0.2 HIV infections, but this effect declines steeply with age, e.g., to 0.08 by age 30. Net financial savings from one VMMC at age 20 are estimated at US$617 at a discount rate of 5% and are lower for circumcisions both at younger ages (because the savings occur later and are discounted more and at older ages (because male circumcision becomes less effective. Investments in male circumcision carry a financial rate of return of up to 14.5% (for circumcisions at age 20. The cost of a male circumcision is refinanced fastest, after 13 y, for circumcisions at ages 20 to 25. Principal limitations of the analysis arise from the long time (decades over which the effects of VMMC unfold-the results are therefore sensitive to the discount rate applied, and

  1. Religion's relationship with social boundaries surrounding gender ...

    African Journals Online (AJOL)

    Religion's relationship with social boundaries surrounding gender. ... is associated with segregation, marginalization and differentiation between men and women. ... are necessary in the society it should not be mistaken for gender inequality.

  2. The use of multi-criteria decision making models in evaluating anesthesia method options in circumcision surgery.

    Science.gov (United States)

    Hancerliogullari, Gulsah; Hancerliogullari, Kadir Oymen; Koksalmis, Emrah

    2017-01-23

    Determining the most suitable anesthesia method for circumcision surgery plays a fundamental role in pediatric surgery. This study is aimed to present pediatric surgeons' perspective on the relative importance of the criteria for selecting anesthesia method for circumcision surgery by utilizing the multi-criteria decision making methods. Fuzzy set theory offers a useful tool for transforming linguistic terms into numerical assessments. Since the evaluation of anesthesia methods requires linguistic terms, we utilize the fuzzy Analytic Hierarchy Process (AHP) and fuzzy Technique for Order Preference by Similarity to Ideal Solution (TOPSIS). Both mathematical decision-making methods are originated from individual judgements for qualitative factors utilizing the pair-wise comparison matrix. Our model uses four main criteria, eight sub-criteria as well as three alternatives. To assess the relative priorities, an online questionnaire was completed by three experts, pediatric surgeons, who had experience with circumcision surgery. Discussion of the results with the experts indicates that time-related factors are the most important criteria, followed by psychology, convenience and duration. Moreover, general anesthesia with penile block for circumcision surgery is the preferred choice of anesthesia compared to general anesthesia without penile block, which has a greater priority compared to local anesthesia under the discussed main-criteria and sub-criteria. The results presented in this study highlight the need to integrate surgeons' criteria into the decision making process for selecting anesthesia methods. This is the first study in which multi-criteria decision making tools, specifically fuzzy AHP and fuzzy TOPSIS, are used to evaluate anesthesia methods for a pediatric surgical procedure.

  3. Evidence-based identification of key beliefs explaining adult male circumcision motivation in Zimbabwe: targets for behavior change messaging.

    Science.gov (United States)

    Montaño, Daniel E; Kasprzyk, Danuta; Hamilton, Deven T; Tshimanga, Mufuta; Gorn, Gerald

    2014-05-01

    Male circumcision (MC) reduces HIV acquisition among men, leading WHO/UNAIDS to recommend a goal to circumcise 80 % of men in high HIV prevalence countries. Significant investment to increase MC capacity in priority countries was made, yet only 5 % of the goal has been achieved in Zimbabwe. The integrated behavioral model (IBM) was used as a framework to investigate the factors affecting MC motivation among men in Zimbabwe. A survey instrument was designed based on elicitation study results, and administered to a representative household-based sample of 1,201 men aged 18-30 from two urban and two rural areas in Zimbabwe. Multiple regression analysis found all five IBM constructs significantly explained MC Intention. Nearly all beliefs underlying the IBM constructs were significantly correlated with MC Intention. Stepwise regression analysis of beliefs underlying each construct respectively found that 13 behavioral beliefs, 5 normative beliefs, 4 descriptive norm beliefs, 6 efficacy beliefs, and 10 control beliefs were significant in explaining MC Intention. A final stepwise regression of the five sets of significant IBM construct beliefs identified 14 key beliefs that best explain Intention. Similar analyses were carried out with subgroups of men by urban-rural and age. Different sets of behavioral, normative, efficacy, and control beliefs were significant for each sub-group, suggesting communication messages need to be targeted to be most effective for sub-groups. Implications for the design of effective MC demand creation messages are discussed. This study demonstrates the application of theory-driven research to identify evidence-based targets for intervention messages to increase men's motivation to get circumcised and thereby improve demand for male circumcision.

  4. Randomized, controlled intervention trial of male circumcision for reduction of HIV infection risk: the ANRS 1265 Trial.

    Directory of Open Access Journals (Sweden)

    2005-11-01

    Full Text Available BACKGROUND: Observational studies suggest that male circumcision may provide protection against HIV-1 infection. A randomized, controlled intervention trial was conducted in a general population of South Africa to test this hypothesis. METHODS AND FINDINGS: A total of 3,274 uncircumcised men, aged 18-24 y, were randomized to a control or an intervention group with follow-up visits at months 3, 12, and 21. Male circumcision was offered to the intervention group immediately after randomization and to the control group at the end of the follow-up. The grouped censored data were analyzed in intention-to-treat, univariate and multivariate, analyses, using piecewise exponential, proportional hazards models. Rate ratios (RR of HIV incidence were determined with 95% CI. Protection against HIV infection was calculated as 1 - RR. The trial was stopped at the interim analysis, and the mean (interquartile range follow-up was 18.1 mo (13.0-21.0 when the data were analyzed. There were 20 HIV infections (incidence rate = 0.85 per 100 person-years in the intervention group and 49 (2.1 per 100 person-years in the control group, corresponding to an RR of 0.40 (95% CI: 0.24%-0.68%; p < 0.001. This RR corresponds to a protection of 60% (95% CI: 32%-76%. When controlling for behavioural factors, including sexual behaviour that increased slightly in the intervention group, condom use, and health-seeking behaviour, the protection was of 61% (95% CI: 34%-77%. CONCLUSION: Male circumcision provides a degree of protection against acquiring HIV infection, equivalent to what a vaccine of high efficacy would have achieved. Male circumcision may provide an important way of reducing the spread of HIV infection in sub-Saharan Africa. (Preliminary and partial results were presented at the International AIDS Society 2005 Conference, on 26 July 2005, in Rio de Janeiro, Brazil..

  5. A fast, easy circumcision procedure combining a CO2 laser and cyanoacrylate adhesive: a non-randomized comparative trial

    Directory of Open Access Journals (Sweden)

    Tahsin Gorgulu

    2016-02-01

    Full Text Available ABSTRACT Background Circumcision is performed as a routine operation in many countries, more commonly for religious and cultural reasons than for indicated conditions, such as phimosis and balanitis. There are many techniques available, and recently electrocautery and both Nd:YAG and CO2 lasers, instead of blades, have been used for skin and mucosal incisions. However, the infection risk in circumcisions performed using a CO2 laser was 10% higher. There are also reports of sutureless procedures using cyanoacrylate, but these have higher risks of hematoma and hemorrhage. We combined a CO2 laser and cyanoacrylate to shorten the operation time and to decrease bleeding complications. Materials and Methods : Circumcisions were performed under general anesthesia with CO2 laser and cyanoacrylate combination in 75 6–9-year-old boys between May 2013 and August 2014 only for religious reasons. As a control, we compared them retrospectively with 75 age-matched patients who were circumcised using the conventional guillotine method in our clinic. Results No hematomas, bleeding, or wound infections were observed. One wound dehiscence (1.33% occurred during the early postoperative period and healed without any additional procedures. The median operating time was 7 (range 6–9 minutes. The conventional guillotine group comprised one hematoma (1.3%, two wound dehiscences (2.6%, and two hemorrhages (2.6%, and the median operating time was 22 (range 20–26 minutes. The difference in surgical time was significant (p<0.001, with no significant difference in the rate of complications between the two groups. Conclusion The combined CO2 laser and cyanoacrylate procedure not only decreased the operating time markedly, but also eliminated the disadvantages associated with each individual procedure alone.

  6. Learning that circumcision is protective against HIV: risk compensation among men and women in Cape Town, South Africa.

    Directory of Open Access Journals (Sweden)

    Brendan Maughan-Brown

    Full Text Available We examined whether knowledge of the HIV-protective benefits of male circumcision (MC led to risk compensating behavior in a traditionally circumcising population in South Africa. We extend the current literature by examining risk compensation among women, which has hitherto been unexplored.We used data on Xhosa men and women from the 2009 Cape Area Panel Study. Respondents were asked if they had heard that MC reduces a man's risk of contracting HIV, about their perceived risk of contracting HIV, and condom use. For each gender group we assessed whether risk perception and condom use differed by knowledge of the protective benefits of MC using bivariate and then multivariate models controlling for demographic characteristics, HIV knowledge/beliefs, and previous sexual behaviors. In a further check for confounding, we used data from the 2005 wave to assess whether individuals who would eventually become informed about the protective benefits of circumcision were already different in terms of HIV risk perception and condom use.34% of men (n=453 and 27% of women (n=690 had heard that circumcision reduces a man's risk of HIV infection. Informed men perceived slightly higher risk of contracting HIV and were more likely to use condoms at last sex (p<0.10. Informed women perceived lower HIV risk (p<0.05, were less likely to use condoms both at last sex (p<0.10 and more generally (p<0.01, and more likely to forego condoms with partners of positive or unknown serostatus (p<0.01. The results were robust to covariate adjustment, excluding people living with HIV, and accounting for risk perceptions and condom use in 2005.We find evidence consistent with risk compensation among women but not men. Further attention should be paid to the role of new information regarding MC, and drivers of HIV risk more broadly, in modulating sexual behavior among women.

  7. Circumcision - slideshow

    Science.gov (United States)

    ... Duplication for commercial use must be authorized in writing by ADAM Health Solutions. About MedlinePlus Site Map FAQs Customer Support Get email updates Subscribe to RSS Follow us Disclaimers Copyright ...

  8. Single-arm evaluation of the AccuCirc device for early infant male circumcision in Botswana.

    Science.gov (United States)

    Plank, Rebeca M; Wirth, Kathleen E; Ndubuka, Nnamdi O; Abdullahi, Rasak; Nkgau, Maggie; Lesetedi, Chiapo; Powis, Kathleen M; Mmalane, Mompati; Makhema, Joseph; Shapiro, Roger; Lockman, Shahin

    2014-05-01

    : Existing devices for early infant male circumcision (EIMC) have inherent limitations. We evaluated the newly developed AccuCirc device by circumcising 151 clinically well, full-term male infants with birth weight ≥2.5 kg within the first 10 days of life from a convenience sample in 2 hospitals in Botswana. No major adverse events were observed. There was 1 local infection, 5 cases of minor bleeding, and 1 case of moderate bleeding. In 3 cases, the device made only partial incisions that were completed immediately by the provider without complications. Parental satisfaction was high: >96% of mothers stated that they would circumcise a future son. The pre-assembled, sterile AccuCirc kit has the potential to overcome obstacles related to supply chain management and on-site instrument disinfection that can pose challenges in resource-limited settings. In our study, the AccuCirc was safe and it should be considered for programmatic EIMC in resource-limited settings.

  9. Correlates of risky sexual behaviors in recently traditionally circumcised men from initiation lodges in the Eastern Cape, South Africa.

    Science.gov (United States)

    Nyembezi, Anam; Sifunda, Sibusiso; Funani, Itumeleng; Ruiter, Robert A C; Van Den Borne, Bart; Reddy, Priscilla S

    This exploratory quantitative study examines past risky sexual behaviors among young men who were circumcised as part of a rite of passage to adulthood embedded within a cultural and traditional belief system in the Eastern Cape Province in South Africa. Following permission from the Eastern Cape House of Traditional Leaders (ECHOTL), individual face-to-face interviews using a structured questionnaire were conducted among 114 initiates. The mean age of the participants was 18.9 years, ranging from 15 to 32 years old. About 79.8% reported already having had sex with a woman prior to initiation. Of those, 89% reported that they ever used condoms when having sex, and 61% reported consistent use. Logistic regression analysis showed that consistent condom use increased with higher educational levels. Those involved in other risky health behaviors (specifically, smoking) were also more likely to report inconsistent condom use. Most participants had positive beliefs about male circumcision and STI/HIV transmission. This study provides a first look at the sexual behaviors of young men at the time of their initiation in adulthood, a process that is intended to make it socially acceptable to initiate sexual relations and highlights a major public health challenge in integrating the protective health benefits of circumcision with indigenous cultural practices.

  10. Enhancement of Afterimage Colors by Surrounding Contours

    Directory of Open Access Journals (Sweden)

    Takao Sato

    2011-05-01

    Full Text Available Presenting luminance contours surrounding the adapted areas in test phase enhances color afterimages in both duration and color appearance. The presence of surrounding contour is crucial to some color phenomenon such as van Lier's afterimage, but the contour-effect itself has not been seriously examined. In this paper, we compared the contour-effect to color afterimages and to actually colored patches to examine the nature of color information subserving color-aftereffect. In the experiment, observers were adapted for 1 sec to a small colored square (red, green, yellow, or blue presented on a gray background. Then, a test field either with or without surrounding contour was presented. Observers matched the color of a test-patch located near the afterimage to the color of afterimage. It was found that the saturation of negative afterimage was almost doubled by the presence of surrounding contours. There was no effect of luminance contrast or polarity of contours. In contrast, no enhancement of saturation by surrounding contours was observed for actually colored patches even though the colors of patches were equalized to that of afterimage without contours. This dissociation in the contour-effect demonstrates the crucial difference between the color information for aftereffects and for ordinary bottom-up color perception.

  11. Explaining preferences for home surroundings and locations

    DEFF Research Database (Denmark)

    Andersen, Hans Skifter

    2011-01-01

    This article is based on a survey carried out in Denmark that asked a random sample of the population about their preferences for home surroundings and locations. It shows that the characteristics of social surroundings are very important and can be divided into three independent dimensions......: avoiding social nuisances, preferring social homogeneity and living close to one’s social network and place of origin. The study shows that most people have many detailed preferences, whereas some have very few. This confirms an earlier theory that some people are very connected to certain places...... with given characteristics and thus do not have priorities regarding home surroundings and locations. For others, mostly young people and singles, home is just a place to sleep and relax, whereas life is lived elsewhere. For this group, there are only preferences for location and there are few specific...

  12. Attitudes to female genital mutilation/cutting among male adolescents in Ilorin, Nigeria.

    Science.gov (United States)

    Adeniran, Abiodun S; Ijaiya, Munirdeen A; Fawole, Adegboyega A; Balogun, Olayinka R; Adesina, Kikelomo T; Olatinwo, Abdul Waheed O; Olarinoye, Adebunmi O; Adeniran, Peace I

    2016-07-04

    The central role of males in female reproductive health issues in patriarchal societies makes them an important group in the eradication of female genital mutilation/cutting (FGM/C). To determine knowledge about and attitudes to FGM/C among male adolescents, and their preparedness to protect their future daughters from it. A cross-sectional survey among male adolescent students in Ilorin, Nigeria. Participants completed a self-administered questionnaire after consent had been obtained from them or their parents. Statistical analysis was with SPSS version 20.0 (IBM, USA). A p-value of <0.05 was taken as significant. Of 1 536 male adolescents (mean age 15.09 (standard deviation 1.84) years, range 14 - 19), 1 184 (77.1%) were aware of FGM/C, 514 (33.5%) supported female circumcision, 362 (23.6%) would circumcise their future daughters, 420 (27.3%) were of the opinion that FGM/C had benefits, mostly as a necessity for womanhood (109, 7.1%), and 627 (40.8%) perceived it as wickedness against females; 546 (35.5%) were aware of efforts to eradicate FGM/C, and 42.2% recommended education as the most important intervention to achieve this. Education and involvement in advocacy may transform male adolescents into agents for eradication of FGM/C.

  13. Factors associated with married women's support of male circumcision for HIV prevention in Uganda: a population based cross-sectional study.

    Science.gov (United States)

    Mati, Komi; Adegoke, Korede K; Salihu, Hamisu M

    2016-08-02

    Despite the protective effect of male circumcision (MC) against HIV in men, the acceptance of voluntary MC in priority countries for MC scale-up such as Uganda remains limited. This study examined the role of women's sociodemographic characteristics, knowledge of HIV and sexual bargaining power as determinants of women's support of male circumcision (MC). Data from the Uganda AIDS Indicator Survey, 2011 were analyzed (n = 4,874). Bivariate and multivariate logistic regression analyses with random intercept were conducted to identify factors that influence women's support of MC. Overall, 67.0 % (n = 3,276) of the women in our sample were in support of MC but only 28.0 % had circumcised partners. Women who had the knowledge that circumcision reduces HIV risk were about 6 times as likely to support MC than women who lacked that knowledge [AOR (adjusted odds ratio) = 5.85, 95 % CI (confidence interval) = 4.83-7.10]. The two indicators of women's sexual bargaining power (i.e., ability to negotiate condom use and ability to refuse sex) were also positively associated with support of MC. Several sociodemographic factors particularly wealth index were also positively associated with women's support of MC. The findings in this study will potentially inform intervention strategies to enhance uptake of male circumcision as a strategy to reduce HIV transmission in Uganda.

  14. Agreement between self-reported and physically verified male circumcision status in Nyanza region, Kenya: Evidence from the TASCO study.

    Science.gov (United States)

    Odoyo-June, Elijah; Agot, Kawango; Mboya, Edward; Grund, Jonathan; Musingila, Paul; Emusu, Donath; Soo, Leonard; Otieno-Nyunya, Boaz

    2018-01-01

    Self-reported male circumcision (MC) status is widely used to estimate community prevalence of circumcision, although its accuracy varies in different settings depending on the extent of misreporting. Despite this challenge, self-reported MC status remains essential because it is the most feasible method of collecting MC status data in community surveys. Therefore, its accuracy is an important determinant of the reliability of MC prevalence estimates based on such surveys. We measured the concurrence between self-reported and physically verified MC status among men aged 25-39 years during a baseline household survey for a study to test strategies for enhancing MC uptake by older men in Nyanza region of Kenya. The objective was to determine the accuracy of self-reported MC status in communities where MC for HIV prevention is being rolled out. Agreement between self-reported and physically verified MC status was measured among 4,232 men. A structured questionnaire was used to collect data on MC status followed by physical examination to verify the actual MC status whose outcome was recorded as fully circumcised (no foreskin), partially circumcised (foreskin is past corona sulcus but covers less than half of the glans) or uncircumcised (foreskin covers half or more of the glans). The sensitivity and specificity of self-reported MC status were calculated using physically verified MC status as the gold standard. Out of 4,232 men, 2,197 (51.9%) reported being circumcised, of whom 99.0% were confirmed to be fully circumcised on physical examination. Among 2,035 men who reported being uncircumcised, 93.7% (1,907/2,035) were confirmed uncircumcised on physical examination. Agreement between self-reported and physically verified MC status was almost perfect, kappa (k) = 98.6% (95% CI, 98.1%-99.1%. The sensitivity of self-reporting being circumcised was 99.6% (95% CI, 99.2-99.8) while specificity of self-reporting uncircumcised was 99.0% (95% CI, 98.4-99.4) and did not differ

  15. Male Circumcision and the Epidemic Emergence of HIV-2 in West Africa

    Science.gov (United States)

    Hewlett, Barry Stephen; Camacho, Ricardo Jorge

    2016-01-01

    Background Epidemic HIV-2 (groups A and B) emerged in humans circa 1930–40. Its closest ancestors are SIVsmm infecting sooty mangabeys from southwestern Côte d'Ivoire. The earliest large-scale serological surveys of HIV-2 in West Africa (1985–91) show a patchy spread. Côte d'Ivoire and Guinea-Bissau had the highest prevalence rates by then, and phylogeographical analysis suggests they were the earliest epicenters. Wars and parenteral transmission have been hypothesized to have promoted HIV-2 spread. Male circumcision (MC) is known to correlate negatively with HIV-1 prevalence in Africa, but studies examining this issue for HIV-2 are lacking. Methods We reviewed published HIV-2 serosurveys for 30 cities of all West African countries and obtained credible estimates of real prevalence through Bayesian estimation. We estimated past MC rates of 218 West African ethnic groups, based on ethnographic literature and fieldwork. We collected demographic tables specifying the ethnic partition in cities. Uncertainty was incorporated by defining plausible ranges of parameters (e.g. timing of introduction, proportion circumcised). We generated 1,000 sets of past MC rates per city using Latin Hypercube Sampling with different parameter combinations, and explored the correlation between HIV-2 prevalence and estimated MC rate (both logit-transformed) in the 1,000 replicates. Results and Conclusions Our survey reveals that, in the early 20th century, MC was far less common and geographically more variable than nowadays. HIV-2 prevalence in 1985–91 and MC rates in 1950 were negatively correlated (Spearman rho = -0.546, IQR: -0.553–-0.546, p≤0.0021). Guinea-Bissau and Côte d'Ivoire cities had markedly lower MC rates. In addition, MC was uncommon in rural southwestern Côte d'Ivoire in 1930.The differential HIV-2 spread in West Africa correlates with different historical MC rates. We suggest HIV-2 only formed early substantial foci in cities with substantial uncircumcised

  16. Smart Chips for Smart Surroundings -- 4S

    NARCIS (Netherlands)

    Schuler, Eberhard; König, Ralf; Becker, Jürgen; Rauwerda, G.K.; van de Burgwal, M.D.; Smit, Gerardus Johannes Maria; Cardoso, João M.P.; Hübner, Michael

    2011-01-01

    The overall mission of the 4S project (Smart Chips for Smart Surroundings) was to define and develop efficient flexible, reconfigurable core building blocks, including the supporting tools, for future Ambient System Devices. Reconfigurability offers the needed flexibility and adaptability, it

  17. Childhood Suicide and Myths Surrounding It.

    Science.gov (United States)

    Greene, Dorothea B.

    1994-01-01

    Dispels five misconceptions surrounding the suicide of children: that children under the age of six do not commit suicide; that suicide in latency years is extremely rare; that psychodynamically and developmentally true depression is not possible in childhood; that child cannot understand finality of death; and that children are cognitively and…

  18. Identification of β-SiC surrounded by relatable surrounding diamond ...

    Indian Academy of Sciences (India)

    β-SiC is identified in the presence of a relatable surrounding diamond medium using subtle, but discernible Raman ... Change in the nature of the surrounding material structure and its .... intensity implies very low graphite content in thin film. In.

  19. Hesitance towards voluntary medical male circumcision in Lesotho: reconfiguring global health governance.

    Science.gov (United States)

    Bulled, Nicola L

    2015-01-01

    Drawing on work examining HIV prevention initiatives in Lesotho, this paper considers the hesitation of national state actors towards the new strategy for HIV prevention - voluntary medical male circumcision (VMMC). Lesotho offers a representative case study on global health governance, given the country's high HIV burden and heavy dependence on foreign donor nations to implement local HIV prevention initiatives. In this paper, I use the case of VMMC opposition in Lesotho to examine how the new era of 'partnerships' has shifted the architecture of contemporary global health, specifically considering how global agreements are translated or negotiated into local practice. I argue that Lesotho's domestic policy-makers, in employing national statistics to assess if VMMC is an effective approach to addressing the local epidemic, are asserting a claim of expertise. In doing so, they challenge the traditional structures of global health politics, which have largely been managed by experts and funders from and in the global North. I explore the development of global VMMC policy, what drives Lesotho's resistance to comply, and consider the impact renegotiation efforts may have on future global health architecture.

  20. Using Option Grids: steps toward shared decision-making for neonatal circumcision.

    Science.gov (United States)

    Fay, Mary; Grande, Stuart W; Donnelly, Kyla; Elwyn, Glyn

    2016-02-01

    To assess the impact, acceptability and feasibility of a short encounter tool designed to enhance the process of shared decision-making and parental engagement. We analyzed video-recordings of clinical encounters, half undertaken before and half after a brief intervention that trained four clinicians how to use Option Grids, using an observer-based measure of shared decision-making. We also analyzed semi-structured interviews conducted with the clinicians four weeks after their exposure to the intervention. Observer OPTION(5) scores were higher at post-intervention, with a mean of 33.9 (SD=23.5) compared to a mean of 16.1 (SD=7.1) for pre-intervention, a significant difference of 17.8 (95% CI: 2.4, 33.2). Prior to using the intervention, clinicians used a consent document to frame circumcision as a default practice. Encounters with the Option Grid conferred agency to both parents and clinicians, and facilitated shared decision-making. Clinician reported recognizing the tool's positive effect on their communication process. Tools such as Option Grids have the potential to make it easier for clinicians to achieve shared decision-making. Encounter tools have the potential to change practice. More research is needed to test their feasibility in routine practice. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  1. Comparative evaluation of two techniques of hemostasis in neonatal circumcision using the Plastibell device.

    Science.gov (United States)

    Kazem, Moslemi Mohammad; Mehdi, Abedin Zadeh; Golrasteh, Kholaseh Zadeh; Behzad, Feis Zadeh

    2010-06-01

    To evaluate the safety of the Plastibell neonatal circumcision technique and the incidence of complications in Iranian neonates. In this study, 7510 term neonates born between 2001 and 2006 in Rafsanjan medical centers, with age range of 3-36h, were randomized into two groups. In group A (3760 cases), an incision was made in the dorsal surface of the prepuce and then 3min frenular manual compression was performed with a sponge. In group B (3750 cases), frenular hemostasis was achieved using ophthalmologic thermal cautery. The two groups were compared in terms of complications of hemorrhage, wound infection, urine retention and delayed wound healing. In group A, bleeding occurred in 15 cases (0.4%), and in group B in two cases (0.05%). The bleeding rate in group A was significantly higher (P=0.002). In group A, urinary retention was seen in 12 cases (0.03%), in comparison to 35 cases (0.9%) in group B. This complication rate was significantly higher in group B (P=0.001). Local or systemic infection was not seen in either group. Although using thermal cautery we have less bleeding, the total complication rate is increased significantly. Copyright (c) 2010 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.

  2. Modeling Impact and Cost-Effectiveness of Increased Efforts to Attract Voluntary Medical Male Circumcision Clients Ages 20-29 in Zimbabwe.

    Directory of Open Access Journals (Sweden)

    Katharine Kripke

    Full Text Available Zimbabwe aims to increase circumcision coverage to 80% among 13- to 29-year-olds. However, implementation data suggest that high coverage among men ages 20 and older may not be achievable without efforts specifically targeted to these men, incurring additional costs per circumcision. Scale-up scenarios were created based on trends in implementation data in Zimbabwe, and the cost-effectiveness of increasing efforts to recruit clients ages 20-29 was examined.Zimbabwe voluntary medical male circumcision (VMMC program data were used to project trends in male circumcision coverage by age into the future. The projection informed a base scenario in which, by 2018, the country achieves 80% circumcision coverage among males ages 10-19 and lower levels of coverage among men above age 20. The Zimbabwe DMPPT 2.0 model was used to project costs and impacts, assuming a US$109 VMMC unit cost in the base scenario and a 3% discount rate. Two other scenarios assumed that the program could increase coverage among clients ages 20-29 with a corresponding increase in unit cost for these age groups.When circumcision coverage among men ages 20-29 is increased compared with a base scenario reflecting current implementation trends, fewer VMMCs are required to avert one infection. If more than 50% additional effort (reflected as multiplying the unit cost by >1.5 is required to double the increase in coverage among this age group compared with the base scenario, the cost per HIV infection averted is higher than in the base scenario.Although increased investment in recruiting VMMC clients ages 20-29 may lead to greater overall impact if recruitment efforts are successful, it may also lead to lower cost-effectiveness, depending on the cost of increasing recruitment. Programs should measure the relationship between increased effort and increased ability to attract this age group.

  3. The quality of voluntary medical male circumcision done by mid-level workers in Tshwane District, South Africa: A retrospective analysis.

    Directory of Open Access Journals (Sweden)

    Sanele Ngcobo

    Full Text Available Voluntary medical male circumcision (VMMC reduces the acquisition of human immunodeficiency virus (HIV in heterosexual men by up to 60%. One HIV infection is averted for every 5 to 15 VMMCs. To conduct VMMCs in large populations, large numbers of trained healthcare professionals are needed. Countries in Sub-Saharan Africa have a high burden of HIV and a shortage of healthcare professionals, creating a healthcare conundrum. To bridge this gap, South Africa launched a new cadre of mid-level medical worker called Clinical Associates (CA. We assessed the ability of CAs to perform circumcisions of adequate quality and their subsequent usefulness to meet the demands of VMMCs in a population with a high HIV burden.We conducted a retrospective analysis, reviewing patient files (n = 4850 of surgical VMMCs conducted over a 16-month period. Patient files were sourced from clinics and hospitals that provided free VMMCs in Tshwane district in South Africa.Clinical associates performed 88.66% of the circumcisions and doctors performed the remaining 11.34% (p < 0.001. The number of adverse events did not differ between the two groups. Data on intra-operative adverse events were available for 4 738 patients. Of these, 341 (7.2% experienced intra-operative adverse events. For the whole sample, 44 (8.1%, n = 543 adverse events occurred during circumcisions done by doctors and 297 (7.1%, n = 4195 occurred during circumcisions done by CAs (p = 0.385. Clinical associates performed circumcisions in shorter times (duration: 14.63 minutes compared to doctors (duration: 15.25 minutes, t = -7.46; p < 0.001. Recorded pain, bleeding, swelling, infection and wound destruction did not differ between clients circumcised by CAs and doctors. This study is limited by the use of data from a single district.Clinical associates contribute to the demands for high numbers of VMMCs in Tshwane district, South Africa. Clinical associates perform VMMCs at a clinical standard that is

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

    Science.gov (United States)

    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 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.

  5. Technique for single-stage reconstruction of obliterative or near-obliterative long urethral strictures in circumcised patients

    Directory of Open Access Journals (Sweden)

    Sher Singh Yadav

    2018-05-01

    Full Text Available Purpose: To report our initial experience with urethral reconstruction using a combined dorsal lingual mucosal graft (LMG and ventral onlay preputial flap for long obliterative or near-obliterative strictures in circumcised patients. Materials and Methods: This was a retrospective study of 10 patients from January 2015 to June 2017 with long obliterative or near-obliterative anterior urethral strictures and circumcised prepuces. All patients underwent a combined approach using a dorsally LMG and a narrow preputial onlay flap ventrally to create a 26–30 Fr. neourethra over a 14-Fr Foley catheter. Success was defined as no requirement for additional urethral instrumentation. The follow-up period ranged from 6 to 32 months. Results: The patients ranged in age from 17 to 44 years (mean, 32.3±9.59 years and stricture length ranged from 9 to 12.5 cm (mean, 10.77±1.15 cm. Four strictures were obliterative and six were near-obliterative. Two patients had a history of prior urethroplasty. The length of the LMGs harvested ranged from 11 to 14 cm (mean, 12.8±1.03 cm. The preputial flaps available were from 1 to 1.5 cm in width (1.29±0.16 cm and the desired length. Maximum urinary flow rate (Qmax achieved ranged from 12 to 26 mL/s (mean, 20.46±3.71 mL/s after 3 months. One patient needed a single direct visualized internal urethrotomy and another patient develop temporary superficial penile necrosis. The success rate was 90%. Conclusions: Long obliterative and near-obliterative penile and penobulbar urethral strictures can still be treated in circumcised patients using available preputial skin along with lingual mucosa with good outcomes.

