Justice sensitivity among nurses and physiotherapists in a Croatian rehabilitation hospital.

The aim of this study was to investigate and compare justice sensitivity between self-perceived beneficiaries, victims, and observers in a sample of 90 healthcare workers (nurses and physiotherapists) at the Varazdinske Toplice Special Medical Rehabilitation Hospital, Croatia. For this purpose we used a questionnaire consisting of demographic data and the Croatian version of the justice sensitivity inventory developed by Schmitt. Regardless of its limitations, our study clearly shows that healthcare professionals at Varazdinske Toplice are most sensitive to injustice from the beneficiary's perspective, that is, as persons who personally benefitted from injustice, although they may not have been instrumental to this effect. They are less sensitive to injustice perceived on the outside (observer's perspective) or to injustice suffered by themselves (victim's perspective). Another important finding is that participants of female gender, rural residence, and nurses (who are all women) are significantly more sensitive to injustice, whereas age and marital status do not seem to contribute to justice sensitivity. Future research should investigate the perception of injustice over a longer timeframe and involve all healthcare workers. It could also address different approaches to management, especially in terms of worker rewards and career advancement. Qualitative research among healthcare workers could provide a broader and clearer idea of social injustice at their workplace.

The European Researchers' Network Working on Second Victim (ERNST) Policy Statement on the Second Victim Phenomenon for Increasing Patient Safety.

Background: The second victim phenomenon refers to the emotional trauma healthcare professionals experience following adverse events (AEs) in patient care, which can compromise their ability to provide safe care. This issue has significant implications for patient safety, with AEs leading to substantial human and economic costs. Analysis: Current evidence indicates that AEs often result from systemic failures, profoundly affecting healthcare workers. While patient safety initiatives are in place, the psychological impact on healthcare professionals remains inadequately addressed. The European Researchers' Network Working on Second Victims (ERNST) emphasizes the need to support these professionals through peer support programs, systemic changes, and a shift toward a just culture in healthcare settings. Policy Options: Key options include implementing peer support programs, revising the legal framework to decriminalize honest errors, and promoting just culture principles. These initiatives aim to mitigate the second victim phenomenon, enhance patient safety, and reduce healthcare costs. Conclusion: Addressing the second victim phenomenon is essential for ensuring patient safety. By implementing supportive policies and fostering a just culture, healthcare systems can better manage the repercussions of AEs and support the wellbeing of healthcare professionals.

Piece by piece-a computer-aided method for virtual re-association of commingled fragmented remains.

Air crashes or explosions with numerous victims may result in thousands of fragmented human remains that present a massive challenge for disaster victim identification teams. Genetic identification may present important financial and technical limits, and the physical re-association of fractured bones by forensic anthropologists may require a time-consuming phase of cleaning and drying. A virtual re-association (VRA) of fragmented human remains using postmortem computed tomography (CT)-scan images could enhance the identification process and reduce the number of genetic analyses required. Therefore, this study investigated the advantages and limitations of a VRA protocol in comparison with physical re-association (PRA) in a laboratory setting and in a real case scenario. As a first step, six porcine femurs were scanned by multi-detector CT before and after physical fragmentation. PRA of the dry bones and VRA of the 3D models of the fragments were then performed. The physically reconstructed dry bones were then once more scanned with CT. The mean distance between intact and reconstructed models, the number of re-associated fragments, and the time needed for the reconstruction were evaluated. In a second step, 87 fragmented remains resulting from a controlled pig bombing were collected, scanned, and virtually re-associated to test the feasibility of the protocol in a real context. The reconstruction of the femurs showed no difference in accuracy between PRA and VRA. Although the VRA was faster than PRA, the preparation of the material still needs to be taken into consideration. The VRA after the controlled pig bombing was limited to 8% of the total fragments. Differences in alveolar and cortical osseous structure and the presence of cartilage resulted in segmentation approximations and difficulties in the re-association itself. The explosion produced an important loss of intermediate bone elements. The VRA method still needs further evaluations with a larger sample size and different fragmentation mechanisms. However, the presented research shows promising results towards enhancing the efficiency of identifying individuals after a mass disaster. Key points: Mass disasters with highly fragmented bodies represent a major challenge for the disaster victim identification (DVI) teams.Using CT-scans of the fragments, a virtual re-association method could enhance the DVI process and reduce the number of genetic analysis required.A laboratory setting using porcine femurs shown that the VRA process could start earlier and was faster than the physical re-association.Although methodological limits were highlighted, and the efficiency of the method has to be re-evaluated, the controlled bombing showed that the VRA could be applied in a real case scenario.

