In this article, the authors wish to offer the product of their reflections on the concept of coercive control, and share various findings from their day-to-day practice. The text should be read as an invitation to clinical reflection on the conceptualization of a specific form of abuse. Reflection on this approach, initially ignored by the authors, has enriched clinical thinking on certain care situations.

Coercive control is a process of violence in which one person acts in such a way as to subject the other to persistent controlling behavior. In the majority of cases, these are men, and the targets are their spouses and children. The psychotraumatic consequences are innumerable, and need to be understood before they can be identified and treated. The repercussions of coercive control are numerous, whether somatic, psychological, familial, social, professional or academic. This article describes the psychotraumatic consequences for both the victim and the children.

This article provides healthcare professionals with an overview of research on coercive control, a paramount concept for understanding domestic violence, primarily targeting women and children. It aims to foster interdisciplinary dialogue and integrate advances into professional practices and (psycho)education. To this end, we present the conceptual evolution of coercive control and the perpetrators\' behavioral patterns, their risks for victims and professionals, their devastating impact on the rights and biopsychosocial health of adult and child victims, and the challenges posed by technology, particularly generative artificial intelligence.

OBJECTIVE: Pain in children and adolescents with autism spectrum disorders remains underdiagnosed due to their inherent communication difficulties. The goal of this review is to identify the most suitable methods for assessing pain in this population and for evaluating the specific perceptions of, or behavioural reactions to, pain whilst considering disorder severity and specifiers (with or without accompanying intellectual impairment, with or without accompanying language impairment).
METHODS: A systematic review and analysis of the international literature was conducted.
RESULTS: Fourteen studies were selected. No difference was found in pain-related behaviours based on the age or gender of children or adolescents with autism. Three studies showed pain-related behaviours in autism spectrum disorders to be similar to control groups. Other studies showed specific behavioural responses in autism spectrum disorders with a longer physiological and behavioural recovery time associated with an episode of acute pain in this population. Similarly, the three studies that focused on sensory perceptions of pain all showed differences in the autism spectrum disorders population compared to control groups. In hospital or daily life contexts, studies essentially showed idiosyncratic expressions, hypervigilance, motor agitation, negative emotional reactions, or vocalizations. Regarding the association of autism severity with hyposensitivity to pain, the results remain unclear even when language disorders or intellectual disabilities are also present (in conjunction with autism). The Non-Communicative Children Pain Checklist and its translation into French and Italian showed good internal validity and was used by almost half of the studies in hetero-assessment, mostly by parents. Studies recommend the inclusion of parents in the assessment in order to optimise the evaluation process. Similarly, analysis of parent/child/caregiver interviews from the studies highlights the importance of personalizing pain assessment of children and adolescents, taking into account subject-specific characteristics, pathology, and context.
CONCLUSIONS: An integrative and personalized approach to pain assessment appears to be the most appropriate for enhancing the understanding and detection of pain in individuals with autism spectrum disorders. This approach aligns well with a care setting where a nominated professional with a good expertise in autism is responsible for pain assessment. Given the complexity of identifying pain in individuals with autism, further qualitative studies, in conjunction with new pain exploration technologies, are considered necessary as well as a more extensive categorization of the population studies.

Supporting children of affected parents by cancer is challenging whether for patients, families and healthcare teams. Several care methods have been developed to support these children (e.g. individual psychological support, support group). However, professionals may feel uncomfortable with their own theoretical and practical limits. Thus, pair working physician/psychologist can make sense in order to melt the different expertise and to provide advices, open discussion and remediation in the family behaviors and feelings. The aim is to help parents communicate with their children about the disease in order to respond appropriately to the child\'s needs and questions. Our study is observational, around five clinical situations. We deal with parental psychological function, family communication, marital function, and parent-child relationship… Most of the time, children of cancer patients live a stressful experience with major psycho-emotional impact. Inappropriate coping mechanism can be subjected to misperception and lack of interaction with their parents. The question often expressed is the balance between telling the truth and protecting children. However, studies have reported positive effects of interventions around children needs. Thus, the doctor-psychologist pair allows for adaptability of responses to family functioning, children and parents, and thus ensures holistic support for the patient with cancer.

