Search results for: sexual autonomy
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 1208

Search results for: sexual autonomy

728 Direct and Indirect Effects of Childhood Traumas, Emotion Regulation Difficulties and Age on Tendency to Violence

Authors: Selin Kara-Bahçekapılı, Bengisu Nehir Aydın

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Objective: In this study, it is aimed to examine the relationship between childhood traumas (overprotection-control, emotional/physical/sexual abuse, emotional/physical neglect), age, emotional regulation difficulties, and the tendency of violence in adults. In the study, the direct and indirect effects of 6 sub-factors of childhood traumas, emotion regulation difficulties, and age on tendency to violence are evaluated on a model that theoretically reveals. Method: The population of this cross-sectional study consists of individuals between the ages of 18-65 living in Turkey. The data from 527 participants were obtained by online surveys and convenience sampling method within the scope of the study. As a result of exclusion criteria and then outlier data analysis, the data of 443 participants were included in the analysis. Data were collected by demographic information form, childhood trauma scale, emotion regulation difficulty scale, and violence tendency scale. Research data were analyzed by SPSS and AMOS using correlation, path analysis, direct and indirect effects. Results: According to the research findings, the variables in the model explained 28.2% of the variance of the mean scores of the individuals' tendency to violence. Emotion regulation difficulties have the most direct effect on the tendency to violence (d=.387; p<.01). The effects of excessive protection and control, emotional neglect, and physical neglect variables on the tendency to violence are not significant. When the significant and indirect effects of the variables on tendency to violence over emotion regulation difficulties are examined, age has a negative effect, emotional neglect has a positive effect, emotional abuse has a positive effect, and overprotection-control has a positive effect. The indirect effects of sexual abuse, physical neglect, and physical abuse on tendency to violence are not significant. Childhood traumas and age variables in the model explained 24.1% of the variance of the mean scores of the individuals’ emotion regulation difficulties. The variable that most affects emotion regulation difficulties is age (d=-.268; p<.001). The direct effects of sexual abuse, physical neglect, and physical abuse on emotion regulation difficulties are not significant. Conclusion: The results of the research emphasize the critical role of difficulty in emotion regulation on the tendency to violence. Difficulty in emotion regulation affects the tendency to violence both directly and by mediating different variables. In addition, it is seen that some sub-factors of childhood traumas have direct and/or indirect effects on the tendency to violence. Emotional abuse and age have both direct and indirect effects on the tendency to violence over emotion regulation difficulties.

Keywords: childhood trauma, emotion regulation difficulties, tendency to violence, path analysis

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727 Effects of Aromatase Inhibitor on Morphology and Body Shape in Sex-Reversal Chicken: Gimmizah Strain

Authors: Hatem Ashur Masoud Shreha

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Aromatase inhibitors administered before sexual differentiation of the gonads in chicken embryo can induce sex reversal in female layer chickens (phenotypic male). To analyze the process of sex reversal, we have followed for several months the changes induced by Fadrozole, a nonsteroidal aromatase inhibitor on morphology of female sex-reversed and female sex-reversed supplemented with L-tyrosine which was previously shown to stimulate release of Gn Rh. Fadrozole (1mg/egg) was injected into eggs on day four of incubation before sex differentiation. phenotypic males and phenotypic males treated with L-tyrosine and males hatched from eggs injected Fadrozole were sacrificed by slaughtering at 16 weeks old and the remaining chicks were sacrificed at 28 weeks old. Both sexes from control chickens were sacrificed at the same age (16 &28 weeks). Hatchability, behavior, body weight, shank length, comb weight, testes weight, blood cells count and wattle weight of sex reversal were tested at 16 and 28 weeks. The results showed that body weight, comb weight, wattles weight and shank length of sex-reversed females were significantly different from control female. Behavior of phenotypic males and phenotypic males fed on L-tyrosine showed aggressive sexual behavior like that of control males and absence of laying behavior. In conclusion our results confirm that Fadrazole injection in eggs before sex differentiation produce a male behavior and morphological index of male in female chicken.

Keywords: sex-reversal, fadrozole, phenotypic male, L-tyrosine

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726 Understanding Gender-Based Violence through an Adolescent Lens: Qualitative Findings from Delhi, India

Authors: Pratishtha Singh

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Gender-based violence (GBV) or gendered violence refers to violence inflicted on a person because of their gender. Majority of men who perpetrate gender-based violence, first do so during their teenage years. Further, the first sexual experience of most girls is coerced. In order to reduce the widespread occurrence of GBV, it is vital to intervene and reach people, especially boys, when their attitudes and beliefs about sexuality and gender are developing. This study aims to understand GBV through an adolescent lens, focusing on their knowledge, attitudes and experiences regarding gendered abuse. This is a cross-sectional, qualitative study. The respondents are Delhi based students in grades 11th and 12th, recruited via snowball sampling. Sixteen in-depth, telephonic interviews were carried out in the month of April, 2020. The data was transcribed verbatim into MS Word and qualitative coding was undertaken in Atlas.ti 8. Twelve out of sixteen respondents admitted experiencing sexual GBV. Out of these, a little more than half of the victims reported it to somebody. Thematic analysis revealed key themes of: (i) Introduction and reinforcement of a patriarchal structure (ii) Violence in teen dating (iii) Acceptability and normalization of violence and (iv) Justice System. Findings reflect a process wherein GBV becomes an intricate part of adolescents’ lives. Participants showed a moderately well-informed understanding of gendered abuse whereas attitudes reflected a complex combination of internalized patriarchy and a desire to bring positive societal reform. The results of this study highlight a need for health promoting, gender-equitable interventions.

Keywords: adolescents, gender, health, violence

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725 Consent, Agency and Abuse: Intimate Partner Violence in the Indian Context: A Primary Study Based on Working Women from Lower Income Groups in Smart Cities across North India

Authors: Shirin Abbas, Sandeep Kumar Dubey

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Intimate partner violence (IPV) is one of the most common forms of gender-based violence (GBV) and is classified as discrimination on the basis of gender. Article 2 of the non-binding UN Declaration on the Elimination of Violence against Women (DEVAW). This was adopted in 1993 as the first international pronouncement regarding violence against women, including physical, sexual, and psychological violence in the family (i.e., domestic violence, marital rape, battery, statutory rape, rape by male members of the family, etc.) While crime against women continues unabated, the Indian government has strongly refuted the 2018 study by the Thomson Reuters Foundation categorizing India as a risky country for women due to the high risk of sexual violence and being forced into slave labour, according to a poll of global experts. This paper has explored consent, agency, and abuse through the lens of intimate partner violence among women from lower income groups in smart cities in the state of Uttar Pradesh, India. Using focused mapping, the paper has explored the situation on IPV internationally and studied the status of working women from lower income groups to ascertain if their lot was any different where IPV was concerned to study. The findings of the study also vindicate global reports which rate India as a country unsafe for women, even within marriage.

