Being confronted with cancer is a life-changing event, with major impact to well-being, quality of life and relationships. Cancer treatments and outcomes have improved, but possess the potential to... Show moreBeing confronted with cancer is a life-changing event, with major impact to well-being, quality of life and relationships. Cancer treatments and outcomes have improved, but possess the potential to impair reproductive and sexual function. International guidelines highlight the importance of timely discussion of sexual function and fertility deterioration resulting from treatments. In spite of these developments, practice behaviour and attitudes of health professionals have been reported to vary.The first part of this thesis demonstrates barriers among oncology professionals in the Netherlands in discussing sexual function during daily practice. In general, consensus exists regarding responsibility for addressing sexual dysfunction. Despite, the implementation of discussing sexual function as a standard of care is not carried out structural.Part two describes practice routines concerning the counselling on impaired fertility and fertility preservation for cancer patients of reproductive age. Medical oncologists and oncology nurses both reported discussing the impact of treatment on fertility. However, it was not performed in all cases and depending on factors like educational level, experience, type of hospital, prognosis and chances of fertility recovery.Furthermore, testicular cancer patients were evaluated on specific items concerning the discussion, referral and process of semen cryopreservation. Long term reproductive concerns were identified among survivors. Show less
The sexual behavior of people in any given society or subculture is guided by certain codes of conduct: written or unwritten rules on how to behave. Cupid on a Leash researches the different codes... Show moreThe sexual behavior of people in any given society or subculture is guided by certain codes of conduct: written or unwritten rules on how to behave. Cupid on a Leash researches the different codes of conduct that guided sexuality in Italy between c. 1450 and 1550. It identifies which codes were present for people of different genders, ages, social classes and sexual orientations. Moreover, the book examines how broadly these codes were shared within the source material, and analyzes the roots and rationalizations of their existence. A wide variety of sources, written by male as well as female authors, is used to analyze these sexual codes of conduct. These sources range from romance epics, novellas, and treatises on love, to sermons, anatomical treatises, and personal correspondence. By revealing the many, often contradictory codes of conduct guiding sexuality, Cupid on a Leash provides insight into the complexities of societal expectations in Renaissance Italy. It studies the arguments that people used to defend sexual codes of conduct, and analyzes the logic behind these arguments, seeking to explain why they were considered so important. Show less
In Savage Embraces: James Purdy, Melodrama, and the Narration of Identity, Looi van Kessel explores the ways in which the early works of the American author James Purdy undermine the notion of a... Show moreIn Savage Embraces: James Purdy, Melodrama, and the Narration of Identity, Looi van Kessel explores the ways in which the early works of the American author James Purdy undermine the notion of a stable and true identity. Writing in the 1950s and 60s, a time in which identity politics enjoyed increased purchase in the United States, Purdy imagines characters who feel the urge to act out their sexual desires without having to conform to oppressive identity categories. In so doing, Purdy is searching for a language that shows how identity is produced through narration. To tease out this language, Looi approaches Purdy’s writing through the mode of melodrama—a mode that focuses on the aesthetic dramatization of tensions in the plot—while also bringing his work in conversation with current queer thinking. Ultimately, this dissertation attempts to bring the disparate fields of narrative theory and queer theory in a meaningful relation with one another. Show less
Stress urinary incontinence (SUI) is the most observed type of urinary incontinence and is defined as the loss of urine following a rise in abdominal pressure. The TVT (Tension-free Vaginal Tape),... Show moreStress urinary incontinence (SUI) is the most observed type of urinary incontinence and is defined as the loss of urine following a rise in abdominal pressure. The TVT (Tension-free Vaginal Tape), a mid-urethral sling (MUS), was introduced in 1996 and soon became the gold standard in the surgical treatment of SUI. Over the last decade, numerous MUS devices have been introduced but only some were able to achieve similar results in comparison to the original TVT. The main question of this thesis is whether slings, old and new, for either male and female, can live up to the expectations of both patients and physicians by being both safe and effective in curing urinary incontinence. Secondly, the question is raised whether sling surgery is anatomically safe with regard to those nervous systems which are essential for the sexual function or may actually be responsible for iatrogenic neurological damage during placement. In this thesis we conclude that many slings were, or still are, freely available on the market without any proper pre-market research. Moreover sling surgery can have serious negative side-effects on sexual function that should be a standard part of the informed consent provided when opting for surgery. Show less
In this thesis the psychological impact of two types of breast reconstruction after prophylactic or therapeutic mastectomy for breast cancer was investigated with a prospective study including 202... Show moreIn this thesis the psychological impact of two types of breast reconstruction after prophylactic or therapeutic mastectomy for breast cancer was investigated with a prospective study including 202 patients from different hospitals in the South-West of the Netherlands between 2007-2012. With semi-structured interviews the motives to opt for breast reconstruction were qualitatively investigated. The impact of breast reconstruction was further investigated with psychological questionnaires from baseline to the end of the breast reconstruction procedure (mean follow-up of 21 months). The psychological outcomes after breast reconstruction that were investigated were: body image, satisfaction with the partner relationship and the sexual relationship, general anxiety and depression, cancer distress, and general mental and physical health. In general, the psychological outcomes after breast reconstruction were acceptable, however a subgroup of women experienced psychological adjustment problems. A percentage of 20-30% remained having problems with changes in their body image and the impact on the intimate partner relationship. Women at risk for psychological adjustment problems were younger women, those with significant cancer distress, women who experienced complications after surgery, particularly if the breast reconstruction failed, and women who underwent bilateral prophylactic mastectomy because of an increased hereditary risk to develop breast cancer. Show less
“Xbalanque’s Marriage” examines the Sun and Moon myth of the Q’eqchi’ Mayas from the perspective of marriage alliance and hunting ideology. On the negative side, the relationship between a tapir... Show more“Xbalanque’s Marriage” examines the Sun and Moon myth of the Q’eqchi’ Mayas from the perspective of marriage alliance and hunting ideology. On the negative side, the relationship between a tapir and the old adoptive mother of Xbalanque and his older brother can be read as the denial of alliance, with the tapir symbolizing antisocial behavior and the old woman incestuous reproduction and paedophiliac cannibalism. The older brother’s abjuration of women has the effect of substituting the transient male brotherhood of hunting bands for a lasting marriage alliance. By contrast, the narrative’s core consists of a tale in which the war chief Xbalanque becomes a hummingbird lover to abduct and marry the daughter of the paramount mountain deity. A central concern of this ‘Hummingbird tale’, and of its many versions elsewhere in Guatemala and Belize, is the ritual alliance to the earth and the acquisition of its products, as personified by the mountain’s daughter. The Q’eqchi’ narrative shows how the dissolution of this alliance sets free the forces of destruction, whereas its reestablishment asserts alliance as a life-giving, cosmic force. Show less