  6. MRI of normal pituitary glands and their surrounding structures

    International Nuclear Information System (INIS)

    Sato, Yoshiyuki

    1991-01-01

    Normal MRI appearances of the pituitary glands and their surrounding structures were evaluated in 332 patients without sellar and parasellar diseases. The height of the pituitary gland was maximum at 10-19 years of age reflecting hormonal activity. The width of the pituitary gland decreased, while that of the cavernous sinus increased with aging. This is probably due to atherosclerotic change of the internal carotid artery. Females younger than 30 years of age tended to show a convex upper surface of the pituitary gland and the displacement of the pituitary stalk was common after 50 years of age. Almost all of the anterior lobe of the pituitary gland showed isointensity relative to the pons or cerebral cortex and the majority (85.1%) of the posterior lobe showed hyperintensity. However, the anterior lobe in 2 newborns showed hyperintensity similar to the normal posterior lobe in adults. The posterior lobe was located off the midline in 19.1% of the subjects. One case of pars intermedia cyst was discovered among 14 subjects who were administered Gd-DTPA. The dural membrane between the pituitary gland and cavernous sinus was recognizable only in 8.6% on the right side and 7.5% on the left side. Primary empty sella was identified in 4.5%. Knowledge of the above normal ranges and variations of the pituitary gland and its surrounding structures is important in diagnosing sellar and parasellar lesions. (author) 52 refs

  7. Voluntary Medical Male Circumcision for HIV Prevention: New Mathematical Models for Strategic Demand Creation Prioritizing Subpopulations by Age and Geography.

    Science.gov (United States)

    Hankins, Catherine; Warren, Mitchell; Njeuhmeli, Emmanuel

    2016-01-01

    Over 11 million voluntary medical male circumcisions (VMMC) have been performed of the projected 20.3 million needed to reach 80% adult male circumcision prevalence in priority sub-Saharan African countries. Striking numbers of adolescent males, outside the 15-49-year-old age target, have been accessing VMMC services. What are the implications of overall progress in scale-up to date? Can mathematical modeling provide further insights on how to efficiently reach the male circumcision coverage levels needed to create and sustain further reductions in HIV incidence to make AIDS no longer a public health threat by 2030? Considering ease of implementation and cultural acceptability, decision makers may also value the estimates that mathematical models can generate of immediacy of impact, cost-effectiveness, and magnitude of impact resulting from different policy choices. This supplement presents the results of mathematical modeling using the Decision Makers' Program Planning Tool Version 2.0 (DMPPT 2.0), the Actuarial Society of South Africa (ASSA2008) model, and the age structured mathematical (ASM) model. These models are helping countries examine the potential effects on program impact and cost-effectiveness of prioritizing specific subpopulations for VMMC services, for example, by client age, HIV-positive status, risk group, and geographical location. The modeling also examines long-term sustainability strategies, such as adolescent and/or early infant male circumcision, to preserve VMMC coverage gains achieved during rapid scale-up. The 2016-2021 UNAIDS strategy target for VMMC is an additional 27 million VMMC in high HIV-prevalence settings by 2020, as part of access to integrated sexual and reproductive health services for men. To achieve further scale-up, a combination of evidence, analysis, and impact estimates can usefully guide strategic planning and funding of VMMC services and related demand-creation strategies in priority countries. Mid-course corrections

  8. Voluntary Medical Male Circumcision for HIV Prevention: New Mathematical Models for Strategic Demand Creation Prioritizing Subpopulations by Age and Geography.

    Directory of Open Access Journals (Sweden)

    Catherine Hankins

    Full Text Available Over 11 million voluntary medical male circumcisions (VMMC have been performed of the projected 20.3 million needed to reach 80% adult male circumcision prevalence in priority sub-Saharan African countries. Striking numbers of adolescent males, outside the 15-49-year-old age target, have been accessing VMMC services. What are the implications of overall progress in scale-up to date? Can mathematical modeling provide further insights on how to efficiently reach the male circumcision coverage levels needed to create and sustain further reductions in HIV incidence to make AIDS no longer a public health threat by 2030? Considering ease of implementation and cultural acceptability, decision makers may also value the estimates that mathematical models can generate of immediacy of impact, cost-effectiveness, and magnitude of impact resulting from different policy choices. This supplement presents the results of mathematical modeling using the Decision Makers' Program Planning Tool Version 2.0 (DMPPT 2.0, the Actuarial Society of South Africa (ASSA2008 model, and the age structured mathematical (ASM model. These models are helping countries examine the potential effects on program impact and cost-effectiveness of prioritizing specific subpopulations for VMMC services, for example, by client age, HIV-positive status, risk group, and geographical location. The modeling also examines long-term sustainability strategies, such as adolescent and/or early infant male circumcision, to preserve VMMC coverage gains achieved during rapid scale-up. The 2016-2021 UNAIDS strategy target for VMMC is an additional 27 million VMMC in high HIV-prevalence settings by 2020, as part of access to integrated sexual and reproductive health services for men. To achieve further scale-up, a combination of evidence, analysis, and impact estimates can usefully guide strategic planning and funding of VMMC services and related demand-creation strategies in priority countries. Mid

  9. Opportunity's Surroundings on Sol 1818 (Vertical)

    Science.gov (United States)

    2009-01-01

    NASA's Mars Exploration Rover Opportunity used its navigation camera to take the images combined into this full-circle view of the rover's surroundings during the 1,818th Martian day, or sol, of Opportunity's surface mission (March 5, 2009). South is at the center; north at both ends. This view is presented as a vertical projection with geometric seam correction. North is at the top. The rover had driven 80.3 meters (263 feet) southward earlier on that sol. Tracks from the drive recede northward in this view. The terrain in this portion of Mars' Meridiani Planum region includes dark-toned sand ripples and lighter-toned bedrock.

  10. Opportunity's Surroundings on Sol 1818 (Polar)

    Science.gov (United States)

    2009-01-01

    NASA's Mars Exploration Rover Opportunity used its navigation camera to take the images combined into this full-circle view of the rover's surroundings during the 1,818th Martian day, or sol, of Opportunity's surface mission (March 5, 2009). South is at the center; north at both ends. This view is presented as a polar projection with geometric seam correction. North is at the top. The rover had driven 80.3 meters (263 feet) southward earlier on that sol. Tracks from the drive recede northward in this view. The terrain in this portion of Mars' Meridiani Planum region includes dark-toned sand ripples and lighter-toned bedrock.

  11. Perceived Quality of In-Service Communication and Counseling Among Adolescents Undergoing Voluntary Medical Male Circumcision.

    Science.gov (United States)

    Van Lith, Lynn M; Mallalieu, Elizabeth C; Patel, Eshan U; Dam, Kim H; Kaufman, Michelle R; Hatzold, Karin; Marcell, Arik V; Mavhu, Webster; Kahabuka, Catherine; Mahlasela, Lusanda; Njeuhmeli, Emmanuel; Seifert Ahanda, Kim; Ncube, Getrude; Lija, Gissenge; Bonnecwe, Collen; Tobian, Aaron A R

    2018-04-03

    Experience with providers shapes the quality of adolescent health services, including voluntary medical male circumcision (VMMC). This study examined the perceived quality of in-service communication and counseling during adolescent VMMC services. A postprocedure quantitative survey measuring overall satisfaction, comfort, perceived quality of in-service communication and counseling, and perceived quality of facility-level factors was administered across 14 VMMC sites in South Africa, Tanzania, and Zimbabwe. Participants were adolescent male clients aged 10-14 years (n = 836) and 15-19 years (n = 457) and completed the survey 7 to 10 days following VMMC. Adjusted prevalence ratios (aPRs) were estimated by multivariable modified Poisson regression with generalized estimating equations and robust variance estimation to account for site-level clustering. Of 10- to 14-year-olds and 15- to 19-year-olds, 97.7% and 98.7%, respectively, reported they were either satisfied or very satisfied with their VMMC counseling experience. Most were also very likely or somewhat likely (93.6% of 10- to 14-year olds and 94.7% of 15- to 19-year olds) to recommend VMMC to their peers. On a 9-point scale, the median perceived quality of in-service (counselor) communication was 9 (interquartile range [IQR], 8-9) among 15- to 19-year-olds and 8 (IQR, 7-9) among 10- to 14-year-olds. The 10- to 14-year-olds were more likely than 15- to 19-year-olds to perceive a lower quality of in-service (counselor) communication (score quality of in-service communication as high and recommend VMMC to their peers; however, many adolescents desire more discussion about key topics outlined in World Health Organization guidance.

  12. Cost drivers for voluntary medical male circumcision using primary source data from sub-Saharan Africa.

    Science.gov (United States)

    Bollinger, Lori; Adesina, Adebiyi; Forsythe, Steven; Godbole, Ramona; Reuben, Elan; Njeuhmeli, Emmanuel

    2014-01-01

    As voluntary medical male circumcision (VMMC) programs scale up, there is a pressing need for information about the important cost drivers, and potential efficiency gains. We examine those cost drivers here, and estimate the potential efficiency gains through an econometric model. We examined the main cost drivers (i.e., personnel and consumables) associated with providing VMMC in sub-Saharan Africa along a number of dimensions, including facility type and service provider. Primary source facility level data from Kenya, Namibia, South Africa, Tanzania, Uganda, and Zambia were utilized throughout. We estimated the efficiency gains by econometrically estimating a cost function in order to calculate the impact of scale and other relevant factors. Personnel and consumables were estimated at 36% and 28%, respectively, of total costs across countries. Economies of scale (EOS) is estimated to be eight at the median volume of VMMCs performed, and EOS falls from 23 at the 25th percentile volume of VMMCs performed to 5.1 at the 75th percentile. The analysis suggests that there is significant room for efficiency improvement as indicated by declining EOS as VMMC volume increases. The scale of the fall in EOS as VMMC volume increases suggests that we are still at the ascension phase of the scale-up of VMMC, where continuing to add new sites results in additional start-up costs as well. A key aspect of improving efficiency is task sharing VMMC procedures, due to the large percentage of overall costs associated with personnel costs. In addition, efficiency improvements in consumables are likely to occur over time as prices and distribution costs decrease.

  13. Cost drivers for voluntary medical male circumcision using primary source data from sub-Saharan Africa.

    Directory of Open Access Journals (Sweden)

    Lori Bollinger

    Full Text Available As voluntary medical male circumcision (VMMC programs scale up, there is a pressing need for information about the important cost drivers, and potential efficiency gains. We examine those cost drivers here, and estimate the potential efficiency gains through an econometric model.We examined the main cost drivers (i.e., personnel and consumables associated with providing VMMC in sub-Saharan Africa along a number of dimensions, including facility type and service provider. Primary source facility level data from Kenya, Namibia, South Africa, Tanzania, Uganda, and Zambia were utilized throughout. We estimated the efficiency gains by econometrically estimating a cost function in order to calculate the impact of scale and other relevant factors. Personnel and consumables were estimated at 36% and 28%, respectively, of total costs across countries. Economies of scale (EOS is estimated to be eight at the median volume of VMMCs performed, and EOS falls from 23 at the 25th percentile volume of VMMCs performed to 5.1 at the 75th percentile.The analysis suggests that there is significant room for efficiency improvement as indicated by declining EOS as VMMC volume increases. The scale of the fall in EOS as VMMC volume increases suggests that we are still at the ascension phase of the scale-up of VMMC, where continuing to add new sites results in additional start-up costs as well. A key aspect of improving efficiency is task sharing VMMC procedures, due to the large percentage of overall costs associated with personnel costs. In addition, efficiency improvements in consumables are likely to occur over time as prices and distribution costs decrease.

  14. Introduction of male circumcision for HIV prevention in Uganda: analysis of the policy process.

    Science.gov (United States)

    Odoch, Walter Denis; Kabali, Kenneth; Ankunda, Racheal; Zulu, Joseph Mumba; Tetui, Moses

    2015-06-20

    Health policy analysis is important for all health policies especially in fields with ever changing evidence-based interventions such as HIV prevention. However, there are few published reports of health policy analysis in sub-Saharan Africa in this field. This study explored the policy process of the introduction of male circumcision (MC) for HIV prevention in Uganda in order to inform the development processes of similar health policies. Desk review of relevant documents was conducted between March and May 2012. Thematic analysis was used to analyse the data. Conceptual frameworks that demonstrate the interrelationship within the policy development processes and influence of actors in the policy development processes guided the analysis. Following the introduction of MC on the national policy agenda in 2007, negotiation and policy formulation preceded its communication and implementation. Policy proponents included academic researchers in the early 2000s and development partners around 2007. Favourable contextual factors that supported the development of the policy included the rising HIV prevalence, adoption of MC for HIV prevention in other sub-Saharan African countries, and expertise on MC. Additionally, the networking capability of proponents facilitated the change in position of non-supportive or neutral actors. Non-supportive and neutral actors in the initial stages of the policy development process included the Ministry of Health, traditional and Muslim leaders, and the Republican President. Using political authority, legitimacy, and charisma, actors who opposed the policy tried to block the policy development process. Researchers' initial disregard of the Ministry of Health in the research process of MC and the missing civil society advocacy arm contributed to delays in the policy development process. This study underscores the importance of securing top political leadership as well as key implementing partners' support in policy development processes

  15. Crust Structure Data of Seas Surrounding Turkey

    International Nuclear Information System (INIS)

    Maden, N.; Gelisli, K.

    2007-01-01

    Black Sea, Aegean, Mediterranean and Marmara Sea, which surround the Turkey, have not been examined with respect to the Geological, Geophysical and other natural sciences sufficiently. In fact, it is not attach importance the Turkish seas adequately and abandoned with respect to the scientific researches. The most important reason of this situation is the lack of the education of the Marine Sciences in the Turkish Universities. In this study, it is tried to construct a crustal structure data base of the surrounding seas of the Turkey by collecting crustal structure data sets done by different authors in different times so far. The data acquired in the base are collected from different data base sources by dragging. The Moho depth in the eastern and western basin of the Black sea is 22 km and 19 km, respectively. In the Marmara Sea the Moho depth is 24 km. The moho value in the southern Aegean is 20 km, in the northern Aegean the moho depth is 30 km. on the other hand, the moho depth value in the eastern and western basin of the Mediterranean Sea are 15-20 km and 25-30 km, respectively

  16. Veracity and rhetoric in paediatric medicine: a critique of Svoboda and Van Howe's response to the AAP policy on infant male circumcision

    NARCIS (Netherlands)

    Morris, Brian J.; Tobian, Aaron A. R.; Hankins, Catherine A.; Klausner, Jeffrey D.; Banerjee, Joya; Bailis, Stefan A.; Moses, Stephen; Wiswell, Thomas E.

    2014-01-01

    In a recent issue of the Journal of Medical Ethics, Svoboda and Van Howe commented on the 2012 change in the American Academy of Pediatrics (AAP) policy on newborn male circumcision, in which the AAP stated that benefits of the procedure outweigh the risks. Svoboda and Van Howe disagree with the AAP

  17. Does Male Circumcision Protect against Sexually Transmitted Infections? Arguments and Meta-Analyses to the Contrary Fail to Withstand Scrutiny.

    Science.gov (United States)

    Morris, Brian J; Hankins, Catherine A; Tobian, Aaron A R; Krieger, John N; Klausner, Jeffrey D

    2014-01-01

    We critically evaluate a recent article by Van Howe involving 12 meta-analyses that concludes, contrary to current evidence, that male circumcision increases the risk of various common sexually transmitted infections (STIs). Our detailed scrutiny reveals that these meta-analyses (1) failed to include results of all relevant studies, especially data from randomized controlled trials, (2) introduced bias through use of inappropriate control groups, (3) altered original data, in the case of human papillomavirus (HPV), by questionable adjustments for "sampling bias," (4) failed to control for confounders through use of crude odds ratios, and (5) used unnecessarily complicated methods without adequate explanation, so impeding replication by others. Interventions that can reduce the prevalence of STIs are important to international health. Of major concern is the global epidemic of oncogenic types of HPV that contribute to the burden of genital cancers. Meta-analyses, when well conducted, can better inform public health policy and medical practice, but when seriously flawed can have detrimental consequences. Our critical evaluation leads us to reject the findings and conclusions of Van Howe on multiple grounds. Our timely analysis thus reaffirms the medical evidence supporting male circumcision as a desirable intervention for STI prevention.

  18. The Effectiveness of Health Education on Maternal Anxiety, Circumcision Knowledge, and Nursing Hours: A Quasi-Experimental Study.

    Science.gov (United States)

    Chang, Shu-Fang; Hung, Chich-Hsiu; Hsu, Yu-Yun; Liu, Yi; Wang, Tsu-Nai

    2017-08-01

    Many studies have shown that providing health education before surgery may significantly increase health knowledge and decrease anxiety in both patients and their family members. However, few studies have compared the effects on pediatric outpatient surgery outcomes of different health education instruction modes. This study compares the effects of two health education delivery modes on maternal knowledge and anxiety, the number of unexpected early hospital follow-up visits, and the time spent by nurses on health education. A quasi-experimental design with pretest and posttest was used to compare the effect on the outcomes of pediatric circumcision of a multimedia compact disc (CD) and a printed material.Seventy mothers of children who underwent Plastibell circumcision participated in this study. Both the printed material and the multimedia CD significantly increased the knowledge and reduced the anxiety levels of the participants. However, no significant differences in unscheduled early hospital follow-up visits postsurgery were found between the two modes of instruction. Furthermore, we found that significantly fewer hours were spent by nurses on health education for the multimedia CD group in comparison with the printed material group. In the current clinical environment of common staffing shortages, information tools may be used to cost-effectively assist and simplify nursing work. The findings of this study may provide a reference to medical centers that are working to reduce the time spent by nurses on health education for outpatient surgery patients. Furthermore, audiovisual health education tools are recommended to increase nursing effectiveness and save nursing time.

  19. Opportunity's Surroundings on Sol 1798 (Polar)

    Science.gov (United States)

    2009-01-01

    NASA's Mars Exploration Rover Opportunity used its navigation camera to take the images combined into this 180-degree view of the rover's surroundings during the 1,798th Martian day, or sol, of Opportunity's surface mission (Feb. 13, 2009). North is on top. This view is presented as a polar projection with geometric seam correction. The rover had driven 111 meters (364 feet) southward on the preceding sol. Tracks from that drive recede northward in this view. For scale, the distance between the parallel wheel tracks is about 1 meter (about 40 inches). The terrain in this portion of Mars' Meridiani Planum region includes dark-toned sand ripples and lighter-toned bedrock.

  20. Opportunity's Surroundings After Sol 1820 Drive (Polar)

    Science.gov (United States)

    2009-01-01

    NASA's Mars Exploration Rover Opportunity used its navigation camera to take the images combined into this full-circle view of the rover's surroundings during the 1,820th to 1,822nd Martian days, or sols, of Opportunity's surface mission (March 7 to 9, 2009). This view is presented as a polar projection with geometric seam correction. North is at the top. The rover had driven 20.6 meters toward the northwest on Sol 1820 before beginning to take the frames in this view. Tracks from that drive recede southwestward. For scale, the distance between the parallel wheel tracks is about 1 meter (about 40 inches). The terrain in this portion of Mars' Meridiani Planum region includes dark-toned sand ripples and small exposures of lighter-toned bedrock.

  1. Opportunity's Surroundings on Sol 1798 (Vertical)

    Science.gov (United States)

    2009-01-01

    NASA's Mars Exploration Rover Opportunity used its navigation camera to take the images combined into this 180-degree view of the rover's surroundings during the 1,798th Martian day, or sol, of Opportunity's surface mission (Feb. 13, 2009). North is on top. This view is presented as a vertical projection with geometric seam correction. The rover had driven 111 meters (364 feet) southward on the preceding sol. Tracks from that drive recede northward in this view. For scale, the distance between the parallel wheel tracks is about 1 meter (about 40 inches). The terrain in this portion of Mars' Meridiani Planum region includes dark-toned sand ripples and lighter-toned bedrock.

  2. Opportunity's Surroundings on Sol 1687 (Vertical)

    Science.gov (United States)

    2009-01-01

    NASA's Mars Exploration Rover Opportunity used its navigation camera to take the images combined into this 360-degree view of the rover's surroundings on the 1,687th Martian day, or sol, of its surface mission (Oct. 22, 2008). Opportunity had driven 133 meters (436 feet) that sol, crossing sand ripples up to about 10 centimeters (4 inches) tall. The tracks visible in the foreground are in the east-northeast direction. Opportunity's position on Sol 1687 was about 300 meters southwest of Victoria Crater. The rover was beginning a long trek toward a much larger crater, Endeavour, about 12 kilometers (7 miles) to the southeast. This view is presented as a vertical projection with geometric seam correction.

  3. Opportunity's Surroundings After Sol 1820 Drive (Vertical)

    Science.gov (United States)

    2009-01-01

    NASA's Mars Exploration Rover Opportunity used its navigation camera to take the images combined into this full-circle view of the rover's surroundings during the 1,820th to 1,822nd Martian days, or sols, of Opportunity's surface mission (March 7 to 9, 2009). This view is presented as a vertical projection with geometric seam correction. North is at the top. The rover had driven 20.6 meters toward the northwest on Sol 1820 before beginning to take the frames in this view. Tracks from that drive recede southwestward. For scale, the distance between the parallel wheel tracks is about 1 meter (about 40 inches). The terrain in this portion of Mars' Meridiani Planum region includes dark-toned sand ripples and small exposures of lighter-toned bedrock.

  4. Opportunity's Surroundings on Sol 1687 (Polar)

    Science.gov (United States)

    2009-01-01

    NASA's Mars Exploration Rover Opportunity used its navigation camera to take the images combined into this 360-degree view of the rover's surroundings on the 1,687th Martian day, or sol, of its surface mission (Oct. 22, 2008). Opportunity had driven 133 meters (436 feet) that sol, crossing sand ripples up to about 10 centimeters (4 inches) tall. The tracks visible in the foreground are in the east-northeast direction. Opportunity's position on Sol 1687 was about 300 meters southwest of Victoria Crater. The rover was beginning a long trek toward a much larger crater, Endeavour, about 12 kilometers (7 miles) to the southeast. This view is presented as a polar projection with geometric seam correction.

  5. Opportunity's Surroundings After Sol 1820 Drive

    Science.gov (United States)

    2009-01-01

    NASA's Mars Exploration Rover Opportunity used its navigation camera to take the images combined into this full-circle view of the rover's surroundings during the 1,820th to 1,822nd Martian days, or sols, of Opportunity's surface mission (March 7 to 9, 2009). South is at the center; north at both ends. The rover had driven 20.6 meters toward the northwest on Sol 1820 before beginning to take the frames in this view. Tracks from that drive recede southwestward. For scale, the distance between the parallel wheel tracks is about 1 meter (about 40 inches). The terrain in this portion of Mars' Meridiani Planum region includes dark-toned sand ripples and small exposures of lighter-toned bedrock. This view is presented as a cylindrical projection with geometric seam correction.

  6. Towards Semantic Understanding of Surrounding Vehicular Maneuvers

    DEFF Research Database (Denmark)

    Kristoffersen, Miklas Strøm; Dueholm, Jacob Velling; Satzoda, Ravi K.

    2016-01-01

    This paper proposes the use of multiple low-cost visual sensors to obtain a surround view of the ego-vehicle for semantic understanding. A multi-perspective view will assist the analysis of naturalistic driving studies (NDS), by automating the task of data reduction of the observed sequences...... into events. A user-centric vision-based framework is presented using a vehicle detector and tracker in each separate perspective. Multi-perspective trajectories are estimated and analyzed to extract 14 different events, including potential dangerous behaviors such as overtakes and cut-ins. The system...... is tested on ten sequences of real-world data collected on U. S. highways. The results show the potential use of multiple low-cost visual sensors for semantic understanding around the ego-vehicle....

  7. Lovelock black holes surrounded by quintessence

    Energy Technology Data Exchange (ETDEWEB)

    Ghosh, Sushant G. [University of KwaZulu-Natal, Astrophysics and Cosmology Research Unit, School of Mathematics, Statistics and Computer Science, Durban (South Africa); Centre for Theoretical Physics, Multidisciplinary Centre for Advanced Research and Studies (MCARS), New Delhi (India); Maharaj, Sunil D.; Baboolal, Dharmanand; Lee, Tae-Hun [University of KwaZulu-Natal, Astrophysics and Cosmology Research Unit, School of Mathematics, Statistics and Computer Science, Durban (South Africa)

    2018-02-15

    Lovelock gravity consisting of the dimensionally continued Euler densities is a natural generalization of general relativity to higher dimensions such that equations of motion are still second order, and the theory is free of ghosts. A scalar field with a positive potential that yields an accelerating universe has been termed quintessence. We present exact black hole solutions in D-dimensional Lovelock gravity surrounded by quintessence matter and also perform a detailed thermodynamical study. Further, we find that the mass, entropy and temperature of the black hole are corrected due to the quintessence background. In particular, we find that a phase transition occurs with a divergence of the heat capacity at the critical horizon radius, and that specific heat becomes positive for r{sub h} < r{sub c} allowing the black hole to become thermodynamically stable. (orig.)

  8. Lovelock black holes surrounded by quintessence

    Science.gov (United States)

    Ghosh, Sushant G.; Maharaj, Sunil D.; Baboolal, Dharmanand; Lee, Tae-Hun

    2018-02-01

    Lovelock gravity consisting of the dimensionally continued Euler densities is a natural generalization of general relativity to higher dimensions such that equations of motion are still second order, and the theory is free of ghosts. A scalar field with a positive potential that yields an accelerating universe has been termed quintessence. We present exact black hole solutions in D-dimensional Lovelock gravity surrounded by quintessence matter and also perform a detailed thermodynamical study. Further, we find that the mass, entropy and temperature of the black hole are corrected due to the quintessence background. In particular, we find that a phase transition occurs with a divergence of the heat capacity at the critical horizon radius, and that specific heat becomes positive for r_h

  9. Infantile masturbation in an African female: is this a justification for female genital cutting?

    Science.gov (United States)

    Otaigbe, Barbara Edewele

    2008-05-01

    Masturbation is a taboo and not discussed openly in Africa. It is still worse when it occurs in an infant and will thus call for a visit to the traditional healers for 'spiritual intervention' and prompt female genital cutting/mutilation to reduce the child's libido and risk of sexual promiscuity as she gets older. Because of its peculiar presentation in children without manual genital stimulation, it is often misdiagnosed. A Medline search showed sparse information on infantile masturbation and none from Africa. A 15-month-old female was brought into a clinic in Port Harcourt, Nigeria, with a history of unusual rocking with adduction of the thighs noticed since 3 months of age. At 10 months of age, the child would lean forward and rock continuously on a hard surface such as a chair or an adult's lap. Rocking was accompanied with lip smacking, eye rolling, shaking, "watching of television in the air", spasm and feeling of fatigue and then resumption of the motions unless she was distracted. The child had been spanked occasionally by both parents with no noticeable change in behavior. Older female relatives had suggested female genital cutting or circumcision, but her father resisted vehemently. Infantile masturbation was viewed by the pediatrician and a 10-minute video recording was taken to confirm the diagnosis. The mother was reassured, counseled about behavioral and environmental modification. There was a marked improvement when the baby was seen 6 weeks later. Infantile masturbation rarely diagnosed in our region is probably due to a low index of suspicion and because mothers are afraid of stigma. We suggest that infantile masturbation should always be considered as a differential diagnosis of strange movement mimicking epilepsy in infants, and when a diagnosis is made parents should be counseled against female genital cutting. A video recording is encouraged fora correct diagnosis.

  10. Female offenders

    NARCIS (Netherlands)

    Vivienne de Vogel; Marijke Louppen

    2017-01-01

    Although girls and women represent only a minority of the forensic mental health and prison populations, studies worldwide suggest that there has been a steady increase in the number of females being convicted for committing offenses, especially violent offenses. In this chapter, an overview will

  11. Knowledge, Attitudes, Practices and Beliefs about Medical Male Circumcision (MMC among a Sample of Health Care Providers in Haiti.

    Directory of Open Access Journals (Sweden)

    Jessy G Dévieux

    Full Text Available Haiti has the highest number of people living with HIV infection in the Caribbean/Latin America region. Medical male circumcision (MMC has been recommended to help prevent the spread of HIV. We sought to assess knowledge, attitudes, practices and beliefs about MMC among a sample of health care providers in Haiti.A convenience sample of 153 health care providers at the GHESKIO Centers in Haiti responded to an exploratory survey that collected information on several topics relevant to health providers about MMC. Descriptive statistics were calculated for the responses and multivariable logistic regression was conducted to determine opinions of health care providers about the best age to perform MMC on males. Bayesian network analysis and sensitivity analysis were done to identify the minimum level of change required to increase the acceptability of performing MMC at age less than 1 year.The sample consisted of medical doctors (31.0%, nurses (49.0%, and other health care professionals (20.0%. Approximately 76% showed willingness to offer MMC services if they received training. Seventy-six percent believed that their male patients would accept circumcision, and 59% believed infancy was the best age for MMC. More than 90% of participants said that MMC would reduce STIs. Physicians and nurses who were willing to offer MMC if provided with adequate training were 2.5 (1.15-5.71 times as likely to choose the best age to perform MMC as less than one year. Finally, if the joint probability of choosing "the best age to perform MMC" as one year or older and having the mistaken belief that "MMC prevents HIV entirely" is reduced by 63% then the probability of finding that performing MMC at less than one year acceptable to health care providers is increased by 35%.Participants demonstrated high levels of knowledge and positive attitudes towards MMC. Although this study suggests that circumcision is acceptable among certain health providers in Haiti, studies

  12. Male circumcision and sexual risk behaviors may contribute to considerable ethnic disparities in HIV prevalence in Kenya: an ecological analysis.

    Directory of Open Access Journals (Sweden)

    Chris Richard Kenyon

    Full Text Available HIV prevalence varies between 0.8 and 20.2% in Kenya's various ethnic groups. The reasons underlying these variations have not been evaluated before.We used data from seven national surveys spanning the period 1989 to 2008 to compare the prevalence of a range of risk factors in Kenya's ethnic groups. Spearman's and linear regression were used to assess the relationship between HIV prevalence and each variable by ethnic group.The ethnic groups exhibited significant differences in a number of HIV related risk factors. Although the highest HIV prevalence group (the Luo had the highest rates of HIV testing (Men 2008 survey: 56.8%, 95% CI 51.0-62.5% and condom usage at last sex (Men 2008∶28.6%, 95% CI 19.6-37.6%, they had the lowest prevalence of circumcision (20.9%, 95% CI 15.9-26.0 the highest prevalence of sex with a non-married, non-cohabiting partner (Men: 40.2%, 95% CI 33.2-47.1% and pre-marital sex (Men 2008∶73.9%, 95% CI 67.5-80.3% and the youngest mean age of debut for women (1989 SURVEY: 15.7 years old, 95% CI 15.2-16.2. At a provincial level there was an association between the prevalence of HIV and male concurrency (Spearman's rho = 0.79, P = 0.04. Ethnic groups with higher HIV prevalence were more likely to report condom use (Men 2008 survey: R2 = 0.62, P = 0.01 and having been for HIV testing (Men 2008 survey: R2 = 0.47, P = 0.04.In addition to differences in male circumcision prevalence, variation in sexual behavior may contribute to the large variations in HIV prevalence in Kenya's ethnic groups. To complement the prevention benefits of the medical male circumcision roll-out in several parts of Kenya, interventions to reduce risky sexual behavior should continue to be promoted.

