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Relational experiences during infancy and early childhood are key drivers for building health, social emotional development, and learning capacities, each vital for wellbeing. The U.S. child health sectors share a commitment to universal health promotion, prevention and early intervention, and a growing enthusiasm for the research‐affirmed primacy of caregiver‐child interactions during the critical first 1000 days of life. Given our nation's growing children's mental health crisis, racial justice awakening and the need to reimagine equitable supports for young families post‐COVID19, the child health sectors seek new tools and clinical approaches that blend science‐to‐practice innovations with co‐developed activities that are meaningful to families. This special section brings together papers about a journey of co‐discovery between researchers, clinicians, and parents during the development and refinement of new video‐ and interview‐based dyadic relational screening and monitoring tools. The collection of papers addresses a range of topics including early relational health (ERH), development and validation of the Early Relational Health Screen, its application within research and clinical settings, and thoughtful discussions from multiple perspectives. Informed by the diversity informed tenets, this journey highlights not only science‐informed approaches, but also co‐development with families of equitable approaches to understanding and serving children and their caregivers. [ABSTRACT FROM AUTHOR]

There is limited research regarding management of temporomandibular disorders (TMD) in adolescents with imaging signs of juvenile idiopathic arthritis (JIA). An 11-year-old girl presented to a hospital-based chiropractor for evaluation of a 1.5-year history of unilateral temporomandibular joint (TMJ) pain and trismus. Previously, pediatric rheumatologists diagnosed JIA after contrast-enhanced magnetic resonance imaging revealed edema, effusion, and bilateral anterior disc displacement, and recommended methotrexate, corticosteroid injection, and arthrocentesis. The chiropractor questioned the JIA diagnosis, instead relating symptoms to a mechanical TMD/disc origin. Manual therapy, TMJ exercises, and acupuncture improved TMJ pain and opening. Invasive medical JIA interventions were avoided without long-term recurrence, further questioning the preceding JIA diagnosis. The success of this case suggests that stepped care, beginning with conservative treatment, has value for adolescents with TMD suspect for JIA. Integration of chiropractors and acupuncturists into healthcare institutions may facilitate this care model by affording nonpharmacologic interventions earlier in patient care. [ABSTRACT FROM AUTHOR]

L'infection urinaire fébrile est l'infection bactérienne la plus fréquente chez l'enfant, pouvant aboutir à des complications sévères infectieuses et rénales, nécessitant un diagnostic précoce et une antibiothérapie ciblée. Notre objectif était d'étudier l'épidémiologie bactérienne locale et le profil de résistance aux antibiotiques chez les enfants hospitalisés pour infection urinaire fébrile dans deux centres pédiatriques du grand-est. L'étude incluait les enfants admis aux urgences pédiatriques du Centre hospitalier universitaire de Strasbourg et du Centre hospitalier de Saverne pour infection urinaire fébrile de janvier 2019 à décembre 2020. Les bactéries isolées et le profil de résistance étaient étudiés à partir des examens cytobactériologiques des urines. Nous avons analysé 214 examens cytobactériologiques des urines réalisés chez 208 patients. Les bactéries principalement retrouvées étaient Escherichia coli (82 %), dont bêtalactamase de spectre étendu (2,8 %), Enterococcus faecalis (7 %), Klebsiella spp (5 %) et Proteus mirabilis (2 %). L' E. coli était résistant dans respectivement 43, 33 et 14 % des cas à l'amoxicilline, l'amoxicilline/acide clavulanique et au cotrimoxazole, et sensible au céfixime et ceftriaxone dans 99 % des cas. Une céphalosporine de 3e génération (C3G) était utilisée en intraveineux dans 98 % des cas en traitement probabiliste. Moins de 2 % des patients eurent un traitement per os par céfixime dès l'initiation de l'antibiothérapie. Nous avons documenté le spectre des uropathogènes et le profil de résistance de l' E. coli dans les infections urinaires fébriles pédiatriques prises en charge dans 2 centres. Un protocole local d'antibiothérapie probabiliste basé sur nos résultats a été rédigé en accord avec les recommandations nationales. Febrile urinary tract infection (UTI) is a common health issue in pediatrics that can lead to serious infectious and renal complications, it requires early diagnosis and a targeted use of antibiotics. The aim of our study was to describe local bacterial agents causing febrile UTIs and their resistance patterns and confront the results with currently used empirical antibacterial therapy in pediatrics emergency departments in Strasbourg and Saverne. We used billing codes (international classification of diseases) to identify all inpatients treated for febrile UTIs in two French pediatric emergency departments between January 2019 and December 2020. Microbial results of urine cultures were retrieved from the laboratory information system. Among 214 microbial results from 208 patients, the distribution of uropathogens was 82% Escherichia coli , with extended-spectrum beta-lactamase in 2.8%, 7% Enterococcus faecalis, 5% Klebsiella , 2% Proteus mirabilis. E. coli was resistant respectively to amoxicillin, amoxicillin/clavulanic acid and cotrimoxazol in 43, 33 and 14% of samples. A third-generation cephalosporin administered intravenously was mainly used (98%) as empirical treatment. Less than 2% of patients were treated with oral cephalosporin from the start. We present the spectrum of uropathogens and susceptibility test results in pediatric UTIs as well as the susceptibility pattern of E. coli , a local treatment protocol was designed based on our results in conformity with national guidelines. [ABSTRACT FROM AUTHOR]

