Emerging adults recall of pornography use, sexual behaviour, and sexting during childhood and adolescence

This thesis contributes to the research on sexual development by exploring the age progression of the first experience of sexual activities in both same-sex and opposite-sex partners. This information is related to pornography use, sexting, attachment style and sex education. Firstly, the interactions between pornography use, sexual activities, and the transmission of self-image nudity during childhood and adolescence were explored, as recalled by emerging adults (EA) aged 18 to 25 years. In total, 3050 English-speaking participants (1627 males and 1423 females) completed an online questionnaire at three separate intervals from May 2016 to July 2018. Overall, 82.4% of males and 59.6% of females described themselves as heterosexual and were analysed separately from non-heterosexuals. Associations were found between viewing porn at less than 12 years of age and earlier age of first romantic relationship (except for heterosexual females), first showing genitals to another, first sexting, first experience with the opposite sex of all 7 sequential sexual activities from kissing to intercourse (except for heterosexual females), and primary school sex education (except non-heterosexual females). Regression analyses showed that first viewing porn under 12 years old was a predictor for under-age sex (less than 16 years of age) for heterosexual males only. Across genders and sexualities, primary school sex education was found to be related to early onset of pornography use (under 12 years old). A relationship was also found between pornography use under 12 years old and early onset of sexting. Associations were found between early onset of sexting and underage sexual intercourse. This is suggestive of a pattern of linked behaviours following primary school sex education. Secondly, the interactions between emotional attachments and age of first experience of sexual intercourse, sexting and viewing pornography, and frequency of viewing/using pornography were investigated. A sample of EA males and females (18 to 25 years old) were recruited using an online survey and were asked retrospective questions for age of first experience of a range of sexual activities with opposite or same-sex partners, first experience of using pornography use and first experience of sending a nude or semi-nude image of oneself to another person. This data was then analysed with regard to emotional attachment style. Of the 621 respondents analysed, 33% endorsed the ‘fearful’ response style, 29.3% ‘secure’, 24.3% ‘preoccupied’ and 13.4% ‘dismissive’. The findings suggest that EA women who endorse a dismissive relationship style are more likely to have had their first sexual experience with the Opposite Sex at an earlier age than those who endorse a Secure or Fearful relationship style. Furthermore, the results suggest that females who endorse a Secure relationship style are more likely to have had their first experience of viewing pornography at a later age than those who endorse a Preoccupied or Dismissive relationship style. The same results were not found for female’s first experience with the same sex or for males, with opposite or same sex. Thirdly, the use and application of the 12-item ‘Problematic Pornography Use Scale’ (PPUS) to assess an individual’s self-reported behaviour over the last 6 months was evaluated. The factors measured by the PPUS are: (1) distress and functional problems, (2) excessive use, (3) control difficulties, and (4) use for escape/avoidance of negative emotions. The overall internal consistency, convergent and construct validity of the PPUS was high. However, concurrent and predictive validity may need further research and development with culturally sensitive norms for both males and females. Fourthly, a systematic review was carried out to explore underage sex in adolescents and children, and the associated risk and protective factors. The search was conducted on six electronic databases as well as within the grey literature to identify quantitative studies which included males and females up to the age of 18 years old (or adults reporting retrospectively), with exposure to risk and protective factors for early onset of sexual intercourse (before 16 years of age), Altogether, 945 studies were identified for potential inclusion and 23 fulfilled the eligibility criteria to be included in the systematic review. Findings from 23 studies between 1996 and 2017 identified risk factors associated with underage sexual intercourse (under 16 years old). The rapid increase of technological advances over the past 10 years, as well as the changing landscape of sexuality, provides policy and lawmakers with the challenge of addressing child and adolescent sexual activities which are occurring at a younger age. Sexting at an earlier age is linked to pornography use at an earlier age. This suggests that exposure to sexualised imagery is on the increase and is related to underage sex, and if unprotected sex, the consequence of an increasing number of teenage pregnancies. This may be damaging to the development of the individual

Emerging adults recall of pornography use, sexual behaviour, and sexting during childhood and adolescence

