[Impact of gender violence on girls and adolescents]. / Impacto de la violencia de género en las niñas y las adolescentes.

Gender is an important determinant of health. Its relationship with inequality and violence allows us to consider being a woman as a risk factor for health. Girls and teenager girls are not exempt from this circumstance, which conditions their lives from before birth and can determine their health status throughout life. It can vary according to social contexts, as various factors intersect with gender, adding risk and vulnerability to being a woman. Gender-based violence is often identified as a problem for adult women; however, the experience of discriminatory gender-based violence is constructed throughout women's lives, producing serious individual and social consequences from childhood. Accepting this violence as a «private or domestic matter¼ often prevents seeing the true dimension of the problem, its consequences, and the need to address it as a global issue.

Medicolegal assessment of human trafficking victims. Descriptive study of a series of forensic cases in Catalonia (Spain). / Valoración médico-legal de las víctimas de trata de seres humanos. Estudio descriptivo de una serie de casos forenses en Cataluña (España).

BACKGROUND AND OBJECTIVE: Human trafficking or contemporary slavery is the recruitment and transfer of people by force or deception for sexual, labour or other types of exploitation. Although the violence, abuse and deprivation that trafficking entails are a threat to the health of its victims, in Spain the clinical or forensic data available in this regard is scarce. At the Institute of Legal Medicine and Forensic Sciences of Catalonia (IMLCFC), a unit specialized in the forensic assessment of these victims was created. The objective of this work was to describe a series of forensic cases of trafficking victims. MATERIAL AND METHOD: Retrospective study of victims in judicial cases opened for an alleged crime of human trafficking registered in the IMLCFC until 06/30/2023. RESULTS: 57 different victims were registered. The majority were women (71.9%). The average age was 30.5 years (s.d. 10.31). All the victims were foreigners, mostly from Latin America (45.5%). The exploitation was mainly sexual (61.4%). There were some sociodemographic differences and in the conditions and consequences of trafficking between victims of sexual exploitation and the rest. Mental health problems were very common in all victims at the time of the assessment (87.5%). CONCLUSIONS: The consequences of trafficking on health, especially mental health, are notable and the forensic assessment of victims is valuable in judicial proceedings. It is necessary to deepen our knowledge of the phenomenon in our environment.

Memory Wars: A Solution to the Conflict / Las Guerras de la Memoria: una Solución al Conflicto

Se discute la validez de la memoria disociativa en contextos forenses y las causas de las llamadas “guerras de la memoria”. Conceptos erróneos entre la psicología clínica y la psicología forense, una definición deficiente de la amnesia y las dificultades inherentes en el estudio de recuerdos traumáticos contribuyen a la persistencia de esta controversia. Particularmente en el campo de la psicología forense, el debate podría atribuirse a la falta de consenso sobre la evidencia científica. Los psicólogos necesitan establecer una base empírica para comprender mejor los mecanismos de la memoria involucrados en recordar y olvidar recuerdos traumáticos. Se esboza el Modelo de Accesibilidad Continua de la Memoria para explicar la recuperación de los diferentes grados de accesibilidad a los recuerdos autobiográficos basados en diferentes factores.(AU)

The validity of dissociative memory in forensic contexts and the causes of the so-called “memory wars” arediscussed. Misconceptions between clinical and forensic psychology, a deficient definition of amnesia, and the difficulties inherent in studying traumatic memories contribute to the persistence of this controversy. Particularly in the field of forensic psychology, the debate could be attributed to the lack of consensus on scientific evidence. Psychologists need to establish an empirical foundation to understand better the mechanisms of memory involved in remembering and forgetting traumatic memories. The Continuous Accessibility Model of Memory is outlined to explain the retrieval of the different degrees of accessibility to autobiographical memories based on different factors.(AU)

Plomo y mercurio en personas víctimas del conflicto armado en Bojayá, Chocó: estudio descriptivo / Lead and mercury in victims of the armed conflict in Bojayá, Chocó: a descriptive study / Chumbo e mercúrio em vítimas do conflito armado em Bojayá, Chocó: um estudo descritivo

Introducción: En los contextos del conflicto armado convergen actividades que potencialmente pueden producir toxicidad por metales pesados; inclusive, muchas víctimas de artefactos explosivos improvisados portan esquirlas residuales interiorizadas, de composición y potencial toxicidad desconocidas. Ello ha sido poco estudiado. Objetivo: Describir los niveles biológicos de plomo y mercurio en civiles supervivientes de la masacre de Bojayá, su eventual exposición actual, así como signos y síntomas compatibles con toxicidad crónica. Metodología: Estudio observacional descriptivo, tipo serie con 13 casos. Resultados: El 38.46 % de los casos tuvo niveles de plomo en sangre superiores o cercanos al valor límite superior, sin fuentes específicas identificadas. Un 46.15 % tuvo niveles mercuriales superiores o cercanos al límite de referencia, y se los considera exposición ambiental por minería aurífera regional. La valoración clínica toxicológica mostró síntomas y signos clínicos potencialmente asociados con toxicidad crónica por metales. Conclusión: Hubo presencia de residuos de artefactos explosivos en personas con hallazgos sugestivos de toxicidad por plomo o mercurio, sin que pueda afirmarse una relación directa y específica entre los dos aspectos; algunos casos sugieren exposición ambiental para mercurio, y exposición a proyectiles para el plomo, relacionadas con dinámicas del conflicto armado. Son necesarios estudios adicionales para afirmar la existencia de asociaciones causales.

Introduction: In the contexts of armed conflict, activities converge that can potentially produce heavy metal toxicity; including many victims of improvised explosive devices carry internalised residual shrapnel, of unknown composition and potential toxicity. This has been little studied. Objective: To describe the biological levels of lead and mercury in civilian survivors of the Bojayá massacre, their possible current exposure, as well as signs and symptoms compatible with chronic toxicity. Methodology: Descriptive observational study, serial type with 13 cases. Results: 38.46 % of the cases had blood lead levels above or close to the upper limit value, with no specific sources identified. 46.15 % had mercury levels above or close to the reference limit, and were considered environmental exposure from regional gold mining. Clinical toxicological assessment showed clinical signs and symptoms potentially associated with chronic metal toxicity. Conclusion: There was a presence of explosive ordnance residues in individuals with findings suggestive of lead or mercury toxicity, without a direct and specific relationship between the two; some cases suggest environmental exposure for mercury, and projectile exposure for lead, related to the dynamics of the armed conflict. Further studies are needed to affirm the existence of causal associations.

