A qualitative insight at gender-based violence among young alcohol consumers in leisure contexts.

OBJECTIVE: To know the characteristics of gender violence that underlies among adolescents in the context of leisure, their behavior and how they overcome these conflicts in leisure contexts where the consume alcohol. METHOD: Qualitative study, with an ethnographic and feminist approach, with the participation of young people aged 16-22, frequenters of nightlife contexts and alcohol consumers, residents of two Andalusian provinces and one of Castilla-La Mancha. The participants were selected through intentional sampling and interviewed in depth. RESULTS: Adolescents frequently suffer from gender-based violence in leisure contexts that they assume normally as part of the role of having fun, while they use their own protection strategies to minimize risks. The abuse of alcohol and other drugs increases the possibility that a gender violence event take place. CONCLUSION: Gender-based violence among young people in the context of leisure, presents special characteristics that it is necessary to know in order to design preventive policies. The most vulnerable are young women who consume alcohol intensively. They usually go to the hospital emergency department for being unconscious due to alcohol consumption.

"Keeping your composure": A digital ethnography of gendered alcohol norms on Instagram.

BACKGROUND: The increase in alcohol consumption among young women has been the most striking change in drinking culture in Spain in recent years. This study sets out to examine how images and stories about alcohol consumption are presented on Instagram, the strategies for constructing them, and the impact of social norms, including gender norms, on the strategies of making alcohol consumption visible. METHODS: We have carried out a digital ethnography study in which different research techniques have been applied. We held 13 discussion groups, conducted a three-month period of observation on Instagram, and 38 in-depth interviews of young Spanish men and women between the ages of 15 and 24 (N = 118). RESULTS: The representation of alcohol consumption on Instagram by young people shows fashionable party spaces for shared disinhibition, fun and youth gatherings. This social network permits different types of alcohol advertising and promotion of the image associated with its consumption, and is thus a space that brands and influencers exploit. Young people avoid the diffusion on Instagram of images related to their heavy use of alcohol through particular strategies. They untag, delete or avoid using their smartphone; and they choose the audience to whom images are directed, and the areas of publication. The desire to be posting and exhibiting constantly converges with embarrassment and precaution with (un)known audiences. Gender is a key element for understanding the differences in the way in which posts on Instagram related to drinking and drunkenness affect young people. CONCLUSIONS: Our data show that Instagram fosters the spreading of an ideal model of "alcohol consumption" online that tends to conceal the adverse effects of the substance, and that the online diffusion of behaviour concerning drinking is not gender-neutral.

"There is nothing better than participating in this study": Living the PAPAartis cardiovascular randomised controlled trial.

Qualitative research can bring new dimensions of understanding decision-making process in clinical trials. Participating in a randomized clinical trial requires patients to accept complex information and make decisions in a context of uncertainty. It becomes especially complicated in the case of serious diseases in which the treatment itself implies unknown risks. This study examines these issues in the context of the PAPAartis randomized clinical trial, which aims to prevent spinal cord injuries that can occur as an adverse event following complex surgical repair of thoracoabdominal aneurysm. In this study, we accessed a group of 16 patients participating in the trial and, through in-depth interviews, sought to understand the decision-making process when taking part in the trial and their experience of it. Our results showed that patients participated for different reasons: due to trust in doctors, the hope of having a better treatment or for altruistic and collaborative reasons with science. Many patients felt they did not fully understand the extraneous information provided about the study and the complex nature of the procedure. Avoidance of paraplegia played a fundamental role in the decision to participate in this trial. Family support and the socioeconomic conditions of the patients influenced the recovery process after surgery.

"A good little tool to get to know yourself a bit better": a qualitative study on users' experiences of app-supported menstrual tracking in Europe.

