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1.
SSM Qual Res Health ; 2: 100181, 2022 Dec.
Article in English | MEDLINE | ID: covidwho-2069707

ABSTRACT

In January 2021, the Swiss government introduced the first COVID-19 vaccines and prioritized allocation to at-risk individuals and professionals working with them. Despite this opportunity, vaccine uptake among staff employed in retirement homes and institutes for people with disabilities was suboptimal. This study aimed to capture real-time decision-making about COVID-19 vaccine among staff employed in nursing homes and institutes for people with disabilities in Southern Switzerland. We conducted semi-structured phone-interviews with 25 staff employed in retirement homes and institutes for people with disabilities between February and May 2021, i.e., when participants had to decide whether they wanted to adhere to the priority vaccination programme. Among participants, 21 either signed up for the COVID-19 vaccination or were fully or partly vaccinated at the time of the interview. For most participants, the vaccination choice was a challenging process: information appeared to be lacking and conflicting; numerous moral principles were at stake and contradictory; the way vaccination was organized clashed with the health values to which respondents had been previously exposed; finally, the fear of discrimination for those who decided not to get vaccinated loomed over the vaccination choice. Participants decided for or against vaccination based on principles, traditions, emotions, and a reflexive assessment of the personal vs. collective benefit of the vaccination, the latter being the most common within the investigated sample. This study shows that deciding to get vaccinated against COVID-19 is a nuanced process and that individuals cannot simply be categorized as "novax" or "provax" based on their vaccination decision.

2.
Int J Public Health ; 67: 1604973, 2022.
Article in English | MEDLINE | ID: covidwho-2065660

ABSTRACT

Objectives: As a risk communication tool, social media was mobilised at an unprecedented level during the COVID-19 pandemic. This study examined health authorities' risk communication on social media in response to the pandemic in 2020. Methods: We analysed 1,633 COVID-19-related posts from 15 social media accounts managed by official health authorities in Germany, Norway, Sweden, Switzerland, and the United Kingdom. Results: The rate at which the authorities posted about COVID-19 on social media fluctuated throughout 2020. Each account's posting frequency peaked between March and May 2020, before dropping considerably during the summer. The messages that the organisations focused on also varied throughout the year but covered most risk communication guidelines. Yet, our analysis highlighted themes that were communicated infrequently, such as long COVID or exercising during the pandemic. Conclusion: With more individuals now following health authorities on social media, platforms such as Instagram hold great potential for future risk communication campaigns and strategies.


Subject(s)
COVID-19 , Health Communication , Social Media , COVID-19/complications , COVID-19/epidemiology , Communication , Humans , Pandemics , SARS-CoV-2
3.
JMIR Public Health Surveill ; 8(11): e41004, 2022 Nov 11.
Article in English | MEDLINE | ID: covidwho-2065330

ABSTRACT

BACKGROUND: Digital proximity-tracing apps have been deployed in multiple countries to assist with SARS-CoV-2 pandemic mitigation efforts. However, it is unclear how their performance and effectiveness were affected by changing pandemic contexts and new viral variants of concern. OBJECTIVE: The aim of this study is to bridge these knowledge gaps through a countrywide digital proximity-tracing app effectiveness assessment, as guided by the World Health Organization/European Center for Prevention and Disease Control (WHO/ECDC) indicator framework to evaluate the public health effectiveness of digital proximity-tracing solutions. METHODS: We performed a descriptive analysis of the digital proximity-tracing app SwissCovid in Switzerland for 3 different periods where different SARS-CoV-2 variants of concern (ie, Alpha, Delta, and Omicron, respectively) were most prevalent. In our study, we refer to the indicator framework for the evaluation of public health effectiveness of digital proximity-tracing apps of the WHO/ECDC. We applied this framework to compare the performance and effectiveness indicators of the SwissCovid app. RESULTS: Average daily registered SARS-CoV-2 case rates during our assessment period from January 25, 2021, to March 19, 2022, were 20 (Alpha), 54 (Delta), and 350 (Omicron) per 100,000 inhabitants. The percentages of overall entered authentication codes from positive tests into the SwissCovid app were 9.9% (20,273/204,741), 3.9% (14,372/365,846), and 4.6% (72,324/1,581,506) during the Alpha, Delta, and Omicron variant phases, respectively. Following receipt of an exposure notification from the SwissCovid app, 58% (37/64, Alpha), 44% (7/16, Delta), and 73% (27/37, Omicron) of app users sought testing or performed self-tests. Test positivity among these exposure-notified individuals was 19% (7/37) in the Alpha variant phase, 29% (2/7) in the Delta variant phase, and 41% (11/27) in the Omicron variant phase compared to 6.1% (228,103/3,755,205), 12% (413,685/3,443,364), and 41.7% (1,784,951/4,285,549) in the general population, respectively. In addition, 31% (20/64, Alpha), 19% (3/16, Delta), and 30% (11/37, Omicron) of exposure-notified app users reported receiving mandatory quarantine orders by manual contact tracing or through a recommendation by a health care professional. CONCLUSIONS: In constantly evolving pandemic contexts, the effectiveness of digital proximity-tracing apps in contributing to mitigating pandemic spread should be reviewed regularly and adapted based on changing requirements. The WHO/ECDC framework allowed us to assess relevant domains of digital proximity tracing in a holistic and systematic approach. Although the Swisscovid app mostly worked, as reasonably expected, our analysis revealed room for optimizations and further performance improvements. Future implementation of digital proximity-tracing apps should place more emphasis on social, psychological, and organizational aspects to reduce bottlenecks and facilitate their use in pandemic contexts.


