Women Reporting on Their Use of Pornography: A Qualitative Study Exploring Women's Perceived Precursors and Perceived Outcomes.

The aim of this study was to explore motivations women describe for using pornography. A qualitative online interview study was conducted with 30 women (Mean age 30.23, range 20-47; residing in the UK and in Greece; of varied sexual orientations and relationship status) about their pornography use, motivations for use, and preferences. Reflexive thematic analysis was used. Results were organized into four themes: Sexual Precursors, Non-sexual Precursors, Intended Outcomes, and Unintended Outcomes. The findings highlight that pornography use for women can have both positive and negative ramifications for women's sexual lives. Implications for clinical practice and education are discussed.

Women in Relationships and Their Pornography Use: A Systematic Review and Thematic Synthesis.

A systematic review and thematic synthesis were conducted on the motivations, purposes, and influence of pornography use among women who are in committed relationships. Pornography use was identified as having both positive and negative outcomes for women's sexual and relationship lives. Women watched pornography for diverse reasons: to feel sexually empowered, to enhance sexual arousal, and for masturbation purposes. Shared use of pornography with partners provided variety in sexual activities, could aid communication about sexual issues and helped improve intimacy. Pornography use can help some women feel sexually empowered, relaxed and better able to enjoy their sexual lives.

An Interdisciplinary Definition of Pornography: Results from a Global Delphi Panel.

In interdisciplinary investigations into the relationships between pornography and its audiences, the issue of how to define the object of study is more complex than in studies situated within a single discipline. A Delphi panel of 38 leading pornography researchers from a wide range of disciplines was asked about various topics, including the definition of pornography. Qualitative and quantitative analyses of two rounds of survey responses suggested two different and-at first sight-incompatible definitions operating. The first was "Sexually explicit materials intended to arouse." The second was a culturally relative definition suggesting pornography has no innate characteristics. This technical report suggests that we should encourage researchers to choose which definition they want to use in a self-reflective way depending on the needs of the project, so long as they make it explicit and justify their decision.

Correction to: An Interdisciplinary Definition of Pornography: Results from a Global Delphi Panel.

Two members of the Delphi panel who completed a tranche of the survey.

Evidence for behavioural interventions addressing condom use fit and feel issues to improve condom use: a systematic review.

Continuing high rates of sexually transmissible infections (STIs) in many countries highlight the need to identify effective behavioural interventions. Consistent and correct use of male condoms is a key strategy for the prevention of STIs. However, some men report problems with condom fit (e.g. the size and shape of the condom) and feel (e.g. tightness, irritation, sensitivity), which inhibits their use. We conducted a systematic review to identify existing interventions addressing condom use fit and feel problems. We searched electronic databases for peer-reviewed articles and searched reference lists of retrieved studies. Five studies met the inclusion criteria. These were generally small-scale pilot studies evaluating behavioural interventions to promote safer sex with men aged under 30 years, addressing, among other things, barriers to condom use relating to fit and feel. There were significant increases in the reported use of condoms, including condom use with no errors and problems. Improvements in some condom use mediators were reported, such as condom use self-efficacy, knowledge, intentions and condom use experience. There were mixed findings in terms of the ability of interventions to reduce STI acquisition. Behavioural interventions addressing condom fit and feel are promising in terms of effectiveness but require further evaluation.

The impact of armed conflict on adolescent transitions: a systematic review of quantitative research on age of sexual debut, first marriage and first birth in young women under the age of 20 years.

