"Everything the hujur tells is very educative but if I cannot apply those in my own life then there is no meaning": a mixed-methods process evaluation of a smoke-free homes intervention in Bangladesh.

BACKGROUND: Second-hand smoke exposure from tobacco significantly contributes to morbidity and mortality worldwide. A cluster RCT in Bangladesh compared a community-based smoke-free home (SFH) intervention delivered in mosques, with or without indoor air quality (IAQ) feedback to households to no intervention. Neither was effective nor cost-effective compared to no intervention using an objective measure of second-hand smoke. This paper presents the process evaluation embedded within the trial and seeks to understand this. METHODS: A mixed method process evaluation comprising interviews with 30 household leads and six imams (prayer leader in mosque), brief questionnaire completed by 900 household leads (75% response), fidelity assessment of intervention delivery in six (20%) mosques and research team records. Data were triangulated using meta-themes informed by three process evaluation functions: implementation, mechanisms of impact and context. RESULTS: IMPLEMENTATION: Frequency of SFH intervention delivery was judged moderate to good. However there were mixed levels of intervention fidelity and poor reach. Linked Ayahs (verses of the Qur'an) with health messages targeting SHS attitudes were most often fully implemented and had greatest reach (along with those targeting social norms). Frequency and reach of the IAQ feedback were good. MECHANISMS OF IMPACT: Both interventions had good acceptability. However, views on usefulness of the interventions in creating a SFH were mixed. Individual drivers to behaviour change were new SFH knowledge with corresponding positive attitudes, social norms and intentions. Individual barriers were a lack of self-efficacy and plans. CONTEXT: Social context drivers to SFH intervention implementation in mosques were in place and important. No context barriers to implementation were reported. Social context drivers to SHS behaviour change were children's requests. Barriers were women's reluctance to ask men to smoke outside alongside general reluctance to request this of visitors. (Not) having somewhere to smoke outside was a physical context (barrier) and driver. CONCLUSIONS: Despite detailed development and adaption work with relevant stakeholders, the SFH intervention and IAQ feedback became educational interventions that were motivational but insufficient to overcome significant context barriers to reduce objectively measured SHS exposure in the home. Future interventions could usefully incorporate practical support for SFH behaviour change. Moreover, embedding these into community wide strategies that include practical cessation support and enforcement of SFH legislation is needed. TRIAL REGISTRATION: Current Controlled Trials ISRCTN49975452.

Role of Mosque Communities in Supporting Muslims with Mental Illness: Results of CBPR-oriented Focus Groups in the Bay Area, California.

Objective The purpose of this study was to explore perspectives of Muslims residing in the Bay Area, California on the role of the mosque community in supporting community members' mental health needs and barriers to mental health care for members who experience mental health challenges. Methods This study employed a CBPR-focused qualitative approach in the form of content analysis of three focus group discussions organized and conducted with the help of a Community Advisory Board made up of members of the Muslim Community Association. Results Two major themes were identified upon examination of the data: services needed in the mosque community and barriers to addressing mental health issues in the mosque community. Specifically, participants reported wanting support groups within the mosque space, mosque-based activities, virtual support, community social workers, and family-oriented services. Barriers reported included community stigma, lack of cultural awareness of race-ethnic minorities within the community, attribution of mental illness to lack of faith or supernatural causes, and specific barriers unique to vulnerable/special subgroups within the community. Conclusion These findings highlight the need for developing mental health-related services and social support initiatives within the mosque space, specifically for those Muslim Americans living in the Bay Area in California. Furthermore, special attention needs to be placed on the barriers to accessing these services as identified by the community members.

Energy consumption, thermal comfort, and indoor air quality in mosques: Impact of Covid-19 measures.

