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Background Surgical site infections (SSI) in the groin after vascular surgery are common. The aim of the study was to evaluate the effect of negative pressure wound therapy (NPWT) on SSI incidence when applied on closed inguinal incisions after endovascular aneurysm repair (EVAR). Methods A multicenter randomized controlled trial (RCT). Between November 2013 and December 2020, 377 incisions (336 bilateral and 41 unilateral) from elective EVAR procedures with the primary intent of fascia closure were randomized and included, receiving either NPWT or a standard dressing. In bilateral incisions, each incision randomly received the opposite dressing of the other side, thereby becoming each other’s control. The primary endpoint was SSI incidence at 90 days postoperatively, analyzed on an intention-to-treat basis. Uni and bilaterally operated incisions were analyzed separately, and their respective p-values combined using Fisher’s method for combining P-values. Study protocol (NCT01913132). Results The SSI incidence at 90 days postoperatively in bilateral incisions was 1.8% (n = 3/168) in the NPWT and 4.8% (n = 8/168) in the standard dressing group, and in unilateral incisions 13.3% (n = 2/15) and 11.5% (n = 3/26), respectively (combined p = 0.49). In all SSIs, bacteria were isolated from incisional wound cultures. No additional SSIs were diagnosed between 90 days and 1 year follow-up. Conclusions No evidence of difference in SSI incidence was seen in these low-risk inguinal incisions when comparing NPWT with standard dressings after EVAR with the primary intent of fascia closure. Clinical Trials: NCT01913132.

Aim While the scientific evidence in favour of negative pressure wound therapy (NPWT) dressings on sutured incisions in the prevention of surgical site infections (SSIs) has increased, the cost-effectiveness after vascular surgery has not been evaluated. The aim of this study was to evaluate the cost-effectiveness of NPWT compared to standard dressings for the prevention of SSIs after open inguinal vascular surgery. Materials and methods Patient data were retrieved from the randomised INVIPS-trial's open arm, which included patients randomised to either NPWT or standard dressings. The patients were surveyed for SSIs for 90 days postoperatively. The patients' individual cost data were included and analysed from a healthcare perspective. The patients' quality of life was measured using the Vascuqol-6 questionnaire pre- and 30 days postoperatively. Cost-effectiveness of NPWT was determined by decreased or equal total costs and a significant reduction in SSI incidence. Results : The mean vascular procedure-related costs at 90 days were €16,621 for patients treated with NPWT (n = 59) and €16,285 for patients treated with standard dressings (n = 60), p = 0.85. The SSI incidence in patients treated with NPWT was 11.9% (n = 7/59) compared to 30.0% (n = 18/60) with standard dressings, p = 0.015. This corresponds to an increased mean cost of €1,853 per SSI avoided. The cost-effectiveness plane of incremental vascular procedure-related costs and difference in Vascuqol-6 score showed that 42% of estimates were in the quadrant where NPWT was dominant. Conclusion: NPWT is considered cost-effective over standard dressings in patients undergoing open inguinal vascular surgery due to reduced SSI incidence at no higher costs.

In this article we examine whether different agents of socialization—family, school, and peers—are differentially associated with offending among different immigrant groups. Our expectation is to find that the association between delinquent friends and offending is stronger for first- and second-generation immigrants than for youths of native Swedish background. We use data from four nationally representative self-report studies of 21,504 adolescents with an average age of 15 years in Sweden. The results show that both first- and second-generation immigrants report committing more offenses than natives. The association is rather weak and the two predictors account for only a marginal amount of the variance in total offending. The results also show that the association between delinquent friends and offending is stronger for both first- and second-generation immigrants than for natives.

Background Infusion with 0.9% saline is a mainstay in the treatment of severe hyperglycemia, but the kinetics of the saline volume in this setting has not been studied. Methods An intravenous infusion of 1 L of 0.9% saline over 30 minutes was given on 31 occasions to 17 patients with hyperglycemia due to poorly controlled diabetes (mean age 51 years). A two-volume kinetic model was fitted to serial data on the hemodilution and urinary excretion, using mixed-effects modeling software. Results Plasma glucose was 36 ± 9 mmol/L on arrival to the hospital. The central volume of distribution (the plasma) was only 2.38 L (mean; 95% confidence interval 1.73-3.04) on the day of admission. Uptake into a remote compartment, believed to be the cells, amounted to 300 mL of the first liter of saline, although only small amounts of insulin were given. Plasma glucose, plasma bicarbonate, urine glucose, and plasma creatinine served as covariates in the kinetic model and mathematically affected the urinary excretion. For example, elimination of the infused fluid tripled from an increase in plasma glucose from 5 to 35 mmol/L and doubled from a reduction in plasma bicarbonate from 24 to 5 mmol/L. Conclusions The excretion of 0.9% saline was increased depending on the degree of hyperglycemia. The kinetics was characterized by glucose-accelerated diuresis, and an intracellular uptake that occurred at two thirds the urine flow rate. These data could help to determine appropriate volumes and rates of infusion of crystalloids in hyperglycemia.

