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Biomedical subjects

P A Michaud

Publications and source records attributed to P A Michaud.

At least 19 recordsLinked to original sources
PubMed2006

[Is it possible to run suicide prevention interventions within the school setting?].

Suicide represent the second cause of death in Switzerland and, between 15 and 20 years of age, 8% of girls and 4% of boys have attempted suicide at least once in their life. "Universal" primary prevention in schools is usually run through courses dealing with the issue of suicide and which are systematically provided to all pupils. There is no evidence that they have any positive effect and even they may be in some instances harmful. The training of professionals working in the school setting to better identify and refer adolescents facing risky situation is probably effective. Another promising approach is the one which aims at improving the school climate in increasing social connectedness and the pupils' life skills. Finally, the school which faces a suicide should set up debriefing activities, thus deterring vulnerable pupils to engage in violent acting as a result of a contamination process.

Adolescent↗
PubMed2005

[Sports activity during adolescence: a challenge for health professionals and for the society].

The rate of teenagers who engage in sports activity on a regular basis has decreased since ten years, whereas the rate of overweight and obesity is steadily increasing. This paper discusses the meaning as well as the limits of sports activity during adolescence. Guidelines for sports participation include: a discussion of the frequency and duration of sports training sessions, which have to be adapted to the growth and pubertal stage of the adolescent. Any symptoms suggesting overuse should be tackled seriously. Physician's counselling in the field of protective behaviour (injury prevention) is effective. Finally, the majority of chronic conditions are compatible with moderate sports activity.

Adolescent↗
PubMed2003

Prevalence and dimensions of sexual orientation in Swiss adolescents: a cross-sectional survey of 16 to 20-year-old students.

AIM: Sexual orientation plays an important part in building identity during adolescence. The aim of this study was to describe patterns of sexual orientation, including sexual attraction, fantasies, affiliations and behaviour. METHODS: The study was based on the analysis of data from computerized self-administered questionnaires of a Swiss national survey on the sexual life of 16 to 20-year-old adolescents (n = 2,075 girls and 2,208 boys.). RESULTS: Overall, 95.0% of girls and 96.2% of boys described themselves as predominantly heterosexual; 1.4% of girls and 1.7% of boys as predominantly homosexual or bisexual; and 2.8% of teenagers (girls: 3.6%; boys: 2.1%) were "unsure" of their sexual orientation. The reported prevalence of homosexual attraction (girls: 2.0%; boys: 2.9%) exceeded homosexual fantasies (girls: 0.4%; boys: 0.5%) and affiliations (girls: 0.3%; boys: 0.5%). Among the 4205 respondents, 31 girls (1.5% of girls) and 56 boys (2.5% of boys) reported sexual behaviour (experience or penetrative intercourse) with a person of the same sex. Among 1.5% of girls and 2.5% of boys who reported sexual behaviour with a person of the same sex, 65% of boys and 80% of girls nevertheless considered themselves as heterosexual. CONCLUSION: For a comprehensive understanding of sexual orientation in adolescence a differentiated look at dimensions of sexual orientation is indispensable. This applies to clinical settings, public health and research.

Adolescent↗
PubMed2002

Abortion requests among adolescents in comparison with young adults in a Swiss region (1990-1998).

AIM: To examine the recent evolution of abortion request rates among adolescents and young adults in the Canton of Vaud (Switzerland) and to describe the circumstances of the abortion requests and sociodemographic characteristics by age subgroups and nationality. METHOD: Data for women aged 14 to 24 y living in Vaud were selected from the 12,358 abortion requests from residents aged 14-49 y between 1990 and 1998. RESULTS: Overall, abortion request rates by age were stable over the study period. However, rates for non-Swiss women were two to three times higher than those for Swiss women, at 4.5 [95% confidence interval [CI]: 3.8-5.2] vs 2.4 [95% CI: 2.1-2.7] per 1000 adolescents below the age of 18, 18.1 [95% CI: 17.2-18.9] vs 8.0 [95% CI: 7.1-8.8] per 1000 women aged 18-19 and 30.5 [95% CI: 29.1-32.0] vs 10.2 [95% CI: 9.6-10.8] per 1000 women aged 20-24. The ratio of abortions to live births was greatest for women under 20 y of age. at 1.9, in comparison with the ratio observed among adult women aged 20-24 (at 0.4). The abortion rate per 1000 conceptions >6 wk remained stable; this rate was 590 per 1000 among 14-19-y-olds in 1997. CONCLUSION: The abortion request rate among youths in this Swiss region has not increased between 1990 and 1998. Efforts must be intensified to ensure universal access to family planning services and contraception, especially for young foreign women and adolescents.

