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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

This study investigated co-morbidity of problem gambling and problematic Internet use (PIU) among adolescent Internet and land-based gamblers, with the classic approach using sum-scores of symptoms and a promising new method, namely the network perspective. This perspective allows testing for how multiple disorders are associated, showing symptoms overlap and centralities. We used cross-sectional data from two population-based samples of adolescents aged 17 years in France (n = 2,240) and Switzerland (n = 944). Measures included Internet gambling, problem gambling and PIU. The classic approach showed that Internet gambling was associated with increased levels of disordered gambling and PIU, but that correlations between disorders were weak (R2 min = 3.2%, R2 max = 17.6%). The network perspective showed that the co-morbid network of Internet gamblers was more connected in comparison with land-based gamblers. Problem gambling and PIU appeared as separate disorders, but their relationship was increased among Internet gamblers in comparison with land-based gamblers. The network perspective appeared as a promising avenue for a better understanding of addictive disorders, but it should not replace the classic approach, which showed increased levels of addictive behaviours among Internet gamblers.

Background: The measurement of Internet use is an under-documented topic despite the worldwide growth of problematic Internet use and the recent debate in addiction research suggesting that heavy use over time should be suitable for population-based assessment. This study compared different measures of Internet use to identify the most relevant one, and tested whether Internet use was a good proxy of self-reported Internet addiction.Methods: Data were collected in the ado@internet.ch study among 3054 Swiss 8th grade adolescents. Different assessments of Internet use (frequency, number of hours spent on Internet, quantity-frequency measure, latent score) were compared using rank invariance across instruments. We also examined associations of Internet use with health outcomes (Internet addiction, wellbeing, somatic health problems, and quantity of sleeping). Additionally, associations of Internet addiction with health outcomes were investigated.Results: Quantity-frequency captured 82% of the variabi...

BackgroundGiven continually rising health care costs, interventions of health care providers should be cost-effective.PurposeThis review aimed to summarize current cost-effectiveness of physical therapy. Specific aims were: (1) to analyze cost-effectiveness of physical therapy only compared with usual care only, (2) to analyze cost-effectiveness of physical therapy added to usual care compared with usual care only, and (3) to specify in which health conditions physical therapy only or physical therapy added to usual care was cost-effective.Data SourcesTopic-related systematic reviews were searched in MEDLINE, CINAHL, PEDro, and Cochrane Library and manually.Study SelectionStudies published between 1998 and 2014 that investigated the cost-effectiveness of interventions carried out by physical therapists were reviewed. The methodological quality was assessed with the Cochrane risk of bias assessment for intervention studies and with the Quality of Health Economic Analyses Scale.Data ExtractionEffectiveness and cost data for calculating incremental cost-effectiveness ratios (ICERs) and the original authors' conclusions were extracted.Data SynthesisThe 18 included studies presented low risk of bias and contained 8 comparisons of physical therapy only with usual care only and 11 comparisons of physical therapy added to usual care with usual care only. Based on ICERs, physical therapy only or added to usual care was cost-effective in 9 out of the 19 comparisons and in 10 comparisons according to the original authors' conclusions.ConclusionPhysical therapy only or added to usual care implies improved health in almost all studies. The cost-effectiveness of such interventions was demonstrated in half of the studies. This result might have been influenced by the fact that different definitions of the notion of “cost-effectiveness” exist.

(Abstract in english) Background: Earlier studies suggested a positive impact of spirituality on addictive disorders, but this effect has rarely been studied in a large adolescent and young adult population. Aim: To examine the association between spiritual beliefs (general belief, the supporting role of spiritual belief, the critical role of spiritual belief) and potentially addictive behaviors (tobacco, alcohol, cannabis and other illegal drugs, excessive Internet use and gambling). Methods: Data were collected using online self-report questionnaires among a sample of 5179 adolescents and young adults aged 15–24 years in post-mandatory education in Switzerland. Statistical analysis at bivariate and multivariate level was performed. Results: At the bivariate level, spiritual beliefs were linked to a lower risk of tobacco smoking, alcohol misuse and cannabis use as well as an increased risk of Internet overuse and gambling. However, at the multivariate level, controlling for age, gender, language and place of birth, significant associations were found only for alcohol misuse, Internet overuse and gambling. Conclusion: The study provides evidence that spiritual belief could protect youth from the risk of alcohol misuse but could also increase the risk of excessive Internet use and gambling. The role of spiritual beliefs in preventing or motivating these problematic behaviors is of great interest for adolescent health care providers and should be considered in the light of the separation-individuation process and transition from adolescence to adulthood. (Resume en francais) L’adolescence est une periode de vie durant laquelle les jeunes sont soumis a leur besoin croissant de l’individualisation, de la prise d’autonomie et de la construction de leurs propres valeurs et identite differentiee de leur famille d’origine. C’est une periode de transition vers l’adulte chargee de changements stressants sans que le systeme nerveux central ait atteint sa maturite sur le plan fonctionnel, raison pour laquelle cette periode est consideree comme critique pour l’emergence des comportements a risque et le developpement des autres psychopathologies. La spiritualite est connue comme etant un facteur de protection pour les comportements addictifs chez l’adulte mais ce lien a ete peu etudie dans une large population d’adolescents et de jeunes adultes. Ce travail de these consiste a etudier ce lien en analysant les donnees collectees via un questionnaire en ligne de maniere anonyme pendant l’annee scolaire 2014-2015 chez 5179 adolescents et jeunes adultes scolarises dans le Canton de Fribourg (Etude GenerationFRee). Les participants rapportent leur certitude sur leur croyance spirituelle sous 3 aspects (la croyance globale, le role soutenant de la croyance, le role critique de la croyance). Sont evalues dans cette etude les comportements potentiellement addictifs suivants: consommation de tabac, de cannabis et des autres drogues illegales, mesusage d’alcool, utilisation excessive d’internet et jeux d’argent. Les resultats de nos analyses statistiques au niveau bi-varie suggerent un effet protecteur de la spiritualite sur la consommation de tabac, de cannabis et le mesusage d’alcool mais egalement un effet renforcateur sur l’utilisation excessive d’internet et les jeux d’argent. Lorsque ces resultats significatifs entrent dans une analyse de regression logistique, en controlant pour les variables sociodemographiques (âge, sexe, langue, lieu de naissance), l’effet protecteur de la spiritualite sur la consommation de tabac et l’effet renforcateur sur l’utilisation excessive d’internet et les jeux d’argent restent statistiquement significatifs. Notre etude demontre que la croyance spirituelle globale, tout comme son composant « role soutenant » et « role critique», presente un effet protecteur de la spiritualite sur la consommation d’alcool chez les adolescents et jeunes adultes en Suisse, comme ce qui a ete suggere par la litterature pour les adultes. Nous constatons egalement que, dans une perspective de transition de l’adolescence a l’âge adulte caracterisee par une recherche active d’individualisation et d’independance financiere, la spiritualite pourrait paradoxalement motiver certains comportements potentiellement addictifs comme l’utilisation excessive d’internet et les jeux d’argent. Afin de continuer a approfondir nos connaissances sur ces liens, des futures etudes longitudinales et qualitatives nous semblent necessaires.