Understanding "Childhood Poly-Victimization" to help uncover abuse during child investigative interviewing: a systematic review.

Introduction: It is well established that child victims are some of the most challenging populations to interview. Indeed, children tend to feel ashamed, scared or in denial, leading to difficulties for law enforcement when gathering information, and subsequently with prosecuting offenders. Moreover, with crimes against children increasing, it is common for interviewed victims to have experienced several abuses (poly-victimization). Thus, the main goals of this study are to (1) identify the facets that are included in poly-victimization, in order to (2) provide a clear definition that can be used by law enforcement during child interviews, which could lead to (3) a better identification of cases of abuse to maximize safeguarding and protect children. Materials and methods: A systematic review was used to establish the differences in conceptualizations of poly-victimization as well as the measurements chosen by research to measure this concept. The current systematic review included research articles on childhood poly-victimization using a quantitative measuring instrument published as of 2007, that focused on populations under 18 years of age. Results: The findings were divided into (1) conceptual dimensions, (2) characteristics of studies' populations and (3) measures and psychometrics properties. It was found that research used various terms for poly-victimization, yet with numerous definitions implying differences in number of abuses, time frame, and mental health aspects to be considered in the identification of poly-victimization. The included papers (n = 6) were from Europe, Asia, and the United States. Over half of the studies used the Juvenile Victimization Questionnaire (JVQ) but adapted either (i) to the study's population, (ii) possible answers, (iii) wording of questions, or (iv) by the removal of questions. Conclusion: Our findings highlight the need for a more theoretically coherent definition of childhood poly-victimization. Questions regarding number of abuses, time consideration (past year vs. lifetime), mental health and severity of abuse should be addressed to develop a unified definition of poly-victimization. Rapport-based interviews should be the focus to uncover the truth and to avoid a secondary trauma in the crisis of a child's disclosure of abuse. A new definition of "Childhood Poly-Victimization" is proposed by the authors as well as a "Decision Tree for Identifying Childhood Poly-Victimization" designed to be used by law enforcement during child investigative interviews.

Beyond the operating room: addressing the "second-victim" phenomenon in surgical practice.

Complications are plausible events during surgical operations. Surgical complications profoundly impact surgeons, often called "second victims" of adverse events. These complications trigger a range of emotional and psychological responses, including guilt, anxiety, heightened empathy, and the looming threat of burnout. Moreover, the toll extends to physical health, with chronic stress and sleep disturbances taking their toll. Surgeons' social lives are not immune to the fallout, and their career satisfaction may wane, pushing some towards defensive medicine practices. While mentorship, counselling, and peer support are crucial support mechanisms, they encounter barriers such as time constraints and the fear of negative perceptions. This paper suggests practical recommendations, including comprehensive wellness programmes, a streamlined badge card system for easy access to resources, and mindfulness training to mitigate stress and burnout. Recognising and proactively addressing these multifaceted impacts is imperative for cultivating a resilient medical community capable of providing optimal patient care.

A victim risk identification model for nature-induced urban disaster emergency response.

In recent years, nature-induced urban disasters in high-density modern cities in China have raised great concerns. The delayed and imprecise understanding of the real-time post-disaster situation made it difficult for the decision-makers to find a suitable emergency rescue plan. To this end, this study aims to facilitate the real-time performance and accuracy of on-site victim risk identification. In this article, we propose a victim identification model based on the You Only Look Once v7-W6 (YOLOv7-W6) algorithm. This model defines the "fall-down" pose as a key feature in identifying urgent victims from the perspective of disaster medicine rescue. The results demonstrate that this model performs superior accuracy (mAP@0.5, 0.960) and inference speed (5.1 ms) on the established disaster victim database compared to other state-of-the-art object detection algorithms. Finally, a case study is illustrated to show the practical utilization of this model in a real disaster rescue scenario. This study proposes an intelligent on-site victim risk identification approach, contributing significantly to government emergency decision-making and response.

