Search

Healthcare professionals have an obligation to maintain their knowledge at the highest level throughout their careers. To this end, the hospital team of a pharmacy for indoor use has developed an original and entertaining training course, mainly intended for nurses, on the subject of analgesics.

In a transcultural therapy session, an auxiliary therapist brings in play dough to the children. This medium will allow the youngs to anchor in the here and now of the session and will ease the therapeutic alliance.

Children love to play; play is their favorite occupation. They flourish through this millennial occupation. Play promotes harmonious development while integrating principles of social life. It is a solid barrier against the growing harms of sedentary lifestyle. The evolution of our societies is marked from the earliest age by a breathtaking decrease in the amount of movement and playtime of children. The consequences are known: delayed psychomotor development, psychological disorders, progression of obesity. Children of pre-carious and vulnerable families are the first victims. This review high-lights some of the essential knowledge related to the importance of play in children aged 0 to 5 years and attempts to suggest issues for recovering from a compromised situation. Solutions are individual, family and societal. The essential role of the family physician is specified.Les enfants aiment jouer ; c’est leur occupation favorite. Ils s’épanouissent grâce à cette occupation millénaire. Le jeu favorise un développement harmonieux tout en intégrant des principes de vie sociale. Il est une barrière solide contre les méfaits de la sédentarité. L’évolution de nos sociétés est marquée dès le plus jeune âge par une diminution vertigineuse de la quantité de mouvements et de temps de jeu des enfants. Les conséquences sont connues : retard du développement psychomoteur, troubles psychologiques, progression de l’obésité. Les enfants de familles précarisées et vulnérables en sont les premières victimes. Cet article rappelle quelques connaissances prioritaires quant à l’importance du jeu chez l’enfant âgé de 0 à 5 ans et propose des pistes de rétablissement d’une situation bien compromise. Les solutions sont individuelles, familiales et sociétales. Le rôle essentiel du médecin de famille est précisé.

The socially interactive therapeutic robot Paro is presented in the form of a soft toy. It can benefit patients suffering from Alzheimer's as well as nurses.

Introduction Les accidents de scooter sont de plus en plus fréquents à Dakar. Le but de ce travail est de rapporter les aspects épidémiologiques et lésionnels des ces accidents chez l'enfant à Dakar. Méthodes Une étude rétrospective et descriptive a été menée dans le Service de Chirurgie Pédiatrique du CHU Aristide Le Dantec de Dakar entre le 1er janvier 2009 et le 31 décembre 2011. Nous avons étudié divers paramètres dont la fréquence, les aspects sociodémographiques et lésionnels. Résultats Les accidents de scooter représentaient 12% des accidents de la voie publique. Ils étaient fréquents entre 12 heures et 14 heures (27%) et entre 18 heures et 20 heures (28,4%). Ils pouvaient survenir tous les jours et étaient fréquents pendant les mois d'avril (17,6%) et de juin (13,5%). Ils survenaient essentiellement dans la périphérie de Dakar (78%). La tranche de 3 à 8 ans (60,8%) était la plus touchée. Le sexe masculin était prédominant (sexe ratio de 1,5). Les piétons étaient les plus vulnérables (93,2%). La chute était le mécanisme dominant (98,7%). Les lésions touchaient surtout le membre inférieur (51,1%) et étaient constituées essentiellement de fracture. Conclusion La fréquence des accidents de scooter chez l'enfant est liée à l'urbanisation galopante et à l'accroissement du parc automobile dans une presqu’île. Les victimes sont essentiellement des piétons et présentent le plus souvent des fractures.

The general practitioner’s (GP) waiting room is an ideal place to conduct health education actions. The use of tools in GP waiting rooms would appear to be a useful approach, but the available tools are not very efficient. The objective of this study was to study the efficacy of a game compared with two other health education strategies.A comparative study was conducted in two general practices. 212 patients were divided into three groups using a paper-game or a booklet or nothing in the waiting room, before a discussion about immunization with the practitioner. The capacity of the tool to encourage questions about immunization was estimated by the GP at the end of the consultation by a questionnaire.The use of a tool in the waiting room facilitated the discussion between patients and practitioners (34% vs 12%, p0.01). The game induced longer discussions than the booklet (1 minute 32 seconds vs 1 minute 14 seconds, p0.05) without more themes. The game and the booklet had a comparable acceptability.Using a multistep education strategy facilitated discussion between the patient and the practitioner. However, the GP is required to trigger the conversation.

