Search results for: sexual distress

Authors: Chalachew Kassaw, Henok Ababu, Bethelhem Sileshy, Lulu Abebe, Birhanie Mekuriaw

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Background: Psychological discomfort is a state of emotional distress caused by everyday stressors and obligations that are difficult to manage. Orthopedic trauma has a wide range of effects on survivors' physical health, as well as a variety of mental health concerns that impede recovery. Psychiatric and behavioral conditions are 3-5 times more common in people who have undergone physical trauma, and they are a predictor of poor outcomes. Despite the above facts, there is a shortage of research done on the subject. Therefore, this study aimed to determine the magnitude of psychological distress and associated factor among patients attending orthopedic treatment at Gedeo zone, South Ethiopia 2022. Methods: A cross-sectional study was undertaken at Dilla University Referral Hospital from October –November 2022. The data was collected via a face-to-face interview, and the Kessler psychological distress scale (K-10) was used to assess psychological distress. A total of 386 patients receiving outpatient and inpatient services at the orthopedic unit were chosen using a simple random selection technique. A Statistical Package for the Social Science version 21 (SPSS-21) was used to enter and evaluate the data. To find related factors, bivariate, and multivariate logistic regressions were used. Variables having a p-value of less than 0.05 were deemed statistically significant. Result: A total of 386 participants with a response rate of 94.8% were included in the study. Out of all respondents, 114 (31.4%) of the individuals have experienced psychological distress. Independent variables such as Females [Adjusted odds ratio (AOR)=5.8, 95%CI=(4.6-15.6)], Average monthly income of <3500 birrs [Adjusted odds ratio (AOR) =4.8, 95% CI=(2.4-9.8) ], Current history of substance use [Adjusted odds ratio (AOR) =2.6, 95% CI=(1.66-4.7)], Strong social support [Adjusted odds ratio (AOR)=0.4, 95% CI= 0.4(0.2-0.8)], and Poor sleep quality (PSQI score>5) [Adjusted odds ratio (AOR)=2.0, 95%CI= 2.0(1.2-2.8)] were significantly associated with psychological distress. Conclusion: The prevalence of psychological distress was high. Being female, having poor social support, and having a high PSQI score were significantly associated factors with psychological distress. It is good if clinicians emphasize orthopedic patients, especially females and those having poor social support and low sleep quality symptoms.

Keywords: psychological distress, orthopedic unit, Dilla University hospital, Dilla Town, Southern Ethiopia

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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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Authors: Sylvie Ekanga Lumumba

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Background and Significance of the Study: Over the past three decades, the perception of sexual violence has changed significantly, it is now recognized that men and boys are victims of sexual violence. However, the body of research on male victims and particularly on their attackers is much more limited. Research on the above is thus more than required. To contribute to the above quest for further studies, the researcher conducted this study on sexual violence perpetrated against men and boys by women, in the Municipality of Ibanda, Town of Bukavu, Province of South Kivu, Democratic Republic of Congo. The main study objectives were the following: to investigate on the statement of sexual violence perpetrated against men and boys in the Municipality of Ibanda, to investigate into its consequences and the statement of medical and psycho-social care given to victims. Methodology: Data were collected using valid and reliable Survey Questionnaire and Interview Schedule. Study population: the 85,882 men and boys from the Municipality of Ibanda. Sampling: led to 150 men and boys, received discreetly by the researcher during November-December 2015. Major findings: First, findings related to sexual abuse and its procedure: 74.2% of men and boys were victims of sexual violence perpetrated by a woman, more than a year ago. 13.3% however, were victims for less than a year now. 79.7% of victims have experienced sexual violence by a sexual act; 3.9% through the intention of the woman to cause the death of the victim, by serious injury to the genitals. The Second group of findings related to the consequences of sexual violence revealed that HIV/AIDS is the most important physical consequence experienced by 77.3 % of victims. Physical psychological consequences are: urinary or defecation problems (72.7%); while key psycho-emotional and behavioral consequence is: living a state of deep shame and humiliation: 68.8%. As for sexual consequences: 71.1% indicated a chronic avoidance of sexual activity and 57% reported sexual dysfunctions. The third group of findings is related to medical and psycho-social care: repetitively, more than 80% of male victims affirmed that with the help of friends and traditional healers, they took care of themselves for all the eight WHO phases of clinical care of rape victims, this was hence not effectively done. Concluding Statement: for this study, the statement of sexual violence of men and boys by women in the Eastern Congo and its consequences are not researched upon and are underestimated; the study also revealed that the care of male victims is grossly ill-conducted, as opposed to female victims care. It therefore calls for further research and further vulgarization of the research results, to convince other stakeholders (politicians for example) to immediately take action.

