Health care workers' influenza vaccination: motivations and mandatory mask policy

Background Vaccination of health care workers (HCW) against seasonal influenza (SI) is recommended but vaccination rate rarely reach >30%. Vaccination coverage against 2009 pandemic influenza (PI) was 52% in our hospital, whilst a new policy requiring unvaccinated HCW to wear a mask during patient care duties was enforced. Aims To investigate the determinants of this higher vaccination acceptance for PI and to look for an association with the new mask-wearing policy. Methods A retrospective cohort study, involving HCW of three critical departments of a 1023-bed, tertiary-care university hospital in Switzerland. Self-reported 2009-10 SI and 2009 PI vaccination statuses, reasons and demographic data were collected through a literature-based questionnaire. Descriptive statistics, uni- and multivariate analyses were then performed. Results There were 472 respondents with a response rate of 54%. Self-reported vaccination acceptance was 64% for PI and 53% for SI. PI vaccination acceptance was associated with being vaccinated against SI (OR 9.5; 95% CI 5.5-16.4), being a physician (OR 7.7; 95% CI 3.1-19.1) and feeling uncomfortable wearing a mask (OR 1.7; 95% CI 1.0-2.8). Main motives for refusing vaccination were: preference for wearing a surgical mask (80% for PI, not applicable for SI) and concerns about vaccine safety (64%, 50%) and efficacy (44%, 35%). Conclusions The new mask-wearing policy was a motivation for vaccination but also offered an alternative to non-compliant HCW. Concerns about vaccine safety and efficiency and self-interest of health care workers are still main determinants for influenza vaccination acceptance. Better incentives are needed to encourage vaccination amongst non-physician HC

