TY - JOUR AU - AU - Caviglia, Marta PY - 2025/4/10 TI - Bridging Data Gaps in Emergency Care: The NIGHTINGALE Project and the Future of AI in Mass Casualty Management JO - J Med Internet Res SP - e67318 VL - 27 KW - AI KW - technology KW - mass casualty incident KW - incident management KW - artificial intelligence KW - emergency care KW - MCI KW - data gaps KW - tool UR - https://www.jmir.org/2025/1/e67318 UR - http://dx.doi.org/10.2196/67318 UR - http://www.ncbi.nlm.nih.gov/pubmed/ ID - info:doi/10.2196/67318 ER - TY - JOUR AU - Pike, E. Caitlin AU - Dohnt, C. Henriette AU - Tully, J. Phillip AU - Bartik, Warren AU - Welton-Mitchell, Courtney AU - Murray, V. Clara AU - Rice, Kylie AU - Cosh, M. Suzanne AU - Lykins, D. Amy PY - 2024/6/4 TI - A Community Mental Health Integrated Disaster Preparedness Intervention for Bushfire Recovery in Rural Australian Communities: Protocol for a Multimethods Feasibility and Acceptability Pilot Study JO - JMIR Res Protoc SP - e53454 VL - 13 KW - bushfires KW - wildfires KW - rural mental health KW - natural disasters KW - mental health KW - disaster preparedness KW - natural hazards resilience KW - community interventions KW - mixed-methods KW - pilot study KW - disaster KW - preparedness KW - preparation KW - natural hazard KW - psychological distress KW - resilience KW - help-seeking N2 - Background: Natural hazards are increasing in frequency and intensity due to climate change. Many of these natural disasters cannot be prevented; what may be reduced is the extent of the risk and negative impact on people and property. Research indicates that the 2019-2020 bushfires in Australia (also known as the ?Black Summer Bushfires?) resulted in significant psychological distress among Australians both directly and indirectly exposed to the fires. Previous intervention research suggests that communities impacted by natural hazards (eg, earthquakes, hurricanes, and floods) can benefit from interventions that integrate mental health and social support components within disaster preparedness frameworks. Research suggests that disaster-affected communities often prefer the support of community leaders, local services, and preexisting relationships over external supports, highlighting that community-based interventions, where knowledge stays within the local community, are highly beneficial. The Community-Based Disaster Mental Health Intervention (CBDMHI) is an evidence-based approach that aims to increase disaster preparedness, resilience, social cohesion, and social support (disaster-related help-seeking), and decrease mental health symptoms, such as depression and anxiety. Objective: This research aims to gain insight into rural Australian?s recovery needs post natural hazards, and to enhance community resilience in advance of future fires. Specifically, this research aims to adapt the CBDMHI for the rural Australian context and for bushfires and second, to assess the acceptability and feasibility of the adapted CBDMHI in a rural Australian community. Methods: Phase 1 consists of qualitative interviews (individual or dyads) with members of the target bushfire-affected rural community. Analysis of these data will include identifying themes related to disaster preparedness, social cohesion, and mental health, which will inform the adaptation. An initial consultation phase is a key component of the adaptation process and, therefore, phase 2 will involve additional discussion with key stakeholders and members of the community to further guide adaptation of the CBDMHI to specific community needs, building on phase 1 inputs. Phase 3 includes identifying and training local community leaders in the adapted intervention. Following this, leaders will co-deliver the intervention. The acceptability and feasibility of the adapted CBDMHI within the community will be evaluated by questionnaires and semistructured interviews. Effectiveness will be evaluated by quantifying psychological distress, resilience, community cohesion, psychological preparedness, and help-seeking intentions. Results: This study has received institutional review board approval and commenced phase 1 recruitment in October 2022. Conclusions: The study will identify if the adapted CBDMHI is viable and acceptable within a village in the Northern Tablelands of New South Wales, Australia. These findings will inform future scale-up in the broader rural Australian context. If this intervention is well received, the CBDMHI may be valuable for future disaster recovery and preparedness efforts in rural Australia. These findings may inform future scale-up in the broader rural Australian context. International Registered Report Identifier (IRRID): DERR1-10.2196/53454 UR - https://www.researchprotocols.org/2024/1/e53454 UR - http://dx.doi.org/10.2196/53454 UR - http://www.ncbi.nlm.nih.gov/pubmed/38833279 ID - info:doi/10.2196/53454 ER - TY - JOUR AU - Weitzel, J. Kirsty AU - Chew, F. Robert AU - Miller, Bryant