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Despite the existence of numerous laws and regulations that govern policy arrangements for the management of sexual harassment cases, victims still lack access to justice. This research examines the rules governing the management of sexual harassment cases in the workplace, with a particular emphasis on ASEAN member countries. This research employs normative juridical methods, which include statutory, conceptual, and comparative approaches. The research results show that, despite the existence of the 1955 Employment Law and Criminal Code in Malaysia, the incidence of sexual harassment continues to rise. To address this issue, it is critical to involve all employees in the development, execution, and oversight of workplace policies. Second, Singapore's primary law for dealing with sexual harassment, the Protection from Harassment Act, is accompanied by an employment law. Nevertheless, there are apprehensions regarding the inadequate remedies, uncertainty, and statutory protections against harassment, particularly in the workplace. Third, Indonesia has implemented numerous laws and regulations to manage sexual harassment cases. However, the government still faces challenges, such as an incomplete and insufficient legal framework, which results in victims being denied justice. Fourth, the effective implementation and protection of women's rights necessitate a comprehensive approach that considers cultural sensitivities, regional dynamics, and international norms to reconstruct sexual harassment regulations in ASEAN countries. As a result, it is critical to establish an anti-sexual harassment organizational culture and restructure sexual harassment regulations to protect victims' rights.

Background: The basic objective of any civilization is to preserve a happy family. The quality of one’s sexual encounters is crucial to a happy marriage. Couples’ dissatisfaction in this area may be the cause of several social, psychological, and medical issues. The way reality is interpreted, which shapes behaviors and emotions, is established by beliefs. These beliefs, which are among the most frequent causes of male sexual problems, include those relating to high performance, women’s sexual enjoyment, and sexual conservatism. Aims: To identify the misconceptions about sexuality among psychiatry patients. Method This cross-sectional study was carried out at the School of Medical Sciences and Research, Sharda University. We enrolled 200 samples and it is assessed through Sexual Beliefs Questionnaire (Male version). Result: Sexual beliefs were assessed in different domains as well as overall sexual belief score was also estimated. The different domains in which the sexual beliefs were scored were sexual conservatism, female sexual power, macho belief, beliefs about women’s sexual satisfaction, restrictive attitude toward sex, and sex as an abuse of men’s power. Conclusion: The development of both psychiatric and sexological care will benefit from the early identification of the intricate relationships between psychopathology, the adverse effects of antipsychotic medicines, and sexuality. However, longitudinal studies are needed to anticipate the relationship more accurately between sexual dysfunction and sexual beliefs at a larger sample size. Sexual beliefs are significant contributors to sexual dysfunction.

BackgroundYouth is a decisive age that shapes the direction of their life and that of their family. However, due to the host of biological, social, and economic factors, youth Industry Park workers can be at high risk of adverse sexual and reproductive health outcomes. Therefore, assessing youth sexual and reproductive health service utilization and associated factors among youth workers is very crucial for timely intervention to their gaps.ObjectiveThis study aimed to assess sexual and reproductive health service utilization and associated factors among youth workers working at Kombolcha Industry Park Kombolcha, Northeast Ethiopia, 2023.MethodsAn institutional-based cross-sectional study was conducted at Kombolcha Industry Park, Kombolcha, among a total of 422 youth workers from 1 January to 30 January 2023. A simple random sampling technique was used to access a total of 422 youth workers in Kombolcha Industry Park. The data were collected using pre-test, structured, and interviewer-administered questionnaires. Data were entered into Epi Data version 3.1 and were exported to SPSS version 26 for analysis. Bi-variable and multivariable binary logistic regression analyses were performed. Adjusted odds ratio with 95% confidence interval was estimated to measure the strength of the association. The level of statistical significance was declared at a p value of less than 0.05.ResultsOverall utilization of reproductive health services was 45.50%. Being married [adjusted odds ratio (AOR) = 5.76, 95% CI (2.94, 11.25)], near distance of sexual and reproductive health (SRH) facility to home [AOR = 2.57, 95% CI (1.60, 4.14)], having good knowledge [AOR = 9.23 95%CI (4.88, 17.44)], and good attitude about SRH [AOR = 2.06 95% CI (1.29, 3.28)] were significantly associated with youth SRHs utilization.ConclusionYouth sexual and reproductive health service utilization among youth workers of Kombolcha Industry Park was low. Ensuring SRHs availability and accessibility, empowering youth with knowledge of SRHs, and advocating sexual and reproductive health services to develop a good attitude might be important in improving reproductive health service utilization. Future researchers should address segments of the population other than Kombolcha Industry Park.

Integrating appreciative inquiry (AI) and pastoral care may help address the complex issues of commercial sexual exploitation and sex trafficking. This article explores the benefits of incorporating AI principles into pastoral care for survivors of commercial sexual exploitation and sex trafficking. Commercial sexual exploitation and trafficking involve exploitation, degradation, and violence, making them complex issues. By understanding the sex trade, we can recognise that prostitution is an act of exploitation. Some scholars believe that prostitution and human trafficking are interconnected, with a focus on exploiting the poor, especially women and children. Commercial sexual exploitation can cause mental, emotional, and spiritual distress. Survivors require comprehensive aftercare to address their spiritual, self-esteem, and dignity needs. Organisational development-based AI is constructive and strength-based. Appreciative inquiry promotes positive development, community and individual strength, and resilience by re-contextualizing narratives and envisioning brighter futures. The use of AI could improve pastoral care and holistic rehabilitation. Pastoral caregivers using AI can promote reconciliation, development, and rehabilitation. Using strengths-based strategies, pastoral care practitioners can help survivors regain agency and purpose. Survivors receive spiritual support through the Appreciative Way, which combines contemplative spirituality and inquiry. Narrative exploration can help trauma survivors envision a bright future based on love and resilience. This study suggests that AI principles may benefit pastoral care recipients who have experienced commercial sexual exploitation and sex trafficking. Pastoral caregivers can help survivors regain dignity, calling, and well-being by implementing an appreciative healing approach. Contribution: The article sheds light on the dehumanising consequences of sex trafficking on vulnerable populations in South Africa, particularly women and children. This article aims to explain how AI concepts can be applied to Practical Theology. Specifically, this article will demonstrate how the Appreciative Way can be utilised in pastoral care for healing from sex trafficking trauma.

Objective: To determine the psychological impact of sexual assaults among males during their childhood. Study Design: Descriptive cross-sectional study. Place and Duration of Study: Combined Military Hospital Okara from 2 August 2022 to 20 March 2023. Materials and Methods: We consecutively sampled 204 subjects who were given proforma to record demographic data including age, socioeconomic status, ethnicity, being victim of sexual assault, relationship to the assailant, numbers of sexual assault, and mode of sexual assault. Post-traumatic stress disorder (PTSD) check list and Trauma symptom check (TSC) list was applied on participants reporting sexual assault and SPSS 23 used for data analysis. Results: Out of 204 study participants 33 (16.1%) males experienced sexual assault while 27 (81.8%) victims experienced PTSD with trauma symptoms of sleep disturbance in 18 (54.5%), sexual dysfunction experienced by 6 (18.1%), anxiety felt by 13 (39.3%), depression presented in 5 (15.1%), while 2 (6.0%) individuals experienced dissociation. Victims of sexual assault, assailant and number of sexual assaults were highly correlated with mode of sexual assault, trauma symptoms (except dissociation), and PTSD (p < 0.001) Conclusion: Sexual assault on males during their childhood is strongly associated with significant psychological distress.

Abstract Background Nightlife environments are high risk settings for sexual violence and bystander intervention programmes are being developed in response. However, more research is needed to understand nightlife-related sexual violence, and factors that influence bystander interventions. This study examined nightlife patron’s experiences of sexual violence and associated factors; and relationships between attitudes towards, awareness and experience of sexual violence, and confidence to intervene. Methods Cross-sectional on-street survey of nightlife patrons (N = 307, aged 18+) on a night out in an English city. Surveys (7.30pm-1.30am; Wednesday-Saturday) established sexual violence awareness, myth acceptance, and experience, and confidence to intervene. Participant’s socio-demographics, nightlife alcohol consumption, and frequency of nightlife usage were collected. Results 58.0% had ever experienced sexual violence whilst on a night out. In adjusted analyses, sexual violence was higher amongst females (adjusted odds ratio [AOR] 4.0; p

Cannabis is an herb known for its significant pharmacological effects. This study evaluated the safety of a female sexual hygiene product containing cannabidiol on the skin of experimental animals and humans. Irritation symptoms were tested using three female New Zealand white rabbits. In human trials, irritation and sensitivity symptoms were assessed in 30 healthy female volunteers. The results from the animal study indicated that body weight and clinical symptoms remained normal, with only slight irritation noted in the primary irritation index of the skin (PII = 0.6). In human trials, transepidermal water loss was observed during the induction phase but decreased over time. No abnormalities were found during the induction phase; however, irritation occurred during the challenge phase, which resolved after 8 h. It was concluded that the rinse-off product caused slight irritation when applied for more than 4 h in animals and 24 h in humans, which differs from its intended use of immediate rinse-off, where no irritation was observed.

