From the website of the publisher: "Use of ED medication can be seen as a marker for ED. ED is associated with increasing age, exposure to traumatic events and physical injuries in military veterans. The objective of this study was to assess the prevalence of use of ED medication in Dutch military personnel in the period 2003–2012 and to assess its association with age and psychotropic medication use. Data on dispensing of ED medication, age and co-medication with psychotropic medication of all Dutch military personnel between 2003 and 2012 were collected. The prevalence of ED medication use in each year was estimated, stratified for age and use of psychotropic medication. The number of ED medication users increased a hundredfold from 0.09 to 9.29 per 1000 per year between 2003 and 2012. ED medication was more often used by men over 40 than under 40 (prevalence in 2012: 2.4% vs 0.2%, OR (2003–2012, adjusted for calendar year) 15.6, 95% CI 13.5–17.9) and by men using psychotropic medication (prevalence in 2012: 3.8% vs 0.9%, OR (2003–2012, adjusted for calendar year) 3.13, 95% CI 2.66–3.67). This study shows a strong increase between 2003 and 2012 in a number of ED medication users in male Dutch military personnel. ED medication use increases with age and with psychotropic medication use."
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Background: Fifty to eighty percent of patients suffering from chronic kidney disease (CKD) experience a form of sexual dysfunction (SD), even after renal transplantation. Despite this, inquiring about SD is often not included in the daily practice of renal care providers. Objectives: This paper explores the perspectives of renal social workers regarding sexual care for patients and evaluates their practice,attitude towards responsibility and knowledge of SD. Design: A cross-sectional study was conducted using a 41-item online survey. Participants: Seventy-nine members of the Dutch Federation of Social Workers Nephrology. Results: It was revealed that 60% of respondents discussed SD with a fifth of their patients. Frequency of discussion was associated with experience (p¼0.049), knowledge (p¼0.001), supplementary education (p¼0.006), and the availability of protocols on sexual care (p¼0.007).Main barriers towards discussing SD consisted of ‘culture and religion’ (51.9%), ‘language and ethnicity’ (49.4%), and ‘presence of a third person’ (45.6%). Sufficient knowledge of SD was present in 28% of respondents. The responsibility for discussion was 96% nephrologists and 81% social workers. Conclusion: This study provides evidence that a part of Dutch nephrology social workers do not provide sexual care regularly, due to insufficient experience and sexual knowledge, absence of privacy and protocols and barriers based on cultural diversity. According to the respondents the responsibility for this aspect of care should be multidisciplinary. Recommendations include a need for further education on the topic, private opportunities to discuss SD and multidisciplinary guidelines on sexual care
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Sexual functioning is often impaired in patientswith Parkinson’s disease (PD) and may affect quality oflife of patients and their spouse. However, little is knownabout the practice patterns of neurologists with regard todiscussing sexuality in this field. The aim of this cross-sectional study was to evaluate to what extent neurologistsdiscuss sexuality with PD patients. A 22-item questionnairewas sent to 139 neurologists specializing in PD. The surveycontained questions about their attitudes, knowledge, andpractice patterns with respect to sexual dysfunction (SD) inpatients with PD. The response rate of the survey was66.9%. Most participants (56.8%) stated that they addresssexuality in less than half of their PD patients. High age ofpatients (42.0%), insufficient consultation time (37.5%),and a lack of patients’ initiative to raise the topic them-selves (36.4%) were frequently reported barriers towardsdiscussing sexuality. The majority of participants consid-ered that discussing sexuality is a responsibility that laywith neurologists (85.2%), nurses (73.9%), and patients(72.7%). One quarter of the neurologists reported to haveinsufficient or no knowledge on SD. The majority of par-ticipants regarded screening for SD important or slightlyimportant (85.2%). A large proportion of Dutch neurolo-gists specializing in PD do not routinely discuss sexualitywith their PD patients. Sexual healthcare in PD patientsmay benefit from time-efficient tools and agreements onwho is responsible for discussing SD. Furthermore, rec-ommendations in PD guidelines on screening and manag-ing SD should be adapted to fit everyday practicehttps://creativecommons.org/licenses/by/4.0/ CC BY 4.0https://creativecommons.org/licenses/by/4.0/
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Background: Sexual deviance is regarded as an important risk factor for sexual offending. However, little is known about the development of deviant sexual interests. The transfer of arousal between emotions, i.e., excitation transfer, could attribute sexual salience to stimuli that would otherwise not be sexual in nature. As such, excitation transfer could contribute to the very beginning of unusual or deviant sexual interests. The current protocol proposes a study to investigate to what extent excitation transfer occurs, i.e., to what extent genital and subjective sexual arousal to sexual stimuli is higher in an emotional state than in a neutral state. Following a prior pilot study, several adjustments were made to the study protocol, including a stronger emotional manipulation by using 360-degree film clips and the inclusion of a larger and more sexually diverse sample. Methods: We will recruit 50 adult male volunteers with diverse sexual interests. We will induce sexual arousal in four different emotional states (aggression/dominance, endearment, fear, disgust) and a neutral state. Sexual arousal will be measured genitally using penile plethysmography and subjectively via self-report. Using paired samples t-tests, sexual arousal in the emotional states will be compared with sexual arousal in the neutral state. Discussion: We aim to show that arousal in response to emotional stimuli that are initially nonsexual in nature, can enhance sexual arousal. These findings have potentially important implications for the development of unusual and/or deviant sexual interests and possibly for the treatment of such sexual deviant interests in people who have committed sexual offenses.
