scholarly journals Cultural factors and sexual dysfunction in clinical practice

2013 ◽  
Vol 19 (2) ◽  
pp. 144-152 ◽  
Author(s):  
Vishal Bhavsar ◽  
Dinesh Bhugra
Keyword(s):  
Sexual Dysfunction ◽  
Cultural Values ◽  
Help Seeking ◽  
Epidemiological Data ◽  
Explanatory Models ◽  
Cultural Factors ◽  
Child Rearing ◽  
Sex Partners ◽  
Therapeutic Engagement

SummaryAttitudes to sex and the perceived role of sexual activity are very strongly influenced by cultural values. Culturally determined gender roles influence relationships between different-sex partners, and cultural values affect attitudes towards sexual variation. Cultures define what is deviant and from where help is sought. Through differing patterns of child-rearing, cultures also affect individuals' cognitive development, world views and explanatory models of emotional distress. It is critical that clinicians are aware of the role of culture in defining sexual dysfunction and how cultural factors can be used in initiating treatment as well as in therapeutic engagement and alliance. Although epidemiological data on prevalence of sexual dysfunction across cultures are scanty, it is likely that prevalences vary, as will pathways into care and patterns of help-seeking. In this article we discuss the potential impact of culture on sexual dysfunction, and issues that clinicians, whether in specialist or in general services, need to be aware of in assessing and treating patients who present with sexual dysfunction.

Dyspareunia, Signs of Epithelial Disruption, and HIV Serostatus in Female Sex Workers and Men Who Have Sex With Men in Nairobi: an Observational Study

2021 ◽  
Author(s):  
Bastian Fischer ◽  
Walter Godfrey Jaoko ◽  
Elvis Kirui ◽  
Bernard Muture ◽  
Isaac Madegwa ◽  
...  
Keyword(s):  
Sexual Dysfunction ◽  
Hiv Infection ◽  
Sex Workers ◽  
Sexual Debut ◽  
Sex Partners ◽  
Hiv Status ◽  
Intravaginal Practices ◽  
Sex With Men ◽  
Epithelial Disruption

Abstract Background: This study investigated HIV infection risk in men who have sex with men (MSM) and female sex workers (FSWs) by analysing signs of anal and vaginal epithelial trauma. It reconsidered the unique role of sexual abstinence for HIV seroconversion from a previous case-control analysis on FSWs in Nairobi who acquired HIV after previously fulfilling criteria of HIV resistance. The approach was based on a similarly unique role of intercourse frequency for anal dyspareunia. We considered confounding behavioural and individual HIV infection risks among the sex workers, who also assessed factors influencing discomfort and pain during sex from a subjective perspective. Methods: At two key population facilities in Nairobi, 322 FSWs and 231 MSM provided data on HIV infection status, sexual dysfunction, intercourse frequency and abstinence behaviour. Additional data addressed sexual debut, relationship status, lubricants, foreplay, the number of sex partners, condom use, group and anonymous sex, vaginal births, intravaginal practices, sex toys, other sexually transmitted infections, alcohol and drug use. Statistical tests included t-tests for the equality of means for abstinence gaps and intercourse frequencies, the number of sex partners, vaginal births, and age of sexual debut. Non-parametric tests were used to compare HIV status and the ordinal variables of sexual behaviour, individual factors, dyspareunia and signs of trauma scores. Subjective assessments of variables for sexual dysfunction were given as percentages of the assessment options. Results: Among FSWs, significant associations were found between HIV status and the longest abstinence gap for vaginal intercourse in the previous month, early sexual debut, foreplay, having anonymous partners, intravaginal practices, drugs and alcohol use, and all the sexual dysfunction or epithelial disruption signs. No significant association between HIV status and sexual dysfunction variables or sexual abstinence gaps could be found in the MSM sample. FSWs agreed that steady partnerships, regularity of intercourse, foreplay and lubrication or artificial lubricants alleviate discomfort and painful intercourse. Conclusions: Dyspareunia and epithelial trauma signs were highly prevalent in FSWs and MSM, indicating considerable limitations to sexual health. Complaint levels were positively associated with HIV infection, suggesting that reducing epithelial disruption may be a novel HIV prevention approach.

