Population In Switzerland Research Articles

Measuring Vaccine Literacy in Switzerland: How is the situation after COVID-19?

Abstract Background Vaccinations are one of the most effective medical health interventions and one of the most important preventive measures. However, the population is often unsure about vaccination, and the roles and responsibilities of the key actors seem often unclear. To adequately protect the population against vaccine-preventable diseases, the Swiss Confederation, the Cantons and other stakeholders have developed the National Vaccination Strategy and an associated action plan. For its implementation, studies on the population’s knowledge, attitudes, skills, and vaccination behavior are crucial. Thus, the Swiss Federal Office of Public Health launched a study to assess vaccine literacy and its relation to vaccination readiness and behavior in the adult population in Switzerland. Methods A representative sample of 2,500 people living in Switzerland will be surveyed in summer 2024. The online questionnaire will include validated instruments, e.g. the HLS19-VAC Instrument to measure vaccine literacy or the 7C Vaccination Readiness Scale, as well as questions on correlates of vaccine literacy, vaccination readiness and behavior. Results The results of the survey will be presented, with a focus on vaccine literacy, vaccination readiness and behavior and their correlates. Specifically, differences among the three main language regions and between specific population groups will be shown. Further, a comparison with data from previous studies will be presented. Conclusions Despite having an advanced healthcare system, to date Switzerland has only partially reached its objectives in terms of vaccination, both for individual protection and collective immunity. New data on vaccine literacy, vaccination readiness and behavior as well as on the influencing factors are needed, especially after the pandemic, to guide effective future actions and measures to improve the vaccine coverage and public health in Switzerland. Key messages • Due to the COVID-19 pandemic the topic of vaccination in general has received increasing attention and may has changed people’s knowledge and attitudes towards vaccination. • Newest data on vaccine literacy, vaccination readiness and behavior are necessary to inform future, targeted actions and increase vaccine uptake.

Genetic structure of the European white elm (Ulmus laevis Pall., Ulmaceae) in Switzerland

Key messagePopulations of the European white elm (Ulmus laevis Pall.) in Switzerland can be considered natural. They show no evidence of genetic differentiation from other European populations. In the past, the U. laevis populations were probably more widespread and continuous in Switzerland with a larger gene flow.ContextIn Switzerland, at the margin of its distribution range, U. laevis is rare and considered endangered. Whether the species is native to Switzerland has been disputed, and it is often surmised to be solely cultivated, without any natural population in the country.AimsThe structure of genetic diversity among Swiss populations of U. laevis and comparison to European populations are expected to shed light on the origin of local populations and support their management.MethodsWe analyzed 19 populations (194 individuals) in Switzerland and 15 populations (158 individuals) from other European countries, using a set of five microsatellite loci.Results(1) 90% of the genetic variation in European and Swiss populations occurs within populations. (2) We did not detect isolation by distance at the regional or continental scale. (3) Clustering analysis did not reveal any spatial pattern in the level of admixture of individuals within Swiss or other European populations.ConclusionModerate levels of genetic diversity and evidence for recent gene flow between populations indicate that habitat deterioration, loss, and fragmentation are the main threats to the persistence of U. laevis populations in Switzerland.

Who are the patients who use non-pharmacological home remedies? Cross-sectional study in Switzerland and France.