Restrictions have been imposed on the number of people, the duration of their stay and air conditioning operation in temples to limit the spread of the SARS-CoV-2 pandemic. This work studied how restrictions affected energy consumption, thermal comfort, and indoor air quality (IAQ) in mosques. Energy consumption data on lighting, heating and cooling before and during the pandemic were analyzed in six mosques of various sizes located in Yalova city, Turkey. The annual energy consumption for lighting was reduced during the pandemic in all mosques due to less usage, while the annual heating and cooling costs were raised in one mosque despite their restricted use. Besides, experiments were conducted to assess the effect of pandemic measures on thermal comfort and IAQ by measuring indoor temperature, relative humidity, air velocity, CO2 and PM concentrations in a typical mosque. Keeping the windows open and limiting occupancy improved the IAQ. This was evidenced by the lower average CO2 concentration during the pandemic (428 ± 40 ppm) than before the pandemic (661 ± 201 ppm). An acceptable thermal environment was achieved under pandemic measures at night during the summer period. Creating excellent conditions can be difficult without air conditioning even with open windows and prayers performed at night.

The role of vulnerable environments in support for homegrown terrorism: Fieldwork using the 3N model.

The 3N model of radicalization proposes that violent radicalization is the result of the contribution of needs, networks, and narratives. Although research has mainly been supportive of this perspective, a substantial amount of ground remains uncovered regarding the network component of the model. Within this framework, we examine why individuals living in certain social environments tend to harbor more positive attitudes toward homegrown terrorism than others. Building on prior research, we hypothesized that individuals living in social environments known to be vulnerable (vs. less vulnerable) are more likely to experience a sense of significance loss (i.e., lack of social integration, perceived conflicts between religious groups), find solace in religious social networks (i.e., mosques), and thus adhere to radical narratives (i.e., legitimization of terrorism). A study with 365 young Muslims from different cities in Spain (Almería, Barcelona, Ceuta, and Melilla)supported these predictions. Theoretical and practical implications for the study of violent extremism are discussed.

Explaining an Influential Model of the Significant Relationship Between Religion, Spirituality, and Environmental Peace in Mosque Interior Architecture.

Investigating the components of environmental peace in an architectural work, especially Islamic mosques, requires a detailed understanding of this concept and its influential factors. In the architecture of the mosques of the past, certain patterns have always followed a continuous trend that made a logical relationship with the time before and after, but this continuity and trend are not seen today. The purpose of this study was to investigate the relationship of environmental peace from two aspects of religion and spirituality. Religion means comprehensive instructions and complete guidelines that, on the one hand, show the goal and teaches the human being how to achieve it, and on the other hand, help the human being on problems that are difficult to understand by universal means of understanding (reason, experience, and intuition). Therefore, the identification of the true ultimate goal in human life as well as the determination of the intermediate goals that indicate the path to the ultimate goal is possible only through the recognition and adherence to the right religion, and this fact shows the close relationship between religion and spirituality. The research method investigates the relationship between variables through a correlation method and then through structural equations. The statistical population was selected based on the Cochran formula including 120 professors and postgraduate students in architecture and Islamic architecture of Tehran Universities. The research tool was a web-based questionnaire and its link was made available to the statistical community online. The structural equation method was used in SPSS and Amos software to test the regression and fitting test model. Pearson correlation test was also used to determine the relationship between research variables. The results show that the model of the influence of "religion" factors in enhancing "environmental peace" through the mediating variable of "spirituality" explains these relationships; in other words, in this indirect causal relation, enhancement of semantic factors mediated by "spirituality" factors enhances environmental peace in architecture.

Muslim women's perspectives on designing mosque-based women's health interventions-An exploratory qualitative study.

Mosques could serve as a promising setting for health interventions. However, little empirical data are available to guide the development of mosque-based health interventions, especially for women. We aimed to assess Muslim women's views on effective strategies for mosque-based educational interventions to promote women's health. A sample of Muslim women of diverse ethnicity and race was recruited from mosques in Chicago to participate in semi-structured interviews. In interviews, nineteen participants (aged 41-67 years) discussed characteristics of the imam and peer educator, aspects of the intervention modality, and content of health messaging that would be effective in mosque-based health programs. Participants reported that imams should have health-related knowledge to deliver to be successful, while peer educators should be respected women, educated in both religion and health. Sermons and group education classes were believed to be modalities that could reach a large portion of the community for discussions of women's health issues. Participants also suggested that sermons should use scriptural sources to convey the importance of women's health. Participants supported imam-led sermons and peer-led educational classes as effective strategies to promote women's health. Our study results speak to strategies for leveraging religious concepts to promote health among Muslim women.

