Validation and Refinement of the Sense of Coherence Scale for a French Population: Observational Study.

BACKGROUND: Salutogenesis focuses on understanding the factors that contribute to positive health outcomes. At the core of the model lies the sense of coherence (SOC), which plays a crucial role in promoting well-being and resilience. OBJECTIVE: Using the validscale Stata command, we aimed to assess the psychometric properties of the French version of the 3-dimension 13-item SOC questionnaire (SOC-13), encompassing the comprehensibility, manageability, and meaningfulness dimensions. We also aimed to determine if a refined scale, assessed through this method, exhibits superior psychometric properties compared to the SOC-13. METHODS: A sample of 880 consecutive primary care patients recruited from 35 French practices were asked to complete the SOC-13. We tested for internal consistency and scalability using the Cronbach α and Loevinger H coefficients, respectively, and we tested for construct validity using confirmatory factor analysis and goodness-of-fit indices (root mean square error of approximation [RMSEA] and comparative fit index [CFI]). RESULTS: Of the 880 eligible patients, 804 (91.4%) agreed to participate (n=527, 65.6% women; median age 51 years). Cronbach α and Loevinger H coefficients for the SOC-13 were all <0.70 and <0.30, respectively, indicating poor internal consistency and poor scalability (0.64 and 0.29 for comprehensibility, 0.56 and 0.26 for manageability, and 0.46 and 0.17 for meaningfulness, respectively). The RMSEA and CFI were >0.06 (0.09) and <0.90 (0.83), respectively, indicating a poor fit. By contrast, the psychometric properties of a unidimensional 8-item version of the SOC questionnaire (SOC-8) were excellent (Cronbach α=0.82, Loevinger H=0.38, RMSEA=0.05, and CFI=0.97). CONCLUSIONS: The psychometric properties of the 3-dimension SOC-13 were poor, unlike the unidimensional SOC-8. A questionnaire built only with these 8 items could be a good candidate to measure the SOC. However, further validation studies are needed before recommending its use in research.

Who are the patients who use non-pharmacological home remedies? Cross-sectional study in Switzerland and France.

BACKGROUND: Many patients may be tempted to use non-pharmacological home remedies (NPHRs) to relieve various complaints. To the best of our knowledge, there is little data on the characteristics of patients using NPHRs. In this cross-sectional study carried out between March 2020 and July 2021, we examined the socio-demographic factors underlying their use in patient populations in Switzerland and France. METHODS: Using official registries, we randomly selected 50 primary care physicians (PCPs) in Geneva (Switzerland) and Lyon/Grenoble (France). Seven research assistants consecutively recruited patients from PCP waiting rooms (20-25 patients per practice). Patients completed a paper-based questionnaire assessing the use [yes/no] of 304 NPHRs for 79 medical conditions. The NPHR list was developed by our team with input from 97 patients. We used univariable and multivariable logistic regressions, adjusting for intra-cluster correlations, to examine associations between NPHR use and patient characteristics (gender, age, practice location, nationality, education level, and self-rated health). RESULTS: Of the 1198 eligible patients, 1012 agreed to participate (85%). Overall, 635 patients (63%) reported using at least one of the remedies tested in the study. In multivariable analysis, women (OR = 1.7 [95%CI = 1.3-2.3], P-value < 0.001), younger patients (< 40 years: OR = 2.1 [95%CI = 1.6-2.9], P-value < 0.001), and French patients (OR = 1.6 [95%CI = 1.1-2.3], P-value < 0.001) tended to use NPHRs more often than other patients. CONCLUSIONS: Many patients, particularly women, young people, and French patients, reported using NPHRs. This survey's findings hold the potential to inform healthcare providers, policymakers, and researchers about the diverse preferences that shape patients' healthcare choices.

Performance of machine translators in translating French medical research abstracts to English: A comparative study of DeepL, Google Translate, and CUBBITT.