The purpose of this research is to elucidate the pattern related to sex education for children with autism using a comparative study between the city of Jakarta in Indonesia and the city of Dhaka in Bangladesh. The current research adopted a qualitative research methodology and a phenomenological research technique. Data were collected through an in-depth interview with eleven informant; six were from Jakarta, Indonesia, and the other five were from Dhaka, Bangladesh. The findings indicated that the children with autism already understand about sex education. The children received preparations for puberty from their parents. Furthermore, most of the children have a high level of independence. The children learn sexual prohibition and ethics toward the opposite sex from their parents. To improve sexual health education, this research recommends that parents attend sexual education seminars, consult with doctors, or send their children to special schools teaching sexual health education. The research conducted a comparative study about sexual health education of children with autism between Jakarta, Indonesia, and Dhaka, Bangladesh.

BackgroundA growing number of advanced neuroimaging studies have compared brain structure and function in long term meditators to non-meditators. The goal is to determine if there may be long term effects on the brain from practicing meditation. In this paper, we present new data on the long term effects of a novel meditation practice in which the focus is on clitoral stimulation. The findings from such a study have implications for potential therapeutic uses with regard to various neurological or psychiatric conditions.MethodsWe evaluated the cerebral glucose metabolism in 40 subjects with an extended history (>1 year of practice, 2–3 times per week) performing the meditation practice called Orgasmic Meditation (OM) and compared their brains to a group of non-meditating healthy controls (N = 19). Both meditation and non-meditation subjects underwent brain PET after injection with 148 to 296 MBq of FDG using a standard imaging protocol. Resting FDG PET scans of the OM group were compared to the resting scans of healthy, non-meditating, controls using statistical parametric mapping.ResultsThe OM group showed significant differences in metabolic activity at rest compared to the controls. Specifically, there was significantly lower metabolism in select areas of the frontal, temporal, and parietal lobes, as well as the anterior cingulate, insula, and thalamus, in the OM group compared to the controls. In addition, there were notable distinctions between the males and females with the females demonstrating significantly lower metabolism in the thalamus and insula.ConclusionsOverall, these findings suggest that the long term meditation practitioners of OM have different patterns of resting brain metabolism. Since these areas of the brain in which OM practitioners differ from controls are involved in cognition, attention, and emotional regulation, such findings have implications for understanding how this meditation practice might affect practitioners over long periods of time.

Global warming-induced environmental changes have resulted in salinity fluctuations that markedly impact aquatic organisms. Consequently, the salinization of freshwater has become a major concern. Among these organisms, planarians are highly sensitive to environmental changes, especially Dugesia bursagrossa, the first freshwater planarian species identified in Saudi Arabia, which reproduces both sexually and asexually through fission. This study examined the reproductive response of sexual and asexual D. bursagrossa specimens to salinity changes. Asexual reproduction rates were found to increase with elevated salinity, whereas sexual reproduction was sensitive to high salinity, evidenced by the absence of cocoons in treated groups. This phenomenon was further explored by investigating the microtubular cytoskeleton’s organization in the sexual form’s ovary using immunolabeled α-tubulin and confocal microscopy. Results revealed a significant decline in the tubulin cytoskeleton with rising salinity levels, supporting the notion that increased salinity restricts sexual reproduction. Given that heightened salinity induces stress, the activities of malondialdehyde (MDA) and various antioxidant indicators, including glutathione (GSH), superoxide dismutase (SOD), and catalase (CAT), were evaluated. Elevated salinity led to a notable increase in MDA levels as well as reduced GSH, SOD, and CAT levels in both sexual and asexual specimens, with sexual organisms exhibiting more pronounced effects. In conclusion, salinity directly impacts the homeostasis and reproduction of D. bursagrossa, with sexual specimens facing greater challenges than their asexual counterparts.

The study aimed to explore information about factors and social realities that influence pre-exposure prophylaxis (PrEP) seeking and accessing behavior in Makassar, South Sulawesi Province. This basic research uses a type of ethnographic research, data from the views of the community (emic views), namely health workers, program managers, PrEP service recipients, key groups, related community groups, and communities. Results show that people with high HIV potential are generally unwilling or embarrassed to disclose and often fill out paperwork dishonestly, due to cultural realities. Customs, habits, and practices among potential PrEP clients, known as user culture, make it difficult for interventions to select appropriate and accurate health services, thus affecting future transmission maps. In conclusion, potential users are still secretive, and their sexual activities and places of use of PrEP services do not want to be known by others. The social and cultural reality demonstrated by PrEP users at the Andalas Puskesmas is that some persons tend to avoid the Andalas Puskesmas working area, claiming that they are embarrassed to be seen by residents.

HIV/AIDS has been a major threat to global public health, with India ranking third when it comes to the global burden of people living with HIV, especially women. It is imperative to assess the level of knowledge women have about transmission and prevention of this infection. This study sought to delineate the determinants of the comprehensive knowledge of HIV/AIDS among women in the reproductive age groups in India. Data from the fifth round of the National Family Health Survey conducted in India were analyzed. The sample included 95,541 women aged 15–49 years. Multilevel logistic regression was fitted with individual characteristics, household characteristics, and community characteristics to identify determinants of comprehensive knowledge on HIV/AIDS. Nearly a fourth (24.8%) of the women aged 15–49 in India who had ever heard of HIV had comprehensive knowledge of HIV/AIDS. Multilevel logistic regression showed that the likelihood of comprehensive knowledge of HIV/AIDS was higher among women aged 40–44 (AOR = 1.57) and 30–34 (AOR = 1.56). The likelihood of having comprehensive knowledge increased with the increase in the level of education. Women with secondary and higher levels of education were 1.9 times and 3.38 times more likely to have comprehensive knowledge, respectively, than those with no education. Household wealth, access to mass media, and having ever tested for HIV were also significant determinants of comprehensive knowledge of HIV/AIDS among women. The odds of having comprehensive knowledge about HIV/AIDS were higher for women with higher community wealth (AOR = 1.31), higher community education (AOR = 1.09), and higher community employment (AOR = 1.12). Factors at both the individual and community levels were shown to be indicators of comprehensive knowledge of HIV/AIDS. Policymakers and public health practitioners in India should come up with plans to close the information gaps about HIV/AIDS that exist among women and their demographic subgroups.

Keflie Yohannes Gebresilassie,1 Alemakef Wagnew Melesse,2 Tilahun Yemanu Birhan,2 Asefa Adimasu Taddese3 1Midwifery Directorate, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia; 2Department of Epidemiology and Biostatistics, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia; 3Department of Health Informatics /Biostatistics/, College of Medicine and Health Sciences, University of Gondar, Gondar, EthiopiaCorrespondence: Keflie Yohannes Gebresilassie, Email yohanneskifle43@gmail.comBackground: Violence Against Women (VAW) becomes a serious public health issue as unnecessary morbidity and mortalities affect women and girls. Women who experience violence had the possibility of another of violence. Although gender-based violence (GBV) is a common problem in Ethiopia, the burden is not well studied.Objective: This study determines the magnitude of Gender-Based Violence among women receiving Sexual and Reproductive Health Services in a Specialized Hospital.Methods: Institution-based retrospective follow-up study was conducted at the University of Gondar Comprehensive Specialized Hospital among gender-based violence (GBV) service users from January 2017 to January 2022. Data were collected from register logbooks and also medical records for some variables, using a tool prepared by refereeing literature and adapting locally available resources and researchers experiences. Epi-info 7 was used to enter the data and exported it to SPSS V-23 for analysis. Descriptive statistics like frequencies, percentages, means and standard deviations are computed for all variables.Results: The lifetime proportion of sexual and physical violence was found to be 81% and 5%, respectively, while 3% of women experienced both sexual and physical violence. One hundred seventy (29.4%) of the incidents were done by an intimate-partners (boyfriend/husband). The majority (86%) had extra genital injuries. After genital examination, about one-fourth (25%) of survivors had fresh hymenal tears. About three-fourths (75.1%) of the survivors visit the health facility within threes day after the incident.Conclusion: The study found that GBV is common in Northwest Ethiopia. Future research should involve sensitive methods and grounded approaches to explore survivors’ experiences and views on local gender cultures and other contextual factors. Establishing One-stop-center could improve the quality of the services provided to the women.Keywords: Gender, Sexual, Physical, Violence, Women, Health, Ethiopia

