Search results for: sexual side effects
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 12322

Search results for: sexual side effects

12202 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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12201 The Perspective of Waria Transgenders in Singaraja on Their Reproduction Health

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

Abstract:

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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12200 The Effectiveness of Sexual Cognitive Behavioral Therapy on Strategic Thinking and Communication Patterns of Couples in Colostomy Patients

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

Abstract:

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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12199 The Conflict between Empowerment and Exploitation: The Hypersexualization of Women in the Media

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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12198 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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12197 Changing Patterns of Marriage and Sexual Relations among Young Single Female Workers in Garment Factories in Gazipur, Bangladesh

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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12196 Case Study of Sexual Violence Victim Assessment in Semarang Regency

Authors: Sujana T, Kurniasari MD, Ayakeding AM

Abstract:

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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12195 The Curse of Vigilante Justice: Killings of Rape Suspects in India and Its Impact on the Discourse on Sexual Violence

Authors: Hrudaya Kamasani

Abstract:

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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12194 Gender Norms and Psychological Mechanisms that Make Sexual Assault Possible

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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12193 Cannabis Use Reported by Patients in an Academic Medical Practice

Authors: Siddhant Yadav, Ann Vincent, Sanjeev Nanda, Karen M. Fischer, Jessica A. Wright

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Statement of the Problem: Despite the growing popularity of cannabis in the general population, there are several unknowns regarding its use, specific reasons for use, patient’s choice of products, health benefits, and adverse effects. The aim of our study was to evaluate patient-reported information related to cannabis use that was recorded in the electronic medical records. Methodology & Theoretical Orientation: We manually reviewed the electronic medical records of cannabis users who were part of a large pharmacogenomic study. Data abstracted included demographics, level of education, concurrent alcohol and tobacco use, type of cannabis utilized, formulation, indication, symptomatic improvement, or adverse effects reported. Following this, we did a descriptive statistical analysis. Findings: Our sample of 164 cannabis users were predominantly female (73.2%); 66% of users reported using cannabis for medical indications. Of the 109 patients who recorded information pertaining to alcohol/tobacco use, two-thirds of cannabis users reported concurrent use of alcohol, and about half of them were former or current tobacco users. The mean age of cannabis use was 66 years. Regarding the type of cannabis, 34.1% reported using marijuana, 32.3% reported CBD use, 1.8% reported using THC, and 1.2% reported using Marinol. Oral formulations (capsules, oils, suspensions, brownies, cakes, and tea) were the most common route (44 %). Indications for use included chronic pain (n=76), anxiety (n=9), counteracting side effects of chemotherapy (n=4), and palliative reasons (n=2). Fifty-eight of the 76 users endorsed improvement in chronic pain (80%), 5 users reported improvement in anxiety, and 2 reported improvement in side effects of chemotherapy. Conclusion & Significance: The majority of our cannabis users were Caucasian females, and there was a high likelihood of coinciding use of alcohol/tobacco in patients using cannabis. Most of our patients used the oral formulation for chronic pain. Importantly, a considerable number of patients reported improvements in chronic pain, anxiety, and side effects of chemotherapy.

Keywords: cannabis use, adverse effects, medical practice, indications

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12192 Six Tropical Medicinal Plants Effects in the Treatment of Prostate Diseases in Forty Different Patients

Authors: T. Nalowa, L. Foncha, S. Eposi

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Prostate enlargement, prostate cancer are major global health problems affecting many men as they advance in age. It is highly recommended to encourage older men to get Prostate Specific Antigen test screening frequently. Conventional treatments like radiation, chemotherapy are associated with many side effects. And this situation is a call for concern. Traditional medicine is affordable, easily prepared with little or no side effects and it contains many phytochemicals. The study aims to find the cure for prostate cancer and prostate enlargement by extracting products from plant tissues of specific herbs to determine anti-inflammatory, anti-cancer, and anti-hematuria properties. Descriptive statistical analysis was applied to describe the data process. The commonly used method of preparation was extraction. Overall, 40 patients were classified based on their medical conditions on their underlying user report. Rural communities in Fako are rich sources of plants with medicinal properties. The used plants consequently provide basic information and aid to investigate the cure of prostate cancer and prostate enlargement, with great significance.

