Thesis (Family Medicine))--University of Limpopo (Medunsa Campus), 2010. / Traditional male circumcision complications are one of the surgical problems you may face as a doctor working in St Lucy’s hospital. Usually there is increased number of circumcision related complications during the winter and summer seasons as this traditional circumcision as a peoples’ culture or ritual is performed during these periods. In a study by Muula S Adamson et al, (2007) they found that there was limited published literature on the complications of male circumcision in sub-Saharan Africa and the vii available evidence regarding the prevalence of complications in male circumcision is conflicting, with some studies reporting significantly high complication prevalence and at least one study reporting no complications. They suggested that a study that may not have reported a single complication may indeed have none to report or that complications may have been considered so minor as to be ‘worth’ reporting. About 25% of world male population is circumcised and circumcision remains one of the oldest and commonest operations performed all over the world. The complication rates of the procedure ranges between 0.19% and 3.1% Wilkinson GB (1997). The expertise of the surgeon or the circumciser determines the outcome. Aim: To establish factors associated with traditional circumcision and the type of complications encountered at St. Lucy’s hospital from January 2006-December 2007. Objective: To determine the types of complications following traditional circumcision. To establish the causes of the complications Methods-: Study design: This is a retrospective descriptive quantitative study. Data was collected from the patients’ records and a questionnaire used as a data collection instrument. Study Population: All male circumcised traditionally seen at St. Lucy’s within the period of study. Inclusion criteria: Files (records) of all male patients circumcised traditionally seen at St Lucy’s within the period of the study. Patient’s file contains all patient data including; names, gender, age, contact number and address, next of kin and race including others. The diagnostic viii details and management of the condition identified with the discharge summary notes. Exclusion criteria: Files (records) of other males and females attending hospital for other reasons. Those circumcised for medical reasons like phimosis or paraphimosis. Results: There were a total of 105 patients’ files (records) that were eligible with majority of the patients’ files, 68 (64.8%) between the ages of 15 and 19years. Majority of them had secondary school education 83 (79). Various reasons were given for traditional circumcision. Of the 105 males patients’ files, 60(57%) went for circumcision to be transformed from boyhood to manhood, 21(20.0%) were found to be circumcised due to peer pressure, 20(19.0%) were as a result of culture and 1(1.0%) was found to be forced. Circumcision was done more between the months of July and Sept. and more were circumcised on the mountain/forest than on the initiation ground. More of the boys were found to be circumcised by the traditionalist and had worse complications when compared with those circumcised by the initiators who had informal training on how the perform circumcision. Wound infections (sepsis) accounted for more than 56.2% of the admissions and complications. Genital mutilation at approx. 26.7% followed by 12(11.4%) dehydration and total amputation of glans 6(5.7%). Complication does not appear to depend on whether a patient had had previous STI or not. In this study it was found that complications were more when the circumciser was a traditionalist. The total rate of complication was 54.3% when a traditionalist was involved as against 28.6% when initiator was involved. The severity and types of complications determine the duration of hospital stay and whether the patient is referred out or not. From the study it followed that most genital sepsis healed from (3-21) days with patients with genital mutilation staying up to four (4) weeks. There were a number of limitations encountered during the study. ix Conclusion: traditional circumcision is mostly performed as a right/ritual that allows the passage from boyhood to manhood in the Xhosa area. In this study it was found that majority of those circumcised did so to be transformed into men and genital sepsis was the highest complication seen and were seen mostly when the circumciser was a traditionalist. The findings did not vary from similar studies which noted that complications were worse when inexperienced surgeons engaged in circumcising the unsuspecting initiates especially during botch surgery.

Thesis (Th. M.)--Dallas Theological Seminary, 1988. / Bibliography: leaves [51]-58.

Thesis (Th. M.)--Westminster Theological Seminary, Philadelphia, 2003. / Includes vita. Includes bibliographical references (leaves 132-141).

Thesis (Th. M.)--Westminster Theological Seminary, Philadelphia, 2003. / Includes vita. Includes bibliographical references (leaves 132-141).

Thesis (Th. M.)--Westminster Theological Seminary, Philadelphia, 2003. / Includes vita. Includes bibliographical references (leaves 132-141).

A mini-dissertation submitted in partial compliance with the requirements for a Master's Degree in Technology: Nursing, Technikon Natal, 2002. / The Ulwaluko (traditional circumcision) custom among the AmaXhosa is a traditional rite of passage. Traditionally all young men are required to undergo the custom. Its modern manifestation, however, has become problematic, because there is an increase in the morbidity and mortality which is associated with gangrenous and septic complications of the wound. Therefore an intervention was needed to reduce the problems. A westernised health care project was developed and implemented but some communities have not accepted it. Therefore there was a need to understand how it came to be accepted in one village in order to adapt it and promote its acceptance by other communities. The purpose of this study is to explain the acceptance of westernised health care into the traditional circumcision and give nurses a better understanding of how to give culturally sensitive care. A qualitative research design was used, specifically Ethnography, since this is the tradition for studying the meaning, patterns, and experiences of a defined cultural group (Polit and Hungier, 1997). ABSTRACT The researcher conducted separate in-depth semi-structured face-to-face interviews with the two key informants from the community and three focus groups. A total of 18 AmaXhosa men participated in the study. Data was transcribed from taped sessions. Thematic analysis was carried out and 12 major themes and eight sub-themes emerged. / M

