Sexual experience in patients with coronary heart disease: a descriptive phenomenological study.

Sex is an essential part of life and is a basic demand for human beings. Coronary heart disease can have an impact on patients' sexual lives; however, not much attention has been paid to it in China, and few studies have been conducted on this topic. Therefore, this study used a qualitative approach to understand the sexual experience of patients after the illness, thus laying the foundation for the development of relevant measures. Semi-structured interviews were conducted with 14 patients. Descriptive phenomenological methods were employed to collect data and explore the sexual experience of patients with coronary heart disease. A total of 4 thematic groups, 9 themes, and 23 subthemes were extracted. The four thematic groups were independent and cross-influenced. In these groups, alterations in the sexual experience, including the change in sexual physiology and psychological state, were affected by the lack of knowledge, age, disease, and other factors. Furthermore, the patient's perception of sexuality affected the quality of sexual life after the illness. The sexual experience of patients with coronary heart disease and its influencing factors, such as age, disease factors, and lack of related knowledge, were described. The findings are expected to aid in formulating targeted and personalized intervention measures.

Anxiety, depression, urinary continence, and sexuality in patients undergoing radical prostatectomy: preliminary findings.

OBJECTIVES: Evaluate the relationship between psychological distress, namely anxiety and depression, with urinary continence and recovery of erectile function in patients undergoing radical prostatectomy (RP). METHODS: We retrospectively analyzed data from 33 consecutive patients who underwent RP in a single tertiary-referral academy between 01/2018 to 01/2019. We used the International Index of Erectile Function (IIEF-15), the Sexual Complaints Screener for Men (SCS-M), and the Hospital Anxiety and Depression Scale (HADS), validated questionnaires for the assessment of sexual function, anxiety, and depression experiences, respectively. These questionnaires were administered at the pre-surgical visit, after surgery, and at intermediate follow-ups (three, six, and twelve months). RESULTS: The analysis of the questionnaires completed during follow-up shows that erectile function is the most affected, with 90% erectile dysfunction (ED) at three months after surgery. In terms of emotional states, anxiety prevails in the first months following surgery and is statistically significantly associated with incontinence (p = 0.02). Depressive symptoms, on the other hand, appear later and prevail over anxiety at six months after surgery, although not statistically significant. CONCLUSIONS: In the early post-surgical phase anxiety and ED are the most frequently detected components, while depressive experiences and decreased desire, typical of later stages, have not yet fully emerged.

[Sexuality among the elderly: understanding the weight of stereotypes]. / Sexualité chez les personnes âgées : comprendre le poids des stéréotypes.

Sexuality is an integral part of health and accompanies human beings throughout their lives. It contributes to well-being and improves quality of life. The social representations conveyed by Western society modulate sexuality and can play a decisive role in the expression of seniors' sexuality.

Exploring the multi-level impacts of a youth-led comprehensive sexuality education model in Madagascar using Human-centered Design methods.

Comprehensive sexuality education (CSE) is recognized as a critical tool for addressing sexuality and reproductive health challenges among adolescents. However, little is known about the broader impacts of CSE on populations beyond adolescents, such as schools, families, and communities. This study explores multi-level impacts of an innovative CSE program in Madagascar, which employs young adult CSE educators to teach a three-year curriculum in government middle schools across the country. The two-phased study embraced a participatory approach and qualitative Human-centered Design (HCD) methods. In phase 1, 90 school principals and administrators representing 45 schools participated in HCD workshops, which were held in six regional cities. Phase 2 took place one year later, which included 50 principals from partner schools, and focused on expanding and validating findings from phase 1. From the perspective of school principals and administrators, the results indicate several areas in which CSE programming is having spill-over effects, beyond direct adolescent student sexuality knowledge and behaviors. In the case of this youth-led model in Madagascar, the program has impacted the lives of students (e.g., increased academic motivation and confidence), their parents (e.g., strengthened family relationships and increased parental involvement in schools), their schools (e.g., increased perceived value of schools and teacher effectiveness), their communities (e.g., increased community connections), and impacted broader structural issues (e.g., improved equity and access to resources such as menstrual pads). While not all impacts of the CSE program were perceived as positive, the findings uncovered opportunities for targeting investments and refining CSE programming to maximize positive impacts at family, school, and community levels.