  13. Opportunity's Surroundings on Sol 1798 (Stereo)

    Science.gov (United States)

    2009-01-01

    [figure removed for brevity, see original site] Left-eye view of a color stereo pair for PIA11850 [figure removed for brevity, see original site] Right-eye view of a color stereo pair for PIA11850 NASA's Mars Exploration Rover Opportunity used its navigation camera to take the images combined into this stereo 180-degree view of the rover's surroundings during the 1,798th Martian day, or sol, of Opportunity's surface mission (Feb. 13, 2009). North is on top. This view combines images from the left-eye and right-eye sides of the navigation camera. It appears three-dimensional when viewed through red-blue glasses with the red lens on the left. The rover had driven 111 meters (364 feet) southward on the preceding sol. Tracks from that drive recede northward in this view. For scale, the distance between the parallel wheel tracks is about 1 meter (about 40 inches). The terrain in this portion of Mars' Meridiani Planum region includes dark-toned sand ripples and lighter-toned bedrock. This view is presented as a cylindrical-perspective projection with geometric seam correction.

  14. Opportunity's Surroundings on Sol 1818 (Stereo)

    Science.gov (United States)

    2009-01-01

    [figure removed for brevity, see original site] Left-eye view of a color stereo pair for PIA11846 [figure removed for brevity, see original site] Right-eye view of a color stereo pair for PIA11846 NASA's Mars Exploration Rover Opportunity used its navigation camera to take the images combined into this full-circle view of the rover's surroundings during the 1,818th Martian day, or sol, of Opportunity's surface mission (March 5, 2009). South is at the center; north at both ends. This view combines images from the left-eye and right-eye sides of the navigation camera. It appears three-dimensional when viewed through red-blue glasses with the red lens on the left. The rover had driven 80.3 meters (263 feet) southward earlier on that sol. Tracks from the drive recede northward in this view. The terrain in this portion of Mars' Meridiani Planum region includes dark-toned sand ripples and lighter-toned bedrock. This view is presented as a cylindrical-perspective projection with geometric seam correction.

  15. Opportunity's Surroundings on Sol 1687 (Stereo)

    Science.gov (United States)

    2009-01-01

    [figure removed for brevity, see original site] Left-eye view of a color stereo pair for PIA11739 [figure removed for brevity, see original site] Right-eye view of a color stereo pair for PIA11739 NASA's Mars Exploration Rover Opportunity used its navigation camera to take the images combined into this stereo, 360-degree view of the rover's surroundings on the 1,687th Martian day, or sol, of its surface mission (Oct. 22, 2008). The view appears three-dimensional when viewed through red-blue glasses. Opportunity had driven 133 meters (436 feet) that sol, crossing sand ripples up to about 10 centimeters (4 inches) tall. The tracks visible in the foreground are in the east-northeast direction. Opportunity's position on Sol 1687 was about 300 meters southwest of Victoria Crater. The rover was beginning a long trek toward a much larger crater, Endeavour, about 12 kilometers (7 miles) to the southeast. This panorama combines right-eye and left-eye views presented as cylindrical-perspective projections with geometric seam correction.

  16. Opportunity's Surroundings After Sol 1820 Drive (Stereo)

    Science.gov (United States)

    2009-01-01

    [figure removed for brevity, see original site] Left-eye view of a color stereo pair for PIA11841 [figure removed for brevity, see original site] Right-eye view of a color stereo pair for PIA11841 NASA's Mars Exploration Rover Opportunity used its navigation camera to take the images combined into this full-circle view of the rover's surroundings during the 1,820th to 1,822nd Martian days, or sols, of Opportunity's surface mission (March 7 to 9, 2009). This view combines images from the left-eye and right-eye sides of the navigation camera. It appears three-dimensional when viewed through red-blue glasses with the red lens on the left. The rover had driven 20.6 meters toward the northwest on Sol 1820 before beginning to take the frames in this view. Tracks from that drive recede southwestward. For scale, the distance between the parallel wheel tracks is about 1 meter (about 40 inches). The terrain in this portion of Mars' Meridiani Planum region includes dark-toned sand ripples and small exposures of lighter-toned bedrock. This view is presented as a cylindrical-perspective projection with geometric seam correction.

  17. The lithosphere-asthenosphere: Italy and surroundings

    International Nuclear Information System (INIS)

    Panza, G.F.; Aoudia, A.; Pontevivo, A.; Chimera, G.; Raykova, R.

    2003-02-01

    The velocity-depth distribution of the lithosphere-asthenosphere in the Italian region and surroundings is imaged, with a lateral resolution of about 100 km, by surface wave velocity tomography and non-linear inversion. Maps of the Moho depth, of the thickness of the lithosphere and of the shear-wave velocities, down to depths of 200 km and more, are constructed. A mantle wedge, identified in the uppermost mantle along the Apennines and the Calabrian Arc, underlies the principal recent volcanoes, and partial melting can be relevant in this part of the uppermost mantle. In Calabria a lithospheric doubling is seen, in connection with the subduction of the Ionian lithosphere. The asthenosphere is shallow in the Southern Tyrrhenian Sea. High velocity bodies, cutting the asthenosphere, outline the Adria-lonian subduction in the Tyrrhenian Sea and the deep-reaching lithospheric root in the Western Alps. Less deep lithospheric roots are seen in the Central Apennines. The lithosphere-asthenosphere properties delineate a differentiation between the northern and the southern sectors of the Adriatic Sea, likely attesting the fragmentation of Adria. (author)

  18. The lithosphere-asthenosphere Italy and surroundings

    CERN Document Server

    Panza, G F; Chimera, G; Pontevivo, A; Raykova, R

    2003-01-01

    The velocity-depth distribution of the lithosphere-asthenosphere in the Italian region and surroundings is imaged, with a lateral resolution of about 100 km, by surface wave velocity tomography and non-linear inversion. Maps of the Moho depth, of the thickness of the lithosphere and of the shear-wave velocities, down to depths of 200 km and more, are constructed. A mantle wedge, identified in the uppermost mantle along the Apennines and the Calabrian Arc, underlies the principal recent volcanoes, and partial melting can be relevant in this part of the uppermost mantle. In Calabria a lithospheric doubling is seen, in connection with the subduction of the Ionian lithosphere. The asthenosphere is shallow in the Southern Tyrrhenian Sea. High velocity bodies, cutting the asthenosphere, outline the Adria-lonian subduction in the Tyrrhenian Sea and the deep-reaching lithospheric root in the Western Alps. Less deep lithospheric roots are seen in the Central Apennines. The lithosphere-asthenosphere properties delineat...

  19. INTERSTELLAR MAGNETIC FIELD SURROUNDING THE HELIOPAUSE

    International Nuclear Information System (INIS)

    Whang, Y. C.

    2010-01-01

    This paper presents a three-dimensional analytical solution, in the limit of very low plasma β-ratio, for the distortion of the interstellar magnetic field surrounding the heliopause. The solution is obtained using a line dipole method that is the integration of point dipole along a semi-infinite line; it represents the magnetic field caused by the presence of the heliopause. The solution allows the variation of the undisturbed magnetic field at any inclination angle. The heliosphere is considered as having blunt-nosed geometry on the upwind side and it asymptotically approaches a cylindrical geometry having an open exit for the continuous outflow of the solar wind on the downwind side. The heliopause is treated as a magnetohydrodynamic tangential discontinuity; the interstellar magnetic field lines at the boundary are tangential to the heliopause. The interstellar magnetic field is substantially distorted due to the presence of the heliopause. The solution shows the draping of the field lines around the heliopause. The magnetic field strength varies substantially near the surface of the heliopause. The effect on the magnetic field due to the presence of the heliopause penetrates very deep into the interstellar space; the depth of penetration is of the same order of magnitude as the scale length of the heliosphere.

  20. Bibliometric analysis of literature on female genital mutilation: (1930 - 2015).

    Science.gov (United States)

    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

  1. Female infertility

    International Nuclear Information System (INIS)

    Hall, D.A.; Yoder, I.

    1984-01-01

    Infertility, defined as 1 year of unprotected intercourse without conception, is becoming of increasingly important medical concern. Fertility in both the male and the female is at its peak in the twenties. Many couples today have postponed marriage and/or childbearing into their 30s until careers are established, but at that point fertility may be diminished. The current epidemic of venereal disease has been associated with an increasing incidence of tubal scarring. In addition, the use of intrauterine devices (IUDs) and birth control pills for contraception have let to later problems with pelvic inflammatory disease (PID) and ovulation disturbances. The problem of infertility intensifies as the number of babies available for adoption decreases. Therefore, it is estimated that approximately 10-20% of couples will eventually seek medical attention for an infertility-related problem. Fortunately, marked improvements in the results of tubal surgery are concurrently occurring secondary to refinements in microsurgical techniques, and many medical alternatives to induce ovulation are being developed. The male factor causes infertility in 30-40 % of couples, and the female factor is responsible in approximately 50% of couples. No cause is found in 10-20% of couples. This chapter discusses the role of coordinated imaging in the diagnosis and therapy of infertility in the female

  2. Understanding community norms surrounding tobacco sales.

    Directory of Open Access Journals (Sweden)

    Patricia A McDaniel

    Full Text Available In the US, denormalizing tobacco use is key to tobacco control; less attention has been paid to denormalizing tobacco sales. However, some localities have placed limits on the number and type of retailers who may sell tobacco, and some retailers have abandoned tobacco sales voluntarily. Understanding community norms surrounding tobacco sales may help accelerate tobacco denormalization.We conducted 15 focus groups with customers of California, New York, and Ohio retailers who had voluntarily discontinued tobacco sales to examine normative assumptions about where cigarettes should or should not be sold, voluntary decisions to discontinue tobacco sales, and government limits on such sales.Groups in all three states generally agreed that grocery stores that sold healthy products should not sell tobacco; California groups saw pharmacies similarly, while this was a minority opinion in the other two states. Convenience stores were regarded as a natural place to sell tobacco. In each state, it was regarded as normal and commendable for some stores to want to stop selling tobacco, although few participants could imagine convenience stores doing so. Views on government's role in setting limits on tobacco sales varied, with California and New York participants generally expressing support for restrictions, and Ohio participants expressing opposition. However, even those who expressed opposition did not approve of tobacco sales in all possible venues. Banning tobacco sales entirely was not yet normative.Limiting the ubiquitous availability of tobacco sales is key to ending the tobacco epidemic. Some limits on tobacco sales appear to be normative from the perspective of community members; it may be possible to shift norms further by problematizing the ubiquitous presence of cigarettes and drawing connections to other products already subject to restrictions.

  3. Understanding community norms surrounding tobacco sales.

    Science.gov (United States)

    McDaniel, Patricia A; Malone, Ruth E

    2014-01-01

    In the US, denormalizing tobacco use is key to tobacco control; less attention has been paid to denormalizing tobacco sales. However, some localities have placed limits on the number and type of retailers who may sell tobacco, and some retailers have abandoned tobacco sales voluntarily. Understanding community norms surrounding tobacco sales may help accelerate tobacco denormalization. We conducted 15 focus groups with customers of California, New York, and Ohio retailers who had voluntarily discontinued tobacco sales to examine normative assumptions about where cigarettes should or should not be sold, voluntary decisions to discontinue tobacco sales, and government limits on such sales. Groups in all three states generally agreed that grocery stores that sold healthy products should not sell tobacco; California groups saw pharmacies similarly, while this was a minority opinion in the other two states. Convenience stores were regarded as a natural place to sell tobacco. In each state, it was regarded as normal and commendable for some stores to want to stop selling tobacco, although few participants could imagine convenience stores doing so. Views on government's role in setting limits on tobacco sales varied, with California and New York participants generally expressing support for restrictions, and Ohio participants expressing opposition. However, even those who expressed opposition did not approve of tobacco sales in all possible venues. Banning tobacco sales entirely was not yet normative. Limiting the ubiquitous availability of tobacco sales is key to ending the tobacco epidemic. Some limits on tobacco sales appear to be normative from the perspective of community members; it may be possible to shift norms further by problematizing the ubiquitous presence of cigarettes and drawing connections to other products already subject to restrictions.

  4. Health workers’ perspectives on implementation of an integrated medical male circumcision strategy in KwaZulu-Natal, South Africa

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    Rogerio Phili

    2014-11-01

    Full Text Available Background: KwaZulu-Natal province began implementation of voluntary medical male circumcision (VMMC as an integral part of its HIV infection prevention strategy that includes other programmes such as HIV counselling and testing (HCT, screening and treatment of sexually transmitted infections and tuberculosis, and other sexual and reproductive health services. This followed randomised controlled trials that showed up to 60% HIV infection risk reduction amongst circumcised men. Implementation of the strategy occurred despite absence of knowledge of operational barriers and its acceptability to health care workers (HCWs. Objectives: The study aimed to explore HCWs’ perspectives of and barriers to strategy implementation at public sector health facilities to inform implementation policy. Method: A purposive quota sampling method was used to select HCWs for focus group discussions at three study sites. Participants were asked open-ended questions using an interview schedule based on a literature review to explore acceptability of and perceptions regarding provision of the strategy. Thematic analysis was conducted. Results: Acceptability of the strategy was high amongst the participants; however, there was limited knowledge of some key concepts of the strategy, personnel role confusion, missed opportunities for client recruitment, and infrastructural constraints. Negative perceptions included beliefs that VMMC would discourage condom use and cause stigma associated with non-circumcision of HIV-positive males, with perceptions of sexual behavioural disinhibition in circumcised men. Conclusion: There is a need to engage further with stakeholders if implementation of VMMC is to be successful. More training and support needs to be provided to HCWs at public sector facilities. Agtergrond: Die implementering van vrywillige mediese manlike besnyding (VMMC is ’n integrale deel van KwaZulu-Natal provinsie se MIV-voorkomingstrategie, wat

  5. Vasectomy as a proxy: extrapolating health system lessons to male circumcision as an HIV prevention strategy in Papua New Guinea

    Directory of Open Access Journals (Sweden)

    Tynan Anna

    2012-09-01

    Full Text Available Abstract Background Male circumcision (MC has been shown to reduce the risk of HIV acquisition among heterosexual men, with WHO recommending MC as an essential component of comprehensive HIV prevention programs in high prevalence settings since 2007. While Papua New Guinea (PNG has a current prevalence of only 1%, the high rates of sexually transmissible diseases and the extensive, but unregulated, practice of penile cutting in PNG have led the National Department of Health (NDoH to consider introducing a MC program. Given public interest in circumcision even without active promotion by the NDoH, examining the potential health systems implications for MC without raising unrealistic expectations presents a number of methodological issues. In this study we examined health systems lessons learned from a national no-scalpel vasectomy (NSV program, and their implications for a future MC program in PNG. Methods Fourteen in-depth interviews were conducted with frontline health workers and key government officials involved in NSV programs in PNG over a 3-week period in February and March 2011. Documentary, organizational and policy analysis of HIV and vasectomy services was conducted and triangulated with the interviews. All interviews were digitally recorded and later transcribed. Application of the WHO six building blocks of a health system was applied and further thematic analysis was conducted on the data with assistance from the analysis software MAXQDA. Results Obstacles in funding pathways, inconsistent support by government departments, difficulties with staff retention and erratic delivery of training programs have resulted in mixed success of the national NSV program. Conclusions In an already vulnerable health system significant investment in training, resources and negotiation of clinical space will be required for an effective MC program. Focused leadership and open communication between provincial and national government, NGOs and

  6. Identification of Key Beliefs Explaining Male Circumcision Motivation Among Adolescent Boys in Zimbabwe: Targets for Behavior Change Communication.

    Science.gov (United States)

    Kasprzyk, Danuta; Tshimanga, Mufuta; Hamilton, Deven T; Gorn, Gerald J; Montaño, Daniel E

    2018-02-01

    Male circumcision (MC) significantly reduces HIV acquisition among men, leading WHO/UNAIDS to recommend high HIV and low MC prevalence countries circumcise 80% of adolescents and men age 15-49. Despite significant investment to increase MC capacity only 27% of the goal has been achieved in Zimbabwe. To increase adoption, research to create evidence-based messages is greatly needed. The Integrated Behavioral Model (IBM) was used to investigate factors affecting MC motivation among adolescents. Based on qualitative elicitation study results a survey was designed and administered to a representative sample of 802 adolescent boys aged 13-17 in two urban and two rural areas in Zimbabwe. Multiple regression analysis found all six IBM constructs (2 attitude, 2 social influence, 2 personal agency) significantly explained MC intention (R 2  = 0.55). Stepwise regression analysis of beliefs underlying each IBM belief-based construct found 9 behavioral, 6 injunctive norm, 2 descriptive norm, 5 efficacy, and 8 control beliefs significantly explained MC intention. A final stepwise regression of all the significant IBM construct beliefs identified 12 key beliefs best explaining intention. Similar analyses were carried out with subgroups of adolescents by urban-rural and age. Different sets of behavioral, normative, efficacy, and control beliefs were significant for each sub-group. This study demonstrates the application of theory-driven research to identify evidence-based targets for the design of effective MC messages for interventions to increase adolescents' motivation. Incorporating these findings into communication campaigns is likely to improve demand for MC.

  7. Male and female genital cutting among Southern Thailand's Muslims: rituals, biomedical practice and local discourses.

    Science.gov (United States)

    Merli, Claudia

    2010-10-01

    This paper explores how local people in a province in southern Thailand perceive the practice of male and female genital cutting. In order to understand the importance placed on these practices, a comparison is drawn between the two and also between the male circumcision and the Buddhist ordination of monks as rites of passage. Discourses on the exposure or concealment of male and female bodies, respectively, witness to the relevance of both the local political-historical context and biomedical hegemony to gendered bodies. The comparisons evince the need to reflect upon the theoretical and ethical implications of studying genital cutting and focusing exclusively on one of the two practices rather than, as this paper claims to be necessary, considering them as inextricably connected.

  8. Health complications of female genital mutilation in Sierra Leone

    Directory of Open Access Journals (Sweden)

    Bjälkander O

    2012-07-01

    Full Text Available Owolabi Bjälkander,1 Laurel Bangura,2 Bailah Leigh,3 Vanja Berggren,1 Staffan Bergström,1 Lars Almroth11Division of Global Health, Department of Public Health, Karolinska Institutet, Stockholm, Sweden; 2Inter Africa Committee, Sierra Leone; 3Department of Community Health, College of Medicine and Allied Health Sciences, University of Sierra Leone, Sierra LeoneAbstract: Sierra Leone has one of the highest rates of female genital mutilation (FGM in the world, and yet little is known about the health consequences of the practice.Purpose: To explore whether and what kind of FGM-related health complications girls and women in Sierra Leone experience, and to elucidate their health care-seeking behaviors.Patients and methods: A feasibility study was conducted to test and refine questionnaires and methods used for this study. Thereafter, a cross-section of girls and women (n = 258 attending antenatal care and Well Women Clinics in Bo Town, Bo District, in the southern region and in Makeni Town, Bombali District, in the northern region of Sierra Leone were randomly selected. Participants answered interview-administrated pretested structured questionnaires with open-ended-questions, administrated by trained female personnel.Results: All respondents had undergone FGM, most between 10 and 14 years of age. Complications were reported by 218 respondents (84.5%, the most common ones being excessive bleeding, delay in or incomplete healing, and tenderness. Fever was significantly more often reported by girls who had undergone FGM before 10 years of age compared with those who had undergone the procedure later. Out of those who reported complications, 187 (85.8% sought treatment, with 89 of them visiting a traditional healer, 75 a Sowei (traditional circumciser, and 16 a health professional.Conclusion: The high prevalence rate of FGM and the proportion of medical complications show that FGM is a matter for public health concern in Sierra Leone. Girls who

  9. Impacts of Artificial Reefs on Surrounding Ecosystems

    Science.gov (United States)

    Manoukian, Sarine

    Artificial reefs are becoming a popular biological and management component in shallow water environments characterized by soft seabed, representing both important marine habitats and tools to manage coastal fisheries and resources. An artificial reef in the marine environment acts as an open system with exchange of material and energy, altering the physical and biological characteristics of the surrounding area. Reef stability will depend on the balance of scour, settlement, and burial resulting from ocean conditions over time. Because of the unstable nature of sediments, they require a detailed and systematic investigation. Acoustic systems like high-frequency multibeam sonar are efficient tools in monitoring the environmental evolution around artificial reefs, whereas water turbidity can limit visual dive and ROV inspections. A high-frequency multibeam echo sounder offers the potential of detecting fine-scale distribution of reef units, providing an unprecedented level of resolution, coverage, and spatial definition. How do artificial reefs change over time in relation to the coastal processes? How accurately does multibeam technology map different typologies of artificial modules of known size and shape? How do artificial reefs affect fish school behavior? What are the limitations of multibeam technology for investigating fish school distribution as well as spatial and temporal changes? This study addresses the above questions and presents results of a new approach for artificial reef seafloor mapping over time, based upon an integrated analysis of multibeam swath bathymetry data and geoscientific information (backscatter data analysis, SCUBA observations, physical oceanographic data, and previous findings on the geology and sedimentation processes, integrated with unpublished data) from Senigallia artificial reef, northwestern Adriatic Sea (Italy) and St. Petersburg Beach Reef, west-central Florida continental shelf. A new approach for observation of fish

  10. Female condoms.

    Science.gov (United States)

    Bounds, W

    1997-06-01

    Early versions of a female condom were available in the 1920s and 1960s, but they were little used and soon forgotten. It took the arrival of AIDS, and the urgent need for a wider range of female-controlled barrier techniques, to rekindle scientific interest in this method. In the 1980s, three groups in Europe and the USA began development of new female condom designs, comprising 'Femidom (Reality)', the 'Bikini Condom', and 'Women's Choice'. Apart from differences in their physical design, Femidom differs from the others in that it is made of a polyurethane membrane, which has several advantages over latex. Of the three, Femidom is the most advanced in terms of development and clinical testing, and it is the only one to have reached the marketing stage. Laboratory studies and clinical trials suggest that its contraceptive efficacy is similar to that documented for the male condom, though a direct comparison is not possible because no comparative clinical trials have, as yet, been undertaken. Reported 'typical-use' pregnancy rates range from 12.4 to 22.2% at 6 months of use in the USA and Latin America, respectively, while a study in the UK observed a rate of 15% at 12 months. As with all barrier methods, most failures appear to be associated with poor compliance or incorrect use. 'Perfect-use' pregnancy rates were substantially lower, indicating that Femidom can be very effective, if used consistently and correctly. Evidence for Femidom's effectiveness to protect against transmission of sexual disease-causing organisms, including HIV, is still very limited and based largely on laboratory studies. Whilst, in theory, the condom should confer reliable protection, its efficacy in clinical use will depend upon correct and consistent use and upon the product's ability to maintain an effective physical barrier throughout penetrative intercourse. In this respect, the results of recent and ongoing clinical studies are expected with much interest. How valuable Femidom will

  11. The PrePex device is unlikely to achieve cost-savings compared to the forceps-guided method in male circumcision programs in sub-Saharan Africa.

    Directory of Open Access Journals (Sweden)

    Walter Obiero

    Full Text Available Male circumcision (MC reduces the risk of heterosexual HIV acquisition in men by approximately 60%. MC programs for HIV prevention are currently being scaled-up in fourteen countries in sub-Saharan Africa. The current standard surgical technique for MC in many sub-Saharan African countries is the forceps-guided male circumcision (FGMC method. The PrePex male circumcision (PMC method could replace FGMC and potentially reduce MC programming costs. We compared the potential costs of introducing the PrePex device into MC programming to the cost of the forceps-guided method.Data were obtained from the Nyanza Reproductive Health Society (NRHS, an MC service delivery organization in Kenya, and from the Kenya Ministry of Health. Analyses are based on 48,265 MC procedures performed in four Districts in western Kenya from 2009 through 2011. Data were entered into the WHO/UNAIDS Decision Makers Program Planning Tool. The tool assesses direct and indirect costs of MC programming. Various sensitivity analyses were performed. Costs were discounted at an annual rate of 6% and are presented in United States Dollars.Not including the costs of the PrePex device or referral costs for men with phimosis/tight foreskin, the costs of one MC surgery were $44.54-$49.02 and $54.52-$55.29 for PMC and FGMC, respectively.The PrePex device is unlikely to result in significant cost-savings in comparison to the forceps-guided method. MC programmers should target other aspects of the male circumcision minimum package for improved cost efficiency.

  12. Women's knowledge and perception of male circumcision before and after its roll-out in the South African township of Orange Farm from community-based cross-sectional surveys.

    Directory of Open Access Journals (Sweden)

    Barbara Maraux

    Full Text Available The roll-out of medical male circumcision (MC is progressing in Southern and Eastern Africa. Little is known about the effect of this roll-out on women. The objective of this study was to assess the knowledge and perceptions of women regarding MC in a setting before and after the roll-out. This study was conducted in the South African township of Orange Farm where MC prevalence among men increased from 17% to 53% in the period 2008-2010. Data from three community-based cross sectional surveys conducted in 2007, 2010 and 2012 among 1258, 1197 and 2583 adult women, respectively were studied. In 2012, among 2583 women, 73.7% reported a preference for circumcised partners, and 87.9% knew that circumcised men could become infected with HIV. A total of 95.8% preferred to have their male children circumcised. These three proportions increased significantly during the roll-out. In 2007, the corresponding values were 64.4%, 82.9% and 80.4%, respectively. Among 2581 women having had sexual intercourse with circumcised and uncircumcised men, a majority (55.8%, 1440/2581 agreed that it was easier for a circumcised man to use a condom, 20.5% (530/2581 disagreed; and 23.07 (611/2581 did not know. However, some women incorrectly stated that they were fully (32/2579; 1.2%; 95%CI: 0.9% to 1.7% or partially (233/2579; 9.0%; 95%CI: 8.0% to 10.2% protected when having unprotected sex with a circumcised HIV-positive partner. This study shows that the favorable perception of women and relatively correct knowledge regarding VMMC had increased during the roll-out of VMMC. When possible, women should participate in the promotion of VMMC although further effort should be made to improve their knowledge.

  13. Evidence-Based Identification of Key Beliefs Explaining Infant Male Circumcision Motivation Among Expectant Parents in Zimbabwe: Targets for Behavior Change Messaging.

    Science.gov (United States)

    Montaño, Daniel E; Tshimanga, Mufuta; Hamilton, Deven T; Gorn, Gerald; Kasprzyk, Danuta

    2018-02-01

    Slow adult male circumcision uptake is one factor leading some to recommend increased priority for infant male circumcision (IMC) in sub-Saharan African countries. This research, guided by the integrated behavioral model (IBM), was carried out to identify key beliefs that best explain Zimbabwean parents' motivation to have their infant sons circumcised. A quantitative survey, designed from qualitative elicitation study results, was administered to independent representative samples of 800 expectant mothers and 795 expectant fathers in two urban and two rural areas in Zimbabwe. Multiple regression analyses found IMC motivation among fathers was explained by instrumental attitude, descriptive norm and self-efficacy; while motivation among mothers was explained by instrumental attitude, injunctive norm, descriptive norm, self-efficacy, and perceived control. Regression analyses of beliefs underlying IBM constructs found some overlap but many differences in key beliefs explaining IMC motivation among mothers and fathers. We found differences in key beliefs among urban and rural parents. Urban fathers' IMC motivation was explained best by behavioral beliefs, while rural fathers' motivation was explained by both behavioral and efficacy beliefs. Urban mothers' IMC motivation was explained primarily by behavioral and normative beliefs, while rural mothers' motivation was explained mostly by behavioral beliefs. The key beliefs we identified should serve as targets for developing messages to improve demand and maximize parent uptake as IMC programs are rolled out. These targets need to be different among urban and rural expectant mothers and fathers.

  14. Messaging Circumstances and Economic Pressures as Influences on Linkage to Medical Male Circumcision following Community-Based HIV Testing for Men in Rural Southwest Uganda: A Qualitative Study

    Directory of Open Access Journals (Sweden)

    Hannah N. Gilbert

    2018-01-01

    Full Text Available Voluntary medical male circumcision (MMC reduces risk of HIV infection, but uptake remains suboptimal among certain age groups and locations in sub-Saharan Africa. We analysed qualitative data as part of the Linkages Study, a randomized controlled trial to evaluate community-based HIV testing and follow-up as interventions promoting linkage to HIV treatment and prevention in Uganda and South Africa. Fifty-two HIV-negative uncircumcised men participated in the qualitative study. They participated in semistructured individual interviews exploring (a home HTC experience; (b responses to test results; (c efforts to access circumcision services; (d outcomes of efforts; (e experiences of follow-up support; and (f local HIV education and support. Interviews were audio-recorded, translated, transcribed, and summarized into “linkage summaries.” Summaries were analysed inductively to identify the following three thematic experiences shaping men’s circumcision choices: (1 intense relief upon receipt of an unanticipated seronegative diagnosis, (2 the role of peer support in overcoming fear, and (3 anticipation of missed economic productivity. Increased attention to the timing of demand creation activities, to who delivers information about the HIV prevention benefits of MMC, and to the importance of missed income during recovery as a barrier to uptake promises to strengthen and sharpen future MMC demand creation strategies.

  15. Systematic monitoring of male circumcision scale-up in Nyanza, Kenya: exploratory factor analysis of service quality instrument and performance ranking.

    Science.gov (United States)

    Omondi Aduda, Dickens S; Ouma, Collins; Onyango, Rosebella; Onyango, Mathews; Bertrand, Jane

    2014-01-01

    Considerable conceptual and operational complexities related to service quality measurements and variability in delivery contexts of scaled-up medical male circumcision, pose real challenges to monitoring implementation of quality and safety. Clarifying latent factors of the quality instruments can enhance contextual applicability and the likelihood that observed service outcomes are appropriately assessed. To explore factors underlying SYMMACS service quality assessment tool (adopted from the WHO VMMC quality toolkit) and; determine service quality performance using composite quality index derived from the latent factors. Using a comparative process evaluation of Voluntary Medical Male Circumcision Scale-Up in Kenya site level data was collected among health facilities providing VMMC over two years. Systematic Monitoring of the Medical Male Circumcision Scale-Up quality instrument was used to assess availability of guidelines, supplies and equipment, infection control, and continuity of care services. Exploratory factor analysis was performed to clarify quality structure. Fifty four items and 246 responses were analyzed. Based on Eigenvalue >1.00 cut-off, factors 1, 2 & 3 were retained each respectively having eigenvalues of 5.78; 4.29; 2.99. These cumulatively accounted for 29.1% of the total variance (12.9%; 9.5%; 6.7%) with final communality estimates being 13.06. Using a cut-off factor loading value of ≥0.4, fifteen items loading on factor 1, five on factor 2 and one on factor 3 were retained. Factor 1 closely relates to preparedness to deliver safe male circumcisions while factor two depicts skilled task performance and compliance with protocols. Of the 28 facilities, 32% attained between 90th and 95th percentile (excellent); 45% between 50th and 75th percentiles (average) and 14.3% below 25th percentile (poor). the service quality assessment instrument may be simplified to have nearly 20 items that relate more closely to service outcomes. Ranking of

  16. Male partner circumcision associated with lower Trichomonas vaginalis incidence among pregnant and postpartum Kenyan women: a prospective cohort study.

