[Scientific consensus-building to promote the link between science and public policy]. / La recherche de consensus scientifique pour promouvoir le lien entre science et politiques publiques.

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.

Le consensus, défini comme la position sur laquelle la plupart des scientifiques spécialistes d'un domaine se mettent d'accord à un moment donné, est un aspect-clé pour augmenter la lisibilité, la crédibilité et in fine l'utilisation des savoirs scientifiques dans les politiques publiques (evidence-based health policy). Cet article présente plusieurs méthodes permettant le développement de consensus entre personnes expertes, telles que l'approche Delphi conventionnelle ou rapide, la technique du groupe nominal, la méthode d'adéquation RAND-UCLA et la conférence de consensus. Ces méthodes permettent la synthèse des jugements experts lorsque des incertitudes persistent dans la littérature ­ chacune avec des spécificités en termes de durée, du nombre d'étapes et de personnes expertes sollicitées, ainsi que des modalités de leur implication.

[New puff-like disposable electronic cigarettes: expert consensus on their regulation]. / Nouvelles cigarettes électroniques jetables « puffs ¼ : consensus d'expert-e-s sur leur réglementation.

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. If this is not possible, a number of aspects should be strictly regulated: taxation, product composition and marketing, and sales and consumption restrictions. These regulations should go further than the current European directive and the future Swiss law. The conclusions will be useful to support and guide political decision making from a public health and environmental perspective.

De nouvelles cigarettes électroniques jetables sont arrivées sur le marché suisse depuis 2020. Notre étude, conduite selon les trois étapes de la démarche Delphi fast-track développée à Unisanté, a obtenu un accord consensuel entre expert-e-s suisses romand-e-s sur la réglementation de ces produits. Dans l'idéal, le panel d'expert-e-s recommande une interdiction de vente du produit. Si cela n'est pas possible, certains aspects doivent être strictement réglementés : taxation, composition des produits et marketing, restrictions de vente et de consommation. Ces réglementations devraient aller plus loin que l'actuelle directive européenne et la future loi suisse. Les conclusions seront utiles pour soutenir et orienter la prise de décision politique dans une perspective de santé publique et environnementale.

Health promotion and prevention in early times of the COVID-19 pandemic: insights from a Delphi study in Switzerland.

BACKGROUND: COVID-19 pandemic and confinement measures had a major impact on the health and well-being of the population. Health promotion and prevention (HP&P) professionals had to rethink their practices to respond to the challenges raised by the pandemic context. This study aimed to build a professional consensus on the HP&P priorities (apart from the COVID-19 fight) in the early times of the pandemic in Switzerland and to identify the most relevant interventions to respond to these issues. METHODS: HP&P experts from the three main linguistic regions of Switzerland reached a consensus through a two-round Delphi methodology with online questionnaires in June-July and October-November, 2020. Out of 282 experts contacted, 121 (43%) contributed in the first round and 99 (35%) in the second. RESULTS: A strong consensus emerged about the importance of tackling mental health problems, non-communicable diseases and their main risk factors, as well as multiple social determinants of health. Although they believed that HP&P priorities changed in this context, experts reported that professional practices had only partially adapted to this new context due to multiple constraints (political, strategic, financial). The experts noted the need to adapt the means of communication to reach the different target groups. They underlined the potential of communication via digital technologies, but also drew attention to the risk of widening social inequalities due to the unequal access to these resources. CONCLUSIONS: This study generated new insights and confirmed pre-established knowledge regarding the orientations the field of HP&P should follow. While stressing the need to consolidate the traditional missions of the field (i.e. the fight against non-communicable diseases and the actions on social determinants of health), experts surveyed in this study also revaluated health priorities and rethought the way of developing HP&P actions in this specific context of the early pandemic of COVID-19.

Prevalence of SARS-CoV-2 in Household Members and Other Close Contacts of COVID-19 Cases: A Serologic Study in Canton of Vaud, Switzerland.

