Effects of Experimentally Adopted Sexual Schemas on Vaginal Response and Subjective Sexual Arousal: A Comparison Between Women with Sexual Arousal Disorder and Sexually Healthy Women

The present study evaluated and compared the effects of experimentally adopted sexual schemas on vaginal response, subjective sexual arousal, and affect in 17 women with Female Sexual Arousal Disorder (FSAD) and 17 sexually healthy women. Positive and negative cognitive schemas were presented to participants before viewing sexually explicit video segments. They were asked to temporarily adopt both schemas, and vaginal response, subjective sexual arousal, and affect were measured in each schema condition. Participants in both groups had significantly greater vaginal response and reported more subjective sexual arousal in the positive schema condition than in the negative schema condition. Sexually healthy women demonstrated significantly higher subjective sexual arousal than women with FSAD, but there were no significant group differences in vaginal response. Moreover, participants in both groups reported higher levels of Positive Affect and Vigor in the positive schema condition than in the negative schema condition but higher levels of Negative Affect, Tension-Anxiety, and Anger-Hostility in the negative schema condition than in the positive schema condition. These findings demonstrate the impact of cognitions on sexual arousal, which has important implications for addressing cognitions in the treatment of FSAD. Moreover, these findings have implications for the conceptualization of FSAD, which may be best characterized as a complex, heterogeneous cluster of symptoms.

正常分娩和剖宫产术后生活质量的对比研究

目的剖宫产术后增加外科手术的干预机会,并且由于这些问题需要住院治疗,因此严重影响妇女产后的生活质量。本研究的目的是比较正常分娩与剖宫产妇女的生活质量。方法这是一前瞻性的研究。样本为正常分娩和剖宫产的病人,其病例资料来自我县的三个医疗机构。生活质量用SF-36分别在两个时间点进行评价（时间点一：分娩后6至8周,时间点二：分娩后12至14周）。并对两组的生活质量进行对比研究。结果总共有100人参与本研究（其中50人是正常分娩组,50人是剖宫产组）。从时间点一到时间点二两组的产后生活质量均提高。然而比较正常分娩组与剖宫产组的结果,发现两个时间点正常分娩组较对照组有较好的产后生活质量。在时间点一两者的生活能力差异有显著性（均数是62.9相对54.4,P=0.03）,同样精神健康方面也有相似的结果（均数是75.1相对66.7,P=0.03）。在第二时间点体格检查评价结果是（均数是88.4相对81.5,P=0.03）。对以上数据进行分析发现正常分娩组生理健康方面提高地较快,而剖宫产组在精神健康方面提高地较快。结论虽然本研究的结果没有提出究竟是正常分娩好还是剖宫产好,但是我们认为正常分娩可以提供一较好的体格健康,因此可以提高产妇的产后生活质量。确实对足月妊娠妇女经阴道正常分娩是一较好的选择。     

Measurement of Sexual Arousal in Postoperative Male-to-Female Transsexuals Using Vaginal Photoplethysmography

Mens sexual arousal patterns are category-specific: Men typically display significantly greater physiological responses to sexual stimuli depicting members of their preferred gender category. Category-specific patterns of sexual arousal have not been consistently reported in natal women. We used vaginal photoplethysmography to examine patterns of sexual arousal in 11 male-to-female (MtF) transsexuals following sex reassignment surgery (SRS) and in 72 natal women. Subjective arousal was measured with a continuous response lever. Video clips depicting sexual activity between two males, two females, or one male and one female were used as erotic stimuli. All transsexual participants displayed category-specific sexual arousal. Five homosexual transsexual participants (attracted exclusively to males before sex reassignment) showed greater genital and subjective responses to male than to female stimuli, while six nonhomosexual transsexual participants showed the opposite pattern. Vaginal pulse amplitude (VPA) was lower in transsexual participants than in natal women. The mean correlation between VPA and subjective responses was high in nonhomosexual transsexuals, but was significantly lower in homosexual transsexuals and in natal women. One transsexual participant who reported a change in sexual orientation following sex reassignment displayed VPA and subjective responses consistent with her pre-reassignment sexual orientation. We conclude that male-to-female transsexuals display male-typical category-specific sexual arousal following SRS, and that vaginal photoplethysmography is a promising methodology for studying patterns of sexual arousal in postoperative transsexuals.     

