Sexual Health in Men With Traumatic Spinal Cord Injuries: A Review and Recommendations for Primary Health-Care Providers
Bibliographic record
Abstract
Sexual health has been well established as a salient priority for men following traumatic spinal cord injury; yet, it continues to be under-addressed by health-care providers in both inpatient and community settings. Given that most men with traumatic spinal cord injuries will be followed by community-based primary health-care providers, including family physicians and nurse practitioners, for their long-term health-care needs, these clinicians are well positioned to address ongoing sexual health issues with this population. A scoping review of literature published between 2007 and 2017 inclusive was undertaken to identify what is known about the sexual health of men with spinal cord injuries. Twenty articles met the inclusion criteria. The findings are presented in four themes: (a) patterns and diversity of sexual health concerns; (b) sexual health recovery as an ongoing priority; (c) clinical barriers to addressing sexual health concerns, and (d) recommended interventions and strategies for primary health-care providers. The findings indicate that physiological changes as well as psychological and social factors influence men's sexual function following spinal cord injury, and that sexual health recovery is an enduring rehabilitation priority. Several barriers including lack of sexual rehabilitation services and consensus around clinician roles, and societal stigmas related to disability and sexuality impede treatment. Attention to sexual health recovery has mainly focused on formal rehabilitation settings; however, many evidence-based clinical strategies and resources are relevant to and adaptable for primary care providers caring for these men in the community.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.008 | 0.023 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.004 | 0.003 |
| Bibliometrics | 0.008 | 0.007 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.004 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".