Search

Dynamic face stimuli are increasingly used in face perception research, as increasing evidence shows they are perceived differently from static photographs. One popular method for creating dynamic faces is the dynamic morph, which can animate the transition between expressions by blending two photographs together. Although morphs offer increased experimental control, their unnatural motion differs from the biological facial motion captured in video recordings. This study aimed to compare ratings of emotion intensity and genuineness in video recordings, dynamic morphs, and static photographs of happy, sad, fearful, and angry expressions. We found that video recordings were perceived to have greater emotional intensity than dynamic morphs, and video recordings of happy expressions were perceived as more genuine compared to happy dynamic morphs. Unexpectedly, static photographs and video recordings had similar ratings for genuineness and intensity. Overall, these results suggest that dynamic morphs may be an inappropriate substitute for video recordings, as they may elicit misleading dynamic effects. [ABSTRACT FROM AUTHOR]

Prior research into bystander responses to hate speech has utilized variable-centered analyses — such approaches risk simplifying the complex nature of bystander behaviors. Hence, the present study used a person-centered analysis to investigate latent hate speech bystander profiles. In addition, individual and classroom-level correlates associated with the various profiles were studied. The sample included 3225 students in grades 7–9 (51.7% self-identified as female; 37.2% with immigrant background) from 215 classrooms in Germany and Switzerland. The latent profile analysis revealed that four distinct profiles could be distinguished: Passive Bystanders (34.2%), Defenders (47.3%), Revengers (9.8%), and Contributors (8.6%). Multilevel logistic regression models showed common and distinct correlates. For example, students who believed that certain social groups are superior were more likely to be Revengers and Contributors than Passive Bystanders, students who felt more connected with teachers were more likely to be Defenders, and students who were more open to diversity were less likely to be Contributors than Passive Bystanders. Students were less likely Defenders and more likely Revengers and Contributors than Passive Bystanders in classrooms with high rates of hate speech perpetration. Further, in classrooms with high hate speech intervention, students were more likely to be Defenders and less likely to be Contributors than Passive Bystanders. In classrooms with stronger cohesion, students were more likely to be Defenders and less likely to be Contributors than Passive Bystanders. In conclusion, the findings add to our understanding of bystander profiles concerning racist hate speech and the relevance of individual and classroom-level factors in explaining various profiles of bystander behavior. [ABSTRACT FROM AUTHOR]

Purpose: The COVID-19 pandemic was associated with a decrease in emergency department (ED) visits. However, contradictory, and sparse data regarding children could not yet answer the question, how pediatric ED utilization evolved throughout the pandemic. Our objectives were to investigate the impact of the pandemic in three language regions of Switzerland by analyzing trends over time, describe regional differences, and address implications for future healthcare. Methods: We conducted a retrospective, longitudinal cohort study at three Swiss tertiary pediatric EDs (March 1st, 2018—February 28th, 2022), analyzing the numbers of ED visits (including patients' age, triage categories, and urgent vs. non-urgent cases). The impact of COVID-19 related non-pharmaceutical interventions (NPIs) on pediatric ED utilization was assessed by interrupted time series (ITS) modelling. Results: Based on 304′438 ED visits, we found a drop of nearly 50% at the onset of NPIs, followed by a gradual recovery. This primarily affected children 0–4 years, and both non-urgent and urgent cases. However, the decline in urgent visits appeared to be more pronounced in two centers compared to a third, where also hospitalization rates did not decrease significantly during the pandemic. A subgroup analysis showed a significant decrease in respiratory and gastrointestinal diseases, and an increase in the proportion of trauma patients during the pandemic. Conclusions: The COVID-19 pandemic had substantial effects on number and reasons for pediatric ED visits, particularly among children 0–4 years. Despite equal regulatory conditions, the utilization dynamics varied markedly between the three regions, highlighting the multifactorial modification of pediatric ED utilization during the pandemic. Furthermore, future policy decisions should take regional differences into account. [ABSTRACT FROM AUTHOR]

Summary: Number and age-standardized incidences of femoral fractures by sex and localization were determined annually between 1998 and 2021 in subjects aged 45 years or older living in Switzerland. The number and incidences of femoral neck, pertrochanteric, subtrochanteric, and femoral shaft fractures followed distinct unexpected trend patterns. Introduction: Long-term incidence trends for femoral fractures by individual localizations are unknown. Methods: Annual absolute number of hospitalizations and median age at hospital admission between 1998 and 2021 were extracted from the medical database of the Swiss Federal Office of Statistics by sex and 10-year age groups for the following 10th International Classification of Diseases (ICD-10) codes: femoral neck (ICD-10 S72.0), pertrochanteric (S72.1), subtrochanteric (S72.2), and femoral shaft fractures (S72.3). Age-standardized incidence rates (ASI) and corresponding trends were calculated. Results: Over 24 years, the number of femoral neck fractures increased in men (+ 45%) but decreased in women (− 7%) with ASI significantly decreasing by 20% and 37% (p < 0.001 for trend for both), respectively. By contrast, the number of pertrochanteric fractures increased by 67% and 45% in men and women, respectively, corresponding to a horizontal ASI-trend in men (n.s.) and a modest significant decreasing ASI-trend in women (p < 0.001). The number of subtrochanteric fractures increased in both sexes with corresponding modest significant reductions in ASI-trends (p = 0.015 and 0.002, respectively). Femoral shaft fractures almost doubled in men (+ 71%) and doubled in women (+ 100%) with corresponding significant increases in ASI-trends (p = 0.001 and p < 0.001, respectively). Age at admission increased for all fracture localizations, more so in men than in women and more so for subtrochanteric and shaft fractures than for "typical" hip fractures. Conclusion: Incidence changes of pertrochanteric fractures and femoral shaft fractures deserve increased attention, especially in men. Pooling diagnostic codes for defining hip fractures may hide differing patterns by localization and sex. [ABSTRACT FROM AUTHOR]

Background: This study aimed to assess a potential organ protective effect of volatile sedation in a scenario of severe inflammation with an early cytokine storm (in particular IL-6 elevation) in patients suffering from COVID-19-related lung injury with invasive mechanical ventilation and sedation. Methods: This is a small-scale pilot multicenter randomized controlled trial from four tertiary hospitals in Switzerland, conducted between April 2020 and May 2021. 60 patients requiring mechanical ventilation due to severe COVID-19-related lung injury were included and randomized to 48-hour sedation with sevoflurane vs. continuous intravenous sedation (= control) within 24 h after intubation. The primary composite outcome was determined as mortality or persistent organ dysfunction (POD), defined as the need for mechanical ventilation, vasopressors, or renal replacement therapy at day 28. Secondary outcomes were the length of ICU and hospital stay, adverse events, routine laboratory parameters (creatinine, urea), and plasma inflammatory mediators. Results: 28 patients were randomized to sevoflurane, 32 to the control arm. The intention-to-treat analysis revealed no difference in the primary endpoint with 11 (39%) sevoflurane and 13 (41%) control patients (p = 0.916) reaching the primary outcome. Five patients died within 28 days in each group (16% vs. 18%, p = 0.817). Of the 28-day survivors, 6 (26%) and 8 (30%) presented with POD (p = 0.781). There was a significant difference regarding the need for vasopressors (1 (4%) patient in the sevoflurane arm, 7 (26%) in the control one (p = 0.028)). Length of ICU stay, hospital stay, and registered adverse events within 28 days were comparable, except for acute kidney injury (AKI), with 11 (39%) sevoflurane vs. 2 (6%) control patients (p = 0.001). The blood levels of IL-6 in the first few days after the onset of the lung injury were less distinctly elevated than expected. Conclusions: No evident benefits were observed with short sevoflurane sedation on mortality and POD. Unexpectedly low blood levels of IL-6 might indicate a moderate injury with therefore limited improvement options of sevoflurane. Acute renal issues suggest caution in using sevoflurane for sedation in COVID-19. Trial registration: The trial was registered on ClinicalTrials.gov (NCT04355962) on 2020/04/21. [ABSTRACT FROM AUTHOR]

