This document summarizes a qualitative study exploring the socio-cultural context of substance use among gay communities in Vancouver, BC. Through interviews with 20 gay and queer men, 3 key themes emerged: 1) Substance use is a social activity that takes place in gay social spaces. 2) The use of drugs and alcohol facilitates social and sexual inclusion in these communities. 3) Participants reported that substance use patterns change over one's lifetime as gay men, with more use occurring during the period of "coming out." The study suggests substance use serves important social and coping functions, but may also influence HIV risk, and interventions should consider how these roles change throughout life.
This article co-written by Dr. Robert J. Winn which aims to quantify the number of lesbian, gay, bisexual, and transgender (LGBT) people in Philadelphia who report to be victims of domestic violence.
Jess Alder (Program Director, Start Strong, Boston Public Health Commission), Nicole Daley (Director of Evaluation and Engagement, One Love Foundation), and Emily F. Rothman, ScD (Professor, Boston University School of Public Health) delved into the topic of whether porn use is a public health problem and highlighted a curriculum they developed for teens to discuss porn, healthy relationships, and sexual violence.
This article co-written by Dr. Robert J. Winn which aims to quantify the number of lesbian, gay, bisexual, and transgender (LGBT) people in Philadelphia who report to be victims of domestic violence.
Jess Alder (Program Director, Start Strong, Boston Public Health Commission), Nicole Daley (Director of Evaluation and Engagement, One Love Foundation), and Emily F. Rothman, ScD (Professor, Boston University School of Public Health) delved into the topic of whether porn use is a public health problem and highlighted a curriculum they developed for teens to discuss porn, healthy relationships, and sexual violence.
Invisible Men who have Sex with Men and Survival: From Practice to Research a...Jim Pickett
John Schneider's, University of Chicago, presentation at the Sex in the City II: Men, Sex, Love and HIV conference, held in Chicago on September 25, 2014. Sponsored by AIDS Foundation of Chicago and other partners.
Very few of us know that 73% of the rape victims know the rapists. Moreover, 40% of rapes happen at victim’s home and 20% occur in the homes of familiar people.
It turned out that most of us have no idea about the effective precautions needed to protect ourselves from the traumatic experience, because we expect danger from a wrong source. A widespread belief is that one should expect a rapist to sit in the bushes in the park late at night, while the reality is different.
My colleague Paulina Grzelak and I were astonished while exploring this topic, as we were quite oblivious to the real situation as well. Therefore, we decided to make a small questionnaire and ask people what they think about rape.
This presentation begins with the analysis of what makes a person become a rapist, which is followed by the comparison of the results of the questionnaire with real data.
I would be grateful if you shared this presentation as many people need this knowledge.
I also want to add that most figures we present come from the States where definition of rape and social situation may differ from ours. Hence, comparing data from the U.S. with opinions from Poland and Ukraine may seem improper. For instance, being forced into sexual contact by husband may not even be recognized as rape in Ukraine, “because it’s his natural right”. And even if a wife admits this fact, social welfare system (which does not exist here, let’s face it) leaves her no option apart from remaining silent, while in the U.S. rape victims are less dependent on family members. Therefore, one has to approach the statistics carefully. Still, we believe that using American data can be justified by the fact that they explore the subject more than any other country.
A new analysis of data from the NUS Hidden Marks survey - which explored UK women students' experiences of violence - has found that lesbian, bisexual and trans (LBT) women respondents were equally, and in some cases more likely, to be victims of harassment, violence and sexual assault as compared with heterosexual, non-trans survey respondents.
This new study looks at the survey responses for LBT respondents, focusing specifically on rates for harassment, physical and sexual violence, and the impact of these experiences on respondents, and makes recommendations for further research in this area.
Key findings include the following:
Over one third of LBT respondents had been victims of sexual assault compared to under a quarter of heterosexual, non-trans women.
LBT respondents were more likely than non-LBT women to have experienced all categories of sexual assault.
Over one quarter of LBT respondents had been victims of physical assault compared to less than one in five heterosexual, non-trans women.
