BACKGROUND & AIMS: OBJECTIVES:To examine associations between sleep duration and health outcomes among distinct groups of sexual minority adults. METHODS:Using data from the 2014 Behavioral Risk Factor Surveillance System, we compared sleep duration (very short: ≤ 5 hr; short: 6 hr; normal: 7-8 hr; and long: ≥ 9 hr per day) between cisgender straight adults and distinct groups of sexual minorities. We further examined associations between sleep duration and 10 chronic health conditions among sexual minorities. RESULTS:Of 146,893 respondents, 142,507 (96.2%) were cisgender straight, and 4,386 (3.8%) were lesbian, gay, bisexual, transgender (LGBT). Overall, 17.3% of LGBT respondents reported very short sleep per day, compared with 12.2% for cisgender straight respondents (p < 0.0001). Among LGBT populations, the prevalence of very short sleep varied significantly among distinct groups, ranging from 13.2% among transgender female to male adults to 35.5% among transgender gender nonconforming adults. Very short sleep was further associated with increased odds of having stroke (aOR = 4.1, 95% CI [2.2-7.6]), heart attack (aOR = 3.0, CI [1.6-5.8]), coronary heart disease (aOR = 3.1, 95% CI [1.5-6.2]), asthma (aOR = 1.7, 95% CI [1.1-2.4]), chronic obstructive pulmonary disease (aOR = 2.5, CI [1.5-4.0]), arthritis (aOR = 2.1, CI [1.4-3.0]), and cancer (aOR = 1.8, 95% CI [1.0-3.2]) among sexual minorities. Disparities in the prevalence of stroke, heart attack, coronary health disease, COPD, diabetes, obesity, arthritis, and cancer were found among LGBT populations. CONCLUSIONS:Sexual minorities have a higher prevalence of sleep deprivation as compared with their straight counterparts. Sleep deprivation varies by sexual identity and gender. Very short sleep duration is associated with some chronic health conditions among LGBT populations. Promotion of sleep health education and routine medical assessment of sleep disorders are critically needed for sexual minority adults.

背景与目标： 目的：研究不同性别的成年少数群体的睡眠时间与健康结局之间的关联。
方法：使用2014年行为危险因素监测系统的数据，我们比较了直食成年成年直觉成年成年人的睡眠时间（非常短：≤5小时;短：6小时;正常：7-8小时;每天：≥9小时）以及不同性别的少数群体。我们进一步研究了性少数群体的睡眠时间与10种慢性健康状况之间的关联。
结果：在146,893名受访者中，有142,507名（96.2％）为顺性别，而有4,386名（3.8％）为女同性恋，男同性恋，双性恋和变性者（LGBT）。总体而言，LGBT受访者中有17.3％的人每天睡眠时间很短，而顺性别的受访者中有12.2％的人每天睡眠时间短（p <0.0001）。在LGBT人群中，不同组别的极短睡眠发生率差异显着，从跨性别女性到男性成年人中的13.2％，到跨性别性别不合格成年人中的35.5％。睡眠时间短还与中风（aOR = 4.1，95％CI [2.2-7.6]），心脏病发作（aOR = 3.0，CI [1.6-5.8]），冠心病（aOR = 3.1， 95％CI [1.5-6.2]），哮喘（aOR = 1.7、95％CI [1.1-2.4]），慢性阻塞性肺疾病（aOR = 2.5，CI [1.5-4.0]），关节炎（aOR = 2.1，CI [1.4-3.0]）和性少数人群中的癌症（aOR = 1.8，95％CI [1.0-3.2]）。在LGBT人群中发现中风，心脏病发作，冠心病，COPD，糖尿病，肥胖症，关节炎和癌症的患病率存在​​差异。
结论：与异性恋人群相比，性少数人群的睡眠剥夺患病率更高。睡眠剥夺因性别和性别而异。极短的睡眠时间与LGBT人群中的某些慢性健康状况有关。性少数成年人迫切需要促进睡眠健康教育和睡眠障碍的常规医学评估。

