Disaster Victims Research Articles

Constraints on Transport of Injured Victims after the Earthquake for Disaster Victims’ Evacuation Model Development: A Phenomenological Study

The big earthquake has an impact on the risk of injury to the victims. The wounded victim needed urgent medical assistance to survive. The effectiveness of this service depends heavily on the response speed of stakeholders. To increase the response rate, a detailed emergency response plan is needed. The study aims to identify restrictive factors in evacuating victims of post-earthquake injuries. This qualitative research has a phenomenological design. Participants in this study were 15 nurses who participated in the Disaster Victim Evacuation (DVE) process and who met the criteria with the purposive sampling technique. Data is collected through a deep interview (IDI) using open questions. Data analysis is done using the inductive content analysis method. Two themes contributed to the DVE process as an ERP, namely, 1) restriction of institutional support and 2) cancellation of evacuation routes. These findings have provided an overview of several factors that directly contributed to the implementation of the DVE process.

Assessing the feasibility of free DNA for disaster victim identification and forensic applications

In tropical disaster victim identification (DVI) scenarios, challenging environmental conditions lead to accelerated DNA degradation in remains. To further enhance the utilization of leached DNA from tissue in the preservative solution (termed “free DNA”) as an alternative source, we incorporated new results by assessing its integrity in postmortem and decomposing cadavers preserved in DNA/RNA Shield™ and modified TENT, with silica-based purification (QIAquick®) for faster processing. The psoas muscle tissues of one decomposed and ten cadavers were preserved in each solution at 25 °C and 35 °C for 3 months. Free DNA efficiency was compared with individual reference samples for reliable results in quantity, quality, and STR profiles. The findings revealed that DNA/RNA Shield™ effectively preserves free DNA integrity for extended storage, while modified TENT is more suitable for short-term storage due to higher degradation levels. Moreover, the use of free DNA samples with massive parallel sequencing displays potential for forensic DNA analysis. Successful amplification of the mtDNA control region enables variant calling and heteroplasmy analysis while also serving as quality control using ACTB and enabling differentiation within the 16S rRNA region for microbiome analysis. The simplicity of handling free DNA for PCR-based forensic analysis adds to its potential for various applications, including DVI and field-based analysis of biological evidence.

Pedestrian evacuation planning under dam-break flood disaster considering road risk and road pedestrian demand

When facing disasters, a well-planned evacuation of people can significantly reduce casualties and disaster losses. Hurricane Katrina struck New Orleans in 2005, causing multiple dam failures and resulting in Lake Pontchartrain flooding back into the city. Taking this disaster as an example, this paper evaluates the risk of pedestrian evacuation on roads during dam-break flood disasters. The evaluation considers three aspects: road evacuation difficulty, disaster risk and road pedestrian demand. The fuzzy VIKOR model was used to evaluate 8 indicators for 50 candidate shelters. A dual-objective planning model was proposed to consider the time-varying and diverse emergency needs of disaster victims. By assessing the risk of pedestrian evacuation on the road and delineating restricted areas, the optimal path distance is calculated. Pareto optimality is then employed to achieve a trade-off between the convenience, cost, and applicability of the evacuation plan. In a complex post-disaster environment, the model can adapt flexibly to emergency rescue situations at various stages by adjusting the parameters in the objective and constraint equation. The Pareto optimal frontier can assist in determining the most suitable solution for the current scenario. In the case of New Orleans, 22 and 18 shelters were respectively selected from 34 candidate shelters for evacuation based on the simulated scenarios.

Disaster risk assessment based on the community’s vulnerability, capacity, and responses in facing an earthquake in the Special Region of Yogyakarta, Indonesia

