Completeness of information in electronic compared with paper-based patients’ records in a maternity setting in Dakar, Senegal

Background: Evaluate the consistency of information in paper-based records when registered in parallel with an electronic medical record.Methods: The study was performed at PMSHC in Dakar Senegal. From the end of year 2016, patients’ files were recorded on both paper-based and electronically. Additionally, previous records were electronically registered. To investigate the completeness of records before and after the electronic recording system has been implemented, information about some maternal and fetal/neonatal characteristics were assessed. When the variable was recorded, the system returned 1, unrecorded variables were coded as 0. We then calculated, for each variable, the unrecorded rate before 2017 and after that date. The study period extended from 2011 to June 2019, a nearly ten-year period. Data were extracted from E-perinatal to MS excel 2019 then SPSS 25 software. Frequencies of unrecorded variables were compared with chi-squared test at a level of significance of 5%.Results: A total of 48,270 unique patients’ records were identified during the eight-year period.  Among the study population, data for patients’ age, address and parity were available most of the time before and after 2017 (0.5% missing data versus 0.3% for age and 2.6% versus 1.3% for home address and from 0.3% to 0.0% for parity). However, phone number, maternal weight, maternal height, last menstrual period and blood group were found to be missing up to 96% before 2017. From 2017, these rates experienced a sudden decrease at a significant level: from 82.4% to 27.8% for phone number, from 96% to 56.3% for maternal weight and from 60.1% to 21.3% for blood group. Regarding newborns’ data, it was found that fetal height, head circumference and chest circumference were missing up to just under 25% before 2017. After that date, their completeness improved and flattened under 5%.Conclusions: Structured and computerized files reduce missing data. There is an urgent need the Ministry of health provides hospitals and health care providers with guidelines that describes the standardized information that should be gathered and shared in health and care records

Sugar Overconsumption during Adolescence Selectively Alters Motivation and Reward Function in Adult Rats

International audienceBACKGROUND:There has been a dramatic escalation in sugar intake in the last few decades, most strikingly observed in the adolescent population. Sugar overconsumption has been associated with several adverse health consequences, including obesity and diabetes. Very little is known, however, about the impact of sugar overconsumption on mental health in general, and on reward-related behavioral disorders in particular. This study examined in rats the effects of unlimited access to sucrose during adolescence on the motivation for natural and pharmacological rewards in adulthood.METHODOLOGY/PRINCIPAL FINDINGS:Adolescent rats had free access to 5% sucrose or water from postnatal day 30 to 46. The control group had access to water only. In adulthood, rats were tested for self-administration of saccharin (sweet), maltodextrin (non-sweet), and cocaine (a potent drug of abuse) using fixed- and progressive-ratio schedules, and a concentration-response curve for each substance. Adult rats, exposed or not exposed to sucrose, were tested for saccharin self-administration later in life to verify the specificity of adolescence for the sugar effects. Sugar overconsumption during adolescence, but not during adulthood, reduced the subsequent motivation for saccharin and maltodextrin, but not cocaine. This selective decrease in motivation is more likely due to changes in brain reward processing than changes in gustatory perception.CONCLUSIONS/SIGNIFICANCE:Sugar overconsumption induces a developmental stage-specific chronic depression in reward processing that may contribute to an increase in the vulnerability to reward-related psychiatric disorders

Motivation for saccharin (sweet) in adult rats exposed to saccharin or water during adolescence.

<p>(A) Percentage of rats reaching the acquisition criterion (>50 reinforcements for 2 consecutive sessions) for saccharin (0.13%, w/v) self-administration; (B) Number of saccharin (0.13%, w/v) reinforcements earned on fixed-ratio 1 (FR1) and fixed-ratio 5 (FR5) schedules; (C) Break point reached during the progressive-ratio (PR) test; and (D) Number of reinforcements earned (FR5) at different saccharin concentrations (in %, w/v), by adult rats exposed to saccharin (N = 8) or water (N = 8) during adolescence. *, ** Indicate significant group differences (p<0.05 and p<0.01, respectively).</p

Motivation for cocaine in adult rats exposed to sucrose or water during adolescence.

<p>(A) Percentage of rats reaching the acquisition criterion (>15 reinforcements for 2 consecutive sessions) for cocaine (250 µg/infusion) self-administration; (B) Number of cocaine (250 µg/infusion) reinforcements earned on fixed-ratio 1 (FR1) and fixed-ratio 5 (FR5) schedules; (C) Breakpoint reached during the progressive-ratio (PR) test; and (D) Number of reinforcements earned (FR5) at different cocaine concentrations (in µg/infusion), by adult rats exposed to sucrose (N = 10) or water (N = 9) during adolescence.</p

Motivation for maltodextrin (non-sweet) in adult rats exposed to sucrose or water during adolescence.

<p>(A) Percentage of rats reaching the acquisition criterion (>50 reinforcements for 2 consecutive sessions) for maltodextrin (5%, w/v) self-administration; (B) Number of maltodextrin (5%, w/v) reinforcements earned on fixed-ratio 1 (FR1) and fixed-ratio 5 (FR5) schedules; (C) Breakpoint reached during the progressive-ratio (PR) test; and (D) Number of reinforcements earned (FR5) at different maltodextrin concentrations (in %, w/v), by adult rats exposed to sucrose (N = 8) or water (N = 8) during adolescence. * Indicates significant group differences (p<0.05).</p

Motivation for saccharin (sweet) in adult rats exposed to sucrose or water during adolescence.

<p>(A) Percentage of rats reaching the acquisition criterion (>50 reinforcements for 2 consecutive sessions) for saccharin (0.13%, w/v) self-administration; (B) Number of saccharin (0.13%, w/v) reinforcements earned on fixed-ratio 1 (FR1) and fixed-ratio 5 (FR5) schedules; (C) Breakpoint reached during the progressive-ratio (PR) test; and (D) Number of reinforcements earned (FR5) at different saccharin concentrations (in %, w/v), by adult rats exposed to sucrose (N = 15) or water (N = 16) during adolescence. *, **, *** Indicate significant group differences (p<0.05, p<0.01 and p<0.001, respectively).</p