Background: Incision complications (IC) have a significant impact on procedure-related morbidity after lower-limb revascularization. One of the most studied IC is surgical site infection (SSI). Reporting these complications in a uniform way is crucial to evaluate treatment approaches. The aim of this study was to propose a comprehensive classification of IC and apply it to compare SSI with other IC in a trial on elective open lower-limb revascularization procedures. Methods: Two hundred twenty-three eligible patients undergoing elective unilateral inguinal and infra-inguinal arterial vascular surgery were extracted from a randomized controlled trial on incisional negative-pressure wound therapy (NPWT) on inguinal vascular surgical incisions. The IC were classified by grades of severity (grade 0-6) that focused on IC-related consequences such as out-patient treatment (grade 1), prolonged in-patient treatment (grade 2), re-admission (grade 3), and re-operation (grade ≥4). An SSI was defined by the ASEPSIS score criteria. Results: An SSI was diagnosed in 63 patients (28.3%). Thirty-five of 160 patients (21.8%) not suffering from SSI underwent IC treatment. Treatment for IC was recorded for 25/144 patients (17.4%) with satisfactory site healing as judged by the ASEPSIS score. The median incision-related in-hospital stay in those with SSI (n = 79) and disturbed healing (n = 16) according to the ASEPSIS score was 13 days in both groups (p = 0.53). Five patients had peri-vascular SSI (IC grade 4 n = 4; grade 5 n = 1). The proposed classification of IC and the ASEPSIS score correlated highly (r = 0.77; p < 0.001). Inter-rater reliability for IC grading was substantial for three investigators with different levels of experience (k = 0.81, 0.71, and 0.70). Conclusions: The proposed incision classification suggests a comparable clinical significance of vascular IC in terms of IC-related in-patient stay, whether there was a surgical site infection or not. This classification system requires external validation.

Background Hyperchloremic metabolic acidosis that develops during the treatment of diabetic ketoacidosis is usually attributed to the chloride content of resuscitation fluids. We explored an alternative explanation, namely that fluid-induced plasma volume expansion alters the absolute differences in the concentrations of sodium and chloride (the Na–Cl gap) enough to affect the acid–base balance. We analyzed data from a prospective single-center cohort study of 14 patients treated for diabetic ketoacidosis. All patients received 1 L of 0.9% saline over 30 min on two consecutive days. Blood gases were sampled before and after the infusions. Results The initial plasma volume was estimated to be 25 ± 13% (mean ± SD) below normal on admission to the intensive care unit. At that time, most patients had an increased actual Na–Cl gap, which counteracts acidosis. However, the correction of the plasma volume deficit revealed that these patients would have had a decreased Na–Cl gap upon admission if they had been normovolemic at that time; the estimated “virtual Na–Cl gap” of 29 ± 5 mmol/L was significantly lower than the uncorrected value, which was 39 ± 5 mmol/L (P . Conclusions The hyperchloremic acidosis commonly seen in diabetic ketoacidosis may not be primarily caused by the chloride content of resuscitation fluids but, rather, by the restoration of plasma volume, which reveals the hidden metabolic acidosis caused by a decreased Na–Cl gap. Trial registration Clinical Trials Identifier NCT02172092, registered June 24, 2014, https://www.clinicaltrials.gov/NCT02172092

Background Previous research on the relationship between social media use and well-being in adolescents has yielded inconsistent results. We addressed this issue by examining the association between various digital media activities, including a new and differentiated measure of social media use, and well-being (internalizing symptoms) in adolescent boys and girls. Method The sample was drawn from the four cross-sectional surveys from the Öckerö project (2016–2019) in eight municipalities in southern Sweden, consisting of 3957 adolescents in year 7 of compulsory education, aged 12–13. We measured the following digital media activities: playing games and three different activities of social media use (chatting, online sociability, and self-presentation). Our outcome measure was internalizing symptoms. Hypotheses were tested with linear regression analysis. Results Social media use and playing games were positively associated with internalizing symptoms. The effect of social media use was conditional on gender, indicating that social media use was only associated with internalizing symptoms for girls. Of the social media activities, only chatting and self-presentation (posting information about themselves) were positively associated with internalizing symptoms. Self-presentation was associated with internalizing symptoms only for girls. Conclusion Our study shows the importance of research going beyond studying the time spent on social media to examine how different kinds of social media activities are associated with well-being. Consistent with research in psychology, our results suggest that young girls posting information about themselves (i.e. self-presentation) might be especially vulnerable to display internalizing symptoms.

