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In this qualitative study, we explored women's and men's experience of sexual desire for their romantic partner and its link to dyadic interactions. During interviews and focus group discussions, our participants described sexual desire as 'elusive', 'conditional', 'responsive' and 'malleable'. The subtheme 'elusive' refers to sexual desire having a will of its own, while the remaining three refer to prerequisites for, triggers of, and strategies for enhancing sexual desire respectively. These subthemes come together in the overarching narrative 'luring the elusive', which articulates one's responsibility to accommodate sexual desire for one's partner, but also the necessity to acknowledge its elusiveness.

BACKGROUND: While sexuality and intimacy are suggested to contribute to quality of life (QoL), it is striking that the sexual problems of head and neck cancer patients have not been adequately studied. OBJECTIVES: Our aim was to prospectively assess the impact of head and neck cancer and its treatment on sexuality and intimacy. MATERIAL AND METHODS: A questionnaire study with a 6-month follow-up period was conducted at the University Hospitals Leuven, Belgium, using the Maudsley marital questionnaire (MMQ), the sexual adjustment questionnaire (SAQ) and the short sexual functioning scale (SSFS) to prospectively assess the impact of head and neck cancer and its treatment on sexuality and intimacy. RESULTS: Twelve patients (67%) reported a negative impact on their sexuality and/or intimacy. There were significant declines in marital, sexual and general life satisfaction (p < 0.000) at the 6-month follow-up as compared to baseline. There was a significant increase in frustration after sexual activity (p = 0.031). Sexual desire was also impacted, with a near doubling of patients reporting a decline. The perceived importance of discussing sexual issues with one's physician significantly increased from 7 to 16 patients (p = 0.004). CONCLUSIONS: Sexual problems are common after head and neck cancer treatment. Using a screening instrument can help to identify patients that need intervention. Discussing sexuality and intimacy issues that patients may face before, during and after treatment can have a positive impact on QoL. ispartof: DENTAL AND MEDICAL PROBLEMS vol:59 issue:3 pages:323-332 ispartof: location:Poland status: published

Objective To compare adnexectomy by vaginal Natural Orifice Transluminal Endoscopic Surgery (vNOTES) versus laparoscopy. Design Parallel group, 1:1 single-centre single-blinded randomised trial, designed as non-inferiority study with a margin of 15%. Setting Belgian teaching hospital POPULATION: Non-pregnant non-virgin women with an intact uterus and without obliteration of the pouch of Douglas scheduled to undergo removal of an adnexal mass assessed to be benign on ultrasound by IOTA criteria. Methods Randomisation to laparoscopy (control group) or vNOTES (experimental group). Stratification according to adnexal size. Blinding of participants and outcome assessors by sham incisions. Main outcome measures The primary outcome measure was adnexectomy by the allocated technique. Secondary outcomes included duration of surgery, pain scores and analgesics used, quality of life and adverse events. Results We randomly assigned 67 participants (34 to the vNOTES group and 33 to the laparoscopy group). The primary endpoint was always reached in both groups: there were no conversions. We performed a sensitivity analysis for the primary outcome, assuming one conversion in the vNOTES group and no conversions in the laparoscopy group: the one-sided 95% upper limit for the differences in proportions of conversion was estimated as 13%, which is below the predefined non-inferiority margin of 15%. The secondary outcomes demonstrated a shorter duration of surgery, lower pain scores, lower total dose of analgesics and a trend for more adverse events in the vNOTES group. Conclusions vNOTES is non-inferior to laparoscopy for a successful adnexectomy without conversion. vNOTES allowed shorter operating times and less postoperative pain but there was a trend for more adverse events.