Purpose: The Swiss voluntary salt iodisation programme has successfully prevented iodine deficiency for 100 years, but dietary habits are changing and today only one-third of processed foods contain iodised salt. We aimed to monitor the current iodine status in children and pregnant women. Methods: We conducted a nationwide cross-sectional study in children (6–12 years) and pregnant women and measured the urinary iodine concentration (UIC) in spot urine samples. We estimated the iodine intake using UIC and urinary creatinine concentration (UCC) and determined the prevalence of intakes below the average requirement (AR) using the SPADE method. We measured dried blood spot (DBS) thyroglobulin (Tg), TSH and total T4 in pregnant women. Results: The median UIC was 127 μg/L (bootstrapped 95% CI 119, 140, n = 362) in children and 97 μg/L (bootstrapped 95% CI 90, 106, n = 473) in pregnant women. The estimated prevalence of inadequate iodine intake (< 65 μg/day) was 5.4% (bootstrapped 95% CI 0.0, 14.6) in children. Half (47%) of the women consumed iodine-containing multivitamin and mineral supplements (≥ 150 μg/day). Compared to non-users, users had higher median UIC (129 vs. 81 μg/L, P < 0.001), lower prevalence of inadequacy (< 160 μg/day; 0.2 vs. 31%) and lower DBS-Tg (23 vs. 29 μg/L, P < 0.001). All women were euthyroid. Conclusions: The Swiss diet and current salt fortification provides adequate iodine intake in children, but not in all pregnant women. Iodine supplements cover the dietary gap in pregnancy but are not universally consumed. Therefore, improved use of iodised salt in processed foods is desired to ensure adequate iodine intake in all population groups. This trial was registered at clinicaltrials.gov as NCT04524013. [ABSTRACT FROM AUTHOR]

Introduction: Risk minimization measures are one of the most important tools in ensuring safe use of medicines. The evaluation of their effectiveness in clinical practice is a big challenge. Diclofenac is a medicine indicated for relief of all grades of pain and inflammation, in a wide range of conditions. Certain cardiovascular diseases are contraindications, whilst certain diseases require precautions for diclofenac prescribing. Objective: The aim of this study is to measure impact of the new digital risk minimization tool, introduced at the level of diclofenac prescribing, on patterns of its prescription in outpatient settings in Montenegro. Methods: Regulatory impact before/after drug utilization study, using electronic health records of patients with cardiovascular contraindications/precautions for diclofenac prescribing, was conducted. The period of observation was 1 year before and 1 year after introduction of the digital risk minimization tool. Results: Introduction of the digital risk minimization tool was associated with significant decrease in number of patients on diclofenac and the number of diclofenac prescriptions/packages, in a cohort of patients who were prescribed diclofenac before the digital intervention. Decrease in diclofenac prescription was more obvious in patients with contraindications, as expected, compared with patients with precautions. Decrease in diclofenac prescriptions in patients with other heart diseases, cerebrovascular diseases, and ischemic heart diseases (contraindications) was 38.79%, 37.62%, and 29.85% respectively. There was also a decrease in diclofenac prescriptions in patients with hypertension (22.86%), hyperlipidemia (23.61%), and diabetes mellitus (26.32%; precautions). After the digital intervention, initiation of diclofenac in diclofenac-naive patients was significantly decreased compared with patients who were prescribed diclofenac before the digital intervention. Conclusions: Although a significant decrease in diclofenac prescription in both cohorts occurred, diclofenac is still prescribed, even in diagnoses contraindicated for its use. Further improvements of existing tools and the creation of new ones are necessary for minimization of cardiovascular and other risks related to diclofenac. [ABSTRACT FROM AUTHOR]

Background: Endotoxin adsorption is a promising but controversial therapy in severe, refractory septic shock and conflicting results exist on the effective capacity of available devices to reduce circulating endotoxin and inflammatory cytokine levels. Methods: Multiarm, randomized, controlled trial in two Swiss intensive care units, with a 1:1:1 randomization of patients suffering severe, refractory septic shock with high levels of endotoxemia, defined as an endotoxin activity ≥ 0.6, a vasopressor dependency index ≥ 3, volume resuscitation of at least 30 ml/kg/24 h and at least single organ failure, to a haemoadsorption (Toraymyxin), an enhanced adsorption haemofiltration (oXiris) or a control intervention. Primary endpoint was the difference in endotoxin activity at 72-h post-intervention to baseline. In addition, inflammatory cytokine, vasopressor dependency index and SOFA-Score dynamics over the initial 72 h were assessed inter alia. Results: In the 30, out of 437 screened, randomized patients (10 Standard of care, 10 oXiris, 10 Toraymyxin), endotoxin reduction at 72-h post-intervention-start did not differ among interventions (Standard of Care: 12 [1–42]%, oXiris: 21 [10–51]%, Toraymyxin: 23 [10–36]%, p = 0.82). Furthermore, no difference between groups could be observed neither for reduction of inflammatory cytokine levels (p = 0.58), nor for vasopressor weaning (p = 0.95) or reversal of organ injury (p = 0.22). Conclusions: In a highly endotoxemic, severe, refractory septic shock population neither the Toraymyxin adsorber nor the oXiris membrane could show a reduction in circulating endotoxin or cytokine levels over standard of care. Trial registration ClinicalTrials.gov. NCT01948778. Registered August 30, 2013. https://clinicaltrials.gov/study/NCT01948778 [ABSTRACT FROM AUTHOR]

Purpose: To investigate time trends in daily fruit consumption among Western European adolescents and in related socioeconomic inequalities. Methods: We used nationally representative data from 18 countries participating in five rounds (2002 to 2018) of the cross-sectional "Health Behaviour in School-aged Children" (HBSC) survey (n = 458,973). The questionnaire, standardised across countries and rounds, was self-administered at school by 11-, 13- and 15-year-old adolescents. Daily fruit consumption was assessed using a short food frequency questionnaire (sFFQ). Socioeconomic inequalities were measured using the Family Affluence Scale (FAS). Multilevel logistic regressions were applied to study linear time trends in daily fruit consumption, overall, by country and by FAS. Results: Between 2002 and 2018, daily fruit consumption increased in 10 countries (OR range, 1.04 to 1.13, p < 0.05) and decreased in 3 (OR range 0.96 to 0.98, p < 0.05). In all survey years combined, prevalence of daily fruit consumption was significantly higher among high FAS groups (42.6%) compared to medium (36.1%) and low FAS groups (31.7%; all countries: p < 0.001). Between 2002 and 2018, socioeconomic inequalities in fruit consumption increased in Austria, Germany, Italy, Netherlands, Scotland, Sweden, and Switzerland. Only in Norway FAS inequalities decreased while the prevalence increased. Conclusion: The prevalence of daily fruit consumption generally increased among adolescents between 2002 and 2018 in Western European countries, yet socioeconomic inequalities increased in some countries. Public health interventions should continue to promote fruit consumption with special attention to lower socioeconomic groups. [ABSTRACT FROM AUTHOR]

Violence against children and adolescents is a widespread problem. However, most studies conducted in this field has been carried out in Western countries and studies are needed in non-Western countries, especially in Sub-Saharan Africa, where rates of child physical violence are high. The present study aimed firstly to document the different forms of physical violence and attitudes toward corporal punishment (CP) across Cameroon, Switzerland, and Togo. The second objective aimed, on the one hand, to understand the influence of cultural context, childhood physical abuse, and parental attitudes on physically violent parental practices in these three different cultural contexts. On the other, this study aimed to investigate the mediating role of childhood physical abuse and parental attitudes on the effect of cultural contexts on parental practices. Five hundred and forty-seven parents from Togo, Cameroon, and Switzerland filled out questionnaires concerning violent parental practices (ICAST-P), childhood physical abuse (CTQ-SF), and parental attitudes in favor of CP. Firstly, results highlighted some cultural differences regarding parental attitudes and practices. Secondly, the hierarchical regression showed that physical violence could be partially predicted by the cultural context, childhood abuse, and attitudes in favor of CP. Finally, childhood abuse and parental attitudes mediated the link between the cultural context and parental practices. This study underscores the importance of considering the cultural context when examining parental practices. Moreover, these results provide a better understanding of these types of parental practices in less studied contexts. [ABSTRACT FROM AUTHOR]

We examined differences in knowledge, attitudes, and practices related to student trauma and trauma-informed practices among various educators and certified staff members in a United States, Midwestern school district. We examined three research questions: 1.) Are there significant differences in knowledge, attitudes, and practices among teachers with differing years' experience? 2.) Are there significant differences in knowledge, attitudes, and practices among primary and secondary educators and staff? 3.) Are there significant differences in knowledge, attitudes, and practices among educators and staff who have participated in professional development (PD) regarding student trauma, and those who have not? We utilized a revised version of the Knowledge, Attitudes, and Practices (KAP) survey (Law, 2019) focused on student trauma. The KAP survey was sent via email to all certified staff members in the school district. No significant differences were found among knowledge and attitudes; however, primary school educators implemented significantly more trauma-informed practices compared to secondary educators. Additionally, educators with PD implemented significantly more trauma-informed practices compared to those without PD. Findings revealed our staff members had similar levels of knowledge and attitudes, though practices differed depending on years' experience, PD, and grades taught. Implications for future research relating to student trauma and the research-to-practice gap are discussed. [ABSTRACT FROM AUTHOR]