Many patients may be tempted to use non-pharmacological home remedies (NPHRs) to relieve various complaints. To the best of our knowledge, there is little data on the characteristics of patients using NPHRs. In this cross-sectional study carried out between March 2020 and July 2021, we examined the socio-demographic factors underlying their use in patient populations in Switzerland and France. Using official registries, we randomly selected 50 primary care physicians (PCPs) in Geneva (Switzerland) and Lyon/Grenoble (France). Seven research assistants consecutively recruited patients from PCP waiting rooms (20-25 patients per practice). Patients completed a paper-based questionnaire assessing the use [yes/no] of 304 NPHRs for 79 medical conditions. The NPHR list was developed by our team with input from 97 patients. We used univariable and multivariable logistic regressions, adjusting for intra-cluster correlations, to examine associations between NPHR use and patient characteristics (gender, age, practice location, nationality, education level, and self-rated health). Of the 1198 eligible patients, 1012 agreed to participate (85%). Overall, 635 patients (63%) reported using at least one of the remedies tested in the study. In multivariable analysis, women (OR = 1.7 [95%CI = 1.3-2.3], P-value < 0.001), younger patients (< 40 years: OR = 2.1 [95%CI = 1.6-2.9], P-value < 0.001), and French patients (OR = 1.6 [95%CI = 1.1-2.3], P-value < 0.001) tended to use NPHRs more often than other patients. Many patients, particularly women, young people, and French patients, reported using NPHRs. This survey's findings hold the potential to inform healthcare providers, policymakers, and researchers about the diverse preferences that shape patients' healthcare choices.

On the Timing of Marriage and Childbearing: Family Formation Pathways Among Immigrants in Switzerland.

This paper examines childbearing in and outside of marriage as a manifestation of the Second Demographic Transition among immigrant populations in Switzerland. Based on full-population register data, we simultaneously analyse fertility and partnership changes at different stages of the migration process. Results from a multistate event history model show that most of the differences in family formation patterns between migrant groups and natives are in the sequencing of marriage and first birth among childless unmarried women. Out of wedlock family trajectories prove to be a common experience for European migrants, but a sustainable family pathway only among natives, as well as among immigrants from France, and Sub-Saharan Africa. Among married women, it is the risk of a third birth that marks the differences between groups; first and second birth rates are relatively similar across migrant groups. Distinguishing between the transition patterns of newly arrived immigrants and settled immigrants (characterised by various residence durations) support the disruption hypothesis among EU migrants and the interrelated life events hypothesis among non-EU groups. Family size and the partnership context of fertility highlight which family regime prevails in different population subgroups and the role that immigrants play in the Second Demographic Transition and family transformation in Europe.

Cis-regulatory polymorphism at fiz ecdysone oxidase contributes to polygenic evolutionary response to malnutrition in Drosophila.

We investigate the contribution of a candidate gene, fiz (fezzik), to complex polygenic adaptation to juvenile malnutrition in Drosophila melanogaster. Experimental populations maintained for >250 generations of experimental evolution to a nutritionally poor larval diet (Selected populations) evolved several-fold lower fiz expression compared to unselected Control populations. Here we show that this divergence in fiz expression is mediated by a cis-regulatory polymorphism. This polymorphism, originally sampled from a natural population in Switzerland, is distinct from a second cis-regulatory SNP previously identified in non-African D. melanogaster populations, implying that two independent cis-regulatory variants promoting high fiz expression segregate in non-African populations. Enzymatic analyses of Fiz protein expressed in E. coli demonstrate that it has ecdysone oxidase activity acting on both ecdysone and 20-hydroxyecdysone. Four of five fiz paralogs annotated to ecdysteroid metabolism also show reduced expression in Selected larvae, implying that malnutrition-driven selection favored general downregulation of ecdysone oxidases. Finally, as an independent test of the role of fiz in poor diet adaptation, we show that fiz knockdown by RNAi results in faster larval growth on the poor diet, but at the cost of greatly reduced survival. These results imply that downregulation of fiz in Selected populations was favored by selection on the nutritionally poor diet because of its role in suppressing growth in response to nutrient shortage. However, they suggest that fiz downregulation is only adaptive in combination with other changes evolved by Selected populations, which ensure that the organism can sustain the faster growth promoted by fiz downregulation.

Quality of life and associated factors in Swiss trans people: a cross-sectional study.