This thesis contributes to the research on sexual development by exploring the age progression of the first experience of sexual activities in both same-sex and opposite-sex partners. This information is related to pornography use, sexting, attachment style and sex education. Firstly, the interactions between pornography use, sexual activities, and the transmission of self-image nudity during childhood and adolescence were explored, as recalled by emerging adults (EA) aged 18 to 25 years. In total, 3050 English-speaking participants (1627 males and 1423 females) completed an online questionnaire at three separate intervals from May 2016 to July 2018. Overall, 82.4% of males and 59.6% of females described themselves as heterosexual and were analysed separately from non-heterosexuals. Associations were found between viewing porn at less than 12 years of age and earlier age of first romantic relationship (except for heterosexual females), first showing genitals to another, first sexting, first experience with the opposite sex of all 7 sequential sexual activities from kissing to intercourse (except for heterosexual females), and primary school sex education (except non-heterosexual females). Regression analyses showed that first viewing porn under 12 years old was a predictor for under-age sex (less than 16 years of age) for heterosexual males only. Across genders and sexualities, primary school sex education was found to be related to early onset of pornography use (under 12 years old). A relationship was also found between pornography use under 12 years old and early onset of sexting. Associations were found between early onset of sexting and underage sexual intercourse. This is suggestive of a pattern of linked behaviours following primary school sex education. Secondly, the interactions between emotional attachments and age of first experience of sexual intercourse, sexting and viewing pornography, and frequency of viewing/using pornography were investigated. A sample of EA males and females (18 to 25 years old) were recruited using an online survey and were asked retrospective questions for age of first experience of a range of sexual activities with opposite or same-sex partners, first experience of using pornography use and first experience of sending a nude or semi-nude image of oneself to another person. This data was then analysed with regard to emotional attachment style. Of the 621 respondents analysed, 33% endorsed the ‘fearful’ response style, 29.3% ‘secure’, 24.3% ‘preoccupied’ and 13.4% ‘dismissive’. The findings suggest that EA women who endorse a dismissive relationship style are more likely to have had their first sexual experience with the Opposite Sex at an earlier age than those who endorse a Secure or Fearful relationship style. Furthermore, the results suggest that females who endorse a Secure relationship style are more likely to have had their first experience of viewing pornography at a later age than those who endorse a Preoccupied or Dismissive relationship style. The same results were not found for female’s first experience with the same sex or for males, with opposite or same sex. Thirdly, the use and application of the 12-item ‘Problematic Pornography Use Scale’ (PPUS) to assess an individual’s self-reported behaviour over the last 6 months was evaluated. The factors measured by the PPUS are: (1) distress and functional problems, (2) excessive use, (3) control difficulties, and (4) use for escape/avoidance of negative emotions. The overall internal consistency, convergent and construct validity of the PPUS was high. However, concurrent and predictive validity may need further research and development with culturally sensitive norms for both males and females. Fourthly, a systematic review was carried out to explore underage sex in adolescents and children, and the associated risk and protective factors. The search was conducted on six electronic databases as well as within the grey literature to identify quantitative studies which included males and females up to the age of 18 years old (or adults reporting retrospectively), with exposure to risk and protective factors for early onset of sexual intercourse (before 16 years of age), Altogether, 945 studies were identified for potential inclusion and 23 fulfilled the eligibility criteria to be included in the systematic review. Findings from 23 studies between 1996 and 2017 identified risk factors associated with underage sexual intercourse (under 16 years old). The rapid increase of technological advances over the past 10 years, as well as the changing landscape of sexuality, provides policy and lawmakers with the challenge of addressing child and adolescent sexual activities which are occurring at a younger age. Sexting at an earlier age is linked to pornography use at an earlier age. This suggests that exposure to sexualised imagery is on the increase and is related to underage sex, and if unprotected sex, the consequence of an increasing number of teenage pregnancies. This may be damaging to the development of the individual

Developing the structural capital of higher education institutions to support work based learning

This chapter considers issues related to the provision of work-based learning [WBL] programmes by higher education institutions and discusses these programmes using the concept of structural capital. ‘Structural capital’ is defined as the organising and structuring capability of the organisation as expressed in formal instruments, policies, regulations, procedures, codes, functional business units, task groups, committees or less formal culture, networks and practices (Stewart, 1997) that influence practices and procedures. Our experiences of operating work-based learning programmes in two very different higher education institutions provide illustrations of structural factors that enable and facilitate work-based learning. The discussion outlines the forms of work-based learning that both universities employ, and considers some key aspects of WBL delivery that are directly impacted upon by the structures and processes within institutions, and contribute to intra-institutional structural capital. A summary of practical examples is given as an appendix to the chapter

Survival outcomes and interval between lymphoscintigraphy and SLNB in cutaneous melanoma- findings of a large prospective cohort study

