Personal and reported partner pornography viewing by Australian women, and association with mental health and body image

Background: Personal and partner pornography viewing may affect health and wellbeing. This study aimed to improve understanding of the effects of pornography on mental health and body image, given emerging evidence of increasing use, particularly among young people. Methods: A cross-sectional survey was implemented, targeting people who had accessed health and fitness content via social media. Convenience sampling was used and participants were recruited via advertising on social media. Results: Overall, 76% (75/99) of women reported having ever viewed pornography, and 21% had viewed pornography frequently (monthly/weekly/daily) in the prior 12 months. The association between frequent viewing and higher-risk Kessler 10 Psychological Distress Scale scores lost significance once controlled for age (adjusted OR 2.30, 95%CI 0.82–6.49, P = 0.11). There was an association with frequent reported partner pornography use (monthly/weekly/daily) and increased Drive for Muscularity scores (adjusted OR 2.20, 95%CI 1.01–4.80, P = 0.048). There were no other associations found with pornography use (personal or partner) and body image or mental health, although this was limited by the small sample size. Most women (85%, 41/48) reported being happy with their partner’s pornography use, and in qualitative responses, indicated that pornography had minimal effect on their lives. Nevertheless, multiple qualitative responses indicated a multiplicity of perceived effects of pornography, including negative effects on body image. Conclusions: Pornography had a minor effect on mental health and body image in this study. Additional research is required to improve understanding of the effects of pornography on body image and mental health, particularly among vulnerable individuals

New genetic loci link adipose and insulin biology to body fat distribution.

Body fat distribution is a heritable trait and a well-established predictor of adverse metabolic outcomes, independent of overall adiposity. To increase our understanding of the genetic basis of body fat distribution and its molecular links to cardiometabolic traits, here we conduct genome-wide association meta-analyses of traits related to waist and hip circumferences in up to 224,459 individuals. We identify 49 loci (33 new) associated with waist-to-hip ratio adjusted for body mass index (BMI), and an additional 19 loci newly associated with related waist and hip circumference measures (P < 5 × 10(-8)). In total, 20 of the 49 waist-to-hip ratio adjusted for BMI loci show significant sexual dimorphism, 19 of which display a stronger effect in women. The identified loci were enriched for genes expressed in adipose tissue and for putative regulatory elements in adipocytes. Pathway analyses implicated adipogenesis, angiogenesis, transcriptional regulation and insulin resistance as processes affecting fat distribution, providing insight into potential pathophysiological mechanisms

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P &lt; 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

Finishing the euchromatic sequence of the human genome

The sequence of the human genome encodes the genetic instructions for human physiology, as well as rich information about human evolution. In 2001, the International Human Genome Sequencing Consortium reported a draft sequence of the euchromatic portion of the human genome. Since then, the international collaboration has worked to convert this draft into a genome sequence with high accuracy and nearly complete coverage. Here, we report the result of this finishing process. The current genome sequence (Build 35) contains 2.85 billion nucleotides interrupted by only 341 gaps. It covers ∼99% of the euchromatic genome and is accurate to an error rate of ∼1 event per 100,000 bases. Many of the remaining euchromatic gaps are associated with segmental duplications and will require focused work with new methods. The near-complete sequence, the first for a vertebrate, greatly improves the precision of biological analyses of the human genome including studies of gene number, birth and death. Notably, the human enome seems to encode only 20,000-25,000 protein-coding genes. The genome sequence reported here should serve as a firm foundation for biomedical research in the decades ahead

Sex, drugs and young people : novel research and health promotion approaches

Young people are at risk of sexually transmitted infections (STI), and engage in sex and drug related risk behaviour. This thesis investigates novel methods to reach youth for research and health promotion. Mobile phone text messages (SMS) are convenient, low cost, fast, and popular among youth. SMS has been utilised in sexual health for clinical management, service delivery and health promotion, but few of these projects have been evaluated. Recognising this lack of research led to the design of a randomised controlled trial investigating the use of SMS and email in sexual health promotion. Recruitment of young people for this trial was piloted at Melbourne’s Big Day Out. 939 young people were recruited in several hours; 30% were classified as being at high risk of STI, and 46% had used illicit drugs in the month prior to the survey. Knowledge of STI was poor. Drug use was associated with both sexual risk behaviour and music preference. The study demonstrated that this festival is a valuable site for sex and drugs research and health promotion. The following year, young people were recruited at the music festival and randomised to an intervention group who received regular sexual health SMS and email, or a control group who received no messages. After 12 months, the intervention group had higher STI knowledge than the control group (OR 2.72, 95%CI 1.68, 4.41) and intervention group females were more likely to have had an STI test (OR 2.51, 95%CI 1.11, 5.69). Respondents’ opinions of the messages were favourable. This simple, low-cost, and novel method was shown to be effective in improving young people’s sexual health. At-risk young people are not well represented in sex and drug behavioural surveillance in Australia. As the pilot study identified that a music festival was a suitable site for sex and drug research, the survey was repeated each year. Between 2005 and 2008, the proportion of young people at risk of STI decreased from 34% to 29%, and recent illicit drug use decreased from 46% to 43%. A limitation of the studies described herein is reliance on self-report, which is subject to recall bias; this can be reduced using diaries to collect behavioural data. Participants completed weekly diaries of sexual behaviour and a retrospective questionnaire. Correlation between the diaries and questionnaire was substantial, adding confidence to the validity of results of other studies in this thesis. Diaries can be collected in different ways; SMS has not previously been used for this purpose. Participants were randomised to complete diaries through SMS, online or paper. Online diaries were superior to SMS in completeness and participant preference, but SMS diaries were more likely to be submitted on time. This thesis has tested several novel options for researching and promoting health to young people. Through music festivals, SMS, and email, young people can be reached through settings and media they are familiar with. Use of these novel methods has increased understanding of risk behaviour among youth and been effective in sexual health promotion