Abstract This study aimed to investigate the effect of wormwood and rosemary supplementation on some reproductive traits of Barbarine rams. The experiment lasted 2 months. Twenty‐four adult rams were divided into four groups (n = 6) balanced for the weight (53.3 ± 1.2 kg body weight [BW] ± SD). All rams received 1200 g of straw and 600 g of barley. Control rams (C) without aromatic medicinal plant (AMP), while experimental rams received 20 g of fresh rosemary leaves (R), 20 g of fresh wormwood leaves (A), and 10 g of fresh rosemary leaves plus 10 g of fresh wormwood leaves (RA). The results revealed that the live weight of all rams increased (p .05). However, when the rams received rosemary plus wormwood, their sperm volume increased (p > .05). The sperm mass motility was higher for the A, R and AR rams in comparison to the C rams (p = .05). On the other hand, biochemical analysis of the seminal fluid showed no effect of diets on calcium and total proteins concentration. But the measurement of glucose and seminal insulin showed a decrease (p

Background and aims: Tramadol and methadone are synthetic opioid drugs that are widely used in various fields of medicine. This review article was performed to investigate the hormone disturbance of long-term tramadol and methadone use in women. Methods: Keywords were determined using the MeSH browser and then searched in ISI, Scopus, EMBASE, and PubMed databases on 25.5.2022. The articles with non-English language, articles whose full text was not retrieved, and studies that were irrelevant to the aim of this study were excluded from the investigation. Results: Methadone and tramadol affected a sexual hormone in women through an impact on the hypothalamic-pituitary-gonadal axis. They could reduce the levels of follicle stimulating hormone and luteinizing hormone, increase prolactin production, and finally, reduce gonadal steroids. Opioids also could influence thyroid and adrenal glands and subsequently increase thyroid-stimulating hormone, and reduce dehydroepiandrosterone. Eventually, this mechanism caused a disturbance in sexual hormone disturbance in women. Conclusion: Overall, long-term methadone and tramadol consumption as opioid substances could cause sexual hormone disturbance in women.

Today the crime of trafficking in persons in the form of sexual exploitation is increasingly common with various modes of operation, one of which is making the wife a commercial sex worker by her husband which can be seen in print and online media, where this can also be categorized as a crime of domestic violence. As an example of the case of the criminal act of trafficking in persons in the form of sexual exploitation committed by a husband against his wife as a commercial sex worker as stated in the Decision of the Sidoarjo District Court Number 889/Pid.Sus/2018/PN. SDA, where in its application law enforcers, especially judges in court, only apply the provisions in the law on the crime of trafficking in persons even though the actions of the accused can be applied to the provisions in other relevant laws. This research is normative legal research by studying the applicable laws and regulations related to court decisions in the cases studied. The results of the study show that law enforcement of sexual exploitation crimes committed by husbands against wives in the decision of the Sidoarjo District Court Number 889/Pid.Sus/2018/PN.SDA applies Article 2 of Law Number 21 of 2007 concerning Eradication of Trafficking Crimes People, but acts of exploitation by perpetrators and victims are bound in a legal marriage, so legally the application of the law can also apply Article 8 letter b of Law Number 23 of 2004 concerning the Elimination of Domestic Violence, so that the perpetrators can be subject to maximum legal sanctions for acts exploits that have been carried out.

Marital issues and depression commonly manifest within couples, displaying a reciprocal connection. This research aimed to assess the impact of group-based dialectical behavior therapy on enhancing emotional, communicative, sexual, and social-recreational intimacy among couples experiencing depression. Conducted as an experimental study with both experimental and control groups, the research involved 20 couples seeking assistance at counseling centers in Shahrekord (Iran) due to depression. The couples were selected through purposive sampling and then randomly assigned to either the experimental or control group. Utilizing a marital intimacy questionnaire, baseline measurements of marital intimacy were taken for both groups prior to the intervention (pre-test). Following an 11-week intervention comprising 90-minute sessions for the experimental group, post-intervention assessments were conducted for both groups using the same questionnaire (post-test). The data underwent analysis involving descriptive statistics and Multivariate Covariance method. The results indicated that dialectical behavior therapy yielded significant enhancements in emotional, communicative, sexual, and social-recreational intimacy for depressed couples within the experimental group, compared to the control group (P

Sexual violence against child is a global problem today. Although international instruments have been ratified, they do not guarantee the realization of the rights of child victims. One reason is that not all countries’ legal systems support victims. The principles of redress for victims of child sexual violence are set out in the United Nations Convention on the Rights of the Child. The Convention recognizes the principle of non-discrimination, the best interests of the child, child survival and development, and values Child opinions. The problem you encountered is related to 1) your security system. 2). Reintegration, psychosocial support, treatment and recovery, protection and support in court proceedings. A model of restorative justice that protects the rights of victims of child sexual violence can use the victim-offender mediation model. This model provides an opportunity for communities to come together and find solutions together when offenders are willing to admit their mistakes and take responsibility according to the needs of the victim’s child. The implications of this research are hoped to make a real contribution to the nation by providing better protection for children who are victims of sexual violence and reducing the trauma they experience.

Abstract Background Adolescents should have access to high quality and responsive sexual and reproductive health, however, it is unclear to what extent the national policy on health and development of adolescent is implemented by health care workers in Plateau State. This study assessed the general availability of sexual and reproductive health services, the delivery of responsive adolescent sexual and reproductive health services and health care worker?s understanding of what constitutes adolescent responsive sexual and reproductive health services. Methods Using a cross sectional design, we interviewed 409 health care workers selected through a multistage sampling technique, across six Local Government Areas of Plateau State, Nigeria using an interviewer-administered survey questionnaire. Results The most available sexual and reproductive health services was antenatal and delivery care (69.2%), contraception 25.9% and 14.9% reported post abortion care. Only 1.2% indicated the availability of the four recommended essential sexual and reproductive health services (counselling/information provision, provision of contraceptives, testing/treatment for sexually transmitted infection (STI) /HIV and post abortion care) in their facilities. Little over half (58.4%) felt their facilities were adequate in meeting the sexual and reproductive health needs of adolescent and this was associated with delivery of post abortion care (AOR=3.612; CI=1.886-6.917; p = .001) and providing sexual and reproductive health services to adolescents without parental consent (AOR=3.612; CI=1.886-6.917; p = .001). Most health care workers had poor understanding of adolescent responsiveness of sexual and reproductive health services, understanding better among health workers who provided services without parental consent and in a separate room for privacy and confidentiality. Conclusion We conclude that adolescent sexual and reproductive health services is not yet as stipulated in the national policy in Plateau State, Nigeria and in general, health workers have poor understanding of what it means to provide adolescent-responsive services.

Plain Language Summary Comprehensive sexuality education programmes are often not implemented properly because facilitators are not adequately prepared, and the community usually resist such programs. Similarly, in Zambia, the teachers and CBHWs implementing sexual and reproductive health activities often felt uncomfortable discussing sensitive sexuality topics with adolescents. This study was conducted within a bigger research project exploring whether teachers and community-based health workers together can effectively deliver sexual and reproductive health information at school and community levels. Discussions on the delivery of ASRHR services were held with teachers and CBHWs to identify their roles, and challenges that they experienced, and find solutions to problems. The interviews showed that the teachers and CBHWs provided sexual reproductive health and rights (SRHR) counselling to adolescents and parents. They were also involved in mobilising communities to attend SRHR meetings, sensitise, and refer them to SRHR services. However, teachers and CBHWs encountered several challenges. These include late reporting and hiding of sexual abuse cases, myths about contraceptives, and stigmatisation of girls with history of sexual abuse, and pregnancy. Further, girls felt shy to participate in SRHR discussions due to customary norms and values regarding marriage. More community engagement opportunities are needed to break the barriers of communication, and shift cultural norms to help enhance adolescent uptake of SRHR services in order to prevent pregnancy and other related challenges.

