<p>The problem of vesico-vagina fistula still remains a ravaging scourge in resource-poor countries of which Nigeria is visibly prominent. A majority of the cases are attributed to prolonged complicated labour due to inaccessibility of adequate and immediate obstetric health care. Complicated labour arises as a result of narrow pelvis bones of victims due to suffering from poor nutrition. While the above factors are noted as the direct cause to the prevalent of VVF, there are other socio-cultural conditions which predispose victims to this disease. Notable among them are the following: poverty; marital age; illiteracy; hazardous traditional practices, such as female circumcision. VVF victims often live an unworthy life. Many of them have been abandoned or divorced by their husbands and become ostracised by families and societies because of their repulsive smell and inability to engage in sexual activity and bear children. VVF victims suffer both physical and social consequences, many of them find it difficult to engage in any economic activity, surviving the hardship is very complicated and pathetic; some victims turn to street begging, while others survive through hawking of “bagged” water and selling firewood.</p><p>Most studies conducted on the problem of Vesico vaginal fistula are done from the medical perspectives, often neglecting the psycho-social consequences faced by the sufferers. This study, however, discusses the socio-cultural and the psychological consequences of the disease. Locally and internationally, attempts are being made to eradicate the problem of VVF, however, if the Nigerian government does not recognise the incidence of VVF as a major public health issue, it will continue to ravage lives of Nigerian women, hence increasing maternal mortality in the country. This study proffers recommendations to help eradicate or alleviate the problem in Nigeria.</p>

Background: The purpose of the present study was to investigate the prevalence and characteristics of deliberate self-harm in a Swedish University population. Method: A random sample of first year students at University of Kalmar was invited to participate in an Internet-based survey in the autumn of 2007. A total of 139 (53,1 %) completed the anonymous survey. Results: The results showed that 25,2 % (n=35) of the students reported having engaged in some kind of deliberate self-harm at least once, and deliberate self-harm was endorsed by 7,9 % within the past year. The most frequently procedures to self-harm were to tear, carve or pinch self, cutting skin and hitting self on purpose. 37,1 % reported that they had told no one about their self-injurious behaviors and 36,4 % significantly reported that they had no one they trusted and who they could talk to if they were concerned about something. Students with self-injurious behavior were also more likely to report a history of emotional, sexual and/or physical abuse, alcohol and drug use, cut classes and questioning their sexual orientation. Conclusions: Findings suggest that self-harm is associated with risk factors and that self-injury is not only associated with adolescence but also with adulthood. It is therefore important to continue studies in both populations.

Thesis (D.Psyc.(Clin.))--University of Wollongong, 2008. / Typescript. Includes bibliographical references: leaf 70-81.

<p>Background: The purpose of the present study was to investigate the prevalence and characteristics of deliberate self-harm in a Swedish University population.</p><p>Method: A random sample of first year students at University of Kalmar was invited to participate in an Internet-based survey in the autumn of 2007. A total of 139 (53,1 %) completed the anonymous survey.</p><p>Results: The results showed that 25,2 % (n=35) of the students reported having engaged in some kind of deliberate self-harm at least once, and deliberate self-harm was endorsed by 7,9 % within the past year. The most frequently procedures to self-harm were to tear, carve or pinch self, cutting skin and hitting self on purpose. 37,1 % reported that they had told no one about their self-injurious behaviors and 36,4 % significantly reported that they had no one they trusted and who they could talk to if they were concerned about something. Students with self-injurious behavior were also more likely to report a history of emotional, sexual and/or physical abuse, alcohol and drug use, cut classes and questioning their sexual orientation.</p><p>Conclusions: Findings suggest that self-harm is associated with risk factors and that self-injury is not only associated with adolescence but also with adulthood. It is therefore important to continue studies in both populations.</p>

Studien handlar om självskadebeteende. Syftet med undersökningen var att få reda på vilka yttre faktorer som påverkade tre unga tjejer att börja skada sig själva. Forskningen på området anser att personer börjar skada sig själva pågrund av sexuella övergrepp i ung ålder, men det framgår tydligt i resultatet att sexuella övergrepp i detta fall inte påverkade tjejerna i studien. Till grund för tjejernas destruktiva beteende ligger traumatiska händelser i deras uppväxt både i lågstadieålder samt högstadieålder. Metoden som användes i studien var semistrukturerade intervjuer eftersom intervjuaren då kan rikta sin fulla uppmärksamhet mot respondenten. Resultatet är utformat på ett narrativt sätt vilket gjorde att resultatet kunde presenteras i berättelseform. I resultatet framkom vilka yttre påverkansfaktorer som påverkade tjejerna att börja skada sig, som till exempel föräldrars skilsmässa, eller plötslig död i deras nära omgivning.

