Clinical performance, audiological outcomes, and quality of life of the Cochlear Osia ® system.

OBJECTIVE: The Cochlear Osseointegrated Steady-State Implant Bone Anchored Hearing Device (Osia) is a surgically implanted titanium apparatus that utilizes a piezoelectric actuator under the skin to address conductive and mixed hearing loss as well as single-sided deafness. The purpose of this study is to examine the clinical, audiologic, and quality-of-life outcomes in patients who underwent Osia implantation. METHODS: This is a retrospective study analyzing 30 adult patients (age 27-86) with conductive healing loss (CHL), mixed hearing loss (MHL), or single-sided deafness (SSD) who were implanted with the Osia device from January 2020 to April 2023 at a single institution by the senior author. Preoperative speech score testing (CNC, AzBio in quiet, AzBio in noise) were performed in all subjects while unaided, wearing conventional air conduction hearing aids, and wearing a softband BAHA. These preoperative speech scores were then compared to post-implantation speech scores using paired t-test analysis to assess for degree of speech improvement. In order to analyze quality of life after Osia implantation, each patient filled out the Glasgow Benefit Inventory (GBI) survey. The GBI is a series of 18 questions answered using a five-point Likert scale that addresses the changes in general health status, physical health status, psychosocial health status, and social support after a medical intervention. RESULTS: CHL, MHL, and SSD patients had significant improvement in hearing and speech recognition scores after Osia implantation compared to preoperative unaided hearing: CNC (14 % vs 80 %, p < 0.0001), AzBio in Quiet (26 % vs 94 %, p < 0.0001), and AzBio in Noise (36 % vs 87 %, p = 0.0001). Preoperative speech scores using the softband BAHA were accurate predictors of post-implantation speech scores and can serve to determine surgical candidacy for the Osia. Post-implantation Glasgow Benefit Inventory patient surveys demonstrated significant improvement in quality of life with patients scoring an average increase of +54.1 points in heath satisfaction. CONCLUSION: Adult patients with CHL, MHL, and SSD can receive significant improvement in speech recognition scores after implantation with the Osia device. This translates to improved quality of life, which was confirmed on the post-implantation Glasgow Benefit Inventory patient surveys.

The Impact of Hostility on Quality of Life, Functioning, and Suicidal Ideation Among Male Veterans with Posttraumatic Stress Disorder.

Veterans with posttraumatic stress disorder (PTSD) often experience high levels of hostility. Although studies have found that PTSD is associated with poorer quality of life (QoL), increased functional impairment, lower levels of social support, and increased suicidal ideation, it is unclear if hostility impacts these domains in veterans with PTSD above and beyond the impact from PTSD and depressive symptoms. The present study aimed to examine whether hostility is related to several indices of poorer QoL and functioning after controlling for demographic characteristics, PTSD symptoms, and depressive symptoms. Participants (N = 641) were male U.S. veterans seeking PTSD treatment through a specialty clinic in the Veterans Affairs Healthcare System. Veterans completed the Davidson Trauma Scale for DSM-IV (DTS), Personality Assessment Inventory (PAI), Quality of Life Inventory, and the Sheehan Disability Scale. Hierarchical regressions were conducted to examine the impact of PAI measures of hostility on QoL, functioning, social support, and suicidal ideation beyond DTS, depression, race, and age. After covarying for DTS total score, depression symptoms, age, and race, higher levels of hostility were significantly associated with higher degrees of functional impairment and lower degrees of social support, ΔR2 = .01 and ΔR2 = .02, respectively. Higher levels of hostility were significantly related to diminished functioning and lower social support beyond PTSD and depressive symptoms in veterans seeking treatment for PTSD. These findings highlight the importance of assessing and treating hostility in veterans with PTSD.

A Qualitative Analysis of Offenders' Emotional Responses to Perpetrating Sexual Assault.

The purpose of this study was to understand sexual assault perpetrators' emotional responses to perpetration to facilitate treatment development and to better understand processes that may give rise to repeat perpetration. Sixty-one firsthand narratives of sexual assault perpetration, posted on Reddit.com , were analyzed using qualitative text analysis. The analysis revealed four primary emotional responses to perpetrating sexual assault: shame, guilt, depression, and anger. Each emotional response was associated with different contextual features that appeared in the narratives. Shame co-occurred with perpetrator alcohol use and consent confusion, guilt co-occurred with perpetrators' stated self-growth, anger co-occurred with denial of responsibility and hostility toward women, and depressed affect co-occurred with social isolation following perpetration. The findings indicate certain emotional responses may be more adaptive than others for protecting against repeat perpetration. This research has important implications for the treatment of perpetrators and supports the idea that self-image and perceived social context may be important treatment targets.

