Evaluating the User Experience of a Smartphone-Delivered Sexual Health Promotion Program for Older Adults in the Netherlands: Single-Arm Pilot Study.

BACKGROUND: Sexual health is an important component of quality of life in older adults. However, older adults often face barriers to attaining a fulfilling sexual life because of issues such as stigma, lack of information, or difficult access to adequate support. OBJECTIVE: We aimed to evaluate the user experience of a self-guided, smartphone-delivered program to promote sexual health among older adults. METHODS: The mobile app was made available to community-dwelling older adults in the Netherlands, who freely used the app for 8 weeks. User experience and its respective components were assessed using self-developed questionnaires, the System Usability Scale, and semistructured interviews. Quantitative and qualitative data were descriptively and thematically analyzed, respectively. RESULTS: In total, 15 participants (mean age 71.7, SD 9.5 years) completed the trial. Participants showed a neutral to positive stance regarding the mobile app's usefulness and ease of use. Usability was assessed as "Ok/Fair." The participants felt confident about using the mobile app. To increase user experience, participants offered suggestions to improve content and interaction, including access to specialized sexual health services. CONCLUSIONS: The sexual health promotion program delivered through a smartphone in a self-guided mode was usable. Participants' perception is that improvements to user experience, namely in content and interaction, as well as connection to external services, will likely improve usefulness and acceptance.

Biopsychosocial determinants of sexual health in older age: the role of health-related, relationship, and psychosexual factors.

BACKGROUND: Given the unprecedented aging of the population and the increased focus on overall well-being in older age, investigating the determining factors of sexual well-being in older adults becomes essential as it offers insights into promoting healthy aging and overall quality of life. AIM: By applying the biopsychosocial model of sexuality in older age, we aimed to identify the role of biomedical and psychosocial factors in predicting sexual well-being in partnered older adults (≥55 years old). METHODS: A total of 111 participants (mean [SD], 63.2 [5.96]) completed a self-report questionnaire assessing biopsychosocial dimensions. Bivariate correlational analyses and hierarchical multiple regression were conducted to investigate factors associated with sexual well-being. Health-related factors were entered into the first regression model. The second model included factors pertaining to relationship dimensions. Sexual beliefs were introduced in the third regression model. OUTCOMES: Self-rated health, psychological distress, subjective cognitive decline, sexual beliefs, duration of the relationship, relationship satisfaction, and sexual well-being were assessed. RESULTS: Findings from the hierarchical regression revealed that duration of relationship [t(104) = -3.07, P < .01], relationship satisfaction [t(104) = 8.49, P < .001], and age-related sexual beliefs [t(104) = -2.75, P < .01] were significant predictors of sexual well-being of partnered older adults [F(6, 104) = 22.77, P < .001, R2 = .57], after controlling for health-related factors. These findings suggest that relationship factors and sexual beliefs play a significant role in predicting sexual well-being of older adults, above and beyond health-related dimensions. CLINICAL IMPLICATIONS: Interventional approaches aimed at promoting sexual well-being in older age might benefit from incorporating exercises that demystify age-related sexual beliefs, by normalizing changes that occur with aging and fostering positive attitudes toward sexual expression in older age; particularly for older adults in long-term relationships, relationship satisfaction must also be considered as an important intervention target. STRENGTHS AND LIMITATIONS: Further investigation using longitudinal designs is required to examine the causal links between these factors and sexual well-being in older age. CONCLUSION: Findings from this study underscore the role of relationship dimensions and age-related sexual beliefs for the sexual well-being of partnered older adults.

Promoting Sexual Health in Colorectal Cancer Patients and Survivors: Results from a Systematic Review.

BACKGROUND: Colorectal cancer diagnosis and treatment negatively impact sexual health. However, there is still a lack of interventions targeting the sexual healthcare needs of colorectal cancer patients and survivors. This systematic review aimed to identify and summarize the efficacy of available psychological interventions aimed at improving colorectal cancer patients' and survivors' sexual health. METHODS: This review followed PRISMA guidelines for systematic reviews. A database search was conducted for studies published until July 2023 on EBSCO Host, Web of Science, PubMed, and the Cochrane Library. Manuscripts were screened according to inclusion and exclusion criteria. The risk of bias was assessed using the Quality Assessment Tool for Quantitative Studies. RESULTS: From the 1499 records screened, four studies describing psychological interventions to improve the sexual health of the target population were identified. All studies reported on e-health programs and showed evidence of their efficacy in the improvement of participants' sexual function. The studies presented low scores on the Quality Assessment Tool for Quantitative Studies. CONCLUSIONS: Despite the evidence that tele/e-health psychological interventions have the potential to effectively promote sexual health in colorectal cancer patients and survivors, more robust research is needed to allow for generalization. Future research should further assess the efficacy of e-health interventions (eMental Health) in promoting sexual health in patients with colorectal cancer.

