Psychometric properties of the Marlowe-Crowne Social Desirability Scale in eight African countries and Switzerland

The purpose of this study was to assess the cross-cultural validity of the Marlowe-Crowne Social Desirability scale short form C, in a large sample of French-speaking participants from eight African countries and Switzerland. Exploratory and confirmatory analyses suggested retaining a two-factor structure. Item bias detection according to country was conducted for all 13 items and effect was calculated with R2. For the two-factor solution, 9 items were associated with a negligible effect size, 3 items with a moderate one, and 1 item with a large one. A series of analyses of covariance considering the acquiescence variable as a covariate showed that the acquiescence tendency does not contribute to the bias at item level. This research indicates that the psychometric properties of this instrument do not reach a scalar equivalence but that a culturally reliable measurement of social desirability could be developed.

Syndromic algorithms for detection of gambiense human african trypanosomiasis in South Sudan.

BACKGROUND: Active screening by mobile teams is considered the best method for detecting human African trypanosomiasis (HAT) caused by Trypanosoma brucei gambiense but the current funding context in many post-conflict countries limits this approach. As an alternative, non-specialist health care workers (HCWs) in peripheral health facilities could be trained to identify potential cases who need testing based on their symptoms. We explored the predictive value of syndromic referral algorithms to identify symptomatic cases of HAT among a treatment-seeking population in Nimule, South Sudan. METHODOLOGY/PRINCIPAL FINDINGS: Symptom data from 462 patients (27 cases) presenting for a HAT test via passive screening over a 7 month period were collected to construct and evaluate over 14,000 four item syndromic algorithms considered simple enough to be used by peripheral HCWs. For comparison, algorithms developed in other settings were also tested on our data, and a panel of expert HAT clinicians were asked to make referral decisions based on the symptom dataset. The best performing algorithms consisted of three core symptoms (sleep problems, neurological problems and weight loss), with or without a history of oedema, cervical adenopathy or proximity to livestock. They had a sensitivity of 88.9-92.6%, a negative predictive value of up to 98.8% and a positive predictive value in this context of 8.4-8.7%. In terms of sensitivity, these out-performed more complex algorithms identified in other studies, as well as the expert panel. The best-performing algorithm is predicted to identify about 9/10 treatment-seeking HAT cases, though only 1/10 patients referred would test positive. CONCLUSIONS/SIGNIFICANCE: In the absence of regular active screening, improving referrals of HAT patients through other means is essential. Systematic use of syndromic algorithms by peripheral HCWs has the potential to increase case detection and would increase their participation in HAT programmes. The algorithms proposed here, though promising, should be validated elsewhere.

Long term retention of retigabine in a cohort of people with drug resistant epilepsy.

PURPOSE: To assess the utility of retigabine (RTG) for epilepsy in clinical practice at a single UK tertiary centre. METHODS: We identified all individuals who were offered RTG from April 2011 to May 2013. We collected demographics, seizure types, previous and current antiepileptic drugs (AEDs), starting and maximum attained daily dose of RTG, clinical benefits, side effects, and reason to discontinue RTG from in- and outpatient encounters until February 28, 2014. RESULTS: 145 people who had failed a median of 11 AEDs took at least one dose of RTG. One year retention was 32% and decreased following the safety alert by the US Federal Drug Administration (FDA) in April 2013. None became seizure free. 34 people (24%) reported a benefit that was ongoing at last assessment in five (3%). The most relevant benefit was the significant reduction or cessation of drop attacks or seizure-related falls in four women, this persisted at last assessment in two. The presence of simple partial seizures was associated with longer retention, as was a higher attained dose of RTG. Adverse effects were seen in 74% and largely CNS-related or nonspecific and affected the genitourinary system in 13%. CONCLUSION: Retention of RTG was less favourable compared to data from open label extension studies of the regulatory trials. In comparison with historical data on similar retention audits retention of RTG at one year appears to be less than lamotrigine, topiramate, levetiracetam, pregabalin, zonisamide, and lacosamide, and slightly higher than gabapentin.

Cardiac involvement in a patient with clinical and serological evidence of African tick-bite fever.

BACKGROUND: Myocarditis and pericarditis are rare complications of rickettsiosis, usually associated with Rickettsia rickettsii and R. conorii. African tick-bite fever (ATBF) is generally considered as a benign disease and no cases of myocardial involvement due to Rickettsia africae, the agent of ATBF, have yet been described. CASE PRESENTATION: The patient, that travelled in an endemic area, presented typical inoculation eschars, and a seroconversion against R. africae, was admitted for chest pains and increased cardiac enzymes in the context of an acute myocarditis. CONCLUSION: Our findings suggest that ATBF, that usually presents a benign course, may be complicated by an acute myocarditis.