Integrating physical experiments with computational fluid dynamics to transform mosque minarets into efficient solar chimneys.

This study explores the potential of repurposing mosque minarets as solar chimneys in hot arid regions to facilitate natural ventilation and diminish the reliance on energy-intensive cooling systems. Originating as a means to call the faithful to prayer, minarets have become iconic landmarks within Islamic cities. This research focuses on Cairo, Egypt, as a representative hot arid environment. The paper traces the evolution of the minaret, underscoring the variations in form that influence the experimental design. The investigation proceeded in two stages: the construction of physical mosque models with variably positioned minarets for laboratory testing, ensuring standardized measurements, followed by computational fluid dynamics (CFD) simulations for comparison. Findings indicate that mosque minarets can be effectively adapted for passive ventilation, with their performance significantly influenced by orientation and placement. This study concludes that traditional mosque minarets offer a viable, sustainable option for passive cooling in hot climates.

Development of energy efficient design proposals for air conditioned mosques: Temperate humid climate case.

Mosques, which are types of religious buildings, are large buildings where many people pray at the same time. The diversity of the user type and density and the variability of the usage schedule make it difficult to establish the homogeneous thermal comfort of these large-volume public buildings. At the same time, the energy consumption in the buildings should be minimal in nowadays when the conventional energy sources decrease. The aim of this study is to evaluate created design strategies for designers and users in order to minimize energy consumption by determining the passive design criteria and choosing the type of air conditioning equipment while providing an acceptable thermal comfort level in mosques. According to the method created for the aim, the scenarios of mosques were compared in terms of thermal comfort and energy consumption in the temperate humid climate conditions. This method includes the analysis of scenarios created from the change of design parameters of mosques (plan, size, roof type of the mosques) with a simulation software which was validated with actual utility data. The suggestions were presented for the selection and design of the mechanical system as a result of the implementation of the created method. When the design scenarios of mosques are compared, the air conditioning of the indoor with radiant method consumed less energy than HVAC equipment with fan system. In accordance with the plan schemes (square, rectangle, circular), the least energy consumption per unit area was in the circular plan scheme and hemispherical design. Compared to the roof types (single dome, multi dome, pyramidal roof, flat roof), the most energy consumption per unit area was generally in the multi dome design. According to the average energy consumption values of the HVAC systems, there was 23 % less energy consumption in the flat plan type (105.06 kWh/m2) compared to the rectangular plan type (129.2 kWh/m2). In the intermittent use schedule of the HVAC system, 8 % more energy was consumed than in the continuous use schedule. According to the air changes per hour in the mosques, there was 5.93 % more energy consumption in 2 ach conditions compared to 0.5 ach conditions.

Occurrence and exposure assessment of microplastics in indoor dusts of buildings with different applications in Bushehr and Shiraz cities, Iran.

The increase in annual usage of plastics for different purposes has led to an increase in microplastics (MPs) particles in various environments including inside of buildings. In the present study, levels and characteristics of MPs in the indoor dust of buildings with different uses including residential house, mosque, hospital, kindergarten, and university in two cities, Bushehr port and Shiraz in Iran, were determined. Thirty dust samples from various buildings were collected. The average numbers of MPs in the indoor dust of buildings of Shiraz and Bushehr were 90.8 and 80.8 items/mg, respectively. Fiber and polyethylene (PE) were the most common shape and polymer types of identified MPs, respectively. The highest number of MPs was observed in the indoor dust of kindergartens with a mean number of 121 items/mg in Bushehr and 104 items/mg in Shiraz. Except for mosques, a significant difference (p-value <0.05) were not observed between the MPs levels of buildings with similar applications in Bushehr and Shiraz cities. In addition, the high daily intake to MPs via indoor dust ingestion and inhalation were found for infants in kindergartens and mosques. The results of this study showed that MPs are present in high concentrations in indoor environments and may pose a high exposure risk for different age groups.

Muslim Communities Learning About Second-hand Smoke in Bangladesh (MCLASS II): a combined evidence and theory-based plus partnership intervention development approach.