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: Human papillomavirus (HPV) is a sexually transmitted infection of particular interest because of its high prevalence rate and strong causal association with cervical cancer. Two prophylactic vaccines have been developed and different countries have made or will soon make recommendations for the vaccination of girls. Even if there is a consensus to recommend a vaccination before the beginning of sexual activity, there are, however, large discrepancies between countries concerning the perceived usefulness of a catch-up procedure and of boosters. The main objective of this article is to simulate the impact on different vaccination policies upon the mid- and long-term HPV 16/18 age-specific infection rates. METHODS: We developed an epidemiological model based on the susceptible-infective-recovered approach using Swiss data. The mid- and long-term impact of different vaccination scenarios was then compared. RESULTS: The generalization of a catch-up procedure is always beneficial, whatever its extent. Moreover, pending on the length of the protection offered by the vaccine, boosters will also be very useful. CONCLUSIONS: To be really effective, a vaccination campaign against HPV infection should at least include a catch-up to early reach a drop in HPV 16/18 prevalence, and maybe boosters. Otherwise, the protection insured for women in their 20s could be lower than expected, resulting in higher risks to later develop cervical cancer.

This study aimed to compare the sexual behavior of adolescents who were or were not exposed to online pornography, to assess to what extent the willingness of exposure changed these possible associations, and to determine the profiles of youths who were exposed to online pornography. Data were drawn from the 2002 Swiss Multicenter Adolescent Survey on Health, a self-administered cross-sectional, paper and pencil questionnaire. From the 7529 adolescents aged 16-20 years, 6054 (3283 males) used the Internet during the previous month and were eligible for our study. Males were divided into three groups (wanted exposure, 29.2%; unwanted exposure, 46.7%; no exposure, 24.1%) whereas females were divided into two groups (exposure, 35.9%; no exposure, 64.1%). The principal outcome measures were demographic characteristics, Internet use parameters and risky sexual behaviors. Risky sexual behaviors were not associated with online pornography exposure in any of the groups, except that males who were exposed (deliberately or not) had higher odds of not having used a condom at last intercourse. Bi/homosexual orientation and Internet use parameters were not associated either. Additionally, males in the wanted exposure group were more likely to be sensation-seekers. On the other hand, exposed girls were more likely to be students, higher sensation-seekers, early maturers, and to have a highly educated father. We conclude that pornography exposure is not associated with risky sexual behaviors and that the willingness of exposure does not seem to have an impact on risky sexual behaviors among adolescents.

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.

Evidence-based and reliable measures of addictive disorders are needed in general population-based assessments. One study suggested that heavy use over time (UOT) should be used instead of self-reported addiction scales (AS). This study compared UOT and AS regarding video gaming and internet use empirically, using associations with comorbid factors. Cross-sectional data from the 2011 French Survey on Health and Consumption on Call-up and Preparation for Defence-Day (ESCAPAD), cross-sectional data from the 2012 Swiss ado@internet.ch study and two waves of longitudinal data (2010-13) of the Swiss Longitudinal Cohort Study on Substance Use Risk Factors (C-SURF). Three representative samples from the general population of French and Swiss adolescents and young Swiss men, aged approximately 17, 14 and 20 years, respectively. ESCAPAD: n =22 945 (47.4% men); ado@internet.ch: n =3049 (50% men); C-SURF: n =4813 (baseline + follow-up, 100% men). We assessed video gaming/internet UOT ESCAPAD and ado@internet.ch: number of hours spent online per week, C-SURF: latent score of time spent gaming/using internet] and AS (ESCAPAD: Problematic Internet Use Questionnaire, ado@internet.ch: Internet Addiction Test, C-SURF: Gaming AS). Comorbidities were assessed with health outcomes (ESCAPAD: physical health evaluation with a single item, suicidal thoughts, and appointment with a psychiatrist; ado@internet.ch: WHO-5 and somatic health problems; C-SURF: Short Form 12 (SF-12 Health Survey) and Major Depression Inventory (MDI). UOT and AS were correlated moderately (ESCAPAD: r = 0.40, ado@internet.ch: r = 0.53 and C-SURF: r = 0.51). Associations of AS with comorbidity factors were higher than those of UOT in cross-sectional (AS: .005 ≤ |b| ≤ 2.500, UOT: 0.001 ≤ |b| ≤ 1.000) and longitudinal analyses (AS: 0.093 ≤ |b| ≤ 1.079, UOT: 0.020 ≤ |b| ≤ 0.329). The results were similar across gender in ESCAPAD and ado@internet.ch (men: AS: 0.006 ≤ |b| ≤ 0.211, UOT: 0.001 ≤ |b| ≤ 0.061; women: AS: 0.004 ≤ |b| ≤ 0.155, UOT: 0.001 ≤ |b| ≤ 0.094). The measurement of heavy use over time captures part of addictive video gaming/internet use without overlapping to a large extent with the results of measuring by self-reported addiction scales (AS). Measuring addictive video gaming/internet use via self-reported addiction scales relates more strongly to comorbidity factors than heavy use over time.