Keywords: cancer, enlargement, metastases, prostate

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12191 Knowledge regarding Sexual and Reproductive Health among Adolescents in Higher Secondary School

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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12190 Posttraumatic Distress, Hope and Growth in Survivors of Commercial Sexual Exploitation and Sex Trafficking in Nepal

Authors: Rebekah Volgin, Jane Shakespeare-Finch, Ian Shochet

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Commercial sexual exploitation (CSE) and sex trafficking affect between 5000-7000 girls and women in Nepal each year and can have devastating physical and psychological consequences. Much research has documented these effects, however, there is no published longitudinal research that focuses on whether healing and growth outcomes are possible for survivors of CSE and sex trafficking. The narratives of 27 girls and women (13-22 years) were taken at two-time points during participation in a six-week group psychoeducation and art therapy program which was delivered across three NGO’s in Kathmandu, Nepal. These narratives form part of a larger ethnographic project. Thematic analysis of the data was undertaken. Themes emerging from time point 1 were: psychological distress in the form of anxiety and grief over loss of family, psychosomatic symptoms, empathy and compassion, and posttraumatic growth (PTG) in the form of new possibilities, relating to others and personal strength. Posttraumatic growth refers to positive changes in the aftermath of trauma. The themes emerging from time point 2, were: empathy and compassion and PTG (cognitive restructuring, new possibilities, relating to others and personal strength). Alongside the distress that these participants experienced, they also experienced positive outcomes such as empathy and compassion and psychological growth. Future research would advance knowledge by further examining the process of PTG in this population, if the changes observed were lasting, and if so, ways in which PTG can be facilitated or promoted.

Keywords: commercial sexual exploitation, human trafficking, posttraumatic growth, sexual trauma

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12189 The Effect of the Side-Weir Crest Height to Scour in Clay-Sand Mixed Sediments

Authors: F. A. Saracoglu Varol, H. Agaccıoglu

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Experimental studies to investigate the depth of the scour conducted at a side-weir intersection located at the 1800 curved flume which located Hydraulic Laboratory of Yıldız Technical University, Istanbul, Turkey. Side weirs were located at the middle of the straight part of the main channel. Three different lengths (25, 40 and 50 cm) and three different weir crest height (7, 10 and 12 cm) of the side weir placed on the side weir station. There is no scour when the material is only kaolin. Therefore, the cohesive bed was prepared by properly mixing clay material (kaolin) with 31% sand in all experiments. Following 24h consolidation time, in order to observe the effect of flow intensity on the scour depth, experiments were carried out for five different upstream Froude numbers in the range of 0.33-0.81. As a result of this study the relation between scour depth and upstream flow intensity as a function of time have been established. The longitudinal velocities decreased along the side weir; towards the downstream due to overflow over the side-weirs. At the beginning, the scour depth increases rapidly with time and then asymptotically approached constant values in all experiments for all side weir dimensions as in non-cohesive sediment. Thus, the scour depth reached equilibrium conditions. Time to equilibrium depends on the approach flow intensity and the dimensions of side weirs. For different heights of the weir crest, dimensionless scour depths increased with increasing upstream Froude number. Equilibrium scour depths which formed 7 cm side-weir crest height were obtained higher than that of the 12 cm side-weir crest height. This means when side-weir crest height increased equilibrium scour depths decreased. Although the upstream side of the scour hole is almost vertical, the downstream side of the hole is inclined.

