Revelations of ancient head shape: Cranial modification in the Cuzco region of Peru, Early Horizon to Inca Imperial Period.

OBJECTIVES: Cranial vault modification (CVM), the intentional reshaping of the head, indicated group affiliation in prehistoric Andean South America. This study aims to analyze CVM data from the Cuzco region of Peru to illuminate patterns of early migration and settlement along with the later impact of the Inca Empire (AD 1438-1532) on the ethnic landscape. MATERIALS AND METHODS: 419 individuals from 10 archaeological sites spanning over 2300 years were assessed for CVM using morphological analysis. RESULTS: CVM patterns show distinct temporal attributes: the tabular type of modification appeared first and dominated the early sample (900 BC-AD 600), followed by an influx of unmodified crania during the Middle Horizon (AD 600-1000). The annular type appeared later during the Late Intermediate Period (AD 1000-1438). In the subsequent period of Inca imperialism, modification rates were higher at sites in the Cuzco countryside than in Cuzco city sites. DISCUSSION: The study results, combined with archaeological and ethnohistoric data, reveal the sociopolitical transformations that occurred prior to and during the rise of the Inca Empire. The influx of unmodified crania during the Middle Horizon resulted at least partly from Wari occupation, while the appearance of the annular type during the LIP points to migration into the area, possibly from the Lake Titicaca region. In the Inca Imperial Period, Inca individuals at Cuzco city sites refrained from modification as a sign of their ethnic identity, while modification patterns in the Cuzco countryside likely reflect state-coerced resettlement of different ethnic groups.

Penile implants and other high risk practices in French Guiana's correctional facility: A cause for concern.

BACKGROUND: Prisoners in French Guiana, a French territory located in South America, have a HIV and hepatitis B prevalence of 4%. Body modifications such as penile implants, tattoos, and body piercings are common among detainees, increasing the risk of blood-borne virus transmission. METHODS: We conducted a cross-sectional randomised survey in which the primary objective was to estimate the prevalence of high risk 'bloody practices' (penile implants, tattoos, body piercings) in French Guiana's only correctional facility. The secondary objective was to describe the risk factors for penile implants, the procedures and motivations for insertion, the reported complications, their risk factors and adverse impact on condom use. RESULTS: Of the 221 male inmates interviewed, 19% had tattoos or body piercings while incarcerated, and 68% had penile implants, of which, 85% had been inserted inside the correctional facility. Addictive behaviors such as cannabis use and alcohol addiction (positive AUDIT-C score), early age at first sexual intercourse, and the number of incarcerations correlated positively with having inserted one or more penile implants while incarcerated. In contrast, having reported previous psychiatric hospitalizations and having a high knowledge score for HIV/AIDS and sexually transmitted infections (STIs) were negatively correlated with the insertion of penile implants while incarcerated. Penile implants were inserted in poor hygienic conditions, usually using the sharp lid of a canned food container, with 18% of early complications, mostly haemorrhage and edema. Condom use was negatively impacted for 52% of men with penile implants. CONCLUSIONS: Our results highlight the need for prevention interventions which should aim at increasing knowledge levels and at implementing comprehensive risk-reduction measures.

Pierced identities: Body modification, borderline personality features, identity, and self-concept disturbances.

Little is known about the connection between body modification and borderline personality disorder (BPD). This study investigated the relation between a wide range of body modification practices (piercing, tattooing, scarification, pubic hair removal, and cosmetic surgery) and BPD features, with a special focus on identity and identity dysfunction, in an adult community sample (N = 330). Results indicated BPD features were positively correlated with total number of body modifications and breadth of body modification practices endorsed, as well as, specifically, increased piercings, tattoos, and scarifications. Furthermore, identity problems (i.e., identity diffusion and low self-concept clarity) were associated with body modifications. Implications of these findings are discussed, including their heuristic value in understanding body modification in light of its connection to BPD (and particularly identity/self-concept functions). (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Traditional uvulectomy, a common practice in South Kivu in the Democratic Republic of Congo.

