Psychological aspects of the treatment of patients with disorders of sex development.

PubMed

Sandberg, David E; Gardner, Melissa; Cohen-Kettenis, Peggy T

2012-10-01

Research on the psychological development of persons with Disorders of Sex Development (DSD) has focused on understanding the influence of atypical sex hormone exposure during steroid-sensitive periods of prenatal brain development on the process of psychosexual differentiation (i.e., gender identity, gender role, and sexual orientation). In contrast, analysis of clinical management strategies has focused on gender assignment and the desirability and timing of genital surgery. This review focuses on the psychological issues that confront clinicians managing the care of persons born with DSD and their families. Particular attention is paid to processes and factors that potentially mediate or moderate psychosocial and psychosexual outcomes within and across developmental stages. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Practical tips for sexual counseling and psychotherapy in premature ejaculation.

PubMed

Rowland, David; Cooper, Stewart

2011-10-01

A number of milestones in the treatment of premature ejaculation (PE) have occurred over the past five decades, including the development of various behavioral and cognitive techniques as well as pharmacotherapies that modify neurophysiological processes involved in ejaculation. Nevertheless, the notion that sexual responses such as PE are influenced by physiological, psychobehavioral, cultural, and relationship factors is as valid now as it was 50 years ago, and therefore, interventions should consider all such domains in the development of effective treatment strategies. Provide an overview of which patients with PE are suitable to receive psychosexual treatment and the psychological approaches for managing this disorder. Review of the literature. Psychosexual treatments that integrate behavioral, psychological, and relationship functioning. PE is typically a couple's problem and, therefore, psychotherapy is best when the partner is involved. Before embarking on psychotherapy, the clinician should obtain a medical history pertaining to sexual-, psychological-, and relationship-related factors, so that the treatment strategy can be tailored to the needs of the individual. General strategies underpinning integrative, "process-oriented" elements of psychotherapy most relevant to PE are: developing the therapist-patient relationship; expressing empathy, genuineness, and positive regard; motivational interviewing, i.e., developing motivation to change; developing discrepancy; working through resistance; identifying PE-related affect, cognitions, and behaviors (including interaction with partners); and supporting self-efficacy. The four main domains that encompass psychotherapy techniques specific to the treatment of PE are: behavioral; cognitive; affective; and relational. Sustained positive outcomes in PE may be obtained using a combination treatment strategy that addresses all elements of PE, including psychological and biological factors. Psychosexual treatments may help the patient with PE and his partner to address their sexual problems and improve their overall relationship. The effects of psychosexual therapy may be augmented by combining this intervention with pharmacotherapy. 2011 International Society for Sexual Medicine.

Gonadal function and psychosexual adjustment in male long-term survivors of bone marrow transplantation.

PubMed

Molassiotis, A; van den Akker, O B; Milligan, D W; Boughton, B J

1995-08-01

Gonadal function and psychosexual adjustment were evaluated in 29 male patients after autologous and allogeneic BMT (mean post-BMT time 35.6 months). Patients were divided into groups according to their interval from transplant in order to evaluate gonadal function throughout the post-BMT years. Thyroid-stimulating hormone (TSH) and free thyroxine (FT4) were normal throughout the post-BMT years. Follicle-stimulating hormone (FSH) and luteinising hormone (LH) were increased throughout the years after BMT, suggesting moderate compensated hypogonadism. Hyperprolactinaemia was observed only in the 2nd year post-BMT and testosterone levels were normal, suggesting that Leydig cells can withstand alkylating agents or TBI. Psychosexual functioning in BMT survivors was compared with that of a group of mixed-diagnosis cancer patients (n = 30) and a group of healthy young subjects (n = 119). Long-term BMT survivors had similar psychosexual adjustment to that of other cancer patients who had received less intensive chemotherapy. Half the patients were dissatisfied with their current sex life. Major problems included impotence/erectile difficulties (37.9%), low sexual desire (37.9%) and altered body image (20.7%). However, both BMT survivors and cancer patients had significantly higher psychosexual dysfunction compared with healthy subjects. The type of chemotherapy, TBI (either single-dose or fractionated), type of transplant and post-BMT time did not correlate with either gonadal or psychosexual functioning.

The clinical communication and information challenges associated with the psychosexual aspects of prostate cancer treatment.

PubMed

Speer, Susan A; Tucker, Samantha R; McPhillips, Rebecca; Peters, Sarah

2017-07-01

Prostate cancer and its treatment have significant sexual side effects that necessitate timely patient information and open communication with healthcare professionals. However, very little is known about men's experiences of talking to clinicians about the psychosexual difficulties associated with the disease. This study aims to advance understanding of men's perceptions of the communication and information challenges associated with the psychosexual aspects of prostate cancer and its treatment. Between October 2013 and April 2014, semi-structured interviews were conducted with 21 men from the UK who had been treated for prostate cancer. Interview transcripts were analysed using thematic analysis. Three themes describe the communication challenges men face: (1) It can be too soon to talk about sex; (2) the psychology of sex is missing; (3) communication is not individually tailored. Clinicians might usefully (1) consider and discuss with patients how their psychosexual communication needs and information processing abilities may fluctuate across the cancer timeline; (2) initiate discussions about the consequences of treatment that extend beyond biological and mechanical aspects to include emotional and relational factors; (3) tailor communication to the dynamic mix of attributes that shape men's individual psychosexual needs, including their relationship status, sexual orientation, sexual motivations and values. Skills-based training in communication and psychosexual awareness may facilitate the proactive and permissive stance clinicians need to discuss sexual side effects with a heterogeneous group of patients. Copyright © 2017 Elsevier Ltd. All rights reserved.

Psychosexual Outcome of Gender-Dysphoric Children

ERIC Educational Resources Information Center

Wallien, Madeleine S.; Cohen-Kettenis, Peggy T.

2008-01-01

The psychosexual outcome of 77 children with gender dysphoria is investigated. Results reveal that after puberty, most gender-dysphoric children will not remain as such. The outcome of gender-dysphoric children in terms of sexual orientation is also studied.

Psychosexual development: an examination of the role of prenatal hormones.

PubMed

Ehrhardt, A A; Meyer-Bahlburg, H F

Naturally occurring endocrine syndromes and the offspring from steroid-treated pregnancies are the major sources of evidence for a role of prenatal hormones in psychosexual development in man. Effects of prenatal androgens have been established for the sex-dimorphic behaviour clusters of energy expenditure (increased), parenting rehearsal (decreased), peer associations (shifted to male), and grooming-related behaviour (decreased); most of the information was obtained on the syndrome of congenital adrenal hyperplasia and in progestin-induced female hermaphroditism. Studies of children and adults exposed prenatally to exogenous oestrogens and/or progestagens suggest slight demasculinizing effects but cannot yet be considered conclusive. Gender identity is largely dependent on the sex of rearing; a direct role of prenatal hormones in its formation has not been shown. The evidence for the role of prenatal hormones in the development of sexual orientation is inconclusive.

Assessment of psychosexual adjustment after insertion of inflatable penile prosthesis.

PubMed

Tefilli, M V; Dubocq, F; Rajpurkar, A; Gheiler, E L; Tiguert, R; Barton, C; Li, H; Dhabuwala, C B

1998-12-01

To evaluate the psychosexual benefit obtained from multicomponent penile implant surgery in patients with erectile dysfunction. A psychosexual questionnaire was given to 35 patients undergoing penile prosthesis implantation before surgery and at 3 months, 6 months, and 1 year after surgery. The questionnaire consisted of 13 questions scored on a scale from 1 through 5. Results of the questionnaire were statistically analyzed for differences among the preoperative, 3-month postoperative, 6-month postoperative, and 1-year postoperative period. The general linear model evaluation showed a significant difference for each overall combination of the following pairs: preoperative versus 3 months postoperative (P=0.0005) and 3 months postoperative versus 6 months postoperative (P=0.002). There was no overall difference between psychosexual total score at 6 months after surgery and 1 year after prosthesis implantation (P=0.85). The patients perceived improvement in their erectile ability and libido. Concern about obtaining and maintaining an erection during intercourse was significantly alleviated. There was an increase in the frequency of sexual activity and an improvement in satisfaction with sex life. A decrease in feelings of sadness, depression, anxiety, anger, frustration, and embarrassment related to sexual activity was also noted. The current study demonstrates significant improvement in the psychosexual well being of multicomponent penile implant recipients, with attainment of a high level of patient satisfaction up to 1 year after surgery.

Long-term outcomes in males with disorders of sex development.

PubMed

van der Zwan, Yvonne G; Callens, Nina; van Kuppenveld, Jet; Kwak, Karen; Drop, Stenvert L S; Kortmann, Barbara; Dessens, Arianne B; Wolffenbuttel, Katja P

2013-09-01

Indications that the prenatal action of testosterone in the brain is an important determinant of gender development and improved reconstructive techniques have caused a shift in male gender assignments in patients with 46XY disorders of sex development. We report long-term outcome data on psychosexual development and sexual function of these individuals in a cross-sectional study. Physical status of 14 men with a mean age of 25 years with disorders of sex development was assessed by structured interview and physical examination. Psychosexual outcome was evaluated by questionnaires and compared to a control group of 46 healthy, age matched men. A total of 13 men underwent 1 to 6 (mean 2) genital surgeries. Mean age at first surgery was 2.7 years. Mean penile length was 6.6 cm. All men reported erections and were able to experience orgasms. Ejaculatory dysfunction was reported by 7 men. Mean penile length was 7.9 cm in patients who were able to achieve penetrative intercourse and 4.9 cm in those who were not. Meatus was glanular in 5 patients, coronal in 7 and at the distal shaft in 1. Compared to controls, men with disorders of sex development were less satisfied with the appearance of the penis and scrotum but not with total body image. These patients reported decreased sexual desire and activities. Outcome in this group of men with disorders of sex development was poor regarding penile length, ejaculation, satisfaction with external genitalia and frequency of sexual activity. Other aspects, such as overall body image and psychosexual functioning, showed no difference from controls. Copyright © 2013 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

[Psychosexual aspects of intersex syndromes].

PubMed

Bosinski, H A G

2006-08-01

Disorders of somatosexual development that lead to ambiguous genitalia occur in one from 3,000-5,000 newborns. Parents and health care professionals are confronted with a number of crucial questions: to what sex should the child be assigned, what is the appropriate treatment in terms of hormonal and surgical interventions, when and how should these take place, and what impact do they have on the development of gender identity (GI), psychosexual well-being and fertility? This paper reviews the etiology, treatment and outcome in terms of GI and sexual health for the following syndromes: congenital adrenal hyperplasia (CAH), complete and partial androgen insensitivity (cAIS, pAIS), and pure and mixed gonadal dysgenesis (pGD, mGD). Emphasis is focussed on the current discussion involving the timing and extent of genital surgery. Finally, a procedure is introduced that covers the sexual-medical needs of patients, parents and health care professionals.

A Randomized Controlled Trial to Examine the Effects of the Tackling Teenage Psychosexual Training Program for Adolescents with Autism Spectrum Disorder

ERIC Educational Resources Information Center

Visser, Kirsten; Greaves-Lord, Kirstin; Tick, Nouchka T.; Verhulst, Frank C.; Maras, Athanasios; van der Vegt, Esther J. M.

2017-01-01

Background: Previous research underscores the importance of psychosexual guidance for adolescents with autism spectrum disorder (ASD). Such guidance is provided in the Tackling Teenage Training (TTT) program, in which adolescents with ASD receive psycho-education and practice communicative skills regarding topics related to puberty, sexuality, and…

Perceived Partner Reactions to Diagnosis and Treatment of Breast Cancer: Impact on Psychosocial and Psychosexual Adjustment

ERIC Educational Resources Information Center

Wimberly, Sarah R.; Carver, Charles S.; Laurenceau, Jean-Philippe; Harris, Suzanne D.; Antoni, Michael H.

2005-01-01

Two studies examined breast cancer patients' perceptions of their partners' reactions to their diagnosis and treatment as influences on 3 aspects of patients' well-being: psychosexual adjustment, emotional distress, and marital satisfaction. Study 1, cross-sectional, indicated that partner initiation of sex, frequency of sex, a positive 1st sexual…

The psychosexual histories of young women with bulimia.

PubMed

Abraham, S F; Bendit, N; Mason, C; Mitchell, H; O'Connor, N; Ward, J; Young, S; Llewellyn-Jones, D

1985-03-01

While it is known that anorexia nervosa patients show a wide range of sexual knowledge, attitudes and practices, the psychosexual histories of bulimia patients have not been studied. In this paper the psychosexual histories of 20 bulimic patients and 20 matched control subjects are presented. Bulimic patients were more likely to experience orgasm with masturbation, were more likely to have experimented with anal intercourse, and were more likely to describe their libido as 'above average.' Control subjects were more likely to experience orgasm during sexual intercourse. Bulimic patients associated high body weights with unattractiveness, and tended to withdraw from social and sexual activity at high weights. In other aspects of their sexual behaviour, and in their attitudes to sexual matters, the two groups were similar.

[Socio-demographic Characterization of Psychosexual Development and Crime in Men Convicted of Sexual Crimes Imprisoned in the Manizales Penitentiary Center].

PubMed

Rivera, Adriana Arcila; Ramírez, Mauricio Castaño; Montoya, Dulcinea Osorio; Quiroz, Germán

2013-03-01

This article introduces the socio-demographic characteristics of psychosexual development and sexual crimes in men deprived of liberty for such crimes who are doing time in a Manizales prison (Colombia) in 2011. It also describes the differences between abusers of individuals under 12 years of age or who are 12 years old, and abusers of individuals over that age. This is a descriptive, retrospective study performed by simple random sampling. It consisted of semi-structured interviews in which socio-demographic characteristics, psychosexual development, characteristics of crime, and prevalence of mental disorders were analyzed in a sample of 80 inmates convicted of sexual offenses at the Medium-security Pentientiary center in the city of Manizales. Univariate and bivariate analysis were performed using the χ(2) test and the logistic regression analysis with variables showing statistical significance in the bivariate analysis. It was found that convicted sex offenders belong to lower socioeconomic levels, have low educational levels, and did not receive any sexual education. Such findings become more relevant when the crimes in questions are committed against 12-year-olders or children under this age. The lack of sexual education, low educational levels and lower socioeconomic levels are associated factors in the case of sexual offenses. It is important for society (particularly health-care institutions) to find additional measures for the criminalization of such behaviors in order to achieve a better control of the problem. Copyright © 2013 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

Psychosexual disorders and dermatologists

PubMed Central

Narang, Tarun; Garima; Singh, Shubh M.

2016-01-01

Sexual problems that are psychological in origin, rather than physiological, are called psychosexual disorders. Multiple factors, such as general health of the patient, chronic illnesses, psychiatric/psychological disorders, and socio-cultural factors, alone or in combination can be attributed to the development of psychosexual dysfunctions. The symptoms of these disorders vary for each individual and differ with gender. These disorders may be categorized as sexual dysfunction, paraphilias, and gender identity disorders. Dermatologists are sometimes consulted for sexual dysfunctions in their routine practice by the patients visiting sexually transmitted infections (STI) clinics because a majority of the patients believe that these problems are caused by dysfunctions in the sex organs, and because people are hesitant to go to sexuality clinics and psychiatrists for such problems. Sometimes these patients are referred from other specialties such as urology or gynecology; most often, we attempt to search for STIs or other dermatoses on the genitalia and refer them back. We often underestimate the prevalence of sexual concerns of the patients or feel uncomfortable discussing matters of sexuality with them. Dermatologists should understand basic sexual medicine and ask patients for sexual problems. They should be trained to manage such patients accordingly. In this review, we will be focusing on sexual dysfunctions, their etiopathogenesis, and management from a dermatologist's perspective. PMID:27294047

Sex, Love, and the Committed Relationship

ERIC Educational Resources Information Center

Whitaker, Carl A.; And Others

1976-01-01

Six responses are presented to the question of relationship of love, sex, and commitment as revised by Sager in the Spring 1976 issue of this journal. Theoretical and historical perspectives as well as issues of coupling, eroticism, sexual dysfunction and therapy, and psychosexual development are discussed. (HLM)

Psychosexual characteristics of male university students in Brazil.

PubMed

Leite, R M; Buoncompagno, E M; Leite, A C; Mergulhao, E A; Battistoni, M M

1995-01-01

Male freshmen (N = 268) at the State University of Campinas (UNICAMP) in the state of Sao Paulo in Brazil responded to a questionnaire concerning aspects of their sexuality from the onset of adolescence. Topics such as physical changes, first ejaculation, masturbation, homosexual manifestations, and sexual practices were investigated, as well as present attitudes toward virginity, intercourse, birth control, abortion, and prevention of AIDS. The quality of the relationship established with parents and the possibilities for dialogue about sex in the family circle were also surveyed. The majority of the subjects revealed satisfactory development in most areas of their sexuality, as well as a good relationship with their parents. Nevertheless, great difficulty was found in dialogue about sex within the family circle. Of these young men, 32% were still virgins at the end of their freshman year, but a considerable number of those already sexually active reported behavior which was inappropriate for the prevention of pregnancy and AIDS. The results are analyzed using psychoanalytic theories of psychosexual development.

Psychosexual Symptoms and Treatment of Peyronie's Disease Within a Collaborative Care Model

PubMed Central

Hartzell, Rose

2014-01-01

Introduction Peyronie's disease (PD) can be emotionally and sexually debilitating for patients and may negatively impact partner relationships. Aims This study aims to present an ongoing collaborative care model for patients with PD and to discuss the critical need for integration of patient care among sexual medicine physicians and mental health practitioners or sex therapists. Methods PubMed searches using the terms “Peyronie's disease” and “natural history,” “treatment,” “psychosexual,” “depression,” “relationship,” and “partner” were conducted. Expert opinion based on review of the relevant published literature and clinical experience was used to identify meaningful treatment targets for patients with PD within a collaborative care model. Main Outcome Measure Characteristics of PD, medical treatment, and important assessment and treatment targets, including physical, emotional, psychosexual, and relationship concerns, from peer-reviewed published literature and clinical experience. Results PD can result in significant patient and partner distress and relationship disruption. Sex therapy interventions may be directed at acute emotional, psychosexual, and relationship problems that occur during the initial diagnosis of PD, the period following minimally invasive or surgical treatment for PD, or recurring problems over the lifelong course of the disease. Sex therapy to improve self-acceptance, learn new forms of sexual intimacy, and improve communication with partners provides comprehensive treatment targeting emotional, psychosexual, and relationship distress. Ongoing communication between the mental health practitioner and physician working with the patient with PD about key assessments, treatment targets, and treatment responses is necessary for coordinated treatment planning and patient care. Conclusions Men with PD are more likely now than in the past to see both a sexual medicine physician and a mental health practitioner or sex therapist, and the integration of assessments and treatment planning is essential for optimal patient outcomes. PMID:25548648

Navy Careers and Adult Development.

DTIC Science & Technology

1983-12-01

development , in which the major conflict is generativity versus stagnation. Erikson sees this stage as the central one: "In this book the emphasis is on...majority of men’s lives and "is an essential stage on the psychosexual and well as on the psychosocial schedule." ( Erikson , p. 267) Unfortunately... development A& AGMAC- mmp ~n.t a ~ .E. Tere are a number of theories based on the idea that adults go through pred ictable stages of development during

The Relationship between STD Locus of Control and STD Acquisition among Adolescent Girls.

ERIC Educational Resources Information Center

Rosenthal, Susan L.; Griffith, Jennifer O.; Succop, Paul A.; Biro, Frank M.; Lewis, Lisa M.; DeVellis, Robert F.; Stanberry, Lawrence R.

2002-01-01

Adolescent girls from an urban-based clinic participated in a longitudinal study about psychosexual development and risk of STD acquisition. The girls were asked about their perceptions of loci of control (parents, internal control) as it relates to STD acquisition. Responses to locus of control correlated over time but variations were not found…

Lessons Learnt from a Secondary School Sex Education Program in Portugal

ERIC Educational Resources Information Center

Sousa, Ana Paula; Soares, Isabel; Vilar, Duarte

2007-01-01

Based on a developmental framework, a study was conducted in Portugal in two groups of youth in terms of relevant aspects related to adolescent psychosexual development: one group participated in an Experimental Project of Sex Education and Health Promotion during high school, whereas the other did not receive any formal sex education in school.…

The 2016 HIGh Heels: Health effects And psychosexual BenefITS (HIGH HABITS) study: systematic review of reviews and additional primary studies.

PubMed

Barnish, Max; Morgan, Heather May; Barnish, Jean

2017-08-01

High-heeled shoes (high heels) are frequently worn by many women and form an important part of female gender identity. Issues of explicit and implicit compulsion to wear high heels have been noted. Previous studies and reviews have provided evidence that high heels are detrimental to health. However, the evidence base remains fragmented and no review has covered both the epidemiological and biomechanical literature. In addition, no review has considered the psychosexual benefits that offer essential context in understanding the public health challenge of high heels. We searched seven major bibliographic databases up to November 2016, in addition to supplementary searches. We initially identified all review articles of any design that assessed either the psychosexual benefits or negative musculoskeletal health effects of high heels, the latter looking at both the epidemiological and biomechanical perspectives. We additionally considered additional primary studies on areas that had not been reviewed before or in which a marked lack of evidence had been noted. Data were extracted onto standardised forms. Proportionate second review was conducted. A total of 506 unique records were identified, 27 full-text publications were screened and 20 publications (7 reviews and 13 additional studies) were included in our evidence synthesis. The most up-to-date epidemiological review provides clear evidence of an association between high heel wear and hallux valgus, musculoskeletal pain and first-party injury. The body of biomechanical reviews provides clear evidence of changes indicative of increased risk of these outcomes, as well as osteoarthritis, which is not yet evidenced by epidemiological studies. There were no reviews on psychosexual benefits, but all five identified original studies provided evidence of increased attractiveness and/or an impact on men's behaviour associated with high heel wear. With regard to second-party injury, evidence is limited to one descriptive study and eight case reports. Our evidence synthesis clearly shows that high heels bring psychosexual benefits to women but are detrimental to their health. In light of this dilemma, it is important that women's freedom of choice is respected and that any remaining issues of explicit or implicit compulsion are addressed.

The struggle towards 'the New Normal': a qualitative insight into psychosexual adjustment to prostate cancer.

PubMed

Hanly, Narelle; Mireskandari, Shab; Juraskova, Ilona

2014-07-30

Despite the growing body of literature which highlights the potential for significant and enduring side-effects of prostate cancer treatment, there is limited research exploring the experience of living with the treatment-induced side-effects such as sexual dysfunction, and their repercussions for men and their partners. The aim of this qualitative study was to explore factors influencing psychosexual adjustment, self-perception, and unmet information and support needs of prostate cancer patients and their partners. Twenty-one men, recruited via a prostate cancer support group newsletter, participated in face-to-face semi-structured interviews, which were subjected to thematic analysis. The qualitative analysis revealed three inter-connected main themes which contributed to men's psychosexual adjustment: i) Psychosexual impact, ii) Communication and support, and iii) Integration process. Men reported distressing sexual and urinary difficulties, tainted self-perception and altered intimate relationships. Receiving adequate information and support, and having good communication with their doctors and partners facilitated better adjustment to prostate cancer treatment. Coming to terms with the significant impact of treatment had involved making lifestyle changes, coping with emotional struggles and striving to accept and integrate their post-treatment "new normal" self and sexual life. The importance of adequate communication with health professionals and partners, especially regarding treatment effects on sexual function and rehabilitation options, was highlighted as a key factor facilitating the adjustment process. Prostate cancer patients would benefit from improved access to timely and tailored information and decision-making resources, ongoing multidisciplinary care, and support groups, as well as appropriate referrals for sexual and psychological counselling.

The Functional Neuroanatomy of Male Psychosexual and Physiosexual Arousal: A Quantitative Meta-Analysis

PubMed Central

Poeppl, Timm B.; Langguth, Berthold; Laird, Angela R.; Eickhoff, Simon B.

2016-01-01

Reproductive behavior is mandatory for conservation of species and mediated by a state of sexual arousal (SA), involving both complex mental processes and bodily reactions. An early neurobehavioral model of SA proposes cognitive, emotional, motivational, and autonomic components. In a comprehensive quantitative meta-analysis on previous neuroimaging findings, we provide here evidence for distinct brain networks underlying psychosexual and physiosexual arousal. Psychosexual (i.e., mental sexual) arousal recruits brain areas crucial for cognitive evaluation, top-down modulation of attention and exteroceptive sensory processing, relevance detection and affective evaluation, as well as regions implicated in the representation of urges and in triggering autonomic processes. In contrast, physiosexual (i.e., physiological sexual) arousal is mediated by regions responsible for regulation and monitoring of initiated autonomic processes and emotions and for somatosensory processing. These circuits are interconnected by subcortical structures (putamen and claustrum) that provide exchange of sensorimotor information and crossmodal processing between and within the networks. Brain deactivations may imply attenuation of introspective processes and social cognition, but be necessary to release intrinsic inhibition of SA. PMID:23674246

The Life Cycle Completed. Extended Version with New Chapters on the Ninth Stage of Development by Joan M. Erikson.

ERIC Educational Resources Information Center

Erikson, Erik H.

This expanded edition of a 1982 book by Erik Erikson summarizes his work on the stages of the human life cycle, including chapters on psychosexuality and the cycle of generations, major stages in psychosocial development, and ego and ethos. An additional chapter on the ninth stage sets forth his philosophy on old age--i.e. the 80s and 90s--and how…

Psychosexual Functioning Among Adult Female Survivors of Childhood Cancer: A Report From the Childhood Cancer Survivor Study

PubMed Central

Ford, Jennifer S.; Kawashima, Toana; Whitton, John; Leisenring, Wendy; Laverdière, Caroline; Stovall, Marilyn; Zeltzer, Lonnie; Robison, Leslie L.; Sklar, Charles A.

2014-01-01

Purpose Childhood cancer survivors may be at risk for impaired psychosexual functioning as a direct result of their cancer or its treatments, psychosocial difficulties, and/or diminished quality of life. Patients and Methods Two thousand one hundred seventy-eight female adult survivors of childhood cancer and 408 female siblings from the Childhood Cancer Survivor Study (CCSS) completed a self-report questionnaire about their psychosexual functioning and quality of life. On average, participants were age 29 years (range, 18 to 51 years) at the time of the survey, had been diagnosed with cancer at a median age of 8.5 years (range, 0 to 20) and were most commonly diagnosed with leukemia (33.2%) and Hodgkin lymphoma (15.4%). Results Multivariable analyses suggested that after controlling for sociodemographic differences, survivors reported significantly lower sexual functioning (mean difference [MnD], −0.2; P = .01), lower sexual interest (MnD, −0.2; P < .01), lower sexual desire (MnD, −0.3; P < .01), lower sexual arousal (MnD, −0.3; P < .01), lower sexual satisfaction (MnD, −0.2; P = .01), and lower sexual activity (MnD, −0.1; P = .02) compared with siblings. Risk factors for poorer psychosexual functioning among survivors included older age at assessment, ovarian failure at a younger age, treatment with cranial radiation, and cancer diagnosis during adolescence. Conclusion Decreased sexual functioning among female survivors of childhood cancers seems to be unrelated to emotional factors and is likely to be an underaddressed issue. Several risk factors among survivors have been identified that assist in defining high-risk subgroups who may benefit from targeted screening and interventions. PMID:25113763

Psychosexual Outcome Among Iranian Individuals With 5α-Reductase Deficiency Type 2 and Its Relationship With Parental Sexism.

PubMed

Khorashad, Behzad S; Aghili, Zahra; Kreukels, Baudewijntje P C; Hiradfar, Mehran; Roshan, Ghasem M; Afkhamizadeh, Mozhgan; Abbaszadegan, Mohammad Reza; Ghaemi, Nosrat; Khazai, Behnaz; Cohen-Kettenis, P T

2016-11-01

Few studies exist on the psychosexual outcome of homogeneous groups of individuals with 5α-reductase deficiency type 2 (5α-RD-2) and the relation between gender changes and parental hostile and benevolent sexism, which are two components of ambivalent sexism that assume a stereotypical approach toward women in an overtly negative way or a chivalrous, seemingly positive way. To report on the psychosexual outcome of individuals with 5α-RD-2 and to investigate its relation to the level of parental sexism in a relatively large sample of Iranians with 5α-RD-2. Twenty participants (mean age = 19.5 years, SD = 6.345) with a molecularly confirmed diagnosis of 5α-RD-2 who were assigned the female gender at birth and raised as female were included in the study. Participants and their parents were interviewed and their medical records were assessed. Parents also completed the Ambivalent Sexism Inventory (ASI), which includes hostile and benevolent sexism subscales. Psychosexual outcome and parental hostile and benevolent sexism measurements. Twelve of 20 participants (60%) were diagnosed with gender identity disorder not otherwise specified (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision). Ten of these transitioned to the male gender. The other 10 participants (50%), including the two diagnosed with gender identity disorder not otherwise specified, continued living in a female gender role. When comparing the ASI subscale scores between families of participants who changed their gender and those who did not, no significant difference was found for ASI total and hostile sexism scores, but there was a difference for benevolent sexism (P = .049): those whose daughters had changed their gender had higher benevolent sexism scores. The high prevalence of gender change and gender dysphoria reported in the literature was confirmed in this relatively large and homogeneous sample of Iranians with 5-α-RD-2 raised as female. Prenatal exposure to testosterone is hypothesized to play a role in the development of gender identity and sexual orientation, but parental attitudes also might be important. Although gender change in individuals with 5-α-RD-2 is often attributed to high levels of hostile sexism in some cultures, our findings show this to be associated with benevolent sexism. Copyright © 2016 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.

Female genital mutilation in Greece.

PubMed

Vrachnis, N; Salakos, N; Iavazzo, C; Iliodromiti, Z; Bakalianou, K; Kouiroukidou, P; Creatsas, G

2012-01-01

The number of migrants and refugees with a female genital mutilation (FGM) living in Greece is rising. This study explores the characteristics and psychosexual issues of women with FGM who were examined in the 2nd Department of Obstetrics and Gynecology, University of Athens Medical School, Greece during the year 2009. The women were asked to fill out an anonymous questionnaire asking for demographic data, obstetric history, current complaints, and psychosexual problems. The results are presented and discussed, as FGM is a new reality for Greece. Healthcare providers have to familiarize themselves with issues related to FGM and improve their skills in transcultural care, so as to manage and support women with FGM adequately.

Sexual health problems and associated help-seeking behavior of people with physical disabilities and chronic diseases.

PubMed

Kedde, Harald; van de Wiel, Harry; Schultz, Willibrord Weijmar; Vanwesenbeeck, Ine; Bender, Jim

2012-01-01

The aim of this study was to investigate help-seeking behavior in relation to sexual problems among people with a disease or an impairment, as well as determining factors that promote people to seek professional sexological help. A total of 341 respondents (224 men, 117 women) participated. Approximately 50% wanted professional help with finding a sexual partner and sexual adjustment problems. Further, approximately 40% wanted professional help for problems in their sexual relationship, practical sexual problems, and the inability to enjoy their sexuality. In total, two third considered contacting a health care professional of which 35% had indeed had contact with a health care professional. Only a third of those evaluated these contacts as positive. To identify factors associated with the respondent's participation in psychosexual therapy, we performed a logistic regression analyses with a participation in a psychosexual intervention as the dependent variable. Sexual dissatisfaction was the strongest predictor of participation in psychosexual therapy. Furthermore, people who indicated that they wanted professional help for their sexual problems and people who had already discussed sexuality issues with a health care professional were more likely to participate. Disease and demographic characteristics did not influence one's decision to participate.

Improving sexual health in men with prostate cancer: randomised controlled trial of exercise and psychosexual therapies

PubMed Central

2014-01-01

Background Despite being a critical survivorship care issue, there is a clear gap in current knowledge of the optimal treatment of sexual dysfunction in men with prostate cancer. There is sound theoretical rationale and emerging evidence that exercise may be an innovative therapy to counteract sexual dysfunction in men with prostate cancer. Furthermore, despite the multidimensional aetiology of sexual dysfunction, there is a paucity of research investigating the efficacy of integrated treatment models. Therefore, the purpose of this study is to: 1) examine the efficacy of exercise as a therapy to aid in the management of sexual dysfunction in men with prostate cancer; 2) determine if combining exercise and brief psychosexual intervention results in more pronounced improvements in sexual health; and 3) assess if any benefit of exercise and psychosexual intervention on sexual dysfunction is sustained long term. Methods/Design A three-arm, multi-site randomised controlled trial involving 240 prostate cancer survivors will be implemented. Participants will be randomised to: 1) ‘Exercise’ intervention; 2) ‘Exercise + Psychosexual’ intervention; or 3) ‘Usual Care’. The Exercise group will receive a 6-month, group based, supervised resistance and aerobic exercise intervention. The Exercise + Psychosexual group will receive the same exercise intervention plus a brief psychosexual self-management intervention that addresses psychological and sexual well-being. The Usual Care group will maintain standard care for 6 months. Measurements for primary and secondary endpoints will take place at baseline, 6 months (post-intervention) and 1 year follow-up. The primary endpoint is sexual health and secondary endpoints include key factors associated with sexual health in men with prostate cancer. Discussion Sexual dysfunction is one of the most prevalent and distressing consequences of prostate cancer. Despite this, very little is known about the management of sexual dysfunction and current health care services do not adequately meet sexual health needs of survivors. This project will examine the potential role of exercise in the management of sexual dysfunction and evaluate a potential best-practice management approach by integrating pharmacological, physiological and psychological treatment modalities to address the complex and multifaceted aetiology of sexual dysfunction following cancer. Trial registration Australian New Zealand Clinical Trials Registry ACTRN12613001179729. PMID:24641777

Exploring the feasibility and acceptability of couple-based psychosexual support following prostate cancer surgery: study protocol for a pilot randomised controlled trial

PubMed Central

2014-01-01

Background Men who undergo surgery for prostate cancer frequently experience significant side-effects including urinary and sexual dysfunction. These difficulties can lead to anxiety, depression and reduced quality of life. Many partners also experience psychological distress. An additional impact can be on the couple relationship, with changes to intimacy, and unmet psychosexual supportive needs in relation to sexual recovery and rehabilitation. The aim of this exploratory randomised controlled trial pilot study is to determine the feasibility and acceptability of a novel family-relational-psychosexual intervention to support intimacy and reduce distress among couples following prostate cancer surgery and to estimate the efficacy of this intervention. Methods/Design The intervention will comprise six sessions of psychosexual and relationship support delivered by experienced couple-support practitioners. Specialist training in delivering the intervention will be provided to practitioners and they will be guided by a detailed treatment manual based on systemic principles. Sixty-eight couples will be randomised to receive either the intervention or standard care (comprising usual follow-up hospital appointments). A pre-test, post-test design will be used to test the feasibility of the intervention (baseline, end of intervention and six-month follow-up) and its acceptability to couples and healthcare professionals (qualitative interviews). Both individual and relational outcome measures will assess sexual functioning, anxiety and depression, couple relationship, use of health services and erectile dysfunction medication/technologies. An economic analysis will estimate population costs of the intervention, compared to usual care, using simple modelling to evaluate the affordability of the intervention. Discussion Given the increasing incidence and survival of post-operative men with prostate cancer, it is timely and appropriate to determine the feasibility of a definitive trial through a pilot randomised controlled trial of a family-relational-psychosexual intervention for couples. The study will provide evidence about the components of a couple-based intervention, its acceptability to patients and healthcare professionals, and its influence on sexual and relational functioning. Data from this study will be used to calculate sample sizes required for any definitive trial. Trial registration ClinicalTrials.gov Identifier: NCT01842438. Registration date: 24 April 2013; Randomisation of first patient: 13 May 2013 PMID:24886676

[Sexual development of Czech girls before and after November 1989].

PubMed

Raboch, J; Raboch, J; Sindlár, M

1996-01-31

It was revealed that sexual development and behaviour of adolescents, in particular girls, reflect rapidly and immediately changes in the social environment. The objective of the present investigation was to assess whether changes of the psychosexual development of girls occurred, i.e. girls examined in 1986 to 1989 and those examined after "velvet revolution" between 1990 to 1994. Using a interview based on a uniform examination pattern comprising 78 items, two sexologists examined in 1986 to 1994 the sexual development and behaviour of 771 Czech girls aged 16-18 years. This number comprised 317 apprentices and 454 secondary school students. The sexological examination was made in Frantiskovy Láznĕ where the probands were sent for preventive treatment, mostly after appendectomies. Comparison of the two sub-groups revealed that the apprentices and students reported changes as regards the motivation of the first sexual intercourse. After November 1989 there was a decline in the group "complied" and a marked increase of the number in the category "desired herself". It was surprising that the psychosexual development of girls after the "velvet revolution" was rather retarded than hastened. The most marked change was recorded in the category "intercourse with several partners" -a drop by 12% (p < 0.03). The findings that despite a markedly increased motivation for the first intercourse in the examined girls no changes were recorded in the girls in some items which characterize the development of sex life, is surprising.

Troubled meditations on psychosexual differentiation: reply to Hegarty (2009).

PubMed

Zucker, Kenneth J; Drummond, Kelley D; Bradley, Susan J; Peterson-Badali, Michele

2009-07-01

P. Hegarty (see record 2009-09998-015) offered several critiques of the articles by G. Rieger, J. A. W. Linsenmeier, L. Gygax, and J. M. Bailey (see record 2007-19851-006) and K. D. Drummond, S. J. Bradley, M. Peterson-Badali, and K. J. Zucker (see record 2007-19851-005) that were published in a Developmental Psychology special section entitled "Sexual Orientation Across the Lifespan," guest-edited by C. J. Patterson and R. C. Savin-Williams (2008): (a) reliance on a "disease paradigm" (i.e., the use of "medicalizing" language) of lesbian-gay-bisexual-transgender issues at the expense of a "stigma paradigm," (b) endorsement of a developmental linkage between childhood sex-typed behavior and later gender identity-sexual orientation, and (c) various sociophilosophical and applied matters pertaining to the diagnosis of gender identity disorder in children. In this reply, we address these 3 criticisms and argue that an interdisciplinary approach, informed by multiple paradigms, will most certainly facilitate, not impede, the discovery of answers to many questions about psychosexual development for which data are currently lacking.

Test-Retest Reliability of Self-Reported Sexual Behavior, Sexual Orientation, and Psychosexual Milestones Among Gay, Lesbian, and Bisexual Youths

PubMed Central

Schrimshaw, Eric W.; Rosario, Margaret; Meyer-Bahlburg, Heino F. L.; Scharf-Matlick, Alice A.

2011-01-01

Despite the importance of reliable self-reported sexual information for research on sexuality and sexual health, research has not examined reliability of information provided by gay, lesbian, and bisexual (GLB) youths. Test-retest reliability of self-reported sexual behaviors, sexual orientation, sexual identity, and psychosexual developmental milestones was examined among an ethnically diverse sample of 64 self-identified GLB youths. Two face-to-face interviews were conducted approximately two weeks apart using the Sexual Risk Behavior Assessment Schedule for Homosexual Youths (SERBAS-Y-HM). Overall, the mean of the test-retest reliability coefficients was substantial for 6 of the 7 domains: lifetime sexual behaviors (M = .89), sexual behavior in the past 3 months (M = .96), unprotected sexual behavior in the past 3 months (M = .93), sexual identity (κ = .89), sexual orientation (M = .82), and ages of various psychosexual developmental milestones (M = .77). Inconsistent reliability was found for reports of sexual behaviors while using substances. A small number of gender differences emerged, with lower reliability among female youths in the lifetime number of same-sex partners. The overall findings suggest that a wide range of self-reported sexual information can be reliably assessed among GLB youths by means of interviewer-administered questionnaires, such as the SERBAS-Y-HM. PMID:16752124

Demographics, behavior problems, and psychosexual characteristics of adolescents with gender identity disorder or transvestic fetishism.

PubMed

Zucker, Kenneth J; Bradley, Susan J; Owen-Anderson, Allison; Kibblewhite, Sarah J; Wood, Hayley; Singh, Devita; Choi, Kathryn

2012-01-01

This study provided a descriptive and quantitative comparative analysis of data from an assessment protocol for adolescents referred clinically for gender identity disorder (n = 192; 105 boys, 87 girls) or transvestic fetishism (n = 137, all boys). The protocol included information on demographics, behavior problems, and psychosexual measures. Gender identity disorder and transvestic fetishism youth had high rates of general behavior problems and poor peer relations. On the psychosexual measures, gender identity disorder patients had considerably greater cross-gender behavior and gender dysphoria than did transvestic fetishism youth and other control youth. Male gender identity disorder patients classified as having a nonhomosexual sexual orientation (in relation to birth sex) reported more indicators of transvestic fetishism than did male gender identity disorder patients classified as having a homosexual sexual orientation (in relation to birth sex). The percentage of transvestic fetishism youth and male gender identity disorder patients with a nonhomosexual sexual orientation self-reported similar degrees of behaviors pertaining to transvestic fetishism. Last, male and female gender identity disorder patients with a homosexual sexual orientation had more recalled cross-gender behavior during childhood and more concurrent cross-gender behavior and gender dysphoria than did patients with a nonhomosexual sexual orientation. The authors discuss the clinical utility of their assessment protocol.

The importance of psychosexual counselling in the re-establishment of organic and erotic functions after penile prosthesis implantation.

PubMed

Pisano, F; Falcone, M; Abbona, A; Oderda, M; Soria, F; Peraldo, F; Marson, F; Barale, M; Fiorito, C; Gurioli, A; Frea, B; Gontero, P

2015-01-01

Although many studies about penile prosthesis implantation (PPI) have been published so far, only a small amount of them take into account patients and partners outcome in terms of satisfaction and erotic function. The aim of this study is to explore the value of psycosexual counselling in and the sexual and erotic function of penile prosthesis recipients. Thirty patients and their partners were randomised into two groups. In arm A (case group) patients and their partners underwent a multistep psychosexual counselling before and after surgery. In arm B (control group) surgery was performed without the specific psychosexual counselling scheme. Specific questionnaires (International Index of Erectile Function (IIEF) and the Sexual Daydreaming Scale (SDS)) were administered before surgery and 12 months afterwards. Twenty-four months postoperatively patients were asked to complete the Global Assessment Questions (GAQ) and the Erectile Dysfunction Inventory of Treatment Satisfaction (EDITS), while their partners were asked to answer to the EDITS partner's section. Between January 2009 and October 2011, we enrolled 30 patients undergoing PPI in our institution (15 in each arm). Twenty-four months postoperative follow-up is available for all of them. No significant differences between the two groups in terms of baseline questionnaires scores were observed. Mean IIEF score was significantly higher in case group (arm A 68.3, arm B 53.4, P-value<0.001). At 12 months after PPI the improvement of erotic function according to SDS was significantly higher in the study group for both patients and their partners. Improvement in satisfaction rates were confirmed at 24 months, with statistically significant scores for EDITS in arm A patients and partners as compared with arm B. PPI with a pre- and postoperative psychosexual counselling scheme resulted in better postoperative sexual activity and erotic function for both patients and partners than PPI alone.

Psychosexual Correlates of Sexual Double Standard Endorsement in Adolescent Sexuality.

PubMed

Emmerink, Peggy M J; Vanwesenbeeck, Ine; van den Eijnden, Regina J J M; Ter Bogt, Tom F M

2016-01-01

Endorsement and enactment of the (hetero)sexual double standard (SDS), prescribing sexual modesty for girls and sexual prowess for boys, has been shown to be negatively related to sexual and mental health. To be able to challenge the SDS, more insight is needed into the conditions that shape gendered sexual attitudes. A survey was conducted among 465 heterosexual adolescents (aged 16-20 years), examining the relationship between a number of relevant demographic and psychosexual variables and SDS endorsement. SDS endorsement was assessed using a newly developed instrument, the Scale for the Assessment of Sexual Standards Among Youth (SASSY). Gender (being male) and religiousness were significantly associated with increased SDS endorsement. For both boys and girls, increased feelings of entitlement to self-induced sexual pleasure (e.g., masturbation) were significantly associated with reduced SDS endorsement, whereas higher gender investment was significantly associated with increased SDS endorsement. Furthermore, increased feelings of entitlement to partner-induced sexual pleasure and more frequent talking about sexuality with peers were associated with increased SDS endorsement among boys but not among girls. We conclude that future research should explore peer influence processes through peer communication about sex, gender investment, and feelings of entitlement to both self and partner-induced sexual pleasure.

Psychosexual and body image aspects of quality of life in Turkish breast cancer patients: a comparison of breast conserving treatment and mastectomy.

PubMed

Alicikus, Zumre Arican; Gorken, Ilknur Bilkay; Sen, Rachel Cooper; Kentli, Suleyman; Kinay, Munir; Alanyali, Hilmi; Harmancioglu, Omer

2009-01-01

Assessing psychosexual and body image aspects of quality of life in Turkish breast cancer patients treated by either mastectomy or breast conserving treatment (BCT). The study group consisted of 112 patients who had undergone all treatment at a single institution under the care of a multidisciplinary breast team. Following surgery, all patients underwent adjuvant radiotherapy with or without chemotherapy and hormone therapy. At the time of this study all patients were disease free with at least 2 years' follow-up. Twenty percent of the patients were premenopausal and 80% postmenopausal. The patients completed a questionnaire consisting of 42 questions related to their sexual relations and body image. Forty-one percent of sexually active patients had experienced a deterioration of sexual functioning after treatment. This was mainly due to loss of libido (80%), loss of interest in partner (54%), and sexual dissatisfaction (59%). Problems tended to develop early in the course of treatment. Decreased sexual desire was significantly more frequent in patients undergoing mastectomy versus BCT (80% vs 61%; P = 0.043) and in premenopausal versus postmenopausal patients (P = 0.024). Although 80% of patients were satisfied with their appearance as a whole, only 54% liked their naked bodies. There was no significant difference in body image scores between patients undergoing mastectomy or BCT apart from a general feeling of physical unattractiveness in mastectomy patients (3.4 vs 2.8; P = 0.03). Significant, similar psychosexual and body image problems occur in patients treated for breast cancer with either mastectomy or BCT. Problems arise early in the course of the disease and therefore detection and treatment of these problems should be addressed during the patients' initial assessment and at the start of treatment. These findings are similar to those reported on similar groups of treated women in American and European populations.

Clitoral reconstruction after female genital mutilation/cutting: case studies.

PubMed

Abdulcadir, Jasmine; Rodriguez, Maria I; Petignat, Patrick; Say, Lale

2015-01-01

Clitoral reconstruction following female genital mutilation/cutting (FGM/C) is a new surgical technique reported to be a feasible and effective strategy to reduce clitoral pain, improve sexual pleasure, and restore a vulvar appearance similar to uncircumcised women. However, data on safety, care offered, and evaluation of sexual and pain outcomes are still limited. This study aims to present the care offered and clinical outcomes of two women who received multidisciplinary care, including psychosexual treatment, with clitoral reconstruction. We report their long-term outcomes, and the histology of the removed periclitoral fibrosis. We report the cases of two women with FGM/C types II and III who requested clitoral reconstruction for different reasons. One woman hoped to improve her chronic vulvar pain, as well as improve her sexual response. The other woman requested surgery due to a desire to reverse a procedure that was performed without her consent, and a wish to have a genital appearance similar to non infibulated women. They both underwent psychosexual evaluation and therapy and surgery. The histology of the periclitoral fibrosis removed during surgery was analyzed. At 1-year postoperatively, the first woman reported complete disappearance of vulvar pain and improved sexual pleasure, including orgasm. Our second patient also described improved sexuality at 1-year follow-up (increased sexual desire, lubrication, vulvar pleasure, and sensitiveness), which she attributed to a better self body image and confidence. Both women reported feeling satisfied, happy, and more beautiful. We show a positive outcome in pain reduction and improved sexual function, self body image, and gender after psychosexual therapy and clitoral reconstruction. More evidence is needed about clitoral reconstruction to develop guidelines on best practices. Until research is conducted that rigorously evaluates clitoral reconstruction for its impact on pain and sexuality, we advise always offering a multidisciplinary care, including sexual therapy before and after the surgery. © 2014 International Society for Sexual Medicine The World Health Organization retains copyright and all other rights in the manuscript of this article as submitted for publication.

The molecular mechanisms of sexual orientation and gender identity.

PubMed

Fisher, Alessandra D; Ristori, Jiska; Morelli, Girolamo; Maggi, Mario

2018-05-15

Differences between males and females are widely represented in nature. There are gender differences in phenotypes, personality traits, behaviors and interests, cognitive performance, and proneness to specific diseases. The most marked difference in humans is represented by sexual orientation and core gender identity, the origins of which are still controversial and far from being understood. Debates continue on whether sexual behavior and gender identity are a result of biological (nature) or cultural (nurture) factors, with biology possibly playing a major role. The main goal of this review is to summarize the studies available to date on the biological factors involved in the development of both sexual orientation and gender identity. A systematic search of published evidence was performed using Medline (from January 1948 to June 2017). Review of the relevant literature was based on authors' expertise. Indeed, different studies have documented the possible role and interaction of neuroanatomic, hormonal and genetic factors. The sexual dimorphic brain is considered the anatomical substrate of psychosexual development, on which genes and gonadal hormones may have a shaping effect. In particular, growing evidence shows that prenatal and pubertal sex hormones permanently affect human behavior. In addition, heritability studies have demonstrated a role of genetic components. However, a convincing candidate gene has not been identified. Future studies (e.i. genome wide studies) are needed to better clarify the complex interaction between genes, anatomy and hormonal influences on psychosexual development. Copyright © 2017. Published by Elsevier B.V.

[Adolescent crises in puberty. Diagnosis and therapy (author's transl)].

PubMed

Müller-Küppers, M

1979-08-24

Psychological disorders which become manifest as adolescent crises must be seen as complex phenomena and treated thoroughly: besides the genetic, biographic and psychosocial background of the youthful individual the cultural and economic aspects play an important role. Nevertheless we must admit that associated causal explanations, e.g. for accelerated or late development are lacking. Focal points for the subsequent symptom complexes of sexual behavior in puberty are: psychosexual prematurity or retardation, masturbation, homosexual relations, pubertal asceticism and premature and frequently changing sexual relations.

[Countertransference in homoerotic transference].

PubMed

Junkert-Tress, B; Reister, G

1995-01-01

Until now psychoanalytic training and literature have hardly considered the transference love of homosexual patients. We summarized the scarce literature and related it to the background of our knowledge of heterosexual transference love. The discussion leaves no doubt that, like the heterosexual, homosexual transference love must be read on all levels of psychosexual development instead of reading it on only one and definitely not on an amorphous "preoedipal" level. This is particularly true for the level of the adult homosexual patient, as the case history demonstrates.

Psychosexual Correlates of Sexual Double Standard Endorsement in Adolescent Sexuality

PubMed Central

Emmerink, Peggy M. J.; Vanwesenbeeck, Ine; van den Eijnden, Regina J. J. M.; ter Bogt, Tom F. M.

2016-01-01

Endorsement and enactment of the (hetero)sexual double standard (SDS), prescribing sexual modesty for girls and sexual prowess for boys, has been shown to be negatively related to sexual and mental health. To be able to challenge the SDS, more insight is needed into the conditions that shape gendered sexual attitudes. A survey was conducted among 465 heterosexual adolescents (aged 16–20 years), examining the relationship between a number of relevant demographic and psychosexual variables and SDS endorsement. SDS endorsement was assessed using a newly developed instrument, the Scale for the Assessment of Sexual Standards Among Youth (SASSY). Gender (being male) and religiousness were significantly associated with increased SDS endorsement. For both boys and girls, increased feelings of entitlement to self-induced sexual pleasure (e.g., masturbation) were significantly associated with reduced SDS endorsement, whereas higher gender investment was significantly associated with increased SDS endorsement. Furthermore, increased feelings of entitlement to partner-induced sexual pleasure and more frequent talking about sexuality with peers were associated with increased SDS endorsement among boys but not among girls. We conclude that future research should explore peer influence processes through peer communication about sex, gender investment, and feelings of entitlement to both self and partner-induced sexual pleasure. PMID:26327361

Carney Landis and the psychosexual landscape of touch in mid-20th-century America.

PubMed

Serlin, David

2012-08-01

In the last quarter of the 1930s, Carney Landis, an associate professor of psychology at Columbia University affiliated with the Psychiatric Institute of New York, headed a Committee for Research in Problems of Sex-funded research project in which he conducted interviews with 100 women between the ages of 18 and 35 who self-identified as physically disabled. Landis interviewed the women about their sex lives, their sexual identities, and their relationship to their bodies and published the results in 1942 under the title The Personality and Sexuality of the Physically Handicapped Woman. The book represents conventional psychosexual presumptions about disabled women's stunted personality and frustrated sexuality stemming from the absence of a Freudian "sexual moment." Yet, the original research notes, housed at the Kinsey Institute for Research in Sex, Gender, and Reproduction, reveal that many of these women engaged in acts of erotic touching that played a far more dynamic and complex role in the development of their sexual subjectivities than Landis or his researchers could recognize. This article examines how touch and tactility produced meanings for Landis' research subjects and thus illuminated forms of sexual subjectivity not regularly associated with either histories of disability or histories of sexuality. (PsycINFO Database Record (c) 2012 APA, all rights reserved).

Penile length is a very important factor for cosmesis, function and psychosexual development in patients affected by hypospadias: Results from a long-term longitudinal cohort study.

PubMed

Ciancio, Francesco; Lo Russo, G; Innocenti, A; Portincasa, A; Parisi, D; Mondaini, N

2015-09-01

Few studies of long-term outcome of hypospadias treatment in terms of voiding, surgical complications, sexual functioning, intimate relationships and cosmetic results have been investigated and contrasting results have been obtained so far. The aim of our study is to investigate the long-term outcome of urinary and sexual function, cosmesis and the quality of intimate relationships in a series of hypospadias. In this study, 42 patients who underwent surgery for hypospadias were prospectively followed for 15 years. Medical records provided the hypospadias data, the number of reconstructive operations and the reconstruction technique that was used. Patients underwent physical examination, including penile length measurement and completed International Prostatic Symptoms Score (I-PSS), International Index Of Erectile Function (IIEF 15) and the Penile Perception Score questionnaire (PPPS). Twenty patients agreed to participate in the study. At the enrolment, the median value of HOSE was 13, as regards PPPS, 18/20 (90%) were satisfied, while in 1998 only 80% were satisfied. No significant statistical difference has been reported from the results obtained at enrolment and those obtained at follow-up, in terms of PPPS (P = 0.81), IPSS and IIEF-15. Penile length was 6.5 cm flaccid and 10.5 cm stretched. Our data show how cosmesis, function and psychosexual development for these patients are highly connected to surgical outcome, which is understood to be a decrease in penile size. © The Author(s) 2015.

Premature menopause.

PubMed

Okeke, Tc; Anyaehie, Ub; Ezenyeaku, Cc

2013-01-01

Premature menopause affects 1% of women under the age of 40 years. The women are at risk of premature death, neurological diseases, psychosexual dysfunction, mood disorders, osteoporosis, ischemic heart disease and infertility. There is need to use simplified protocols and improved techniques in oocyte donation to achieve pregnancy and mother a baby in those women at risk. Review of the pertinent literature on premature menopause, selected references, internet services using the PubMed and Medline databases were included in this review. In the past, pregnancy in women with premature menopause was rare but with recent advancement in oocyte donation, women with premature menopause now have hoped to mother a child. Hormone replacement therapy is beneficial to adverse consequences of premature menopause. Women with premature menopause are at risk of premature death, neurological diseases, psychosexual dysfunction, mood disorders, osteoporosis, ischemic heart disease and infertility. Public enlightenment and education is important tool to save those at risk.

Premature Menopause

PubMed Central

Okeke, TC; Anyaehie, UB; Ezenyeaku, CC

2013-01-01

Premature menopause affects 1% of women under the age of 40 years. The women are at risk of premature death, neurological diseases, psychosexual dysfunction, mood disorders, osteoporosis, ischemic heart disease and infertility. There is need to use simplified protocols and improved techniques in oocyte donation to achieve pregnancy and mother a baby in those women at risk. Review of the pertinent literature on premature menopause, selected references, internet services using the PubMed and Medline databases were included in this review. In the past, pregnancy in women with premature menopause was rare but with recent advancement in oocyte donation, women with premature menopause now have hoped to mother a child. Hormone replacement therapy is beneficial to adverse consequences of premature menopause. Women with premature menopause are at risk of premature death, neurological diseases, psychosexual dysfunction, mood disorders, osteoporosis, ischemic heart disease and infertility. Public enlightenment and education is important tool to save those at risk. PMID:23634337

Low self-esteem in women with eating disorders and alcohol abuse as a psycho-social factor to be included in their psychotherapeutic approach.

PubMed

Iorgulescu, Gabriela

2010-01-01

Authors have analyzed the psychosocial peculiarities of the women from Romania who are affected by eating disorders and alcohol excessive consumption, and studied the manner of the link between these diseases and the psychosexual. 120 participants at the study (Oltenia district) were divided into 2 groups: 60 healthy women, 30 with eating disorders and 30 alcohol dependent women. In all subjects were applied the following tests: Scale for compulsive appetite (SCA) and Scale of interest for own weight, both for eating disorders, CAGE questionnaire for alcohol dependence and two scales for determining: the gender-role ambivalence (O'Neil and Caroll Scale) and the masculinity and feminity index (A. Chelcea). The results obtained in both lots of Romanian women with pathologic behavior (food and/or alcohol consumption) have indicated a low psychosexual identity versus control group but no correlation with masculinity/feminity index.

Psychosexual and social-cognitive correlates of sexual risk behavior among male clients of female sex workers in Tijuana, Mexico

PubMed Central

Semple, Shirley J.; Strathdee, Steffanie A.; Gallardo Cruz, Manuel; Robertson, Angela; Goldenberg, Shira; Patterson, Thomas L.

2011-01-01

Male clients of female sex workers (FSWs) may act as a bridge to the general population contributing to the spread of HIV and other sexually transmitted infections in the United States and Mexico. This study used cross-sectional data to identify psychosexual and social cognitive factors associated with sexual risk behavior in a bi-national sample of 300 male clients of FSWs recruited in Tijuana, Mexico from June to October, 2008. In a multiple regression analysis, the number of unprotected vaginal sex acts with FSWs was associated with higher sexual compulsivity scores, lower self-efficacy for condom use, greater use of illicit drugs, and more financial need. Behavioral interventions are urgently needed to assist clients of FSWs in reducing high-risk behaviors in an effort to prevent the spread of HIV/STIs in this high-risk population and their sexual partners. PMID:21154035

How children learn about sex: a cross-species and cross-cultural analysis.

PubMed

Josephs, Lawrence

2015-05-01

Scattered and not widely disseminated evidence from primatology, anthropology, and history of childhood sexuality support the hypothesis that throughout much of human behavioral evolution that human children have learned about sex through observing parental sexuality and then imitating it in sexual rehearsal play with peers. Contemporary theories of psychosexual development have not considered the possibility that young children are predisposed to learn about sex through observational learning and sexual rehearsal play during early childhood, a primate-wide trait that is conserved in humans but suppressed in contemporary contexts.

Hypersexual, Sexually Compulsive, or Just Highly Sexually Active? Investigating Three Distinct Groups of Gay and Bisexual Men and Their Profiles of HIV-Related Sexual Risk

PubMed Central

Rendina, H. Jonathon; Ventuneac, Ana; Moody, Raymond L.; Grov, Christian

2015-01-01

Emerging research supports the notion that sexual compulsivity (SC) and hypersexual disorder (HD) among gay and bisexual men (GBM) might be conceptualized as comprising three groups—Neither SC nor HD; SC only, and Both SC and HD—that capture distinct levels of severity across the SC/HD continuum. We examined data from 370 highly sexually active GBM to assess how the three groups compare across a range of risk factors for HIV infection. Comparisons focused on psychosexual measures—temptation for condomless anal sex (CAS), self-efficacy for avoiding CAS, sexual excitation and inhibition—as well as reports of actual sexual behavior. Nearly half (48.9 %) of this highly sexually active sample was classified as Neither SC nor HD, 30 % as SC Only, and 21.1 % as Both SC and HD. While we found no significant differences between the three groups on reported number of male partners, anal sex acts, or anal sex acts with serodiscordant partners, the Both SC and HD group reported higher numbers of CAS acts and CAS acts with serodiscordant partners and also had a higher proportion of their anal sex acts without condoms compared to the SC Only group. Our findings support the validity of a three-group classification system of SC/HD severity in differentiating psychosexual and HIV-related sexual risk behavior outcomes in a sample of GBM who report similarly high levels of sexual activity. Notwithstanding the need for sex positive HIV prevention programs, interventions that attempt to help Both SC and HD men deal with distress and address their psychosexual needs specifically may derive HIV prevention benefits. PMID:25750052

Psychosexual outcome of gender-dysphoric children.

PubMed

Wallien, Madeleine S C; Cohen-Kettenis, Peggy T

2008-12-01

To establish the psychosexual outcome of gender-dysphoric children at 16 years or older and to examine childhood characteristics related to psychosexual outcome. We studied 77 children who had been referred in childhood to our clinic because of gender dysphoria (59 boys, 18 girls; mean age 8.4 years, age range 5-12 years). In childhood, we measured the children's cross-gender identification and discomfort with their own sex and gender roles. At follow-up 10.4 +/- 3.4 years later, 54 children (mean age 18.9 years, age range 16-28 years) agreed to participate. In this group, we assessed gender dysphoria and sexual orientation. At follow-up, 30% of the 77 participants (19 boys and 4 girls) did not respond to our recruiting letter or were not traceable; 27% (12 boys and 9 girls) were still gender dysphoric (persistence group), and 43% (desistance group: 28 boys and 5 girls) were no longer gender dysphoric. Both boys and girls in the persistence group were more extremely cross-gendered in behavior and feelings and were more likely to fulfill gender identity disorder (GID) criteria in childhood than the children in the other two groups. At follow-up, nearly all male and female participants in the persistence group reported having a homosexual or bisexual sexual orientation. In the desistance group, all of the girls and half of the boys reported having a heterosexual orientation. The other half of the boys in the desistance group had a homosexual or bisexual sexual orientation. Most children with gender dysphoria will not remain gender dysphoric after puberty. Children with persistent GID are characterized by more extreme gender dysphoria in childhood than children with desisting gender dysphoria. With regard to sexual orientation, the most likely outcome of childhood GID is homosexuality or bisexuality.

Sport and Sex-Role Orientation.

ERIC Educational Resources Information Center

Fisher, A. Craig

Psychosexual personality is not exclusively a postnatal and learned phenomenon. Three biologically-based sex differences can be cited as having promoted status differentiation between males and females. These are (a) greater physical strength of males, (b) greater aggressiveness of males, and (c) child-rearing and nursing roles of females. The…

Gender identity, gender assignment and reassignment in individuals with disorders of sex development: a major of dilemma.

PubMed

Fisher, A D; Ristori, J; Fanni, E; Castellini, G; Forti, G; Maggi, M

2016-11-01

Disorders of Sex Development (DSD) are a wide range of congenital conditions characterized by an incongruence of components involved in sexual differentiation, including gender psychosexual development. The management of such disorders is complex, and one of the most crucial decision is represented by gender assignment. In fact, the primary goal in DSD is to have a gender assignment consistent with the underlying gender identity in order to prevent the distress related to a forthcoming Gender Dysphoria. Historically, gender assignment was based essentially on surgical outcomes, assuming the neutrality of gender identity at birth. This policy has been challenged in the past decade refocusing on the importance of prenatal and postnatal hormonal and genetic influences on psychosexual development. (1) to update the main psychological and medical issues that surround DSD, in particular regarding gender identity and gender assignment; (2) to report specific clinical recommendations according to the different diagnosis. A systematic search of published evidence was performed using Medline (from 1972 to March 2016). Review of the relevant literature and recommendations was based on authors' expertise. A review of gender identity and assignment in DSD is provided as well as clinical recommendations for the management of individuals with DSD. Given the complexity of this management, DSD individuals and their families need to be supported by a specialized multidisciplinary team, which has been universally recognized as the best practice for intersexual conditions. In case of juvenile GD in DSD, the prescription of gonadotropin-releasing hormone analogues, following the World Professional Association for Transgender Health and the Endocrine Society guidelines, should be considered. It should always be taken into account that every DSD person is unique and has to be treated with individualized care. In this perspective, international registries are crucial to improve the understanding of these challenging conditions and clinical practice, in providing a better prediction of gender identity.

Are survivors of childhood cancer with an unfavourable psychosocial developmental trajectory more likely to apply for disability benefits?

PubMed

Maurice-Stam, H; Verhoof, E J; Caron, H N; Grootenhuis, M A

2013-03-01

The aim of this study was to investigate whether an unfavourable psychosocial developmental trajectory while growing up with childhood cancer is related to a smaller likelihood of labour participation in adult life. A total of 53 childhood cancer survivors (CCS) with and 313 CCS without disability benefits, and 508 peers from the general Dutch population (reference group) completed the Course of Life Questionnaire (CoLQ) about the achievement of psychosocial developmental milestones. Differences between the three groups were tested by conducting analysis of variance with contrasts (scale scores CoLQ) and logistic regression analysis (individual milestones). Effect sizes and odds ratios were calculated. Compared with the reference group, both CCS with and CCS without benefits reported lower scale scores with respect to social and psychosexual development. CCS with disability benefits had lower social (d = - 0.6; p < 0.001) and psychosexual (d = -0.4; p < 0.01) scale scores than the CCS without disability benefits. CCS with disability benefits scored less favourably (p < 0.01) than peers from the general population on 14 out of 22 psychosocial milestones whereas the number was only six for those without disability benefits. CCS with an unfavourable developmental trajectory while growing up were more likely to apply for disability benefits in adulthood than CCS with a more favourable development. Early recognition and support are warranted. Further research is needed on risk factors of application for disability benefits. In addition, research should show whether stimulating the achievement of developmental milestones while growing up will create conditions for a better labour market position. Copyright © 2011 John Wiley & Sons, Ltd.

Jokes and the Freudian Unconscious.

ERIC Educational Resources Information Center

Juni, Samuel

1985-01-01

Investigated fixations of the psychosexual stages in Freud's Jokes and their Relation to the Unconscious. Results indicate that the one fixational area which seems quite repressed in Freud's unconscious is anality. This finding is related to the hypothesis that anal drives are by necessity repressed in productive individuals in order to allow for…

Sexual dysfunction within an adult developmental perspective.

PubMed

Fagan, P J; Meyer, J K; Schmidt, C W

1986-01-01

The focus of this paper is on the adult who has adequately mastered the oedipal stage of psychosexual development and who presents with a sexual dysfunction. Drawing on the developmental sequence of Erik Erikson, the authors suggest that failure to address adequately an adult psychosocial crisis may result in sexual dysfunction. There may be both adult developmental deficits and regression to adolescent and adult stages previously negotiated. Both may be symptomatically represented by sexual dysfunction. The authors urge that the sexual and marital problems be evaluated within an adult developmental framework and that the therapy address the psychosocial issues which are appropriate to the developmental stage of the patient.

[The role of gender in intersexual experiments in the second half of the 20th century].

PubMed

Klöppel, Ulrike

2006-01-01

This paper shows the formation of the psychological concept of gender from the testing of a new intersex treatment in the 1950s. By analyzing the initial refusal and final success of the new concept and guidelines in the German speaking medical community, it points to the decisive role of treating intersexuals as "experiments of nature" for the clinical research in psychosexual development. This new technology brought the divergent problematizations of "ambiguous sex" in line thus bridging the gap between scientific and clinical approaches and providing the material basis for turning gender into a scientific and practical entity.

Experiment of nurture: ablatio penis at 2 months, sex reassignment at 7 months, and a psychosexual follow-up in young adulthood.