Keywords: consent and agency, domestic violence, gender based violence GBV, intimate partner violence IPV

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724 Aspects of the Reproductive Biology of the Reticulate Knife Fish, Papyrocranus afer (Gunther, 1868) In Lekki Lagoon, Nigeria

Authors: Adiaha A. A. Ugwumba, Femi V. Oluwale

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Sizes at maturity (Lₘ₅₀), fecundity, sex ratio, and gonadosomatic indices (GSI) of the reticulate knife fish, Papyrocranus afer, collected from Lekki Lagoon, were investigated. A Total of 1154 specimens with standard lengths of 5.2-75.9 cm (mean = 34.86±17.2cm) and body weight of 7.9-1, 958.8g (mean = 249.12±28.56g) were collected by means of artisanal passive and active gears (traps, long lines, and nets) and examined. Sexes of fish specimens were determined macroscopically and microscopically after dissection. The length at which 50% of the fish population reached sexual maturity (Lₘ₅₀) was considered as length at sexual maturity. Fecundity was determined by total counts of eggs; sex ratio by the proportion of males to females, while GSI was determined as gonad weight expressed as a percentage of total body weight. Results showed that the most frequently caught fish was 34.5cm long, while the sizes at maturity were 49.1cm (males) and 53.4cm (females). Matured specimens had characteristic urinogenital papillae prominent in males but vestigial in females. Sex ratio (1: 0.6; Male: female) was significantly different (X² (1) = 32.21, p < 0.0001). Fecundity was low (mean 49 ± 17 eggs for a fish of 52.86 ±7.53cm); it increased with fish size (r = 0.71). Higher GSI during the rainy season with a peak in July (female: 0.44 ± 0.14 %; male: 0.22 ± 0.01 %) indicated seasonal/annual spawning. Low fecundity and annual spawning underlined the need for sustainable management of this species in Lekki Lagoon.

Keywords: breeding season, fecundity, gonad maturity, Lekki lagoon, Papyrocranus afer, sex ratio

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723 Ethically Integrating Robots to Assist Elders and Patients with Dementia

Authors: Suresh Lokiah

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The emerging trend of integrating robots into elderly care, particularly for assisting patients with dementia, holds the potential to greatly transform the sector. Assisted living facilities, which house a significant number of elderly individuals and dementia patients, constantly strive to engage their residents in stimulating activities. However, due to staffing shortages, they often rely on volunteers to introduce new activities. Despite the availability of social interaction, these residents, frequently overlooked in society, are in desperate need of additional support. Robots designed for elder care are categorized based on their design and functionality. These categories include companion robots, telepresence robots, health monitoring robots, and rehab robots. However, the integration of such robots raises significant ethical concerns, notably regarding privacy, autonomy, and the risk of dehumanization. Privacy issues arise as these robots may need to continually monitor patient activities. There is also a risk of patients becoming overly dependent on these robots, potentially undermining their autonomy. Furthermore, the replacement of human touch with robotic interaction may lead to the dehumanization of care. This paper delves into the ethical considerations of incorporating robotic assistance in eldercare. It proposes a series of guidelines and strategies to ensure the ethical deployment of these robots. These guidelines suggest involving patients in the design and development process of the robots and emphasize the critical need for human oversight to respect the dignity and rights of the elderly and dementia patients. The paper also recommends implementing robust privacy measures, including secure data transmission and data anonymization. In conclusion, this paper offers a thorough examination of the ethical implications of using robotic assistance in elder care. It provides a strategic roadmap to ensure this technology is utilized ethically, thereby maximizing its potential benefits and minimizing any potential harm.

Keywords: human-robot interaction, robots for eldercare, ethics, health, dementia

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722 Contested Space for Regulation in Higher Education

Authors: Sulila Anar

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Institutions of any kind are regulated by laws which could be formal or informal, visible or invisible that influences the very structure of the institutions itself. Here in this paper the attempt will be to see how institutions of higher education are regulated by the regulatory institutions by taking the case of India, the third largest education system in the world. The attempt is to try to see how regulation of higher education creates a space for contestation among regulatory institutions based on secondary resources and how this affects the governance of university to achieve the goals and visions.

Keywords: higher education, regulation, autonomy, space

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721 Research and Development of Net-Centric Information Sharing Platform

Authors: Wang Xiaoqing, Fang Youyuan, Zheng Yanxing, Gu Tianyang, Zong Jianjian, Tong Jinrong

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Compared with traditional distributed environment, the net-centric environment brings on more demanding challenges for information sharing with the characteristics of ultra-large scale and strong distribution, dynamic, autonomy, heterogeneity, redundancy. This paper realizes an information sharing model and a series of core services, through which provides an open, flexible and scalable information sharing platform.

Keywords: net-centric environment, information sharing, metadata registry and catalog, cross-domain data access control

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720 Prediction on the Pursuance of Separation of Catalonia from Spain

Authors: Francis Mark A. Fernandez, Chelca Ubay, Armithan Suguitan

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Regions or provinces in a definite state certainly contribute to the economy of their mainland. These regions or provinces are the ones supplying the mainland with different resources and assets. Thus, with a certain region separating from the mainland would indeed impinge the heart of an entire state to develop and expand. With these, the researchers decided to study on the effects of the separation of one’s region to its mainland and the consequences that will take place if the mainland would rule out the region to separate from them. The researchers wrote this paper to present the causes of the separation of Catalonia from Spain and the prediction regarding the pursuance of this region to revolt from its mainland, Spain. In conducting this research, the researchers utilized two analyses, namely: qualitative and quantitative. In qualitative, numerous of information regarding the existing experiences of the citizens of Catalonia were gathered by the authors to give certainty to the prediction of the researchers. Besides this undertaking, the researchers will also gather needed information and figures through books, journals and the published news and reports. In addition, to further support this prediction under qualitative analysis, the researchers intended to operate the Phenomenological research in which the examiners will exemplify the lived experiences of each citizen in Catalonia. Moreover, the researchers will utilize one of the types of Phenomenological research which is hermeneutical phenomenology by Van Manen. In quantitative analysis, the researchers utilized the regression analysis in which it will ascertain the causality in an underlying theory in understanding the relationship of the variables. The researchers assigned and identified different variables, wherein the dependent variable or the y which represents the prediction of the researchers, the independent variable however or the x represents the arising problems that grounds the partition of the region, the summation of the independent variable or the ∑x represents the sum of the problem and finally the summation of the dependent variable or the ∑y is the result of the prediction. With these variables, using the regression analysis, the researchers will be able to show the connections and how a single variable could affect the other variables. From these approaches, the prediction of the researchers will be specified. This research could help different states dealing with this kind of problem. It will further help certain states undergoing this problem by analyzing the causes of these insurgencies and the effects on it if it will obstruct its region to consign their full-pledge autonomy.

