Effective management of Inflammatory bowel diseases (IBD) before and during pregnancy is crucial as women with well-controlled IBD at conception tend to remain in remission throughout pregnancy, experiencing outcomes similar to women without IBD. Most IBD medications are considered safe during pregnancy, except for methotrexate. Despite reassuring data, previous studies have highlighted that women often have negative perceptions and fears related to IBD medications, leading to poor adherence. There is a lack of data regarding how IBD is treated before and during pregnancy in Switzerland. We aimed to assess the prevalence and usage patterns of various IBD medications in Switzerland before and during pregnancy over time. A descriptive study using the MAMA cohort based on Swiss health insurance claims from 2012 to 2019. We identified pregnancies with a pharmaceutical cost group (PCG) indicating IBD and at least one dispensed IBD medication before pregnancy. We defined three groups based on dispensation timing: continuers (dispensation in pre-pregnancy and in or after trimester 2), switchers (different dispensation between pre-pregnancy and in or after trimester 2), and discontinuers (dispensation in pre-pregnancy but no dispensation in or after trimester 2). Among 84,317 deliveries, 0.4

Purpose Patients and healthcare professionals overestimate the risks of using antidepressants during pregnancy. According to current literature, approximately half of people stop taking an anti-depressant medication when they become pregnant. Discontinuing antidepressants during pregnancy increases risks of postnatal relapses. Factors like socioeconomic status, education, and planned pregnancies play a role in the decision to continue antidepressant medication, which can worsen disparities in maternal and child health. Our aim was to identify the sociodemographic factors associated with antidepressant continuation after awareness of pregnancy.Methods We used representative data from the Adolescent Brain Cognitive Development (ABCD) study that captures maternal medication during pregnancy. We identified women who used antidepressants before awareness of their pregnancy. We calculated crude and adjusted associations between sociodemographic factors and continuation of antidepressant medication during pregnancy. Our model included age, education, ethnicity, first language, household income, living with a partner, having planned the pregnancy, pregnancy duration and smoking during pregnancy.Results In total, 199 women continued antidepressants and 100 discontinued. The logistic regressions resulted in only one significant factor: first language. Native English speakers were more likely to continue medication than other mothers (adjusted OR = 14.94, 95% CI = [2.40; 291.45], p = .015).Conclusions Language differences were associated with continuation of antidepressants. Non-native English speakers were more likely to discontinue antidepressants, which may lead to health inequities. This finding should be taken into account to reinforce information about the limited risks of antidepressants among people with non-English speaking backgrounds in the USA.

Introduction Approximately 4%–5% of mothers develop childbirth-related post-traumatic stress disorder (CB-PTSD) and approximately 12.3% of mothers develop some CB-PTSD symptoms (CB-PTSS). To date, there is a dearth of studies on fathers and other coparents. Parental CB-PTSD and CB-PTSS may have a negative impact not only on the parents but also on the infant. Understanding risk and protective factors of CB-PTSD for both parents and its consequences on the family is key to detecting or anticipating it, to developing interventions aimed at reducing its detrimental effects and to supporting parents.Methods and analysis This study protocol describes an observational, population-based study, consisting of a longitudinal prospective cohort with online surveys at four time points. The population of interest consist of women, in the third trimester of pregnancy or at 6–12 weeks postpartum, and their partner/coparent, who will give birth or gave birth in the French-speaking part of Switzerland. The target sample size is 300–500 women and a proportional number of partners. The primary outcome of this study is the prevalence of CB-PTSD and CB-PTSS. The secondary outcomes focus on: (1) the impact of CB-PTSD and CB-PTSS on the marital and coparental relationships, the bonding with the infant, parental burnout and healthcare seeking behaviours, (2) the role of the childbirth experience in the development of CB-PTSD and CB-PTSS and (3) the social and economic determinants of CB-PTSD and CB-PTSS.Ethics and dissemination Ethical approval was granted by the human research ethics committee of the Canton de Vaud (study number 2022-00284). All study participants signed an informed consent form. Dissemination of results will occur via national and international conferences, in peer-reviewed journals, public conferences and social media.Trial registration number NCT05865704.