Longitudinal associations between relational and sexual well-being in couples transitioning to parenthood.

There is limited understanding of the dynamic between relational and sexual well-being as couples adjust to new parenthood, despite this being a vulnerable period for couples' relationships. This study was aimed at examining the bidirectional links between relationship quality and sexual well-being (i.e., sexual satisfaction, sexual distress) across the transition to parenthood. We assessed new parent couples (N = 257) across four time points (two prenatal) from mid-pregnancy through 6 months postpartum. Parallel dyadic latent growth curve modeling was employed to examine the associations between trajectories of perceived relationship quality, sexual satisfaction, and sexual distress. New parents' declines in relationship quality were associated with declines in own and partners' sexual satisfaction and with increases in own sexual distress. Mothers' prenatal relationship quality and sexual distress predicted subsequent changes in own sexual distress and fathers' relationship quality, respectively. Results indicate that changes to new parents' relational and sexual well-being mutually influence each other over time. Current results indicate that the impact of the transition on couples' relationships is partly determined by own and partners' prenatal factors, to which clinicians and researchers can attend to early on. Cross-domain links between relational and sexual well-being should be considered in research and clinical practice.

Psychometric Validation of the Portuguese Version of the Sexual Self-Consciousness Scale (SSCS).

The Sexual Self-Consciousness Scale (SSCS) is an instrument for assessing dispositional propensities for self-consciousness experienced in a sexual context, with wide application in both clinical and research settings. The objective of the current study was to test some psychometric characteristics of the Portuguese version of the SSCS using a convenience sample of 210 men and 210 women. Participants completed a sociodemographic questionnaire and the Portuguese version of the SSCS. A subsample of 87 participants was assessed at a second time point after a 2-week period for measuring test-retest reliability of the instrument. Confirmatory factor analysis identified two factors and replicated the structure of the original instrument. Measurement invariance was confirmed for men and women with overall index scores indicating a good fit in all models. Reliability analyses indicated that the factors possessed both satisfactory internal consistency and stability over time. The Portuguese version of the SSCS was shown to be a useful and adequate instrument to assess dispositional propensities for self-consciousness in sexual situations within the Portuguese-speaking population.

Mapping the contributions of dyadic approaches to couples' psychosocial adaptation to prostate cancer: a scoping review.

INTRODUCTION: Prostate cancer is the second-most prevalent cancer diagnosis worldwide among males. Although prostate cancer affects the physical, sexual, and mental health of patients, the impact of prostate cancer on partners has also been increasingly recognized. Hence, taking a dyadic approach is of relevance. Moreover, there is evidence of the utility of dyadic approaches to the study of relational stress that chronic diseases such as prostate cancer can bring to couples, even though knowledge is sparse about prostate cancer. OBJECTIVES: This scoping review aimed to map existing dyadic studies on the psychosocial adaptation of couples to prostate cancer. METHODS: A systematic search of studies published from 2005 to November 2022 was conducted on electronic databases (PubMed, Cochrane Library, EBSCOHost, Scopus, and Web of Science) following PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-analyses-Extension for Scoping Reviews). RESULTS: The review included 25 eligible studies from the initial 2514 articles retrieved. Overall, the results emphasized the interdependency between couple members and suggested how partners' adaptation influences patients' adaptation to prostate cancer and vice versa, regarding several psychosocial dimensions (eg, intimacy, quality of life). CONCLUSIONS: This work can bring awareness to health care professionals to adopt a couples approach when managing prostate cancer whenever there is a partner, due to these interdependent influences. For researchers and future studies, this work can strengthen the relevance of dyadic approaches on how couples adapt to prostate cancer and explore which other dimensions influence these complex dynamics.

The effect of emotional regulation difficulties on sexual and psychological distress using repetitive negative thinking as a mediator.