OBJECTIVE: A randomized controlled trial (RCT) was undertaken to determine the effect of negative pressure wound therapy (NPWT) on closed incisions after inguinal vascular surgery regarding surgical site infections (SSIs) and other wound complications. BACKGROUND: SSIs are a major concern in open vascular procedures involving the inguinal region. Prophylactic NPWT on closed incisions has shown promising results, but the quality of evidence can be debated. This study aims to objectively evaluate whether NPWT on sutured inguinal incisions after elective vascular surgery can decrease the incidence of surgical site complications. METHODS: One hundred thirty-nine patients undergoing elective open vascular surgery with inguinal incisions received either NPWT or a standard dressing. Patients with bilateral incisions randomly received a dressing on one incision and the opposite dressing on the other. The primary endpoints were SSI or other wound complications at 3 months, assessed by wound care experts blinded to the treatment arm and using objective wound assessment criteria (ASEPSIS-score). Statistical analysis was performed on an intention-to-treat basis and obtained P values from analyses in the uni- and bilateral groups were combined to an overall P value using Fisher's method for combining P values. RESULTS: The incidence of SSI was reduced in the NPWT group compared with the control group [11.9% vs 29.5% in the unilateral group (n = 120), 5.3% vs 26.3% in the bilateral group (n = 19), respectively; combined P = 0.02]. No differences regarding other surgical site complications were observed between the groups. CONCLUSION: NPWT on closed inguinal vascular surgical incisions in elective patients reduces the incidence of SSI. (Less)

This study investigates the direction and rate of change in self-reported crime over time, based on immigrant status and region of origin. The study is based on eight nationally representive school surveys conducted by the National Council for Crime Prevention between 1999 and 2017, with a sample of 50,657 adolescents. Results in this study showed a decreasing trend in self-reported offending among both first and second generation immigrant youth, and also among immigrant youths from different regions of origin. The results also show that offending has declined at a faster rate among first generation immigrants by comparison with native Swedes.

Background: Acute lower limb ischemia with a motor deficit (Rutherford IIb) needs urgent revascularization to avoid major amputation and mortality. It is unclear whether immediate revascularization without performing CT angiography (CTA) prior to revascularization in Rutherford IIb acute lower limb ischemia (ALI) is associated with better outcomes.Methods: Retrospective observational study of Rutherford IIb ALI patients treated between 2006 and 2018. A propensity score adjusted analysis was performed to compare outcomes after the performance of CTA examination or not.Results: Among 681 patients, 260 had Rutherford IIb ALI. CTA prior to revascularization was performed in 131 (50.4%) and increased (p < 0.001) throughout the study period. Open vascular and endovascular surgery was first performed in 147 (56.5%) and 113 (43.5%) patients, respectively. The proportion of endovascular treatment increased while the open vascular surgery decreased during the study period (p = 0.031). In the propensity score adjusted analysis, the performance of CTA was associated with decreased risk of combined major amputation /mortality (odds ratio 0.52, 95% confidence interval 0.27–0.99; p = 0.046) at 1 year.Conclusion: Performance of CTA was associated with a higher amputation-free survival in revascularized patients with Rutherford IIb ALI. CTA seem to provide guidance in selecting the most appropriate candidates for revascularization and choice of technique.

This study examines whether unstructured and structured activities interact in their association with delinquency and cannabis use. We hypothesize that unstructured activities are more strongly associated with delinquency and cannabis use for those who are less engaged in structured activities. Data are drawn from three nationally representative self-report studies conducted between 2005 and 2011 in Sweden, and include 19,644 adolescents. The results support the hypothesis that unstructured activities interact with structured activities in the association with delinquency and cannabis use. The association between unstructured activities and these outcomes is stronger for those with lower levels of structured activities. Sporting activities constitute the structured activity that most clearly interacts with unstructured activities in the association with delinquency and cannabis use.

The stay-at-home restrictions to control the spread of COVID-19 led to unparalleled sudden change in daily life, but it is unclear how they affected urban crime globally. We collected data on daily counts of crime in 27 cities across 23 countries in the Americas, Europe, the Middle East and Asia. We conducted interrupted time series analyses to assess the impact of stay-at-home restrictions on different types of crime in each city. Our findings show that the stay-at-home policies were associated with a considerable drop in urban crime, but with substantial variation across cities and types of crime. Meta-regression results showed that more stringent restrictions over movement in public space were predictive of larger declines in crime., The implementation of COVID-19 stay-at-home policies was associated with a considerable drop in urban crime in 27 cities across 23 countries. More stringent restrictions over movement in public space were predictive of larger declines in crime.

