What’s a (Childless) Man Without a Woman? The Differential Importance of Couple Dynamics for the Wellbeing of Childless Men and Women in the Netherlands

Using rich couple data from the Netherlands Kinship Panel Study, we investigated to what extent there were gender differences in couple dynamics within childless couples (N = 163). Though the childless partners reported similar relationship satisfaction, we found gender differences in the link between relationship conflict and relationship satisfaction - the childless men were more strongly affected by the negative aspects of the partnership. This gender difference was not evident for the association between partner support and relationship satisfaction - the positive aspects of the partnership were equally important for the male and the female childless partners. Furthermore, the association between relationship satisfaction and health was stronger for the childless men than for the childless women and this difference was particularly evident when the levels of relationship satisfaction were low. These results indicate that when they are in unsatisfying romantic relationships, childless men are at a greater risk than childless women of physical and mental ill health

Investigation on the effects of guava (Psidium guajava L.) infusions on germination, root tips and meristematic cells of Latuca sativa

Guava (Psidium guajava L.) is a plant often employed in popular medicine. Recently several studies have alerted about the toxicity of substances present in medicinal plants, which can pose risks to the human health. In this sense, the present work aimed to investigate the phytotoxic, cytotoxic and genotoxic action of three guava varieties - Paluma, Pedro Sato and Roxa (purple) - on the plant test system Lactuca sativa L. Thus, macro- and microscopic evaluations were carried out for five infusion concentrations (2.5, 5.0, 10.0, 20.0 and 40.0 g.L-1) prepared from each variety. Distilled water was used as negative control. Chromatographic and spectroscopic analysis by HPLC-PAD indicated that the chemical composition of the infusion of Roxa is different than that of the infusions of the varieties Paluma and Pedro Sato. It was observed that seed germination and root growth in L. sativa exposed to infusions decreased with increasing infusion concentration, regardless of the tested cultivar. For the mitotic index, no statistical differences were observed. On the other hand, a significant increase in the frequency of cell cycle alterations was verified, especially for the highest concentrations tested. The cytogenotoxic was significant. Therefore, guava should not be used indiscriminately in popular medicine.A goiaba (Psidium guajava L.) é uma planta bastante utilizada na medicina popular. Recentemente alguns trabalhos tem alertado acerca da toxicidade de substâncias presentes em plantas medicinais, o que pode trazer riscos à saúde humana. Neste sentido, o presente trabalho objetivou investigar a ação fitotóxica, citotóxica e genotóxica de três variedades de goiaba - Paluma, Pedro Sato e Roxa - no sistema teste vegetal Lactuca sativa L. Assim, foram realizadas avaliações macro- e microscópicas para cinco concentrações de infusões (2,5, 5,0, 10,0, 20,0 e 40,0 g.L-1) preparadas a partir de cada variedade. A água destilada foi usada como controle negativo. As análises cromatográficas e espectroscópicas por HPLC-PAD indicaram que a composição química da infusão da Roxa é diferente das infusões das variedades Paluma e Pedro Sato. Foi observado que a germinação das sementes e o crescimento da raiz em L. sativa expostas às infusões diminuem com o aumento da concentração da infusão, independentemente da cultivar testada. Para o índice mitótico, diferenças estatísticas não foram observadas. Por outro lado, foi verificado um aumento significativo na frequência de alterações do ciclo celular, especialmente para as maiores concentrações testadas. O efeito citogenotóxico foi significativo. Portanto, a goiaba não deve ser utilizada indiscriminadamente na medicina popular.Universidade Federal do Espírito Santo Centro de Ciências Agrárias Departamento de BiologiaUniversidade Federal de Lavras Departamento de BiologiaUniversidade Estadual Paulista Faculdade de Ciências Departamento de QuímicaUniversidade Estadual Paulista Faculdade de Ciências Departamento de Químic

Pooled analysis of who surgical safety checklist use and mortality after emergency laparotomy

Background: The World Health Organization (WHO) Surgical Safety Checklist has fostered safe practice for 10 years, yet its place in emergency surgery has not been assessed on a global scale. The aim of this study was to evaluate reported checklist use in emergency settings and examine the relationship with perioperative mortality in patients who had emergency laparotomy. Methods: In two multinational cohort studies, adults undergoing emergency laparotomy were compared with those having elective gastrointestinal surgery. Relationships between reported checklist use and mortality were determined using multivariable logistic regression and bootstrapped simulation. Results: Of 12 296 patients included from 76 countries, 4843 underwent emergency laparotomy. After adjusting for patient and disease factors, checklist use before emergency laparotomy was more common in countries with a high Human Development Index (HDI) (2455 of 2741, 89⋅6 per cent) compared with that in countries with a middle (753 of 1242, 60⋅6 per cent; odds ratio (OR) 0⋅17, 95 per cent c.i. 0⋅14 to 0⋅21, P < 0⋅001) or low (363 of 860, 42⋅2 percent; OR 0⋅08, 0⋅07 to 0⋅10, P < 0⋅001) HDI. Checklist use was less common in elective surgery than for emergency laparotomy in high-HDI countries (risk difference −9⋅4 (95 per cent c.i. −11⋅9 to −6⋅9) per cent; P < 0⋅001), but the relationship was reversed in low-HDI countries (+12⋅1 (+7⋅0 to +17⋅3) per cent; P < 0⋅001). In multivariable models, checklist use was associated with a lower 30-day perioperative mortality (OR 0⋅60, 0⋅50 to 0⋅73; P < 0⋅001). The greatest absolute benefit was seen for emergency surgery in low-and middle-HDI countries. Conclusion: Checklist use in emergency laparotomy was associated with a significantly lower perioperative mortality rate. Checklist use in low-HDI countries was half that in high-HDI countries

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p<0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p<0·001). Interpretation Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication. Funding DFID-MRC-Wellcome Trust Joint Global Health Trial Development Grant, National Institute of Health Research Global Health Research Unit Grant