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

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

Inertial motion capture based teleoperation of a mobile robot manipulator with a multigrasp hand

Autonomous mobile robots are still not reliable enough for performing complex tasks such as search and rescue, space or undersea exploration and explosive ordnance disposal. Human intelligence is frequently employed for high-level robot decision making and control. Moreover, for most of the cases low-weight and dexterous end-effectors are required for performing delicate tasks efficiently

Inertial motion capture based teleoperation of a mobile robot manipulator with a multigrasp hand

Autonomous mobile robots are still not reliable enough for performing complex tasks such as search and rescue, space or undersea exploration and explosive ordnance disposal. Human intelligence is frequently employed for high-level robot decision making and control. Moreover, for most of the cases low-weight and dexterous end-effectors are required for performing delicate tasks efficiently

Sign segmentation with changepoint-modulated pseudo-labelling

The objective of this work is to find temporal boundaries between signs in continuous sign language. Motivated by the paucity of annotation available for this task, we propose a simple yet effective algorithm to improve segmentation performance on unlabelled signing footage from a domain of interest. We make the following contributions: (1) We motivate and introduce the task of source-free domain adaptation for sign language segmentation, in which labelled source data is available for an initial training phase, but is not available during adaptation. (2) We propose the Changepoint-Modulated Pseudo-Labelling (CMPL) algorithm to leverage cues from abrupt changes in motion-sensitive feature space to improve pseudo-labelling quality for adaptation. (3) We showcase the effectiveness of our approach for category-agnostic sign segmentation, transferring from the BSLCORPUS to the BSL-1K and RWTH-PHOENIX-Weather 2014 datasets, where we outperform the prior state of the art

Single dose of intra-muscular platelet rich plasma reverses the increase in plasma iron levels in exercise-induced muscle damage: A pilot study

Background Platelet rich plasma (PRP) therapy is widely used in enhancing the recovery of skeletal muscle from injury. However, the impact of intramuscular delivery of PRP on hematologic and biochemical responses has not been fully elucidated in exercise-induced muscle damage. The purpose of this investigation the effects of intramuscular delivery of PRP on hematologic and biochemical responses and recovery strategy muscle damage induced by high intensity muscle exercise (exercise-induced muscle damage, EIMD). Methods Moderately active male volunteers participated in this study and were assigned to a control group (control, n = 6) and PRP administration group (PRP, n = 6). The subjects performed exercise with a load of 80% one repetition maximum (1RM) maximal voluntary contraction of the elbow flexors until point of exhaustion of the non-dominant arm was reached. The arms were treated with saline or autologous PRP post-24 h EIMD. Venous blood samples were obtained in the morning to establish a baseline value and 1–4 days post-exercise and were analyzed for serum ferritin, iron, iron binding capacity (IBC), creatinine kinase (CK), lactate dehydrogenase (LDH), aspartate aminotransferase (AST), and alanine aminotransferase (ALT). Results The baseline levels of plasma iron, ferritin, IBC, CK, LDH, AST, and ALT were similar in both the control and PRP groups. However, 24-h following exercise a significant increase in these parameters was observed in both groups between 1 and 4 days during the recovery period. Interestingly, PRP administration decreased plasma iron levels compared to the control on the second day post-exercise. Plasma IBC increased in PRP group from Days 2 to 4 post-exercise compared to the control group whilst PRP administration had no effect on plasma ferritin, CK, AST, ALT, or LDH. Conclusion Acute exhaustive exercise increased muscle damage markers, including plasma iron, IBC, and ferritin levels, indicating muscle damage induced by exercise. PRP administration improves inflammation by reversing the increase in the iron levels post-exercise without displaying any myotoxicity and may have a role to play in the recovery of exercise-induced muscle damage

Preventing female genital mutilation in high income countries: A systematic review of the evidence