Experiences of stressful life events during transition may have a negative impact on quality of life (QoL) in trans persons. Little attention has been paid to this population in Switzerland, resulting in sparse data on their QoL and associated social factors. 30 participants were recruited during their medical transition treatment and surveyed on their experiences within this time period (13 months after the first medical intervention on average). After performing a diagnostic interview to evaluate their mental health, health-related QoL, psychological distress, self-esteem and the impact of life events that occurred in the last six months on participants were further assessed. Approximately 17% of participants had suffered from major depression, 43% reported having had suicidal thoughts or having attempted suicide, and 43% suffered from an anxiety disorder. Psychological distress was twice as high compared to the norm values of the cis population. With regard to QoL, trans individuals showed impairments in the mental domain. Stressful life events were particularly evident on a psychological and social level. Analysis showed a negative correlation between impact of life events and mental QoL and between psychological distress and mental QoL. At the same time, there was a positive correlation between self-esteem and mental QoL. Psychological distress and self-esteem emerged as independent significant predictors of mental QoL. This study shows lowered mental QoL and associations of low mental QoL with psychological distress, low self-esteem and stressful life events in trans individuals in Switzerland. The findings concur with the Gender Minority Stress Model and point out that medical transition must not be viewed in isolation but must be embedded in the framework of integrative psychosocial support.

A Cross-Sectional Study of the Prevalence and Determinants of Common Mental Health Problems in Primary Care in Switzerland.

Objective: This study investigated the prevalence of the most common mental health symptoms in a large primary care patient population and characterized their determinants. Methods: Data came from a 2015-16 cross-sectional study of a primary care population in Switzerland. An investigator presented the study to patients in waiting rooms, and 1,103 completed a tablet-based questionnaire measuring stress in daily life, sleep disorders and anxiety and depressive symptoms. Diagnoses and treatments were recorded. Results: Moderate-to-high anxiety and depressive symptoms concerned 7.7% of patients; 27.6% felt stressed at least once a week; 17.2% had severe sleep disorders. Sociodemographic determinants were associated with psychiatric symptoms: female sex, young age, and frequency of consultations with a GP. Participants taking psychotropics had high levels of mental distress. Conclusion: Even though most patients were regularly monitored by their GP, a significant number of mental health problems were found. GPs should be provided with concrete tools to manage these patients better. Collaboration with mental health specialists should be encouraged in primary care settings.

Long-Term Risk of Stroke After Transcatheter Aortic Valve Replacement: Insights From the SwissTAVI Registry

BackgroundStroke after transcatheter aortic valve replacement (TAVR) is associated with considerable morbidity and mortality. Predictors of stroke and the long-term risk after TAVR remain incompletely understood. ObjectivesThe authors sought to investigate the short- and long-term incidence and predictors of stroke after TAVR in the SwissTAVI Registry. MethodsBetween February 2011 and June 2021, consecutive patients undergoing TAVR were included. Standardized stroke ratios (SSRs) were calculated to compare trends in stroke of TAVR patients with an age- and sex-matched general population in Switzerland derived from the 2019 Global Burden of Disease study. ResultsA total of 11,957 patients (81.8 ± 6.5 years of age, 48.0% female) were included. One-third of the patients (32.3%) had a history of atrial fibrillation, and 11.8% had a history of cerebrovascular accident. The cumulative 30-day incidence rate of stroke was 3.0%, with 69% of stroke events occurring within the first 48 hours after TAVR. The incidence of stroke was 4.3% at 1 year, and 7.8% at 5 years. Compared with an age- and sex-adjusted general population, the risk of stroke was significantly higher in the TAVR population during the first 2 years after TAVR: first year: SSR 7.26 (95% CI: 6.3-8.36) and 6.82 (95% CI: 5.97-7.79) for males and females, respectively; second year: SSR 1.98 (95% CI: 1.47-2.67) and 1.48 (95% CI: 1.09-2.02) for males and females, respectively; but returned to a comparable level to that observed in the matched population thereafter. ConclusionsCompared with an age- and sex-matched population, TAVR patients experienced a higher risk of stroke for up to 2 years after the procedure, and a comparable risk thereafter. (SwissTAVI Registry; NCT01368250)

Psychological distress during the COVID-19 pandemic: changes over time and the effect of socioeconomic status