Literature review on sexuality in the elderly: What is being taught and with what technologies. / Revisión de literatura sobre sexualidad en las personas mayores: qué se educa y con qué tecnologías.

Chile is facing an increasingly aging population and, with it, changes in its demographic, epidemiological, and healthcare structure. As a result, the sexual health of the elderly is an emerging area at the social level and in healthcare systems. This research aims to identify general aspects of sexuality in the elderly and learn about educational content delivered to this group using digital technologies. To do this, we proposed a review of scientific literature on the subject between January 1st, 2018, and December 31st, 2022, in the databases Web of Science, MEDLINE/PubMed, LILACS, Cochrane, Scopus, and Google Scholar. The articles found, and the emerging information was analyzed. A total of 1573 articles were found, of which 21 papers were finally included, 11 with qualitative methodology, six quantitative, and four mixed. In addition, nine addressed the area of sexuality, and 12 focused on technological innovations for the elderly. Sexuality is a growing topic worldwide, carrying with it sociocultural beliefs associated with dogmatic opinions and myths, with discrimination against this age group, especially if they belong to sexual minorities. This group also has better access to new digital technologies that facilitate access to training, social integration, and timely healthcare. Scientific evidence shows that the sexuality of the elderly is a topic of global interest, invisibilized, with low education and training of healthcare workers. The latter are neither informed nor able to solve the reasons for consultation in the traditional way or with new digital health technologies.

Chile es un país que enfrenta un envejecimiento poblacional acelerado, y con ello cambios en la estructura demográfica, epidemiológica y asistencial, donde la salud sexual de las personas mayores es un área emergente a nivel social y en los sistemas de salud. Esta investigación tiene por objetivos identificar aspectos generales de la sexualidad en las personas mayores, y conocer contenidos educativos entregados a este grupo con tecnologías digitales. Para ello, se propuso una revisión de literatura científica que buscó investigaciones en la materia entre el 1 de enero de 2018 y el 31 diciembre de 2022, en las bases de datos, A partir de ello se analizaron los artículos encontrados y la información emergente. Se encontraron 1573 artículos de los cuales se incluyeron 21 trabajos, 11 con metodología cualitativa, 6 cuantitativa y 4 mixta. Además, 9 trataron el área de sexualidad y 12 respecto de innovaciones tecnológicas en personas mayores. Se aprecia que la sexualidad es un tema creciente a nivel mundial, que arrastra idearios socioculturales asociados a visiones dogmáticas y a mitos, con discriminación hacia este grupo de edad, sobre todo si pertenecen a minorías sexuales. También se observa en este grupo de interés un mejor acceso a nuevas tecnologías digitales para acceder a capacitación, integración social y atención oportuna en salud. La evidencia científica demuestra que la sexualidad de las personas mayores es un tema de interés mundial, invisibilizado, con baja formación y capacitación del personal sanitario. Este personal no educa ni resuelve estos motivos de consulta en forma tradicional o con nuevas tecnologías digitales en salud.

Co-designing for behavioural change: understanding barriers and enablers to addressing sexuality after traumatic brain injury and mapping intervention strategies in a multi-disciplinary rehabilitation unit.