Syndrome respiratoire aigu après inhalation de sprays imperméabilisants

Au cours de l'hiver 2002-2003, le Centre suisse d'information toxicologique a enregistré une augmentation inhabituelle de troubles respiratoires après exposition à des sprays imperméabilisants utilisés pour l'imprégnation du cuir et des textiles. Plus de 150 cas ont ainsi été rapportés. De telles épidémies sont déjà survenues au cours des vingt dernières années dans divers pays. Sur le plan clinique, des symptômes de toux, dyspnée et fièvre apparaissent dans le minutes ou les heures qui suivent l'exposition. Certains patients présentent une détresse respiratoire aiguë nécessitant une hospitalisation en soins intensifs. L'évolution clinique est favorable en quelques jours dans la majorité des cas, mais une dyspnée ou une toux chroniques pourraient persister chez certains patients. Un récent changement de formulation chimique semble être la cause de l'épidémie survenue en Suisse. Les produits incriminés ont été retirés de la vente. De nouveaux cas pourraient toutefois survenir à l'avenir en lien avec l'utilisation accrue de sprays imperméabilisants durant l'hiver et la possible commercialisation de nouveaux produits. [¨Résumé des Auteurs] A la suite de l'épidémie survenue en Suisse, l'Office fédéral de la santé publique a fait classer tous les sprays imperméabilisants pour cuirs et textiles dans la classe de toxicité 5S. Leurs emballages comporteront donc davantage d'avertissements aux utilisateurs. Il est actuellement recommandé d'employer ces sprays à l'air libre, d'éviter de s'exposer au brouillard de vaporisation (ne pas employer le spray contre le vent), et de bien laisser sécher les articles imperméabilisés à l'extérieur. L'emploi à l'intérieur est à éviter. Il ne suffit pas d'ouvir une fenêtre. Les personnes atteintes de maladies respiratoires (par exemple, asthme) devraient éviter d'utiliser elles-mêmes ces produits et ne pas se tenir à proximité d'un endroit où ils sont employés. [Auteurs, p. 2177]]]> Aerosols ; Respiratory Tract Diseases ; Environmental Exposure fre oai:serval.unil.ch:BIB_28738 2022-05-07T01:13:32Z <oai_dc:dc xmlns:dc="http://purl.org/dc/elements/1.1/" xmlns:xs="http://www.w3.org/2001/XMLSchema" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns:oai_dc="http://www.openarchives.org/OAI/2.0/oai_dc/" xsi:schemaLocation="http://www.openarchives.org/OAI/2.0/oai_dc/ http://www.openarchives.org/OAI/2.0/oai_dc.xsd"> https://serval.unil.ch/notice/serval:BIB_28738 Substances végétales toxiques et allergisantes. Giroud, C info:eu-repo/semantics/bookPart incollection 2003 Plantes, Pollen &amp; Allergies, vol. 3, pp. 50-63 oai:serval.unil.ch:BIB_28738FE2CF5F 2022-05-07T01:13:32Z <oai_dc:dc xmlns:dc="http://purl.org/dc/elements/1.1/" xmlns:xs="http://www.w3.org/2001/XMLSchema" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns:oai_dc="http://www.openarchives.org/OAI/2.0/oai_dc/" xsi:schemaLocation="http://www.openarchives.org/OAI/2.0/oai_dc/ http://www.openarchives.org/OAI/2.0/oai_dc.xsd"> https://serval.unil.ch/notice/serval:BIB_28738FE2CF5F Comparative Studies of Fluoroquinolones in the Treatment of Urinary Tract Infections info:doi:10.1093/clinids/10.supplement_1.s153 info:eu-repo/semantics/altIdentifier/doi/10.1093/clinids/10.supplement_1.s153 Malinverni, R. Glauser, M. P. info:eu-repo/semantics/article article 1988 Clinical Infectious Diseases, vol. 10, no. Supplement_1, pp. S153-S163 info:eu-repo/semantics/altIdentifier/pissn/1537-6591 info:eu-repo/semantics/altIdentifier/pissn/1058-4838 eng oai:serval.unil.ch:BIB_28739 2022-05-07T01:13:32Z <oai_dc:dc xmlns:dc="http://purl.org/dc/elements/1.1/" xmlns:xs="http://www.w3.org/2001/XMLSchema" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns:oai_dc="http://www.openarchives.org/OAI/2.0/oai_dc/" xsi:schemaLocation="http://www.openarchives.org/OAI/2.0/oai_dc/ http://www.openarchives.org/OAI/2.0/oai_dc.xsd"> https://serval.unil.ch/notice/serval:BIB_28739 Grössenselektive personenbezogene Staubprobenahme : Verwendung offenporiger Schäume Möhlmann, C. Aitken, R. J. Kenny, L. C. Görner, P. Vu Duc, T. Zambelli, G. info:eu-repo/semantics/article article 2003 Gefahrstoffe - Reinhaltung der Luft, vol. 63, no. 10, pp. 413-416 info:eu-repo/semantics/altIdentifier/pissn/0949-8036 ger oai:serval.unil.ch:BIB_28740 2022-05-07T01:13:32Z <oai_dc:dc xmlns:dc="http://purl.org/dc/elements/1.1/" xmlns:xs="http://www.w3.org/2001/XMLSchema" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns:oai_dc="http://www.openarchives.org/OAI/2.0/oai_dc/" xsi:schemaLocation="http://www.openarchives.org/OAI/2.0/oai_dc/ http://www.openarchives.org/OAI/2.0/oai_dc.xsd"> https://serval.unil.ch/notice/serval:BIB_28740 Intellectuelle ou militante? le serpent de mer fait son numéro. Kraus, C Malbois, F Messant, F Pannatier, G Perrin, C info:eu-repo/semantics/article article 2003 Nouvelles Questions Féministes, vol. volume 22, n° 1, pp. 4-12 oai:serval.unil.ch:BIB_28742 2022-05-07T01:13:32Z <oai_dc:dc xmlns:dc="http://purl.org/dc/elements/1.1/" xmlns:xs="http://www.w3.org/2001/XMLSchema" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns:oai_dc="http://www.openarchives.org/OAI/2.0/oai_dc/" xsi:schemaLocation="http://www.openarchives.org/OAI/2.0/oai_dc/ http://www.openarchives.org/OAI/2.0/oai_dc.xsd"> https://serval.unil.ch/notice/serval:BIB_28742 Poétique et dramaturgie: les didascalies de personnage. Exemple du théâtre de Georges Ferydeau. Myszkorowska, M info:eu-repo/semantics/article article 2003 Pratiques, vol. 119-120, pp. 35-66 oai:serval.unil.ch:BIB_286DBB5FB136 2022-05-07T01:13:32Z openaire documents urnserval <oai_dc:dc xmlns:dc="http://purl.org/dc/elements/1.1/" xmlns:xs="http://www.w3.org/2001/XMLSchema" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns:oai_dc="http://www.openarchives.org/OAI/2.0/oai_dc/" xsi:schemaLocation="http://www.openarchives.org/OAI/2.0/oai_dc/ http://www.openarchives.org/OAI/2.0/oai_dc.xsd"> https://serval.unil.ch/notice/serval:BIB_286DBB5FB136 Low-grade glioma: a challenge in therapeutic options: the role of radiotherapy. info:doi:10.1093/annonc/mdn434 info:eu-repo/semantics/altIdentifier/doi/10.1093/annonc/mdn434 info:eu-repo/semantics/altIdentifier/pmid/18790954 Baumert, B.G. Stupp, R. info:eu-repo/semantics/review article 2008 Annals of Oncology, vol. 19, no. Suppl 7, pp. vii217-vii222 info:eu-repo/semantics/altIdentifier/pissn/1569-8041 Antineoplastic Combined Chemotherapy Protocols; Brain Neoplasms; Chemotherapy, Adjuvant; Dacarbazine; Glioma; Humans; Lomustine; Neoplasm Recurrence, Local; Procarbazine; Prognosis; Radiotherapy; Radiotherapy Dosage; Vincristine eng https://serval.unil.ch/resource/serval:BIB_286DBB5FB136.P001/REF.pdf http://nbn-resolving.org/urn/resolver.pl?urn=urn:nbn:ch:serval-BIB_286DBB5FB1362 info:eu-repo/semantics/altIdentifier/urn/urn:nbn:ch:serval-BIB_286DBB5FB1362 info:eu-repo/semantics/publishedVersion info:eu-repo/semantics/openAccess Copying allowed only for non-profit organizations https://serval.unil.ch/disclaimer application/pdf oai:serval.unil.ch:BIB_286DD50ABE29 2022-05-07T01:13:32Z openaire documents urnserval <oai_dc:dc xmlns:dc="http://purl.org/dc/elements/1.1/" xmlns:xs="http://www.w3.org/2001/XMLSchema" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns:oai_dc="http://www.openarchives.org/OAI/2.0/oai_dc/" xsi:schemaLocation="http://www.openarchives.org/OAI/2.0/oai_dc/ http://www.openarchives.org/OAI/2.0/oai_dc.xsd"> https://serval.unil.ch/notice/serval:BIB_286DD50ABE29 Cycling to Work : An Analysis of the Practice of Utility Cycling info:doi:10.1007/978-3-030-62256-5 info:eu-repo/semantics/altIdentifier/doi/10.1007/978-3-030-62256-5 urn:isbn:9783030622558 info:eu-repo/semantics/altIdentifier/isbn/9783030622558 urn:isbn:9783030622565 info:eu-repo/semantics/altIdentifier/isbn/9783030622565 info:eu-repo/semantics/altIdentifier/pissn/2191-530X info:eu-repo/semantics/altIdentifier/pissn/2191-5318 Rérat, Patrick info:eu-repo/semantics/book book 2021 <![CDATA[This book presents a thorough discussion of utility cycling, cycling in the urban environment, and everyday mobility. It is based on large survey answered by 14,000 participants in the bike to work action in Switzerland, and quantifies the various dimensions of utility cycling. It proposes an innovative theoretical framework to analyse and understand the various dimensions of the uses of bikes and their diversity. It addresses the factors that motivate commuters to get on their bike, and highlights the barriers to this practice between deficient infrastructures and lack of legitimacy. This research makes a diagnosis and discusses the way to develop this sustainable mode of transportation. By combining quantitative results in the form of tables, figures, and maps, and including qualitative results in the form of quotations from survey participants, this book provides a thorough and enjoyable read. It will be of interest to researchers, policy makers, advanced students in the field of urban planning, social sciences, and transportation

