Global cross-cultural validation of a brief measure for identifying potential suicide risk in 42 countries.

OBJECTIVES: This study aimed to examine the psychometric properties of the P4 suicide screener in a multinational sample. The primary goal was to evaluate the reliability and validity of the scale and investigate its convergent validity by analyzing its correlation with depression, anxiety, and substance use. STUDY DESIGN: The study design is a cross-sectional self-report study conducted across 42 countries. METHODS: A cross-sectional, self-report study was conducted in 42 countries, with a total of 82,243 participants included in the final data set. RESULTS: The study provides an overview of suicide ideation rates across 42 countries and confirms the structural validity of the P4 screener. The findings indicated that sexual and gender minority individuals exhibited higher rates of suicidal ideation. The P4 screener showed adequate reliability, convergence, and discriminant validity, and a cutoff score of 1 is recommended to identify individuals at risk of suicidal behavior. CONCLUSIONS: The study supports the reliability and validity of the P4 suicide screener across 42 diverse countries, highlighting the importance of using a cross-cultural suicide risk assessment to standardize the identification of high-risk individuals and tailoring culturally sensitive suicide prevention strategies.

Sexological and traumatic aspects in reproductive difficulties: a psychometric study on couples seeking help for infertility.

PURPOSE: To investigate the impact of infertility in gender differences on psycho-traumatological, sexological, relational and emotional aspects and gender differences in couples requiring assisted reproductive treatment. METHODS: 151 couples were recruited with a mean age of 36.7 ± 4.8 years for women and 39.8 ± 6.6f or men. 43% of women and 34% of men had already received the diagnosis of infertility. To recruited subjects was administered the following psychometric tests: Sexological and Emotional in Infertility questionnaire (SEIq), Arizona Sexual Experience Scale (ASEX), the Orgasmomether and the International Trauma Questionnaire (ITQ). RESULTS: There was a significant difference in traumatic symptoms between men and women (t = 5,859, p < 0.05). Gender differences were found in the sexological dimension of the SEIq (t = 7,858, p < .001) and in the total ASEX score (t = 3,979, p < .001). Specifically, significant correlations emerged between the ASEX domains and the emotional and sexological aspects related to infertility only in women. The reaction to the diagnosis was negatively correlated with the emotional area of ​​the couple (r = -0.683, p < .001) and positively with the couple relationship (r = 0.815, p < .001). Multiple regression revealed that the overall functioning of the couple, rather than the single scales, is the main predictor of sexuality (R2 = 0.77). CONCLUSION: A clear impact of infertility on the couple's psycho-traumatological, psycho-sexological and relational aspects emerged. It could be useful to promote targeted support interventions on the most compromised areas of couple functioning in assisted reproductive centers.

Hypersexuality as a tip of the iceberg of a primary psychopathology: a joined position statement of the Italian Society of Andrology and Sexual Medicine (SIAMS) and of the Italian Society of Psychopathology (SOPSI).

In the last years, hypersexual behavior has been broadly scientifically studied. The interest in this topic, belonging to psycho-sexology and sexual medicine, has been due to its still unclear aetiology, nature, and its manifestation in relationship with several organic and psychopathological conditions. So, the specialist (the psychologist, psychiatrist, endocrinologist, neurologist) may encounter some difficulties in diagnosing and managing this symptom. The first main objective of this position statement, which has been developed in collaboration between the Italian Society of Andrology and Sexual Medicine (SIAMS) and the Italian Society of Psychopathology (SOPSI) is to give to the reader evidence about the necessity to consider hypersexuality as a symptom related to another underlying condition. Following this consideration, the second main objective is to give specific statements, for the biopsychosocial assessment and the diagnosis of hypersexual behavior, developed on the basis of the most recent literature evidence. To develop a psycho-pharmacological treatment tailored on patients' needs, our suggestion is to assess the presence of specific comorbid psychopathological and organic conditions, and the impact of pharmacological treatments on the presence of an excess of sexual behavior. Finally, a suggestion of a standardized psychometric evaluation of hypersexuality will be given.