BACKGROUND: Sexual distress, a determinant factor in diagnosing sexual dysfunction, plays a significant role in individuals' sexual well-being, yet it has been overlooked in research. AIM: This exploratory study adopted a transdiagnostic approach to sexual distress and sought to examine the association between emotional regulation difficulties and sexual and psychological distress, with repetitive negative thinking as a potential mediator. METHODS: We used a quantitative cross-sectional design with a sample of 509 partnered individuals. OUTCOMES: The survey included a sociodemographic questionnaire, the Difficulties in Emotion Regulation Scale-Short Form, the Kessler Psychological Distress Scale, the Persistent and Intrusive Negative Thoughts Scale, and the Female Sexual Distress Scale-Revised. RESULTS: Correlational analysis revealed significant associations among emotional regulation difficulties, repetitive negative thinking, psychological distress, and sexual distress. Furthermore, a mediation model demonstrated that repetitive negative thinking significantly mediated emotion dysregulation and psychological and sexual distress. CLINICAL IMPLICATIONS: These findings underscore the importance of considering emotion regulation difficulties and repetitive negative thinking as a maladaptive coping strategy when evaluating sexual distress and suggest that therapeutic interventions targeting such difficulties and thoughts may yield beneficial outcomes. STRENGTHS AND LIMITATIONS: These findings reinforce the importance of considering the role of emotional regulation difficulties and, consequently, repetitive negative thinking as a dysfunctional coping strategy, when studying and intervening in sexual distress. Future research with clinical samples should be developed to establish better the significance of considering these two dimensions in assessment and therapeutic intervention. CONCLUSION: Future research should corroborate and expand upon these findings to advance our understanding of sexual distress and optimize interventions in this domain.

A systematic review on the efficacy of CBT interventions for the mental and sexual health of survivors of prostate cancer.

INTRODUCTION: Prostate cancer (PCa) is the second-most frequently diagnosed oncologic condition among biological men, affecting physical and psychological well-being, as well as sexual health and quality of life. Prior research has shown that cognitive-behavioral therapy (CBT) can be effective in addressing a range of psychological and sexual problems but also in improving the sexual and mental health of survivors of PCa. OBJECTIVES: This systematic review aimed to methodically research and summarize results concerning the efficacy of CBT in the mental and sexual health of survivors of PCa. METHODS: A systematic search was carried out via electronic databases until August 2022 (EBSCO, MEDLINE, Cochrane Library, and Web of Science). By combining specific search words and following the PRISMA checklist, we identified 15 eligible articles among 8616 initial records. RESULTS: Four studies showed evidence of intervention efficacy for the improvement of sexual health, specifically for overall sexual function, erectile function, sexual desire, and sexual satisfaction. Eight studies found intervention efficacy for the improvement of mental health dimensions, such as psychological distress, depressive symptoms, anxiety, and quality of life. CONCLUSION: There is evidence that CBT interventions have the potential to effectively promote mental and sexual health in survivors of PCa, but further research comprising larger and more diverse populations is needed. Future studies should focus on understanding mechanisms of change through CBT interventions to ensure the mental and sexual health of survivors of PCa.

The Role of Men's Sexual Beliefs on Sexual Function/Dysfunction: A Systematic Review.

Cognitive models of sexual dysfunction postulate that inflexible, unrealistic, and erroneous sexual beliefs work as a vulnerability factor for the development of sexual dysfunctions and existing studies give some support to this hypothesis. However, to date, there is no published systematic review of studies testing the association between men's sexual beliefs and sexual functioning. This systematic review was conducted from searches using EBSCO, PubMed, and Web of Science databases identifying peer-reviewed studies and gray literature sources from inception to November 2021. Twenty cross-sectional studies, assessing correlations between the degree of endorsement of sexual beliefs and sexual functioning and comparing endorsement of sexual beliefs in men with and without sexual problems were included. Despite the small effect sizes, results indicate that higher endorsement of inflexible/unrealistic/erroneous sexual beliefs is associated with poorer sexual functioning and that men presenting with sexual problems tend to report higher endorsement of these sexual beliefs. Further research with clinical samples as well as longitudinal studies are necessary to explore the ways these associations emerge and develop. The state of evidence on this research topic, including gaps and limitations, is discussed.