Keywords: clay-sand mixed sediments, scour, side weir, hydraulic structures

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12188 The Special Testimony as a Methodology for Social Workers to Ensure the Rights of Children and Adolescents Who Are Victims of Sexual Violence

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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12187 Factors Associated with the Use of Long-Acting Reversible Contraceptive Methods among Women of Reproductive Age 15-49 Years in Jinja District

Authors: Helen Nelly Naiga, Christopher Garimoi Orach

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Introduction: Long-acting reversible contraceptive (LARC) methods are highly effective. However, LARC use in Uganda is low (13%). We assessed the factors associated with the use of long-acting reversible contraceptives among women of reproductive age (15-49 yrs) in Jinja District. Methods: We conducted a facility-based cross-sectional study. A total of 314 women aged 15–49 years attending public health facilities (1 hospital and 3 health center IV) in Jinja district, were randomly selected. A total of 6 key informants and 6 in-depth interviews were conducted. Logistic regression analysis was conducted using Stata version 14. Qualitative data were analysed using thematic analysis. Results: The study found that 40.45% of the respondents had ever used LARC. The commonest LARC method used was implanting (38.22%). The factors significantly associated with use of LARC were employment (AOR =2.91; 95% CI (1.05-8.08), access to LARC methods (AOR =4.48; 95% CI (1.24-16.21), husband support (AOR =4.90; 95% CI (1.56-15.41), and experience of no side effects (AOR =3.48; 95% CI (1.00-12.19). Conclusion and recommendations: The study showed that 4 in 10 women of reproductive age in Jinja District were using LARC. The factors associated with LARC use were employment, husband support, access to LARC methods, and the lack of side effects. There is a need to strengthen client education, improve accessibility to LARC methods at all levels of health centers, improve male partner’s decision-making in LARC use and manage the side effects effectively.

Keywords: family planning, implants, intrauterine device, long-acting reversible contraceptives (LARC)

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12186 Factors Contributing to the Risk and Vulnerability to HIV Infection among Individuals with Spinal Cord Injuries (SCI) in South Africa

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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12185 Investigation of the Effect of Preschool Sex Education Program on Parents' Level of Sexual Development Knowledge, Attitude, Communication and Sexual Abuse Awareness

Authors: Sila Uzkul, Ayse Dilek Ogreti̇r Ozceli̇k

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Sexual development, which starts from fertilization, gainssocial, cultural and psychological dimensions with birth and becomes a lifelongpart of human life. Inorderforchildrentogrowup as healthyindividuals, alldevelopmentalareasneedto be supportedcorrectly, but when it comestosexualdevelopmentandeducation, studiesshowthateducatorsandparentsareinsufficient in terms of information on this subject, andtheyareworried, inadequate In, In restless, In uncomfortableandexcited in In terms In of communication. With this research, it is aimedtoincreasetheknowledgelevel of the parents, theirpositiveattitudetowardssexualeducation, positivecommunicationduringsexualeducationandawareness of sexualabusebyprovidingsexualeducationtotheparents of childrenreceivingpre-schooleducation. The study group of this research, which was designed in quantitativeresearchtype, experimental design, and Solomon four-group model, will be composed of parents of childrenattendingpre-schooleducationinstitutions. In the preparation of the Preschool SexEducation Program to be applied to parents, primaryandsecondarydatasourceswill be used, literaturereviewandarchivescanningmethodswill be used. In the content of the program, theeight main topics (our body, sexuality, emotions, relationships, health, norms, reproductionandrights) thatthe World HealthOrganizationstatesshould be addressed in sexualeducation how toteachthesesubjectstotheirchildren, how toanswerquestionsfromthechild, childsexualdevelopmentandsexualabusetopicswill be included. Theparentsexualeducation program is plannedto be held online (byzoom) for about 45 minutesonce a weekfor 11 weeks. Data will be collectedusingtheSexualCommunicationScale, theSexualEducationAttitudeScale, the sexual Development Knowledge Level andtheAbuse Information/AttitudeScaleforParents. Demographic information of the the parents will be collectedwiththePersonal Information Form to be preparedbytheresearchers. Appropriatestatisticalmethodswill be used in theanalysis of thedata. Studyfindingswill be given in an oral presentation.