Contact tracing investigation after professional exposure to tuberculosis in a Swiss hospital using both tuberculin skin test and IGRA.

SETTING: A 950 bed teaching hospital in Switzerland. AIM: To describe the result of a contact investigation among health care workers (HCW) and patients after exposure to a physician with smear-positive pulmonary tuberculosis in a hospital setting using standard tuberculin skin tests (TST) and Interferon-gamma release assay (IGRA). METHOD: HCW with a negative or unknown TST at hiring had a TST two weeks after the last contact with the index case (T0), repeated six weeks later if negative (T6). All exposed HCW had a T-SPOT.TB at T0 and T6. Exposed patients had a TST six weeks after the last contact, and a T-SPOT.TB if the TST was positive. RESULTS: Among 101 HCW, 17/73 (22%) had a positive TST at T0. TST was repeated in 50 at T6 and converted from negative to positive in eight (16%). Twelve HCW had a positive T-SPOT.TB at T0 and ten converted from negative to positive at T6. Seven HCW with a positive T-SPOT.TB reverted to negative at T6 or at later controls, most of them with test values close to the cut-off. Among 27 exposed patients tested at six weeks, ten had a positive TST, five of them confirmed by a positive T-SPOT.TB. CONCLUSIONS: HCW tested twice after exposure to a case of smear-positive pulmonary TB demonstrated a possible conversion in 10% with T-SPOT and 16% with TST. Some T-SPOT.TB reverted from positive to negative during the follow-up, mostly tests with a value close to the cut-off. Due to the variability of the test results, it seems advisable to repeat the test with values close to the cut-off before diagnosing the presence of a tuberculous infection

Health care workers' influenza vaccination: motivations and mandatory mask policy

BACKGROUND: Vaccination of health care workers (HCW) against seasonal influenza (SI) is recommended but vaccination rate rarely reach &gt;30%. Vaccination coverage against 2009 pandemic influenza (PI) was 52% in our hospital, whilst a new policy requiring unvaccinated HCW to wear a mask during patient care duties was enforced. AIMS: To investigate the determinants of this higher vaccination acceptance for PI and to look for an association with the new mask-wearing policy. METHODS: A retrospective cohort study, involving HCW of three critical departments of a 1023-bed, tertiary-care university hospital in Switzerland. Self-reported 2009-10 SI and 2009 PI vaccination statuses, reasons and demographic data were collected through a literature-based questionnaire. Descriptive statistics, uni- and multivariate analyses were then performed. RESULTS: There were 472 respondents with a response rate of 54%. Self-reported vaccination acceptance was 64% for PI and 53% for SI. PI vaccination acceptance was associated with being vaccinated against SI (OR 9.5; 95% CI 5.5-16.4), being a physician (OR 7.7; 95% CI 3.1-19.1) and feeling uncomfortable wearing a mask (OR 1.7; 95% CI 1.0-2.8). Main motives for refusing vaccination were: preference for wearing a surgical mask (80% for PI, not applicable for SI) and concerns about vaccine safety (64%, 50%) and efficacy (44%, 35%). CONCLUSIONS: The new mask-wearing policy was a motivation for vaccination but also offered an alternative to non-compliant HCW. Concerns about vaccine safety and efficiency and self-interest of health care workers are still main determinants for influenza vaccination acceptance. Better incentives are needed to encourage vaccination amongst non-physician HCW

Safety of human immunisation with a live-attenuated Mycobacterium tuberculosis vaccine: a randomised, double-blind, controlled phase I trial.