Different pain types may be encoded in different brain circuits. Here, we examine similarities and differences in brain processing of visceral and somatic pain. We analyze data from seven fMRI studies (N = 165) and five types of pain and discomfort (esophageal, gastric, and rectal distension, cutaneous thermal stimulation, and vulvar pressure) to establish and validate generalizable pain representations. We first evaluate an established multivariate brain measure, the Neurologic Pain Signature (NPS), as a common nociceptive pain system across pain types. Then, we develop a multivariate classifier to distinguish visceral from somatic pain. The NPS responds robustly in 98% of participants across pain types, correlates with perceived intensity of visceral pain and discomfort, and shows specificity to pain when compared with cognitive and affective conditions from twelve additional studies (N = 180). Pre-defined signatures for non-pain negative affect do not respond to visceral pain. The visceral versus the somatic classifier reliably distinguishes somatic (thermal) from visceral (rectal) stimulation in both cross-validation and independent cohorts. Other pain types reflect mixtures of somatic and visceral patterns. These results validate the NPS as measuring a common core nociceptive pain system across pain types, and provide a new classifier for visceral versus somatic pain., 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.

Purpose The purpose of this study is to examine the association between parental migration and adolescents’ styles of close relationships with parents, friends and romantic partners. Design/methodology/approach In total, 197 adolescents from Cuenca (Ecuador) participated in the study, of which 35% reported a background of parental migration. The Behavioral Systems Questionnaire was used to assess participants’ relational styles. Findings The study reveals that, although parental migration is associated with the development of lower secure styles for parents and friends, it is not associated with the development of insecure styles. Moreover, parental migration does not appear to be associated with the development of romantic styles. Based on the differential impact of the migration of one or two parents, the migration of two parents appeared to have a stronger association with lower secure styles. Originality/value The results are discussed in light of the socio-cultural context in which parental migration occurs in Ecuador, which may offer clue variables in shaping the relational styles of adolescents. The study addresses an important consequence of migration focusing on a scarce studies group, adolescents who stay in their home country while their parents migrate. Moreover, its main findings challenge the preconceptions that parent-child separations necessarily involve a direct negative impact on relational functioning.

This article presents a new conceptual framework that shows how dementia may affect the sexual relationship between partners, and how different actors become progressively more involved in “managing” the sexual relationship during consecutive phases of dementia, that is, the premorbid, preclinical, and clinical phases. Each phase challenges couples in different ways and these challenges may affect the expression of sexuality in their relationship. The person living with dementia and/or the partner’s desire to continue to be sexually active may result in conflicts with health care professionals and family members who want to protect the person living with dementia from becoming the perpetrator and/or the victim of “inappropriate” or “harming” sexual behavior. The framework posits that a diagnosis of dementia instigates a journey of renegotiating sexuality in which gradually more actors—who often approach sexuality from a sex-negative point of view—become involved. Therefore, the new framework starts from a sex-positive perspective and is presented together with a new research agenda that ensues from this framework. Research based on this framework that starts from the experience of both people living with dementia and their partners will help us to better understand the relational and sexual effects of a dementia diagnosis. This knowledge will enable health care professionals to provide tailored care with respect for the sexual needs of couples living with dementia. Hence, clinical implications arising from the framework are presented.

Contains fulltext : 237447.pdf (Publisher’s version ) (Closed access) Background and aims: The prevalence of sexual dysfunctions in people with diabetes is still debated and understudied in women. This study examines the prevalence of sexual dysfunction in men and women with type 1 or type 2 diabetes (T1D or T2D) and the associations with clinical and psychological variables. Methods: Adults with diabetes (n = 756) completed an online survey including questions on sexual functioning (adapted Short Sexual Functional Scale), general emotional well-being (WHO-5), symptoms of anxiety (GAD-7) and diabetes distress (PAID-20). Results: One third of participants reported a sexual dysfunction. Men reported erectile dysfunction (T1D: 20%; T2D: 33%), and orgasmic dysfunction (T1D: 22%; T2D: 27%). In men, sexual dysfunction was independently associated with, older age (OR = 1.05, p = 0.022), higher waist circumference (OR = 1.04; p