Circumcision of infant males has been a medical procedure that has been performed for thousands of years. Over the centuries, there have been multiple techniques that have made the procedure more efficient, safer, less painful, and easier to perform. The three techniques that were the most common and preferred were the Mogen, Gomco, and Plastibell techniques [Bailey, 2017]. This literary thesis is a retrospective study that looks to previously published papers to determine the preferred circumcision method. This analysis is not in support or in opposition to the topic of circumcision, but rather to promote a uniform understanding of the various techniques. The benefit of such standardization will provide uniform training for providers, better care for patients, and minimized risk of complications. In this analysis, the Gomco, Mogen, and Plastibell methods are compared in terms of safety, pain, and provider preference. A randomized control trial determined that the Mogen clamp is associated with less pain and discomfort, and is safer, faster, and preferred by surgeons [Sinkey 2015]. Surveys from various providers show that Mogen clamp was the preferred method for circumcision, stating that it has many benefits: the instrument has only one piece, one size can be used for all patients, and it can be reused [Abdulwahab 2013]. Additionally, the Mogen clamp took the least amount of time to complete and required the fewest number of procedures for the providers to develop competency [Abdulwahab 2013, Bailey 2019] The Mogen clamp was associated with the least amount of pain in a study analyzing the physiological response of a newborn. The study showed that the Mogen clamp had the lowest absolute and percentage change of cortisol levels [Sinkey 2015]. Kurtis et al reported that neonates in the Mogen group, regardless of anesthesia type, had less physiological changes such as heart rate and respiratory rate. However, despite Mogen having a faster procedure time and a lower change in cortisol levels between pre and postoperative groups, there was no difference in CRIES scores between circumcision groups [Sinkey 2015]. Of the three devices Mogen appears to be the best choice for circumcisions. However, additional research is needed to find or devise a new device to address shortcomings of current methods.

Thesis (M.C.S.)--Regent College, 1992. / Abstract and vita. Includes bibliographical references (leaves 106-112).

A research report submitted to the School of Public Health, University of the Witwatersrand in partial fulfillment of the requirements for the degree of Master of Public Health 24th October, 2014 / Background: Male circumcision (MC) has a substantial effect in reducing HIV infections in men by 60 -70% making it one of the best available evidence-based biomedical HIV prevention interventions. Swaziland included Voluntary Medical Male Circumcision (VMMC) as part of its comprehensive HIV prevention package but the national scale up has been constrained by the limited availability of trained physicians, who are the only professionals permitted to perform the surgery. Task-shifting has been proposed as a possible strategy to increase service providers in the face of HIV and AIDS and the human resource for health crisis. Study Aim: The aim of this study was to determine the attitudes of doctors and nurses towards task shifting of male circumcision procedures to nurses in 2012. Methodology: A cross-sectional, descriptive survey was carried out. A self-administered questionnaire with close-ended rating and reverse coded questions was distributed to all nurses and doctors affiliated to the non-governmental organization (NGO), governmental, missionary and privately-run VMMC clinics nationwide. Data from returned questionnaires were entered, cleaned and analyzed using Statistical Package for Social Science (SPSS) version 22 and Microsoft Excel. Analysis of the internal reliability of the questionnaire scale and sub-scales was conducted. The main statistical procedures were descriptive statistics and tests of association. Results: The study recruited 398 participants (25.4% doctors and 74.6% nurses), of which 44.2% were male and 56% were Swaziland nationals. This study found that 80.4% of the participants (doctors and nurses) had a positive attitude towards the reform of task-shifting VMMC to nurses. Nurses had a more positive attitude than doctors (p<0.001), while male nurses had a significantly more positive attitude than female nurses (p<0.001).However, there was no significant difference between the attitudes of male and female doctors (p=0.130). The study found that sex (p=0.001), profession (doctor vs. nurse) (p<0.001), nationality (expatriate vs. local) (p<0.001) and having ever practically performed the surgical procedure (p<0.001) were significantly associated with the participants attitude. However, their primary role (administrator vs. clinician) (p=0.059) and time spent in the VMMC programme (p=0.112) did not significantly influence the participants’ attitude towards the task-shifting policy reform. Conclusions and Recommendations: Doctors and nurses in Swaziland generally have a positive attitude towards task-shifting of male circumcision to nurses. Nurses, males, participants with longer exposure and practical experience in VMMC, older participants and expatriates had even more positive attitudes towards the reform than their counterparts. The findings of the study suggest that the government should consider development of a task-shifting policy after further research that looks into determining attitudes of other stakeholders in VMMC and should also consider strategies to address the special groups that had lower or negative attitudes towards the reform than their counterparts, such as through sensitization campaigns. Feasibility, cost-effectiveness and other practical issues in our setting also need to be taken into consideration, including a possible trial (pilot). The reform should, however, be introduced with consideration of aspects of adequate training, development, supervision and support, administrative regulation, staff motivation and recognition.

Thesis (M.A.)--George Mason University, 2007. / Vita: p. 85. Thesis director: Paula Gilbert. Submitted in partial fulfillment of the requirements for the degree of Master of Arts in Foreign Languages. Title from PDF t.p. (viewed July 18, 2008). Includes bibliographical references (p. 81-84). Also issued in print.