Introdução: Nos contextos de conflito armado, convergem atividades que podem potencialmente produzir toxicidade por metais pesados; Na verdade, muitas vítimas de dispositivos explosivos improvisados carregam lascas residuais internalizadas de composição desconhecida e potencial toxicidade. Isto tem sido pouco estudado. Objetivo: Descrever os níveis biológicos de chumbo e mercúrio em civis sobreviventes do massacre de Bojayá, sua eventual exposição atual, bem como sinais e sintomas compatíveis com toxicidade crônica. Metodologia: Estudo observacional descritivo, tipo série com 13 casos. Resultados: 38.46 % dos casos apresentaram níveis de chumbo no sangue superiores ou próximos ao valor limite superior, sem fontes específicas identificadas. 46.15 % apresentaram níveis de mercúrio superiores ou próximos ao limite de referência e são considerados exposição ambiental devido à mineração regional de ouro. A avaliação clínica toxicológica mostrou sintomas e sinais clínicos potencialmente associados à toxicidade crônica por metais. Conclusão: Houve presença de resíduos de artefatos explosivos em pessoas com achados sugestivos de toxicidade por chumbo ou mercúrio, sem que se pudesse afirmar uma relação direta e específica entre os dois aspectos; Alguns casos sugerem exposição ambiental ao mercúrio e exposição a projéteis de chumbo, relacionadas com a dinâmica do conflito armado. Estudos adicionais são necessários para confirmar a existência de associações causais.

Condición de discapacidad y victimización por robo en pobladores de Perú / Disability status and robbery victimization in Peruvian villager

Fundamentos: alrededor del 15% de la población mundial tiene algún grado de discapacidad. La violencia y el crimen afectan primordialmente a la región de américa latina, especialmente a perú. El objetivo de este estudio fue determinar la asociación entre la condición de discapacidad y la victimización por robo en pobladores peruanos durante 2017. Métodos: se realizó un estudio transversal de análisis secundario de datos de la encuesta nacional especializada sobre victimi-zación (enevic) 2017. La variable independiente fue la condición de discapacidad y la variable dependiente fue la victimización por robo; además, se incluyeron variables de confusión. Para demostrar la asociación se realizó una regresión de poisson y se calcularon razones de prevalencia (rp) con sus intervalos de confianza al 95% (ic95%).resultados: se incluyeron los registros de 32.199 peruanos de dieciocho o más años. Las personas con discapacidad tuvieron un 24% menos probabilidad de ser víctimas de robo que las personas sin discapacidad (rp=0,76; ic95%: 0,61-0,95), ajustado por las variables de confusión. Sin embargo, esta asociación solo fue estadísticamente significativa en las mujeres, adultos mayores y en el estrato socioeconómico alto. Conclusiones: en perú, las personas con discapacidad tienen menor probabilidad de ser víctimas de robo que las personas sin discapacidad, aunque solamente si son mujeres, adultos mayores y provienen de un nivel socioeconómico alto. En los demás grupos poblacionales, las probabilidades de sufrir de este hecho de victimización serían semejantes entre las personas con y sin discapacida.(AU)

Background: about 15% of the world’s population has some degree of disability. Violence and crime primarily affect the latin american region, especially peru. This study aimed to determine the association between disability status and robbery victimization in peruvian villagers in 2017. Methods: a cross-sectional study of secondary data analysis from the national specialized victimization survey (enevic) 2017 was conducted. The independent variable was disability status, and the dependent variable was robbery victimization; in addition, confounding variables were included. Poisson regression was performed to demonstrate the association, and prevalence ratios (pr) with their 95% confidence intervals (95%ci) were calculated.results: records of 32,199 peruvians aged 18 years or older were included. People with disabilities were 24% less likely to be rob-bery victims than people without disabilities (pr=0.76; 95%ci: 0.61-0.95), adjusted for confounding variables. However, this association was only statistically significant in women, older adults, and the high socioeconomic stratum. Conclusions: in peru, people with disabilities are less likely to be robbery victims than people without disabilities. However, only if they are women, older adults, and come from a high socioeconomic level. In the other population groups, the probabilities of suffering this victimization would be similar between people with and without disabilities.(AU)

Perfil de las víctimas mortales por intoxicaciones agudas en Costa Rica del 2012 al 2021 asociadas al consumo de sustancias psicoactivas y drogas de abuso: etanol, metanol, benzodiacepinas, anfetaminas, heroína, cocaína y mixto / Profile of fatalities due to acute intoxications in Costa Rica from 2012 to 2021 associated with the consumption of psychoactive substances and drugs of abuse: ethanol, methanol, benzodiazepines, amphetamines, heroin, cocaine and mixed

Resumen Introducción: La mortalidad por intoxicaciones agudas de sustancias psicoactivas representa un problema de salud pública, especialmente en personas jóvenes. El objetivo del estudio fue crear un perfil de las víctimas mortales por intoxicación aguda en Costa Rica entre los años 2012 y 2021 asociado al consumo de sustancias psicoactivas y drogas de abuso. Materiales y métodos: Se recopilaron datos de Sección de Patología Forense del Departamento de Medicina Legal en Costa Rica, con los cuales se realizó una revisión de las víctimas mortales por intoxicaciones agudas a partir del 1 de enero de 2012 hasta el 31 de diciembre de 2021. La revisión incluyó las siguientes variables: variables epidemiológicas: sexo, edad, nacionalidad, ocupación, estado civil, provincia, consumo frecuente asociado, manera de muerte, tipo de sustancia y lugar de intoxicación. Resultados: De los 456 casos de muertes asociados a intoxicaciones agudas por etanol, metanol, benzodiacepinas, anfetaminas, heroína, cocaína y mixtas; reportados entre el 1 de enero de 2012 y el 31 de diciembre de 2021: el año que más casos reportó fue 2020; 82% de las víctimas fueron hombres y 18% mujeres; las principales edades de las personas reportadas abarcan entre 41 y 60 años. 80% de las personas eran costarricenses; San José fue la provincia con mayor número de casos de intoxicación letal, siendo el domicilio el sitio más frecuente. 14% de las víctimas eran desempleadas; 77% de las personas presentaban algún trastorno de la adicción o consumo frecuente de alguna de las sustancias estudiadas. La mayoría de muertes fueron de manera accidental. Conclusiones: El perfil predominante de las víctimas fue: masculino, entre 41 y 60 años, costarricense, de estado civil indeterminado o soltero, desempleado, que muere de manera accidental, en su domicilio, por intoxicación aguda con alcohol o mixta (alcohol y cocaína).