Background Pubic hair removal (PHR) is a widespread practice that entails certain health risks; however, there remains a lack of scientific information on the prevalence and antecedents of PHR, as well as on its association with sexual behavior and relational satisfaction. Aims To explore women’s and men’s attitudes regarding PHR and their PHR practices and the associations with demographic, relational, and sexual characteristics. Methods A total of 2,687 men and 1,735 women living in Flanders (the Northern part of Belgium) completed an online survey. Participants ranged in age from 15 to 60+ years; they self-identified as heterosexual, bisexual, or homosexual and reported various relationship statuses. Main Outcome Measures Demographic items (ie, age, religion, partner relationship status), sexuality-related items (ie, sexual activity, sexual orientation, age at first intercourse, number of sexual partners), PHR items (ie, reasons, inclination to have or not have sex after PHR, perceived partner preferences, partner’s PHR), and relationship satisfaction, assessed with the Maudsley Marital Questionnaire. Results Fewer men (39.1%) than women (80.3%) reported (partially) removing their pubic hair. In both men and women, the practice was associated with age, sexual activity, relationship status, and partner’s PHR practice and expectations. In men, sexual and relationship satisfaction were correlated with their partner’s PHR practices and whether these were in line with the men’s expectations. In women, sexual and relationship satisfaction were mostly correlated with whether both partner’s expectations were met. Although both men and women reported that the reasons for PHR were related to their sexual experiences and to their partner’s preference, only women reported that PHR was a way to enhance feelings of femininity. Finally, the reasons for not engaging in PHR were related to partner preferences and side effects. Conclusion PHR is a widespread practice and seems strongly associated with personal, partner-related, sexual, and relational factors. Strategies to prevent men and women from being confronted with health risks should take all these factors into account.

While the interactive nature of sexual desire in women is increasingly recognized, dyadic factors affecting it, including partner interactions, have as yet received little research attention. In this cross-sectional study, we examined the associations among intimacy, celebrated otherness, and object-of-desire affirmation and explored how they complement each other in the prediction of sexual desire in women. Based on the reports of 662 participants, positive correlations were found among all factors. However, in a multiple regression analysis, object-of-desire affirmation emerged as the only positive predictor of sexual desire. ispartof: JOURNAL OF SEX & MARITAL THERAPY vol:45 issue:5 pages:414-423 ispartof: location:England status: published

In most theoretical models, sexual desire for one's partner is predominantly conceptualized from an individual perspective. There is, however, a growing body of empirical evidence on the dyadic aspects of sexual desire. That evidence is as yet not well-integrated into theoretical conceptualizations of sexual desire. Aiming to fill this gap, we present the Dyadic Interactions Affecting DyadIC Sexual desire model (DIADICS), a new conceptual model inspired by systems theory that describes how dyadic interactions between partners influence dyadic sexual desire in romantic relationships. After defining dyadic sexual desire, we discuss (1) the structure of dyadic interactions, (2) their content, and (3) the process through which they affect dyadic sexual desire in a romantic relationship. Thereafter, we review theoretical, clinical, and empirical insights underscoring the relation between dyadic interactions and (dyadic) sexual desire, use DIADICS as a framework for understanding fluctuations in dyadic sexual desire in long-term relationships, and conclude by discussing implications of DIADICS for research and clinical practice.

Approaching people and their experiences of sexual pleasure as continually in a state of becoming, we have aimed to allow for and explore these movements throughout data gathering, analysis, and presentation of a study on the sexual wellbeing of (four) women with traumatic (i.e., non-congenital) spinal cord injury. The data gathering methods—ranging from individual life story interviews over ‘on-the-road’ conversations during fieldwork to a focus group discussion—aimed to provide the participants with different routes to reflect on their subjective experience of the bodies in/with/through which they live and intimate relationships in the past, present, and future, sometimes resulting in a transformation of their sense of self and their bodily expression potential. The assembled glimpses of life were analysed by drawing on post-intentional phenomenology and plugging in the concepts of containment and sexual and intimate pleasure as becoming. Through a mix of autoethnography, fiction, and participants' words, the metaphor of a chastity belt is presented to capture how material-discursive practices around sexuality, touch and (health)care as well as the women’s ‘own’ meaning-giving of sexual pleasure and their body challenge their imaginative manoeuvrability, i.e., imagination related to one’s potential for sexual pleasure.