In recent years, social research surrounding the consequences of infertility has increasingly focused on the male perspective; however, a gap exists in the understanding of men's experiences of male infertility treatment. This review aims to synthesize the existing evidence concerning the psychological, social, and sexual burden of male infertility treatment on men, as well as patient needs during clinical care. A systematic search identified 12 studies that are diverse in design, setting, and methods. Psychological evaluations have found that urological surgery may have a lasting impact on infertility-specific stress, and treatment failure can lead to feelings of depression, grief, and inadequacy. Men tended to have an avoidant coping mechanism throughout fertility treatment, and their self-esteem, relationship quality, and sexual functions can be tied to outcomes of treatment. Partner bonds can be strengthened by mutual support and enhanced communication; couple separation, however, has been noted as a predominant reason for discontinuing male infertility treatment and may be associated with difficult circumstances surrounding severe male infertility. Surgical treatments can affect the sexual functioning of infertile men; however, the impact of testicular sperm extraction outcomes appears to be psychologically driven whereas the improvements after microsurgical varicocelectomy are only evident in hypogonadal men. Clinically, there is a need for better inclusion, communication, education, and resource provision, to address reported issues of marginalization and uncertainty in men. Routine psychosocial screening in cases of severe male infertility and follow-up in cases of surgical treatment failure are likely beneficial.

Background: Men with sex with men (MSM) may face obstacles in accessing culturally competent and quality healthcare services since current medical practice does not often promote discussing sexual habits. The coronavirus disease-2019 (COVID-19) pandemic has further affected this group. This study assessed the impacts of COVID-19 and the general challenges of MSM in Benue State, Nigeria. Materials and Methods: This study was a quantitative cross-sectional survey conducted across three geopolitical zones of Benue State using a multistage cluster sampling method to collect data from MSM. The data collected were analyzed using IBM-Statistical Package for Social Sciences (IBM-SPSS) version 25.0 for Windows IBM Corp., Armonk, New York. Result: More than half (59.2%) of respondents said they were not denied healthcare services, and 78.4% were not afraid to seek them. Most (88%) were comfortable seeking medical help, and 61.6% did not experience stigmatization from healthcare providers. Many (68.0%) were not exposed to violence after sharing their status with healthcare providers. About half (50.4%) said COVID-19 did not affect their general quality of life. Over half (51.2%) said there was a decline in access to resources like food and money during the pandemic, 49.6% experienced difficulties accessing HIV testing, and 52.0% could not access PrEP. More than half (53.6%) reported challenges getting viral load or other laboratory tests, but 57.5% had no trouble getting HIV medication prescriptions. Conclusion: The Federal Government, and the Ministry of Health, Nigeria, should support intervention programs, peer educators, and outreach workers providing services to MSM.

BACKGROUND: Sexual changes in breast cancer occur after diagnosis and treatment, including a mastectomy. Sexual assertiveness is an effective factor in sexual satisfaction, which means the ability to convey sexual feelings, beliefs, and thoughts. Given the limited studies on sexual assertiveness in breast cancer and different client participation, this study was conducted to compare the effect of sexual counseling based on two models of PLISSIT (Permission, Limited Information, Specific Suggestion, Intensive Therapy) and BETTER (Bring Up, Explain, Tell, Time, Education, Record) on sexual assertiveness in women after mastectomy. MATERIALS AND METHODS: This quasi-experimental intervention was conducted in 2021 in Mashhad, Iran. Seventy-eight mastectomized women with breast cancer were assigned to the BETTER (n = 39) and PLISSIT (n = 39) groups using permuted block randomization with a block size of 4 and an allocation ratio of 1:1. Both groups received four individual counseling sessions, one week apart. The research tools included a demographic information form and the Hulbert index of sexual assertiveness. Changes in the mean scores of sexual assertiveness between the two groups were evaluated before and four weeks after the intervention, and the mean changes were compared between the groups. Data analysis was conducted using the Kolmogorov-Smirnov test, independent t-test, paired t-test, and Chi-square tests using Statistical Package for the Social Sciences (SPSS) version 25 (P < 0.05). RESULTS: The results of the study showed that before the intervention, there was no significant difference in the score of sexual assertiveness in both groups (P = 0.253). The mean score of sexual assertiveness changes before and after the intervention in the BETTER group (8.07 ± 4.9) was significantly higher than in the PLISSIT group (5.58 ± 4.7) (P < 0.001). CONCLUSION: The results indicated that BETTER sexual counseling was more effective in increasing the sexual assertiveness of mastectomized women than PLISSIT counseling. Due to its simplicity and client-centeredness, this model can be used in breast cancer care programs.

The emergence of several phenomena of sexual violence on television media between lecturers and students raises concerns for all circles in the campus environment. Unfortunately, most of the student victims are unaware that they are getting sexual harassment, especially verbally. One form of verbal abuse is sexist humor. This study aimed to find about what makes sexist humor a form of sexual violence and what we can do to prevent and control it at UIN Raden Fatah Palembang. This study used a qualitative research method. In collecting the data, a quantitative method was used by distributing the questionnaires, and qualitatively, by conducting in-depth interviews. The theory used was the theory of Communication Privacy Management (CPM). The findings and results of this study concluded that this sexist humor will continue to occur if there is no prevention and proper handling on campus, mainly because there are no institutions that can act as bridges for students to report, consult and protect victims. Another thing that is also a concern is the lack of understanding and information about sexual violence, both verbally and non-verbally, among students.

INTRODUCTION: The global burden of Sexual and Reproductive Health (SRH) problems has remained a significant challenge to the wellbeing of men and limits the effectiveness of SRH interventions for females. This study explored men and healthcare providers’ perception of ideal male-oriented Sexual and Reproductive Health (SRH) services. METHODS: This was an exploratory qualitative study involving three focus group discussions among men in selected communities and eight interviews among healthcare service providers in Ekiti State, Nigeria. Focus Group Discussion (FGD) and Key Informant Interview (KII) guides were used to collect qualitative data from twenty-six men and eight healthcare service providers, respectively. Participants for the study were selected from three different units of the selected hospital and twelve communities. Data were sorted, transcribed, and analyzed using Atlas ti software. Inductive-deductive thematic analysis was performed. RESULTS: Three main themes emerged from the study: (a) ideal men-oriented SRH service provision within a unit specially made and named after men, (b) 24-hour daily SRH clinic and (c) locating SRH Clinic in the healthcare institutions with outlets in the communities and schools. The participants identified primary needs as SRH organs assessments; screening services; family planning services; and education and counselling on prevention and treatment of male SRH problems. CONCLUSION: Men have SRH service preferences that focused on preventive and therapeutic sexual and reproductive health needs that are desired to be male-oriented, dedicated and provided in health facilities with public outlets.

Background: Sexual self-concept is an individual's perception of his/her sexual feelings and actions, which can be affected by chronic diseases, including diabetes. As a biological and psychological crisis, diabetes can cause mood changes. The present study was conducted to determine the effects of virtual emotion regulation training on the positive and negative sexual self-concept of diabetic married women. Methods: An interventional study was conducted on women with type 2 diabetes covered by the comprehensive health service centers of Gorgan (Iran) in 2019. Overall, 36 eligible diabetic women were enrolled via available sampling. The subjects were assigned to an intervention group (n=19) and a control group (n=17) through four-block allocation and random selection without placement. Virtual emotion regulation training was held during 4 sessions, once a week, for the intervention group. Both groups completed the Persian version of Beck’s Depression Inventory and Snell’s Multidimensional Sexual Self-Concept Questionnaire at baseline, immediately after the last virtual training session, and one month after the last training session. Data were analyzed using ANOVA and Bonferroni's post hoc test at a significance level of 0.05. Results: The mean score of positive sexual self-concept of patients after the last training session was 133.68 ± 18.91in the intervention and 131.17 ± 18.86 in the control group. The mean score of positive sexual self-concept of patients one month after the training was 10± 9.51in the intervention group and 15.17 ± 11.92in the control group. The mean score of negative sexual self-concept of patients after the last training session was 10.42± 10.04 in the intervention and 14.52± 14.39 in the control group. The interaction effects of time and group on the positive sexual self-concept did not differ significantly (P=0.316). The group effect was also not statistically significant (P=0.58). The interaction effects of time and group on the negative sexual self-concept were significant (P=0.023), and the group effect was not statistically significant (P₌0.47). Conclusion: The significant interaction of time and group on negative sexual self-concept indicates that the negative sexual self-concept in diabetic women has been affected by the intervention. Given the significant effects of virtual emotion regulation training on the management of negative emotions, this type of intervention can be beneficial for improving the health of diabetic women.

