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BackgroundHospital patient registries provide substantial longitudinal data sets describing the clinical and medical health statuses of inpatients and their pharmacological prescriptions. Despite the multiple advantages of routinely collecting multidimensional longitudinal data, those data sets are rarely suitable for advanced statistical analysis and they require customization and synthesis. ObjectiveThe aim of this study was to describe the methods used to transform and synthesize a raw, multidimensional, hospital patient registry data set into an exploitable database for the further investigation of risk profiles and predictive and survival health outcomes among polymorbid, polymedicated, older inpatients in relation to their medicine prescriptions at hospital discharge. MethodsA raw, multidimensional data set from a public hospital was extracted from the hospital registry in a CSV (.csv) file and imported into the R statistical package for cleaning, customization, and synthesis. Patients fulfilling the criteria for inclusion were home-dwelling, polymedicated, older adults with multiple chronic conditions aged ≥65 who became hospitalized. The patient data set covered 140 variables from 20,422 hospitalizations of polymedicated, home-dwelling older adults from 2015 to 2018. Each variable, according to type, was explored and computed to describe distributions, missing values, and associations. Different clustering methods, expert opinion, recoding, and missing-value techniques were used to customize and synthesize these multidimensional data sets. ResultsSociodemographic data showed no missing values. Average age, hospital length of stay, and frequency of hospitalization were computed. Discharge details were recoded and summarized. Clinical data were cleaned up and best practices for managing missing values were applied. Seven clusters of medical diagnoses, surgical interventions, somatic, cognitive, and medicines data were extracted using empirical and statistical best practices, with each presenting the health status of the patients included in it as accurately as possible. Medical, comorbidity, and drug data were recoded and summarized. ConclusionsA cleaner, better-structured data set was obtained, combining empirical and best-practice statistical approaches. The overall strategy delivered an exploitable, population-based database suitable for an advanced analysis of the descriptive, predictive, and survival statistics relating to polymedicated, home-dwelling older adults admitted as inpatients. More research is needed to develop best practices for customizing and synthesizing large, multidimensional, population-based registries. International Registered Report Identifier (IRRID)RR2-10.1136/bmjopen-2019-030030

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Since Voas and Crockett (2005), a consensus has emerged in the sociology of religions on the fact that secularization is largely due to a cohort effect. That is, each birth cohort is less religious than the previous one. We use data from the Swiss Household Panel (SHP), a multi-thematic survey based on a random sample representative of the general population since 1999, to understand what is the cohort effect in Switzerland on three indicators of religiosity: religious affiliation, frequency of religious service attendance, and personal prayer, taking into account the socio-demographic characteristics of individuals, which could interfere with cohort, period, or age effects. A first general observation can be drawn from the SHP: for the three religious indicators, a cohort effect is a key factor in explaining the decline of religiosity. Each birth cohort is less religious on all three indicators, that is, younger individuals are less affiliated, practice less often, and pray less than the older cohort. More subtly, we also observe an effect of age or life cycle, especially on the practice, and a period effect on the religious disaffiliation of individuals. Each birth cohort shows a more religious profile of individuals at the start of the cohort than at the end. There is, therefore, an initial movement of distancing from religion by birth cohorts, but this is further accentuated by a period effect for disaffiliation and sometimes accelerated and, at other times, slightly contained by a life-cycle effect. [ABSTRACT FROM AUTHOR]

This article examines the emergence, in the Swiss context, of a new category of ecologically oriented 'spiritual' activists. The authors look at empirical studies conducted internationally on the link between religion and environmentalism and argue that 'spiritually oriented activists' are rarely investigated in quantitative studies. The authors then examine the ndings of a case study of local milieus in two Swiss cities and nationwide data collected as part of the Swiss Household Panel (SHP). They close the gap between results coming from case studies, on the one hand, and representative studies, on the other, by introducing the variable of spirituality into quantitative research. The results suggest that an ecological milieu is emerging comprised of people who are located politically on the left, do not self-identify as religious, but nonetheless practice meditation and have holistic feelings. The forms of spirituality practiced by these ecologists are 'subtle' in the sense of being adaptable, located in the background, and supportive of sustainability. [ABSTRACT FROM AUTHOR]

