Gender differences in lung cancer epidemiology - do Austrian male lung cancer patients still die earlier in life?

Objective: Previous analyses reported an unexpected decline of mean age of death of Austrian male lung cancer patients until 1996 and a subsequent turnaround of this epidemiological trend after the mid-1990s until 2007. In light of ongoing changes in smoking behavior of men and women, this study aims to investigate the development of mean age of death from lung cancer in Austria during the past three decades. Materials and methods: This study used data about the annual mean age of death from lung cancer, including malignant neoplasm of trachea, bronchus and lung, between 1992 and 2021 obtained from Statistics Austria, Federal Institution under Public Law. One-way analysis of variance (ANOVA) and independent samples t-tests were applied to explore any significant differences of mean values in the course of time as well as between men and women. Results: Overall, mean age of death of male lung cancer patients increased consistently throughout the observed time periods, whereas women did not show any statistically significant change in the last decades. Conclusion: Possible reasons for the reported epidemiological development are discussed in this article. Research and Public Health measures should increasingly focus on smoking behaviors of female adolescents.

Anticholinergic and Sedative Medications Are Associated With Neurocognitive Performance of Well Treated People With Human Immunodeficiency Virus.

Background: We previously showed that anticholinergic (ACH) medications contribute to self-reported neurocognitive impairment (NCI) in elderly people with human immunodeficiency virus (PWH). The current cross-sectional study further evaluated the effect of ACH and sedative drugs on neurocognitive function in PWH who underwent comprehensive neuropsychological evaluation. Methods: A medication review was performed in PWH enrolled in the prospective Neurocognitive Assessment in Metabolic and Aging Cohort within the Swiss HIV Cohort Study. Neurocognitive functions were analyzed in 5 domains (motor skills, speed of information, attention/working memory, executive functions, and verbal learning memory). The effect of ACH and sedative medications on neurocognitive functioning was evaluated using linear regression models for the continuous (mean z-score) outcome and multivariable logistic regression models for the binary (presence/absence) outcome. Results: A total of 963 PWH (80% male, 92% Caucasian, 96% virologically suppressed, median age 52) were included. Fourteen percent of participants were prescribed ≥1 ACH medication and 9% were prescribed ≥1 sedative medication. Overall, 40% of participants had NCI. Sedative medication use was associated with impaired attention/verbal learning and ACH medication use with motor skills deficits both in the continuous (mean z-score difference -0.26 to -0.14, P < .001 and P = .06) and binary (odds ratio [OR], ≥1.67; P < .05) models. Their combined use was associated with deficits in overall neurocognitive functions in both models (mean z-score difference -0.12, P = .002 and OR = 1.54, P = .03). These associations were unchanged in a subgroup analysis of participants without depression (n = 824). Conclusions: Anticholinergic and sedative medications contribute to NCI. Clinicians need to consider these drugs when assessing NCI in PWH.

Multidisciplinary expert group: communication measures to increase vaccine compliance in adults.

The WHO categorized vaccine hesitancy as one of the greatest threats to global health worldwide. Vaccination of elderly persons is of increasing relevance, given that they represent a growing segment in the population and considering the burden diseases pose to them. Many factors leading to vaccine hesitancy are related to inadequate communication. In the present report, experts from various academic fields present recommendations to support communication strategies that may help to initiate targeted communication measures to enhance vaccination compliance in adults.

Self-reported vaccination status and attitudes towards mandatory vaccinations for health care workers among medical students.

Health care workers (HCWs) are exposed to a high risk of infectious diseases at work, and of transmitting these to their patients and colleagues. Medical students constitute an important, yet neglected, group within HCW because of their contact with patients in the course of compulsory or voluntary practical training courses at health care institutions. The aim of this study was to determine the current vaccination status of medical students at the Medical University of Vienna and assess their attitudes towards occupationally indicated mandatory vaccinations for doctors and other HCW. Nearly 80% of the students considered mandatory vaccinations for doctors an appropriate measure and 88% would recommend them in settings involving immunocompromised patients. The acceptance of mandatory immunisation differs very markedly for individual vaccinations; it ranges from 82.8% for hepatitis B to 40% for influenza. The self-reported vaccination status among medical students was 90.1%, 89.9%, 88.1% and 84.4% for hepatitis B, tetanus, polio and hepatitis A, respectively. Inadequately low rates of 78%, 70.5% and 70.5%, and 28.7% were reported for MMR, varicella, pertussis and influenza (2014/15 season), respectively. CONCLUSION: The majority of medical students at the MUW had a positive attitude towards vaccinations and considered mandatory vaccinations for doctors and HCW an appropriate measure. However, the large majority of the vaccination rates are worthy of improvement.