羊水偏少孕妇阴式分娩的安全性分析

目的探讨足月妊娠羊水偏少的孕妇阴式分娩的安全性。方法2006年1月至2008年6月在浙江省龙泉市人民医院对192例单胎头位自愿选择阴式分娩、经超声诊断羊水偏少的孕妇（观察组）资料进行分析。并与同期单胎头位选择阴式分娩、羊水正常的孕妇（对照组）200例进行对照比较。观察两组的分娩方式,孕产妇、胎婴儿结局及对新生儿发病率的影响。结果观察组剖宫产率为42．70％,稍高于对照组39．00％,但差异无统计学意义（P〉0．05）。两组产后出血、胎儿窘迫和死产发生率比较无统计学意义（P〉0．05）。结论观察组产前综合监护正常,无其他高危因素,在严密的监护下阴式分娩是较为安全的。     

Health and Sexual Outcomes of Women Who Have Experienced Forced or Coercive Sex

Previous research has linked women's history of experiencing sexual assault with negative health outcomes; however, much of this research is over a decade old. Furthermore, little research has examined the relationship between sexual assault and women's sexuality. In the current study the authors aimed to assess the relation of experiencing sexual assault to women's health and sexuality and the relation of repeat victimization by multiple different perpetrators to such outcomes. Data were collected from a convenience sample of 2,915 women using an online questionnaire. Nearly half (n = 1,394, 47.8%) indicated having experienced forced or coercive sex. Women who had experienced forced or coercive sex were more likely to report negative health outcomes (Adj. OR = 1.56; 95% CI: 1.35–1.82, p < .001) and some negative sexual outcomes compared to women without a history of forced or coercive sex. Similarly, women who experienced repeat victimizations by multiple different perpetrators were even more likely to report negative health outcomes (Adj. OR = 1.43; 95% CI: 1.28–1.59, p < .001) as well as some negative sexual outcomes. Healthcare providers should be aware of the relation of sexual assault to health and sexuality and continue to address health and sexuality issues associated with sexual assault for their patients.     

Bed Death and Other Lesbian Sexual Problems Unraveled: A Qualitative Study of the Sexual Health of Lesbian Women Involved in a Relationship

ABSTRACT

Objectives: To shed light on lesbian “bed death” among lesbian women. To explore the wishes and expectations of lesbian women with respect to healthcare professionals.

Methods: Semi-structured interviews with 30 self-identified lesbian women. The interviews were audio recorded. Three researchers classified and analyzed the most important themes.

Results: The women indicated few sexual problems except for “bed death,” a quasi-complete cessation of sexual activity. Twenty-three women experienced “bed death” during the current relationship or a previous one. The factors felt by the women to contribute to “bed death” were environmental influences, the existence of a symbiotic relationship, hormonal factors, and reduced sexual initiative. The women indicated that they would like family doctors to adopt a neutral attitude, be knowledgeable about homosexuality, and be able to recognize homosexuality in their patients.

Discussion: A careful examination of the potential causes of “bed death” suggests that the phenomenon is more closely linked to a patient's gender than to her sexual orientation. Lesbian women would also like general practitioners to possess at least some basic knowledge about homosexuality.     

