Los efectos de la inteligencia emocional, la legitimidad y la disuasión en la conducta antisocial

Previous research suggests that antisocial and criminal behaviors are more prevalent in individuals with low emotional intelligence, as well as in those who perceive a low probability of punishment and no legitimacy of authorities. The aim of this research was to analyze the effects of emotional intelligence, deterrence (specifically, the perception of the probability of receiving a sanction), and the legitimacy of authorities on antisocial behavior in inmates compared to a control group. The group of inmates was composed of 105 adults from a Social Reinsertion Center in a city in northwestern Mexico, with a mean age of 32.03 years (SD = 8.986); and the control group was composed of 105 adults with no criminal record, with a mean age of 32.08 years (SD = 10.094). Both samples were selected by convenience. Significant differences were detected in the scales of emotional intelligence (t = -4.14, p <.001), legitimacy (t = -3.09, p ><.01), and probability of punishment (t = -4.66, p ><.001),  legitimacy (t = -3.09, p <.01) and probability of punishment (t = -4.66, p <.001). The control group presented higher emotional intelligence  (d = -0.81), higher perception of legitimacy (d = -0.60), and higher perception of probability of punishment (d = -0.90) in contrast to the inmate sample. A Structural Equations Model (SEM) showed that emotional intelligence and perceived probability of punishment influenced antisocial behavior, which indicates that emotional competences may have an impact on the fear of being sanctioned when committing certain antisocial behaviors.Investigaciones previas sugieren que las conductas antisociales y delictivas son más prevalentes en individuos que presentan una baja inteligencia emocional, así como en aquellos que perciben una baja probabilidad de sanción y una nula legitimidad de las autoridades. El objetivo de esta investigación fue analizar los efectos de la inteligencia emocional, la disuasión (específicamente la percepción de probabilidad de recibir sanción) y la legitimidad de las autoridades en la conducta antisocial en reclusos en comparación con un grupo control. El grupo de reclusos estuvo compuesto por 105 sujetos provenientes de un Centro de Reinserción Social de una ciudad del noroeste de México, con una media de edad de 32.03 años (DE = 8.986); y el grupo control, por 105 adultos sin antecedentes penales, con una media de edad de 32.08 años (DE = 10.094). Ambas muestras seleccionadas por conveniencia. Los resultados mostraron diferencias significativas en las escalas de inteligencia emocional (t = –4.14, p < .001), legitimidad (t = –3.09, p < .01) y probabilidad de castigo (t = –4.66, p < .001); específicamente, la d de Cohen indicó que la muestra control presentó mayor inteligencia emocional (d = –0.81), mayor percepción de legitimidad (d = –0.60) y mayor percepción de probabilidad de sanción (d = –0.90) en contraste con la muestra de reclusos. Dentro del modelo de ecuaciones estructurales, las variables de inteligencia emocional y percepción de probabilidad de castigo influyeron en el comportamiento antisocial, lo cual indica que posiblemente las competencias emocionales podrían repercutir sobre el temor de recibir alguna sanción ante la comisión de determinadas conductas antisociales

Intensive Medical Nutrition Therapy Alone or with Added Metformin to Prevent Gestational Diabetes Mellitus among High-Risk Mexican Women: A Randomized Clinical Trial

The aim of this study was to examine the efficacy of intensive medical nutrition therapy (MNT) plus metformin in preventing gestational diabetes mellitus (GDM) among high-risk Mexican women. An open-label randomized clinical trial was conducted. Inclusion criteria were pregnant women with three or more GDM risk factors: Latino ethnic group, maternal age >35 years, body mass index >25 kg/m2, insulin resistance, and a history of previous GDM, prediabetes, a macrosomic neonate, polycystic ovarian syndrome, or a first-degree relative with type 2 diabetes. Women before 15 weeks of gestation were assigned to group 1 (n = 45): intensive MNT-plus metformin (850 mg twice/day) or group 2 (n = 45): intensive MNT without metformin. Intensive MNT included individual dietary counseling, with ≤50% of total energy from high carbohydrates. The primary outcome was the GDM incidence according to the International Association of Diabetes Pregnancy Study Groups criteria. There were no significant differences in baseline characteristics and adverse perinatal outcomes between the groups. The GDM incidence was n = 11 (24.4%) in the MNT plus metformin group versus n = 7 (15.5%) in the MNT without metformin group: p = 0.42 (RR: 1.57 [95% CI: 0.67–3.68]). There is no benefit in adding metformin to intensive MNT to prevent GDM among high-risk Mexican women. Clinical trials registration: NCT01675310