Kvinnlig könsstympning utförs idag i cirka 30 länder i Afrika, Asien och Sydamerika. Omkring 200 miljoner kvinnor och flickor antas idag vara könsstympade och cirka tre miljoner utsätts årligen. Proceduren innefattar alla typer av ingrepp på det kvinnliga yttre könsorganet som inte är medicinskt motiverat. Kvinnlig könsstympning ger svåra komplikationer och leder i värsta fall till döden. Skälen till varför det utförs varierar, det handlar ibland om kulturella traditioner eller religiösa ritualer och ibland enbart för att kontrollera kvinnans sexualitet. Ingreppet är i de flesta västerländska länder, däribland Sverige, olagligt. Syftet var att belysa kunskaper och attityder hos sjukvårdspersonal gentemot kvinnlig könsstympning.En litteraturöversikt enligt Friberg har utförts. Sökningarna har gjorts i databaserna Academic Search Complete, CINAHL Complete och PubMed. Elva artiklar valdes ut; fem kvantitativa, fyra kvalitativa och två med mixad metod. I resultatet framgick att det var brist på kunskaper om kvinnlig könsstympning hos sjukvårdspersonal. Attityden kring kvinnlig könsstympning skiftade men de flesta ansåg att det var mot mänskliga rättigheter. I länder där sedvänjan praktiseras upplevdes sjukvårdspersonal ambivalenta. Den globala migrationen ökar. Trots det finns det väldigt lite kunskaper om kvinnlig könsstympning hos sjukvårdspersonalen världen över. Attityden kring kvinnlig könsstympning skiftar, både i länder där det praktiseras och i länder där det inte praktiseras. Bristen på information under utbildningen uppges vara en anledning till att sjukvårdspersonalen inte vet hur de ska bemöta en kvinna som utsatts för könsstympning. Resultaten diskuteras i linje med Leiningers teori om det transkulturella omvårdandet. / Female genital mutilation is performed in about 30 countries in Africa, Asia, and South America. Nearly 200 million girls and women have undergone circumcision and annually 3 million are at risk. Female genital mutilation includes all forms of harm towards the outer female genitals without any medical indications. It results in severe complications and is even fatal. The reasons vary, sometimes they are explained as cultural traditions or religious traditions, and sometimes just to control women's' sexuality. The procedure is illegal in most western countries, Sweden included. The aim was to illuminate knowledge and attitudes among health care professionals regarding female genital mutilation. A literature review was conducted according to Friberg. Three databases were used: Academic Search Complete, CINAHL Complete and PubMed. This resulted in five quantitative articles, four qualitative articles and two with mixed method. The main findings were that there is a lack of knowledge among health care professionals. Also, attitudes differ but many of the participants agreed that it is violating human rights. In practicing countries there were often ambivalent feelings towards female genital mutilation. Even though the global migration is as high as ever, the knowledge among health care professionals is insufficient. The attitudes differ, both in countries where the tradition is practiced and in countries where it is not practiced. The lack of educational information is mentioned as a reason to why health care professionals feel unsure on how to handle meeting a mutilated woman. The results were discussed with Leininger's nursing theory as a model.

The current study is motivated by the relative lack of research on the contagion of deliberate self-harm, research on self-harm among adolescents in children's homes, as well as South African research on self-harm. In this study, I explore three aspects concerning deliberate self-harm in the South African context: The perceptions of adolescents in children's homes concerning the possible contagion of self-harm; the frequency, methods, duration and severity of self-harm among adolescents in children's homes; and lastly, the motivations of adolescent self-harm in children's homes. I make use of both quantitative measures, being the Deliberate Self-Harm Inventory (DSHI) developed by Gratz (2001) and the Functional Assessment of Self-Mutilation (FASM) developed by Lloyd (1997), and qualitative measures, being the logbooks completed by participants and three semi-structured interviews conducted, to address these questions. The current study uses both the functional approach to deliberate self-harm, that classifies self-harm according to the four functions that produce and maintain such behaviour, and the environmental model that emphasises the situational influences on the contagion of deliberate self-harm. The findings of the study indicate that 10 of the 12 adolescent participants have experienced either the acquisition or episodes of co-occurrence of self-harm through contagion, both outside the children's homes and within the children's homes. The contagion of self-harm is influenced by the desensitisation and growing prevalence of self-harm, frequent observations of self-harm, close personal relationships between individuals who selfharm, and the influence of the visual media. With regard to the findings of the DSHI, the methods most commonly employed for self-harm in the study include cutting, carving words into the skin, as well as the breaking of bones; the majority of the methods had been employed by the participants within the last year; and the emotions present immediately prior to the episode of self-harm include anger, depression, sadness, frustration, anxiety and disappointment. Findings from the FASM indicate that the motivation for the majority of the adolescent participants' self-harm is 'to stop bad feelings'. Furthermore, the findings of the study indicate that psychological intervention may be available to adolescents in several situations; that the personal histories of the adolescent participants include experiences of physical, emotional and sexual abuse, parental unavailability, the observation of parental alcoholism, as well as the experience of human trafficking; and suicide attempts have been made by the participants following instances of perceived ineffectiveness of self-harm. From the findings, it is evident that the contagion of self-harm is no longer a hypothetical phenomenon. Further implications of the study include the need for continued research on the methods reported by South African individuals who engage in self-harm that are not as prevalent in other research; and the influence of the study on the development and implementation of interventions to address self-harm in children's homes. Copyright / Dissertation (MA)--University of Pretoria, 2012. / Psychology / unrestricted