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Introduction Optimal medication management is one of the basic conditions necessary for home-dwelling older adults living with multiple chronic conditions (OAMCC) to be able to remain at home and preserve their quality of life. Currently, the reasons for such high numbers of emergency department visits and the very significant rate of hospitalisations for OAMCC, due to medication-related problems (MRPs), is poorly explored. This study aims to reveal the current state of the medication management practices of polymedicated, home-dwelling OAMCC and to make proposals for improving clinical and medication pathways through an innovative and integrated model for supporting medication management and preventing adverse health outcomes. Methods and analysis A mixed-methods study will address the medication management of polymedicated, home-dwelling OAMCC. Its explanatory sequential design will involve two major phases conducted sequentially over time. The quantitative phase will consist of retrospectively exploiting the last 5 years of electronic patient records from a local hospital (N ≈ 50 000) in order to identify the different profiles—made up of patient-related, medication-related and environment-related factors—of the polymedicated, home-dwelling OAMCC at risk of hospitalisation, emergency department visits, hospital readmission (notably for MRPs), institutionalisation or early death. The qualitative study will involve: (a) obtaining and understanding the medication management practices and experiences of the identified profiles extracted from the hospital data of OAMCC who will be interviewed at home (N ≈ 30); (b) collecting and analysing the perspectives of the formal and informal caregivers involved in medication management at home in order to cross-reference perspectives about this important dimension of care at home. Finally, the mixed-methods findings will enable the development of an innovative, integrated model of medication management based on the Agency for Clinical Innovation framework and Bodenheimer and Sinsky’s quadruple aim. Ethics and dissemination Ethical approval has been obtained from the Human Research Ethics Committee of the Canton Vaud (2018-02196). Findings will be disseminated in peer-reviewed journals, professional conferences and other knowledge transfer activities with primary healthcare providers, hospital care units, informal caregivers’ and patients’ associations. [ABSTRACT FROM AUTHOR]

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Collecting data on households and individuals since 1999, the Swiss Household Panel (SHP) is an ongoing, unique, large-­-scale, nationally representative, longitudinal study in Switzerland (N=7,383 households and N=12,119 persons interviewed in 2014). The data of the SHP provide a rich source of information to study social change in Switzerland over a significant period on a wide variety of topics. The SHP aims to provide both continuity and innovation in measurement and data collection, with the combination of retrospective and prospective longitudinal data in the most recent refreshment sample as one notable example of such an innovation. This paper provides an overview of the SHP - focusing on its origin, aims, design, content, data collection and adjustments, possibilities for cross-­-national comparisons, data use and accomplishments. [ABSTRACT FROM AUTHOR]

Copyright of Swiss Journal of Sociology / Schweizerische Zeitschrift für Soziologie is the property of Sciendo and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

In Switzerland, residential independence under the age of 30 usually results in a decrease of the income at disposal. Nevertheless, both, financial management capability and satisfaction with the financial situation remain stable. The latter even increases for those youth coming from low-income households. Following Elder's life course theory (1998), we explain these results in terms of the effects of context, temporality, "linked lives," and individual capacities to apply an order of priorities on economic acts. [ABSTRACT FROM AUTHOR]

Studies of the gender division of housework show that women spend more time on domestic tasks than men, and that the gender gap widens following entry into union and the birth of children. But what happens after a relationship ends? Do women spend less time on housework if they no longer have a man to look after? And are men obliged to devote more time to such tasks? Using individual data from eleven successive waves of the Swiss Household Panel, Boris WERNLI and Caroline HENCHOZ analyse changes in the amount of time devoted to basic household tasks (washing, cooking, cleaning) by men and women in the year following the end of a conjugal relationship. For comparable characteristics, women whose partnership has ended spend less time on housework, refl ecting a certain reversibility of the effect of union formation. By contrast, union dissolution does not have such a clear impact on men's investment in housework, which increases only for the pivot generations (persons born between 1935 and 1954) and among men in the younger generations who go from family life to living alone. [ABSTRACT FROM AUTHOR]

