Vocation as tragedy: Love and knowledge in the lives of the Mills, the Webers, and the Russells.

Can love affect knowledge and knowledge affect love? John Stuart Mill and Harriet Taylor-Mill, Max and Marianne Weber, and Bertrand and Dora Russell had a definite vocation: they wanted to change the world. They questioned traditional gender arrangements through publications on equality, marriage, and education. They were liberal thinkers, advocating individual freedom and autonomy, vis à vis the constraints of state and society. Their partnership inspired their work, a living experiment conducted through their own unconventional relationship. Over time, their increasingly radical, avant-garde ideas on marriage complicated the ongoing negotiation over power and intimacy which typified their marriages. Building on the historiography of social science couples, and by means of an analysis of the micro-social dynamics of marriage as documented in the life writings of the Mills, the Webers, and the Russells, I analyse the connections between gender, intimacy, and creativity. These couples' experiences highlight the non-rational dimension of a most rational endeavour.

Do perfectionism, body image concerns, and intimacy predict genitopelvic pain in the postpartum? A prospective study of new mothers.

BACKGROUND: Genitopelvic pain following childbirth is common and likely to challenge the psychological, relational, and sexual well-being of new mothers. While genitopelvic pain generally decreases during the postpartum period, personal and interpersonal characteristics may explain why genitopelvic pain persists beyond the period of physical recovery in some mothers. Body image concerns, increased stress, and relationship challenges would be particularly salient during pregnancy and the postpartum period, which could put new mothers at greater risk of sexual difficulties. Also, mothers may display a negative appraisal regarding genitopelvic pain and doubt their ability to cope with it, which may contribute to the pain. AIM: The current study aimed to examine the role of perfectionism, body image concerns, and perceived intimacy in the occurrence and change in genitopelvic pain in new mothers in postpartum. METHODS: A total of 211 new mothers and their partners were recruited for a larger prospective dyadic study on the transition to parenthood. OUTCOMES: Mothers completed a single item assessing genitopelvic pain, in addition to brief validated questionnaires measuring perfectionism, body image concerns, and perceived couple intimacy during pregnancy and at 4, 8, and 12 months postpartum. RESULTS: Five multilevel modeling analyses revealed that adaptive perfectionism, maladaptive perfectionism, and body image concerns were associated with a higher occurrence of genitopelvic pain from 4 to 12 months postpartum. Mothers' and partners' perceived intimacy was not significantly related to new mothers' genitopelvic pain. None of the predictors modified the trajectory of genitopelvic pain over time. CLINICAL IMPLICATIONS: Raising awareness among health care professionals regarding the role of perfectionism and body image concerns in genitopelvic pain may help them identify new mothers at risk of chronic genitopelvic pain, while offering a new avenue of intervention. STRENGTHS AND LIMITATIONS: There has been little research examining the role of perfectionism, body image concerns, and intimacy in postpartum genitopelvic pain. Based on a longitudinal prospective approach, this study identified perfectionism and body image concerns as significant predictors of postpartum genitopelvic pain. However, prepregnancy genitopelvic pain, genitopelvic pain intensity, and sexual distress were not measured. CONCLUSION: Adaptive and maladaptive perfectionism and body image concerns are associated with new mothers' genitopelvic pain up to 12 months postpartum.

Identifying the Unmet Needs of People Living With Amyotrophic Lateral Sclerosis: A National Survey to Inform Interdisciplinary Palliative Care.