Subject(s)
COVID-19 , Mobile Applications , Humans , Pandemics/prevention & control , SARS-CoV-2 , Contact Tracing , Cross-Sectional Studies , Switzerland/epidemiology , COVID-19/epidemiology , COVID-19/prevention & control
4.
23rd Annual International Conference on Digital Government Research: Intelligent Technologies, Governments and Citizens, DGO 2022 ; : 235-243, 2022.
Article in English | Scopus | ID: covidwho-2064295

ABSTRACT

Over the past decade, Open Government Data (OGD) strategies have become a continuing concern in administrative services. This is even truer than at any time. Given the current situation, data management, specifically consistent data publication, has been central to public institutions. The Covid-19 pandemic has shown that data collected by public administrations could make valuable contributions. However, in Switzerland, the pandemic has highlighted the limitations of public organizations' capability to lead the publication of their data. Based on an ethnography and a literature review, this paper explores how data governance components impact OGD publication process and presents a model of OGD governance. For this purpose, we identify key data governance components necessary to OGD publication-structural, procedural, and relational-And illustrate how OGD challenges rarely arise from the publication of OGD or the open nature of data itself, but a lack of data governance. © 2022 ACM.

5.
Chest ; 162(4 Supplement):A1586-A1587, 2022.
Article in English | EMBASE | ID: covidwho-2060846

ABSTRACT

SESSION TITLE: Technological Innovations in Imaging SESSION TYPE: Original Investigations PRESENTED ON: 10/17/22 1:30 PM - 2:30 PM PURPOSE: Central airway stenosis (CAS) is an important cause of pulmonary morbidity and mortality. Current grading and classification systems include subjective qualitative components, with limited data on reproducibility. We propose a novel radiographic segmentation approach to more objectively quantify CAS. Inter-rater reliability of this novel outcome, which is used in an ongoing randomized controlled trial (NCT04996173), has not been previously assessed. METHOD(S): Computed tomography (CT) scans demonstrating tracheal stenoses were identified in the Vanderbilt University Medical Center Benign Tracheal Stenosis registry. CTs were analyzed in OsiriX (Geneva, Switzerland) after upload via a secured cloud transfer service. Four independent readers with variable experience in CT interpretation were chosen (one chest radiologist, one pulmonary fellow, two internal medicine residents). Readers identified the point of nadir airway lumen, measured 1.5 cm above and below that point, then manually segmented visible tracheal lumen area on the soft tissue window of each axial CT slice within that 3 cm length. Missing ROI's were then generated in-between manual segmented areas. The Repulsor function was used to manually adjust the boundaries of the ROI to achieve fit. Intraclass correlation (ICC) was used to calculate the inter-rater reliability of the tracheal lumen volume of between readers. Other data collection variables included the type of CT scan, axial slice interval, the suspected underlying cause of CAS, and average stenotic volume. RESULT(S): Fifty CT scans from 38 individual patients identified in the registry from 2011-2021 were randomly chosen for inclusion. Most (22 of 38, 57.9%) had iatrogenic BCAS (either post-intubation or post-tracheostomy) and 10 (26.3%) had idiopathic subglottic stenosis. Half of the scans (n=25, 50%) were contrasted neck CT and half were non contrasted chest CTs. Scan slice thickness ranged 1 to 5 mm, median 2 mm (1.25-2.875). The median stenotic volume across all readers was 3.375 cm3 (2.52-4.51). The average ICC across all four readers was 0.969 (95% CI 0.944 - 0.982). CONCLUSION(S): Our proposed volume rendering and segmentation approach to BCAS proves to have substantial precision and agreement amongst readers of different skill levels. CLINICAL IMPLICATIONS: A NOVEL METHOD TO ASSESS SEVERITY OF BENIGN CENTRAL AIRWAY STENOSIS DISCLOSURES: No relevant relationships by Leah Brown No relevant relationships by Alexander Gelbard no disclosure on file for Robert Lentz;PI ofan investigator-initiated study relationship with Medtronic Please note: >$100000 by Fabien Maldonado, value=Grant/Research Support PI on investigator-initiated relationship with Erbe Please note: $5001 - $20000 by Fabien Maldonado, value=Grant/Research Support Consulting relationship with Medtronic Please note: $5001 - $20000 by Fabien Maldonado, value=Honoraria co-I industry-sponsored trial relationship with Lung Therapeutics Please note: $5001 - $20000 by Fabien Maldonado, value=Grant/Research Support Board of director member relationship with AABIP Please note: $1-$1000 by Fabien Maldonado, value=Travel No relevant relationships by Khushbu Patel No relevant relationships by Ankush Ratwani Consultant relationship with Medtronic/Covidien Please note: $1001 - $5000 by Otis Rickman, value=Consulting fee No relevant relationships by Evan Schwartz Copyright © 2022 American College of Chest Physicians