Beyond Burnout: Nurses' Perspectives on Chronic Suffering During and After the COVID-19 Pandemic.

Nurses around the globe have been impacted psychologically and emotionally during and after the COVID-19 pandemic. The purpose of this study was to describe nurses' perspectives on the concepts of compassion fatigue, second victimhood, burnout, and moral injury. Eight nurses were interviewed either individually or in groups of two. Data were analyzed using conventional content analysis. The following themes were identified: waves of compassion fatigue, traumatization within second victimhood, never the same after chronic burnout, moral injury: nurses couldn't do their best, and connections across concepts. Results showed nurses were most familiar with burnout and compassion fatigue, which remain chronic struggles. Second victimhood and moral injury were more distinct experiences related to traumatic or morally distressing events and likely contributed to experiencing burnout or compassion fatigue. Nurses' suffering heightened during the COVID-19 pandemic and remains prominent three years later. Future research and interventions are urgently needed globally to reduce workplace stressors and promote nurse well-being.

From Non-Traditional Sexual Behavior to Non-Legitimate Victims: Moral Virtue, Victim Blame, and Helping Intentions Toward a Woman Victim of Image-Based Sexual Abuse.

Image-based sexual abuse represents an increasingly common form of gender-based violence, consisting of the act of non-consensually capturing, distributing, or threatening to distribute sexually explicit material depicting another person. The purpose of the present study was to investigate how women victims' noncompliance with traditional female sexuality influences bystanders' perceptions of the phenomenon. Specifically, we experimentally examined whether a woman's sexual agency (high vs. low) and the length (steady vs. transient) of the relationship with the perpetrator affected her moral evaluation, victim blaming, and participants' willingness to support her. A sample of 597 adults (65.7% women, Mage = 31.29 years) took part in the study. The findings indicated that while a transient (vs. steady) relationship with the perpetrator significantly lowered the woman's perceived moral virtue and increased the extent to which she was blamed for the incident, a high (vs. low) woman's sexual agency decreased participants' helping intentions towards her. Additionally, results showed that men were less likely than women to attribute moral virtue and help the victim. Lastly, through the mediation of moral virtue and victim blaming, the length of the relationship indirectly influenced participants' helping intentions.

Effects of Technique and Dummy Mass on Law Enforcement-Specific Body Drags: Testing and Training Implications.

Current law enforcement body drag tests may use dummy masses that are underweight compared to current population norms. This study aimed to determine differences in 74.84-kg and 90.72-kg body drag times when performed with a standard (pick up and stand with dummy prior to dragging), adapted (incorporation of time to lift dummy to standing), and preferred (drag with any technique) technique. Forty-three (24 males, 19 females) physically-active, healthy civilians (surrogate population for police recruits) completed drags over 9.75 m with 74.84-kg and 90.72-kg dummies using the three techniques previously stated. A 2 (mass) × 3 (technique) within-factorial ANOVA (p < 0.05), with Bonferroni post hoc, derived any dummy and technique differences. Thirty-five participants completed all the standard and adapted drags; all participants completed the preferred drag. There were significant main effects for dummy mass (F (1,34) = 14.762, p < 0.001) and technique (F (2,33) = 23.272, p < 0.001). Participants dragged the 74.84-kg dummy faster than the 90.72-kg dummy. The standard drag was completed faster than the adapted and preferred drags (p < 0.001). The adapted drag was completed faster than the preferred drag (p = 0.024). Even if a recruit is assessed with a lighter dummy, they need the capacity to perform heavier drags in the field. Activity-specific strength training during academy could aid this process. Though the time was slower, the adapted technique may offer information the standard technique does not as it includes the lifting portion of the drag. The preferred technique allowed all participants to complete the task, which could influence the drag techniques allowed if agencies increase testing dummy masses.

Detection of substance use in clinical forensic cases: urine analysis of victims and perpetrators.

