Vaud Switzerland Research Articles

Effectiveness of annual influenza campaigns and vaccination in reducing influenza burden in nursing homes of Canton Vaud in Switzerland

BackgroundInfluenza infections pose significant risks for nursing home (NH) residents. Our aim was to evaluate the impact of the cantonal influenza campaign, and influenza vaccination coverage of residents and healthcare workers (HCWs) on influenza burden in NHs in a context of enhanced infection prevention and control measures (IPC) during the SARS-CoV-2 pandemic.MethodsWe extracted data from epidemic reports provided by our unit to NHs over two consecutive winter seasons (2021-22 and 2022-23) and used linear regression to assess the impact of resident and HCW vaccination coverage, and participation in the campaign, on residents’ cumulative influenza incidence and mortality.ResultsThirty-six NHs reported 155 influenza cases and 21 deaths during the two winter seasons corresponding to 6.2% of infected residents and a case fatality ratio of 13.5%. Median vaccination coverage was 83% for residents, 25.8% for HCWs, while 87% of NHs participated in the campaign. Resident vaccination was significantly associated with a decrease in odds of death (odds ratio (OR) 0.96, 95% confidence interval (CI): 0.93–0.99). There was no significant effect of HCW vaccination coverage on resident infections and deaths. Campaign participation was associated with decreased odds of infection and death among residents (OR: 0.17, 95% CI: 0.06–0.47 and OR: 0.06, 95% CI: 0.02–0.17 respectively).ConclusionOur analysis suggests that in a context of reinforced IPC measures, influenza still represents a significant burden for NH residents. The most effective measures in decreasing resident influenza burden in NHs was participation in the cantonal influenza vaccination campaign and resident vaccination.

Evaluation of the prehospital administration of tranexamic acid for injured patients: a state-wide observational study with sex and age-disaggregated analysis

BackgroundTranexamic acid (TXA) decreases mortality in injured patients and should be administered as soon as possible. Despite international guidelines recommending TXA in the prehospital setting, its use remains low. The...

Simulation of the impact of a wine supply management tool: a potential implementation of a climatic reserve in Switzerland

PurposeThis study aims to identify the economic impact of a potential implementation of a Climatic Reserve for the Swiss predominant white grape variety (Chasselas) vinified in the AOC (controlled designation of origin) category. The Climatic Reserve would imply the possibility of harvesting an additional quantity of grapes whose commercialization in wine would be delayed until it is approved by the relevant authority.Design/methodology/approachThe impact of a potential implementation of this wine supply management tool is simulated through an innovative method that combines the vector autoregressive (VAR) model to estimate the influence of the previous consumptions and productions on the current consumption and linear regression [ordinary least square (OLS) method] to estimate the price elasticity to measure the evolution of the price depending on the simulated consumption. The VAR model is based on state-level data about production, stocks, and consumption (all the channels of distribution combined), while the OLS regression for estimating price elasticity uses the retail market data (Nielsen Panel). With the sales and price variables on a monthly frequency design, the latter represents about 40% of the wine market in Switzerland.FindingsAccording to simulations carried out at the level of a region from the canton of Vaud in Switzerland (2000–2018), the increase in turnover linked to the release of the Climatic Reserve would be +3.1% for the indigenous white grape variety Chasselas.Originality/valueThe Climatic Reserve is a wine supply management tool that could complement the existing yield restriction, which does not significantly influence the quantities sold, according to previous studies. Our paper contributes to the literature by demonstrating the economic advantage of this supply management tool to deal with the increasingly frequent climatic hazards in wine production and market. The methodology could be applied to other wine regions (contexts) or other agricultural sectors.

Towards a ‘low ambition equilibrium’: managing refugee aspirations during the integration process in Switzerland

ABSTRACT This article explores the role of policy in influencing refugee educational and occupational aspirations and how this translates into promoting or hindering certain integration paths. 29 refugees in the canton of Vaud in Switzerland were interviewed and asked about their educational and occupational aspirations. Three policies were identified as having an important influence on their aspirations formation namely, asylum policy, integration policy in addition to university access and degree recognition policy. Findings show that the three policies combined contribute to creating what I refer to as ‘Low Ambition Equilibrium’. This means that on one hand these policies promote the quickest and most accessible integration paths to reduce refugees’ dependence on the welfare state. On the other hand, the experience of forced migration combined with a ‘policy-dense’ environment create a lot of uncertainty in the life of refugees and the urgency to find a lost ‘normality’ at the expense of their aspirations.