Bantul is one of the regencies in the Special Region of Yogyakarta (DIY) that are prone to earthquakes. In 2006, Yogyakarta was hit by a tectonic earthquake with a magnitude of 5.9 on the Richter scale, resulting in a death toll of 6,234 people, with 1,754 severely injured (e.g., spinal injuries) and in need of paraplegia rehabilitation. The high number of casualties indicates a high disaster risk, which means high disaster vulnerability and low disaster management capacity. The research aims to assess disaster risks based on the community’s vulnerability and capacity in facing the 2006 earthquake disaster in DIY. This study uses a mixed method, consisting of a survey with 44 disaster victims suffering from injuries that result in disabilities (paraplegia) and in-depth interviews with ten family members of the victims. The results show that disaster vulnerability will likely result in a physical risk, i.e., disaster injuries that leave the victims with paraplegia. Such vulnerability is caused by the community’s low capacity and poor response to disasters, including the 2006 earthquake. Another physical risk is the collapsing houses, which lead to economic risk as the community suffers losses of between 30 and 91 million rupiah. Meanwhile, the social risk is a change in the status of the victims from people without disabilities to people with disabilities. That said, social relations increase because the disaster victims with paraplegia have become active members of an organization.

A Systematic Review of the Use of Intraoral Scanning for Human Identification Based on Palatal Morphology.

A common application for intraoral scanners is the digitization of the morphology of teeth and palatal rugae. Palatal scans are most commonly required to fabricate complete dentures and immediate transitional dentures and serve as a reference point for assessing orthodontic results. However, they are also frequently included by accident, even though the main purpose of intraoral scanning is to reconstruct dentition using computer-aided manufacturing (CAM). The literature shows that the identification of disaster victims has frequently involved palatal rugae impressions. As the skull provides sound insulation, the rugae are resistant to heat, chemicals, and stress. Antemortem data might be difficult to find during a forensic inquiry, particularly in disaster victim identification cases. In contrast with DNA and fingerprints, there is a greater likelihood of having a dental record that contains palatal scans. With specialized software, the scans can be exported as open stereolithography (STL) files. Considering that a full case consumes up to about 100 MB of hard drive space, long-term storage should not be an issue compared to a plaster model. Additionally, dentists widely use online databases to exchange data for smile design, implant registration, and orthodontic purposes. This will produce a digital database that grows quickly and is readily usable for forensic investigations. The uniqueness of forensic features is frequently challenged; however, palatal morphology's unique trait could make it possible as it is characteristic of individuals as well as the most distinguishing factor. This review will highlight how rugae, palatal morphology, mirroring, superimposition, and geometrics can serve in forensic identification.

YOUTH EDUCATION INTEGRATING THEIR SENIOR AND NESTOR FUTURE TOO? WITH AS BRIDGE: WISDOM

A central issue in education and learning is the transfer of knowledge, knowhow, intelligence between generations. Another crucial aspect is the transfer of Wisdom. Both the transfer between generations, as well as the transfer of wisdom have in the last decennia be not planned and informal. Moreover the learning and education are adapted to the several age groups, but in general it is neglected for children that they have to learn already skills, knowhow which will keep to have crucial impact for their health and wellbeing when they have age 60 or 70: nestors… Most children will become nestors, if they can avoid to become victims of nuclear wars, genocides or other disasters. In view of the impact of AI, we need to reorient more and more the curriculum concerning the education and learning towards the neglected intergeneration transfer including the care for wisdom. We see today the rediscovery of wisdom. From the intergeneration perspective, we elaborate on topics as exercises, nutrition: gut microbiota, myokine, adipokines. Moreover we elaborate on the educational bridges between young people, children and the elderly (nestors aged 70 and more) taking into account their similarities and complementarities.

General hospital preparedness in facing flood disasters

Hospitals had a very important function in disaster management, especially in providing health services to reduce the suffering of disaster victims in the form of deceases and injuries. Hospital preparedness in facing disasters was contained in the Hospital Disaster Plan which was prepared based on the Safe Hospital Framework [1], and the Hospital Safety Index[2]. The purpose of this study was to analyze the preparedness of Aceh Tamiang General Hospital in facing flood disasters from 4 (four) aspects or evaluation modules namely, Hazard Affecting, Structural Safety, Non-Structural Safety, Emergency and Disaster Management, specifically analyzing the aspect of “Emergency and Disaster Management” according to the research focus namely, hospital policies, human resources preparedness and hospital infrastructure readiness in facing flood disasters. The research methodology was qualitative with a phenomenological design by 7 (seven) informants. The results of the study showed that the policies of the hospital leadership had been good, with the existence of a Leadership Decree concerning the Formation of a Hospital Disaster Management Team, since 2019 ago. However, there were still hospital personnel who did not know about the organizational structures, goals and functions as team members. Many hospital health workers could not go to work because their homes and access to the hospital were flooded. Besides that, hospital infrastructure, especially motorized vehicles such as ambulances and other operational vehicles, could not operate due to flood conditions that reached up to 1 meter. Therefore it was suggested that the socialization of the Disaster Management Team and Disaster Management Simulation should be carried out periodically, for example, twice a year. It should be suggested that the hospital proposed procuring an ambulance with certain specifications and a rescue boat, so that it could break through the floods that occur almost every year.