Download a presentation about the findings here.
To find out what you can do to support LBT victims of domestic violence, read the briefing we published on this issue last year.
Read about more Hidden Marks projects being carried out by NUS Women's Campaign here.
The analysis was carried out by Tami Peterson from NUS LGBT Committee on behalf of NUS LGBT Campaign.
Filipinos getting infected with HIV-AIDS continued to balloon notwithstanding the intervention through comprehensive prevention, dissemination and control programs. In Eastern Visayas there were 69 cases coming from most risk population primarily Men Having Sex with Men (MSM) either homosexual, heterosexual and bisexual modes of transmissions. Bearing this epidemic, sexual networking, using the internet for sex served as cruising sites for casual sex and promiscuity maybe accounted for this surge. This study made use of descriptive cross sectional method with 214 active users from different social sites using time- location sampling through interviews, group discussions and questionnaires. Results showed that most of the respondents joined the site for sex and had an average of 1-5 different sexual intercourse for the past three months. Sexual practices were oral, anal and oral-anal. Respondents were aware on the different modes of transmission but fully unaware of existing services of the DOH and were willing to be screened for HIV.
Dr. Julia bailey, from the University College of London e-Health Unit, presents the development, implementation and results for the Sexunzipped online survey as a tool for measuring sexual wellbeing in youth aged 16-20 yrs. Presented at YTH Live 2014, session "Advancing Data Collection Methods."
Invisible Men who have Sex with Men and Survival: From Practice to Research a...Jim Pickett
John Schneider's, University of Chicago, presentation at the Sex in the City II: Men, Sex, Love and HIV conference, held in Chicago on September 25, 2014. Sponsored by AIDS Foundation of Chicago and other partners.
Very few of us know that 73% of the rape victims know the rapists. Moreover, 40% of rapes happen at victim’s home and 20% occur in the homes of familiar people.
It turned out that most of us have no idea about the effective precautions needed to protect ourselves from the traumatic experience, because we expect danger from a wrong source. A widespread belief is that one should expect a rapist to sit in the bushes in the park late at night, while the reality is different.
My colleague Paulina Grzelak and I were astonished while exploring this topic, as we were quite oblivious to the real situation as well. Therefore, we decided to make a small questionnaire and ask people what they think about rape.
This presentation begins with the analysis of what makes a person become a rapist, which is followed by the comparison of the results of the questionnaire with real data.
I would be grateful if you shared this presentation as many people need this knowledge.
I also want to add that most figures we present come from the States where definition of rape and social situation may differ from ours. Hence, comparing data from the U.S. with opinions from Poland and Ukraine may seem improper. For instance, being forced into sexual contact by husband may not even be recognized as rape in Ukraine, “because it’s his natural right”. And even if a wife admits this fact, social welfare system (which does not exist here, let’s face it) leaves her no option apart from remaining silent, while in the U.S. rape victims are less dependent on family members. Therefore, one has to approach the statistics carefully. Still, we believe that using American data can be justified by the fact that they explore the subject more than any other country.
A new analysis of data from the NUS Hidden Marks survey - which explored UK women students' experiences of violence - has found that lesbian, bisexual and trans (LBT) women respondents were equally, and in some cases more likely, to be victims of harassment, violence and sexual assault as compared with heterosexual, non-trans survey respondents.
This new study looks at the survey responses for LBT respondents, focusing specifically on rates for harassment, physical and sexual violence, and the impact of these experiences on respondents, and makes recommendations for further research in this area.
Key findings include the following:
Over one third of LBT respondents had been victims of sexual assault compared to under a quarter of heterosexual, non-trans women.
LBT respondents were more likely than non-LBT women to have experienced all categories of sexual assault.
Over one quarter of LBT respondents had been victims of physical assault compared to less than one in five heterosexual, non-trans women.
Download a presentation about the findings here.
To find out what you can do to support LBT victims of domestic violence, read the briefing we published on this issue last year.
Read about more Hidden Marks projects being carried out by NUS Women's Campaign here.
