899 results match your criteria: "Centre for Primary Care and Public Health[Affiliation]"

Background: We have previously demonstrated that an extrafascial injection of 20 ml of local anaesthetic for interscalene brachial plexus block (ISB) reduces the rate of hemidiaphragmatic paralysis by 70% compared with an intrafascial injection, with similar efficacy. In this double-blind trial, we tested the hypothesis that a local anaesthetic volume of 10 ml injected extrafascially would reduce the rate of hemidiaphragmatic paralysis vs a volume of 20 ml, while providing similar analgesia.

Methods: Sixty ASA physical status 1-3 patients scheduled for elective shoulder surgery under general anaesthesia were randomised to receive ultrasound-guided extrafascial ISB using ropivacaine 0.

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Automatic (near-) duplicate content document detection in a cancer registry.

Int J Med Inform

January 2025

Centre for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland.

Background: Duplicate and near-duplicate medical documents are problematic in document management, clinical use, and medical research. In this study, we focus on multisourced medical documents in the context of a population-based cancer registry in Switzerland. Although the data collection process is well-regulated, the volume of transmitted documents steadily increases and the presence of full or near-duplicates slows down and complicates document processing.

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Effect of e-cigarettes for smoking cessation on depressive and anxiety symptoms: Secondary analysis of a randomized controlled trial.

Gen Hosp Psychiatry

January 2025

Institute of Primary Health Care (BIHAM), University of Bern, Switzerland; Laboratory of Population Health (#PopHealthLab), University of Fribourg, Fribourg, Switzerland. Electronic address:

Objective: This study aims to assess differences in depressive and anxiety symptoms at 6-month follow-up in a smoking cessation trial using e-cigarettes as quitting aids.

Methods: We conducted a secondary analysis of the Swiss multicentre ESTxENDS smoking cessation randomized controlled trial (RCT) assessing differences in depressive (Patient Health Questionnaire-9, PHQ-9, range: 0-27) and anxiety symptoms (General Anxiety Disorder-7, GAD-7, range: 0-21) at 6-month follow-up comparing participants who received e-cigarettes to those who received smoking cessation counseling alone.

Results: Of 1244 participants 913 completed the PHQ-9 and 884 the GAD-7 at 6-month follow-up.

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Introduction: Many tobacco smokers try to quit with electronic nicotine delivery systems (ENDS or e-cigarettes). We aimed to describe e-liquid flavors and nicotine concentration use over 6 months in a prospective cohort of smokers willing to quit with ENDS.

Methods: We included 622 participants from the intervention group of the Efficacy, Safety and Toxicology of ENDS randomized controlled trial.

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Objective: In the UK and worldwide, there are substantial ethnic inequalities in maternal and perinatal care and outcomes. We aim to assess the impact of the unprecedented change in care provision during the COVID-19 pandemic on inequalities in adverse maternity outcomes.

Design: Retrospective cohort study using structured electronic health record data.

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: Timely and appropriate outpatient care can prevent potentially avoidable hospitalizations (PAHs) for heart failure (HF). We analyzed the trends, determinants, and consequences of PAHs for HF in Switzerland over two decades.; : Hospital discharge data of Switzerland from 1998 to 2018 were utilized.

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Digital clinical decision support tools have contributed to improved quality of care at primary care level health facilities. However, data from real-world randomized trials are lacking. We conducted a cluster randomized, open-label trial in Tanzania evaluating the use of a digital clinical decision support algorithm (CDSA), enhanced by point-of-care tests, training and mentorship, compared with usual care, among sick children 2 to 59 months old presenting to primary care facilities for an acute illness in Tanzania (ClinicalTrials.

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Introduction: The relations between coffee and tea consumption and head and neck cancer (HNC) incidence are unclear. With increasing global HNC burden, this study aims to examine the association between coffee, tea, and HNC.

Methods: A pooled analysis of 9548 HNC cases and 15,783 controls from 14 individual-level case-control studies was conducted from the International Head and Neck Cancer Epidemiology consortium.

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Robustness assessment of regressions using cluster analysis typologies: a bootstrap procedure with application in state sequence analysis.

BMC Med Res Methodol

December 2024

Department of Epidemiology and Health Systems, Centre for Primary Care and Public Health (Unisanté), University of Lausanne, Route de La Corniche 10, 1010, Lausanne, Switzerland.

Background: In standard Sequence Analysis, similar trajectories are clustered together to create a typology of trajectories, which is then often used to evaluate the association between sequence patterns and covariates inside regression models. The sampling uncertainty, which affects both the derivation of the typology and the associated regressions, is typically ignored in this analysis, an oversight that may lead to wrong statistical conclusions. We propose utilising sampling variation to derive new estimates that further inform on the association of interest.

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Background: Timely and appropriate outpatient care can prevent potentially avoidable hospitalizations (PAH) for diabetes. We analysed the trends, determinants, and consequences of PAH for diabetes in Switzerland over two decades.

Methods: hospital discharge data for years 1998-2018 were used.