Employers' attitudes towards long-term unemployed people and the role of activation in Switzerland

Over the last few years, most OECD countries have extended their activation policy to new groups of non-working people, including the long-term unemployed (LTU). However, it is widely known that employers tend to regard LTU people as potentially problematic persons. This is likely to constitute a major obstacle for long-term unemployed jobseekers. On the basis of a survey among employers in a Swiss canton (N = 722), this article aims to shed light on the perception employers have of the long-term unemployed and whether this may matter for their recruitment practices. It also asks what, from the employer point of view, may facilitate access to employment for an LTU person. A key finding is that large companies have a worse image of the long-term unemployed and are less likely to hire them. Furthermore, independent of company size, a test period or the recommendation of a trustworthy person is seen as the factors most likely to facilitate access to jobs for LTU people.

Key cognitive and collaborative aptitudes in ambulance people

The aim of our study was to identify and document some key cognitive aptitudes used by ambulance people in emergency situations. Better knowing such aptitudes is necessary for a school of ambulance people in order to improve the selection and education of students. The idea was to better consider real work activity requirements and characteristics, and to develop and implement genuine educational content and selection tools. We followed the work activity of ambulance professionals involved in real emergency situations. Some interventions were filmed and post-analyzed. We completed and validated our analysis by means of interviews with ambulance personnel. We selected some video sequences and used them as a support for the interviews. We identified and documented many different key aptitudes like orientation and spatial sense, the capacity to perform complex cognitive tasks and delicate manipulations in the context of divided attention, as well as diverse aptitudes relevant in collaborative work.

A mixed ecologic-cohort comparison of physical activity & weight among young adults from five populations of African origin.

BACKGROUND: Examination of patterns and intensity of physical activity (PA) across cultures where obesity prevalence varies widely provides insight into one aspect of the ongoing epidemiologic transition. The primary hypothesis being addressed is whether low levels of PA are associated with excess weight and adiposity. METHODS: We recruited young adults from five countries (500 per country, 2500 total, ages 25-45 years), spanning the range of obesity prevalence. Men and women were recruited from a suburb of Chicago, Illinois, USA; urban Jamaica; rural Ghana; peri-urban South Africa; and the Seychelles. PA was measured using accelerometry and expressed as minutes per day of moderate-to-vigorous activity or sedentary behavior. RESULTS: Obesity (BMI ≥ 30) prevalence ranged from 1.4% (Ghanaian men) to 63.8% (US women). South African men were the most active, followed by Ghanaian men. Relatively small differences were observed across sites among women; however, women in Ghana accumulated the most activity. Within site-gender sub-groups, the correlation of activity with BMI and other measures of adiposity was inconsistent; the combined correlation across sites was -0.17 for men and -0.11 for women. In the ecological analysis time spent in moderate-to-vigorous activity was inversely associated with BMI (r = -0.71). CONCLUSION: These analyses suggest that persons with greater adiposity tend to engage in less PA, although the associations are weak and the direction of causality cannot be inferred because measurements are cross-sectional. Longitudinal data will be required to elucidate direction of association.

Self-reported adherence and associated factors regarding antihypertensive medication in Seychelles

Introduction. Adherence to medication for asymptomatic disease is often low. We assessed factors associated with good adherence to medication for high blood pressure (HBP) in a country of the African region. Methods. A population-based survey of adults aged 25-64 years (N=1240 and participation rate=73%). Information was available in knowledge attitude and practice, SES and other variables. One question assessed adherence. Good adherence to treatment was defined as answering "I forget very rarely" vs "I forget on 1-2 days in a week" or "I forget on 3 or more days in a week". Results. In a univariate model adherence was strongly associated with belief that hypertension is a long-term disease (OR 2.6, p<0.001) and was negatively associated with concomitant use of traditional medicine (OR 0.36, p<0.005). The following variables tended to be associated with good adherence for HBP treatment: age, SES, BMI, belief that HBP is not symptomatic, going to government's clinics, medium stress level, controlled hypertension, taking statins. The following variables were not associated with good adherence for HBP treatment: education, higher BP, knowing people who had a stroke/MI, suffering from another chronic condition. In a multivariate model, pseudo R2 was 0.14. Conclusion. We built a multidimensional model including a wide range of variable. This model only predicted 14% of adherence variability. Variables associated with good adherence were demographics or related to knowledge attitude and practice. The latter one is modifiable by different type of interventions.