BACKGROUND & AIMS: :This study investigated the dynamics of Aspergillus fumigatus azole-resistant phenotypes in two compost heaps with contrasting azole exposures: azole free and azole exposed. After heat shock, to which sexual but not asexual spores are highly resistant, the azole-free compost yielded 98% (49/50) wild-type and 2% (1/50) azole-resistant isolates, whereas the azole-containing compost yielded 9% (4/45) wild-type and 91% (41/45) resistant isolates. From the latter compost, 80% (36/45) of the isolates contained the TR46/Y121F/T289A genotype, 2% (1/45) harbored the TR46/Y121F/M172I/T289A/G448S genotype, and 9% (4/45) had a novel pan-triazole-resistant mutation (TR463/Y121F/M172I/T289A/G448S) with a triple 46-bp promoter repeat. Subsequent screening of a representative set of clinical A. fumigatus isolates showed that the novel TR463 mutant was already present in samples from three Dutch medical centers collected since 2012. Furthermore, a second new resistance mutation was found in this set that harbored four TR46 repeats. Importantly, in the laboratory, we recovered the TR463 mutation from a sexual cross between two TR46 isolates from the same azole-containing compost, possibly through unequal crossing over between the double tandem repeats (TRs) during meiosis. This possible role of sexual reproduction in the emergence of the mutation was further implicated by the high level of genetic diversity of STR genotypes in the azole-containing compost. Our study confirms that azole resistance mutations continue to emerge in the environment and indicates compost containing azole residues as a possible hot spot. Better insight into the biology of environmental resistance selection is needed to retain the azole class for use in food production and treatment of Aspergillus diseases.IMPORTANCE Composting of organic matter containing azole residues might be important for resistance development and subsequent spread of resistance mutations in Aspergillus fumigatus In this article, we show the dominance of azole-resistant A. fumigatus in azole-exposed compost and the discovery of a new resistance mutation with clinical relevance. Furthermore, our study indicates that current fungicide application is not sustainable as new resistance mutations continue to emerge, thereby threatening the use of triazoles in medicine. We provide evidence that the sexual part of the fungal life cycle may play a role in the emergence of resistance mutations because under laboratory conditions, we reconstructed the resistance mutation through sexual crossing of two azole-resistant A. fumigatus isolates derived from the same compost heap. Understanding the mechanisms of resistance selection in the environment is needed to design strategies against the accumulation of resistance mutations in order to retain the azole class for crop protection and treatment of Aspergillus diseases.

背景与目标： ：这项研究调查了两个堆肥堆中烟熏曲霉的耐唑性表型的动态，这两种堆肥与对照暴露的吡咯不同：无吡咯和暴露于吡咯。在热休克后，对性但非无性孢子具有很高的抵抗力，无唑堆肥产生98％（49/50）野生型和2％（1/50）对唑的抗药性，而含吡咯的堆肥产生9％（4/45）野生型和91％（41/45）抗性分离株。在后一种堆肥中，80％（36/45）的分离株含有TR46 / Y121F / T289A基因型，2％（1/45）具有TR46 / Y121F / M172I / T289A / G448S基因型，9％（4 / 45）具有新的泛三唑抗性突变（TR463 / Y121F / M172I / T289A / G448S），具有三重46 bp启动子重复序列。随后对代表性的临床烟曲霉菌株进行了筛选，结果显示自2012年以来从三个荷兰医学中心收集的样品中已经存在新的TR463突变体。此外，在该菌株中发现了第二个新的耐药突变，其中包含四个TR46重复序列。重要的是，在实验室中，我们可能是通过减数分裂过程中双串联重复序列（TR）之间的不相等交换，从同一个含唑的堆肥中的两个TR46分离株之间的有性杂交中恢复了TR463突变。在含唑的堆肥中，STR基因型的高水平遗传多样性进一步暗示了性繁殖在突变出现中的这种可能作用。我们的研究证实，环境中仍会继续出现唑类抗性突变，并表明含有唑类残留物的堆肥可能是热点。需要更好地了解环境抗性选择的生物学以保持唑类用于食品生产和治疗曲霉病。重要事项含吡咯残留物的有机物的堆肥对于烟曲霉的抗性发展和随后的抗性突变的传播可能很重要。在本文中，我们显示了对吡唑有抵抗力的烟曲霉在暴露于吡咯的堆肥中的优势地位，并发现了与临床相关的新的抗药性突变。此外，我们的研究表明，随着新的耐药性突变的不断出现，当前杀菌剂的应用是不可持续的，从而威胁到三唑类药物的使用。我们提供的证据表明，真菌生命周期的性部分可能在耐药性突变的出现中起作用，因为在实验室条件下，我们通过对两个具有唑类抗性的A进行有性杂交来重建耐药性突变。来自同一堆肥堆的烟熏分离株。需要了解环境中抗性选择的机制，以设计针对抗性突变积累的策略，以保留用于农作物保护和曲霉病治疗的唑类。

BACKGROUND & AIMS: :Understanding situations that increase HIV risk among men who have sex with men (MSM) requires consideration of the context in which risky behaviors occur. Relationships are one such context. This study examines the presence and predictors of unprotected anal intercourse (UAI) in the past 3 months among 566 MSM couples. A majority of couples allowed sex with outside partners. Overall, 65% of the sample engaged in UAI with primary partner, including nearly half of discordant couples. Positive relationship factors, such as attachment and intimacy, were associated with an increased likelihood of UAI with primary partner. Meanwhile, 22% of the sample engaged in at least one episode of UAI with an outside partner, half of whom were discordant or unknown HIV status outside partners. Higher levels of HIV-specific social support, equality, and sexual agreement investment were significantly associated with a decreased likelihood of engaging in UAI with a discordant or unknown HIV status outside partner. HIV-positive men in discordant relationships had two and one half times the odds of having UAI with a discordant or unknown HIV status outside partner as their HIV-negative partners. Many MSM in relationships, including some in serodiscordant ones, engage in UAI with primary partners. Potential explanations include relationship closeness, relationship length, and agreement type. In addition, relationship context appears to have a differential impact upon UAI with primary and outside partners, implying that prevention messages may need to be tailored for different types of couples. Prevention efforts involving MSM couples must take into account relationship characteristics as couples balance safer sex and HIV risk with intimacy and pleasure.