Summary Background Suffering from a chronic disease or disability (CDD) during adolescence can be a burden for both the adolescents and their parents. The aim of the present study is to assess how living with a CDD during adolescence, the quality of parent–adolescent relationship (PAR) and the adolescent's psychosocial development interact with each other. Methods Using the Swiss Multicenter Adolescent Survey on Health 2002 (SMASH02) database, we compared adolescents aged 16–20 years with a CDD (n = 760) with their healthy peers (n = 6493) on sociodemographics, adolescents' general and psychosocial health, interparental relationship and PAR. Results Bivariate analyses showed that adolescents with a CDD had a poorer psychosocial health and a more difficult relationship with their parents. The log-linear model indirectly linked CDD and poor PAR through four variables: two of the adolescents' psychosocial health variables (suicide attempt and sensation seeking), the need for help regarding difficulties with parents and a highly educated mother that acted as a protective factor, allowing for a better parent–adolescent with a CDD relationship. Conclusion It is essential for health professionals taking care of adolescents with a CDD to distinguish between issues in relation with the CDD from other psychosocial difficulties, in order to help these adolescents and their parents deal with them appropriately and thus maintain a healthy PAR.

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 3,067 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 non-intact families, to report poor emotional wellbeing 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. CONCLUSIONS: 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. This article is protected by copyright. All rights reserved. Language: en

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.

The main aim of this paper is to describe the use of the Markovian-based Hidden Mixture Transition Distribution (HMTD) model for the clustering of longitudinal sequences of continuous data. We especially discuss the use of covariates to improve the clustering process. The HMTD is compared to the well-known Growth Mixture Model (GMM) that is considered here as a gold standard. Both models are applied to a sample of n = 185 adolescents, who are repeatedly evaluated for Internet overuse using the Internet Addiction Test (IAT). The best solution provided by the HMTD model has four groups and it uses five covariates. This solution is related to the subjects’ level of emotional well-being, body mass index, gender, and education track, but shows no relation with age. Compared to a GMM clustering, the HMTD solution provides highly interpretable results with quite equilibrate cluster size, while GMM tends to identify very small clusters allowing for less generalization.

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.

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.International Journal of Obesity advance online publication 8 September 2015; doi:10.1038/ijo.2015.146.

Objective:To investigate scanpath abnormalities during the encoding of static stimuli in schizophrenia and their interaction with visuospatial working memory (VSWM) dysfunction.Methods:Outpatients with schizophrenia and control subjects were asked to encode a static pattern for subsequent recognition after a short delay. We measured the number of correct and incorrect choices. We also assessed the number and the distribution of fixations, the scanning time in specific regions of interest (ROIs) and the head movements during the encoding of the stimuli. The distributions of fixations and scanning time in definite ROIs during the discrimination of the correct pattern from the foils were also measured.Results:Patients recognised fewer correct patterns than controls. Correct trials in patients were characterised by a specific exploration of the central part of the stimulus during its presentation, whereas this feature was absent in incorrect trials. However, the scanning time and the numbers of fixations and head movements during encoding were similar in both groups and unrelated to recognition accuracy. In both groups, correct trials were associated with a selective exploration of the correct pattern amongst the six possibilities during recognition. Furthermore, patients gave more attention to incorrect patterns with a leftmost element identical to that of the correct response and also those approximating its global structure.Conclusion:Patients showed a VSWM deficit independent of oculomotor dysfunctions and head movements during encoding. Patients’ correct trials were related to specific scanning during encoding and discrimination phases. Analysis of these patterns suggests that patients try to compensate for reduced VSWM ability by using specific encoding strategies.

Because of their higher status, members of national majorities (e.g., linguistic, ethnic, or religious) are likely to develop a stronger sense of ownership of the nation than members of national minorities (Sidanius, Feshbach, Levin, & Pratto, 1997), which is reflected in a stronger attachment to the nation as a whole (e.g., Staerkle, Sidanius, Green, & Molina, 2010). Accordingly, members of national majorities are expected to hold a stricter conception of nationhood, that is to be stricter regarding who should or should not belong to the national community (Kunovich, 2009). Based on data from two large surveys (European Social Survey [ESS] 2002, International Social Survey Programme [ISSP] 2003), the present study tests this expectation by comparing conceptions of nationhood across the two largest linguistic subnational groups in Switzerland. However, observed differences between the groups can either reflect substantive differences or result from measurement artifacts, as distinctive features of the subnational groups (e.g., different languages; Davidov & De Beuckelaer, 2010) may impact the measurement itself. Therefore, measurement equivalence should be tested for before undertaking substantive mean comparisons (e.g., Steenkamp & Baumgartner, 1998). While measurement equivalence testing is frequently carried out in cross-national studies (e.g., Davidov, 2009; Reeskens & Hooghe, 2010), it is rarely established when comparing data drawn from distinct national subgroups within countries (see, however, Billiet, 2003; Billiet, Maddens, & Beerten, 2003). Thus, this study has both a substantive and a methodological rationale: Beyond testing the assumption that members of national majorities hold a stricter conception of nationhood than members of national minorities, it aims at illustrating the necessary steps of analysis–using exploratory and multigroup confirmatory factor analyses–for conducting valid latent mean comparisons across subnational groups.