    Science.gov (United States)

    Pintye, Jillian; Drake, Alison L; Unger, Jennifer A; Matemo, Daniel; Kinuthia, John; McClelland, R Scott; John-Stewart, Grace

    2017-03-01

    Trichomonas vaginalis is the world's most common curable STI and has implications for reproductive health in women. We determined incidence and correlates of T. vaginalis in an HIV-uninfected peripartum cohort. Women participating in a prospective study of peripartum HIV acquisition in Western Kenya were enrolled during pregnancy and followed until 9 months post partum. T. vaginalis was assessed every 1-3 months using wet mount microscopy. Correlates of incident T. vaginalis were determined using Cox proportional hazards models. Among 1271 women enrolled, median age was 22 years (IQR 19-27) and gestational age was 22 weeks (IQR 18-26); most (78%) were married and had uncircumcised male partners (69%). Prevalent T. vaginalis was detected in 81 women (6%) at enrolment. Among women without T. vaginalis at enrolment, 112 had T. vaginalis detected during 1079 person-years of follow-up (10.4 per 100 person-years). After adjustment for socio-economic factors, male partner circumcision status, pregnancy status and other STIs, T. vaginalis incidence was higher during pregnancy than post partum (22.3 vs 7.7 per 100 person-years, adjusted HR (aHR) 3.68, 95% CI 1.90 to 7.15, pvaginalis compared with women with uncircumcised partners (aHR 0.42, 95% CI 0.23 to 0.76, p=0.004). Employed women had lower risk of incident T. vaginalis than unemployed women (aHR 0.49, 95% CI 0.31 to 0.79, p=0.003); recent STI was associated with increased T. vaginalis risk (aHR 2.97, 95% CI 1.49 to 5.94, p=0.002). T. vaginalis was relatively common in this peripartum cohort. Male circumcision may confer benefits in preventing T. vaginalis . 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/.

  17. HIV behavioural surveillance among refugees and surrounding host ...

    African Journals Online (AJOL)

    We used a standardised behavioural surveillance survey (BSS), modified to be directly relevant to populations in conflict and post-conflict settings as well as to their surrounding host populations, to survey the populations of a refugee settlement in south-western Uganda and its surrounding area. Two-stage probability ...

  18. Investigation of the readout electronics of DELPHI surround muon chamber

    International Nuclear Information System (INIS)

    Khovanskij, N.; Krumshtejn, Z.; Ol'shevskij, A.; Sadovskij, A.; Sedykh, Yu.; Molnar, J.; Sicho, P.; Tomsa, Z.

    1995-01-01

    The characteristics of the readout electronics of the DELPHI surround muon chambers with various AMPLEX chips (AMPLEX 16 and AMPLEX-SICAL) are presented. This electronics is studied in a cosmic rays test of the real surround muon chamber model. 4 refs., 6 figs., 1 tab

  19. Stimulus size dependence of hue changes induced by chromatic surrounds.

    Science.gov (United States)

    Kellner, Christian Johannes; Wachtler, Thomas

    2016-03-01

    A chromatic surround induces a change in the perceived hue of a stimulus. This shift in hue depends on the chromatic difference between the stimulus and the surround. We investigated how chromatic induction varies with stimulus size and whether the size dependence depends on the surround hue. Subjects performed asymmetric matching of color stimuli with different sizes in surrounds of different chromaticities. Generally, induced hue shifts decreased with increasing stimulus size. This decrease was quantitatively different for different surround hues. However, when size effects were normalized to an overall induction strength, the chromatic specificity was largely reduced. The separability of inducer chromaticity and stimulus size suggests that these effects are mediated by different neural mechanisms.

  20. Changes in unique hues induced by chromatic surrounds.

    Science.gov (United States)

    Klauke, Susanne; Wachtler, Thomas

    2016-03-01

    A chromatic surround can have a strong influence on the perceived hue of a stimulus. We investigated whether chromatic induction has similar effects on the perception of colors that appear pure and unmixed (unique red, green, blue, and yellow) as on other colors. Subjects performed unique hue settings of stimuli in isoluminant surrounds of different chromaticities. Compared with the settings in a neutral gray surround, unique hue settings altered systematically with chromatic surrounds. The amount of induced hue shift depended on the difference between stimulus and surround hues, and was similar for unique hue settings as for settings of nonunique hues. Intraindividual variability in unique hue settings was roughly twice as high as for settings obtained in asymmetric matching experiments, which may reflect the presence of a reference stimulus in the matching task. Variabilities were also larger with chromatic surrounds than with neutral gray surrounds, for both unique hue settings and matching of nonunique hues. The results suggest that the neural representations underlying unique hue percepts are influenced by the same neural processing mechanisms as the percepts of other colors.

  1. Behavioural aspects surrounding medicine purchases from pharmacies in Australia

    Directory of Open Access Journals (Sweden)

    Emmerton L

    2008-09-01

    Full Text Available Objective: This study aimed to produce current data regarding behavioural aspects of non-prescription (over-the-counter medicine purchases, in light of changes in the pharmaceutical market and increasing provision of professional services in pharmacies.Methods: Data were collected in 15 community pharmacies in South-East Queensland, Australia, over 540 hours in five days in August, 2006. The method, previously validated, involved documentation of both observational and interview data. Fifteen trained researchers were stationed in a selected pharmacy each to unobtrusively observe all eligible sales of non-prescription medicines, and, where possible, interview the purchasers post-sale. Non-response was supplemented by observational data and recall by the salesperson. The data included details of the purchase and purchasing behaviour, while new questions addressed issues of topical importance, including customers’ privacy concerns. A selection of the analyses is reported here.Results: In total, 3470 purchases were documented (135-479 per pharmacy, with customers of 67.5% of purchases (74.7% excluding an outlier pharmacy participating in the survey. Customers averaged 1.2 non-prescription medicines per transaction. Two-thirds (67.2% of customers were female, and 38.8% of the customers were aged 31-45 years. Analgesics and respiratory medicines accounted for two-thirds of the sales data (33.4% and 32.4%, respectively. Intended-brand purchases comprised 71% of purchases (2004/2824; in-store substitution then occurred in 8.8% of these cases, mainly following recommendations by pharmacy staff. Medicines intended for self-use comprised 62.9% of purchases (1752/2785. First-time purchases (30.8%, 799/2594 were more commonly influenced by pharmacy staff than by advertising.Conclusions: This study used validated methods adapted to a changing marketplace, thus providing data that both confirm and add to knowledge surrounding medicine purchases. Despite the

  2. Sociocultural attitudes surrounding menstruation and alternative menstrual products: the explanatory role of self-objectification.

    Science.gov (United States)

    Grose, Rose Grace; Grabe, Shelly

    2014-01-01

    We extend objectification theory research to consider the relationship between self-objectification and attitudes toward an alternative menstrual product in a diverse sample of female undergraduates from the United States (N = 151). We use a survey design to investigate attitudes toward one's menstruation as a potential mechanism that may explain this relationship. Reactions to an alternative menstrual product were predominantly negative, supporting prior research on stigma and shame surrounding menstruation. Exploratory structural equation modeling revealed attitudes toward one's menstruation mediated the relationship between self-objectification and participants' reactions to an alternative menstrual product. Implications for women's health are discussed.

  3. Development of rat female genital cortex and control of female puberty by sexual touch.

    Directory of Open Access Journals (Sweden)

    Constanze Lenschow

    2017-09-01

    Full Text Available Rat somatosensory cortex contains a large sexually monomorphic genital representation. Genital cortex undergoes an unusual 2-fold expansion during puberty. Here, we investigate genital cortex development and female rat sexual maturation. Ovariectomies and estradiol injections suggested sex hormones cause the pubertal genital cortex expansion but not its maintenance at adult size. Genital cortex expanded by thalamic afferents invading surrounding dysgranular cortex. Genital touch was a dominant factor driving female sexual maturation. Raising female rats in contact with adult males promoted genital cortex expansion, whereas contact to adult females or nontactile (audio-visual-olfactory male cues did not. Genital touch imposed by human experimenters powerfully advanced female genital cortex development and sexual maturation. Long-term blocking of genital cortex by tetrodotoxin in pubescent females housed with males prevented genital cortex expansion and decelerated vaginal opening. Sex hormones, sexual experience, and neural activity shape genital cortex, which contributes to the puberty promoting effects of sexual touch.

  4. Development of rat female genital cortex and control of female puberty by sexual touch.

    Science.gov (United States)

    Lenschow, Constanze; Sigl-Glöckner, Johanna; Brecht, Michael

    2017-09-01

    Rat somatosensory cortex contains a large sexually monomorphic genital representation. Genital cortex undergoes an unusual 2-fold expansion during puberty. Here, we investigate genital cortex development and female rat sexual maturation. Ovariectomies and estradiol injections suggested sex hormones cause the pubertal genital cortex expansion but not its maintenance at adult size. Genital cortex expanded by thalamic afferents invading surrounding dysgranular cortex. Genital touch was a dominant factor driving female sexual maturation. Raising female rats in contact with adult males promoted genital cortex expansion, whereas contact to adult females or nontactile (audio-visual-olfactory) male cues did not. Genital touch imposed by human experimenters powerfully advanced female genital cortex development and sexual maturation. Long-term blocking of genital cortex by tetrodotoxin in pubescent females housed with males prevented genital cortex expansion and decelerated vaginal opening. Sex hormones, sexual experience, and neural activity shape genital cortex, which contributes to the puberty promoting effects of sexual touch.

  5. A synchronous surround increases the motion strength gain of motion.

    Science.gov (United States)

    Linares, Daniel; Nishida, Shin'ya

    2013-11-12

    Coherent motion detection is greatly enhanced by the synchronous presentation of a static surround (Linares, Motoyoshi, & Nishida, 2012). To further understand this contextual enhancement, here we measured the sensitivity to discriminate motion strength for several pedestal strengths with and without a surround. We found that the surround improved discrimination of low and medium motion strengths, but did not improve or even impaired discrimination of high motion strengths. We used motion strength discriminability to estimate the perceptual response function assuming additive noise and found that the surround increased the motion strength gain, rather than the response gain. Given that eye and body movements continuously introduce transients in the retinal image, it is possible that this strength gain occurs in natural vision.

  6. Surrounding Moving Obstacle Detection for Autonomous Driving Using Stereo Vision

    Directory of Open Access Journals (Sweden)

    Hao Sun

    2013-06-01

    Full Text Available Detection and tracking surrounding moving obstacles such as vehicles and pedestrians are crucial for the safety of mobile robotics and autonomous vehicles. This is especially the case in urban driving scenarios. This paper presents a novel framework for surrounding moving obstacles detection using binocular stereo vision. The contributions of our work are threefold. Firstly, a multiview feature matching scheme is presented for simultaneous stereo correspondence and motion correspondence searching. Secondly, the multiview geometry constraint derived from the relative camera positions in pairs of consecutive stereo views is exploited for surrounding moving obstacles detection. Thirdly, an adaptive particle filter is proposed for tracking of multiple moving obstacles in surrounding areas. Experimental results from real-world driving sequences demonstrate the effectiveness and robustness of the proposed framework.

  7. Contamination of nebulisers and surrounding air at the bedside of ...

    African Journals Online (AJOL)

    An air sampler was used to collect air samples from the surrounding bedside environment. .... individualised resealable plastic bags and stored upside down in a cooler .... conventional and mesh technology nebulisers used at home by adults.

  8. Glow phenomenon surrounding the vertical stabilizer and OMS pods

    Science.gov (United States)

    1994-01-01

    This 35mm frame, photographed as the Space Shuttle Columbia was orbiting Earth during a 'night' pass, documents the glow phenomenon surrounding the vertical stabilizer and the Orbital Maneuvering System (OMS) pods of the spacecraft.

  9. Aspirations and realities in a North-South partnership for health promotion: lessons from a program to promote safe male circumcision in Botswana.

    Science.gov (United States)

    Katisi, Masego; Daniel, Marguerite; Mittelmark, Maurice B

    2016-07-28

    International donors support the partnership between the Government of Botswana and two international organisations: U.S. Centers for Disease Control and Prevention and Africa Comprehensive HIV/AIDS Partnership to implement Voluntary Medical Male Circumcision with the target of circumcising 80 % of HIV negative men in 5 years. Botswana Government had started integration of the program into its health system when international partners brought in the Models for Optimizing Volume and Efficiency to strengthen delivery of the service and push the target. The objective of this paper is to use a systems model to establish how the functioning of the partnership on Safe Male Circumcision in Botswana contributed to the outcome. Data were collected using observations, focus group discussions and interviews. Thirty participants representing all three partners were observed in a 3-day meeting; followed by three rounds of in-depth interviews with five selected leading officers over 2 years and three focus group discussions. Financial resources, "ownership" and the target influence the success or failure of partnerships. A combination of inputs by partners brought progress towards achieving set program goals. Although there were tensions between partners, they were working together in strategising to address some challenges of the partnership and implementation. Pressure to meet the expectations of the international donors caused tension and challenges between the in-country partners to the extent of Development Partners retreating and not pursuing the mission further. Target achievement, the link between financial contribution and ownership expectations caused antagonistic outcome. The paper contributes enlightenment that the functioning of the visible in-country partnership is significantly influenced by the less visible global context such as the target setters and donors.

  10. Bridging the accountability divide: male circumcision planning in Rwanda as a case study in how to merge divergent operational planning approaches.

    Science.gov (United States)

    McPherson, Dacia B; Balisanga, Helene N; Mbabazi, Jennifer K

    2014-10-01

    When voluntary medical male circumcision (MC) was confirmed as an effective tool for HIV prevention in sub-Saharan Africa in 2007, many public health policy makers and practitioners were eager to implement the intervention. How to roll out the tool as part of comprehensive strategy however was less clear. At the time, very little was known about the capacity of health systems to scale delivery of the new intervention. Today, nearly all countries prioritized for the intervention are far behind their targets. To contribute to the discourse on why this is, we develop a historical analysis of medical MC planning in sub-Saharan Africa using our own experience of this process in Rwanda. We compare our previously unpublished feasibility analysis from 2008 with international research published in 2009, which suggested how Rwanda could reduce HIV incidence through a rapid MC intervention, and Rwanda's eventual 2010 official operational plan. We trace how, in the face of uncertainty, operational plans avoided discussing the details of feasibility and focused instead on defining optimal circumcision capacity needed to achieve country level target reductions in HIV incidence. We show a distinct gap between the targets set in the official operational plan and what we determined was feasible in 2008. With actual data from the ground now available, we show our old feasibility models more closely approximate circumcision delivery rates to date. With an eye toward the future of long-term policy planning, we discuss the mechanics of how accountability gaps like this occur in global health policy making and how practitioners can better create achievable operational targets. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2013.

  11. Monitoring program of surrounding of the NPP SE-EBO

    International Nuclear Information System (INIS)

    Dobis, L.; Kostial, J.

    1997-01-01

    The paper dealt with monitoring program of radiation control of surrounding of the NPP Bohunice, which has the aim: (1) to ensure the control of influence of work of the NPP Bohunice on the environment in their surrounding; (2) to ensure the back-ground for regular brief of control and supervisory organs about condition of the environment in surrounding of the NPP Bohunice; (3) to maintain the expected technical level of control of the NPP Bohunice and to exploit optimally the technical means; (4) to solicit permanently the data about the radioactivity of environment in surrounding of the NPP Bohunice for forming of files of the data; (5) to exploit purposefully the technical equipment, technical workers and to maintain their in permanent emergency and technical eligibility for the case of the breakdown; (6) to obtain permanently the files of the values for qualification of the reference levels. This program of monitoring includes the radiation control of surrounding of the NPP Bohunice, in the time of normal work of power-station's blocks, inclusively of all types of trouble-shooting and repairer works in surrounding of the NPP Bohunice, up to distance 20 km from power-station. The monitoring includes: outlets from the NPP Bohunice, monitoring of radiation characteristics in surrounding of the NPP Bohunice, (aerosols, fall-outs, soil), the links of food chains: (grass and fodder, milk, agriculture products), hydrosphere in surrounding (surface waters, drink water, bores of radiation control in complex of the NPP Bohunice, components of the hydrosphere), measurement of radiation from external sources (measurement of the dose rates, measurement of the doses [sk

  12. Chromatic induction from surrounding stimuli under perceptual suppression.

    Science.gov (United States)

    Horiuchi, Koji; Kuriki, Ichiro; Tokunaga, Rumi; Matsumiya, Kazumichi; Shioiri, Satoshi

    2014-11-01

    The appearance of colors can be affected by their spatiotemporal context. The shift in color appearance according to the surrounding colors is called color induction or chromatic induction; in particular, the shift in opponent color of the surround is called chromatic contrast. To investigate whether chromatic induction occurs even when the chromatic surround is imperceptible, we measured chromatic induction during interocular suppression. A multicolor or uniform color field was presented as the surround stimulus, and a colored continuous flash suppression (CFS) stimulus was presented to the dominant eye of each subject. The subjects were asked to report the appearance of the test field only when the stationary surround stimulus is invisible by interocular suppression with CFS. The resulting shifts in color appearance due to chromatic induction were significant even under the conditions of interocular suppression for all surround stimuli. The magnitude of chromatic induction differed with the surround conditions, and this difference was preserved regardless of the viewing conditions. The chromatic induction effect was reduced by CFS, in proportion to the magnitude of chromatic induction under natural (i.e., no-CFS) viewing conditions. According to an analysis with linear model fitting, we revealed the presence of at least two kinds of subprocesses for chromatic induction that reside at higher and lower levels than the site of interocular suppression. One mechanism yields different degrees of chromatic induction based on the complexity of the surround, which is unaffected by interocular suppression, while the other mechanism changes its output with interocular suppression acting as a gain control. Our results imply that the total chromatic induction effect is achieved via a linear summation of outputs from mechanisms that reside at different levels of visual processing.

  13. Risk Compensation Following Medical Male Circumcision: Results from a 1-Year Prospective Cohort Study of Young School-Going Men in KwaZulu-Natal, South Africa.

    Science.gov (United States)

    Govender, K; George, G; Beckett, S; Montague, C; Frohlich, J

    2018-02-01

    This study sought to assess risk compensation following voluntary medical male circumcision of young school-going men. Risk compensation is defined as an inadvertent increase in sexual risk behaviors and a corresponding decrease in self-perceived risk for contracting HIV following the application of a risk reduction technology. This study documented the sexual practices of circumcised (n = 485) and uncircumcised (n = 496) young men in 42 secondary schools at three time points (baseline and 6 and 12 months) in a sub-district of KwaZulu-Natal, South Africa. Study participants were aged from 16 to 24 years old. At the end of the study period, there was no significant difference between the two cohorts concerning learners' perceptions of being at risk of contracting HIV (interaction effect: b = -0.12, p = 0.40). There was also no significant difference in the number of sexual partners in the previous month (interaction effect: b = -0.23, p = 0.15). The proportion of learners who have never used a condom decreased significantly over time (time effect: b = -0.27, p = 0.01), and there was no difference between the circumcised and uncircumcised learners (interaction effect: b = -0.09, p = 0.91). Risk compensation, as evidenced in this study over a 1-year period, was not associated with undergoing voluntary medical male circumcision (VMMC) in our sample of young school-going men. However, it is of concern that at the end of this study, less than half of the sexually active sample in a high-HIV-prevalence community used condoms consistently in the previous month (39% for both study cohorts). The latter underscores the need to view VMMC as a potential entry point for planned HIV and sexuality education interventions targeting young men in this community.

  14. Female genital mutilation: A tragedy for women's reproductive health

    African Journals Online (AJOL)

    Hamid Rushwan

    governments also resisted open discussion about what appeared to be popular ... In southern. Egypt infibulation continues as well; cases have also been reported ... and the United States and elsewhere continue to circumcise their daughters ...

  15. Forest Fragments Surrounded by Sugar Cane Are More Inhospitable to Terrestrial Amphibian Abundance Than Fragments Surrounded by Pasture

    Directory of Open Access Journals (Sweden)

    Paula Eveline Ribeiro D’Anunciação

    2013-01-01

    Full Text Available In recent years, there has been increasing interest in matrix-type influence on forest fragments. Terrestrial amphibians are good bioindicators for this kind of research because of low vagility and high philopatry. This study compared richness, abundance, and species composition of terrestrial amphibians through pitfall traps in two sets of semideciduous seasonal forest fragments in southeastern Brazil, according to the predominant surrounding matrix (sugar cane and pasture. There were no differences in richness, but fragments surrounded by sugar cane had the lowest abundance of amphibians, whereas fragments surrounded by pastures had greater abundance. The most abundant species, Rhinella ornata, showed no biometric differences between fragment groups but like many other amphibians sampled showed very low numbers of individuals in fragments dominated by sugar cane fields. Our data indicate that the sugar cane matrix negatively influences the community of amphibians present in fragments surrounded by this type of land use.

  16. Normal Female Reproductive Anatomy

    Science.gov (United States)

    ... historical Searches are case-insensitive Reproductive System, Female, Anatomy Add to My Pictures View /Download : Small: 720x756 ... Large: 3000x3150 View Download Title: Reproductive System, Female, Anatomy Description: Anatomy of the female reproductive system; drawing ...

  17. Counseling Received by Adolescents Undergoing Voluntary Medical Male Circumcision: Moving Toward Age-Equitable Comprehensive Human Immunodeficiency Virus Prevention Measures.

    Science.gov (United States)

    Kaufman, Michelle R; Patel, Eshan U; Dam, Kim H; Packman, Zoe R; Van Lith, Lynn M; Hatzold, Karin; Marcell, Arik V; Mavhu, Webster; Kahabuka, Catherine; Mahlasela, Lusanda; Njeuhmeli, Emmanuel; Seifert Ahanda, Kim; Ncube, Getrude; Lija, Gissenge; Bonnecwe, Collen; Tobian, Aaron A R

    2018-04-03

    The minimum package of voluntary medical male circumcision (VMMC) services, as defined by the World Health Organization, includes human immunodeficiency virus (HIV) testing, HIV prevention counseling, screening/treatment for sexually transmitted infections, condom promotion, and the VMMC procedure. The current study aimed to assess whether adolescents received these key elements. Quantitative surveys were conducted among male adolescents aged 10-19 years (n = 1293) seeking VMMC in South Africa, Tanzania, and Zimbabwe. We used a summative index score of 8 self-reported binary items to measure receipt of important elements of the World Health Organization-recommended HIV minimum package and the US President's Emergency Plan for AIDS Relief VMMC recommendations. Counseling sessions were observed for a subset of adolescents (n = 44). To evaluate factors associated with counseling content, we used Poisson regression models with generalized estimating equations and robust variance estimation. Although counseling included VMMC benefits, little attention was paid to risks, including how to identify complications, what to do if they arise, and why avoiding sex and masturbation could prevent complications. Overall, older adolescents (aged 15-19 years) reported receiving more items in the recommended minimum package than younger adolescents (aged 10-14 years; adjusted β, 0.17; 95% confidence interval [CI], .12-.21; P benefits or uptake of HIV testing. These self-reported findings were confirmed during counseling observations. Moving toward age-equitable HIV prevention services during adolescent VMMC likely requires standardizing counseling content, as there are significant age differences in HIV prevention content received by adolescents.

  18. Withstanding trauma: the significance of Emma Eckstein's circumcision to Freud's Irma dream.

    Science.gov (United States)

    Bonomi, Carlo

    2013-07-01

    The author considers the medical rationale for Wilhelm Fliess's operation on Emma Eckstein's nose in February 1895 and interprets the possible role that this played in Freud's dream of Irma's injection five months later. The author's main argument is that Emma likely endured female castration as a child and that she therefore experienced the surgery to her nose in 1895 as a retraumatization of her childhood trauma. The author further argues that Freud's unconscious identification with Emma, which broke through in his dream of Irma's injection with resistances and apotropaic defenses, served to accentuate his own "masculine protest". The understanding brought to light by the present interpretation of Freud's Irma dream, when coupled with our previous knowledge of Freud, allows us to better grasp the unconscious logic and origins of psychoanalysis itself.(1.) © 2013 The Psychoanalytic Quarterly, Inc.

  19. SA HEALTH Templete

    African Journals Online (AJOL)

    ...

    Department of Advanced Nursing Science: University of South Africa. Keywords: puberty rites; female circumcision; vukhomba; sexuality education; ethnography ...... KHUPISO, V 2000: Teens tell of abduction and forced circumcision.

  20. Female genital mutilation in African and African American women's literature

    Directory of Open Access Journals (Sweden)

    Darja Marinšek

    2007-12-01

    Full Text Available The article builds on the existing dispute between African and African American women writers on the competence of writing about female genital mutilation (FGM, and tries to determine the existence and nature of the differences between the writings of these two groups. The author uses comparative analysis of two popular African and African American novels, comparing their ways of describing FGM, its causes and consequences, the level ob objectivity and the style of the narrations.This is followed by a discussion on the reasons for such differences, incorporating a larger circle of both African and African American women authors, at the same time analysing the deviance within the two groups. While the differences between African American writers are not that great, as they mostly fail to present the issue from different points of view, which is often the result of their lack of direct knowledge of the topic, African authors' writing is in itself discovered to be ambivalent and not at all invariable. The reasons for such ambivalence are then discussed in greater context, focusing on the effect of the authors' personal contact with circumcision as well as their knowledge and acceptance of Western values. The author concludes by establishing the African ambivalent attitude towards FGM, which includes different aspects of the issue, as the most significant difference between their and African American writers' description of this practice.

  1. An overview of female genital mutilation in Nigeria.

    Science.gov (United States)

    Okeke, Tc; Anyaehie, Usb; Ezenyeaku, Cck

    2012-01-01

    Nigeria, due to its large population, has the highest absolute number of female genital mutilation (FGM) worldwide, accounting for about one-quarter of the estimated 115-130 million circumcised women in the world. The objective of this review is to ascertain the current status of FGM in Nigeria. Pertinent literature on FGM retrieved from internet services [Google search on FGM in Nigeria, www.online Nigeria, PubMed of the national library of medicine www.medconsumer. Info/tropics/fgm.htm, Biomedcentral and African Journal Online (AJOL) (FGM)] and textbooks, journals, and selected references for proper understanding of the topic was included in this review. The national prevalence rate of FGM is 41% among adult women. Evidence abound that the prevalence of FGM is declining. The ongoing drive to eradicate FGM is tackled by World Health Organization, United Nations International Children Emergency Fund, Federation of International Obstetrics and Gynecology (FIGO), African Union, The economic commission for Africa, and many women organizations. However, there is no federal law banning FGM in Nigeria. There is need to eradicate FGM in Nigeria. Education of the general public at all levels with emphasis on the dangers and undesirability of FGM is paramount.

  2. Placental vascular responses are dependent on surrounding tissue

    DEFF Research Database (Denmark)

    Brøgger, Torbjørn Halle

    -depth understanding of the mechanism regulating blood flow and perfusion is necessary if we are to come up with new ideas for intervention and treatment. Method: From fresh born placentas stem villi arteries were carefully dissected. The artery branches were divided. The surrounding tissue was removed from one end...... and was left untouched in the other end. Then using wire myography they were investigated in terms of contractility and sensitivity to physiological relevant human-like agonists. Results: Sensitivity to PGF2α, Tx-analog, 5-HT and endothelin-1 was significantly lower in arteries with intact surrounding tissue...... compared to arteries stripped of the tissue. The maximal force development was also significantly lower in arteries with surrounding tissue, when they were depolarized high extracellular [K+] or stimulated with PGF2α or endotheline-1. Conclusion: The perivascular tissue significantly alters stem villi...

  3. Placental vascular responses are dependent on surrounding tissue

    DEFF Research Database (Denmark)

    Brøgger, Torbjørn Halle

    . Materials and methods. From fresh born placentas, stem villi arteries were carefully dissected. The artery branches were divided. The surrounding tissue was removed from one end and was left untouched in the other end.Then, using wire myography, they were investigated in terms of contractility...... and sensitivity to physiological relevant human-like agonists. Results. Sensitivity to PGF2α, Tx-analog, 5-HT and endothelin-1 was significantly lower in arteries with intact surrounding tissue compared to arteries stripped of the tissue. The maximal force development was also significantly lower in arteries...... with surrounding tissue when they were depolarized high extracellular [K+] or stimulated with PGF2α or endotheline-1. Conclusion. The perivascular tissue significantly alters stem villi arteries' sensitivity and force development in a suppressive way. This implicates a new aspect of blood flow regulation...

  4. Surrounding rock stress analysis of underground high level waste repository

    International Nuclear Information System (INIS)

    Liu Wengang; Wang Ju; Wang Guangdi

    2006-01-01

    During decay of nuclear waste, enormous energy was released, which results in temperature change of surrounding rock of depository. Thermal stress was produced because thermal expansion of rock was controlled. Internal structure of surrounding rock was damaged and strength of rock was weakened. So, variation of stress was a dynamic process with the variation of temperature. BeiShan region of Gansu province was determined to be the depository field in the future, it is essential to make research on granite in this region. In the process of experiment, basic physical parameters of granite were analyzed preliminary with MTS. Long range temperature and stress filed was simulated considering the damage effect of surrounding rock, and rules of temperature and stress was achieved. (authors)

  5. Perceived medical benefit, peer/partner influence and safety and cost to access the service: client motivators for voluntary seeking of medical male circumcision in Iganga district eastern Uganda, a qualitative study.

    Science.gov (United States)

    Muhamadi, Lubega; Ibrahim, Musenze; Wabwire-Mangen, Fred; Peterson, Stefan; Reynolds, Steven J

    2013-01-01

    Although voluntary medical male circumcision (VMMC) in Iganga district was launched in 2010 as part of the Uganda national strategy to prevent new HIV infections with a target of having 129,896 eligible males circumcised by 2012, only 35,000 (27%) of the anticipated target had been circumcised by mid 2012. There was paucity of information on why uptake of VMMC was low in this setting where HIV awareness is presumably high. This study sought to understand motivators for uptake of VMMC from the perspective of the clients themselves in order to advocate for feasible approaches to expanding uptake of VMMC in Iganga district and similar settings. In Iganga district, we conducted seven key informant interviews with staff who work in the VMMC clinics and twenty in-depth interviews with clients who had accepted and undergone VMMC. Ten focus-group discussions including a total of 112 participants were also conducted with clients who had undergone VMMC. Motivators for uptake of VMMC in the perspective of the circumcised clients and the health care staff included: perceived medical benefit to those circumcised such as protection against acquiring HIV and other sexually transmitted diseases, peer/partner influence, sexual satisfaction and safety and cost to access the service. Since perceived medical benefit was a motivator for seeking VMMC, it can be used to strengthen campaigns for increasing uptake of VMMC. Peer influence could also be used in advocacy campaigns for VMMC expansion, especially using peers who have already undergone VMMC. There is need to ensure that safety and cost to access the service is affordable especially to rural poor as it was mentioned as a motivator for seeking VMMC.

  6. Ornitocenosis of the Sursky pond and its close the surroundings

    International Nuclear Information System (INIS)

    Lacko, J.; Ambrus, B.; Fupso, A.

    2013-01-01

    The paper focuses on the qualitative-quantitative research of fishpond bird community of the Sursky and its surroundings as well as on analysis of seasonal population dynamics of the avifauna as well as on placing the determined species into environmental groups and guilds. Another object is the comparison of our results with recent work focused on research of bird communities on this site.

  7. Review of Ordered Anarchy: Jasay and his Surroundings

    Directory of Open Access Journals (Sweden)

    Aschwin de Wolf

    2009-02-01

    Full Text Available Anthony de Jasay is among the most important social thinkers of our time. His oeuvre offers a sustained critique of government and its defenders. In the book Ordered Anarchy: Jasay and His Surroundings, colleagues and friends pay tribute to the man in the form of an inspiring collection of essays.