The analysis was carried out by Tami Peterson from NUS LGBT Committee on behalf of NUS LGBT Campaign.
Filipinos getting infected with HIV-AIDS continued to balloon notwithstanding the intervention through comprehensive prevention, dissemination and control programs. In Eastern Visayas there were 69 cases coming from most risk population primarily Men Having Sex with Men (MSM) either homosexual, heterosexual and bisexual modes of transmissions. Bearing this epidemic, sexual networking, using the internet for sex served as cruising sites for casual sex and promiscuity maybe accounted for this surge. This study made use of descriptive cross sectional method with 214 active users from different social sites using time- location sampling through interviews, group discussions and questionnaires. Results showed that most of the respondents joined the site for sex and had an average of 1-5 different sexual intercourse for the past three months. Sexual practices were oral, anal and oral-anal. Respondents were aware on the different modes of transmission but fully unaware of existing services of the DOH and were willing to be screened for HIV.
Dr. Julia bailey, from the University College of London e-Health Unit, presents the development, implementation and results for the Sexunzipped online survey as a tool for measuring sexual wellbeing in youth aged 16-20 yrs. Presented at YTH Live 2014, session "Advancing Data Collection Methods."
Here is the presentation that I did for the Rosa Parks lecture at UNLV on Feb. 10, 2010. The presentation is entitled, "Reproductive Health, Social Determinants, Health Disparities, and Public Policy: Let\'s Come Up with Solutions." This presentation reviews some of the work that I have done over the years to bring me to some key conclusions. If you have any questions or comments about the presenation, please do not hesitate to contact me.
Illegal Drug Problem in the City of Ormoc As Perceived By User and Non-User R...inventionjournals
The study was conducted primarily to: describe the socio-demographic characteristics of user and non-user respondents; determine the reasons for engaging in illegal drugs among user respondents; document local and national ordinances enacted against illegal drug users; and identify the programs implemented by government and non-government organizations to make the City of Ormoc a drug-free community. The results of the study revealed that the mean age of the illegal drug users was 22 years old. Majority of them were males whose income fell below P10,000.00 in the form of allowance. They were aware of the illegality of the drugs used. Marijuana was the dominant drug abused. Influence of Peers and Curiosity were the topmost reasons why they got into drugs due to misinformation and assurance from friends who claim to have enjoyed the experience as perceived by the respondents. Among the National and Local Ordinances enacted against illegal drugs users in the City of Ormoc were: the implementation of RA 9165 – Dangerous Drugs Act of 2002; LOI 36/97: ALPHA BANAT (Barangay Against Narcotics Abusers and Traffickers) and Information dissemination of the ill effects of drugs through the Barangay Anti-Drug Abuse Counsel (BADAC).
Running Head ISSUES IN SEXUALITY SCHOLARLY VS. POPULAR MEDIA1.docxcharisellington63520
Running Head: ISSUES IN SEXUALITY: SCHOLARLY VS. POPULAR MEDIA 1
ISSUES IN SEXUALITY: SCHOLARLY VS. POPULAR MEDIA 7
Issues in Sexuality: Scholarly vs. Popular Media
Student
Instructor
Course
Date
Article “It’s a Quick Way to Get What You Want”: Formative Exportation about HIV Risk within Urban Massachusetts Men Who Have Sex with Men (MSM) Who Attend Sex Parties” had been the article obtained from AIDS Patient Care along with STD Journal this had been published within Oct of the year 2010. Authors of the article are Mimiaga M. J., Bland S., Reisner L. Sari, Isenberg D., Cranston K., Van Derwarker R. Driscoll A. Maura, and Mayer K. Major concentration of research had been to investigate HIV sexual risk behaviors about MSM which reported attending as well as hosting sex parties within the Massachusetts in last twelve months.
Men who have sex among men at those sex parties have been at the bigger risk of getting HIV or the STI because of the fact that there have been rest of the factors included such as alcohol, drugs, higher mean of the anonymous partners, along with unprotected sex (Migiaga, 2010). This research happened at Fenway Health, a health care and research facility. There had been forty preselected participants which finished the in depth, semi structured qualitative interview along with the interviewer administered comprehensive quantitative assessment series for 1 hour and half. This study or interviews had been done through one of 2 trained interviewers.
