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Background and Purpose: Complementary medicine has been undergoing a process of regulation and professionalization in many countries where the biomedical model is dominant. However, little is known about therapists' opinions regarding these changes. The aim of the study was thus to explore therapists' views on the regulation of their practice and on collaboration between CM and biomedicine., Materials and Methods: We conducted this qualitative descriptive study by means of focus groups consisting of non-physician acupuncturists, naturopaths, and osteopaths in two cantons of Switzerland. A qualitative content analysis was carried out on the verbatim transcripts of the focus groups., Results: Four main themes were identified: contributions to the healthcare system, collaboration with biomedicine, pathways to recognition, and integrative medicine. Therapists defined their role in the healthcare system in comparison to biomedicine, allowing them to highlight how they could complement it. They also noted an improved relationship with biomedicine, while highlighting the remaining barriers to optimal collaboration. Different ways were mentioned to achieve a higher level of recognition: better educating and informing physicians about CM, structured training of therapists that is federally recognized, state regulation, and development of scientific research on CM. Finally, although unfamiliar with the concept, therapists defined integrative medicine as horizontal collaboration between CM and biomedicine., Conclusion: Despite the differences between the three CM practiced by the therapists, they produced fairly similar discourse regarding aspirations and concerns in the face of integration. This discourse should be considered in order to facilitate the integration of CM in the Swiss healthcare system., Competing Interests: Competing interests The authors declare that they have no competing interests., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Aim: Young people with childhood-onset motor disabilities face unique challenges in understanding and managing their condition. This study explored how they learnt about their condition., Method: A descriptive qualitative study was conducted in 2023-2024 at a Swiss paediatric neurorehabilitation unit. Ten participants aged 15-24 years were recruited through purposive sampling, representing diverse conditions and socio-educational backgrounds. Inductive thematic analysis was conducted on interview transcripts., Results: Four themes emerged. First, learning paths revealed that participants gradually acquired knowledge about their condition. Early explanations often involved parents and visual aids, with moments of awareness and evolving information needs shaping their learning over time. Second, building blocks of understanding showed that knowledge was constructed through interactions with physicians, therapists, parents, peers and the Internet. Third, interacting with healthcare professionals highlighted the importance of trust and continuity in relationships with healthcare professionals to support learning. Last, improving the learning process suggested strategies such as dedicated consultations for recapping information during adolescence and increasing disability awareness in schools., Conclusion: Young people with motor disabilities require information and support tailored to their individual learning needs. Adapting these resources could enhance their understanding of their condition, supporting the development of their autonomy and self-advocacy within healthcare., (© 2025 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.)

Introduction: Anti-retroviral therapy (ART) simplification strategies are needed for treatment-experienced people with HIV (PWH) and multidrug-resistant viruses. These individuals are commonly treated with boosted ART regimens and are thereby at risk for harmful drug-drug interactions (DDI). In this trial, we aim to assess the efficacy of the combination doravirine, dolutegravir and lamivudine (DOR/DTG/3TC) among people with a history of virological failure who receive boosted ART., Methods and Analysis: B-Free is a multistage, randomised, multicentre, open-label, non-inferiority trial, embedded within the Swiss HIV Cohort Study and conducted in collaboration with cohorts of PWH in the Netherlands and France. Cohort participants with a history of ART change due to virologic failure and who maintain HIV virologic suppression with an ART regimen consisting of a pharmacological booster and at least two drugs from classes other than nucleoside reverse transcriptase inhibitors are included. Patients with major drug resistance mutations against DTG or DOR and individuals with chronic hepatitis B virus infection are not eligible for the study. Individuals are randomised 1:1 to either receiving co-formulated DTG/3TC and DOR once daily or continuing their boosted ART regimen. The primary outcome is the proportion of individuals lacking virologic control (HIV-RNA ≥50 cp/mL) at 48 weeks, according to the Food and Drug Administration snapshot algorithm. Changes in DDI burden (assessed using a DDI score), treatment satisfaction (assessed using the HIV Treatment Satisfaction Questionnaire), quality of life and mental health represent key secondary outcomes. Additional secondary outcomes include the proportion of individuals developing new resistance-associated mutations and changes in quality of life and mental health. In a qualitative substudy, we will conduct semistructured interviews with a subset of participants to assess their expectations and experiences towards HIV treatment and clinical research in general. Enrolling 210 individuals will provide 80% power to demonstrate non-inferiority, defined as less than 8% absolute increase in loss of viral suppression in individuals randomised to DOR/DTG/3TC (one-sided type I error rate of 0.025)., Ethics and Dissemination: The study was approved by the competent ethics committees (reference number BASEC 2023-01060) and the regulatory authority Swissmedic (reference number 701655) in Switzerland before the enrolment of the first participant. Approval by the European Medicines Agency and local ethical committees in the Netherlands and France will be obtained prior to including participants in these countries. Participant's written informed consent is obtained by the investigators before enrolment. The results of all major B-Free study outcomes will be submitted to peer-reviewed journals that enable Open Access publication., Trial Registration Number: Swiss National Clinical Trials Portal (SNCTP000005686, registered on 06 November 2023) and Clinicaltrials.gov (NCT06037564, registered on 07 September 2023)., Competing Interests: Competing interests: BS reports financial support for travel grants from Gilead Sciences and ViiV Healthcare and for advisory boards from Gilead Sciences and MSD, paid to his institution. GW has received research grants from Gilead Sciences and Roche Diagnostics, as well as fees for advisory boards and lectures from ViiV Healthcare, MSD, Roche Diagnostics and Gilead Sciences (all paid to his institution). MC’s institution received research grants and expert opinion fees from Gilead Sciences, MSD and ViiV Healthcare. DLB received money paid to himself outside of the submitted work for advisory boards and lectures from the companies Gilead Sciences, MSD, Pfizer and ViiV Healthcare and money for a research grant from the company ViiV Healthcare. The institution of EB received study grants from Merck and Gilead Sciences; it also received travel grants and fees for EB participation to advisory boards from Gilead Sciences, Merck, ViiV Healthcare, Pfizer AG, Moderna, AstraZeneca, AbbVie and Eli Lilly. DH received fees for consultancies from AstraZeneca, Bavarian Nordic, Gilead Sciences, UCB and ViiV Healthcare, a travel grant from Gilead Sciences, and institutional funding from AstraZeneca, Gilead Sciences, GSK, A. Menarini, MSD and ViiV Healthcare. MvdV has received research grants and fees for participation in advisory boards from Gilead Sciences, MSD and ViiV Healthcare, all paid to his institution. MS reports financial support for travel grants from Gilead Sciences and for advisory boards from Gilead Sciences, MSD and ViiV Healthcare, paid to his institution. AR received research grants from Gilead Sciences, paid to his institution; travel expenses from Gilead Sciences and Pfizer, paid to his institution; and honoraria for advisory board consultations from MSD and Moderna, paid to his institution. PS’s institution has received travel grants, congress and advisory fees from ViiV Healthcare and Gilead Sciences unrelated to this work. All other authors report no conflicts of interest., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY. Published by BMJ.)

