Internet pornography (IP) use has increased over the past 10 years. The effects of IP use are widespread and are both negative (e.g., relationship and interpersonal distress) and positive (e.g., increases in sexual knowledge and attitudes toward sex). Given the possible negative effects of IP use, understanding the definition of IP, the types of IP used, and reasons for IP use is important. The present study reviews the methodology and content of available literature regarding IP use in nondeviant adult populations. The study seeks to determine how the studies defined IP, utilized validated measures of pornography use, examined variables related to IP, and addressed form and function of IP use. Overall, studies were inconsistent in their definitions of IP, measurement, and their assessment of the form and function of IP use. Discussion regarding how methodological differences between studies may impact the results and the ability to generalize findings is provided, and suggestions for future studies are offered.
Objectives
The objective of this study is to characterize the bleeding, transfusion and other outcomes of patients related to the timing of prasugrel or clopidogrel withdrawal prior to coronary artery bypass grafting (CABG).
Background
There is little evidence to guide clinical decision making regarding the use of prasugrel in patients who may need urgent or emergency CABG. Experience with performing CABG in the presence of clopidogrel has raised concern about perioperative bleeding complications that are unresolved.
Methods
A subset of the TRITON TIMI 38 study, where patients with acute coronary syndrome were randomized to treatment with aspirin and either clopidogrel or prasugrel, underwent isolated CABG (N=346). A supplemental case report form was designed and administered, and the data combined with the existing TRITON-TIMI 38 database. Baseline imbalances were corrected for using elements of the European System for Cardiac Operative Risk Evaluation and The Society of Thoracic Surgeons predictive algorithm.
Results
A significantly higher mean 12 hr chest tube blood loss (655±580 ml vs. 503±378 ml, p=0.050) was observed with prasugrel compared to clopidogrel, without significant differences in red blood cell transfusion (2.1 units vs. 1.7 units, p=0.442) or the total donor exposure (4.4 units vs. 3.0 units, p=0.463). All-cause mortality was significantly reduced with prasugrel (2.31%) compared to 8.67% with clopidogrel (adjusted odds ratio [OR], 0.26, p=0.025).
Conclusion
Despite an increase in observed bleeding, platelet transfusion and surgical re-exploration for bleeding, prasugrel was associated with a lower rate of death following CABG compared to clopidogrel.
Background
The current study examined rates of comorbidity among children’s symptoms of posttraumatic stress (PTS) and depression after a natural disaster, Hurricane Ike. We also compared children with comorbid symptoms to children without comorbid symptoms, examining recovery, severity of symptoms, and risk factors.
Method
Children (n=277; 52% girls; 38% Hispanic, 28% White, 19% Black; grades 2–4) were assessed at 8 and 15 months postdisaster. Children completed measures of PTS and depressive symptoms at both time points and measures of exposure and recovery stressors at 8 months postdisaster.
Results
At 8 months postdisaster, 13% of children reported elevated PTS-only, 11% depression-only, and 10% comorbid symptoms of PTS and depression. At 15 months postdisaster, 7% of children reported elevated PTS-only, 11% depression-only, and 7% comorbid symptoms of PTS and depression. Children with comorbid symptoms of PTS and depression had poorer recovery, more severe symptoms, and they reported greater exposure and recovery stressors.
Limitations
We lacked information on children’s predisaster functioning and diagnostic interview of psychological distress symptoms.
Conclusions
Children with comorbid symptoms need to be identified early postdisaster. Levels of stressors should be monitored postdisaster, as highly stressed youth have difficulties recovering and may need help. Interventions should be tailored for children with comorbid symptoms of PTS and depression.
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