Healthcare under siege: Geopolitics of medical service provision in the Gaza Strip.

PubMed

Smith, Ron J

2015-12-01

Siege, a process of political domination aimed at isolating an entire population, represents a unique threat to healthcare provision. This study is a qualitative examination of the impacts of siege on the practices and systems that underlie health in Gaza. Data are from participant observation conducted over a period of six years (2009-2014), along over 20 interviews with doctors and health administrators in the Non-Governmental Organisation (NGO), Governmental, and United Nations sectors. Analyses were informed by two connected theories. First, the theory of surplus population was used, an idea that builds on Marx's conception of primitive accumulation and Harvey's accumulation by dispossession. Second, Roy's theory of de-development was used, particularly as it is connected to neoliberal trends in healthcare systems organizing and financing. Findings indicate that siege impinges on effective healthcare provision through two central, intertwined processes: withholding materials and resources and undermining healthcare at a systems level. These strains pose considerable threats to healthcare, particularly within the Ministry of Health but also within and among other entities in Gaza that deliver care. The strategies of de-development described by participants reflect the ways the population that is codified as a surplus population. Gazan society is continually divested of any of the underpinnings necessary for a well-functioning sovereign health care infrastructure. Instead of a self-governing, independent system, this analysis of health care structures in Gaza reveals a system that is continually at risk of being comprised entirely of captive consumers who are entirely dependent on Israel, international bodies, and the aid industry for goods and services. This study points to the importance of foregrounding the geopolitical context for analysis of medical service delivery within conflict settings. Findings also highlight the importance of advocating for

Childrens mental health and civil society in the Gaza strip.

PubMed

Thirkell, Lucy

2012-09-01

The Gaza Strip, with a population of 1.7 million, over half of whom are under 18 years old, has existed in a state of ongoing conflict and containment for years, most notably since its closure in 2007. There is much concern for the mental health of the vast young generation who have little memory of other circumstances of existence, and even less exposure to the outside world. Their society forms the site of direct conflict and social destruction pertaining to untreated stress among the adults. However, leaving the social realm for the institutional for mental health treatment carries strong taboo, especially for adults. Civil society expert organisations offering a range of mental health work primarily pertaining to childrens social development can bypass some of this taboo and can also intervene at their schools and in their families, and may be most strategically located as social rather than institutional actors. Empowering the youth and seeking to strengthen Gazan society through them and for them causes some friction with the local government. However, despite the cultural and political challenges of mental health treatment for children within the Gaza Strip, the wider fact remains that however treated and psychosocially rehabilitated, society is predictably the site of renewed trauma in the short term and foreseeable future, enmeshing the mental health of its future generation inseparably with the international politics it inhabits.

Psychiatric symptoms and psychosocial functioning among hospital personnel during the Gaza War: a repeated cross-sectional study.

PubMed

Ben-Ezra, Menachem; Palgi, Yuval; Wolf, Jonathan Jacob; Shrira, Amit

2011-10-30

Studies of mental health among hospital personnel during armed conflict are scarce and usually include single time point investigations without a comparison group. The authors compared the psychiatric symptoms and psychosocial functioning of exposed and unexposed hospital personnel at two time points. The research was conducted during 2009 and included a survey of two random samples of hospital personnel (physicians and nurses), one collected during the Gaza War and the other 6 months later. Each sample included hospital personnel who were exposed to war-related stress and others who were not (Study 1: n=67 and 74 for exposed and unexposed, respectively; Study 2: n=57 and 50 for exposed and unexposed, respectively). Levels of psychiatric symptoms and psychosocial functioning were measured. Compared to unexposed hospital personnel, exposed hospital personnel had a significantly higher level of post-traumatic symptoms during the Gaza War and 6 months later. In addition, during the Gaza War, exposed hospital personnel had a significantly higher level of depressive symptoms. However, in the second study, depressive symptoms were similar to those found in the unexposed group. These findings may suggest that war-related stress is associated with post-traumatic symptoms among hospital personnel even 6 months after exposure. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Smoking, awareness of smoking-associated health risks, and knowledge of national tobacco legislation in Gaza, Palestine.

PubMed

Abu Shomar, Reem T; Lubbad, Ihab K; El Ansari, Walid; Al-Khatib, Issam A; Alharazin, Hatem J

2014-06-01

To assess university students' extent of smoking, knowledge of smoking health risks, and awareness of existing national anti-smoking laws. Self-administered questionnaire was employed across 7 universities (1,104 students, equal proportions of males and females) located in Gaza Strip, Palestine. About 55% of participants reported ever smoking, 31% were current cigarette smokers, and 36% were 'strictly' (only) narghile (water pipe) smokers. Mean age of smoking initiation was 17 +/- 3.15 years. Smokers had less knowledge of smoking associated health risks than nonsmokers. Students' knowledge of existing anti-smoking laws was generally low (11.3-25.5%), and significantly more smokers had knowledge about existing laws (ban of advertisement of smoking, ban of smoking in public places, and ban of selling cigarettes to minors) than non-smokers. About 81% of current smokers tried to quit smoking at least once during their life, 53% felt ready to quit smoking if cessation assistance was provided, 17% were not ready to quit, and 30% were reluctant/felt unsure if they were ready to quit. Most students (94.3%) reported that there were no smoking cessation centres in Palestine, or did not know if such centres existed. Males were associated with almost all categories of smoking (e.g. smoking both cigarettes and narghile, or smoking narghile only). There is a lack of knowledge about the existing national anti-smoking legislation among university students in Gaza, Palestine. Smoking cessation centres also seem non-existent in Gaza. Multi-level interventions and actions are required by policy makers, educators and non-governmental agencies to prevent smoking among university students in Gaza, and to educate them on tobacco cessation counselling, on the dangers of tobacco use, and about effective stress management strategies to help them to cope with stressors. Smoking cessation interventions are required to address both cigarette and narghile use. Efforts need to be invested in

Histopathological study of Enterobius vermicularis among appendicitis patients in Gaza strip, Palestine.

PubMed

Hamdona, Shereen M; Lubbad, Abdel Monem; Al-Hindi, Adnan I

2016-03-01

Enterobius vermicularis is one of the most common intestinal parasite in human. The main objective of this study is to determine the role of E. vermicularis in appendicitis through histopathological examination. A cross sectional study included 200 patients who had appendectomy from three hospitals in Gaza strip. The inflamed appendix was the cause of attending the hospital. Histopathological examination for each appendix was carried out. A questionnaire was designed (interview with patients who underwent appendectomy), and information were obtained from patient and analyzed by using SPSS. The study showed that 30 (15.0 %) of 200 appendices had E. vermicularis in histopathological examination. It was found that ages of patients with histologically proven E. vermicularis in appendices less than 18 years old was found to be (18.2 %). Regarding sex, (16.5 %) of females, (14.0 %) of males patients had E. vermicularis in appendices. Patients who had the highest infection with E. vermicularis were students (17.3 %). In conclusion E. vermicularis occurs more frequently inflamed appendices than in normal. From these results we can conclude that E. vermicularis could be associated to cause of appendicitis in Gaza strip.

Sources of salinity and boron in the Gaza strip: Natural contaminant flow in the southern Mediterranean coastal aquifer

NASA Astrophysics Data System (ADS)

Vengosh, Avner; Kloppmann, Wolfram; Marei, Amer; Livshitz, Yakov; Gutierrez, Alexis; Banna, Mazen; Guerrot, Catherine; Pankratov, Irena; Raanan, Hadas

2005-01-01

Salinization in coastal aquifers is a global phenomenon resulting from the overexploitation of scarce water resources. The Gaza Strip is one of the most severe cases of salinization, as accelerated degradation of the water quality endangers the present and future water supply for over 1 million people. We investigate the chemical and isotopic (87Sr/86Sr, δ11B, δ18O, δ2H, and δ34SSO4) compositions of groundwater from the southern Mediterranean coastal aquifer (Israel) and the Gaza Strip in order to elucidate the origin of salinity and boron contamination. The original salinity in the eastern part of the aquifer is derived from discharge of saline groundwater from the adjacent Avedat aquitard (Na/Cl < 1, 87Sr/86Sr ˜ 0.7079, and δ11B ˜ 40‰). As the groundwater flows to the central part of the aquifer, a dramatic change in its composition occurs (Na/Cl > 1, high B/Cl, SO4/Cl, and HCO3, 87Sr/86Sr ˜ 0.7083; δ11B ˜ 48‰), although the δ18O-δ2H slope is identical to that of the Avedat aquitard. The geochemical data suggest that dissolution of pedogenic carbonate and gypsum minerals in the overlying loessial sequence generated the Ca-rich solution that triggered base exchange reactions and produced Na- and B-rich groundwater. The geochemical data show that most of the salinization process in the Gaza Strip is derived from the lateral flow of the Na-rich saline groundwater, superimposed with seawater intrusion and anthropogenic nitrate pollution. The methodology of identification of multiple salinity sources can be used to establish a long-term management plan for the Gaza Strip and can also be implemented to understand complex salinization processes in other similarly stressed coastal aquifers.

Sources of salinity and boron in the Gaza strip: Natural contaminant flow in the southern Mediterranean coastal aquifer

NASA Astrophysics Data System (ADS)

Vengosh, Avner; Kloppmann, Wolfram; Marei, Amer; Livshitz, Yakov; Gutierrez, Alexis; Banna, Mazen; Guerrot, Catherine; Pankratov, Irena; Raanan, Hadas

2005-01-01

Salinization in coastal aquifers is a global phenomenon resulting from the overexploitation of scarce water resources. The Gaza Strip is one of the most severe cases of salinization, as accelerated degradation of the water quality endangers the present and future water supply for over 1 million people. We investigate the chemical and isotopic (87Sr/86Sr, δ11B, δ18O, δ2H, and δ34SSO4) compositions of groundwater from the southern Mediterranean coastal aquifer (Israel) and the Gaza Strip in order to elucidate the origin of salinity and boron contamination. The original salinity in the eastern part of the aquifer is derived from discharge of saline groundwater from the adjacent Avedat aquitard (Na/Cl < 1, 87Sr/86Sr ~ 0.7079, and δ11B ~ 40‰). As the groundwater flows to the central part of the aquifer, a dramatic change in its composition occurs (Na/Cl > 1, high B/Cl, SO4/Cl, and HCO3, 87Sr/86Sr ~ 0.7083; δ11B ~ 48‰), although the δ18O-δ2H slope is identical to that of the Avedat aquitard. The geochemical data suggest that dissolution of pedogenic carbonate and gypsum minerals in the overlying loessial sequence generated the Ca-rich solution that triggered base exchange reactions and produced Na- and B-rich groundwater. The geochemical data show that most of the salinization process in the Gaza Strip is derived from the lateral flow of the Na-rich saline groundwater, superimposed with seawater intrusion and anthropogenic nitrate pollution. The methodology of identification of multiple salinity sources can be used to establish a long-term management plan for the Gaza Strip and can also be implemented to understand complex salinization processes in other similarly stressed coastal aquifers.

Assessing food security in water scarce regions by Life Cycle Analysis: a case study in the Gaza strip

NASA Astrophysics Data System (ADS)

Recanati, Francesca; Castelletti, Andrea; Melià, Paco; Dotelli, Giovanni

2013-04-01

Food security is a major issue in Palestine for both political and physical reasons, with direct effects on the local population living conditions: the nutritional level of people in Gaza is classified by FAO as "insecure". As most of the protein supply comes from irrigated agricultural production and aquaculture, freshwater availability is a limiting factor to food security, and the primary reason for frequent conflicts among food production processes (e.g. aquaculture, land livestock or different types of crops). In this study we use Life Cycle Analysis to assess the environmental impacts associated to all the stages of water-based protein production (from agriculture and aquaculture) in the Gaza strip under different agricultural scenarios and hydroclimatic variability. As reported in several recent studies, LCA seems to be an appropriate methodology to analyze agricultural systems and assess associated food security in different socio-economic contexts. However, we argue that the inherently linear and static nature of LCA might prove inadequate to tackle with the complex interaction between water cycle variability and the food production system in water-scarce regions of underdeveloped countries. Lack of sufficient and reliable data to characterize the water cycle is a further source of uncertainty affecting the robustness of the analysis. We investigate pros and cons of LCA and LCA-based option planning in an average size farm in Gaza strip, where farming and aquaculture are family-based and integrated by reuse of fish breeding water for irrigation. Different technological solutions (drip irrigation system, greenhouses etc.) are evaluated to improve protein supply and reduce the pressure on freshwater, particularly during droughts. But this use of technology represent also a contribution in increasing sustainability in agricultural processes, and therefore in economy, of Gaza Strip (reduction in chemical fertilizers and pesticides etc.).

National G6PD neonatal screening program in Gaza Strip of Palestine: rationale, challenges and recommendations.

