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SettingSeven family practices in Switzerland. MethodThe team collaborated with GPs and young people to develop the intervention. Seven GPs piloted its use in their consultations. Patients aged 15 to 24 years consulting for any health problem were recruited before the consultation. Cannabis use, other substance use, and their psychosocial correlates were assessed with a short confidential questionnaire administered before the consultation and 1 month later. GPs, staff, and patients were asked to comment on the study and its feasibility. ResultsOf 81 young people invited to participate, 78 (70% female) agreed (participation rate: 96%). One in seven (13.2%, 95% confidence interval = 7.5% to 18.9%) used cannabis at least once a week. Data at 1 month were available for 42% who had provided email contact details and 91% of those who had provided their mobile phone number (63% overall). In most cases, the intervention lasted no more than 5 minutes. Comments from participants added favourable data towards the feasibility of the study. ConclusionThis pilot study provides a solid base on which to build a randomised trial of a brief intervention addressing cannabis use in young people consulting in family practice.

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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.

This Delphi-like study defined what themes should be included and at what age they need to be addressed with patients with a chronic rheumatology disease and their families during transition. This checklist reached a strong international and interdisciplinary consensus while examining transition in a broad way. It should now be spread widely to health professionals to be used by all those who care for adolescents aged≥12 years at times of transition. It could be transposed to most chronic conditions. Recommendations for further research are given.

BackgroundKnowledge of patient’s reasons for encounter is useful to inform health service planning and health professional education. Our aim was to describe reasons for encounter as stated by an unselected group of young people attending primary care practices in the French-speaking part of Switzerland.MethodsConsecutive patients aged between 15 and 24 years were recruited as part of the PRISM-Ado trial (n = 594). They completed an anonymous questionnaire in the waiting room, including their main reason for encounter (free text). Reasons for encounter were coded using ICPC-2 classification and analyzed according to sex, age and living in a rural or urban area.Results95 % of questionnaires contained valid data about reasons for encounter (n = 567). General and unspecific (A) reasons were the most common in boys (44 %) and girls (42 %), followed by respiratory, musculoskeletal, dermatological and psychological reasons. Psychological reasons were more frequent in girls attending urban practices; musculoskeletal and dermatological reasons were more frequent in rural areas. Sexually transmitted infections or substance use were very rarely stated as a reason for encounter.ConclusionsThis is the first study describing reasons for encounter as stated by young people themselves in primary care in Switzerland. These findings provide useful guidance for family doctors training and health service planning in Europe.Trial registrationAustralian New Zealand Clinical Trials Registry, ACTRN12608000432314.

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Adolescent vaccination coverage is very variable in European countries and data are scarce. The aim of this study was to assess immunization status and analyze potential variations according to sociodemographic variables in a youth clinic in Geneva, Switzerland. Immunization status was assessed retrospectively: Tetanus (number of doses or in absence of data tetanus antibodies) and measles as indicators of childhood coverage as well as hepatitis B and human papillomavirus. All new patients (N = 390) of Geneva University Hospital's youth clinic were included between January 2010 and June 2011. Vaccine coverage was low for all vaccines regardless of sex or origin. 89% of young people tested (mostly recent immigrants with no available data) had tetanus antibodies indicating adequate childhood immunization but hepatitis B and HPV coverage was low especially in recent immigrants. Systematic assessment allows better adolescent vaccine coverage and can improve safety by avoiding unnecessary dosis.