Not only COVID-19 disease impacts ambulance emergency demands but also lockdowns and quarantines

BackgroundThe pandemic has impacted both patients infected by the SARS-CoV-2 virus and patients who seek emergency assistance due to other health issues. Changes in emergency demands are expected to have occurred during the pandemic, the objective of this investigation is to characterize the changes in ambulance emergency demands during the first year of the COVID-19 pandemic in the Vaud State of Switzerland. The goal of this research is to identify the collateral effects of the COVID-19 pandemic on emergency demands. To do so, this study quantifies the differences in health issues, level of severity, and patients’ sociodemographic characteristics (age, location, gender) prior to and during the outbreak.MethodThis is a retrospective, descriptive and comparative statistical analysis of all ambulance emergency missions from 2018 to 2020 (n = 107,150) in the State of Vaud in Switzerland. Variables analyzed were the number of ambulance missions, patient age and gender, health issues, severity (NACA scores), number of non-transports, mission times and locations. Variables were compared between prepandemic and pandemic situations across years and months. Comparative analysis used bivariate analysis, χ2 test, Student’s t test, and Mann‒Whitney U test.ResultsThe pandemic has had two major impacts on the population’s emergency demands. The first appears to be due to COVID-19, with an increase in respiratory distress cases that doubled in November 2020. The second relates to the implementation of lockdown and quarantine measures for the population and the closures of restaurants and bars. These might explain the decrease in both the number of traumas and intoxications, reaching more than 25% and 28%, respectively. An increase in prehospital emergency demands by the older population, which accounted for 53% of all demands in 2020, is measured.ConclusionCollateral effects occurred during 2020 and were not only due to the pandemic but also due to protective measures deployed relative to the population. This work suggests that more targeted reflections and interventions concerning the most vulnerable group, the population of people 65 and older, should be of high priority. Gaining generalizable knowledge from the COVID-19 pandemic in prehospital settings is critical for the management of future pandemics or other unexpected disasters.

Improving communication with hard of hearing and D/deaf patients: a capacity-building intervention

Abstract Background D/deaf and hard of hearing (D&HoH) populations are disproportionally affected by physical and mental health problems while facing barriers to accessing health services. These barriers stem from communication challenges with healthcare providers, who are often unprepared to meet their specific needs. This study aimed to develop and evaluate an intervention to improve healthcare providers’ skills to communicate with these patients. Methods This study featured a participative action research design. Consistently, the intervention was developed through iterative phases together with the target populations and key stakeholders. The finale version was tested in healthcare workers in Canton of Vaud in Switzerland. Participants completed a questionnaire before (T0) and 6 months after (T1) the intervention, assessing perceived knowledge of deafness and hard of hearing and tools to improve communication, self-efficacy on how to communicate with D&HoH patients and institutional benefits (application frequency of communication rules and tools). Results The final intervention aimed to increase participants’ 1) awareness of D&HoH experience and communication needs, 2) knowledge of the tools and basic rules to improve communication. Two D&HoH trainers led one half-day intervention among 28 healthcare providers (e.g., nurses, pharmacists; mean age=43.6). Paired-sample t-tests revealed significant increases in knowledge between T0 and T1, t (23) = -7.81, p < .001 and in self-efficacy, t (24) = -10.23, p < .001, whereas there was no significant difference between institutional benefits at T0 and T1. Conclusions Although findings suggest the intervention is a promising means to increase perceived knowledge and self-efficacy on how communicating with D&HoH patients, complementary approaches, such as a resource person within the institutions providing day-to-day support to the teams besides the intervention, may be necessary to induce institutional changes. Key messages • Future research should implement the intervention more broadly within inpatient and outpatient settings in Switzerland to increase knowledge on how communicating with D&HoH patients. • Intervention implementation should be complemented by an additional structural approach to induce sustainable changes in practice and evaluated over 12 months to ensure sustainability.

