Explore the vast range of titles available.

•Over half of New York State pharmacies rarely or never stocked buprenorphine•Independent pharmacies had significantly lower stocking rates than chains.•Pharmacists cited wholesaler caps and Drug Enforcement Administration oversight as key barriers.•Many pharmacists reported limited training on buprenorphine dispensing. Despite initiatives to improve opioid treatment access by increasing availability of buprenorphine, substantial barriers persist, impacting treatment engagement across New York State (NYS). Pharmacists play a critical role in dispensing buprenorphine, yet their knowledge and perceptions significantly affect medication accessibility. We evaluated pharmacists’ knowledge and perceptions about buprenorphine dispensing at pharmacies across NYS and assessed variations based on pharmacy characteristics. A 2019 NYS Department of Health survey collected data from pharmacists about their experiences and perspectives related to buprenorphine dispensing. Statistical analyses were conducted to describe the associations between pharmacies, region, and other characteristics. Of responding pharmacies (n = 620) 54.8% were in New York City, 22.7% of pharmacists had previously declined a buprenorphine prescription, with 65.5% declining prescriptions in the last 6 months alone. Key barriers included stocking issues on the supply side (19.9%) and lack of demand by patients (14.7%). Pharmacists play a critical role in providing access to buprenorphine. Addressing pharmacist knowledge gaps and stigma through education initiatives may improve opioid treatment access. Additional studies are required to evaluate the extent of the existing buprenorphine pharmacy accessibility barriers and to identify approaches to addressing and eliminating those barriers.

Abstract Administrative data may provide incomplete understanding of pandemic disease impact. Medical record review–based assessments of COVID-19–related causes of death were conducted among people with diagnosed HIV in New York State, which identified more COVID-19–related causes of death than Vital Statistics, thereby offering a deeper understanding of the pandemic’s impact on this population.

Sexual pleasure is a key determinant of condom use. We developed and validated a male, event-level sexual pleasure scale (EMSEXpleasure) among a sample of condom-using men in the United States in order to facilitate improved measurement of sexual pleasure. Based on an expert panel process, a 12-item scale was developed. An online sample of 169 men who have sex with men and 162 men who have sex with women were recruited. Factor analysis yielded a two-factor solution that matched domains identified a priori by the expert panel, general pleasure and condom-specific pleasure, indicating internal validity of the instrument. One item was deleted from the scale due to poor validity performance. The overall EMSEXpleasure scale, and each subscale, had high (>0.8) Cronbach’s alpha coefficients, indicating internal reliability. The scale demonstrated convergent validity, with theoretically-related constructs associated both with individual scale items and with scale totals. Overall relationship quality (B 3.0, 95%CI 2.0, 4.0), sexual relationship quality (B 2.9, 95%CI 2.0, 4.0), foreplay quality (B 7.5, 95%CI 2, 13), positive feelings about condoms (B18.8, 95CI 15, 23) and erection problems while using condoms (B −17.9, 95%CI −22, −14) were associated with the EMSEXpleasure scale in expected directions. The validated EMSEXpleasure event-level scale may be advantageous for future assessments of the ephemeral experience of sexual pleasure, including clinical trials of condoms and other interventions, because it can be used immediately after sex, potentially limiting recall error.

Sexual pleasure is a key determinant of condom use. We developed and validated a male, event-level sexual pleasure scale (EMSEXpleasure) among a sample of condom-using men in the U.S. in order to facilitate improved measurement of sexual pleasure. Based on an expert panel process, a 12-item scale was developed. An online sample of 169 men who have sex with men and 162 men who have sex with women were recruited. Factor analysis yielded a two-factor solution that matched domains identified a priori by the expert panel, general pleasure and condom-specific pleasure, indicating internal validity of the instrument. One item was deleted from the scale due to poor validity performance. The overall EMSEXpleasure scale, and each subscale, had high (> 0.8) Cronbach’s alpha coefficients, indicating internal reliability. The scale demonstrated convergent validity, with theoretically related constructs associated both with individual scale items and with scale totals. Overall relationship quality ( b 3.0, 95% CI 2.0, 4.0), sexual relationship quality ( b 2.9, 95% CI 2.0, 4.0), foreplay quality ( b 7.5, 95% CI 2, 13), positive feelings about condoms ( b 18.8, 95% CI 15, 23), and erection problems while using condoms ( b − 17.9, 95% CI − 22, − 14) were associated with the EMSEXpleasure scale in expected directions. The validated EMSEXpleasure event-level scale may be advantageous for future assessments of the ephemeral experience of sexual pleasure, including clinical trials of condoms and other interventions, because it can be used immediately after sex, potentially limiting recall error.