Report of the 21st Annual Meeting of the International Scientific Working Group on Tick-Borne Encephalitis (ISW-TBE): TBE - record year 2018.

The 21st Meeting of the International Scientific Working Group on Tick-Borne Encephalitis (ISW-TBE) - a group of neurologists, general practitioners, clinicians, travel physicians, virologists, pediatricians, ecologists, and epidemiologists - was held under the theme "TBE - record year 2018″. Several key topics in the field of TBE were extensively discussed, among them current epidemiological developments in different countries, expansion of risk areas, virological and clinical aspects, importance of awareness, traveling and mobility, and latest news on TBE vaccination. The main goals that have been achieved by the ISW-TBE so far are, among others, an increased awareness in endemic and non-endemic countries, an increase of vaccination rates in various countries, getting TBE acknowledged and established as a travel-related risk, and building contact with the European Centre for Disease Prevention and Control.

Influenza vaccination in Austria: Persistent resistance and ignorance to influenza prevention and control.

OBJECTIVE: In the Austrian population approximately 350,000-400,000 cases and 1,000-1,200 deaths are observed during an average epidemic, which puts influenza-related deaths on top of the list of vaccine-preventable cases of death. In face of extensive vaccination recommendations, the current vaccination rate of the general population of about 6% is one of the lowest worldwide. The objective of this study was to provide an update regarding the use of influenza vaccination in Austria over the period 1982-2015. METHODS: This paper presents data on influenza vaccine use in Austria displayed by the number of distributed doses per 1,000 population over a period of 33 years. Further data was collected from representative population-based telephone surveys. RESULTS: Austria has always been among the countries with a low number of distributed doses of influenza vaccine. The highest number ever was reached in 2006 with 142 doses/1,000. From 2007 onwards, a steady decrease happened to 62 doses/1,000 in the 2015/16 season, which corresponds to the level of the mid-nineties. CONCLUSION: Despite the fact that Austria is a country with comprehensive recommendations for influenza vaccination, this vaccination continues to be misjudged by the Austrian population and many areas of the medical system. From a public health point of view, this situation is not acceptable. Efforts must be increased to attain a much higher vaccination rate, e.g. the importance of the healthcare workers' influence must be recognized, the options of social marketing have to be utilized and studies on the main barriers in Austria are urgently needed.

[Immunizing is not only a children's matter! : Why vaccinations are also important for adults]. / Impfen ist nicht nur Kindersache! : Warum Impfungen auch für Erwachsene wichtig sind.

Vaccinations belong to the ten most effective public health achievements worldwide. While immunization programms for children are installed in Europe, vaccinations for adults are not established. However, adult vaccination is extremely meaningful: increasing age means a higher susceptibility to infectious diseases, health problems and multimorbidity will increase. The burden of vaccine-preventable diseases is still high in Europe. Due to immunosenescence (older) adults are less protected against pathogens, antibody titers after vaccinations are lower and immunity lasts shorter. There is striking lack of data of adult vaccination rates and an international consensus regarding adult vaccination recommendations or guidelines are not available in Europe. In only six countries a comprehensive document describing recommended vaccinations for adults is available, among them Austria. The awareness of the importance of adult vaccination over the whole lifetime is not present to the necessary extent in Europe and has to be promoted.

Report of the 20th annual meeting of the International Scientific Working Group on Tick-Borne Encephalitis (ISW-TBE): ISW-TBE: 20 years of commitment and still challenges ahead.

The 20th Meeting of the International Scientific Working Group on Tick-Borne Encephalitis (ISW-TBE) - a group of neurologists, general practitioners, clinicians, travel physicians, virologists, pediatricians, ecologists, and epidemiologists - was held under the theme "ISW-TBE: 20 years of commitment & still challenges ahead". On the occasion of the 20th anniversary of the ISW-TBE several key topics in TBE were extensively discussed, among them current epidemiological developments and investigations, expansion of risk areas, clinical aspects and cases, traveling and mobility, and latest news on TBE vaccination. The main goals that have been achieved by the ISW-TBE so far are, among others, an increased awareness in endemic and non-endemic countries, an increase of vaccination rates in various countries, getting TBE acknowledged and established as a travel-related risk, and building contact with the European Centre for Disease Prevention and Control.