Keywords: sexual violence, men and boys, medical care, psycho-social care

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Authors: Amichai Ben ari, Daniella Margalit

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Medical procedures, such as surgery, may have traumatic significance for some children. This study examines the relationship between maltreatment in children and the development Pediatric Medical Traumatic Stress (PMTS). To this end, differences in the level of distress of children after surgery were examined between two groups: children who were maltreated ("children at risk") and children from the control group ("children who are not at risk"). The study involved 230 parents of children who came to the hospital to undergo surgery. Parents filled out demographic questionnaires to measure socioeconomic variables and psychological questionnaires to measure the distress of the child and parent before surgery. After 6 months from the time of surgery, the parents again filled in the questionnaire measuring the child's distress. The results of the study showed that the level of distress experienced by children at risk after surgery was significantly higher relative to children who are not at risk. It was also found that the level of distress experienced by parents of children at risk in relation to their child’s surgery is significantly higher compared to parents of children who are not at risk. Finally, it was found that the variables: (1) pre-morbid psychological functioning of the child. (2) Parental and family functioning in daily life. (3) Exposure of the child to traumatic events. (4) Support factors for the family. Are variables that predict the development of PMTS in children after surgery, but only for children at risk and not for children who are not at risk. The significance of the findings in relation to the need to identify at-risk populations in the hospitals and the policies derived from them were discussed, and several directions were raised for further research.

Keywords: children at risk, pediatric medical traumatic stress (PMTS), PTSD, medical procedures

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Authors: Amy Kless, Peter Reuter

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The purpose of this study was to explore the association between the teachings of religious doctrine on the use of contraceptives and its influence on the behavior of female college students. The religious doctrine of both Christian and non-Christian religions states that sexual intercourse shall only take place between people that are married. Additionally, the teachings of most Christian and non-Christian religions prohibit the use of contraceptives during sexual intercourse. Being away from home for the first time, students that grew up in religious households may stop attending church services or stop practicing religion entirety. The college years are also a time for sexual exploration. The desire for sexual exploration leaves many students, both religious and non-religious, with having to choose between abstaining from sexual intercourse or using a form of contraceptive to prevent pregnancy. Of 1,130 female students anonymously surveyed at a southern university between Spring 2016 and Fall 2020, 50% reported having religious beliefs. Less than 50% of the students who reported having religious beliefs attend church services on a regular basis. Nearly 75% of the same students reported having participated in sexual intercourse with close to 60% utilizing some form of contraceptive to prevent pregnancy. The data suggest that female college students do not follow religious teachings on abstinence from premarital sex or the ban on the use of contraceptives.

Keywords: contraceptives, females, intercourse, religion

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Authors: Manish Kumar

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Reinforced cement concrete is getting extensively used for construction of different type of structures for the last one century. During this period, we have constructed many structures like buildings, bridges, industrial structures, pavement, water tanks etc. using this construction material. These structures have been created with huge investment of resources. It is essential to maintain those structures in functional condition. Since deterioration in RCC Structures is a common and natural phenomenon it is required to have a detailed plan, methodology for structural repair and rehabilitation shall be in place for dealing such issues. It is important to know exact reason of distress, type of distress and correct method of repair concrete structures. The different methods of repair are described in paper according to distress category which can be refereed for repair. Major finding of the study is that to protect our structure we need to have maintenance frequency and correct material to be chosen for repair. Also workmanship during repair needs to be taken utmost care for quality repair.

Keywords: deterioration, functional condition, reinforced cement concrete, resources

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Authors: Sadandaula Rose Muheriwa Matemba, Alexander Glazier, Natalie M. LeBlanc

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In the United States, up to 10% of girls and 22 % of boys 10-14 years have had sex, 5% of them had their first sex before 11 years, and the age of first sexual encounter is reported to be 8 years. Over 4,000 adolescent girls, 10-14 years, become pregnant every year, and 2.6% of the abortions in 2019 were among adolescents below 15 years. Despite these negative outcomes, little research has been conducted to understand the sexual health education offered to young adolescents ages 10-14. Early sexual health education is one of the most effective strategies to help lower the rate of early pregnancies, HIV infections, and other sexually transmitted. Such knowledge is necessary to inform best practices for supporting the healthy sexual development of young adolescents and prevent adverse outcomes. This qualitative descriptive study was conducted to explore the community stakeholders’ experiences in sexual health education for young adolescents ages 10-14 and ascertain the young adolescents’ sexual health support needs. Maximum variation purposive sampling was used to recruit a total sample of 13 community stakeholders, including health education teachers, members of youth-based organizations, and Adolescent Clinic providers in Rochester, New York State, in the United States of America from April to June 2022. Data were collected through semi-structured individual in-depth interviews and were analyzed using MAXQDA following a conventional content analysis approach. Triangulation, team analysis, and respondent validation to enhance rigor were also employed to enhance study rigor. The participants were predominantly female (92.3%) and comprised of Caucasians (53.8%), Black/African Americans (38.5%), and Indian-American (7.7%), with ages ranging from 23-59. Four themes emerged: the perceived need for early sexual health education, preferred timing to initiate sexual health conversations, perceived age-appropriate content for young adolescents, and initiating sexual health conversations with young adolescents. The participants described encouraging and concerning experiences. Most participants were concerned that young adolescents are living in a sexually driven environment and are not given the sexual health education they need, even though they are open to learning sexual health materials. There was consensus on the need to initiate sexual health conversations early at 4 years or younger, standardize sexual health education in schools and make age-appropriate sexual health education progressive. These results show that early sexual health education is essential if young adolescents are to delay sexual debut, prevent early pregnancies, and if the goal of ending the HIV epidemic is to be achieved. However, research is needed on a larger scale to understand how best to implement sexual health education among young adolescents and to inform interventions for implementing contextually-relevant sexuality education for this population. These findings call for increased multidisciplinary efforts in promoting early sexual health education for young adolescents.

