Background Breast cancer is the most common form of cancer for women. Sexual health, which is important for women's well-being, can be affected by breast cancer and its treatment. Nurses working with sexual health requires that their own attitude to sexuality is positive and respectful in order to safeguard the well-being of their patient. Aim The aim of this literature study was to describe women's experiences of sexual health in relation to breast cancer. Method The results of this literature-based study include eleven qualitative empirical and scientific articles. The method used for this literature study was an analysis of qualitative research based on a five-stage model. Results The results of this literature study showed that women's sexual health can be affected by breast cancer and its treatment. Two themes emerged: Changes in the sexual life and Changes of body image. Four sub-themes emerged: To experience decreased sexual desire and activity, To experience physical and emotional distress, Feelings of less femininity and Being ashamed of the body. Conclusion Breast cancer and its treatment have physical and emotional impact on women's sexual health. / Bröstcancer är den vanligaste formen av cancer hos kvinnor i världen och i Sverige drabbas cirka 8000 kvinnor varje år. Syftet med denna litteraturstudie var att beskriva kvinnors upplevelse av sexuell hälsa i samband med bröstcancer. Sexuell hälsa definieras som ett välbefinnande och kan uppnås trots sjukdom. Elva vetenskapliga och empiriska artiklar som svarade mot syftet söktes fram i tre olika databaser och analyserades genom att jämföra likheter och skillnader i deras resultat. Resultaten sammanställdes och två huvudteman och fyra underteman växte fram. Det första huvudtemat var förändring av det sexuella livet, med underteman att uppleva minskad sexuell lust och aktivitet och att uppleva fysiska och emotionella besvär. Det andra huvudtemat var förändrad kroppsbild, med underteman att känna sig mindre kvinnlig och att skämmas över sin kropp. Resultat visade att många kvinnor upplevde minskad sexlust efter kirurgi, cytostatika och hormonbehandling och att den intima relationen påverkades. Fysiska besvär så som torra slemhinnor i vaginan och smärta vid samlag var vanligt vid behandlingen. För många kvinnor var sex en viktig faktor i deras intima relation och de kände sig hjälplösa när de intima relationerna begränsades. Många kvinnor upplevde brösten som en del av kvinnan och att bröstcancern var ett angrepp mot deras kvinnlighet. Många kvinnor upplevde att de hade förlorat en bit av sig själva och många skämdes över sin förändrade kropp. Resultatet visade också att många kvinnor upplevde svårigheter med att tala om sin sexuella hälsa. Slutsatsen är att bröstcancer och dess behandling har en betydande inverkan på många kvinnors sexuella hälsa. Sjuksköterskan möter ofta dessa kvinnor i olika vårdsammanhang och behöver därför ha kunskap om kvinnornas upplevelser för att kunna möta deras behov av stöd.

By using critical discourse as a method three discourses have been exposed as active in the advicing articles published on the website of Amelia, a Swedish magazine for women. The three discourses are the neoliberalist, postfeminist and the heteronormative. The research shows, by using the theories of governmentality and the heterosexual matrix, that these discourses collaborate to form the advices that is being given around women’s sexuality and their sexual health on the website of Amelia. The discourses that is being exposed in the research can be described as they are imposing guilt upon women. It also poses women as the solely responsible for the relationship to work and the women are as well expected to conform to their partner, which often is described as a man. This implies that in the advicing articles of Amelia, women and men are not allocated the same position in a relationship. Indicating that it exists an inequal relation in the context, where women are subordinated to men. Finally, the research can contribute to an understanding of the ambiguous expectations existing regarding women´s sexuality.