This study investigates the prevalence of substance use among victims and perpetrators involved in clinical forensic cases. Urine samples from 455 individuals aged 18 and above, collected in 2019, were analyzed using two LC-MS-based analytical methods and an HS-GC-FID method for the most frequently reported substances of abuse and medication. Data from case documents, encompassing gender, age, and the individual's role, were recorded in a database. Both the urine samples and the information from case documents were fully anonymized. The most frequently detected substance was alcohol (37% of all cases), followed by cannabis (22% of all cases) and central nervous system stimulants (24% of all cases). Other classes of substances detected included benzodiazepines, anabolic steroids, antipsychotic agents, and antidepressants. No drugs or alcohol were detected in 32% of the victims and 19% of the perpetrators. The study also examines the interrelationship of drug patterns between victims and perpetrators, and results show that both parties were influenced by substances at the time of the incident. Furthermore, there was a significant difference in the use of substances between perpetrators of blunt and sharp force cases and perpetrators in cases of sexual assault. Timely sample collection and a structured toxicological analysis of both victims and perpetrators in the same case are vital in clinical forensic cases to enhance comprehension of the connection between criminal activities and substance use. This understanding enables the development of prevention strategies at an informed level.

Two simplified tooth sample preparation methods for conventional laboratory and RapidHIT™ ID workflows.

Disaster victim identification (DVI) refers to the forensic identification of unknown individuals following a mass disaster event. Human dental structures can contain viable DNA sources when other soft tissues are compromised. However, labor-intensive sample preparation performed by extensively trained personnel is needed to expose the nuclear material for traditional forensic DNA workflows. With this in mind, we evaluated two simplified sample preparation protocols for processing tooth samples using either a conventional forensic DNA workflow or the Applied Biosystems® RapidHIT™ ID instrument. Briefly, sample sets for both protocols included 10 deciduous teeth that were cleaned prior to either fragmentation with a claw hammer (for RapidHIT™ ID processing) or fine-powder pulverization with a consumer-grade coffee grinder (for traditional workflows). The average percentage of expected STR alleles that were detected above analytical threshold for these tooth samples were comparable between methods: RapidHIT™ ID = 99.0% and GlobalFiler™ = 99.8%. Average intralocus heterozygote peak height ratios (PHRs) were comparable: RapidHIT™ ID = 0.80 and GlobalFiler™ = 0.86. Importantly, 9 of 10 samples analyzed via the RapidHIT™ ID required analyst review for flagged artifact peaks and quality issues. Across all profiles, 91% of alleles passed quality metrics for the RapidHIT™ workflow versus 100% for conventional GlobalFiler™ analysis. Collectively, these results suggest that quick, low-tech tooth sample fragmentation followed by analysis with the RapidHIT™ ID instrument can produce complete STR profiles from aged tooth samples. Future studies should include larger samples sets, more challenging tooth samples, and further simplification of sample preparation to enable field-forward, on-scene DVI.

Traumatised Nurses' Desired Support Needs for Continued Recovery After the COVID-19 Pandemic: A Qualitative Descriptive Study Utilising Photovoice.

AIMS: The aims of this study were to describe the experiences of nurses in the aftermath of the COVID-19 pandemic and to explore nurses' current desired support needs. DESIGN: This study used a qualitative descriptive design. METHODS: This study was conducted in the Southeastern United States at an academic health system encompassing acute care hospitals and outpatient speciality clinics. Thirteen nurses were interviewed in August and September of 2023 in five small groups of two or three nurses. Photovoice was used for data collection and each nurse submitted two photographs. Data were analysed utilising conventional content analysis, with transcripts and photograph analysis occurring concurrently. RESULTS: Three themes were identified: (1) organisational turmoil, (2) personal traumatisation and transitions and (3) striving for revival and renewal. A conceptual model illustrating the three themes and their relationships was developed to depict study findings. CONCLUSION: Nurses were impacted by organisational factors, such as staffing issues and lack of support, and personally through psychological trauma that has remained challenging. Nurses found revival and renewal in their personal lives, but still desire continued improvement in organisational factors to enhance their well-being in ways not currently being addressed to allow for full recovery. Findings from this study are pertinent for healthcare organisations and leaders to develop organisational changes and mental health solutions to support nurse well-being. IMPLICATIONS FOR THE PROFESSION: The prioritisation of nurse well-being is critical for the nursing profession and healthcare organisations. Organisational improvements and the implementation of support resources are urgently needed to aid in nurse recovery, nurse retention and to ensure patients receive quality care. IMPACT: This study identified nurses' struggles 3 years after the beginning of the COVID-19 pandemic, highlighting the ongoing need to provide resources and interventions that support nurse well-being. Our findings offer nurses' descriptions of their experiences and support needs for organisations and healthcare leaders to consider in the future. REPORTING METHOD: Standards for Reporting Qualitative Research (SRQR) Checklist. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.