© The Author(s) 2018. This article explores what (working with) matter can tell us that language cannot or does not completely tell, about becoming a sensual, sexual woman free to move smoothly in and with her body. It explores how (working with) matter can transform living in, with and through a body, and how it affects and is affected. The text is centred around “touchpoints,” that is, encounters through touch, as experienced by the first author as a dancer on wheels, and diffracted and narrated through poetry and images interwoven with theory. These encounters are seen as mo(ve)ments in a powerful agential assemblage that holds both danger and transformative possibilities, leading us to reimagine freedom as a river of sparring intensities. ispartof: QUALITATIVE INQUIRY vol:26 issue:7 pages:733-742 status: published

There has been little comparative, cross-cultural research on sexual difficulties and associated distress, and factors associated with these, among older women. Therefore, the aim of this study was to investigate prevalence rates of sexual difficulties, distress related to these difficulties, and associated sociodemographic, relational, and health factors, among sexually active older women (60-75 years) in committed relationships across four European countries (Norway, Denmark, Belgium, and Portugal). These data could inform us about what differentiates women who do and do not experience distressing sexual difficulties and facilitate the identification of older women who might benefit from clinical interventions as well as the development of new interventions. In total, 1057 women (357 Norwegian; 322 Danish; 237 Belgian; 141 Portuguese) completed a cross-sectional questionnaire assessing six sexual difficulties-vaginal dryness, orgasmic difficulties, lacking interest in sex, lacking enjoyment in sex, pain during sex, and no excitement/arousal during sex-and associated distress. We found a high prevalence of sexual difficulties lasting 3 months or longer in the past year (between 23.5 and 50.2%, depending on the specific difficulty). With the exception of vaginal dryness and pain during sex, however, the majority of women reporting sexual difficulties (50.0% to 86.1%, depending on the specific difficulty) reported no or mild distress. There were relatively few cross-country differences, either in the prevalence of sexual difficulties or related distress. Few sociodemographic or health variables were associated with distressing sexual difficulties, but higher sexual intimacy, higher emotional intimacy, and better mental health were associated with less distress about some sexual difficulties. The findings underline the importance of healthcare professionals asking older women about sexual function and especially associated distress, and suggest that careful attention to the psychological and relationship context of these sexual difficulties is needed, as these could be important targets in the treatment process. ispartof: ARCHIVES OF SEXUAL BEHAVIOR vol:49 issue:8 pages:2951-2961 ispartof: location:United States status: published

OBJECTIVE: To compare hysterectomy by transvaginal natural orifice transluminal endoscopic surgery (vNOTES) versus total laparoscopic hysterectomy (TLH) as a day-care procedure. DESIGN: Parallel group, 1:1 randomised single-centre single-blinded trial, designed as a non-inferiority study with a margin of 15%. SETTING: Belgian teaching hospital. POPULATION: Women aged 18-70 years scheduled to undergo hysterectomy for benign indications. METHODS: Randomisation to TLH (control group) or vNOTES (experimental group). Stratification according to uterine volume. Blinding of participants and outcome assessors. MAIN OUTCOME MEASURES: The primary outcome was hysterectomy by the allocated technique. We measured the proportion of women leaving within 12 hours after hysterectomy and the length of hospital stay as secondary outcomes. RESULTS: We randomly assigned 70 women to vNOTES (n = 35) or TLH (n = 35). The primary endpoint was always reached in both groups: there were no conversions. We performed a sensitivity analysis for the primary outcome, assuming one conversion in the vNOTES group and no conversions in the TLH group: the one-sided 95% upper limit for the differences in proportions of conversion was estimated as 7.5%, which is below the predefined non-inferiority margin. More women left the hospital within 12 hours after surgery after vNOTES: 77 versus 43%, difference 34% (95% CI 13-56%), P = 0.007. The hospital stay was shorter after vNOTES: 0.8 versus 1.3 days, mean difference -0.5 days, (95% CI -0.98 to -0.02), P = 0.004. CONCLUSIONS: vNOTES is non-inferior to TLH for successfully performing hysterectomy without conversion. Compared with TLH, vNOTES may allow more women to be treated in a day-care setting. TWEETABLE ABSTRACT: RCT: vNOTES is just as good as laparoscopy for successful hysterectomy without conversion but allows more day-care surgery. ispartof: BJOG-AN INTERNATIONAL JOURNAL OF OBSTETRICS AND GYNAECOLOGY vol:126 issue:1 pages:105-113 ispartof: location:England status: published

Besides erectile difficulties, age-related prevalence rates of male sexual difficulties remain inconsistent. Moreover, apart from erectile and premature ejaculation, epidemiological studies...

