[Transition to adult care: an overview]. / Transition aux soins adultes: une vue d'ensemble.

Nowadays nearly 90% of children with a chronic condition survive to adulthood and must make the transition from pediatric to adult care. This transition must include not only the continuity of care but also the preparation for adult life so that these young people can develop their full potential. Divided into three phases (preparation, transfer and engagement), the transition process should be adapted to adolescents and ensure access to quality care.

[Factors associated with HPV immunization for 13-14-year-old girls in the Geneva district, Switzerland]. / Facteurs associés à la vaccination HPV chez les jeunes filles de 13 à 14ans dans le canton de Genève, Suisse.

BACKGROUND: School vaccination programs against human papilloma virus (HPV) have been implemented in most Western countries. Only a few studies have investigated socio-economic factors related to school-based vaccination. METHOD: A cross-sectional study was conducted using the vaccination cards of 1158 randomized girls aged 13 to 14 years enrolled in the public schools of the canton of Geneva. Several other socio-economic variables (nationality, socio-professional category and marital status of the parents) were collected. RESULTS: Immunization coverage for three doses of HPV vaccine was 56%. After having controlled the covariates, Portuguese adolescents (adjusted OR [95% CI]: 4.18 [1.76-9.92]), adolescents whose mothers were workers (adjusted OR [95% CI]: 1.91 [1.38-2.65]) or married (adjusted OR [95% CI]: 1.44 [1.06-1.98]) showed significantly higher immunization rates than Swiss adolescents or those whose mothers' socio-professional category was senior manager or executive. CONCLUSION: This study shows that the HPV vaccine coverage is not yet optimal in Geneva and varies significantly according to the socio-economic status, thus better promotion of HPV vaccination for certain target groups must be implemented.

Undocumented migrants in Switzerland: geographical origin versus legal status as risk factor for tuberculosis.

Undocumented migrants, meaning migrants without a legal residency permit, come to Geneva from countries with high tuberculosis (TB) incidence. We estimate here whether being undocumented is a determinant of TB, independently of origin. Cross-sectional study including undocumented migrants in a TB screening program in 2002; results were compared to 12,904 age and frequency matched participants in a general TB screening program conducted at various workplaces in Geneva, Switzerland from 1992 to 2002. A total of 206 undocumented migrants (36% male, 64% female, mean age 37.8 years (SD 11.8), 82.5% from Latin America) participated in the TB screening program. Compared to legal residents, undocumented migrants had an adjusted OR for TB-related fibrotic signs of 1.7 (95% CI 0.8;3.7). The OR of TB-related fibrotic signs for Latin American (vs. other) origin was 2.7 (95% CI 1.6;4.7) among legal residents and 5.5 (95% CI 2.8;10.8) among undocumented migrants. Chest X-ray screening identified a higher proportion of TB-related fibrotic signs among Latin Americans, independently of their residency status.

[Motivational interviewing: some theoretical aspects and some practical exercises]. / L'entretien motivationnel: quelques repères thèoriques et quelques exercices pratiques.

Heath behavior change is an important task for caregivers. Motivational Interviewing (MI) is an effective evidence-based approach to overcoming the ambivalence that keeps many people from desired changes in their lives. In a warm and empathic atmosphere and in a basic trust in the patient self efficacy for achieving the change, MI is a patient-centered approach to enhance patient motivation to commit them in the change decision. Among critical conditions of change, MI practicing emphasizes on expressing empathy, supporting self-efficacy, rolling with resistance and developing discrepancy. Regular practicing with helping and non judgmental teachers is a necessary condition of a fruitful learning.