Keywords: preschool, sexual development, sexuality education, sexual communication, early childhood, parents' sex education

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12184 “It Just Feels Risky”: Intuition vs Evidence in Child Sexual Abuse Cases. Proposing an Empirically Derived Risk and Protection Protocol

Authors: Christian Perrin, Nicholas Blagden, Louise Allen, Sarah Impey

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Social workers in the UK and professionals globally are faced with a particular challenge when dealing with allegations of child sexual abuse (CSA) in the community. In the absence of a conviction or incontestable evidence, staff can often find themselves unable to take decisive action to remove a child from harm, even though there may be a credible threat to their welfare. Conversely, practitioners may over-calculate risk through fear of being accountable for harm. This is, in part, due to the absence of a structured and evidence-based risk assessment tool which can predict the likelihood of a person committing child sexual abuse. Such assessments are often conducted by forensic professionals who utilise offence-specific data and personal history information to calculate risk. In situations where only allegations underpin a case, this mode of assessment is not viable. There are further ethical issues surrounding the assessment of risk in this area which require expert consideration and sensitive planning. This paper explores this entangled problem extant in the wider call to prevent sexual and child sexual abuse in the community. To this end, 32 qualitative interviews were undertaken with social workers dealing with CSA cases. Results were analysed using thematic analysis and operationalised to formulate a risk and protection protocol for use in case management. This paper reports on the early findings associated with the initial indications of protocol reliability. Implications for further research and practice are discussed.

Keywords: sexual offending, child sexual offence, offender rehabilitation, risk assessment, offence prevention

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12183 A Study of the Disorders of Sexual Functioning in Women with Type 2 Diabetes Mellitus in a Tertiary Care Hospital in India

Authors: Mehak Nagpal, T. S. Sathyanarayan Rao

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Background: Sexual functioning is a neglected aspect of health in women with diabetes, though it contributes greatly towards quality of life and feeling of wellbeing. Also women with DM are at higher risk than men of developing sexual dysfunction and depression. Materials and Methods: Cross-sectional comparison study. Sample size: 100 previously diagnosed type 2DM patients attending Outpatient Diabetic Clinic at Medicine department JSS Hospital Mysore; aged 20-65 years and 60 normal healthy female subjects for Control group. Data was collected with ethical approval over a period of 2 years. Tools Used: 1) Hamilton Depression Rating Scale (HAMD – 17 item) 2) Female Sexual Functioning Index (FSFI) 3) Arizona Sexual Experience Scale (ASEX-F) for female-for screening. 4) The Appraisal of Diabetes Scale (ADS). Results: Statistically significant differences were observed in prevalence rate and severity of depression between diabetic group (45% vs 11% syndromal depression) and controls. Depression scores correlated significantly with glycaemic control, adherence to treatment, BMI and the cognitive appraisal of diabetes. There was significantly greater impairment in the sexual functioning of women with type 2 diabetes mellitus as compared to controls; both prevalence (62% vs 38.3%) and severity (p value < 0.01). Arousal (74.2% vs 53.3%), Desire (76.3% vs 50%) and Satisfaction (76.7% vs 63.7%) were most affected and 64.5% were affected in 2 or more domains. A negative illness appraisal on ADS correlated significantly with poor glycaemic control, higher rates of depression and also more severe female sexual dysfunction (p value < 0.05). Conclusion: Diabetes specific factors that correlated significantly with FSD in this study included the psychological appraisal of diabetes, duration of diabetes, presence of complications and BMI.

