The influence of parents on cohabitation in Italy: insights from two regional contexts

In view of the demographic changes that affect all European countries, the diffusion of new living arrangements such as non-marital cohabitation is particularly interesting. In this article we concentrate on Italy, a country that is characterized by a low pace in the diffusion of cohabitation. Earlier studies found statistical evidence of the impact of parents’ characteristics on young adults’ decisions for cohabitation. However, there is only limited empirical knowledge about the actual mechanism through which parents influence the choices of their children. We employ qualitative research methods and focus on two regional contexts in order to analyze if and how parents intervene in the choices young adults.Italy, cohabitation, parents, qualitative methods

Economic insecurity and cohabitation strategies in Italy

A particular aspect of demographic behavior among young people in Italy is postponement of entering first union. High youth unemployment, a tense housing situation, and a passive welfare state are currently creating a precarious economic situation, in which most young adults are unable to choose cohabitation. Thus, not surprisingly, previous studies found evidence that in Italy cohabitation was only a choice for people who were economically independent. Also of interest is that the percentage of informal unions varies to a considerable extent across Italy, showing higher proportions of cohabitation in the more prosperous regions of the North, unlike the South, where informal unions are much less prevalent and the economic system is affected by mismanagement, unemployment, and the informal economy. This suggests an interrelationship between the diffusion of cohabitation and the regional economic situation. In this qualitative study we are particularly interested in the question of how job insecurity affects cohabitation – or more precisely: How are job insecurity and resulting economic shortages related to the hesitant spread of cohabitation in Italy? For our analysis we investigated two different regional settings: Bologna in the North and Cagliari (Sardinia) in the South. Our findings show that, when compared to their counterparts in Cagliari, couples in Bologna benefited from higher opportunities to access at least temporary job contracts. Benefiting also from the availability of parental support during cohabitation, the Bologna couples faced fewer obstacles when deciding on an informal union. In Cagliari, couples were strongly affected by unstable employment conditions; further, the lack of parental approval of cohabitation often led to decreasing economic support, thereby making cohabitation an expensive choice.Italy, cohabitation, economic resources, qualitative methods

The influence of parents on cohabitation in Italy - Insights from two regional contexts

In view of the demographic changes that affect all European countries, the diffusion of new living arrangements such as non-marital cohabitation is particularly interesting. In this article we concentrate on Italy, a country that is characterized by a low pace in the diffusion of cohabitation. Earlier studies found statistical evidence of the impact of parents’ characteristics on young adults’ decisions for cohabitation. However, there is only limited empirical knowledge about the actual mechanism through which parents influence the choices of their children. We employ qualitative research methods and focus on two regional contexts in order to analyze if and how parents intervene in the choices of young adults.cohabitation, Italy, out-of-wedlock, qualitative methods, transition to adulthood, union formation

Are SRI funds conventional funds in disguise or do they live up to their name?

In recent years, the socially responsible investing (SRI) industry has become an important segment of international capital markets by incorporating ESG (Environmental, Social and Governance) factors into investment selection and management processes. This study analyses whether SRI mutual funds are conventional funds in disguise or invest in line with their ESG objectives. In contrast to other studies, the analysis exclusively focuses on the non-financial performance of SRI vis-à-vis conventional funds and applies ESG corporate ratings of three rating agencies (Oekom, Sustainalytics and ASSET4) to a European and global fund universe. The SRI and non-SRI funds are analyzed with respect to differences in their Top 10 fund holdings, their average ESG rankings and the significance of rating differences by utilizing cross-sectional regressions. At a first glance, the top holdings of both fund types seem very similar, but the results of the ranking analysis show that SRI funds have on average higher ESG rankings. Additionally, the cross-sectional regressions show that the ESG rating differences between SRI funds and conventional funds are significantly positive, i.e. SRI funds exhibit higher ESG ratings than conventional funds. These findings are robust as they hold for every single ESG factor and total scores and as well as across the different ratings applied