Adam AU - Oppenheimer, W. Caroline AU - Lowe, Ashley AU - Yaros, Anna PY - 2023/2/8 TI - The Use of Crisis Services Following the Mass School Shooting in Uvalde, Texas: Quasi-Experimental Event Study JO - JMIR Public Health Surveill SP - e42811 VL - 9 KW - mass shooting KW - Crisis Text Line KW - firearms KW - mental health KW - suicide KW - trauma KW - indirect exposure KW - public health KW - crisis management KW - mental health support KW - mass casualty KW - shooting KW - crisis service N2 - Background: Mass shootings result in widespread psychological trauma for survivors and members of the affected community. However, less is known about the broader effects of indirect exposure (eg, media) to mass shootings. Crisis lines offer a unique opportunity to examine real-time data on the widespread psychological effects of mass shootings. Objective: Crisis Text Line is a not-for-profit company that provides 24/7 confidential SMS text message?based mental health support and crisis intervention service. This study examines changes in the volume and composition of firearm-related conversations at Crisis Text Line before and after the mass school shooting at Robb Elementary School on May 24, 2022, in Uvalde, Texas. Methods: A quasi-experimental event study design was used to compare the actual volume of firearm-related conversations received by Crisis Text Line post shooting to forecasted firearm conversation volume under the counterfactual scenario that a shooting had not occurred. Conversations related to firearms were identified among all conversations using keyword searches. Firearm conversation volume was predicted using a seasonal autoregressive integrated moving average model trained on the 3 months of data leading up to the shooting. Additionally, proportions of issue tags (topics coded post conversation by volunteer crisis counselors at Crisis Text Line after the exchange) were compared in the 4 days before (n=251) and after (n=417) the shooting to assess changes in conversation characteristics. The 4-day window was chosen to reflect the number of days conversation volume remained above forecasted levels. Results: There was a significant increase in the number of conversations mentioning firearms following the shooting, with the largest spike (compared to forecasted numbers) occurring the day after the shooting (n=159) on May 25, 2022. By May 28, the volume reverted to within the 95% CI of the forecasted volume (n=77). Within firearm conversations, ?grief? issue tags showed a significant increase in proportion in the week following the shooting, while ?isolation/loneliness,? ?relationships,? and ?suicide? issue tags showed a significant decrease in proportions the week following the shooting. Conclusions: The results suggest that the Uvalde school shooting may have contributed to an increase in demand for crisis services, above what would be expected given historical trends. Additionally, we found that these firearm-related crises conversations immediately post event are more likely to be related to grief and less likely to be related to suicide, loneliness, and relationships. Our findings provide some of the first data showing the real-time repercussions for the broader population exposed to school shooting events. This work adds to a growing evidence base documenting and measuring the rippling effects of mass shootings outside of those directly impacted. UR - https://publichealth.jmir.org/2023/1/e42811 UR - http://dx.doi.org/10.2196/42811 UR - http://www.ncbi.nlm.nih.gov/pubmed/36753321 ID - info:doi/10.2196/42811 ER - TY - JOUR AU - Abd Rahman, Anita AU - Abdul Manaf, Rosliza AU - Lim, Ying Poh AU - Suppiah, Subapriya AU - Juni, Hanafiah Muhammad PY - 2021/8/13 TI - Developing a Risk Governance Framework on Radiological Emergency, Preparedness, and Response for Emergency Responders: Protocol for a Mixed Methods Study JO - JMIR Res Protoc SP - e25877 VL - 10 IS - 8 KW - emergency KW - preparedness KW - radiological KW - risk governance KW - risk practices N2 - Background: Risk governance involves processes and mechanisms to understand how risk decisions are taken and executed. This concept has gained a reputation over time as being essential for emerging comprehensive management that defines the success of an organization. While guiding documents that explain the use of risk management related to nuclear safety and security are available worldwide, few locally conducted studies have explained risk governance practices in areas where hazard usage is known, such as in radiological emergencies. Objective: This paper describes a protocol that was used to determine several factors that influence emergency responders? perceptions toward radiological risk practices and visualize the risk radiological framework for emergency preparedness and response. Methods: A mixed methods study with a convergent design was performed. A qualitative analysis was performed using a case study approach