PubMed

Bradley, S J; Oliver, G D; Chernick, A B; Zucker, K J

1998-07-01

Guidelines of psychosexual management for infants born with physical intersex conditions are intended to assist physicians and parents in making decisions about sex of assignment and rearing including the following: 1) sex assignment should be to the gender that carries the best prognosis for good reproductive function, good sexual function, normal-looking external genitalia and physical appearance, and a stable gender identity; 2) the decision regarding sex assignment should be made as early as possible, preferably during the newborn period, with an upper age limit for reversal of an initial sex assignment no later than 18 to 24 months; and 3) there should be minimal uncertainty and ambiguity on the part of parents and professionals regarding the final decision about sex assignment and rearing. J. Money used these guidelines in a case of a biologically normal male infant (one of a pair of monozygotic twins) whose penis was accidentally ablated during a circumcision at the age of 7 months. The decision to reassign the infant boy to the female sex and to rear him as a girl was made at 17 months, with surgical castration and initial genital reconstruction occurring at 21 months. Money reported follow-up data on this child through the age of 9 years. Although the girl was described as having many "tomboyish" behavioral traits, a female gender identity had apparently differentiated. Thus, it was concluded that gender identity is sufficiently incompletely differentiated at birth as to permit successful assignment of a genetic male as a girl, in keeping with the experiences of rearing. Subsequent follow-up by other investigators reported that by early adolescence the patient had rejected the female identity and began to live as a male at the age of 14 years. In adulthood, the patient recalled that he had never felt comfortable as a girl, and his mother reported similar recollections. At age 25, the patient married a woman and adopted her children. The patient reported exclusive sexual attraction to females. The present case report is a long-term psychosexual follow-up on a second case of ablatio penis in a 46 XY male. During an electrocautery circumcision at the age of 2 months, the patient sustained a burn of the skin of the entire penile shaft, and the penis eventually sloughed off. At age 7 months, the remainder of the penis and the testes were removed. By age 7 months, if not earlier, the decision was made to reassign the patient as a female and to raise the infant as a girl. The patient was interviewed on two occasions: at 16 years and twice while in the hospital for additional surgery at 26 years of age. At ages 16 and 26, the patient was living socially as a woman and denied any uncertainty about being a female. During childhood, the patient recalled that she self-identified as a "tomboy" and enjoyed stereotypically masculine toys and games; however, the patient also recalled that her favorite playmates were usually girls and that her best friend was always a girl. When seen at age 16, the patient had been admitted to the hospital for vaginoplasty. At that time, she wished to proceed with the further repair of her genitalia to make them suitable for sexual intercourse with males. At age 26, the patient returned to the hospital for further vaginoplasty. Regarding the patient's sexual orientation, she was attracted predominantly to women in fantasy, but had had sexual experiences with both women and men. At the time of the second surgery, she was in a relationship with a man and wished to be able to have intercourse. The patient's self-described sexual identity was "bisexual." After surgery at age 26 years, the patient developed a rectovaginal fistula. Within a few months of the surgery, the patient and her male partner separated for reasons other than the patient's physical problems. The patient subsequently began living with a new partner, a woman, in a lesbian relationship. The psychosexual development of our patient was bot the other patient was married to a woman. Our patient had a "bisexual" sexual identity; the other patient had a "heterosexual" sexual identity. The patients were similar in that they had a childhood history of "tomboyism." Our patient was predominantly sexually attracted to women; the other patient was exclusively sexually attracted to women. Our patient had sexual experiences with both women and men; the other patient had sexual experiences only with women. The most plausible explanation of our patient's differentiation of a female gender identity is that sex of rearing as a female, beginning at around age 7 months, overrode any putative influences of a normal prenatal masculine sexual biology. Because cases of ablatio penis in infancy are so rare and long-term follow-up data are scant, it is obviously impossible to know whether our patient or the previous case would be more typical of the psychosexual outcome in a larger sample of such individuals. However, our case suggests that it is possible for a female gender identity to differentiate in a biologically "normal" genetic male. At present, however, the clinical literature is deeply divided on the best way to manage cases of traumatic loss of the penis during infancy. Further study is clearly required to decide on the optimal model of psychosocial and psychosexual management for affected individuals.

The Psychosexual Impacts on Adolescent Girls Viewing Sexually Explicit Internet Material

ERIC Educational Resources Information Center

Grant, Piper S.

2014-01-01

Literature indicates that 72% of adolescent girls are exposed to sexually explicit Internet material (SEIM) before the age of 18, and between 2%-30% of girls report intentionally seeking SEIM. Despite the recognition that adolescent girls are consuming SEIM, and that their use impacts behaviors, beliefs, and attitudes, there has been limited…

Management of sexual disorders.

PubMed

Kok, L P

1993-12-01

Sexual disorders comprise (a) disorders of function in which sexual functioning is disturbed leading to problems during sexual intercourse, (b) disorders of orientation whereby a non heterosexual partner or object is sought, and (c) other disorders involving aberrant psychosexual behaviour. In managing such problems a thorough psychosexual assessment is required in order to ascertain the exact nature of the problem and what the precipitating, predisposing and prolonging factors are. In disorders of orientation and disorders involving aberrant sexual behaviours, the developmental history and early childhood relationships must be looked into carefully. Laboratory investigations are usually indicated in erectile dysfunction as up to 80% would have an organic aetiology--vascular, neurological and endocrine disorders have to be ruled out. Treatment of the various conditions involves general sexual counselling, behaviour therapy including stress management, psychotherapy, marital therapy and drug therapy as indicated. However, in erectile dysfunction, drug treatment (including intracavernosal injections), mechanical aids, or surgery may be indicated; and in transsexualism--for those who are unable to revert to accepting their natural status--a sex reassignment operation is the treatment of choice.

Sexual communication, dyadic adjustment, and psychosexual well-being in premenopausal women with self-reported dyspareunia and their partners: a controlled study.

PubMed

Pazmany, Els; Bergeron, Sophie; Verhaeghe, Johan; Van Oudenhove, Lukas; Enzlin, Paul

2014-07-01

Although research that takes into account partner and relationship factors in dyspareunia is slowly emerging, little is known about how these couples communicate about their sexuality. Additionally, partner psychosexual adjustment has not been examined in a controlled fashion. This study aimed to compare dyadic sexual communication, dyadic adjustment, psychological adjustment, and sexual well-being of women with self-reported dyspareunia and their partners with those of pain-free control women and their partners. Premenopausal women (n = 38; mean [M] age = 24.92) with self-reported dyspareunia, their partners (n = 38; M age = 26.71), as well as pain-free control women (n = 44; M age = 25.86) and their partners (n = 44; M age = 27.95) completed an online survey measuring dyadic sexual communication, dyadic adjustment, anxiety, depression, sexual functioning, and sexual distress. Assessments of women and men's (i) dyadic sexual communication; (ii) dyadic adjustment; (iii) anxiety; (iv) depression; (v) sexual functioning; and (vi) women's sexual distress were the main outcome measures. Compared with pain-free controls, women with dyspareunia reported significantly poorer dyadic sexual communication, a difference not found between partners of women with dyspareunia and control partners. Compared with partners of control women, those of women with dyspareunia reported significantly more impaired sexual functioning. No differences in dyadic adjustment were found between women with dyspareunia and pain-free control women, or between their respective partners. Finally, compared with control women, those with dyspareunia reported significantly more impaired psychological and sexual well-being. Findings suggest that dyspareunia impacts not only the psychosexual adjustment of affected women but also that of their partners. It seems relevant to include both members of the couple in future research and treatment for dyspareunia. © 2014 International Society for Sexual Medicine.

Psychiatrists and Their Role in an Integrative Approach to Sexual Problems.

PubMed

Raisi, Firoozeh; Yahyavi, Seyyed Taha

2015-03-01

Sexuality is a unit part of humans that has been evaluated as several fragmented particles for years. Although many biomedical and psychosocial approaches have been developed in the field of sex, these approaches usually have not been led to the complete satisfaction of the patients. It seems that for a comprehensive evaluation and management of the sexual problems, the unity of sex should be respected and the biopsychosocial multilayer aspects of the sex should be apprehended. Psychiatry is a unique point that both biomedical and psychosocial sciences reach each other. Therefore, psychiatrists should play a critical role as a modulator in the multidisciplinary team for management of the sexual problems. In this regard, comprehensive training of psychiatrists is highly recommended. One of the primary steps could be developing the psychosexual fellowship.

An Investigation of Placement and Type of Seductive Details: The Primacy Effect of Seductive Details on Text Recall

ERIC Educational Resources Information Center

Rowland, Emily; Skinner, Christopher H.; Davis-Richards, Kai; Saudargas, Richard; Robinson, Daniel H.

2008-01-01

Seductive details are interesting, but sometimes irrelevant to the target material present in texts and lectures. In the current study, 388 undergraduate students read six paragraphs describing Sigmund Freud's psychosexual stages (i.e., target material). Participants in four groups also read one of two biographical paragraphs. The biographical…

Investigating the Interaction of Graphic Organizers and Seductive Details: Can a Graphic Organizer Mitigate the Seductive-Details Effect?

ERIC Educational Resources Information Center

Rowland-Bryant, Emily; Skinner, Christopher H.; Skinner, Amy L.; Saudargas, Richard; Robinson, Daniel H.; Kirk, Emily R.

2009-01-01

The interaction between seductive details (SD) and a graphic organizer (GO) was investigated. Undergraduate students (n = 207) read a target-material passage about Freud's psychosexual stages. Depending on condition, the participants also read a biographical paragraph (SD-only), viewed a graphic organizer that linked the seductive details to the…

A Case Report of Dissociative Neurosis (Depersonalization Disorder) in an Adolescent Treated with Family Therapy and Behavior Modification.

ERIC Educational Resources Information Center

Dollinger, Stephen J.

1983-01-01

Describes the use of behavioral procedures as part of systems-oriented family therapy for the treatment of an adolescent girl's functional blackouts. Treatment successfully eliminated blackouts without directly addressing clear psychosexual issues. Discusses the case in terms of conceptualizing etiology and treatments and advocates working with…

Play Behavior and Efficacy in Ghetto Four-Year-Olds: Organization and Psychosexual Content of Play.

ERIC Educational Resources Information Center

Borowitz, Gene H.; And Others

Effectance, defined as the child's independent, effective interaction with people and things, is studied through observation of the play of 36 preschool low income black children. The children were observed and filmed in semi-structured play sessions, primarily with family dolls, doll furniture, and small baby bottle. Instruments used were: (1)…

New perspectives in the hormonal treatment of gender dysphoria in adolescence.

PubMed

Fernández, María; Guerra, Patricia; Díaz, Mónica; García-Vega, Elena; Álvarez-Diz, Jose A

2015-01-01

Hormonal treatments have been used in adolescents with gender dysphoria in the last decade. The professionals working in gender dysphoria treatment units cannot ignore this new demand. The evolution of care for such adolescents according to the last three versions of the Standards of Care (SC) of the World Professional Association for Transgender Health is described. Starting with the fifth version of the SC, hormonal treatment of adolescents has been contemplated. Recent protocols for hormonal intervention carried out by specialized clinics are analyzed. Finally, the pros and cons of hormonal treatment are debated. These hormonal interventions have major impact on the physical, social, and psychosexual development of patients and have ethical and moral implications for professionals.

Practical approach to childhood masturbation--a review.

PubMed

Mallants, Charita; Casteels, Kristina

2008-10-01

The aim of this article is to review the literature for information that could guide the clinical practitioner in the assessment and management of childhood masturbation. The boundary between normal and abnormal or deviant masturbation in children remains unclear. Besides the link with sexual abuse, other environmental factors and individual factors, as well as psychiatric disorders, are mentioned in relation to masturbation and sexual behaviour in general in children. However, evidence-based information is missing and, therefore, a safety management approach is advised when a clinician is confronted with childhood masturbation. We conclude that normal psychosexual development, as well as environmental and individual factors, should be considered in the assessment and management of childhood masturbation.

Girls who cut: treatment in an outpatient psychodynamic psychotherapy practice with adolescent girls and young adult women.

PubMed

Ruberman, Louise

2011-01-01

The observation of deficits in the capacity for mature emotional self-regulation in girls who cut is noted in the literature (Daldin, 1990; Novick & Novick, 1991; Nock et al., 2008). The acquisition of the ability to respond in a healthy manner to stress and challenge, either from outside or inside the self is one of the most important tasks of early development; girls who cut have not accomplished this developmental task or are seriously compromised in their efforts to do so. The connection between this observation, the psychosexual developmental antecedents of this deficit, and psychodynamic approaches to treatment are explored in the literature and in case reviews.

Sibling Sexual Abuse: An Empirical Analysis of Offender, Victim, and Event Characteristics in National Incident-Based Reporting System (NIBRS) Data, 2000-2007

ERIC Educational Resources Information Center

Krienert, Jessie L.; Walsh, Jeffrey A.

2011-01-01

Sibling sexual abuse is identified as the most common form of familial sexual abuse. Extant literature is plagued by definitional inconsistencies, data limitations, and inadequate research methodology. Trivialized as "normal" sexual exploration, sibling sexual abuse has been linked to psychosocial/psychosexual dysfunction. Research has relied on…

Troubled Meditations on Psychosexual Differentiation: Reply to Hegarty (2009)

ERIC Educational Resources Information Center

Zucker, Kenneth J.; Drummond, Kelley D.; Bradley, Susan J.; Peterson-Badali, Michele

2009-01-01

P. Hegarty (2009) offered several critiques of the articles by G. Rieger, J. A. W. Linsenmeier, L. Gygax, and J. M. Bailey (2008) and K. D. Drummond, S. J. Bradley, M. Peterson-Badali, and K. J. Zucker (2008) that were published in a "Developmental Psychology" special section entitled "Sexual Orientation Across the Lifespan," guest-edited by C. J.…

[Psychosexual functioning of women after breast cancer therapy].

PubMed

Mroczek, Bozena; Kurpas, Donata; Grochans, Elzbieta; Kuszmar, Grazyna; Rotter, Iwona; Zułtak-Baczkowska, Katarzyna; Karakiewicz, Beata

2012-01-01

The study was to assess psychosexual functioning of women after breast cancer treatment, since this problem is very rarely discussed in Polish professional literature. Our study involved 103 women after breast cancer treatment. The questionnaire was based on the Likert scale, the Beck Depression Inventory, and the authors' own questions. Some 52% of respondents were operated in 2002-2008; 93% had a radical mastectomy or a breast-sparing operation without reconstruction. About 71% accepted themselves before falling ill, and 65% regarded themselves as pretty. After surgery 57% felt attractive as sexual partners, 48.5% found it difficult to look at themselves naked, and 37.9% were embarrassed in their partners' presence. Some 26.21% of the women had a very good and 42.71% had a satisfactory sexual life before the disease. Following surgery, 54% did not notice any changes in their partners' behaviour, 14% avoided intimate situations, and 11% have not had sexual intercourse since the operation. In the relationships where sex was important, the quality of sexual intercourse improved. A factor which contributes to successful sexual life of a woman is her acceptance of her body and her feeling of attractiveness.

Gender role behavior, sexuality, and psychosocial adaptation in women with congenital adrenal hyperplasia due to CYP21A2 deficiency.

PubMed

Frisén, Louise; Nordenström, Anna; Falhammar, Henrik; Filipsson, Helena; Holmdahl, Gundela; Janson, Per Olof; Thorén, Marja; Hagenfeldt, Kerstin; Möller, Anders; Nordenskjöld, Agneta

2009-09-01

Gender-atypical behavior has been described in young girls as well as in women with congenital adrenal hyperplasia (CAH) due to a CYP21A2 deficiency. The aim of the study was to assess health-related, psychosexual, and psychosocial parameters and correlate the results to CYP21A2 genotype. Sixty-two Swedish women with CAH and age-matched controls completed a 120-item questionnaire and a validated quality of life instrument [psychological general well-being (PGWB) formula] to identify psychosexual and psychosocial parameters. The patients were divided into four CYP21A2 genotype groups. The women with CAH held more male-dominant occupations (30%) compared to controls (13%) (P = 0.04), especially those in the null genotype group (55%) (P = 0.006). They also reported a greater interest in rough sports (74%) compared to controls (50%) (P = 0.007). Eight women with CAH (14%) reported a prime interest in motor vehicles, compared to none of the controls (P = 0.002). Non-heterosexual orientation was reported by 19% of women with CAH (P = 0.005), 50% in the null genotype group (P = 0.0001), 30% in I2 splice (NS), and 5% in I172N (NS). PGWB total score did not differ between patients and controls. We identified increased gender-atypical behavior in women with CAH that could be correlated to the CYP21A2 genotype. This speaks in favor of dose-dependent effects of prenatal androgens on the development of higher brain functions. The impact of the disease on upbringing and interpersonal relationships did not correlate with disease severity, indicating that other factors, such as coping strategies, are important for psychosocial adaptation. This illustrates the need for psychological support to parents and patients.

A neuropsychologic profile of homosexual and heterosexual men and women.

PubMed

Wegesin, D J

1998-02-01

To examine the applicability of psychosexual differentiation theory to the development of sexual orientation, heterosexual (HT) women, HT men, lesbians, and gay men (20 per group) completed a lexical-decision/semantic monitoring task (LD/SM) to assess verbal ability, as well as a Water Level Task (WLT) and two Mental Rotation (MR) Tasks designed to assess spatial ability. All tests have been shown to differentiate HT men and women. Results replicated previously reported sex differences between the HT men and women. Further, gay men performed akin to HT women on the verbal task and the MR tasks, but not in the WLT. Lesbians, however, primarily performed in a sex-typical manner. The dissociation in sex-atypicality between lesbians and gay men is discussed in relation to neurobiological factors related to the development of both sex-dimorphic cognitive ability and sexual orientation.

Untapped richness in Erik H. Erikson's rootstock.

PubMed

Kivnick, Helen Q; Wells, Courtney K

2014-02-01

Erik H. Erikson published his groundbreaking theory of 8 stages of lifelong psychosocial development in 1950. His theory expanded psychoanalytic concepts of psychosexual development to include the importance of social dynamics; it transcended then-current thinking that psychological development culminated in early adulthood, acknowledging that systematic human development continues throughout the entire life cycle. The theory made Erikson a pioneer in developmental psychology. His last authored book, Vital Involvement in Old Age, rearticulated and elaborated 3 principles that, in different words, are rooted in his original theory of healthy life cycle development: (1) Dynamic Balance of Opposites; (2) Vital Involvement; and (3) Life in Time. Using a lens informed by knowledge gained over the past 30 years and by reflections of one of the original researchers on that project, the current manuscript seeks to spark new interest in Erikson's late-life contribution. It explains the principles in new detail, links them to relevant research, and suggests ways they could enable Erikson's ideas to further enrich gerontological practice and research.

Mammalian animal models of psychosexual differentiation: when is 'translation' to the human situation possible?

PubMed

Baum, Michael J

2006-11-01

Clinical investigators have been forced primarily to use experiments of nature (e.g., cloacal exstrophy; androgen insensitivity, congenital adrenal hyperplasia) to assess the contribution of fetal sex hormone exposure to the development of male- and female-typical profiles of gender identity and role behavior as well as sexual orientation. In this review, I summarize the results of numerous correlative as well as mechanistic animal experiments that shed significant light on general neuroendocrine mechanisms controlling the differentiation of neural circuits controlling sexual partner preference (sexual orientation) in mammalian species including man. I also argue, however, that results of animal studies can, at best, provide only indirect insights into the neuroendocrine determinants of human gender identity and role behaviors.

Psychosexual characteristics of female university students in Brazil.

PubMed

Leite, R M; Buoncompagno, E M; Leite, A C; Mergulhao, E A; Battistoni, M M

1994-01-01

Freshmen women (N = 240) at the State University of Campinas (UNICAMP) in the state of Sao Paulo, Brazil responded to a questionnaire concerning several aspects of their sexuality from the beginning of adolescence. Topics such as body changes during puberty, menarche, menstruation, masturbation, sexual identity, virginity, sexual relations, maternity, contraceptives, abortion, and attitudes toward AIDS were investigated, as well as the level and sources of information about sex and the quality of the subjects' relationships with their parents. The majority of the subjects revealed satisfactory development in most of the aspects surveyed, as well as in their relationships with their parents except where sexual issues were concerned. Nevertheless, most of the students reported menstrual disturbances, and a significant number of the sexually active reported inappropriate behavior in relation to contraception and AIDS prevention. The results of the research are analyzed using psychodynamic theories of sexual development.

Adverse Psychosexual Impact Related to the Treatment of Genital Warts and Cervical Intraepithelial Neoplasia

PubMed Central

Campaner, Adriana Bittencourt; Vespa Junior, Nelson; Giraldo, Paulo César; Leal Passos, Mauro Romero

2013-01-01

Objective. To compare the psychosexual impact related to the treatment of genital warts and cervical intraepithelial neoplasia (CIN) in women. Methods. 75 patients presenting with HPV-induced genital lesions, belonging to one of two patient groups, were included in the study: 29 individuals with genital warts (GWs) and 46 individuals with CIN grades 2 or 3 (CIN 2/3). Initially, medical charts of each woman were examined for extraction of data on the type of HPV-induced infection and treatment administered. Subjects were interviewed to collect sociodemographic data as well as personal, gynecologic, obstetric, and sexual history. After this initial anamnesis, the Sexual Quotient-Female Version (SQ-F) questionnaire was applied to assess sexual function. After application of the questionnaire, patients answered specific questions produced by the researchers, aimed at assessing the impact of the disease and its treatment on their sexual lives. Results. It is noteworthy that patients with CIN 2/3 had statistically similar classification of sexual quotient to patients with GWs (P = 0.115). However, patients with GWs more frequently gave positive answers to the specific questions compared to patients with CIN 2/3. Conclusion. Based on these findings, it is clear that GWs have a greater impact on sexual behavior compared to CIN 2/3. PMID:26316956

Cyclones, bi-cycles, and psychoanalysis: the witch-of-us? complex and The Wizard of Oz.

PubMed

Stern, Jeffrey

2003-01-01

Works of applied psychoanalysis normally use psychoanalytic theory to reveal the secret meanings of works of art. An attempt is made to reverse the directionality of such analyses and see whether a work of art, The Wizard of Oz, has something to teach psychoanalysis about adolescent female psychosexual development. The author argues that the popularity and importance of the film is an effect of its symbolic representation of a girl's entry into menarche, and the meaning of this milestone for herself and for her mother. He addresses ideas about feminine castration fears (or what more recently have been called fears of genital injury), issues about menopause, and fantasies--both surprising and violent--around the meanings of menarche for both mother and daughter.

[Sexual development of Czech girls before and after the "Velvet Revolution"].

PubMed

Raboch, J; Raboch, J; Sindlár, M

1996-01-01

Sexual development and behavior of 771 Czech girls 16 to 18 years old had been investigated by two sexuologists during the period of 1986 till 1994. A standardized interview of 78 items had been applied in a setting of a rehabilitation facility in Franzensbad. The majority of probands were there for rehabilitation after appendectomy. There were 389 examinees (158 apprentices and 231 students) interviewed before "the velvet revolution" and 382 girls (159 apprentices and 223 students) in the course of the years 1990 to 1994. A comparison of these two groups revealed a definite change in the psychosexual development of girls in the Czech society after the "Velvet Revolution". Particularly the motivation for the first coitus had changed. After November 1989 it was noticed that the answer "obliged her partner" had significantly decreased and the answer "wished it for myself" has substantially increased. Also in the group of probands with multiple sexual partners (21.5% of the sample) their average number decreased unexpectedly after "the Velvet Revolution".

Gender Development in 46,XY DSD: Influences of Chromosomes, Hormones, and Interactions with Parents and Healthcare Professionals

PubMed Central

Wisniewski, Amy B.

2012-01-01

Variables that impact gender development in humans are difficult to evaluate. This difficulty exists because it is not usually possible to tease apart biological influences on gender from social variables. People with disorders of sex development, or DSD, provide important opportunities to study gender within individuals for whom biologic components of sex can be discordant with social components of gender. While most studies of gender development in people with 46,XY DSD have historically emphasized the importance of genes and hormones on gender identity and gender role, more recent evidence for a significant role for socialization exists and is considered here. For example, the influence of parents' perceptions of, and reactions to, DSD are considered. Additionally, the impact of treatments for DSD such as receiving gonadal surgeries or genitoplasty to reduce genital ambiguity on the psychological development of people with 46,XY DSD is presented. Finally, the role of multi-disciplinary care including access to peer support for advancing medical, surgical and psychosexual outcomes of children and adults with 46,XY DSD, regardless of sex of rearing, is discussed. PMID:24278745

A comparison of demographic and psychosexual characteristics of women with primary versus secondary provoked vestibulodynia.

PubMed

Brotto, Lori A; Sadownik, Leslie A; Thomson, Sydney; Dayan, Marcy; Smith, Kelly B; Seal, Brooke N; Moses, Melissa; Zhang, Areiyu

2014-05-01

Provoked vestibulodynia (PVD) is a distressing genital pain condition affecting approximately 12% of premenopausal women. It has been speculated that primary (ie, lifelong) and secondary (ie, acquired) PVD may represent 2 distinct conditions with different etiologies. There is also evidence that primary and secondary PVD subtypes may respond differently to conventional treatments. The goal of this study was to compare the demographic, clinical, and psychosexual characteristics of a large sample of premenopausal women with primary and secondary PVD. A total of 132 premenopausal women (n=42 primary; n=90 secondary) with PVD who sought treatment in a Multidisciplinary Vulvodynia Program completed demographic questions and a battery of validated self-report measures before treatment. Women with primary PVD had a longer duration of PVD as well as more time before diagnosis. Women with secondary PVD reported significantly more clitoral hood pain, higher overall vestibular pain levels, more overall sexual dysfunction and sex-related distress, and proportionately more intercourse occasions that were painful. Women with primary pain stated they had significantly more dysmenorrhea and were more likely to report that their partners were unaware of their PVD symptoms. There were no significant subtype differences on any psychological measure but a trend towards higher magnification of symptoms in women with secondary PVD. Overall the findings suggest some important differences in the characteristics of women with primary versus secondary PVD which may have management-related implications.

Psychosexual well-being in women using oral contraceptives containing drospirenone.

PubMed

Nappi, Rossella E; Albani, Francesca; Tonani, Silvia; Santamaria, Valentina; Pisani, Carla; Terreno, Erica; Martini, Ellis; Polatti, Franco

2009-01-01

Considerable advances have been made in hormonal contraception in recent years, geared at maximizing compliance and minimizing discontinuation. In oral contraceptive (OC) formulations, the estrogenic component, generally ethinyl estradiol (EE), has been reduced significantly and newer progestins like dienogest and drospirenone (DRSP), compounds with different molecular structures, have been introduced; in addition, new regimens (extended, flexible, 24/4 formats instead of the standard 21/7 format) and innovative delivery systems (vaginal rings, transdermal patches, subcutaneous implants and intrauterine devices) are available. The multitude of choices allows hormonal contraception to be tailored to the individual woman in order to obtain non-contraceptive benefits, without significant side effects, and also a favorable risk/benefit profile for her general and reproductive health. Over the past few years, new OC formulations combining DRSP (3 mg), a unique progestin with both antimineralocorticoid and antiandrogenic activities, with estrogen (30 mcg or 20 mcg EE), in two regimens (24/4 and 21/7) of active pills in a 28-day cycle, have shown positive effects on water retention-related weight gain and physical, emotional and psychosexual well-being. It seems likely that the use of a low-dose, well-balanced OC and the shorter 4-day hormone-free interval may minimize the side effects that can impair quality of life and thus increase women's compliance with hormonal contraception therapy.

Stress and hormones

PubMed Central

Ranabir, Salam; Reetu, K.

2011-01-01

In the modern environment one is exposed to various stressful conditions. Stress can lead to changes in the serum level of many hormones including glucocorticoids, catecholamines, growth hormone and prolactin. Some of these changes are necessary for the fight or flight response to protect oneself. Some of these stressful responses can lead to endocrine disorders like Graves’ disease, gonadal dysfunction, psychosexual dwarfism and obesity. Stress can also alter the clinical status of many preexisting endocrine disorders such as precipitation of adrenal crisis and thyroid storm. PMID:21584161

[The sequential traumatisation of a Sinti-child Holocaust-survivor].

PubMed

Purucker, Michael

2004-05-01

The subject of this case-report is the life-history, nosogenesis and history of compensation claims of a 64-years old Sinti-woman, who survived Nazi-persecution and WWII as a child. She and her mother spent 3 years in a concentration camp. At the end of the war she witnessed her mothers death. Her life is characterised by psychosomatic symptoms, disorders of psychosexual development, including infertility, and a chronic Post Traumatic Stress Disorder. The non-treated course of the Holocaust survivor syndrom, described by Niederland, which was mostly denied in Germany, could be now shown by detailed exploration and the reanalysis of former expert reports of her symptoms. Furthermore, this case report presents the internationally described characteristics of long-term effects in children that have survived the Holocaust. These symptoms are typical of cases that were not been treated throughout life. The former lack of acceptance in Germany of these long-term effects has - like in this and other cases - lead to development into a chronic disorder.

Research priorities for gender nonconforming/transgender youth: gender identity development and biopsychosocial outcomes.

PubMed

Olson-Kennedy, Johanna; Cohen-Kettenis, Peggy T; Kreukels, Baudewijntje P C; Meyer-Bahlburg, Heino F L; Garofalo, Robert; Meyer, Walter; Rosenthal, Stephen M

2016-04-01

The review summarizes relevant research focused on prevalence and natural history of gender nonconforming/transgender youth, and outcomes of currently recommended clinical practice guidelines. This review identifies gaps in knowledge, and provides recommendations foci for future research. Increasing numbers of gender nonconforming youth are presenting for care. Clinically useful information for predicting individual psychosexual development pathways is lacking. Transgender youth are at high risk for poor medical and psychosocial outcomes. Longitudinal data examining the impact of early social transition and medical interventions are sparse. Existing tools to understand gender identity and quantify gender dysphoria need to be reconfigured to study a more diverse cohort of transgender individuals. Increasingly, biomedical data are beginning to change the trajectory of scientific investigation. Extensive research is needed to improve understanding of gender dysphoria, and transgender experience, particularly among youth. Recommendations include identification of predictors of persistence of gender dysphoria from childhood into adolescence, and a thorough investigation into the impact of interventions for transgender youth. Finally, examining the social environments of transgender youth is critical for the development of appropriate interventions necessary to improve the lives of transgender people.

An Exploration of the Psycho-Sexual Experiences of Women Who Have Undergone Female Genital Cutting: A Case of the Maasai in Kenya

PubMed Central

Esho, T.

2012-01-01

The research explored the link between type II Female Genital Cutting (FGC) and sexual functioning. This thesis summary thus draws from an exploratory ethnographic field study carried out among the Maasai people of Kenya where type II FGC is still being practiced. A purposely sample consisting of 28 women and 19 men, within the ages of 15-80 years took part in individual interviews and 5 focus group discussions. Participants responded to open-ended questions, a method deemed appropriate to elicit insider’s in-depth information. The study found out that one of the desired effects of FGC ritual among the Maasai was to reduce women’s sexual desire, embodied as tamed sexuality. This consequence was however not experienced as an impediment to sexual function. The research established that esteeming transformational processes linked with the FGC ‘rite of passage’ are crucial in shaping a woman’s femininity, identity, marriageable status and legitimating sexuality. In turn, these elements are imperative in inculcating and nurturing a positive body-self image and sex appeal and consequently, positive sexual self actualization. These finding brings to question the validity of conventional sexuality theory, particularly those that subscribe to bio-physical models as universal bases for understanding the subject of female sexual functioning among women with FGC. Socio-cultural-symbolic nexus and constructions of sexuality should also be considered when investigating psychosexual consequences of FGC. PMID:24753899

Correlates of Self-efficacy for Condom Use among Male Clients of Female Sex Workers in Tijuana, Mexico

PubMed Central

Volkmann, Tyson; Wagner, Karla D.; Strathdee, Steffanie A.; Semple, Shirley J.; Ompad, Danielle C.; Chavarin, Claudia V.; Patterson, Thomas L.

2013-01-01

Male clients of female sex workers (FSWs) in Tijuana, Mexico engage in high levels of unprotected sex. While behavioral change theories posit that self-efficacy predicts condom use, correlates of self-efficacy for condom use remain largely unstudied. We examined these correlates among male clients of FSWs in Tijuana. Eligible male clients were at least 18 years of age, HIV-negative, lived in Tijuana or San Diego, reported unprotected sex with a Tijuana FSW at least once in the past four months, and agreed to be treated for sexually transmitted infections (STIs). Participants completed an interviewer-administered questionnaire including demographics, substance use, psychosocial and psychosexual characteristics (e.g., outcome expectancies for negotiation of safer sex, social support, and sexual sensation seeking), and sexual behaviors. Participants also underwent HIV/STI testing. A stepwise hierarchical multiple regression analysis identified correlates of self-efficacy for condom use. Of 393 male clients, median age was 37 years. Participants were mostly Spanish-speaking and employed. Factors independently associated with higher self-efficacy for condom use were higher positive outcome expectancies for negotiation of safer sex, lower sexual sensation seeking scores, and higher social support scores. Both psychosocial and psychosexual factors may influence self-efficacy for condom use among male clients of FSWs. These factors represent central constructs in sociocognitive models that explain behavioral change and could be intervention targets for improving self-efficacy for condom use and, ultimately, safer sex behavior. PMID:23842786

Psychological aspects of vasectomy in Malaysia.

PubMed

Wolfers, H; Subbiah, N; Ariffin Bin Mazurka

1973-09-01

246 men, aged 21-59, living on rubber estates on the outskirts of Kuala Lumpur, Malaysia, were interviewed 1-4 years after vasectomy in a study conducted by the International Institute for the Study of Human Reproduction of Columbia University and the National Family Planning Board of Malaysia. Most of the men were of Indian origin; 223 were Hindus. The incidence and nature of psychological and medical complications were investigated, but this article treats only the psychological effects. The basic interviews consisted of verbal questionnaires; care was taken to avoid drawing attention to the researchers' interest in psychosexual effects. Men claiming regrets, fears, ill effects, and problems in married life after the operation were 9%, 11%, 54%, and 4%, respectively, of the total population. 11.8% of the men claimed to have a loss of libido. The percentages of men expressing regrets and fears decreased with increasing age, parity, and pregnancies of wife; age here is probably the overriding variable. When the vasectomy decision was joint, rather than the individual decision of either husband or wife, regrets and fears were significantly less (p.05 for both regrets and fears). No couple in the sample was without at least 1 living son, this suggesting that men without heirs will refrain from vasectomy in Malaysia. Higher proportions of men who had lost children reported anxiety. Men reporting psychosexual complications were reinterviewed in depth. In these depth interviews a variety of fantasies associated with the operation was revealed.

Surviving testicular cancer: the Lebanese lived experience.

PubMed

Saab, Mohammad; Noureddine, Samar; Abu-Saad Huijer, Huda; Dejong, Jocelyn

2014-01-01

Testicular cancer is thought to have a great impact on its survivors, yet there has been limited literature on the topic globally and no literature on the topic in Lebanon and the Arab region. The purpose of this study was to explore the lived experience of Lebanese testicular cancer survivors and gain an in-depth understanding of the psychosexual aspect of their experience. A hermeneutic phenomenological approach with semistructured digitally recorded interviews and observational field notes was utilized. A purposive sample of Lebanese testicular cancer survivors, aged between 18 and 50 years, in remission for at least 3 years, and willing to share personal information was recruited. Interviews were transcribed verbatim in Arabic. Data saturation was achieved at the seventh interview; a total of eight informants were recruited. The opening question was, "Tell me about your life since you got treated for testicular cancer," and was followed by probing questions. Two to three weeks after the initial interview, informants were called to validate the investigators' primary analysis. Six core themes emerged: cancer perception in the Lebanese culture; "do not show, do not tell"; cancer experience is a turning point; fertility, manhood, and relationships; coping with cancer; and preserved aspects of life. The findings provide an in-depth understanding of the experience of Lebanese testicular cancer survivors with a focus on the psychosexual aspect of this experience. The results suggest the need to educate patients about testicular cancer and its effect on their fertility.

Correlates of self-efficacy for condom use among male clients of female sex workers in Tijuana, Mexico.

PubMed

Volkmann, Tyson; Wagner, Karla D; Strathdee, Steffanie A; Semple, Shirley J; Ompad, Danielle C; Chavarin, Claudia V; Patterson, Thomas L

2014-05-01

Male clients of female sex workers (FSWs) in Tijuana, Mexico engage in high levels of unprotected sex. While behavioral change theories posit that self-efficacy predicts condom use, correlates of self-efficacy for condom use remain largely unstudied. We examined these correlates among male clients of FSWs in Tijuana. Eligible male clients were at least 18 years of age, HIV-negative, lived in Tijuana or San Diego, reported unprotected sex with a Tijuana FSW at least once in the past 4 months, and agreed to be treated for sexually transmitted infections (STIs). Participants completed an interviewer-administered questionnaire including demographics, substance use, psychosocial and psychosexual characteristics (e.g., outcome expectancies for negotiation of safer sex, social support, and sexual sensation seeking), and sexual behaviors. Participants also underwent HIV/STI testing. A stepwise hierarchical multiple regression analysis identified correlates of self-efficacy for condom use. Of 393 male clients, median age was 37 years. Participants were mostly Spanish-speaking and employed. Factors independently associated with higher self-efficacy for condom use were higher positive outcome expectancies for negotiation of safer sex, lower sexual sensation seeking scores, and higher social support scores. Both psychosocial and psychosexual factors may influence self-efficacy for condom use among male clients of FSWs. These factors represent central constructs in sociocognitive models that explain behavioral change and could be intervention targets for improving self-efficacy for condom use and, ultimately, safer sex behavior.

[Sexuality and pregnancy].

PubMed

Sueiro, E; Gayoso, P; Perdiz, C; Doval, J L

1998-10-15

We intend to describe the sexual behaviour of pregnancies women. Family Planning Center Nóvoa Santos, of Galician Health Service (SERGAS), of Ourense (SPAIN). 206 pregnancies women that are attended in a obstetric psychoprophylaxis's programme, during two years (January/93-January/95). We analysed the social economic, of reproduction, of medical attention and psycho-sexual variables. We use the PRESTA and SPSS statistics programmes. The average age is 28 years old, is married, has elementary studies and this is the first pregnancy. Her pregnancy is desire and normally developed. Her sexual desire and intercourse frequency is the same (1-2 per week); the intercourse is pleasant and the more habitual position is she over. Some times, the couple has relations without coitus and she practises the masturbation, and she enjoy of this practice. The pregnancies women have different sexual behaviours. They are satisfied with all them. The health' professional should favour the complete enjoy of the sexuality during the pregnancy.

[Sexual health symptoms and problems in a population of patients in a day hospital for neurotic disorders].

PubMed

Sobański, Jerzy A; Müldner-Nieckowski, Łukasz; Klasa, Katarzyna; Rutkowski, Krzysztof; Dembińska, Edyta

2012-01-01

Analysis of prevalence of symptoms and problems connected with sexuality in patients admitted to a day hospital for neurotic and behavioral disorders' treatment. The results of diagnostics of 2582 women and 1347 men, admitted for psychotherapy in a day hospital, because of neurotic, behavioral and personality disorders. Symptoms from the sexuality area revealed themselves to be frequent in the population of patients entering psychotherapy in a day hospital for neurotic disorders, and they were not directly linked to sexological treatment. Also traumatic events potentially disturbing psychosexual development were reported by patients, however with a different frequency, this being higher for self-assessed lack of sexual education in childhood or forced sexual debut, and low for incest or very early commencement, and for being punished for masturbation. Psychotherapists as well as other professionals treating neurotics, should expect--besides numerous typical symptoms: anxiety, somatization etc.--complaints from area of sexual dysfunctions.

[Adolescent arsonists--psychodynamics, family dynamics and attempt at framing a typology based on 40 expert opinions].

PubMed

Klosinski, G; Bertsch, S L

2001-02-01

Psychiatric, psychological and medical data of 40 adolescent firesetters are obtained from a retrospective analysis of expert opinions which have been drawn up by the Department of Child and Adolescent Psychiatry in Tübingen over a period of 16 years (1981-1997). This analysis mainly focusses on the patients' physical and psychosexual development, their social integration and competence and their family dynamics. It further concentrates on the psychic situation at the time of the offense, the reasons and motives given for firesetting (by the patient and by the expert) and specific psychological test results. According to the results three different characteristic groups can be found: 1st a group of offenders who have set fires to their parents' house, 2nd firesetters being member of the firebrigade, and 3rd an unspecific inhomogeneous group of firesetters.

Temperament, insecure attachment, impulsivity, and sexuality in women in jail.

PubMed

Iliceto, Paolo; Pompili, Maurizio; Candilera, Gabriella; Rosafio, Iole; Erbuto, Denise; Battuello, Michele; Lester, David; Girardi, Paolo

2012-03-01

Women constitute only a small proportion of inmates, but several studies have shown that they have higher rates of psychiatric disturbance than incarcerated men and community samples. Mental health treatment is necessary to prevent severe illness and suicide in these women. The convenience sample consisted of 40 female detainees and 40 controls who were administered self-report questionnaires to assess temperament (TEMPS-A), insecure attachment (ECR), impulsivity (BIS-11), and sexual behavior (SESAMO). The incarcerated women had higher levels of affective temperament (except for hyperthymia), avoidance, anxiety, impulsivity, and psychosexual issues than the female community sample. Many interrelated emotional and affective disturbances affect the physical and psychological well-being of women in jail, and it is possible that these problems may lead to suicide. Health professionals need to develop gender-specific therapeutic interventions for women in jail. © 2012 International Association of Forensic Nurses.

Scales measuring psychosocial antecedents of coital initiation among adolescents in a rural southern state.

PubMed

Nagy, Stephen; Watts, Graham F; Nagy, M Christine

2003-06-01

The psychometric properties of psychosexual scales designed to examine intentions toward sexual intercourse were examined. Participants from 22 schools in central Alabama provided data on demographics, knowledge, attitudes, beliefs, and intentions toward sexual intercourse. Theoretical constructs from Theory of Reasoned Action and Social Cognitive Theory guided the development of items assessing psychosocial aspects of sexual intercourse. Findings indicated that approximately half of the conceptual items (13 items) loaded on four factors. The four scales were (a) Coital Intentions, (b) Attitudes toward Negative Sexual Outcomes, (c) Social Norms toward Premature Sex, and (d) Self-efficacy of Sexual Refusal Skills. These factors showed adequate independence and explained 46% of the variance in the data. Cronbach alpha ranged from .69 to .78. Scales show acceptable evidence for evaluation; however, additional research from other geographical districts and other ethnic groups is needed to confirm their generalizability.

Role of oestrogen in male sexual behaviour: insights from the natural model of aromatase deficiency.

PubMed

Carani, C; Rochira, V; Faustini-Fustini, M; Balestrieri, A; Granata, A R

1999-10-01

In order to evaluate the role of oestrogens on human male sexual behaviour, the gender-identity, psychosexual orientation and sexual activity of a man with a congenital lack of oestradiol resulting from an inactivating mutation of the aromatase P450 gene was investigated. The psychosexual and sexual behavioural evaluations were performed before and during testosterone treatment and before oestradiol treatment, during three phases of different dosages of oestradiol treatment. The study was performed before (phase A) and during (phase B) testosterone enanthate treatment (250 mg i.m. every 10 days, for 6 months), during testosterone withdrawal (phase C), and during each of the following transdermal oestradiol treatments: 50 microg twice a week for 6 months (phase D); 25 microg twice a week for 9 months (phase E), and 12.5 microg twice a week for 9 months (phase F). Sexual behaviour was investigated by a sexological interview and by a 2-month self-reported daily diary performed during each phase of the protocol study. Furthermore, during each oestradiol treatment (phase C, D, E and F), a study of depression, anxiety trait and sexual behaviour was performed by the Beck Depression Inventory (BDI), the Spielberger Trait Anxiety Inventory (STAI) and the Golombok-Rust Inventory of Sexual Satisfaction (GRISS), respectively. Sexual orientation and gender-identity were evaluated by the BEM Sex Role Inventory (BSRI). Serum testosterone and oestradiol were measured during each phase of the study. Before oestradiol treatment (phase C), serum oestradiol was undetectable, while it rose to 356.1, 88.1 and 55.1 pmol/l during phases D, E and F, respectively. Before any oestradiol treatment, during phase D, phase E and phase F serum testosterone was 18.13, 0.72, 14.3 and 18.51 nmol/l, respectively. The patient's gender-identity as assessed by BSRI and by the sexological interview was clearly male. The psychosexual orientation evaluated by BSRI, by the sexological interview and by the analysis of the self-filled diary was heterosexual. Relevant modification of the patient's sexual behaviour occurred only during oestrogen treatment. This was more evident during both phase E and phase F, and concerned the behavioural parameters with an increase of libido, frequency of sexual intercourse, masturbation and erotic fantasies. A reduction of BDI and STAI scores was detected during the oestrogen phases. The study of the sexual behaviour in this man with aromatase deficiency suggests that oestrogens in humans do not affect gender-identity and sexual orientation but could have a role in male sexual activity.

Psychosexual responses to infertility.

PubMed

Keye, W R

1984-09-01

Clearly, infertility is one of several gynecologic conditions that may have a profound effect on the psychological and sexual status of its victim. It is obvious from indepth discussions with many infertile couples that they want their physician to help them recognize and deal with these problems. Unfortunately, we are often ill-prepared to meet such a request. Hopefully, however, the next several years will see an increase in the systematic and scientific study of such problems and their solutions, thus providing us with a rational and proven method of dealing with these problems.

As the wheel turns: a centennial reflection on Freud's Three Essays on the Theory of Sexuality.

PubMed

Person, Ethel Spector

2005-01-01

Freud's theories of psychosexual development, while highly original, were anchored in the explosion of scientific studies of sex in the nineteenth century. Most of these studies were based on masturbation, homosexuality, and deviance, with little attention given to normal sexuality. Around the turn of the century, the narrow interest in pathological sexuality and sexual physiology gradually gave way to a broader interest in normal sexuality. It was in the context of these expanding studies of sexuality that Freud proposed the first psychological view of sexuality, a theory that defined sex as being at the interface between soma and psyche. Libido theory, which Freud developed, is a theory of drives and conflicts. For Freud, libido was the major force in personality development, and he posited sexual conflicts as the heart of neuroses, sexual fixations as the essence of perversions. This article traces the way Freud's libido theory has served as one of the mainsprings in the development of psychoanalytic theory. It also addresses the major revisions that have taken place in libido theory, with a focus primarily on object relations theory, and the impact of culture on the way sex and sexual mores are parsed.

Penile vascular evaluation and sexual function before and after radical retropubic prostatectomy: 5-year follow-up.

PubMed

Dubbelman, Yvette D; Wildhagen, Mark F; Dohle, Gert R

2008-09-01

Sexual dysfunction is common after surgery for prostate cancer. The aetiology of changes in sexual potency after radical prostatectomy is probably multifactorial, including neurogenic, vascular and psychosexual factors. A prospective study was designed to investigate haemodynamic and psychosexual changes before and after radical retropubic prostatectomy (RRP) for organ-confined prostate cancer. Penile haemodynamic evaluation and an assessment of sexual excitement were performed preoperatively and 3 months after RRP by colour Doppler ultrasonography (CDU) with visual erotic stimulation combined with a single intracavernous injection of a mixture of papaverine/phentolamine. Questionnaires on sexual function [International Index of Erectile Function (IIEF)], general health and quality of life were sent to the patients preoperative, 3 months and 5 years after operation. Forty-eight men participated in the study. Mean age was 62.6 years (range 55-69). CDU did not show any significant reduction in mean peak systolic flow velocity and mean resistance index. From the men who preoperatively had normal arterial inflow 18% developed arteriogenic insufficiency. Some form of veno-occlusive insufficiency and low resistance indices were already present in the majority of normal potent men preoperatively. Surgical technique did not influence penile arterial blood flow after the operation. Three months and 5 years postoperatively, there was a highly significant reduction in erectile function, intercourse satisfaction, overall satisfaction, orgasmic function and sexual desire. However, with respect to the outcome at 3 months there was a significant improvement of orgasmic function 5 years after operation, especially after a bilateral nerve sparing procedure. Erections sufficient for vaginal penetration (questions 3 and 4 of the IIEF, score >or=8) improved from 2% to 11% 3 months and 5 years after RRP respectively. Total IIEF score was significantly better after a bilateral nerve-sparing procedure compared with non-nerve sparing. No structural vascular changes were observed 3 months after operation. Vascular factors appear to be less important in the aetiology of ED after RRP. There seems to be a trend of a better improvement of sexual function over time, especially orgasmic function, in patients with bilateral nerve-sparing surgery.

Psychosexual and functional outcomes after creation of a neovagina with laparoscopic Davydov in patients with vaginal agenesis.

PubMed

Allen, Lisa M; Lucco, Kerith L; Brown, Cortney M; Spitzer, Rachel F; Kives, Sari

2010-11-01

To describe sexual function and satisfaction after laparoscopic Davydov vaginoplasty in patients with an absent vagina due to Mayer-Rokitansky-Kuster-Hauser syndrome or androgen insensitivity syndrome compared with a control female population. A descriptive study of standardized, validated psychosexual and functional outcomes using a self-report questionnaire. Two tertiary care hospitals at an academic medical center. Six women with Mayer-Rokitansky-Kuster-Hauser syndrome or androgen insensitivity syndrome who underwent laparoscopic Davydov. Patients postoperatively completed a self-report survey of their medical, surgical, and sexual history and the standardized, validated Female Sexual Function Index (FSFI) and select questions from the Golombok Rust Inventory of Sexual Satisfaction (GRISS). Total scores and domain scores (desire, arousal, lubrication, orgasm, pain, satisfaction) on the FSFI were compared with a published control population of women. Descriptive results of domain questions on the selected questions of the GRISS were identified. Six patients, aged 20-52 years, returned the questionnaires. Responses to the modified GRISS are represented by visual frequency of response bar graphs. Compared with the control population, the patients' scores were lower for arousability, lubrication, orgasm, and comfort on the FSFI. Sexual function appears impaired in these six women who underwent laparoscopic Davydov as assessed by the FSFI. This may reflect characteristics of the patient population, as well as the inclusion of all patients' data even if they did not attempt vaginal intercourse in the previous month. Copyright © 2010 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

'Chronophilia': Entries of Erotic Age Preference into Descriptive Psychopathology.

PubMed

Janssen, Diederik F

2015-10-01

A scientific nomenclature of erotic age preferences informed the mid- through late nineteenth century joint appearance of homosexuality and sexual abuse of minors on the medico-legal scene. Yet, even in the twenty-first century, legal, psychiatric and culture-critical dimensions of related terms are rarely cleanly distinguished. Review of primary sources shows the ongoing Western suspension of notions of 'sick desire', alongside and beyond the medicalisation of homosexuality, between metaphor, legal interdiction and postulated psychopathology. Virtually all early attention to erotic age preference occurred in the context of emergent attention to erotic gender preference. Age of attraction and age difference centrally animate modern homosexuality's pre-modern past; its earliest psychiatric nomenclature and typologies (1844-69); its early aetiologies stipulating degrees of sexual differentiation (1890 s); its concomitant sub-classification (1896-1914); its earliest psychophysiological tests (1950s); and, finally, its post-psychiatric, social scientific typologies (1980s). Several identifications of 'paedophilia' were seen throughout the 1890 s but as a trope it gained cultural momentum only during, and as a seemingly intriguing corollary of, the progressive depsychiatricisation of homosexuality across the Anglo-European world (late 1950s through 1980s). Early twentieth century sources varied in having it denote (1) a distinct perversion, thus possible 'complication' of sexual inversion (2) a discrete corollary of psychosexual differentiation akin to gender preference (3) a distinct subtype of fetishism, thus a likely imprint of early seduction (4) a more intricate expression of erotic symbolism or psychosexual complex or (5) a taste answering to culture, a lack of it, or a libertine disregard for it.

Hypothalamus, sexual arousal and psychosexual identity in human males: a functional magnetic resonance imaging study.

PubMed

Brunetti, M; Babiloni, C; Ferretti, A; Del Gratta, C; Merla, A; Olivetti Belardinelli, M; Romani, G L

2008-06-01

In a recent functional magnetic resonance imaging study, a complex neural circuit was shown to be involved in human males during sexual arousal [A. Ferretti et al. (2005) Neuroimage, 26, 1086]. At group level, there was a specific correlation between penile erection and activations in anterior cingulate, insula, amygdala, hypothalamus and secondary somatosensory regions. However, it is well known that there are remarkable inter-individual differences in the psychological view and attitude to sex of human males. Therefore, a crucial issue is the relationship among cerebral responses, sexual arousal and psychosexual identity at individual level. To address this issue, 18 healthy male subjects were recruited. Their deep sexual identity (DSI) was assessed following the construct revalidation by M. Olivetti Belardinelli [(1994) Sci. Contrib. Gen. Psychol., 11, 131] of the Franck drawing completion test, a projective test providing, according to this revalidation, quantitative scores on 'accordance/non-accordance' between self-reported and psychological sexual identity. Cerebral activity was evaluated by means of functional magnetic resonance imaging during hard-core erotic movies and sport movies. Results showed a statistically significant positive correlation between the blood oxygen level-dependent signal in bilateral hypothalamus and the Franck drawing completion test score during erotic movies. The higher the blood oxygen level-dependent activation in bilateral hypothalamus, the higher the male DSI profile. These results suggest that, in male subjects, inter-individual differences in the DSI are strongly correlated with blood flow to the bilateral hypothalamus, a dimorphic brain region deeply implicated in instinctual drives including reproduction.

Ferret mothers provide more anogenital licking to male offspring: possible contribution to psychosexual differentiation.

PubMed

Baum, M J; Bressler, S C; Daum, M C; Veiga, C A; McNamee, C S

1996-08-01

European ferret (Mustela putorius furo) mothers displayed significantly higher levels of anogenital licking (AGL) towards male as opposed to female kits in tests given on postpartum (P) days 6, 12, and 15. In these tests the entire litter was removed from the nestbox for 10 min, whereupon individual male and female kits were reintroduced to the mother in a counterbalanced order. In a second study an analysis of videotapes, sampled over the 24 h of several days, showed that mothers provided significantly more AGL to males than to females on P15, with a similar trend being observed on P1 and P8. This difference was no longer present on P22. In neither experiment was any sex difference observed in the amount of maternal licking of other (nonanogenital) body parts or in maternal carrying behavior received by kits. These results are comparable to those previously published for rat and gerbil, and further emphasize the possible contribution of sex differences in maternal stimulation, especially AGL, to the development of sexually dimorphic features of brain and behavioral development in different mammalian orders.

Research Priorities for Gender Nonconforming/Transgender Youth: Gender Identity Development and Biopsychosocial Outcomes

PubMed Central

Olson-Kennedy, J; Cohen-Kettenis, P. T.; Kreukels, B.P.C; Meyer-Bahlburg, H.F.L; Garofalo, R; Meyer, W; Rosenthal, S.M.

2016-01-01

This review summarizes relevant research focused on prevalence and natural history of gender non-conforming / transgender youth, and outcomes of currently recommended clinical practice guidelines. This review identifies gaps in knowledge, and provides recommendations foci for future research. Recent findings Increasing numbers of gender nonconforming youth are presenting for care. Clinically useful information for predicting individual psychosexual development pathways is lacking. Transgender youth are at high risk for poor medical and psychosocial outcomes. Longitudinal data examining the impact of early social transition and medical interventions are sparse. Existing tools to understand gender identity and quantify gender dysphoria need to be reconfigured in order to study a more diverse cohort of transgender individuals. Increasingly, biomedical data are beginning to change the trajectory of scientific investigation. Summary Extensive research is needed to improve understanding of gender dysphoria, and transgender experience, particularly among youth. Recommendations include identification of predictors of persistence of gender dysphoria from childhood into adolescence, and a thorough investigation into the impact of interventions for transgender youth. Finally, examining the social environments of transgender youth is critical for the development of appropriate interventions necessary to improve the lives of transgender people. PMID:26825472

Sexuality and reproductive issues in children with myelomeningocele.

PubMed

Joyner, B D; McLorie, G A; Khoury, A E

1998-02-01

Recent advancements in surgical and medical therapies have improved the life expectancy of children with myelomeningocele. Yet, there has been a contrasting lack of improvement with regards to sexual function and reproductive issues that continue to infantilize this population. This article identifies five major risk factors that contribute to these delays which invariably lead to irreversible emotional trauma if they are not addressed early in childhood. Adequate psychosexual education of myelomeningocele patients and their families is a tremendous societal challenge. But, only with education will there be trends away from policies of isolation to those that reinforce community integration of the physically disabled.

Breast reconstruction with anatomical implants: A review of indications and techniques based on current literature.

PubMed

Gardani, Marco; Bertozzi, Nicolò; Grieco, Michele Pio; Pesce, Marianna; Simonacci, Francesco; Santi, PierLuigi; Raposio, Edoardo

2017-09-01

One important modality of breast cancer therapy is surgical treatment, which has become increasingly less mutilating over the last century. Breast reconstruction has become an integrated part of breast cancer treatment due to long-term psychosexual health factors and its importance for breast cancer survivors. Both autogenous tissue-based and implant-based reconstruction provides satisfactory reconstructive options due to better surgeon awareness of "the ideal breast size", although each has its own advantages and disadvantages. An overview of the current options in breast reconstruction is presented in this article.

The Case of Abel: Religion as Boon and Bane for a Catholic Gay Man.

PubMed

Cerbone, Armand R; Danzer, Graham

2017-08-01

Conservative religions that condemn homosexual sexual orientation and acts as unnatural and sinful pose significant challenges for gay persons whose faith is a core part of their identity. The condemnation presents a serious barrier to the acceptance and integration of their sexuality, a primary task of psychosexual development. As a result, they can manifest depression, anxiety, suicidal ideation, and even suicide attempts. The ecclesiastical censure also imposes an untenable dilemma for homosexuals in that they feel pressed to reject their sexual identity or renounce their spiritual identity and heritage. Psychotherapists who treat gay persons caught in this quandary can find themselves facing a similar problem: how to help their homosexual client reconcile their proscribed sexuality with their spiritual commitments. The case presented here recounts the treatment over many years of a gay man suffering from such a conflict and his eventual accommodation of both his homosexuality and his faith. Recommendations are offered for constructive treatment with those torn between two conflicting core identities. © 2017 Wiley Periodicals, Inc.

Male partners of women with provoked vestibulodynia: attributions for pain and their implications for dyadic adjustment, sexual satisfaction, and psychological distress.

PubMed

Jodoin, Mélanie; Bergeron, Sophie; Khalifé, Samir; Dupuis, Marie-José; Desrochers, Geneviève; Leclerc, Bianca

2008-12-01

Provoked vestibulodynia is a female genital pain condition that results in sexual dysfunction and impacts negatively on the couple. Although patients' causal attributions have been linked to worse psychosexual outcomes, no study has documented the male partners' perspective of this distressing problem and its potential influence on their psychosexual adaptation. To identify whether male partners' attributions for vestibulodynia are possible predictors of their dyadic adjustment, sexual functioning, sexual satisfaction, and psychological distress, as well as of women's pain and sexual functioning. Thirty-eight women with vestibulodynia first completed measures of pain intensity and sexual functioning. Male partners responded to mailed questionnaires assessing their own attributions for genital pain as well as their psychological distress, relationship adjustment, sexual functioning, and sexual satisfaction. Women completed the McGill-Melzack Pain Questionnaire (MPQ) and the Female Sexual Function Index (FSFI). Attributions of male partners were measured using an adapted version of the Attributional Style Questionnaire (ASQ)-Partner Version. Men also filled out the Brief Symptom Inventory (BSI), the Dyadic Adjustment Scale (DAS), the Sexual History Form (SHF), and the Global Measure of Sexual Satisfaction (GMSEX). All four negative attribution dimensions and higher levels of women's pain intensity successfully predicted increased psychological distress in male partners. Higher levels of both internal and global attributions were associated with men's poorer dyadic adjustment, whereas global and stable attributions were related to their lower sexual satisfaction. Attributions failed to significantly predict sexual functioning in male partners and women's pain and sexual functioning. Evaluation and treatment of sexual pain problems should involve both partners and should explore the role of negative attributions.

Female Partners of Men With Peyronie's Disease Have Impaired Sexual Function, Satisfaction, and Mood, While Degree of Sexual Interference Is Associated With Worse Outcomes.

PubMed

Davis, Seth N P; Ferrar, Saskia; Sadikaj, Gentiana; Gerard, Marina; Binik, Yitzchak M; Carrier, Serge

2016-07-01

Peyronie's disease (PD) causes penile deformity and can result in sexual dysfunction and psychological distress. Currently, nothing is known about the psychosexual impact on the partners of men with PD. Research carried out on the partners of men with other chronic illnesses suggests that the partners of men with PD might have increased rates of sexual dysfunction and decreased sexual satisfaction. To examine (i) sexual functioning, sexual satisfaction, negative affect, and relationship satisfaction of men with PD and their female partners and (ii) the effect of male-perceived sexual interference on partners' outcomes. Forty-four men diagnosed with PD and their female partners completed a questionnaire package. Each partner filled out the Revised Dyadic Adjustment Scale, the Positive and Negative Affect Scale, the Global Measure of Sexual Satisfaction, and the Female Sexual Function Index (women) or the International Index of Erectile Function (men). Overall, partners of men with PD were found to have decreased sexual function, sexual satisfaction, and mood compared with population-based norms. Men and their partners showed non-distressed levels of relationship satisfaction. The degree to which PD interfered with sexual activity was an important correlate of outcomes. Increased sexual interference was associated with lower sexual function and satisfaction for the person experiencing interference. Sexual interference also was associated with negative affect and relationship satisfaction in partners and the person experiencing interference. PD is associated with negative psychosexual and psychosocial effects on those with the disease and their partners. As a result, assessment and intervention should include the two members of the couple. Copyright © 2016 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.

Erectile dysfunction and premature ejaculation: interrelationships and psychosexual factors.

PubMed

Brody, Stuart; Weiss, Petr

2015-02-01

Both erectile dysfunction (ED) and premature ejaculation (PE) impair the quality of sexual intercourse for both men and their female partners. This study aims to examine with a large representative sample the interrelationships of measures of ED, PE, typical intravaginal ejaculatory latency time (IELT), men's perceived relationship quality with their mother, and age of first being in love. In this cross-sectional study, a nationally representative sample of 960 Czech coitally experienced men (aged 15-84), provided age, International Index of Erectile Function 5-item (IIEF-5), Index of Premature Ejaculation (IPE) scores, IELT, rating of relationship with their mother, and age at first being in love. Correlations, partial correlations adjusting for age, analysis of covariance (ANCOVA), and multiple regression statistical methods were used. IIEF-5, IPE, and IELT were significantly intercorrelated (IIEF-5 and IPE: r=0.64). Better IIEF-5 scores were associated with younger age at first (and ever) being in love. Poorer IPE score, shorter IELT, and mild-moderate ED were associated with poorer perceived mother relationship (which was also associated with first being in love at an older age). Multiple regression analyses revealed that: (i) greater IELT was associated with better erectile function and better mother relationship, but not with age; and (ii) IELT of <1 minute was associated with poorer perceived mother relationship and poorer IIEF-5, but marginally with age. History of homosexual activity was unrelated to IIEF-5, IPE, IELT, and perceived mother relationship scores. The findings suggest that degrees of ED and PE are often comorbid, and both ED and PE are associated with less favorable early experiences with women. Brody S and Weiss P. Erectile dysfunction and premature ejaculation: Interrelationships and psychosexual factors. J Sex Med 2015;12:398-404. © 2014 International Society for Sexual Medicine.

‘Chronophilia’: Entries of Erotic Age Preference into Descriptive Psychopathology

PubMed Central

Janssen, Diederik F.

2015-01-01

A scientific nomenclature of erotic age preferences informed the mid- through late nineteenth century joint appearance of homosexuality and sexual abuse of minors on the medico-legal scene. Yet, even in the twenty-first century, legal, psychiatric and culture-critical dimensions of related terms are rarely cleanly distinguished. Review of primary sources shows the ongoing Western suspension of notions of ‘sick desire’, alongside and beyond the medicalisation of homosexuality, between metaphor, legal interdiction and postulated psychopathology. Virtually all early attention to erotic age preference occurred in the context of emergent attention to erotic gender preference. Age of attraction and age difference centrally animate modern homosexuality’s pre-modern past; its earliest psychiatric nomenclature and typologies (1844–69); its early aetiologies stipulating degrees of sexual differentiation (1890s); its concomitant sub-classification (1896–1914); its earliest psychophysiological tests (1950s); and, finally, its post-psychiatric, social scientific typologies (1980s). Several identifications of ‘paedophilia’ were seen throughout the 1890s but as a trope it gained cultural momentum only during, and as a seemingly intriguing corollary of, the progressive depsychiatricisation of homosexuality across the Anglo-European world (late 1950s through 1980s). Early twentieth century sources varied in having it denote (1) a distinct perversion, thus possible ‘complication’ of sexual inversion (2) a discrete corollary of psychosexual differentiation akin to gender preference (3) a distinct subtype of fetishism, thus a likely imprint of early seduction (4) a more intricate expression of erotic symbolism or psychosexual complex or (5) a taste answering to culture, a lack of it, or a libertine disregard for it. PMID:26352305

A proposed model of psychodynamic psychotherapy linked to Erik Erikson's eight stages of psychosocial development.

PubMed

Knight, Zelda Gillian

2017-09-01

Just as Freud used stages of psychosexual development to ground his model of psychoanalysis, it is possible to do the same with Erik Erikson's stages of development with regards to a model of psychodynamic psychotherapy. This paper proposes an eight-stage model of psychodynamic psychotherapy linked to Erik Erikson's eight stages of psychosocial development. Various suggestions are offered. One such suggestion is that as each of Erikson's developmental stages is triggered by a crisis, in therapy it is triggered by the client's search. The resolution of the search often leads to the development of another search, which implies that the therapy process comprises a series of searches. This idea of a series of searches and resolutions leads to the understanding that identity is developmental and therapy is a space in which a new sense of identity may emerge. The notion of hope is linked to Erikson's stage of Basic Trust and the proposed model of therapy views hope and trust as essential for the therapy process. Two clinical vignettes are offered to illustrate these ideas. Psychotherapy can be approached as an eight-stage process and linked to Erikson's eight stages model of development. Psychotherapy may be viewed as a series of searches and thus as a developmental stage resolution process, which leads to the understanding that identity is ongoing throughout the life span. Copyright © 2017 John Wiley & Sons, Ltd.

Sequelae of postpartum sterilization.

PubMed

Rosenfeld, B L; Taskin, O; Kafkashli, A; Rosenfeld, M L; Chuong, C J

1998-01-01

This study was designed to investigate the menstrual, psychosexual, psychological and somatic sequelae in a group of women who may be more prone to express regret following postpartum sterilization. The follow-up was conducted by questionnaire at six months and five years following the procedure. Data were available from 242 patient; 76.8% were below the age of 30. Of all patients, 21.9% expressed regrets. About one third had various menstrual disturbances. Patients rated their sex life as generally more enjoyable in many aspects. The most common psychological symptoms were irritability, nervousness and depression; while the common somatic symptoms were pelvic/abdominal pain and backache and tiredness.

First stirrings: cultural notes on orgasm, ejaculation, and wet dreams.

PubMed

Janssen, Diederik F

2007-05-01

Both the findings and the limitations of numeric milestone research in sexology have a bearing on the pedagogical status of pleasure, as well as the cultural underpinnings of the notion of a psychosexual milestone. An overview is offered of international data pertaining to the chronology of three "milestones" in sexual autobiography: first orgasm (orgasmarche), first ejaculation (oigarche), and first wet dream (nocturnal emission). Methodological problems associated with the measurement of these variables are discussed. These problems are then situated in a culturalist perspective. It is concluded that orgasms are cultural artifacts in terms of their chronological occurrence as well as perceived salience, necessity, and "age appropriateness".

[Ejaculatory disorders except premature ejaculation, orgasmic disorders].

PubMed

Rigot, J-M; Marcelli, F; Giuliano, F

2013-07-01

Disorders of ejaculation and orgasm apart from premature ejaculation are pretty uncommon. Medical literature was reviewed and combined with expert opinion of the authors. The semiology of these disorders is essential: aspermia, hypospermia, retrograde ejaculation, delayed or absent ejaculation with or without orgasm. Whether this is a lifelong or acquired condition, it is essential to assess the side-effects of medications i.e. psychotropic drugs, including antidepressant, neuroleptics, tramadol, alphablockers: tamsulosin and silodosin must always be surveyed. The management is often difficult, especially with a parenthood perspective. The management of lifelong disorders must rely on psychosexual therapies. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

Mental disorders in battered women: an empirical study.

PubMed

Gleason, W J

1993-01-01

Prevalence of mental disorders in 62 battered women receiving services from a Florida battered woman agency was identified by means of a structured interview, the Diagnostic Interview Schedule. Of the total sample of battered women, 30 were in a shelter operated by the agency and 32 were living in their own homes and receiving assistance from the agency. Resultant diagnoses met diagnostic criteria developed in the Diagnostic and Statistical Manual (3rd. ed.) of the American Psychiatric Association. The Diagnostic Interview Schedule is a 263 item structured interview used in the National Institute of Mental Health Epidemiological Catchment Area program carried out in the early 1980s. The Diagnostic Interview Schedule permits the use of 10,953 females in the epidemiological study as a comparison group of normal women. Scoring of the interviews was done by a computer diagnostic program with absolute decision rules. Extremely high prevalence was found for psychosexual dysfunction, major depression, post traumatic stress disorder, generalized anxiety disorder, and obsessive compulsive disorder. These diagnoses appear to reflect the major components of the battered woman syndrome developed by Lenore Walker and the study approximates Walker's request for improved methodology in the research into the psychology of the battered woman.

Autism-spectrum disorders in adolescence and adulthood: focus on sexuality.