Copyright of Archives of Cardiovascular Diseases is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Annales Françaises de Médecine d'Urgence is the property of John Libbey Eurotext Ltd. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Medication errors are one of the causes of iatrogenic medication use in children. The POPI tool for detecting inappropriate drug prescriptions and prescription omissions in paediatrics was the first tool to be published in this field in 2014. Our aim was to update the POPI tool for French use based on current recommendations and practice. Criteria were removed, updated or added based on recommendations from learned societies and national bodies. The two-round Delphi method was used to reach a consensus of experts. The level of agreement of the healthcare professionals' proposals was rated on a 9-point Likert scale. In the first round, only proposals with a median agreement of 7 to 9 and an agreement of more than 65% were retained. In the second round, only those with a median agreement of 7 to 9 and over 75% agreement were retained. The POPI tool now includes eight categories (various, infectiology, gastroenterology, pneumonology, dermatology, neurology/pedopsychiatry, haematology and excipients). All the criteria were supported by bibliographical references. They were submitted to 20 French healthcare professionals: 9 pharmacists and 11 doctors (17 hospital-based and 3 self-employed). After two rounds of Delphi testing, 166 criteria were retained and validated (111 inappropriate prescriptions and 55 omissions). In conclusion, this study made it possible to update the POPI tool, which is still available for assessing paediatric prescriptions., (Copyright © 2024 Académie Nationale de Pharmacie. Published by Elsevier Masson SAS. All rights reserved.)

Objective: To determine the incidence and outcomes of uveitis following coronavirus (COVID-19) vaccination in the pediatric population., Methods: A case series of all patients under the age of 18years diagnosed with uveitis within 28days of COVID-19 vaccination., Results: Out of 33 patients under the age of 18years who presented with uveitis from July 2021 until May 2022, eight (24.2%) developed uveitis following COVID-19 vaccination within 28days. Four had a previous history of uveitis. The mean time interval from COVID-19 vaccination to uveitis diagnosis was 14.75days. The most common anatomic diagnosis was anterior uveitis in four children, followed by panuveitis in two and posterior uveitis in two. Seven children were treated with systemic steroids/immunomodulatory agents. Improved or unaffected visual acuity was noted in all children at the final follow-up., Conclusion: The pediatric population may demonstrate uveitis following COVID-19 vaccination. All children were treated successfully, and good final visual acuity was achieved., (Copyright © 2024 Elsevier Masson SAS. All rights reserved.)

The transition of young type 1 diabetic patients from pediatrics to adult diabetes services is a delicate stage, with the risk of a break in the care pathway. These adolescents are apprehensive about leaving the pediatric sector, and often experience the change as an abandonment. It is therefore vital to prepare them and support them during and after the transfer, in order to improve their experience., (Copyright © 2024 Elsevier Masson SAS. All rights reserved.)

