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Si bien varios estudios han sugerido que las ideologías de género tradicionales están fuertemente arraigadas en las poblaciones latinas, aún se sabe poco sobre la forma en que estas operan en las relaciones románticas de los adolescentes. Este estudio de método mixto se realizó con adolescentes de Cuenca en Ecuador. En el componente cuantitativo, evaluamos el apoyo a las ideologías tradicionales de género en una muestra de 562 adolescentes (n = 309 niñas). Se encontró que la mayoría de los adolescentes podrían ser clasificados como «acríticos» hacia las ideologías tradicionales de masculinidad (82%) y feminidad (79%). En el componente cualitativo, las narrativas de una muestra de 20 adolescentes reflejaron los discursos existentes sobre los roles tradicionales de género y revelaron cómo estos se traducen en comportamientos específicos. En este contexto, las relaciones románticas pueden convertirse en espacios negativos y disfuncionales que pueden afectar el desarrollo de los adolescentes.

Whether the brain processes different types of pain similarly or differently remains unknown. The authors show that an established neurologic pain signature responds to five different types of visceral and somatic pain; they also develop a new classifier that reliably discriminates between both pain modalities.

ObjectiveThis study aimed to investigate the prevalence and risk factors associated with sexual dysfunction in a well-characterized cohort of women with type 1 diabetes.Research design and methodsThe study was conducted in women enrolled in the long-term Epidemiology of Diabetes Interventions and Complications (EDIC) study, a North American study of men and women with type 1 diabetes. At year 10 of the EDIC study, 652 female participants were invited to complete a validated self-report measure of sexual function, standardized history and physical examinations, laboratory testing, and mood assessment.ResultsOf the sexually active women with type 1 diabetes in the EDIC study, 35% met criteria for female sexual dysfunction (FSD). Women with FSD reported loss of libido (57%); problems with orgasm (51%), lubrication (47%), and arousal (38%); and pain (21%). Univariate analyses revealed a positive association between FSD and age (P = 0.0041), marital status (P = 0.0016), menopausal status (P = 0.0019), microvasculopathy (P = 0.0092), and depression (P = 0.0022). However, in a multivariate analysis, only depression (P = 0.004) and marital status (P = 0.003) were significant predictors of FSD.ConclusionsFSD is common in women with type 1 diabetes and affects all aspects of sexual function and satisfaction. Depression is the major predictor of sexual dysfunction in women with type 1 diabetes. These findings suggest that women with type 1 diabetes should be routinely queried about the presence of sexual dysfunction and possible co-association with depression.

Objective: In DSM-5, pain-related fear during anticipation of vaginal penetration is a diagnostic criterion of Genito-Pelvic Pain/Penetration Disorder (GPPPD). We aimed to investigate subjective and brain responses during anticipatory fear and subsequent induction of vestibular pain in women with GPPPD. Methods: Women with GPPPD (n=18) and age-matched healthy controls (HC) (n=15) underwent fMRI scanning during vestibular pain induction at individually titrated pain threshold after a cued anticipation period. (Pain-related) fear and anxiety traits were measured with questionnaires prior to scanning, and anticipatory fear and pain intensity were rated during scanning using visual analog scales. Results: Women with GPPPD reported significantly higher levels of anticipatory fear and pain intensity. During anticipation and pain induction they had stronger and more extensive brain responses in regions involved in cognitive and affective aspects of pain perception, but the group difference did not reach significance for the anticipation condition. Pain-related fear and anxiety traits as well as anticipatory fear ratings were positively associated with pain ratings in GPPPD, but not in HC. Further, in HC, a negative association was found between anticipatory fear ratings and brain responses in regions involved in cognitive and affective aspects of pain perception, but not in women with GPPPD. Conclusions: Women with GPPPD are characterized by increased subjective and brain responses to vestibular pain and, to a lesser extent, its anticipation, with fear and anxiety associated with responses to pain, supporting the introduction of anticipatory fear as a criterion of GPPPD in DSM-5. Keywords: Anticipation of pain, Pain-related fear and anxiety, Vestibular pain, fMRI, Genito-pelvic pain/penetration disorder, Provoked vestibulodynia