Abstract Introduction. Mortality from acute poisoning of psychoactive substances represents a public health problem, especially in young adults. The purpose of the study was to create a profile of fatalities due to acute poisoning in Costa Rica between 2012 and 2021 associated with the consumption of psychoactive substances and drugs of abuse. Materials and methods. Data were collected from the Forensic Pathology Section of the Legal Medicine Department in Costa Rica, then a review of fatalities due to acute poisoning was carried out from January 1, 2012 to December 31, 2021. The review included the following epidemiological variables: sex, age, nationality, occupation, marital status, province, consumption associated, manner of death, type of substance, and place of intoxication. Results. Out of the 456 reported cases of deaths associated with acute intoxication with ethanol, methanol, benzodiazepines, amphetamines, heroin, cocaine, and mixed substances between January 1, 2012, and December 31, 2021: the year with the highest number of cases reported was 2020; 82% of the victims were male, and 18% were female; the main age group of reported victims ranged from 41 to 60 years old. 80% of the victims were Costa Rican, and San Jose was the province with the highest number of lethal intoxication cases, with the home being the most frequent site. 14% of the victims were unemployed, and 77% of the individuals had some addiction disorder or frequent consumption of one of the studied substances. The majority of deaths were accidental. Conclusion. The main profile of the victims was male, between 41 and 60 years old, Costa Rican, of indeterminate or single marital status, unemployed, who died accidentally, at home, due to acute intoxication with alcohol or a mixture of substances (alcohol and cocaine).

Conductas autolíticas suicidas y no suicidas en víctimas de violencia sexual infantil / Suicidal and Non-Suicidal Self-Harm Behaviors in Victims of Sexual Violence Against Children

La violencia sexual hacia la infancia y las conductas autolesivas suicidas y no suicidas son dos problemáticas sociales y de salud que han incrementado. Las agresiones sexuales conllevan un impacto, afectando a la tendencia a realizar comportamientos autolíticos. Por ello, se pretendía estudiar la relación existente entre haber sido víctima de VSI y la probabilidad de realizar conductas autolesivas suicidas y no suicidas en adolescencia y adultez temprana. Para ello, se ha realizado una revisión sistemática, a través de las bases de datos Pubmed y PsicInfo de artículos publicados entre 2015 y 2022. Se ha hallado una relación significativa entre ambas problemáticas, observando que los intentos de suicidios de estas víctimas estaban relacionados intrínsecamente con sus experiencias de agresión. Así, se ha encontrado que variables como el género, la rumiación, la desregulación emocional, el apoyo social y las características de la agresión median la relación existente entre la violencia sexual infantil y las conductas autolíticas suicidas y no suicidas. Este tipo de investigaciones nos ayuda a establecer el foco de intervención en los casos de víctimas de agresión sexual infantil, pero debe también ayudar a dar visibilidad a la problemática e impulsar la intervención preventiva protegiendo la infancia. (AU)

Sexual violence against children and suicidal and non-suicidal self-injurious behaviors are two social and health problems that have increased. Sexual assaults have an impact, affecting the tendency to carry out autolytic behaviors. Therefore, it was intended to study the relationship between having been a victim of sexual violence in their childhood and the probability of engaging in suicidal and non-suicidal self-injurious behaviors in adolescence and early adulthood. For this, a systematic review has been carried out, through the Pubmed and PsycInfo databases of articles published between 2015 and 2022. A significant relationship has been found between both problems, observing that the suicide attempts of these victims were intrinsically related to their experiences of aggression. Thus, it has been found that variables such as gender, rumination, emotional dysregulation, social support, and characteristics of aggression mediate the relationship between sexual violence against children and suicidal and non-suicidal autolytic behaviors. This type of investigation helps us to establish the focus of intervention in the cases of victims of child sexual assault, but it should also help to give visibility to the problem and promote preventive intervention protecting children. (AU)

Conductas autolíticas suicidas y no suicidas en víctimas de violencia sexual infantil / Suicidal and Non-Suicidal Self-Harm Behaviors in Victims of Sexual Violence Against Children

La violencia sexual hacia la infancia y las conductas autolesivas suicidas y no suicidas son dos problemáticas sociales y de salud que han incrementado. Las agresiones sexuales conllevan un impacto, afectando a la tendencia a realizar comportamientos autolíticos. Por ello, se pretendía estudiar la relación existente entre haber sido víctima de VSI y la probabilidad de realizar conductas autolesivas suicidas y no suicidas en adolescencia y adultez temprana. Para ello, se ha realizado una revisión sistemática, a través de las bases de datos Pubmed y PsicInfo de artículos publicados entre 2015 y 2022. Se ha hallado una relación significativa entre ambas problemáticas, observando que los intentos de suicidios de estas víctimas estaban relacionados intrínsecamente con sus experiencias de agresión. Así, se ha encontrado que variables como el género, la rumiación, la desregulación emocional, el apoyo social y las características de la agresión median la relación existente entre la violencia sexual infantil y las conductas autolíticas suicidas y no suicidas. Este tipo de investigaciones nos ayuda a establecer el foco de intervención en los casos de víctimas de agresión sexual infantil, pero debe también ayudar a dar visibilidad a la problemática e impulsar la intervención preventiva protegiendo la infancia. (AU)

Sexual violence against children and suicidal and non-suicidal self-injurious behaviors are two social and health problems that have increased. Sexual assaults have an impact, affecting the tendency to carry out autolytic behaviors. Therefore, it was intended to study the relationship between having been a victim of sexual violence in their childhood and the probability of engaging in suicidal and non-suicidal self-injurious behaviors in adolescence and early adulthood. For this, a systematic review has been carried out, through the Pubmed and PsycInfo databases of articles published between 2015 and 2022. A significant relationship has been found between both problems, observing that the suicide attempts of these victims were intrinsically related to their experiences of aggression. Thus, it has been found that variables such as gender, rumination, emotional dysregulation, social support, and characteristics of aggression mediate the relationship between sexual violence against children and suicidal and non-suicidal autolytic behaviors. This type of investigation helps us to establish the focus of intervention in the cases of victims of child sexual assault, but it should also help to give visibility to the problem and promote preventive intervention protecting children. (AU)

Effectiveness of prolonged exposure (PE) after implementation at a crime victim support centre.