Keywords: autonomy, liberty, prediction, separation

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719 Factors Influencing the Integration of Comprehensive Sexuality Education into Educational Systems in Low- And Middle-Income Countries: A Systematic Review

Authors: Malizgani Paul Chavula

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Background: Comprehensive sexuality education (CSE) plays a critical role in promoting youth and adolescents’ sexual and reproductive health and well-being. However, little is known about the enablers and barriers affecting the integration of CSE into educational programmes. The aim of this review is to explore positive and negative factors influencing the integration of CSE into national curricula and educational systems in low- and middle-income countries. Methods: We conducted a systematic literature review (January 2010 to August 2022). The results accord with the Preferred Reporting Items for Systematic Reviews and Meta-analysis standards for systematic reviews. Data were retrieved from the PubMed, Cochrane, Google Scholar, and Web of Hinari databases. The search yielded 431 publications, of which 23 met the inclusion criteria for full-text screening. The review is guided by an established conceptual framework that incorporates the integration of health innovations into health systems. Data were analyzed using a thematic synthesis approach. Results: The magnitude of the problem is evidenced by sexual and reproductive health challenges such as high teenage pregnancies, early marriages, and sexually transmitted infections. Awareness of these challenges can facilitate the development of interventions and the implementation and integration of CSE. Reported aspects of the interventions include core CSE content, delivery methods, training materials and resources, and various teacher-training factors. Reasons for adoption include perceived benefits of CSE, experiences and characteristics of both teachers and learners, and religious, social, and cultural factors. Broad system characteristics include strengthening links between schools and health facilities, school and community-based collaboration, coordination of CSE implementation, and the monitoring and evaluation of CSE. Ultimately, the availability of resources, national policies and laws, international agendas, and political commitment will impact upon the extent and level of integration. Conclusion: Social, economic, cultural, political, legal, and financial contextual factors influence the implementation and integration of CSE into national curricula and educational systems. Stakeholder collaboration and involvement in the design and appropriateness of interventions is critical.

Keywords: comprehensive sexuality education, factors, integration, sexual reproductive health rights

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718 Discrimination Faced by Dalit Women in India

Authors: Soundarya Lahari Vedula

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Dalit women make up a significant portion of the Indian population. However, they are victims of age old discrimination. This paper presents a brief background of the Indian caste system which is a hierarchical division placing Dalits at the lowest rank. Dalits are forced to perform menial and harsh tasks. They often face social ostracism. The situation of Dalit women is of unique significance as they face triple discrimination due to their caste, gender, and class. Dalit women are strictly withheld by the rigid boundaries of the caste system. They are discriminated at every stage of their life and are denied access to public places, education and healthcare facilities among others. They face the worst forms of sexual violence. In spite of legislations and international conventions in place, their plight is not adequately addressed. This paper discusses, in brief, the legal mechanism in place to prohibit untouchability. Furthermore, this paper details on the specific human rights violations faced by Dalit women in the social, economic and political spheres. The violations range from discrimination in public places, denial of education and health services, sexual exploitation and barriers to political representation. Finally, this paper identifies certain lacunae in the existing Indian statutes and broadens on the measures to be taken to improve the situation of Dalit women. This paper offers some recommendations to address the plight of Dalit women such as amendments to the existing statutes, effective implementation of legal mechanisms and a more meaningful interpretation of the international conventions.

Keywords: Dalit, caste, class, discrimination, equality

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717 Fostering Teacher Professional Well-being: Understanding the Impact of School Administration Leadership and Other Factors

Authors: Monika Simkute-Bukante

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Teachers significantly influence student achievements, personal development, and academic success. Consequently, they are subject to heightened expectations and scrutiny from governments, school administrations, parents, and even students. Increasing responsibilities and pressures impact teachers’ professional well-being, contributing to a global trend of increased teacher turnover and shortages due to stress and heavy workloads. Given the critical role of teachers in educating young people, it is essential to implement strategies to retain them. School administrations are pivotal in creating an environment conducive to optimal performance. However, there remains a gap in understanding how school administration leadership impacts teachers' professional well-being and its potential for improvement. This research aims to define teacher professional well-being, identify its attributes, and explore the factors influencing it, with a particular focus on the role of school administration. Employing the concept analysis method, this study reviews scholarly publications from 2019 to 2024 to articulate the components of teacher professional well-being. The findings highlight key attributes of teacher well-being, including self-efficacy, work engagement, job satisfaction, relationships with colleagues and students, support from administration, work autonomy, school climate, time pressure, workload, resilience, stress, burnout, and turnover intentions. The analysis demonstrates that school administration leadership directly affects these aspects by providing support in challenging situations, empowering teachers, offering recognition, facilitating open communication, and ensuring autonomy at work. In conclusion, the research shows that teachers' professional well-being is heavily dependent on relationships with school administration, colleagues, and students, as well as the overall school climate. It suggests that by enhancing these elements, school leaders can significantly improve teacher professional well-being. Recommendations are made for developing strategies to support these relationships, thereby fostering an environment that enhances teacher retention and effectiveness.

Keywords: concept analysis, teacher professional well-being, school administration leadership, well-being factors

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716 Film Censorship and Female Chastity: Exploring State's Discourses and Patriarchal Values in Reconstructing Chinese Film Stardom of Tang Wei

Authors: Xinchen Zhu

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The rapid fame of the renowned female film star Tang Wei has made her a typical subject (or object) entangled with sensitive issues involving the official ideology, sexuality, and patriarchal values of contemporary China. In 2008, Tang Wei’s official ban has triggered the wave of debates concerning state power and censorship, actor’s rights, sexual ethics, and feminism in the public sphere. Her ban implies that Chinese film censorship acts as a key factor in reconstructing Chinese film stardom. Following the ban, as sensational media texts are re-interpreting the official discourses, the texts also functioned as a crucial vehicle in reconstructing Tang's female image. Therefore, the case study of Tang's film stardom allows us to further explore how female stardom has been entangled with the issues involving official ideology, female sexual ethics, and patriarchal values in contemporary China. This paper argues that Chinese female film stars shoulder the responsibility of film acting which would conform to the official male-dominated values. However, with the development of the Internet, the state no longer remains an absolute control over the new venues. The netizens’ discussion about her ban reshaped Tang’s image as a victim and scapegoat under the unfair oppression of the official authority. Additionally, this paper argues that similar to State’s discourse, netizens’ discourse did not reject patriarchal values, and in turn emphasized Tang Wei’s female chastity.

