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Background: Young adults are not considered a risk group for contracting COVID-19, but they are disproportionately affected by pandemic containment measures compared to other age groups. University students were confronted with abrupt changes both in their personal and academic lives. The ‘‘Health in Students during the Corona pandemic’’ study (HES-C) investigated the health and health behavior, concerns and views in students of the Zurich University of Applied Sciences. In the current analyses, we focused on COVID-19 related preventive behaviors, alcohol and marijuana consumption during the pandemic. Methods: All students of the Zurich University of Applied Sciences (N = 12,429) were invited to a voluntary repeated crosssectional open cohort survey which took place from the April 3 2020 (T0) to January 25 (T5), covering two university semesters with overall 6 surveys. Participation rates varied from T0 20% to T5 13%. Results: While overall adherence to containment measures was high, men yielded lower adjusted odds (OR; 95%-CI) of adherence regarding the following measures: social distancing (0.68; 0.53- 0.87), non-utilization of public transport (0.74; 0.56-0.97), 5- person limit for social gatherings (0.47; 0.35-0.64) and the stay at home rule (0.64; 0.51-0.82). In addition to gender, factors associated with adherence were information source and perceived susceptibility to the virus. Out of 80% who reported having drunk alcohol during the last 30 days at T0, 31% engaged at least once in binge drinking (>5 beverages) and 18% consumed more than usual. Marijuana was consumed by 11%, of which 27% reported higher use during the lock-down than before. Longitudinal data on risk behavior and factors associated with risk behavior and changes in behavior are currently being analyzed and will be presented. Conclusions: Public health communication targeting university students should not only address pandemic related preventive behavior but also risk behavior during the pandemic. Key messages: The pandemic has led to increased risky health behavior among certain students. Public health communication targeting university students should not only address pandemic related preventive behavior but also risk behavior during the pandemic. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 pandemic has forced around 50 % of employees of Switzerland into a working from home setting during March and April 2020. Working from home appears to change the work experience of office workers considerably. The aim of this analysis was to investigate the effect of the first COVID-19 lockdown on work stress conditions. Methods: We based this longitudinal analysis on control group data from an ongoing stepped-wedge cluster randomized controlled trial. Office workers from two Swiss organizations, aged 18-65 years, were included. Baseline data from January 2020 (before the COVID-19 pandemic) were compared with follow-up data collected during the fourth and fifth week of the first lockdown (April 2020). Work stress conditions were measured using the Job-Stress-Index (JSI). The JSI indicates the ratio of workrelated resources (e.g., appreciation at work) and stressors (e.g., work organisation) on a scale from 0 (stressors < resources) to 100 (stressors > resources). Paired sample t-tests were performed for statistical analysis. Results: Data from 75 participants were analysed. Fifty-three participants were female (70.7 %). The mean age was 42.8 years (range from 21.8 to 62.7) at baseline. At baseline, the mean JSI was 47.6 (SD = 5.0), with 77.7 (SD = 12.4) for resources and 22.3 (SD = 10.1) for stressors. At follow-up, the mean JSI was 47.4 SD = 4.5), with 77.5 (SD = 11.7) for resources and 21.4 (SD = 9.6) for stressors. We found no evidence for a difference in JSI (estimate = 0.67, 95 % CI: -0.33 to 0.66, p-value = 0.50), its index of resources (estimate = 0.23, 95 % CI: -1.32 to 1.69, p-value = 0.82) or the index of work stressors (estimate = 1.4, 95 % CI: -0.32 to 2.02, p-value = 0.15) between measurement time points. Conclusions: The first COVID-19 lockdown did not result in a difference of work stress conditions among our sample of Swiss office workers. Improved working times and work-life balance may have contributed to this finding. Key messages: Improved working times and work-life balance may have contributed to stable task-related stressors and resources in the early phase of the lockdown. Other, non-work-related environmental stressors should be investigated to explain COVID-19-related changes in mental and physical health. [ABSTRACT FROM AUTHOR]

Objective: To assess the relative risk of low daily fruit and vegetable consumption for six large migrant groups in Switzerland.Design: Cross-sectional health survey carried out 2007 (Swiss Health Survey) and 2010 (Swiss Migrant Health Survey) in Switzerland. Multinomial logistic regression models were used to estimate relative risk rates (RRR) of migrants relative to Swiss nationals.Setting: Data obtained from representative samples of Swiss and foreign nationals living in Switzerland.Subjects: A random sample (n =14637) of the Portuguese, German, Italian, Turkish, Serbian, Kosovan and Swiss permanent resident adult population (17-64 years old) was interviewed.Results: The proportion of participants who adhered to the recommended fruit and vegetable consumption was below one-third in all study populations. Compared with Swiss nationals, the relative risk of low daily fruit and vegetable intake relative to recommended intake was higher in Turkish nationals (RRR = 2.92, 95 % CI 1.91, 4.48; P = 0.0000) and Kosovan nationals (RRR = 4.76, 95 % CI 3.01, 7.55; P = 0.0000). The respective relative risks of Portuguese, Serbian, German and Italian nationals were not significantly different from the Swiss reference group.Conclusions: Initiatives for the promotion of fruit and vegetable consumption should continue to address the population at large. At the same time, programmes that are tailored to the specific needs of migrants from Turkey and Kosovo should be considered. [ABSTRACT FROM AUTHOR]

Abstract Background The Swiss Health Survey (SHS) provides the only source of data for monitoring overweight and obesity in the general population in Switzerland. However, this survey reports body mass index (BMI) based on self-reported height and weight, and is therefore subject to measurement errors. Moreover, it is not possible to differentiate between overall and abdominal overweight. In this study, we aimed to gain a better understanding of the need for weight management in the general population of Switzerland by exploring and comparing prevalence rates of BMI and waist circumference (WC) based on physical measurements by trained observers, based on data from the 2009 National Blood Pressure Week (NBPW). Methods Sample selection was based on a one-stage cluster design. A total of 385 pharmacies representing 3,600 subjects were randomly selected from pharmacies participating in NBPW. BMI measures based on physical weight and height (NBPW) were compared with self-reported BMI measures from the SHS. BMI and WC measurements from NBPW were then used to produce population estimates of overweight and obesity. Results BMI-based overall prevalence of overweight and obesity was 43.6%, which was 4.7% higher than the value based on the respective SHS data. Overweight and obesity were more common in men (54.3%) than in women (33.5%). However, the overall prevalence of increased WC in the general population was estimated to be 64.4%, with more women (68.4%) than men (60.1%) exhibiting a WC above the threshold. The prevalence of subjects requiring weight management in the Swiss population remained high, even after adjusting WC for false positive and negative cases. Conclusions Firstly, it may be more appropriate for health promotion programs to address the wider group identified by WC, which includes subjects who need to reduce their weight, or gain no further weight. Secondly, the gender differences are reversed depending on the use of WC or BMI to identify subjects suitable for health promotion programs; more women than men are identified by WC, and more men than women using BMI. These differences should be accounted for in gender-specific health promotion programs.