Background: Recent practice guidelines strongly recommend evidence-based psychotherapies (EBPs) as the first-line treatment for post-traumatic stress disorder (PTSD). However, previous studies found barriers to the implementation of EBPs and a relatively high dropout rate in clinical settings. After proving the efficacy of prolonged exposure (PE) in Japan [Asukai, N., Saito, A., Tsuruta, N., Kishimoto, J., & Nishikawa, T. (2010). Efficacy of exposure therapy for Japanese patients with posttraumatic stress disorder due to mixed traumatic events: A randomized controlled study. Journal of Traumatic Stress, 23(6), 744-750. https://doi.org/10.1002/jts.20589], we began implementing PE in a real-world clinical setting at the Victim Support Center of Tokyo (VSCT).Objective: We aimed to investigate the effectiveness and benefit of PE for crime-induced PTSD among VSCT clients and what causes dropout from treatment.Method: Of 311 adult clients who received counselling from clinical psychologists at VSCT due to violent or physical crime victimization from April 2008 through December 2019, 100 individuals received PE and participated in this study. Their PTSD symptoms were evaluated before and after treatment using the Impact of Event Scale-Revised and the Clinician-Administered PTSD Scale for DSM-IV.Results: A total of 93 participants completed PE and seven dropped out after six sessions or less. The completers group improved in PTSD symptoms with significant score differences between pre- and post-treatment in IES-R and CAPS-IV. Participants' symptoms did not exacerbate after treatment. Forty of 49 completers who left their workplace or college/school after victimization returned to work or study shortly after treatment. Compared to the completers, all dropout participants were women and younger. The majority were rape survivors, with significantly shorter intervals between victimization and treatment. The reasons for dropout were difficulty scheduling treatment between work/study schedules and manifestation of bipolar disorder or physical illness.Conclusions: PE can be implemented with significant effectiveness and a low dropout rate in a real-world clinical setting if advantages in the system and policies, local organizational context, fidelity support and patient engagement are fortified.

We conducted prolonged exposure (PE) with a low dropout rate for crime-induced PTSD in a non-Western real-world practice setting.Patient outcomes and low dropout rate of PE for PTSD in this study may be due to advantages in the following areas: system and policies, local organizational context, fidelity support and patient engagement.When introducing PE for PTSD, it is important to confirm that patients can be reasonably engaged with PE, and to carefully assess the status of other psychiatric and physical illnesses.

La voz de las mujeres: el tránsito de víctimas a la legitimidad como constructoras de paces / The voice of women: the transition from victims to legitimacy as peace builders

Resumen El objetivo fue analizar las formas de afrontamiento de las violencias sexuales en mujeres víctimas sobrevivientes y su participación en los procesos de construcción de paz. Fue una investigación cualitativa a través de la Teoría Fundamentada, con el Interaccionismo Simbólico para originar la teoría, desde los significados que surgen en la interacción entre las personas y su entorno. Se recolectó la información con entrevistas a profundidad. La teoría construida resalta la experiencia de las violencias sexuales, la cual simboliza desazón, exilio, destrucción de sus metas y proyectos, la dificultad para perdonar por la magnitud del daño e incumplimiento de las leyes. Aunado a esto, las condiciones del territorio y su historia influyeron en los significados que las personas participantes asignaron a su experiencia inolvidable por las huellas del dolor; una de las formas de afrontamiento fue poder alzar su voz como un instrumento fundamental para el tránsito de víctimas a la legitimidad como constructoras de paces. Se concluye que, en la unión y en la mutualidad, encontraron la manera de legitimar sus voces y hacerlas oír por sus comunidades. El significado de la paz en las mujeres está representado en el estar en armonía, disfrutar de su cotidianidad, sentirse libres, sentirse importantes y únicas cuando hablan de la historia de dolor.

Abstract The objective was to analyze the ways of coping with sexual violence in surviving female victims and their participation in peacebuilding processes. It was a qualitative investigation through Grounded Theory, with Symbolic Interactionism to originate the theory, from the meanings that arise in the interaction between people and their environment. Information was collected through in-Depth interviews. The constructed theory highlights the experience of sexual violence, which symbolizes embodies the despair, exile, destruction of their goals and projects, the difficulty to forgive for the magnitude of the damage, and non compliance with the laws. In addition to this, the conditions of the territory and its history influenced the meanings that they assigned to their experience, duly unforgettable due to the traces of pain. One of the ways of coping was to be able to raise their voice as a fundamental instrument, for the transit of victims to legitimacy, as peace builders. We conclude that, in union and mutuality, they found the way to legitimize their voices and make them heard by their communities. The meaning of peace in women is represented by being in harmony, enjoying their daily lives, feeling free, feeling important and unique when they talk about their history of pain.

Análisis dinámico de un equipo interprofesional que implementa un programa de atención psicosocial a víctimas de la guerra / Dynamic analysis of an interprofessional team implementing a psychosocial intervention program for war victims

Resumen Este estudio analiza los cambios estructurales experimentados por un equipo interprofesional que implementa un programa de intervención psicosocial dirigido a víctimas de la guerra en Colombia. Los equipos están compuestos por psicólogos, trabajadores sociales y facilitadores comunitarios que proporcionan atención a nivel individual, familiar y comunitario. Se aplicaron métodos de evaluación estructural para identificar cambios en la cohesión de las redes de reconocimiento entre profesionales, así como la preferencia para colaborar y el intercambio de información enviada y recibida. La recogida de información se produjo en dos series temporales -tiempo 1 (T1) y tiempo 2 (T2)- con un intervalo de tres meses. Se utilizó una estadística aplicada al análisis de datos relacionales para determinar los cambios en las redes en T1 y T2. En el período de referencia se incrementó la densidad en las redes de reconocimiento [. = 1.7105, (IC 95 %: -.0123 - .185), . < .0444] y de preferencia para trabajar [. = 2.0942, (IC 95 %: .005 - .1521), . < .0218]. Las redes de intercambio de información no experimentaron cambios significativos. Las regresiones múltiples a nivel diádico indican que la preferencia para trabajar e intercambiar información en T1, predicen el intercambio de información relativo tanto a peticiones de información recibidas como enviadas en T2. Se discuten los resultados para optimizar la implementación de programas de intervención psicosocial desarrolladas por equipos interprofesionales.

