Psychophysical Fitness Research Articles

Roadside inspections, traffic events and traffic accidents from 2010–2022 in the experience of the Institute of Forensic Research as a consulting body in light of the proposed thresholds for the states of ‘after use’ and ‘under the influence’ for THC = Kontrole, zdarzenia i wypadki drogowe z lat 2010–2022 w praktyce opiniodawczej Instytutu Ekspertyz Sądowych w świetle propozycji progów „po

Road traffic safety depends largely on the psychophysical fitness of drivers. Apart from ethyl alcohol, this efficiency is influenced by many other factors, including: presence in the blood of the so-called substances that act similarly to alcohol, and cannabinols constitute one of the most popular groups of these substances. The paper presents statistics on delta-9-tetrahydrocannabinol (THC) – the main psychoactive ingredient of cannabis detected in the blood of drivers subjected to 7269 road inspections and involved in 4697 road events and accidents in the years 2010–2022 throughout Poland. Based on the results obtained, it was found that THC is present in the blood of 25–61% of roadside inspection cases, and in the case of road incidents and accidents, 5–15% of drivers have THC in a concentration equal to or higher than 1 ng/ml. The data in the charts are given in relation to two THC concentration ranges: 1.0–2.5 ng/ml and above 2.5 ng/ml (the value proposed as the limit of the state “after use” and “under the influence” of THC) and in relation to concentration ranges based on the THC elimination curve in human serum. The study did not distinguish between chronic or acute participants and occasional participants. It was based on THC and THCCOOH concentrations. The analyzes were performed using the enzyme-linked immunosorbent method (ELISA) and confirmatory methods such as liquid and gas chromatography coupled with mass spectrometry, in which the limit of quantification of 1 ng/ml was in accordance with the applicable requirement contained in the Regulation of the Minister of Health of July 16, 2014 on the list of similarly acting agents to alcohol and the conditions and method of conducting tests for their presence in the body.

Forming professional reliability of railway power supply specialists

The high level of technological, technical, logistics, organizational and economic changes occurring in the railway industry determines the trajectory of development of professional training of specialists. The priority of safety issues in the context of the complex influence of occupational risks actualizes the scientific understanding of the problem associated with the substantiation of effective characteristics that allow one to withstand the cumulative influence of occupational risks, effectively develop in the professional community, maintaining a stable equilibrium state of the “man – technology – production environment” system. Analysis of research and methodological literature, experience of professional applied physical training at railway universities of the Russian Federation made it possible to identify areas of research aimed at bringing the indicators of psychophysical fitness of specialists into line with the conditions for the implementation of their professional activities. In the structure of professional competence of railway transport specialists, researchers highlight readiness for professional activity. At the same time, in today’s rapidly changing conditions of the professional world, it is necessary to form not only the current (basic) professionally significant qualities of a future specialist, but also to create conditions for the development of potential professional abilities, which will allow effectively confronting risk situations and ensuring the formation of self-regulation mechanisms. The quality that ensures the mobilization and activation of available funds, reserves, sources to achieve set goals, solve problems, and unlock opportunities in a certain area is reliability. In the article it is shown that convergence of play with learning determines the developmental effect of the game method. The complex nature of the gaming method allows to form indicators in the structure of professional reliability of railway power supply specialists.

САМООЦЕНКА ЗДОРОВЬЯ И РЕСУРСНОГО СОСТОЯНИЯ У ДЕВУШЕК, ОБУЧАЮЩИХСЯ В МЕДИЦИНСКОМ ВУЗЕ

A comprehensive study of the health status of girls studying at Tyumen State Medical University showed a high level of awareness about risk factors for developing diseases. Correlations between the lifestyle of girls and awareness of the main and additional risk factors for the development of chronic non-communicable diseases and infections. no sexually transmitted diseases have been identified. The low level of stress resistance in girls is due to lack of time and academic workload, including physical education classes. Chronotype - late evening or early morning did not affect sleep quality and stress resistance in the study group. All the girls had difficulty waking up in the morning and fell asleep late. The sleep deficit was compensated by waking up late on weekends. During the holidays, the rhythm of work and rest changed, shifting to late falling asleep and late waking up in the morning, but almost all the girls felt rested and ready to continue their studies in the new semester. According to the questionnaire and food diary, the diet of most girls was dominated by easily digestible carbohydrates and chicken meat. The diet was unbalanced and irregular, 15.6% of girls were overweight, and 12.8% were underweight. All girls studied in the main or special groups in physical education, but only 22.7% of students led an active lifestyle and were fond of sports, choreography or dancing, and visited fitness studios or a gym. Among girls, a small group was identified with an average degree of dependence on nicotine according to the Fagerström test – 4.7%. More than half of the survey participants have experience of drinking alcohol. Overall, we didn't notice the characteristics typical of Generation Z. It was not possible to identify a single girl who, in terms of psychophysical fitness, psychological and social well-being, met the definition of a healthy person by the World Health Organization.