6.
Chest ; 162(4):A604, 2022.
Article in English | EMBASE | ID: covidwho-2060645

ABSTRACT

SESSION TITLE: COVID-19 Co-Infections SESSION TYPE: Rapid Fire Case Reports PRESENTED ON: 10/19/2022 12:45 pm - 1:45 pm INTRODUCTION: SARS-CoV-2 has been associated with co-infecting pathogens, such as bacteria, viruses, and fungi. Little has been reported about community acquired atypical bacterial co-infections with SARS-CoV-2. We present a case of a patient with recent COVID-19 pneumonia and diagnosis of Legionella and Mycoplasma pneumonia, in addition of E. coli and C. perfringens bacteremia, that emphasizes SARS-CoV-2 impact in human immunity and the need to consider community acquired infections. CASE PRESENTATION: A 64-year-old male with history of hypertension, alcohol use disorder, iron deficiency anemia, and recent COVID-19 pneumonia presented to the ED with shortness of breath, dark urine, and increased confusion. The patient was admitted to the hospital a week prior with COVID-19 pneumonia and acute kidney injury. He received dexamethasone, remdesivir, and IV fluids. After 8 days, he was discharged home. Upon evaluation, he was afebrile and normotensive, but tachycardic, 129/min, on 4 L of nasal cannula sating 100%. On exam, the patient was oriented only to person and had decreased breath sounds bilaterally. Labs revealed an elevated WBC, 15.3 K/mcL, with left shift, low Hgb, 7.8 g/dL, with low MCV, 61 fL, increased BUN/Cr, 56 mg/dL and 2.8 mg/dL, and an abnormal hepatic panel, AST 121 U/L, ALT 45 U/L, alkaline phosphatase 153 U/L. Ammonia, GGT, CPK and lactic acid were within normal range;but the D-dimer and procalcitonin were elevated, 4618 ng/mL and 25.12 ng/mL, respectively. A urinalysis showed gross pyuria, positive leukocyte esterase and mild proteinuria. CT head showed no acute abnormalities, but the chest X-Ray revealed a hazy opacity in the left mid and lower lung, followed by a CT chest that demonstrated peripheral and lower lobe ground glass opacities and a CT abdomen that showed right sided perinephric and periureteral stranding. Given increased risk for thromboembolism, a VQ scan was done being negative for pulmonary embolism. The patient was admitted with acute metabolic encephalopathy, acute kidney injury, transaminitis, pyelonephritis and concern for hospital acquired pneumonia. Vancomycin, cefepime and metronidazole were ordered. HIV screen was negative. COVID-19 PCR, Legionella urine antigen and Mycoplasma IgG and IgM serologies were positive. Blood cultures grew E. coli and C. perfringens. Infectious Disease and Gastroenterology were consulted. The patient was started on azithromycin and a colonoscopy was done showing only diverticulosis. After an extended hospital course, the patient was cleared for discharge, without oxygen needs, to a nursing home with appropriate follow up. DISCUSSION: Co-infection with bacteria causing atypical pneumonia and bacteremia should be considered in patients with recent or current SARS-CoV-2. CONCLUSIONS: Prompt identification of co-existing pathogens can promote a safe and evidence-based approach to the treatment of patients with SARS-CoV-2. Reference #1: Alhuofie S. (2021). An Elderly COVID-19 Patient with Community-Acquired Legionella and Mycoplasma Coinfections: A Rare Case Report. Healthcare (Basel, Switzerland), 9(11), 1598. https://doi.org/10.3390/healthcare9111598 Reference #2: Hoque, M. N., Akter, S., Mishu, I. D., Islam, M. R., Rahman, M. S., Akhter, M., Islam, I., Hasan, M. M., Rahaman, M. M., Sultana, M., Islam, T., & Hossain, M. A. (2021). Microbial co-infections in COVID-19: Associated microbiota and underlying mechanisms of pathogenesis. Microbial pathogenesis, 156, 104941. https://doi.org/10.1016/j.micpath.2021.104941 Reference #3: Zhu, X., Ge, Y., Wu, T., Zhao, K., Chen, Y., Wu, B., Zhu, F., Zhu, B., & Cui, L. (2020). Co-infection with respiratory pathogens among COVID-2019 cases. Virus research, 285, 198005. https://doi.org/10.1016/j.virusres.2020.198005 DISCLOSURES: No relevant relationships by Albert Chang No relevant relationships by Eric Chang No relevant relationships by KOMAL KAUR No relevant relationships by Katiria Pintor Jime ez

7.
Embase; 2021.
Preprint in English | EMBASE | ID: ppcovidwho-344416

ABSTRACT

Genome sequences from evolving infectious pathogens allow quantification of case introductions and local transmission dynamics. We sequenced 11,357 SARS-CoV-2 genomes from Switzerland in 2020 - the 6th largest effort globally. Using a representative subset of these data, we estimated viral introductions to Switzerland and their persistence over the course of 2020. We contrast these estimates with simple null models representing the absence of certain public health measures. We show that Switzerland's border closures de-coupled case introductions from incidence in neighboring countries. Under a simple model, we estimate an 86 - 98% reduction in introductions during Switzerland's strictest border closures. Furthermore, the Swiss 2020 partial lockdown roughly halved the time for sampled introductions to die out. Finally, we quantified local transmission dynamics once introductions into Switzerland occurred, using a novel phylodynamic model. We find that transmission slowed 35 - 63% upon outbreak detection in summer 2020, but not in fall. This finding may indicate successful contact tracing over summer before overburdening in fall. The study highlights the added value of genome sequencing data for understanding transmission dynamics. Copyright The copyright holder for this preprint is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. It is made available under a CC-BY-NC-ND 4.0 International license.

8.
Swiss Medical Weekly ; 152(Supplement 259):61S-62S, 2022.
Article in English | EMBASE | ID: covidwho-2058309

ABSTRACT

Introduction The zoonotic infection with Brucella melitensis can be acquired by inges-tion of unpasteurized goat's or sheep's milk. The infection is common in Eastern Mediterranean countries (EMC), but rare in western Europe (6 cases in Switzerland, 2021). When evaluating patients with symptoms of septic arthritis, brucellosis is not the foremost differential diagnosis. How-ever, with the increasing population of people from EMC in western Eu-rope, the incidence may be rising. We present a patient who was initially suspected to suffer from Long-COVID-Syndrome (LCS), which underscores the relevance of this case in a pandemic situation. Methods/Results A 58-year-old male patient was admitted to the emergency department with a painful right knee effusion after a minor trauma. Additionally, he suffered from fatigue, subfebrile temperatures, back pain and myalgias for more than two months. He was suspected to suffer from LCS after a mild COVID-19 three months earlier. The culture of the arthrocentesis (14.400 cells/mul with 61% polynuclear cells) unexpectedly turned positive for B. melitensis. The patient declared that he had been drinking three liters of unpasteurized goat's milk to cure the presumptive LCS. To ensure staff safety, arthroscopic lavage was postponed until brucella-active antibiotics had been administered for at least 24 hours. Surgery was performed under strict infection control measures to avoid generating aerosols. According to Duke, one major (continuous bacteremia over 14 days) and 2 minor criteria (fever, most probably septic embolic gonarthritis) were fulfilled. Therefore, possible endocarditis had to be assumed although transesophageal echocardiography was normal. Antibiotic treatment was escalated to a quadruple regimen (intravenous gentamicin for three weeks;as well as oral doxycycline, trimethoprim/sulfomethoxazole and rifampin for at least 3 months). The clinical recovery - still under treatment - is protracted with slowly improving knee pain and normalizing signs of inflammation. Conclusion Although B. melitensis is a rare pathogen in Switzerland, orthopedic sur-geons, rheumatologists and infectious disease specialists need to be aware of diseases with low incidence and non-specific symptoms espe-cially in times of a global pandemia. A high index of suspicion is needed in patients related to EMC. When brucellosis is confirmed, strict infection control measures to protect staff involved in aerosol generating proce-dures must be adopted.

