Témoignage à l’attention des enseignants des universités et des centres de formations

The writers propose that an academic learning and continuing educations may be conceived from the experiences of its teams and those of clinicians who get involved in the different socio-educational and judicial sectors. They suggest that novice professionals emerging from the clinical and educational scenes – who have to deal for the first time with practices with teenagers – may be taken into account. They have to receive knowledge about the teenager and his environment and they also need landmarks in order to be able to exercise other jobs confronted with the same situation. According to them the acid test of the interdisciplinary works is anthropology: discipline focused on the understanding of the humans. The presence in the socio-educational and judicial fields of teenagers the most affected by difficulties is considered as a clinical paradigm (frequency of co-morbidity behind a social trouble). To conclude this paradigm introduces the concept of “sacrificed children”.     

Place et enjeux de la formation des acteurs de santé auprès des adolescents

Teenagers’ Houses are a tremendous resource to bring professionals together on the questions of adolescence. They are meeting places, places of care and places of professional training too. After delimiting a new teenager's clinical comprehension, we describe the stead and the issues of the professional trainings of the health protagonists working beside teenagers. Being in charge of the “Teenager's Medicine and Health” Inter-University Degree, we detail the importance of these professional trainings. They are source of reassessments and evolution of the ways of thought. They are too source of dynamism, creativity and daring, indispensable for those who work beside teenagers.     

Évaluation des connaissances et des pratiques d’hygiène des mains au niveau de l’unité de néonatologie et soins intensifs du service de médecine infantile et néonatologie de l’hôpital Nord, Marseille

Background

The hygiene of hands stays the basic measure to reduce the incidence of the hospital-borne infections. Its importance is major in a service of neonatology. Our work aimed at estimating the knowledge and the practices on the hygiene of hands.

Method

The study was realized at the level of the unit of neonatology and the intensive care of the service of infant medicine and neonatology of the north hospital of Marseille and took place from 1st till 15 August 2008.

Results

We questioned 55 persons of the staff, seek attendants and observed 30 persons. Near the quarter of the staff (23.6%) think that the solutions hydro-alcoholic are less effective than the simple wash of hands and more half (the 51%) than they are less effective than the hygienic wash. In respectively 20% and 36% of the cases, the staff underestimates the duration of the procedure of wash of hands and the hydro-alcoholic friction. In 58.1% of the cases, the staff ignores that the hydro-alcoholic solutions can be used in all the situations where hands are not soiled. Attendants seems to have a good knowledge of the hydro-alcoholic solutions. They know the indication about it in 56.2% of the cases and think that they are effective in 50% of the cases. The staff seems to have a good theoretical knowledge (87.2 in 96.4%) measures of hygiene of hands to be before adopted and after the most current gestures in the unit. There is an inobservance of the hygiene of hands in 33.3% of the cases. None of the persons outside the service practised a measure of hygiene of hands. A bad quality of the wash of hands concerning the contagion at the end of procedure was found in 64.7% of the cases and it in all the observed categories.

Conclusion

There is a real lack of information of the staff about the hygiene of hands. For the improvement of the quality of the care, the evaluation of the practices and the training of the staff turn out indispensable.     

Nouvelles données sur I'étude des anomalies constitutionnelles des enfants et des particularitéy de leur metabolisme.

Professeur de clinique des maladies infantiles de l'Academie Militaire de Médeeine à Leningrade.     

Les changements institutionnels amenés par la loi de février 2005 pour l’égalité des droits et des chances,la participation et la citoyenneté des personnes handicapées

First, the author describes the changes produced by the 1975's law. A change of perspective on disability has been the source of the law of February 11, 2005. This has changed the relationship of children with disabilities with the school. In the MDPH, a personalized project of schooling is constructed. The articulation of the role of each stakeholder is taking place gradually. This leads to some important questions. The National Solidarity Fund for Autonomy supports activities that promote this articulation. Some of its actions are focused on assessing the needs of people.     

Estime de soi et démobilisation scolaire des adolescents

Objective

The objective of this research is to identify the psychological processes underlying the phenomenon of school demobilization and highlight the protective factors of dropping out, with particular attention to the impact of self-esteem of adolescents.

