Sahiyo Stories brought together women from across the United States to create personalized digital stories narrating the experience of undergoing female genital mutilation/cutting (FGM/C). FGM/C continues because people believe that if a girl does not undergo it, she will not grow up to be a "good woman." For centuries, then, women have been afraid to speak about FGM/C for fear of ostracization from their communities, getting loved ones in trouble, and other reasons. Sahiyo Stories shatters this silence and the digital stories collection is woven together by a united sentiment to protect future generations of girls from this harm.
Teaching about Human Rights: Female Genital Mutilation in America Abstract Increasing immigration from Asia, Latin America, Africa, and the Middle East has enhanced cultural diversity in the United States. The wide array of foods, languages, customs, and unique historical experiences associated with immigration have contributed to the political, social, and economic fabric of a multicultural democracy. However, immigrants may also bring certain cultural practices which violate American constitutional law and various state laws. Moreover, these practices, such as female genital mutilation (FGM), are incompatible with American ideals of equality, social justice, and human rights. Recent research indicates that an increasing number of girls and women in the United States have undergone or are at risk for various forms of FGM. This practice is also a violation of the Universal Declaration of Human Rights, signed by the United States in 1948. This article will describe the nature, causes, and consequences of FGM on girls and women and articulate social studies activities and methods that teachers can use to inform secondary students about this human rights issue. This may stimulate student activism, a major goal in social studies. Furthermore, the article will describe the legal and professional responsibilities teachers must take if they have students at risk of FGM in their classes.
INTRODUCTION: Female genital mutilation/cutting (FGM/C) refers to ritual surgical procedures performed that intentionally alter genitalia for nonmedical purposes. Female genital mutilation/ cutting is a lifelong problem for women that can have detrimental effects on menstruation, pregnancy, sexual health, and self-esteem. In 2016 the Centers for Disease Control and Prevention estimated 513,000 women and children in the United States were victims of or at risk for FGM/C. Currently, few studies discuss potential management options for FGM/C and their associated complications. Aims of this study are to review contemporary research on FGM/C, discuss current surgical therapies in the pediatric and adult populations, and draw attention to the urgent need for further education. METHODS: The authors conducted a literature review using PubMed, and identified 731 articles in the adult and pediatric populations. The articles were cross-referenced with 2 systematic reviews, and duplicates were discarded. Based on our criteria, 9 articles were included. RESULTS: Based on our findings, defibulation offers patients a better quality of life with a low rate of complication. Similarly, clitoral reconstruction has shown favorable results for treatment of FGM/C. Using the Female Sexual Function Index can better help standardize measurements of sexual health outcomes. Currently, established clinical guidelines are lacking and there is limited training on the recognition and treatment of FGM/C. CONCLUSIONS: This study supports clitoral reconstruction and defibulation as effective therapies for FGM/C. Reconstructive surgeons are at the forefront of developing and providing these surgical treatments. Further research including randomized controlled studies and long-term follow-up are needed to better elucidate the best therapeutic options.
Lavanya Easwaran, Sarah A. Eidelson, Anika Jain et al.
1. Introduction Although violence against children and adolescents is an extremely important issue for society, it is still a topic that is not much debated in Brazil. Currently in Brazil, complaints of violence against children and teenagers are made in several different places and there is no program to regulate and follow on those complaints. As a result, in several cases there is no knowledge of how those cases ended. In Brazil, in cases of suspicion or confirmation of violence against children and teenagers, the notification is mandatory according to article 13 of Law number 8069/1990 - Child and Adolescent Statute. …
BACKGROUND: Indigenous children are overrepresented in the child protection system in Canada, particularly in Nunavik, Quebec, where Inuit children face significant risks of being placed outside their communities. Previous studies have often centered on service providers or the perspectives of non-Indigenous foster families, neglecting the voices of Inuit foster parents themselves. OBJECTIVE: This study explored the motivations and experiences of Inuit foster parents in Nunavik for becoming and remaining foster parents, as well as factors that could lead to a cessation of care provision. PARTICIPANTS AND METHODS: Fifteen Inuit foster parents (12 women, 3 men) from various communities in Nunavik participated in semi-structured interviews. Interviews were analyzed using inductive thematic analysis. RESULTS: Key motivations for fostering included keeping children within the family, preserving cultural identity, and respecting the child's preferences. Foster parents reported significant challenges, including a lack of support from child protection services and dealing with trauma. CONCLUSIONS: The study highlights the critical role of Inuit foster parents in maintaining cultural continuity for Inuit children and underscores the need for supportive policies and practices that recognize their motivations and values. Enhanced support and culturally sensitive approaches are essential to improve the recruitment and retention of Inuit foster parents.