BACKGROUND: Non-English speaking researchers may find it difficult to write articles in English and may be tempted to use machine translators (MTs) to facilitate their task. We compared the performance of DeepL, Google Translate, and CUBBITT for the translation of abstracts from French to English. METHODS: We selected ten abstracts published in 2021 in two high-impact bilingual medical journals (CMAJ and Canadian Family Physician) and used nine metrics of Recall-Oriented Understudy for Gisting Evaluation (ROUGE-1 recall/precision/F1-score, ROUGE-2 recall/precision/F1-score, and ROUGE-L recall/precision/F1-score) to evaluate the accuracy of the translation (scores ranging from zero to one [= maximum]). We also used the fluency score assigned by ten raters to evaluate the stylistic quality of the translation (ranging from ten [= incomprehensible] to fifty [= flawless English]). We used Kruskal-Wallis tests to compare the medians between the three MTs. For the human evaluation, we also examined the original English text. RESULTS: Differences in medians were not statistically significant for the nine metrics of ROUGE (medians: min-max = 0.5246-0.7392 for DeepL, 0.4634-0.7200 for Google Translate, 0.4815-0.7316 for CUBBITT, all p-values > 0.10). For the human evaluation, CUBBITT tended to score higher than DeepL, Google Translate, and the original English text (median = 43 for CUBBITT, vs. 39, 38, and 40, respectively, p-value = 0.003). CONCLUSION: The three MTs performed similarly when tested with ROUGE, but CUBBITT was slightly better than the other two using human evaluation. Although we only included abstracts and did not evaluate the time required for post-editing, we believe that French-speaking researchers could use DeepL, Google Translate, or CUBBITT when writing articles in English.

How well does NamSor perform in predicting the country of origin and ethnicity of individuals based on their first and last names?

BACKGROUND: We aimed to evaluate NamSor's performance in predicting the country of origin and ethnicity of individuals based on their first/last names. METHODS: We retrieved the name and country of affiliation of all authors of PubMed publications in 2021, affiliated with universities in the twenty-two countries whose researchers authored ≥1,000 medical publications and whose percentage of migrants was <2.5% (N = 88,699). We estimated with NamSor their most likely "continent of origin" (Asia/Africa/Europe), "country of origin" and "ethnicity". We also examined two other variables that we created: "continent#2" ("Europe" replaced by "Europe/America/Oceania") and "country#2" ("Spain" replaced by "Spain/Hispanic American country" and "Portugal" replaced by "Portugal/Brazil"). Using "country of affiliation" as a proxy for "country of origin", we calculated for these five variables the proportion of misclassifications (= errorCodedWithoutNA) and the proportion of non-classifications (= naCoded). We repeated the analyses with a subsample consisting of all results with inference accuracy ≥50%. RESULTS: For the full sample and the subsample, errorCodedWithoutNA was 16.0% and 12.6% for "continent", 6.3% and 3.3% for "continent#2", 27.3% and 19.5% for "country", 19.7% and 11.4% for "country#2", and 20.2% and 14.8% for "ethnicity"; naCoded was zero and 18.0% for all variables, except for "ethnicity" (zero and 10.7%). CONCLUSION: NamSor is accurate in determining the continent of origin, especially when using the modified variable (continent#2) and/or restricting the analysis to names with accuracy ≥50%. The risk of misclassification is higher with country of origin or ethnicity, but decreases, as with continent of origin, when using the modified variable (country#2) and/or the subsample.

Women Are Underrepresented Among Authors of Retracted Publications: Retrospective Study of 134 Medical Journals.

We examined the gender distribution of authors of retracted articles in 134 medical journals across 10 disciplines, compared it with the gender distribution of authors of all published articles, and found that women were underrepresented among authors of retracted articles, and, in particular, of articles retracted for misconduct.

The level of the gender gap in academic publishing varies by country and region of affiliation: A cross-sectional study of articles published in general medical journals.

BACKGROUND: Women are generally under-represented as authors of publications, and especially as last authors, but this under-representation may not be uniformly distributed across countries. We aimed to document by country and region the proportion of female authors (PFA) in high-impact general medical journals. METHODS: We used PyMed, a Python library that provides access to PubMed, to retrieve all PubMed articles published between January 2012 and December 2021 in the fifty general internal medicine journals with the highest 2020 impact factor according to Journal Citation Reports. We extracted first/last authors' main country of affiliation for all these articles using regular expressions and manual search, and grouped the countries into eight regions (North/Latin America, Western/Eastern Europe, Asia, Pacific, Middle East, and Africa). We used NamSor to determine first/last authors' gender and computed the PFA for each country/region. RESULTS: We retrieved 163,537 publications for first authors and 135,392 for last authors. Gender could be determined for 160,891 and 133,373 publications, respectively. The PFA was 41% for first authors and 33% for last authors, but it varied widely by country (first authors: >50% for eight countries, maximum = 63% in Romania, minimum = 19% in Japan; last authors: >50% for two countries, maximum = 53% in Romania, minimum = 9% in Japan). The PFA also varied by region. It was highest for Eastern Europe (first authors = 53%, last authors = 40%), and lowest for Asia (36% and 29%) and the Middle East (35% and 27%). CONCLUSION: We found that the PFA varied widely by country and region, and was lowest in Asia, particularly Japan, and the Middle East. The under-representation of women as authors of publications, especially in these two regions, needs to be addressed and correcting persistent gender discrimination in research should be a top priority.

