Search results for: female sexual dysfunction
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 3406

Search results for: female sexual dysfunction

3256 Crossing Boundaries: Emerging Identities from Folk Theatre

Authors: Sonia Wahengbam, Natasha Elangbam

Abstract:

Female impersonation has existed through the length of human civilization and the breadth of its cultures. Transvestism and drag queen cultures have created multi-sited spaces where in the shadow of art, one can cross the gender barrier and express one’s hidden identity. This paper will explore a dynamic cultural space that exists in Manipur, a state in the northeastern region of India, where the female impersonators (nupi shabis) of a folk theater (Shumang Leela) are using this traditional and popular art form to claim social acceptance of their homosexual identities through the medium of entertainment. It will highlight how by crossing the gender boundary, this third gender group has carved out a unique socio-economic niche where they have exploited their sexual identities to their advantage. The paper will trace the expanding cultural ‘’borderland’’ of Manipur where there is an increasing sense of ‘becoming’, belonging and sharing” of identities through the interweaving of old and new media. The research will be based on interviews with the nupi shabis, cultural critics and other experts.

Keywords: transvestism, Manipur, female impersonators (nupi shabis), Shumang Leela, gender

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3255 Increasing Sexual Safety Awareness and Capacity for Mental Health Professionals

Authors: Tara Hunter, Kristine Concepcion, Wendy Cheng, Brianna Pike, Jane Estoesta, Anne Stuart

Abstract:

In 2015, Family Planning NSW was contracted by the NSW Ministry of Health to design and deliver Sexual Safety Policy training (SSPT) to mental health professionals across NSW. The training was based on their current guidelines and developed in consultation with an expert reference group. From October 2015 to April 2017 it was delivered to over 2,400 mental health professionals with a view to supporting implementation of consistent prevention and intervention related to sexual safety in the mental health setting. An evaluation was undertaken to determine the knowledge and confidence of participants related to sexual safety before and after the training, and whether any improvements were translated into changes in practice. Participants were invited to complete a survey prior to the training, upon completion and three to six months thereafter. Telephone interviews were conducted among service managers and mental health champions six months post-training. Prior to training, the majority of mental health professionals reported being slightly to moderately confident in identifying a sexual safety incident. When asked on their understanding of sexual safety, gender sensitive practice and trauma informed care, they reported no confidence, slight confidence and moderate confidence. Immediately after the training, 54.5% reported being very confident and 10.9% extremely confident in identifying a sexual safety incident. More than half felt very confident or extremely confident in their understanding of sexual safety principles. The impact survey (six months later) found that the majority of participants (91%) were highly confident in identifying a sexual safety incident. Telephone interviewees reported a change in workplace culture and increased awareness after the training. Mental health professionals experienced increased knowledge and confidence about sexual safety principles following the training and were able to implement positive changes and concrete actions to better address sexual safety issues in their workplace.

Keywords: sexual safety, mental health professionals, trauma informed care, policy training

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3254 Women with Disabilities: A Study of Contributions of Sexual and Reproductive Rights for Theology

Authors: Luciana Steffen

Abstract:

People with disabilities are often neglected in the exercise of their sexuality, facing several prejudices and discrimination in this area. For women with disabilities, the negligence is even major. Studies that relate sexual and reproductive rights with the experience of women with disabilities are rare, and in the field of Theology, practically nonexistent in Brazil. The aim of this work is to reflect on the relationship between women with disabilities, sexual and reproductive rights and Theology, according to a feminist perspective. The work is a literature review and involves the areas of Gender Studies, Disability Studies, Feminist Studies and Theology. In the article it will be addressed the relations between disability, sexual and reproductive rights, feminism, as well as the relations with the area of Theology, reflecting on these themes toward a fairer and more inclusive understanding of feminism, sexuality and women with disabilities. To reflect on sexual and reproductive rights of women with disabilities, it is important to reflect on religious concepts about the body, sexuality, reproduction and gender roles, because they are all connected. So, a critical analysis of traditional theological values taking into consideration the dimensions of sexuality and women with disability is important for a more liberating and inclusive understand about sexual and reproductive rights of women with disabilities. Theology should help the other areas in the understanding that all people have the right to live their lives with completeness, dignity and respect, so women with disabilities must have the opportunity of making their own choices on the fields of sexuality and reproduction.

Keywords: gender, disability, sexual and reproductive rights, theology

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3253 An Increase in Glucose Uptake per se is Insufficient to Induce Oxidative Stress and Vascular Endothelial Cell Dysfunction

Authors: Heba Khader, Victor Solodushko, Brian Fouty

Abstract:

Hyperglycemia is a hallmark of uncontrolled diabetes and causes vascular endothelial dysfunction. An increase in glucose uptake and metabolism by vascular endothelial cells is the presumed trigger for this hyperglycemia-induced dysfunction. Glucose uptake into vascular endothelial cells is mediated largely by Glut-1. Glut-1 is an equilibrative glucose transporter with a Km value of 2 mM. At physiologic glucose concentrations, Glut-1 is almost saturated and, therefore, increasing glucose concentration does not increase glucose uptake unless Glut-1 is upregulated. However, hyperglycemia downregulates Glut-1 and decreases rather than increases glucose uptake in vascular endothelial cells. This apparent discrepancy necessitates further study on the effect of increasing glucose uptake on the oxidative state and function of vascular endothelial cells. To test this, a Tet-on system was generated to conditionally regulate Glut-1 expression in endothelial cells by the addition and removal of doxycycline. Glut-1 overexpression was confirmed by Western blot and radiolabeled glucose uptake measurements. Upregulation of Glut-1 resulted in a 4-fold increase in glucose uptake into endothelial cells as determined by 3H deoxy-D-glucose uptake. Increased glucose uptake through Glut-1 did not induce an oxidative stress nor did it cause endothelial dysfunction in rat pulmonary microvascular endothelial cells determined by monolayer resistance, cell proliferation or advanced glycation end product formation. Increased glucose uptake through Glut-1did not lead to an increase in glucose metabolism, due in part to inhibition of hexokinase in Glut-1 overexpressing cells. In summary, this study demonstrates that increasing glucose uptake and intracellular glucose by overexpression of Glut-1 does not alter the oxidative state of rat pulmonary microvascular endothelial cells or cause endothelial cell dysfunction. These results conflict with the current paradigm that hyperglycemia leads to oxidative stress and endothelial dysfunction in vascular endothelial cells through an increase in glucose uptake.