Keywords: community stakeholders’ perspectives, sexual development, sexual health education, young adolescents

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Authors: Glauberto S. Quirino, Emanuelly V. Pereira, Amana S. Figueiredo, Antonia T. F. Santos, Paulo R. A. Firmino, Denise F. F. Barbosa, Caroline B. Q. Aquino, Eveliny S. Martins, Cinthia G. P. Calou, Ana K. B. Pinheiro

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Introduction: During pregnancy there are adjustments in the physical, emotional, existential and sexual areas, which may contribute to changes in sexual behavior. The objective was to analyze the sexual behavior of pregnant women. Methods: Quantitative, exploratory-descriptive study, approved by the Ethics and Research Committee of the Regional University of Cariri. For data collection, it was used the Sexuality Questionnaire in Gestation and Sexual Quotient - Female Version. It was carried out in public institutions in the urban and rural areas of three municipalities of the Metropolitan Region of Cariri, south of Ceará, Brazil from February to September 2016. The sampling was proportional stratified by convenience. A total of 815 pregnant women who were literate and aged 20 years or over were broached. 461 pregnant women were excluded because of high risk, adolescence, saturation of the extract, incomplete filling of the instrument, mental and physical handicap, without sexual partner, and the sample was 354 pregnant. The data were grouped, organized and analyzed in the statistical program R Studio (version 386 3.2.4). Descriptive frequency statistics and non-parametric tests were used to analyze the variables, and the results were shown in graphs and tables. Results: The women presented a minimum age of 20, maximum 35 and average of 26.9 years, predominantly urban area residents, with a monthly income of up to one minimum wage (US$ 275,00), high school, catholic, with fixed partner, heterosexuals, multiparous, multiple sexual partners throughout life and with the beginning of sexual life in adolescence (median age 17 years). There was a reduction in sexual practices (67%) and when they were performed, they were more frequent in the first trimester (79.7%) and less frequent in the third trimester (30.5%). Preliminary sexual practices did not change and were more frequent in the second trimester (46.6%). Throughout the gestational trimesters, the partner was referred as the main responsible for the sexual initiative. The women performed vaginal sex (97.7%) and provided greater pleasure (42.8%) compared to non-penetrative sex (53.9%) (oral sex and masturbation). There was also a reduction in the sexual disposition of pregnant women (90.7%) and partner (72.9%), mainly in the first trimester (78.8%), and sexual positions. Sexual performance ranged from regular to good (49.7%). Level of schooling, marital status, sexual orientation of the pregnant woman and the partner, sexual practices and positions, preliminaries, frequency of sexual practices and importance attributed to them were variables that influenced negatively sexual performance and satisfaction. It is concluded that pregnancy negatively changes the sexual behavior of the women and it is suggested to further investigations and approach of the partner, in order to clarify the influence of these variables on the sexual function and subsidize intervention strategies, with a view to the integrality of sexual and reproductive health.

Keywords: obstetric nursing, pregnant women, sexual behavior, women's health

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Authors: Avigail Moor

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A decline in women’s sexual desire over the course of long-term relationships, relative to men’s, has been frequently noted. Yet, while there is ample evidence that this change in women is quite common, it is still generally pathologized. Moreover, little is known regarding its true meaning for women and the effect it has on their wellbeing. In light of that, our primary goal was to investigate women's subjective experiences of this reality. Do they connect it to dysfunction in self or marriage, or rather they don't equate love and sex, which for them simply become less connected with time, even as the relationship remains entirely fulfilling? A second goal was to explore how such gender-based differences in sexual desire impact women, and indirectly the couple and partner, in terms of wellbeing and satisfaction from the relationship. In-depth semi-structured interviews were conducted with 15 women in committed long-term relations, aged 25 and over. The findings indicate that for women, there is no contradiction between a loving relation and a decline in spontaneous sexual desire. At the same time, while not rooted in a problem, it does create some. Tension, frustration, conflict, and pressure are some of the negative sequelae that carry adverse effects for women’s wellbeing, the solution to which requires, in their opinion, honest dialogue, mutual respect, and reasonable compromise.