BACKGROUND: Menstrual apps facilitate observation and analysis of menstrual cycles and associated factors through the collection and interpretation of data entered by users. As a subgroup of health-related apps, menstrual apps form part of one of the most dynamic and rapidly growing developments in biomedicine and health care. However, despite their popularity, qualitative research on how people engaging in period-tracking use and experience these apps remains scarce. METHODS: Between June 2016 and March 2017, we conducted 26 qualitative interviews with menstrual app users living in Austria and Spain. The participants were asked about their practices and experiences regarding app-supported menstrual tracking. The interviews were audio recorded, transcribed verbatim, and coded using the software NVivo. RESULTS: An inductive content analysis was performed and eight characteristics of app-supported menstrual tracking were identified: 1) tracking menstrual cycle dates and regularities, 2) preparing for upcoming periods, 3) getting to know menstrual cycles and bodies, 4) verifying menstrual experiences and sensations, 5) informing healthcare professionals, 6) tracking health, 7) contraception and seeking pregnancy, and 8) changes in tracking. Our study finds that period-tracking via apps has the potential to be an empowering practice as it helps users to be more aware of their menstrual cycles and health and to gain new knowledge. However, we also show that menstrual tracking can have negative consequences as it leads to distress in some cases, to privacy issues, and the work it requires can result in cessation. Finally, we present practical implications for healthcare providers and app developers. CONCLUSIONS: This qualitative study gives insight into users' practices and experiences of app-supported menstrual tracking. The results provide information for researchers, health care providers and app designers about the implications of app-supported period-tracking and describe opportunities for patient-doctor interactions as well as for further development of menstrual apps.

Paraplegia prevention in aortic aneurysm repair by thoracoabdominal staging with 'minimally invasive staged segmental artery coil embolisation' (MIS²ACE): trial protocol for a randomised controlled multicentre trial.

INTRODUCTION: Spinal cord injury (SCI) including permanent paraplegia constitutes a common complication after repair of thoracoabdominal aortic aneurysms. The staged-repair concept promises to provide protection by inducing arteriogenesis so that the collateral network can provide a robust blood supply to the spinal cord after intervention. Minimally invasive staged segmental artery coil embolisation (MIS2ACE) has been proved recently to be a feasible enhanced approach to staged repair. METHODS AND ANALYSIS: This randomised controlled trial uses a multicentre, multinational, parallel group design, where 500 patients will be randomised in a 1:1 ratio to standard aneurysm repair or to MIS2ACE in 1-3 sessions followed by repair. Before randomisation, physicians document whether open or endovascular repair is planned. The primary endpoint is successful aneurysm repair without substantial SCI 30 days after aneurysm repair. Secondary endpoints include any form of SCI, mortality (up to 1 year), length of stay in the intensive care unit, costs and quality-adjusted life years. A generalised linear mixed model will be used with the logit link function and randomisation arm, mode of repair (open or endovascular repair), the Crawford type and the European System for Cardiac Operative Risk Evaluation (euroSCORE) II as fixed effects and the centre as a random effect. Safety endpoints include kidney failure, respiratory failure and embolic events (also from debris). A qualitative study will explore patient perceptions. ETHICS AND DISSEMINATION: This trial has been approved by the lead Ethics Committee from the University of Leipzig (435/17-ek) and will be reviewed by each of the Ethics Committees at the trial sites. A dedicated project is coordinating communication and dissemination of the trial. TRIAL REGISTRATION NUMBER: NCT03434314.

Intensive alcohol consumption by adolescents in Southern Spain: The importance of friendship.

BACKGROUND: There has been an increase in intensive alcohol drinking by Spanish adolescents since the 1990s, especially among the females, but there has been limited exploration of this phenomenon. The objective of this study was to analyse the discourses of Spanish adolescents on their drinking behaviour at contextual, relational, and personal levels. METHODS: A qualitative study was undertaken in 96 adolescents aged between 14 and 17 years who had experienced at least one intensive drinking episode during the previous year. They lived with family members and were not offenders or at risk of social exclusion. Participants were recruited at educational centres and youth centres in two provinces in southern Spain. Ten focus groups and 30 in-depth individual interviews were conducted. A summative content analysis was performed. RESULTS: Intensive alcohol drinking was widely practiced in this study population. Consolidation of this practice was influenced by cultural, interpersonal and personal dimensions. Consumption in public spaces emerged as a key influential factor, especially the botellón, a collective space-time in which Spanish adolescents socialize and become initiated into intensive alcohol consumption. Besides the facilitating elements of the social and cultural setting, the results also evidence the effects of interpersonal relationships within the peer group, which offer a series of approaches to risk and protective practices. In these adolescents, the main reason for engaging in alcohol drinking was to enhance their social relationships, which acted as a mechanism to normalize intensive alcohol consumption. CONCLUSIONS: Policies to reduce the harm caused to adolescents by intensive alcohol drinking need to take account of the contextual, relational and personal dimensions of this practice. The discourses of these adolescents from Southern Spain point to a potential role for the peer group in harm reduction strategies.

