Quantitative Metrics in Mass-Gathering Studies: A Comprehensive Systematic Review.

INTRODUCTION: Mass gatherings are events where many people come together at a specific location for a specific purpose, such as concerts, sports events, or religious gatherings, within a certain period of time. In mass-gathering studies, many rates and ratios are used to assess the demand for medical resources. Understanding such metrics is crucial for effective planning and intervention efforts. Therefore, this systematic review aims to investigate the usage of rates and ratios reported in mass-gathering studies. METHODS: In this systematic review, the PRISMA guidelines were followed. Articles published through December 2023 were searched on Web of Science, Scopus, Cochrane, and PubMed using the specified keywords. Subsequently, articles were screened based on titles, abstracts, and full texts to determine their eligibility for inclusion in the study. Finally, the articles that were related to the study's aim were evaluated. RESULTS: Out of 745 articles screened, 55 were deemed relevant for inclusion in the study. These included 45 original research articles, three special reports, three case presentations, two brief reports, one short paper, and one field report. A total of 15 metrics were identified, which were subsequently classified into three categories: assessment of population density, assessment of in-event health services, and assessment of out-of-event health services. CONCLUSION: The findings of this study revealed notable inconsistencies in the reporting of rates and ratios in mass-gathering studies. To address these inconsistencies and to standardize the information reported in mass-gathering studies, a Metrics and Essential Ratios for Gathering Events (MERGE) table was proposed. Future research should promote consistency in terminology and adopt standardized methods for presenting rates and ratios. This would not only enhance comparability but would also contribute to a more nuanced understanding of the dynamics associated with mass gatherings.

Psychological Hardiness and Compassion Satisfaction Among the Turkish Red Crescent: The Case of 2023 Kahramanmaras Earthquake.

OBJECTIVES: This study assessed psychological hardiness and compassion satisfaction among the Türk Kizilay (Turkish Red Crescent) personnel and volunteers involved in the 2023 Kahramanmaras earthquake. Additionally, the relationship between compassion satisfaction and psychological hardiness was also investigated. METHODS: This cross-sectional study was conducted between March and July 2023. Participants completed an online survey, which included the Sociodemographic Information Form, Psychological Hardiness Scale, and Compassion Satisfaction Scale. The data was analyzed with SPSS version 25 (IBM Corp., Armonk, New York, USA), using a significance level of 95% and p < 0.05. RESULTS: The study involved 400 participants, comprising 84 (21%) personnel and 316 (79%) volunteers. Participants exhibited an average psychological hardiness level of 24.56 ± 7.25 and a compassion satisfaction level of 47.40 ± 17.28. A significant positive correlation was observed between compassion satisfaction and psychological hardiness (r = 0.571; p < 0.001). The results of logistics regression have revealed that the level of psychological hardiness is higher in males compared to females (OR = 1.930, CI = 1.115 - 3.340; P < 0.05) and is also higher in those with high compassion satisfaction compared to those with low compassion satisfaction (OR = 1.386, CI = 1.256 - 1.529; p < 0.001). CONCLUSIONS: The findings of this study indicate that individuals involved in disaster response should consider compassion satisfaction as an important tool for enhancing psychological hardiness.

Challenges Faced by Medical Rescue Teams During Disaster Response: A Systematic Review Study.

This study was conducted to identify the challenges faced by medical rescue teams during the response phase of sudden-onset disasters and provide a comprehensive understanding of these challenges. Peer-reviewed, English-language articles published until January 2023 that described the challenges faced by medical rescue teams during disaster response were searched in the Web of Science, Scopus, Cochrane, PubMed, and Science Direct databases. The articles were assessed using the Mixed Methods Appraisal Tool (MMAT) version 2018, a quality evaluation tool, and a qualitative thematic synthesis approach was adopted. A total of 353 publications were identified, and 18 of these met the inclusion criteria. Of the 18 included studies, 8 were review articles, 4 were special reports, 3 were cross-sectional studies, 1 was a mixed methods study, 1 was a qualitative study, and 1 was a short communication. Through qualitative analysis, the challenges faced by medical rescue teams during disaster response were categorized into 6 factors: organizational, individual, environmental and health, logistical, communication and information, and other factors. These factors are significant in terms of issues such as delayed access to disaster victims, disruptions in response processes, and an increase in morbidity and mortality rates. Therefore, the findings in our study shed light on future research in the field of disasters and offer opportunities to develop a roadmap for improving the conditions of medical rescue teams.

Analysis of the Medical Consequences of Global Terrorist Attacks in Turkic States in the Last 50 Years by Weapon and Attack Type.