Introduction/Aims: This national survey builds on previous qualitative research examining potential palliative care needs among people living with ALS (pALS) by quantifying and investigating relationships among pALS' stage of illness progression; physical, emotional, social, spiritual, and intimacy-related concerns; advance care planning behaviors; perceptions of feeling heard and understood by healthcare providers; and overall quality of life. Methods: Researchers partnered with national organizations to recruit pALS to participate in a one-time survey comprising items from validated instruments (eg, the ALS Specific Quality of Life Instrument-Revised) and researcher-generated measures. Data were analyzed using logistic and linear regression. Results: Among pALS (n = 112), many respondents indicated they had discussed their wishes for end-of-life care with family or friends, shared their wishes with providers, and documented their wishes in writing (79.5%, 49.1%, and 63.4%, respectively). Mean (M) quality of life scores were moderate (M ≈ 6 of 10). Illness stage was associated with documentation of end-of-life care wishes but not with having discussed these wishes with others or with overall quality of life. Reported emotional intimacy received was comparable to that desired (difference = .01 of 10); however, a greater desire for physical intimacy relative to that received was indicated (difference = 1.75 of 10). Discussion: Interdisciplinary palliative care teams may enhance ALS care by promoting advance care planning behaviors (particularly discussing one's wishes with healthcare providers), providing interventions to improve quality of life, and supporting pALS in navigating challenges related to physical intimacy.

Differences in proximal and intimacy-related defense mechanisms among patients with cancer in different psychological stages of dying.

Purpose: This study measured three of the psychological stages of dying in patients with cancer and explored the differences in proximal and intimacy-related defense mechanisms at each stage. Patients and methods: A total of 220 cancer patients were recruited for this study; 168 patients met the inclusion criteria and were included in the data analysis. The participants were divided into three groups using the "Death Attitudes Questionnaire Revised" (1994) and then completed the Death-Thought Accessibility Test, Self-Control Questionnaire, Rumination Reflection Questionnaire, Attachment Type Test, Intimacy Test, External Control Test, and Positive and Negative Affect Scale. Results: In the death avoidance stage, which represents a defense stage without cognitive processes, patients are in an irrational state with the highest level of self-control and the lowest level of external control; they tend to prefer close relationships with many people while experiencing high levels of fear and depression. In the bargaining stage, which represents a biased cognitive defense stage, the level of rationality increases, the level of fear and depression decreases, and patients tend to prefer relationships with many people that do not involve intimacy. In the neutral death acceptance stage, which represents a defense stage without cognitive bias, self-control is lowest, external control is highest, patients tend to prefer intimate relationships with a few people, and experience the lowest levels of fear and depression. Conclusion: Three psychological stages of death exist in cancer patients, with differences in proximal and intimacy-related defense mechanisms in each stage. The findings have theoretical and practical implications for psychological interventions for cancer patients.

Psychoanalytic Contributions to Psychodynamic Psychiatry and Psychotherapy: Erik Erikson's Psychosocial Developmental Theory.

Erik Erikson gives us a comprehensive psychosocial schema encompassing the life cycle from birth to death. In elucidating key issues at each life stage-the epigenetic crises-he defines important parameters of development that distinguish between the normative and the pathologic. Individuals at any developmental stage can be evaluated with respect to these fundamental milestones.

Influences of communication ability, organizational intimacy, and trust among colleagues on job satisfaction of nurses in comprehensive nursing care service units.

Background: Communication abilities, organizational intimacy, trust among colleagues, and job satisfaction of nurses in comprehensive nursing care service units are emphasized more than any other ward, and research on this is necessary. Objective: The study was to examine the influences of communication ability, organizational intimacy, and trust among colleagues on the job satisfaction of nurses in the comprehensive nursing care service units. Methods: This study used a cross-sectional descriptive design. The participants were 155 nurses caring for patients in the comprehensive nursing care service units in Seoul. Measures included the general characteristics of study participants, communication ability, organizational intimacy, trust among colleagues, and job satisfaction. The data were analyzed using the SPSS/WIN version 27.0 program. The data collection period was from August to September 2022. Results: Factors influencing the job satisfaction of nurses at the comprehensive nursing care service units were organizational intimacy (ß = 0.36), communication abilities (ß = 0.26), trust among colleagues (ß = 0.22), and the average number of patients assigned to a nurse (ß = -0.19), which explained 67% of the variance. Conclusions: Organizational intimacy was the greatest factor influencing the job satisfaction of nurses in the comprehensive nursing care service units. To increase the job satisfaction of ward nurses working in the comprehensive nursing care service, securing manpower is required, and it is necessary to provide effective nursing care with an average number of patients of 5 or less. In particular, a systematic job training program is needed to increase organizational intimacy among team nurses.

