Culture and Sexuality: Cognitive–Emotional Determinants of Sexual Dissatisfaction Among Iranian and New Zealand Women

Background

Several studies have demonstrated that culture plays a fundamental role in individuals' beliefs, attitudes, and values toward sexuality, and influences their ability to enjoy sex. It follows that culture may influence sexual satisfaction or dissatisfaction.

Perinatal Outcomes and Nativity: Does Place of Birth Really Influence Infant Health?

ABSTRACT: In recent years nativity or nation of origin has become the focus of numerous pregnancy outcome studies. A recent research synthesis found that, although considerable heterogeneity in study designs hinders the development of broad generalizations concerning differences in pregnancy outcomes, migrant women were more likely to have better low‐birthweight and preterm birth outcomes than women born in the receiving country in most of the studies that could be incorporated in the meta‐analysis. Researchers considering studies of migration and pregnancy outcomes should incorporate more comprehensive measures of the migrant experience, as the dichotomous variable born or not born in the receiving country only opens the door to understanding the meaning of empirical observations concerning advantage or disadvantage in outcomes of pregnancy among migrant women. (BIRTH 38:4 December 2011)     

The Urinary Protein-to-Creatinine Ratio in Canadian Women at Risk of Preeclampsia: Does the Time of Day of Testing Matter?

ObjectivesTo determine the performance of a protein-to-creatinine ratio threshold of 30 mg/mmol in pregnant women investigated for hypertension according to the time of day of the sampleMethodsThis prospective study included ambulatory pregnant women investigated for hypertensive disorders. A single voided random urine specimen was obtained to determine the protein-to-creatinine ratio, followed immediately by a 24-hour urine collection. Statistical analyses included Spearman correlation, sensitivity, specificity, predictive values, likelihood ratios, and receiver-operator characteristic curves with 95% confidence intervals. A P value < 0.05 was considered statistically significant.ResultsAmong the 91 specimens analyzed, 47.3% showed significant proteinuria in the 24-hour collection and 33% were first morning samples. The protein-to-creatinine ratio and 24-hour urinary protein excretion were highly correlated (r = 0.92, P < 0.001). The diagnostic accuracy of the protein-to-creatinine ratio threshold of 30 mg/mmol was lower in first morning samples than in samples obtained during the rest of the day, with sensitivity 58% and 90%, specificity 93% and 100%, positive predictive value 88% and 100%, negative predictive value 72% and 92%, positive likelihood ratio 8 and not calculable, and negative likelihood ratio 0.45 and 0.1, respectively. The receiver-operator characteristic area under the curve was 0.94 (95% CI 0.86 to 1) for first morning samples and 1.0 (95% CI 0.99 to 1) for other samples.ConclusionA protein-to-creatinine ratio threshold of 30 mg/mmol reliably identifies significant proteinuria, but its reliability is reduced in first morning samples. Consequently, such samples should not be used for this purpose.     

Anxiety and Depression Among Sexual Minority Women and Men in Sweden: Is the Risk Equally Spread Within the Sexual Minority Population?

IntroductionSexual minority individuals have a higher risk of anxiety and depression compared with heterosexuals. However, whether the higher risk is spread equally across the sexual minority population is not clear.AimTo investigate the association between sexual orientation and self-reported current anxiety and a history of diagnosis of depression, paying particular attention to possible subgroup differences in risks within the sexual minority population, stratified by sex and to examine participants' history of medical care for anxiety disorders and depression.MethodsWe conducted a population-based study of 874 lesbians and gays, 841 bisexuals, and 67,980 heterosexuals recruited in 2010 in Stockholm County. Data were obtained from self-administered surveys that were linked to nationwide registers.Main Outcome MeasuresBy using logistic regression, we compared risks of current anxiety, histories of diagnosed depression, and register-based medical care for anxiety and/or depression in lesbian and gay, bisexual, and heterosexual individuals.ResultsBisexual women and gay men were more likely to report anxiety compared with their heterosexual peers. Bisexual individuals and gay men also were more likely to report a past diagnosis of depression. All sexual minority groups had an increased risk of having used medical care for anxiety and depression compared with heterosexuals, with bisexual women having the highest risk.ConclusionBisexual women appear to be a particularly vulnerable sexual minority group. Advocating for non-discrimination and protections for lesbian, gay, and bisexual people is a logical extension of the effort to lower the prevalence of mental illness.Björkenstam C, Björkenstam E, Andersson G, et al. Anxiety and Depression Among Sexual Minority Women and Men in Sweden: Is the Risk Equally Spread Within the Sexual Minority Population? J Sex Med 2017;14:396–403.     

Diagnosis and treatment delay in gynecological malignancies. Does it affect outcome?

