Intimate partner violence during pregnancy - Prevalence and associations with women's health: A cross-sectional study.

OBJECTIVE: Intimate partner violence (IPV) against women occurs in all settings. Exposure to intimate partner violence, especially during pregnancy, is associated with serious adverse health outcomes and is recognized as a global health issue. AIM: To describe the prevalence of physical, psychological, and sexual intimate partner violence among pregnant women in Sweden during current pregnancy, and to investigate potential associations between exposure and sociodemographic characteristics and health. METHODS: Between October and December 2020, a cross-sectional survey study was conducted at 35 midwifery clinics in Stockholm, Sweden. RESULTS: The questionnaire was answered by 3399 pregnant women. The results showed that 2.1% of the women reported exposure to intimate partner violence during pregnancy, with exposure to psychological violence being most common (1.8%), followed by exposure to physical violence (0.6%) and sexual violence (0.1%). Exposure to intimate partner violence was significantly associated with living situation and depressive symptoms, as well as education, country of birth, and employment status. CONCLUSION: Exposure to intimate partner violence occurs even during pregnancy and it is crucial to identify pregnant women exposed to intimate partner violence in order to inform clinical practice and to provide adequate support. More research is needed to develop screening instruments to detect violence against pregnant women.

Zero-Phase-Difference Josephson Current Based on Spontaneous Symmetry Breaking via Parametric Excitation of a Movable Superconducting Dot.

Recent advances have attracted attention to nonstandard Josephson junctions in which a supercurrent can flow despite zero phase difference between the constituent superconducting leads. Here, we propose a zero-phase-difference nanoelectromechanical junction which, in contrast to other considered systems, exhibits symmetry between leftward and rightward tunneling through the junction. We show that a supercurrent is, nevertheless, possible as a result of spontaneous symmetry breaking. In the suggested junction, the supercurrent is mediated by tunneling via a superconducting Cooper-pair box on a mechanical resonator. An alternating electric potential parametrically excites mechanical oscillations which are synchronized with charge oscillations of the box. This leads to coherent transfer of Cooper pairs through the junction. The direction of the supercurrent is a result of spontaneous symmetry breaking and thus it can be reversed without changing the parameters.

Nanoelectromechanical Heat Engine Based on Electron-Electron Interaction.

We theoretically show that a nanoelectromechanical system can be mechanically actuated by a heat flow through it via an electron-electron interaction. In contrast to most known actuation mechanisms in similar systems, this new mechanism does not involve an electronic current nor external ac fields. Instead, the mechanism relies on deflection-dependent tunneling rates and a heat flow which is mediated by an electron-electron interaction while an electronic current through the device is prohibited by, for instance, a spin-valve effect. Therefore, the system resembles a nanoelectromechanical heat engine. We derive a criterion for the mechanical instability and estimate the amplitude of the resulting self-sustained oscillations. Estimations show that the suggested phenomenon can be studied using available experimental techniques.

Feasibility of home delivery of pemetrexed in patients with advanced non-squamous non-small cell lung cancer.

OBJECTIVES: To evaluate the feasibility and adherence to home delivery (HD) of pemetrexed maintenance treatment in patients with advanced non-squamous non-small cell lung cancer (nsqNSCLC). MATERIALS AND METHODS: Exploratory, prospective, single-arm, Phase II study in advanced nsqNSCLC patients, with an Eastern Cooperative Oncology Group (ECOG) performance status of 0/1 that did not progress after 4 first-line induction cycles of a platinum doublet. The first cycle of pemetrexed (500mg/m(2)) was hospital administered, further cycles were HD until progressive disease or discontinuation. Feasibility was assessed by the adherence rate to HD (probability of reversion to hospital administration or treatment discontinuation due to HD) as primary endpoint, and by health-related quality-of-life (HRQoL: EQ-5D, lung cancer symptom scale [LCSS]), satisfaction with HD, overall survival (OS), and safety. RESULTS: 52 patients (UK & Sweden) received a median of 4 (range 1-19) pemetrexed maintenance cycles. Adherence rate up to Cycle 6 was 98.0% (95% confidence interval [CI]: 86.4%, 99.7%). All but 2 patients remained on HD. 1 patient discontinued after Cycle 1 (patient decision), and 1 after Cycle 6 (non-compliance with oral dexamethasone). 87% (33/38) of the patients preferred home to hospital treatment and in 90% (28/31) of cases, physicians were satisfied with distant management of patients. During HD Cycles 2-4 mean change from baseline ranged from 3.0 to 7.7 for EQ-5D visual analog scale. The 6-month OS rate was 73% (95% CI: 58%, 83%). 1 patient had an HD-related adverse event (device-related infection, Grade 2) and 1 patient died after Cycle 1, before HD, due to a possibly drug-related atypical pneumonia. CONCLUSION: HD of pemetrexed maintenance treatment in patients with advanced nsqNSCLC was feasible, safe, and preferred by patients, while maintaining HRQoL. Physicians were satisfied with distant patient management.