Background & aim: Inadequate laws to prevent sexual violence against women and to protect victims as well as the factors such as patriarchal culture, and misconceptions of some religious and Islamic teachings can lead to temper divorce and betrayal. This study was performed to review the jurisprudential and legal protections for domestic sexual violence in Iran.Methods: In this review, the published evidence on the supportive aspects of domestic sexual violence between 1990 and 2021 was searched in the English database of Scopus, PubMed, Science Direct, and EBSCO as well as Persian databases of Magiran, SID, and IranMedex. To collect data, searching was done using the key words of Violence, Domestic, Family Violence, Sex Offenses, Partner Abuse, Sexual Violence, Civil Law, legislation, jurisprudence and religion of Islam alone or in combination in English and their Persian equivalents.Results: Among 69 studies related to the legal and religious aspects of sexual violence, 35 studies were reviewed. In Iranian law, there is legal material only in a number of cases of sexual violence in the section on punishments and the Islamic Penal Code. There is also disagreement among Shiite scholars about some unusual sexual behaviors. Ongoing counseling is emphasized due to the importance of different dimensions such as unconventional sexual request, and sexual violence with reluctance of wife.Conclusion: Some cases of sexual violence are not properly restricted. Therefore, more attention to these cases by jurists and legislators can reduce the occurrence of many forms of sexual violence against women.

Abstract Introduction Adverse childhood experiences (ACEs) are proposed to increase the risk of developing multiple sclerosis (MS) later in life. This systematic review aimed to explore the correlation between ACEs and MS development, age of onset, quality of life in MS patients and MS relapse rates. Methods We searched a total of six databases in June 2022 and retrieved the relevant studies. The population included adult (18+) individuals who either had been diagnosed or were at risk for developing MS and also had exposure to ACEs. Our primary outcomes include the risks of MS development, age of MS onset, and MS relapse rate in patients who were exposed to different types of ACEs. Results A total of 11 studies were included in our review. A study reported that among 300 women diagnosed with MS, 71 (24%) reported a history of childhood abuse; moreover, with further research, it was concluded that ACEs were associated with the development of MS. Abuse that occurred 2–3 times per week was associated with an 18.81‐fold increased risk of having MS when compared to the unexposed sample. The relapse rate of MS was found to be substantially greater in severe cases of ACEs compared to individuals who did not report any ACEs. Conclusions Results support a significant association between ACEs and the development of MS; individuals with a positive history of ACEs develop MS symptoms earlier. Moreover, the severity of ACEs is also linked with increased relapse rates of MS.

Background: Most street children studied in lower- and middle-income African countries are without family links. However, the majority of street children are children on the street, living with families during the night and spending their day-time on the streets. The health of this majority group is poorly captured in the literature despite the growing epidemic of child streetism. Aim: To explore the health of children on the street of Ibadan using multiple qualitative studies. Setting: A street in each of the five urban local government areas of Ibadan Oyo State, Nigeria. Methods: Participants comprising of children on the street, parental figures, street shop owners and child-welfare officers were purposively selected and interviewed. Interviews were audio recorded, transcribed, and thematically analyzed. Results: Using triangulated data from 53 interviews, the study found that the children on the streets of Ibadan experienced many health challenges. Outstanding are poor carbohydrate-based diet, open defaecation with consequent infections, physical injuries and few deaths from road traffic accidents. Sexual, verbal and substance abuse were common although few children acquired resilience to adversity. The children had poor health-seeking behaviour and resorted to patent medicine dealers or tradomedical practitioners on the streets. Conclusion: This study bridged some gaps in the literature regarding the health of children on the streets in Nigeria. The straddling of children between the family and street has cumulative health consequences as depicted in this study. Contribution: This research can inform family-level intervention and primary health care plans to forestall the health challenges of children on the streets.

IntroductionDespite the existence of a legal policy framework, financing of adolescent and youth sexual and reproductive health (AYSRH) services has remained weak. External donors are the main financing agents, which has implications for the sustainability of service provision. International development partners have reduced funding for health programs from historically high levels. In Kenya, the health sector's budget allocation has remained below the 15% committed to under the Abuja declaration. With Kenya's devolved government structure, a greater proportion of financial resources are dedicated towards recurrent and structural expenses as opposed to addressing health systems gaps.ObjectivesThe purpose of this manuscript is to assess the contribution of The Challenge Initiative (TCI) Business Unusual model on AYSRH services in the counties of Kilifi and Migori, as well as to examine the institutionalization of high impact interventions (HIIs) within the annual work plan, budget, and systems of the said counties. Additionally, this study aims to analyse the trend in contraceptive uptake among adolescent and young women aged 15 to 24 in Kilifi and Migori counties.MethodsMigori and Kilifi Counties chose to partner with TCI to implement the Business Unusual model. Interested counties apply for the initiative's support and commit to contributing a portion of the funding needed to adapt and implement high impact interventions (HIIs). Based on the identified gaps, TCI supported the counties to prioritize the HIIs including integrated outreaches, youth fixed days, whole site orientation, youth champions, and youth dialogues. The program was implemented between July 2018 to June 2021 in 60 and 68 public health facilities of Kilifi and Migori Counties, respectively. The county teams identified and selected program implementation team whose key role was to coordinate, review, monitor, mobilize resources and report AYSRH program implementation progress.ResultsThe results showed a 60% increase in financial commitments on AYSRH programming from 2018 to 2021 in both counties. The average expenditure for committed funds for Kilifi and Migori Counties was 116% and 41% respectively. As the counties continued to allocate and spend funds on the implementation of HIIs, there was a noticeable increase in contraceptive uptake among the young people aged 15 to 24 who visited health facilities for services. There was a 59% and 28% percentage increase in contraceptive uptake among young people (15–24 years) between 2018 and 2021. The proportion of adolescents amongst those presenting for first ANC clinic dropped from 29.4% in 2017 to 9% in 2021 in Kilifi County and from 32.2% in 2017 to 14% in 2021 in Migori County. Using the TCI's Sisi kwa Sisi coaching model of lead-assist-observe-monitor, 20 master coaches were trained. The master coaches cascaded the training to over 97 coaches. The coaches will continue to build capacity of peers in advocacy for resource mobilization and implementation of HIIs. At least nine of TCI's HIIs have been adopted in Kilifi and Migori County strategies and annual work plans, and there is financial support for their sustainability.DiscussionThe increase in adolescent contraceptive uptake might have been as a result of the system strengthening through self-financing of AYSRH programs, the institutionalization of HIIs, and the coaching. Local governments can invest in and sustain their own AYSRH programs, which will lead to an improvement in adolescent and youth access to contraceptive services and, as a result, a reduction in adolescent pregnancies, maternal mortality, and infant mortality.

BackgroundGender-based violence is an important topic that needs to be taken into account when identifying gender-related gaps and disadvantages that a person might face because of their gender. Violence against women could result in psychological and physical adverse outcomes. Therefore, this study aims to assess the prevalence and predictors of gender-based violence among female students at Wolkite University, southwest Ethiopia, 2021.MethodAn institutional-based cross-sectional study was conducted among 393 female students and the students were selected by using a systematic sampling method. Data were checked for completeness and entered into EpiData version 3.1 and then exported to SPSS version 23 for further analysis. Binary and multivariable logistic regressions were employed to determine the prevalence and predictors of gender-based violence. The adjusted odds ratio (AOR) with its 95% confidence interval (CI) at a p-value of ≤0.05 was used to check statistical association.ResultIn this study, the overall prevalence of gender-based violence among female students was 46.2%. The prevalence of physical violence and sexual violence was 56.1% and 47.0%, respectively. Factors that were significantly associated with gender-based violence among female university students were: being a 2nd-year student or having a lower educational level [AOR = 2.56 (95% CI, 1.06–6.17)], being married or living with a male partner [AOR = 3.35 (95% CI, 1.07–10.5], having a father with no formal education [AOR = 15.46 (95% CI, 5.204–45.39)], having a drinking habit [AOR = 2.53 (95% CI, 1.21–6.30)] and not being able to freely discuss issues with their families [AOR = 2.48 (95% CI, 1.27–4.84)]Conclusions and recommendationsThe result of this study showed that more than one-third of the participants were exposed to gender-based violence. Thus, gender-based violence is an important topic deserving of more consideration; further investigations are important to decrease gender-based violence among university students.