BACKGROUND: Young women in conflict-affected regions are at risk of a number of adverse outcomes as a result of violence, economic deterioration and the breakdown of community structures and services. This paper presents the findings of a systematic review of quantitative literature reporting how key sexual and reproductive health (SRH) outcomes among young women under the age of 20 years are affected by exposure to armed conflict; namely, sexual debut, first marriage and first birth. Increases in these outcomes among young women are all associated with potential negative public health consequences. It also examines and documents possible causal pathways for any changes seen. METHODS: To fit with our inclusion criteria, all reviewed studies included outcomes for comparable populations not exposed to conflict either temporally or spatially. A total of 19 studies with results from 21 countries or territories met our inclusion criteria; seven presented findings on marriage, four on fertility and eight on both of these outcomes. Only one study reporting on sexual debut met our criteria. RESULTS: Findings show clear evidence of both declines and increases in marriage and childbirth among young women in a range of conflict-affected settings. Several studies that showed increases in marriage below the age of 20 years reported that such increases were concentrated in the younger teenagers. Trends in fertility were predominantly driven by marriage patterns. Suggested causal pathways for the changes observed could be grouped into three categories: involuntary, gender and psycho-social and economic and material factors. CONCLUSION: The review reveals a paucity of literature on the impact of conflict on SRH outcomes of young women. Further quantitative and qualitative studies are needed to explore how conflict influences SRH events in young women over both the short- and longer-term.

Implementing the United Kingdom's ten-year teenage pregnancy strategy for England (1999-2010): How was this done and what did it achieve?

BACKGROUND: In 1999, the UK Labour Government launched a 10-year Teenage Pregnancy Strategy for England to address the country's historically high rates and reduce social exclusion. The goal was to halve the under-18 conception rate. This study explores how the strategy was designed and implemented, and the features that contributed to its success. METHODS: This study was informed by examination of the detailed documentation of the strategy, published throughout its 10-year implementation. RESULTS: The strategy involved a comprehensive programme of action across four themes: joined up action at national and local level; better prevention through improved sex and relationships education and access to effective contraception; a communications campaign to reach young people and parents; and coordinated support for young parents (The support programme for young parents was an important contribution to the strategy. In the short term by helping young parents prevent further unplanned pregnancies and, in the long term, by breaking intergenerational cycles of disadvantage and lowering the risk of teenage pregnancy.). It was implemented through national, regional and local structures with dedicated funding for the 10-year duration. The under-18 conception rate reduced steadily over the strategy's lifespan. The 2014 under-18 conception rate was 51% lower than the 1998 baseline and there have been significant reductions in areas of high deprivation. One leading social commentator described the strategy as 'The success story of our time' (Toynbee, The drop in teenage pregnancies is the success story of our time, 2013). CONCLUSIONS: As rates of teenage pregnancy are influenced by a web of inter-connected factors, the strategy was necessarily multi-faceted in its approach. As such, it is not possible to identify causative pathways or estimate the relative contributions of each constituent part. However, we conclude that six key features contributed to the success: creating an opportunity for action; developing an evidence based strategy; effective implementation; regularly reviewing progress; embedding the strategy in wider government programmes; and providing leadership throughout the programme. The learning remains relevant for the UK as England's teenage birth rate remains higher than in other Western European countries. It also provides important lessons for governments and policy makers in other countries seeking to reduce teenage pregnancy rates.

Social disclosure about lymphoedema symptoms: A qualitative study among Japanese breast cancer survivors.

Disclosing illness-related problems is the first step in help-seeking. The aim of this qualitative study was to explore Japanese breast cancer (BC) survivors' decision-making about disclosure of lymphoedema symptoms to people in their social networks. A total of ten women participated in group discussions in Japan. A dual analytic approach, thematic analysis and conceptual analysis, was applied to the transcripts. Two themes (perceived responsibility of social roles within the family and unsupportive reactions to BC from others) affected participants' decision-making. Support programs for Japanese BC survivors who feel unable to disclose lymphoedema symptoms to family members are suggested.

Positive changes in Japanese breast cancer survivors: a qualitative study.

Despite traumatic experiences of cancer, survivors often report positive changes. Since little research has been conducted into such changes among Japanese breast cancer survivors, our knowledge is minimal. This qualitative study aimed to explore the nature of the positive changes among this group. A thematic analysis suggested that participants had experienced seven types of positive change: Attitudinal changes towards life, strengthening trust in family and friends, increased appreciation of life, self-development, future perspectives, education for friends, and efforts towards bodily change. Awareness of vulnerability in life, received social support and social comparisons appear to trigger some of the positive changes.