Summary: This registry-based study of 3068 patients with osteoporosis compared the anti-fracture effectiveness of denosumab versus bisphosphonates. Denosumab was associated with significantly greater risk reduction than alendronate or ibandronate for vertebral and any fractures. No difference in fracture risk reduction was found between zoledronate and denosumab. Purpose: To analyse the fracture risk of patients with osteoporosis receiving bisphosphonates or denosumab in a real-world setting. Methods: This registry-based cohort study evaluated patients taking denosumab, bisphosphonates or both sequentially. Fractures were analysed using rates, rate ratios and hazard ratios (HR), including both therapies as time-varying co-variates. Fracture risk hazards were adjusted (aHR) for baseline T-Scores and trabecular bone score (TBS) and were additionally analysed with inverse probability treatment weighting. Results: A total of 3068 patients (89% female; median age at treatment onset, 69 years [63 to 76]) received denosumab (median duration 2.8 years, [2.2 to 4.7]), bisphosphonates (3.4 years, [2.1 to 5.7]) or both sequentially. Thus, 11,078 subject-years were assessed for bisphosphonates (41% alendronate, 36% ibandronate, 23% zoledronate) and 4216 for denosumab. Moreover, 48,375 subject-years were observed before treatment onset, in addition to 2593 years of drug holidays. A total of 1481 vertebral fractures (435 under therapy), 1508 non-vertebral fractures (499 under therapy) and 202 hip fractures (67 under therapy) occurred after age 50. The risks of vertebral, non-vertebral and hip fractures were significantly lower under all bisphosphonates, denosumab and drug holidays than before treatment onset (all p < 0.001). After adjusting for age, baseline T-scores and TBS, denosumab was associated with lower risk than alendronate or ibandronate for vertebral fractures (aHR 0.47 (0.35 to 0.64) and 0.70 [0.53 to 0.91], p < 0.001 and p = 0.009, respectively) and any fractures (aHR 0.62 [0.51 to 0.76] and 0.77 [0.64 to 0.92], p < 0.001 and p = 0.004). With propensity weighting, denosumab was associated with a lower hip fracture risk compared to alendronate (HR 0.54 [0.29 to 0.98], p = 0.044). No difference in fracture risk reduction (vertebral, non-vertebral or hip) was found between zoledronate and denosumab. Conclusions: When adjusting for disease severity, denosumab was associated with significantly greater risk reduction than alendronate and ibandronate for vertebral fractures. No difference in fracture risk reduction was found between zoledronate and denosumab. [ABSTRACT FROM AUTHOR]

Background: Little is known about the long-term social and professional outcomes in adults after pediatric kidney replacement therapy (KRT). In this study, we described social and professional outcomes of adults after kidney failure during childhood and compared these outcomes with the general population. Methods: We sent a questionnaire to 143 individuals registered in the Swiss Pediatric Renal Registry (SPRR) with KRT starting before the age of 18 years. In the questionnaire, we assessed social (partner relationship, living situation, having children) and professional (education, employment) outcomes. Logistic regression models adjusted for age at study and sex were used to compare outcomes with a representative sample of the Swiss general population and to identify socio-demographic and clinical characteristics associated with adverse outcomes. Results: Our study included 80 patients (response rate 56%) with a mean age of 39 years (range 19–63). Compared to the general population, study participants were more likely to not have a partner (OR = 3.7, 95%CI 2.3–5.9), live alone (OR = 2.5, 95%CI 1.5–4.1), not have children (OR = 6.8, 95%CI 3.3–14.0), and be unemployed (OR = 3.9, 95%CI 1.8–8.6). No differences were found for educational achievement (p = 0.876). Participants on dialysis at time of study were more often unemployed compared to transplanted participants (OR = 5.0, 95%CI 1.2–21.4) and participants with > 1 kidney transplantation more often had a lower education (OR = 3.2, 95%CI 1.0–10.2). Conclusions: Adults after pediatric kidney failure are at risk to experience adverse social and professional outcomes. Increased awareness among healthcare professionals and additional psycho-social support could contribute to mitigate those risks. [ABSTRACT FROM AUTHOR]

We aimed to map the evidence, based on population-based and migrant-specific datasets in Switzerland, on mental health and wellbeing of the population with migrant background. The research questions were: What is known from the existing quantitative evidence about the mental health of the population with migrant background living in Switzerland? What are the research gaps that can be addressed with existing secondary datasets in Switzerland? We used the scoping review approach to describe existing research. We searched Ovid MEDLINE and APA PsycInfo (2015 - September 2022). This resulted in a total of 1862 potentially relevant studies. In addition, we manually searched other sources, such as Google Scholar. We used a evidence map to visually summarise research characteristics and identify research gaps. In total, 46 studies were included in this review. Most studies used cross-sectional design (78.3%, n = 36) and theirs aims were descriptive (84.8%, n = 39). The studies tend to examine mental health or wellbeing of the population with migrant background in the context of social determinants (69.6%, n = 32). The most frequently studied social determinants were at the individual level (96.9%, n = 31). Out of 46 included studies, 32.6% (n = 15) included depression or anxiety, and 21.7% (n = 10) post-traumatic stress disorder and other traumas. Other outcomes were less commonly investigated. There was a lack of studies using longitudinal data investigating mental health of migrants that go beyond descriptive aims (i.e., explanatory and predictive), and have large nationally representative samples. Moreover, there is a need for research examining social determinants of mental health and wellbeing at the structural, family and community levels. We propose that existing nationally representative population-based surveys are used to a greater extent to study various aspects of migrants' mental health and wellbeing. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic highlighted health inequities for vulnerable populations and the need for more equitable care and access to vaccination. This article described the implementation of a COVID-19 vaccination program for undocumented migrants in a regional academic center of general medicine and public health (Unisanté). The vaccination program's specific components included: triple coordination between the health authorities, the regional center and community partners, a walk-in and free service, no health insurance required, qualified nursing and administrative staff with previous experience with vulnerable populations, translated information materials and interpreters, a guarantee of confidentiality and a widespread communication campaign within the communities. In total, 2'351 undocumented migrants from 97 nationalities received at least one dose of mRNA COVID-19 vaccine (Spikevax) and 2242 were considered fully vaccinated. Although it was hard to assess its global effectiveness, the program vaccinated a significant number of undocumented adult migrants in the Canton of Vaud. The difficulties linked to the pandemic context, the heavy workload for healthcare staff and the limited resources were overcome by strong collaborations between the different actors involved throughout the program. Targeted public health policies, such as vaccination programs for undocumented migrants, are essential to guarantee equitable care, especially in pandemic times. [ABSTRACT FROM AUTHOR]

This longitudinal, prospective study investigated associations between perceived COVID-19-related stress, coping strategies, and mental health status among adolescents during the first lockdown of the COVID-19 pandemic and one year after the lockdown in Switzerland within a large, national sample. A self-report on-line survey was completed by 553 adolescents (age-range 12–18 years in 2021) in the summers of 2020 and 2021, assessing symptoms of various mental health problems, perceived COVID-19-related stressors, and coping strategies. Overall, participants reported less COVID-19 related stress one year after the lockdown, though mental health status remained stable. 'Challenges at home or with others' were significantly associated with mental health problems in both genders, whereas 'trouble getting medical care or mental health services 'was associated with mental health problems in girls. Perceived stress and pre-existing psychiatric problem were significantly linked to all mental health outcomes at both time points. Parents' poor relationships with partners during the lockdown was associated with increased anxiety symptoms in their children. Using cognitive restructuring to cope with stress was associated with less, while negative coping was associated with more anxiety, depression, and attention deficit hyperactivity disorder (ADHD) symptoms one year post lockdown. Girls appear to have been more affected by the pandemic than boys, with youths with pre-existing psychiatric problems especially vulnerable to its detrimental effects. Healthcare and school professionals should support to identify high-risk adolescents with negative and avoidant coping strategies and train youths to use positive coping strategies. [ABSTRACT FROM AUTHOR]

Asylum seekers face multiple language, cultural and administrative barriers that could result in the inappropriate implementation of COVID-19 measures. This study aimed to explore their knowledge and attitudes to recommendations about COVID-19. We conducted a cross-sectional survey among asylum seekers living in the canton of Vaud, Switzerland. We used logistic regressions to analyze associations between knowledge about health recommendations, the experience of the pandemic and belief to rumors, and participant sociodemographic characteristics. In total, 242 people participated in the survey, with 63% of men (n = 150) and a median age of 30 years old (IQR 23–40). Low knowledge was associated with linguistic barriers (aOR 0.36, 95% CI 0.14–0.94, p = 0.028) and living in a community center (aOR 0.43, 95% CI 0.22–0.85, p = 0.014). Rejected asylum seekers were more likely to believe COVID-19 rumors (aOR 2.81, 95% CI 1.24–6.36, p = 0.013). This survey underlines the importance of tailoring health recommendations and interventions to reach asylum seekers, particularly those living in community centers or facing language barriers. [ABSTRACT FROM AUTHOR]