Developing Core Indicators for Evaluating Second Victim Programs: An International Consensus Approach.

Objectives: To establish a consensus for evaluating second victims (SV) support interventions to facilitate comparison over time and across different organizations. Methods: A three-phase qualitative study was conducted from June 2023 to March 2024. This consensus approach engaged members of the European Researchers Network Working on Second Victims. A nominal group technique and insights from a scoping review were used to create a questionnaire for Delphi Rounds. Indicators were rated 1-5, aiming for agreement if over 70% of participants rated an indicator as feasible and sensitive with scores above 4, followed by a consensus conference. Results: From an initial set of 113 indicators, 59 were assessed online, with 35 advancing to the Delphi rounds. Two Delphi rounds were conducted, achieving response rates of over 60% and 80% respectively, resulting in consensus on 11 indicators for evaluating SV support programs. These indicators encompass awareness and activation, outcomes of SV support programs, as well as training offered by the institution. Conclusion: This study presents a scoreboard for designing and monitoring SV support programs, as well as measuring standardized outcomes in future research.

Pharmacy prevalence of second victim syndrome in a comprehensive cancer center.

DISCLAIMER: In an effort to expedite the publication of articles, AJHP is posting manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time. PURPOSE: The results of a survey to determine the pharmacy prevalence of second victim syndrome (SVS) at a comprehensive cancer center are presented. METHODS: The division of pharmacy was surveyed using a 47-item online Qualtrics-platform questionnaire to help determine the prevalence of SVS. The questionnaire included demographic questions, questions about self-perceived SVS, and the validated Second Victim Experience and Support Tool (SVEST). The questionnaire was distributed electronically through senior leadership. RESULTS: The response rate was 95%, with self-perceived SVS reported in 37% of all respondents. Overall, 53% of pharmacists and 15% of pharmacy technicians reported having experienced SVS in their lifetime. Self-perceived time needed to recover from the most pronounced event was either less than a week or less than a month for 60% of respondents, with 10% never fully recovering. The SVEST score, which helped assess SVS impact, was neutral with a mean (SD) of 2.79 (0.51). The psychological distress and professional self-efficiency dimensions of SVEST each had a mean score of 3.5 or higher, suggesting prevalence of SVS symptoms. The resources most desired to help individuals recover from SVS were a peer support program, a specified peaceful location, time away from the unit, and an employee assistance program. CONCLUSION: The pharmacy division at a comprehensive cancer center is experiencing SVS. Programs targeting SVS should be considered for a pharmacy department or division at a comprehensive cancer center to help improve their employees' well-being and job performance. Multiple avenues of support resources are needed to meet everyone's needs.

Collisions and Perceptions of Cyberbullying: Comparison of Intergenerational Experiences.

With regard to negative consequences, cyberbullying is recognized as one of the most traumatic types of cyber aggression. The aim is to study the specific features of adolescents and youth's cyberbullying experience in the role of an aggressor, victim or bystander, as well as awareness on the part of parents of adolescents. A total of 3395 adolescents, youth and parents filled out specially designed questionnaires. Older adolescents turned out to be at higher risk of cyberbullying. In two-thirds of cases, cyberbullying is related to real-life incidents. Aggressors are motivated by domination and entertainment, primarily employing strategies of social exclusion, harassment and denigration. As victims of cyberbullying, younger adolescents turn to their parents and friends for social support, whereas older adolescents and young adults are more likely turn to their peers. In the role of a bystander, almost half of younger adolescents and about a third of older adolescents and young adults choose the prosocial strategy of protecting a victim. The parents often underestimate the experience of encountering cyberbullying or find it difficult to assess such experience. The identified risk groups and strategies and the lack of parents' awareness are important to take into account when drawing up cyberbullying prevention programs.

