Factors Influencing the Health of Participants in Religious Mass Gathering Ceremonies in Iraq: A Systematic Review

Introduction: In the last decade, the number of religious mass gathering ceremonies, which take place in Iraq, has increased considerably. Millions of participants visit the country annually from across the world to reach Karbala on foot or by other vehicles for participation in a religious ritual called Arbaeen, which lasts about 20 days. Unlike the Hajj mass gathering, another important annual religious mass gathering event of Muslims, an evidence-based review of scientific literature about influential factors on the health of participants in these ceremonies in Iraq has not been done.Methods: Using PRISMA guidelines and searching PubMed, Scopus, ISI_Web of Science, Cochrane Library, ProQuest, and Google Scholar databases, original English language studies focused on participants' health in religious ceremonies of Iraq until October 2021 were selected. The methodological quality of the studies and the risk of bias were checked using the Joanna Briggs Institute (JBI) checklists. In addition, the data from the Iraqi Ministry of Health and other organizations, including WHO and CDC, about Iraq's health condition and other resources were used to describe the related findings better and make health recommendations for the participants.Results: Thirty-two studies passed our criteria and were included for analysis. There was not any clinical trial. All of them were observational (cross-sectional) or qualitative (interview) research;the majority had low to moderate quality scores. Considering the limitations, the leading health risks of participants in religious ceremonies in Iraq include road accidents, insufficiency of Iraq's health system, cardiovascular disease, respiratory tract (including Covid-19) infections, unhealthy food and drink, gastrointestinal infections (including hepatitis), and zoonotic infections(leishmaniasis).Conclusion: Regarding the grandeur of Iraqi-related mass gatherings, preparation must begin before the events. Pre-participation examination, vaccination of high-risk individuals, and training of pilgrims and authorities on the health hazards are critical.

Population health management

Population health management (PHM) is a systematic approach that uses information technology and digital health tools to improve health and healthcare at the population-level. PHM programs identify individuals who could benefit from a set of PHM interventions;implement computable logic to stratify patients according to risk;and implement protocol-based logic to assign individuals within each stratum to specific interventions. PHM is a promising approach to help achieve the Quintuple Aim of healthcare: (i) improving population health through population-level interventions;(ii) enhancing the care experience by shifting healthcare from the clinic to the patient's home;(iii) reducing costs by focusing on health promotion and prevention;(iv) improving the work life of the health care workforce by reducing clinic workload;and (v) advancing health equity by maximizing reach through a combination of digital and human-based patient outreach interventions. This chapter discusses the components of a technical infrastructure to support PHM, including data sources (registries, electronic health records), data analytics tools, patient outreach and engagement tools, and patient tracking dashboards. We also describe real-world examples of PHM programs focused on chronic disease management, genetic testing for hereditary cancers, colorectal cancer screening, COVID-19 testing and vaccination, and tobacco cessation. PHM is expected to experience substantial growth with novel digital health technologies, such as sensors, phone apps, conversational agents, and virtual reality;artificial intelligence;and new data sources. © 2023 Elsevier Inc. All rights reserved.

Collaboration to combat COVID-19: policy responses and best practices in local integrated care settings.

PURPOSE: This illustrative case study describes and evaluates drivers of effective inter-organizational collaboration to mitigate the impact and spread of COVID-19 among homeless people in two cities in the Netherlands. The aims of this study are: (1) to explore the strategic and operational policy responses in two local integrated care settings at the start of the crisis, (2) to identify best policy practices and lessons learned. The authors interpret and evaluate the findings by combining insights from the population health management (PHM) and collaborative governance literature. DESIGN/METHODOLOGY/APPROACH: The authors describe and illustrate the experiences of two Dutch municipalities, Rotterdam and The Hague, in the early policy responses to sudden operational challenges around the impact of COVID-19 on homeless people as experienced by local decision-makers, medical doctors and clients. FINDINGS: The authors show that best policy practices revolve around (1) using data and risk stratification methods for identifying and targeting populations at-risk in local policy making, and (2) having an inter-organizational data sharing architecture in place ex ante. These two factors were clear prerequisites for tailor-made policy responses for newly-defined groups at risk with the existing and well-documented vulnerable population, and executing crisis-induced tasks efficiently. ORIGINALITY/VALUE: This paper is among the first to illustrate the potential of combining collaborative governance and PHM perspectives to identify key drivers of effective local governance responses to a healthcare crisis in an integrated care setting.