Recent studies increasingly demonstrated that gender differences are linked with macro-cultural factors. The stereotypes in Latin America that shape gender roles are machismo and marianismo. In contrast, with the ample publications on the importance of machismo, empirical research on machismo and certainly marianismo is still in its infancy despite both being well known concepts. To this end, the present study explores how Ecuadorian adolescents from Cuenca experience, and make sense of, gender stereotypes. Twelve focus groups were carried out, involving 127 male and female adolescents. The data were analyzed using thematic analysis. Four categories related to machismo emerged: cognition regarding machismo, manifestations of machismo, adolescents’ expectations by gender, and advantages of traditional norms. The results showed that participants know about machismo and stated that gender stereotypes are transmitted to adolescents by parents and society in general to the next generations. Our participants blame gender stereotypes for the inequality in the society, but at the same time, their intervention showed that they absorbed these stereotypes in their belief system.

Behavior research revealed that attitudes are important in understanding the roots of violence. People acquire those attitudes by social learning, particularly in adolescence, because in this stage of life is the influence of social environment strongest. This study aimed to assess adolescents’ attitude toward violence and their related factors. The Questionnaire on Attitudes toward Diversity and Violence1 was applied. This questionnaire addresses the following factors: justification of violence toward peers as a reaction of courage, sexist beliefs and justification of domestic violence, and tolerant beliefs and rejection of violence. An extra factor was incorporated in the research to evaluate the attitude toward the justification of sexual violence. Analysis of the responses to the questionnaire disclosed middle level of justification and rejection toward violence. The stronger attitudes of justification of violence toward peers, domestic violence and sexual violence were related with male sex, alcohol consumption, violence among siblings and higher level of enjoyment of violence in media. The stronger tolerant beliefs and rejection of violence was related with female sex, the experience of sexual violence and the age group of 14-16 years old. Results clearly recommend the need to work with adolescents and their families to eliminate prejudices that justify violence and to promote violence rejection as preventive measures, considering the related factors.

Parents' contribution to sex education is increasingly receiving research attention. This growing interest stems from recognition of the influence that parental attitudes may have both on young people's sexual attitudes and behaviour, and on school-based sex education. Studies regarding parental attitudes towards sexuality are, however, still rare. The two main objectives of this study were to explore parental views about sexuality and to understand parental attitudes towards sex education. Four focus group discussions were conducted with parents from high schools in Cuenca, Ecuador. Data were analysed using thematic analysis. The study revealed that parents held a restricted view about sex education, grounded in traditional religious ideas about sexuality, which led parents to understand it as a morally and physically dangerous activity. Although parents expressed a willingness to make good quality sex education available to their children, they reported having insufficient personal resources to fulfil that objective. The results of this study provide important information about the need to develop and adapt sex education to each specific cultural context, thereby confirming the importance of knowing about the cultural traditions and religious beliefs that may form obstacles to effective sex education for young people in Ecuador.