Keywords: film censorship, Chinese female film stardom, party-state’s power, national discourses, Tang Wei

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715 Oak Gall Wasps (Hymenoptera, Cynipidae, Cynipini) and Galls Form Recorded from Georgia

Authors: Marine Nozadze, George Japoshvili, George Melika

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In 2020-2021 we studied oaks gall wasps of different oak species in Georgia at 7 locations of their natural distribution: 1. Quercuse petrea subsp. iberica - Mtskheta municipality, village. Mukhattskaro; 2. Quercus subsp. pendunculifloria - Kvareli municipality, village. Gramy;3. Quercus robur subsp. imeretina -Baghdati Municipality, Ajameti Reserve; 4. Quercus pontica -Chokhatauri municipality, village. Tskhratskaro; 5. Quercus macranthera -Tetritskaro Municipality, Algeti National Park; 6. Quercuse petrea subsp. iberica - Shuakhevi municipality, village. Uchamba 7. Quercus hartwissiana - Baghdatis municipality, village. Dimi. Samples were collected from early spring to late autumn. As a result, 7 forms of galls were collected and described wich caused by different species of oak gall wasps: 1. Neuroterus numismalis asexual gall 2. Neuroterus quercusbaccarum asexual galls 3. Cynips korsakovi asexual gall 4. Biorhiza pallida sexual gall 5. Neuroterus quercusbaccarum asexual galls 6. Neuroterus numismalis sexual gall 7. Cynips quercusfolii. Neuroterus quercusbaccarum asexual galls form the most represented of them: In Algeti National Park; In Mtskheta municipality; In Shuakhevi municipality and Ajameti reserve. The most damaged locations by oak gall wasps were Algeti National Park and Mtskheta Municipality, whereas the most biodiversity according to galls form was represented In Algeti National Park.

Keywords: gall wasps, oak, cynipidae, species

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714 Effects of SNP in Semen Diluents on Motility, Viability and Lipid Peroxidation of Sperm of Bulls

Authors: Hamid Reza Khodaei, Behnaz Mahdavi, Alireza Banitaba

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Nitric oxide (NO) plays an important role in all sexual activities of animals. It is made in body from NO syntheses enzyme and L-arginin molecule. NO can make band with sulfur-iron complexes and due to production of steroid sexual hormones related to enzymes which have this complex, NO can change the activity of these enzymes. NO affects many cells including endothelial cells of veins, macrophages and mast cells. These cells are found in testis leydig cells and therefore are important source of NO in testis tissue. Minimizing damages to sperm at the time of sperm freezing and thawing is really important. The goal of this study was to determine the function of NO before freezing and its effects on quality and viability of sperms after thawing and incubation. 4 Holstein bulls were selected from the age of 4, and artificial insemination was done for 3 weeks (2 times a week). Treatments were 0, 10, 50 and 100 nm of sodium nitroprusside (SNP). Data analysis was performed by SAS98 program. Also, mean comparison was done using Duncan's multiple ranges test (P<0.05). Concentrations used were found to increase motility and viability of spermatozoa at 1, 2 and 3 hours after thawing significantly (P<0.05) but there was no significant difference at zero time. SNP levels reduced the amount of lipid peroxidation in sperm membrane, increased acrosome health and improved samples membranes especially in 50 and 100 nm treatments. According to results, adding SNP to semen diluents increases motility and viability of spermatozoa. Also, it reduces lipid peroxidation in sperm membrane and improves sperm function.

Keywords: sperm motility, nitric oxide, lipid peroxidation, spermatozoa

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713 Meeting the Pedophile: Attitudes toward Pedophilia among Psychology Students

Authors: Rebecca Heron, Julie Karsten, Lena Schweikert

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Adverse consequences of stigma towards pedophilia can, among other things, increase dynamic risk factors for sexual offending. Decreasing stigma, therefore, is a plausible approach in the attempt to prevent child sexual abuse. Stigma research suggests that providing direct contact to a stigmatized individual is the most efficient way of reducing stigma. The present study involved an educational intervention, followed by direct contact to a pedophile, to maximize effectiveness. It aimed at finding out whether a dichotomous anti-stigma intervention can change psychology students' attitudes towards pedophiles regarding perceived dangerousness, intentionality, deviance, and punitive attitudes. In a one sample pre-post design, 162 students of the University of Groningen attended a lecture about pedophilia, which was held by a psychology master’s student. Participants learned about child sex offending and pedophilia in addition to the importance of distinguishing between pedophiles and child sex offenders (CSOs). The guest lecturer Gabriel, shared his experiences about growing up, coping, and living with pedophilia. Results of the Wilcoxon signed-rank test revealed significantly diminished negative attitudes towards pedophiles after the intervention. Students perceived pedophiles as less dangerous, having less intent, and being less psychologically deviant. Additionally, students' punitive attitudes towards pedophiles diminished significantly. Also, a thematic analysis revealed that students were highly interested in the topic of pedophilia and greatly appreciative of Gabriel sharing his story. This study was the first to provide direct contact with a pedophile within an anti-stigma intervention.

Keywords: pedophilia, anti-stigma intervention, punitive attitudes, attitude change

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712 Individual and Contextual Factors Associated with Modern Contraceptive Use among Sexually Active Adolescents and Young Women in Zambia: A Multilevel Analysis