Keywords: gender, sexuality, sexual desire, well being

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Authors: Avigail Moor

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

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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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Authors: Made Kurnia Widiastuti Giri, Nyoman Kanca, Arie Swastini, Bambang Purwanto

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Aim: Waria transgenders are a phenomenon whose existence is undeniable. The sexual behaviours of waria transgenders belong to the groups of high-risk STDs infections, especially HIV/AIDS. The present study was aimed at finding out the general idea of the existence of waria transgenders in Singaraja, their sexual transactions, their sexual behaviours, and at exploring the factors affecting their sexual behaviours along with their participation in regular reproduction health control. Methods: The subjects of the present research were male-to-female transgenders living in the town of Singaraja. The research applied a qualitative approach. Data collection in this research was conducted through in-depth interview and observation. Results: The results of the study exposed 1) the existence of waria transgender community in Singaraja observed from their active participation in social events such as taking the roles of counsellors in the campaign of prevention and control of HIV/AIDS with the Local Commission of AIDS Control and other foundations; 2) the sexual services provided by waria transgenders which were performed in squeeze method, oral and anal sex which could be categorized as HIV/AIDS high-risk sexual behaviours, while the consistency in doing safe sex among the trangenders in Singaraja showed that most of the waria transgenders (80%) were aware of the urgency of using condoms during sexual intercourse; and 3) the low participation of the waria transgenders in Singaraja in regular reproduction health check up at the local Centre of Public Health Service was caused by their negative perception about being examined by female doctors. Conclucions: Waria in singaraja categorized as HIV/AIDS high-risk sexual behaviours but they do have consistency in doing safe sex by using condoms. They have a negative psychological perception about being examined by female doctors.

Keywords: waria transgenders, sexual behaviours, reproduction health, hiv/aids

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Authors: Alireza Monzavi Chaleshtari, Mahnaz Aliakbari Dehkordi, Seyedeh Somayeh Amiri, Mozhgan Shakhseniaei, Amin Asadi Hieh

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The purpose of this research was to determine the effectiveness of sexual cognitive behavioral therapy on strategic thinking and communication patterns of couples in colostomy patients. In this study, experimental research was conducted with a pre-test and post-test design with a control group and a follow-up period. The statistical population studied were married female colostomy patients referring to the Iranian Ostomy Association. 30 qualified people were selected by voluntary sampling and randomly divided into two experimental and control groups (15 people in each group). Both groups responded to Goleman's strategic thinking (2007) and the communication patterns of Christensen and Sulawai questionnaires (1984). The results of covariance analysis showed that sexual cognitive behavioral therapy has an effect on improving strategic thinking. Based on the results of this test, sexual cognitive behavioral therapy is effective in improving the strategic thinking of colostomy patients until the follow-up stage. Also, sexual cognitive behavioral therapy has an effect on improving the communication patterns of couples in colostomy patients. Based on the results of this test, sexual cognitive behavioral therapy is effective in improving communication patterns of couples in patients with colostomy until the follow-up stage. Based on the results of this research, sexual cognitive behavioral therapy can be used to improve strategic thinking and communication patterns of couples of colostomy patients.

Keywords: sexual cognitive behavioral therapy, strategic thinking, communication patterns of couples, colostomy

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Authors: Seung Won Park

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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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Authors: Ahmad Zulfahmi Mohd Kamaruzaman, Mohd Ismail Ibrahim, Ariffin Marzuki Mokhtar, Maizun Mohd Zain, Saiful Nazri Satiman, Mohd Najib Majdi Yaacob

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Background: Aftermath any patient safety incidents, the involved healthcare providers possibly sustained second victim-related distress (second victim distress and reduced their professional efficacy), with subsequent negative work-related outcomes or vice versa cultivating resilience. This study aimed to investigate the factors affecting negative work-related outcomes and resilience, with the triad of support; colleague, supervisor, and institutional support as the hypothetical mediators. Methods: This was a cross sectional study recruiting a total of 733 healthcare providers from three tertiary care in Kelantan, Malaysia. Three steps of hierarchical linear regression were developed for each outcome; negative work-related outcomes and resilience. Then, four multiple mediator models of support triad were analyzed. Results: Second victim distress, professional efficacy, and the support triad contributed significantly for each regression model. In the pathway of professional efficacy on each negative work-related outcomes and resilience, colleague support partially mediated the relationship. As for second victim distress on negative work related outcomes, colleague and supervisor support were the partial mediator, and on resilience; all support triad also produced a similar effect. Conclusion: Second victim distress, professional efficacy, and the support triad influenced the relationship with the negative work-related outcomes and resilience. Support triad as the mediators ameliorated the effect in between and explained the urgency of having good support for recovery post encountering patient safety incidents.

Keywords: second victims, patient safety incidents, hierarchical linear regression, mediation, support

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Authors: Stuart Bassman

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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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Authors: Buse Bahitli, Samiye Mete

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The aim of the study was to evaluate the quality of sexual life of women with diagnosed gynecological cancer and receive treatment. The study was a descriptive and cross-sectional type, and it was carried out with 276 women. Information Form and Sexual Quality of Life Scale-Female (SQOL) form was used in the study. The data was evaluated using Mann-Whitney U and Kruskal-Wallis test. In the study, Sexual Quality of Life Scale-Female average score was 68.83 ± 21.17. The %43.1 of women was endometrial cancer, %30.8 was cervical cancer, %24.6 was ovarian cancer, and %1.4 was vulvar cancer. The average time to diagnosis of patients is 41.80 ± 47.64 months. There was no significant difference mean SQOL according to individual/sociodemographic characteristics like age, education. Gynecological cancer-related characteristics like gynaecological cancer type, treatment type, surgery type were found not to affect the mean score of SQOL. However, it was found that the difference was due to the higher SQOL score in the group with a diagnosis time of 25 months and over (X²KW= 6.356, p= 0.046). The reason of significant difference means SQOL according to diagnosis over time might be that women adapted to cancer diagnosis. While women with gynaecologic cancer are evaluating their sexual lives, it is necessary to evaluate them with good evaluation tools.