Aim To explore palliative care nurses' attitudes, roles and concrete experience with regard to addressing sexual issues in their daily practice. Background Patients and their partners in palliative care might experience dramatic changes in their sexuality and want nurses to provide the opportunity to address them. Moreover, it is argued that the holistic philosophy of palliative care encourages nurses working in this area to include sexual issues in their daily care. It is, however, unknown how palliative care nurses address sexual issues. Design A generic qualitative study was performed. Methods In total, 21 in-depth interviews were done with nurses from different facilities of palliative care networks in Flanders. Data were collected between September 2014 - September 2016 and thematic analysis was used to analyse the data. Results It was found that the way palliative care nurses addressed sexual issues was clearly influenced by their own interpretation of the philosophical principles underlying palliative care. The different interpretations of these basic principles create tensions for nurses about how to address sexual issues in the daily practice of palliative care and nurses vary in their reactions to these tensions. The present findings show that palliative care nurses - when they were able to overcome these tensions - use a "sex-positive approach" that fits with their tendency to focus on quality of life. Conclusion Out of the results of this study, we made a list of good practices for palliative care nurses addressing sexual issues. This list can be used in nursing educational programs.

Aims: The identification and discussion of sexual care needs in people with type 2 diabetes mellitus (T2DM) in primary care is currently insufficient. The objective of this study was to determine the prevalence of sexual dissatisfaction, sexual problems and need for help by using a screening instrument among people with T2DM in primary care. Methods: Data were collected in 45 general practices in the Netherlands from January 2015 to February 2016. The Brief Sexual Symptom Checklist (BSSC) was used to screen among 40-75 year old men and women. Results: In total, 786 people with T2DM (66.5% men) were screened. The prevalence of sexual dissatisfaction was 36.6%, significantly higher among men than among women (41.1% vs. 27.8%). Sexually dissatisfied men most often reported erectile dysfunction (71.6%); for sexually dissatisfied women, low sexual desire (52.8%) and lubrication problems (45.8%) were most common. More than half of all dissatisfied people had a need for care (61.8%), significantly more men than women (66.8% vs. 47.2%). Conclusions: One third of people with T2DM is sexually dissatisfied and more than half of these people report a need for help. The BSSC could be used a tool to proactively identify sexually dissatisfied people in primary care. (C) 2017 Elsevier Inc. All rights reserved

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., Highlights • Both subjective and brain responses during anticipation and induction of vestibular pain are increased in women with GPPPD. • Between-group differences were found in brain regions involved in cognitive and affective aspects of the pain experience. • These results support the addition of pain-related fear and anxiety in the diagnostic criteria of GPPPD in DSM-5.

IntroductionThe African Copperbelt is a site of intense artisanal and industrial mining and refining of copper and cobalt. Anecdotal reports of erectile dysfunction (ED) among mineworkers in the area led us to conduct an explorative study to investigate the possible association between ED and working in mining-related jobs.MethodsWe included 42 consecutive men (18–40 years) buying sildenafil (the active substance of Viagra) from a pharmacy located in a popular neighbourhood in Lubumbashi, and 42 age-matched (±2 years) men buying painkillers. All participants replied to questionnaires administered face-to-face to obtain sociodemographic data, including information on occupation, and a score of erectile function using the International Index of Erectile Function (IIEF6).ResultsThe IIEF6 score (maximum 30) was lower among sildenafil-buyers (median 17, range 8–30) than among painkiller-buyers (median 30, range 17–30). The proportion of mining-related jobs was higher among sildenafil-buyers (19/42, 45%) than among painkiller-buyers (7/42, 17%), yielding an OR of 4.1 (95% CI 1.5 to 11.3; p=0.009). The proportion of mining-related jobs was higher among men with ED (defined as IIEF6 DiscussionThe findings of this preliminary study justify further epidemiological studies of the possible role of occupational exposures in the pathogenesis of male sexual dysfunction among miners and workers in the copper and cobalt industry.