Chronic non-cancer pain is a highly prevalent health issue with personal and societal consequences. Patients suffering from chronic non-cancer pain are mainly cared for by primary care physicians, but research shows that the latter perceive treating chronic pain as difficult. This qualitative descriptive study aimed to explore how primary care physicians in Switzerland manage patients with chronic non-cancer pain and what factors influence patient management. Data were collected through semi-structured interviews amongst primary care physicians in the German speaking part of Switzerland. A thematic analysis of the interviews allowed to identify four main themes: Investigation of chronic pain; patient-provider relationship; patient characteristics, and medical recommendations. These themes were closely interconnected and influenced each other. Physicians not only enquired about the origin of pain but also about the patients' beliefs and expectations towards it. They stressed the role of communication in fostering a good patient-physician relationship and to help patients cope with their pain. In addition to purely medical considerations, the psychological, social and economic situation of their patients and their possible impacts on the management of chronic non-cancer pain played a crucial role when recommending a treatment. This study highlighted the complexity of chronic pain management, which entails that primary care physicians need to figure out a unique strategy for each patient. By integrating patients' values and beliefs, as well as socioeconomic aspects, primary care physicians are in a position to take the lead in chronic non-cancer pain management. However, considering the burden of this disease, more continuous medical education on chronic pain is needed for primary care physicians, especially to better take into account the social determinants of pain., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Rufener et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Purpose: Emergency contraception (EC) access was liberalised in 2002 in Switzerland by making it accessible in pharmacies without medical prescription. However, its dispensation still requires a confidential interview with a pharmacist. This qualitative study aims to explore experiences of adolescent and young adult (AYA) females who have gone to a pharmacy in order to obtain EC., Materials and Methods: Thirty interviews were conducted from April to August 2019 with females aged between 15 and 25 years old at the interview. Inclusion criteria was to have requested at least one EC in a pharmacy between 2014 and 2019. A thematic content analysis was performed to extract themes brought up by the participants., Results: Some participants reported that the most difficult moment in the process was the request at the counter. The majority of participants were escorted in a private back room but opinions were divided regarding this isolation. Experiences were sometimes negative due to lack of information and knowledge regarding the dispensation process. The interview also has also a preventive aim, but the information given during it often focussed solely on the risk of vomiting. Several participants reported having perceived or received moral judgements from pharmacists., Conclusions: Pharmacists are key resources and EC dispensation an opportunity for sexual health. This exploratory study presents several elements requiring the adaptation of practices in order to prevent them from becoming barriers for AYA to access EC. Concerns are regularly expressed by young women about privacy, embarrassment and judgement in the pharmacy context regarding contraception.