Resumen: Objetivo: Conocer la extensión y las características de las experiencias adversas y de victimización en una muestra de personas adultas con un trastorno mental grave residentes en la ciudad de Barcelona. Método: Estudio descriptivo, cuantitativo y transversal. Las experiencias adversas y de victimización se evaluaron a partir de 26 ítems del Adverse Childhood Experiences Questionnaire (ACE-IQ), el cual se amplió para incluir experiencias acontecidas en la edad adulta. Se entrevistó a 74 personas con trastorno mental grave (edad media: 42,03 años; desviación estándar: 9,60). Resultados: Todas las personas entrevistadas reportaron haber vivido como mínimo dos victimizaciones a lo largo de su vida. Las más frecuentes fueron los delitos comunes (87,8%) y la victimización por parte de los cuidadores principales (86,5%). Las mujeres presentaban casi 13 veces más probabilidades de sufrir victimización sexual que los hombres a lo largo de la vida (odds ratio: 12,75; intervalo de confianza del 95%: 4,19-38,71). Antes de los 18 años destaca la alta prevalencia de violencia física por parte de los cuidadores principales (52,7%) y el abuso sexual infantil (32,4%). Conclusiones: La victimización sufrida por las personas con un trastorno mental grave es un problema extendido que ha recibido muy poca atención. Los resultados de este estudio son coherentes con los obtenidos en investigaciones previas y ponen de manifiesto la necesidad de trasladar estos conocimientos a la práctica médica, teniéndolos en cuenta para desarrollar tratamientos con un abordaje integral de la salud mental. Abstract: Objective: To describe the extension of the adverse experiences, including victimization, lived in childhood and adulthood in a sample of people with severe mental illness residing in Barcelona, Spain. Method: Descriptive, quantitative and cross-sectional study. Adverse and victimization experiences were assessed using 26 items from the Adverse Childhood Experiences Questionnaire (ACE-IQ). Items were included obtain information regarding victimization during adulthood. Seventy-four people with severe mental illness were interviewed (median age: 42.03 years; standard deviation: 9.60). Results: All participants reported at least two victimization experiences throughout their lifetime. The most frequent experiences were conventional crimes (87.8%) and victimization by caregivers (86.5%). Before age 18, half of the participants reported having experienced physical violence by their caregivers (52.7%) and almost one out of three reported to have been victim of sexual abuse (32.4%). Women were almost 13 times more likely to experience sexual victimization than men throughout their lifetime (odds ratio: 12.75; 95% confidence interval: 4.19–38.71). Conclusions: Victimization experienced by people with severe mental illness is a widespread problem that has received little attention. The results of this study are consistent with those obtained in previous investigations and underscore the need to translate this knowledge into medical practice into medical practice, considering them in order to develop treatments with a comprehensive approach to mental health.

Sexual violence is a big problem in society, because the negative impact on the victim causes prolonged suffering. Assistance for victims is carried out at the individual, group and institutional levels, both formal and informal. They act as support providers for sexual violence victims. Support providers often experience difficulties because victims find it difficult to open up due to the trauma they have experienced. A strategy to communicate is necessary, so the providers can well provide supports and assistances to victims. This study wanted to explore communication strategies used by support providers in dealing with and helping sexual violence victims. This study used a qualitative approach with descriptive analysis method.Data were collected through in-depth interviews. Informants from this study were support providers that deal with sexual violence victims. The key informants consisted of three people, namely a police officer for the women and children protection (PPA), psychologist who was a victim of sexual violence, and clergyman (church worker). The study results indicated that the support providers implemented a communication strategy by applying the principles of empathy, support and equality, so the victims were willing to open up and get help. They applied rapport techniques in building relationships, practiced active listening skills, and did self-disclosure to be on par with the victim, so the victims can be more open

Prosecutors as executors of court decisions are required to be able to be anticipatory in the process of law enforcement against sexual violence crimes following medical doctors’ refusal to be involved in the execution of chemical castration. This study aims to find a model of chemical castration execution that can be applied through the administration of police medical operation (Dokpol) which combines the roles and positions of medical doctors and law enforcers simultaneously to support the implementation of police duties. The statements of the problem are set to find answers to the questions: Should the execution of chemical castration imposed by the court always be carried out? And can chemical castration be carried out through the implementation of police duties? The research method used is a normative juridical method. The availability of resources of police medical operation who have competence in the health sector is expected to be a solution for prosecutors to prepare chemical castration executors in accordance with the provisions required in Article 9 letter b of Government Regulation No. 70 of 2020, in order to achieve legal certainty regarding the implementation of the Mojokerto District Court decision whose execution is planned to take place in 2031.

ABSTRACTBackground: Sexual behavior is a form of behavior that is carried out to attract attention with the opposite sex and involves a touch on the limbs carried out between men or women so that they reach the stage of intimate relationships. Health belief model (HBM) is one of the patterns in determining the relationship between health beliefs and behavior. The behavior of adolescents who have sexual relations is reviewed using the Health Belief Model theory because it can predict and influence the possibility that adolescents can prevent or not believe in the individual's own beliefs.Objectives: To analyze how the relationship between perceived susceptibility, perceived seriousness, perceived benefits, perceived barriers, self-efficacy and cues to action with adolescent sexual behavior based on the Health Belief ModelMethods: This study is a non-experimental study using a cross-sectional approach. The sample in this study were 300 respondents who were conducted at SMA X Kotamobagu by taking purposive sampling technique. The instrument used is a questionnaire. Statistical test using Pearson Product Moment with a=Results: The majority of respondents showed less behavior as much as 148 (49.3%), the majority of respondents were 17 years old (30.0%), the majority of female respondents were 204 (68.0%). The results of the analysis showed that there was a relationship between perceived susceptibility, perceived barriers, self-efficacy, cues to action p=Conclusions: Based on the results of the analysis there is a relationship between perceived susceptibility, perceived barriers, self-efficacy, cues to action with risky sexual behavior p=

The news in the mass media regarding sexual harassment against children are increasing day by day so that it is troubling not only families, but also the community. Children are soulmates, family assets, images and reflections of the future that we must take care of well. The implementation of legal protection for child sexual harassment victims in Indonesia has not been fully maximized. This research aims to find out the forms of legal protection for child victims of crime in accordance with the provisions of the laws in force in Indonesia.

ROLE OF INFORMATION MEDIA ON ADOLESCENT SEXUAL BEHAVIOR. Youth is an important phase of life in an individual’s developmental cycle. This phase is a transition period that can be directed towards the development of a healthy adulthood, thus bringing happiness and success in carrying out developmental tasks in the next phase. The purpose of community service is expected to be a medium for the dissemination of information related to the role of Information media in adolescent sexual behavior. This community service partner is Megarezky University and CV. Faira Aksara with lecture method using zoom application. From the processed data using Wilcoxon test with a sample number of 53 people obtained there was an increase in knowledge from the average value of quisioner pre-test obtained the correct answer value of 63.20 after counseling changed to 77.73. with a value of ρ 0.000. Community Service activities are one of the means of conveying information to teenagers, health workers, teachers, and parents so that it can be applied to teenagers both in the school environment or at home and in the youth social environment.

O tema evoca um conflito de paradigmas entre os fundamentos da civiliação judaico-cristã, a evolução dos costumes na pós-modernidade, a psicanálise como uma prática relativa à regulação do gozo no campo da psicopatologia e o discurso do Direito que regula a distribuição do gozo no laço social. A psicanálise nasce sob o paradigma da modernidade. Freud desvela a origem perversa e polimorfa da sexualidade, que é posteriormente submetida à lei por meio da função do Nome-do-Pai. Muitos filósofos pós-modernos rejeitam o primado da diferença anatômica entre os sexos, da fantasia infantil da castração e da ficção que atribui ao pai o protagonismo na interdição do incesto. Vamos contrastar os conceitos de diferença, diversidade e autodefinição sexual.

ABSTRACT Objective: to identify the multidisciplinary health team’s perception on aspects of the physical and emotional development of children and adolescents who have suffered sexual violence. Methods: a qualitative study, carried out with 30 health professionals in a hospital in Bahia, Brazil, between June and July 2019. Data were collected from an interview guided by a semi-structured questionnaire. The results were interpreted according to Symbolic Interactionism. Results: some sexually violated children were under five years old and healthy, others had physical/mental disabilities. Victimized adolescents were in the pre-pubertal phase, with fragile body structure, not emotionally mature and unaware of sexuality. Final considerations: children’s physical and emotional aspects make children vulnerable to sexual victimization, as they facilitate the control and dominion that offenders need to have over them. As a protection strategy, it is recommended using sexual and health education linked to greater surveillance of family members, multidisciplinary team and educators.

