Search

Abusive head trauma (AHT) is a criminal offence that is prosecuted ex officio, following report to the police from physicians or child protection services. The aim of this study was to assess whether the judicial outcome (dismissal vs indictment) was influenced by the quality of the medical documentation and/or the time span between AHT diagnosis and reporting child abuse to the police. The cohort was divided in two groups: 13/23 dismissals (57%) and 10/23 indictments (43%). The diagnostic probability of the AHT cases was certain for both groups. Nonetheless, in fraction of dismissed cases, alternative explanations for the observed lesions seemed plausible to the public prosecutor. Legal files of only 3/12 dismissed cases had a forensic report, while 6/10 cases that were indicted included a forensic report. Further, the legal file of several dismissed cases entirely lacked medical documentation (3/12), which was not the cases for indicted cases. The period between AHT diagnosis and reporting to the police was not different for dismissals (29 ± 19 days) and indictments (7 ± 4 days) (p = 0.32). Physicians filed reports more rapidly (6 ± 1 days) compared to childhood protection service (70 ± 46 days) (p = 0.01) and that may increase the rate of indictments (9/18) compared to reporting via the childhood protection service (1/5). Despite diagnostic certainty, other causes for the lesions were considered as plausible alternative explanations to judicial professionals in several dismissed cases. These seemed to have less medical documentation and forensic evaluations. In addition, more rapid reporting to the police by physicians seems to increase the likelihood of indictments., (© 2024. The Author(s).)

Neglect of children and adolescents is the most common form of abuse and occurs when their basic needs are not met. The negative impact on physical and mental health can be significant. Early detection by primary care physicians and support for parents and the community, in collaboration with the social and health network, are essential to ensure that minors have an environment conducive to their healthy development. Recognizing the needs of children and teenagers is an important issue in social and preventive medicine, as is defending their interests and rights., Competing Interests: Les auteurs n’ont déclaré aucun conflit d’intérêts en relation avec cet article.

Exposure to domestic violence affects a significant number of minors and is recognized as psychological abuse of children, with harmful consequences for their health in the absence of protection. The identification of such situations by professionals remains a major challenge, given the culture of secrecy that often prevails in such circumstances. When the situation of children or adolescents exposed to domestic violence is known, it is essential to set up an assessment. A brief intervention led by psychologists has recently been developed within the CHUV's Pediatrics Department. Considering the family context and the type of violence, this service assesses the needs of minors and guides them, placing them at the heart of the support process., Competing Interests: Les auteures n’ont déclaré aucun conflit d’intérêts en relation avec cet article.

Growing up in a climate of domestic violence can have serious repercussions on the health and development of minors. The Child Abuse and Neglect Team (CAN Team) specializes in detecting and analyzing this type of violence. Based on the literature, a tool for structuring the clinical assessment of the child's situation has been created, considering the context of the violence and the risk and protective factors. The tool is described in this article, which offers recommendations for primary care physicians in assessing the danger to a child or adolescent's development., Competing Interests: Les auteures n’ont déclaré aucun conflit d’intérêts en relation avec cet article.

With current migratory movements, the population is becoming increasingly mixed, and consultations are receiving more migrants. The paediatrician or general practitioner is often the front-line health professional who has to assess how to welcome a newcomer family, investigate their life history, discuss mental health with them and sometimes overcome the negative prejudices that some cultures and people may have about psychiatry. Identifying worrying symptoms is an important first step in the overall assessment. It is then essential to support these families while working on protective factors and offering support for parenthood. Finally, working with the network will be key to ensuring continuity of care and the most appropriate support for the migrant's needs., Competing Interests: Les auteurs n’ont déclaré aucun conflit d’intérêts en relation avec cet article

Mobbing amongst students represent a worrying public health issue. The role of doctors, whether in the hospital or in the office, is decisive in the early detection of suffering related to a context of violence at school. The CAN Team offers support to professionals confronted with these situations in order to improve the collaboration of adults, professionals or parents, who accompany these young people. Since 2015, the canton of Vaud has been deploying a comprehensive system in schools to prevent and deal with mobbing amongst students. A communication procedure between the CAN Team and the schools has been set up in order to offer a coherent care for all children and adolescents in the canton., Competing Interests: Les auteures n’ont déclaré aucun conflit d’intérêts en relation avec cet article.

Competing Interests: Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

During the semi-confinement period linked to the COVID-19 pandemic, the CHUV's Child Abuse and Neglect Team observed a decrease in cases of child abuse. Has confinement made it easier for families to avoid violence or, on the contrary, to hide it? Within the framework of this second hypothesis, we propose that the relaxation of the measures be an opportunity for professionals to explore in families the possible occurrence of domestic abuse., Competing Interests: Les auteurs n’ont déclaré aucun conflit d’intérêts en relation avec cet article.

Youth sports participation is often perceived as a positive contributor to physical and psychological development. However, we must acknowledge that sometimes the sports environment can be plagued by events of abuse and non-accidental violence of different types. A global and systemic approach will allow the limitation of these catastrophic events in young athletes' lives. Healthcare professionals must be able and knowledgeable to identify abuse correctly and in a timely fashion, to report it and to manage applying interdisciplinary principles. Their role is paramount in the education of all stakeholders, helping to raise awareness around abuse in adolescent athletes. Sporting organizations must apply existing recommendations from health and sporting authorities to guarantee the welfare of the adolescents they welcome in their world., Competing Interests: Les auteurs n’ont déclaré aucun conflit d’intérêts en relation avec cet article.

Social determinants have an impact on patients' access to care and on their health at any age. Young adults are a population at risk of being affected in their health because of a lack of social protection or unavailability of healthcare system adapted to their specific needs. Primary healthcare providers need to identify that window of social vulnerability in order to avoid a discontinuation in healthcare and to prevent biopsychosocial co-morbidity leading to ongoing consequences on their health., Competing Interests: Les auteurs n’ont déclaré aucun conflit d’intérêts en relation avec cet article.

Benefits of physical activity during adolescence have widely been demonstrated. Yet, raising awareness among young athletes and their surrounding about risks associated with too early specialization or energy deficit--with or without eating disorder--is of outmost importance. Such behaviours can affect adolescents' physical or psychological development as well as compromise their athletic career not to mention the potential negative impact on their athletic performance. Primary care practitioners play an important role in early detection and prevention of overuse injuries as well as psychological distress associated with intense physical activity. Such situations need the intervention of an interdisciplinary team in order to prevent long-term complications.

Every pediatrician will be confronted with newborns oryoung infants with skin lesions in proximity of the vertebral column. It is important not to miss a spinal dysraphism because of the risk of meningeal infection or of the possible presence of a tethered cord. A practical algorithm is presented. Non-accidental injury in young infants and toddlers is not rare but difficult to detect. Bruises and fractures are highly suspicious for non-accidental injury and should trigger specific investigations. Emergency departments and hospitals are switching from hypotonic to isotonic solutions as maintenance infusions of children. They reduce the risk of hyponatremia without increasing that of hypernatremia, and they should be used preferentially in the majority of pediatric clinical settings.

Sport activity is a determinant of health and well-being for adolescents' psychological and physic development. Early detection of traumatic lesions or pathological condition among sportive adolescent in the light of their developmental stage is of outmost importance and is best done by an interdisciplinary team. This clinical management also aims at preventing consequences of inappropriate training. The CHUV has set-up a specific sports medicine outpatient consultation clinic for adolescents in the order to provide the best integrative management of young athletes.