Three-dimensional (3D) bioprinting is a cutting-edge technology that has come to light recently and shows a promising potential whose progress will change the face of medicine. This article reviews the most commonly used techniques and biomaterials for 3D bioprinting. We will also look at the advantages and limitations of various techniques and biomaterials and get a comparative idea about them. In addition, we will also look at the recent applications of these techniques in different industries. This article aims to get a basic idea of the techniques and biomaterials used in 3D bioprinting, their advantages and limitations, and their recent applications in various fields., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2022, Sachdev et al.)

Background: Adolescence and early adulthood are periods of experimentation during which health detrimental behaviours might be acquired., Objective: This study's purpose is to evaluate physicians' likelihood of addressing health risk behaviours with youths depending on the youths' wishes, risk behaviours and personal characteristics., Methods: Data were drawn from the third wave (2017-18) of the GenerationFRee longitudinal study carried out on a sample of 1970 youths aged 17-26 in Switzerland. Analysed risk behaviours were: eating disorders, substance use, emotional wellbeing, problematic Internet use and gambling. Bivariate and multivariate analyses were performed, results are presented as adjusted odds ratios (aORs)., Results: Physicians discussed most risk behaviours with less than half of the youths. The odds of addressing risk behaviours were seldom raised when the risk behaviour was present, or when the youth wished to discuss it. Emotional wellbeing was addressed with half as many males as females (aOR 0.47), and drugs were found to be addressed more frequently with youths reporting a low family socio-economic status (aOR 6.18). When a risk behaviour is addressed it is mostly alongside an extended screening., Conclusions: This study confirmed the low levels of health risk behaviours screening, regardless of the youths' wish to discuss the topic with their physician. Despite the low levels, physicians do tend to screen systematically, especially when discussing substance use. There is a need to improve physicians training in risk behaviour screening and counselling in order to increase this practice., (© The Author(s) 2020. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

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., (© 2020 Walter de Gruyter GmbH, Berlin/Boston.)

What Is Known on the Subject: To date, research on emotional wellbeing among youths has been mostly based on cross-sectional studies, and little is known about its evolution over time., What Does This Article Add: Our study adds a longitudinal approach to emotional wellbeing and defines different groups of youths according to their evolution over a two-year period. Stress and perceived health status seem to be the most important factors related to emotional wellbeing. Our research shows the importance of health care professionals exploring psychological health, especially when a youth has atypical somatic complaints. This could allow the early detection of psychological problems and the provision of proper timely treatment., Aim of the Study: To assess how emotional wellbeing evolves over a two-year period among youths in Switzerland, and to assess their characteristics., Methods: Data were obtained from the first and third waves of the GenerationFRee study (n = 1311, aged 15–24 at baseline). The sample was divided into four groups according to the evolution of their emotional wellbeing (WB): good at both waves (GoodWB: 67.9%), poor at T1 and good at T3 (BetterWB: 8.4%), good at T1 and poor at T3 (WorseWB: 13.2%), or poor at both waves (PoorWB: 10.4%). Significant variables at the bivariate level were included in a multinomial regression analysis using GoodWB as the reference category. Results are given as relative risk ratios (RRRs)., Results: The BetterWB group reported more stress at T1 (RRR 1.34), as did the WorseWB group at T3 (1.43). Those in the WorseWB group were more likely to report poorer health status at T3 (6.51). Finally, the PoorWB group reported more stress at T1 (1.33) and T3 (1.44), and poorer health status at T1 (9.39) and T3 (5.75). Other variables not significant in all groups were perceived onset of puberty, having a chronic condition, area of residence and relationships with parents., Conclusion: Using a longitudinal approach, stress and perceived health status seem to be the main factors that change with emotional wellbeing among youths. Inquiring about stress could be a good proxy for emotional wellbeing, especially among males, who tend to underestimate their emotional worries.

Background: One of the possible negative consequences of sexting is the non-consensual sharing of received-intimate content. This study aimed to determine the characteristics and motives of youths who shared received-intimate images without consent. Methods: Data were obtained from a self-administrated Swiss survey on sexual behaviours among young adults (aged 24-26 years). Out of the 7142 participants, 5175 responded to the question 'Have you ever shared (forwarding or showing) a sexy photograph/video of someone else (known or unknown) without consent'?; 85% had never shared (Never), 6% had shared once (Once) and 9% had shared several times (Several). Data are presented as relative risk ratios with 95% confidence intervals. Results: Participants who had shared received-intimate content without consent had higher odds of being male [2.73 (2.14-3.47)], foreign-born [1.45 (1.04-2.03)], reporting a non-heterosexual orientation [1.46 (1.10-1.93)], having sent one's own intimate image [1.76 (1.32-2.34)] and receiving a shared-intimate image of someone unknown [4.56 (3.28-6.36)] or known [2.76 (1.52-5.01)] compared with participants who had never shared. The main reported motivations were for fun (62%), showing off (30%) and failure to realise what they were doing (9%). Conclusions: Given the reported motivations, it appears crucial to remind youths of the seriousness of non-consensual sharing. Although females may also be perpetrators, the behaviour was more prevalent among males. Prevention and education need to consider a broad range of young people in their scenarios. Even if a particular focus on understanding and preventing males' perpetration must be considered, overall perpetration, including female's, must be discussed.

