Childhood obesity and overweight are increasing, with short-, medium- and long-term consequences for children and for healthcare systems. Data on how a child’s Body Mass Index (BMI) category affects primary healthcare use in children remain limited, especially in France.This study assessed the association between overweight and obesity and general practice (GP) consultation rate in children aged 2–17 years.A retrospective cohort study (2012–2022) from the PRIMEGE health data warehouse was established. International Obesity Task Force (IOTF) criteria were used to define BMI categories (underweight, normal BMI, overweight and obesity). The primary outcome was to estimate the change in consultation rates after transitions from normal BMI to overweight and overweight to obesity. An interrupted time‐series analysis was conducted with a negative binomial and zero-inflated mixed model.A total of 1,321 children were included in the analysis, accounting for 43,069 consultations. The transition from normal BMI to overweight was concerning 1,126 children and was associated with an increase in consultation rates of 42.4% [33.4%; 52.1%]. The transition from overweight to obesity concerned 195 children with an increase of 61.6% [35.2%; 93.4%].The results of this study regarding the role of obesity in increased general practice consultations are consistent with the existing literature, whereas the pattern observed among children with overweight has not, to our knowledge, been previously reported. Owing to the self-controlled design, this study accounts for numerous confounding factors, including unmeasured ones, thereby strengthening the findings, although the real-world nature of the data may introduce bias, particularly selection bias.This study shows that increases in BMI categories are associated with higher GP consultation rates among French children. These findings underscore the need for preventive strategies and to consider the specific healthcare needs of children with excess weight.

Childhood fever is a common reason for medical consultation and a major contributor to healthcare use. Inappropriate consultations, driven by fever phobia and insufficient parental knowledge, contribute to healthcare system overload. Although fever phobia is culturally rooted, multimodal parental education can improve knowledge and promote more appropriate healthcare-seeking behavior, particularly in primary care.To evaluate the effectiveness of a multimodal parental education intervention on childhood fever. The primary outcome was improvement in parental knowledge of fever-related warning signs. Secondary outcomes included overall fever knowledge and parental confidence.This study comprised a descriptive analysis followed by a matched pre–post comparative analysis of parents’ knowledge after an educational intervention among those contacting SOS Médecins for childhood fever. Data were collected within the SOS Médecins Lyon population between February and June 2024, with baseline assessment during home visits and follow-up five days later. The intervention combined quizzes, patient information leaflets, general practitioner-delivered advice, and a video.Overall, 142 parents completed the first quiz and 96 the second, yielding a response rate of 67.6%. Parents were predominantly aged ≥35 years (58.5%), living alone (19.7%), unemployed (28.2%), and receiving social assistance benefits (33.1%). Pre–post analysis showed significant improvements in general knowledge, understanding of severity criteria, and confidence in managing a febrile episode (all p < 10⁻⁴). Similar improvements were observed among parents receiving social assistance.Parents consulting SOS Médecins for childhood fever showed baseline characteristics similar to emergency department populations but with greater socioeconomic vulnerability. A home-based, multimodal parental education intervention significantly improved knowledge of fever severity criteria and parental confidence, particularly among disadvantaged parents. These findings support integrating parental education into out-of-hours primary care to improve healthcare-seeking behavior.In a socioeconomically vulnerable population managed by SOS Médecins, a home-based multimodal parental education intervention significantly improved parental knowledge and confidence. These findings support parental education as a key primary care strategy and warrant evaluation of its long-term impact on reducing unnecessary consultations. MeSH  :  Fever; Child; Patient Education as Topic; Primary Health Care; General Practice; Socioeconomic Factors; Home Care Services

Infant regurgitation is a physiological phenomenon affecting 50–70% of infants. Gastroesophageal reflux disease (GERD) is less common (12.6%) in infants. According to French guidelines, when the GERD is confirmed by pH-metry, it may justify proton pump inhibitor (PPI) treatment, prescribed off-label before the age of one (<1Y). However, PPI prescriptions for infants <1Y in primary care continue to rise in France.The objective of this study was to describe the proportion of GPs who had prescribed a PPI for GERD in infants <1Y and the conditions surrounding these prescriptions.A quantitative, observational, descriptive, and cross-sectional study was conducted between 12/2024 and 06/2025 through an online questionnaire distributed to general practitioners. Bivariate analyses were performed to explore potential associations between the collected variables. The p-value was set at <0.05 for statistical significance. Logistic regression was conducted to identify factors independently associated with specific prescribing practicesA total of 204 questionnaires were analysed. Overall, 55.7% of GPs had prescribed a PPI to an infant <1Y, most often after specialist advice (23%) or pH monitoring (7.1%). Only 9% of the respondents mentioned the term “off-label” on the prescription. Fifty-one percent had prescribed a CMPA formula, with 25% doing so after PPIs. GPs who prescribed a CMPA formula were 7.6 times more likely to request a CMPA blood test (p < 0.001).Most GPs did not follow the 2024 French guidelines and prescribed PPIs without prior diagnostic testing, seemingly relying on international recommendations (NASPGHAN/ESPGHAN). The difficulties resulted from the diagnostic complexity of GERD in infants, parental pressure, and limited access to specialists. The prescription of CMPA formula sometimes after PPI failure seems to reflect a reversal of the recommended algorithm. These findings highlight the need to strengthen continuing medical education. The mention "off-label" is required by law, the lack of disclosure exposes practitioners to medico-legal risk.It is probably necessary to review the guidelines and the marketing authorization under one year old. Further research, including a study on parental perceptions of PPI effectiveness and, afterwards a pragmatic randomized trial in primary care, is needed to evaluate their real-world effectiveness in outpatient settings.