背景与目标： ：要了解与男性发生性关系（MSM）的男性中增加HIV风险的情况，需要考虑发生危险行为的背景。关系就是这样一种背景。这项研究检查了过去3个月中566对MSM夫妇中无保护的肛门性交（UAI）的存在和预测因素。大多数夫妇允许与外部伴侣发生性关系。总体而言，有65％的样本是与主要伴侣进行UAI的，其中包括近一半的不和谐夫妻。积极的关系因素，例如依恋和亲密感，与主要伴侣进行UAI的可能性增加有关。同时，有22％的样本与外部伴侣进行了至少一次UAI发作，其中一半是外部伴侣的不和谐或未知的HIV状况。特定于艾滋病毒的社会支持，平等和性协议投资的增加，与在伴侣外部或艾滋病毒状况不明或未知的情况下参与UAI的可能性大大降低有关。处于不和谐关系中的HIV阳性男性患UAI且其伴侣之外的HIV状况处于不和谐或未知状态的几率是其HIV阴性伴侣的两倍半。许多关系中的MSM，包括一些血清异常的人，都与主要合作伙伴一起参与UAI。可能的解释包括关系亲密性，关系长度和协议类型。此外，关系背景似乎对与主要和外部合作伙伴的UAI有不同的影响，这意味着可能需要针对不同类型的夫妻量身定制预防信息。涉及MSM夫妇的预防工作必须考虑到夫妻之间的关系特征，因为夫妇要在安全的性行为和HIV风险与亲密和愉悦之间取得平衡。

BACKGROUND & AIMS: UNLABELLED:This article summarizes the work done to adapt and to validate the short form of Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12) for its use in Spain. It will become the first validated questionnaire in this country for the evaluation of the sexual function in women with Pelvic Organ Prolapse and/or Urinary Incontinence. PATIENTS AND METHOD:49 women who visited a specialized unit with symptoms of pelvic floor were included. Patients filled in the Spanish version of the questionnaire to validate (PISQ-12), the Urinary Incontinence Questionnaire (ICIQ-UI-SF); the Female Sexual Function Questionnaire (FSM) and the Bladder Control Autoevaluation Questionnaire (CACV). Factibility, reliability and validity of the new questionnaire were evaluated. RESULTS:Factibility: 99.83% of the sample answered all the items (only one patient did not answer one of the items); average administration time 3.5 (1.5) minutes. RELIABILITY:Cronbach's alpha was 0,829. VALIDITY:PISQ-12 correlation with FSM was 0,71; with ICIQ-UI-SF it was -0,038; with the CACV "symptoms" dimension the correlation was -0,30 and with the "discomfort" dimension it was -0,40. The existence of the same three dimensions of the PISQ-12 original version in the adapted Spanish questionnaire is checked through a factorial analysis. The score in PISQ-12 was worse (lower) in the case of women with Hyperactive Bladder symptoms and discomfort measured with the CACV questionnaire and in women with sexual dysfunction measured with FSM. PISQ-12 is an instrument with the appropriate psychometric characteristics to evaluate sexual function in women with pelvic floor problems.

背景与目标： UNLABELLED：本文总结了为适应和验证在西班牙使用的盆腔器官脱垂/尿失禁性问卷（PISQ-12）的简短形式所做的工作。它将成为该国第一份经过验证的问卷，用于评估盆腔器官脱垂和/或尿失禁的女性的性功能。
患者与方法：纳入49名到访有骨盆底症状的专门科室的妇女。患者填写西班牙问卷进行验证（PISQ-12），即尿失禁问卷（ICIQ-UI-SF）；女性性功能问卷（FSM）和膀胱控制自我评估问卷（CACV）。评价了新问卷的可行性，信度和效度。
结果：可行性：99.83％的样本回答了所有项目（只有一名患者没有回答其中一项）；平均管理时间3.5（1.5）分钟。
可靠性：克伦巴赫的alpha为0,829。
有效性：PISQ-12与FSM的相关性为0.71；使用ICIQ-UI-SF时为-0038； CACV“症状”维度的相关系数为-0,30，而“不适”维度的相关系数为-0,40。通过析因分析，对经过改编的西班牙问卷中的PISQ-12原始版本是否存在相同的三个维度进行了检查。对于使用膀胱过度活动症症状和不适的女性（通过CACV问卷调查）以及在患有性功能障碍的女性中，通过FSM测量的PISQ-12评分较差（较低）。 PISQ-12是一种具有适当心理计量学特征的仪器，可用于评估骨盆底疾病女性的性功能。

