To examine innovative methods of seeking assistance during disasters and crises in vulnerable groups through a systematic review approach.

This study is a systematic review. The necessary data were obtained using relevant keywords from PubMed, Scopus, Web of Knowledge, Embase, ProQuest databases, and the Google Scholar search engine. The study was conducted without any time limitations and using the PRISMA protocol. The CASP tool was used for assessing the quality of the articles.

Of 6002 initial articles, 11 final articles were selected and included in the study. Most of the studies were from Australia, and the most frequently examined vulnerable groups were disabled people and people who are deaf or hard of hearing. The basis for the methods and tools used in seeking assistance and managing disasters was the disaster risk reduction programs in communities, which utilized information systems, educational frameworks, communication platforms, and media tools to achieve the goals, considering specific environmental and cultural conditions.

Given the emergency nature of disasters, government commitment and support should be based on the allocation of special resources and the active participation of vulnerable individuals.

Rinsing only with water or washing with soap and water are common methods of skin decontamination for skin contaminated during a chemical hazard release. The null hypothesis was that a 15-minute water irrigation (decontamination method 1) would not be superior to decontamination using a microfiber towel, followed by a wet wipe (Signature Select Softly Flushable Tissue Better Living Brands LLC, Pleasanton, CA), followed by using another microfiber towel (decontamination method 2).

A simulated contaminant (Magic Fluorescent Glow Paint for Face and Body, iLC Shenzhen Fulimei Technology Co. LTD, Shenzhen, the People’s Republic of China) was applied to the dorsal skin of each subject’s forearms. Then, photographs of these subject’s skin were taken before and after decontamination of the simulated contaminant by using either decontamination method 1 or 2. Each of the subjects underwent both decontamination methods in separate trials, with each subject using one forearm for decontamination method 1 and their other forearm for decontamination method 2. Discrete points of contamination were quantified on the photographs that were taken with the skin illuminated by ambient visible light or ultraviolet light (395nm, Roceei ultraviolet flashlight, China).

Under visible light, no residual contamination was seen by inspecting photographs taken after decontaminating with either method. Under ultraviolet light, less visible contamination was seen by inspecting photographs taken after decontaminating with method 1 than after decontaminating with method 2.

In this study, skin decontamination with water irrigation was superior to skin decontamination without water irrigation.

Oncological and palliative care patients face unique stressors which increase their risk of developing depression and anxiety. Cognitive behavioural therapy (CBT) and mindfulness has established success in improving this population’s mental health. Traditional face-to-face psychotherapy is costly, has long wait lists, often lacks accessibility, and has strict scheduling, each of which can make attending psychotherapy physically, mentally, and financially out of reach for oncological and palliative patients. Web-based CBT (e-CBT) is a promising alternative that has shown efficacy in this and other patient populations.

To quantify the efficacy of online CBT and mindfulness therapy in oncological and palliative patients experiencing depression and anxiety symptoms.

Participants with depression or anxiety related to their diagnosis were recruited from care settings in Kingston, Ontario, and randomly assigned to 8 weekly e-CBT/mindfulness modules (N= 25) or treatment as usual (TAU; N=24). Modules consisted of CBT concepts, problem-solving, mindfulness, homework, and personalised feedback from their therapist through a secure platform (Online Psychotherapy Tool- OPTT) Participants completed PHQ-9 and GAD-7 in weeks 1, 4, and 8. (NCT04664270: REB# 6031471).

Significant decreases in PHQ-9 and GAD-7 scores within individuals support the hypothesis of efficacy. At this time, 10 e-CBT/mindfulness and 12 TAU have completed the study. Decreases in PHQ-9 and GAD-7 scores within e-CBT group support the hypothesis of efficacy. Specifically, PHQ-9 scores decreased over the 3 repeated measures (ANOVA, 2 groups, 3 repeated measures and the decrease in GAD-7 scores was similarly large)

As hypothesized, the results suggest that e-CBT/mindfulness therapy is an affordable, accessible, and efficacious mental health treatment for this population. The virtual, asynchronous delivery format is particularly appropriate given the unique barriers.

N. Alavi Shareolder of: OPTT inc, Grant / Research support from: department psychiatry Queen’s University, M. Omrani Shareolder of: OPTT inc, A. Shirazi: None Declared, G. Layzell: None Declared, J. Eadie: None Declared, J. Jagayat: None Declared, C. Stephenson: None Declared, D. Kain: None Declared, C. Soares: None Declared, M. Yang: None Declared

Lockdowns and social distancing resulting from the COVID-19 pandemic have worsened population mental health and made it more difficult for individuals to receive care. Electronic cognitive behavioural therapy (e-CBT) is a cost-effective and evidence-based treatment that can be accessed remotely. The objective of the study was to investigate the efficacy of online psychotherapy during the pandemic.

