No description available.

Female Genital Mutilation is a cultural and historical practice engrained in the African Culture.This practice is part of the African Rite of Passage; where a young girl passes on from being achild into being a grown woman. According to Martha Nussbaums’s Capability Approach thispractice undermines the woman and violates her rights as a human being, on the other handMelville Herskovits’ Cultural Relativist theory encourages acceptance and respect of the variouscultures and their beliefs; thus making female genital mutilation a cultural tradition that shouldbe respected like any other tradition around the world.

No description available.

Bakgrund: Över 200 miljoner kvinnor och flickor i världen uppskattas ha blivit utsatta för könsstympning. De söker vård för fysiska och psykiska besvär, som kan vara en långvarig komplikation av könsstympningen. Detta kan lätt förbises om vårdpersonalen inte har kunskap om kvinnlig könsstympning och i vilka länder det utövas. Syfte: Syftet med studien var att beskriva erfarenheter av mötet med vårdpersonal för kvinnor som har blivit utsatta för könsstympning. Metod: En litteraturstudie baserad på åtta vetenskapliga kvalitativa artiklar. Databaserna PubMed och Cinahl användes vid sökningen. Analysen genomfördes med Fribergs femstegsmodell. Resultat: Analysen gav tre kategorier, “Behov av information och rak kommunikation”, “Kvinnornas erfarenhet av vårdpersonalens kunskap och kompetens” och “Bemötande som skapar barriär eller främjar en personcentrerad vård” och sju underkategorier. Konklusion: Bristande kulturell kompentens bland vårdpersonalen och en tystnad kring kvinnlig könsstympning kan leda till att kvinnor som har blivit könsstympade inte får den vård de är i behov av och har rätt till. Vårdpersonalen behöver en kulturell förståelse för kvinnornas situation och medicinsk kompetens avseende kvinnlig könsstympning. Kvinnor som har blivit utsatta för könsstympning är i behov av empowerment och utbildning för att kunna bli mer delaktiga i sin vård. / Background: Over 200 million women and girls are estimated to have undergone female genital mutilation. They seek healthcare for physical and psychological problems, which can be a long-term complication from female genital mutilation (FGM). This can easily be overlooked by the healthcare staff if they do not have knowledge about female genital mutilation and in which countries it is practiced.  Aim: The aim of the study was to describe the experiences from the meeting with healthcare providers for women who have undergone genital mutilation.  Methods: A literature review with eight scientific qualitative studies. The databases Cinahl and PubMed were used in the literature search. The data was analyzed using Friberg’s Five-step model.  Results: The analysis gave three categories, “Need for information and direct communication”, “Women’s experiences of knowledge and competence of healthcare providers” and "Attitudes that create barriers or promote person-centered care” and seven subcategories.  Conclusion: A lack of cultural competence among healthcare providers and a silence around the topic female genital mutilation can lead to that women who have undergone female genital mutilation not receiving the care they are in need of and are entitled to. The healthcare providers need a cultural understanding of the women’s situation and medical competence regarding female genital mutilation. Women who have undergone female genital mutilation are in need of empowerment and education to be more involved in their healthcare.

