Clinical evolution of patients with lower extremity peripheral artery disease during the COVID-19 pandemic (the COVID-PAD study).

Background: The COVID-19 pandemic has led to significant disruptions in chronic disease care and forced people to stay at home. The effects of such issues on outpatients with lower extremity peripheral artery disease (PAD) remain unknown. Patients and methods: Single-centre, retrospective-prospective study conducted in a Swiss University Hospital. Patients with PAD were included between May 1 and July 31, 2020, with a follow-up visit at 12 months. Upon both visits, the Leriche-Fontaine PAD stage was recorded, and study participants underwent ankle-brachial index (ABI) calculation to assess limb perfusion. Functional capacities were assessed through the 6-minute walking and treadmill tests. Major adverse cardiovascular (MACE) and limb events (MALE) were recorded. Data collected during the pandemic were compared with the pre-pandemic period (January 1, 2019-April 30, 2020). Results: Overall, 259 patients were included. Mean age was 69 years and male sex was prevalent (69.1%). Odds of experiencing a degradation in PAD stage were lower during the pandemic than before (odds ratio [OR]: 0.43; 95% confidence interval [CI]: 0.21-0.87; p = 0.018). No significant difference was found between periods in terms of ABI trends. Both pain-free walking time at treadmill test (p = 0.003) and maximal pain intensity at 6-minute walking test (p = 0.001) significantly improved during the pandemic. Compared with the pre-pandemic period, during the pandemic patients were hospitalized less frequently (p = 0.028) and were less likely to undergo elective limb revascularization (p<0.001). No significant difference was found between periods in terms of MALE (p = 0.311), whereas non-fatal strokes were less frequently reported during the pandemic (p = 0.043). Conclusion: In a cohort of outpatients with PAD, we found no evidence of clinical deterioration during the pandemic compared with the pre-pandemic period, though rates of adverse events were nonnegligible in both periods. In case of future pandemics, patients with PAD should be encouraged to maintain an active lifestyle while being closely monitored to avoid clinical worsening.

Uses of psychotropic drugs by university students in Switzerland.

The use of psychotropic drugs among students is well known, but very few studies have been carried out outside North America, and data on Switzerland are particularly scarce. This study investigates the factors that determine the use of drugs and psychotropic substances among students at the University of Lausanne. Our hypotheses were that study pressure could lead to psychotropic drug use; that use could be either regular or experimental; and that users and non-users would have different opinions about the reasons for use and the consequences. Based on a convenience sample (n = 1199) collected by Master's students from other university students as part of a course given in 2019, our three hypotheses were confirmed. The use of psychotropic drugs is well associated with poorer academic performance. Regarding frequency of use, certain types of psychotropic drugs are used regularly (e.g. antidepressants), while others are used on occasionally (e.g. tranquilizers). Psychotropic substances such as cannabis and cocaine, on the other hand, are mainly used irregularly. Finally, the majority of psychotropic drug users report that they use them as part of their medical treatment, while the majority of non-users suggest that they use them mainly to reduce anxiety and stress in everyday life and at school. Our results show that Switzerland, like other countries, is affected by the phenomenon of psychotropic drug use by students, even outside medical supervision. Accordingly, better information on the negative effects of these substances should then be provided to all university students.

Parents, teens and screens during COVID-19 containment: An exploratory study.

OBJECTIVE: One of the main concerns of parents is the amount of screen time of their teenagers, and most of them try to set rules about it. The objective of this exploratory study was to compare whether parents' rules changed during confinement and whether these changes were successful. METHODS: We studied a group of parents (N = 47) of 13-year-olds in Switzerland surveyed before and during the COVID-19 pandemic. RESULTS: Most parents (83%) indicated that screen-time rules for their teens had changed during containment, mainly to be less strict. Although only a minority of parents were successful in defining screen-time spaces or schedules for their teenagers, almost three out of four were successful when they encouraged non-screen-based activities. CONCLUSIONS: This exploratory study reveals that, during containment, parents decided to be less strict with their teens' screen-time use even though it remained their main worry. However, it also suggests that when activities non-involving screens are proposed, teens are likely to participate. These results seem to indicate that reducing screen time is not a matter of imposing restrictions but, rather, of proposing alternatives. Finally, further research is warranted to assess whether these changes in screen-time use are exceptional or here to stay.

