What happens when you are not on social networks? A survey among middle-school teens in Switzerland.

AIM: The aim of the study was to describe the differences between users and non-users of social networks controlling for explanatory factors. METHODS: Data were drawn from a survey on media and Internet use carried out among 2893 10th graders in Switzerland. Participants were asked whether they were active in 10 different social networks and divided into two groups: Not active (answering no to the 10 networks; n = 176) and Active (answering positively to at least one; n = 2717). The groups were compared on sociodemographic, health, and screen-related variables. All variables significant in the bivariate analysis were included in a backward logistic regression. RESULTS: The backward logistic regression revealed that inactive participants were more likely to be males, younger, to live in an intact family, and to assess their screen time as below average, and less likely to practice extracurricular sport, to spend ≥4 h of screen time per day, to be around their smartphone at all times, to have parental rules about Internet content, or to discuss Internet use with parents. CONCLUSION: Most young adolescents use social networks. However, this activity does not seem to be associated with academic problems. Therefore, the use of social networks should not be demonized but considered part of their social life.

Is vulnerability associated with substance use? A study among youth in Switzerland.

Adolescence is a period of exploration and experimentation that includes risk behaviors such as substance use. Adolescents living in a situation of vulnerability could be more prone to using substances. In this cross-sectional study, we aimed to evaluate the association between the level of vulnerability and substance use considering explanatory factors. Data were obtained from the first wave of the GenerationFRee project (http://www.generationfree.ch), a longitudinal study based on data collected yearly between 2014 and 2019 on youth aged 15-24 years in high schools and professional schools. The sample included 5179 participants. We designated four risk behaviors: current tobacco smoking, alcohol misuse, cannabis use, and other illegal drug use. We defined vulnerability based on three criteria: the relationship with parents, school performance, and the family socioeconomic status (SES). According to this definition, participants were divided into three groups: no vulnerability, moderate vulnerability, and high vulnerability. Each substance was compared by vulnerability level and controlled with explanatory factors such as age, gender, perceived health, emotional well-being, academic track, nationality, living with parents, residence, family structure, money earned, and perceived personal financial situation. The results show that all substances except alcohol misuse are associated with vulnerability at the bivariate level. All the explanatory factors were also significant with the exception of academic track and amount of money earned per month. In the multinomial regression, for the moderate- and high-vulnerability groups, cannabis use was the only behavior that remained significant. In conclusion, this study shows the association between level of vulnerability and substance use, especially cannabis use. The results also demonstrate the complexity around vulnerability and how the interaction with social aspects influences vulnerability. Youths presenting familial, educational, or financial problems need to be especially screened for substance use by healthcare providers.

Transition from paediatric to adult care: what makes it easier for parents?

OBJECTIVE: To assess differences between parents of adolescents with chronic illness (CI) going through a self-reported easy or difficult transfer. METHODS: Seventy-two parents of CI youths who had already transferred to adult care were divided according to whether they considered that the transfer had been easy (n = 45) or difficult (n = 27). We performed a bivariate analysis comparing both groups and variables with a significance level < .1 were included in a logistic regression. Results are presented as adjusted odds ratio (aOR). RESULTS: Over one third of parents (27/72) reported a difficult transfer. At the multivariate level, higher socioeconomic status (aOR: 7.74), parents feeling ready for transfer (aOR: 6.54) and a good coordination between teams (aOR: 7.66) were associated with an easy transfer. CONCLUSIONS: An easy transfer for parents is associated with feeling ready and considering that the coordination between teams is good. Health providers should consider these requisites for a successful transfer.

The relation between internet use and overweight among adolescents: a longitudinal study in Switzerland.

OBJECTIVE: This longitudinal study aimed to investigate the characteristics and predictive risk factors of overweight among adolescents. The hypothesis was that baseline overweight predicted most overweight over time compared to other factors, especially excessive internet use. SUBJECTS: A sample of 621 youths were followed from age 14 (T0 Spring 2012) to age 16 (T1 Spring 2014) in Switzerland. Participants were divided into two groups according to their weight at the final assessment: overweight and non-overweight. At T0, participants reported demographic, health, substance use and internet use data. A logistic regression was performed to assess the explanatory variables of overweight at T1. Data are presented as adjusted odds ratios (aORs) with 95% confidence interval. RESULTS: The 2-year evolution showed a net BMI increase of 4.8%. Overweight adolescents were significantly more likely to be male, to live in an urban area, to be on a diet and to report using the internet more than 2 h per day on weekends at T0. However, with the addition of baseline overweight, only the excessive use of internet on weekends remained as an explanatory variable. An adolescent who was already overweight at T0 had a more than 20-fold risk (aOR 21.04) of being overweight 2 years later. Moreover, among adolescents becoming overweight between T0 and T1, internet use did not show any significant effect. CONCLUSION: The risk of being overweight is mostly influenced by weight status at baseline compared to excessive internet use. Thus, our results do not confirm the negative effect of internet on healthier activities. Internet use could at most reinforce an already existing risk of being overweight.