BACKGROUND & AIMS: :This investigation examined differences in symptom patterns of two different trauma samples using the Minnesota Multiphasic Personality Inventory-2 (MMPI-2). MMPI-2s of 122 male combat veterans seeking outpatient treatment for combat-related PTSD were compared with those of 64 PTSD-diagnosed adults seeking outpatient treatment for the effects of child sexual abuse (CSA). We examined variables related to degree of health concerns, depression, somatization, anger and hostility, masculine-feminine traits, paranoid ideation, anxiety, difficulties thinking and concentrating, elevated mood, and social introversion, as well as test-taking attitude. MANOVAs revealed between-group differences on several variables. However, when analyses controlled for the effect of age, nearly all differences disappeared; the only remaining difference was in a scale measuring anger. Thus, it appears CSA survivors and combat veterans are much more similar than different in their clinical presentation on the MMPI-2. Conceptual issues in the assessment of PTSD are discussed.

背景与目标： ：这项研究使用明尼苏达州多相人格量表2（MMPI-2）检验了两种不同创伤样本的症状模式差异。比较了122名寻求与战斗相关PTSD进行门诊治疗的男性退伍军人的MMPI-2s与64名经PTSD诊断为儿童性虐待（CSA）寻求门诊治疗的成年人的MMPI-2。我们研究了与健康程度，抑郁，躯体化，愤怒和敌对，男性女性特征，偏执观念，焦虑，思维和专心的困难，情绪升高，社交内向以及应试态度有关的变量。 MANOVAs揭示了几个变量之间的组间差异。然而，当分析控制了年龄的影响时，几乎所有的差异都消失了。唯一剩下的区别是测量愤怒的天平。因此，CSA幸存者和退伍军人似乎在MMPI-2的临床表现上相似之处远胜于不同之处。讨论了创伤后应激障碍的评估中的概念性问题。

BACKGROUND & AIMS: :The purpose of this study was to evaluate the effect of female sexual hormones on intestinal and serum cytokines following traumatic brain injury (TBI). Adult female rats were ovariectomized and distributed among the following 9 groups: (i) sham trauma, (ii) TBI (Marmarou's method), (iii) vehicle (dimethylsulfoxide) treated, (iv) estrogen (E2) treated, (v) progesterone (P) treated, (vi) treated with E2+P, (vii) propylpyrazole triol (PPT) treated, (viii) diarylpropionitrile (DPN) treated, and (ix) control. PPT and DPN are estrogen receptor αand β agonists, respectively. Serum and intestinal levels of interleukin (IL)-1β were increased by TBI (P < 0.001). The level of intestinal IL-1β was increased in the group treated with E2 (P < 0.001). There was a reduction in serum IL-1β (P < 0.01) and an increase in intestinal IL-1β level (P < 0.001) in the PPT-treated group compared with the vehicle-treated group. TBI reduced serum IL-6 (P < 0.01) and increased intestinal IL-6 (P < 0.001). Serum IL-6 was increased in the group treated with E2 (P < 0.001), P (P < 0.001), E2+P (P < 0.01), and DPN (P < 0.001) after TBI; however, intestinal IL-6 was higher in the E2-treated group compared with the vehicle-treated group (P < 0.01). Intestinal tumor necrosis factor α (TNF-α) was increased by TBI (P < 0.001). Progesterone decreased serum TNF-α (P < 0.01). Intestinal TNF-α in the E2 (P < 0.01), E2+P (P < 0.001), and PPT (P < 0.001) treatment groups was less than in the vehicle-treated group. In conclusion, estrogen influences the intestinal levels of proinflammatory cytokines, in particular TNF-α, mediated through estrogen receptor α.

背景与目标： ：这项研究的目的是评估女性性激素对脑外伤（TBI）后肠道和血清细胞因子的影响。将成年雌性大鼠切除卵巢，并分布在以下9组中：（i）假创伤，（ii）TBI（Marmarou方法），（iii）媒介物（二甲亚砜）治疗，（iv）雌激素（E2）治疗，（v）孕酮（P）处理，（vi）用E2 P处理，（vii）丙基吡唑三醇（PPT）处理，（viii）二芳基丙腈（DPN）处理，以及（ix）对照。 PPT和DPN分别是雌激素受体α和β激动剂。 TBI可提高血清和肠道白细胞介素（IL）-1β的水平（P <0.001）。 E2治疗组肠道IL-1β水平升高（P <0.001）。与溶媒治疗组相比，PPT治疗组的血清IL-1β降低（P <0.01），肠内IL-1β水平升高（P <0.001）。 TBI降低血清IL-6（P <0.01），增加肠道IL-6（P <0.001）。 TBI后E2组（P <0.001），P组（P <0.001），E2P组（P <0.01）和DPN组（P <0.001），血清IL-6水平升高。然而，E2治疗组的肠道IL-6高于媒介物治疗组（P <0.01）。 TBI可增加肠道肿瘤坏死因子α（TNF-α）（P <0.001）。孕酮降低血清TNF-α（P <0.01）。 E2（P <0.01），E2 P（P <0.001）和PPT（P <0.001）治疗组的肠道TNF-α低于溶媒治疗组。总之，雌激素影响通过雌激素受体α介导的促炎细胞因子，特别是TNF-α的肠道水平。