BACKGROUND: Research on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission within households and other close settings using serological testing is scarce. METHODS: We invited coronavirus disease 2019 (COVID-19) cases diagnosed between February 27 and April 1, 2020, in Canton of Vaud, Switzerland, to participate, along with household members and other close contacts. Anti-SARS-CoV-2 immunoglobulin G antibodies were measured using a Luminex immunoassay. We estimated factors associated with serological status using generalized estimating equations. RESULTS: Overall, 219 cases, 302 household members, and 69 other close contacts participated between May 4 and June 27, 2020. More than half of household members (57.2%; 95% CI, 49.7%-64.3%) had developed a serologic response to SARS-CoV-2, while 19.0% (95% CI, 10.0%-33.2%) of other close contacts were seropositive. After adjusting for individual and household characteristics, infection risk was higher in household members aged ≥65 years than in younger adults (adjusted odds ratio [aOR], 3.63; 95% CI, 1.05-12.60) and in those not strictly adhering to simple hygiene rules like hand washing (aOR, 1.80; 95% CI, 1.02-3.17). The risk was lower when more than 5 people outside home were met during semiconfinement, compared with none (aOR, 0.35; 95% CI, 0.16-0.74). Individual risk of household members to be seropositive was lower in large households (22% less per each additional person). CONCLUSIONS: During semiconfinement, household members of a COVID-19 case were at very high risk of getting infected, 3 times more than close contacts outside home. This highlights the need to provide clear messages on protective measures applicable at home. For elderly couples, who were especially at risk, providing external support for daily basic activities is essential.

Education of children and adolescents for the prevention of dog bite injuries.

BACKGROUND: Dog bites can have dramatic consequences for children and adolescents. Educating young people on how to interact with dogs could contribute to reducing dog bite injuries. OBJECTIVES: To determine the effectiveness of educational interventions that target children and adolescents in reducing dog bite injuries and their consequences. SEARCH STRATEGY: We searched the following databases: The Cochrane Injuries Group's Specialised Register, CENTRAL (The Cochrane Library Issue 3, 2008), CAB Abstracts, Zetoc, SIGLE, MEDLINE, EMBASE, ERIC, PsycInfo, SPECTR, CINAHL, National Research Register, LILACs, African Healthline, Science Citation Index, Social Science Citation Index, CurrentClinicalTrials.Gov, Centrewatch, Controlledtrials.com, Vetgate and the WHO database. We checked the bibliographies of relevant reviews and trials and also contacted experts in the field. The searches were carried out to 18 July 2008. SELECTION CRITERIA: We included randomised controlled trials and controlled before-after studies that evaluated the effectiveness of educational interventions, in populations under 20 years old, for preventing dog bites. DATA COLLECTION AND ANALYSIS: Two review authors selected eligible studies based on information from the title and abstract. Two review authors decided on the inclusion of eligible trials and extracted data from the trial reports. We contacted authors of eligible studies to obtain more information. MAIN RESULTS: Two studies met the inclusion criteria. No study looked at our main outcome: dog bite rates. The included studies were randomised controlled trials conducted in kindergarten and primary schools. Their methodology was of moderate quality. One study showed that the intervention group showed less 'inappropriate behaviour' when observed in the presence of a dog after a 30-minute educational intervention. Another study showed an increase in knowledge and in caution after an information programme. AUTHORS' CONCLUSIONS: There is no direct evidence that educational programmes can reduce dog bite rates in children and adolescents. Educating children who are less than 10 years old in school settings could improve their knowledge, attitude and behaviour towards dogs. Educating children and adolescents in settings other than schools should also be evaluated. There is a need for high quality studies that measure dog bite rates as an outcome. To date, evidence does not suggest that educating children and adolescents is effective as a unique public health strategy to reduce dog bite injuries and their consequences.

[Evolution of the immunization coverage of 13 to 14 year-old adolescents in Geneva between four years]. / Evolution à quatre ans de la couverture vaccinale chez les 13-14 ans à Genève.

This study aims to examine changes in immunization coverage for diphtheria, tetanus, whooping cough, polio, measles, mumps, rubella and hepatitis B during the academic calendars of 2003-2004 and 2007-2008 for students aged 13 to 14 years. Data were collected on an annual basis and systematically from the vaccination records 85% of adolescents enrolled in public institutions in Geneva. The immunization coverage increased for diphtheria, tetanus and polio by 2.3, 2.1 and 1.1 points respectively. Vaccination for pertussis (whooping cough) increased from 20.7% in 2003-2004 to 61% in 2007-2008. Vaccinations administered against measles, mumps and rubella increased by nearly 20 points. During this period, the coverage rate for hepatitis B increased by 10.3 points in 5 years. The recommended vaccination coverage rates are not being achieved for any of the vaccines currently being used in Switzerland, with the exception of those for diphtheria and polio.