Purpose: Myasthenia is a rare disease in children, with an estimated incidence of 1 to 5 per million children. However, the potential severity of its consequences and the existence of specific treatments require prompt diagnosis by pediatric ophthalmologists., Methods: Retrospective review of patient records. Patients were identified from a rare disease database. Patients under the age of 18 years with confirmed diagnosis of myasthenia and ocular symptoms seen in a specialized clinic between 2005 and 2021 were included., Results: Twenty-six (16 girls) with confirmed myasthenia and ocular symptoms were included. Ten patients had definite autoimmune myasthenia gravis (AIMG); 6 had suspected AIMG with negative antibody testing. Six patients had definite congenital myasthenic syndrome (CMS); 4 had suspected CMS with no evidence of mutation. Mean age at diagnosis of myasthenia was 5 years-3 years and 5 months for CMS and 6 years and 3 months for AIMG. Male to female (M:F) ratio was 6/10 for autoimmune myasthenia gravis and 4/6 for CMS. Ptosis was present in all cases; strabismus in 21 patients (68%). The clinical forms of myasthenia were ocular myasthenia in 12 patients (10 AIMG and 2 CMS), generalized in 12 patients (7 CMS and 5 AIMG) and secondary generalization of ocular myasthenia in 2 patients (2 AIMG)., Discussion: These results are based on only 26 cases, which can be explained by the rarity of this diagnosis in children. As in adults, the first signs are often ophthalmologic - ptosis alone or associated with strabismus. Diagnosis is difficult because of the absence of clinical signs, laboratory tests or electrophysiological signs with high sensitivity. Thus, the work-up may remain completely negative in secondarily proven forms. In addition, electroneuromyograms and oculomotor recordings in small children are more difficult to perform than in adults. For these reasons, the clinical examination is essential. In the case of strong suspicion, all additional medical examinations are carried out in a day unit, in order to reach a positive diagnosis of myasthenia. The so-called "congenital" forms, which are genetic, are proportionately higher than in adults, and diagnosis and treatment are often more difficult than in the classic autoimmune forms., Conclusion: Myasthenia can affect children from a very young age and can present as ptosis, initially isolated or associated with strabismus. Diagnosis and treatment may be difficult and should be organized in specialized centers., (Copyright © 2024 Elsevier Masson SAS. All rights reserved.)

In paediatrics, the pulmonary function test (PFT) is most often performed to support the diagnosis or in follow-up of asthma patients. Whatever the pathology responsible for respiratory symptoms and/or functional impairment, repeated PFTs make it possible to establish a prognosis (pulmonary function trajectories…) and to orient preventive interventions. PFT can be performed routinely from the age of three years, provided that the following requirements are met: suitable techniques and equipment, staff trained to apply the techniques and to receive young children, reference values for each technique indicating the limits of normal values and of between-test significant variation. From the age of three, children can be subjected to tidal breathing measurement of: resistance of the respiratory system (oscillometry, Rrs; airflow interruption, Rint) or of airways specific resistance (sRaw) and functional residual capacity (by applying a dilution technique). With maturity, the child will become capable of mobilizing his or her slow vital capacity to measure total lung capacity (TLC), once again by applying a dilution technique, then later by breathing against a closed shutter (plethysmography TLC and Raw). Finally, the child will be able to carry out forced expiration (forced spirometry) along with all of the other PFTs. It is important to take into account the paediatric adaptations specified in the international recommendations regarding the performance, reproducibility and quality of PFTs targeting this population., (Copyright © 2024 SPLF. Published by Elsevier Masson SAS. All rights reserved.)

In this article, the authors wish to offer the product of their reflections on the concept of coercive control, and share various findings from their day-to-day practice. The text should be read as an invitation to clinical reflection on the conceptualization of a specific form of abuse. Reflection on this approach, initially ignored by the authors, has enriched clinical thinking on certain care situations., (Copyright © 2024 Elsevier Masson SAS. All rights reserved.)