PubMed

Turner, Daniel; Briken, Peer; Schöttle, Daniel

2017-11-01

The combination of the core symptoms, characterizing individuals with autism-spectrum disorder (ASD), can lead to problems in romantic relationships and sexual functioning. The purpose of this article is to review studies on sexuality in individuals with ASD published since January 2016. Individuals with ASD and especially women show a higher diversity in sexual orientation in comparison with the non-ASD population. Furthermore, ASD women are more frequently in a relationship and usually report more previous sexual experiences. Up to now, sexual education programs specifically addressing the needs of the ASD population were scarce, which was criticized by patients, their parents, and caregivers. With the development of the Tackling Teenage Training program, a psychoeducational intervention designed specifically for ASD individuals was introduced, leading to significant improvements in psychosexual functioning and knowledge. Such programs are needed because a considerable rate of problematic sexual behaviors, including public masturbation and paraphilic sexual interests were found in the ASD population. Just like their typically developing counterparts, individuals with ASD show the whole range of normal-to-problematic sexual behaviors. Improving sexual knowledge could lead to less inappropriate sexual behaviors and could improve sexual health as part of a healthy and satisfying life.

Gender Dysphoria and Gender Change in Disorders of Sex Development/Intersex Conditions: Results From the dsd-LIFE Study.

PubMed

Kreukels, Baudewijntje P C; Köhler, Birgit; Nordenström, Anna; Roehle, Robert; Thyen, Ute; Bouvattier, Claire; de Vries, Annelou L C; Cohen-Kettenis, Peggy T

2018-05-01

Information on the psychosexual outcome of individuals with disorders of sex development (DSDs) and intersex conditions is of great importance for sex assignment at birth of newborns with DSD. To assess gender change and gender dysphoria in a large sample of individuals with different DSDs. A cross-sectional study was conducted in 14 European centers with 1,040 participants (717 female-identifying and 311 male-identifying persons and 12 persons identifying with another gender) with different forms of DSD. The cohort (mean age = 32.36 years, SD = 13.57) was divided into 6 major subgroups: women with 45,X DSD and variants (Turner syndrome; n = 325), men with 47,XXY DSD and variants (Klinefelter syndrome; n = 219), women with XY DSD without androgen effects (n = 107) and with androgen effects (n = 63), men with XY DSD (n = 87), and women with 46,XX congenital adrenal hyperplasia (n = 221). Data on psychosexual outcome were gathered by medical interviews and questionnaires. Gender change and gender dysphoria. Although gender changes were reported by 5% of participants, only in 1% (3% if those with Klinefelter and Turner syndromes-conditions in which gender issues are not prominent-are excluded) did the gender change take place after puberty and was likely initiated by the patient. 39 participants (4%) reported gender variance: between male and female, a gender other than male or female, or gender queer, alternating gender roles, or a gender expression that differed from the reported gender. This group had lower self-esteem and more anxiety and depression than the other participants. Clinicians should be aware of and sensitive to the possibility that their patients with DSD not only might have transgender feelings and a desire to change gender, but also identify as different from male or female. The complexity of their feelings might require counseling for some patients. The study is unique in the large number of participants from many different clinics, with sizable numbers in most subgroups, and in the large number of aspects that were measured. However, the very broadness of the study made it impossible to focus in detail on gender issues. Also, there is a need for instruments specifically measuring gender dysphoria in individuals with DSD that take non-binary genders into account. To make appropriate gender care possible for people with DSD, the gender-normative and gender-variant development of children with DSD should be studied in longitudinal studies. Kreukels BPC, Köhler B, Nordenström A, et al. Gender Dysphoria and Gender Change in Disorders of Sex Development/Intersex Conditions: Results From the dsd-LIFE Study. J Sex Med 2018;15:777-785. Copyright © 2018 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.

The course of life of survivors of childhood cancer.

PubMed

Stam, H; Grootenhuis, M A; Last, B F

2005-03-01

The developmental consequences in adulthood of growing up with childhood cancer are not well understood. The Course of life questionnaire was developed to assess the attainment of developmental milestones retrospectively and socio-demographic outcomes in young adulthood. The aim of this study was to assess the course of life and socio-demographic outcomes in young adult survivors of childhood cancer. Knowledge about possible gaps in the course of life could enable health care providers to aim for the most favourable course of life. A total of 353 Dutch survivors and a comparison group of 508 peers without a history of cancer, all aged between 18 and 30, filled in the Course of life questionnaire. The course of life of the survivors was found to be hampered. The young adult survivors of childhood cancer in the Netherlands turned out to have achieved fewer milestones than their peers with respect to autonomy development, social development, and psycho-sexual development, or to have achieved the milestones when they were older than their peers. In addition, survivors displayed less risk behaviour than the comparison group. The survivors and the comparison group also differed on some socio-demographic issues. A considerably lower percentage of survivors than peers in the comparison group were married or living together, and/or employed. Their educational level, on the other hand, was as high as that of their peers. Copyright 2004 John Wiley & Sons, Ltd.

Androgen imprinting of the brain in animal models and humans with intersex disorders: review and recommendations.

PubMed

Hrabovszky, Zoltan; Hutson, John M

2002-11-01

Psychosexual development, gender assignment and surgical treatment in patients with intersex are controversial issues in the medical literature. Some groups are of the opinion that gender identity and sexual orientation are determined prenatally secondary to the fetal hormonal environment causing irreversible development of the nervous system. We reviewed the evidence in animal and human studies to determine the possible role of early postnatal androgen production in gender development. An extensive literature review was performed of data from animal experiments and human studies. RESULTS Many animal studies show that adding or removing hormonal stimulus in early postnatal life can profoundly alter gender behavior of the adult animal. Human case studies show that late intervention is unable to reverse gender orientation from male to female. Most studies have not permitted testing of whether early gender assignment and treatment as female with suppression/ablation of postnatal androgen production leads to improved concordance of the gender identity and sex of rearing. Animal studies support a role for postnatal androgens in brain/behavior development with human studies neither completely supportive nor antagonistic. Therefore, gender assignment in infants with intersex should be made with the possibility in mind that postnatal testicular hormones at ages 1 to 6 months may affect gender identity. A case-control study is required to test the hypothesis that postnatal androgen exposure may convert ambisexual brain functions to committed male behavior patterns.

Dreams In Jungian Psychology: The use of Dreams as an Instrument For Research, Diagnosis and Treatment of Social Phobia.

PubMed

Khodarahimi, Siamak

2009-10-01

The significance of dreams has been explained in psychoanalysis, depth psychology and gestalt therapy. There are many guidelines in analytic psychology for dream interpretation and integration in clinical practice. The present study, based on the Jungian analytic model, incorporated dreams as an instrument for assessment of aetiology, the psychotherapy process and the outcome of treatment for social phobia within a clinical case study. This case study describes the use of dream analysis in treating a female youth with social phobia. The present findings supported the three stage paradigm efficiency in the Jungian model for dream working within a clinical setting, i.e. written details, reassembly with amplification and assimilation. It was indicated that childhood and infantile traumatic events, psychosexual development malfunctions, and inefficient coping skills for solving current life events were expressed in the patient's dreams. Dreams can reflect a patient's aetiology, needs, illness prognosis and psychotherapy outcome. Dreams are an instrument for the diagnosis, research and treatment of mental disturbances in a clinical setting.

Pharmacotherapy of Sexual Dysfunctions : Current Status

PubMed Central

Avasthi, Ajith; Biswas, Parthasarathy

2004-01-01

The sexual dysfunctions are one of the most prevalent conditions. Sexual dysfunctions can have profound effect on the psychological well-being of an individual and the psychosexual relationship of a couple. Management of the sexual dysfunction should be preceded by an accurate diagnosis reached after a complete medical and sexual history and physical examination. Current focus of researchers has been on understanding the pathophysiology of erectile dysfunction, premature ejaculation and other sexual dysfunctions that can help in developing newer pharmacological cures for these conditions. Recently, a number of clinical trials have studied the potential effectiveness of the phosphodiesterase (PDE)-5 inhibitor sildenafil in the treatment of Erectile Dysfunction (ED) and Premature Ejaculation (PME). The introduction of PDE-5 inhibitors like sildenafil, vardenafil and tadalafil has revolutionized the treatment of sexual dysfunctions. This review focuses on the recent pharmacological advances in the treatment of common sexual dysfunctions like ED and PME with special focus on the role of PDE-5 inhibitors. Also discussed is the pharmacological treatment of other less prevalent and recognized disorders like female sexual dysfunction, drug induced sexual dysfunction etc. PMID:21224902

[Kallmann syndrome. Fundamentals and two medical histories].

PubMed

Hefner, J; Csef, H; Seufert, J

2009-10-01

Kallmann syndrome is defined as a combination of isolated hypogonadotropic hypogonadism (IHH), hyposmia or anosmia and several optional neurological or anatomical particularities. The genetically caused illness affects mechanisms of neuronal migration, first of all concerning GnRH-producing neurons and those of the olfactory bulb.The first, nowadays rather seldom case, serves as an example of a patient suffering from grave, especially somatic symptoms of the disease. IHH, anosmia, eunuchoidism (physique, puerile voice, gynecomastia, micropenis, missing secondary sex characteristics) and distinct osteoporosis were verified.With the case of the second patient, late psychosexual sequelae of the syndrome are elucidated. The patient had been treated with testosterone after contracting mumps orchitis in early childhood. The physical development of the second patient progressed well since initiation of hormone substitution; however, infertility was still present. Now he complains of symptoms of depression caused by the separation from his female partner. Intermittent disorders of sexual functions and difficulties in establishing a male sexual identity lowered his self-esteem. Diagnostic and therapeutic capabilities and limits are particularized and items of future concern are emphasized.

Noninvasive Prenatal Diagnosis of Congenital Adrenal Hyperplasia.

PubMed

Khattab, Ahmed; Yuen, Tony; Sun, Li; Yau, Mabel; Barhan, Ariella; Zaidi, Mone; Lo, Y M Dennis; New, Maria I

2016-01-01

A major hallmark of classical congenital adrenal hyperplasia (CAH) is genital ambiguity noted at birth in affected females, which leads to psychological and psychosexual issues in adult life. Attempts to correct genital ambiguity through surgical intervention have been partially successful. Fetal hyperandrogenemia and genital ambiguity have been shown to be preventable by prenatal administration of low-dose dexamethasone initiated before the 9th week of gestation. In 7 of 8 at-risk pregnancies, the unaffected fetus is unnecessarily exposed to dexamethasone for weeks until the diagnosis of classical CAH is ruled out by invasive procedures. This therapeutic dilemma calls for early prenatal diagnosis so that dexamethasone treatment can be directed to affected female fetuses only. We describe the utilization of cell-free fetal DNA in mothers carrying at-risk fetuses as early as 6 gestational weeks by targeted massively parallel sequencing of the genomic region including and flanking the CYP21A2 gene. Our highly personalized and innovative approach should permit the diagnosis of CAH before genital development begins, therefore restricting the purposeful administration of dexamethasone to mothers carrying affected females. © 2016 S. Karger AG, Basel.

Dreams In Jungian Psychology: The use of Dreams as an Instrument For Research, Diagnosis and Treatment of Social Phobia

PubMed Central

Khodarahimi, Siamak

2009-01-01

Background: The significance of dreams has been explained in psychoanalysis, depth psychology and gestalt therapy. There are many guidelines in analytic psychology for dream interpretation and integration in clinical practice. The present study, based on the Jungian analytic model, incorporated dreams as an instrument for assessment of aetiology, the psychotherapy process and the outcome of treatment for social phobia within a clinical case study. Method: This case study describes the use of dream analysis in treating a female youth with social phobia. Results: The present findings supported the three stage paradigm efficiency in the Jungian model for dream working within a clinical setting, i.e. written details, reassembly with amplification and assimilation. It was indicated that childhood and infantile traumatic events, psychosexual development malfunctions, and inefficient coping skills for solving current life events were expressed in the patient’s dreams. Conclusion: Dreams can reflect a patient’s aetiology, needs, illness prognosis and psychotherapy outcome. Dreams are an instrument for the diagnosis, research and treatment of mental disturbances in a clinical setting. PMID:22135511

PSYCHOLOGICAL ASPECTS OF INFERTILITY*

PubMed Central

Thara, R.; Ramachandran, V.; Hassan, P.P. Mohammed

1986-01-01

SUMMARY Forty couples who attended the Infertility clinic of Government Royapettah Hospital, Madras, were included in the study and compared with matched controls who had off springs. All 80 persons were administered the M.H.Q. and the E.P.I. Psychosocial data was recorded and a clinical psychiatric evaluation was done. 51 out of 80 in the study group had psychiatric problems, predominantly depression and anxiety. These problems increased with increasing duration of childless marriage. 40 % of the infertile group had psychosexual dysfunction such as premature ejaculation and erectile disturbances as opposed to 2.5% in the controls. Presence of vaginisms, dysmenorrhea and sexual dissatisfaction were more in the women of the study group. 15 males bad oligospermia/azospermia. PMID:21927198

Research gaps in the care of women with female genital mutilation: an analysis.

PubMed

Abdulcadir, J; Rodriguez, M I; Say, L

2015-02-01

Female genital mutilation (FGM) includes procedures involving the partial or total removal of the external female genitals for non-therapeutic reasons. They can have negative psychosexual and health consequences that need specific care. In this paper, we review some key knowledge gaps in the clinical care of women with FGM, focusing on obstetric outcomes, surgical interventions (defibulation and clitoral reconstruction), and the skills and training of healthcare professionals involved in the prevention and management of FGM. We identify research priorities to improve the evidence necessary to establish guidelines for the best multidisciplinary care, communication, and prevention, and to improve health-promotion measures for women with FGM. © 2014 Royal College of Obstetricians and Gynaecologists.

[Various forms of current sex taboo-ism from the gynecologist's point of view].

PubMed

Kvíz, D

1977-05-01

Antisexual primary Christian traditions, which consist of, as a rule, a mixture of suppression, silencing, intimidation, and threat, still have sufficiently extensive sociopsychological consequences to disrupt the psychosexual equilibrium of an individual. This has been seen through the great number of single women who, upon requesting artificial abortion, desire to keep their situation a secret, particularly from the parents. A similar attitude of "taboo" has been observed in regard to venereal diseases. These sociosexual attitudes, and the sense of shame involved, are linked to very old social and religious antisexual traditions. Some efforts have been made in the direction of sex education in the schools, notably with the very popular book by Pondelickova-Maslova.

Predictors of sexual desire disorders in women.

PubMed

Brotto, Lori A; Petkau, A John; Labrie, Fernand; Basson, Rosemary

2011-03-01

A historic belief was that testosterone was the "hormone of desire." However, recent data, which show either minimal or no significant correlation between testosterone levels and women's sexual desire, suggest that nonhormonal variables may play a key role. To compare women with hypoactive sexual desire disorder (HSDD) and those with the recently proposed more symptomatic desire disorder, Sexual Desire/Interest Disorder (SDID), on the relative contribution of hormonal vs. nonhormonal variables. Women with HSDD (N = 58, mean age 52.5) or SDID (N = 52, mean age 50.9) participated in a biopsychosocial assessment in which six nonhormonal domains were evaluated for the degree of involvement in the current low desire complaints. Participants provided a serum sample of hormones analyzed by gas chromatography-mass spectrometry or liquid chromatography/mass spectrometry/mass spectrometry. Logistic regression was used to assess the ability of variables (nonhormonal: history of sexual abuse, developmental history, psychosexual history, psychiatric status, medical history, and sexual/relationship-related factors; hormonal: dehydroepiandrosterone [DHEA], 5-diol, 4-dione, testosterone, 5-α-dihydrotestosterone, androsterone glucuronide, 3α-diol-3G, 3α-diol-17G, and DHEA-S; and demographic: age, relationship length) to predict group membership. Women with SDID had significantly lower sexual desire and arousal scores, but the groups did not differ on relationship satisfaction or mood. Addition of the hormonal variables to the two demographic variables (age, relationship length) did not significantly increase predictive capability. However, the addition of the six nonhormonal variables to these two sets of predictors significantly increased ability to predict group status. Developmental history, psychiatric history, and psychosexual history added significantly to the predictive capability provided by the basic model when examined individually. Nonhormonal variables added significant predictive capability to the basic model, highlighting the importance of their assessment clinically where women commonly have SDID in addition to HSDD, and emphasizing the importance of addressing psychological factors in treatment. © 2010 International Society for Sexual Medicine.

Do adult men with untreated ventral penile curvature have adverse outcomes?

PubMed

Menon, Vani; Breyer, Benjamin; Copp, Hillary L; Baskin, Laurence; Disandro, Michael; Schlomer, Bruce J

2016-02-01

Congenital ventral penile curvature without hypospadias is often treated surgically in childhood. The history of untreated ventral curvature is unknown. This study's aim was to examine the association of untreated ventral penile curvature with various sexual and psychosexual outcomes. An electronic survey was advertised to men older than 18 years on Facebook. Men with possible ventral penile curvature identified themselves by choosing sketches that most closely represented their anatomy. Outcomes assessed included: Sexual Health Inventory for Men, difficulty of intercourse because of curvature, International Prostate Symptom Score, Penile Perception Score, psychosexual milestones, paternity, infertility, sitting to urinate, and the CDC HRQOL-4 module. Among participants, 81 out of 684 men (11.8%) reported untreated ventral penile curvature. Participants with self-reported curvature noted more difficulty with intercourse because of curvature (4.5 vs 4.9, p < 0.001), more unhealthy mental days (8.6 vs 6.2, p = 0.02), and increased dissatisfaction with penile self-perception compared with men without reported curvature (8.6 vs 9.5, p < 0.001). Men with possible untreated ventral curvature reported worse penile perception scores, more mentally unhealthy days, and increased difficulty with intercourse secondary to curvature compared with men without curvature. A limitation to this study is selection bias; responses collected were self-reported from survey volunteers. Additionally, the question identifying ventral penile curvature is not validated but performed well in pretesting. Most questions were from validated surveys, but some were modeled after validated surveys and/or contained high face validity types of questions. Men with possible untreated ventral penile curvature reported more dissatisfaction with penile appearance, increased difficulty with intercourse, and more unhealthy mental days. Given high success rates, low complications, and improved outcomes after surgical correction of penile curvature reported in the literature, our results support correction of congenital penile curvature in childhood. Copyright © 2015 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.

Do adult men with untreated ventral penile curvature have adverse outcomes?

PubMed Central

Menon, Vani; Breyer, Benjamin; Copp, Hillary L.; Baskin, Laurence; Disandro, Michael; Schlomer, Bruce J.

2016-01-01

Summary Introduction Congenital ventral penile curvature without hypospadias is often treated surgically in childhood. The history of untreated ventral curvature is unknown. Objective This study’s aim was to examine the association of untreated ventral penile curvature with various sexual and psychosexual outcomes. Study design An electronic survey was advertised to men older than 18 years on Facebook. Men with possible ventral penile curvature identified themselves by choosing sketches that most closely represented their anatomy. Outcomes assessed included: Sexual Health Inventory for Men, difficulty of intercourse because of curvature, International Prostate Symptom Score, Penile Perception Score, psychosexual milestones, paternity, infertility, sitting to urinate, and the CDC HRQOL-4 module. Results Among participants, 81 out of 684 men (11.8%) reported untreated ventral penile curvature. Participants with self-reported curvature noted more difficulty with intercourse because of curvature (4.5 vs 4.9, p < 0.001), more unhealthy mental days (8.6 vs 6.2, p = 0.02), and increased dissatisfaction with penile self-perception compared with men without reported curvature (8.6 vs 9.5, p < 0.001). Discussion Men with possible untreated ventral curvature reported worse penile perception scores, more mentally unhealthy days, and increased difficulty with intercourse secondary to curvature compared with men without curvature. A limitation to this study is selection bias; responses collected were self-reported from survey volunteers. Additionally, the question identifying ventral penile curvature is not validated but performed well in pretesting. Most questions were from validated surveys, but some were modeled after validated surveys and/or contained high face validity types of questions. Conclusion Men with possible untreated ventral penile curvature reported more dissatisfaction with penile appearance, increased difficulty with intercourse, and more unhealthy mental days. Given high success rates, low complications, and improved outcomes after surgical correction of penile curvature reported in the literature, our results support correction of congenital penile curvature in childhood. PMID:26776946

Body image and sexuality in Indonesian adults with a disorder of sex development (DSD).

PubMed

Ediati, Annastasia; Juniarto, Achmad Zulfa; Birnie, Erwin; Drop, Stenvert L S; Faradz, Sultana M H; Dessens, Arianne B

2015-01-01

In Indonesia, disorders of sex development (DSDs) are not well recognized and medical care for affected individuals is scarce. Consequently, many patients live with ambiguous genitalia and appearance. We compared reported outcomes on body image, sexual functioning, and sexual orientation of 39 adults with DSDs (aged 18 to 41) and 39 healthy controls matched for gender, age, and residential setting (urban, suburban, rural). Differences in gender and treatment status (treated or untreated) were also explored. On body image, adults with DSDs reported dissatisfaction with sex-related body parts. Compared to the matched controls, women with DSDs reported greater sexual distress, and men with DSDs reported lower erectile and ejaculation frequencies, and more dissatisfaction with sexual life but not with sexual desire and activities. Men with DSDs who had undergone genital surgery reported higher erectile and ejaculation frequencies than untreated men. More women than men in the DSDs group reported a nonexclusive heterosexual orientation. DSDs and infertility had a great impact on sexuality. Fear of ostracism complicated DSD acceptance. Findings were compared to those of Western studies. Based on these results, education about DSDs and their psychosexual consequences may help reduce the sexual distress and problems in adults with DSDs and improve quality of life.

[Medical students' sexuality--development and fulfilment of sexual needs].

PubMed

Müldner-Nieckowski, Łukasz; Klasa, Katarzyna; Sobański, Jerzy A; Rutkowski, Krzysztof; Dembińska, Edyta

2012-01-01

Education in human sexual physiology and pathology, as well as own sexual health of medical doctors determines in a large proportion the ability to talk with patients about their sexual disorders. Therefore the authors considered important to collect and assess data regarding sexual health and development of Medical Faculty students. Analysis of selected aspects of psychosexual development and sex life of IVth grade medical students. We applied the self-report Questionnaire of Satisfaction with Sexual Life (KSS2), an instrument created to assess sexual problems in patients treated with group psychotherapy. Medical students filled the questionnaire when attending the courses of Psychopathology of neurotic disorders or Psychotherapy. Analysis of the collected data revealed a relatively high differentiation of the studied group in regard of satisfaction and experiences with sexual life, attitudes towards masturbation, relationships and sexual activity. Regarding some aspects, significant differences between women and men occurred. A set of factors were identified, some of them may negatively influence medical doctor's competencies in the domain of sexual health. These are not having sexual debut or even lack of any erotic experiences and lack of sexual satisfaction. The results indicate a significant prevalence of factors, which may impede students education as well as taking into consideration the sexual issues during the medical interview. Assessment of influence of students' and doctors' own sexuality on their competencies in diagnostics and treatment requires further studies.

Psychosexual Adjustment After Vulvar Surgery

PubMed Central

Andersen, Barbara L.; Hacker, Neville F.

2009-01-01

Fifteen patients treated surgically for vulvar cancer from two institutions participated in semistructured interviews and objective assessment to examine postoperative psychologic, social, marital, and sexual adjustment. Descriptive statistics indicate that after vulvar surgery patients report mild distress, but they report reasonable levels of and satisfaction with their free-time and social activities. Mild levels of marital distress may exist. Sexual functioning and body image appear to undergo major disruption despite the fact that intercourse remains possible. Women reported levels of sexual arousal at the eighth percentile and body image at the fourth percentile. Although replication of these findings is clearly necessary, this investigation provides the first substantive look at the posttreatment life circumstances for these patients and offers a data base for future investigation. PMID:6888823

Posttraumatic Stress Disorder Relapse and Clitoral Reconstruction After Female Genital Mutilation.

PubMed

Abdulcadir, Jasmine; Bianchi Demicheli, Francesco; Willame, Alexia; Recordon, Nathalie; Petignat, Patrick

2017-02-01

Evidence on clitoral reconstruction after female genital mutilation is lacking. A woman with female genital mutilation experiencing clitoral pain during sex consulted to undergo clitoral reconstruction. The surgery was complicated by a wound infection responsible for severe postoperative pain. Such genital pain made our patient recall the traumatic experience of genital mutilation and experience a relapse of posttraumatic stress disorder symptoms. She reported anxiety; spontaneous, intrusive recurrent memories of the cutting; hypervigilance; and depressed mood. We successfully treated the infection and posttraumatic stress disorder. At 6 months postsurgery, she reported no clitoral pain and improved sexual function. Genital pain after clitoral reconstruction may cause recall of memories of the genital mutilation. We recommend multidisciplinary comprehensive psychosexual care and adequate analgesia.

Puberty, sexual milestones and abuse: how are they related in eating disorder patients?

PubMed

Schmidt, U; Evans, K; Tiller, J; Treasure, J

1995-03-01

In order to assess the relationship pubertal development, sexual milestones and childhood sexual abuse in women with eating disorders, 44 patients with restricting anorexia nervosa (RAN), 26 with bulimic anorexia nervosa (BAN), 29 with bulimia nervosa and also with a history of anorexia nervosa (BN/HistAN), and 69 with bulimia nervosa but without a history of anorexia nervosa (BN) completed questionnaires on pubertal and sexual development and unpleasant sexual experiences. Forty-four female college students complete the sexual development questionnaire only. Different eating disorder groups were found to be similar in terms of their pubertal development. All eating disorder groups showed delays in aspects of their psychosexual development (age at first kiss, masturbation, genital fondling and first sexual intercourse) compared with the control group, although to a different degree. The RAN group was delayed on almost all sexual milestones whereas the other groups were delayed on only some. On some variables, most noticeably on first sexual intercourse, restricters also were more delayed than the other eating disorder groups. Similarly, the median number of sexual partners differed significantly between groups (RAN = 1, BAN = 2, BN/HistAN = 4, BN = 4, controls = 5, P < 0.0001). Eating disorder patients, in particular RAN patients, were less positive about sexual relationships than controls, but did not differ from controls in attitudes to masturbation, marriage, children or pregnancy. Of the eating disorder patients 22-31% had been sexually abused during childhood. A history of abuse affected attitudes to masturbation, but did not appear to affect sexual development.

Stop female genital mutilation: appeal to the international dermatologic community.

PubMed

Morrone, Aldo; Hercogova, Jana; Lotti, Torello

2002-05-01

Female genital mutilation (FGM) is a traditional cultural practice, but also a form of violence against girls, which affects their lives as adult women. FGM comprises a wide range of procedures: the excision of the prepuce; the partial or total excision of the clitoris (clitoridectomy) and labia; or the stitching and narrowing of the vaginal orifice (infibulation). The number of girls and women who have been subjected to FGM is estimated at around 137 million worldwide and 2 million girls per year are considered at risk. Most females who have undergone mutilation live in 28 African countries. Globalization and international migration have brought an increased presence of circumcised women in Europe and developed countries. Healthcare specialists need to be made aware and trained in the physical, psychosexual, and cultural aspects and effects of FGM and in the response to the needs of genitally mutilated women. Health education programs targeted at immigrant communities should include information on sexuality, FGM, and reproduction. Moreover, healthcare workers should both discourage women from performing FGM on their daughters and receive information on codes of conduct and existing laws. The aim is the total eradication of all forms of FGM.

Sex differences in partner preferences in humans and animals.

PubMed

Balthazart, Jacques

2016-02-19

A large number of morphological, physiological and behavioural traits are differentially expressed by males and females in all vertebrates including humans. These sex differences, sometimes, reflect the different hormonal environment of the adults, but they often remain present after subjects of both sexes are placed in the same endocrine conditions following gonadectomy associated or not with hormonal replacement therapy. They are then the result of combined influences of organizational actions of sex steroids acting early during development, or genetic differences between the sexes, or epigenetic mechanisms differentially affecting males and females. Sexual partner preference is a sexually differentiated behavioural trait that is clearly controlled in animals by the same type of mechanisms. This is also probably true in humans, even if critical experiments that would be needed to obtain scientific proof of this assertion are often impossible for pragmatic or ethical reasons. Clinical, epidemiological and correlative studies provide, however, converging evidence strongly suggesting, if not demonstrating, that endocrine, genetic and epigenetic mechanisms acting during the pre- or perinatal life control human sexual orientation, i.e. homosexuality versus heterosexuality. Whether they interact with postnatal psychosexual influences remains, however, unclear at present. © 2016 The Author(s).

After Cologne: male circumcision and the law. Parental right, religious liberty or criminal assault?

PubMed

Merkel, Reinhard; Putzke, Holm

2013-07-01

Non-therapeutic circumcision violates boys' right to bodily integrity as well as to self-determination. There is neither any verifiable medical advantage connected with the intervention nor is it painless nor without significant risks. Possible negative consequences for the psychosexual development of circumcised boys (due to substantial loss of highly erogenous tissue) have not yet been sufficiently explored, but appear to ensue in a significant number of cases. According to standard legal criteria, these considerations would normally entail that the operation be deemed an 'impermissible risk'-neither justifiable on grounds of parental rights nor of religious liberty: as with any other freedom right, these end where another person's body begins. Nevertheless, after a resounding decision by a Cologne district court that non-therapeutic circumcision constitutes bodily assault, the German legislature responded by enacting a new statute expressly designed to permit male circumcision even outside of medical settings. We first criticise the normative foundations upon which such a legal concession seems to rest, and then analyse two major flaws in the new German law which we consider emblematic of the difficulty that any legal attempt to protect medically irrelevant genital cutting is bound to face.

Lack of differences between males with or without perceived same sex attraction.

PubMed

Lee, Peter A; Houk, Christopher P

2006-02-01

Adolescent males are often concerned that they may be homosexual because of a sense of sexual attraction to other males. This not uncommon concern is often expressed to pediatric endocrinologists who come into contact with these boys because of concerns with abnormal pubertal development. To explore the character and prevalence of these types of homosexual concerns we assessed the perceptions of a group of healthy adolescent males using a structured questionnaire. The aim of this study was to determine whether males concerned about homosexual tendencies manifest a unique self-perception profile or interact differently with others. A multi-item questionnaire regarding demographic, behavioral, psychological and sexual characteristics was administered to 52 18-24 year-old males. Overall, there were few differences between males admitting to an adolescent homosexual attraction to males and males without this attraction. Differences between these two groups included more exposure to some kinds of pornography (including male to male imagery), noticeable psychosexual responses to male pornography, internal questioning over homosexual tendencies, comparisons of genitalia and perceptions of body build. There were no differences in demographics, family structure, religious beliefs, socio-economic status, knowledge of puberty, inter-personal relationships or sources of information about sexuality.

Gender role across development in adults with 46,XY disorders of sex development including perineoscrotal hypospadias and small phallus raised male or female.

PubMed

Pappas, Kara B; Wisniewski, Amy B; Migeon, Claude J

2008-07-01

Self-rated degree of femininity and masculinity across development were evaluated for 40 adults affected by 46,XY disorders of sex development (DSDs) who presented at birth with a small phallus and perineoscrotal hypospadias, raised either male (n = 22) or female (n = 18). Most participants were confirmed or presumed to be affected by partial androgen insensitivity syndrome (n = 14), partial gonadal dysgenesis (n = 11), or were considered to have a poorly defined case of 46,XY DSD including ambiguous external genitalia (n = 15). Participants retrospectively evaluated their degree of masculinity and femininity during their childhood, adolescence, adulthood, and in the past 12 months of filling out a questionnaire pertaining to their psychosexual development. Participants raised male reported more masculinity than those raised female due to an increase in masculinization during adolescence and adulthood. Participants raised male also reported less femininity than those raised female throughout development. Participants raised female reported more femininity than those raised male due to an increase in feminization during adolescence and adulthood. Participants raised female also reported less masculinity than those raised male throughout development. These data support the proposition that some aspects of gender role (GR), such as masculinity and femininity, are capable of proceeding along female- or male-typic patterns depending on sex of rearing among individuals affected by specific types of 46,XY DSD. Furthermore, regardless of male or female rearing, GR increasingly corresponds with assigned sex as individuals proceed through sexual maturity and into adulthood. These results are consistent with the idea that socialization/learning contributes to GR development in humans in addition to data from others demonstrating endocrine influences.

Defibulation: A Visual Reference and Learning Tool.

PubMed

Abdulcadir, Jasmine; Marras, Sandra; Catania, Lucrezia; Abdulcadir, Omar; Petignat, Patrick

2018-04-01

Female genital mutilation type III (infibulation) is achieved by narrowing the vaginal orifice by creating a covering seal, accomplished by cutting and appositioning the labia minora and/or labia majora, with or without clitoral excision. Infibulation is responsible for significant urogynecological, obstetrical, and psychosexual consequences that can be treated with defibulation (or de-infibulation), an operation that opens the infibulation scar, exposing the vulvar vestibule, vaginal orifice, external urethral meatus, and eventually the clitoris. This article provides a practical comprehensive, up-to-date visual learning tool on defibulation, with information on pre-operative, post-operative, and follow-up information. Abdulcadir J, Marras S, Catania L, et al. Defibulation: a visual reference and learning tool. J Sex Med 2018;15:601-611. Copyright © 2018 International Society for Sexual Medicine. All rights reserved.

Are pedophiles with aggressive tendencies more sexually violent?

PubMed

Greenberg, D M; Bradford, J M; Curry, S

1996-01-01

Pedophiles use varying degrees of persuasion, coercion, and physical force in their sexual assaults. Pedophiles may also display aggressiveness and characteristics of hostility in nonsexual areas of their behavior. This study (N = 263) investigates the relationship between pedophiles with aggressive tendencies and the degree of sexual violence in their pedophilic acts. The degree of sexual violence was rated subjectively after a comprehensive psychiatric and psycho-sexual assessment and obtaining collateral information from police reports and witness statements. The degree of sexual violence was also rated more objectively using the penile plethysmography. Strict DSM-IV pedophilic disorder criteria were adopted for this study. The authors discuss whether sexual violence in a pedophilic population is focused to sexual areas or tends to be more generalized in other physically aggressive and hostile areas.

[Diagnosis of ambiguous genitalia].

PubMed

de Sanctis, C; Einaudi, S; De Sanctis, L

1990-03-01

Diagnosis in patients with ambiguous genitalia is based on various investigations. Simple genital examination is not sufficient to attribute sex. Scarce androgenization in a male patient or marked androgenization in a female may both lead to the same stages of genital ambiguity according to Prader. It is important to get information about genital ambiguity in the family, drug consumption during gestation and signs of virilization in pregnant mothers. External genital findings must be integrated by visualization of urogenital sinus by X-rays, ultrasounds and endoscopy. Furthermore, hormonal evaluations on plasma and 24 hours urines allow diagnosis of some disorders of adrenal and gonadal steroidogenesis. To define genetic sex, chromosomal examination is required to integrate X chromatine investigation and fluorescent staining of Y chromosome. Evaluation of psychosexuality in patients who have already got gender identity is mandatory.

Thunder among the pines: defining a pan-Asian soma.

PubMed

Dannaway, Frederick

2009-03-01

Many ancient cultures and religions engaged in various techniques and used various substances to instigate religious experience and to alter perception. These techniques of psycho-sexual drug yoga reached an unparalleled level of sophistication that arose and was often cloaked in practical terms of alchemy and metallurgy. The Vedic tradition describes this plant-based ritualism as soma, which has been identified by Gordon Wasson as the mushroom Amanita muscaria. This article traces these soma-influenced sects of esoteric Buddhism that exerted influences from India, China and Tibet to Japan. Some of the key components, practices and symbolism are retained despite numerous cultural filters. Japan's tradition of esoteric Buddhism can thus be seen to have preserved and incorporated the soma/amrita mushroom lore into its own traditions of mountain ascetic mystics.

Developmental endocrine influences on gender identity: implications for management of disorders of sex development.

PubMed

Byne, William

2006-11-01

When a baby is born, the first medical pronouncement is usually, "It's a boy," or "It's a girl." In most cases, this pronouncement is based simply upon the appearance of the child's external genitalia. Due to variations in the process of sexual differentiation, sometimes the gender that should be assigned is not apparent from inspection of the external genitalia, either because they are "ambiguous" or because their appearance is not congruent with the internal anatomy. Decisions must be made not only about the most appropriate gender to assign the infant but also about the medical and rearing practices that will facilitate optimal psychological development and quality of life for the affected individual. This article will review the approach to managing gender disorders that has evolved since the 1950s. Three issues are identified as central to current shifts that are occurring in the management of these disorders: (a) increased understanding of the biological substrates of gender identity; (b) questions regarding the indications for irreversible cosmetic genital surgeries as a means of reinforcing gender assignments in infancy, and (c) ethical issues pertaining to informed consent and who is entitled to give it, particularly with regard to surgical gender reassignments in infancy. In keeping with the neuropsychiatry theme of this issue, the focus of this article is on prenatal sexual differentiation of the brain as it pertains to the question of psychosexual neutrality at birth.

Sexual Activity, Psychosexual Distress, and Fear of Progression in Women With Human Papillomavirus-Related Premalignant Genital Lesions.

PubMed

Nagele, Eva; Reich, Olaf; Greimel, Elfriede; Dorfer, Martha; Haas, Josef; Trutnovsky, Gerda

2016-02-01

Genital human papillomavirus (HPV) infections are very common in women 18 to 30 years old and substantially affect women's sexual health. To examine sexual activity, psychosexual distress, and fear of progression in women diagnosed with HPV-related precancerous genital lesions. In this observational study, women diagnosed with premalignant lesions of the cervix, vagina, or vulva were recruited from a university hospital-based colposcopy clinic. Quantitative data from three validated patient-administered questionnaires (Sexual Activity Questionnaire, German version of the Cervical Dysplasia Distress Questionnaire, and Fear of Progression Questionnaire) were compared within the study population, according to the location of the genital lesion, and with relevant reference populations. Qualitative data from two written open-ended questions about women's thoughts regarding diagnosis and information were analyzed. Two-hundred nine women completed the questionnaires. Seventy-eight percent of women (n = 162) were referred for evaluation of suspect lesions of the cervix, 8% (n = 17) of the vagina, and 14% (n = 30) of the vulva. There were no significant differences in questionnaire results among the three patient groups, except for sexual consequences (Cervical Dysplasia Distress Questionnaire) and recent sexual activity (Sexual Activity Questionnaire). Women with vulvar lesions were most likely to worry about sexual consequences (ie, being unable to have children, being sexually less attractive, or infecting a sexual partner; P = .04). The Sexual Activity Questionnaire subscales sexual pleasure (P = .15) and sexual habits (P = 1.00) were similar to those in a healthy control population, whereas sexual discomfort (P = .51) was comparable to that in a reference population of women who survived cervical cancer. The subscale partner-specific concerns (Fear of Progression Questionnaire) was similar to that in a reference population of patients with cancer (P = .28). HPV-related precancerous genital lesions, especially of the vulva, are likely to cause concerns about sexual health. Effective information and communication are important to lessen negative sexual consequences and anxiety. Copyright © 2016 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.

Original technique for penile girth augmentation through porcine dermal acellular grafts: results in a 69-patient series.

PubMed

Alei, Giovanni; Letizia, Piero; Ricottilli, Francesco; Simone, Pierfranco; Alei, Lavinia; Massoni, Francesco; Ricci, Serafino

2012-07-01

Although different techniques for augmentation phalloplasty have been reported in the medical literature, this issue is still highly controversial, and none of the proposed procedures has been unanimously approved. The aim of this study is to describe an innovative surgical technique for penile girth augmentation with porcine dermal acellular grafts, through a small transverse incision at the penile base, along the penopubic junction. Between 2000 and 2009, 104 patients were referred to our institution for penile enhancement. After a preoperative psychosexual consultation and a general medical assessment, 69 patients were deemed suitable good candidates for surgery. The average penis circumference was measured at the mid-length of the penis and was 8.1 cm (5.4-10.7 cm) and 10.8 cm (6.5-15.8 cm) during flaccidity and erection, respectively. All patients received penile augmentation with porcine dermal acellular grafts. Results evaluation of an innovative technique for penile girth augmentation through exogenous porcine grafts and small penobubic incision. Postoperative measurements were performed at 6 and 12 months. At the 1-year follow-up, the average penis circumference was 11.3 cm (8.2-13.2 cm, 3.1 cm mean increase) during flaccidity and 13.2 cm (8.8-14.5 cm, 2.4 cm mean increase) during erection. No major complications occurred in the series. Minor complications were resolved with conservative treatment within 3 weeks. Sexual activity was resumed from 1 to 2 months after surgery. The psychosexual impact of the operation was beneficial in the majority of cases. Penile girth enlargement with acellular dermal matrix grafts has several advantages over augmentation with autogenous dermis-fat grafts: the elimination of donor site morbidity and a significantly shorter operation time. With this approach, through a short dorsal incision at the base of the penis, the scar is concealed in a crease covered by pubic hair and thus hardly visible. © 2012 International Society for Sexual Medicine.

[The effect of selected socio-medical factors on quality of life and psychosexual functioning in women after surgical treatment of breast cancer].

PubMed

Zdończyk, Sebastian Artur

2015-01-01

According to the National Cancer Registry, 16 534 new cases of breast cancer were confirmed in 2011 in Poland. Surgical treatment poses not only a serious oncological problem, but also a cosmetic and psychological one. Women fear they will lose their femininity and sexual attractiveness after the surgery. They feel defective (half woman complex) and they experience such feelings as shame, anger and depression. Sexuality is a sphere of life that is particularly susceptible to all kinds of perturbation of physical and mental states. The main cognitive objective of the presented research is the analysis of life quality level and mental and sexual functioning of women who underwent breast cancer surgical treatment. The research was carried out from October 2013 to February 2014 among 250 adult women who underwent breast cancer surgery. The questionnaire includes questions regarding sociomedical and sociosexology questions, and five standardised research tools: Life Quality Questionnaire SF-36 v. 2, licence No. QM020862, Mell-Krat Questionnaire prepared by Z. Lew-Starowicz, Female Sexual Function Index Questionnaire, A List of Health Behaviours by Z. Juczyński, Courtauld Emotional Control Scale (CECS) adapted by Z. Juczyński. The research received a positive opinion from the Bioethical Commission of The Pomeranian Medical University in Szczecin. On the basis of the conducted research and statistical analyses it was found that the extensiveness of the surgical procedure, the effectiveness of oncological treatment, age, the number of children, education, material conditions, and the occupational status of the subject women have an impact on life quality and psychosexual functioning. Women who underwent mastectomy with reconstruction of the mammary gland gained higher results in comparison to women who underwent mastectomy without reconstruction as regards physical and mental functioning within life quality. The respondents who had their oncological treatment completed were featured with a lower intensity of sexual dysfunctions than women who had their treatment in progress. The participants of the research with higher educational level, high material status and stable job condition had higher indicators of health behaviours intensity than women with lower material status and lower educational level.

Pedophiles and stalkers as transplant candidates: one program's experience.

PubMed

Paris, Wayne; Miller, Rachel; Hille, Cheryl; Nour, Bakr; Griggs, Johnny

2005-12-01

Transplant assessment of pedophiles and stalkers presents a challenge for clinicians and requires the ability to separate the science from the hysteria. Although rarely seen in organ transplant clinics, the presence of psychosexual disorders can result in both criminal charges and harsh societal reactions. Clinicians must be able to assess and make informed recommendations about the suitability of the candidate and any potential risks for staff, other patients, and society at large. Six patients (5 pedophiles and 1 stalker) were assessed at our major regional multiorgan transplant program; each patient presented with unique and challenging assessment, treatment, and selection issues for the transplant team. The objectives of this article are to raise awareness of the issues associated with pedophiles and stalkers, and to provide the basis for better-informed discussions based on one program's struggles with its candidate selection and follow-up.

High risk of hypogonadism after traumatic brain injury: clinical implications.

PubMed

Agha, Amar; Thompson, Christopher J

2005-01-01

Several recent studies have convincingly documented a close association between traumatic brain injury (TBI) and pituitary dysfunction. Post-traumatic hypogonadism is very common in the acute post-TBI phase, though most cases recover within six to twelve months following trauma. The functional significance of early hypogonadism, which may reflect adaptation to acute illness, is not known. Hypogonadism persists, however, in 10-17% of long-term survivors. Sex steroid deficiency has implications beyond psychosexual function and fertility for survivors of TBI. Muscle weakness may impair functional recovery from trauma and osteoporosis may be exacerbated by immobility secondary to trauma. Identification and appropriate and timely management of post-traumatic hypogonadism is important in order to optimise patient recovery from head trauma, improve quality of life and avoid the long-term adverse consequences of untreated sex steroid deficiency.

Is the increase of hypomanic stages during adolescence related to gender and developmental tasks?

PubMed

Brand, Serge; Angst, Jules; Holsboer-Trachsler, Edith

2010-04-01

To detach themselves from their family of origin, adolescents need to develop proactive behaviour which includes increased risk-taking and novelty seeking. These behaviours may be attributable both to developmental issues and to hypomanic-like stages. Since there is a lack of research focusing on hypomania in adolescents, the aim of the study was to compare hypomania scores of adolescents with those of adult outpatients suffering from bipolar II disorders, and to investigate possible gender-related differences. One hundred and seven adolescents (mean age: 18 years) took part in the study; 60 of them indicated that they experienced intense romantic love; 47 were controls. Participants completed the Hypomania Check List, and data were compared with those of adult outpatients suffering from bipolar II disorders. Scores of adolescents in early-stage intense romantic love differed from those of adolescent controls, but not from those of outpatients suffering from a bipolar II disorder. Factor analyses revealed that both groups of adolescents displayed higher scores for the factor "irritable/risk-taking" hypomania. A gender-related pattern was found, with increased scores for female adolescents. Adolescents' developmental tasks surrounding experiences in social, psychosexual and substance use-related engagement may lead to temporary and gender-related hypomanic-like stages.

Perceived stigma of purchasing sex among Latino and non-Latino male clients of female sex workers in Tijuana, Mexico

PubMed Central

Pitpitan, Eileen V.; Strathdee, Steffanie A.; Semple, Shirley J.; Wagner, Karla D.; Chavarin, Claudia V.; Earnshaw, Valerie A.; Patterson, Thomas L.

2013-01-01

HIV prevention efforts must be comprehensive in their understanding of the factors involved in HIV risk. Male clients, who have received less research attention than female sex workers (FSWs), may experience stigma as a function of purchasing sex. Perceived stigma may be related to poor psychological outcomes, risky psychosexual characteristics, and higher drug and sexual risk behavior among male clients of FSWs. However, perceived stigma of purchasing sex may differ between clients of different ethnic groups. In the present study, we examine the correlates of perceived stigma of purchasing sex among Latino vs. non-Latino male clients of FSWs in Tijuana, Mexico. Using time-location sampling, we recruited 375 male clients (323 Latino, 52 non-Latino) in Tijuana who completed a computerized survey on various measures. We measured perceived stigma of purchasing sex using three items we developed for this study. Using linear regression analyses we found that perceived stigma was associated with greater guilt, a greater feeling of escape from everyday life, and more negative condom attitudes among Latino clients. This was not found among non-Latino clients. Features of Latino culture, like machismo, and how they may relate to stigma of purchasing sex are discussed. PMID:23979714

Perceived stigma of purchasing sex among Latino and non-Latino male clients of female sex workers in Tijuana, Mexico.

PubMed

Pitpitan, Eileen V; Strathdee, Steffanie A; Semple, Shirley J; Wagner, Karla D; Chavarin, Claudia V; Earnshaw, Valerie A; Patterson, Thomas L

2015-02-01

HIV prevention efforts must be comprehensive in their understanding of the factors involved in HIV risk. Male clients, who have received less research attention than female sex workers (FSWs), may experience stigma as a function of purchasing sex. Perceived stigma may be related to poor psychological outcomes, risky psychosexual characteristics, and higher drug and sexual risk behavior among male clients of FSWs. However, perceived stigma of purchasing sex may differ between clients of different ethnic groups. In the present study, we examine the correlates of perceived stigma of purchasing sex among Latino versus non-Latino male clients of FSWs in Tijuana, Mexico. Using time-location sampling, we recruited 375 male clients (323 Latino, 52 non-Latino) in Tijuana who completed a computerized survey on various measures. We measured perceived stigma of purchasing sex using three items we developed for this study. Using linear regression analyses we found that perceived stigma was associated with greater guilt, a greater feeling of escape from everyday life, and more negative condom attitudes among Latino clients. This was not found among non-Latino clients. Features of Latino culture, like machismo, and how they may relate to stigma of purchasing sex are discussed.

Development and validation of the multidimensional vaginal penetration disorder questionnaire (MVPDQ) for assessment of lifelong vaginismus in a sample of Iranian women.

PubMed

Molaeinezhad, Mitra; Roudsari, Robab Latifnejad; Yousefy, Alireza; Salehi, Mehrdad; Khoei, Effat Merghati

2014-04-01

Vaginismus is considered as one of the most common female psychosexual dysfunctions. Although the importance of using a multidisciplinary approach for assessment of vaginal penetration disorder is emphasized, the paucity of instruments for this purpose is clear. We designed a study to develop and investigate the psychometric properties of a multidimensional vaginal penetration disorder questionnaire (MVPDQ), thereby assisting specialists for clinical assessment of women with lifelong vaginismus (LLV). MVPDQ was developed using the findings from a thematic qualitative research conducted with 20 unconsummated couples from a former study, which was followed by an extensive literature review. Then, during a cross-sectional design, a consecutive sample of 214 women, who were diagnosed as LLV based on Diagnostic and Statistical Manual of Mental Disorders (DSM)-IV-TR criteria completed MVPDQ and additional questions regarding their demographic and sexual history. Validation measures and reliability were tested by exploratory factor analysis and Cronbach's alpha coefficient via Statistical Package for the Social Sciences (SPSS) version 16. After conducting exploratory factor analysis, MVPDQ emerged with 72 items and 9 dimensions: Catastrophic cognitions and tightening, helplessness, marital adjustment, hypervigilance, avoidance, penetration motivation, sexual information, genital incompatibility, and optimism. Subscales of MVPDQ showed a significant reliability that varied between 0.70 and 0.87 and results of test-retest were satisfactory. The present study shows that MVPDQ is a valid and reliable self-report questionnaire for clinical assessment of women complaining of LLV. This instrument may assist specialists to make a clinical judgment and plan appropriately for clinical management.

Biological aspects of gender disorders.

PubMed

Corsello, S M; Di Donna, V; Senes, P; Luotto, V; Ricciato, M P; Paragliola, R M; Pontecorvi, A

2011-12-01

The scientific community is very interested in the biological aspects of gender disorders and sexual orientation. There are different levels to define an individual's sex: chromosomal, gonadic, and phenotypic sex. Concerning the psychological sex, men and women are different by virtue of their own gender identity, which means they recognize themselves as belonging to a determinate sex. They are different also as a result of their own role identity, a set of behaviors, tendencies, and cognitive and emotional attitudes, commonly defined as "male" and "female". Transsexuality is a disorder characterized by the development of a gender identity opposed to phenotypic sex, whereas homosexuality is not a disturbance of gender identity but only of sexual attraction, expressing sexual orientation towards people of the same sex. We started from a critical review of literature on genetic and hormonal mechanisms involved in sexual differentiation. We re-examined the neuro-anatomic and functional differences between men and women, with special reference to their role in psychosexual differentiation and to their possible implication in the genesis of homosexuality and identity gender disorders. Homosexuality and transsexuality are conditions without a well defined etiology. Although the influence of educational and environmental factors in humans is undeniable, it seems that organic neurohormonal prenatal and postnatal factors might contribute in a determinant way in the development of these two conditions. This "organicistic neurohormal theory" might find support in the study of particular situations in which the human fetus is exposed to an abnormal hormonal environment in utero.

Gender identity and recalled gender related childhood play-behaviour in adult individuals with different forms of intersexuality.

PubMed

Richter-Appelt, Hertha; Discher, Christine; Gedrose, Benjamin

2005-09-01

The concept of intersexuality subsumes a wide variety of phenomena with very specific underlying causes. In all these cases, an untypical development takes place during the prenatal sex differentiation process becoming clinically manifest, either at, or soon after birth or at the time of puberty. It subsumes conditions in which biological sexual characteristics (e.g. chromosomal sex, gonadal sex, hormonal sex, morphological sex) differ from each other and one person cannot easily be assigned to one sex. One of the main goals of medical treatment of persons with intersex-syndroms is the development of a stable gender identity. Over the last few years, sex (and gender) assignment of persons with different forms of intersexuality has become a much discussed topic. An interesting--and very obviously observable--variable that was brought in connection with sex assignment is gender related childhood play behaviour. The purpose of the presented study is to examine 37 persons with different forms of intersexuality (disturbances of androgen biosynthesis, partial and complete androgen insensitivity, gonadal dysgenesis with 46,XY and congenital adrenal hyperplasia with 46,XX) with regard to gender identity and gender role behaviour in childhood. Not all subjects in the study group had developed a clear female or male gender identity. In contrast to previous studies, some persons with CAIS did not recall distinguished female childhood play behaviour and these persons did not show a clear female gender identity. In contrast to results from other studies, the CAH-affected girls in this study did not seem to recall masculinized behaviour. Further research is needed to guarantee better psychosexual development with good quality of life in individuals with intersexuality.

The biology of human psychosexual differentiation.

PubMed

Gooren, Louis

2006-11-01

Most attempts to identify biological underpinnings of gender identity and sexual orientation in humans have investigated effects of sex steroids, so pivotal in the differentiation of the genitalia, showing strong parallels between animals and the human. The information on humans is derived from the so-called 'experiments of nature', clinical entities with a lesser-than-normal androgen exposure in XY subjects and a higher than normal androgen exposure in XX subjects. Prenatal androgenization appears to predispose to a male gender identity development, but apparently not decisively since 40-50% of 46,XY intersexed children with a history of prenatal androgen exposure do not develop a male gender identity. Obviously, male-to-female transsexuals, with a normal androgen exposure prenatally (there is no serious evidence to the contrary) develop a female gender identity, through unknown biological mechanisms apparently overriding the effects of prenatal androgens. The latest studies in 46, XX subjects exposed to prenatal androgens show that prenatal androgenization of 46,XX fetuses leads to marked masculinization of later gender-related behavior but does not lead to gender confusion/dysphoria. The example of female-to-male transsexuals, without evidence of prenatal androgen exposure, indicates that a male gender identity can develop without a significant androgen stimulus. So we are far away from any comprehensive understanding of hormonal imprinting on gender identity formation. Brain studies in homosexuals have not held up in replication studies or are in need of replication in transsexuals. Genetic studies and the fraternal birth order hypothesis provide indications of familial clustering of homosexuality but in many homosexuals these genetic patterns cannot be identified. The biological explanations advanced for the birth order hypothesis lack any experimental support.

Cumulative Childhood Trauma and Adult Sexual Satisfaction: Mediation by Affect Dysregulation and Sexual Anxiety in Men and Women.

PubMed

Bigras, Noémie; Daspe, Marie-Ève; Godbout, Natacha; Briere, John; Sabourin, Stéphane

2017-05-19

Childhood cumulative trauma (CCT) refers to an amalgam of childhood maltreatment experiences that can lead to a range of symptoms and problems in adulthood. The current study examined an integrative model of CCT for its relevance to psychosexual adjustment in adult survivors. A total of 620 participants aged 18 years and over completed a questionnaire assessing early life experiences, affect dysregulation, sexual anxiety, and sexual satisfaction. Path analyses confirmed the hypothesis that CCT is associated with affect dysregulation and sexual anxiety that, in turn, predict lower levels of sexual satisfaction. The validity of this mediational model was demonstrated for different operationalizations of CCT. The results suggested that sex therapists, who are likely to encounter CCT survivors in their practice, should consider targeting affect dysregulation in their efforts to decrease sexual anxiety and increase sexual satisfaction.

Therapeutic strategies for patients with micropenis or penile dysmorphic disorder.

PubMed

Kayes, Oliver; Shabbir, Majid; Ralph, David; Minhas, Suks

2012-09-01

Micropenis in adults is defined as a stretched length of <7.5 cm. Many aetiologies exist, including congenital and endocrinological causes as well as pathological conditions, such as penile lichen sclerosus, trauma and genital cancer. The resulting reduction in functional penile length can lead to considerable psychosexual morbidity. Furthermore, the subset of patients with micropenis who also suffer from penile dysmorphic disorder require careful and intensive psychological counselling. Corrective surgery for micropenis can be performed in patients with realistic expectations. Total phalloplasty using radial-artery-based forearm skin flaps can offer restoration of normal penile length in selected patients. More-conservative surgical techniques to improve length or girth are limited by minimal enhancement but associated with a significantly lower rate of complications and comorbidity compared to total phalloplasty. Emerging tissue engineering techniques might represent a suitable alternative to penile replacement surgery in the future.

Testicular cancer: a review.

PubMed

Hawkins, C; Miaskowski, C

1996-09-01

To describe the pathophysiologic mechanisms, histologic and clinical staging, diagnosis, and medical and nursing management of testicular cancer. Published studies, review articles, and Physician Data Query database. Testicular cancer is a complex disease resulting from transformation of gonadal tissues. The pathophysiologic mechanisms involve damage to tissue in utero and after birth. Orchiectomy is the treatment of choice for early-stage disease. Orchiectomy can have profound physiologic and psychological consequences for young males. Subsequent chemotherapy and radiation therapy also may have severe side effects including azoospermia, bone marrow suppression, nephrotoxicity, and pulmonary toxicity. Early detection of this disease results in improved patient outcomes. Patients treated with radical inguinal orchiectomy and radiation therapy have fewer long-term side effects and toxicities than patients who require more extensive surgery and chemotherapy. Nursing care must focus not only on relieving the patient's physical symptoms but on helping him deal with the psychosexual issues associated with the disease and its treatment.

Contraception for the older woman.

PubMed

Glasier, A; Gebbie, A

1996-04-01

Contraception presents particular problems for women over the age of 40. Although fertility is declining and the risk of pregnancy may be small, the consequences of an unplanned pregnancy may be socially devastating and medically ill-advised. Menstrual dysfunction and psychosexual difficulties increase with age and may exacerbate the side-effects of some methods of contraception. The long-term risks of combined hormonal contraception, particularly cardiovascular disease, become more pertinent to women whose natural risk of disease increases with age. Patterns of sexual activity and contraceptive use change with age. The advantages and disadvantages of currently available methods of contraception are difficult to quantify, and the choice of method is very much a matter for individual concern. The increasing prevalence of HRT may complicate matters for some women who are unsure for how long to continue using contraception. Contraceptives of the future may be designed to improve the reproductive health of all women, particularly those approaching the menopause.

Gender identity disorders in childhood and adolescence: currently debated concepts and treatment strategies.

PubMed

Korte, Alexander; Lehmkuhl, Ulrike; Goecker, David; Beier, Klaus Michael; Krude, Heiko; Grüters-Kieslich, Annette

2008-11-01

Gender identity disorders (GID) can appear even in early infancy with a variable degree of severity. Their prevalence in childhood and adolescence is below 1%. GID are often associated with emotional and behavioral problems as well as a high rate of psychiatric comorbidity. Their clinical course is highly variable. There is controversy at present over theoretical explanations of the causes of GID and over treatment approaches, particularly with respect to early hormonal intervention strategies. This review is based on a selective Medline literature search, existing national and international guidelines, and the results of a discussion among experts from multiple relevant disciplines. As there have been no large studies to date on the course of GID, and, in particular, no studies focusing on causal factors for GID, the evidence level for the various etiological models that have been proposed is generally low. Most models of these disorders assume that they result from a complex biopsychosocial interaction. Only 2.5% to 20% of all cases of GID in childhood and adolescence are the initial manifestation of irreversible transsexualism. The current state of research on this subject does not allow any valid diagnostic parameters to be identified with which one could reliably predict whether the manifestations of GID will persist, i.e., whether transsexualism will develop with certainty or, at least, a high degree of probability. The types of modulating influences that are known from the fields of developmental psychology and family dynamics have therapeutic implications for GID. As children with GID only rarely go on to have permanent transsexualism, irreversible physical interventions are clearly not indicated until after the individual's psychosexual development ist complete. The identity-creating experiences of this phase of development should not be restricted by the use of LHRH analogues that prevent puberty.

Body image and self-esteem in disorders of sex development: A European multicenter study.

PubMed

van de Grift, Tim C; Cohen-Kettenis, Peggy T; de Vries, Annelou L C; Kreukels, Baudewijntje P C

2018-04-01

Disorders/differences of sex development (DSD) refer to congenital conditions with atypical sex development and are associated with psychosexual issues. The aim of this study was to assess body image and self-esteem across the DSD spectrum and to study the impact of diagnosis and mediating characteristics. Data collection was part of dsd-LIFE, a cross-sectional study conducted by 14 European expert clinics on wellbeing and health care evaluation of adults diagnosed with DSD. Main outcome measures in the present analyses were the Body Image Scale and Rosenberg Self-Esteem Scale. Additional data were obtained on treatments, openness, body embarrassment, sexual satisfaction, anxiety, and depression. The participating sample (n = 1,040) included 226 classified as Congenital Adrenal Hyperplasia, 225 as Klinefelter Syndrome, 322 as Turner Syndrome, and 267 as conditions with 46,XY karyotype. Many participants had received hormonal and surgical treatments. Participants scored lower on body image and self-esteem compared to control values, whereas each diagnosis showed different areas of concern. Limited openness, body embarrassment, and sexual issues were frequently reported. Overall body satisfaction was associated with BMI, hormone use, openness, body embarrassment, anxiety, and depression; genital satisfaction with age at diagnosis, openness, sexual satisfaction, and body embarrassment. Body embarrassment, anxiety, and depression predicted lower self-esteem. While each DSD showed specific issues related to body image and self-esteem, our findings indicate that the related factors were similar across the conditions. Clinical care on this subject could be improved by giving specific attention to factors like openness, body embarrassment, sexuality, anxiety, and depression. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Prenatal Exposure to Progesterone Affects Sexual Orientation in Humans.

PubMed

Reinisch, June M; Mortensen, Erik Lykke; Sanders, Stephanie A

2017-07-01

Prenatal sex hormone levels affect physical and behavioral sexual differentiation in animals and humans. Although prenatal hormones are theorized to influence sexual orientation in humans, evidence is sparse. Sexual orientation variables for 34 prenatally progesterone-exposed subjects (17 males and 17 females) were compared to matched controls (M age = 23.2 years). A case-control double-blind design was used drawing on existing data from the US/Denmark Prenatal Development Project. Index cases were exposed to lutocyclin (bioidentical progesterone = C 21 H 30 O 2 ; M W : 314.46) and no other hormonal preparation. Controls were matched on 14 physical, medical, and socioeconomic variables. A structured interview conducted by a psychologist and self-administered questionnaires were used to collect data on sexual orientation, self-identification, attraction to the same and other sex, and history of sexual behavior with each sex. Compared to the unexposed, fewer exposed males and females identified as heterosexual and more of them reported histories of same-sex sexual behavior, attraction to the same or both sexes, and scored higher on attraction to males. Measures of heterosexual behavior and scores on attraction to females did not differ significantly by exposure. We conclude that, regardless of sex, exposure appeared to be associated with higher rates of bisexuality. Prenatal progesterone may be an underappreciated epigenetic factor in human sexual and psychosexual development and, in light of the current prevalence of progesterone treatment during pregnancy for a variety of pregnancy complications, warrants further investigation. These data on the effects of prenatal exposure to exogenous progesterone also suggest a potential role for natural early perturbations in progesterone levels in the development of sexual orientation.

Beliefs about penis size: validation of a scale for men ashamed about their penis size.

PubMed

Veale, David; Eshkevari, Ertimiss; Read, Julie; Miles, Sarah; Troglia, Andrea; Phillips, Rachael; Echeverria, Lina Maria Carmona; Fiorito, Chiara; Wylie, Kevan; Muir, Gordon

2014-01-01

No measures are available for understanding beliefs in men who experience shame about the perceived size of their penis. Such a measure might be helpful for treatment planning, and measuring outcome after any psychological or physical intervention. Our aim was to validate a newly developed measure called the Beliefs about Penis Size Scale (BAPS). One hundred seventy-three male participants completed a new questionnaire consisting of 18 items to be validated and developed into the BAPS, as well as various other standardized measures. A urologist also measured actual penis size. The BAPS was validated against six psychosexual self-report questionnaires as well as penile size measurements. Exploratory factor analysis reduced the number of items in the BAPS from 18 to 10, which was best explained by one factor. The 10-item BAPS had good internal consistency and correlated significantly with measures of depression, anxiety, body image quality of life, social anxiety, erectile function, overall satisfaction, and the importance attached to penis size. The BAPS was not found to correlate with actual penis size. It was able to discriminate between those who had concerns or were dissatisfied about their penis size and those who were not. This is the first study to develop a scale for measurement of beliefs about penis size. It may be used as part of an assessment for men who experience shame about the perceived size of their penis and as an outcome measure after treatment. The BAPS measures various manifestations of masculinity and shame about their perceived penis size including internal self-evaluative beliefs; negative evaluation by others; anticipated consequences of a perceived small penis, and extreme self-consciousness. © 2013 International Society for Sexual Medicine.

Development and validation of the multidimensional vaginal penetration disorder questionnaire (MVPDQ) for assessment of lifelong vaginismus in a sample of Iranian women

PubMed Central

Molaeinezhad, Mitra; Roudsari, Robab Latifnejad; Yousefy, Alireza; Salehi, Mehrdad; Khoei, Effat Merghati

2014-01-01

Background: Vaginismus is considered as one of the most common female psychosexual dysfunctions. Although the importance of using a multidisciplinary approach for assessment of vaginal penetration disorder is emphasized, the paucity of instruments for this purpose is clear. We designed a study to develop and investigate the psychometric properties of a multidimensional vaginal penetration disorder questionnaire (MVPDQ), thereby assisting specialists for clinical assessment of women with lifelong vaginismus (LLV). Materials and Methods: MVPDQ was developed using the findings from a thematic qualitative research conducted with 20 unconsummated couples from a former study, which was followed by an extensive literature review. Then, during a cross-sectional design, a consecutive sample of 214 women, who were diagnosed as LLV based on Diagnostic and Statistical Manual of Mental Disorders (DSM)-IV-TR criteria completed MVPDQ and additional questions regarding their demographic and sexual history. Validation measures and reliability were tested by exploratory factor analysis and Cronbach's alpha coefficient via Statistical Package for the Social Sciences (SPSS) version 16. Results: After conducting exploratory factor analysis, MVPDQ emerged with 72 items and 9 dimensions: Catastrophic cognitions and tightening, helplessness, marital adjustment, hypervigilance, avoidance, penetration motivation, sexual information, genital incompatibility, and optimism. Subscales of MVPDQ showed a significant reliability that varied between 0.70 and 0.87 and results of test–retest were satisfactory. Conclusion: The present study shows that MVPDQ is a valid and reliable self-report questionnaire for clinical assessment of women complaining of LLV. This instrument may assist specialists to make a clinical judgment and plan appropriately for clinical management. PMID:25097607

[Sexual pain disorders in females and males].

PubMed

Monforte, M; Mimoun, S; Droupy, S

2013-07-01

The occurrence of pain during sex is one of the most common complaints in gynecological and sexological practice but nonetheless one of the most difficult problems to deal with and treat effectively. A literature review was conducted on Medline considering the articles listed until January 2012 dealing with sexual pain in women and men. The different descriptions of painful intercourse (dyspareunia, vestibulo-vulvodynies, vaginismus) are not separate entities but the result of the interaction of many factors including genital pain, emotional and behavioral responses to penetration, caresses, desire and excitement, in a context of possible organic pathology (infection, endometriosis, inflammatory or dermatological disease, morphological or pelvic abnormality, hormonal deficiency) sometimes associated with chronic pain phenomena self-sustained by neurogenic inflammation. The clinical expression of sexual pain is as variable as its causes are many. The etiological investigation is essential but should not omit the sexological context and the need for appropriate management. The neurogenic inflammation and hypersensitivity impose an algological approach associated to etiological and sexological treatment. Chronic sexual pains, whether they are superficial or deep, can be the sign of organic or psycho-sexual (primary or secondary) disorders. The development of a "therapeutic program" helps patients, allows them to restore self-confidence and leads to the disappearance of the symptom in more than half cases. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

Young adolescents' sexual and romantic reference displays on Facebook.