Development of the Psycho-social Discomfort Scale (PsDS): investigation of psychometric properties among Japanese breast cancer survivors.

OBJECTIVE: To develop a new scale to assess psycho-social discomfort in breast cancer (BC) survivors in Japanese society and to investigate its psychometric properties. METHOD: A total of 248 Japanese BC survivors completed both the Psycho-social Discomfort Scale (PsDS) and WHO Quality of Life BREF Japanese version (WHO QoL-Jp). A principal component factor analysis (with promax rotation) was performed, and internal consistency was examined using Cronbach's alpha. Divergent and convergent validities and criterion validity were examined using the Spearman's R. RESULTS: The factor analysis extracted three factors: 'internalised stigma (IS)', 'social disclosure of BC (SD)', and 'psychological resources to live with BC (PR)'. The factors were moderately correlated. The scale had good internal consistency (alpha = 0.80). All sub-scales were inversely correlated with all the domains in the WHO QoL-Jp (r = -0.09 to -0.47). BC stage was significantly correlated with the SD sub-scale, and type of surgery was significantly correlated with the IS sub-scale. CONCLUSIONS: The PsDS has 25 items. It measures psycho-social discomfort that Japanese BC survivors experienced or were experiencing in their community. It has a simple factor structure, relatively good internal consistency, and a satisfactory divergent validity.

Information provision and problem-solving processes in Japanese breast cancer survivors with lymphoedema symptoms.

BACKGROUND: In Japan, a high proportion of breast cancer (BC) survivors develop lymphoedema as a consequence of the treatment received. Japanese BC survivors are generally not provided with standardised information about risks, early signs and symptom management. The effects of (in)adequate information on the problem-solving processes among Japanese BC survivors with lymphoedema symptoms have not been investigated. PURPOSE: The aim of this study was to explore how the provision of medical information by doctors affected the problem-solving processes of Japanese BC survivors with lymphoedema symptoms. METHOD: Ten Japanese BC survivors participated in audio-taped focus group discussions. Transcripts were analysed using an inductive thematic analysis. RESULTS: Analysis identified two phases during which participants attempted to address problems with managing their lymphoedema symptoms - a help-seeking phase and an evaluation phase. Perceptions of information provision affected emotional responses to the onset and cognitive appraisals of lymphoedema symptoms (seen as accepted or burden). However, perceptions of information provision did not affect help-seeking behaviours from surgeons or adherence behaviours. Participants often perceived compression sleeves as inefficient and not worth continuing. CONCLUSION: This study suggests that information provision is a key process in helping BC patients to adjust to symptoms of lymphoedema. In order to promote effective symptom management, doctors and nurses should provide support not only during the help-seeking phase but also the evaluation phase. Further research on the most effective ways to change negative treatment beliefs should be conducted.

Who presents more than once? Repeat abortion among women in Britain.

BACKGROUND AND METHODOLOGY: Around one in three sexually active women in Britain will have an abortion during their lifetime and a third of those women will experience more than one. Using data collected during the second National Survey of Sexual Attitudes and Lifestyles the characteristics of women who have presented for a second or subsequent abortion are compared to those women who have obtained only one. RESULTS: Results indicate that increased age and parity are key characteristics distinguishing between women who have experienced only one abortion and those women who have had more. Findings also reveal that those who have sought abortion on more than one occasion are more likely (than those who have had one abortion) to be Black, have left school at an earlier age, be living in rented accommodation, report an earlier age at first sexual experience, be less likely to have used a reliable method of contraception at sexual debut and report a greater number of sexual partners. DISCUSSION AND CONCLUSIONS: It is well recognised that attendance at abortion services presents an important opportunity for the provision of individually tailored information regarding contraception to assist women avoid the need for subsequent procedures. However, differential use of abortion services may also indicate variations in knowledge levels, attitudes to risk, attitudes towards abortion, partner communication, gender power and differential access to services. Further research is required to clarify these potential relationships so that suitable health promotion activities can be developed.

