Obstetric History And Sexual Health Screening Among Sexual Minority Women

Sexual minority women (SMW) face multiple barriers to sexual and reproductive health care including cervical cancer screening and sexually transmitted infection (STI) screening. Despite beliefs that they are not at risk for STIs or cervical cancer, most SMW should be screened according to standard clinical guidelines. Aspects of obstetric history, including pregnancy, birth, and elective termination, may represent opportunities for these two types of screening. Guided by intersectionality theory, we reviewed the existing literature for evidence that health care experiences may be correlates to cervical cancer screening among SMW. The review identified important healthcare experience factors, including hormonal contraceptive use, pregnancy history, provider-recommended cervical cancer screening, previous discrimination in health care settings, and disclosing one’s sexual orientation to providers. We then performed secondary analyses employing cross-sectional data from the Chicago Health and Life Experiences of Women (CHLEW) Study, a diverse sample of SMW. The primary aim was to examine associations between obstetric history and the outcomes of cervical cancer and STI screening. In our final logistic regression model of cervical cancer screening, older age was associated with decreased odds (β 0.98, p\u3c0.01) of past year Pap testing. Having health insurance (β 1.72, p\u3c0.01) and being Black/African American (β 1.61, p\u3c0.05) were associated with increased odds of past year Pap testing. Variables significantly associated with increased odds of STI testing included higher numbers of lifetime sex partners (β 6.07, p \u3c0.0001 for the highest quartile group), and being bisexual (β 3.13, p\u3c0.0001). An annual income ≥$75,000 was associated with decreased odds of STI testing compared to an income of \u3c$15,000 (β 0.41, p 0.004). Decision tree analysis revealed the significance of age at coming out, early sexual initiation, and early drinking on the two screening outcomes; the models also identified specific subgroups of SMW that were less likely to report Pap testing, including SMW over 60 years old. Overall, our findings suggest the need for primary, longitudinal studies of SMW’s sexual and reproductive health. They also illustrate the significance of developmental milestones on later sexual health outcomes, and support the validity of intersectionality theory in investigating cervical cancer screening among SMW

Private and censorship-resistant communication over public networks

Society’s increasing reliance on digital communication networks is creating unprecedented opportunities for wholesale surveillance and censorship. This thesis investigates the use of public networks such as the Internet to build robust, private communication systems that can resist monitoring and attacks by powerful adversaries such as national governments. We sketch the design of a censorship-resistant communication system based on peer-to-peer Internet overlays in which the participants only communicate directly with people they know and trust. This ‘friend-to-friend’ approach protects the participants’ privacy, but it also presents two significant challenges. The first is that, as with any peer-to-peer overlay, the users of the system must collectively provide the resources necessary for its operation; some users might prefer to use the system without contributing resources equal to those they consume, and if many users do so, the system may not be able to survive. To address this challenge we present a new game theoretic model of the problem of encouraging cooperation between selfish actors under conditions of scarcity, and develop a strategy for the game that provides rational incentives for cooperation under a wide range of conditions. The second challenge is that the structure of a friend-to-friend overlay may reveal the users’ social relationships to an adversary monitoring the underlying network. To conceal their sensitive relationships from the adversary, the users must be able to communicate indirectly across the overlay in a way that resists monitoring and attacks by other participants. We address this second challenge by developing two new routing protocols that robustly deliver messages across networks with unknown topologies, without revealing the identities of the communication endpoints to intermediate nodes or vice versa. The protocols make use of a novel unforgeable acknowledgement mechanism that proves that a message has been delivered without identifying the source or destination of the message or the path by which it was delivered. One of the routing protocols is shown to be robust to attacks by malicious participants, while the other provides rational incentives for selfish participants to cooperate in forwarding messages

The Trials, Tribulations, and Celebrations of Younger LGB Couples in Long-term Relationships