Sustainability of the hookah diving fishery in Turkey

Hookah diving is a traditional fishing method based on the hand collection of commercial benthic organisms. Fishers continue their profession without paying attention to their physical health and psychophysical fitness. Ignoring the diving safety and decompression rules underwater, using improvised diving systems, and economic concerns carry risks that can result in death. The long-term sustainability of work depends on nations’ ability to control fishing practices and promote good management. This study discusses the current situation of hookah divers in Turkey based on official statistics from the ministry and face-to-face interviews with hookah divers. The data were subjected to strengths, weaknesses, opportunities, and threats (SWOT) analysis and synthesised with the literature for strategic analysis. The sector’s contribution to the national economy, economic satisfaction of divers, and supporting rural employment were evaluated as strengths. Lack of expertise in the professional career and complex laws were identified as threats that require urgent solutions. Multidirectional national efforts are needed for sustainable fishing, including stakeholder networking, diving safety, hookah equipment, underwater fishing strategies, training curricula and professional career development. Our findings offer strategic and planning approaches for the sustainable development of hookah diving in Turkey.

School Gardens in Poland – Rediscovered Places

School gardens have been present in the educational space of the Polish school for many years. In recent decades, however, they have ceased to be appreciated. Efforts have been made to modernize laboratories, they have been equipped with measuring instruments, digital devices and multimedia equipment. A natural laboratory, which a garden in fact is, has become a symbol of the past. It remained only in few schools, performing rather an aesthetic function, less often didactic or educational one. The present article depicts a historical outline, shows earlier and currently noticed possibilities of using school gardens in Poland. An analysis of previous studies on gardens is presented as well. A contemporary design of a school garden was proposed to prepare students of pedagogical faculties for activities in the garden with children. School gardens may contribute to the prevention of “nature deficit” (Louv 2014, 54), they may give a sense of closeness to nature also in urban realities[1]. M. Vogt-Kostecka notes that the fear of dirt, wind and ticks limits children's free play in a meadow and in a forest. Limited access to nature is particularly visible among urban children (Vogt-Kostecka 2017, 11). Gradually, the view of school gardens has been changing and their therapeutic potential (hortitherapy) is noticed. [1] According to R. Louv, the nature deficit is manifested in problems with concentration of attention, hyperactivity, and reduced psychophysical fitness.

Evaluation of Psychophysical Fitness in Drivers over 65 Years of Age

Background: The deterioration of cognitive and psychophysical ability associated with aging has an effect on road safety, especially in the driving of vehicles. The current study’s main objective is to evaluate the psychophysical aptitudes in drivers over 65 years of age in a sample of drivers in Spain. Methods: The sample was formed of a total of 1663 drivers who attended a Driver Recognition Center. The evaluation of their psychophysical aptitudes was carried out following the Medical-Psychological Exploration Protocol for Driver Recognition Centers, edited by the Ministry of Health and the General Directorate of Traffic. Results: The results show increased restrictions in the evaluation of driving ability with age, which are especially significant after 75 years of age. Regarding sex, 70.1% of women have an approved evaluation, compared to men aged between 65–69, although from 69 onwards, the percentage of approved women decreases significantly. The loss of visual capabilities and poor performance in psycho-technical tests are the main causes associated with an evaluation with restrictions, with the number of restrictive conditions increasing with age. Conclusions: There is an increase in the number of cases with age-related restrictions, especially in the case of women and ophthalmologic-related problems, although the majority of drivers over 65 years old continue driving, thus continuing with a practice that has been related to the well-being and quality of life of older adults.

