Men Presenting With Sexual Thoughts of Children or Coercion: Flights of Fancy or Plans for Crime?

Introduction. There is limited evaluation of clinical and theoretical claims that sexual thoughts of children and coercing others facilitate sexual offending. The nature of these thoughts (what they contain) is also unknown. Aims. To examine the relationship between child/coercive sexual thoughts and sexual offending, and to determine the nature of these thoughts and any differences between sexual offending (SO), non-sexual offending (NSO) and non-offending (NO) men. Methods. In a cross-sectional computerized survey, anonymous qualitative and quantitative self-reported sexual thought and experience data were collected from 279 adult volunteers, comprising equal numbers of SO, NSO and NO men recruited from a medium-security UK prison and a community sample of 6081 men. Main Outcome Measures. Computerized Interview for Sexual Thoughts and Computerized Inventory of Sexual Experiences. Results. Three analytical approaches found child sexual thoughts were related to sexual offending; sexual thoughts with coercive themes were not. Latent class analyses identified three types of child sexual thought (primarily differentiated by interpersonal context: the reporting of own emotions, emotions of others or both) and four types of sexual thoughts of coercing others (chiefly discriminated by the other person’s response: no emotional states reported, consent, non-consent, mixed). Type of child sexual thought and participant group were not significantly related. Type of coercive sexual thought and group were marginally related; the consensual type was more common for the NO group, the non-consensual type more common for the SO group, than expected statistically. Conclusions. Child sexual thoughts are a risk factor for sexual offending and should be assessed by clinicians. Generally, sexual thoughts with coercive themes are not a risk factor, though thought type may be important (i.e. thoughts where the other person expresses an enduring lack of consent). Exploring the dynamic risk factors associated with each type of child/coercive thought may lead to more targeted treatment

169 Similar Proportions Return to Work Following Fusion and Decompression Alone for Degenerative Grade 1 Lumbar Spondylolisthesis, Though the Trajectories Differ: An Analysis of the Quality Outcomes Database

Abstract INTRODUCTION Low back pain is a leading cause of work-related disability in the United States and results in significant costs, including up to $20 billion annually due to lost productivity of the gainfully employed. Thus, return to work (RTW) is an important metric in the comparison of fusion versus decompression alone for grade 1 degenerative lumbar spondylolisthesis (DLS). METHODS This was a retrospective analysis of a prospective registry. A total of 599 patients underwent surgery for grade 1 DLS at 12 high-enrolling sites. Baseline variables were collected. Employment was defined as being employed and actively working or employed and on leave at time of surgery. RTW was assessed at 3 and 12 mo following surgery. RESULTS At baseline, 264 patients (44.1%) were employed. At baseline, there were a higher proportion of patients in the fusion cohort (219/462; 47.4%) who were employed compared with the decompression alone cohort (45/137; 32.8%; P = .003). At 3 and 12 mo, for patients eligible for RTW, 62.6% and 74.3%, respectively, were able to do so. In a subgroup analysis of the decompression alone cohort, 64.1% demonstrated RTW at 3 mo with a rate that was similar at 12 mo (65.0%) (P = .94). In the fusion cohort, 62.3% demonstrated RTW at 3 mo with rates that continued to increase at 12 mo (75.8%) (P = .01). There were no significant differences in RTW between the decompression alone and fusion cohorts at 3 and 12 mo (P = .83 and P = .30, respectively). CONCLUSION At 12 mo, the overall RTW rate was equivalent between the decompression and fusion cohorts. The decompression alone cohort reached peak RTW at 3 mo, which remained stable at 12 mo. Though the fusion cohort showed similar RTW at 3 mo, the proportion continued to rise at 12 mo. Further study is required to determine RTW rates in longer follow-up

The impact of digital imaging in the field of cytopathology

With the introduction of digital imaging, pathology is undergoing a digital transformation. In the field of cytology, digital images are being used for telecytology, automated screening of Pap test slides, training and education (e.g. online digital atlases), and proficiency testing. To date, there has been no systematic review on the impact of digital imaging on the practice of cytopathology. This article critically addresses the emerging role of computer-assisted screening and the application of digital imaging to the field of cytology, including telecytology, virtual microscopy, and the impact of online cytology resources. The role of novel diagnostic techniques like image cytometry is also reviewed