where 6 key informants were purposely sampled for in-depth interview, and a cross-sectional study involving a self-administered questionnaire was conducted among approximately 260 emergency respondents from national regulatory, research, and services organizations. NVivo (version 12, QSR International) was used to analyze the interview transcripts and emerging themes were identified through abductive coding. Simultaneously, multiple logistic regression analysis was used to determine significant predictors that form the equation model. Results: The study is still underway. Qualitative findings were based on transcript-coding that informed the relevant thematic analysis, while statistical analyses including multiple logistic regression analysis measured the adjusted odds ratio of significant variables for the equation model. The study is expected to conclude in late 2021. Conclusions: Important emerging themes and significant factors that are related to the emergency responders? perceptions regarding radiological governance practices were determined through the convergent design. This potentially facilitated the development of a plausible radiological risk governance framework. Furthermore, our results will provide key insights that can be used in future studies. International Registered Report Identifier (IRRID): DERR1-10.2196/25877 UR - https://www.researchprotocols.org/2021/8/e25877 UR - http://dx.doi.org/10.2196/25877 UR - http://www.ncbi.nlm.nih.gov/pubmed/34398793 ID - info:doi/10.2196/25877 ER - TY - JOUR AU - Post, Lori AU - Mason, Maryann AU - Singh, Nadya Lauren AU - Wleklinski, P. Nicholas AU - Moss, B. Charles AU - Mohammad, Hassan AU - Issa, Z. Tariq AU - Akhetuamhen, I. Adesuwa AU - Brandt, A. Cynthia AU - Welch, B. Sarah AU - Oehmke, Francis James PY - 2021/4/22 TI - Impact of Firearm Surveillance on Gun Control Policy: Regression Discontinuity Analysis JO - JMIR Public Health Surveill SP - e26042 VL - 7 IS - 4 KW - firearm surveillance KW - assault weapons ban KW - large-capacity magazines KW - guns control policy KW - mass shootings KW - regression lines of discontinuity N2 - Background: Public mass shootings are a significant public health problem that require ongoing systematic surveillance to test and inform policies that combat gun injuries. Although there is widespread agreement that something needs to be done to stop public mass shootings, opinions on exactly which policies that entails vary, such as the prohibition of assault weapons and large-capacity magazines. Objective: The aim of this study was to determine if the Federal Assault Weapons Ban (FAWB) (1994-2004) reduced the number of public mass shootings while it was in place. Methods: We extracted public mass shooting surveillance data from the Violence Project that matched our inclusion criteria of 4 or more fatalities in a public space during a single event. We performed regression discontinuity analysis, taking advantage of the imposition of the FAWB, which included a prohibition on large-capacity magazines in addition to assault weapons. We estimated a regression model of the 5-year moving average number of public mass shootings per year for the period of 1966 to 2019 controlling for population growth and homicides in general, introduced regression discontinuities in the intercept and a time trend for years coincident with the federal legislation (ie, 1994-2004), and also allowed for a differential effect of the homicide rate during this period. We introduced a second set of trend and intercept discontinuities for post-FAWB years to capture the effects of termination of the policy. We used the regression results to predict what would have happened from 1995 to 2019 had there been no FAWB and also to project what would have happened from 2005 onward had it remained in place. Results: The FAWB resulted in a significant decrease in public mass shootings, number of gun deaths, and number of gun injuries. We estimate that the FAWB prevented 11 public mass shootings during the decade the ban was in place. A continuation of the FAWB would have prevented 30 public mass shootings that killed 339 people and injured an additional 1139 people. Conclusions: This study demonstrates the utility of public health surveillance on gun violence. Surveillance informs policy on whether a ban on assault weapons and large-capacity magazines reduces public mass shootings. As society searches for effective policies to prevent the next mass shooting, we must consider the overwhelming evidence that bans on assault weapons and/or large-capacity magazines work. UR - https://publichealth.jmir.org/2021/4/e26042 UR - http://dx.doi.org/10.2196/26042 UR - http://www.ncbi.nlm.nih.gov/pubmed/33783360 ID - info:doi/10.2196/26042 ER - TY - JOUR AU - Alqahtani, S. Amani AU - Alsharif, A. Saeed AU - Garnan, A. Mohammad AU - Tashani, Mohamed AU - BinDhim, F. Nasser AU - Heywood, E. Anita AU - Booy, Robert AU - Wiley, E. Kerrie AU - Rashid, Harunor