Literature on dietary behaviours of the pediatric Crohn's Disease (CD) population and the relationship between dietary intake and CD activity is limited. Three dietary indices were developed and tested to conduct dietary pattern analysis in pediatric patients with CD consuming a free diet following remission induction via exclusive enteral nutrition ( n  = 11). Index scores underwent descriptive and inferential analysis. The mean adjusted scores (out of 100) for the Pediatric Western Diet Index, Pediatric Prudent Diet Index, and Pediatric-Adapted 2010 Alternate Healthy Eating Index (PA2010-AHEI) were 29.82 ± 15.22, 34.25 ± 15.18, and 51.50 ± 11.69, respectively. The mean Western-to-Prudent ratio was 0.94 ± 0.55. A significant correlation ( r  = -0.71) and relationship (F [1, 9]  = 9.04, P  < 0.05, R 2  = 0.501) between the Western-to-Prudent ratio and PA2010-AHEI was found. The results suggest participants were not following a Western or Prudent diet, and were consuming foods not captured by the indices. More research is needed to describe dietary intake of individuals with CD, validate dietary indices in diverse samples, and explore the utility of these indices in CD assessment and treatment. The co-authors hope this work will stimulate/inspire subsequent interprofessional, dietitian-led research on this topic.

Copyright of Pediatrie pro Praxi is the property of SOLEN sro and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The aim of this publication is to explore the ethical tensions during withholding and withdrawing treatment in infant decision making. The first difficulty is to identify an unreasonable obstinacy. Wilfulness, singularity of the situations, resort to dual effect theory, uncertainty, are studied. The parents' place is evocated. Collegiality and an ethical approach inspired by Ricoeur's thinking are proposed as a possible way to resolve some of the ethical tensions. [ABSTRACT FROM AUTHOR]

Copyright of KONTAKT - Journal of Nursing & Social Sciences related to Health & Illness is the property of University of South Bohemia in Ceske Budejovice, Faculty of Health & Social Sciences and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of KONTAKT - Journal of Nursing & Social Sciences related to Health & Illness is the property of University of South Bohemia in Ceske Budejovice, Faculty of Health & Social Sciences and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of KONTAKT - Journal of Nursing & Social Sciences related to Health & Illness is the property of University of South Bohemia in Ceske Budejovice, Faculty of Health & Social Sciences and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Psycho-Oncologie is the property of PiscoMed Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Psycho-Oncologie is the property of PiscoMed Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Semi-solid extrusion (SSE), one of the additive manufacturing techniques, is attracting particular attention due to its use for printing thermosensitive drugs. Among the materials used in SSE, hydrogels have received the most attention in pharmaceutical applications due to their ability to provide spatial and temporal control of the release of various therapeutic agents. 3D printing of these hydrogel-based materials requires a fundamental understanding of their non-Newtonian flow during extrusion. In this work, agar gels were subjected to extrusion tests at apparent shear rates corresponding to their printing speeds. The rheology of these gels was then studied using a laboratory setup consisting of a syringe piston pushed by varying weight and the data obtained was modelled using the Herschel–Bulkley equation to obtain the yield stress, the consistency and flow indices. The 4% (w/w) concentration of agar gel showed the best fit to the modelled data and had the optimal rheological properties. This concentration was thus used in printing cylindrical objects, and the effect of the infill density on the porosity of the objects as well as on the dissolution of a tracer was studied.