Background Developing a better understanding of drinking patterns across immigrant generations and how these change over time is important for the development of effective alcohol polices. This study investigates the direction and rate of change in youth alcohol intoxication over time, based on immigrant status, and by family structure and parental employment status. Method The study is based on eight nationally representative school surveys conducted by the Swedish National Council for Crime Prevention between 1999 and 2017, with a combined sample of 50,657 adolescents. Group by time interactions were examined to compare rates of change of alcohol intoxication over time across immigrant generations. Results The results show a decreasing trend in alcohol intoxication among both first and second generation immigrant youth, and also among immigrant youth across different family structures and parental employment statuses. The results also show that the decrease in alcohol intoxication over time is greater for youths born abroad and for youths with two immigrant parents than for native Swedes, and that the decrease over time is greater for youths from intact families than for native Swedish youths from non-intact families and youths with one immigrant parent. Conclusion Native and first- and second-generation immigrant youth may differ substantially from one another in many ways, and may therefore manifest different patterns of drinking behaviours. From a policy and prevention perspective, the data in this study imply that native youths and youths with one immigrant parent should be a central target group for alcohol prevention policy in Sweden

Background There is a well-documented gender difference in offending, with evidence that boys, on average, are more involved in crime than girls. Opinions differ, however, on whether the causes of crime apply to girls and boys similarly. Aims Our aim is to explore crime propensity in boys and girls. Our research questions were (1) are there differences between boys and girls in moral values and self-control; (2) are these attributes similarly correlated with offending among girls and boys; and (3) is any interaction effect between morality and self-control identical for girls and boys. Methods Data were drawn from the Malmo Individual and Neighbourhood Development Study, which includes 481 girls and boys aged 16-17. An 8-item self-control scale was derived from Grasmick's self-control instrument; we created a 16-item morality scale. Analysis of variance was used to test for differences in scale scores. Results There were significant gender differences in moral values but not self-control. Moral values and self-control were significantly correlated with offending among both girls and boys. In the multiple regression analysis, the three-way interaction term used to test the interaction between gender, self-control and moral values was non-significant, indicating that the magnitude of the self-control-moral value interaction is not affected by gender. Conclusions Our findings indicate that effects of morality and self-control are general and apply to girls and boys similarly, so more research is needed to explain gender differences in crime prevalence. © 2018 The Authors Criminal Behaviour and Mental Health Published by John Wiley & Sons Ltd.

This work provides an overview of the current state of research on Situational Action Theory (SAT). Studies that have examined core propositions of SAT within the period 2006 to 2015 are reviewed. The principal aim of this narrative review is to answer the following four questions: (1) Which hypotheses of SAT have been put to the test in empirical enquiries? (2) What does the empirical evidence say about these propositions? (3) Which statements of the theory have received little attention? (4) What are the consequences of the results for future enquiries? An overall finding of this review is that numerous studies have tested selected propositions of the theory using different methods, data and statistical procedures. A majority of these studies found some support for the hypotheses tested, but there are also a few studies that did not back key assumptions of the theory. The reasons for the divergent results are discussed.

The present research note studies the interaction between the ability to exercise self-control and extremist moral beliefs with regard to the explanation of violent extremism. Although some evidence exists for the interaction between moral beliefs and self-control in the explanation of adolescent offending, no previous study has studied this interaction effect in a survey of young adults and with regard to politically or religiously motivated violence. This study therefore extends the existing literature by testing a key proposition of Situational Action Theory. We use a large-scale web survey of young adults in Belgium. The results support the hypothesis that the effect of the ability to exercise self-control is conditional upon one’s extremist beliefs. The results are stable across extremism-specific measures of extremist beliefs.

Background Surgical-site infection (SSI) after groin incisions for arterial surgery is common and may lead to amputation or death. Incisional negative pressure wound therapy (NPWT) dressings have been suggested to reduce SSIs. The aim of this systematic review with meta-analysis was to assess the effects of incisional NPWT on the incidence of SSI in closed groin incisions after arterial surgery. Methods A study protocol for this systematic review of RCTs was published in Prospero (CRD42018090298) a priori, with predefined search, inclusion and exclusion criteria. The records generated by the systematic research were screened for relevance by title and abstract and in full text by two of the authors independently. The selected articles were rated for bias according to the Cochrane risk-of-bias tool. Results Among 1567 records generated by the search, seven RCTs were identified, including 1049 incisions. Meta-analysis showed a reduction in SSI with incisional NPWT (odds ratio (OR) 0·35, 95 per cent c.i. 0·24 to 0·50; P < 0·001). The heterogeneity between the included studies was low (I2 = 0 per cent). The quality of evidence was graded as moderate. Two studies had multiple domains in the Cochrane risk-of-bias tool rated as high risk of bias. A subgroup meta-analysis of three studies of lower limb revascularization procedures only (363 incisions) demonstrated a similar reduction in SSI (OR 0·37, 0·22 to 0·63; P < 0·001; I2 = 0 per cent). Conclusion Incisional NPWT after groin incisions for arterial surgery reduced the incidence of SSI compared with standard wound dressings. The risk of bias highlighted the need for a high-quality RCT with cost-effectiveness analysis.