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Since 2018, the Provincial Government of Ontario has begun transformation within the public health sector, which emphasizes the increased application of a population health approach. The goal of this transformation is to maximize the contribution of public health in improving the health of Ontarians by moving from a reactive to a proactive model that is focused on prevention. To support this transformation the standards that guide the programs and services provided through public health units underwent modernization in 2018. The emphasis of the modernized standards is about expanding the scope and reach of public health, by supporting the role of population health in the development and delivery of programs and services. This thesis used quantitative data to examine the extent that a population health approach was implemented in sexual health programs and services in public health units across Ontario. Qualitative data was gathered to explore public health managers’ and supervisors’ perceptions of barriers and facilitators that influenced the implementation of this approach. A mixed-methods study was used to determine if the qualitative findings helped our understanding of the quantitative results. This multi-phase mixed methods study involved four sequential phases. Phase 1 and 2 involved instrument development which included a literature review, input from experts, and testing; in phase 3 instrument administration was conducted; and phase 4 involved interviews with sexual health managers and supervisors. A qualitative descriptive approach was used as part of phases 1, 2, and in phase 4 for data collection and analysis using focus groups and semi-structured interviews with sexual health managers and supervisors delivering sexual health programs and services. The instrument was developed based on Health Canada’s Population Health Key Elements Template with multiple activities listed under each element and was administered in phase 3. Descriptive statistics were used to analyze this data. The Consolidated Framework for Implementation Research (CFIR) guided the development of the interviews for phase 4 and the qualitative analysis. Quantitative data showed that some population health elements were implemented more than others. For example, Address Determinants of Health and their Interactions was implemented by most health units while Employ Mechanisms for Public Involvement was implemented by a few. Qualitative data revealed that most factors influencing the implementation of a population health approach fit within CFIR’s domains of the inner and outer setting. For example Address Determinants of Health and Their Interactions and Focus on the Health of Populations were highly implemented by health units, due to factors such as organizational culture, and access to data. On the other hand, the elements Collaborate Across Sectors and Levels and Employ Mechanism for Public Involvement were less often implemented which were influenced by resources (e.g., human and financial) that were available to the health unit. This study fills an existing gap in the research and offers evidence of how to implement a population health approach within sexual health programs and services in public health. / Thesis / Candidate in Philosophy / Traditionally, sexual health programs and services provided by Ontario public health units have focused on providing services for individuals, such as clinic services. More recently, there has been a shift in public health to apply a population health approach, which focuses attention on addressing the broader social and economic influences on health. This is viewed as important to improving the health of communities and disadvantaged groups within those communities. It is not known to what extent this shift in the approach to sexual health services or programs is being implemented within Ontario public health units. Therefore, it is important to understand how public health units have moved towards a broader approach in sexual health and what challenges they have faced. This thesis examines how much sexual health programs and services have implemented a population health approach within sexual health programs and services in public health units. It also explores what helped or hindered this change. Some key population health activities (e.g., using evidence to plan programs, offering clinic services) have been implemented but not all (e.g., working with community partners, participating in primary research). An example of a barrier to implementation is having a lack of resources (human and financial). New knowledge from this study can support public health organizations to apply a broader population health approach in sexual health programs and services.

Access to health care services is critical to both personal health outcomes and health equity within a community. While non-monogamous behavior is widespread, stigma surrounding consensual non-monogamy can create barriers to health care access. This research outlines the experiences of non-monogamous women during sexual health care visits, how class acts to modify those experiences, the barriers to health care access that they encounter, and the adaptive strategies they employ. The sample for this research was 23 consensually non-monogamous women. Participants were contacted through online support groups, message boards, and snowball sampling. In-depth interviews about their sexual health care experiences were conducted. Interviews were recorded, transcribed, and analyzed for themes related to the intersection of non-monogamy and health care experiences. The interactions between health care professionals and non-monogamous women, whether or not those women disclose their non-monogamous status, were often perceived as stigmatizing. Increased class status, both of participant and of provider, was described as increasing experiences of stigma and barriers to care. The information provided by this research may be used to better understand, and thus improve, the barriers health care access experienced by non-monogamous women. Suggestions given by the participants for improving their health care access and decreasing experiences of stigma are included.