PubMed

Sirdah, M M; Al-Kahlout, M S; Reading, N S

2016-09-01

Congenital genetic disorders affecting neonates or young children can have serious clinical consequences if undiagnosed and left untreated. Early detection and an accurate diagnosis are, therefore, of major importance for preventing negative patient outcomes. Even though the occurrence of each specific metabolic disorder may be rare, their collective impact of preventable complications may be of considerable importance to the public health. Our previous studies showed that glucose-6-phosphate dehydrogenase (G6PD) deficiency is a problem of public health importance that has been shown to be a predominant cause of acute hemolytic anemia requiring hospitalization in Palestinian young children in Gaza Strip. Intriguingly, the majority of these children had one of the three variants, Mediterranean(c.) (563T) , African G6PD A-(c.) (202A) (/c.) (376G) and heretofore unrecognized as a common G6PD-deficient variant G6PD Cairo(c.) (404C) . The high prevalence of G6PD deficiency, as well as dietary factors in the region that precipitate anemia, argues for a need to protect the Palestinian children from a treatable and manageable genetic and metabolic disorder. This work reviews and discusses rationales and challenges of G6PD screening program in Gaza Strip. We advocate adopting a national neonatal G6PD screening program in Gaza Strip to identify children at risk and promote wellness and health for Palestine. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Online Teacher Training in a Context of Forced Immobility: The Case of Gaza, Palestine

ERIC Educational Resources Information Center

Fassetta, Giovanna; Imperiale, Maria Grazia; Frimberger, Katja; Attia, Mariam; Al-Masri, Nazmi

2017-01-01

This article discusses an action research study that involved the design and delivery of an online training course for teachers of Arabic to speakers of other languages in the Gaza Strip (Palestine). Grounded in Freirean pedagogy, the course aimed to respond to the employment needs of university graduates by creating opportunities for online…

Assessment by Employers of Newly Graduated Civil Engineers from the Islamic University of Gaza

ERIC Educational Resources Information Center

Enshassi, Adnan; Hassouna, Ahmed

2005-01-01

The evaluation process is very important to identify and recognize the strengths and the weaknesses of graduated students. The purpose of this paper is to evaluate the performance of the newly graduated civil engineers from the Islamic University of Gaza in Palestine. The methodology was based on questionnaires and informal interview. The…

Israel’s Blockade of Gaza, the Mavi Marmara Incident, and Its Aftermath

DTIC Science & Technology

2010-06-16

navy zodiac boats intercepted them and naval commandos took over five ships, reportedly without incident. However, the Marmara resisted and...CRS Report for Congress Prepared for Members and Committees of Congress Israel’s Blockade of Gaza, the Mavi Marmara Incident, and Its...Documentation Page Form ApprovedOMB No. 0704-0188 Public reporting burden for the collection of information is estimated to average 1 hour per response

Offshore tsunami deposits signify risk for heavily populated southern Levant Coastline (Gaza and Ashkelon)

NASA Astrophysics Data System (ADS)

Hoffmann, Nadine; Goodman-Tchernov, Beverly; Galanti, Barak; Katz, Oded

2016-04-01

The southern Levantine coastline is exposed to a variety of potential tsunami-generating sources, including far field influences such as large earthquakes and volcanic eruptions as well as near field offshore landslides along the continental slope, where slumping features are present throughout the area. Not only does this coast boast a long history of continuous occupation but also today large cities (e.g. Tel Aviv, Ashdod, Ashkelon, and Gaza) and related critical infrastructure such as ports, power plants, chemical industries, roads, etc. are located along this corridor. In addition, further to the south, the Gaza Strip has one of the highest population densities in the world and is dependent on external assistance for many basic needs, goods and infrastructure. Newly obtained sediment cores from the shallow shelf offshore Ashkelon (~12 km north of Gaza City) exhibit several events that can be linked to historical records. These cores can be subdivided in two general horizon types that show relative changes to one another across different proxies. The continuous input of Nile-delta sands results in a homogenous and stable 'background' sediment represented by well sorted, finer sands, few inclusions, lower proportions of A. parkinsoniana relative to fossil tests, and very few yellow-stained and blackened specimens. Contrasting these normal marine condition deposits are high energy tsunamigenic deposits characterized by poor sorting, with inclusions of a range of whole, articulated, and fragmented shells, wood, charcoal, and sub-angular to rounded pebbles. Newly mapped and quantified offshore bathymetric evidence for landslides and slumping motion has identified features that are large enough to generate tsunamis that would affect the study area. These were modeled as possible sources and compared to different far field events. Some of those tsunamigenic horizons could be assigned to specific events ranging between the youngest at 1202AD to the oldest prehistoric

Israel’s Blockade of Gaza, the Mavi Marmara Incident, and Its Aftermath

DTIC Science & Technology

2010-06-23

Israeli navy zodiac boats intercepted them and naval commandos took over five ships, reportedly without incident. However, the Marmara resisted and...CRS Report for Congress Prepared for Members and Committees of Congress Israel’s Blockade of Gaza, the Mavi Marmara Incident, and Its...c11173008 Report Documentation Page Form ApprovedOMB No. 0704-0188 Public reporting burden for the collection of information is estimated to average 1 hour

Increasing Neonatal Mortality among Palestine Refugees in the Gaza Strip.

PubMed

van den Berg, Maartje M; Madi, Haifa H; Khader, Ali; Hababeh, Majed; Zeidan, Wafa'a; Wesley, Hannah; Abd El-Kader, Mariam; Maqadma, Mohamed; Seita, Akihiro

2015-01-01

The United Nations Relief and Works Agency for Palestine refugees in the Near East (UNRWA) has periodically estimated infant mortality rates among Palestine refugees in Gaza. These surveys have recorded a decline from 127 per 1000 live births in 1960 to 20.2 in 2008. We used the same preceding-birth technique as in previous surveys. All multiparous mothers who came to the 22 UNRWA health centres to register their last-born child for immunization were asked if their preceding child was alive or dead. We based our target sample size on the infant mortality rate in 2008 and included 3128 mothers from August until October 2013. We used multiple logistic regression analyses to identify predictors of infant mortality. Infant mortality in 2013 was 22.4 per 1000 live births compared with 20.2 in 2008 (p = 0.61), and this change reflected a statistically significant increase in neonatal mortality (from 12.0 to 20.3 per 1000 live births, p = 0.01). The main causes of the 65 infant deaths were preterm birth (n = 25, 39%), congenital anomalies (n = 19, 29%), and infections (n = 12, 19%). Risk factors for infant death were preterm birth (OR 9.88, 3.98-24.85), consanguinity (2.41, 1.35-4.30) and high-risk pregnancies (3.09, 1.46-6.53). For the first time in five decades, mortality rates have increased among Palestine refugee newborns in Gaza. The possible causes of this trend may include inadequate neonatal care. We will estimate infant and neonatal mortality rates again in 2015 to see if this trend continues and, if so, to assess how it can be reversed.

The detection of phosphorus in the tissue of bomb victims in Gaza.

PubMed

Thomsen, Jørgen L; Worm-Leonhard, Martin

2010-01-01

One of the authors went on a fact finding mission to Gaza immediately after the termination of the Israeli invasion. One of the allegations towards the invading Israeli army was the use of phosphorus bombs. The author was able to take samples of tissue from burn victims. Attempts were made to demonstrate the presence of phosphorus in the burn wounds. Using histology and Raman spectroscopy it was found with a high degree of probability that phosphorus was present, although it was not proven with absolute certainty.

An EMIS for Palestine: The Education Management Information System in the West Bank and Gaza Strip.

ERIC Educational Resources Information Center

Sultana, Ronald G.

2002-01-01

Describes the introduction of an Education Management and Information System in the West Bank and Gaza Strip (led by the Palestinian Ministry of Education) in terms of educational goals targeted, usefulness of this system for rational organization and management of an educational system, and the impact of the availability and sound use of data on…

Difficulties Students Face in Understanding Drama in English Literature at the Islamic University of Gaza (IUG)

ERIC Educational Resources Information Center

Shakfa, Mahmoud Dawoud Ali

2012-01-01

The present paper explores the problems of English Language and Literature junior and senior majors, who are enrolled in a drama course at the Islamic University of Gaza (IUG). The course emphasizes the significance of drama. Morgan (1987: 7) defines drama as an "art of communication," which is essential in teaching literature. A survey…

Prevalence of metabolic syndrome and associated socioeconomic and demographic factors among Palestinian adults (20-65 years) at the Gaza Strip.

PubMed

Sirdah, Mahmoud M; Al Laham, Nahed A; Abu Ghali, Asmaa S

2011-01-01

Metabolic syndrome (MetS) is a multifaceted syndrome and has been described as a clustering of several risk factors for cardiovascular disease. This study was conducted to estimate the prevalence of MetS and its individual components among Palestinian adults, 20-65 years old in Gaza Strip. In addition to find any possible associations with socioeconomic and demographic factors. The study sample included 230 adults aged 20-65 years. Data were collected by questionnaire interviews, anthropometrics, and biochemical analysis that included: serum glucose, total cholesterol, triglyceride, HDL, and LDL. MetS was defined according to the NCEP/ATP III diagnostic criteria. Overall prevalence of MetS was 23.0% among the study subjects, with no significant differences between males (18.1%) and females (28.1%). The prevalence of MetS increased significantly with age and was associated significantly with physical activity and martial status, while no significant associations were found with household income; geographical locality; smoking; watching TV; or family history. Age, sex, physical activity and marital status are risk factors independently associated with MetS in the Palestinian population at the Gaza Strip. National health awareness and preventive programs should be established aiming at decreasing of MetS trends in the Palestinian population at Gaza Strip. Copyright © 2012 Diabetes India. Published by Elsevier Ltd. All rights reserved.

Birth Defects in Gaza: Prevalence, Types, Familiarity and Correlation with Environmental Factors

PubMed Central

Naim, Awny; Al Dalies, Hedaya; El Balawi, Mohammed; Salem, Eman; Al Meziny, Kholud; Al Shawwa, Raneem; Minutolo, Roberto; Manduca, Paola

2012-01-01

This is the first report of registration at birth, and of incidence of major structural birth defects (BD) obtained in Gaza at Al Shifa Hospital, where 28% of total births in Gaza Strip occur. Doctors registered 4,027 deliveries, with a protocol comprehensive of clinical, demographic, kin and environmental questions. Prevalence of BD is 14/1,000, without association with intermarriage or gender of the child. Prevalence of late miscarriages and still births are respectively 23.3/1,000 and 7.4/1,000, and of premature births 19.6/1,000. Couples with a BD child have about 10 times higher frequency of recurrence of a BD in their progeny than those with normal children, but none of their 694 siblings and only 10/1,000 of their 1,423 progeny had BD, similar to the frequency in general population. These data suggest occurrence of novel genetic and epigenetic events in determination of BD. Children with BD were born with higher frequency (p < 0 001) in families where one or both parents were under “white phosphorus” attack, that in the general population. Bombing of the family home and removal of the rubble were also frequently reported by couples with BD occurrence. These data suggests a causative/favoring role of acute exposure of parents to the weapons-associated contaminants, and/or of their chronic exposure from their persistence in the environment on the embryonic development of their children. PMID:22754469

Increasing Neonatal Mortality among Palestine Refugees in the Gaza Strip

PubMed Central

van den Berg, Maartje M.; Madi, Haifa H.; Khader, Ali; Hababeh, Majed; Zeidan, Wafa’a; Wesley, Hannah; Abd El-Kader, Mariam; Maqadma, Mohamed; Seita, Akihiro

2015-01-01

Background The United Nations Relief and Works Agency for Palestine refugees in the Near East (UNRWA) has periodically estimated infant mortality rates among Palestine refugees in Gaza. These surveys have recorded a decline from 127 per 1000 live births in 1960 to 20.2 in 2008. Methods We used the same preceding-birth technique as in previous surveys. All multiparous mothers who came to the 22 UNRWA health centres to register their last-born child for immunization were asked if their preceding child was alive or dead. We based our target sample size on the infant mortality rate in 2008 and included 3128 mothers from August until October 2013. We used multiple logistic regression analyses to identify predictors of infant mortality. Findings Infant mortality in 2013 was 22.4 per 1000 live births compared with 20.2 in 2008 (p = 0.61), and this change reflected a statistically significant increase in neonatal mortality (from 12.0 to 20.3 per 1000 live births, p = 0.01). The main causes of the 65 infant deaths were preterm birth (n = 25, 39%), congenital anomalies (n = 19, 29%), and infections (n = 12, 19%). Risk factors for infant death were preterm birth (OR 9.88, 3.98–24.85), consanguinity (2.41, 1.35–4.30) and high-risk pregnancies (3.09, 1.46–6.53). Conclusion For the first time in five decades, mortality rates have increased among Palestine refugee newborns in Gaza. The possible causes of this trend may include inadequate neonatal care. We will estimate infant and neonatal mortality rates again in 2015 to see if this trend continues and, if so, to assess how it can be reversed. PMID:26241479

British Council, Work-Based Learning Research Centre and Islamic University Gaza E-Learning Workshop: Five Years on

ERIC Educational Resources Information Center

Basiel, Anthony; Commins, Ralph

2010-01-01

This article describes the process for training Palestinians in Gaza on developing e-learning courses using WebCT. The training was delivered at a distance using information and communications technologies. The project used a problem-based approach to introduce e learning concepts and practice for the pedagogy of online content, learning theory,…

The effects of the Israeli siege on health provision in the Gaza Strip: a qualitative and theoretical analysis.

PubMed

Smith, Ron J

2018-02-21

Siege, a process of political domination aimed at isolating an entire population, is a unique threat to health-care provision. The aim of this study was to qualitatively examine the effects of the Israeli siege on the practices and systems that underlie health in the Gaza Strip. Data were from participant observation between 2009 and 2017, including 20 interviews with doctors and health administrators in non-governmental organisations (NGO), government, and UN sectors. All participants were provided with a description of the study and provided written consent to participate. The study was approved through the Human Subjects Review process at Bucknell University and the University of Washington. The data were analysed using a critical political economic framework, based on the concepts of primitive accumulation, accumulation by dispossession, surplus populations, and de-development. These analytical frames are further developed to interpret neoliberal trends in health-care systems organising and financing as they apply in the distorted social and economic context of siege. The elimination of political sovereignty through the twin processes of occupation and siege are the primary impediments to the successful promotion of public health in the Gaza Strip. Findings indicate that siege impinges on effective health-care provision by withholding materials and resources and undermining the health care at a systems level. These strains pose considerable threats to health care, within the ministry of health and among other entities in the Gaza Strip that deliver care. Gazan society is divested of the underpinnings necessary for a well functioning sovereign health-care infrastructure. Instead of a self-governing, independent system, this analysis reveals a system that is comprised of captive clients who are entirely dependent on Israel, international bodies, and the aid industry for goods and services, with no means of independent development. The siege represents a

MRSA clonal complex 22 strains harboring toxic shock syndrome toxin (TSST-1) are endemic in the primary hospital in Gaza, Palestine.