A Smartphone-Delivered Program (Anathema) to Promote the Sexual Health of Older Adults, Colorectal Cancer Survivors, and Stroke Survivors: Protocol for a Feasibility Pilot Randomized Controlled Trial.

BACKGROUND: Despite the prevalence of sexual distress and dysfunction in older adults in general and stroke and colorectal cancer survivors in particular, access to specialized care is limited by organizational barriers and stigma, embarrassment, and discrimination. The internet allows reaching services that would otherwise be difficult or impossible to reach, and as smartphones are personal (intimate) technologies, they are a promising vehicle to close this gap. However, research focusing on smartphone-delivered sexual health promotion programs is scarce. OBJECTIVE: This study aims to assess the acceptability, feasibility, and preliminary efficacy of Anathema, an 8-week, iOS/Android smartphone-delivered, individually tailored, cognitive-behavioral sexual health promotion program developed to improve relationship and sexual satisfaction, sexual functioning, sexual distress, sexual pleasure, and health-related quality of life (HRQoL) in older adults, colorectal cancer survivors, and stroke survivors compared to treatment as usual in a waiting-list control condition. METHODS: Two-arm, parallel, open-label, waiting list, feasibility, pilot randomized controlled trials (RCTs) will be conducted involving older adults, stroke survivors, and colorectal cancer survivors. The primary outcomes are the acceptability, usability, and feasibility of Anathema. Sexual function, relationship and sexual satisfaction, sexual pleasure, sexual distress, anxiety, depression, and HRQoL are the secondary outcomes. This study has been reviewed and approved by the ethics committees of Instituto Português de Oncologia do Porto Francisco Gentil, Europacolon Portugal, Faculty of Psychology and Educational Sciences, University of Porto, and Sigmund Freud University (approval numbers: CES218R/021, CES19/023, and 2022/01-05b). RESULTS: This project is funded by the European Commission through the Active and Assisted Living (AAL) Programme (reference: AAL-2020-7-133-CP) from April 2021 to December 2023. Recruitment for the pilot RCTs started on January 2023 in Portugal, Austria, and the Netherlands and is currently ongoing. As of May 2023, we randomized 49 participants in the trials. We expect to complete the RCTs in September 2023. The results on the acceptability, feasibility, and preliminary efficacy of Anathema are expected in the second semester of 2023. We expect Anathema to be highly accepted by the populations under study; to prove feasible to scale up to parent RCTs; and to be potentially efficacious in improving sexual functioning, relationship and sexual satisfaction, sexual distress, sexual pleasure, and HRQoL in older adults, colorectal cancer survivors, and stroke survivors compared to treatment as usual in a waiting-list control condition. The study results will be published in open-access venues according to COREQ (Consolidated Criteria for Reporting Qualitative Research) and CONSORT EHEALTH (Consolidated Standards of Reporting Trials of Electronic and Mobile Health Applications and Online Telehealth) guidelines. CONCLUSIONS: The study results will inform the refinement and scale-up of Anathema. Anathema's wider-scale implementation can potentially promote the sexual health of largely neglected user groups such as older adults, colorectal cancer survivors, and stroke survivors. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/46734.

Sexual boredom and sexual desire in long-term relationships: a latent profile analysis.

