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71.
This mixed-methods study of BDSM investigates the nuances of BDSM participants’ role identities, role frequencies, and role fluidities—shifts in identities and play across time, location, scene, and play partner. Data were gathered from 202 online surveys and 25 semistructured interviews about participants’ roles given their gender and sexual identities. These data reveal that men tend to self-identify as Dominant, Master, Top, or Sadist (DMTS) and always perform dominant roles, while women tend to self-identify as Submissive, Slave, Bottom, or Masochist (SSBM) and always perform submissive roles. Although this would seem to support the theory that BDSM reinforces gendered dominant/submissive binaries, further analyses indicate that women and queer/pansexual individuals disrupt this binary through their Switch identities and roles. Switching and queer identities, thus, offer the possibility for transforming dominant/submissive and other binaries.  相似文献   
72.

Background

Second-degree tears are the most common form of perineal trauma occurring after vaginal birth managed by New Zealand midwives, although little is known about midwives’ perineal practice.

Aim

The aim of this study was to identify how midwives managed the last second-degree perineal tear they treated and the level to which their practice reflects National Institute for Health and Care Excellence guidelines.

Methods

An (anonymous) online survey was conducted over a six-week period in 2013. New Zealand midwives who self-identified as currently practising perineal management and could recall management of the last second-degree tear they treated were included in the analysis.

Findings

Of those invited, 645 (57.1% self-employed, 42.9% employed) were eligible and completed surveys. Self-employed midwives reported greater confidence (88.0% vs 74.4%, p < 0.001) and more recent experience (85.1% vs 57.4%, p < 0.001) with perineal repair than employed midwives. Midwives who left the last second-degree tear unsutured (7.3%) were more likely to report low confidence (48.9% vs 15.4%, p < 0.001) and less recent experience with repair (53.2% vs 24.7%, p < 0.001), and were less likely to report a digital-rectal examination (10.6% vs 49.0%, p < 0.001), compared to midwives who sutured. Care consistent with evidence-based guidelines (performing a digital-rectal examination, 59.4% vs 49.3% p = 0.005; optimal suturing techniques, 62.2% vs 48.7%, p = 0.001) was associated with recent perineal education.