The role of culture in early interventions

2019 ◽  
pp. 17-26
Author(s):  
Antonio Ventriglio ◽  
Dinesh Bhugra
Keyword(s):  
Family Support ◽  
Psychiatric Symptoms ◽  
Explanatory Models ◽  
Intervention Strategies ◽  
Idioms Of Distress ◽  
Critical Threshold ◽  
Diagnostic Categories ◽  
Therapeutic Engagement ◽  
Marriage Problems

Cultures play a major role in shaping people’s behaviours and attitudes. They also shape individuals’ social and cognitive development, and the idioms of distress they use and the pathways into care they take. In addition, cultures shape the causation, precipitation, and perpetuation of psychiatric symptoms which may not always fit neatly into diagnostic categories. Cultures define what is normal and what is abnormal or deviant. This, in turn, will influence how diseases are recognized and what early intervention strategies are put into place. For psychoses, the untreated duration of mental illness can last for years depending upon the resources available and the models of illness. The preclinical state is often a non-state and offers a critical threshold, and, according to resources, cultures will often dictate, in subtle ways, what the threshold is in order to develop psychiatric services. In many cultures—depending upon the available services and the personality of individuals, as well as the level of family support—a risk assessment may well contribute to stress and may also affect the likelihood of getting health or other insurance. It may also lead to personal difficulties, such as marriage problems. Clinicians need to remember that cultural differences in communication between doctors and patients may well contribute to tensions and poor therapeutic engagement if the patients’ or their carers’ views and explanatory models are not taken into account.

What next?

2021 ◽  
pp. 649-650
Author(s):  
Dinesh Bhugra
Keyword(s):  
Health Care ◽  
Cultural Competence ◽  
Curriculum Development ◽  
Cultural Values ◽  
Health Professionals ◽  
Explanatory Models ◽  
Service Planning ◽  
Therapeutic Engagement ◽  
Planning Development ◽  
Culturally Appropriate Services

Migration occurs for a number of reasons and there are various stages and types of migration. These experiences are heterogenous and require different approaches. This chapter includes recommendations for service planning, development, and delivery for migrants’ health care. It is important that all health professionals are suitably trained in cultural competence. Explanatory models held by the patients, their carers, and families must be acknowledged and not denigrated. Researchers need to be culturally sensitive, whereas policymakers have legal and ethical obligations to provide adequate resources to deliver accessible and culturally appropriate services. The specific nature of migration and experiences carry with them specific challenges in therapeutic engagement for a number of reasons, which must be understood. Cultural values, nuances, and differences must be recognized and acknowledged. Specific recommendations are made for service planners, clinicians, policymakers, and researchers. Suggestions are made for curriculum development in cultural competence.

Therapeutic encounters

2018 ◽  
Author(s):  
Dinesh Bhugra ◽  
Antonio Ventriglio ◽  
Kamaldeep S. Bhui
Keyword(s):  
Healthcare Professional ◽  
Help Seeking ◽  
Economic Status ◽  
Explanatory Models ◽  
Primary Language ◽  
Therapeutic Interaction ◽  
Therapeutic Engagement ◽  
Help Seeking Behaviour ◽  
Therapeutic Encounters ◽  
Social Sectors

When individuals experience distress, they try to make sense of this and, in the first instance, may seek help from personal, folk, or social sectors. If these interventions do not work, they will contact the professional sector. It is likely that the healthcare system will direct their help-seeking behaviour. In addition, the explanatory models they have will direct them into help-seeking accordingly. Once therapeutic interaction has started, the explanatory models of the individuals, their families, carers, and those of the clinician will affect therapeutic engagement. Race, gender, social status, education, and economic status will all affect explanatory models and where individuals seek help. If different from that of the patient, the culture of the clinician will affect therapeutic alliance. Working with interpreters requires training if the primary language of the patient differs from that of the healthcare professional.

Cultural variations in LGBT issues

2016 ◽  
Vol 33 (S1) ◽  
pp. S70-S70
Author(s):  
D. Bhugra
Keyword(s):  
Cultural Values ◽  
Coming Out ◽  
Help Seeking ◽  
Pathways To Care ◽  
Sex Partners ◽  
Cultural Variations ◽  
Therapeutic Adherence ◽  
Lgbt Issues ◽  
Number Of Factors ◽  
Competing Interest