Detecting and describing heterogeneity in health care cost trajectories among asylum seekers

BackgroundThe mechanism underlying the health care cost trajectories among asylum seekers is not well understood. In the canton of Vaud in Switzerland, a nurse-led health care and medical Network for Migrant Health (“Réseau santé et migration” RESAMI) has established a health care model focusing on the first year after arrival of asylum seekers, called the “community health phase”. This model aims to provide tailored care and facilitate integration into the Swiss health care system. The aim of this study is to explore different health care cost trajectories among asylum seekers during this phase and identify the associated factors.MethodsWe detected different patterns of health care cost trajectories using time-series clustering of longitudinal data of asylum seekers in the canton of Vaud in Switzerland. These data included all adult asylum seekers and recipients of emergency aid who entered the canton between 2012 and 2015 and were followed until 2018. The different clusters of health care cost trajectories were then described using a multinomial logistic regression model.ResultsWe identified a concave, an upward trending, and a downward trending cluster of health care cost trajectories with different characteristics being associated with each cluster. The likelihood of being in the concave cluster is positively associated with coming from the Eastern Mediterranean region or Africa rather than Europe and with a higher share of consultations with an interpreter. The likelihood of being in the upward trending cluster, which accrued the highest costs, is positively associated with 20–24-year-olds rather than older individuals, coming from Europe than any other region and having a mental disorder. In contrast to the other two clusters, the likelihood of being in the downward trending cluster is positively associated with having contacted the RESAMI network within the first month after arrival, which might indicate the potential of early intervention. It is also positively associated with older age and living in a group lodge.ConclusionsAsylum seekers are heterogeneous in terms of health care cost trajectories. Exploring these differences can help point to possible ways to improve the care and supporting services provided to asylum seekers. Our findings could indicate that early and patient-centered interventions might be well-suited to this aim.

Waste taxes at work: Evidence from the canton of Vaud in Switzerland

This paper estimates the impact of the introduction of a tax on unsorted waste increasing the 35-l bag price from 0.24 to 1.95 CHF in 2013 in the canton of Vaud. Using panel data for 22 districts over the period 2010–2017, we identify the effects over time of the waste tax on unsorted waste and recycling. The neighbouring cantons of Geneva and Valais form our control group. The waste tax decreases the amount of yearly unsorted household-waste by about 47 kg, corresponding to a reduction of about one fourth per inhabitant. The effect is strongest the year after the introduction of the tax and is persistent over time. We further find a robust increase in organic waste recycling. For recycling of paper and glass, the effect is not clear-cut. Interestingly, in terms of weight, the reduction in unsorted waste is not fully compensated by increased recycling. Given that there are no signs for illegal waste disposal, this means that consumers probably reduced their total packaging bought.

The relationship between equine pastern dermatitis, meteorological factors, and the skin microbiota.

BackgroundEquine pastern dermatitis (EPD) is a multifactorial syndrome, with prolonged exposure to moisture assumed to be a predisposing or primary factor.Hypothesis/ObjectivesTo examine the course of EPD lesion severity, changes in bacterial skin microbiota, and the influence of meteorological factors.AnimalsProspective, longitudinal cohort study over a one‐year period, with six Franches‐Montagnes stallions, four affected by EPD and two unaffected, that were kept under the same conditions.Methods and materialsPasterns were scored for lesion severity and sampled once a month for 12 consecutive months. Lesion severity, the skin microbiota and meteorological factors were examined for associations.ResultsEPD lesions tended to worsen in autumn and at the beginning of spring. The relationship between lesion severity and the meteorological factor precipitation was not clearly evident; high scores were preceded by both low or high rates of precipitation. Microbiota in affected pasterns appeared to have experienced a reduction in alpha diversity. Beta diversity analyses demonstrated that bacterial community structures were altered in affected versus unaffected pasterns, and that alterations were more pronounced with higher EPD scores (P = 0.005). Meteorological factors also had considerable influences on the bacterial composition, whereby these influences appeared to be more marked in the affected pasterns (P = 0.001, F = 3.19) than in unaffected ones (P = 0.005, F = 1.83).Conclusions and clinical relevanceOur study provides preliminary observations of the relationships between lesion severity, meteorological factors and cutaneous bacteria. The population was too small to draw firm conclusions, and further studies on environmental factors and the involvement of bacteria in this multifactorial disease are needed.