INTRODUCTION: The COVID-19 pandemic strongly affected mental health, increasing the prevalence of depression, anxiety, and stress worldwide. Previous research has shown that low education and low income can negatively impact mental health. During the pandemic, the population of Switzerland had to change their daily lives, which might have influenced their mental health. AIMS OF THE STUDY: We used longitudinal data on mental health during the COVID-19 pandemic to (a) assess psychological distress in the adult general population, (b) investigate changes in psychological distress during the pandemic, and (c) evaluate the association of income and education with psychological distress. METHODS: Participants were recruited between January and May 2021 using a random sampling method, provided by the Federal Office of Statistics, from the adult general population in the canton of Lucerne (age ≥20 years, n = 5092). Sociodemographic data were collected with a baseline questionnaire. Mental health data were collected via monthly digital follow-up surveys using the validated Depression, Anxiety, and Stress Scale (DASS-21, three subscales with five categories from “normal” to “extremely severe”) to assess psychological distress. We used descriptive statistics to measure psychological distress and a one-way repeated measures ANOVA to test for the differences between the mean depression, anxiety, and stress scores over time. We used multilevel ordered logistic regression models to assess the association of income and education with psychological distress, adjusting for sex, age, nationality, employment, and previous Polymerase Chain Reaction (PCR) tests, as these factors are known to influence psychological distress and socioeconomic position within countries. RESULTS: In total, 953 (83%) individuals completed at least one digital follow-up survey (mean age = 57 years, range: 20–91). Most had achieved secondary education (95%) and had a monthly household income of 6001–12,000 Swiss Francs (41%). The majority (&gt;80%) of the population reported “normal” depression, anxiety, and stress levels according to the DASS-21. We found no significant change in any of the subscales over time. Compared to those with middle household incomes, people with low household incomes reported higher anxiety levels (Odds Ratio [OR] = 2.11, p = 0.041). People with a tertiary education reported lower anxiety levels than those with a secondary education (OR = 0.39, p = 0.009). CONCLUSIONS: Most participants reported normal levels of psychological distress during the COVID-19 pandemic from February to November 2021. People with lower education levels and low incomes were more vulnerable to anxiety and should be considered in mental health campaigns.

Thelong-lasting legacy of reproduction: lifetime reproductive success shapes expected genetic contributions of humansafter 10 generations.

An individual's lifetime reproductive success (LRS) measures its realized genetic contributions to the next generation, but how well does it predict this over longer periods? Here we use human genealogical data to estimate expected individual genetic contributions (IGC) and quantify the degree to which LRS, relative to other fitness proxies, predicts IGC over longer periods. This allows an identification of the life-history stages that are most important in shaping variation in IGC. We use historical genealogical data from two non-isolated local populations in Switzerland to estimate the stabilized IGC for 2230 individuals approximately 10 generations after they were born. We find that LRS explains 30% less variation in IGC than the best predictor of IGC, the number of grandoffspring. However, albeit less precise than the number of grandoffspring, we show that LRS does provide an unbiased prediction of IGC. Furthermore, it predicts IGC better than lifespan, and accounting for offspring survival to adulthood does not improve the explanatory power. Overall, our findings demonstrate the value of human genealogical data to evolutionary biology and suggest that reproduction-more than lifespan or offspring survival-impacts the long-term genetic contributions of historic humans, even in a population with appreciable migration.

Educational level-dependent melanoma awareness in a high-risk population in Switzerland.

The worldwide incidence of melanoma has been increasing rapidly in recent decades with Switzerland having one of the highest rates in Europe. Ultraviolet (UV) radiation is one of the main risk factors for skin cancer. Our objective was to investigate UV protective behavior and melanoma awareness in a high-risk cohort for melanoma. In this prospective monocentric study, we assessed general melanoma awareness and UV protection habits in at-risk patients (≥100 nevi, ≥5 dysplastic nevi, known CDKN2A mutation, and/or positive family history) and melanoma patients using questionnaires. Between 01/2021 and 03/ 2022, a total of 269 patients (53.5% at-risk patients, 46.5% melanoma patients) were included. We observed a significant trend toward using a higher sun protection factor (SPF) in melanoma patients compared with at-risk patients (SPF 50+: 48% [n=60] vs. 26% [n=37]; p=0.0016). Those with a college or university degree used a high SPF significantly more often than patients with lower education levels (p=0.0007). However, higher educational levels correlated with increased annual sun exposure (p=0.041). Neither a positive family history for melanoma, nor gender or Fitzpatrick skin type influenced sun protection behavior. An age of ≥ 50 years presented as a significant risk factor for melanoma development with an odd's ratio of 2.32. Study participation resulted in improved sun protection behavior with 51% reporting more frequent sunscreen use after study inclusion. UV protection remains a critical factor in melanoma prevention. We suggest that melanoma awareness should continue to be raised through public skin cancer prevention campaigns with a particular focus on individuals with low levels of education.