PubMed

Al Laham, Nahed; Mediavilla, José R; Chen, Liang; Abdelateef, Nahed; Elamreen, Farid Abu; Ginocchio, Christine C; Pierard, Denis; Becker, Karsten; Kreiswirth, Barry N

2015-01-01

Methicillin-resistant Staphylococcus aureus (MRSA) is an important pathogen in both community and healthcare-related settings worldwide. Current knowledge regarding the epidemiology of S. aureus and MRSA in Gaza is based on a single community-based carriage study. Here we describe a cross-sectional analysis of 215 clinical isolates collected from Al-Shifa Hospital in Gaza during 2008 and 2012. All isolates were characterized by spa typing, SCCmec typing, and detection of genes encoding Panton-Valentine leukocidin (PVL) and toxic shock syndrome toxin (TSST-1). Representative genotypes were also subjected to multilocus sequence typing (MLST). Antibiotic susceptibility testing was performed using VITEK2 and MicroScan. MRSA represented 56.3% of all S. aureus strains, and increased in frequency from 2008 (54.8%) to 2012 (58.4%). Aside from beta-lactams, resistance was observed to tetracycline, erythromycin, clindamycin, gentamicin, and fluoroquinolones. Molecular typing identified 35 spa types representing 17 MLST clonal complexes (CC), with spa 998 (Ridom t223, CC22) and spa 70 (Ridom t044, CC80) being the most prevalent. SCCmec types I, III, IV, V and VI were identified among MRSA isolates, while type II was not detected. PVL genes (lukF/S-PV) were detected in 40.0% of all isolates, while the TSST-1 gene (tst) was detected in 27.4% of all isolates, with surprisingly high frequency within CC22 (70.4%). Both PVL and TSST-1 genes were found in several isolates from 2012. Molecular typing of clinical isolates from Gaza hospitals revealed unusually high prevalence of TSST-1 genes among CC22 MRSA, which is noteworthy given a recent community study describing widespread carriage of a CC22 MRSA clone known as the 'Gaza strain'. While the latter did not address TSST-1, tst-positive spa 998 (Ridom t223) has been detected in several neighboring countries, and described as endemic in an Italian NICU, suggesting international spread of a 'Middle Eastern variant' of pandemic CC22

Genomic Characterization of VIM Metallo-β-Lactamase-Producing Alcaligenes faecalis from Gaza, Palestine.

PubMed

Al Laham, Nahed; Chavda, Kalyan D; Cienfuegos-Gallet, Astrid V; Kreiswirth, Barry N; Chen, Liang

2017-11-01

Carbapenemase-producing Gram-negative bacteria (CP-GNB) have increasingly spread worldwide, and different families of carbapenemases have been identified in various bacterial species. Here, we report the identification of five VIM metallo-β-lactamase-producing Alcaligenes faecalis isolates associated with a small outbreak in a large hospital in Gaza, Palestine. Next-generation sequencing analysis showed bla VIM-2 is harbored by a chromosomal genomic island among three strains, while bla VIM-4 is carried by a novel plasmid in two strains. Copyright © 2017 American Society for Microbiology.

Managing water and salinity with desalination, conveyance, conservation, waste-water treatment and reuse to counteract climate variability in Gaza

NASA Astrophysics Data System (ADS)

Rosenberg, D. E.; Aljuaidi, A. E.; Kaluarachchi, J. J.

2009-12-01

We include demands for water of different salinity concentrations as input parameters and decision variables in a regional hydro-economic optimization model. This specification includes separate demand functions for saline water. We then use stochastic non-linear programming to jointly identify the benefit maximizing set of infrastructure expansions, operational allocations, and use of different water quality types under climate variability. We present a detailed application for the Gaza Strip. The application considers building desalination and waste-water treatment plants and conveyance pipelines, initiating water conservation and leak reduction programs, plus allocating and transferring water of different qualities among agricultural, industrial, and urban sectors and among districts. Results show how to integrate a mix of supply enhancement, conservation, water quality improvement, and water quality management actions into a portfolio that can economically and efficiently respond to changes and uncertainties in surface and groundwater availability due to climate variability. We also show how to put drawn-down and saline Gaza aquifer water to more sustainable and economical use.

Prevalence and Associated Factors for Dual Form of Malnutrition in Mother-Child Pairs at the Same Household in the Gaza Strip-Palestine.

PubMed

El Kishawi, Rima Rafiq; Soo, Kah Leng; Abed, Yehia Awad; Wan Muda, Wan Abdul Manan

2016-01-01

In many developing countries nutritional, and epidemiological transitions are emerging into continuing undernutrition and escalating overnutrition, giving rise to the double burden of the malnutrition phenomenon. This study aims to determine the prevalence of the dual form of malnutrition (overweight mother/underweight child) in the same household and its associated factors in the Gaza Strip. A total of 357 mother-child pairs from the same households were surveyed from three different geographical locations in the Gaza Strip, namely, El Remal urban area, Jabalia refugee camp, and Al Qarara rural area. The height and weight of mothers aged 18-50 years were measured, and their body mass index (BMI) was computed. The mothers were categorized according to the criterion of the World Health Organization (WHO) for BMI as overweight if they have a BMI ≥ 25 kg/m2. Anthropometric indices were measured for children aged two to five years to classify the underweight children Z-score <-1. The results showed the prevalence of the dual form of malnutrition in the Gaza Strip was 15.7%, and its associated factors were child's birth order (ORadj, 1.50, 95% CL, 1.22, 1.82; p = <0.001), father's educational (low or medium) levels (ORadj, 3.19, 95% CL, 1.07, 9.5; p = 0. 036), or (ORadj, 3.4, 95% CL, 1.12, 10.37; p = 0. 031), high scores of mothers' nutrition knowledge (ORadj, 1.23, 95% CL, 1.01, 1.52; p = 0. 048), and low monthly income (ORadj, 0.28, 95% CL, 0.09, 0.88; p = 0. 030). The results from this study showed the dual form of malnutrition in the same household was prevalent in the Gaza Strip. This is a public health issue that must be understood and addressed and policy makers must implement an appropriate nutrition action plan to control dual form of malnutrition based on the underlying specific risk factors in the study population. In addition, interventions are needed to help individuals to translate their nutrition knowledge into healthy dietary behaviors.

The reliability of the National Cholesterol Education Program's Adult Treatment Panel III (NCEP/ATP III) and the International Diabetes Federation (IDF) definitions in diagnosing metabolic syndrome (MetS) among Gaza Strip Palestinians.

PubMed

Sirdah, Mahmoud M; Abu Ghali, Asmaa S; Al Laham, Nahed A

2012-01-01

Metabolic syndrome (MetS) which is a multifaceted syndrome, has been demonstrated as a common precursor for developing cardiovascular diseases and/or type 2 diabetes mellitus. Different diagnostic definitions for MetS have been proposed and recommended. We set up to evaluate the reliabilities of the National Cholesterol Education Program's Adult Treatment Panel III (NCEP/ATP III) and the International Diabetes Federation (IDF) definitions in diagnosing MetS among Gaza Strip Palestinians. This cross sectional study involved a randomly selected two hundred and thirty apparently healthy adults from the Gaza Strip. Anthropometric measurements, blood pressure, fasting plasma glucose, lipid profile, and questionnaire interviews were performed. The overall prevalence of MetS in our Gaza Strip cohort was 23.0% and 39.5% according to NCEP/ATP III and IDF definitions respectively (p<0.001). No significant differences were seen in the number of MetS components in individuals having MetS by either definition (mean 3.42 ± 0.63 vs 3.52 ± 0.69 respectively, p=0.865). Both IDF and NCEP/ATP III showed an increased prevalence of MetS with age, and body mass index (BMI), however they revealed different prevalence trends with sex. Except for BMI, there were no significant differences in the general and metabolic related characteristics between subjects with MetS of IDF and NCEP/ATP III definitions. Independently of the definition used, MetS is highly prevalent in Gaza Strip population, with a steady increase in MetS prevalence through age and BMI. The IDF definition tends to give higher values for MetS prevalence, and therefore could be more appropriate for diagnosing MetS in Gaza Strip cohort. Copyright © 2012 Diabetes India. Published by Elsevier Ltd. All rights reserved.

Prevalence and Associated Factors for Dual Form of Malnutrition in Mother-Child Pairs at the Same Household in the Gaza Strip-Palestine

PubMed Central

El Kishawi, Rima Rafiq; Soo, Kah Leng; Abed, Yehia Awad; Wan Muda, Wan Abdul Manan

2016-01-01

Background In many developing countries nutritional, and epidemiological transitions are emerging into continuing undernutrition and escalating overnutrition, giving rise to the double burden of the malnutrition phenomenon. Objectives This study aims to determine the prevalence of the dual form of malnutrition (overweight mother/underweight child) in the same household and its associated factors in the Gaza Strip. Methods A total of 357 mother-child pairs from the same households were surveyed from three different geographical locations in the Gaza Strip, namely, El Remal urban area, Jabalia refugee camp, and Al Qarara rural area. The height and weight of mothers aged 18–50 years were measured, and their body mass index (BMI) was computed. The mothers were categorized according to the criterion of the World Health Organization (WHO) for BMI as overweight if they have a BMI ≥ 25 kg/m2. Anthropometric indices were measured for children aged two to five years to classify the underweight children Z-score <-1. Results The results showed the prevalence of the dual form of malnutrition in the Gaza Strip was 15.7%, and its associated factors were child’s birth order (ORadj, 1.50, 95% CL, 1.22, 1.82; p = <0.001), father’s educational (low or medium) levels (ORadj, 3.19, 95% CL, 1.07, 9.5; p = 0. 036), or (ORadj, 3.4, 95% CL, 1.12, 10.37; p = 0. 031), high scores of mothers' nutrition knowledge (ORadj, 1.23, 95% CL, 1.01, 1.52; p = 0. 048), and low monthly income (ORadj, 0.28, 95% CL, 0.09, 0.88; p = 0. 030). Conclusions The results from this study showed the dual form of malnutrition in the same household was prevalent in the Gaza Strip. This is a public health issue that must be understood and addressed and policy makers must implement an appropriate nutrition action plan to control dual form of malnutrition based on the underlying specific risk factors in the study population. In addition, interventions are needed to help individuals to translate their nutrition

Dietary Patterns and Metabolic Syndrome among Type 2 Diabetes Patients in Gaza Strip, Palestine.

PubMed

El Bilbeisi, Abdel Hamid; Hosseini, Saeed; Djafarian, Kurosh

2017-05-01

The prevalence of metabolic syndrome is raising worldwide; however, the role of diet in the origin of metabolic syndrome is not understood well. This study identifies major dietary patterns among type 2 diabetes mellitus patients with and without metabolic syndrome; and its association with metabolic syndrome components in Gaza Strip, Palestine. This cross sectional study was conducted among 1200 previously diagnosed type 2 diabetes mellitus (both genders, aged 20 - 64 years) patients receiving care in primary healthcare centers in Gaza Strip, Palestine. Metabolic syndrome was defined based on the International Diabetes Federation criteria; dietary patterns were evaluated using a validated semi-quantitative food frequency questionnaire. Statistical analysis was performed using SPSS version 20. Two major dietary patterns were identified by factor analysis: Asian-like pattern and sweet-soft drinks-snacks pattern. After adjustment for confounding variables, patients in the highest tertile of the Asian-like pattern characterized by a high intake of whole grains, potatoes, beans, legumes, vegetables, tomatoes and fruithad a lower odds for (Metabolic syndrome, central obesity, high triglycerides, low HDL cholesterol and high blood pressure), (OR 0.766 CI 95% (.642-.914)), (OR 0.797 CI 95% (.652-.974)), (OR 0.791 CI 95% (.687-.911)), (OR 0.853 CI 95% (.743-.978)) and (OR 0.815 CI 95% (.682-.973)) respectively, (P value < 0.05 for all). No significant association was found between the sweet-soft drinks-snacks pattern with metabolic syndrome and its components. The Asian-like pattern may be associated with a lower prevalence of metabolic syndrome and its components among type 2 diabetes patients.

Calpain-10 gene polymorphism in type 2 diabetes mellitus patients in the Gaza Strip.

PubMed

Zaharna, Mazen M; Abed, Abdalla A; Sharif, Fadel A

2010-01-01

To examine the role of calpain-10 SNP-44, -43, -63 and del/ins-19 in genetic susceptibility to type 2 diabetes mellitus (T2DM) and associations with triglycerides and total cholesterol in a group of subjects residing in the Gaza Strip. Ninety-six individuals were examined: 48 T2DM patients and 48 controls. The groups were genotyped for calpain-10 SNP-44, -43, -63, and del/ins-19. Mutagenically separated polymerase chain reaction was used to examine SNP-44; del/ins-19 was examined by electrophoresis of the PCR product on agarose gel, while the restriction fragment length polymorphism method was used for SNP-43 and -63. There was evidence that the C allele at SNP-44 played a possible role in susceptibility to T2DM (p = 0.01). T2DM patients with G/A genotype were found to have higher levels of total cholesterol in comparison to those homozygous for allele 1 (G/G) in SNP-43. Total cholesterol levels increased in T2DM patients who are homozygous for del/ins-19 allele 2, in T2DM patients with the 121/221 haplotype combination, and in control subjects with the haplotype combination 111/121. SNP-44 polymorphism of the calpain-10 gene has a significant association with T2DM patients in the Gaza strip. Certain polymorphisms of calpain-10 also have associations with the levels of total cholesterol in both T2DM patients and controls. Copyright © 2010 S. Karger AG, Basel.