9.
Drug Safety ; 45(10):1186-1187, 2022.
Article in English | ProQuest Central | ID: covidwho-2046674

ABSTRACT

Introduction: During the Covid-19 vaccination campaign, Swissmedic received approximately 50% of the spontaneous reports from health care professionals (HCP) and 50% directly from patients/consumers. The rate of adverse drug reactions (ADRs) following Covid-19 vaccination categorized as "serious" by the reporters is approximately 35% in Switzerland and thus significantly higher than e.g. in the US (6.6%), while rates of reports with fatal outcome are comparable (1.4% vs. 1.3%) (1). A high proportion of the cases labelled as "serious" in Switzerland was classified based on the category "medically important". Since this criterion is used very commonly but is less distinct than the other seriousness criteria, we aimed to analyze whether it is used correctly by the reporters and whether differences between healthcare professionals and patients/consumer can be identified. Objective: To evaluate the appropriate usage of the seriousness criterion "medically important" in spontaneous ADR reports submitted by health care professionals compared to non-health care professionals following immunization with a Covid-19 vaccine. Methods: All serious ADR reports received between the 1st of January 2021 and 31st of December 2021 following immunization with a Covid-19 vaccine were extracted from the Swiss database. Cases categorized as "medically important" were further analyzed. We extracted the preferred terms (PT) according to the medical dictionary for regulatory activities (MedDRA) (2) of the reported ADRs and matched them with the important medical event terms list (IME list) (3). Results: From a total of 11,115 ADR reports, 4,125 (37.1%) were classified as "serious". 2,773 (67.2%) of the serious cases were reported by HCPs and 1,352 (32.8%) by non-HCPs. In 2,260 (55%) reports, the seriousness was based solely on the criterion "medically important". 755 (33.4%) of these reports would also be classified as "serious" according to the IME List. 498 (39%) reports by HCP and 257 (26%) by non-HCP match with the IME list. The proportion of correctly categorized ADRs is significantly higher (p < 0.0001) in reports from HCPs compared to non-HCPs. Conclusion: Only approximately one third of the cases, which were classified as "medically important" and thus reported as "serious", would also be classified as such according to the IME list. The proportion of correctly categorized ADRs is significantly higher in reports from HCPs. Additional information and training for HCPs appears necessary to achieve a higher rate of appropriate seriousness categorization in ADR reports. The usage of the category "medically important" in reports by patients/consumers requires general revision.

10.
Drug Safety ; 45(10):1233, 2022.
Article in English | ProQuest Central | ID: covidwho-2046319

ABSTRACT

Introduction: The post-marketing surveillance of COVID-19 mRNA vaccines revealed that ürticarial reactions coüld occür with a delayed time course following both primary vaccinations [1-4] and the booster vaccinations [5,6]. While delayed urticarial reactions following COVID-19 primary vaccinations resolve in general with a median of 2-4 days, delayed urticaria after booster vaccination can show a prolonged and intermittent clinical course requiring treatment for several weeks [5,6]. Shortly after the booster vaccination campaign began in Switzerland in December 2021, an increasing number of delayed urticarial reactions in association with Spikevax® was reported to Swissmedic, whereby a safety signal was opened. Objective: To characterize cases of delayed urticarial reactions reported in Switzerland following booster vaccination with Spikevax®. Methods: Case-by-case assessment of spontaneously reported delayed urticarial reactions following booster vaccination with Spikevax® recorded in the Swiss national pharmacovigilance database up to February 8th, 2022. Results: There were 107 cases of delayed urticaria following booster vaccination with Spikevax®. Of these, 79 (73.8%) were reported by consumers/non-health professionals. Women were more frequently affected (55, 51.4%) and median age was 38 years (interquartile range, IQR, 34-44 years). Urticaria developed a median of 10 days after booster vaccination (IQR 9-11.5 days). In 55 (51.4%) cases, urticaria was the solely reported adverse event, whilst 52 (48.6%) cases reported urticaria with additional adverse events, including pruritus (n = 27) and angioedema (n = 7). In 81 (75.7%) cases, delayed urticaria had not serious consequences (i.e. did not require/ prolonged hospitalisation, was not disabling/incapacitating, did not determine other clinically relevant conditions). In 69 (64.5%) cases the outcome of urticaria was not recovered at the time of reporting, which occurred a median of 14 days after booster administration (IQR 6-21 days). Conclusion: To our knowledge, this is the first case series to date of delayed urticaria following booster vaccination with Spikevax®, showing that these reactions were more frequently not self-limiting and with a prolonged course in contrast to delayed urticaria developed after COVID-19 mRNA primary vaccinations. Although these reactions should not discourage from subsequent COVID-19 mRNA vaccinations, further investigations with regard to additional booster vaccinations seem necessary.