Abstract The study analyzes the structural changes experienced by an interprofessional team implementing a psychosocial intervention program for victims of war in Colombia. The program is called "PAPSIVI" (Programa de Atención Psicosocial y Salud Integral a Víctimas), which has been operating in Colombia since 2013, thanks to Law 1448 of 2011 to improve the quality of life and repair the damage of the victims of the armed conflict in Colombia. It only served people registered in the Single Registry of Victims (RUV), which had 9'165,126 records throughout the country until September 2021. This program follows a comprehensive and restorative approach that defines victims as protagonists of their own process of empowerment and positive change (Laplante and Holguin, 2006; Thompson, 1996). For this purpose, a multilevel intervention is carried out at the individual, family and community levels. The program is implemented by teams of professionals (psychologists, social workers and community facilitators) of varying sizes depending on the number of victims served in the municipalities. Psychologists provide individual psychological care and, to a lesser extent, family therapy is also offered to try to repair psychosocial damage from exposure to situations of violence (Oficina de Promoción Social, 2017). Social workers carry out community interventions to promote the associative fabric and social capital. Community promoters are facilitators and connect professionals with the potential beneficiaries of the intervention. The latter are very important, having themselves the status of victims, which increases the ecological validity of the intervention. Due to the characteristics of the implementation of this initiative, which takes into account the difficulties of the context (with situations of deprivation and vulnerability), as well as the particularities of the participants, it is valid to ask in this research what are the structural changes experienced by the teams of professionals who implement PAPSIVI. For this, structural evaluation methods were applied to identify changes in the cohesion of recognition networks among professionals, the preference to collaborate and the exchange of information sent and received. Data collection took place in two time series (T1 before - T2 after) with an interval of three months. Statistics applied to relational data analysis were used to determine changes in the networks at time T2. In the results it was found that in the baseline period the density in the recognition [t = 1.7105, (95 % CI: -.0123 - .185), p < .0444] and work preference [t = 2.0942, (95 % CI: .005 - .1521), p < .0218] networks increased. Information exchange networks did not experience significant changes. Multiple regressions at the dyadic level indicate that the preference for working and exchanging information at T1 predicts information exchange relative to both information requests received and sent at T2. It is concluded that the results shed light for: (a) optimize the design of psychosocial intervention teams; (b) improve their functioning by introducing horizontal organizational communication tools (among the members of each team), transversal (among the members of the teams implementing the program in different municipalities), and vertical (by promoting communication between professionals and program managers/responsible persons), and (c) achieve that changes in the structure of the teams serve as a diagnostic tool for functional problems of the team associated with the exchange of professional information and the referral of users. Ultimately, better integration of the teams leads to better psychosocial profiles of the users of programs such as PAPSIVI and allows them to better adapt their activities to the needs of the users, which improves the effectiveness of the intervention (Virto, 2021).

La Instalación del Trauma en dos comunidades de Colombia: Trauma Colectivo y Marcos Discursivos / The Installation of Trauma in Two Communities in Colombia: Collective Trauma and Discursive Frames

Resumen Las comunidades que enfrentan experiencias de violencia extrema sufren daños en su estructura social, que afectan relaciones interpersonales, sentimientos de integración social e identidades personales. Propusimos el concepto de instalación del trauma como construcción sociopolítica y eje de asignación de sentido, que permite a las comunidades explicar lo desconcertante. La instalación consiste en el andamiaje de recursos, materiales y simbólicos, que ofrecen interpretaciones situacionales de una experiencia; nos enfocamos en elementos simbólicos, específicamente en marcos discursivos, que son soportes de significación y organizan contenidos con el fin de comprender eventos. En esta investigación analizamos marcos discursivos de dos comunidades que enfrentaron situaciones de violencia extrema (masacres), con el objetivo de estudiar términos de instalación y elaboración del trauma colectivo. Identificamos marcos discursivos genéricos y específicos, que posibilitaron la construcción comunitaria de una narrativa del trauma. El concepto de instalación del trauma sirve para revisar estrategias de contención psicosocial ante eventos que alteran el tejido social de una comunidad.

Abstract Communities that experience extreme violence suffer damage in their social structure. This affects interpersonal relationships, feelings of social integration, and personal identities. In this article, we propose the concept of installation of trauma as both a sociopolitical construction and a strategy of meaning that allows a community to elaborate traumatic events. The installation consists of the scaffolding of resources, both material and symbolic, that offer situational interpretations of an experience. Focusing on symbolic elements, specifically on discursive frames, or structures of meaning with communicative purposes, we analyze the discursive frames of two communities that faced events of extreme violence (massacres), with the aim of studying the terms of installation and elaboration of collective trauma. This helped identify generic and specific discursive frames that allowed the community the construction of the trauma narrative. The concept of trauma installation serves to study psychosocial holding strategies in communities facing tragedy.

La odontología en la identificación de sucesos con víctimas múltiples / Forensic odontology in human identification in multiple victims’ incidents

La aprobación en 2009, del Protocolo Nacional de actuación Médico-Forense y de Policía Científica en sucesos con víctimas múltiples, supuso la base normativa para regular formalmente los procedimientos y técnicas que deben aplicarse, como las distintas tareas forenses que se tienen que realizar en los supuestos de sucesos con víctimas múltiples en España. En este artículo se revisan los procedimientos y métodos que se emplean en odontología forense para la identificación humana en casos de grandes catástrofes con múltiples víctimas. Dado que el reconocimiento de las características individualizadoras de las piezas dentarias, y en general los datos bucodentales, supone un proceso altamente especializado, resulta imprescindible el apoyo técnico de odontólogos/as forenses con experiencia en este campo, quienes dispondrán de la formación y los conocimientos necesarios para la realización de la toma de registros dentales, la interpretación precisa de los resultados y la obtención adecuada de las conclusiones. Finalmente se incluyen recomendaciones para la elaboración de los informes forenses de identificación odontológica. (AU)

The approval in 2009, of the Protocolo Nacional de actuación Médico-Forense y de Policía Científica en sucesos con víctimas múltiples, was the basic normative to formally regulate both the technical procedures that must be applied, and the different tasks to be carried out in a disaster victim incident in Spain. This article reviews the procedures and techniques used in forensic odontology for human identification in DVI incidents with multiple victims. Given that the recognition of the individualizing characteristics of the teeth, and in general the odontological data, supposes a highly specialized process, it is essential the assistance of forensic dentists with experience in this field, who will have the training and the knowledge to carry out the dental procedures such as documenting dental records, accurate interpretation of the results and withdraw precise dental identification conclusions. Finally, recommendations for the preparation of forensic dental identification reports are included in this review. (AU)

