Trauma-related psychological disorders among Palestinian children and adults in Gaza and West Bank, 2005-2008

BACKGROUND: Trauma from war and violence has led to psychological disorders in individuals living in the Gaza strip and West Bank. Few reports are available on the psychiatric disorders seen in children and adolescents or the treatment of affected populations. This study was conducted in order to describe the occurrence and treatment of psychiatric disorders in the Palestinian populations of the Gaza strip and Nablus district in the West Bank. METHODS: From 2005 to 2008, 1369 patients aged more than 1 year were identified through a local mental health and counseling health network. All were clinically assessed using a semi-structured interview based on the DSM-IV-TR criteria. RESULTS: Among 1254 patients, 23.2% reported post-traumatic stress disorder [PTSD], 17.3% anxiety disorder (other than PTSD or acute stress disorder), and 15.3% depression. PTSD was more frequently identified in children < or = 15 years old, while depression was the main symptom observed in adults. Among children < or = 15 years old, factors significantly associated with PTSD included being witness to murder or physical abuse, receiving threats, and property destruction or loss (p < 0.03). Psychological care, primarily in the form of individual, short-term psychotherapy, was provided to 65.1% of patients, with about 30.6% required psychotropic medication. Duration of therapy sessions was higher for children < or = 15 years old compared with adults (p = 0.05). Following psychotherapy, 79.0% had improved symptoms, and this improvement was significantly higher in children < or = 15 years old (82.8%) compared with adults (75.3%; p = 0.001). CONCLUSION: These observations suggest that short-term psychotherapy could be an effective treatment for specific psychiatric disorders occurring in vulnerable populations, including children, living in violent conflict zones, such as in Gaza strip and the West Bank

Estimating wild boar ( Sus scrofa ) abundance and density using capture-resights in Canton of Geneva, Switzerland

We estimated wild boar abundance and density using capture-resight methods in the western part of the Canton of Geneva (Switzerland) in the early summer from 2004 to 2006. Ear-tag numbers and transmitter frequencies enabled us to identify individuals during each of the counting sessions. We used resights generated by self-triggered camera traps as recaptures. Program Noremark provided Minta-Mangel and Bowden's estimators to assess the size of the marked population. The minimum numbers of wild boars belonging to the unmarked population (juveniles and/or piglets) were added to the respective estimates to assess total population size. Over the 3years, both estimators showed a stable population with a slight diminishing tendency. We used mean home range size determined by telemetry to assess the sampled areas and densities. Mean wild boar population densities calculated were 10.6individuals/km2 ± 0.8 standard deviation (SD) and 10.0ind/km2 ± 0.6 SD with both estimators, respectively, and are among the highest reported from Western Europe. Because of the low proportion of marked animals and, to a lesser extent, of technical failures, our estimates showed poor precision, although they displayed similar population trends compared to the culling bag statistics. Reported densities were consistent with the ecological conditions of the study are

Can wild boar be surveyed using GPS?

The Global Positioning System (GPS) is an important new technology for spatial behaviour studies of terrestrial vertebrates. Although VHF telemetry has been substantially used, our study is the first report, to our knowledge, on GPS technology used to track free-ranging wild boars. Although the need for collars larger than those used for VHF tracking, the crowded vegetation of habitat and the particular features of social group behaviour of wild boars led to some technical difficulties, three adult sows were successfully fitted with two GPS collars and one dummy GPS. The collars remained on the wild boars for over 283 days without causing any injury to the animals. Forty-one daily cycles (24 hours), as well as daily locations over 142 days, could be recorded for a single animal. Detection efficiency and fixes were better during the night than during the day. In the light of these results, the GPS technique appears to be an efficient tool to study wild boar movements. Progress in the survey of animal movements at a fine scale is of prime interest for animal management programs in order to obtain and maintain a sustainable level of animal population regarding damage problems

Aspect traumatogène de l’exclusion sociale, une analyse enthnopsychanalytique

International audienceThis research explores the phenomenon of social exclusion into a complementarist approach using interviews with six people as a starting point. Thanks to a qualitative method based on the grounded theory, we carried out a comparative analysis of our material. The analysis helped to show the traumatogenic dimension of social exclusion. We used the concept of liminality from the cultural anthropologist Victor Turner, in order to describe the destabilizing aspect of this experience, but also its potential to provoque profound change. The traumatogenic dimension appears in each story, butsometimes it provoques a real “initiatory transformation”. In other cases it may lead to defensive psychic arrangements which are constructed on the basis of a splitting between the “sacred" and the “profane” and even really become traumatic.Cette recherche explore le phénomène d’exclusion sociale dans une approche complémentariste en partant d’entretiens effectués avec six personnes. Grâce à une méthode qualitative basée sur la grounded theory, nous avons réalisé une analyse comparative de différentes parties de notre matériel. Nous avons mis en évidence la dimension traumatogène de l’exclusion sociale. La notion de liminalité de l’anthropologue Victor Turner nous a permis de décrire le potentiel déstabilisant de cette expérience, tout autant que sa capacité de «métamorphose » : si la dimension traumatogène est présente dans chacun des récits, la situation d’exclusion sociale peut, dans certains cas, prendre la forme d’une véritable « transformation initiatique ». Pour d’autres, elle peut aussi amener à des aménagements défensifs construits sur un clivage entre le « sacré » et le « profane », ou encore devenir véritablement traumatique

