Implementation and evaluation of an algorithm for the management of scabies outbreaks.

BACKGROUND: Infestations with scabies mites are a global burden affecting individuals of all ages, classes and ethnicities. As poor sanitation and overcrowding favor the transmission of this highly contagious disease, epidemic outbreaks are frequently observed among displaced persons and asylum seekers. Due to the growing influx of refugees during the last years, public health authorities in host countries are frequently confronted with the challenge to treat individuals with diagnosed or suspected scabies promptly and effectively to avoid further spreading of the infestation. This study aimed to establish a straightforward and efficient algorithm for rapid screening and treatment of large numbers of patients with confirmed or suspected scabies infestations. METHODS: Forty-eight individuals (58% males, mean age 22.4 yrs.) from Syria with suspected scabies infestation were allocated to 3 colour-coded groups: (1) no signs or symptoms of infestation, (2) itch only, and (3) itch and typical skin lesions. Patients were treated with a single (group 1) or two doses of oral ivermectin at an interval of 7 days (group 2), or with a combination of 2 doses of ivermectin plus 2 applications of permethrin ointment at an interval of 7 days (group 3). Follow-ups were performed 4 weeks after initial treatments. RESULTS: All individuals with signs and/or symptoms of infestation had improved skin lesion; in 10/11 (90.9%) lesion had completely resolved. All individuals with initial itch only (n = 32) reported improvement of its intensity or complete resolution. None of the patients of group 1 developed itch or skin lesions. The algorithm was reapplied in 4 individuals (8.3%) after 4 weeks and the outbreak was completely controlled after 8 weeks. Colour-coding ensured fast flow of information between health-care providers at the interfaces of the algorithm. CONCLUSIONS: Our algorithm proved to be both highly efficient for treatment of large numbers of patients with suspected or diagnosed scabies infestation as well as for prevention of spreading of the disease. Hence, this algorithm is well suited for the management of scabies mass outbreaks.

Giving blood and enrolling on the stem cell donor registry: ranking of obstacles and motives in Switzerland.

BACKGROUND: To obtain a better understanding of factors affecting blood and blood stem cell donation behavior in Switzerland, a series of studies has been performed. In the recent study of this series, which is described here, motivators and barriers in the field of blood and blood stem cell donation were identified. METHODS: Web-based survey data from a non-random sample of the Swiss population 2012/2013 (n = 3,153) were used to describe and compare the ranking of motives and obstacles to donate blood and to enroll on the Swiss blood stem cell registry. Wilcoxon rank-sum test and Spearman's rank correlations were used to assess differences and associations between ranks and groups. RESULTS: The prospect of saving lives and solidarity were the top two motives to donate blood or to enroll on the blood stem cell registry. The top two obstacles to enroll on the blood stem cell registry were lack of general information on blood stem cell donation and on its risks, whereas the top two obstacles to donate blood were the lack of information where and when to donate and deferral of or exclusion from blood donation. CONCLUSION: Classical altruistic motives are top drivers for giving blood as well as registering for blood stem cell donation. Recruitment campaigns should focus on these motivators. Similarities in motivational factors as well as in obstacles regarding blood and blood stem cell donation can be found.

Measurement invariance of the Personality Inventory for the DSM-5 across U.S. East Asian, Southeast Asian, and White participants.

The Personality Inventory for the Diagnostic and Statistical Manual of Mental Disorders (DSM), Fifth Edition (PID-5) was developed as a measure of the traits included in the alternative model of personality disorders (AMPD) in Section III of the DSM. The PID-5 is composed of 25 scales measuring each trait in the AMPD across five domains: negative affectivity, detachment, disinhibition, antagonism, and psychoticism. Previous research suggests that there may be important differences in the expression of personality pathology across race and culture, particularly between people with eastern and western cultural heritages. The goal of the current research was to examine the measurement invariance of the PID-5 across these groups. In the current study, 865 young men and women who identified as White, East Asian, or Southeast Asian completed the PID-5 and international personality item pool (IPIP). On the domain level, a multigroup exploratory structural equation model found that the PID-5 had configural and metric invariance, but lacked complete scalar invariance. On an item level, all scales had configural invariance, one lacked metric invariance, and 11 of the 25 scales lacked scalar invariance across race. For the invariant scales, East and Southeast Asians tended to have higher mean scores than White participants. The PID-5 scales had similar relations with IPIP scales across groups. These results suggest that the PID-5 scales are measuring similar constructs across groups on a global, structural level, but that mean scores may represent different levels of latent personality pathology across groups. The PID-5 may be confidently used in these groups, but mean comparisons should be interpreted with caution. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Individual Characteristics Associated with Blood Donation: A Cross-National Comparison of the German and Swiss Population between 1994 and 2010.