BACKGROUND: Research suggests a general link between sexual boredom and sexual desire, but its understanding is currently very limited. AIM: To identify distinct (latent) groups of women and men in long-term relationships based on their reported levels of sexual boredom and sexual desire. METHODS: Latent profile analysis (LPA) was conducted in an online sample of 1223 Portuguese participants aged 18 and 66 years (mean ± SD, 32.75 ± 6.11), using indicators of sexual boredom and partner-related, attractive other-related, and solitary sexual desire to categorize participants. Multinomial logistic regression analysis was carried out to explore predictors and correlates of the latent profiles. OUTCOMES: Sexual boredom was assessed by the Sexual Boredom Scale, while sexual desire was measured with the Sexual Desire Inventory. RESULTS: As compared with women, men reported higher levels of sexual boredom and sexual desire. LPA indicated 3 profiles in women and 2 profiles in men. Among women, P1 was characterized by above-average sexual boredom, below-average partner- and attractive other-related sexual desire, and very low solitary sexual desire; P2 by below-average sexual boredom, attractive other-related sexual desire, and solitary sexual desire and above-average partner-related sexual desire; and P3 by above-average sexual boredom, attractive other-related sexual desire, and solitary sexual desire and below-average partner-related sexual desire. In men, P1 was characterized by high sexual boredom, above-average partner-related sexual desire, and high attractive other-related and solitary sexual desire and P2 by below-average sexual boredom and above-average partner-related, attractive other-related, and solitary sexual desire. The latent profiles did not differ according to relationship duration. Overall, the sole consistent correlate of the latent categorization was sexual satisfaction. CLINICAL IMPLICATIONS: In women, above-average levels of sexual boredom were linked to below-average levels of partner-related desire, which suggests likely benefits of helping the couple to minimize or cope better with their sexual routines. In men, participants in the 2 profiles did not differ in partner-related sexual desire, suggesting that clinical interventions dealing with male sexual boredom should investigate factors beyond the current relationship. STRENGTHS AND LIMITATIONS: This study explored different facets of sexual desire and used LPA, rendering advantages over previous research. The male sample has lower statistical power than the female sample. CONCLUSION: Patterns of sexual boredom and sexual desire among individuals in long-term monogamous relationships are distinct and consistently related to sexual satisfaction in women and men and to relationship satisfaction among only women, which have important clinical ramifications.

Longitudinal associations between mindfulness and changes to body image in first-time parent couples.

Pregnancy and postpartum are associated with declines in body image. Research on postpartum body image focuses almost exclusively on the person who gave birth and studies examining protective factors for postpartum body image are scarce. We assessed 257 new-parent couples from mid-pregnancy to 6-months postpartum to examine whether mindfulness-a recognized contributor to psychological well-being-buffered against declines in both partners' perceptions of mothers' body. Mothers' positive body image and partners' perception of mothers' body were collected at four time-points (second and third trimester; 3- and 6-months postpartum); both partners' mindfulness facets-observing, describing, awareness acting, non-judgement, and non-reactivity-were assessed in the second trimester. Dyadic latent growth curve modeling revealed that both partners' perceptions of mothers' body were positively correlated at all moments; however, mothers' positive body image worsened over time, whereas partners' perception of mothers' body remained stable. Mindfulness facets were positively associated with mothers' positive body image (observe, describe, and non-judging) and fathers' (non-judging) perceptions of mothers' body in pregnancy. Mothers' mindfulness facets (acting with awareness, non-judging) were associated with subsequent trajectories of their own body image. By identifying mindfulness facets as targetable protective factors during pregnancy, these findings have implications for future research and interventions focused on perinatal body image.

Biopsychosocial Predictors of Couples' Trajectories of Sexual Function and Sexual Distress Across the Transition to Parenthood.

The prevailing narrative about sexual declines during the transition to parenthood is largely based on studies assessing the average couple, but there is increasing evidence of variability in the sexual well-being of new parents. We sought to establish distinct subgroups of couples based on sexual function and sexual distress trajectories and examine biopsychosocial risk and protective factors of these trajectories. A prospective cohort of 257 first-time parent couples reported on sexual function and sexual distress from 20-week pregnancy (baseline) to 6 months postpartum across four time-points. Biopsychosocial factors were assessed at baseline and 3 months postpartum. Dyadic latent class growth analysis identified two distinct sexual function classes (high, 85%; discrepant, 15%) and three sexual distress classes (low, 77%; moderate, 12%; discrepant, 11%). We identified biomedical (vaginal delivery, perineal tear, breastfeeding) and psychosocial (fatigue, stress, anxiety, depression, attitudes toward sex during pregnancy, relationship quality, perceived partner support) factors that can be assessed at critical time-points (i.e., 20-week pregnancy and 3 months postpartum) to identify high-risk couples. Current results indicate that the course of change in sexual well-being for new parents is heterogeneous, with most new parents retaining high function and low distress and only a minority showing trajectories in which mothers, but not fathers, experience clinically significant and persistent levels of low sexual function and high sexual distress. These results may facilitate more nuanced approaches to the assessment and intervention of new parents' sexual well-being.

Changes in Intimacy and Sexuality During the COVID-19 Pandemic: A Qualitative Analysis of Data from a Survey on Partnered Individuals in Eight European Countries.