Background Persistent changes in sexuality often follow traumatic brain injury (TBI). However, health professionals remain reticent about discussing sexuality and have reported barriers including uncertainties around whose role it is and limited educational and institutional support. This study employed a co-design and implementation process, aiming to promote team-wide behavioural change, whereby health professionals at a TBI rehabilitation unit would attempt to address sexuality with patients routinely. Methods Focus group sessions with multidisciplinary health professionals were conducted to identify barriers and enablers to behavioural change, identify areas for development, and co-design intervention options. Implementation deliverables were then finalised and provided to the team. The Theoretical Domains Framework was used to map factors influencing behaviours and the Behaviour Change Wheel was used to map interventions. Thematic analysis was used to further analyse barrier themes. Results Thirty-five barriers and eight enablers falling within 12 theoretical domains to behavioural change were identified. Thematic analysis revealed highly correlated barriers in initiating and sustaining change. Nine co-designed intervention options aligned with five intervention functions of the Behaviour Change Wheel, resulting in six final implementation deliverables. Conclusions Barriers were highly interrelated, influencing the approach to implementation deliverables. Simultaneously addressing multiple barriers could potentially alleviate discomfort associated with discussing sexuality. Concerns around initiating change were related to confidence in achieving sustainable changes. Achieving change requires organisational and team-level environmental restructuring and enablement. The next step involves evaluating the effectiveness of the co-design and implementation process in driving behavioural change and potential impacts on patient satisfaction and sexuality outcomes.

Love (and) ageing well: A qualitative study of sexual health in the context of ageing well among women aged 50 and over.

BACKGROUND: The United Nations has declared 2021-2030 the 'Decade of Healthy Ageing' and identified the need to strengthen the evidence base on interpretations and determinants of healthy ageing to inform policy. OBJECTIVES: This study sought to interrogate a 'policy blind spot' and examine interpretations and experiences of sexuality and sexual health within the context of ageing well among women aged 50+. DESIGN: The qualitative study design was underpinned by an interpretivist epistemology. Research was guided by principles of feminist scholarship and located in an affirmative ageing framework. METHODS: Semi-structured individual interviews were conducted between April-June 2019 with 21 English-speaking women aged 52-76. Women were recruited through community organizations in North West England. Transcripts were analysed using a framework approach to thematic analysis, applying an inductive approach to theme generation. RESULTS: Narratives encompassed six broad themes: reflections on 'ageing well'; age alone does not define sexuality and sexual health; interpretations of sexual health and sexuality; vulnerability and resistance in later-life sexual health; narratives of (in)visibility; and reimagining services to promote sexual health in later life. There was a dominant belief that sexual health represents a component of ageing well, despite a broad spectrum of sexual expression and health challenges. Sexual expression was diversely shaped by conflicting societal expectations within an evolving digitized environment. In clinical settings, however, sexual health discussions were often muted or framed from a disease-focussed lens. Women expressed a preference for holistic, person-centred sexual health provision from an orientation of wellness to support varied sexual expression, sensitive to wider health, life and relationship realities. CONCLUSION: This work strengthens calls to disentangle sexual health from disease-centred narratives and legitimize sexual health as part of the healthy ageing agenda.

Testicular Cancer Treatments and Sexuality: A Narrative Review.

The incidence of testicular cancer (TC) has been rapidly increasing over the past years. Diagnosis and early treatment have shown good oncological control, guaranteeing the patient different treatment approaches according to histology and tumor stage. Currently, physicians usually prioritize oncological outcomes over sexual outcomes and quality of life, considering as a first aim the overall survival of the patients; however, differently from other neoplasms, quality of life is still strongly affected among TC patients, and sexual outcomes are frequently compromised after each TC treatment. Several studies have suggested that each treatment approach may be associated with sexual dysfunctions, including erectile dysfunction, ejaculatory disorders, fertility issues, and hormonal changes. Since testicular cancer patients are more frequently young men, the subject of this work is substantial and should be analyzed in detail to help specialists in the management of this disease. The aim of the current narrative review is to generally describe every treatment for TC, including surgery, chemotherapy, radiotherapy, and retroperitoneal lymph node dissection, and to establish which sexual dysfunction may be specifically associated with each therapy.