Patient and General Population Preferences Regarding the Benefits and Harms of Treatment for Metastatic Prostate Cancer: A Discrete Choice Experiment

BackgroundPatient preferences for treatment outcomes are important to guide decision-making in clinical practice, but little is known about the preferences of patients with metastatic hormone-sensitive prostate cancer (mHSPC). ObjectiveTo evaluate patient preferences regarding the attributed benefits and harms of systemic treatments for mHSPC and preference heterogeneity between individuals and specific subgroups. Design, setting, and participantsWe conducted an online discrete choice experiment (DCE) preference survey among 77 patients with metastatic prostate cancer (mPC) and 311 men from the general population in Switzerland between November 2021 and August 2022. Outcome measurements and statistical analysisWe evaluated preferences and preference heterogeneity related to survival benefits and treatment-related adverse effects using mixed multinomial logit models and estimated the maximum survival time participants were willing to trade to avert specific adverse effects. We further assessed characteristics associated with different preference patterns via subgroup and latent class analyses. Results and limitationsPatients with mPC showed an overall stronger preference for survival benefits in comparison to men from the general population (p = 0.004), with substantial preference heterogeneity between individuals within the two samples (both p < 0.001). There was no evidence of differences in preferences for men aged 45–65 yr versus ≥65 yr, patients with mPC in different disease stages or with different adverse effect experiences, or general population participants with and without experiences with cancer. Latent class analyses suggested the presence of two groups strongly preferring either survival or the absence of adverse effects, with no specific characteristic clearly associated with belonging to either group. Potential biases due to participant selection, cognitive burden, and hypothetical choice scenarios may limit the study results. ConclusionsGiven the relevant heterogeneity in participant preferences regarding the benefits and harms of treatment for mHSPC, patient preferences should be explicitly discussed during decision-making in clinical practice and reflected in clinical practice guidelines and regulatory assessment regarding treatment for mHSPC. Patient summaryWe examined the preferences (values and perceptions) of patients and men from the general population regarding the benefits and harms of treatment for metastatic prostate cancer. There were large differences between men in how they balanced the expected survival benefits and potential adverse effects. While some men strongly valued survival, others more strongly valued the absence of adverse effects. Therefore, it is important to discuss patient preferences in clinical practice.

A discrete choice experiment on price and flavour effects on the appeal of nicotine products: a pilot study among young adults in Switzerland.

