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Individuals with concealable stigma continually decide whether, and if so, how to disclose to others. These complex decision-making processes are evident across various stigmatized sexual health contexts, including sexually transmitted diseases and infections, LGBTQ+ identities, and sexual trauma, among others. One context that has received less attention within communication scholarship is difficulty orgasming among women. Due to the stigma associated with this experience, women are often reluctant to disclose their orgasm difficulties to others, especially their sexual and/or relational partners. However, the motivations women have for, and the factors they consider prior to disclosure have yet to be identified. Building upon extant sexual health communication, concealable stigma, and disclosure research, this study used semi-structured interviews (N = 31) to examine how women disclose orgasm difficulties within their sexual and/or romantic relationships. Our findings highlight several motivations women have for (non)disclosure, and various contextual and situational factors that complicate their disclosure processes. This study contributes to our theoretical understanding of the disclosure processes model (DPM) and the disclosure of concealable (sexual health) stigma. This study also offers practical insights for improving disclosure and experiences with stigma within this context. [ABSTRACT FROM AUTHOR]

The EA-QOL questionnaire measures quality-of-life specifically for children born with esophageal atresia (EA) aged 8–18 and was completed in Sweden and Germany. This study aimed to describe an international collaborative initiative to establish a semantically equivalent linguistic version of the EA-QOL questionnaires in 12 new countries. The 24-item EA-QOL questionnaire was translated into the target languages and the translated questionnaire was evaluated through cognitive debriefing interviews with children with EA aged 8–18 and their parents in each new country. Participants rated an item as to whether an item was easy to understand and sensitive/uncomfortable to answer. They could choose not to reply to a non-applicable/problematic item and provide open comments. Data were analyzed using predefined psychometric criteria; item clarity ≥80%, item sensitive/uncomfortable to answer ≤20%, item feasibility(missing item responses ≤5%). Decision to improve any translation was made by native experts–patient stakeholders and the instrument developer. Like in Sweden and Germany, all items in the cross-cultural analysis of child self-report (ntot = 82, 4–10 children/country) met the criteria for item clarity in all 12 new countries, and in parent-report (ntot = 86, 5–10 parents/country) in 8/12 countries. All items fulfilled the criteria for sensitive/uncomfortable to answer (child-report 1.2–9.9%; parent-report 0–11.6%) and item feasibility. Poor translations were resolved. Hence, this study has established semantically equivalent linguistic versions of the EA-QOL questionnaire for use in children aged 8–18 with repair of EA in and across 14 countries. [ABSTRACT FROM AUTHOR]

Background: There is considerable burden of illness in hereditary angioedema (HAE). However, instruments to assess health-related quality of life (HRQoL) in HAE are limited. The Angioedema Quality of Life Questionnaire (AE-QoL) was developed to measure HRQoL in patients with recurrent angioedema; the validity of the AE-QoL in patients with HAE is described. Methods: To identify disease-related experiences with a focus on the impact of HAE on HRQoL, interviews were conducted with a group of clinician experts and patients with HAE from Canada, France, Germany, Spain, the United Kingdom, and the United States, along with a targeted literature review. Concepts were mapped to the AE-QoL to assess item relevance, interpretation, and conceptual coverage. Cognitive interviews assessed item clarity and relevance. A psychometric validation was performed using data from a phase 3 trial. Results: Interviews were conducted with seven clinicians and 40 adult patients. Patients reported 35 unique impacts of HAE on their lives, the most frequent being on work/school, social relationships, physical activities, and emotions, particularly fear/worrying and anxiety. Saturation for these impacts was reached, and all concepts covered in the AE-QoL were reported during the interviews. Patients agreed that the questionnaire items and response options were clear and relevant, and the 4-week recall period was appropriate. The psychometric validation included data from 64 patients. For AE-QoL total scores, excellent internal consistency (Cronbach's alpha > 0.90), test-retest reliability (intraclass coefficient > 0.80), convergent validity with the Sheehan Disability Scale (r = 0.663), divergent validity with the EQ-5D-5L index (r = 0.292) and EQ-VAS (r = 0.337), and known-groups validity (p < 0.0001; ɳ2 = 0.56) were demonstrated. Conclusions: Qualitative and psychometric analyses showed that the AE-QoL is a reliable and valid instrument for measuring HRQoL in adult patients with HAE from six countries. [ABSTRACT FROM AUTHOR]

Abstract: Background: Heavy birthweight is one of the few established risk factors for childhood acute lymphoblastic leukaemia (ALL). To provide new insight into this relationship, particularly at the extremes (<1500 and >4500g), we pooled data from three of the largest childhood cancer case–control studies ever conducted. Methods: Birthweight and gestational age on 4075 children with ALL and 12,065 controls were collected during the course of three studies conducted in the USA, the UK and Germany in the 1990s. Information was obtained from mothers at interview, and the impact of bias was evaluated using the UK study which accessed birth registrations of participants and non-participants. Odds ratios (OR) and 95% confidence intervals (CIs) were estimated using unconditional logistic regression models. Results: Children with ALL were, on average, heavier than controls at all gestations, the disparity being driven by a deficit of low-birthweight at all gestations and an excess of high-birthweight at ⩾40weeks. Overall, a 1.2 (95% CI 1.1–1.3) increase in ALL risk per kg increase in birthweight was observed; the ORs rising from 0.2 (0.1–0.7) at ⩽1500g through to 1.2 (0.9–1.6) at ⩾4500g; and 0.8 (0.7–0.9) <10th centile through to 1.3 (1.1–1.4) ⩾90th centile. Conclusion: Our findings demonstrate the importance of looking across the full birthweight spectrum when examining associations with disease risk. The new observation of a deficit of very-low-birthweight cases at all gestations has aetiological and study design implications for future work examining not only the in utero origins of ALL, but also other childhood and adult cancers. [Copyright &y& Elsevier]

The aging population is recognized by many as a unique global phenomenon and has become a subject of interest among multidisciplinary professionals. Perhaps one of the most common key concerns among individuals and family members in many countries today is to meet the increasing demand for elderly healthcare, particularly the real challenges and crisis in old age morbidity and health. As the socioeconomic, demographic and cultural context of populations. [ABSTRACT FROM AUTHOR]