Sexuality, intimacy, and body image among adolescents and young adults with cancer: a qualitative, explorative study.

AIM: The aim of this study was threefold: (1) to explore Danish adolescents and young adults' (AYAs) thoughts concerning sexual health particularly focusing on sexuality, intimacy, and body image throughout a cancer trajectory, (2) to investigate how AYAs experience healthcare professionals address of- and respond to sexual health issues, and (3) to identify AYAs' suggestions on how to support conversation about sexual health. METHODS: A qualitative, single-center study was conducted, including AYAs (18-29 years) diagnosed with cancer recruited at the University Hospital of Copenhagen, Rigshospitalet. Individual semi-structured interviews were conducted from January-February 2023, recorded, transcribed verbatim, and analyzed using thematic analysis. RESULTS: Twelve participants were interviewed, aged 20-29; five were diagnosed with hematological- and seven with oncological cancer. Our analyses yielded three themes: (1) sexuality and body image as part of the identity, (2) excluding relatives in conversations about sexual health, and (3) uncertainty how to discuss sexual health with healthcare professionals. Finally, the AYAs' suggestions to support conversations about sexual health were organized into six thematic categories. CONCLUSION: In this study, participants experienced altered sexual subsequent impacts on body image and self-esteem during their cancer trajectory. While some adapted to these changes, discussing them with healthcare providers was difficult, especially in the presence of relatives, as the AYAs wanted to shield them from additional concerns. To enhance support, AYAs suggest regular discussions on sexual health and the use of a dialog tool by healthcare professionals.

The association between family cohesion and depression: A systematic review and meta-analysis.

BACKGROUND: Many studies have analyzed the association between family cohesion and depression, but there are different views and the results are inconsistent. It is necessary to use meta-analysis to explore the association between family cohesion and depression and its influencing factors. METHODS: Chinese database (China National Knowledge Infrastructure) and English databases (ERIC, MEDLINE, Web of Science Core Collection, Elsevier SD, PsycINFO, PsycArticles, and ProQuest dissertations and theses) were searched for articles published by November 2023. Measurements of family cohesion and depression, study design, age, gender, cultural background, and sampling year were analyzed as moderators. Meta-analysis was performed using the random effects model in CMA3.0 software. RESULTS: A total of 71 studies (90,023 participants) were included in this study. The meta-analysis revealed a significant negative correlation between family cohesion and depression (r = -0.31, 95 % CI [-0.35, -0.27]). The association was moderated by measurements of family cohesion and depression, design type, and cultural background, but not by age, gender, or sampling year. LIMITATIONS: The sample size included in this study is relatively small in European and African cultures, making it challenging to analyze cultural differences in the study results at present comprehensively. CONCLUSIONS: The findings contribute to the ongoing debate between Social Support Theory and The Circumplex Model, showing that individuals with lower family cohesion tend to experience higher levels of depression.

The effectiveness of couple-based interventions on the marital outcomes of women with genital and breast cancer and their partners: a systematic review and meta-analysis.