Bakgrund: Kvinnlig könsstympning är en skadlig sedvänja som innebär ingrepp med avsikt att ändra eller skada kvinnans könsorgan. Traditionellt utförs det i stora delar av världen på flickor och kvinnor utan medicinska skäl. Idag beräknas cirka 200 miljoner flickor och kvinnor i världen ha utsatts för könsstympning och cirka 68 000 beräknas vara bosatta i Sverige. Syfte: Syftet var att beskriva könsstympade kvinnors upplevelse av mötet med vården. Metod: Studien är en beskrivande litteraturstudie som baserades på 13 kvalitativa originalstudier som söktes i databasen PubMed. Huvudresultat: Resultatet visade att könsstympade kvinnor i mötet med vården upplevde bristfällig kunskap hos vårdpersonal samt otillräcklig information, vilket ledde till att kvinnorna inte fick relevant vård. Kvinnor upplevde bristfällig kommunikation med vårdpersonal, delvis på grund av språksvårigheter. Kvinnor upplevde utsatthet, kände skam och användes som studieobjekt. De blev av vårdpersonal misstänkta för brott i form av att de skulle könsstympa sina döttrar. Resultatet visade även att könsstympade kvinnor hade bra upplevelser med vården där kvinnor upplevde omtänksamma och välkomnande attityder hos vårdpersonal. Slutsats: Vårdpersonalens kunskap om könsstympning var grundläggande för de könsstympade kvinnornas upplevelser av vården. Brist på kunskap, kommunikation och information ledde till skam och utsatthet för kvinnorna. Detta tyder på att könsstympning är ett ämne som bör lyftas fram då vården i nuläget riskerar att inte räcka till för denna patientgrupp. Vårdpersonal bör vara uppmärksamma och lyhörda för att främja en god upplevelse för könsstympade kvinnors möte med vården. / Background: Female genital mutilation is a harmful practice that involves procedures with the intention of changing or damaging a woman´s genitals. Traditionally, it is performed in large parts of the world on girls and women without medical reasons. Today, approximately 200 million girls and women in the world are estimated to have been subjected to female genital mutilation and approximately 68,000 are estimated to live in Sweden. Aim: The aim was to describe women with female genital mutilation´s experience of the encounter with healthcare. Method: The study is a descriptive literature review that was based on 13 qualitative primary studies searched in PubMed. Main result: The results showed that in the meeting with healthcare, women with female genital mutilation experienced deficient knowledge with healthcare personnel and received insufficient information, which led to the women not receiving relevant care. The women experienced a lack of communication in relation to the healthcare personnel, partly due to language difficulties. Women experienced vulnerability, felt shame and were used as study objects. They were suspected by healthcare personnel of crimes in form of exposing their daughters to genital mutilation. The results also showed that women with female genital mutilation had good experiences with healthcare where women experienced caring and welcoming attitudes from health care personnel. Conclusion: Healthcare personnel´s knowledge of genital mutilation was fundamental to the women exposed to female genital mutilation´s experiences of healthcare. Lack of knowledge, communication and information led to shame and vulnerability for the women. This indicates that female genital mutilation is a topic that should be highlighted as the healthcare currently risks not being sufficient for this patient group. Healthcare personnel should be attentive and responsive to promote a good experience for women exposed to female genital mutilation encounters with care.

Orientadores: Viviane Hermann, Cássio Luiz Zanettini Riccetto / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-18T22:47:40Z (GMT). No. of bitstreams: 1 Manente_FernandaDalphorno_M.pdf: 1640371 bytes, checksum: bb7045d453650447e32f75b7c7322b55 (MD5) Previous issue date: 2011 / Resumo: Introdução: Os slings sintéticos marcaram a transição do tratamento invasivo para o tratamento minimamente invasivo da incontinência urinária de esforço feminina. Técnicas igualmente eficazes, porém com menores riscos de complicações têm sido pesquisadas. Os mini-slings, utilizando incisão única e de acesso exclusivamente vaginal podem representar uma alternativa à técnica de sling tradicional. Objetivo: Avaliar a eficácia do mini sling Ophira para o tratamento da incontinência urinária de esforço feminina. Material e Método: Foram avaliadas 49 mulheres que compareceram ao Ambulatório de Uroginecologia do HC da UNICAMP no período de abril de 2008 a maio de 2009 com queixa clínica de incontinência urinária de esforço. Todas as pacientes foram submetidas a Estudo Urodinâmico pré-operatório e avaliadas através de história clínica, exame físico, urina I e urocultura, teste de esforço, Pad test de uma hora e aplicação do questionário de qualidade de vida UDI-6. A colocação de mini sling Ophira foi realizada sob anestesia local em regime ambulatorial com alta após micção espontânea. As avaliações subsequentes foram realizadas após seis dias e um, três, seis e 12 meses após o procedimento, compreendendo exame físico, Pad test de uma hora e aplicação do UDI-6. A cura objetiva foi avaliada através do Pad test e do teste de esforço. A cura subjetiva foi avaliada pela queixa clínica e pelo questionário de qualidade de vida. Resultados: A análise da percepção subjetiva dos resultados demonstrou que, após 12 meses de seguimento, 37 pacientes (76%) referiram cura da IUE e sete (14%) melhora. O escore do questionário UDI-6, inicialmente com média de 41,29, caiu para 7,24 após 12 meses de seguimento. O Pad test de uma hora apresentou queda de 6,2g no préoperatório para 1g após o término do acompanhamento. Apenas seis pacientes apresentavam teste de esforço positivo no seguimento de 12 meses. Não houve complicações intra-operatórias. Apenas um caso de dor pós-operatória foi observado. Obteve-se taxa de extrusão do sling de 12,2%. Conclusão: O mini sling Ophira representa uma alternativa cirúrgica segura e eficaz para o tratamento da incontinência urinária de esforço feminina, no período de tempo avaliado / Abstract: Introduction: The synthetic slings marked the transition from invasive treatment to minimally invasive treatment of stress urinary incontinence. Techniques equally effective but with fewer risks of complications have been proposed. The minislings, with single incision and accessing exclusively the vaginal route represents an alternative to tradicional sling technique. Objective: To evaluate the efficacy of mini sling Ophira for the treatment of stress urinary incontinence in women. Methods: We evaluated 49 women attending the outpatient clinic of Urogynecology at the HC/UNICAMP from April 2008 to May 2009 with clinical complaints of stress urinary incontinence. All patients were initially submitted to urodynamic investigation, clinical and physical evaluation, urine analysis, stress test, 1-hour pad test and UDI- 6 Quality of life questionnaire. Mini sling Ophira was placed under local anesthesia and patients were dismissed after spontaneous voiding. Evaluation was undertaken 6 days after surgery and 1, 3, 6 and 12 months follow-up. Objective cure was assessed by Pad test and stress test. Subjective cure was assessed by QoL questionnaire. Results: Subjective analysis demonstrated that, after 12 months, 37 (76%) of patients referred themselves as cured and 7 (14%) as improved. UDI score significantly dropped from 41.29 to 7.24 and 1 hour Pad-test significantly decreased from 6.2 g to 1.0 g. Only 6 patients had persistent positive stress test. No intra operative complications occurred and only one patient complained of pain. Mesh erosion rate was 12.2%. Conclusion: Mini sling Ophira represents a safe and effective alternative to female stress urinary incontinence treatment, should the results proved to be long lasting / Mestrado / Fisiopatologia Cirúrgica / Mestre em Ciências