The purpose of the present study was to develop and administer an e-psychotherapy program for patients with depression and anxiety d), affected by the COVID-19 pandemic . The program aimed to significantly reduce stress and psychological distress in patients, from pre- to post-intervention.

Participants (n = 59) diagnosed with MDD and/or GAD, whose mental health symptoms initiated or worsened during the COVID-19 pandemic. The online psychotherapy program focused on teaching coping, mindfulness, and problem-solving skills. Symptoms of anxiety and depression, resilience, and quality of life were assessed.

From the participants assessed for eligibility, n = 14 did not meet the inclusion and exclusion criteria and n = 7 declined to participate. As a result, n = 59 participants commenced the study. In total, 21 participants dropped out of the study (n = 11 from Weeks 1-3, n = 7 from Weeks 4-6, and n = 3 at Week 7), and 38 participants completed the study. The large majority of the total sample identified as women (n = 41, 69%). Two participants identified as Other and both dropped out of the treatment at Weeks 4 and 6, respectively. The average age of the sample was 32.26 (SD = 12.67). No significant differences were observed at baseline for any demographic variables or scores of treatment completers and dropouts . A significant difference was observed between the number of sessions completed by those who dropped out and those who finished the program (p < 0.001). On average, treatment dropouts completed approximately 41% of the treatment before dropping out.

Participants demonstrated significant improvements in symptoms of anxiety (p = 0.023) and depression (p = 0.029) after the intervention. Similar trends were observed in intent-to-treat analysis. No significant differences were observed in resilience and quality of life measures.

The evidence strongly suggests that online psychotherapy can supplement the current care model. Although no changes in quality of life or resilience were reported, these findings may be due to the persistent environmental challenges that are outside the normative levels observed pre-pandemic. While the efficacy of e-CBT has been observed across various populations, it is warranted for future studies to investigate the role of gender in treatment availability and help-seeking.

E. Moghimi: None Declared, M. Omrani Shareolder of: OPTT inc, A. Shirazi: None Declared, J. Jagayat: None Declared, C. Stephenson: None Declared, N. Alavi Shareolder of: OPTT inc

Depression is a leading cause of disability, annually affecting up to 300 million people worldwide, yet fewer than one third of patients receive care. Cognitive behavioural therapy (CBT) is an effective treatment for depression, but there are barriers to access therapy. Electronic CBT (e-CBT) can address these barriers, but the digital format may reduce personalization and patient compliance. A balanced, hybrid model (i.e., combination of e-CBT & supervised care) could make therapy scalable and effective through a stepped-care model: a care model that begins treatment with the least resource intensive, yet effective, method while slowly ‘stepping up’ to intensive care based on patients’ needs.

-To examine the efficacy of a stepped-care e-CBT model for depression through reduction in depressive symptoms.

-To develop a decision-making process that can effectively allocate the appropriate level of care for each patient.

This is a single-blinded randomized controlled trial (RCT). Participants were randomized to either the e-CBT group (n = 53) or the e-CBT with stepped care group (n = 26). Both groups received a 12/13-weeks e-CBT program tailored to depression. The e-CBT program was provided through a secure online mental health clinic called the Online Psychotherapy Tool (OPTT). Participants read through the sessions and completed assignments related to each session. Each participant was designated a care provider who was a trained research assistant. Participants in the experimental group received extra interventions based on their standard questionnaire scores, and textual data.

Figure 1: The average PHQ-9 (A), QLESQ (B), and QIDS (C) scores pre-, mid-, and post- treatment for the e-CBT only (n = 53) and stepped care groups (n = 26).

* Depressive symptoms: PHQ-9 (Patient Health Questionnaire-9) & QIDS (Quick Inventory of Depressive Symptomatology)

* Quality of Life Measure: QLESQ (Quality of Life Enjoyment and Satisfaction Questionnaire – Short Form)

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Stepped care model can be reliable and effective method of delivering targeted care to future patients. Using this approach, the amount of care each patient receives is tailored to their needs, allowing for more efficient usage of scarce resources. This would also lower the general cost of care for each patient. By understanding the therapeutic needs of each patient, we can use these results to develop objective interventions and efficient algorithms to triage individuals. This technique could scale up care capacity without sacrificing the quality of care for each patient.

N. Alavi Shareolder of: OPTT inc, M. Omrani Shareolder of: OPTT inc, J. Jagayat: None Declared, A. Shirazi: None Declared, A. Kumar: None Declared, A. Pannu: None Declared, Y. Shao: None Declared

Nowadays, the Covid-19 pandemic is 1 of the most important challenges worldwide, especially in terms of health. The most important strategy to prevent and control the Covid-19 pandemic is mass vaccination. This study aimed at developing a roadmap for the mass vaccination of COVID-19 in Iran.

