Asexuality: Classification and characterization

This is a post-print version of the article. The official published version can be obtaineed at the link below.The term “asexual” has been defined in many different ways and asexuality has received very little research attention. In a small qualitative study (N = 4), individuals who self-identified as asexual were interviewed to help formulate hypotheses for a larger study. The second larger study was an online survey drawn from a convenience sample designed to better characterize asexuality and to test predictors of asexual identity. A convenience sample of 1,146 individuals (N = 41 self-identified asexual) completed online questionnaires assessing sexual history, sexual inhibition and excitation, sexual desire, and an open-response questionnaire concerning asexual identity. Asexuals reported significantly less desire for sex with a partner, lower sexual arousability, and lower sexual excitation but did not differ consistently from non-asexuals in their sexual inhibition scores or their desire to masturbate. Content analyses supported the idea that low sexual desire is the primary feature predicting asexual identity

Somatization and psychological distress among women with vulvar vestibulitis syndrome

ObjectiveTo investigate the distribution of psychological characteristics and pain reporting among women with vulvar vestibulitis syndrome (VVS).MethodsIn this exploratory study, 109 women with VVS completed a battery of questionnaires to assess pain with intercourse and psychological characteristics (e.g. somatization, anxiety, distress). The distribution of these characteristics was compared, first with a conventional binary classification schema (primary and secondary) and subsequently with a 3â category schema (primary, latent primary, secondary).ResultsSeverity of pain with intercourse did not differ among the subgroups using either classification schema. Women with primary VVS consistently showed higher levels of somatization, anxiety, and distress compared with those with secondary VVS. Using a 3â tiered classification system, we found no difference between latent primary diagnosis and the other 2 groups (primary and secondary).ConclusionThis study highlights the critical need for research on subtype definition and the role of psychological factors in VVS.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/135448/1/ijgo38.pd

Pre-dialysis clinic attendance improves quality of life among hemodialysis patients

BACKGROUND: Although previous research has demonstrated that referral to pre-dialysis clinics is associated with favourable objective outcomes, the benefit of a pre-dialysis clinic from the perspective of patient-perceived subjective outcomes, such as quality of life (QOL), is less well defined. METHODS: A retrospective incident cohort study was conducted to determine if pre-dialysis clinic attendance was a predictor of better QOL scores measured within the first six months of hemodialysis (HD) initiation. Inclusion criteria were HD initiation from January 1 1998 to January 1 2000, diagnosis of chronic renal failure, and completion of the QOL questionnaire within six months of HD initiation. Patients receiving HD for less than four weeks were excluded. An incident cohort of 120 dialysis patients was identified, including 74 patients who attended at least one pre-dialysis clinic and 46 patients who did not. QOL was measured using the SF 36-Item Health Survey. Independent variables included age, sex, diabetes, pre-dialysis clinic attendance and length of attendance, history of ischemic heart disease, stroke, peripheral vascular disease, heart failure, malignancy, and chronic lung disease, residual creatinine clearance at dialysis initiation, and kt/v, albumin and hemoglobin at the time of QOL assessment. Bivariate and multivariate linear regression analyses were used to identify predictors of QOL scores. RESULTS: Multivariate analysis suggested that pre-dialysis clinic attendance was an independent predictor of higher QOL scores in four of eight health domains (physical function, p < 0.01; emotional role limitation, p = 0.01; social function, p = 0.01; and general health, p = 0.03), even after statistical adjustment for age, sex, residual renal function, kt/v, albumin, and co-morbid disease. Pre-dialysis clinic attendance was also an independent predictor of the physical component summary score (p = 0.03). CONCLUSIONS: We conclude that pre-dialysis clinic attendance favourably influences patient-perceived quality of life within six months of dialysis initiation

Ethical and policy issues in cluster randomized trials: rationale and design of a mixed methods research study

<p>Abstract</p> <p>Background</p> <p>Cluster randomized trials are an increasingly important methodological tool in health research. In cluster randomized trials, intact social units or groups of individuals, such as medical practices, schools, or entire communities – rather than individual themselves – are randomly allocated to intervention or control conditions, while outcomes are then observed on individual cluster members. The substantial methodological differences between cluster randomized trials and conventional randomized trials pose serious challenges to the current conceptual framework for research ethics. The ethical implications of randomizing groups rather than individuals are not addressed in current research ethics guidelines, nor have they even been thoroughly explored. The main objectives of this research are to: (1) identify ethical issues arising in cluster trials and learn how they are currently being addressed; (2) understand how ethics reviews of cluster trials are carried out in different countries (Canada, the USA and the UK); (3) elicit the views and experiences of trial participants and cluster representatives; (4) develop well-grounded guidelines for the ethical conduct and review of cluster trials by conducting an extensive ethical analysis and organizing a consensus process; (5) disseminate the guidelines to researchers, research ethics boards (REBs), journal editors, and research funders.</p> <p>Methods</p> <p>We will use a mixed-methods (qualitative and quantitative) approach incorporating both empirical and conceptual work. Empirical work will include a systematic review of a random sample of published trials, a survey and in-depth interviews with trialists, a survey of REBs, and in-depth interviews and focus group discussions with trial participants and gatekeepers. The empirical work will inform the concurrent ethical analysis which will lead to a guidance document laying out principles, policy options, and rationale for proposed guidelines. An Expert Panel of researchers, ethicists, health lawyers, consumer advocates, REB members, and representatives from low-middle income countries will be appointed. A consensus conference will be convened and draft guidelines will be generated by the Panel; an e-consultation phase will then be launched to invite comments from the broader community of researchers, policy-makers, and the public before a final set of guidelines is generated by the Panel and widely disseminated by the research team.</p