Keywords: gynecological cancers, sexuality, quality of sexual life, SQOL

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Authors: Runa Laila

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In Bangladesh, migration and employment opportunities in the ready-made garment factories presented an alternative to early and arranged-marriage to many young women from the countryside. Although the positive impact of young women’s labour migration and employment in the garment industry on economic independence, increased negotiation power, and enhancement of self-esteem have been well documented, impact of employment on sexual norms and practices remained under-researched. This ethnographic study comprising of an in-depth interview of 21 single young women working in various garment factories in Gazipur, Dhaka, explores the implication of work on sexual norms and practices. This study found young single garment workers experience a range of consensual and coercive sexual relations. The mixed-sex work environment in the garment manufacturing industry and private housing arrangements provide young single women opportunities to develop romantic and sexual relationships in the transient urban space, which was more restricted in the rural areas. The use of mobile phones further aids lovers to meet in amusement parks, friends’ houses, or residential hotels beyond the gaze of colleagues and neighbors. Due to sexual double standard, men’s sexual advantage is seen as natural and accepted, while women are being blamed as immoral for being engaged in pre-marital sex. Although self-choice marriage and premarital relations reported to be common among garment workers, stigma related to premarital sex lead young single women to resort to secret abortion practices. Married men also use power position to lure women in a subordinate position in coerce sexual relations, putting their reproductive and psychological health at risk. To improve sexual and reproductive health and wellbeing of young female garment workers, it is important to understand these changing sexual practices which otherwise remain taboo in public health discourses.

Keywords: female migration, ready-made garment, reproductive health, sexual practice

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Authors: Sujana T, Kurniasari MD, Ayakeding AM

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Background: Sexual violence is one of the violence with high incidence in Indonesia. Purpose: This research aims to describe the implementation of sexual violence victim assessment in Semarang Regency. Method: This research is a qualitative research with embeded single case study design. Data is analized with two units of analysis. The first unit of analysis is victim’s examiner with minimum one year of work experience. Semi-structured interview method is used to obtain the data. The second unit of analysis is document related. The data is taken by observing the pathway and description of every document and how it supported each implementation of assessment. Results: This study is resulted with three themes, which are: The first theme is assessments of sexual violence in Semarang regency has been standardized. The laws of the Republic of Indonesia have regulated the handling of victims of sexual violence in outline. Victims of sexual violence can be dealt with by the police, the Integrated Service Center for Women and Children Empowerment and the Regional General Hospital. Each examination site has different operational procedures standards for dealing with victims of sexual violence. Cooperation with family and witnesses is also required in the review process to obtain accurate results and evidence; The second idea that resulted from this study is there are inhibits factors in the assessments process. Victims sometimes feel embarrassed and reluctant to recount the chronological events during reporting. The examining officer should be able to approach and build a trust to convince the victim to be able to cooperate. The third theme is there are other things to consider in the process of assessing victims of sexual violence. Ensuring implementation in accordance with applicable operational procedures standards, providing exclusive examination rooms, counseling and safeguarding the privacy of victims are important to be considered in the assessment.

Keywords: assessment, case study, Semarang regency, sexual violence

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Authors: Hrudaya Kamasani

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The cultural prevalence of vigilante justice is sustained through the social sanction for foregoing a judicial trial to determine guilt. Precisely due to its roots in social sanction, it has repercussions as more than just being symptomatic of cultural values that condone violence. In the long term, the practice of vigilante justice as a response to incidents of sexual violence, while veiled in civic discontent over the standards of women’s security in society, can adversely affect the discourse on sexual violence. To illustrate the impact that acts of vigilante justice can have in prematurely ending a budding discourse on sexual violence, the paper reviews three cases of heinous crimes committed against women in India that gained popular attention in the discursive spaces. The 2012 Nirbhaya rape and murder case in Delhi demonstrates how the criminal justice system can spur a social movement and can result in legislative changes and a discourse that challenged a wide range of socio-cultural issues of women’s security and treatment. The paper compares it with two incidents of sexual violence in India that ended with the suspects being killed in the name of vigilante justice that had wide social sanction. The two cases are the 2019 extrajudicial killing of Priyanka Reddy rape and murder case suspects in Hyderabad and the 2015 mob lynching of an accused in a rape case in Dimapur. The paper explains why the absence of judicial trials in sexual violence cases results in ending any likelihood of the instances inspiring civic engagement with the discourse on sexual violence.