A qualitative study of adolescents with medically unexplained symptoms and their parents. Part 2: How is healthcare perceived?

Medically unexplained symptoms (MUS) are common among adolescents and an important cause of clinical visits. This study sought to understand the experiences with, and perceptions of, the healthcare of adolescents who have MUS and their parents. Using a qualitative approach, six focus groups and two individual interviews were conducted with a total of ten adolescents and sixteen parents. The participants were recruited in a university hospital in Switzerland. A thematic analysis was conducted in accordance with the Grounded Theory. Six main themes emerged: needing a label for the symptoms, seeking an etiology to explain the symptoms, negotiating the medical system, medication and treatments, interactions with doctors, and the inclusion of parents during consultations. Transcending these themes, however, was the need for good communication between the adolescents, their parents and the clinicians. When explaining the symptoms, clinicians should make sure to discuss the results, investigations and lack of organic origin.

[Transition to adult care: an overview]. / Transition aux soins adultes: une vue d'ensemble.

Nowadays nearly 90% of children with a chronic condition survive to adulthood and must make the transition from pediatric to adult care. This transition must include not only the continuity of care but also the preparation for adult life so that these young people can develop their full potential. Divided into three phases (preparation, transfer and engagement), the transition process should be adapted to adolescents and ensure access to quality care.

[Does talking about it make a difference? Opinions of chronically ill young adults after being transferred to adult care]. / Est-ce qu'en discuter fait la différence ? Opinions de jeunes adultes atteints de maladies chroniques après avoir été transférés vers des soins pour adultes.

INTRODUCTION: The goal of transition in healthcare for young people with chronic illnesses is to maximize their functioning and potential. The purpose of this pilot study was to assess whether young adults with chronic illnesses found that the transition to adult care was easier when the transition was discussed in advance with their pediatric specialist. METHODS: Two groups were created according to whether patients had discussed (n=70) or not (n=22) the transition with their pediatric specialist and compared regarding demographic and health-related variables. All the significant variables at the bivariate level were included in a backward stepwise logistic regression. RESULTS: Youth who had discussed the transition were significantly more likely to feel ready for the transfer (72.9% vs 45.5%) and accompanied (58.6% vs 27. %) during transfer, to have consulted their specialist for adults (60.0% vs 31.8%), and seen their doctor without the presence of their parents (70.0% vs 40.9%). At the multivariate level, only feeling accompanied during transfer (adjusted odds ratio (aOR): 3.56) and having consulted their specialist for adults (aOR: 4.14) remained significant. CONCLUSIONS: Preparing chronically ill youths for transfer to adult care appears to be beneficial for them. However, transfer is only a small part of the much broader transition that is preparation for adult life. A well-planned transition should allow these young people to reach their full potential.

Are adolescents with chronic conditions particularly at risk for bullying?

OBJECTIVE: To compare the prevalence and intensity of victimisation from bullying and the characteristics of the victim of bullying, comparing adolescents with and adolescents without chronic conditions (CC). DESIGN: School survey. SETTING: Postmandatory schools. PARTICIPANTS: A total of 7005 students (48% females) aged 16-20 years, distributed into adolescents with CC (728, 50% females) and controls (6277, 48% females). Chronic condition was defined as having a chronic disease and/or a physical disability. OUTCOME MEASURES: Prevalence of bullying-intensity of bullying-and sociodemographic, biopsychosocial, familial, school and violence context characteristics of the victims of bullying. RESULTS: The prevalence of bullying in our sample was 13.85%. Adolescents with CC were more likely to be victims of bullying (adjusted OR 1.53), and to be victims of two or three forms of bullying (adjusted OR 1.92). Victims of bullying with CC were more likely than non-victims to be depressed (RR 1.57), to have more physical symptoms (RR 1.61), to have a poorer relationship with their parents (RR 1.33), to have a poorer school climate (RR 1.60) and to have been victims of sexual abuse (RR 1.79) or other forms of violence (RR 1.80). Although these characteristics apply to victims in general, in most cases, they are less pronounced among victims without CC. CONCLUSIONS: CC seems to be a risk factor for victimisation from bullying. Therefore, as adolescents with CC are increasingly mainstreamed, schools should be encouraged to undertake preventive measures to avoid victimisation of such adolescents.