Conclusions

Midwives’ management of the last second-degree perineal tear is variable and influenced by factors including: employment status, experience, confidence, and perineal education. There is potential for improvement in midwives’ management through increased uptake of evidence-based guidelines and through ongoing education.  相似文献   
73.
Nearly 20% of South African youth experience forced or coerced sexual intercourse. Understanding the factors associated with forced sex is important for informing prevention programs aimed at reducing sexual violence and HIV and AIDS. Multilevel regression models test the association between sexual situation self‐efficacy and forced sex among 2,893 South African adolescents. Findings suggest that youth are more likely to experience forced sex after periods of time when their levels of self‐efficacy are lower than their average levels of self‐efficacy. Furthermore, youth who are lower on their self‐efficacy compared to their peers are more likely to experience forced sex. Implications for prevention research are discussed.  相似文献   
74.
Committed to developing an institution-wide intercultural competence curriculum for master’s-level students preparing for international careers, a team of nine professors from across disciplines deliberated for a year on their fundamental understandings of intercultural competence and what it would mean to facilitate the development of that competence in students. This article recounts the team’s philosophical debates related to intercultural competence: definitions, effective methods of teaching, intersectionality of identities, Western bias in the literature, power and inequity, and the role of language learning. The deliberations became the foundation for an institution-wide curriculum, focused on helping graduates to be not only effective workers and managers in multicultural settings, but also to be leaders in social change. This article shares the conversations and considerations of the planning process and the breadth and emphasis of the curriculum that emerged. Reflections on students’ learning and recommendations for curriculum developers are offered.  相似文献   
75.
Attachment researchers have proposed that the attachment, caregiving, and sexual behavioral systems are interrelated in adult love relationships (Mikulincer &; Shaver, 2007 Mikulincer , M. , &; Shaver , P. R. ( 2007 ). Attachment in adulthood: Structure, dynamics, and change . New York , NY : Guilford . [Google Scholar]). This study examined whether aspects of partners’ caregiving (proximity, sensitivity, control, compulsive caregiving) mediated the association between their attachment insecurities (anxiety and avoidance) and each other's sexual satisfaction in two samples of committed couples (Study 1: 126 cohabiting or married couples from the general community; Study 2: 55 clinically distressed couples). Partners completed the Experiences in Close Relationships measure (Brennan, Clark, &; Shaver, 1998 Brennan , K. A. , Clark , C. L. , &; Shaver , P. R. ( 1998 ). Self-report measurement of adult attachment: An integrative overview . In J. A. Simpson &; W. W. Rholes (Eds.), Attachment theory and close relationships (pp. 4676 ). New York : Guilford .[Crossref] [Google Scholar]), the Caregiving Questionnaire (Kunce &; Shaver, 1994 Kunce , L. J. , &; Shaver , P. R. ( 1994 ). An attachment-theoretical approach to caregiving in romantic relationships . In K. Bartholomew &; D. Perlman (Eds.), Advances in personal relationships (pp. 205237 ). London : Kingsley . [Google Scholar]), and the Global Measure of Sexual Satisfaction (Lawrance &; Byers, 1998 Lawrance , K. , &; Byers , E. S. ( 1998 ). Interpersonal Exchange Model of Sexual Satisfaction Questionnaire . In C. M. Davis , W. L. Yarber , R. Bauserman , G. Schreer &; S. L. Davis (Eds.), Sexuality-related measures: A compendium (pp. 514519 ). Thousand Oaks , CA : Sage . [Google Scholar]). Path analyses based on the actor-partner interdependence model (APIM) revealed that caregiving proximity mediated the association between low attachment avoidance and partners’ sexual satisfaction in distressed and nondistressed couples. Sensitivity mediated this association in nondistressed couples only. Control mediated the association between men's insecurities (attachment-related avoidance and anxiety) and their partners’ low sexual satisfaction in nondistressed couples. Attachment anxiety predicted compulsive caregiving, but this caregiving dimension was not a significant mediator. These results are discussed in light of attachment theory and their implications for treating distressed couples.  相似文献   
76.
Despite a number of studies investigating the effect of pharmacotherapy on treatment costs for schizophrenia patients, there has been little attention given to the effect of family intervention. In this study, data from the Kansas Medicaid system were used to analyze healthcare costs for 164 schizophrenia patients who had participated in family intervention. Structural equation modeling was used to test two competing views of the role of family intervention in treatment. The results showed that a model including direct and indirect effects of family intervention provided a better fit to the data. Family intervention had a significant indirect effect on general medical costs (through other psychological treatment) that showed a savings of $586 for each unit increase in the provision of these services. In addition, the total indirect effects for family intervention showed a $580 savings for general medical costs and $796 for hospitalization costs (for each unit increase).  相似文献   
77.
This study explores whether youth involvement in Scouting has positive consequences later in life. We examine whether the number of years of participation in Scouting is positively associated with human and social capital and recreational lifestyles in adulthood, and whether these are linked to subjective well-being: relational, emotional, and physical health. To explore this potential relationship, we estimated a structural equation model, analyzing data from a national sample of adult males. We found that youth involvement in Scouting is positively related to subjective well-being indirectly via the positive adult outcomes.  相似文献   
78.
The neurodiversity movement claims that there are neurological differences in the human population, and that autism is a natural variation among humans – not a disease or a disorder, just ‘a difference’. A ‘politics of neurodiversity’ is based on the claim that the ‘neurodiverse’ population constitutes a political grouping comparable with those of class, gender, sexuality or race. This paper considers the limits and possibilities of neurodiverse political activism, and concludes by calling for a politics of identity that does not depend on a politics of ‘us’ and ‘them’.  相似文献   
79.
The debate over whether same‐sex couples should be allowed to enter into civil marriages continues in the United States. Forty‐nine adolescents and emerging adults (ages 14–29) with lesbian, gay, and bisexual parents were interviewed for the current exploratory study, which examined how individuals perceived themselves and their families as being affected by marriage (in)equality, as well as the factors that shaped their perspectives. More than two thirds of participants voiced unequivocal support for marriage equality, citing numerous legal and symbolic benefits that their families were denied. One quarter of participants articulated critical perspectives of marriage or the fight for marriage equality, while also acknowledging the benefits associated with marriage. As the first study to examine the perspectives of individuals with lesbian, gay, and bisexual parents with regard to marriage (in)equality, this research has important implications for the marriage equality debate and provides a springboard for future studies on this topic.  相似文献   
80.
Data from the 1999-2000 Chinese Health and Family Life Survey were merged with community-level data from the 1982, 1990, and 2000 Chinese censuses to examine the relationship between the local sex ratio (number of men per 100 women) and sexual outcomes among women (N = 1,369). Consistent with hypotheses derived from demographic-opportunity theory, multilevel logistic regression analyses showed that women are more likely to be sexually active, to have had premarital sexual intercourse, to have been forced to have sex, and to test positive for a sexually transmitted infection when there is a relative abundance of age-matched men in their local community. Education, birth cohort, and geographic location also emerged as significant predictors of women's sexual experiences.  相似文献   
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