L’eSoi : de l’hypotrophie de la représentation du corps à l’hypertrophie de l’image du soi

Screens bring a new element to the environment of the child and even more to that of the adolescent. As a new partner in their development, screens are increasingly retaining the child's attention, and have multiple effects. They alter the relationship to space, time and attention and introduce a new dimension in the construction of the sexuality of young people. They are challenging–for the moment–educational practices. But the impact of screens on young people also depends a lot on the context of use and the environment in which they live. Alongside the child, there are parents, with their educational practices and their own use of screens, and there is society, with its values, the benchmarks it offers to its members, its culture and its models. Screens have become ubiquitous and invite humans to interact through their accessibility, the amusing simplicity of their job and their possibilities of interactivity. This tool will promote and even stimulate the child's empowerment vis-à-vis parents in his discovery and exploration of the world. Access to a screen connected to the Internet explodes the possibilities of interactions and exploration of a virtual space that is almost infinite. More and more, there is a striking contrast between the increasing spatial framing of the child confined in socially dedicated places, the room, the parental apartment, then the school, spaces set up for his protection… and his freedom to explore and interact with the virtual environment made possible by the connected screens that parents offer him. For safety reasons, children, especially younger ones, are no longer being opened to the streets, and they spend less and less time in parks or natural spaces (forests, fields, rivers, etc.). Children are increasingly reclusive in the interior spaces of homes and in playgrounds designed for their safety, which sanitizes the encounter with the natural environment. In contrast to this physical framing, the child's framing in the discovery and exploration of the virtual world increasingly escapes parents, despite the “parental control” devices. In this article, we try to identify some of the effects of the significant use of screens by children and adolescents on the construction of space and on the relationship to their bodies illustrating it in clinical vignettes. Indeed, the body-environment interaction is at the basis of the construction of the representation of one's own body, as well as that of space, essential for the building of identity.     

Prise en charge de la paralysie faciale périphérique chez l’enfant

Peripheral facial nerve palsy may (secondary) or may not have a detectable cause (idiopathic facial palsy or Bell's palsy). Idiopathic facial palsy is the common form of facial palsy. It remains diagnosis by exclusion. The prognosis is more favourable in children than in adults. We present current diagnostic procedures and recommendations regarding treatment in children.     

Mise à jour des vaccinations de l’enfant arrivant de l’étranger (adopté, réfugié ou migrant) en France

In France, international adoption includes around to 90,000 children since 1980 and near 300,000 immigrant children were counted in 2008. This population is heterogeneous, according to age and country of origin, and its large number. It is not easy to completely and surely assess the vaccine status of the child. Due to a great variability of individual situations, it is not possible to have systematic and unchangeable rules. This article aims to give an update of catch-up vaccination of internationally adopted or refugee or migrant children in France. The vaccination status of a child who recently arrived in France is complex and has to be adapted to his country of origin. Some of them were never vaccinated whereas the vaccine status of others is uncertain or unknown. Three parameters have to be considered: the age of the child, the country of origin, and sometimes serology in the case of doubts of his vaccine status. Catch-up vaccination of foreign children has to be adapted to French vaccine recommendations, as a reference, and to vaccines already administered to the child.     

Conséquences psychosociales de l’exposition à une catastrophe technologique à l’adolescence : l’exemple de la tragédie ferroviaire de Lac-Mégantic

BackgroundIn 2013, a train derailment in Lac-Megantic (Quebec, Canada) caused significant human and material losses. This study documents the consequences of exposure to this disaster on the psychosocial functioning of adolescents.MethodsThree and a half years after the tragedy, 689 students aged 12 to 18 completed a self-administered questionnaire at their school, for a response rate of 85.3%. The questionnaire included multiple choice questions designed to describe the sociodemographic, family, educational and social characteristics of the respondents as well as their psychological health. It was designed using scales or questions that were previously validated with young people during national surveys.ResultsThe study shows that teenagers exposed to such a disaster are more at risk of developing psychological health problems than their unexposed peers. Significantly, more students exposed to the train derailment than unexposed youth saw a decrease in the quality of life in their community (12.9%). They also scored significantly lower for their resilience and for three of the five resilience protection factors measured using the Resilience Factors Inventory (IFR – 40). They had more psychological difficulties, including manifestations of post-traumatic stress (15.6%). They also had suicide thoughts in the 12 months prior to the survey (38.9%) and had lower self-esteem compared to their unexposed peers. Finally, significantly more exposed teenagers reported personal, family and school difficulties due to their alcohol consumption.ConclusionThe study shows that in the long term after a technological disaster, teenagers who have been directly or indirectly exposed are more affected than their unexposed peers. In light of the results obtained, research must continue in order to guide professionals in setting up psychosocial interventions that adequately respond to the experiences and needs of these young people.     

Marche allergique chez l’enfant,de la rhinite à l’asthme : prise en charge,place de la désensibilisation

Allergic rhinitis (AR) is a common IgE dependent disorder. AR is maybe one of the steps of the allergic march, which starts with atopic dermatitis and food allergy and includes atopic asthma. AR and asthma are frequently associated. AR is frequently under-diagnosed and undertreated although it affects quality of life and school performance. Management of AR depends on its severity and will associate environmental control (best guided by environmental investigation and skin testing of specific IgE antibodies), pharmacotherapy (with antihistamines and intranasal corticosteroids as first line drugs). At present allergen immunotherapy is considered in patients with severe AR, insufficiently controlled by pharmacotherapy and who demonstrate specific IgE antibodies to relevant allergens. Sublingual immunotherapy is well tolerated. Only immunotherapy with the right allergens has the potential to alter the natural history of the allergic march, by preventing the development of new allergen sensitizations and reducing the risk for the subsequent development of asthma. This fact might extend the indications of specific allergen immunotherapy. Patients (and parents) education is of utmost importance in the management of allergic disorders.     

Prise en charge de la violence et du décrochage scolaire à l’école I. Revue de la littérature

Background

Violence at school and school dropout constitute a big concern as well for the teachers, for the parents as for the clinicians. Several explanatory factors are proposed: individual, familial, school climate or factors in connection with the group of peers. These factors impact on the psychic, school and social health of the child. Coverages are proposed at the national and international level and seem to give convincing results. Each of these initiatives implied in a differentiated way to parents, pupils and teachers. None put in the work a project integrating the educational triangle that is at the same time the parents, the children and the teachers within the school. The objective of this work is to make a theoretical current situation on the school dropout and the violence to the school and to present some devices of coverage of the pupils concerned by these difficulties.     

Le vécu par le pédiatre de l’annonce d’une « mauvaise nouvelle » à l’enfant et à l’adolescent

Few studies are available on pediatricians’ experience with announcing bad news. Announcing bad news is an important component of medical practice and is even more complex in pediatrics because parents must be associated. We had 20 hospital pediatricians complete a questionnaire containing 30 questions about their own experience announcing bad news to a child or a teenager. In spite of their experience and the time they have spent practicing medicine, there are many limitations stemming from different factors concerning children, teenagers, their families, and themselves. The difficulties encountered by pediatricians are mainly related to the timing of the announcement, the location, the choice of the words used, and the poor understanding of children and families, due to intellectual, cultural, or psychological limitations. Pediatricians question their own capacity to make such an announcement, wondering if the information has actually been well understood. They indicate that they are themselves affected. Most of them develop and implement strategies to refute the emotional instability caused by the announcement of bad news. Yet many of them feel weak, even talking about a deep sense of loneliness and guilt.