非异常妊娠两种分娩途径产后情况比较

目的 比较非异常妊娠初产时剖宫产和阴道产后的母婴情况，评估剖宫产术的近期安全性。方法 采用历史性队列研究方法，对武汉市4所医院2002年10月至12月间非异常妊娠分娩初产妇产后以及新生儿情况进行比较分析。结果 剖宫产后感染的发生率是阴道分娩的1．93倍(8．70％／4．51％)，其他并发症和异常情况的发生率是阴道分娩的9．55倍(2．77％／0．28％)；除新生儿窒息以外的新生儿疾病和异常情况发生率是阴道分娩的1．73倍(14．62％／8．45％)，其差异都具有统计学意义。结论 排除产前异常影响因素之后，初产妇剖宫产术后感染等并发症以及除新生儿窒息以外的新生儿疾病和异常清况剖宫产组高于阴道分娩组。为保障母婴健康，必须严格掌握剖宫产指征．     

不同分娩方式对产后压力性尿失禁的影响

目的:探讨不同分娩方式对产后压力性尿失禁的影响。方法:健康初产妇135例按不同分娩方式分为阴道顺产组(A组)64例和选择性剖宫产组(B组)70例,分别记录产后42天、3个月的产后压力性尿失禁(SUI)分度并进行统计分析。结果:产后42天A组SUI患病率68.75%,B组为37.14%;产后3个月A组SUI患病率62.50%,B组为17.14%,两组不同时点比较差异均有统计学意义(P<0.01)。B组患者3个月时,Ⅰ度SUI患病率明显下降(P<0.01)。结论:选择性剖宫产比阴道顺产的产妇SUI发生率低,且康复速度比阴道顺产的产妇快。     

Ability to pay and impoverishment among women who give birth at a University Hospital in Kathmandu,Nepal

Abstract

Pregnant women giving birth in Nepal need to use out-of-pocket payment for delivery care services due to a lack of insurance policies. The objective of this study was to examine the ability of pregnant Nepalese women to pay for delivery care services and the effects of the current household health expenditure on impoverishment due to hospital-based delivery services, especially normal delivery (ND) and caesarean section (CS). A cross-sectional study was conducted from May to August 2009 at Tribhuvan University Teaching Hospital. Ability to pay was defined as the current health spending being less than 5% of annual household income. Poverty occurred when a household's per capita income fell to less than US$1 per day. Impoverishment was considered as poverty headcount and normalised poverty gap. On average, the percentage of annual household income spent on current delivery care was 5.9% in the ND group and 9.7% in the CS group. The CS group had a stronger impoverishment effect resulting in a high per cent change of payment-induced poverty headcount by 78.1% and poverty gap by 97.3% compared to 7.7 and 24.1% in the ND group, respectively. There is a strong need to develop a well-prepared financial system to prevent the issue of poverty and impoverishment.     

阴式子宫切除术与腹腔镜辅助阴式子宫切除术的术式比较

目的探讨阴式子宫切除术(TVH)和腹腔镜辅助阴式子宫切除术(LAVH)的临床效果及应用价值。方法回顾性分析2007年1月至2010年12月在本院行TVH的86例患者(TVH组)与同期行LAVH的92例患者(LAVH组)的临床资料,对两组患者术中、术后情况进行统计学分析(本研究遵循的程序符合本院人体试验委员会制定的伦理学标准,得到该委员会批准,并与其签署临床研究知情同意书)。两组患者既往盆腔手术史、孕次、产次、合并贫血及子宫增大(相应孕周)情况比较,差异无统计学意义(P>0.05)。结果 TVH组患者手术时间、术中出血量及手术费用均较LAVH组短、少和低,两组比较,差异有统计学意义(P<0.05);但术后排气时间、术后病率及住院时间比较,差异无统计学意义(P>0.05)。所有患者无一例中转开腹及脏器损伤或大出血等严重并发症发生,均无发热、肠粘连、肠梗阻和术后血栓性静脉炎等手术相关并发症。结论 TVH较LAVH具有手术时间短、术中出血量少、费用低廉等优势,但TVH更适应于子宫大小<孕4个月、盆腔无明显粘连患者。LAVH可扩大TVH的适应证。临床应根据个体情况选择合适的子宫切除方式,以达到最佳治疗效果。     