BACKGROUND: Tuberculosis remains one of the world's deadliest transmissible diseases despite widespread use of the BCG vaccine. MTBVAC is a new live tuberculosis vaccine based on genetically attenuated Mycobacterium tuberculosis that expresses most antigens present in human isolates of M tuberculosis. We aimed to compare the safety of MTBVAC with BCG in healthy adult volunteers. METHODS: We did this single-centre, randomised, double-blind, controlled phase 1 study at the Centre Hospitalier Universitaire Vaudois (CHUV; Lausanne, Switzerland). Volunteers were eligible for inclusion if they were aged 18-45 years, clinically healthy, HIV-negative and tuberculosis-negative, and had no history of active tuberculosis, chemoprophylaxis for tuberculosis, or BCG vaccination. Volunteers fulfilling the inclusion criteria were randomly assigned to three cohorts in a dose-escalation manner. Randomisation was done centrally by the CHUV Pharmacy and treatments were masked from the study team and volunteers. As participants were recruited within each cohort, they were randomly assigned 3:1 to receive MTBVAC or BCG. Of the participants allocated MTBVAC, those in the first cohort received 5 × 10(3) colony forming units (CFU) MTBVAC, those in the second cohort received 5 × 10(4) CFU MTBVAC, and those in the third cohort received 5 × 10(5) CFU MTBVAC. In all cohorts, participants assigned to receive BCG were given 5 × 10(5) CFU BCG. Each participant received a single intradermal injection of their assigned vaccine in 0·1 mL sterile water in their non-dominant arm. The primary outcome was safety in all vaccinated participants. Secondary outcomes included whole blood cell-mediated immune response to live MTBVAC and BCG, and interferon γ release assays (IGRA) of peripheral blood mononuclear cells. This trial is registered with ClinicalTrials.gov, number NCT02013245. FINDINGS: Between Jan 23, 2013, and Nov 6, 2013, we enrolled 36 volunteers into three cohorts, each of which consisted of nine participants who received MTBVAC and three who received BCG. 34 volunteers completed the trial. The safety of vaccination with MTBVAC at all doses was similar to that of BCG, and vaccination did not induce any serious adverse events. All individuals were IGRA negative at the end of follow-up (day 210). After whole blood stimulation with live MTBVAC or BCG, MTBVAC was at least as immunogenic as BCG. At the same dose as BCG (5×10(5) CFU), although no statistical significance could be achieved, there were more responders in the MTBVAC group than in the BCG group, with a greater frequency of polyfunctional CD4+ central memory T cells. INTERPRETATION: To our knowledge, MTBVAC is the first live-attenuated M tuberculosis vaccine to reach clinical assessment, showing similar safety to BCG. MTBVAC seemed to be at least as immunogenic as BCG, but the study was not powered to investigate this outcome. Further plans to use more immunogenicity endpoints in a larger number of volunteers (adults and adolescents) are underway, with the aim to thoroughly characterise and potentially distinguish immunogenicity between MTBVAC and BCG in tuberculosis-endemic countries. Combined with an excellent safety profile, these data support advanced clinical development in high-burden tuberculosis endemic countries. FUNDING: Biofabri and Bill &amp; Melinda Gates Foundation through the TuBerculosis Vaccine Initiative (TBVI)

Combined Use of Mycobacterium tuberculosis-Specific CD4 and CD8 T-Cell Responses Is a Powerful Diagnostic Tool of Active Tuberculosis.

Immune-based assays are promising tools to help to formulate diagnosis of active tuberculosis. A multiparameter flow cytometry assay assessing T-cell responses specific to Mycobacterium tuberculosis and the combination of both CD4 and CD8 T-cell responses accurately discriminated between active tuberculosis and latent infection

Chemical pneumonitis and subsequent reactive airways dysfunction syndrome after a single exposure to a household product: a case report