Sammanfattning Bakgrund Fokus för studien är att uppmärksamma Socialstyrelsens vägledande information rörande könsstympning av flickor och kvinnor. Traditionen innebär total eller delvis borttagning av det kvinnliga yttre könsorganet, vilket innefattar avsiktliga skador som förändrar eller orsakar defekter på det kvinnliga könsorganet utan medicinska skäl eller grunder (WHO, 2008). Till följd av migration och befolkningsomflyttningar har traditionen kommit att uppmärksammas internationellt och även i Sverige. I Sverige har traditionen en tydlig relevans för socialt arbete eftersom könsstympning diskuteras och definieras som våld mot kvinnor/barn, förtryck, heder, brott mot mänskliga och barns rättigheter (Talle, 2008). Myndigheter i Sverige står inför en utmaning att informera, uppmärksamma, integrera och arbeta preventivt med denna målgrupp.   Syfte Syftet med studien är att beskriva och analysera hur socialstyrelsen via sin webbplattform förmedlar kunskap om könsstympning av flickor och kvinnor. Utifrån hemsidans tillgängliga texter granskas och analyseras vägledning och kunskapsstöd riktade till olika professioner, exempelvis socialtjänsten och hälso-och sjukvård. Vidare studeras hur kunskapsstöd vägleder professioner till att förstå och handla i frågor som rör könsstympning som ett arbete på samhälls-, grupp och individnivå. Utifrån det analyseras hur socialstyrelsen främja det sociala arbetet kring könsstympning.   Metod Studien bygger på en kvalitativ forskning baserad på systematisk litteraturstudie och induktiv ansats. Litteraturstudien grundades på analys och granskning av socialstyrelsen kunskapsstöd. Genom en webbaserad innehållsanalys granskades 53 publicerade dokument som direkt eller indirekt berör könsstympning av flickor och kvinnor.     Resultat I resultatdelen identifieras tilltänkta mottagare av det publicerade materialet som illustreras i form av ett diagram. Den allmängiltiga informationen representerar hälften av urvalet. De två mer framträdande grupper identifieras som Hälso-och sjukvård och den berörda målgruppen. I mindre omfattning riktas material till socialtjänst och samhälls-/hälsokommunikatörer. Resultat påvisar att Hälso-sjukvården i sitt arbete med könsstympning, har i större omfattning tillgång till praktiskt och teoretisk vägledning i jämförelse med de andra representerade mottagargrupperna.   Slutsatser Studien visar att socialstyrelsen förmedlar ett arbete mot traditionen på individ-, grupp- och samhällsnivå. Information kring könsstympning av flickor och kvinnor stämmer i stort sett överens med tidigare forskning gällande ursprung, förekomst, utformning och konsekvenser. Studien visar att Socialstyrelsen är en källa för kunskap och information kring ämnet. Det föreligger dock skillnader i den praktiska vägledningen som skapar grund för handling. Vid det konkreta arbetet på individnivå framträder skillnader beroende på om frågan aktualiseras inom hälso- och sjukvård eller socialtjänst. / Abstract Background The focus of the study is to draw attention to the National Board of Health and Welfare directory information concerning female genital mutilation (FMG). The tradition involving the total or partial removal of the female external genitalia, including intentional damage which alter or cause defects on the female genitalia without medical reasons or reasons (WHO, 2008). As a result of migration and population movements, the tradition came to be recognized internationally and in Sweden. In Sweden, the tradition has a clear relevance to social work because FGM is discussed and defined as violence against women/children, oppression, honour, violation of human and children's rights (Talle, 2008). Authorities in Sweden is facing a challenge to inform, alert, integrate and work preventively with this audience. Purpose The purpose of this study is to describe and analyse how the National Board of Health and Welfare by its web platform conveys knowledge of FGM. Based on the websites available texts examined and analysed guidance and knowledge subsidies to various professions, such as social and health care. Further studies show knowledge and support guides professionals to understand and act on issues related to FGM as a work of social, group and at a individual level. Based on the analysis of how the National Board of Health and Welfare promotes the social work of FGM. Method The study is based on a qualitative research based on a systematic literature review and inductive approach. The literature review was based on analysis and review by the National Board of Health and Welfare knowledge support. Through a web-based content analysis examined 53 published documents that directly or indirectly affects FGM. Results In the results section identified the receiver to think of the published material illustrated in the form of a diagram. The universal information represents half of the sample. The two prominent groups identified as Health and the touch target. In smaller scale material is directed to social and community -/health communicators. Results demonstrate that the health-care system in his work on FGM, has been more widely access to practical and theoretical guidance in comparison to the other receiver groups represented. Conclusions The study shows that the National Board of Health and Welfare conveys a work against the tradition of individual, group and societal level. Information about FGM are broadly in line with previous research on the origin, presence, design and impact. The study shows that the National Board of Health and Welfare is a source of knowledge and information on the subject. However, there are differences in the practical guide to creating a basis for action. In the concrete work at the individual level, disparities, depending on whether the issue arises in healthcare or social services.