Addressing male sexual and reproductive health in the wake of COVID-19 outbreak.

PURPOSE: The COVID-19 pandemic, caused by the SARS-CoV-2, represents an unprecedented challenge for healthcare. COVID-19 features a state of hyperinflammation resulting in a "cytokine storm", which leads to severe complications, such as the development of micro-thrombosis and disseminated intravascular coagulation (DIC). Despite isolation measures, the number of affected patients is growing daily: as of June 12th, over 7.5 million cases have been confirmed worldwide, with more than 420,000 global deaths. Over 3.5 million patients have recovered from COVID-19; although this number is increasing by the day, great attention should be directed towards the possible long-term outcomes of the disease. Despite being a trivial matter for patients in intensive care units (ICUs), erectile dysfunction (ED) is a likely consequence of COVID-19 for survivors, and considering the high transmissibility of the infection and the higher contagion rates among elderly men, a worrying phenomenon for a large part of affected patients. METHODS: A literature research on the possible mechanisms involved in the development of ED in COVID-19 survivors was performed. RESULTS: Endothelial dysfunction, subclinical hypogonadism, psychological distress and impaired pulmonary hemodynamics all contribute to the potential onset of ED. Additionally, COVID-19 might exacerbate cardiovascular conditions; therefore, further increasing the risk of ED. Testicular function in COVID-19 patients requires careful investigation for the unclear association with testosterone deficiency and the possible consequences for reproductive health. Treatment with phosphodiesterase-5 (PDE5) inhibitors might be beneficial for both COVID-19 and ED. CONCLUSION: COVID-19 survivors might develop sexual and reproductive health issues. Andrological assessment and tailored treatments should be considered in the follow-up.

Erectile function recovery in men treated with phosphodiesterase type 5 inhibitor administration after bilateral nerve-sparing radical prostatectomy: a systematic review of placebo-controlled randomized trials with trial sequential analysis.

The impact of phosphodiesterase type 5 inhibitor (PDE5I) treatment modality (on-demand vs. daily), PDE5I half-life and time from surgery to PDE5I prescription on the achievement of drug-assisted erectile function (EF) recovery is uncertain. We systematically reviewed published randomized clinical trials (RCTs). We performed meta-analyses of data on 2317 men treated with PDE5Is after nerve-sparing radical prostatectomy (NSRP). A PubMed and SCOPUS search was performed for trials published from 1 January 1969 to 30 June 2016. PDE5Is are effective in achieving drug-assisted recovery of erectile function (EF). From a statistical standpoint, these studies were subjected to Trial Sequential Analysis to determine whether the pooled data were adequately powered to verify the study outcomes. On-demand treatment with PDE5Is was significantly better than daily treatment in recovering drug-assisted EF. This effect was maintained even when the drugs were stratified according with half-life. Although not based on head-to-head trials, Avanafil used on-demand was the most effective PDE5I in recovering drug-assisted EF. Whereas tadalafil was equally effective when used both on-demand and daily, vardenafil significantly improved drug-assisted EF recovery only when used on-demand. The start of PDE5I treatment six months or more after surgery compared to treatment started earlier did not negatively affect the rate of drug-assisted EF recovery or the possibility to have successful intercourse based on the Sexual Encounter Profile question-3 (SEP-3). Current trials do not support the hypothesis that PDE5I use recovers drug-unassisted EF, although chronic low-dose tadalafil administration may help to preserve erectile tissue integrity. Potential shortcomings in the trials design may partially explain these disappointing results and several questions concerning the recovery of drug-unassisted EF remain unanswered. Thus, there is a need for well-designed new RCTs requiring changes in the timing of PDE5I administration as well as in the dose and the treatment duration.

Cross-cultural and socio-demographic correlates of homophobic attitude among university students in three European countries.