Doing gender in a toxic world. Women and freebase cocaine in the city of Buenos Aires (Argentina).

Consumption of freebase cocaine in Argentina has been investigated among males but not females. This qualitative study focuses on the complexity of relationships between gender identity and the use of drugs, investigating freebase cocaine as an example in the Metropolitan Area of Buenos Aires, Argentina. In-depth interviews were conducted with female consumers in 2010. The results reveal the different ways in which female identity is constructed in the context of social vulnerability. We identify ways of doing gender and feeling like a woman in a man's world that are associated with a higher risk of violence and exclusion for being female.

[Adolescents, risk situations and road safety]. / Adolescentes, situaciones de riesgo y seguridad vial.

OBJECTIVE: Describe the risk behaviour relationships with road safety in adolescents. DESIGN: Cross-sectional descriptive study. SETTING: Madrid and Andalusia Regions, representative samples. PARTICIPANTS: The sample included 3,612 in secondary school pupils from Madrid (n=1708) and Andalusia (n=1904). The survey was carried out during May and June 2007. MAIN MEASUREMENTS: The data collected included sociodemographic areas (age, sex, grade, father's profession, birth place, etc.) and risk situation and behaviour (risk behaviour as driver or passenger). RESULTS: 16.2% of the adolescents have been involved in a dangerous situation with motorcycles during the last year. 16.7% never use a helmet when riding a motorcycle and 62% do not wear one when riding a bicycle on the road; 17.4% frequently ride a motorcycle over the speed limit and 24.5% when driving a car. There are significant differences regarding sex, grade and region (Madrid or Andalusia). There are four factors which explain 62% of the variance: drug factor, speed factor, security factor and passenger factor. Two of these have twice the probability of having a dangerous situation when riding a motorcycle: drug factor (OR=1.96; 95% CI, 1.77-2.18) and the speed factor ((OR=2.13; 95% CI, 1.92-2.36). CONCLUSIONS: Adolescents in higher grades and living in Andalusia were less road safety conscious. This pattern should be taken into account when designing preventive actions in Road Safety Education.

[What do adolescents and young people think about recreational drug use and sexual risks?]. / Qué opinan adolescentes y jóvenes sobre el consumo de drogas recreativas y las conductas sexuales de riesgo?

The objective of this article is to analyse the opinions of adolescents and young people, from gypsy and non-gypsy populations, on the relationship between recreational drug use and sexual practices that increase the risk of HIV infection. A descriptive qualitative research was undertaken. 14 focus groups were conducted with 98 adolescents and young people, and 7 semi-structured interviews with young recreational drug users. Both sort of results were triangulated. Two major discursive lines emerge in the analysis. The first one defends the notion that moderate consumption of alcohol facilitates the sexual encounter, but it does not imply risky behaviours. However, polydrug use or an elevated use of recreational drugs is related to a lack of concern for sexual risks, and in men with the loss of sexual sensitivity that sometimes justifies not using a condom. The second line argues other reasons for the non-use of condoms, such as their lack of availability, confidence in one's sexual partner, a concept of desire as something uncontrollable, infatuation and the state of mind or self-esteem. Some recommendations to prevent sexual transmission of HIV are derived from the results, such as the distribution of condoms in places where alcohol and other drugs are consumed, publicising the use of condoms and other latex barriers for oral genital sexual practices, working with young males on the optimisation of pleasure, designing preventive interventions targeting stable partners, and training adolescent girls in the social skills needed to negotiate the use of condoms.