Addressing Japan’s disposal of nuclear-contaminated water from the perspective of international human rights law

The discharge of nuclear-contaminated water containing radionuclides into the ocean by Japan will lead to its integration into the entire ecosystem through processes of circulation and biomagnification, eventually entering the human body via the food chain. This poses a substantial risk of irreversible damage to both the ecosystem and human health, a situation that will worsen with the ongoing discharge of such water. The respect and protection of human rights represent an international consensus, and safeguarding fundamental human rights is a substantial obligation that states must undertake in accordance with both international and domestic law. Since the Fukushima nuclear disaster, Japan has continuously violated its international legal obligations to protect human rights in several areas, including the resettlement of disaster victims, the reduction of nuclear radiation levels, and the handling of contaminated water. Such actions have compromised and will continue to compromise the basic human rights of not only its citizens but also those of people worldwide, including environmental rights, the right to life, development rights, and food rights. In the aftermath of the Fukushima meltdown, the public and workers involved in handling nuclear contaminants have been continually exposed to high radiation levels, endangering their rights to life, development, and health. Japan’s inadequate efforts in victim resettlement and environmental restoration have jeopardized the environmental and food rights of its citizens to live healthily and access food in an environment unaffected by nuclear radiation. The release of nuclear-contaminated water poses a risk of Japan’s nuclear pollution to the people of neighboring countries and the global population at large. The principle of human rights underpins the theory of a community with a shared future for humanity, and human rights are a crucial area of China’s active participation in United Nations affairs and global governance. By voicing concerns over Japan’s potential human rights violations globally, China demonstrates its role as a responsible major country. In response to Japan’s breach of legal obligations and human rights violations, China can adopt a reasoned and beneficial approach, including calling on the international community to hold Japan criminally accountable for crimes against humanity under the Rome Statute and advancing scholarly discussions on ecocide and crimes against the marine environment. Furthermore, China should persist in seeking advisory opinions from the International Court of Justice and strive for substantive accountability, utilizing the mechanisms of international human rights organizations to make its voice heard.

Targeted enrichment of whole-genome SNPs from highly burned skeletal remains.

Genetic assessment of highly incinerated and/or degraded human skeletal material is a persistent challenge in forensic DNA analysis, including identifying victims of mass disasters. Few studies have investigated the impact of thermal degradation on whole-genome single-nucleotide polymorphism (SNP) quality and quantity using next-generation sequencing (NGS). We present whole-genome SNP data obtained from the bones and teeth of 27 fire victims using two DNA extraction techniques. Extracts were converted to double-stranded DNA libraries then enriched for whole-genome SNPs using unpublished biotinylated RNA baits and sequenced on an Illumina NextSeq 550 platform. Raw reads were processed using the EAGER (Efficient Ancient Genome Reconstruction) pipeline, and the SNPs filtered and called using FreeBayes and GATK (v. 3.8). Mixed-effects modeling of the data suggest that SNP variability and preservation is predominantly determined by skeletal element and burn category, and not by extraction type. Whole-genome SNP data suggest that selecting long bones, hand and foot bones, and teeth subjected to temperatures <350°C are the most likely sources for higher genomic DNA yields. Furthermore, we observed an inverse correlation between the number of captured SNPs and the extent to which samples were burned, as well as a significant decrease in the total number of SNPs measured for samples subjected to temperatures >350°C. Our data complement previous analyses of burned human remains that compare extraction methods for downstream forensic applications and support the idea of adopting a modified Dabney extraction technique when traditional forensic methods fail to produce DNA yields sufficient for genetic identification.