PURPOSE: The aim of this study was to investigate homophobic attitudes in three European countries: Italy, Albania, and Ukraine. One thousand and forty-eight students were recruited in Italian (n = 766), Albanian (n = 180), and Ukrainian (n = 102) university centers. METHODS: A socio-demographic questionnaire and Homophobia Scale (HS) were administered by our staff. RESULTS: Cross-cultural and significant differences among Italian, Albanian, and Ukrainian students were found on the Homophobia Scale (HS; Italy: mean = 22.26 ± 16.73; Albania: mean = 38.15 ± 17.28; Ukraine: mean = 59.18 ± 16.23). The analysis of socio-demographic characteristics revealed that the male gender emerged as main predictor of homophobic attitude in all the three countries, although also a conservative political orientation and the religious belief predict higher homophobia levels in Italy and Albania, particularly. CONCLUSIONS: This study revealed that in these European countries assessed, attitudes toward homosexuality are different. Ukrainians display higher levels of homophobia than Albanians and Italians, confirming the central role of cultural differences in homophobic attitudes. Nevertheless, some socio-demographic aspects such as identification as male have a similar influence on homophobic attitudes in all assessed populations.

Who has the worst attitudes toward sexual minorities? Comparison of transphobia and homophobia levels in gender dysphoric individuals, the general population and health care providers.

PURPOSE: To date, few studies have addressed attitudes toward transgender individuals. In addition, little is known about health care providers' (HCP) attitudes toward sexual minorities. The aim of the present study is to compare attitudes toward homosexual and transgender individuals between gender dysphoric individuals (GDs), general population controls (C) and HCP. METHODS: A total of 310 subjects were considered, including 122 GDs (63 transwomen and 59 transmen), 53 heterosexual HCP (26 males and 27 females) and 135 C. Participants completed the Modern Homophobia Scale (MHS) and the Attitudes Toward Transgendered Individuals Scale (ATTI) in order to assess attitudes toward gay men and lesbian women and toward transgender individuals, respectively. In addition, GDs completed the Gender Identity/Gender Dysphoria Questionnaire (GIDYQ-AA) and ATTI to measure, respectively, gender dysphoria levels and internalized transphobia. Religious attitudes were evaluated by means of the Religious Fundamentalism Scale (RFS), and Discrimination and Stigma Scale (DISC-12) was used to measure perceived discrimination. RESULTS: (1) Men showed significantly higher levels of homophobia and transphobia when compared to women (p < 0.001); (2) perceived discrimination was higher in lesbian women compared to gay men and in transwomen compared to transmen (p < 0.001 and p < 0.05, respectively); and (3) religious fundamentalism was associated with both homophobia and transphobia (both p < 0.001). CONCLUSIONS: Our results underline the need to promote awareness and acceptance of the sexual minorities, who are more at risk of discriminatory attitudes, which are strongly dependent on religious precepts and dogma.

The impact of premature ejaculation on the subjective perception of orgasmic intensity: validation and standardisation of the 'Orgasmometer'.