The purpose of this article is to identify tobacco and cannabis co-consumptions and consumers' perceptions of each substance. A qualitative research including 22 youths (14 males) aged 15-21 years in seven individual interviews and five focus groups. Discussions were recorded, transcribed verbatim and transferred to Atlas.ti software for narrative analysis. The main consumption mode is cannabis cigarettes which always mix cannabis and tobacco. Participants perceive cannabis much more positively than tobacco, which is considered unnatural, harmful and addictive. Future consumption forecasts thus more often exclude tobacco smoking than cannabis consumption. A substitution phenomenon often takes place between both substances. Given the co-consumption of tobacco and cannabis, in helping youths quit or decrease their consumptions, both substances should be taken into account in a global approach. Cannabis consumers should be made aware of their tobacco use while consuming cannabis and the risk of inducing nicotine addiction through cannabis use, despite the perceived disconnect between the two substances. Prevention programs should correct made-up ideas about cannabis consumption and convey a clear message about its harmful consequences. Our findings support the growing evidence which suggests that nicotine dependence and cigarette smoking may be induced by cannabis consumption.

Purpose: To assess whether living with a chronic condition (CC) is associated with risk behaviors among youths. Methods: Data were drawn from the baseline wave (2014-15; N¼5179) of the GenerationFRee survey, a longitudinal study among post-mandatory youths aged 15-24 years in Fribourg, Switzerland. Students were divided into three groups depending on whether they reported having a CC or not: healthy controls (no CC: N¼4529; 46.2% females), CC without limitation (CCWL: N¼536; 52.6% females) and CC limiting daily activities (CCLDA: N¼114; 58.9% females). At the bivariate level groups were compared on sociodemographic data and six risk behaviors (current smoking; current (at least once in the past 30 days) alcohol misuse, cannabis use and use of other illegal drugs; violent behavior and antisocial behavior at least once in the past 12 months). In a second step, a multinomial logistic regression was conducted including all variables significant at the .05 level. Results are given as Relative Risk Ratios (RRR) with 95% confidence intervals.

Purpose To assess the evolution of sexual dysfunctions among young males after an average of 15 months follow-up to determine the predictive factors for this evolution and the characteristics differentiating young males who continue reporting a sexual dysfunction from those who do not. Methods We conducted a prospective cohort study in two Swiss military recruitment centers mandatory for all Swiss national males aged 18–25 years. A total of 3,700 sexually active young males filled out a questionnaire at baseline (T0) and follow-up (T1: 15.5 months later). Main outcome measures were self-reported premature ejaculation (PE) and erectile dysfunction (ED). Results Overall, 43.9% of young males who reported (PE) and 51% of those reporting (ED) at T0 still reported it at T1. Moreover, 9.7% developed a PE problem and 14.4% developed an ED problem between T0 and T1. Poor mental health, depression, and consumption of medication without prescription were predictive factors for PE and ED. Poor physical health, alcohol consumption, and less sexual experience were predictive factors for PE. ED persistence was associated with having multiple sexual partners. Conclusions This is the first longitudinal study to examine sexual dysfunctions among young males. Our results show high prevalence rates among young males for maintaining or developing a sexual dysfunction over time. Consequently, when consulting with young males, health professionals should inquire about sexual dysfunctions as part of their routine psychosocial assessment and leave the subject open for discussion. Future research should examine in more detail the relationship between sexual dysfunctions and poor mental health.

International audience; The validity of the 34-item and shortened versions of the Body Shape Questionnaire (BSQ) has been evaluated in various languages. To date, only the validity of the 34-item French BSQ scale has been tested in a nonclinical sample. This study assessed the reliability and validity of the 34-item French BSQ and 7 shortened versions in clinical and nonclinical samples. The 34-item French BSQ was administered to 159 obese women with and without binge eating disorders and to 1,169 female undergraduate students. The results suggested that the BSQ-8B was the best French BSQ to use in nonclinical and clinical samples.

In the past two decades, the iconography of victimhood mobilized by child rights advocates has changed significantly. In particular, the child victim of violence has replaced the street child as the dominant icon on the international agenda. Based on data from more than 300 documents produced between 1989 and 2009 and interviews with leading advocates, this article explores the diverging trajectories of iconic child victims. It follows the traces of the successive translations of the idea of ‘stolen childhood’ and locates them against the backdrop of evolutions in the children’s rights field.

It is now a standard practice to replace missing data in longitudinal surveys with imputed values, but there is still much uncertainty about the best approach to adopt. Using data from a real survey, we compared different strategies combining multiple imputation and the chained equations method, the two main objectives being 1) to explore the impact of the explanatory variables in the chained regression equations, 2) to study the effect of imputation on causality between successive waves of the survey. Results were very stable from one simulation to another, and no systematic bias did appear. The critical points of the method lied in the proper choice of covariates and in the respect of the temporal relation between variables.