The asked questions as, How would we define the sex party? While did we start hosting or attending the sex parties? Describe sex parties we attended or hosted? Have condoms along with lube present at those parties? What type of sexual behaviors do men involve in along with what HIV as well as Sexual Transmitted Infection risk behaviors do we see for happening? Do we organize or participates such parties? Any of the rules include in the parties?
When asking such questions, they assessed psycho-social factor such as anxiety, depression, alcohols used problematic as well as history of the alcohol or drug abuse along with trauma history such as child-hood sexual abuse. Results or the conclusion of study advised that men who had attended such parties have been at very much risk for acquiring and transmitting HIV because of reasons explaining in the whole the article (Migiaga, 2010).
“Party, Play—And Pay” had been article taken from “Newsweek Journal”, which had been published in the year of 2005 (Jefferson, 2005). Such article provided brief detailed account of what the sex party of men on the crystal meth has been as otherwise called as “Party & Play”, or as a short form “PnP”. Authors discuss sex party’s scene like room of approximately thirty to forty men paying twenty dollars piece to host of such party, they had put each of their belong in the hefty bag for the safe-keeping when they walk-around in nude by having the sex with many partners un-protected as well as us.
Gender Studies__Homwork 4__Sex and Sexualities__assigned by Prof. Kasumi Naka...Som Oeurn MAO
Som Oeurn MAO
Sharing knowledge to peers, friends and others is one of my habits and passion, and I hope that this little preparation will help others to gain more knowledge for their own benefits, family and society as a whole.
Joshua Riley presented for the Kolmac School in Silver Spring, MD on Friday, April 24, 2015. "Working with LGBT Substance Abuse Users and the Persistence of Methamphetamine Use Among Gay and Bi-Sexual Men" was adored by all. Enjoy his slides!
Chamberlain College of Nursing NR 305 RN HEALTH ASSESSMENT .docxcravennichole326
Chamberlain College of Nursing NR 305 RN HEALTH ASSESSMENT
Week 5 Discussion Video Transcript
Video Audio
Anne at her
desk
reviewing a
patient
chart as she
expresses
her inner
thoughts
Anne: Let’s see… my next patient is Mary. She’s 53, Caucasian, and had a heart attack a
year ago. She is being seen today for an exacerbation of COPD. She also has controlled
Type II diabetes. She’s had depression that started when she lost her job a year ago.
She’s still is unemployed but receiving government checks. But that isn’t enough
income for her to live independently. She had to move in with her daughter and son-
in-law.
Today her chief complaint is a harsh productive cough and increased shortness of
breath. And she’s still smoking, which is upsetting her daughter who has a young child
who is bothered by the second-hand smoke.
Anne and
Mary in an
exam room
Anne: Hi, Mary. How are you feeling today?
Mary: Overall, I feel pretty healthy. I walk for about half an hour every single day. And
I’ve been following the diet that the dietician suggested, watching what I eat. I’m
proud of the fact that my diabetes has never been better controlled!
Anne: So far, so good. Is there anything that concerns you?
Mary: Yes. Lately I’ve been coughing so hard and having difficulty catching my breath
which is causing me to feel like I might be having some twinges in my chest, and I’m
scared to death I’m going to have another heart attack. I want to know what more I
can do to prevent that from happening again.
Anne: I’d be happy to explore healthy options. To start, I’d like to ask you a few follow-
up questions related to the history form you filled out in the waiting room. You’re still
smoking?
Mary: (Sigh…) Yes, cigarettes are my one remaining vice. I’ve been smoking over 40
years. My parents smoked and they taught me how to light their cigarettes when I was
12!
Anne: How much are you smoking?
Mary: About a pack a day. That’s 20 cigarettes. I light up first thing in the morning. If I
don’t, it’s all I think about. My body craves it. It is just so frustrating, especially since it
is upsetting my daughter and son in law so much. I don’t know where I will go if they
kick me out of their home.