Report of the 19th Annual Meeting of the International Scientific Working Group on Tick-Borne Encephalitis (ISW-TBE) - TBE in a changing world.

The 19th meeting of the International Scientific Working Group on Tick-Borne Encephalitis (ISW-TBE) - a group of neurologists, general practitioners, clinicians, travel physicians, virologists, pediatricians and epidemiologists-was held under the title "TBE in a changing world". Key topics within virology, current epidemiological developments and investigations, expansion of risk areas, clinical aspects and cases, traveling and mobility, vaccination rates, and latest news on vaccination were presented and extensively discussed. Over the past four decades, TBE has become a growing public health challenge in Europe and parts of Asia. It may be considered a complex eco-epidemiological system, characterized by an intricate interplay between the virus, ticks and tick hosts on the one hand and human exposure strongly influenced by socioeconomic conditions on the other hand. Although the facts are simple - vaccination is the best prevention - the socioeconomic conditions keep changing, and with them the ability or willingness of people to get vaccinated.

Tick-borne encephalitis-still on the map: Report of the 18th annual meeting of the international scientific working group on tick-borne encephalitis (ISW-TBE).

The 18th meeting of the International Scientific Working Group on Tick-Borne Encephalitis (ISW-TBE)-a group of neurologists, general practitioners, clinicians, travel physicians, virologists, pediatricians and epidemiologists-was held under the title 'Tick-borne encephalitis-still on the map'. The conference agenda was divided into six sessions: 'National Implementation of EU notifiable disease status', 'Virology', 'Epidemiology and Risk areas & Poster Walk Epidemiological Update', 'Clinic', 'Environmental Factors' and 'New Findings and Diagnosis'. Key topics such as 'TBE as a notifiable disease-results of the third European survey', 'TBE vaccines over the years', 'Overview of flaviviruses', 'TBE virus phylogenetics', 'Current epidemiological developments and investigations', 'Clinical aspects', 'TBE in veterinary medicine', 'Laboratory diagnostic', 'Occupational risk', 'Allergy, obesity, and vaccination' were presented and extensively discussed.

The International Scientific Working Group on Tick-Borne Encephalitis (ISW TBE): Review of 17 years of activity and commitment.

Tick-borne encephalitis (TBE) has been a growing public health problem in Europe and other parts of the world for the past 20 years. In 1999, in order to encourage the control of TBE, international experts created a new body: The International Scientific Working Group on Tick-Borne Encephalitis (ISW-TBE). This Working Group has been composed of internationally recognized scientific experts from tick-borne encephalitis virus (TBEv)-endemic and non-endemic regions with extensive personal expertise in the field and a high level of commitment to improve the knowledge of TBE and to increase the public awareness of TBE. Since the foundation of the Working Group, ISW-TBE members meet annually. Every meeting is dedicated to a specific topic, and since 2004 a yearly conference report has been published to inform the scientific community about the latest developments. Among the specific issues that have been extensively discussed over the years were the following: clinical aspects of the disease, TBE in children and golden agers, epidemiology, possible causes for the increase in TBE incidence in Europe, TBE and awareness, TBE and travel, (low) vaccination rates, and the cooperation with the European Centre for Disease Prevention and Control (ECDC). This paper gives an overview of the most important activities and achievements of the ISW-TBE over the past 17 years.

THE AUSTRIAN VACCINATION PARADOX: TICK-BORNE ENCEPHALITIS VACCINATION VERSUS INFLUENZA VACCINATION.

This paper describes a paradoxical situation in Austria. The vaccination rate against tick-borne encephalitis (TBE) in the general population is 82%, which is the highest worldwide, whereas the vaccination rate against influenza is about 8% and is among the lowest worldwide. A high awareness of TBE among the Austrian population achieved by an annual social marketing programme and the wide use of effective and well-tolerated vaccines have led to a successful containment of that disease. The vaccination coverage increased from 6% in 1980 to 82% in 2013 and exceeds 90% in some high-risk areas. This has led to a steady decline in the number of TBE cases from several hundred cases to 50 to 100 cases per year. The situation in regard to influenza vaccination is the opposite. Although Austria has issued one of the most extensive recommendations for influenza vaccination worldwide, the vaccination rate of the general population is extremely low. The possible reasons for the failure in the implementation of recommendations are ignorance, lack of social marketing and the predominance of a distinct discordance within the health system in general, and the Austrian medical fraternity in particular.