Screens are occupying an increasingly bigger place in families, which can have harmful consequences on the development of young children. To ensure their harmonious construction, children must not be deprived of games which involve interaction with the outside world and adults. They need exchanges with their parents and with professionals aware of the role which they have to play in a child's discoveries.

Inflatable amusement attractions, structures that are air-supported and inflated by a blower, have recently gained popularity. The purpose of this study was to describe the epidemiology of inflatable-related injuries presenting to Canadian emergency departments.The Canadian Hospitals Injury Reporting and Prevention Program (CHIRPP) is an injury and poisoning surveillance system presently operating in the emergency departments of all 11 pediatric and 4 general hospitals across Canada. The CHIRPP was searched for cases of injuries associated with commercial inflatable amusement structures.Overall, 674 cases were identified over the 20-year surveillance period, during which time the average annual percent increase was 24.6% (95% CI: 21.6, 27.7). Children aged 2 to 9 years were the most frequently injured (59.3/100,000 CHIRPP cases), and fractures accounted for 34.5% of all injuries.A sharp increase in emergency department visits for injuries associated with commercial inflatable amusement structures has been observed in recent years. Injury mechanisms could be mitigated by product design modifications and stricter business operational practices.Blessures associées aux jeux gonflables traitées dans des services d'urgence au Canada, 1990-2009.Les jeux gonflables, à savoir des structures de jeu alimentées par une soufflerie, ont récemment gagné en popularité. Cette étude visait à décrire l’épidémiologie des blessures liées aux jeux gonflables traitées dans des services d’urgence au Canada.Le Système canadien hospitalier d’information et de recherche en prévention des traumatismes (SCHIRPT) est un système de surveillance des blessures et des intoxications mis en œuvre dans le service d’urgence de 4 hôpitaux généraux et des 11 hôpitaux pour enfants du Canada. Nous avons consulté le SCHIRPT pour trouver des cas de blessures associées aux jeux gonflables commerciaux.Nous avons recensé 674 cas sur la période de surveillance de 20 ans, et nous avons observé une augmentation annuelle moyenne de 24,6 % (IC à 95 % : 21,6 à 27,7) pendant cette période. Les enfants de 2 à 9 ans étaient le plus fréquemment touchés (59,3/100 000 cas figurant dans le SCHIRPT), et les fractures représentaient 34,5 % des blessures subies.Nous avons observé une augmentation marquée, au cours des dernières années, des visites aux services d’urgence pour des blessures associées à des jeux gonflables commerciaux. On pourrait agir sur les mécanismes lésionnels en modifiant la conception des produits et en s’assurant que les entreprises œuvrant dans le domaine resserrent leurs pratiques.

The South and West Francilien Pediatric Network (Réseau Pédiatrique du Sud et Ouest Francilien [RPSOF]) has established a protocol for the developmental follow up of infants inspired by the existing developmental scales adapted to the current practice of out patient consultation. The consultation described here collects a set of very simple objects and trade toys that are a support for a qualitative exploration of the development for the infants of less than 4 years of age. Different fields are taken into account: global motor skills, hand-eye coordination, manipulation and construction, communication and language, attentional capacity, relational and social behaviour. The time of exchange and play between the paediatrician and the infant allows a first detection of possible problems: the orientation towards a specialized professional for a consultation, a standard check-up or even a therapeutic care becomes easier and clearer. This playful environment also offers a space for the parents, and supports their participation as primary role players in the development of their child. This time, integral part of the consultation, is completed by the somatic examination and sensory screening tests. At present reserved for children identified as being at risk, this type of consultation could be universalised for all infants.