Background Neonatal sepsis (NS) is a global health issue, particularly in Sub-Saharan Africa, where it accounts for a substantial portion of neonatal morbimortality. This multicountry survey aimed to elucidate current practices, challenges and case definitions in managing NS among clinicians in Sub-Saharan Africa.Methods The survey targeted physicians and medical practitioners working in neonatal care who participated in a Self-Administered Web Questionnaire. The main objective was to understand NS and infection case definitions and management from the clinician's point of view and to identify challenges and opportunities in sepsis management. Participants were queried on demographics, definitions and diagnostic criteria, treatment approaches, and infection prevention and control (IPC) measures. A total of 136 participants from 93 healthcare structures responded, providing valuable insights into NS management practices.Results From May to July 2022 across 21 Sub-Saharan African countries, 136 neonatal clinicians with an average from 93 structures with on average 10-year experience took the survey. NS ranked highest among prevalent neonatal conditions. Diagnostic case definitions between sepsis and infection were attributed to clinical signs, anamnesis, C reactive protein, white blood cll count and blood cultures with no statistically significant differences. Early-onset sepsis was defined within 72 hours by 48%, while late-onset varied. Antibiotics were likely on admission (86.4%) and during the stay (82.2%). Treatment abandonment was reported unlikely. The preferred antibiotic regimen for early-onset sepsis was intravenous amoxicillin (or ampicillin), gentamycin and cefotaxime. Blood culture availability and IPC protocols were reported as limited, particularly concerning patient environment, pharmacy protocols and clean-dirty circuits.Conclusions This NS survey emphasises clinicians' challenges due to limited access to diagnostic tools and raises concerns about antimicrobial overexposure. IPC also seem limited, according to participants. Addressing these challenges can enhance diagnostic practices, antibiotic stewardship and infection control in the region.

Single-measurement-point data collection to assess change has increased with studies assessing the impact of the Covid-19 pandemic and of its containment, despite evidence of its lack of validity. Retrospective change is not equivalent to change in repeated self-reported measures giving raise to questions about the validity of the former. This paper purports to investigate inconsistencies between change measures by confronting retrospective change to information from longitudinally self-reported measures from the C-SURF cohort study. The study sample consists of 2,279 young men who participated in C-SURF between 2020 and 2021, and completed between May and June 2021 a survey covering change in alcohol, cigarette, cannabis and other addictive behaviors related to the pandemic. The aforementioned behaviors were assessed longitudinally at two time points using self-reports, and retrospective change since the onset of the Covid-19 crisis was also assessed at the second measurement time. Information from both prospective and retrospective change measures were confronted to identify inconsistent information for each behavior. Additionally, multiple logistic regressions were performed to assess associations between socioeconomic status, impulsivity, depression, and different indicators of motivation to complete the study and inconsistency between both measures for each behavior of interest. Importantly, inconsistent information in at least one of the investigated behaviors was found in about 90% of the participants. Small associations were found between inconsistency and different factors with a consistent effect of impulsivity. In the absence of evidence of the validity of retrospective change measures, studies relying on retrospective change should be interpreted with caution.

Noma (cancrum oris) is an orofacial gangrene affecting young children living in extreme poverty. The acute morbidity is high, and survivors suffer from physical and social sequelae. When diagnosed early, noma can be cured. Noma is especially prevalent in sub-Saharan Africa, where traditional medicine is the norm. The aim of this work was to provide 1 -day training to traditional healers in Burkina Faso and to evaluate change in knowledge of noma across time. A sample of 78 healers who attended the training were asked to complete the same questionnaire before, immediately after, and 8 months after the training. A total of 66 healers completed the entire study. Before training, more than 40% of the participants did not know any of its key messages. Most of the key messages were acquired and still present after 8 months by a large proportion of the participants. Systematic intraoral examination was practiced by 7 (9.0%) of the traditional healers before training, and 43 (65.2%) reported doing so 8 months after training. The key messages aiming to improve early diagnosis as well as rapid and adequate treatment (the recognition of facilitating factors and the need to perform a systematic oral examination and to advise hospital transfer) have been well integrated. The study suggests that organizing a self -managed training program is feasible when done within an association, as was the case here, and owing to the willingness to collaborate shown by the traditional healers who participated in our study.