Quality principles of retrospective data collected through a life history calendar.

To assert the quality of retrospective data, most studies using tools such as life history calendars rely on comparisons with external sources. Our research aimed to integrate quality principles into a life history calendar and test their capacity to evaluate the data quality. The purpose was to avoid reliance on external data sources because of their possible unavailability. The first quality principle was the relationship between the dating accuracy of verifiable events and the data quality of the life domains of the calendar. The second was the certainty, as self-assessed by participants through color coding, that an event took place at the quarter indicated. We designed an experiment using a paper-and-pencil life history calendar that was completed by 104 university students. Our research highlighted the relevance to use the self-assessment of certainty to assert the data quality. However, we could not establish a relationship between the dating accuracy of verifiable events and the data quality of the life domains. In addition, we present a set of qualitative findings from 20 interviews conducted with study participants explaining the approaches used to complete a life calendar and the difficulties encountered. Supplementary Information: The online version contains supplementary material available at 10.1007/s11135-022-01563-x.

Relationship between the COVID-19 Pandemic and the Well-Being of Adolescents and Their Parents in Switzerland.

This study is based on two waves of data collected by the Swiss Household panel, the first one in 2019, before the beginning of the COVID-19 pandemic, and the second one in May-June 2020, just after the end of the partial lockdown that was decided by the Swiss government. We considered "couples" of adolescents (age 14-24, mean = 18.82, 51.96% female) and their parents living together (n = 431). Our main goal was to determine whether the evolution of the well-being among adolescents was similar to the evolution of the well-being among parents. Ten indicators of well-being were measured identically in both waves and for both adolescents and their parents. Results indicate that while almost all indicators of well-being decreased during partial lockdown for both adolescents and their parents, adolescents were more strongly impacted than their parents. Furthermore, the change observed in adolescents was virtually unaffected by the change observed in their parents, and vice versa. This research is a reminder that while different population groups may be affected differently by a sudden and extreme event, it is not only older people who will be most affected. Here, adolescents appear to have been more adversely affected than adults.

Associations between community participation and types of places visited among persons living with and without dementia: risks perception and socio-demographic aspects.

INTRODUCTION: Increasingly, literature has focused on community participation in places visited by persons living with and without dementia. Earlier research indicates that multiple factors, including socio-demographic aspects and risk perception may influence community participation. AIM AND METHODS: This cross-sectional, explorative study aims to inquire into how places visited, socio-demographic aspects and risks perception are associated with self-rated community participation for persons living with and without dementia (n = 70) in Switzerland. Data was collected through face-to-face interviews with questionnaires (ACT-OUT, MoCA, sociodemographic). First, we investigated whether the number of places visited was correlated with self-rated participation; then we added socio-demographic and risks perception factors with a bivariate analysis; and searched for a model using multinomial logistic regressions. RESULTS: For the group of participants living with dementia, risks of falling (p = .014) and of getting lost (p = .037) were significantly associated with self-rated participation. For the group of participants living without dementia, visiting places outside the home was significantly associated with self-rated participation, especially visiting places in domain D/places for recreational and physical activities (p = .005). DISCUSSION AND CONCLUSIONS: The results of exploring multiple factors and searching for a model highlights the complexity of community participation as a construct. Risks and visiting places for recreational and physical activities seem to play a role in self-rated participation. Mobile interviews might be better suited to gain in-depth understanding on community participation for persons living with dementia.

Sending One's Own Intimate Image: Sexting Among Middle-School Teens.

BACKGROUND: There is a gap in the literature regarding data on sexting among youth under the age of 16 whereas the problems related to this practice could affect them more because of their ongoing development. This study aims to determine the prevalence rate and characteristics of sending one's own sexually related image among middle-school teens. METHODS: Data were obtained from a web-based in-school survey conducted between October 2019 and February 2020. The sample comprised 3006 (mean age 13.7; 50.2% males) 10th-grade pupils in the canton of Vaud (Switzerland). Participants were asked "Have you ever sent a sexually related/sexy image of yourself?". Analysis of variance/chi-square tests and multinomial regression analyses were used to compare the groups. RESULTS: Overall, 93.0% reported never, 3.7% once and 3.3% several times. No gender differences were found. Sending was associated with older age, low academic performance, cyberbullying victimization and reception of unsolicited sexually related images. CONCLUSIONS: Education and health professionals should be aware that it is necessary to discuss the theme, perhaps with a more global approach including pressure, consent, exchange of nonsexual images, and so on from an early age. The context and reasons for sending remain to be explored, particularly to determine if the pressure is greater at this age.