Keywords: endothelial cells, glucose uptake, Glut1, hyperglycemia

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3252 Systematic Review of Sexual Assault Prevention Methods for Older Adults: Exploring the Hidden Needs of a Growing Population

Authors: Michelle Hand, Brieanne Beaujolais

Abstract:

Rape stereotypes have long involved the assault of young females by strangers desiring sex. As such, older adult women and men have largely been excluded from research, policies, and awareness raising initiatives to address sexual violence. Moreover sexual assault accounts for the most underreported type of abuse experienced by older adults, highlighting a need to expand our knowledge base in this area. Thus a systematic review of peer-reviewed scholarly articles and reports was conducted to explore the ways sexual assault has been prevented among older adults in recent years and to identify implications for researchers and practitioners as they aim to meet the needs of this population. Articles and reports published during or after 2007 were eligible if their focus included methods to address sex abuse among older adults as well as practice or research implications. Forty-four articles met this criteria and were included in this systematic review. The findings from this review will provide an in-depth understanding of the under-researched issue of sexual violence among older adult women and men as well as current prevention strategies. In addition, implications and recommendations will be provided for practitioners, educators and researchers as they aim to meet the hidden needs of this growing yet under-researched population.

Keywords: elder, rape, sexual assault, sexual violence

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3251 The Optimization of Sexual Health Resource Information and Services for Persons with Spinal Cord Injury

Authors: Nasrin Nejatbakhsh, Anita Kaiser, Sander Hitzig, Colleen McGillivray

Abstract:

Following spinal cord injury (SCI), many individuals experience anxiety in adjusting to their lives, and its impacts on their sexuality. Research has demonstrated that regaining sexual function is a very high priority for individuals with SCI. Despite this, sexual health is one of the least likely areas of focus in rehabilitating individuals with SCI. There is currently a considerable gap in appropriate education and resources that address sexual health concerns and needs of people with spinal cord injury. Furthermore, the determinants of sexual health in individuals with SCI are poorly understood and thus poorly addressed. The purpose of this study was to improve current practices by informing a service delivery model that rehabilitation centers can adopt for appropriate delivery of their services. Methodology: We utilized qualitative methods in the form of a semi-structured interview containing open-ended questions to assess 1) sexual health concerns, 2) helpful strategies in current resources, 3) unhelpful strategies in current resources, and 4) Barriers to obtaining sexual health information. In addition to the interviews, participants completed surveys to identify socio-demographic factors. Data gathered was coded and evaluated for emerging themes and subthemes through a ‘code-recode’ technique. Results: We have identified several robust themes that are important for SCI sexual health resource development. Through analysis of these themes and their subthemes, several important concepts have emerged that could provide agencies with helpful strategies for providing sexual health resources. Some of the important considerations are that services be; anonymous, accessible, frequent, affordable, mandatory, casual and supported by peers. Implications: By incorporating the perspectives of individuals with SCI, the finding from this study can be used to develop appropriate sexual health services and improve access to information through tailored needs based program development.

Keywords: spinal cord injury, sexual health, determinants of health, resource development

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3250 The Lived Experiences of Stigma in Non-offending Pedophiles

Authors: Rebecca Heron, Steal Adcock, Karen Parsonson

Abstract:

Non-offending pedophiles are an under- researched, hard to reach population. This group of individuals are often hesitant to come forward and fail to seek help ongoing stigma experienced in society.In order to better understand non-offending pedophiles experiences of their identity and the stigma they face, semi-structured qualitative interviews were conducted with 10 non-offending pedophiles, who were recruited through online support groups for individuals who have sexual attractions towards children. Participants were interviewed over skype, and the data was analysed using interpretative phenomenological analysis (IPA) approach, anda number of themes were generated from the rich data set produced. Four main themes emerged, providing insight into how non-offending pedophiles experience stigma. The themes included ‘stigma in relation to themselves’, ‘others’, ‘the media portrayal’and ‘impact of the stigma of MAP’s seeking treatment’. Findings are discussed in relation to existing literature, and practical recommendations are proposed to hopefully allow this population to feel more comfortable sharing their sexual interests, which will allow them to seek help resulting in them not offending and, ultimately, the prevention of sexual abuse. This study fills the void in terms of lack of research with this population, especially when it comes to qualitative in depth studies, including not just male minor attracted persons but female minor attracted persons as well.

Keywords: pedophillia, stigma, non-offending pedophiles, minor attracted persons, prevention

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3249 Men Act, Women Are Acted Upon: Morphosyntactic Framing of the Sexual Intercourse in Online Pornography Titles

Authors: Aleksandra Tomic

Abstract:

According to reliable sources, 4% of all websites is devoted to pornographic material, yet these estimates are often reported to be much higher. The largest internet pornography streaming website reports 21.2 billion visits in 2015 only. Considering the ubiquity of online pornography and the frequency of use, it is necessary to examine its potential influence on the construal of the sexual act and the roles of participants. Apart from the verbal and physical interactions in the pornographic movies themselves, the language in the titles of movies has the power to frame the sexual intercourse. In this study, Critical Discourse Analysis and corpus linguistics approaches will be used to examine the way the sexual intercourse and the roles of the participants are ideologically construed and perpetuated in the Internet pornography discourse. To this end, the study will explore the association between the specific morphosyntactic aspects of the references to performers of both genders, the person and the thematic role, and the gender of referred performer in the corpus of online pornographic movie titles. Distinctive collexeme analysis will be conducted to uncover possible associations between for gender of the performer denoted by the linguistic expression, and the person and thematic role assigned to it in the titles of online pornography movies. Initial results of the chi-square procedure performed on a sample of 295 online pornography movie titles on the largest pornography streaming website ‘Pornhub’ yielded significant results. The use of the three person categories was not equally distributed between genders, X2 (2, N = 106) = 32.52, p < 0.001, with female performers being referred to in the third person in 71.7% of the instances, and speaking in the first person 20.8% of the time, whereas male performers spoke in the first person 68% of the time, and were referred to in the third person in 17% of the instances. Moreover, there was a gender disparity in the assignment of thematic roles, with linguistic expressions for women being assigned the Patient role and men the Agent role in 58.8% of the cases, whereas the roles were reversed in 41.2% of the instances, X2 (1, N = 262) = 8.07633, p < 0.005. The results are discussed in terms of the ideologies surrounding female and male sexuality in the pornography discourse. Potential patterns of power imbalance, objectification, and discrimination are highlighted. Finally, the evidence from psycholinguistic studies on the influence of the language structure on event construal is related to the results of the study.