Quality of life, primary traumatisation, and positive and negative affects in primary school students in the Gaza Strip.

PubMed

Veronese, Guido; Pepe, Alessandro; Almurnak, Feda; Jaradah, Alaa; Hamdouna, Husam

2018-02-21

Many researchers have reported that exposure to war and ongoing political violence increases mental health problems in children. Results of studies have also shown a high prevalence (58-80%) of post-traumatic stress disorder in war-affected children living in the occupied Palestinian territory. The aim of this study was to estimate the direct and indirect effects of perceived life satisfaction on the consequences of children's exposure to trauma and the balance of positive and negative affect. Palestinian children were recruited from primary schools in four refugee camps in the Gaza Strip (Bureij, Gaza Beach Camp, Jabalia, Rafah). All children had been involved in or witnessed one or more episodes of violence involving other people in the 2 months prior to the study (the 2012 Gaza War). We used the Multidimensional Students Life Satisfaction Scale (peers, self, living environment, school, family), the Positive and Negative Affect Scale for Children, and the revised Children Impact of Events scale (intrusion and avoidance symptoms) to test (through structural equation modelling) the moderation effect of life satisfaction on war trauma via positive emotions. 1276 Palestinian children were enrolled in this study. The model tested with structural equation modelling was robust. Children's life satisfaction influenced both the intrusion (β=-0·48; p=0.003) and avoidance (β=-11; p=0·021) effects of primary traumatisation. The consequences of primary traumatisation by intrusion (β=0·34; p=0·008) and avoidance (β=0·27; p=0.011) contributed to increasing negative affect. Finally, perceived life satisfaction had direct effects on affective experience, specifically increasing positive affect and diminishing negative affect. Perceived quality of life in children has a role in controlling war-related traumas. Life satisfaction contributes both directly and indirectly to change affectivity. When children perceive themselves to be highly satisfied with their home and

Possible risk factors associated with burn wound colonization in burn units of Gaza strip hospitals, Palestine

PubMed Central

Al Laham, N.A.; Elmanama, A.A.; Tayh, G.A.

2013-01-01

Summary The epidemiological pattern and risk factors of burns and burn infections varies widely in different parts of the world. This study aims to determine the epidemiologic pattern of burn injuries and possible risk factors associated with burn infections in burn units of Gaza strip hospitals. A total of 118 patients were included in the study. The data collected included: patient age and gender, the causes, site, degree, and TBSA of the burns, as well as surgical operations, length of hospital stay, and microbiological profile of samples collected from patients, the environment, and from health care staff. Pediatric and adult patients accounted for 72% and 28% respectively. 58.5% of all patients were male and 41.5% were female. The most common etiological factors in children were scalding, while in adults these were open fire and flammable liquids. The mean TBSA was 12% with a range from 1–90%. Second and third degree burns accounted for 78% and 22% respectively. The area of the body most often affected was the torso (39%), followed by the lower limb (29.7%), and upper limb (17.8%). The predominant microorganisms isolated from burn wounds were Pseudomonas aeruginosa, Enterobacter spp. and Staphylococcus spp. The study showed the highest risk groups to be children and males, and enabled us to identify possible risk factors that can help in future efforts toward prevention and minimizing nosocomial infections in burn units of Gaza strip hospitals. PMID:24133399

Resilience and distress: Israelis respond to the disengagement from Gaza and the second Lebanese war.

PubMed

Ben-Zur, Hasida; Gilbar, Ora

2011-10-01

Resilience and distress in Israeli society were assessed at three points in time: before and after the Israeli disengagement from Gaza, and after the second Lebanese war. A random sample of 366 Israelis was assessed for nation-related anxiety and hostility, personal resources and post-traumatic symptoms. The lowest levels of anxiety were observed at the second time point, after the disengagement. Respondents with high-resilience profiles showed lower levels of post-traumatic symptoms and higher levels of personal resources. The findings underscore Israelis' resilience and the importance of personal resources in ongoing nationally stressful situations.

The ’Irreversibility’ of Israel’s Annexation of the West Bank and Gaza Strip: A Critical Evaluation.

DTIC Science & Technology

1985-10-01

to the West Bank - 22 - and Gaza Strip warrant the conclusion that political initiatives based on the presumption that Israeli withdrawal is feasible...with the possible and important exception of East Jerusalem, the second, psycho-cultural threshold, has not yet been crossed. An ingrained presumption ...HQ USAF/IN Washington, D.C. 20330 AFSAC/ INOC Fort Belvoir, VA 22060-5788 Commandant USAF Academy Colorado Springs, CO 80914 AFIS/DPT Fort Belvoir, VA

Post-Traumatic Stress Disorder Among Health Care Providers Following the Israeli Attacks Against Gaza Strip in 2014: A Call for Immediate Policy Actions.

PubMed

Abu-El-Noor, Nasser Ibrahim; Aljeesh, Yousef Ibrahim; Radwan, AbdalKarim Said; Abu-El-Noor, Mysoon Khalil; Qddura, Ibrahim Abdel-Ilhady; Khadoura, Khalid Jamal; Alnawajha, Samer Khader

2016-04-01

This study aimed to assess the level of posttraumatic stress disorder and to examine the relationship between exposure to war stress and posttraumatic symptoms among health care providers following Israeli offensives against Gaza Strip in 2014. A cross-sectional design was used for this study. We targeted all nurses and doctors working in three governmental hospitals in the Gaza Strip and worked with victims of the last war, more specifically, those who were working in emergency departments, intensive care units, operating rooms, surgical departments, and burn units. A demographic sheet and Impact Event Scale-Revised were used in this study. The Impact Event Scale-Revised has three sub-scales; intrusion, avoidance, and hyper-arousal. The results showed that 291 (89.8%) of 324 participants had scores more than 35 (threshold cut-off point) on the Impact Event Scale-Revised. Scores ranged from zero to 80 with a mean of 52.13. Females had higher levels of stress (55.79) than males (51.63) and nurses (54.85) had more stress than physicians (47.38). The most frequent symptoms of trauma subscales was "avoidance" (mean=20.04), followed by "intrusion" (mean=17.83), and then "hyper-arousal" (mean=14.27). Levels of trauma symptoms were not affected by place of living, hospital of work, while level of education had impacted level of trauma. The findings showed that health care providers suffered from severe posttraumatic symptoms after exposure to prolonged war stress. This level of trauma among health care providers warrants intervention programs to reduce stress and trauma among Gaza health care providers after the war. Copyright © 2015 Elsevier Inc. All rights reserved.

Health journalism in the service of power: 'moral complacency' and the Hebrew media in the Gaza-Israel conflict.

PubMed

Birenbaum-Carmeli, Daphna

2014-05-01

The power of health news as a vehicle in the production of meaning in the service of power is the core of this article. Tracking the media coverage of a medical service, it shows how a routine practice can be invoked at a time of armed conflict so as to enhance a benevolent state image. The case at hand is the medical treatment of Gaza children in Israeli hospitals. A series of Internet searches revealed a group of publications on the subject in the Hebrew media, during and shortly after Israel's assault on Gaza in the winter of 2008-2009. In the press articles the treatments were invariably constituted as the epitome of Israel's compassion towards the enemy's children. This image relied, however, on a simultaneous silencing of other aspects of these treatments, which would have challenged this image. The monolithic depictions give rise to the notion of reversed moral panic or 'moral complacency', wherein the media amplifies a little-known social phenomenon into an epitome of societal values and charges it with significance on a national scale. The article ends with considering some features that possibly render health news an especially convenient domain for state-supportive media presentations. © 2014 The Author. Sociology of Health & Illness © 2014 Foundation for the Sociology of Health & Illness/John Wiley & Sons Ltd.

Microbial contamination of the drinking water distribution system and its impact on human health in Khan Yunis Governorate, Gaza Strip: seven years of monitoring (2000-2006).

PubMed

Abu Amr, S S; Yassin, M M

2008-11-01

To assess total and faecal coliform contamination in water wells and distribution networks over the past 7 years, and their association with human health in Khan Yunis Governorate, Gaza Strip. Historical data and interview questionnaire. Data were obtained from the Palestinian Ministry of Health on total and faecal coliform contamination in water wells and distribution networks, and on the incidence of water-related diseases in Khan Yunis Governorate. An interview questionnaire was conducted with 210 residents of Khan Yunis Governorate. Total and faecal coliform contamination exceeded the World Health Organization's limit for water wells and networks. However, the contamination percentages were higher in networks than in wells. Diarrhoeal diseases were strongly correlated with faecal coliform contamination in water networks (r=0.98). This is consistent with the finding that diarrhoeal diseases were the most common self-reported diseases among the interviewees. Such diseases were more prevalent among subjects who drank municipal water than subjects who drank desalinated or home-filtered water (odds ratio=2.03). Intermittent water supply, insufficient chlorination and sewage flooding seem to be associated with self-reported diseases. Residents in the Gaza Strip have a good level of knowledge about drinking water contamination, and this is reflected in good practice. Water quality has deteriorated in the Gaza Strip, and this may contribute to the prevalence of water-related diseases. Self-reported diseases among interviewees in Khan Yunis Governorate were associated with source of drinking water, intermittent water supply, insufficient chlorination, sewage flooding and age of water networks.

Demonstration of the Effectiveness of Augmented Reality Telesurgery in Complex Hand Reconstruction in Gaza

PubMed Central

Luck, Joshua; Billingsley, Michael L.; Heyes, Richard; Smith, Oliver J.; Mosahebi, Afshin; Khoussa, Abu; Abu-Sittah, Ghassan; Hachach-Haram, Nadine

2018-01-01

Summary: Augmented reality (AR) is defined as “a technology that superimposes a computer-generated image on a user’s view of the real world, thus providing a composite view.”1 This case report describes how emerging AR telesurgery technologies may be used to facilitate international surgeon–surgeon collaboration and training. Here, we illustrate how a remote surgeon in Beirut, Lebanon, was able to offer assistance to a surgeon in Gaza, Palestine, during a complex hand reconstruction case following a bomb-blast injury in an 18-year-old male. We discuss the implications of AR technology on the future of global surgery and how it may be used to reduce structural inequities in access to safe surgical care. PMID:29707463

Health-related quality of life of Palestinian preschoolers in the Gaza Strip: a cross-sectional study

PubMed Central

2011-01-01

Background Research on children's responses to wartime trauma has mostly addressed Post-Traumatic Stress Disorder (PTSD). However, PTSD is only one aspect of a complex set of responses. This study proposes to expand knowledge of well-being in children exposed to political violence through widening the conceptualization of well-being beyond PTSD, morbidity, and mortality by measuring health-related quality of life (HRQOL) and its facets, physical health, and psychosocial health. Methods In 2007, we used a cross-sectional random sample of kindergartens to examine factors associated with HRQOL, as measured by the PedsQL 4.0, in 350 preschoolers in the Gaza Strip, Palestine, where political violence and deprivation are widespread. Results About 65% of the mothers reported severely impaired psychosocial and emotional functioning in their children. Preschoolers had lower HRQOL than the US reference sample and samples of children in other low income countries with large effect size. HRQOL was comparable to those of US children with several chronic diseases. Factors associated with lower HRQOL were older child age, male gender, and more exposures to traumatic events. Factors associated with HRQOL subscales were for lower psychosocial health: older child age, history of food, water, and electricity deprivation during incursion, and witnessing assassination of people by rockets. For lower physical health: older child age, history of food, water, and electricity deprivation during incursion, and having heard of a killing of a friend by soldiers. Conclusions HRQOL, including psychosocial health and emotional functioning is often severely impaired among preschoolers in the Gaza Strip. Exposure to both violent and non-violent negative events was associated with HRQOL in preschoolers. PMID:21510877

Assessment of health-care waste management in a humanitarian crisis: A case study of the Gaza Strip.

PubMed

Caniato, Marco; Tudor, Terry Louis; Vaccari, Mentore

2016-12-01

Health-care waste management requires technical, financial and human resources, and it is a challenge for low- and middle income countries, while it is often neglected in protracted crisis or emergency situations. Indeed, when health, safety, security or wellbeing of a community is threatened, solid waste management usually receives limited attention. Using the Gaza Strip as the case study region, this manuscript reports on health-care waste management within the context of a humanitarian crisis. The study employed a range of methods including content analyses of policies and legislation, audits of waste arisings, field visits, stakeholder interviews and evaluation of treatment systems. The study estimated a production from clinics and hospitals of 683kg/day of hazardous waste in the Gaza Strip, while the total health-care waste production was 3357 kg/day. A number of challenges was identified including lack of clear definitions and regulations, limited accurate data on which to base decisions and strategies and poor coordination amongst key stakeholders. Hazardous and non-hazardous waste was partially segregated and treatment facilities hardly used, and 75% of the hazardous waste was left untreated. Recommendations for mitigating these challenges posed to patients, staff and the community in general are suggested. The outputs are particularly useful to support decision makers, and re-organize the system according to reliable data and sound assumptions. The methodology can be replicated in other humanitarian settings, also to other waste flows, and other sectors of environmental sanitation. Copyright © 2016 Elsevier Ltd. All rights reserved.

The Association between Physical Activity and the Metabolic Syndrome among Type 2 Diabetes Patients in Gaza Strip, Palestine.

