Contextual determinants of Intimate Partner Violence: a multi-level analysis in six European cities

Objectives: To assess whether city-level characteristics influence the risk of intimate partner violence (IPV) victimization across six European cities. Methods: The DOVE Study included 3496 participants from Athens-Greece, Budapest-Hungary, London-UK, Östersund-Sweden, Porto-Portugal and Stuttgart-Germany. IPV victimization was assessed using the Revised Conflict Tactics Scales and several contextual variables were included: GINI coefficient, gender equality index, an index of social support, unemployment rate and proportion of residents with tertiary education. Multilevel models were fitted to estimate the associations (Odds ratio, 95% Confidence Intervals) between each type of victimization and contextual and individual-level variables. Results: 62.3% of the participants reported being a victim of IPV during the previous year, with large between-city differences (53.9%-72.4%). Contextual variables accounted for a substantial amount of this heterogeneity. Unemployment rates were associated with psychological (1.05, 1.01-1.08) and physical IPV (1.07, 1.01-1.13). GINI coefficient showed a positive association with any form of IPV (1.06, 1.01-1.11) and sexual coercion (1.13, 1.01-1.25). Conclusions: We found significant associations between contextual determinants and IPV, which emphasizes the importance of considering contextual socioeconomic conditions when policy measures are designed to address IPV

Postoperative outcomes in oesophagectomy with trainee involvement

BACKGROUND: The complexity of oesophageal surgery and the significant risk of morbidity necessitates that oesophagectomy is predominantly performed by a consultant surgeon, or a senior trainee under their supervision. The aim of this study was to determine the impact of trainee involvement in oesophagectomy on postoperative outcomes in an international multicentre setting. METHODS: Data from the multicentre Oesophago-Gastric Anastomosis Study Group (OGAA) cohort study were analysed, which comprised prospectively collected data from patients undergoing oesophagectomy for oesophageal cancer between April 2018 and December 2018. Procedures were grouped by the level of trainee involvement, and univariable and multivariable analyses were performed to compare patient outcomes across groups. RESULTS: Of 2232 oesophagectomies from 137 centres in 41 countries, trainees were involved in 29.1 per cent of them (n = 650), performing only the abdominal phase in 230, only the chest and/or neck phases in 130, and all phases in 315 procedures. For procedures with a chest anastomosis, those with trainee involvement had similar 90-day mortality, complication and reoperation rates to consultant-performed oesophagectomies (P = 0.451, P = 0.318, and P = 0.382, respectively), while anastomotic leak rates were significantly lower in the trainee groups (P = 0.030). Procedures with a neck anastomosis had equivalent complication, anastomotic leak, and reoperation rates (P = 0.150, P = 0.430, and P = 0.632, respectively) in trainee-involved versus consultant-performed oesophagectomies, with significantly lower 90-day mortality in the trainee groups (P = 0.005). CONCLUSION: Trainee involvement was not found to be associated with significantly inferior postoperative outcomes for selected patients undergoing oesophagectomy. The results support continued supervised trainee involvement in oesophageal cancer surgery

Chlorhexidine versus povidone–iodine skin antisepsis before upper limb surgery (CIPHUR) : an international multicentre prospective cohort study

Introduction Surgical site infection (SSI) is the most common and costly complication of surgery. International guidelines recommend topical alcoholic chlorhexidine (CHX) before surgery. However, upper limb surgeons continue to use other antiseptics, citing a lack of applicable evidence, and concerns related to open wounds and tourniquets. This study aimed to evaluate the safety and effectiveness of different topical antiseptics before upper limb surgery. Methods This international multicentre prospective cohort study recruited consecutive adults and children who underwent surgery distal to the shoulder joint. The intervention was use of CHX or povidone–iodine (PVI) antiseptics in either aqueous or alcoholic form. The primary outcome was SSI within 90 days. Mixed-effects time-to-event models were used to estimate the risk (hazard ratio (HR)) of SSI for patients undergoing elective and emergency upper limb surgery. Results A total of 2454 patients were included. The overall risk of SSI was 3.5 per cent. For elective upper limb surgery (1018 patients), alcoholic CHX appeared to be the most effective antiseptic, reducing the risk of SSI by 70 per cent (adjusted HR 0.30, 95 per cent c.i. 0.11 to 0.84), when compared with aqueous PVI. Concerning emergency upper limb surgery (1436 patients), aqueous PVI appeared to be the least effective antiseptic for preventing SSI; however, there was uncertainty in the estimates. No adverse events were reported. Conclusion The findings align with the global evidence base and international guidance, suggesting that alcoholic CHX should be used for skin antisepsis before clean (elective upper limb) surgery. For emergency (contaminated or dirty) upper limb surgery, the findings of this study were unclear and contradict the available evidence, concluding that further research is necessary

A study on functional and structural traits of the nocturnal flowers of Capparis spinosa L.