BACKGROUND & AIMS: OBJECTIVE:To analyze factors predictive for changes in sexual function after pelvic floor surgery and explore differences between stress urinary incontinence (SUI) and pelvic organ prolapse (POP) surgery. DESIGN:Prospective observational study. SETTING:St Olav Hospital, Trondheim University Hospital, Norway. SAMPLE:Of 346 mailed questionnaires for women scheduled for SUI and POP surgery, 65 questionnaires were available for analysis together with examination findings before and 1 year after surgery. METHODS:Postal questionnaires including Prolapse and Incontinence Sexual Function Questionnaire (PISQ 12), Hopkins Symptom Checklist 5 for psychological distress, questions from the validated Body Image Questionnaire, a general health question, questions addressing goals for improvement after surgery, clinical findings based on the Pelvic Organ Prolapse Quantification System and Brief Sexual Function Index for partners. Uni- and multivariate linear regressions adjusting for age were performed. MAIN OUTCOME MEASURES:Change in PISQ 12 score at follow-up. RESULTS:Sexual function significantly improved in the total group (p = 0.000). After stratification into SUI and POP surgery, improvement only remained significant after SUI surgery (p = 0.001). Improvement for the total group was predicted by good health or coital incontinence, whereas psychological distress or the goal of improved defecation predicted deterioration. For women undergoing SUI surgery, increasing age, parity or the goal of improving sexuality or body image predicted improvement, while for women undergoing POP surgery, menopausal status or anterior colporrhaphy predicted improvement. CONCLUSION:Significantly improved sexuality was observed after pelvic floor surgery. Predictive factors for change differed for women undergoing SUI surgery and and those undergoing POP surgery.

背景与目标： 目的：分析预测骨盆底手术后性功能改变的因素，探讨压力性尿失禁（SUI）和骨盆器官脱垂（POP）手术之间的差异。
设计：前瞻性观察研究。
地点：挪威特隆赫姆大学医院圣奥拉夫医院。
样本：在346份计划进行SUI和POP手术的女性邮寄调查表中，有65份调查表可用于分析手术前和手术后1年的检查结果。
方法：邮寄问卷，包括脱垂和失禁性功能问卷（PISQ 12），霍普金斯症状困扰清单5，心理困扰，经过验证的身体影像问卷，一般健康问题，解决手术后改善目标的问题，基于以下内容的临床发现伙伴的骨盆器官脱垂量化系统和简短的性功能指数。进行了针对年龄的单变量和多元线性回归。
主要观察指标：随访时PISQ 12评分改变。
结果：整个组的性功能显着改善（p = 0.000）。在分层进行SUI和POP手术后，只有在SUI手术后才有显着改善（p = 0.001）。总体状况的好转是由于身体健康或性交失禁所致，而心理困扰或改善排便的目标预示着情况将会恶化。对于接受SUI手术的女性，增加年龄，产次或改善性欲或提高身体形象的目标可望改善，而对于接受POP手术的女性，绝经期或前阴道炎则有望改善。
结论：骨盆底手术后性行为明显改善。进行SUI手术的妇女和进行POP手术的妇女的变化预测因素有所不同。

BACKGROUND & AIMS: :Empirical studies suggest that childhood sexual abuse is associated with sexual revictimization by a male romantic partner in female survivors. Yet, the potential mechanisms underlying this association remain understudied. Past studies indicated that women childhood sexual abuse survivors report more sexual anxiety, which in turn was linked to an increased risk of sustaining sexual coercion. The current study, conducted with a sample of 448 adult women from the community, aimed to examine sexual anxiety as a potential mechanism in the association between childhood sexual abuse and sexual coercion sustained by women in heterosexual romantic relationships. Results from path analyses confirmed the indirect effect of sexual anxiety in the relationship between childhood sexual abuse and sexual coercion victimization. Findings indicated that childhood sexual abuse is associated with higher levels of sexual anxiety, which in turn, was linked to a higher frequency of sexual coercion experiences perpetrated by the romantic partner. This study contributes to a better understanding of the determinants of sexual violence against women and provides an empirical basis to better inform prevention initiatives and guide future interventions.