  8. Neutron spectrum in small iron pile surrounded by lead reflector

    International Nuclear Information System (INIS)

    Kimura, Itsuro; Hayashi, S.A.; Kobayashi, Katsuhei; Matsumura, Tetsuo; Nishihara, Hiroshi.

    1978-01-01

    In order to save the quantity of sample material, a possibility to assess group constants of a reactor material through measurement and analysis of neutron spectrum in a small sample pile surrounded by a reflector of heavy moderator, was investigated. As the sample and the reflector, we chose iron and lead, respectively. Although the time dispersion in moderation of neutrons was considerably prolonged by the lead reflector, this hardly interferes with the assessment of group constants. Theoretical calculation revealed that both the neutron flux spectrum and the sensitivity coefficient of group constants in an iron sphere, 35 cm in diameter surrounded by the lead reflector, 25 cm thick, were close to those of the bare iron sphere, 108 cm in diameter. The neutron spectra in a small iron pile surrounded by a lead reflector were experimentally obtained by the time-of-flight method with an electron linear accelerator and the result was compared with the predicted values. It could be confirmed that a small sample pile surrounded by a reflector, such as lead, was as useful as a much larger bulk pile for the assessment of group constants of a reactor material. (auth.)

  9. Linking disadvantaged housing areas to the surrounding city

    DEFF Research Database (Denmark)

    Stender, Marie

    Several disadvantaged social housing areas in Denmark are currently undergo-ing thorough physical refurbishments, aiming to integrate them better with the surrounding city. The ambition is to attract new users and residents by opening up the borders of the area and establish attractive, new...

  10. Ecological mechanisms linking protected areas to surrounding lands.

    Science.gov (United States)

    Hansen, Andrew J; DeFries, Ruth

    2007-06-01

    Land use is expanding and intensifying in the unprotected lands surrounding many of the world's protected areas. The influence of this land use change on ecological processes is poorly understood. The goal of this paper is to draw on ecological theory to provide a synthetic framework for understanding how land use change around protected areas may alter ecological processes and biodiversity within protected areas and to provide a basis for identifying scientifically based management alternatives. We first present a conceptual model of protected areas embedded within larger ecosystems that often include surrounding human land use. Drawing on case studies in this Invited Feature, we then explore a comprehensive set of ecological mechanisms by which land use on surrounding lands may influence ecological processes and biodiversity within reserves. These mechanisms involve changes in ecosystem size, with implications for minimum dynamic area, species-area effect, and trophic structure; altered flows of materials and disturbances into and out of reserves; effects on crucial habitats for seasonal and migration movements and population source/sink dynamics; and exposure to humans through hunting, poaching, exotics species, and disease. These ecological mechanisms provide a basis for assessing the vulnerability of protected areas to land use. They also suggest criteria for designing regional management to sustain protected areas in the context of surrounding human land use. These design criteria include maximizing the area of functional habitats, identifying and maintaining ecological process zones, maintaining key migration and source habitats, and managing human proximity and edge effects.

  11. The bird species of pandam wildlife park and the surrounding ...

    African Journals Online (AJOL)

    The effect of time of day as well as vegetation variables on bird species diversity in the park and surrounding farmlands was also conducted. 10 transects in each study site were surveyed twice between during the dry season and vegetation variables (trees, fingers, finger-rings two- hand, grazing, farming, canopy cover, ...

  12. Experiences during the decontamination process of areas surrounding to Fukushima

    International Nuclear Information System (INIS)

    Molina, G.

    2014-10-01

    In this work the experience gained during the decontamination of areas surrounding to Fukushima NPP, rugged during the earthquake and tsunami in 2011 and caused the contamination with fission products in these areas is described. Actions taken by the Japanese government are reported and some of the techniques used, the intervention levels and the progress made and disposal techniques considered are presented. (Author)

  13. Traditional Indian customs surrounding birth A review | Chalmers ...

    African Journals Online (AJOL)

    Since 1960, only a few studies have been made of traditional custOIns surrounding birth in Indian culture. Very few of these have described customs followed by Indians in South Africa. A review of these publications is presented here. Customs described include religious, social and psychological aspects of behaviour in ...

  14. Vasculature surrounding a nodule: A novel lung cancer biomarker.

    Science.gov (United States)

    Wang, Xiaohua; Leader, Joseph K; Wang, Renwei; Wilson, David; Herman, James; Yuan, Jian-Min; Pu, Jiantao

    2017-12-01

    To investigate whether the vessels surrounding a nodule depicted on non-contrast, low-dose computed tomography (LDCT) can discriminate benign and malignant screen detected nodules. We collected a dataset consisting of LDCT scans acquired on 100 subjects from the Pittsburgh Lung Screening study (PLuSS). Fifty subjects were diagnosed with lung cancer and 50 subjects had suspicious nodules later proven benign. For the lung cancer cases, the location of the malignant nodule in the LDCT scans was known; while for the benign cases, the largest nodule in the LDCT scan was used in the analysis. A computer algorithm was developed to identify surrounding vessels and quantify the number and volume of vessels that were connected or near the nodule. A nonparametric receiver operating characteristic (ROC) analysis was performed based on a single nodule per subject to assess the discriminability of the surrounding vessels to provide a lung cancer diagnosis. Odds ratio (OR) were computed to determine the probability of a nodule being lung cancer based on the vessel features. The areas under the ROC curves (AUCs) for vessel count and vessel volume were 0.722 (95% CI=0.616-0.811, plung cancer group 9.7 (±9.6) compared to the non-lung cancer group 4.0 (±4.3) CONCLUSION: Our preliminary results showed that malignant nodules are often surrounded by more vessels compared to benign nodules, suggesting that the surrounding vessel characteristics could serve as lung cancer biomarker for indeterminate nodules detected during LDCT lung cancer screening using only the information collected during the initial visit. Copyright © 2017 Elsevier B.V. All rights reserved.

  15. Voluntary medical male circumcision scale-up in Nyanza, Kenya: evaluating technical efficiency and productivity of service delivery.

    Science.gov (United States)

    Omondi Aduda, Dickens S; Ouma, Collins; Onyango, Rosebella; Onyango, Mathews; Bertrand, Jane

    2015-01-01

    Voluntary medical male circumcision (VMMC) service delivery is complex and resource-intensive. In Kenya's context there is still paucity of information on resource use vis-à-vis outputs as programs scale up. Knowledge of technical efficiency, productivity and potential sources of constraints is desirable to improve decision-making. To evaluate technical efficiency and productivity of VMMC service delivery in Nyanza in 2011/2012 using data envelopment analysis. Comparative process evaluation of facilities providing VMMC in Nyanza in 2011/2012 using output orientated data envelopment analysis. Twenty one facilities were evaluated. Only 1 of 7 variables considered (total elapsed operation time) significantly improved from 32.8 minutes (SD 8.8) in 2011 to 30 minutes (SD 6.6) in 2012 (95%CI = 0.0350-5.2488; p = 0.047). Mean scale technical efficiency significantly improved from 91% (SD 19.8) in 2011 to 99% (SD 4.0) in 2012 particularly among outreach compared to fixed service delivery facilities (CI -31.47959-4.698508; p = 0.005). Increase in mean VRS technical efficiency from 84% (SD 25.3) in 2011 and 89% (SD 25.1) in 2012 was not statistically significant. Benchmark facilities were #119 and #125 in 2011 and #103 in 2012. Malmquist Productivity Index (MPI) at fixed facilities declined by 2.5% but gained by 4.9% at outreach ones by 2012. Total factor productivity improved by 83% (p = 0.032) in 2012, largely due to progress in technological efficiency by 79% (p = 0.008). Significant improvement in scale technical efficiency among outreach facilities in 2012 was attributable to accelerated activities. However, ongoing pure technical inefficiency requires concerted attention. Technological progress was the key driver of service productivity growth in Nyanza. Incorporating service-quality dimensions and using stepwise-multiple criteria in performance evaluation enhances comprehensiveness and validity. These findings highlight site-level resource use and sources of

  16. Voluntary Medical Male Circumcision Scale-Up in Nyanza, Kenya: Evaluating Technical Efficiency and Productivity of Service Delivery

    Science.gov (United States)

    Omondi Aduda, Dickens S.; Ouma, Collins; Onyango, Rosebella; Onyango, Mathews; Bertrand, Jane

    2015-01-01

    Background Voluntary medical male circumcision (VMMC) service delivery is complex and resource-intensive. In Kenya’s context there is still paucity of information on resource use vis-à-vis outputs as programs scale up. Knowledge of technical efficiency, productivity and potential sources of constraints is desirable to improve decision-making. Objective To evaluate technical efficiency and productivity of VMMC service delivery in Nyanza in 2011/2012 using data envelopment analysis. Design Comparative process evaluation of facilities providing VMMC in Nyanza in 2011/2012 using output orientated data envelopment analysis. Results Twenty one facilities were evaluated. Only 1 of 7 variables considered (total elapsed operation time) significantly improved from 32.8 minutes (SD 8.8) in 2011 to 30 minutes (SD 6.6) in 2012 (95%CI = 0.0350–5.2488; p = 0.047). Mean scale technical efficiency significantly improved from 91% (SD 19.8) in 2011 to 99% (SD 4.0) in 2012 particularly among outreach compared to fixed service delivery facilities (CI -31.47959–4.698508; p = 0.005). Increase in mean VRS technical efficiency from 84% (SD 25.3) in 2011 and 89% (SD 25.1) in 2012 was not statistically significant. Benchmark facilities were #119 and #125 in 2011 and #103 in 2012. Malmquist Productivity Index (MPI) at fixed facilities declined by 2.5% but gained by 4.9% at outreach ones by 2012. Total factor productivity improved by 83% (p = 0.032) in 2012, largely due to progress in technological efficiency by 79% (p = 0.008). Conclusions Significant improvement in scale technical efficiency among outreach facilities in 2012 was attributable to accelerated activities. However, ongoing pure technical inefficiency requires concerted attention. Technological progress was the key driver of service productivity growth in Nyanza. Incorporating service-quality dimensions and using stepwise-multiple criteria in performance evaluation enhances comprehensiveness and validity. These findings

  17. Implementation of adolescent-friendly voluntary medical male circumcision using a school based recruitment program in rural KwaZulu-Natal, South Africa.

    Directory of Open Access Journals (Sweden)

    Carl Montague

    Full Text Available BACKGROUND: Epidemiological data from South Africa demonstrate that risk of human immunodeficiency virus (HIV infection in males increases dramatically after adolescence. Targeting adolescent HIV-negative males may be an efficient and cost-effective means of maximising the established HIV prevention benefits of voluntary medical male circumcision (VMMC in high HIV prevalence-, low circumcision practice-settings. This study assessed the feasibility of recruiting male high school students for VMMC in such a setting in rural KwaZulu-Natal. METHODS AND FINDINGS: Following community and key stakeholder consultations on the acceptability of VMMC recruitment through schools, information and awareness raising sessions were held in 42 high schools in Vulindlela. A three-phase VMMC demand-creation strategy was implemented in partnership with a local non-governmental organization, ZimnadiZonke, that involved: (i community consultation and engagement; (ii in-school VMMC awareness sessions and centralized HIV counselling and testing (HCT service access; and (iii peer recruitment and decentralized HCT service access. Transport was provided for volunteers to the Centre for the AIDS Programme of Research in South Africa (CAPRISA clinic where the forceps-guided VMMC procedure was performed on consenting HIV-negative males. HIV infected volunteers were referred to further care either at the CAPRISA clinic or at public sector clinics. Between March 2011 and February 2013, a total of 5165 circumcisions were performed, the majority (71% in males aged between 15 and 19 years. Demand-creation strategies were associated with an over five-fold increase in VMMC uptake from an average of 58 procedures/month in initial community engagement phases, to an average of 308 procedures/month on initiation of the peer recruitment-decentralized service phase. Post-operative adverse events were rare (1.2%, mostly minor and self-resolving. CONCLUSIONS: Optimizing a high volume

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

    Science.gov (United States)

    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 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.

  19. Ultrastructural relationship of the phagophore with surrounding organelles.

    Science.gov (United States)

    Biazik, Joanna; Ylä-Anttila, Päivi; Vihinen, Helena; Jokitalo, Eija; Eskelinen, Eeva-Liisa

    2015-01-01

    Phagophore nucleates from a subdomain of the endoplasmic reticulum (ER) termed the omegasome and also makes contact with other organelles such as mitochondria, Golgi complex, plasma membrane and recycling endosomes during its formation. We have used serial block face scanning electron microscopy (SB-EM) and electron tomography (ET) to image phagophore biogenesis in 3 dimensions and to determine the relationship between the phagophore and surrounding organelles at high resolution. ET was performed to confirm whether membrane contact sites (MCSs) are evident between the phagophore and those surrounding organelles. In addition to the known contacts with the ER, we identified MCSs between the phagophore and membranes from putative ER exit sites, late endosomes or lysosomes, the Golgi complex and mitochondria. We also show that one phagophore can have simultaneous MCSs with more than one organelle. Future membrane flux experiments are needed to determine whether membrane contacts also signify lipid translocation.

  20. Trajectories and Maneuvers of Surrounding Vehicles with Panoramic Camera Arrays

    DEFF Research Database (Denmark)

    Dueholm, Jacob Velling; Kristoffersen, Miklas Strøm; Satzoda, Ravi K.

    2016-01-01

    Vision-based research for intelligent vehicles have traditionally focused on specific regions around a vehicle, such as a front looking camera for, e.g., lane estimation. Traffic scenes are complex and vital information could be lost in unobserved regions. This paper proposes a framework that uses...... four visual sensors for a full surround view of a vehicle in order to achieve an understanding of surrounding vehicle behaviors. The framework will assist the analysis of naturalistic driving studies by automating the task of data reduction of the observed trajectories. To this end, trajectories...... are estimated using a vehicle detector together with a multiperspective optimized tracker in each view. The trajectories are transformed to a common ground plane, where they are associated between perspectives and analyzed to reveal tendencies around the ego-vehicle. The system is tested on sequences from 2.5 h...

  1. Mechanical Characteristics Analysis of Surrounding Rock on Anchor Bar Reinforcement

    Science.gov (United States)

    Gu, Shuan-cheng; Zhou, Pan; Huang, Rong-bin

    2018-03-01

    Through the homogenization method, the composite of rock and anchor bar is considered as the equivalent material of continuous, homogeneous, isotropic and strength parameter enhancement, which is defined as reinforcement body. On the basis of elasticity, the composite and the reinforcement are analyzed, Based on strengthening theory of surrounding rock and displacement equivalent conditions, the expression of reinforcement body strength parameters and mechanical parameters is deduced. The example calculation shows that the theoretical results are close to the results of the Jia-mei Gao[9], however, closer to the results of FLAC3D numerical simulation, it is proved that the model and surrounding rock reinforcement body theory are reasonable. the model is easy to analyze and calculate, provides a new way for determining reasonable bolt support parameters, can also provides reference for the stability analysis of underground cavern bolting support.

  2. Self catheterization - female

    Science.gov (United States)

    ... female Images Bladder catheterization, female References Davis JE, Silverman MA. Urologic procedures. In: Roberts JR, ed. Roberts ... provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial ...

  3. Diversity of vascular plants of Piestany and surroundings (presentation)

    International Nuclear Information System (INIS)

    Penzesova, A.; Galusova, T.

    2013-01-01

    In this presentation is a summary of the results of floristic research aimed at determining diversity of vascular plants of Piestany and its surroundings. Plant taxa we determined using the designation keys. We have compiled a list of plant species occurring in the monitored area, we evaluated the selected botanical-phytogeographical characteristics of flora, we've put together a list of local protected, endangered and rare species and a list of local invasive and expansive species according to sources. (Authors)

  4. Methods of Assessing Noise Nuisance of Real Estate Surroundings

    Directory of Open Access Journals (Sweden)

    Szopińska Kinga

    2016-03-01

    Full Text Available Testing what factors create the market value of real estate is key information when preparing property valuations as well as other opinions and professional evaluations on the basis of which court verdicts or administrative decisions are made. One of the factors influencing the value of some real estate is the level of noise present in the surroundings, which can lead to the occurrence of noise nuisance negatively affecting social relations.

  5. Numerical Simulation on Zonal Disintegration in Deep Surrounding Rock Mass

    Directory of Open Access Journals (Sweden)

    Xuguang Chen

    2014-01-01

    Full Text Available Zonal disintegration have been discovered in many underground tunnels with the increasing of embedded depth. The formation mechanism of such phenomenon is difficult to explain under the framework of traditional rock mechanics, and the fractured shape and forming conditions are unclear. The numerical simulation was carried out to research the generating condition and forming process of zonal disintegration. Via comparing the results with the geomechanical model test, the zonal disintegration phenomenon was confirmed and its mechanism is revealed. It is found to be the result of circular fracture which develops within surrounding rock mass under the high geostress. The fractured shape of zonal disintegration was determined, and the radii of the fractured zones were found to fulfill the relationship of geometric progression. The numerical results were in accordance with the model test findings. The mechanism of the zonal disintegration was revealed by theoretical analysis based on fracture mechanics. The fractured zones are reportedly circular and concentric to the cavern. Each fracture zone ruptured at the elastic-plastic boundary of the surrounding rocks and then coalesced into the circular form. The geometric progression ratio was found to be related to the mechanical parameters and the ground stress of the surrounding rocks.

  6. Numerical simulation on zonal disintegration in deep surrounding rock mass.

    Science.gov (United States)

    Chen, Xuguang; Wang, Yuan; Mei, Yu; Zhang, Xin

    2014-01-01

    Zonal disintegration have been discovered in many underground tunnels with the increasing of embedded depth. The formation mechanism of such phenomenon is difficult to explain under the framework of traditional rock mechanics, and the fractured shape and forming conditions are unclear. The numerical simulation was carried out to research the generating condition and forming process of zonal disintegration. Via comparing the results with the geomechanical model test, the zonal disintegration phenomenon was confirmed and its mechanism is revealed. It is found to be the result of circular fracture which develops within surrounding rock mass under the high geostress. The fractured shape of zonal disintegration was determined, and the radii of the fractured zones were found to fulfill the relationship of geometric progression. The numerical results were in accordance with the model test findings. The mechanism of the zonal disintegration was revealed by theoretical analysis based on fracture mechanics. The fractured zones are reportedly circular and concentric to the cavern. Each fracture zone ruptured at the elastic-plastic boundary of the surrounding rocks and then coalesced into the circular form. The geometric progression ratio was found to be related to the mechanical parameters and the ground stress of the surrounding rocks.

  7. Enhanced sources of acoustic power surrounding AR 11429

    International Nuclear Information System (INIS)

    Donea, Alina; Hanson, Christopher

    2013-01-01

    Multi-frequency power maps of the local acoustic oscillations show acoustic enhancements (''acoustic-power halos'') at high frequencies surrounding large active region. Computational seismic holography reveals a high-frequency ''acoustic-emission halo'', or ''seismic glory'' surrounding large active regions. In this study, we have applied computational seismic holography to map the seismic seismic source density surrounding AR 11429. Studies of HMI/SDO Doppler data, shows that the ''acoustic halos'' and the ''seismic glories'' are prominent at high frequencies 5–8 mHz. We investigate morphological properties of acoustic-power and acoustic emission halos around an active region to see if they are spatially correlated. Details about the local magnetic field from vectormagnetograms of AR 11429 are included. We identify a 15'' region of seismic deficit power (dark moat) shielding the white-light boundary of the active region. The size of the seismic moat is related to region of intermediate magnetic field strength. The acoustic moat is circled by the halo of enhanced seismic amplitude as well as enhanced seismic emission. Overall, the results suggest that features are related. However, if we narrow the frequency band to 5.5 – 6.5 mHz, we find that the seismic source density dominates over the local acoustic power, suggesting the existence of sources that emit more energy downward into the solar interior than upward toward the solar surface.

  8. Tissue reaction surrounding miniscrews for orthodontic anchorage: An animal experiment

    Directory of Open Access Journals (Sweden)

    Stephanie Shih-Hsuan Chen

    2012-03-01

    Results and conclusions: (1 Tissue surrounding roots damaged by a miniscrew showed a significant inflammatory response. (2 Root resorption was occasionally observed after 3 weeks following insertion of a miniscrew even if the miniscrew was not in direct contact with the root. (3 Root repair was noted with a cementoblast lining along the resorption surface at as early as 3 weeks after miniscrew insertion. Alveolar bone filled in the lesion when the root damage was large so that the contour of the alveolar bone followed that of the damaged root, with the width of the periodontal ligament space being maintained. (4 Stable miniscrews were mainly those which did not contact adjacent roots, and for which the surrounding tissue showed only a small inflammatory response with some extent of direct bone contact around the miniscrew. On the contrary, most of the failed miniscrews were those which had direct contact with adjacent roots, and which exhibited severe tissue inflammation and were covered by thick layers of soft tissue. Failure was detected 3 weeks after insertion. Surprisingly, the epithelial lining surrounding the miniscrews might not have spontaneously resolved 6 weeks after screw removal. Persistent infection in the sinus tract was noted, and this would require attention.

  9. A permeability barrier surrounds taste buds in lingual epithelia

    Science.gov (United States)

    Dando, Robin; Pereira, Elizabeth; Kurian, Mani; Barro-Soria, Rene; Chaudhari, Nirupa

    2014-01-01

    Epithelial tissues are characterized by specialized cell-cell junctions, typically localized to the apical regions of cells. These junctions are formed by interacting membrane proteins and by cytoskeletal and extracellular matrix components. Within the lingual epithelium, tight junctions join the apical tips of the gustatory sensory cells in taste buds. These junctions constitute a selective barrier that limits penetration of chemosensory stimuli into taste buds (Michlig et al. J Comp Neurol 502: 1003–1011, 2007). We tested the ability of chemical compounds to permeate into sensory end organs in the lingual epithelium. Our findings reveal a robust barrier that surrounds the entire body of taste buds, not limited to the apical tight junctions. This barrier prevents penetration of many, but not all, compounds, whether they are applied topically, injected into the parenchyma of the tongue, or circulating in the blood supply, into taste buds. Enzymatic treatments indicate that this barrier likely includes glycosaminoglycans, as it was disrupted by chondroitinase but, less effectively, by proteases. The barrier surrounding taste buds could also be disrupted by brief treatment of lingual tissue samples with DMSO. Brief exposure of lingual slices to DMSO did not affect the ability of taste buds within the slice to respond to chemical stimulation. The existence of a highly impermeable barrier surrounding taste buds and methods to break through this barrier may be relevant to basic research and to clinical treatments of taste. PMID:25209263

  10. A permeability barrier surrounds taste buds in lingual epithelia.

    Science.gov (United States)

    Dando, Robin; Pereira, Elizabeth; Kurian, Mani; Barro-Soria, Rene; Chaudhari, Nirupa; Roper, Stephen D

    2015-01-01

    Epithelial tissues are characterized by specialized cell-cell junctions, typically localized to the apical regions of cells. These junctions are formed by interacting membrane proteins and by cytoskeletal and extracellular matrix components. Within the lingual epithelium, tight junctions join the apical tips of the gustatory sensory cells in taste buds. These junctions constitute a selective barrier that limits penetration of chemosensory stimuli into taste buds (Michlig et al. J Comp Neurol 502: 1003-1011, 2007). We tested the ability of chemical compounds to permeate into sensory end organs in the lingual epithelium. Our findings reveal a robust barrier that surrounds the entire body of taste buds, not limited to the apical tight junctions. This barrier prevents penetration of many, but not all, compounds, whether they are applied topically, injected into the parenchyma of the tongue, or circulating in the blood supply, into taste buds. Enzymatic treatments indicate that this barrier likely includes glycosaminoglycans, as it was disrupted by chondroitinase but, less effectively, by proteases. The barrier surrounding taste buds could also be disrupted by brief treatment of lingual tissue samples with DMSO. Brief exposure of lingual slices to DMSO did not affect the ability of taste buds within the slice to respond to chemical stimulation. The existence of a highly impermeable barrier surrounding taste buds and methods to break through this barrier may be relevant to basic research and to clinical treatments of taste. Copyright © 2015 the American Physiological Society.

  11. Female reproductive disorders

    DEFF Research Database (Denmark)

    Crain, D Andrew; Janssen, Sarah J; Edwards, Thea M

    2008-01-01

    To evaluate the possible role of endocrine-disrupting compounds (EDCs) on female reproductive disorders emphasizing developmental plasticity and the complexity of endocrine-dependent ontogeny of reproductive organs. Declining conception rates and the high incidence of female reproductive...... disruptions warrant evaluation of the impact of EDCs on female reproductive health....

  12. Epidemiology of Epidemic Ebola Virus Disease in Conakry and Surrounding Prefectures, Guinea, 2014–2015

    Science.gov (United States)

    Brody, Debra; Coronado, Fátima; Rondy, Marc; Fiebig, Lena; Carcelen, Andrea; Deyde, Varough M.; Mesfin, Samuel; Retzer, Kyla D.; Bilivogui, Pepe; Keita, Sakoba; Dahl, Benjamin A.

    2016-01-01

    In 2014, Ebola virus disease (EVD) in West Africa was first reported during March in 3 southeastern prefectures in Guinea; from there, the disease rapidly spread across West Africa. We describe the epidemiology of EVD cases reported in Guinea’s capital, Conakry, and 4 surrounding prefectures (Coyah, Dubreka, Forecariah, and Kindia), encompassing a full year of the epidemic. A total of 1,355 EVD cases, representing ≈40% of cases reported in Guinea, originated from these areas. Overall, Forecariah had the highest cumulative incidence (4× higher than that in Conakry). Case-fatality percentage ranged from 40% in Conakry to 60% in Kindia. Cumulative incidence was slightly higher among male than female residents, although incidences by prefecture and commune differed by sex. Over the course of the year, Conakry and neighboring prefectures became the EVD epicenter in Guinea. PMID:26812047

  13. Epidemiology of Epidemic Ebola Virus Disease in Conakry and Surrounding Prefectures, Guinea, 2014-2015.

    Science.gov (United States)

    Rico, Adriana; Brody, Debra; Coronado, Fátima; Rondy, Marc; Fiebig, Lena; Carcelen, Andrea; Deyde, Varough M; Mesfin, Samuel; Retzer, Kyla D; Bilivogui, Pepe; Keita, Sakoba; Dahl, Benjamin A

    2016-02-01

    In 2014, Ebola virus disease (EVD) in West Africa was first reported during March in 3 southeastern prefectures in Guinea; from there, the disease rapidly spread across West Africa. We describe the epidemiology of EVD cases reported in Guinea's capital, Conakry, and 4 surrounding prefectures (Coyah, Dubreka, Forecariah, and Kindia), encompassing a full year of the epidemic. A total of 1,355 EVD cases, representing ≈40% of cases reported in Guinea, originated from these areas. Overall, Forecariah had the highest cumulative incidence (4× higher than that in Conakry). Case-fatality percentage ranged from 40% in Conakry to 60% in Kindia. Cumulative incidence was slightly higher among male than female residents, although incidences by prefecture and commune differed by sex. Over the course of the year, Conakry and neighboring prefectures became the EVD epicenter in Guinea.

  14. Improving the Quality of Voluntary Medical Male Circumcision through Use of the Continuous Quality Improvement Approach: A Pilot in 30 PEPFAR-Supported Sites in Uganda

    Science.gov (United States)

    Opio, Alex; Calnan, Jacqueline; Njeuhmeli, Emmanuel

    2015-01-01

    Background Uganda adopted voluntary medical male circumcision (VMMC) (also called Safe Male Circumcision in Uganda), as part of its HIV prevention strategy in 2010. Since then, the Ministry of Health (MOH) has implemented VMMC mostly with support from the United States President’s Emergency Plan for AIDS Relief (PEPFAR) through its partners. In 2012, two PEPFAR-led external quality assessments evaluated compliance of service delivery sites with minimum quality standards. Quality gaps were identified, including lack of standardized forms or registers, lack of documentation of client consent, poor preparedness for emergencies and use of untrained service providers. In response, PEPFAR, through a USAID-supported technical assistance project, provided support in quality improvement to the MOH and implementing partners to improve quality and safety in VMMC services and build capacity of MOH staff to continuously improve VMMC service quality. Methods and Findings Sites were supported to identify barriers in achieving national standards, identify possible solutions to overcome the barriers and carry out improvement plans to test these changes, while collecting performance data to objectively measure whether they had bridged gaps. A 53-indicator quality assessment tool was used by teams as a management tool to measure progress; teams also measured client-level indicators through self-assessment of client records. At baseline (February-March 2013), less than 20 percent of sites scored in the “good” range (>80%) for supplies and equipment, patient counseling and surgical procedure; by November 2013, the proportion of sites scoring “good” rose to 67 percent, 93 percent and 90 percent, respectively. Significant improvement was noted in post-operative follow-up at 48 hours, sexually transmitted infection assessment, informed consent and use of local anesthesia but not rate of adverse events. Conclusion Public sector providers can be engaged to address the quality of

  15. A Clinical Trial to Introduce Voluntary Medical Male Circumcision for HIV Prevention in Areas of High Prevalence in the Dominican Republic

    Science.gov (United States)

    Brito, Maximo O.; Lerebours, Leonel; Volquez, Claudio; Basora, Emmanuel; Khosla, Shaveta; Lantigua, Flavia; Flete, Roberto; Rosario, Riqui; Rodriguez, Luis A.; Fernandez, Mathius; Donastorg, Yeycy; Bailey, Robert C.

    2015-01-01

    Background Voluntary Medical Male Circumcision (VMMC) is an effective strategy to reduce the risk of HIV infection. Studies conducted in the Dominican Republic (DR) suggest that acceptability of VMMC among men may be as high as 67%. The goal of this clinical trial was to assess the acceptability, uptake and safety for VMMC services in two areas of high HIV prevalence in the country. Methods This was a single-arm, non-randomized, pragmatic clinical trial. Study personnel received background information about the risks and benefits of VMMC and practical training on the surgical technique. A native speaking research assistant administered a questionnaire of demographics, sexual practices and knowledge about VMMC. One week after the surgery, participants returned for wound inspection and to answer questions about their post-surgical experience. Results 539 men consented for the study. Fifty seven were excluded from participation for medical or anatomical reasons and 28 decided not to have the procedure after providing consent. A total of 454 men were circumcised using the Forceps Guided Method Under Local Anesthesia. The rate of adverse events (AE) was 4.4% (20% moderate, 80% mild). There were no serious AEs and all complications resolved promptly with treatment. Eighty eight percent of clients reported being “very satisfied” and 12% were “somewhat satisfied” with the outcome at the one-week postoperative visit. Conclusions Recruitment and uptake were satisfactory. Client satisfaction with VMMC was high and the rate of AEs was low. Roll out of VMMC in targeted areas of the DR is feasible and should be considered. Trial Registration ClinicalTrials.gov NCT02337179 PMID:26367187

  16. Improving the Quality of Voluntary Medical Male Circumcision through Use of the Continuous Quality Improvement Approach: A Pilot in 30 PEPFAR-Supported Sites in Uganda.