Different factors influence ADL performance among nursing home (NH) residents in long term care. The aim was to investigate which factors were associated with a significant change of ADL performance in NH residents, and whether or not these factors were gender-specific. The design was a survival analysis. The 10,199 participants resided in ninety Swiss NHs. Their ADL performance had been assessed by the Resident Assessment Instrument Minimum Data Set (RAI-MDS) in the period from 1997 to 2007. Relevant change in ADL performance was defined as 2 levels of change on the ADL scale between two successive assessments. The occurrence of either an improvement or a degradation of the ADL status) was analyzed using the Cox proportional hazard model. The analysis included a total of 10,199 NH residents. Each resident received between 2 and 23 assessments. Poor balance, incontinence, impaired cognition, a low BMI, impaired vision, no daily contact with proxies, impaired hearing and the presence of depression were, by hierarchical order, significant risk factors for NH residents to experience a degradation of ADL performance. Residents, who were incontinent, cognitively impaired or had a high BMI were significantly less likely to improve their ADL abilities. Male residents with cancer were prone to see their ADL improve. The year of NH entry was significantly associated with either degradation or improvement of ADL performance. Measures aiming at improving balance and continence, promoting physical activity, providing appropriate nourishment and cognitive enhancement are important for ADL performance in NH residents.

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. 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 non-energy 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 non-users 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. This article is protected by copyright. All rights reserved.

Purpose : To assess the characteristics and associated risk factors of young problematic gamblers. Methods: Data were drawn from the GenerationFRee study, a Swiss cross-sectional in-school survey including 5179 youths aged 15-24 (mean age 18.3). Among these participants, 1371 (26.5%) reported having gambled in the last 12 months and were included in the study. Gamblers were divided into two groups according to the South Oaks Gambling Screen (SOGS) scale adapted for adolescents: non-problematic gamblers (SOGS=2; N=255). Participants reported demographic, family and academic data, risk behaviors (current smoking, alcohol misuse, cannabis use, use of other illegal drugs, violent and antisocial acts, and Internet addiction) and sensation seeking. All variables significant at the bivariate level were included in a logistic regression analysis to assess the variables associated with at risk/problematic gambling using non-problematic gamblers as the reference category. Data are presented as adjusted odds ratios (aOR) with 95% confidence interval.

Purpose: To assess whether young people not engaging in risk behaviors do better than their risk-taking peers. Methods: Data were drawn from the GenerationFRee study, a cross-sectional in-school survey including 5179 youths aged 15-24. Six risk behaviors were studied: smoking, alcohol misuse, cannabis use, use of other illegal drugs, violent behavior and antisocial behavior. A score obtained after adding the behaviors permitted to divide the subjects into Abstainers (score=0; N=1920) and Risk-takers (score>0; N=3259). Groups were compared on personal, familial, academic characteristics. All variables significant at the bivariate level were included in a logistic regression using Risk-takers as the reference category. Results are given as adjusted Odds Ratios (aOR) with 95% confidence interval.

Purpose The purposes of this study are to measure the prevalence of premature ejaculation (PE) and erectile dysfunction (ED) among a population of Swiss young men and to assess which factors are associated with these sexual dysfunctions in this age-group. Methods For each condition (PE and ED), we performed separate analyses comparing young men suffering from the condition with those who were not. Groups were compared for substance use (tobacco, alcohol, cannabis, other illegal drugs, and medication without a prescription), self-reported body mass index, sexual orientation, physical activity, professional activity, sexual experience (sexual life length and age at first intercourse), depression status, mental health, and physical health in a bivariate analysis. We then used a log-linear analysis to consider all significant variables simultaneously. Results Prevalence rates for PE and ED were 11% and 30%, respectively. Poor mental health was the only variable to have a direct association with both conditions after controlling for potential confounders. In addition, PE was directly associated with tobacco, illegal drugs, professional activity, and physical activity, whereas ED was directly linked with medication without a prescription, length of sexual life, and physical health. Conclusions In Switzerland, one-third of young men suffer from at least one sexual dysfunction. Multiple health-compromising factors are associated with these dysfunctions. These should act as red flags for health professionals to encourage them to take any opportunity to talk about sexuality with their young male patients.

The Swiss school system is based on selectivity and classification. From a relatively young age, students are assigned to levels leading to different professional orientations, from apprenticeship to university. Using data from the Swiss ISRD-2 (Second International Self-Reported Delinquency Study), this study analyses the link between Swiss schools and delinquency, as measured by prevalence in the 12 months before filling out the questionnaire. Three dependent variables with large prevalence rates were considered: shoplifting, vandalism and a composite variable, all offences. The results were generated using two analytical methods, controlling for sociodemographic and individual characteristics and variables related to the family and the neighbourhood. The analyses reveal that being in the lowest track either in the school itself or in the school system is not related to increased risk of delinquency.

Improving nutritional knowledge is a frequent goal in nutritional education programs. However, there is a lack of valid instruments to assess nutritional knowledge in children. Questionnaires on nutritional knowledge are usually related to a specific curriculum or program, and their development or validation process is rarely available. Our goal was to develop a valid, self-administered questionnaire to assess nutritional knowledge among French-speaking children and adolescents aged 9-15 years. The conceptual framework and concepts were based on a literature review. For each concept, an expert panel selected a number of items, and successive versions of the questionnaire were pretested. The edited version of a 30-item questionnaire (QuesCA) was administered to 475 children aged 9-15, in two French-speaking cantons in Switzerland. We calculated internal consistency (Cronbach alpha), the rate of correct answers for each question, and the mean scores for each concept. The mean scores were 16.32 (95% CI: [15.69; 16.94]) in the 9- to11-year-olds and 18.62 [18.19; 19.06] in the 12- to 15-year-olds (maximum possible, 30). Beverages, breakfast, fruit, and vegetables were the concepts that gathered the most correct answers. The overall Cronbach alpha score was good (0.66), but as the internal consistency for each concept was low (0.06-0.45), we developed an optimal scale for each age group. The result is a two-part questionnaire: QuesCA 9-11 and QuesCA 12-15, with 9 items each, that enables a rapid and reliable assessment of nutritional knowledge in children and adolescents.