Objectives: We aimed to assess the efficacy of a person-centered care intervention in improving quality of life (QoL) for people with dementia in long-term care facilities., Design: This study was a stepped-wedge cluster-randomized clinical trial of monthly person-centered outcome measurements, followed by collaborative nurse-led person profile interventions involving nursing staff and family members, compared with monthly person-centered outcome measurements alone., Setting and Participants: We included people with a medical diagnosis of Alzheimer's disease or vascular dementia or with clinical symptoms of dementia from 23 long-term care facilities in the German-speaking part of Switzerland., Methods: The primary outcome was QoL, as assessed using the QUALIDEM. Secondary outcomes were the QUALIDEM subscales and the Integrated Palliative Care Outcome Scale for People with Dementia subscales. The study duration was 15 months, and linear mixed-effect models were used for the analysis., Results: We recruited 240 people with dementia from 23 long-term care facilities. Modeling 1143 observations, we found a statistically significant positive intervention effect of 2.6 points according to the QUALIDEM (95% CI, 1.34-3.86; P < .001; total QUALIDEM intervention: 67; 95% CI, 64.8-69.1 vs 64.4; 95% CI, 62.3-66.4 for the control). We also found positive effects of the intervention on all secondary outcomes., Conclusions and Implications: Once-a-month person profile interventions based on person-centered outcome measurements provided a small but significant improvement in QoL. Thus, our findings suggest a potential benefit to the broader implementation of person profiles involving nursing staff and family members in long-term care facilities., Competing Interests: Disclosure The authors declare no conflicts of interest., (Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved.)

Aim: To compare student nurses' expectations and newly qualified nurses' experiences regarding clinical practice in Switzerland 1 year after graduation., Design: A secondary explorative analysis of a cross-sectional survey., Methods: The data were sourced from the Swiss National Graduate Survey of Health Professionals covering six universities of applied sciences between 2016 and 2019, with information on three cohorts of bachelor student nurses, with a 1-year follow-up between each year. The participants were 533 bachelor-prepared nursing graduates., Results: The student nurses' overall expectations included the following top two prioritized aspects: 'contributing to something important' and 'adequate time to spend with patients'. Newly graduated nurses' clinical practice experiences demonstrated that not all expectations were met 1 year after graduation. The largest gaps were found in 'adequate time to spend with patients', 'work-life balance' and experiencing 'good management'., Conclusion: The most crucial expectation gaps are related to having sufficient time to spend with patients and a good work-life balance. The most important result is whether there is a shortage of places for nurses to work rather than the oft-cited shortage of nurses., Implications for the Profession And/or Patient Care: The expectations of Swiss newly qualified nurses can be better met by an assessment in the first year about which individual perceptions of workplace characteristics cause them to make choices to change something about their work, affect their job satisfaction or influence their intention to stay., Impact: Few of the student nurses' expectations were met 1 year after graduation, therefore Swiss healthcare institutions should improve needs assessments to strengthen the nurse workforce starting early in employment. The results underscore the importance of a constructive management culture, such as that in magnet hospitals in the United States which underpins the philosophy of changing in nursing. The results can be used internationally as a benchmark and as a basis for introducing potential interventions for nurse retention., Reporting Method: This study was reported following the Standardized Reporting of Secondary Data Analyses Checklist., Patient or Public Contribution: There were no patient or public contributions., Trial and Protocol Registration: This study has not been registered., (© 2024 The Authors. Journal of Advanced Nursing published by John Wiley & Sons Ltd.)

Objectives: The aim of this study is to investigate the effect of treatment choice on survival, transfusion needs and hospitalizations in patients > 64 years old with newly diagnosed acute myeloid leukaemia (AML)., Material and Methods: This study retrospectively analysed patients over 64 years with AML diagnosed at a regional healthcare network in Switzerland between 2017 and 2020. Patients underwent four therapy groups: intensive chemotherapy (IC), hypomethylating agent in combination with the BCL2-Inhibitor venetoclax (HMA + VEN), hypomethylating agents alone (HMA) or best supportive care (BSC)., Results: Of 54 patients 12 (22%) were selected for IC, 13 (24%) for HMA + VEN, 17 (32%) for HMA and 12 (22%) for BSC. The median overall survival of the patients was 76 days, with a significant difference in the four therapy groups (IC 119 days, HMA + VEN 732 days, HMA monotherapy 73 days and BSC 12 days Log-Rank Test Chi2(2): p  < 0.001). Patients with HMA + VEN spent significantly less time in the hospital 6.8 days/month compared to IC (19.5 days/month), HMA (20.5 days/month) and BSC (10.5 days/month) ( p  = 0.005). Transfusion needs were the highest in IC (7.0 RBC/month, 8.0 PC/month) ( p  = 0.023), whereas there was no difference between HMA + VEN (2.5 RBC/month, 3.2 PC/month), HMA monotherapy (5.3 RBC/month, 6.2 PC/month) and BSC (3.0 RBC/month, 1.4 PC/month)., Conclusion: Our real-world data demonstrate superior OS rates of HMA + VEN when compared to IC, HMC or BSC, with a favourable side effect profile with regard to transfusion needs or hospitalization days., Abbreviations: AML, acute myeloid leukaemia; BCL2, B-cell leukaemia/lymphoma-2; BSC, best supportive care; CR, complete response; Cri, complete response with incomplete haematologic regeneration; FLT3, Fms Related Receptor Tyrosine Kinase 3; EKOS, Ethikkomission Ostschweiz; ELN, European Leukaemia Net; HMA, hypomethylating agent; IC, intensive chemotherapy; IDH, Isocitratdehydrogenase; LDAC, low-dose Cytarabine; NCCN, National Comprehensive Cancer Network; OS, overall survival; PC, platelet concentrate; RBC, red blood cell; RCT, randomized controlled trials; t-AML, therapy relative acute myeloid leukaemia'; VEN, venetoclax.

