Regulación de la expresión sexual de los mayores ingresados en residencias: la visión de los profesionales

Introduction

The purpose of this study is to determine the opinion of professionals working in residential aged care facilities on the regulation of sexuality in these settings.

Materials and methods

Fifty-three professionals from five residential aged care facilities located in the metropolitan area of Barcelona answered several questions regarding the advisability of establishing measures for the regulation of sexuality in RACFs, the elements that could contribute to this, and the aspects that such regulations should consider.

Results

Around 50% of the participants recognized the advisability of having some type of measures for sexuality regulation in residential aged care facilities. According to their responses this should be developed taking into account professional opinions, but also the points of view of the residents and their relatives. The most frequently mentioned regulations were those that ensured that any kind of sexually charged situation occurred in a private environment. The development of strategies are suggested to distinguish those people with dementia that are competent to consent to sexual acts from those who are not.

Conclusions

The opinion of professionals working in RACFs regarding the advisability of establishing measures for sexuality regulation seems to be considerably divided. Thus, whilst around 50% of them recognize their potential usefulness, the other half consider them unnecessary or even counterproductive for the sexual freedom of residents. Associating regulation with prohibition and sexuality with sexual activity was not uncommon among the responses of the participants.     

Clonal growth is enhanced in the absence of a mating morph: a comparative study of fertile stylar polymorphic and sterile monomorphic populations of Nymphoides montana (Menyanthaceae)

Background and Aims

Many aquatic species with stylar polymorphisms have the capacity for clonal and sexual reproduction and are sensitive to the balance of the two reproductive modes when there are a limited number of mating morphs within a population. This study asked how the clonal and sexual reproductive modes perform in populations that contain only a single morph and where fitness gain through sexual reproduction is rare. In clonal aquatic Nymphoides montana, polymorphic populations normally contain two mating morphs in equal frequencies. Populations are sexually fertile and appear to be maintained by pollen transfer between the two partners. However, in a monomorphic population of N. montana where mating opportunities are unavailable, female and male function is impaired and clonality maintains the population. Here, the consequences of intraspecific variation in sexuality were explored between monomorphic and polymorphic N. montana populations in eastern Australia.

Methods

Comparative measurements of male and female fertility, total dry mass and genotypic diversity using ISSR markers were made between populations with variable sexuality.

Key Results and Conclusions

Very few seeds were produced in the monomorphic population under natural and glasshouse conditions due to dysfunctional pollen and ovules. Stigma–anther separation was minimal in the monomorphic population, which may be a consequence of the relaxed selective pressures that regulate the maintenance of sexual function. However, clonal reproduction was favoured at the expense of sexual reproduction in the monomorphic population; this may facilitate the establishment of sterility throughout the population via resource reallocation or pleiotropic effects. The ISSR results showed that the monomorphic population was one large, single genotype, unlike the multi-genotypic fertile polymorphic populations. Evolutionary loss of sex in a clonal population in which a mating morph is absent was evident; under these conditions clonal growth may assure reproduction and expand the population via spreading stolons.     

Retentissement sexuel, conjugal et social d’une population d’hommes stériles consultants en Andrologie: le point de vue du psychiatre de liaison

Material and methods

The study population consisted of 39 subjects divided into two groups: 21 azoospermic males and 18 oligoazoospermic males. These men were selected in andrology departments over a period of six months. The andrology and liaison psychiatry departments of Lille university hospital established a general infertility questionnaire. This semi-structured questionnaire comprising 40 questions was based on clinical experience and describes the clinical and symptomatic context of infertility. An individual 50-item questionnaire was then used to analyse the psychosocial, marital and sexual effects of male infertility and the representation of the psychiatrist in the andrology department.