11.
Drug Safety ; 45(10):1233-1234, 2022.
Article in English | ProQuest Central | ID: covidwho-2046318

ABSTRACT

Introduction: Initial knowledge on the COVID-19 vaccines' safety from randomised clinical trials was limited and concerned mostly common adverse events related to vaccine immunogenicity occurring rapidly after vaccination [1,2]. Since these vaccines have been approved and used in large scale, the Swiss Agency for Therapeutic Products Swissmedic has been conducting an intensive surveillance activity on their safety, based on the collection and analysis of spontaneous reports from healthcare professionals and patients. Objective: Signal detection in spontaneous reports associated with COVID-19 vaccines first relies on a case-by-case analysis by clinically qualified assessors who take into account detailed information provided by reporters. However, with the number of reports increasing, the clinical review could benefit from the use of statistical methods for signal detection, such as disproportionality analysis [3]. Methods: In light of this, the Institute of Pharmacological Sciences of Southern Switzerland, in close collaboration with Swissmedic, set up and routinely perform a signal detection activity by disproportionality analysis in VigiBase, the global database of the World Health Organization (WHO) Programme for International Drug Monitoring, using spontaneous reports originating from Switzerland and concerning adverse events following immunization (AEFIs) associated with the Moderna (Spikevax) and Pfizer/BioNTech (Comirnaty) COVID-19 vaccines. These included the measurement of the reporting odds ratios (RORs) for COVID-19 vaccine/AEFI combinations meeting two predefined statistical signal detection criteria, namely a minimum of 5 reports concerning a COVID-19 vaccine/AEFI combination and a ROR lower limit of the 95% confidence interval[1. Excluding AEFIs either already labelled in the Swiss information for healthcare professionals, or already debated internationally, a panel of pharmacovigilance and clinical pharmacology experts are examining and discussing findings on novel and unexpected COVID-19 vaccine/AEFI combinations, in order to promptly detect potential safety signals that could warrant further investigation. Results: Since the start of the signal detection activity in August 2021, an early signal of disproportionate reporting in VigiBase for paraesthesia with the Moderna (Spikevax) vaccine was detected in Switzerland. This occurred a few months before the same signal was assessed and validated by the European Medicines Agency, which ultimately added paraesthesia to the European summary of product characteristics for the Moderna (Spikevax) vaccine [4]. Conclusion: Disproportionality analysis has some limitations such as lack of information about incidence rate of the adverse event in the population, and the existence of reporting biases. Nevertheless, continued research on newly identified safety signals can provide valuable information to support public health, guide regulatory decisions and design specific follow-up confirmatory studies.