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., (© 2020 Walter de Gruyter GmbH, Berlin/Boston.)

Background The aims of this research were to determine personal differences depending on the reason for regretting or not first vaginal intercourse and its effects on sexual behaviour later on among young adults, and to assess the association between reasons for engaging in first vaginal intercourse and regretting it., Methods: Data were drawn from the 2017 Swiss national survey on youth sexual behaviours among young adults (mean age 26 years) living in Switzerland. Out of the 7142 participants, 4793 (51% females) answered the question 'Looking back now to the first time you had vaginal intercourse, do you think that…' with five possible answers: (1) I should not have done it (6.7%); (2) I should have waited longer (7.7%); (3) I should have done it earlier (7.4%); (4) It was about the right time (67.9%); and (5) I don't know (10.3%). The five groups were compared on sociodemographic and sex behaviour-related variables, analysed separately by gender., Results: One-third of participants regretted their first experience. In the multivariate analysis, compared with the 'right time' group, all other groups were more likely to find their first experience unpleasant and to have done it with a casual partner. Those in the 'I should not have done it' and 'I should have waited longer' groups were also more likely to have done it because of external pressure, especially among females., Conclusions: The study results underline the significance to choose the right time and the right partner for first vaginal intercourse and the importance of including partner respect and avoiding external pressure as part of sexual education.

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.

Sexting was originally made public by dramatic consequences involving youths with contents that were disseminated and then used as a base for harassment. Despite a growing public and research interest, there is no consensus regarding its definition and measurements. As part of a larger qualitative study on sexting, we aimed to gather and compare opinions and perceptions of 32 youths (16-21 years) and 29 adults (11 parents and 18 teachers) on how sexting can be defined. Different constituent elements were discussed in terms of knowledge, mediums (text-only, photographs, videos, etc.), characteristics, actions (receiving, sending, disseminating, etc.) and contexts. The knowledge and the use of the term sexting was approximate for several participants. Youths used more suggestive elements in their definition and the vast majority of them defined sexting as an activity that could be positive and respectful between two consenting persons. It is necessary to develop a precise and consensual definition of sexting by separating different dimensions and by using a specific vocabulary according to youth perceptions as their main definition of sexting seems to be different from the one of most adults. Prevention messages should aim to reduce the risks by targeting the problems linked to sexting rather than prohibiting sexting per se. This exploratory study could pave the way for a clearer definition and measurement of sexting.

Purpose: To compare risk behaviors between youths living with a chronic condition (CC) and their healthy peers, controlling for condition severity., Methods: Data were drawn from the baseline wave of the GenerationFRee study (students aged 15-24 years in postmandatory education) during the 2014-2015 school year. The sample (N = 5,179) was divided into youths with CC without limitations (N = 536; 10.4%), youths with limitations (N = 114; 2.2%), and a control group (CG; N = 4,529; 87.4%). Groups were compared on internalizing (perceived health status, vision of their future, emotional wellbeing) and externalizing behaviors (substance use, gambling, excessive internet use, disordered eating, violent and antisocial acts) controlling for potential confounders. Statistical analyses were carried out through structural equation modeling. Results are given as unstandardized coefficients., Results: Overall, CC youths showed an association with internalizing behaviors (coefficient: .78) but not with externalizing behaviors. In fact, the connection with externalizing behaviors was indirect via the internalizing behaviors (.32). CC Youths reporting psychological issues were more likely to adopt every externalizing behavior. Analyzing separately youths with CC limiting daily life activities and those without limitations, the results did not change substantially. However, the association with internalizing behaviors was much higher for those reporting limitations (2.18 vs. .42)., Conclusions: Our results show that the link between suffering from a CC and adopting risk behaviors is indirect through internalizing behaviors. Health professionals should address emotional wellbeing and perception of the future rather than focus exclusively on the effects of risk behaviors on specific diseases., (Copyright © 2018 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.)

Disordered eating (DE) is known to predominate among girls, and historically studies have focused primarily on them. This cross-sectional study aimed to investigate the characteristics of adolescent and young adult males at risk of DE. Participants (N = 2269; 15-24 years) in a study assessing their lifestyle were divided into two groups based on the SCOFF five-question screening tool: a SCOFF[+] group for participants at risk of disordered eating, and a SCOFF[-] group for everyone else. SCOFF[+] participants were more likely to be overweight and obese; have a lower socio-economic status and non-Swiss parents; experience weight issues; and report a chronic condition, poorer emotional well-being and a less positive attitude towards life. With 10% of males at risk of DE, clinicians should be aware of their specific characteristics, which should be considered red flags. DE is no longer a female-specific issue.