Optimization of Algorithms and Models in Two Scenarios for Picking up-Dropping off Disaster Victims in Islands Cities

Earthquakes in the past have caused significant damage, injuries, and deaths. The remaining resources do not equal the amount needed. For this reason, effective and efficient disaster management methods are needed. Learning from recent research that describes how they optimize the coordination function of hospital systems to overcome the imbalance between need and care capacity, we add the bed occupancy ratio (BOR) of healthcare facilities to the modeling. This paper aims to provide information about the distribution mechanism for injured victims by minimizing the total time to arrive at the healthcare facility. This victim evacuation modeling uses the integer linear programming method with two scenarios. Simulations were carried out on 164 injured victims, estimated by residents who live in areas that cross the Great Sumatran fault. The results show that the second scenario, which involves distributing it to the nearest healthcare facility, is 3.6 hours shorter compared to taking it to the general hospital in the first scenario.

The Application Of Parachute Goods As An Alternative Logistics Distribution To Help Victims Of Natural Disasters In Isolated Areas

Facing the complexity of logistics distribution related to natural disasters in Indonesia, a geographically vulnerable country to various types of disasters, especially in isolated areas, requires an efficient and effective solution. One solution being explored is the implementation of cargo parachutes as an alternative logistics distribution to enhance the resilience of communities in those areas. This research aims to provide an in-depth understanding of the potential and challenges of using cargo parachutes in the context of logistics distribution in Indonesia. Through a literature review conducted using the Systematic Literature Review (SLR) method, this study explores information regarding the advantages, challenges, and practical implications of implementing cargo parachutes. It was found that the use of cargo parachutes offers a quick and responsive solution in distributing logistics aid in isolated areas, often difficult to reach by conventional land transportation. The main advantage of implementing cargo parachutes is their ability to provide faster response times in logistics distribution. In the context of natural disasters, speed is crucial to ensure that aid arrives promptly where it is needed. Cargo parachutes can also improve the accessibility of aid, especially in isolated areas that may be challenging to reach conventionally. However, this study also identifies several challenges that need to be addressed. Landing accuracy is a critical issue, especially with weather variability, wind direction, and the topography of the area. Additionally, safety aspects, operational costs, and coordination among various stakeholders are challenges that must be overcome to ensure the success of cargo parachute implementation. Practical recommendations emerging from this research involve the use of monitoring technology, training for personnel involved in logistics distribution using cargo parachutes, and the development of clear Emergency Standard Operating Procedures (SOP). Monitoring technology, such as GPS, can help improve landing accuracy, while personnel training and emergency SOPs can enhance operational effectiveness and safety.

Pelaksanaan Kewenangan Pemerintah Daerah Dalam Upaya Rehabilitasi Pasca Bencana Gempa Bumi Di Nagari Kajai Pasaman Barat

Natural disasters seem to be daily events and news in Indonesia, and even the world. Various forms of disasters have caused enormous losses, both moral and material losses. The earthquake that occurred on February 25 2022, centered in Talamau District, West Pasaman Regency, was a major disaster. As the epicenter of the earthquake, Talamau District was the worst affected area. It was recorded that 25 people were killed and 465 people were injured, 14 of whom were residents of East Pasaman. Apart from immaterial losses, the earthquake that occurred in West Pasaman Regency also resulted in material losses such as heavily damaged public facilities, schools and houses of worship (mosques). Due to this disaster, thousands of West Pasaman residents are waiting for development assistance from the government, however the expected assistance is still being delayed before it can be realized immediately by the Regional Government. This problem needs to be formulated into two problem statements. First, how is the implementation of regional government authority in post-earthquake rehabilitation efforts in Nagari Kajai, West Pasaman Regency? Second, what are the obstacles to implementing Regional Government Authority in post-earthquake rehabilitation efforts in Nagari Kajai, West Pasaman Regency? This research is a type of normative legal research or doctrinal legal research. The results of this research show that as a form of disaster management, the West Pasaman Regional Government carries out rehabilitation activities, one of these activities is providing assistance to repair houses for people affected by the disaster. This development is carried out through three systems, namely: independent reinbuce, facilitator reinbuce, and self-sufficiency. In an effort to exercise its authority to carry out post-disaster rehabilitation, the Regional Government encountered obstacles, including APIP's finding that there was an error in collecting data on houses of disaster victims which required data collection again, which took quite a long time and the regional financial capacity was inadequate.