OBJECTIVE: This research aimed to conduct an epidemiological analysis of the terrorist attacks, which took place in the Turkic states between 1970 and 2019, and their medical consequences in terms of weapons and attack types. The data collected from this research will be valuable for the development of preventive systems against attacks on Turkic states and offer insights on how to effectively prepare for potential future attacks. METHODS: The population of the research consisted of the weapons and types of attacks of the terrorist attacks in the Turkic states drawn from the Global Terrorism Database provided free of charge by START. The number of deaths, injuries, property damage, primary weapons, and types of attacks were analyzed by country. RESULTS: Between 1970 and 2019, 4629 terrorist incidents occurred and 7496 people lost their lives and 10 928 people were injured. Among the types of weapons, the number of people who lost their lives was mostly in firearms, whereas the number of the injured was mostly in explosive weapons. Among the types of attacks, the number of people who lost their lives was mostly observed in the armed attack, whereas the injuries occurred mostly in the bombing attacks. Among the Turkic states, Turkey is the country most affected in terms of medical outcomes. CONCLUSION: The terrorist attacks in the Turkic states reached their maximum number in the last 10 years. It is predicted that this number will increase further in the next years and affect more people medically.

Evaluation of the National Health System Utilization Status of the Syrian Refugees in Turkey Between 2011 and 2017.

BACKGROUND: The objective of this study is to evaluate the status of the Syrian refugees (SR) in Turkey in terms of using the National Health System (NHS) between 2011 and 2017. METHODS: The study is a descriptive and cross-sectional epidemiological research ORACLE SQL Developer program was used for data analysis, and frequency analyzes regarding the person, place, and time characteristics of the health services that SR received between 2011 and 2017 were presented. RESULTS: The SRs benefited from NHS hospital services approximately 35 million times (34,973,029). Approximately 40% of the SRs that benefited from the NHS are under the age of 18. The proportion of those under 5 y old is 15.8%; 55.8% of the SRs that benefited from the NHS are women. The utilization status of the SRs from the NHS by region is as follows: 33.4% Mediterranean Region, 29.2% Southeastern Anatolia Region, and 19.0% Marmara Region. The types of health institutions that the SRs used are as follows: 44.0% state hospitals, 15.0% family medicine centers, and 13.3% training and research hospitals. A total of 16,009,524 cases were intervened as part of EMS. CONCLUSION: Syrian refugees in Turkey comprehensively benefited from primary, secondary, and tertiary health services free of charge between 2011 and 2017 in Turkey. It is seen that they have access to private and high-cost health services, such as air ambulance, cancer treatment, and dental treatment.

The Science of Disaster Medicine: From Response to Risk Reduction.

The scientific advancement of the disaster medicine concept started approximately five decades ago. Different disciplines, such as public health, emergency health services, emergency medicine, and military medicine, work within the disaster medicine framework. Disaster medicine aimed to ensure that health services and facilities are operational both in the pre- and post-disaster periods to prevent and reduce the negative health circumstances of the society facing disaster risks. It is a discipline with slow scientific progress due to unclearly systematized multidisciplinary structure and sub-study areas. However, important targets regarding the field of disaster medicine were indicated in the Sendai Framework for Disaster Risk Reduction 2015-2030 published by the United Nations. Among the global goals of disaster medicine, are to reduce the number of deaths and injuries, reduce the number of affected people, strengthen critical facility infrastructure, and ensure functional sustainably of these facilities during disasters. To achieve these goals, disaster medicine is expected to rapidly develop both institutionally and academically. Disaster medicine is a global, mass, administrative, and doctrinal discipline that means beyond clinical studies. Particularly, the development and dissemination of disaster medicine education were emphasized for the first time with the Sendai Framework for Disaster Risk Reduction, which was determined globally in 2015. The disaster medicine discipline is seen to reach a very strong point by 2030.

Longitudinal SARS-CoV-2 Seroconversion Course and Antibody Levels by Blood Groups in Convalescent Plasma Donors in Turkey.

Objective: The present study investigates the seroconversion time course of the IgG antibody against SARS-CoV-2 and ascertains whether its levels change according to the patient's ABO blood group. Method: A total of 36,003-convalescent plasma (CP) donations of 12,315 Turkish Red Crescent CP donors were analyzed. The ABO blood group of the CP donors was determined by Gel Centrifugation; and IgG was measured using the Euroimmun anti-SARS-CoV-2 ELISA. The differences in the distributions of mean IgG ratios among the different ABO blood groups were analyzed with One-Way ANOVA and Independent Samples T-test. Results: Among the CP donors, 98.4% were male. An antibody response to SARS-CoV-2 was noted-although in a few CP donors- on the 244th day, and a significant association between the ABO blood groups and the mean IgG ratios was noted (p: 0.001). The highest (mean±SD) antibody level was observed in the AB blood group (39.5±15.7), followed by the B (37.9±11.5) and the A blood groups (36.6±10.7), while the lowest value was recorded in the O blood group (34.4±11.5). Significant differences between all paired groups were noted in pairwise comparisons. The Rh (-) blood group (37.4±13.6) had a significantly higher antibody level than the Rh (+) blood group (36.3±11.2) (p: 0.005). Conclusion: An antibody response to SARS-CoV-2 was noted in a CP donor on the 244th day. The average IgG ratios were higher in the CP donors with the AB blood group, but lower in the O blood group. These results may be considered a valuable indication of the effectiveness of CP therapy used for the treatment of COVID-19 patients with clinically relevant blood types.