Comparison of two approaches in multichannel sequence analysis using the Swiss Household Panel.

Sequence analysis is an established approach to study life courses. When several life domains are considered simultaneously, multichannel sequence analysis (MSA) and the extended alphabet (EA) approach are the most frequently used strategies. We compare these two methods using real data composed of four life domains (cohabitational status, children, professional status, health), and we focus on clustering since sequence analysis usually aims to identify typical patterns in sequences. As professional status trajectories, and potentially their relationship with other domains, proved to be different between men and women, the analyses were run separately by sex. We describe step by step the approach followed and the different criteria to judge the relevance of a typology. Neither of the two approaches is clearly superior, and the typologies obtained with both methods are often close. However, even if MSA is generally easier to use and applies to a broader range of situations, EA can provide original typologies in specific cases and we therefore propose guidelines for choosing between the two approaches depending on the context.

Improvement in 6-Minute Walking Distance after Supervised Exercise Training Is Related to Changes in Quality of Life in Patients with Lower Extremity Peripheral Artery Disease.

This study aimed to investigate the relationship between supervised exercise training (SET)-induced changes in treadmill performance and 6 min walking distance, and changes in general (physical and mental) self-perceived health-related quality of life (HRQoL) in symptomatic patients with lower extremity peripheral artery disease (PAD). This is an observational study investigating Fontaine stage II PAD patients participating in 3-month SET. Before and following SET, treadmill performance (pain-free (PFWD) and maximal (MWD)), and 6 min walking distance (6MWD) were assessed. Self-perceived HRQoL was assessed with the Medical Outcomes Study Short-Form 36 (SF-36). Ankle- and toe-brachial indexes were also measured. One-hundred forty-seven patients with PAD were included (64.9 ± 9.6 y, 70% men). After SET, PFWD (+102%, p ≤ 0.001), MWD (+87%, p ≤ 0.001), and 6MWD (+14%, p ≤ 0.001) significantly increased. All eight SF-36 subscale scores significantly improved following SET (p ≤ 0.04). SET significantly improved physical and mental component summaries of the SF-36 (p ≤ 0.001). Larger increases in 6MWD were associated with greater improvements in physical (ß = 0.19; p = 0.02) and mental (ß = 0.24; p = 0.005) component summaries of the SF-36. No significant relationship was observed between changes in treadmill performance and changes in physical and mental component summaries of the SF-36. These results show that improvements in 6MWD following SET are related to improvements in general self-perceived HRQoL in patients with symptomatic lower extremity PAD. On the contrary, changes in treadmill performance were not related to improvements in HRQoL. These results suggest that the 6 min walking test is an essential outcome measure to assess overall patient functional status following interventions in patients with PAD.

Effect of Mathematical Modeling and Fitting Procedures on the Assessment of Critical Speed and Its Relationship With Aerobic Fitness Parameters.

An accurate estimation of critical speed (CS) is important to accurately define the boundary between heavy and severe intensity domains when prescribing exercise. Hence, our aim was to compare CS estimates obtained by statistically appropriate fitting procedures, i.e., regression analyses that correctly consider the dependent variables of the underlying models. A second aim was to determine the correlations between estimated CS and aerobic fitness parameters, i.e., ventilatory threshold, respiratory compensation point, and maximal rate of oxygen uptake. Sixteen male runners performed a maximal incremental aerobic test and four exhaustive runs at 90, 100, 110, and 120% of the peak speed of the incremental test on a treadmill. Then, two mathematically equivalent formulations (time as function of running speed and distance as function of running speed) of three different mathematical models (two-parameter, three-parameter, and three-parameter exponential) were employed to estimate CS, the distance that can be run above CS (d'), and if applicable, the maximal instantaneous running speed (s max ). A significant effect of the mathematical model was observed when estimating CS, d', and s max (P < 0.001), but there was no effect of the fitting procedure (P > 0.77). The three-parameter model had the best fit quality (smallest Akaike information criterion) of the CS estimates but the highest 90% confidence intervals and combined standard error of estimates (%SEE). The 90% CI and %SEE were similar when comparing the two fitting procedures for a given model. High and very high correlations were obtained between CS and aerobic fitness parameters for the three different models (r ≥ 0.77) as well as reasonably small SEE (SEE ≤ 6.8%). However, our results showed no further support for selecting the best mathematical model to estimate critical speed. Nonetheless, we suggest coaches choosing a mathematical model beforehand to define intensity domains and maintaining it over the running seasons.