    Science.gov (United States)

    Byabagambi, John; Marks, Pamela; Megere, Humphrey; Karamagi, Esther; Byakika, Sarah; Opio, Alex; Calnan, Jacqueline; Njeuhmeli, Emmanuel

    2015-01-01

    Uganda adopted voluntary medical male circumcision (VMMC) (also called Safe Male Circumcision in Uganda), as part of its HIV prevention strategy in 2010. Since then, the Ministry of Health (MOH) has implemented VMMC mostly with support from the United States President's Emergency Plan for AIDS Relief (PEPFAR) through its partners. In 2012, two PEPFAR-led external quality assessments evaluated compliance of service delivery sites with minimum quality standards. Quality gaps were identified, including lack of standardized forms or registers, lack of documentation of client consent, poor preparedness for emergencies and use of untrained service providers. In response, PEPFAR, through a USAID-supported technical assistance project, provided support in quality improvement to the MOH and implementing partners to improve quality and safety in VMMC services and build capacity of MOH staff to continuously improve VMMC service quality. Sites were supported to identify barriers in achieving national standards, identify possible solutions to overcome the barriers and carry out improvement plans to test these changes, while collecting performance data to objectively measure whether they had bridged gaps. A 53-indicator quality assessment tool was used by teams as a management tool to measure progress; teams also measured client-level indicators through self-assessment of client records. At baseline (February-March 2013), less than 20 percent of sites scored in the "good" range (>80%) for supplies and equipment, patient counseling and surgical procedure; by November 2013, the proportion of sites scoring "good" rose to 67 percent, 93 percent and 90 percent, respectively. Significant improvement was noted in post-operative follow-up at 48 hours, sexually transmitted infection assessment, informed consent and use of local anesthesia but not rate of adverse events. Public sector providers can be engaged to address the quality of VMMC using a continuous quality improvement approach.

  17. Female reproductive disorders

    DEFF Research Database (Denmark)

    Crain, D Andrew; Janssen, Sarah J; Edwards, Thea M

    2008-01-01

    To evaluate the possible role of endocrine-disrupting compounds (EDCs) on female reproductive disorders emphasizing developmental plasticity and the complexity of endocrine-dependent ontogeny of reproductive organs. Declining conception rates and the high incidence of female reproductive disrupti......To evaluate the possible role of endocrine-disrupting compounds (EDCs) on female reproductive disorders emphasizing developmental plasticity and the complexity of endocrine-dependent ontogeny of reproductive organs. Declining conception rates and the high incidence of female reproductive...... disruptions warrant evaluation of the impact of EDCs on female reproductive health....

  18. Silencing women’s sexuality: global AIDS policies and the case of the female condom

    Science.gov (United States)

    Peters, Anny JTP; van Driel, Francien TM; Jansen, Willy HM

    2013-01-01

    Introduction The female condom is the only evidence-based AIDS prevention technology that has been designed for the female body; yet, most women do not have access to it. This is remarkable since women constitute the majority of all HIV-positive people living in sub-Saharan Africa, and gender inequality is seen as a driving force of the AIDS epidemic. In this study, we analyze how major actors in the AIDS prevention field frame the AIDS problem, in particular the female condom in comparison to other prevention technologies, in their discourse and policy formulations. Our aim is to gain insight into the discursive power mechanisms that underlie the thinking about AIDS prevention and women’s sexual agency. Methods We analyze the AIDS policies of 16 agencies that constitute the most influential actors in the global response to AIDS. Our study unravels the discursive power of these global AIDS policy actors, when promoting and making choices between AIDS prevention technologies. We conducted both a quantitative and qualitative analysis of how the global AIDS epidemic is being addressed by them, in framing the AIDS problem, labelling of different categories of people for targeting AIDS prevention programmes and in gender marking of AIDS prevention technologies. Results We found that global AIDS policy actors frame the AIDS problem predominantly in the context of gender and reproductive health, rather than that of sexuality and sexual rights. Men’s sexual agency is treated differently from women’s sexual agency. An example of such differentiation and of gender marking is shown by contrasting the framing and labelling of male circumcision as an intervention aimed at the prevention of HIV with that of the female condom. Conclusions The gender-stereotyped global AIDS policy discourse negates women’s agency in sexuality and their sexual rights. This could be an important factor in limiting the scale-up of female condom programmes and hampering universal access to

  19. INTERACTIONS OF THE INFRARED BUBBLE N4 WITH ITS SURROUNDINGS

    Energy Technology Data Exchange (ETDEWEB)

    Liu, Hong-Li; Li, Jin-Zeng; Yuan, Jing-Hua; Huang, Maohai; Huang, Ya-Fang; Zhang, Si-Ju [National Astronomical Observatories, Chinese Academy of Sciences, 20A Datun Road, Chaoyang District, Beijing 100012 (China); Wu, Yuefang [Department of Astronomy, Peking University, 100871 Beijing (China); Liu, Tie [Korea Astronomy and Space Science Institute 776, Daedeokdae-ro, Yuseong-gu, Daejeon, 305-348 (Korea, Republic of); Dubner, G.; Paron, S.; Ortega, M. E. [1Instituto de Astronomía y Física del Espacio (IAFE, CONICET-UBA), CC 67, Suc. 28, 1428 Buenos Aires (Argentina); Molinari, Sergio [Istituto di Astrofisica e Planetologia Spaziali—IAPS, Istituto Nazionale di Astrofisica—INAF, via Fosso del Cavaliere 100, I-00133 Roma (Italy); Zavagno, Annie; Samal, Manash R., E-mail: hlliu@nao.cas.cn [Aix Marseille Universit, CNRS, LAM (Laboratoire d’Astrophysique de Marseille) UMR 7326, F-13388, Marseille (France)

    2016-02-10

    The physical mechanisms that induce the transformation of a certain mass of gas in new stars are far from being well understood. Infrared bubbles associated with H ii regions have been considered to be good samples for investigating triggered star formation. In this paper we report on the investigation of the dust properties of the infrared bubble N4 around the H ii region G11.898+0.747, analyzing its interaction with its surroundings and star formation histories therein, with the aim of determining the possibility of star formation triggered by the expansion of the bubble. Using Herschel PACS and SPIRE images with a wide wavelength coverage, we reveal the dust properties over the entire bubble. Meanwhile, we are able to identify six dust clumps surrounding the bubble, with a mean size of 0.50 pc, temperature of about 22 K, mean column density of 1.7 × 10{sup 22} cm{sup −2}, mean volume density of about 4.4 × 10{sup 4} cm{sup −3}, and a mean mass of 320 M{sub ⊙}. In addition, from PAH emission seen at 8 μm, free–free emission detected at 20 cm, and a probability density function in special regions, we could identify clear signatures of the influence of the H ii region on the surroundings. There are hints of star formation, though further investigation is required to demonstrate that N4 is the triggering source.

  20. Blooming Trees: Substructures and Surrounding Groups of Galaxy Clusters

    Science.gov (United States)

    Yu, Heng; Diaferio, Antonaldo; Serra, Ana Laura; Baldi, Marco

    2018-06-01

    We develop the Blooming Tree Algorithm, a new technique that uses spectroscopic redshift data alone to identify the substructures and the surrounding groups of galaxy clusters, along with their member galaxies. Based on the estimated binding energy of galaxy pairs, the algorithm builds a binary tree that hierarchically arranges all of the galaxies in the field of view. The algorithm searches for buds, corresponding to gravitational potential minima on the binary tree branches; for each bud, the algorithm combines the number of galaxies, their velocity dispersion, and their average pairwise distance into a parameter that discriminates between the buds that do not correspond to any substructure or group, and thus eventually die, and the buds that correspond to substructures and groups, and thus bloom into the identified structures. We test our new algorithm with a sample of 300 mock redshift surveys of clusters in different dynamical states; the clusters are extracted from a large cosmological N-body simulation of a ΛCDM model. We limit our analysis to substructures and surrounding groups identified in the simulation with mass larger than 1013 h ‑1 M ⊙. With mock redshift surveys with 200 galaxies within 6 h ‑1 Mpc from the cluster center, the technique recovers 80% of the real substructures and 60% of the surrounding groups; in 57% of the identified structures, at least 60% of the member galaxies of the substructures and groups belong to the same real structure. These results improve by roughly a factor of two the performance of the best substructure identification algorithm currently available, the σ plateau algorithm, and suggest that our Blooming Tree Algorithm can be an invaluable tool for detecting substructures of galaxy clusters and investigating their complex dynamics.

  1. Earthquakes in Switzerland and surrounding regions during 2007

    Energy Technology Data Exchange (ETDEWEB)

    Baer, M.; Deichmann, N.; Clinton, J.; Husen, S.; Faeh, D.; Giardini, D.; Kaestli, P.; Kradolfer, U.; Wiemer, S

    2008-12-15

    This report of the Swiss Seismological Service summarizes the seismic activity in Switzerland and surrounding regions during 2007. During this period, 531 earthquakes and 92 quarry blasts were detected and located in the region under consideration. Of these earthquakes, 30 are aftershocks of the stimulation of a proposed geothermal reservoir beneath the city of Basel in December of 2006. With 20 events with {mu}{sub {iota}} {>=} 2.5, four of which were artificially induced, the seismic activity in the year 2007 was far below the average over the previous 32 years. (author)

  2. Isoperimetric inequalities in surround system and space science

    OpenAIRE

    JiaJin Wen; Jun Yuan; ShanHe Wu

    2016-01-01

    Abstract By means of the algebraic, analysis, convex geometry, computer, and inequality theories we establish the following isoperimetric inequality in the centered 2-surround system S ( 2 ) { P , Γ , l } $S^{(2)} \\{P,\\varGamma ,l \\}$ : ( 1 | Γ | ∮ Γ r ¯ P p ) 1 / p ⩽ | Γ | 4 π sin l π | Γ | [ csc l π | Γ | + cot 2 l π | Γ | ln ( tan l π | Γ | + sec l π | Γ | ) ] , ∀ p ⩽ − 2 . $$\\begin{aligned}& \\biggl(\\frac{1}{|\\varGamma |} \\oint_{\\varGamma }\\bar{r}_{P}^{p} \\biggr)^{1/p}\\leqslant\\frac{|\\varG...

  3. Induced radioactivity in a 4 MW target and its surroundings

    CERN Document Server

    Agosteo, Stefano; Otto, Thomas; Silari, Marco

    2003-01-01

    An important aspect of a future CERN Neutrino Factory is the material activation arising from a 2.2 GeV, 4 MW proton beam striking a mercury target. An estimation of the hadronic inelastic interactions and the production of residual nuclei in the target, the magnetic horn, the decay tunnel, the surrounding rock and a downstream dump was performed by the Monte Carlo hadronic cascade code FLUKA. The aim was both to assess the dose equivalent rate to be expected during maintenance work and to evaluate the amount of residual radioactivity, which will have to be disposed of after the facility has ceased operation.

  4. Mutual seismic interaction between tunnels and the surrounding granular soil

    Directory of Open Access Journals (Sweden)

    Mohamed Ahmed Abdel-Motaal

    2014-12-01

    Study results show that the maximum exerted straining actions in tunnel lining are directly proportional to the relative stiffness between tunnel and surrounding soil (lining thickness and soil shear modulus. Moreover, it is highly affected by the peak ground acceleration and the tunnel location (embedment depth. A comprehensive study is performed to show the effect of tunnel thickness and tunnel diameter on both the induced bending moment and lining deformation. In general, it is concluded that seismic analysis should be considered in regions subjected to peak ground acceleration greater than 0.15g.

  5. Earthquakes in Switzerland and surrounding regions during 2007

    International Nuclear Information System (INIS)

    Baer, M.; Deichmann, N.; Clinton, J.; Husen, S.; Faeh, D.; Giardini, D.; Kaestli, P.; Kradolfer, U.; Wiemer, S.

    2008-01-01

    This report of the Swiss Seismological Service summarizes the seismic activity in Switzerland and surrounding regions during 2007. During this period, 531 earthquakes and 92 quarry blasts were detected and located in the region under consideration. Of these earthquakes, 30 are aftershocks of the stimulation of a proposed geothermal reservoir beneath the city of Basel in December of 2006. With 20 events with Μ ι ≥ 2.5, four of which were artificially induced, the seismic activity in the year 2007 was far below the average over the previous 32 years. (author)

  6. Diversity of vascular plants of Piestany and surroundings

    International Nuclear Information System (INIS)

    Penzesova, A.; Galusova, T.

    2013-01-01

    In the present work is a summary of the results of floristic research aimed at determining diversity of vascular plants of Piestany and its surroundings. Plant taxa we determined using the designation keys. We have compiled a list of plant species occurring in the monitored area, we evaluated the selected botanical-phytogeographical characteristics of flora, we've put together a list of local protected, endangered and rare species and a list of local invasive and expansive species according to sources. (Authors)

  7. One Japanese case on taxation surrounding foreign trust

    OpenAIRE

    SUZUKI, Yuya

    2015-01-01

    Taxation surrounding trust at cross-border situation is paid attention to byworldwide basis. Japan is not exception. According to recent Japanesejurisprudence, where a trust had been established in accordance with State law ofNew Jersey, the U.S., it was disputed whether or not the act settling that trust fellwithin “shintaku koui (an act of trust)” and one of the related members, who had beena minor child at that time, fell within “jyueki sha (beneficiary)” under JapaneseInheritance Tax Act....

  8. Female feticide in India.

    Science.gov (United States)

    Ahmad, Nehaluddin

    2010-01-01

    Women are murdered all over the world. But in India a most brutal form of killing females takes place regularly, even before they have the opportunity to be born. Female feticide--the selective abortion of female fetuses--is killing upwards of one million females in India annually with far-ranging and tragic consequences. In some areas, the sex ratio of females to males has dropped to less than 8000:1000. Females not only face inequality in this culture, they are even denied the right to be born. Why do so many families selectively abort baby daughters? In a word: economics. Aborting female fetuses is both practical and socially acceptable in India. Female feticide is driven by many factors, but primarily by the prospect of having to pay a dowry to the future bridegroom of a daughter. While sons offer security to their families in old age and can perform the rites for the souls of deceased parents and ancestors, daughters are perceived as a social and economic burden. Prenatal sex detection technologies have been misused, allowing the selective abortions of female offspring to proliferate. Legally, however, female feticide is a penal offence. Although female infanticide has long been committed in India, feticide is a relatively new practice, emerging concurrently with the advent of technological advancements in prenatal sex determination on a large scale in the 1990s. While abortion is legal in India, it is a crime to abort a pregnancy solely because the fetus is female. Strict laws and penalties are in place for violators. These laws, however, have not stemmed the tide of this abhorrent practice. This article will discuss the socio-legal conundrum female feticide presents, as well as the consequences of having too few women in Indian society.

  9. Sexuality, Schooling, and Adolescent Females: The Missing Discourse of Desire.

    Science.gov (United States)

    Fine, Michelle

    1988-01-01

    The author combines a literature review with results from her school-based research to argue that the anti-sex rhetoric surrounding sex education and school-based clinics inhibits the development of sexual responsibility and subjectivity in female adolescents. Current practices lead to increased victimization, teenage pregnancy, and dropout rates.…

  10. Cortical Surround Interactions and Perceptual Salience via Natural Scene Statistics.

    Directory of Open Access Journals (Sweden)

    Ruben Coen-Cagli

    Full Text Available Spatial context in images induces perceptual phenomena associated with salience and modulates the responses of neurons in primary visual cortex (V1. However, the computational and ecological principles underlying contextual effects are incompletely understood. We introduce a model of natural images that includes grouping and segmentation of neighboring features based on their joint statistics, and we interpret the firing rates of V1 neurons as performing optimal recognition in this model. We show that this leads to a substantial generalization of divisive normalization, a computation that is ubiquitous in many neural areas and systems. A main novelty in our model is that the influence of the context on a target stimulus is determined by their degree of statistical dependence. We optimized the parameters of the model on natural image patches, and then simulated neural and perceptual responses on stimuli used in classical experiments. The model reproduces some rich and complex response patterns observed in V1, such as the contrast dependence, orientation tuning and spatial asymmetry of surround suppression, while also allowing for surround facilitation under conditions of weak stimulation. It also mimics the perceptual salience produced by simple displays, and leads to readily testable predictions. Our results provide a principled account of orientation-based contextual modulation in early vision and its sensitivity to the homogeneity and spatial arrangement of inputs, and lends statistical support to the theory that V1 computes visual salience.

  11. Effectively Communicating the Uncertainties Surrounding Ebola Virus Transmission.

    Directory of Open Access Journals (Sweden)

    Andy Kilianski

    2015-10-01

    Full Text Available The current Ebola virus outbreak has highlighted the uncertainties surrounding many aspects of Ebola virus virology, including routes of transmission. The scientific community played a leading role during the outbreak-potentially, the largest of its kind-as many of the questions surrounding ebolaviruses have only been interrogated in the laboratory. Scientists provided an invaluable resource for clinicians, public health officials, policy makers, and the lay public in understanding the progress of Ebola virus disease and the continuing outbreak. Not all of the scientific communication, however, was accurate or effective. There were multiple instances of published articles during the height of the outbreak containing potentially misleading scientific language that spurred media overreaction and potentially jeopardized preparedness and policy decisions at critical points. Here, we use articles declaring the potential for airborne transmission of Ebola virus as a case study in the inaccurate reporting of basic science, and we provide recommendations for improving the communication about unknown aspects of disease during public health crises.

  12. Effectively Communicating the Uncertainties Surrounding Ebola Virus Transmission.

    Science.gov (United States)

    Kilianski, Andy; Evans, Nicholas G

    2015-10-01

    The current Ebola virus outbreak has highlighted the uncertainties surrounding many aspects of Ebola virus virology, including routes of transmission. The scientific community played a leading role during the outbreak-potentially, the largest of its kind-as many of the questions surrounding ebolaviruses have only been interrogated in the laboratory. Scientists provided an invaluable resource for clinicians, public health officials, policy makers, and the lay public in understanding the progress of Ebola virus disease and the continuing outbreak. Not all of the scientific communication, however, was accurate or effective. There were multiple instances of published articles during the height of the outbreak containing potentially misleading scientific language that spurred media overreaction and potentially jeopardized preparedness and policy decisions at critical points. Here, we use articles declaring the potential for airborne transmission of Ebola virus as a case study in the inaccurate reporting of basic science, and we provide recommendations for improving the communication about unknown aspects of disease during public health crises.

  13. REMOTE SENSING EFFICIENCY FOR URBAN ANALYSIS OF MECCA AND SURROUNDS

    Directory of Open Access Journals (Sweden)

    A. Imam

    2016-06-01

    Full Text Available Situated in the southwest of Saudi Arabia, Mecca is considered the spiritual capital of one and a half billion worldwide Muslims. The city is visited by millions of pilgrims every year. It has undergone significant changes in land cover (LC since the government first embarked on a series of ambitious development projects 20 years ago to accommodate the growing number of pilgrims and citizens. The main objective of our study is to detect, identify, analyze and measure the evolving land cover and urban morphology composition from multi-temporal satellite images. To characterize the morphological change during a period of twenty years, four satellite images, acquired in 1998 by Landsat TM and in 2003, 2008 and 2013 by Landsat ETM+, were classified into five main categories: Urban, Street, Soil and Vegetation. In addition, DEM has been extracted and included as Mountain. Change detection (CD analysis is applied using post-classification comparison and GIS. As part of the study, morphological index, such as, Entropy is included for better understanding of urban structures behaviour. Mecca and its surroundings show a noticeable increase in urban and vegetation cover. Urban cover (UC changes were divided into five radial directions: Northeast, Southeast, Southwest, East, and Northwest. These changes are influenced by mountain ranges surrounding the city and the highways. These revelations can play a significant role towards future planning and development activities, which may further promote urban growth.

  14. Remote Sensing Efficiency for Urban Analysis of Mecca and Surrounds

    Science.gov (United States)

    Imam, Ayman; Alhaddad, Bahaa; Roca, Josep

    2016-06-01

    Situated in the southwest of Saudi Arabia, Mecca is considered the spiritual capital of one and a half billion worldwide Muslims. The city is visited by millions of pilgrims every year. It has undergone significant changes in land cover (LC) since the government first embarked on a series of ambitious development projects 20 years ago to accommodate the growing number of pilgrims and citizens. The main objective of our study is to detect, identify, analyze and measure the evolving land cover and urban morphology composition from multi-temporal satellite images. To characterize the morphological change during a period of twenty years, four satellite images, acquired in 1998 by Landsat TM and in 2003, 2008 and 2013 by Landsat ETM+, were classified into five main categories: Urban, Street, Soil and Vegetation. In addition, DEM has been extracted and included as Mountain. Change detection (CD) analysis is applied using post-classification comparison and GIS. As part of the study, morphological index, such as, Entropy is included for better understanding of urban structures behaviour. Mecca and its surroundings show a noticeable increase in urban and vegetation cover. Urban cover (UC) changes were divided into five radial directions: Northeast, Southeast, Southwest, East, and Northwest. These changes are influenced by mountain ranges surrounding the city and the highways. These revelations can play a significant role towards future planning and development activities, which may further promote urban growth.

  15. TRIGGERED STAR FORMATION SURROUNDING WOLF-RAYET STAR HD 211853

    Energy Technology Data Exchange (ETDEWEB)

    Liu Tie; Wu Yuefang; Zhang Huawei [Department of Astronomy, Peking University, 100871 Beijing (China); Qin Shengli, E-mail: liutiepku@gmail.com [I. Physikalisches Institut, Universitaet zu Koeln, Zuelpicher Str. 77, 50937 Koeln (Germany)

    2012-05-20

    The environment surrounding Wolf-Rayet (W-R) star HD 211853 is studied in molecular, infrared, as well as radio, and H I emission. The molecular ring consists of well-separated cores, which have a volume density of 10{sup 3} cm{sup -3} and kinematic temperature {approx}20 K. Most of the cores are under gravitational collapse due to external pressure from the surrounding ionized gas. From the spectral energy distribution modeling toward the young stellar objects, the sequential star formation is revealed on a large scale in space spreading from the W-R star to the molecular ring. A small-scale sequential star formation is revealed toward core 'A', which harbors a very young star cluster. Triggered star formations are thus suggested. The presence of the photodissociation region, the fragmentation of the molecular ring, the collapse of the cores, and the large-scale sequential star formation indicate that the 'collect and collapse' process functions in this region. The star-forming activities in core 'A' seem to be affected by the 'radiation-driven implosion' process.

  16. TRIGGERED STAR FORMATION SURROUNDING WOLF-RAYET STAR HD 211853

    International Nuclear Information System (INIS)

    Liu Tie; Wu Yuefang; Zhang Huawei; Qin Shengli

    2012-01-01

    The environment surrounding Wolf-Rayet (W-R) star HD 211853 is studied in molecular, infrared, as well as radio, and H I emission. The molecular ring consists of well-separated cores, which have a volume density of 10 3 cm –3 and kinematic temperature ∼20 K. Most of the cores are under gravitational collapse due to external pressure from the surrounding ionized gas. From the spectral energy distribution modeling toward the young stellar objects, the sequential star formation is revealed on a large scale in space spreading from the W-R star to the molecular ring. A small-scale sequential star formation is revealed toward core 'A', which harbors a very young star cluster. Triggered star formations are thus suggested. The presence of the photodissociation region, the fragmentation of the molecular ring, the collapse of the cores, and the large-scale sequential star formation indicate that the 'collect and collapse' process functions in this region. The star-forming activities in core 'A' seem to be affected by the 'radiation-driven implosion' process.

  17. Cytoplasmic movement profiles of mouse surrounding nucleolus and not-surrounding nucleolus antral oocytes during meiotic resumption.

    Science.gov (United States)

    Bui, Thi Thu Hien; Belli, Martina; Fassina, Lorenzo; Vigone, Giulia; Merico, Valeria; Garagna, Silvia; Zuccotti, Maurizio

    2017-05-01

    Full-grown mouse antral oocytes are classified as surrounding nucleolus (SN) or not-surrounding nucleolus (NSN), depending on the respective presence or absence of a ring of Hoechst-positive chromatin surrounding the nucleolus. In culture, both types of oocytes resume meiosis and reach the metaphase II (MII) stage, but following insemination, NSN oocytes arrest at the two-cell stage whereas SN oocytes may develop to term. By coupling time-lapse bright-field microscopy with image analysis based on particle image velocimetry, we provide the first systematic measure of the changes to the cytoplasmic movement velocity (CMV) occurring during the germinal vesicle-to-MII (GV-to-MII) transition of these two types of oocytes. Compared to SN oocytes, NSN oocytes display a delayed GV-to-MII transition, which can be mostly explained by retarded germinal vesicle break down and first polar body extrusion. SN and NSN oocytes also exhibit significantly different CMV profiles at four main time-lapse intervals, although this difference was not predictive of SN or NSN oocyte origin because of the high variability in CMV. When CMV profile was analyzed through a trained artificial neural network, however, each single SN or NSN oocyte was blindly identified with a probability of 92.2% and 88.7%, respectively. Thus, the CMV profile recorded during meiotic resumption may be exploited as a cytological signature for the non-invasive assessment of the oocyte developmental potential, and could be informative for the analysis of the GV-to-MII transition of oocytes of other species. © 2017 Wiley Periodicals, Inc.

  18. MAPPING THE SURROUNDINGS AS A REQUIREMENT FOR AUTONOMOUS DRIVING

    Directory of Open Access Journals (Sweden)

    M. Steininger

    2016-11-01

    Full Text Available Motivated by the hype around driverless cars and the challenges of the sensor integration and data processing, this paper presents a model for using a XBox One Microsoft Kinect stereo camera as sensor for mapping the surroundings. Today, the recognition of the environment of the car is mostly done by a mix of sensors like LiDAR, RADAR and cameras. In the case of the outdoor delivery challenge Robotour 2016 with model cars in scale 1:5, it is our goal to solve the task with one camera only. To this end, a three-stage approach was developed. The test results show that our approach can detect and locate objects at a range of up to eight meters in order to incorporate them as barriers in the navigation process.

  19. Natural occurring radioactivity in Palmyra and its surrounding

    International Nuclear Information System (INIS)

    Al-Masri, M. S.; Shwekani, R.; Raja, G.; Hushari, M.; Al-Hent, R.; Issa, M.

    2006-06-01

    In this work, the natural radiation background has been carried out for Palmyra city and its surroundings area. The study has covered gamma radiation measurements, indoor radon gas concentration and radionuclides levels in environmental samples (soil, water, plat). The results showed that indoor radon gas concentrations and radiation exposure rates are within the background levels. Also, the results showed that there is no artificial radiation in the area and there is no correlation between the natural radiation levels and the reported cancer cases. Therefore, the reported cancer cases in this area may be due to non-radiation cases, which must be investigated, or they are within the natural levels in Syria unless accurate statistics proves the opposite. (author)

  20. Physical geography of the Nete basin and surroundings

    International Nuclear Information System (INIS)

    Beerten, K.

    2011-01-01

    The report briefly describes the main features of the physical geography of the Nete basin (Campine region, Belgium) and its immediate surroundings. First, an integrated overview of the topography, morphology and hydrography is given. This overview serves as the basis for the assessment of the morphological stability of the region and also explains the relationship between the topography and the hydrology. Furthermore, special attention is paid to soil science including a quantitative survey of some soil characteristics data. Another part of this report deals with erosion processes caused by water and wind action, and the (potential) impact on the morphology. Finally, the palaeogeographical evolution during the Quaternary is discussed. This evolution shows that the environment is stable over 10 000 years or more in the current and similar climatic conditions. Altering climatic conditions, notably glacial-interglacial periods, have impacted erosion with periods of strong erosion.

  1. Precision Security: Integrating Video Surveillance with Surrounding Environment Changes

    Directory of Open Access Journals (Sweden)

    Wenfeng Wang

    2018-01-01

    Full Text Available Video surveillance plays a vital role in maintaining the social security although, until now, large uncertainty still exists in danger understanding and recognition, which can be partly attributed to intractable environment changes in the backgrounds. This article presents a brain-inspired computing of attention value of surrounding environment changes (EC with a processes-based cognition model by introducing a ratio value λ of EC-implications within considered periods. Theoretical models for computation of warning level of EC-implications to the universal video recognition efficiency (quantified as time cost of implication-ratio variations from λk to λk+1, k=1,2,… are further established. Imbedding proposed models into the online algorithms is suggested as a future research priority towards precision security for critical applications and, furthermore, schemes for a practical implementation of such integration are also preliminarily discussed.

  2. A Study of the Flow Field Surrounding Interacting Line Fires

    Directory of Open Access Journals (Sweden)

    Trevor Maynard

    2016-01-01

    Full Text Available The interaction of converging fires often leads to significant changes in fire behavior, including increased flame length, angle, and intensity. In this paper, the fluid mechanics of two adjacent line fires are studied both theoretically and experimentally. A simple potential flow model is used to explain the tilting of interacting flames towards each other, which results from a momentum imbalance triggered by fire geometry. The model was validated by measuring the velocity field surrounding stationary alcohol pool fires. The flow field was seeded with high-contrast colored smoke, and the motion of smoke structures was analyzed using a cross-correlation optical flow technique. The measured velocities and flame angles are found to compare reasonably with the predicted values, and an analogy between merging fires and wind-blown flames is proposed.

  3. Teacher Leadership: Everyday Practices Surrounding Work- Related Stress

    Directory of Open Access Journals (Sweden)

    Chiweshe Nigel

    2015-06-01

    Full Text Available This interpretivist study contributes to our scholarly understanding of how everyday practices surrounding work-related stress in education affect teacher leadership and successful learning outcomes. Insights are drawn from our long-standing engagement in the field where we observed how teaching staff, students, and management interacted. These observations were supplemented by in-depth interviews with 20 teaching staff. Our findings reveal competing demands and practices across the individual intrapersonal environment and the work related environment. There were three key themes that emerged in answer to the core research question: 1 the role of relational practices in managing teacher burnout, 2 the role of surveillance practices in education and 3 the role of assimilating practices in education. Drawing insights from these practices, we develop a conceptual framework that will help us to see relations at work anew, and develop a deeper understanding of ‘sickies’, motivation, learning outcomes and teacher leadership opportunities in education

  4. Biogeography of azooxanthellate corals in the Caribbean and surrounding areas

    Science.gov (United States)

    Dawson, J.

    2002-04-01

    Biogeographic patterns for azooxanthellate corals are not as well known as those of zooxanthellate (primarily reef-building) corals. I analyzed occurrences of 129 species of azooxanthellate corals in 19 geopolitical regions in the Caribbean and surrounding areas. I performed an unweighted pair-group method with arithmetic averages (UPGMA) cluster analysis using Bray-Curtis' similarity measure on the complete data set and shallow- and deep-water subsets of the data. The results indicate two provinces, each with a widespread (tropical and subtropical distributions) component to its fauna. One province has a tropical and primarily insular component to it, while the other has a subtropical and primarily continental component. By contrast, zooxanthellate corals have a uniform faunal composition throughout the Caribbean. Moreover, zooxanthellate corals have half as many species in the Caribbean as the azooxanthellate corals even though their global diversities are equal. These differences in diversity and geographic distribution patterns should be considered when developing conservation strategies.

  5. The surrounding tissue modifies the placental stem villous vascular responses

    DEFF Research Database (Denmark)

    Brøgger, Torbjørn; Forman, Axel; Aalkjær, Christian

    2014-01-01

    is available. In-depth understanding of the mechanisms involved in control of placental vascular tone are needed to develop new tissue targets for therapeutic intervention. Method: From fresh born placentas segments of stem villous arteries were carefully dissected. The artery branches were divided....... The surrounding trophoblast was removed from one end and left intact in the other, and the segment was divided to give two ring preparations, with or without trophoblast. The preparations were mounted in wire myographs and responses to vasoactive agents were compared. Results: pD2values for PGF2α, Tx-analog U...... or endotheline-1. These differences partly disappeared in the presence of L-NAME. Conclusion: The perivascular tissue significantly reduces sensitivity and force development of stem villous arteries, partly due to release of NO This represents a new mechanism for control of human stem villous artery tone....