INTRODUCTION: Deaths from second-hand smoke (SHS) exposure are increasing, but there is not sufficient evidence to recommend a particular SHS intervention or intervention development approach. Despite the available guidance on intervention reporting, and on the role and nature of pilot and feasibility studies, partial reporting of SHS interventions is common. The decision-making whilst developing such interventions is often under-reported. This paper describes the processes and decisions employed during transitioning from the aim of adapting an existing mosque-based intervention focused on public health messages, to the development of the content of novel community-based Smoke-Free Home (SFH) intervention. The intervention aims to promote smoke-free homes to reduce non-smokers' exposure to SHS in the home via faith-based messages. METHODS: The development of the SFH intervention had four sequential phases: in-depth interviews with adults in households in Dhaka, identification of an intervention programme theory and content with Islamic scholars from the Bangladesh Islamic Foundation (BIF), user testing of candidate intervention content with adults, and iterative intervention development workshops with Imams and khatibs who trained at the BIF. RESULTS: It was judged inappropriately to take an intervention adaptation approach. Following the identification of an intervention programme theory and collaborating with stakeholders in an iterative and collaborative process to identify barriers, six potentially modifiable constructs were identified. These were targeted with a series of behaviour change techniques operationalised as Quranic verses with associated health messages to be used as the basis for Khutbahs. Following iterative user testing, acceptable intervention content was generated. CONCLUSION: The potential of this community-based intervention to reduce SHS exposure at home and improve lung health among non-smokers in Bangladesh is the result of an iterative and collaborative process. It is the result of the integration of behaviour change evidence and theory and community stakeholder contributions to the production of the intervention content. This novel combination of intervention development frameworks demonstrates a flexible approach that could provide insights for intervention development in related contexts.

Pantokrator Monastery-Zeyrek Mosque: The Preserved Byzantine Hospital in Istanbul.

BACKGROUND: Istanbul, home to numerous historical treasures, houses one of the oldest fully constructed hospitals. METHODS: This 50-bed hospital was built in the early 12th century during the Byzantine period by Empress Irene of Hungary and her husband Emperor John II Komnenos inside one of the largest monasteries of its time. The monastery housed one of the first hospitals and schools of medicine and included a nursing home, ophthalmologic health center, library, and cemetery. After the Empress died, her husband continued to enlarge the complex to its current state. Soon after the fall of Constantinople in 1453, the complex was renamed after Zeyrek Mehmet, who was ordered by Fatih Sultan Mehmet (Mehmet II or Mehmed the Conqueror) to convert the monastery into a mosque, constructing a Fatih Medrese for a short period of time. The hospital, however, remained untouched, and its rooms were used for Koran lessons. The building was fully restored from 2009 to 2017 and is still used as a mosque today. We would like to introduce the Pantokrator Monastery, maybe the only remaining hospital of the Byzantine era. CONCLUSION: Although it was built in the 12th century, the monastery is still a modern facility meeting current standards.

The Islamic principle of hifz al-nafs (protection of life) and COVID-19 in Indonesia: A case study of nurul iman mosque of Bengkulu city.

BACKGROUND: The act of worshipping in mosque is often not only considered to be one of the factors causing the transmission of coronavirus disease 2019 (covid-19), but also a contributing factor to health protocol violations. Against this backdrop, the purpose of this paper is to examine the application of the Islamic principle of hifz al-nafs (protection of life) in the practice of worshipping at the Nurul Iman mosque as it relates to the prevention of transmission of covid-19. METHODS: This research uses a sociology of law perspective to the connection and the dynamics between the adoption of the principle of hifz al-nafs and the implementation of worship at the Nurul Iman mosque. As a case study, the data collection technique used includes interviews, observation, documentation reviews, and triangulation techniques, while the analysis technique used content analysis techniques. RESULTS: The application of the principle of hifz al-nafs (protection of life) in the practices of worship at the Nurul Iman mosque have proven to be in accordance with health protocols and at the same time all members of the mosque congregation have been free from the transmission of covid-19. From an Islamic needs framework perspective, in the context of Covid-19 pandemic, the application of the hifz al-nafs principle at this mosque is a considered primary necessity (daruriyyat) in that it protects life while providing spiritual continuity of collective religious worshipping, hence integrating the community together within a health and sanctity of life paradigm during this challenging time. Equally important, this research also challenges the thesis of the direct linkage between worshipping in mosque and Covid-19 transmission. CONCLUSION: the application of the principle of hifz al-nafs in the practices of worship in mosque has demonstrably shown that the congragants levels of health consciousness has increased and that they have also been kept safe. In essence, the effective contextualization of Islamic principle is able to provide the twin benefits of health and spirituality.

