Introduction Good history-taking skills are the first step towards achieving a correct diagnosis of sexual dysfunction (SD). However, studies show most general practitioners (GPs) do not take the initiative to ask the patient about SD, and when diagnosing a condition, they tend to give preference to their own criteria over clinical guidelines. Aim The aim of this study is to characterize GPs' attitudes towards taking sexual history, identifying its frequency and focus, and to describe GPs' diagnostics and therapeutic approaches including the use of clinical guidelines, exploring patients' and doctor-related differences. Methods Cross-sectional study using confidential self-administrated questionnaires applied to GPs working in primary healthcare units in the Lisbon region. Main Outcome Measures Data concerning GPs' consultation of guidelines, active exploration of SD in male and in female patients, and focus on sexual history taking was collected. Results Of the 50 participants (73.5% response rate), 15.5% actively ask their patients about SD. The main reasons for asking patients about their sexuality are diabetes (84.0%), prescription of medication with adverse effects on sexuality (78.0%), and family planning (72.0%), the latter being a significantly more frequent reason for GPs with 20 or less years of practice. Routine sexual history taking (22.0%) appears as one of the least mentioned motives. The percentage of appointments with active exploration of SD was positively associated with guidelines' consultation, as well as considering the specialty as a good source of information and having longer appointments when SD is mentioned. However, 76.0% report not having consulted any guidelines in the previous year. Lack of time (31.6%) and low accessibility (25.0%) were referred to as the main reasons for not consulting guidelines. Conclusions Routine sexual history taking and consultation of guidelines about SD are not yet a generalized practice in primary care. Data should be interpreted with caution as they are self-reported. Further objective measurement such as direct observation or clinical files consultation should be implemented.

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ABSTRACT:In this paper, a hysteretic model with pinching is presented that is able to reproduce realistically the cyclic response of generic steel joints. Secondly, the computer implementation and adaptation of the model in a spring element within the computer code SeismoStruct is described. The model is subsequently calibrated using a series of experimental test results for steel joints subjected to cyclic loading. Finally, typical parameters for the various joint configurations are proposed.Keywords: structural engineering, steel structures, buildings, component method, beam-to-column joints, dynamic behaviour, seismic behaviour, joint model INTRODUCTIONThe behaviour of steel or composite joints under cyclic loading is characterized by hysteretic loops with progressive degradation of strength and stiffness that eventually lead to failure of the joint. A typical natural event that, for simplicity, is usually approximated by cyclic loading is an earthquake. Usually, seismic events provoke relatively high amplitudes of rotation in the joint area, so that steel repeatedly reaches the plastic range and the joint fails after a relatively small number of cycles. This typical behaviour is usually called oligocyclic fatigue, in close analogy with the behaviour of steel under repeated cyclic loading stressed into the plastic range (Fig. 1a).