Exposure to Amosite-Containing Ceiling Boards in a Public School in Switzerland: A Case Study.

The measurement of an airborne concentration in Amosite fibers above 5035 F/m3 in a school prompted a retrospective quantitative health risk assessment. Dose estimates were built using air measurements, laboratory experiments, previous exposure data, and interviews. A dose response model was adapted for amosite-only exposure and adjusted for the life expectancy and lung cancer incidence in the Swiss population. The average yearly concentrations found were 52-320 F/m3. The high concentration previously observed was not representative of the average exposure in the building. Overall, the risk estimates for the different populations of the school were low and in the range of 2 × 10-6 to 3 × 10-5 for mesothelioma and 4 × 10-7 to 8 × 10-6 for lung cancer. The results evidenced however that children have to be considered at higher risk when exposed to asbestos, and that the current reference method and target values are of limited use for amphibole-only exposures. This study confirmed that quantitative health risk assessments and participatory approaches are powerful tools to support public decisions and build constructive communication between exposed people, experts, and policy-makers.

Incidence of Chronic Spontaneous Urticaria Following Receipt of the COVID-19 Vaccine Booster in Switzerland.

This cohort study examines the association of the COVID-19 vaccine booster with chronic spontaneous urticaria in Swiss patients.

Social paediatrics.

Social paediatrics is an approach to child health that focuses on the child, in illness and in health, within the context of their society, environment, school, and family. The glossary clarifies the range of terms used to describe aspects of paediatric practice that overlap or are subsumed under social paediatrics and defines key social paediatric concepts. The glossary was compiled by a process of consultation and consensus building among the authors who are all members of the European Society for Social Paediatrics. Social paediatricians from outside Europe were included giving a more international perspective.

Evolution of overweight and obesity among elementary school children in Geneva.

QUESTIONS UNDER STUDY: In view of the alarming trend in childhood obesity (O) and overweight (OW) observed in certain countries, the aim of the study is to measure the prevalence of O and OW in successive cohorts of elementary school children in Geneva. METHODS: All 5-6-year-old children attending public schools in the Canton of Geneva were measured and weighed during a systematic health check at school from 2003 to 2008. BMI was calculated and plotted on standardised BMI for age tables, using Cole's and Kromeyer's references. RESULTS: Using Cole's references, the overall trend was a small non-significant decrease for OW 0.7 points (p = 0.33) and O 0.5 points (p = 0.23) over the 5-year period. For girls, OW decreased by 1.1 point (p = 0.47) and O decreased by 0.5 points (p = 0.61), whilst for boys OW decreased by 0.3 points (p = 0.54) and O decreased by 0.6 points (p = 0.23). A non-significant decrease or stabilisation in the prevalence of overweight and obesity was observed over the 5-year period in both boys and girls. CONCLUSION: These observations corroborate observations from Sweden and France, showing a levelling off in obesity and overweight in young children.

Safety education of pedestrians for injury prevention: a systematic review of randomised controlled trials.

OBJECTIVES: To quantify the effectiveness of safety education of pedestrians. DESIGN: Systematic review of randomised controlled trials of safety education programmes for pedestrians of all ages. MAIN OUTCOME MEASURES: Effect of safety education on pedestrians' injuries, behaviour, attitude, and knowledge and on pedestrian-motor vehicle collisions. Quality of trials: methods of randomisation; and numbers lost to follow up. RESULTS: We identified 15 randomised controlled trials of safety education programmes for pedestrians. Fourteen trials targeted children, and one targeted institutionalised adults. None assessed the effect of safety education on the occurrence of pedestrian injury, but six trials assessed its effect on behaviour. The effect of pedestrian education on behaviour varied considerably across studies and outcomes. CONCLUSIONS: Pedestrian safety education can change observed road crossing behaviour, but whether this reduces the risk of pedestrian injury in road traffic crashes is unknown. There is a lack of good evidence of effectiveness of safety education for adult pedestrians, specially elderly people. None of the trials was conducted in low or middle income countries.