OBJECTIVE: A randomized controlled trial (RCT) was undertaken to determine the effect of negative pressure wound therapy (NPWT) on closed incisions after inguinal vascular surgery regarding surgical site infections (SSIs) and other wound complications. BACKGROUND: SSIs are a major concern in open vascular procedures involving the inguinal region. Prophylactic NPWT on closed incisions has shown promising results, but the quality of evidence can be debated. This study aims to objectively evaluate whether NPWT on sutured inguinal incisions after elective vascular surgery can decrease the incidence of surgical site complications. METHODS: One hundred thirty-nine patients undergoing elective open vascular surgery with inguinal incisions received either NPWT or a standard dressing. Patients with bilateral incisions randomly received a dressing on one incision and the opposite dressing on the other. The primary endpoints were SSI or other wound complications at 3 months, assessed by wound care experts blinded to the treatment arm and using objective wound assessment criteria (ASEPSIS-score). Statistical analysis was performed on an intention-to-treat basis and obtained P values from analyses in the uni- and bilateral groups were combined to an overall P value using Fisher's method for combining P values. RESULTS: The incidence of SSI was reduced in the NPWT group compared with the control group [11.9% vs 29.5% in the unilateral group (n = 120), 5.3% vs 26.3% in the bilateral group (n = 19), respectively; combined P = 0.02]. No differences regarding other surgical site complications were observed between the groups. CONCLUSION: NPWT on closed inguinal vascular surgical incisions in elective patients reduces the incidence of SSI. (Less)

Purpose of the investigation Scar formation is an important, permanent surrogate marker for wound healing. The main aim of this randomized trial was to evaluate the effects of incisional negative pressure wound therapy (iNPWT) on scar formation in uncomplicated wound healing with 3-dimensional (3D) digital imaging. Basic procedures Patients undergoing bilateral inguinal incisions after vascular surgery were randomized to receive iNPWT and standard dressing on separate sides. The incisional scars were documented at a median time of 808 days (range 394-1194) after surgery with 3D photography, which were objectively evaluated by two plastic surgeons using the Stony Brook scar evaluation scale (SBSES) and a 10-point graded numeric ranking scale (NRS10). Subjective evaluation was performed with the patient observer scar assessment scale (POSAS). Patients with surgical site infection or other wound complications were excluded to minimize bias. The p-values were calculated using McNemar's and Wilcoxon signed-rank test for paired nominal and paired continuous data, respectively. Main findings Among 33 patients, 32 patients had undergone endovascular aortic repair (EVAR) and 31 patients had transverse inguinal incisions. Objective and subjective scar evaluation showed no difference between iNPWT and standard dressing. In objective scorings, 18.8 and 21.9% received the highest possible SBSES total score in the iNPWT and standard dressing groups, while 43.8 and 37.5% received the highest possible NRS10 score, respectively. The inter-rater reliability between the two assessors for SBSES total score and NRS10 showed an intra-class correlation (ICC) of 0.78 and 0.68 for NPWT and 0.70 and 0.77 for traditional dressing, respectively. Principal conclusion The present randomized trial showed that iNPWT and standard dressings on closed transverse inguinal incisions after EVAR resulted in equal subtle scar formation. Objective scar evaluation with 3D images showed good inter-rater agreement.

Morality, and particularly the capacity to experience shame and/or guilt, may be viewed as sediments of early experiences with the commitment of acts of crime and rule-breaking and the consequences of these acts. This chapter addresses the specific roles of moral beliefs and moral emotions such as shame and guilt and how they are related to criminal decisions. It presents an overview of relevant theoretical frameworks that explain why and how moral beliefs and moral emotions affect criminal decision making. The focus of this chapter is particularly on anticipations of shame and guilt, two powerful and painful emotions that humans naturally want to avoid. In addition, findings from empirical studies are reviewed, and implications for criminological theory and prevention are addressed.