Cette enquête réalisée auprès des médecins internes d'Île-de-France a pour but d'effectuer un état des lieux de la formation actuelle et des connaissances des internes en médecine concernant l'accompagnement de la transidentité chez l'adolescent et l'enfant. Cette enquête a été effectuée au cours du mois de juin 2020, par le biais d'un questionnaire en ligne anonyme composé de 16 questions. Les résultats, collectés auprès de 143 internes, montrent un manque de connaissances aussi bien théorique que pratique pour l'ensemble des spécialités ayant répondu. Cela inclut les spécialités de pédiatrie et pédopsychiatrie pourtant directement concernées. Cette situation est principalement due à : un manque de formation et d'enseignement mis en place en amont au sein des universités de médecine et des hôpitaux ; un sujet encore considéré comme tabou au sein même du corps médical. Il semble important de noter ici, que suite à ce constat, les internes interrogés sont ainsi dans la très grande majorité en demande d'un enseignement plus complet, et cela intégré à leur cursus de formation médicale. Il semble plus qu'important de considérer ce sujet, véritable enjeu de santé publique qui prend une place de plus en plus importante en consultation de l'enfant et de l'adolescent, afin de permettre un meilleur accompagnement des patients et un meilleur accès aux soins au sein d'une population fragilisée par des années de discriminations et d'inégalités face au droit fondamental que constitue la santé. Gender dysphoria, non-binarity, trans-identity, neutrality, gender fluid. faced with the emergence of a redefinition and reaffirmation of gender, what place and training are there for the doctors of tomorrow? A public health issue is coming to the fore as the suicide rate among these adolescents is seven times higher than among so-called "cisgender" adolescents. So how do you take care of these patients and their families, for whom access to care is so difficult? Several doctors have found themselves confronted with this real tidal wave of requests for gender consultations without any training or clear recommendations. This survey, carried out among resident doctors in the Île-de-France region, aims to assess the current practical and theoretical training concerning the care of children and adolescents with a trans-identity status. This survey was carried out during the month of June 2020, using an anonymous online questionnaire consisting of 16 questions including multiple choices as well as open-ended ones. The questions concerned a self-assessment of practical and theoretical knowledge according to the year and specialty of the residency. It also addressed the issue of training programs implemented by medical faculties and university hospitals as well as the confrontation to trans-identity in clinical practice and the reflections emerging from it. The findings, collected from the answers of 143 resident doctors, show an overall lack of knowledge, theoretical and practical, without medical specialization distinction. It includes pediatric and child psychiatric specialties that are all the more directly concerned. This gap is mostly attributed to the lack of training and teaching in medical universities and hospitals, as well as to a subject still considered taboo within the medical profession itself. The overwhelming majority of doctors are thus in demand for more comprehensive education on the issue as part of their general medical training curriculum. It appears more than important to consider trans-identity status a real public health issue. This matter is taking on an increasingly crucial role in child and adolescent medical counselling. In the coming years, this will enable better patient support and better access to care within a population weakened by years of discrimination and inequality in relation to the fundamental right to health. [ABSTRACT FROM AUTHOR]

Analyse de différents aspects psychologiques de la drépanocytose chez les sujets atteints. Plus spécifiquement, nous nous intéressons à l'impact de leur maladie, à l'adhérence au traitement, aux émotions liées à leur maladie et à leur souhait d'éducation thérapeutique. Nous soumettons l'adaptation du questionnaire « Brief Illness Perception Questionnaire » à des sujets atteints de 7 à 19 ans. L'échantillon compte 45 sujets, la majorité est issue du Congo. La moitié de nos sujets est issue de la première génération de migration. La majorité des sujets estime avoir une bonne santé. L'impact de la maladie sur leur quotidien à domicile est faible. Ils ont le sentiment de bien comprendre leur maladie. Globalement, ils ressentent des émotions variables en pensant à la drépanocytose. Ces émotions sont corrélées à la migration. Ils associent difficilement au sujet de leur maladie. La drépanocytose est vécue de manière plutôt positive. Les sujets sévèrement atteints vont psychologiquement moins bien. De plus, la tristesse, la colère et la peur ressenties par rapport à la maladie sont corrélées. La migration a un impact péjoratif important sur l'impact de la maladie chez nos sujets. La drépanocytose reste difficile à penser pour les sujets atteints. Il est capital de poursuivre le travail d'information sociétale, en Belgique et en Afrique. Analysis of how subjects with sickle cell disease experience their disease. More specifically, we are interested in the impact of their condition, their adherence to treatment and their emotions concerning their illness and their desire for therapeutic education. We submitted the adaptation of the "Brief Illness Perception Questionnaire" to subjects aged from 7 to 19. The sample consists of 45 subjects, the majority of whom come from the Congo. Half of our subjects come from the first generation of migration. The majority of subjects consider themselves to be in good health. The impact of the disease on their daily lives at home is low and they feel they have a good understanding of their condition. Overall, they experience few variable emotions when thinking about sickle cell anemia. These emotions are correlated with migration, and they find it difficult to associate with their disease. Sickle cell disease is experienced rather positively, but severely affected subjects are more psychologically distressed. In addition, the sadness, the anger and the fear that the subjects experience about the disease are correlated. Migration also has a significant negative effect on the way our subjects are affected by their disease. Sickle cell disease remains difficult to imagine for those affected. It is essential to continue the work of societal information, in Belgium as well as in Africa. [ABSTRACT FROM AUTHOR]