Copyright of Swiss Journal of Sociology / Schweizerische Zeitschrift für Soziologie is the property of Sciendo and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of BMS: Bulletin de Méthodologie Sociologique (l'Association Internationale de Méthodologie Sociologique (AIMS)) is the property of l'Association Internationale de Methodologie Sociologique (AIMS) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Swiss Political Science Review is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Swiss Journal of Sociology / Schweizerische Zeitschrift für Soziologie is the property of Sciendo and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: The present study sought to determine the prevalence of chronic non-cancer pain (CNCP) among older adult inpatients with polypharmacy. It also aimed to analyse prescription patterns and assess the therapy adequacy and patient complexity for those with and without CNCP., Methods: This 4-year longitudinal study examined data from an exhaustive acute care hospital register on home-dwelling older adult patients (≥65) with polypharmacy. Commonly known combinations of potentially inappropriate medications were used to estimate therapy adequacy. Patient complexity was evaluated by comparing number of comorbidities and investigating physical and cognitive deficits., Results: We determined a prevalence of CNCP of 9.7% among all older adult inpatients with polypharmacy, rising to 11.3% for those aged ≥85. Overall, CNCP patients were prescribed more drugs and had more comorbidities and physical and cognitive deficits than patients without CNCP. Older adult patients with CNCP received more analgesics, greater quantities of opioids, paracetamol and co-analgesics and elevated opioid dosages. Older adult patients with CNCP aged ≥85 received fewer analgesics, opioids, non-steroidal anti-inflammatory drugs and co-analgesics but more paracetamol. Older adult patients with CNCP were prescribed more potentially inappropriate medications involving opioids. In particular, 24.5% received an opioid and a hypnotic (benzodiazepine or Z-drug), and 8.6% received an opioid and a gabapentinoid., Conclusion: Observed differences in medication use between older adult inpatients with or without CNCP may be relevant for clinical practice. Potentially inadequate co-prescribing (such as hypnotics and opioids) affects a higher proportion of patients with CNCP and may have serious unintended consequences., Significance Statement: This study describes differences in prescription patterns between people with and without chronic non-cancer pain in a large dataset of 20,422 discharges. The differences found may be relevant to clinical practice. In particular, high co-prescribing of opioids and hypnotics may have serious unintended consequences. Greater physical and cognitive deficits may indicate greater patient complexity, and appropriate interventions need to be developed to improve the management of this vulnerable patient group., (© 2024 The Author(s). European Journal of Pain published by John Wiley & Sons Ltd on behalf of European Pain Federation ‐ EFIC ®.)