Keywords: depression, female sexual dysfunction, India, type 2 diabetes mellitus

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12182 Application of Double Side Approach Method on Super Elliptical Winkler Plate

Authors: Hsiang-Wen Tang, Cheng-Ying Lo

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In this study, the static behavior of super elliptical Winkler plate is analyzed by applying the double side approach method. The lack of information about super elliptical Winkler plates is the motivation of this study and we use the double side approach method to solve this problem because of its superior ability on efficiently treating problems with complex boundary shape. The double side approach method has the advantages of high accuracy, easy calculation procedure and less calculation load required. Most important of all, it can give the error bound of the approximate solution. The numerical results not only show that the double side approach method works well on this problem but also provide us the knowledge of static behavior of super elliptical Winkler plate in practical use.

Keywords: super elliptical winkler plate, double side approach method, error bound, mechanic

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12181 Social Influences on HIV Services Engagement among Sexual Minorities Experiencing Intersectional Stigma and Discrimination during COVID-19 Pandemic in Uganda

Authors: Simon Mwima, Evans Jennifer Mann, Agnes Nzomene, Edson Chipalo, Eusebius Small, Moses Okumu, Bosco Mukuba

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Introduction: In Uganda, sexual minorities experience exacerbated intersectional stigma and discrimination that exposes them to elevated HIV infections and impedes access to HIV testing and PrEP with low treatment adherence. We contribute to the lack of information about sexual minorities living with HIV in Uganda by using modified social-ecological theory to explore social influences impacting HIV services engagement. Findings from focused group discussion (FGD) involving 31 sexual minorities, ages 18-25, recruited through urban HIV clinics in Kampala reveal the protective and promotive social influence within the individual and interpersonal relationships (sexual partners and peers). Further, inhibitive social influences were found within family, community, societal, and healthcare settings. During the COVID-19 pandemic, these adolescents strategically used promotive social influences to increase their engagement with HIV care services. Interviews were recorded in English, transcribed verbatim, and analyzed using Dedoose. Conclusions: The findings revealed that young people (identified as sexual minorities) strategically used promotive social influences and supported each other to improve engagement with HIV care in the context of restrictive laws in Uganda during the COVID-19-Pandemic. Future HIV prevention, treatment, and care responses could draw on how peers support each other to navigate the heavily criminalized and stigmatized settings to access healthcare services.

Keywords: HIV/AIDS services, intersectional stigma, discrimination, adolescents, sexual minorities, COVID-19 pandemic Uganda

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12180 Sexuality and Quality of Life Among Older Adults

Authors: Ahuva Even-Zohar, Shoshi Werner

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Context: Sexuality is an important aspect of overall quality of life for individuals across different age groups and health conditions. Sexual interest and activity continue to be important and play a role in people's life as they age. Despite this, there is limited research on the sexual health of older adults. Research Aim: The study aims to examine the knowledge, attitudes, and sexual activity of older adults and to explore the relationship between sexual activity and quality of life among this population. Methodology: The study involved 203 Jewish participants from Israel, with an average age of 69.59. The participants completed questionnaires administered through an Internet panel. The questionnaires measured variables such as knowledge about and attitudes towards sexuality, sexual activity, quality of life, and socio-demographic information. Findings: The study found that a majority of the participants reported engaging in sexual activity, with most of them experiencing full sexual intercourse. Approximately half of the participants expressed high levels of satisfaction with their sexual activity. The results indicated that older adults demonstrated a moderate level of knowledge and permissive attitudes towards sexuality in later life. Moreover, higher levels of knowledge and permissive attitudes were associated with increased sexual activity. The frequency of sexual activity was identified as a predictor of quality of life, with a mediating effect on the relationship between attitudes towards older adults' sexuality and quality of life. Notably, men and older adults who were married or in a relationship reported higher frequencies of sexual activity compared to women and older adults without a partner. Furthermore, a majority of participants did not seek professional help or discuss their sexual concerns with a therapist. Theoretical Importance: This research contributes to our understanding of a topic that is often considered taboo - sexuality among older adults. It highlights that older adults maintain an interest in sexual activity, and that engaging in such activity contributes to their overall quality of life. Data Collection and Analysis Procedures: The data for this study were collected using structured questionnaires administered through an Internet panel. The questionnaires included closed-ended questions, allowing for quantitative data analysis. Descriptive statistics and regression analysis were performed to examine the relationships between the variables. Questions Addressed: This study aimed to address the following questions: What is the level of knowledge and attitudes towards sexuality among older adults? How prevalent is sexual activity among older adults and what factors are associated with it? How does sexual activity impact the quality of life of older adults? Do older adults seek professional help for their sexual concerns? Conclusion: The main conclusion drawn from this research is that sexuality is a crucial aspect of older adults' lives and significantly contributes to their quality of life. The study emphasizes the need for educational programs aimed at older adults and professionals, which promote the understanding and benefits of sexuality in later life. It also suggests that professionals should actively encourage older individuals to seek help and support when experiencing difficulties related to sexuality.