Results

One third of patients discovered the diagnosis of infertility when the biologist gave them the results of the semen analysis. Our patients initially envisaged marital, psychological and social problems, but very few sexual problems. They imagined that infertility was more disturbing for women than for men, from a psychological and sexual point of view. 82% of our subjects imagined that their partner had no sexual problems. 48.7% of them thought that their partner had no psychological difficulties related to their infertility. The oligoasthenospermia group considered that the partner had significantly more “psychological difficulties” compared to the azoospermia group. 41% of our patients felt guilty towards their partner because of their infertility diagnosis. 10.3% of patients presented sexual disorders before the diagnosis of male infertility and 25.6% presented sexual disorders after this diagnosis. Contrary to data in the literature, a major change of sexuality was not observed in the majority of the couples after the diagnosis. When sexuality changed, it generally consisted of a reduction of the frequency of sexual relations. Among the patients who reported sexual difficulties, only 40% related them to infertility. 50% did not report any relationship between the psychological difficulties related to infertility and the sexual difficulties. Contrary to the data in the literature, neither the loss of spontaneity during sexual relations, nor the complementary investigations necessary for artificial insemination had any influence on sexuality. 89.8% of our patients are ready to change their sexual practices in order to be more fertile without causing any sexual or psychological problems. However, only 34.3% of patients reported a concern about reproductive efficacy during sexual relations. A more marked sexuality/reproduction dissociation was observed in oligoazoospermic males than in azoospermic males. 28.2% of patients reported that talking about their sexual and/or psychological problems with a psychiatrist was helpful.

Conclusion

Many contradictions and underestimations were observed in the answers to the questions. We confirmed the existence of a psychological and sexual distress, but which was quantitatively less severe than that described in “gynaecological” populations. However, a real psychological and sexual distress does exist in our population, which is why we propose from the outset a psychosomatic and sexological treatment of infertility in order to prevent the onset of these sexual difficulties. Our questionnaire was based on clinical experience and helped our patients to identify their psychological and sexual difficulties related to infertility and its treatment. It would therefore be useful for the practitioner, andrologist or psychiatrist, to help the patient express the effects related to this “new medicalized sexuality”.     

Introgression of apomixis into sexual species is inhibited by mentor effects and ploidy barriers in the Ranunculus auricomus complex

Background and Aims

Apomictic plants maintain functional pollen, and via pollination the genetic factors controlling apomixis can be potentially transferred to congeneric sexual populations. In contrast, the sexual individuals do not fertilize apomictic plants which produce seeds without fertilization of the egg cells. This unidirectional introgressive hybridization is expected finally to replace sexuality by apomixis and is thought to be a causal factor for the wide geographical distribution of apomictic complexes. Nevertheless, this process may be inhibited by induced selfing (mentor effects) of otherwise self-incompatible sexual individuals. Here whether mentor effects or actual cross-fertilization takes place between diploid sexual and polyploid apomictic cytotypes in the Ranunculus auricomus complex was tested via experimental crosses.

Methods

Diploid sexual mother plants were pollinated with tetra- and hexaploid apomictic pollen donators by hand, and the amount of well-developed seed compared with aborted seed was evaluated. The reproductive pathways were assessed in the well-developed seed via flow cytometric seed screen (FCSS).

Key Results

The majority of seed was aborted; the well-developed seeds have resulted from both mentor effects and cross-fertilization at very low frequencies (1·3 and 1·6 % of achenes, respectively). Pollination by 4x apomictic pollen plants results more frequently in cross-fertilization, whereas pollen from 6x plants more frequently induced mentor effects.

Conclusions

It is concluded that introgression of apomixis into sexual populations is limited by ploidy barriers in the R. auricomus complex, and to a minor extent by mentor effects. In mixed populations, sexuality cannot be replaced by apomixis because the higher fertility of sexual populations still compensates the low frequencies of potential introgression of apomixis.Key words: Apomixis, Ranunculus auricomus, evolution, geographical parthenogenesis, crossing experiments, flow cytometry     

Genetic tests of ancient asexuality in Root Knot Nematodes reveal recent hybrid origins

Background  

The existence of "ancient asexuals", taxa that have persisted for long periods of evolutionary history without sexual recombination, is both controversial and important for our understanding of the evolution and maintenance of sexual reproduction. A lack of sex has consequences not only for the ecology of the asexual organism but also for its genome. Several genetic signatures are predicted from long-term asexual (apomictic) reproduction including (i) large "allelic" sequence divergence (ii) lack of phylogenetic clustering of "alleles" within morphological species and (iii) decay and loss of genes specific to meiosis and sexual reproduction. These genetic signatures can be hard to assess since it is difficult to demonstrate the allelic nature of very divergent sequences, divergence levels may be complicated by processes such as inter-specific hybridization, and genes may have secondary roles unrelated to sexual reproduction. Apomictic species of Meloidogyne root knot nematodes have been suggested previously to be ancient asexuals. Their relatives reproduce by meiotic parthenogenesis or facultative sexuality, which in combination with the abundance of nematode genomic sequence data, makes them a powerful system in which to study the consequences of reproductive mode on genomic divergence.     

