[MAYbe Less Sugar : a campaign to prevent sugar overconsumption]. / MAYbe Less Sugar : une action pour lutter contre la surconsommation de sucre.

Swiss people consume an average of 107g of sugar per day whereas a maximum of 50g is recommended. During May 2023, the MAYbe Less Sugar initiative invited people from the French-speaking part of Switzerland to investigate their use of added sugar. An online calculator enabled them to evaluate it so they could take action. The campaign reached 6 920 participants and more than 11 000 people via the website maybeless-sugar.ch and social networks. In addition, numerous events and media coverage have put sugar at the heart of the debate. Although people who overconsume sugar were targeted, they are still difficult to reach. The 37 partners plead for MAYbe Less Sugar to be continued and involve health professionals as well as politicians in order to change behaviors but also the environment that should become conducive to health for everybody.

Les Suisses consomment en moyenne 107 g de sucre par jour, soit plus du double du maximum de 50 g recommandé. En mai 2023, l'initiative MAYbe Less Sugar a invité la population de Romandie à s'intéresser à sa consommation de sucres ajoutés et l'évaluer grâce à un calculateur en ligne, pour pouvoir agir. L'action a atteint 6 920 participants et plus de 11 000 personnes via le site https://maybeless-sugar.ch et les réseaux sociaux. En outre, de nombreux événements et relais médiatiques ont mis le sucre au centre du débat. Bien que l'action ciblait les personnes les plus concernées, celles-ci restent difficiles à toucher. De l'avis des 37 partenaires, MAYbe Less Sugar devrait se reconduire et impliquer les professionnels de la santé ainsi que les politiques, pour faire évoluer les comportements mais aussi l'environnement afin qu'il devienne favorable à la santé de tous.

[Offer a physical activity to the patient : the platform "Je me bouge pour ma santé" ("I move for my health")]. / Proposer une activité physique aux patient-e-s : la plateforme « Je me bouge pour ma santé ¼.

Adapted physical education services are numerous but their access is limited by scattered and disease-linked information. « Je me bouge pour ma santé¼ website centralizes the offers available in the canton of Vaud. Any sedentary people wishing to move again can thus find an adapted physical activity program. This website proposing more than 300 offers is a useful tool for patients, their medical doctors, or other health professionals who want to counsel and help them find an adapted physical activity.

Les offres d'activité physique adaptée sont nombreuses mais leur accès est entravé par la dispersion des informations souvent ciblées par maladie. Le site « Je me bouge pour ma santé ¼ recense les prestations proposées dans le canton de Vaud pour permettre à toute personne sédentaire souhaitant se mettre, ou se remettre, à bouger de trouver chaussure à son pied, quels que soient ses besoins, attentes et limitations fonctionnelles. Le site regroupe plus de 300 offres et constitue un outil utile tant pour les personnes concernées que pour les médecins et autres professionnel-le-s de la santé souhaitant les conseiller pour la reprise d'une activité.

[Results from a community based diabetic foot screening campaign]. / Résultats d'une campagne de dépistage du pied diabétique.

A community-based diabetic foot screening campaign was introduced during one week in the French-speaking part of Switzerland to emphasize the preventive impact of systematic foot inspections. Of 494 screened people, 46 % never had their feet checked - and as many as 63% if only standardized examinations according to the recommendations are considered. The risk of diabetic foot complications may appear as early as a few years after diagnosis, underlining the importance of a systematic annual check-up.

Une campagne de dépistage gratuit du pied diabétique a été organisée en Suisse romande pendant une semaine afin de sensibiliser les personnes diabétiques à l'importance de contrôles réguliers des pieds et d'améliorer l'accès aux soins pour tous. Sur les 494 personnes dépistées, 46 % n'avaient pas eu de contrôle préalable des pieds ­ et même 63 % si l'on ne considère que les examens réalisés selon les standards recommandés. Les risques de complication peuvent apparaître dès les premières années suivant le diagnostic, soulignant l'importance d'un contrôle annuel systématique.

Interest in and use of person-centred pharmacy services - a Swiss study of people with diabetes.