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Background: Osteogenesis imperfecta (OI) is a rare hereditary bone disease resulting from a defect in collagen synthesis or processing, leading to bone fragility, frequent fractures and skeletal deformities. OI is associated with increased respiratory morbidity and mortality, but the mechanisms of lung involvement are poorly understood, and there are no data on the natural history of lung function. We studied lung function over time in a cohort of adult OI patients at one center.

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Introduction: Anti-retroviral therapy (ART) simplification strategies are needed for treatment-experienced people with HIV (PWH) and multidrug-resistant viruses. These individuals are commonly treated with boosted ART regimens and are thereby at risk for harmful drug-drug interactions (DDI). In this trial, we aim to assess the efficacy of the combination doravirine, dolutegravir and lamivudine (DOR/DTG/3TC) among people with a history of virological failure who receive boosted ART.

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Aim: The evidence-based policy paradigm has been criticized for poorly representing drug and other health policy processes, with evidence showing various social forces influencing knowledge translation. However, less research has examined the social forces influencing knowledge production. Applying a social constructivist lens, this study investigates how politics, power, economics, philosophy, and discourse influence the evidence generating processes related to drug policy.

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Objectives: To examine the impact of the COVID-19 pandemic on deprivation-related inequalities in hospitalisations for cardiovascular disease (CVD) conditions in Denmark and England between March 2018 and December 2021.

Design: Time-series studies in England and Denmark.

Setting: With the approval of National Health Service England, we used English primary care electronic health records, linked to secondary care and death registry data through the OpenSAFELY platform and nationwide Danish health registry data.

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Background: COVID-19 pandemic and confinement measures had a major impact on the health and well-being of the population. Health promotion and prevention (HP&P) professionals had to rethink their practices to respond to the challenges raised by the pandemic context. This study aimed to build a professional consensus on the HP&P priorities (apart from the COVID-19 fight) in the early times of the pandemic in Switzerland and to identify the most relevant interventions to respond to these issues.

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Article Synopsis
  • A web-based assessment tool for lung point-of-care ultrasound (POCUS) training was developed to evaluate skills in low- and middle-income countries (LMIC) where onsite experts may be unavailable.
  • *The tool adapted the validated lung ultrasound score and was used to assess participants from Benin and South Africa at different intervals after training, yielding an overall success rate of 84%.
  • *Results showed no significant differences in skill success rates based on geographical location or time since training, indicating the assessment tool's effectiveness across varying contexts.
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Twenty-year trends of potentially avoidable hospitalizations for hypertension in Switzerland.

Hypertens Res

October 2024

Centre for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland.

We assessed the trends, characteristics, and consequences of potentially avoidable hospitalizations (PAH) for hypertension in Switzerland, for the period 1998 to 2018. Data from 117,507 hospitalizations (62.1% women), minimum age 20 years.

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Introduction: Compassion fatigue (CF) refers to emotional or physical exhaustion and emotional reactions resulting from prolonged exposure to traumatic events, commonly experienced by professionals in caregiving roles. CF is prevalent among healthcare professionals, including those in animal care. Several Patient-Reported Outcome Measures (PROMs) were developed to measure CF, but their psychometric validity was not reviewed systematically.

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Background: Intrathecal morphine provides effective analgesia for a range of operations. However, widespread implementation into clinical practice is hampered by concerns for potential side-effects. We undertook a systematic review, meta-analysis, and meta-regression with the primary objective of determining whether a threshold dose for non-pulmonary complications could be defined and whether an association could be established between dose and complication rates when intrathecal morphine is administered for perioperative or obstetric analgesia.

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Background: Collaboration between physicians and pharmacists facilitates the conduct of medication optimisation efforts. In the context of deprescribing, pharmacists' roles are often described as making deprescribing recommendations to physicians. Little is known about factors associated with pharmacists' willingness to make deprescribing recommendations and their interprofessional collaboration with physicians in Swiss primary care settings.

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Trametinib is a targeted therapy used for the treatment of solid tumours, with significant variability reported in real-life studies. This variability increases the risk of suboptimal exposure, which can lead to treatment failure or increased toxicity. Using model-based simulation, this study aims to characterize and investigate the pharmacokinetics and the adequacy of the currently recommended doses of trametinib.

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Factors associated with intent to stay in the profession: an exploratory cluster analysis across healthcare professions in Switzerland.

Eur J Public Health

December 2024

Department of Epidemiology and Health Systems, Centre for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland.

Retention issues are widespread within the health workforce. This cross-sectional study used data collected from 1707 healthcare professionals in 2022-23 to identify with k-means clustering groups of individuals sharing similar working experiences. These profiles were linked with varying levels of turnover intentions and a range of healthcare professions.

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Background: Recommendations suggest favouring regional over general anaesthesia to reduce impact on postoperative sleep apnoea severity, but there is currently no evidence to support this. We compared the impact of general vs spinal anaesthesia on postoperative sleep apnoea severity and assessed the evolution of sleep apnoea severity up to the third postoperative night.

Methods: This post hoc analysis used pooled data from two previous randomised controlled trials in patients undergoing total hip arthroplasty under general or spinal anaesthesia (n=96), without performing a preliminary power analysis.

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