AU - PY - 2020/7/14 TI - The Impact of Receiving Pretravel Health Advice on the Prevention of Hajj-Related Illnesses Among Australian Pilgrims: Cohort Study JO - JMIR Public Health Surveill SP - e10959 VL - 6 IS - 3 KW - Hajj KW - health behavior KW - mass gathering KW - pretravel health advice KW - travelers N2 - Background: Pretravel health advice can play a crucial role in improving both travelers? awareness about disease risk and compliance with preventive measures. General practitioners (GPs) and the internet have been reported internationally to be the main sources of health advice for travelers to non?mass gathering (MG) destinations. However, few studies have attempted to investigate the sources of health advice among travelers to MGs including the Hajj pilgrimage, and none of these studies further investigated the impact of pretravel advice on pilgrims? health behaviors. Objective: The objective of this study was to investigate the impact of the source of pretravel health advice (from GPs and specialized Hajj travel agents) on Hajj pilgrims? awareness of and compliance with health recommendations, and the incidence of Hajj-associated illnesses. Methods: A prospective cohort study (before and during Hajj) was conducted among Australian pilgrims aged ?18 years in 2015. Results: A total of 421 pilgrims participated prior to Hajj, and 391 (93%) provided follow-up data during Hajj. All participants obtained pretravel health advice from one or more sources, with Hajj travel agents (46%) and general practitioners (GPs; 40%) the most commonly reported sources. In total, 288 (74%) participants reported Hajj-related symptoms, of which 86% (248/288) were respiratory symptoms. Participants who obtained pretravel health advice from travel agents were more likely to be aware of the official Saudi recommendations (adjusted odds ratio [aOR] 2.1, 95% CI 1.2-3.8; P=.01), receive recommended vaccines before travel (aOR 2.4, 95% CI 1.4-3.9; P=.01), use hand sanitizers including soap (aOR 2.5, 95% CI 1.1-6.1; P=.03), and wash their hands after touching an ill person during Hajj (aOR 2.9, 95% CI 1.1-7.1; P=.01), compared to those who sought advice from GPs. However, neither advice from travel agents nor GPs was associated with a lower incidence of Hajj-related illnesses. Conclusions: Advice from travel agents appeared to be accessed by more travelers than that from GPs, and was associated with an increased likelihood of positive travel health behaviors. UR - https://publichealth.jmir.org/2020/3/e10959 UR - http://dx.doi.org/10.2196/10959 UR - http://www.ncbi.nlm.nih.gov/pubmed/32673259 ID - info:doi/10.2196/10959 ER - TY - JOUR AU - Du, Lin PY - 2020/6/25 TI - Medical Emergency Resource Allocation Model in Large-Scale Emergencies Based on Artificial Intelligence: Algorithm Development JO - JMIR Med Inform SP - e19202 VL - 8 IS - 6 KW - medical emergency KW - resource allocation model KW - distribution model KW - large-scale emergencies KW - artificial intelligence N2 - Background: Before major emergencies occur, the government needs to prepare various emergency supplies in advance. To do this, it should consider the coordinated storage of different types of materials while ensuring that emergency materials are not missed or superfluous. Objective: This paper aims to improve the dispatch and transportation efficiency of emergency materials under a model in which the government makes full use of Internet of Things technology and artificial intelligence technology. Methods: The paper established a model for emergency material preparation and dispatch based on queueing theory and further established a workflow system for emergency material preparation, dispatch, and transportation based on a Petri net, resulting in a highly efficient emergency material preparation and dispatch simulation system framework. Results: A decision support platform was designed to integrate all the algorithms and principles proposed. Conclusions: The resulting framework can effectively coordinate the workflow of emergency material preparation and dispatch, helping to shorten the total time of emergency material preparation, dispatch, and transportation. UR - http://medinform.jmir.org/2020/6/e19202/ UR - http://dx.doi.org/10.2196/19202 UR - http://www.ncbi.nlm.nih.gov/pubmed/32584262 ID - info:doi/10.2196/19202 ER - TY - JOUR AU - Chitheer, Abdulaal AU - Lami, Faris AU - Radhi, Ahmed AU - Arbaji, Ali PY - 2020/5/28 TI - Injuries Reported by Selected Health Facilities During the Arbaeenia Mass Gathering at Babel Governorate, Iraq, 2014: Retrospective Records Analysis JO - JMIR Public Health Surveill SP - e10877 VL - 6 IS - 2 KW - mass gathering KW - Injury KW - Karbala, Iraq N2 - Background: Arbaeenia is the largest religious mass gathering in Iraq. The conditions associated with mass gatherings result in high rates of injury. There have been no prior studies on injuries during the Arbaeenia mass gathering. Objective: This study describes the injuries observed during the Arbaeenia mass gathering in Babel Governorate in Iraq between November 24 and December 14, 2014. Methods: The study was conducted in Babel Governorate at the emergency departments of six public hospitals and two major temporary medical units that were located along the three roads connecting the Middle and Southern Iraqi governorates. We used the Iraq Injury Surveillance System modified form to collect information on injured patients treated in the selected facilities. Data on fatal injuries was obtained from the coroner?s office. The following data were collected from the patients: demographics, outcome of injury, place and time of occurrence, mode of evacuation and medical care before arriving at the hospital, duration of travel from place of occurrence to hospital, disposition of non-fatal injury, cause and mode of injury, and whether the injury occurred in connection with the Arbaeenia mass gathering. Results: Information was collected on 1564 injury cases, of which 73 were fatal. About half of the reported nonfatal injuries, 687/1404 (48.9%), and a quarter of fatalities, 18/73 (25%) were related to the Arbaeenia mass gathering (P<.001). Most of the reported injuries were unintentional, 1341/1404 (95.51%), occurred on the street, 864/1323 (65.6%), occurred during the daytime 1103/1174 (93.95 %). Most of those injured were evacuated by means other than ambulance 1107/1206 (91.79%) and did not receive pre-hospital medical care 788/1163 (67.7%). Minor injuries 400/1546 (25.9%) and traffic accidents 394/1546 (25.5%) were the most common types of injuries, followed by falls 270/1546 (17.5%). Among fatal injuries, traffic accidents 38/73 (52%) and violence 18/73 (25%) were the leading causes of death. Mass gathering injuries were more likely to occur among individuals aged 21-40 years (odds ratio [OR] 3.5; 95% CI 2.7-4.5) and >41 years (OR 7.6; 95% CI 5.4-10.6) versus those <21 years; more likely to be unintentional than assault (OR 5.3; 95% CI 1.8-15.5); more likely to happen on the street versus at home (OR 37.7; 95% CI 22.4-63.6); less likely to happen at night than during the day (OR 0.2; 95% CI 0.1-0.4); and less likely to result in hospital admission (OR 0.5; 95% CI 0.3-0.7). Conclusions: The study shows that most injuries were minor, unintentional, and nonfatal, and most people with injuries had limited access to ambulance transportation and did not require hospitalization. UR - http://publichealth.jmir.org/2020/2/e10877/ UR - http://dx.doi.org/10.2196/10877 UR - http://www.ncbi.nlm.nih.gov/pubmed/32463371 ID - info:doi/10.2196/10877 ER - TY - JOUR AU - Al Nsour, Mohannad PY - 2020/4/8 TI - Iraq Mass Gathering Preparedness and Public Health Recommendations JO - JMIR Public Health Surveill SP - e15886 VL - 6 IS - 2 KW - mass gathering KW - Iraq UR - http://publichealth.jmir.org/2020/2/e15886/ UR - http://dx.doi.org/10.2196/15886 UR - http://www.ncbi.nlm.nih.gov/pubmed/32267241 ID - info:doi/10.2196/15886 ER - TY - JOUR AU - Hantoosh, Hayder AU - Lami, Faris AU - Saber, Basel PY - 2019/10/16 TI - Disease Burden on Health Facilities in Governorates South of Karbala During the Arbaeenia Mass Gathering in Iraq in 2014: Cross-Sectional Study JO - JMIR Public Health Surveill SP - e10917 VL - 5 IS - 4 KW - mass gathering KW - Arbaeenia KW - Iraq KW - disease burden N2 - Background: Millions of Iraqi pilgrims travel annually from the southern governorates to Karbala and pass through Thiqar, Muthana, and Diwania Governorates to join the Arbaeenia mass gathering event. During this event, participants are at high risk for diseases and death and stifle local health care resources. In addition, the mass gathering causes considerable burden on health facilities in the hosting localities. Objective: This study aims to estimate the disease burden on health facilities caused by the pilgrims passing through Thiqar, Muthana, and Diwania Governorates en route to Karbala in Iraq. Methods: This cross-sectional study was conducted on all health facilities in three governorates (Thiqar, Muthana, and Diwania) situated along the southern way to Karbala from Basra. The study started on December 11, 2014, and ended on December 24, 2014. The morbidity and mortality were collected from surveillance logbooks and death registers. Drug purchase data were obtained from the personnel in charge of the pharmacies. The study period was divided into three phases on the basis of the timing of the mass gathering event: pre-event, the event, and postevent. Results: There were 884,834 incidents reported during the study. The majority of incidents were reported during the event phase (95%) and were attended mostly at mobile clinics (77%). The average daily incidents during the pre-event, event, and postevent phases were 4300, 56,040, and 4548 incidents, respectively. Musculoskeletal disorders were the most common illness reported (55%). The average number of daily