  6. Female terrorism : a review

    NARCIS (Netherlands)

    Jacques, Karen; Taylor, Paul J.

    2009-01-01

    The sharp growth in the number of publications examining female involvement in terrorism has produced a valuable but un-integrated body of knowledge spread across many disciplines. In this paper, we bring together 54 publications on female terrorism and use qualitative and quantitative analyses to

  7. Female Labor Supply

    NARCIS (Netherlands)

    Maassen-van den Brink, te Henriet

    1994-01-01

    To gain insight on factors that impede economic independence of women, this book concentrates on female labor supply in relation to child care, male-female wage differentials, the division of unpaid labor, and marital conflicts between women and men. It may very well be that restrictions on the

  8. Influence of surrounding environment on subcritical crack growth in marble

    Science.gov (United States)

    Nara, Yoshitaka; Kashiwaya, Koki; Nishida, Yuki; , Toshinori, Ii

    2017-06-01

    Understanding subcritical crack growth in rock is essential for determining appropriate measures to ensure the long-term integrity of rock masses surrounding structures and for construction from rock material. In this study, subcritical crack growth in marble was investigated experimentally, focusing on the influence of the surrounding environment on the relationship between the crack velocity and stress intensity factor. The crack velocity increased with increasing temperature and/or relative humidity. In all cases, the crack velocity increased with increasing stress intensity factor. However, for Carrara marble (CM) in air, we observed a region in which the crack velocity still increased with temperature, but the increase in the crack velocity with increasing stress intensity factor was not significant. This is similar to Region II of subcritical crack growth observed in glass in air. Region II in glass is controlled by mass transport to the crack tip. In the case of rock, the transport of water to the crack tip is important. In general, Region II is not observed for subcritical crack growth in rock materials, because rocks contain water. Because the porosity of CM is very low, the amount of water contained in the marble is also very small. Therefore, our results imply that we observed Region II in CM. Because the crack velocity increased in both water and air with increasing temperature and humidity, we concluded that dry conditions at low temperature are desirable for the long-term integrity of a carbonate rock mass. Additionally, mass transport to the crack tip is an important process for subcritical crack growth in rock with low porosity.

  9. Quasars Probing Quasars: the Circumgalactic Medium Surrounding z ~ 2 Quasars

    Science.gov (United States)

    Lau, Marie; Quasars Probing Quasars survey

    2018-01-01

    Understanding the circumgalactic medium--the gaseous halo surrounding a galaxy, is an integral part to understanding galaxy evolution. The z ~ 2-3 universe is interesting as this is when the star formation rate and AGN activity peak. My thesis concludes the decade-long Quasars Probing Quasars survey designed for studying massive galaxy formation and quasar feedback. I use background quasar sightlines that pass close to foreground quasars to study the circumgalactic medium of quasar-host galaxies in absorption. My sample of 149 quasar pairs involve spectra taken with 17 different optical and near IR instruments. I present results on the statistical and physical properties of the circumgalactic medium. The circumgalactic medium is enriched even beyond the virial radius. The alpha/Fe abundance ratio is enhanced, suggesting enrichment from core-collapse supernovae. The cool gas mass within the virial radius is enough to fuel star formation for another Gyr, and may account for 1/3 of the baryonic budget of the galaxy halo. The ionization state increases with projected distance from the quasar, which implies the quasar does not dominate the ionizing radiation flux. However, detection of fluorescent Lyman-alpha emission and NV absorption imply these transverse absorbers are partially illuminated by the quasar. In one peculiar case, the absorbing clump has density >100 cm^-3 and sub-parsec size. The average absorption in the circumgalactic medium exhibits large velocity widths, and is asymmetric about the systemic redshift of the galaxies. The widths are consistent with gravitational motions and Hubble flow, and outflows are not required to explain them. The asymmetry can be explained if the ionizing radiation from the quasar is anisotropic or intermittent and the gas is not in inflow. My results pose challenges for cosmological hydrodynamic simulations to produce a substantial cool gas reservoir surrounding quasars, that is also enriched and shows extreme kinematics.

  10. How A Black Hole Lights Up Its Surroundings

    Science.gov (United States)

    Kohler, Susanna

    2017-10-01

    How do the supermassive black holes that live at the centers of galaxies influence their environments? New observations of a distant active galaxy offer clues about this interaction.Signs of CoevolutionPlot demonstrating the m-sigma relation, the empirical correlation between the stellar velocity dispersion of a galactic bulge and the mass of the supermassive black hole at its center. [Msigma]We know that the centers of active galaxies host supermassive black holes with masses of millions to billions of suns. One mystery surrounding these beasts is that they are observed to evolve simultaneously with their host galaxies for instance, an empirical relationship is seen between the growth of a black hole and the growth of its host galaxys bulge. This suggests that there must be a feedback mechanism through which the evolution of a black hole is linked to that of its host galaxy.One proposed source of this coupling is the powerful jets emitted from the poles of these supermassive black holes. These jets are thought to be produced as some of the material accreting onto the black hole is flung out, confined by surrounding gas and magnetic fields. Because the jets of hot gas and radiation extend outward through the host galaxy, they provide a means for the black hole to influence the gas and dust of its surroundings.In our current model of a radio-loud active galactic nuclei,a region of hot, ionized gas the narrow-line region lies beyond the sphere of influence of the supermassive black hole. [C.M. Urry and P. Padovani]Clues in the Narrow-Line RegionThe region of gas thought to sit just outside of the black holes sphere of influence (at a distance of perhaps a thousand to a few thousand light-years) is known as the narrow line region so named because we observe narrow emission lines from this gas. Given its hot, ionized state, this gas must somehow be being pummeled with energy. In the canonical picture, radiation from the black hole heats the gas directly in a process

  11. Sequential Cross-Sectional Surveys in Orange Farm, a Township of South Africa, Revealed a Constant Low Voluntary Medical Male Circumcision Uptake among Adults despite Demand Creation Campaigns and High Acceptability.

    Directory of Open Access Journals (Sweden)

    Esaie Marshall

    Full Text Available WHO recommends a male circumcision (MC prevalence rate higher than 80% to have a substantial impact on the HIV-AIDS epidemic in Eastern and Southern Africa. Orange Farm, a township in South Africa, has a free-for-service voluntary medical male circumcision (VMMC clinic in operation since 2008. Following an intense campaign from 2008 to 2010, MC prevalence rate increased to 55.4% (ANRS-12126. Ongoing and past VMMC campaigns focused on youths, through school talks, and adults at a community level. The main objective of the study was to assess the change in MC prevalence rate among adults aged 18-19 and 18-49 years in the past 5 years.A cross-sectional survey (ANRS-12285 was conducted among a random sample of 522 adult men in 2015. MC status and characteristics of participants were collected through a genital examination and a face-to-face questionnaire.MC prevalence rate among young adult men aged 18-19 years increased markedly from 61.2% (95%CI: 57.4% to 65.0% in 2010 to 87.5% (76.0% to 94.6% in 2015 (p<0.001. In the same period, among men aged 18-49 years, MC prevalence rate varied slightly from 55.4% (53.6% to 57.1% to 56.7% (52.4% to 60.9%. In 2015, 84.9% (79.2% to 89.5% of uncircumcised adult men reported that they were willing to be circumcised. However, we estimated that only 4.6% (11/237; 2.5% to 7.9% of the uncircumcised men underwent circumcision in 2015, despite 117/185 (63.2%; 95%CI: 56.1% to 69.9% who reported that they were definitely willing to become circumcised.In Orange Farm, VMMC campaigns were successful among the youth and led to a sufficiently high MC prevalence rate to have a substantial impact in the future on the HIV-AIDS epidemic. However, despite high acceptability and a free VMMC service, VMMC campaigns since 2010 have failed to increase MC prevalence rate among adults to above 80%. These campaigns should be revisited.

  12. Evaluating the cost of adult voluntary medical male circumcision in a mixed (surgical and PrePex site compared to a hypothetical PrePex-only site in South Africa

    Directory of Open Access Journals (Sweden)

    Hae-Young Kim

    2015-12-01

    Full Text Available Background: Several circumcision devices have been evaluated for a safe and simplified male circumcision among adults. The PrePex device was prequalified for voluntary male medical circumcision (VMMC in May 2013 by the World Health Organization and is expected to simplify the procedure safely while reducing cost. South Africa is scaling up VMMC. Objective: To evaluate the overall unit cost of VMMC at a mixed site vs. a hypothetical PrePex-only site in South Africa. Design: We evaluated the overall unit cost of VMMC at a mixed site where PrePex VMMC procedure was added to routine forceps-guided scalpel-based VMMC in Soweto, South Africa. We abstracted costs and then modeled these costs for a hypothetical PrePex-only site, at which 9,600 PrePex circumcisions per year could be done. We examined cost drivers and modeled costs, varying the price of the PrePex device. The healthcare system perspective was used. Results: In both sites, the main contributors of cost were personnel and consumables. If 10% of all VMMC were by PrePex at the mixed site, the overall costs of the surgical method and PrePex were similar – US$59.62 and $59.53, respectively. At the hypothetical PrePex-only site, the unit cost was US$51.10 with PrePex circumcisions having markedly lower personnel and biohazardous waste management costs. In sensitivity analysis with the cost of PrePex kit reduced to US$10 and $2, the cost of VMMC was further reduced. Conclusions: Adding PrePex to an existing site did not necessarily reduce the overall costs of VMMC. However, starting a new PrePex-only site is feasible and may significantly reduce the overall cost by lowering both personnel and capital costs, thus being cost-effective in the long term. Achieving a lower cost for PrePex will be an important contributor to the scale-up of VMMC.

  13. Acceptability of female-controlled HIV/STI prevention options by ...

    African Journals Online (AJOL)

    The attitudes of working professionals, particularly in the healthcare sector, may play a large role in the acceptance or otherwise of female-controlled HIV/STI prevention options. In 2002, we conducted an exploratory study on the perceptions surrounding female-controlled HIV/STI prevention options, principally the ...

  14. Female sex trafficking: conceptual issues, current debates, and future directions.

    Science.gov (United States)

    Meshkovska, Biljana; Siegel, Melissa; Stutterheim, Sarah E; Bos, Arjan E R

    2015-01-01

    Female sex trafficking is a pressing concern. In this article, we provide a comprehensive overview of relevant issues regarding the concept of female sex trafficking and research in the field of human trafficking, drawing on a variety of disciplines, including economics, gender and sexuality studies, psychology, sociology, law, and social work. We discuss the debates surrounding the definition of human trafficking, compare and contrast it with human smuggling, and outline connections between female sex trafficking and the issue of sex work and prostitution. We further discuss the history and current estimations of female sex trafficking. We then outline the main actors in female sex trafficking, including trafficked persons, traffickers, clients, and service providers, and we overview the trafficking process from recruitment to identification, recovery, and (re)integration. Finally, we conclude with recommendations for future research that tie together the concepts of vulnerability, exploitation, and long-term recovery and (re)integration.

  15. Re-establishing safer medical-circumcision-integrated initiation ceremonies for HIV prevention in a rural setting in Papua New Guinea. A multi-method acceptability study.

    Directory of Open Access Journals (Sweden)

    Clement Morris Manineng

    Full Text Available Efforts to stem the spread of Human Immunodeficiency Virus (HIV in Papua New Guinea (PNG are hampered by multiple interrelated factors including limited health services, extreme diversities in culture and language and highly prevalent gender inequity, domestic violence and poverty. In the rural district of Yangoru-Saussia, a revival of previously ceased male initiation ceremonies (MICs is being considered for a comprehensive approach to HIV prevention. In this study, we explore the local acceptability of this undertaking including replacing traditional penile cutting practices with medical male circumcision (MMC.A multi-method study comprising three phases. Phase one, focus group discussions with male elders to explore locally appropriate approaches to HIV prevention; Phase two, interviews and a cross-sectional survey with community men and women to assess views on MICs that include MMC for HIV prevention; Phase three, interviews with cultural leaders and a cross sectional survey to assess the acceptability of replacing traditional penile bleeding with MMC.Cultural leaders expressed that re-establishing MICs was locally appropriate for HIV prevention given the focus on character building and cultural preservation. Most surveyed participants (81.5% supported re-establishing MICs and 92.2% supported adapting MICs with MMC. Changes to penile bleeding emerged as a contentious and contested issue given its cultural significance in symbolizing initiates' transition from childhood to adulthood. Participants were concerned about potential clash with modern education, introduced religious beliefs and limited government support in leadership and funding.Most people in this study in Yangoru-Saussia support re-establishing MICs and replacing traditional penile bleeding with MMC. This culturally-sensitive alignment of MMC (and HIV prevention with revived MICs responds to a national health priority in PNG and acts as an example of providing culturally

  16. Tomography images of the Alpine roots and surrounding upper mantle

    Science.gov (United States)

    Plomerova, Jaroslava; Babuska, Vladislav

    2017-04-01

    Teleseismic body-wave tomography represents powerful tool to study regional velocity structure of the upper mantle and to image velocity anomalies, such as subducted lithosphere plates in collisional zones. In this contribution, we recapitulate 3D models of the upper mantle beneath the Alps, which developed at a collision zone of the Eurasian and African plates. Seismic tomography studies indicate a leading role of the rigid mantle lithosphere that functioned as a major stress guide during the plate collisions. Interactions of the European lithosphere with several micro-plates in the south resulted in an arcuate shape of this mountain range on the surface and in a complicated geometry of the Alpine subductions in the mantle. Early models with one bended lithosphere root have been replaced with more advanced models showing two separate lithosphere roots beneath the Western and Eastern Alps (Babuska et al., Tectonophysics 1990; Lippitsch et al., JGR 2003). The standard isotropic velocity tomography, based on pre-AlpArray data (the currently performed passive seismic experiment in the Alps and surroundings) images the south-eastward dipping curved slab of the Eurasian lithosphere in the Western Alps. On the contrary, beneath the Eastern Alps the results indicate a very steep northward dipping root that resulted from the collision of the European plate with the Adriatic microplate. Dando et al. (2011) interpret high-velocity heterogeneities at the bottom of their regional tomographic model as a graveyard of old subducted lithospheres. High density of stations, large amount of rays and dense ray-coverage of the volume studied are not the only essential pre-requisites for reliable tomography results. A compromise between the amount of pre-processed data and the high-quality of the tomography input (travel-time residuals) is of the high importance as well. For the first time, the existence of two separate roots beneath the Alps has been revealed from carefully pre

  17. Female genital cutting: an evidence-based approach to clinical management for the primary care physician.

    Science.gov (United States)

    Hearst, Adelaide A; Molnar, Alexandra M

    2013-06-01

    The United States has more than 1.5 million immigrants from countries in Africa and the Middle East where female genital cutting (FGC) is known to occur. Often, FGC occurs in infancy and childhood in the countries where it is practiced, but patients of any age can present with complications. Lack of understanding of this common problem can potentially alienate and lower quality of care for this patient population. We provide an introduction to the practice of FGC and practice guidelines for the primary care physician. We reviewed original research, population-based studies, and legal research from PubMed, Scopus, CINAHL plus, PsycINFO, and Legal Trac. The terms searched included female genital cutting, female genital circumcision, and female genital mutilation alone and with the term complications or health consequences; no limit on date published. Legal databases were searched using the above terms, as well as international law and immigration law. Editorials and review articles were excluded. This review discusses the different types of FGC, important cultural considerations for physicians caring for patients with FGC, the common early and late medical complications and their management, and psychosocial issues associated with FGC. Current laws pertaining to FGC are briefly reviewed, as well as implications for patients seeking asylum status in the United States because of FGC. Finally, the article presents evidence-based, culturally sensitive approaches to discussions of FGC with girls and women for whom this is an issue. Copyright © 2013 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

  18. Female urethral carcinoma

    International Nuclear Information System (INIS)

    Saitoh, Masahiko; Kondo, Atsuo; Sakakibara, Toshihumi

    1988-01-01

    Urethral carcinoma in 2 females has been treated with irradiation together with adjunct chemotherapy. In case 1, a 73-year-old female with squamous cell carcinoma was successfully treated with irradiation of 4,000 rad and peplomycin of 60 mg intravenously given. She has been free from the disease for the past 43 months. In case 2, a 61-year-old female with transitional cell carcinoma was initially treated with irradiation of 5,000 rad together with peplomycin 90 mg, which was followed by another 5,000 rad irradiation. The tumor recurred and the patient was operated on for cystourethrectomy and partial resection of the vagina. A further chemotherapy of cisplatin, peplomycin, and mitomycin C was instituted. She died of the tumor recurrence 23 months after the first visit to our clinic. Diagnosis and treatment modalities on the female urethral carcinoma are briefly discussed. (author)

  19. Female Reproductive System

    Science.gov (United States)

    ... of the Female Reproductive System Print en español Sistema reproductor femenino About Human Reproduction All living things ... of Use Notice of Nondiscrimination Visit the Nemours Web site. Note: All information on KidsHealth® is for ...

  20. Female pattern baldness

    Science.gov (United States)

    Alopecia in women; Baldness - female; Hair loss in women; Androgenetic alopecia in women; Hereditary balding or thinning in women ... in the skin called a follicle. In general, baldness occurs when the hair follicle shrinks over time, ...

  1. Female Athlete Triad

    Science.gov (United States)

    ... for some competitive female athletes, problems such as low self-esteem, a tendency toward perfectionism, and family stress place ... depression, pressure from coaches or family members, or low self-esteem and can help her find ways to deal ...

  2. A nebula of gases from Io surrounding Jupiter.

    Science.gov (United States)

    Krimigis, Stamatios M; Mitchell, Donald G; Hamilton, Douglas C; Dandouras, Jannis; Armstrong, Thomas P; Bolton, Scott J; Cheng, Andrew F; Gloeckler, George; Hsieh, K C; Keath, Edwin P; Krupp, Norbert; Lagg, Andreas; Lanzerotti, Louis J; Livi, Stefano; Mauk, Barry H; McEntire, Richard W; Roelof, Edmond C; Wilken, Berend; Williams, Donald J

    2002-02-28

    Several planetary missions have reported the presence of substantial numbers of energetic ions and electrons surrounding Jupiter; relativistic electrons are observable up to several astronomical units (au) from the planet. A population of energetic (>30[?]keV) neutral particles also has been reported, but the instrumentation was not able to determine the mass or charge state of the particles, which were subsequently labelled energetic neutral atoms. Although images showing the presence of the trace element sodium were obtained, the source and identity of the neutral atoms---and their overall significance relative to the loss of charged particles from Jupiter's magnetosphere---were unknown. Here we report the discovery by the Cassini spacecraft of a fast (>103[?]km[?]s-1) and hot magnetospheric neutral wind extending more than 0.5[?]au from Jupiter, and the presence of energetic neutral atoms (both hot and cold) that have been accelerated by the electric field in the solar wind. We suggest that these atoms originate in volcanic gases from Io, undergo significant evolution through various electromagnetic interactions, escape Jupiter's magnetosphere and then populate the environment around the planet. Thus a 'nebula' is created that extends outwards over hundreds of jovian radii.

  3. Earthquakes in Switzerland and surrounding regions during 2006

    Energy Technology Data Exchange (ETDEWEB)

    Baer, M.; Deichmann, N.; Braunmiller, J.; Clinton, J.; Husen, S.; Faeh, D.; Giardini, D.; Kaestli, P.; Kradolfer, U.; Wiemer, S

    2007-12-15

    This report of the Swiss Seismological Service summarizes the seismic activity in Switzerland and surrounding regions during 2006. During this period, 572 earthquakes and 91 quarry blasts were detected and located in the region under consideration. Of these earthquakes, two occurred in conjunction with the construction of the new Gotthard railway tunnel and 165 were induced artificially by the stimulation of a proposed geothermal reservoir beneath the city of Basel. With 20 events with {mu}{sub {iota}} {>=} 2.5, five of which were artificially induced, the seismic activity in the year 2006 was far below the average over the previous 31 years. Nevertheless, six events were felt by the public, most prominently the strongest of the induced Basel events ({mu}{sub {iota}} 3.4), which caused some non-structural building damage. Noteworthy are also the two earthquakes near Cortaillod ({mu}{sub {iota}} 3.2), on the shore of Lake Neuchatel, and in Val Mora ({mu}{sub {iota}} 3.5), between the Engadin and Val Muestair, as well as the 42 aftershocks of the {mu}{sub {iota}} 4.9 Vallorcine earthquake, between Martigny and Chamonix, of September 2005. (author)

  4. Mercury's interior, surface, and surrounding environment latest discoveries

    CERN Document Server

    Clark, Pamela Elizabeth

    2015-01-01

    This SpringerBrief details the MESSENGER Mission, the findings of which present challenges to widely held conventional views and remaining mysteries surrounding the planet. The work answers the question of why Mercury is so dense, and the implications from geochemical data on its planetary formation. It summarizes imaging and compositional data from the terrestrial planet surface processes and explains the geologic history of Mercury.  It also discusses the lack of southern hemisphere coverage. Our understanding of the planet Mercury has been in a transitional phase over the decades since Mariner 10. The influx of new data from the NASA MESSENGER Mission since it was inserted into the orbit of Mercury in March of 2011 has greatly accelerated that shift. The combined compositional data of relatively high volatiles (S, K), relatively low refractories (Al, Ca), and low crustal iron, combined with an active, partially molten iron rich core, has major implications for Mercury and Solar System formation. From a s...

  5. Groundwater quality in Taiz City and surrounding area, Yemen Republic

    International Nuclear Information System (INIS)

    Metwali, R.

    2002-01-01

    Fifty one water samples were collected from production wells used for human consumption from Taiz City and its surroundings, Yemen Republic. The water quality was investigated with respect to bacteriological and physico-chemical parameters. The achieved results revealed that most water samples, especially from private wells, contain a high number of total coliforms (TC) which exceed the permissible limit recommended by the World Health Organization, WHO (1996). Also faecal coliforms (FC) were recorded in the majority of polluted samples. A quantitative estimation was done for each of temperature (18-26C), pH (6.12-8.79), total hardness (58-2200 mg/L), electrical conductivity (218-4600 m.Mohs), total dissolved solids (117-3700mg/L), nitrate (10-187mg/L) and type of aquifer (rocky and alluvium). It is worthy to notice that from the total of fifty-one wells, there was pollution in (65%) of them. Recommendations were suggested for the treatment of the water of such polluted wells and rigid government control in a trial to prevent human and animal illness. (author)

  6. Motor training reduces surround inhibition in the motor cortex.

    Science.gov (United States)

    Akkad, Haya; Di Stasio, Flavio; Tibold, Robert; Kassavetis, Panagiotis; Rothwell, John C; Edwards, Mark J

    2016-06-01

    Surround inhibition (SI) is thought to facilitate focal contraction of a hand muscle by keeping nearby muscles silent. Unexpectedly, SI is reduced in skilled pianists. We tested whether repeated practice of focal contraction in non-pianists could reduce SI. Motor-evoked potentials were elicited by transcranial magnetic stimulation in the relaxed abductor digiti minimi randomly at the onset and 5s after offset of a 2s focal contraction (10% maximum) of the first dorsal interosseous (FDI). Over 5 blocks of 40 trials participants obtained points for increasing contraction speed and stability in FDI. In a final block, the interval between contractions was varied randomly to increase attention to the task. Over the first 5 blocks, SI declined as performance (points scored) improved. In the final "attention" block SI increased towards baseline without affecting performance. Although SI may be useful during the early stages of learning, skilled focal finger movement does not require SI to prevent activity in non-involved muscles. This could be due to better targeting of the excitatory command to move. Results from the final block suggest that increased attention can re-engage SI when task parameters change. SI is not necessary for successful focal contraction, but may contribute during learning and during attention to task. Copyright © 2016 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.

  7. Democratizing rendering for multiple viewers in surround VR systems

    KAUST Repository

    Schulze, Jürgen P.

    2012-03-01

    We present a new approach for how multiple users\\' views can be rendered in a surround virtual environment without using special multi-view hardware. It is based on the idea that different parts of the screen are often viewed by different users, so that they can be rendered from their own view point, or at least from a point closer to their view point than traditionally expected. The vast majority of 3D virtual reality systems are designed for one head-tracked user, and a number of passive viewers. Only the head tracked user gets to see the correct view of the scene, everybody else sees a distorted image. We reduce this problem by algorithmically democratizing the rendering view point among all tracked users. Researchers have proposed solutions for multiple tracked users, but most of them require major changes to the display hardware of the VR system, such as additional projectors or custom VR glasses. Our approach does not require additional hardware, except the ability to track each participating user. We propose three versions of our multi-viewer algorithm. Each of them balances image distortion and frame rate in different ways, making them more or less suitable for certain application scenarios. Our most sophisticated algorithm renders each pixel from its own, optimized camera perspective, which depends on all tracked users\\' head positions and orientations. © 2012 IEEE.

  8. Thermoelectric Performance Enhancement by Surrounding Crystalline Semiconductors with Metallic Nanoparticles

    Science.gov (United States)

    Kim, Hyun-Jung; King, Glen C.; Park, Yeonjoon; Lee, Kunik; Choi, Sang H.

    2011-01-01

    Direct conversion of thermal energy to electricity by thermoelectric (TE) devices may play a key role in future energy production and utilization. However, relatively poor performance of current TE materials has slowed development of new energy conversion applications. Recent reports have shown that the dimensionless Figure of Merit, ZT, for TE devices can be increased beyond the state-of-the-art level by nanoscale structuring of materials to reduce their thermal conductivity. New morphologically designed TE materials have been fabricated at the NASA Langley Research Center, and their characterization is underway. These newly designed materials are based on semiconductor crystal grains whose surfaces are surrounded by metallic nanoparticles. The nanoscale particles are used to tailor the thermal and electrical conduction properties for TE applications by altering the phonon and electron transport pathways. A sample of bismuth telluride decorated with metallic nanoparticles showed less thermal conductivity and twice the electrical conductivity at room temperature as compared to pure Bi2Te3. Apparently, electrons cross easily between semiconductor crystal grains via the intervening metallic nanoparticle bridges, but phonons are scattered at the interfacing gaps. Hence, if the interfacing gap is larger than the mean free path of the phonon, thermal energy transmission from one grain to others is reduced. Here we describe the design and analysis of these new materials that offer substantial improvements in thermoelectric performance.

  9. Sound Environments Surrounding Preterm Infants Within an Occupied Closed Incubator.

    Science.gov (United States)

    Shimizu, Aya; Matsuo, Hiroya

    2016-01-01

    Preterm infants often exhibit functional disorders due to the stressful environment in the neonatal intensive care unit (NICU). The sound pressure level (SPL) in the NICU is often much higher than the levels recommended by the American Academy of Pediatrics. Our study aims to describe the SPL and sound frequency levels surrounding preterm infants within closed incubators that utilize high frequency oscillation (HFO) or nasal directional positive airway pressure (nasal-DPAP) respiratory settings. This is a descriptive research study of eight preterm infants (corrected agenoise levels were observed and the results were compared to the recommendations made by neonatal experts. Increased noise levels, which have reported to affect neonates' ability to self-regulate, could increase the risk of developing attention deficit disorder, and may result in tachycardia, bradycardia, increased intracranial pressure, and hypoxia. The care provider should closely assess for adverse effects of higher sound levels generated by different modes of respiratory support and take measures to ensure that preterm infants are protected from exposure to noise exceeding the optimal safe levels. Copyright © 2016 Elsevier Inc. All rights reserved.

  10. Preliminary Analysis of Slope Stability in Kuok and Surrounding Areas

    Directory of Open Access Journals (Sweden)

    Dewandra Bagus Eka Putra

    2016-12-01

    Full Text Available The level of slope influenced by the condition of the rocks beneath the surface. On high level of slopes, amount of surface runoff and water transport energy is also enlarged. This caused by greater gravity, in line with the surface tilt from the horizontal plane. In other words, topsoil eroded more and more. When the slope becomes twice as steep, then the amount of erosion per unit area be 2.0 - 2.5 times more. Kuok and surrounding area is the road access between the West Sumatra and Riau which plays an important role economies of both provinces. The purpose of this study is to map the locations that have fairly steep slopes and potential mode of landslides. Based on SRTM data obtained,  the roads in Kuok area has a minimum elevation of + 33 m and a maximum  + 217.329 m. Rugged road conditions with slope ranging from 24.08 ° to 44.68 ° causing this area having frequent landslides. The result of slope stability analysis in a slope near the Water Power Plant Koto Panjang, indicated that mode of active failure is toppling failure or rock fall and the potential zone of failure is in the center part of the slope.

  11. Democratizing rendering for multiple viewers in surround VR systems

    KAUST Repository

    Schulze, Jü rgen P.; Acevedo-Feliz, Daniel; Mangan, John; Prudhomme, Andrew; Nguyen, Phi Khanh; Weber, Philip P.

    2012-01-01

    We present a new approach for how multiple users' views can be rendered in a surround virtual environment without using special multi-view hardware. It is based on the idea that different parts of the screen are often viewed by different users, so that they can be rendered from their own view point, or at least from a point closer to their view point than traditionally expected. The vast majority of 3D virtual reality systems are designed for one head-tracked user, and a number of passive viewers. Only the head tracked user gets to see the correct view of the scene, everybody else sees a distorted image. We reduce this problem by algorithmically democratizing the rendering view point among all tracked users. Researchers have proposed solutions for multiple tracked users, but most of them require major changes to the display hardware of the VR system, such as additional projectors or custom VR glasses. Our approach does not require additional hardware, except the ability to track each participating user. We propose three versions of our multi-viewer algorithm. Each of them balances image distortion and frame rate in different ways, making them more or less suitable for certain application scenarios. Our most sophisticated algorithm renders each pixel from its own, optimized camera perspective, which depends on all tracked users' head positions and orientations. © 2012 IEEE.

  12. Ultrastructural study of tissues surrounding replanted teeth and dental implants.

    Science.gov (United States)

    Shioya, Kazuhiro; Sawada, Takashi; Miake, Yasuo; Inoue, Sadayuki; Yanagisawa, Takaaki

    2009-03-01

    The aim of this study was to describe the ultrastructure of the dentogingival border at replanted teeth and implants. Wistar rats (8 weeks old) were divided into groups for replantation and implantation experiments. In the former, the upper right first molars were extracted and then immediately replanted. In the latter, pure titanium implants were used. All tissues were fixed, demineralized and embedded in epoxy resin for ultrastructural observations. One week after replantation, the junctional epithelium was lost, and the oral sulcular epithelium covered the enamel surface. The amount of the epithelium increased in 2 weeks, and resembled the junctional epithelium, and the internal basal lamina and hemidesmosomes were formed in 4 weeks. One week after implantation, peri-implant epithelium was formed, and in 2 and 4 weeks, this epithelium with aggregated connective tissue cells were observed. In 8 weeks, the peri-implant epithelium receded, and aligned special cells with surrounding elongated fibroblasts and bundles of collagen fibers appeared to seal the implant interface. In replantation of the tooth, the internal basal lamina remained at the surface of the enamel of the replanted tooth, which is likely to be related to regeneration of the junctional epithelium and the attachment apparatus at the epithelium-tooth interface. Following implantation, a layer of cells with characteristics of connective tissue cells, but no junctional epithelium and attachment apparatus, was formed to seal the site of the implant.