Accelerated surgery versus standard care in hip fracture (HIP ATTACK) : an international, randomised, controlled trial

Background: Observational studies have suggested that accelerated surgery is associated with improved outcomes in patients with a hip fracture. The HIP ATTACK trial assessed whether accelerated surgery could reduce mortality and major complications. Methods: HIP ATTACK was an international, randomised, controlled trial done at 69 hospitals in 17 countries. Patients with a hip fracture that required surgery and were aged 45 years or older were eligible. Research personnel randomly assigned patients (1:1) through a central computerised randomisation system using randomly varying block sizes to either accelerated surgery (goal of surgery within 6 h of diagnosis) or standard care. The coprimary outcomes were mortality and a composite of major complications (ie, mortality and non-fatal myocardial infarction, stroke, venous thromboembolism, sepsis, pneumonia, life-threatening bleeding, and major bleeding) at 90 days after randomisation. Patients, health-care providers, and study staff were aware of treatment assignment, but outcome adjudicators were masked to treatment allocation. Patients were analysed according to the intention-to-treat principle. This study is registered at ClinicalTrials.gov (NCT02027896). Findings: Between March 14, 2014, and May 24, 2019, 27 701 patients were screened, of whom 7780 were eligible. 2970 of these were enrolled and randomly assigned to receive accelerated surgery (n=1487) or standard care (n=1483). The median time from hip fracture diagnosis to surgery was 6 h (IQR 4\u20139) in the accelerated-surgery group and 24 h (10\u201342) in the standard-care group (p<0\ub70001). 140 (9%) patients assigned to accelerated surgery and 154 (10%) assigned to standard care died, with a hazard ratio (HR) of 0\ub791 (95% CI 0\ub772 to 1\ub714) and absolute risk reduction (ARR) of 1% ( 121 to 3; p=0\ub740). Major complications occurred in 321 (22%) patients assigned to accelerated surgery and 331 (22%) assigned to standard care, with an HR of 0\ub797 (0\ub783 to 1\ub713) and an ARR of 1% ( 122 to 4; p=0\ub771). Interpretation: Among patients with a hip fracture, accelerated surgery did not significantly lower the risk of mortality or a composite of major complications compared with standard care. Funding: Canadian Institutes of Health Research

Global attitudes in the management of acute appendicitis during COVID-19 pandemic: ACIE Appy Study

Background: Surgical strategies are being adapted to face the COVID-19 pandemic. Recommendations on the management of acute appendicitis have been based on expert opinion, but very little evidence is available. This study addressed that dearth with a snapshot of worldwide approaches to appendicitis. Methods: The Association of Italian Surgeons in Europe designed an online survey to assess the current attitude of surgeons globally regarding the management of patients with acute appendicitis during the pandemic. Questions were divided into baseline information, hospital organization and screening, personal protective equipment, management and surgical approach, and patient presentation before versus during the pandemic. Results: Of 744 answers, 709 (from 66 countries) were complete and were included in the analysis. Most hospitals were treating both patients with and those without COVID. There was variation in screening indications and modality used, with chest X-ray plus molecular testing (PCR) being the commonest (19\ub78 per cent). Conservative management of complicated and uncomplicated appendicitis was used by 6\ub76 and 2\ub74 per cent respectively before, but 23\ub77 and 5\ub73 per cent, during the pandemic (both P < 0\ub7001). One-third changed their approach from laparoscopic to open surgery owing to the popular (but evidence-lacking) advice from expert groups during the initial phase of the pandemic. No agreement on how to filter surgical smoke plume during laparoscopy was identified. There was an overall reduction in the number of patients admitted with appendicitis and one-third felt that patients who did present had more severe appendicitis than they usually observe. Conclusion: Conservative management of mild appendicitis has been possible during the pandemic. The fact that some surgeons switched to open appendicectomy may reflect the poor guidelines that emanated in the early phase of SARS-CoV-2