"This Time It Was Different:" Creating a Multidisciplinary, Trauma-Informed, Victim-Centered Approach to Sexual Assault Cold Case Investigations and Prosecutions.

Police and prosecutors recommend that sexual assault survivors have a medical forensic exam and the collection of a sexual assault kit (SAK; also known as a "rape kit") to preserve biological evidence (e.g., semen, blood, saliva, hair) if they want to pursue criminal prosecution. However, law enforcement personnel do not routinely submit SAKs to crime laboratories for forensic DNA testing. Instead, they often place untested kits in storage and close many of these reported cases after minimal investigation. Current estimates indicate there are 300,000 to 400,000 untested SAKs in law enforcement agencies throughout the United States. In response to this national problem, the U.S. Department of Justice created the Sexual Assault Kit Initiative (SAKI) Project to support kit testing, re-investigation, and prosecution of these "cold case" sexual assaults. The SAKI program also provides training and technical assistance to police, prosecutors, and victim advocates on how to use a multidisciplinary, trauma-informed, and victim-centered approach in cold case prosecutions. This study examined the extent to which one SAKI-funded site implemented these three guiding principles in their interactions with victims while prosecuting cold case sexual assaults. We conducted semistructured qualitative interviews with N = 32 sexual assault survivors from the first cohort of cold cases that were re-opened and prosecuted in this jurisdiction. Nearly all cases (n = 31) ended in a guilty plea or trial conviction, and the vast majority of survivors indicated that they had positive experiences with the SAKI team. Survivors noted that they were listened to, believed, supported, and well-prepared by a multidisciplinary team of practitioners who were personally invested in their cases and in their well-being. Implications for creating multidisciplinary, trauma-informed, and victim-centered approaches with other communities are discussed.

Second Victims in Industries beyond Healthcare: A Scoping Review.

The second victim phenomenon (SVP) refers to workers negatively impacted by involvement in unanticipated adverse events or errors. While this phenomenon has been extensively studied in healthcare since its acknowledgment over 20 years ago, its presence and management in other high-risk industries have remained unclear. We conducted a scoping review aiming to map the SVP in non-healthcare industries, as well as to explore the available interventions or support programs addressed to help second victims (SVs). A total of 5818 unique records were identified and, after the screening process, 18 studies from eight sectors were included. All industries acknowledged the existence of the SVP, though many did not use a specific term for defining the SV. Similarities in psychological and emotional consequences were found across sectors. Support strategies varied, with the aviation sector implementing the most comprehensive programs. Self-care and peer support were the most reported interventions, while structured clinical support was not mentioned in any industry. Our review highlighted a lack of standardized terminology and industry-specific, evidence-based support interventions for the SVP outside of healthcare. Healthcare appears to be at the forefront of formally recognizing and addressing the SVP, despite traditionally learning from other high-reliability industries in safety practices. This presents opportunities for reciprocal learning and knowledge transfer between healthcare and other high-risk sectors.

Development and evaluation of an external second victim support program for nurses: a single-group feasibility study.

BACKGROUND: Psychological support programs can help nurses who involved in patient safety incidents. However, most of these programs are operated internally by healthcare providers and utilize peer supporters, which may take a long time to implement. Therefore, there is a need to develop programs that can be used by healthcare providers in healthcare institutions that have difficulty implementing their own programs. This feasibility study aimed to develop an external support program for nurses as second victims and to examine the feasibility, acceptability, and impact of the program. METHODS: This study was conducted using a single-group pretest-posttest design. Nurses who experienced patient safety incidents were recruited through posters at three advanced general hospitals, as well as open online recruitment and via a research agency panel from September 2020 to April 2021. The 11 participants attended a total of three one-on-one counseling sessions. Feasibility was evaluated based on participant recruitment and retention, resource availability, program procedures, and the practicability of data collection. Acceptability was assessed through program satisfaction and participant feedback. Psychological impact was measured using the Impact of Event Scale-Revised Korean version. RESULTS: Out of 26 applicants, 11 (42.3%) completed the program, with 10 (38.5%) participants completing both pre and post-program surveys. Most participants responded that they were satisfied with the program and expressed their intention to recommend the program to others and participate in it again if similar situations arise. The participants' median total IES-R-K score decreased significantly from 30.0 to 16.0 (p = 0.028, r = 0.67). CONCLUSION: This study demonstrates the feasibility of an external second victim support program and provides preliminary data suggesting its potential to alleviate the psychological impact of participants. To overcome the limitations of this study, it is necessary to conduct additional controlled trials with a longer follow-up period and a larger sample size.