Aims of the Study: Health-related quality of life (HRQoL) indicators are patient-reported outcomes (PROs). PROs are defined as any report of the status of a patient's health condition or health behaviour that comes directly from the patient, without interpretation of the patient's response by a clinician or anyone else. Despite Swiss national bodies (FOPH, FMH) recognising the potential of PRO measures (PROMs) for improving the health system, no consensus has yet emerged regarding a generic PROM framework or specific domains for practical uptake. The aim of the present digital Delphi study was to generate a consensual Swiss expert opinion on a generic PROM framework, measurement domains and items from a validated instrument (PROMIS [Patient-Reported Outcome Measurement Information System]) as well as on the role and implementation of PROs in the Swiss healthcare system via PRO consensus statements., Methods: A 4-round digital Delphi study was conducted among Swiss PRO stakeholders. A total of n = 21 Swiss PROM stakeholders completed round 1 surveys on the PROM framework. During the stakeholder meeting, n = 11 stakeholders completed round 2 and round 3 surveys pertaining to measurement domains and items, respectively. In-meeting key questions and discussion items were extracted, consolidated into statements and subjected to consensus voting in a round 4, post-meeting survey. Consensus was defined as ≥70% agreement., Results: Pre-meeting, agreement was reached for the tripartite framework of physical, mental and social health (95-100%). During the meeting, agreement was reached on all seven measurement domains of a generic PROM (PROMIS-29), ranging from 80% (Anxiety, Sleep Disturbance) to 100% (Pain Interference, Depression, Ability to Participate in Social Roles). Consensus was also reached for all PROMIS-29 items, with average domain consensus ranging from 83% (Sleep Disturbance, Ability to Participate in Social Roles) to 100% (Depression). Finally, four post-meeting consensus statements regarding PROs in Switzerland reached agreement., Conclusions: A Delphi method can help identify areas of need regarding PROMs in Switzerland. The current study identified a generic PROM as a missing quality indicator for the Swiss national health system's value. A pre-meeting informational briefing, expert presentations and moderation supported three voting rounds to help identify PROMIS-29 as a PROM framework (round 1), measurement domains (round 2) and items (round 3) as a basis for further validation research. The empirical agreement among diverse stakeholders supports broad consensus towards preliminary feasibility of integrating generic PROMs into the Swiss health system based on content relevance.

Background: The need to maintain physical and social distance between people and the stay-at-home recommendation/order to contain the spread of COVID-19 have raised concerns about the possible increase in loneliness. However, few studies have analyzed trends or changes in loneliness in samples of young adults. The present study aimed to explore the prevalence of loneliness and its change during the COVID-19 pandemic., Participants and Procedure: This is a repeated cross-sectional study analyzing data collected through six online surveys between April 2020 and March 2021 from 5,669 university students in Switzerland. Logistic regression models were used to examine trends in loneliness and associations between loneliness, well-being, life at home, COVID-19 symptoms and tests., Results: Loneliness decreased between April 2020 and May-June 2020. In contrast, loneliness was higher in December 2020, January and March 2021 compared to April 2020. Loneliness was associated with younger age, studying architecture, design and civil engineering or engineering, enjoying time spent with family/partner, experiencing tensions and conflicts at home, boredom, feeling locked up and subjective well-being and current health., Conclusions: Our findings highlight an increase in loneliness during the second wave of the COVID-19 pandemic, although a seasonality effect cannot be excluded. Public health systems and educational institutions need to monitor the effects of social distancing measures and reduced social contact on students' loneliness and well-being., Competing Interests: The authors declare no conflict of interest., (Copyright © Institute of Psychology, University of Gdansk.)

In myelofibrosis, comorbidities (CMs) add prognostic information independently from the Dynamic International Prognostic Scoring System (DIPSS). The Myelodysplastic Syndrome-Specific Comorbidity Index (MDS-CI) offers a simple tool for CM assessment as it is calculable after having performed a careful history and physical examination, a small routine chemistry panel (including creatinine and liver enzymes) and a limited set of functional diagnostics. To assess the prognostic impact of the MDS-CI in addition to the DIPSS and the Mutation-Enhanced International Prognostic Scoring System (MIPSS)-70, we performed a retrospective chart review of 70 MF patients who had not received allogeneic stem cell transplantation (primary MF, n = 51; secondary MF, n = 19; median follow-up, 40 months) diagnosed at our institution between 2000 and 2020. Cardiac diseases (23/70) and solid tumors (12/70) were the most common CMs observed at MF diagnosis. Overall survival (OS) was significantly influenced by the MDS-CI (median OS MDS-CI low (n = 38): 101 months; MDS-CI intermediate (n = 25): 50 months; and high (n = 7): 8 months; p < 0.001). The MDS-CI added prognostic information after inclusion as a categorical variable in a multivariate model together with the dichotomized DIPSS or the dichotomized MIPSS70: MDS-CI high HR 14.64 (95% CI 4.42; 48.48), p = 0.0002, and MDS-CI intermediate HR 1.97 (95% CI 0.96; 4.03), p = 0.065, and MDS-CI high HR 19.65 (95% CI 4.71; 81.95), p < 0.001, and MDS-CI intermediate HR 1.063 (95% CI 0.65; 4.06), p = 0.2961, respectively. The analysis of our small and retrospective MF cohort suggests that the MDS-CI represents a useful tool to identify MF patients with an increased vulnerability due to comorbidities. However, analyses of larger cohorts are necessary to define the value of the MDS-CI as a prognostic tool in comparison with other comorbidity indices.

Background: The Integrated Palliative Care Outcome Scale for People with Dementia is a promising instrument for nursing home quality improvement and research in dementia care. It enables frontline staff in nursing homes to understand and rate the needs and concerns of people with dementia. We recently adapted the measure to include easy language for users from various educational backgrounds., Objectives: In this study, we examine the inter-rating reliability of the Integrated Palliative Care Outcome Scale for People with Dementia for frontline staff in nursing homes., Methods: In this secondary analysis of an experimental study, 317 frontline staff members in 23 Swiss nursing homes assessed 240 people with dementia from a convenience sample. Reliability for individual items was computed using Fleiss Kappa. Because of the nested nature of the primary data, a generalisability and dependability study was performed for an experimental IPOS-Dem sum score., Results: The individual Integrated Palliative Care Outcome Scale for People with Dementia items showed kappa values between .38 (95% CI .3-.48) and .15 (95% CI .08-.22). For the experimental IPOS-Dem sum score, a dependability index of .57 was found. The different ratings and time between ratings explain less than 2% of the variance in the sum score. The different nursing homes make up 12% and the people with dementia make up 43% of the sum score variance. The dependability study indicates that an experimental IPOS-Dem sum score could be acceptable for research by averaging two ratings., Conclusion: Limited research has been conducted on the measurement error and reliability of patient-centred outcome measures for people with dementia who are living in nursing homes. The Swiss Easy-Read IPOS-Dem is a promising instrument but requires further improvement to be reliable for research or decision making. Future studies may look at its measurement properties for different rater populations or at different stages of dementia. Furthermore, there is a need to establish the construct validity and internal consistency of the easy-read IPOS-Dem., Competing Interests: AK, FS, PL and TV are the translators/developers of the Swiss easy-read IPOS-Dem. The Swiss easy-read IPOS- Dem is a secondary outcome measure in a trial where AK is the Principal Investigator. This does not alter our adherence to PLOS ONE policies on sharing data and materials., (Copyright: © 2023 Spichiger et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: Musculoskeletal pain, especially back pain, is common among health care professionals (HP). For prevention purposes, it is important to know whether HP develop their symptoms before or after entering the health care workforce. Cross-sectional studies among HP cannot answer this question. This follow-up study measures the prevalence and individual course of musculoskeletal pain among full-time HP students at the end of their studies and one year after entering the health care workforce., Method: Self-reported one-year prevalence for low back pain, neck/shoulder pain, pain in arms/hands, and pain in legs/feet was collected at two timepoints from 1046 participating HP using an online questionnaire. Participants were asked whether their musculoskeletal pain was related to study or work conditions. Generalized estimating equation (GEE) models of the binomial family with log link were used to estimate adjusted prevalence and corresponding normal based 95% confidence intervals were derived using the bootstrap method with 1000 replications., Results: The prevalence of low back pain as well as neck and shoulder pain was very high at baseline and follow-up in all full-time students and later HP. Prevalence for pain in arms/hands, legs/feet was low and there were significant differences between the professions. HP clearly associated their low back pain and neck/shoulder pain with study and work conditions; HP strongly associated pain in arms/hands, legs/feet only with work conditions., Conclusion: Many HP suffer from back/neck/shoulder pain already as students before starting their professional career. The prevention of back/neck/shoulder pain must be part of the education of all health professions at universities. As an example of best practice, universities should incorporate ergonomic measures and exercises into the daily routine of training health professionals. The effects of physically demanding professional tasks on the upper and lower extremities need to be investigated in further studies to take preventive measures., (© 2023. The Author(s).)

