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IntroductionToday, we are facing increased and continued adverse sexual health outcomes in the United States, including high post-COVID-19 pandemic rates of sexually transmitted infections (STIs). For the past 20 years, there have been calls for a national health strategy and a more comprehensive sexual health approach to address the myriad of persistent sexual health problems in this country. Employing a sexual health approach requires shifting from a longstanding, stigmatizing focus on morbidity toward a holistic and integrated focus on health rather than disease. While strategies are being implemented by multisectoral stakeholders, it is also important to establish a core set of indicators that broadly describe the state of sexual health in the U.S. and allow for measurement across time. The development of a comprehensive scorecard with key sexual health indicators has been proposed by other entities (e.g., Public Health England, World Health Organization), but such an attempt has not been made in the U.S.MethodsA review of national U.S. surveys and surveillance systems with items related to sexual health was conducted for years 2010–2022 to develop an inventory of existing data that yield national estimates for potential indicators of sexual health.ResultsWe selected 23 sexual health indicators in four broad domains including: (1) knowledge; communication and attitudes (five indicators); (2) behaviors and relationships (four indicators); (3) service access and utilization (seven indicators); and (4) adverse health outcomes (seven indicators). Recent data for each indicator are provided.DiscussionA growing body of evidence shows the positive effects of moving away from a morbidity focus toward an integrated, health-promoting approach to sexual health. Yet, not much has been done in terms of how we implement this national shift. We argue that measurement and monitoring are key to future change. We envision these core sexual health indicators would be published in the form of an index that is publicly available and updated frequently. These sexual health indicators could be used for ongoing monitoring, and to guide related research, programming, and policy development to help promote sexual health in coming years.

Abstract Background Sexual health is generally considered an integral part of medical and allied healthcare professional training. However, many medical schools do not offer this as a mandatory curriculum, or minimize it. Sexual health as an academic area was introduced in the 1970s, but there have been few cohort evaluations of its impact. This was limited by the availability of few psychometric scales for evaluation. We evaluated the full, mandatory, sexual health course in year 1 medicine at a large state university in the Midwest US, including the course with lectures; panels and tutorials; a video app to give students feedback on their sexual history taking skills; and a 3-station sexual history OSCE at the end of the course. Results Seventy-four medical students (43% of the course cohort) volunteered, for an incentive, to complete evaluation materials pre- and post-course. We used the Sexual Health Education for Professionals Scale (SHEPS), designed and with appropriate psychometric standardization for such evaluation. The SHEPS data covers 7-point Likert scale ratings of 37 patient situations, asking first how well the student could communicate with such a patient, and on the second part how much knowledge they have to care for such a patient. The third subscale examines personal sexual attitudes and beliefs. Data indicated that the matched pretest-posttest ratings for skills and knowledge were all statistically significant and with very large effect sizes. Few of the attitude subscale items were significant and if so, had small effect sizes. Sexual attitudes and beliefs may be well-formed before entry into medical school, and sexual health teaching and learning has minimal effect on sexual attitudes in this US sample. However, using the 3 sexuality OSCE cases scores as outcomes, two of the 26 attitude-belief items predicted > 24% of the variance. Conclusions The sexual health course produced major changes in Communications with patients sexual health skills and Knowledge of sexual health, but little change in personal Attitudes about sexuality. These data suggest that personal attitude change is not essential for teaching US medical students to learn about sexual health and sexual function and dysfunction, and comfortably take a comprehensive sexual history.

Las macrófitas transportan oxigeno atmosférico a la rizosfera creando un ambiente aireados para los miroorganismos que contribuyen a la disminución de la demanda biológica de oxígeno, demanda química de oxígenos y sólidos suspendido, así como en la remoción de sustancias orgánicas como nutrientes, metales pesados, fenoles, ácido fórmico, colorantes, pesticidas entre otros. Esta investigación pretende evaluar a nivel de laboratorio el mejoramiento de la calidad de aguas residuales utilizando plantas acuáticas de jacinto (Eichhornia crassipes) y lechuga de agua (Pistia stratiotes). Los tratamientos evaluados fueron: plantas con barrera, plantas sin barrera, sin plantas con barrera y sin plantas sin barreras. El análisis de varianza al contenido de oxígeno disuelto en aguas residuales mostró diferencia significativa (p < 0.05) entre especies y tratamiento. Jacinto presenta valores promedios de 2.60 a 5.08 mg l-l en un periodo de nueve días de observación, asimismo el tratamiento sin barrera muestra mayor valor en un rango de 2.7 a 4.85 mg l-l. Con lechuga de agua se observan mayores valores en el tratamiento sin barrera (2.27 a 4.81 mg l-l) y con barrera (1.24 a 1.53 mg l-l). Jacinto con barrera y sin barrera presenta valores de oxígeno disuelto transferido entre 0.46 y 0.45 mg O2 d-1 l-1 respectivamente. Jacinto sin barrera removió en aguas residuales el 20.23 % de la demanda biológica de oxígeno y con berrera el 19 % al final del noveno día de observación. El tratamiento sin plantas sin barrera removió un promedio de 63 %, de la demanda biológica de oxígeno, mientras el tratamiento sin plantas con barrera fue de 42 %. Jacinto sin barrera mostró mayor promedio de peso de biomasa seca total (6.06 g) y concentración de oxígeno disuelto (3.63 – 5.34 mg l-l) lechuga de agua sin barrera (3.20 g) y oxígeno disuelto (1.7-4.81 mg l-l).

Aim: Cancellation of university classes during the coronavirus disease 2019 pandemic challenges teaching inperson sexual history–taking skills to medical, physician assistant, and nursing students. We used commercial online electronic services for medical students to learn sexual history–taking skills. Methods: A total of 174 medical students viewed a lecture on sexual history taking and the PLISSIT model (Permission, Limited Information, Specific Suggestion, Intensive Therapy) and were then randomized into dyads. They arranged a time to meet online on Zoom with their partner, chose a simple sexual history case-history (male or female) from a small selection, and recorded the 5- to 6-minute sexual history within a 1-week time frame. Each student played a “provider” or “patient” and then switched roles with a new case. One of the course tutors, all sexual health practitioners, downloaded 10 videos randomly assigned to them asynchronously and viewed and commented on the interaction of each “provider” along with comments on what to improve in the sexual history. 2 weeks later after the remainder of the lectures in the course, a second, more complex set of 8 cases were provided, so students could move at their comfort pace and choose 1. Main Outcome Measure: Students were required to make 1 online post and 1 comment on another student's post for each case, on the experience, and associated issues arising, positive or negative. All comments were downloaded and analyzed by theme. Results: Major themes included developing comfort in using sexual language, using simpler sexual terms suitable for patients, feeling confidence and mastery, excitement using technology developing clinical skills, surprise watching their performances and body language, observation of how they appeared to the “patient,” organizing sexual histories and incorporating PLISSIT model, ability to ask about context and relationships, and seeing the exercise as building on existing clinical skills training. Some expressed anxiety and nervousness, which by the second case had largely or completely dissipated. Conclusion: A readily replicable, secure, cheap cloud-based model to integrate sexual history training asynchronously was provided, with tutors’ comments, and student skills development, and performance evaluated.Ross MW, Newstrom N, Coleman E. Teaching Sexual History Taking in Health Care Using Online Technology: A PLISSIT-Plus Zoom Approach During the Coronavirus Disease 2019 Shutdown. Sex Med 2021;9:100290