背景与目标： ：经验研究表明，儿童期的性虐待与女性幸存者中男性浪漫伴侣的性重新定罪有关。然而，这种关联的潜在机制仍未得到充分研究。过去的研究表明，儿童时期遭受性虐待的女性幸存者报告称性焦虑更为严重，而这又与维持性胁迫的风险增加有关。当前的研究是对来自社区的448名成年女性进行的抽样调查，旨在检验性焦虑是儿童性虐待与女性在异性恋爱关系中维持的性强迫之间联系的一种潜在机制。路径分析的结果证实，性焦虑对儿童性虐待和性强迫受害之间的关系具有间接影响。研究结果表明，儿童时期的性虐待与更高水平的性焦虑有关，而后者又与浪漫伴侣进行性胁迫的频率更高有关。这项研究有助于更好地了解针对妇女的性暴力的决定因素，并为更好地为预防举措提供信息并指导今后的干预措施提供了经验基础。

BACKGROUND & AIMS: :Theoretical frameworks positing qualitatively distinct trajectories of posttrauma outcome have received initial empirical support, but have not been investigated in cases of severe interpersonal trauma. To address this limitation, we conducted latent class growth analysis with longitudinal data collected from 119 female sexual assault survivors at 1-, 2-, 3-, and 4-months postassault. Participants' mean age was 33 years; 63% were White. We hypothesized that given the severity of exposure associated with sexual assault, resilience would not be the modal course of adaptation. Four distinct PTSD growth trajectories, representing unique latent classes of participants, best fit the data: a high chronic trajectory, a moderate chronic trajectory, a moderate recovery trajectory, and a marked recovery trajectory. Contrary to previous studies and recent theoretical models, resilience and resistance trajectories were not observed, as high levels of distress were evident in nearly all participants at 1-month postassault. These results suggest that theoretical models of posttrauma response positing resilience as the modal outcome may not generalize to cases of sexual assault.

背景与目标： ：创伤后结局的定性定性理论框架已经获得了初步的经验支持，但是在严重的人际交往中并未进行过研究。为了解决这一局限性，我们利用在攻击后1个月，2个月，3个月和4个月内从119名女性性侵犯幸存者那里收集的纵向数据进行了潜伏类增长分析。参与者的平均年龄为33岁； 63％是白人。我们假设，鉴于与性侵犯相关的暴露严重性，适应力将不是适应的模态过程。代表独特潜在参与者类别的四种不同的PTSD生长轨迹最适合该数据：高慢性轨迹，中度慢性轨迹，中度恢复轨迹和明显的恢复轨迹。与先前的研究和最新的理论模型相反，未观察到复原力和抵抗力的轨迹，因为在袭击后1个月内几乎所有参与者中都表现出很高的苦恼程度。这些结果表明，创伤后反应的理论模型将复原力作为模态结果，可能无法推广到性侵犯案件中。

BACKGROUND & AIMS: -2

背景与目标： -2

BACKGROUND & AIMS: PURPOSE:Pregnancy rates among adolescents have declined in the U.S. and Britain but remain high compared with other high-income countries. This comparison describes trends in pregnancy rates, recent sexual activity, and contraceptive use among women aged 16-19 years in the U.S. and Britain to consider the contribution of these two behavioral factors to the decline in pregnancy rates in the two countries and the differences between them. METHODS:We use data from two rounds of the U.S. National Survey of Family Growth, conducted 2002-2003 and 2011-2015, and the British National Survey of Sexual Attitudes and Lifestyles, conducted 2000-2001 and 2010-2012, to describe population-level differences between countries and over time in sexual activity and contraceptive use. We calculate pregnancy rates using national births and abortions data. RESULTS:Pregnancy rates declined in both countries; this began earlier in the U.S. and was steeper. There was no change in sexual activity in Britain, but in the U.S., the proportion reporting recent sex declined. In both countries, there was a shift toward more effective contraception. A higher proportion in Britain than the U.S. reported ever having had sex (65% vs. 49%) and sex in the last year (64% vs. 45%), 6 months (59% vs. 39%), and 4 weeks (48% vs. 29%). A higher proportion in Britain reported using more effective contraception (68% vs. 52%). CONCLUSIONS:In both countries, improvements in contraceptive use have contributed substantially to declines in pregnancy rates; however, the steeper decline in the U.S. likely also reflects declines in recent sex occurring only in that country.

背景与目标： 目的：美国和英国的青少年怀孕率有所下降，但与其他高收入国家相比仍然很高。这项比较描述了美国和英国16-19岁女性的怀孕率，近期性行为和使用避孕药具的趋势，以考虑这两个行为因素对两国怀孕率下降的贡献以及两者之间的差异。他们。
方法：我们使用来自2002年至2003年和2011年至2015年的美国全国家庭增长调查和2000年至2001年以及2010年至2012年的英国全国性态度和生活方式调查的两轮数据来描述以下人群：各国之间以及不同时期性行为和避孕方法使用水平的差异。我们使用全国出生和堕胎数据计算怀孕率。
结果：两个国家的怀孕率均下降；这是在美国较早开始的，而且难度更大。英国的性活动没有变化，但在美国，报告最近发生性行为的比例有所下降。在这两个国家，人们都在朝着更有效的避孕方式发展。在英国，发生性行为的比例（65％比49％）和去年（64％比45％），6个月（59％比39％）和4周曾经发生过性行为的比例更高。 （48％比29％）。英国较高的比例表示使用了更有效的避孕方法（68％比52％）。
结论：在这两个国家，避孕药具使用的改善在很大程度上导致了妊娠率的下降。但是，美国的急剧下降也可能反映出仅在该国发生的近期性行为下降。