Virtual dental autopsy: undertaking forensic dental identification remotely using an intra-oral video camera.

INTRODUCTION: The aim of this study was to evaluate whether a forensic odontologist working remotely could accurately undertake forensic dental identifications using videos produced by non-dental forensic staff operating an intra-oral video camera (IOVC). The study's aims were to assess the accuracy and time taken to perform remote forensic dental identifications in this manner. MATERIALS AND METHODS: Eight cadavers from the Centre for Anatomy and Human Identification (CAHID), University of Dundee, UK, were examined by a forensic odontologist via a traditional dental examination. Their dental condition was recorded to serve as ante-mortem records for this study. Videos of each dentition were produced using an IOVC operated by a medical student. Post-mortem records were produced for each dentition from the videos by a remote second forensic odontologist who was not present at the traditional dental examination. The ante-mortem and post-mortem records were then compared, and identification was classified as positively established, possible or excluded. RESULTS: Established identifications were positively made in all eight cases although there were some non-critical inconsistencies between ante-mortem and post-mortem records. Before the second opinion, 85.6% of the teeth per study subject were charted consistently. After the second opinion, the percentage of consistency increased to 97.2%. Each video on average was about 4.13 minutes in duration and the average time taken to interpret and chart the post-mortem dental examination at the first attempt was 11.63 minutes. The time taken to chart from the videos was greater than is typical of a traditional dental examination. CONCLUSION: This pilot study supports the feasibility of undertaking remote dental identification. This novel "tele-dental virtopsy" approach could be a viable alternative to a traditional post-mortem dental examination, in situations where access to forensic dental services is difficult or limited due to geographical, logistical, safety, and/or political reasons.

"Learn from Errors": Post-traumatic growth among second victims.

BACKGROUND: Second victims, defined as healthcare providers enduring emotional and psychological distress after patient safety incidents (PSIs). The potential for positive transformation through these experiences is underexplored but is essential for fostering a culture of error learning and enhancing patient care. OBJECTIVE: To explore the level and determinants of post-traumatic growth (PTG), applying the stress process model. METHODS: The study was conducted at a tertiary general hospital in Chongqing, China. A descriptive, cross-sectional study design was used. A total of 474 s victims were included. An online survey was conducted in November 2021 to assess various factors related to the second victim experience. These factors included PSIs (considered as stressors), coping styles, perceived threats, and social support (acting as mediators), as well as the outcomes of second victim syndrome (SVS) and PTG. Statistical description, correlation analysis, and structural equation modeling were utilized for the data analysis. A p-value ≤ 0.05 was considered to indicate statistical significance. RESULTS: The participants reported moderate distress (SVS = 2.84 ± 0.85) and PTG (2.72 ± 0.85). The total effects on SVS of perceived threat, negative coping, social support, positive coping, and PSIs were 0.387, 0.359, -0.355, -0.220, and 0.115, respectively, accounting for 47% of the variation in SVS. The total effects of social support, positive coping, and PSIs on PTG were 0.355, 0.203, and - 0.053, respectively, accounting for 19% of the variation in PTG. CONCLUSIONS: The study provides novel insights into the complex interplay between perceived threats, coping styles, and social support in facilitating PTG among second victims. By bolstering social support and promoting adaptive coping strategies, the adverse effects of PSIs can be mitigated, transforming them into opportunities for resilience and growth, and offering a fresh perspective on managing PSIs in healthcare settings.