Female Sexuality in Aotearoa/New Zealand: Factors and Sexual Response Associated with Masturbation.

Objectives: Sexual health includes the state of physical, emotional, mental, and social well-being related to sexuality. Masturbation is an important sexual activity with many potential benefits which has gained considerable interest in sexuality research in the past twenty years; however, this research is the first of its kind within the Aotearoa/New Zealand context. In this in-depth investigation, we examined frequencies of, reasons for, and activities during masturbation as well as the relationship between masturbation and other factors. Methods: Participants were 698 New Zealand women at least 18 years of age participating in a 42-item anonymous online survey collecting comprehensive information about sexual practices and related factors. Results: The results indicated that female masturbation has high prevalence in the New Zealand population. Conclusion: The pattern of results enabled us to identify the positive effects of masturbation, masturbation practices commonly used by New Zealand women and the differences between New Zealand women who masturbate frequently and less frequently.

Burden of injury along the development spectrum: associations between the Socio-demographic Index and disability-adjusted life year estimates from the Global Burden of Disease Study 2017.

BACKGROUND: The epidemiological transition of non-communicable diseases replacing infectious diseases as the main contributors to disease burden has been well documented in global health literature. Less focus, however, has been given to the relationship between sociodemographic changes and injury. The aim of this study was to examine the association between disability-adjusted life years (DALYs) from injury for 195 countries and territories at different levels along the development spectrum between 1990 and 2017 based on the Global Burden of Disease (GBD) 2017 estimates. METHODS: Injury mortality was estimated using the GBD mortality database, corrections for garbage coding and CODEm-the cause of death ensemble modelling tool. Morbidity estimation was based on surveys and inpatient and outpatient data sets for 30 cause-of-injury with 47 nature-of-injury categories each. The Socio-demographic Index (SDI) is a composite indicator that includes lagged income per capita, average educational attainment over age 15 years and total fertility rate. RESULTS: For many causes of injury, age-standardised DALY rates declined with increasing SDI, although road injury, interpersonal violence and self-harm did not follow this pattern. Particularly for self-harm opposing patterns were observed in regions with similar SDI levels. For road injuries, this effect was less pronounced. CONCLUSIONS: The overall global pattern is that of declining injury burden with increasing SDI. However, not all injuries follow this pattern, which suggests multiple underlying mechanisms influencing injury DALYs. There is a need for a detailed understanding of these patterns to help to inform national and global efforts to address injury-related health outcomes across the development spectrum.

Is the Rivermead Post-Concussion Symptoms Questionnaire a Reliable and Valid Measure to Assess Long-Term Symptoms in Traumatic Brain Injury and Orthopedic Injury Patients? A Novel Investigation Using Rasch Analysis.

Persistent post-concussion syndrome (PCS) symptoms are known to last years after traumatic brain injury (TBI), and similar symptoms are increasingly being documented among those who have not experienced a TBI. There remains however, a dearth of empirical evidence on the structural composition of symptoms beyond the post-acute symptom phase after TBI, and little is known about the potential use of PCS symptom scales to measure PCS-like symptoms in non-TBI individuals. Our objective was therefore to examine the psychometric performance and dimensionality of the Rivermead Post-Concussion Symptoms Questionnaire (RPQ) as a measure of long-term PCS symptoms among a TBI and non-TBI sample. A case-control sample of 223 patients with injury, consisting of age- and sex-matched TBI participants (n = 109) and orthopedic participants (n = 114) were recruited from a regional trauma registry in New Zealand (NZ), and assessed at mean 2.5 years post-injury. Results from the Rasch analysis showed that the RPQ achieved fit to the Rasch model, demonstrating very good reliability (Person Separation Index [PSI] = 0.87), thereby indicating that the measure can be used reliably for individual and group assessment of symptoms among both TBI and orthopedic patients. In this study we demonstrated evidence of a unidimensional construct of PCS symptoms in both groups, which helps alleviate previous uncertainty about factor structure, and permits the calculation of a total RPQ score. Conversion of ordinal to interval total scores presented within are recommended for clinicians and researchers, to improve instrument precision, and to facilitate the interpretation of change scores and use of parametric methods in data analysis.

Validation of the WHOQOL-BREF and Shorter Versions Using Rasch Analysis in Traumatic Brain Injury and Orthopedic Populations.