En ese artículo se presentan los resultados de un estudio de conocimientos y actitudes en sexualidad y en educación sexual dirigido a docentes de 17 colegios públicos de la ciudad de Cuenca-Ecuador. Se evaluó el impacto de un curso de capacitación sobre sexualidad que fue planificado por el proyecto VLIR-UOS “Promoción de la salud sexual en Adolescentes” de la Universidad de Cuenca-Ecuador. Con el objetivo de evaluar el efecto del curso, se aplicó a los docentes y 2 grupos de profesores no asistentes como testigos, una evaluación diagnóstica y una evaluación final, a través de 3 cuestionarios: el cuestionario de conocimientos sobre sexualidad y educación sexual con los siguientes ejes temáticos: sexualidad y actitudes, docencia y educación sexual, sexualidad y adolescencia, sexualidad: diversidad y bienestar personal-social y metodología en educación sexual. El cuestionario de actitudes hacia la sexualidad, con los siguientes ejes: valores personales claros, actitudes hacia la sexualidad en la vida, actitudes hacia la anticoncepción, actitudes hacia las relaciones prematrimoniales y autoestima. Finalmente, se aplicó el cuestionario de actitudes hacia la educación sexual. Los resultados muestran avances significativos en el nivel de conocimientos del grupo de capacitación; en la valoración inicial los docentes obtuvieron una media de .76 (DE = .07) y en post test este valor se elevó a .81 (DE = .07). En las actitudes hacia la sexualidad las diferencias no fueron estadísticamente significativas, la media inicial fue de 3.92 (DE = .52) y posteriormente fue de 4.16 (DE = .81). En las actitudes hacia la educación sexual, el valor medio inicial fue de 1.79 (DE = .58) que descendió a 1.52 (DE = .29) lo que indica una mejoría significativa en este aspecto. Se considera que variables tales como la edad de los participantes, perfil profesional y la modalidad del curso tuvieron una marcada influencia en el resultado de esta capacitación en sexualidad y educación sexual. Se discute sobre las medidas correctivas para mejorar la eficacia del curso.

Romantic relationships are a central aspect of the life of adolescents and have an important influence on the socio-affective and sexual development. This paper presents a review of the scientific literature on romantic relationships during adolescence and aims to unravel the ongoing debate in the literature and to identify possible gaps. The review encompasses the analysis of 36 studies on romantic relationships in adolescence, all published in peer-reviewed English scientific journals. The analysis of the published data was guided by five central characteristics of romantic relationships of adolescents: i.e., involvement, partner selection, content, quality, and emotions and cognitions emerging from the relationship. It was found that although during the last decade a growing interest of scholars in the study of romantic relationships in adolescents emerged, providing a certain body of knowledge on the topic in general, there are still gaps in the understanding of adolescents’ romantic relationships in different socio-cultural contexts. Limitations of the reviewed studies in terms of agreement on definitions, inconsistencies in sample population, research design and methodological approach are discussed.

Xeroderma pigmentosum (XP) is caused by defects in the nucleotide excision repair (NER) pathway. NER removes helix-distorting DNA lesions, such as UV-induced photodimers, from the genome. Patients suffering from XP exhibit exquisite sun sensitivity, high incidence of skin cancer, and in some cases neurodegeneration. The severity of XP varies tremendously depending upon which NER gene is mutated and how severely the mutation affects DNA repair capacity. XPF-ERCC1 is a structure-specific endonuclease essential for incising the damaged strand of DNA in NER. Missense mutations in XPF can result not only in XP, but also XPF-ERCC1 (XFE) progeroid syndrome, a disease of accelerated aging. In an attempt to determine how mutations in XPF can lead to such diverse symptoms, the effects of a progeria-causing mutation (XPF(R153P)) were compared to an XP-causing mutation (XPF(R799W)) in vitro and in vivo. Recombinant XPF harboring either mutation was purified in a complex with ERCC1 and tested for its ability to incise a stem-loop structure in vitro. Both mutant complexes nicked the substrate indicating that neither mutation obviates catalytic activity of the nuclease. Surprisingly, differential immunostaining and fractionation of cells from an XFE progeroid patient revealed that XPF-ERCC1 is abundant in the cytoplasm. This was confirmed by fluorescent detection of XPF(R153P)-YFP expressed in Xpf mutant cells. In addition, microinjection of XPF(R153P)-ERCC1 into the nucleus of XPF-deficient human cells restored nucleotide excision repair of UV-induced DNA damage. Intriguingly, in all XPF mutant cell lines examined, XPF-ERCC1 was detected in the cytoplasm of a fraction of cells. This demonstrates that at least part of the DNA repair defect and symptoms associated with mutations in XPF are due to mislocalization of XPF-ERCC1 into the cytoplasm of cells, likely due to protein misfolding. Analysis of these patient cells therefore reveals a novel mechanism to potentially regulate a cell's capacity for DNA repair: by manipulating nuclear localization of XPF-ERCC1.