This qualitative study explores experiences of intimacy and sexuality during the first phase of the COVID-19 pandemic of 3357 participants from Croatia, the Czech Republic, the Netherlands, France, Germany, Portugal, Sweden, and Turkey. Data were collected through open-ended questions within a survey on sexuality during the pandemic. Based on a reflexive thematic analysis three themes occurred. The first theme No change was described by 41% when summarizing their sex life during the pandemic. The second theme Positive change was experienced by 25%, and the third theme Negative change by 21%. An overarching theme then emerged as: "Still the same trajectories, but the pandemic could be a catalyst for improved or worsened sex- life." For those intimate partnered individuals who already had problems with intimacy and sexuality before the COVID-19 pandemic it seemed to remain the same or deteriorated throughout the pandemic. For those with positive experiences of intimacy and sexuality before the COVID-19 pandemic it remained the same or improved throughout the pandemic. These findings are relevant for researchers and clinicians in developing preventive and supportive interventions in the context of crisis and social isolation.

Questionário I-SHARE Brasil: adaptação do português de Portugal para o português do Brasil / I-SHARE Brazil questionnaire: adaptation from Portuguese to Brazilian Portuguese

A pandemia de COVID-19 trouxe desafios acrescidos aos já existentes, em termos de acesso aos serviços, respostas adequadas, garantia de direitos, entre outros, para a área da saúde sexual e reprodutiva no Brasil e no mundo. A pesquisa "International Sexual Health and Reproductive Health Survey" (I-SHARE), um estudo global desenvolvido em mais de 40 países, surge da necessidade de investigar essa situação, sendo necessário criar e adaptar instrumentos capazes de captar esta nova realidade mundial. O objetivo do presente artigo é apresentar o processo de adaptação do questionário I-SHARE de português de Portugal para o português do Brasil. A versão brasileira do questionário I-SHARE incluiu 15 grandes blocos de questões relacionadas a COVID-19, violência e saúde sexual e reprodutiva. A adaptação obrigou a acomodar diferenças linguísticas, culturais e institucionais de diferente natureza. O pré-teste, realizado com 10 pessoas, revelou uma boa aceitação, não se tendo verificado dificuldades de compreensão e análise por parte dos/as participantes. Conclui-se que o questionário I-SHARE Brasil, além de ter servido uma pesquisa particular no contexto da pandemia de COVID-19, poderá ser adaptado a outras realidades e estudos futuros no âmbito da saúde sexual e reprodutiva no Brasil.

The COVID-19 pandemic brought increased challenges regarding access to services, adequate responses, guaranteeing rights, among others, for the area of sexual and reproductive health in Brazil and around the world. The "International Sexual Health and Reproductive Health Survey" (I-SHARE), a global study carried out in more than 40 countries, arises from the need to investigate this situation, making it necessary to create and adapt instruments capable of capturing this new global reality. The objective of this article is to present the process of adapting the I-SHARE questionnaire from Portuguese to Brazilian Portuguese. The Brazilian version of the I-SHARE questionnaire included 15 large blocks of questions related to COVID-19, violence and sexual and reproductive health. Adaptation forced to accommodate linguistic, cultural and institutional differences of different nature. The pre-test, carried out with 10 people, revealed good acceptance, with no difficulties in understanding or analyzing on the part of the participants. It is concluded that the I-SHARE Brazil questionnaire, in addition to having served as a particular research in the context of the COVID-19 pandemic, can be adapted to other realities and future studies in the field of sexual and reproductive health in Brazil.

A Systematic Review on Psychological Interventions for Sexual Health in Older Age.

Objectives: The present review aims to identify the existing evidence on outcome-treatment studies of psychological sexual health interventions in older age. Methods: A systematic search was conducted for studies published until October 2022. Data search was conducted on EBSCO, MEDLINE, Web of Science, and Cochrane Central Register of Controlled Trials databases. Results: From 30,840 screened records, 12 reports were selected. Results were grouped into four categories according to the intervention that was implemented. Conclusions: Despite results presenting some bias concerns, this review suggests that educational and cognitive-behavioral approaches seem to be effective for promoting sexual health in older age.

A systematic review of sexual health and subjective well-being in older age groups.