Nonpharmacological home remedies for upper respiratory tract infections: a cross-sectional study of primary care patients in Switzerland and France.

BACKGROUND: Many patients might be tempted to use nonpharmacological home remedies (NPHRs) to relieve upper respiratory tract infection (URTI) symptoms. However, primary care physicians (PCPs) rarely recommend NPHRs due to a lack of knowledge in this field. We conducted a questionnaire-based survey among primary care patients in Switzerland and France to explore which NPHRs they use and consider effective for 3 common URTI symptoms: sore throat/cough/common cold. METHODS: Using official physician registries, we randomly selected 50 PCPs in Geneva (Switzerland) and Lyon/Grenoble (France). Seven research assistants were involved in the recruitment of consecutive patients from the waiting rooms of these PCPs (20-25 patients per practice). Patients were asked to complete a paper-based questionnaire to assess the use and perceived effectiveness of 72 NPHRs for URTI symptoms. The list of NPHRs was developed by our research team with the help of 97 patients. Remedies were considered effective if patients reported that they were effective/very effective. Data were analysed descriptively. RESULTS: Of the 1,198 eligible patients, 1,012 agreed to participate (84.5%). The 4 most frequently used NPHRs were honey/lemon/thyme/herbal teas. Most patients using these NPHRs considered them as effective (between 77% of patients for onion syrup for cough and 94% of patients for thyme inhalations for common colds). CONCLUSIONS: Many patients reported using honey/lemon/thyme/herbal teas for URTI symptoms, and generally considered these treatments to be effective. Future research should explore the extent to which these remedies can be safely proposed as alternatives for the symptomatic treatment of ear/nose/throat complaints in primary care.

Use and perceived effectiveness of non-pharmacological home remedies for digestive symptoms: a questionnaire-based survey among primary care patients.

BACKGROUND: Patients frequently visit their primary care physician (PCP) for digestive symptoms. We aimed to compile a list of non-pharmacological home remedies (NPHRs) that patients frequently use and find effective so that PCPs can then propose them to their patients with various digestive symptoms. METHODS: In this questionnaire-based survey on the use and perceived effectiveness of NPHRs for digestive symptoms, 50 randomly selected Swiss or French PCPs consecutively recruited 20-25 patients between March 2020 and July 2021. These patients were given a list of 53 NPHRs previously developed by our research team. They were asked whether they used them (Y/N) and whether they considered them to be ineffective, not very effective, moderately effective, or very effective in treating abdominal pain (14 NPHRs), bloating (2), constipation (5), diarrhoea (10), digestion trouble (12), nausea/vomiting (2) and stomach pain (8). We considered NPHRs to be perceived as effective if patients reported that they were moderately or very effective. RESULTS: A total of 1,012 patients agreed to participate in the study (participation rate = 84.5%, median age = 52 years, women = 61%). The two most frequently used NPHRs were rice cooking water for diarrhoea (29% of patients) and prunes for constipation (22%). The perceived effectiveness of the NPHRs ranged from 82% (fennel infusions for abdominal pain) to 95% (bicarbonate for stomach pain). CONCLUSION: Our data could be useful to PCPs interested in proposing NPHRs to their patients suffering from digestive disorders, and more generally to all PCPs interested in learning more about patients' use of NPHRs in primary care.

Gender Inequalities in Citations of Articles Published in High-Impact General Medical Journals: a Cross-Sectional Study.

BACKGROUND: Besides the number of publications, the number of citations is another key metric often used to compare researchers with each other. While women researchers tend to have fewer publications than their men colleagues, the data is scarce for the number of citations. We aimed to determine whether there is a gender gap in citations. METHODS: We used Web of Science to retrieve the number of citations per year for all research articles and reviews published between January 2015 and December 2019 in fourteen high-impact general medical journals (impact factor > 5). We used Gender API to identify the gender of the first/last authors. We compared the results by gender using multivariable negative binomial regressions (adjusting for intra-cluster correlations within journals). RESULTS: The gender of the first/last author was determined for 13,218/13,350 (99%) and 11,894/12,026 (99%) articles, respectively. The proportion of women among first/last authors was 40% and 29%, respectively. The median number of citations per year was 5 (IQR = 11.3) for women and 6.8 (IQR = 17.8) for men for first authors (IRR = 1.5 [95% CI = 1.3-1.8], p value < 0.001), and 6 (IQR = 12.4) and 7.5 (IQR = 17.4) for last authors (IRR = 1.3 [95% CI = 1.2-1.5], p value < 0.001). Articles whose first and last authors were women were the least cited and those whose first and last authors were men were the most cited. CONCLUSION: In this cross-sectional study, we found that articles authored by women were cited less often than those authored by men. Further studies are needed to explore the reasons for these gender differences in article citations.