BACKGROUND: Breast cancer and genital cancer are known as cancers that affect people's relationships with their partners. Women with such cancers are emotionally vulnerable and need more support from their partners. The present systematic review and meta-analysis evaluated the effectiveness of couple-based interventions on the marital outcomes of patients with these cancers and their intimate partners. METHODS: To perform this systematic review, Google Scholar and databases such as PubMed, Web of Science, Cochrane, Scopus, SID (Scientific Information Database), and Magiran were searched systematically. The reviewed studies included randomized controlled trials and quasiexperimental studies in which the intervention group, couple-based interventions, and the control group received routine care, general education or no intervention for cancer treatment. In this study, the included participants were patients with breast cancer or genital cancer and their intimate partners. The primary outcomes considered in this study included patients' marital adjustment, patients' marital satisfaction, patients' marital intimacy, and patients' marital relationships. The secondary outcomes were partners' marital adjustment, partners' marital satisfaction, partners' marital intimacy, and partners' marital relationships. A meta-analysis was performed with Review Manager v. 5.3 software (The Nordic Cochrane Centre, Cochrane Collaboration, 2014; Copenhagen, Denmark). The intervention impacts on continuous outcomes were measured using standardized mean differences (SMDs) with 95% confidence interval because of the use of various scales to evaluate the outcomes. The quality of evidence presented in the included studies was evaluated using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. In the subgroup analysis, the studied outcomes were divided into two parts (theory-based and non-theory-based) in terms of the theoretical context of couple-based interventions. RESULTS: From a total of 138 retrieved studies, 14 trials were eligible for inclusion in the study. The results of the meta-analysis showed that the patient's marital satisfaction increased significantly with couple-based interventions (SMD 0.46, 95% confidence interval 0.07 to 0.85; 7 trials, 341 patients, very low certainty) compared to the control group, but the evidence was uncertain. However, there were no significant differences between the groups in the partner's marital satisfaction, the patient's and partner's marital adjustment, and the patient's and partner's marital intimacy. Additionally, the results of the subgroup analysis showed that the couple-based interventions significantly increased the patient's marital adjustment (SMD 1.96, 95% CI 0.87 to 3.06; 4 trials, 355 patients, very low certainty), the partner's marital adjustment (SMD 0.53, 95% CI 0.20 to 0.86; 4 trials, 347 partners, very low certainty), the patient's marital satisfaction (SMD 0.89, 95% CI 0.35 to 1.43; 2 trials, 123 patients, very low certainty), and the partner's marital satisfaction (SMD 0.57, 95% CI 0.20 to 0.94; 2 trials, 123 partners, very low certainty) compared to the control group in theory-based studies. In. However, in non-theory-based studies, the results of the meta-analysis revealed no significant differences between the intervention and control groups. CONCLUSIONS: The results of this study demonstrated the impact of couple-based interventions on the marital outcomes of patients with breast and genital cancers. Because of the very low confidence in the evidence, high-quality randomized trials with a sufficient sample size should be conducted considering the proper theoretical context.

The Influence of Mindful Parenting on Children's Creative Tendencies: The Chain Mediating Effect of Parent-Child Intimacy and Connectedness to Nature.

(1) Objectives: The aim of this study was to examine the relationship between mindful parenting and children's creative tendencies and to investigate the mediating role of parent-child intimacy and connectedness to nature in the relationship between mindful parenting and children's creative tendencies. (2) Methods: In this cross-sectional study, nearly 800 mothers of children aged 3-6 were enrolled. General sociodemographic data, the Mindfulness in Parenting Questionnaire (MIPQ), the Creativity Assessment Packet (CAP), the Child-Parent Relationship Scale-Short Form (CPRS-SF), and the Connectedness to Nature Index-Parents of Preschool Children (CNI-PPC) were all included in the questionnaire survey. (3) Results: There were significant positive correlations among mindful parenting, parent-child intimacy, connectedness to nature, and children's creative tendencies. Mindful parenting had a positive predictive effect on children's creative tendencies. Parent-child intimacy played a mediating role between mindful parenting and children's creative tendencies. Connectedness to nature played a mediating role between mindful parenting and children's creative tendencies. The correlation between mindful parenting and children's creative tendencies may be impacted by the chain mediation effects of parent-child intimacy and connectedness to nature. (4) Conclusions: By promoting parent-child intimacy and connectedness to nature, and by utilizing the chain mediating effects of both, mindful parenting positively impacted children's creative tendencies.