Trastorno eréctil ¿Qué factores pueden afectar a su gravedad? Un estudio descriptivo-correlacional / Erectile dysfunction: what factors affect its severity? A descriptive correlate story

Una de las disfunciones sexuales más comunes es el trastorno eréctil (TE). Pretendemos identificar factores asociados a la gravedad del TE. Treinta y seis hombres, entre 18 y 70 años, que presentan un diagnóstico de TE, basado en los criterios DSM-V, han sido evaluados a través de una entrevista clínica y de una batería de 7 cuestionarios (IIEF, SCL-90, PDQ-4, PSWQ, STAI, SSES, SSEI). La metodología se centró en un estudio cuantitativo, de tipo descriptivo-correlacional de diseño ex post facto con muestreo por conveniencia. Los resultados del modelo de regresión final muestran que la autoeficacia sexual, determinadas tendencias de personalidad y la sintomatología de depresión, somatización, obsesión-compulsión y ansiedad son factores asociados a la gravedad del TE, explicando el 51,3% de la varianza. Poder identificar aquellos factores asociados a la gravedad del TE, puede tener una relevante importancia para poder trabajar en su prevención y mejorar la orientación de las intervenciones psicológicas.(AU)

One of the most common sexual dysfunctions is erectile disorder (ED). Therefore, this research aims to identify factors associated with the severity of ED. Thirty-six men, aged 18 to 70 years, with a diagnosis of ED, based on DSM-V criteria, were assessed by means of a clinical interview and a battery of 7 questionnaires (IIEF, SCL-90, PDQ-4, PSWQ, STAI, SSES, SSEI). The methodology focused on a quantitative, descriptive-correlational study of ex post facto design with convenience sampling. The results of the final regression model shows that sexual self-efficacy, certain personality tendencies and the symptomatology of depression, somatization, obsession-compulsion and anxiety are factors associated with the severity of TE, explaining 51.3% of the variance. Being able to identify those factors associated with the severity of TE may be of relevant importance in order to work on its prevention and improve the orientation of psychological interventions.(AU)

Amor, deseo, sexualidad y salud mental / [Love, desire, sexuality and mental health]

La presente aportación versa acerca del amor y el deseo sexual, así como de su escasamente documentada neurofisiología; también, de sus relaciones con la salud sexual y la mental, que incluye esta última los trastornos mentales, del comportamiento y del neurodesarrollo. Estas cuestiones se abordarán sucintamente desde una perspectiva eminentemente científica. Se han escrutado varios repertorios bibliográficos electrónicos cualificados internacionales y nacionales, sin pretender una imposible exhaustividad. Se constata que la información de calidad al respecto es extremadamente limitada, heterogénea y a menudo subjetiva o con sesgos deficientemente controlados. Según los hallazgos, resultan probables las diferencias psicofisiológicas para el amor y el deseo según sea el sexo y género de las personas, lo que sucede igualmente cuando concurren psicopatologías. El mecanismo regulador de la excitación sexual es complejo en sus correlatos neuronales y todavía son inciertas las bases neurofisiológicas correspondientes. Los trastornos mentales con influencia potencialmente más distorsionadora sobre el amor y el deseo sexual son los del estado de ánimo y, obviamente, los parafílicos. Se necesita investigar más y con mayor rigor acerca de la psiconeurobiología subyacente a estas cuestiones usuales. (AU)

The present contribution is about love and sexual desire and their relationship with sexual and mental health, what includes the latter mental, behavioural and neurodevelopmental disorders. All these issues will be succinctly addressed from an eminently scientific perspective. Several qualified national and international electronic bibliographical indexes have been examined without intending an impossible exhaustiveness. It is established that quality information on this regard is extremely limited, heterogeneous and frequently subjective or with poorly controlled bias. As a result of our findings, the psychophysiological differences for love and desire according to people’s sex and gender are likely to occur as it also happens when psychopathologies come together. The sexual arousal regulator mechanism is complex in its neural correlates and the corresponding neurophysiological basis are still uncertain. The mental disorders with a potentially more distorting influence on love and sexual desire are those related to mood and, obviously, paraphilic disorders. Further rigorous research on psychoneurobiology underlying this usual matters is needed. (AU)

Sexuality and self-concept of morbidly obese women who are sexually attracted to men after bariatric surgery: a phenomenological study.