To the best of our knowledge, no psychometric tools have been specifically developed to measure if premature ejaculation (PE) is related to low sexual pleasure in terms of perception of orgasmic intensity. Hence, the aim of this study was to evaluate if men with PE suffer from a low perception of orgasmic intensity using a new tool, the 'Orgasmometer', to quantitatively measure the intensity of orgasmic pleasure. Among 329 subjects attending our andrological unit for suspected PE, 257 men fulfilled the inclusion criteria. Of these, 156 (60.7%; 156/257) were affected by PE (PE group) and 101 (39.3%; 101/257) did not have any sexual dysfunction (Control group). Men were requested to fill out the Premature Ejaculation Diagnostic Tool (PEDT) and the Orgasmometer, a new visual tool recording orgasm intensity on a Likert scale. Interestingly, MANCOVA analysis revealed a statistically significant difference between the two groups (p = 0.044) in the subjective perception of orgasm intensity with the PE group scoring lower on the Orgasmometer (mean 5.8; 95% CI 5.191-6.409) than the Control group (mean 7.95; 95% CI 7.033-8.87). In addition, multiple linear regression revealed an inverse correlation between the PEDT and the Orgasmometer scores (p < 0.0001). Hence, higher PEDT scores were associated with a lower subjective perception of orgasmic intensity. The Orgasmometer was well understood, had good test-retest reliability and a high AUC in differentiating between men with high and low orgasmic pleasure intensity. The ROC curve analysis showed that a cut-off ≤6 had 87.7% sensitivity (95% CI 79.6-92.6), 95% specificity (95% CI 88.7-98.4), 95.3% positive predictive value (PPV) and 86.4% negative predictive value (NPV). Men affected by premature ejaculation perceived significantly lower orgasmic intensity than sexually healthy men. The Orgasmometer is an easy-to-perform, user-friendly tool for measuring orgasmic intensity.

SIAMS survey on sexological screening during the assisted reproductive technologies in Italy.

PURPOSE: The assessment of sexual function is fundamental to the Assisted Reproductive Technology (ART). Nevertheless, it is still not a common clinical routine among infertility centres. The aim of this survey is to describe the main aspects of sexological screening that are considered in Italian centres of ART. METHODS: After the consensus of the Italian Society of Andrology and Sexual Medicine (SIAMS), a mailing list of reproductive medicine centres was created. Then, we sent a questionnaire concerning the essential characteristics of sexological screening. The respondents to compilers of the questionnaire sent back the information from their centres, and an analysis of absolute frequencies and percentages was performed. RESULTS: First, 16 centres completed and returned the questionnaire, while 5 ignored the invitation. The main findings concerned the wide use consideration of vardenafil 10 mg (68.7%; 11/16) for the treatment of erectile dysfunction in comorbidity with reproductive problems, the diffuse administration of International Index of Erectile Function (68.2%; 11/16) and Structured Interview for the Erectile Dysfunction (50%; 8/16) as psychometric tools and lesser use of Female Sexual Function Index (31.2%; 5/16) for the evaluation of female sexuality in the infertile couple. CONCLUSIONS: To conclude, we noticed a major focus on male sexuality and the eventual treatment or evaluation of sexual dysfunction compared to female sexuality. This aspect highlights an important issue for clinical practice to strongly consider and eventually reinforce. In this regard, improvement of the assessment and treatment of possible female sexual problems in reproductive medicine seems necessary.

Attachment styles and sexual dysfunctions: a case-control study of female and male sexuality.

The aim of this study was to investigate attachment styles in a group of women and men with sexual dysfunction. We recruited 44 subjects (21 women and 23 men) with sexual dysfunction and 41 subjects (21 women and 20 men) with healthy sexual function as the control group. Validated instruments for the evaluation of male and female sexual dysfunctions (M/F SD) and a psychometric tool specifically designed to investigate attachment style were administered. In women, significant differences were found between subjects with sexual dysfunction and healthy controls. The scales indicating an insecure attachment showed: discomfort with closeness (FSD = 42.85 ± 11.55 vs CTRL = 37.38 ± 8.54; P < 0.01), relationship as secondary (FSD = 26.76 ± 2.60 vs CTRL = 18.42 ± 7.99; P < 0.01), and need for approval (FSD=26.38 ± 3.61 vs CTRL = 20.76 ± 7.36; P < 0.01). Healthy women also had significantly higher scores in secure attachment (confidence: FSD = 24.57 ± 3.89 vs CTRL = 33.42 ± 5.74; P < 0.01). Men with sexual dysfunctions differed from healthy men in confidence (MSD = 30 ± 6.33 vs CTRL = 36.05 ± 5.26; P < 0.01) and in discomfort with closeness (MSD = 39.08 ± 8 vs CTRL = 34.25 ± 7.54; P < 0.05). These results suggest that particular aspects related to insecure attachment have a determinant role in people with sexual dysfunctions. It is therefore fundamental to identify the attachment styles and relational patterns in patients receiving counselling and psychological treatments focussed on sexual problems.