ASSESSMENT OF SUPERFICIAL SENSITIVITY IN SENIOR POPULATION AFTER PARTICIPATION IN THE TAILORED PROGRAM OF BIOPSYCHOSOCIAL REHABILITATION IN THE LIGHT OF GERONTO-PROPHYLAXIS

Positive attitudes to old age and successful ageing are the trends in contemporary gerontology. Promotion of an active period of old age, the maintenance of cognitive and physical abilities in seniors as well as active participation in various activities and social roles are challenges and tasks for geronto-prophylaxis and psychosocial rehabilitation. The process of ageing, apart from its effect on the body systems and functions has also a marked effect on the perception of sensory stimuli. Sensitivity to touch decreases with age. The aim of the presented study was to show the effect of a tailored program of sensorimotor activation in seniors with different fitness levels on changes in touch sensation in the area of the arms. The main cognitive goal of the presented research project was an assessment of sensory stimuli perception on the completion of the biopsychosocial rehabilitation program using an esthesiometer.The sample included 51 seniors from two care units, aged 77.52 9.51 years. The assessment of superficial sensitivity perception in- volved the two-point discrimination approach using a wheel esthe- siometer (Touch Test-Two Point Discriminator). The study was conducted immediately before and after the application of the rehabilitation program.A significant improvement in sensory perception was noted on the finger bulbs of both hands within the studied senior population, re- gardless of the levels of psychophysical fitness and the social support center where they stayed. The following average values, corresponding to the changes in both hands, were obtained from: 6.6mm to 4.45 in the seniors from the Social Care Unit and from 6.35 to 4.2 in the seniors from the Senior Support (p<0.05). According to the norms for touch sensation (2-point discrimination) for the hand, before the start the level of sensation was satisfactory, below the norm limit, while after rehabilitation this level turned out to be good.The proposed program of biopsychosocial rehabilitation (activation of seniors undergoing hand treatment) fulfilled the settled cognitive and practical goals and was welcomed with great satisfaction and engagement by the beneficiaries In the case of senior rehabilitation the area of geronto-prophylaxis is oriented to the stimulation and improvement of sensory stimuli perception in the hands, using various manual forms of movement.

Inclusive physical education program of schoolchildren with autism spectrum disorders

Purpose: The purpose was to develop an inclusive physical education program for schoolchildren with ASD and experimentally test its effectiveness.
 Materials and methods: An inclusive physical education curriculum for children with ASD was made up and incorporated into the process of physical education in secondary schools. At the beginning and the end of the pedagogical experiment, 12-year-old children were tested in the experimental (involved in the author's program, n=9) and control groups (involved in the traditional curriculum, n=11). The indicators of psychophysical fitness of children were determined according to the results of 19 test exercises. The reliability of the differences was determined by the Mann-Whitney U test. 
 Results: Under the influence of the author's program, physical fitness of children of the experimental group improved significantly. Whereas the trend towards improving almost all indicators of the physical fitness of children with ASD in the traditional program has not been confirmed statistically. The traditional physical education program was most effective in promoting flexibility (inclinations forward) and coordination (passing and catching a ball against a wall) in children with ASD.
 Conclusions: The author's program was proven to be significantly more effective than the traditional ones in the formation of the strength of shoulder extensors and hand flexors, fine coordination of hand muscles, the speed-strength of leg muscles, and balance. This allows us to recommend it for use in physical education lessons in institutions of general secondary education.

Influence of Physical and Psycho-Physical Fitness of Students on a Healthy Lifestyle

The article analyzes the interdependence of the healthy lifestyle of representatives of student youth and the level of their physical and psychophysical fitness. The purpose of the article is to study the impact of physical and psychophysical preparation of students on a healthy lifestyle by bringing these concepts into the plane of health-oriented personal activity. During the analysis of the literature, the key concepts were specified: healthy lifestyle, physical and psychophysical preparedness. The practical part of the research is represented by a survey of students of 2-4 years, among the respondents 20% study in the field of "physical education and sports". These students are part of the general sample and at the same time are the control group. A comparison of the survey results of the general sample and the control group demonstrates differences in the level of physical and psychophysical training of students and the quality of their lifestyle. Students of the control group rate their own level of physical and psychophysical fitness higher, adhere to a healthy lifestyle to a greater extent, and among the factors that prevent adherence to a healthy lifestyle, they often choose excessive workload. On the basis of theoretical and practical research, a conclusion was drawn that there is an undeniable relationship between the level of physical and psychophysical fitness of students and their adherence to a healthy lifestyle. The obtained data can be used to develop and optimize programs of educational work with students of higher education institutions in the direction of preserving the health of young people.