Keywords: men, older adults, quality of life, sexuality, women

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12179 A Study of the Alumina Distribution in the Lab-Scale Cell during Aluminum Electrolysis

Authors: Olga Tkacheva, Pavel Arkhipov, Alexey Rudenko, Yurii Zaikov

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The aluminum electrolysis process in the conventional cryolite-alumina electrolyte with cryolite ratio of 2.7 was carried out at an initial temperature of 970 °C and the anode current density of 0.5 A/cm2 in a 15A lab-scale cell in order to study the formation of the side ledge during electrolysis and the alumina distribution between electrolyte and side ledge. The alumina contained 35.97% α-phase and 64.03% γ-phase with the particles size in the range of 10-120 μm. The cryolite ratio and the alumina concentration were determined in molten electrolyte during electrolysis and in frozen bath after electrolysis. The side ledge in the electrolysis cell was formed only by the 13th hour of electrolysis. With a slight temperature decrease a significant increase in the side ledge thickness was observed. The basic components of the side ledge obtained by the XRD phase analysis were Na3AlF6, Na5Al3F14, Al2O3, and NaF.5CaF2.AlF3. As in the industrial cell, the increased alumina concentration in the side ledge formed on the cell walls and at the ledge-electrolyte-aluminum three-phase boundary during aluminum electrolysis in the lab cell was found (FTP No 05.604.21.0239, IN RFMEFI60419X0239).

Keywords: alumina distribution, aluminum electrolyzer, cryolie-alumina electrolyte, side ledge

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12178 A Comparison of Efficacy of Two Drugs Combinations of 0.0625% Levobupivacaine with Fentanyl and 0.1% Ropivacaine with Fentanyl for Postoperative Analgesia after Cytoreductive Surgery with Hyperthermic Intraperotineal Chemotherapy (Crs + Hipec)

Authors: Vishal Bhatnagar

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The objective of this study is to compare the efficacy of epidural analgesia of two amide local anesthetics, ropivacaine and levobupivacaine, with fentanyl for postoperative analgesia in major abdominal surgery CRS+HIPEC. Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS+HIPEC) are done for primary peritoneal malignancies or peritoneal spread of malignant neoplasm. CRS and HIPEC are considered one of the most painful surgery among all major abdominal surgeries. Poorly managed postoperative pain elevates stress, increases anxiety, causes prolonged Hospital stay, increases opioid requirement and side effects, increases the cost of treatment and psychological effects on patient and family. It affects the quality of life of patients. The epidural technique provides better postoperative analgesia, earlier recovery of bowel function, fewer side effects, higher patient satisfaction, and an improvement in life quality in the postoperative days after abdominal surgery than other analgesic techniques.