Objectives: This systematic review aimed at assessing the associations between sexual health and subjective well-being in older age groups (i.e. people aged between 40 and ≥90 years). Methods: A systematic search was conducted of the Web of Science, MEDLINE, EBSCO, Scopus, SciELO and LILACS (Latin American and Caribbean Health Sciences Literature) databases for studies published until September 2021. Search strings included a combination of terms such as "sexual health" or "sexuality" and "well-being" and terms related to the measures that assess the constructs of interest. This systematic review followed PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Results were grouped into four categories that assess the interplay between sexual health and subjective well-being: cognitive and attitudinal factors, sexual behavior, sexual function and sexual satisfaction. The subjective well-being domains that were analyzed were life satisfaction, positive and negative affect, and psychological well-being. Results: A total of 15 quantitative studies were reviewed, of which 14 were articles and 1 was a doctoral dissertation. Findings suggest that living a fulfilling sexual life is an essential part of subjective well-being. Conclusions: This review suggests that programs aiming to promote well-being in older age groups should also encourage a fulfilling sexual life.

A systematic review of sexual health and subjective well-being in older age groups

[ABSTRACT]. Objectives. This systematic review aimed at assessing the associations between sexual health and subjective well-being in older age groups (i.e. people aged between 40 and ≥90 years). Methods. A systematic search was conducted of the Web of Science, MEDLINE, EBSCO, Scopus, SciELO and LILACS (Latin American and Caribbean Health Sciences Literature) databases for studies published until September 2021. Search strings included a combination of terms such as “sexual health” or “sexuality” and “well-being” and terms related to the measures that assess the constructs of interest. This systematic review followed PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Results were grouped into four categories that assess the interplay between sexual health and subjective well-being: cognitive and attitudinal factors, sexual behavior, sexual function and sexual satisfaction. The subjective well-being domains that were analyzed were life satisfaction, positive and negative affect, and psychological well-being. Results. A total of 15 quantitative studies were reviewed, of which 14 were articles and 1 was a doctoral dis- sertation. Findings suggest that living a fulfilling sexual life is an essential part of subjective well-being. Conclusions. This review suggests that programs aiming to promote well-being in older age groups should also encourage a fulfilling sexual life.

[RESUMEN]. Objetivos. El objetivo de esta revisión sistemática es evaluar las asociaciones entre salud sexual y bienestar subjetivo en grupos de mayor edad (es decir, personas entre 40 y 90 años o más). Métodos. Se realizó una búsqueda sistemática en las bases de datos Web of Science, MEDLINE, EBSCO, Scopus, SciELO y LILACS (Literatura Latinoamericana y del Caribe en Ciencias de la Salud) de estudios publicados hasta septiembre del 2021. Las cadenas de búsqueda incluyeron una combinación de términos como “salud sexual” o “sexualidad” y “bienestar” y términos relacionados con las medidas que evalúan los constructos de interés. Esta revisión sistemática siguió las directrices PRISMA (sigla en inglés de elementos de referencia para publicar revisiones sistemáticas y metaanálisis). Los resultados se agruparon en cuatro categorías que evalúan la interacción entre la salud sexual y el bienestar subjetivo: factores cognitivos y acti- tudinales, comportamiento sexual, función sexual y satisfacción sexual. Los dominios de bienestar subjetivo analizados fueron la satisfacción vital, el afecto positivo y negativo y el bienestar psicológico. Resultados. Se revisaron 15 estudios cuantitativos en total: 14 artículos y 1 tesis doctoral. Los resultados indican que experimentar una vida sexual satisfactoria es una parte esencial del bienestar subjetivo. Conclusiones. Esta revisión sugiere que los programas destinados a promover el bienestar en los grupos de mayor edad también deben fomentar una vida sexual satisfactoria.

[RESUMO]. Objetivos. Esta revisão sistemática teve como objetivo avaliar as associações entre saúde sexual e bem-estar subjetivo em faixas etárias mais velhas (ou seja, pessoas com idade entre 40 e 90 anos ou mais). Métodos. Foi realizada uma pesquisa sistemática nas bases de dados Web of Science, MEDLINE, EBSCO, Scopus, SciELO e LILACS (Latin American and Caribbean Health Sciences Literature) para estudos publica- dos até setembro de 2021. Os termos de busca incluíram uma combinação de termos como “saúde sexual” ou sexualidade” e ”bem-estar”, e termos relacionados às medidas que avaliam os construtos de interesse. A revisão sistemática seguiu as diretrizes PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). Os resultados foram agrupados em quatro categorias de avaliação da interação entre saúde sexual e bem-estar subjetivo: fatores cognitivos e atitudinais, comportamento sexual, função sexual e satis- fação sexual. Os domínios de bem-estar subjetivo analisados foram satisfação com a vida, afeto positivo e negativo, e bem-estar psicológico. Resultados. Foram revisados 15 estudos quantitativos, sendo 14 artigos e uma tese de doutorado. Os resul- tados sugerem que viver uma vida sexual plena é uma parte essencial do bem-estar subjetivo. Conclusões. Esta revisão sugere que os programas destinados a promover bem-estar nas faixas etárias mais velhas também devem incentivar uma vida sexual plena.