Caring During COVID-19: Reconfigurations of Gender and Family Relations During the Pandemic in Switzerland.

COVID-19 caused major changes in private and public arenas. Individuals were forced to reorganise their daily lives in response to the restrictive measures imposed by governments. The redistribution of gender roles and the responsibility for care provides an example of the reconfigurations that took place during the pandemic. This article sheds light on the implications of the pandemic for gender inequalities by exploring how care work was reconfigured as women and men sought to protect family members and navigated risks of infection. The study is based on qualitative data – interviews and observations – gathered in an interdisciplinary medical anthropology project. In the article, the authors focus on seven cases selected from a larger corpus to illustrate how reconfigurations of the gendered division of care work within families shifted during the pandemic as men assumed greater moral responsibility for safeguarding family members, without infringing the norms of masculinity. The first part of the article explores the intensification of care activities during lockdown for women living in the Canton de Vaud in Switzerland. The second part centres on the moral responsibility and duty for women and men to protect family members from viral exposure. The results from the study confirm not only that most care activities continued to be delegated to female family members, but also that men’s roles evolved. While their safeguarding role can be understood as a new form of caring for men, the findings suggest that it was essentially crisis specific and did not challenge masculinity norms. The extent to which this reconfiguration of gender roles might have a longer-term impact on gender inequalities remains to be seen. Meanwhile, these observations could have important implications for policies aimed at mitigating the medium and long-term effects of the pandemic on gender inequality.

Implementation and preliminary testing of a theory-guided nursing discharge teaching intervention for adult inpatients aged 50 and over with multimorbidity: a pragmatic feasibility study protocol

BackgroundDischarge teaching by nurses during hospitalization is essential to provide multimorbid inpatients with the knowledge and skills to self-manage their health conditions. However, available disease-specific teaching guidelines do not address the cumulative complexity of multiple chronic diseases that occur with greater frequency in older adults. Therefore, there is a need for a discharge teaching intervention which uses concepts that specifically address the needs of these patients, such as considering their level of activation (i.e. knowledge, skills and confidence to self-manage their health) and the burden of multimorbid disease. The objectives of this pragmatic study will be to (1) test the feasibility of implementing a nursing discharge teaching intervention and (2) conduct a preliminary test of this novel discharge teaching intervention with adult inpatients age 50 or greater who have multiple comorbid conditions.MethodsThis study uses a two-group pre-posttest design. Participants are drawn from medical units in three hospitals in the French-speaking part of Switzerland. The implementation of the intervention will be facilitated by implementation strategies from the Theoretical Domains Framework and the Behavior Change Wheel and will target change in nurses’ teaching behaviours. Implementation outcomes will include measures of feasibility of the implementation strategies and the intervention process. Participants in the intervention group will receive tailored discharge teaching by trained teaching nurses. Patient outcomes will inform the preliminary testing of the intervention and will be measured with validated questionnaires assessing patients’ activation level, health confidence, perceived readiness for discharge, experience with the discharge process and rate of and time to readmission.DiscussionThe study takes a pragmatic approach to examining the feasibility of implementing the discharge teaching intervention to contribute to the knowledge development within the context of the real-world practice setting. Results will provide the foundation for clinical trials to build evidence for widespread adoption of this intervention.Trial registrationThe trial is registered at ClinicalTrials.gov (ID: NCT04253665) on the 30 of January 2020 and has been approved by the Cantonal Ethics Committee Vaud in Switzerland (2020-00141).

A computer science and robotics integration model for primary school: evaluation of a large-scale in-service K-4 teacher-training program

Integrating computer science (CS) into school curricula has become a worldwide preoccupation. Therefore, we present a CS and Robotics integration model and its validation through a large-scale pilot study in the administrative region of the Canton Vaud in Switzerland. Approximately 350 primary school teachers followed a mandatory CS continuing professional development program (CPD) of adapted format with a curriculum scaffolded by instruction modality. This included CS Unplugged activities that aim to teach CS concepts without the use of screens, and Robotics Unplugged activities that employed physical robots, without screens, to learn about robotics and CS concepts. Teachers evaluated positively the CPD and their representation of CS improved. Voluntary adoption rates reached 97% during the CPD and 80% the following year. These results combined with the underpinning literature support the generalisability of the model to other contexts.