[Tick-borne encephalitis (TBE) and TBE-vaccination in Austria: Update 2014]. / Frühsommer-Meningo-Enzephalitis (FSME) und FSME-Schutzimpfung in Österreich: Update 2014.

TBE is a public health problem well under control in Austria because of a mass vaccination programme. There have been 50-100 registered cases per year for many years, the vaccination rate of the population is currently 85 %. Special attention has to be given to the "older" generation 40 plus as this is the segment of the population where the majority of cases are observed annually. In comparison of the counties, Tyrol and Upper Austria finished first and second after a long time when Styria and Carynthia had observed most of the cases. For TBE applies the same as for Tetanus, namely the principle of disease control or disease elimination: The virus cannot be eliminated and vaccination provides individual protection. The both available TBE vaccines have proven to be very effective with an effectivity of 96-99 %, also when given irregular vaccinations the protection rate is still very high (>90 %). More than 4000 prevented cases between 2000 and 2011 prove this impressively.

Tick-borne encephalitis as a notifiable disease--Status quo and the way forward. Report of the 17th annual meeting of the International Scientific Working Group on Tick-Borne Encephalitis (ISW-TBE).

The 17th meeting of the International Scientific Working Group on Tick-Borne Encephalitis (ISW-TBE), a group of neurologists, general practicioners, clinicians, travel physicians, virologists, pediatricians, and epidemiologists, was held under the title "Tick-borne encephalitis as a notifiable disease--status quo and the way forward". The conference agenda was divided into three parts on the first day: "Epidemiology & Risk areas", "Poster Walk: Epidemiological Update in Europe", and "News in TBE Research". On the second day, a World Café Working Session took place where the participants could choose three tables out of six to join for discussion. Key topics on current epidemiological developments and investigations, risk areas, cases, travel and mobility, TBE in children, vaccination rates, and latest news on vaccination were presented and extensively discussed.

Tick-borne encephalitis - a notifiable disease, a review after one year: report of the 16th Annual Meeting of the International Scientific Working Group on Tick-Borne Encephalitis (ISW-TBE).

The 16th Meeting of the International Scientific Working Group on Tick-Borne Encephalitis (ISW-TBE) - a group of neurologists, general practitioners, clinicians, travel physicians, virologists, paediatricians, and epidemiologists - was held under the title "Tick-borne Encephalitis - a Notifiable Disease, a Review after One Year". With the inclusion of TBE in the list of notifiable diseases in 2012, an important measure was established to continue improving the level of evidence on TBE in Europe to better help guide policies and methods to lower the burden of this disease. The conference agenda was divided into six parts concerning Travel Medicine, Epidemiology & Risk Areas, Poster Session with an Epidemiological Update in Europe, Interactive Debate, Cases, and Social Communication and Recommendations. Important topics regarding current epidemiological investigations, risk areas, mobility, cases, TBE in children, treatment options, vaccination rates, and latest news on vaccination were presented and extensively discussed.

A short tool to screen HIV-infected patients for mild neurocognitive disorders - a pilot study.

BACKGROUND: We aimed to evaluate the accuracy and acceptability of a short screening test battery for mild neurocognitive deficits. METHODS: HIV-infected individuals with a suppressed viral load were examined at the University Hospital Basel with a screening test consisting of a questionnaire and selected cognitive tests, administered by trained nurses, followed by an in-depth neuropsychological examination. Test acceptance was evaluated with a questionnaire. RESULTS: 30 patients were included in this study (median age of 52.5 years (interquartile range (IQR) 47-64), prior AIDS-defining condition in 37%, median CD4 cell count 658 (IQR 497-814) cells/µl). Overall, 25 (83%) patients were diagnosed with HIV-associated neurocognitive disorders (HAND) on in-depth neuropsychological assessment (16 patients had asymptomatic neurocognitive impairment (ANI), 8 a mild neurocognitive disorder (MND) and 1 patient HIV-associated dementia (HAD). Among 25 patients with HAND, only 9 patients (36%) were complaining of memory loss. The screening battery revealed neurocognitive deficits in 17 (57%) patients (sensitivity 64%, specificity 80%, positive predictive value 94% and negative predictive value 31%). Most patients (83%) estimated the screening test as valuable and not worrisome. CONCLUSIONS: A questionnaire combined with selected neuropsychological tests is a short, easy-to-perform very well accepted screening tool for mild neurocognitive disorders in asymptomatic HIV-infected individuals.

Influenza vaccination in Austria from 1982 to 2011: a country resistant to influenza prevention and control.