Evaluation of sexual functions and sexual behaviors after penile brachytherapy in men treated for penile carcinoma

Purpose

To assess sexual functions and behaviors of men treated by penile brachytherapy for a cancer of the penis.

Materials and methods

Thirty eight men (19 patients treated by penile brachytherapy for a cancer of the penis and 19 age paired-matched controls) participated in a survey about sexuality. The mean age of patients and controls were 73.2 +/- 11.7 and 70.0 +/- 10.5 years, respectively (NS). Controls were men without penile pathology, without history of cancer and no evidence of cognitive impairment. All agreed to participate in the survey about sexuality using 2 questionnaires : the IIEF questionnaire, which explores 4 domains of sexual functions, namely erection, satisfaction, orgasm and desire, and a questionnaire created using the BASIC IDEA grid, which addresses nine domains: behavior, affect, sensation, self-image, cognition, interpersonal, drugs, expectation and attitude.

Results

Patients had better scores than controls in 3 domains of the IIEF: erection, desire and satisfaction. These results contrasted with the frequency of intercourse and the quality of erection (evaluated through the BASIC IDEA questionnaire) that were not significantly different between the two populations. Patients also had significantly higher frequency of masturbation (p <0.001) lower worry about sexual performance and higher expected satisfaction for future life (p: 0.021) than controls.

Conclusion

Penile brachytherapy is a treatment of cancer of the penis that seems to have a moderated impact on sexual functions since most of sexual scores are not inferior in these patients than in age pair-matched controls.

     

Expresión sexual y regulación de la sexualidad en residencias de personas mayores

Objectives

The study had three objectives: (a) To determine how staff perceives the frequency of different sexual expressions in long-term care facilities for older people; (2) to quantify policies aimed at guaranteeing residents’ sexual rights in such institutions, and (3) to determine factors influencing the presence of these kind of policies.

Prostate response to prolactin in sexually active male rats

Background  

The prostate is a key gland in the sexual physiology of male mammals. Its sensitivity to steroid hormones is widely known, but its response to prolactin is still poorly known. Previous studies have shown a correlation between sexual behaviour, prolactin release and prostate physiology. Thus, here we used the sexual behaviour of male rats as a model for studying this correlation. Hence, we developed experimental paradigms to determine the influence of prolactin on sexual behaviour and prostate organization of male rats.     

Identification of Schistosoma mansoni gender-associated gene transcripts by cDNA microarray profiling

Background  

Parasitic helminths of the genus Schistosoma mate, achieve sexual maturity and produce eggs in the bloodstream of their definitive hosts, and the most important pathological consequences of the infection are associated with this process. We have used cDNA microarray technology to initiate genome-wide gene-expression studies of sex and sexual development in mature Schistosoma mansoni parasites.     

Phylogeography of competing sexual and parthenogenetic forms of a freshwater flatworm: patterns and explanations

Background  

Models of the maintenance of sex predict that one reproductive strategy, sexual or parthenogenetic, should outcompete the other. Distribution patterns may reflect the outcome of this competition as well as the effect of chance and historical events. We review the distribution data of sexual and parthenogenetic biotypes of the planarian Schmidtea polychroa.     

The effect of body mass index on global brain volume in middle-aged adults: a cross sectional study

Background  

Obesity causes or exacerbates a host of medical conditions, including cardiovascular, pulmonary, and endocrine diseases. Recently obesity in elderly women was associated with greater risk of dementia, white matter ischemic changes, and greater brain atrophy. The purpose of this study was to determine whether body type affects global brain volume, a marker of atrophy, in middle-aged men and women.     