deaths was 43, 36, and 45 during the pre-event, event, and postevent, respectively, and these values did not differ significantly. Cardiovascular diseases (43.5%), injuries (29.8%), and respiratory illnesses (12%) were the leading causes of deaths. Approximately US $1.3 million was spent on drug purchases during this mass gathering in the three governorates. Conclusions: The Arbaeenia mass gathering causes a tremendous disease and economic burden on governorates that pilgrims pass through to attend this mass gathering in Karbala. Although Iraq?s Ministry of Health is aware of the high burden of this mass gathering on the health facilities in these governorates, more work is needed to ensure quality services during the event. UR - https://publichealth.jmir.org/2019/4/e10917 UR - http://dx.doi.org/10.2196/10917 UR - http://www.ncbi.nlm.nih.gov/pubmed/31621637 ID - info:doi/10.2196/10917 ER - TY - JOUR AU - Lami, Faris AU - Hameed, Inam AU - Arbaji, Ali PY - 2019/10/4 TI - Assessment of Temporary Community-Based Health Care Facilities During Arbaeenia Mass Gathering at Karbala, Iraq: Cross-Sectional Survey Study JO - JMIR Public Health Surveill SP - e10905 VL - 5 IS - 4 KW - Arbaeenia mass gathering KW - community-based health care KW - Iraq N2 - Background: Arbaeenia mass gathering (MG) in Karbala, Iraq, is becoming one of the largest MGs in the world. The health care infrastructure in Iraq is inadequately prepared to serve the health needs of the millions of pilgrims. Objective: This study aimed to describe the temporary health care facilities installed and run by the local community to provide health care services to Arbaeenia pilgrims in Karbala, Iraq. Methods: A survey was conducted in all community-based health care facilities located along part of Najaf to Karbala road within Karbala governorate. A structured questionnaire was answered through an interview with the workers and direct observation. Data were collected on staff profile, type of services provided, use of basic infection control measures, medical equipment, drugs and supplies, and the most commonly encountered medical problems. Results: The total number of health care facilities was 120, staffed by 659 workers. Only 18 (15.0%, 18/120) facilities were licensed, and 44.1% (53/120) of the workers were health professionals. The health care workers provided different services including dispensing drugs (370/1692, 21.87%), measuring blood pressure and blood sugar (350/1692, 20.69%), and caring for wounds and injuries (319/1692, 18.85%). Around 97% (116/120) health facilities provided services for musculoskeletal disorders and only 16.7% (20/120) provided services for injuries. The drugs available in the clinic were analgesics, drugs for gastrointestinal and respiratory diseases, and antibiotics, with an availability range of 13.3% to 100.0%. Infection control practices for individual protection, environmental sanitation, and medical waste disposal were available in a range of 18.1% to 100.0%. Conclusions: Community-based health care facilities experienced a profound shortage of trained human resources and medical supplies. They can significantly contribute to health services if they are adequately equipped and follow standardized operation procedures. UR - https://publichealth.jmir.org/2019/4/e10905 UR - http://dx.doi.org/10.2196/10905 UR - http://www.ncbi.nlm.nih.gov/pubmed/31588911 ID - info:doi/10.2196/10905 ER - TY - JOUR AU - Lami, Faris AU - Jewad, Wahhab Abdul AU - Hassan, Abulameer AU - Kadhim, Hadeel AU - Alharis, Sura PY - 2019/9/30 TI - Noncommunicable Disease Emergencies During Arbaeenia Mass Gathering at Public Hospitals in Karbala, Najaf, and Babel Governorates, Iraq, 2014: Cross-Sectional Study JO - JMIR Public Health Surveill SP - e10890 VL - 5 IS - 3 KW - mass gathering KW - Iraq KW - noncommunicable diseases N2 - Background: Arbaeenia is the largest religious mass gathering (MG) in Iraq where millions of people from Iraq and many other countries visit Karbala city, south Iraq. MGs are associated with high rates of morbidity and mortality from different noncommunicable diseases (NCDs) such as cardiovascular diseases, diabetes mellitus, and asthma. There is a scarcity of publications that address MGs in Iraq. Objective: This study aimed to explore the NCD emergencies in public hospitals in Karbala, Najaf, and Babel governorates in Iraq, during the Arbaeenia MG and assess predisposing factors for NCD emergencies. Methods: The study was conducted from November 27 to December 16, 2014. Data were collected in the pre-event and during MG event from 7 selected hospitals. The pre-event data were collected from emergency room (ER) registers and logbooks, and the data on the MG event were collected daily through direct interview with patients and treating physicians using a structured questionnaire. Results: In total, 4425 NCD emergencies were recorded. Of these, 80.13% (3546/4425) were collected during the MG