Background: Since 2001, a recommendation of no more than 2 h per day of screen time for children 2 years of age or older was adopted in many countries. However, this recommendation was rarely examined empirically. The goal of the present study was to question this recommendation in today's connected world., Methods: We used data from the ado@internet.ch survey (spring 2012), a representative sample of 8th graders in the Canton of Vaud, Switzerland (n = 2942, 50.6% female). Internet use, health outcomes, substance use, well-being and socio-demographic characteristics were considered. Bi-variate statistical analyses were performed., Results: All outcomes were significantly associated with the time spent on internet, more time being associated with a higher prevalence of adverse consequences. Youth spending on average one more hour on Internet per day than the reference category (1.5-2.5 h) did not differ in terms of adverse health outcomes. Differences began to appear on sleeping problems, tobacco use, alcohol misuse, cannabis use and sport inactivity with youth spending between 3.5 h and 4.5 h per day on internet., Conclusions: This study demonstrates the absence of justification for setting a limit to only 2 h of screen time per day. Significant effects on health seem to appear only beyond 4 h per day and there may be benefits for those who spend less than an hour and a half on internet.

Objectives: To design a transitional care checklist to be used by and facilitate the work of health professionals in providing transitional care for children with a chronic rheumatologic disease and their families., Methods: A Delphi-like study among an international expert panel was carried out in four steps: (1) a working group of 6 specialists established a draft; (2) a web-survey among a panel of international experts evaluated it; (3) a 2-day consensus conference with an expert panel discussed items not reaching agreement; (4) a web-survey among the panel of international experts with the list of reformulated items., Results: The first draft of the checklist included 38 items in 3 phases of transition and 5 age groups. Thirty-three international experts evaluated the checklist reaching≥80% agreement for 26 items and ≤80% for 12. The consensus conference of 12 experts discussed and redefined the 12 items. Twenty-five international experts filled out the web-survey and all items reached a minimum of 80% agreement except one. The final checklist was reached., Conclusions: This Delphi-like study defined what themes should be included and at what age they need to be addressed with patients with a chronic rheumatology disease and their families during transition. This checklist reached a strong international and interdisciplinary consensus while examining transition in a broad way. It should now be spread widely to health professionals to be used by all those who care for adolescents aged≥12 years at times of transition. It could be transposed to most chronic conditions. Recommendations for further research are given., (Copyright © 2017 Société française de rhumatologie. Published by Elsevier Masson SAS. All rights reserved.)

The aim of this pilot study was to evaluate Children's at Home (C@H), a dedicated social media website for parents of adolescents with neurofibromatosis type 1 (NF1). The interventional study included two phases: (1) creating video intervention/prevention assessment (VIA) visual narratives about having an adolescent with NF1 and (2) interacting on C@H, a secure, medically moderated social media website. C@H was evaluated qualitatively at three time points. At enrollment (T0, N = 17), participants reported needing C@H to break their isolation, connect with other families, and receive accurate information, advice, and support from others facing similar challenges. At T1, after creating VIA during 6 months (N = 13, 145 videos), participants mostly valued the opportunity to speak about the challenges they face with NF1 and their journey since diagnosis. At T2, after interacting on C@H for 7 weeks (N = 10, two sign-ins/week/parent), participants reported connecting with other parents of children with NF1 for the first time, valuing the "real faces" and emotions of other parents with shared experiences providing a sense of normalcy. Qualitative analysis suggested that C@H decreased feelings of isolation, provided relief to talk about NF1 without having to explain it, provided new knowledge about NF1 and the opportunity to address non-medical issues of NF1 never discussed in clinic, and helped participants with putting their lives into perspective. C@H allowed parents of adolescents with NF1 to overcome previous isolation and connect for the first time. Innovative applications of social media dedicated to those who care for children with chronic conditions can provide peer-to-peer support, shared experience, and reliable medical information.

Question Under Study: Switzerland has been receiving migrants of various origins for more than 50 years. The adoption of risk-taking behaviours among migrant youths is unclear. Moreover, when studied, migrant youths are rarely analysed according to whether they are first or second generation, or just young people with mixed origins. The aim of this study was to assess whether there are any differences between first-and second-generation immigrants, youths of mixed origins and their native peers in Switzerland concerning their engagement in risk behaviours., Methods: A total of 5834 youths from eleven post-mandatory schools in the canton of Fribourg (Switzerland) participated in the baseline survey of the GenerationFRee study, a longitudinal study to assess their lifestyle. Participants were divided by gender and by origin into: (a) natives: Swiss-born youths with Swiss-born parents, (b) first-generation migrants: foreign-born youths with foreign-born parents, (c) second-generation migrants: Swiss-born youths with foreign-born parents, (d) mixed-origin youths: Swiss-born youths with one Swiss-born parent and one foreign-born parent. Participants reported personal, family and school information, and attitudes towards eight risk behaviours. All significant variables at the bivariate level were included in a binary logistic regression., Results: The logistic regression showed that, compared with natives, first-and second-generation migrant boys were less likely to misuse alcohol. Boys of mixed origins were similar to migrants, although at the bivariate level they were more exposed to risk behaviours than were migrants. First-and second-generation migrant girls were less likely to misuse alcohol but three times more likely to be excessive Internet users. Girls of mixed origin were more likely to have their parents not living together and reported antisocial behaviours almost twice more often., Conclusions: Our findings expose a lower engagement in risk behaviours among migrants. The migrant status in these two groups is clearly buffered if other control variables are considered. Thus, we can affirm that in the present study, migrants are not a high-risk population or not more at risk than the native group. Mixed origin youths showed higher risk behaviours than natives and migrants. Special attention should be given to this specific group, as they may be more vulnerable during adolescence.