PubMed

El Bilbeisi, Abdel Hamid; Hosseini, Saeed; Djafarian, Kurosh

2017-05-01

Metabolic syndrome is a major health problem worldwide. Globally, the World Health Organization identified physical inactivity as the fourth leading risk factor for mortality. This study was conducted to evaluate the association between physical activities and metabolic syndrome and diabetes complications among type 2 diabetes patients in Gaza Strip, Palestine. This cross-sectional study was conducted among 1200 previously diagnosed type 2 diabetes mellitus patients (from both genders, aged 20 to 64 years) receiving care in the primary health care centers. Metabolic syndrome was defined based on the International Diabetes Federation criteria. The International Physical Activity Questionnaire was used to measure physical activity. Statistical analysis was performed using SPSS version 20. A significant inverse association was found between inactive patients and metabolic syndrome. In our study, 93.7% of inactive patients, 66.4% of active patients and 23.5% of very active patients had metabolic syndrome (OR .048 CI 95% (.03-.072)), (OR .787 CI 95% (.59-1.03)) and (OR 15.9 CI 95% (11.8-21.3)) respectively. Our results showed a significant inverse association between physical activity levels and anthropometric measurements in both gender. Moreover, a significant association was found between physical activity levels and triglycerides, HDL-cholesterol and blood pressure in both sexes (P value < 0.05 for all) and diabetes complications (P value < 0.05 for all). We conclude that low levels of physical activity are associated with increased prevalence of metabolic syndrome. Furthermore, inactive patients had a high percentage of diabetes complications among type 2 diabetes patients in Gaza Strip, Palestine.

Theoretical Evaluation of Electromagnetic Emissions from GSM900 Mobile Telephony Base Stations in the West Bank and Gaza Strip-Palestine.

PubMed

Lahham, Adnan; Alkbash, Jehad Abu; ALMasri, Hussien

2017-04-20

Theoretical assessments of power density in far-field conditions were used to evaluate the levels of environmental electromagnetic frequencies from selected GSM900 macrocell base stations in the West Bank and Gaza Strip. Assessments were based on calculating the power densities using commercially available software (RF-Map from Telstra Research Laboratories-Australia). Calculations were carried out for single base stations with multiantenna systems and also for multiple base stations with multiantenna systems at 1.7 m above the ground level. More than 100 power density levels were calculated at different locations around the investigated base stations. These locations include areas accessible to the general public (schools, parks, residential areas, streets and areas around kindergartens). The maximum calculated electromagnetic emission level resulted from a single site was 0.413 μW cm-2 and found at Hizma town near Jerusalem. Average maximum power density from all single sites was 0.16 μW cm-2. The results of all calculated power density levels in 100 locations distributed over the West Bank and Gaza were nearly normally distributed with a peak value of ~0.01% of the International Commission on Non-Ionizing Radiation Protection's limit recommended for general public. Comparison between calculated and experimentally measured value of maximum power density from a base station showed that calculations overestimate the actual measured power density by ~27%. © The Author 2016. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Hemolysis and Mediterranean G6PD mutation (c.563 C>T) and c.1311 C>T polymorphism among Palestinians at Gaza Strip.

PubMed

Sirdah, Mahmoud; Reading, N Scott; Perkins, Sherrie L; Shubair, Mohammad; Aboud, Lina; Prchal, Josef T

2012-04-15

The G6PD c.563 C>T deficient mutation is endemic among Mediterranean populations but its clinical significance is not well delineated. We set up to estimate the proportion of G6PD deficient children presenting with hemolytic anemia at Al Nasser Pediatric Hospital at Gaza Strip, Palestine. We then established the prevalence of c.563T Mediterranean mutation and its linkage to c.1311 C>T polymorphism in this population. G6PD deficiency was identified in children presenting with hemolytic anemia at Al Nasser Pediatric Hospital by spectrophotometric measurement of G6PD activity. G6PD exon 6 and exon 11 were amplified from genomic DNA and evaluated for c.563T mutation by sequencing and the c.1311T polymorphism by restriction fragment analysis. Seventy X-chromosomes (60 males and 5 females) from G6PD deficient patients and 40 X-chromosomes from a control group known to be not G6PD deficient were tested. Over 80% of these children presenting with hemolytic anemia were G6PD deficient and 34% of these had the Mediterranean G6PD deficient variant. The allelic frequencies of Mediterranean c.563T and c.1311T polymorphisms among G6PD deficient patients were 0.33 and 0.38 respectively. The c.1311T polymorphism was linked in 95.2% of patients with the Mediterranean mutation, an allele frequency of 0.87, compared to the control non-G6PD deficient group with an allele frequency of 0.18. We conclude that G6PD deficiency accounts for majority of hemolytic anemia encountered in Gaza children treated at Al Nasser Pediatric Hospital Emergency department. The Mediterranean mutation c.563T, while not accounting for a majority of G6PD deficiency, is common among G6PD deficient Gaza Strip Palestinians and is frequently, but not always, linked to the c.1311T polymorphism. This work provides a foundation for the population screening of Palestinians for G6PD deficiency and for investigations of ancestral origin of the Mediterranean variant in world populations. Copyright © 2012 Elsevier Inc

First report of extended-spectrum β-lactamases among clinical isolates of Escherichia coli in Gaza Strip, Palestine.

PubMed

Tayh, Ghassan; Ben Sallem, Rym; Ben Yahia, Houssem; Gharsa, Haythem; Klibi, Naouel; Boudabous, Abdellatif; Ben Slama, Karim

2016-09-01

This study aimed to assess the occurrence of extended-spectrum β-lactamases (ESBLs) in clinical Escherichia coli isolates from Palestine and to characterise their type, genetic environments and associated resistance genes. Twenty-seven broad-spectrum-cephalosporin-resistant E. coli isolates were recovered between April and June 2013 in Gaza Strip hospitals. Characterisation of ESBL genes and their genetic environments, detection of associated resistance genes, and the presence and characterisation of integrons were performed by PCR and sequencing. The clonal relationship among ESBL-positive E. coli strains was determined by pulsed-field gel electrophoresis (PFGE) using the restriction enzyme XbaI. Phylogroup typing and virulence factors were studied by PCR. The following ESBL genes were identified: blaCTX-M-15 (21 isolates); blaCTX-M-14a (2 isolates); blaCTX-M-1 (2 isolates); blaCTX-M-3 (1 isolate); and blaCTX-M-27 (1 isolate). The blaTEM-1 gene was also detected in eight CTX-M-producing strains. The ISEcp1 sequence was found upstream of blaCTX-M in 23 isolates, and orf477 was found downstream of this gene in 24 isolates. IS903 was also detected downstream in three isolates. Six isolates carried class 1 integrons with the gene cassette arrangement dfrA17-aadA5. High clonal diversity was observed among the studied isolates by PFGE (24 unrelated profiles). The virulence gene fimA was detected in 23 isolates, the aer gene in 8 isolates and the papC gene in 7 isolates. The studied isolates belonged to phylogroups B2 (12 isolates), D (12 isolates) and A (3 isolates). This is the first report of the detection of CTX-M class β-lactamases in E. coli of clinical origin in Gaza Strip hospitals. Copyright © 2016 International Society for Chemotherapy of Infection and Cancer. Published by Elsevier Ltd. All rights reserved.

The relationships between family functioning and attachment orientations to post-traumatic stress symptoms among young adults who were evacuated from Gaza Strip settlements as adolescents.

PubMed

Zerach, Gadi; Tam, Elkanor

2016-01-01

This study examined post-traumatic stress disorder (PTSD) symptoms among young adults that were evicted from their residences in Gaza settlements ("Gush Katif") as adolescents and actively participated in the resistance events. Furthermore, we examined the moderating role of exposure to forced relocation on the association between attachment orientations and family functioning and PTSD symptoms. We conducted a correlative, cross-sectional study in 2013. Participants were Israeli evicted residents (ER group; N = 102), comparison groups of evicted nonresidents (ENR group; N = 27), and nonevicted nonresidents (NENR group; N = 53). All participants completed a battery of self-reported questionnaires. The ER group reported a higher number of PTSD symptoms as compared to the comparison groups. However, ER participants did not differ from ENR and NENR participants in their perception of family functioning. Importantly, the group (ER vs. NENR) moderated the association between attachment-anxiety and PTSD symptoms and between family adaptability and PTSD symptoms. Nine years after the forced relocation from Gaza settlements, young adults that were evicted from their residences as adolescents suffer from PTSD symptoms that are more related to the relocation itself than the stress entailed in the resistance events.

The nature of the Pleistocene-Holocene palaeosols in the Gaza Strip, Palestine

NASA Astrophysics Data System (ADS)

Ubeid, Khalid F.

2011-09-01

The Pleistocene to Holocene succession in the Gaza Strip, Palestine, consists of an alternation of calcareous sandstones and reddish fine-grained deposits (palaeosols). The palaeosols can be subdivided into two main groups based on the sand-sized versus clay- to silt-sized grains: (1) the sandy hamra palaeosols, and (2) the loess and loess-derived palaeosols. The hamra palaeosols can, in turn, also be subdivided into two main types according to their colour and grain size: (1) light brown loamy to sandy hamra palaeosols, and (2) dark brown sandy clay hamra palaeosols. The hamra palaeosols are polygenetic and originated in humid environments. Their red colour results from ferric oxides coating the sand grains, but also by illuviation. The various pedogenitic units and their gradual transition to loess palaeosols are due to different phases of dust accretion. Both groups of palaeosols developed during the last glacial. They are considered to represent different climate environments: hamra palaeosols represent humid climates, whereas the loess and loess-derived palaeosols represent dry and semi-dry climates.

Assessing the impacts of climate change in Mediterranean catchments under conditions of data scarcity - The Gaza case study

NASA Astrophysics Data System (ADS)

Gampe, David; Ludwig, Ralf

2013-04-01

According to current climate projections, Mediterranean countries are at high risk for an even pronounced susceptibility to changes in the hydrological budget and extremes. While there is scientific consensus that climate induced changes on the hydrology of Mediterranean regions are presently occurring and are projected to amplify in the future, very little knowledge is available about the quantification of these changes, which is hampered by a lack of suitable and cost effective hydrological monitoring and modeling systems. The European FP7-project CLIMB is aiming to analyze climate induced changes on the hydrology of the Mediterranean Basins by investigating seven test sites located in the countries Italy, France, Turkey, Tunisia, Gaza and Egypt. CLIMB employs a combination of novel geophysical field monitoring concepts, remote sensing techniques and integrated hydrologic modeling to improve process descriptions and understanding and to quantify existing uncertainties in climate change impact analysis. One of those seven sites is the Gaza Strip, located in the Eastern Mediterranean and part of the Palestinian Autonomous Area, covers an area of 365km² with a length of 35km and 6 to 12km in width. Elevation ranges from sea level up to 104m in the East of the test site. Mean annual precipitation varies from 235mm in the South to 420mm in the North of the area. The inter annual variability of rainfall and the rapid population growth in an highly agricultural used area represent the major challenges in this area. The physically based Water Simulation Model WaSiM Vers. 2 (Schulla & Jasper (1999)) is setup to model current and projected future hydrological conditions. The availability of measured meteorological and hydrological data is poor as common to many Mediterranean catchments. The lack of available measured input data hampers the calibration of the model setup and the validation of model outputs. WaSiM was driven with meteorological forcing taken from 4

Association of dietary patterns with diabetes complications among type 2 diabetes patients in Gaza Strip, Palestine: a cross sectional study.

PubMed

El Bilbeisi, Abdel Hamid; Hosseini, Saeed; Djafarian, Kurosh

2017-11-15

The prevalence of diabetes mellitus is rising worldwide. When diabetes is uncontrolled, it has dire consequences for health and well-being. However, the role of diet in the origin of diabetes complications is not understood well. This study identifies major dietary patterns among type 2 diabetes patients and its association with diabetes complications in Gaza Strip, Palestine. This cross sectional study was conducted among 1200 previously diagnosed type 2 diabetes mellitus (both genders, aged 20-64 years), patients receiving care in primary healthcare centers in Gaza Strip, Palestine. Dietary patterns were evaluated using a validated semi-quantitative food frequency questionnaire. Additional information regarding demographic and medical history variables was obtained with an interview-based questionnaire. Statistical analysis was performed using SPSS version 20. Two major dietary patterns were identified by factor analysis: Asian-like pattern and sweet-soft drinks-snacks pattern. After adjustment for confounding variables, patients in the lowest tertile of the Asian-like pattern characterized by a high intake of whole grains, potatoes, beans, legumes, vegetables, tomatoes and fruit had a lower odds for (High BP, kidney problems, heart problems, extremities problems and neurological problems), (OR 0.710 CI 95% (.506-.997)), (OR 0.834 CI 95% (.700-.994)), (OR 0.730 CI 95% (.596-.895)), (OR 0.763 CI 95% (.667-.871)) and (OR 0.773 CI 95% (.602-.991)) respectively, (P value <0.05 for all). No significant association was found between the sweet-soft drinks snacks pattern with diabetes complications. The Asian-like pattern may be associated with a lower prevalence of diabetes complications among type 2 diabetes patients.

"We must cooperate with one another against the Enemy": Agency and activism in school-aged children as protective factors against ongoing war trauma and political violence in the Gaza Strip.

