How to Approach Real Mathematical Modeling in Surge Capacity: Clinical Review

Objectives: Science of surge is one of most important topics in the realm of disaster preparedness. Since 2006, after Academic Emergency Medicine (AEM) Consensus Conference, few articles with quantitative data address decision making in surge capacity. The aim of this article is looking forward to the facts about mathematical modeling and proposes real modeling in decision making to have better outcome. Methods: Literature Research was performed on database for the last ten years (2007-2017). Articles with mathematical modeling were separated and classified based on the usage of them in the field. Results: All current mathematical studies compared based on pre-hospital and hospital setting and flexibility in change of global level of care in time. Integrated model of sigmoid curve and HASC (Hospital Acute Care Surge Capacity) with name B-H integrated modeling in two-hour interval proposed. Conclusion: This study shows dynamic process of disaster planning based on outcome and reality. The proposed model makes surge capacity more predictable and adjustable.

A Community Study on Attitudes to and Knowledge of Mental Illness in Tehran

There are a limited number of studies on attitudes towards mental illness and mentally ill from Islamic countries even though Islam is the second largest of the religious beliefs in the world. An interesting element in Islamic teaching is the idea that mental illness as well as other ailments might be an effect of the will of Allah. This could imply that persons suffering from mental disorders might be less stigmatized. The aim of this study was to determine the knowledge and attitudes towards mental illness in the city of Tehran, Iran. Eight hundred subjects, randomly chosen from 4 districts of Tehran, responded to a modified version of a questionnaire developed by the World Psychiatric Association to reduce stigma because of schizophrenia. The self-completed questionnaire was delivered by 4 trained psychologists. The mean age of the sample was 37.5 years and 53.3% being males. A majority agreed that mental illness could be treated outside the hospital (70%) and 74% thought that mentally ill “can work in regular jobs”. Almost half agreed that “mentally ill are a public nuisance” and that “mentally ill people are dangerous”. One quarter agreed that they “would be ashamed if people knew someone in the family who was diagnosed with mental illness”. Generally males seemed to be more accepting than women. Generally the level of negative attitudes in Tehran population is at the same level as in other countries and cultures studied. Cultural beliefs and Islamic influence on attitudes towards mental illness and mentally ill need further studies. The result indicates a need for further actions to reduce the negative attitudes towards mentally ill in Tehran, Iran.

Internalized stigma of mental illness in Sweden and Iran—A comparative study

Objectives: Stigma and discrimination because of mental illness is still prevalent even in high-income countries where a lot of emphasis has been given to anti-stigma activities and measures to reduce the marginalization of these persons. One aspect of the stigma issue is the self-stigmatization that persons suffering from mental illness are experiencing. In this study two different societies have been compared as regards internalized stigma of mental illness. Methods: A widely used questionnaire was used by the Internalized Stigma of Mental Illness scale (ISMI). One sample of psychiatric patients from Sweden (N = 163) and from Iran (N = 138) is compared. Results: The Swedish sample generally reports lower levels of experienced stigma except for items covering selfblame and feelings of alienation. Conclusions: There are reasons to consider the aspect of self-stigmatization when working with mentally ill persons even in high income countries with well developed mental health services.