<p>Abstract</p> <p>Introduction</p> <p>Household products are usually safe to use. Adverse events arising from their use are mostly reported in patients with pre-existing atopy or pulmonary problems and usually only after a prolonged exposure to such products. We report the case of a patient with no prior problems who developed significant side effects from a single exposure to a domestic product.</p> <p>Case presentation</p> <p>A 43-year-old Caucasian American man, previously in good health, used a domestic aerosol product called 'Stand N' Seal "Spray-On" Grout Sealer' in an enclosed room in his house. The product contained n-butyl acetate (<5%), propane (10%), isobutane (<5%), C8-C9 petroleum hydrocarbon solvent (80%), a fluoropolymer resin and a solvent. Within a few hours of exposure to the sealant, he developed rapidly progressive shortness of breath and a severe non-productive cough. By the time he reached the emergency room he was severely hypoxic. A diagnosis of chemical pneumonitis was made based on the clinical scenario and the diffuse infiltrates on the computer tomography scan. With supportive therapy, his condition improved and he was discharged from the hospital. However, he continued to have symptoms of intermittent cough and shortness of breath in response to strong odours, fumes, cold air and exertion even after his chest radiograph had normalized. Three months later, bronchial hyper-responsiveness was documented by a methacholine inhalation test and a diagnosis of reactive airways dysfunction syndrome was made. The patient was started on high-dose inhaled steroids and his symptoms improved. The mechanism of toxicity and determination of the exact agent responsible is still under investigation.</p> <p>Conclusion</p> <p>A household product may still prove unsafe to use even after it has gone through vigorous testing and approval processes. Even healthy individuals are susceptible to adverse outcomes after a brief exposure. Extra precautions should be taken when using any chemical product at home.</p

Characterizing emission and breathing-zone concentrations following exposure cases to fluororesin-based waterproofing spray mists.

Measurements and simulations were performed to assess workers' exposure to solvent vapors and aerosols during the waterproofing of a tiled surface. This investigation followed two recent incidents in the same company where workers experienced acute respiratory illness after spraying a stain-repellent resin containing fluorinated polymers on stone-tiled walls and floors. Because the waterproofing activity had been done for years at the tile company without encountering any exposure problems prior to these cases, it was strongly suspected that the incidents were linked to a recent change in the composition of the coating mixture. Experimental measurements and simulations indicated that the emission rate of particles smaller than 10 microm may be estimated at 0.66 mg/sec (SD 0.10) for the old resin and at 0.37 mg/sec (SD 0.04) for the new one. The measurement of the solvent emission rate from surfaces coated with the two resins indicated that shortly after spraying, the emission was in the range of 18 to 20 mg/sec x m2 and was similar for both products. Solvent and overspray emission rates were introduced in a two-zone compartment model. The results obtained in the near-field indicate significant exposure to overspray mist (7 and 34 mg/m3 for new resin) and solvent vapors (80 to 350 ppm for the new resin). It was also shown that the introduction of the new resin tended to significantly decrease the levels of solvents and particulates in the workers' breathing zone. These results strongly suggest that cases of acute respiratory illness are related to the specific toxicity of the fluorinated polymer itself. The fact that the same polymer is used in various commercial products raises concern regarding other possible occupational and domestic exposures

Infections nosocomiales en médecine ambulatoire: importance et prévention [Importance and prevention of nosocomial infections in the outpatient setting]

The concept of nosocomial infections (or healthcare-related infections) applies to the outpatients clinics. However, data are scarce and imprecise in this setting compared with hospitals. The choice of preventive measures is therefore difficult. A lower risk in the outpatient facilities does not justify the complete implementation of hospital precautions. The latter can nevertheless be adapted since infection may be acquired during an ambulatory consultation through the same mechanisms as in hospitals. We propose a preventive strategy derived from standard precautions to be applied in every case, transmission-based precautions that are more rarely needed, and asepsis in case of invasive procedure

Burnout des médecins : le dossier médical informatisé comme nouvelle cause [Burnout among physicians : a new related reason ?]

Prevalence of burnout in physicians is increasing, affecting their health and satisfaction at work as well as quality and security of healthcare. Several causes have been identified, of which growing intensity of work, loss of meaning and feeling that healthcare structure reforms prevent one's job being done properly are the main reasons. New data shows an association between burnout and use of the yet widespread electronic health record. It has a proven impact on the multiple aspects of physician's work, and users' satisfaction is often mediocre. Hence, among the broad prevention field of physicians' burnout, specific measures related to the digital domain are needed