Comparison of Female Sexual Function Index in patients with psoriatic and rheumatoid arthritis and healthy controls.

OBJECTIVE: The aim of the recent study was to identify and compare the Female Sexual Function Index (FSFI) of three female populations: those with rheumatoid arthritis (RA), psoriatic arthritis (PsA), and healthy individuals. METHODS: In this descriptive correlational study, convenience sampling was used to recruit 50 female RA patients, 36 female PsA patients and 50 healthy women between June and September 2018. RESULTS: The mean ages of the RA patients, PsA patients and healthy controls were, respectively, 53.1 ± 11.8 years, 51.6 ± 13.7 years and 37.4 ± 10.4 years. Controls were significantly younger than RA (p < 0.001) and PsA (p = 0.002) patients. Data including all participants: Based on the total sexual functioning cut-off score of 26.55, 68% of RA patients (34/50), 67% of PsA patients (22/33) and 44% of healthy controls (11/25) met the criteria for sexual dysfunction. Data excluding participants who reported not having had sex in the previous month: Controls had significantly higher FSFI scores than the RA patients across all six domains (p ≤ 0.001) and the overall score (p < 0.001). Controls had significantly higher FSFI scores than the PsA patients across four of the six domains (p ≤ 0.026) and the overall score (p = 0.008). There were no statistically significant differences between the RA and PsA groups. Patient pain, patient global status and Health Assessment Questionnaire scores were not significantly correlated with the total FSFI score in either PsA or RA. CONCLUSIONS: These findings demonstrate that decreased sexual functioning is more common in women with RA and PsA when compared with controls. All female patients with RA and PsA should be screened for sexual dysfunction.

The Future of General Surgery: Evolving to Meet a Changing Practice.

PURPOSE: Similar to other countries, the practice of General Surgery in Canada has undergone significant evolution over the past 30 years without major changes to the training model. There is growing concern that current General Surgery residency training does not provide the skills required to practice the breadth of General Surgery in all Canadian communities and practice settings. PROCEDURE: Led by a national Task Force on the Future of General Surgery, this project aimed to develop recommendations on the optimal configuration of General Surgery training in Canada. A series of 4 evidence-based sub-studies and a national survey were launched to inform these recommendations. MAIN FINDINGS: Generalized findings from the multiple methods of the project speak to the complexity of the current practice of General Surgery: (1) General surgeons have very different practice patterns depending on the location of practice; (2) General Surgery training offers strong preparation for overall clinical competence; (3) Subspecialized training is a new reality for today's general surgeons; and (4) Generation of the report and recommendations for the future of General Surgery. A total of 4 key recommendations were developed to optimize General Surgery for the 21st century. CONCLUSIONS: This project demonstrated that a high variability of practice dependent on location contrasts with the principles of implementing the same objectives of training for all General Surgery graduates. The overall results of the project have prompted the Royal College to review the training requirements and consider a more "fit for purpose" training scheme, thus ensuring that General Surgery residency training programs would optimally prepare residents for a broad range of practice settings and locations across Canada.