According to the recommendations of the French health products safety agency (AFSSAPS) in 2009, botulinum toxin injections are recommended to reduce spasticity in children with cerebral palsy. Apprehension of the session can increase the pain. Therefore, programmes have been put in place which help to win over the child and gain their trust. Since 2008 a nurse consultation which informs the child through play has been set up in the centre for physical medicine and rehabilitation of the Association for the social and professional integration of disabled people.

Conjunctival synthetic fiber granulomas, or "Teddy bear granulomas", are rare granulomatous responses to synthetic fabric fibers. We report the case of a 3-year-old boy with no prior infectious or traumatic history, brought in by his parents for an incidentally discovered conjunctival growth in his right eye. Slit lamp examination revealed a 10-mm growth in the inferior fornix surrounding a small greyish foreign body. Surgical excision and histopathology revealed granulomatous inflammatory cell response with foreign body giant cells surrounding exogenous material. This foreign material was birefringent in polarized light, very suggestive of synthetic fabric fibers, which permitted the diagnosis of Teddy bear granuloma. Synthetic fiber granulomas present in children as unilateral, more or less inflammatory growths in the inferior conjunctival fornix. Surgical excision with histopathology makes the diagnosis and effects the cure.

The 2010 Abbott Diabetes Care--Société Francophone du Diabète (SFD) Paramédical prize was awarded to the nursing team of the paediatric unit of the William Morey hospital in Chalon-sur-Saône (71) for the creation of a new educational tool. The interactive game aims to encourage children with type 1 diabetes to do sport by providing them with the education and knowledge they need to manage their diabetes before, during and after the physical activity.

Dangerous games inside or outside school are a serious social phenomenon, but unfortunately underrecognized. Aggressive games are a part of school bullying, which is in expansion. Choking games are very dangerous, with many deaths or serious neurologic complications. Pediatricians should be knowledgeable about risky behaviors encountered by their patients, and provide guidance about its dangers.

Owing to an increase in nosocomial septicaemias in the Neonatalogy department, we've judged it necessary to consider the role of items not linked to the nursing procedures, and nevertheless present in the incubators, as well as the hygiene techniques applied to them. In November 2007, we've made a longitudinal prospective study consisting in an observation audit during 3 successive days, observing every single incubator with a newborn baby. In each incubator, we've checked whether there were or not items that weren't required by the nursing activities, along with their characteristics and the hygiene procedures applied to them. We've inquired as well whether the parents and the nursing staff knew and applied the required hygiene procedures. In 13 among the 17 incubators under survey, at least one item not strictly required by the nursing procedures could be found. The number of toys in each incubator varied from seven to one. Among the 33 toys surveyed, 24 (73%) of them showed a score of maximum fluffiness (4 out of 4), and only 10 wore labels giving cleansing advice from the manufacturers. Without any record about the cleaning/disinfecting of the toys brought in hospital, we have observed that the parents were given varied advice about how to clean the toys at home before putting them in the incubators (only four parents had washed the toys in their washing machines at more than 30 degrees C). From the six samples under scrutiny, all the culture results were tested positive. In particular two of the soft toys sampled were found infected by a Pseudomonas oryzihabitans. These particular toys belonged to a baby who had been diagnosed with a septicaemia characterized by hemocultures positive to a P. oryzihabitans of a different strain. Our audit has been an efficient reminder that any item put in an incubator is a potential vector and reservoir of pathogen organisms. After a general feedback towards the department staff, the medical staff then prescribed to permanently ban all the items not strictly required by the nursing activities from all the incubators of the department.

To assess the management of orbital floor fractures and their aftereffects in children.We retrospectively studied five children with isolated orbital floor fractures who were operated (with a perioperative steroid and antibiotic treatment) between 1998 and 2007 in our pediatric hospital. At the first visit, they all had a complete clinical examination, a Hess-Lancaster test, and a computed tomography (CT) scan. At the last visit, they all had a clinical examination and four children underwent a Hess-Lancaster test.After a median follow-up of 26 months (range, 4-100 months), no child had diplopia, all Hess-Lancaster tests were normal, and two children suffered from infraorbital hypoesthesia.Surgical repair associated with steroids and antibiotics in orbital floor fracture with our surgical indications has led to good functional results with minimal complications.