© 2019 The Author(s). Background: Female genital mutilation (FGM) is prevalent in communities of migration. Given the harmful effects of the practice and its illegal status in many countries, there have been concerted primary, secondary and tertiary prevention efforts to protect girls from FGM. However, there is paucity of evidence concerning useful strategies and approaches to prevent FGM and improve the health and social outcomes of affected women and girls. Methods: We analysed peer-reviewed and grey literature to extract the evidence for FGM prevention interventions from a public health perspective in high income countries by a systematic search of bibliographic databases and websites using appropriate keywords. Identified publications were screened against selection criteria, following the PRISMA guidelines. We examined the characteristics of prevention interventions, including their programmatic approaches and strategies, target audiences and evaluation findings using an apriori template. Findings: Eleven documents included in this review described primary and secondary prevention activities. High income countries have given attention to legislative action, bureaucratic interventions to address social injustice and protect those at risk of FGM, alongside prevention activities that favour health persuasion, foster engagement with the local community through outreach and the involvement of community champions, healthcare professional training and capacity strengthening. Study types are largely process evaluations that include measures of short-term outcomes (pre- and post-changes in attitude, knowledge and confidence or audits of practices). There is a dearth of evaluative research focused on empowerment-oriented preventative activities that involve individual women and girls who are affected by FGM. Beattie's framework provides a useful way of articulating negotiated and authoritative prevention actions required to address FGM at national and local levels. Conclusion: FGM is a complex and deeply rooted sociocultural issue that requires a multifaceted response that encompasses socio-economic, physical and environmental factors, education and learning, health services and facilities, and community mobilisation activities. Investment in the rigorous longitudinal evaluation of FGM health prevention efforts are needed to provide strong evidence of impact to guide future decision making. A national evidence-based framework would bring logic, clarity, comprehension, evidence and economically more effective response for current and future prevention interventions addressing FGM in high income countries

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

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

The role of men in abandonment of female genital mutilation: A systematic review

© 2015 Varol et al. Background: Men in their roles as fathers, husbands, community and religious leaders may play a pivotal part in the continuation of female genital mutilation (FGM). However, the research on their views of FGM and their potential role in its abandonment are not well described. Methods: We undertook a systematic review of all publications between 2004 and 2014 that explored men's attitudes, beliefs, and behaviours in regards to FGM, as well as their ideas about FGM prevention and abandonment. Results: We included twenty peer-reviewed articles from 15 countries in the analysis. Analysis revealed ambiguity of men's wishes in regards to the continuation of FGM. Many men wished to abandon this practice because of the physical and psychosexual complications to both women and men. Social obligation and the silent culture between the sexes were posited as major obstacles for change. Support for abandonment was influenced by notions of social obligation, religion, education, ethnicity, urban living, migration, and understanding of the negative sequelae of FGM. The strongest influence was education. Conclusion: The level of education of men was one of the most important indicators for men's support for abandonment of FGM. Social obligation and the lack of dialogue between men and women were two key issues that men acknowledged as barriers to abandonment. Advocacy by men and collaboration between men and women's health and community programs may be important steps forward in the abandonment process

Evidence to inform education, training and supportive work environments for midwives involved in the care of women with female genital mutilation: A review of global experience

© 2014 Elsevier Ltd. Objective: to identify how midwives in low and middle income countries (LMIC) and high income countries (HIC) care for women with female genital mutilation (FGM), their perceived challenges and what professional development and workplace strategies might better support midwives to provide appropriate quality care. Design: an integrative review involving a narrative synthesis of the literature was undertaken to include peer reviewed research literature published between 2004 and 2014. Findings: 10 papers were included in the review, two from LMIC and eight from HIC. A lack of technical knowledge and limited cultural competency was identified, as well as socio-cultural challenges in the abandonment process of the practice, particularly in LMIC settings. Training in the area of FGM was limited. One study reported the outcomes of an education initiative that was found to be beneficial. Key conclusions: professional education and training, a working environment supported by guidelines and responsive policy and community education, are necessary to enable midwives to improve the care of women with FGM and advocate against the practice. Implications for practice: improved opportunities for midwives to learn about FGM and receive advice and support, alongside opportunities for collaborative practice in contexts that enable the effective reporting of FGM to authorities, may be beneficial and require further investigation