OBJECTIVE: to understand the perception of teachers and health professionals regarding the use of the Play Nicely Program for parents/caregivers in the prevention of violence against children. METHOD: a descriptive and exploratory qualitative study was conducted through three focus groups with twenty primary school teachers and primary health care professionals who implemented the Program for parents/caregivers in 2022. The data analysis was guided by French discourse analysis, interpreted through the lens of Urie Bronfenbrenner's theory. RESULTS: three categories emerged from the participants' perceptions: innovation and utility; theory applicability in practice; reinterpreting attitudes of austerity and impatience towards children; disciplining rather than punishing children: dilemmas and challenges. The testimonies highlighted that the Program is innovative, easily accessible, clear in language, and easy to apply in practice for parents/caregivers. CONCLUSION: the use of the Program added knowledge and fostered positive attitudes toward the development of the bioecological system in addressing and preventing violence against children.
Janaína Recanello Begui, Andressa Larissa Dias Müller de Souza, Naiara Barros Polita et al.
Social movements, such as the “#MeToo movement,” have the potential to foster awareness and inspire policy and advocacy efforts regarding issues that impact physical, mental, and emotional health. News stories surrounding the #MeToo movement have most noticeably been focused on sexual violence against women in entertainment, media, and politics. Nonetheless, the #MeToo movement has led to an increased recognition of and empathy for victims of sexual violence across society.1 The movement started in 2006 when Tarana Burke, a civil rights activist, coined the phrase “#MeToo” as a means of creating solidarity among victims of sexual violence.1 As accusations accumulate throughout Hollywood; Washington, DC; and the world, Burke’s circle of solidarity has been widened substantially. The movement has gained such significance that those at TIME magazine chose the “Silence Breakers” as the 2017 Persons of the Year.1 In the magazine, Burke and those (particularly celebrities) who have courageously disclosed their traumatic experiences and demonstrated support for and solidarity with other victims were highlighted.1The #MeToo movement has become widespread and potentially transformational; however, there is potential for further progress. As health care providers for children, we hope the movement can be expanded and used to focus attention toward the sexual violence that children, both girls and boys, experience. According to the Centers for Disease Control and Prevention, 42.2% of all women who are sexually assaulted in the United States experienced their first assault before they reached 18 years old.2 Sexual violence against children encompasses a broad spectrum of exploitative as well as nonexploitative sexual acts ranging from online and off-line harassment to forced sexual intercourse3 and permeates our entire nation and global community. In the most recent United Nations International Children’s Emergency Fund report on global violence against children, it is estimated that 120 million girls (10% of girls) have been forced to conduct sexual acts at some point in their lives, with the majority of adolescents admitting to experiencing their first act between 15 and 19 years old and 20% experiencing their first act between 10 and 14 years old.3 More than 70% of children do not disclose their experiences or seek help or services to obtain treatment or prevent additional episodes.3 Furthermore, the United Nations International Children’s Emergency Fund report reveals that in the United States, ∼35% of girls and 20% of boys have experienced sexual violence before their 18th birthday.3 A clear opportunity has arisen, and the pediatric community stands in position as the ideal advocate to increase awareness of sexual violence against children.The pediatrician has many potential roles in increasing awareness of sexual violence against children. From a clinical perspective, practitioners should remain up to date on the evidence-based literature, particularly the various clinical guidelines on the evaluation of children who are exposed to sexual violence.4,5 Per the guidelines from the American Academy of Pediatrics, if a patient and caregiver present with a concern of sexual abuse, the clinician should interview and examine the patient alone without the caregiver present in a trustworthy, nonjudgmental, and objective manner.4 Child victims of sexual violence face many difficult challenges in reporting their experiences, particularly if they have caregivers who do not believe them, which can lead to self-blame.5 Just as the #MeToo movement has led to an emphasis on trusting women and believing their experiences, we must do the same with girls and boys who are traumatized. In most cases, the pediatrician’s primary responsibility will be to determine if there is adequate concern of sexual violence to make necessary referrals to the appropriate government agencies and specialty child maltreatment clinics.4 Such multidisciplinary clinics provide comprehensive, trauma-informed medical and forensic evaluations.5 However, if neither a specialty clinic nor child abuse expert is available, the general clinician’s responsibilities in evaluating and managing these patients will likely be expanded. In such cases, proficiency in the clinical guidelines on sexual violence would be even more important.4Pediatricians and their colleagues may also take on broader nonclinical roles in increasing awareness of sexual violence against children. Clinicians may educate children, parents, teachers, and other adult caregivers about the prevention, recognition, and appropriate response to sexual violence against children. Potentially relevant topics include the dangers of online sexual predators and dating violence in teenagers. Practitioners can also use medical education to teach trainees how to appropriately screen for and recognize sexual violence among patients in their practices.Pediatricians can advocate for and impact policy at all levels of government. They can work with various local governmental agencies