To explore the effects of prices and flavour availability on the appeal of different tobacco and nicotine products, including conventional cigarettes, Electronic Nicotine Delivery Systems (ENDS) and Heated Tobacco Systems (HTS) among an adult population in Switzerland. We performed a Discrete Choice Experiment among a group of Swiss aged ≥18 years via the online recruiting platform Prolific in a convenience sample. Our sample included both non-smokers and smokers. We used a within-subject, alternative-specific block design in a series of choice sets including different smoking products. We fixed the attributes of nicotine content (high or medium) and harmfulness (in years of life lost) for each product. Attributes of interest included price (ranging from CHF 5 to 25 in increments of 5) and flavour (fruity/menthol vs none/tobacco flavour). We performed a conditional logistic regression on the attributes' influence on the appeal of cigarettes, ENDS and HTS. A total of 108 out of 153 participants (n = 25 smokers and n = 83 non-smokers, completion rate = 71%) successfully completed our pilot survey experiment. We found that, in general, increasing the price of combustible cigarettes, ENDS and HTS by one standard deviation (around CHF 7) reduced their appeal by approximately 66% (relative risk [RR]: 0.34; 95% CI: 0.28-0.42). Unflavoured alternative nicotine products were found to be less appealing than flavoured products, especially for non-smokers, with a 86% decrease in appeal (RR: 0.14; 95% CI: 0.13-0.16). For non-smokers, an increase in price by one standard deviation was associated with a decrease in the appeal of any product by approximately 19% (RR: 0.81; 95% CI: 0.72-0.92). For smokers, the effect sizes were smaller, but overall, the appeal of all products decreased with increasing prices and reduced flavours. Our Discrete Choice Experiment suggests that, for the Swiss context, limiting the availability of flavours for alternative smoking products has the potential to reduce their appeal to non-smokers by 86% and that a small but significant increase in prices to CHF 15 for cigarettes, ENDS and HTS could lead to a major (around 66%) decrease in their appeal.

Exploring vulnerability to heat and cold across urban and rural populations in Switzerland

Heat- and cold-related mortality risks are highly variable across different geographies, suggesting a differential distribution of vulnerability factors between and within countries, which could partly be driven by urban-to-rural disparities. Identifying these drivers of risk is crucial to characterize local vulnerability and design tailored public health interventions to improve adaptation of populations to climate change. We aimed to assess how heat- and cold-mortality risks change across urban, peri-urban and rural areas in Switzerland and to identify and compare the factors associated with increased vulnerability within and between different area typologies. We estimated the heat- and cold-related mortality association using the case time-series design and distributed lag non-linear models over daily mean temperature and all-cause mortality series between 1990–2017 in each municipality in Switzerland. Then, through multivariate meta-regression, we derived pooled heat and cold-mortality associations by typology (i.e. urban/rural/peri-urban) and assessed potential vulnerability factors among a wealth of demographic, socioeconomic, topographic, climatic, land use and other environmental data. Urban clusters reported larger pooled heat-related mortality risk (at 99th percentile, vs. temperature of minimum mortality (MMT)) (relative risk = 1.17 (95%CI: 1.10; 1.24), vs peri-urban 1.03 (1.00; 1.06), and rural 1.03 (0.99; 1.08)), but similar cold-mortality risk (at 1st percentile, vs. MMT) (1.35 (1.28; 1.43), vs rural 1.28 (1.14; 1.44) and peri-urban 1.39 (1.27–1.53)) clusters. We found different sets of vulnerability factors explaining the differential risk patterns across typologies. In urban clusters, mainly environmental factors (i.e. PM2.5) drove differences in heat-mortality association, while for peri-urban/rural clusters socio-economic variables were also important. For cold, socio-economic variables drove changes in vulnerability across all typologies, while environmental factors and ageing were other important drivers of larger vulnerability in peri-urban/rural clusters, with heterogeneity in the direction of the association. Our findings suggest that urban populations in Switzerland may be more vulnerable to heat, compared to rural locations, and different sets of vulnerability factors may drive these associations in each typology. Thus, future public health adaptation strategies should consider local and more tailored interventions rather than a one-size fits all approach.

Are actual and perceived environmental conditions associated with variation in mental health?

ObjectiveEmpirical evidence on the relationship between environmental factors and mental health remains inconclusive. One reason is that there is only scant evidence on the association between mental health and subjective exposure to environmental stressors, relative to objective pollution. We thus focus on how the perceived and actual presence of noise, air pollution, and green spaces relates to mental health. Methods and resultsOur cross-sectional study is based on a large representative sample of the adult population in Switzerland (n = 5729). Using individual-level geocodes of subjects’ residence, we combined data from a survey of these individuals with data on objectively measured longer-term environmental conditions (noise, air pollution, green spaces). Subclinical mental health was assessed with the 12-item General Health Questionnaire (GHQ-12). When fitting multiple regressions and mediation models, we find that perceptions of environmental stressors are a better predictor of mental distress than objectively measured stressors. In addition, the predictive power of actual nature visits is stronger than the predictive power of mere proximity to green spaces at the place of residence. We found no direct link between actual environmental stressors and mental health, but mediation via perceived environmental stressors. Further, the association between the frequency of nature visits and mental health is mediated by perceived, but not actual pollution. ConclusionSince actual environmental stressors are not perceived as equally burdensome by all people, their subjective perception is crucial when evaluating policy interventions aimed at improving mental health. Even a relatively low level of environmental stressors, classified as non-harmful to human health in a physical or biological sense, may thus contribute to negative mental health outcomes. The main policy implication is that attractive and accessible green spaces may provide individuals with an enhanced sense of control over their exposure to environmental stressors and thereby reduce negative impacts.