event. The NCD emergencies attended at ER hospitals during MG were severe hypertension (HT), diabetes (hyperglycemia), ischemic heart disease (IHD), asthma, and pulmonary edema. The load of NCD emergencies and the daily average emergencies increased 4-fold and 2-fold during the MG event, respectively. Most of the NCD emergencies were treated at ER departments, and a few were hospitalized. Intense physical activities and poor adherence to diet and medication were risk factors for IHD, severe HT, and hyperglycemic diabetes emergencies. Exposure to noxious gases or fumes and recent respiratory infections were risk factors for asthma emergencies. Conclusions: As the pilgrims approached Karbala city during the Arbaeenia MG, the hospitals on the roads leading to the city experienced an increased load of patients because of different NCD emergencies. Although hospitals should be equipped with the necessary supplies, health education for pilgrims is mandatory, particularly on the factors that can exacerbate their diseases. UR - http://publichealth.jmir.org/2019/3/e10890/ UR - http://dx.doi.org/10.2196/10890 UR - http://www.ncbi.nlm.nih.gov/pubmed/31573917 ID - info:doi/10.2196/10890 ER - TY - JOUR AU - Lami, Faris AU - Ali, Abdalkader Ali AU - Fathullah, Kareem AU - Abdullatif, Hana PY - 2019/9/26 TI - Assessment of Temporary Medical Clinics During the Arbaeenia Mass Gathering at Al-Karkh, Baghdad, Iraq, in 2014: Cross-Sectional Study JO - JMIR Public Health Surveill SP - e10903 VL - 5 IS - 3 KW - medical staff KW - medical services KW - mass gathering KW - Iraq N2 - Background: During mass gatherings, public health services and other medical services should be planned to protect attendees and people living around the venue to minimize the risk of disease transmission. These services are essential components of adequate planning for mass gatherings. The Arbaeenia mass gathering signifies the remembrance of the death of Imam Hussain, celebrated by Shiite Muslims, and takes place in Karbala, which is a city in southern Iraq. This annual mass gathering is attended by millions of people from within and outside Iraq. Objective: This study aimed to map the availability of medical supplies, equipment, and instruments and the health workforce at the temporary clinics located in Al-Karkh, Baghdad, Iraq, in 2014. Methods: This assessment was conducted on the temporary clinics that served the masses walking from Baghdad to Karbala. These clinics were set up by governmental and nongovernmental organizations (NGOs) and some faith-based civil society organizations, locally known as mawakib. We developed a checklist to collect information on clinic location, affiliation, availability of safe water and electricity, health personnel, availability of basic medical equipment and instruments, drugs and other supplies, and average daily number of patients seen by the clinic. Results: A total of 30 temporary clinics were assessed: 18 clinics were set up by the Ministry of Health of Iraq and 12 by other governmental organizations and NGOs. The clinics were staffed by a total of 44 health care workers. The health workers served 16,205 persons per day, an average of 540 persons per clinic, and 368 persons per health care worker per day. The majority of clinics (63% [19/30]-100% [30/30]) had basic medical diagnostic equipment. Almost all clinics had symptom relief medications (87% [26/30]-100% [30/30]). Drugs for diabetes and hypertension were available in almost half of the clinics. The majority of clinics had personal hygiene supplies and environmental sanitation detergents (78%-90%), and approximately half of the clinics had medical waste disposal supplies. Instruments for cleansing and dressing wounds and injuries were available in almost all clinics (97%), but only 4 clinics had surgical sterilization instruments. Conclusions: Although temporary clinics were relatively equipped with basic medical supplies, equipment, and instruments for personal medical services, the health workforce was insufficient, given the number of individuals seeking care, and only limited public health service, personal infection control, and supplies were available at the clinics. UR - https://publichealth.jmir.org/2019/3/e10903 UR - http://dx.doi.org/10.2196/10903 UR - http://www.ncbi.nlm.nih.gov/pubmed/31573925 ID - info:doi/10.2196/10903 ER - TY - JOUR AU - Alqahtani, S. Amani AU - Tashani, Mohamed AU - Heywood, E. Anita AU - Booy, Robert AU - Rashid, Harunor AU - Wiley, E. Kerrie PY - 2019/05/23 TI - Exploring Australian Hajj Tour Operators? Knowledge and Practices Regarding Pilgrims? Health Risks: A Qualitative Study JO - JMIR Public Health Surveill SP - e10960 VL - 5 IS - 2 KW - Hajj KW - health advice KW - mass gathering KW - travel agents KW - travel KW - respiratory infections N2 - Background: Travel agents are known to be one of the main sources of health information for pilgrims, and their advice is associated with positive