Introduction: Sentinel lymph node biopsy (SLNB) in cutaneous melanoma (CM) is performed to identify patient at risk of regional and distant relapse. We hypothesized that timing of lymphoscintigraphy may influence the accuracy of SLNB and patient outcomes. Methods: We reviewed prospective data on patients undergoing SLNB for CM at a large university cancer-center between 2008-2015, examining patient and tumor demographics and time between lymphoscintigraphy (LS) and SLNB. Kaplan-Meier survival analysis assessed disease-specific (DSS) and overall-survival (OS), stratified by timing of LS. Cox multivariate regression analysis assessed independent risk factors for survival. Results: We identified 1015 patients. Median follow-up was 45 months (IQR 26-68 months). Univariate analysis showed a 6.8% absolute DSS (HR 1.6 [1.03-2.48], p= 0.04) benefit and a 10.7% absolute OS (HR 1.64 [1.13-2.38], p=0.01) benefit for patients whose SLNB was performed 12 hours (n=652). Multivariate analysis identified timing of LS as an independent predictor of OS (p=0.007) and DSS (p=0.016) when competing with age, sex, Breslow thickness (BT) and SLN status. No difference in nodal relapse rates (5.2% v 4.6%; p=0.67) was seen. Both groups were matched for age, sex, BT and SLN status. Conclusion: These data have significant implications for SLNB services, suggesting delaying SLNB >12 hours after LS using a Tc99-labelled nanocolloid has a significant negative survival impact for patients and should be avoided. We hypothesise that temporal tracer migration is the underlying cause and advocate further trials investigating alternative, 'stable' tracer-agents

Erdheim-Chester Disease:Two cases from an ophthalmic perspective

Purpose: We report two patients who presented initially to ophthalmology clinics with symptoms and signs of orbital inflammation that led to a diagnosis of Erdheim-Chester Disease (ECD). Observations: ECD is a rare form of non-Langerhans cell histiocytosis (LCH) which is characterised by multi-system organ involvement and poor prognosis with standard therapies. Both patients were positive for the BRAF V600E mutation on genetic testing and were treated with the BRAF inhibitors Vemurafenib and Dabrafenib respectively. These cases highlight the variable clinical presentation and course of ECD, the classical radiological and histopathological findings, and the high degree of clinical suspicion necessary to reach this diagnosis. Conclusions and importance: The combination of xanthelasma and bilateral, diffuse intraconal orbital masses must suggest to the clinician the possibility of ECD; and consideration to arrange further investigation with a full body CT or FDG PET/CT scan should be given, even in the absence of wider systemic symptoms or signs. With the advent of targeted therapies such as BRAF inhibitors, it is of even more importance that a diagnosis of ECD is established in a timely manner in order to give these patients the best chance of reduced morbidity and increased survival

A Classification Method Based on Principal Components of SELDI Spectra to Diagnose of Lung Adenocarcinoma

Lung cancer is the leading cause of cancer death worldwide, but techniques for effective early diagnosis are still lacking. Proteomics technology has been applied extensively to the study of the proteins involved in carcinogenesis. In this paper, a classification method was developed based on principal components of surface-enhanced laser desorption/ionization (SELDI) spectral data. This method was applied to SELDI spectral data from 71 lung adenocarcinoma patients and 24 healthy individuals. Unlike other peak-selection-based methods, this method takes each spectrum as a unity. The aim of this paper was to demonstrate that this unity-based classification method is more robust and powerful as a method of diagnosis than peak-selection-based methods.The results showed that this classification method, which is based on principal components, has outstanding performance with respect to distinguishing lung adenocarcinoma patients from normal individuals. Through leaving-one-out, 19-fold, 5-fold and 2-fold cross-validation studies, we found that this classification method based on principal components completely outperforms peak-selection-based methods, such as decision tree, classification and regression tree, support vector machine, and linear discriminant analysis.The classification method based on principal components of SELDI spectral data is a robust and powerful means of diagnosing lung adenocarcinoma. We assert that the high efficiency of this classification method renders it feasible for large-scale clinical use

The influence of different culture microenvironments on the generation of dendritic cells from non-small-cell lung cancer patients

This study extends the model developed in Williams and Seaman’s [Williams, J. J. and Seaman, A. E. (2010). Corporate Governance and Mindfulness: The Impact of Management Accounting Systems Change, The Journal of Applied Business Research, Vol. 26, No. 5, pp. 1-17] exploratory paper examining the moderating effects of management accounting systems (MAS) change on the corporate governance/mindfulness relationship for a Canadian sample of 124 top-level accounting professionals. Canonical correlation analysis was applied to the linkage of multiple cognitive processes of mindfulness (Weick and Sutcliffe, 2001; 2007) and the governance dimensions of performance and conformance specified by the International Federation of Accountants (2009), underpinned by the moderating effects of five different components of MAS change, which yielded 13 significant relationships. The latter were subsequently analyzed for important gestalts (i.e., patterns) in the overall relationship, and assessed within the context of aligning professional accounting practices involving systems changes to the IFAC (2009) governance framework. These findings appear to have implications for improved governance structures in practice as well as offering a rich foundation for future research