Patients with Testicular Germ Cell Tumors (TGCT) may suffer from several late effects due to their diagnosis or treatment. Follow-up care aims to identify the recurrence of cancer and support patients with TGCT in their experienced late effects. In the Netherlands, the validated Dutch version of the Edmonton Symptom Assessment System, Utrecht Symptom Diary (USD) is used to assess and monitor patient reported symptoms. As a first step to develop a specific USD module for TGCT-patients, it was necessary to identify the prevalence and intensity of late effects in patients with TGCT, covering the physical, social, psychical and existential domains of care. A cross-sectional study was conducted. First, literature was systematically assessed to create a comprehensive list of symptoms. This generated list was reviewed by expert healthcare professionals and the research group. Lastly, a survey was distributed amongst patients with TGCT in follow-up care in the University Medical Center Utrecht (UMCU) outpatient clinic. In total, 65 TGCT-patients completed the survey. All described late effects were recognized by TGCT-patients, with 'fatigue', 'disturbed overall well-being', 'concentration problems' and 'neuropathy', indicated as most prevalent and scored with highest intensity. When prioritizing these late effects, patients assigned 'neuropathy' as most important. This study provided insight into prevalence and intensity of late effects, as indicated by TGCT-patients. In clinical practice, follow-up care can improve by empowering patients to discuss important items in daily life with their health-care professionals. • First step towards a specific instrument for standardized monitoring of individually experienced late effects after testicular germ cell tumors (TGCT). • Unique insights into the prevalence and intensity of late effects in TGCT-patients were provided. • Fatigue, concentration problems, neuropathy and disturbed overall well-being were the most prevalent late effects. [ABSTRACT FROM AUTHOR]

Introduction Breast cancer (BC) and/or its treatments may affect sexual functioning based on physiological and psychosocial mechanisms. The aim of this study was to prospectively investigate sexual adjustment of BC patients during a follow-up period of one year after mastectomy (ME) or breast conserving therapy (BCT). Methods In this prospective controlled study, women with BC and an age-matched control group of healthy women completed the Beck Depression Inventory Scale, World Health Organization 5 Well-being scale, Body Image Scale, EORTC QLQ questionnaire, Dyadic Adjustment Scale, Short Sexual Functioning Scale and Specific Sexual Problems Questionnaire to assess various aspects of sexual and psychosocial functioning before surgery, six months and one year after surgical treatment. Results In total, 149 women with BC and 149 age-matched healthy controls completed the survey. Compared to the situation before surgery, significantly more BCT women reported problems with sexual arousal six months after surgery and significantly more women of the ME group reported problems with sexual desire, arousal and the ability to achieve an orgasm six months and one year after surgery. While in comparison with healthy controls, no significant differences in sexual functioning were found after BCT surgery, significantly more women who underwent ME reported problems with sexual desire, arousal, the ability to achieve an orgasm and intensity of the orgasm. Conclusions Although little differences were seen in sexual functioning in the BCT group during prospective analyses and in comparison with healthy controls, analyses revealed that women who underwent a ME were at risk for post-operative sexual dysfunctions. [ABSTRACT FROM AUTHOR]