Keywords: sexual violence, vigilante justice, extrajudicial killing, cultural values of violence, Nirbhaya rape case, mob violence

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Authors: Ahmad Esmaillzadeh, Javad Anjom-Shoae, Omid Sadeghi,

Abstract:

Background: Although considerable research has been devoted to the link between consumption of legume and nuts and metabolic abnormalities, few studies have examined legume and nuts consumption in relation to psychological disorders. Objective: The current study aimed to examine the association of legume and nuts consumption with depression, anxiety and psychological distress in Iranian adults. Methods: This cross-sectional study was carried out among 3172 adult participants aged 18-55 years. Assessment of legume and nuts consumption was conducted using a validated dish-based 106-item semi-quantitative food frequency questionnaire. The Iranian validated version of Hospital Anxiety and Depression Scale (HADS) was used to examine psychological health. Scores of 8 or more on either subscale in the questionnaire were considered to indicate the presence of depression or anxiety. Data on psychological distress were collected through the use of General Health Questionnaire (GHQ), in which the score of 4 or more was considered as having psychological distress. Results: Mean age of participants was 36.5±7.9 years. Compared with the lowest quintile, men in the highest quintile of legume and nuts consumption had lower odds of anxiety; such that after adjusting for potential confounding variables, men in the top quintile of legume and nuts consumption were 66% less likely to be anxious than those in the bottom quintile (OR: 0.34; 95% CI: 0.14-0.82). Such relationship was not observed among women. We failed to find any significant association between legume plus nuts consumption and depression or psychological distress after adjustment for potential confounders. Conclusion: We found that consumption of legume and nuts was associated with lower odds of anxiety in men, but not in women. No significant association was seen between consumption of legume and nuts and odds of depression or psychological disorder. Further prospective studies are required to confirm these findings.

Keywords: anxiety, depression, legumes, nuts, psychological distress

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Authors: Moor Avigail

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This research examines gender norms that underlie the propensity to commit sexual assault and to carry it out. Factors that have been shown to relate to such propensity will be enumerated and tied to their ramifications. These include sexual objectification of women, endorsement of gender-based rape myths blaming the victim, masculine entitlement, low empathy to victims, along with elevated empathy towards rapists. Heavy use of pornography as well as a misconstruing of the meaning of refusal to sex, have also been implicated. Additionally, a cutting-edge investigation, which we have just completed, examined what seems to occur in the perpetrator's mind during the assault. No research to date has ventured to uncover what essentially allows the rape to be carried out in real time, in the sense of what mental mechanisms go into operation in rapists during the assault itself. Our findings demonstrate that dehumanization and rationalization are pivotal. On the one hand, the perpetrator apparently allows himself to disregard the victim's humanity while simultaneously justifying his actions in relation to the victim's behavior.

Keywords: gender norms, gender psychology, sexual assault, gender

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Authors: Kopila Shrestha

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Adolescent sexual reproductive health is one of the most important issues in the world. Reproductive ability is taking place at an earlier age and adolescents are indulging in risk taking behaviors day by day. A descriptive cross-sectional study was conducted in Kathmandu valley to assess the knowledge regarding sexual and reproductive health among adolescent. Total of 200 respondents were selected through non-probability convenient sampling technique. Self-administered written questionnaires using semi-structured questions were used. The collected data were analyzed by using descriptive statistics such as frequency, percentage, mean, standard deviation and inferential statistics such as Chi-square test. The findings revealed that most of the respondents had adequate knowledge regarding transmission and protection of HIV/AIDs and STIs but still some respondents had a misconception regarding it. Few respondents had knowledge regarding legal age for marriage and the minimum age for first child bearing. The statistical analysis revealed that the total mean knowledge score with standard deviation was 45.02±8.674. Nearly half of the respondents (49.5%) had a moderate level of knowledge, followed by an inadequate level of knowledge 29.5% and adequate level of knowledge 21.0% regarding sexual and reproductive health. There was significant association of level of knowledge with area of residence (p-value .002) but no association with age (p-value .067), sex (p-value .999), religion (p-value .082) and ethnicity (p-value .114). Nearly half of the participants possess some knowledge about sexual and reproductive health but still effective educational intervention is required in higher secondary school to encourage more sensible and healthy behaviour.

Keywords: adolescents, higher secondary school, knowledge, sexual and reproductive health

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Authors: Farzaneh Askari, Jila Ganji, Sedigheh Hasani Moghadam