  13. Earthquakes in Switzerland and surrounding regions during 2006

    International Nuclear Information System (INIS)

    Baer, M.; Deichmann, N.; Braunmiller, J.; Clinton, J.; Husen, S.; Faeh, D.; Giardini, D.; Kaestli, P.; Kradolfer, U.; Wiemer, S.

    2007-01-01

    This report of the Swiss Seismological Service summarizes the seismic activity in Switzerland and surrounding regions during 2006. During this period, 572 earthquakes and 91 quarry blasts were detected and located in the region under consideration. Of these earthquakes, two occurred in conjunction with the construction of the new Gotthard railway tunnel and 165 were induced artificially by the stimulation of a proposed geothermal reservoir beneath the city of Basel. With 20 events with Μ ι ≥ 2.5, five of which were artificially induced, the seismic activity in the year 2006 was far below the average over the previous 31 years. Nevertheless, six events were felt by the public, most prominently the strongest of the induced Basel events (Μ ι 3.4), which caused some non-structural building damage. Noteworthy are also the two earthquakes near Cortaillod (Μ ι 3.2), on the shore of Lake Neuchatel, and in Val Mora (Μ ι 3.5), between the Engadin and Val Muestair, as well as the 42 aftershocks of the Μ ι 4.9 Vallorcine earthquake, between Martigny and Chamonix, of September 2005. (author)

  14. What can offer us reclaimed landscape surrounding future lake Medard

    Energy Technology Data Exchange (ETDEWEB)

    Hrajnohova-Gillarova, H.; Kazmierski, T.; Martis, M. [Czech Univ. of Life Sciences, Prague (Czech Republic); Pecharova, E. [Czech Univ. of Life Sciences, Prague (Czech Republic); South-Bohemian Univ., Ceske Budejovice (Czech Republic)

    2010-07-01

    Soon after closing down a mine, the landscape that had been systematically disturbed by mining, should start to serve people from neighbouring towns and villages. This study characterized the Medard site located in the western part of the Czech Republic. The future Lake Medard includes the area of the former Medard-Libik Mine. Medard was an opencast brown coal mine, where mining finished in 2000 and reclamation plans involve its flooding until the year 2013. Forestry reclamation was also in progress. This paper presented a survey that was designed to help determine what the reclaimed landscape surrounding the future Lake Medard could offer. The paper provided background information on Medard Lake and outlined the methodology and results of the study. The methodology involved use of recent orthophotomaps, a study of the future lake Medard and data from the field survey. The study examined the long-term impacts on the social and environmental situation in the area. It was concluded that, once the reclamations are finished, there should be natural trails with information and educational infrastructure so that visitors to the area can learn about the places of interest. 17 refs., 6 figs.

  15. Female Sex Tourism

    OpenAIRE

    Mc Intyre, Maria Kleivan

    2017-01-01

    ABSTRACT This project explores the phenomenon of North American and Western European women, who travel to the Global South and engage in sexual encounters with the local men. This project has positioned itself as a postcolonial critique, arguing that female sex tourism is a form of neocolonialism. It has also investigated the term romance tourism, where it has found that as a result of essentialist gender stereotyping, the female version of sex tourism has been titled ‘romance tourism’. The p...

  16. Female physicist doctoral experiences

    OpenAIRE

    Katherine P. Dabney; Robert H. Tai

    2013-01-01

    The underrepresentation of women in physics doctorate programs and in tenured academic positions indicates a need to evaluate what may influence their career choice and persistence. This qualitative paper examines eleven females in physics doctoral programs and professional science positions in order to provide a more thorough understanding of why and how women make career choices based on aspects both inside and outside of school and their subsequent interaction. Results indicate that female...

  17. The lonely female partner

    DEFF Research Database (Denmark)

    Bruun, Poul; Pedersen, Birthe D; Osther, Palle J

    2011-01-01

    The aim of this qualitative study was to investigate the experiences of female partners to men with prostate cancer. The women found the capacity to manage their lives through mutual love in the family and through their faith.......The aim of this qualitative study was to investigate the experiences of female partners to men with prostate cancer. The women found the capacity to manage their lives through mutual love in the family and through their faith....

  18. Female pattern hair loss

    Directory of Open Access Journals (Sweden)

    İdil Ünal

    2014-06-01

    Full Text Available Female androgenetic alopecia is the commonest cause of hair loss in women. It is characterized by a diffuse reduction in hair density over the crown and frontal scalp with retention of the frontal hairline and a characteristic pattern distribution in genetically predisposed women. Because of the uncertain relationship with the androgens Female Pattern Hair Loss (FPHL is the most preferred definition of the condition. This review has been focused on the clinical features, diagnosis and treatment alternatives of FPHL.

  19. Online Female Escort Advertisements

    Directory of Open Access Journals (Sweden)

    James D. Griffith

    2016-05-01

    Full Text Available Female escorts represent an occupational group that charges a fee for sex, which can be regarded as an extreme form of short-term mating. The present study examined if the fees charged by escorts are related to traits typically associated with female short-term mate value. A total of 2,925 advertisements for female escorts offering sexual services in the United States were examined, as a customized software program was used to download all the advertisements from an online escort directory. The advertisement content was coded, and relationships between advertised physical characteristics and the hourly rate charged by female escorts were examined. The analyses showed that higher fees were associated with female escorts who advertised a waist-to-hip ratio near 0.7, lower weight and body mass index, younger age, and photographic displays of breast and buttocks nudity. The findings provide evidence that evolutionarily relevant traits associated with female short-term mate value are systematically related to fees charged for sexual services.

  20. Male sexual harassment alters female social behaviour towards other females.

    Science.gov (United States)

    Darden, Safi K; Watts, Lauren

    2012-04-23

    Male harassment of females to gain mating opportunities is a consequence of an evolutionary conflict of interest between the sexes over reproduction and is common among sexually reproducing species. Male Trinidadian guppies Poecilia reticulata spend a large proportion of their time harassing females for copulations and their presence in female social groups has been shown to disrupt female-female social networks and the propensity for females to develop social recognition based on familiarity. In this study, we investigate the behavioural mechanisms that may lead to this disruption of female sociality. Using two experiments, we test the hypothesis that male presence will directly affect social behaviours expressed by females towards other females in the population. In experiment one, we tested for an effect of male presence on female shoaling behaviour and found that, in the presence of a free-swimming male guppy, females spent shorter amounts of time with other females than when in the presence of a free-swimming female guppy. In experiment two, we tested for an effect of male presence on the incidence of aggressive behaviour among female guppies. When males were present in a shoal, females exhibited increased levels of overall aggression towards other females compared with female only shoals. Our work provides direct evidence that the presence of sexually harassing males alters female-female social behaviour, an effect that we expect will be recurrent across taxonomic groups.

  1. Scientific Advice, Traditional Practices and the Politics of Health-Care : The Australian Debate over Public Funding of Non-Therapeutic Circumcision, 1985

    Directory of Open Access Journals (Sweden)

    Robert Darby

    2011-12-01

    Full Text Available In 1985 the Australian Government sought to delete circumcision of infants from the benefits payable under its newly established universal health scheme, Medicare. Although the decision had been recommended by the government's health advisers and was welcomed by medical authorities, it was soon reversed after protests from Jewish community leaders. I present a detailed narrative of this affair and explain why a decision based on sound medical knowledge advice was rescinded after quite mild objections. The answer is found to lie partly in contingent factors, such as the details of the policy change, the personalities of the government figures involved, and problems with implementation and communication; and partly in the sensibilities of the ethnic/religious communities most directly affected. I dispel the misconception that the original decision aroused widespread opposition and show, on the contrary, that it was based on good advice, represented sound public policy, and was widely supported. I conclude that the episode may have useful lessons for other governments seeking to implement or resist policy changes that affect the sensitivities of cultural minorities.

  2. Male circumcision to prevent syphilis in 1855 and HIV in 1986 is supported by the accumulated scientific evidence to 2015: Response to Darby.

    Science.gov (United States)

    Morris, Brian J; Wamai, Richard G; Krieger, John N; Banerjee, Joya; Klausner, Jeffrey D

    2017-10-01

    An article by Darby disparaging male circumcision (MC) for syphilis prevention in Victorian times (1837-1901) and voluntary medical MC programs for HIV prevention in recent times ignores contemporary scientific evidence. It is one-sided and cites outlier studies as well as claims by MC opponents that support the author's thesis, but ignores high quality randomised controlled trials and meta-analyses. While we agree with Darby that risky behaviours contribute to syphilis and HIV epidemics, there is now compelling evidence that MC helps reduce both syphilis and HIV infections. Although some motivations for MC in Victorian times were misguided, others, such as protection against syphilis, penile cancer, phimosis, balanitis and poor hygiene have stood the test of time. In the absence of a cure or effective prophylactic vaccine for HIV, MC should help lower heterosexually acquired HIV, especially when coupled with other interventions such as condoms and behaviour. This should save lives, as well as reducing costs and suffering. In contrast to Darby, our evaluation of the evidence leads us to conclude that MC would likely have helped reduce syphilis in Victorian times and, in the current era, will help lower both syphilis and HIV, so improving global public health.

  3. Voluntary medical male circumcision: matching demand and supply with quality and efficiency in a high-volume campaign in Iringa Region, Tanzania.

    Science.gov (United States)

    Mahler, Hally R; Kileo, Baldwin; Curran, Kelly; Plotkin, Marya; Adamu, Tigistu; Hellar, Augustino; Koshuma, Sifuni; Nyabenda, Simeon; Machaku, Michael; Lukobo-Durrell, Mainza; Castor, Delivette; Njeuhmeli, Emmanuel; Fimbo, Bennett

    2011-11-01

    The government of Tanzania has adopted voluntary medical male circumcision (VMMC) as an important component of its national HIV prevention strategy and is scaling up VMMC in eight regions nationwide, with the goal of reaching 2.8 million uncircumcised men by 2015. In a 2010 campaign lasting six weeks, five health facilities in Tanzania's Iringa Region performed 10,352 VMMCs, which exceeded the campaign's target by 72%, with an adverse event (AE) rate of 1%. HIV testing was almost universal during the campaign. Through the adoption of approaches designed to improve clinical efficiency-including the use of the forceps-guided surgical method, the use of multiple beds in an assembly line by surgical teams, and task shifting and task sharing-the campaign matched the supply of VMMC services with demand. Community mobilization and bringing client preparation tasks (such as counseling, testing, and client scheduling) out of the facility and into the community helped to generate demand. This case study suggests that a campaign approach can be used to provide high-volume quality VMMC services without compromising client safety, and provides a model for matching supply and demand for VMMC services in other settings.

  4. Morphological Segregation in the Surroundings of Cosmic Voids

    Energy Technology Data Exchange (ETDEWEB)

    Ricciardelli, Elena; Tamone, Amelie [Laboratoire d’Astrophysique, École Polytechnique Fédérale de Lausanne (EPFL), 1290 Sauverny (Switzerland); Cava, Antonio [Observatoire de Genève, Université de Genève, 51 Ch. des Maillettes, 1290 Versoix (Switzerland); Varela, Jesus, E-mail: elena.ricciardelli@epfl.ch [Centro de Estudios de Física del Cosmos de Aragón (CEFCA), Plaza San Juan 1, E-44001 Teruel (Spain)

    2017-09-01

    We explore the morphology of galaxies living in the proximity of cosmic voids, using a sample of voids identified in the Sloan Digital Sky Survey Data Release 7. At all stellar masses, void galaxies exhibit morphologies of a later type than galaxies in a control sample, which represent galaxies in an average density environment. We interpret this trend as a pure environmental effect, independent of the mass bias, due to a slower galaxy build-up in the rarefied regions of voids. We confirm previous findings about a clear segregation in galaxy morphology, with galaxies of a later type being found at smaller void-centric distances with respect to the early-type galaxies. We also show, for the first time, that the radius of the void has an impact on the evolutionary history of the galaxies that live within it or in its surroundings. In fact, an enhanced fraction of late-type galaxies is found in the proximity of voids larger than the median void radius. Likewise, an excess of early-type galaxies is observed within or around voids of a smaller size. A significant difference in galaxy properties in voids of different sizes is observed up to 2 R {sub void}, which we define as the region of influence of voids. The significance of this difference is greater than 3 σ for all the volume-complete samples considered here. The fraction of star-forming galaxies shows the same behavior as the late-type galaxies, but no significant difference in stellar mass is observed in the proximity of voids of different sizes.

  5. Isoperimetric inequalities in surround system and space science

    Directory of Open Access Journals (Sweden)

    JiaJin Wen

    2016-02-01

    Full Text Available Abstract By means of the algebraic, analysis, convex geometry, computer, and inequality theories we establish the following isoperimetric inequality in the centered 2-surround system S ( 2 { P , Γ , l } $S^{(2} \\{P,\\varGamma ,l \\}$ : ( 1 | Γ | ∮ Γ r ¯ P p 1 / p ⩽ | Γ | 4 π sin l π | Γ | [ csc l π | Γ | + cot 2 l π | Γ | ln ( tan l π | Γ | + sec l π | Γ | ] , ∀ p ⩽ − 2 . $$\\begin{aligned}& \\biggl(\\frac{1}{|\\varGamma |} \\oint_{\\varGamma }\\bar{r}_{P}^{p} \\biggr^{1/p}\\leqslant\\frac{|\\varGamma |}{4\\pi}\\sin\\frac{l\\pi}{|\\varGamma |} \\biggl[ \\csc \\frac{l\\pi}{|\\varGamma |}+\\cot^{2} \\frac{l\\pi}{|\\varGamma |} \\ln \\biggl(\\tan \\frac{l\\pi}{|\\varGamma |}+\\sec\\frac{l\\pi}{|\\varGamma |} \\biggr \\biggr], \\\\& \\quad \\forall p\\leqslant -2. \\end{aligned}$$ As an application of the inequality in space science, we obtain the best lower bounds of the mean λ-gravity norm ∥ F λ ( Γ , P ∥ ‾ $\\overline{\\Vert {\\mathbf{F}}_{\\lambda} ( \\varGamma ,P \\Vert }$ as follows: ∥ F λ ( Γ , P ∥ ‾ ≜ 1 | Γ | ∮ Γ 1 ∥ A − P ∥ λ ⩾ ( 2 π | Γ | λ , ∀ λ ⩾ 2 . $$\\overline{\\bigl\\Vert {\\mathbf{F}}_{\\lambda} ( \\varGamma ,P \\bigr\\Vert } \\triangleq\\frac{1}{|\\varGamma |} \\oint_{\\varGamma }\\frac{1}{\\|A-P\\|^{\\lambda }}\\geqslant \\biggl(\\frac{2\\pi}{|\\varGamma |} \\biggr^{\\lambda},\\quad \\forall \\lambda\\geqslant2. $$

  6. Rain Simulation for the Test of Automotive Surround Sensors

    Science.gov (United States)

    Hasirlioglu, Sinan; Riener, Andreas; Doric, Igor

    2017-04-01

    The WHO Global Health Observatory data indicates that over 1.25 million people die in traffic accidents annually. To save lives, car manufacturers spend lot of efforts on the development of novel safety systems aiming to avoid or mitigate accidents and provide maximum protection for vehicle occupants as well as vulnerable road users. All the safety features mainly rely on data from surround sensors such as radar, lidar and camera and intelligent vehicles today use these environmental data for instant decision making and vehicle control. As already small errors in sensor data measurements could lead to catastrophes like major injuries or road traffic fatalities, it is of utmost importance to ensure high reliability and accuracy of sensors and safety systems. This work focuses on the influence of environmental factors such as rain conditions, as it is known that rain drops scatter the electromagnetic waves. The result is incorrect measurements with a direct negative impact on environment detection. To identify potential problems of sensors under varying environmental conditions, systems are today tested in real-world settings with two main problems: First, tests are time-consuming and second, environmental conditions are not reproducible. Our approach to test the influence of weather on automotive sensors is to use an indoor rain simulator. Our artificial rain maker, installed at CARISSMA (Center of Automotive Research on Integrated Safety Systems and Measurement Area), is parametrized with rain characteristics measured in the field using a standard disdrometer. System behavior on artificial rain is compared and validated with natural rainfall. With this simulator it is finally possible to test environmental influence at various levels and under reproducible conditions. This saves lot of efforts required for the test process itself and furthermore has a positive impact on the reliability of sensor systems due to the fact that test driven development is enabled.

  7. Issues surrounding orphan disease and orphan drug policies in Europe.

    Science.gov (United States)

    Denis, Alain; Mergaert, Lut; Fostier, Christel; Cleemput, Irina; Simoens, Steven

    2010-01-01

    An orphan disease is a disease with a very low prevalence. Although there are 5000-7000 orphan diseases, only 50 orphan drugs (i.e. drugs developed to treat orphan diseases) were marketed in the EU by the end of 2008. In 2000, the EU implemented policies specifically designed to stimulate the development of orphan drugs. While decisions on orphan designation and the marketing authorization of orphan drugs are made at the EU level, decisions on drug reimbursement are made at the member state level. The specific features of orphan diseases and orphan drugs make them a high-priority issue for policy makers. The aim of this article is to identify and discuss several issues surrounding orphan disease and drug policies in Europe. The present system of orphan designation allows for drugs for non-orphan diseases to be designated as orphan drugs. The economic factors underlying orphan designation can be questioned in some cases, as a low prevalence of a certain indication does not equal a low return on investment for the drug across its indications. High-quality evidence about the clinical added value of orphan drugs is rarely available at the time of marketing authorization, due to the low number of patients. A balance must be struck between ethical and economic concerns. To this effect, there is a need to initiate a societal dialogue on this issue, to clarify what society wants and accepts in terms of ethical and economic consequences. The growing budgetary impact of orphan drugs puts pressure on drug expenditure. Indications can be extended for an orphan drug and the total prevalence across indications is not considered. Finally, cooperation needs to be fostered in the EU, particularly through a standardized approach to the creation and use of registries. These issues require further attention from researchers, policy makers, health professionals, patients, pharmaceutical companies and other stakeholders with a view to optimizing orphan disease and drug policies in

  8. Evaluation of Optic Canal and Surrounding Structures Using Cone Beam Computed Tomography: Considerations for Maxillofacial Surgery.

    Science.gov (United States)

    Sinanoglu, Alper; Orhan, Kaan; Kursun, Sebnem; Inceoglu, Beste; Oztas, Bengi

    2016-07-01

    The optic canal connects the anterior cranial fossa and the orbit and maintains the optic nerve and the ophthalmic artery. Within the extent of the surgical approach of the region, risk of iatrogenic injury of the neural and vascular structures increases. The aim of this retrospective morphometric study is to investigate the radiological anatomy of orbita, optic canal, and its surrounding using cone beam computed tomography (CBCT) scans in a group of Turkish population.Cone beam computed tomography images of a total of 182 patients were evaluated by 2 observers. Anatomical parameters regarding optic canal and orbita were measured for all patients from axial, sagittal, and three-dimensional reconstructed images. To assess intraobserver reliability, the Wilcoxon matched-pairs test was used. Pearson χ test and Student t test were performed for statistical analysis of differences, sex, localization, and measurements (P  0.05). The orbita width and height were larger for the males than females (P  0.05). Examination CBCT scans revealed that the shape of the optic canal was 70% funnel and 28% Hourglass shape, 2% amorph type round.These results provide detailed knowledge of the anatomical characteristics in the orbital area which may be of assistance for surgeons preoperatively. Cone beam computed tomography scans can be an alternative modality for multislice computed tomography with submillimeter resolution and lower dose in preoperative imaging of the orbit.

  9. Female physicist doctoral experiences

    Directory of Open Access Journals (Sweden)

    Katherine P. Dabney

    2013-04-01

    Full Text Available The underrepresentation of women in physics doctorate programs and in tenured academic positions indicates a need to evaluate what may influence their career choice and persistence. This qualitative paper examines eleven females in physics doctoral programs and professional science positions in order to provide a more thorough understanding of why and how women make career choices based on aspects both inside and outside of school and their subsequent interaction. Results indicate that female physicists experience conflict in achieving balance within their graduate school experiences and personal lives and that this then influences their view of their future careers and possible career choices. Female physicists report both early and long-term support outside of school by family, and later departmental support, as being essential to their persistence within the field. A greater focus on informal and out-of-school science activities for females, especially those that involve family members, early in life may help influence their entrance into a physics career later in life. Departmental support, through advisers, mentors, peers, and women’s support groups, with a focus on work-life balance can help females to complete graduate school and persist into an academic career.

  10. Female physicist doctoral experiences

    Science.gov (United States)

    Dabney, Katherine P.; Tai, Robert H.

    2013-06-01

    The underrepresentation of women in physics doctorate programs and in tenured academic positions indicates a need to evaluate what may influence their career choice and persistence. This qualitative paper examines eleven females in physics doctoral programs and professional science positions in order to provide a more thorough understanding of why and how women make career choices based on aspects both inside and outside of school and their subsequent interaction. Results indicate that female physicists experience conflict in achieving balance within their graduate school experiences and personal lives and that this then influences their view of their future careers and possible career choices. Female physicists report both early and long-term support outside of school by family, and later departmental support, as being essential to their persistence within the field. A greater focus on informal and out-of-school science activities for females, especially those that involve family members, early in life may help influence their entrance into a physics career later in life. Departmental support, through advisers, mentors, peers, and women’s support groups, with a focus on work-life balance can help females to complete graduate school and persist into an academic career.

  11. Female athlete triad update.

    Science.gov (United States)

    Beals, Katherine A; Meyer, Nanna L

    2007-01-01

    The passage of Title IX legislation in 1972 provided enormous opportunities for women to reap the benefits of sports participation. For most female athletes, sports participation is a positive experience, providing improved physical fitness, enhanced self-esteem, and better physical and mental health. Nonetheless, for a few female athletes, the desire for athletic success combined with the pressure to achieve a prescribed body weight may lead to the development of a triad of medical disorders including disordered eating, menstrual dysfunction, and low bone mineral density (BMD)--known collectively as the female athlete triad. Alone or in combination, the disorders of the triad can have a negative impact on health and impair athletic performance.

  12. Highly Enriched Uranium Metal Cylinders Surrounded by Various Reflector Materials

    International Nuclear Information System (INIS)

    Bernard Jones; J. Blair Briggs; Leland Monteirth

    2007-01-01

    A series of experiments was performed at Los Alamos Scientific Laboratory in 1958 to determine critical masses of cylinders of Oralloy (Oy) reflected by a number of materials. The experiments were all performed on the Comet Universal Critical Assembly Machine, and consisted of discs of highly enriched uranium (93.3 wt.% 235U) reflected by half-inch and one-inch-thick cylindrical shells of various reflector materials. The experiments were performed by members of Group N-2, particularly K. W. Gallup, G. E. Hansen, H. C. Paxton, and R. H. White. This experiment was intended to ascertain critical masses for criticality safety purposes, as well as to compare neutron transport cross sections to those obtained from danger coefficient measurements with the Topsy Oralloy-Tuballoy reflected and Godiva unreflected critical assemblies. The reflector materials examined in this series of experiments are as follows: magnesium, titanium, aluminum, graphite, mild steel, nickel, copper, cobalt, molybdenum, natural uranium, tungsten, beryllium, aluminum oxide, molybdenum carbide, and polythene (polyethylene). Also included are two special configurations of composite beryllium and iron reflectors. Analyses were performed in which uncertainty associated with six different parameters was evaluated; namely, extrapolation to the uranium critical mass, uranium density, 235U enrichment, reflector density, reflector thickness, and reflector impurities. In addition to the idealizations made by the experimenters (removal of the platen and diaphragm), two simplifications were also made to the benchmark models that resulted in a small bias and additional uncertainty. First of all, since impurities in core and reflector materials are only estimated, they are not included in the benchmark models. Secondly, the room, support structure, and other possible surrounding equipment were not included in the model. Bias values that result from these two simplifications were determined and associated

  13. Severe blood-brain barrier disruption and surrounding tissue injury.

    Science.gov (United States)

    Chen, Bo; Friedman, Beth; Cheng, Qun; Tsai, Phil; Schim, Erica; Kleinfeld, David; Lyden, Patrick D

    2009-12-01

    Blood-brain barrier opening during ischemia follows a biphasic time course, may be partially reversible, and allows plasma constituents to enter brain and possibly damage cells. In contrast, severe vascular disruption after ischemia is unlikely to be reversible and allows even further extravasation of potentially harmful plasma constituents. We sought to use simple fluorescent tracers to allow wide-scale visualization of severely damaged vessels and determine whether such vascular disruption colocalized with regions of severe parenchymal injury. Severe vascular disruption and ischemic injury was produced in adult Sprague Dawley rats by transient occlusion of the middle cerebral artery for 1, 2, 4, or 8 hours, followed by 30 minutes of reperfusion. Fluorescein isothiocyanate-dextran (2 MDa) was injected intravenously before occlusion. After perfusion-fixation, brain sections were processed for ultrastructure or fluorescence imaging. We identified early evidence of tissue damage with Fluoro-Jade staining of dying cells. With increasing ischemia duration, greater quantities of high molecular weight dextran-fluorescein isothiocyanate invaded and marked ischemic regions in a characteristic pattern, appearing first in the medial striatum, spreading to the lateral striatum, and finally involving cortex; maximal injury was seen in the mid-parietal areas, consistent with the known ischemic zone in this model. The regional distribution of the severe vascular disruption correlated with the distribution of 24-hour 2,3,5-triphenyltetrazolium chloride pallor (r=0.75; P<0.05) and the cell death marker Fluoro-Jade (r=0.86; P<0.05). Ultrastructural examination showed significantly increased areas of swollen astrocytic foot process and swollen mitochondria in regions of high compared to low leakage, and compared to contralateral homologous regions (ANOVA P<0.01). Dextran extravasation into the basement membrane and surrounding tissue increased significantly from 2 to 8 hours of

  14. Intention toward the continuation of female genital mutilation in Bale Zone, Ethiopia

    Directory of Open Access Journals (Sweden)

    Bogale D

    2015-01-01

    Full Text Available Daniel Bogale,1 Desalegn Markos,2 Muhammedawel Kaso1 1Department of Public Health, 2Department of Nursing, College of Medicine and Health Sciences, Madawalabu University, Bale Goba, Ethiopia Background: Female genital mutilation (FGM is a harmful traditional practice that is deeply rooted in Africa. It is associated with health complications and human rights violations. Research on intention for the continuation of FGM and the social determinants underpinning this practice are scarce. Therefore, this study intended to assess the intention of women toward the continuation of FGM among Bale Zone reproductive-age women.Methods: A community-based cross-sectional study design supplemented by qualitative methods was conducted in 2014. A total of 634 reproductive-age women were involved in the quantitative part of the study. The respondents were drawn from five randomly selected districts of Bale Zone. The total sample was allocated proportionally to each district based on the number of reproductive-age women it has. Purposive sampling method was used for qualitative study. Then, data were collected using a pretested and structured questionnaire. The collected data were analyzed by Statistical Package for Social Sciences for Windows version 16.0. Multiple logistic regressions were carried out to examine the existence of a relationship between intentions for the continuation of FGM and selected determinant factors.Results: This study revealed that 26.7% of the respondents had intention for the continuation of FGM. Religion, safeguarding virginity, tradition, and social values were the major reasons for the perpetuation of this practice. Circumcised respondents and those who were not able to read and write were ~3 (adjusted odds ratio = 2.89, 95% confidence interval = [1.33, 6.20] and 7.58 (adjusted odds ratio = 7.58, 95% confidence interval = [3.47, 16.54] times more likely intending the continuation of FGM than uncircumcised and those who

  15. Male depression in females?

    Science.gov (United States)

    Möller-Leimkühler, Anne Maria; Yücel, Mete

    2010-02-01

    Scientific evidence for a male-typed depression ("male depression") is still limited, but mainly supports this concept with respect to single externalizing symptoms or symptom clusters. In particular, studies on non-clinical populations including males and females are lacking. The present study aims at assessing general well-being, the risk and the symptoms of male depression dependent on biological sex and gender-role orientation on instrumental (masculine) and expressive (feminine) personality traits in an unselected community sample of males and females. Students (518 males, 500 females) of the Ludwig-Maximilians-University of Munich, Germany, were asked to participate in a "stress study" and complete the following self-report questionnaires: the WHO-5 Well-being Index [Bech, P., 1998. Quality of Life in the Psychiatric Patient. Mosby-Wolfe, London], the Gotland Scale for Male Depression [Walinder, J., Rutz, W., 2001. Male depression and suicide. International Clinical Psychopharmacology 16 (suppl 2), 21-24] and the German Extended Personal Attribute Questionnaire [Runge, T.E., Frey, D., Gollwitzer, P.M., et al., 1981. Masculine (instrumental) and feminine (expressive) traits. A comparison between students in the United States and West Germany. Journal of Cross-Cultural Psychology 12, 142-162]. General well-being of the students was significantly lower compared to population norms. Contrary to expectations, female students had a greater risk of male depression than male students (28.9% vs. 22.4%; p<0.05). Overall, prototypic depressive symptoms as well as externalizing symptoms were more pronounced in females. In the subgroup of those at risk for male depression, biological sex and kind of symptoms were unrelated. Principal component analyses revealed a similar symptom structure for males and females. Low scores on masculinity/instrumentality significantly predicted higher risk of male depression, independent of biological sex. The study sample is not

  16. Do (Female) Founders Influence (Female) Joiners to Become Founders too?

    DEFF Research Database (Denmark)

    Rocha, Vera; Van Praag, Mirjam

    -founder (gender) homophily affects the likelihood of female and male joiners to become founders themselves. We find a relatively large and robust positive effect among female joiners that can be attributed to the role modeling function of female founders. Female entrepreneurs hiring personnel may thus have...

  17. Females and Toxic Leadership

    Science.gov (United States)

    2012-12-14

    labeled as toxic, can he or she be rehabilitated?; Are there leadership styles that can be promoted to combat toxic leadership?; and Are the senior...examines leadership styles that are favorable for female leaders, and offers Transformational/Adaptive leadership as a style promising rehabilitative tools

  18. Perspectives on Female Entrepreneurs

    DEFF Research Database (Denmark)

    Kuada, John Ernest; Janulevièienë, Rûta

    2003-01-01

    The aim of this paper is to compare the contents of the academic evidence and debate on female entrepreneurship in the West with the current stream of research and thinking in the Central and Eastern European Countries with a view to identifying similarities and differences in thoughts and findin...

  19. Female sexual dysfunction

    DEFF Research Database (Denmark)

    Giraldi, Annamaria; Wåhlin-Jacobsen, Sarah

    2016-01-01

    Female sexual dysfunction (FSD) is a controversial condition, which has prompted much debate regarding its aetiology, components, and even its existence. Our inability to work together as clinicians, psychologists, patients, and advocates hinders our understanding of FSD, and we will only improve...

  20. Female sexual arousal disorders

    NARCIS (Netherlands)

    Giraldi, Annamaria; Rellini, Alessandra H.; Pfaus, James; Laan, Ellen

    2013-01-01

    Definitions and terminology for female sexual arousal disorder (FSAD) are currently being debated. While some authors have suggested that FSAD is more a subjective response rather than a genital response, others have suggested that desire and arousal disorders should be combined in one entity.