Convalescent plasma therapy in patients with COVID-19.

INTRODUCTION: Passive antibody therapy has been used to immunize vulnerable people against infectious agents. In this study, we aim to investigate the efficacy of convalescent plasma (CP) in the treatment of severe and critically ill patients diagnosed with COVID-19. METHOD: The data of severe or critically ill COVID-19 patients who received anti-SARS-CoV-2 antibody-containing CP along with the antiviral treatment (n = 888) and an age-gender, comorbidity, and other COVID-19 treatments matched severe or critically ill COVID-19 patients at 1:1 ratio (n = 888) were analyzed retrospectively. RESULTS: Duration in the intensive care unit (ICU), the rate of mechanical ventilation (MV) support and vasopressor support were lower in CP group compared with the control group (p = 0.001, p = 0.02, p = 0.001, respectively). The case fatality rate (CFR) was 24.7 % in the CP group, and it was 27.7 % in the control group. Administration of CP 20 days after the COVID-19 diagnosis or COVID-19 related symptoms were associated with a higher rate of MV support compared with the first 3 interval groups (≤5 days, 6-10 days, 11-15 days) (p=0.001). CONCLUSION: CP therapy seems to be effective for a better course of COVID-19 in severe and critically ill patients.

Psychopathology and Associated Risk Factors Among Forcibly Displaced Syrian Children and Adolescents.

More than half of the 2.7 million registered Syrian refugees in Turkey are under 18 years of age. This study investigates prevalence of psychopathology and associated risk factors in refugee children in Turkey. Of a total of 218 children aged 9-15 years, 56.2% lost someone important to them, 55.1% saw dead or wounded people, 70.4% witnessed explosions or gun battles, 42.5% witnessed people being tortured and 25.6% personally experienced cruelty/torture during war. Prevalence of PTSD was 18.3% and that of anxiety-related disorders were as high as 69.0%. Death of an important person (p = .032) and male gender (p = .040) were associated with PTSD; whilst exposure to cruelty or torture (p = .014) and increasing duration of refuge (p = .042) were significantly associated with development of anxiety disorders. Findings of the present study reveals existence of the expected but unspoken mental health needs among the Syrian children in Turkey.

Rural surgery in Guinea Bissau: an experience of Doctors Worldwide Turkey.

OBJECTIVE: In Africa, there is critical shortage of surgeons. Majority of the surgeons work in urban centers, and almost none of them is working in the rural areas. This study documents surgical interventions performed in Guinea-Bissau by Doctors Worldwide Turkey. METHODS: A group of surgeons from the Doctors Worldwide Turkey performed various surgical interventions in the Simao Mendes, Gabu and Bafata community hospitals. Demographics, surgical methods, anesthesia techniques and complications were recorded. RESULTS: Sixty- four procedures were undertaken between 5-16 February 2010 and 6-11 May 2011. The patient population consisted of 47 male (82.5%) and 10 female (17.5%) patients with a mean age of 44.5 (range: 6-81) years. Five emergency cases were observed. Hartmann's procedure for rectal carcinoma; modified radical mastectomy for breast carcinoma; 2 right total thyroidectomies, 1 bilateral subtotal thyroidectomy; 2 incisional hernia repairs with mesh, 1 breast lumpectomy, 3 mass excisions, 2 keloidectomies, and various techniques of hernia repair for 35 inguinal hernias (4 bilateral, 3 strangulated and 2 coexisting with hydrocele), Winkelmann's procedure for 5 hydroceles (1 bilateral), and unilateral orchiectomy for 1 bilateral hydrocele were recorded. Sixteen patients received general (23.5%), 23 spinal (33.8%), 7 epidural (10.3%), 15 local (22.1%), and 7 ketamine (10.3%) anesthesia. There was no mortality. CONCLUSION: Surgical diseases, majority of which are hernias threaten public health in underdeveloped regions of Africa. Blitz surgery may be an efficient temporary solution.