The recent multi-country outbreak of Mpox (Monkeypox disease) constituted a public health emergency. Although animal-to-human transmission is known to be the primary way of transmission, an increasing number of cases transmitted by person-to-person contact have been reported. During the recent Mpox outbreak sexual or intimate contact has been considered the most important way of transmission. However, other routes of transmission must not be ignored. The knowledge of how the Monkeypox Virus (MPXV) spreads is crucial to implement adequate measures to contain the spread of the disease. Therefore, this systematic review aimed to collect scientific data published concerning other implicated sources of infection beyond sexual interaction, such as the involvement of respiratory particles, contact with contaminated surfaces and skin-to-skin contact. The current study was performed using the guidelines of Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Publications analyzing contacts of Mpox index cases and their outcome after contact were included. A total of 7319 person-to-person contacts were surveyed and 273 of them became positive cases. Positive secondary transmission of MPXV was verified after contact with people cohabiting in the same household, with family members, with healthcare workers, or within healthcare facilities, and sexual contact or contact with contaminated surfaces. Using the same cup, sharing the same dishes, and sleeping in the same room or bed were also positively associated with transmission. Five studies showed no evidence of transmission despite contact with surfaces, skin-to-skin contact, or through airway particles within healthcare facilities where containment measures were taken. These records support the case for person-to-person transmission and suggest that other types of contact beyond sexual contact pose a significant risk of acquiring the infection. Further investigation is crucial to elucidate MPXV transmission dynamics, and to implement adequate measures to contain the spread of the infection.

El embarazo y el parto es un período especial en la vida de la mujer, ya que tiene implicaciones físicas, hormonales y psicológicas, además de cambios sociales y culturales que pueden influir en su sexualidad. Múltiples factores se han asociado con un aumento en la frecuencia de disfunción sexual durante la gestación y el posparto, la cual puede alcanzar una incidencia hasta del 50% en estas etapas. Objetivo: Evaluar la prevalencia de disfunción sexual durante la gestación y su relación con algunos factores de riesgo y describir el comportamiento sexual de las mujeres embarazadas y postparto. Métodos: Estudio de corte transversal de pacientes embarazadas y postparto inmediato de tres centros médicos de atención obstétrica de la ciudad de Medellín. Resultados: Por medio de una encuesta personal se evaluaron 259 mujeres en embarazo y posparto en 3 diferentes centros de atención obstétrica de la ciudad de Medellín. Se encontró una prevalencia de disfunción sexual femenina del 60,2%. El tipo más frecuente de relaciones sexuales fue la vaginal (69%). El 85% de las madres y el 71,4% de los padres consideraban que existía riesgo de un posible daño al bebe con las relaciones sexuales. El 59,1% de las embarazadas recibieron información sobre sexualidad durante la gestación, siendo el 30% por parte del médico y se asoció como factor protector para disfunción sexual, junto con la estabilidad de la pareja. Como factores de riesgo se identificó el régimen subsidiado del sistema de seguridad social y la idea de daño al embarazo por parte de la madre. Conclusión: La disfunción sexual es una entidad con una mayor prevalencia y algunas consideraciones especiales durante el embarazo, comparado con la población general. Debido a esto, los profesionales de la salud deben explorar este aspecto en la atención prenatal y brindar una adecuada información sobre la seguridad de las relaciones sexuales durante el embarazo y los posibles cambios en el deseo, el alcance del orgasmo y la satisfacción sexual.

Justin Loloi,1 Nathan Feiertag,2 Kripali Gautam,2 Pedro Maria1 1Department of Urology, Montefiore Medical Center, Bronx, NY, USA; 2Albert Einstein College of Medicine, Bronx, NY, USACorrespondence: Pedro MariaDepartment of Urology, Montefiore Medical Center, Bronx, NY, 10467, USATel +1 718 920 4531Email pmaria@montefiore.orgAbstract: Benign prostatic hyperplasia (BPH) is a ubiquitous urologic disease affecting aging men. Patients often experience bothersome lower urinary tract symptoms (LUTS) that warrant urologic evaluation and management. Routinely, patients are initially treated with medical therapies with the goal of both relaxing the bladder neck and shrinking the prostate in order to relieve obstruction secondary to prostatic enlargement. Transurethral resection of the prostate (TURP) serves as a first-line surgical intervention in those who fail medical therapy. Recently, novel minimally invasive surgical techniques for BPH management have emerged. Of these, prostatic urethral lift (PUL or Urolift) has gained attention given its presumed effectiveness and minimal risk of sexual side effects when compared to the standard TURP. The purpose of this review is to describe past and current trends in the implementation of PUL for BPH and to highlight important outcomes.Keywords: benign, prostate, minimally-invasive, urethral, urinary, sexual

The present research examined the associations that narcissistic personality features had with subjective arousal in response to sexually aggressive behaviors, as well as whether these associations were mediated by the power that was believed to accompany these behaviors. Participants were 221 community members (115 women, 106 men) who completed a self-report instrument that captured narcissistic admiration (an agentic form of narcissism) and narcissistic rivalry (an antagonistic form of narcissism). In addition, participants were asked to rate how powerful they would expect to feel if they actually engaged in an array of sexually aggressive behaviors (e.g., “Tying up a person during sexual intercourse against her/his will”) as well as how sexually aroused they would be by each behavior. A multilevel mediation analysis revealed that both narcissistic admiration and narcissistic rivalry were positively associated with subjective arousal in response to sexual aggression and that these associations were mediated by the perceived power that was believed to accompany these sexually aggressive behaviors. These results suggest that perceptions of power may play an important role in the connections that narcissistic personality features have with subjective arousal in response to sexually aggressive behavior for both men and women. This discussion will focus on the implications of these results for understanding the connections between narcissism and sexual aggression in both men and women.

Abstract Background Well-trained, competent, and motivated human resources for health (HRH) are crucial to delivering quality service provision across the sexual, reproductive, maternal, and newborn health (SRMNH) care continuum to achieve the 2030 Sustainable Development Goals (SDGs) maternal and neonatal health targets. This review aimed to identify HRH interventions to support lay and/or skilled personnel to improve SRMNH care quality along the continuum in low- and lower-middle-income countries (LLMICs). Methods A structured search of CINAHL, Cochrane Library/trials, EMBASE, PubMed, SCOPUS, Web of Science, and HRH Global Resource Centre databases was undertaken, guided by the PRISMA framework. The inclusion criteria sought to identify papers with a focus on 1. HRH management, leadership, partnership, finance, education, and/or policy interventions; 2. HRH interventions' impact on two or more quality SRMNH care packages across the continuum from preconception to pregnancy, intrapartum and postnatal care; 3. Skilled and/or lay personnel; and 4. Reported primary research in English from LLMICs. A deductive qualitative content analysis was employed using the World Health Organization-HRH action framework. Results Out of identified 2157 studies, 24 intervention studies were included in the review. Studies where ≥ 4 HRH interventions had been combined to target various healthcare system components, were more effective than those implementing ≤ 3 HRH interventions. In primary care, HRH interventions involving skilled and lay personnel were more productive than those involving either skilled or lay personnel alone. Results-based financing (RBF) and its policy improved the quality of targeted maternity services but had no impact on client satisfaction. Local budgeting, administration, and policy to deliver financial incentives to health workers and improve operational activities were more efficacious than donor-driven initiatives. Community-based recruitment, training, deployment, empowerment, supportive supervision, access to m-Health technology, and modest financial and non-financial incentives for community health workers (CHWs) improved the quality of care continuum. Skills-based, regular, short, focused, onsite, and clinical simulation, and/or mobile phone-assisted in-service training of skilled personnel were more productive than knowledge-based, irregular, and donor-funded training. Facility-based maternal and perinatal death reviews, coupled with training and certification of skilled personnel, positively affected SRMNH care quality across the continuum. Preconception care, an essential component of the SRMNH care continuum, lacks studies and services in LLMICs. Conclusions We recommend maternal and perinatal death audits in all health facilities; respectful, woman-centered care as a critical criterion of RBF initiatives; local administration of health worker allowances and incentives; and integration of CHWs into the healthcare system. There is an urgent need to include preconception care in the SRMNH care continuum and studies in LLMICs.

