Shared Recklessness

A collection of fiction, nonfiction, and short shorts that together demonstrate my development as a writer. In these pieces, I explore themes of sexuality, religion, and death. I am interested in why people do what they do, especially actions that are considered taboo. One of my goals was to investigate socially abhorrent behaviors to find the truth and empathy hidden there. My characters embark on journeys, and take risks to ultimately forge connections to people and to life, despite the questions of loneliness and meaninglessness

ASSOCIATIONS OF ATTACHMENT STYLE AND REASONS TO PRETEND ORGASM; DEVELOPMENT AND VALIDATION OF REASONS TO PRETEND ORGASM MEASURE IN A RELATIONAL CONTEXT

Although pretending orgasm is a relatively common phenomenon, a review of the literature revealed no theory driven research investigating the relationship correlates of this sexual behavior. The current research uses a well validated theory of close relationships (Attachment Theory) to construct and validate a measure of Reasons for Pretending Orgasm (the RPO). Exploratory Factor Analysis revealed a six factor structure that was confirmed using a separate sample and a Confirmatory Factor Analysis. Using a large separate internet sample, certain factors from the RPO (Manipulation/Power, Insecurity, Not into Sex) were related to poor relationship outcomes (lower trust, intimacy, love, commitment, and overall relationship satisfaction) suggesting that the reasons for pretending orgasm play an important role in the relationship outcomes of this sexual behavior. Additional analyses (structural equation modeling) revealed that negative relationship outcomes might increase pretending orgasm, rather than pretending increasing negative outcomes. Further, higher frequency of pretending orgasm was also related to: an anxious attachment style, gender (more common among women, replicating previous findings), lower orgasm frequency, tendency to lie to one's partner, more sexual behavior, and lower commitment in relationships, even when controlling for other factors such as the big five personality dimensions. Implications of these findings for clinical practice, and future directions are discussed

Delayed phlegmon with gallstone fragments masquerading as soft tissue sarcoma.

Complications from lost gallstones after cholecystectomy are rare but varied from simple perihepatic abscess to empyema and expectoration of gallstones. Gallstone complications have been reported in nearly every organ system, although reports of malignant masquerade of retained gallstones are few. We present the case of an 87-year-old woman with a flank soft tissue tumor 4 years after laparoscopic cholecystectomy. The initial clinical, radiographic and biopsy findings were consistent with soft tissue sarcoma (STS), but careful review of her case in multidisciplinary conference raised the suspicion for retained gallstones rather than STS. The patient was treated with incisional biopsy/drainage of the mass, and gallstones were retrieved. The patient recovered completely without an extensive resectional procedure, emphasizing the importance of multidisciplinary sarcoma care to optimize outcomes for potential sarcoma patients

Managing behavioural and psychological symptoms in community dwelling older people with dementia:1. A systematic review of the effectiveness of interventions

© 2018 The Author(s) This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence CC BY 4.0 (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.Background: Two-thirds of people living with dementia live at home in the UK and many experience distressing behavioural and psychological symptoms. This systematic review evaluates the effectiveness of non-pharmacological interventions for behavioural and psychological symptoms among community-dwelling people living with dementia. Methods: This two-stage review undertook an initial mapping of the literature followed by a systematic review of relevant randomised controlled trials. We searched electronic databases for pertinent studies reporting outcomes from interventions from January 2000 to March 2015 and updated searches in October 2016. We included studies that considered behavioural and psychological symptom management for older people living with dementia who live at home and excluded studies conducted in long-term care settings. This paper presents findings from a narrative synthesis of 48 randomised controlled trials evaluating interventions for people living with dementia alone, family carers alone and patient-carer dyads. Results: We retrieved 17,871 de-duplicated records and screened them for potential inclusion. Evidence from 48 randomised controlled trials suggests that family carer training and educational programmes that target problem behaviours and potential triggers can improve outcomes. Nurses and occupational therapists appear to help people with dementia with behavioural and psychological symptoms, but professional comparisons are lacking and there is no shared language about or understanding of behavioural and psychological symptoms amongst professionals, or between professionals and family carers. Conclusions: Future research should focus on the effectiveness of components of multi-faceted programmes and their cost effectiveness and include qualitative data to better target interventions for behavioural and psychological symptoms. It is important to consider family carer readiness to use non-pharmacological strategies and to develop a shared language about the inherent needs and communications of behavioural and psychological symptoms.Peer reviewe

An analysis of post-traumatic stress symptoms in United States Air Force drone operators

Remotely piloted aircraft (RPA), commonly referred to as “drones,” have emerged over the past decade as an innovative warfighting tool. Given there is a paucity of empirical research assessing drone operators, the purpose of this study was to assess for the prevalence of PTSD symptoms among this cohort. Of the 1084 United States Air Force (USAF) drone operators that participated, a total of 4.3% endorsed a pattern of symptoms of moderate to extreme level of severity meeting criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders-4th edition. The incidence of PTSD among USAF drone operators in this study was lower than rates of PTSD (10–18%) among military personnel returning from deployment but higher than incidence rates (less than 1%) of USAF drone operators reported in electronic medical records. Although low PTSD rates may be promising, limitations to this study are discussed