Keywords: corpus linguistics, gender studies, pornography, thematic roles

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3248 Gender Differences in the Impact and Subjective Interpretation of Childhood Sexual Abuse Survivors

Authors: T. Borja-Alvarez, V. Jiménez-Borja, M. Jiménez Borja, C. J. Jiménez-Mosquera

Abstract:

Research on child sexual abuse has predominantly focused on female survivors. This has resulted in less research looking at the particular context in which this abuse takes place for boys and the impact this abuse may have on male survivors. The aim of this study is to examine the sex and age of the perpetrators of child sexual abuse and explore gender differences in the impact along with the subjective interpretation that survivors attribute to these experiences. The data for this study was obtained from Ecuadorian university students (M = 230, F = 293) who reported sexual abuse using the ISPCAN Child Abuse Screening Tool Retrospective version (ICAST-R). Participants completed Horowitz's Impact of Event Scale (IES) and were also requested to choose among neutral, positive, and negative adjectives to describe these experiences. The results indicate that in the case of males, perpetrators were both males (adults =27%, peers =20%, relatives =10.3%, cousins =7.4%) and young females (girlfriends or ex-girlfriends =25.6%, neighborhood =20.7%, school =16.7%, cousins =15.3%, strangers =12.8%). In contrast, almost all females reported that adult males were the perpetrators (relatives =29.6%, neighborhood =11.9%, strangers =19.9%, family friends =9.7%). Regarding the impact of these events, significant gender differences emerged. More females (50%) than males (20%) presented symptoms of post-traumatic stress disorder (PTSD). Gender differences also surfaced in the way survivors interpret their experiences. Almost half of the male participants selected the word “consensual” followed by the words “normal”, “helped me to mature”, “shameful”, “confusing”, and “traumatic”. In contrast, almost all females chose the word “non-consensual” followed by the words “shameful”, “traumatic”, “scary”, and “confusing”. In conclusion, the findings of this study suggest that young females and adult males were the most common perpetrators of sexually abused boys whereas adult males were the most common perpetrators of sexually abused girls. The impact and the subjective interpretation of these experiences were more negative for girls than for boys. The factors that account for the gender differences in the impact and the interpretation of these experiences need further exploration. It is likely that the cultural expectations of sexual behaviors for boys and girls in Latin American societies may partially explain the differential impact in the way these childhood sexual abuse experiences are interpreted in adulthood. In Ecuador, as is the case in other Latin American countries, the machismo culture not only accepts but encourages early sexual behaviors in boys and negatively judges premature sexual behavior in females. The result of these different sexual expectations may be that sexually abused boys may re-define these experiences as “consensual” and “normal” in adulthood, even though these were not consensual at the time of occurrence. Future studies are needed to more deeply understand the different contexts of sexual abuse for boys and girls in order to analyze the long-term impact of these experiences.

Keywords: abuse, child, gender differences, sexual

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3247 Teaching for Gender and Sexual Diversity in South African Primary Schools

Authors: Shakila Singh, Devanya Reddy, Navisha Sewnath

Abstract:

Children spend a substantial time at school, and their awareness and construction of sexual identities are significantly impacted by their teachers. South African primary schools locate sex and sexuality education in the Life Orientation (LO), leaving all engagement with issues of identity and diversity in the domain of LO teachers. This paper examines the views and experiences of selected teachers regarding their engagement with sexual diversity in a primary school in South Africa. This is a small-scale qualitative study. The sample comprised twelve teachers (including non-LO teachers), and the main research method was a semi-structured interview. The findings show that the teachers have limited understanding of sexual diversity. They mostly hold heteronormative and moralistic views, negate children's sexuality, and they are awkward about acknowledging and discussing diverse sexualities. We argue that teachers need to reflect on their own conservative socialisation and moral judgements, address their discomfort concerning addressing issues of sex and sexual diversity with children, and create an environment for children to construct their sexualities within a supportive context. Teacher Education must, therefore, prepare teachers in a manner that recognises the complex ways gender and sexuality infuse all aspects of learners' lives and prepare all teachers for a non-judgmental approach to sexual inclusion that challenges heteronormativity in primary school.

Keywords: primary school, sexuality education, sexual diversity, teachers

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3246 Associations Between Pornography Use Motivations and Sexual Satisfaction in Gender Diverse and Cisgender Individuals in the 43-Country International Sex Survey

Authors: Aurélie Michaud, Émilie Gaudet, Mónika Koós, Léna Nagy, Zsolt Demetrovics, Shane W. Kraus, Marc N. Potenza, Beáta Bőthe

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Pornography use is prevalent among adults worldwide. Prior studies have assessed the associations between pornography use frequency and sexual satisfaction, in cisgender and heterosexual individuals, with mixed results. However, measuring pornography use solely by pornography use frequency is problematic, as it can lead to disregarding important contextual factors that may be related to pornography use’s potential effects. Pornography use motivations (PUMs) represent key predictors of sexual behaviors. Yet, their associations with different indicators of sexual wellbeing have yet to be extensively studied. This cross-cultural study examined the links between the eight PUMs most often reported in the general population (i.e. sexual pleasure, sexual curiosity, emotional distraction or suppression, fantasy, stress reduction, boredom avoidance, lack of sexual satisfaction, and self-exploration) and sexual satisfaction in gender diverse and cisgender individuals. Given the lack of scientific data on associations between individuals’ PUMs and sexual satisfaction, these links were examined in an exploratory manner. A total of 43 countries from five continents were included in the International Sex Survey (ISS). A secure online platform was used to collect self-report, anonymous data from 82,243 participants (39.6% men, 57% women, 3.4% gender diverse individuals; M = 32.4 years, SD = 12.5). Gender-based differences in levels of sexual pleasure, sexual curiosity, emotional distraction, fantasy, stress reduction, boredom avoidance, lack of sexual satisfaction, and self-exploration PUMs were examined using one-way ANOVAs. Then, for each gender group, the associations between each PUM and sexual satisfaction were examined using multiple linear regression, controlling for frequency of masturbation. One-way ANOVAs indicated significant differences between men, women, and gender diverse individuals on all PUMs. For sexual pleasure, sexual curiosity, fantasy, boredom avoidance, lack of sexual satisfaction, emotional distraction, and stress reduction PUMs, men showed the highest scores, followed by gender-diverse individuals, and women. However, for self-exploration, gender-diverse individuals had higher average scores than men. For all PUMs, women’s average scores were the lowest. After controlling for frequency of masturbation, for all genders, sexual pleasure, sexual curiosity and boredom avoidance were significant positive predictors of sexual satisfaction, while lack of sexual satisfaction PUM was a significant negative predictor. Fantasy, stress reduction and self-exploration PUMs were positive significant predictors of sexual satisfaction, and fantasy was a negative significant predictor, but only for women. Findings highlight important gender differences in regards to the main motivations underlying pornography use and their relations to sexual satisfaction. While men and gender diverse individuals show similar motivation profiles, woman report a particularly unique experience, with fantasy, stress reduction and self-exploration being associated to their sexual satisfaction. This work outlines the importance of considering the role of pornography use motivations when studying the links between pornography viewing and sexual well-being, and may provide basis for gender-based considerations when working with individuals seeking help for their pornography use or sexual satisfaction.