A method to assess the probability of thickness and volume estimates of small and shallow initial landslide ruptures based on surface area

A new inventory of 66 small and shallow landslides within six pilot areas was created based on a high-resolution digital elevation model in the canton of Vaud in Switzerland. The geometrical characteristics of the landslides were recorded (i.e. surface area, maximum thickness and length), and the volumes were estimated. These data permitted the development of a model that provides the probability for a landslide to possess a maximum thickness or volume smaller than a given value based on the landslide horizontal surface area. The results are compared with three existing power-law relationships of surface area–volumes. This new approach constitutes a way to improve the quantification of the uncertainty of volume and maximum depth estimations for small and shallow landslides.

Home visits made by general practitioners in the canton of Vaud between 2006 and 2015.

Although physicians’ home visits are highly valued by patients, and are among the measures that contribute to maintaining elderly patients at home, their number is decreasing worldwide. We aimed to describe the trends in home visits made by general practitioners (GPs) in the canton of Vaud in Switzerland between 2006 and 2015, and to explore their associated characteristics. We retrospectively analysed billing data from family physicians (internists, generalists and practicing physicians) transmitted to the cantonal trust centre between 2006 and 2015. We explored physician and patient characteristics, first over the entire 10-year study period and then averaged by year. To explore factors associated with the number of home visits, we fitted a mixed effect negative binomial regression of the annual number of home visits per physician. Over ten years, 631 physicians billed a total of 451,634 home visits, of which 19.8% (n = 89,966) were emergency visits, and 9.7% (n = 43,915) were over the weekend. Home visits represented 2.5% of all consultations. Although the average annual number of physicians doing home visits remained stable at around 400, the mean annual number of visits per physician decreased from 125 in 2006 to 75 in 2015, resulting in a 40% decline in the absolute number of visits. Male physicians undertook more home visits than their female counterparts did, although the difference diminished over time. Visits to elderly patients (65+) represented 84.2% of the home visits. Although most physicians in the canton of Vaud continue to visit patients at home, the overall number of home visits is declining. Most home visits consist of routine visits to elderly patients. Physicians’ gender, age and specialty are associated with the number of home visits. In the rapidly evolving context of an ageing population and the development of home care, physicians’ role in home care provision should be revised, taking into account patient expectations and current health system constraints.

Decoupling municipal solid waste generation and economic growth in the canton of Vaud, Switzerland

Switzerland is one of the largest producers of municipal solid waste (MSW) per capita. The principle of decoupling attempts to evaluate the relationship between consumption and production, and to measure the relationship between an activity and its impact on the environment. This paper uses the Environmental Kuznets Curve (EKC) hypothesis to understand the impact of three socio-economic drivers on MSW generation in the canton of Vaud in Switzerland. Vaud is a French-speaking canton that recently implemented several measures to limit MSW generation. We used time series of indicators for income, urbanisation and policy implementation in ten of the canton’s districts, which were set as independent variables, between 1996 and 2015. A panel data analysis was performed using a generalized least squares procedure to test for an EKC. Evidence shows that urbanization was slightly negatively associated with MSW generation, but without statistical significance. However, a direct policy mechanism such as the waste bag tax was significantly correlated with a decrease in waste generation. Overall, the presence of an EKC cannot be confirmed in the canton of Vaud, as waste generation tends to stabilize as income increases. It would be useful to perform a similar assessment in other cantons to fully inform decision-makers.