BACKGROUND & AIMS: PURPOSE OF REVIEW:This review highlights recent literature regarding online sexual offending, including the prevalence, characteristics, a brief review of recent typology literature, victimization risk factors, risk factors of being a "crossover" offender, rates and risk factors for recidivism, and a discussion of prevention efforts. RECENT FINDINGS:Online sexual offenders are overwhelmingly White men with relationship problems who were rarely previously arrested for felonies. They score lower on measures of antisocial behavior, compared to offenders who commit contact sexual offenses against children. Individuals who commit pornography offenses are at lower risk to commit contact offenses and their risk factors include having sexual interest in children and antisocial attitudes. Online offenders are different from contact sexual offenders and from offenders who commit both types of offenses. Recidivism in online noncontact offenders is difficult to assess due to the lack of empirically supported tools and the inappropriateness of using popular actuarial tools that lack norms on these offenders, but a new measure (CPORT) is being studied for use with this population.

背景与目标： 审查的目的：这篇综述重点介绍了有关在线性犯罪的最新文献，包括患病率，特征，对近期类型学文献的简要综述，受害风险因素，成为“跨界”犯罪者的风险因素，累犯的发生率和风险因素，以及预防工作的讨论。
最近的调查结果：网上性犯罪者绝大多数是有恋爱关系的白人，以前很少因重罪而被捕。与对儿童实施接触性犯罪的罪犯相比，他们在反社会行为方面的得分较低。犯下色情罪行的人犯接触罪行的风险较低，其危险因素包括对儿童的性兴趣和反社会态度。在线罪犯不同于接触性罪犯和犯两种类型犯罪的罪犯。由于缺乏经验支持的工具以及使用缺乏针对这些犯罪者的规范的流行精算工具的不适当性，在线非接触犯罪者的累犯性难以评估，但是正在研究针对该人群的新措施（CPORT）。

BACKGROUND & AIMS: BACKGROUND:Although teen pregnancy rates decreased dramatically in the United States over the past decade, the rates of sexually transmitted infections (STIs) among adolescents and young adults increased. STI rates disproportionately affect African American youth and young adults. Innovative, accessible, and culturally relevant sexual health interventions are urgently needed. OBJECTIVE:This study aimed to identify the optimal modality for a game-based sexual health intervention; develop the educational, entertainment, and technological aspects of the serious game; and demonstrate its usability and acceptance by the target population. METHODS:This project was grounded in formative data collection with community-based participatory research principles and practices combined with a user-centered design and development approach. Sexually Active Adolescent-Focused Education (SAAFE) was developed using input and feedback from African American youths aged 15 to 21 years who participated in a youth advisory board and focus group discussions to inform the co-design and cocreation of the serious game. The process was highly iterative with multiple sessions for user input following design changes. It proceeded in 3 stages. Social cognitive theory and problem-solving theory were leveraged to provide evidence-based, trauma-informed education through a serious game. Usability testing assessed the quality of user experience with the prototype. RESULTS:Across all 3 stages, a total of 86 self-identified African American males and females aged 15 to 21 years from the District of Columbia and Birmingham, Alabama, participated. Participants requested a dating simulation game. They wanted SAAFE to be customizable, realistic, entertaining, educational, modern, and experiential, linking consequences to their gameplay decisions. Usability testing resulted in an initial System Usability Survey score of 77.7, placing the game in the 82nd percentile and above average for usability. CONCLUSIONS:Initial results suggest that the SAAFE prototype is a promising intervention to engage African American youth in sexual health education using a role-playing game. If proven efficacious, the game has the potential to meet the need for sex education, counterbalance unhealthy portrayals of sex in popular media, and respond to the disparities in the STI epidemic.