Keywords: pornography, sexual satifsaction, cross-cultural, gender diversity

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3245 Sexual Harassment at Workplace in Cuttack District

Authors: Anasuya P. Pradhan, Netajee Abhinandan

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Today's workplace is diverse and keeps changing continuously. Sexual harassment in the work place has emerged as a growing obstacle in women’s progress and being a sex discrimination issue has made the society vulnerable.Such issues indicate that, today women are comparatively more insecure in our society irrespective of their social status, position, and educational qualification. Hence, it needs to be addressed in the academic pedagogy.The study aimed to learn how far people are gender-sensitized, how far they are aware about the laws related to the issue, and how far women employees raise their voice against it. The findings revealed that even being educated and working in the organized sectors, people are unaware and are not sensitized. The study therefore recommends both the Government and managers of institutions how to critically identify the root causes of sexual harassment, its implications on our society and how best to address it.

Keywords: workplace power, gender discrimination, gender sensitization, sexual harassment

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3244 Promoting Gender Diversity in the UN Peacekeeping Operations: An Analysis of Factors Influencing Female Military Troops Deployment

Authors: Rahab Kisio

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The persistent underrepresentation of female miltary in United Nations (UN) peacekeeping missions remains a critical concern for addressing the multifaceted challenges in conflict-affected regions. This research explores the factors influencing countries’ decisions to deploy female military troops to UN peacekeeping operations, examining data ranging from 2010 to 2020. The study highlights the urgent need for policymakers and international organizations to recognize gender equality as key instrument in dealing with sexual exploitation and abuse within these missions. The study suggests three reasons for the low female military troops deployment. Firstly, countries actively breaking down barriers for women in the workforce are more likely to send female military troops. Secondly, nations supporting women in politics are more likely to deploy female military troops, showing their value for gender equality. Lastly, countries with a history of conflict may send more female military troops to align with the UN's call and potentially gain international support in future conflicts. Theoretical approaches are presented to explore these motivations further, and the study uses negative binomial regression with country-year as the unit of analysis to test various explanations for a country's contribution of female military troops to UN peacekeeping missions. Findings shows that there is a connection between troop contributing countries’ gender equality and the participation of female military troops in peacekeeping operations. Nations that prioritize gender equality and empower women have a higher likelihood of deploying more female military personnel. The study emphasizes the significance of women in political leadership, indicating that countries actively addressing barriers to women's political representation are more willing to contribute higher numbers of female military troops to peacekeeping missions. While the research supports hypotheses related to gender equality and political representation, it finds no significant evidence that a country's history of conflict directly influences the deployment of female military troops in other conflict-ridden nations. This research contributes valuable insights into gender equality within peacekeeping forces, shedding light on factors influencing the deployment of female military personnel. The implications underscore the importance of actively addressing discrimination, promoting women's political participation, and understanding the influence of a nation's conflict history. The interdisciplinary nature of this work calls for collaborative efforts from policymakers, international organization, and researchers to formulate strategies for effectively increasing female military troops participation in UN peacekeeping

Keywords: UN peacekeeping, gender diversity, female military troops, discrimination

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3243 NO2 Exposure Effect on the Occurrence of Pulmonary Dysfunction the Police Traffic in Jakarta

Authors: Bambang Wispriyono, Satria Pratama, Haryoto Kusnoputranto, Faisal Yunus, Meliana Sari

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Introduction/objective: The impact of the development of motor vehicles is increasing the number of pollutants in the air. One of the substances that cause serious health problems is NO2. The health impacts arising from exposure to NO2 include pulmonary function impairment. The purpose of this study was to determine the relationship of NO2 exposure on the incidence of pulmonary function impairment. Methods: We are using a cross-sectional study design with 110 traffic police who were divided into two groups: exposed (police officers working on the highway) and the unexposed group (police officers working in the office). Election subject convenient sampling carried out in each group to the minimum number of samples met. Results: The results showed that the average NO2 in the exposed group was 18.72 ppb and unexposed group is 4.14 ppb. Pulmonary dysfunction on exposed and unexposed groups showed that FVC (Forced Vital Capacity) value are 88.68 and 90.27. And FEV1 (Forced Expiratory Volume in One) value are 94.9 and 95.16. Some variables like waist circumference, Body Mass Index, Visceral Fat, and Fat has associated with the incidence of Pulmonary Dysfunction (p < 0.05). Conclusion: Health monitoring is needed to decreasing health risk in Policeman.

Keywords: NO2, pulmonary dysfunction, police traffic, Jakarta

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3242 The Associations of Family Support with Sexual Behaviour and Repeat Induced Abortion among Chinese Adolescents

Authors: Jiashu Shen

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Background: The abortion rate has increased significantly, which is harmful especially to adolescents, making repeat induced abortion (RIA) among adolescents a social problem. This study aims to investigate the associations of family support with sexual behavior and repeat induced abortion among Chinese adolescents Methods: This study based on a national hospital-based sample with 945 girls aged 15-19 who underwent induced abortion in 43 hospitals. Multivariate logistic regressions were performed to estimated odds ratio for the risk factors. Results: Adolescences living with parents were less inclined to undergo RIA, especially if they were rural (adjusted odds ratio=0.48 95%CI 0.31-0.72) and local (adjusted odds ratio =0.39 95%=0.23-0.66). Those with parental financial support were likely to have less sexual partnersand take contraceptives more regularly. Those with higher self-perceived importance in family were more likely to take contraceptives during the first sexual intercourse in higher age, and with higher first abortion age and less sexual partners. Conclusion: In mainland China, living with parents, parental financial support, high self-perceived importance in family and adequate family sexuality communications may contribute to lower incidence of RIA.