health behaviors. Objective: This study aimed to investigate travel agents? health knowledge, what health advice they provide to the pilgrims, and their sources of health information. Methods: In-depth interviews were conducted among specialist Hajj travel agents in Sydney, Australia. Thematic analysis was undertaken. Results: Of the 13 accredited Hajj travel agents, 9 (69%) were interviewed. A high level of awareness regarding gastrointestinal infections, standard hygiene methods, and the risk of injury was noted among the participants and was included in advice provided to pilgrims. However, very limited knowledge and provision of advice about the risk of respiratory infections was identified. Knowledge of the compulsory meningococcal vaccine was high, and all participated travel agents reported influenza vaccine (a recommended vaccine) as a second ?compulsory? vaccine for Hajj visas. Conversely, participants reported very limited knowledge about other recommended vaccines for Hajj. The Ministry of Hajj website and personal Hajj experience were the main sources of information. Conclusions: This study identifies a potential path for novel health promotion strategies to improve health knowledge among Hajj travel agents and subsequently among Hajj pilgrims. UR - http://publichealth.jmir.org/2019/2/e10960/ UR - http://dx.doi.org/10.2196/10960 UR - http://www.ncbi.nlm.nih.gov/pubmed/31124464 ID - info:doi/10.2196/10960 ER - TY - JOUR AU - Boltin, Nicholas AU - Valdes, Diego AU - Culley, M. Joan AU - Valafar, Homayoun PY - 2018/06/22 TI - Mobile Decision Support Tool for Emergency Departments and Mass Casualty Incidents (EDIT): Initial Study JO - JMIR Mhealth Uhealth SP - e10727 VL - 6 IS - 6 KW - triage KW - mass casualty incidents KW - decision support tools KW - mobile technology KW - biomedical informatics KW - human-computer interaction N2 - Background: Chemical exposures pose a significant threat to life. A rapid assessment by first responders and emergency nurses is required to reduce death and disability. Currently, no informatics tools exist to process victims of chemical exposures efficiently. The surge of patients into a hospital emergency department during a mass casualty incident creates additional stress on an already overburdened system, potentially placing patients at risk and challenging staff to process patients for appropriate care and treatment efficacy. Traditional emergency department triage models are oversimplified during highly stressed mass casualty incident scenarios in which there is little margin for error. Emerging mobile technology could alleviate the burden placed on nurses by allowing the freedom to move about the emergency department and stay connected to a decision support system. Objective: This study aims to present and evaluate a new mobile tool for assisting emergency department personnel in patient management and triage during a chemical mass casualty incident. Methods: Over 500 volunteer nurses, students, and first responders were recruited for a study involving a simulated chemical mass casualty incident. During the exercise, a mobile application was used to collect patient data through a kiosk system. Nurses also received tablets where they could review patient information and choose recommendations from a decision support system. Data collected was analyzed on the efficiency of the app to obtain patient data and on nurse agreement with the decision support system. Results: Of the 296 participants, 96.3% (288/296) of the patients completed the kiosk system with an average time of 3 minutes, 22 seconds. Average time to complete the entire triage process was 5 minutes, 34 seconds. Analysis of the data also showed strong agreement among nurses regarding the app?s decision support system. Overall, nurses agreed with the system 91.6% (262/286) of the time when it came to choose an exposure level and 84.3% (241/286) of the time when selecting an action. Conclusions: The app reliably demonstrated the ability to collect patient data through a self-service kiosk system thus reducing the burden on hospital resources. Also, the mobile technology allowed nurses the freedom to triage patients on the go while staying connected to a decision support system in which they felt would give reliable recommendations. UR - http://mhealth.jmir.org/2018/6/e10727/ UR - http://dx.doi.org/10.2196/10727 UR - http://www.ncbi.nlm.nih.gov/pubmed/29934288 ID - info:doi/10.2196/10727 ER - TY - JOUR AU - Pan, Chih-Long AU - Lin, Chih-Hao AU - Lin, Yan-Ren AU - Wen, Hsin-Yu AU - Wen, Jet-Chau PY - 2018/02/02 TI - The Significance of Witness Sensors for Mass Casualty Incidents and Epidemic Outbreaks JO - J Med Internet Res SP - e39 VL - 20 IS - 2 KW - social media KW - mass casualty incident KW - internet KW - sensor UR - https://www.jmir.org/2018/2/e39/ UR - http://dx.doi.org/10.2196/jmir.8249 UR - http://www.ncbi.nlm.nih.gov/pubmed/29396388 ID - info:doi/10.2196/jmir.8249 ER -