Overview of the influenza vaccination activities and legal frameworks in 26 Swiss cantons during the influenza season 2019/20

Background In Switzerland, the implementation of national health and prevention strategies is regulated at the cantonal level. To date, no in-depth inventory outlining the cantonal health activities and legal frameworks for influenza vaccination exists. Objective To assess the activities and legal frameworks for influenza vaccination during the 2019/20 season across all 26 Swiss cantons. Method Survey using a structured closed-ended questionnaire. Results The activities’ range across the cantons is broad from 11 activities in the canton Vaud to one in cantons Grisons and Jura. French/Italian-speaking cantons conduct 1.5 times more influenza vaccination activities on average than the German-speaking cantons. 23 of 26 cantons authorize influenza vaccination by pharmacists. All cantons allow nurses to vaccinate under the responsibility of a doctor. Conclusion Influenza vaccination activities and vaccination-specific legal frameworks vary by canton and linguistic regions. Future vaccination strategies should consider concerted approaches to optimize their successful implementation

Peri-Pandemic Acceptance of Influenza and COVID-19 Vaccination by Swiss Healthcare Workers in Primary Care 2020/21: A Cross-Sectional Study

Objectives: To assess and compare influenza and COVID-19 vaccination uptake of Swiss healthcare workers (HCWs) in primary care 2020/21.Methods: Influenza and COVID-19 vaccination uptake and recommendation behaviours of HCWs in the primary care were assessed using an online semi-structured questionnaire. Associations between vaccination rates and age, language, gender, profession, vaccination history, vaccination training and recommendation behaviours were evaluated using descriptive and multivariable logistic regression analyses. Results: Vaccinated against COVID-19 in 2020/21 were 91.8% of the 1,237 participating HCWs, while 60.1% were vaccinated against influenza. Physicians and pharmacists presented the highest influenza vaccination rates (87.3%, 73.7%, respectively) compared to nurses (45.8%) and medical practice assistants (52.5%) while COVID-19 vaccination rates were high across all professions. Influenza and COVID-19 vaccination rates were significantly associated with age, profession, vaccination history, vaccination training and recommendation behaviours. Conclusion: Acceptance for influenza vaccination has increased during the pandemic but is lower than that for COVID-19 among the HCWs. Demographics, vaccination status and vaccination training impact the vaccination behaviour among HCWs and should be considered in future campaigns to increase vaccination uptake

Raum vor der Territorialisierung. Probleme und Perspektiven der schwäbischen Landesgeschichte – ein Versuch am Beispiel der Vita Ulrichs von Augsburg

Die Geschichte des Raumes ist in der Landesgeschichte bisher überwiegend als eine Geschichte der Entwicklung und Ausformung institutionalisierter Strukturen in einem spezifischen räumlichen Gebilde geschrieben worden. Für die Erforschung des früh- und hochmittelalterlichen Schwaben war daher das Herzogtum Schwaben zentral. In den letzten Jahren ist durch den sogenannten spatial turn eine neue Perspektive eröffnet worden, welche die landesgeschichtlichen Fragestellungen um einige Facetten erweitert. Der spatial turn hat in der Geschichtswissenschaft das Bewusstsein dafür geschärft, dass Raum keine objektive Kategorie ist, sondern aus Wahrnehmungsprozessen der Akteure entsteht. Historische Räume werden deshalb unter Einbeziehung dieser Prämisse nicht mehr als ausschließlich geographische Einheiten betrachtet, vielmehr wird thematisiert, wie die in diesen Räumen agierenden Personen sie formen und beschreiben. Hier setzt der Beitrag an und fragt anhand der Vita Udalrici und mit dem Fokus auf Schwaben danach, wie Zeitgenossen über räumliche Zusammenhänge sprachen, sie gestalteten und organisierten. Letztlich soll so die räumliche Konzeption von Schwaben als Handlungsrahmen erhellt werden

Effects of intrauterine exposure to synthetic glucocorticoids on fetal, newborn, and infant hypothalamic-pituitary-adrenal axis function in humans : a systematic review