Objectives This study aims to determine whether adolescent girls with severe dysmenorrhea (SD) have different psychological characteristics from their peers. Study design Cross-sectional survey (SMASH 02). Settings Nationally representative sample of adolescents attending post-mandatory education. Participants N = 7548, of whom 3340 were females, aged 16-20 years. Intervention Self-administered, anonymous survey consisted of 565 items on 4 main topics: sociodemographic determinants of health, health status, health behaviors, and health care use. Outcomes Body image variables, mental health, and associated variables like sexual abuse and health perceptions. Bivariate analysis and binomial logistic regression controlling for explanatory variables were performed. Results 12.4% (95% confidence interval [CI]: 11.0-14) declared SD. Compared to their peers, subjects with SD were more likely to report depressive symptoms (adjusted odds ratio [AOR]: 1.73; 95% CI: 1.38-2.15), have a higher gynecological age (AOR: 1.13; 95% CI: 1.05-1.20), and attend vocational school (AOR: 1.33; 95% CI: 1.00-1.76). Moreover, the proportion of those reporting dissatisfaction with their body appearance was higher (AOR: 1.50; 95% CI: 1.02-2.22). Conclusion Patients with SD not only show a different profile from their peers in terms of their mental health academic track and gynecological age, but they are also more dissatisfied with their body appearance. Clinicians should pay particular attention to patients with SD and offer them a global evaluation, bearing in mind what factors can be associated with SD.

Purpose: To examine the characteristics of adolescents and young adults (AYA) who perceive themselves as unpopular with peers from the same-sex, opposite-sex, or both. Methods: We used the baseline wave (2014-15; N¼5179) of the Generation FRee longitudinal study, gathering a cantonal representative sample of in-school 15-24 year-olds. The web-based in school administered questionnaire included the 2 items “Among same-sex/opposite-sex peers, I am very popular” (yes/no). Respondents were divided into 4 groups: Those who perceived themselves as popular with same-sex and opposite-sex peers (POP; N¼3’164, 61.09%); as unpopular with same-sex and opposite-sex peers (UNPOP; N¼1’228, 23.71%); as unpopular with same-sex peers only (UNPOPSame; N¼284, 5.48%), and as unpopular with opposite-sex peers only (UNPOPOther; N¼503, 9.72%). At the bivariate level, groups were compared on sociodemographic data, making same-sex and opposite-sex friends easily, emotional well-being, school performance and track, and substance use (current smoking, past 30-days e-cigarette, cannabis, and alcohol misuse, and other illegal drug use ever). All significant variables (p

Purpose: To assess the characteristics of offenders and victims of youth dating violence. Methods: Data were drawn from the second wave (2015-16) of the GenerationFRee study, a Swiss longitudinal in-school survey including 2627 youths aged 15-22. Dating violence was defined as psychological (insults and threats), physical (to push and hit) or sexual (to insist and to force to have sex) and to happen in an intimate relationship. Participants were divided into four groups: non-violent (64.7%), offender-only (7.1%), victim-only (3.9%), victim-offender (20.1%).They were compared according to demographic, family and academic data, emotional well-being, pubertal timing and risk behaviors (current smoking, alcohol misuse, cannabis and illegal drugs use, violent and antisocial behaviors). All significant variables (p

Rapport de syntheseCette recherche s'interesse a investiguer d'une part si les residents en Suisse entre 15 et 24 ans suivent les recommandations nutritionnelles actuelles et d'autre part, s'il y a des differences entre ceux en surpoids et ceux en poids normal. Les donnees sont tirees de l'Enquete Suisse sur la Sante ESS 2007. Pour notre etude, seules les 1813 personnes âgees entre 15 et 24 ans ont ete selectionnees.Dans une premiere analyse bivariee, l'adherence aux recommandations alimentaires a ete comparee entre hommes et femmes. Les quantites proposees par le questionnaire ESS sont: 1 a 2 portions de fruits, 3 portions de legumes et 3 portions de produits laitiers par jour, ainsi qu'un maximum de 5 portions de viande et au moins une portion de poisson par semaine. Ces quantites sont en accord avec les recommandations de la Societe Suisse de Nutrition.L'adherence aux recommandations alimentaires est plutot basse quelque soit le genre, en particulier pour les legumes et les produits laitiers. Les femmes ont tendance a manger les quantites recommandees de fruits, legumes et viande, tandis que les hommes ont tendance a manger la quantite recommandee de produits laitiers. Pour le poisson aucune difference n'a ete observee entre personnes du sexe oppose.Ensuite, les personnes en surpoids ont ete comparees dans une analyse bivariee aux personnes en poids normal, en fonction du sexe. Plusieurs facteurs ont ete consideres: participation a une activite physique avec essoufflement pendant au mois 20 minutes et au moins 4 jours par semaine, attitude envers leur poids corporel (satisfaction avec le poids, desir de perdre du poids et regime suivi pour perdre du poids), consommation d'alcool, de cigarettes et presence d'un etat depressif majeur. Finalement, des facteurs potentiellement confondants (âge, nationalite et lieu de domicile) ont ete inclus dans une analyse multivariee.Concernant l'adherence aux recommandations alimentaires, la seule difference significative est une consommation de legumes plus basse chez les femmes en surpoids. Seulement 4.2% des femmes en surpoids mangent 3 portions de legumes ou plus par jour compare a 18.1% des femmes avec un poids normal. La consommation de produits laitiers est tres basse dans tous les groupes, seulement environ 10% des repondants mangent les 3 portions recommandees de produits laitiers.Pour le niveau d'activite physique, aucune difference significative n'a ete observee. L'analyse bivariee montre que les femmes en surpoids mangent moins de legumes, sont moins satisfaites de leur corps et ont plus souvent suivi un regime pour perdre du poids. Cependant elles ne souhaitent pas plus souvent perdre du poids en comparaison des femmes en poids normal. Les hommes en surpoids sont moins satisfaits de leur corps, desirent plus souvent perdre du poids, mais n'ont pas plus souvent suivi un regime que les hommes ayant un poids normal.Ces resultats montrent qu'il est difficile de suivre les recommandations alimentaires pour les 15-24 ans. Une recherche plus approfondie est necessaire afin de determiner comment ces recommandations pourraient etre mieux adaptees a la vie quotidienne des jeunes. La faible consommation de produits laitiers est preoccupante, vu que la periode entre l'adolescence et l'âge adulte est un moment crucial pour le developpement de la densite osseuse. De nouvelles strategies doivent etre trouvees pour ameliorer la consommation de produits laitiers chez les jeunes. Comme le comportement alimentaire et l'attitude envers le poids corporel different beaucoup selon le sexe, les programmes de prevention de surpoids devraient cibler les jeunes specifiquement par sexe.

