Yara Barrense-Dias

Transition from paediatric to adult care: what makes it easier for parents?

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 < .1 were included in a logistic regression. Results are presented as adjusted odds ratio (aOR). RESULTS Over one third of parents (27/72) reported a difficult transfer. At the multivariate level, higher socioeconomic status (aOR: 7.74), parents feeling ready for transfer (aOR: 6.54) and a good coordination between teams (aOR: 7.66) were associated with an easy transfer. CONCLUSIONS An easy transfer for parents is associated with feeling ready and considering that the coordination between teams is good. Health providers should consider these requisites for a successful transfer.

Consuming energy drinks at the age of 14 predicted legal and illegal substance use at 16.

This study examined whether consuming energy drinks at the age of 14 predicted substance use at 16.

Disordered Eating: The Young Male Side

ABSTRACT 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.

Alcohol misuse and gateway theory: a longitudinal study among adolescents in Switzerland

Abstract 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.

Youth With Chronic Conditions and Risky Behaviors: An Indirect Path

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

Daily internet time: towards an evidence-based recommendation?

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 todays 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.

Risk behaviours among native and immigrant youths in Switzerland: a cross-sectional study

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

Monitoring screen use: a qualitative exploration of family strategies in Swiss homes

Abstract Background Digital technologies make family managing more complicated, as parents are worried about their children’s well-being and want to protect them from excessive Internet use. Objective The objective of this study was to investigate both youths’ and parents’ views on strategies and rules set at home to regulate and monitor Internet use. Subjects Thirty-five adolescents (19 females), aged between 11 and 18 years, and 27 parents (17 mothers) from the French-speaking part of Switzerland participated in different focus groups. Methods Using a qualitative approach, results were analyzed using the grounded theory. Results Eight different mediation strategies emerged. One relevant finding is that rules regarding problematic content were never mentioned, while rules about screen time and location of use were numerous. This might indicate that parents are more worried about the time spent in front of the screen than about the actual activities their children engage in. Conclusions It could be recommended to parents to keep striving for an environment contributing to open discussion and exchange on Internet use, even if their digital literacy is lower than their youngsters’ are.