Background: Little is known about health-related quality of life (HRQoL) in adults after kidney failure during childhood. In this study, we analyzed HRQoL of adults after pediatric kidney failure in Switzerland and investigated socio-demographic and clinical factors associated with HRQoL. Methods: In this cohort study, we sent questionnaires to 143 eligible patients registered in the Swiss Pediatric Renal Registry with continuous kidney replacement therapy starting before the age of 18 years. We assessed HRQoL using the Short-Form 36 version 1, compared HRQoL scores between our sample and the Swiss general population, and used linear regression models to examine socio-demographic and clinical factors associated with HRQoL. Results: We included 79 patients (response rate 55%) with a mean age of 38.6 years (range 19.4–63.1). Compared to the general population, HRQoL scores were lower for physical functioning (− 12.43, p < 0.001), role physical (− 13.85, p = 0.001), general health (− 14.42, p < 0.001), vitality (− 4.98, p = 0.035), and physical HRQoL (− 6.11, p < 0.001), but we found no difference in mental HRQoL (− 0.13, p = 0.932). The socio-demographic factors—lower education, unemployment, and not being in a relationship—were associated with lower HRQoL. The only clinical factor associated with HRQoL was the type of kidney disease. Patients with acquired kidney diseases had lower mental HRQoL than patients with congenital anomalies of the kidney and urinary tract (− 11.4, p = 0.007) or monogenetic hereditary diseases (− 9.5, p = 0.018). Conclusions: Adults after pediatric kidney failure in Switzerland have lower physical, but similar mental HRQoL compared to the general population. Subgroups may require special attention with regard to their HRQoL. [ABSTRACT FROM AUTHOR]

This study focuses on Switzerland where child-care is limited in offer and costly. It examines what child-care patterns parents of 0- to 4-years old children use; and, how different arrangements relate to several domains of mothers' and fathers' cognitive and affective subjective well-being (SWB). A major contribution of the present study is the distinction between child-care provided by parents, grandparents, relatives, formal institutions and mixed arrangements. Based on data from the Swiss Household Panel (SHP) from 2002 to 2017, multilevel regression models are applied to estimate the relationship between child-care arrangements and both parents' SWB. The results demonstrate that grandparental care relates positively to both parents' SWB: Compared to grandparental child-care, relatives and formal or mixed child-care arrangements tend to decrease most of the satisfaction dimensions. Formal child-care and child-care provided by relatives as well as mixed arrangements relate to a decrease in positive affect. Negative affect is not significantly associated to the different child-care arrangements. Highlights: Based on a nationally representative sample, this study differentiates a large array of child-care arrangements. The relationship between child-care type and five dimensions of both parents' subjective well-being (SWB) is analyzed. Relatives, formal and mixed child-care arrangements decrease the level of most of the satisfaction dimensions of SWB. Child-care provided by relatives as well as formal and mixed arrangements relate to a decrease in positive affect. Grandparental care relates positively to both parents' SWB dimensions. [ABSTRACT FROM AUTHOR]

Gestures embody concepts in the form of universal representations. Researchers have highlighted that social communication often embodies nonverbal behavior. A forensic interviewer's nonverbal behavior, such as gesturing during an interview, could communicate misleading information and may cause inaccuracies in the interviewees' testimonies. The current study was conducted in Switzerland and included 108 child participants, in three age groups (a younger sample aged 6–9 years, n = 32) (a middle sample aged 10–11 years, n = 40) and an older sample aged 12–13 years, n = 36). Participants viewed a video and completed an interview about the video, individually, immediately after. During the questioning, the interviewer deliberately misled the interviewees with nonverbal gestures. The results showed that 95 children were misled by at least one gesture and that gestures led to a significant decrease in accuracy. Children also incorporated misleading gestures and reported false information; adding to existing evidence that misinformation can also be communicated through nonverbal gestures. Our findings demonstrate the negative influence of misleading gestures in child eyewitness interviews and provide more evidence for the robustness of the gestural misinformation effect, reported in previous research. [ABSTRACT FROM AUTHOR]

The paper reports the results of an exploratory online survey among German, Austrian, and Swiss hospital chaplains (n = 158, response rate 17%) to identify the ethical conflicts they encounter in their work. Respondents indicated that questions surrounding end-of-life care are predominant among the conflicts faced. Chaplains get involved with these conflicts most often through the patients themselves or through nursing staff. Most encounters occur during pastoral care visits rather than in structured forms of ethics consultation such as clinical ethics committees. The results add to the ongoing discussion of chaplains as agents in ethics consultation within healthcare systems as well as their specific role and contribution. [ABSTRACT FROM AUTHOR]

FGM/C is a harmful practice that involves injury of the external female genitalia without medical purpose. It is mainly practiced in Africa, Asia, and the Middle East. However, with the migratory flows, women and girls with FGM/C and its consequences live all over the world. The lack of knowledge on how to care for women and girls living with FGM/C extends among all categories of health professionals involved in women's health, including infectious disease specialists. This is a national, exploratory descriptive cross-sectional study aimed to generate descriptive statistics about FGM/C among HIV-infected migrant women included in the Swiss HIV Cohort Study (SHCS). Among the 387 women interviewed about FGM/C and who provided an answer, 80 (20.7%) reported to have undergone FGM/C. Fifty-six of the 80 women (70.0%) who reported having undergone FGM/C, also reported that they had never discussed their cutting with a health professional before. Our study demonstrates how common female genital mutilation is in women living with HIV and who have migrated to Switzerland and suggest how care and prevention could be improved significantly. [ABSTRACT FROM AUTHOR]

Background: Bioethics can play an important role in addressing diversity both in and outside of academia, setting precedents for meaningful contributions to public discourse, research, teaching, training, and policy development. However, in order to do so, these conversations also need to reflect on the issue of diversity within the field of bioethics across the globe. This study aims to examine current gender representation and diversity at medical ethics and humanities institutes in Germany, the German-speaking areas of Switzerland, and Austria. Methods: A total of forty-nine medical ethics and humanities institutes from Germany (n=42), the German-speaking areas of Switzerland (n=5), and Austria (n=2) were included in the study. Institutes websites were reviewed in the first week of March 2021 and the details of each staff member listed on the website recorded. Results: Overall, a total of 964 staff members were identified at the forty-nine German-speaking medical ethics and humanities institutes. Just over half (530/964; 55%) of all staff were female. There were significant differences between gender in some staff positions: 64.6 per cent (31/48) of directors were male (χ2(1)=4.1, P=.04); 62.7 per cent (84/134) of student assistants were female (χ2(1)=8.6, P=.003); and 83.7 per cent (77/92) of administrative staff were female (χ2(1)=41.8, P<.001). There were no significant differences between staff gender for researchers and lecturers, or associated researchers. In addition, 65.5 per cent (19/29) of researchers and lecturers who had a professor title were male, but the difference between genders was not found to be significant. However, significantly more of the researchers and lecturers who had completed a habilitation were male (75.8% (25/33); χ2(1)=8.8, P=.003). When comparing the institute director's gender presentation with staff gender presentation, it was found that male-led institutes had 53.4 per cent (286/536) female staff overall but had 52.7 per cent (136/258) male researchers and lecturers. However, the difference between genders were not found to be significant. On the other hand, female-led institutes had significantly more female staff overall (59.9% (223/372); χ2(1)=14.7, P<.001) and also significantly more female researchers and lecturers (58.9% (119/202; χ2(1)=6.4, P=.01). Conclusions: There has been a significant push to address gender diversity in German-speaking academia, and this study finds overall good gender parity in medical ethics and humanities institutes. However, there has not been a similar openness to discussing issues of systemic racism or how other forms of inequality affect academic diversity. Taking diversity seriously requires opening up conversations around intersectionality, including difficult conversations around race and cultural background that have long been taboo in German-speaking countries. [ABSTRACT FROM AUTHOR]