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Background and Aim: Endometriosis has been reported as one of the most common chronic gynecological conditions characterized by physical and psychological complications. Given that the impact of this disease on marital relationships and quality of life is multidimensional, the present review study aimed to reflect on the effect of psychosomatic aspects of endometriosis on marital relationships and quality of life. Materials and Methods: A narrative review methodology using keywords determined by the Medical Subject Headings (MeSH) thesaurus was adopted in this study. For this purpose, the databases of ScienceDirect, Scientific Information Database (SID), Google Scholar, and PubMed were searched by means of key terms including endometriosis, marital relationships, physical complications, psychological complications, and quality of life in English and Persian from 2005 to 2020. At the end of the search, 38 articles were retrieved, and ultimately a total number of 16 studies were recruited for this review. Results: A review of the selected articles demonstrated that endometriosis could affect marital relationships and quality of life among couples featuring in three different categories, i.e. “category I: physical health dimension” (chronic pelvic pain, dysmenorrhea, cramps but not period, reduction and loss of fertility), “category II: sexual health dimension” (no sexual intercourse, dyspareunia, lack of sexual satisfaction), and “category III: psychosocial health dimension” (negative self-esteem, low energy, sense of loneliness, depression, social isolation, insufficient sleep, marital distress, divorce and marriage breakdown, inability to work and socialize). Conclusion: In general, it is suggested to pay particular attention to psychosomatic aspects of marital problems in patients affected with endometriosis. Accordingly, implementing educational and counseling strategies to minimize the complications of this disease can provide the grounds for improving marital relationships and maintaining the quality of life in these patients.

Keywords: Endometriosis, marital relationships, psychosomatic complications, quality of life

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Authors: Simona Capossela, Ramona Schaniel, Singer Franziska, Aquino Fournier Catharine, Daniel Stekhoven, Jivko Stoyanov

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A spinal cord injury (SCI) is a traumatic life event that often results in ageing associated health conditions such as muscle mass decline, adipose tissue increase, decline in immune function, frailty, systemic chronic inflammation, and psychological distress and depression. Psychological, oxidative, and metabolic stressors may facilitate accelerated ageing in the SCI population with reduced life expectancy. Research designs using biomarkers of aging and stress are needed to elucidate the role of psychological distress in accelerated aging. The aim of this project is a feasibility pilot study to observe changes in stress biomarkers and correlate them with aging markers in SCI patients during their first rehabilitation (longitudinal cohort study). Biological samples were collected in the SwiSCI (Swiss Spinal Cord Injury Cohort Study) Biobank in Nottwil at 4 weeks±12 days after the injury (T1) and at the end of the first rehabilitation (discharge, T4). The "distress thermometer" is used as a selfassessment tool for psychological distress. Stress biomarkers, as cortisol and protein carbonyl content (PCC), and markers of cellular aging, such as telomere lengths, will be measured. 2 Preliminary results showed that SCI patients (N= 129) are still generally distressed at end of rehabilitation, however we found a statistically significant (p< 0.001) median decrease in distress from 6 (T1) to 5 (T4) during the rehabilitation. In addition, an explorative transcriptomics will be conducted on N=50 SCI patients to compare groups of persons with SCI who have different trajectories of selfreported distress at the beginning and end of the first rehabilitation after the trauma. We identified 4 groups: very high chronic stress (stress thermometer values above 7 at T1 and T4; n=14); transient stress (high to low; n=14), low stress (values below 5 at T1 and T4; n=14), increasing stress (low to high; n=8). The study will attempt to identify and address issues that may occur in relation to the design and conceptualization of future study on stress and aging in the SCI population.

Keywords: stress, aging, spinal cord injury, biomarkers

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Authors: Seraphina Bakta

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In many societies in Africa, it is a taboo to speak, let alone to practice or in any way to engage in matters relating to sexual and reproductive health. For instance, girls using contraceptives may be labeled prostitutes, and married women using family planning methods may be divorced on account that they are disobedient to their husbands as they do not want to bear children. As such, sexual and reproductive health as a right is still very far from reality to many men and women. To a large extent, the objections are mainly backed up in culture, which is deeply rooted in many African traditions. While such culture have both the good and bad side, the African Charter on Human and Peoples Rights has identified the bad ones as’ harmful cultural practices. This paper argues that, while cultural norms may hinder the realization of human rights, adopting a human rights based approach to address harmful cultural practices is likely, the best approach to realizing women’s rights to sexual and reproductive health rights in Africa.

Keywords: rights, culture, health, women

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Authors: Maha Salah Abdullah Ismail, Mahmoud M. Alsagheir, Mohammed Salah Abd Allah

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Acute respiratory distress syndrome (ARDS) is characterized by permeability pulmonary edema and refractory hypoxemia. Lung-protective ventilation is still the key of better outcome in ARDS. Prone position reduces the trans-pulmonary pressure gradient, recruiting collapsed regions of the lung without increasing airway pressure or hyperinflation. Prone ventilation showed improved oxygenation and improved outcomes in severe hypoxemic patients with ARDS. This study evaluates the effect of prone positioning on mechanically ventilated patients with ARDS. A quasi-experimental design was carried out at Critical Care Units, on 60 patients. Two tools were utilized to collect data; Socio demographic, medical and clinical outcomes data sheet. Results of the present study indicated that prone position improves oxygenation in patients with severe respiratory distress syndrome. The study recommended that use prone position in patients with severe ARDS, as early as possible and for long sessions. Also, replication of this study on larger probability sample at the different geographical location is highly recommended.