Anne: I’m sure that is very upsetting to think about, Mary. Let me take a quick listen
to you and then we can discuss some options that may be available to you.
Mary: Sure, that would be fine.
Discriminatory Behavior toward the LGBTQ Community
Introduction
Discrimination against the LGBTQ or the lesbians, gay, bisexual and transgender community is presently on the world stage. Substantial gain has been conducted on the approval of this community. However, there is still a thirty percent increase in bias and discriminatory behavior towards the LGBTQ community. The LGBTQ community is ten times more likely to encounter discrimination grounded in their sexual orientation compared to the homosexual community. The ...
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
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We specializes in exporting high quality Research chemical, medical intermediate, Pharmaceutical chemicals and so on. Products are exported to USA, Canada, France, Korea, Japan,Russia, Southeast Asia and other countries.
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
1. The Socio-Cultural Context of Substance Use
among Gay Communities in Vancouver, BC
Ashleigh Rich1, Jamie Forrest1, Allan Lal1, Terry Howard2, Robert Hogg1, 3,
David Moore1, 4, Eric Roth5
1 BC Centre
for Excellence in HIV/AIDS,
Living Society of British Columbia
3 Simon Fraser University
4 University of British Columbia
5 University of Victoria
2 Positive
Page 1
2. Momentum Health Study
• Access to HIV treatment
technologies continues to
expand in BC
• Important to understand how
sexual health & substance use
beliefs and behaviours change
over time for gay/bi/MSM
• Qualitative inquiry to explore
the socio-cultural context of
substance use among
Vancouver gay men
Treatment as Prevention
ART Optimism
Sexual Altruism
Substance Use
Risk Behaviour
Page 2
3. Study Objectives include:
CIHR
Examine sexual behaviour and recreational drug
use among a representative sample of MSM in
BC over a period of five years, and to monitor
changes in these behaviours as ART access
expands
NIH
Examine how self-reported drug-use before and
during sex contributes to HIV sexual risk
behaviour
Page 3
4. Formative Research
Purpose
Study design &
planning
Methods
24 KII, 6 FGD, 39
community
mapping exercises
Key questions
Where do MSM
live, gather and
play?
Which sub-groups
of MSM might be
difficult to reach?
By which
categories does
the community
self-organise?
•
Findings from Momentum formative
research indicated that substance use
patterns structure social-sexual
environments for Vancouver gay men.1
Substance use patterns were associated
with particular neighbourhoods and
social spaces
Social identity groups have unique
substance use patterns and those who
abstain from use may be socially isolated
1. Forrest JI, Stevenson B, Pai J, Michelow W, Roth EA, Moore D, &
Hogg RS. Substance use preference and social-sexual desire in
structuring social environments for MSM in Vancouver, BC:
implications for Respondent Driven Sampling (RDS). 21st Annual
Canadian Conference on HIV/AIDS Research (CAHR). April 2011.
Montreal, Quebec.
Page 4
5. Substance use and sexual risk
• MSM more likely to use multiple substances, and use
substances with sex1
• Certain substances have specific sexual uses for gay men
• Substance use may be associated with a greater risk of
transmission of HIV2
1. Stall R, McKusick L, Wiley J, Coates TJ, Ostrow DG. Alcohol and drug use during sexual activity and compliance with
safe sex guidelines for AIDS: the AIDS behavioral research project. Health Educ Behav. 1986;13:359–71.
1. Beckett M, Burnam A, Collins RL, Kanouse DE, Beckman R. Substance use and high-risk sex among people with HIV: a
comparison across exposure groups. AIDS Behav. 2003;7:209–19.
Page 5
6. Methods
• Semi-structured qualitative
interviews were conducted
with twenty (20) respondents
• Purposely sampled from the
Momentum Health Study
cohort
• Interviews were structured through use of an interview guide
and community maps as prompts
• Open ended interview questions were developed based on
formative research findings and literature
Page 6
7. Analysis
• Audio recorded interviews were transcribed verbatim and a
thematic analysis was conducted
• Phenomenological approach framed the analysis1
• Transcripts were systematically reviewed to identify emergent
themes
• Transcript data was analyzed using Nvivo
Green J & Thorogood N. Qualitative methodology and health research. In: Qualitative Methods for Health Research. 2nd ed. Los
Angeles: Sage; 2009. p. 3-34.