OBJECTIVE: The aim of this study is to compare individual characteristics associated with blood donation in the German and Swiss population between 1994 and 2010. METHODS: Population-based survey data from the Eurobarometer 1994 and 2009, the Swiss Health Survey 1997, and the Swiss Blood Donation Survey 2010 were used to compare age-adjusted percentages of German and Swiss adults ever having donated blood (n = 8,746). A multivariate logistic regression was applied to the pooled data to estimate odds ratios (OR). RESULTS: Donor rates between 1994 and 2010 increased by 8.6% in Germany (p = 0.0045) and remained stable in Switzerland. The likelihood to report donating increased with age. Gender differences (OR = 2.85; p = 0.0000) and differences between education levels were more pronounced in Switzerland as compared to Germany (OR = 2.56; p = 0.0000 and OR = 2.73; p = 0.0010). Furthermore education differences were more marked in men in both countries (OR = 1.99; p = 0.0000 and OR = 1.68; p = 0.0140). CONCLUSION: The blood establishments should intensify their efforts to motivate women and lower educated people to give blood. Our data suggest that population-based surveys could be a helpful tool to describe donor rates in different countries and to guide future recruitment strategies.

Impact of selection of cord blood units from the United States and swiss registries on the cost of banking operations.

BACKGROUND: Over the last 2 decades, cord blood (CB) has become an important source of blood stem cells. Clinical experience has shown that CB is a viable source for blood stem cells in the field of unrelated hematopoietic blood stem cell transplantation. METHODS: Studies of CB units (CBUs) stored and ordered from the US (National Marrow Donor Program (NMDP) and Swiss (Swiss Blood Stem Cells (SBSQ)) CB registries were conducted to assess whether these CBUs met the needs of transplantation patients, as evidenced by units being selected for transplantation. These data were compared to international banking and selection data (Bone Marrow Donors Worldwide (BMDW), World Marrow Donor Association (WMDA)). Further analysis was conducted on whether current CB banking practices were economically viable given the units being selected from the registries for transplant. It should be mentioned that our analysis focused on usage, deliberately omitting any information about clinical outcomes of CB transplantation. RESULTS: A disproportionate number of units with high total nucleated cell (TNC) counts are selected, compared to the distribution of units by TNC available. Therefore, the decision to use a low threshold for banking purposes cannot be supported by economic analysis and may limit the economic viability of future public CB banking. CONCLUSIONS: We suggest significantly raising the TNC level used to determine a bankable unit. A level of 125 × 10(7) TNCs, maybe even 150 × 10(7) TNCs, might be a viable banking threshold. This would improve the return on inventory investments while meeting transplantation needs based on current selection criteria.

Measurement invariance of commonly used psychosis-screening scales in U.S. Spanish- and English-speaking Hispanic participants.

Two of the most commonly used psychosis screening measures are the Prodromal Questionnaire-Brief (PQ-B) and the Youth Psychosis at Risk Questionnaire-Brief (YPARQ-B). Both scales have considerable support for the reliability and validity of their scores for use with English- and Spanish-speaking participants, with measurement equivalence established across a subset of demographic characteristics. However, measurement invariance has not been examined across several important demographic variables, including native language, language of the scales used with Hispanic participants, education, occupation, income, birth country, and generation status. In the present study, (N = 1,191) measurement invariance was examined for each of these variables across three samples (ns = 505, 714, and 126). The PQ-B total scores and YPARQ-B were found to demonstrate configural and scalar invariance, while PQ-B Distress scores displayed configural, metric, and scalar invariance across most tested demographic variables. Psychosis scores were associated with social determinants of health (SDoH) including major and everyday experiences of discrimination, food insecurity, financial insecurity, acculturation, and ethnic identity. The associations between psychosis and SDoH were mostly consistent across groups. Compared to White-non-Hispanic participants, Hispanic participants had higher scores on all psychosis measures and tended to have higher scores on discrimination, food and housing insecurity, affirmation aspects of ethnic identity, and acculturative stress. Despite differences in psychosis levels, the groups did not differ in history of treatment. Overall, these results provide strong evidence that the PQ-B and YPARQ provide equivalent, nonbiased, valid, and reliable scores in Hispanic and Non-Hispanic participants in both English and Spanish. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Swiss Blood Stem Cells: More than Just a Registry.