"Comforting, Reassuring, and Hot": A Qualitative Exploration of Engaging in Bondage, Discipline, Domination, Submission, Sadism and (Sado)masochism and Kink from the Perspective of Autistic Adults.

Background: There is a lack of research on autistic intimacy; however, a small body of research suggests that bondage, discipline, domination, submission, sadism and (sado)masochism (BDSM)/kink may be appealing to autistic people. We aimed at exploring how engagement in BDSM/kink related to autistic identity, using a phenomenological approach. Methods: We recruited six autistic adults through purposive sampling on social media. All participants took part in a one-to-one spoken interview about their engagement in BDSM/kink and how it related to their sense of identity. Results: We used interpretative phenomenological analysis to analyze the data and found three key themes. Theme 1, "Practicing safe 'sex'" highlighted how the clear communication and explicit focus on consent present in BDSM/kink facilitated a feeling of safety. Theme 2, "So many ways to touch and be touched" was focused on the sensory draw of BDSM/kink, and how it provided exciting ways to explore sensory joy (and sometimes revulsion). Theme 3, "Subverting (neuro)normativity" showed how autistic people can find pleasure in intimate practices that transgress normative expectations. Conclusion: Our findings highlighted the importance of exploring the perceptions of autistic adults in relation to their own intimate practices. Autistic intimacy is an emerging area of research, with very little focus on lived experience. Although engagement in BDSM/kink may appear niche, our findings suggest that there are aspects which are inherently appealing to autistic people. These findings can be used to destigmatize both autistic intimacy and engagement in alternative intimate practices more broadly.

Why is this an important issue?: Autistic intimacy is an under-explored area, with very little focus on the lived experiences of autistic adults and their preferences. Bondage, discipline, domination, submission, sadism and (sado)masochism (BDSM) and kink are alternative intimate practices. There are aspects of BDSM/kink that may appeal to autistic people (e.g., sensory experiences such being restrained during intimacy). However, to date, there is very little research to explore this. What was the purpose of this study?: This study aimed at exploring the experiences and motivations of autistic people who engage in BDSM/kink from their own perspectives. What did the researchers do?: We conducted online video interviews with six autistic adults. We purposefully recruited a small number of people, choosing to use a method called "interpretative phenomenological analysis" that emphasizes deep explorations of the experiences of a small number of people. This method is particularly suitable for areas where very little research exists. What were the results of the study?: We found three key themes: Theme 1, "Practicing safe 'sex'" highlighted how the clear communication and explicit focus on consent present in BDSM/kink facilitated a feeling of safety for our participants, who found uncertainty during intimacy stressful. The sense of safety fostered within these interactions also provided the participants with a space to be their authentic selves, and "switch off" from the outside world. Theme 2, "So many ways to touch and be touched" was focused on the sensory lure of BDSM/kink, and how it provided exciting ways to explore sensory joy (and sometimes revulsion) for autistic people. Theme 3, "Subverting (neuro)normativity" showed how autistic people can find pleasure in intimate practices that other people might find unusual. What do these findings add to what was already known?: To our knowledge, this is the first study to explore autistic engagement in BDSM/kink from a first-person perspective. Our findings show that some alternative ways of being intimate might attract autistic people, because they provide stability, pathways for sensory exploration, or because they are fun in ways that other people sometimes find unexpected. What are potential weaknesses in the study?: We only interviewed a small number of people, and most of them shared similar interests within BDSM/kink. In future, it would be good to find out about the interests of a larger number of autistic people. How will these findings help autistic adults now or in the future?: There is very little research exploring autistic intimacy from a validating perspective. Our findings will help to destigmatize autistic intimacy and normalize conversations about things that people might think of as "taboo.".

"Not Now, I Am Too Stressed": Stress and Physical Intimacy in Early Marriage.