Sosialisasi dan Simulasi Mitigasi Bencana dan Pertolongan Pertama pada Gen-Z di Kota Jayapura

Natural disasters cannot be avoided. The provision that can be given is to provide training to all elements of society so that they have the ability to be able to face natural disasters. disaster mitigation and first aid that was held was to increase public awareness about the risk of natural disasters, increase public knowledge in dealing with disasters and increase knowledge about examples of disaster response simulations. The urgency of this activity is to equip generation Z (Gen-Z) in responding to disaster conditions. The partner in this activity is Basarnas with training participants are the community, students and students. Knowledge and techniques to save themselves and victims of natural disasters are important points for Gen-z to remain socialised and not always dependent on technology.

Detection of ABO Blood Groups From Dentin and Pulp by Using the Absorption-Elution Technique: A Forensic Cross-Sectional Study Among the Population of the Al Jouf Province, Saudi Arabia.

Background and objective Human teeth have a significant forensic importance. As they are the hardest of all human tissues, they are not just chemically stable but also their characteristics are maintained for a long time after death even in the most harsh environmental conditions. Despite the advances made in DNA analysis, fingerprinting, etc., ABO blood grouping still plays a significant role in the forensic practice in the field of personal identification, paternity disputes, and several other scenarios including the identification of mass disaster victims. The term blood groups refers to inherited antigens on the surface of red blood cells (RBCs) detected by specific antibodies. Since tooth pulp contains numerous blood vessels, blood group antigens are most certainly bound to be present in tooth pulp. Various studies have shown that blood group antigens in the pulp and dentin are preserved as long as up to two years after the demise of an individual. Absorption-elution technique has been proven to be the most sensitive, reliable, and consistent method to determine the ABO blood group from both the pulp and dentine.This study aimed toascertain the ABO blood group from both the hard (dentin) as well as the soft tissue (pulp) of the tooth by using the absorption-elution (AE) technique and also to determine if there are any variations in identifying the blood groups from the teeth based on age and gender. Material and methods After obtaining due consent, we included patients of both genders aged between 16-60 years visiting the outpatient department (OPD) clinics at the College of Dentistry for periodontal or orthodontic extractions.One patient's blood type was determined by using the slide agglutination technique before any capillary blood extraction was performed; this patient served as a control. For this investigation, we used the pulp and powdered dentin samples taken from the dental extractions to test for the presence of ABO and Rhesus (Rh) factor antigens by using the AE method. The study samples were compared with the control for blood group determination. Statistical analysis was carried out using the chi-square test with Monte Carlo (MC) simulation to check for any correlation of blood grouping with age and gender. Results The dentin and pulp were shown to have positive blood group antigens for the ABO and Rh factors.While neither pulp nor dentin performed significantly differently in identifying the blood group antigens, pulp showed marginally higher accuracy.There was no discernibledifference regarding gender or age in the dentin or pulp of any of the 45 samples studied. Conclusions For determining an individual's blood type and Rh factor, both the hard (dentin) and soft (pulp) tissues of a tooth are valid sources. This is particularly helpful in forensic medicine cases where teeth are the onlyremains that can be viably used to find out a person's identity.

Preliminary exploratory research on the application value of oral and intestinal meta-genomics in predicting subjects' occupations-A case study of the distinction between students and migrant workers.

In the field of forensic science, accurately determining occupation of an individual can greatly assist in resolving cases such as criminal investigations or disaster victim identifications. However, estimating occupation can be challenging due to the intricate relationship between occupation and various factors, including gender, age, living environment, health status, medication use, and lifestyle habits such as alcohol consumption and smoking. All of these factors can impact the composition of oral or gut microbial community of an individual. In this study, we collected saliva and feces samples from individuals representing different occupational sectors, specifically students and manual laborers. We then performed metagenomic sequencing on the DNA extracted from these samples to obtain data that could be analyzed for taxonomic and functional annotations in five different databases. The correlation between occupation with microbial information was assisted from the perspective of α and β diversity, showing that individuals belonging to the two occupations hold significantly different oral and gut microbial communities, and that this correlation is basically not affected by gender, drinking, and smoking in our datasets. Finally, random forest (RF) models were built with recursive feature elimination (RFE) processes. Models with 100% accuracy in both training and testing sets were constructed based on three species in saliva samples or on a single pathway annotated by the KEGG database in fecal samples, namely, "ko04145" or Phagosome. Although this study may have limited representativeness due to its small sample size, it provides preliminary evidence of the potential of using microbiome information for occupational inference.