PubMed

Veronese, Guido; Pepe, Alessandro; Jaradah, Alaa; Murannak, Feda; Hamdouna, Housam

2017-08-01

This exploratory qualitative study investigated self-perceived risk and protection factors that may reinforce the ability of children living in refugee camps on the Gaza Strip to adjust to a traumatic and risky life context characterized by loss and dispossession. The sample comprised 200 Palestinian children recruited at primary schools in four refugee camps in the Gaza Strip following the Israeli military operation "Pillar of Defence" in 2012. Thematic content analysis was applied to written materials and narratives produced by the children. Environment, friends, emotions, family, play, self, sociality, health, school, and spirituality were the dimensions that emerged from the narrative texts. Palestinian children's psychological adaptability and ability to reposition themselves along the continuum between ease and disease is underpinned by constant political agency and activism - a dimension that guides sense-making activities in a traumatizing environment marked by continuous uncertainty, loss and bereavement. We therefore recommend a politically-informed focus, both when assessing children and when designing intervention for them in contexts of chronic political violence and war. Copyright © 2017 Elsevier Ltd. All rights reserved.

Childhood burns: an analysis of 124 admissions in the Gaza Strip

PubMed Central

Elsous, A.; Salah, M.; Ouda, M.

2015-01-01

Summary Burns are a serious public health problem among paediatrics. Little is known about the epidemiological profile and outcomes of hospitalized paediatric burns in the Gaza Strip. A cross-sectional retrospective review was conducted of medical records of patients aged 15 years and below, admitted to the Al Alamy burn centre in the Al Shifa Medical Complex from 30 June, 2013 to 01 July, 2014. There were 189 admissions; 124 (65.6%) of them were below 15 years, their mean age ± SD being 4.02 ± 2.85 years. 72 of these cases (58.1%) were males, giving a male to female ratio of 1.6:1. 89.5% of the injuries were accidents and 96% were home-located. Scalds, which were a common cause of burns, represented 83.9% of cases. Mean TBSA was 10.72 ± 8.15%: half of the patients (50.8%) sustained second-degree burns, while 34.7% were a mix of second- and third-degree. Mean length of hospital stay was 10.23 ± 10.60 days. Only two children died during the study period, giving a case fatality rate and total mortality rate of 1.6% and 1.0% respectively. In conclusion, there is a need to focus on home safety and parents’ education as a means of reducing childhood burns. PMID:27777545

Risk factors for DSM 5 PTSD symptoms in Israeli civilians during the Gaza war.

PubMed

Gil, Sharon; Weinberg, Michael; Or-Chen, Keren; Harel, Hila

2015-04-01

In light of the current modifications presented in the diagnostic criteria of posttraumatic stress disorder (PTSD) in the DSM 5, this study aimed at revalidating well-known PTSD risk factors, including gender, peritraumatic dissociation, social support, level of threat, and trait tendency for forgiveness. Five hundred and one Israeli civilians were assessed during real-time exposure to missile and rocket fire at the eruption of the Gaza war. Assessments took place approximately one to 2 weeks after the beginning of this military operation, relying on web administration of the study, which allowed simultaneous data collection from respondents in the three regions in Israel that were under attack. A structural equation model design revealed that higher levels of forgiveness toward situations were associated with fewer PTSD symptoms, whereas peritraumatic dissociation and high levels of objective and subjective threat were positively associated with PTSD symptoms. Additionally, females were at higher risk for PTSD symptoms than males. The findings of this study provide further evidence for the importance of directing preventive attention to those vulnerable to the development of elevated levels of PTSD symptoms. Theoretical and clinical implications of the findings are discussed.

Nutritional status of Palestinian preschoolers in the Gaza Strip: a cross-sectional study

PubMed Central

2012-01-01

Background The authors examined factors associated with nutritional resilience/vulnerability among preschoolers in the Gaza Strip in 2007, where political violence and deprivation are widespread. Methods This cross-sectional study was carried out in 2007 using random sampling of kindergartens in order to select 350 preschoolers. Binary logistic regression was used to compare resilient (adequate nutrition) and vulnerable (stunted) groups with those with moderate nutrition. Results Approximately 37% of the subjects demonstrated nutritional resilience and 15% were vulnerable. Factors associated with nutritional resilience were child younger age, normal birth weight, actively hand- or spoon-feeding when the child was below two years, and residential stability in the past two years. The only factor associated with nutritional vulnerability was lower total score on the mother's General Health Questionnaire, which we interpret as a marker of maternal mental health. Conclusions Children with low-birth weight and older children had worse nutritional resiliency outcomes. Further, poorer outcomes for children were associated with lower maternal mental health status, as well as increased family residential instability. Our results add to the large literature on the pervasive effects of violence and instability on children and underscore the need for resources for early intervention and for the urgent resolution of the Palestinian and other armed conflicts. PMID:22236142

Nutritional status of Palestinian preschoolers in the Gaza Strip: a cross-sectional study.

PubMed

Massad, Salwa G; Nieto, F J; Palta, Mari; Smith, Maureen; Clark, Roseanne; Thabet, Abdel-Aziz

2012-01-11

The authors examined factors associated with nutritional resilience/vulnerability among preschoolers in the Gaza Strip in 2007, where political violence and deprivation are widespread. This cross-sectional study was carried out in 2007 using random sampling of kindergartens in order to select 350 preschoolers. Binary logistic regression was used to compare resilient (adequate nutrition) and vulnerable (stunted) groups with those with moderate nutrition. Approximately 37% of the subjects demonstrated nutritional resilience and 15% were vulnerable. Factors associated with nutritional resilience were child younger age, normal birth weight, actively hand- or spoon-feeding when the child was below two years, and residential stability in the past two years. The only factor associated with nutritional vulnerability was lower total score on the mother's General Health Questionnaire, which we interpret as a marker of maternal mental health. Children with low-birth weight and older children had worse nutritional resiliency outcomes. Further, poorer outcomes for children were associated with lower maternal mental health status, as well as increased family residential instability. Our results add to the large literature on the pervasive effects of violence and instability on children and underscore the need for resources for early intervention and for the urgent resolution of the Palestinian and other armed conflicts. © 2012 Massad et al; licensee BioMed Central Ltd.

Advocating multi-disciplinarity in studying complex emergencies: the limitations of a psychological approach to understanding how young people cope with prolonged conflict in Gaza.

PubMed

Hundt, Gillian Lewando; Chatty, Dawn; Thabet, Abdel Aziz; Abuateya, Hala

2004-07-01

The paper looks at the limitations and strengths of using the A-cope questionnaire for measuring strategies for coping with prolonged conflict by Palestinian young people in Gaza. The scale was administered to young people between the ages of 8 and 17. The results show some gender differences in coping strategies. However, some items on the subscales are not relevant for Muslim societies or societies in situations of prolonged conflict. The authors suggest that combining an anthropological contextual perspective and qualitative data with psychological instruments is an effective way of addressing the limitations of using a single quantitative method of assessment in non-Western complex social and cultural settings.

Posttraumatic stress disorder among preschoolers exposed to ongoing missile attacks in the Gaza war.

PubMed

Kaufman-Shriqui, Vered; Werbeloff, Nomi; Faroy, Michal; Meiri, Gal; Shahar, Danit R; Fraser, Drora; Novack, Yelena; Bilenko, Natalya; Vardi, Hillel; Elhadad, Naama; Pietrzak, Robert H; Harpaz-Rotem, Ilan

2013-05-01

The prevalence and manifestation of posttraumatic stress symptoms in young children may differ from that observed in adults. This study examined sociodemographic, familial, and psychosomatic correlates of posttraumatic stress disorder (PTSD) among preschool children and their mothers who had been exposed to ongoing missile attacks in the Gaza war. One hundred and sixty-seven mothers of preschoolers (aged 4.0-6.5 years) were interviewed regarding PTSD and psychosomatic symptomatology of their children, as well as their own reactions to trauma. Fourteen mothers (8.4%) and 35 children (21.0%) screened positive for PTSD. Sociodemographic characteristics were not associated with PTSD among mothers or children. Among children, the only significant risk factor was having a mother with PTSD (OR = 12.22, 95% CI 2.75-54.28). Compared to children who did not screen positive for PTSD, those who did screen positive displayed significantly higher rates of psychosomatic reactions to trauma, most notably constipation or diarrhea (OR = 4.36, 95% CI 1.64-11.60) and headaches (OR = 2.91, 95% CI 1.07-7.94). Results of this study add to the burgeoning literature on child PTSD, emphasizing the important role of maternal anxiety and the psychosomatic reactions associated with exposure to ongoing traumatic experiences in young children. © 2013 Wiley Periodicals, Inc.

Seawater intrusion risk analysis under climate change conditions for the Gaza Strip aquifer (Palestine)

NASA Astrophysics Data System (ADS)

Dentoni, Marta; Deidda, Roberto; Paniconi, Claudio; Marrocu, Marino; Lecca, Giuditta

2014-05-01

Seawater intrusion (SWI) has become a major threat to coastal freshwater resources, particularly in the Mediterranean basin, where this problem is exacerbated by the lack of appropriate groundwater resources management and with serious potential impacts from projected climate changes. A proper analysis and risk assessment that includes climate scenarios is essential for the design of water management measures to mitigate the environmental and socio-economic impacts of SWI. In this study a methodology for SWI risk analysis in coastal aquifers is developed and applied to the Gaza Strip coastal aquifer in Palestine. The method is based on the origin-pathway-target model, evaluating the final value of SWI risk by applying the overlay principle to the hazard map (representing the origin of SWI), the vulnerability map (representing the pathway of groundwater flow) and the elements map (representing the target of SWI). Results indicate the important role of groundwater simulation in SWI risk assessment and illustrate how mitigation measures can be developed according to predefined criteria to arrive at quantifiable expected benefits. Keywords: Climate change, coastal aquifer, seawater intrusion, risk analysis, simulation/optimization model. Acknowledgements. The study is partially funded by the project "Climate Induced Changes on the Hydrology of Mediterranean Basins (CLIMB)", FP7-ENV-2009-1, GA 244151.

Fluoride enrichment in groundwater of semi-arid urban area: Khan Younis City, southern Gaza Strip (Palestine)

NASA Astrophysics Data System (ADS)

Abu Jabal, Mohamed Shaban; Abustan, Ismail; Rozaimy, Mohd Remy; Al-Najar, Hussam

2014-12-01

The aim of this study is to determine fluoride enhancement in the groundwater of semi-arid urban area of Khan Younis City, southern Gaza Strip. Physicochemical data for a total of 200 groundwater samples were analyzed. The fluoride concentrations were varied from 0.3 to 6.45 mg/L with average value of 2.87 mg/L. Correlations between fluorides with other measured ions were relatively observed, negative correlation with calcium and the positive correlation with pH, bicarbonate and sodium increase the dissolution/solubility of fluoride bearing minerals, leading to fluoride leaching into the groundwater. Fluoride enrichment in the groundwater of the area is due to water hydrochemistry, mineral-water interaction (mainly calcite and fluorite), fluorite resulted from fluorapatite dissolution. The saturation indexes evaluation indicated that 42% of the samples are over saturated with respect to calcite and 35.5% under saturated with respect to fluorite, while 40.5% approached equilibrium with respect to both calcite and fluorite. At fluoride concentrations of less than 2.2 mg/L fluorite saturation indexes show under-saturation condition for fluorite and at higher fluoride concentrations show near saturation condition.

Nursing perceptions of patient safety climate in the Gaza Strip, Palestine.

PubMed

Elsous, A; Akbari Sari, A; AlJeesh, Y; Radwan, M

2017-09-01

This study was undertaken to assess the perception of nurses about patient safety culture and to test whether it is significantly affected by the nurses' position, age, experience and working hours. Patient safety has sparked the interest of healthcare mangers, yet there is limited knowledge about the current patient safety culture among nurses in the Gaza Strip. This was a descriptive cross-sectional study, administering the Arabic Safety Attitude Questionnaire (Short Form 2006) to 210 nurses in four public general hospitals. Job Satisfaction was the most highly perceived factor affecting patient safety, followed by Perception of Management. Safety culture varied across nursing position, age, work experience and working hours. Nurse Managers had more positive attitudes towards patients than frontline clinicians did. The more experience nurses had, the better their attitudes towards patient safety. Nurses who worked the minimum weekly required hours and who were 35 years and older had better attitudes towards all patient safety dimensions except for Stress Recognition. Nurses with a positive attitude had better collaboration with healthcare professionals than those without a positive attitude. Generalization is limited, as nurses who worked in private and specialized hospitals were excluded. Evaluation of the safety culture is the essential starting point to identify hindrances or drivers for safe patient care. Job Satisfaction, Perception of Management and Teamwork necessitate reinforcement, while Working Conditions, Stress Recognition and Safety Climate require improvement. Ensuring job satisfaction through adequate staffing levels, providing incentives and maintaining a collegial environment require both strategic planning and institutional policies at the higher administrative level. Creation of a non-punitive and learning environment, promoting open communication and fostering continuous education should be fundamental aspects of hospital management. A policy

Soft tissue infection after missile injuries to the extremities--a non-randomized, prospective study in Gaza City.

PubMed

Hamouda, Hazem M; Witsø, Eivind; Moghani, Nedal K E; Shahwan, Ahmed; Nygaard, Oystein P

2007-01-01

Patients with soft tissue injuries caused by missile attacks during wartime have been treated with radical debridement and delayed closure. In a study in Gaza City, the rate of infection of missile injuries to the extremities when treated with minimal surgical intervention, was measured. Patients with severe soft tissue damage, compound fractures, and injuries to major blood vessels and/or nerves were excluded from the study. One hundred fourteen patients were treated according to a standardized regime that included a superficial, minor surgery revision of the inlet and the outlet opening, and antibiotic treatment. Local soft tissue infection was defined as the presence of at least two signs of local infection. A total of 109 out of 114 patients attended the first follow-up visit. Eleven (10%) of these patients had an infected wound. A total of 105 of the patients (92%) attended a second follow-up. None of these patients had an infected wound. Under conditions with a high number of casualties, minimal surgical treatment followed by the administration of antibiotics is a safe procedure for patients with penetrating missile injuries and less severe soft tissue damage.