PubMed

Doornwaard, Suzan M; Moreno, Megan A; van den Eijnden, Regina J J M; Vanwesenbeeck, Ine; Ter Bogt, Tom F M

2014-10-01

Social networking sites (SNSs) form increasingly popular venues for adolescents to express their developing identity, including their sexual self. This study investigated how and to what extent early and middle adolescents display sexuality and romance on SNSs and the demographic and psychosexual factors associated with their displays. Dutch adolescents aged 11-18 years were recruited and Facebook friended. Participants' Facebook profiles were evaluated for sexual and romantic references and Facebook engagement. Participants completed a digital questionnaire measuring constructs related to romantic and sexual development. Analyses included chi-square and Student's t-tests. A total of 104 adolescents (M(age) = 15.01, 68.3% female) were Facebook friended. Of 104 profiles, 25 (24.0%) contained 67 sexual references, and 27 (26.0%) contained 204 romantic references. Sexual references were mostly posted by others and referring to others or to no one in particular, whereas romantic references were predominantly posted by and referring to the profile owner. Displayers of sexual and romantic references were, compared with nondisplayers, older, more engaged in Facebook, more sexually experienced, and perceived more of their peers as approving of sex and as sexually active. In addition, sexual displayers were more likely boys and more sexually interested. There were no differences with respect to sexual intention and sexual attitudes. A minority of young adolescents display sexual and romantic references on SNSs. References may reflect adolescents' offline sexual and romantic experiences. Yet, they may be powerful in creating behavioral norms; therefore, guidance on interpreting and displaying such messages should be promoted. Copyright © 2014 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Childhood trauma and dissociation among women with genito-pelvic pain/penetration disorder

PubMed Central

Özen, Beliz; Özdemir, Y Özay; Beştepe, E Emrem

2018-01-01

Objective Causes such as childhood trauma, negative attitude about sexuality, inadequate sexual knowledge and education, relationship problems, and unconscious motivation are reported about psychosexual development in the etiology of genito-pelvic pain/penetration disorder (GPP/PD). There are few studies that focus directly on research etiology of GPP/PD and use structured scales. The aim of this study was to research childhood trauma and dissociation forms among women with GPP/PD. Patients and methods Fifty-five women with GPP/PD according to the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders and 61 healthy women with no complaints of sexual function as a control group, in the age range of 18–60 years, were included in this study. Sociodemographic data form, Childhood Trauma Questionnaire (CTQ-28), Dissociative Experiences Scale (DES), and Somatoform Dissociation Questionnaire (SDQ-20) were administered to all participants. Results Sexual abuse, emotional abuse, and emotional neglect scores, which comprise the subgroups of CTQ, were found high among women with GPP/PD compared with the control group (p=0.003, p=0.006, p=0.001). While a significant difference between the two groups’ SDQ scores was obtained (p=0.000), no significant difference was detected between the two groups’ DES scores (p=0.392). Discussion The results evoke the question are genitopelvic pain conditions, vaginismus and dyspareunia, that cannot be explained with a medical cause and that cause penetration disorder, a kind of dissociative symptom prone to develop in some women with childhood psychogenic trauma. PMID:29503548

Forensic nursing interventions with patients with personality disorder: a holistic approach.

PubMed

Byrt, Richard

2013-01-01

Research findings suggest that nursing assessment and care and psychotherapy of forensic patients with personality disorder should be based on a holistic approach that addresses a wide range of their needs. Such an approach should be in collaboration with patients, informal carers, and other professionals and informed by appropriate education, training, clinical supervision, and support. Holistic care includes areas (such as physical health, cultural, spiritual, and psychosexual needs) that are addressed to a limited extent in the literature on patients with personality disorder. Despite limitations in research evidence, findings suggest that some patients with personality disorder benefit from psychotherapies, sometimes facilitated by nurse-therapists, and therapeutic community principles. These interventions should take account of patients' cultural and spiritual needs and perspectives. Helping patients to manage anger has potentially positive consequences for their physical health, personal and work relationships, and other areas. Research is needed to consider how to deliver holistic care with limited resources and in organizations, such as prisons, with conflicting goals.

Dismantling the man-made myths upholding female genital mutilation.

PubMed

Jiménez Ruiz, Ismael; Almansa Martínez, Pilar; Alcón Belchí, Carolina

2017-05-01

Female genital mutilation (FGM) is internationally considered an affront to human rights and an act of violence against women and young girls. Furthermore, it hierarchizes and perpetuates inequality and denies women and girls the right to physical and psychosexual integrity. The aim of this study is to detect the weak points and false premises underlying male justification of FGM and to present demythologization as a health education tool. We used a qualitative methodology with an ethonursing focus via semistructured individual and group interviews in 25 men associated with FGM. Our results found that nine myths and their mythologization are presented through the masculine voices of those associated with this tradition. These myths are used as justification by men and women in order to uphold the practice of FGM. Demythologization as a nursing intervention based on reorienting or restructuring models of cultural care allows us to work against the false premises making up the myths which act to protect this tradition.

Do single and partnered women with gynecologic cancer differ in types and intensities of illness- and treatment-related psychosocial concerns? A pilot study.

PubMed

de Groot, Janet M; Mah, Kenneth; Fyles, Anthony; Winton, Susan; Greenwood, Sarah; DePetrillo, Denny; Devins, Gerald M

2007-09-01

We compared the psychosocial and psychosexual concerns of single and partnered women with gynecologic cancer, since relationship status and psychosocial context are known to affect sexuality, a life domain commonly affected by this cancer. A cross-sectional convenience sample of 49 women (68% response), with ovarian (n=31), endometrial (n=12), and cervical (n=6) cancer, responded to a 72-item self-report Cancer Concerns Questionnaire and additional psychosocial questionnaires. Single (n=13) and partnered women (n=36) similarly reported prognosis as their highest concern, but single women (26% of the sample) reported that communication with the treatment team, treatment side effects, and prognosis were of greater salience to them than did partnered women. The latter group had greater sexuality and partner relationship concerns. These preliminary findings suggest that relationship status, whether partnered or single, influences current psychosocial concerns among women with gynecologic cancer, despite similar levels of illness- and treatment-related intrusions on important life domains.

Effects of a behavioral intervention to reduce serodiscordant unsafe sex among HIV positive men who have sex with men: the Positive Connections randomized controlled trial study.

PubMed

Rosser, B R Simon; Hatfield, Laura A; Miner, Michael H; Ghiselli, Margherita E; Lee, Brian R; Welles, Seth L

2010-04-01

Few behavioral interventions have been conducted to reduce high-risk sexual behavior among HIV-positive Men who have Sex with Men (HIV+ MSM). Hence, we lack well-proven interventions for this population. Positive Connections is a randomized controlled trial (n = 675 HIV+ MSM) comparing the effects of two sexual health seminars--for HIV+ MSM and all MSM--with a contrast prevention video arm. Baseline, 6-, 12- and 18-month follow-up surveys assessed psychosexual variables and frequency of serodiscordant unprotected anal intercourse (SDUAI). At post-test, intentions to avoid transmission were significantly higher in the sexual health arms. However, SDUAI frequency decreased equally across arms. HIV+ MSM engaging in SDUAI at baseline were more likely to leave the study. Tailoring interventions to HIV+ MSM did not increase their effectiveness in this study. A sexual health approach appeared as effective as an untailored video-based HIV prevention intervention in reducing SDUAI among HIV+ MSM.

Androgen and psychosexual development: core gender identity, sexual orientation and recalled childhood gender role behavior in women and men with congenital adrenal hyperplasia (CAH).

PubMed

Hines, Melissa; Brook, Charles; Conway, Gerard S

2004-02-01

We assessed core gender identity, sexual orientation, and recalled childhood gender role behavior in 16 women and 9 men with CAH and in 15 unaffected female and 10 unaffected male relatives, all between the ages of 18 and 44 years. Women with congenital adrenal hyperplasia (CAH) recalled significantly more male-typical play behavior as children than did unaffected women, whereas men with and without CAH did not differ. Women with CAH also reported significantly less satisfaction with the female sex of assignment and less heterosexual interest than did unaffected women. Again, men with CAH did not differ significantly from unaffected men in these respects. Our results for women with CAH are consistent with numerous prior reports indicating that girls with CAH show increased male-typical play behavior. They also support the hypotheses that these women show reduced heterosexual interest and reduced satisfaction with the female sex of assignment. Our results for males are consistent with most prior reports that boys with CAH do not show a general alteration in childhood play behavior. In addition, they provide initial evidence that core gender identity and sexual orientation are unaffected in men with CAH. Finally, among women with CAH, we found that recalled male-typical play in childhood correlated with reduced satisfaction with the female gender and reduced heterosexual interest in adulthood. Although prospective studies are needed, these results suggest that those girls with CAH who show the greatest alterations in childhood play behavior may be the most likely to develop a bisexual or homosexual orientation as adults and to be dissatisfied with the female sex of assignment.

Sexual function in adolescent and young adult cancer survivors-a population-based study.

PubMed

Olsson, Maria; Steineck, Gunnar; Enskär, Karin; Wilderäng, Ulrica; Jarfelt, Marianne

2018-03-05

Previous research has established that treatments for cancer can result in short- and long-term effects on sexual function in adult cancer patients. The purpose was to investigate patient-reported physical and psychosexual complications in adolescents and young adults after they have undergone treatment for cancer. In this population-based study, a study-specific questionnaire was developed by a method used in several previous investigations carried out by our research group, Clinical Cancer Epidemiology. The questionnaire was developed in collaboration with adolescent and young adult cancer survivors (15-29 years) and validated by professionals from oncology units, midwives, epidemiologists, and statisticians. The topics covered in the questionnaire were psychosocial health, body image, sexuality, fertility, education, work, and leisure. The web-based questionnaire was sent to adolescent and young adult cancer survivors and matched controls in Sweden. In this study, adolescent and young adult cancer survivors (15-29 years) showed low satisfaction regarding sexual function compared to controls (P < 0.01). Female adolescent and young adult cancer survivors had a statistically significant lower frequency of orgasm during sexual activity than the controls (P < 0.01). Male adolescent and young adult cancer survivors had statistically significant lower sexual desire than the controls (P = 0.04). We found that adolescent and young adult cancer survivors perceived themselves as being less satisfied with their sexual function than matched population-based controls. Adolescent and young adult cancer survivors need psychological rehabilitation support from the health care profession during and after cancer treatment to help them to reduce their reported poor sexual function to enhance a good sexual quality of life.

Validation of the partner version of the multidimensional vaginal penetration disorder questionnaire: A tool for clinical assessment of lifelong vaginismus in a sample of Iranian population.

PubMed

Molaeinezhad, Mitra; Khoei, Effat Merghati; Salehi, Mehrdad; Yousfy, Alireza; Roudsari, Robab Latifnejad

2014-01-01

The role of spousal response in woman's experience of pain during the vaginal penetration attempts believed to be an important factor; however, studies are rather limited in this area. The aim of this study was to develop and investigate the psychometric indexes of the partner version of a multidimensional vaginal penetration disorder questionnaire (PV-MVPDQ); hence, the clinical assessment of spousal psychosexual reactions to vaginismus by specialists will be easier. A mixed-methods sequential exploratory design was used, through that, the findings from a thematic qualitative research with 20 unconsummated couples, which followed by an extensive literature review used for development of PV-MVPDQ. A consecutive sample of 214 men who their wives' suffered from lifelong vaginismus (LLV) based on Diagnostic and Statistical Manual of Mental Disorders 4(th) version (DSM)-IVTR criteria during a cross-sectional design, completed the questionnaire and additional questions regarding their demographic and sexual history. Validation measures and reliability were conducted by exploratory factor analysis (EFA) and Cronbach's alpha coefficient through SPSS version 16 manufactured by SPSS Inc. (IBM corporation, Armonk, USA). After conducting EFA PV-MVPDQ emerged as having 40 items and 7 dimensions: Helplessness, sexual information, vicious cycle of penetration, hypervigilance and solicitous, catastrophic cognitions, sexual and marital adjustment and optimism. Subscales of PV-MVPDQ showed a significant reliability (0.71-0.85) and results of test-retest were satisfactory. The present study shows PV-MVPDQ is a multi-dimensional valid and reliable self-report questionnaire for assessment of cognitions, sexual and marital relations related to vaginal penetrations in spouses of women with LLV. It may assist specialists to base on which clinical judgment and appropriate planning for clinical management.

Validation of the partner version of the multidimensional vaginal penetration disorder questionnaire: A tool for clinical assessment of lifelong vaginismus in a sample of Iranian population

PubMed Central

Molaeinezhad, Mitra; Khoei, Effat Merghati; Salehi, Mehrdad; Yousfy, Alireza; Roudsari, Robab Latifnejad

2014-01-01

Background: The role of spousal response in woman's experience of pain during the vaginal penetration attempts believed to be an important factor; however, studies are rather limited in this area. The aim of this study was to develop and investigate the psychometric indexes of the partner version of a multidimensional vaginal penetration disorder questionnaire (PV-MVPDQ); hence, the clinical assessment of spousal psychosexual reactions to vaginismus by specialists will be easier. Materials and Methods: A mixed-methods sequential exploratory design was used, through that, the findings from a thematic qualitative research with 20 unconsummated couples, which followed by an extensive literature review used for development of PV-MVPDQ. A consecutive sample of 214 men who their wives’ suffered from lifelong vaginismus (LLV) based on Diagnostic and Statistical Manual of Mental Disorders 4th version (DSM)-IVTR criteria during a cross-sectional design, completed the questionnaire and additional questions regarding their demographic and sexual history. Validation measures and reliability were conducted by exploratory factor analysis (EFA) and Cronbach's alpha coefficient through SPSS version 16 manufactured by SPSS Inc. (IBM corporation, Armonk, USA). Results: After conducting EFA PV-MVPDQ emerged as having 40 items and 7 dimensions: Helplessness, sexual information, vicious cycle of penetration, hypervigilance and solicitous, catastrophic cognitions, sexual and marital adjustment and optimism. Subscales of PV-MVPDQ showed a significant reliability (0.71-0.85) and results of test-retest were satisfactory. Conclusion: The present study shows PV-MVPDQ is a multi-dimensional valid and reliable self-report questionnaire for assessment of cognitions, sexual and marital relations related to vaginal penetrations in spouses of women with LLV. It may assist specialists to base on which clinical judgment and appropriate planning for clinical management. PMID:25540787

Partial androgen insensitivity syndrome due to somatic mosaicism of the androgen receptor.

PubMed

Batista, Rafael Loch; Rodrigues, Andresa De Santi; Machado, Aline Zamboni; Nishi, Mirian Yumie; Cunha, Flávia Siqueira; Silva, Rosana Barbosa; Costa, Elaine M F; Mendonca, Berenice B; Domenice, Sorahia

2018-01-26

Androgen insensitivity syndrome (AIS) is the most frequent etiology of 46,XY disorders of sex development (DSDs), and it is an X-linked disorder caused by mutations in the androgen receptor (AR) gene. AIS patients present a broad phenotypic spectrum and individuals with a partial phenotype present with different degrees of undervirilized external genitalia. There are more than 500 different AR gene allelic variants reported to be linked to AIS, but the presence of somatic mosaicisms has been rarely identified. In the presence of a wild-type AR gene, a significant degree of spontaneous virilization at puberty can be observed, and it could influence the gender assignment, genetic counseling and the clinical and psychological management of these patients and the psychosexual outcomes of these patients are not known. In this study, we report two patients with AR allelic variants in heterozygous (c.382G>T and c.1769-1G>C) causing a partial AIS (PAIS) phenotype. The first patient was raised as female and she had undergone a gonadectomy at puberty. In both patients there was congruency between gender of rearing and gender identity and gender role. Somatic mosaicism is rare in AIS and nonsense AR variant allelic can cause partial AIS phenotype in this situation. Despite the risk of virilization and prenatal androgen exposure, the gender identity and gender role was concordant with sex of rearing in both cases. A better testosterone response can be expected in male individuals and this should be considered in the clinical management.

Quality of life of homosexual males with genital warts: a qualitative study

PubMed Central

2010-01-01

Background A recent qualitative study in Denmark showed that genital warts (GWs) can considerably lower the quality of life of heterosexual patients. In this follow-up study, we interviewed men having sex with men (MSM) suffering from GWs to obtain an in-depth understanding of their perception of GWs and determine the extent to which minority (homosexual) cultural issues affect these patients' experiences. Qualitative interviews with six MSM were performed using a semi-structured interview guide. Questions were formulated on the basis of the earlier qualitative study in heterosexual patients with GWs along with a literature review. Data were analysed using a medical anthropological approach. Findings Many MSM worried about being stigmatised and excluded from the small homosexual 'scene', their key social group, thereby lowering their chances of finding sex and love. Most participants had suffered from GWs for several years which added to the negative psycho-sexual and social effects of the disease. Participants' fears of developing anal cancer were similar to those expressed about cervical cancer by females with GWs. Conclusions Ano-genital human papillomavirus (HPV) infection is common and has a serious psychological and sexual impact among MSM. However, they do not benefit to the same extent as heterosexual men from the herd immunity effect of HPV vaccination of girls. The pathological profile and concerns specific to MSM should be addressed when communicating with these patients, and should be taken into account when considering HPV vaccination of boys. PMID:21050431

German medical students' interest in and knowledge about human sexuality in 1972 and 2012.

PubMed

Turner, Daniel; Jopt, Konstantin; Nieder, Timo O; Briken, Peer

2014-08-01

During the 1970s, a growing number of medical schools began to recognize the importance of medical education concerning human sexuality. Currently, most medical schools provide at least some instruction in human sexuality. In light of this development, the present study aimed to compare the interest in and knowledge about human sexuality of medical students from two different time periods. The answers to a self-constructed questionnaire of 236 students in 1972 were compared with those of 259 students in 2012. Students were asked whether they were interested in education regarding human sexuality and which specific topics they felt should be included in the medical curriculum. The students' knowledge in the following domains was assessed: sexual development, sexual behavior, sexual physiology and psychology, and sexual medicine. The two cohorts were compared with regard to those specific sexuality-related topics in which the students were most and least interested in. Furthermore, the number of correct responses to the knowledge questions was compared. While in 1972, 99.2% of the students were interested in medical education about human sexuality, in 2012, 80.3% showed an interest. The connection of disorders from different medical disciplines with sexuality was rated as most interesting by both the students from 1972 and 2012. Medical students from 2012 gave 50.3% correct answers to the knowledge questions, whereas students from 1972 correctly answered 46.3% of the questions. Although interest in education concerning human sexuality has decreased, the majority of students view it as an important topic. Nevertheless, medical students still lack knowledge about important aspects of human sexuality (e.g., psychosexual development and relative safety of different contraceptives). Therefore, more time should be dedicated to education concerning human sexuality and its cultural, societal, and health aspects in particular. © 2014 International Society for Sexual Medicine.

Psychosexual development, maternalism, nonpromiscuity, and body image in 15 females with precocious puberty.

PubMed

Money, J; Walker, P A

1971-03-01

Fifteen females with a history of idiopathic sexual precocity were selected without known sampling bias. They had been followed for as long as 18 years. They showed various behavioral characteristics as a group, but were also individually unique. If the IQ permitted, they benefited socially from school acceleration. Left to their own devices, the majority preferred friends nearer to them in physique age rather than chronologic age. Play interests, though influenced by the age of playmates, showed no features unique to the precocious onset of hormonal puberty. About half of the girls had occasional moody or depressed spells and wanted to be left alone. Maternalistic interests were strongly represented; only one girl was a tomboy. Masturbation and sexual play in childhood were rarely confirmed, and in no instances were totally contrary to family or community mores. No consistent progression of erotic dream content was discerned. Dreams of having a baby were rare, but antedated intercourse dreams, which were also rarely reported and did not include sensations of climax. Whereas the youngest age of having a serious boyfriend was 8 years, and the youngest age of intercourse, 11, the majority of girls did not report romantic and sexual involvements before the middle teenage years or later. In the three instances of marriage, the youngest was at age 21. Motherhood has so far been achieved by only one patient. She delivered her first child at age 11. The visible appearance of early sexual development and early advanced statural growth created a problem in childhood human relationships for most of the girls, regardless of what they said, and regardless of their skill or ineptitude in handling it. They all benefited even from minimal counseling, as did their parents. Early appearance of physical sexual development does not automatically lead to premature engagement in erotic activity or promiscuous sexual behavior. Such activity and behavior require appropriate experience and facilitating knowledge of erotic opportunities.

Effects of female sterilization: one year follow-up in a prospective controlled study of psychological and psychiatric outcome.

PubMed

Cooper, J E; Bledin, K D; Brice, B; Mackenzie, S

1985-01-01

A prospective controlled study of the psychological effects of elective interval and postpartum tubal sterilization was carried out on a selected sample of women. Subjects were interviewed pre-operatively (n = 138) and one year post-operatively (n = 116; 83%), using standardized instruments and procedures, including the Present State Examination. No differences within or between sterilization and control groups were found over the follow-up year in the prevalence of psychiatric morbidity, which was no higher than would be expected in a general population sample. Beneficial effects of sterilization were reported on a number of psychosexual variables. Adverse effects such as regret or deterioration in marital relationship were rare, but were more likely to occur in postpartum subjects, among whom abdominal pain was also reported more commonly at one year follow-up than pre-operatively. The relevance of "normal" postnatal events and of the role of pre-operative counselling are considered in relation to these findings. Less favourable outcome at one year follow-up was commonly associated with higher PSE scores pre-operatively.

Psychosocial vulnerability and HIV/AIDS epidemiological situation among people with hearing disabilities in four towns in Cameroon.

PubMed

Mboua, C P; Touko, A

2016-11-01

The scientific literature about disabled people has stressed their high exposure to social exclusion and marginalization, linked to ways of thinking and representations about them. In the area of HIV/AIDS, this marginalization, which results in higher levels of self-stigmatization and especially in inequalities in prevention, continues to put disabled people at high risk of HIV infection. The current study, conducted with a socioepidemiological and behavioral approach, included 317 people with hearing disabilities, recruited through purposive sampling combined with a snowball approach. Participants, after providing informed consent in accordance with the declaration of Helsinki, completed a questionnaire and underwent HIV screening. The results showed a high rate of early sexual intercourse and a high prevalence of HIV, associated with their many risk factors and vulnerability. The analysis also revealed that social marginalization, erroneous beliefs, lack of communication and more generally of appropriate prevention adapted to them, a high rate of multiple partners, a low rate of condom use, psychosexual violence, and difficulties in negotiating social relations, particularly those of sexual relations, are the principal factors of vulnerability and risk.

Depression, anxiety and sexual satisfaction in breast cancer patients and their partners-Izmir oncology group study.

PubMed

Alacacioglu, Ahmet; Ulger, Eda; Varol, Umut; Yildiz, Ibrahim; Salman, Tarik; Bayoglu, Vedat; Dirican, Ahmet; Demir, Lutfiye; Akyol, Murat; Yildiz, Yasar; Kucukzeybek, Yuksel; Ataman, Gorkem; Can, Huseyin; Alacacioglu, Inci; Tarhan, Mustafa Oktay

2014-01-01

We aimed to investigate anxiety, depression and sexual satisfaction levels and the effects of depression and anxiety upon the sexual satisfaction of Turkish breast cancer patients and their partners. Data were collected from one hundred breast cancer patients and their partners, using three forms: one covering information about socio-demographic characteristics of the patients, the Hospital Anxiety and Depression Scale (HADs) and the Golombok-Rust Inventory of Sexual Satisfaction (GRISS). The frequencies, avoidance and touch subscores were statistically significantly high in the patients. Among those with high anxiety scores, the frequency, communication, satisfaction, touch, and anorgasmic subscale scores of GRISS were found to be significantly high. Among the partners whose anxiety scores were high, only the premature ejaculation subscale was statistically significant. It was determined that for partners with higher depression scores, the communication, satisfaction, avoidance, premature ejaculation and erectile dysfunction subscores of GRISS were statistically higher compared to partners with lower depression scores. Patients' quality of life may be increased by taking precautions to reduce their and their partners' psychosocial and psychosexual concerns.

Women showing off: notes on female exhibitionism.

PubMed

Balsam, Rosemary H

2008-03-01

The limitations of the phallocentric cast of earlier psychoanalytic formulations of "female exhibitionism" linger into the present. In part this connects to certain historical expectations for women's social behavior, and to the vicissitudes of Freud's insufficient knowledge of women in his libidinal psychosexual phasing used as a basis for analytic understanding. The contemporary fade of libido theory contributes to the neglect of such topics as they relate to the biological body. Yet ease and conflict regarding conscious and unconscious female body image representations related to that stepchild of theory-pregnancy and childbirth in particular-play a major role in female body display. Recognition of such body fantasies and female body meanings from early childhood into maturity tends to be marginalized within all of the psychoanalytic theories current today. The focus here on female exhibitionism suggests a normative spectrum for pleasurably active sex seeking and pleasurable procreative desire and fantasy that is present in a female's use of her body and which (of course, but secondarily) can become caught up in conflict. Two cases accenting analyses of female "showing off" behavior are included.

Erectile dysfunction management options in Nigeria.

PubMed

Afolayan, Anthony Jide; Yakubu, Musa Toyin

2009-04-01

In Nigeria, the prevalence of erectile dysfunction (ED) among patients attending primary care clinics, age-standardized to the U.S. population in 2000 is 57.4%. This is considered high enough to warrant the attention of scientist for critical studies and analysis. The high ED prevalence is associated with etiologies such as psychosexual factors, chronic medical conditions, and some lifestyles. ED constitutes a major public health problem, influencing the patient's well-being and quality of life. It also leads to broken homes and marriages, psychological, social, and physical morbidity. To give an account of various ED management options in Nigeria. Review of peer-reviewed literature, questionnaire, and ethnobotanical survey to some indigenous herb sellers and herbalists. Cross cultural perspectives of ED management in Nigeria. The review suggests that traditional (phytotherapy, zootherapy, and occultism) and nontraditional, orthodox practice (drug therapy, psychological, and behavioral counseling) are applicable to ED management in Nigeria. This review should help in creating awareness into various options available for managing ED in the country, but does not recommend self medication of any form, be it the use of orthodox or herbal remedy.

The frequency of lymphogranuloma venereum in persons with perirectal abscesses, fistulae in ano, or both

PubMed Central

Greaves, A. B.

1963-01-01

Altogether 94 patients with perirectal abscesses and/or fistulae in ano were tested for lymphogranuloma venereum in a Washington, D.C., clinic. They included men and women of low socio-economic status, many of the men being overt psycho-sexual hermaphrodites. The findings were compared with those in a control group of similar sex distribution (females, male homosexuals, male heterosexuals). All persons in the study were tested for lymphogranuloma venereum by the complement-fixation and Frei tests. Homosexuals and persons with rectal lesions were also examined by proctoscopy. Among other findings, a significantly higher frequency of Frei reactors or positive complement-fixation reactions was observed among patients (both male and female) with abscesses than among the controls and among male homosexuals than heterosexuals. The author concludes that lymphogranuloma venereum should be excluded in the differential diagnosis of perirectal abscess and fistual in ano, that homosexuals should be routinely tested for lymphogranuloma venereum, and that sexual perversion should be considered in male patients with ano-rectal disease of lymphogranuloma venereum origin. PMID:14107753

Addressing Female Genital Mutilation/Cutting (FGM/C) in the Era of Clitoral Reconstruction: Plastic Surgery.

PubMed

Sigurjonsson, Hannes; Jordal, Malin

2018-01-01

The aim of this review is to give an overview of the recent evidence on clitoral reconstruction and other relevant reconstructive plastic surgery measures after female genital mutilation/cutting (FGM/C). Recent publications present refinements and modifications of the surgical technique of clitoral reconstruction along with reconstruction of the labia majora and clitoral hood. Novel approaches with reposition of the clitoral nerve, anchoring of the labia majora, fat grafting, and full thickness mucosa grafts have been introduced. The current evidence on outcomes of clitoral reconstruction shows potential benefits. However, there is a risk of postoperative complications and a negative outcome. Experts in the field advocate for a multidisciplinary approach including psychosexual counseling and health education with or without subsequent clitoral reconstructive surgery. The evolution of reconstructive treatment for women with FGM/C is expanding, however at a slow rate. The scarcity of evidence on clitoral reconstruction halters availability of clinical guidelines and consensus regarding best practice. Clitoral reconstruction should be provided by multidisciplinary referral centers in a research setting with long-term follow-up on outcomes of postoperative morbidity and possible benefits.

Vaginismus in peri- and postmenopausal women: a pragmatic approach for general practitioners and gynaecologists.

PubMed

Hope, Mairi E; Farmer, Laura; McAllister, Kay F; Cumming, Grant P

2010-06-01

Vaginismus is generally described as an involuntary contraction of the vaginal musculature, which usually results in the failure of penetration. Despite a lack of consensus as to the exact definition, prevalence rates vary between 4.2% and 42%. It is commonly diagnosed at both gynaecological and psychosexual clinics. The majority of studies and treatment options concentrate on the premenopausal age group. It is accepted that even within this age group, the diagnosis is often incorrect as symptoms can be confused with dyspareunia and other sexual pain disorders. There is no literature discussing vaginismus in the postmenopausal patient, despite evidence that an active sex life is important to the majority of women, irrespective of age. It is known that the majority of women do not report difficulties in their sex life and it may be that the older patient is more embarrassed at disclosing any such difficulties. This review aims to highlight the possible causes of vaginismus in this older age group and to aid the clinician in asking the appropriate questions, performing the appropriate examination and suggesting possible treatment options.

Clinical Holistic Medicine: Avoiding the Freudian Trap of Sexual Transference and Countertransference in Psychodynamic Therapy

PubMed Central

Ventegodt, Søren; Kandel, Isack; Merrick, Joav

2008-01-01

Sexual transference and countertransference can make therapy slow and inefficient when libidinous gratification becomes more important for both the patient and the therapist than real therapeutic progress. Sexual transference is normal when working with a patient's repressed sexuality, but the therapeutic rule of not touching often hinders the integration of sexual traumas, as this needs physical holding. So the patient is often left with sexual, Oedipal energies projected onto the therapist as an “idealized father” figure. The strong and lasting sexual desire for the therapist without any healing taking place can prolong therapy for many years, as it often does in psychodynamic psychotherapy and psychoanalysis. We call this problem “Freud's Trap”. Freud used intimate bodywork, such as massage, in the beginning of his career, but stopped, presumably for moral and political reasons. In the tradition of psychoanalysis, touch is therefore not allowed. Recent research in clinical holistic medicine (CHM), salutogenesis, and sexual healing has shown that touch and bodywork (an integral part of medicine since Hippocrates) are as important for healing as conversational therapy. CHM allows the patient to regress spontaneously to early sexual and emotional traumas, and to heal the deep wounds on body, soul, and sexual character from arrested psychosexual development. CHM treats sexuality in therapy more as the patient’s internal affair (i.e., energy work) and less as a thing going on between the patient and the therapist (i.e., transference). This accelerates healing, and reduces sexual transference and the need for mourning at the end of therapy. PMID:18454245

A Cross-Section Study of the Ontogeny of Gender Roles in Women with DSD.

PubMed

Wisniewski, Amy; Aston, Christopher E

2015-01-01

A review of gender role (GR) differentiation from early childhood through adulthood was conducted on males and females in general, as well as on females affected by congenital adrenal hyperplasia (CAH) due to 21-hydroxylase deficiency or complete androgen insensitivity syndrome (CAIS). Additionally, retrospective and current, self-rated GR assessments were evaluated from women with CAH (n = 9) or CAIS (n = 12), and unaffected women and men ranging in age from 16 to 59 years. Overall, GR differentiation occurs in early childhood and persists through adulthood. With advanced age, this differentiation may evolve into androgyny or even become undifferentiated for the general population. While more studies of GR exist for girls and women with CAH compared to those affected by CAIS, some developmental patterns can be observed from the limited data that exist. First, girls and women with CAIS report a female GR that persists through adulthood. Second, girls and women with CAH are more likely to report less feminine/ more masculine play in childhood followed by interests in male-typical leisure activities and career choices in adulthood. However, our data indicate that women with CAH report more feminine/ less masculine patterns of GR with age. Self-reported GR for women with CAH was indistinguishable from that of women with CAIS at the time of study participation in adulthood. With the availability of effective medications for treating hormone deficiencies associated with CAH, affected women are expected to live a full lifespan. Thus, our understanding of psychosexual development into older age is warranted.

Clinical holistic medicine: avoiding the Freudian trap of sexual transference and countertransference in psychodynamic therapy.

PubMed

Ventegodt, Søren; Kandel, Isack; Merrick, Joav

2008-04-14

Sexual transference and countertransference can make therapy slow and inefficient when libidinous gratification becomes more important for both the patient and the therapist than real therapeutic progress. Sexual transference is normal when working with a patient's repressed sexuality, but the therapeutic rule of not touching often hinders the integration of sexual traumas, as this needs physical holding. So the patient is often left with sexual, Oedipal energies projected onto the therapist as an "idealized father" figure. The strong and lasting sexual desire for the therapist without any healing taking place can prolong therapy for many years, as it often does in psychodynamic psychotherapy and psychoanalysis. We call this problem "Freud's Trap". Freud used intimate bodywork, such as massage, in the beginning of his career, but stopped, presumably for moral and political reasons. In the tradition of psychoanalysis, touch is therefore not allowed. Recent research in clinical holistic medicine (CHM), salutogenesis, and sexual healing has shown that touch and bodywork (an integral part of medicine since Hippocrates) are as important for healing as conversational therapy. CHM allows the patient to regress spontaneously to early sexual and emotional traumas, and to heal the deep wounds on body, soul, and sexual character from arrested psychosexual development. CHM treats sexuality in therapy more as the patient's internal affair (i.e., energy work) and less as a thing going on between the patient and the therapist (i.e., transference). This accelerates healing, and reduces sexual transference and the need for mourning at the end of therapy.

Sexuality and sexual health among female youth with borderline personality disorder pathology.

PubMed

Thompson, Katherine N; Betts, Jennifer; Jovev, Martina; Nyathi, Yolanda; McDougall, Emma; Chanen, Andrew M

2017-10-27

Borderline personality disorder (BPD) is a severe mental disorder that is characterized by unstable relationships, impulsive behaviours and identity disturbance. BPD usually has its onset between puberty and young adulthood and presents disproportionately among females in clinical settings. Taken together, this makes young women with BPD a particularly vulnerable group with regard to healthy psychosexual development. It was hypothesized that female youth with BPD pathology would be more likely to score worse on measures of sexual health and safety, and to show greater uncertainty in sexual identity formation. Fifty 15 to 24 yr-old females with 3 or more Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-IV) BPD criteria were compared with 204 females from a nationally representative sample. Both groups were interviewed using a comprehensive interview for sexual health and relationships. The patient group completed a structured diagnostic interview. Young women with borderline personality pathology engaged in sexual relationships at a younger age, with more sexual partners in the previous year, in more casual relationships. They were more likely to practice unsafe sex for their first sexual experience, to be coerced into unwanted sexual activity, to be unclear about their sexual identity or their sexual attraction, and to report worse overall health status. BPD pathology in youth is associated with poor sexual health and safety, and uncertainty in sexual identity formation. These findings support the need for assessment of the sexuality and sexual health of youth with BPD, along with the need for routine screening in sexual health services for BPD features among high-risk youth. © 2017 John Wiley & Sons Australia, Ltd.

Sexual quality of life after total phalloplasty in men with penile deficiency: an exploratory study.

PubMed

Callens, Nina; De Cuypere, Griet; T'Sjoen, Guy; Monstrey, Stan; Lumen, Nicolaas; Van Laecke, Erik; Hoebeke, Piet; Cools, Martine

2015-01-01

Total phalloplasty is rarely performed today in males with severe penile deficiency, despite its successful use in the transgender population. Can phalloplasty replicate the complexity of penile anatomy and function on the long term? Sexual quality of life (QoL) was assessed in 10 men (aged 20-43 years) at least 1 year after phalloplasty in a single institution (80 % radial forearm flap and 20 % anterolateral thigh flap). In all but one, an erectile prosthesis was implanted on average 1 year after phallic reconstruction. Sexual QoL outcomes were compared to those of men with hypospadias repair (n = 73) and control men (n = 50). After phalloplasty (mean 36.9 months, 14-92 months), all men were sexually active (80 % intercourse and 100 % masturbation with orgasm and ejaculation). However, 75 % indicated to be inhibited in seeking sexual contacts, compared to 40 % of hypospadias patients (p < 0.05) and 11 % of controls (p < 0.01). Although 90 % were satisfied with the final surgical result, dissatisfaction with some aspects of genital appearance was present in 50 %. Erogenous neophallus sensitivity was said to be less than previously hoped for. Six men developed urinary complications (urethral stricture and/or fistula), and one man underwent revision of the erectile implant because of dysfunction. Nevertheless, all indicated they would choose again for phalloplasty if necessary. Total phalloplasty opens new horizons for the treatment of men with penile deficiency, but limitations of the technique should be emphasized prior to surgery. An exploration of patient expectations and continued follow-up including psychological support is important for optimizing psychosexual comfort.

Psychological Symptoms, Social Outcomes, Socioeconomic Attainment, and Health Behaviors Among Survivors of Childhood Cancer: Current State of the Literature.

PubMed

Brinkman, Tara M; Recklitis, Christopher J; Michel, Gisela; Grootenhuis, Martha A; Klosky, James L

2018-06-06

The diagnosis, treatment, and medical late effects of childhood cancer may alter the psychosocial trajectory of survivors across their life course. This review of the literature focuses on mental health symptoms, achievement of social milestones, socioeconomic attainment, and risky health behaviors in survivors of childhood cancer. Results suggest that although most survivors are psychologically well adjusted, survivors are at risk for anxiety and depression compared with siblings. Although the absolute risk of suicide ideation and post-traumatic stress symptoms is low, adult survivors are at increased risk compared with controls. Moreover, young adult survivors are at risk for delayed psychosexual development, lower rates of marriage or cohabitation, and nonindependent living. Survivors' socioeconomic attainment also is reduced, with fewer survivors graduating college and gaining full-time employment. Despite risk for late health-related complications, survivors of childhood cancer generally engage in risky health behaviors at rates similar to or only slightly lower than siblings and peers. CNS tumors and CNS-directed therapies are salient risk factors for poor psychosocial outcomes. In addition, physical health morbidities resulting from cancer-directed therapies are associated with worse psychosocial functioning. Several studies support the effectiveness of cognitive and behavioral interventions to treat psychological symptoms as well as to modify health behaviors. Additional randomized controlled trials are needed to evaluate the efficacy and long-term outcomes of intervention efforts. Future research should focus on the identification of potential genetic predispositions related to psychosocial outcomes to provide opportunities for preventive interventions among survivors of childhood cancer.

Is There a Relationship Between Borderline Personality Disorder and Sexual Masochism in Women?

PubMed

Frías, Álvaro; González, Laura; Palma, Cárol; Farriols, Núria

2017-04-01

Sexual masochism disorder is considered the most prevalent paraphilia among women. However, little is known about the etiology and clinical correlates involved in this disorder. We aimed at addressing this issue through a potentially high-risk clinical cohort. This case-control study consisted of 60 women who met DSM-IV criteria for borderline personality disorder (BPD) and 60 women with other personality disorders. For both groups, sexual masochism disorder comorbidity was assessed through the Structured Clinical Interview, Sexual Disorders Module. Several etiological, psychosexual, and personality features were measured. Sexual masochism disorder was 10 times higher in BPD women than in women with other personality disorders (10 vs. 0 %). Among BPD women, those with sexual masochism disorder reported more child sexual abuse, more hostile/dismissing attachments, higher sensation seeking, and more frequently exploratory/impersonal sexual fantasies than BPD without sexual masochism. Correlation analysis confirmed a significant positive relationship between disinhibition and sexual masochism severity for BPD women. Our findings point out that BPD women may represent a high-risk cohort, especially those with higher disinhibition and detached attachment. Childhood sexual abuse may also play a predispositional role on this comorbidity. Further research may help to elucidate the intriguing relationship between both disorders.

SSRI and SNRI withdrawal symptoms reported on an internet forum.

PubMed

Stockmann, Tom; Odegbaro, Dolapo; Timimi, Sami; Moncrieff, Joanna

2018-05-09

Antidepressant withdrawal symptoms are well-recognised, but their potential duration remains uncertain. We aimed to describe the characteristics of withdrawal associated with two popular classes of antidepressants, including duration. We analysed the content of a sample of posts on an antidepressant withdrawal website. We compared the characteristics of withdrawal associated with SSRIs and SNRIs, including time of onset, duration and nature of symptoms. 110 posts about SSRI withdrawal, and 63 concerning SNRI withdrawal, were analysed. The mean duration of withdrawal symptoms was significantly longer with SSRIs than SNRIs: 90.5 weeks (standard deviation, SD, 150.0) and 50.8 weeks (SD 76.0) respectively; p = 0.043). Neurological symptoms, such as 'brain zaps,' were more common among SNRI users (p = 0.023). Psychosexual/genitourinary symptoms may be more common among SSRI users (p = 0.054). The website aims to help people with antidepressant withdrawal, and is therefore likely to attract people who have difficulties. Length of prior use of antidepressants was long, with a mean of 252.2 weeks (SD 250.8). People accessing antidepressant withdrawal websites report experiencing protracted withdrawal symptoms. There are some differences in the characteristics of withdrawal associated with different classes of antidepressants.

Effects of Immunomodulators and Biologic Agents on Sexual Health in Patients With Inflammatory Bowel Disease.

PubMed

Kanar, Ozdemir; Berry, Andrew C; Nakshabendi, Rahman; Lee, Ann Joo; Aldridge, Petra; Myers, Travis; Eid, Emely

2017-01-01

Although much knowledge has been gained regarding the medical and surgical management of inflammatory bowel disease (IBD), a paucity of information is available on the psychosexual issues related to IBD. The aim of this study was to evaluate the sexual health of patients with IBD who were taking immunomodulators and/or biologic agents vs patients with IBD who were not on that medication regimen. All study participants completed a validated sexual health questionnaire, the Female Sexual Function Index or the International Index of Erectile Function, to assess their subjective perception of the effect of IBD on the different domains of sexual function during the prior 1-month time period. No statistically significant differences in any baseline demographic variables were found for either sex between the group taking immunomodulators/biologic agents and the nontreatment group. Among females and males, individual question responses, domain scores, and total scores showed no statistically significant differences between the 2 treatment groups. Our data suggest that the use of immunomodulators or biologic agents does not affect female or male sexual health. However, treatment of patients with IBD must be individualized based on the aggressive nature of the disease, treatment goals, and the tolerability of various medications.

The pathophysiology of delayed ejaculation

PubMed Central

2016-01-01

Delayed ejaculation (DE) is probably least studied, and least understood of male sexual dysfunctions, with an estimated prevalence of 1–4% of the male population. Pathophysiology of DE is multifactorial and including psychosexual-behavioral and cultural factors, disruption of ejaculatory apparatus, central and peripheral neurotransmitters, hormonal or neurochemical ejaculatory control and psychosocial factors. Although knowledge of the physiology of the DE has increased in the last two decade, our understanding of the different pathophysiological process of the causes of DE remains limited. To provide a systematic update on the pathophysiology of DE. A systematic review of Medline and PubMed for relevant publications on ejaculatory dysfunction (EjD), DE, retarded ejaculation, inhibited ejaculation, and climax was performed. The search was limited to the articles published between the January 1960 and December 2015 in English. Of 178 articles, 105 were selected for this review. Only those publications relevant to the pathophysiology, epidemiology and prevalence of DE were included. The pathophysiology of DE involves cerebral sensory areas, motor centers, and several spinal nuclei that are tightly interconnected. The biogenic, psychogenic and other factors strongly affect the pathophysiology of DE. Despite the many publications on this disorder, there still is a paucity of publications dedicated to the subject. PMID:27652227

Vasectomy and vasectomy reversal the Thai way.

PubMed

Gojaseni, P

1982-12-01

In 1972 the ratio of female sterilization acceptors to vasectomy acceptors in Thailand was 24.5:1; in 1978 the ratio was 2.8:1. Several factors are responsible for this change. First, a national family planning program to support voluntary family planning started in 1970 and lowered the population growth rate from 3.2% in 1973 to 2.1% in 1982. Second, the desired family size in Thailand is 3 and it is generally agreed that the solution is voluntary sterilization as a more cost effective fertility control method. Thirdly, misunderstandings about vasectomy were cleared up through media campaigns which cleared the way for greater acceptance. Fourth, in 1975 special clinics at big hospitals and a mobile unit were set up to perform vasectomies. Lastly, a group of nongovernment organizations has been set up, such as the Thai Association for Voluntary Sterilization, to provide the infrastructure for vasectomy campaigns. Requests for vasectomy reversals have, expectedly, increased as well, usually caused by marriage, child's death, improved finances, and psychosexual health. In a recent study of 32 cases, positive sperm reappearance after vas reanastomosis was found in 71.4% and the pregnancy rate was 52.3%.

Online-based interventions for sexual health among individuals with cancer: a systematic review.

PubMed

Kang, Hee Sun; Kim, Hyun-Kyung; Park, Seong Man; Kim, Jung-Hee

2018-03-07

Online interventions have the advantages of being widely available, accessible, comfortable, cost effective, and they can provide tailored information and support. Despite these benefits, the effects of specifically devised online intervention programs for cancer patients' sexual problems are somewhat unclear. The aim of this review is to describe online-based interventions and to assess their effects on sexual health among cancer survivors and/or their partners. We investigated the effects of online sexual interventions among individuals with cancer or their partners. Among these, we considered 4 eligible articles. Despite the diversity of contents of the interventions, the identified modes of delivery among most of the interventions were as follows: education, interactive methods, cognitive behavior therapy, tailored information, and self-monitoring. Methods of monitoring the interventions, including the utilization of the web site and post-treatment program rating, were reported. All the online intervention programs incorporated a focus on physical, psychological, cognitive, and social aspects of sexual health. Significant effects on patient sexual function and interest and the psychological aspect of sexual problems were reported. This study provides evidence that online-based interventions would be effective in improving the psycho-sexual problems of cancer survivors and their partners.

Lifetime prevalence of sexual intercourse and contraception use at last sex among adolescents and young adults with congenital heart disease.

PubMed

Fry, Kevin M; Gerhardt, Cynthia A; Ash, Jerry; Zaidi, Ali N; Garg, Vidu; McBride, Kim L; Fitzgerald-Butt, Sara M

2015-04-01

Because of the increased risks associated with unplanned pregnancy for males and females with congenital heart disease (CHD), we investigated sexual intercourse and contraception use in these adolescents and young adults (AYA) and compared the same with national and state population data. We recruited 337 AYA with structural CHD aged 15-25 years (Mage = 19 years, standard deviation = 3.1; 53% male, 84% white) from an outpatient cardiology clinic to participate in a larger study assessing genetic knowledge and health behaviors. Cumulative lifetime prevalence of adolescent (aged 15-18 years) sexual intercourse was compared with the 2011 Youth Risk Behavior Surveillance System and the 2007 Ohio Youth Risk Behavior Survey. Cumulative lifetime prevalence of young adult (aged 19-25 years) sexual intercourse and contraception use at last sex were compared with the 2006-2008 National Survey of Family Growth. Reported rates of ever having sexual intercourse, 26% of adolescents and 74% of young adults with CHD, were significantly lower than general population rates (47% and 86% respectively; p < .001). Similar to the general population, 77% of previously sexually active young adults with CHD reported using at least one effective method of contraception at last intercourse, whereas 25% used dual effective methods and 23% used no effective method. Lower rates of ever having sexual intercourse in this population suggest that the psychosexual development of AYA with CHD may lag behind their peers. As nearly one in four participants reported using no effective method of contraception, health care providers should increase discussions of contraception with males and females with CHD. Copyright © 2015 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Gender Identity and Sex-of-rearing in Children with Disorders of Sexual Differentiation

PubMed Central

2006-01-01

Aim: To compare declared sexual identity to sex-of-rearing in individuals with disorders of sexual differentiation. Methods: All 84 patients ≥5 years old in a pediatric psychosexual development clinic were assessed for sex-of-rearing and sexual identity. Diagnoses included 1) male-typical prenatal androgen effects but an absent or severely inadequate penis - 45 patients with cloacal exstrophy or aphallia; 2) inadequate prenatal androgens and a Y-chromosome - 28 patients with partial androgen insensitivity (pAIS) mixed gonadal dysgenesis (MGD), hermaphroditism, or craniofacial anomalies with genital ambiguity; 3) inappropriate prenatal androgen effects and a 46,XX karyotype - 11 patients with congenital adrenal hyperplasia (CAH). Results: Of 73 patients with disordered sexual differentiation and a Y-chromosome, 60 were reared female 26 of the 60 (43%) declared female identity while 32 (53%) declared male identity including 18 (55%) with cloacal exstrophy, six (55%) with MGD, four (40%) with pAIS, one (50%) with aphallia, one (100%) with hermaphroditism, and two (67%) with craniofacial anomalies; two (3%) declined to discuss identity. Nine of 11 patients with CAH and a 46,XX karyotype were reared female and two reared male; six (55%) declared female identity and five (45%) declared male identity. Of 84 total patients, 69 were reared female, but only 32 lived as female, while 29 lived as male; four patients refused to discuss sex-of-living; parents of four patients rejected their declarations of male identity. All 15 patients reared male lived as male including two genetic females. Conclusion: Active prenatal androgen effects appeared to dramatically increase the likelihood of recognition of male sexual identity independent of sex-of-rearing. Genetic males with maletypical prenatal androgen effects should be reared male. PMID:16042322

Gender identity and sex-of-rearing in children with disorders of sexual differentiation.

PubMed

Reiner, William G

2005-06-01

To compare declared sexual identity to sex-of-rearing in individuals with disorders of sexual differentiation. All 84 patients > or =5 years old in a pediatric psychosexual development clinic were assessed for sex-of-rearing and sexual identity. Diagnoses included 1) male-typical prenatal androgen effects but an absent or severely inadequate penis - 45 patients with cloacal exstrophy or aphallia; 2) inadequate prenatal androgens and a Y-chromosome - 28 patients with partial androgen insensitivity (pAIS), mixed gonadal dysgenesis (MGD), hermaphroditism, or craniofacial anomalies with genital ambiguity; 3) inappropriate prenatal androgen effects and a 46,XX karyotype - 11 patients with congenital adrenal hyperplasia (CAH). Of 73 patients with disordered sexual differentiation and a Y-chromosome, 60 were reared female; 26 of the 60 (43%) declared female identity while 32 (53%) declared male identity including 18 (55%) with cloacal exstrophy, six (55%) with MGD, four (40%) with pAIS, one (50%) with aphallia, one (100%) with hermaphroditism, and two (67%) with craniofacial anomalies; two (3%) declined to discuss identity. Nine of 11 patients with CAH and a 46,XX karyotype were reared female and two reared male; six (55%) declared female identity and five (45%) declared male identity. Of 84 total patients, 69 were reared female, but only 32 lived as female, while 29 lived as male; four patients refused to discuss sex-of-living; parents of four patients rejected their declarations of male identity. All 15 patients reared male lived as male including two genetic females. Active prenatal androgen effects appeared to dramatically increase the likelihood of recognition of male sexual identity independent of sex-of-rearing. Genetic males with male-typical prenatal androgen effects should be reared male.

Revised definitions of women's sexual dysfunction.

PubMed

Basson, Rosemary; Leiblum, Sandra; Brotto, Lori; Derogatis, Leonard; Fourcroy, Jean; Fugl-Meyer, Kerstin; Graziottin, Alessandra; Heiman, Julia R; Laan, Ellen; Meston, Cindy; Schover, Leslie; van Lankveld, Jacques; Schultz, Willibrord Weijmar

2004-07-01

Existing definitions of women's sexual disorders are based mainly on genitally focused events in a linear sequence model (desire, arousal and orgasm). To revise definitions based on an alternative model reflecting women's reasons/incentives for sexual activity beyond any initial awareness of sexual desire. An International Definitions Committee of 13 experts from seven countries repeatedly communicated, proposed new definitions and presented at the 2nd International Consultation on Sexual Medicine in Paris July 2003. Expert opinions/recommendations are based on a process that involved review of evidence-based medical literature, extensive internal committee discussion, informal testing and re-testing of drafted definitions in various clinical settings, public presentation and deliberation. Women have many reasons/incentives for sexual activity. Desire may be experienced once sexual stimuli have triggered arousal. Arousal and desire co-occur and reinforce each other. Women's subjective arousal may be minimally influenced by genital congestion. An absence of desire any time during the sexual experience designates disorder. Arousal disorder subtypes are proposed that separate an absence of subjective arousal from all types of sexual stimulation, from an absence of subjective arousal when the only stimulus is genital. A new arousal disorder has provisionally been suggested, namely that of persistent genital arousal. Orgasm disorder is limited to absence of orgasm despite high subjective arousal. Dyspareunia includes partial painful vaginal entry attempts as well as pain with intercourse. Variable reflex muscle tightening around the vagina and an absence of abnormal physical findings are noted in the definition of vaginismus. Women's sexuality is highly contextual and descriptors are recommended re past psychosexual development, current context, as well as medical status. Diagnosing sexual disorders need not imply intrinsic dysfunction of the woman's own sex response system. The International Definitions Committee has recommended a number of fundamental changes to the existing definitions of women's sexual disorders.

Standard operating procedures in the disorders of orgasm and ejaculation.

PubMed

McMahon, Chris G; Jannini, Emmanuele; Waldinger, Marcel; Rowland, David

2013-01-01

Ejaculatory/orgasmic disorders are common male sexual dysfunctions and include premature ejaculation (PE), inhibited ejaculation, anejaculation, retrograde ejaculation, and anorgasmia. To provide recommendations and guidelines of the current state-of-the-art knowledge for management of ejaculation/orgasmic disorders in men as standard operating procedures (SOPs) for the treating health care professional. The International Society of Sexual Medicine Standards Committee assembled over 30 multidisciplinary experts to establish SOPs for various male and female sexual medicine topics. The SOP for the management of disorders of orgasm and ejaculation represents the opinion of four experts from four countries developed in a process over a 2-year period. Expert opinion was based on grading of evidence-based medical literature, limited expert opinion, widespread internal committee discussion, public presentation, and debate. PE management is largely dependent upon etiology. Lifelong PE is best managed with PE pharmacotherapy (selective serotonin reuptake inhibitors and/or topical anesthetics). The management of acquired PE is etiology specific and may include erectile dysfunction (ED) pharmacotherapy in men with comorbid ED. All men seeking treatment for PE should receive basic psychosexual education. Graded behavioral therapy is indicated when psychogenic or relationship factors are present and is often best combined with PE pharmacotherapy in an integrated treatment program. Delayed ejaculation, anejaculation, and/or anorgasmia may have a biogenic and/or psychogenic etiology. Men with age-related penile hypoanesthesia should be educated, reassured, and instructed in revised sexual techniques which maximize arousal. Retrograde ejaculation is managed by education, patient reassurance, and pharmacotherapy. Additional research is required to further the understanding of the disorders of ejaculation and orgasm. © 2012 International Society for Sexual Medicine.

Pubic hair and sexuality: a review.

PubMed

Ramsey, Sara; Sweeney, Clare; Fraser, Michael; Oades, Gren

2009-08-01

Hair is a distinguishing feature of mammals, though the persistence of visible head, axillary, and pubic hair remains anthropologically unclear. Humans throughout the ages have modified their head and body hair, but aesthetic removal of pubic hair has become the "the ultimate barometer of how fashionable you really are" in the 21st century. The aim of the article is to examine the trends in pubic hair removal and its impact on health and sexuality. A literature search was performed, with a further search performed using an Internet-based search engine. For discussion, the results have been classified into the topics of "Development and anthropology","Cultural and artistic significance", "Medical implications", "Psychological and sexual significance and popular culture", "Impact of body hair loss on sexuality" and "Style and terminology." Pubic hair removal has been common since the ancient times. Pubic hair was rarely depicted in artistic representations of the nude until the late 19th century. It is postulated that the current trend of pubic hair removal may be related to the increased accessibility of Internet-based pornography. Anecdotally, pubic hair removal may carry benefits regarding increased sexual sensation and satisfaction though there is no quantative research in this field. There is a recognized morbidity to pubic hair removal, and also a lack of standardization of terms for styles adopted. We propose a definitive grading system for male and female body hair based on the widely used Tumor Node Metastasis staging system. Pubic hair removal appears to be an important aspect of expressing one's sexuality and participation in sexual activity. This practice has an interesting psychosexual basis which, to date, has not yet been fully explored in sexual medicine.

The problem of vaginismus with congenital malformation of the genital tract.

PubMed

Jarząbek-Bielecka, Grażyna; Pisarska-Krawczyk, Magdalena; Kędzia, Witold; Mizgier, Małgorzata; Friebe, Zbigniew

2016-05-31

The persistent or recurrent difficulties of the woman to allow vaginal entry of a penis, a finger, and/or any object, despite the woman's expressed wish to do so" is vaginismus. Early traumatic sexual experiences (e.g. sexual abuse), religious orthodoxy, low self-esteem and body image, negative attitudes about sexuality, lack of knowledge about sex and fear responses are some of the traditional etiological correlates of vaginismus. Vaginismus is largely a diagnosis of exclusion. An interview is crucial in differentiating the causes of this disease and it should involve the following key questions: -whether the contraction of the vaginal muscles was recorded from the first sexual contact and still remains a need for sexual satisfaction is achieved without relations vaginal or -symptom occurs for some time and what circumstances it bound or -contraction of the muscles is independent of the will, reflex and is at the very idea of sexual intercourse, and -that the contraction of the vaginal muscles occurs when you try to enter the member into the vagina which is very painful. The physical, gynecological and sexuological examinations exclude local causes of the disease. The mainstay of treatment in the majority of cases is psychosexual support. The cause of organic vaginismus is congenital malformation of the genital tract. It results from abnormal development of genital paramesonephric (Müllerian) ducts and the urogenital sinus, which are structures involved in the process of oviduct, uterus, and vagina organogenesis. This has strong implications in the practices of gynecology and sexuology in general, not only in adolescent gynecology and sexuology. Vaginismus with congenital malformation is an important problem in these fields.

Sexuality issues in gynaecological oncology patients: post treatment symptoms and therapeutic options.

PubMed

Iavazzo, C; Johnson, K; Savage, H; Gallagher, S; Datta, M; Winter-Roach, B A

2015-03-01

According to recent studies up to 80% of patients would like to receive more information about how cancer treatments can affect their sexual functioning. Moreover, 75 % of them would not feel comfortable being the first to bring up the subject. Our Gynaecological Advice Clinic was established in 2006 at the Christie Hospital and offers support to cancer patients who face sexuality issues. A previous evaluation established that the service sees approximately, 200 patients per year. The aims of this study are to evaluate the service by collecting data relating to levels of attendance, type and amount of clinical activity and to explore further patients' experiences and management. This is a retrospective study which was carried out in 2012-2013. Different models are used to evaluate our patients including history taking integrated therapy model, consultations to understand the normal anatomy and physiology with the use of diagrams and photographs, psycho-education and the international classification "Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition" (DSMV). The treatment options advised include medications such as hormone replacement treatment, testosterone, antidepressant, local oestrogen, tibolone, aqueous cream, lubrication to introitus, diprobase, dermal cream and advice for massage to areas of discomfort. Moreover, the use of vaginal dilators, the role of pelvic floor exercises, vulval care and self examination are explained. The team works closely with the psycho-oncology department. The most frequently discussed topics that were covered during the consultation are analysed. 41 outpatient clinics were held between 2012 and 2013. 194 patients attended those clinics during the study period. Single and not group therapy was offered to all the participants. 216 patients were offered appointments while 194 patients actually attended (90%). Patients' age ranged from 24 to 91 years with a mean age of 59 years. 45% had endometrial and 32% cervical cancer, 18% vulval cancer, 4 % ovarian cancer. 74% attended on their own while 18% with their partners and 8% with another family member or friend. 98% of the patients had confidence/trust in the healthcare professional. 95% felt involved with treatment decisions. 82% reported completely understanding information about side-effects. 16% were unaware of who to contact once they had completed treatment. 8% were attending for on-going help with psycho-sexual concerns following completion of treatment. The clinic was positively evaluated by patients, they had a high level of trust in the nurses running the service and they found it beneficial. Consultations were generally lasting 20-30 min and most patients reported this was an appropriate length. It once again highlights that although the service was set-up to address psycho-sexual concerns, in reality it dealt with a variety of other patient concerns. Due to the success of the clinic, the service has expanded and we are now supporting patients from other tumour groups such as colorectal, urology and plastic surgery.

Puberty suppression in gender identity disorder: the Amsterdam experience.

PubMed

Kreukels, Baudewijntje P C; Cohen-Kettenis, Peggy T

2011-05-17

The use of gonadotropin-releasing hormone analogs (GnRHa) to suppress puberty in adolescents with gender dysphoria is a fairly new intervention in the field of gender identity disorders or transsexualism. GnRHa are used to give adolescents time to make balanced decisions on any further treatment steps, and to obtain improved results in the physical appearance of those who opt to continue with sex reassignment. The effects of GnRHa are reversible. However, concerns have been raised about the risk of making the wrong treatment decisions, as gender identity could fluctuate during adolescence, adolescents in general might have poor decision-making abilities, and there are potential adverse effects on health and on psychological and psychosexual functioning. Proponents of puberty suppression emphasize the beneficial effects of GnRHa on the adolescents' mental health, quality of life and of having a physical appearance that makes it possible for the patients to live unobtrusively in their desired gender role. In this Review, we discuss the evidence pertaining to the debate on the effects of GnRHa treatment. From the studies that have been published thus far, it seems that the benefits outweigh the risks. However, more systematic research in this area is needed to determine the safety of this approach.

[The evolution of the canons law code and the mental nature reasons of marital incapacity during the last 25 years].

PubMed

Drogowski, Marian

2010-01-01

The aim of the article was to investigate how during the last 25 years of implementation of the new canons law code changed the use of these new law regulations by the church lawyers as well as the mental causes for marital incapacity. The basis of investigation was the analysis of 135 forensic-psychiatric opinions made by the author for the Metropolitan Tribunal of Gniezno in the legal proceedings carried out in the years 1984-2008. On the basis of the analysis, the author got the following results. During the first 10 years of implementation of the new canon law code, the legal proceedings were carried on mostly of no 1 or together of no 1 and no 3 canon 1095, but during the last 15 years mostly of no 3 this canon of mental incapacity to undertaking the essentials marital duties. The mental causes of the marital incapacity also changed very significantly in this time. During the first 15 years, there were serious mental disorders such as schizophrenia, epilepsy or oligophrenia, but during the last 10 years the main causes of incapacity to undertaking the essential marital duties were personality disorders, alcohol dependences or psychosexual deviations.

Postwar writing and the literature of the women's liberation movement.

PubMed

Haymes, H J

1975-11-01

This article explores the relationship between both popular and scholarly writing about women in the postwar years 1946 to 1962, and the literature of the women's liberation movement written from 1963 to the early 1970s. The current feminist movement was particularly eager to discredit Freudian theories of female psychosexual maturation. This women's liberationist focus was entirely appropriate, since Freudian theories about women represented the last respectable academic prop upholding a dichotomous estimation of the socio-politico-economic potential of the sexes--i.e., sexism, as it has come to be called. Postwar scholarship had manifested a split perspective--that is, it was anti-Freudian and pro-feminist or pro-Freudian and anti-feminist. What is more, considerable academic writing about the "woman question" proposed an expanded role for females, advocating a point of view quite similar to that of contemporary feminists. In contrast, the popular literature--e.g., Life, Look, Ladies Home Journal, and the like--proposed only a Freudian (dichotomous) answer to the question, "What are the proper roles of the sexes?" While the findings with regard to popular writing are not too surprising, the extent of early scholarly support (i.e., prior to the women's liberation movement--roughly before 1963) for an expanded role for women was entirely anticipated.

Psychological Treatments for Provoked Vestibulodynia: Integration of Mindfulness-Based and Cognitive Behavioral Therapies.

PubMed

Dunkley, Cara R; Brotto, Lori A

2016-07-01

Provoked vestibulodynia (PVD) is a chronic and distressing genital pain condition involving sharp pain to the vulvar vestibule with lifetime prevalence as high as 12%. PVD is the most prevalent cause of pain during sexual intercourse (dyspareunia) in premenopausal women, and gives rise to considerable sexual and relational concerns. As intercourse for women with PVD is either painful or impossible, PVD has pronounced negative effects on women's romantic relationship adjustment and sexual intimacy, as well as their emotional well-being and sense of sexual self-efficacy. Given the low efficacy and high side-effect profile of medications for the treatment of PVD, attention has shifted toward psychological interventions over the past decade. Psychological treatments for PVD have the advantage of targeting both the experience of pain and its many psychosexual consequences, such as reduced desire and arousal. Cognitive behavioral therapy (CBT) currently represents one of the most popular first-line psychological interventions for PVD. Mindfulness has been increasingly used alongside, or instead of CBT for a variety of health-related conditions, particularly with respect to chronic pain disorders and more recently in women with PVD. This review provides a detailed overview of CBT and mindfulness-based approaches in treating PVD. © 2016 Wiley Periodicals, Inc.

Sexual function and quality of life in genitourinary medicine (GUM) outpatients and preliminary validation of a self-report questionnaire measure.

PubMed

Daker-White, Gavin; Crowley, Tessa

2003-05-01

A cross-sectional questionnaire survey of 216 men and 191 women attending a genitourinary medicine (GUM) clinic was undertaken to explore the relationship between sexual symptoms and quality of sexual life, and to test the psychometric validity of a pilot self-report measure of Sexual Function and Quality of Sexual Life (SFQoSL). Statistical comparisons were made with three reference groups: volunteers attending GUM for psychosexual counselling, outpatients at an Obstetrics and Gynaecology Department, and staff. Exploratory principal components analysis (with varimax rotation) of questionnaire item responses suggested an 11 (in women) and 13 (in men) factor solution, incorporating four multi-item scales. Internal consistency (Cronbach's alpha) of core items was 0.84 in 186 women (19 items) and 0.87 in 210 men (22 items). Construct validity was supported in comparisons with reference groups using one-way analysis of variance and post-hoc Scheffé testing. Overall, 116 (54%) male and 132 (69%) female GUM outpatients had scores indicating sexual dysfunction. Thirty-seven (17%) men reported erectile dysfunction; 54 (28%) women reported vaginal dryness affecting sex; 48 (25%) women reported genital changes affecting sex; 45 (21%) men and 64 (34%) women reported problems reaching orgasm.

[Unconscious resistance to contraception].

PubMed

Gloor, P A

1978-12-01

The Swiss penal code of 1942 requires the presence of a psychiatrist in all decisions about termination of pregnancy and of sterilization. The so called sexual revolution of the last 20 years has brought about a dissociation of the traditional psychosexual behavior, where eroticism, affection, and desire of a child do not integrate as harmoniously as before. Narcissistic libido, inherent in all of us, can make an individual want a baby for reasons other than normal, but as a reflection of a parent, as a toy for an infantile mother, as a termination to free, sexual life, felt as sin, for a young couple, as a hope for the future, as the rival of one of the parents, as a remedy for something lost. These are just some of the reasons why contraception, completely accepted on a conscious level, can be rejected on an unconscious one, leading to unwanted pregnancies. Family planning, through a better and deeper psychological preparation of its personnel, should better identify patients more at risk of contraceptive failure, and the unconscious resistances of individuals and couples. This very important task can be started in schools with sex education, and in family planning centers with sexual therapy for the couple. This new approach would imply an increased interest for psychology on the part of doctors assisting young couples.

Evaluation of the Treatment of Congenital Penile Curvature Including Psychosexual Assessment.

PubMed

Zachalski, Wojciech; Krajka, Kazimierz; Matuszewski, Marcin

2015-08-01

Penile corporoplasty is a well-established treatment method of congenital penile deviation (CPD). Anatomical results are good with only slight differences between surgical procedures used. The disease however has huge influence on young male quality of life. This issue is not well analyzed in the literature. The aim of the study was to evaluate quality of life of the patients affected with CPD before and after the surgical treatment Study population consisted of 107 patients with CPD referred for surgical management. Patients were evaluated with not only clinical assessment, but also by four questionnaires measuring various aspects of quality of life. They were: Short-Form Medical Outcomes, Sexual Quality of Life Questionnaire for Man, Beck Depression Inventory, and International Index of Erectile Function. Quality of life measurements showed deep decrease in the general quality of life, sexual performance, depression scale, as well as in physical and mental health in men with CPD. All these parameters were restored to normal after the successful surgical treatment with any method. CPD deeply decreases the quality of life of the affected men in many aspects. Surgical treatment is able to repair the anatomical deformity and as well as significantly restore the patients' psychosocial well-being. © 2015 International Society for Sexual Medicine.

Body Dissatisfaction Among Sexual Minority Men: Psychological and Sexual Health Outcomes.

PubMed

Blashill, Aaron J; Tomassilli, Julia; Biello, Katie; O'Cleirigh, Conall; Safren, Steven A; Mayer, Kenneth H

2016-07-01

Body dissatisfaction is common among sexual minority (i.e., gay and bisexual) men; however, few studies have investigated the relationship between body dissatisfaction and psychosexual health variables among this population. The data that do exist are exclusively cross-sectional, casting uncertainty regarding temporal associations. Thus, the aims of the current study were to assess the prospective relationship between body dissatisfaction and psychological and sexual health outcomes. Participants were 131 gay and bisexual men who completed a battery of self-report measures across two time points (baseline and 3-month follow-up), including assessment of body dissatisfaction, depressive symptoms, and sexual health variables (sexual self-efficacy and sexual anxiety). Generalized linear modeling was employed to assess the prospective relationship between body dissatisfaction and outcomes variables, accounting for non-normal distributions. Body dissatisfaction significantly predicted elevated depressive symptoms (B = .21, p = .01), lower sexual self-efficacy (B = -.22, p = .04), and elevated sexual anxiety (B = .05, p = .03). Elevated body dissatisfaction is prospectively associated with negative psychological and sexual health outcomes. Given the high prevalence of body image concerns in sexual minority men, depression and/or HIV/STI prevention programs may benefit from routinely assessing for body dissatisfaction among this population, and addressing those who report concerns.

I love you with all my brain: laying aside the intellectually dull sword of biological determinism

PubMed Central

Woodson, James C.