Mobile health apps: An exploration of user-generated reviews in Google Play Store on a physical activity application.

OBJECTIVE: This study aimed to evaluate reviews that have been posted publicly on the app 'MapMyRun' to investigate which features were associated with usage of the app. A secondary aim was to determine whether MapMyRun consisted of specific behaviour change techniques that would have increased the likelihood of users being engaged with the app. METHODS: Reviews posted on MapMyRun by users between 1st May 2017- 30th April 2018 were extracted, coded and analysed using content analysis. RESULTS: Eleven behaviour change techniques were identified among the features of MapMyRun. A total of 3,253 reviews met the inclusion/exclusion criteria, and 12 codes were developed. The codes were grouped into 8 subthemes within 2 main themes: 'Effort' and 'Self-monitoring'. Consistent with previous literature, 'Goal-Setting' and 'Self-Monitoring of Behaviour' were two techniques included in MapMyRun. Social features of MapMyRun facilitated competition among users, their family, and friends. CONCLUSIONS: This was the first qualitative review to assess a single mobile health physical activity app and analyse it from the perspectives of the users. Creators of future mobile health apps should focus on user friendliness and the use of social features, as both may increase the chances of users' continued use with the app.

Understanding the decline in under-18 conception rates throughout England's local authorities between 1998 and 2017.

We consider England's two-decade teenage conception decline in the context of societal changes: rising educational aspirations; growing second- and third-generation teenage ethnic minority populations; increased deprivation associated with economic recession and post-2008 Government austerity; and changing housing availability. Using England's Local Authority Districts (LAD) 1998-2017, we explore the role of area characteristics in explaining spatial differences in under-18 conception rates and how changing characteristics may explain temporal changes. Urban/rural distinctions in teenage conceptions are largely minimised after considering LAD characteristics. Area characteristics continue to partly explain teenage conception rates but are better at explaining area differences than variation over time.

Perisylvian sulcal morphology and cerebral asymmetry patterns in adults who stutter.

Previous investigations of cerebral anatomy in persistent developmental stutterers have reported bilateral anomalies in the perisylvian region and atypical patterns of cerebral asymmetry. In this study, perisylvian sulcal patterns were analyzed to compare subjects with persistent developmental stuttering (PDS) and an age-, hand-, and gender-matched control group. This analysis was accomplished using software designed for 3-dimensional sulcal identification and extraction. Patterns of cerebral asymmetry were also investigated with standard planimetric measurements. PDS subjects showed a small but significant increase in both the number of sulci connecting with the second segment of the right Sylvian fissure and in the number of suprasylvian gyral banks (of sulci) along this segment. No differences were seen in the left perisylvian region for either sulcal number or gyral bank number. Measurements of asymmetry revealed typical patterns of cerebral asymmetry in both groups with no significant differences in frontal and occipital width asymmetry, frontal and occipital pole asymmetry, or planum temporale and Sylvian fissure asymmetries. The subtle difference in cortical folding of the right perisylvian region observed in PDS subjects may correlate with functional imaging studies that have reported increased right-hemisphere activity during stuttered speech.

Accuracy of parent identification of stuttering occurrence.

BACKGROUND: Clinicians rely on parents to provide information regarding the onset and development of stuttering in their own children. The accuracy and reliability of their judgments of stuttering is therefore important and is not well researched. AIM: To investigate the accuracy of parent judgements of stuttering in their own children's speech when compared with judgements made by the parents of normally fluent children and experienced clinicians. METHODS & PROCEDURES: Twenty parents of children who stutter made judgements of stuttering during repeated presentations of 3-min audio-visual samples of their children. Twenty control parents of children (age and gender matched) who do not stutter also assessed the children who stutter speech samples. OUTCOMES & RESULTS: The parents of both the children who stutter and those who do not stutter displayed high levels of judgement accuracy (parents, of children who stutter percentage agreement mean (standard deviation) = 90.9 (6.02); parents of children who do not stutter = 86.4 (9.7)) and consistency (90.3-90.6%) in judging stuttering in young children. But the parents of children who stutter showed significantly higher levels of accuracy (t(59) = 4.63, p<0.0001; d = 0.8) in judging stuttered intervals than the children who do not stutter parents. CONCLUSIONS & IMPLICATIONS: Parents of children who stutter may be both accurate and reliable in identifying brief intervals of speech containing stuttering and non-stuttering in their own children.

