The Sexual Function Evaluation Questionnaire (SFEQ) to Evaluate Effectiveness of Treatment for Sexual Difficulties: Development and Validation in a Clinical Sample.

Progress toward establishing the effectiveness of biopsychosocial treatment for patients with sexual problems is limited by the lack of brief measurement tools assessing change across various domains of the treatment model. We developed and psychometrically validated a new clinical evaluation tool, the Sexual Function Evaluation Questionnaire (SFEQ) to meet this gap. The SFEQ combines into a single scale the best performing items from two instruments that were piloted in a UK sexual problems clinic (n = 486): the Natsal-SF Clinical Version and the National Sexual Outcomes Group 1 measure. Internal construct validity evidence from exploratory and confirmatory factor analyses supported a 16-item measure consisting of one overarching dimension of overall sexual function distributed along four subscales: problem distress, partner relationship, sex life, and sexual confidence. The measure had satisfactory configural, metric, and scalar invariance over time and across groups based on gender, ethnicity, and age. Correlations with patient depression and anxiety demonstrated external validity. Change in scores over the course of therapy varied as predicted, with greater improvement in younger patients and in areas more amenable to change via therapy (sexual confidence and problem distress). The SFEQ is a brief clinical tool with the potential to assess sexual function and evaluate the effectiveness of biopsychosocial treatment programs.

Evolving Document Patterns in UK Research Assessment Cycles.

Researcher behavior is shown to change under assessment. An unexpected time-skew toward most recent papers in each census period was found among the outputs selected by UK academics for the research assessment cycles of the 1990s. This skew changed to a more even time-based distribution for scientists and engineers in later cycles. At the same time, engineers switched their preferred output type for submission, from conference proceedings to journal articles. Social scientists also switched, from monographs to journal art. There was no discussion of these output patterns at the time, or later, but the patterns and their evolution had marked consistency across subjects and institutions. These changes are discussed in terms of consensus and influences on researcher concepts of the evidence of excellence. The increasing availability of citation data in the 1990s and the likely role of citation analysis as a steering factor are noted.

Bibliometric Assessment of European and Sub-Saharan African Research Output on Poverty-Related and Neglected Infectious Diseases from 2003 to 2011.

BACKGROUND: The European & Developing Countries Clinical Trials Partnership (EDCTP) is a partnership of European and sub-Saharan African countries that aims to accelerate the development of medical interventions against poverty-related diseases (PRDs). A bibliometric analysis was conducted to 1) measure research output from European and African researchers on PRDs, 2) describe collaboration patterns, and 3) assess the citation impact of clinical research funded by EDCTP. METHODOLOGY/PRINCIPAL FINDINGS: Disease-specific research publications were identified in Thomson Reuters Web of Science using search terms in titles, abstracts and keywords. Publication data, including citation counts, were extracted for 2003-2011. Analyses including output, share of global papers, normalised citation impact (NCI), and geographical distribution are presented. Data are presented as five-year moving averages. European EDCTP member countries accounted for ~33% of global research output in PRDs and sub-Saharan African countries for ~10% (2007-2011). Both regions contributed more to the global research output in malaria (43.4% and 22.2%, respectively). The overall number of PRD papers from sub-Saharan Africa increased markedly (>47%) since 2003, particularly for HIV/AIDS (102%) and tuberculosis (TB) (81%), and principally involving Southern and East Africa. For 2007-2011, European and sub-Saharan African research collaboration on PRDs was highly cited compared with the world average (NCI in brackets): HIV/AIDS 1.62 (NCI: 1.16), TB 2.11 (NCI: 1.06), malaria 1.81 (NCI: 1.22), and neglected infectious diseases 1.34 (NCI: 0.97). The NCI of EDCTP-funded papers for 2003-2011 was exceptionally high for HIV/AIDS (3.24), TB (4.08) and HIV/TB co-infection (5.10) compared with global research benchmarks (1.14, 1.05 and 1.35, respectively). CONCLUSIONS: The volume and citation impact of papers from sub-Saharan Africa has increased since 2003, as has collaborative research between Europe and sub-Saharan Africa. >90% of publications from EDCTP-funded research were published in high-impact journals and are highly cited. These findings corroborate the benefit of collaborative research on PRDs.

Transsexualism - attitudes in general practice.

Transsexualism was long regarded by the medical profession as a mental disorder. Historically, denial, aversion therapies, hormone 'reinforcement' and even electroconvulsive shock treatments were the lot of those compelled to articulate their overwhelming need to identify as members of the gender opposite that assigned to them at birth. We now know and understand that, just as the gonads, genitals and chromosomes are differentiated as to gender, so too is the brain. While the relationship between brain morphology and 'gender identity' is yet to be finally proven beyond scientific doubt, the extent of empirical and anecdotal evidence supporting it continues to grow such that the factors to be considered when determining the legal gender of a person now include the person's self perception and any biological features of the person's brain that are associated with a particular gender.

Sex ratios and the risks of haematological malignancies.

Although the sex of an individual confers one of the greatest of the known risks for contracting leukaemia and lymphomas, very little attention is paid to these risks. It is the purpose of this paper to stimulate further research in this area. The sex rate ratios are presented for the commoner haematological malignancies. The male excess in the lymphoid cancers is most marked in the youngest age group in non-Hodgkin's lymphoma and Hodgkin's disease, while acute lymphoblastic leukaemia shows equal sex ratios in the childhood peak. Both chronic lymphocytic leukaemia and lymphocytic lymphoma display an unusual pattern, hitherto undescribed, with a large male excess specific to the 40s and 60s age groups. The myeloid sex ratios are all characterized by slight female excess in early adulthood followed by marked male excess. The reasons for these patterns are discussed.

Increasing incidence and descriptive epidemiology of extranodal non-Hodgkin lymphoma in parts of England and Wales.

INTRODUCTION: The incidence of non-Hodgkin lymphoma (NHL) arising from extranodal tissue has been reported to be increasing in Western countries and yet the epidemiology of this heterogeneous disease has been poorly described. PATIENTS AND METHODS: : Cases of extranodal NHL were reported to a specialist population-based registry covering neoplastic hematological conditions in parts of England and Wales from 1986 to 1993. RESULTS: Nearly one third of all NHL, 3556 cases, were extranodal in origin giving a world standardised incidence rate of 1.9/10(5) per year. The most common sites were the skin, stomach and small intestine and high-grade malignancies were predominant. An excess in male incidence was observed for extranodal NHL overall, at all ages, and for most sites. Time-trend analyses indicated significant increases in incidence for all extranodal NHL and NHL of the gastrointestinal tract, skin, central nervous system and male genital organs. Incidence rates increased proportionally more for middle-aged persons, especially females, and for skin lymphomas excluding mycosis fungoides and Sezary disease. CONCLUSION: These results suggest that the rise in incidence of extranodal NHL may be due, at least in part, to an increase specifically in B-cell skin lymphomas and that particular environmental factors such as sunlight might be involved rather than the increases being the results of improvements in diagnostic practices.