Reaching the Unreached: Bridging Islam and Science to Treat the Mental Wounds of War.

Radical new paradigms are needed to equip non-professionals and leverage community faith-based infrastructure to address the individual and communal wounds of war- and conflict-related trauma. Muslims in war-torn regions like Somalia experience high rates of trauma and posttraumatic stress; yet, lack of providers, potential stigma, and lack of integration with one's faith are substantial barriers to care. In this pre-post feasibility clinical trial (NCT03761732), mosque leaders implemented a brief, group- and mosque-based intervention, Islamic Trauma Healing, targeting trauma-related psychopathology and community reconciliation for trauma survivors (N = 26) in Somaliland, Somalia. Leaders were trained in a brief 2-day training, with supervision provided remotely via WhatsApp. This six-session intervention combines empirically-supported trauma-focused psychotherapy and Islamic principles, focusing on wisdom from the lives of the Prophets and turning to Allah in dua about trauma. There were large, clinically meaningful effects for PTSD (g = 1.91), depression (g = 2.00), somatic symptoms (g = 2.73), and well-being (g = 1.77). Qualitative data from group members highlighted how well the program was aligned with their Islamic faith, built community, and need to expand the program. These results highlight the feasibility of this non-expert, easily up-scalable mental health approach in war-torn Muslim regions and refugee communities. This program has the potential to provide a low-cost, self-sustaining, Islam-based intervention addressing the psychological wounds of war consistent with the IOM's call to develop novel approaches to address unmet clinical needs. ClinicalTrials.gov Identifier: NCT03761732.

Paradox of Protective Behaviors Among Muslim Men During the Early Stage of the COVID-19 Pandemic in Aceh, Indonesia.

OBJECTIVE: The imposition of protective health protocols in public spaces to curb the spread of coronavirus disease (COVID-19) has confronted the ritual of congregational prayers in mosques for Muslims. This study examines the adoption of protective behaviors in the early stage of the COVID-19 outbreak and the influence of religion on risk perception by comparing precautionary behaviors in public and in mosques. METHODS: Data were collected through an online survey of 327 Muslim men across the Aceh Province, Indonesia, from April 21, 2020, to May 2, 2020. The Wilcoxon signed-rank test and the paired t-test were employed to compare the uptake of protective behaviors in public and mosques. RESULTS: The adoption of protective behaviors was higher in public rather than in mosques. It further revealed that the understanding of Islamic teachings during the pandemic has influenced perceived risk and the way Muslim men comply with the protective guidelines. Those who have complete, incomplete, or no compliance of precautionary behaviors have their own interpretation of Islamic teachings that inform their individual actions to manage the risk. CONCLUSION: This study suggests the significance of religious views for developing public health preparedness during the current and future pandemics in Aceh and other Muslim majority regions.

Hand Hygiene Knowledge, Perception, and Practices among Domestic Visitors to the Prophet's Mosque in Al Madinah City Amid the COVID-19 Pandemic: A Cross-Sectional Study.