Exposition aux facteurs de stress et impact psychosocial du tremblement de terre de Tohoku et de ses conséquences sur les Français présents au Japon en mars 2011 - Étude qualitative

The Great East Japan Earthquake and Tsunami of the 11 th of March 2011 was followed by a nuclear accident. This study aim to identify the exposure to stress, the psychosocial impact and information need of the French Nationals who were in Japan at this time as well as the care they were looking for. A qualitative study based on 10 semi-structured interviews of French nationals was carried out between June and October 2013. They were chosen among the French who answered to the registry launched by the InVS considering the importance of the event. The interviews were face to face (7 in France, 2 in Japan) except for one in Japan that was performed by videoconference.This study confirms the impact of this disaster on real life experience. Some interviewed relate anxious and thymic manifestations or impacts on personality that might lead to seek care, even two years after the events. Beyond stress factors usually linked to natural disaster, this study showed that the issue of information was considerable, in particular about nuclear contamination that makes the feeling of worrying long lasting. Living abroad is a specificity that modifies the experience of such extreme events. This experience influenced the life-course of the exposed. These results will be useful for future post-disaster epidemiological studies. They plaid also for registering involved people as well as preparing appropriate and sustained information and mental health screening which allows people to stay active in their choices and decisionsLe séisme survenu au Japon le 11 mars 2011 a entraîné un tsunami et un accident nucléaire. L’objectif de cette étude est de mieux connaître, pour les ressortissants français présents, les expositions aux facteurs de stress liés à ces événements, ainsi que l’impact psychosocial et les besoins d’information et de prise en charge qui en ont résulté.Une étude qualitative par entretiens semi-directifs a été réalisée auprès d’une dizaine de personnes sélectionnées parmi celles qui avaient répondu à l’enregistrement proposé par l’InVS. Les entretiens se sont déroulés entre juin et octobre 2013 en face à face (7 en France, 2 au Japon) ou par visioconférence pour une personne domiciliée au Japon. Les résultats confirment le vécu bouleversant de cette catastrophe multiple pouvant contribuer, parfois à distance de l’événement, à la survenue de manifestations anxieuses, thymiques ou des modifications de la personnalité qui peuvent nécessiter un recours aux soins. Les facteurs de stress classiquement identifiés en rapport avec les catastrophes naturelles sont retrouvés. La question de l’information a été centrale, notamment au sujet de la contamination radiologique suscitant une inquiétude prolongée. L’expatriation est une situation particulière qui modifie les modalités de vécu de tels événements. Cette expérience a sensiblement influencé ou précipité des décisions relatives à l’existence. Ces résultats vont être utilisés pour planifier les études épidémiologiques post-catastrophe. Ils confirment l'importance d'un enregistrement initial des personnes impliquées et d'une offre d’information et de dépistage adaptée et maintenue dans le long terme qui donne aux personnes exposées la possibilité de rester actives dans leurs choix et leurs décisions

Against the Odds: Psychomotor Development of Children Under 2 years in a Sudanese Orphanage.

Providing abandoned children the necessary medical and psychological care as possible after their institutionalization may minimize developmental delays. We describe psychomotor development in infants admitted to an orphanage in Khartoum, Sudan, assessed at admission and over an 18-month follow-up. Psychological state and psychomotor quotients were determined using a simplified Neonatal Behavior Assessment Scale (NBAS), the Brunet-Lezine and Alarm distress baby (ADBB) scale. From May-September 2005, 151 children were evaluated 2, 4, 9, 12 and 18 months after inclusion. At admission, ∼15% of children ≤1 month had a regulation impairment according to the NBAS, and 33.8% presented a distress state (ADBB score >5). More than 85% (129/151) recovered normal psychomotor development. The results of the program reinforce the importance of early detection of psychological disorders followed by rapid implementation of psychological case management to improve the development of young children in similar institutions and circumstances

Événements traumatiques et médias : quelles répercussions pour les sujets impliqués ?

International audienceLes médias relaient quotidiennement les événements traumatiques qui se passent à travers le monde comme au plus près du quotidien à grand renfort de reportages audiovisuels et des personnes jusqu'alors anonymes. Cette surenchère d'images s'inscrit dans un contexte où logique politique, logique judiciaire, logique médiatique et logique soignante sont contraintes de coexister. La mise en spectacle de la détresse et de la souffrance envahit tout l'espace et conduit à marquer les impliqués du stigmate de la victime, aussi vite sanctuarisée que sacrifiée sur la scène de l'audimat. Notre propos vise à mieux comprendre les enjeux liés à l'évolution de la culture médiatique et ses répercussions tant auprès des sujets directement impliqués dans l'événement traumatique que du côté des spectateurs

Evaluation of psychological support for victims of sexual violence in a conflict setting: results from Brazzaville, Congo