Epidemiology and Outcomes of Hospitalized Burn Patients in Gaza Strip: A Descriptive Study.

PubMed

Elsous, Aymen; Ouda, Mahmoud; Mohsen, Samah; Al-Shaikh, Mohammed; Mokayad, Siham; Abo-Shaban, Nafiz; Hamad, Abed Al-Rahman

2016-01-01

Burns are serious health problems and leading causes of mortality and morbidity in the Eastern Mediterranean Region. This study aimed to overview the epidemiological profile and to present outcomes among hospitalized burn patients in AL Alamy burn center in Gaza. This was a cross-sectional retrospective study of medical records of hospitalized patients from July 2013 to June 2014. Descriptive analysis for studied variables was applied and P ≤ 0.05 considered statistically significant. One humdred eighty nime admissions, 60.8% were males and 63% were under 10 years old. Burn patients in the age range between 19-40 years represented 25.9%. Most common burn injuries were accidental (86.2%), located at home (88.9%), caused by scald (66.1%) and by fire flame (23.8%). On admission, the majority of cases presented with second degree burn (45.5%) or mixed burn (38.6%). The mean TBSA was 11.86 (SD ± 10.78) ranging from 1% to 75% whereas, the mean hospital length of stay was 11.45 (SD ± 12.60) ranging from 1 to 115 days. Total in hospital mortality rate was 2.1% and length of stay was significantly associated with TBSA (P < 0.001). Young children below 10 years seem to be at a higher risk for burn injuries. A significant improvement in burn patients care is observed and practiced and in hospital mortality rate is better compared to neighbouring countries. Preventive programs focusing on safety measures, especially for mothers working in the home, should be implemented urgently to save our children.

Gender difference and characteristics attributed to coronary artery disease in Gaza-Palestine.

PubMed

Jamee, Amal; Abed, Yehia; Jalambo, Marwan O

2013-05-26

Traditionally coronary artery disease (CAD) has been considered as disease affecting men, and for long time women were not included in researches programme. In both sexes, coronary heart disease risk increases with age. Extensive clinical and statistical studies have identified serial factors that increase the risk of coronary heart disease, some of them can be modified, and some cannot. This study was performed to analyze the extent to which cardiovascular risk factors can explain the gender difference in coronary heart disease. The study design is a cross sectional study based on 155 cardiac patients admitted to cardiology department in Al-shifa hospital Gaza. The following cardiac risk factors were determined from the patient's records, smoking, diabetes, high blood pressure, Dyslipedemia and presence of family history of coronary artery disease. Catheterization results review were done. Statistical Package for Social Science version 17 was used for data entry and analysis. Frequency and cross tabulation were done to explore the relationship between the study variables. Chi-square test was used for testing statistical and P-value less than 0.05 were considered as significant. Most of risk factors were more favorable in females and increase with age. Myocardial infarction in male compared with female was 2 times higher, and chronic angina pain is common in female than male respectively 71.4% and 46.7%. Around 77% of female have two vessels disease and more. No great differences in number of diseased vessels among patients with myocardial infarction or chronic stable angina. Patients with low EF <50% have higher chance of affected vessels (82.9%). CAD stay the major problem in male and female, certain patient's characteristics and clinical conditions may place female at higher risk of coronary artery disease development or progression. This article addresses emerging knowledge regarding gender differences in CAD risk factors and responsiveness to risk reduction

Modeling of nitrate concentration in groundwater using artificial intelligence approach--a case study of Gaza coastal aquifer.

PubMed

Alagha, Jawad S; Said, Md Azlin Md; Mogheir, Yunes

2014-01-01

Nitrate concentration in groundwater is influenced by complex and interrelated variables, leading to great difficulty during the modeling process. The objectives of this study are (1) to evaluate the performance of two artificial intelligence (AI) techniques, namely artificial neural networks and support vector machine, in modeling groundwater nitrate concentration using scant input data, as well as (2) to assess the effect of data clustering as a pre-modeling technique on the developed models' performance. The AI models were developed using data from 22 municipal wells of the Gaza coastal aquifer in Palestine from 2000 to 2010. Results indicated high simulation performance, with the correlation coefficient and the mean average percentage error of the best model reaching 0.996 and 7 %, respectively. The variables that strongly influenced groundwater nitrate concentration were previous nitrate concentration, groundwater recharge, and on-ground nitrogen load of each land use land cover category in the well's vicinity. The results also demonstrated the merit of performing clustering of input data prior to the application of AI models. With their high performance and simplicity, the developed AI models can be effectively utilized to assess the effects of future management scenarios on groundwater nitrate concentration, leading to more reasonable groundwater resources management and decision-making.

A simulation/optimization study to assess seawater intrusion management strategies for the Gaza Strip coastal aquifer (Palestine)

NASA Astrophysics Data System (ADS)

Dentoni, Marta; Deidda, Roberto; Paniconi, Claudio; Qahman, Khalid; Lecca, Giuditta

2015-03-01

Seawater intrusion is one of the major threats to freshwater resources in coastal areas, often exacerbated by groundwater overexploitation. Mitigation measures are needed to properly manage aquifers, and to restore groundwater quality. This study integrates three computational tools into a unified framework to investigate seawater intrusion in coastal areas and to assess strategies for managing groundwater resources under natural and human-induced stresses. The three components are a three-dimensional hydrogeological model for density-dependent variably saturated flow and miscible salt transport, an automatic calibration procedure that uses state variable outputs from the model to estimate selected model parameters, and an optimization module that couples a genetic algorithm with the simulation model. The computational system is used to rank alternative strategies for mitigation of seawater intrusion, taking into account conflicting objectives and problem constraints. It is applied to the Gaza Strip (Palestine) coastal aquifer to identify a feasible groundwater management strategy for the period 2011-2020. The optimized solution is able to: (1) keep overall future abstraction from municipal groundwater wells close to the user-defined maximum level, (2) increase the average groundwater heads, and (3) lower both the total mass of salt extracted and the extent of the areas affected by seawater intrusion.

Maternal pre- and postnatal mental health and infant development in war conditions: The Gaza Infant Study.

PubMed

Punamäki, Raija-Leena; Diab, Safwat Y; Isosävi, Sanna; Kuittinen, Saija; Qouta, Samir R

2018-03-01

Women and their infants need special protection in war context, as traumatic events can risk maternal mental and obstetric health and compromise infant development. This prospective study examined, first, how exposure to war trauma is associated with maternal mental health in pregnancy and postpartum, obstetric and newborn health, and infant development. Second, it tested the role of maternal mental health and obstetric risks in mediating between war trauma and infant development. Palestinian women (N = 511) from the Gaza strip participated during pregnancy (T1) and at 4 (T2) and 12 (T3) months postpartum. They reported PTSD, depressive, anxiety, and dissociative symptoms, as well as pregnancy complications, newborn health risks such as prematurity, and infant sensorimotor and language development. First, exposure to war trauma was associated with high levels of maternal mental health and complications at pregnancy, and with increased postpartum mental health symptoms, but exposure was not directly associated with newborn health risks or problems in infant development. Second, maternal mental health both in pregnancy and postpartum, but not pregnancy complications or newborn health, mediated the negative impact of war trauma on infant sensorimotor and language development at 12 months. Interventions to protect early child development in war conditions should be tailored to support maternal mental health. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Gender Difference and Characteristics Attributed to Coronary Artery Disease in Gaza-Palestine

PubMed Central

Jamee, Amal; Abed, Yehia; Jalambo, Marwan O.

2013-01-01

Traditionally coronary artery disease (CAD) has been considered as disease affecting men, and for long time women were not included in researches programme. In both sexes, coronary heart disease risk increases with age. Extensive clinical and statistical studies have identified serial factors that increase the risk of coronary heart disease, some of them can be modified, and some cannot. This study was performed to analyze the extent to which cardiovascular risk factors can explain the gender difference in coronary heart disease. Methods: The study design is a cross sectional study based on 155 cardiac patients admitted to cardiology department in Al-shifa hospital Gaza. The following cardiac risk factors were determined from the patient's records, smoking, diabetes, high blood pressure, Dyslipedemia and presence of family history of coronary artery disease. Catheterization results review were done. Statistical Package for Social Science version 17 was used for data entry and analysis. Frequency and cross tabulation were done to explore the relationship between the study variables. Chi-square test was used for testing statistical and P-value less than 0.05 were considered as significant. Results: Most of risk factors were more favorable in females and increase with age. Myocardial infarction in male compared with female was 2 times higher, and chronic angina pain is common in female than male respectively 71.4% and 46.7%. Around 77% of female have two vessels disease and more. No great differences in number of diseased vessels among patients with myocardial infarction or chronic stable angina. Patients with low EF<50% have higher chance of affected vessels (82.9%). Conclusion: CAD stay the major problem in male and female, certain patient's characteristics and clinical conditions may place female at higher risk of coronary artery disease development or progression. This article addresses emerging knowledge regarding gender differences in CAD risk factors and

Elite formation under occupation: the internal stratification of palestinian elites in the West Bank and Gaza Strip.

PubMed

Mazawi, A E; Yogev, A

1999-09-01

This paper examines the internal stratification of Palestinian elites in the West Bank and Gaza Strip under Israeli occupation. Our general aim is to clarify the extent to which social and political subordination to outside rule influences the development of indigenous elites in stateless societies. In contrast to nation-state societies, such elites may be horizontally stratified into a wider range of institutional settings, and vertically stratified by anti-occupation activism alongside the attainment of occupational prestige. In addition, context-specific determinants of their stratification patterns, such as refugee status, regionality, and country in which educational credentials were acquired, should be considered. A secondary content analysis of interviews conducted by the Palestinian Panorama centre with 249 elite members reveals, that the vertical stratification of Palestinian elites along occupational attainment and anti-occupation activism constitutes two quite independent status dimensions. A multinomial logit regression shows that, horizontally, elite groups are embedded in four distinct types of institutional activity, further demonstrating the multi-faceted formation of Palestinian elites. Contextual resources, such as refugee versus non-refugee status, regionality, and the acquiring of Western credentials, have differential effects on the vertical and horizontal stratification of Palestinian elites. The implications of these findings for further research on elite formation in the post-Oslo Palestinian society and in other stateless societies are discussed in conclusion.

Child protection assessment in humanitarian emergencies: case studies from Georgia, Gaza, Haiti and Yemen.

PubMed

Ager, Alastair; Blake, Courtney; Stark, Lindsay; Daniel, Tsufit

2011-12-01

The paper reviews the experiences of conducting child protection assessments across four humanitarian emergencies where violence and insecurity, directly or indirectly, posed a major threat to children. We seek to identify common themes emerging from these experiences and propose ways to guide the planning and implementation of assessments that effectively identify, and suggest means of response to, threats to children's rights and well-being in emergency settings. In the context of a field evaluation of an inter-agency resource kit, crisis settings where an inter-agency assessment of child protection had been considered in the period August 2008 to July 2010 were identified. Email correspondence, telephone-based structured interviews and documentary review collated information from child protection coordinating agencies from a total of twenty sites, the minority of which had proceeded to complete an assessment. This paper presents case studies of the experience in Georgia (following the conflict between Russian and Georgian forces in August 2008), Gaza (following the Israeli military incursion beginning in December 2008), Haiti (following the earthquake of January 2010), and Yemen (following the ceasefire agreement between the government and rebel forces in early 2010). CASE STUDY FINDINGS: In each setting the context of the humanitarian emergency is outlined. The processes of the planning (and, where appropriate, implementation) of the child protection assessment is described. Where available, the findings of the child protection assessment and their use in shaping interventions are summarized. Case studies document experience across humanitarian settings widely divergent in terms of the nature of the emergency, social-political context, and institutional capacity. Despite such differences, analysis suggests securing inter-agency coordination, preparation and capacity building, and means of ensuring timeliness of findings to be recurrent themes in the effective

Metals detected by ICP/MS in wound tissue of war injuries without fragments in Gaza

PubMed Central

2010-01-01

Background The amount and identity of metals incorporated into "weapons without fragments" remain undisclosed to health personnel. This poses a long-term risk of assumption and contributes to additional hazards for victims because of increased difficulties with clinical management. We assessed if there was evidence that metals are embedded in "wounds without fragments" of victims of the Israeli military operations in Gaza in 2006 and 2009. Methods Biopsies of "wounds without fragments" from clinically classified injuries, amputation (A), charred (C), burns (B), multiple piercing wounds by White Phosphorus (WP) (M), were analyzed by ICP/MS for content in 32 metals. Results Toxic and carcinogenic metals were detected in folds over control tissues in wound tissues from all injuries: in A and C wounds (Al, Ti, Cu, Sr, Ba, Co, Hg, V, Cs and Sn), in M wounds (Al, Ti, Cu, Sr, Ba, Co and Hg) and in B wounds (Co, Hg, Cs, and Sn); Pb and U in wounds of all classes; B, As, Mn, Rb, Cd, Cr, Zn in wounds of all classes, but M; Ni was in wounds of class A. Kind and amounts of metals correlate with clinical classification of injuries, exposing a specific metal signature, similar for 2006 and 2009 samples. Conclusions The presence of toxic and carcinogenic metals in wound tissue is indicative of the presence in weapon inducing the injury. Metal contamination of wounds carries unknown long term risks for survivors, and can imply effects on populations from environmental contamination. We discuss remediation strategies, and believe that these data suggest the need for epidemiological and environmental surveys. PMID:20579349

One flag, two rallies: Mechanisms of public opinion in Israel during the 2014 Gaza war.