Investigative genetic genealogy for human remains identification.

Investigative genetic genealogy (IGG) has emerged as a highly effective tool for tying a forensic DNA sample to an identity. While much of the attention paid to IGG has focused on cases where the DNA is from an unknown suspect, IGG has also been used to help close hundreds of unidentified human remains (UHR) cases. Genome-wide single-nucleotide polymorphism (SNP) genotype data can be obtained from forensic samples using microarray genotyping or whole-genome sequencing (WGS) with protocols optimized for degraded DNA. After bioinformatic processing, the SNP data can be uploaded to public GG databases that allow law enforcement usage, where it can be compared with other users' data to find distant relatives. A genetic genealogist can then build the family trees of the relatives to narrow down the identity of the source of the forensic DNA sample. To date, 367 UHR identifications using IGG have been publicly announced. The same IGG techniques developed and refined for UHR cases have significant potential for disaster victim identification, where DNA is often extremely compromised, and close family references may not be available. This paper reviews the laboratory, bioinformatic, and genealogical techniques used in IGG for UHR cases and presents three case studies that demonstrate how IGG is assisting with remains identification.

Managing large volume data sets in the process of identifying missing persons: Contributions from the International Commission on Missing Persons.

The process of locating and identifying missing persons presents a complex challenge that hinges on the collection and comparison of diverse data sets. This commentary offers an overview of some of the difficulties and considerations associated with data management in the context of large-scale missing person identifications. Such complexities include the uniqueness of each disaster event, the response time to the event, the variable quality and quantity of data, and the involvement of numerous stakeholders, all of which contribute to the intricacies of data management. In addition, the paramount considerations of privacy and ethical standards further compound these challenges, especially when dealing with sensitive information such as genetic data. This commentary describes the integrated Data Management System (iDMS) developed by the International Commission on Missing Persons (ICMP) as one example of a comprehensive, freely available solution for data collection, storage, protection, and analysis in missing person cases. The various advantages of the system are discussed, including the system's interoperability among the diverse array of stakeholders involved. While the iDMS streamlines data management processes and therefore represents a significant advancement in the field of missing person identification, it is concluded that the pending issue extends beyond thesoftware tools to encompass the lack of political will among stakeholders to collaborate there remains a pressing need for all stakeholders involved in the identification process to commit to a mechanism that facilitates compatibility and interoperability if different tools are used in disaster victim identification (DVI) scenarios.

Improve disaster response by planning for and logistically supporting acute exacerbations of chronic diseases.

Provide a more effective medical response by emphasizing the management of acute exacerbations of chronic diseases in disasters. Disaster victims need treatment for their acute exacerbations of and ongoing chronic medical conditions, medication refills, mental health resources, and have an expectation that medical facilities will provide resources beyond medical care. Medical response is more efficient, cost effective, and effectual when these considerations are supported.

Le Centre Régional de Psychotraumatisme Paris Centre et Sud : quel profil psychotraumatique pour les victimes appelant sa plateforme téléphonique ?