Purpose Neck pain is common among office workers and leads to work productivity loss. This study aimed to investigate the effect of a multi-component intervention on neck pain-related work productivity loss among Swiss office workers. Methods Office workers, aged 18-65 years, and without serious neck-related health problems were recruited from two organisations for our stepped-wedge cluster randomized controlled trial. The 12-week multi-component intervention included neck exercises, health-promotion information, and workplace ergonomics. The primary outcome of neck pain-related work productivity loss was measured using the Work Productivity and Activity Impairment Questionnaire and expressed as percentages of working time. In addition, we reported the weekly monetary value of neck pain-related work productivity loss. Data was analysed on an intention-to-treat basis using a generalized linear mixed-effects model. Results Data from 120 participants were analysed with 517 observations. At baseline, the mean age was 43.7 years (SD 9.8 years), 71.7% of participants were female (N = 86), about 80% (N = 95) reported mild to moderate neck pain, and neck pain-related work productivity loss was 12% of working time (absenteeism: 1.2%, presenteeism: 10.8%). We found an effect of our multi-component intervention on neck pain-related work productivity loss, with a marginal predicted mean reduction of 2.8 percentage points (b = -0.27; 95% CI: -0.54 to -0.001, p = 0.049). Weekly saved costs were Swiss Francs 27.40 per participant. Conclusions: Our study provides evidence for the effectiveness of a multi-component intervention to reduce neck pain-related work productivity loss with implications for employers, employees, and policy makers.Trial Registration ClinicalTrials.gov, NCT04169646. Registered 15 November 2019-Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT04169646 ., (© 2022. The Author(s).)

Background: During the 2020/2021 winter, the labour market was under the impact of the COVID-19 pandemic. Changes in socioeconomic resources during this period could have influenced individual mental health. This association may have been mitigated or exacerbated by subjective risk perceptions, such as perceived risk of getting infected with SARS-CoV-2 or perception of the national economic situation. Therefore, we aimed to determine if changes in financial resources and employment situation during and after the second COVID-19 wave were prospectively associated with depression, anxiety and stress, and whether perceptions of the national economic situation and of the risk of getting infected modified this association., Methods: One thousand seven hundred fifty nine participants from a nation-wide population-based eCohort in Switzerland were followed between November 2020 and September 2021. Financial resources and employment status were assessed twice (Nov2020-Mar2021, May-Jul 2021). Mental health was assessed after the second measurement of financial resources and employment status, using the Depression, Anxiety and Stress Scale (DASS-21). We modelled DASS-21 scores with linear regression, adjusting for demographics, health status, social relationships and changes in workload, and tested interactions with subjective risk perceptions., Results: We observed scores above thresholds for normal levels for 16% (95%CI = 15-18) of participants for depression, 8% (95%CI = 7-10) for anxiety, and 10% (95%CI = 9-12) for stress. Compared to continuously comfortable or sufficient financial resources, continuously precarious or insufficient resources were associated with worse scores for all outcomes. Increased financial resources were associated with higher anxiety. In the working-age group, shifting from full to part-time employment was associated with higher stress and anxiety. Perceiving the Swiss economic situation as worrisome was associated with higher anxiety in participants who lost financial resources or had continuously precarious or insufficient resources., Conclusion: This study confirms the association of economic stressors and mental health during the COVID-19 pandemic and highlights the exacerbating role of subjective risk perception on this association., (© 2023. The Author(s).)

In myelofibrosis, the C-reactive protein (CRP)/albumin ratio (CAR) and the Glasgow Prognostic Score (GPS) add prognostic information independently of the Dynamic International Prognostic Scoring System (DIPSS). Their prognostic impact, if molecular aberrations are considered, is currently unknown. We performed a retrospective chart review of 108 MF patients (prefibrotic MF n = 30; primary MF n = 56; secondary MF n = 22; median follow-up 42 months). In MF, both a CAR > 0.347 and a GPS > 0 were associated with a shorter median overall survival (21 [95% CI 0-62] vs. 80 months [95% CI 57-103], p < 0.001 and 32 [95% CI 1-63] vs. 89 months [95% CI 65-113], p < 0.001). Both parameters retained their prognostic value after inclusion into a bivariate Cox regression model together with the dichotomized Mutation-Enhanced International Prognostic Scoring System (MIPSS)-70: CAR > 0.374 HR 3.53 [95% CI 1.36-9.17], p = 0.0095 and GPS > 0 HR 4.63 [95% CI 1.76-12.1], p = 0.0019. An analysis of serum samples from an independent cohort revealed a correlation of CRP with levels of interleukin-1β and albumin with TNF-α, and demonstrated that CRP was correlated to the variant allele frequency of the driver mutation, but not albumin. Albumin and CRP as parameters readily available in clinical routine at low costs deserve further evaluation as prognostic markers in MF, ideally by analyzing data from prospective and multi-institutional registries. Since both albumin and CRP levels reflect different aspects of MF-associated inflammation and metabolic changes, our study further highlights that combining both parameters seems potentially useful to improve prognostication in MF.