Copyright of Archives of Cardiovascular Diseases is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Pediatrie pro Praxi is the property of SOLEN sro and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Daily life has changed for families due to the COVID-19 pandemic. The aim of this repeated cross-sectional study was to describe movement behaviours in Canadian children and youth 6 months into the pandemic (T2; October 2020) compared with the start of the pandemic (T1, April 2020). An online survey was distributed to parents (N = 1568) of children and/or youth (5–17 years; 58% girls) in October 2020. The survey assessed changes in movement behaviours (physical activity and play, sedentary behaviours, and sleep) from before the pandemic to October 2020 (T2). We compared these data with spring data (T1; April 2020; Moore et al. 2020; Int. J. Behav. Nutr. Phys. Act, 17:85) collected using identical methodology (N = 1472; 54% girls). We report correlations between movement behaviours and relevant parental factors and provide word frequency distributions for open-ended responses. During the second wave, 4.5% of children (4.6% girls; 4.3% boys) and 1.9% of youth (1.3% girls, 2.4% boys) met the movement guidelines (3.1% overall). Whereas, during the first wave, 4.8% (2.8% girls, 6.5% boys) of children and 0.6% (0.8% girls, 0.5% boys) of youth were meeting combined guidelines (2.6% overall). Parental support was correlated with their child's movement behaviours (T1 and T2). Our study demonstrates the ongoing challenges for children and youth to engage in healthy movement during the pandemic. Novelty: Our large-scale national study demonstrates that children and youth were not meeting the 24-hour movement guidelines during the second wave of the pandemic. Our findings illustrate the need to protect children and youth from the collateral consequences of the pandemic. [ABSTRACT FROM AUTHOR]

La population française est la plus hésitante au monde concernant la sécurité vaccinale. Les hésitations peuvent être regroupées en 4 familles ; intégrité des politiques vaccinales, l'aspect réglementaire, doutes concernant l'efficacité, et la dangerosité des vaccins. Nous avons réalisé la première étude évaluant et comparant les hésitations des médecins généralistes (MG) et des patients. Notre étude concerne le département de l'Ariège. Nous avons adressé un questionnaire aux 123 MG du département, ainsi qu'à 90 parents amenant leur enfant en consultation. Au total, 48 % (n = 59) des MG et 76 % (n = 68) des patients ont répondu. Les hésitations étaient très fréquentes, puisque 61 % des MG et 72 % des patients en présentaient. La répartition des craintes était similaire entre ces 2 populations ; la peur la plus fréquente dans les 2 groupes portait sur l'intégrité des politiques vaccinales (p < 0,05). Cela traduit des doutes importants concernant la transparence des autorités de santé. Les sujets ressentaient rarement les 4 hésitations à la fois (2 % des MG et 12 % des patients). La décision vaccinale est fragile. Ce travail illustre la nécessité de cibler précisément ce qui fait hésiter les patients. En effet, la vaccination n'étant pas refusée en bloc la plupart du temps, il semble possible de leur proposer une réponse adaptée à leur(s) propre(s) hésitation(s). Nous avons également mis en évidence une défiance importante vis-à-vis des autorités de santé, de la part des patients mais aussi des MG (montrant qu'une réponse institutionnelle à cet enjeu de santé publique est essentielle). French population is the most worried in the world about vaccine safety. Concerns can be grouped into 4 families; integrity of vaccine policy, conspiracy theory, doubts concerning the effectiveness, and the danger of vaccines. We conducted the first study evaluating and comparing the concerns of GP and patients. Our study concerns the department of Ariege, in France. We sent a survey to the 123 GP of the department, and to 90 parents bringing their child in consultation. In total, 48% (n = 59) of GP and 76% (n = 68) of patients responded. Concerns were very frequent; 61% of GP and 72% of patients were worried. Fears distribution was similar between these 2 populations; the most common fear in the 2 groups was the conspiracy theory (P < 0.05). This reflects significant doubts about the transparency of health authorities. Subjects rarely felt 4 concerns both (1.7% of GP and 11.8% of patients). Vaccine decision is fragile. This work illustrates the need to target precisely what worried patients. Indeed, as vaccination is not wholly denied most of the time, it seems possible to offer an appropriate response to their own concern(s). We have also highlighted a significant distrust in health authorities, from patient and also from GP (showing that an institutional response to this public health issue is essential). [ABSTRACT FROM AUTHOR]