Romania: Childbearing metamorphosis within a changing context

In 1989, the socialist regime in Romania collapsed and the state’s coercive pro-natalist policy ended. Since then, fertility has gone through major changes, namely, a massive reduction in fertility and important structural changes: birth postponement, an end to universal childbearing, and the emergence of non-marital births. Family formation has been postponed, but a pattern of early marriage still persists compared to other European countries. Although unmarried cohabitation is rising, it is rarely seen as an alternative to marriage. Modern contraceptive methods are being used increasingly, but traditional contraceptive methods continue to be widespread. Abortion, which was re-legalized in 1989 and made available after two decades of prohibition, has been practiced extensively ever since, especially after first birth. Romanians in 2004 continue to have a universal preference for parenting. However, the preference for the two-child family has declined and the desire for a larger family has become the exception. The transformation of the socialist regime into a democratic society with a market economy generated a socio-economic crisis, and the majority of social benefits have therefore been oriented towards alleviating poverty. Other social policies, including those affecting the family, were redefined. However, fewer funds were made available than for those geared to promote economic development or reduce poverty and, as a consequence, their impact on childbearing has been small.childbearing, Europe, fertility, Romania

Lean back and wait for the alarm? Testing an automated alarm system for nosocomial outbreaks to provide support for infection control professionals

INTRODUCTION: Outbreaks of communicable diseases in hospitals need to be quickly detected in order to enable immediate control. The increasing digitalization of hospital data processing offers potential solutions for automated outbreak detection systems (AODS). Our goal was to assess a newly developed AODS. METHODS: Our AODS was based on the diagnostic results of routine clinical microbiological examinations. The system prospectively counted detections per bacterial pathogen over time for the years 2016 and 2017. The baseline data covers data from 2013-2015. The comparative analysis was based on six different mathematical algorithms (normal/Poisson and score prediction intervals, the early aberration reporting system, negative binomial CUSUMs, and the Farrington algorithm). The clusters automatically detected were then compared with the results of our manual outbreak detection system. RESULTS: During the analysis period, 14 different hospital outbreaks were detected as a result of conventional manual outbreak detection. Based on the pathogens' overall incidence, outbreaks were divided into two categories: outbreaks with rarely detected pathogens (sporadic) and outbreaks with often detected pathogens (endemic). For outbreaks with sporadic pathogens, the detection rate of our AODS ranged from 83% to 100%. Every algorithm detected 6 of 7 outbreaks with a sporadic pathogen. The AODS identified outbreaks with an endemic pathogen were at a detection rate of 33% to 100%. For endemic pathogens, the results varied based on the epidemiological characteristics of each outbreak and pathogen. CONCLUSION: AODS for hospitals based on routine microbiological data is feasible and can provide relevant benefits for infection control teams. It offers in-time automated notification of suspected pathogen clusters especially for sporadically occurring pathogens. However, outbreaks of endemically detected pathogens need further individual pathogen-specific and setting-specific adjustments

Increase in consumption of alcohol-based hand rub in German acute care hospitals over a 12 year period

Background: Hand hygiene plays a crucial role in the transmission of pathogens and the prevention of healthcare-associated infections. In 2007, a voluntary national electronic surveillance tool for the documentation of consumption of alcohol-based hand rub (AHC) was introduced as a surrogate for hand hygiene compliance (HAND-KISS) and for the provision of benchmark data as feedback.The aim of the study was to determine the trend in alcohol-based hand rub consumption between 2007 and 2018. Materials and methods: In this cohort study, AHC and patient days (PD) were documented on every ward in participating hospitals by trained local staff. Data was collected and validated in HAND-KISS. Intensive care units (ICU), intermediate care units (IMC), and regular wards (RW) that provided data during the study period between 2007 until 2018 were included into the study. Results: In 2018, 75.2% of acute care hospitals in Germany (n=1.460) participated. On ICUs (n=1998) mean AHC increased 1.74 fold (95%CI 1.71, 1.76; p<.0001) from 79.2ml/PD to 137.4ml/PD. On IMCs (n=475) AHC increased 1.69 fold (95%CI 1.60, 1.79; p<.0001) from 41.4ml/PD to 70.6ml /PD..On RWs (n=14,857) AHC was 19.0ml/PD in 2007 and increased 1.71 fold (95%CI 1.70, 1.73; p<.0001) to 32.6ml/PD in 2018. Conclusions: AHC in German hospitals increased on all types of wards during the past 12years. Surveillance of AHC is widely established in German hospitals. Large differences among medical specialties exist and warrant further investigation

