Coping with sexual difficulties: the lived experience of women taking selective serotonin reuptake inhibitor (SSRI) medication

This study used Interpretive Phenomenological Analysis to explore women’s experiences of coping with the sexual side effects of selective serotonin reuptake inhibitors (SSRIs). Coping strategies included searching; suffering in silence; trying to resolve; and accepting what is. The findings emphasise the need to recognise and address psychological, social and cultural factors which may influence how women cope with sexual side effects, and underline the need for a multidisciplinary management approach that moves beyond biomedical interventions

Women’s experiences of coping with the sexual side effects of antidepressant medication

A growing body of evidence has highlighted the sexual side effects of selective serotonin reuptake inhibitor (SSRI) medication. Whilst most of the research has focused on the prevalence and treatment of sexual difficulties, little is known about how patients cope with the SSRI-related sexual side effects. The objective of this study was to explore women’s experiences of coping with the sexual side effects of SSRI medication and interpretative phenomenological analysis was employed for an in-depth exploratory study of a sample of 10 women. Four broad themes emerged which are discussed under the following headings: searching, suffering in silence, trying to resolve and accepting what is. The themes provide an insight into the different strategies used by women to cope with the sexual side effects of SSRI medication and highlight the importance of contextualising these difficulties as part of an overall approach to improve the management and treatment of SSRI-related sexual side effects

Searching for answers and validation: Australian women's experiences of coping with the adverse sexual effects of antidepressants

Sexual difficulties relating to selective serotonin reuptake inhibitor (SSRI) medication have an impact on quality of life and are a common cause for non-adherence to medication. While most research has focussed on the prevalence and treatment of sexual difficulties, little is known about how patients cope with the adverse sexual effects of SSRIs. This qualitative study, using Interpretive Phenomenological Analysis (IPA), investigated the experiences of 10 Australian women currently coping with the adverse sexual effects of this antidepressant by conducting semi-structured interviews. This paper presents one major theme from the study and reports the findings related to women's self-reported experiences of interacting with GPs in their search for answers and validation of their concerns. Findings from the study add to the current literature by providing an insight into how interactions with GPs impact on women's abilities to cope with adverse sexual effects. Empathic discussions and shared decision-making between GPs and women can provide the opportunity to improve the management of the adverse sexual effects of SSRIs and may lead to improved outcomes for women

Disclosure of domestic violence and sexual assault within the context of abortion: meta-ethnographic synthesis of qualitative studies protocol.

BackgroundOne third of women will have an abortion in their lifetime (Kerr, QUT Law Rev 14:15, 2014; Aston and Bewley, Obstetrician & Gynaecologist 11:163-8, 2009). These women are more likely to have experienced domestic violence or sexual assault than women who continue with their pregnancies. Frontline health personnel involved in the care of women seeking abortions are uniquely positioned to support patients who choose to disclose their violence. Yet, the disclosure of domestic violence or sexual assault within the context of abortion is not well understood. To enhance service provision, it is important to understand the disclosure experience, that is, how frontline health personnel manage such disclosures and how victims/survivors perceive this experience. This review aims to provide a systematic synthesis of qualitative literature to increase understanding of the phenomena and identify research gaps.MethodsA meta-ethnography of qualitative evidence following PRISMA-P recommendations for reporting systematic reviews will be performed to better understand the experiences of domestic violence and sexual assault disclosure from the perspective of frontline health personnel providing support and women seeking an abortion. A three-stage search strategy including database searching, citation searching and Traditional Pearl Growing will be applied starting with the terms "domestic violence", "sexual assault", "disclosure" and "abortion", their common synonyms and MeSH terms. The database search will include CINAHL, MEDLINE, Embase and PsycINFO. Published studies from 1970, written in English and from all countries will be included. Two reviewers will screen titles and abstracts and if suitable will then perform a full-text review. To attribute weight to each study, two reviewers will perform the critical appraisal using a modified version of the "Guidelines for Extracting Data and Quality Assessing Primary Studies in Educational Research". Data extraction and coding will occur using EPPI-Reviewer 4 and will be carried out by two reviewers.DiscussionThe reviewers will illuminate what transpires at the interface when women seeking an abortion in the context of domestic violence and sexual assault meet frontline health personnel. Increased knowledge in this area will improve the frontline health personnel's practices and responsiveness to women who seek out healthcare in the context of violence.Systematic review registrationPROSPERO CRD42016051136