An approach for evaluating the role of protection measures in rockfall hazard zoning based on the Swiss experience

Abstract. Rockfall hazard zoning is essential for ensuring the safety of communities settled at the toe of potentially unstable slopes. Rockfall hazard zoning can be performed to include the effect of protection measures when land use restrictions might not be enough to mitigate hazards. The real effectiveness of the measures must be assessed to make sure they can play their role, especially in those cases when measures might have been installed at a given site for years. This article focuses on how to evaluate the effectiveness of rockfall protection measures and how hazard zoning can be influenced by their correct operation. The approach presented is divided into four main stages, which include a two-step procedure to evaluate the effectiveness of both existing and new protections. It is based on quite a comprehensive rockfall protection database built for the canton of Vaud in Switzerland, and on the Swiss Federal Guidelines for hazard zoning; however, all the methodological framework proposed and related considerations could be in principle extended to any other regional or national context in which a combination of intensity and frequency is used to assess rockfall hazards.

“Neighborhood in Solidarity”: A community development methodology that emerged throughout an action research experience

Population aging and urbanization are often associated with a restriction of the living environment and an increasing tendency to remain at home. This community development report presents the “Neighborhood in Solidarity” methodology as a response to counter or at least slow this restriction and enhance the ability of elderly persons to be active within their neighborhoods. Co-constructed throughout the action research process, the Neighborhood in Solidarity methodology is based on a 13-year experience, accumulated through 22 projects in 17 cities, with promising results in the Canton of Vaud in Switzerland. The genesis and the emergence of the methodology throughout action research workshops and interregional structures are described in the document. The description of Neighborhood in Solidarity is a snapshot of a living methodology, which continues to evolve on a daily basis. The process focuses on empowering the older people through a five-year methodology, which is intended to create an autonomous community that can resolve its own problems. The methodology comprises six steps described throughout the paper: (1) preliminary analysis, (2) diagnostic, (3) construction, (4) project design, (5) project implementation, and (6) empowerment. In 2013, an external assessment evaluated the Neighborhood in Solidarity methodology as effective at and appropriate for achieving its objectives. The promising results of this original methodology motivated this publication.

Disease profiles of detainees in the Canton of Vaud in Switzerland: gender and age differences in substance abuse, mental health and chronic health conditions.

BackgroundLiterature on the disease profile of prisoners that differentiates by age and gender remains sparse. This study aimed to describe the health of correctional inmates in terms of substance abuse problems and mental and somatic health conditions, and compare it by gender and age.MethodsThis study examined cross-sectional data from the Canton of Vaud in Switzerland on the health conditions of detainees who were in prison on January 1, 2011 or entered prison in 2011. Health conditions validated by physician examination were reported using the International Classification of Diseases (ICD) version 10. The analyses were descriptive by groups of prisoners: the entire sample (All), Men, Older adults and Women.ResultsA total of 1,664 individuals were included in the analysis. Men comprised 91.5 % of the sample and had a mean age of 33 years. The other 8.5 % were women and had an average age of 39. Older adults (i.e., age 50 and older) represented 7 % of the total sample. Overall, 80 % of inmates were non-Swiss citizens, but the proportion of Swiss prisoners was higher among the older adults (51 %) and women (29 %). Overall, 41 % of inmates self-reported substance abuse problems. Of those, 27 % were being treated by psychiatrists for behavioral disorders related to substance abuse. Chronic infectious diseases were found in 9 % of the prison population. In addition, 27 % of detainees suffered from serious mental health conditions. Gender and age had an influence on the disease profile of this sample: compared to the entire prison population, the older inmates were less likely to misuse illegal drugs and to suffer from communicable infections but exhibited more problems with alcohol and a higher burden of chronic health conditions. Female prisoners were more disposed to mental health problems (including drug abuse) and infectious diseases. In terms of chronic diseases, women suffered from the same conditions as men, but the diseases were more prevalent in women.ConclusionIt is important to understand the different disease profiles of prisoners by gender and age, as it helps identify the needs of different groups and tailor age-and gender-specific interventions.

A comprehensive metabolomic study of wine from the Vaud Switzerland vineyard

A comprehensive metabolomic study of wine from the Vaud Switzerland vineyard

Des professionnels dans la tendresse. Entretien avec Paul et Danielle Beck

During twenty years, Paul and Danielle Beck have been the general managers of a palliative care hospice in the Canton de Vaud in Switzerland. As such they have created and promoted, a place (Rive-Neuve, R.-N.) where every care giver, no matter their position, are supposed to be supportive with the patients. The goal of this interview is that of presenting a point of view coming from the practise without promoting any sociological or anthropological analysis.