Building caregivers' emotional, parental and social support skills to prevent violence against adolescent girls:Findings from a cluster randomised controlled trial in Democratic Republic of Congo.

Introduction Parenting programmes are increasingly popular for reducing children’s exposure to interpersonal violence in low/middle-income countries, but there is limited evidence on their effectiveness. We investigated the incremental impact of adding a caregiver component to a life skills programme for adolescent girls, assessing girls’ exposure to violence (sexual and others) and caregivers’ gender attitudes and parenting behaviours.Methods In this two-arm, single-blinded, cluster randomised controlled trial, we recruited 869 adolescent girls aged 10–14 and 764 caregivers in South Kivu, Democratic Republic of Congo. Following a baseline survey, participants were divided into 35 clusters based on age, language and location. Eighteen clusters were randomised to the treatment arm and 17 clusters to the wait-list control arm. Adolescent girls in both arms received 32 life skills sessions; caregivers in the treatment arm received 13 complementary caregiver sessions. The primary outcome was girls’ self-reported exposure to sexual violence in the last 12 months; secondary outcomes included self-reports of specific forms of sexual violence, physical and emotional violence, transactional sex, child marriage for girls and parenting behaviours for caregivers. Intent-to-treat and per-protocol analyses were conducted.Results At 12 months of follow-up, the intervention showed no impact on sexual violence (adjusted OR=0.95; 95% CI 0.65 to 1.37) or any secondary outcomes for girls. The intervention was associated with improved supportive parenting behaviours. Protocol adherence was also associated with improvements in these outcomes.Conclusion While the caregiver curriculum improved some parenting outcomes, additional programmatic adaptations may be needed to reduce adolescent girls’ violence exposure in humanitarian settings.Trial registration number NCT02384642

Gliquidone

The title compound {systematic name: N-cyclo­hexyl­carba­moyl-4-[2-(7-meth­oxy-4,4-dimethyl-1,3-dioxo-1,2,3,4-tetra­hydro­isoquinolin-2-yl)eth­yl]benzene­sulfonamide}, C27H33N3O6S, displays an intra­molecular N—H⋯O=S inter­action, as well as inter­molecular N—H⋯O=C hydrogen bonds. The latter inter­actions lead to the formation of hydrogen-bonded chains parallel to the c axis. The conformation of the sulfonyl­urea fragment is in agreement with a recent theoretical study [Kasetti et al. (2010 ▶). J. Phys. Chem. B, 114, 11603–11610]

Polythia­zide

The crystal structure of the title compound, C11H13ClF3N3O4S3 (systematic name: 6-chloro-2-methyl-3-{[(2,2,2-trifluoro­eth­yl)sulfan­yl]meth­yl}-3,4-dihydro-2H-1,2,4-benzothia­diazine-7-sul­f­on­amide 1,1-diox­ide; CRN: 346–18–9), exhibits a two-dimensional network of hydrogen-bonded mol­ecules parallel to (01). The NH and NH2 groups act as donor sites and the sulfonyl O atoms as acceptor sites in N—H⋯O hydrogen bonds, and a C—H⋯O interaction also occurs. The thiadiazine ring adopts an envelope conformation with the N atom bonded to sulfur at the tip of the flap, and the methyl substituent is in an axial position

Increasing frailty is associated with higher prevalence and reduced recognition of delirium in older hospitalised inpatients: results of a multi-centre study

Purpose: Delirium is a neuropsychiatric disorder delineated by an acute change in cognition, attention, and consciousness. It is common, particularly in older adults, but poorly recognised. Frailty is the accumulation of deficits conferring an increased risk of adverse outcomes. We set out to determine how severity of frailty, as measured using the CFS, affected delirium rates, and recognition in hospitalised older people in the United Kingdom. Methods: Adults over 65 years were included in an observational multi-centre audit across UK hospitals, two prospective rounds, and one retrospective note review. Clinical Frailty Scale (CFS), delirium status, and 30-day outcomes were recorded. Results: The overall prevalence of delirium was 16.3% (483). Patients with delirium were more frail than patients without delirium (median CFS 6 vs 4). The risk of delirium was greater with increasing frailty [OR 2.9 (1.8–4.6) in CFS 4 vs 1–3; OR 12.4 (6.2–24.5) in CFS 8 vs 1–3]. Higher CFS was associated with reduced recognition of delirium (OR of 0.7 (0.3–1.9) in CFS 4 compared to 0.2 (0.1–0.7) in CFS 8). These risks were both independent of age and dementia. Conclusion: We have demonstrated an incremental increase in risk of delirium with increasing frailty. This has important clinical implications, suggesting that frailty may provide a more nuanced measure of vulnerability to delirium and poor outcomes. However, the most frail patients are least likely to have their delirium diagnosed and there is a significant lack of research into the underlying pathophysiology of both of these common geriatric syndromes

A theory of collaborative organising

EThOS - Electronic Theses Online ServiceGBUnited Kingdo