Culturally determined gender roles influence relationships between different-sex partners, and cultural values affect attitudes towards sexual variation. LGBT patients face stigma, discrimination and prejudice and have specific issues related to a number of factors, in addition to the nature of sexuality. These factors affect help-seeking and also cause delays in pathways to care. In specific instances, gay, lesbian and transgender individuals show higher than expected levels of psychopathology. The clinician's attitudes affect therapeutic adherence and therapeutic alliance. LGBT patients may also have specific issues related to “coming out” and this may influence their relationships directly and indirectly. Furthermore, they may experience a reluctance to share their sexual orientation. Matching of therapists may offer one way forward but this is not always possible, and may not work due to a number of reasons.Disclosure of interestThe author has not supplied his declaration of competing interest.

scholarly journals The Role of Socio-Cultural Factors in Informal Cross-Border Flows between Borderland Communities of Nigeria and Niger Republic: The Case of Illela-Birni N’konni International Border Communities

2018 ◽  
Vol 6 (2) ◽  
Author(s):  
Abubakar Liman
Keyword(s):  
Cultural Values ◽  
Cultural Factors ◽  
Cross Border ◽  
International Borders ◽  
Border Communities ◽  
Borderland Communities ◽  
Security Network ◽  
International Border

This study examines the contributions of socio-cultural factors towards promoting informal cross-border flows between international borders dividing Nigeria and Niger republic. It did so by focusing on the micro zone of Illela (Nigeria) and Birni N’Konni (Niger republic).The study discovered that, despite colonial division, both communities still retain their socio-cultural values and still employ it in fostering their relations outside the official circle. The research concluded that if adequately utilised, informal cross-border flows between the two communities can be used to build a security network beyond the official realm.

scholarly journals The role of cultural values in consumers' evaluation of online review helpfulness: a big data approach

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Raffaele Filieri ◽  
Marcello Mariani
Keyword(s):  
Big Data ◽  
Cultural Values ◽  
Information Overload ◽  
Online Reviews ◽  
Cultural Factors ◽  
Third Party ◽  
Consumer Reviews ◽  
Content Type ◽  
Review Helpfulness

PurposeOnline consumer reviews are increasingly used by third-party e-commerce organizations to shed light on the positive and negative sides of the brands they sell. However, the large number of consumer reviews requires these organizations to shortlist the most helpful ones to cope with information overload. A growing number of scholars have been investigating the determinants of review helpfulness; however, little is known about the influence of cultural factors in consumer's evaluation of review helpfulness.Design/methodology/approachThis study has adopted Hofstede's cultural values framework to assess the influence of cultural factors on review helpfulness. We used a sample of 570,669 reviews of 851 hotels published by reviewers from 81 countries on Booking.com.FindingsFindings reveal that reviewers from cultural contexts that score high on power distance, individualism, masculinity, uncertainty avoidance and indulgence are more likely to write helpful reviews.Originality/valueThis is one of the first cross-cultural studies in marketing using a big data approach in examining how users of reviews from different countries evaluate the helpfulness of online reviews.

Asiana Airlines Flight 214

2014 ◽  
Vol 4 (2) ◽  
pp. 113-121 ◽  
Author(s):  
Stephanie Chow ◽  
Stephen Yortsos ◽  
Najmedin Meshkati
Keyword(s):  
Human Factors ◽  
Aviation Safety ◽  
Cultural Factors ◽  
Vital Role ◽  
Cultural Issues ◽  
Flight Crew ◽  
Pilot Performance ◽  
Engineering Designs ◽  
Flight Deck

This article focuses on a major human factors–related issue that includes the undeniable role of cultural factors and cockpit automation and their serious impact on flight crew performance, communication, and aviation safety. The report concentrates on the flight crew performance of the Boeing 777–Asiana Airlines Flight 214 accident, by exploring issues concerning mode confusion and autothrottle systems. It also further reviews the vital role of cultural factors in aviation safety and provides a brief overview of past, related accidents. Automation progressions have been created in an attempt to design an error-free flight deck. However, to do that, the pilot must still thoroughly understand every component of the flight deck – most importantly, the automation. Otherwise, if pilots are not completely competent in terms of their automation, the slightest errors can lead to fatal accidents. As seen in the case of Asiana Flight 214, even though engineering designs and pilot training have greatly evolved over the years, there are many cultural, design, and communication factors that affect pilot performance. It is concluded that aviation systems designers, in cooperation with pilots and regulatory bodies, should lead the strategic effort of systematically addressing the serious issues of cockpit automation, human factors, and cultural issues, including their interactions, which will certainly lead to better solutions for safer flights.

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