12.
Annals of Oncology ; 33:S1427-S1428, 2022.
Article in English | EMBASE | ID: covidwho-2041570

ABSTRACT

Background: AAP or ENZ added to ADT improves outcomes for mHSPC. Any benefit of combining ENZ & AAP in this disease setting is uncertain. Methods: STAMPEDE is a multi-arm, multi-stage (MAMS), platform protocol conducted at 117 sites in the UK & Switzerland. 2 trials with no overlapping controls randomised mHSPC patients (pts) 1:1 to ADT +/- AAP (1000mg od AA + 5mg od P) or AAP + ENZ (160mg od). Treatment was continued to progression. From Jan 2016 docetaxel 75mg/m2 3-weekly with P 10mg od was permitted + ADT. Using meta-analysis methods, we tested for evidence of a difference in OS and secondary outcomes (as described previously: failure-free, metastatic progression-free, progression-free & prostate cancer specific survival) across the 2 trials using data frozen 3 Jul 2022. All confidence intervals (CI) 95%. Restricted mean survival times (RMST) restricted to 84 months (m). Results: Between Nov 2011 & Jan 2014, 1003 pts were randomised ADT +/- AAP & between Jul 2014 & Mar 2016, 916 pts were randomised ADT +/- AAP + ENZ. Randomised groups were well balanced across both trials. Pt cohort: age, median 68 years (yr), IQR 63, 72;PSA prior to ADT, median 95.7 ng/ml, IQR 26.5, 346;de novo 94%, relapsed after radical treatment, 6%. In AAP + ENZ trial, 9% had docetaxel + ADT. OS benefit in AAP + ENZ trial, HR 0.65 (CI 0.55‒0.77) p = 1.4×10-6;in AAP trial, HR 0.62 (0.53, 0.73) p = 1.6×10-9. No evidence of a difference in treatment effect (interaction HR 1.05 CI 0.83‒1.32, p = 0.71) or between-trial heterogeneity (I2 p = 0.70). Same for secondary end-points. % (CI) of pts reporting grade 3-5 toxicity in 1st 5 yr: AAP trial, ADT: 38.5 (34.2-42.8), + AAP: 54.4 (50.0-58.8);AAP + ENZ trial, ADT: 45.2 (40.6 – 49.8), + AAP + ENZ: 67.9 (63.5 – 72.2);most frequently increased with AAP or AAP + ENZ = liver derangement, hypertension. At 7 yr in AAP trial (median follow-up: 95.8m), % (CI) pts alive with ADT: 30 (26, 34) versus with ADT + AAP: 48 (43, 52);RMST: ADT: 50.4m, ADT + AAP: 60.6m, p = 6.6 x 10-9. Conclusions: ENZ + AAP need not be combined for mHSPC. Clinically important improvements in OS when adding AAP to ADT are maintained at 7 yr. Clinical trial identification: NCT00268476. Legal entity responsible for the study: Medical Research Council Clinical Trials Unit at University College London. Funding: Cancer Research UK, Medical Research Council, Janssen, Astellas. Disclosure: G. Attard: Financial Interests, Personal, Invited Speaker: Janssen, Astellas, AstraZeneca;Financial Interests, Personal, Advisory Board: Janssen, Astellas, Novartis, Bayer, AstraZeneca, Pfizer, Sanofi, Sapience, Orion;Financial Interests, Personal, Royalties, Included in list of rewards to discoverers of abiraterone: Institute of Cancer Research;Financial Interests, Institutional, Research Grant: Janssen, Astellas;Non-Financial Interests, Principal Investigator: Janssen, Astellas;Non-Financial Interests, Advisory Role: Janssen, AstraZeneca. W.R. Cross: Financial Interests, Personal, Invited Speaker, Speaker fee: Myriad Genetics, Janssen, Astellas;Financial Interests, Personal, Advisory Board, Advisory Board fee: Bayer;Financial Interests, Institutional, Research Grant, Research grant: Myriad Genetics. S. Gillessen: Financial Interests, Personal, Advisory Board, 2018: Sanofi, Roche;Financial Interests, Personal, Advisory Board, 2018, 2019: Orion;Financial Interests, Personal, Invited Speaker, 2019 Speaker's Bureau: Janssen Cilag;Financial Interests, Personal, Advisory Board, 2020: Amgen;Financial Interests, Personal, Invited Speaker, 2020: ESMO;Financial Interests, Personal, Other, Travel Grant 2020: ProteoMEdiX;Financial Interests, Institutional, Advisory Board, 2018, 2019, 2022: Bayer;Financial Interests, Institutional, Advisory Board, 2020: Janssen Cilag, Roche, MSD Merck Sharp & Dohme, Pfizer;Financial Interests, Institutional, Advisory Board, 2018: AAA International, Menarini Silicon Biosystems;Financial Interests, Institutional, Advisory Board, 2019, 2020: Astellas Pharma;Financial Interests, Institutional, Advisory B ard, 2019: Tolero Pharmaceuticals;Financial Interests, Personal, Invited Speaker, 2021, 2022: SAKK, DESO;Financial Interests, Institutional, Advisory Board, 2021: Telixpharma, BMS, AAA International, Novartis, Modra Pharmaceuticas Holding B.V.;Financial Interests, Institutional, Other, Steering Committee 2021: Amgen;Financial Interests, Institutional, Advisory Board, 2021, 2022: Orion, Bayer;Financial Interests, Personal, Invited Speaker, 2021: SAKK, SAKK, SAMO - IBCSG (Swiss Academy of Multidisciplinary oncology);Financial Interests, Personal, Advisory Board, 2021: MSD Merck Sharp & Dhome;Financial Interests, Personal, 2021: RSI (Televisione Svizzera Italiana);Financial Interests, Institutional, Invited Speaker, 2021: Silvio Grasso Consulting;Financial Interests, Institutional, Other, Faculty activity 2022: WebMD-Medscape;Financial Interests, Institutional, Advisory Board, 2022: Myriad genetics, AstraZeneca;Financial Interests, Institutional, Invited Speaker, 2022: TOLREMO;Financial Interests, Personal, Other, Travel support 2022: AstraZeneca;Financial Interests, Institutional, Funding, 2021, Unrestricted grant for a Covid related study as co-investigator: Astellas;Non-Financial Interests, Advisory Role, 2019: Menarini Silicon Biosystems, Aranda;Non-Financial Interests, Advisory Role, Continuing: ProteoMediX. C. Pezaro: Financial Interests, Personal, Advisory Board, Ad board Dec 2020: Advanced Accelerator Applications;Financial Interests, Personal, Advisory Board, Aug 2021: Astellas;Financial Interests, Personal, Advisory Board, Oct 2021: Bayer;Financial Interests, Personal, Invited Speaker, Sept-Oct 2020: AstraZeneca;Financial Interests, Personal, Invited Speaker, Oct 2020: Janssen;Financial Interests, Personal, Advisory Board, July-Sept 2022: Pfizer. Z. Malik: Financial Interests, Personal, Advisory Board, advisry board for new hormonal therapy for breast cancer: sanofi;Financial Interests, Institutional, Invited Speaker, research grant for CHROME study: sanofi;Other, Other, support to attend meetings or advisory boards in the past: Astellas,Jaansen,Bayer;Other, Other, Sponsorship to attend ASCO meeting 2022: Bayer. M.R. Sydes: Financial Interests, Personal, Invited Speaker, Speaker fees at clinical trial statistics training sessions for clinicians (no discussion of particular drugs): Janssen;Financial Interests, Personal, Invited Speaker, Speaker fees at clinical trial statistics training session for clinicians (no discussion of particular drugs): Eli Lilly;Financial Interests, Institutional, Research Grant, Educational grant and drug for STAMPEDE trial: Astellas, Janssen, Novartis, Pfizer, Sanofi;Financial Interests, Institutional, Research Grant, Educational grant and biomarker costs for STAMPEDE trial: Clovis Oncology. L.C. brown: Financial Interests, Institutional, Research Grant, £170k educational grant for the FOCUS4-C Trial from June 2017 to Dec 2021: AstraZeneca;Financial Interests, Institutional, Funding, Various grants awarded to my institution for work undertaken as part of the STAMPEDE Trial: janssen pharmaceuticals;Non-Financial Interests, Other, I am a member of the CRUK CERP funding advisory panel and my Institution also receive grant funding from CRUK for the STAMPEDE and FOCUS4 trials: Cancer Research UK. M.K. Parmar: Financial Interests, Institutional, Full or part-time Employment, Director at MRC Clinical Trials Unit at UCL: Medical Research Council Clinical Trials Unit at UCL;Financial Interests, Institutional, Research Grant: AstraZeneca, Astellas, Janssen, Clovis;Non-Financial Interests, Advisory Role, Euro Ewing Consortium: University College London;Non-Financial Interests, Advisory Role, rEECur: University of Birmingham;Non-Financial Interests, Advisory Role, CompARE Trial: University of Birmingham. N.D. James: Financial Interests, Personal, Advisory Board, Advice around PARP inhibitors: AstraZeneca;Financial Interests, Personal, Advisory Board, Prostate cancer therapies: Janssen, Clovis, Novartis;Financial Interests, Institutional, Expert Testimony, Assisted with submissions regarding licencing for abiraterone: Janssen;Financial Interests, Personal, Advisory Board, Docetaxel: Sanofi;Financial Interests, Institutional, Expert Testimony, Providing STAMPEDE trial data to facilitate licence extensions internationally for docetaxel: Sanofi;Financial Interests, Personal, Advisory Board, Bladder cancer therapy: Merck;Financial Interests, Personal, Advisory Board, Advice around novel hormone therapies for prostate cancer: Bayer;Financial Interests, Personal, Invited Speaker, Lecture tour in Brazil August 2022 - speaking on therapy for advanced prostate cancer: Merck Sharp & Dohme (UK) Limited;Financial Interests, Institutional, Invited Speaker, Funding for STAMPEDE trial: Janssen, Astellas;Financial Interests, Institutional, Invited Speaker, Funding for RADIO trial bladder cancer: AstraZeneca. All other authors have declared no conflicts of interest.