BACKGROUND: Morbid Obesity (MO) is a public health problem that affects a person's physical, psychological and sexual well-being. Women with MO are affected by their body image and self-concept, and obesity stigma may affect women in social and sexual relationships. OBJECTIVE: To describe and understand the experiences of morbidly obese heterosexual women (who are sexually attracted to men) in relation to their body image and sexuality after bariatric surgery. METHODOLOGY: Qualitative study using Merleau-Ponty's hermeneutic phenomenology as a philosophical framework. Data collection took place between 2020 and 2021 in a southern Spanish province. A total of 22 in-depth interviews were conducted using open-ended questions until data saturation was reached. RESULTS: Two main themes were identified: (1) "Escaping from a cruel environment": weight loss to increase self-esteem; with the sub-themes: 'I love myself now', and 'Body image and social relationships; a vicious circle; (2) "Now, I am truly me": accepting my body to reclaim my sexuality, with the sub-themes: 'The body as the focal point of sexuality', and 'When regaining your sex drive reignites your sex life and relationship'. CONCLUSION: Weight loss and body acceptance radically change morbidly obese women's sex lives after bariatric surgery. They rediscover their bodies, have increased self-esteem, and see improvements in their social relationships and sexuality. These women feel seen, loved and desired, and now value their body image and femininity. As they go through continuous improvements following bariatric surgery, they gradually regain self-esteem, acceptance of their bodies and control over their sex life. Even though the women's partners benefit from these improvements, they seem to be afraid of being left.

Obesity is a problem that affects women's physical, psychological and sexual well-being, as well as their social relationships. It is important to explore and understand the experiences of heterosexual women regarding their body and sexuality. After other treatments, women undergo surgery to reduce their obesity. After bariatric surgery women feel happier about themselves, experience less stigma and progressively recover their social and sex lives.

Exploring the sexual experiences and challenges of individuals with cerebral palsy.

PURPOSE: Cerebral palsy (CP) is a prevalent motor disorder affecting children, with evolving demographics indicating an increasing survival into adulthood. This shift necessitates a broader perspective on CP care, particularly in addressing the often overlooked aspect of sexuality. The purpose of this study was to investigate experiences of, challenges with, and related factors of sexuality and intimacy that people with CP are facing. METHODS: This was a descriptive and cross-sectional single institution survey among individuals with CP, ages 18 to 65, who had the ability to independently complete an online survey. RESULTS: A total of 40 respondents participated in the survey (Gross Motor Function Classification System [GMFCS] level I/II, 32.5%; III, 35%; IV, 32.5%). Of those, 45% were partnered, 60% had past sexual experience, 47.5% were currently sexually active at the time of submitting the survey, 80% had masturbation experience, and 45.8% believed it had positive effect on their self-esteem. Only 10% received sex education tailored for people with disability, whereas school (72.5%) and internet (35%) were the most common sources of sex education. Muscle spasms, positioning difficulty, and pain/discomfort were the most common physical challenges experienced during intimate activity amongst all function stratifications. Stratification analysis showed that, compared to higher functioning respondents, a smaller proportion of lower functioning respondents were partnered (GMFCS IV, 23.1%; quadriplegic, 31.6%), had past or current sexual experience (GMFCS IV, 44.4%, 36.4%; quadriplegic, 42.1%, 26.3%, respectively), and had masturbation experience (GMFCS IV, 61.5%); Also, they had worse Quality of Life Scale scores on average (GMFCS IV, 88.4; quadriplegic, 88.3) and a higher rate of reported positive effects of sexual experiences on self-esteem than negative (GMFCS IV, 38.5%; quadriplegic, 35%).