Reframing health promotion research and practice in Australia and the Pacific: the value of arts-based practices

In health promotion research, the arts can take many forms: as the focus of the research or evaluation; as a tool of inquiry; as an avenue of dissemination; or as a combination of each of these. Each art form occurs within a place-based or social and spatial context, and it is the interdependence of form and context that gives rise to ethical and methodological tensions. In this chapter, we argue that arts-based research (ABR) is an aesthetic, iterative, and organic research process and health promotion practice that brings to the fore ethical and methodological tensions inherent in participatory research. The value of ABR lies in how it advances and enhances scientific practices and methodologies. However, there are also tensions inherent in designing studies that respond to community-led research priorities because ABR provides opportunities for ethical and methodological development/advancement

Comparative analysis of ammonia monooxygenase (amoA) genes in the water column and sediment-water interface of two lakes and the Baltic Sea

The functional gene amoA was used to compare the diversity of ammonia-oxidizing bacteria (AOB) in the water column and sediment-water interface of the two freshwater lakes Plusssee and Schöhsee and the Baltic Sea. Nested amplifications were used to increase the sensitivity of amoA detection, and to amplify a 789-bp fragment from which clone libraries were prepared. The larger part of the sequences was only distantly related to any of the cultured AOB and is considered to represent new clusters of AOB within the Nitrosomonas/Nitrosospira group. Almost all sequences from the water column of the Baltic Sea and from 1-m depth of Schöhsee were related to different Nitrosospira clusters 0 and 2, respectively. The majority of sequences from Plusssee and Schöhsee were associated with sequences from Chesapeake Bay, from a previous study of Plusssee and from rice roots in Nitrosospira-like cluster A, which lacks sequences from Baltic Sea. Two groups of sequences from Baltic Sea sediment were related to clonal sequences from other brackish/marine habitats in the purely environmental Nitrosospira-like cluster B and the Nitrosomonas-like cluster. This confirms previous results from 16S rRNA gene libraries that indicated the existence of hitherto uncultivated AOB in lake and Baltic Sea samples, and showed a differential distribution of AOB along the water column and sediment of these environment

Time-series analyses of Monterey Bay coastal microbial picoplankton using a ‘genome proxy’ microarray

To investigate the temporal, spatial and phylogenetic resolution of marine microbial community structure and variability, we designed and expanded a genome proxy array (an oligonucleotide microarray targeting marine microbial genome fragments and genomes), evaluated it against metagenomic sequencing, and applied it to time-series samples from the Monterey Bay. The expanded array targeted 268 microbial genotypes across much of the known diversity of cultured and uncultured marine microbes. The target abundances measured by the array were highly correlated to pyrosequence-based abundances (linear regression R2 = 0.85–0.91, P < 0.0001). Fifty-seven samples from ∼4 years in Monterey Bay were examined with the array, spanning the photic zone (0 m), the base of the surface mixed layer (30 m) and the subphotic zone (200 m). A significant portion of the expanded genome proxy array's targets showed signal (95 out of 268 targets present in ≥ 1 sample). The multi-year community survey showed the consistent presence of a core group of common and abundant targeted taxa at each depth in Monterey Bay, higher variability among shallow than deep samples, and episodic occurrences of more transient marine genotypes. The abundance of the most dominant genotypes peaked after strong episodic upwelling events. The genome-proxy array's ability to track populations of closely related genotypes indicated population shifts within several abundant target taxa, with specific populations in some cases clustering by depth or oceanographic season. Although 51 cultivated organisms were targeted (representing 19% of the array) the majority of targets detected and of total target signal (85% and ∼92% respectively) were from uncultivated genotypes, often those derived from Monterey Bay. The array provided a relatively cost-effective approach (∼$15 per array) for surveying the natural history of uncultivated lineages.Gordon and Betty Moore FoundationNational Science Foundation (U.S.) (Science and Technology Center Award EF0424599)National Science Foundation (U.S.) (Microbial Observatory Award MCB-0348001)United States. Dept. of Energy. Office of Scienc