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PurposeThis study evaluated current fertility care forCKD patients by assessing the perspectives of nephrolo-gists and nurses in the dialysis department.MethodsTwo different surveys were distributed forthis cross-sectional study among Dutch nephrologists(N=312) and dialysis nurses (N=1211). ResultsResponse rates were 50.9% (nephrologists) and45.4% (nurses). Guidelines on fertility care were presentin the departments of 9.0% of the nephrologists and 15.6%of the nurses. 61.7% of the nephrologists and 23.6% ofthe nurses informed ≥50% of their patients on potentialchanges in fertility due to a decline in renal function.Fertility subjects discussed by nephrologists included “wishto have children” (91.2%), “risk of pregnancy for patients’health” (85.8%), and “inheritance of the disease” (81.4%).Barriers withholding nurses from discussing FD werebased on “the age of the patient” (62.6%), “insufficienttraining” (55.2%), and “language and ethnicity” (51.6%).29.2% of the nurses felt competent in discussing fertility,8.3% had sufficient knowledge about fertility, and 75.7%needed to expand their knowledge. More knowledge andcompetence were associated with providing fertility healthcare (p< 0.01). ConclusionsIn most nephrology departments, the guide-lines to appoint which care provider should provide fertil-ity care to CKD patients are absent. Fertility counselingis routinely provided by most nephrologists, nurses oftenskip this part of care mainly due to insufficiencies in self-imposed competence and knowledge and barriers based oncultural diversity. The outcomes identified a need for fer-tility guidelines in the nephrology department and trainingand education for nurses on providing fertility care. CC BY 4.0https://creativecommons.org/licenses/by/4.0/
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Introduction: Hardly any research exists on the relationship between substance use and sexual behaviors in patients with a substance use disorder. This study aimed to examine this relation by looking into perceived positive effects on sexual behavior, perceived negative effects and risky sexual behavior due to substance use in patient groups of users of alcohol, stimulants, sedatives and Gamma hydroxybutyrate (GHB). In addition, the current study aimed to address the question whether sexual behavior (e.g. number of sexual partners, sexualactivity) differs between these patient groups.Method: A total of 180 patients with a substance use disorder (i.e. alcohol, amphetamine, cannabis, cocaine, GHB and opiates) participated. A self-report questionnaire was administered with questions on substance use,sexual behaviors (e.g. sexual activity, masturbation, use of pornography) and statements about the perceived changes in sexual functioning and behavior under influence of the primary substance of abuse.Results: All four groups reported changes in sexual thoughts, feelings and behavior due to the use of their primary substance. More than half of the patients reported enhancements in sexual domains (i.e. sexual pleasure,sexual arousal, sexual behavior), but also decrements or risky behaviors and about a quarter stated that their sexual thoughts, feelings and behaviors were often associated with the use of their primary substance of abuse.Patients with a GHB use disorder reported the strongest relation between drug use and sexual behavior. Users of HB not only reported more enhancement in several sexual domains, but also less decline in sexual domains compared to the other patient groups and more risky behavior or more sexual activity than some of the other groups of patients.Conclusions: The results underline the importance of addressing the relationship between substance use and sexual behavior in treatment programs, as patients may be hesitant to stop their use of substances when they experience many positive effects in their sexual behavior. Future research directions are suggested.
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