The explanations given by child pornography offenders for their crimes were explored in two samples, one interviewed by the police as part of a criminal investigation and the second assessed by clinicians following a child pornography conviction. There were many similarities across the two samples with regard to demographic characteristics, criminal history and explanations. Many offenders in both samples admitted possession of child pornography, a majority admitted they deliberately accessed child pornography, and substantial minorities acknowledged their sexual interest in child pornography and/or children. Similar proportions claimed curiosity or accidental access. Relatively few offenders reported internet addiction, child pornography as a substitute for contact offending or indiscriminate sexual interests. There was evidence to suggest that the recently arrested offenders were more sexually deviant, as they were more likely to have images of boys, larger collections, images depicting sexual violence or other paraphilic content and more involvement in online trading and communication.

In a cluster randomized trial, Patricia Priest and colleagues find that providing hand sanitizer along with hand hygiene education in primary school classrooms, compared with hand hygiene alone, does not reduce school absences. Please see later in the article for the Editors' Summary

These results suggest that a significant number of New Zealand children do not currently have access to high quality hygiene facilities at school.

BackgroundNew Zealand has relatively high rates of morbidity and mortality from infectious disease compared with other OECD countries, with infectious disease being more prevalent in children compared with others in the population. Consequences of infectious disease in children may have significant economic and social impact beyond the direct effects of the disease on the health of the child; including absence from school, transmission of infectious disease to other pupils, staff, and family members, and time off work for parents/guardians. Reduction of the transmission of infectious disease between children at schools could be an effective way of reducing the community incidence of infectious disease. Alcohol based no-rinse hand sanitisers provide an alternative hand cleaning technology, for which there is some evidence that they may be effective in achieving this. However, very few studies have investigated the effectiveness of hand sanitisers, and importantly, the potential wider economic implications of this intervention have not been established.AimsThe primary objective of this trial is to establish if the provision of hand sanitisers in primary schools in the South Island of New Zealand, in addition to an education session on hand hygiene, reduces the incidence rate of absence episodes due to illness in children. In addition, the trial will establish the cost-effectiveness and conduct a cost-benefit analysis of the intervention in this setting.Methods/DesignA cluster randomised controlled trial will be undertaken to establish the effectiveness and cost-effectiveness of hand sanitisers. Sixty-eight primary schools will be recruited from three regions in the South Island of New Zealand. The schools will be randomised, within region, to receive hand sanitisers and an education session on hand hygiene, or an education session on hand hygiene alone. Fifty pupils from each school in years 1 to 6 (generally aged from 5 to 11 years) will be randomly selected for detailed follow-up about their illness absences, providing a total of 3400 pupils. In addition, absence information will be collected on all children from the school rolls. Investigators not involved in the running of the trial, outcome assessors, and the statistician will be blinded to the group allocation until the analysis is completed.Trial registrationACTRN12609000478213

Background Loop ileostomy (LI) formation is a common practice for patients undergoing low anterior resection or restorative ileo-anal pouch surgery. This can be performed using a stapled or hand-sewn technique, with or without resection. If hand-sewn, the closure can be one or two layers. Randomised controlled trials have not demonstrated one technique to be superior, and meta-analyses are limited by the heterogeneity of published studies. Our primary aim is to compare stapled ileostomy closure with single- and two-layer, hand-sewn closures.Methods This retrospective, single-centre cohort study included patients undergoing LI closure between January 1999 – April 2016. Patient demographics, anastomotic technique, operative time, and patient outcomes were collected.Results Our analysis included 244 patients (median age 67 years, 43.4% female). There were no significant differences in mean operative times (71.5, 73.1, and 88.5 minutes, for stapled, single-, and two-layer hand-sewn closures respectively, adjusted overall p=0.262), or morbidity (21.5% vs 20.4% vs 17.6%, adjusted overall p=0.934) between stapled or hand-sewn anastomoses, and no mortality. Once adjusting for age, sex, ASA, and consultant surgeon, the LOS was similar between stapled and single-layer closures (4.2 vs 5.5 days, p=0.105), but significantly different between stapled and two-layer closures (4.2 vs 8.3 days, p=0.026) (overall p=0.034). No evidence of differences in complications was found.Conclusions Stapled and single-layered hand-sewn closures are similar in length of procedure, LOS, and complication rates. A two-layer, hand-sewn technique is associated with a significant increase in stay compared to a stapled ileostomy closure.

Background Loop ileostomy (LI) formation is a common practice for patients undergoing low anterior resection or restorative ileo‐anal pouch surgery. Ileostomy closure can be performed using a stapled or hand‐sewn technique, with or without resection. If hand‐sewn, the closure can be one or two layers. Randomized controlled trials have not demonstrated one technique to be superior, and meta‐analyses are limited by the heterogeneity of published studies. Our primary aim is to compare stapled ileostomy closure with single‐ and two‐layer hand‐sewn closures. Methods This retrospective, single‐centre cohort study included patients undergoing LI closure between January 1999 and April 2016. Patient demographics, anastomotic technique, operative time and patient outcomes were collected. Results Our analysis included 244 patients (median age 67 years, 43.4% female). There were no significant differences in mean operative times (71.5, 73.1 and 88.5 min, for stapled, single‐ and two‐layer hand‐sewn closures, respectively, adjusted overall P = 0.262), or morbidity (21.5% versus 20.4% versus 17.6%, adjusted overall P = 0.934) between stapled or hand‐sewn anastomoses, and no mortality. Once adjusting for age, sex, American College of Anaesthesiology grade, and consultant surgeon, the length of stay was different (overall P = 0.034), being similar between stapled and single‐layer closures (4.2 versus 5.5 days, P = 0.105), but significantly different between stapled and two‐layer closures (4.2 versus 8.3 days, P = 0.026). Conclusion Stapled and single‐layered hand‐sewn closures are similar in length of procedure, length of stay and complication rates. A two‐layer, hand‐sewn technique is associated with a significant increase in stay compared to a stapled ileostomy closure.

The authors have withdrawn this preprint from Research Square.