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To offset the burden on the health system, hospitals set up telehealth interventions, such as online forward triage tools (OFTT). The website www.coronabambini.ch was developed to specifically address the needs of children and their families in Switzerland and to facilitate the decision to test, isolate, attend school, or access the health care system.Video interviews were held with key informants (Three main themes emerged: i) the usefulness of the OFTT to the users, ii) expectation management and importance of stakeholder involvement in OFTT development, and iii) OFTT limitations.Our study highlights opportunities, limitations, and lessons to consider when developing a pediatric COVID-19 OFTT. The involvement of stakeholders, parents, teachers, and health care providers in the design, set up, implementation, and evaluation of telehealth interventions is critical as this can help with expectation management and enhance OFTT utility.

The pandemic has made public health communication even more daunting because acceptance and implementation of official guidelines and recommendations hinge on this. The situation becomes even more precarious when children are involved. Our child-specific COVID-19 online forward triage tool (OFTT) revealed some of the public health communication challenges. We aimed to explore attitudes, experiences, and challenges faced by OFTT users and their families, in regard to public health recommendations.We selected key informants (Several themes emerged, namely; (1) definition and expectations of high-risk persons, (2) quarantine instructions and challenges, (3) blurred division of responsibility between authorities and parents, (4) a novel condition and the evolution of knowledge, (5) definition and implications of socioeconomic status, (6) new normal and societal divisions, and (7) the interconnectedness of these factors-systems thinking.As the virus is evolving and circumstances are changing rapidly, the communication of public health to the different interest groups becomes, both an art and science, even more so when using a new technological communication channel: an OFTT. A myriad of interconnected factors seems to influence attitudes toward public health recommendations, which calls for systems thinking in public health communication.

BACKGROUND To support the Swiss Federal Office of Public Health (FOPH) national pediatric COVID-19 testing strategy, we created an online public health decision tool for caregivers and healthcare workers. OBJECTIVE To describe the development and usage of www.coronabambini.ch as an example of a pediatric electronic public health application and to explore its potential in providing information on disease epidemiology and public health policy implementation. METHODS We developed and maintained a non-commercial online decision support tool, www.coronabambini.ch, based on the FOPH pediatric COVID-19 guidelines around testing and school/daycare attendance. We analyzed the online decision tool as well as a voluntary follow-up survey from October 2020 to September 2021 to explore its potential as a surveillance tool for public health policy and epidemiology. RESULTS 68’269 users accessed the tool and 52’726 filled out the complete online decision tool. 3% (1’399/52’726) filled out a voluntary follow-up survey via mail after 14 days. 92% (18’797/20’330) of users were parents. Certain dynamics of the pandemic and changes in testing strategies were reflected in the data captured by the tool: gastrointestinal symptoms were reported more frequently in the younger age groups (13% (3’308/26’180) in children 0-5 years, 9% (3’934/42’089) in children ≥6years, X 2=184, P= CONCLUSIONS www.coronabambini.ch played a central role during the COVID-19 pandemic in Switzerland through supporting testing decisions for children. Certain patterns in epidemiology and adherence to public health policy could be depicted showing the potential of digital decision support as public health tools.

Still little is known about the 24-hr pattern of transient lower esophageal sphincter relaxations (TLESRs), particularly in patients with GERD. The aim of our study was to evaluate the 24-hr esophageal and LES motor pattern and esophageal pH and to identify the relationship between TLESRs and gastroesophageal reflux in healthy subjects and in GERD patients. Ten healthy subjects and nine patients with esophagitis (grade I–II) underwent a 24-hr pH manometric recording by means of a portable electronic device. The recording aimed at identifying the temporal relationships between reflux episodes and LES motor events. The GERD patients showed a greater number of either reflux episodes or TLESRs during the 24 hr as compared to controls. While most refluxes occurred during TLESRs in both groups, a small percentage of TLESRs was followed by reflux episodes in healthy people, with only a slight increase in GERD patients. In conclusion, although representing an important motor pattern during gastroesophageal reflux both in healthy subjects and in patients with GERD, TLESR could probably be considered one of the pathophysiologic mechanisms of gastroesophageal reflux more than the primary cause of reflux episodes.