Keywords: Chinese adolescent, family support, repeat induced abortion, sexual behavior

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3241 Empirical Analysis of the Love Languages in the Context of Relationship Satisfaction, Sexual Satisfaction and Empathy in Romantic Heterosexual Couples

Authors: Olha Mostova, Maciej Stolarski, Gerald Matthews

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The present paper explores and tests Gary Chapman’s claims that (1) people vary in the ways they prefer to receive and express affection and (2) romantic partners, who communicate their feelings correspondingly to their partner’s preferences, experience greater relationship quality. The author proposes five distinct preferences for and tendencies to express love, including acts of service, physical touch, words of affirmation, quality time, and gifts. In the present study, partners (N = 100 romantic, heterosexual couples) completed measures assessing their preferences and behavioral tendencies reflecting 1) how they a) tend to express and b) prefer to receive signs of affection in correspondence to the five proposed categories; 2) relationship satisfaction; 3) sexual satisfaction and 4) empathy, which was expected to be the factor that leads to a better understanding of and responding to the partner’s needs. The degree of the within-couple match was calculated separately for each individual based on the discrepancies between one’s felt (preferred) and their partner’s expressed love language. The joint discrepancy indicator was a sum of such discrepancies across the five love languages. Conducted analyses provided evidence for significant associations between matching on love languages and both relationship and sexual satisfaction. In particular, people who expressed their affection in the way their partners preferred to receive it experienced greater satisfaction with their relationships and were more sexually satisfied compared to those who met their partner’s needs to a lesser extent. Other results provide some support for mediating effects of certain domains of empathy in the said associations among male but not female participants.

Keywords: affection, empathy, love languages, relationship satisfaction, romantic couples, sexual satisfaction

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3240 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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3239 Male-Youth-Related Sexual and Reproductive Health and Rights Interventions in Bangladesh: Challenges of Program Implementation

Authors: Nahela Nowshin, Rafia Sultana, Farzana Misha, Sabina F. Rashid

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Sexual and reproductive health and rights (SRHR) are currently an area of neglect for males (aged 15-24 years) in Bangladesh. The lack of focus on the male youth population has consequences not only for their own health and wellbeing, but the patriarchal structure of Bangladeshi society and socio-cultural norms mean that the male population’s SRH behavior can severely impact the lives of their female counterparts. A majority of sexual and reproductive health and rights-related research and interventions in the country are female-centric. Although the Government of Bangladesh has taken many initiatives to improve the SRHR of the general population, the male youth segment has not been prioritized in most of these interventions. There is an urgent need for male-youth-focused SRHR interventions in Bangladesh, but due to a lack of evidence-based research on this issue, there exist data gaps on how such interventions could be better designed and implemented. Therefore, to ascertain strategies for better program design and smoother implementation of male-youth-focused sexual and reproductive health and rights interventions, we carried out 25 key informant interviews with experts as well as focal persons involved in more than 20 ongoing and recently-ended SRHR-related interventions of national and international non-government organizations in which male youth were targeted or engaged. The results show that program implementers face several challenges at the field, organizational and policy levels. Some of the most common field challenges include high sensitivity to SRHR topics due to cultural reasons, difficulties in acquiring access to boys and young men due to their high mobility and engagement in labor for commercial purposes, as well as accessing them in hard-to-reach areas due to transportation and communication issues. Common organizational-level challenges include a lack of skilled manpower. Policy-level challenges include the prohibition of SRH service provision to unmarried adolescents and youth and lack of readiness of local governments to implement existing action plans. Some ways in which male-youth-focused SRHR interventions can be made more effective are through sensitization of service providers, awareness-raising at the community level to engage parents, advocacy to increase donor interest, and generating data on SRHR of male youth.

Keywords: Bangladesh, intervention, male, SRHR

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3238 A Study on Knowledge, Attitude and Behavior on Emergency Contraception among Higher Secondary and Bachelor Level Youth Students of Lekhnath Municipality, Nepal

Authors: Gokul Pathak, Dilip Kumar Yadav

Abstract:

Background: Unsafe/unprotected and early sexual relations are highly responsible for the problems of unwanted pregnancy, child birth and other adverse consequences. Emergency contraception (EC) refers to methods that women can use to prevent pregnancy after unprotected sexual intercourse, method failure or incorrect use. Aim and Objective: The objective of this research study was to assess the level of knowledge, attitude and behavior on emergency contraception among youth students of Lekhnath Municipality. Methodology: This institution based descriptive study was carried out in August-October 2012 on Lekhnath Municipality, Nepal. Multistage simple random sampling procedure with pretested semi structured questionnaire following self administered technique was used to collect information. Collected data was coded and entered in the EpiData 3.1 ® and exported to Statistical Package for Social Science (SPSS®) version 20.0 for analysis. Chi-square test and Spearman correlation was applied wherever required. Results: A total of 641 students (87.6 %), youth students participated in this study which incorporates 354 male and 287 female youth students, of them 54.3% were from Higher Secondary level and 45.7% were from Undergraduate level. The awareness of EC among respondents was found only 64.7%. 25.8% respondents were found to have fair knowledge level where as 74.2% had poor knowledge level. Level of knowledge was significantly associated with age, educational level, faculty and educational status of mother. The study showed 82.4% respondent’s favorable attitude towards use of EC. 21.1% respondents were found to be sexually active (29.7% male and 10.5% female) and only 28.1% of sexually active respondents had ever used any method of EC. Conclusion: Knowledge about EC was found quiet low among youth. There was significant lack of knowledge about exact time limit of using devices of EC. Similarly several misconceptions regarding EC were found very high among youth. Health education initiatives should target students as they are more likely to be sexually active.

Keywords: emergency contraception, youth, unsafe/unprotected sexual intercourse, knowledge, attitude and behavior

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3237 Cross-Sectional Analysis of Partner Support and Contraceptive Use in Adolescent Females

Authors: Ketan Tamirisa, Kathleen P. Tebb

Abstract:

In the U.S., annually, there are over 1 million pregnancies in teenagers and most (85%) are unintended. The need for proactive prevention measures is imperative to support adolescents with their pregnancy prevention and family planning goals. To date, there is limited research examining the extent to which support from a sexual partner(s) influences contraceptive use. To address this gap, this study assessed the relationship between sexually active adolescents, sex-assigned birth as female, and their perceived support from their sexual partner(s) about their contraceptive use in the last three months. Baseline data from sexually active adolescent females, between 13-19 years who were not currently using a long-acting contraceptive device, were recruited from 32 school-based health centers (SBHCs) in seven states in the U.S. as part of a larger study to evaluate Health-E You/ Salud iTuTM, a web-based contraceptive decision support tool. Fisher’s exact test assessed the cross-sectional association between perceived sexual partner support of contraceptive use in the past three months (felt no support, felt little support, and felt a lot of support), and current use of non-barrier contraception. A total of 91 sexually active adolescent females were eligible and completed the baseline survey. The mean age was 16.7 and nearly half (49.3%) were Hispanic/Latina. Most (85.9%) indicated it was very important to avoid becoming pregnant. A total of 60 participants (65.9%) reported use of non-barrier contraception. Of these, most used birth control pills (n=26), followed by Depo-Provera injection (n=12), patch (n=1), and ring (n=1). Most of the participants (80.2%) indicated that they perceived a lot of support from their partners and 19.8% reported no or little support. Among those reporting a lot of support, 69.9% (51/73) reported current use of non-barrier contraception compared to 50% (9/18) who felt no/little support and reported contraceptive use. This difference approached but did not reach statistical significance (p=0.096). Results from this preliminary data indicate that many adolescents who are coming in for care at SBHCs are at risk of unintended pregnancy. Many participants also reported a lot of support from their sexual partner(s) to use contraception. While the associations only approached significance, this is likely due to the small sample size. This and future research can better understand this association to inform interventions aimed at sexual partners to strengthen education and social support, increase healthcare accessibility, and ultimately reduce rates of unintended pregnancy.