The applicability of historical Japanese and Polish fencing to the development of acting competences

Historically, a fit body, combined with a balanced mind and an enhanced ability for focusing, was a basic tool for warriors from various cultures. Today, it also provides valuable assistance to actors. Undoubtedly, fighting arts improve psychophysical fitness, agility and the ability to concentrate. They make the body more flexible, better coordinated, able to see and/or sense one’s own and one’s opponent’s movements and balance as well as the amount and direction of force. Traditional fencing systems, such as the Polish ‘cross art’ of the hussar sabre and Japanese kenjutsu seem particularly apt in the context of actor training. Why are they worth recommending to actors for the development of their competences? What values enshrined in historical forms of fencing may prove beneficial in performer training? I seek answers to these questions by referring to my own − 40 years plus – practical experience as a martial artist, fighting arts researcher, sports activist, trainer and competitor.

Hepcidin (rs10421768), Transferrin (rs3811647, rs1049296) and Transferrin Receptor 2 (rs7385804) Gene Polymorphism Might Be Associated with the Origin of Multiple Sclerosis.

Multiple sclerosis (MS) is a demyelinating disease of the central nervous system in which there is a multifocal damage to the nerve tissue. Additionally, the literature emphasizes the excessive accumulation of iron in the central nervous system of patients, which is negatively correlated with their psychophysical fitness. Iron metabolism genes polymorphisms may modulate iron deposition in the body and thus affect the clinical course of MS. We aimed to assess the frequency of HAMP, TFR2, and TF polymorphisms in MS patients and their impact on the clinical course of the disease. The studied polymorphisms were identified by the Real-Time PCR using TaqMan technology. Neurological assessment by means of EDSS scale was conducted. This cross-sectional study included 176 patients, with the mean age of onset of symptoms at 30.6 years. The frequency of alleles of the studied polymorphisms was as follows: (a) HAMP rs10421768: A 75.9% (n = 267), G 24.1% (n = 65), (b) TF rs1049296: C 89.2% (n = 314), T 10.8% (n = 38), (c) TF rs3811647: A 39.8% (n = 140), G 60.2% (n = 212), (d) TFR2 rs7385804: A 59.1% (n = 59.1%), C 40.9% (n = 144). In the codominant inheritance model of TF rs1049269, it was shown that people with the CT genotype scored statistically significantly lower points in the EDSS scale at the time of diagnosis than those with the CC genotype (CC Me = 1.5, CT Me = 1.0 p = 0.0236). In the recessive model of TF inheritance rs3811647, it was noticed that the primary relapses were significantly more frequent in patients with at least one G allele compared with those with the AA genotype (AG + GG = 81.2%, AA = 18.8%, p = 0.0354). In the overdominant model rs7385804 TFR2, it was shown that among patients with the AA genotype, multiple sclerosis occurs significantly more often in relatives in a straight line compared with people with the AC and CC genotypes (AA = 100.0%, AC + CC = 0.0%, p = 0.0437). We concluded that the studied polymorphisms might affect the clinical course of MS.

Association between Diet, Physical Activity and Nutritional Status of Male Border Guard Officers.

The main factors that determine the effectiveness and reliability of duties and tasks performed by border guard officers, are very good health and maintaining a high level of psychophysical fitness that depend mainly on adequate diet and physical activity and thus, nutritional status. The aim of the study was to verify the correlations between dietary habits, physical activity level and selected nutritional status indicators. One hundred and sixty-nine male border guard officers participated in the study. A 61-item food frequency questionnaire (FFQ) was used to assess dietary habits and a long-form International Physical Activity Questionnaire (IPAQ) was used to assess physical activity. Fat mass was determined by bioelectrical impedance analysis (BIA) and bone calcification was assessed by the dual energy X-ray absorptiometry (DXA). Many correlations between dietary habits, as well as the physical activity of officers and body mass index (BMI), fat mass index (FMI) and visceral fat level (VFL) were found, while bone mineral density (BMD T-score) negatively correlated only with two food groups and 6 out of 61 products but did not correlate with physical activity. The results also confirmed many poor dietary habits and abnormalities in nutritional status. Thus, there is a need for nutritional education and further monitoring of health-related behaviors, as well as monitoring the nutritional status of border guard officers.