Visiting Out-of-Home Places When Living With Dementia: A Cross-Sectional Observational Study: Visiter des lieux hors du domicile lorsque l'on vit avec une démence: étude transversale observationnelle.

BACKGROUND.: Persons living with dementia face a reduction of their life space outside home and disengagement from participation, linked to places visited. PURPOSE.: This study explored stability and change in perceived participation in places visited outside home and its relationship with occupational gaps among older adults. METHOD.: Older adults living with (n = 35) or without (n = 35) dementia were interviewed using the Participation in ACTivities and Places OUTside Home (ACT-OUT) questionnaire and the Occupational Gaps Questionnaire (OGQ). Data analysis used descriptive and inferential statistics. FINDINGS.: The group of people living with dementia reported significantly fewer places (p < .001) visited than the comparison group and having abandoned more places visited (p < .001) than the comparison group. The number of occupational gaps was significantly different between groups (p < .001). IMPLICATIONS.: Participation outside home is not influenced in a uniform and straightforward way for persons living with dementia; the shrinking world effect appears differently in relation to types of places.

Consistency of data collected through online life history calendars.

The collection of longitudinal data is crucial in some domains such as life course studies. However, prospective studies are considerably costly, and thus retrospective data are an appealing alternative. A life history calendar is a tool specifically conceived to collect retrospective data. However, although it is designed to enhance the recall process of the respondents, the accuracy of the data collected through this approach remains unknown, particularly when data is collected online. In this study, we conducted a secondary analysis of data collected from n = 5,181 respondents through an online survey regarding their sexual health. Because we inquired about the occurrence of certain events twice during the survey, once using a life calendar and once through a traditional questionnaire, we were able to perform three types of consistency checks: (1) reporting of single events, (2) age when the events occurred and (3) correct timing between two events. The main results indicated that it is generally more difficult to remember the exact age of occurrence of an event than the event itself, that the report of related events is generally coherent, and that women are generally more accurate in their answers than men. Based on our results, it is therefore possible to identify a subset of persons whose answers are more consistent throughout the survey. This study also shows that data obtained through an online life history calendar can be of a quality similar to that obtained through a traditional online questionnaire.

Siblings of youths with chronic conditions: a school-based survey.

PURPOSE: The purpose of this study was to explore the differences between youths with a sibling affected by a chronic condition or a disability (SCCD) and their peers with healthy siblings. METHOD: Using data from the second wave of GenerationFRee study, we compared adolescents from each gender with healthy siblings to adolescents with SCDD on demographical, familial, internalizing and externalizing behavior variables. Subsequently we repeated the analysis excluding from each group adolescents who suffered from a chronic condition or disability themselves. RESULTS: At the bivariate and multivariate level, among those with SCDD, healthy females reported more somatic symptoms, healthy males more violent behaviors, and both genders lived more often in non-intact families. When considering both healthy and unhealthy adolescents, at bivariate analysis female adolescents with SCDD were more likely to have a poorer relationship to their mother, to be unhealthy, to smoke, to be at risk for disordered eating and to report somatic symptoms. At multivariate level, only the association with SCDD and smoking remained. Male adolescents with SCDD, at both bivariate and multivariate analyses, were more likely to be unhealthy and to live in larger and non-intact families. CONCLUSION: Healthy adolescents with an SCDD are more at risk of somatic symptoms and violent behaviors than their peers with healthy siblings. Health professionals in contact with adolescents should always consider them with a systemic approach. Parents should be informed about the potential effect on the siblings of a CDD child, but also reassured, as adolescents with SCDD are not different from their peers with healthy siblings.

Multimodal Supervised Exercise Significantly Improves Walking Performances Without Changing Hemodynamic Parameters in Patients With Symptomatic Lower Extremity Peripheral Artery Disease.