Aportaciones y avances de la genética forense en los sucesos con víctimas múltiples / Contributions and advances of forensic genetics in mass fatality incidents

La identificación de los afectados por un suceso con víctimas múltiples es una prioridad por razones humanitarias y legales. La genética forense juega un importante papel en estas situaciones que, por su complejidad, a menudo se convierten en un reto para los distintos profesionales implicados. El establecimiento de guías y recomendaciones facilita el seguimiento de protocolos estandarizados que permiten garantizar la fiabilidad del resultado final de la identificación. Así mismo, los avances en la genética forense contribuyen a agilizar la respuesta, aportando nuevas estrategias de análisis y herramientas de tipo bioinformático. Con este artículo, se pretende ofrecer una visión general de cómo la genética forense y sus avances pueden contribuir en estas situaciones, así como algunas claves para entender la labor de los laboratorios de genética forense en la identificación de cadáveres en sucesos con víctimas múltiples. (AU)

Disaster victim identification is crucial for humanitarian and legal reasons. Forensic genetics plays an important role in these situations which often become a challenge for the different professionals involved due to their complexity. The establishment of guidelines and recommendations makes it easier to follow standardized protocols that make it possible to guarantee the reliability of the identification final result. Likewise, advances in forensic genetics contribute to speeding up the response, providing new analysis strategies and bioinformatic tools. This article aims to provide an overview of how forensic genetics and its advances can contribute in these situations, as well as some keys to understanding the work of forensic genetics laboratories in the identification of corpses in events with multiple victims. (AU)

Hacia un cambio de paradigma en la atención psicológica en grandes emergencias: de incidentes con múltiples víctimas a incidentes con múltiples afectados / Towards a paradigm shift in psychological care in major emergencies: from incidents with multiple victims to incidents with multiple victims

Las grandes emergencias o desastres plantean grandes retos a la sociedad y en especial a todos los servicios de emergencia. En las últimas décadas, se ha incorporado la perspectiva de la salud mental como una parte importante de la atención sanitaria integral a los afectados. Así, el cambio conceptual de «incidente de múltiples víctimas» (IMV) a «incidente de múltiples afectados» (IMA) se centra en la atención y bienestar de todas las personas afectadas por un incidente, no solo en aquellos que han sufrido lesiones físicas. El objetivo del presente artículo se centra en conocer las posibilidades de intervención con afectados etiquetados en un triaje como verdes psicológicos (sin afectación y/o lesiones físicas), a partir de la intervención psicológica avanzada en emergencias (IPA). La IPA, más allá de alejar a los afectados del peligro, persigue aumentar su sensación de control y eficacia, tanto para afrontar la situación como para aumentar su sentido de competencia en la vivencia de trauma posterior respecto a esa experiencia. En este sentido, las posibilidades recientes de evaluación, así como los enfoques de primeros auxilios psicológicos, permiten nuevas aplicaciones de intervención en emergencias como las que posibilitan los soportes aéreos remotos (drones). Se discute su aplicación y posibilidades como opciones de futuro. (AU)

Major emergencies or disasters pose great challenges to society and especially to all emergency services. In the last decades, the Mental Health perspective has been incorporated as an important part of comprehensive health care for those affected. Thus, the conceptual change from “multiple casualty incident” (MCI) to “multiple affected incident” (MAI) focuses on the care and well-being of all people affected by an incident, not only those who have suffered physical injuries. The objective of this article is focused on finding out the possibilities of intervention with patients labeled in triage as psychological green (without affectation and/or physical injuries), based on advanced psychological intervention in emergencies (IPA). The IPA, beyond removing those affected from danger, seeks to increase their sense of control and efficacy, both to face the situation and to increase their sense of competence in the experience of subsequent trauma with respect to that experience. In this sense, recent assessment possibilities, as well as psychological first aid approaches, allow new intervention applications in emergencies such as those made possible by remote air support (drones). Its application and possibilities as future options are discussed. (AU)

Somatización, ansiedad y depresión en mujeres víctimas de violencia de pareja íntima / Somatization, anxiety and depression in women victims of intimate partner violence

Resumen A pesar de que la violencia de pareja íntima (VPI) presenta en la mujer una variedad de síntomas evidenciables, varios de los actores involucrados en el sistema de salud no cuentan con mecanismos de evaluación temprana, ni de reconocimiento de los tipos de secuelas psicológicas, entre los que se incluye una diversa sintomatología psicofisiológica. Con el objetivo de conocer las características de somatización, ansiedad y depresión en mujeres víctimas de VPI, como parte de una investigación macro de corte transversal no experimental de campo, se realizó el presente estudio cuantitativo correlacional a través de las variables del Inventario de Evaluación de la Personalidad (PAI). Los datos obtenidos se sometieron a análisis estadístico con métodos descriptivos e inferenciales. La muestra consta de 50 mujeres de la población de víctimas de VPI de la sierra ecuatoriana. Los resultados obtenidos son bastante contradictorios en cuanto al bajo porcentaje de mujeres con afectación típica relacionada con este tipo de violencia, en comparación con los datos presentados por otros autores sobre los niveles de somatización, ansiedad y depresión en ellas. A pesar de esto, se obtuvieron tres factores independientes presentes en esta muestra: trastorno ansioso-depresivo, con elementos de estrés postraumático; trastorno obsesivo compulsivo, con elementos de ansiedad, y quejas somáticas. Al momento de finalizar este estudio, se puede concluir que el PAI, sin su validación previa en esta población, no muestra una idoneidad suficiente para evaluar mujeres víctimas de VPI en el Ecuador. Se recomiendan nuevas investigaciones en otras muestras, en las que se utilicen diversos esquemas empíricos que incluyan varios instrumentos y medios cualitativos.