Сurrent state of the organization of physical training cadets of higher education institutions of internal affairs

The purpose of the study to summarize the experience of modern methods of organizing physical training of law enforcement officers and criteria for assessing physical fitness for joining the police. Results. The article considers topical issues related to the organization of physical training of cadets of higher education institutions of internal affairs bodies. Relevant areas for improving the process of psychophysical readiness are the use of priority sports, increasing the adaptation of freshmen to specific learning conditions, the use of pedagogical technologies, the introduction of new technologies for assessing the physical fitness of cadets and methods of physical training taking into account climatic and geographical conditions. Having conducted a detailed analysis of the state of organization of physical training of police cadets, the negative dynamics of physical training of cadets was established. In senior courses, the level of physical fitness decreases. The results of the scientific research confirm that the physical fitness of more than 40% of entrants is low, there is no motivation to improve their physical capabilities. Only 19.1% of respondents are satisfied with their physical shape. The experience of law enforcement shows that the underestimation of the importance of psychophysical readiness of personnel leads to injuries and wounds of law enforcement officers during the performance of official duties.
 The modern tendencies of improvement of physical training of police, and necessary conditions for development of professionally important physical qualities of militiamen are studied. A comparative analysis of Ukrainian and foreign experience of professional selection and evaluation criteria of physical fitness to law enforcement agencies. Conclusions. It was found that the priority issues that need to be addressed are the provision of favorable conditions for adaptation of freshmen to specific learning conditions, revision of criteria for assessing physical fitness, professional selection and the need to develop differentiated programs for psychophysical fitness of cadets.

Impact of the comprehensive outpatient rehabilitation on reducing intensification of depressive symptoms in people over 60 years of age

Abstract Introduction. As a result of involution processes and diseases, changes occur in the human body, as a result of which, psychophysical fitness declines with age. Comprehensive rehabilitation is the way of improving and maintaining health condition, including, among others, the appropriate level of physical activity and the quality of affective functioning. This type of program was carried out as part of the Outpatient Healthcare Home (DDOM) at the Witold Chodźko Institute of Rural Health in Lublin. Aim. The objective of the present study was to assess the impact of comprehensive ambulatory rehabilitation, including tailored endurance training preceded by an ergospirometry test, on indicators demonstrating the level of involvement in daily physical activities and the severity of depressive symptoms of patients over 60 years of age receiving health services at DDOM. Material and methods. The study involved 60 seniors participating in the rehabilitation cycle implemented as part of the services provided to patients at DDOM of the Witold Chodźko Institute of Rural Health in Lublin. The tests were carried out in the test-retest model on the first and last day of the kinesiotherapy cycle. The tests were performed with use of International Physical Activity Questionnaire IPAQ and Geriatric Depression Scale GDS. The patient rehabilitation program included adapted systemic kinesiotherapy (endurance training with a load determined according to individual exercise capacity, as determined on the basis of the ergospirometry test) and local kinesiotherapy and physical therapy adapted to the needs resulting from the condition of the musculoskeletal system. Results. After the completion of the rehabilitation cycle we compared the tests carried out before it, and the patients received higher scores in the scales of IPAQ questionnaire for measuring weekly, intensive and mode-rate physical activity and time required for walking and were less likely to spend their time sitting or lying down. There were also lower scores of the respondents in GDS scale used to assess the severity of depressive symptoms. Conclusions. As a result of the rehabilitation program applied, DDOM patients simultaneously obtained the desired changes in the level of involvement in physical activity and minimization of the intensity of depressive symptoms.

Comprehensive outpatient rehabilitation increases the ability of people over 60 to live independently.