Does clinical equipoise apply to cluster randomized trials in health research?

This article is part of a series of papers examining ethical issues in cluster randomized trials (CRTs) in health research. In the introductory paper in this series, Weijer and colleagues set out six areas of inquiry that must be addressed if the cluster trial is to be set on a firm ethical foundation. This paper addresses the third of the questions posed, namely, does clinical equipoise apply to CRTs in health research? The ethical principle of beneficence is the moral obligation not to harm needlessly and, when possible, to promote the welfare of research subjects. Two related ethical problems have been discussed in the CRT literature. First, are control groups that receive only usual care unduly disadvantaged? Second, when accumulating data suggests the superiority of one intervention in a trial, is there an ethical obligation to act

Automatic and Deliberate Affective Associations with Sexual Stimuli in Women with Superficial Dyspareunia

Current views suggest that in women with superficial dyspareunia the prospect of penile–vaginal intercourse automatically activates fear-related associations. The automatic activation of negative associations is assumed to interfere with the development of sexual arousal. In turn, this may further aggravate the dyspareunia-related complaints. To assess whether automatic negative associations are involved in this sexual pain disorder, women with superficial dyspareunia (n = 35) and a control group (n = 35) completed a modified pictorial Affective Simon Task (AST). Questioning the role of dysfunctional automatic associations in superficial dyspareunia, the AST indicated that symptomatic women displayed relatively positive rather than negative automatic associations with sexual stimuli. At the self-report level, however, affective associations with sex cues were significantly more negative for women with dyspareunia than for controls. This discrepancy between “reflective” and “reflexive” affective associations with sexual stimuli in women with dyspareunia points to the relevance of conscious appraisal and deliberate rather than automatic processes in the onset and maintenance of dyspareunia

Cambio demográfico, migración y salud reproductiva : el papel de las mujeres senegalesas en la constitución de las familias

En aquest paper presentem en primer lloc els trets més característics de la transició de la nupcialitat i de la fecunditat a Senegal fent referència a alguns indicadors de la salut sexual i reproductiva de les dones. A continuació presentem els indicadors que resumeixen la biografia migratòria, nupcial i reproductiva d'un col·lectiu de dones senegaleses que han immigrat a Catalunya i que estan construint les seves famílies a cavall de dues cultures i de dos continents, fent referència entre altres coses a la poligamia, al lloc de naixement i residència dels seus fills i a la utilització de mètodes de planificació familiar. Acabem la comunicació amb algunes reflexions sobre el paper de les dones com agents actius en les decisions en materia de sexualitat i reproducció, en una societat que no és la seva, de la qual agraeixen els serveis de salut públics però sense deixar de banda la seva pròpia concepció de la família i de la salut.En este artículo presentamos en primer lugar los elementos más rellevantes de la transición de la nupcialidad y de la fecundidad en Senegal haciendo referencia a algunos indicadores de salud sexual y reproductiva de las mujeres. A continuación presentamos los indicadores que resumen la biografía migratoria, nupcial y reproductiva de un colectivo de mujeres de Senegal que han inmigrado a Cataluña y que están formando sus familias en el contexto de dos culturas y de dos continentes, haciendo referencia entre otras cosas a la poligamia, al lugar de nacimiento y residencia de sus hijos y a la utilización de métodos de planificación familiar. Finalizamos la comunicación con algunas reflexiones sobre el papel de las mujeres como agentes activos en las decisiones en materia de sexualidad y reproducción, en una sociedad que no es la suya propia, de la que agradecen los servicios de salud públicos pero sin olvidar su propia concepción de la familia y de la salud.In this paper we present the main characteristics from Senegal's nuptuality and fertility transition according to a group of measures related to women's sexual and reproductive health. We then show those indicators that summarise Senegal's women biography in terms of their migration, nuptuality and reproduction for those who have immigrated to Catalunya and have to raise a family between two cultures and two continents. In this way the article makes reference, among other things, to polygamy, the birthplace and residence of their offspring, as well as the existence of family planning. Lastly, we finish this paper with some ideas about the role of Senegal's women making sexual and reproduction decisions in a different society where they can obtain public health services while keeping their own approach to family and health issues