Page 7
8. Interview participants
• 20 gay and queer identified men
• Mixed sero-status sample
(HIV+ n=6, HIV- n=14)
• Living in the Greater Vancouver Region
• Had been sexually active with other men within the previous six
months
• Age range: 20’s to 60’s (median age category: 20’s)
Page 8
9. Results
The perspectives of gay, bisexual men in this study indicate
that:
• Theme 1: Substance use is a social activity, taking place in
gay social spaces
• Theme 2: Use of drugs and alcohol facilitates social-sexual
inclusion
• Theme 3: Use of substances changes over the lifetime
Page 9
10. Substance use as a social activity
The narratives of gay men indicate that substance use is a social
activity among Vancouver gay communities and sites of
consumption as social spaces
A lot of the time social events are catered towards drinking or drug use even if
it isn’t heavy drug use. It could be casual or recreational. … A lot of the time
those are in the environment of our social spaces that we share.” (HIV
negative, 20’s)
Page 10
11. Substance use as a social activity
Participants described drug and alcohol use as way to participate
in gay communities
And I think a lot of drug use is like a social activity and a way to find
community and I think that’s what most guys are looking for and I think that’s
probably one of the ways to get it, just like going to like a church or whatever.
I think that’s what people are often looking for and I think a lot of people in the
city are super isolated and that’s probably one of the ways that they can find
people. (HIV negative, 20’s)
And then of course when you start doing MDMA at a club, it becomes this
dance fast and everyone’s loving each other and like it kind of forms this like
really beautiful community for like a really specific amount of time. (HIV
negative, 20’s)
Page 11
12. Social-sexual context of substance use
Gay men’s narratives described substance use as a
barrier/facilitator of social participation
And, you know, whether you’re included in that or not it tends to be obviously,
people who are using drugs tend to congregate together and if you’re not
using drugs you get somewhat excluded or you self exclude just because you
don’t feel like you belong. (HIV negative, 30’s)
It’s like I can’t do sober. I got to drink something because then I’ll like put aside
my thoughts and I’ll actually start talking to random people and hopefully I’ll
meet some people to hang out with. (HIV negative, 20’s)
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13. Social-sexual context of substance use
Participants described alcohol and drug use affecting sex-seeking
behaviour within social spaces
If you don’t do drugs then you’re not invited to any parties or you’re not, a lot
of people I found also sexually, if you’re not doing drugs then you’re out. (HIV
positive, 50’s)
Typically that I’m drunk my like inhibition lowers and I might as well just go
find someone. (HIV negative, 20’s)
I never knew a bathhouse when I was sober. (HIV negative, 20’s)
Page 13
14. Substance use over the life course
Participant reported that gay men’s attitudes and behaviours
around substance use will shift over their lifetimes, with more use
among younger men
There was a time where my friend circle was … doing a lot of different
drugs…And then the group dynamic all just kind of like went from there and
just slowly kind of changed and that kind of just went away and so it’s just
kind of how … maybe because we grew up a little bit and so we just stopped
and so like now it’s very infrequent and some of them are in jobs where they
might be drug tested so they’re just totally … they’re like no, can’t do it, job’s
more important…the dynamic just changed over time. (HIV negative, 20’s)
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15. Substance use over the life course
Participant narratives indicated substance use as more common
during the ‘coming out’ period of gay men’s lives
I think when you’re first coming out, it’s really hard to go into a gay club without being
drunk. I know I had that struggle, like just I’ve been to a gay club sober and it was
terrible. (HIV negative, 20’s)
When you’re young you like to experiment, okay? And so there’s that, the curiosity of
experimentation. Also, because you’re young I see that as wanting to belong, ‘cause
they have an assumption that, “I should be trying these things or doing these activities
to belong and be accepted.” So … because I think they haven’t lived long enough to
gain a confidence of who they are and … and feeling confident enough who they are no
matter where they go and they have to feel they have to belong to the certain group or
whatever, to feel this confidence of acceptance. (HIV positive, 60’s)
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16. Conclusions
The perspectives of gay men participating in this study suggest that:
Substance use takes place within a complex HIV risk environment1,
serving a number of social-sexual functions among Vancouver gay
communities.
