Sexual Activity After Bariatric Surgery: A Prospective Monocentric Study Using the PISQ-IR Questionnaire

IntroductionObesity can lead to pelvic floor disorders, interfering with women’s sexual life; Prolapse/Incontinence Sexual Questionnaire-International Urogynecology Association–Revised (PISQ-IR) is a new instrument to measure sexual life in women with pelvic floor disorders.AimsTo assess the utility of using PISQ-IR in morbidly obese women undergoing bariatric surgery and to show the improvement of bariatric surgery on sexuality.MethodsThis prospective monocentric study included all women who underwent bariatric surgery from June 2016–May 2017. Sleeve gastrectomy (SG) or Roux-en-Y gastric bypass (RYGB) was performed by 1 surgeon, and data were collected by 1 researcher. Demographics, medical history, number of deliveries, and type of bariatric surgery (SG or RYGB) were collected at baseline. At the 1-year follow-up consultation, postoperative complications, percentage of total body weight loss (TWL) and percentage excess weight loss were assessed. Questionnaires were given at baseline and at 1-year follow-up.Main Outcome MeasuresPostoperative complications and total weight loss were measured at the 1-year follow-up. Sexual activity, using the PISQ-IR, and pelvic organ prolapse, urinary incontinence, and anal incontinence, using the urinary symptom profile and PFDI (Pelvic Floor Distress Inventory) 20, were compared before surgery and at 1-year follow-up.Results72 patients were included at baseline, 54 (75%) were considered for final analysis (30 RYGB and 24 SG), and 51 patients were considered for PISQ-IR. The mean preoperative body mass index was 41 ± 5.4 kg/m², and mean age was 43 ± 11.8 years. Both procedures induced an important weight loss (mean TWL of 33%) and had a similar percentage of TWL for each procedure: 31 (15–46) for SG vs 34 (9–51) for RYGB. 9 patients (17 [6%]) became sexually active 1 year after surgery. For the sexually inactive population after 1 year, there was no differences in the PISQ-IR in the follow-up. When body mass index loss was >13 kg/m², a higher percentage of the sexually active population improved their different scores, and there were significant results for both global quality of life and desire (P = .026 and .046). The other questionnaires showed a significant decrease in urinary incontinence symptoms (P < .001) associated with weight loss, whereas there was no difference in terms of pelvic organ prolapse or anal incontinence.ConclusionPISQ-IR is a useful instrument to measure sexual function regarding pelvic floor disorders. Bariatric surgery improves sexual activity in obese women 1 year after surgery.Treacy PJ, Mazoyer C, Falagario U, et al. Sexual Activity After Bariatric Surgery: A Prospective Monocentric Study Using the PISQ-IR Questionnaire. J Sex Med 2019;16:1930–1937.     

You never know when your last day will come and your trip will be over – Existential expressions from a melanoma diagnosis

AimThe aim of this study was to further explore expressions of existential experiences by patients diagnosed with malignant melanoma (MM).MethodSemi-structured interviews were performed consecutively after diagnosis among 30 patients with MM. The methodological approach was inspired by Gadamer's hermeneutic philosophy.ResultsThe analysis of expressions of existential experiences after having been diagnosed with malignant melanoma revealed that it is an existential process that people go through, beginning with feelings of suddenly becoming groundless at the time of the diagnosis, including being empty and in a vacuum, being in chaos and uncertainty and being confronted with one's own death. Next theme searching for solid ground included striving to understand what lies ahead, striving to find a balance in life – fighting, hoping, going on living and striving to prioritize family. The last theme creating islands of solid ground when living with cancer included understanding what is meaningful in life, living in the moment – seizing the day and keeping watch on the body.ConclusionOn being diagnosed with malignant melanoma, people go through a process where many questions emerge, including an existential turmoil, which health professionals should be aware of to provide these patients with sufficient support.     

Local injection of botulinum toxin A: An alternative therapy for axillary osmidrosis

The objective of this study was to investigate the efficacy of local injection of botulinum toxin A for treating axillary osmidrosis. One hundred and fifty patients with axillary osmidrosis were randomly divided to receive botulinum toxin A injection treatment (50 U of botulinum toxin A was injected intracutaneously into 6–20 different sites within each axilla, n = 74) or surgical excision of the apocrine glands (n = 76). The patients were followed up for 1–3 months to analyze the therapeutic effect and complications of the two methods. The curative effect in patients with mild and moderate axillary osmidrosis was not significantly different between the botulinum toxin A injection group and operation group. However, for patients with severe axillary osmidrosis, surgery treatment seemed to be superior to botulinum toxin A treatment (P = 0.005). There was also no significant difference in the modified Dermatology Life Quality Index between the two treatments. Two cases showed complications related to hemorrhage and incision infection in the operation group. In conclusion, local injection of botulinum toxin A is a safe, fast and effective treatment for mild and moderate axillary osmidrosis, but the long‐term effect remains to be further investigated.     