Abortion Applicants↗
PubMed2002

[How to improve use of emergency contraception by adolescents?].

OBJECTIVES: To give an overview of knowledge on emergency contraception (EC) and its utilization in the adolescent population, and to present the practical guidelines useful for EC prescription. METHODS: Review of the literature on EC and results of a survey on sexual behavior of 16-20-year-olds in Switzerland are used. RESULTS: Both estrogen-progestin and estrogen are used for EC. Condom breakage, lack of compliance in oral contraception and failure in contraceptive use are the main reasons for using EC. Sexually active adolescents are aware of CPC and 20% of girls have used it in Switzerland. However, insufficient information and low quality of services in emergency situation could be important barriers to the use of EC. DISCUSSION: and conclusion. Practical knowledge and information on EC must be disseminated among adolescents and both professional training and development of the quality of services have to provide better access to EC.

Adolescent↗
PubMed2001

Mapping adolescent health and lifestyles in a multi-state country: methodological aspects and first results.

OBJECTIVES: To explore the feasibility of a geographical analysis (mapping) of data from a national adolescent survey. METHODS: Teenagers 15 to 19 years in high school or apprenticeship (N = 5275 boys and 3993 girls) answered a self-administered anonymous questionnaire targeting health and lifestyles. Switzerland was divided in 14 subunits, each one including at least 400 subjects: large cantons were isolated by themselves whereas smaller ones were aggregated taking into account common cultural, geographical and health characteristics. To minimize the impact of sample differences across the cantons, subsamples were weighted according to age, sex, and professional background. For each variable, the discretization of the values in five classes was performed using the threshold approach which maximizes intergroup differences and minimizes the intragroup differences. RESULTS: The analysis suggests different patterns of distribution depending on the type of variable studied: substance use differs mostly between urban and rural cantons, while mental health differs between French and German-speaking cantons. CONCLUSIONS: Whereas most available atlases are derived from population-based data (i.e., mortality rates), this research demonstrates the feasibility of using self-reported data from school-based survey samples. The presentation of data on attractive maps provides a unique opportunity for generating hypotheses as to the causes of differences across cantons in a multi-ethnic, multicultural country.

Adolescent↗
PubMed2001

Who are the adolescents who stop smoking?

UNLABELLED: In most industrialised countries, the number of adolescent smokers has increased dramatically during the past several years. Encouraging smokers to quit constitutes one of several methods to control smoking. To improve our understanding of quitting during adolescence and help professionals address the specific attributes and needs of those who quit, we compared the characteristics of youth who report having quit (former smokers, FS) with those of both "regular" smokers (RS) and nonsmokers (NS). As part of the Swiss Multicentre Adolescent Survey on Health, anonymous self-administered questionnaires were distributed to a national representative sample of 9268 15- to 20-year-old teenagers. A multiple logistic regression analysis showed FS to differ from NS for the following variables: suicide attempt (odds ratio, OR 2.10); sleeping difficulties (OR 1.67); delinquency (1.61); assault (OR 1.55); painting of graffiti (OR 1.52); shoplifting (OR 1.51); dissatisfaction with academic choices (OR 1.46); suffering from back problems (OR 1.31); belonging to a sports club (OR 0.78); receiving good marks at school (OR 0.75); and having a positive future expectation with regard to health (OR 0.74). FS differed from RS for the following variables: practising sport (OR 2.18); scouting (OR: 1.97); shoplifting (OR 0.63); tardiness (OR 0.63 and having many friends (OR 0.59). CONCLUSION: Former smokers resemble regular smokers as far as mental health and general health are concerned, whereas they behave similarly to nonsmokers in the field of social and sports activities.