Abstract Various studies have noticed that women victims of intimate partner violence (IPV) also report having various types of health-related problems. However, health systems do not appear to have established procedures to recognize these problems (i. e., psychophysiological) in women. This study assessed somatic symptoms, anxiety, and depressive characteristics in women who have been victims of IPV. These symptoms were assessed using the scales of the Personality Assessment Inventory (PAI). The sample consisted of 50 women victims of IPV from the Ecuadorian sierra. Group participants came from two different cities: the first group included 28 women victims of IPV from Riobamba. Their ages ranged from 15 to 58. These women were receiving psychological services from a not-for-profit organization in the city. The second group included 22 women with similar characteristics between the ages of 27-63. This group of women came from the southern regions of Quito, the capital city of Ecuador. Women in this group were receiving services from two different places offering help to women experiencing IPV. Sixteen percent of women reported having a medium level of "anxiety" (some level of stress), and 14 % reported having a high level of tension and stress. Thirty-four percent of women reported medium levels of "anxiety-related disorders". These women reported having specific fears, little confidence in themselves and negative perspectives of their future. Sixteen percent of the women reported high levels of anxiety. They reported imitations in daily life (i. e., specific fears and feelings of insecurity in social situations). Thirty percent of women reported having medium levels of "depression" (sensitivity, pessimism, and feeling unhappy part of the time). Eighteen percent of women reported having high levels of "depression" (notable unhappiness and dysphoria). Forty-four percent of women in this study reported having some type of physical problem. These findings suggest that women who are victims of IPV could benefit from receiving mental health services aimed at managing their tension, stress, specific fears, and symptoms of depression. They also suggest that women victims of IPV could benefit from receiving training to increase their social competency and medical assistance to address their somatic complaints. Findings in this study are somewhat divergent from the results observed in previous investigations. Previous studies identified that most women who experienced IPV report symptoms of depression and anxiety. However, in this study, only a relatively low percentage of women reported having these symptoms. The sole utilization of the PAI as a method of evaluation may not have been sufficient to identify these symptoms. These results suggest the importance of using qualitative methods (i. e., clinical interview) or more holistic methodologies (i. e., clinical interview and tests) to better assess mental health symptoms in this group of women. It is also possible that the PAI might not be the most adequate tool to assess these symptoms in this population. The results of this investigation do reveal the importance of evaluating other mental health symptoms in women victims of IPV: post-traumatic stress, and obsessive-compulsive disorder. Future studies should focus on assessing these symptoms using other assessment methodologies (e. g. instruments designed to assess post-traumatic stress and obsessive-compulsive disorder). The efficiency of health systems evaluations and interventions depends on the methodologies used to assess problems. The sole use of one instrument such as the PAI may not provide sufficient information about symptoms experienced by women experiencing IPV. Health systems should use batteries of instruments in conjunction with the clinical interviewing processes to readily assess symptoms. However, such an alternative may not be entirely feasible taking into account that such methodology requires more time and likely financial support to acquire tests.

La macroviolencia encubridora y la invisibilización de las víctimas del conflicto. Estudio etnográfico de la masacre de Cienaguita-Pita (Atlántico) / Macroviolence and the invisibilization of the victims of the conflict. Ethnographic study of the Cienaguita-Pita massacre (Atlántico) / Macro-violência e a invisibilização das vítimas do conflito. Estudo etnográfico do massacre de Cienaguita-Pita (Atlántico)

Este artículo argumenta que la macroviolencia ha invisibilizado buena parte de las masacres ocurridas en regiones donde el conflicto interno fue de menor intensidad, ha banalizado sus efectos en pequeñas poblaciones, y con ello, ha provocado una relación transaccional entre el Estado y victimarios con las víctimas de masacres de menor escala. Por esta razón, por medio de un estudio de caso, haciendo uso de entrevistas semiestructuradas, grupos focales y encuestas al universo de habitantes de Cienaguita-Pita (Atlántico), se ilustrará cuáles fueron los efectos de la masacre, las entradas diferenciadas del Estado y el acceso que tuvieron las víctimas a los derechos a la verdad, justicia, reparación, no repetición y dignificación. Por último, este artículo pretende visibilizar una de las masacres ocurridas en el Caribe, que ha sido oculta por cuenta de la macroviolencia que caracterizó a la región en las décadas de 1990 y 2000, y demostrar, además, que el Estado es quien ha asumido la carga de indemnizar a las víctimas y establecer algunos insumos para reconstruir la verdad en el conflicto armado.

This article argues that macro-violence has made invisible a good part of the massacres that occurred in regions where the internal conflict was of lesser intensity, has trivialized its effects in small populations, and with it, has provoked a transactional relationship between the State and victimizers with the victims of smaller scale massacres. For this reason, by means of a case study, using semi-structured inter-views, focus groups and surveys of the universe of inhabitants of Cie-naguita-Pita (Atlántico), we will illustrate the effects of the massacre, the State>s differentiated approaches and the victims> access to the rights to truth, justice, reparation, non-repetition and dignity. Finally, this article aims to make visible one of the massacres that occurred in the Caribbean, which has been hidden due to the macro-violence that characterized the region in the 1990s and 2000s, and also to demonstrate that the State has assumed the burden of compensating the victims and establishing some inputs to reconstruct the truth in the armed conflict.

Este artigo argumenta que a macro-violência tornou invisível uma grande parte dos massacres que ocorreram em regiões onde o conflito interno foi de menor intensidade, banalizou os seus efeitos em pequenas populações, e provocou assim uma relação transaccional entre o Estado e os perpetradores com as vítimas de massacres de menor escala. Por este motivo, através de um estudo de caso, utilizando entrevistas semi-estruturadas, grupos focais e inquéritos aos habitantes de Cienaguita-Pita (Atlántico), ilustraremos os efeitos do massacre, as abordagens diferenciadas do Estado e o acesso das vítimas aos direitos à verdade, à justiça, à reparação, à não repetição e à dignidade. Finalmente, este artigo visa tornar visível um dos massacres ocorridos nas Caraíbas, que foi escondido devido à macro-violência que caracterizou a região nos anos 90 e 2000, e também demonstrar que o Estado assumiu o ónus de compensar as vítimas e estabelecer alguns contributos para a reconstrução da verdade no conflito armado.

Women's perception of urban insecurity in the Monterrey metropolitan area during COVID-19 / Percepción femenina de la inseguridad urbana en el área metropolitana de Monterrey en tiempos de COVID-19 / A percepção das mulheres sobre a insegurança urbana na área metropolitana de Monterrey em tempos de COVID-19

The purpose of this paper it to explore women's perception of urban insecurity prevailing during the COVID-19 pandemic in the Monterrey metropolitan area (MMA) in Mexico. In recent decades, large cities have grown and with them, so has crime increased. As a result, the issue of urban insecurity has become important, particularly during this COVID-19 pandemic. For this purpose, a cross-sectional, descriptive, non-probabilistic study was conducted involving 69 women aged 18 to 58, with Universidad Autónoma de Nuevo León being taken as the sample frame. Our findings show that 74% of the participants indicate that urban safety near their homes, ranges fair to very bad, while 81% feel the same about safety near their workplaces. Ninety-three per cent say that crime has increased. Meanwhile, 55% say that the situation has affected their quality of life severely to very severely, denoting the MAM population's transition from one of social well-being to one of vulnerability, which has been further aggravated by the health contingency.