Parent-adolescent relationship quality as a predictor of leaving home

IntroductionLeaving home is a significant life transition that effects both emerging adults and their families. The age of leaving home has been increasing across industrialized societies, and children remain dependent on their parents for a longer time. The present study investigated the association between parent-adolescent relationships and timing of leaving home over a timespan of six years: From middle adolescence to emerging adulthood.MethodsData came from three cohorts of two longitudinal studies in the Netherlands (N = 1100). At the start of the study, participants had a mean age of 16.41 (SD=.71), and approximately half of them (n = 547) were male. Adolescents completed questionnaires on parent-adolescent relationship quality. The impact of positive and negative relationship characteristics on timing of leaving home were examined separately for mothers and fathers.ResultsSurvival analysis results showed that higher levels of mother's and father's warmth, and higher levels of power attributed to father, but not mother, predicted later timing of leaving home. Higher levels of parental autonomy support predicted earlier timing of leaving home. Conflict with parents was not associated with timing of leaving home, except in the father-daughter relationship. Only, the effect of parental warmth on timing of leaving home remained robust when controlling for age, gender, education level, and SES.ConclusionsOur findings indicate that certain parent-adolescent relationship characteristics contribute to the increase in age of leaving home. Parents may be able to prepare their children for a self-sufficient living by balancing warmth and autonomy support they provide during adolescence.     

Developmental trajectory of purpose identification during adolescence: Links to life satisfaction and depressive symptoms

IntroductionWhereas evidence has shown that a sense of purpose is linked to optimal adjustment, longitudinal work investigating the development of purpose identification as well as its effect on psychological functioning among non-Western samples during adolescence is needed.MethodsThree hundred and eighty-seven senior high school students (253 female, 65.37%; mean age = 15.76 years at the first investigation) from Taiwan completed surveys four times beginning in the fall of tenth grade and ending in the spring of eleventh grade with a six-month interval. Using self-ratings, purpose identification was evaluated in all four assessments and psychological functioning was examined through life satisfaction and depressive symptoms in the first and the last survey.ResultsGrowth curve analyses revealed an increased slope in purpose identification over the first two years of high school, and such a trajectory was similar across boys and girls. Additionally, increases in purpose identification predicted enhanced life satisfaction and reduced depressive symptoms among both boys and girls. There was only one gender difference: The negative association between purpose identification trajectory and depressive symptoms was stronger for girls than for boys.ConclusionsThere is an increase in the development of identified purpose during middle adolescence among high school students in Taiwan. Such change not only promotes life satisfaction in adolescents but is also preventive of adolescent depression. As such, the current findings highlight the significance for adolescents to discover and commit to a purpose.     

社区居民睡眠质量与生活质量相关性调查分析

目的对上海远郊泥城社区失眠人群进行睡眠质量与生活质量的相关性分析，为使用中医护理技术-“耳穴埋豆治疗失眠”提供依据。方法采用匹兹堡睡眠质量指数（PSQI）量表及世界卫生组织生活质量简表（WHOQOL-BREF）对泥城社区116位18～60岁的居民进行调查分析。结果泥城社区失眠人群生活质量四个维度得分为生理领域（10．62±2．1）分、心理领域（12．55±1．2）分、社会关系领域（12．10±1．3）分、环境领域（11．48±0．9）分；睡眠质量总分及各因子的评分与生存质量各维度的评分呈负相关。结论泥城社区失眠人群的生活质量差。社区护士应采取适宜的护理干预措施，改善他们的睡眠质量。     

Doll tales: foregrounding children's voices in research

This paper discusses how the use of Persona dolls in research is an effective means of enabling children (ages 4–6) to share life experiences openly. It investigated the place of race in the peer choice of preschool children. Two key research questions drove the inquiry: (1) Do four‐ to six‐year‐old children know their own racial identity? (2) Do four‐ to six‐year‐old children choose friends based on racial characteristics? Semi‐structured interviews using Persona dolls were conducted, with the dolls acting as conduits through which the children engaged in conversations with the researcher. Findings revealed that children were aware of stereotypes and discrimination. One minority child showed deep empathy with the posed dilemma of a dark skinned Persona doll and her inability to establish friendships. Implications are shared with regard to the significance of Persona dolls, play and life stories in presenting the views of young children.     

社区老年抑郁患者采用综合干预对其抑郁症状及生活质量的改善作用

目的探讨社区抑郁患者采用综合干预对其抑郁症状及生活质量的改善作用。方法将上海市静安区彭浦新村街道社区卫生服务中心306例老年抑郁患者按照随机数字表法分组为对照组与干预组,对照组除原服用抗抑郁药外,不采取任何措施;干预组除原服用抗抑郁药外,据病情轻、中、重给予不同层次干预措施,社区医生每两周干预一次,并予相关的记录。结果干预组患者从随访的第6周末至48周末汉密尔顿抑郁量表HAMD评分逐渐降低,P0.05;对照组患者则评分变化不明显,P0.05;干预组从第6周末至48周末HAMD评分明显低于对照组,差异均存在统计学意义,P0.05。结论实施综合干预可有助于社区老年抑郁患者抑郁症状的改善,提高其生活质量。