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

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

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

Incidence of primary large vessel vasculitis in Norfolk, UK from 2011 to 2020

Objectives: To report the annual incidence of primary large vessel vasculitis (LVV) in the adult population of Norfolk County, UK, including giant cell arteritis (GCA) (in those ≥50 years) and Takayasu arteritis (TAK). Methods: Individuals diagnosed by histology or imaging who lived in NR1-NR30 postcode districts were included. Validated criteria from 1990 and 2022 were applied for final classification. Population data were available from the Office of National Statistics, UK. Results: 270 individuals were diagnosed with primary LVV over 4.7 million person-years. The annual incidence (95% CI) of primary LVV was 57.5 (50.8, 64.7)/million person-years in the adult population. 227 and 244 individuals were diagnosed with GCA over ~2.5 million person-years using 1990 and 2022 criteria, respectively. The annual incidence (95% CI) of GCA was 91.6 (80.0, 104.3)/million person-years aged ≥50 years using 1990 criteria and 98.4 (86.4, 111.6)/million person-years aged ≥50 years using 2022 criteria. 13 and 2 individuals were diagnosed with TAK over 4.7 million person-years. The annual incidence (95% CI) of TAK was 2.8 (1.5, 4.7)/million person-years using 1990 criteria and 0.4 (0.0, 1.4)/million person-years using 2022 criteria, in the adult population. The incidence of GCA rose sharply in 2017 coincident with the introduction of a fast-track pathway and fell during the pandemic when the pathway was disrupted. Conclusions: This is the first study that reports the incidence of objectively verified primary LVV in the adult population. The incidence of GCA may be affected by the availability of diagnostic pathways. The use of the 2022 classification criteria results in a rise in the classification of GCA and fall in that of TAK

The Effects of Alcohol Abuse on Pulmonary Alveolar-Capillary Barrier Function in Humans

Aims: Alcohol abuse is associated with the development of the acute respiratory distress syndrome, a disorder characterized by abnormal alveolar-capillary permeability. We hypothesized that individuals with a history of alcohol abuse would have clinical evidence of abnormal alveolar-capillary permeability even in the absence of symptoms. This could contribute to their propensity for the development of this disorder. Methods: Thirty-three subjects with a history of alcohol abuse, but no other medical problems, and 13 age- and smoking-matched controls inhaled 99mTc–DTPA (technetium-labeled diethylenetriamine penta-acetate; an isotope used to measure lung permeability) for a 3-min period, and washout of this isotope was measured for a 90-min period. The rate at which it was cleared from the lungs was assessed and compared between subjects and controls. Results: The half-life of 99mTc–DTPA in the lungs of subjects with alcohol abuse was significantly shorter than that observed in matched controls, even when correcting for the effects of concomitant tobacco use. When the half-life of the isotope for smoking alcohol-abusing subjects and smoking controls were compared separately, there was a trend for the alcohol-abusing subjects to have a shorter half-life of the isotope present in the lungs. This was also true when non-smokers were compared. Conclusions: These observations provide further evidence that alcohol abuse affects the normal permeability of the alveolar-capillary barrier and thereby may contribute to the development of the acute respiratory distress syndrome in individuals with alcohol abuse