2012-01-01

Background By organizing and activating our passions with both hormones and experiences, the heart and mind of sexual behavior, sexual motivation, and sexual preference is the brain, the organ of learning. Despite decades of progress, this incontrovertible truth is somehow lost in the far-too-often biologically deterministic interpretation of genetic, hormonal, and anatomical scientific research into the biological origins of sexual motivation. Simplistic and polarized arguments are used in the media by both sides of the seemingly endless debate over sexual orientation, equality, and human rights with such catch phrases as ‘born gay’ contrasted against attempts of “reparative therapy” or “pray the gay away”. Though long abandoned in practically every other area of psychology, this remnant of the nature-nurture controversy remains despite its generally acknowledged insufficiency in explaining any adult aspect of the human condition within the scientific community. Methods This theoretical review article identifies three factors: 1) good intentions with regard to the argument from immutability; 2) false dichotomies limiting intellectual progress by oversimplification of theory and thus hypothesis, and most dangerously, interpretation and; 3) Tradition: a historical separation of the disciplines of biology and psychology, which, to this day, interferes with the effective translation of well-conducted science into good public understanding and policy. Results Studies clearly demonstrate that progress toward sexual-orientation equality is being made, if slowly, despite the apparent irrelevance of the “born gay” argument from immutability. Evidence is further provided supporting the inadequacy of polarized, dichotic theories of sexual development, particularly those pitting “blank slate learning” against a fated, deterministic biological perspective. Results of this review suggest that an emerging interactionist perspective will promote both better scientific progress and better public understanding, hopefully contributing to progress toward nondiscriminatory public policy. Conclusion Accepting that the brain is a highly plastic, modularly dimorphic, developmentally biased organ of learning, one which is organized and activated by both hormones and experiences across the lifespan, is essential for doing “good science” well. Interactionist theories of psychosexual development provide an empirically sound, strong, yet modifiable foundation for testable hypotheses exploring biologically biased sexual learning. PMID:24693345

I love you with all my brain: laying aside the intellectually dull sword of biological determinism.

PubMed

Woodson, James C

2012-01-01

By organizing and activating our passions with both hormones and experiences, the heart and mind of sexual behavior, sexual motivation, and sexual preference is the brain, the organ of learning. Despite decades of progress, this incontrovertible truth is somehow lost in the far-too-often biologically deterministic interpretation of genetic, hormonal, and anatomical scientific research into the biological origins of sexual motivation. Simplistic and polarized arguments are used in the media by both sides of the seemingly endless debate over sexual orientation, equality, and human rights with such catch phrases as 'born gay' contrasted against attempts of "reparative therapy" or "pray the gay away". Though long abandoned in practically every other area of psychology, this remnant of the nature-nurture controversy remains despite its generally acknowledged insufficiency in explaining any adult aspect of the human condition within the scientific community. THIS THEORETICAL REVIEW ARTICLE IDENTIFIES THREE FACTORS: 1) good intentions with regard to the argument from immutability; 2) false dichotomies limiting intellectual progress by oversimplification of theory and thus hypothesis, and most dangerously, interpretation and; 3) Tradition: a historical separation of the disciplines of biology and psychology, which, to this day, interferes with the effective translation of well-conducted science into good public understanding and policy. Studies clearly demonstrate that progress toward sexual-orientation equality is being made, if slowly, despite the apparent irrelevance of the "born gay" argument from immutability. Evidence is further provided supporting the inadequacy of polarized, dichotic theories of sexual development, particularly those pitting "blank slate learning" against a fated, deterministic biological perspective. Results of this review suggest that an emerging interactionist perspective will promote both better scientific progress and better public understanding, hopefully contributing to progress toward nondiscriminatory public policy. Accepting that the brain is a highly plastic, modularly dimorphic, developmentally biased organ of learning, one which is organized and activated by both hormones and experiences across the lifespan, is essential for doing "good science" well. Interactionist theories of psychosexual development provide an empirically sound, strong, yet modifiable foundation for testable hypotheses exploring biologically biased sexual learning.

Sexual activity of women with Mayer-Rokitansky-Küster-Hauser syndrome (MRKHS)--preliminary study.

PubMed

Beisert, Maria; Szymañska-Pytlińska, Marta; Kapczuk, Karina; Chodeckal, Aleksandra; Walczyk-Matyja, Katarzyna; Kędzia, Witold

2015-09-01

The aim of the study was to assess sexual activity of women with Mayer-Pokitansky-K0ster-Hauser syndrome (MRKHS) in relation to age-matched con trots. The hypotheses on differences betwedn them in regard to various types of sexual activity and its characteristics were verified. 31 patients with MRKHS and 31 healthy women were examined. Psychosexual biography by M. Beisert was used to gain information on autoerotic and dyadic behavior: Phi-coefficient and U Mann-Whitney test were performed. Women with the MRKHS started autoerotic be ha vior at a similar age (U=58, 00; ns), practiced masturbation with the same frequency (in adolescence--U=350,00; ns and adulthood--U=137.50; ns) and manifested a similar level of sexual arousal (U=326,50; ns) as the age-matched controls. They declared experiencing vaginal (Phi=0.507; p<0.001) and oral (Phi=0.318; p<0.05) intercourse less frequently than healthy women. They also initiated dyadic sexual activity at a higher age than the controls (petting U=182,00; p<0.01; req=0.41; vaginal intercourse (U=64.00; 0<0.001; req = 0.59; oral contact (U=91.50; p<0.05; req=0.56) with exception of anal intercourse, where the age of initiation was the same in both groups (U=30,50; ns). Women in both groups experienced similar orgasm frequency during petting (U=108.50; ns), oral intercourse (U=97.50; ns), anal Tntercourse (U=25.50; ns). However, patients with the MPKHS reported significantly lower frequency of orgasm during vaginal intercourse (U=60.50; p<0.05; req=0.36). Sexual development of patients with the MRKHS and healthy women is partly similar Differences in dyadic sexual activity are not limited to vaginal intercourse thus are probably determined by biological conditions and their psychological implications.

The Psychosexual Profile of Sexual Assistants: An Internet-Based Explorative Study

PubMed Central

Limoncin, Erika; Galli, Debora; Ciocca, Giacomo; Gravina, Giovanni Luca; Carosa, Eleonora; Mollaioli, Daniele; Lenzi, Andrea; Jannini, Emmanuele A.

2014-01-01

Introduction Sexual assistance may have some aspects that resemble prostitution and others that might lead one to think of sexual assistants as similar to a group of subjects whose sexual object is disability (devotees). In this study, we investigate whether a rigorous selection and training process on the part of specialised organisations may reduce the risk of training subjects with an atypical sexual interest and behaviours resembling prostitution. Materials and Methods The study population consisted of 152 subjects defining themselves as sexual assistants. Subjects were initially contacted on websites specifically dedicated to sexual assistants and prostitutes. One hundred and twenty subjects were selected, by propensity score analysis, and studied by means of a modified version of a semi-structured questionnaire previously developed to investigate a population of subjects attracted by disability. Results The study group was composed of 80 trained and 40 untrained sexual assistants, with mean ages of 41.5 (SD +/−12.58) and 44.5 (SD +/−11.62), respectively. A significant number of untrained subjects affirmed that their motivation in carrying out sexual assistance was of a remunerative nature, while this number was lower among the trained assistants (p = 0.001). Nearly all untrained subjects claimed to do one or more of the following activities during sexual assistance: sexual intercourse, oral sex, and masturbation. Among the trained subjects, however, only 47.5% claimed to do one or more of these activities, which means that there is a significant gap between trained and untrained assistants (p<0.0001). The existence of an atypical sexual interest was more evident between untrained rather than between trained subjects (p<0.0001). Conclusions Sexual assistance represents a way through which people affected by disabilities may attain the right to explore their sexuality in a safe setting. This can be guaranteed only if sexual assistants are trained and carefully selected by specialised organisations. PMID:24919176

Do adult men with untreated hypospadias have adverse outcomes? A pilot study using a social media advertised survey

PubMed Central

Schlomer, Bruce; Breyer, Benjamin; Copp, Hillary; Baskin, Laurence; DiSandro, Michael

2014-01-01

Objective Hypospadias is usually treated in childhood. Therefore, the natural history of untreated mild hypospadias is unknown. We hypothesized that men with untreated hypospadias, especially mild, do not have adverse outcomes. Materials Facebook was used to advertise an electronic survey to men older than 18 years. Men with untreated hypospadias identified themselves and indicated the severity of hypospadias with a series of questions. Outcomes included: Sexual Health Inventory for Men (SHIM), penile curvature and difficulty with intercourse, International Prostate Symptom Score (IPSS), Penile Perception Score (PPS), psychosexual milestones, paternity, infertility, sitting to urinate, and the CDC HRQOL-4 module. Results 736 men completed self-anatomy questions and 52 (7.1%) self-identified with untreated hypospadias. Untreated hypospadias participants reported worse SHIM (p < 0.001) and IPSS scores (p = 0.05), more ventral penile curvature (p = 0.003) and resulting difficulty with intercourse (p < 0.001), worse satisfaction with meatus (p = 0.011) and penile curvature (p = 0.048), and more sitting to urinate (p = 0.07). When stratified by mild and severe hypospadias, severe hypospadias was associated with more adverse outcomes than mild hypospadias. Conclusion Men with untreated hypospadias reported worse outcomes compared with non-hypospadiac men. Mild untreated hypospadias had fewer adverse outcomes than severe hypospadias. Research is needed to determine if treatment of childhood hypospadias improves outcomes in adults, especially for mild hypospadias. PMID:24613143

Safety and efficacy of vardenafil versus sertraline in the treatment of premature ejaculation: a randomised, prospective and crossover study.

PubMed

Mathers, M J; Klotz, T; Roth, S; Lümmen, G; Sommer, F

2009-06-01

We investigated safety and efficacy of vardenafil and sertraline in premature ejaculation (PE). Seventy-two men graded their primary PE on a scale of 0-8 (0 = almost never, 8 = almost always). Intravaginal ejaculatory latency time (IELT) was measured. Patients were included if they scored their PE as 4 or greater and their IELTs were less than 1.30 min. After 6 weeks of behavioural psychosexual therapy, 49 patients still had a PE of 4 or greater and an IELT less than 1.30 min and they were randomised: 6 weeks vardenafil (10 mg) or sertraline (50 mg). After a wash-out phase for 1 week, medication was changed in a cross-over design. Initially, all 72 men with PE received behavioural therapy. Twenty-three men were satisfied with treatment and excluded. The remaining 49 men graded their PE as 5.94 +/- 1.6 and IELT was 0.59 min and patients were randomised. Four men discontinued the study. Vardenafil improved PE grading: 2.7 +/- 2.1 (P < 0.01) and IELT increased to 5.01 +/- 3.69 (P < 0.001). PE grading improved 1.92 +/- 1.32, (P < 0.01) and IELT 3.12 +/- 1.89 (P < 0.001) with sertraline. It is concluded that vardenafil and sertraline are useful agents in the pharmacological treatment of PE.

"It's Not Something I Chose You Know": Making Sense of Pedophiles' Sexual Interest in Children and the Impact on Their Psychosexual Identity.

PubMed

Blagden, Nicholas James; Mann, Ruth; Webster, Stephen; Lee, Rachael; Williams, Fiona

2017-03-01

Sexual interest in children is one of the most strongly predictive of the known risk factors for sexual reconviction. It is an important aspect of risk assessment to identify the presence of such interest, and an important task for treatment providers to address such a sexual interest where it is present. It has been argued that understanding pedophiles' deviant sexual interest in children can enhance risk assessment, management, and treatment planning. This research study aims to explore the phenomenology of deviant sexual interest in children, the impact it has on pedophilic offenders' identities, and their views on the treatability of that interest. The study used semistructured interviews and repertory grids to make sense of participants' experiences. The results revealed three superordinate themes: "'living' with a deviant sexual interest," "relational sexual self," and "possible and feared sexual self." The analysis unpacks these themes and repertory grid analysis is used to explore a subset of participants' identities in more detail. The results reveal that there needs to be an acceptance from both client and therapist that their sexual interest in children may never go away. Through this acceptance, clients could work on enhancing sexual self-regulation, recognizing their triggers, and so managing their sexual thoughts, feelings, and behavior. Implications for treatment are also discussed.

Sex, women and the menopause: are specialist trainee doctors up for it? A survey of views and attitudes of specialist trainee doctors in Community Sexual & Reproductive Health and Obstetrics & Gynaecology around sexuality and sexual healthcare in the (peri)menopause.

PubMed

Gleser, Heike

2015-03-01

Sexual health, function and pleasure can contribute significantly towards the wellbeing of (peri-)menopausal women. Healthcare professionals specialising in women's health should therefore be able to provide 'sex-positive' menopause care, which proactively addresses any sexual issues and assesses the need for contraception and prevention of sexually transmitted infections. A survey was used to investigate the views and attitudes of specialist trainee doctors in Community Sexual & Reproductive Health (cSRH) and Obstetrics & Gynaecology towards sexual health in the (peri)menopause as they play a key role in promoting the sexual wellbeing of their patients. The results showed that both study groups had positive attitudes towards sexuality and sexual healthcare of mid-life and older women. However, cSRH trainees had significantly more confidence in dealing with psychosexual problems and perceived significantly less barriers to deliver comprehensive menopausal care within the mostly community-based Sexual & Reproductive Healthcare settings they are working in compared to their mainly hospital-based gynaecological colleagues. Profiting from seemingly better training in the topic cSRH trainees also noticed considerably less embarrassment from their patients when addressing sexual issues. Nonetheless, training needs were identified in both trainee groups. © The Author(s) 2015 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

The role of men in abandonment of female genital mutilation: a systematic review.

PubMed

Varol, Nesrin; Turkmani, Sabera; Black, Kirsten; Hall, John; Dawson, Angela

2015-10-08

Men in their roles as fathers, husbands, community and religious leaders may play a pivotal part in the continuation of female genital mutilation (FGM). However, the research on their views of FGM and their potential role in its abandonment are not well described. We undertook a systematic review of all publications between 2004 and 2014 that explored men's attitudes, beliefs, and behaviours in regards to FGM, as well as their ideas about FGM prevention and abandonment. We included twenty peer-reviewed articles from 15 countries in the analysis. Analysis revealed ambiguity of men's wishes in regards to the continuation of FGM. Many men wished to abandon this practice because of the physical and psychosexual complications to both women and men. Social obligation and the silent culture between the sexes were posited as major obstacles for change. Support for abandonment was influenced by notions of social obligation, religion, education, ethnicity, urban living, migration, and understanding of the negative sequelae of FGM. The strongest influence was education. The level of education of men was one of the most important indicators for men's support for abandonment of FGM. Social obligation and the lack of dialogue between men and women were two key issues that men acknowledged as barriers to abandonment. Advocacy by men and collaboration between men and women's health and community programs may be important steps forward in the abandonment process.

Men versus women on sexual brain function: prominent differences during tactile genital stimulation, but not during orgasm.

PubMed

Georgiadis, Janniko R; Reinders, A A T Simone; Paans, Anne M J; Renken, Remco; Kortekaas, Rudie

2009-10-01

Biological differences in male and female sexuality are obvious in the behavioral domain, but the central mechanisms that might explain these behavioral gender differences remain unclear. In this study, we merged two earlier positron emission tomography data sets to enable systematic comparison of the brain responses in heterosexual men and women during sexual tactile genital (penile and clitoral) stimulation and during orgasm. Gender commonalities were most evident during orgasm, a phase which demonstrated activations in the anterior lobe of the cerebellar vermis and deep cerebellar nuclei, and deactivations in the left ventromedial and orbitofrontal cortex in both men and women. During tactile genital stimulation, deactivations in the right amygdala and left fusiform gyrus were found for both genders. Marked gender differences were seen during this phase: left fronto-parietal areas (motor cortices, somatosensory area 2 and posterior parietal cortex) were activated more in women, whereas in men, the right claustrum and ventral occipitotemporal cortex showed larger activation. The only prominent gender difference during orgasm was male-biased activation of the periaqueductal gray matter. From these results, we conclude that during the sexual act, differential brain responses across genders are principally related to the stimulatory (plateau) phase and not to the orgasmic phase itself. These results add to a better understanding of the neural underpinnings of human sexuality, which might benefit treatment of psychosexual disorders.

Sexual behavior of infertile women: a qualitative study.

PubMed

Bokaie, Mahshid; Simbar, Masoumeh; Yassini Ardekani, Seyed Mojtaba

2015-10-01

Infertility makes an essential challenge to the sexual life of couples, especially infertile women. When pregnancy does not happen, infertile women think that sexual intercourse is not fruitful and sexual desire became reduce gradually. Infertile women progressively forget that their sexual relationship is also a response to their natural need. This qualitative study was conducted to explore the infertility consequences in the sexual behavior of infertile women. This was a qualitative content analysis study; and it was part of a widespread study, used a sequential mixed-method and conducted from August 2014 until February 2015. A purposeful sampling was used to recruit infertile women who had referred to Yazd Research and Clinical Center for Infertility. Data gathering techniques employed in this research included in-depth semi structured open face-to-face interviews and field notes. Credibility, transferability, confirm ability, and dependability were assessed for the rigor of the data collection. Totally, 15 infertile women and 8 key informants were interviewed. Data analysis showed four themes about impact of infertility on female sexual behavior: 1/ Impact of infertility drugs on couple sexual behavior, 2/ Impact of assisted reproductive technologies on female sexual behavior, 3/ Timed intercourse during infertility and 4/ The psychological impact of infertility on sexual behavior. Some of Iranian infertile women could cope with their problems, but some of them were very affected by infertility drugs and assisted reproductive technologies procedures. Psychosexual counseling before medical treatment could help them to have a better sexual life.

Couple-based treatment for sexual problems following breast cancer: A review and synthesis of the literature.

PubMed

Carroll, Allison J; Baron, Shirley R; Carroll, Richard A

2016-08-01

Although there are many physical and psychological impacts on women's sexuality following breast cancer diagnosis and treatment, sexual problems often remain unaddressed in these cancer survivors. Given the crucial role of the partner in sexual issues, couple-based sex therapy would appear to be a logical first-line treatment for this population, but there is scant research on the efficacy of couple-based treatments and/or sex therapy in breast cancer survivors. A review of the literature was conducted using the PMC, PsycINFO, EMBASE, and MEDLINE databases. Articles were included that presented the results of an experimental or quasi-experimental clinical trial evaluating a psychosexual intervention for couples, targeted women diagnosed with breast cancer and their partners, and included outcome measures of sexual function and sexuality. Studies were excluded if the primary intervention was not focused on sexual problems or if they were published in a language other than English. From 2231 records, five articles met criteria for inclusion in the present review. Couple-based sex therapy appears to be an effective and highly accepted treatment for addressing sexual problems in breast cancer patients. These interventions were associated with improvements in sexual physiology, sexual functioning, sexual self-image, and sexual relationships, as well as improved psychological well-being of both breast cancer patients and their partners. Based on this review, the authors address clinical implications, particularly incorporating psychological treatment for sexual problems in comprehensive cancer care, and provide recommendations for further study.

[Chronic Koro-like Syndrome (KLS) in recurrent depressive disorder as a variant of Cotard's delusion in an italian male patient. A case report and historical review].

PubMed

Bandinelli, Pier Luca; Trevisi, Manuela; Kotzalidis, Giorgio Demetrio; Manfredi, Giovanni; Rapinesi, Chiara; Ducci, Giuseppe

2011-01-01

Cotard’s syndrome is a delusional syndrome, first described in the 1880ies by Cotard, characterized by a nihilistic delusions about the self and/or the world. In same other cases there is an intense nihilistic belief that the patient’s entire body or parts of it are disintegrated or dead. The syndrome is often associated with severe depression, but are also described neurological cases. Koro was described a little later from Asia and consisted in the belief that one’s own genitalia are shrinking or disappearing and death will ensue thereafter, but there are many cultural variants and the syndrome may present in an incomplete form. We report on a KLS sharing more features with annihilation delusions, such as Cotard’s syndrome. In KLS, the délire de négation may be limited to localized systems or organs. We believe that some complete and incomplete forms of Koro, when embedded in a depressive core, may represent a variant of Cotard’s delusion. In fact, our patient did not reach a complete denial of his entire body, but rather focused on sexual identity. We analysed the psychosexual issues of our case according to Kretschmer’s 1918 view of a “bipolar setting” between sthenic and asthenic characters of a patient suffering from sensitive delusions of (self-) reference. This view may allow us to relate the personological character to the genetic comprehensibility of the delusion.

Sexual behavior of infertile women: a qualitative study

PubMed Central

Bokaie, Mahshid; Simbar, Masoumeh; Yassini Ardekani, Seyed Mojtaba

2015-01-01

Background: Infertility makes an essential challenge to the sexual life of couples, especially infertile women. When pregnancy does not happen, infertile women think that sexual intercourse is not fruitful and sexual desire became reduce gradually. Infertile women progressively forget that their sexual relationship is also a response to their natural need. Objective: This qualitative study was conducted to explore the infertility consequences in the sexual behavior of infertile women. Materials and Methods: This was a qualitative content analysis study; and it was part of a widespread study, used a sequential mixed-method and conducted from August 2014 until February 2015. A purposeful sampling was used to recruit infertile women who had referred to Yazd Research and Clinical Center for Infertility. Data gathering techniques employed in this research included in-depth semi structured open face-to-face interviews and field notes. Credibility, transferability, confirm ability, and dependability were assessed for the rigor of the data collection. Results: Totally, 15 infertile women and 8 key informants were interviewed. Data analysis showed four themes about impact of infertility on female sexual behavior: 1/ Impact of infertility drugs on couple sexual behavior, 2/ Impact of assisted reproductive technologies on female sexual behavior, 3/ Timed intercourse during infertility and 4/ The psychological impact of infertility on sexual behavior. Conclusion: Some of Iranian infertile women could cope with their problems, but some of them were very affected by infertility drugs and assisted reproductive technologies procedures. Psychosexual counseling before medical treatment could help them to have a better sexual life. PMID:26644793

Do adult men with untreated hypospadias have adverse outcomes? A pilot study using a social media advertised survey.

PubMed

Schlomer, Bruce; Breyer, Benjamin; Copp, Hillary; Baskin, Laurence; DiSandro, Michael

2014-08-01

Hypospadias is usually treated in childhood. Therefore, the natural history of untreated mild hypospadias is unknown. We hypothesized that men with untreated hypospadias, especially mild, do not have adverse outcomes. Facebook was used to advertise an electronic survey to men older than 18 years. Men with untreated hypospadias identified themselves and indicated the severity of hypospadias with a series of questions. Outcomes included: Sexual Health Inventory for Men (SHIM), penile curvature and difficulty with intercourse, International Prostate Symptom Score (IPSS), Penile Perception Score (PPS), psychosexual milestones, paternity, infertility, sitting to urinate, and the CDC HRQOL-4 module. 736 men completed self-anatomy questions and 52 (7.1%) self-identified with untreated hypospadias. Untreated hypospadias participants reported worse SHIM (p < 0.001) and IPSS scores (p = 0.05), more ventral penile curvature (p = 0.003) and resulting difficulty with intercourse (p < 0.001), worse satisfaction with meatus (p = 0.011) and penile curvature (p = 0.048), and more sitting to urinate (p = 0.07). When stratified by mild and severe hypospadias, severe hypospadias was associated with more adverse outcomes than mild hypospadias. Men with untreated hypospadias reported worse outcomes compared with non-hypospadiac men. Mild untreated hypospadias had fewer adverse outcomes than severe hypospadias. Research is needed to determine if treatment of childhood hypospadias improves outcomes in adults, especially for mild hypospadias. Copyright © 2014 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.

Identifying the needs of penile cancer sufferers: a systematic review of the quality of life, psychosexual and psychosocial literature in penile cancer.

PubMed

Maddineni, Satish B; Lau, Maurice M; Sangar, Vijay K

2009-08-08

Penile cancer is an uncommon malignancy with an incidence of 1 per 100,000. Conservative and radical treatments can be disfiguring and may have an impact on sexual function, quality of life (QOL), social interactions, self-image and self-esteem. Knowledge of how this disease affects patients is paramount to developing a global, multi-disciplinary approach to treatment. A Medline/PubMed literature search was conducted using the terms "sexual function penis cancer"; "quality of life penis cancer" and "psychological effects penis cancer" from 1985 to 2008. Articles containing quantitative data on QOL, sexual function or psychological well-being were included. 128 patients from 6 studies were included. 5 studies contained retrospective data whilst 1 study collected prospective data on erectile function. In the 6 studies 13 different quantitative tools were used to assess psychological well-being, QOL and sexual function. The General Health Questionnaire (GHQ) showed impaired well-being in up to 40% in 2 studies. Patients undergoing more mutilating treatments were more likely to have impaired well-being. The Hospital Anxiety and Depression Score (HADS) demonstrated pathological anxiety up to 31% in 2 studies. 1 study used the Diagnostic and Statistical Manual of Mental Disorders of psychiatric illness (DSM III-R) with 53% exhibiting mental illness, 25% avoidance behaviour and 40% impaired well-being. 12/30 suffered from post-traumatic stress disorder. The IIEF-15 was the commonest tool used to assess sexual function. The results varied from 36% in 1 study with no sexual function to 67% in another reporting reduced sexual satisfaction to 78% in another reporting high confidence with erections. The treatment of penile cancer results in negative effects on well-being in up to 40% with psychiatric symptoms in approximately 50%. Up to two-thirds of patients report a reduction in sexual function. This study demonstrates that penile cancer sufferers can exhibit significant psychological dysfunction, yet no standardised tools or interventional pathways are available. Therefore, there is a need to identify and assess adequate tools to measure psychological and sexual dysfunction in this group of patients.

Culture Clash? Investigating constructions of sexual and reproductive health from the perspective of 1.5 generation migrants in Australia using Q methodology.

PubMed

Dune, T; Perz, J; Mengesha, Z; Ayika, D

2017-04-04

In Australia, those who migrate as children or adolescents (1.5 generation migrants) may have entered a new cultural environment at a crucial time in their psychosexual development. These migrants may have to contend with constructions of sexual and reproductive health from at least two cultures which may be at conflict on the matter. This study was designed to investigate the role of culture in constructions of sexual and reproductive health and health care seeking behaviour from the perspective of 1.5 generation migrants. Forty-two adults from various ethno-cultural backgrounds took part in this Q methodological study. Online, participants rank-ordered forty-two statements about constructions of sexual and reproductive health and health seeking behaviours based on the level to which they agreed or disagreed with them. Participants then answered a series of questions about the extent to which their ethnic/cultural affiliations influenced their identity. A by-person factor analysis was then conducted, with factors extracted using the centroid technique and a varimax rotation. A seven-factor solution provided the best conceptual fit for constructions of sexual and reproductive health and help-seeking. Factor A compared progressive and traditional sexual and reproductive health values. Factor B highlighted migrants' experiences through two cultural lenses. Factor C explored migrant understandings of sexual and reproductive health in the context of culture. Factor D explained the role of culture in migrants' intimate relationships, beliefs about migrant sexual and reproductive health and engagement of health care services. Factor E described the impact of culture on sexual and reproductive health related behaviour. Factor F presented the messages migrant youth are given about sexual and reproductive health. Lastly, Factor G compared constructions of sexual and reproductive health across cultures. This study has demonstrated that when the cultural norms of migrants' country of origin are maintained it has a significant influence on how 1.5 generation migrants construct, experience and understand various aspects of sexual and reproductive health. Policy makers, health care professionals and resettlement service providers are advised to engage with migrant parents and youth in exploring, discussing, reframing and reconstructing SRH in an Australian context.

Medical Help-Seeking for Sexual Concerns in Prostate Cancer Survivors

PubMed Central

Hyde, Melissa K.; Zajdlewicz, Leah; Wootten, Addie C.; Nelson, Christian J.; Lowe, Anthony; Dunn, Jeff; Chambers, Suzanne K.

2016-01-01

Introduction Although sexual dysfunction is common after prostate cancer, men's decisions to seek help for sexual concerns are not well understood. Aim Describe predictors of actual prior help-seeking and intended future medical help-seeking for sexual dysfunction in prostate cancer survivors. Methods A cross-sectional survey of 510 prostate cancer survivors assessed masculine beliefs, attitudes, support/approval from partner/peer networks (subjective norm), and perceived control as predictors of medical help-seeking for sexual concerns. A theory of planned behavior (TPB) perspective was used to examine actual prior and planned future behavior and contributing factors. Statistical analyses included multiple and logistic regressions. Main Outcome Measures Intention to see a doctor for sexual advice or help in the next 6 months was measured using the intention subscale adapted from the Attitudes to Seeking Help after Cancer Scale. Prior help-seeking was measured with a dichotomous yes/no scale created for the study. Results Men were Mage 71.69 years (SD = 7.71); 7.54 years (SD = 4.68) post-diagnosis; received treatment(s) (58.1% radical prostatectomy; 47.1% radiation therapy; 29.4% hormonal ablation); 81.4% reported severe ED (IIED 0–6) and 18.6% moderate–mild ED (IIED 7–24). Overall, 30% had sought sexual help in the past 6 months, and 24% intended to seek help in the following 6 months. Prior help-seeking was less frequent among men with severe ED. Sexual help-seeking intentions were associated with lower education, prior sexual help-seeking, sexual importance/ priority, emotional self-reliance, positive attitude, and subjective norm (R2 = 0.56). Conclusion The TPB has utility as a theoretical framework to understand prostate cancer survivors' sexual help-seeking decisions and may inform development of more effective interventions. Masculine beliefs were highly salient. Men who were more emotionally self-reliant and attributed greater importance to sex formed stronger help-seeking intentions. Subjective norm contributed most strongly to help-seeking intentions suggesting that health professionals/partners/peers have a key role as support mechanisms and components of psycho-sexual interventions. PMID:26796856

Patient perspectives on quality of life after penile cancer.

PubMed

Mortensen, Gitte Lee; Jakobsen, Jakob Kristian

2013-07-01

Penile cancer (PC) is a rare, but ominous disease. In 50-60% of squamous cell carcinomas of the penis, human papilloma virus infection, particularly with types 16 and 18, is part of the pathogenesis. Depending on cancer invasiveness, PC is treated with local resection of the glans and partial or total penectomy. This quality of life (QoL) study aimed at obtaining in-depth knowledge about patients' experiences with PC. A literature study was carried out to identify relevant topics for a semi-structured interview. Qualitative interviews with four former PC patients were transcribed verbatim and analysed using a medical anthropological approach. The analysis focused on the ways patients frame their disease experiences and relate the physical, sexual and emotional disease impact. Varying degrees of amputation affected the participants' sexual capabilities. Still, three participants (aged 66-72 years) said that their partner relationships were not negatively affected by the disease. In contrast, the impact on sexual function and self-esteem had been devastating to the fourth participant (aged 44 years) who was single and worried about the disease impeding his chance of finding love in life. For all participants, having had a potentially fatal disease put the physical disease impact into perspective. PC may greatly impact the psycho-sexual QoL of PC patients, particularly at a younger age and depending on their partnership status. Disease impact appears to be related to age, overall life situation and the cancer experience. The study was funded by an unrestricted research grant from Sanofi Pasteur MSD. not relevant.

Qualitative research on infertile Chinese couples' understanding of sexuality.

PubMed

Zhuoran, Wang; Wanpeng, Liu; Tao, Peng; Coates, Rosemary

2018-01-16

Family physicians play an important role in the initial counselling and evaluation of infertility. Despite infertility regarded as a stressor and a life crisis for individuals or couples, little is known about the psychosexual aspects of infertility. On the basis that sexuality is a crucial part of quality of life, it is worthwhile to give more attention to sexuality of infertile couples during their time of experiencing infertility. This study aimed to gain insight into the dynamic features of the sexuality of infertile couples and to provide meaningful evidence for improving their quality of life. We employed a qualitative approach to conduct this study. Utilizing purposive sampling method, 56 participants (28 infertile Chinese couples) were recruited from the reproductive medicine centre of a general hospital, and in-depth interviews were conducted with each participant. Thematic content analysis was used to analyse the transcripts. Four themes emerged from the respondents' narratives; these themes relate to the infertile couples' understanding of sexuality: (i) gender identity, (ii) communication about sex, (iii) sexual life and (iv) sexual satisfaction. It was further found that Chinese culture's values of fertility, perceptions about sexuality and sex, social norms regarding gender, and expectations about marital sexual life can have significant effects on infertile Chinese couples' sexuality. These findings should be highly considered by family physicians in their practice to provide infertile couples with information related to sexual well-being, coping styles, relationship, etc. © The Author 2017. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Cultural issues in menopause: an exploratory qualitative study of Macedonian women in Australia.

PubMed

Strezova, Anita; O'Neill, Sheila; O'Callaghan, Cathy; Perry, Astrid; Liu, Jinzhu; Eden, John

2017-03-01

This study explored the attitudes to, and experience of, menopause among Macedonian women living in Australia, including attitudes and responses to hormone therapy (HT) and complementary therapies, as well as related psycho-sexual, relationship and other midlife issues. Using qualitative methodology, the study was based on seven unstructured, nondirective group discussions. Natural social groups were recruited, meeting wherever each group felt most at home. A total of 81 participants ranged in age from 45 to 75 years. The women included both first-generation immigrants and women born in Australia to Macedonian parents. A bilingual Macedonian researcher conducted the fieldwork. Participants typically claimed they lacked information about menopause in their native language, and their knowledge of HT was highly variable. Some women only felt comfortable approaching Macedonian doctors. Others reported an easing of symptoms when they revisited their homeland. Deeply religious participants claimed their faith helped them through this phase of life, and that they were as likely to consult a priest as a doctor. A recurring theme was that Macedonian men tended to regard their wives differently after menopause, sometimes treating them as "non-sexual." Women regarded this shift in male attitudes as a precipitating factor in domestic violence, extramarital affairs and divorce. Symptoms such as hot flashes and mood swings were associated with negative attitudes toward menopause. Culturally determined attitudes appear to affect the perception and experience of menopause. Other influencing factors include migration, women's roles, marital status, religion, use of herbal and traditional remedies, social situation, access to information, knowledge and experience of menopausal symptoms.

Testosterone Treatment and Sexual Function in Older Men With Low Testosterone Levels.

PubMed

Cunningham, Glenn R; Stephens-Shields, Alisa J; Rosen, Raymond C; Wang, Christina; Bhasin, Shalender; Matsumoto, Alvin M; Parsons, J Kellogg; Gill, Thomas M; Molitch, Mark E; Farrar, John T; Cella, David; Barrett-Connor, Elizabeth; Cauley, Jane A; Cifelli, Denise; Crandall, Jill P; Ensrud, Kristine E; Gallagher, Laura; Zeldow, Bret; Lewis, Cora E; Pahor, Marco; Swerdloff, Ronald S; Hou, Xiaoling; Anton, Stephen; Basaria, Shehzad; Diem, Susan J; Tabatabaie, Vafa; Ellenberg, Susan S; Snyder, Peter J

2016-08-01

The Testosterone Trials are a coordinated set of seven trials to determine the efficacy of T in symptomatic men ≥65 years old with unequivocally low T levels. Initial results of the Sexual Function Trial showed that T improved sexual activity, sexual desire, and erectile function. To assess the responsiveness of specific sexual activities to T treatment; to relate hormone changes to changes in sexual function; and to determine predictive baseline characteristics and T threshold for sexual outcomes. A placebo-controlled trial. Twelve academic medical centers in the United States. A total of 470 men ≥65 years of age with low libido, average T <275 ng/dL, and a partner willing to have sexual intercourse at least twice a month. Men were assigned to take T gel or placebo for 1 year. Sexual function was assessed by three questionnaires every 3 months: the Psychosexual Daily Questionnaire, the Derogatis Interview for Sexual Function, and the International Index of Erectile Function. Compared with placebo, T administration significantly improved 10 of 12 measures of sexual activity. Incremental increases in total and free T and estradiol levels were associated with improvements in sexual activity and desire, but not erectile function. No threshold T level was observed for any outcome, and none of the 27 baseline characteristics predicted responsiveness to T. In older men with low libido and low T levels, improvements in sexual desire and activity in response to T treatment were related to the magnitude of increases in T and estradiol levels, but there was no clear evidence of a threshold effect.

Paedophilia on the Internet--a study of 33 convicted offenders in the Canton of Lucerne.

PubMed

Frei, Andreas; Erenay, Nuray; Dittmann, Volker; Graf, Marc

2005-08-20

The connection between the consumption of pornography and "contact-crimes" is unclear. The Internet has facilitated the mass consumption of pornography in general and specifically illegal pornography such as child-pornography. In 1999, the owners of "Landslide Production Inc.", an international provider of child-pornography in the USA were arrested and the credit-card-numbers of their clients were put at the disposal of the law enforcement agencies of the countries concerned. Roughly 1300 Swiss citizens were subsequently arrested in the course of the nationwide action "Genesis". In the canton of Lucerne 33 men were identified. The police-files of these men were screened for psychosocial, criminological and psychosexual data. Most of these middle-aged men held comparatively elevated professional positions, only ten were married, eleven had never had an intimate relationship to a woman, and only thirteen of them had children. Only one of them had a relevant criminal record. The level of abuse depicted in the illegal material was high, all but one consumed pornography from other fields of sexual deviation. The personal statements of the offenders in general were hardly reliable, in three cases, however, the diagnosis of sexual deviation could be established from the files. The estimated time some of the offenders must have spent online in order to retrieve the material allows the diagnosis of Pathological Internet-Use. Deviant sexual fantasies seem to be widespread also among men otherwise not registered for any offences. The consumption of even particularly disgusting material may not be a specific risk factor for "contact" crimes.

Gender identity and sexual orientation in women with borderline personality disorder.

PubMed

Singh, Devita; McMain, Shelley; Zucker, Kenneth J

2011-02-01

In the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, text revision (DSM-IV-TR) (and earlier editions), a disturbance in "identity" is one of the defining features of borderline personality disorder (BPD). Gender identity, a person's sense of self as a male or a female, constitutes an important aspect of identity formation, but this construct has rarely been examined in patients with BPD. In the present study, the presence of gender identity disorder or confusion was examined in women diagnosed with BPD. We used a validated dimensional measure of gender dysphoria. Recalled gender identity and gender role behavior from childhood was also assessed with a validated dimensional measure, and current sexual orientation was assessed by two self-report measures. A consecutive series of 100 clinic-referred women (mean age, 34 years) with BPD participated in the study. The women were diagnosed with BPD using the International Personality Disorder Exam-BPD Section. None of the women with BPD met the criterion for caseness on the dimensional measure of gender dysphoria. Women who self-reported either a bisexual or a homosexual sexual orientation had a significantly higher score on the dimensional measure of gender dysphoria than the women who self-reported a heterosexual sexual orientation, and they also recalled significantly more cross-gender behavior during childhood. Results were compared with a previous study on a diagnostically heterogeneous group of women with other clinical problems. The importance of psychosexual assessment in the clinical evaluation of patients with BPD is discussed. © 2010 International Society for Sexual Medicine.

Predictive factors of health-related quality of life in patients with polycystic ovary syndrome: a structural equation modeling approach.

PubMed

Bazarganipour, Fatemeh; Ziaei, Saeide; Montazeri, Ali; Foroozanfard, Fatemeh; Kazemnejad, Anoshirvan; Faghihzadeh, Soghrat

2013-11-01

To determine association between health-related quality of life (HRQOL) and psychosexual variables in patients with polycystic ovary syndrome (PCOS). Cross-sectional study. Two private gynecology clinics. A sample of 300 women with PCOS were entered into the study and were subdivided into three groups: hyperandrogenism (HA) and PCO morphology; menstrual dysfunction and PCO morphology; menstrual dysfunction and HA and/or PCO morphology. Then each patient completed the following questionnaires: the Hospital Anxiety and Depression Scale, the Body Image Concern Inventory, the Rosenberg Self-Esteem Scale, the Short-Form Health Survey, and the Female Sexual Function Index. None. Both direct and indirect relationships among clinical symptoms, psychologic status, self-esteem, body image, and sexual function as independent predictors of HRQOL were examined with the use of structural equation modeling analysis. The clinical variables and psychologic distress had the strongest indirect relationships with HRQOL in the HA phenotype. The highest effect of PCOS symptoms on HRQOL impairment in patients with menstrual irregularities along with HA and patients with menstrual irregularities along with polycystic ovaries was exerted by clinical variables, poor perception of self-worth, negative body image, and sexual dysfunction. In patients with various phenotypes of PCOS, the effects of mediating variables on HRQOL are different. In patients with PCOS, the findings suggest that mediating factors, especially psychologic distress, self-esteem, body image, and sexual function, play an important role and should be taken into consideration and adequately treated if present. Copyright © 2013 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

Enhancing breast projection in autologous reconstruction using the St Andrew's coning technique and 3D volumetric analysis.

PubMed

Chae, Michael P; Rozen, Warren Matthew; Patel, Nakul Gamanlal; Hunter-Smith, David J; Ramakrishnan, Venkat

2017-12-01

An increasing number of women undergo mastectomy for breast cancer and post-mastectomy autologous breast reconstruction has been shown to significantly improve the psychosexual wellbeing of the patients. A goal of treatment is to achieve symmetry and projection to match the native breast, and/or the contralateral breast in the case of a unilateral reconstruction. Autologous reconstruction, particularly with the deep inferior epigastric artery perforator (DIEP) flap, is particularly advantageous as it can be manipulated to mimic the shape and turgor of the native breast. However, very few techniques of shaping the breast conus when insetting the DIEP flap to enhance aesthetic outcome have been reported to date. With the aide of three-dimension (3D) photography and 3D-printed mirrored image of the contralateral breast as a guide intraoperatively, we describe our St Andrew's coning technique to create a personalized flap projection. We report a prospective case series of 3 delayed unilateral breast reconstructions where symmetrization procedure to the contralateral breast was not indicated. Using a commercial 3D scanner (VECTRA XR, Canfield Scientific), the breast region was imaged. The mirrored image was 3D-printed in-house using a desktop 3D printer. In all cases, projection of the breast mound was able to be safely achieved, with a demonstrated central volume (or 'cone') able to be highlighted on imaging and a 3D printed breast. A 3D print of the contralateral breast was able to be used intraoperatively to guide the operative approach. The St Andrew's coning technique is a useful aesthetic maneuver for achieving breast projection during DIEP flap breast reconstruction, with 3D imaging techniques able to assist in perioperative assessment of breast volume.

Premature ejaculation: on defining and quantifying a common male sexual dysfunction.

PubMed

Broderick, Gregory A

2006-09-01

Premature ejaculation (PE) and its individual and relationship consequences have been recognized in the literature for centuries. PE is one of the most common male sexual dysfunctions, affecting nearly one in three men worldwide between the ages of 18 and 59 years. Until recently, PE was believed to be a learned behavior predominantly managed with psychosexual therapy; however, the past few decades have seen significant advances in understanding its etiology, diagnosis, and management. There is, as yet, no one universally agreed upon definition of PE. To review five currently published definitions of PE. The Sexual Medicine Society of North America hosted a State of the Art Conference on Premature Ejaculation on June 24-26, 2005 in collaboration with the University of South Florida. The purpose was to have an open exchange of contemporary research and clinical information on PE. There were 16 invited presenters and discussants; the group focused on several educational objectives. Data were utilized from the World Health Organization, the American Psychiatric Association, the European Association of Urology, the Second International Consultation on Sexual Dysfunctions, and the American Urological Association. The current published definitions of PE have many similarities; however, none of these provide a specific "time to ejaculation," in part because of the absence of normative data on this subject. While investigators agree that men with PE have a shortened intravaginal ejaculatory latency time (IELT; i.e., time from vaginal penetration to ejaculation), there is now a greater appreciation of PE as a multidimensional dysfunction encompassing several components, including time and subjective parameters such as "control,"satisfaction," and "distress." There is a recent paradigm shift away from PE as a unidimensional disorder of IELT toward a multidimensional description of PE as a biologic dysfunction with psychosocial components.

Psychological Impact of Primary Screening (PIPS) for HPV: a protocol for a cross-sectional evaluation within the NHS cervical screening programme.

PubMed

McBride, Emily; Marlow, Laura; Forster, Alice S; Moss, Sue; Myles, Jonathan; Kitchener, Henry; Patnick, Julietta; Waller, Jo

2016-12-23

The NHS Cervical Screening Programme is now using human papillomavirus (HPV) testing as the primary test in six sentinel sites in England, with the intention of rolling this out across the whole of England. Previous research evaluating HPV testing in the cervical screening context suggests that an HPV-positive result may increase anxiety beyond that associated with abnormal cytology, but this has not been explored in the context of primary HPV testing. The main aim of this study is to explore the impact of the HPV primary screening programme on anxiety and distress. A cross-sectional between-groups design (total N ∼ 673) will be employed to assess the psychological impact of different HPV and cytology results at three time points: shortly after receiving the results, and 6 and 12 months later. Women will fall into one of six groups based on their screening results. The primary outcomes will be anxiety and general distress. Secondary outcomes will include understanding of screening results, perceived risk of cervical cancer, psychosexual functioning, intention to attend future screening and knowledge of HPV. General linear modelling will be used to test for differences between groups and changes over the three time points. Health Research Authority approval was received on 26 September 2016. Ethical approval was received from London- Surrey Borders NHS Research Ethics Committee on 30 August 2016. Section 251 approval was received from the Confidentiality Advisory Group on 24 August 2016. Results will be disseminated via peer-reviewed publication and presentation at national and international conferences. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Erectile dysfunction and phosphodiesterase type 5 inhibitor use: associations with sexual activities, function and satisfaction in a population sample of older men.

PubMed

Lee, D M; Nazroo, J; Pendleton, N

2015-07-01

The objective of this study was to examine the association between sexual activities, problems and satisfaction, and ED and PDE5 inhibitor (PDE5i) use. A nationally representative sample of men (n=2612) aged 51-87 years from the English Longitudinal Study of Ageing completed an in-depth Sexual Relationships and Activities Questionnaire. Associations between ED and/or PDE5i use and sexual outcomes were explored using logistic regression models adjusted for age, health and lifestyle factors. PDE5i use in the preceding 3 months was reported by a total of 191 (7%) men, whereas 542 (21%) reported ED but no PDE5i use (untreated ED). Compared with men without ED, PDE5i users were more likely to be sexually active and report more frequent sexual intercourse. Men with untreated ED reported the lowest frequency of sexual activities. Compared with men without ED, both PDE5i users and those with untreated ED were more likely to report being concerned about their level of sexual desire, frequency of sexual activities, erectile function, waking erections and orgasmic experience. PDE5i users were also more concerned about and dissatisfied with their overall sex life than men without ED. This population-based study shows that while PDE5i use is associated with improved sexual functioning, this is not equally reflected in decreased levels of concern and dissatisfaction with their overall sexual health. Clinicians should be aware of this disparity between functional gains and continuing sexual concerns and dissatisfaction, and, where appropriate, offer psychosexual counselling as an adjunct to PDE5i medication.

An online psychological intervention can improve the sexual satisfaction of men following treatment for localized prostate cancer: outcomes of a Randomised Controlled Trial evaluating My Road Ahead.

PubMed

Wootten, Addie C; Meyer, Denny; Abbott, Jo-Anne M; Chisholm, Katherine; Austin, David W; Klein, Britt; McCabe, Marita; Murphy, Declan G; Costello, Anthony J

2017-07-01

Prostate cancer treatment often results in significant psycho-sexual challenges for men following treatment; however, many men report difficulty in accessing appropriate care. A randomized controlled trial was undertaken to assess the efficacy of a 10-week self-guided online psychological intervention called My Road Ahead (MRA) for men with localized prostate cancer in improving sexual satisfaction. Participants were randomized to 1 of 3 conditions MRA alone or MRA plus online forum, or forum access alone. Pre, post, and follow-up assessments of overall sexual satisfaction were conducted. Mixed models and structural equation modeling were used to analyze the data. One hundred forty-two men (mean age 61 y; SD = 7) participated. The majority of participants had undergone radical prostatectomy (88%) and all men had received treatment for localized prostate cancer. Significant differences were obtained for the 3 groups (P = .026) and a significant improvement in total sexual satisfaction was observed only for participants who were allocated to MRA + forum with a large effect size (P = .004, partial η 2  = 0.256). Structural equation modeling indicated that increases in sexual function, masculine self-esteem, and sexual confidence contributed significantly to overall sexual satisfaction for the MRA + forum plus forum condition. This study is the first, to our knowledge, that has evaluated a self-guided online psychological intervention tailored to the specific needs of men with prostate cancer. The findings indicate the potential for MRA to deliver support that men may not otherwise receive and also highlight the importance of psychological intervention to facilitate improved sexual outcomes. Copyright © 2016 John Wiley & Sons, Ltd.

Sexual dysfunction among female patients of reproductive age in a hospital setting in Nigeria.

PubMed

Fajewonyomi, Benjamin A; Orji, Ernest O; Adeyemo, Adenike O

2007-03-01

Although sexual dysfunction is an important public-health problem in Nigeria, little research has been conducted on this topic in Nigeria. This cross-sectional study was conducted to determine the prevalence of sexual dysfunction and their correlates among female patients of reproductive age using a questionnaire. Respondents were recruited from the out-patients clinics of a teaching hospital setting in Ile-Ife/ Ijesa administrative health zone, Osun State, Nigeria. Of 384 female patients interviewed, 242 (63%) were sexually dysfunctional. Types of sexual dysfunction included disorder of desire (n=20; 8.3%), disorder of arousal (n=l 3; 5.4%), disorder of orgasm (n=154; 63.6%), and painful coitus (dyspareunia) (n=55; 22.7%). The peak age of sexual dysfunction was observed among the age-group of 26-30 years. Women with higher educational status were mostly affected. The reasons for unsatisfactory sexual life mainly included psychosexual factors and medical illnesses, among which included uncaring partners, present illness, excessive domestic duties, lack of adequate foreplay, present medication, competition among wives in a polygamous family setting, previous sexual abuse, and guilt-feeling of previous pregnancy termination among infertile women. The culture of male dominance in the local environment which makes women afraid of rejection and threats of divorce if they ever complain about sexually-related matters might perpetrate sexual dysfunction among the affected individuals. Sexual dysfunction is a real social and psychological problem in the local environment demanding urgent attention. It is imperative to carry out further research in society at large so that the health and lifestyles of affected women and their partners could be improved.

Autologous dermal graft combined with a modified degloving procedure for penile augmentation in young adults: a preliminary study.

PubMed

Zhang, G-X; Weng, M; Wang, M-D; Bai, W-J

2016-09-01

In order to evaluate the effect of penile enhancement, we retrospectively reviewed the data of the patients operated with autologous dermal graft implantation combined with a modified penile degloving procedure. The patients with the complaints of small penis, asking for penile augmentation, and normal erectile function were psychologically screened and enrolled. Data of follow-up visit including patient demographics, medical history, surgical procedure, patient-reported outcomes were analysed. In all, 30 eligible persons were operated. After degloving of the penis, the suspensory ligament was incised and the tunica albuginea was fixed to the proximal tunica dartos at the penile base. Then, the dermis graft was implanted on the dorsal surface of the tunica albuginea. The file of follow-up visit was available in 17 (57%) patients. The mean age was 23.7 years (19-35 years) and the mean follow-up was 13 months (range, 4-24 months). During the follow-up period, the average gain in the penis length was 2.7 cm in flaccid and 0.8 cm in erection, respectively. And the average gain in the penis circumference was 1.5 cm in flaccid and 1.2 cm in erection, respectively. Also, psychosexual sexual self-esteem and confidence of the patients were significantly improved (p < 0.001). Overall, 13 (76%) patients reported satisfaction with the penile appearance. We believe that the surgery is both safe and effective in the enhancement of the penis, however, further clinical studies with a larger patient population are necessary. © 2016 American Society of Andrology and European Academy of Andrology.

Psychosexual Intervention in Patients With Stage I-III Gynecologic or Breast Cancer

ClinicalTrials.gov

2018-05-25

Ovarian Sarcoma; Ovarian Stromal Cancer; Stage I Uterine Sarcoma; Stage I Vaginal Cancer; Stage I Vulvar Cancer; Stage IA Cervical Cancer; Stage IA Endometrial Carcinoma; Stage IA Fallopian Tube Cancer; Stage IA Ovarian Epithelial Cancer; Stage IA Ovarian Germ Cell Tumor; Stage IA Primary Peritoneal Cavity Cancer; Stage IB Cervical Cancer; Stage IB Endometrial Carcinoma; Stage IB Fallopian Tube Cancer; Stage IB Ovarian Epithelial Cancer; Stage IB Ovarian Germ Cell Tumor; Stage IB Primary Peritoneal Cavity Cancer; Stage IC Fallopian Tube Cancer; Stage IC Ovarian Epithelial Cancer; Stage IC Ovarian Germ Cell Tumor; Stage IC Primary Peritoneal Cavity Cancer; Stage II Endometrial Carcinoma; Stage II Gestational Trophoblastic Tumor; Stage II Uterine Sarcoma; Stage II Vaginal Cancer; Stage II Vulvar Cancer; Stage IIA Cervical Cancer; Stage IIA Fallopian Tube Cancer; Stage IIA Ovarian Epithelial Cancer; Stage IIA Ovarian Germ Cell Tumor; Stage IIA Primary Peritoneal Cavity Cancer; Stage IIB Cervical Cancer; Stage IIB Fallopian Tube Cancer; Stage IIB Ovarian Epithelial Cancer; Stage IIB Ovarian Germ Cell Tumor; Stage IIB Primary Peritoneal Cavity Cancer; Stage IIC Fallopian Tube Cancer; Stage IIC Ovarian Epithelial Cancer; Stage IIC Ovarian Germ Cell Tumor; Stage IIC Primary Peritoneal Cavity Cancer; Stage III Gestational Trophoblastic Tumor; Stage III Uterine Sarcoma; Stage III Vaginal Cancer; Stage III Vulvar Cancer; Stage IIIA Cervical Cancer; Stage IIIA Endometrial Carcinoma; Stage IIIA Fallopian Tube Cancer; Stage IIIA Ovarian Epithelial Cancer; Stage IIIA Ovarian Germ Cell Tumor; Stage IIIA Primary Peritoneal Cavity Cancer; Stage IIIB Cervical Cancer; Stage IIIB Endometrial Carcinoma; Stage IIIB Fallopian Tube Cancer; Stage IIIB Ovarian Epithelial Cancer; Stage IIIB Ovarian Germ Cell Tumor; Stage IIIB Primary Peritoneal Cavity Cancer; Stage IIIC Endometrial Carcinoma; Stage IIIC Fallopian Tube Cancer; Stage IIIC Ovarian Epithelial Cancer; Stage IIIC Ovarian Germ Cell Tumor; Stage IIIC Primary Peritoneal Cavity Cancer; Breast Cancer

Double-blind, controlled, clinical trial planned in germany to investigate the efficacy of psychotherapy combined with triptorelin in adult male patients with severe pedophilic disorders: presentation of the study protocol.

PubMed

Briken, Peer; Berner, Wolfgang

2012-01-01

The treatment of paraphilias, especially of pedophilia, centers upon cognitive-behavioral psychotherapy and pharmacologic interventions. Two open, uncontrolled clinical studies using the synthetic LHRH-agonist triptorelin suggested that, combined with psychotherapy, antiandrogen treatment reduced deviant sexual fantasies, urges, and behaviors in paraphilic patients. There is a need for further research using controlled, randomized trials to examine the effectiveness of sexual offender treatment including psychotherapeutic and pharmacologic interventions. The aim of this pilot study is to evaluate the efficacy and tolerability of cognitive-behavioral psychotherapy together with intramuscular (IM) 3-monthly injections of triptorelin in adult men with severe pedophilia. In this multicenter, forensic psychiatric hospital-based, double-blind, controlled, parallel group phase IV trial conducted in Germany, convicted male sexual offenders aged ≥ 18 years with pedophilia, as defined by DSM-IV-TR criteria, will be randomized to receive study-specific psychotherapy together either with triptorelin or placebo for 12 months (total of 4 injections). This is a pilot study, therefore exploratory data analyses will be carried out of three different target parameters: 1. Changes in psychosexual characteristics using the Multiphasic Sex Inventory (scale: sexual abuse of children) 2. Changes in the risk of violent sexual behavior using the Sexual Violence Risk-20 total score 3. Changes in serum testosterone concentration Treatment effects will be assessed by comparing baseline values with those at the final examination (month 12). The absence of real-life stimulants to test for actual recidivism limits possible findings. The study will be conducted in agreement with the European GCP-guideline, all relevant legal requirements, and the legal framework for voluntary treatment of convicted sexual offenders in Germany.

Sexuality and fertility in men with hypospadias; improved outcome.

PubMed

Örtqvist, L; Fossum, M; Andersson, M; Nordenström, A; Frisén, L; Holmdahl, G; Nordenskjöld, A

2017-03-01

The aim of this study was to investigate sexual function and fertility in adult men born with hypospadias. Patients born with hypospadias, age-matched controls, and a group of circumcised men completed a questionnaire constructed to reflect their psychosexual situation and fertility. Core gender identity, sexual orientation, and gender role behavior was also assessed. 167 patients [63% distal, 24% mid shaft and 13% proximal, mean age 34 (19-54) years], 169 controls from the general population [mean age 33 (19-48) years] and 47 controls circumcised because of phimosis (mean age 26 [19-44]) participated and completed the questionnaire. There were no differences in having a partner, reported fertility, age at sexarche (mean age 17.8), number of sex partners or sexual interest between the patients and controls. More patients than controls reported anejaculation. Reported glanular sensitivity was lower in hypospadias patients and circumcised controls compared with non-circumcised controls. The odds of being satisfied with their sexual life increased with a higher penile perception score in patients (OR = 1.54, p = 0.01). There was no association with penile length. Sexual orientation, core gender identity and gender role behavior were sex-typical in both patients and controls. Patients with proximal hypospadias had a lower reported fertility, experienced anejaculation more often, and were less satisfied with their sexual life. Men born with hypospadias have a good long-term outcome concerning sexual function and fertility. Men born with proximal hypospadias have a more impaired outcome concerning both sexual function and fertility. As satisfaction with genital appearance is important for sexual life satisfaction, clinical, and psychological follow-up into adulthood is especially important in boys born with proximal hypospadias. © 2016 American Society of Andrology and European Academy of Andrology.

Erectile Dysfunction Is Not a Predictor of Atrial Fibrillation: A Population-Based Propensity-Score Matched Cohort Study.

PubMed

Liu, Kuan-Liang; Ye, Ling-Long; Chou, Shing-Hsien; Tung, Ying-Chang; Lin, Yu-Sheng; Wu, Lung-Sheng; Lin, Chia-Pin; Shia, Ben-Chang; Chu, Pao-Hsien

2016-01-01

Erectile dysfunction (ED) has been regarded a marker of cardiovascular diseases. Nevertheless, the association between ED and incident atrial fibrillation (AF) remains unknown. To determine the association between ED and incident AF. This population-based cohort study was conducted using the National Health Insurance Research Database in Taiwan. In total, 6,273 of patients with ED without a prior diagnosis of AF were enrolled from January 1, 2001 through December 31, 2009, and a propensity-score matching method was used to identify 3,516 patients in the ED and control groups. Newly incident AF at follow-up was recorded as the end point. The mean age of the study population was 40.0 ± 17.1 years, and the follow-up period was 8.0 ± 0.5 years. Compared with the control group, patients with ED were older and had more of the following comorbidities: D'Hoore Charlson Comorbidity Index, hypertension, congestive heart failure, diabetes mellitus, dyslipidemia, chronic kidney disease, coronary artery disease, stroke, chronic lung disease, major depression disorder, obstructive sleep apnea, and hyperthyroidism. After adjusting for confounders, the ED group was not associated with more incident AF compared with the control group (hazard ratio = 1.031, 95% confidence interval = 0.674-1.578, P =.888). In these patients, ED of an organic origin was associated with a trend of having AF more often compared with ED of a psychosexual type (P =.272 by log-rank test). Although ED is known as a predictor of atherosclerotic cardiovascular diseases, it is not independently associated with incident AF in men. Copyright © 2016 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.

Reversal Surgery in Regretful Male-to-Female Transsexuals After Sex Reassignment Surgery.

PubMed

Djordjevic, Miroslav L; Bizic, Marta R; Duisin, Dragana; Bouman, Mark-Bram; Buncamper, Marlon

2016-06-01

Sex reassignment surgery (SRS) has proved an effective intervention for patients with gender identity disorder. However, misdiagnosed patients sometimes regret their decision and request reversal surgery. This review is based on our experience with seven patients who regretted their decision to undergo male-to-female SRS. To analyze retrospectively seven patients who underwent reversal surgery after regretting their decision to undergo male-to-female SRS elsewhere. From November 2010 through November 2014, seven men 33 to 53 years old with previous male-to-female SRS underwent reversal phalloplasty. Preoperatively, they were examined by three independent psychiatrists. Surgery included three steps: removal of female genitalia with scrotoplasty and urethral lengthening, total phalloplasty with microvascular transfer of a musculocutaneous latissimus dorsi flap, and neophallus urethroplasty with penile prosthesis implantation. Self-reported esthetic and psychosexual status after reversion surgery and International Index of Erectile Function scores for sexual health after phalloplasty and penile prosthesis implantation. Follow-up was 13 to 61 months (mean = 31 months). Good postoperative results were achieved in all patients. In four patients, all surgical steps were completed; two patients are currently waiting for penile implants; and one patient decided against the penile prosthesis. Complications were related to urethral lengthening: two fistulas and one stricture were observed. All complications were repaired by minor revision. According to patients' self-reports, all patients were pleased with the esthetic appearance of their genitalia and with their significantly improved psychological status. Reversal surgery in regretful male-to-female transsexuals after SRS represents a complex, multistage procedure with satisfactory outcomes. Further insight into the characteristics of persons who regret their decision postoperatively would facilitate better future selection of applicants eligible for SRS. Copyright © 2016 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.

The Psychosexual Impact of Postmastectomy Breast Reconstruction.

PubMed

Hart, Alexandra M; Pinell-White, Ximena; Losken, Albert

2016-11-01

The surgical management of breast cancer with mastectomy and breast reconstruction (BR) has been shown to increase the quality of life of cancer survivors. Yet the impact of surgery on sexuality, femininity, and condition of intimate relationships as a measure for sexual health has not been fully evaluated. Ninety-six women who underwent mastectomy and immediate BR participated in the series. Surveys assessed patients' level of sexual health in the areas of femininity, sexual confidence during intimate relationships, and the role of breast sensibility in sexual satisfaction as compared with how they felt preoperatively. Surveys were scored on a 5-point Likert scale (5 = strongly agree). Inclusion criteria included longer than 1 year follow-up. After BR, the majority felt that their breasts were as important to self-confidence (86.3%), femininity (84.0%), and sexuality (61.5%) as they were preoperatively. Women older than 50 years were more likely to feel that their breasts were not a significant part of their femininity (26.7% vs 11.8%, P = 0.05). Women with a BMI greater than 30 were more likely to feel that their partner's view of their breasts did not affect their self-confidence (46.2% vs. 20.7%P = 0.027). Women with a BMI less than 30 (23.2% vs 4.0%, P = 0.05), and those who had a major complication (22.2% vs 0.00%, P = 0.08) were more likely to disagree that nipple aerolar complex reconstruction improved their sexual confidence. Most women agree that their sexuality, femininity, and intimate relationships are maintained after BR. Increasing age and BMI may lead to changes in sexual health postoperatively.

Female genital cosmetic and plastic surgery: a review.

PubMed

Goodman, Michael P

2011-06-01

This review studies rationale and outcome of vulvovaginal aesthetic surgery. Discuss procedures designed to alter genital appearance and function; investigate sexual, philosophical, and ethical issues; examine outcomes. (i) Medline search of the existing literature utilizing terms labiaplasty, clitoral hood reduction, hymenoplasty (HP), vaginoplasty (VP), perineoplasty (PP), female genital surgery, sexual satisfaction/body image, and anterior/posterior colporrhaphy; (ii) references from bibliographies of papers found through the literature search and in the author's reading of available literature. (i) Demographics and psychosexual dynamics of women requesting female genital plastic/cosmetic surgery; (ii) overall and sexual satisfaction of subjects undergoing these procedures. The majority of studies regarding patient satisfaction and sexual function after vaginal aesthetic and functional plastic procedures report beneficial results, with overall patient satisfaction in the 90-95% range, sexual satisfaction over 80-85%. These data are supported by outcome data from nonelective vaginal support procedures. Complications appear minor and acceptable to patients. There are little data available regarding outcomes and satisfaction of HP, or function during the rigors of subsequent vaginal childbirth, although the literature contains no case reports of labiaplasty disruption during parturition. Women requesting labiaplasty and reduction of their clitoral hoods do so for both cosmetic and functional (chafing, interference with coitus, interference with athletic activities, etc.) reasons, while patients requesting VP and/or PP do so in order to increase friction and sexual satisfaction, occasionally for aesthetic reasons. Patients appear generally happy with outcomes. The majority of patients undergoing genital plastic surgery report overall satisfaction and subjective enhancement of sexual function and body image, but the literature is retrospective. Female genital plastic surgery procedures appear to fulfill the majority of patient's desires for cosmetic and functional improvement, as well as enhancement of the sexual experience. Little information is available regarding HP outcomes. © 2011 International Society for Sexual Medicine.

Health-related quality of life, developmental milestones, and self-esteem in young adults with bleeding disorders.

PubMed

Limperg, P F; Haverman, L; Maurice-Stam, H; Coppens, M; Valk, C; Kruip, M J H A; Eikenboom, J; Peters, M; Grootenhuis, M A

2018-01-01

The treatment of bleeding disorders improved in the last decades. However, the effect of growing up with bleeding disorders on developmental, emotional, and social aspects is understudied. Therefore, this study assesses HRQOL, developmental milestones, and self-esteem in Dutch young adults (YA) with bleeding disorders compared to peers. Ninety-five YA (18-30 years) with bleeding disorders (78 men; mean 24.7 years, SD 3.5) and 17 women (mean 25.1 years, SD 3.8) participated and completed the Pediatric Quality of Life Inventory Young Adult version, the Course of Life Questionnaire, and the Rosenberg Self-Esteem Scale. Differences between patients with bleeding disorders and their peers, and between hemophilia severity groups, were tested using Mann-Whitney U tests. YA men with bleeding disorders report a slightly lower HRQOL on the total scale, physical functioning, and school/work functioning in comparison to healthy peers (small effect sizes). YA men with severe hemophilia report more problems on the physical functioning scale than non-severe hemophilia. YA men with bleeding disorders achieved more psychosexual developmental milestones than peers, but show a delay in 'paid jobs, during middle and/or high school.' A somewhat lower self-esteem was found in YA men with bleeding disorders in comparison to peers (small effect size). For YA women with bleeding disorders, no differences were found on any of the outcomes in comparison to peers. This study demonstrates some impairments in HRQOL and self-esteem in YA men with bleeding disorders. By monitoring HRQOL, problems can be identified early, especially with regard to their physical and professional/school functioning.

Questionnaire-based evaluation of sexual life after laparoscopic surgery for endometriosis: a systematic review of prospective studies.

PubMed

Franck, Cecilie; Poulsen, Marlene H; Karampas, Grigorios; Giraldi, Annamaria; Rudnicki, Martin

2018-05-12

Endometriosis is a benign disease that affects women of reproductive age. Laparoscopic excision of endometriotic implants is considered one of the most effective therapeutic options. The disease and its treatment can have a major impact on psychosexual well-being but this is often overlooked as most studies focus on pain instead of sexuality in a holistic approach. The aim of this study was to review the current literature regarding the effect of laparoscopic surgery for endometriosis on quality of sexual life (QoSL). Following the "Preferred Reporting Items for Systematic Reviews and Meta-Analyses" guidelines we conducted a systematic review that involved searching PubMed and Embase databases for prospective studies evaluating the effect of laparoscopic surgery for endometriosis on QoSL, using validated questionnaires. Of 357 papers, 17 were selected for full text evaluation. Twelve studies using seven different questionnaires fulfilled the inclusion criteria. All studies reported improvements in QoSL following laparoscopic surgery for endometriosis. A meta-analysis could not be performed due to substantial heterogeneity among the included studies arising from differences in questionnaires, follow-up duration, stages of endometriosis, use of hormonal treatment, and missing data. Laparoscopic excision of endometriosis can improve QoSL. However, there is a need for randomized controlled trials based on a new validated questionnaire regarding specifically QoSL in association with endometriosis. As sexual functioning is a complex phenomenon driven by multiple physical, psychological and social factors, QoSL should be holistically evaluated by a team of different healthcare providers, implementing treatment programs that are individualized to each woman. © 2018 Nordic Federation of Societies of Obstetrics and Gynecology.

Vaginal orgasm is associated with less use of immature psychological defense mechanisms.