Sturge-Weber syndrome is a neurocutaneous disease associating facial and pial angioma. Focal epilepsy is a common sign. In a few cases, generalized seizures have been reported.We report on a four-year-old girl with Sturge-Weber syndrome. The first focal seizures occurred at three years of age. She developed refractory status epilepticus. At discharge from the PICU, she was on a ketogenic diet and received three antiepileptic drugs. No seizures were observed for four months. The patient then developed several types of seizures: myoclonic seizures, focal clonic seizures, and sudden falls. We were unable to determine the etiology of the falls. Typical myoclonic astatic seizures were identified on video-electroencephalographic recordings.Seizures in Sturge-Weber syndrome are usually focal. Four patients with Sturge-Weber syndrome and myoclonoastatic seizures are reported in the literature. We discuss the pathophysiological mechanisms leading from a focal lesion to generalized myoclonoastatic seizures.

Experiencing cancer is an ordeal for a child and his/her family, even if the majority of these children are cured. In order to alleviate destabilization or possible psychological sequels, the medical staff must be competent and also provide supportive care and information, so that mutual knowledge and confidence can be established. The child's and adolescent's specific landmarks must be protected (school, friends, play, fantasy, creativity, body image, sense of beauty and of identity, self confidence and trust in their parents, relation with their siblings, plans...). Parents also need assistance for possible practical, social, financial difficulties and, most of all, to maintain confidence in their parental competence. Siblings need help to understand the situation and to cope with it. Accompanying the child when the treatment is over will allow him/her to resume a normal life or to cope with possible sequels. If the child dies, accompanying the parents and the siblings through the grieving process is helpful. The psycholo-oncologist helps the child and his/her family to understand their emotions and their conscious and unconscious thoughts, and to live through this ordeal.

As there is little documentation pertaining to playfulness in adults, its therapeutic potential remains uncertain. PURPOSE AND METHODOLOGY: A qualitative approach was used in order to develop a conceptual model of playfulness in adults and to discuss its potential uses in occupational therapy.The model identifies the influential sources and the consequences of playfulness in adults. The identified consequences support both the privileged intervention in occupational therapy, in other words, the meaningful activity, and the objectives of the intervention, those which include being the capacity to act, health and well-being. For these reasons, the proposed model presents interesting potential for occupational therapy intervention.This conceptual model presents a unique and innovative vision of playfulness in adults that could offer a new perspective on meaningful activity. It suggests that playfulness could become an important tool in occupational therapy in developing the capacity to act. Consequently, the model proposes an innovative client-based approach.

In the 17th and 18th centuries, empiries were travelling in Europe, coming, in majority from actual Italy. To attract the crowds, they put up boards on the street and play some pantomimes, parades or improvised scenes. In the 17th century this street show, little or none at all printed, was in a normal way in the day life. In the 18th century this street show is still alive and whole families as the Brioché, the Contugi, the Toscano, the Ricci, the Borsari have transmitted the art of the stage and the empiric practice. A few individuals of these families moved from empirics to be graduate dentists. In other families of dentists as the Talma or Fauchard it is the stage which brought some.

To report a first case of Terson-like syndrome associated with asphyxiophilic practices in an adolescent.A 12-year-old boy was referred for decreased visual acuity in his right eye. His father had been diagnosed 3 weeks before with subarachnoidal hemorrhage. Fundus examination showed a dense preretinal hemorrhage in the right eye suggestive of Terson syndrome.Angio-magnetic resonance imaging eliminated aneurysm and arteriovenous malformation from the diagnosis. After questioning the boy further, he reported that he had participated in the "scarf game", a very popular (but lethal) asphyxiophilic practice in middle school, some hours before he noticed a sharp drop in the visual acuity of his right eye. After 2 months of follow-up, he recovered 20/20 vision in his right eye.Retinal hemorrhages are quite rare in children. When the cause is not clear (subarachnoidal hemorrhage, arteriovenous malformation, shaken baby syndrome), it must be determined whether the patient has participated in the asphyxiophilic "scarf game" in order to prevent its lethal consequences.