Verbenaceae from the Parque Estadual do Biribiri, Minas Gerais State, Brazil / Verbenaceae no Parque Estadual do Biribiri, Estado de Minas Gerais, Brasil

We present the floristic treatment for the Verbenaceae from the Parque Estadual do Biribiri, located at the Diamantina Plateau, Espinhaço Range, State of Minas Gerais. With a current extension of 16,998.66 ha, this state conservation unit integrates an area of special biological importance, with vegetation represented predominantly by campos rupestres. After fieldwork and herbaria consultation we found 14 taxa of Verbenaceae included in three genera: Lantana fucata, Lippia alba, Lippa corymbosa, Lippia diamantinensis, Lippia hederifolia, Lippia hermannioides, Lippia lacunosa, Lippia origanoides, Lippia pseudothea, Lippia raoniana, Lippia rotundifolia, Lippia stachyoides var. martiana, Stachytarpheta glabra and Stachytarpheta reticulata. We highlight the occurrence of Lippia raoniana, preliminarily assessed as critically endangered, within the limits of the Park, expanding the knowledge about its geographic distribution. In order to recognize each taxon, we provided morphological descriptions, identification key, pictures, along with taxonomic and ecological comments.

Apresentamos o tratamento florístico de Verbenaceae no Parque Estadual do Biribiri, localizado no Planalto de Diamantina, Cadeia do Espinhaço, Estado de Minas Gerais. Com extensão atual de 16.998,66 ha, essa Unidade de Conservação estadual integra uma área de importância biológica especial, com vegetação representada predominantemente por campos rupestres. Após o estudo de campo e consulta a herbários nós encontramos 14 táxons de Verbenaceae incluídos em três gêneros: Lantana fucata, Lippia alba, Lippia corymbosa, Lippia diamantinensis, Lippia hederifolia, Lippia hermannioides, Lippia lacunosa, Lippia origanoides, Lippia pseudothea, Lippia raoniana, Lippia rotundifolia, Lippia stachyoides var. martiana, Stachytarpheta glabra e Stachytarpheta reticulata. Destacamos a ocorrência de Lippia raoniana, preliminarmente avaliada como criticamente ameaçada, dentro dos limites do Parque, expandindo o conhecimento sobre sua distribuição geográfica. Para reconher cada táxon, nós fornecemos descrições morfológicas, chave de identificação, fotografias, juntamente com comentários taxonômicos e ecológicos.

Human metabolic emissions of carbon dioxide and methane and their implications for carbon emissions.

Carbon dioxide (CO2) and methane (CH4) are important greenhouse gases in the atmosphere and have large impacts on Earth's radiative forcing and climate. Their natural and anthropogenic emissions have often been in focus, while the role of human metabolic emissions has received less attention. In this study, exhaled, dermal and whole-body CO2 and CH4 emission rates from a total of 20 volunteers were quantified under various controlled environmental conditions in a climate chamber. The whole-body CO2 emissions increased with temperature. Individual differences were the most important factor for the whole-body CH4 emissions. Dermal emissions of CO2 and CH4 only contributed ~3.5% and ~5.5% to the whole-body emissions, respectively. Breath measurements conducted on 24 volunteers in a companion study identified one third of the volunteers as CH4 producers (exhaled CH4 exceeded 1 ppm above ambient level). The exhaled CH4 emission rate of these CH4 producers (4.03 ± 0.71 mg/h/person, mean ± one standard deviation) was ten times higher than that of the rest of the volunteers (non-CH4 producers; 0.41 ± 0.45 mg/h/person). With increasing global population and the expected large reduction in global anthropogenic carbon emissions in the next decades, metabolic emissions of CH4 (although not CO2) from humans may play an increasing role in regional and global carbon budgets.