BACKGROUND: Diabetes is one of the most important chronic diseases and affects 9% of the world's population. To support these people in the day-to-day management of their treatments, pharmacies can offer professional pharmacy services. These are defined as one or more actions organized or provided in a pharmacy to optimize the process of care, with the goal of improving health outcomes and the value of healthcare. Such services have to be tailored to the needs and interests of patients. This study aimed to evaluate interest in and use of pharmacy services among people with diabetes in the canton of Vaud, Switzerland. METHODS: This cross-sectional study analysed self-reported data from 790 people with diabetes included in the CoDiab-VD cohort. Questions focused on sociodemographic and economic characteristics, diabetes and its management, and interest in and use of pharmacy services related to (1) medication intake and adherence and (2) diabetes and general health. Descriptive analyses were first conducted. Logistic regression analyses were then performed for pharmacy services that were of interest to ≥50% of respondents. RESULTS: The mean age of participants was 66 years, and the sample included more males (59%) than females. The pharmacy services that interested the most respondents were individual interview, pill boxes or weekly pill boxes, treatment plans, checks of all medications, first medical opinions from pharmacists and counselling on devices. Factors significantly associated with interest in pharmacy services were being older, having a lower self-efficacy score, taking more than three medications and having a positive opinion about pharmacists. CONCLUSIONS: This study provides key information on interest in and use of pharmacy services among patients with diabetes in Switzerland; it should help pharmacists individualize their services for patients.

[EVIVO program adapted for the labor sector†: a help for managing chronic condition and professional life]. / Adaptation du cours EVIVO au secteur du travail : concilier maladie chronique et vie professionnelle.

EVIVO is a well-established chronic disease self-management program, having been successfully implemented during the last decade in Switzerland. The program has shown positive results in facilitation of self-management competences for patients living with chronic diseases and their relatives. EVIVO was designed to run for 6 weeks with weekly sessions of 2 and a half hour each. We tested the effectiveness of a shortened version of EVIVO, running it over five half days in order to make it more focused for patients who are challenged by managing their chronic illness within the context of their professional life. Participants in the five-session version showed comparable self-efficacy levels compared with those who had attended the standard six-week six-session courses. Overall, the five-session version was well accepted, considered very useful, met the participants' needs and changed their perception of their own expectations towards self-management of their illness.

Le cours EVIVO «â€…Devenir acteur de sa santé avec une maladie chronique ¼ a été implémenté en Suisse et s'est montré utile pour aider les personnes concernées et/ou leurs proches à renforcer leurs capacités à gérer la maladie et vivre le quotidien de manière plus positive. Structuré sur 6 semaines à raison d'une session de 2 h 30 par semaine, il a été reformaté sur 5 demi-journées afin d'être implémenté dans le monde du travail. L'évaluation d'EVIVO sur 5 sessions montre des résultats comparables dans l'évolution du sentiment d'autoefficacité comparable au cours sur 6 sessions. De plus, la version en 5 sessions ciblant les enjeux liés au travail s'est globalement révélée acceptable, utile et répondant aux besoins des participant·e·s qui ont exprimé avoir changé leurs attentes envers l'autogestion de leur maladie.

[Non-communicable diseases and vulnerable populations: overview of the situation and vision for the future]. / Maladies chroniques et populations vulnérables : état des lieux et vision d'avenir.

The care of vulnerable people with non-communicable diseases faces numerous barriers including difficulties in identifying affected people, lack of time, resources, tools and skills to address these issues, poor intersectoral work between health-care and social work. We plea for a systematic public policy which allows to implement intersectoral collaborations at all levels.

La prise en charge des personnes vulnérables vivant avec des maladies chroniques rencontre de nombreuses difficultés, dont l'identification des populations concernées, le manque de temps, de ressources, d'outils et de compétences pour traiter ces questions et l'insuffisance du travail intersectoriel entre la santé et le social. Une politique publique systématique est nécessaire pour mettre en œuvre des collaborations intersectorielles à tous les niveaux.

[Cantonal diabetes Program - a response at local level to address public health issues related to non-communicable diseases]. / Programme cantonal Diabète Vaud - Une réponse aux enjeux de santé publique liés aux maladies chroniques à l'échelle d'un canton.

In 2010 the canton of Vaud has innovated by launching the Cantonal Diabetes Program (PcD) aimed at reducing the impact of diabetes on the population. The evaluation after 7 years shows that some clinical examinations are performed more regularly and lower limb amputations tend to decrease. The contributions and interprofessional collaborations resulting from the PcD provide concrete guidelines for the implementation of a more comprehensive strategy of prevention and management of non-communicable diseases. It should be developed according to a chronicity model integrating social vulnerability.

Les autorités sanitaires du canton de Vaud ont innové en lançant en 2010 le Programme cantonal Diabète (PcD) dans le but de diminuer l'impact du diabète sur la population vaudoise. Le bilan réalisé après sept ans montre une amélioration de certains contrôles systématiques et une diminution des amputations des membres inférieurs. Les contributions et les collaborations interprofessionnelles résultant du programme fournissent des pistes concrètes pour la mise en œuvre d'une stratégie plus globale de prévention et prise en charge des maladies non transmissibles. Elle devrait se développer selon un modèle de chronicité intersectoriel intégrant notamment la vulnérabilité sociale.