This study aimed to assess hand hygiene knowledge, perception, and practices of visitors to the Prophet's Mosque in Al Madinah City, Saudi Arabia. Using a self-administered electronic questionnaire, a cross-sectional survey was conducted among domestic residents, who visited the mosque between 31 July and 3 August 2020. Participants' demographic data, hand hygiene knowledge, perception, and practices were collected. Four hundred participants aged 18-65 (median 36) years completed the survey, of which 215 (53.8%) were female. The visitors' mean knowledge score about hand hygiene was 6.4 (± standard deviation (SD) 1.35) of total 12. Most participants (392, 98%) were aware of the role of hand hygiene in preventing Coronavirus Disease 2019 (COVID-19); nevertheless, 384 (96%) said hand hygiene lowers body immunity and 316 (79%) thought <60% alcohol is sufficient for hand disinfection. Males had a higher knowledge score than females (6.46 (±1.41) vs. 6.14 (±1.27), p = 0.02) and, visitors who had no formal education scored higher than those with post-graduate education (6.88 (±1.45) vs 5.73 (±1.12), p = 0.01). Washing hands with soap and water was the predominant method practiced after a meal (365, 91.7%), after toilet visit (354, 88.5%), after touching a surface (262, 65.7%), after waste disposal (332, 83.2%), and when hands were visibly dirty (357, 89.5%). Al Madinah visitors had moderate knowledge about hand hygiene, but demonstrated some knowledge gaps and negligence in practice that are crucial to curb the spread of COVID-19.

Delivering a childhood obesity prevention intervention using Islamic religious settings in the UK: What is most important to the stakeholders?

Ten per cent of the childhood population in the UK are of South Asian (SA) origin. Within this population, over 40% are living with overweight or obesity. The majority of SA children are Muslim and attend Islamic religious settings (IRS) daily after school. Because of their reach and influence, IRS may be an appropriate channel for obesity prevention initiatives. We conducted 20 in-depth interviews with parents of children attending IRS, 20 with Islamic leaders, and 3 focus group discussions with 26 managers and workers of IRS in Bradford and Birmingham. Topic guides were developed, interviews and focus group discussions were audio-recorded, transcribed, and analysed thematically. Muslim parents, Islamic leaders and IRS staff were supportive of the delivery of obesity prevention interventions for children using IRS. Participants identified important components of an intervention including: Prophet Muhammad (PBUH) as a role model for healthy lifestyle; healthy diet, physical activity, and organisational behaviour change within IRS. Participants suggested that Islamic narrative on healthy diet and physical fitness could increase delivery uptake. Staff showed willingness to conduct physical activity sessions for boys and girls. Barriers for the intervention delivery were poor funding systems and time constraints for staff. All participant groups thought that it would be possible to deliver a childhood obesity prevention intervention. Interventions should be co-designed, culturally and religiously sensitive and combine the scientific guidelines on healthy living with Islamic narrative on importance of healthy diet consumption and physical activity.

An analysis of the hospitals of Sultan Suleyman and Hurrem: Two different approaches to healthcare in sixteenth-century Ottoman Empire.

This study concentrates on two monumental Ottoman pious endowments, each with a major component devoted to healing. The first is the hospital of the Haseki Mosque Complex built by the wife of Sultan Suleyman the Magnificent. An examination of the deed and the modus operandi of this endowment will impart a sense of the role that women of the ruling class played in Ottoman society as builders and healers in the sixteenth century. The analysis of the Haseki Hospital will be followed by an examination of the hospital that is part of the Suleymaniye Mosque Complex built by Sultan Suleyman. The differences between the two perspectives in the promotion of public health will be emphasized, arguing that the Sultan's approach to healthcare was academic and research-oriented, whereas his wife's was holistic and devoted to rehabilitation. The endowment deeds and the physical layouts of the two hospitals shed light upon a dual approach to healthcare with gender-specific roles affirmed and shaped by Hurrem and Suleyman the Magnificent, who each built hospitals of their own in Istanbul, the Ottoman capital city.

Muslim Communities Learning About Second-hand Smoke in Bangladesh (MCLASS II): study protocol for a cluster randomised controlled trial of a community-based smoke-free homes intervention, with or without Indoor Air Quality feedback.