BACKGROUND: Synthetic glucocorticoids are commonly used in reproductive medicine. Fetal organ systems are highly sensitive to changes in the intrauterine environment, including overexposure to glucocorticoids. Structural and functional alterations resulting from such changes may persist throughout life and have been associated with diverse diseases. One system that could be particularly sensitive to fetal glucocorticoid overexposure is the hypothalamic-pituitary-adrenal (hpa) axis. Many human studies have investigated this possibility, but a systematic review to identify consistent, emergent findings is lacking. METHODS: We systematically review 49 human studies, assessing the effects of intrauterine exposure to synthetic glucocorticoids on fetal, neonate, and infant hpa function. RESULTS: Study quality varied considerably, but the main findings held true after restricting the analyses to higher-quality studies: intrauterine exposure to synthetic glucocorticoids reduces offspring hpa activity under unstimulated conditions after pain but not pharmacological challenge. Although reduced unstimulated hpa function appears to recover within the first 2 wk postpartum, blunted hpa reactivity to pain is likely to persist throughout the first 4 months of life. There is some evidence that the magnitude of the effects is correlated with the total amount of glucocorticoids administered and varies with the time interval between glucocorticoid exposure and hpa assessment. CONCLUSIONS: This systematic review has allowed the demonstration of the way in which intrauterine exposure to various regimens of synthetic glucocorticoids affects various forms of hpa function. As such, it guides future studies in terms of which variables need to be focused on in order to further strengthen the understanding of such therapy, whilst continuing to profit from its clinical benefits

Gottes Haus

Using the idea that church buildings are sacred spaces, this study seeks to examine a central figure of thought in medieval society, the "ecclesia". Using normative, liturgical, and exegetic-theological sources, the book traces the profound transformational process that took place in the political and religious view of society from Late Antiquity to the Early Middle Ages. The study describes the dynamics that led to the development of a ecclesiology with a powerful impact on an entire epoch

Influence of cantonal health policy frameworks & activities on the influenza vaccination rate in patients with non-communicable diseases in Switzerland

Background and objective Seasonal influenza may cause serious illness, especially in high-risk populations such as older adults and individuals suffering from non-communicable diseases (NCD) and may be prevented by a vaccination. However, an assessment of the impact of the Swiss legal frameworks and number of health activities on influenza vaccination coverage of the population at the cantonal level is lacking. Methods Two participating healthcare insurers sent out 25,000 semi-structured questionnaires to their subscribers aged 60–85 in five Swiss cantons selected according to the number of health activities and legal framework regarding influenza vaccination and linguistic region. Influenza vaccination coverage of the participants was evaluated and stratified by disease status, age, canton, and linguistic region. Results were compared by cantonal activities, legal framework, and linguistic region. Results 7,617 valid questionnaires were evaluated from the cantons Aargau, Jura, St. Gallen, Schwyz, and Vaud. 47.9 % stated to have an NCD, with the most frequent being muscle/ skeletal disease (36.7%). Before 2018, 48.6% were vaccinated against influenza, and 35.9% in 2019, with the highest in canton Vaud. In all cantons and in both survey periods, NCD patients and those aged 73–85 had a higher vaccination coverage than participants without NCD, and aged 60–72. There was no difference in the odds of getting an influenza shot based on legal framework. Although a comparison of the number of activities between the German-speaking cantons did not reveal any significant differences, the odds of the participants living in a French-speaking canton getting an influenza vaccination was more likely than those living in a German-speaking canton. Conclusion There was no association between the investigated cantonal frameworks and number of health activities and influenza vaccination coverage in NCD patients in the selected cantons. However, age, disease status and linguistic region appear to have an influence on vaccination uptake

Influenza Vaccination Behaviour of Healthcare Workers in Switzerland: A Cross-Sectional Study

Objectives: As no data are available regarding the influenza vaccination status of Swiss healthcare workers (HCW) in the ambulatory setting, this study aims to investigate their influenza vaccination behaviours. Methods: We conducted an online survey using a four-item, semi-structured questionnaire to assess HCWs influenza vaccination coverage and behaviour. Associations between influenza vaccination status, age and language as well as recommendation behaviour and reasons for vaccination were assessed using descriptive statistics and logistic regression analyses. Results: Of the 1057 completed questionnaires, 425 (40.2%) HCW were vaccinated and 632 (59.8%) not. 78.1% of the physicians and 47.3% pharmacists were vaccinated, compared to only 29.1% of the nurses, 24.3% pharmacy technicians and 13.0% medical practice assistants (MPA). There was a significant association between influenza vaccination status and HCW profession, age, language and how often an influenza vaccination recommendation was made. Conclusion: Demographic factors seem to influence HCWs’ attitudes towards influenza vaccination, which in turn affects the prospect of them recommending the influenza vaccination. Diverse strategies might be necessary to encourage HCW to get vaccinated and hence, promote influenza vaccination