PubMed

Brody, Stuart; Costa, Rui Miguel

2008-05-01

Freud implied a link between inability to have a vaginal orgasm and psychosexual immaturity. Since Kinsey, many sexologists have asserted that no such link exists. However, empirical testing of the issue has been lacking. The objective was to determine the relationship between different sexual behavior triggers of female orgasm and use of immature psychological defense mechanisms. Women reported their past month frequency of different sexual behaviors and corresponding orgasm rates and completed the Defense Style Questionnaire (DSQ-40). The association between ability to have vaginal intercourse orgasm (versus clitoral orgasm) and the use of DSQ-40 immature psychological defense mechanisms (associated with various psychopathologies) was examined. In a sample of 94 healthy Portuguese women, vaginal orgasm (triggered solely by penile-vaginal intercourse) was associated with less use of DSQ-40 immature defenses. Vaginal orgasm was associated with less somatization, dissociation, displacement, autistic fantasy, devaluation, and isolation of affect. Orgasm from clitoral stimulation or combined clitoral-intercourse stimulation was not associated with less use of immature defenses, and was associated with more use of some immature defenses. In one regression analysis, more masturbation and less vaginal orgasm consistency made independent contributions to the statistical prediction of immature defenses. In another regression analysis, any use of extrinsic clitoral stimulation for intercourse orgasm, and lack of any vaginal orgasm, made independent contributions to the statistical prediction of immature defenses. Vaginally anorgasmic women had immature defenses scores comparable to those of established (depression, social anxiety disorder, panic disorder, and obsessive-compulsive disorder) outpatient psychiatric groups. Results were not confounded by social desirability responding or relationship quality. The results linking penile-vaginal orgasm with less use of immature psychological defense mechanisms are consistent with both early psychoanalytic personality theory and recent advances in sexual physiology. Implications for diagnosis and sex therapy are noted.

The Phosphodiesterase 5-Inhibitors (PDE-5i) for ERECTILE DYSFUNCTION (ED): A Therapeutic Challenge For Psychiatrists.

PubMed

Koon, Chong Siew; Sidi, Hatta; Kumar, Jaya; Das, Srijit; Xi, Ong Wan; Hatta, Muhammad Hizri; Alfonso, Cesar

2017-02-15

Erectile function (EF) is a prerequisite for satisfactory sexual intercourse (SI) and central to male sexual functioning. Satisfactory SI eventually leads to orgasm - a biopsychophysiological state of euphoria - leading to a sense of bliss, enjoyment and positive mental well being. For a psychiatrist, treating ED is self-propelled to harmonize these pleasurable experiences alongside with encouragement of physical wellness and sensuality. Hence, the role of PDE-5i is pivotal in the context of treating ED constitutes a therapeutic challenge. PDE-5i work via the dopaminergic-oxytocin-nitric oxide pathway by increasing the availability of endothelial's guanosine monophosphate (GMP), immediately causing relaxation of the penile smooth muscle and an erection. The PDE-5i, like sildenafil, vardenafil and tadalafil, are effective in the treatment of ED with some benefits and disadvantages compared to other treatment modalities. Prescribed PDE-5i exclusively improve EF, fostering male's self-confidence and self-esteem. Treatment failures are associated with factors such as absent (or insufficient) sexual stimulation, psychosexual conflicts and the co-existence of medical disorders. Managing ED requires dealing with underlying medical diseases, addressing other co-morbid sexual dysfunctions like premature ejaculation (PE), and educating the patient on healthy life-styles beside being cautious with the potential side-effects and drug-drug interactions. Furthermore, by dealing with interpersonal dynamics within the couple and embracing adequate lifestyles (managing stress and revising one's sexual scripts), PDE-5i treatment benefits may be enhanced. In this review, we propose a holistic conceptual framework approach for psychiatric management of patients with ED. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

Sexual dysfunction, Part II: Diagnosis, management, and prognosis.

PubMed

Halvorsen, J G; Metz, M E

1992-01-01

Sexual problems are common but infrequently diagnosed. They are classified into four major categories: (1) sexual desire disorders, (2) sexual arousal disorders, (3) orgasmic disorders, and (4) sexual pain disorders. MEDLINE files from 1966 to the present were searched using the specific sexual dysfunctions as key words along with the general key word "sexual dysfunction" to review the published literature. Additional articles came from the reference lists of dysfunction-specific reviews. The key to diagnosis often rests on the physician's willingness to raise the issue with patients. A rational protocol can be followed to identify causative organic and psychogenic factors using the psychosexual and medical history, a comprehensive physical examination, psychological assessment instruments, laboratory tests, and special procedures. Current psychological treatment includes one or more of the following components: sensate focus exercises, cognitive-behavioral therapy, relaxation training, hypnosis and guided imagery, and group therapies. Specific techniques, such as directed self-stimulation, the stop-start and squeeze techniques, the sexological examination, systematic desensitization, and Kegel exercises, are added therapy when appropriate. Marital therapy to improve communication and resolve conflict is also part of standard therapy. Medical management can include pharmacologic agents to correct endocrine dysfunctions or to alter the progression of the sexual response. Surgical management can involve arterial revascularization, venous ligation, and penile implants. A noninvasive vacuum constriction device is also used to treat erectile disorders. The long-term prognosis of the sexual dysfunctions varies with the type of disorder and its causes. Generally good results (80 to 95 percent satisfaction) are obtained when treating vaginismus, dyspareunia, male erectile disorders, and female orgasmic dysfunctions. Long-term results are modestly successful (40 to 80 percent) when treating inhibited male orgasm and premature ejaculation. Long-term success is poorest at present for treating sexual desire disorders.

Proposals or findings for a new approach about how to define and diagnose premature ejaculation.

PubMed

Wang, Weifu; Kumar, Pardeep; Minhas, Suks; Ralph, David

2005-09-01

To review and present the proposals or findings for a new approach about how to define and diagnose premature ejaculation (PE). Using Medline to search for international peer reviewed manuscripts published from 1996 to 2004 about the definition and diagnosis of PE. PE, to date, has not a universally agreed definition and diagnostic criterion. Many definitions are partial, subjective and nonspecific. An ideal definition or diagnostic criterion should consist of intravaginal ejaculatory latency time (IELT), the ability to control over ejaculation, the extent of male sexual satisfaction, the extent of female sexual satisfaction, the frequency of female sexual partner reaching orgasm and the extent of psychological and pathological factors. Therefore, the Chinese Index of Premature Ejaculation (CIPE) seems an ideal tool and criterion used to diagnose PE due to including all the elements above. In the majority of cases, PE is the result of a mix of psychogenic, physiological and organic factors. So, besides some routine tests such as urine routine test, endocrine hormone assay, psychosexual counseling, couple evaluation and physical examination, prostate examination, serum leptin assay, semen magnesium assessment and glans hypersensitivity measurement, are suggested to be performed in the diagnosis of PE. Although elucidated by two clinical trials and further confirmed, serum leptin assay seems a promising and objective marker to diagnose PE because it is related to the serotonergic system whose disorder has been confirmed to contribute to the etiology of PE. None of these definitions and diagnoses has been accepted as a universal agreement of PE. CIPE seems an ideal tool and criterion used to diagnose PE and leptin maybe become a promising and objective marker for PE.

Long term outcomes in 46, XX adult patients with congenital adrenal hyperplasia reared as males.

PubMed

Khattab, A; Yau, M; Qamar, A; Gangishetti, P; Barhen, A; Al-Malki, S; Mistry, H; Anthony, W; Toralles, M B; New, Maria I

2017-01-01

Patients with Congenital Adrenal Hyperplasia (CAH) owing to 21-hydroxylase deficiency and whose karyotype is 46, XX are usually assigned to the female gender. Reported herein are the long term outcomes in three patients with CAH whose karyotype is 46, XX and who were reared as males. A retrospective review of three CAH patients with a 46, XX karyotype who were reared as males was conducted. Gender assignment, clinical and biochemical data, pre and post-genitoplasty genital examinations were reviewed. Gender identity was tested by an extensive questionnaire. Gender role, sexual preference, marital status and sexual satisfaction were evaluated by interview. The three patients were genotyped for the CYP21A2 gene confirming the diagnosis of CAH. Owing to genital virilization, cultural preferences for male gender and the lack of newborn screening programs the three patients reported herein were assigned to the male gender at birth before the diagnosis of CAH was established. In adulthood the patients remained significantly virilized. Thorough psychosexual assessments in adulthood revealed well established male gender identities compatible with their male gender assignments at birth. In all three patients, gender role and behavior were consistent with male gender identity including sexual intercourse with female partners. The three patients reported herein revealed that male gender assignment to CAH patients with a 46, XX karyotype may have a successful outcome providing there is strong parental support and expert endocrine care. No standard guidelines have been published for the gender assignment of CAH patients with a 46, XX karyotype and genital ambiguity. More studies concerning gender assignment in CAH patients with a 46, XX karyotype reared as males are needed. Copyright © 2016 Elsevier Ltd. All rights reserved.

A review of patients with advanced cervical cancer presenting to palliative care services at Queen Elizabeth Central Hospital in Blantyre, Malawi.

PubMed

Bates, M J; Mijoya, A

2015-09-01

Cervical cancer is the commonest cancer affecting women in Malawi, which has the highest rate of this disease in the world. Most cases are diagnosed at an advanced stage. To describe the symptom burden, palliative care interventions, and outcomes of cervical cancer patients who entered care at Tiyanjane Clinic in Blantyre, Malawi, between January and December 2012. We reviewed the case files of 72 patients presenting to our hospital-based palliative care service over one year. The mean age was 49.5 years. Twenty-six patients (36%) were HIV-positive and the majority of these (n = 22; 85%) were on antiretroviral medication at presentation to palliative care. Pain (n = 66; 92%), vaginal discharge (n = 44; 61%), and unpleasant odour (n = 37; 51%) were commonly reported. Over a third of patients (n = 26; 36%) reported pain in two or more sites. Fourteen patients (19%) reported vaginal bleeding. Spousal breakdown (through widowhood or divorce) was noted in over half (n = 41; 57%) of all cases. Pain relief was provided to 69 (96%) of the patients (morphine to 40 patients; 56%). Common interventions provided included metronidazole tablets (used vaginally), sanitary items, and counselling. At the end of the study period, 18 patients (25%) were still under the care of palliative services. Access to medications such as morphine, metronidazole and tranexamic acid can improve quality of life, even when radiotherapy is limited. Health care teams require necessary skills and training, including how to perform a comprehensive assessment, with an emphasis on the provision of psychosexual counselling, to assist with the complexity of symptoms occurring in this vulnerable group.

Sex and relationships for HIV positive women since HAART: a quantitative study

PubMed Central

Lambert, S; Keegan, A; Petrak, J

2005-01-01

Objective: To investigate current levels of sexual activity, enjoyment, condom use, and other factors affecting sexual behaviour in a sample of women living with HIV. Method: Participants were self selected. A cross sectional design using semi-structured questionnaires was employed. 82 HIV positive women completed questionnaires asking about demographics, relationships, sexual behaviour, and safer sex practices. The Hospital Anxiety and Depression Scale (HADS) and Golombok-Rust Inventory of Sexual Satisfaction (GRISS) were administered. Results: 28% of women had had no sexual partners since diagnosis. Mean time diagnosed was 69 months, range 4–191 months. Time since diagnosis was not associated with having had a sexual partner. 59% of women had a current sexual partner, half reporting intercourse in the past month. Infrequent sex (84%), avoidance (84%), non-communication (69%), and dysfunction (60%) were among the most prevalent sexual difficulties. Endorsement of HIV impaired sexual enjoyment was associated with reduced sexual frequency (p = 0.006) and sexual dysfunction (p = 0.042). Sexual dissatisfaction was associated with infrequency of sex (p = 0.037), avoidance (p = 0.02), and non-communication (p = 0.032). Clinically significant levels of anxiety and depression were reported in 60% and 38% of cases, respectively. Depression was associated with avoidance of sex and higher total GRISS scores (p = 0.006 and p = 0.042). 60% of respondents stated that they "always" used condoms; a trend was observed between reduced condom use and higher levels of depression and anxiety (p = 0.09 and p = 0.06, respectively). Conclusion: Sexual difficulties, including abstinence, were prevalent in this sample indicating the potential for interventions addressing the psychosexual needs of HIV positive women and their partners. PMID:16061542

Sexual Dysfunction among Female Patients of Reproductive Age in a Hospital Setting in Nigeria

PubMed Central

Fajewonyomi, Benjamin A.; Adeyemo, Adenike O.

2007-01-01

Although sexual dysfunction is an important public-health problem in Nigeria, little research has been conducted on this topic in Nigeria. This cross-sectional study was conducted to determine the prevalence of sexual dysfunction and their correlates among female patients of reproductive age using a questionnaire. Respondents were recruited from the out-patients clinics of a teaching hospital setting in Ile-Ife/Ijesa administrative health zone, Osun State, Nigeria. Of 384 female patients interviewed, 242 (63%) were sexually dysfunctional. Types of sexual dysfunction included disorder of desire (n=20; 8.3%), disorder of arousal (n=13; 5.4%), disorder of orgasm (n=154; 63.6%), and painful coitus (dyspareunia) (n=55; 22.7%). The peak age of sexual dysfunction was observed among the age-group of 26–30 years. Women with higher educational status were mostly affected. The reasons for unsatisfactory sexual life mainly included psychosexual factors and medical illnesses, among which included uncaring partners, present illness, excessive domestic duties, lack of adequate foreplay, present medication, competition among wives in a polygamous family setting, previous sexual abuse, and guilt-feeling of previous pregnancy termination among infertile women. The culture of male dominance in the local environment which makes women afraid of rejection and threats of divorce if they ever complain about sexually-related matters might perpetrate sexual dysfunction among the affected individuals. Sexual dysfunction is a real social and psychological problem in the local environment demanding urgent attention. It is imperative to carry out further research in society at large so that the health and lifestyles of affected women and their partners could be improved. PMID:17615910

Enhancing breast projection in autologous reconstruction using the St Andrew’s coning technique and 3D volumetric analysis

PubMed Central

Chae, Michael P.; Patel, Nakul Gamanlal; Hunter-Smith, David J.; Ramakrishnan, Venkat

2017-01-01

Background An increasing number of women undergo mastectomy for breast cancer and post-mastectomy autologous breast reconstruction has been shown to significantly improve the psychosexual wellbeing of the patients. A goal of treatment is to achieve symmetry and projection to match the native breast, and/or the contralateral breast in the case of a unilateral reconstruction. Autologous reconstruction, particularly with the deep inferior epigastric artery perforator (DIEP) flap, is particularly advantageous as it can be manipulated to mimic the shape and turgor of the native breast. However, very few techniques of shaping the breast conus when insetting the DIEP flap to enhance aesthetic outcome have been reported to date. With the aide of three-dimension (3D) photography and 3D-printed mirrored image of the contralateral breast as a guide intraoperatively, we describe our St Andrew’s coning technique to create a personalized flap projection. Method We report a prospective case series of 3 delayed unilateral breast reconstructions where symmetrization procedure to the contralateral breast was not indicated. Using a commercial 3D scanner (VECTRA XR, Canfield Scientific), the breast region was imaged. The mirrored image was 3D-printed in-house using a desktop 3D printer. Results In all cases, projection of the breast mound was able to be safely achieved, with a demonstrated central volume (or ‘cone’) able to be highlighted on imaging and a 3D printed breast. A 3D print of the contralateral breast was able to be used intraoperatively to guide the operative approach. Conclusions The St Andrew’s coning technique is a useful aesthetic maneuver for achieving breast projection during DIEP flap breast reconstruction, with 3D imaging techniques able to assist in perioperative assessment of breast volume. PMID:29302489

The life mission theory IV. Theory on child development.

PubMed

Ventegodt, Søren; Merrick, Joav

2003-12-11

We can identify five important needs that children have: the need for acknowledgment, acceptance, awareness or attention, respect, and care. If these needs are not met, children will modify themselves by denying central parts of their nature in order to adjust to their parents and the situation at large. When a child denies his or her talents, powers, and gender or aspects thereof, he or she loses quality of life, the ability to function, and physical or mental health. The loss of ability takes the form of diminished social ability, psychosexual potency, joy, energy, and fantasy while playing, as well as diminished ability to concentrate, focus, and learn. Many modifications result in a child with severely damaged self-confidence, self-worth, and poor performance. A child more or less deprived of self-worth cannot enjoy, give, or receive. A child deprived of emotions turns cold, rational, asocial, socially stiff, uncomfortable, and in the extreme case...intentionally "evil". When a child denies his or her own sex, it becomes invisible, uninteresting, and vague or becomes like the opposite sex in behavior and appearance. The general holistic solution to the vast diversity of symptoms in children with low quality of life is to improve the situation for the child and give the child the holding and support he or she needs. It is very important to realize that a negative belief often has survival value to the child as it helps the child to avoid taking responsibility for problems, which really belong to the parents or other adults. Children have a fine capability for spontaneous healing, and seem to enter this process more easily than adults, given sufficient holding. The symptoms of children with poor thriving ability are often difficult to understand, as they are caused by a complex combination of self-modification in five existential dimensions. This often leads to complex medical diagnosis, giving the idea that the child is sick and without therapeutic reach, while sufficient holding could solve the problem. If holding and support of the child is not enough, the situation must be carefully analyzed to find other possible causes of poor quality of life, health, and functional ability. Education of the parent in holding is often mandatory. Most children with bad thriving ability can thus be helped by simple means.

Erectile dysfunction, masculinity, and psychosocial outcomes: a review of the experiences of men after prostate cancer treatment.

PubMed

Chambers, Suzanne K; Chung, Eric; Wittert, Gary; Hyde, Melissa K

2017-02-01

Prostate cancer (PC) treatment side-effects such as erectile dysfunction (ED) can impact men's quality of life (QoL), psychosocial and psycho-sexual adjustment. Masculinity (i.e., men's identity or sense of themselves as being a man) may also be linked to how men respond to PC treatment and ED however the exact nature of this link is unclear. This review aims to provide a snapshot of the current state of evidence regarding ED, masculinity and psychosocial impacts after PC treatment. Three databases (Medline/PsycINFO, CINHAL, and EMBASE) were searched January 1st 1980 to January 31st 2016. Study inclusion criteria were: patients treated for PC; ED or sexual function measured; masculinity measured in quantitative studies or emerged as a theme in qualitative studies; included psychosocial or QoL outcome(s); published in English language, peer-reviewed journal articles. Fifty two articles (14 quantitative, 38 qualitative) met review criteria. Studies were predominantly cross-sectional, North American, samples of heterosexual men, with localised PC, and treated with radical prostatectomy. Results show that masculinity framed men's responses to, and was harmed by their experience with, ED after PC treatment. In qualitative studies, men with ED consistently reported lost (no longer a man) or diminished (less of a man) masculinity, and this was linked to depression, embarrassment, decreased self-worth, and fear of being stigmatised. The correlation between ED and masculinity was similarly supported in quantitative studies. In two studies, masculinity was also a moderator of poorer QoL and mental health outcomes for PC patients with ED. In qualitative studies, masculinity underpinned how men interpreted and adjusted to their experience. Men used traditional (hegemonic) coping responses including emotional restraint, stoicism, acceptance, optimism, and humour or rationalised their experience relative to their age (ED inevitable), prolonged life (ED small price to pay), definition of sex (more than erection and penetration), other evidence of virility (already had children) or sexual prowess (sown a lot of wild oats). Limitations of studies reviewed included: poorly developed theoretical and context-specific measurement approaches; few quantitative empirical or prospective studies; moderating or mediating factors rarely assessed; heterogeneity (demographics, sexual orientation, treatment type) rarely considered. Clinicians and health practitioners can help PC patients with ED to broaden their perceptions of sexual relationships and assist them to make meaning out of their experience in ways that decrease the threat to their masculinity. The challenge going forward is to better unpack the relationship between ED and masculinity for PC patients by addressing the methodological limitations outlined so that interventions for ED that incorporate masculinity in a holistic way can be developed.

Erectile dysfunction, masculinity, and psychosocial outcomes: a review of the experiences of men after prostate cancer treatment

PubMed Central

Chung, Eric; Wittert, Gary; Hyde, Melissa K.

2017-01-01

Prostate cancer (PC) treatment side-effects such as erectile dysfunction (ED) can impact men’s quality of life (QoL), psychosocial and psycho-sexual adjustment. Masculinity (i.e., men’s identity or sense of themselves as being a man) may also be linked to how men respond to PC treatment and ED however the exact nature of this link is unclear. This review aims to provide a snapshot of the current state of evidence regarding ED, masculinity and psychosocial impacts after PC treatment. Three databases (Medline/PsycINFO, CINHAL, and EMBASE) were searched January 1st 1980 to January 31st 2016. Study inclusion criteria were: patients treated for PC; ED or sexual function measured; masculinity measured in quantitative studies or emerged as a theme in qualitative studies; included psychosocial or QoL outcome(s); published in English language, peer-reviewed journal articles. Fifty two articles (14 quantitative, 38 qualitative) met review criteria. Studies were predominantly cross-sectional, North American, samples of heterosexual men, with localised PC, and treated with radical prostatectomy. Results show that masculinity framed men’s responses to, and was harmed by their experience with, ED after PC treatment. In qualitative studies, men with ED consistently reported lost (no longer a man) or diminished (less of a man) masculinity, and this was linked to depression, embarrassment, decreased self-worth, and fear of being stigmatised. The correlation between ED and masculinity was similarly supported in quantitative studies. In two studies, masculinity was also a moderator of poorer QoL and mental health outcomes for PC patients with ED. In qualitative studies, masculinity underpinned how men interpreted and adjusted to their experience. Men used traditional (hegemonic) coping responses including emotional restraint, stoicism, acceptance, optimism, and humour or rationalised their experience relative to their age (ED inevitable), prolonged life (ED small price to pay), definition of sex (more than erection and penetration), other evidence of virility (already had children) or sexual prowess (sown a lot of wild oats). Limitations of studies reviewed included: poorly developed theoretical and context-specific measurement approaches; few quantitative empirical or prospective studies; moderating or mediating factors rarely assessed; heterogeneity (demographics, sexual orientation, treatment type) rarely considered. Clinicians and health practitioners can help PC patients with ED to broaden their perceptions of sexual relationships and assist them to make meaning out of their experience in ways that decrease the threat to their masculinity. The challenge going forward is to better unpack the relationship between ED and masculinity for PC patients by addressing the methodological limitations outlined so that interventions for ED that incorporate masculinity in a holistic way can be developed. PMID:28217451

“What Motivates Her”: Motivations for Considering Labial Reduction Surgery as Recounted on Women's Online Communities and Surgeons' Websites

PubMed Central

Zwier, Sandra

2014-01-01

Introduction Increasing numbers of women are seeking labial reduction surgery. We studied the motivations for considering labial reduction surgery as recounted on women's online communities and surgery provider's websites. Aims The study analyzed motivations for considering labial reduction surgery expressed by women on online communities, looked at the role of the women's age and nationality, compared findings with motivations indicated on the websites of an international sample of surgery providers, and identified similarities to and differences from what is known from extant studies. Methods Quantitative content analysis of the posts of 78 American, British, and Dutch women on online communities, and 40 international surgery providers' websites about labial reduction surgery was conducted. Main Outcome Measures Main outcome measures concerned the incidence and prominence of different motivational categories (functional/emotional and discomfort/enhancement related). Differences in motivations as a function of age, national background, and women's vs. surgeons' stated motivations were tested. Results Emotional discomfort regarding self-appearance and social and sexual relationships was found to be the most frequent and most prominent motivation for considering labial reduction surgery on women's online communities, regardless of age and national background. Functional discomfort and desired emotional enhancement ranked second. Very few age or national differences were found. The surgeons' websites recognized functional discomfort more and elaborated upon emotional issues in sexual relationships less than members of the online communities. Conclusions Feelings of emotional and psychosexual distress in addition to functional distress are a highly prevalent motivation among women considering labial reduction surgery. Emotional distress appears to be greater and more freely emphasized when women communicate on online communities, while functional issues appear to receive greater notice on surgery provider's websites. Zwier S. “What motivates her”: Motivations for considering labial reduction surgery as recounted on women's online communities and surgeons' websites. Sex Med 2014;2:16–23. PMID:25356297

Body image in women with primary and secondary provoked vestibulodynia: a controlled study.

PubMed

Maillé, Delphine L; Bergeron, Sophie; Lambert, Bernard

2015-02-01

Provoked vestibulodynia (PVD) is a women's genito-pelvic pain condition associated with psychosexual impairments, including depression. Body image (BI) has been found to be different in women with primary (PVD1) and secondary (PVD2) PVD. No controlled study has compared BI in women with PVD1 and PVD2 and investigated its associations with sexual satisfaction, sexual function, and pain. The aims of this study were to (i) compare BI in women with PVD1, PVD2, and asymptomatic controls and (ii) to examine associations between BI and sexual satisfaction, sexual function, and pain during intercourse in women with PVD. Fifty-seven women (20 with PVD1, 19 with PVD2, and 18 controls) completed measures of BI, sexual satisfaction, sexual function, pain during intercourse, and depression. The main outcome measures were (i) Global Measure of Sexual Satisfaction Scale, (ii) Female Sexual Function Index, and (iii) pain numerical rating scale. Controlling for depression, women with PVD1 reported more body exposure anxiety during sexual activities than women with PVD2 and controls F(2,51)=4.23, P=0.02. For women with PVD, more negative BI during sexual activities was associated with lower sexual satisfaction (β=-0.45, P=0.02) and function (β=-0.39, P=0.04) and higher pain during intercourse (β=0.59, P=0.004). More positive body esteem was associated with higher sexual function (β=0.34, P=0.05). Findings suggest that women with PVD1 present more body exposure anxiety during sexual activities than women with PVD2 and asymptomatic women. Body esteem and general attitudes toward women's genitalia were not significantly different between groups. Higher body exposure anxiety during sexual activities was associated with poorer sexual outcomes in women with PVD. Further studies assessing interventions targeting BI during sexual activities in this population are needed, as improving BI during sexual interactions may enhance sexual outcomes in women with PVD. © 2014 International Society for Sexual Medicine.

Do romantic partners' responses to entry dyspareunia affect women's experience of pain? The roles of catastrophizing and self-efficacy.

PubMed

Lemieux, Ashley J; Bergeron, Sophie; Steben, Marc; Lambert, Bernard

2013-09-01

Entry dyspareunia is a sexual health concern which affects about 21% of women in the general population. Characterized by pain provoked during vaginal penetration, introital dyspareunia has been shown by controlled studies to have a negative impact on the psychological well-being, sexual function, sexual satisfaction, and quality of life of afflicted women. Many cognitive and affective variables may influence the experience of pain and associated psychosexual problems. However, the role of the partner's cognitive responses has been studied very little. The aim of the present study was to examine the associations between partners' catastrophizing and their perceptions of women's self-efficacy at managing pain on one side and women's pain intensity, sexual function, and sexual satisfaction on the other. One hundred seventy-nine heterosexual couples (mean age for women = 31, SD = 10.0; mean age for men = 33, SD = 10.6) in which the woman suffered from entry dyspareunia participated in the study. Both partners completed quantitative measures. Women completed the Pain Catastrophizing Scale and the Painful Intercourse Self-Efficacy Scale. Men completed the significant-other versions of these measures. Dependent measures were women's responses to (i) the Pain Numeric Visual Analog Scale; (ii) the Female Sexual Function Index; and (iii) the Global Measure of Sexual Satisfaction scale. Controlled for women's pain catastrophizing and self-efficacy, results indicate that higher levels of partner-perceived self-efficacy and lower levels of partner catastrophizing are associated with decreased pain intensity in women with entry dyspareunia, although only partner catastrophizing contributed unique variance. Partner-perceived self-efficacy and catastrophizing were not significantly associated with sexual function or satisfaction in women. The findings suggest that partners' cognitive responses may influence the experience of entry dyspareunia for women, pointing toward the importance of considering the partner when treating this sexual health problem. © 2013 International Society for Sexual Medicine.

Applying extender devices in patients with penile dysmorphophobia: assessment of tolerability, efficacy, and impact on erectile function.

PubMed

Nowroozi, Mohammad Reza; Amini, Erfan; Ayati, Mohsen; Jamshidian, Hassan; Radkhah, Kayvan; Amini, Shahab

2015-05-01

Most men seeking penile enhancement techniques have a normal penile size. They are either misinformed or suffer from penile dysmorphophobia and should be discouraged from undergoing invasive procedures. Less invasive techniques including penile extenders are not associated with major complications and may be beneficial from a psychological perspective. We conducted this study to assess the efficacy and safety of AndroPenis (Andromedical, Madrid, Spain) penile extender. Between December 2010 and December 2013, 163 men presented to our institution complaining of small penile length and/or girth. All patients received structured psychosexual counseling. Fifty-four patients were willing to use the AndroPenis penile extender after counseling. Patients with major psychiatric disorders were excluded from enrollment. The patients were instructed to wear the device between 4 and 6 hours per day for 6 months. Penile dimensions including flaccid stretched and erected lengths were measured at baseline and after 1, 3, 6, and 9 months. Erectile function was assessed at baseline and 9 months after treatment using the simplified International Index of Erectile Function (IIEF-5). An institutional nonstandardized questionnaire was used to evaluate patient satisfaction at the end of study. Penile length and girth enhancement as well as satisfaction rate and improvement in erectile function were assessed during follow-up. At 6-month follow-up, a mean gain of 1.7 ± 0.8, 1.3 ± 0.4, and 1.2 ± 0.4 cm was noted for the flaccid, stretched, and erected penile lengths, respectively (all P values < 0.001). During the off treatment period, there were no significant changes in penile lengths. No effect on penile girth was observed. Patient satisfaction survey revealed modest satisfaction. From 13 patients with mild baseline erectile dysfunction, nine patients reported normal erectile function after 9 months. Penile extender as a minimally invasive technique is safe and provides modest benefits and patient satisfaction. © 2015 International Society for Sexual Medicine.

Female sexual arousal disorder with and without a distress criterion: prevalence and correlates in a representative Czech sample.

PubMed

Weiss, Petr; Brody, Stuart

2009-12-01

Sexual medicine would benefit from large representative surveys examining the prevalence of genital female sexual arousal disorder (FSAD) symptoms (with and without the increasingly controversial distress criterion), as well as novel FSAD correlates and potential "protective" factors. To examine the extent to which genital FSAD symptoms, with and without a distress criterion, are associated with both historical and current aspects of sexual behavior. In a representative sample of the Czech population (aged 15-88), 1,000 women were asked whether they currently have impaired lubrication and vaginal swelling (and if so, if this produces marked distress or interpersonal difficulty). They provided details of vaginal orgasm (induced by penile-vaginal intercourse [PVI] without clitoral masturbation) consistency, feelings during their first PVI, estimates of their typical foreplay and PVI durations, their degree of mental focus on vaginal sensations during PVI, among other factors. The current prevalence of FSAD with and without a distress criterion and their associations with current and antecedent sexual behaviors and responses. The current prevalence of FSAD was 10.3% without, plus 7.5% with a distress criterion (which tended to be associated with more impairments than without distress). History of vaginal orgasm (odds ratio = 2.78), never masturbating (odds ratio = 2.4), not having felt pain and discomfort on first PVI (odds ratio = 2.27), and not having frequent anal intercourse are protective against FSAD with distress, but not without distress. Age (especially over 50) and inadequate focusing of mental attention on vaginal sensations during PVI are associated with increased FSAD risk both with and without distress. FSAD with and without distress appear to be different entities to some extent, with the distressed group showing more long-term signs of psychosexual impairment. We suggest that FSAD with and without distress be considered two different disorders.

Rationale of combination therapy with antioxidants in medical management of Peyronie’s disease: results of clinical application

PubMed Central

Paulis, Gianni; Paulis, Andrea; Romano, Gennaro; Barletta, Davide; Fabiani, Andrea

2017-01-01

Peyronie’s disease (PD) is a connective tissue disorder involving the tunica albuginea of the corpora cavernosa of the penis. We have published several studies describing a “combined therapy” for PD patients, but the present study aims to clearly demonstrate how the association between various antioxidants in PD treatment can significantly increase the likelihood of therapeutic success. We used the following substances: silymarin, ginkgo biloba, vitamin E, bilberry, topical diclofenac sodium, and pentoxifylline (PTX). We analyzed the therapeutic impact and possible side effects of one or more antioxidants in patients with early-stage PD. To clearly prove that it is possible to achieve better results when combining more than one agent, we designed this study with five treatment groups, corresponding, respectively, to the administration of a single oral antioxidant; two oral antioxidants; three oral antioxidants; five oral antioxidants + local diclofenac; and five oral antioxidants + local diclofenac + PTX by perilesional injection. One hundred and twenty patients were assigned to five groups of treatment designed according to the abovementioned study aim. Outcomes after 6 months of treatment showed that combined antioxidant therapy is effective in treating PD. Statistical analysis showed significant differences between the treatment groups with regard to: improvement and disappearance of penile pain; percentage of reduction in the volume of penile plaque; reduction in penile curvature; recovery of erectile function in patients with erectile dysfunction; increase in the International Index of Erectile Function score; and reduction of psychosexual impact. Furthermore, we observed that the clinical efficacy of combined therapy is greater when topical use of diclofenac gel and perilesional injection of PTX are added to oral treatment with more than one antioxidant. Although several articles have already been published reporting the effectiveness of combined treatment in PD, this is the first study clearly proving how, as the number of substances used in treatment rises, a proportionally greater therapeutic effect is achieved. PMID:28791261

The quality of life of patients with genital warts: a qualitative study

PubMed Central

2010-01-01

Background Genital warts, which are caused by infection with human papillomavirus (HPV), are one of the most common sexually transmitted diseases in Europe. Although genital warts are commonly perceived as a non-serious condition, treatment is often long, of varying effectiveness and the recurrence rate is high. Very few studies have been performed on the personal consequences of genital warts. The aim of this qualitative study, set in Denmark, was to examine the ways in which genital warts may affect patients' quality of life. Methods To obtain an in-depth understanding of patients' perceptions of genital warts, we used qualitative focus-group interviews with five men and five women aged between 18 and 30 years who had genital warts. The interview guide was based on a literature review that identified important issues and questions. The data were analysed using a medical anthropological approach. Results Patients' experiences were related to cultural conceptions of venereal diseases and the respective identities and sexuality of the sexes. The disease had negative psychological and social effects both for men and for women and it affected their sex and love lives, in particular. The psychological burden of the disease was increased by the uncertain timeline and the varying effectiveness of treatment. We identified a need for more patient information about the disease and its psycho-sexual aspects. Conclusions The men and women participating in this study considered their quality of life to be significantly lowered because of genital warts. The experiences described by the participants give insights that may be valuable in treatment and counselling. The quadrivalent HPV vaccine that has now been added to the childhood vaccination programme for girls in Denmark for the prevention of cervical cancer can also prevent 90% of cases of genital warts. Our results suggest that HPV vaccination could considerably reduce the largely unacknowledged psychological and social burden associated with genital warts, in men as well as women. PMID:20205944

Interventions for vaginismus.

PubMed

Melnik, Tamara; Hawton, Keith; McGuire, Hugh

2012-12-12

Vaginismus is an involuntary contraction of the vaginal muscles which makes sexual intercourse difficult or impossible. It is one of the more common female psychosexual problems. Various therapeutic strategies for vaginismus, such as sex therapy and desensitisation, have been proposed, and uncontrolled case series appear promising. To assess the effects of different interventions for vaginismus. We searched the Cochrane Depression, Anxiety and Neurosis Group's Specialised Register (CCDANCTR-Studies and CCDANCTR-References) to August 2012. This register contains relevant randomised controlled trials from: The Cochrane Library (all years), EMBASE (1974 to date), MEDLINE (1950 to date) and PsycINFO (1967 to date). We searched reference lists and conference abstracts. We contacted experts in the field regarding unpublished material. Controlled trials comparing treatments for vaginismus with another treatment, a placebo treatment, treatment as usual or waiting list control. The review authors extracted data which we verified with the trial investigator where possible. Five studies were included, of which four with a total of 282 participants provided data. No meta-analysis was possible due to heterogeneity of comparisons within included studies as well as inadequate reporting of data. All studies were considered to be at either moderate or high risk of bias. The results of this systematic review indicate that there is no clinical or statistical difference between systematic desensitisation and any of the control interventions (either waiting list control, systematic desensitisation combined with group therapy or in vitro (with women under instruction by the therapist) desensitisation) for the treatment of vaginismus. The drop-out rates were higher in the waiting list groups. A clinically relevant effect of systematic desensitisation when compared with any of the control interventions cannot be ruled out. None of the included trials compared other behaviour therapies (e.g. cognitive behaviour therapy, sex therapy) to pharmacological interventions. The findings are limited by the evidence available and as such conclusions about the efficacy of interventions for the treatment of vaginismus should be drawn cautiously.

The quality of life of patients with genital warts: a qualitative study.

PubMed

Mortensen, Gitte Lee; Larsen, Helle K

2010-03-07

Genital warts, which are caused by infection with human papillomavirus (HPV), are one of the most common sexually transmitted diseases in Europe. Although genital warts are commonly perceived as a non-serious condition, treatment is often long, of varying effectiveness and the recurrence rate is high. Very few studies have been performed on the personal consequences of genital warts. The aim of this qualitative study, set in Denmark, was to examine the ways in which genital warts may affect patients' quality of life. To obtain an in-depth understanding of patients' perceptions of genital warts, we used qualitative focus-group interviews with five men and five women aged between 18 and 30 years who had genital warts. The interview guide was based on a literature review that identified important issues and questions. The data were analysed using a medical anthropological approach. Patients' experiences were related to cultural conceptions of venereal diseases and the respective identities and sexuality of the sexes. The disease had negative psychological and social effects both for men and for women and it affected their sex and love lives, in particular. The psychological burden of the disease was increased by the uncertain timeline and the varying effectiveness of treatment. We identified a need for more patient information about the disease and its psycho-sexual aspects. The men and women participating in this study considered their quality of life to be significantly lowered because of genital warts. The experiences described by the participants give insights that may be valuable in treatment and counselling.The quadrivalent HPV vaccine that has now been added to the childhood vaccination programme for girls in Denmark for the prevention of cervical cancer can also prevent 90% of cases of genital warts. Our results suggest that HPV vaccination could considerably reduce the largely unacknowledged psychological and social burden associated with genital warts, in men as well as women.

A historical appraisal of America's experience with "pyromania"--a diagnosis in search of a disorder.

PubMed

Geller, J L; Erlen, J; Pinkus, R L

1986-01-01

When "pyromania" from 1840-1890 is reviewed, it stands out as a concept that at first found favor in an era of moral insanity and moral treatment. During this period pyromania was variously labeled as a form of monomania, moral insanity, impulsive mania, or instinctive mania. As early as 1850, and clearly after the Civil War, however, controversial arguments regarding the locus of personal responsibilty emerged. Arguments were put forward that there could be diseased brains but not diseased minds. Without the proof of an organic lesion in the brain, fire-setting became an act whose locus rested in the individual's moral fabric, and in this historical context became a nonmedical concern punishable by law. Pyromania, at the hands of those physicians who limited insanity to disorders of the brain, might have received the same fate as other diseases of the mind or will: it could have simply been dismissed. But it lingered. The period 1880-1917 witnessed professional attention directed toward prophylaxis, mental hygiene, and a reorientation of American psychiatry toward an endorsement of psychotherapy (Sicherman, 1980). Attention to pyromania was more quiescent than it had been. The development of psychoanalytic theory which followed allowed for the re-emergence of pyromania as a disease entity. The diagnosis then flourished from 1924 until 1957, with descriptions of it including: an irresistible impulse, a urethra-erotic character trait, an obsession, or a psychosexually based impulse neurosis. The period of 1924-1985 can be viewed as a repetition of the period between 1840-1890 in terms of the evolution of the place of pyromania in the lexicon of psychiatry, of its existence as a disease entity, and of its implications for personal responsibility for destructive acts. Supported at the outset of this later period as a disease, this time grounded in psychoanalytic rather than moral theories of responsibility, it loses favor as the psychobiologic position ascends. And like the preceding period, the conception of pyromania as a specific disorder wanes but never dies, as advocacy for the psychodynamic (replacing moral) approach diminishes but does not disappear. The cyclical nature of pyromania has parallels in cycles of reform in standards of civil commitment (Livermore, Malmquist & Meehl, 1958; Dershowitz, 1974), in the use of physical therapies and medications (Tourney, 1967; Mora, 1974), in treatment of the chronically mentally ill (Deutsch, 1949; Morrissey & Goldman, 1984), and in institutional practices (Treffert, 1967; Morrissey, Goldman & Klerman (1980).(ABSTRACT TRUNCATED AT 400 WORDS)

[Eating disorders and sexual function].

PubMed

Kravvariti, V; Gonidakis, Fr

2016-01-01

Women suffering from eating disorders, present considerable retardation and difficulties in their psychosexual development during adolescence. This leads to primary or secondary insufficiencies in their adult sexual life. The cause of these difficulties seems to be a series of biological, family and psychosocial factors. The majority of the research findings indicate that eating disorders have a negative impact on the patient's sexual function. The factors related to eating disorders symptomatology that influence sexuality are various and differ among each eating disorder diagnostic categories. Considering anorexia nervosa, it has been reported that women have negative attitudes to sexual issues and their body. Their sexual motivation increases when they engage in psychotherapy and their body weight is gradually restored. Starvation and its consequences on the human physiology and especially on the brain function seem to be the main factor that leads to reduced sexual desire and scarce sexual activity. Moreover, personality traits that are common in patients suffering from anorexia nervosa such as compulsivity and rigidity are also related with difficulties initiating and retaining romantic and sexual relationships. Usually patients suffering from anorexia nervosa report impaired sexual behavior and lack of interest to engage in a sexual relationship. Considering Bulimia Nervosa, impulsivity and difficulties in emotion regulation that are common features of the individuals that suffer from bulimia nervosa are also related to impulsive and sometimes self-harming sexual behaviors. Moreover women sufferers often report repulsion, anger and shame towards their body and weight, mainly due to the distorted perception that they are fat and ugly. It is interesting that a number of research findings indicate that although patients suffering from bulimia nervosa are more sexually active and have more sexual experiences than patients suffering from anorexia nervosa, both groups of patients report more often than general population a lack of satisfaction from their sexual experiences. Other factors that are common to eating disorders and sexual dysfunction are personality traits, negative body-image, adverse childhood experiences, negative family climate and especially early traumatic experiences such as sexual abuse. Furthermore, comorbidity of eating disorders with depression may have a negative impact on the patient's sexual function. The treatment and improvement of sexual behavior is quite problematic when the patient is also suffering from an eating disorder. Eating Disorder patients are often very reluctant to discuss their sexual life with the therapist and to engage in any kind of therapeutic intervention. Comorbidity with a number of other disorders makes psychotherapy even more difficult for those patients. Furthermore, a considerable percentage of Anorexia Nervosa patients do not have any kind of sexual activity, at least until nutrition and weight are restored.

Addressing sexual dysfunction after risk-reducing salpingo-oophorectomy: effects of a brief, psychosexual intervention.

PubMed

Bober, Sharon L; Recklitis, Christopher J; Bakan, Jennifer; Garber, Judy E; Patenaude, Andrea F

2015-01-01

Women at high risk for ovarian cancer due to BRCA1 or BRCA2 mutation or family history are recommended to undergo risk-reducing salpingo-oophorectomy (RRSO) after age 35 or completion of childbearing. This potentially life-saving surgery leads to premature menopause, frequently resulting in distressing and unaddressed sexual dysfunction. To pilot a novel sexual health intervention for women with BRCA1/2 mutations who previously underwent RRSO a using a single-arm trial. Feasibility and primary outcomes including sexual dysfunction and psychological distress were assessed. This single-arm trial included a one-time, half-day educational session comprised of targeted sexual health education, body awareness and relaxation training, and mindfulness-based cognitive therapy strategies, followed by two sessions of tailored telephone counseling. Assessments were completed at baseline and 2 months postintervention. Study end points include feasibility and effectiveness as reported by the participant. Thirty-seven women completed baseline and postintervention assessments. At baseline, participants had a mean age of 44.4 (standard deviation [SD] = 3.9) years and mean duration of 3.8 (SD = 2.7) years since RRSO. Overall sexual functioning (P = 0.018), as well as desire (P = 0.003), arousal (P = 0.003), satisfaction (P = 0.028), and pain (P = 0.018), improved significantly. There were significant reductions in somatization (P = 0.029) and anxiety scores (P < 0.001), and, overall, for the Global Severity Index (P < 0.001) of the Brief Symptom Inventory. Sexual self-efficacy and sexual knowledge also improved significantly from baseline to postintervention (both P < 0.001). Women were highly satisfied with the intervention content and reported utilizing new skills to manage sexual dysfunction. This intervention integrates elements of cognitive behavioral therapy with sexual health education to address a much-neglected problem after RRSO. Results from this promising single-arm study provide preliminary data to move toward conducting a randomized, controlled trial. © 2014 International Society for Sexual Medicine.

Vaginal and Sexual Health Treatment Strategies within a Female Sexual Medicine Program for Cancer Patients and Survivors

PubMed Central

Carter, Jeanne; Stabile, Cara; Seidel, Barbara; Baser, Raymond E.; Goldfarb, Shari; Goldfrank, Deborah J.

2016-01-01

Purpose We sought to evaluate patient adherence and response to simple vaginal and sexual health treatment strategies in female cancer patients receiving treatment at a female sexual medicine and health program, and identify improvements of physical symptoms, per patient and clinical evaluation. Methods Evalubility criteria included gynecologic exam at initial visit; at least one follow-up with gynecologic exam within 8 months of initial visit; and all consecutive follow-ups <6 months apart. Demographics, medical information, and clinical assessments from 175 evaluable patients with at least 1 follow-up from 09/12–10/14 were analyzed. The majority of patients were being treated for or had a history of breast (n=90, 53%), gynecologic (n=54, 32%), or colorectal/anal (n=15, 9%) cancers. An assessment form included a clinician evaluation, Vaginal Assessment Scale (VAS), Vulvar Assessment Scale (VuAS), and patient-reported outcomes. Compliance with treatment recommendations were summarized, and changes over time were compared for clinical outcomes. Results Mean number of visits was 3.43. Mean age was 55.4 years; 92% (n=155/169) were in menopause. Treatment strategies included rationale and instruction for use of vaginal moisturizers, lubricants, pelvic floor exercises and dilator therapy, in addition to psychosexual education regarding sexual changes (response, anatomy and function) associated with cancer treatment and support. At last assessment, 89% had complied with the clinical recommendation (moisturize 2–5+ times/week). Vaginal pH scores >6.5 declined over time (p=0.03). VAS scores improved by last assessment (p<0.001), as did VuAS scores (p=0.001). Sexual function scores significantly improved (p<0.001), confidence about future sexual activity increased (p=0.004), and sexual/vaginal health concerns decreased (p=0.00003). Conclusion Significant changes were observed in women using treatment strategies, with improvement in vulvovaginal symptoms, a decrease in elevated vaginal pH and pain with exams, enhanced sexual function, and intimacy confidence. Implications for Cancer Survivors These findings have high clinical relevance for symptom management with improvement of sexual function using simple strategies and clinical tools in the oncology setting. PMID:27868156

The mothering experience of women with FGM/C raising 'uncut' daughters, in Ivory Coast and in Canada.

PubMed

Koukoui, Sophia; Hassan, Ghayda; Guzder, Jaswant

2017-04-05

While Female Genital Cutting (FGM/C) is a deeply entrenched cultural practice, there is now mounting evidence for a gradual decline in prevalence in a number of geographical areas in Africa and following migration to non-practicing countries. Consequently, there is now a growing number of women with FGM/C who are raising 'uncut' daughters. This study used a qualitative methodology to investigate the experience of women with FGM/C raising daughters who have not been subjected to the ritual. The aim of this study was to shed light on mothers' perception of the meaning and cultural significance of the practice and to gain insight into their mothering experience of 'uncut' girls. To this end, in-depth interviews were conducted with fifteen mothers living in Abidjan, Ivory Coast and in Montreal, Canada (8 and 7, respectively). Thirteen mothers intrinsically refused to perpetuate FGM/C onto their daughters and two diasporic mothers were in favour of FGM/C but forewent the practice for fear of legal repercussions. Whether the eschewing of FGM/C was deliberate or legally imposed, raising 'uncut' daughters had significant consequences in terms of women's mothering experiences. Mothers faced specific challenges pertaining to community and family pressure to have daughters undergo FGM/C, and expressed concerns regarding their daughters' sexuality. Conversely, women's narratives were also infused with pride and hope for their daughters, and revealed an accrued dialogue between the mother-daughter dyad about cultural norms and sexuality. Interestingly, women's mothering experience was also bolstered by the existence of informal networks of support between mothers with FGM/C whose daughters were 'uncut'. These communities of mothers engaged in open dialogue about the consequences of FGM/C and offered reciprocal solidarity and support in their decision to forego FGM/C for their children. Women with FGM/C who are raising 'uncut' daughters in their homeland and in their country of immigration vastly report a positive experience. However, they also face specific challenges related to immigration, psychosocial, and psychosexual considerations, which must be tackled from a multidisciplinary perspective.

Living with genital pain: Sexual function, satisfaction, and help-seeking among women living in Sweden.

PubMed

Thomtén, Johanna

2017-12-29

Background and aims Female genital pain is a debilitating problem that negatively affects several aspects of the life of women. Several studies present figures of prevalence indicating that the problem affects nearly 20% of young women. However, many women fail to consult health care and the estimated prevalence therefore remains insecure. Historically, genital pain was commonly viewed as either physiological or psychosexual. Although the current field of research and clinical expertise in general agree upon a biopsychosocial conceptualization, less is known about the manifestation of the problem in everyday life and the experience of seeking health care among afflicted women. The objectives of the present study was to examine genital pain in a general female population living in Sweden cross-sectionally in terms of prevalence, sexual function, sexual satisfaction and help seeking, and to identify possible predictors of genital pain among women. Methods The study was a population-based study using a postal questionnaire administered to 4052 women (age 18--35). Of these 944 (response rate: 23%) took part in the study. Results Genital pain of six months duration was reported by 16.1% of the women. Women with pain more commonly reported fungal infections, other pain problems, sexual dysfunctions and symptoms of anxiety than pain-free women and in addition lower sexual satisfaction. There were no differences in sexual frequency. Pain was most commonly reported during sexual intercourse, but many women also experienced pain during non-sexual activities, with pain durations of several hours after the pain eliciting activity was interrupted. Of those reporting pain, 50% had sought care for their pain. The most common was to counsel a doctor and to receive topical treatment. However, the experienced effects of the treatments were on average low. In the explanatory model, fungal infections, and sexual dysfunctions were associated with genital pain. Conclusions The study had a low response rate, but still indicates that genital pain is common and negatively affects several aspects of women' life, not just sexual activities. Although many women report pro-longed pain experiences, many fail to consult health care and among those who seek care the effects of treatment are on average poor. There are strong associations between sexual dysfunctions (lack of sexual arousal, vaginal muscle tension hindering intercourse) and genital pain that, based on previous findings in this field of research, might be viewed in terms of circular maintaining processes. Implications Female genital pain is not just limited to the sexual context, but often negatively affects several situations in women' life. The size of the problem calls for immediate development of preventive interventions and treatment programs that focus on sexual education and to encourage a healthy sexuality among women and their partners. There is a need to identify methods in order to assemble evidence based interventions of female genital pain. Such methods are currently lacking, resulting in poor treatment options for women with pain.

Surgical interventions for high grade vulval intraepithelial neoplasia

PubMed Central

Kaushik, Sonali; Pepas, Litha; Nordin, Andy; Bryant, Andrew; Dickinson, Heather O

2014-01-01

Background Vulval intraepithelial neoplasia (VIN) is a pre-malignant condition of the vulval skin. This uncommon chronic skin condition of the vulva is associated with a high risk of recurrence and the potential to progress to vulval cancer. The condition is complicated by its’ multicentric and multifocal nature. The incidence of this condition appears to be rising particularly in the younger age group. There is a lack of consensus on the optimal surgical treatment method. However, the rationale for surgical treatment of VIN has been to treat symptoms and exclude underlying malignancy with the continued aim of preservation of vulval anatomy and function. Repeated treatments affect local cosmesis and cause psychosexual morbidity thus impacting on the patients’ quality of life. Objectives To evaluate the effectiveness and safety of surgical interventions for high grade VIN. Search methods We searched the Cochrane Central Register of Controlled Trials (CENTRAL), Issue 3, 2010, Cochrane Gynaecological Cancer Group Trials Register, MEDLINE and EMBASE up to September 2010. We also searched registers of clinical trials, abstracts of scientific meetings, reference lists of included studies and contacted experts in the field. Selection criteria Randomised controlled trials (RCTs) that compared surgical interventions, in adult women diagnosed with high grade vulval intraepithelial neoplasia. Data collection and analysis Two review authors independently abstracted data and assessed risk of bias. Main results We found only one RCT which included 30 women that met our inclusion criteria and this trial reported data on carbon dioxide laser (CO2 laser) versus ultrasonic surgical aspiration (USA). There was no statistically significant difference in the risk of disease recurrence after one year follow-up, pain, presence of scarring, dysuria or burning, adhesions, infection, abnormal discharge and eschar between women who received CO2 laser and those who received USA. The trial lacked statistical power due to the small number of women in each group and the low number of observed events, but was at low risk of bias. Authors’ conclusions The included trial lacked statistical power due to the small number of women in each group and the low number of observed events. Therefore in the absence of reliable evidence regarding the effectiveness and safety of the two surgical techniques for the management of vulval intraepithelial neoplasia precludes any definitive guidance or recommendations for clinical practice. PMID:21249698

Patterns and trends in sources of information about sex among young people in Britain: evidence from three National Surveys of Sexual Attitudes and Lifestyles.

PubMed

Tanton, Clare; Jones, Kyle G; Macdowall, Wendy; Clifton, Soazig; Mitchell, Kirstin R; Datta, Jessica; Lewis, Ruth; Field, Nigel; Sonnenberg, Pam; Stevens, Amy; Wellings, Kaye; Johnson, Anne M; Mercer, Catherine H

2015-03-05

To assess progress in meeting young people's sex education needs in Britain by examining the current situation and changes over the past 20 years in sources of information about sexual matters and unmet information needs. Cross-sectional probability sample surveys. British general population. 3869 men and women aged 16-24 years, interviewed 2010-2012 for the third National Survey of Sexual Attitudes & Lifestyles (Natsal-3), compared with 16-24 year-olds in Natsal-1 (1990-1991; 792 men and women) and Natsal-2 (1999-2001; 2673 men and women). Reported source of information about sexual matters, unmet information needs and preferred source of additional information. Between 1990 and 2012, the proportion citing school lessons as their main source of information about sexual matters increased from 28.2% (95% CI 24.6 to 32.1) to 40.3% (95% CI 38.6 to 42.1). In 2010-2012, parents were reported as a main source by only 7.1% (95% CI 5.8 to 8.7) of men and 14.1% (95% CI 12.6 to 15.7) of women and, for women, were less commonly reported than in 1999-2001 (21.7%; 95% CI 19.6 to 24.0). Most young people reported not knowing enough when they first felt ready for sexual experience (68.1% men, 70.6% women), and this did not change substantially over time. They wanted more information about psychosexual matters (41.6% men, 46.8% women), as well as sexually transmitted infections (27.8% men, 29.8% women) and, for women, contraception (27.5%). Young people primarily wanted this information from school, parents or health professionals. Over the past 20 years, young people have increasingly identified school lessons as their main source of information about sex, although they continue to report needing more information on a broad range of topics. The findings support the expressed need for improved sex and relationships education in schools alongside greater involvement of parents and health professionals. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Bibliometric analysis of literature on female genital mutilation: (1930 - 2015).

PubMed

Sweileh, Waleed M

2016-10-10

Female genital mutilation/cutting (FGM/C) is a common harmful traditional practice in many communities in Africa and to a lesser extent in Middle East and other regions in the world. In order to better understand publishing on this topic, we conducted a bibliometric study on FGM/C. Bibliometric analyses can be used as an indicator of the extent of interaction of researchers, health authorities, and communities with a particular health issue. Scopus database was used to retrieve data on FGM/C. Keywords used were "female genital mutilation", "female genital circumcision", "female genital cutting" and "female circumcision". Specifically, the number of publications, top productive countries and institutions, highly cited articles, citation analysis, co-authorships, international collaboration, role of African countries, top active authors, and journals involved in publishing articles on FGM/C were reviewed and analyzed. We indirectly assessed the impact of publications using total number of citations received, average number of citations per article, Hirsch-index, percentage of highly cited articles, and journal's impact factor. One thousand and thirty-five publications on FGM/C were retrieved. The h-index of retrieved articles was 37. A steep rise in number of publications was noticed in mid-1990s and again in 2012. More than half of retrieved articles were published from 2006 - 2015. A total of 65 countries contributed. The top ten productive countries included ones from Northern America, Europe and Africa. Nigeria and Egypt were the most active African countries in FGM/C publications. At least nine African academic institutions were actively involved on FGM/C publications. Articles on FGM/C that received the highest number of citations were those that focused on negative physical and psychosexual consequences of FGM/C. Journal topic areas were obstetrics/gynecology, public health, and psychological sociology. Collaboration between African and European countries on FGM/C research was evident. Bibliometric analysis reveals that research publications on FGM/C have been increasing since the l970s, with collaboration between African and Western countries, and articles are being published in higher impact journals, not only obstetrics, but also public health and social sciences. FGM/C research can be helpful to international health agencies and governments not only to document negative outcomes, but also to identify best practices, and to note gaps in implementation and practice.

What do we know about assessing healthcare students and professionals' knowledge, attitude and practice regarding female genital mutilation? A systematic review.

PubMed

Abdulcadir, Jasmine; Say, Lale; Pallitto, Christina

2017-05-22

Improving healthcare providers' capacities of prevention and treatment of female genital mutilation (FGM) is important given the fact that 200 million women and girls globally are living with FGM. However, training programs are lacking and often not evaluated. Validated and standardized tools to assess providers' knowledge, attitude and practice (KAP) regarding FGM are lacking. Therefore, little evidence exists on the impact of training efforts on healthcare providers' KAP on FGM. The aim of our paper is to systematically review the available published and grey literature on the existing quantitative tools (e.g. scales, questionnaires) measuring healthcare students' and providers' KAP on FGM. We systematically reviewed the published and grey literature on any quantitative assessment/measurement/evaluation of KAP of healthcare students and providers about FGM from January 1 st , 1995 to July 12 th , 2016. Twenty-nine papers met our inclusion criteria. We reviewed 18 full text questionnaires implemented and administered to healthcare professionals (students, nurses, midwives and physicians) in high and low income countries. The questionnaires assessed basic KAP on FGM. Some included personal and cultural beliefs, past clinical experiences, personal awareness of available clinical guidelines and laws, previous training on FGM, training needs, caregiver's confidence in management of women with FGM, communication and personal perceptions. Identified gaps included the medical, psychological or surgical treatments indicated to improve girls and women's health; correct diagnosis, recording ad reporting capacities; clitoral reconstruction and psychosexual care of circumcised women. Cultural and personal beliefs on FGM were investigated only in high prevalence countries. Few questionnaires addressed care of children, child protection strategies, treatment of short-term complications, and prevention. There is a need for implementation and testing of interventions aimed at improving healthcare professionals' and students' capacities of diagnosis, care and prevention of FGM. Designing tools for measuring the outcomes of such interventions is a critical aspect. A unique, reproducible and standardized questionnaire could be created to measure the effect of a particular training program. Such a tool would also allow comparisons between settings, countries and interventions. An ideal tool would test the clinical capacities of providers in managing complications and communicating with clients with FGM as well as changes in KAP.

Obstetric outcomes for women with female genital mutilation at an Australian hospital, 2006-2012: a descriptive study.

PubMed

Varol, Nesrin; Dawson, Angela; Turkmani, Sabera; Hall, John J; Nanayakkara, Susie; Jenkins, Greg; Homer, Caroline S E; McGeechan, Kevin

2016-10-28

Women, who have been subjected to female genital mutilation (FGM), can suffer serious and irreversible physical, psychological and psychosexual complications. They have more adverse obstetric outcomes as compared to women without FGM. Exploratory studies suggest radical change to abandonment of FGM by communities after migration to countries where FGM is not prevalent. Women who had been subjected to FGM as a child in their countries of origin, require specialised healthcare to reduce complications and further suffering. Our study compared obstetric outcomes in women with FGM to women without FGM who gave birth in a metropolitan Australian hospital with expertise in holistic FGM management. The obstetric outcomes of one hundred and ninety-six women with FGM who gave birth between 2006 and 2012 at a metropolitan Australian hospital were analysed. Comparison was made with 8852 women without FGM who gave birth during the same time period. Data were extracted from a database specifically designed for women with FGM and managed by midwives specialised in care of these women, and a routine obstetric database, ObstetriX. The accuracy of data collection on FGM was determined by comparing these two databases. All women with FGM type 3 were deinfibulated antenatally or during labour. The outcome measures were (1) maternal: accuracy and grade of FGM classification, caesarean section, instrumental birth, episiotomy, genital tract trauma, postpartum blood loss of more than 500 ml; and (2) neonatal: low birth weight, admission to a special care nursery, stillbirth. The prevalence of FGM in women who gave birth at the metropolitan hospital was 2 to 3 %. Women with FGM had similar obstetric outcomes to women without FGM, except for statistically significant higher risk of first and second degree perineal tears, and caesarean section. However, none of the caesarean sections were performed for FGM indications. The ObstetriX database was only 35 % accurate in recording the correct FGM type. Women with FGM had similar obstetric outcomes to women without FGM in an Australian metropolitan hospital with expertise in FGM management. Specialised FGM services with clinical practice guideline and education of healthcare professionals may increase the detection rate of FGM and improve obstetric management of women with FGM.

Infertility etiologies are genetically and clinically linked with other diseases in single meta-diseases.

PubMed

Tarín, Juan J; García-Pérez, Miguel A; Hamatani, Toshio; Cano, Antonio

2015-04-15

The present review aims to ascertain whether different infertility etiologies share particular genes and/or molecular pathways with other pathologies and are associated with distinct and particular risks of later-life morbidity and mortality. In order to reach this aim, we use two different sources of information: (1) a public web server named DiseaseConnect ( http://disease-connect.org ) focused on the analysis of common genes and molecular mechanisms shared by diseases by integrating comprehensive omics and literature data; and (2) a literature search directed to find clinical comorbid relationships of infertility etiologies with only those diseases appearing after infertility is manifested. This literature search is performed because DiseaseConnect web server does not discriminate between pathologies emerging before, concomitantly or after infertility is manifested. Data show that different infertility etiologies not only share particular genes and/or molecular pathways with other pathologies but they have distinct clinical relationships with other diseases appearing after infertility is manifested. In particular, (1) testicular and high-grade prostate cancer in male infertility; (2) non-fatal stroke and endometrial cancer, and likely non-fatal coronary heart disease and ovarian cancer in polycystic ovary syndrome; (3) osteoporosis, psychosexual dysfunction, mood disorders and dementia in premature ovarian failure; (4) breast and ovarian cancer in carriers of BRCA1/2 mutations in diminished ovarian reserve; (5) clear cell and endometrioid histologic subtypes of invasive ovarian cancer, and likely low-grade serous invasive ovarian cancer, melanoma and non-Hodgkin lymphoma in endometriosis; and (6) endometrial and ovarian cancer in idiopathic infertility. The present data endorse the principle that the occurrence of a disease (in our case infertility) is non-random in the population and suggest that different infertility etiologies are genetically and clinically linked with other diseases in single meta-diseases. This finding opens new insights for clinicians and reproductive biologists to treat infertility problems using a phenomic approach instead of considering infertility as an isolated and exclusive disease of the reproductive system/hypothalamic-pituitary-gonadal axis. In agreement with a previous validation analysis of the utility of DiseaseConnect web server, the present study does not show a univocal correspondence between common gene expression and clinical comorbid relationship. Further work is needed to untangle the potential genetic, epigenetic and phenotypic relationships that may be present among different infertility etiologies, morbid conditions and physical/cognitive traits.

Vaginal and sexual health treatment strategies within a female sexual medicine program for cancer patients and survivors.

PubMed

Carter, Jeanne; Stabile, Cara; Seidel, Barbara; Baser, Raymond E; Goldfarb, Shari; Goldfrank, Deborah J

2017-04-01

We sought to evaluate patient adherence and response to simple vaginal and sexual health treatment strategies in female cancer patients receiving treatment at a female sexual medicine and health program and identify improvements of physical symptoms, per patient and clinical evaluation. Evaluability criteria included gynecologic exam at initial visit, at least one follow-up with gynecologic exam within 8 months of initial visit, and all consecutive follow-ups <6 months apart. Demographics, medical information, and clinical assessments from 175 evaluable patients with at least one follow-up from 09/12 to 10/14 were analyzed. The majority of patients were being treated for or had a history of breast (n = 90, 53 %), gynecologic (n = 54, 32 %), or colorectal/anal (n = 15, 9 %) cancers. An assessment form included a clinician evaluation, Vaginal Assessment Scale (VAS), Vulvar Assessment Scale (VuAS), and patient-reported outcomes. Compliance with treatment recommendations were summarized, and changes over time were compared for clinical outcomes. Mean number of visits was 3.43. Mean age was 55.4 years; 92 % (n = 155/169) were in menopause. Treatment strategies included rationale and instruction for use of vaginal moisturizers, lubricants, pelvic floor exercises, and dilator therapy, in addition to psychosexual education regarding sexual changes (response, anatomy, and function) associated with cancer treatment and support. At last assessment, 89 % had complied with the clinical recommendation (moisturize 2-5+ times/week). Vaginal pH scores >6.5 declined over time (p = 0.03). VAS scores improved by last assessment (p < 0.001), as did VuAS scores (p = 0.001). Sexual function scores significantly improved (p < 0.001), confidence about future sexual activity increased (p = 0.004), and sexual/vaginal health concerns decreased (p = 0.00003). Significant changes were observed in women using treatment strategies, with improvement in vulvovaginal symptoms, a decrease in elevated vaginal pH and pain with exams, enhanced sexual function, and increased intimacy confidence. These findings have high clinical relevance for symptom management with improvement of sexual function using simple strategies and clinical tools in the oncology setting.

Psychosexual therapy for delayed ejaculation based on the Sexual Tipping Point model.

PubMed

Perelman, Michael A

2016-08-01

The Sexual Tipping Point(®) (STP) model is an integrated approach to the etiology, diagnosis and treatment of men with delayed ejaculation (DE), including all subtypes manifesting ejaculatory delay or absence [registered trademark owned by the MAP Educational Fund, a 501(c)(3) public charity]. A single pathogenetic pathway does not exist for sexual disorders generally and that is also true for DE specifically. Men with DE have various bio-psychosocial-behavioral & cultural predisposing, precipitating, maintaining, and contextual factors which trigger, reinforce, or worsen the probability of DE occurring. Regardless of the degree of organic etiology present, DE is exacerbated by insufficient stimulation: an inadequate combination of "friction and fantasy". High frequency negative thoughts may neutralize erotic cognitions (fantasy) and subsequently delay, ameliorate, or inhibit ejaculation, while partner stimulation (friction) may prove unsatisfying. Assessment requires a thorough sexual history including inquiry into masturbatory methods. Many men with DE engage in an idiosyncratic masturbatory style, defined as a masturbation technique not easily duplicated by the partner's hand, mouth, or vagina. The clinician's most valuable diagnostic tool is a focused sex history (sex status). Differentiate DE from other sexual problems and review the conditions under which the man can ejaculate. Perceived partner attractiveness, the use of fantasy during sex, anxiety-surrounding coitus and masturbatory patterns require meticulous exploration. Identify important DE causes by juxtaposing an awareness of his cognitions and the sexual stimulation experienced during masturbation, versus a partnered experience. Assist the man in identifying behaviors that enhance immersion in excitation and minimize inhibiting thoughts, in order to reach ejaculation in his preferred manner. Discontinuing, reducing or altering masturbation is often required, which evokes patient resistance. Coaching tips are offered on how to ensure adherence to this suspension, manage resistance and facilitate success. Depending on motivation level, masturbation interruption may be compromised and negotiated. Encourage a man who continues to masturbate to alter style ("switch hands") and to approximate the stimulation likely to be experienced with his partner. Success will require most men to be taught to learn bodily movements and fantasies that approximate the thoughts and sensations experienced in masturbation. Fertility issues, as well as patient/partner anger are important causational factors, which often require individual and/or conjoint consultation. Drug treatment would benefit men particularly with severe DE, regardless of concomitant psychosocial-behavioral and cultural complications. When and if a safe effective medication for DE becomes available, this author's transdisciplinary perspective supports appropriate medication use when integrated with counseling. This approach emphasizes the utility of a biopsychosocial-cultural perspective combined with special attention to the patient's narrative. Treatment is patient-centered, holistic and integrates a variety of therapies as needed.