Authors: Chinyama Lukama, Million Phiri, Namuunda Mutombo

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Background: Improving access and utilization to high-quality sexual and reproductive health (SRH) information and services, including family planning (FP) commodities, is central to the global developmental agenda of sub-Saharan Africa (SSA). Despite the importance of family planning use in enhancing maternal health outcomes and fertility reduction, the prevalence of adolescents and young women using modern contraception is generally low in SSA. Zambia is one of the countries in Southern Africa with a high prevalence of teenage pregnancies and fertility rates. Despite many initiatives that have been implemented to improve access and demand for family planning commodities, utilization of FP, especially among adolescents and young women, has generally been low. The objective of this research agenda was to better understand the determinants of modern contraceptive use in adolescents and young women in Zambia. This analysis produced findings that will be critical for informing the strengthening of sexual and reproductive health policy strategies aimed at bolstering the provision and use of maternal health services in order to further improve maternal health outcomes in the country. Method: The study used the recent data from the Demographic and Health Survey of 2018. A sample of 3,513 adolescents and young women (ADYW) were included in the analysis. Multilevel logistic regression models were employed to examine the association of individual and contextual factors with modern contraceptive use among adolescents and young women. Results: The prevalence of modern contraception among sexually active ADYW in Zambia was 38.1% [95% CI, 35.9, 40.4]. ADYW who had secondary or higher level education [aOR = 2.16, 95% CI=1.35–3.47], those with exposure to listening to the radio or watching television [aOR = 1.26, 95% CI=1.01–1.57], and those who had decision-making power at household level [aOR = 2.18, 95% CI=1.71–2.77] were more likely to use modern contraceptives. Conversely, strong neighborhood desire for large family size among ADYW [aOR = 0.65 95% CI = 0.47–0.88] was associated with less likelihood to use modern contraceptives. Community access to family planning information through community health worker visits increased the likelihood [aOR = 1.48, 95% CI=1.16–1.91] of using modern contraception among ADYW. Conclusion: The study found that both individual and community factors were key in influencing modern contraceptive use among adolescents and young women in Zambia. Therefore, when designing family planning interventions, the Government of Zambia, through its policymakers and sexual reproductive health program implementers at the Ministry of Health, in collaboration with stakeholders, should consider the community context. There should also be deliberate actions to encourage family planning education through the media.

Keywords: adolescents, young women, modern contraception use, fertility, family planning

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711 Understanding Awareness, Agency and Autonomy of Mothers and Potential of Digital Technology in Expanding Maternal Health Information Access: A Survey of Mothers in Urban India

Authors: Sumiti Saharan, Pallav Patankar, Lily W. Lee

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Understanding the health-seeking behaviors and attitudes of women towards maternal health in the context of gender roles and family dynamics is tremendously crucial for designing effective and impactful interventions aimed at improving maternal and child health outcomes. Further, as the digital world becomes more accessible and affordable, it is imperative to scope the potential of digital technology in enabling access to maternal health information in different socio-economic groups (SEGs). In the summer of 2017, we conducted a study with 500 women across different SEGs in urban India who were pregnant or had had a delivery in the last year. The study was undertaken to assess their maternal health information seeking behavior with a particular focus on probing their use of digital technology for health-related information. The study also measured women's decision-making autonomy in the context of maternal health, awareness of their rights to quality and respectful maternal healthcare, and agency to voice their rights. We probed the impact of key variables including education, age, and socioeconomic status on all outcome variables. In terms of health-seeking behaviors, we found that women heavily relied on medical professionals and/or their mothers and mothers-in-law for all maternal health advice. Digital adoption was found to be high across all SEGs, with around 70% of women from all populations using the internet several times a week. On the other hand, use of the internet for both accessing maternal health information and choosing maternity hospitals were both significantly dependent on SEG. The key reasons reported for not using the internet for health purposes were lack of awareness and lack of trust on content accuracy. Decisions around health practices and type of delivery were found to be jointly made by women and other family members. Almost all women reported their husbands to play a key role in all maternal health decisions and for decisions with a clear financial implication like choice of hospital for delivery, husbands were reported to be the sole decision maker by a majority of women. The agency of women was also found to be low in interactions with maternal healthcare providers with a third of respondents not comfortable with voicing their opinions and preferences to their doctors. Interestingly, we find that this relatively low agency was prominent in both lower middle class and middle-class SEGs. Recognition of the sociocultural determinants of behavior is the first step in developing actionable strategies for improving maternal health outcomes. Our study quantifies the agency and autonomy of women in urban India and the variables that impact them. Our findings emphasize the value of gender normative approaches that factor in the key role husbands play in guiding maternal health decisions. They also highlight the power of digital approaches for catalyzing access to maternal health information. These insights into the attitude and behaviors of mothers in context of their sociocultural environments—and their relationship with digital technology—can help pave the way towards designing effective, scalable maternal and child health programs in developing nations like India.

Keywords: access to healthcare information, behavior, digital health, maternal health

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710 A Quality Improvement Approach for Reducing Stigma and Discrimination against Young Key Populations in the Delivery of Sexual Reproductive Health and Rights Services

Authors: Atucungwiire Rwebiita

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Introduction: In Uganda, provision of adolescent sexual reproductive health and rights (SRHR) services for key population is still hindered by negative attitudes, stigma and discrimination (S&D) at both the community and facility levels. To address this barrier, Integrated Community Based Initiatives (ICOBI) with support from SIDA is currently implementing a quality improvement (QI) innovative approach for strengthening the capacity of key population (KP) peer leaders and health workers to deliver friendly SRHR services without S&D. Methods: Our innovative approach involves continuous mentorship and coaching of 8 QI teams at 8 health facilities and their catchment areas. Each of the 8 teams (comprised of 5 health workers and 5 KP peer leaders) are facilitated twice a month by two QI Mentors in a 2-hour mentorship session over a period of 4 months. The QI mentors were provided a 2-weeks training on QI approaches for reducing S&D against young key populations in the delivery of SRHR Services. The mentorship sessions are guided by a manual where teams base to analyse root causes of S&D and develop key performance indicators (KPIs) in the 1st and 2nd second sessions respectively. The teams then develop action plans in the 3rd session and review implementation progress on KPIs at the end of subsequent sessions. The KPIs capture information on the attitude of health workers and peer leaders and the general service delivery setting as well as clients’ experience. A dashboard is developed to routinely track the KPIs for S&D across all the supported health facilities and catchment areas. After 4 months, QI teams share documented QI best practices and tested change packages on S&D in a learning and exchange session involving all the teams. Findings: The implementation of this approach is showing positive results. So far, QI teams have already identified the root causes of S&D against key populations including: poor information among health workers, fear of a perceived risk of infection, perceived links between HIV and disreputable behaviour. Others are perceptions that HIV & STIs are divine punishment, sex work and homosexuality are against religion and cultural values. They have also noted the perception that MSM are mentally sick and a danger to everyone. Eight QI teams have developed action plans to address the root causes of S&D. Conclusion: This approach is promising, offers a novel and scalable means to implement stigma-reduction interventions in facility and community settings.