This study examines whether deterrence and morality interact in the explanation of adolescent offending. On the basis of the Situational Action Theory, the author hypothesizes that deterrence is more effective in preventing offending among individuals with low levels of morality than among individuals with high levels of morality. To test this hypothesis, self-report data are used from a sample of young adolescents in Halmstad, Sweden ( N = 891). The findings provide strong support for the hypothesis that the effect of deterrence (measured as the perceived risk of getting caught, that is, “certainty”) on offending is dependent on the individual’s level of morality, indicating that deterrence has a significantly stronger effect on offending for individuals with low levels of morality than for individuals with higher levels of morality.

There is a well-documented gender difference in offending, with evidence that boys, on average, are more involved in crime than girls. Opinions differ, however, on whether the causes of crime apply to girls and boys similarly.Our aim is to explore crime propensity in boys and girls. Our research questions were (1) are there differences between boys and girls in moral values and self-control; (2) are these attributes similarly correlated with offending among girls and boys; and (3) is any interaction effect between morality and self-control identical for girls and boys.Data were drawn from the Malmö Individual and Neighbourhood Development Study, which includes 481 girls and boys aged 16-17. An 8-item self-control scale was derived from Grasmick's self-control instrument; we created a 16-item morality scale. Analysis of variance was used to test for differences in scale scores.There were significant gender differences in moral values but not self-control. Moral values and self-control were significantly correlated with offending among both girls and boys. In the multiple regression analysis, the three-way interaction term used to test the interaction between gender, self-control and moral values was non-significant, indicating that the magnitude of the self-control-moral value interaction is not affected by gender.Our findings indicate that effects of morality and self-control are general and apply to girls and boys similarly, so more research is needed to explain gender differences in crime prevalence. © 2018 The Authors Criminal Behaviour and Mental Health Published by John WileySons Ltd.

The present study assesses the relationship between family and educational disadvantage on self-reported offending, victimisation and violent youth group involvement in a Belgian medium-sized city. Many studies have focused on the relationship between family disadvantage (one-parent families, immigrant background) and educational disadvantage (vocational tracking, school failure) and violent youth group involvement, offending/victimisation in surveys. The present study primarily assesses to what extent social bonds (parental monitoring and the school social bond), deviant beliefs, low self-control and lifestyle risk are stable mediators of the relationship between family and educational disadvantage and self-reported offending, victimisation and troublesome youth group involvement among young adolescents. The results indicate that the lifestyle-exposure model, which was initially used to explain individual differences in victimisation is much better capable of explaining differences in selfreported offending and violent youth group involvement than victimisation. The implications for further studies are discussed.

Background Experimental animal studies and previous randomized trials suggest an improvement in mortality and neurologic function with induced hypothermia after cardiac arrest. International guidelines advocate the use of a target temperature management of 32 degrees C to 34 degrees C for 12 to 24 hours after resuscitation from out-of-hospital cardiac arrest. A systematic review indicates that the evidence for recommending this intervention is inconclusive, and the GRADE level of evidence is low. Previous trials were small, with high risk of bias, evaluated select populations, and did not treat hyperthermia in the control groups. The optimal target temperature management strategy is not known. Methods The TTM trial is an investigator-initiated, international, randomized, parallel-group, and assessor-blinded clinical trial designed to enroll at least 850 adult, unconscious patients resuscitated after out-of-hospital cardiac arrest of a presumed cardiac cause. The patients will be randomized to a target temperature management of either 33 degrees C or 36 degrees C after return of spontaneous circulation. In both groups, the intervention will last 36 hours. The primary outcome is all-cause mortality at maximal follow-up. The main secondary outcomes are the composite outcome of all-cause mortality and poor neurologic function (cerebral performance categories 3 and 4) at hospital discharge and at 180 days, cognitive status and quality of life at 180 days, assessment of safety and harm. Discussion The TTM trial will investigate potential benefit and harm of 2 target temperature strategies, both avoiding hyperthermia in a large proportion of the out-of-hospital cardiac arrest population. (Am Heart J 2012; 163:541-8.)

The truncated [1 + 9–76] CCL2 analogue, also known as 7ND, has been described in numerous reports as an anti-inflammatory and anti-fibrotic agent in a wide spectrum of animal models, e.g. models of cardiovascular disease, graft versus host disease and bleomycin-induced pulmonary fibrosis. 7ND has been reported to function as a competitive inhibitor of CCL2 signaling via CCR2 in human in vitro systems. In contrast, the mechanistic basis of 7ND action in animal models has not been previously reported. Here we have studied how 7ND interacts with CCL2 and CCR2 of murine origin. Surprisingly, 7ND was shown to be a weak inhibitor of murine CCL2/CCR2 signaling and displaced murine CCL2 (JE) from the receptor with a K i > 1 μM. Using surface plasmon resonance, we found that 7ND binds murine CCL2 with a K d of 670 nM, which may indicate that 7ND inhibits murine CCL2/CCR2 signaling by a dominant negative mechanism rather than by competitive binding to the CCR2 receptor. In addition we observed that sub-nanomolar levels of 7ND mediate anti-fibrotic effects in CCR2 negative fibroblasts cultured from fibrotic lung of bleomycin-induced mice. Basal levels of extracellular matrix proteins were reduced (collagen type 1 and fibronectin) as well as expression levels of α-smooth muscle actin and CCL2. Our conclusion from these data is that the previously reported effects of 7ND in murine disease models most probably are mediated via mechanisms independent of CCR2.