Sexting among youths has become a necessary topic of interest in research because of the negative consequences that this activity could create, especially when content is shared with others. Indeed, this loss of control could lead to humiliation, (cyber)bullying, or harassment. The development of new technologies, press coverage, and increase of prevalence rates could also explain the growth of interest in sexting. However, its definition is still a gray area. This review examines the different definitions of sexting used in the literature and its correlates. Several elements of the definition of sexting were assessed: actions (sending, receiving, and forwarding); media types (text, images, and videos); sexual characteristics; and transmission modes. Nine databases were searched for studies on sexting among youths up to 18 years of age. Eighteen studies published between 2012 and 2015 were included. Prevalence rates of sexting ranged between .9% and 60% partly depending on the definition. Most studies assessed sending, but when sending and receiving were measured, prevalence rates were higher for receiving. Some articles found associations with age, gender, race, sexual behavior, romantic relationships, risky behaviors, online activity, psychological difficulties, and social pressure. Finding a consensus regarding the definition is essential to assess accurately the activity and adapt prevention. Adolescents' interpretations of the activity are important as sexting could be used as a sexual behavior between two consenting persons. Prevention strategies should focus on sexting that goes wrong when it is forwarded to a third party and when it occurs in a context of pressure or harassment., (Copyright © 2017 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.)

Electronic cigarettes (ECs) acting as a gateway to smoking traditional cigarettes (TCs) is a growing public health concern of EC use among youths. To gather the opinions and perceptions of adolescents and young adults (AYAs) on whether and how EC can act as a gateway to smoking TC among youths. A qualitative method included 42 AYAs. Participants identified a significant risk of EC acting as a gateway to TC use, several factors contributing to this phenomenon such as a facilitated transition to smoking or its perception as a harmless toy. Participants considered an even greater gateway threat regarding very young adolescents. A minority did not identify the gateway risk and some believed that it was nicotine-dependent. This potential gateway effect brought forth several recommendations: health professionals should screen adolescents (even very young ones) for EC use and inform consumers of the potential gateway effect; this possible effect should be acknowledged to end the harmless perception many might have; there is an urge for better preventive and regulatory policies directed at protecting adolescents and children who never smoked and support those who have quit., (© The Author 2017. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.)

Many studies have shown that the use of electronic media is related to sleep disturbance, but few have examined the impact of smartphones. The objective of this study was to assess longitudinally whether acquiring a smartphone had an effect on adolescents' sleeping duration. The study included 591 adolescents observed at baseline (T0, Spring 2012; mean age 14.3 years, 288 females) and 2 years later (T1). They were divided into owners (those owning a smartphone at T0 and T1; N = 383), new owners (those owning a smartphone at T1 but not at T0; N = 153), and non-owners (those not owning a smartphone at any time-point; N = 55). Groups were compared on sleep duration, sleep problems, and sociodemographic variables. Overall, all three groups decreased their sleeping time between T0 and T1. At T0, owners of a smartphone were found to sleep significantly less than non-owners and new-owners, especially on school days, and to report significantly more sleeping problems. At T1, new-owners and owners showed no differences on sleep duration or sleeping problems., Conclusion: The results emphasize that owning a smartphone tends to entail sleep disturbance. Therefore, adolescents and parents should be informed about the potential consequences of smartphone use on sleep and health. What is Known: • The use of electronic media plays an important role in the life of adolescents. • Smartphone use is increasing among young people and allows them to be connected almost anytime anywhere. What is New : • Adolescents owning a smartphone sleep less hours on school days than their peers. • Smartphones seem to have an important impact on youths' sleep duration.

Aim: This study examined whether consuming energy drinks at the age of 14 predicted substance use at 16., Methods: We followed 621 youths from an area of Switzerland who completed a longitudinal online survey in both 2012 and 2014 when they were 14 and 16 years of age. At 14, participants, who were divided into nonenergy drink users (n = 262), occasional users (n = 183) and regular users (n = 176), reported demographic, health-related and substance use data. Substance use at 16 was assessed through logistic regression using nonusers as the reference group and controlling for significant variables at 14., Results: At the bivariate level, energy drink consumption was associated with substance use at both 14 and 16. Energy drink consumers were also more likely to be male, older, less academic, sleep less on schooldays and live in an urban area. In the multivariate analysis, smokers, alcohol misusers and cannabis users at the age of 16 were significantly more likely to have been regular energy drink users at the age of 14., Conclusion: Consuming energy drinks at 14 years of age predicted using legal and illegal substances at 16. Health providers should screen young adolescents for energy drink use and closely monitor weekly users., (©2016 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.)

