Temporary cities provide unique challenges in terms of urban planning and management. In particular, there are problems in terms of providing adequate service provision and ensuring an equitable access to those services. In addition, when temporary cities also involve a mass gathering for an event, there is a need for a strategic plan for managing the movement of this crowd over time. The Hajj is an annual religious event which hosts about 3 million pilgrims each year. It is the second largest annual gathering of Muslims in the world. The pilgrims reside for a number of days in the "tent city" of Mina. The organisers of the Hajj must plan the location of services to support this huge temporary population and also provide a plan to facilitate the performing of the religious rituals in an easy and safe manner (in particular to avoid overcrowding). In this paper, we estimate and map the distribution of populations across Mina during the Hajj and explore the location of existing services to investigate how well served the population is within various parts of the City. For illustrative purposes, we explore access to health centres and civil defence (mainly fire services). After analysing the current provision of these services across the City (through building suitable accessibility measures) we use a location allocation model to compare the current provision with a set of optimal, model-based locations. The model is also used to operationalise a series of what-if scenarios including reducing the number of facilities in line with increased Government concerns over escalating costs and changing demand in line with pilgrim movements throughout the day. The results of the location-allocation modelling could also help revamp staffing rotas-not only can the model provide optimal locations they can estimate the workloads associated with each facility location (based on the volume of local demand), meaning the thousands of health workers could be also located more optimally.

Background: This study aimed to provide an overview of perceptions of quality improvement among nurses working in Saudi Arabia. Methods: We conducted a descriptive cross-sectional study of 497 Saudi nurses working in public and private hospitals in Al-Qassim Province. Descriptive statistics were computed for quality improvement nursing attitude items and demographic factors. Results: A total of 497 nurses took part in the study; 29.1% of participants were females, and half of the participants were between the ages of 25–30 years. Most respondents were employed in governmental hospitals (98.7%), and 41.9% of participants had work experience ranging between 1 and 5 years. Nurses involved in providing direct patient care recognize the quality improvement attitudes related to changes in the healthcare delivery processes. Saudi nurses’ quality improvement nursing attitudes were moderate. Female, married, and older age group nurses and nurses who were working fewer hours per week showed better quality improvement attitudes. Conclusions: Saudi nurses’ quality improvement nursing attitudes are found to be moderate. Age, gender, marital status, and working hours of nurses are associated with their quality improvement attitudes. To empower nurses to improve healthcare, nursing administrators need to focus on improving the quality improvement attitudes environment.

Platinum-based chemotherapeutic treatment of cancer patients is associated with debilitating adverse effects. Several adverse effects have been well investigated, and can be managed satisfactorily, but chemotherapy-induced peripheral neuropathy (CIPN) remains poorly treated. Our primary aim in this study was to investigate the neuroprotective effect of the immunomodulatory drug rapamycin in the mitigation of cisplatin-induced neurotoxicity. Pain assays were performed in vivo to determine whether rapamycin would prevent or significantly decrease cisplatin-induced neurotoxicity in adult male Balb/c mice. Neuropathic pain induced by both chronic and acute exposure to cisplatin was measured by hot plate assay, cold plate assay, tail-flick test, and plantar test. Rapamycin co-treatment resulted in significant reduction in cisplatin-induced nociceptive-like symptoms. To understand the underlying mechanisms behind rapamycin-mediated neuroprotection, we investigated its effect on certain inflammatory mediators implicated in the propagation of chemotherapy-induced neurotoxicity. Interestingly, cisplatin was found to significantly increase peripheral IL-17A expression and CD8- T cells, which were remarkably reversed by the pre-treatment of mice with rapamycin. In addition, rapamycin reduced the cisplatin-induced neuronal apoptosis marked by decreased neuronal caspase-3 activity. The rapamycin neuroprotective effect was also associated with reversal of the changes in protein expression of p21Cip1, p53, and PUMA. Collectively, rapamycin alleviated some features of cisplatin-induced neurotoxicity in mice and can be further investigated for the treatment of cisplatin-induced peripheral neuropathy.

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