Keywords: adolescents, contraception, pregnancy, SBHCs, sexual partners

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3236 Effective Sexual Assault Treatment as Viewed by Survivors and Expert Therapists

Authors: Avigail Moor

Abstract:

Rape and sexual assault have been widely linked to severe psychological sequelae, the recovery from which often requires professional help. Thanks to the current shift in societal attitudes towards sexual violence, the victim's perspective is increasingly being heard. The present study is yet another step in that direction. Through the investigation of what recovered survivors of sexual assault identify as the therapeutic interventions that most assisted them in overcoming their trauma, guidelines for optimal sexual assault treatment are established. These receive further support from a comparison with expert therapists as to what they view as being most conducive to recovery from rape. In-depth semi-structured interviews were conducted with 15 survivors who have experienced a successful course of therapy and 15 therapists with extensive expertise in the field. The results document considerable agreement between the two perspectives, which share much in common. First, irrespective of the specific techniques involved, both survivors and therapists placed the greatest importance on a respectful and validating therapeutic relationship, that operates to counter the dehumanization and degradation entailed in the assault. In addition, specific interventions were identified, which include the reprocessing of all rape-specific peri-traumatic reactions coupled with the intentional countering of their consequences within the therapeutic relationship. Together, these reports provide a detailed account of post-rape treatment needs and the interventions required for their effective resolution.

Keywords: sexual assault, rape, treatment efficacy, survivors

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3235 Sexual Consent: Exploring the Perceptions of Heterosexual, Gay, and Bisexual Men

Authors: Shulamit Sternin, Raymond M. McKie, Carter Winberg, Robb N. Travers, Terry P. Humphreys, Elke D. Reissing

Abstract:

Issues surrounding sexual consent negotiation have become a major topic of societal concern. The majority of current research focuses on the complexities of sexual consent negotiations and the multitude of nuanced issues that surround the consent obtainment of heterosexual adults in post-secondary educational institutions. To date, the only study that has addressed sexual consent negotiation behaviour in same-sex relationships focused on the extent to which individuals used a variety of different verbal and nonverbal sexual consent behaviours to initiate or respond to sexual activity. The results were consistent with trends found within heterosexual individuals; thus, suggesting that the current understanding of sexual consent negotiation, which is grounded in heterosexual research, can serve as a strong foundation for further exploration of sexual consent negotiation within same-sex relationships populations. The current study quantitatively investigated the differences between heterosexual men and gay and bisexual men (GBM) in their understanding of sexual consent negotiation. Exploring how the perceptions of GBM differ from heterosexual males provides insight into some of the unique challenges faced by GBM. Data were collected from a sample of 252 heterosexual men and 314 GBM from Canada, the United States, and Western Europe. Participants responded to the question, 'do you think sexual consent and sex negotiation is different for heterosexual men compared to gay men? If so, how?' by completed an online survey. Responses were analysed following Braun & Clarke’s (2006) six phase thematic analysis guidelines. Inter-rater coding was validated using Cohen’s Kappa value and was calculated at (ϰ = 0.84), indicating a very strong level of agreement between raters. The final thematic structure yielded four major themes: understanding of sexual interaction, unique challenges, scripted role, and universal consent. Respondents spoke to their understanding of sexual interaction, believing GBM sexual consent negotiation to be faster and more immediate. This was linked to perceptions of emotional attachment and the idea that sexual interaction and emotional involvement were distinct and separate processes in GBM sexual consent negotiation, not believed to be the case in heterosexual interactions. Unique challenges such as different protection concerns, role declaration, and sexualization of spaces were understood to hold differing levels of consideration for heterosexual men and GBM. The perception of a clearly defined sexual script for GBM was suggested as a factor that may create ambiguity surrounding sexual consent negotiation, which in turn holds significant implications on unwanted sexual experiences for GBM. Broadening the scope of the current understanding of sexual consent negotiation by focusing on heterosexual and GBM population, the current study has revealed variations in perception of sexual consent negotiation between these two populations. These differences may be understood within the context of sexual scripting theory and masculinity gender role theory. We suggest that sexual consent negotiation is a health risk factor for GBM that has not yet been adequately understood and addressed. Awareness of the perceptions that surround the sexual consent negotiation of both GBM and heterosexual men holds implications on public knowledge, which in turn can better inform policy making, education, future research, and clinical treatment.

Keywords: sexual consent, negotiation, heterosexual men, GBM, sexual script

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3234 The Conflict between Empowerment and Exploitation: The Hypersexualization of Women in the Media

Authors: Seung Won Park

Abstract:

Pornographic images are becoming increasingly normalized as innovations in media technology arise, the porn industry explosively grows, and transnational capitalism spreads due to government deregulation and privatization of media. As the media evolves, pornography has become more and more violent and non-consensual; this growth of ‘raunch culture’ reifies the traditional power balance between men and women in which men are dominant, and women are submissive. This male domination objectifies and commodifies women, reducing them to merely sexual objects for the gratification of men. Women are exposed to pornographic images at younger and younger ages, providing unhealthy sexual role models and teaching them lessons on sexual behavior before the onset of puberty. The increasingly sexualized depiction of women in particular positions them as appropriately desirable and available to men. As a result, women are not only viewed as sexual prey but also end up treating themselves primarily as sexual objects, basing their worth off of their sexuality alone. Although many scholars are aware of and have written on the great lack of agency exercised by women in these representations, the general public tends to view some of these women as being empowered, rather than exploited. Scholarly discourse is constrained by the popular misconception that the construction of women’s sexuality in the media is controlled by women themselves.