Our laboratory has four separate methods for the analysis of trenbolone, stilbenes, resorcyclic acid lactones, and estradiol in bovine urine. The method described in this paper was in response to a client request to consolidate the methods preferably into one method. A multiresidue semi-quantitative method was developed and any suspect positive samples detected by the method were subjected to the method of standard addition to accurately quantify the concentration of the positive analyte. Samples were enzymatically hydrolyzed using β-glucuronidase after which, supported liquid extraction on HM-N cartridges was performed, followed by solvent exchange into methyl tert-butyl ether (MTBE). The samples were evaporated and reconstituted into 10% methanol in water and loaded onto a SampliQ OPT SPE. The cleaned-up extract was further cleaned up on a SampliQ NH2 cartridge. The SPE eluate was split into two for analysis by gas chromatography-mass spectrometry (GC-MS) using electron ionization (EI) and liquid chromatography-tandem mass spectrometry (LC-MS/MS) using both positive and negative electrospray. It was found that with the exception of estradiol and trenbolone all compounds could be analyzed by both GC-MS and LC-MS/MS, providing a semi-quantitative method. It is recommended that quantification is achieved using standard addition. Of the 13 compounds successfully monitored, the limits of detection (LODs), and the limits of quantification (LOQs) obtained were within the Codex limits for the target concentrations. As far as the authors are aware, the use of supported liquid extraction has not been reported for bovine urine analysis. © 2016 Her Majesty the Queen in Right of Canada. Drug Testing and Analysis © 2016 John Wiley & Sons, Ltd., (© 2016 Her Majesty the Queen in Right of Canada. Drug Testing and Analysis © 2016 John Wiley & Sons, Ltd.)

Objective: Adolescence is a transitory and exploratory stage during which risky behaviors such as substance use take place. This study aims to assess the characteristics and predictive risk factors of alcohol misuse among adolescents., Methods: A sample of 621 youths was followed from ages 14 to 16 years in Switzerland between spring 2012 (T0) and spring 2014 (T1). Participants were divided into two groups according to their alcohol misuse evolution: those who increased it (Misusers) and those who decreased or never experimented it (Non-misusers). The final sample consisted of 574 adolescents. At T0, participants reported demographic data, substance use data and emotional well-being. A multivariate regression was performed to assess the explanatory variables of alcohol misuse at T1 using Non-misusers as the reference category., Results: Alcohol misuse in the previous month increased dramatically from 2.4% (T0) to 29.2% (T1). At the bivariate level, alcohol misuse was associated with residence, use of alcohol, tobacco and cannabis. Compared to Non-misusers, Misusers were significantly more likely to live in a rural area (aOR: 1.75 [1.1:2.8]), use cannabis (aOR: 3.2 [1.0:9.8]) and have consumed alcohol (aOR: 2.65 [1.6:4.3]) at T0., Conclusion: Alcohol misuse increases dramatically with age. However, the only demographic difference between groups was that young adolescents living in rural areas were more likely to misuse alcohol. Moreover, having consumed alcohol without drunkenness and using cannabis at age 14 years predicted alcohol misuse at age 16 years. This finding is in line with the reverse gateway theory, where cannabis use precedes the use of legal substances.

Medically unexplained symptoms (MUS) are common among adolescents and are frequently encountered in primary care. Our aim was to explore how these adolescents and their parents experience the condition and its impact on their daily lives and to provide recommendations for health professionals. Using a qualitative approach, six focus groups and two individual interviews were conducted. These involved a total of ten adolescents with different types of MUS and sixteen parents. The respondents were recruited in a university hospital in Switzerland. A thematic analysis was conducted according to the Grounded Theory. The analysis of the data highlighted four core themes: disbelief, being different, concealing symptoms, and priority to adolescent's health. Transcending these themes was a core issue regarding the discrepancy between the strategies that adolescents and their parents use to cope with the symptoms. Health professionals should be made aware of the emotional needs of these patients and their families., (Copyright © 2015 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.)

Unlabelled: While problematic Internet use is recognized to be predominant among male adolescents, a female trend is gradually becoming apparent. Our study aimed at investigating the characteristics of female Internet users and distinguishing between the online activities of problematic and regular Internet users' on school days. Data were retrieved from a cross-sectional survey of a representative sample of 3067 8th graders in the canton of Vaud, Switzerland, that completed an online questionnaire in 2012. Only females were included. Based on the Internet addiction test, the sample was divided into regular (RUs) (IAT < 50, n = 1339) and problematic users (PIUs) (IAT ≥ 50, n = 201). Groups were compared regarding sociodemographic variables, online activities, devices used to access the Internet, substance use, and physical activity. Significant variables were included in a backward logistic regression. At the multivariate level, PIUs were more prone to spend time online for leisure activities (odds ratio [OR] 2.38) and to access the Internet through a smartphone (OR 1.79) or tablet (OR 1.84). PIUs were less likely to be physically active (OR 0.86) and more likely to present poor emotional well-being (OR 2.67) and to smoke (OR 1.88)., Conclusion: A sizeable percentage of female adolescents are problematic Internet users. When performing a comprehensive biopsychosocial assessment, teenagers owning numerous devices to access the Internet, presenting other health-compromising behaviors or poor emotional well-being should be specifically targeted.