Keywords: key populations, sexual reproductive health and rights, stigma and discrimination , quality improvement approach

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709 Oral Sex Practice among Men Who Have Sex with Men: A Cross-Sectional Study in Indonesian Urban Settings

Authors: I Putu Yuda Hananta, Inke Kusumastuti

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The latest Indonesian Biology and Behavior Surveillance (IBBS) conducted by Indonesian Ministry of Health reported a large proportion of men who have sex with men (MSM) engaging in oral sex in their recent sexual history. While it is considered as a pleasuring and safe, oral sex might facilitate the transmission of various sexually transmitted infection (STI) pathogens. This study was aimed to investigate the oral sex practice among MSM in Indonesian urban settings to help delineate demographic and behavior determinants of such practice. In 2014, 501 MSM in 8 clinic-based and outreach STI services were recruited in Jakarta, Yogyakarta and Denpasar, Indonesia. Respondents completed a self-administered questionnaire inquiring about their demographics and sexual history. Median age (interquartile range) of the respondents was 27 (24-30) years; most completed senior high school (54.3%), worked in informal jobs (57.9%), and single (60.9%); and 32.3% reported receiving money in exchange for sex. Oral sex was practiced by most respondents: insertive only (10.0%), receptive only (6.0%), and both (82.4%). A separate multivariable analysis was performed using logistic regression to identify the determinants for receptive and insertive oral sex. Factors associated with receptive oral sex were having more than 10 sex partner(s) in the preceding 6 months vs 1 partner, adjusted odds ratio (aOR) [95% CI]=3.40 [1.22-9.42], p=0.03; and history of receptive-insertive anal sex vs no history, aOR=4.37 [1.76-10.82], p=0.01. Factors associated with insertive oral sex were receiving money for sex vs. not receiving, aOR=2.98 [1.10-8.04], p=0.02; and history of receptive-insertive anal sex vs. no history, aOR=2.10 [0.51-8.74], p<0.001. Only a few respondents reported consistent condom use (11.6% and 12.0% for receptive and insertive oral sex, respectively). Our findings demonstrated that while oral sex is a common practice among MSM, the consistency of condom use in oral sex is very low. In addition, certain sex behavior (number of sex partners, sex work and history of anal sex) were associated with oral sex, and this might need to be addressed during health promotion efforts on STI prevention through oral-genital contact.

Keywords: behavior, Indonesia, men who have sex with men, oral sex

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708 The Relationship between Central Bank Independence and Inflation: Evidence from Africa

Authors: R. Bhattu Babajee, Marie Sandrine Estelle Benoit

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The past decades have witnessed a considerable institutional shift towards Central Bank Independence across economies of the world. The motivation behind such a change is the acceptance that increased central bank autonomy has the power of alleviating inflation bias. Hence, studying whether Central Bank Independence acts as a significant factor behind the price stability in the African economies or whether this macroeconomic aim in these countries result from other economic, political or social factors is a pertinent issue. The main research objective of this paper is to assess the relationship between central bank autonomy and inflation in African economies where inflation has proved to be a serious problem. In this optic, we shall measure the degree of CBI in Africa by computing the turnover rates of central banks governors thereby studying whether decisions made by African central banks are affected by external forces. The purpose of this study is to investigate empirically the association between Central Bank Independence (CBI) and inflation for 10 African economies over a period of 17 years, from 1995 to 2012. The sample includes Botswana, Egypt, Ghana, Kenya, Madagascar, Mauritius, Mozambique, Nigeria, South Africa, and Uganda. In contrast to empirical research, we have not been using the usual static panel model for it is associated with potential mis specification arising from the absence of dynamics. To this issue a dynamic panel data model which integrates several control variables has been used. Firstly, the analysis includes dynamic terms to explain the tenacity of inflation. Given the confirmation of inflation inertia, that is very likely in African countries there exists the need for including lagged inflation in the empirical model. Secondly, due to known reverse causality between Central Bank Independence and inflation, the system generalized method of moments (GMM) is employed. With GMM estimators, the presence of unknown forms of heteroskedasticity is admissible as well as auto correlation in the error term. Thirdly, control variables have been used to enhance the efficiency of the model. The main finding of this paper is that central bank independence is negatively associated with inflation even after including control variables.

Keywords: central bank independence, inflation, macroeconomic variables, price stability

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707 Challenging Heteronormativity and Mononormativity in Academia: Incorporating Consensual Non-Monogamy into Psychological Romantic Relationship Research

Authors: Jessica Wood, Serge Desmarais

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There has been recent resurgence in the popular and academic interest of consensual non-monogamous (CNM) relationships- an umbrella term that defines relationships in which each partner has openly agreed to engage in additional romantic and/or sexual relationships outside of their primary partnership. Despite an increase in the academic study of CNM, little psychological attention has been paid to the study of CNM, with the consideration of these relationships commonly occurring within related social science disciplines such as sociology or anthropology. As a discipline, psychology has a history of conducting research in the area of intimate relationships, and psychologists have amassed a wealth of theoretical knowledge in this field. However, historically individuals who engage in "alternative" sexual and romantic behaviours, such as non-heterosexual sex or sex with multiple partners have been pathologized within psychological research. Individuals in CNM relationships or individuals identifying as lesbian, gay, bisexual, trans or queer have often been excluded from research or “othered” in psychological interpretations of what healthy relationships entail. Thus, our current theoretical understandings of romantic relationships are limited to heterosexual, monogamous relationships. The goal of this presentation is to examine commonly cited components of relationship satisfaction (e.g., commitment, communication) and to critically assess how CNM experiences are presented in, or missing from, the psychological literature on romantic relationships. Additionally, the presentation will also consider how CNM relationships may add to our understanding or enhancement of traditional psychological theories and address issues related to heteronormativity and mononormativity within the discipline. Finally, we will close with a consideration of additional theoretical perspectives that may aid in our understanding of CNM relationships and suggest directions for future research.

Keywords: heteronormativity, mononormativity, psychological research, diverse relationships, gender, sexuality, feminism, queer theory

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706 Doing More with Less: Passion for Entrepreneurship in the Research-Constraint Contexts of Developing and Emerging Economies

Authors: Marcel Hechler

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Since passion is considered one of the most important motivating factors for entrepreneurship, we examined the influence of the availability of resources and information on the emergence of a harmonious passion for entrepreneurship (HPE). Drawing on self-determination theory and a cross-cultural sample of 1,085 entrepreneurs from seven developing countries, we argue that the availability of resources and information increases an entrepreneur's autonomy and, thus, promotes the emergence of HPE.