OBJECTIVE: Acetaminophen is the most widely antipyretic analgesic medicine used in adults and children worldwide. Rectal acetaminophen is widely used in children who resist or cannot take oral medications. This study was designed to compare the efficacy of rectal and IV acetaminophen in children with fever and mild to moderate pain.
METHODS: Total 60 children aged six months to 6 years, with fever and pain, that were treated with rectal or intravenous acetaminophen were selected and assigned in two groups. The IV group received 10mg/kg paracetamol as an IV infusion, and the rectal group received a 15mg/kg dose immediately after admission. Pain score was calculated using the FLACC method, and the axillary temperature was recorded at baseline and then 0.5, 1, 2, 4, and 6hours after drug administration. Blood samples were collected at baseline and then at 30min-intervals for the first 90minutes.
RESULTS: The trend of changes in mean pain score at different time intervals was significantly different between the two groups. Body temperature decrease was more prominent in the IV group. The plasma concentration increased in both groups significantly with time. This increase was sharper in the IV group, just in the first 60minutes after drug administration.
CONCLUSIONS: IV acetaminophen has more rapid onset of action, while rectal dosage form control fever and pain for longer duration. Considering its favorable effects with ease of administration and lower cost, rectal acetaminophen can be a reasonable option in selected patients with pain or fever.

BACKGROUND: Ocular toxocariasis is a rare disease, predominantly affecting children and young adolescents, and usually presenting as unilateral posterior uveitis. We report the case of a child with toxocariasis associated with serous retinal detachment.
METHODS: A 8-year-old child with no previous history of toxocariasis was referred for a 1-year decline in visual acuity, unimproved by optical correction, with vitreous condensation on examination, without central or peripheral granulomas, and serous retinal detachment on OCT. The diagnosis was made after extensive questioning, with evidence of contact with dogs and positive serology. Medical treatment combining corticosteroid therapy and antiparasitic therapy was initiated, and the clinical picture improved.
CONCLUSIONS: Ocular toxocariasis is a rare infection, unilateral in 90% of cases. Its clinical manifestation in children is pars planitis, posterior uveitis with a posterior pole chorioretinal focus associated with vitreoretinal traction and/or peripheral granuloma. In our case, the patient presented with vitreous condensation only, with OCT serous retinal detachment and no peripheral or central granulomas. Positive plasma serology or ocular samples confirmed the diagnosis.
CONCLUSIONS: Ocular toxocariasis should not be ruled out in the absence of a typical clinical picture, and seropositivity enables confirmation of the diagnosis when clinical suspicion arises.