Abstract. Menczer J. Diagnosis and treatment delay in gynecological malignancies. Does it affect outcome?
Delay of diagnosis and treatment of malignant tumors is perceived as unfavorably affecting outcome. However, tumor behavior may be determined early in the histogenesis process and the outcome may be more a function of the biologic properties of the tumor than of our ability to make an early diagnosis. The objective of the present review is to evaluate data concerning the effect of diagnosis and treatment delay on outcome in gynecological malignancies. A medline search including the terms diagnosis delay, treatment delay, outcome, vulvar carcinoma, cervical carcinoma, endometrial carcinoma and ovarian carcinoma was conducted and all pertinent articles in the English language were included. Relatively few investigations deal with the effect of diagnosis and treatment delay on prognostic factors and on outcome in invasive gynecological malignancies. The reviewed data do not seem to indicate an unequivocal deleterious effect of a delay of several weeks or even several months in patients with some gynecological malignancies. Intentional delay of diagnosis or treatment of gynecologic malignancies is unjustified; however, the data presented should encourage a closer scrutiny and possibly a revision of the concept of early diagnosis and of the notion that delay of any duration has a definite, unfavorable effect on outcome.     

Relationship Between Masturbation and Partnered Sex in Women: Does the Former Facilitate,Inhibit, or Not Affect the Latter?

IntroductionThe relationship between masturbation activities and their effect on partnered sex is understudied.AimThe aim of this study was to assess the alignment of activities between masturbation and partnered sex, and to determine whether different levels of alignment affect orgasmic parameters during partnered sex.Methods2,215 women completed an online survey about activities during masturbation and reasons for orgasmic difficulty during masturbation, and these were compared with activities and reasons for orgasmic difficulty during partnered sex.Main Outcome MeasureDegree of alignment between masturbation activities and partnered sex activities was used to predict sexual arousal difficulty, orgasmic probability, orgasmic pleasure, orgasmic latency, and orgasmic difficulty during partnered sex.ResultsWomen showed only moderate alignment regarding masturbation and partnered sex activities, as well as reasons for masturbation orgasmic difficulty and reasons for partnered sex orgasmic difficulty. However, those that showed greater alignment of activities showed better orgasmic response during partnered sex and were more likely to prefer partnered sex over masturbation.Clinical ImplicationsWomen tend to use less conventional techniques for arousal during masturbation compared with partnered sex. Increasing alignment between masturbation and partnered sexual activities may lead to better arousal and orgasmic response, and lower orgasmic difficulty.Strength & LimitationsThe study was well-powered and drew from a multinational population, providing perspective on a long-standing unanswered question. Major limitations were the younger age and self-selection of the sample.ConclusionWomen that align masturbation stimulation activities with partnered sex activities are more likely to experience orgasm and enhanced orgasmic pleasure, with sexual relationship satisfaction playing an important role in this process.Rowland DL, Hevesi K, Conway GR, et al. Relationship Between Masturbation and Partnered Sex in Women: Does the Former Facilitate, Inhibit, or Not Affect the Latter? J Sex Med 2020;17:37–47.     

Patients’ obstetric history in mid-trimester termination of pregnancy with gemeprost: Does it really matter?

OBJECTIVE: The objective was to investigate the importance of previous obstetric history for termination of pregnancy in the second-trimester with gemeprost alone. STUDY DESIGN: A consecutive series of 423 mid-trimester inductions of abortion at our teaching hospital was reviewed. Termination of pregnancy was carried out with 1mg of vaginal gemeprost every 3h up to three doses over a 24-h period, repeated the following day if necessary. Failed induction was defined as women undelivered by 96 h. The study population was then stratified by gestational age, parity, gravidity and previous uterine scars. Main outcome parameters were failed induction and complication rates. Statistical analysis was performed using the chi(2) test or Fisher's exact test for categorical data, and the t-test and linear regression for continuous variables. RESULTS: No significant differences were found in the primary outcome parameters with regard to the obstetric parameters considered. The failed induction rate was 1.2% with an overall incidence of complications of 7.4%. Parity was the main factor that affected clinical response (time to abortion interval and number of pessaries). CONCLUSION: Patients' obstetric history does affect the clinical response to gemeprost, but its safety and effectiveness are preserved. These data provide clinicians with important information for correct counselling.     

Qualitative research in fertility and reproduction: Does it have any value?

Quantitative researchers may argue that a finding or result is more likely to be accepted as a fact if it is quantified (expressed in numbers), than if it is not (Black, 1994). 'There is little or no scientific evidence, for example to support the well-known "fact" that one couple in 10 is infertile, yet most of us are happy to accept uncritically such simplified, reductionist, and blatantly incorrect statements, so long as they contain at least one number' (Greenhalgh & Taylor, 1997, p. 740). Interest in qualitative methods and their wider exposure in health care has led to necessary scrutiny of this type of research (Mays & Pope, 2000). This article compares the basic purpose and focus of quantitative and qualitative research, and draws attention to the relative lack of qualitative research in fertility and reproduction compared to quantitative methods. The authors highlight the strengths and weaknesses of both methods and promote qualitative methods as a valuable tool in fertility and reproduction related studies.     