The Referral Pattern in a Central Hospital in Iran During the First COVID-19 Peak: The Role of Media and Health Planning

Background: A better understanding of the pattern of epidemic-related referrals to healthcare centers might allow the identifica-tion of vulnerabilities and the required changes that the healthcare management system should undergo. Objectives: This study aimed to investigate the COVID-19 referral pattern and the role of media and health management planning in changing the trends. Methods: Data extracted from the electronic medical database of Imam Khomeini Hospital Complex (IKHC), located in Tehran, Iran, from February 20 to June 4, 2020 were examined. Individuals were divided into two groups, COVID-19 positive and negative. We used Google Trends to evaluate Google Internet search queries and also available policy documents, programs, and official news related to COVID-19 in Iran during the mentioned period. Results: In this study, 8647 individuals aged 46.05 ± 16.5 years were referred to IKHC. Approximately 57% were male, and 70% were COVID-19 positive. The most clinical symptoms were dyspnea, fever, cough, and myalgia. Chronic kidney disease (CKD) and type 2 diabetes mellitus were the most common underlying health conditions. In the first two weeks, the percentage of negative cases was higher than positive cases and then the pattern was reversed, when people searched for information about COVID-19 in media. Conclusions: Proper and timely information and education to people through the media and health management measures can be effective in reducing unnecessary visits to health centers, preventing the exhaustion of medical staff, and controlling the disease during epidemics.

A Protocol for a Mixed-Methods Process Evaluation of a Local Population Health Management System to Reduce Inequities in COVID-19 Vaccination Uptake.

Population health management is an emerging technique to link and analyse patient data across several organisations in order to identify population needs and plan care. It is increasingly used in England and has become more important as health policy has sought to drive greater integration across health and care organisations. This protocol describes a mixed-methods process evaluation of an innovative population health management system in North Central London, England, serving a population of 1.5 million. It focuses on how staff have used a specific tool within North Central London's population health management system designed to reduce inequities in COVID-19 vaccination. The COVID-19 vaccination Dashboard was first deployed from December 2020 and enables staff in North London to view variations in the uptake of COVID-19 vaccinations by population characteristics in near real-time. The evaluation will combine interviews with clinical and non-clinical staff with staff usage analytics, including the volume and frequency of staff Dashboard views, to describe the tool's reach and identify possible mechanisms of impact. While seeking to provide timely insights to optimise the design of population health management tools in North Central London, it also seeks to provide longer term transferable learning on methods to evaluate population health management systems.

The full (and necessary) integration of Occupational Health into Public Health

The COVID-19 pandemic is clearly showing the importance for the surveillance and protection of human health of acting in all settings of life: family, community, education, leisure or work, among others, as well as addressing the multiple determinants that influence the health and well-being of the population: demographic, healthcare, environmental, social, economic, cultural or occupational, among others. With respect to occupational health and the work-related determinants of health, the potential of occupational health services acting at the company level is clear, and could be generalized to almost any public health action setting. This article reflects on the opportunities for coordination between the occupational health system in Spain (including resources from mutual insurance companies, companies themselves and administrations) and the public health system, including both health care (primary care, hospital) and public health services. We examine this in the context of health crises, like the present one, but also with a broader vision, commensurate with the necessary comprehensive care for human health, guaranteeing health as a fundamental and universal right in all life circumstances. To advance along these lines, we propose the incorporation of the "occupational health perspective" in all actions and services of the public healthcare system, especially with respect to public health services under the purview of the health administration.

One Digital Health: A Unified Framework for Future Health Ecosystems.

One Digital Health is a proposed unified structure. The conceptual framework of the One Digital Health Steering Wheel is built around two keys (ie, One Health and digital health), three perspectives (ie, individual health and well-being, population and society, and ecosystem), and five dimensions (ie, citizens' engagement, education, environment, human and veterinary health care, and Healthcare Industry 4.0). One Digital Health aims to digitally transform future health ecosystems, by implementing a systemic health and life sciences approach that takes into account broad digital technology perspectives on human health, animal health, and the management of the surrounding environment. This approach allows for the examination of how future generations of health informaticians can address the intrinsic complexity of novel health and care scenarios in digitally transformed health ecosystems. In the emerging hybrid landscape, citizens and their health data have been called to play a central role in the management of individual-level and population-level perspective data. The main challenges of One Digital Health include facilitating and improving interactions between One Health and digital health communities, to allow for efficient interactions and the delivery of near-real-time, data-driven contributions in systems medicine and systems ecology. However, digital health literacy; the capacity to understand and engage in health prevention activities; self-management; and collaboration in the prevention, control, and alleviation of potential problems are necessary in systemic, ecosystem-driven public health and data science research. Therefore, people in a healthy One Digital Health ecosystem must use an active and forceful approach to prevent and manage health crises and disasters, such as the COVID-19 pandemic.