BACKGROUND: Second-hand smoke (SHS) is a serious health hazard costing 890,000 lives a year globally. Women and children in many economically developing countries are worst affected as smoke-free laws are only partially implemented and homes remain a major source of SHS exposure. There is limited evidence on interventions designed to reduce SHS exposure in homes, especially in community settings. Following a successful pilot, a community-based approach to promote smoke-free homes in Bangladesh, a country with a strong commitment to smoke-free environments but with high levels of SHS exposure, will be evaluated. The study aims to assess the effectiveness and cost-effectiveness of a community-based intervention, Muslims for better Health (M4bH), with or without Indoor Air Quality (IAQ) feedback, in reducing non-smokers' exposure to SHS in the home. METHODS/DESIGN: Based on behaviour-change theories, M4bH and IAQ feedback are designed to discourage people from smoking indoors. M4bH consists of a set of messages couched within mainstream Islamic discourse, delivered weekly by faith leaders (imams and khatibs) in mosques over 12 weeks (one message each week). The messages address key determinants of current smoking behaviours including lack of knowledge and misconceptions on specific harms associated with SHS exposure. IAQ feedback consists of personalised information on IAQ measured by a particulate matter (PM2.5) monitor within the home. Following adaptation of M4bH and IAQ feedback for the Bangladeshi context, a three-arm cluster randomised controlled trial will be conducted in Dhaka. Forty-five mosques and 1800 households, with at least one smoker and one non-smoker, will be recruited. Mosques will be randomised to: M4bH and IAQ feedback; M4bH alone; or usual services only. The primary outcome is 24-h mean household concentration of indoor fine particulate matter (PM2.5) at 12 months post randomisation. Secondary outcomes are 24-h mean household PM2.5 at 3 months post randomisation, frequency and severity of respiratory symptoms, health care service use and quality of life. A cost-effectiveness analysis and process evaluation will also be conducted. DISCUSSION: The MCLASS II trial will test the potential of a community-based intervention to reduce second-hand smoke exposure at home and improve lung health among non-smokers in Bangladesh and beyond. TRIAL REGISTRATION: ISRCTN, ISRCTN49975452 . Registered on 11 January 2018.

The aftermath of the Kuwait mosque bombing: A retrospective cohort analysis and lessons learned.

INTRODUCTION: The occurrence of terrorist attacks are still recurrent incidents plaguing the middle east region. However, Kuwait has been mostly spared from these attacks over the years. Therefore, when the bombing of the mosque in 2015 happened, it shocked a country that is not prepared for such disasters. Our aim was to present the incident that occurred on that day and on the lessons learned from it. METHODS: A collaborative effort among the hospitals in Kuwait examined the details and outcomes of the initial response to the bombing. The centers reported their retrospective data, which was analyzed to determine prehospital and intra-hospital management and assess the medical response to the terrorist bombing. RESULTS: A total of 239 victims were involved in the explosion, of which 18 were pronounced dead on site. 147 (67%) were transferred to the hospital for care 22 min after the explosion occurred. The injuries seen were not localized to one region of the body, but afflicted various organ systems. 86 patients were admitted to the hospital, for which five required urgent surgical intervention. Total mortality (on-site and in-hospital) reported after the bombing was 11.2%. CONCLUSION: Rapid response after a mass casualty is of utmost importance for the adequate management of the victims of such tragedies, and could ensure excellent outcomes if performed precisely. However, many lessons can be learned from this shocking event, especially that it exposed the gaps currently present in our disaster plan systems and the importance of looking into addressing them.

An Ecological Exploration of Facilitators to Participation in a Mosque-Based Physical Activity Program for South Asian Muslim Women.

BACKGROUND: This descriptive qualitative study informed by an ecological framework explored factors influencing South Asian Muslim women's decisions to participate in a mosque-based physical activity intervention. METHODS: Individual, face-to-face, semistructured interviews were conducted in English, Hindi, or Urdu with 12 South Asian Muslim women at their home or mosque in Ontario, Canada. All interviews were audio-recorded, transcribed verbatim and managed, sorted, and analyzed for themes through a process of descriptive analysis. RESULTS: The participants described as follows: (1) intrapersonal facilitators, which included their feelings, beliefs, and motivations to continue with this intervention; (2) interpersonal facilitators detailing the support that they had received from others during the intervention; and (3) environmental facilitators, which highlighted convenience and access to physical activity opportunities in a local community setting. CONCLUSION: This intervention displayed how South Asian Muslim women were motivated to continue with the mosque-based physical activity intervention due to interpersonal, intrapersonal, and environmental facilitators. The findings can be used to increase further understanding of how mosques may provide culturally and religiously sensitive contexts for physical activity interventions for South Asian Muslim women.