Sexual Coercion and Behavior Among a Sample of Sexual Minority Women

Sexual coercion may affect the sexual experiences of sexual minority women differently. Women (n = 445) aged 18 to 71 years (Mean = 30.38) answered an online survey on sexual orientation, lifetime coercion, and sexual history. Sexual minority women (45.8%, n = 204) were more likely to report having been coerced into unwanted sexual behavior (56.5%) than heterosexual women (44.8 %; p = 0.010). Coerced sexual minority women reported earlier ages of initiation into performing oral sex (p = 0.016), penile-vaginal (p = 0.024), and penile-anal (p = 0.027) intercourse. In multiple logistic regression models, currently being in a partnered relationship was the sole factor related to lifetime engagement in penile-vaginal intercourse and receiving oral sex from partners. Having at least a graduate degree was the only characteristic related to engagement in lifetime penile-anal intercourse. Sexual coercion was not related to any lifetime sexual behavior outcomes. The nature of sexual initiation and coercion should be explored further among sexual minority women, with the goal of incorporating their experiences into prevention and treatment initiatives.     

阴式子宫切除术和腹腔镜辅助阴式子宫切除术比较

目的通过100例阴式子宫切除术（VH）、腹腔镜辅助阴式子宫切除术（LAVH）的比较,对比其优缺点。方法选用我院2003年1月-2008年3月符合VH和LAVH手术指征的患者进行手术,其中VH50例,LAVH50例予以对比分析。结果 VH与LAVH结果相同,明显比开腹全子宫切除术为优。LAVH手术适应证明显超过VH。结论 LAVH和VH和传统全子宫切除术比较,可减少手术创伤,避免剖腹,有明显优越之处。     

腹腔镜辅助阴式子宫切除术与阴式全子宫切除术的疗效比较

目的：分析腹腔镜辅助阴式子宫切除术（LAVH）与阴式全子宫切除术（TVH）的手术效果。方法：回顾性分析2010年5月-2011年7月在本院进行子宫切除的110例患者,按其术式分为LAVH组55例及TVH组55例,分析比较两组患者的术中出血量、手术时间、术后体温恢复时间、肛门排气时间、住院时间、住院费用及并发症发生率。结果：LAVH组的术中出血量、手术时间、术后体温恢复时间及术后并发症发生率都少于TVH组（P〈0.05）。LAVH组与TVH组的肛门排气时间及住院时间比较差异无统计学意义（P〉0.05）。LAVH组的住院费用因术中使用全麻,高于TVH组（P〈0.05）。结论：腹腔镜辅助阴式子宫切除术（LAVH）与阴式全子宫切除术（TVH）皆属微创手术,前者费用较高,但手术效果比后者好。     

Vaginal Lubrication in Women with Scleroderma and Sjogren's Syndrome

Prior to this study, there has been little published material about sexual response in women with scleroderma and Sjogren's syndrome. We therefore conducted an investigation of sexual problems and sexual knowledge in women with scleroderma. Eighty-three women with scleroderma participated in the study. Over 37% of respondents reported that they had been diagnosed with Sjogren's syndrome, and 56.9% of respondents reported experiencing sexual problems. Despite these experiences, however, the respondents were remarkably poorly informed about the sexual effects of scleroderma and Sjogren's syndrome. Only 4 women realized that Sjogren's syndrome can cause vaginal dryness. This ignorance is especially appalling when one considers the fact that the study participants were recruited through scleroderma organizations: women who seek out scleroderma organizations are likely to be better informed than the average patient. We urge health care providers to begin to view sexuality education as part of their mission.     

阴道助产与剖宫产对脐带脱垂预后的影响

目的:比较阴道助产与剖宫产对脐带脱垂预后的影响。方法:52例发生胎儿脐带脱垂的产妇,根据临床情况分别进行剖宫产和阴道助产,比较两组间新生儿死亡率、新生儿产伤和产妇产褥感染、出血或血肿、组织损伤的发生率。结果:剖宫产组新生儿死亡率和产伤发生率、出血和组织损伤发生率均较阴道助产组明显降低(P<0.05),而产褥感染在两组间无显著性差异(P>0.05)。结论:以剖宫产处理脐带脱垂可以相对降低新生儿死亡率及减少母婴并发症,优于阴道助产。