Adolescent↗
PubMed2001

Cross-cultural surveys of adolescent health and behavior: progress and problems.

Adolescent health surveys administered in different countries or regions often are described as cross-cultural. Although most include youth of different ethnic and cultural groups, few attempt to define these constructs or to collect data that allow their characterization. This paper explores four challenges shared by large-scale surveys of adolescent health-related behaviors and beliefs. First, adolescent health investigators have used the terms culture and ethnicity loosely. The growing interest in contextual analysis demands standardization of the definitions as they apply to adolescents, followed by correct usage of the terms. Hypotheses regarding the associations between race, ethnicity, culture, health-related behaviors, and health outcomes should be clearly stated and incorporated into conceptual models. Second, cross-cultural analyses are interpretable only when the study designs and sampling methods provide adequate representation of cultural and ethnic minorities and when the survey items allow differentiation of factors related to race, ethnicity, culture, and socioeconomic factors. Third, cross-cultural research may expose traditions, beliefs, and behaviors that are supported by one population yet criticized by another. Investigators must recognize their own personal biases and must work collaboratively to analyze and interpret their data correctly. Fourth, generalizations about cultural/ethnic comparisons can evoke powerful emotional reactions. Interpretation and dissemination of research findings should be done sensitively and with the help of experts from the cultural/ethnic groups that have been studied.

Adolescent↗
PubMed2001

Sports activities related to injuries? A survey among 9-19 year olds in Switzerland.

BACKGROUND: Most data on sports injuries are gathered in clinical settings so that their epidemiology in the general population is not well known. OBJECTIVE: To explore the link between sports injuries with the type and the amount of sports activity and biological factors. METHODS: In 1996, 3,609 in-school adolescents 10-19 years (1,847 girls and 1,762 boys) participated in a regional survey. This included anthropometric measurements and a self administered questionnaire. RESULTS: Altogether 28.2% of girls and 35.9% of boys reported one or more sports injuries during the previous year and 2.1% of girls and 6.5% of boys reported at least one hospitalization due to a sports injury. Using the mean rate of injuries as reference level, some sports are highly related to injury occurrence: body building (relative risk (RR) 1.7, 95% confidence interval (CI) 1.5 to 1.9), skateboarding and rollerskating (RR 1.6, 1.4 to 1.8), athletics (RR 1.5, 1.3 to 1.7), snowboarding (RR 1.5, 1.4 to 1.6), basketball (RR 1.3, 1.2 to 1.4), soccer (RR 1.3, 1.2 to 1.4), and ice hockey (RR 1.2, 1.1 to 1.3). Using a logistic regression, several variables associated with a higher risk of injury were identified: the amount of physical activity, high risk sports, and Tanner pubertal stages. CONCLUSION: The risk of sports injury increases not so much with age but with exposure to specific sports and with pubertal development.

Adolescent↗
PubMed2000

First sexual intercourse and contraception: a cross-sectional survey on the sexuality of 16-20-year-olds in Switzerland.