Purpose: It is currently unclear whether management and outcomes of critically ill patients differ between men and women. We sought to assess the influence of age, sex and diagnoses on the probability of intensive care provision in critically ill cardio- and neurovascular patients in a large nationwide cohort in Switzerland.Methods: Retrospective analysis of 450,948 adult patients with neuro- and cardiovascular disease admitted to all hospitals in Switzerland between 01/2012 and 12/2016 using Bayesian modeling.Results: For all diagnoses and populations, median ages at admission were consistently higher for women than for men [75 (64;82) years in women vs. 68 (58;77) years in men, p < 0.001]. Overall, women had a lower likelihood to be admitted to an intensive care unit (ICU) than men, despite being more severely ill [odds ratio (OR) 0.78 (0.76-0.79)]. ICU admission probability was lowest in women aged > 65 years (OR women:men 0.94 (0.89-0.99), p < 0.001). Women < 45 years had a similar ICU admission probability as men in the same age category [OR women:men 1.03 (0.94-1.13)], in spite of more severe illness. The odds to die were significantly higher in women than in men per unit increase in Simplified Acute Physiology Score (SAPS) II (OR 1.008 [1.004-1.012]).Conclusion: In the care of the critically ill, our study suggests that women are less likely to receive ICU treatment regardless of disease severity. Underuse of ICU care was most prominent in younger women < 45 years. Although our study has several limitations that are imposed by the limited data available from the registries, our findings suggest that current ICU triage algorithms could benefit from careful reassessment. Further, and ideally prospective, studies are needed to confirm our findings. [ABSTRACT FROM AUTHOR]

Refugees face various nutritional challenges during and after migration. This cross-sectional, mixed-methods study seeks to investigate the prevalence of undernutrition and obesity among refugees in Geneva, and to identify barriers to healthy eating. Anthropometric measurements of 354 adult refugees were collected between 2017 and 2019 by trained nurses and dietitians. Seven focus group discussions totaling 51 participants, refugees and social workers, investigated conceptions and needs regarding diet. The mean Body Mass Index is 24.6 ± 4.8 kg/m2. Women are disproportionately affected by obesity compared to men (p < 0.001). Weight gain post-migration is correlated positively with length of stay in Geneva (p < 0.001). Major obstacles to healthy eating are economic and linguistic. For participants, cooking workshops and free physical activities are highly needed interventions. Post-migration lifestyle interventions should be implemented to prevent weight gain in this population. Such interventions must be multi-level, to overcome structural, social and behavioral barriers to healthy eating. [ABSTRACT FROM AUTHOR]

Background: While the long-term evolution of disease behavior in Crohn's disease has been well described in the pre-anti-TNF era, our knowledge thereon remains scarce after the introduction of anti-TNF.Aims: Our investigation examined the long-term evolution of disease concerning Montreal classification's B-stages over time in patients enrolled into the Swiss IBD Cohort Study between 2006 and 2017.Methods: We analyzed prospectively collected SIBDCS data using a Markov model and multivariate testing for effects of treatment and other confounders on B-stage migration over time. The primary outcome was a transition in disease behavior from B1 to either B2 or pB3, or from B2 to pB3, respectively.Results: The 10- and 15-year probability of remaining in B1 was 0.61 and 0.48, as opposed to a probability to migrate to B2 or B3 of 0.25 or 0.14, and 0.32 or 0.2, after 10 and 15 years, respectively. In multivariate testing, the hazard ratio for migrating from B1 to pB3 (HR 0.27) and from B2 to pB3 (HR 0.12) was lower in patients > 40 years compared to patients < 17 years. We found that immunosuppression (HR 0.38) and treatment with anti-TNF for > 1 year (HR 0.30) were associated with a decreased likelihood of transitioning from stage B1 to pB3.Conclusions: While in the anti-TNF era most patients with Crohn's disease will eventually develop stricturing and/or penetrating complications, our data indicate that immunosuppressive and anti-TNF treatment for more than 1 year reduce the risk of transitioning from stage B1 to pB3 in the long-term run. [ABSTRACT FROM AUTHOR]

Iron deficiency is the most prevalent nutritional deficiency affecting children and adolescents worldwide. A consistent body of epidemiological data demonstrates an increased incidence of iron deficiency at three timepoints: in the neonatal period, in preschool children, and in adolescents, where it particularly affects females.Conclusion: This narrative review focuses on the most suggestive symptoms of iron deficiency in childhood, describes the diagnostic procedures in situations with or without anemia, and provides Swiss expert-based management recommendations for the pediatric context.What is Known:• Iron deficiency (ID) is one of the most common challenges faced by pediatricians.• Significant progress in the diagnosis and therapy of ID has been made over the last decade.What is New:• Our expert panel provides ID management recommendations based on the best available evidence.• They include strategies for ID diagnosis and therapy, both oral and intravenous. [ABSTRACT FROM AUTHOR]

Objectives: The 8th International Forum for Liver Magnetic Resonance Imaging (MRI), held in Basel, Switzerland, in October 2017, brought together clinical and academic radiologists from around the world to discuss developments in and reach consensus on key issues in the field of gadoxetic acid-enhanced liver MRI since the previous Forum held in 2013.Methods: Two main themes in liver MRI were considered in detail at the Forum: the use of gadoxetic acid for contrast-enhanced MRI in patients with liver cirrhosis and the technical performance of gadoxetic acid-enhanced liver MRI, both opportunities and challenges. This article summarises the expert presentations and the delegate voting on consensus statements discussed at the Forum.Results and Conclusions: It was concluded that gadoxetic acid-enhanced MRI has higher sensitivity for the diagnosis of hepatocellular carcinoma (HCC), when compared with multidetector CT, by utilising features of hyperenhancement in the arterial phase and hypointensity in the hepatobiliary phase (HBP). Recent HCC management guidelines recognise an increasing role for gadoxetic acid-enhanced MRI in early diagnosis and monitoring post-resection. Additional research is needed to define the role of HBP in predicting microvascular invasion, to better define washout during the transitional phase in gadoxetic acid-enhanced MRI for HCC diagnosis, and to reduce the artefacts encountered in the arterial phase. Technical developments are being directed to shortening the MRI protocol for reducing time and patient discomfort and toward utilising faster imaging and non-Cartesian free-breathing approaches that have the potential to improve multiphasic dynamic imaging.Key Points: • Gadoxetic acid-enhanced MRI provides higher diagnostic sensitivity than CT for diagnosing HCC. • Gadoxetic acid-enhanced MRI has roles in early-HCC diagnosis and monitoring post-resection response. • Faster imaging and free-breathing approaches have potential to improve multiphasic dynamic imaging. [ABSTRACT FROM AUTHOR]

Purpose: To assess the cross-sectional and longitudinal association between self-reported vitamin C + E dietary supplementation and markers of grip strength and frailty in community-dwelling Swiss adults. Methods: Population-based study including 3277 participants (1722 women) aged 40–80 years at baseline. The associations between vitamin C + E dietary supplementation and grip strength were examined cross-sectionally and after a follow-up of 5.2 years on average. Results: There were 253 (7.7%) self-reported vitamin C + E supplement users. Female users had significantly lower grip strength than non-users (average ± standard deviation: 24.3 ± 6.1 versus 25.6 ± 6.1 kg, respectively). However, the association disappeared after multivariate adjustment (24.7 ± 0.5 versus 25.6 ± 0.1 kg, for users versus non-users, respectively). No differences were found in men regarding grip strength. No differences were found in the highest quintile of grip strength or prevalence of low grip strengthin in users versus non-users during cross-sectional analysis for both genders. After 5.2 years of follow-up, no associations were found between vitamin C + E supplementation and change in grip strength for raw values (difference between baseline and follow-up: 1.2 ± 5.0 versus 0.4 ± 5.2 kg for female and 0.6 ± 6.5 versus 1.1 ± 6.8 kg for male users and non-users, respectively) or after multivariable adjustment (1.2 ± 0.5 versus 0.4 ± 0.1 kg for female and 0.6 ± 0.8 versus 1.1 ± 0.2 kg for male users and non-users, respectively) when taking baseline vitamin C + E supplementation into account. No association was also found for incidence of low grip strength. Conclusion: In a sample of community-dwelling Swiss adults, vitamin C + E supplementation neither improved grip strength nor prevented low-grip strength over a 5-year period. [ABSTRACT FROM AUTHOR]

Purpose: This study examined the provision of palliative care and related decision-making in Swiss pediatric oncology settings. The aim was to determine if and when children who died from cancer received palliative care, whether there were differences by cancer diagnosis, and inclusion of children in decision-making regarding palliative care.Methods: Using a standardized data extraction form, a retrospective review of medical records of deceased pediatric patients was conducted. The form captured information on demographics, diagnosis, relapse(s), treatments, decision-making during palliative care, and circumstances surrounding a child's death.Results: For 170 patients, there was information on whether the child received palliative care. Among those, 38 cases (22%) did not receive palliative care. For 16 patients, palliative care began at diagnosis. The mean duration of palliative care was 145 days (Mdn = 89.5, SD = 183.4). Decision to begin palliative care was discussed solely with parent(s) in 60.9% of the cases. In 39.1%, the child was involved. These children were 13.6 years of age (SD = 4.6), whereas those not included were 7.16 years old (SD = 3.9). Leukemia patients were less likely to receive palliative care than the overall sample, and patients with CNS neoplasms received palliative care for a longer time than other patients.Conclusions: There are still high numbers of late or non-referrals, and even children older than 12 years were not involved in decision-making regarding palliative care. These results do not align with international organizational guidelines which recommend that palliative care should begin at diagnosis. [ABSTRACT FROM AUTHOR]