Copyright of Revue Francaise d'Allergologie is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: Cancer is defined as a chronic disease, in view of the length of treatment and its repercussions on the life of the child. Therapeutic education could be an essential tool to improve the quality of life of sick children. Objectives: Identify the conceptions of caregivers in pediatric oncohaematology institutions and services on educational actions and the implementation of patient therapeutic education programs. Method: Cross-sectional, multicentre qualitative study based on four semi-structured individual interviews and a focus group. Results: Conceptions of the carers in paediatric oncohaematology establishments and services are based on major themes: conceptions of education linked to care, conceptions of the patient therapeutic education session, conceptions of the specificities linked to paediatrics, conceptions of the resources for setting up a patient therapeutic education programme and conceptions of patient therapeutic education linked to the institution. Discussion: Larger study in order to obtain interviews with all the centres de lutte contre le cancer (CLCC) to better understand the obstacles to the implementation of patient therapeutic education programmes and the actions already in place in order to propose a national strategy to formalise and enhance the actions of the CLCCs. [ABSTRACT FROM AUTHOR]

Copyright of Canadian Oncology Nursing Journal is the property of Pappin Communications and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Les papillomavirus humains (HPV) sont des pathogènes cutanéo-muqueux. Ils sont en particulier responsables de lésions bénignes ou malignes des muqueuses anogénitales et oropharyngées, dont l'une des formes les plus prévalentes est le cancer du col de l'utérus, lié à l'infection persistante par un HPV à haut risque (HPV-HR). En France, de récentes modifications ont été apportées dans le dépistage du cancer du col de l'utérus, avec l'introduction du test virologique de détection des HPV-HR chez les femmes âgées de 30 à 65 ans. L'autre volet de la prévention des cancers du col de l'utérus et d'une partie des pathologies HPV-induites repose sur la vaccination, désormais recommandée à l'adolescence à la fois chez les filles et les garçons, à l'aide du vaccin nonavalent. Pour l'enfant plus jeune, si les HPV sont avant tout impliqués dans des verrues cutanées, il ne faut pas méconnaître la possibilité d'atteintes muqueuses ou de formes infectieuses associées à des maladies génétiques. Human Papillomaviruses (HPV) are pathogens infecting skin and mucosa. HPV are responsible for benign or malignant mucosal lesions, mostly at the anogenital and oropharyngeal sites. The most prevalent HPV-induced cancer is cervical cancer, associated to a persistent infection by a high-risk HPV (HR-HPV). In France, the strategy of cervical cancer screening has changed recently, with the introduction of HR-HPV testing for women aged 30 to 65 years. In order to better prevent HPV-associated diseases, vaccine recommendation has been extended to teenage boys. For young children, warts are the most frequent manifestations of HPV infections, although some mucosal infections and specific HPV diseases in a context of genetic disorders may also occur. [ABSTRACT FROM AUTHOR]