Background Despite the increased interest in female offending trajectories over the last decades, knowledge is still limited. Aim To meet the need for more knowledge on female offending trajectories by studying sex differences in criminal career patterns. Method Data on 518 female and 2567 male offenders up to age 30 from the Swedish longitudinal Project Metropolitan study were analysed using latent class analysis. Results The female offenders were much less predisposed to offend than the males, but when they did, they tended to follow a similar set of trajectories to males in their criminal development over time. Four criminal career patterns were identified for each sex. Two patterns were the same between the sexes, and two were gender unique. All career patterns had meaningful and distinct associations with crime characteristics. Conclusions Our study presents indicators relating both to gender differences and to heterogeneity within the group of female offenders. One important finding was the identification of an adult-onset offender group unique to females. This group was characterised by high criminal activity over the years following their late onset. Further research will focus on the childhood origins, pathways and outcomes of different female antisocial and criminal careers. Copyright © 2012 John Wiley & Sons, Ltd.

The present study explores the strength of the relationship between offending and victimization among young adolescents. We focus especially on the role background characteristics such as gender, immigrant background and family structure and causal mechanisms such as risky lifestyles and low self-control as many scholars have argued that the correlation between offending and victimization may be caused by common characteristics of offenders and victims. The article build upon two large-scale self-reported delinquency studies in Sint-Niklaas (Belgium) and Halmstad (Sweden). The correlation between offending and victimization is strong, even when controlling for demographics, lifestyles and low self-control. However, the lifestyle and low self-control model predicts offending better than victimization and the independent effect of offending on victimization is larger than the independent effect of victimization of offending. The same pattern is found in both samples, suggesting the stability of findings. The implications of these findings are discussed.

This study examines whether having delinquent friends interacts with other peer-related variables in the explanation of adolescent offending. We hypothesise that the relationship between delinquent friends and offending might be conditioned by the effect of (1) how much time they spend with their friends, (2) how much time they spend in unstructured routine activities and (3) their emotional relationship with their friends. To test these three hypotheses we use data from two independent samples of young adolescents in Halmstad, Sweden ( N = 1,003) and in Cologne and Freiburg, Germany ( N = 955). The results found strong support that the effect of delinquent friends on adolescent offending is conditional on the level of time they spend in unstructured routine activities. This indicates that delinquent friends have a stronger effect on offending for adolescents who often spend their free time in unstructured routine activities.

In this paper we will test one of the key assumptions of Situational Action Theory: that individuals’ (law-relevant) morality is more fundamental to their crime involvement than their ability to exercise self-control. We specifically hypothesize that, for individuals with a strong morality, their capability to exercise self-control plays less of a role in their crime involvement than it does for individuals with a weak morality, whose capability to exercise self-control may substantially influence their engagement in crime. To test this hypothesis we use data from the Peterborough Youth Study (PYS), a cross-sectional survey of 1957 adolescents aged 14—15 from the UK city of Peterborough. The findings support the main hypothesis: young people with a strong (law-relevant) morality do not engage in crime, regardless of their ability to exercise self-control. However, among those with a weaker (law-relevant) morality, their ability to exercise self-control is an important factor in their crime involvement.

This study examines whether morality and self-control have an interactional effect on offending. Drawing from the situational action theory, the authors hypothesize that self-control has a more important effect on offending for individuals with low levels of morality than for individuals with high levels of morality. To test this hypothesis, self-report data were used from three independent samples of young adolescents in Antwerp, Belgium ( N = 2,486); Halmstad, Sweden ( N = 1,003); and South-Holland, the Netherlands ( N = 1,978). The findings provide strong support for the hypothesis that the effect of self-control on offending is dependent on the individual’s level of morality. The similarity of the results across three independent samples suggests that the findings are robust among different cultural backgrounds and among studies with different operationalizations of the central concepts of interest.