Introduction Venlafaxine is a serotonin-norepinephrine reuptake inhibitor and its extensive use for major depressive disorder and anxiety disorders. Although it has been reported that venlafaxine may have various side effects, as far as we know, spontaneous ejaculation(SE) has not been reported yet. Objectives We aim to describe this clinical case with venlafaxine-induced SE and to discuss the possible etiological factors. Methods Case report and literature review. Results A 53-year-old male with generalized anxiety disorder was initiated venlafaxine treatment with 75 mg/day. After two months patient’s complaints partially regressed and the dose of venlafaxine treatment was increased to 150 mg/day. 10 days after the dose increase, the patient applied with the complaint of SE 2-3 times a day. No urological etiology was found. During outpatient follow-ups, after the 5 days from reducing the daily dose to 75 mg/day, SE complaint completely regressed. After following couple of months, the patient by himself, increased the dose of venlafaxine to 150 mg/day without consulting a psychiatrist. Then SE recurred approximately 15 days later. Venlafaxine treatment dose was reduced again to 75 mg/day and urological complaints spontaneously regressed. Conclusions SE, a rare sexual side effect, represents ejaculation that occurs involuntarily and in the absence of any sexual stimuli. The possible mechanism of SE, detected as a side effect in our case, may be that increased adrenergic activity reduces ejaculatory latency and triggers spontaneous ejaculation. Antidepressant-associated sexual dysfunction could be a dose-dependent adverse event. Therefore, reducing the dosage of the treatment to a minimum effective dose could be an option. Disclosure No significant relationships.

Introduction Sexual dysfunction (SD) can often be a side-effect of treatment with antipsychotics (APS). It often jeopardizes long-term adherence to treatment, while deeply affecting the patient’s quality of life. The pathogenic mechanisms may be associated with postsynaptic dopamine antagonism, a1-antagonism and prolactin elevation. APS-induced hyperprolactinemia has been linked to the occurrence of galactorrhea, gynecomastia, amenorrhea and SD. Objectives To synthesize the available evidence on the management of APS-related sexual dysfunction, with a main focus on the second-generation antipsychotics. Methods A search for randomized controlled trials (RCT) published between 2021 and 2011 on PubMed was made using the keywords “sexual”; “dysfunction”; “antipsychotic” and “treatment”, from which resulted sixteen articles. Only six of those were considered relevant for the study’s objectives. Results Three studies focused on the comparison between different APS and prolactin levels and SD occurrence, showing that treatment with aripiprazole is mostly related to prolactin levels with the normal range and a lower incidence of sexual dysfunction. Addition of aripiprazole to previous APS may be associated with normalization of sexual function and pose as a possible management option. Adjunctive treatment with tadalafil showed no significant effect on its primary outcome. Conclusions There seems to be a general consensus that patients treated with first-generation antipsychotics (FGA), along with risperidone, paliperidone and amissulpride show higher prolactin levels and incidence of SD. Whether there is a causal relationship between these two variables still remains a question. Larger and more prolonged trials are still needed to evaluate APS-related sexual dysfunction and its management. Disclosure No significant relationships.

Abstract Background Sexual and reproductive health (SRH), a globally recognized fundamental health concern and a basic human right is poorly addressed and seldom researched in the Arab world. Disregarding this aspect of health creates various obstacles to accessing SRH related services and education. This threatens the health of a female, namely through increasing the probability of unplanned pregnancies and unsafe abortions, augmenting the risk of acquiring sexually transmitted infections, and most importantly, increasing the hazard of maternal and neonatal death. Thus, this study aimed to assess the level of SRH related knowledge and awareness among single unmarried women living in Lebanon. Methods A descriptive cross-sectional study design was conducted using a self-administered questionnaire in both English and Arabic languages. The questionnaire included 9 sections; socio-demographic characteristics section, sexually transmitted infections (STIs) section, premarital tests section, vaccines section, menstruation and its abnormalities section, pregnancy symptoms and identification section, methods of contraception section, vitamins section, and honeymoon events section. The questionnaire was distributed among all Lebanese governorates to 491 single unmarried women living in Lebanon aged between 17 and 55 years. Student t-test and Chi-Square test were used to analyze results. Results It was found that only 8.8% of all the participants had adequate knowledge. The highest level of SRH related knowledge was about pregnancy (88.0%), and the least was about contraception (13.5%). Most of the knowledgeable participants lived in Beirut governorate (13.6%, n = 8) and had reached universities (10.3%, n = 41), but this was not statistically significant (p-value > 0.05). The effect of a prior visit to a gynecologist was statistically non-significant on the overall level of knowledge (p-value = 0.269). Conclusion Due to the inadequate level of knowledge, SRH education campaigns empowered by the Ministry of Public Health in collaboration with primary care physicians and gynecologists, are recommended in both the societal and academic sectors to enhance the awareness level and make SRH knowledge readily available among unmarried women aged between 17 and 55. Knowing the massive role of social media nowadays, the messages they present should contribute to enhancing the level of SRH knowledge and redirect attitudes and behaviors of unmarried females in Lebanon.

Background: Workplace violence is a multi-causal, multifaceted, public health, legal and social problem faced by all occupations worldwide. Recently, there has been an increase in the prevalence of workplace violence against doctors. Even though the government has attempted to address these problems in India, doctors are still experiencing violence in their workplaces. Aim: The aim of this survey was to determine the prevalence and awareness of workplace violence among dental surgeons. Methodology: This cross-sectional study was conducted among the dental surgeons. A self-administered questionnaire containing 15 questions was made and validated. A Web-based questionnaire was developed using Google forms and was circulated. A total of 112 responses were obtained. Questions were answered with “yes” “no” or by marking the correct responses. Frequency analysis and percentage analysis were done with the obtained results. Results: Our study showed that 74.1% of the participants heard about the workplace violence and 30.4% faced violence in their clinic. The nature of the violence was physical in 0.9%, verbal in 39.3%, and sexual in 0.9% among the participants who faced violence. A total of 92.9% of the participants reported that they require policies and guidelines against this workplace violence. Conclusion: Dental surgeons should have proper knowledge about the work-related violence and methods to control this violence. Policies, procedures, and intervention strategies should be undertaken to manage this alarming issues.

Khaled Al-Surimi,1,2 Munirah Al Omar,1,2 Khalid Alahmary,1,2 Mahmoud Salam1– 3 1Department of Health System Management, College of Public Health and Health Informatics, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia; 2King Abdullah International Medical Research Center, Riyadh, Saudi Arabia; 3Hariri School of Nursing, American University of Beirut, Beirut, LebanonCorrespondence: Mahmoud SalamKing Saud bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, Riyadh 22490, Saudi ArabiaTel +96170054397Email mahmoudsalam@hotmail.comBackground: Workplace bullying (WPB) refers to any form of repeated and unreasonable verbal, physical or sexual harassment that an employee endures by a person or a group. In healthcare settings, practitioners are occasionally victims of WPB incidents. The aim of this study was to survey victims of WPB and determine factors associated with being a victim of WPB at a multiregional health care facility in Saudi Arabia.Methods: This cross-sectional study was conducted in 2018, by distributing a self-administered questionnaire via a private electronic mail to all fulltime healthcare practitioners within a multi-regional hospital in Saudi Arabia. Healthcare practitioners included physicians, nurses, allied healthcare professionals and pharmacists who reported being exposed to WPB in the past year. Study outcomes were the prevalence rate ratio of WPB and its associated factors, such as victim, perpetrator and incident characteristics.Results: WPB has been reported by 684 participants. Perpetrators were mainly patients (36.1%), their families/relatives (29.5%), and hospital staff (27.2%) or managers/supervisors (7.2%). The type of WPB incident was mostly verbal abuse (98.1%) followed by physical harassment (11.8%) and sexual connotations (5.8%). WPB was 30% more prevalent among younger nurses and 24% less prevalent among higher educated nurses compared to their counter groups, P< 0.001 each. Among technicians and administrative employees, WPB was 54% more prevalent among females, 36% more prevalent among the younger group, and 25% more prevalent among expatriate workers compared to their counter groups P< 0.014, P< 0.001 and P=0.017, respectively. WPB was 20% less prevalent among higher educated allied health professionals, P=0.002. Among physicians, WPB was 33% more prevalent among females, P=0.041 and was 47% more prevalent among higher educated physicians compared to their counter groups, P=0.018.Conclusion: WPB might occur any time, anywhere and by any person within health care facilities. The prevalence of WPB varies within health occupational groups. Gender, age, educational level, and nationality were significantly associated factors with WPB.Keywords: nurse, physician, pharmacist, bullying, verbal, physical, sexual