Keywords: construction of gender, hypersexualization, media, objectification

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3233 Gingival Tissue Appearance Changes According Hormonal Oscillations at Female Patients

Authors: Ilma Robo, Saimir Heta, Vera Ostreni, Elsaida Agrushi, Eduart Kapaj

Abstract:

Introduction: Cyclic hormonal fluctuations are known from literature to have a clinically visible effects on gingival tissue reactions, to the diagnosed processes of gingival inflammation. Materials and methods: At a total of 47 female patients, ad-hock presented at the University Clinic, were recorded data on effect of hormonal oscillations at periodontal treatment protocol. Oral examination was performed on soft tissue of gingiva and the oral mucous membrane, always respecting the air-drying procedure and then checking with free eye differences in oral mucosal relief. After the patients were informed about the study protocol, the purpose of the study and the ongoing procedure, verbal consensus was required. Results: The study was conducted in a total of 47 patients, out of which 13 patients were under the gingivitis classification, and 24 patients under the periodontal classification. Patients included in the study are divided by age, cycle week respectively 1,2,3 and 4.The younger age of female patients is more prone to the appearance of gingivitis, which is further aggravated by the effects of sexual hormones and the effect of the controlled or non-regulated fluctuations of the latter. Conclusions: The healing process is more fuel-intensive in the absence of high hormone levels, as they are these pro-inflammatory hormones, both in or near the ho Younger women are more open to volunteering in studies that record individual and study data that may last in time.

Keywords: gingiva, hormonal oscillations, female patients, mucosa, periodontal non-surgical treatment

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3232 Reconstruction of the 'Bakla' as an Identity

Authors: Oscar H. Malaco Jr.

Abstract:

Homosexuality has been adapted as the universal concept that defines the deviations from the heteronormative parameters of society. Sexual orientation and gender identities have been used in a concretely separate manner the same way as the dynamics between man and woman, male and female, gender and sex operate. These terms are all products of human beings’ utilization of language. Language has proven its power to define and determine the status and the categories of the subjects in society. This tool developed by human beings provides a definition of their own specific cultural community and their individual selves that either claim or oppugn their space in the social hierarchy. The label ‘bakla’ is reasoned as an identity which is a reaction to the spectral disposition of gender and sexuality in the Philippine society. To expose the Filipino constitutes of bakla is the major attempt of this study. Through the methods of Sikolohiyang Pilipino (Filipino Psychology), namely Pagtatanung-tanong (asking questions) and Pakikipagkuwentuhan (story-telling), the utterances of the bakla were gathered and analyzed in a rhetorical and ideological manner. Furthermore, the Dramatistic Pentad of Kenneth Burke was adapted as a methodology and also utilized as a perspective of analysis. The results suggest that the bakla as an identity carries the hurdles of class. The performativity of the bakla is proven to be a cycle propelled by their guilt to be identified and recognized as subjects in a society where heteronormative power contests their gender and sexual expressions as relatively aberrational to the binary gender and sexual roles. The labels, hence, are potent structures that control the disposition of the bakla in the society, reflecting an aspect of the disposition of Filipino identities. After all, performing kabaklaan in the Philippine society is interplay between resistance and conformity to the hegemonic dominions as a result of imperial attempts to universalize the concept of homosexuality between and among distant cultural communities.

Keywords: gender identity, sexual orientation, rhetoric, performativity

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3231 The Effectiveness of Men Who Have Sex with Men (MSM) Sensitivity Training for Nigerian Health Care Providers (HCPs)

Authors: Chiedu C. Ifekandu, Olusegun Sangowawa, Jean E. Njab

Abstract:

Background: Health care providers (HCPs) in Nigeria receive little or no training of the healthcare needs of men who have sex with men (MSM) limiting the quality and effectiveness of comprehensive HIV prevention and treatment services. Consequently, most MSM disguise themselves to access services which limit the quality of care provided partly due to challenges related to stigma and discrimination, and breach of confidentiality. Objective: To assess the knowledge of healthcare providers on effective intervention for MSM. Methods: We trained 122 HIV focal persons drawn from 60 health facilities from twelve Nigerian states. , the participants were requested to complete a pre-training questionnaire to assess their level of working experience with key populations as a baseline. Participants included male and female doctors, nurses and counselors/testers. A test was administered to measure their knowledge on MSM sexual risk practices, HIV prevention and healthcare needs and also to assess their attitudes (including homophobia) and beliefs and how it affects service uptake by key populations particularly MSM prior and immediately after the training to ascertain the impact of the training. Results: The mean age of the HCP was 38 years +/- SD Of the 122 HCPs (45 % female, 55 % male; 85 % counsellor/testers; 15 % doctors and nurses; 92 % working in government facilities) from 42 health facilities were trained, of which 105 attempted the test questions. At the baseline, few HCPs reported any prior sensitivity training on MSM. Most of the HCPs had limited knowledge of MSM sexual health needs. Over 90% of the HCPs believed that homosexuality is a mental illness. 8 % do not consider MSM, FSW and PWID as key populations for HIV infection. 45 % lacked knowledge on MSM anal sexual practices. The post-test showed that homophobic attitudes had decreased significantly by the end of the training; the health care providers have acquired basic knowledge compared to the pre-test. Conclusions: Scaling up MSM sensitivity training for Nigerian HCPs is likely to be a timely and effective means to improve their understanding of MSM-related health issues, reduce homophobic sentiments and enhance their capacity to provide responsive HIV prevention, treatment and care services in a supportive and non-stigmatizing environment.

Keywords: healthcare providers, key population, men who have sex with men, HCT

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3230 Case Report: Cap Polyposis with Advanced Pelvic Floor Dysfunction: Stronger Evidence of Mechanical Prolapse-related Pathology

Authors: Adrian Sebastian, Chris Gillespie

Abstract:

We describe a case of diffuse rectal involvement with cap polyposis, manifesting with a protein-losing colopathy and occurring in the setting of advanced mechanical pelvic floor dysfunction. A 59-year-old male with a 5-year history of persistent excessive flatulence, defecatory difficulties, and diarrhea. He had extensive cap polyposis of the entire rectum endoscopically. His symptoms progressed to severe fecal incontinence with mucus leakage, pelvic pain, weight loss, and hypoalbuminemia. Clinical examination exhibited severe perineal descent, a large rectocele, poor anal squeeze, and a poor defecatory technique. After a trial of nonoperative therapies addressing his defecatory dysfunction, and Helicobacter pylori eradication, surgical resection was offered due to severe symptoms with ongoing incontinence and protein loss with no other reasonable options. A robotic abdominoperineal resection with a permanent colostomy was performed, followed by an uncomplicated recovery. Our observation of coexisting mechanical pelvic floor changes in this patient lends weight to the concept of a prolapse-related phenomenon in the pathophysiology of this rare condition.

