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Résumé Objectifs Actuellement, les services d’accueil des urgences pédiatriques (SAUP) vivent une hausse de fréquentation par des cas « non urgents », souvent reflets d’une angoisse des parents ou d’une mauvaise compréhension des informations médicales reçues. Face à ce constat, l’objectif de cette étude était de connaître l’expérience et les besoins des familles usagères des SAUP afin de proposer des solutions adaptées. Méthodes Entretiens semi-directifs et questionnaires aux parents, après la consultation ou en salle d’attente. Résultats Expérience très satisfaisante sur la qualité de la prestation médicale, la relation soignant–enfant et l’attitude générale des soignants. Les points critiques concernaient l’accueil (aspects pratiques et organisationnels essentiellement), l’attente, ainsi que divers points liés à la relation soignants–familles. Discussion Les préoccupations des parents sont multidimensionnelles, allant du stress de voir leur enfant malade à des questions purement organisationnelles. Leur inquiétude influence la décision de se rendre aux SAUP, le vécu de la prise en charge, et surtout de l’attente, ainsi que le jugement sur la qualité médicale de la consultation. Les familles souhaitent plus de communication et de présence de la part des soignants. Sur la base de leurs suggestions, nous proposons une structuration de la prise en charge relationnelle en quatre temps (temps d’attente, d’écoute, d’information et de validation finale). Conclusions Les familles, témoignant d’un stress global, demandent principalement à se sentir rassurées, entendues et informées. Par ailleurs, réfléchir globalement (en termes de santé publique) à la prise en charge des cas « non urgents », reste évidemment d’actualité. Summary Objective Today, pediatric emergency services receive a rising number of “non-urgent” cases, which are due to parental anxiety or a miscomprehension of medical explanations. The aim of this study was therefore to understand what those families experience and need when they consult in such cases, in order to respond with adapted solutions. Methods Semi-structured interviews and questionnaires with parents, after the consultation or in the waiting room. Results Based on the families’ narratives, we present the results in six steps, which correspond to the steps they experience from the decision to go to the hospital to the consultation. Families’ experiences are very satisfactory regarding the quality of medical care, the relationship between staff and children, and the staff's overall attitude. Critical points concern practical aspects (parking, food, and play facilities); the waiting time and the lack of information; and the communication between the medical staff and the parents, most particularly related to their anxiety and waiting time. Discussion The results show first that parents have multiple preoccupations: many stress factors and organizational difficulties are added to their child's disease. These preoccupations are mostly related to the lack of information about the waiting time, information that they would need to organize their day and their time in the hospital. Second, the results show that parental anxiety influences their decision to come to the emergency department, their experience of care and of the waiting time, and their judgment about the quality of the medical care. Considering this, families requested practical improvements (i.e., more toys in the waiting room), and suggest more communication and presence from the medical staff. Based on their demands, we suggest an agenda of care in four steps: a waiting time, a time for sharing, a time for information giving, and a validation time. Conclusions Overall, parents are stressed and anxious when they come to the emergency department and request more reassurance, attention, and explanations from the healthcare staff. We propose a final “validation time” to verify that the medical explanations are understood as well as the emotional state of the family. In this way, we can ensure good follow-up care at home, avoid unnecessary readmissions, and promote parental health education. [ABSTRACT FROM AUTHOR]

The article focuses on the positive impact of using internet on children and adolescents. A study conducted by doctor Richard E. Belanger revealed that intensity of internet use and depressive tendencies among youth are connected to each other. Nonuse of internet may be the sign of social isolation and depressive symptoms among teenagers.

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.)

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.)

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.