SAMMANFATTNING Bakgrund   Cirka 200 miljoner kvinnor lever världen över med någon form av könsstympning, och varje år utsätts 3.9 miljoner kvinnor i världen för detta ingrepp. Ingreppet utförs främst i afrikanska länder och vissa länder i mellanöstern. I och med den pågående migrationen kommer några av dessa kvinnor komma i kontakt med hälso- och sjukvården i de mottagande länder när de söker vård. Kvinnorna har olika upplevelser av vårdmötet beroende på hur de blir bemötta. Inom transkulturell omvårdnad är det en viktig förutsättning för sjukvårdspersonal att ha kunskap om andra kulturer, idéer och värderingar kring hälsa, ohälsa och omvårdnad. Syfte Att belysa upplevelser av mötet med hälso- och sjukvården hos kvinnor som tidigare genomgått könsstympning. Metod En icke-systematisk litteraturöversikt har genomförts baserat på 16 vetenskapliga artiklar av både kvalitativ och kvantitativ design. De inkluderade artiklarna har eftersökts i databaserna PubMed, CINAHL, Academic Search Elite och PsycINFO med relevanta sökord relaterat till studiens syfte. Resultat Vid sammanställning av resultatet framträdde tre huvudkategorier: Brist på kunskap om könsstympning hos sjukvården, Betydelsen av anpassad omvårdnad samt Informerande vårdmöten kan ändra kvinnans inställning till könsstympning. Utifrån de tre huvudkategorierna skapades två underkategorier där det beskrivs sviterna av vårdmötet i ursprungsländer och bristfälligt bemötande från vården i mottagande länder, vad det kan innebära för kvinnor som är könsstympade. Slutsats Några delar av hälso- och sjukvården är inte bereda att erbjuda kulturellt anpassad vård till kvinnor med könsstympning och därför bemöts kvinnorna av okunskap i vårdmötet. Att bli bemött på ett lyhört, empatiskt och respektfullt sätt gör att dessa kvinnor känner sig trygga i mötet med vården och att deras problem tas på allvar. En tillitsfull relation med vården kan vara ett verktyg för att bekämpa det fortsatta utförandet av ingreppet på framtida generationer av flickor och kvinnor. / ABSTRACT Background Around 200 million women worldwide live with some form of genital mutilation and the number is growing as 3.9 million women are being exposed to this procedure every year. The procedure is performed mainly in African countries and some countries in the Middle East. With the ongoing migration patterns, healthcare in the host countries will encounter more and more women living with some form of genital mutilation. The women have different experiences of their encounter with the health care system based on how they were treated. In transcultural nursing, it is an important prerequisite for healthcare professionals to have knowledge of other cultures and their ideas and values around health, sickness, and nursing.  Aim To highlight the experiences of women previously exposed to genital mutilation encounters with health care. Method A non-systematic literature review has been conducted based on 16 scientific articles of both qualitative and quantitative design. The included articles have been searched in four databases with keywords relevant to the purpose of the study.  Results The quality of selected articles was examined, and the content was analyzed to be compiled into three main categories: Lack of knowledge about genital mutilation within the healthcare system, The importance of tailored nursing as well as Informative meetings with healthcare providers can change the woman's attitude to genital mutilation. Based on the first main category, two subcategories were created: The outcome of encounters with healthcare in the country of origin and Unsatisfactory treatment from healthcare in the host countries.  Conclusions The encounter can be experienced in various ways by women who have undergone genital mutilation based on how they are treated by health care professionals. There are some parts of the meeting that carry more weight than others. Being treated in a responsive, empathetic, and respectful manner gives these women a feeling of safety during the encounter and that their health issues are taken seriously. A trusting relationship with health care can even be a way to fight the continuation of the tradition on future generations of girls.