In an attempt to extend our understanding of how social contexts co-create female sexuality in Latin America, the aim of the current study was to explore the beliefs, views, and ideas about sexual assertiveness in Latino emerging adult women. Seventeen women between 22 and 30 years old living in Cuenca, Ecuador, participated in focus groups. A constructivist grounded theory approach was used to analyze the data. Findings suggest that the overall views about sexual assertiveness in emerging adult women can be grouped into five categories: (1) gender role schemata; (2) concerns about the partner's thoughts and reactions; (3) gendered attitudes towards the use of specific methods of contraception; (4) talking about sexual histories as a challenging task; and (5) replication of family patterns. The findings of this study are discussed within existing literature that highlights the influence of gender role schemata on sexual assertiveness. Finally, a plea for more culturally sensitive research is formulated as well as some educational - the need to reinforce sex education programs - and clinical - highlighting the ability to be sexually assertive from the start of a relationship - implications are mentioned. ispartof: JOURNAL OF SEX RESEARCH vol:57 issue:3 pages:307-321 ispartof: location:United States status: published

In psychosocial migration literature, the perspective of ambiguous loss has been relevant to articulate personal and relational experiences in the context of transnational families and ongoing separation. Most studies have focused on adult members' experiences of transnational families, but research exploring ambiguous loss in adolescents whose parents have migrated is still lacking. The present study aimed to explore adolescents' lived experiences of parental migration. In a pilot explorative study, 14 adolescents with at least one parent who migrated were interviewed about their lived experiences of transnational parent-child relationships and ongoing parent-child separation. Data analysis identified four themes in participants' accounts: practices of separation creating confusion; current relationship with migrant parents permeated by ambiguity; distrustful representations of migrant parents; and family and social dynamics reactivating the pain of loss. The findings reveal how in the context of parental migration, patterns of separation and ongoing relational processes, compounded by the uncertainty of reunification and an exclusionary social fabric, constitute core elements that shape adolescents' lived experiences of parent-child relationships characterized by ambiguity.En la bibliografía sobre las consecuencias psicosociales de la migración, la perspectiva de la pérdida ambigua ha sido relevante para expresar las experiencias personales y relacionales en el contexto de las familias transnacionales y la separación constante. La mayoría de los estudios se han centrado en las experiencias de los miembros adultos de las familias transnacionales, pero aun faltan investigaciones que analicen la pérdida ambigua en los adolescentes cuyos padres han emigrado. El presente estudio tiene como finalidad analizar las vivencias de los adolescentes de padres migrantes. En un estudio piloto exploratorio, se entrevistó a 14 adolescentes con al menos un padre que emigró acerca de sus vivencias con respecto a las relaciones transnacionales entre padre e hijo y la separación constante entre padre e hijo. Los análisis de datos identificaron cuatro temas en los informes de los participantes: las prácticas de separación que generan confusión; la relación actual con los padres emigrantes impregnada por la ambigüedad; las representaciones desconfiadas de los padres emigrantes; y la dinámica familiar y social que reactiva el dolor de la pérdida. Los resultados revelan cómo, en el contexto de la migración parental, los patrones de separación y los procesos relacionales constantes, agravados por la incertidumbre de la reunificación y una estructura social exclusivista, constituyen elementos fundamentales que moldean las vivencias de los adolescentes en las relaciones entre padres e hijos caracterizadas por la ambigüedad.在关于移民的心理社会学问题的文献中,模糊性失落被用于解释在跨国家庭和长期分离状况下的个体体验和个体与他人的关系的亲历体验。大多数研究都集中在跨国家庭中成年家庭成员的经历,关于青少年中因为父母移居不在身边而导致的模糊性失落的研究还非常欠缺。本研究旨在探索那些家长已移民的青少年的人生经历。初步的探索性研究中有14名青少年参加访谈,他们中至少有一个家长移居不在身边。访谈的内容主要是关于跨国亲子关系的亲历体验和长期性的亲子分离经历。对参与者的叙述进行数据分析后得出四个主要的主题:分离这种亲子关系实践造成困惑;移居离家的父母和其孩子之间的关系的现状充满着模糊性;孩子讲述已移居离家的家长时表露出对他们的不信任感;家庭的动态关系和社交性方面的动力状态引发失去亲人的痛苦。研究结果表明在家长移居的情况下,分离的主要模式和长期的相互关系过程由于团聚的不确定性和排他性的社会关系网络而变得复杂,它们是影响青少年与家长的亲子关系经历的核心组成因素,这类亲子关系的特点就是模糊性。.