Use of hand-to-hand impedancemetry to predict body composition of African women as measured by air displacement plethysmography.

OBJECTIVES: To test the validity of a simple, rapid, field-adapted, portable hand-held impedancemeter (HHI) for the estimation of lean body mass (LBM) and percentage body fat (%BF) in African women, and to develop specific predictive equations. DESIGN: Cross-sectional observational study. SETTINGS: Dakar, the capital city of Senegal, West Africa. SUBJECTS: A total sample of 146 women volunteered. Their mean age was of 31.0 y (s.d. 9.1), weight 60.9 kg (s.d. 13.1) and BMI 22.6 kg/m(2) (s.d. 4.5). METHODS: Body composition values estimated by HHI were compared to those measured by whole body densitometry performed by air displacement plethysmography (ADP). The specific density of LBM in black subjects was taken into account for the calculation of %BF from body density. RESULTS: : Estimations from HHI showed a large bias (mean difference) of 5.6 kg LBM (P<10(-4)) and -8.8 %BF (P<10(-4)) and errors (s.d. of the bias) of 2.6 kg LBM and 3.7 %BF. In order to correct for the bias, specific predictive equations were developed. With the HHI result as a single predictor, error values were of 1.9 kg LBM and 3.7 %BF in the prediction group (n=100), and of 2.2 kg LBM and 3.6 %BF in the cross-validation group (n=46). Addition of anthropometrical predictors was not necessary. CONCLUSIONS: The HHI analyser significantly overestimated LBM and underestimated %BF in African women. After correction for the bias, the body compartments could easily be estimated in African women by using the HHI result in an appropriate prediction equation with a good precision. It remains to be seen whether a combination of arm and leg impedancemetry in order to take into account lower limbs would further improve the prediction of body composition in Africans.

Neighbourhood socio-economic position, late presentation and outcomes in people living with HIV in Switzerland.

OBJECTIVES: Inequalities and inequities in health are an important public health concern. In Switzerland, mortality in the general population varies according to the socio-economic position (SEP) of neighbourhoods. We examined the influence of neighbourhood SEP on presentation and outcomes in HIV-positive individuals in the era of combination antiretroviral therapy (cART). METHODS: The neighbourhood SEP of patients followed in the Swiss HIV Cohort Study (SHCS) 2000-2013 was obtained on the basis of 2000 census data on the 50 nearest households (education and occupation of household head, rent, mean number of persons per room). We used Cox and logistic regression models to examine the probability of late presentation, virologic response to cART, loss to follow-up and death across quintiles of neighbourhood SEP. RESULTS: A total of 4489 SHCS participants were included. Presentation with advanced disease [CD4 cell count <200 cells/μl or AIDS] and with AIDS was less common in neighbourhoods of higher SEP: the age and sex-adjusted odds ratio (OR) comparing the highest with the lowest quintile of SEP was 0.71 [95% confidence interval (95% CI) 0.58-0.87] and 0.59 (95% CI 0.45-0.77), respectively. An undetectable viral load at 6 months of cART was more common in the highest than in the lowest quintile (OR 1.52; 95% CI 1.14-2.04). Loss to follow-up, mortality and causes of death were not associated with neighbourhood SEP. CONCLUSION: Late presentation was more common and virologic response to cART less common in HIV-positive individuals living in neighbourhoods of lower SEP, but in contrast to the general population, there was no clear trend for mortality.

Gambling against neglect: unconscious spatial biases induced by reward reinforcement in healthy people and brain-damaged patients.

Orienting attention in space recruits fronto-parietal networks whose damage results in unilateral spatial neglect. However, attention orienting may also be governed by emotional and motivational factors; but it remains unknown whether these factors act through a modulation of the fronto-parietal attentional systems or distinct neural pathways. Here we asked whether attentional orienting is affected by learning about the reward value of targets in a visual search task, in a spatially specific manner, and whether these effects are preserved in right-brain damaged patients with left spatial neglect. We found that associating rewards with left-sided (but not right-sided) targets during search led to progressive exploration biases towards left space, in both healthy people and neglect patients. Such spatially specific biases occurred even without any conscious awareness of the asymmetric reward contingencies. These results show that reward-induced modulations of space representation are preserved despite a dysfunction of fronto-parietal networks associated with neglect, and therefore suggest that they may arise through spared subcortical networks directly acting on sensory processing and/or oculomotor circuits. These effects could be usefully exploited for potentiating rehabilitation strategies in neglect patients.