Childcare workers and carers using childcare in a multilingual, lower socioeconomic, culturally diverse local population in XXX.  The population sampled has the second highest use of antibiotics amongst children in XXX, a country with very high antibiotic use.  Childcare has been identified internationally as a possible driver of antibiotic use in children.The aim of this study was to investigate the knowledge, attitudes and behaviours of childcare workers and parents/care givers regarding antibiotic use in children attending childcare in a culturally and linguistically diverse community.In this qualitative study parents and childcare workers from a large, culturally diverse, lower socioeconomic, multilingual local government area were purposively sampled to maximise diversity, including English speakers and those preferring other languages. Recruitment was hampered by the COVID-19 epidemic. Semi-structured telephone interview transcripts were thematically analysed using methodology proposed by Braun and Clark.Eighteen childcare staff and 20 parents were interviewed, drawn from 7 participating services. Interview findings were grouped under two major themes: the culture regarding antibiotic use and the regulatory and administrative environment of childcare centres. Interview responses demonstrated interaction between themes and provided insights into the knowledge, attitudes, and behaviours of staff and parents/carers in relation to antibiotic use.The study did not find evidence of explicit pressure to obtain antibiotics for children. The themes appeared to work together to increase antibiotic prescriptions. Parents and care providers expressed beliefs in antibiotic efficacy for numerous conditions, contrary to scientific knowledge and public health messaging. Respondents were unaware that antibiotic use in the region is unusually high. The regulatory and administrative context governing attendance during illness does not seem to overtly drive antibiotic seeking behaviour. However, parents expressed an imperative to work which appeared to drive adoption of strategies perceived to shorten illness, including using antibiotics. These factors may also increase doctor attendance seeking certificates to facilitate early return to childcare. Doctor attendance may increase antibiotic prescriptions. These issues deserve further investigation which should also include doctors’ perspectives.Cultural factors and the regulatory/administrative environment of childcare may increase pressure for antibiotic use in the absence of explicit advice to parents to obtain antibiotics

Childhood overweight is a major health concern with long-term consequences. Dutch guidelines recommend that general practitioners (GPs) screen for overweight in children at every visit, yet GPs infrequently initiate weight-related conversations, citing limited time and concerns about parental reactions as barriers.We aimed to (1) explore barriers and facilitators influencing GPs’ initiation of conversations about childhood overweight, identifying determinants with highest potential for change, and (2) examine the role of equanimity, an accepting and non-reactive mindset, and emotional responses in initiating conversations.A cross-sectional survey was distributed to GPs (in training) in the Netherlands between March-May 2025. Measures included the Determinants of Implementation Behaviour Questionnaire (based on the Theoretical Domains Framework), validated emotional valence and arousal assessments, Equanimity Scale-16, and single items on self-reported intention to initiate conversations and implementation success. Descriptive and correlational analyses assessed determinants’ potential for change, and associations between emotion, equanimity, and intention to initiate were calculated. Open-ended responses were analyzed using content analysis.A total of 57 GPs completed the survey; 25 were in training and 46 were women. Most  reported adequate skills (66%), knowledge (61%), and motivation(74%); yet 25% reported high implementation success. Highest potential for change was found for making initiation a habitual action. Other high-potential determinants included beliefs that raising the topic prompts reflection and action, ease of recalling appropriate action, adequate organizational arrangements, and expected conversation initiation from colleagues. Emotional responses to initiating conversation were evident, with a subset (10–15%) reporting strong reactions in valence and arousal. Valence, in contrast with arousal, was positively associated with initiation (r=0.45, p = <0.001). Equanimity scores were high but not significantly associated with intention to initiate conversations.More research is needed to explore if the strong emotional charge of these conversations may constitute a barrier, which equanimity could help to overcome.While GPs express strong intentions to initiate conversations about childhood overweight, actual implementation remains limited. Strengthening habit formation, fostering positive affect, and managing expectations about parental and child responses may stimulate the initiation of weight-related conversations.

Fever without source (FWS) in adolescents remains a diagnostic challenge in primary care, where clinicians must differentiate between common self-limiting viral processes and less frequent but potentially serious bacterial, inflammatory, or malignant conditions. A structured approach, an understanding of red flags, and timely referral pathways are essential to ensure both patient safety and the avoidance of unnecessary investigations.A 16-year-old male presented to primary care with a 10-day history of vespertine fever up to 39°C, chills, diffuse abdominal pain migrating to the right iliac fossa, vomiting, and diarrhoea. Physical examination showed abdominal tenderness without peritoneal signs. Initial laboratory tests revealed markedly elevated inflammatory markers and mild cytopenias. Due to persistent fever and new abdominal focality, the patient was referred to the emergency department to rule out acute appendicitis. Further evaluation included blood cultures, viral PCR, extended serologies, autoimmune testing, hematologic assessment, abdominal CT, PET-CT, transthoracic echocardiography, and endoscopic ultrasound-guided lymph node biopsy. Imaging demonstrated a splenic infarction and multiple infradiaphragmatic lymphadenopathies. All infectious, autoimmune, and hematologic studies were negative. Histopathology confirmed reactive lymphadenitis. The patient improved spontaneously with supportive care and a brief course of empirical antibiotics, remaining afebrile before discharge.This case underscores the importance of monitoring cytopenia recovery, ensuring resolution of systemic symptoms, and maintaining vigilance for late lymphoproliferative manifestations. Coordinated diagnostic pathways between primary and secondary care prevent both under- and over-investigation and provide reassurance to families.Despite alarming imaging findings, the final diagnosis was a benign reactive process. This case illustrates the importance of structured assessment in primary care, early identification of red flags, and thoughtful escalation.Significant radiological abnormalities in FWS may still correspond to self-limited disease, emphasising the value of continuity and clinical judgement in primary care