Keywords: acute respiratory distress syndrome, critical care, mechanical ventilation, prone position

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Authors: Nicole Scott, Emily Dwyer, Cara Patrissy, Samantha Bonventre, Lina Begdache

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Across North America, the use and abuse of Attention Deficit Hyperactivity Disorder (ADHD) medication, cannabis, nicotine, and other psychoactive substances across college campuses have become an increasingly prevalent problem. Students frequently use these substances to aid their studying or deal with their mental health issues. However, it is still unknown what psychoactive substances are likely to be abused when college students illicitly use ADHD medication. In addition, it is not clear which psychoactive substance is associated with mental distress. Thus, the purpose of this study is to fill these gaps by assessing the use of different psychoactive substances when illicit ADHD medication is used; and how this association relates to mental stress. A total of 702 undergraduate students from different college campuses in the U.S. completed an anonymous survey distributed online. Data were self-reported on demographics, the use of ADHD medications, cannabis, nicotine, other psychoactive drugs, and mental distress, and feelings and opinions on the use of illicit study drugs were all included in the survey. Mental distress was assessed using the Kessler Psychological Distress 6 Scale. Data were analyzed in SPSS, Version 25.0, using Pearson’s Correlation Coefficient. Our results show that use of ADHD medication, cannabis use (non-frequent and very frequent), and nicotine use (non-frequent and very frequent), there were both statistically significant positive and negative correlations to specific psychoactive substances and their corresponding frequencies. Along the same lines, ADHD medication, cannabis use (non-frequent and very frequent), and nicotine use (non-frequent and very frequent) had statistically significant positive and negative correlations to specific mental distress experiences. As these findings are combined, a vicious loop can initiate a cycle where individuals who abuse psychoactive substances may or may not be inclined to use other psychoactive substances. This may later inhibit brain functions in those main areas of the brain stem, amygdala, and prefrontal cortex where this vicious cycle may or may not impact their mental distress. Addressing the impact of study drug abuse and its potential to be associated with further substance abuse may provide an educational framework and support proactive approaches to promote awareness among college students.

Keywords: stimulant, depressant, nicotine, ADHD medication, psychoactive substances, mental health, illicit, ecstasy, adrenochrome

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Authors: Natany Rodrigues De Carvalho, Denise Bomtempo Birche De Carvalho

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The purpose of this study is to analyze the Special Testimony as a methodology for social workers to ensure the rights of children and adolescents who are victims of sexual violence. The specific objectives are: a) to contextualize, through the specialized literature, the social history of childhood and adolescence; b) to investigate, in the scientific literature, the sexual violence against children and adolescents as an analytical category; c) identify, with the social workers, if there is any defense of children and adolescents in the special testimony. To answer the research objectives we use qualitative research, in three axes that complement each other: a) participant observation through the insertion in the research field (supervised internship I and II); b) survey of literature on the subject; c) semi-structured interviews with social workers of the TJDFT. We used content analysis to systematize and interpret the collected data. The results of the research were organized into three chapters with the following contents: a) literature review, contextualizing the social history of childhood and adolescence to the present; b) sexual violence against children and adolescents and their categories of analysis; c) understanding of the special testimony in the Federal District and Territories in guaranteeing the rights of children and adolescents, identifying their main points from the perspective of social workers. The results showed how the lack of interdisciplinarity in the Special Testimony can lead to the non-integral protection of children and adolescents victims of sexual violence.

Keywords: childhood and adolescence, sexual violence, special testimony, social work

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Authors: J. J. Lloyd, J. S. Phillips

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Background: HIV/AIDS has made a huge impact on human development and sexual reproductive habits in this century in the world and especially in sub-Saharan Africa. It has only recently been acknowledged that HIV/AIDS has an equal if not greater effect on or threat to people with disabilities. Survivors of traumatic spinal cord injury (SCI) with resultant disability are incorrectly believed to be sexually inactive, unlikely to use drugs or alcohol and at less risk of violence or rape than their non-disabled peers. This group can thus be described as economically, educationally and socially disadvantaged, which in itself, suggest that they are a high-risk group for HIV infection. Objectives: Thus, the overall objective of this study was to assess the factors that exacerbate the risk and vulnerability of individuals with spinal cord injuries to HIV infection in order to develop a more effective HIV intervention. Methodology: This paper reports on the cross-sectional data gathered from individuals with a traumatic spinal cord injury in 4 conveniently selected provinces in South Africa. Data was collected by means of self-administered questionnaires. The questionnaire consisted of various sections requesting for information on Demographics; HIV-Knowledge (HIV- KQ-18); Sexual behaviours; sexual communication, and negotiation skills and Self-efficacy to refuse sex. Results: The majority of the study sample was males (72.7%) with a mean age of 34.6 years. The majority reported lifetime sexual intercourse (92.4%) but only 31.8% reported condom use with last sexual intercourse. Low level of HIV knowledge, and being male were the strongest predictor of risky sexual behaviours in this sample. Conclusion: Significant numbers of individuals with spinal cord injuries are thus engaging in risky sexual behaviours pointing to a need to strengthen comprehensive sexual health education to increase access to HIV testing, promote safe sex and condom use among this group.

Keywords: Human Immunodeficiency Virus (HIV), individuals with spinal cord injuries, risky sexual behaviours, HIV risk factors, sub-saharan Africa

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