Sexual distress in relation to pelvic floor dysfunction-related distress

Background: Sexual distress is seen as an essential component of female sexual dysfunction. Sexual distress originates from problems with sexual desire, sexual arousal, lubrication, orgasm, or painful intercourse, for which women could and do seek help, for example, in a pelvic physical therapy (PPT) practice. In PPT practice, sexual dysfunction is often presented as a main reason to seek help, besides commonly treated complaints, such as urinary and fecal incontinence, micturition and defecation problems, pelvic organ prolapses, and pelvic pain. However, it is not clear if sexual dysfunction and distress is the main reason to seek help. In this study, women’s help-seeking behavior in PPT practice was investigated, focusing on sexual distress in relation to pelvic floor complaints. Method: Pelvic floor dysfunction-related distress was assessed with the Pelvic Floor Distress Inventory, pelvic pain-related distress with a question from the Four-Dimensional Symptom Questionnaire, and painful intercourse with a question from the Female Sexual Functioning Index. Sexual distress was assessed with the Female Sexual Distress Scale. Women with PPT experience were compared to women without PPT experience. Results: Women with PPT experience scored higher on the Female Sexual Distress Scale in comparison to women without PPT experience. However, when corrected for the distress scores, this effect disappeared. Pelvic floor dysfunction-related distress completely mediated the relationship between help-seeking and sexual distress. Reversed mediation analysis did not show such an effect. That is, no effect of sexual distress was found on the relationship between help-seeking and pelvic floor dysfunction-related distress. Conclusion: In the current study, pelvic floor dysfunction-related distress was the main reason for seeking help in a PPT practice, not sexual distress

Sexual distress in relation to pelvic floor dysfunction-related distress

Background: Sexual distress is seen as an essential component of female sexual dysfunction. Sexual distress originates from problems with sexual desire, sexual arousal, lubrication, orgasm, or painful intercourse, for which women could and do seek help, for example, in a pelvic physical therapy (PPT) practice. In PPT practice, sexual dysfunction is often presented as a main reason to seek help, besides commonly treated complaints, such as urinary and fecal incontinence, micturition and defecation problems, pelvic organ prolapses, and pelvic pain. However, it is not clear if sexual dysfunction and distress is the main reason to seek help. In this study, women’s help-seeking behavior in PPT practice was investigated, focusing on sexual distress in relation to pelvic floor complaints. Method: Pelvic floor dysfunction-related distress was assessed with the Pelvic Floor Distress Inventory, pelvic pain-related distress with a question from the Four-Dimensional Symptom Questionnaire, and painful intercourse with a question from the Female Sexual Functioning Index. Sexual distress was assessed with the Female Sexual Distress Scale. Women with PPT experience were compared to women without PPT experience. Results: Women with PPT experience scored higher on the Female Sexual Distress Scale in comparison to women without PPT experience. However, when corrected for the distress scores, this effect disappeared. Pelvic floor dysfunction-related distress completely mediated the relationship between help-seeking and sexual distress. Reversed mediation analysis did not show such an effect. That is, no effect of sexual distress was found on the relationship between help-seeking and pelvic floor dysfunction-related distress. Conclusion: In the current study, pelvic floor dysfunction-related distress was the main reason for seeking help in a PPT practice, not sexual distress

Prevalence and consequences of patient safety incidents in general practice in the Netherlands: a retrospective medical record review study

BACKGROUND Patient safety can be at stake in both hospital and general practice settings. While severe patient safety incidents have been described, quantitative studies in large samples of patients in general practice are rare. This study aimed to assess patient safety in general practice, and to show areas where potential improvements could be implemented. METHODS We conducted a retrospective review of patient records in Dutch general practice. A random sample of 1,000 patients from 20 general practices was obtained. The number of patient safety incidents that occurred in a one-year period, their perceived underlying causes, and impact on patients' health were recorded. RESULTS We identified 211 patient safety incidents across a period of one year (95% CI: 185 until 241). A variety of types of incidents, perceived causes and consequences were found. A total of 58 patient safety incidents affected patients; seven were associated with hospital admission; none resulted in permanent disability or death. CONCLUSIONS Although this large audit of medical records in general practices identified many patient safety incidents, only a few had a major impact on patients' health. Improving patient safety in this low-risk environment poses specific challenges, given the high numbers of patients and contacts in general practice.The Dutch Ministry of Health, Welfare and Sport (VWS) initiated the project and supported the project financially (without restrictions on the scientific work; grant number 313741)

Software Components for Serious Game Development

The presentation explains the approach of the RAGE project. It presents three examples of RAGE software components and how these can be easily reused for applied game development.This study is part of the RAGE project. The RAGE project has received funding from the European Union’s Horizon 2020 research and innovation programme under grant agreement No 644187. This publication reflects only the author's view. The European Commission is not responsible for any use that may be made of the information it contains

Blood clearance and tissue distribution of PEGylated and non-PEGylated gold nanorods after intravenous administration in rats\ud

Aims: To develop and determine the safety of gold nanorods, whose aspect ratios can be tuned to obtain plasmon peaks between 650 and 850 nm, as contrast enhancing agents for diagnostic and therapeutic applications. Materials & methods: In this study we compared the blood clearance and tissue distribution of cetyl trimethyl ammonium bromide (CTAB)-capped and polyethylene glycol (PEG)-coated gold nanorods after intravenous injection in the tail vein of rats. The gold content in blood and various organs was measured quantitatively with inductively coupled plasma mass spectrometry. Results & discussion: The CTAB-capped gold nanorods were almost immediately (<15 min) cleared from the blood circulation whereas the PEGylation of gold nanorods resulted in a prolonged blood circulation with a half-life time of 19 h and more wide spread tissue distribution. While for the CTAB-capped gold nanorods the tissue distribution was limited to liver, spleen and lung, the PEGylated gold nanorods also distributed to kidney, heart, thymus, brain and testes. PEGylation of the gold nanorods resulted in the spleen being the organ with the highest exposure, whereas for the non-PEGylated CTAB-capped gold nanorods the liver was the organ with the highest exposure, per gram of organ. Conclusion: The PEGylation of gold nanorods resulted in a prolongation of the blood clearance and the highest organ exposure in the spleen. In view of the time frame (up to 48 h) of the observed presence in blood circulation, PEGylated gold nanorods can be considered to be promising candidates for therapeutic and diagnostic imaging purpose

Multidimensional fatigue during rehabilitation in persons with recently acquired spinal cord injury

Objectives: To examine the change in multidimensional fatigue in people with spinal cord injury during post-acute rehabilitation, and to compare these scores with those of healthy adults. Furthermore, to examine correlations between different dimensions of fatigue at discharge and demographics, injury-related variables and indices of psychological adjustment. Design: Longitudinal cohort study. Subjects: From 86 patients admitted for spinal cord injury rehabilitation, between June 2011 and January 2013, 78 met the inclusion criteria, and 70 (90%) agreed to participate. Methods: Self-reported questionnaires were completed at admission and in the week before discharge. Questionnaires used assessed demographics, injury-related variables, multidimensional fatigue, and psychological adjustment. Results: At admission, fatigue scores were very high and decreased significantly during rehabilitation. At discharge, fatigue scores were still significantly higher than those of healthy adults. The fatigue total score at discharge was weakly associated with demographic variables and injury related variables. Psychological adjustment variables explained the largest proportion of variance of the fatigue total score and each of the subscales. Conclusion: Fatigue is an important consequence in people with recently acquired spinal cord injury. Associations between fatigue and psychological adjustment suggest that psychological interventions might be useful to diminish fatigue