背景与目标： 背景：尽管在过去的十年中，美国的青少年怀孕率急剧下降，但青少年和年轻人中的性传播感染（STI）发生率却有所上升。性传播感染率对非裔美国青年和年轻人的影响不成比例。迫切需要创新，可及且与文化相关的性健康干预措施。
目的：本研究旨在确定基于游戏的性健康干预的最佳方式。开发严肃游戏的教育，娱乐和技术方面；并证明其可用性和目标人群的接受度。
方法：该项目的基础是形成性数据收集，结合基于社区的参与性研究原则和实践以及以用户为中心的设计和开发方法。性活跃的青少年重点教育（SAAFE）是根据15至21岁的非裔美国人青年的意见和反馈而开发的，这些青年参加了青年顾问委员会并进行了焦点小组讨论，为严肃游戏的共同设计和创作提供了信息。设计更改后，该过程是高度迭代的，有多个会话供用户输入。它分三个阶段进行。社会认知理论和解决问题的理论被用来通过认真的游戏提供基于证据的，具有创伤知识的教育。可用性测试评估了原型用户体验的质量。
结果：在所有三个阶段中，共有来自哥伦比亚特区和阿拉巴马州伯明翰的86位15至21岁的自我识别的非洲裔美国男性和女性参加了研究。参与者要求进行约会模拟游戏。他们希望SAAFE具有可定制性，现实性，娱乐性，教育性，现代性和体验性，并将其后果与他们的游戏决策联系起来。可用性测试得出的初始系统可用性调查得分为77.7，使该游戏在可用性上处于第82个百分位，并且高于平均水平。
结论：初步结果表明，SAAFE原型是一种有前途的干预措施，可通过使用角色扮演游戏让非洲裔美国年轻人参与性健康教育。如果经证明有效，那么这款游戏就有可能满足对性教育的需求，平衡大众媒体对性的不良描写，并应对性传播疾病中的性别差异。

BACKGROUND & AIMS: OBJECTIVES:To investigate whether the presence of persistent self-reported oral lesions (PSOLs) is associated with sexual behaviors and with the presence of sexually transmitted infections (STIs) in individuals aged 16-25 years in the state capitals of Brazil. MATERIALS AND METHODS:Data from the POP-Brazil study were analyzed. An association analysis was performed by Poisson regression with the presence of PSOLs as the outcome. The exposure variables were the age at first sexual intercourse, the number of partners, oral sex practice, and aspects of condom use for model 1, and the presence of a self-reported STI or a positive rapid test for HIV/syphilis and the presence of genital human papillomavirus (HPV) for model 2. The results were adjusted for socioeconomic variables. RESULTS:The prevalence of PSOLs was 76% higher among individuals who had two or more sexual partners in the past year (p = 0.046) and 68% higher in those who reported not using condoms for contraception (p = 0.032). The group with HIV/syphilis or self-reported STI had a 140% higher PSOL prevalence (p = 0.003). CONCLUSIONS:The self-report of oral lesions in adolescents and young adults may suggest risky sexual behavior and the presence of STI. CLINICAL RELEVANCE:It is necessary to contextualize the reality of the young person to optimize oral health care.

背景与目标： 目的：调查在巴西州首府16-25岁的人群中，持续自我报告的口腔损伤（PSOL）的存在是否与性行为以及性传播感染（STI）的存在有关。
材料与方法：对来自POP-巴西研究的数据进行了分析。通过Poisson回归进行关联分析，并以PSOLs作为结果。暴露变量是第一次性交的年龄，伴侣的数量，口交行为以及模型1使用安全套的方面，是否存在自我报告的性传播感染或对HIV /梅毒的快速快速检测以及是否存在模型2的生殖器人类乳头瘤病毒（HPV）的检测结果。根据社会经济变量对结果进行了调整。
结果：在过去的一年中，有两个或多个性伴侣的人中PSOLs的患病率高76％（p = 0.046），而那些不使用避孕套进行避孕的人（p = 0.032）则高68％。 HIV /梅毒或自我报告的性传播感染者的PSOL患病率高140％（p = 0.003）。
结论：青少年和青年人口腔损伤的自我报告可能提示危险的性行为和性传播感染的存在。
临床相关性：有必要根据年轻人的实际情况，以优化口腔保健。

BACKGROUND & AIMS: AIM:This article provides an overview of current sexual behaviour research in later life by describing associated factors, including the physical and psychological benefits. METHODS:Recent systematic reviews were interrogated for findings on sexual behaviour research in adults aged 60+. RESULTS:Regardless of research methods employed, all studies showed that there were a range of physical and psychological benefits to remaining sexually active in later life. While quantitative studies placed an emphasis on measuring penile-vaginal intercourse, they provided no definitive conclusion about the benefits due to 'inconsistent results' across studies. Qualitative studies described the myriad ways in which older adults redefine what constitutes sexual activity despite the onset of dysfunction and disability. CONCLUSION:While the different research methods show that engaging in sexual behaviour has physical and psychological benefits at all adult ages, there is limited conclusive evidence about what the overall benefits might be in later life.

背景与目标： 目的：本文通过描述相关因素（包括身体和心理上的好处），概述了当前晚年性行为研究的概况。
方法：对最近的系统评价对60岁成年人的性行为研究进行了调查。
结果：无论采用何种研究方法，所有研究均表明，在以后的生活中保持性活跃有一系列生理和心理上的益处。虽然定量研究强调测量阴茎-阴道性交，但由于整个研究的“结果不一致”，他们没有给出有关益处的明确结论。定性研究描述了尽管功能障碍和残疾发作，老年人重新定义性活动的无数方法。
结论：尽管不同的研究方法表明，在所有成年年龄进行性行为都具有生理和心理上的益处，但是关于最终生活可能带来的总体益处的确凿证据有限。