BACKGROUND: Traditional uvulectomy in children, a very common and dangerous practice, remains poorly documented in the Democratic Republic of Congo (DRC). The aim of this study was to establish the epidemiological and clinical profile of children after a traditional uvulectomy and to determine their outcome of the children after this practice in 2 pediatric emergency unities in South Kivu province, DRC. METHOD: This was a cross-sectional study took place conducted in 2 pediatric emergency unities in Bukavu town, in South Kivu province, throughout from January to December 2016. It included all children from 0 to 15 years of age. The usual statistical measures (frequenciesy, percentages, means, and medians) were used. Differences in group proportions and categorical variables were assessed withusing the chi-square test. These different tests were considered statistically significant at P < 0.05. FINDINGS: In all, A total of 1078 children were admitted to these pediatric emergency departments during the study period, including 202 cases of traditional uvulectomy, forgiving a prevalence of 18.7% among admissions. The median age of the children was 11 (1-168) months. Of the mothers who resorted to this practice, 153 One hundred fifty-three (75.7%) mothers who resorted to this practice had a low level of education. The main reasons for this practice were fever (50%), vomiting (15.8%), and refusal to suckle (12.4%). The mortality rate after uvulectomy was 11.9%. Risk factors associated with mortality following traditional uvulectomy were HIV infection ([OR (95 % CI) 3.16, 95% CI (1.28-7.79); P = 0.040] and acute malnutrition ([OR (95% CI) 2.87, 95% CI (1.28 - 6.43); P = 0.024)]. CONCLUSION: The prevalence of traditional uvulectomy and the mortality rate after traditional uvulectomy both remain high. Information, education, and communication campaigns on this practice must be developed in order to reduce this scourge.

Adolescent and Young Adult Tattooing, Piercing, and Scarification.

Tattoos, piercing, and scarification are now commonplace among adolescents and young adults. This first clinical report from the American Academy of Pediatrics on voluntary body modification will review the methods used to perform the modifications. Complications resulting from body modification methods, although not common, are discussed to provide the pediatrician with management information. Body modification will be contrasted with nonsuicidal self-injury. When available, information also is presented on societal perceptions of body modification.

[Use of industrial liquid silicone to transform the body: prevalence and factors associated with its use among transvestites and transsexual women in São Paulo, Brazil]. / Silicone líquido industrial para transformar o corpo: prevalência e fatores associados ao seu uso entre travestis e mulheres transexuais em São Paulo, Brasil.

This study aimed to estimate the prevalence of use of industrial liquid silicone (ILS) among transvestite persons and transsexual women and identify associated factors. This was a cross-sectional study in seven municipalities in São Paulo State, Brazil, with data collected in 2014 and 2015 in a sample of 576 individuals. Analysis of the associated factors used a Poisson model with robust variance to estimate the crude and adjusted prevalence ratios. Prevalence of use of ILS was 49%, mean age at first injection of ILS was 22 (± 5.3) years, and 43% reported health problems resulting from its use. Having less than a university education, age 20 years and older, self-identification as transvestite, and sex work were positively associated with use of ILS according to the multivariate model. There was a high prevalence of ILS use and resulting health problems, indicating the need to prevent its use and reduce the resulting health problems. It is thus essential to ensure access to the necessary resources for body changes during transition through comprehensive care for transvestites and transsexual persons in the Brazilian Unified National Health System (SUS). Finally, health policies should include demands for body changes as part of gender identity construction, respecting each person's unique needs in this transition process.

Silicone líquido industrial para transformar o corpo: prevalência e fatores associados ao seu uso entre travestis e mulheres transexuais em São Paulo, Brasil / Use of industrial liquid silicone to transform the body: prevalence and factors associated with its use among transvestites and transsexual women in São Paulo, Brazil / Silicona líquida industrial para transformar el cuerpo: prevalencia y factores asociados a su uso entre travestis y mujeres transexuales en São Paulo, Brasil

O objetivo deste trabalho foi estimar a prevalência do uso de silicone líquido industrial (SLI) entre pessoas travestis e mulheres transexuais e identificar os fatores relacionados a esta prática. Trata-se de estudo transversal realizado em sete municípios do Estado de São Paulo, Brasil, com dados coletados entre 2014 e 2015, em uma amostra de 576 pessoas. Na análise dos fatores associados, utilizamos o modelo de Poisson com variância robusta para estimar as razões de prevalências bruta e ajustada. A prevalência do uso de SLI foi de 49%, a média de idade para a primeira colocação de SLI foi de 22 (± 5,3) anos e aproximadamente 43% informaram a ocorrência de problemas de saúde decorrente do uso. No modelo múltiplo ter escolaridade menor que o nível superior, estar em faixa etária a partir dos 20 anos, identificar-se como travesti e exercer a prostituição foram associados positivamente com a utilização de SLI. Houve uma elevada prevalência do uso de SLI e de problemas decorrentes desta prática, indicando um desafio acerca da prevenção do uso e da redução dos danos à saúde provocados pelo SLI. Dessa forma, torna-se fundamental assegurar o acesso aos recursos necessários para a realização das modificações corporais ao longo do percurso de transição por meio de uma atenção integral à saúde das pessoas travestis e transexuais no Sistema Único de Saúde. Finalmente, incluir nas políticas de saúde as demandas por modificações corporais como parte da construção da identidade de gênero, respeitando as necessidades singulares de cada pessoa neste processo de transição.