Functional and structural traits of the Capparis spinosa flower were studied in order to understand the mechanisms that allow this species to flower during the dry summer in the Mediterranean. Stomata were found on the abaxial surface of sepals, and on both the adaxial and abaxial surfaces of petals. Filaments and style were densely packed with small cells, exhibiting an increased density of cell wall material that provides strength. Petals possessed vacuolated parenchyma cells with large intercellular space. Turgor of petals was sustained mainly due to a decline in solute potential during the night and to a rise in water potential and solute potential at sunrise, concomitantly with a decrease in solute accumulation. Estimates of total sugars made in floral tissues of nine successive flowers along newborn stems were 100-fold higher than those of proline accumulation. Unsaturated fatty acids were identified as major components of lipids in petals, thereby influencing the fluidity of membranes. © 2006 Elsevier Ltd. All rights reserved

Empathy, mentalizing, and cognitive functioning in anorexia nervosa and bulimia nervosa

The existing evidence on the specific profile and the determinants of empathic and mentalizing abilities in anorexia nervosa (AN) and bulimia nervosa (BN) is not conclusive. Moreover, it is not clear whether patients with eating disorders also exhibit diminished ability to accurately appraise their own empathic skills. We examine in AN and BN: (a) the impairments in various aspects of empathy and theory of mind (ToM), while accounting for the effect of other cognitive functions and (b) the accuracy of self-appraisal of empathy. Self-reported and performance-based empathy, ToM, and cognitive functions were assessed in 46 patients with AN, 30 patients with BN, and 42 healthy controls (HC). Both AN and BN patients reported diminished overall empathic abilities, whereas only BN patients reported reduced cognitive empathy compared to HC. Deficits in performance-based empathy were found in both patient groups. Cognitive ToM was impaired only in AN. Significant correlations between self-reported and performance-based empathy were found in BN and HC but not in AN. Cognitive deficits negatively affected the self-appraisal of empathy in AN but not empathic skills per se. Our findings highlight a double deficit related to empathic responding in AN: diminished performance and inaccurate self-appraisal of empathic abilities, indicating dysfunctional self-reflection. © 2020 Informa UK Limited, trading as Taylor & Francis Group

A study on functional and structural traits of the nocturnal flowers of Capparis spinosa L.

Functional and structural traits of the Capparis spinosa flower were studied in order to understand the mechanisms that allow this species to flower during the dry summer in the Mediterranean. Stomata were found on the abaxial surface of sepals, and on both the adaxial and abaxial surfaces of petals. Filaments and style were densely packed with small cells, exhibiting an increased density of cell wall material that provides strength. Petals possessed vacuolated parenchyma cells with large intercellular space. Turgor of petals was sustained mainly due to a decline in solute potential during the night and to a rise in water potential and solute potential at sunrise, concomitantly with a decrease in solute accumulation. Estimates of total sugars made in floral tissues of nine successive flowers along newborn stems were 100-fold higher than those of proline accumulation. Unsaturated fatty acids were identified as major components of lipids in petals, thereby influencing the fluidity of membranes. © 2006 Elsevier Ltd. All rights reserved

The impact of theory of mind and neurocognition on delusionality in anorexia nervosa

The current study aimed to examine the impact of theory of mind (ToM) deficits on body image delusionality in anorexia nervosa (AN) while accounting for the effect of other cognitive functions. ToM and other cognitive functions were assessed in 46 patients with AN and 42 healthy controls. We used the Brown Assessment of Beliefs Scale to assess the degree of delusionality of body image beliefs in AN patients. Delusional body image beliefs were identified in 26.1% and overvalued ideas in 30.4% of the AN patients. Moderate but significant associations were found between impairments in ToM—overall capacity, cognitive and affective components—and body image delusionality. The effect of overall ToM performance on delusionality remained significant after controlling for other cognitive factors. General intelligence was also significantly associated with delusionality. Our findings support the notion that difficulties in taking the perspective of others contribute to insight impairment in AN. Further investigation is required to examine the effect of failures in social cognition and metacognition on insight in AN. © 2020, © 2020 Informa UK Limited, trading as Taylor & Francis Group

Internet addiction in the island of Hippocrates: The associations between internet abuse and adolescent off-line behaviours

Background: To investigate the phenomenon of internet addiction and concurrent social (off-line) behaviours of an adolescent population a cross-sectional survey of the entire adolescent student population (N=1270, aged 14-18) of the island of Kos in Greece was conducted. Method: Completion by the survey participants of a demographic questionnaire, the 8-question YDQ (Diagnostic Questionnaire for Internet Addiction) and the 20-question IAT (Internet Addiction Test), followed by comparative analysis between and within usage groups. Results: Results demonstrate that 7.2% of male and 5.1% of female internet users present addictive behaviours while using the internet. Conclusions: Anti-social, aggressive behaviours were significantly correlated with an increase to the pattern of abusive internet use in both sexes. Boys and girls had distinct profiles of off-line and online preferences. Boys tended to favour interest-driven online activities as their levels of addictive behaviour increased while girls favoured communication-driven online activities. © 2011 The Authors. Child and Adolescent Mental Health © 2011 Association for Child and Adolescent Mental Health