OBJECTIVE: Report the epidemiological and lesion aspects of hand bone fractures in children.
METHODS: We did a retrospective and descriptive study over a 10-year period. This study involved 222 childre nunder the age of 16 with 261 fracture cases. The parameters studied were frequency, age, sex, mechanism, circumstances of fracture, consultation time, data from standard physical examination and x-ray of the hand, and associated lesions.
RESULTS: Hand bone fractures accounted for 6.4% of all fractures in children in our service. The average age of the children was 8.5 years with a standard deviation of 4. There was a male predominance with a sex ratio of 2. Domestic accidents led the way with 44.3% of cases. They were followed by playful accidents with 33.94% of cases. Receiving heavy objects and fallingwith hand reception were the most common mechanisms. 62.8% of patients consulted within the first 24 hours. All fractures were in the metacarpals and phalanxes with 31% and 69% of cases, respectively. Head and diaphysis fractures each accounted for 28.1% of cases followed by cervical fractures with 27.8%. Non-displaced fractures accounted for 65% of cases. Associated lesions were found in 10 patients.
CONCLUSIONS: Hand bone fractures are quite common. They often interest the bigchild in the decoy of a domestic or playful accident, by crushing the hand or falling with reception on the hand. Fractures of the phalanxes are the most common while those of carp are absent.
UNASSIGNED: Rapporter les aspects épidémiologiques et lésionnels des fractures des os de la main chez l\'enfant.
UNASSIGNED: Nous avons fait une étude rétrospective et descriptive sur une période de 10 ans. Cette étude concernait 222 enfants âgés de moins de 16 ans et ayant présenté 261 cas de fracture. Les paramètres étudiés étaient la fréquence, l\'âge, le sexe, le mécanisme, les circonstances de survenue de la fracture, le délai de consultation, les données de l\'examen physique et de la radiographie standard de la main ainsi que les lésions associées.
UNASSIGNED: Les fractures des os de la main représentaient 6,4% de l\'ensemble des fractures chez l\'enfant dans notre service. L\'âge moyen des enfants était de 8,5 ans avec un écart-type de 4. On notait une prédominance masculine avec un sexe ratio de 2. Les accidents domestiques arrivaient en tête avec 44,3% des cas. Ils étaient suivis des accidents ludiques avec 33,94% des cas. La réception d\'objets lourds et les chutes avec réception sur la main étaient les mécanismes les plus fréquents. 62,8% des patients ont consulté dans les 24 premières heures. Toutes les fractures siégeaient au niveau des métacarpes et des phalanges avec respectivement 31% et 69% des cas. Les fractures de la tête et de la diaphyse représentaient chacune 28,1% des cas suivies des fractures du col avec 27,8%. Les fractures non déplacées représentaient 65 % des cas. Des lésions associées ont été retrouvées chez 10 patients.
CONCLUSIONS: Les fractures des os de la main sont assez fréquentes. Elles intéressent souvent le grand enfant au décours d\'un accident domestique ou ludique, par écrasement de la main ou chute avec réception sur la main. Les fractures des phalanges sont les plus fréquentes alors que celles intéressant le carpe sont absentes.

BACKGROUND: Sickle cell disease is the most common hemoglobinopathy in the world. Serious in its major form (SS), it exposes the sickle cell subject to osteoarticular complications that can be early and disabling.
OBJECTIVE: The objective of this study was to contribute to a better understanding of the osteoarticular complications of hemoglobinopathy S and C in pediatric settings.
METHODS: It was a retrospective cross-sectional study, conducted over a period of 3 years, from January 1, 2017 to December 31, 2019. Were included, children aged 0 to 15 years with hemoglobin S or C confirmed by electrophoresis and having an osteo-articular complication.
RESULTS: The analysis focused on 42 cases including 24 boys and 18 girls. The median age was 7.5 years. Functional impotence and fever were the main clinical signs observed. Osteomyelitis was the majority diagnosis (59.6%). Hemoglobin electrophoresis found 33.3% SS hemoglobin and 21.4% SC hemoglobin. Staphylococcus aureus was the main germ isolated from the samples. Radiological lesions were multifaceted and dominated by the periosteal reaction. Management based mainly on orthopedic treatment allowed a favorable evolution in 69% of cases. The average length of hospitalization was 23.78 days.
CONCLUSIONS: Osteoarticular complications of hemoglobinopathies S and C are not exceptional. Of chronic and sometimes disabling course, their management requires a preventive approach of primary and secondary type of sickle cell disease.
BACKGROUND: La drépanocytose est l\'hémoglobinopathie la plus fréquente dans le monde. Grave dans sa forme majeure (SS), elle expose le sujet drépanocytaire à des complications ostéo-articulaires qui peuvent être précoces et invalidantes.
OBJECTIVE: L\'objectif de cette étude était de contribuer à une meilleure connaissance des complications ostéo-articulaires des hémoglobinoses S et C en milieu pédiatrique.
UNASSIGNED: Il s\'est agi d\'une étude transversale, descriptive et rétrospective, conduite sur une période de 3 ans, allant du 1er janvier 2017 au 31 décembre 2019. Ont été inclus, les enfants âgés de 0 à 15 ans porteurs d\'une hémoglobine Sou C confirmée par l\'électrophorèse et ayant une complication ostéo-articulaire.
UNASSIGNED: L\'analyse a porté sur 42 cas dont 24 garçons et 18 filles. L\'âge moyen était de 7,5 ans. L\'impotence fonctionnelle et la fièvre étaient les principaux signes cliniques observés. L\'ostéomyélite était le diagnostic majoritaire (59,6%). L\'électrophorèse de l\'hémoglobine retrouvait 33,3% de phénotypes SS et 21,4% phénotypes SC. Le staphylocoque doré a été le principal germe isolé dans les prélèvements. Les lésions radiologiques étaient multiformes et dominées par la réaction périostée. La prise en charge basée principalement sur le traitement orthopédique a permis une évolution favorable dans 69% des cas. La durée moyenne d\'hospitalisation était de 23,78 jours.
CONCLUSIONS: Les complications ostéo-articulaires des hémoglobinoses S et C ne sont pas exceptionnelles. D\'évolution chronique et parfois invalidante, leur prise en charge passe par une approche préventive de type primaire et secondaire de la drépanocytose.