The answer to current social and health needs of people aged over 60 are the multidirectional and carefully planned, comprehensive activation and rehabilitation activities carried out as part of Daycare Centres (DCC). The aim of creating and the functioning of DCCs deployed all over Poland is to improve the health and psychophysical fitness of this group of people. Health factors and psychophysical fitness determine the ability to live independently, both today, and later in life. The objective of the study was to assess the impact of comprehensive ambulatory rehabilitation, including tailored endurance training preceded by an ergospirometry test, on indicators demonstrating the ability to live independently and the risk ratio of future health problems in the elderly. 60 people participating in a rehabilitation cycle implemented as part of the services provided to patients aged over 60 in the DCC of the Witold Chodźko Institute of Rural Medicine (IMW) in Lublin comprised the sample. The tests were carried out in the test-retest model on the first and last day of the kinesiotherapy cycle. Patients were tested using standardized Barthel, I-ADL and VES-13 questionnaires. The rehabilitation programme applied included systemic kinesiotherapy (endurance training) with a load determined according to individual exercise capacity, determined on the basis of a ergospirometry test, and varied rehabilitation activities resulting from the condition of the locomotor system, as provided for under the project. After completing the rehabilitation cycle, patients obtained higher results in comparison to the tests carried out before the beginning of the cycle in the Barthel index used to measure functional efficiency (Z = 5.41; p = 0.001), as well as lower in the I-ADL scale used to test the degree of dependence on the help of others when performing complex activities of everyday life (Z = 2.63; p = 0.009) and in VES-13 scale used to assess the risk of geriatric health problems (Z = 5.47; p = 0.001). As the result of the use of comprehensive rehabilitation, including obligatory endurance training, desired changes were achieved in terms of fitness and independence in performing advanced daily activities and reducing the risk of geriatric health problems.

Active noise control system in a fire helmet – a proposal of the solution

An auditory warning signal emitted by a moving emergency vehicle is intended to inform other road users about an approaching emergency vehicle and the need to give way to it. Emission of a warning signal with the highest possible sound pressure level is the main method of ensuring the audibility and recognition of the warning signal by traffic participants at unknown and varying traffic noise, acoustic insulation of vehicles and noise in the interior of the vehicle. The A-weighted sound pressure level of the auditory warning signal reaching the interior of an emergency vehicle may exceed 90 dB, which can be harmful to the hearing, can adversely affect psychophysical fitness of the crew members and can significantly hinder verbal communication in the vehicle. This article presents the concept and results of numerical simulations of an active noise control system in fire helmets, which will reduce the exposure of the crew to the warning signal and improve the quality of verbal communication in an emergency vehicle. This system is integrated with the signal generation system. The Notch algorithm and the NLMS adaptation algorithm were used in the system's control algorithm. The construction of the controller was based on a microcontroller from the STM32F4 family.

HEALTH PROMOTION IN OLDER AGE GROUPS AS AN OBJECTIVE OF THE SENIOR POLICY: EUROPEAN CHALLENGES

Successful ageing is understood to mean a satisfactory health status, high level of financial independence, firm family and social ties and opportunities for self-realization. The best form of health promotion among the elderly is to promote physical activity. Physical and recreational health-oriented activity and prevention of diseases helps improve physical endurance and strength, and increase muscle mass, flexibility and overall motor coordination. Adequate level of physical exercise at older age effectively prevents ageing processes and ensures maintaining good psychophysical fitness, thus stimulating social integration. The study presents selected forms of recreational forms of physical activity of older adults in local environments resulting from the needs of this group of people and initiatives of local self-governments to promote health.

Fitness for duty and psychophysical fitness in hazardous occupations

Fitness for duty and psychophysical fitness in hazardous occupations

La aptitud laboral y la aptitud psicofísica en las profesiones de riesgo

La aptitud laboral y la aptitud psicofísica en las profesiones de riesgo

Last Lovers by William Wharton in the opinions of seniors

The issues of old age, once neglected in terms of reflection and research on this period of life, in recent years took on another dimension. With the growth of the elderly population in the world, gradually more attention is paid to issues related to improving the quality of life of seniors. Of particular interest are those aspects of life that have a direct impact on the sense of well-being of the elderly, namely: family, health, finances. The aspect of health is however considered mostly in the context of an overall psychophysical fitness, access to health care, adequate pensions enabling the purchase of medicines, rehabilitation, etc. In contrast, they less frequently deal with issues related to sexual attractiveness of the seniors and their erotic needs. Old age still does not go hand in hand with the sexual appeal. Elderly women are seen as unnecessary, invisible. They are not perceived as being able to evoke sexual desire. This social reception affects the senior women’s perception of themselves. In the eyes of a community an elderly woman may still be attractive intellectually, but not physically. Stereotypes built around the old age also assume that people in late adulthood have no sexual needs