Keywords: harmonious passion, access to resources and information, developing and emerging countries, self-determination theory

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705 Effect of a Single Injection of hCG on Testosterone Concentration in Male Alpacas

Authors: A. ElZawam, D. McLean, A. Tibary

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In alpaca, age at puberty is variable and the factors regulating the pattern of puberty and sexual maturation are a subject of controversy. Plasma testosterone level is often used as an indicator of sexual maturity. Our hypothesis is that hCG treatment will cause an increase in testosterone level that is correlated with animal age. The specific aim was to investigate the testicular tissue response to a single hCG injection by monitoring the serum testosterone concentration. Eighty four (n=84) males ranging in age from 6 to 60 months were used. Alpacas were grouped based on their ages into 15 groups. Each group had three to five male animals. Blood samples were collected from the jugular vein before treatment with hCG and 2 hours after intravenous administration of 3000 IU of hCG (Chorulon®). The serum was harvested and stored at -20ºC until the analysis. The effect of age on basal testosterone level and response to hCG treatment was evaluated by Analysis of Variance. As a result, basal serum testosterone concentrations were very low (<0.1ng/ml) until 9 months of age. Although basal serum testosterone concentrations increased steadily with age there was a significant variation amongst males within the same age group. Administration of 3000 IU of hCG, resulted in an average increase of 50% (P<0.05) in serum testosterone concentration after 2 hours. The percentage increase in serum testosterone in response to hCG stimulation varied from 51 to 81%. There was no correlation between the degree of response and age. However, the response to hCG injection presented two modes of increase depending on the age of animals. The first mode occurred at ages 9 to 14 months and the second mode was observed between 22 and 36 months. In conclusion, our results suggest that testicular growth and sensitivity to LH stimulation may be bimodal in the male alpaca with a rapid increase in growth and sensitivity between 9 and 14 months of age and a second phase of increased responsiveness after 21 months of ages.

Keywords: alpaca, testosterone, hCG, animal science

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704 Effects of Adding Sodium Nitroprusside in Semen Diluents on Motility, Viability and Lipid Peroxidation of Sperm of Holstein Bulls

Authors: Leila Karshenas, Hamid Reza Khodaei, Behnaz Mahdavi

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We know that nitric oxide (NO) plays an important role in all sexual activities of animals. It is made in body from NO synthase enzyme and L-arginin molecule. NO can bound with sulfur-iron complexes and because production of steroid sexual hormones is related to enzymes which have this complex, NO can change the activity of these enzymes. NO affects many cells including endothelial cells of veins, macrophages and mast cells. These cells are found in testis leydig cells and therefore are important source of NO in testis tissue. Minimizing damages to sperm at the time of sperm freezing and thawing is really important. The goal of this study was to determine the function of NO before freezing and its effects on quality and viability of sperms after thawing and incubation. 4 Holstein bulls were selected from the age of 4, and artificial insemination was done for 3 weeks (2 times a week). Treatments were 0, 10, 50 and 100 nm of sodium nitroprusside (SNP). Data analysis was performed by SAS98 program. Also, mean comparison was done using Duncan's multiple ranges test (P<0.05). Concentrations used was found to increase motility and viability of spermatozoa at 1, 2 and 3 hours after thawing significantly (P<0.05), but there was no significant difference at zero time. SNP levels reduced the amount of lipid peroxidation in sperm membrane, increased acrosome health and improved sample membranes especially in 50 and 100 nm treatments. According to results, adding SNP to semen diluents increases motility and viability of spermatozoa. Also, it reduces lipid peroxidation in sperm membrane and improves sperm function.

Keywords: sperm motility, nitric oxide, lipid peroxidation, spermatozoa

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703 Access to Sexual Reproductive Health (SRH) Education and Services to Deaf Adolescents in Wakiso, Uganda - The Ugandan Perspective

Authors: Racheal Ayanga, Nancy Katumba Muwangala, Jane Babirye, Harriet Kivumbi

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Background: Deaf adolescents are vulnerable. Deafness limits their access to resources that are accessed by their hearing peers. There is minimal attention placed on the SRH needs of persons with disabilities, especially in developing countries. We sought to assess barriers to access of SRH education and services for deaf adolescents in Uganda. Methods: We performed a cross sectional study using a questionnaire on knowledge of and access to SRH education and services from a selected sample of deaf adolescents aged 13-19 years at Wakiso Secondary school for the deaf. A consecutive sample of eligible participants was asked to join the study after obtaining informed consent until the target sample size was reached. Results: From 01 Jul 2022 to 30 Jan 2023, 70 quantitative interviews were conducted. Participants’ mean age was 17 years, and 66% were female. 89% had heard about several components of SRH. 99% reported a need for education and services but had challenges with access 85% of the time. 54% reported receipt of education and services from government or private facilities, and the rest from friends, parents, siblings, teachers and the internet. Conclusion: Government needs to look into availing tailored, sustainable SRH education/services to deaf adolescents at health facilities and teach health workers sign language. SRH education to parents, teachers and communities of deaf adolescents improves access in hard-to-reach areas. Integration of services into routine health care is key in creating and improving models of access to wider communities of persons with disabilities to improve their mental health.

Keywords: sexual and reproductive health, deaf, adolescents, education, services, disabilities, mental health, hard-to-reach areas

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702 Women’s Empowerment on Modern Contraceptive Use in Poor-Rich Segment of Population: Evidence from South Asian Countries

Authors: Muhammad Asim

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Background: Less than half of women in South Asia (SA) use any modern contraceptive method which leads to a huge burden of unintended pregnancies, unsafe abortions, maternal deaths, and socioeconomic loss. Women empowerment plays a pivotal role in improving various health seeking behaviours, including contraceptive use. The objective of this study to explore the association between women's empowerment and modern contraceptive, among rich and poor segment of population in SA. Methods: We used the most recent, large-scale, demographic health survey data of five South Asian countries, namely Afghanistan, Pakistan, Bangladesh, India, and Nepal. The outcome variable was the current use of modern contraceptive methods. The main exposure variable was a combination (interaction) of socio-economic status (SES) and women’s level of empowerment (low, medium, and high), where SES was bifurcated into poor and rich; and women empowerment was divided into three categories: decision making, attitude to violence and social independence. Moreover, overall women empowerment indicator was also created by using three dimensions of women empowerment. We applied both descriptive statistics and multivariable logistic regression techniques for data analyses. Results: Most of the women possessed ‘medium’ level of empowerment across South Asian Countries. The lowest attitude to violence empowerment was found in Afghanistan, and the lowest social independence empowerment was observed in Bangladesh across SA. However, Pakistani women have the lowest decision-making empowerment in the region. The lowest modern contraceptive use (22.1%) was found in Afghanistan and the highest (53.2%) in Bangladesh. The multivariate results depict that the overall measure of women empowerment does not affect modern contraceptive use among poor and rich women in most of South Asian countries. However, the decision-making empowerment plays a significant role among both poor and rich women to use modern contraceptive methods across South Asian countries. Conclusions: The effect of women’s empowerment on modern contraceptive use is not consistent across countries, and among poor and rich segment of population. Of the three dimensions of women’s empowerment, the autonomy of decision making in household affairs emerged as a stronger determinant of mCPR as compared with social independence and attitude towards violence against women.