Multimodal neuroimaging studies provide support for a role of alterations in sensory processing circuits and endogenous pain modulatory systems in provoked vestibulodynia (PVD). In this study, we tested the hypotheses that PVD compared with healthy controls (HCs) would demonstrate gray matter volume (GMV) alterations in regions associated with sensorimotor, corticothalamic, and basal ganglia circuits. We also tested the replicability of previously reported gray matter increases in basal ganglia and hippocampal volumes in PVD vs HCs. In addition, disease specificity of GMV alterations were examined by comparing PVD with another chronic pain disorder. Finally, we examine whether GMV alterations are correlated with symptom measures. Structural magnetic resonance imaging was obtained in 119 premenopausal women (45 PVD, 45 HCs, and 29 irritable bowel syndrome [IBS]). A voxel-based morphometry analysis was applied to determine group differences in the hypothesized regions of interest. Compared with HCs, PVD women exhibited greater GMV in the basal ganglia, hippocampus, and sensorimotor cortices. Compared to patients with IBS, women with PVD had greater GMV in the hippocampus, and sensorimotor network, but lower GMV in the thalamus and precentral gyrus. Regional GMV alterations were associated with patient reports of pain during intercourse and muscle tenderness. The current findings provide further evidence that GMV is increased in PVD compared with HCs in several regions of the sensorimotor network and the hippocampus in patients with PVD. In addition, GMV distinct alterations in the sensorimotor network were identified between 2 pelvic pain disorders, PVD compared with IBS.

Although transnational migration and its impact on families and society has received considerable attention from scholars, still little is known about its effects on the family members who stay in their home country. The aim of this qualitative study was to explore adolescents’ experiences of close relationships in the context of transnational migration. The study was based on in-depth interviews with male and female adolescents whose parents had migrated. For administration of these interviews, a tool consisting of 15 pieces of wood was developed in order to invite participants to represent family members in an expressive modality that could facilitate discussion and decrease tension provoked by parental migration. Thematic analysis showed that adolescents experienced growing up within tri-generational families whose structure and dynamics allow for a sense of stability. In these families, adolescents experience meaningful relationships that are important sources of support to cope with the delicate emotional situation inherent in transnational families. However, the present study also revealed that adolescents experience the relationship with their migrant parents as a recurrent source of distress and emotional ambivalence, leading to a potential perspective on the parent-child separation in the context of transnational migration as an experience of an ambiguous loss.

Introduction Because severity and duration of sexual impairment and any distress caused by the sexual impairment are not assessed in most epidemiologic studies on sexual dysfunction, the available prevalence rates are probably an overestimation. Aims To provide prevalence estimates of severe and persistent sexual difficulties that cause personal distress and to explore the association between personal sexual distress and avoidance of sex, help-seeking behavior, and sexual satisfaction. Methods This study used home-based computer-assisted personal interviewing and computer-assisted self-interviewing of a representative, randomly selected, population-based cross-sectional sample of 651 Flemish men and 695 women 14 to 80 years old. Main Outcome Measures Prevalence of sexual difficulties, prevalence of sexual dysfunctions (ie, sexual difficulties causing personal distress), and association of sexual distress with avoidance of sex, help-seeking behavior, and sexual satisfaction. Results In this sample, 43.5% of women (95% CI =39.7–47.3) and 34.8% of men (95% CI =31.3–38.3) reported a moderate to severe sexual difficulty. When considering the diagnostic criteria of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (ie, minimum duration of 6 months and presence of personal sexual distress), prevalence rates decreased to 19.0% in women (95% CI =16.0–22.0) and to 15.1% in men (95% CI =12.4–17.8). Sexual distress was associated with more sexual dissatisfaction and greater sexual avoidance. Sexual distress also was associated with help-seeking behavior, although most individuals with distressing sexual difficulties had not sought help. Conclusion Although sexual difficulties per se are quite prevalent, severe and persistent sexual difficulties causing sexual distress are far less common. Despite sexual distress being associated with avoidance of sex and lower sexual satisfaction, most people tend not to seek help for their sexual problem, even when being distressed by the problem.