OBJECTIVE: To use Rasch analysis to validate the World Health Organization Quality of Life-BREF (WHOQOL-BREF) and existing short versions in individuals with traumatic brain injury and orthopedic injuries, with comparisons to a general population group. DESIGN: The Partial Credit Rasch model was applied to evaluate the WHOQOL-BREF as well as shortened versions using a cross-sectional study design. SETTING: Regional hospital, and national electoral sample in New Zealand. PARTICIPANTS: Individuals with traumatic brain injury (n=74), individuals with orthopedic injuries (n=114), general population (n=140). INTERVENTIONS: None. MAIN OUTCOME MEASURE: WHOQOL-BREF. RESULTS: The WHOQOL-BREF met expectations of the unidimensional Rasch model and demonstrated good reliability (person separation index [PSI] =0.82) when domain items were combined into physical-psychological, social, and environmental superitems. Analysis of shorter versions, the EUROHIS-QOL-8 and World Health Organization Quality of Life-5 (WHOQOL-5), indicated overall acceptable fit to the Rasch model and evidence of unidimensionality. The EUROHIS-QOL-8 showed good reliability (PSI=0.81); however, reliability of the WHOQOL-5 (PSI=0.68) was below acceptable standards for group comparisons, in addition to demonstrating poor person-item targeting. CONCLUSIONS: The WHOQOL-BREF and the 8-item EUROHIS-QOL-8 version are both reliable and valid in the assessment of quality of life in both injury and general populations. Ordinal-interval conversion tables published for these validated scales as well as for the WHOQOL-5 can be used to improve precision of assessment. The transformation of ordinal scale scores into an interval measure of health-related quality of life also permits the calculation of a single summary score for the WHOQOL-BREF, which will be useful in a wide range of clinical and research contexts. Further validation work of the WHOQOL-5 is needed to ascertain its psychometric properties.

Determining the feasibility and preliminary efficacy of a stroke instructional and educational DVD in a multinational context: a randomized controlled pilot study.

OBJECTIVE: To assess the feasibility of conducting a randomized controlled trial of an instructional and educational stroke DVD and determine the feasibility and preliminary efficacy of this intervention in a multinational context. DESIGN: Non-funded, pilot randomized controlled trial of intervention versus usual care. SETTING: International, multicentre, community-based. PARTICIPANTS: Community-living adults up to three years post stroke with moderate to severe disability and their nominated informal caregivers. INTERVENTIONS: Intervention patients viewed and practised rehabilitation techniques demonstrated in the DVD over six weeks. MAIN MEASURES: Trial feasibility by number of active recruitment sites, recruitment efficiency, randomization and follow-up. Intervention feasibility by patient and caregiver impressions. Preliminary efficacy by the quality of life - 5-level EuroQol-5D (EQ-5D) health status measure, General Health Questionnaire and Centre for Epidemiological Studies-Depression at two months. RESULTS: In total, 14 recruitment sites were established across eight countries. Recruitment was achieved at nine (64%) sites. Over 16 months, 66 participants were recruited (mean (SD) age = 63.5 (12.47) years) and randomized to intervention ( n = 34) and control ( n = 32) groups. In total, 54 (82%) completed a follow-up assessment. Patient and/or caregiver comments about the benefits and barriers to accessing the intervention were mixed. There were no significant between-group differences in outcomes at two months ( P > 0.05). CONCLUSION: Conducting a multinational trial of a stroke DVD requires full funding. The intervention was acceptable to some patients and their caregivers, yet a generalized education approach did not fully meet their needs and/or expectations. A more individualized method may be required to meet peoples' changing needs during stroke recovery.

A systematic review of the worldwide prevalence of survivors of poliomyelitis reported in 31 studies.

BACKGROUND: Accurate prevalence figures estimating the number of survivors of poliomyelitis (disease causing acute flaccid paralysis) following poliovirus infection are not available. We aim to undertake a systematic review of all literature concerning the prevalence of survivors of poliomyelitis. METHODS: Electronic databases were searched from 1900 up to May 2016 for peer-reviewed studies using a population-based approach witha defined denominator and some form of diagnostic or clinical verification of polio. Exclusion criteria were any prevalence data that were unable to be extracted or calculated and studies reporting on incidence only. The quality of each included study was assessed using an existing tool modified for use in prevalence studies. Average crude prevalence rates were used to calculate worldwide estimates. RESULTS: Thirty-one studies met criteria with 90% of studies conducted in low-income to lower middle-income countries. Significant variability in the prevalence of survivors of poliomyelitis was revealed, in low- income to lower middle-income (15 per 100 000 in Nigeria to 1733 in India) and upper-middle to high-income countries (24 (Japan) to 380 per 100 000 (Brazil). The total combined prevalence of survivors of poliomyelitis for those studies at low to moderate risk of bias ranged from 165 (high-income countries) to 425 (low-income to lower middle-income countries) per 100 000 person-years. Historical lameness surveys of children predominated, with wide variation in case definition and assessment criteria, and limited relevance to current prevalence given the lack of incidence of poliovirus infection in the ensuing years. CONCLUSIONS: These results highlight the need for future epidemiological studies of poliomyelitis to examine nationally representative samples, including all ages and greater focus on high-income countries. Such efforts will improve capacity to provide reliable and more robust worldwide prevalence estimates.