We evaluated the outcome of multimodal supervised exercise training (SET) on walking performances and different hemodynamic parameters (ankle/toe-brachial index [ABI/TBI], and transcutaneous oxygen pressure [TcPO2]) in patients with symptomatic lower extremity peripheral artery disease (PAD). Whether hemodynamic parameters predict walking performances at baseline and following SET was also investigated. Fontaine stage II PAD's patients following a 3-month SET were retrospectively included. Hemodynamic parameters and walking performances (pain-free [PFWD], maximal [MWD], and 6-minute [6MWD] walking distance) were measured in each patient. Eighty-five symptomatic PAD patients were included. Following SET, PFWD, MWD, and 6MWD significantly increased (+142%, +94%, +14%; respectively; P ≤ .001). Toe-brachial index significantly increased (MD: 0.04 ± 0.01; P = .02), whereas ABI and TcPO2 did not change significantly. At baseline, patients with higher TBI and TcPO2 performed significantly better (PFWD: ß = 0.25, P = .01 for TBI; PFWD: ß = 0.30, P = .005, and MWD: ß = 0.22, P = .04, for TcPO2). No significant relationship was observed at baseline between ABI and walking performances. Baseline values of hemodynamic parameters did not significantly correlate with changes in walking performances. Multimodal SET significantly improves walking performances. Following SET, no significant changes in ABI and TcPO2 were observed. Toe-brachial index values significantly improved after SET. However, this increase was very modest and its clinical relevance remains questionable. Although baseline TBI and supine TcPO2 values predict baseline walking performances, no association was found between baseline hemodynamic parameters and changes in walking performances following SET.

Meaning in life and quality of life: palliative care patients versus the general population.

BACKGROUND AND OBJECTIVES: Meaning in life (MIL) represent a key topic in palliative care. The aims of this study were to explore (1) the differences in perceived MIL and in the meaning-relevant life areas between a representative sample of the Swiss population and palliative care patients, and (2) to what extent MIL can be considered as a significant predictor of quality of life (QOL). METHODS: A cross-sectional study was conducted separately for the patients (face-to-face interviews) and the general population (telephone survey). MIL was measured with the Schedule for Meaning in Life Evaluation (SMILE) and QOL with a single-item visual analogue scale (0-10). Sociodemographic variables were controlled for in the analyses. RESULTS: 206 patients and 1015 participants from the Swiss population completed the protocol. Results indicated high MIL scores in both populations even if the difference was significant (patients 81.9 vs general population 87, p<0.001). Patients were more likely to cite 'family' (OR=1.78), 'social relations' (OR=1.9), 'spirituality and religion' (OR=3.93), 'social commitment' (OR=1.94) and 'growth' (OR=2.07), and less likely to cite 'finances' (OR=0.15) and 'health' (OR=0.21) as MIL-relevant areas. The SMILE scores and MIL areas explained 21.8% of the QOL variance for the patients and 15.1% for the representative sample. CONCLUSIONS: Our data emphasise the importance of MIL as a contributor to QOL in both populations. It highlights the importance of the life areas contributing to MIL, especially social interactions for both populations, and spirituality and areas related to growth in palliative care patients.

Characteristics defining perceived popularity among same-sex and opposite-sex peers.

OBJECTIVES: The objective of this study was to compare the characteristics of adolescents and young adults (AYA) who perceive themselves as popular with AYAs who perceive themselves as unpopular vis-á-vis peers from same-sex, opposite-sex, or both. METHODS: Among a representative sample of in-school 15-24 year-olds students (n=5,179) who completed a self-administrated questionnaire, we measured self-perception of popularity, socio-demographic data, ease to make same/opposite-sex friends, emotional well-being, school variables, substance use, sensation seeking, self-perception of pubertal timing, and aggressive/violent behavior. RESULTS: Overall, our findings put forth that popularity was associated to easiness of making same/opposite-sex friends, emotional well-being, socio-economical background, sensation seeking behaviors, and alcohol misuse. Differences appeared between males or females. CONCLUSION: Findings indicate that popularity remains a very important issue among this age group and should be a red flag in clinical assessment. Future research should explore whether feeling of unpopularity can be used as a marker of adolescent well-being and hence help identify those youths who might need help.

Substance use as a function of activity level among young Swiss men.