Respiratory diseases are associated with increased cardiovascular risk in adults, but little is known on the early impact on the vasculature in youth. The SAPALDIA Youth study, the offspring study of the Swiss Study on Air Pollution and Lung and Heart Disease In Adults (SAPALDIA), investigated the association between physician-diagnosed asthma status and common carotid artery intima media thickness (CIMT). Offspring underwent standardized clinical protocols and provided information on early life factors, health, and lifestyle. The association between per subject averages of CIMT and asthma was estimated using mixed linear regression analyses adjusting for main confounders, testing for interaction with gender and age. Of 257 offspring (mean age 15 years, 53% female), 11.5% reported doctor-diagnosed asthma (male 17%, female 7%). Mean CIMT was significantly different by gender (male 0.53 mm (± 0.045), female 0.50 mm (± 0.048); p < 0.001). Interaction was highly significant by gender (p = 0.001) with significantly increased CIMT in asthmatic vs. non-asthmatics boys (difference 0.023 mm, 95% CI 0.003; 0.043), as compared to girls.Conclusion: Our study suggests an increased risk for early vascular change in adolescent asthmatic boys. Whereas the small number of girls limits the interpretation, the result necessitates further research into sex-specific atherosclerotic burden related to respiratory health in adolescence. What is Known: • Evidence points to a significant impact of adult respiratory disease on cardiovascular health indicators as well as on endpoints. • Inflammation is a key pathway in vascular change across the life course. What is New: • We observe an adverse association between physician-diagnosed asthma and carotid intima media thickness in adolescent boys. • Albeit a limited number of asthmatic girls, we hypothesize the gender typical timing of asthma or a higher male cardiovascular vulnerability as possible explanations for the gender-specific results. [ABSTRACT FROM AUTHOR]

Purpose: Given the broad range of biopsychosocial difficulties resulting from major depressive disorder (MDD), reliable evidence for predictors of improved mental health is essential, particularly from unbiased prospective community samples. Consequently, a broad spectrum of potential clinical and non-clinical predictors of improved mental health, defined as an absence of current major depressive episode (MDE) at follow-up, were examined over a 5-year period in an adult community sample.Methods: The longitudinal population-based PsyCoLaus study from the city of Lausanne, Switzerland, was used. Subjects having a lifetime MDD with a current MDE at baseline assessment were selected, resulting in a subsample of 210 subjects. Logistic regressions were applied to the data.Results: Coping styles were the most important predictive factors in the present study. More specifically, low emotion-oriented coping and informal help-seeking behaviour at baseline were associated with the absence of an MDD diagnosis at follow-up. Surprisingly, neither formal help-seeking behaviour, nor psychopharmacological treatment, nor childhood adversities, nor depression subtypes turned out to be relevant predictors in the current study.Conclusions: The paramount role of coping styles as predictors of improvement in depression found in the present study might be a valuable target for resource-oriented therapeutic models. On the one hand, the positive impact of low emotion-oriented coping highlights the utility of clinical interventions interrupting excessive mental ruminations during MDE. On the other hand, the importance of informal social networks raises questions regarding how to enlarge the personal network of affected subjects and on how to best support informal caregivers. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to assess the prevalence, the change, and the determinants of change in polypharmacy in a population-based sample. Methods: Baseline (2003-2006) and follow-up (2009-2012) data are from 4679 participants aged between 35 and 75 years (53.5% women, mean age 52.6 ± 10.6 years) from the population of Lausanne, Switzerland. Polypharmacy was defined by the regular use of ≥5 drugs. Four categories of change were defined: never (no polypharmacy at baseline and follow-up), initiating (no polypharmacy at baseline but at follow-up), maintaining, or quitting. Results: Polypharmacy increased from 7.7% at baseline to 15.3% at follow-up. Cardiovascular drugs were the most prescribed medicines at baseline and follow-up. Gender, age, obesity, smoking, previously diagnosed hypertension, or diabetes or dyslipidemia were significantly and independently associated with initiating and maintaining polypharmacy. Conclusion: In a population-based sample, prevalence of polypharmacy doubled over a 5.6-year period. The main determinants of initiating polypharmacy were age, overweight and obesity, smoking status, and previously diagnosed cardiovascular risk factors. [ABSTRACT FROM AUTHOR]

Peer victimization has been identified as a risk factor for depressive symptoms. The current study investigated the longitudinal interplay among social support, peer victimization and depressive symptoms in early adolescence. We specifically investigated the promotive and protective role of parental and friendship support on the longitudinal relationship between victimization and depressive symptoms. A total of 960 Swiss adolescents (49% female, M 13.2 years) completed an electronic questionnaire four times, with 6-month intervals. Trivariate cross-lagged models with latent longitudinal moderations were computed. The analyses confirmed that peer victimization was positively associated with changes in depressive symptoms, and depressive symptoms were positively associated with changes in victimization. Furthermore, bidirectional longitudinal associations between both parental and friendship support and depressive symptoms were found, while neither parental nor friendship support was found to be longitudinally associated with peer victimization. Further, neither parental nor friendship support moderated the longitudinal relationship between victimization and depressive symptoms. Thus, the present results suggested that parental and friendship support were promotive factors for adolescents' well-being, while neither parental, nor friendship support buffered the effect of victimization on depressive symptoms, thereby yielding no evidence for their longitudinal protective effect. [ABSTRACT FROM AUTHOR]

Purpose: To characterize the dietary intake of subjects aged 40-80 years according to self-reported diabetes and presence of an anti-diabetic diet. Methods: Cross-sectional study conducted between 2009 and 2012 on 4289 participants (2274 women) living in Lausanne. Results: Of the 299 (7 %) participants with self-reported diabetes, only 151 (51 %) reported an anti-diabetic diet. Compared to participants not reporting diabetes, participants with self-reported diabetes (with or without a diet) had a higher consumption of artificial sweeteners (0.3 ± 0.7 vs. 0.4 ± 0.8 and 0.8 ± 1.0 times/day) and a lower consumption of honey/jam (mean ± standard deviation: 0.5 ± 0.5 vs. 0.4 ± 0.4 and 0.4 ± 0.4 times/day) or sugar (0.6 ± 0.9 vs. 0.4 ± 0.7 and 0.2 ± 0.5 times/day) for participants not reporting diabetes, participants with self-reported diabetes not on a diet and on a diet, respectively. Compared to participants not on a diet, participants on a diet had a higher consumption of vegetables (1.8 ± 1.3 vs. 1.4 ± 1.0 portions/day), while no differences were found regarding all other food groups and nutrients. Participants with self-reported diabetes on a diet had a higher consumption of meat (5.6 ± 3.6 vs. 4.8 ± 2.9 portions/week) and a lower consumption of simple carbohydrates (21.0 ± 7.9 vs. 23.5 ± 8.4 % total energy intake) than participants not reporting diabetes. Conclusion: People with diabetes eat less simple carbohydrates, but do not comply with current advice on fish, nuts, fruits and vegetables. Improvement of the dietary intake in persons with diabetes in Switzerland is needed. [ABSTRACT FROM AUTHOR]

The article discusses two intensive longitudinal studies on the daily variations in health behaviors (HB) and daily functioning of young adults. Topics mentioned include the association between day-to-day HB and academic performance, the effects of sleep quality and physical activity on learning goal achievement via affect, and the correlation between self-report measurements of HB and behavioral measurements.