OBJECTIVE: To assess knowledges and practices on iron prescription in pediatric ward in CHU Gabriel Touré of Bamako, Mali.
METHODS: It was a prospective and transversal study canied out. We submitted questionnaire and analyzed the case history of to the children aged 1-60 months old who received iron during the study period from 1rstto 30 July 2012. The prescriptators\' consent were solicited and obtained at first of all.
RESULTS: Fifty prestators were interviewed among them 10 pediatricians (20%), 31 pediatrics\' resident (62 %), 2 generalists physicians (4%), 7 medical student (14%). One hundred 100 were analyzed medical records. More than half of the prestators known the need of iron in children. Thirty percent have received iron at 8 to 10mg/kg. The medication duration wasn\'t indicating in 92% of patients. In our context prestators well know about meaning and the needs of iron in children bout they\'re limited on iron food sources and iron storage.
CONCLUSIONS: The well theorical knowledge on indications and prescription roules on iron in children didn\'t escape from miss practices in its prescription. Moreover works should analyze the reasons of discrepancies.
UNASSIGNED: Evaluer les connaissances et les pratiques relatives à la prescription du fer dans le service de pédiatrie du Centre Hospitalier Universitaire Gabriel Touré (CHU-GT) de Bamako, Mali.
UNASSIGNED: Il s\'agissait d\'une étude transversale réalisée du 1 er au 30 Juillet 2012 à la pédiatrie. Nous avons soumis un questionnaire aux prestataires et analysé les dossiers des enfants âgés de 1 à 60 mois hospitalisés ayant reçu du fer. Le consentement des prescripteurs à été demandé et obtenu au préalable.
UNASSIGNED: nous avons enquêté cinquante prestataires dont 10 pédiatres (20%), 31 médecins CES de pédiatrie (62 %), 2 médecins généralistes (4%), 7 étudiants en fin de cycle médical (14%) et analysé 100 dossiers. Trente pour cent des prestataires ont correctement défini le fer. Plus de la moitié des prestataires connaissaient les besoins en fer chez l\'enfant. Les réserves en fer étaient connues de 42% des prestataires. Huit pour cent des prestataires savaient que les fers apportés par l\'alimentation étaient le fer héminique ou le fer non héminique. Trente pourcent des malades ont reçu le fer à la dose de 8 à 10mg/kg. La durée du traitement n\'a pas été précisée chez 92% des malades.
CONCLUSIONS: Dans notre contexte la bonne connaissance théorique des indications et des règles de prescription du fer chez l\'enfant n\'excluait pas les mauvaises pratiques de sa prescription. D\'autres travaux devraient analyser les raisons de cette discordance.