A multi-stage approach to support timely health policy decisions during crisis: the fast-track Delphi.

Background: Scientists can play an important role in policymaking by providing evidence and consensual expert opinion on the state of scientific knowledge. Delphi surveys have been widely used to develop consensus on a topical issue, yet not compatible with public health crisis situations requiring rapid decisions. We developed a fast-track Delphi process, providing experts with a structured approach to rapidly develop and quantify consensus in support of informed policy decisions.

[PFAS and 5G: what can we tell patients about these two current scientific topics?].

Issues such as PFAS and 5G are regularly in the media spotlight like this of Nutri-Score which is discussed in a second article. The model of the physician possessing all medical knowledge is evolving. Patients now come to consultations with information from a variety of sources, some of which are exhaustive, some of which are not.

[Nutri-Score : what can we tell patients about this current scientific topic?].

Issues such as the Nutri-score is regularly in the media spotlight like those of PFAS and 5G which are discussed in a second article. The model of the physician possessing all medical knowledge is evolving. Patients now come to consultations with information from a variety of sources, some of which are exhaustive, some of which are not.

[Patient decision aids for cancer prevention Synthesis for the francophone community].

In recent years, the relationship between patients and healthcare professionals, and more broadly between public health actors and citizens, has shifted from a paternalistic, top-down approach to one of increased patient involvement in decision-making. Primary and secondary cancer prevention involve both benefits and risks, underscoring the importance of informed decision-making aligned with each patient and citizen's unique values and preferences. Shared decision-making, supported by decision aids, offers patients and citizens clear and comprehensible information about their options, enabling informed choices.

[Scientific consensus-building to promote the link between science and public policy].

Consensus, defined as the position on which most scientists specialized in a given field agree at a given time, is a key aspect in increasing the readability, credibility and, ultimately, the use of scientific knowledge in public (evidence-based health policy). This article presents several methods aiming at developing scientific consensus between experts, such as the conventional or rapid Delphi approach, the nominal group technique, the RAND-UCLA appropriateness method and the consensus development conference. These methods are used to synthesize expert judgements when uncertainties persist in the literature - each with its own specificities in terms of duration, number of steps and expert participants enlisted, as well as the ways in which they are involved.

[REVIAC: ten years of advice for populations in vulnerable situations].

The REVIAC device was designed ten years ago, with the aim of advising social workers in their efforts to support and reintegrate people in vulnerable situations. In this article, it will be a question of identifying the current issues and the challenges to be met for the future.

[Promoting physical activity in primary care practices. Review fifteen years after the launch of PAPRICA training].

This article reviews the PAPRICA (Physical Activity promotion in PRImary CAre) program fifteen years after the first training course in physical activity counseling for primary care physicians in French-speaking Switzerland. Subsequent developments are also presented, based on the PAPRICA experience. The article then looks at the national strategy for promoting physical activity in the medical practice, the issues involved in financing the services, and the situation in other comparable countries.

Why did Swiss citizens vote to ban tobacco advertising?

In February 2022, Swiss citizens agreed to modify the Swiss Constitution to ban tobacco advertising reaching children and adolescents. This case study analyses the arguments used by both opponents and supporters of the constitutional amendment. Opponents argued that the proposed regulation went too far, threatened the economy, restricted personal freedom, was superfluous as the current law already protected youth and that it opened the door to marketing bans of other harmful products.

Antigen rapid tests, nasopharyngeal PCR and saliva PCR to detect SARS-CoV-2: A prospective comparative clinical trial.

Background: Nasopharyngeal antigen Rapid Diagnostic Tests (RDTs), saliva RT-PCR and nasopharyngeal (NP) RT-PCR have shown different performance characteristics to detect patients infected by SARS-CoV-2, according to the viral load (VL)-and thus transmissibility.

Methods: In October 2020, we conducted a prospective trial involving patients presenting at testing centres with symptoms of COVID-19. We compared detection rates and performance of RDT, saliva PCR and nasopharyngeal (NP) PCR, according to VL and symptoms duration.

[New puff-like disposable electronic cigarettes: expert consensus on their regulation].

New disposable electronic cigarettes have arrived on the Swiss market since 2020. Our study, conducted according to the three steps of the Delphi fast-track approach developed at Unisanté, obtained a consensual agreement among French-speaking Switzerland experts on the regulation of these products. Ideally, the panel of experts recommends a sales ban of the product.

Cigarette smoking during pregnancy and adverse perinatal outcomes: a cross-sectional study over 10 years.

Background: It has been shown that active exposure to tobacco is associated with adverse pregnancy outcomes including, but not limited to, intrauterine fetal death, reduced fetal weight, and higher risk of preterm birth. We want to investigate these effects in a high-income country.

Methods: This cross-sectional study examined 20,843 pregnant women who delivered over 10 years at the Maternity Hospital of the Centre Hospitalier Universitaire Vaudois (CHUV) in Lausanne, Switzerland.

[Risk assessment and management: between epidemiology and social acceptability].

Risk is a well-known concept in medicine and in epidemiology and its approach intend to be rational and measurable. Risk measurement makes it possible to communicate with a patient or a population the risk of occurrence of an event. However, it is often difficult to estimate accurately the probability of occurrence of an adverse event and there is therefore uncertainty.

Nicotine Replacement Therapy for Smokers with Acute Aneurysmal Subarachnoid Hemorrhage: An International Survey.

Introduction: Smoking prevalence is twice as high among patients admitted to hospital because of the acute condition of aneurysmal subarachnoid hemorrhage (aSAH) as in the general population. Smoking cessation may improve the prognosis of aSAH, but nicotine replacement therapy (NRT) administered at the time of aSAH remains controversial because of potential adverse effects such as cerebral vasospasm. We investigated the international practice of NRT use for aSAH among neurosurgeons.

Investigating acceptability of a training programme in precision medicine for frontline healthcare professionals: a mixed methods study.

Background: Precision Medicine offers tailored prevention, diagnosis, treatment and management to patients that considers genomics, lifestyle and environmental factors. If implementation of Precision Medicine is to advance, effective, focused upskilling of frontline healthcare professionals through quality continuing professional development is needed. This study reports on an evidence-based approach to needs assessment to investigate the current level of knowledge of Precision Medicine, acceptable content for training, the perceived potential of a more precision approach to patient care and motivation to participate in a training programme among pharmacists, advanced practice nurses and general practitioners.

The neighborhood environment and its association with the spatio-temporal footprint of tobacco consumption and changes in smoking-related behaviors in a Swiss urban area.

This study aimed to evaluate the association of the neighborhood environment with the spatio-temporal dependence of tobacco consumption and changes in smoking-related behaviors in a Swiss urban area. Data were obtained from the CoLaus cohort (2003-2006, 2009-2012, and 2014-2017) in Lausanne, Switzerland. Local Moran's I was performed to assess the spatial dependence of tobacco consumption.

Shared decision-making and patient and public involvement: Can they become standard in Switzerland?

The Swiss healthcare system is highly decentralized, making implementation of shared decision making (SDM) and patient and public involvement (PPI) quite slow; nonetheless, change is happening. SDM is now a core communication competency for medical school graduates, as reflected by a dedicated station on the federal exam, and is endorsed by several national societies. Multiple local initiatives are contributing to international best practices, local implementation, and increased capacity.