Context: Understanding the process through which adolescents and young adults are trying legal and illegal substances is a crucial point for the development of tailored prevention and treatment programs. However, patterns of substance first use can be very complex when multiple substances are considered, requiring reduction into a few meaningful number of categories.Data: We used data from a survey on adolescent and young adult health conducted in 2002 in Switzerland. Answers from 2212 subjects aged 19 and 20 were included. The first consumption ever of 10 substances (tobacco, cannabis, medicine to get high, sniff (volatile substances, and inhalants), ecstasy, GHB, LSD, cocaine, methadone, and heroin) was considered for a grand total of 516 different patterns.Methods: In a first step, automatic clustering was used to decrease the number of patterns to 50. Then, two groups of substance use experts, three social field workers, and three toxicologists and health professionals, were asked to reduce them into ...

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.

Purpose To determine the characteristics specific to boys with disordered eating behaviors (DEB) and the general context in which these DEB occur. Method Data were drawn from the SMASH02 database, a survey carried out among post–mandatory school students in Switzerland aged 16–20 years in 2002. Only males (N = 3890) were included, and were classified into into one of four groups based on their level of concern about weight/food and on their eating behaviors, as follows: group 1: one concern without behavior (N = 862); group 2: more than one concern without behavior (N = 361); group 3: at least one behavior (N = 798); and a control group (N = 1869), according to previously validated items. Groups were compared for personal, family, school, experience of violence, and health-compromising behaviors variables on the bivariate level. All significant variables were included in a multinomial logistic regression using Stata 9 software. Results About one-half of the boys reported either a concern or unhealthy eating behavior. Compared with the control group, boys from the three groups were more likely to be students and to report a history of sexual abuse, delinquency, depression, and feeling fat. In addition, boys from group 3 were more likely to report a history of dieting, early puberty, peer teasing, having experienced violence, frequent inebriation, and being overweight. Conclusion DEB concern adolescent males more frequently than thought and seem to be integrated in a general dysfunctional context, in which violence is predominant. Adolescent males also need to be screened for DEB. Moreover, prevention programs should target the increasing social and media pressure regarding boys ideal body shape and raise public consciousness about this phenomenon.

Background: Gambling has and still entertains people in almost all societies throughout the world. Western societies have faced considerable changes in the amount and accessibility of gambling possibilities during the last decades, and the rates of both adolescent gamblers and problem gamblers have increased significantly. Objective: To determine the characteristics of at-risk and problem adolescent gamblers in Switzerland. Subjects: The study population consisted of 3134 students (1669 females) attending post-mandatory education in 15 randomly chosen centres. Participants were divided into non- (n=2207), non-problematic (n=754) and at-risk/ problematic gamblers (n=176). Methods: Both gambling groups were compared to non-gamblers on socio-demographic measures, substance use and Internet use. Overall, 29.6% had gambled during the past year and 5.6% had gambled in a risky or problematic way. Compared to non-gamblers and after controlling for potential confounders, non-problem gamblers were significantly more likely to be male, apprentices and to misuse alcohol. At-risk/problematic gamblers were additionally more likely to smoke cannabis, to be problematic Internet users and to be non-Swiss than non-gamblers. Conclusion: At-risk and problematic adolescent gambling is associated with other health risk behaviours. Health practitioners should include gambling in the psycho-social screening and preventive counselling of adolescents.