Sex, drugs and young people : novel research and health promotion approaches

Young people are at risk of sexually transmitted infections (STI), and engage in sex and drug related risk behaviour. This thesis investigates novel methods to reach youth for research and health promotion. Mobile phone text messages (SMS) are convenient, low cost, fast, and popular among youth. SMS has been utilised in sexual health for clinical management, service delivery and health promotion, but few of these projects have been evaluated. Recognising this lack of research led to the design of a randomised controlled trial investigating the use of SMS and email in sexual health promotion. Recruitment of young people for this trial was piloted at Melbourne’s Big Day Out. 939 young people were recruited in several hours; 30% were classified as being at high risk of STI, and 46% had used illicit drugs in the month prior to the survey. Knowledge of STI was poor. Drug use was associated with both sexual risk behaviour and music preference. The study demonstrated that this festival is a valuable site for sex and drugs research and health promotion. The following year, young people were recruited at the music festival and randomised to an intervention group who received regular sexual health SMS and email, or a control group who received no messages. After 12 months, the intervention group had higher STI knowledge than the control group (OR 2.72, 95%CI 1.68, 4.41) and intervention group females were more likely to have had an STI test (OR 2.51, 95%CI 1.11, 5.69). Respondents’ opinions of the messages were favourable. This simple, low-cost, and novel method was shown to be effective in improving young people’s sexual health. At-risk young people are not well represented in sex and drug behavioural surveillance in Australia. As the pilot study identified that a music festival was a suitable site for sex and drug research, the survey was repeated each year. Between 2005 and 2008, the proportion of young people at risk of STI decreased from 34% to 29%, and recent illicit drug use decreased from 46% to 43%. A limitation of the studies described herein is reliance on self-report, which is subject to recall bias; this can be reduced using diaries to collect behavioural data. Participants completed weekly diaries of sexual behaviour and a retrospective questionnaire. Correlation between the diaries and questionnaire was substantial, adding confidence to the validity of results of other studies in this thesis. Diaries can be collected in different ways; SMS has not previously been used for this purpose. Participants were randomised to complete diaries through SMS, online or paper. Online diaries were superior to SMS in completeness and participant preference, but SMS diaries were more likely to be submitted on time. This thesis has tested several novel options for researching and promoting health to young people. Through music festivals, SMS, and email, young people can be reached through settings and media they are familiar with. Use of these novel methods has increased understanding of risk behaviour among youth and been effective in sexual health promotion

Mental health and associated sexual health behaviours in a sample of young people attending a music festival in Melbourne, Victoria

Poor mental health has previously been associated with risky sexual health behaviours among young people internationally and in clinical samples, but little is known about this relationship in non-clinical settings. We conducted a cross-sectional survey with a convenience sample of 1345 Australians aged 15–29. Multivariable logistic regression was used to identify sexual health behaviours independently associated with recent poor mental health including contraception use, STI testing, sexting and age at first sexual intercourse. Recent poor mental health was reported by 29.7 % of participants and independently associated with female gender (OR 1.8; 95 % CI 1.4–2.4), not identifying as heterosexual (OR 3.0; 95 % CI 2.1–4.4) and young age at first sexual intercourse among female participants (OR 1.4; 95 % CI 1.0–2.0). Results suggest mental health is largely driven by variables other than sexual health behaviours, although youth mental health services should consider inclusion of sexual health promotion within the scope of their services

What behaviors do young heterosexual Australians see in pornography? A cross-sectional study

This study investigated how frequently a group of young heterosexual Australians (ages 15 to 29) saw a range of behaviors represented in pornography over the previous 12 months. Participants were recruited to an anonymous online survey. Those who reported having viewed pornography in the past 12 months (n = 517) indicated how frequently they saw each of a list of 17 behaviors when they watched pornography in the past 12 months. Men’s pleasure (83%) was seen frequently by the highest proportion of young people surveyed, followed by a man being portrayed as dominant (70%). Women were more likely to report frequently seeing violence toward a woman (p < 0.01). Men were more likely to report frequently seeing heterosexual anal sex (p < 0.01), ejaculation onto a woman’s face (p < 0.01), women portrayed as dominant (p < 0.01), a man being called names or slurs (p < 0.01), and violence toward a man that appears consensual (p < 0.01). Younger age was significantly associated with frequently seeing women’s pleasure (p < 0.05), violence toward women which appeared consensual, and all types of violence (p < 0.01). Older age was associated with frequently seeing men’s pleasure (p < 0.01) and heterosexual anal sex (p < 0.05). Our findings draw attention to the gendered ways that behaviors in pornography are seen and identified by young heterosexual audiences