Clinical Characteristics of Men Interested in Seeking Treatment for Use of Pornography

Background and aims This study examined the prevalence of, and factors associated with, men’s interest in seeking treatment for use of pornography. Methods Using an Internet-based data-collection procedure, we recruited 1,298 male pornography users to complete questionnaires assessing demographic and sexual behaviors, hypersexuality, pornography-use characteristics, and current interest in seeking treatment for use of pornography. Results Approximately 14% of men reported an interest in seeking treatment for use of pornography, whereas only 6.4% of men had previously sought treatment for use of pornography. Treatment-interested men were 9.5 times more likely to report clinically significant levels of hypersexuality compared with treatment-disinterested men (OR = 9.52, 95% CI = 6.72–13.49). Bivariate analyses indicated that interest-in-seeking-treatment status was associated with being single/unmarried, viewing more pornography per week, engaging in more solitary masturbation in the past month, having had less dyadic oral sex in the past month, reporting a history of seeking treatment for use of pornography, and having had more past attempts to either “cut back” or quit using pornography completely. Results from a binary logistic regression analysis indicated that more frequent cut back/quit attempts with pornography and scores on the Hypersexual Behavior Inventory – Control subscale were significant predictors of interest-in-seeking-treatment status. Discussion and conclusions Study findings could be used to inform current screening practices aimed at identifying specific aspects of sexual self-control, impulsivity, and/or compulsivity associated with problematic use of pornography among treatment-seeking individuals

Patient Perspectives on Adherence to the New Hepatitis C Antiviral Medications: ‘A New Lease on Life’

This study explored patients’ perspectives about taking the new direct-acting antivirals (DAAs) for the treatment of Hepatitis C (i.e., sofosbuvir, simeprevir, ledipasvir/sofosbuvir, ombitasvir/paritraprevir/ritonavir and dasabuvir) to identify facilitators of medication adherence. The project was conducted using semi-structured interviews with 12 Veterans who successfully completed a treatment course on the new DAAs. The Veterans were recruited using purposive sampling. The data collected from the semi-structured interviews was analyzed using an adapted open coding method outlined by Auerbach and Silverstein (2003), with identification of relevant text sub-grouped into repeating ideas, and then creation of overarching themes and constructs. Results obtained provide insight into factors that influenced the Veterans’ medication adherence during the course of treatment. Key constructs, embodying major themes supported by repeating ideas, included recognizing the “burden of HCV,” the importance of the “treatment engagement process,” and anticipation of “positive outcomes.” Clinical implications are discussed

The development and initial evaluation of the Pornography-Use Avoidance Self-Efficacy Scale

Background and aims This study employed a newly developed questionnaire to evaluate whether men’s self-efficacy to avoid using pornography in each of 18 emotional, social, or sexually arousing situations was associated with either their typical frequency of pornography use or their hypersexuality. Methods Using an Internet-based data collection procedure, 229 male pornography users (Mage = 33.3 years, SD = 12.2) who had sought or considered seeking professional help for their use of pornography completed questionnaires assessing their situationally specific self-efficacy, history of pornography use, self-efficacy to employ specific pornography-reduction strategies, hypersexuality, and demographic characteristics. Results Frequency of pornography use was significantly negatively associated with level of confidence in 12 of the 18 situations. In addition, lower hypersexuality and higher confidence to employ pornography-use-reduction strategies were associated with higher confidence to avoid using pornography in each of the 18 situations. A principal axis factor analysis yielded three clusters of situations: (a) sexual arousal/boredom/opportunity, (b) intoxication/locations/easy access, and (c) negative emotions. Discussion and conclusions This questionnaire could be employed to identify specific high-risk situations for lapse or relapse and as a measure of treatment outcome among therapy clients, but we recommend further examination of the psychometric properties and clinical utility of the questionnaire in treatment samples. Because only one of the three clusters reflected a consistent theme, we do not recommend averaging self-efficacy within factors to create subscales

The Lantern Vol. 48, No. 1, December 1981

• While Sipping Scotch and Soda • I Remember • The Apology • Growing • It Seems Like Time Has Stood Still • Zimmerman Encounters Pessimism • Deliverer • Genus Sublime • Yours, Still • The Rising Sun • Person, Valley, Things • It Lay Motionless • Les Parques • Opportunity • The Park - I, II • Another Dimension • Grand Mal • Moments Later • Look Into A Pond • Trust and Dependency • From Foundlings • Drought • Girl at Fence • Campus • Clocking Time • A Letter From Clarence • When Flat Lines • Every Now and Then • Loneliness • Emotion No. 2 • You\u27re Walking • Battle Cries • The Ultimate Feudal Lord • Monologue From A Farther Roomhttps://digitalcommons.ursinus.edu/lantern/1119/thumbnail.jp

The Lantern Vol. 48, No. 2, May 1982

• Atonement to the Clown • 5 A.M. • Les Moulins a Vent • Isn\u27t It a Bitter Cold • Eyes That Want • I Am a Life Saver • The Death of Chicken Little • The Secret • In a Little Jungle • Night • From Foundlings • Night Was My Friend • The Librarian of Langden Hall • The Heart • Daybreak • City Song • Chance • Cotton Panels • To Phlebas • Attraction • Fall • Coming Home • June • Breaking Free • Mother • Ice Tree • Return from Nhatrang • What It All Comes Down To • To Benjamin • The Light • Piano Practice • Mother\u27s Song to Her Son • Sister\u27s Song • Shopping • Grandfather • Closing Statement • Dreaming • Another Sunset • Clear, Cold and Crystal • Jog!!! • Empty Nightshttps://digitalcommons.ursinus.edu/lantern/1120/thumbnail.jp