Stressful events can disrupt couples' emotional connection, yet prior research is mixed regarding whether stress also disrupts couples' physical intimacy. This study considered whether stress must reach a critical threshold before hindering couples' sexual activity and physical affection (i.e., a curvilinear association). Couples (N = 144 couples plus four additional wives) completed two 14-day daily diary tasks during the early years of marriage. Multilevel modeling revealed a within-person curvilinear association between daily stress and sexual activity. Contrary to expectations, the likelihood of sexual activity declined as stress increased from low to moderate, then leveled off as stress continued to increase. For physical affection, a linear effect emerged. On days of greater stress, women, but not men, reported less affection. Further analyses suggested that women's stress is more influential than men's stress for couple's physical intimacy. Findings highlight the nuanced ways in which stress is linked to a vital component of satisfying relationships.

Family intimacy and adaptability and non-suicidal self-injury: a mediation analysis.

BACKGROUND: Current research has been focusing on non-suicidal self-injury (NSSI) behaviors among adolescents with depression. Although family intimacy and adaptability are considered protective factors for NSSI, evidence supporting this relationship is lacking. OBJECTIVE: This study aims to examine the mechanisms operating in the relationship between family intimacy and adaptability and NSSI behaviors among adolescents. METHODS: A self-administered general demographic information questionnaire, the Behavioral Functional Assessment Scale for Non-Suicidal Self-Injury, the Family Intimacy and Adaptability Scale, the Connor-Davidson Resilience Scale, and the Self-Assessment of Depression Scale were distributed among adolescents with depression in three tertiary hospitals in Jiangsu Province. RESULTS: The relationship between family intimacy and adaptability and NSSI was assessed among 596 adolescents with depression. The results revealed the following: (1) Family intimacy and adaptability were negatively correlated with NSSI behavior. (2) Psychological resilience and depression levels acted as chain mediators in the relationship between family intimacy and adaptability and NSSI behavior. CONCLUSIONS: Enhancing psychological resilience, controlling depressive symptoms, and reducing depression severity among adolescents by improving their family intimacy and adaptability are conducive to preventing and mitigating their NSSI behaviors.

Cross-cultural adaptation of the Scale of Perception of Respect for and Maintenance of the Dignity of the Inpatient (CuPDPH) to Brazilian Portuguese and its psychometric properties-A multicenter cross-sectional study.

OBJECTIVE: To adapt the Scale of Perception of Respect for and Maintenance of the Dignity of the Inpatient (CuPDPH) to the Brazilian language and culture and to assess its psychometric properties. RESULTS: The scale was evaluated by 15 experts, and 239 patients from three tertiary hospitals in Rio de Janeiro. All participants signed a consent form. Data have shown adequacy of the model (KMO=0.839, Bartlett's test of sphericity: χ2(171) = 2241.3, p = 0.000010), good adjusted content validity (CVCa ≥ 0.90), internal consistency and reliability, such as α = 0.927. DISCUSSION: CuPDPH is a rating scale on observable professional attitudes. Illnesses change lives and impose adaptation to a new situation, perceived as depersonalization, leading patients to try to regain control of their lives. Patients expressed "ill will" to fill out the scale. Psychiatric patients' scale filling time was higher than others. A sample from three Rio de Janeiro third-level hospitals may not reflect the country's population; also, this adaptation may not comprise all linguistic variations of Brazilian Portuguese and Portuguese-speaking countries. CONCLUSION: The Portuguese version of the Scale of Perception of Respect for and Maintenance of the Dignity of the Inpatient (CuPDPH), a 19-item, six-component version is a reliable instrument to measure the perception of internal medicine, surgical, and psychiatric patients on the maintenance of their dignity in Rio de Janeiro, Brazil. This knowledge could be used in advancing research on patients' perception of dignity, as well as professional ethical competencies, staff-patient relationship skills, and leadership development in medical and other healthcare professional education.

The absence of one's intimate partner promotes dyadic competition through enhanced interbrain synchronization between opponents.