PurposeThe second International Consensus Conference on B3 lesions was held in Zurich, Switzerland, in March 2018, organized by the International Breast Ultrasound School to re-evaluate the consensus recommendations.MethodsThis study (1) evaluated how management recommendations of the first Zurich Consensus Conference of 2016 on B3 lesions had influenced daily practice and (2) reviewed current literature towards recommendations to biopsy.ResultsIn 2018, the consensus recommendations for management of B3 lesions remained almost unchanged: For flat epithelial atypia (FEA), classical lobular neoplasia (LN), papillary lesions (PL) and radial scars (RS) diagnosed on core-needle biopsy (CNB) or vacuum-assisted biopsy (VAB), excision by VAB in preference to open surgery, and for atypical ductal hyperplasia (ADH) and phyllodes tumors (PT) diagnosed at VAB or CNB, first-line open surgical excision (OE) with follow-up surveillance imaging for 5 years. Analyzing the Database of the Swiss Minimally Invasive Breast Biopsies (MIBB) with more than 30,000 procedures recorded, there was a significant increase in recommending more frequent surveillance of LN [65% in 2018 vs. 51% in 2016 (p = 0.004)], FEA (72% in 2018 vs. 62% in 2016 (p = 0.005)), and PL [(76% in 2018 vs. 70% in 2016 (p = 0.04)] diagnosed on VAB. A trend to more frequent surveillance was also noted also for RS [77% in 2018 vs. 67% in 2016 (p = 0.07)].ConclusionsMinimally invasive management of B3 lesions (except ADH and PT) with VAB continues to be appropriate as an alternative to first-line OE in most cases, but with more frequent surveillance, especially for LN.

Today's healthcare system is facing many challenges, such as changes in the population, a shift from acute to chronic degenerative conditions, and disparities in access and outcomes. An integrative health approach, in combination with interprofessional collaborative practice, is viewed as an effective response to these changing demands. Curricular strategies must be developed and implemented that help prepare health professions students for these ongoing changes in the health delivery system. In this paper, we provide lessons learned from a 5-year interprofessional education (IPE) experiential learning curriculum for graduate physician assistant, physical therapy, and occupational therapy students and undergraduate nursing students. The program's experience suggests the need for common knowledge across disciplines, extensive faculty involvement, institutional support and flexibility, and ongoing community engagement. With these key elements in place, authors believe IPE learning can be successfully implemented with a wide range of graduate and undergraduate health professions disciplines and diverse community partners.

The article Second International Consensus Conference on lesions of uncertain malignant potential in the breast (B3 lesions), written by Christoph J Rageth, Elizabeth AM O’Flynn, Katja Pinker, Rahel A Kubik-Huch, Alexander Mundinger, Thomas Decker, Christoph Tausch, Florian Dammann, Pascal A. Baltzer, Eva Maria Fallenberg, Maria P Foschini, Sophie Dellas, Michael Knauer, Caroline Malhaire, Martin Sonnenschein, Andreas Boos, Elisabeth Morris, Zsuzsanna Varga, was originally published electronically on the publisher’s internet portal (currently SpringerLink) on November 30, 2018 without open access.

What I am most grateful for, though, is [Marc Masterson]'s leadership in the arts community. Perhaps because of his early experience with a hand- to-mouth company, he has understood both the richness the small and struggling arts organizations contribute to Pittsburgh's cultural life, and their need to be part of the conversation about arts policy. I'm grateful to Marc and wish him and his family well. He leaves Pittsburgh a better place than he found it, a legacy worth emulating. I love Eminem, and I love the Backstreet Boys. Beth [Feedback, Aug. 11], how could you make the assumption that ALL teen-agers should like boy bands? Mallory and Alex [Feedback, Aug. 4] knew what they were talking about, and so do I. Do you have any idea what us as teen-agers, are exposed to every day of our lives? The things we've seen and heard in our short lives makes Eminem's raps seem like hymns. Even though Eminem can go a bit overboard and graphic at times, he has admitted that all his songs are not all totally autobiographical and true. Although I do agree with you, you say, \"parents out there need to do their job and make sure their kids know the difference between right and wrong,\" but letting their teen-ager actually hear about the troubles and reality of life through Eminem's lyrics could possibly do more good than harm. Basically all I'm saying is that teen-agers, like me, will listen to whatever we want to, mostly because it's more tempting to do what we are told not to. I have to cry \"foul\" when it is illustrated as being uniquely a Pittsburgh issue. Pittsburgh long ago outgrew the shot-and-beer attitude that outsiders still hold as the image of what Pittsburghers are like, and from my experience, the behavior of Pittsburgh audiences is actually light years better than what I have witnessed in some New York performances.