Methods

We proceeded to the award and the statistical validation of two scales (self-esteem and school mobilization) with a sample of 405 college students for the testing of our hypothesis, with linear regression analyzes.

Results

The results support the hypothesis that self-esteem has an effect on school mobilization. More self-esteem is high, especially the so socio-emotional and academic self, more school mobilization is strong, suggesting that emotional control but also the assessment that the young because of his academic skills, would manage the process of competition and struggle for social recognition that college students are confronted by the expression of strong mobile on the school and knowledge.

Conclusion

In conclusion, the results of this research suggest that self-esteem is a preventive dimension of demobilization school. They underline the importance of questioning earlier in adolescents, their school mobilization, conceived as a co-construction, by differentiating the dimensions of the report to the school's relation to knowledge and engagement in school work, taking into account their self-esteem.     

Facteurs de risque psychosociaux et troubles psychiatriques des jeunes pris en charge par l’aide sociale à l’enfance et ayant recours à des soins hospitaliers

Background

Children and adolescents involved with foster care are a population at high risk of developing psychiatric disorders. Here, we aimed to assess in children and adolescents admitted in a University Department of Child and Adolescent Psychiatry whether being involved with foster care would change psychopathology and risk factors they face.

Method

We conducted a case-control study in a sample of 103 inpatients aged 6 to 18 years (52 supported by foster care; 51 not supported). Assessment included family and medical histories, psychopathology using the MINI neuropsychiatric interviews (Kid and parents) for axis 1 diagnoses and the diagnostic interview for borderline for axis 2 diagnoses. We also scored the following scales: Global Assessment Functioning, Eysenck Impulsivity and Empathy Scale, Buss and Durkee Hostility Inventory, Harvey Affective Liability Scale.

Results

We found more psychosocial life events, both past and recent (occurring less than 2 years) in inpatients involved with foster care (family conflicts, single parent, repeated breaks in places of life, academic failures). We also found more family history of antisocial personality disorder, alcoholism and other drug abuses in first-degree relatives. Regarding axis 1 psychopathologies, we found significantly more conduct disorders, specific developmental disorders and learning difficulties among youths supported by foster care. Finally, we found several prevalent traits of the borderline personality and higher scores of impulsivity, emotional liability and hostility. However, we did not find significant difference for empathy score between the two groups. The results emphasize a condition of cumulative risk factors in the inpatients population involved with foster care.

Conclusion

The severity and prevalence of psychiatric disorders among youths involved with foster care and requiring psychiatric inpatient stay show the impact of interactions with the environment on the development of psychopathology in children and, for some of them, the inadequacy of the means of prevention.     

Atrésie des voies biliaires : une urgence diagnostique et thérapeutique

Every neonatal jaundice lasting more than 2 weeks needs urgent investigations, beginning with examination of stools colour, and blood tests with total and conjugated serum bilirubin. If neonatal cholestasis (NC) is confirmed, vitamin K should be immediately injected, and the child should be referred to a specialised centre for investigations and treatment. Biliary atresia (BA) is the first cause of NC. Its diagnosis is urgent, since the chance of success of the conservative surgical treatment (Kasai operation or variants) decreases rapidly as the age at surgery increases. Normal ultrasound scans cannot rule out BA. After prompt work-up looking for the main other causes of NC, BA can often be strongly suspected before surgery, and is confirmed by operative findings and cholangiogram if needed. In case of failure to restore the biliary drainage, biliary cirrhosis progresses and leads to liver transplantation, generally in the first years of life. Currently, more than 90 % of children with BA can live, with a close to normal quality of life for most of them. Early diagnosis and treatment of BA contribute to decrease the needs for liver transplantation in infancy and childhood.     

Approche psychopharmacologique des troubles du comportement chez l’enfant et l’adolescent

The aim of this article is to present the state of the art of the psychopharmacological approach to behavioral disorders in children and adolescents. First, we will specify the phenomenology of behavioral disorders with a particular attention to the notion of aggressiveness. Then we will present a review of the psychopharmacology of behavioral disorders according to the various syndroms in which, these behaviors are observed and we will end with some recommendations concerning the pharmacological approach to this type of disorders.