[Virtual reality: a tool that can be used in outpatient diabetes services]. / Réalité virtuelle : un outil utilisable en consultation diabétologique.

Health-related emerging technologies are growing fast. The use of virtual reality in diabetes outpatient care still remains unprecedented, notably in Switzerland. Thus, the Programme cantonal Diabète led a pilot study to assess the feasibility of an immersive application in such an outpatient setting. Results emphasize that this device is practicable and useful in diabetes care. Patients and their relatives overall appreciate the game, each of them for specific reasons: playful quality, opportunity to « learn differently ¼ or to exchange about the subjective experience. Furthermore, there is no restraint (age, language, educational level…) in the ability to use such a device, except for emerging technologies habit.

L'utilisation des nouvelles technologies en lien avec la santé est en plein essor. L'usage de la réalité virtuelle en consultation diabétologique reste cependant un domaine inédit, notamment en Suisse. Partant de ce constat, le Programme cantonal Diabète a mené une étude-pilote, questionnant la faisabilité de l'emploi d'une application immersive dans le domaine des soins. Les résultats montrent que l'utilisation du dispositif testé est envisageable et utile. Le jeu est globalement très bien reçu par les patients et leurs proches, chacun y trouvant un apport spécifique : côté ludique, possibilité d'apprendre autrement ou encore de dialoguer sur le vécu subjectif. En outre, aucune des caractéristiques (âge, langue maternelle …) n'entrave la capacité d'utilisation d'un tel dispositif, si ce n'est l'habitude des nouvelles technologies.

Awareness and practices regarding eye diseases among patients with diabetes: a cross sectional analysis of the CoDiab-VD cohort.

BACKGROUND: The increasing prevalence of diabetes is leading to a rise of eye diseases, augmenting the risk of sight-threatening complications. The aim of this study was to evaluate prevalence, awareness and practices regarding eye diseases among patients with diabetes in the canton of Vaud, Switzerland. METHODS: A cohort of 323 patients with diabetes completed a self-administered questionnaire assessing prevalence, awareness and practices regarding eye diseases, besides health status and quality of care measures. Descriptive analyses followed by exploratory subgroup analyses and linear regressions were performed to investigate factors associated with awareness and practices. RESULTS: While diabetic retinopathy was reported by 40.9% of patients with type 1 diabetes and 9.8% of patients with type 2 diabetes, 35.8% and 12.6% of all participants reported cataract and glaucoma, respectively. Awareness that diabetes could damage the eyes was reported by almost all participants; the majority was also aware of the importance of glycemic control and regular eye examination in preventing eye diseases. In contrast, only 70.5% of participants underwent an eye examination by an ophthalmologist during the past year. Eye examination was associated with better patients' awareness. Barriers mentioned by patients revealed a lack of knowledge about screening guidelines, in particular regarding the preventive nature of eye examinations. CONCLUSIONS: Despite high levels of awareness regarding diabetic eye diseases, a significant proportion of patients with diabetes did not report annual eye examination. Both healthcare strategic efforts targeting the promotion of regular eye examination and initiatives aiming at improving knowledge of screening guidelines should be encouraged. TRIAL REGISTRATION: ClinicalTrials.gov on 9th July 2013, identifier NCT01902043 (retrospectively registered).

[Protection from exposure to second-hand tobacco smoke in the canton of Vaud : review and outcomes]. / Protection contre la fumée passive dans le canton de Vaud : rétrospective et bilan.

At the beginning of the 2000's the dissemination of scientific evidence, public opinion shift and the example of private or public workplaces led the Latin part of Switzerland to plead for a comprehensive smoke-free ban. In the canton of Vaud, the smoke-free public places law entered into force on September 15th 2009 after a 3-year process initiated by a popular initiative. Key factors included public awareness and information actions, civil society engagement and the involvement of every stakeholder. Smoke-free public- and workplaces led to health improvements in the general population and an evolving social norm towards tobacco use. These outcomes are still challenged by the development of new tobacco products.

En Suisse latine, la prise en compte des connaissances scientifiques, l'évolution de l'opinion publique et l'exemple d'entreprises ou d'administrations ont convergé au début des années 2000 vers l'exigence d'une protection universelle contre le tabagisme passif. La loi vaudoise sur l'interdiction de fumer dans les lieux publics est entrée en vigueur le 15 septembre 2009, après un processus débuté trois ans plus tôt par une initiative populaire. L'information et la sensibilisation, l'engagement de la société civile et l'implication des différents acteurs figurent parmi les facteurs déterminants. L'introduction de lieux publics et de travail sans fumée a amélioré l'état de santé de l'ensemble de la population et modifié la norme sociale en matière de tabagisme. Cependant, les nouveaux produits du tabac continuent à défier les conditions-cadres.