Les prothèses gonflables dans le traitement de l'impuissance: résultats de 80 implantations

Objective

The goal of this study is the evaluation of the functionnal results and the complications of this type of surgery. Such questions have been poorly discussed in the literature.

Methods

We report our experience on 80 inflatable prostheses that were implanted between october 1987 and october 1994. The mean follow-up is 3 years and the assessment of the objective (mechanical functioning of the prosthesis and complications) and sujective results (sexuality of the patients) is carried out on 68 patients.

Results

The results are the following:

? 54.5% of functioning disturbances,

? 7% of infections,

? 27.5% of prosthesis removals.

Most of the patients considered they were satisfied although only 65% returned to a regular sexual activity.     

Résultats fonctionnels de la radiofréquence par Prostiva? dans le traitement de l’hypertrophie bénigne de la prostate (HBP) non compliquée résistante aux traitements médicamenteux

Objective

To assess prospectively on objective and subjective parameters functional outcomes of prostatic thermotherapy by radiofrequency (Prostiva?) on urinary discomfort and sexual life in the treatment of uncomplicated symptomatic and resistant to drug treatment benign prostatic hypertrophy (BPH).

Patients and methods

Patients with eligibility criteria for this treatment published by HAS have been treated in our urology unit. They were called at one month for a clinical examination and analysis of objective data (maximum urine flow [Qmax], post-voiding residual, international prostate score symptom [IPSS]). They were contacted in December 2009 and submitted to a questionnaire on urinary symptoms (IPSS), quality of life (question 8 of IPSS), assessment of sexual function (IIEF, DAN SEX) and subjective assessment of treatment (Likert score).

Results

From December 2006 to January 2009, 20 patients (median age: 63 years) were treated with Prostiva?. Four patients had acute retention of urine in the immediate postoperative needing a urinary catheterization in emergency. We made a systematic evaluation of all patients at one month and in December 2009. The median follow-up was 20.6 months (12?C37 months). There was a significant improvement of IPSS (?6.7 points; IC95= [?10.3; ?3.1]), an improvement of sexuality functions, quality of life data, and a sense of global improvement of urinary symptoms (+ 1.8 = improved on the Likert score). Four patients were considered as failures: three patients resumed drug therapy, one patient received a prostate resection.

Conclusion

Our single centre study performed in selected patients according to the criteria of HAS consolidated the results of published studies. Results were positive on urinary symptoms, with a low morbidity and a positive subjective evaluation on symptoms. It demonstrated the safety of thermotherapy on patients?? sexuality and even better, the positive impact of the treatment on erections and satisfaction relations.     

JMATING: a software for the analysis of sexual selection and sexual isolation effects from mating frequency data

Background  

Many different sexual isolation and sexual selection statistics have been proposed in the past. However, there is no available software that implements all these statistical estimators and their corresponding tests for the study of mating behaviour.     

Developing a realistic sexual network model of chlamydia transmission in Britain

Background  

A national chlamydia screening programme is currently being rolled out in the UK and other countries. However, much of the epidemiology remains poorly understood. In this paper we present a stochastic, individual based, dynamic sexual network model of chlamydia transmission and its parameterisation. Mathematical models provide a theoretical framework for understanding the key epidemiological features of chlamydia: sexual behaviour, health care seeking and transmission dynamics.     

Coolidge effect in pond snails: male motivation in a simultaneous hermaphrodite

Background  

The simultaneously hermaphroditic pond snail, Lymnaea stagnalis, can mate in the male and female role, but within one copulation only one sexual role is performed at a time. Previous work has shown that male motivation is determined by the availability of seminal fluid in the prostate gland, which is detected via a nervous connection by the brain area controlling male behaviour. Based on this knowledge, patterns of sexual role alternations within mating pairs can be explained.     

A systemic gene silencing method suitable for high throughput,reverse genetic analyses of gene function in fern gametophytes

Background  

Ceratopteris richardii is a useful experimental system for studying gametophyte development and sexual reproduction in plants. However, few tools for cloning mutant genes or disrupting gene function exist for this species. The feasibility of systemic gene silencing as a reverse genetics tool was examined in this study.     