ABSTRACT: BACKGROUND: Little is known about the impact of psychological support in war and transcultural contexts and in particular, whether there are lasting benefits. Here, we present an evaluation of the late effect of post-rape psychological support provided to women in Brazzaville, Republic of Congo. METHODS: Women who attended the Médecins Sans Frontières program for sexual violence in Brazzaville during the conflict were selected to evaluate the psychological consequences of rape and the late effect of post-rape psychological support. A total of 178 patients met the eligibility criteria: 1) Women aged more than 15 years; 2) raped by unknown person(s) wearing military clothes; 3) admitted to the program between the 1/1/2002 and the 30/4/2003; and 4) living in Brazzaville. RESULTS: The initial diagnosis according to DSM criteria showed a predominance of anxious disorders (54.1%) and acute stress disorders (24.6%). One to two years after the initial psychological care, 64 women were evaluated using the Trauma Screening Questionnaire (TSQ), the Global Assessment of Functioning scale (GAF) and an assessment scale to address medico-psychological care in emergencies (EUMP). Two patients (3.1%) met the needed criteria for PTSD diagnosis from the TSQ. Among the 56 women evaluated using GAF both as pre and post-test, global functioning was significantly improved by initial post-rape support (50 women (89.3%) had extreme or medium impairment at first post-rape evaluation, and 16 (28.6%) after psychological care; p = 0.04). When interviewed one to two years later, the benefit was fully maintained (16 women (28.6%) presenting extreme or medium impairment). CONCLUSION: We found the benefits of post-rape psychological support to be present and lasting in this conflict situation. However, we were unable to evaluate all women for the long-term impact, underscoring the difficulty of leading evaluation studies in unstable contexts. Future research is needed to validate these findings in other settings

Human Mas-related G protein-coupled receptors-X1 induce chemokine receptor 2 expression in rat dorsal root ganglia neurons and release of chemokine ligand 2 from the human LAD-2 mast cell line

Primate-specific Mas-related G protein-coupled receptors-X1 (MRGPR-X1) are highly enriched in dorsal root ganglia (DRG) neurons and induce acute pain. Herein, we analyzed effects of MRGPR-X1 on serum response factors (SRF) or nuclear factors of activated T cells (NFAT), which control expression of various markers of chronic pain. Using HEK293, DRG neuron-derived F11 cells and cultured rat DRG neurons recombinantly expressing human MRGPR-X1, we found activation of a SRF reporter gene construct and induction of the early growth response protein-1 via extracellular signal-regulated kinases-1/2 known to play a significant role in the development of inflammatory pain. Furthermore, we observed MRGPR-X1-induced up-regulation of the chemokine receptor 2 (CCR2) via NFAT, which is considered as a key event in the onset of neuropathic pain and, so far, has not yet been described for any endogenous neuropeptide. Up-regulation of CCR2 is often associated with increased release of its endogenous agonist chemokine ligand 2 (CCL2). We also found MRGPR-X1-promoted release of CCL2 in a human connective tissue mast cell line endogenously expressing MRGPR-X1. Thus, we provide first evidence to suggest that MRGPR-X1 induce expression of chronic pain markers in DRG neurons and propose a so far unidentified signaling circuit that enhances chemokine signaling by acting on two distinct yet functionally co-operating cell types. Given the important role of chemokine signaling in pain chronification, we propose that interruption of this signaling circuit might be a promising new strategy to alleviate chemokine-promoted pain

Prospective study on a fast-track training in psychiatry for medical students: the psychiatric hat game

Abstract: Background: While medical students are losing interest in lectures in favor of other educational materials, many studies suggest the benefit of active learning, combined with gamified educational tools. The authors developed a psychiatric adaptation of the « Hat Game ». It was hypothesised that this game would increase both knowledge and motivation in medical students toward psychiatric semiology. The aim of the study was to assess the benefit of a Psychiatric Hat Game session for learning psychiatric symptoms in third-year medical students. Student performance was also evaluated at 3 months. Methods: This gamified fast-track training consists of two teams and each team has to guess as many psychiatric semiology terms as possible using different techniques (i.e. speech, mime). The study involved a pre- and post-evaluation of knowledge (Multiple Choice Questions) and a satisfaction survey. Baseline, post-immediate, and three-months scores were compared by using Friedman analysis for paired samples. Comparisons of mean scores at two different times were performed by using Wilcoxon test for paired samples. Results: One hundred and sixty-six students were proposed to take part in the study. Among them 129 completed the whole program (response rate = 77.7%). Mean scores measured at the three points in time were significantly different (p < 0.001, N = 129). Knowledge mean scores were significantly higher after the game than before (+ 28.6%, p < 0.001). Improvement was maintained 3 months after the game (+ 18.9%, p < 0.001). Satisfaction survey items highlighted that students enjoyed and would recommend this type of gamified training. Conclusions: The Psychiatric Hat Game improved knowledge of psychiatric semiology in medical students. Results suggest that it is a promising and efficient tool to playfully teach medical semiology, with transferable features, utility and acceptability from one medical field to another. This study contributes to the growing body of knowledge advocating for serious games and gamified training in medical education.Version of Recor