Introduction: Immunoadsorption (IA) of isohemagglutinins is an often-crucial procedure in preparation of major ABO blood group-incompatible living donor kidney transplantation (ABOi LDKT). Standard citrate-based anticoagulation during the procedure has potential disadvantages for distinct patient groups. In this study, we report our experience with an alternative anticoagulation scheme using heparin during IA for selected patients., Methods: We conducted a retrospective analysis of all patients who underwent IA with heparin anticoagulation between February 2013 and December 2019 at our institution with focus on the safety and efficacy of the adapted procedure. For further validation, we compared graft function, graft survival, and overall survival with those of all recipients of living donor kidney transplants with or without pretransplant desensitizing apheresis for ABO antibodies at our institution during the same period., Results: In thirteen consecutive patients prepared for ABOi LDKT with IA with heparin anticoagulation, no major bleeding or other significant complications were observed. All patients achieved sufficient isohemagglutinin titer reduction to proceed to transplant surgery. Graft function, graft survival, and overall survival did not significantly differ from patients treated with standard anticoagulation for IA or ABO compatible recipients of living donor kidneys., Conclusion: IA with heparin in preparation of ABOi LDKT is safe and feasible for selected patients after internal validation., Competing Interests: The authors have no conflicts of interest to declare., (Copyright © 2023 by The Author(s). Published by S. Karger AG, Basel.)

Background: Due to the complexity of the provision of care for people with dementia, pain assessment and management is still considered to be lacking. An optimal way to support frontline staff in providing pain assessment and management for people with dementia living in nursing homes has not yet been identified. The success of supporting interventions seems dependent on contextual factors in the nursing homes. This study, therefore, analyzes the feasibility of a nurse-led training intervention, using repeated on-site case studies, in modifying pain intensity and frequency in people with dementia., Methods: Using a quasi-experimental design, we undertook a multi-center study of nurse-led training in pain management, with subsequent on-site case studies. Healthcare workers from 3 nursing homes assessed pain in 164 residents with dementia over 147 days. We used mixed-effect growth curve models with spline regression to analyze the data., Results: We found that on-site case studies support frontline staff with pain management and assessment. Repeated reflection in case studies led to significantly longer pain free intervals (from 4.7 at baseline to 37.1 days at second follow-up) and decreased frequency of pain events (OR 0.54 at first follow-up and 0.43 at second follow-up). However no trends regarding pain intensity could be found. Therefore, on-site case studies may be valuable for improving pain frequency and pain-free intervals over time., Conclusion: This feasibility study shows the potential of on-site support for frontline nursing home staff. On-site case studies may also affect health outcomes in people with dementia. However, the complexity of dementia care necessitates the management of a broader range of needs., Trial Registration: The study was retrospectively registered on the tenth of January 2017 with the German registry of clinical trials (DRKS00009726)., (© 2022. The Author(s).)

(1) Background and objective: to explore the experiences of Swiss health care providers involved in a community fall prevention pilot project on barriers and facilitations in interprofessional cooperation between 2016 and 2017 in three regions of Switzerland. (2) Methods: semi-structured interviews with health care providers assessed their perspective on the evaluation of jointly developed tools for reporting fall risk, continuous training of the health care providers, sensitizing media campaigns, and others. (3) Results: One of the project's strengths is the interprofessional continuous trainings. These trainings allowed the health care providers to extend their network of health care providers, which contributed to an improvement of fall prevention. Challenges of the project were that the standardization of the interprofessional collaboration required additional efforts. These efforts are time consuming and, for some categories of health care providers, not remunerated by the Swiss health care system. (4) Conclusions: On a micro and meso level, the results of the present study indicate that the involved health care providers strongly support interprofessional collaboration in fall prevention. However, time and financial constraints challenge the implementation. On a macro level, potential ways to strengthen interprofessional collaboration are a core element in fall prevention.

Introduction: During treatment for alcohol use disorder (AUD), about 40% of patients return to drinking. Whether the risk of relapse changes during treatment and how relapses may affect the risk of subsequent relapse are unclear, however. The current study, therefore, aims to identify when and with what probability relapses occur., Methods: One hundred and three inpatients at an AUD treatment center participated in this observational study. The study documented relapse to drinking using breath analyzers, urine tests, and self-reported incidents for 42 days after the start of treatment. Time to the first relapse event and to any subsequent relapse event served as the outcome measures. The study determined the proportion of patients who had not experienced a relapse event at any given point by Kaplan-Meier estimates and Cox proportional hazards models. The study team computed the instantaneous probability of experiencing an event at any given point using generalized estimating equation (GEE) models of the binomial family with log-link and exchangeable correlation structure to estimate unadjusted and adjusted hazards., Results: Whereas the hazards of experiencing a first relapse event declined steadily over the 42 days, the hazards of experiencing a subsequent relapse following an initial event remained stable. Both first-time and recurrent relapses were positively associated with the number of DSM-5 AUD criteria., Conclusion: Whereas the risk of relapse declines with each day of abstinence during treatment, it remains high after an individual relapse for the first time. This finding implies that therapy should focus on strengthening self-efficacy for low-risk groups and on relapse-prevention strategies for high-risk groups., (Copyright © 2022 Elsevier Inc. All rights reserved.)

Objectives: Young adults have been overly affected by the containment measures against COVID-19 and, consequently, worsening in mental health and change in health behavior have been reported. Because the life phase of emerging adulthood is crucial for developing health behaviors, this study aims to examine increase in alcohol consumption, single and multiple binge drinking, and associated factors in students during lockdown and post-lockdown periods., Methods: A prospective open cohort study design with nine survey time points between April 2020 and June 2021 was conducted. The present study uses pooled data from the first survey T0 (3 April to 14 April) and follow-ups at T1 (30 April to 11 May 2020) and T2 (28 May to 8 June 2020). Students from all faculties of the Zurich University of Applied Sciences (ZHAW) ( N = 12'431) were invited. Of the 1,300 students who participated at baseline and in at least one follow-up, 1,278 (98.3%) completed the questionnaires, final net sample size was 947. Generalized Estimating Equations (GEE) models were used to investigate the factors associated with increases in alcohol consumption based on number of occasions/last 30 days; drinks/week, and binge drinking at T0, and respective changes at T1 and T2 (increases, decreases, no change)., Results: Overall, 20% of Swiss university students reported an increased alcohol consumption and 26% engaged in binge drinking. Number of drinks at baseline was associated with a higher probability of increased alcohol consumption, as well as engaging in single and multiple binge drinking events. Higher anxiety scores were associated with a higher probability to increase the alcohol consumption and engaging at least once in binge drinking. Additional factors associated with any binge drinking were male gender, younger age and not living with parents. Higher perceived social support was only associated with engaging in heavy binge drinking., Conclusions: A substantial number of students developed a more risky health behavior regarding alcohol consumption. It is important to identify at risk students and design target prevention including factors such as age, gender and social norms. Further, health behavior and determinants of health behaviors of students should be carefully monitored during the further course of the pandemic., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Zysset, Volken, Amendola, von Wyl and Dratva.)