ContextPsychotrauma is a public health issue. Prior to 1995 in France, support for victims of psychotrauma was mainly provided by associations. Following the terrorist bombing in the Paris metro at the Saint-Michel station on 25 July 1995, a new emergency care unit, the Cellule d’Urgence Médico-Psychologique (CUMP), was created. Its main mission is to provide immediate and post-traumatic event care to victims of disasters or events involving a large number of victims and likely to result in significant psychological repercussions. Following the 2015 attacks in Paris and Saint-Denis, the creation of the National Resource and Resilience Center and the Regional Psychotrauma Centers in 2018, represented a major step forward in the field of victim care and resilience. The Regional Psychotrauma Center for Central and Southern Paris (CRPPCS), which covers an area that consists of several departments (including Paris and the south of the Île-de-France region), is organized on a model of the federation of several care and associative structures. The originality of the CRPPCS system lies in the establishment of a call center, assessment, and referral platform. Three state-certified nurses trained in psychotraumatology engage callers in a semi-structured interview, explaining the course and purpose of the interview; noting the reason for the call, then evaluating any psychotraumatic symptoms according to a grid inspired by the Posttraumatic Stress Disorder Checklist version DSM-5. They also evaluate potential comorbidities (associated depression, addictions, suicidal behaviors, somatoform disorders, etc.). The callers’ psychiatric and addictological history are explored. ObjectivesThe aim of this study is to establish the profiles of callers, studying the different types of trauma, addictive comorbidity, treatment approaches and demographic data. Materials and methodsThis is a descriptive and retrospective observational study that was carried out from September 2020 to the end of June 2021. Our sample comprised 502 people, 75% of whom were women, 70% of whom were aged between 25 and 60, and the majority of whom were from the Île-de-France region (98%). ResultsPsychotrauma was diagnosed in 411 out of the 502 individuals. The main causes of trauma, in descending order of importance, were: domestic violence (32%), rape, physical assault, psychological assault, sexual assault other than rape, traumatic bereavement, confrontation with death, traffic accidents, verbal aggression/psychological violence/harassment at work, fire/explosion, traumatic migration path, assistance provided to a loved one in danger, and serious medical problems. For 24% of the sample, a previous history of traumatic events was reported. Among, these callers, 289 were redirected to a specialized structure for further treatment, and 20% of them also had an addictive comorbidity. Of the 52 people with a substance use disorder, 20 % reported a sexual assault as a child, 31% had been the victim of a rape, 26% of a sexual assault in adulthood and 43% of a traumatic migration journey. Of the 289 calls involving psychotrauma in the network, the distribution between the different subtypes was as follows: 137 people experienced a simple psychotrauma (47%) and 152 people were suffering from a complex psychotrauma (52%). ConclusionThe high prevalence of psychotrauma as well as the medical and social cost of its chronicity and associated frequent comorbidities illustrate the urgency to act in order to establish coherent public health strategies. The CRPPCS telephone platform provides direct access to specially trained staff. It contributes to an improvement in mental health by identifying disorders at an early stage and by referring patients for appropriate specialized care for psychotrauma and associated comorbidities. Our study highlights the significant addictive comorbidity associated with PTSD, which is often secondary to the onset of PTSD, as well as the risk of developing complex trauma if early treatment is not provided. These conclusions stress the need for simultaneous joint care of both the psychotrauma and the comorbidity of addiction.

The Jerusalem tribune collapse incident: Challenges in the management of a pediatric mass casualty incident.

Children comprise up to 30-50 percent of all disaster victims. Pediatric disaster medicine is a poorly established field, and most protocols are designed without adequate emphasis on the special needs of the pediatric population. During the 2021 Shavuot holiday in Israel, the collapse of temporary steel bleachers in a partially constructed synagogue resulted in a mass casualty incident (MCI) with a majority of pediatric casualties. This study analyzed the differences in post-incident casualty management, treatment, and outcomes in three Jerusalem medical centers. Multicenter retrospective data were collected from two tertiary level 1 trauma centers and one secondary hospital in Jerusalem. The data included demographics, triage scores, injury mechanisms, medical workups, and the management of the pediatric patients. A total of 171 children and adolescents aged 9-18 years presented to three centers. In two institutions, the triage was performed by a senior emergency medicine physician, and in the third institution, by a senior trauma physician. Different protocols were applied, resulting in significant differences in triage, identification and documentation, admission strategies, adherence, and analgesic treatment. Most patients presented with orthopedic injuries (115/171, 67 percent). A small number had head, chest, abdominal, and multisystem injuries (11, 5, 2, and 2 percent, respectively). Pediatric MCI management presents specific challenges. The lack of consistency in triage, registry, and management highlights the need for robust pediatric MCI training programs.