Successful early postpartum support linked to management, informational, and relational continuity.

OBJECTIVE: to explore ways in which parents experience support from health professionals in the early postpartum period and understand how parenting support is related to management, informational, and relational continuity. DESIGN: a qualitative study consisting of focus group interviews followed by deductive content analysis. SETTING AND PARTICIPANTS: a large city in Sweden; 18 women and 16 men. FINDINGS: study participants reported that parenting support occurs by providing consistent advice; indicating who to ask when care questions arise; enabling access to the care system when needs surface; providing sufficient information about self-management for mother or baby; involving parents in discharge planning; distributing information that empowers parents; enabling team/clinical care consistency; and appointing persons in the care system who can foster parents׳ feelings of trust--in short: by enabling management, informational, and relational continuity. KEY CONCLUSIONS: care continuity experiences lead to perceived parenting support in the early postpartum period. Effective health care organisations within the postpartum care system must embody these types of continuity: management, informational, and relational. There is a need for researchers to design tools for measuring continuity and for policymakers to enable coherence and co-ordination among professionals. IMPLICATIONS FOR PRACTICE: identify parents׳ needs so that health professionals can plan for parents׳ first few weeks at home and ensure that parents get access to appropriate care.

Maintenance bevacizumab-pemetrexed after first-line cisplatin-pemetrexed-bevacizumab for advanced nonsquamous nonsmall-cell lung cancer: updated survival analysis of the AVAPERL (MO22089) randomized phase III trial.

BACKGROUND: The randomized, phase III AVAPERL trial evaluated the safety and efficacy of bevacizumab maintenance with or without pemetrexed in nonsquamous nonsmall-cell lung cancer (nsNSCLC). Progression-free survival (PFS) was significantly prolonged with bevacizumab-pemetrexed, but overall survival (OS) data were immature. In this article, we report an independent, updated analysis of survival outcomes in AVAPERL. PATIENTS AND METHODS: Patients with advanced nsNSCLC received first-line bevacizumab (7.5 mg/kg), cisplatin (75 mg/m(2)), and pemetrexed (500 mg/m(2)) every 3 weeks (q3w) for four cycles. Nonprogressing patients were randomized to maintenance bevacizumab (7.5 mg/kg) or bevacizumab-pemetrexed (500 mg/m(2)) q3w until progression or consent withdrawal. The primary end point of the trial was PFS; in this independent OS analysis, participating study centers were contacted to collect survival data on patients still alive at the time of the first analysis. RESULTS: A total of 376 patients received induction treatment. Disease control was confirmed in 71.9% of patients; 253 patients were randomized to maintenance treatment with bevacizumab (n = 125) or bevacizumab-pemetrexed (n = 128). At a median follow-up of 14.8 months, patients allocated to bevacizumab-pemetrexed had significantly improved PFS versus those on bevacizumab when measured from randomization [7.4 versus 3.7 months, hazard ratio (HR), 0.57, 95% confidence interval (CI) 0.44-0.75); P < 0.0001]. OS events occurred in 58% of all patients. OS was numerically longer with bevacizumab-pemetrexed versus bevacizumab when measured from randomization [17.1 versus 13.2 months, HR 0.87 (0.63-1.21); P = 0.29]. Second-line therapy was administered in 77% and 70% of patients in the bevacizumab and bevacizumab-pemetrexed arms, respectively. No new adverse events were reported during this updated analysis. CONCLUSION: In an unselected population of nsNSCLC patients achieving disease control on platinum-based induction therapy, maintenance with bevacizumab-pemetrexed was associated with a nonsignificant increase in OS over bevacizumab alone.