Women with cervical cancer (CC) may be faced with changes in sexual functioning resulting from the cancer itself and/or its surgical treatment. The aims of this study were to prospectively investigate sexual adjustment of CC patients during a follow-up period of 2 years after radical hysterectomy without adjuvant treatment and to compare the results with women who underwent a hysterectomy for a benign gynecological condition and with healthy control women.In this prospective controlled study, participants completed the Short Sexual Functioning Scale, Specific Sexual Problems Questionnaire, Beck Depression Inventory Scale, World Health Organization-5 Well-Being Scale, and Dyadic Adjustment Scale to assess various aspects of sexual and psychosocial functioning at certain time intervals, namely, before surgery and 6 months, 1 year, and 2 years after surgical treatment.Thirty-one women with CC, 93 women with a benign gynecological condition, and 93 healthy controls completed the survey. In CC survivors, no differences were found in sexual functioning during prospective analyses and in comparison with women with a benign gynecological condition. However, compared with healthy women, preoperatively and postoperatively, significantly more CC patients reported sexual dysfunctions, including sexual arousal dysfunction, entry dyspareunia, deep dyspareunia, abdominal pain during intercourse, and reduced intensity of the orgasm. Furthermore, compared with healthy controls, CC patients reported worse psychological functioning before surgery and at 6 months after surgery. Finally, before surgery, quality of partner relationship was rated significantly better by CC patients compared with healthy controls; however, quality of the partner relationship declined during the first year of follow-up compared with the situation before surgery.In CC patients, no differences were found in sexual functioning when prospectively comparing the situation before and after surgery. However, when compared with healthy controls, CC patients are at high risk for sexual dysfunctions, both before and after surgical treatment. [ABSTRACT FROM AUTHOR]

Vulvectomy for vulvar malignancy can affect sexual functioning based on anatomic, physiologic, psychologic, and relational mechanisms. The aims of this study were to prospectively investigate sexual adjustment of women with vulvar malignancy during a follow-up period of 1 year after vulvectomy and to compare the results with healthy control women.In this prospective controlled study, participants completed the Beck Depression Inventory scale, World Health Organization-5 Well-being scale, Dyadic Adjustment Scale, Short Sexual Functioning Scale, and Specific Sexual Problems Questionnaire to assess various aspects of psychosocial and sexual functioning just before surgery, 6 months, and 1 year after treatment.Twenty-nine women with vulvar malignancy and 29 healthy controls completed the survey. Compared with the presurgery status, no significant differences were found in psychologic, relational, and sexual functioning in women after surgery for vulvar malignancy. Compared with healthy control women, women with vulvar malignancy reported significantly lower psychologic well-being and quality of partner relationship, both before and after treatment. Moreover, significantly more patients with vulvar malignancy reported preoperative and postoperatively sexual dysfunctions than healthy controls, including entry and deep dyspareunia, abdominal pain during intercourse, reduced ability to achieve orgasm, and reduced intensity of orgasm.This prospective study yielded no differences in psychosocial and sexual functioning for women with vulvar malignancy before and after vulvectomy. However, when compared with healthy controls, patients with vulvar malignancy are at high risk for sexual dysfunctions, both before and after surgical treatment. [ABSTRACT FROM AUTHOR]

The article discusses a study which explores the impact of pelvic surgery for gynaecological cancer (GC) on the sexual and psychological functioning in women. It states that pelvic surgery for gynecological cancer may affect sexuality and lead to sexual dysfunction. Women who underwent gynecological surgery and from a control group completed questionnaires that evaluated their marital satisfaction, depression and sexual function. The study found that women with GC have reported sexual problems.

BACKGROUND: The recognition of the distressing character of infertility diagnosis and treatment has led to the development of several psychosocial interventions for infertile couples. At the Leuven University Fertility Centre, a body–mind marital group intervention was developed to help infertile couples cope with the distress related to infertility. METHODS AND RESULTS: This treatment programme was originally adapted from a mind–body approach, but integrated concepts and techniques from body-oriented therapy, art therapy and multi-family group therapy. In this paper, the therapeutic foundations, treatment goals and practical implications of the mind–body marital group intervention are outlined. Further, the treatment procedure is explained in detail and illustrated by clinical vignettes. CONCLUSIONS: Although the first clinical impressions about the usefulness of the body–mind group programme in fertility clinics seem promising, further research is needed to assess its effectiveness. [ABSTRACT FROM AUTHOR]