Background and Objectives: Antibodies (Ab) against HLA and HPA antigens play an important role in HCT. In this prospective study we evaluated prevalence and kinetics of HLA- and HPA-Ab after HCT, including a possible donor-recipient transfer and their clinical relevance in respect to platelet transfusion refractoriness (PTR)., Materials and Methods: Patients were consecutively recruited. Ab were determined by microbead assay technique and a mean fluorescence intensity cut-off of 1,000., Results: At baseline, 21 donors (42 %) and 27 patients (54 %) had HLA-Ab with a mean panel reactivity (cPRA) of 34.9 ± 29.4 % and 46.1 ± 36.5 %, respectively. We observed a significant higher number of HLA-Ab specificities in female donors and patients and a predominance of HLA-class I Ab. At day 0 we detected an increase of HLA-Ab (from 526 to 673) and cPRA (55.2 ± 31.9 %). Thirty-six patients (72 %) developed new HLA-Ab, mainly 3 weeks after HCT. In 7 patients an HLA-Ab with the same specificity as detected in the corresponding donor emerged, suggesting a possible transfer from the donor to the recipient. Overall, MFI showed a high variation. Type and number of transfusions were not associated with number and intensity of HLA-Ab (ρ: -0.05 - 0.02). Number of HLA-Ab, cPRA and intensity were not associated with PTR, which occurred in 9 patients (18 %) and none had bleeding WHO > 2., Conclusions: Although a considerable number of patients have and develop HLA-Ab before and early after HCT, we found no association with PTR and bleeding and management should be individualized., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

Background: In Switzerland, there is a lack of adequate rehabilitation services, and effective coordination, that take into account the multifactorial health risks of older people. The literature shows that the hospitalisation rate in rehabilitation facilities has increased in recent years and that a gender bias exists. Additionally, there is little or no evidence available on the effect that a post-acute care programme might have over an extended period on functioning, quality of life and the informal network of older people. Therefore, the aim of this trial is to evaluate the sustainability of post-acute care within three nursing homes in Zurich, Canton of Zurich, Switzerland., Methods: The Prevention Admission into Nursing homes (PAN) study is a explorative, prospective, longitudinal pilot trial based on a convenience sample of three long-term care facilities in the Swiss Canton of Zurich. The proposed pilot study will examine the effects of a post-acute care programme on people aged ≥65 years with a post-acute care potential ≥ three admitted to any of the three post-acute care units (n = 260). Older people of all sexes admitted to one of the post-acute care units and likely to be discharged to home within 8 weeks will be eligible for participation in the study. The primary endpoint is functionality based on the Barthel Index. The secondary endpoints are independency based on delirium, cognition, mobility, falling concerns, frailty, weight/height/body mass index, post-acute care capability, quality of life, and lastly, the informal network. As part of process evaluation, a qualitative evaluation will be conducted based on constructive grounded theory to specifically analyse how the experience of informal caregivers (n = 30) can contribute to a successful daily life 6 months after discharge., Discussion: We expect to observe improved functional status and independence after the post-acute care programme. The qualitative evaluation conducted with caregivers will complement our description of the transition of older people towards living at home., Trial Registration: This study is registered in the German Clinical Trials Register under DRKS00016647 (registered on 23.05.2019)., (© 2022. The Author(s).)

Background: Hospitals are using nursing-sensitive outcomes (NSOs) based on administrative data to measure and benchmark quality of nursing care in acute care wards. In order to facilitate comparisons between different hospitals and wards with heterogeneous patient populations, proper adjustment procedures are required. In this article, we first identify predictors for common NSOs in acute medical care of adult patients based on administrative data. We then develop and cross-validate an NSO-oriented prediction model., Methods: We used administrative data from seven hospitals in Switzerland to derive prediction models for each of the following NSO: hospital-acquired pressure ulcer (≥ stage II), hospital-acquired urinary tract infection, non-ventilator hospital-acquired pneumonia and in-hospital mortality. We used a split dataset approach by performing a random 80:20 split of the data into a training set and a test set. We assessed discrimination of the models by area under the receiver operating characteristic curves. Finally, we used the validated models to establish a benchmark between the participating hospitals., Results: We considered 36,149 hospitalisations, of which 51.9% were male patients with a median age of 73 years (with an interquartile range of 59-82). Age and length of hospital stay were independently associated with all four NSOs. The derivation and validation models showed a good discrimination in the training (AUC range: 0.75-0.84) and in the test dataset (AUC range: 0.77-0.81), respectively. Variation among different hospitals was relevant considering the risk for hospital-acquired pressure ulcer (≥ stage II) (adjusted Odds ratio [aOR] range: 0.51 [95% CI: 0.38-0.69] - 1.65 [95% CI: 1.33-2.04]), the risk for hospital-acquired urinary tract infection (aOR range: 0.46 [95% CI: 0.36-0.58] - 1.45 [95% CI: 1.31-1.62]), the risk for non-ventilator hospital-acquired pneumonia (aOR range: 0.28 [95% CI: 0.09-0.89] - 2.87 [95% CI: 2.27-3.64]), and the risk for in-hospital mortality (aOR range: 0.45 [95% CI: 0.36-0.56] - 1.39 [95% CI: 1.23-1.60])., Conclusion: The application of risk adjustment when comparing nursing care quality is crucial and enables a more objective assessment across hospitals or wards with heterogeneous patient populations. This approach has potential to establish a set of benchmarks that could allow comparison of outcomes and quality of nursing care between different hospitals and wards.

Background: In this article, we report the cultural adaption and translation of the Integrated Palliative Care Outcome Scale for People with Dementia (IPOS-Dem) into a Swiss-German easy language version for proxy assessment of people with dementia living in Swiss nursing homes. The Swiss-German easy language version of the IPOS-Dem was developed and culturally adapted in a six-phase process from the German IPOS-Dem using recommended guidelines. With nursing home staff and laypeople, the conceptual definition and relevance of IPOS-Dem items were established during phase I. Phase II encompassed the completion of forward translations. Independent native speakers blind to the original scale translated and back-translated the Swiss-German easy language version. The resulting IPOS-Dem version was then blindly back-translated in phase III. Experts reviewed all resulting translations in phase IV to produce a pre-final IPOS-Dem version. Finally, the phase V cognitive debriefing involved two focus groups assessing the pre-final IPOS-Dem version. Phase V included cognitive interviews with laypeople (n = 2), family members of those with dementia (n = 4) and staff from different care contexts (n = 12)., Results: Using easy language specialists yielded a clinically relevant, comprehensive and understandable translation. In addition, face and content validity for the easy language version were established in the cognitive interviews., Conclusions: With an easy language IPOS-Dem, all frontline staff and family members can be empowered to communicate their observations after caring interactions. Enhanced clinical communication with easy language tools shows the potential for research and clinical applications. In addition, attentive use in scales of easy language communication may foster increased engagement with untrained laypeople in clinical and care research., (© 2022. The Author(s).)