Bakgrund: Kvinnlig könsstympning är en gammal tradition där delar av könsorganet avlägsnas och ibland sys ihop. Det icke-medicinska ingreppet utförs på kulturella grunder och syftar till att kontrollera sexualiteten och omvandla flickan till kvinna. Trots att ingreppet bryter mot de mänskliga rättigheterna beräknas 140 miljoner kvinnor världen över vara könsstympade. Det är därför relevant för sjuksköterskor att införskaffa sig kunskap om de vårdbehov som kan finnas hos denna grupp kvinnor.  Syfte: Att beskriva kvinnors upplevelser efter att ha genomgått könsstympning.  Metod: Litteraturöversiktens material utgörs av tolv kvalitativa och två kvantitativa studier. Databaserna som användes var Cinahl Complete, PsykINFO och Medline.  Resultat: Resultatet delades in i fyra teman; att känna rädsla och smärta i nära relationer, att mötas med förståelse men också brist på kunskap, att känna sig påverkad själsligt och kroppsligt samt att känna utanförskap men behöva samhörighet.  Slutsats: Kvinnor som lever med könsstympning upplever sig ha blivit stigmatiserade och fråntagna bestämmanderätten över sin kropp i möten med vården. Kunskapsbrist hos vårdaren har lett till känslor av otrygghet och rädsla hos kvinnorna. Då majoriteten lever med fysiska och psykiska konsekvenser från ingreppet behöver vården ha kompetens för att möta dessa kvinnor. Upplevelser av smärta och ångest i sexuella och sociala möten med partnern tydliggör även att omvårdnaden måste omfatta hela familjen. En bredare syn på sex påverkade kvinnornas upplevelser av att ha en god sexuell hälsa. / Background: Female circumcision is an old tradition where parts of genitalia are removed and sometimes sewn together. The non-medical procedure is performed on cultural grounds and aims to control sexuality and to transform the girl into a woman. Despite the violation of human rights an estimated 140 million women worldwide are genitally mutilated. It is therefore relevant for nurses to gain knowledge about the health interventions needed for this group of women. Aim: To describe women’s experiences after genital mutilation. Method: The material in this literaturereview consists of twelve qualitative and two quantitative studies. The databases used were Cinahl Complete, PsykINFO and Medline. Results: Four themes occurred; to feel fear and pain in close relationships, to be met with understanding but also lack of knowledge, to feel affected mentally and physically and to feel exclusion but need belonging. Conclusion: Women living with genital mutilation feel stigmatized and deprived of the right to decide over their own bodies in encounters with healthcare. Lack of knowledge by the caregivers has led to feelings of insecurity and fear. As the majority live with physical and mental consequences from the procedure, the caregivers need competence to meet the womens needs. Experiences of pain and anxiety in sexual and social encounters with partners also makes it clear that the health interventions must adress the whole family. A broader view of sex affected the womens view on having a good sexual health.

Many attempts have been made to eradicate female genital mutilation over the past decades, yet the sustained practice continues to be a risk for women’s health and agency. In Kenya, an intervention with increasing proliferation is the alternative rites of passage. The approach has existed for some time, however little and highly contextual research has been produced around it. This thesis examines the general characteristics of an alternative rite of passage by combining primary and secondary data. Interviews were conducted with Kenyan professionals working with alternative rites of passage, as well as a systematic literature review. The findings demonstrate the balance between individual agency and social structure among the different actors usually included in the approach. In both instances, the notion of power is presented through the many perceived costs and benefits of female genital mutilation. Rather than focusing solely on the girls at risk of being cut, the alternative rite of passage is a pursuit to reframe the role of culture in targeted communities. Alternative rites of passage are often a systematic and longer process defined by communication, based on rational choice, external influences, and community validation. This thesis serves as an introduction to understanding the present alternative rites of passage in Kenya. By expanding the knowledge of an approach still at an early stage, it is possible for future research to study its effectiveness and long-term consequences on girls at risk of female genital mutilation.

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