13.
Annals of Oncology ; 33:S1261, 2022.
Article in English | EMBASE | ID: covidwho-2041557

ABSTRACT

Background: Exercise is a promising strategy to improve fatigue and quality of life in patients with metastatic breast cancer (MBC). However, little is known about patients’ barriers, facilitators, and preferences for supervised exercise programs. An in-depth understanding of the patients’ perspective could help to define the role of exercise professionals in this regard and support the development and implementation of successful exercise interventions. Methods: Eleven online focus groups were held, including a total of 44 participants from four European countries (DE, ESP, PL, SE). In semi-structured group sessions, patients were encouraged to discuss their reasons to participate in supervised exercise programs, experienced barriers and exercise preferences. Interviews were transcribed verbatim, translated into English, and coded based on a preliminary coding framework, supplemented by themes that emerged during the sessions. Results: Participants expressed positive attitudes towards exercise. Facilitating factors for participation in supervised programs included the benefits of social contact, professional guidance, and the experience of physical and psychological benefits. The main barriers cited were practical issues, physical limitations due to cancer and its treatment, and safety concerns due to Covid-19. Participants did not have a clear, shared preference regarding exercise type or setting, but would appreciate mixed exercises (i.e., aerobic, strength, and mind-body exercises) in flexible training modules. Individualized training programs and feedback from exercise professionals were strongly desired. Conclusions: While there was common ground regarding several barriers and facilitators, patients expressed mixed preferences for exercise programs. This related to benefits of social interaction in group exercise on the one hand, and the need for individualized tailoring to deal with physical restrictions on the other hand. Exercise professionals can play an important role in supporting exercise for MBC patients by identifying individual needs and providing training programs that are adjusted to patients' abilities and preferences. Legal entity responsible for the study: Netherlands Cancer Institute / Antoni van Leeuwenhoek Hospital. Funding: European Commission Research & Innovation Horizon 2020. Disclosure: A.M. May: Financial Interests, Institutional, Advisory Role, Paid to institution: COMPASS. K. Steindorf: Financial Interests, Personal, Expert Testimony, < €5,000: Institut National contre le cancer (INCA), Paris, France;Financial Interests, Personal, Expert Testimony, Member of Data Monitoring Board;< €1,000: Swiss Group for Clinical Research (SAAK), Switzerland;Financial Interests, Personal, Invited Speaker, < €1,000: Adviva, Heidelberg, Germany, Pierre Fabre, Freiburg, Germany, Takeda, Breast Cancer Care Center, Unna, Germany, Audi Health Care Insurance, Ingolstadt, Germany, University of Mainz, Germany;Financial Interests, Personal, Invited Speaker, Lecturer fee in Master Course, < €2,000: University of Heidelberg, Germany;Financial Interests, Personal, Expert Testimony, compensation of travel costs, no further fees: German Research Foundation (DFG), Bonn, Germany;Financial Interests, Personal, Expert Testimony, < €1,000: University of Vienna, Vienna, Austria. All other authors have declared no conflicts of interest.

14.
Revista de Management Comparat International ; 23(3):454-474, 2022.
Article in English | ProQuest Central | ID: covidwho-2040617

ABSTRACT

Purpose: The Egyptian banking sector adopts an expansion strategy in the field of digital transformation to face the competition resulting from the entry of ICT companies, the repercussions of the Corona virus and the spread of financial technology companies in the banking services market. This trend offers multiple benefits to banks and customers, including ease of conducting transactions, reducing operating expenses, and meeting the needs of customers who prefer banking transactions via the Internet and smart phones, On the other hand, it introduces wide changes to the size and quality of banking jobs in the future, and threatens the disappearance of some of them ,therefore this study analyses empirical evidence of the impact of the digital transformation on staffing strategy in the Egyptian banking sector. Design/Methodology/Approach: This study depends on the analysis of secondary data obtained from the reports of the Central Bank of Egypt on the indicators of digital transformation and the number and quality of banking staffs during the period from 20162021, using the analysis of correlation and regression coefficients. Findings: The results of the study indicate that there is no negative impact of digital transformation on new staffing operations in the short term, because the rate of bank penetration into the banking services market is still low and therefore Egyptian banks are expanding their traditional branch network alongside digital banking services channels. This transformation has also created a new type of job that keeps pace with banking digitalization, while in the long term digital transformation threatens the disappearance of some jobs to be replaced by artificial intelligence, internet banking, mobile banking and electronic wallets. Originality/Value: The novelty of this study is to examine the relationship between digital transformation indictors and the size and quality of staffing in the Egyptian banking sector. Practical Implications: The importance of this study is to provide recommendations to the HR management in Egyptian banks to deal proactively to deal with the potential impacts of digital transformation in the banking sector. Limitations/implications: There are limitations to the results of this study represented in the insufficiency of the study period, and there are many factors affecting the size and quality of employees in the banking sector other than digital transformation. In addition, the study relied on the method of quantitative analysis of the study variables. Hence further studies can be carried out with different methodologies such as surveys, case studies and qualitative analysis methods

15.
Montenegrin Journal of Economics ; 18(4):61-70, 2022.
Article in English | ProQuest Central | ID: covidwho-2040445

ABSTRACT

This paper aims to assess the European tax havens in terms of corporate financial misconduct risks. The study relies on an index method developed by a group of economists belonging to the international non-governmental organization - the Tax Justice Network. The method allowed the authors to calculate the Corporate Tax Harbor Index (CTHI) and determine the role of a particular jurisdiction in global corporate financial misconduct risks. The study established a ranking of European tax havens and jurisdictions with features of tax havens and classified these tax havens based on corporate financial misconduct risks. The study found that European tax havens and tax haven jurisdictions accounted for nearly 40% of global corporate financial misuse risks in 2020. The classification of European tax havens according to corporate financial misconduct risks demonstrated that the Netherlands, Switzerland, the UK, Ireland, and Luxembourg accounted for more than half of the risks. The shares of Liechtenstein (1%), Monaco (1%), Andorra, and San Marino (less than 1%) did not exceed 3% of the European share of the global risk. The results show the need for adjustments to the regulatory policy of international organizations currently focused on fighting classic tax havens. Their real share of global misuse risks is very small compared to the share of 'gray cardinals' of the offshore market.

16.
PLoS Global Public Health ; 2(8), 2022.
Article in English | CAB Abstracts | ID: covidwho-2039235

ABSTRACT

Background: After 18 months of responding to the COVID-19 pandemic, there is still no agreement on the optimal combination of mitigation strategies. The efficacy and collateral damage of pandemic policies are dependent on constantly evolving viral epidemiology as well as the volatile distribution of socioeconomic and cultural factors. This study proposes a data-driven approach to quantify the efficacy of the type, duration, and stringency of COVID-19 mitigation policies in terms of transmission control and economic loss, personalised to individual countries.