Swiss Transfusion SRC, division Swiss Blood Stem Cells (SBSC), is an important national organization for all matters relating to blood stem cells. Not only has its name changed several times over the years but also its role has developed steadily and today goes beyond registry alone. For example, on order of and in close collaboration with transplant doctors, the organization searches for suitable donors worldwide. Searching for unrelated donors for Swiss patients and organizing the deliveries of the transplant tissues for Swiss and foreign patients are the most time-consuming procedures at SBSC. Additionally, the organization pays special attention to the problem of donor follow-up. Here it has made important contributions to the field of data collection (minimal data set) and helped to strengthen international coordination. As of January 2011, the organization has a new structure, because it has joined forces with the SRC Blood Transfusion Service. The new organization will be called Swiss Transfusion SRC, but SBSC remains as a main operational unit of the new organization. In 2009, SBSC implemented a successful new strategy to increase the numbers of donors: donors can now register online. This step led to a remarkable increase of donor numbers from 2009 to 2010.

Parallel trade of pharmaceuticals: a review of legal, economic, and political aspects.

OBJECTIVES: An overview of the status quo of parallel trade of pharmaceuticals (pharmaceutical parallel trade [PPT]) was performed. The different economic, political, and legal viewpoints as well as the public health perspective are being taken into consideration. Analysis is being undertaken on a worldwide level, focusing on the situation of Switzerland in the context of current developments in the United States as well as in the European Union (EU). METHODS: Desktop analysis using publicly available information (e.g., scientific literature, congress reports, official statistical databases) was performed during the years 2006 through 2007. Such gathered information was compiled and systematically structured to allow a crude overview of the development of intellectual property law in the last 100 years (as a prerequisite under which PPT legally can exist) as well as a description of the health economic and political context in which PPT is set currently. RESULTS: It could be shown that PPT is an ubiquitous phenomenon, appearing in industrialized countries as well as in the developing world. Economically, it has gained a significant weight in substantial parts of the EU in the last decade. This has to be seen in the context of EU efforts of enhanced economic and political integration. The worldwide constant growth of health-care expenditures, with its strain on national health-care budgets, has led to increased discussions about the necessity and consequences including possible dangers of PPT, namely, in the United States and in Switzerland, where up to now PPT has been only of marginal importance. CONCLUSIONS: The analysis of the value of PPT depends strongly on the importance that is given to different perspectives by the individual analyst. It is clear that an item-centered view of PPT is not able to analyze this phenomenon in an equitable way. Further attempts have to be made to standardize evaluation as well as to increase available information to empower science and decision-makers to perform objective analyses and informed decisions.

Cost effectiveness of cord blood versus bone marrow and peripheral blood stem cells.

Umbilical cord blood (CB) has become, since its first successful use more than two decades ago, an increasingly important source of blood stem cells. In this light, an overview of current usage of CB in the field of unrelated hematopoietic blood stem cell transplantation (HSCT) is given. The three main sources of hematopoietic stem cells: bone marrow (BM), peripheral blood stem cells (PBSC), and cord blood (CB) are compared as regards their current quantitative usage in HSCT. A cost analysis of the named three hematopoietic blood stem cell (HSC) sources, taking into account various factors, is undertaken. The health economical comparison shows significant differences between CB on the one side, and BM and PBSC on the other. The consequences for the public health side and propositions for a possible health care policy, especially regarding future resource allocation towards the different choices for HSCT products, are discussed. An outlook on the possible future usage of BM, PBSC, and CB and its implications on health systems, donor registries, and CB banks is given.