Effectiveness of an Attachment-Informed Working Alliance in Interdisciplinary Pain Therapy

Attachment theory provides a useful framework for understanding individual differences inpain patients, especially with insecure attachment shown to be more prevalent in chronic pain patients compared to the general population. Nevertheless, there is little evidence of attachment-informed treatment approaches for this population. The present study compares outcomes from two different attachment-informed treatment modalities for clinicians, with outcomes from treatment as usual (TAU). In both intervention groups (IG1 and IG2), clinicians received bi-monthly training sessions on attachment. Additionally, clinicians in IG1 had access to the attachment diagnostics of their patients. All treatments lasted for four weeks and included a 6-month follow up. A total of 374 chronic pain patients were recruited to participate in this study (TAU = 159/IG1 = 163/IG2 = 52). Analyses were carried out using multilevel modeling with pain intensity as the outcome variable. Additionally, working alliance was tested as a mediator of treatment efficacy. The study was registered under the trial number DRKS00008715 on the German Clinical Trials Register (DRKS). Findings show that while IG2 was efficient in enhancing treatment outcomes, IG1 did not outperform TAU. In IG2, working alliance was a mediator of outcome. Results of the present study indicate that attachment-informed treatment of chronic pain can enhance existing interdisciplinary pain therapies; however, caveats are discussed.Fil: Pfeifer, Ann Christin. Ruprecht Karls Universitat Heidelberg.; AlemaniaFil: Meredith, Pamela. University of Queensland; AustraliaFil: Schröder Pfeifer, Paul. Ruprecht Karls Universitat Heidelberg.; AlemaniaFil: Gómez Penedo, Juan Martín. Universidad de Buenos Aires. Facultad de Psicología; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Ehrenthal, Johannes. Ruprecht Karls Universitat Heidelberg.; AlemaniaFil: Schroeter, Corinna. Ruprecht Karls Universitat Heidelberg.; AlemaniaFil: Neubauer, Eva. Ruprecht Karls Universitat Heidelberg.; AlemaniaFil: Schiltenwolf, Marcus. Ruprecht Karls Universitat Heidelberg.; Alemani

Implementation of an automated cluster alert system into the routine work of infection control and hospital epidemiology: experiences from a tertiary care university hospital

Background: Early detection of clusters of pathogens is crucial for infection prevention and control (IPC) in hospitals. Conventional manual cluster detection is usually restricted to certain areas of the hospital and multidrug resistant organisms. Automation can increase the comprehensiveness of cluster surveillance without depleting human resources. We aimed to describe the application of an automated cluster alert system (CLAR) in the routine IPC work in a hospital. Additionally, we aimed to provide information on the clusters detected and their properties. Methods: CLAR was continuously utilized during the year 2019 at Charite university hospital. CLAR analyzed microbiological and patient-related data to calculate a pathogen-baseline for every ward. Daily, this baseline was compared to data of the previous 14 days. If the baseline was exceeded, a cluster alert was generated and sent to the IPC team. From July 2019 onwards, alerts were systematically categorized as relevant or non-relevant at the discretion of the IPC physician in charge. Results: In one year, CLAR detected 1,714 clusters. The median number of isolates per cluster was two. The most common cluster pathogens were Enterococcus faecium (n = 326, 19 %), Escherichia coli (n = 274, 16 %) and Enterococcus faecalis (n = 250, 15 %). The majority of clusters (n = 1,360, 79 %) comprised of susceptible organisms. For 906 alerts relevance assessment was performed, with 317 (35 %) alerts being classified as relevant. Conclusions: CLAR demonstrated the capability of detecting small clusters and clusters of susceptible organisms. Future improvements must aim to reduce the number of non-relevant alerts without impeding detection of relevant clusters. Digital solutions to IPC represent a considerable potential for improved patient care. Systems such as CLAR could be adapted to other hospitals and healthcare settings, and thereby serve as a means to fulfill these potentials