Perceived Effectiveness and Overall Satisfaction of Using a Toilet Stool to Prevent or Treat Constipation: An Analysis of Online Comments.

INTRODUCTION: Constipation is a common complaint in the general population. Squatting (using a toilet stool) is associated with faster and more complete bowel emptying, and could therefore help prevent or treat constipation. We analyzed the reviews of online buyers of a toilet stool to assess perceived effectiveness, overall satisfaction and potential side effects. METHODS: In this exploratory mixed-method study, we collected all plain text reviews left between November 2013 and March 2020 by buyers of a toilet stool on Amazon. We adapted the Framework method to perform a seven-step process to analyze user reviews. We assigned numerical values from -5 (minimum) to +5 (maximum) to perceived effectiveness and overall satisfaction. RESULTS: We included comments left by 10,027 customers who purchased 19 different types of toilet stools (79.1% seven-inch stools, 16.1% folding stools, 4.8% other stools). Perceived effectiveness and overall satisfaction were high (median = 5 and interquartile range = 0 for both variables). Eighty-one individuals reported adverse events related to toilet stool use, mainly musculoskeletal pain (N = 26), numbness in the lower limbs (N = 16), falls (n = 11), constipation (N = 9), anorectal symptom (N = 8), and cramps (N = 6). CONCLUSION: Perceived effectiveness and overall satisfaction were rated high by those who purchased a toilet stool online. In addition, their use seems to be safe (<1% reported adverse effects). Our results suggest a good risk-benefit ratio. The device may offer an inexpensive option to treat or prevent constipation, and may reduce the frequency of medical visits and the risks associated with long-term use of laxatives.

Risk of COVID-19 and Psychological Impact of the Pandemic in Swiss Primary Care Physicians.

BACKGROUND AND OBJECTIVES: There is limited data on primary care physicians (PCPs) who suffered from COVID-19. We aimed to assess the proportion of PCPs with COVID-19, the proportion hospitalized with COVID-19, and the number of days off work. We also explored their psychological suffering due to the pandemic. METHODS: We selected a random sample of 1,000 PCPs practicing in the seven cantons of Western Switzerland (November/December 2020). PCPs were invited by mail to complete a questionnaire. RESULTS: The participation rate was 51% (N=506). The burden of disease was high among PCPs: 13% suffered from COVID-19, 0.4% needed hospitalization, and 10 days off work were required on average. In addition, many PCPs reported experiencing heightened psychological symptoms, mainly fatigue (53%) and stress/anxiety (48%). CONCLUSIONS: These findings highlight the urgent need to implement preventive measures to reduce the risk of COVID-19 and psychological illness in PCPs.

Primary care patients' perspectives on the use of non-pharmacological home remedies in Geneva: a cross-sectional study.

BACKGROUND: Home remedies are anchored in patients' everyday life, but their use in Western cultures remains scarcely explored. Our objectives were to investigate primary care patients' perspectives and use of non-pharmacological home remedies in Geneva (Switzerland). METHODS: In spring 2020, we conducted a cross-sectional survey among adult primary care patients in randomly selected general practices (N = 15). Patients were recruited in the waiting rooms and asked to complete a questionnaire about their sociodemographic characteristics, their home remedy use, and their expectations and reasons for using (or not using) home remedies. We employed descriptive statistics to summarise the data and logistic regression adjusted for clustering within practices to explore associations between home remedy use and participants' sociodemographic characteristics. RESULTS: Three hundred fourteen of three hundred ninety patients agreed to participate in the study (participation rate 80.5%). Home remedies were used by 64.4% of patients. The main reasons given were for preventive purposes (55.3%), self-care (41.0%), as an alternative to conventional medicine (40.5%) and to avoid or delay a medical consultation (38.5%). One-third of patients considered that it was the GP's role to spontaneously inform them about home remedies (36.4%), another third considered that it was the GP's role to inform them, but only upon specific request (32.3%), and the last third of patients declared that it was not the GP's role to provide information about home remedies (30.3%). Patients living in an urban zone (adjusted OR 2.1; 95%CI 1.0-4.4; p 0.05) and those with a tertiary education background (adjusted OR 1.9; 95%CI 1.0-3.6; p 0.05) believed that it was their GP's role to inform them about home remedies. CONCLUSIONS: Home remedies are used by a majority of primary care patients in Geneva. For a comprehensive and safe healthcare management in the context of patient-oriented medicine, more evidence-based research on efficacy and safety of home remedies as well as their place in primary care consultation is required.