Retail food reform: How to effectively bridge what we say and what we do in our hospital settings.

Hospital leaders in Eastern Ontario, Canada, have acknowledged the critical role of food to health and the need for progressive change that goes beyond personal responsibility paradigms. The Healthy Foods in Champlain Hospitals program aims to create supportive, healthy nutrition environments in hospital retail food settings. Twenty independent hospital corporations have collectively initiated a plan to transition cafeteria, vending, franchise, and volunteer operations towards healthier offerings. Hospitals are actively implementing a set of progressively phased, evidence-based nutrition criteria, which cover food and beverage categories, preparation methods, product placement, and provision of nutrition information. Implementation strategies and successes, as well as challenges and limitations, are discussed.

Trajectories of male sexual aggression from adolescence through college: A latent class growth analysis.

Approximately 25% of male college students report engaging in some form of sexual coercion by the end of their fourth year of college. White and Smith (2004) found that negative childhood experiences-childhood sexual abuse, childhood physical abuse, and witnessing domestic violence-predicted sexual aggression perpetrated before college, but not during the subsequent college years, a puzzling finding in view of the reasonably consistent rates of sexual aggression from adolescence to the first 2 years of college. The current study takes a person-centered approach to sexual aggression in an attempt to resolve this discrepancy. We examined the possibility of cohesive subgroups of men in terms of their frequency of sexual aggression across the pre-college and college years. A series of latent class growth models were fit to an existing longitudinal dataset of sexual experiences collected across four time points-pre-college through year 3 of college. A four-trajectory model fit the data well, exhibiting significantly better fit than a three-trajectory model. The four trajectories are interpreted as men who perpetrate sexual aggression at (1) low (71.5% of the sample), (2) moderate (21.2%), (3) decreasing (4.2%), and (4) increasing (3.1%) frequencies across time. Negative childhood experiences predicted membership of the decreasing trajectory, relative to the low trajectory, but did not predict membership of the increasing trajectory, explaining the discrepancy uncovered by White and Smith. Implications for primary prevention of sexual aggression are discussed.

The Scope of Rape Victimization and Perpetration Among National Samples of College Students Across 30 years.

Research Questions: Rape prevention practice and policy have roots in data from 1985. This study uses 2015 national data to project recent prevalence, assesses whether rates now differ from those of 30 years ago, and disaggregates 2015 prevalence into rape of alcohol incapacitated victims, rapes combining both alcohol and physical tactics, and violent rape. Methods: Cross-sectional analyses were conducted comparing two national samples. The first was collected in 1984-85 (Koss, Gidycz, & Wisniewski, 1987); the second was collected 30 years later in 2014-2015. Both surveys used in-person administration and measurement by the most current version at the time of the Sexual Experiences Survey (SES). Prevalence rates were compared using Bayesian binomial tests. Results: In 2015, 33.4% (1 in 3) of women reported experiencing rape or attempted rape and 12.7% of men reported perpetration (1 in 8). Using Jeffreys' label for effect size of the Bayes binomial (1961), both results are "decisively" greater than expected given the 1985 benchmarks of 27.9% for victimization and 7.7% for perpetration. Victimization when incapacitated characterized approximately 75% of incidents in 2015 up from 50% in 1985. Cautions apply as cross-sectional data does not establish causality and the recent data set involved the revised SES. Conclusions: Across 30 years, neither containment nor reduction of rape was demonstrated and the increasingly prominent association with alcohol was apparent. Among the men who disclosed raping, 9 of 10 incidents were alcohol-involved. Prevention focus might profitably be directed to constraining alcohol environments and policies that facilitate rape of incapacitated persons and on misconduct responses that are proportional to the harm caused to rape victims, thereby raising the perceived risks of perpetration.

Childhood Neglect History, Depressive Symptoms, and Intimate Partner Violence Perpetration by College Students.

College students experience intimate partner violence (IPV) at an alarming rate, and preventing such violence depends on identifying factors that contribute to perpetration. Although there is extensive research that has established a link between childhood neglect and later physical IPV perpetration, less is known about the specific mechanisms through which childhood neglect leads to IPV perpetration. In the present study, we examined potential mediators of the relationship between childhood neglect and IPV perpetration by college students, with special emphasis on the role of depressive symptoms and IPV victimization. A total of 302 college students reported on their experiences of childhood maltreatment, depressive symptoms, and IPV victimization and perpetration. Results indicate that increasing levels of childhood emotional and physical neglect correspond with increasing rates of IPV perpetration, after accounting for the effect of childhood emotional, physical, and sexual abuse. This effect between childhood neglect and IPV perpetration was fully mediated by the combination of IPV victimization and depressive symptoms for the overall sample. However, when examining the model for men and women separately, only the indirect effect through victimization remained statistically significant for men. Our findings suggest that research on the link between childhood neglect and IPV perpetration should also consider the impact of IPV victimization, as neglect may lead to IPV perpetration within the context of a mutually aggressive relationship. Furthermore, these findings indicate that childhood neglect leads to long-term emotional consequences that contribute to later IPV perpetration, and treating depressive symptoms may help prevent IPV perpetration against college students who experienced childhood neglect.