Background: Video gaming is a popular activity among young people. Time spent with gaming was found to be only moderately associated with gaming disorder. However, patterns of binge gaming (playing more than 5 h consecutively) were rarely considered in research on gaming. This study explores how binge gaming frequency is related with gaming disorder and mental health. Methods: The sample came from the Cohort study on substance use risk factors (C-SURF) and comprised 5,358 young men aged 28.26 years (SD = 1.27). ANCOVA was conducted to estimate the association between binge gaming frequency (gaming at least 5 h consecutively) and gaming disorder (measured with the Game Addiction Scale) as well as indicators of mental health. Results: A total of 33.3% of the sample engaged in binge gaming at least once in the previous year, and 6.1% at least weekly. Frequency of binge gaming was associated with gaming disorder score in a linear dose-response relationship (linear trend = 2.30 [2.14, 2.46]) even if adjusted for time spent gaming (linear trend = 1.24 [1.03, 1.45). More frequent binge gaming was associated with lower life satisfaction and sleep quality, and with more major depression and social anxiety disorder symptoms. Conclusions: Binge gaming patterns, especially daily or almost daily binge gaming, are important to consider with regard to gaming disorder and mental health. Asking about binge gaming may be a promising screening question for gaming related problems. Encouraging regular breaks from gaming may be a valuable prevention strategy to reduce negative outcomes of gaming.

The scientific literature on noma (Cancrum Oris) has clearly increased in recent decades, but there seems to have been limited analysis of issues around the psycho-social impacts of this disease. Even when these issues have been addressed, the focus has tended to be on patient experiences, whereas the community dimension of the disease and the role of healthcare professionals and community leaders in mitigating these impacts remain largely unexplored. A study in the form of semi-directed interviews with 20 noma survivors and 10 healthcare professionals and community leaders was conducted between January and March 2021 in Burkina Faso with the aim of describing the experiences of noma survivors, generating knowledge about living with the burden of the disease and understanding the attitudes of community leaders towards the disease. The results reveal that noma is a disease that affects economically vulnerable populations and leads to extreme household poverty. As far as treatment is concerned, patients tend to turn to practitioners of both traditional and modern medicine. Within communities, noma survivors face discrimination and stigma. The study highlighted a lack of information and knowledge about noma. However, surgical operations lead to patient satisfaction and these remain one of the coping strategies used to tackle the stigma and discrimination. The recommendations set out in this article are aimed firstly at stepping up research into the psycho-social impacts of noma, and secondly at considering these impacts in regional programmes and national plans to combat the disease.

Background: While noma affects hundreds of thousands of children every year, taking their lives, disfiguring them and leaving them permanently disabled, the economic and social costs of the disease have not been previously estimated. An understanding of the nature and levels of these costs is much needed to formulate and implement strategies for the prevention and control of this disease, or to mitigate its burden. The objectives of our study were to develop a model for estimating the economic and social costs of noma and to provide estimates by applying this model to the specific contexts of two countries in the “noma belt”, namely Burkina Faso and Niger. Methods: Three main approaches were used. The estimation of prevalence levels of potential noma cases and of cases that should receive and actually do receive medical care was carried out using a literature review. The documentary approach made it possible to estimate the direct costs of noma by analyzing the database of a non-governmental organization operating in this field and present in both countries. Indirect costs were estimated using the human capital method and the cost component analysis technique. Results: The direct costs of care and management of noma survivors amount to approximately USD 30 million per year in Burkina Faso, compared to approximately USD 31 million in Niger. They mainly include costs for medical treatment, surgery, hospital stays, physiological care, psychological care, social assistance, schooling, vocational training and care abroad. Indirect costs are estimated at around 20 million in lost production costs in Burkina and around 16 million in Niger. Costs related to premature deaths are estimated at more than USD 3.5 billion in Burkina Faso and USD 3 billion in Niger. Finally, the costs to survivors who are unable to marry are around USD 13.4 million in Burkina and around USD 15 million in Niger. Intangible costs were not calculated. Conclusions: The neglect of noma and inaction in terms of prevention and control of the disease have enormous economic and social costs for households, communities and states. Future studies of this kind are necessary and useful to raise awareness and eradicate this disease, which impacts the health and well-being of children and results in lifelong suffering and severe economic and social costs to survivors and their families.