Objective: This study aimed to investigate medication management among polymedicated, home-dwelling older adults after discharge from a hospital centre in French-speaking Switzerland and then develop a model to optimise medication management and prevent adverse health outcomes associated with medication-related problems (MRPs)., Design: Explanatory, sequential, mixed methods study based on detailed quantitative and qualitative findings reported previously., Setting: Hospital and community healthcare in the French-speaking part of Switzerland., Participants: The quantitative strand retrospectively examined 3 years of hospital electronic patient records (n=53 690 hospitalisations of inpatients aged 65 years or older) to identify the different profiles of those at risk of 30-day hospital readmission and unplanned nursing home admission. The qualitative strand explored the perspectives of older adults (n=28), their informal caregivers (n=17) and healthcare professionals (n=13) on medication management after hospital discharge., Results: Quantitative results from older adults' profiles, affected by similar patient-related, medication-related and environment-related factors, were enhanced and supported by qualitative findings. The combined findings enabled us to design an interprofessional, collaborative medication management model to prevent MRPs among home-dwelling older adults after hospital discharge. The model comprised four interactive fields of action: listening to polymedicated home-dwelling older adults and their informal caregivers; involving older adults and their informal caregivers in shared, medication-related decision-making; empowering older adults and their informal caregivers for safe medication self-management; optimising collaborative medication management practices., Conclusion: By linking the retrospective and prospective findings from our explanatory sequential study involving multiple stakeholders' perspectives, we created a deeper comprehension of the complexities and challenges of safe medication management among polymedicated, home-dwelling older adults after their discharge from hospital. We subsequently designed an innovative, collaborative, patient-centred model for optimising medication management and preventing MRPs in this population., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Objective: To investigate patient characteristics and the available health and drug data associated with unplanned nursing home admission following an acute hospital admission or readmission., Design: A population-based hospital registry study., Setting: A public hospital in southern Switzerland (Valais Hospital)., Participants: We explored a population-based longitudinal dataset of 14 705 hospital admissions from 2015 to 2018., Outcome Measures: Sociodemographic, health and drug data, and their interactions predicting the risk of unplanned nursing home admission., Results: The mean prevalence of unplanned nursing home admission after hospital discharge was 6.1% (n=903/N=14 705). Our predictive analysis revealed that the oldest adults (OR=1.07 for each additional year of age; 95% CI 1.05 to 1.08) presenting with impaired functional mobility (OR=3.22; 95% CI 2.67 to 3.87), dependency in the activities of daily living (OR=4.62; 95% CI 3.76 to 5.67), cognitive impairment (OR=3.75; 95% CI 3.06 to 4.59) and traumatic injuries (OR=1.58; 95% CI 1.25 to 2.01) had a higher probability of unplanned nursing home admission. The number of International Classification of Diseases, 10th version diagnoses had no significant impact on nursing home admissions, contrarily to the number of prescribed drugs (OR=1.17; 95% CI 1.15 to 1.19). Antiemetics/antinauseants (OR=2.53; 95% CI 1.21 to 5.30), digestives (OR=1.78; 95% CI 1.09 to 2.90), psycholeptics (OR=1.76; 95% CI 1.60 to 1.93), antiepileptics (OR=1.49; 95% CI 1.25 to 1.79) and anti-Parkinson's drugs (OR=1.40; 95% CI 1.12 to 1.75) were strongly linked to unplanned nursing home admission., Conclusions: Numerous risk factors for unplanned nursing home admission were identified. To prevent the adverse health outcomes that precipitate acute hospitalisations and unplanned nursing home admissions, ambulatory care providers should consider these risk factors in their care planning for older adults before they reach a state requiring hospitalisation., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY. Published by BMJ.)

Objectives: The present study analysed 4 years of a hospital register (2015-2018) to determine the risk of 30-day hospital readmission associated with the medical conditions and drug regimens of polymedicated, older inpatients discharged home., Design: Registry-based cohort study., Setting: Valais Hospital-a public general hospital centre in the French-speaking part of Switzerland., Participants: We explored the electronic records of 20 422 inpatient stays by polymedicated, home-dwelling older adults held in the hospital's patient register. We identified 13 802 hospital readmissions involving 8878 separate patients over 64 years old., Outcome Measures: Sociodemographic characteristics, medical conditions and drug regimen data associated with risk of readmission within 30 days of discharge., Results: The overall 30-day hospital readmission rate was 7.8%. Adjusted multivariate analyses revealed increased risk of hospital readmission for patients with longer hospital length of stay (OR=1.014 per additional day; 95% CI 1.006 to 1.021), impaired mobility (OR=1.218; 95% CI 1.039 to 1.427), multimorbidity (OR=1.419 per additional International Classification of Diseases, 10th Revision condition; 95% CI 1.282 to 1.572), tumorous disease (OR=2.538; 95% CI 2.089 to 3.082), polypharmacy (OR=1.043 per additional drug prescribed; 95% CI 1.028 to 1.058), and certain specific drugs, including antiemetics and antinauseants (OR=3.216 per additional drug unit taken; 95% CI 1.842 to 5.617), antihypertensives (OR=1.771; 95% CI 1.287 to 2.438), drugs for functional gastrointestinal disorders (OR=1.424; 95% CI 1.166 to 1.739), systemic hormonal preparations (OR=1.207; 95% CI 1.052 to 1.385) and vitamins (OR=1.201; 95% CI 1.049 to 1.374), as well as concurrent use of beta-blocking agents and drugs for acid-related disorders (OR=1.367; 95% CI 1.046 to 1.788)., Conclusions: Thirty-day hospital readmission risk was associated with longer hospital length of stay, health disorders, polypharmacy and drug regimens. The drug regimen patterns increasing the risk of hospital readmission were very heterogeneous. Further research is needed to explore hospital readmissions caused solely by specific drugs and drug-drug interactions., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY. Published by BMJ.)