Objective: This pilot experimental study tested the feasibility and intended effect of an educational intervention for parents to help them assist their adolescent child with chronic illness (CI) in becoming autonomous., Methods: A two-phase pre-post pilot intervention study targeting parents of adolescents with CI was conducted. Parents were allocated to group 1 and 2 and received the four-module intervention consecutively. Intended effect was measured through online questionnaires for parents and adolescents before, at 2 months after, and at 4-6 months after the intervention. Feasibility was assessed through an evaluation questionnaire for parents., Results: The most useful considered modules concerned the future of the adolescent and parents and social life. The most valued aspect was to exchange with other parents going through similar problems and receiving a new outlook on their relationship with their child. For parents, improvement trends appeared for shared management, parent protection, and self-efficacy, and worsening trends appeared for coping skills, parental perception of child vulnerability, and parental stress. For adolescents, improvement trends appeared for self-efficacy and parental bonding and worsening trends appeared for shared management and coping skills., Conclusion: Parents could benefit from peer-to-peer support and education as they support the needed autonomy development of their child. Future studies should test an online platform for parents to find peer support at all times and places.

Background: The objectives of this research were to describe the main reason(s) why adolescents use electronic cigarettes, to assess how e-cigarette experimenters and users differ based on personal characteristics, and to determine whether its use is associated with the use of other substances among a representative sample of youths in Switzerland., Methods: A representative sample of 621 youths (308 females) was divided into never users (n=353), experimenters (Only once, n=120) and users (Several times, n=148) of e-cigarettes. Groups were compared on socio-demographic data and current smoking, alcohol misuse and cannabis use. Reasons for e-cigarette use were compared between experimenters and users. A multinomial regression was performed using never users as the reference category., Results: Forty-three percent had ever tried e-cigarettes, and the main reason was curiosity. Compared to never users, experimenters were more likely to be out of school (Relative Risk Ratio [RRR]: 2.68) and to misuse alcohol (RRR: 2.08), while users were more likely to be male (RRR: 2.75), to be vocational students (RRR: 2.30) or out of school (RRR: 3.48) and to use any of the studied substances (tobacco, RRR: 5.26; alcohol misuse, RRR: 2.71; cannabis use, RRR: 30.2)., Conclusions: Although often still part of adolescent experimentation, e-cigarettes are becoming increasingly popular among adolescents and they should become part of health providers' standard substance use screening. As health providers (and especially paediatricians) do not seem to have high levels of knowledge and, consequently, little comfort in discussing e-cigarettes, training in this domain should be available to them., (Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.)

Purpose: The purpose of this study was to reach an international consensus to determine what key elements should be part of a transition program and what indicators could be used to assess its success., Methods: For this purpose, a Delphi study including an international panel of 37 experts was carried out. The study consisted of three rounds, with response rates ranging from 86.5% to 95%. At each round, experts were asked to assess key elements (defined as the most important elements for the task) and indicators (defined as quantifiable characteristics). At each round, panelists were contacted via e-mail explaining them the tasks to be done and giving them the Web link where to complete the questionnaire. At Round 3, each key element and indicator was assessed as essential, very important, important, accessory, or unnecessary. A 70% agreement was used as cutoff., Results: At Round 3, more than 70% of panelists agreed on six key elements being essential, with one of them (Assuring a good coordination between pediatric and adult professionals) reaching an almost complete consensus (97%). Additionally, 11 more obtained more than 70% agreement when combined with the Very important category. Among indicators, only one (Patient not lost to follow-up) was considered almost unanimously (91%) as essential by the panelists and seven others also reached consensus when the Very important category was included., Conclusions: Using these results as a framework to develop guidelines at local, national, and international levels would allow better assessing and comparing transition programs., (Copyright © 2015 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.)

Aim: This study examined whether problematic Internet use was associated with substance use among young adolescents and assessed whether this association accounted for the use of tobacco, alcohol, cannabis and other drugs., Methods: Using the Internet Addiction Test, we divided a representative sample of 3067 adolescents in Switzerland (mean age 14 years) into regular and problematic Internet users. We performed a bivariate analysis and two logistic regression models, to analyse substances separately and simultaneously, and developed a log-linear model to define the associations between significant variables., Results: Problematic Internet users were more likely to be female, to use substances, to come from nonintact families, to report poor emotional well-being and to be below average students. The first model showed significant associations between problematic users and each substance, with adjusted odds ratios of 2.05 for tobacco, 1.72 for alcohol, 1.94 for cannabis and 2.73 for other drugs. Only smoking remained significant in the second model, with an adjusted odds ratio of 1.71., Conclusion: Problematic Internet use is associated with other risky behaviours and may be an important early predictor of adolescent substance use. Therefore, it should be included in the psychosocial screening of adolescents., (©2015 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.)