Women´s experiences of menopause: A qualitative study among women in Soweto, South Africa.

Women today are experiencing menopause for decades more than in previous generations. This 'change of life' is defined by an entire stage of physical, hormonal, and emotional changes that accompany menstrual irregularity and the cessation of fertility, although limited medical research has focused on it. Yet, the inevitability of menopause is universal for all human females around 50 years old. In this article, we conducted twenty-five 20-60 min semi-structured qualitative interviews. Most women marked menopause by fertility cessation and social transition to old age, pushing back against a medical framework of menopause that emphasises hormonal deficiency and becoming disordered. In contrast, women frame menopause as a natural process that contributes to a critical social role transition, which they perceive as deeply private in part because it is associated with a reduction in femininity, sexuality, and power. On the other hand, menopause was also described as a liberating process through which women no longer needed to purchase pads or manage blood loss. Recognising how women may perceive menopause not as a deficit or disorder but as a social role transition that has both costs and benefits is useful for medical practitioners when discussing clinical options.

[Sex therapy and support for women and couples]. / Sexothérapie et accompagnement de la femme et du couple.

Sexuality is shaped by experience and by what has been passed down. Body image and sex influence desire and pleasure. In the case of endometriosis, suffering and pain can lead to shame and guilt. Encouraging people to talk to each other helps to create a free eroticism that resembles the couple.

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.

Women's access to sexual and reproductive health services and information in Ismailia, Egypt.

BACKGROUND: Sexual and reproductive health (SRH) is a right that should be guaranteed to every woman worldwide in order to have a healthy and safe sex life. In most Arab countries, including Egypt, there are different cultural, political, and religious factors that have contributed significantly to how society views and treats women's bodies and sexuality. As a result, it is difficult to provide solid data and information to guide policymakers, policies, and to implement awareness and preventive programmes. This study sought to address this gap by looking at the intersectionality of women's access to SRH services and information in Ismailia, Egypt. METHODS: The study utilised qualitative research methods. Semi-structured interviews were conducted with twelve married women and two key informant interviews with health professionals (a gynecologist and a pharmacist) in the study area. RESULTS: The study revealed that married women suffer from scarcity of understanding and knowledge of their SRH and lack of access to adequate SRH services and information. Married women's experiences of accessing SRH services and information were influenced by intersecting factors located at the micro and macro levels. These intersected factors (e.g., power dynamics, socioeconomic factors, cultural norms, and religious misconception) shaped oppression and privilege structures which created unequal access to SRH information and services. CONCLUSION: There is a need for building quality parental relationships for women before and after marriage in order to promote positive SRH attitudes and behavior. There is an urgent need to empower women before and after marriage with accurate, safe, and affordable SRH services and information that could have life-long benefits to protect them. There is a need to conduct educational programmes, and initiate media awareness campaigns, to equip women with information and knowledge about their SRH services and information.

Disfunción sexual en las mujeres con enfermedad pulmonar obstructiva crónica / Sexual dysfunction in women with chronic obstructive lung disease

Objetivo Determinar la prevalencia de la disfunción sexual en las mujeres con enfermedad pulmonar obstructiva crónica (EPOC) y los factores relacionados con su aparición. Métodos Se llevó a cabo un estudio observacional transversal a lo largo del año 2021, con inclusión de mujeres con EPOC diagnosticadas por espirometría mediante muestreo por conveniencia. Se recogieron datos de edad, tabaquismo, espirométricos, comorbilidades y fármacos utilizados, Además, se realizó un cuestionario de salud sexual. Resultados Se incluyeron 101 mujeres con edad media 59,7 (11,3) años. Todas ellas habían experimentado un cambio en su actividad sexual y 44% lo atribuyeron a la EPOC. Tenía disnea durante el coito 51,5%. La prevalencia de disfunción sexual fue de 52,5%. Las pacientes que experimentaron esto eran de más edad y tenían un índice de Tiffeneau más bajo. Asimismo, con más frecuencia consumían alcohol, tenían hipertensión arterial y enfermedad cerebrovascular, y con menos tenían diabetes e insuficiencia cardiaca. Sin embargo, puntuaban más bajo en el índice de Charlson corregido por edad. Aquellas con disfunción sexual utilizaban con menos regularidad la triple terapia inhalada. Conclusiones La disfunción sexual es frecuente en las mujeres con EPOC. Son necesarios más estudios que investiguen las causas, mecanismos y posibles tratamientos de la misma. (AU)

