ORCID Profile
0000-0002-1483-5020
Current Organisations
Inselspital, Universitätsspital Bern
,
University of Oslo
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Publisher: Springer Science and Business Media LLC
Date: 21-04-2023
DOI: 10.1007/S11136-023-03414-0
Abstract: The COVID-19 pandemic forced people to give up their daily routines and adjust to new circumstances. This might have affected health-related quality of life (HRQOL). We aimed to compare HRQOL during the first COVID-19 wave in 2020 to HRQOL before the pandemic and to identify determinants of HRQOL during the pandemic in Switzerland. We conducted a cross-sectional online survey during the pandemic (between May and July 2020 CoWELL s le convenience s le). Before the pandemic (2015–2016), we had conducted a cross-sectional paper-based survey among a representative random s le of the Swiss general population (SGP s le). In both s les, we assessed physical and mental HRQOL (Short Form-36) and socio-demographic characteristics. In the CoWELL s le, we additionally assessed health- and COVID-19-related characteristics. Data were analysed using linear regressions. The CoWELL s le included 1581 participants (76% women mean age = 43 years, SD = 14 years) and the SGP s le 1209 participants (58% women, mean age = 49 years, SD = 15 years). Adjusted for sex, age, and education, the CoWELL s le reported higher physical HRQOL (PCS, +5.8 (95% CI: 5.1, 6.6), p 0.001) and lower mental HRQOL (MCS, −6.9 (−7.8, −6.0), p 0.001) than the SGP s le. In the CoWELL s le, especially persons with lower health literacy, who had no support network or who have had COVID-19, reported lower HRQOL. Aspects unique to the COVID-19 pandemic affected HRQOL. Vulnerable persons such as those having had COVID-19, less support opportunities, and with lower health literacy are especially prone to impaired HRQOL during the COVID-19 pandemic.
Publisher: Wiley
Date: 23-08-2021
DOI: 10.1002/AUR.2599
Abstract: It is biologically plausible that risk of autism spectrum disorder (ASD) is elevated by both short and long interpregnancy intervals (IPI). We conducted a retrospective cohort study of singleton, non‐nulliparous live births, 1998–2007 in Denmark, Finland, and Sweden ( N = 925,523 births). Optimal IPI was defined as the IPI at which minimum risk was observed. Generalized additive models were used to estimate relative risks (RR) of ASD and 95% Confidence Intervals (CI). Population impact fractions (PIF) for ASD were estimated under scenarios for shifts in the IPI distribution. We observed that the association between ASD ( N = 9302) and IPI was U‐shaped for all countries. ASD risk was lowest (optimal IPI) at 35 months for all countries combined, and at 30, 33, and 39 months in Denmark, Finland, and Sweden, respectively. Fully adjusted RRs at IPIs of 6, 12, and 60 months were 1.41 (95% CI: 1.08, 1.85), 1.26 (95% CI: 1.02, 1.56), and 1.24 (95% CI: 0.98, 1.58) compared to an IPI of 35 months. Under the most conservative scenario PIFs ranged from 5% (95% CI: 1%–8%) in Denmark to 9% (95% CI: 6%–12%) in Sweden. The minimum ASD risk followed IPIs of 30–39 months across three countries. These results reflect both direct IPI effects and other, closely related social and biological pathways. If our results reflect biologically causal effects, increasing optimal IPIs and reducing their indications, such as unintended pregnancy and delayed age at first pregnancy has the potential to prevent a salient proportion of ASD cases. Waiting 35 months to conceive again after giving birth resulted in the least risk of autism. Shorter and longer intervals resulted in risks that were up to 50% and 85% higher, respectively. About 5% to 9% of autism cases might be avoided by optimizing birth spacing.
Publisher: Springer Science and Business Media LLC
Date: 20-03-2023
DOI: 10.1007/S00404-023-07002-Y
Abstract: To examine the association between endometriosis and adverse pregnancy and perinatal outcomes (preecl sia, placenta previa, and preterm birth). A population-based retrospective cohort study was conducted among 468,778 eligible women who contributed 912,747 singleton livebirths between 1980 and 2015 in Western Australia (WA). We used probabilistically linked perinatal and hospital separation data from the WA data linkage system’s Midwives Notification System and Hospital Morbidity Data Collection databases. We used a doubly robust estimator by combining the inverse probability weighting with the outcome regression model to estimate adjusted risk ratios (RR) and 95% confidence intervals (CIs). There were 19,476 singleton livebirths among 8874 women diagnosed with endometriosis. Using a doubly robust estimator, we found pregnancies in women with endometriosis to be associated with an increased risk of preecl sia with RR of 1.18, 95% CI 1.11–1.26, placenta previa (RR 1.59, 95% CI 1.42–1.79) and preterm birth (RR 1.45, 95% CI 1.37–1.54). The observed association persisted after stratified by the use of Medically Assisted Reproduction, with a slightly elevated risk among pregnancies conceived spontaneously. In this large population-based cohort, endometriosis is associated with an increased risk of preecl sia, placenta previa, and preterm birth, independent of the use of Medically Assisted Reproduction. This may help to enhance future obstetric care among this population.
Publisher: Public Library of Science (PLoS)
Date: 04-03-2022
DOI: 10.1371/JOURNAL.PONE.0264427
Abstract: Conducting high quality investigator-initiated trials (IITs) is challenging and costly. The costs of investigational medicinal products (IMPs) in IITs and the role of hospital pharmacies in the planning of IITs are unclear. We conducted a mixed-methods study to compare planned and actual costs of IMPs in Swiss IITs, to examine potential reasons for differences, and to gather stakeholder views about hospital services for IITs. We included all IITs with IMP services from the Basel hospital pharmacy invoiced between January 2014 and June 2020 (n = 24). We documented trial and IMP characteristics including planned and actual IMP costs. Our working definition for a substantial cost difference was that the actual IMP costs were more than 10% higher than the planned IMP costs in a trial. We conducted semi-structured interviews with investigators, clinical trials unit and hospital pharmacy staff, and qualitatively analyzed transcribed interviews. For 13 IITs we observed no differences between planned and actual costs of IMPs (median, 11’000 US$ interquartile range [IQR], 8’882–16’302 US$), but for 11 IITs we found cost increases from a median of 11’000 US$ (IQR, 8’922–36’166 US$) to a median over 28’000 US$ (IQR, 13’004–49’777 US$). All multicenter trials and 10 of 11 IITs with patients experienced substantial cost differences. From the interviews we identified four main themes: 1) Patient recruitment and organizational problems were identified as main reasons for cost differences, 2) higher actual IMP costs were bearable for most investigators, 3) IMP services for IITs were not a priority for the hospital pharmacy, and 4) closer collaboration between clinical trial unit and hospital pharmacy staff, and sufficient staff for IITs at the hospital pharmacy could improve IMP services. Multicenter IITs enrolling patients are particularly at risk for higher IMP costs than planned. These trials are more difficult to plan and logistically challenging, which leads to delays and expiring IMP shelf-lives. IMP services of hospital pharmacies are important for IITs in Switzerland, but need to be further developed.
Publisher: Elsevier BV
Date: 03-2201
Location: United Kingdom of Great Britain and Northern Ireland
No related grants have been discovered for Vera Mitter.