[Colorectal cancer screening program in the canton of Vaud: raising awareness]. / Programme vaudois de dépistage du cancer colorectal : évolution de la sensibilisation.

After five years of deployment, the participation rate in the Vaud colorectal cancer (CRC) screening program remains below projected targets. It was found that the communication tools made available to the population did not provide explicit recommendations regarding how to participate. To this end, Unisanté led a project between 2022 and 2023 to increase awareness and widely disseminate tools specifically designed with the target population. The intention was to provide decision-support tools (I decide to participate) and guidance in the system (in what way) to improve participation by the population targeted by the Vaud CRC screening program. This project incorporated the principles of proportionate universalism, that is to say, adapting screening methods to the specific needs of population sub-groups, such as those in a disadvantaged socio-economic position with low or very low levels of health literacy.

À l'issue de cinq années de déploiement, le taux de participation de la population au programme vaudois de dépistage du cancer colorectal (CCR) s'est révélé en dessous des objectifs souhaités Afin de faciliter une décision de participation, un projet global a été conçu par Unisanté entre 2022 et 2023, dont la finalité était de déployer des actions spécifiques de sensibilisation et de mettre à disposition de la population cible des informations d'une très large accessibilité. L'intention était de disposer d'outils d'aide à la décision (je décide à participer) et d'orientation dans le dispositif (de quelle manière) permettant d'amplifier la participation de la population ciblée par le programme vaudois de dépistage du CCR. Ce projet a permis d'adapter la sensibilisation sur les modalités de dépistage aux populations avec un niveau de littératie en santé faible, voire très faible.

Production and reproduction responses for dairy cattle supplemented with oral calcium bolus after calving: Systematic review and meta-analysis.

Among the commonly implemented strategies developed to support calcium (Ca) metabolism postpartum, oral Ca supplementation is within the most studied. However, research shows varying responses to treatment in regard to production and reproduction. Our objectives were (1) to identify and synthesize the literature evaluating the associations between postpartum oral Ca supplementation as bolus and milk yield and risk of pregnancy to first service using a systematic review, and (2) to quantify these associations using meta-analytical methods. Nine relevant studies published between January 2010 and September 2021 were identified after systematic search of 4 databases (Biosis, CAB Abstracts, Medline, Scopus). The studies were conducted in commercial confined and grazing farms. Eight of the 9 studies reported feeding low to negative dietary cation-anion difference diets prepartum. Oral Ca bolus supplementation strategies varied among studies but were predominantly centered on the first 24 h postpartum. Milk yield and pregnancy to first service were evaluated in 9 and 6 of the studies, respectively. Other productive (energy-corrected milk yield, peak milk yield, or fat and protein concentrations) and reproductive (estrus cyclicity, days from calving to first service, or pregnancy by 150 or 210 days in milk) outcomes were evaluated in 4 of the studies. The meta-analyses revealed a lack of evidence for associations between prophylactic blanket postpartum oral Ca bolus supplementation and milk yield (including 8 studies) or risk of pregnancy to first service (including 6 studies). Some of the evaluated studies reported statistically significant associations after data stratification. However, not enough studies reported estimates for the evaluated conditional factors to perform a meta-analysis among the identified subgroups. In conclusion, future research should study and report the production, reproduction, and health estimates of cow-level conditional factors of interest for the evaluated response, and investigate alternative regimes of oral Ca bolus supplementation.

Comparative analysis of tools to predict rapid progression in autosomal dominant polycystic kidney disease.

Background: Autosomal dominant polycystic kidney disease (ADPKD) is the most common genetic kidney disease and shows a wide phenotype. Only patients with rapid progression (RP) are included in clinical trials or are approved to receive disease-modifying drugs. This study aims at comparing different available predictive tools in ADPKD with the Mayo classification (MC) identification of rapid progressors based on high total kidney volume (TKV) according to age. Methods: A total of 164 ADPKD patients were recruited retrospectively from a single centre. The performance of diverse tools to identify RP defined as being in MC categories 1C-1E was assessed. Results: A total of 118 patients were MC 1C-1E. The algorithm developed by the European Renal Association-European Dialysis and Transplant Association Working Group on Inherited Kidney Disorders/European Renal Best Practice had a low sensitivity in identifying MC 1C-1E. The sensitivity and specificity of TKV to predict RP depend on the cut-off used. A kidney length of >16.5 cm before age 45 years has high specificity but low sensitivity. Assessing the MC by ultrasonography had high levels of agreement with magnetic resonance imaging (MRI) data, especially for 1A, 1D and 1E. The estimated glomerular filtration rate (eGFR) decline was very sensitive but had low specificity. In contrast, the Predicting Renal Outcome in Polycystic Kidney Disease (PROPKD) score was very specific but had poor sensitivity. Having hypertension before 35 years of age is a good clinical predictor of MC 1C-1E. Family history can be of help in suggesting RP, but by itself it lacks sufficient sensitivity and specificity. Conclusions: The MC by ultrasonography could be an option in hospitals with limited access to MRI as it performs well generally, and especially at the extremes of the MC, i.e. classes 1A, 1D and 1E. The eGFR decline is sensitive but not very specific when compared with the MC, whereas the PROPKD score is very specific but has low sensitivity. Integrating the different tools currently available to determine RP should facilitate the identification of rapid progressors among patients with ADPKD.