While drug and alcohol use can be associated with HIV
transmission risk for gay men, it can also be a form of resiliency
and community connectedness
Effective health prevention and promotion interventions must
take into account that substance use changes over the life course
for gay men
1. Rhodes T. The risk environment': a framework for understanding and reducing drug-related harm. International Journal of Drug
Policy. 2002;13(2):85-94.
Page 16
17. Next Steps
• Mixed methods analysis:
Use Momentum psychosocial data
• Further qualitative exploration:
How the interaction between substance use and social
coping changes over the life course
Page 17
18. Acknowledgements
Funding Agencies
Research Program Coordination
Academic Investigators &
Governing Research Ethics Councils
Clinical Coordination & STI Screening
Community Partnerships
Research Consultation
Page 18
*I’m going to present the findings from qualitative interviews that were conducted with 20 gay and bisexual men here in Vancouver, as part of the larger longitudinal bio-behavioral Momentum Health Study
*gay/bi/other MSM represent more than 50% of new infections in BC, as well as over half of those living with HIV in the province*While development, implementation and uptake of HAART has greatly reduced HIV-associated morbidity and mortality, the potential of HAART to act as a preventative measure at the population level depends on what happens with HIV risk behaviours at the individual levelIn this environment of expanded access to treatment technologies, including (PrEP) and(PEP), it is increasingly crucial to understand how sexual health and drug use attitudes and behaviours change over time for gay, bisexual and other men who have sex with men (MSM).This qualitative inquiry was designed to explore the socio-cultural context of substance use among Vancouver gay men
Study objectives include examination of relationship between substance use and HIV sexual risk behaviour, in the context of expanded ART access over time, as well as contribution of drug use before and during sex relates to HIV sexual risk
*We conducted an initial exploratory formative phase of research to inform the design and implementation of the Momentum study, in particular the use of Respondent Driven Sampling among Vancouver gay men.*The research team conducted 24 KIIS and 39 FGDs among demographically diverse groups of gay men to better understand how the various local communities are structured*Findings indicated that substance use patterns structure geographic and social-sexual environments for Vancouver gay men
*Previous research has demonstrated linkages between substance use, high risk sexual behaviour and seroconversion*Specifically, research has recognized an increased likelihood to use substances for gay versus heterosexual men*Specific substances have particular uses for this population, -distinction between recreational and sex drugs -some substances used for multiple purposes, like crystal meth -some substances serving distinct sexual functions (poppers associated with receptive AI b/c of muscle relaxant effect / Viagra/Cialis assoc with insertive AI)*and that substance use may be associated with an elevated HIV transmission risk. *In light of this evidence, we conducted a qualitative inquiry to explore the socio-cultural context of substance use among local gay communities.