Propensity to offend is an important and stable predictor of offending. A person’s propensity is often thought of as a multidimensional trait consisting of morality and low self-control. The aim of this paper is to explain individual differences in propensity to offend as one single construct and two of its dimensions, namely morality and low self-control. It is well established that low levels of morality and low self-control increase the risk of offending. However, there is less empirical research that focuses on the main predictors of morality and self-control. Therefore the main research question for this study is to explain to what extent parental attachment, parental control and the school social bond have a direct effect on one’s propensity to offend (low morality or delinquency tolerance and low self-control). The data are drawn from two different samples of young adolescents in Antwerp, Belgium (N = 2,486), and Halmstad, Sweden (N = 1,003). The results show that parental control, parental attachment and the school social bond have direct effects on individual differences in propensity to offend, regardless of individual background variables. The results are highly equivalent in both samples. The similarity of the results across two independent samples suggests that the findings are stable. Implications for further studies are discussed.

The aim of this paper is to explain individual differences in lifestyle risk. Lifestyle risk has previously been identified as a key social mechanism which has strong direct effects on juvenile offending. Building on statements derived from the Situational Action Theory (SAT), we test the assumptions that (1) family structure explains individual differences in lifestyle risk, (2) these effects are moderated by mechanisms of social control, and (3) the effects of mechanisms of control are moderated by the effect of propensity to offend (morality and self-control). It is assumed that this model holds in different population segments such as subpopulations by gender and ethnic background. Results from two independently drawn urban samples in Belgium and Sweden are used to discuss the generalization of these findings. Mixed support is found for the `equality of effects' thesis.

This study examines the effects on adolescent offending of lifestyle risk and the individual propensity to offend. It is assumed that lifestyle risk will have a more important effect on offending for those individuals with high levels of individual propensity, whereas for individuals with low levels of individual propensity it is assumed that a risky lifestyle will not, or will only marginally, influence their involvement in offending. The data are drawn from two different samples of young adolescents in Antwerp, Belgium ( N = 2,486), and Halmstad, Sweden ( N = 1,003). The data provide strong support for the hypothesis that the effect of lifestyle risk is dependent on the strength or weakness of individual propensity, indicating that lifestyle risk has a stronger effect on delinquency for individuals with a high propensity to offend. The similarity of the results across two independent samples suggests the findings are stable.

Most cross-national studies of crime and violence explore variation in levels of crime without empirically addressing the causes of these variations. Drawing upon the theoretical framework of the situational action theory of crime causation (e.g. Wikström 2006), in this study we aim to explore and test whether the difference in levels of violence among young people in England and Sweden can be explained (fully or partly) by country differences in young people's crime propensities and lifestyles and their interaction. To achieve this we use data from the English Peterborough Youth Study and the Swedish Eskilstuna Youth Study. The findings show that in both cities (1) young people's self-reported violent behaviour is predicted by crime propensity and lifestyle, and their interaction, and (2) a substantial proportion (40 percent) of the difference in the level of violence vanishes when taking into account national differences in young people's crime propensity and lifestyles. We conclude that the findings support the notion that one major cause of the difference in the level of violence among young people in England and Sweden is that more young people in England have a higher crime propensity and are living criminogenic lifestyles than in Sweden.

The phenomenon of item nonresponse, i.e. missing data, in surveys is well known among methodologists. Item nonresponse is a problem when it is biased to the dependent variables in aetiological research. The occurrence of item nonresponse in self-reported delinquency studies has been associated with the threatening nature of questions about previous delinquent behaviour, but item nonresponse also occurs in scales measuring aetiological variables (theoretical concepts) in aetiological research, and in sociology has also been associated with negative attitudes towards the survey, although evidence from self-reported delinquency studies in support of this concern has not yet been given. The aim of this study is to evaluate the seriousness of the problem of item nonresponse in two independently drawn self-reported delinquency data sets of two classroom delinquency studies conducted among adolescents in Antwerp (Belgium) and Halmstad (Sweden) using paper and pencil interviews (PAPI). We do this by evaluating the non-random character of item nonresponse in scales of delinquency and aetiological variables, by looking at the correlates of item nonresponse and by evaluating the effects of assigning values on the missing data with regard to reliability and correlational validity. The results are rather optimistic about the hypothesized negative effects of item nonresponse.

Many honest attempts have been made to define a universal security testing process. Some attempts to explain such a process have been more widely accepted than others.

Being a good security tester takes a lot of passion and dedication. An interesting side to the security tester profession is that there will always be new threats and vulnerabilities to dig into.

This chapter is meant to provide a transition from the theoretical aspects of security testing to the hands-on hacking. The following sections will explain different technical approaches to security testing that will result in a well-structured report. This chapter will also address the benefits, and the potential side effects, of running security tests against pre-production and/or production systems.

No two systems are identical. This means that each security test is more or less unique. But having the knowledge to categorize different types of security tests is key to getting a good and valuable result.