BACKGROUND: The onset of sexual activity represents an important development stage with positive aspects, such as love, discovery, intimate relationships, plans for the future, but also with fears of pregnancy, of sexually transmitted diseases and of AIDS. OBJECTIVE: To study perceptions, attitudes, and behaviour related to sexual life, AIDS and contraception; to explore the onset of first sexual relationships and the process of choice of a contraceptive method by the adolescents, in order to improve prevention programmes for young people. METHOD: Analysis of data from a Swiss national survey on adolescent sexuality using a computerised self-administered questionnaire, involving 2075 girls and 2208 boys between the ages of 16 and 20. The use of computers helps improve confidentiality, response rates and acceptability since survey questions are limited to the subjects' sexual experience only. RESULTS: The young people's responses emphasised the importance of emotion in sexual relationships, girls choosing intimacy and fidelity while boys attached more importance to physical pleasure. Three out of four respondents have had a sexual experience and one out of two have had penetrative sexual intercourse. The percentages of condom or oral contraception use are high: at first sexual intercourse, 86.5% used one or the other, while 7.4% did not declare any contraceptive method. The percentages are lower when age at first intercourse is below 15 years, when a girl had an older partner (age difference 7 years and more) and when the 1st relationship is a casual one. During their first stable relationship 41.1% of girls and 30.9% of boys say they have changed their contraceptive method from condom to contraceptive pill, 2.4% of girls and 2.9% of boys say they have given up any form of contraception. Among girls, condom use at first sexual intercourse with a new partner decreases in favour of oral contraception between first and last steady relationships (75.6 vs 58.0%, p < 0.05), the decrease being insignificant between the first and last casual relationships (73.5 and 62.2%, n.s.). Among boys the rates of condom use are equal at first intercourse with the first and last partner (steady relationship: 74.1 and 77.2%; causal relationship: 78.3 and 76.2% respectively). CONCLUSION: The use of condoms is high among Swiss adolescents, particularly at first sexual intercourse. By integrating the prevention of sexually transmitted diseases and of unwanted pregnancies, preventive programmes would address adolescents' needs more effectively.

Adolescent↗
PubMed2000

[A clinical questionnaire for facilitating consultation with the adolescent].

The use of a self-administered questionnaire, filled in by the adolescent before the first encounter with a physician, represents an excellent screening tool. The questionnaire is highly confidential and its use is optional. This paper analyses the way the questionnaire was accepted and used by 361 young patients, during the first year of activity of the Multidisciplinary Unit for Adolescent Health in Lausanne. It shows the kind of problems which were reported by the adolescents, depending on their gender, their age and their reason for visit. The questionnaire serves several purpose: firstly, it outlines the global conception of health which forms the basis of the multidisciplinary approach used within the UMSA. Secondly, it constitutes a kind of guide for younger physicians training in adolescent medicine and allows them to screen in an appropriate period of time a large array of themes pertaining to health problems and symptoms, mental health, well-being, lifestyles and finally personal as well as environmental resources. Finally, it allows the young patient to disclose preoccupation or problems on very personal, intimate matters, which would be difficult to discuss openly in a first face to face interview. The experience gained during nine months shows that the questionnaire is very well accepted and useful. It's content will however be improved, since, in the opinion of both the patients and the staff, it still is too much focused on negative and problematic issues and not enough oriented towards resources and resilience.

Adolescent↗
PubMed2000

[The practitioner's office as a place for preventive measures for adolescents].

During adolescence, health care and health prevention activities are closely linked. In his office, every physician can have an impact on his young patients' health in different ways: screening for unmet health needs, increasing this adolescent's compliance in providing him with adequate information, discussing the consultant's behaviour and lifestyles, etc. Routine examinations (like before sports camp or entry into apprenticeship) represent excellent opportunities for such preventive activities. Finally, in this activity, the physician should evaluate and make use of his patient's resources; as well, he should not underestimate the impact of the adolescent's environment (climate in the family, social environment, working conditions, etc.).

Adolescent↗
PubMed2000

Drinking behaviour among teenagers in Switzerland and correlation with lifestyles.