[Pediatric diabetes health Service from East canton of Vaud : towards a model of proximity care delivery ?] / Filière diabéto-pédiatrique de l'Est vaudois : vers une modélisation des soins de proximité ?

Learning to live with a chronic condition is one of the greatest challenges regarding health today, either at individual or societal level. Type 1 diabetes affecting young people and their family raises new care delivery. Proximity structures, inserted into the regional network, accessible and responsive to the needs of patients and their families, are thus promising to encourage empowerment in persons affected by a chronic disease as well as in their entourage.

Apprendre à vivre avec une maladie chronique est un des défis majeurs auxquels est confronté le monde de la santé aujourd'hui, tant au plan de l'individu que de la société dans son ensemble. Le diabète de type 1, qui touche des individus jeunes et leur entourage, suscite le développement de nouvelles offres de soins. Ainsi, des structures de proximité, insérées dans le réseau régional, faciles d'accès et répondant aux besoins des patients et de leur entourage, sont prometteuses car elles favorisent le processus d'autonomisation tant chez les personnes concernées que leur entourage.

Detection of cognitive impairment with the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) in adolescents with psychotic symptomatology.

Cognitive impairment has been identified in the early phase of schizophrenia spectrum disorders, and is a major contributor to disease-related disability. While screening tools assessing cognitive impairment have been validated for adult schizophrenic populations, there is a need for brief, easily administered, standardized instruments that provide clinically relevant information for adolescents. This study examines the utility of the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) in identifying and quantifying neurocognitive impairment in adolescents with schizophrenia spectrum disorders and other serious psychiatric illnesses. 112 adolescents, including 32 healthy subjects and 80 patients, were administered the RBANS. Patients with psychotic disorders demonstrated significant impairment on the RBANS total score compared to patients with other disorders and healthy controls, but this impairment appeared somewhat less severe than is typically reported for in adult patients with schizophrenia on this measure. The RBANS appears to be sensitive in the detection of neurocognitive impairment in a psychiatric population of adolescents with psychotic symptomatology, and may therefore have utility as a clinical screening instrument and/or neurocognitive outcome measure in this population.

Party drug use in techno nights: a field survey among French-speaking Swiss attendees.

This study was designed to investigate the lifestyle and substance use habits of dance music event attendees together with their attitudes toward prevention of substance misuse, harm reduction measures and health-care resources. A total of 302 attendees aged 16-46 years (mean=22.70, S.D.=4.65) were randomly recruited as they entered dance music events. Rates for lifetime and current use (last 30 days) were particularly high for alcohol (95.3% and 86.6%, respectively), cannabis (68.8% and 53.8%, respectively), ecstasy (40.4% and 22.7%, respectively) and cocaine (35.9% and 20.7%, respectively). Several patterns of substance use could be identified: 52% were alcohol and/or cannabis only users, 42% were occasional poly-drug users and 6% were daily poly-drug users. No significant difference was observed between substance use patterns according to gender. Pure techno and open-air events attracted heavier drug users. Psychological problems (such as depressed mood, sleeping problems and anxiety attacks), social problems, dental disorders, accidents and emergency treatment episodes were strongly related to party drug use. Party drug users appeared to be particularly receptive to harm reduction measures, such as on-site emergency staff, pill testing and the availability of cool water, and to prevention of drug use provided via counseling. The greater the involvement in party drug use, the greater the need for prevention personnel to be available for counseling. General practitioners appeared to be key professionals for accessing health-care resources.

Adolescent Drug Abuse Diagnosis (ADAD) vs. Health of Nation Outcome Scale for Children and Adolescents (HoNOSCA) in clinical outcome measurement.

BACKGROUND: The Adolescent Drug Abuse Diagnosis (ADAD) and Health of Nation Outcome Scales for Children and Adolescents (HoNOSCA) are both measures of outcome for adolescent mental health services. AIMS: To compare the ADAD with HoNOSCA; to examine their clinical usefulness. METHODS: Comparison of the ADAD and HoNOSCA outcome measures of 20 adolescents attending a psychiatric day care unit. RESULTS: ADAD change was positively correlated with HoNOSCA change. HoNOSCA assesses the clinic's day-care programme more positively than the ADAD. The ADAD detects a group for which the mean score remains unchanged whereas HoNOSCA does not. CONCLUSIONS: A good convergent validity emerges between the two assessment tools. The ADAD allows an evidence-based assessment and generally enables a better subject discrimination than HoNOSCA. HoNOSCA gives a less refined evaluation but is more economic in time and possibly more sensitive to change. Both assessment tools give useful information and enabled the Day-care Unit for Adolescents to rethink the process of care and of outcome, which benefited both the institution and the patients.