This study aimed to: (a) investigate whether, and if so which, sexual problems are present in people with a limb amputation; (b) analyze how they experience their sexuality; and (c) investigate whether sexuality was discussed with them during their rehabilitation process.In total, 301 participants completed a survey consisting of a questionnaire on participant characteristics, the Hospital Anxiety and Depression Scale (HADS), the Maudsley Marital Questionnaire (MMQ), the Amputee Body Image Scale (ABIS), the Questionnaire about Sexual Counselling, the Questionnaire about Sexuality and the Short Sexual Functioning Scale (SSFS).Overall, 20% of the participants experienced one or more sexual dysfunction(s). Participants who had at least one sexual dysfunction were more likely to be male, had an amputation more recently, and had a more negative body image. Moreover, sexuality was only scantly discussed by rehabilitation professionals.Sexual problems and sexual dysfunctions do occur in people with a limb amputation, but these problems are not discussed during the rehabilitation process. Justice for a person's "whole body" can only be served when sexuality is taken seriously in rehabilitation care in order to avoid cutting sexuality out of an amputee's life. Implications for Rehabilitation People with a limb amputation may be confronted with sexual problems and/or sexual dysfunctions. It is therefore important that sexuality is taken seriously as a part of standard rehabilitation care and that professionals bring up the issue of sexuality during the rehabilitation process.

El objetivo de este estudio fue presentar una revision de literatura sobre la asertividad sexual (AS), sobre los factores y experiencias de vida asociados con su desarrollo, y sobre su funcion en la sexualidad humana. Se encontro que, variables demograficas (ej. edad, educacion, genero), experiencias sexuales (ej. tipo de pareja, victimizacion sexual), aspectos psicosexuales (ej. funcionamiento sexual, autoestima con la imagen corporal, regulacion de emociones, inventiva) y factores culturales (ej. guiones sexuales, estereotipos de genero) podrian contribuir positiva o negativamente a la AS. Asimismo, se presentan los efectos de la AS tanto en los individuos como en las relaciones de pareja. Basados en esta revision se concluye que, pese a que la AS puede ser entrenada, el contexto cultural aun dificulta a algunos individuos a alcanzar niveles satisfactorios de AS.Finalmente, se presentan recomendacionessobre como continuar estudiando la AS.

Different forms of sexual expression can be beneficial to health and quality of life of older adults. While research on sexual well- being and aging has focused primarily on negative dynamics, this approach may not fit well the sexual reality of aging men and women. We used data from a probability-based survey carried out in 2016 among men and women aged 60+ years from four European countries to develop and validate a measure of sexual well- being. This multi-dimensional measure included items on sexual satisfaction, physical inti - macy, emotional closeness during sex, sexual compatibility and distress related to problem - atic sexual function, was characterized with a good fit to the data, partial scalar invariance across gender and configural invariance across country. The measure was consistently asso - ciated with emotional intimacy, frequency of sexual intercourse and masturbation. No sys - tematic gender differences in sexual well-being were observed. Higher sexual well-being corresponded to better self-reported health and being partnered or married. Given the lack of information about successful sexual aging and the absence of sexuality education for older adults, this study’s findings about the facets of sexual well-being in aging men and women may assist health workers and other professionals working with this popula

While not all sexual difficulties cause distress, research and clinical experience suggest that, apart from personal distress, partner and relational sexual distress are also often an important reason to seek professional help. The current study explored the associations between personal, perceived partner, and relational distress that men and women experience as a result of sexual difficulties. Data from heterosexual Flemish individuals ages 16 to 74 who were in a relationship (13,800 men and 13,242 women, mean age of 43.69, SD = 14.94) were collected via an online survey. Presence and severity of sexual difficulties and associated personal, perceived partner, and relational sexual distress were assessed. Among men and women with desire difficulties, either the three types of sexual distress were almost equally common or partner distress was most common. Arousal, orgasm, and sexual pain difficulties were most often associated with personal distress, particularly in men. Both men and women, however, most commonly reported that they experienced all three types of distress. These results are discussed in relation to Western gender-specific sexual scripts. Clinical implications and the importance of couples therapy and suggestions for clinically useful diagnostic criteria are presented.