Thesis (M.S.)--Boston University / PLEASE NOTE: Boston University Libraries did not receive an Authorization To Manage form for this thesis or dissertation. It is therefore not openly accessible, though it may be available by request. If you are the author or principal advisor of this work and would like to request open access for it, please contact us at open-help@bu.edu. Thank you. / 2031-01-01

Endocrine disrupting chemicals (EDCs) of exogenous origin refer to compounds that disrupt the regular functioning of the endocrine system responsible for maintaining hormonal balance in the body. These disruptors are prevalent in our surroundings and are present in various consumer products, including cosmetics, plastics, and pesticides. The means of action vary depending on the specific chemical and target hormone receptor. EDCs can mimic, obstruct, alter hormone production, transport, and metabolize, leading to a range of health risks such as metabolic disorders, immune system dysfunction, and endocrine-related cancers, as well as reproductive abnormalities. Interference with the production, transport, and function of hormones responsible for the menstrual cycle and pregnancy, including estrogen, progesterone, and luteinizing hormone, leads to reproductive problems. EDCs also cause permanent alterations in the development of the female reproductive system during fetal and early childhood stages. Some of the most widely known EDCs include bisphenol-A (BPA), phthalates, and polychlorinated biphenyls (PCBs), which have been found in human tissue and fluids, such as urine and breast milk. Researchers continue to discover and analyze EDC prevalence and the effects on human health. While efforts have been made to reduce exposure to these compounds, they remain prevalent in the environment. There are lifestyle interventions that can help with the prevention and exposure to EDCs. Such interventions include healthier eating habits, avoiding the use of plastic containers containing EDCs, choosing safer personal care products, filtering drinking water, reducing exposure to air pollution, and supporting policies and regulations that promote the use of safer chemicals.

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Over the last decade, the incidence rates of many sexually transmitted infections (STI) have been on the rise, especially amongst young adults. Popular Canadian media outlets have speculated that the reason behind these increases is the use of mobile dating applications which foster romantic and sexual connections. This cross-sectional study assesses whether students who use mobile dating apps are more or less likely to have been diagnosed with an STI in the previous 12 months and engage in risky sexual behaviour, compared to students who did not use mobile dating apps in the previous 12 months. An anonymous online questionnaire was used to collect data from 965 study participants currently enrolled at an Ontario university. The survey required participants to self-report STI testing behaviour and diagnoses, as well as sexual behaviours, including number of sexual partners, relationship type, condom use, substance use and sex work. I found that Ontario university students who used dating apps in the previous 12 months were more likely to have a greater number of sexual partners in the previous year (p<0.05), have multiple concurrent sexual partners (OR=10.72, 95% CI: 6.10-18.84), frequently use alcohol (OR=3.94, 95% CI:2.17-7.14) and cannabis (OR=3.36, 95% CI:1.45-7.78) in combination with sexual activity, and were more likely to have been tested for STIs in the previous 12 months (OR=2.25, 95% CI: 1.73-2.94) compared to non-dating app users. However, mobile dating app users were not more likely to have been diagnosed with an STI in the previous 12 months compared to non-dating app users. / Thesis / Master of Public Health (MPH) / This study investigated whether students who use mobile dating apps are more or less likely to engage in risky sexual behavior, and to have been tested for and diagnosed with a sexually transmitted infection (STI) in the previous 12 months, compared to students who do not use mobile dating apps. An anonymous online survey was used to collect data on sexual behaviour and STI history from Ontario university students. I found that Ontario university students who used dating apps in the previous 12 months were more likely to have a greater number of sexual partners in the previous year, have multiple concurrent sexual partners, use alcohol and cannabis in combination with sexual activity, and get tested for STIs more frequently than non-dating app users. However, mobile dating app users were not more likely to have been diagnosed with an STI in the previous 12 months compared to non-dating app users.

Student voice could improve the effectiveness of sex education curricula, student input, however, is generally limited or totally absent in sex education development. This dissertation explores student content preferences in sex education curricula and how school officials can incorporate student feedback to ensure content is relevant, relatable, and reliable. Results also show that adolescents are in favor of receiving social media-delivered sex education from local health departments. To build an adolescent following and greater awareness about SNS accounts that disseminate sex education, participants suggested LHDs 1) inform intended audiences about products by building offline connections 2) use promotions to create awareness 3) emphasize price during giveaways, publicize free services and 4) use the right people to motivate others to follow accounts.