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ImportanceWith the ongoing COVID-19 pandemic, it is crucial to assess the current burden of disease of community-acquired SARS-CoV-2 Omicron variant in hospitalized patients to tailor appropriate public health policies. Comparisons with better-known seasonal influenza infections may facilitate such decisions.ObjectiveTo compare the in-hospital outcomes of patients hospitalized with the SARS-CoV-2 Omicron variant with patients with influenza.Design, Setting, and ParticipantsThis cohort study was based on a national COVID-19 and influenza registry. Hospitalized patients aged 18 years and older with community-acquired SARS-CoV-2 Omicron variant infection who were admitted between January 15 and March 15, 2022 (when B.1.1.529 Omicron predominance was >95%), and hospitalized patients with influenza A or B infection from January 1, 2018, to March 15, 2022, where included. Patients without a study outcome by August 30, 2022, were censored. The study was conducted at 15 hospitals in Switzerland.ExposuresCommunity-acquired SARS-CoV-2 Omicron variant vs community-acquired seasonal influenza A or B.Main Outcomes and MeasuresPrimary and secondary outcomes were defined as in-hospital mortality and admission to the intensive care unit (ICU) for patients with the SARS-CoV-2 Omicron variant or influenza. Cox regression (cause-specific and Fine-Gray subdistribution hazard models) was used to account for time-dependency and competing events, with inverse probability weighting to adjust for confounders with right-censoring at day 30.ResultsOf 5212 patients included from 15 hospitals, 3066 (58.8%) had SARS-CoV-2 Omicron variant infection in 14 centers and 2146 patients (41.2%) had influenza A or B in 14 centers. Of patients with the SARS-CoV-2 Omicron variant, 1485 (48.4%) were female, while 1113 patients with influenza (51.9%) were female (P = .02). Patients with the SARS-CoV-2 Omicron variant were younger (median [IQR] age, 71 [53-82] years) than those with influenza (median [IQR] age, 74 [59-83] years; P < .001). Overall, 214 patients with the SARS-CoV-2 Omicron variant (7.0%) died during hospitalization vs 95 patients with influenza (4.4%; P < .001). The final adjusted subdistribution hazard ratio (sdHR) for in-hospital death for SARS-CoV-2 Omicron variant vs influenza was 1.54 (95% CI, 1.18-2.01; P = .002). Overall, 250 patients with the SARS-CoV-2 Omicron variant (8.6%) vs 169 patients with influenza (8.3%) were admitted to the ICU (P = .79). After adjustment, the SARS-CoV-2 Omicron variant was not significantly associated with increased ICU admission vs influenza (sdHR, 1.08; 95% CI, 0.88-1.32; P = .50).Conclusions and RelevanceThe data from this prospective, multicenter cohort study suggest a significantly increased risk of in-hospital mortality for patients with the SARS-CoV-2 Omicron variant vs those with influenza, while ICU admission rates were similar.

In recent decades, we have witnessed the diffusion of policy diffusion studies across many sub-disciplines of political science. Four mechanisms of policy diffusion-learning, competition, emulation and coercion-have become widely accepted as explanations for how policymaking processes and policy outcomes in one polity influence those in other polities. After pointing to major shortcomings of this inductively gained set of mechanisms, we present a theoretically more coherent typology that draws on key concepts from International Relations and Policy Studies. The four mechanisms we lay down consider rationalist and social constructivist approaches equally and they incorporate symmetric and asymmetric constellations. By further distinguishing between processes confined to one policy field and those arising from links across policy fields, we present a typology of eight theoretically consistent pathways of policy diffusion. Our framework enables the aggregation of knowledge and contributes to conceptual coherence in multi-methods research.

An influential explanation for the persistent political underrepresentation of minorities in elected office is that minority candidates are discriminated against by voters of the dominant ethnic group. We argue, however, for the need to distinguish between two forms of discrimination: ingroup favoritism and outgroup hostility. We measure the impact of each by using an extensive data set drawn from Swiss elections, where voters can cast both positive and negative preference votes for candidates. Our results show that immigrant-origin candidates with non-Swiss names incur an electoral disadvantage because they receive more negative preference votes than candidates with typically Swiss names. But we also find that minority candidates face a second disadvantage: voters discriminate in favor of majority candidates by allocating them more positive preference votes. These two forms of electoral discrimination are critically related to a candidate’s party, whereas the impact of the specific outgroup to which a minority candidate belongs is less pronounced than expected.

Scholars have examined the role that negative stereotypes play in electoral discrimination against minority candidates. Incorporating literature on in-group favoritism, the author argues here that some degree of this discrimination can be explained instead by voters holding positive stereotypes of majority candidates and discriminating in their favor. Based on the results of an original moderation-of-process survey experiment carried out in Italy, the study provides evidence of electoral discrimination pertaining to immigrant-origin candidates, concentrated among right-wing citizens. It finds that stereotypes have little mediating effect on discrimination against candidates with a migration background; rather, the primary role played by stereotypes is in discrimination in favor of majority candidates, that is, positive bias that reserves electoral benefits to them. The relevance of in-group favoritism is corroborated by the finding that large segments of the Italian voting population hold distinctively positive stereotypes of majority candidates without also negatively stereotyping immigrant-origin candidates.