Deteriorated visual backward masking in the shine-through effect in adolescents with psychosis.

Visual backward masking is a reliable and widely used tool in schizophrenia research. Whereas many studies have shown masking deficits in adult patients, there are only very few studies with adolescents with psychosis-and with controversial results. Masking deficits of adolescents are of primary interest because they are not caused by long-term suffering from the disease and severe medication. We investigated 15 adolescents with psychosis and 19 age-matched controls in the shine-through backward masking paradigm for which strong performance deficits were shown previously in adult schizophrenic patients and their relatives. Adolescents with psychosis were strongly impaired in the shine-through effect compared to controls. This result adds further evidence that backward masking is an endophenotype of schizophrenia.

Adolescent substance-use assessment: methodological issues in the use of the Adolescent Drug Abuse Diagnosis (ADAD).

During the past twenty years, various instruments have been developed for the assessment of substance use in adolescents, mainly in the United States. However, few of them have been adapted to, and validated in, French-speaking populations. Consequently, although increasing alcohol and drug use among teenagers has become a major concern, the various health and social programs developed in response to this specific problem have received little attention with regard to follow-up and outcome assessment. A standardized multidimensional assessment instrument adapted for adolescents is needed to assess the individual needs of adolescents and assign them to the most appropriate treatment setting, to provide a single measurement within and across health and social systems, and to conduct treatment outcome evaluations. Moreover, having an available instrument makes it possible to develop longitudinal and transcultural research studies. For this reason, a French version of the Adolescent Drug Abuse Diagnosis (ADAD) was developed and validated at the University Child and Adolescent Psychiatric Clinic in Lausanne, Switzerland. This article aims to discuss the methodological issues that we faced when using the ADAD instrument in a 4-year longitudinal study including adolescent substance users. Methodological aspects relating to the content and format of the instrument, the assessment administration and the statistical analyses are discussed.

Youth smoking cessation: an update for primary care physicians.

Tobacco use is a major public health problem, and onset usually begins in youth. This article reviews current knowledge and evidence of specific aspects of smoking in youth, tobacco control strategies, and smoking cessation interventions that target young people. Finally, it provides recommendations for primary care physicians.

Substance use and depression. Comparative course in adolescents.

OBJECTIVE: To examine the relation between depression and substance use in adolescents and the concomitant courses of both disorders. METHODS: Four individual interviews were administered to 85 adolescent substance users aged 14-19 years (mean 17.1 years, SD 1.4) over a 3.5 year period using the Adolescent Drug Abuse Interview (ADAD) and the Beck Depression Inventory (BDI-13). RESULTS: No predictive effect was observed on one dimension over the other, but each dimension was predictive of its own course. A decrease in substance-use severity paralleled a decrease in depressive state. Similarly, stable substance-use rates, either at a low or a high level, tended to be associated with low or high levels of depression, respectively. However, an increase in substance use was not accompanied by an increase in depressive states. Moreover, depression varied greatly between adolescents, and according to gender and age. CONCLUSIONS: Depressive states and substance use in adolescents can vary considerably overtime, and are closely but rather synchronically related. Since most of the adolescents do not seek help for substance-related problems, substance use should be systematically assessed in adolescents presenting with a depressive state.

Adolescents' beliefs about marijuana use: a comparison of regular users, past users and never/occasional users.

A questionnaire investigating adolescents' opinions and experiences regarding marijuana use was administered to 163 adolescents and young adults (96 boys and 67 girls) aged 13 to 20 (mean age = 16.8, s.d. = 1.5). Items referred to marijuana and other substances' dangerousness, representations regarding the positive and negative consequences of marijuana use. Responses were compared according to marijuana use status (classified into never/occasional use, current regular use and past regular use). Results show that adolescents' opinions differ according to their experience with marijuana use. Current regular users evaluate marijuana as less dangerous, but alcohol and heroin as more dangerous in comparison with never/occasional and past users. Current and past users are more likely to define marijuana as a medical drug and a plant used in agriculture, and less likely to define it as an illegal drug. Current and past users evaluate marijuana use as a way to cope with stress, to relax to a greater extent than do never/occasional users do. The latter attribute more negative consequences to marijuana use such as diminished driving ability and school performance and a pathway to hard drugs.