Competition is a common occurrence in life, but the influence of intimate relationships on people's competitiveness remains unknown. Grounded in Darwin's theory of sexual selection, this study utilized EEG hyperscanning technology to investigate the influence of the presence of romantic partners and the gender of competitors on the interbrain synchronization of female individuals during competitive contexts. The research results showed that in competitive interactions, there was a significant increase in Theta and Alpha frequency band activity between females and their competitors. Interbrain synchronization was strongest when their partners were not nearby and females competed with same gender competitors. The research results indicate that intimate companionship has an impact on the early alertness and late cognitive execution mechanisms of female individuals in competition, and due to intimate relationships, females pay more attention to same-gender competitors. This study demonstrates that the presence of intimate partners can affect a female's competitive state and brain synchronization with opponents of different genders, improving the theoretical explanation of intimate relationships and competitive interactions.

The Impact of Inflammatory Bowel Disease on Intimacy: A Multimethod Examination of Patients' Sexual Lives and Associated Healthcare Experiences.

BACKGROUND: Inflammatory bowel disease (IBD) can negatively impact sexual well-being, and some patients desire healthcare for these issues. Research capturing the lived experiences of patients in these areas is lacking. The present study investigated the sexual well-being impacts of IBD (objective 1) and patients' experiences accessing support for these concerns in the healthcare system (objective 2) through multimethod analyses. METHODS: A total of 480 adults with IBD were recruited for an online survey study. Reflexive thematic analysis was used to analyze responses to 2 open-ended questions (ie, qualitative data; question 1, n = 326, question 2, n = 309). Frequency analyses and contingency tables were used to analyze quantitative data (n = 436). RESULTS: Thematic analysis (objective 1) generated 8 themes highlighting the negative impacts of IBD on patients' sexual/intimate lives (eg, sexual activity, intimate relationships) and the influence of broader psychosocial experiences (eg, self-perception, mental health) on patients' sexual well-being. Quantitative analyses (objective 2) indicated that 39.2% of participants wanted sexual health information from a healthcare provider, but only 5.7% of our sample reported both wanting and receiving this information. Thematic analysis generated 5 themes highlighting the lack of support and information available for sexuality concerns in IBD healthcare and detailed patients' perceived barriers to obtaining support in this area. CONCLUSIONS: IBD has myriad impacts on patients' sexual lives. However, patients who want healthcare in this area rarely receive satisfactory support.

"I too have a responsibility for my partner's life": Communal coping among Malawian couples living with HIV and cardiometabolic disorders.

RATIONALE: HIV and cardiometabolic disorders including hypertension and diabetes pose a serious double threat in Malawi. Supportive couple relationships may be an important resource for managing these conditions. According to the theory of communal coping, couples will more effectively manage illness if they view the illness as "our problem" (shared illness appraisal) and are united in shared behavioral efforts. METHODS: This study qualitatively investigated communal coping of 25 couples living with HIV and hypertension or diabetes in Zomba, Malawi. Partners were interviewed separately regarding relationship quality, shared illness appraisal, communal coping, and dyadic management of illness. RESULTS: Most participants (80%) were living with HIV, and more than half were also living with hypertension. Most participants expressed high levels of unity and the view that illness was "our problem." In some couples, partners expected but did not extend help and support and reported little collaboration. Communal coping and dyadic management were strongly gendered. Some women reported a one-sided support relationship in which they gave but did not receive support. Women were also more likely to initiate support interactions and offered more varied support than men. In couples with poor relationship quality and weak communal coping, dyadic management of illness was also weak. Partner support was particularly crucial for dietary changes, as women typically prepared meals for the entire family. Other lifestyle changes that could be supported or hindered by a partner included exercise, stress reduction, and medication adherence. CONCLUSION: We conclude that gendered power imbalances may influence the extent to which couple-level ideals translate into actual communal coping and health behaviors. Given that spouses and families of patients are also at risk due to shared environments, we call for a shift from an illness management paradigm to a paradigm of optimizing health for spouses and families regardless of diabetes or hypertension diagnosis.