This study aimed to estimate the prevalence of use of industrial liquid silicone (ILS) among transvestite persons and transsexual women and identify associated factors. This was a cross-sectional study in seven municipalities in São Paulo State, Brazil, with data collected in 2014 and 2015 in a sample of 576 individuals. Analysis of the associated factors used a Poisson model with robust variance to estimate the crude and adjusted prevalence ratios. Prevalence of use of ILS was 49%, mean age at first injection of ILS was 22 (± 5.3) years, and 43% reported health problems resulting from its use. Having less than a university education, age 20 years and older, self-identification as transvestite, and sex work were positively associated with use of ILS according to the multivariate model. There was a high prevalence of ILS use and resulting health problems, indicating the need to prevent its use and reduce the resulting health problems. It is thus essential to ensure access to the necessary resources for body changes during transition through comprehensive care for transvestites and transsexual persons in the Brazilian Unified National Health System (SUS). Finally, health policies should include demands for body changes as part of gender identity construction, respecting each person's unique needs in this transition process.

El objetivo de este trabajo fue estimar la prevalencia del uso de silicona líquida industrial (SLI) entre personas travestis y mujeres transexuales e identificar los factores relacionados con esta práctica. Se trata de un estudio transversal, realizado en siete municipios del estado de São Paulo, Brasil, con datos recogidos entre 2014 y 2015, en una muestra de 576 personas. En el análisis de los factores asociados, utilizamos el modelo de Poisson con variancia robusta para estimar las razones de prevalencias bruta y ajustada. La prevalencia del uso de SLI fue de un 49%, la media de edad para la primera colocación de SLI fue de 22 (± 5,3) años y, aproximadamente, un 43% informaron la ocurrencia de problemas de salud derivada de su uso. En el modelo múltiple tener escolaridad inferior al nivel superior, estar en una franja de edad a partir de los 20 años, identificarse como travesti y ejercer la prostitución estuvieron asociados positivamente con la utilización de SLI. Hubo una elevada prevalencia del uso de SLI y de problemas derivados de esta práctica, indicando un desafío acerca de la prevención del uso y de la reducción de los daños a la salud provocados por el SLI. De esta forma, es perentorio asegurar el acceso a los recursos necesarios para la realización de las modificaciones corporales a lo largo de la duración de esta transición, mediante una atención integral a la salud de las personas travestis y transexuales en el Sistema Único de Salud. Finalmente, incluir en las políticas de salud las solicitudes de modificaciones corporales como una parte de la construcción de la identidad de género, respetando las necesidades singulares de cada persona en este proceso de transición.

More nurses are needed to deal with a 'national scandal'.

Female genital mutilation (FGM) is a public health issue for nurses working in school, community and general practice settings (Features June 25).

HIV seroprevalence and high-risk sexual behavior among female sex workers in Central Brazil.

Female sex workers (FSWs) are considered a high-risk group for human immunodeficiency virus (HIV) infection due to their social vulnerability and factors associated with their work. We estimated the prevalence of HIV, and identified viral subtypes and risk factors among FSWs. A cross-sectional study using respondent-driven sampling (RDS) method was conducted among 402 FSWs in Campo Grande city, Brazil, from 2009 to 2011. Participants were interviewed using a standardized questionnaire about sociodemograpic characteristics and risk behavior. Blood samples were collected for serological testing of HIV. Of the 402 FSWs, median age and age of initiating sex work were 25 years (Interquartile range [IQR]: 9) and 20 years (IQR: 6), respectively. The majority reported use of alcohol (88.5%), had 5-9 years (median: 9; IQR: 3) of schooling (54.5%), 68.6% had tattoos/body piercings, and 45.1% had more than seven clients per week (median: 7; IQR: 10). Only 32.9% of FSW reported using a condom with nonpaying partners in the last sexual contact. Prevalence of HIV infection was 1.0% (95% CI: 0.1-2.6%). Genotyping for HIV-1 performed on three samples detected subtypes B, C, and F1. Sex work in the Midwestern region of Brazil is characterized by reduced education, large numbers of clients per week, and inconsistent condom use, mainly with nonpaying partners. Although prevalence of HIV infection is currently low, elevated levels of high-risk sexual behavior confirm a need to implement prevention measures. Specific interventions targeting FSWs must emphasize the risk associated with both clients and nonpaying partners while providing knowledge about HIV prevention.