Introduction: Job satisfaction of midwives is important to prevent skill shortage. Those working in midwife-led models of care work more independently and have more responsibility. No previous study investigated if a self-initiated and self-responsible project could enhance job satisfaction of midwives working in a medicalled maternity unit. The aim of this study was therefore to assess job satisfaction before and after the implementation of such a project., Methods: This is longitudinal observational study at three time points using quantitative and qualitative methods. A total of 43 midwives working in a Swiss labor ward participated in the online surveys and in the focus group discussions. The surveys comprised questions from validated instruments to assess job satisfaction. Descriptive and multivariable time series analysis were used for quantitative and content analysis for qualitative data., Results: Adjusted predicted scores decreased between t 0 and t 1 , and subsequently increased at t 2 without reaching baseline values (e.g. 'professional support subscales' between t 0 and t 1 : (0.65; 95% CI: 0.45-0.86 vs 0.26; 95% CI: 0.08-0.45, p=0.005) and between t 0 and t 2 (0.65; 95% CI: 0.45-0.86 vs 0.29; 95% CI: 0.12-0.47, p=0.004). Focus group discussions revealed four themes: 'general job satisfaction', 'challenges with the implementation', 'continuity of care' and 'meaning for the mothers'. Midwives perceived the additional tasks as stressors., Conclusions: The implementation of new projects might enhance work-related stress and consequently have negative impacts on job satisfaction in an early phase. Heads of institutions and policy makers should recognize the needs of support and additional resources for staff when implementing new projects., Competing Interests: The authors have completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest and none was reported., (© 2022 Grylka-Baeschlin S. et al.)

Introduction: Home-dwelling older people with chronic diseases often need the support of informal and formal caregivers in order to continue living at home. Family members, however, need to be willing and prepared for caregiving together with home care nurses., Objectives: The purpose of this study was to explore factors associated with family caregivers' preparedness to care for older home-dwelling adults who also receive home care nursing services., Methods: For this cross-sectional correlational study, a structured questionnaire was sent to family caregivers of adults aged 65 years or older receiving services from a community care agency. A total of 243 participants returned the questionnaire, of which 199 could be analyzed., Results: The stepwise backward regression model explained 29.1% of the variance of family caregivers' preparedness. Mutuality was the most strongly associated factor with family caregivers' preparedness whereas professional involvement of family caregiver in care process was important as well. Care intensity showed no significant impact., Conclusion: Nurses should support the whole family emotionally, and appreciate, admire, reinforce, and respect the caregivers' situation. Home care nurses need to invest in helping families to find solutions, to strengthen their relationships between family members and the older person dwelling at home.

Background: Young adults are not considered a risk group, but the public health response to COVID-19 impacts all citizens. We investigated the impact on young adults' and their adherence to containment measures addressing potential gender differences., Methods: In April 2020 12 341 students of the Zurich University of Applied Sciences were invited to a longitudinal health survey. Survey topics spanned socio-demographic data, students' health status and behavior, COVID-19 specific impact, concerns, information sources, adherence to containment measures, and trust in government bodies. Group comparisons by gender and multivariate ordinal regression models assessing adherence to restrictions of mobility and social contacts were conducted (n = 2373)., Results: Mean age was 26.4 (SD = 5.6), 70% were female. 43.5% reported some concern about their own health, 2.7% stated major worries. Women experienced more conflicts (p < 0.000) and, enjoyed time with the family more (p < 0.000). Men felt less locked up (p = 0.001). The most frequented COVID-19 information source was public media (48%) and confidence in government bodies was high (82%) for both genders. Men yielded lower adjusted odds (OR; 95%-CI) of adherence regarding the following measures: social distancing (0.68; 0.53-0.87), non-utilization of public transport (0.74; 0.56-0.97), 5-person limit for social gatherings (0.47; 0.35-0.64) and the stay at home rule (0.64; 0.51-0.82)., Conclusion: Early in the pandemic a high degree of adherence was observed in this young academic population. Containment measures restricting movement and social contact yielded considerable differences by gender, information source and perceived susceptibility to the virus. More targeted communication may increase adherence regarding mobility restrictions., (© The Author(s) 2021. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.)

Transfusions are the mainstay of supportive therapy in patients with aplastic anemia (AA) and may lead to anti- HLA alloimmunization, thereby also increasing the risk for donor-specific antibodies in the setting of HLA-mismatched transplantation. Historically, AA patients were thought to be at particularly high risk for HLA alloimmunization. In past decades, blood product manufacturing (leukoreduction) and HLA antibody testing have improved significantly by single antigen bead (SAB) technology. It is currently unknown how those developments have impacted HLA alloimmunization and treatment outcome in patients with AA. We retrospectively investigated 54 AA patients treated by immunosuppressive therapy or allogeneic hematopoietic cell transplantation after the introduction of the SAB assay at our center. We compared the HLA antibody results to a historical AA cohort (n = 26), treated before introduction of leukoreduced blood products from 1975 to 1995. HLA alloimmunization was detected in 43 of 54 (80%) recently treated patients. Past pregnancy, female gender, disease severity, age, and a history of other transfusions were significantly associated with a larger number or higher intensity (mean fluorescence intensity) of HLA antibodies. Treatment outcome including bleeding episodes, response to treatment, engraftment, graft-versus-host disease, and overall survival was not associated with HLA alloimmunization. In the historical cohort a significantly higher number of HLA antibodies (P < .01) with a higher mean fluorescent intensity (P < .01) was observed. HLA alloimmunization remains frequent in AA tested by current techniques, but it has significantly decreased since prior decades and does not affect treatment outcome. © 2021 American Society for Blood and Marrow Transplantation. Published by Elsevier Inc. All rights reserved., (Copyright © 2021 The American Society for Transplantation and Cellular Therapy. Published by Elsevier Inc. All rights reserved.)

