[Motivations for a consultation before adoption: A multicenter study]. / Étude multicentrique sur les motivations d'une consultation avant adoption.

INTRODUCTION: While the number of international adoptions in France is decreasing, adopted children are older and in poorer health than they used to be. This phenomenon has resulted in an increase in the demand for preadoption consultations over the past several years. This study analyses the reasons for these consultations. METHOD: Prospective multicenter study conducted from 1 January to 31 December 2013. RESULTS: Ten centers contributed to the study, i.e., 196 preadoption consultations. Seeking medical advice was the reason for 88% of the consultations, whether the advice was based on the study of an identified child's medical file (32%) or a country's healthcare characteristics, whether the country was identified (34%) or not (23%). In 6% of cases, the motive for preadoption consultations was social and familial, and in the last 5% it was to obtain general information about adoption and its procedures. In more than 40% of the cases, whether the child or the country identified, Russia is the subject of the consultation because of the complexity of the files and because of the dreaded but rarely mentioned fetal alcohol syndrome. CONCLUSION: The deterioration of adopted children's health is an additional worry for future adoption applicants. To provide them with the best information possible without making choices for them, specialists should have substantial experience in adoption before going into these preadoption consultations.

[Pneumococcal conjugate vaccine coverage in a hospital center of the Metropolis of Lille in 2008]. / Couverture vaccinale par le vaccin pneumococcique heptavalent conjugué dans un centre hospitalier de la métropole lilloise en 2008.

OBJECTIVE: To describe the vaccine coverage of Prevenar(®), follow its evolution since its universal recommendation from 2006 and search the influence of certain socio-economic factors. METHOD: A prospective descriptive study by a questionnaire enrolled the first 250 children born after 2001 and aged more than 2 months admitted at our hospital emergency room with their health record. RESULTS: 77.11% of children from any age merged received the first dose of Prevenar(®); 89.51% of those less than 24 months versus 60.38% of those more than 24 months, p<0.0001. The follow-up by a paediatrician and the high mother educational level influenced positively the vaccination by Prevenar(®). CONCLUSION: Prevenar(®) vaccine coverage evolved well since its universal recommendation achieving a 89.51% rate for the first dose. The chase of a brought closer follow-up seems important to assess the impact of this new vaccine strategy.