Exploring the Etiological Pathways of Problematic Pornography Use in NoFap/PornFree Rebooting Communities: A Critical Narrative Analysis of Internet Forum Data.

Problematic pornography use (PPU) has been extensively studied in terms of its negative implications for various life domains. The empirical literature reveals measured outcomes of interpersonal and intrapersonal dysfunction in participants' everyday living, supporting its classification as a disorder. The increasing number of complaints around PPU opens the door to the creation of online self-help rebooting communities. This qualitative study aimed to provide a better understanding of this behavior by investigating potential etiological pathways contributing to the onset of PPU, as they were expressed by members of the online NoFap/PornFree self-help communities with self-perceived PPU. The critical narrative analysis reveals a complex web of mutually informing causal connections. The dialectical relationship between situational resources, material conditions, and an embodied spectator gives rise to an online persona with motivations of self-exploration, experimentation, and socializing. A sense of vulnerability rendered the use of pornography as a means of escape and validation. Furthermore, commitment to abstinence, framed by the notions of recovery and relapse, was found to be a major factor for maintaining distress. The study highlighted the need for a thorough understanding of the etiological pathways of PPU for a more effective and targeted intervention. Moving beyond biomedical conceptualizations suggests an intervention whereby PPU is placed in a context of a crisis of meaning.

Responsibilities in cancer preventive care in Greece. A physicians' survey.

BACKGROUND: Colorectal cancer is the second leading cause of cancer death in European countries. Differences in screening implementation may explain USA vs. European survival differences. The proportion of European primary care physicians advising colorectal screening has been reported to be inconsistent. We therefore hypothesised the presence of a belief-related bias among European physicians regarding who is responsible for cancer screening delivery. OBJECTIVES: To index beliefs in cancer screening implementation among a wide sample of Greek physicians. Study design Cross-sectional survey. METHODS: Three hundred and sixty-six physicians involved in primary care activities in 15 provinces answered a questionnaire about responsibility in cancer screening delivery. Results 22.4% and 7.6% of physicians declared that the health system and the patients, respectively, have the main responsibility for cancer screening implementation, while 70 % advocated patient-health system co-responsibility. Beliefs were statistically correlated to age (p=0.039) and specialisation category (p=0.002). Patients' will was mainly indicated by internists, trainee internists and physicians older than 30, while GPs, trainee GPs and house officers were mainly health system-oriented. Worryingly, when physicians were asked about which specialty should inform the population, 81% indicated family doctor (for-fee-service) while the involvement of free-from-fee specialities was inconsistent. CONCLUSION: A considerable disorientation about responsibilities in cancer screening delivery was observed in our study sample. Continual medical education and clear redefinition of primary care physicians' activities are required.

Cancer screening in Greece. Guideline awareness and prescription behavior among Hellenic physicians.

BACKGROUND: Primary cancer prevention is offered by the Greek health care system to the population on an opportunistic basis. This means that screening depends on advice from primary care providers and on individuals' request for screening, since a centralized invitational register is lacking. In planning preventive services, an accurate identification of baseline levels of performance for preventive activities is fundamental, so that realistic goals can be set. METHODS: 366 primary care physicians (39.3% response rate) from nine Greek provinces were surveyed by means of a self-reporting questionnaire of prescription habits. Physicians' screening behaviors and screening recommendations were analyzed for both cost-effective and non-recommended tests during usual check-up visits and targeted cancer screening activities were analyzed. RESULTS: A wide variety of recommendation habits were observed among primary care physicians. With the exception of PAP test, cost-effective tests were advised at sub-optimal rates, with colorectal cancer screening being much less than desirable. Moreover, non-recommended tests were frequently advised. CONCLUSION: Screening tests are performed sporadically and an overall understanding of primary care prevention is lacking. More focused educational interventions must be implemented if primary care is to make an impact on cancer mortality.

Colorectal cancer screening coverage in Greece. PACMeR 02.01 study collaboration.

BACKGROUND AND AIMS: Colorectal cancer is a major cause of cancer death in European countries and differences in screening implementation may in part explain USA vs European survival differences. Despite the evidence, no study has evaluated the population colorectal cancer screening (CCS) coverage in any European country. We aimed to index the current CCS practices among a large sample of Greek healthy adults. MATERIALS AND METHODS: The study was designed as a cross-sectional survey. Screening practice habits of 5,259 healthy adults, aged 50-80, were surveyed. Both overall and screening practices of stool occult blood test (SOBT), digital rectal examination (DRE), and colonoscopy or sigmoidoscopy (COL/SIG) were analyzed. RESULTS: Of the population analyzed, 90.1% declared that they were interested in cancer prevention activities. Overall SOBT practice rate within the last 2 years was 4.77%. When only screening procedures were analyzed, this percentage shrank to 1.73%. Overall and screening COL/SIG rates within the last 10 years were 8.76 and 1.74%, respectively. The respective proportions of individuals who underwent DRE were 14.54 and 5.2%. Evidence-based screening practices were influenced by age, family history of colorectal cancer, profession, and educational level; however, SOBT and colonoscopy/sigmoidoscopy did not overcome 4.1 and 4.6% in any subpopulation analyzed. CONCLUSION: The level of CCS coverage among the examined sample of Greek adults was discouraging. Surveys among other European countries are encouraged.