AIM:This research aims to understand the place and role of nurses holding a PhD or PhD students (nurse doctor [ND]/nurse doctoral students [NDS]) in health care organizations in France.CONTEXT:Worldwide, many nurses are undertaking doctoral studies. France is no exception. However, in France, there is no doctorate dedicated to nursing. The question of ND/NDS integration into health organizations is thus raised in a specific manner.METHODS:We used a two-stage mixed methodology. The first stage used data from questionnaires that were sent to 165 ND/NDS in France. To contextualize issues raised by these data, we used qualitative methods which comprised 45 semi-structured interviews with nurses, 10 interviews with health managers and chief nurses and 27 h of in situ observations with research coordinators.RESULTS:Seventy-nine participants (47.9% response rate) completed questionnaires. The data showed that work organization in some departments-intensive care units (ICUs), oncology and psychiatry-favoured the development of scientific expertise among nurses. Favourable elements promoting the professional and academic development of ND/NDS included the potential for medical teaching in healthcare services, participation in research projects and, most importantly, medical proximity. Conversely, our data also identified poor visibility and recognition of nursing doctoral courses in French health organizations: A lack of task missions, a lack of suitable posts and poor integration into the nursing profession. Currently, French nurses define their profession as providing direct care to patients and their families-yet this definition fails to consider other important professional elements, such as research.CONCLUSIONS:Our study identified how proper ND/NDS integration is important to health care organizations. We identified key organization factors facilitating the integration of ND/NDS, such as participating in research teams and providing research support management.IMPLICATIONS FOR NURSING MANAGEMENT:In recent years, the nursing profession has significantly evolved. We are interested in the impact of these changes in work organizations following the development of new scientific skills. Our study investigates all aspects of the nursing profession (teaching, practice, research and organizations). Our study advocates managerial roles, among others, to improve ND and NDS integration into work organizations. We directly observed work organizations that helped develop nursing research. Our study is also aimed at managers who have roles as decision-makers in promoting and facilitating research and nurse researchers.

Some authors recently underlined the existence of programs generating invalid responses in online surveys as an emerging threat for the different crowdsourced research fields (e.g., botnets, form fillers or survey bots). Accordingly, online data research might include computer-generated sets of responses representing invalid data at risk of largely distorting study results. Several statistical indices exist in order to detect problematic data. In line with a previous study that compared these indices in Likert-type scale questionnaire data, this study purported to extend the analyses with dichotomous-itemed questionnaires. Three samples of about more than 2,000 participants were mixed with different proportions (i.e., 5% to 50%) of simulated data to mimic their effect. Then, seven indices were compared in terms of correct detections of non-human response sets. Consistent with former findings, three indices resulted in superior correct detection rates: response coherence, the Mahalanobis distance and the person-total correlation. Two of them can easily be computed using basic statistical software. The current study findings represent an encouragement to use them in priority as routine for data screening.

Background The Older people Quality of Life-7 domains (OQoL-7) is a 28-item multidimensional questionnaire developed to measure community-dwelling older people’s QoL. The OQoL-7 assesses both importance of and satisfaction in seven QoL domains (Material resources; Close entourage; Social and cultural life; Esteem and recognition; Health and mobility; Feeling of safety; and Autonomy). This study aimed to investigate concurrent and construct validity of the OQoL-7. A secondary aim was to compare different methods of weighting participants’ ratings of satisfaction according to their individual ratings of importance, as compared to the OQoL-7 total score (unweighted). Methods Data came from the first and second samples of the Lausanne cohort 65+ study, assessed at the same age of 72–77 years in 2011 (N = 1117) and 2016 (N = 1091), respectively. To assess concurrent validity, the OQoL-7 was compared to other measures of the same concept (single QoL item) or related concepts (self-rated health, SF-12). Construct validity was tested by comparing subscores in the seven QoL domains in the presence and absence of two stressful events during the preceding year (financial difficulties and relationship difficulties). The effect of importance weighting was assessed using moderated regression analysis. Results The OQoL-7 total score was significantly associated with the single QoL item (Spearman’s rho 0.46), self-rated health (Spearman’s rho 0.34), SF-12 physical (Spearman’s rho 0.22) and mental (Spearman’s rho 0.28) component scores. Large differences (Cohen’s d > 0.8) were observed in the presence or absence of stressful events in the expected QoL domains: “Material resources” in the presence or absence of “Financial difficulties” (Cohen’s d 1.34), and “Close entourage” in the presence or absence of “Relationship difficulties” (Cohen’s d 0.84). Importance weighting resulted in a very small improvement in the prediction of the single QoL item (ΔR 2 0.018). All results were highly consistent across 2011 and 2016 samples. Conclusions The OQoL-7 showed adequate concurrent and construct validity in two samples of older people. In future studies, the decision to use weighted or unweighted scores will depend on the priority given to either optimizing the prediction of QoL or limiting the burden on respondents and the amount of missing data.