Evidence for Multiple Classes of Sexually-Violent College Men.

OBJECTIVE: Research on college sexual violence perpetration suggests there are multiple groups of male perpetrators. It is important to understand the distinctions between perpetrator subgroups to determine appropriate prevention strategies, as multiple strategies may be necessary to address multiple types of perpetrators. However, previous studies on subgroups of sexually-violent college men have relied on theoretically based distinctions, and there is currently no consensus on how to best classify perpetrators based on their sexually violent behaviors. The purpose of the current study was to take a data-driven approach to identifying subgroups of sexually-violent college men to help clarify: 1) the number and size of cohesive subgroups of sexually-violent college men, and 2) the types of behaviors that characterize each group. METHODS: 1,982 college men across five universities in the U.S. self-reported their past sexually-violent behaviors, using the Sexual Experiences Survey (SES; Koss et al., 2007). RESULTS: Latent class analysis uncovered evidence for three groups: (1) a group unlikely to perpetrate any SV (88.6%); (2) a group likely to perpetrate SV using coercive tactics (verbal coercion or victim intoxication), but unlikely to use physical force (9.8%); and (3) a group likely to perpetrate the full range of SV (1.5%). Although the coercive tactics group was composed of men unlikely to use forceful tactics, it included the majority who attempted or completed rape based on legal definitions. CONCLUSIONS: Our findings suggest that there are multiple, distinct perpetrator subgroups and signal the need for multiple prevention approaches, including approaches that address campus social norms.

Number and frequency of physiotherapy services for motor vehicle-induced whiplash: interrogating motor accident insurance data 2006-2009.

OBJECTIVE: Whilst prognostic factors for recovery from whiplash associated disorders have been documented, factors related to high physiotherapy use are not well recognized. This study profiles predictors for high use of physiotherapy services from a large dataset from an Australian state insurer for motor vehicle accidents. METHOD: A dataset of Motor Accident Commission claims in South Australia for whiplash associated disorders (2006-2009) was interrogated. RESULTS: The median number of physiotherapy services per claimant was 15 (range: 1-194). The typical high user of physiotherapy was female, aged 25-59 years, living in a high socio-economic area, with legal representation, who delayed obtaining physiotherapy for at least 28 days after the accident. The largest mean number of days between treatments (5.4 days) in the first 5 treatments related to the lowest subsequent use of physiotherapy services. CONCLUSION: This represents the first review of physio-therapy service use based on an insurance dataset. A range of factors were related to high use of physiotherapy services. It is hoped that identifying the mean number and spread of physiotherapy interventions for whiplash associated disorders, and the profile of high users of physiotherapy will help gauge the success of strategies to maximize the efficacy of physiotherapy management of whiplash associated disorders.

Evaluation of screening criteria to identify persons with hepatitis C virus infection among sexually transmitted disease clinic clients: results from the San Diego Viral Hepatitis Integration Project.

BACKGROUND: The Centers for Disease Control and Prevention estimates that 1.8% of the US population is infected with hepatitis C virus (HCV), and most are unaware of their infection. GOAL: The goal was to evaluate risk-based HCV screening criteria for clients attending an urban sexually transmitted disease (STD) clinic. STUDY DESIGN: This was a cross-sectional study of HCV prevalence among all STD clinic clients during an 8-month period (September 1999 through April 2000) in San Diego, California. RESULTS: HCV prevalence was 4.9% (165/3367). Clients who reported that they were injecting drug users (IDUs) were much more likely to be HCV-positive than other clients (51% versus 2%; P < 0.001). Selective screening of IDUs, sex partners of IDUs, and persons having received a blood transfusion before 1992 would have identified 70% of HCV-infected clients while screening only 12% of the clinic's attendees. The HCV prevalence among clients with a history of a bacterial STD (in the past 5 years) and no other major risk factors was only 2.5%. CONCLUSION: In STD clinics, integrating risk-based screening into routine clinic services is an efficient way to identify HCV-infected persons.