Adolescence is a period of life during which many people experiment with different kinds of legal and illegal substances. However, young people practising physical activities at a high level should avoid taking such substances. On the basis of a large sample of Swiss male recruits (C-SURF baseline data), we explore the consumption of substances among three subgroups of young adults, defined according to level of physical activity: high, medium, and low. Our results show that respondents classified into the high level of physical activity group went through the same experimentation processes with substances as respondents in the other groups, but that they reduced their overall consumption level, as indicated by measures regarding the last 12 months only. However, substantial differences are observed when we look at each substance separately. In particular, smokeless tobacco products are consumed more in the high group, and alcohol consumption is high in all groups. Physical activity, even at a high level, is not a protective factor against substance consumption. Therefore, physicians should not forget to investigate substance use among people with high levels of physical activity, especially since their consumption can (1) differ from the general population; and (2) have important consequences on their physical performance.

Does the Primary Resource of Sex Education Matter? A Swiss National Study.

Sex education (SE) remains a subject of debate, including controversies on resources. The purpose of this paper was to determine the main SE resource during adolescence and its associations with personal characteristics and sexual behaviors of youths. Data were obtained from a self-administrated Swiss national survey on sexuality among young adults (mean age 26.3). Participants (N = 4978) were divided into six groups according to their main SE resource during their adolescence: Friends (1939; 38.9%), Parents (1361; 27.3%), School (n = 949; 19.1%), The Internet (399; 8.0%), Nobody (172; 3.5%) and Other (157; 3.2%). Groups were compared on sociodemographic, first sexual experiences, pregnancy, risky sexual behaviors, and undesired sexual experiences data. Males and non-heterosexual participants were overrepresented in the Internet group while, females more often reported their parents as their main SE resource. Participants in the School group reported the lowest rates of sexually transmitted infections and Friends the highest. Compared to the School group, those in the Friends, Internet, Nobody, and Other groups were more likely to report undesired sexual experiences. Few differences appeared between parents and school. Even though some resources such as friends or the Internet presented negative outcomes when they were assessed individually, we cannot deny the important place that they occupy in the lives of some youths.

Illustrating Instrumental Variable Regressions Using the Career Adaptability - Job Satisfaction Relationship.

This article illustrates instrumental variable (IV) estimation by examining an unexpected finding of the research on career adaptability and job satisfaction. Theoretical and empirical arguments suggest that in the general population, people's abilities to adapt their careers are beneficial to their job satisfaction. However, a recent meta-analysis unexpectedly found no effect when personality traits are controlled for. We argue that a reverse effect of job satisfaction on career adaptability, originating from affective tendencies tied to personality, might explain this null effect. Our argument implies that the estimates obtained with traditional ordinary least squares (OLS) regressions are biased by endogeneity, a correlation between an explanatory variable and the error term in a regression model. When experimental manipulations are impossible, IV estimations, such as two-stage least squares (2SLS) regressions, are one possible solution to the endogeneity problem. Analyzing three waves of data from a sample of 836 adults, the concurrent and time-lagged effect of job satisfaction on career adaptability was revealed to be more consistent than the reverse. Our results provide an explanation, rooted in affective dispositions, as to why recent meta-analytical estimates unexpectedly found that career adaptability does not predict job satisfaction at the interindividual level. We also discuss IV estimation in terms of its limits, weight the interpretation of its estimates against the temporality criterion for causal inference, and consider its possible extension to analyses of change.

The Heterogeneity of Disability Trajectories in Later Life: Dynamics of Activities of Daily Living Performance Among Nursing Home Residents.

Objective: This study investigated the variability in activities of daily living (ADL) trajectories among 6,155 nursing home residents using unique and rich observational data. Method: The impairment in ADL performance was considered as a dynamic process in a multi-state framework. Using an innovative mixture model, such states were not defined a priori but inferred from the data. Results: The process of change in functional health differed among residents. We identified four latent regimes: stability or slight deterioration, relevant change, variability, and recovery. Impaired body functions and poor physical performance were main risk factors associated with degradation in functional health. Discussion: The evolution of disability in later life is not completely gradual or homogeneous. Steep deterioration in functional health can be followed by periods of stability or even recovery. The current condition can be used to successfully predict the evolution of ADL allowing to set and target different care priorities and practices.