Purpose: The Nutrition Societies in Germany, Austria, and Switzerland recommend a daily intake of 20 µg vitamin D for adults when endogenous synthesis is absent. The current study aimed to elucidate whether this vitamin D dose impacts cardiovascular risk markers of adults during the winter months. Methods: The study was conducted in Halle (Saale), Germany (51 northern latitude) as a placebo-controlled, double-blinded, randomised trial (from January to April). A total of 105 apparently healthy subjects (male and female, 20-71 years old) were included. Subjects were randomly allocated to two groups. One group received a daily 20-µg vitamin D dose ( n = 54), and the other group received a placebo ( n = 51) for 12 weeks. Outcome measures included blood pressure, heart rate, concentrations of renin, aldosterone, serum lipids and vascular calcification markers, and haematologic variables such as pro-inflammatory monocytes. Results: Blood pressure and systemic cardiovascular risk markers remained unchanged by vitamin D supplementation, although serum 25-hydroxyvitamin D increased from 38 ± 14 to 73 ± 16 nmol/L at week 12. The placebo and vitamin D groups did not differ in their final cardiovascular risk profile. Conclusion: Daily supplementation of 20 µg vitamin D during winter is unlikely to change cardiovascular risk profile. [ABSTRACT FROM AUTHOR]

Background: The European Randomised Study of Prostate Cancer Screening has shown a 21% relative reduction in prostate cancer mortality at 13 years. The causes of death can be misattributed, particularly in elderly men with multiple comorbidities, and therefore accurate assessment of the underlying cause of death is crucial for valid results. To address potential unreliability of end-point assessment, and its possible impact on mortality results, we analysed the study outcome adjudication data in six countries.Methods: Latent class statistical models were formulated to compare the accuracy of individual adjudicators, and to assess whether accuracy differed between the trial arms. We used the model to assess whether correcting for adjudication inaccuracies might modify the study results.Results: There was some heterogeneity in adjudication accuracy of causes of death, but no consistent differential accuracy by trial arm. Correcting the estimated screening effect for misclassification did not alter the estimated mortality effect of screening.Conclusions: Our findings were consistent with earlier reports on the European screening trial. Observer variation, while demonstrably present, is unlikely to have materially biased the main study results. A bias in assigning causes of death that might have explained the mortality reduction by screening can be effectively ruled out. [ABSTRACT FROM AUTHOR]

Background: Vesicoureteral reflux (VUR) is a frequent cause of chronic kidney disease (CKD) in children. Using blood oxygenation level-dependent magnetic resonance imaging (BOLD-MRI), we measured cortical and medullary oxygenation in children with CKD due to VUR and compared the results to those obtained on healthy controls. Method: The study population comprised 37 children (19 with CKD due to VUR and 18 healthy age-matched controls). BOLD-MRI was performed before and after furosemide treatment. MR images were analyzed with the region-of-interest (ROI) technique to assess the mean R2* values (=1/T2*) of the cortex and medulla of each kidney and with the concentric object (CO) technique that divides renal parenchyma in 12 equal layers. Results: R2* values were significantly lower (corresponding to higher oxygenation) in the cortex and medulla of kidneys of children with CKD due to VUR than in those of the healthy controls (cortex 16.4 ± 1.4 vs. 17.2 ± 1.6 s, respectively; medulla 28.4 ± 3.2 vs. 30.3 ± 1.9 s, respectively; P < 0.05), and furosemide-induced changes in medullary R2* were smaller in the former than in the latter (−5.7 ± 3.0 vs. −6.9 ± 3.4 s, respectively; P < 0.05). Similar results were found with the CO technique. In children with a history of unilateral reflux ( n = 9), the non-affected contralateral kidneys presented similar R2* values as the diseased kidneys, but their response to furosemide was significantly larger (−7.4 ± 3.2 vs. −5.7 ± 3.0, respectively; P = 0.05). Conclusions: Chronic kidney disease due to VUR is not associated with kidney tissue hypoxia in children. The significantly larger furosemide-induced decrease in medullary R2* levels in the healthy group and unaffected contralateral kidneys of the VUR group points towards more intense renal sodium transport in these kidneys. [ABSTRACT FROM AUTHOR]

Background: Little is known about health-related quality of life (HRQoL) and mental health of parents having children with a history of hemolytic uremic syndrome (HUS). Methods: This study included 63 mothers and 58 fathers of a cohort of 63 HUS-affected children. At assessment, the mean time since a child experienced an acute episode of HUS was 6.4 years. Parental HRQoL, mental health and posttraumatic stress disorder (PTSD) were assessed with standardized self-report questionnaires. Medical data were extracted from patients' hospital records. Results: The HRQoL and mental health of both the mothers and fathers were not impaired compared to normative data. However, a shorter time since a child's acute HUS episode was a significant predictor of lower HRQoL among the mothers, while no such effect was found among the fathers. Two fathers (3 %), but no mothers, met the criteria for a diagnosis of HUS-related full PTSD; one father (2 %) and four mothers (6 %) met the criteria for a diagnosis of HUS-related partial PTSD. Conclusions: Our study shows that most parents of our study sample were doing well in terms of HRQoL and mental health, although a small number met the criteria for full or partial PTSD diagnosis due to their child's HUS. We therefore recommend that healthcare providers pay special attention to parents regarding PTSD symptoms during the clinical follow-up of a HUS-affected child since some parents may benefit from psychological support. [ABSTRACT FROM AUTHOR]

Purpose: Glomerular hyperfiltration has been suggested as a possible mechanism linking obesity and chronic kidney disease (CKD), independently of classical risk factors. We explored the association of overweight and obesity with glomerular hyperfiltration in a large sample of the Swiss adult population, accounting for several confounders including dietary factors. Methods: Data from a 2010 to 2012 cross-sectional population-based survey in Switzerland were used. Creatinine clearance (CrCl) was determined from 24-h urine collection; CrCl > 140 ml/min was used to define glomerular hyperfiltration. Participants were categorized into lean (<25 kg/m), overweight (25-29.9 kg/m) and obese (≥30 kg/m) according to body mass index (BMI). Results: A total of 1339 participants were included in the analysis [median (IQR) age 49.4 (34.3-63.5) years, 48.9 % men]. The prevalences of overweight and obesity were 32.2 and 14.2 %, respectively. Median CrCl was 102[84-121] ml/min in lean, 110 [87-136] ml/min in overweight and 124 [97-150] ml/min in obese participants ( p < 0.001). The prevalence of glomerular hyperfiltration increased across BMI categories (10.4, 20.8 and 34.7 %, respectively; p < 0.001). This positive association remained significant after adjusting for age, sex, hypertension, diabetes, smoking and dietary factors (sodium and protein intakes): odds ratio [95 %CI] 2.39 [1.52-3.76] ( p < 0.001) for overweight versus lean and 4.10[2.31-7.27] ( p < 0.001) for obesity versus lean. Conclusions: BMI categories and glomerular hyperfiltration are positively associated, independently of other known CKD risk factors and dietary confounders, suggesting that glomerular hyperfiltration may represent an early renal phenotype in obesity. Our observations confirm the significant association of glomerular hyperfiltration with sodium and protein intakes and identify sodium intake as an important modifying factor of the association between hyperfiltration and obesity. [ABSTRACT FROM AUTHOR]

Purpose: Obesity is a global epidemic affecting around 10 % of 5- to 17-year olds. With the causes for obesity being multifactorial, a better understanding of the influencing factors is essential for effective treatment and prevention programs. The aim of this study was therefore to identify specific risk factors for overweight and obesity in children in Switzerland. Methods: A nationally representative sample of children aged 6-12 years was recruited ( n = 2724). Height and weight were measured to calculate BMI (kg/m). In addition, a questionnaire was distributed to all children asking about their physical activity, media consumption, and dietary habits as well as some parental factors. Results: The prevalence of overweight and obesity in boys was 11.8 and 7.5 %, respectively, and in girls, it was 11.9 and 5.7 %. In univariate analyses, a number of parental, dietary, and activity factors were shown to be associated with BMI category. Based on a multinomial logistic regression, parent nationality and media consumption were the most important factors predicting obesity in boys, while in girls it was parental education, nationality, and physical activity. Conclusion: We have demonstrated that parental nationality and education play an important role in the development of childhood obesity, together with media consumption and physical activity. However, risk factors are also different according to child gender. Thus, an important target group for the treatment and prevention of childhood obesity in Switzerland are immigrant families, and the problem needs to be tackled differently in boys and girls as their risk factors are not the same. [ABSTRACT FROM AUTHOR]

Purpose: More than 95 % of the body carnitine is located in skeletal muscle, where it is essential for energy metabolism. Vegetarians ingest less carnitine and carnitine precursors and have lower plasma carnitine concentrations than omnivores. Principle aims of the current study were to assess the plasma and skeletal muscle carnitine content and physical performance of male vegetarians and matched omnivores under basal conditions and after l-carnitine supplementation. Results: Sixteen vegetarians and eight omnivores participated in this interventional study with oral supplementation of 2 g l-carnitine for 12 weeks. Before carnitine supplementation, vegetarians had a 10 % lower plasma carnitine concentration, but maintained skeletal muscle carnitine stores compared to omnivores. Skeletal muscle phosphocreatine, ATP, glycogen and lactate contents were also not different from omnivores. Maximal oxygen uptake (VOmax) and workload ( P) per bodyweight (bicycle spiroergometry) were not significantly different between vegetarians and omnivores. Sub-maximal exercise (75 % VOmax for 1 h) revealed no significant differences between vegetarians and omnivores (respiratory exchange ratio, blood lactate and muscle metabolites). Supplementation with l-carnitine significantly increased the total plasma carnitine concentration (24 % in omnivores, 31 % in vegetarians) and the muscle carnitine content in vegetarians (13 %). Despite this increase, P and VOmax as well as muscle phosphocreatine, lactate and glycogen were not significantly affected by carnitine administration. Conclusions: Vegetarians have lower plasma carnitine concentrations, but maintained muscle carnitine stores compared to omnivores. Oral l-carnitine supplementation normalizes the plasma carnitine stores and slightly increases the skeletal muscle carnitine content in vegetarians, but without affecting muscle function and energy metabolism. [ABSTRACT FROM AUTHOR]