The sexual attraction toward disabilities: a preliminary internet-based study.

Devotism, defined as sexual attraction toward disabilities, has not undergone extensive study. To verify whether devotees have characteristics suggestive of a paraphilic behavior, an ad hoc internet questionnaire was developed to study a population of 209 subjects enrolled from online devotee communities. With respect to the sexual preference, we observe a first population comprising subjects sexually attracted by disability per se and considers it as an erotic object. In the absence of disability, this group is also unable to become sexually aroused and experiences discomfort due to their condition. The second subpopulation comprises subjects attracted by specific characteristics of people with disabilities such as adaptability, fortitude, courage and ability to overcome obstacles. This group experiences low levels of discomfort for their sexual preference. Further studies will be necessary to confirm these data.

Alexithymia and vaginismus: a preliminary correlation perspective.

The aim of this study was to measure the prevalence of alexithymia and emotional dysregulation in women with vaginismus not associated with other organic or psychopathological disorders. The study involved the psychometric assessment of 41 patients with vaginismus and 100 healthy women, all of childbearing age. Alexithymia was evaluated by TAS-20 (Toronto Alexithymia Scale). Sexual function was assessed by FSFI (Female Sexual Function Index). In patients with vaginismus, the primary diagnosis of dyspareunia was excluded and an expert psychologist evaluated patients and controls according to DSM IV (Diagnostic and Statistical Manual of Mental Disorders: 4th edition) criteria to exclude mental disorders. Over half (51.1%) of the patients with vaginismus were classified as alexithymic or borderline (alexithymic trend), compared with just 18% of the control group. In addition, there was a significant difference in the TAS-20 total scores between the two groups (P<0.0001). In terms of relative risk, women suffering from vaginismus thus have a 3.8 times higher probability of showing alexithymia than do healthy women. Vaginismus is a complex syndrome and alexithymia is far from being its only characteristic. However, we found a significant correlation between vaginismus and alexithymia. In theory, alexithymia could thus be a risk factor for vaginismus, although future studies are required to demonstrate any chain of causation between these two conditions.

Estudio preliminar de patrones de mordedura según forma del cráneo, mediante el análisis morfológico y morfométrico de semiarcadas dentarias de perro doméstico (Canis familiaris) con fines de identificación / Preliminary study of bite patterns according to skull shape, by morphological and morphometric analysis of dental semi arcs of domestic dog (Canis familiaris) for identification

La Odontología forense es una rama de las Ciencias Forenses que se utiliza para establecer la identidad de una víctima o victimario mediante el estudio de las huellas de mordeduras, estimación de edad cronológica, entre otros. Dada la inexistencia de este tipo de estudios en Chile y la magnitud que alcanza el problema de mordidas de perros en Chile, se compararon los patrones de huellas de mordedura según forma del cráneo, mediante el análisis morfológico y morfométrico de semiarcadas dentarias de perro doméstico (Canis familiaris) con fines médico legal. Para ello se obtuvieron modelos dentarios en yeso e impresiones de huellas de mordedura en cera de tres razas puras: Bóxer, Dálmata y Ovejero Alemán. Las mediciones contemplaron la distancia máxima externa entre caninos superiores e inferiores y la distancia máxima externa entre incisivos superiores e inferiores. Los principales resultados muestran que sólo la distancia máxima entre caninos superiores permitiría identificar la raza en forma estadísticamente significativa (p0,05) en los modelos de yeso. En el estudio ciego y desde el punto de vista morfométrico se identificaron especialmente los Dálmata con un alto grado de sensibilidad y especificidad. Un poco menor y en forma variable se observó en Bóxer y Ovejero Alemán. El estudio morfológico permitió identificar e individualizar al 100 por ciento de los perros. Por tanto los métodos morfométricos y morfológicos son herramientas complementarias para identificar e individualizar a un posible perro agresor.