[Adolescent medicine male clinic]. / Médecine de l'adolescence. Consultation garçons.

The vast majority of Swiss adolescents see a physician at least once a year. However, a sizeable proportion of them indicate that they don't have the opportunity to address their own concerns and problems. While female adolescents have access to health care in the field of sexual and reproductive health through family planning clinics, this is not the case of adolescent males. The "clinic for boys only" is an open space for adolescent males where they can bring questions and health problems related to their body, their growth and their puberty, just as their difficulties and their fears regarding their normality, their sexuality, their feelings, sexual dysfunctions and questions related to violence within the couple. They can also get information/treatment in the area of sexually transmitted infections.

Gender-related psychological and behavioural correlates of pubertal timing in a national sample of Swiss adolescents.

The potential consequences of early and late puberty on the psychological and behavioural development of the adolescent are not well known. This paper presents focused analyses from the Swiss SMASH study, a self-administered questionnaire survey conducted among a representative sample of 7488 adolescents from 16 to 20 years old. Data from participants reporting early or late timing of puberty were compared with those reporting average timing of maturation. Early maturing girls reported a higher rate of dissatisfaction with body image (OR=1.32) and functional symptoms (OR=1.52) and reported engaging in sexual activity more often (OR=1.93). Early maturing boys reported engaging in exploratory behaviours (sexual intercourse, legal and illegal substance use) at a significantly higher rate (OR varying between 1.4 and 1.99). Both early and late maturing boys reported higher rates of dysfunctional eating patterns (OR=1.59 and 1.38, respectively), victimisation (OR=1.61 and 1.37, respectively) and depressive symptoms (OR=2.11 and 1.53, respectively). Clinicians should take into account the pubertal stage of their patients and provide them, as well as their parents, with appropriate counselling in the field of mental health and health behaviour.

Correlates of extracurricular sport participation among Swiss adolescents.

BACKGROUND: Based on a large national survey on the health of adolescents, this paper focuses on the socio-demographic and lifestyle correlates of sport practice among Swiss adolescents. The SMASH2002 database includes 7428 vocational apprentices and high school students between the ages of 16 and 20 who answered a self-administered anonymous questionnaire containing 565 items targeting perceived health, health attitudes and behaviour. Weekly episodes of extracurricular sport activity were measured by a four-category scale, and the sample was dichotomised between active (>or=two episodes of sport/week) and inactive (

The adolescent with a chronic condition. Part I: developmental issues.

The prevalence of chronic conditions among adolescents is difficult to assess due to the lack of quality data focusing specifically on this age group, as well as the diversity in methodology and definitions used. However, surveys carried out by self administered questionnaires among in-school adolescent populations indicate that around 10% of adolescents suffer from such a condition. The aim of this paper is to analyse the reciprocal effects of chronic conditions and adolescent development by reviewing the effect of chronic disease on growth and puberty and on psychosocial development, and the effect of developmental issues on the course and management of chronic disease.

The adolescent with a chronic condition. Part II: healthcare provision.

The treatment and management of chronic conditions during adolescence pose specific issues that need to be appropriately handled by health professionals. In this paper, questions related to disclosure of the diagnosis, the management of adherence to therapy, the need for an interdisciplinary network approach, lifestyles' anticipatory guidance and prevention, and the transition into an adult healthcare setting are reviewed. Special areas such as the issue of life threatening diseases and the ethical aspects of the treatment of chronic conditions are also discussed.

Factores de riesgo, pronóstico y screening en el carcinoma de ovario / Risk factors, prognostic and screening in ovarian cancer

Objetivo: Revisar la epidemiología, factores de riesgo y pronóstico del carcinoma de ovario, así como el estado actual de screening de esta enfermedad.Fuentes: Literatura médica hasta abril del año 2000 a través del Medline.Conclusiones: Hoy por hoy los dos factores pronósticos más importantes siguen siendo el estadio de la enfermedad en el momento del diagnóstico y la radicalidad de la cirugía. El análisis del verdadero valor de los múltiples factores de 'riesgo' permitiría la identificación de los que exigirían un control exhaustivo de las pacientes y quizá el tan deseado diagnóstico precoz o temprano de la enfermedad (AU)