UNLABELLED: Several criteria (frequency, hazardous use, drunkenness) were used to delineate four distinct groups and to analyse the relations between patterns of alcohol use and other health variables. In the 1993 Swiss Multicentre Adolescent Survey on Health, anonymous self-administered questionnaires were distributed to a national representative sample of in-school 15 to 20-year-old adolescents. Of the respondents, 25% answered a module targeting alcohol use (n = 2359) of whom 13% were totally abstinent, 55.1% were moderate drinkers (< or = 1 drink/week and < 3 times drunk), 21.7% were 'social' drinkers (> 3 times drunk and < twice driven when drunk) and 10.2% were 'problem drinkers' (> twice driven whilst drunk or > 1 drink/day). Differences between problem drinkers and the rest of the sample showed the former as being predominantly boys with an odds ratio (OR) of 6.3, having a higher lifetime prevalence rate of cannabis use (OR = 3.4), never using seat belts (OR = 2.5), having their family/peers more often involved in alcohol consumption (OR = 1.9), being predominantly apprentices (against high school pupils OR = 1.9), having cheated during courses (OR = 1.9), being a member of a gang (OR = 1.7), having stolen in a public area (OR = 1.7) and having considered suicide (OR = 1.8). CONCLUSION: Within the Swiss context, whereas moderate/occasional use of alcohol must be considered as part of an adolescents' development, regular use of alcohol, often associated with drunkenness and driving while drunk, is associated with various health hazards and problems. Preventive strategies should be built accordingly.

Adolescent↗
PubMed2000

[Adolescents and ambulatory care: results from a national survey of young people 15 to 20 years of age in Switzerland].

UNLABELLED: In industrialized countries, statistics on health services exhibit a low level of health care use by adolescents, despite the fact that their needs have been widely described. OBJECTIVES: To assess ambulatory health care use by 15-20-year-old teenagers in Switzerland. METHOD: Nine thousand, two hundred and sixty-eight adolescents responded to the self-administered questionnaire distributed in secondary schools and vocational classes for the Swiss Adolescent Health Survey. Questions about visits to general practitioners, specialists and gynecologists, reasons for visit, the availability of a regular health care provider and a confidential health care resource were analysed. RESULTS: Within the previous 12 months, 87.6% of the girls and 75.3% of the boys reported having seen a physician. General practitioners were visited more frequently than specialists. The contact with a specialist was the only one to be related to socio-demographic variables: a lower proportion of reported visits to a specialist was related to apprenticeship, low educational status of parents or rural living area. Thirty-nine percent of the girls reported having seen a gynecologist during the previous 12 months. Two adolescents out of three reported having a personal doctor, and one out of two declared being aware of a confidential health care resource. Girls reported a larger number of reasons for visits than boys: chronic conditions, fatigue, headache and depressive symptoms were the most often cited in a list of ten reasons. Among the subjects who declared a health concern (sleep disturbances, eating disorders, depressive symptoms, smoking or alcohol-related problems) and a need for help, less than 10% declared having seen a health care provider for this reason, even if more than 70% reported contact with a physician within the last 12 months. CONCLUSION: These results show that most adolescents, especially girls, reported recent use of medical services, but did not discuss their health concerns with the doctor. Training should be improved to give better knowledge and counseling skills to health professionals, in order to allow them to address adolescents' health needs.

Adolescent↗
PubMed2000

Food and nutrient intakes in a group of 11 to 16 year old Swiss teenagers.

Better knowledge of the dietary intake of teenagers is necessary to help health professionals to provide better advice on an individual and data for prevention and health programme. We carried out a dietary survey by 3-day records technique in a group of adolescents living in the Canton of Vaud, Switzerland. Food habits were traditional but rich in refined products and poor in plant food. Mean daily energy intake, which was 8025 kJ for the girls and 9350 kJ for boys, was lower than the recommended dietary allowances, especially for girls. Independently of the gender, breakfast represented 19% of the total daily energy intake, lunch 31% and dinner 29%. Total energy provided by snacks was 23.0% for girls and 20.4% for boys. The percentage of energy supplied by the afternoon snack was 15.8% for the girls and 13.3% for the boys. The source of energy was 14% from protein, 37% from fat and 49% from carbohydrates. A high percentage of adolescents had low micronutrient intakes (vitamins A, E, B1, B6, C, folates and for minerals magnesium, calcium and iron). An increase intake of vegetables and fruit should thus be strongly encouraged; snacking could offer a target vector to improve dietary nutritional quality.

Adolescent↗