Long-term impacts of vaginal birth with mediolateral episiotomy on sexual and pelvic dysfunction and perineal pain

Objective: To investigate whether spontaneous vaginal birth with mediolateral episiotomy has any long-term impact on urinary and/or fecal incontinence, sexual dysfunction and perineal pain in primiparous women.

Methods: This matched case-control study included 150 women between 25 and 35 years old who had a singleton childbirth at least five years previously. Patients were grouped as; women who had a spontaneous vaginal delivery with mediolateral episiotomy (Group 1), an elective cesarean delivery (Group 2), and who had no delivery (Group 3). Controls were matched for age and delivery time. Urinary/fecal incontinence were questioned and Female Sexual Function Index (FSFI) questionnaire was completed. Total FSFI and domain scores were compared. Statistical evaluation was performed using One-way ANOVA test or χ² test. Statistical significance was defined as p?Results: No women had urinary/fecal incontinence nor sexual dysfunction. Mean total FSFI points in Group 1 were significantly lower than in Groups 2 and 3 (p?=?0.001). There were significant differences in sexual desire between groups 1 and 3 (p?=?0.005), in arousal and in orgasm between both groups 1 and 2 (p?=?0.001 and p?=?0.038, respectively) and groups 1 and 3 (p?=?0.001 and p?=?0.001, respectively). There was no significant difference between groups 2 and 3 in any parameters or total points.

Conclusions: Vaginal delivery with mediolateral episiotomy is not associated with urinary and/or fecal incontinence and sexual dysfunction but associated with a decreased sexual functioning as well as sexual desire, arousal and orgasm within postpartum five years.     

Associations Between Initial Subjective Experiences with Tobacco and Self-Reported Recent Use in Young Adulthood

Background: Youth tobacco use behaviors are predictive of patterns in adulthood and effect long-term health outcomes. Yet, few studies have examined the effect of initial subjective experiences (ISEs) during first tobacco use, which has been found to be an indicator of individuals. sensitivity to nicotine and vulnerability to dependence. Objective: The present study aimed to determine the prevalence of ISEs across a variety of tobacco products, evaluate the factor structure of ISEs by first tobacco product used, and examine the relationship between ISEs and recent (30-day) use of tobacco products across time, using a university sample. Methods: Exploratory factor analyses were conducted to identify latent factors present with respect to items measuring ISEs with tobacco, separately by tobacco product (e.g. cigarettes, cigars, hookah, e-cigarettes). Factor scores for positive and negative ISEs were calculated. Multiple logistic regression analyses were conducted to examine associations between ISEs and recent use of each tobacco product, adjusted for age at first use, sex, race/ethnicity, and cohort. Results: ISEs differ by the first tobacco product used. Associations between factor scores for positive and negative ISEs and recent use were found across a variety of tobacco products. Overall, positive ISEs were more strongly associated with recent use, relative to negative ISEs. Conclusions: Further research is needed to identify genetic and biological pathways and social contexts influencing initial subjective experiences with tobacco use, in efforts to delay the initiation for tobacco use and reduce risk for continued use among young adults.     

The examination of Turkish early childhood education teachers’ professional identity

The purpose of the study is to examine professional identity of Turkish early childhood education teachers working in public and private preschools serving children from three to six years. The participants of the study, 1021 early childhood education teachers, were gathered through simple random sampling. The data for the study were gathered through A Professional Identity Scale (PRIS) (Kremer, L., & Hofman, J. E. (1985). Teachers’ professional identity and burn-out. Research in Education, 34, 89–95.), which is adapted into Turkish through preliminary psychometric investigation of its validity and reliability. Based on correlation analysis, independent samples t-test and analysis of variance gender, age, years of experience in occupation, age group of children, monthly income, educational level and background, job position and marital status of teachers were examined. Findings suggest that teachers’ professional identity was affected by such factors as gender, monthly income, educational level and background, job position, current work experience and marital status of teachers.     

The Ascending Reticular Activating System in a Patient With Severe Injury of the Cerebral Cortex: A Case Report

We reported on the ascending reticular activating system (ARAS) finding of a patient in whom severe injury of the cerebral cortex was detected following a hypoxic-ischemic brain injury (HIBI).A 67-year-old female patient who suffered from HIBI induced by cardiac arrest after surgery for lumbar disc herniation underwent cardiopulmonary resuscitation approximately 20 to 30 minutes after cardiac arrest. The patient exhibited impaired alertness, with a Glasgow Coma Scale (GCS) score of 4 (eye opening: 2, best verbal response: 1, and best motor response: 1). Approximately 3 years after onset, she began to whimper sometimes and showed improved consciousness, with a GCS score of 10 (eye opening: 4, best verbal response: 2, and best motor response: 4) and Coma Recovery Scale-Revised score of 9 (auditory function: 1, visual function: 1, motor function: 2, verbal function: 2, communication: 1, and arousal: 2).Results of diffusion tensor tractography for the upper connectivity of the ARAS showed decreased neural connectivity to each cerebral cortex in both hemispheres. The right lower ARAS between the pontine reticular formation and the thalamic intralaminar nuclei (ILN) was thinner compared with the left side.Severe injury of the upper portion of the ARAS between the thalamic ILN and cerebral cortex was demonstrated in a patient with some level of consciousness.