Psychosexual therapy for delayed ejaculation based on the Sexual Tipping Point model

PubMed Central

2016-01-01

The Sexual Tipping Point® (STP) model is an integrated approach to the etiology, diagnosis and treatment of men with delayed ejaculation (DE), including all subtypes manifesting ejaculatory delay or absence [registered trademark owned by the MAP Educational Fund, a 501(c)(3) public charity]. A single pathogenetic pathway does not exist for sexual disorders generally and that is also true for DE specifically. Men with DE have various bio-psychosocial-behavioral & cultural predisposing, precipitating, maintaining, and contextual factors which trigger, reinforce, or worsen the probability of DE occurring. Regardless of the degree of organic etiology present, DE is exacerbated by insufficient stimulation: an inadequate combination of “friction and fantasy”. High frequency negative thoughts may neutralize erotic cognitions (fantasy) and subsequently delay, ameliorate, or inhibit ejaculation, while partner stimulation (friction) may prove unsatisfying. Assessment requires a thorough sexual history including inquiry into masturbatory methods. Many men with DE engage in an idiosyncratic masturbatory style, defined as a masturbation technique not easily duplicated by the partner’s hand, mouth, or vagina. The clinician’s most valuable diagnostic tool is a focused sex history (sex status). Differentiate DE from other sexual problems and review the conditions under which the man can ejaculate. Perceived partner attractiveness, the use of fantasy during sex, anxiety-surrounding coitus and masturbatory patterns require meticulous exploration. Identify important DE causes by juxtaposing an awareness of his cognitions and the sexual stimulation experienced during masturbation, versus a partnered experience. Assist the man in identifying behaviors that enhance immersion in excitation and minimize inhibiting thoughts, in order to reach ejaculation in his preferred manner. Discontinuing, reducing or altering masturbation is often required, which evokes patient resistance. Coaching tips are offered on how to ensure adherence to this suspension, manage resistance and facilitate success. Depending on motivation level, masturbation interruption may be compromised and negotiated. Encourage a man who continues to masturbate to alter style (“switch hands”) and to approximate the stimulation likely to be experienced with his partner. Success will require most men to be taught to learn bodily movements and fantasies that approximate the thoughts and sensations experienced in masturbation. Fertility issues, as well as patient/partner anger are important causational factors, which often require individual and/or conjoint consultation. Drug treatment would benefit men particularly with severe DE, regardless of concomitant psychosocial-behavioral and cultural complications. When and if a safe effective medication for DE becomes available, this author’s transdisciplinary perspective supports appropriate medication use when integrated with counseling. This approach emphasizes the utility of a biopsychosocial-cultural perspective combined with special attention to the patient’s narrative. Treatment is patient-centered, holistic and integrates a variety of therapies as needed. PMID:27652228

Sexual function in adult patients with classic bladder exstrophy: A multicenter study.

PubMed

Park, Weon; Zwink, Nadine; Rösch, Wolfgang H; Schmiedeke, Eberhard; Stein, Raimund; Schmidt, Dominik; Noeker, Meinolf; Jenetzky, Ekkehart; Reutter, Heiko; Ebert, Anne-Karoline

2015-06-01

The bladder exstrophy-epispadias complex (BEEC) comprises a spectrum of congenital anomalies that represents the severe end of urorectal malformations, and has a profound impact on continence as well as sexual and renal functions. The relation between severity of BEEC and its associated functional impairments, on one hand, and the resulting restrictions in quality of life and potential psychopathology determine the patients' outcome. It is important for improving further outcome to identify BEEC-related sources of distress in the long term. Genital function and sexuality becomes an important issue for adolescent and adult BEEC individuals. Hence, the present study focused on sexual function and psychological adaption in patients with BEEC. In a multicenter study 52 patients (13 females, 39 males) with classic bladder exstrophy (BE) with their bladders in use were assessed by a self-developed questionnaire about sexual function, and psychosexual and psychosocial outcome. The patients were born between 1948 and 1994 (median age 31 years). Twelve of 13 (92%) females and 25 of 39 (64%) males with classic BE had answered the questions on sexual function. Of these, 50% females and 92% males answered that they masturbated. Females had sexual intercourse more frequently. Six (50%) females affirmed dyspareunia whereas only two (8%) males reported pain during erection. Eight (67%) females specified having orgasms. Eighteen (72%) males were able to ejaculate. Two males and none of the females lived in a committed partnership (Figure). Two (15%) females and 13 (33%) males answered all psychosocial questions. The majority of these patients had concerns about satisfactory sexuality and lasting, happy partnerships. A minority of patients of both sexes were willing to answer psychosocial questions. Sexual activity and relationships of many adult BE patients seems to be impaired. Not surprisingly, sexual activity and awareness were different in males and females even in a multi-organ anomaly. To date, one of the main goals of the medical treatment of BEEC/BE patients is to enable normal sexual life and fertility. However, only a few outcome studies have focused on these issues with contradicting results, most of them not using standardized outcome measures. In accordance with other studies, our female BE patients have dyspareunia and most of our male BE patients were able to ejaculate. But the question of normal force of ejaculation, ejaculated volume, or semen analysis remains unanswered. Despite partial confirmation of previous findings, there is inconsistency referring to the outcome measured by the available studies. This might in part be explained by the fact that, other than this study, most previous studies are the result of single-institution experience. Thus, selection bias in the patient sampling due to different a clinical collective in different hospitals may be the consequence. Furthermore, patients' honesty and self-reflection in answering difficult questions regarding their sexual and cosmetic impairments is questionable. In addition, studies include a wide range of age groups and are connected with this life period. Fears and condition-specific anxieties might change over time. Hence, the strengths of this study are the nationwide and treating physician-independent data acquisition as well as the large sample size of adult patients with a very rare congenital malformation. Unfortunately, more detailed analyses on sexual function and current psychosocial situation, for example correlation of data with clinical symptoms such as continence status, was not possible as data were mainly not answered by patients. To improve the quality of life of patients with BEEC/BE, treatment and follow-up should emphasize physical but also psychological care in these patients. Physicians should further re-evaluate their preconceptions and should take care of the patients throughout their lives. Copyright © 2015 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.

A psychoanalytic study of Alexander the Great.

PubMed

Thomas, K R

1995-12-01

The purpose of this paper was to demonstrate how Freudian concepts such as the Oedipus complex, castration anxiety, fear of loss of love, the psychosexual stages of development, and the tripartite structure of personality can be used to understand the life and achievements of Alexander the Great. To accomplish this purpose, specific incidents, myths, and relationships in Alexander's life were analyzed from a Freudian psychoanalytic perspective. Green (1991), in his recent biography of Alexander, has questioned the merit of using Freudian concepts to understand Alexander's character. In fact, he stated specifically: If he (Alexander) had any kind of Oedipus complex it came in a poor second to the burning dynastic ambition which Olympias so sedulously fostered in him; those who insist on his psychological motivation would do better to take Adler as their mentor than Freud (p.56). Later, in the concluding section of his book, Green (1991, pp. 486-487) discounted Freudian interpretations of Alexander's distaste for sex, the rumors of his homosexual liaisons, his partiality for middle-aged or elderly ladies, and the systematic domination of his early years by Olympias as little more than the projected fears and desires of the interpreters. And again, an Adlerian power-complex paradigm was suggested as the preferable theoretical framework to use. Green's argument was based primarily on an exchange, reported originally by Plutarch, which took place between Alexander and Philip prior to Alexander's tutorship with Aristotle. Purportedly, Philip enjoined his son to study hard and pay close attention to all Aristotle said "so that you may not do a great many things of the sort that I am sorry I have done." At this point, Alexander "somewhat pertly" took Philip to task "because he was having children by other women besides his wife." Philip's reply was: "Well then, if you have many competitors for the kingdom, prove yourself honorable and good, so that you may obtain the kingdom not because of me, but because of yourself." Green interpreted this exchange as confirming that Alexander was more interested in his succession to the throne (power) than in any sexual relationships Philip might be having with any women other than Olympias. That is, Alexander's concern in this exchange was not about Philip's marital infidelity per se, but rather about the prospect of potential competitors (other children) for the throne. Significantly, by emphasizing the manifest content of the exchange, Green ignored a myriad of other possible fears and wishes on Alexander's part, including the fear of castration, the wish to have sex (like his father) with Olympias and other women, the wish to challenge his father's authority and superiority, the fear of loss of love, and the wish (given Philip's homosexual exploits with other boys) to have sex with Philip. Moreover, one could easily explain what Green has described as "the burning dynastic ambition which Olympias so sedulously fostered in him" (p.56), and Alexander's so called "power-complex" in terms which are perfectly consistent with drive/structure theory (e.g., see Freud, 1900/1953a and Freud, 1914/1957, respectively). In other words, Green's arguments against the possibility of a Freudian solution to the puzzle of Alexander's character are less than compelling. By contrast, as demonstrated in this paper, a plethora of historical data exist to suggest that much of Alexander's personality structure and behavior can be explained by his unresolved Oedipus complex, the ambition and self-confidence instilled in him by Olympias, the anal-sadistic and narcissistic organization of his character, his unconscious wish to please his mother, and his being lapped (from birth) in the myth of the hero. Although it is risky, at best, to attempt to analyze an individual without the benefit of clinical data, and even more risky to base such an analysis on fragmentary and often contradictory data assimilated long

[Validation of a scale of sexuality (interests, emotions, relationships: IERS) in prime adolescence (12 to 15 years)].

PubMed

Courtois, R; Potard, C; Réveillère, C; Moltrecht, B

2011-02-01

Early adolescence, which we also call prime adolescence, is marked by the transformations of puberty and the sexualisation of the body, changes in cognition and the progressive involvement in sexuality. This study is the continuation of an earlier work dealing with the construction and validation of a questionnaire on sexuality during adolescence (Courtois et al., 1998) [8]. Population. The sample was composed of 312 middle-school students (7 to 9(th) grade) from four middle-schools in Tours and its suburbs (Indre-et-Loire, France): 164 girls (52.6%) and 148 boys (47.4%); with a mean age of 13.8 (S.D.=1.02; from 10.7 to 16.9) (without significant differences between boys and girls). Material. The material was composed of 22 items calling for true or false answers and including 13 items from the initial questionnaire by Courtois et al. (1998) [7,8] structured in three dimensions ("Behavioral engagement in sexuality", "Love and fidelity" and "Taste for flirting"). Procedure. The study was carried out in 2008 in the classroom (anonymity guaranteed). The results of the factorial analysis (as the main component and by the method which maximizes variance, Varimax) made it possible to find three factors which explain 41% of total variance: "Going out with someone" (value of 4.6, explaining 21% of the total variance); "Giving priority to love" (value of 2.8 explaining 13% of the variance); "Flirting with the aim of having sexual relations" (value of 1.6 explaining 7% of variance). The Cronbach alphas are 0.79, 0.70 and 0.66 respectively. The first and third factors are correlated. In order to obtain a shorter final instrument and to favor the orthogonality between factors, we only retained the items which are strongly saturated by the factors (>0.50). A confirmatory analysis revealed the good adequation of the model retained (Chi(2): 162, 87 dof, P<0.001; Goodness of fitness index [GFI] of Joreskog: 0.91; Root mean square error of approximation [RMSEA]=0.05). Following these analyses, we are able to propose a shorter questionnaire (15 items), structured in three dimensions of sexuality significant in prime adolescence (in accordance with interests, emotions and relationships). The analyses were conducted according to gender and age. There is no significant difference for "Going out with someone" between boys and girls. On the other hand, there is a difference between "Giving priority to love", which is more important for girls (P<0.05) and for "Flirting with the aim of having sexual relations", more important for boys (P<0.001). However, as ages increase, we notice a rise in scores for "Going out with someone" for girls as well as for boys (P<0.05); a drop in scores for "Giving priority to love" (for girls, (P<0.05) and an increase in the scores for "Flirting with the aim of having sexual relations" (only for boys (p<0.05). This study allowed us to validate a scale of sexuality in prime adolescence that presents good psychometric qualities. It was carried out on a larger and more representative sample of this period than the initial study, although essentially finding the same results as previously. Thus, the use of this scale, coupled or not with the individual analysis of the items which make it up, could allow us to understand sexuality in prime adolescence in three significant dimensions of psychosexual development, as well as regarding risky sexuality, i.e., an excessive interest in genital sexuality, behavioral involvement and precocious sexual relations or an absence of feelings. Copyright © 2010 L'Encéphale, Paris. Published by Elsevier Masson SAS. All rights reserved.

24 CFR 941.404 - Completion of development.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false Completion of development. 941.404 Section 941.404 Housing and Urban Development Regulations Relating to Housing and Urban Development... DEVELOPMENT PUBLIC HOUSING DEVELOPMENT Project Development § 941.404 Completion of development. (a) When all...

24 CFR 905.604 - Mixed-finance development.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 24 Housing and Urban Development 4 2014-04-01 2014-04-01 false Mixed-finance development. 905.604... DEVELOPMENT THE PUBLIC HOUSING CAPITAL FUND PROGRAM Development Requirements § 905.604 Mixed-finance development. (a) General. Mixed-finance development refers to the development (through new construction or...

24 CFR 941.102 - Development methods and funding.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 24 Housing and Urban Development 4 2013-04-01 2013-04-01 false Development methods and funding... URBAN DEVELOPMENT PUBLIC HOUSING DEVELOPMENT General § 941.102 Development methods and funding. (a... housing units using this method. (b) Funding. A PHA may develop public housing with: (1) Development funds...

24 CFR 941.102 - Development methods and funding.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 24 Housing and Urban Development 4 2012-04-01 2012-04-01 false Development methods and funding... URBAN DEVELOPMENT PUBLIC HOUSING DEVELOPMENT General § 941.102 Development methods and funding. (a... housing units using this method. (b) Funding. A PHA may develop public housing with: (1) Development funds...

Minority Business Development and Economic Development Policy in New York. Implications for Black Entrepreneurs and Communities. Report of the Subcommittee on Economic Development. Volume 5, Economic Development.

ERIC Educational Resources Information Center

New York Governor's Advisory Committee for Black Affairs, Albany.

New York State should develop a comprehensive justification for its involvement in minority business development and each State program should be closely associated with that rationale. Minority business development programs are often short-sighted, potentially conflicting, and yield unimpressive results. Development of Economic Development Zones…

Sustainable Development: The Challenge for Community Development.

ERIC Educational Resources Information Center

Gamble, Dorothy N.; Weil, Marie O.

1997-01-01

Five areas of inquiry shape the sustainable development movement: environmental movement, women's movement, overpopulation concerns, critique of development models, and new indicators of social progress. Community development workers are challenged to prepare local development projects within a sustainable development framework. (SK)

The development speed paradox: can increasing development speed reduce R&D productivity?

PubMed

Lendrem, Dennis W; Lendrem, B Clare

2014-03-01

In the 1990s the pharmaceutical industry sought to increase R&D productivity by shifting development tasks into parallel to reduce development cycle times and increase development speed. This paper presents a simple model demonstrating that, when attrition rates are high as in pharmaceutical development, such development speed initiatives can increase the expected time for the first successful molecule to complete development. Increasing the development speed of successful molecules could actually reduce R&D productivity - the development speed paradox. Copyright © 2013 Elsevier Ltd. All rights reserved.

[Example of product development by industry and research solidarity].

PubMed

Seki, Masayoshi

2014-01-01

When the industrial firms develop the product, the research result from research institutions is used or to reflect the ideas from users on the developed product would be significant in order to improve the product. To state the software product which developed jointly as an example to describe the adopted development technique and its result, and to consider the modality of the industry solidarity seen from the company side and joint development. The software development methods have the merit and demerit and necessary to choose the optimal development technique by the system which develops. We have been jointly developed the dose distribution browsing software. As the software development method, we adopted the prototype model. In order to display the dose distribution information, it is necessary to load four objects which are CT-Image, Structure Set, RT-Plan, and RT-Dose, are displayed in a composite manner. The prototype model which is the development technique was adopted by this joint development was optimal especially to develop the dose distribution browsing software. In a prototype model, since the detail design was created based on the program source code after the program was finally completed, there was merit on the period shortening of document written and consist in design and implementation. This software eventually opened to the public as an open source. Based on this developed prototype software, the release version of the dose distribution browsing software was developed. Developing this type of novelty software, it normally takes two to three years, but since the joint development was adopted, it shortens the development period to one year. Shortening the development period was able to hold down to the minimum development cost for a company and thus, this will be reflected to the product price. The specialists make requests on the product from user's point of view are important, but increase in specialists as professionals for product development will increase the expectations to develop a product to meet the users demand.

Exploring Faculty Developers' Experiences to Inform Our Understanding of Competence in Faculty Development.

PubMed

Baker, Lindsay; Leslie, Karen; Panisko, Danny; Walsh, Allyn; Wong, Anne; Stubbs, Barbara; Mylopoulos, Maria

2018-02-01

Now a mainstay in medical education, faculty development has created the role of the faculty developer. However, faculty development research tends to overlook faculty developers' roles and experiences. This study aimed to develop an empirical understanding of faculty developer competence by digging deeper into the actions, experiences, and perceptions of faculty developers as they perform their facilitator role. A constructivist grounded theory approach guided observations of faculty development activities, field interviews, and formal interviews with 31 faculty developers across two academic institutions from 2013 to 2014. Analysis occurred alongside and informed data collection. Themes were identified using a constant comparison process. Consistent with the literature, findings highlighted the knowledge and skills of the faculty developer and the importance of context in the design and delivery of faculty development activities. Three novel processes (negotiating, constructing, and attuning) were identified that integrate the individual faculty developer, her context, and the evolution of her competence. These findings suggest that faculty developer competence is best understood as a situated construct. A faculty developer's ability to attune to, construct, and negotiate her environment can both enhance and minimize the impact of contextual variables as needed. Thus, faculty developers do not passively experience context; rather, they actively interact with their environment in ways that maximize their performance. Faculty developers should be trained for the adaptive, situated use of knowledge.

Serious Gaming in Medical Education: A Proposed Structured Framework for Game Development.

PubMed

Olszewski, Aleksandra E; Wolbrink, Traci A

2017-08-01

Serious games are increasingly being used for medical education. However, the design and development of serious games for the education of health professionals is highly variable, and very few articles report the development process used for game development. There are many established processes for software development that can improve and streamline development, and incorporating the best practices from educational pedagogy and software development may enhance teamwork and communication, decrease development costs, and improve the quality of serious games. In this article, we review and summarize the literature for serious game development for medical education, and combining the best practices, we propose a structured three-phase iterative development framework for serious game development.

24 CFR 941.102 - Development methods and funding.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 24 Housing and Urban Development 4 2011-04-01 2011-04-01 false Development methods and funding... URBAN DEVELOPMENT PUBLIC HOUSING DEVELOPMENT General § 941.102 Development methods and funding. (a) Methods. A PHA may use any generally accepted method of development including, but not limited to...

Growing a green economy in China

NASA Astrophysics Data System (ADS)

Weng, Qingqing; Xu, He; Ji, Yijun

2018-02-01

With the rapid development of economy, resource depletion and environmental degradation have become serious challenges for Chinese sustainable development. Green development is a mode of well environmental and high-quality economic development. It is necessary for China to implement green development. In this review, it discusses the green development problems in China, the international experience and connotation of green development are summarized and identified further. Based on the connotation and experience of green economy development, it puts forward several countermeasures and suggestions for Chinese green development finally.

Developed-developing country partnerships: benefits to developed countries?

PubMed

Syed, Shamsuzzoha B; Dadwal, Viva; Rutter, Paul; Storr, Julie; Hightower, Joyce D; Gooden, Rachel; Carlet, Jean; Bagheri Nejad, Sepideh; Kelley, Edward T; Donaldson, Liam; Pittet, Didier

2012-06-18

Developing countries can generate effective solutions for today's global health challenges. This paper reviews relevant literature to construct the case for international cooperation, and in particular, developed-developing country partnerships. Standard database and web-based searches were conducted for publications in English between 1990 and 2010. Studies containing full or partial data relating to international cooperation between developed and developing countries were retained for further analysis. Of 227 articles retained through initial screening, 65 were included in the final analysis. The results were two-fold: some articles pointed to intangible benefits accrued by developed country partners, but the majority of information pointed to developing country innovations that can potentially inform health systems in developed countries. This information spanned all six WHO health system components. Ten key health areas where developed countries have the most to learn from the developing world were identified and include, rural health service delivery; skills substitution; decentralisation of management; creative problem-solving; education in communicable disease control; innovation in mobile phone use; low technology simulation training; local product manufacture; health financing; and social entrepreneurship. While there are no guarantees that innovations from developing country experiences can effectively transfer to developed countries, combined developed-developing country learning processes can potentially generate effective solutions for global health systems. However, the global pool of knowledge in this area is virgin and further work needs to be undertaken to advance understanding of health innovation diffusion. Even more urgently, a standardized method for reporting partnership benefits is needed--this is perhaps the single most immediate need in planning for, and realizing, the full potential of international cooperation between developed and developing countries.

Identity formation of occasional faculty developers in medical education: a qualitative study.

PubMed

O'Sullivan, Patricia S; Irby, David M

2014-11-01

Faculty developers play a crucial role in preparing faculty members for their instructional responsibilities. In some programs, faculty developers are clinicians and scientists who only occasionally conduct workshops. The authors examine the identity formation of such part-time faculty developers. From April 2012 through March 2012, structured interviews were conducted with full-time faculty members who, from 2007 to 2012, periodically volunteered to teach workshops in the University of California, San Francisco School of Medicine's faculty development program. This qualitative study used a modified grounded theory approach. The authors interviewed 29 occasional faculty developers who had 1 to 22 years of experience conducting faculty development programs. All faculty had an educator identity along with their professional identity. The additional faculty developer identity generally evolved over time and aligned with their identity in one of four ways: compartmentalized, hierarchical, parallel, or merged. Their roles as faculty developers enhanced their status in their work community and influenced the way they worked with others and advanced their careers. Faculty development influences the institutional culture, and the institutional culture supports faculty development. Most occasional faculty developers possessed a merged identity that developed over time and was moderated by the topic that they taught. Although experience contributed to this development, both junior and senior faculty developers could have a merged identity. Those who lead faculty development programs can use these findings to recruit and retain faculty developers.

Nanotechnology Divides: Development Indicators and Thai Construction Industry

NASA Astrophysics Data System (ADS)

Kitisriworaphan, T.; Sawangdee, Y.

Nanotechnology and disparity between developed and developing nations could increase the gap of global development while it also affects to construction industry where workers have potentially exposed to nanomaterials application. This research examined the influence of development indicators as demographic, social and economic factors on nanotechnology policy among 250 nations. Results revealed that 68.2% of developed countries have policy on nanotechnology while only 18% of developing countries have such a policy. Fertility and mortality declining with the increasing of literacy, urbanization and energy consumption provide significant positive effect on nanotechnology divides. Furthermore, results pointed out the existing gap of development between developed and developing worlds.

Integrating developed and developing world knowledge into global discussions and strategies for sustainability. 2. Economics and governance.

PubMed

Ramaswami, Anu; Zimmerman, Julie B; Mihelcic, James R

2007-05-15

Knowledge transfer from the developing to the developed world is described in the domain of economics and governance for sustainable development. Three system areas are explored: the structure of commons governance institutions, the process of community-based participatory action research, and the role of microfinance and microenterprise for the development, adoption, and diffusion of sustainable technologies. Case studies from both the developed and developing world demonstrate the effectiveness of social networks and community cooperative strategies in a wide range of sectors. Developing world experiences are shown to be particularly rich in the application of local knowledge and social capital toward sustainable development.

Exploring land developer perspectives on conservation subdivision design and environmentally sustainable land development.

PubMed

Göçmen, Z Aslıgül

2014-11-01

Insight into land developers' perspectives on alternative residential developments and the barriers they experience in trying to develop them can be crucial in efforts to change environmentally damaging low-density, large-lot, and automobile-dependent residential patterns. Using a semi-structured interview instrument followed by short surveys, I examined the views of 16 developers in Waukesha County, WI, USA, a county that has experienced significant development pressures and widespread implementation of conservation subdivision design. The land developer investigation focused on conservation subdivision design familiarity and implementation, and identified a number of barriers that developers experienced in implementing the design. While the majority of the developers appeared familiar with the design and had experience developing conservation subdivisions, their motivations for developing them varied, as did their on-site conservation practices. The barriers included the lack of land use regulations supporting the design, economic factors, community opposition, and a lack of knowledge about sustainable residential development practices. Strategies to promote more environmentally sustainable residential land development patterns include providing a more supportive institutional environment, enacting different regulations and guidelines for natural resources protection, and offering education on ecologically sound development and planning practices.

Exploring Land Developer Perspectives on Conservation Subdivision Design and Environmentally Sustainable Land Development

NASA Astrophysics Data System (ADS)

Göçmen, Z. Aslıgül

2014-11-01

Insight into land developers' perspectives on alternative residential developments and the barriers they experience in trying to develop them can be crucial in efforts to change environmentally damaging low-density, large-lot, and automobile-dependent residential patterns. Using a semi-structured interview instrument followed by short surveys, I examined the views of 16 developers in Waukesha County, WI, USA, a county that has experienced significant development pressures and widespread implementation of conservation subdivision design. The land developer investigation focused on conservation subdivision design familiarity and implementation, and identified a number of barriers that developers experienced in implementing the design. While the majority of the developers appeared familiar with the design and had experience developing conservation subdivisions, their motivations for developing them varied, as did their on-site conservation practices. The barriers included the lack of land use regulations supporting the design, economic factors, community opposition, and a lack of knowledge about sustainable residential development practices. Strategies to promote more environmentally sustainable residential land development patterns include providing a more supportive institutional environment, enacting different regulations and guidelines for natural resources protection, and offering education on ecologically sound development and planning practices.

12 CFR 24.2 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-01-01

...) Community development loan funds or lending consortia; (6) Community development real estate investment trusts; (7) Business development companies; (8) Community development closed-end mutual funds; (9) Non... nonbank community development corporations; (3) CDFI Fund-certified Community Development Financial...

7 CFR 1924.5 - Planning development work.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 7 Agriculture 12 2011-01-01 2011-01-01 false Planning development work. 1924.5 Section 1924.5... Planning development work. (a) Extent of development. For an FO loan, the plans for development will... for development work. The total cash cost of all planned development will be shown on Form FmHA or its...

Developed-developing country partnerships: Benefits to developed countries?

PubMed Central

2012-01-01

Developing countries can generate effective solutions for today’s global health challenges. This paper reviews relevant literature to construct the case for international cooperation, and in particular, developed-developing country partnerships. Standard database and web-based searches were conducted for publications in English between 1990 and 2010. Studies containing full or partial data relating to international cooperation between developed and developing countries were retained for further analysis. Of 227 articles retained through initial screening, 65 were included in the final analysis. The results were two-fold: some articles pointed to intangible benefits accrued by developed country partners, but the majority of information pointed to developing country innovations that can potentially inform health systems in developed countries. This information spanned all six WHO health system components. Ten key health areas where developed countries have the most to learn from the developing world were identified and include, rural health service delivery; skills substitution; decentralisation of management; creative problem-solving; education in communicable disease control; innovation in mobile phone use; low technology simulation training; local product manufacture; health financing; and social entrepreneurship. While there are no guarantees that innovations from developing country experiences can effectively transfer to developed countries, combined developed-developing country learning processes can potentially generate effective solutions for global health systems. However, the global pool of knowledge in this area is virgin and further work needs to be undertaken to advance understanding of health innovation diffusion. Even more urgently, a standardized method for reporting partnership benefits is needed—this is perhaps the single most immediate need in planning for, and realizing, the full potential of international cooperation between developed and developing countries. PMID:22709651

National prevalence of coronary heart disease and its relationship with human development index: A systematic review.

PubMed

Zhu, Ke-Fu; Wang, Yu-Ming; Zhu, Jin-Zhou; Zhou, Qin-Yi; Wang, Ning-Fu

2016-03-01

Coronary heart disease has become a major health concern over the past several decades. Several reviews have assessed the effects of socioeconomic status on the coronary heart disease epidemic in communities and countries, but only a few reviews have been performed at a global level. This study was to explore the relationship between the prevalence of coronary heart disease and socioeconomic development worldwide using the Human Development Index. Systematic review. The data in this study were collected from the MEDLINE database. Cross-sectional studies reporting the prevalence of coronary heart disease until November 2014 were collected. The Human Development Index was sourced from the United Nations Development Programme Database and was used to measure the socioeconomic achievements of countries. Each country was classified as a developing or developed country based on its level of development according to the Human Development Index value. Based on the data analysis on the global level, coronary heart disease prevalence had no association with the national Human Development Index (rho = 0.07). However, there was a positive association between coronary heart disease prevalence and the national Human Development Index in developing countries, although a negative association existed in developed countries (rho = 0.47 and -0.34, respectively). In addition, the past decades have witnessed a growing coronary heart disease epidemic in developing countries, with reverse trends observed in developed countries (P = 0.021 and 0.002, respectively). With the development of socioeconomic status, as measured by the Human Development Index, the prevalence of coronary heart disease is growing in developing countries, while declining in developed countries. Future research needs to pay more attention to the reasonable allocation of medical resources and control of coronary heart disease risk factors. © The European Society of Cardiology 2015.

Community development: an important way for coordinating development of population and social economy in rural areas of China.

PubMed

Li, J

1995-01-01

This article explains how community development is important to rural socioeconomic development in China. Almost all rural socioeconomic activities occur at the community level. Community development encourages voluntarism and self-development, which contribute to adoption of more modern ideas, morals, and values. Community development stimulates changes that favor decreased childbearing and a high quality of child rearing. The special features of Chinese rural communities are identified as underdevelopment, population pressure and resource degradation, collective entities, greater social cohesion, flexibility, affiliations as government units, and access to other useful community organizations. The development model for communities varied over time from an emphasis on family planning to a focus on women's development, poverty alleviation, or economic development. Well-developed communities focused on social security systems, service networks, or environmental protection. Community development is tied to economic development. The growth of collectives played an important role in community development. Women's active and extensive participation and leadership by other influential persons were important forces in community development. Women served as agents of change. Mass participation is now a key feature of community development. Former communes did not include the same level of voluntarism. Community development directly supports increased incomes for families, which decreases the emphasis on children as a source of income. The economic value of children is reduced when communities provide social security. The greater value placed on males is reduced when women's income is increased. Community development lowers the social value of children by improving people's quality of life and by creating a modern social environment.

Five Flaws of Staff Development and the Future Beyond

ERIC Educational Resources Information Center

Hargreaves, Andy

2007-01-01

Student learning and development do not occur without teacher learning and development. Not any teacher development will do, though. The old flaws of weak and wayward staff development are well-known--no staff development, in which trial and error are assumed to be enough; staff development that is all ideas and no implementation, i.e. the…

Image forming apparatus

DOEpatents

Satoh, Hisao; Haneda, Satoshi; Ikeda, Tadayoshi; Morita, Shizuo; Fukuchi, Masakazu

1996-01-01

In an image forming apparatus having a detachable process cartridge in which an image carrier on which an electrostatic latent image is formed, and a developing unit which develops the electrostatic latent image so that a toner image can be formed, both integrally formed into one unit. There is provided a developer container including a discharge section which can be inserted into a supply opening of the developing unit, and a container in which a predetermined amount of developer is contained, wherein the developer container is provided to the toner supply opening of the developing unit and the developer is supplied into the developing unit housing when a toner stirring screw of the developing unit is rotated.

Faculty Development: Not Just a Bandwagon.

ERIC Educational Resources Information Center

Hipps, Opal S.

1978-01-01

Considers problems in traditional faculty development programs, comments on the relation between faculty development and evaluation, and reviews the instructional development model, the organizational development approach, and the personal development model. Offers suggestions for nursing faculties and administrators in organizing a nursing…

24 CFR 200.73 - Property development.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 24 Housing and Urban Development 2 2011-04-01 2011-04-01 false Property development. 200.73 Section 200.73 Housing and Urban Development Regulations Relating to Housing and Urban Development... URBAN DEVELOPMENT GENERAL INTRODUCTION TO FHA PROGRAMS Requirements for Application, Commitment, and...

Essence of Black Colleges in Community Development.

ERIC Educational Resources Information Center

Technical Assistance Consortium To Improve Coll. Services, Washington, DC.

The response of black colleges and universities in the area of community development are discussed in relation to management and organization development, telecommunication, human resource development, educational innovations, and environmental services. Management and organization development encompasses small business development, public service…

Identity Formation in Career Development for Gifted Women.

ERIC Educational Resources Information Center

Phelps, Christine E.

1991-01-01

Necessary developmental tasks concerned with identity development of gifted college women include developing competence, managing emotions, developing autonomy, establishing identity, freeing interpersonal relationships, developing purpose, and developing integrity. These issues may be used as counseling interventions to raise career aspirations.…

A Bibliography of Rural Development: Listings by Topic.

ERIC Educational Resources Information Center

Parker, Carrie G.; And Others

Over 776 journal articles pertaining to rural development are cited. Entries are arranged by topic: agriculture, area development, community, economic development, environmental improvement, facilities and services, human resource development, leadership, organization, rural development, rural-urban relationships, and social action. Some articles…

Improving core outcome set development: qualitative interviews with developers provided pointers to inform guidance.

PubMed

Gargon, Elizabeth; Williamson, Paula R; Young, Bridget

2017-06-01

The objective of the study was to explore core outcome set (COS) developers' experiences of their work to inform methodological guidance on COS development and identify areas for future methodological research. Semistructured, audio-recorded interviews with a purposive sample of 32 COS developers. Analysis of transcribed interviews was informed by the constant comparative method and framework analysis. Developers found COS development to be challenging, particularly in relation to patient participation and accessing funding. Their accounts raised fundamental questions about the status of COS development and whether it is consultation or research. Developers emphasized how the absence of guidance had affected their work and identified areas where guidance or evidence about COS development would be useful including, patient participation, ethics, international development, and implementation. They particularly wanted guidance on systematic reviews, Delphi, and consensus meetings. The findings raise important questions about the funding, status, and process of COS development and indicate ways that it could be strengthened. Guidance could help developers to strengthen their work, but over specification could threaten quality in COS development. Guidance should therefore highlight common issues to consider and encourage tailoring of COS development to the context and circumstances of particular COS. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

Through the eyes of professional developers: Understanding the design of learning experiences for science teachers

NASA Astrophysics Data System (ADS)

Higgins, Tara Eileen

Professional development is important for improving teacher practice and student learning, particularly in inquiry-oriented and technology-enhanced science instruction. This study examines professional developers' practices and their impact on teachers' classroom instruction and student achievement. It analyzes professional developers designing and implementing a five-year professional development program designed to support middle school science teachers. The professional developers are four university-based researchers who worked with sixteen science teachers over three years, setting program goals, facilitating workshops, providing in-classroom support for teachers, and continually refining the program. The analysis is guided by the knowledge integration perspective, a sociocognitive framework for understanding how teachers and professional developers integrate their ideas about teaching and learning. The study investigates the professional developers' goals and teachers' interpretations of those goals. It documents how professional developers plan teacher learning experiences and explores the connection between professional development activities and teachers' classroom practice. Results are based on two rounds of interviews with professional developers, audio recordings of professional developers' planning meetings and videotaped professional development activities. Data include classroom observations, teacher interviews, teacher reflections during professional development activities, and results from student assessments. The study shows the benefit of a professional development approach that relies on an integrated cycle of setting goals, understanding teachers' interpretations, and refining implementation. The professional developers based their design on making inquiry and technology accessible, situating professional development in teachers' work, supporting collaboration, and sustaining learning. The findings reflect alignment of the design goals with the perspective guiding the curriculum design, and consider multiple goals for student and teacher learning. The study has implications for professional development design, particularly in supporting inquiry-oriented science and technology-enhanced instruction. Effective professional developers formulate coherent conceptions of program goals, use evidence of teacher outcomes to refine their goals and practices, and connect student and teacher learning. This study illustrates the value of research on the individuals who design and lead professional development programs.

Longitudinal Development of Secondary Sexual Characteristics in Girls and Boys Between Ages 9½ and 15½ Years

PubMed Central

Susman, Elizabeth J.; Houts, Renate M.; Steinberg, Laurence; Belsky, Jay; Cauffman, Elizabeth; DeHart, Ganie; Friedman, Sarah L.; Roisman, Glenn I.; Halpern-Felsher, Bonnie L.

2010-01-01

Objectives To identify ages when adolescents were in sexual maturity stages 2 through 5; to explain the relations between breast (girls), genital (boys), and pubic hair (girls and boys) development between ages 9½ and 15½ years; and to evaluate synchrony of pubertal development across characteristics. Design Annual pubertal assessments. Setting Ten locations in the United States. Participants A total of 859 adolescents (427 boys [49.7%] and 432 girls [50.3%]; 737 white [85.8%] and 122 black [14.2%]). Main Outcome Measures Changes in the 5 stages of breast, genital, and pubic hair development. Results Girls were in breast maturity stages 2 and 3 earlier than comparable pubic hair stages. Although breast development in girls started earlier than pubic hair development, girls completed breast and pubic hair development at approximately the same age. Black girls were in all stages of breast and pubic hair development earlier than white girls. Boys were in stages 2, 3, 4, and 5 of genital development before the comparable pubic hair stage. In boys, genital development started earlier than pubic hair development, but pubic hair development was completed in less time. Black boys were in genital and pubic hair development about 7 months earlier than white boys. Black and white boys completed genital development in approximately 4½ years, but black boys took approximately 6 months longer than white boys to complete pubic hair development. At stage 2, for 66.2% of girls, breast development preceded their pubic hair development; for 91.1% of boys, genital development preceded their pubic hair development. Conclusions The results of this study are useful in understanding normative variation in the timing and change in the development of secondary sexual characteristics at puberty. They will help identify adolescents with atypical changes in sexual maturation and unusual progression of sexual maturation and growth disorders. PMID:20124146

Longitudinal development of secondary sexual characteristics in girls and boys between ages 91/2 and 151/2 years.

PubMed

Susman, Elizabeth J; Houts, Renate M; Steinberg, Laurence; Belsky, Jay; Cauffman, Elizabeth; Dehart, Ganie; Friedman, Sarah L; Roisman, Glenn I; Halpern-Felsher, Bonnie L

2010-02-01

To identify ages when adolescents were in sexual maturity stages 2 through 5; to explain the relations between breast (girls), genital (boys), and pubic hair (girls and boys) development between ages 9(1/2) and 15(1/2) years; and to evaluate synchrony of pubertal development across characteristics. Annual pubertal assessments. Ten locations in the United States. A total of 859 adolescents (427 boys [49.7%] and 432 girls [50.3%]; 737 white [85.8%] and 122 black [14.2%]). Changes in the 5 stages of breast, genital, and pubic hair development. Girls were in breast maturity stages 2 and 3 earlier than comparable pubic hair stages. Although breast development in girls started earlier than pubic hair development, girls completed breast and pubic hair development at approximately the same age. Black girls were in all stages of breast and pubic hair development earlier than white girls. Boys were in stages 2, 3, 4, and 5 of genital development before the comparable pubic hair stage. In boys, genital development started earlier than pubic hair development, but pubic hair development was completed in less time. Black boys were in genital and pubic hair development about 7 months earlier than white boys. Black and white boys completed genital development in approximately 4(1/2) years, but black boys took approximately 6 months longer than white boys to complete pubic hair development. At stage 2, for 66.2% of girls, breast development preceded their pubic hair development; for 91.1% of boys, genital development preceded their pubic hair development. The results of this study are useful in understanding normative variation in the timing and change in the development of secondary sexual characteristics at puberty. They will help identify adolescents with atypical changes in sexual maturation and unusual progression of sexual maturation and growth disorders.

Identity formation and motivation of new faculty developers: A replication study in a resource constrained university.

PubMed

O'Sullivan, Patricia S; Mkony, Charles; Beard, Jessica; Irby, David M

2016-09-01

Previous studies on the identity development and motivation of faculty developers have occurred with seasoned developers in a research-rich environment. We sought to determine if the findings of those studies could be replicated with novice faculty developers in a resource-constrained environment. We interviewed 15 novice faculty developers from Muhimbili University of Health and Allied Sciences (MUHAS) who, at the time, had led faculty development activities for no more than two years. We conducted a qualitative analysis sensitized by the previous findings. Results were very similar to the previous work. The developers described compartmentalized, hierarchical, and merged identities. The impact was on their teaching as well as on others at MUHAS and on the institution itself. The motivations related to mastery, purpose, duty, satisfaction, and relatedness. This replication led us to conclude that identity development as a faculty developer occurs even in novice developers who do faculty development as only part of their work and despite constrained resources and a different culture. These developers find the work richly rewarding and their motivations benefit the institution. This body of research highlights how faculty development provides benefits to the institution as well as engaging career opportunities.

ZEP520A cold-development technique and tool for ultimate resolution to fabricate 1Xnm bit pattern EB master mold for nano-imprinting lithography for HDD/BPM development

NASA Astrophysics Data System (ADS)

Kobayashi, Hideo; Iyama, Hiromasa

2012-06-01

Poor solvent developers are effective for resolution enhancement on a polymer-type EB resist such as ZEP520A. Another way is to utilize "cold-development" technique which was accomplished by a dip-development technique usually. We then designed and successfully built a single-wafer spin-development tool for the cold-development down to -10degC in order to dissolve difficulties of the dip-development. The cold-development certainly helped improve ZEP520A resolution and hole CD size uniformity, and achieved 35nm pitch BPM patterns with the standard developer ZED-N50, but not 25nm pitch yet. By employing a poor solvent mixture of iso-Propyl Alcohol (IPA) and Fluoro-Carbon (FC), 25nm pitch BPM patterns were accomplished. However, the cold-development showed almost no improvement on the IPA/FC mixture developer solvent. This paper describes cold-development technique and a tool, as well as its results, for ZEP520A resolution enhancement to fabricate 1Xnm bits (holes) for EB master-mold for Nano-Imprinting Lithography for 1Tbit/inch2 and 25nm pitch Bit Patterned Media development.

[The general concepts of development and the principle of sustainable development].

PubMed

Romanov, Iu A

1995-01-01

A concept of the sustainable development principle proposed by the United Nations/International Committee on Environment and Development (ICED, 1987) and gained acceptance at the United Nations Conference on Environment and Development (Rio-de-Janeiro, 1992) lies not in the notion of a sustained character of the development but in an understanding of the development as a steadily and long existing and maintained process that is in advocating the stability of the development. It is known, that the state instability of open self-organizing and self-developing systems including the social ones is the the source of the development having a probabilistic, bifurcate and not quite predictable character. Such an understanding of the development should be well represented in the action initiated in the frame work of national and international state ecological policies.

GIS Based Application of Advanced Traveler Information System in India

NASA Astrophysics Data System (ADS)

Kumar, P.; Singh, V.

2012-02-01

Developed countries like USA, Canada, Japan, UK, Australia and Germany have adopted advanced traveler information technologies expeditiously in comparison to developing countries. But, unlike developed countries, developing countries face considerable financial and framework constraints. Moreover local traffic, roadway, signalization, demographic, topological and social conditions in developing countries are quite different from those in developed countries. In this paper, a comprehensive framework comprising of system architecture, development methodology and salient features of a developed Advanced Traveler Information System (ATIS) for metropolitan cities in developing countries has been discussed. Development of proposed system is based on integration of two well known information technologies viz. Geographic Information Systems (GIS) and World Wide Web (WWW). Combination of these technologies can be utilized to develop an integrated ATIS that targets different types of travelers like private vehicle owners, transit users and casual outside visitors.

Faculty Development and the Community College LRC.

ERIC Educational Resources Information Center

Kazlauskas, Edward John; Maxwell, William

1990-01-01

Urges community college libraries to provide and expand services in faculty development. Considers trends toward an increasing emphasis on faculty development, the professional development needs of community college faculty, faculty development methods, consulting services, reward structures for faculty development, and program evaluation. (DMM)

24 CFR 904.103 - Development.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 24 Housing and Urban Development 4 2011-04-01 2011-04-01 false Development. 904.103 Section 904.103 Housing and Urban Development REGULATIONS RELATING TO HOUSING AND URBAN DEVELOPMENT (CONTINUED) OFFICE OF ASSISTANT SECRETARY FOR PUBLIC AND INDIAN HOUSING, DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT...

24 CFR 1006.205 - Development.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 24 Housing and Urban Development 4 2011-04-01 2011-04-01 false Development. 1006.205 Section 1006.205 Housing and Urban Development REGULATIONS RELATING TO HOUSING AND URBAN DEVELOPMENT (CONTINUED) OFFICE OF ASSISTANT SECRETARY FOR PUBLIC AND INDIAN HOUSING, DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT...

13 CFR 120.862 - Other economic development objectives.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 13 Business Credit and Assistance 1 2010-01-01 2010-01-01 false Other economic development... LOANS Development Company Loan Program (504) Project Economic Development Goals § 120.862 Other economic... meet the specified economic development objective. (a) Community Development goals: (1) Improving...

13 CFR 120.850 - Expiration of Associate Development Company designation.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Development Company designation. 120.850 Section 120.850 Business Credit and Assistance SMALL BUSINESS ADMINISTRATION BUSINESS LOANS Development Company Loan Program (504) Associate Development Companies (adcs) § 120.850 Expiration of Associate Development Company designation. The designation of Associate Development...

13 CFR 120.862 - Other economic development objectives.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 13 Business Credit and Assistance 1 2011-01-01 2011-01-01 false Other economic development... LOANS Development Company Loan Program (504) Project Economic Development Goals § 120.862 Other economic... meet the specified economic development objective. (a) Community Development goals: (1) Improving...

13 CFR 120.862 - Other economic development objectives.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 13 Business Credit and Assistance 1 2012-01-01 2012-01-01 false Other economic development... LOANS Development Company Loan Program (504) Project Economic Development Goals § 120.862 Other economic... meet the specified economic development objective. (a) Community Development goals: (1) Improving...

13 CFR 120.862 - Other economic development objectives.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 13 Business Credit and Assistance 1 2014-01-01 2014-01-01 false Other economic development... LOANS Development Company Loan Program (504) Project Economic Development Goals § 120.862 Other economic... meet the specified economic development objective. (a) Community Development goals: (1) Improving...

13 CFR 120.862 - Other economic development objectives.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 13 Business Credit and Assistance 1 2013-01-01 2013-01-01 false Other economic development... LOANS Development Company Loan Program (504) Project Economic Development Goals § 120.862 Other economic... meet the specified economic development objective. (a) Community Development goals: (1) Improving...

Regional Sustainable Development Analysis Based on Information Entropy—Sichuan Province as an Example

PubMed Central

Liang, Xuedong; Si, Dongyang; Zhang, Xinli

2017-01-01

According to the implementation of a scientific development perspective, sustainable development needs to consider regional development, economic and social development, and the harmonious development of society and nature, but regional sustainable development is often difficult to quantify. Through an analysis of the structure and functions of a regional system, this paper establishes an evaluation index system, which includes an economic subsystem, an ecological environmental subsystem and a social subsystem, to study regional sustainable development capacity. A sustainable development capacity measure model for Sichuan Province was established by applying the information entropy calculation principle and the Brusselator principle. Each subsystem and entropy change in a calendar year in Sichuan Province were analyzed to evaluate Sichuan Province’s sustainable development capacity. It was found that the established model could effectively show actual changes in sustainable development levels through the entropy change reaction system, at the same time this model could clearly demonstrate how those forty-six indicators from the three subsystems impact on the regional sustainable development, which could make up for the lack of sustainable development research. PMID:29027982

Regional Sustainable Development Analysis Based on Information Entropy-Sichuan Province as an Example.

PubMed

Liang, Xuedong; Si, Dongyang; Zhang, Xinli

2017-10-13

According to the implementation of a scientific development perspective, sustainable development needs to consider regional development, economic and social development, and the harmonious development of society and nature, but regional sustainable development is often difficult to quantify. Through an analysis of the structure and functions of a regional system, this paper establishes an evaluation index system, which includes an economic subsystem, an ecological environmental subsystem and a social subsystem, to study regional sustainable development capacity. A sustainable development capacity measure model for Sichuan Province was established by applying the information entropy calculation principle and the Brusselator principle. Each subsystem and entropy change in a calendar year in Sichuan Province were analyzed to evaluate Sichuan Province's sustainable development capacity. It was found that the established model could effectively show actual changes in sustainable development levels through the entropy change reaction system, at the same time this model could clearly demonstrate how those forty-six indicators from the three subsystems impact on the regional sustainable development, which could make up for the lack of sustainable development research.

A Roadmap for Using Agile Development in a Traditional Environment

NASA Technical Reports Server (NTRS)

Streiffert, Barbara; Starbird, Thomas; Grenander, Sven

2006-01-01

One of the newer classes of software engineering techniques is called 'Agile Development'. In Agile Development software engineers take small implementation steps and, in some cases, they program in pairs. In addition, they develop automatic tests prior to implementing their small functional piece. Agile Development focuses on rapid turnaround, incremental planning, customer involvement and continuous integration. Agile Development is not the traditional waterfall method or even a rapid prototyping method (although this methodology is closer to Agile Development). At the Jet Propulsion Laboratory (JPL) a few groups have begun Agile Development software implementations. The difficulty with this approach becomes apparent when Agile Development is used in an organization that has specific criteria and requirements handed down for how software development is to be performed. The work at the JPL is performed for the National Aeronautics and Space Agency (NASA). Both organizations have specific requirements, rules and processes for developing software. This paper will discuss some of the initial uses of the Agile Development methodology, the spread of this method and the current status of the successful incorporation into the current JPL development policies and processes.

A Roadmap for Using Agile Development in a Traditional Environment

NASA Technical Reports Server (NTRS)

Streiffert, Barbara A.; Starbird, Thomas; Grenander, Sven

2006-01-01

One of the newer classes of software engineering techniques is called 'Agile Development'. In Agile Development software engineers take small implementation steps and, in some cases they program in pairs. In addition, they develop automatic tests prior to implementing their small functional piece. Agile Development focuses on rapid turnaround, incremental planning, customer involvement and continuous integration. Agile Development is not the traditional waterfall method or even a rapid prototyping method (although this methodology is closer to Agile Development). At Jet Propulsion Laboratory (JPL) a few groups have begun Agile Development software implementations. The difficulty with this approach becomes apparent when Agile Development is used in an organization that has specific criteria and requirements handed down for how software development is to be performed. The work at the JPL is performed for the National Aeronautics and Space Agency (NASA). Both organizations have specific requirements, rules and procedure for developing software. This paper will discuss the some of the initial uses of the Agile Development methodology, the spread of this method and the current status of the successful incorporation into the current JPL development policies.

24 CFR 891.140 - Development cost limits.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false Development cost limits. 891.140 Section 891.140 Housing and Urban Development Regulations Relating to Housing and Urban Development... AND URBAN DEVELOPMENT (SECTION 8 HOUSING ASSISTANCE PROGRAMS, SECTION 202 DIRECT LOAN PROGRAM, SECTION...

24 CFR 891.853 - Development cost limits.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false Development cost limits. 891.853 Section 891.853 Housing and Urban Development Regulations Relating to Housing and Urban Development... AND URBAN DEVELOPMENT (SECTION 8 HOUSING ASSISTANCE PROGRAMS, SECTION 202 DIRECT LOAN PROGRAM, SECTION...

24 CFR 971.11 - HOPE VI developments.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false HOPE VI developments. 971.11 Section 971.11 Housing and Urban Development Regulations Relating to Housing and Urban Development... DEVELOPMENT ASSESSMENT OF THE REASONABLE REVITALIZATION POTENTIAL OF CERTAIN PUBLIC HOUSING REQUIRED BY LAW...

Children and Adolescents; A Biocultural Approach to Psychological Development.

ERIC Educational Resources Information Center

Alexander, Theron

In a discussion of psychological development separate sections are devoted to (1) biological and cultural influences on development, (2) development in infancy, early childhood, middle childhood, and adolescence, (3) physiological foundations of behavior, (4) motivation and cognitive development, (5) intellectual development, (6) imagination and…

Management Development: The State of the Art as Perceived by HRD Professionals.

ERIC Educational Resources Information Center

Rothwell, William J.; Kazanas, H. C.

1994-01-01

Reviews the literature on management development and summarizes results of a survey of human resources development (HRD) professionals' perceptions about management development practices. Topics discussed include identifying management development needs; strategic business plans, succession plans, and individual development plans; frequency and…

Gifted and Talented Education: Elementary Curriculum Guide.

ERIC Educational Resources Information Center

Corono-Norco Unified School District, Corono, CA.

The curriculum ideas were developed by elementary teachers in a gifted and talented program. Five strands are incorporated throughout curriculum areas: development of problem solving skills, development of ethical standards, development of sensitivity and responsibility to others, development of a healthy self concept, and development of…

Framework Programmable Platform for the Advanced Software Development Workstation (FPP/ASDW). Demonstration framework document. Volume 1: Concepts and activity descriptions

NASA Technical Reports Server (NTRS)

Mayer, Richard J.; Blinn, Thomas M.; Dewitte, Paul S.; Crump, John W.; Ackley, Keith A.

1992-01-01

The Framework Programmable Software Development Platform (FPP) is a project aimed at effectively combining tool and data integration mechanisms with a model of the software development process to provide an intelligent integrated software development environment. Guided by the model, this system development framework will take advantage of an integrated operating environment to automate effectively the management of the software development process so that costly mistakes during the development phase can be eliminated. The Advanced Software Development Workstation (ASDW) program is conducting research into development of advanced technologies for Computer Aided Software Engineering (CASE).

Nursing leadership in academic nursing: The wisdom of development and the development of wisdom.

PubMed

Pesut, Daniel J; Thompson, Sarah A

The purpose of this article is to discuss insights derived from adult cognitive developmental theories and relate the insights to vertical leadership development in academic nursing contexts. Equipped with developmental understanding, academic leaders are in a better position to support the vertical leadership development of one's self, faculty, peers, and colleagues. From a cognitive developmental perspective, the authors' reason as leaders develop, grow, and evolve, sense making becomes more sophisticated and nuanced resulting in the development of wisdom. Leadership wisdom is a function of horizontal (acquisition of information, skills, and competencies) and vertical development (the development of more complex and sophisticated ways of thinking). Ways to enhance vertical development, and sense making to cultivate wisdom are discussed. Principles and practices that promote vertical development in self and others deepens performance expectations of those in the academy and supports personal professional development and organizational success. Copyright © 2017 Elsevier Inc. All rights reserved.

Using practice development methodology to develop children's centre teams: ideas for the future.

PubMed

Hemingway, Ann; Cowdell, Fiona

2009-09-01

The Children's Centre Programme is a recent development in the UK and brings together multi-agency teams to work with disadvantaged families. Practice development methods enable teams to work together in new ways. Although the term practice development remains relatively poorly defined, its key properties suggest that it embraces engagement, empowerment, evaluation and evolution. This paper introduces the Children's Centre Programme and practice development methods and aims to discuss the relevance of using this method to develop teams in children's centres through considering the findings from an evaluation of a two-year project to develop inter-agency public health teams. The evaluation showed that practice development methods can enable successful team development and showed that through effective facilitation, teams can change their practice to focus on areas of local need. The team came up with their own process to develop a strategy for their locality.

14 CFR 152.107 - Project eligibility: Airport development.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 14 Aeronautics and Space 3 2010-01-01 2010-01-01 false Project eligibility: Airport development....107 Project eligibility: Airport development. (a) Except in the case of approved stage development, each project for airport development must provide for— (1) Development of an airport or unit of an...

14 CFR 152.107 - Project eligibility: Airport development.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 14 Aeronautics and Space 3 2011-01-01 2011-01-01 false Project eligibility: Airport development....107 Project eligibility: Airport development. (a) Except in the case of approved stage development, each project for airport development must provide for— (1) Development of an airport or unit of an...

24 CFR 598.615 - Economic development standards.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 24 Housing and Urban Development 3 2010-04-01 2010-04-01 false Economic development standards. 598... DESIGNATIONS Empowerment Zone Grants § 598.615 Economic development standards. (a) Economic development... the planned use of HUD EZ Grant Funds must meet one of the following economic development standards...

Prenatal development of the foot and ankle.

PubMed

Bareither, D

1995-12-01

The general development of the lower limb and the specific development of the foot and ankle are discussed for each horizon in the embryonic and fetal periods of development. Lower limb general development is discussed only to the extent necessary for the understanding of foot and ankle development.

24 CFR 598.615 - Economic development standards.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 24 Housing and Urban Development 3 2014-04-01 2013-04-01 true Economic development standards. 598... DESIGNATIONS Empowerment Zone Grants § 598.615 Economic development standards. (a) Economic development... the planned use of HUD EZ Grant Funds must meet one of the following economic development standards...

24 CFR 598.615 - Economic development standards.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 24 Housing and Urban Development 3 2011-04-01 2010-04-01 true Economic development standards. 598... DESIGNATIONS Empowerment Zone Grants § 598.615 Economic development standards. (a) Economic development... the planned use of HUD EZ Grant Funds must meet one of the following economic development standards...

24 CFR 598.615 - Economic development standards.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 24 Housing and Urban Development 3 2013-04-01 2013-04-01 false Economic development standards. 598... DESIGNATIONS Empowerment Zone Grants § 598.615 Economic development standards. (a) Economic development... the planned use of HUD EZ Grant Funds must meet one of the following economic development standards...

24 CFR 598.615 - Economic development standards.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 24 Housing and Urban Development 3 2012-04-01 2012-04-01 false Economic development standards. 598... DESIGNATIONS Empowerment Zone Grants § 598.615 Economic development standards. (a) Economic development... the planned use of HUD EZ Grant Funds must meet one of the following economic development standards...

36 CFR 910.12 - Development density.

Code of Federal Regulations, 2011 CFR

2011-07-01

... GUIDELINES AND UNIFORM STANDARDS FOR URBAN PLANNING AND DESIGN OF DEVELOPMENT WITHIN THE PENNSYLVANIA AVENUE DEVELOPMENT AREA Urban Planning and Design Concerns § 910.12 Development density. (a) Land would be developed... urban design elements. (c) Development density is limited by the Zoning Regulations of the District of...

Comparing Spiritual Development and Cognitive Development.

ERIC Educational Resources Information Center

Love, Patrick G.

2002-01-01

Three spiritual development theories and theorists (i.e., Parks, Fowler, and Helminiak) were compared with traditional cognitive development theory and theorists. The analysis reveals both commonalities between the two sets of theories and unique contributions to an understanding of student development on the part of spiritual development theory.…

Exploring Faculty Developers’ Experiences to Inform Our Understanding of Competence in Faculty Development

PubMed Central

Leslie, Karen; Panisko, Danny; Walsh, Allyn; Wong, Anne; Stubbs, Barbara; Mylopoulos, Maria

2018-01-01

Purpose Now a mainstay in medical education, faculty development has created the role of the faculty developer. However, faculty development research tends to overlook faculty developers’ roles and experiences. This study aimed to develop an empirical understanding of faculty developer competence by digging deeper into the actions, experiences, and perceptions of faculty developers as they perform their facilitator role. Method A constructivist grounded theory approach guided observations of faculty development activities, field interviews, and formal interviews with 31 faculty developers across two academic institutions from 2013 to 2014. Analysis occurred alongside and informed data collection. Themes were identified using a constant comparison process. Results Consistent with the literature, findings highlighted the knowledge and skills of the faculty developer and the importance of context in the design and delivery of faculty development activities. Three novel processes (negotiating, constructing, and attuning) were identified that integrate the individual faculty developer, her context, and the evolution of her competence. Conclusions These findings suggest that faculty developer competence is best understood as a situated construct. A faculty developer’s ability to attune to, construct, and negotiate her environment can both enhance and minimize the impact of contextual variables as needed. Thus, faculty developers do not passively experience context; rather, they actively interact with their environment in ways that maximize their performance. Faculty developers should be trained for the adaptive, situated use of knowledge. PMID:28678104

24 CFR 941.102 - Development methods and funding.

Code of Federal Regulations, 2010 CFR

2010-04-01

... the staff of the PHA perform the work. (4) Mixed-finance. This method involves financing from both... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false Development methods and funding... URBAN DEVELOPMENT PUBLIC HOUSING DEVELOPMENT General § 941.102 Development methods and funding. (a...

Spatial analysis of rural land development

Treesearch

Seong-Hoon Cho; David H. Newman

2005-01-01

This article examines patterns of rural land development and density using spatial econometric models with the application of Geographical Information System (GIS). The cluster patterns of both development and high-density development indicate that the spatially continuous expansions of development and high-density development exist in relatively remote rural areas....

World Development Report 1985. International Capital and Economic Development. World Development Indicators.

ERIC Educational Resources Information Center

International Bank for Reconstruction and Development, Washington, DC.

Focusing on the contribution that international capital makes to economic development, this report shows how countries at different stages of development have used external finance productively; how the institutional and policy environment affects the volume and composition of financial flows to developing countries; and how the international…

Development and Interdependence. A One-Semester Model Curriculum for Secondary Schools and Undergraduate Colleges.

ERIC Educational Resources Information Center

Schaeffler, Walter S.; Collier, Anne B.

The interdisciplinary curriculum on global economic and social development and interdependence traces Western development trends, investigates current issues and processes in development, and offers a development planning exercise. An introductory section serves as a teacher's guide. It discusses the skills developed by the activities, suggests…

24 CFR 891.815 - Mixed-finance developer's fee.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 24 Housing and Urban Development 4 2011-04-01 2011-04-01 false Mixed-finance developer's fee. 891...-Profit Limited Partnerships and Mixed-Finance Development for Supportive Housing for the Elderly or Persons with Disabilities § 891.815 Mixed-finance developer's fee. (a) Mixed-finance developer's fee. A...

24 CFR 891.815 - Mixed-finance developer's fee.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 24 Housing and Urban Development 4 2013-04-01 2013-04-01 false Mixed-finance developer's fee. 891...-Profit Limited Partnerships and Mixed-Finance Development for Supportive Housing for the Elderly or Persons with Disabilities § 891.815 Mixed-finance developer's fee. (a) Mixed-finance developer's fee. A...

24 CFR 891.815 - Mixed-finance developer's fee.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 24 Housing and Urban Development 4 2012-04-01 2012-04-01 false Mixed-finance developer's fee. 891...-Profit Limited Partnerships and Mixed-Finance Development for Supportive Housing for the Elderly or Persons with Disabilities § 891.815 Mixed-finance developer's fee. (a) Mixed-finance developer's fee. A...

24 CFR 891.815 - Mixed-finance developer's fee.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 24 Housing and Urban Development 4 2014-04-01 2014-04-01 false Mixed-finance developer's fee. 891...-Profit Limited Partnerships and Mixed-Finance Development for Supportive Housing for the Elderly or Persons with Disabilities § 891.815 Mixed-finance developer's fee. (a) Mixed-finance developer's fee. A...

Competencies for a Leadership Role in Educational Development

ERIC Educational Resources Information Center

Verbeke, Kristi J.

2014-01-01

Because the field of educational development (also known as faculty development, academic development, and staff development) is relatively new, very little is known about the competencies required for those who work in the field. Additionally, there are no formal pathways or means of formal preparation for educational developers. This study…

Characteristics of Sports-Based Youth Development Programs

ERIC Educational Resources Information Center

Perkins, Daniel F.; Noam, Gil G.

2007-01-01

The term "sports-based youth development programs" is coined and defined in the context of the community youth development framework. Sports-based youth development programs are out-of-school-time programs that use a particular sport to facilitate learning and life skill development in youth. Community youth development programs use a community…

Entrepreneurial Intentions in Developing and Developed Countries

ERIC Educational Resources Information Center

Iakovleva, Tatiana; Kolvereid, Lars; Stephan, Ute

2011-01-01

Purpose: This study proposes to use the Theory of Planned Behaviour to predict entrepreneurial intentions among students in five developing and nine developed countries. The purpose is to investigate whether entrepreneurial intention and its antecedents differ between developing and developed countries, and to test the theory in the two groups of…

24 CFR 972.109 - Conversion of developments.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 24 Housing and Urban Development 4 2011-04-01 2011-04-01 false Conversion of developments. 972.109... DEVELOPMENT CONVERSION OF PUBLIC HOUSING TO TENANT-BASED ASSISTANCE Required Conversion of Public Housing Developments Required Conversion Process § 972.109 Conversion of developments. (a)(1) The PHA may proceed to...

24 CFR 972.109 - Conversion of developments.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false Conversion of developments. 972.109... DEVELOPMENT CONVERSION OF PUBLIC HOUSING TO TENANT-BASED ASSISTANCE Required Conversion of Public Housing Developments Required Conversion Process § 972.109 Conversion of developments. (a)(1) The PHA may proceed to...

24 CFR 983.154 - Conduct of development work.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 24 Housing and Urban Development 4 2011-04-01 2011-04-01 false Conduct of development work. 983... Constructed Units § 983.154 Conduct of development work. (a) Development requirements. The owner must carry out development work in accordance with the Agreement and the requirements of this section. (b) Labor...

Building Your Camp's Future: How to Hire a Development Director.

ERIC Educational Resources Information Center

Merriman, Suzanne G.

1993-01-01

Discusses the importance for camp development efforts of collaboration between the camp's chief administrative officer (CAO) and development director. Describes qualities of an effective development director; where and how to begin the search for a development director; and the importance of retaining an effective development director in meeting…

34 CFR 263.1 - What is the Professional Development program?

Code of Federal Regulations, 2011 CFR

2011-07-01

... 34 Education 1 2011-07-01 2011-07-01 false What is the Professional Development program? 263.1... Development Program § 263.1 What is the Professional Development program? (a) The Professional Development... Professional Development program requires individuals who receive training to— (1) Perform work related to the...

App Development Paradigms for Instructional Developers

ERIC Educational Resources Information Center

Luterbach, Kenneth J.; Hubbell, Kenneth R.

2015-01-01

To create instructional apps for desktop, laptop and mobile devices, developers must select a development tool. Tool selection is critical and complicated by the large number and variety of app development tools. One important criterion to consider is the type of development environment, which may primarily be visual or symbolic. Those distinct…

36 CFR 910.61 - Height of development.

Code of Federal Regulations, 2012 CFR

2012-07-01

... DEVELOPMENT AREA Glossary of Terms § 910.61 Height of development. Height of development means the vertical... 36 Parks, Forests, and Public Property 3 2012-07-01 2012-07-01 false Height of development. 910.61 Section 910.61 Parks, Forests, and Public Property PENNSYLVANIA AVENUE DEVELOPMENT CORPORATION GENERAL...

36 CFR 910.61 - Height of development.

Code of Federal Regulations, 2014 CFR

2014-07-01

... DEVELOPMENT AREA Glossary of Terms § 910.61 Height of development. Height of development means the vertical... 36 Parks, Forests, and Public Property 3 2014-07-01 2014-07-01 false Height of development. 910.61 Section 910.61 Parks, Forests, and Public Property PENNSYLVANIA AVENUE DEVELOPMENT CORPORATION GENERAL...

Developing clinical leadership capability.

PubMed

Pintar, Kristi A; Capuano, Terry A; Rosser, Gwendolyn D

2007-01-01

Nursing facilities must be committed to ongoing leadership development and to developing and retaining their staff in the increasingly competitive healthcare market. In this article, the authors share the processes involved in creating a focused small group approach to developing clinical leaders. Programmatic approaches to development, clarity of needs of those targeted for development, individual development plans, external expertise partnerships, and small group session dynamics are discussed. Applications of the process and lessons learned from the program will benefit others in their efforts to enhance organization succession planning, leadership development, group learning, and program administration.

Haystack Observatory Technology Development Center

NASA Technical Reports Server (NTRS)

Beaudoin, Chris; Corey, Brian; Niell, Arthur; Cappallo, Roger; Whitney, Alan

2013-01-01

Technology development at MIT Haystack Observatory were focused on four areas in 2012: VGOS developments at GGAO; Digital backend developments and workshop; RFI compatibility at VLBI stations; Mark 6 VLBI data system development.

Making mental health an integral part of sustainable development: the contribution of a social determinants framework.

PubMed

De Silva, M J

2015-04-01

There have been repeated calls to include mental health in the sustainable development goals (SDGs), arguing that progress in development will not be made without improvements in mental health. Although these calls are starting to gain political traction, currently only a tiny fraction of international development work includes mental health. A social determinants framework may be useful in incorporating mental health into sustainable development because it promotes a multi-sectorial and multi-disciplinary approach which is the corner stone of good development practice. Two approaches are suggested to make mental health a part of sustainable development: (1) integrate mental health into existing development programmes to promote social and economic environments that prevent mental health problems developing; (2) ensure that mental health programmes are better at promoting sustainable development by preventing the negative social and economic consequences of mental illness. Real-world examples of these approaches are provided. To achieve this, the mental health impact of wider development programmes, and the social and economic consequences of mental health interventions, must be evaluated. Development agencies should ensure that they have equity for mental health in all their policies, and investment must be increased for those mental health prevention, promotion and treatment programmes which have the greatest impact on sustainable development. The SDGs bring the promise of a more holistic approach to development. It is now the task of global mental health to demonstrate not just that mental health is an integral part of sustainable development, but that affordable and effective solutions exist which can improve mental health and development more broadly.

Against the odds: experiences of nurse leaders in Clinical Development Units (Nursing) in Australia.