Keywords: HIPEC, postoperative analgesia, cytoreductive surgery, VAS score, rescue analgesia

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12177 One of the Missing Pieces of Inclusive Education: Sexual Orientations

Authors: Sıla Uzkul

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As a requirement of human rights and children's rights, the basic condition of inclusive education is that it covers all children. However, the reforms made in the context of education in Turkey and around the world include a limited level of inclusiveness. Generally, the inclusiveness mentioned is for individuals who need special education. Educational reforms superficially state that differences are tolerated, but these differences are extremely limited and often do not include sexual orientation. When we look at the education modules of the Ministry of National Education within the scope of inclusive education in Turkey, there are children with special needs, bilingual children, children exposed to violence, children under temporary protection, children affected by migration and terrorism, and children affected by natural disasters. No training modules or inclusion terms regarding sexual orientations could be found. This research aimed to understand the perspectives of research assistants working in the preschool education department regarding sexual orientations within the scope of inclusive education. Six research assistants working in the preschool teaching department at a public university in Ankara (Turkey) participated in this qualitative research study. Participants were determined by typical case sampling, which is one of the purposeful sampling methods. The data of this research was obtained through a "survey consisting of open-ended questions". Raw data from the surveys were analyzed and interpreted using the "content analysis technique" (Yıldırım & Şimşek, 2005). During the data analysis process, the data from the participants were first numbered, then all the data were read, and content analysis was performed, and possible themes, categories, and codes were extracted. The opinions of the participants in the research regarding sexual orientations in inclusive education are presented under three main headings within the scope of the research questions. These are: (a) their views on inclusive education, (b) their views on sexual orientations (c) their views on sexual orientations in the preschool period.

Keywords: sexual orientation, inclusive education, child rights, preschool education

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12176 Decisional Regret in Men with Localized Prostate Cancer among Various Treatment Options and the Association with Erectile Functioning and Depressive Symptoms: A Moderation Analysis

Authors: Caren Hilger, Silke Burkert, Friederike Kendel

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Men with localized prostate cancer (PCa) have to choose among different treatment options, such as active surveillance (AS) and radical prostatectomy (RP). All available treatment options may be accompanied by specific psychological or physiological side effects. Depending on the nature and extent of these side effects, patients are more or less likely to be satisfied or to struggle with their treatment decision in the long term. Therefore, the aim of this study was to assess and explain decisional regret in men with localized PCa. The role of erectile functioning as one of the main physiological side effects of invasive PCa treatment, depressive symptoms as a common psychological side effect, and the association of erectile functioning and depressive symptoms with decisional regret were investigated. Men with localized PCa initially managed with AS or RP (N=292) were matched according to length of therapy (mean 47.9±15.4 months). Subjects completed mailed questionnaires assessing decisional regret, changes in erectile functioning, depressive symptoms, and sociodemographic variables. Clinical data were obtained from case report forms. Differences among the two treatment groups (AS and RP) were calculated using t-tests and χ²-tests, relationships of decisional regret with erectile functioning and depressive symptoms were computed using multiple regression. Men were on average 70±7.2 years old. The two treatment groups differed markedly regarding decisional regret (p<.001, d=.50), changes in erectile functioning (p<.001, d=1.2), and depressive symptoms (p=.01, d=.30), with men after RP reporting higher values, respectively. Regression analyses showed that after adjustment for age, tumor risk category, and changes in erectile functioning, depressive symptoms were still significantly associated with decisional regret (B=0.52, p<.001). Additionally, when predicting decisional regret, the interaction of changes in erectile functioning and depressive symptoms reached significance for men after RP (B=0.52, p<.001), but not for men under AS (B=-0.16, p=.14). With increased changes in erectile functioning, the association of depressive symptoms with decisional regret became stronger in men after RP. Decisional regret is a phenomenon more prominent in men after RP than in men under AS. Erectile functioning and depressive symptoms interact in their prediction of decisional regret. Screening and treating depressive symptoms might constitute a starting point for interventions aiming to reduce decisional regret in this target group.