Forensic dentistry is a branch of Forensic Sciences used to establish the identity of a crime victim or perpetrator, among these studies are bite marks and dental chronological age studies. In the absence of such studies in Chile and considering the widespread problem of dog bites in Chile, bite patterns were compared according to skull shape, by morphological and morphometric analysis of dental semi arcs of domestic dog (Canis Familiaris) for medico legal purposes. Plaster dental models and impressions of bite marks were obtained of three pure breeds: Boxer, Dalmatian and German shepherd. Measures included he maximum external distance between upper and lower canine, and maximum external distance between upper and lower incisors. Main results show that only the maximum distance between upper canine would allow statistically significant race identification, (p0.05) in cast models. In a blind study and from a morphometric point of view, Dalmatians were identified with a high rate of sensitivity and specificity. A somewhat lesser and variable form was observed in Boxer and German Shepherd. The morphological study allowed identification and individualization of 100 percent of dogs. Therefore, both morphological and morphometric methods are useful and complementary tools to identify and individualize a potentially aggressive dog.

Fluctuation of annexin-A1 positive mast cells in chronic granulomatous inflammation.

OBJECTIVE: We have applied here a model of chronic granulomatous inflammation to study the profile of mast cell activation and their expression of annexin-A1 in the nodular lesion. MATERIALS: Granulomatous inflammation was induced by injection of croton oil and Freund's complete adjuvant (CO/FCA) into the dorsal air-pouches of mice. Skin tissue samples were collected from control group (24 h time-point; i. e. before disease development) and 7, 14, 21, 28 and 42 days post-CO/FCA treatment. RESULTS: Histopathological analyses revealed an on-going inflammation characterized by an increased number of activated mast cells at sites of the chronic inflammatory reaction in all experimental groups. Immunohistochemical analysis showed skin mast cells highly immunoreactive for annexin-A1, both at an initial (day 7) and a delayed (day 28) phase of the inflammatory reaction. CONCLUSIONS: The observed time-dependent modulation of mast cell activation, during the granulomatous injury, indicates that multiple pathways centred on annexin-A1 might become activated at different stages of this chronic inflammatory response, including the delayed and pro-resolving phase.

[A tribute to the professors of forensic medicine at the University of Chile]. / Homenaje a los profesores de la Cátedra de Medicina Legal de la Universidad de Chile.

The outstanding work of professors of the chair of Forensic Medicine at the School of Medicine of the University of Chile is highlighted. This chair is divided in three periods, that are paralell to the history of Chilean medicine. During these periods, the chair initiated, developed and fortified its teaching activities. The practice of forensic medicine was institutionalized and spread throughout the country. Its field of action and knowledge areas also increased.

Homenaje a los profesores de la Cátedra de Medicina Legal de la Universidad de Chile / A tribute to the professors of forensic medicine at the University of Chile

The outstanding work of professors of the chair of Forensic Medicine at the School of Medicine of the University of Chile is highlighted. This chair is divided in three periods, that are paralell to the history of Chilean medicine. During these periods, the chair initiated, developed and fortified its teaching activities. The practice of forensic medicine was institutionalized and spread throughout the country. Its field of action and knowledge areas also increased.

Homenaje a los profesores de la cátedra de medicina legal de la Universidad de Chile / A tribute to the professors of forensic medicine at the University of Chile

The outstanding work of professors of the chair of Forensic Medicine at the School of Medicine of the University of Chile is highlighted. This chair is divided in three periods, that are paralell to the history of Chilean medicine. During these periods, the chair initiated, developed and fortified its teaching activities. The practice of forensic medicine was institutionalized and spread throughout the country. Its field of action and knowledge areas also increased. (AU)