The current study was conducted using a qualitative approach with a content analysis method. In the first step, the review of literature and documents was carried out by a search in scientific databases. In the next step, the data were amassed via in-depth and semi-structured interviews with experts who were selected purposefully, including policymakers, health care workers, and managers. After this, 3 multidisciplinary expert panels for roadmap development were held.

Based on the literature review, interviews, and 3 stages of an expert panel, the final roadmap was developed with 5 dimensions. These included outcomes, planning and preparation, strategies, and preparation, implementation, monitoring, and evaluation.

This roadmap was developed to improve mass vaccination during the COVID-19 pandemic. According to our findings, it is strongly recommended that the vaccination roadmap with all the above-mentioned features and comprehensive structure should be applied to mitigate the consequences of the COVID-19 pandemic.

Emergencies and disasters occur in any society, and it is the hospitals and their emergency department staff who must be prepared in such cases. Therefore, 1 of the effective methods of training medical care staff is the use of simulators. However, when introducing new simulation approaches, we face many challenges. The aim of this study was to identify challenges of the simulation of the hospital emergency department during disasters and provide effective solutions.

This conventional content, thematic, analysis study was conducted in 2021. Participants were selected from Iranian experts using purposeful and snowball sampling methods. Data were collected using semi-structured interviews and were analyzed by the content analysis.

After analyzing the data, the challenges of simulating the hospital emergency department during disasters were identified in 2 main components and 6 perspectives, which included organizational components (inappropriate and aimless training methods, lack of interaction and cooperation, lack of funding, and inadequate physical space) and technological components (weak information management and lack of interdisciplinary cooperation). Solutions included management (resource support) and data sharing and exchange (infrastructures, cooperation and coordination).

The simulation technology can be used as a method for training and improving the quality of health care services in emergencies. Considering that most of these challenges can be solved and need the full support of managers and policy makers, by examining these issues, supporting staff of health care centers are advised to make a significant contribution to the advancement of education and problem reduction in the event of disasters.

The provision and continuation of the basic needs of affected communities, including water, food, and shelter remain the most important priorities in responding to disasters. In this regard, this study sought to investigate the management challenges of humanitarian hygiene items in recent disasters in Iran.

This qualitative study was conducted through a semi-structured interview. Nineteen participants with different experiences, roles, and responsibilities in the recent disaster of Iran and experiences of various events in the national and international arenas were included in the study. A thematic analysis was used, and an initial conceptual framework was defined based on the study aim. The relationship between the components was compared and interpreted in this framework and the main and subthemes were extracted accordingly.

Six main themes and 21 subthemes were extracted based on the results. The main challenges in recent disasters were the lack of protocols and standard guidelines, inappropriate selection of items in each hygiene kit, the lack of standard distribution of hygiene kits, and the lack of attention to the affected population’s culture.

Overall, it is necessary to define a system for preparation, supply, storage, and timely distribution of hygiene. Finally, it is suggested that an organization should be appointed for this purpose.

Drug addiction is one of the most common social disorders in Iran. It is estimated that about 2 million Iranian are addicted and the number is rising.

This study is done to investigate the educational history and its related issues of addicted participants.

Participants are a convenience sample of 71 drug addicted males who came to one of the 17 addiction treatment centers in Yasouj- Iran. Data were collected via a self administered questionnaire.

Patients were all male, age from 19 to 50 years old. Only 1.4% (one patient) was illiterate, and 10.1% had university degrees. 59.9% did not started (1.4%) or finished (58.5%) their national compulsory educational program. Addiction was reported as the main reason for withdrawing from school (19.6%). More than 73% of the participants had educational difficulties (e.g. failed subject) and 74% used to be aggressive during their study period. More than 46% were under 18 years old (33.3% under 16) when they used drugs for the first time. School was the place of the first use of drug for 6.1% of the participants.

Educational issues seem to be a common problem for the drug addicted participants. This is due to either addiction itself or educational problems can be considered as indicators for later attempt for using drugs or more precisely addiction. It would be reasonable to do further work to find out more specific educational difficulties which can predict later risk for addiction.

Individuals who engage in drugs abusing are more susceptible to a variety of physical, social and psychological health problems.

This study describes mental disorders of patients with opium and heroin addiction before taking MMT.

Participants included 172 addicts (162 men and 10 women), referring to Fanoos addiction relief center, whose age ranged from 16–66 with mean age of 32.8. All participants were asked to complete a questionnaire about their bad feelings experienced during past month before taking methadone maintenance therapy.

The average age of the first drug abusing was 20.5 with range of 10–60. The most frequent bad feelings that were reported by participants were sensation of anxiety, hopelessness and aloneness. 68.6% of patients had a history of depression, 56.4% were aggressive and 26.3% of them had ideas of suicide.

Exploring of mental status of addict people before taking MMT can be used for evaluation of treatment effects and designing more effective interventions.