Healthy aging in Geneva : the innovative approach of the VieSA project

With Switzerland's population ageing, promoting healthy ageing remains a public health issue. This represents a challenge for the healthcare system, which is still mainly focused on curative or palliative care. It has been clearly established that it is possible to maintain the functional capacity of older people by taking early action on health-related behaviors. The VieSA (Vieillissement en Santé) project in the canton of Geneva, inspired by the WHO's ICOPE programme, offers innovative ways of promoting healthy ageing for and by seniors, by focusing on maintaining seniors' resources rather than targeting any deficits.

How prevalent is a cancer-protective lifestyle? Adherence to the 2018 World Cancer Research Fund/American Institute for Cancer Research cancer prevention recommendations in Switzerland.

Population monitoring of lifestyle behaviours that are crucial as risk and protective factors for major chronic diseases is vital for the identification of priority areas for public health. In this study, we aimed to investigate the prevalence of adherence to the World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) cancer prevention recommendations in Switzerland, overall and by selected sociodemographic and lifestyle characteristics. Data from the population-based, cross-sectional survey menuCH were used. We constructed a score reflecting adherence to the 2018 WCRF/AICR cancer prevention recommendations. Multinomial logistic regression models were fitted to investigate the association of sociodemographic and lifestyle characteristics with the level of adherence to the WCRF/AICR cancer prevention recommendations. The least frequently met cancer prevention recommendations were the ones on fibre intake (met by 13·7 %), red and processed meat (25·4 %), and ultra-processed food (33·3 %) consumption, while the recommendation on physical activity was met by almost 80 %. Women and individuals with tertiary education were more likely to have a score of ≥ 5 (as a reflection of adherence to the cancer prevention recommendations), compared with men or those who completed secondary education, respectively. Current smokers were less likely to have a score of ≥ 5, compared with never smokers. A high proportion of the population in Switzerland was found to not adhere closely to the WCRF/AICR cancer prevention recommendations. Differences were detected based on sociodemographic characteristics. Education and policy actions are needed to facilitate the adoption of a cancer-protective lifestyle.

A Web-Based Self-help Intervention for Coping With the Loss of a Partner: Protocol for Randomized Controlled Trials in 3 Countries.