Feasibility and effectiveness of communication tools for addressing intimacy and sexuality in patients with cancer: a systematic review.

PURPOSE: Patients diagnosed with cancer might experience changes in intimacy and sexuality due to the illness itself, treatment, or psychological and social factors. Healthcare professionals (HCPs) often feel reluctant to discuss these changes. This study aimed to provide an overview of the feasibility and effectiveness of communication tools that support communication regarding changes in intimacy or sexuality among patients with cancer. METHODS: This is a systematic review. Databases are PubMed, Embase, CINAHL, PsycInfo, Web of Science and Cochrane Library from inception to June 2023. The Mixed Methods Appraisal Tool was used to assess included studies. Data were summarized in data charting forms. RESULTS: In total 35 studies were included, published between 2001 and 2023. Most had a quantitative design and moderate methodological quality. In 11 studies, the PLISSIT model (Permission, Limited Information, Specific Suggestions, Intensive Therapy) was used. Tools were integrated in counselling sessions or training programmes for individual patients, couples, groups of patients, or HCPs. All tools were considered feasible by patients or HCPs. Twenty studies reported significant improvement in sexual functioning, quality of life, quality of care or combined outcomes. CONCLUSION: Tools to support communication about changes in intimacy and sexuality among patients with cancer seem feasible and effective. The most commonly used tool, the PLISSIT model, proved to be feasible for HCPs and to have a positive effect on patients' and partners' sexual functioning and quality of life. Giving attention to changes in intimacy and sexuality seems to be important in itself, regardless of the communication tool or approach used.

Attachment as an intermediary variable between childhood maltreatment and perceived partner responsiveness in adolescents and young adults.

Cumulative childhood maltreatment (CCM) is associated with relationship difficulties including lower perceived partner responsiveness (PPR)-the degree of feeling cared for, understood, and validated by a person's partner. Attachment theory is understood via its representations of self and others and could offer a better understanding of how CCM effects continue into adulthood and affect PPR. We examined whether CCM is related to PPR via attachment in French-speaking adolescents and young adults. A sample of 427 individuals in a romantic relationship and another sample of 159 couples completed self-report measures. In both samples, a person's CCM was associated with their own lower PPR via their higher attachment anxiety and avoidance. In the dyadic sample, a person's CCM was associated with their partner's lower PPR via their own higher attachment anxiety. Attachment insecurities help understand the associations between CCM and PPR and may represent an important intervention target.

Gender and Sexuality Disparities in Perception, Attitude and Social Intimacy Among Sinophone Youth Toward Transgender and Gender Non-Conforming Individuals: Based on an Internet Survey.

The study aims at assessing gender and sexuality characteristics (GSC) in perception, attitude, and social intimacy among Sinophone youth toward transgender and gender non-conforming (TGNC) people. Based on an internet survey with 3 825 valid questionnaires, we distinguished the general public into TGNC, cisgender heterosexual, and cisgender non-heterosexual individuals. Then we classified TGNC individuals into trans females, trans males, and non-binary/genderqueer people and cisgender individuals into cisgender females and cisgender males. The chi-square test, one-way analysis of variance (ANOVA), and multiple linear regression were used. We found that the evident gender and sexuality disparities in perception, attitude, and social intimacy toward TGNC individuals exist both in and out of TGNC individuals. Negative perceptions and attitudes as well as alienated social intimacy were most pronounced among cisgender heterosexual people (Chi-square test, one-way ANOVA, and multiple linear regression: all p < .001). Cisgender females exhibit higher levels of supportiveness compared to cisgender males. Trans females were the most positive while they also had more concerns regarding public space and gender expression-related issues. The findings are practical for community-based advocacy for raising public awareness of the presences and experiences of TGNC people in Sinophone societies.