17.
BMC Complement Med Ther ; 22(1): 240, 2022 Sep 15.
Article in English | MEDLINE | ID: covidwho-2029706

ABSTRACT

BACKGROUND: To curb the spread of the first wave of the COVID-19 pandemic, the Swiss government declared a state of health emergency and ordered a legal restriction concerning the opening of healthcare institutions. In this study, we aimed to assess the proportion of traditional Chinese medicine (TCM) physicians and therapists who consulted patients regarding COVID-19 during the first wave of the pandemic in 2020 in Switzerland, as well as the extent to which COVID-19 affected their practices during the same period. METHODS: A retrospective study was performed by using a questionnaire from January to April 2021 among a random sample of TCM physicians and therapists based in Switzerland. The survey included questions on demographic characteristics, opening status of practices, channels of communication used for the medical encounter, and experience in managing the prevention, acute, and recovery stages of COVID-19 infection. RESULTS: Among the 320 participants, 76% consulted a patient regarding COVID-19 at least once. Overall, physicians and therapists consulted more patients during recovery (76.3%) and prevention (67.8%) than during the acute stage (19.8%) of the disease. Acupuncture was the most frequently used technique among TCM therapists and physicians consulting for prevention (80.4%) and recovery (92.5%), whereas Chinese pharmacopeia was the most used technique among those consulting for the acute stage (59.3%). Of those who closed their practices from March to April 2020 but kept consulting, telephone (30.4%) and home visits (29.9%) were the two principal methods of consultation. CONCLUSIONS: The restriction concerning the opening of practices induced a loss of the health workforce, especially among TCM therapists. Nonetheless, TCM therapists and physicians consulted patients regarding COVID-19, especially during the recovery stage. As there is a demand for the use of TCM in the context of COVID-19, it raises the need for a better consideration of TCM in the Swiss health care system.


Subject(s)
COVID-19 , Medicine, Chinese Traditional , Humans , Pandemics , Retrospective Studies , Switzerland
18.
Int J Health Policy Manag ; 2022 Sep 13.
Article in English | MEDLINE | ID: covidwho-2026624

ABSTRACT

BACKGROUND: The severe acute respiratory syndrome coronavirus 2 (SARS­CoV­2) pandemic forced hospitals to redistribute resources for the treatment of patients with coronavirus disease 2019 (COVID-19), yet the impact on elective and emergency inpatient procedure volumes is unclear. METHODS: We analyzed anonymized data on 234 921 hospitalizations in 2017-2020 (55.9% elective) from a big Swiss health insurer. We used linear regression models to predict, based on pre-pandemic data, the expected weekly numbers of procedures in 2020 in the absence of a pandemic and compared these to the observed numbers in 2020. Compensation effects were investigated by discretely integrating the difference between the two numbers over time. RESULTS: During the first COVID-19 wave in spring 2020, elective procedure numbers decreased by 52.9% (95% confidence interval -64.5% to -42.5%), with cardiovascular and orthopedic elective procedure numbers specifically decreasing by 45.5% and 72.4%. Elective procedure numbers normalized during summer with some compensation of postponed procedures, leaving a deficit of -9.9% (-15.8% to -4.5%) for the whole year 2020. Emergency procedure numbers also decreased by 17.1% (-23.7% to -9.8%) during the first wave, but over the whole year 2020, net emergency procedure volumes were similar to control years. CONCLUSION: Inpatient procedure volumes in Switzerland decreased considerably in the beginning of the pandemic but recovered quickly after the first wave. Still, there was a net deficit in procedures at the end of the year. Health system leaders must work to ensure that adequate access to non-COVID-19 related care is maintained during future pandemic phases in order to prevent negative health consequences.

19.
Int J Public Health ; 67: 1604226, 2022.
Article in English | MEDLINE | ID: covidwho-2023032

ABSTRACT

Objectives: This study examined factors associated with COVID-19 vaccination intention at the very beginning of the vaccination campaign in a representative sample of the population in southern Switzerland. Methods: In March 2021, we measured vaccination intention, beliefs, attitudes, and trust in a sample of the Corona Immunitas Ticino study. Results: Of the 2681 participants, 1933 completed the questionnaire (response rate = 72%; 55% female; meanage = 41, SD = 24, rangeage = 5-91). Overall, 68% reported an intention to get vaccinated. Vaccination intention was higher in social/healthcare workers, and increased with age, trust in public health institutions, and confidence in the vaccine efficacy. Prior infection of a family member, predilection for waiting for more evidence on the safety and efficacy of the vaccine, and for alternative protective means were negatively associated with intention. Conclusion: In view of needs of COVID-19 vaccine boosters and of suboptimal vaccination coverage, our results have relevant public health implications and suggest that communication about vaccine safety and efficacy, and aims of vaccination programs, should be bi-directional, proportionate, and tailored to the concerns, expectations, and beliefs of different population subgroups.


Subject(s)
COVID-19 Vaccines , COVID-19 , Adolescent , Adult , Aged , Aged, 80 and over , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19 Vaccines/therapeutic use , Child , Child, Preschool , Cross-Sectional Studies , Female , Humans , Intention , Male , Middle Aged , SARS-CoV-2 , Switzerland , Vaccination , Young Adult
20.
Emerg Infect Dis ; 28(10): 2087-2090, 2022 Oct.
Article in English | MEDLINE | ID: covidwho-2022573

ABSTRACT

Of 1,118 patients with COVID-19 at a university hospital in Switzerland during October 2020-June 2021, we found 83 (7.4%) had probable or definite healthcare-associated COVID-19. After in-hospital exposure, we estimated secondary attack rate at 23.3%. Transmission was associated with longer contact times and with lower cycle threshold values among index patients.


Subject(s)
COVID-19 , Cross Infection , COVID-19/epidemiology , Cross Infection/epidemiology , Humans , Incidence , SARS-CoV-2 , Switzerland/epidemiology , Tertiary Care Centers
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