No description available.

Foi realizado um estudo bioquímico, morfológico e morfométrico de células epiteliais da tuba uterina de bovinos na presença e ausência de soro fetal bovino in vitro. Para determinar os efeitos dos soro fetal bovino sobre as células foram utilizados como parâmetros sua influência sobre o crescimento, a morfologia qualitativa e quantitativa, o consumo de glicose, a síntese protéica, a atividade da fosfatase láctica e da deidrogenase láctica, em diferentes dias de cultivo. Nas eletromicrografias foram analisados os seguintes componentes celulares: núcleo, grânulos de secreção, mitocôndrias, retículo endoplasmático rugoso, aparelho de Golgi e outras estruturas citoplasmáticas. A cinética de crescimento foi maior na presença de soro. A microscopia eletrônica de transmissão evidenciou inicialmente dois tipos de células, as ciliadas e as secretoras que foram gradativamente diferenciando-se durante todo o tempo de cultivo, na presença e na ausência de soro fetal bovino. Na presença de soro observou-se uma monocamada confluente no dia cinco, enquanto na ausência do mesmo não se notou monocamada confluente até o final do experimento. Um terceiro tipo celular foi observado, tratava-se de uma célula da monocamada com microvilosidades. A análise morfométrica revelou que os três tipos celulares apresentaram diferenças significativas em alguns dos parâmetros avaliados. A análise bioquímica evidenciou algumas diferenças significativas no meio de cultivo. Pode-se concluir que o soro fetal bovino não interfere nas principais características morfológicas, mas sim na formação da monocamada e de certos parâmetros morfométricos e bioquímicos, talvez por apresentar componentes desconhecidos, tais como, proteínas, ácidos graxos, fatores de crescimento, aminoácidos e/ou vitaminas, sendo que a presença e concentração destes pode variar muito entre diferentes lotes, alterando o meio de cultivo. Estudos com outros suplementos ou mesmo fatores de aderência devem ser realizados visando um modelo in vitro que auxilie na compreensão das interações das células da tuba uterina com os gametas e embriões. / The biochemistry, morphology and morphometry study were performed in bovine tuba uterina epithelial cells in vitro with and without bovine calf serum. It has been observed the effects of bovine calf serum in the cells by growth, qualitative and quantitative morphology, glucose and protein source, acid phosphatase and lactica deidrogenase in differents days. It has been analysed some cell structures, like: nuclei, Golgi regions, rough endoplasmatic reticulum, mitochondria, secretory vesicles and others by the electron microscopy. The cell growth was higher with serum. The electron microscopy has showed two cells: the secretory and ciliated, both were differentiating during the experiment. The monolayers with serum was confluent in the day 5, but it has not happened the same without serum. The structural analysis of monolayer showed a cell with microvilli. The morphometry and biochemistry have showed significant differences in both cells and in the medium. Maybe it has been happened because the serum is an effective growth-promoting supplement. Therefore, more studies are needed with others supplements or attachment factors to have in vitro model that mimic in vivo conditions most closely to study the interactions between bovine tuba uterina epithelial cells and gametes or embryos