To date, little is known about the long-term trajectory of generalized anxiety disorder (GAD) symptoms in health professions (HP) students over the course of the pandemic. Like health professionals in general, HP students may have a significantly greater susceptibility to GAD symptoms due to their involvement in the health care system and the associated specific stressors and risks during the COVID-19 pandemic. The HEalth in Students during the Corona pandemic study (HES-C) provided the opportunity to investigate the long-term course of GAD symptoms with eight measurement points over 14 months in 9380 HP and non-HP students in Switzerland between March 2020 and June 2021. We employed logistic regression models with clustered sandwich standard errors to estimate unadjusted and adjusted prevalence of GAD symptoms. In the full model, we adjusted for age, gender, nationality, social status, social support, self-efficacy, and COVID-19 symptoms in the past 4 weeks. At baseline, the estimated adjusted GAD symptom prevalence was 17.6% (95% CI = 14.4-20.7) in HP students and 24.4% (95% CI = 22.3-26.5) in their peers. With the peak of the second SARS-CoV-2 infection wave in October/November 2020, GAD symptom prevalence substantially increased and then remained stable over time, despite changes in the epidemiological situation and its associated containment measures. At the last follow-up in June 2021, GAD symptom prevalence in HP and non-HP students was 22.9% (95% CI = 16.3-29.5) and 36.9% (95% CI = 32.9-40.9), respectively. Absolute differences in GAD symptom prevalence between student groups over all eight measurement points ranged from 6.2% to 14.9% (all p < 0.05). Non-HP students are identified as a specifically vulnerable group. Accordingly, target group-specific public health campaigns and interventions should be developed with the aim to strengthen their resources, reducing GAD symptoms, and preventing chronification.

Aims: We aim to evaluate the effectiveness of the Integrated Palliative Care Outcome Scale for people with dementia-based case studies to improve the caring quality for people with dementia in nursing homes by frontline staff and family members., Background: Swiss nursing homes mostly care for people with dementia. This population is at high risk of receiving little to no palliation for their complex needs. The majority of Swiss frontline healthcare staff do not systematically report on the needs of their residents. Additionally, family members do not routinely participate in assessment processes., Design: We will conduct a stepped-wedge cluster randomized trial of repeated assessment using the Integrated Palliative Care Outcome Scale for people with dementia (IPOS-Dem) and subsequent case studies. Clusters will consist of Swiss nursing homes randomly assigned to one of three sequential intervention time points., Methods: The study population will consist of people with dementia living in nursing homes with and without specialized dementia care facilities. Over 16 months, staff working at the frontline and family members will assess the needs and concerns of people with dementia using IPOS-Dem. Depending on sequence allocation, facilitated case studies will start after 3, 6 or 9 months. The primary outcome will be caring quality measured by QUALIDEM. The secondary outcome will be symptoms and concerns, as indicated by the IPOS-Dem sum-score. The Zürich Ethics Committee approved the study in 2019 (2019-01847)., Impact: The results of this study will contribute to improving the effectiveness of person-centred care for people with dementia. Collaboration between healthcare staff and family members will be systematically developed and built upon thorough assessment using the IPOS-Dem and related case studies. The use of IPOS-Dem will offer all frontline staff a systematic approach to have an independent voice within the nursing process, regardless of their qualification or grade., (© 2021 The Authors. Journal of Advanced Nursing published by John Wiley & Sons Ltd.)

The speed and innovation of the COVID-19 vaccine development has been accompanied by insecurity and skepticism. Young adults' attitude to vaccination remains under investigation, although herd immunity cannot be reached without them. The HEalth in Students during the Corona pandemic study (HES-C) provided the opportunity to investigate vaccination intention in 1478 students in the sixth survey wave (January 2021), including vaccination intention, psychological antecedents of vaccine hesitancy, trust in government's vaccination strategy, and vaccination history. Associations with vaccination intention were analyzed with multivariate ordinal regression and predicted margins were calculated adjusting for gender, age, anxiety, health profession, and subjective health status. A third was decided (yes 25.1%, no 7.6%), and 68% were unsure about getting the COVID-19 vaccine when available. Next to demographic characteristics, vaccination history (influenza vaccination OR = 1.39; 95% CI: 1.06-1.83, travel vaccination OR = 1.29; 95% CI: 1.04-1.60), trust in vaccination strategy (OR = 2.40; 95% CI: 1.89-3.05), and 5C dimensions were associated with vaccination intention: confidence (OR = 2.52; 95% CI: 2.09-3.03), complacency (OR = 0.79; 95% CI: 0.66-0.96), calculation (OR = 0.79; 95% CI: 0.70-0.89), constraints (OR = 1.18; 95% CI: 0.99-1.41), and collective responsibility (OR = 4.47; 95% CI: 3.69-5.40). Addressing psychological antecedents and strengthening trust in official strategies through targeted campaigns and interventions may increase decisiveness and result in higher vaccination rates.

Purpose: The aim of this study was to investigate the effect of working from home on neck pain (NP) among office workers during the COVID-19 pandemic., Methods: Participants from two Swiss organisations, aged 18-65 years and working from home during the lockdown (n = 69) were included. Baseline data collected in January 2020 before the lockdown (office work) were compared with follow-up data in April 2020 during lockdown (working from home). The primary outcome of NP was assessed with a measure of intensity and disability. Secondary outcomes were quality of workstation ergonomics, number of work breaks, and time spent working at the computer. Two linear mixed effects models were fitted to the data to estimate the change in NP., Results: No clinically relevant change in the average NP intensity and neck disability was found between measurement time points. Each working hour at the computer increased NP intensity by 0.36 points (95% CI: 0.09 to 0.62) indicating strong evidence. No such effect was found for neck disability. Each work break taken reduced neck disability by 2.30 points (95% CI:  - 4.18 to  - 0.42, evidence). No such effect was found for NP intensity. There is very strong evidence that workstation ergonomics was poorer at home., Conclusion: The number of work breaks and hours spent at the computer seem to have a greater effect on NP than the place of work (office, at home), measurement time point (before COVID-19, during lockdown) or the workstation ergonomics. Further research should investigate the effect of social and psychological factors., Trial Registration: ClinicalTrials.gov, NCT04169646. Registered 15 November 2019-Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT04169646 ., (© 2021. The Author(s).)

Objective: The COVID-19 pandemic and government measures implemented to counter the spread of the infection may be a major stressor affecting the psychological health of university students. This study aimed to explore how anxiety symptoms changed during the pandemic., Methods: 676 students (76% females) at Zurich University of Applied Sciences participated in the first (T0) and second (T1) survey waves. Anxiety symptoms were assessed using the Generalized Anxiety Disorder-Scale-7 (GAD-7). Risk and protective factors (e.g., COVID-19-related variables) were examined., Results: GAD-7 scores decreased significantly from T0 to T1 (mean change: -0.446, SE = 0.132, 95% CI: -0.706, -0.186, t = -3.371, df = 659, p = 0.001). Participants with moderate-to-severe anxiety score were 20.2 and 15.6% at T0 and T1, respectively. The following positively predicted anxiety: older age, female gender, non-Swiss nationality, loneliness, participants' concern about their own health, and interaction between time and participants' concern about their own health. Resilience and social support negatively predicted anxiety., Conclusions: Our findings provide information for public health measures and psychological interventions supporting the mental health of university students during the COVID-19 emergency., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Amendola, von Wyl, Volken, Zysset, Huber and Dratva.)