AIMS: To assess the cumulative impact of environmental and individual factors associated with adolescent alcohol misuse and their correlation with self-reported consequences of drinking. METHOD: Cross-sectional school-based survey of a nationally representative sample of 7548 post-mandatory school students and apprentices aged 16-20 years, Switzerland 2002. Alcohol misuse defined by frequency of alcohol use, episodes of drunkenness and driving while drunk. RESULTS: Fifteen significant risk factors were identified among both boys, and girls. An individual score of cumulated risk factors was created by adding the risk factors. The association between the score and the likelihood of being engaged in alcohol misuse was highly significant and dose-dependent (p

Study Objective To identify social and behavioral factors associated with unintended pregnancy among adolescents in Russia. Design Cross-sectional. Setting and Participants The investigation group consisted of 145 adolescents aged 15-19 years admitted to a youth-friendly clinic for induced abortion. The control group consisted of 77 sexually active never pregnant adolescent girls of similar age admitted for other reasons. Interventions Both groups completed a self-administered questionnaire about their occupation, educational level of their mother, family structure and socioeconomic status, relationship with their mother, sexual behavior, and substance use. Main Outcome Measures Factors associated with unintended pregnancy. Results In the bivariate analysis pregnant adolescents tended to have a lower educational level, to live in a nonintact family, to prefer stronger alcohol drinks, and to have a younger age at sexual debut and more frequent sexual intercourse. In the log-linear model six factors appeared to be directly linked to pregnancy: mother's lower education, alcohol consumption, nonintact family structure, low academic grades, higher frequency of sexual intercourse, and lower age at sexual debut. Conclusion Although the issue of unwanted pregnancy and possible ways to prevent it should be kept in mind in the psychosocial assessment of any adolescent, the results of our study suggest that some adolescents are at increased risk of unwanted pregnancy. This group includes adolescent girls with low educational attainment, living in a disrupted family, and reporting other risk behaviors. These adolescents might specially benefit from specific preventive programs to reduce the number of adverse outcomes.

Introduction Au vu de l’augmentation continue des frais de sante, les interventions des professionnels de la sante doivent etre efficaces et optimisees. Cette etude avait pour objectif de synthetiser le rapport cout/efficacite actuel de la physiotherapie. Les objectifs specifiques etaient d’analyser le rapport cout/efficacite de la physiotherapie en la comparant aux soins habituels seuls, d’analyser le rapport cout/efficacite de la physiotherapie ajoutee aux soins habituels par rapport aux soins habituels seuls et de preciser pour quelles pathologies la physiotherapie seule ou la physiotherapie ajoutee aux soins habituels offrait le meilleur rapport cout/efficacite. Methodes Nous avons recherche des analyses du rapport cout/efficacite de la physiotherapie dans les bases de donnees Medline, CINAHL, PEDro et Cochrane Library ; nous avons egalement consulte des revues systematiques sur papier. Nous avons inclus des etudes publiees entre 1998 et 2014 portant sur le rapport cout/efficacite des interventions de physiotherapie. La qualite methodologique a ete evaluee au moyen de l’outil d’evaluation du risque de biais Cochrane (Cochrane Risk of Bias Assessment) pour les etudes portant sur les interventions, ainsi qu’au moyen de la Quality of Health Economic Analyses Scale. Nous avons calcule les rapports cout/efficacite incrementaux (ICER) et rapporte les conclusions des auteurs ainsi que nos propres conclusions. Resultats Les 18 etudes incluses presentent un faible risque de biais. Elles contiennent 8 comparaisons de la physiotherapie seule avec les soins habituels seuls et 11 comparaisons de la physiotherapie en complement des soins habituels avec les soins habituels seuls. En se basant sur les ICER, la physiotherapie seule ou en complement des soins habituels offre un rapport cout/efficacite satisfaisant dans 9 comparaisons sur 19, et dans 10 comparaisons selon les conclusions des auteurs. Le rapport cout/efficacite de la physiotherapie a ete demontre pour les troubles musculosquelettiques tels que les cervicalgies, les lombalgies chroniques, l’arthrose du genou, l’arthrose de la hanche et le syndrome rotulien (articulation femoro-patellaire). Ce resultat est utile au vu de la prevalence elevee des troubles musculo-squelettiques. Il a aussi ete possible de montrer le rapport cout/efficacite de la physiotherapie pour les patients atteints de la maladie de Parkinson et de claudication intermittente. Discussion et conclusion La physiotherapie seule ou en complement des soins habituels permet une amelioration de l’etat de sante dans presque toutes les etudes. Le rapport cout/efficacite de ces interventions est demontre dans la moitie des etudes. Ce resultat peut avoir ete influence par le fait qu’il existe plusieurs definitions de la notion « cout/efficacite ». Il est probable que le caractere actif et formateur des interventions de physiotherapie contribue au bon rapport cout/efficacite. Les seances en groupes sont par ailleurs moins onereuses que les seances individuelles ; elles favorisent le partage benefique des connaissances entre patients atteints d’un meme probleme de sante. Le nombre de seances ne semble pas influer sur les couts. Cependant, une evaluation reguliere des effets du traitement (apres 6 a 9 seances par exemple) est recommandee pour limiter les depenses inutiles. A l’avenir, les etudes randomisees controlees evaluant l’efficacite de la physiotherapie devraient inclure une perspective socioeconomique.

Purpose: To assess whether there are individual, familial, academic or social differences between youths being overweight, obese or normal weight. Methods: Data were drawn from the GenerationFRee study, a cross-sectional survey including 5179 youths aged 15-24. Using Cole’s cut-off points of body mass index (BMI), individuals were divided into normal weight (NW; N=4291), overweight (OW; N=646), and obese (OB, N=242). Groups were compared on age, gender, emotional wellbeing, self-reported health status, family structure, relationship with father and with mother, life satisfaction, socioeconomic status, pubertal timing, popularity among peers, easiness to make friends, at risk for eating disorders, parents nationality, own nationality, and academic track. All variables at the bivariate level were included in multinomial logistic regression using NW as the reference category. Results are given as Relative Risk Ratios (RRR) with 95% confidence interval.