Keywords: women empowerment, contraceptive use, South Asia, women autonomy

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701 Women’s Empowerment on Modern Contraceptive Use in Poor-Rich Segment of Population: Evidence From South Asian Countries

Authors: Muhammad Asim

Abstract:

Background: Less than half of women in South Asia (SA) use any modern contraceptive method which leads to a huge burden of unintended pregnancies, unsafe abortions, maternal deaths, and socioeconomic loss. Women empowerment plays a pivotal role in improving various health seeking behaviours, including contraceptive use. The objective of this study to explore the association between women's empowerment and modern contraceptive, among rich and poor segment of population in SA. Methods: We used the most recent, large-scale, demographic health survey data of five South Asian countries, namely Afghanistan, Pakistan, Bangladesh, India, and Nepal. The outcome variable was the current use of modern contraceptive methods. The main exposure variable was a combination (interaction) of socio-economic status (SES) and women’s level of empowerment (low, medium, and high), where SES was bifurcated into poor and rich; and women empowerment was divided into three categories: decision making, attitude to violence and social independence. Moreover, overall women empowerment indicator was also created by using three dimensions of women empowerment. We applied both descriptive statistics and multivariable logistic regression techniques for data analyses. Results: Most of the women possessed ‘medium’ level of empowerment across South Asian Countries. The lowest attitude to violence empowerment was found in Afghanistan, and the lowest social independence empowerment was observed in Bangladesh across SA. However, Pakistani women have the lowest decision-making empowerment in the region. The lowest modern contraceptive use (22.1%) was found in Afghanistan and the highest (53.2%) in Bangladesh. The multivariate results depict that the overall measure of women empowerment does not affect modern contraceptive use among poor and rich women in most of South Asian countries. However, the decision-making empowerment plays a significant role among both poor and rich women to use modern contraceptive methods across South Asian countries. Conclusions: The effect of women’s empowerment on modern contraceptive use is not consistent across countries, and among poor and rich segment of population. Of the three dimensions of women’s empowerment, the autonomy of decision making in household affairs emerged as a stronger determinant of mCPR as compared with social independence and attitude towards violence against women.

Keywords: women empowerment, modern contraceptive use, South Asia, women autonomy

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700 Through the Lens of Forced Displacement: Refugee Women's Rights as Human Rights

Authors: Pearl K. Atuhaire, Sylvia Kaye

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While the need for equal access to civil, political as well as economic, social and cultural rights is clear under the international law, the adoption of the Convention on the Elimination of all forms of Discrimination against women in 1979 made this even clearer. Despite this positive progress, the abuse of refugee women's rights is one of the basic underlying root causes of their marginalisation and violence in their countries of asylum. This paper presents a critical review on the development of refugee women's rights at the international levels and national levels. It provides an array of scholarly literature on this issue and examines the measures taken by the international community to curb the problem of violence against women in their various provisions through the instruments set. It is cognizant of the fact that even if conflict affects both refugee women and men, the effects on women refugees are deep-reaching, due to the cultural strongholds they face. An important aspect of this paper is that it is conceptualised against the fact that refugee women face the problem of sexual and gender based first as refugees and second as women, yet, their rights are stumbled upon. Often times they have been rendered "worthless victims" who are only in need of humanitarian assistance than active participants committed to change their plight through their participation in political, economic and social participation in their societies. Scholars have taken notice of the fact that women's rights in refugee settings have been marginalized and call for a need to incorporate their perspectives in the planning and management of refugee settings in which they live. Underpinning this discussion is feminism theory which gives a clear understanding of the root cause of refugee women's problems. Finally, this paper suggests that these policies should be translated into action at local, national international and regional levels to ensure sustainable peace.

Keywords: feminism theory, human rights, refugee women, sexual and gender based violence

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699 Comparing Community Health Agents, Physicians and Nurses in Brazil's Family Health Strategy

Authors: Rahbel Rahman, Rogério Meireles Pinto, Margareth Santos Zanchetta

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Background: Existing shortcomings of current health-service delivery include poor teamwork, competencies that do not address consumer needs, and episodic rather than continuous care. Brazil’s Sistema Único de Saúde (Unified Health System, UHS) is acknowledged worldwide as a model for delivering community-based care through Estratégia Saúde da Família (FHS; Family Health Strategy) interdisciplinary teams, comprised of Community Health Agents (in Portuguese, Agentes Comunitário de Saude, ACS), nurses, and physicians. FHS teams are mandated to collectively offer clinical care, disease prevention services, vector control, health surveillance and social services. Our study compares medical providers (nurses and physicians) and community-based providers (ACS) on their perceptions of work environment, professional skills, cognitive capacities and job context. Global health administrators and policy makers can leverage on similarities and differences across care providers to develop interprofessional training for community-based primary care. Methods: Cross-sectional data were collected from 168 ACS, 62 nurses and 32 physicians in Brazil. We compared providers’ demographic characteristics (age, race, and gender) and job context variables (caseload, work experience, work proximity to community, the length of commute, and familiarity with the community). Providers perceptions were compared to their work environment (work conditions and work resources), professional skills (consumer-input, interdisciplinary collaboration, efficacy of FHS teams, work-methods and decision-making autonomy), and cognitive capacities (knowledge and skills, skill variety, confidence and perseverance). Descriptive and bi-variate analysis, such as Pearson Chi-square and Analysis of Variance (ANOVA) F-tests, were performed to draw comparisons across providers. Results: Majority of participants were ACS (64%); 24% nurses; and 12% physicians. Majority of nurses and ACS identified as mixed races (ACS, n=85; nurses, n=27); most physicians identified as males (n=16; 52%), and white (n=18; 58%). Physicians were less likely to incorporate consumer-input and demonstrated greater decision-making autonomy than nurses and ACS. ACS reported the highest levels of knowledge and skills but the least confidence compared to nurses and physicians. ACS, nurses, and physicians were efficacious that FHS teams improved the quality of health in their catchment areas, though nurses tend to disagree that interdisciplinary collaboration facilitated their work. Conclusion: To our knowledge, there has been no study comparing key demographic and cognitive variables across ACS, nurses and physicians in the context of their work environment and professional training. We suggest that global health systems can leverage upon the diverse perspectives of providers to implement a community-based primary care model grounded in interprofessional training. Our study underscores the need for in-service trainings to instill reflective skills of providers, improve communication skills of medical providers and curative skills of ACS. Greater autonomy needs to be extended to community based providers to offer care integral to addressing consumer and community needs.

Keywords: global health systems, interdisciplinary health teams, community health agents, community-based care

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