This thesis explores the long-term relationship experiences of younger LGB couples. It builds upon existing knowledge and understandings of LGB couple relationships and the lives of younger adults. The study utilised multiple qualitative methods informed by social science research on intimate relationships whilst appraising the biographical, socio-cultural, and temporal contexts within which LGB couple relationship experiences are situated. The research highlights the importance of attending to how couples ‘do’ their relationships as well as the ‘practices’ which sustain them. Findings emphasise the interconnected dimensions of time, space, and intimacy as resources for sustaining couple relationships, with analysis underlining the role of the ‘relational present’ as a lens for understanding everyday relationship experiences. It provides insight into how couples negotiate their everyday lives through relationship work, to facilitate connection, and to maintain and cultivate personal autonomy alongside their couple identity. The temporal horizons of the past and the future inform relationship experiences in different ways, increasing understanding of relating behaviours and signifying a commitment to a shared future. Such futures included marriage/civil partnership, children, and buying homes. Experiences were embedded in the context of participant biography, the wider relationships and communities of the couple, and the current zeitgeist of increased acceptance and civil rights for LGB individuals in the UK. The thesis concludes by discussing the findings in terms of age, reciprocity, relationship resources, and gender

Health Service Utilization and Stigma among HIV-Positive Men-Who-Have-Sex-With Men (MSM) in Rural Appalachia

ABSTRACT Health Service Utilization and Stigma among HIV-Positive Men-Who-Have-Sex-With-Men (MSM) in Rural Appalachia by Roger Lee Blackwell The world has now entered the third decade of the AIDS epidemic. Men-who-have-sex-with-men continue to be disproportionately affected by HIV/AIDS. The United States still struggles in its response to this ongoing crisis in many areas: disease prevention, treatment, and HIV related stigma, prejudice and discrimination. Much of the information reported on MSM living with HIV has come from urban population centers, but only a few studies have focused on HIV positive MSM living in rural areas. Therefore, the overall aim of this dissertation was to explore the lived experiences of MSM living with HIV/AIDS, in particular the intersection of HIV related stigma with social, behavioral and health outcomes in rural, South Central Appalachia. For this dissertation, data were collected via semi-structured, face-to-face interviews with 23 HIV-positive MSM living in South Central Appalachia. Using a descriptive narrative approach, the researcher sought to address the influence of HIV/AIDS related stigma in the lives of these men and provide a forum for their voices. Qualitative data were sorted into various categories from which emergent themes and topics were generated using Nvivo software for data management and manipulation. In addition to qualitative interviews, demographic data were gathered and analyzed to produce basic, descriptive statistics. Results indicated that MSM participating in this study accessed health services through various agencies. MSM also experienced stigma in multiple and overlapping ways; MSM described stigmatizing experiences stemming from religious sources, communities, family and friends, and from the medical establishment. Moreover, it was revealed that homophobia and HIV-related stigma were related; participants did not differentiate between the two. Homophobia and HIV related stigma were specifically contextualized in relation to rurality and religiosity. The use of health related services was not mediated by stigma. The results within this dissertation are intended to inform health professionals in the planning and implementation of interventions and treatments for this hidden population in Appalachia. This exploratory dissertation provides insight and contextual information for a highly stigmatized population. Lastly, this project provided rural MSM with a voice

Cyber Infrastructure Protection: Vol. II

View the Executive SummaryIncreased reliance on the Internet and other networked systems raise the risks of cyber attacks that could harm our nation’s cyber infrastructure. The cyber infrastructure encompasses a number of sectors including: the nation’s mass transit and other transportation systems; banking and financial systems; factories; energy systems and the electric power grid; and telecommunications, which increasingly rely on a complex array of computer networks, including the public Internet. However, many of these systems and networks were not built and designed with security in mind. Therefore, our cyber infrastructure contains many holes, risks, and vulnerabilities that may enable an attacker to cause damage or disrupt cyber infrastructure operations. Threats to cyber infrastructure safety and security come from hackers, terrorists, criminal groups, and sophisticated organized crime groups; even nation-states and foreign intelligence services conduct cyber warfare. Cyber attackers can introduce new viruses, worms, and bots capable of defeating many of our efforts. Costs to the economy from these threats are huge and increasing. Government, business, and academia must therefore work together to understand the threat and develop various modes of fighting cyber attacks, and to establish and enhance a framework to assess the vulnerability of our cyber infrastructure and provide strategic policy directions for the protection of such an infrastructure. This book addresses such questions as: How serious is the cyber threat? What technical and policy-based approaches are best suited to securing telecommunications networks and information systems infrastructure security? What role will government and the private sector play in homeland defense against cyber attacks on critical civilian infrastructure, financial, and logistical systems? What legal impediments exist concerning efforts to defend the nation against cyber attacks, especially in preventive, preemptive, and retaliatory actions?https://press.armywarcollege.edu/monographs/1527/thumbnail.jp