Objective To determine the prevalence of sexual dysfunction in women with COPD and the factors related to its presence. Methods Cross-sectional observational study during 2021, including women with COPD diagnosed by spirometry through convenience sampling. Data on age, smoking status, spirometric data, comorbidities and medications used were collected. A sexual health questionnaire was administered. Results The study included 101 women with a mean age of 59.7 (11.3) years. All had experienced a change in sexual activity, with 44% attributing it to COPD. Among them, 51.5% experienced dyspnea during coitus. The prevalence of sexual dysfunction was 52.5%. Women with sexual dysfunction were older and had a lower Tiffeneau index. Furthermore, they consumed alcohol more frequently and had hypertension and cerebrovascular disease, and less often, they had diabetes and heart failure. However, they scored lower on the Charlson index corrected for age. Patients with sexual dysfunction used inhaled triple therapy less frequently. Conclusions Sexual dysfunction is common in women with COPD. Further studies are needed to investigate its causes, mechanisms, and potential treatments. (AU)

Social Representations and Experiences of Sexual Transactions Among Swiss Youth.

This article relies on quantitative data collected in Switzerland as part of a research study on sexual transactions among youth. Building on an analytical framework that defines sexual transactions in terms of negotiated exchanges rooted in social representations, we explored how they were perceived by the Swiss young people included in our sample at a cognitive, ethical, and political level. We found that research participants who reported having experienced sexual transactions viewed them much more positively than those who reported never having engaged in such exchanges. While this was especially true among young women, we also found that the tendency of respondents to perceive sexual transactions negatively increased with age. When analyzed in light of the qualitative results of our study, these quantitative findings suggest that negative representations of sexual transactions are less likely to be based on lived experience than on an ideal-type of sexual behavior. In other words, our research highlights how young people interpret sexuality according to norms developed within a heteronormative matrix.

Implementing Comprehensive Sex and Sexuality Education in Kindergarten-Grade 12 Schools: Guiding Practices and Examples.

BACKGROUND: Comprehensive sex and sexuality education (CSE) is an evidence-based intervention associated with improved sexual and reproductive health outcomes. Currently, there are no standardized requirements for sex and sexuality education in the United States, despite expert recommendations. CONTRIBUTIONS TO THEORY: In the United States, a Whole School, Whole Community, Whole Child theoretical model proposed by the Centers for Disease Control, and current examples of school sex education policy is used to make recommendations for the standardization of comprehensive sexual health education in K-12 schools. This article describes the necessary components to adopt CSE equitably, and provides an example of the process implemented to improve CSE in 1 school district in Pittsburgh, PA. IMPLICATIONS FOR SCHOOL HEALTH POLICY, PRACTICE, AND EQUITY: Understanding the key components of legislation that align with recommended standards, and the process of advocating for school policy change, allows local advocacy groups and education policymakers to create and pass feasible legislation that will ensure appropriate instruction. There is additional room for improvement in states and local districts that have current CSE legislation, to adopt approaches grounded in frameworks that critically evaluate social determinants of health and amend legislation to further improve health equity. CONCLUSIONS: Several states and local districts have passed CSE regulations, and are implementing and evaluating their efficacy, providing support and examples for other regions interested in adopting similar policies and processes. Pittsburgh Public Schools can be used as an example adapting current legislation and adopting more comprehensive language.