PubMed

Atsalos, Christine; O'Brien, Louise; Jackson, Debra

2007-06-01

This paper is a report of a longitudinal study to develop an understanding of the phenomena of Clinical Development Unit (Nursing) leadership by exploring the experiences of the nurse leaders of nine Australian units as they attempted to develop their existing wards or units into recognized centres of nursing excellence. The concept of Clinical Development Unit (Nursing) in Australia originated in the British Nursing Development Unit movement, which has been widely credited with introducing innovative approaches to developing nurses and nursing. A network of nine Clinical Development Units (Nursing) was set up in a suburban area health service in Australia. The aim was to develop existing wards or units into centres of excellence by disseminating a new vision for Australian nurses that was based on the pioneering work of the British Nursing Development Unit movement. Principles of Heideggerian hermeneutic phenomenology provided a framework for the study. Nine Clinical Development Unit (Nursing) leaders participated in qualitative interviews from 1998 to 2002. These interviews were transcribed into text and thematically analysed. Despite attempts to implement a variety of measures to nurture these Clinical Development Units (Nursing) until they had become well established, the new Clinical Development Unit (Nursing) leaders were unable to maintain the Clinical Development Unit (Nursing) vision with which they had been entrusted. This paper discusses their reactions to the problems they faced and the new understandings they developed of their Clinical Development Unit (Nursing) role over time. The findings illuminate the difficulties involved in maintaining the commitment of all levels of staff and management when attempting to introduce new nursing projects.

Developing the Developers: Supporting and Researching the Learning of Professional Development Facilitators

ERIC Educational Resources Information Center

Perry, Emily; Boylan, Mark

2018-01-01

Research on teacher professional development is extensive but there are fewer studies about the practitioners who facilitate professional development. Here we report on a pilot programme for professional development facilitators rooted in a cycle of action research. Informed by a categorisation of professional knowledge and skills of facilitators,…

Universities' Role in Regional Development: A Case Study of University for Development Studies, Ghana

ERIC Educational Resources Information Center

Abonyi, Usman Kojo

2016-01-01

This study, employing an interpretive research paradigm, sought to investigate into how University for Development Studies (UDS) is responding to its regional development mandate with a specific focus on how it is responding to human capital development, innovation capabilities, and social and environmental development in northern Ghana. A study…

Human Resource Development Issues in the Implementation of the Western China Development Strategy

ERIC Educational Resources Information Center

Xiao, Mingzheng

2007-01-01

This paper systematically illustrates the value and role of human resource development in the implementation of the Western China development strategy. It analyzes in details some current human resource issues constraining the implementation of the Western China development strategy and those on the sustainable development process of economic…

Towards Model-Driven End-User Development in CALL

ERIC Educational Resources Information Center

Farmer, Rod; Gruba, Paul

2006-01-01

The purpose of this article is to introduce end-user development (EUD) processes to the CALL software development community. EUD refers to the active participation of end-users, as non-professional developers, in the software development life cycle. Unlike formal software engineering approaches, the focus in EUD on means/ends development is…

Role of the developing nations in the development and optimal use of space technology

NASA Technical Reports Server (NTRS)

Pena, M. S.

1982-01-01

The economic and social factors are discussed which play a role in the advancement of space technology in developing nations. It is concluded that mutual collaboration between developed and developing nations is the basic element which will allow developing nations to take part in space experiments and research.

Concept Development and the Development of the God Concept in the Child: A Bibliography.

ERIC Educational Resources Information Center

Pitts, V. Peter, Comp.

This is a 600-reference bibliography on the development of children's conceptions and artistic representations of God. References are presented in 12 categories: (1) The God Concept, (2) Concept Development, (3) Child Development and Developmental Child Psychology, (4) Religious Education, (5) Children's Religious Thought and Development, (6)…

Educational Planning and Human Resources Development with Reference to Arab Countries.

ERIC Educational Resources Information Center

Galaleldin, Mohamed Al Awad

Human resources development sees human beings as the means to socioeconomic development. This differs from human development which sees human beings as the immediate and ultimate goals and ends of socio-economic development. Arab states have tended to utilize the human resources development approach as part of their forecasting of manpower…

Teaching and Learning Development Economics: Retrospect and Prospect

ERIC Educational Resources Information Center

Chen, Edward K. Y.

2005-01-01

The author has chosen three major topics in development economics for a discussion on how to teach the subject: the concepts and measurement of development, models of growth and development, and the international aspects of economic development. For the concepts of development, it is important to emphasize the coherence of the topics to be…

The Early Development of the Open University: Report of the Vice-Chancellor January 1969-December 1970.

ERIC Educational Resources Information Center

Open Univ., Walton, Bletchley, Bucks (England).

This report concerns the extablishment and development of the British Open University. Contents include the descriptions of: the development of the institution; staffing the open university; development of the Milton Keynes Campus; undergraduate course development; regional organization; demand for open university courses; development, production,…

The Orientation and Development of the Public Affair Management Specialty

ERIC Educational Resources Information Center

Li, Chenghui; Fu, Yongxian; Chen, Rongxiang; Hu, Xueqi

2010-01-01

Though the specialty of the public affair management has been developed for ten years, but it is still facing the actuality that the orientation and development are difficult. Only by confirming the cultivation target and the development orientation, the development of the specialty could find the development approach and method. According to the…

Austin Community College Video Game Development Certificate

ERIC Educational Resources Information Center

McGoldrick, Robert

2008-01-01

The Video Game Development program is designed and developed by leaders in the Austin video game development industry, under the direction of the ACC Video Game Advisory Board. Courses are taught by industry video game developers for those who want to become video game developers. The program offers a comprehensive approach towards learning what's…

24 CFR 891.815 - Mixed-finance developer's fee.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false Mixed-finance developer's fee. 891.815 Section 891.815 Housing and Urban Development Regulations Relating to Housing and Urban Development (Continued) OFFICE OF THE ASSISTANT SECRETARY FOR HOUSING-FEDERAL HOUSING COMMISSIONER, DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT (SECTION 8...

The Development of Professional Learning Community in Primary Schools

ERIC Educational Resources Information Center

Sompong, Samoot; Erawan, Prawit; Dharm-tad-sa-na-non, Sudharm

2015-01-01

The objectives of this research are: (1) To study the current situation and need for developing professional learning community in primary schools; (2) To develop the model for developing professional learning community, and (3) To study the findings of development for professional learning community based on developed model related to knowledge,…

Challenges of Research and Human Capital Development in Nigeria

ERIC Educational Resources Information Center

Chikwe, Christian K.; Ogidi, Reuben C.; Nwachukwu, K.

2015-01-01

The paper discussed the challenges of research and human capital development in Nigeria. Research and human capital development are critical to the development of any nation. Research facilitates human capital development. A high rating in human capital development indices places a country among the leading countries of the world. The paper…

Development costs of reusable launch vehicles

NASA Astrophysics Data System (ADS)

Koelle, D.

2002-07-01

The paper deals first with the definition and understanding of "Development Costs" in general. Usually there is large difference between initial "development cost guesses", "Proposal Cost Estimations" and the final "Cost-to-Completion". The reasons for the usual development cost increases during development are discussed. The second part discusses the range of historic launch systems' development costs under "Business-as-Usual" (BaU) - Conditions and potential cost reductions for future developments of RLVs, as well as the comparison to commercial, industrial development cost. Part three covers the potential reduction of development cost by application of "Cost Engineering Principles". An example of the large potential cost range (between 6 and 17 Billion USD) for the development of the same winged rocket-propelled SSTO launch vehicle concept is presented. Finally the tremendous development cost differences are shown which exist for the different potential Reusable Launch System Options which are under discussion. There remains an unresolved problem between the primary goals of the national space agencies with emphasis on new technology development/national prestige and the commercial market requirement of a simple low-cost RLV-System.

The effect of temperature on development of Sarconesia chlorogaster, a blowfly of forensic importance.

PubMed

Lecheta, Melise Cristine; Thyssen, Patricia Jacqueline; Moura, Mauricio Osvaldo

2015-12-01

The blowfly Sarconesia chlorogaster (Diptera: Calliphoridae) is of limited forensic use in South America, due to the poorly known relationship between development time and temperature. The purpose of this study was to determine development time of S. chlorogaster at different constant temperatures, thereby enabling the forensic use of this fly. Development time of this species was examined by observing larval development at six temperatures (10, 15, 20, 25, 30, 35 °C). The thermal constant (K), the minimum development threshold (t 0), and development rate were calculated using linear regressions of the development time interval at five temperatures (10-30 °C). Development interval from egg to adult varied from 14.2 to 95.2 days, depending on temperature. The t0 calculated for total immature development is 6.33 °C and the overall thermal constant is 355.51 degree-days (DD). Temperature affected the viability of pupae, at 35 °C 100 % mortality was observed. Understanding development rate across these temperatures now makes development of S. chlorogaster a forensically useful tool for estimating postmortem interval.

Management Development from a Dutch Perspective.

ERIC Educational Resources Information Center

Paauwe, Jaap, Ed.; Williams, Roger, Ed.

2001-01-01

Includes "Seven Key Issues for Management Development" (Paauwe, Williams); "Typology of Management Development" (Jansen, van der Velde, Mul); "Management Development at Royal Dutch/Shell" (Mahieu); "Management Development in Unilever" (Reitsma); "International Co-ordination and Management…

Ramathibodi Language Development Questionnaire: A Newly Developed Screening Tool for Detection of Delayed Language Development in Children Aged 18-30 Months.

PubMed

Chuthapisith, Jariya; Wantanakorn, Pornchanok; Roongpraiwan, Rawiwan

2015-08-01

To develop a parental questionnaire for screening children with delayed language development in primary care settings. Ramathibodi Language Development (RLD) questionnaire was developed and completed by groups of 40 typically developing children age 18 to 30 months old and 30 children with delayed language development. The mean score was significantly lower in the delay language group (6.7 ± 1.9), comparing with the typically developing group (9.6 ± 0.7). The optimal ROC curve cut-off score was 8 with corresponding sensitivity and specificity were 98% and 72%, respectively. The corresponding area under the curve was 0.96 (95% CI = 0.92-0.99). The RLD questionnaire was the promising language developmental screening instrument that easily utilized in well-child examination settings.

[Research on survey analysis and development strategies of traditional Chinese preparations in Guangdong Province hospitals].

PubMed

Wang, Wen-ming; Yan, Zhen; Liu, Han-jiang; Zhang, Lei-hong; Xia, Li; Zhao, Zhen-dong

2013-12-01

To provide reference for the government to formulate policies and medical institution to formulate development plan, the present situation of medical institutions of traditional Chinese preparation and some countermeasures for developing the research of traditional Chinese preparation in Guangdong province were studied. Combined with development situation of traditional Chinese preparation of medical institutions in Guangdong province in recent years, the development countermeasure of traditional Chinese preparation was discussed. In order to promote the development of traditional Chinese preparation of medical institutions, suggestions and countermeasures for the government and related departments were proposed. Government departments should formulate policies to support the development of traditional Chinese preparation, the medical institutions should make scientific development planning, strengthen the construction of hardware and software and develop special traditional Chinese preparation to promote the healthy development of traditional Chinese preparation.

The influence of demographics and work related goals on adaptive development for work related learning amongst private hospital employees.

PubMed

Tones, Megan; Pillay, Hitendra; Fraser, Jennifer

2010-01-01

Contemporary lifespan development models of adaptive development have been applied to the workforce to examine characteristics of the ageing employee. Few studies have examined adaptive development in terms of worker perceptions of workplace, or their learning and development issues. This study used the recently developed Revised Learning and Development Survey to investigate employee selection and engagement of learning and development goals, opportunities for learning and development at work, and constraints to learning and development at work. Demographic and career goal variables were tested amongst a sample of private hospital employees, almost all of whom were nurses. Workers under 45 years of age perceived greater opportunities for training and development than more mature aged workers. Age and physical demands interacted such that physical demands of work were associated with lower engagement in learning and development goals in mature aged workers. The opposite was observed amongst younger workers. Engagement in learning and development goals at work predicted goals associated with an intention to decrease work hours or change jobs to a different industry when opportunities to learn via work tasks were limited. At the same time limited opportunities for training and development and perceptions of constraints to development at work predicted the intention to change jobs. Results indicate consideration must be paid to employee perceptions in the workplace in relation to goals. They may be important factors in designing strategies to retain workers.

The relationship between parity and overweight varies with household wealth and national development.

PubMed

Kim, Sonia A; Yount, Kathryn M; Ramakrishnan, Usha; Martorell, Reynaldo

2007-02-01

Recent studies support a positive relationship between parity and overweight among women of developing countries; however, it is unclear whether these effects vary by household wealth and national development. Our objective was to determine whether the association between parity and overweight [body mass index (BMI) > or =25 kg/m(2)] in women living in developing countries varies with levels of national human development and/or household wealth. We used data from 28 nationally representative, cross-sectional surveys conducted between 1996 and 2003 (n = 275 704 women, 15-49 years). The relationship between parity and overweight was modelled using logistic regression, controlling for several biological and sociodemographic factors and national development, as reflected by the United Nations' Human Development Index. We also modelled the interaction between parity and national development, and the three-way interaction between parity, household wealth and national development. Parity had a weak, positive association with overweight, which varied by household wealth and national development. Among the poorest women and women in the second tertile of household wealth, parity was positively related to overweight only in the most developed countries. Among the wealthiest women, parity was positively related to overweight regardless of the level of national development. As development increases, the burden of parity-related overweight shifts to include poor as well as wealthy women. In the least-developed countries, programmes to prevent parity-related overweight should target wealthy women, whereas such programmes should be provided to all women in more developed countries.

Integrating the results of user research into medical device development: insights from a case study.

PubMed

Martin, Jennifer L; Barnett, Julie

2012-07-19

It is well established that considering users is an important aspect of medical device development. However it is also well established that there are numerous barriers to successfully conducting user research and integrating the results into product development. It is not sufficient to simply conduct user research, it must also be effectively integrated into product development. A case study of the development of a new medical imaging device was conducted to examine in detail how users were involved in a medical device development project. Two user research studies were conducted: a requirements elicitation interview study and an early prototype evaluation using contextual inquiry. A descriptive in situ approach was taken to investigate how these studies contributed to the product development process and how the results of this work influenced the development of the technology. Data was collected qualitatively through interviews with the development team, participant observation at development meetings and document analysis. The focus was on investigating the barriers that exist to prevent user data from being integrated into product development. A number of individual, organisational and system barriers were identified that functioned to prevent the results of the user research being fully integrated into development. The user and technological aspects of development were seen as separate work streams during development. The expectations of the developers were that user research would collect requirements for the appearance of the device, rather than challenge its fundamental concept. The manner that the user data was communicated to the development team was not effective in conveying the significance or breadth of the findings. There are a range of informal and formal organisational processes that can affect the uptake of user data during medical device development. Adopting formal decision making processes may assist manufacturers to take a more integrated and reflective approach to development, which should result in improved business decisions and a higher quality end product.

Integrating the results of user research into medical device development: insights from a case study

PubMed Central

2012-01-01

Background It is well established that considering users is an important aspect of medical device development. However it is also well established that there are numerous barriers to successfully conducting user research and integrating the results into product development. It is not sufficient to simply conduct user research, it must also be effectively integrated into product development. Methods A case study of the development of a new medical imaging device was conducted to examine in detail how users were involved in a medical device development project. Two user research studies were conducted: a requirements elicitation interview study and an early prototype evaluation using contextual inquiry. A descriptive in situ approach was taken to investigate how these studies contributed to the product development process and how the results of this work influenced the development of the technology. Data was collected qualitatively through interviews with the development team, participant observation at development meetings and document analysis. The focus was on investigating the barriers that exist to prevent user data from being integrated into product development. Results A number of individual, organisational and system barriers were identified that functioned to prevent the results of the user research being fully integrated into development. The user and technological aspects of development were seen as separate work streams during development. The expectations of the developers were that user research would collect requirements for the appearance of the device, rather than challenge its fundamental concept. The manner that the user data was communicated to the development team was not effective in conveying the significance or breadth of the findings. Conclusion There are a range of informal and formal organisational processes that can affect the uptake of user data during medical device development. Adopting formal decision making processes may assist manufacturers to take a more integrated and reflective approach to development, which should result in improved business decisions and a higher quality end product. PMID:22812565

Optimization of space system development resources

NASA Astrophysics Data System (ADS)

Kosmann, William J.; Sarkani, Shahram; Mazzuchi, Thomas

2013-06-01

NASA has had a decades-long problem with cost growth during the development of space science missions. Numerous agency-sponsored studies have produced average mission level cost growths ranging from 23% to 77%. A new study of 26 historical NASA Science instrument set developments using expert judgment to reallocate key development resources has an average cost growth of 73.77%. Twice in history, a barter-based mechanism has been used to reallocate key development resources during instrument development. The mean instrument set development cost growth was -1.55%. Performing a bivariate inference on the means of these two distributions, there is statistical evidence to support the claim that using a barter-based mechanism to reallocate key instrument development resources will result in a lower expected cost growth than using the expert judgment approach. Agent-based discrete event simulation is the natural way to model a trade environment. A NetLogo agent-based barter-based simulation of science instrument development was created. The agent-based model was validated against the Cassini historical example, as the starting and ending instrument development conditions are available. The resulting validated agent-based barter-based science instrument resource reallocation simulation was used to perform 300 instrument development simulations, using barter to reallocate development resources. The mean cost growth was -3.365%. A bivariate inference on the means was performed to determine that additional significant statistical evidence exists to support a claim that using barter-based resource reallocation will result in lower expected cost growth, with respect to the historical expert judgment approach. Barter-based key development resource reallocation should work on spacecraft development as well as it has worked on instrument development. A new study of 28 historical NASA science spacecraft developments has an average cost growth of 46.04%. As barter-based key development resource reallocation has never been tried in a spacecraft development, no historical results exist, and a simulation of using that approach must be developed. The instrument development simulation should be modified to account for spacecraft development market participant differences. The resulting agent-based barter-based spacecraft resource reallocation simulation would then be used to determine if significant statistical evidence exists to prove a claim that using barter-based resource reallocation will result in lower expected cost growth.

Rural development--national improvement.

PubMed

Malhotra, R C

1984-05-01

Rural development should be viewed as the core of any viable strategy for national development in developing countries where an average 2/3 of the population live in rural areas. Rural development is multisectoral, including economic, sociopolitical, environmental, and cultural aspects of rural life. Initially, the focus is on the provision of basic minimum needs in food, shelter, clothing, health, and education, through optimum use and employment of all available resources, including human labor. The development goal is the total development of the human potential. The hierarchy of goals of development may be shown in the form of an inverted pyramid. At the base are basic minimum needs for subsistence whose fulfillment leads to a higher set of sociopolitical needs and ultimately to the goal of total developmentand the release of creative energies of every individual. If development, as outlined, were to benefit the majority of the people then they would have to participate in decision making which affects their lives. This would require that the people mobilize themselves in the people'ssector. The majority can equitably benefit from development only if they are mobilized effectively. Such mobilization requires raising the consciousness of the people concerning their rights and obligations. All development with the twin objectives of growth with equity could be reduced to restructuring the socioeconomic, and hence political relationships. Desinging and implementing an intergrated approach to rural development is the 1st and fundamental issue of rural development management. The commonly accepted goals and objectives of a target group oriented antipoverty development strategy include: higher productivity and growth in gross national product (GNP); equitable distribution of the benefits of development; provision of basic minimum needs for all; gainful employment; participation in development; self reliance or self sustaining growth and development; maintenance of environmental balance. The most challenging task for development managers in developing countries is to mobilize the vast reservoir of surplus human labor and to channel it to productive use. Forest development and management of forest resources is important for rural development for 2 major objectives: to provide firewood, fodder, and other products; and in many areas and particularly in mountainous countries, forest depletion, largely from uncontrolled agricultural expansion, is leading to a loss of environmental protection of the forest, resulting in floods, droughts, erosion, desertification, silation, and loss of agricultural production.

Research on the Direction of China's Energy Development and Coping Strategies Based on the Trend of World Energy Development

NASA Astrophysics Data System (ADS)

Zhang, Lixin; Tao, Ye; Jiang, Yan; Ma, Ju

2018-06-01

To realize the modernization of the national economy, it is necessary to develop energy science and technology for China,which is third largest countries in the world.The rapid development of science and technology has promoted the continuous transformation of the global energy industry. By analyzing the trend of energy development in the world today, this paper discusses the challenges that the global energy development facing and the situation and tasks faced by China's energy sustainable development, and looks forward to China's strategies to cope with the development of the world's energy.

User participation in healthcare IT development: a developers' viewpoint in Finland.

PubMed

Martikainen, Susanna; Korpela, Mikko; Tiihonen, Tuija

2014-03-01

Recent research showed that physicians in Finland were highly critical of their information technology (IT) systems. They were also critical of the methods of collaboration with the developers of the health IT systems (HITS) in use at the time of the questionnaire. This study turned the set-up around and asked systems developers the same questions about collaboration. What is developers' view on end user participation in HITS development at the moment? How would developers wish end users to participate in systems development? Do the developers' views differ from the physicians' (end users') views of the current state of collaboration in developing IT systems? A web-based questionnaire study was conducted in one of the major HITS provider companies in Finland among all developers, including software developers and customer support and sales personnel. Both quantitative and free-text questions of a previous study were adapted for the purpose. The responses were analyzed with qualitative and basic quantitative methods. The response rate of the questionnaire was 37% and 136 responses were received. The developers who responded were experienced workers; 81% of the respondents had 6 years or more of work experience in IT systems development and 35% of them had 6 years or more of work experience in the healthcare domain. Almost three-quarters (72%) of the respondents agreed with the statement 'I work with users'. Almost all the developers (90%) thought that they are interested in user feedback and also 81% thought that they take the end users' opinions and experiences into account when developing software. A majority of the developers (57%) considered that corrections and modifications are currently not implemented quickly enough. The most popular means of user participation were that 'users would present their work and needs related to it in their workplace' (76%), followed by user groups (75%). The developers suggested many traditional user-centered and usability design methods, too. The developers' views were compared to the views of the physicians who primarily used the case company's products. The views were in direct opposition on whether developers are interested in end users' views (90% of the developers agreed, vs. 60% of the physicians disagreed) and take them into account (81% of the developers agreed, vs. 63% of the physicians disagreed), as well as on user groups (favored by 75% of the developers vs. 14% of the physicians). The majority of the respondents, both developers (57%) and physicians (74%), were dissatisfied with the pace of implementation of corrections and modifications. Both physicians and developers seem to be "willing but not able" to collaborate with each other. Possible reasons for the differences in views include the fact that there is no return channel of communication on what happened to the end users' feedback, and that developers collaborate with customer representatives who are not end users. It is obvious that there are one or more spots along the route between the "end developers" and end users where there is a breakdown of the information flow. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Evaluating Youth Development Programs: Progress and Promise

PubMed Central

Brooks-Gunn, Jeanne

2016-01-01

Advances in theories of adolescent development and positive youth development have greatly increased our understanding of how programs and practices with adolescents can impede or enhance their development. In this paper the authors reflect on the progress in research on youth development programs in the last two decades, since possibly the first review of empirical evaluations by Roth, Brooks-Gunn, Murray, and Foster (1998). The authors use the terms Version 1.0, 2.0 and 3.0 to refer to changes in youth development research and programs over time. They argue that advances in theory and descriptive accounts of youth development programs (Version 2.0) need to be coupled with progress in definitions of youth development programs, measurement of inputs and outputs that incorporate an understanding of programs as contexts for development, and stronger design and evaluation of programs (Version 3.0). The authors also advocate for an integration of prevention and promotion research, and for use of the term youth development rather than positive youth development. PMID:28077922

Innovative development path of ethnomedicines: a case study.

PubMed

Zhu, Zhaoyun; Gui, Yali; Wang, Li; Wang, Ting; Yang, Yang; Niu, Yunzhuang; Fu, Dehuan; Wang, Jingkun; Cui, Tao

2017-06-01

Innovative development extends the vitality of ethnomedicines. Developing ethnomedicines is not only beneficial to the public but also to the related industry and transforms economic growth, driving local social and economic development further. Its economic benefit can be used to optimize and promote the hardware and software of the platform, as well as support the sustainable development of ethnomedicines. Apart from research and discussion on the innovative development of ethnomedicines on the basis of theory and regulations, this series of articles also summarizes cases that are conducive to the overall understanding of the necessity and feasibility of the innovative development. In terms of industrial development, large enterprises and products, such as Yunnan Baiyao, Guizhou Miao ethnomedicines, Cheezheng Tibetan Medicine, products developed from Dengzhanhua (Erigeron breviscapus), the Gold series of Yi ethnomedicines, and products developed from Sanqi (Panax notoginseng), in China are introduced and summarized, focusing on resource superiority, sustainable innovation, standard research and development, and production, as well as intellectual property protection.

Characteristics of sports-based youth development programs.

PubMed

Perkins, Daniel F; Noam, Gil G

2007-01-01

The term "sports-based youth development programs" is coined and defined in the context of the community youth development framework. Sports-based youth development programs are out-of-school-time programs that use a particular sport to facilitate learning and life skill development in youth. Community youth development programs use a community youth development approach to create opportunities for youth to connect to others, develop skills, and use those skills to contribute to their communities. This, in turn, increases their ability to succeed. The authors describe how sports-based youth development programs can be contexts that promote positive youth development. The features of positive developmental settings for youth from the work of the National Research Council and the Institute of Medicine, as well as the features identified by other researchers, are presented in the context of sports-based youth development programs. For example, a sports program that provides appropriate structure has delineated clear rules, expectations, and responsibilities for youth, parents, coaches, officials, and other organizers.

Development of the talent development environment questionnaire for sport.

PubMed

Martindale, Russell J J; Collins, Dave; Wang, John C K; McNeill, Michael; Lee, Kok Sonk; Sproule, John; Westbury, Tony

2010-09-01

As sporting challenge at the elite level becomes ever harder, maximizing effectiveness of the talent development pathway is crucial. Reflecting this need, this paper describes the development of the Talent Development Environment Questionnaire, which has been designed to facilitate the development of sporting potential to world-class standard. The questionnaire measures the experiences of developing athletes in relation to empirically identified "key features" of effective talent development environments. The first phase involved the generation of questionnaire items with clear content and face validity. The second phase explored the factor structure and reliability. This was carried out with 590 developing athletes through application of exploratory factor analysis with oblique rotation, principal axis factoring extraction and cronbach alpha tests. This yielded a 59-item, seven-factor structure with good internal consistency (0.616-0.978). The Talent Development Environment Questionnaire appears to be a promising psychometric instrument that can potentially be useful for education and formative review in applied settings, and as a measurement tool in talent development research.

[Primary health care: reality or utopia in a developing country?].

PubMed

Abiodun, P O; Wolf, H

1988-07-01

Though it is 20 years since the acceptance, by member nations of WHO, of the concept of primary health care (PHC) as the best and cheapest means of achieving "Health for All in the Year 2000", most developing nations have made little or no progress toward its attainment. This is due, among other things, to a misconception of the meaning of PHC, by both developing and developed nations. While many developing nations see it as a new vertical programme, and therefore fail to integrate it into already existing ones, most developed nations take it, wrongly to mean that the developing nations should return to ancient, primitive medicine, which in earlier times led to high morbidity even in the developed nations. In the developing countries, there is still a disproportionately high concentration of resources in urban areas, and much more emphasis is still being placed on curative than on preventive measures. To achieve "Health for all in the Year 2000", therefore, a reorientation of both the developed and the developing nations is urgently needed.

Framework programmable platform for the advanced software development workstation. Integration mechanism design document

NASA Technical Reports Server (NTRS)

Mayer, Richard J.; Blinn, Thomas M.; Mayer, Paula S. D.; Reddy, Uday; Ackley, Keith; Futrell, Mike

1991-01-01

The Framework Programmable Software Development Platform (FPP) is a project aimed at combining effective tool and data integration mechanisms with a model of the software development process in an intelligent integrated software development environment. Guided by this model, this system development framework will take advantage of an integrated operating environment to automate effectively the management of the software development process so that costly mistakes during the development phase can be eliminated.

Incremental development and prototyping in current laboratory software development projects: Preliminary analysis

NASA Technical Reports Server (NTRS)

Griesel, Martha Ann

1988-01-01

Several Laboratory software development projects that followed nonstandard development processes, which were hybrids of incremental development and prototyping, are being studied. Factors in the project environment leading to the decision to use a nonstandard development process and affecting its success are analyzed. A simple characterization of project environment based on this analysis is proposed, together with software development approaches which have been found effective for each category. These approaches include both documentation and review requirements.

NASA Planetary Science Division's Instrument Development Programs, PICASSO and MatISSE

NASA Technical Reports Server (NTRS)

Gaier, James R.

2016-01-01

The Planetary Science Division (PSD) has combined several legacy instrument development programs into just two. The Planetary Instrument Concepts Advancing Solar System Observations (PICASSO) program funds the development of low TRL instruments and components. The Maturation of Instruments for Solar System Observations (MatISSE) program funds the development of instruments in the mid-TRL range. The strategy of PSD instrument development is to develop instruments from PICASSO to MatISSE to proposing for mission development.

Development Index, A Proposed Pattern for Organizing and Facilitating the Flow of Information Needed By Man in Furthering His Own Development, With Particular Reference to the Development of Buildings and Communities and Other Forms of Environmental Control.

ERIC Educational Resources Information Center

Michigan Univ., Ann Arbor.

The organization of knowledge related to the development of the environment and the building industry is provided in this index which provides a framework or classification system for a broad range of information. Man's development in terms of environmental structuring and control is discussed as development goals, development cycle, and…

Comparison of Psychomotor Development Screening Test and Clinical Assessment of Psychomotor Development

PubMed

Radmilović, Goranka; Matijević, Valentina; Zavoreo, Iris

2016-12-01

Numerous adverse factors are acting in the prenatal, perinatal and postnatal period of life and may be the cause of later mild or severe deviations from normal psychomotor development. Therefore, it is crucial to identify infants with neurological risk factors and infants that already have a delay from orderly development, in order to immediately initiate the rehabilitation process. The aim of this study was to determine whether there is difference in the assessment of psychomotor development in neurological risk children based on the psychomotor development test (Croatian, Razvoj psihomotorike, RPM test) and clinical evaluation of neuromotor development. RPM test is designed for rough estimate of psychomotor development in children in the first two years of life. The study included 15 full term children (8 male and 7 female) with clinical diagnosis of mild paraparesis and mild deviation from normal psychological and social development, and 15 full term children (8 male and 7 female) without neurological risk factors and deviations from normal psychomotor development, all at the age of 12-24 months. Of the 15 children diagnosed with mild paraparesis, none had delayed psychomotor development, 6.7% had suspect development and 93.3% had normal development on RPM test. All children in the control group had normal development on RPM test. According to the results, the RPM test is not sensitive enough to detect mild neurodevelopmental disorders.

Strategic environmental assessment can help solve environmental impact assessment failures in developing countries

DOE Office of Scientific and Technical Information (OSTI.GOV)

Alshuwaikhat, Habib M.

2005-05-15

The current trend of industrialization and urbanization in developing nations has a huge impact on anthropogenic and natural ecosystems. Pollution sources increase with the expansion of cities and cause contamination of water, air and soil. The absence of urban environmental planning and management strategies has resulted in greater concern for future urban development. This paper advocates the adoption of strategic environmental assessment (SEA) as a means to achieve sustainable development in developing countries. It investigates project-level environmental impact assessment (EIA) and its limitations. The exploration of SEA and its features are addressed. The effective implementation of SEA can create amore » roadmap for sustainable development. In many developing countries, the lack of transparency and accountability and ineffective public participation in the development of the policy, plan and program (PPP) would be mitigated by the SEA process. Moreover, the proactive and broadly based characteristics of SEA would benefit the institutional development of the PPP process, which is rarely experienced in many developing countries. The paper also explores the prospects for SEA and its guiding principles in developing countries. Finally, the paper calls for a coordinated effort between all government, nongovernment and international organizations involved with PPPs to enable developing countries to pursue a path of sustainable development through the development and application of strategic environmental assessment.« less

36 CFR 910.2 - Purpose.

Code of Federal Regulations, 2010 CFR

2010-07-01

...: public improvements construction and square development. Public improvements construction consists of... configuration, and pedestrian amenities. Square development consists of design and construction of development projects primarily on city blocks, known as squares, within the Development Area. These development...

36 CFR 910.2 - Purpose.

Code of Federal Regulations, 2014 CFR

2014-07-01

...: public improvements construction and square development. Public improvements construction consists of... configuration, and pedestrian amenities. Square development consists of design and construction of development projects primarily on city blocks, known as squares, within the Development Area. These development...

36 CFR 910.2 - Purpose.

Code of Federal Regulations, 2012 CFR

2012-07-01

...: public improvements construction and square development. Public improvements construction consists of... configuration, and pedestrian amenities. Square development consists of design and construction of development projects primarily on city blocks, known as squares, within the Development Area. These development...

36 CFR 910.2 - Purpose.

Code of Federal Regulations, 2011 CFR

2011-07-01

...: public improvements construction and square development. Public improvements construction consists of... configuration, and pedestrian amenities. Square development consists of design and construction of development projects primarily on city blocks, known as squares, within the Development Area. These development...

Skills Development for the Knowledge Economy in Asia: Some Conclusions from the OECD Experience

ERIC Educational Resources Information Center

Martinez-Fernandez, Cristina; Weyman, Tamara

2014-01-01

The development of a knowledge-based economy relies greatly on developing the skills and education needed for inclusive and sustainable development so that growth will reach all parts of the society. Addressing skills development for all is challenging for all OECD countries; Asian economies are working towards developing integrated pathways of…

Youth Aspirations and the Reality of Jobs in Developing Countries: Mind the Gap. Development Centre Studies

ERIC Educational Resources Information Center

OECD Publishing, 2017

2017-01-01

Many governments in developing countries are realising that good quality jobs matter for development. However, little attention has been paid so far to explore what actually matters for young people in terms of job characteristics and employment conditions. Today, in many developing and emerging countries, a key development challenge is that…

PISA for Development and the Sustainable Development Goals. PISA for Development Brief 17

ERIC Educational Resources Information Center

OECD Publishing, 2017

2017-01-01

The PISA for Development brief series is a set of concise monthly education policy-oriented notes published by the OECD which are designed to describe a specific PISA for Development topic. In this brief, PISA's role in monitoring the fourth United Nations Sustainable Development Goal--to "ensure inclusive and equitable quality education and…

Lessons Learned from the Process of Curriculum Developers' and Assessment Developers' Collaboration on the Development of Embedded Formative Assessments

ERIC Educational Resources Information Center

Brandon, Paul R.; Young, Donald B.; Shavelson, Richard J.; Jones, Rachael; Ayala, Carlos C.; Ruiz-Primo, Maria Araceli; Yin, Yue; Tomita, Miki K.; Furtak, Erin Marie

2008-01-01

Our project to embed formative student assessments in the Foundational Approaches in Science Teaching curriculum required a close collaboration between curriculum developers at the Curriculum Research & Development Group (CRDG) and assessment developers at the Stanford Educational Assessment Laboratory (SEAL). This was a new endeavor for each…

Poverty and Child Development: Relevance of Research in Developing Countries to the United States.

ERIC Educational Resources Information Center

Pollitt, Ernesto

1994-01-01

Maintains that research from developing countries may help in understanding effects of poverty on child development in the United States, citing three cases: (1) the link between anemia and decreased levels of mental and motor development; (2) the positive effects of supplemental nutrition programs on child development; and (3) effects of poor…

Sustainable Development in Higher Education: Current Practice and Future Development: A Case Study of University of Calabar-Nigeria

ERIC Educational Resources Information Center

Ajake, Uchenna E.; Omori, Anne E.; Essien, Margaret

2011-01-01

The study highlighted the Nigerian Universities' new sustainable development strategies: emphasizes the role that entrepreneurship education can play in both raising awareness among young people about sustainable development and giving them the skills to put sustainable development into practice. Universities place priority on the development of…

Development and Application of a Two-Tier Diagnostic Test for High School Students' Understanding of Flowering Plant Growth and Development

ERIC Educational Resources Information Center

Lin, Sheau-Wen

2004-01-01

This study involved the development and application of a two-tier diagnostic test measuring students' understanding of flowering plant growth and development. The instrument development procedure had three general steps: defining the content boundaries of the test, collecting information on students' misconceptions, and instrument development.…

Classroom Teacher Candidates' Perceptions of Teacher Self-Efficacy in Developing Students' Reading, Writing and Verbal Skills: Scale Development Study

ERIC Educational Resources Information Center

Canbulat, Ayse Nur Kutluca

2017-01-01

This work uses exploratory and confirmatory factor analyses to study Verbal Skills Development Teacher Self-Efficacy Scale (VSDTS), Reading Skills Development Teacher Self-Efficacy Scale (RSDTS) and Writing Skills Development Teacher Self-Efficacy Scale (WSDTS) developed to identify classroom teacher candidates' perceptions of teacher…

Women Education and Economic Development in Kenya: Implications for Curriculum Development and Implementation Processes

ERIC Educational Resources Information Center

Syomwene, Anne; Kindiki, Jonah Nyaga

2015-01-01

This paper is a discussion of the relationship between women education and sustainable economic development in Kenya and its implications for curriculum development and implementation processes. The argument advanced in this paper is that the solution to the development problems in Kenya and other developing nations lies on women education.…

Part I: Cognitive Development in Children--Piaget Development and Learning

ERIC Educational Resources Information Center

Piaget, Jean

2003-01-01

In this article, the author gives a general introduction of a few ideas on cognitive development in children. In the first part, he deals with the topic of development, a process which concerns the totality of the structures of knowledge. He reviews the stages of development of operational structures, distinguishes four main stages of development,…

Development Education and Engineering: A Framework for Incorporating Reality of Developing Countries into Engineering Studies

ERIC Educational Resources Information Center

Perez-Foguet, A.; Oliete-Josa, S.; Saz-Carranza, A.

2005-01-01

Purpose: To show the key points of a development education program for engineering studies fitted within the framework of the human development paradigm. Design/methodology/approach: The bases of the concept of technology for human development are presented, and the relationship with development education analysed. Special attention is dedicated…

Popular Participation in Development: Emerging Trends in Community Development.

ERIC Educational Resources Information Center

United Nations, New York, NY. Dept. of Economic and Social Affairs.

A first attempt is made to place in perspective the accumulated experience of nearly 20 years of community development activity in both developed and developing countries. The purpose of this study is to stimulate further inquiry into community development practice, process, and theory in order for it to become a more effective instrument in the…

Perspectives on the Present State and Future of Higher Education Faculty Development in Kazakhstan: Implications for National Human Resource Development

ERIC Educational Resources Information Center

Seitova, Dinara

2016-01-01

The article aims at examining the present state of higher education faculty development in Kazakhstan in the context of multidimensional nationwide development reforms and exploring implications for the National Human Resource Development of the country. For the purpose of this research, theoretical human resource development (HRD) and…

Fundamental frequency development in typically developing infants and infants with severe-to-profound hearing loss

PubMed Central

Iyer, Suneeti Nathani; Oller, D. Kimbrough

2010-01-01

Little research has been conducted on the development of suprasegmental characteristics of vocalizations in typically developing infants (TDI) and the role of audition in the development of these characteristics. The purpose of the present study was to examine the longitudinal development of fundamental frequency (F0) in eight TDI and eight infants with severe-to-profound hearing loss matched for level of vocal development. Results revealed no significant changes in F0 with advances in pre-language vocal development for TDI. Infants with hearing loss, however, showed a statistically reliable higher variability of F0 than TDI, when age was accounted for as a covariate. The results suggest development of F0 may be strongly influenced by audition. PMID:19031191

On System Engineering a Barter-Based Re-allocation of Space System Key Development Resources

NASA Astrophysics Data System (ADS)

Kosmann, William J.

NASA has had a decades-long problem with cost growth during the development of space science missions. Numerous agency-sponsored studies have produced average mission level development cost growths ranging from 23 to 77%. A new study of 26 historical NASA science instrument set developments using expert judgment to re-allocate key development resources has an average cost growth of 73.77%. Twice in history, during the Cassini and EOS-Terra science instrument developments, a barter-based mechanism has been used to re-allocate key development resources. The mean instrument set development cost growth was -1.55%. Performing a bivariate inference on the means of these two distributions, there is statistical evidence to support the claim that using a barter-based mechanism to re-allocate key instrument development resources will result in a lower expected cost growth than using the expert judgment approach. Agent-based discrete event simulation is the natural way to model a trade environment. A NetLogo agent-based barter-based simulation of science instrument development was created. The agent-based model was validated against the Cassini historical example, as the starting and ending instrument development conditions are available. The resulting validated agent-based barter-based science instrument resource re-allocation simulation was used to perform 300 instrument development simulations, using barter to re-allocate development resources. The mean cost growth was -3.365%. A bivariate inference on the means was performed to determine that additional significant statistical evidence exists to support a claim that using barter-based resource re-allocation will result in lower expected cost growth, with respect to the historical expert judgment approach. Barter-based key development resource re-allocation should work on science spacecraft development as well as it has worked on science instrument development. A new study of 28 historical NASA science spacecraft developments has an average cost growth of 46.04%. As barter-based key development resource re-allocation has never been tried in a spacecraft development, no historical results exist, and an inference on the means test is not possible. A simulation of using barter-based resource re-allocation should be developed. The NetLogo instrument development simulation should be modified to account for spacecraft development market participant differences. The resulting agent-based barter-based spacecraft resource re-allocation simulation would then be used to determine if significant statistical evidence exists to prove a claim that using barter-based resource re-allocation will result in lower expected cost growth.

Staff development and secondary science teachers: Factors that affect voluntary participation

NASA Astrophysics Data System (ADS)

Corley, Theresa Roebuck

2000-10-01

A researcher-designed survey assessed the perceptions of Alabama secondary science public school teachers toward the need for staff development and toward certain staff development strategies and programs. Factors that encouraged or discouraged attendance at voluntary staff development programs and opinions regarding effective and ineffective features of programs were identified. Data were analyzed using descriptive techniques. Percentages and frequencies were noted. Average rankings were computed for the staff development techniques considered most and least effective and for the preferred designs of future staff development offerings. Chi squares were computed to respond to each of the 4 research hypotheses. Narrative discussions and tables were utilized to report the data and provide clarification. This study related demographic information to the research hypotheses. Analysis of the research hypotheses revealed that experienced teachers agree more strongly about the features of staff development programs that they consider effective and about the factors that may affect participation in staff development programs. Analysis of the research questions revealed that secondary science teachers in Alabama agree that staff development is a personal responsibility but that the school systems are responsible for providing staff development opportunities. Teachers believe that staff development is needed annually in both science content and teaching strategies and favor lengthening the school year for staff development. Teachers identified interest level, graduate credit, ability to implement material, scheduling factors, and the reputation of the organizer as the most important factors in determining participation in voluntary staff development programs. Hands-on workshops were identified as the most effective type of voluntary staff development and teachers requested that future staff development experiences include hands-on workshops, networking, curriculum development, mentoring, support groups, training trainers, cooperative learning groups, coaching, implementing changes, and collecting resources.

pyam: Python Implementation of YaM

NASA Technical Reports Server (NTRS)

Myint, Steven; Jain, Abhinandan

2012-01-01

pyam is a software development framework with tools for facilitating the rapid development of software in a concurrent software development environment. pyam provides solutions for development challenges associated with software reuse, managing multiple software configurations, developing software product lines, and multiple platform development and build management. pyam uses release-early, release-often development cycles to allow developers to integrate their changes incrementally into the system on a continual basis. It facilitates the creation and merging of branches to support the isolated development of immature software to avoid impacting the stability of the development effort. It uses modules and packages to organize and share software across multiple software products, and uses the concepts of link and work modules to reduce sandbox setup times even when the code-base is large. One sidebenefit is the enforcement of a strong module-level encapsulation of a module s functionality and interface. This increases design transparency, system stability, and software reuse. pyam is written in Python and is organized as a set of utilities on top of the open source SVN software version control package. All development software is organized into a collection of modules. pyam packages are defined as sub-collections of the available modules. Developers can set up private sandboxes for module/package development. All module/package development takes place on private SVN branches. High-level pyam commands support the setup, update, and release of modules and packages. Released and pre-built versions of modules are available to developers. Developers can tailor the source/link module mix for their sandboxes so that new sandboxes (even large ones) can be built up easily and quickly by pointing to pre-existing module releases. All inter-module interfaces are publicly exported via links. A minimal, but uniform, convention is used for building modules.

The correlation of housing estate area with regional infrastructure development in peri-urban region of metropolitan Bandung Raya

NASA Astrophysics Data System (ADS)

Vitriana, A. N. I. T. A.

2018-03-01

Housing estates development in the peri-urban area is often used as a solution to meet the needs of urban housing. In this case, the development of housing estates built by developers, are including housing units as well as the facilities and infrastructure. Based on this practice, then two opposite opinions emerge about the participation of developers in the development of housing infrastructure. The first opinion acknowledges that residential developers have assisted the government in providing settlement infrastructure. Meanwhile, the second opinion considers the infrastructure development undertaken by the residential developers has precisely caused inefficient regional infrastructure development. This study aims to examine the correlation between the development of housing estates and the development of regional infrastructure by using simple linear regression analyses, in order to prove whether there is a relationship between the two variables. This research was conducted at West Bandung Regency (Kabupaten Bandung Barat), one of the regency that located in peri-urban of Metropolitan Bandung Area. Two variables used in this study consist of the area of housing estates variable and the infrastructure development variable. The infrastructure development variable is represented by The IKG score (Geographic Difficulties Index). In this study, two different levels of the area were conducted to the examination, the village, and the subdistrict. The result of this examination shows that there is a weak correlation between the variables of the housing estates area and The IKG, even though its relationship is getting stronger when the test performed on a larger area. Based on this research, it can be said that the development of housing estates infrastructure in West Bandung Regency has a lack of significant effect on the regional infrastructure development.

Development of High Power Vacuum Tubes for Accelerators and Plasma Heating

NASA Astrophysics Data System (ADS)

Srivastava, Vishnu

2012-11-01

High pulsed power magnetrons and klystrons for medical and industrial accelerators, and high CW power klystrons and gyrotrons for plasma heating in tokamak, are being developed at CEERI. S-band 2.0MW pulsed tunable magnetrons of centre frequency 2856MHz and 2998 MHz were developed, and S-band 2.6MW pulsed tunable magnetron is being developed for medical LINAC, and 3MW pulsed tunable magnetron is being developed for industrial accelerator. S-band (2856MHz), 5MW pulsed klystron was developed for particle accelerator, and S-band 6MW pulsed klystron is under development for 10MeV industrial accelerator. 350MHz, 100kW (CW) klystron is being developed for proton accelerator, and C-band 250kW (CW) klystron is being developed for plasma heating. 42GHz, 200kW (CW/Long pulse) gyrotron is under development for plasma heating. Plasma filled tubes are also being developed for switching. 25kV/1kA and 40kV/3kA thyratrons were developed for high voltage high current switching in pulse modulators for magnetrons and klystrons. 25kV/3kA Pseudospark switch of current rise time of 1kA/|a-sec and pulse repetition rate of 500Hz is being developed. Plasma assisted high power microwave device is also being investigated.

[Coupling coordinated development of ecological-economic system in Loess Plateau].

PubMed

Zhang, Qing-Feng; Wu, Fa-Qi; Wang, Li; Wang, Jian

2011-06-01

Based on system theory, a coupling coordinated development model of ecological-economic system in Loess Plateau was established, and the evaluation criteria and basic types of the coordinated development of the ecological-economic system were proposed. The county-level coupling coordinated development of the ecological-economic system was also discussed, based on the local characteristics. The interactions between the ecological and economic systems in Loess Plateau could be divided into four stages, i.e., seriously disordered development stage, mild-disordered development stage, low-level coordinated development stage, and high level well-coordinated development stage. At each stage, there existed a cyclic process of profit and loss-antagonist-running-dominant-synchronous development. The coupling development degree of the ecological-economic system in Loess Plateau was overall at a lower level, being about 62.7% of the counties at serious disorder, 30.1% of the counties at mild disorder, and 7.1% of the counties at low but coordinated level. The coupling development degree based on the model established in this study could better reflect the current social-economic and ecological environment situations, especially the status of coordination. To fully understand the coupling of ecological-economic system and to adopt appropriate development mode would be of significance to promote the county-level coordinated development in Loess Plateau.

77 FR 19178 - Proposed Information Collection; Comment Request; Comprehensive Economic Development Strategy

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-30

... DEPARTMENT OF COMMERCE Economic Development Administration Proposed Information Collection; Comment Request; Comprehensive Economic Development Strategy AGENCY: Economic Development Administration... to John Cobb, Program Analyst, Office of Regional Affairs, Room 7009, Economic Development...

36 CFR § 910.2 - Purpose.

Code of Federal Regulations, 2013 CFR

2013-07-01

...: public improvements construction and square development. Public improvements construction consists of... configuration, and pedestrian amenities. Square development consists of design and construction of development projects primarily on city blocks, known as squares, within the Development Area. These development...

Assessment of sustainable urban transport development based on entropy and unascertained measure.

PubMed

Li, Yancang; Yang, Jing; Shi, Huawang; Li, Yijie

2017-01-01

To find a more effective method for the assessment of sustainable urban transport development, the comprehensive assessment model of sustainable urban transport development was established based on the unascertained measure. On the basis of considering the factors influencing urban transport development, the comprehensive assessment indexes were selected, including urban economical development, transport demand, environment quality and energy consumption, and the assessment system of sustainable urban transport development was proposed. In view of different influencing factors of urban transport development, the index weight was calculated through the entropy weight coefficient method. Qualitative and quantitative analyses were conducted according to the actual condition. Then, the grade was obtained by using the credible degree recognition criterion from which the urban transport development level can be determined. Finally, a comprehensive assessment method for urban transport development was introduced. The application practice showed that the method can be used reasonably and effectively for the comprehensive assessment of urban transport development.

United States Research and Development effort on ITER magnet tasks

DOE PAGES

Martovetsky, Nicolai N.; Reierson, Wayne T.

2011-01-22

This study presents the status of research and development (R&D) magnet tasks that are being performed in support of the U.S. ITER Project Office (USIPO) commitment to provide a central solenoid assembly and toroidal field conductor for the ITER machine to be constructed in Cadarache, France. The following development tasks are presented: winding development, inlets and outlets development, internal and bus joints development and testing, insulation development and qualification, vacuum-pressure impregnation, bus supports, and intermodule structure and materials characterization.

Technology Development Risk Assessment for Space Transportation Systems

NASA Technical Reports Server (NTRS)

Mathias, Donovan L.; Godsell, Aga M.; Go, Susie

2006-01-01

A new approach for assessing development risk associated with technology development projects is presented. The method represents technology evolution in terms of sector-specific discrete development stages. A Monte Carlo simulation is used to generate development probability distributions based on statistical models of the discrete transitions. Development risk is derived from the resulting probability distributions and specific program requirements. Two sample cases are discussed to illustrate the approach, a single rocket engine development and a three-technology space transportation portfolio.

Standards application and development plan for solar thermal technologies

NASA Astrophysics Data System (ADS)

Cobb, H. R. W.

1981-07-01

Functional and standards matrices, developed from input from ST users and from the industry that will be continually reviewed and updated as commercial aspects develop are presented. The matrices highlight codes, standards, test methods, functions and definitions that need to be developed. They will be submitted through ANSI for development by national consensus bodies. A contingency action is proposed for standards development if specific input is lacking at the committee level or if early development of a standard would hasten commercialization or gain needed jurisdictional acceptance.

Training Home Economists for Rural Development. Report of a Global Study on the Development of Criteria for Establishing Training Institutions for Home Economics Staff in Rural Development. FAO Economic and Social Development Paper 6.

ERIC Educational Resources Information Center

Cornell Univ., Ithaca, NY.

In 1973 a global study aimed toward the development of criteria for establishing institutions for training home economists for rural development programs was initiated by the Home Economics and Social Programmes Services of the Food and Agriculture Organization of the U.N. As a first step, a survey was developed on the variety of roles appropriate…

Conserving biodiversity and ecosystem function through limited development: an empirical evaluation.

PubMed

Milder, Jeffrey C; Lassoie, James P; Bedford, Barbara L

2008-02-01

Suburban, exurban, and rural development in the United States consumes nearly 1 million hectares of land per year and is a leading threat to biodiversity. In response to this threat, conservation development has been advanced as a way to combine land development and land conservation while providing functional protection for natural resources. Yet, although conservation development techniques have been in use for decades, there have been few critical evaluations of their conservation effectiveness. We addressed this deficiency by assessing the conservation outcomes of one type of conservation development project: conservation and limited development projects (CLDPs). Conducted by land trusts, landowners, and developers, CLDPs use revenue from limited development to finance the protection of land and natural resources. We compared a sample of 10 CLDPs from the eastern United States with their respective baseline scenarios (conventional development) and with a sample of conservation subdivisions--a different conservation development technique characterized by higher-density development. To measure conservation success, we created an evaluation method containing eight indicators that quantify project impacts to terrestrial and aquatic ecosystems at the site and in the surrounding landscape. The CLDPs protected and managed threatened natural resources including rare species and ecological communities. In terms of conservation benefits, the CLDPs significantly outperformed their respective baseline scenarios and the conservation subdivisions. These results imply that CLDPs can offer a low-impact alternative to conventional development and a low-cost method for protecting land when conventional conservation techniques are too expensive. In addition, our evaluation method demonstrates how planners and developers can incorporate appropriate ecological considerations when designing, reviewing, and evaluating conservation development projects.

VIOLENCE AND NON-VIOLENCE-RELATED INJURIES AND ALCOHOL IN WOMEN FROM DEVELOPED AND DEVELOPING COUNTRIES: A MULTI-SITE EMERGENCY ROOM STUDY

PubMed Central

da Silva, Rosiane Lopes; Diehl, Alessandra; Cherpitel, Cheryl J.; Figlie, Neliana B.

2014-01-01

This study sought to analyze the association between alcohol consumption and the occurrence of injuries in women attending the emergency room (ER) from developing and developed countries. The sample consisted of ER data from women in 15 countries that were collected as part of two multi-site studies using similar methodologies: the Emergency Room Collaborative Alcohol Analysis Project (ERCAAP), and World Health Organization Collaborative Study on Alcohol and Injuries (WHO Study). Women ranged in age from 18 and 98 years. Those from developed countries had higher levels of education (43% completed high-school) than women from developing countries (37%). Over half of the women from developing countries reported they had not consumed alcohol in the last 12 months (abstentious), while 2% reported drinking every day. In addition, current drinking women from developing countries reported more binge drinking episodes (33% reported 5 to 11 drinks and 15% reported 12 or more drinks on an occasion) compared to those from developed countries (28% and 11%, respectively). Violence-related injury was more prevalent in developing countries (18%) compared to developed countries (9%). An association between injury and the frequency of alcohol consumption in the last 12 months was observed in both developing and developed countries. Although women from developing countries who suffered violence-related injuries were more likely to demonstrate alcohol abstinence or have lower rates of daily alcohol consumption, these women drank in a more dangerous way, and violence-related injuries were more likely to occur in these women than in those living in developed countries. PMID:25452073

Cold-development tool and technique for the ultimate resolution of ZEP520A to fabricate an EB master mold for nano-imprint lithography for 1Tbit/inch2 BPM development

NASA Astrophysics Data System (ADS)

Kobayashi, Hideo; Iyama, Hiromasa; Kagatsume, Takeshi; Watanabe, Tsuyoshi

2012-11-01

Cold-development is well-known for resolution enhancement on ZEP520A. Dipping a wafer in a developer solvent chilled by a freezer, such a typical method had been employed. But, it is obvious that the dip-development method has several inferiorities such as developer temperature instability, temperature inconsistency between developer and a wafer, water-condensation on drying. We then built a single wafer spin-develop tool, and established a process sequence, to solve those difficulties. And, we tried to see their effect down to -10degC over various developers. In specific, we tried to make hole patterns in hexagonal closest packing in 40nm, 35nm, 30nm, 25nm pitch, and examined holes pattern quality and resolution limit by varying setting temperature from room temperature to -10degC in the cold-development, as well as varying developer chemistry from the standard developer ZED N-50 (n-amyl acetate, 100%) to MiBK and IPA mixture which was a rinsing solvent mixture originally. We also examined the other developer (poor solvent mixture) we designed, N-50 and fluorocarbon (FC) mixture, MiBK and FC mixture, and IPA+FC mixture. This paper describes cold-development tool and technique, and its results down to minus (-) 10degC, for ZEP520A resolution enhancement to obtain 1Xnm bits (holes) in 25nm pitch to fabricate an EB master mold for Nano-Imprinting Lithography for 1Tbit/in2 bit patterned media (BPM) in HDD development and production.

77 FR 64794 - Membership of the Economic Development Administration Performance Review Board

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-23

... DEPARTMENT OF COMMERCE Economic Development Administration Membership of the Economic Development Administration Performance Review Board AGENCY: Economic Development Administration, Department of Commerce. ACTION: Notice of Membership on the Economic Development Administration's Performance Review Board...

75 FR 63813 - Membership of the Economic Development Administration Performance Review Board

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-18

... DEPARTMENT OF COMMERCE Economic Development Administration Membership of the Economic Development Administration Performance Review Board AGENCY: Economic Development Administration, Department of Commerce. ACTION: Notice of membership on the Economic Development Administration's Performance Review Board...

Organization Development

ERIC Educational Resources Information Center

Huse, Edgar F.

1978-01-01

Organization Development (OD) is the application of behavioral-science knowledge to enhance an organization's effectiveness and efficiency. This article discusses the evolution of organization development, the basic components of an OD program, typologies of OD interventions, problems with organization development, and organization development in…

Developing putative AOPs from high content dataDeveloping putative AOPs from high content dataDeveloping putative AOPs from high content dataDeveloping putative AOPs from high content data

EPA Science Inventory

Developing putative AOPs from high content data Shannon M. Bell1,2, Stephen W. Edwards2 1 Oak Ridge Institute for Science and Education 2 Integrated Systems Toxicology Division, National Health and Environmental Effects Research Laboratory, Office of Research and Development,...

75 FR 76455 - Coso Energy Developers; Coso Finance Partners; Coso Power Developers; Notice Of Filing

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-08

... DEPARTMENT OF ENERGY Federal Energy Regulatory Commission [Docket No. EL11-4-000] Coso Energy Developers; Coso Finance Partners; Coso Power Developers; Notice Of Filing December 1, 2010. Take notice that on November 18, 2010, Coso Energy Developers, Coso Finance Partners, and Coso Power Developers, pursuant to section 207 of the Federal Energy...

Educational Developer 2.0: How Educational Development Leaders Will Need to Develop Themselves in the Era of Innovation

ERIC Educational Resources Information Center

Sievers, Julie

2016-01-01

How should educational developers develop their own expertise and skills in the twenty-first century? Today educational developers are drawing on new discoveries in educational research, supporting new pedagogies in many fields, and experimenting with new technologies for teaching and learning. Yet they must do so in a time of uncertain and…

Development and Validation of an Instrument to Assess Youth Motivation to Participate in Career Development Events

ERIC Educational Resources Information Center

Knobloch, Neil A.; Brady, Colleen M.; Orvis, Kathryn S.; Carroll, Natalie J.

2016-01-01

Career development events develop career and life skills in youth, but limited work has been done to assess the motivation of students who participate in these events. The purpose of this study was to validate an instrument developed to measure youth motivation to participate in career development events. An instrument grounded in expectancy-value…

Talent Development, Work Habits, and Career Exploration of Chinese Middle-School Adolescents: Development of the Career and Talent Development Self-Efficacy Scale

ERIC Educational Resources Information Center

Yuen, Mantak; Gysbers, Norman C.; Chan, Raymond M. C.; Lau, Patrick S. Y.; Shea, Peter M. K.

2010-01-01

This article describes the development of an instrument--the "Career and Talent Development Self-Efficacy Scale (CTD-SES)"--for assessing students' self-efficacy in applying life skills essential for personal talent development, acquisition of positive work habits, and career exploration. In Study 1, data were obtained from a large…

Communication challenges in system development: involvement of system developers in small-scale IT projects.

PubMed

Petersen, Lone Stub; Bjoernes, Charlotte D; Bertelsen, Pernille

2010-01-01

A well-known challenge in system development is the aspect of user participation. In this paper we shift perspective from how to involve users in system development to how project managers with a clinical background, but without technical system knowledge, can involve system developers in IT projects. Using data from the development of an online patient book (an ICT application for clinical practice), we analyze challenges using the concept of language-games. We conclude that further research and development of participatory and communicative methods to involve system developers in IT projects, based in a clinical context, is needed.

Developing high-quality educational software.

PubMed

Johnson, Lynn A; Schleyer, Titus K L

2003-11-01

The development of effective educational software requires a systematic process executed by a skilled development team. This article describes the core skills required of the development team members for the six phases of successful educational software development. During analysis, the foundation of product development is laid including defining the audience and program goals, determining hardware and software constraints, identifying content resources, and developing management tools. The design phase creates the specifications that describe the user interface, the sequence of events, and the details of the content to be displayed. During development, the pieces of the educational program are assembled. Graphics and other media are created, video and audio scripts written and recorded, the program code created, and support documentation produced. Extensive testing by the development team (alpha testing) and with students (beta testing) is conducted. Carefully planned implementation is most likely to result in a flawless delivery of the educational software and maintenance ensures up-to-date content and software. Due to the importance of the sixth phase, evaluation, we have written a companion article on it that follows this one. The development of a CD-ROM product is described including the development team, a detailed description of the development phases, and the lessons learned from the project.

Lessons learned in the transition to Ada from FORTRAN at NASA/Goddard

NASA Technical Reports Server (NTRS)

Brophy, Carolyn Elizabeth

1989-01-01

Two dynamics satellite simulators are developed from the same requirements, one in Ada and the other in FORTRAN. The purpose of the research was to find out how well the prescriptive Ada development model worked to develop the Ada simulator. The FORTRAN simulator development, as well as past FORTRAN developments, provided a baseline for comparison. Since this was the first simulator developed, the prescriptive Ada development model had many similarities to the usual FORTRAN development model. However, it was modified to include longer design and shorter testing phases, which is generally expected with Ada developments. One result was that the percentage of time the Ada project spent in the various development activities was very similar to the percentage of time spent in these activities when doing a FORTRAN project. Another finding was the difficulty the Ada team had with unit testing as well as with integration. It was realized that adding additional steps to the design phase, such as an abstract data type analysis, and certain guidelines to the implementation phase, such as to use primarily library units and nest sparingly, would have made development easier. These are among the recommendations made to be incorporated in a new Ada development model next time.

Development assistance for health in central and eastern European Region.

PubMed

Suhrcke, Marc; Rechel, Bernd; Michaud, Catherine

2005-12-01

We aimed to quantify development assistance for health to countries of central and eastern Europe and the Commonwealth of Independent States (CEE-CIS). We used the International Development Statistics database of the Organisation for Economic Co-operation and Development and the database on development assistance for health compiled for the Commission on Macroeconomics and Health to quantify health development assistance to the region, compared to global and overall development assistance. We based our analysis on standard health indicators, including child mortality, life expectancy at birth and health expenditures. Although total development assistance per capita to CEE-CIS was higher than that for most other regions of the world, development assistance for health was very low compared to other countries with similar levels of child mortality, life expectancy at birth and national expenditures on health. The allocation of development assistance for health on a global scale seems to be related far more to child mortality rather than adult mortality. Countries of CEE-CIS have a high burden of adult morbidity and mortality from non-communicable diseases, which does not appear to attract proportionate development assistance. Levels of development assistance for health should be determined in consideration of the region's particular burden of disease.

Heterochrony and early left-right asymmetry in the development of the cardiorespiratory system of snakes.

PubMed

van Soldt, Benjamin J; Metscher, Brian D; Poelmann, Robert E; Vervust, Bart; Vonk, Freek J; Müller, Gerd B; Richardson, Michael K

2015-01-01

Snake lungs show a remarkable diversity of organ asymmetries. The right lung is always fully developed, while the left lung is either absent, vestigial, or well-developed (but smaller than the right). A 'tracheal lung' is present in some taxa. These asymmetries are reflected in the pulmonary arteries. Lung asymmetry is known to appear at early stages of development in Thamnophis radix and Natrix natrix. Unfortunately, there is no developmental data on snakes with a well-developed or absent left lung. We examine the adult and developmental morphology of the lung and pulmonary arteries in the snakes Python curtus breitensteini, Pantherophis guttata guttata, Elaphe obsoleta spiloides, Calloselasma rhodostoma and Causus rhombeatus using gross dissection, MicroCT scanning and 3D reconstruction. We find that the right and tracheal lung develop similarly in these species. By contrast, the left lung either: (1) fails to develop; (2) elongates more slowly and aborts early without (2a) or with (2b) subsequent development of faveoli; (3) or develops normally. A right pulmonary artery always develops, but the left develops only if the left lung develops. No pulmonary artery develops in relation to the tracheal lung. We conclude that heterochrony in lung bud development contributes to lung asymmetry in several snake taxa. Secondly, the development of the pulmonary arteries is asymmetric at early stages, possibly because the splanchnic plexus fails to develop when the left lung is reduced. Finally, some changes in the topography of the pulmonary arteries are consequent on ontogenetic displacement of the heart down the body. Our findings show that the left-right asymmetry in the cardiorespiratory system of snakes is expressed early in development and may become phenotypically expressed through heterochronic shifts in growth, and changes in axial relations of organs and vessels. We propose a step-wise model for reduction of the left lung during snake evolution.

Heterochrony and Early Left-Right Asymmetry in the Development of the Cardiorespiratory System of Snakes

PubMed Central

van Soldt, Benjamin J.; Metscher, Brian D.; Poelmann, Robert E.; Vervust, Bart; Vonk, Freek J.; Müller, Gerd B.; Richardson, Michael K.

2015-01-01

Snake lungs show a remarkable diversity of organ asymmetries. The right lung is always fully developed, while the left lung is either absent, vestigial, or well-developed (but smaller than the right). A ‘tracheal lung’ is present in some taxa. These asymmetries are reflected in the pulmonary arteries. Lung asymmetry is known to appear at early stages of development in Thamnophis radix and Natrix natrix. Unfortunately, there is no developmental data on snakes with a well-developed or absent left lung. We examine the adult and developmental morphology of the lung and pulmonary arteries in the snakes Python curtus breitensteini, Pantherophis guttata guttata, Elaphe obsoleta spiloides, Calloselasma rhodostoma and Causus rhombeatus using gross dissection, MicroCT scanning and 3D reconstruction. We find that the right and tracheal lung develop similarly in these species. By contrast, the left lung either: (1) fails to develop; (2) elongates more slowly and aborts early without (2a) or with (2b) subsequent development of faveoli; (3) or develops normally. A right pulmonary artery always develops, but the left develops only if the left lung develops. No pulmonary artery develops in relation to the tracheal lung. We conclude that heterochrony in lung bud development contributes to lung asymmetry in several snake taxa. Secondly, the development of the pulmonary arteries is asymmetric at early stages, possibly because the splanchnic plexus fails to develop when the left lung is reduced. Finally, some changes in the topography of the pulmonary arteries are consequent on ontogenetic displacement of the heart down the body. Our findings show that the left-right asymmetry in the cardiorespiratory system of snakes is expressed early in development and may become phenotypically expressed through heterochronic shifts in growth, and changes in axial relations of organs and vessels. We propose a step-wise model for reduction of the left lung during snake evolution. PMID:25555231

Etiology of Childhood Infectious Diarrhea in a Developed Region of China: Compared to Childhood Diarrhea in a Developing Region and Adult Diarrhea in a Developed Region.

PubMed

Wang, Xin; Wang, Jing; Sun, Hao; Xia, Shengli; Duan, Ran; Liang, Junrong; Xiao, Yuchun; Qiu, Haiyan; Shan, Guangliang; Jing, Huaiqi

2015-01-01

In China, great differences in economy, social characteristics and hygiene exist between developing and developed regions. A comparative study of infectious diarrhea between two regions was needed. Three groups of diarrheal patients were collected: children ≤5 year-olds from Beijing (developed region) and Henan Province (developing region), and adults over 18 year-olds from Beijing. A questionnaire was used to survey and feces samples were examined for 16 enteropathogens. We enrolled 1422 children and 1047 adults from developed region and 755 children from developing region. Virus positive rates were 32.98% for children and 23.67% for adults in developed region. The most prevalent pathogen for children was rotavirus whereas for adults was norovirus. Bacterial isolation rates were 13.92% for children from developed region, while 29.14% for children from the developing regions. For the greatest difference, Shigella accounted for 50.79% and was the dominant pathogen in the developing region, whereas in the developed region it was only 1.45%. There was no significant relationship between the local levels of development with diarrheogenic Escherichia coli (DEC) categories. But it was seen the notable differences between the population with different age: enteropathogenic E.coli (EPEC) and enteroaggregative E.coli (EAggEC) were the primary classes of DEC in children from both regions, whereas it was enterotoxigenic E.coli (ETEC) in adults. The symptoms of Shigella and Salmonella infection, such as bloody stools, white blood cells (WBC) and red blood cells (RBC) positivity and fever were similar in children, which may lead to the misidentification. Yersinia enterocolitica and shiga toxin-producing E.coli (STEC) infections were firstly reported in Beijing. There was a large difference in etiology of bacterial diarrhea between children in developing and developed regions of China.