Coparenting refers to the support parents bring to each other when rearing a child. Supportive coparenting ensures cohesiveness of the family, which is linked with child outcomes. Little is known, however, about the coparental relationship in stepfamilies between the custodial parent, usually the mother, and the new partner, and how it compares to coparenting with the father. This study addressed mother-reported coparenting in stepfamilies and also compared it with that in first-marriage families. Three dimensions of coparenting were considered: family integrity, disparagement, and conflict. Mothers ( N = 300) completed questionnaires on their coparenting relationship with the father and with the partner, marital satisfaction, and attachment. Half the mothers were living in a stepfamily with a child between 5 and 13 years old from a previous marriage, and half in a first-marriage family. The main results show that (a) mothers promote family integrity in stepfamilies either with the partner, or with the father, but not with both; (b) the older the child, the less the mothers reported integrity with the father in both families, and the more they reported disparagement against the partner and conflict with the partner in stepfamilies; and (c) maternal marital satisfaction is linked with all dimensions of coparenting with the father in first-marriage families, but only with disparagement against the partner and conflict with the partner in stepfamilies. Overall, coparenting has similar characteristics in both types of families, but also presents differences that should be considered when working with parents who are committed to a new relationship. [ABSTRACT FROM AUTHOR]

This study sought to determine the distribution of early-onset restrictive eating disturbances characteristic of the new DSM-5 diagnosis, avoidant/restrictive food intake disorder (ARFID) in middle childhood, as well as to evaluate the screening instrument, Eating Disturbances in Youth-Questionnaire (EDY-Q). A total of 1,444 8- to 13-year-old children were screened in regular schools (3rd to 6th grade) in Switzerland using the self-report measure EDY-Q, consisting of 12 items based on the DSM-5 criteria for ARFID. 46 children (3.2 %) reported features of ARFID in the self-rating. Group differences were found for body mass index, with underweight children reporting features of ARFID more often than normal and overweight children. The EDY-Q revealed good psychometric properties, including adequate discriminant and convergent validity. Early-onset restrictive eating disturbances are commonly reported in middle childhood. Because of possible negative short- and long-term impact, early detection is essential. Further studies with structured interviews and parent reports are needed to confirm this study's findings. [ABSTRACT FROM AUTHOR]

Study design:This is a retrospective analysis.Objectives:The objective of this study was to describe and quantify the discrepancy in the classification of the International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI) by clinicians versus a validated computational algorithm.Settings:European Multicenter Study on Human Spinal Cord Injury (EMSCI).Methods:Fully documented ISNCSCI data sets from EMSCI's first years (2003-2005) classified by clinicians (mostly spinal cord medicine residents, who received in-house ISNCSCI training by senior SCI physicians) were computationally reclassified. Any differences in the scoring of sensory and motor levels, American Spinal Injury Association Impairment Scale (AIS) or the zone of partial preservation (ZPP) were quantified.Results:Four hundred and twenty ISNCSCI data sets were evaluated. The lowest agreement was found in motor levels (right: 62.1%, P=0.002; left: 61.8%, P=0.003), followed by motor ZPP (right: 81.6%, P=0.74; left 80.0%, P=0.27) and then AIS (83.4%, P=0.001). Sensory levels and sensory ZPP showed the best concordance (right sensory level: 90.8%, P=0.66; left sensory level: 90.0%, P=0.30; right sensory ZPP: 91.0%, P=0.18; left sensory ZPP: 92.2%, P=0.03). AIS B was most often misinterpreted as AIS C and vice versa (AIS B as C: 29.4% and AIS C as B: 38.6%).Conclusion:Most difficult classification tasks were the correct determination of motor levels and the differentiation between AIS B and AIS C/D. These issues should be addressed in upcoming ISNCSCI revisions. Training is strongly recommended to improve classification skills for clinical practice, as well as for clinical investigators conducting spinal cord studies.Sponsorship:This study is partially funded by the International Foundation for Research in Paraplegia, Zurich, Switzerland. [ABSTRACT FROM AUTHOR]

Working memory (WM) and intraindividual variability (IIV) in processing speed are both hypothesized to reflect general attentional processes. In the present study, we aimed at exploring the relationship between WM capacity and IIV in reaction times (RTs) and its possible variation with development across the lifespan. Two WM tasks and six RT tasks of varying complexity were analyzed in a sample of 539 participants, consisting of five age groups: two groups of children (9-10 and 11-12 years of age), one group of young adults, and two groups of older adults (59-69 and 70-89 years of age). Two approaches were adopted. First, low-span and high-span individuals were identified, and analyses of variance were conducted comparing these two groups within each age group and for each RT task. The results consistently showed a span effect in the youngest children and oldest adults: High-span individuals were significantly faster and less variable than low-span individuals. In contrast, in young adults no difference was observed between high- and low-span individuals, whether in terms of their means or IIV. Second, multivariate analyses were conducted on the entire set of tasks, to determine whether IIV in RTs brought different information than the mean RT. The results showed that, although very strongly correlated, the mean and IIV in speed should be kept separate in terms of how they account for individual differences in WM. Overall, our results support the assumption of a link between WM capacity and IIV in RT, more strongly so in childhood and older adulthood. [ABSTRACT FROM AUTHOR]

The Health Action Process Approach (HAPA) assumes that volitional processes are important for effective behavioral change. However, intraindividual associations have not yet been tested in the context of smoking cessation. This study examined the inter- and intraindividual associations between volitional HAPA variables and daily smoking before and after a quit attempt. Overall, 100 smokers completed daily surveys on mobile phones from 10 days before until 21 days after a self-set quit date, including self-efficacy, action planning, action control, and numbers of cigarettes smoked. Negative associations between volitional variables and daily numbers of cigarettes smoked emerged at the inter- and intraindividual level. Except for interindividual action planning, associations were stronger after the quit date than before the quit date. Self-efficacy, planning and action control were identified as critical inter- and intraindividual processes in smoking cessation, particularly after a self-set quit attempt when actual behavior change is performed. [ABSTRACT FROM AUTHOR]

Purpose: Reports on the protective effect of a Mediterranean diet on mortality usually refer to populations from Mediterranean countries, leaving uncertain whether really diet is the fundamental cause. Our aim was to examine the effect of a Mediterranean diet on mortality in Switzerland, a country combining cultural influences from Mediterranean and Central European countries within a common national health and statistical registry. Methods: In this prospective investigation, we included 17,861 men and women aged ≥16 years who participated 1977-1993 in health studies and were followed up for survival until 2008 by anonymous record linkage with the Swiss National Cohort. A 9-point score Mediterranean Diet Score (MDS) was used to assess adherence to a Mediterranean diet. Mortality hazard ratios (HR) and 95 % confidence intervals (CIs) were calculated by using Cox regression models adjusted for age, sex, survey wave, marital status, smoking, body mass index, language region and nationality. Results: In all language regions, MDS was inversely associated with mortality. Consumption of dairy products was also consistently associated with lower mortality. When categorizing dairy food consumption as beneficial instead of harmful, this association between MDS and mortality increased in strength and was partly statistically significant. For all causes of death combined (HR for a one-point increase in MDS 0.96, 95 % CI 0.94-0.98), in men (0.94, 0.92-0.97), in women (0.98, 0.95-1.02) for cardiovascular diseases (CVD, 0.96, 0.92-0.99; 0.95, 0.90-1.00; 0.98, 0.92-1.04) and for cancer (0.95, 0.92-0.99; 0.92, 0.88-0.97; 0.98, 0.93-1.04). Conclusions: Stronger adherence to a Mediterranean diet was associated with lower all-cause, CVD and cancer mortality, largely independently of cultural background. These associations were primary due to the effect in men. Our finding of a beneficial rather than a deleterious impact of dairy products consumption prompts at considering culturally adapted Mediterranean diet recommendations. However, results should be interpreted with caution since only a crude 1-day dietary estimate was available to assess individuals' habitual dietary intake. [ABSTRACT FROM AUTHOR]