to help educate caregivers and children about sexual violence. At the state and federal levels, pediatricians and advocates can inform politicians about the acute and chronic health impacts of sexual violence on our children as well as its economic consequences. A 2014 study by the Centers for Disease Control and Prevention revealed significant economic costs and losses associated with child maltreatment in the hundreds of billions of dollars; factors include increased health care, child welfare, and criminal justice expenditures and productivity losses.6 Advocates may also engage with federal policy makers about the importance of continuing to support and fund legislation already in place that is focused on preventing and responding to sexual violence, including the Violence Against Women Reauthorization Act of 2013 and the Family Violence Prevention and Services Act.7Moreover, policy makers should be encouraged to continue to create new legislation in response to newly exposed threats that make our children vulnerable. The episode regarding Larry Nassar, a physician at Michigan State University and team doctor for United States of America Gymnastics who was accused and convicted of sexually abusing 150 young athletes, serves as an example. Less than 1 week after Nassar’s sentencing, the US House of Representatives passed new legislation (US Federal Bill S.534) that was used to install additional protections and remedies for young amateur athletes who are victims of abuse.8 This episode also reveals the unsettling realization that perpetrators of sexual violence against children exist within our health care profession, and we have a responsibility to recognize and report concerning behaviors when they occur within our professional community.Given the global nature of sexual violence against children, there is a need to advocate for the health of children worldwide. The US government plays a critical role in global child-health initiatives and programs. Therefore, pediatricians may advocate at the federal level for the maintenance of global-health funding even in the wake of political uncertainty. Such efforts at the federal level require collaboration with other advocates, professional societies, and nonprofit organizations. From a policy and research standpoint, specific goals that can be emphasized in combatting sexual violence against children globally include enhancing the surveillance of both online and off-line sexual violence and educating adult caregivers and communities to change specific cultural norms, which have been drivers for violence against children globally.3It is critical that through their various clinical, research, educational, and advocacy roles, pediatricians continue to increase awareness of sexual violence against children just as the #MeToo movement has done for women. The #MeToo movement has been particularly effective because it has led to an emphasis on women’s autonomy, giving women the power to choose when and how they disclose their experiences of sexual violence and creating solidarity. Because of legal restrictions and mandated reporting laws, children don’t have that same autonomy and consequential solidarity. In the absence of this autonomy and agency, pediatricians are in the ideal position to represent and protect these children.
Nickolas Theophilos Agathis, Carolyn Payne, Jean L. Raphael
OBJECTIVE: This study sought to evaluate the effectiveness of Family Nurture Intervention (FNI) in the NICU on enhancing early brain activity of preterm infants. This unit-wide implementation of FNI is referred to as Family Nurture Care (FNC). METHODS: This was a single-center prospective phased effectiveness study conducted in two sequential phases in the NICU (NCT03267043). In Phase I, all mother-infant dyads received the baseline standard care (SC), and in Phase II, all mother-infant dyads received SC supplemented with FNC starting at NICU admission. Preterm infants (25-34 weeks gestational age) and their mothers were eligible for participation. Preterm infants (25-34 weeks gestational age) were sequentially assigned to receive standard care (SC, Phase I) or FNC (Phase II) during their NICU stay. The primary outcome was EEG power assessed at two ages, ∼35 weeks (SC, n = 34; FNC, n = 28) and near to term (SC, n = 28; FNC, n = 27). FNC consisted of repeated calming sessions (∼3 times/week) facilitated by nurture specialists during which mothers engaged in emotional expression during clothed or skin-to-skin holding, vocal soothing, and eye contact. EEGs were collected from 128 leads. EEG power was computed using fast Fourier transforms. RESULTS: Infants receiving FNC were found to have significantly higher brain activity (EEG power) at 35 weeks in the left frontal polar region. The effects at lower frequencies 4-15 Hz ranged from 26% to 44% with effect sizes exceeding 0.60. CONCLUSIONS: FNI is practicable as standard of care in the NICU and leads to enhanced brain activity early in life. SIGNIFICANCE: FNC is designed to facilitate the emotional connection and coregulation between mothers and infants in the NICU, resulting in profound effects on early brain development.
Christiana Farkouh‐Karoleski, Michael M. Myers, Philip G. Grieve et al.
Every family who enters a hospital is on a personal journey. The awareness of that particular journey allows us to make more intentional and purposeful choices about how health and medical professionals want to be spiritually involved with each child and family. Spiritual care for sick children raises an important concern for health and medical professionals. The purpose of this article is to introduce the role of children’s spirituality in administering intentional spiritual care for the hearts, minds, and spirits of sick children and their families in health care settings. Characteristics and principles of intentional spiritual care are discussed along with a variety of activities and interventions healthcare professionals can use effectively when taking care of the spiritual needs of young patients in hospitals. By conducting an ethnographic research study and collecting data as a participant-observer, the author documented activities with hospitalised children and how medical personnel nurtured and supported their spiritual domain.
