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Un regard sur l’histoire des médecins scolaires (MS) montre que leur activité a toujours été étroitement liée aux conditions de vie et à la situation sanitaire des enfants, adolescent-e-s, leurs familles et leur entourage. Les MS travaillaient en réseau avec les institutions dans lesquelles se trouvent les enfants et qui agissent autour de l’enfant, et ils entretenaient le contact avec les groupes marginaux. Il s’agissait en première ligne de rattraper celles et ceux qui tombaient entre les mailles du système; cela pour permettre, au moyen d’une approche à bas seuil et si nécessaire active, l’accès aux soins et à la prévention à toutes et tous, indépendamment du statut social.

Zusammenfassung. Humane Papilloma Viren sind assoziiert mit diversen genitalen (Zervix-, Anal-, Vulva- und Vagina-, Peniskarzinome) und nicht-genitalen Karzinomen (Oropharyngealkarzinome), sowie mit Genitalwarzen. In der Schweiz sind zwei hochwirksame Impfstoffe erhältlich, die über ein sehr gutes Sicherheitsprofil verfügen. Die Sicherheit der Impfstoffe wurde immer wieder kontrovers diskutiert, konnte jedoch bis anhin stets bestätigt werden. In der Schweiz wird seit 2008 im Rahmen von kantonalen Programmen die Impfung für Mädchen und junge Frauen angeboten. Seit 2015 gibt es neu die Impfempfehlung für Knaben und junge Männer, die auf Juli 2016 mit Kostenübernahme in die Programme integriert wird. Im Artikel werden die Krankheitslast, die Wirksamkeit und die Sicherheit der Impfung diskutiert, sowie die Anwendung der Impfstoffe vorgestellt. Speziell wird der ärztliche Umgang mit der Urteilsfähigkeit von Jugendlichen zur Einwilligung zu Impfungen besprochen. Es folgt ein Ausblick auf die Zukunft v.a. auf einen neuen Impfstoff mit erweitertem Spektrum von HPV-Typen.

Erworben im Rahmen der Schweizer Nationallizenzen (http://www.nationallizenzen.ch)

This chapter describes the evolution of school health services in Albania and three former republics of the Soviet Union: the Republic of Moldova, Tajikistan, and Ukraine. The four countries share a very similar historical and health system context in which school health services evolved. After independence in the early 1990s, the health care systems in these countries faced major financing problems with massive exodus of school health personnel. The accumulation of unresolved issues inherited from the Semashko centralized state-owned model of healthcare organization and management, exacerbated by certain aspects of health care reforms after independence triggered the need to reform school health services. Between 2007 and 2012, with WHO support these countries embarked in a process of revision of school health services. This chapter describes the step-by-step approach that these countries undertook, and its main results.

Human Papilloma Viruses are associated with genital carcinoma (of the cervix, anus, vulva, vagina and the penis) as well as with non-genital carcinoma (oropharyngeal carcinoma) and genital warts. In Switzerland two highly efficient and safe vaccines are available. The safety of these vaccines has been repeatedly subject of controversial discussions, however so far post marketing surveillance has always been able to confirm the safety. In Switzerland girls and young women have been offered the HPV vaccination within cantonal programmes since 2008. 2015 the recommendation for the HPV-vaccination for boys and young men was issued, and starting July 1, 2016 they as well will be offered vaccination free of charge within the cantonal programmes. This article discusses the burden of disease, efficacy and safety of the vaccines and presents facts which are important for vaccinating these young people. Specifically, aspects of the decisional capacity of adolescents to consent to the vaccination are presented. Finally, the future perspective with a focus on a new vaccine with an enlarged spectrum of HPV-types is discussed.

Purpose To select and propose a set of knowledge, attitudes, and skills essential for the care of adolescents; to encourage the development of adolescent health multidisciplinary networks; and to set up training programs in as many European countries as possible. Methods The curriculum was developed by 16 physicians from 11 European countries with various professional specializations. In line with modern guidelines in medical education, it is a modular, flexible instrument which covers the main teaching areas in the field, such as basic skills (i.e. setting, rights and confidentiality, gender and cultural issues) as well as specific themes (i.e. sexual and reproductive health, eating disorders, chronic conditions). It consists of 17 thematic modules, each containing detailed objectives, learning approaches, examples, and evaluation methods. Result Two international one-week summer schools were used to assess the feasibility and appropriateness of the curriculum. The overall evaluation was good, with most of the items surpassing three on a four-point Likert scale. However, it pointed to several aspects (process and content) which will need to be refined in the future, such as an increase in interactive sessions (role playing), and a better mix of clinical and public health issues.

Objective To assess and compare the training needs in adolescent medicine of doctors within 6 specialties as a basis for the development of pre/postgraduate and continuing medical education (CME) training curricula. Design Cross-sectional postal survey. Setting Switzerland. Participants National, representative, random sample of 1857 practising doctors in 6 disciplines (general practitioners, paediatricians, gynaecologists, internists, psychiatrists, child psychiatrists) registered with the Swiss Medical Association. Main outcome measures Perceived importance of and training interest in 35 topics related to adolescent medicine listed in a self-administered, anonymous questionnaire. Results A total of 1367 questionnaires were returned, representing a response rate of 73·9%. Clear interest in adolescent medicine was reported by 62·1% of respondents. Topics perceived to be the most important in everyday practice were functional symptoms (71·4%), acne (67·1%), obesity (64·6%), depression-anxiety (68·1%) and communication with adolescents (61·7%). Differences between disciplines were especially marked for gynaecologists, who expressed interest almost exclusively in medical topics specific to their field. In contrast, other disciplines commonly reported a keen interest in psychosocial problems. Accordingly, interest in further training was expressed mostly for functional symptoms (62·4%), eating disorders (56·3%), depression-anxiety (53·7%) and obesity (52·6%). Issues related to injury prevention, chronic disease and confidentiality were rated as low priorities. Conclusions Regardless of discipline, Swiss primary care doctors expressed a strong interest in adolescent medicine. Continuing medical education courses should include both interdisciplinary courses and discipline-specific sessions. Further training should address epidemiological and legal/ethical issues (e.g. injury prevention, confidentiality, impact of chronic conditions).