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Les violences et maltraitances intrafamiliales concernent celles conjugales qui sont intimement liées aux violences faites aux femmes ainsi que les maltraitances et violences sur enfants et ascendants âgés. Le présent article a pour objectifs de définir juridiquement les notions de violences et de maltraitances, ces dernières étant quasi indissociables de la notion de vulnérabilité apparue dans le registre pénal en 1994. Il synthétise les données épidémiologiques actuelles en France et dans le monde et rapporte une sous-estimation évidente des violences intrafamiliale aussi bien en France que dans le monde au regard des problématiques liées au signalement des faits, ainsi qu'à une définition équivoque de la maltraitance. L'article souligne parallèlement que les faits à l'encontre des personnes âgées lorsqu'ils sont avérés sont moins judiciarisés que ceux à l'encontre des femmes et des enfants. Enfin, les auteurs proposent une approche psychopathologique, des éléments de compréhension issus des neurosciences, ainsi que des perspectives thérapeutiques concernant les violences et maltraitances intrafamiliales. Intra-familial violence and abuse includes domestic violence that is not specifically identified as violence against women, abuse and violence against children or elderly relatives. This article provides a legal definition of the notions of violence and abuse. Abuse is virtually inseparable from the notion of vulnerability, which appeared in the 1994 Penal Code in France. The present article summarizes current epidemiological data in France and worldwide and highlights the obvious underestimation of domestic violence both in France and in other parts of the world. One French survey reported that in 1997, 50,000 women were victims of rape and more recently, that 225,000 women had reported being victims of domestic violence. In 2021, there were 143 murders in the context of domestic violence, 85% of which involved women. The mechanisms of this violence are usually described as consisting of 4 cyclic phases alternating between a climate of tension, aggression, disempowerment, and remission (repentance on the part of the perpetrator). From a psychodynamic viewpoint, the phenomenon of ascendancy, initially conceptualized by Freud, makes it possible to understand the submission of the victim towards the aggressor. This phenomenon can lead to the inability of the perpetrator to recognize the otherness of the other (the victim). Systemic approaches recall the notion of circular causality, making the victim part of the system without denying the responsibility for his acts on the part of the perpetrator. The consequences are usually very negative representations of self for the victim and an increased dependence toward the aggressor. The judicial and clinical world has for several years advocated dealing with perpetrators of conjugal violence by issuing an injunction to submit to treatment. This can also include victims who consent to these therapeutic proposals. Child abuse in France involved more than 35,000 children in 2018. In 80% of the cases, the perpetrators were one of the victim's parents. The abuse ranged from psychological violence (about 30%) to sexual violence (3.6%). Globally, the prevalence of physical violence against children was estimated to concern from 5 to 35% of children in 2014. Fifteen to 30% of girls versus 5 to 15% of boys are thought to have suffered some form of sexual violence. The tender age of the child is the first risk factor, given that 50% of violent deaths in 2011 concerned subjects under the age of four months. From a psychodynamic perspective, child abuse and violence induce trauma with lasting effects on the personality. Several authors mention resulting attachment disorders and behaviors similar to the Stockholm syndrome. Furthermore, in the neurosciences, repeated trauma is considered to lead to disruption between warning neuroanatomical structures and memorization structures, preventing the memorization of events as representations in a space-time continuum, and retaining them only as a strong stress signal. In addition to violent deaths and immediate traumatic facial injuries, this abuse leads to precarious physical and mental health throughout life. The abuse of older people has become a fact of society worldwide. This phenomenon potentially affects 141,000,000 people worldwide and nearly 7000 people in France. The victims are most often women, widows, and dependents and with some financial resources. The perpetrators are often reported to be exhausted caregivers, but this does not explain the frequency of abuse involving money. Prosecutions after the facts are reported are rare. There is an obvious, underestimation of intra-familial violence both in France and globally, whether this relates to the problems involved in reporting such incidents, or to the ambiguous definitions attributed to abuse. This article underlines how violence against the elderly is less often reported to the courts than those against women and children. Finally, the authors propose a psychopathological approach, neuroscientific insights and therapeutic perspectives on intra-family violence and abuse. [ABSTRACT FROM AUTHOR]

Identify, describe and produce an evidence map of studies investigating psychosocial factors association with, or effect on, clinical outcomes for people with knee osteoarthritis. Scoping review of interventional and observational studies was performed. Medline (Ovid), Embase (Ovid), Cumulated Index in Nursing and Allied Health Literature, PsycInfo and Web of Science were searched on the 15th May 2023. Screening, data extraction and analysis was performed by two independent researchers. Extracted information included characteristics of studies plus which psychosocial factors were used to investigate association with, or effect on, clinical outcome(s). Descriptive statistics summarized the study design, temporal trend, geographic distribution, frequency of each psychosocial factor and whether associations/effects were observed. 23,065 records were screened, with 108 studies selected. Eighty-two percent of studies (n = 89/108) were cross-sectional in design. Number of studies increased over time and spanned 28 countries. Most research originated from the Americas region (55 %, 59/108). Twenty-four psychosocial factors (11 psychological, 13 social) were identified. Depression (47 %, n = 48/102) and education (28 %, n = 29/102) were the most frequently reported psychological and social factors, respectively. Psychological factors were often reported to have an association with/effect on pain (81 %, n = 71/88) and physical function (75 %, n = 56/74). Social factors were less frequently reported to have an association with or effect on pain (57 %, n = 46/81) and physical function (50 %, n = 18/36). Psychosocial factors are often associated with clinical outcomes for people with knee osteoarthritis. High-quality longitudinal studies examining a wide range of psychosocial factors across diverse cultural and geographical settings are key to continue informing the development of biopsychosocial models of care. [ABSTRACT FROM AUTHOR]

Intraoperative Raman spectroscopy (RS) has been identified as a potential tool for surgeons to rapidly and noninvasively differentiate between diseased and normal tissue. Since the previous meta-analysis on the subject was published in 2016, improvements in both spectroscopy equipment and machine learning models used to process spectra may have led to an increase in RS efficacy. Therefore, we decided to conduct a meta-analysis to determine the efficacy of RS when differentiating between glioma tissue and normal brain tissue. Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed while conducting this meta-analysis. A search was conducted on PubMed and Web of Science for prospective and retrospective studies published between 2016 and 2022 using intraoperative RS and standard histology methods to differentiate between glioma and normal brain tissue. Meta-analyses of log odds ratios, sensitivity, and specificity were conducted in JASP using the random-effects model with restricted maximum likelihood estimation. A total of 9 studies met our inclusion criteria, comprising 673 patients and 8319 Raman spectra. Meta-analysis of log diagnostic odds ratios revealed high heterogeneity (I2 = 79.83%) and yielded a back-transformed diagnostic odds ratio of 76.71 (95% confidence interval: 39.57–148.71). Finally, meta-analysis for sensitivity and specificity of RS for glioma tissue showed high heterogeneity (I2 = 99.37% and 98.21%, respectively) and yielded an overall sensitivity of 95.3% (95% confidence interval: 91.0%–99.6%) and an overall specificity of 71.2% (95% confidence interval: 54.8%–87.6%). Calculation of a summary receiver operating curve yielded an overall area under the curve of 0.9265. Raman spectroscopy represents a promising tool for surgeons to quickly and accurately differentiate between healthy brain tissue and glioma tissue. [ABSTRACT FROM AUTHOR]