Biological species is the only possible form of existence for higher organisms: the evolutionary meaning of sexual reproduction

   

Consistent holistic view of sexual species as the highest form of biological existence is presented. The Weismann's idea that sex and recombination provide the variation for the natural selection to act upon is dominated in most discussions of the biological meaning of the sexual reproduction. Here, the idea is substantiated that the main advantage of sex is the opposite: the ability to counteract not only extinction but further evolution as well. Living systems live long owing to their ability to reproduce themselves with a high fidelity. Simple organisms (like bacteria) reach the continued existence due to the high fidelity of individual genome replication. In organisms with a large genome and complex development, the achievable fidelity of DNA replication is not enough for the precise reproduction of the genome. Such species must be capable of surviving and must remain unchanged in spite of the continuous changes of their genes. This problem has no solution in the frame of asexual ("homeogenomic") lineages. They would rapidly degrade and become extinct or blurred out in the course of the reckless evolution. The core outcome of the transition to sexual reproduction was the creation of multiorganismic entity - biological species. Individual organisms forfeited their ability to reproduce autonomously. It implies that individual organisms forfeited their ability to substantive evolution. They evolve as a part of the biological species. In case of obligatory sexuality, there is no such a thing as synchronic multi-level selection. Natural selection cannot select anything that is not a unit of reproduction. Hierarchy in biology implies the functional predestination of the parts for the sake of the whole. A crucial feature of the sexual reproduction is the formation of genomes of individual organisms by random picking them over from the continuously shuffled gene pool instead of the direct replication of the ancestor's genome. A clear anti-evolutionary consequence of the sexuality is evident from the fact that the genotypes of the individuals with an enhanced competitiveness are not transmitted to the next generation. Instead, after mating with "ordinary" individuals, these genotypes scatter and rearrange in new gene combinations, thus preventing the winner from exploiting the success.     

Apomixis is not prevalent in subnival to nival plants of the European Alps

Background and Aims

High alpine environments are characterized by short growing seasons, stochastic climatic conditions and fluctuating pollinator visits. These conditions are rather unfavourable for sexual reproduction of flowering plants. Apomixis, asexual reproduction via seed, provides reproductive assurance without the need of pollinators and potentially accelerates seed development. Therefore, apomixis is expected to provide selective advantages in high-alpine biota. Indeed, apomictic species occur frequently in the subalpine to alpine grassland zone of the European Alps, but the mode of reproduction of the subnival to nival flora was largely unknown.

Methods

The mode of reproduction in 14 species belonging to seven families was investigated via flow cytometric seed screen. The sampling comprised 12 species typical for nival to subnival plant communities of the European Alps without any previous information on apomixis (Achillea atrata, Androsace alpina, Arabis caerulea, Erigeron uniflorus, Gnaphalium hoppeanum, Leucanthemopsis alpina, Oxyria digyna, Potentilla frigida, Ranunculus alpestris, R. glacialis, R. pygmaeus and Saxifraga bryoides), and two high-alpine species with apomixis reported from other geographical areas (Leontopodium alpinum and Potentilla crantzii).

Key Results

Flow cytometric data were clearly interpretable for all 46 population samples, confirming the utility of the method for broad screenings on non-model organisms. Formation of endosperm in all species of Asteraceae was documented. Ratios of endosperm : embryo showed pseudogamous apomixis for Potentilla crantzii (ratio approx. 3), but sexual reproduction for all other species (ratios approx. 1·5).

Conclusions

The occurrence of apomixis is not correlated to high altitudes, and cannot be readily explained by selective forces due to environmental conditions. The investigated species have probably other adaptations to high altitudes to maintain reproductive assurance via sexuality. We hypothesize that shifts to apomixis are rather connected to frequencies of polyploidization than to ecological conditions.     

Elastic,not plastic species: Frozen plasticity theory and the origin of adaptive evolution in sexually reproducing organisms

Background  

Darwin's evolutionary theory could easily explain the evolution of adaptive traits (organs and behavioral patterns) in asexual but not in sexual organisms. Two models, the selfish gene theory and frozen plasticity theory were suggested to explain evolution of adaptive traits in sexual organisms in past 30 years.