Prevalence and correlates of pubic hair grooming among low-income Hispanic, Black, and White women.

The purpose of this paper was to describe pubic hair grooming behaviors (shaving, waxing, trimming or dyeing) and the extent to which grooming was related to demographic characteristics and sexual history among low-income Hispanic, Black, and White women. Data were collected from 1677 women aged 16-40 years between July 2010 and August 2011 as part of a larger study. Participants completed a cross-sectional written survey. Multivariable analyses were used to identify correlates of pubic hair grooming. Being a current groomer was associated with being White, a younger age, under or normal weight, having a yearly household income >$30,000, and having 5 or more lifetime sexual partners. Overall, we discovered pubic hair grooming was extremely common among women of varying demographics. It is important for health and research professionals to understand pubic hair grooming practices so they can address behavioral and clinical concerns.

Body art in adolescents: paint, piercings, and perils.

Tattoos and body piercings are becoming increasingly popular, particularly in adolescents and young adults. As the frequency of body art increases, so does the potential for adverse outcomes. Reasons for obtaining body art include need for individual expression and peer support. Techniques for tattooing are advancing, along with development of newer inks that may be less reactive. When patients become tired of their body art, or develop complications from the art itself, removal needs to be considered. Newer laser modalities may provide tattoo removal options with less scarring potential.

Evaluation of a psychometric instrument designed to assess the HIV risk behaviors of ex-prisoners.

This study determined the readability, test-retest reliability, and internal consistency of a questionnaire designed to assess the HIV risk behaviors of ex-prisoners. The questionnaire was administered twice within a 2-week interval to 119 ex-prisoners. The test-retest agreement for the questionnaire's 25 HIV behavior items ranges from 82% to 100%. Of these 25 items, agreement was ''fair'' (k = .20 to .40) for 1, ''moderate'' (k = .40 to .60) for 5, ''substantial'' (k = .60 to .80) for 11, ''almost perfect'' (k = .80 to .99) for 7, and ''perfect'' (k = 1.00) for 1. The overall Cronbach's alpha (Cα) is .81 (p < .001). By subscale, the Cα for tattooing, .89; body piercing, .93; injection drug use, .93; and HIV risk sexual behavior, .79. Based on these findings, the authors conclude that the questionnaire is reliable and internally consistent.

Pulling teeth for fashion: dental modification in modern day Cape Town, South Africa.

Friedling and Morris (2005) have reported that intentional removal of incisors as a form of dental modification is relatively common in Cape Town. In this paper we further report on the style of modification and the reasons for the modification. A survey of eight adjoining areas in the northern suburbs of the Cape Town Metropole in the Western Cape was done to investigate the current prevalence of this practice. The survey was conducted by means of a questionnaire. Three groups of study subjects (scholars, working people and retired people) were included to gain a perspective of the community in general. The individual ages ranged from 15 to 83-years-old. A total of 2167 individuals participated in this study. Forty one percent had modified their teeth. More males (44,8%) than females (37,9%) were involved in this practice. Six "styles" of modification were identified. The removal of the upper four incisors was by far the most common modification (93,7%). There were four reported reasons for dental modification i.e. gangsterism, peer pressure, fashion and medical (dental) or accidental. More than two thirds (69,8%) of individuals with modifications also wore dentures.

Body art: piercing, tattooing, and scarification.

Body art, particularly piercings and tattoos, is becoming more common. Many patients get their first piercing or tattoo during adolescence or young adulthood. Clinicians should understand the potential complications of these procedures and their management. It also is important for clinicians to feel comfortable counseling adolescents and their families about practices in safer body art facilities.