The treatment of acute osteomyelitis is becoming more challenging since the emergence of community-acquired methicillin-resistant Staphylococcus aureus. We collected data on all patients with acute osteomyelitis caused by this germ over a period of 21 years (January 1995- December 2016) and we analyzed the peculiarities of this disorder. Our case series includes 15 children, with an average age of 9 years. All patients had affected lower limb. Local trauma was reported in 8 cases and skin carriage in 4 cases. Acute onset was reported in 12 cases associated with pseudoparalysis of the affected limb. One patient had Staphylococcus aureus pulmonary infection with signs of septicopyemia. Blood culture was positive in 8 cases. In one case PCR assay for detection of Panton-Valentine leukocidin was performed with positive result. All these patients underwent surgical debridement and received secondarily adapted empirical antibiotic therapy. Outcome was good in 8 cases and poor in the other cases, with transition to a chronic state in 6 cases and one case of death. Pathological fracture was reported in 3 cases. Osteomyelitis cause by community-acquired methicillin-resistant Staphylococcus aureus is associated with a pejorative outcome. Recognizing the clinical and paraclinical signs of these infections is essential for a specific and early therapeutic management. [ABSTRACT FROM AUTHOR]

• L'ostéomyélite chronique non bactérienne (OCN) est une maladie osseuse auto-inflammatoire. • Il n'existe pas actuellement de recommandations standardisées concernant le diagnostic ou le traitement de l'OCN. • L'imagerie par résonance magnétique du corps entier peut détecter des lésions infracliniques. • Le traitement par anti-TNF représente une alternative efficace et sûre pour les patients atteints d'OCN. L'ostéomyélite chronique non bactérienne (OCN) est une atteinte osseuse auto-inflammatoire pour laquelle il n'existe actuellement pas de recommandations standardisées concernant le diagnostic ou le traitement. L'objectif de cette étude est de décrire notre expérience de la biothérapie chez des enfants atteints de cette maladie. Revue rétrospective des dossiers de patients atteints d'OCN sous biothérapie suivis dans deux établissements de soins tertiaires entre janvier 2007 et avril 2020. Chez la plupart des patients, la biothérapie instituée a été un traitement ciblant le TNF, instaurée en raison de la persistance de l'activité de la maladie après un traitement standard par au moins deux médicaments (anti-inflammatoires non stéroïdiens et corticoïdes et/ou pamidronate). Vingt cinq dossiers de patients ont été colligés, dont 19 (15 filles) n'ont pas répondu au traitement conventionnel. L'âge moyen au moment du diagnostic était de 8,8 ± 2,9 ans et le délai moyen avant le diagnostic de 6,9 ± 8,3 mois. Tous les patients présentaient des douleurs osseuses et six sur 19 avaient également de la fièvre. Les os touchés étaient, par ordre de fréquence, le fémur (9 patients), la clavicule (6), le tibia (6) et les vertèbres (5). Neuf enfants présentaient des lésions cutanées. La protéine réactive C (CRP) était élevée chez 13 patients sur 19 (moyenne 20,2 ± 11,7 mg/l), et la vitesse de sédimentation (VS) était élevée chez 16 patients sur 19 (moyenne 48 ± 29 mm/h). Tous les patients ont reçu des anti-inflammatoires non stéroïdiens, 15 sur 19 du pamidronate, 10 sur19 des corticoïdes et les19 des anti-TNF. À la dernière visite de suivi, 10 patients sur 19 recevaient toujours une biothérapie (8 de l'adalimumab et 2 de l'infliximab) et 18 patients sur les19 étaient asymptomatiques. En ce qui concerne les effets indésirables, l'un des patients sous infliximab a développé une ostéomyélite à staphylococcus aureus et le second, une leishmaniose cutanée. Cette étude montre que les anti-TNF semblent une alternative efficace et sûre pour les patients atteints d'OCN réfractaire aux traitements conventionnels. [ABSTRACT FROM AUTHOR]

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