Este artículo investiga la percepción femenina de la inseguridad urbana que prevalece durante la pandemia de COVID-19 en el área metropolitana de Monterrey (MAM) en México. En las últimas décadas las grandes urbes han crecido y con esto también se favorece la delincuencia. Por lo tanto, el tema de inseguridad urbana se ha tornado pertinente y, particularmente, ha sido de interés abordarlo durante esta pandemia de COVID-19. Para esto, se realizó un estudio de carácter transversal y descriptivo, no probabilístico, en 69 mujeres de 18 a 58 años, y se consideró la Universidad Autónoma de Nuevo León como el sitio de muestreo. En el presente documento los hallazgos muestran que 74% de las participantes indica que la seguridad urbana cercana a sus casas es regular a muy mala. Similar situación se presenta en sus lugares de trabajo, según afirma el 81%. El 93% asevera que los actos delictivos aumentaron. Entre tanto, el 55% dice que esta situación afectó de grave a muy gravemente su calidad de vida. Esta situación denota la transición de la sociedad en el MAM de bienestar social a otra de vulnerabilidad, que se ha incrementado por el escenario de la contingencia sanitaria que ha padecido.

Este artigo investiga a percepção das mulheres sobre a insegurança urbana prevalecente durante a pandemia COVID-19 na área metropolitana de Monterrey (MMA), no México. Nas últimas décadas, as grandes cidades cresceram e, com isso, a criminalidade também aumentou. Portanto, a questão da insegurança urbana tornou-se relevante e, particularmente, tem sido de interesse abordá-la durante esta pandemia da COVID-19. Para este fim, foi realizado um estudo transversal, descritivo e não-probabilístico entre 69 mulheres de 18 a 58 anos, e a Universidade Autônoma de Nuevo León foi considerada como o local de amostragem. Neste documento, os resultados mostram que 74% dos participantes indicam que a segurança urbana perto de suas casas é justa a muito ruim. Uma situação semelhante é encontrada em seus locais de trabalho, de acordo com 81%. Noventa e três por cento dizem que a criminalidade aumentou. Enquanto isso, 55% dizem que esta situação tem afetado seriamente a qualidade de vida deles. Esta situação reflete a transição da sociedade no MMA de uma situação de bem-estar social para uma situação de vulnerabilidade, que tem aumentado devido ao cenário de contingência de saúde que experimentou.

Somatoprótesis y Estallido Social Chileno 2019

Durante el Estallido Social en Chile 2019, la Odontología tomó un rol protagónico que nadie esperaba: La rehabilitación protésica de las víctimas de trauma ocular. Estos eventos dejaron al desnudo importantes fragilidades del sistema de salud Chileno.

During the social unrest in Chile in 2019, dentistry took a protagonist role that no one foresaw: The prosthetic rehabilitation of the ocular trauma victims. These events revealed important flaws on the Chilean Health system.

Análisis descriptivo de los incidentes con múltiples víctimas intencionados en entorno civil en Europa durante el periodo 2000-2018 / Intentional mass-casualty incidents with civil society targets in Europe a descriptive analysis for 2000 to 2018

Objetivo: Conocer las características principales de los incidentes con múltiples víctimas intencionados (IMVi) en entorno civil en Europa entre los años 2000 y 2018. Método: Estudio retrospectivo, descriptivo-analítico de los IMVi acontecidos en Europa entre 2000-2018, registrados en la Global Terrorism Database. Se recogieron país, año, arma principal y secundaria, subtipo de arma principal, número de atacantes, víctimas, número de focos, autoría, objetivo y lugar. Resultados: Se identificaron 469 focos en 373 IMVi independientes (86% unifocales) que causaron 15.066 víctimas (11.410 heridos y 3.656 muertos). El año y el país con más IMVi fue 2014 (58) y Rusia (50,1%), respectivamente. España fue el tercero (8,7%) y el más afectado de Europa Occidental. Las armas más utilizadas fueron explosivos (71,4%), arma de fuego (19,6%) y vehículo a motor (2,6%). Esta última, en aumento en los últimos años, fue la de mayor poder lesivo significativamente, con una mediana (P25-75) de 19 (12-59) víctimas por IMVi (p = 0,026). Existió una correlación positiva significativa entre el número de atacantes en las armas de fuego y el número de víctimas (r = 0,357, p = 0,011). El objetivo principal mayoritario fue la población civil (53,1%) y el lugar elegido la vía pública (24,3%). Conclusiones: En el siglo XXI ya han acontecido casi 500 IMVi en Europa, la mayoría por explosivos y armas de fuego. El uso de vehículo a motor, en aumento, es sin embargo el de mayor potencial lesivo. El conocimiento de los datos aportados puede ayudar en la mejora de los planes de emergencias que den respuesta a los IMVi. (AU)

Objective: To describe the main characteristics of intentional mass-casualty incidents (MCIs) with civil society targets in Europe between 2000 and 2018. Methods: Retrospective, descriptive analysis of intentional MCIs in Europe between 2000 and 2018 recorded in the Global Terrorism Database. We collected information on country; year; main and secondary weapons used and mainweapon subtype; numbers of attackers, victims, and points of attack; targets; and type of location. Results: A total of 469 points of attack were identified in 373 independent intentional MCIs (86% with multiple points of focus) that caused 15066 victims (11410 persons injured, 3656 deaths). The year with the most MCIs was 2014 (58 MCIs), and Russia saw the largest percentage (50.1%). Spain ranked third, with 8.7% of the MCIs in Europe, the highest proportion in Western Europe. Explosive devices were the weapons used most often (in 71.4%), followed by firearms (in 19.6%), and motor vehicles (in 2.6%). Vehicles, which use has been on the rise, caused themost injuries, with a median (interquartile range) of 19 (12-59) victims per intentional MCI (P = .026). The number of attackers in MCIs involving firearms correlated positively with the number of victims (r = 0.357, P = .011). The most frequent target was the civil population (in 53.1%), and public spaces and thoroughfares were the locations most often chosen (in 24.3%). Conclusions: Nearly 500 intentional MCIs have occurred in Europe in this XXI century. Most involved explosives or firearms. However, motor vehicles are the most potentially harmful weapons, and their use is increasing. These data may help to improve MCI emergency response planning. (AU)