Institutional Ethnography: Utilizing Battered Women’s Standpoint to Examine How Institutional Relations Shape African American Battered Women’s Work Experiences In Christian Churches

The purpose of the collected papers dissertation was to critically examine the individual and institutional conditions that shaped battered women’s work experiences in church organizations. The studies in the collected papers shared the provision of using a methodological and analytic tool, institutional ethnography (IE), that offers a strategic and comprehensive means of investigating issues related to institutions and institutional processes that merge a macro and micro view. The first paper was a conceptual paper that emphasized the socio-political context in which adult vocation education is practiced and shared a practical means of using IE to uncover the interconnected and interdependent social processes that prohibit an individual’s ability to navigate structural and political subsystems that impact learning, teaching, and work. The second paper was an empirical paper that used IE to help us see how battered women’s needs as workers in Christian churches are evaporated behind institutional ideologies and actions that invalidate her concerns while preserving their ideals. The study revealed four ways that African American battered women entered into an institutional death process by direct disclosure or assumed disclosure: (a) invalidation, (b) overspiritualization, (c) inauthenticity, (d) and bifurcation. It was found, that once disclosure took place, women placed a different expectation upon the church to respond to their issue of domestic abuse. In summation, Study #2 highlighted the use of IE in uncovering the institutional relations that shaped women’s experiences as work in Christian churches. Overall, the findings elucidate ways that social workers, churches, adult educators, and HRD researchers and practitioners can engage in research that has implications for how to collaborate for implementable solutions. The findings provide ways for African American women to navigate oppressive regimes; and lends insight to how adult educators, HRD practitioners, and pastors who work with battered women can assist and intervene in the educational, emotional, and natural support areas for African American battered women working in Christian churches

Cyberterrorism: A postmodern view of networks of terror and how computer security experts and law enforcement officials fight them.

The purpose of this study is to investigate how cyberterrorists create networks in order to engage in malicious activities against the Internet and computers. The purpose of the study is also to understand how computer security labs (i.e., in universities) and various agencies (that is, law enforcement agencies such as police departments and the FBI) create joint networks in their fight against cyberterrorists. This idea of analyzing the social networks of two opposing sides rests on the premise that it takes networks to fight networks. The ultimate goal is to show that, because of the postmodern nature of the Internet, the fight between networks of cyberterrorists and networks of computer security experts (and law enforcement officials) is a postmodern fight. Two theories are used in this study: social network theory and game theory.This study employed qualitative methodology and data were collected via in-depth conversational (face-to-face) interviewing. Twenty-seven computer security experts and law enforcement officials were interviewed. Overall, this study found that cyberterrorists tend not to work alone. Rather, they team up with others through social networks. It was also found that it takes networks to fight networks. As such, it is necessary for experts and officials to combine efforts, through networking, in order to combat, let alone understand, cyberterrorist networks. Of equal relevance is the fact that law enforcement agents and computer security experts do not always engage in battle with cyberterrorists. They sometimes try to interact with them in order to obtain more information about their networks (and vice versa). Finally, four themes were identified from the participants' accounts: (1) postmodern state of chaos, (2) social engineering, (3) know thy enemy, and (4) the enemy of my enemy is my friend

Legal Implications of a Ubiquitous Metaverse and a Web3 Future

The metaverse is understood to be an immersive virtual world serving as the locus for all forms of work, education, and entertainment experiences. Depicted in books, movies, and games, the metaverse has the potential not just to supplement real-world experiences but to substantially supplant them. This Article explores the rapid emergence and evolution of the Web3 technologies at the heart of the metaverse movement. Web3 itself is a paradigmatic shift in internet commerce