Keywords: active surveillance, decisional regret, depressive symptoms, erectile functioning, prostate cancer, radical prostatectomy

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12175 Dopamine and Female Sexual Function: A Clinical and Biochemical Study

Authors: Azza Gaber Antar Farag, Eman Abd El Fatah Badr, Wesam Ahmed Tawfik Hasssan Abdel Aal, Mustafa Elsayed Elshaib

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Background: Female Sexual Dysfunction (FSD) represents recurrent and persistent problems that distress women and/or strain their relationships with their partners. Dopamine can affect sexual function and interacts with ovarian hormones in the ventromedial area in the hypothalamus. Objective: To investigate the possible role of dopamine in FSD. Method: This prospective case-control study was carried on 100 women having FSD and 100 healthy volunteer females. They were recruited from the Al-Menoufia governorate. All included women were subjected to the questionnaire to assess their demographic and gynecological data as well as sexual function. They were investigated for serum levels of dopamine, estradiol, progesterone and DHEA hormones. Results: Dopamine serum levels were significantly lower in females having sexual dysfunction (6.68±4.14) than controls (57.97±26.26) (P>0.001). This decreased dopamine level was of a significant positive correlation with the arousal domain and significant negative correlation regarding the pain domain (r=-0.19, p=0.01). Also, estradiol serum levels were significantly lower (P>0.001), but progesterone and DHEA serum levels were significantly higher in the FSD group than controls (P>0.001). There was a significant negative correlation between dopamine and DHEA serum levels (r= -0.45, p <0.001). Conclusions: Decreased dopamine serum levels may have an active role in the pathophysiology of FSD, impacting mainly arousal and pain domains, and its targeting should be considered during FSD management.

Keywords: dopamine, estradiol, progesterone, DHEA, females sexual dysfunction

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12174 An Interview and PhotoVoice Exploration of Sexual Education Provision to Women with Physical Disability and Potential Experiences of Violence

Authors: D. Beckwith

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This research explored sexual identity for women with physical disability, both congenital and acquired. It also explored whether exposure to violence or negative risk-taking had played a role in their intimate relationships. This phenomenological research used semi-structured interviews and photo elicitation with the researcher’s insider knowledge adding experiential substance and understanding to the discussion. Findings confirm sexuality for women with physical disability is marginalised and de-gendered making it less of a priority for professionals and policy makers and emphasising the need to more effectively support women with disability in relation to their sexuality, sexual expression and violence.

Keywords: lived-experience, identity, PhotoVoice, sexuality, violence, women with physical disability

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12173 Sexual Cognitive Behavioral Therapy: Psychological Performance and Openness to Experience

Authors: Alireza Monzavi Chaleshtari, Mahnaz Aliakbari Dehkordi, Amin Asadi Hieh, Majid Kazemnezhad

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This research was conducted with the aim of determining the effectiveness of sexual cognitive behavioral therapy on psychological performance and openness to experience in women. The type of research was experimental in the form of pre-test-post-test. The statistical population of this research was made up of all working and married women with membership in the researcher's Instagram social network who had problems in marital-sexual relationships (N=900). From the statistical community, which includes working and married women who are members of the researcher's Instagram social network who have problems in marital-sexual relationships, there are 30 people including two groups (15 people in the experimental group and 15 people in the control group) as available sampling and selected randomly. They were placed in two experimental and control groups. The anxiety, stress, and depression scale (DASS) and the Costa and McCree personality questionnaire were used to collect data, and the cognitive behavioral therapy protocol of Dr. Mehrnaz Ali Akbari was used for the treatment sessions. To analyze the data, the covariance test was used in the SPSS22 software environment. The results showed that sexual cognitive behavioral therapy has a positive and significant effect on psychological performance and openness to experience in women. Conclusion: It can be concluded that interventions such as cognitive-behavioral sex can be used to treat marital problems.

Keywords: sexual cognitive behavioral therapy, psychological function, openness to experience, women

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