The death of a partner is a critical life event in later life, which requires grief work as well as the development of a new perspective for the future. Cognitive behavioral web-based self-help interventions for coping with prolonged grief have established their efficacy in decreasing symptoms of grief, depression, and loneliness. However, no study has tested the efficacy for reducing grief after losses occurring less than 6 months ago and the role of self-tailoring of the content. This study aims to evaluate the clinical efficacy and acceptance of a web-based self-help intervention to support the grief process of older adults who have lost their partner. It will compare the outcomes, adherence, and working alliance in a standardized format with those in a self-tailored delivery format and investigate the effects of age, time since loss, and severity of grief at baseline as predictors. Focus groups to understand user experience and a cost-effectiveness analysis will complement the study. The study includes 3 different randomized control trials. The trial in Switzerland comprises a waitlist control group and 2 active arms consisting of 2 delivery formats, standardized and self-tailored. In the Netherlands and in Portugal, the trials follow a 2-arm design that will be, respectively, complemented with focus groups on technology acceptance and cost-effectiveness analysis. The main target group will consist of adults aged >60 years from the general population in Switzerland (n≥85), the Netherlands (n≥40), and Portugal (n≥80) who lost their partner and seek help for coping with grief symptoms, psychological distress, and adaptation problems in daily life. The trials will test the intervention's clinical efficacy for reducing grief (primary outcome) and depression symptoms and loneliness (secondary outcomes) after the intervention. Measurements will take place at baseline (week 0), after the intervention (week 10), and at follow-up (week 20). The trials started in March 2022 and are expected to end in December 2022 or when the needed sample size is achieved. The first results are expected by January 2023. The trials will provide insights into the efficacy and acceptance of a web-based self-help intervention among older adults who have recently lost a partner. Results will extend the knowledge on the role of self-tailoring, working alliance, and satisfaction in the effects of the intervention. Finally, the study will suggest adaptations to improve the acceptance of web-based self-help interventions for older mourners and explore the cost-effectiveness of this intervention. Limitations include a self-selective sample and the lack of cross-cultural comparisons. Switzerland: ClinicalTrials.gov NCT05280041; https://clinicaltrials.gov/ct2/show/NCT05280041; Portugal: ClinicalTrials.gov NCT05156346; https://clinicaltrials.gov/ct2/show/NCT05156346. PRR1-10.2196/37827.

491 Education level is associated with increased sun exposure, but also ultraviolet radiation protection and melanoma awareness in a high-risk population in Switzerland

The global incidence of melanoma has risen rapidly over the last decades in Caucasian populations with Switzerland reporting among the highest rates in Europe. Ultraviolet (UV) radiation is one of the main risk factors for melanoma. Our aim was to investigate the UV protection behavior and melanoma awareness in a high-risk cohort for melanoma. In this prospective monocentric study comparing 2D- and 3D-imaging with deep-learning based risk assessments and routine skin cancer screenings by dermatologists for early detection of melanoma, we assessed general melanoma awareness and UV protection habits in high-risk patients for melanoma (≥ 100 nevi, ≥ 5 dysplastic nevi, known CDKN2A mutation and/or positive family history) and melanoma patients by questionnaires.

Trends in Tropical Nights and their Effects on Mortality in Switzerland across 50 years

Despite its temperate climate, increasing temperature and more frequent and severe heat waves in Switzerland are leading to more heat-related health burden. Especially, high nocturnal temperature, usually associated to urban heat island effect, reduces the well-being of the society. We aimed to assess the spatiotemporal patterns in the frequency, the exposed population to Tropical Nights and its effect on daily mortality in Switzerland. We derived the number of TN (night temperature &amp;#x2265;20&amp;#xb0;C) per district using district-specific population-weighted temperature series based on high resolution hourly mean temperature (ERA5-Land reanalysis data set) between 1969-2019. Through a spatiotemporal analysis, we assessed the change of TN frequency as well as the exposed population per district and decade. We then estimated the TN-mortality association by canton using conditional quasi-Poisson regression analysis using data on all-cause mortality at district level from 1980-2019. The model accounted for long-term and seasonal patterns and daily mean temperature. We found an overall increase in the frequency of TN and exposed population in Switzerland between 1969-2019, mainly in the surrounding areas of the main cities of Lausanne, Geneva, Basel, Lugano and region of Zurich, and during the last 2 decades. Across Cantons, no clear spatial patterns were found in the level of vulnerability. In particular, TNs were associated with an increase of 37-22% in the risk of mortality in the cantons of Vaud (RR:1.37 [CI:1.19-1.59]), Zurich (1.33 [0.99-1.79]), Lucerne (1.33 [0.95-1.87]) and Solothurn (1.22 [0.88-1.69]), while a negative association was observed in Ticino (0.51 [0.37-0.7]), Basel-Land (0.4 [0.24-0.65]) and Thurgau (0.65 [0.5-0.85]). A null association was found in the remaining Cantons. Our findings indicate that TN is a relevant health hazard for a large part of the Swiss population with potentially larger impacts in the future due to climate change and increasing urbanization. Climate Change, Tropical Night, Mortality, Human Health, Switzerland