BACKGROUND: Austria's position on influenza vaccination is unique. Generally it is recommended for everyone, and specifically for those over the age of 50 years and all children between 6 months and 5 years. However, the vaccination rate among the general public is one of the lowest in the world (<10%). Our objective was to provide baseline information to allow a better understanding of the low vaccination rate. METHODS: This paper presents data on influenza vaccine use in Austria during a period of almost 30 years, from 1982 to 2011. Data presented in this study were obtained from three sources. RESULTS: Between 1982 and 1992, Austria showed little change in its low proportion of vaccinations (from 20 to 23 doses/1000); from 1992 to 1995, the proportion increased to 52 doses/1000, retaining its status as one of the low-use countries. By 2003, the proportion had increased to 127 doses/1000, but Austria remained one of the three lowest-use Western European countries. Between 2007 and 2011/2012, a steady decrease to 81 doses/1000 was observed. CONCLUSION: The Austrian population, and parts of the medical system, have shown distinct ignorance regarding the prevention and control of influenza over past decades. Possible reasons for this development are discussed.

Tick-borne encephalitis: a disease neglected by travel medicine.

Tick-borne encephalitis (TBE) is a vector-borne disease that is primarily transmitted to humans by infected ticks and causes infection of the central nervous system. Clinical presentations range from meningitis to encephalitis with or without myelitis, and infection may result in death or long-term neurological sequelae. TBE is endemic in regions of at least 27 European as well as in some Asian countries. Infection and disease, however, can be averted successfully by tick-bite prevention and active vaccination. The risk of infection has shifted from daily life and occupational exposure to leisure-time activities, including travelling. Outdoor activities during the tick season with contact with nature increase the risk of tick bites. Although the number of travel-associated cases is unknown, it is certainly under-estimated because there is hardly any awareness of TBE in non-endemic countries. Therefore, the majority of cases remain undiagnosed, also because of the lack of diagnostic serology, as there is no routine screening for TBE in non-endemic regions. Because of the increasing number of travellers from TBE non-endemic to endemic regions, and in view of the fact that TBE was included in the list of notifiable diseases in the European Union in September 2012, this disease needs to become an important issue in travel medicine.

Tick-borne encephalitis--a notifiable disease: report of the 15th Annual Meeting of the International Scientific Working Group on Tick-Borne Encephalitis (ISW-TBE).

The 15th Meeting of the International Scientific Working Group on Tick-Borne Encephalitis (ISW-TBE)--a group of neurologists, general practicioners, clinicians, travel physicans, virologists, pediatricians, and epidemiologists--was held under the title "Tick-Borne Encephalitis--a notifiable disease". With the inclusion of TBE in the list of notifiable diseases, an important measure was established to continue improving the level of evidence on TBE in Europe to better help guide policies and methods to lower the burden of this disease. Due to differences in diagnosis, case definition, and reporting in European countries, the overall epidemiology and burden of TBE remains unclear. During the meeting, important issues regarding epidemiology, risk areas, vaccination rates, and latest news on vaccination were presented and extensively discussed. A poster session provided an overview of the epidemiological situation 2012 in 13 European countries.

Tick-borne encephalitis (TBE): an underestimated risk still: report of the 14th annual meeting of the International Scientific Working Group on Tick-Borne Encephalitis (ISW-TBE).

Today, the risk of getting tick-borne encephalitis (TBE) is still underestimated in many parts of Europe and worldwide. Therefore, the 14th meeting of the International Scientific Working Group on Tick-Borne Encephalitis (ISW-TBE) - a group of neurologists, general practitioners, clinicians, travel physicians, virologists, pediatricians, and epidemiologists - was held under the title "Tick-borne encephalitis: an underestimated risk…still". Among the discussed issues were: TBE, an underestimated risk in children, a case report in two Dutch travelers, the very emotional report of a tick victim, an overview of the epidemiological situation, investigations to detect new TBE cases in Italy, TBE virus (TBEV) strains circulation in Northern Europe, TBE Program of the European Centre for Disease Prevention and Control (ECDC), efforts to increase the TBE vaccination rate in the Czech Republic, positioning statement of the World Health Organization (WHO), and TBE in dogs. To answer the question raised above: Yes, the risk of getting TBE is underestimated in children and adults, because awareness is still too low. It is still underestimated in several areas of Europe, where, for a lack of human cases, TBEV is thought to be absent. It is underestimated in travelers, because they still do not know enough about the risk, and diagnostic awareness in non-endemic countries is still low.