*Semi-structured in-depth interviews were conducted with 20 purposively sampled gay/bisexual men, between August and October 2012*Respondents were recruited from those who had previously completed a quantitative questionnaire and clinical study visit, as part of the Momentum Health Study cohort, a five-year bio-behavioural research study*Interviews lasted from 1-2 hours*Interviews were structured through the use of an interview guide, as well as community maps as prompts. These maps were produced by individual participants in Focus Group Discussions conducted during formative research for Momentum*Formative research findings and literature guided the development of open-ended interview questions*We employed a broad definition of substance use in the interviews to include all drug and alcohol use
*Audio recorded interviews were transcribed verbatim and a thematic analysis was conducted*A phenomenological methodological approach informed data analysis*Interview transcripts were systematically reviewed to identify emergent themes within the data*Transcript data was analyzed using the qualitative analysis software Nvivo *Individual accounts were grouped into discrete categories which described common themes of experience*Regular member checking during analysis helped guide interpretation of findings
*20 gay and queer identified menwere purposefully sampled from the larger Momentum Health Study cohort for a diversity of sero-status, age, income, race/ethnicity, and area of residence. *Participants were eligible for inclusion in the cohort who were16 years of age or older, living in the Greater Vancouver area, who had been sexually active with other men within the previous 6 months, and were able to do a questionnaire in English*Ages ranged from 20s to 60s, participant median age category: 20s
RESULTSThe perspectives of gay, bisexual men in this study indicate that:Theme 1: Substance use is a social activity, taking place in gay social spaces Theme 2: Use of drugs and alcohol facilitates social-sexual inclusionTheme 3: Use of substances changes over the lifetime
Participants described substance use as a social activity and sites of consumption as social spaces. A distinction was made between types of substance use, with certain drugs being deemed casual while others were party or hard. Type of substance use is related to social sub-group participation, and social setting. Some substances are more available in certain settings, such as harder drugs at house parties.
*Beyond talking about this data in terms of HIV risk, I also wanted to highlight elements of resiliency that the men I interviewed spoke to.*Some participants described using drugs and alcohol as a way of participating in gay communities*Using drugs, and especially MDMA, created a space of social participation and community connectedness
*Use of drugs and alcohol facilitated entry into and participation in social-sexual scenes within local gay communities*Drugs and alcohol are used as a strategy for coping with social pressure or cultural anxiety, making people feel more comfortable with themselves in gay social settings.*Participants described using alcohol and drugs acting as a facilitator of social inclusion*Someparticipants narratives identified substance use as necessary for entry into gay social spaces, and some an inability to be in certain social settings without consuming alcohol or drugs.
The use of substances, including specifically alcohol affected people’s sex seeking behavior, both making potential sexual partners seem more desirable and making it easier to pursue a sexual encounter
Substance use changes across the lifetime. Narratives indicated that alcohol and drug use is an integral part of the gay community for all members at some point in their livesPeople’s attitudes and behaviours around substance use will shift over their lifetimes, with more substance use among younger men, who may experience cultural pressures more acutely.
While participants accounts identified drugand alcohol use as part of gay men’s lives generally, substance use was described as more common for those recently coming out or entering gay social-sexual scenes for the first time. *Drugs and alcohol was described as a means of coping with the stresses of coming out as well as the intragroup stresses of initiation into gay communities*Motivations for using drugs and alcohol changed over the course of gay men’s lives, as competing social, professional or financial pressures supersede those that prioritize substance use, and as men aged past the coming out period in their lives
*Risk environment*Gay men’s accounts suggest that substance use takes place within what Tim Rhodes and collegues term a complex HIV risk environment, in which complex social, economic and physical level factors interact to produce individual drug and alcohol use and related health risk and outcomes*LifecourseThe findings demonstrate that substance use changes over time for gay men, affected by age and historical time, particularly the ‘coming out’ periodEffective health prevention and promotion interventions must take into account that substance use changes over the life course for gay men
Where do we go from here?1) Future research plans include analyzing these qualitative data in conjunction with relevant psychosocial data from the Momentum behavioural survey. We have eventlevel data from the egocentric sexual network matrix documenting last five previous partners, and associated substance use in 2 hours prior to and during sexIt would also be interesting to look at these qualitative findings in relation to quantitative data on mental health variables, sexual-sensation seeking scales, and social connectedness measures2) Potential for further qualitative exploration of how the interaction between substance use and social coping changes over time during gay men’s lives, and its relationship to HIV transmission risk-better understand differences in substance use patterns by birth cohort, relationship to minority stress/coping/coming out timeline, and how this changes over historical time
*Funding agencies: NIH and CIHR*Research Program coordinated by the BC Centre for Excellence in HIV & AIDS housed at St. Paul’s Hospital*Academic Investigators & Governing Research Ethics Councils: UBC, SFU and University of Victoria