OBJECTIVE:This study aimed to investigate the associations between mental disorders recorded at baseline and participation in the subsequent follow-up interview (vs. attrition) or baseline questionnaire completion (vs. non-response) within the psychiatric arm of a population-based study.METHODS:Participants of a physical health survey were initially invited to also participate in a semi-structured interview covering mental disorders and were reassessed approximately 5.5 years later. They were also asked to complete self-rating questionnaires at baseline. Associations between the presence of lifetime mental disorders assessed at baseline and attrition at follow-up as well as non-completion of self-rating questionnaires at baseline were established.RESULTS:After controlling for sociodemographic variables, a significant negative association was found between anxiety disorders at baseline and attrition at follow-up (Adjusted odds ratio (AOR) = 0.84; 95% confidence interval (CI) = 0.71-1.00) and a positive association between major depressive disorders (MDD) and non-response to the self-rating questionnaires at baseline (AOR = 1.24; 95% CI = 1.05-1.45).CONCLUSIONS:The associations of anxiety disorders during lifetime with a higher participation rate in interviews at follow-up and of MDD during lifetime with the non-completion of self-rating questionnaires are potential sources of bias and should be taken into account in future longitudinal research.

Maladaptive daydreaming (MD) is a newly described mental disorder characterized by extensive mental fantasy activity featuring addiction-like longing for fantasizing. accompanying repetitive movement, and feeling hindered in everyday life. This study describes the first validation of a non-English version of the Maladaptive Daydreaming Scale (MDS) and provides additional evidence for MD as a clinical phenomenon. The Maladaptive Daydreaming Scale-Hebrew version (MDS-H) is an adaptation of the 14-item English MDS (Somer, Lehrfeld. Bigelsen, & Jopp, 2016), a self-report questionnaire developed on the basis of qualitative information provided by self-identified maladaptive daydreamers (MDers). The MDS-H was administered to 280 individuals aged 13 to 73 years, including 45 self-identified MDers. Findings confirmed the expected 3-factorial structure, scalar invariance in comparison to the English MDS validation sample, and good psychometric properties. MDS-H scores were associated with dissociation, obsessive-compulsive behavior, and attentiondeficit/hyperactivity. Given high sensitivity and specificity separating MDers and non-MDers, the MDS-H represents a useful tool to assess MD among Hebrew speakers, suggesting the relevance of MD in a non-English speaking culture, and highlighting the potential value of the MDS for world-wide investigation of this condition.

Objectives In countries with universal health coverage (UHC), national public health insurances cover 70% of health expenditures on average, but health care user fees and out-of-pocket expenditures have been neglected in empirical patient-centered health inequality research. This study is the first to investigate how health care-related factors are associated with health status among middle-aged and elderly people—vulnerable groups for the burden of illness—in countries with UHC. Design Longitudinal observational cohort study. Setting Population-based cohort Survey of Health, Ageing and Retirement in Europe (SHARE) in twelve countries with UHC. Participants Non-institutionalized people aged 50 and older (n = 29,260). Two subsamples were also used: participants without global activity limitation at baseline (n = 16,879) and participants without depression at baseline (n = 21,178). Main outcome measures Risk of death, risk of global activity limitations, and risk of depression. We used mixed-effects Cox proportional hazards regressions to estimate hazard ratios (HR) for all-cause mortality, physical limitations, and depression. Results Having a voluntary private insurance to cover health expenses not included in the public health care system (44.1% of the total sample) was a protective factor for all outcomes (HR≤0.91), controlling for a large range of socio-economic variables. On the contrary, having out-of-pocket expenditures (62.4%) was a risk factor (HR≥1.12). Conclusions UHC systems are not free from health inequalities: there is a potential effect of lack of voluntary private insurance and out-of-pocket expenditures on mortality and health. Health care-related factors should be at focus in future researches designed to understand and address health inequalities. Reducing out-of-pocket expenditures and developing voluntary private insurance may protect against premature illness and death.

With the development of online data collection and instruments such as Amazon's Mechanical Turk (MTurk), the appearance of malicious software that generates responses to surveys in order to earn money represents a major issue, for both economic and scientific reasons. Indeed, even if paying one respondent to complete one questionnaire represents a very small cost, the multiplication of botnets providing invalid response sets may ultimately reduce study validity while increasing research costs. Several techniques have been proposed thus far to detect problematic human response sets, but little research has been undertaken to test the extent to which they actually detect nonhuman response sets. Thus, we proposed to conduct an empirical comparison of these indices. Assuming that most botnet programs are based on random uniform distributions of responses, we present and compare seven indices in this study to detect nonhuman response sets. A sample of 1,967 human respondents was mixed with different percentages (i.e., from 5% to 50%) of simulated random response sets. Three of the seven indices (i.e., response coherence, Mahalanobis distance, and person-total correlation) appear to be the best estimators for detecting nonhuman response sets. Given that two of those indices-Mahalanobis distance and person-total correlation-are calculated easily, every researcher working with online questionnaires could use them to screen for the presence of such invalid data.