Evidence-based treatment and stuttering--historical perspective.

PURPOSE: To illustrate the way in which both fluency shaping (FS) and stuttering management (SM) treatments for developmental stuttering in adults are evidence based. METHOD: A brief review of the history and development of FS and SM is provided. It illustrates that both can be justified as evidence-based treatments, each treatment seeking evidence of a different kind: FS seeks evidence concerning treatment outcome, and SM seeks evidence concerning the nature of the stutter event. CONCLUSION: Although outcome evidence provides the principal support for FS, support for SM comes principally from a cognitive learning model of defensive behavior as applied to the nature of the stutter event. Neither approach can claim anything like uniform success with adults who stutter. However, self-management and modeling are strategies common to both approaches and have shown consistently positive effects on outcome. It is argued that both strategies merit additional treatment efficacy study. Cognitive behavior theory may provide a useful framework for this research.

Does language influence the accuracy of judgments of stuttering in children?

PURPOSE: To determine whether stuttering judgment accuracy is influenced by familiarity with the stuttering speaker's language. METHOD: Audiovisual 7-min speech samples from nine 3- to 5-year-olds were used. Icelandic children who stutter (CWS), preselected for different levels of stuttering, were subdivided into 5-s intervals. Ten experienced Icelandic speech-language pathologists (ICE-SLPs) and 10 experienced U.S. speech-language pathologists (US-SLPs), the latter being unfamiliar with the Icelandic language, independently judged each 5-s interval (n = 756) as stuttered or nonstuttered on 2 separate occasions. RESULTS: As in previous studies, intervals judged to contain stuttering showed wide variability within the ICE-SLP and US-SLP groups. However, both SLP groups (a) displayed satisfactory mean intrajudge agreement, (b) met an independent stuttering judgment accuracy criterion test using English-speaking CWS samples, and (c) met an agreement criterion on approximately 90% of their stuttering and nonstuttering judgments on the Icelandic-speaking CWS samples. CONCLUSION: Experienced SLPs were shown to be highly accurate in recognizing stuttering and nonstuttering exemplars from young CWS speaking in an unfamiliar language. The findings suggest that judgments of occurrences of stuttering in CWS are not generally language dependent, although some exceptions were noted.

Measurement of speech effort during fluency-inducing conditions in adults who do and do not stutter.

PURPOSE: To investigate the effects of 4 fluency-inducing (FI) conditions on self-rated speech effort and other variables in adults who stutter and in normally fluent controls. METHOD: Twelve adults with persistent stuttering and 12 adults who had never stuttered each completed 4 ABA-format experiments. During A phases, participants read aloud normally. During each B phase, they read aloud in 1 of 4 FI conditions: auditory masking, chorus reading, whispering, and rhythmic speech. Dependent variables included self-judged speech effort and observer-judged stuttering frequency, speech rate, and speech naturalness. RESULTS: For the persons who stuttered, FI conditions reduced stuttering and speech effort, but only for chorus reading were these improvements obtained without diminishing speech naturalness or speaking rate. By contrast, speech effort increased during all FI conditions for adults who did not stutter. CONCLUSIONS: Self-rated speech effort differentiated the effects of 4 FI conditions on speech performance for adults who stuttered, with chorus reading best approximating normally fluent speech. More generally, self-ratings of speech effort appeared to constitute an independent, reliable, and validly interpretable dimension of fluency that may be useful in the measurement and treatment of stuttering.