Keywords: cap polyposis, pelvic dysfunction, fecal incontinence, case report

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3229 Central Vascular Function and Relaxibility in Beta-thalassemia Major Patients vs. Sickle Cell Anemia Patients by Abdominal Aorta and Aortic Root Speckle Tracking Echocardiography

Authors: Gehan Hussein, Hala Agha, Rasha Abdelraof, Marina George, Antoine Fakhri

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Background: β-Thalassemia major (TM) and sickle cell disease (SCD) are inherited hemoglobin disorders resulting in chronic hemolytic anemia. Cardiovascular involvement is an important cause of morbidity and mortality in these groups of patients. The narrow border is between overt myocardial dysfunction and clinically silent left ventricular (LV) and / or right ventricular (RV) dysfunction in those patients. 3 D Speckle tracking echocardiography (3D STE) is a novel method for the detection of subclinical myocardial involvement. We aimed to study myocardial affection in SCD and TM using 3D STE, comparing it with conventional echocardiography, correlate it with serum ferritin level and lactate dehydrogenase (LDH). Methodology: Thirty SCD and thirty β TM patients, age range 4-18 years, were compared to 30 healthy age and sex matched control group. Cases were subjected to clinical examination, laboratory measurement of hemoglobin level, serum ferritin, and LDH. Transthoracic color Doppler echocardiography, 3D STE, tissue Doppler echocardiography, and aortic speckle tracking were performed. Results: significant reduction in global longitudinal strain (GLS), global circumferential strain (GCS), and global area strain (GAS) in SCD and TM than control (P value <0.001) there was significantly lower aortic speckle tracking in patients with TM and SCD than control (P value< 0.001). LDH was significantly higher in SCD than both TM and control and it correlated significantly positive mitral inflow E, (p value:0.022 and 0.072. r: 0.416 and -0.333 respectively) lateral E/E’ (p value.<0.001and 0.818. r. 0.618 and -0. 044.respectively) and septal E/E’ (p value 0.007 and 0.753& r value 0.485 and -0.060 respectively) in SCD but not TM and significant negative correlation between LDH and aortic root speckle tracking (value 0.681& r. -0.078.). The potential diagnostic accuracy of LDH in predicting vascular dysfunction as represented by aortic root GCS with a sensitivity 74% and aortic root GCS was predictive of LV dysfunction in SCD patients with sensitivity 100% Conclusion: 3D STE LV and RV systolic dysfunction in spite of their normal values by conventional echocardiography. SCD showed significantly lower right ventricular dysfunction and aortic root GCS than TM and control. LDH can be used to screen patients for cardiac dysfunction in SCD, not in TM

Keywords: thalassemia major, sickle cell disease, 3d speckle tracking echocardiography, LDH

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3228 Progression of Trauma: Myth Mess Mastery, Addressing and Grooming

Authors: Stuart Bassman

Abstract:

Services that focus on the synthesis of research and clinical practice are vital in providing efficacious change for the men and women who have been victims of childhood sexual abuse. This study will address what processes have been helpful in being a catalyst in changing one’s inner life as well as providing meaningful applications and fulfilling experiences. Initially, we would focus on the Myths regarding childhood sexual abuse. This would include Grooming behaviors and Delayed Disclosures. Subsequently, we would address the Mess that follows from not recognizing the adverse impairments that result from Childhood Sexual Abuse. Finally, we would conclude by looking at the Mastery that could arise from moving from being a Victim to a Survivor and a Thriver.

Keywords: trauma, childhood, somatic, treatment

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3227 The Efficacy of Lithium vs. Valporate on Bipolar Patients and Their Sexual Side Effect: A Meta-Analysis of 4159 Patients

Authors: Yasmeen Jamal Alabdallat, Almutazballlah Bassam Qablan, Obada Ahmad Al Jayyousi, Ihdaa Mahmoud Bani Khalaf, Eman E. Alshial

Abstract:

Background: Bipolar disorder, formerly known as manic depression, is a mental health status that leads to extreme mood swings that include emotional lows (depression) and highs (mania or hypomania). This systematic review and meta-analysis aimed to assess the safety and efficacy of lithium versus valproate among bipolar patients. Methods: A computer literature search of PubMed, Scopus, Web of Science, and Cochrane Central Register of Controlled Trials was conducted from inception until June 2022. Studies comparing lithium versus valproate among bipolar patients were selected for the analysis, and all relevant outcomes were pooled in the meta-analysis using Review Manager Software. Results: 11 Randomized Clinical Trials were included in this meta-analysis with a total of 4159 patients. Our meta showed that lithium was superior to valproate in terms of Young Mania Rating Scale (YMRS) (MD = 0.00 with 95% CI, (-0.55 – 0.55; I2 = 0%), P = 1.00). The results of the Hamilton Depression Rating Scale (HDRS) showed that the overall effect favored the valproate treated group (MD = 1.41 with 95% CI, (-0.15 – 2.67; I2 = 0%), P = 0.03). Concerning the results of the Montgomery-Asberg Depression Rating Scale (MADRS), the results showed that the lithium was superior to valproate (MD = 0.03 with 95% CI, (-0.80 to 0.87; I2 = 40%), P = 0.94). In terms of the sexual side effect, we found that the valproate was superior to lithium (RR 1.19 with 95% CI, (0.74 to 1.91; I2 = 0%), P = 0.47). The lithium-treated group was superior in comparison to valproate treated group in terms of Abnormal Involuntary Movement Scale (AIMS) (MD = -0.03 with 95% CI (-0.38 to 0.32; I2 = 0%), P = 0.87). The lithium was more favorable in terms of Simpson-Agnes scale (MD = -0.40 with 95% CI, (-0.86 to 0.06; I2 = 0%), P = 0.09). The results of the Barnes akathisia scale showed that the overall effect of the valproate was more favorable in comparison to lithium (MD = 0.05 with 95% CI, (-0.12 to 0.22; I2 = 0%), P = 0.57). Conclusion: Our study revealed that on the scales of efficacy Lithium treated group surpassed Valproate treated group in terms of Young Mania Rating Scale (YMRS), Abnormal Involuntary Movement Scale (AIMS) and Simpson-Agnes scale, but valproate surpassed it in Barnes Akathisia scale. Furthermore, on the scales of depression Hamilton Depression Rating Scale (HDRS) showed that the overall effect favored Valproate treated group, but Lithium surpassed valproate in terms of Montgomery-Asberg Depression Rating Scale (MADRS). Valproate surpassed Lithium in terms of sexual side effects.

Keywords: bipolar, mania, bipolar-depression, sexual dysfunction, sexual side effects, treatment

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