Revue medicale suisse最新文献

School bullying is a public health issue due to its high prevalence and the significant consequences for the targeted student or witness, if it is not identified and addressed. Physicians must be able to identify this problem in their patients early on and to communicate with school professionals to provide support that is tailored to the complexity and chronic nature of the situation. Interdisciplinary work is often essential to identify the problem by combining different perspectives, offer treatment, implement early intervention, and, sometimes, support parents in pursuing legal action.

The patient, whether a child or adult, interacts with the surrounding systems (family, social, medical) and, through reciprocity (circularity), these systems impact the patient. A child's illness therefore disrupts family dynamics. Like any living organism, the family unit seeks a new balance (homeostasis) between its internal elements (parents, siblings) and external elements (school, work) and modifies for example the roles and tasks of each. Caregivers witness the stages of crisis, transition, and stabilization (life cycle) of families. Training in the systemic approach allows professionals to explore the interactions between the different systems related to the patient in order to identify resources, needs, and difficulties, and to co-construct solutions.

Adverse childhood experiences are common and have a lasting impact on physical and mental health, as well as on risky behaviors. The mechanisms involved include chronic activation of the stress response, as well as brain, immune, and epigenetic alterations that contribute to long-term vulnerability. However, these effects are not irreversible: the presence of protective factors can mitigate their consequences. Healthcare workers play a crucial role in strengthening parental and social support while promoting positive childhood experiences, all of which are key determinants of long-term health and development.

Currently a large number of people living in long-term care facilities suffer from cognitive disorders such as dementia. In this context, new robotic technologies, including social robotics in animals form, can be helpful tools for care and support. However, there are ethical issues that need to be addressed in order to ensure that the use of such robots with vulnerable residents is beneficial. Using the principles of medical ethics, autonomy, beneficence, non-maleficence and justice, we propose a number of ethical assessment criteria for the use of animal-based social robotics with residents of long-term care facilities.

When caregivers are unable to meet their children's needs, psychosocial stress may affect the children's neurodevelopment. Even before or during pregnancy, parental stress is associated with alterations in fetal brain development that may affect later neurodevelopment. Moreover, while parental attitudes and beliefs about child-rearing may impact neurodevelopment (sleep, physical activity, screen time), neurodevelopmental disorders may also affect family mental health. The interaction between psychosocial stress and child neurodevelopment is bidirectional and warrants careful monitoring by primary care health professionals, as suboptimal parenting may hinder the treatment of learning disorders. Thus, early detection and scaffolding of the family structure are key.