Coupling of fog and marine microbial content in the near-shore coastal environment

Microbes in the atmosphere (microbial aerosols) play an important role in climate and provide an ecological and biogeochemical connection between oceanic, atmospheric, and terrestrial environments. However, the sources and environmental factors controlling the concentration, diversity, transport, and viability of microbial aerosols are poorly understood. This study examined culturable microbial aerosols from a coastal environment in Maine (USA) and determined the effect of onshore wind speed and fog presence on deposition rate, source, and community composition. During fog events with low onshore winds (<2 m s−1) the near-shore deposition of microbial aerosols (microbial fallout) decreased with increasing wind speeds, whereas microbial fallout rates under clear conditions and comparable low wind speeds showed no wind speed dependence. Mean aerosol particle size also increased with onshore wind speed when fog was present, indicating increased shoreward transport of larger aerosol particles. 16S rRNA sequencing of culturable ocean surface bacteria and microbial aerosols deposited onshore resulted in the detection of 31 bacterial genera, with 5 dominant genera (Vibrio, Bacillus, Pseudoalteromonas, Psychrobacter, Salinibacterium) making up 66 % of all sequences. The sequence library from microbial aerosol isolates, as with libraries found in other coastal/marine aerosol studies, was dominated at the phylum level by Proteobacteria, with additional representation from Firmicutes, Actinobacteria and Bacteroidetes. Seventy-five percent of the culturable microbial aerosols falling out under foggy conditions were most similar to GenBank-published sequences detected in marine environments. Using a 97 % similarity cut-off, sequence libraries from ocean surface and fog isolates shared eight operational taxonomic units (OTU's) in total, three of which were the most dominant OTU's in the library, representing large fractions of the ocean (28 %) and fog (21 %) libraries. The fog and ocean surface libraries were significantly more similar in microbial community composition than clear (non-foggy) and ocean surface libraries, according to both Jaccard and Sorenson indices. These findings provide the first evidence of a difference in community composition and microbial culturability of aerosols associated with fog compared to clear conditions. The data support a dual role for fog in enhancing the fallout of viable microbial aerosols via increased gravitational settling rates and decreased aerosolization stress on the organisms, which may include relief from UV inactivation, desiccation, and oligotrophic microconditions. This study provides a strong case for ocean to terrestrial transport of microbes and a potential connection between water quality and air quality at coastal sites

Challenges to managing microbial fecal pollution in coastal environments: extra-enteric ecology and microbial exchange among water, sediment and air.

Human population growth, especially in coastal ur- ban cities, increases the potential for fecal pollution of adjacent waterways, requiring continued advances in pollution monitoring and management. Infections remain the largest health risk from contact with fecal- and sewage-polluted wa- ters, and a small number of fecal indicator bacteria (FIB) are used as primary pollution assessment tools. While FIB con- tinue to be useful tools, some of the assumptions about the behavior of FIB in the environment, and the associated path- ways for pathogen exposure, have come into question. Research into the extra-enteric ecology of these indicators has identified management-relevant complexities including particle association, prolonged environmental persistence, and multidirectional microbial exchange among water, sedi- ment, and air. These complexities provide opportunities for improving current monitoring and modeling strategies and to better understand exposure pathways for sewage-related infections