Pain Care in the Department of Veterans Affairs: Understanding How a Cultural Shift in Pain Care Impacts Provider Decisions and Collaboration

OBJECTIVE: Over the past decade, the Department of Veterans Affairs (VA) has experienced a sizeable shift in its approach to pain. The VA\u27s 2009 Pain Management Directive introduced the Stepped Care Model, which emphasizes an interdisciplinary approach to pain management involving pain referrals and management from primary to specialty care providers. Additionally, the Opioid Safety Initiative and 2017 VA/Department of Defense (DoD) clinical guidelines on opioid prescribing set a new standard for reducing opioid use in the VA. These shifts in pain care have led to new pain management strategies that rely on multidisciplinary teams and nonpharmacologic pain treatments. The goal of this study was to examine how the cultural transformation of pain care has impacted providers, the degree to which VA providers are aware of pain care services at their facilities, and their perceptions of multidisciplinary care and collaboration across VA disciplines. METHODS: We conducted semistructured phone interviews with 39 VA clinicians in primary care, mental health, pharmacy, and physical therapy/rehabilitation at eight Veterans Integrated Service Network medical centers in New England. RESULTS: We identified four major themes concerning interdisciplinary pain management approaches: 1) the culture of VA pain care has changed dramatically, with a greater focus on nonpharmacologic approaches to pain, though many old school providers continue to prefer medication options; 2) most facilities in this sample have no clear roadmap about which pain treatment pathway to follow, with many providers unaware of what treatment to recommend when; 3) despite multiple options for pain treatment, VA multidisciplinary teams generally work together to ensure that veterans receive coordinated pain care; and 4) veteran preferences for care may not align with existing pain care pathways. CONCLUSIONS: The VA has shifted its practices regarding pain management, with a greater emphasis on nonpharmacologic pain options. The proliferation of nonpharmacologic pain management strategies requires stakeholders to know how to choose among alternative treatments

The Lantern Vol. 47, No. 2, May 1981

• Festival • Ode to Old Tom • Living Room • Writing a Poem • Mission Impossible • The Hinge is Oiled • The Potter\u27s Field at Malvern • Points of Time • Attempted Autonomy • My Love • Love, not War • Death Comes Quickly • You Can\u27t Always Get What You Don\u27t Really Want • You See (Johnny\u27s Tale): An Elegy • Sanguine Hopeshttps://digitalcommons.ursinus.edu/lantern/1118/thumbnail.jp

Testing implementation facilitation of a primary care-based collaborative care clinical program using a hybrid type III interrupted time series design: a study protocol

Abstract Background Dissemination of evidence-based practices that can reduce morbidity and mortality is important to combat the growing opioid overdose crisis in the USA. Research and expert consensus support reducing high-dose opioid therapy, avoiding risky opioid-benzodiazepine combination therapy, and promoting multi-modal, collaborative models of pain care. Collaborative care interventions that support primary care providers have been effective in medication tapering. We developed a patient-centered Primary Care-Integrated Pain Support (PIPS) collaborative care clinical program based on effective components of previous collaborative care interventions. Implementation facilitation, a multi-faceted and dynamic strategy involving the provision of interactive problem-solving and support during implementation of a new program, is used to support key organizational staff throughout PIPS implementation. The primary aim of this study is to evaluate the effectiveness of the implementation facilitation strategy for implementing and sustaining PIPS in the Veterans Health Administration (VHA). The secondary aim is to examine the effect of the program on key patient-level clinical outcomes—transitioning to safer regimens and enhancing access to complementary and integrative health treatments. The tertiary aim is to determine the categorical costs and ultimate budget impact of PIPS implementation. Methods This multi-site study employs an interrupted time series, hybrid type III design to evaluate the effectiveness of implementation facilitation for a collaborative care clinical program—PIPS—in primary care clinics in three geographically diverse VHA health care systems (sites). Participants include pharmacists and allied staff involved in the delivery of clinical pain management services as well as patients. Eligible patients are prescribed either an outpatient opioid prescription greater than or equal to 90 mg morphine equivalent daily dose or a combination opioid-benzodiazepine regimen. They must also have an upcoming appointment in primary care. The Consolidated Framework for Implementation Research will guide the mixed methods work across the formative evaluation phases and informs the selection of activities included in implementation facilitation. The RE-AIM framework will be used to assess Reach, Effectiveness, Adoption, Implementation, and Maintenance of PIPS. Discussion This implementation study will provide important insight into the effectiveness of implementation facilitation to enhance uptake of a collaborative care program in primary care, which targets unsafe opioid prescribing practices.https://deepblue.lib.umich.edu/bitstream/2027.42/146542/1/13012_2018_Article_838.pd

Far-UV FUSE spectra of peculiar magnetic cataclysmic variables

We present far-UV spectra of the three magnetic cataclysmic variables (MCVs) BY Cam, V1309 Ori and AE Aqr obtained with the FUSE satellite. These MCVs have revealed strongly unusual NV and CIV UV resonance lines. The FUSE spectra exhibit broad OVI lines as well as a strong NIII line at 991A, while the CIII 1175A line is nearly absent, supporting non-solar CNO abundances of the accreting matter in these sources. The spectrum of BY Cam shows molecular H2 lines which might be of circumstellar nature. The flaring activity of AE Aqr is also observed in the far-UV range. The radial velocities of the broad OVI components in AE Aqr are orbitally modulated and would indicate an emission region close to the magnetosphere.Comment: 7pages, 4 figures, To appear in `Magnetic Cataclysmic Variables', IAU Col. 190, Capetown, Eds.: M. Cropper & S. Vrielmann, uses newpasp.st