Does Endometriosis Affect Sexual Activity and Satisfaction of the Man Partner? A Comparison of Partners From Women Diagnosed With Endometriosis and Controls

Background

Endometriosis-associated pain and dyspareunia influence female sexuality, but little is known about men's experiences in affected couples.

Skilled Birth Attendants in Mexico: How Does Care During Normal Birth by General Physicians,Obstetric Nurses,and Professional Midwives Compare With World Health Organization Evidence‐Based Practice Guidelines?

Introduction: We evaluated the quality of basic obstetric care provided by Mexican general physicians, obstetric nurses, and professional midwives compared with World Health Organization (WHO) guidelines for evidence‐based practices and national guidelines. Methods: Vaginal births were observed in 5 hospitals in 5 states from June 2006 until July 2007. We created 5 indices based on WHO guidelines and national standards for care during normal birth. These indices included 1) favorable practices at admission, 2) favorable practices during labor, birth, and immediately postpartum, 3) harmful or excessively used practices, 4) newborn practices, and 5) obstetric outcomes. We assessed each provider type's performance as high or low compared with the WHO standard and performed bivariate and multivariate logistic regression analyses to assess the association between indices, patient characteristics, and provider type, adjusting for standard errors for intragroup correlation. Results: We observed 876 independently managed vaginal births. Adjusted regression analyses compared with the general physicians standard revealed significant results for favorable care by obstetric nurses on admission (odds ratio [OR] 6.25; 95% confidence interval [CI], 2.08‐18.84); for care by professional midwives (OR 21.08; 95% CI, 4.24‐104.94) and obstetric nurses (OR 7.88; 95% CI, 2.76‐22.52) during labor, birth, and postpartum; and for newborn practices by obstetric nurses (OR 4.14; 95% CI, 1.08‐15.90). Professional midwives were least likely to perform harmful/excessively used practices during labor, birth, and the postpartum period (OR 0.06; 95% CI, 0.00‐0.35). Discussion: Professional midwives and obstetric nurses perform equally or better than general physicians when assessed by use or misuse of evidence‐based practices. Professional midwives are an underutilized resource in Mexico. If integrated into the mainstream Mexican health system, they may improve the quality of obstetric care.     

Breastfeeding: How Could it be Enhanced? The Perceptions of Vietnamese Women in Sydney,Australia

In Australia, the prevalence and duration of breastfeeding is on the decline. The low incidence of breastfeeding includes the immigrant Vietnamese. The purpose of this study was to examine Vietnamese women's perceptions of factors that might influence their choice of infant feeding and how breastfeeding could be promoted and maintained by nurses, midwives, other health professionals, and the health care system as a whole. A convenience sample of 124 postnatal Vietnamese women from community agencies in western and southwestern suburbs of Sydney was interviewed. Content analysis showed that factors that affect their choice of infant feeding method were language difficulties in communicating with health professionals concerning breastfeeding, lack of social support and follow-up care, and attitudes of health professionals toward breastfeeding. To promote and maintain breastfeeding within the Vietnamese community in Sydney, Australia, appropriate health care planning and implementation based on their social, cultural, and language backgrounds and practices need to be considered.     

Narrow-Band Imaging in Diagnosis of Endometrial Cancer and Hyperplasia: A New Option?

Study ObjectiveTo estimate whether the use of narrow-band imaging (NBI) hysteroscopy increases concordance between visual identification and a histologic diagnosis of endometrial cancer and hyperplasia.DesignProspective study (Canadian Task Force classification: II-2).SettingDepartment of obstetrics and gynecology, University of Eastern Piedmont, Novara, Italy.Patients209 consecutive patients with abnormal uterine bleeding.InterventionsWhite-light hysteroscopy and NBI hysteroscopy followed by direct biopsy.Measurements and Main ResultsThe sensitivity and specificity of conventional hysteroscopy in predicting a diagnosis of cancer and hyperplasia were, respectively, 84.21% (95% confidence interval [CI], 79.27–89.15) and 99.47% (95% CI, 98.49–100.0), and 64.86% (95% CI, 58.39–71.34) and 98.77% (95% CI, 97.27–100.0), and of NBI hysteroscopy were 94.74% (95% CI, 91.71–97.76) and 97.89% (95% CI, 95.95–99.84), and 78.38% (95% CI, 72.8–83.96) and 97.67% (95% CI, 96.63–99.72). The concordance of conventional and NBI hysteroscopy with the histopathologic findings (measured using the Cohen κ) was, respectively, 88.80% (95% CI, 86.2%–96.3%) and 91.78% (95% CI, 89.6%–98.2%), a difference of 2.98% (95% CI, 0–9) in favor of NBI.ConclusionNarrow-band imaging hysteroscopy can accurately predict a histologic diagnosis of endometrial cancer or hyperplasia.