PubMed

Feinstein, Yuval

2018-01-01

In Israel, public reaction to the 2014 Gaza war included massive support for the military operation and a sharp increase in the popularity of Prime Minister Netanyahu. To understand what caused these "rally-round-the-flag" (RRTF) effects, panel data were collected from a representative sample of the Jewish majority in Israel during and after the war. The article integrate empirical and theoretical arguments from public opinion studies, and from social and political psychology, to contextualize and guide the analysis. The results reveal that perceived threat to collective security produced two simultaneous rally outcomes through distinct processes: First, increased identification with the ethno-national Jewish group led to a rally behind Israel's prime minister. Second, anger toward Hamas and sentiment of national superiority, which was activated by increased ethno-national identification, produced a rally behind the military operation. In addition to explaining its specific empirical case, this study makes three broader contributions. First, it extends the investigation of the RRTF phenomenon in wartime beyond the popularity of the head of the state (the focus of most previous studies) by also examining levels of support for the use of military power. Second, it reveals some of the mechanisms through which distinct elements of popular nationalism mediate the relationship between war events and heterogeneous rally effects. Third, this study shows that the mechanisms that have been detected in studies of individual attitudes and behavior in small groups under conditions of perceived threat or competition can help explain the behavior of these individuals as members of larger, imagined national communities during war. Copyright © 2017 Elsevier Inc. All rights reserved.

Integrating an artificial intelligence approach with k-means clustering to model groundwater salinity: the case of Gaza coastal aquifer (Palestine)

NASA Astrophysics Data System (ADS)

Alagha, Jawad S.; Seyam, Mohammed; Md Said, Md Azlin; Mogheir, Yunes

2017-12-01

Artificial intelligence (AI) techniques have increasingly become efficient alternative modeling tools in the water resources field, particularly when the modeled process is influenced by complex and interrelated variables. In this study, two AI techniques—artificial neural networks (ANNs) and support vector machine (SVM)—were employed to achieve deeper understanding of the salinization process (represented by chloride concentration) in complex coastal aquifers influenced by various salinity sources. Both models were trained using 11 years of groundwater quality data from 22 municipal wells in Khan Younis Governorate, Gaza, Palestine. Both techniques showed satisfactory prediction performance, where the mean absolute percentage error (MAPE) and correlation coefficient ( R) for the test data set were, respectively, about 4.5 and 99.8% for the ANNs model, and 4.6 and 99.7% for SVM model. The performances of the developed models were further noticeably improved through preprocessing the wells data set using a k-means clustering method, then conducting AI techniques separately for each cluster. The developed models with clustered data were associated with higher performance, easiness and simplicity. They can be employed as an analytical tool to investigate the influence of input variables on coastal aquifer salinity, which is of great importance for understanding salinization processes, leading to more effective water-resources-related planning and decision making.

How to assess solid waste management in armed conflicts? A new methodology applied to the Gaza Strip, Palestine.

PubMed

Caniato, Marco; Vaccari, Mentore

2014-09-01

We have developed a new methodology for assessing solid waste management in a situation of armed conflict. This methodology is composed of six phases with specific activities, and suggested methods and tools. The collection, haulage, and disposal of waste in low- and middle-income countries is so complicated and expensive task for municipalities, owing to several challenges involved, that some waste is left in illegal dumps. Armed conflicts bring further constraints, such as instability, the sudden increase in violence, and difficulty in supplying equipment and spare parts: planning is very difficult and several projects aimed at improving the situation have failed. The methodology was validated in the Gaza Strip, where the geopolitical situation heavily affects natural resources. We collected information in a holistic way, crosschecked, and discussed it with local experts, practitioners, and authorities. We estimated that in 2011 only 1300 tonne day(-1) were transported to the three disposal sites, out of a production exceeding 1700. Recycling was very limited, while the composting capacity was 3.5 tonnes day(-1), but increasing. We carefully assessed system elements and their interaction. We identified the challenges, and developed possible solutions to increase system effectiveness and robustness. The case study demonstrated that our methodology is flexible and adaptable to the context, thus it could be applied in other areas to improve the humanitarian response in similar situations. © The Author(s) 2014.

Medications Adherence and Associated Factors among Patients with Type 2 Diabetes Mellitus in the Gaza Strip, Palestine.

PubMed

Elsous, Aymen; Radwan, Mahmoud; Al-Sharif, Hasnaa; Abu Mustafa, Ayman

2017-01-01

The aim of this study was to evaluate the adherence to anti-diabetic medications among patients with type 2 diabetes mellitus (DM) seeking medical care in the Gaza Strip, Palestine. A cross-sectional study was conducted among 369 primary care patients with type 2 DM from October to December 2016. Adherence to medications was measured using the Morisky Medication Adherence Scale (MMAS-4). Socio-demographic and clinical variables, provider-patient relationship, health literacy, and health belief were examined for each patient. Univariate, binary logistic regression and multiple linear regression were applied to determine the independent factors influencing adherence to anti-diabetic medications using SPSS version 22. Of all the respondents, 214 (58%), 146 (39.5%), and nine (2.5%) had high (MMAS score = 0), medium (MMAS score = 1 + 2), and low (MMAS score ≥ 3) adherence to anti-diabetic medications, respectively. Factors that were independently associated with adherence to anti-diabetic medications were as follows: female gender [odds ratio (OR): 1.657, 95% confidence interval (CI): 1.065-2.578] and perception of disease's severity (OR: 1.510, 95% CI: 0.410-5.560). Elderly ( t  = 1.345) and longer duration of DM ( t  = 0.899) were also predictors of adherence but showed no statistical significance ( p  > 0.05). The level of complete adherence to anti-diabetic medications was sub-optimal. New strategies that aim to improve patients' adherence to their therapies are necessary taking into consideration the influencing factors and the importance of having diabetes educators in the primary care centers.

Palestinian Territories Analysis Brief

EIA Publications

2014-01-01

The Palestinian Territories of the West Bank and Gaza Strip do not have any proved hydrocarbon reserves, but fields on the Israeli side of the boundaries may extend across the West Bank and Gaza borders. The discovery of the Gaza Marine field in the Mediterranean Sea in 2000 indicates the presence of hydrocarbons, although the resources are not yet commercially viable. The Gaza Marine field holds an estimated 1.6 trillion cubic feet in recoverable natural gas resources.

Management of acute ischaemic stroke at Nasser Hospital, Gaza Strip: a clinical audit.

PubMed

Alkhatib, Mohammed N; Abd-Alghafoor, Tamer; Elmassry, AlaaEldeen; Albarqouni, Loai; Böttcher, Bettina; Alfaqawi, Maha

2018-02-21

Stroke is a leading cause of morbidity and mortality worldwide. The aim of this study was to assess the standard of care for patients with acute ischaemic stroke at the internal medicine department of Nasser Hospital, Gaza Strip. For this retrospective clinical audit, we selected a random sample of 100 medical records for patients with stroke who were admitted to Nasser Hospital between January and August, 2016. Clinical practice was compared with the recommendations in the 2013 American Heart Association and American Stroke Association guidelines. Patient confidentiality was maintained, and ethical approval was obtained from the Palestinian Ministry of Health. Five patient records were not coded and therefore excluded. Of the remaining 95 patients, 51 (54%) were men with a mean age of 67 years (SD 14). 53 patients presented with dysarthria. The duration of stroke symptoms before admission was not reported in 86 (91%) records. A complete blood count and renal function tests were done for all patients, lipid profiling for 87 (92%) patients, electrocardiography for 85 (89%) patients, carotid duplex ultrasound for 32 (34%) patients, and CT scan for all patients. None of the patients had continuous cardiac monitoring or an assessment of swallowing function, and 70 (74%) patients received immediate anti-platelet therapy (325 mg aspirin). 80 (85%) patients received venous thromboembolism prophylaxis. 41 (43%) patients were given antibiotics without a recorded indication. None of the patients received thrombolytic therapy. As recommended in the guidelines, 41 (43%) patients did not receive anti-hypertensive agents on the first day of hospitalisation. 46 (48%) patients had diabetes, and glycaemic control was achieved by day 3 in 26 (57%) patients. No Palestinian guidelines exist for the management of patients with acute ischaemic stroke, and in most cases management was based on personal experience rather than evidence. The development of evidence-based guidelines is

Compliance with the national palestinian infection prevention and control protocol at governmental paediatric hospitals in gaza governorates.

PubMed

Eljedi, Ashraf; Dalo, Shareef

2014-08-01

Nosocomial infections are a significant burden for both patients and the healthcare system. For this reason, infection prevention and control (IPC) practices are extremely important. The Palestinian Ministry of Health adopted the national IPC Protocol in 2004. This study aimed to assess the compliance of healthcare providers (HCPs) with the Protocol in three governmental paediatric hospitals in Gaza governorates. This descriptive cross-sectional study was conducted from February to November 2010. Data were collected from a sample of doctors, nurses and physiotherapists (N = 334) using a self-administered questionnaire and observation checklists to record HCP practices and assess the hospital environment. The response rate was 92%. The most important reasons for non-compliance with the IPC Protocol were the absence of an education programme (61.5%), lack of knowledge (52.4%) and the scarcity of required supplies (46.9%). Only 2.3% of respondents had a copy of the IPC Protocol, while 65.8% did not know of its existence. Only 16.9% had participated in training sessions regarding general IPC practices. The observation checklist regarding HCP practices revealed low levels of compliance in hand washing (45.9%), wearing gloves (40.7%) and using antiseptics/disinfectants (49.16%). The health facilities checklist indicated that there was a lack of certain essential equipment and materials, such as covered waste containers and heavy-duty gloves. Due to the lack of HPC knowledge, the authors recommend that the IPC Protocol be made available in all hospitals. In addition, a qualified team should implement intensive IPC education and training programmes and facilities should provide the required equipment and materials.

Can people remain engaged and vigorous in the face of trauma? Palestinians in the West Bank and Gaza.

PubMed

Hobfoll, Stevan E; Johnson, Robert J; Canetti, Daphna; Palmieri, Patrick A; Hall, Brian J; Lavi, Iris; Galea, Sandro

2012-01-01

This is the first study to investigate how actively engaged and vigorous people remain in their life tasks in the midst of chronic exposure to significant traumatic events. We sought to identify risk and protective factors for engagement within the context of ongoing exposure to political violence and social upheaval. We randomly identified and interviewed 1,196 adult residents of the West Bank and Gaza during a period of violent conflict on 3 occasions: (1) September-October 2007, (2) April-May 2008, and (3) October-November 2008. Participants were asked about their exposure to political violence, symptoms of depression, and posttraumatic stress (PTS) symptoms, their level of social support, psychosocial resource loss, and positive engagement in life tasks. Path modeling revealed that trauma exposure indirectly affected engagement through its impact on resource loss and PTS and depression symptoms. PTS symptoms at Wave 2 were modestly related to greater engagement at Wave 3, and depression symptoms did not independently predict engagement at Wave 3. Psychosocial resource loss at Wave 1 and Wave 2 was the best overall predictor of engagement at Wave 3, through its direct and indirect effects via PTS symptoms. Greater engagement was also predicted by greater social support, being more educated, being younger, and being more religious. The relative independence of psychological distress and engagement was noted as a critical finding supporting a key tenet of positive psychology. The relationship of resource loss and social support with engagement suggests that bolstering psychosocial resources may offer a route for primary and secondary prevention amidst chronic traumatic conditions. © 2012 Guilford Publications, Inc.

Quality of life, human insecurity, and distress among Palestinians in the Gaza Strip before and after the Winter 2008-2009 Israeli war.

PubMed

Hammoudeh, Weeam; Hogan, Dennis; Giacaman, Rita

2013-11-01

This study investigates changes in the quality of life (QoL) of Gaza Palestinians before and after the Israeli winter 2008-2009 war using the World Health Organization's WHOQOL-Bref; the extent to which this instrument adequately measures changing situations; and its responsiveness to locally developed human insecurity and distress measures appropriate for context. Ordinary least squares regression analysis was performed to detect how demographic and socioeconomic variables usually associated with QoL were associated with human insecurity and distress. We estimated the usual baseline model for the three QoL domains, and a second set of models including these standard variables and human insecurity and distress to assess how personal exposure to political violence affects QoL. No difference between the quality of life scores in 2005 and 2009 was found, with results suggesting lack of sensitivity of WHOQOL-Bref in capturing changes resulting from intensification of preexisting political violence. Results show that human insecurity and individual distress significantly increased in 2009 compared to 2005. Results indicate that a political domain may provide further understanding of and possibly increase the sensitivity of the instrument to detect changes in the Qol of Palestinians and possibly other populations experiencing intensified political violence.

A cross sectional study of the relationship between the exposure of pregnant women to military attacks in 2014 in Gaza and the load of heavy metal contaminants in the hair of mothers and newborns

PubMed Central

Manduca, Paola; Diab, Safwat Y; Qouta, Samir R; Albarqouni, Nabil MA; Punamaki, Raiija-Leena

2017-01-01

Objective Metal contamination of humans in war areas has rarely been investigated. Weaponry’s heavy metals become environmentally stable war remnants and accumulate in living things. They also pose health risks in terms of prenatal intake, with potential long term risks for reproductive and children’s health. We studied the contribution of military attacks to the load of 23 metals in the hair of Palestinian women in the Gaza Strip, who were pregnant at the time of the military attacks in 2014, and their newborns. We compared the metal load in the mothers with values for adult hair from outside the war area (RHS) as the reference. We investigated heavy metals trans-passing in utero, and assessed if the heavy metal intake could derive from sources unrelated to the war. Design Cross sectional study. Participants and setting Cross sectional convenience sample of 502 mothers delivering in the Gaza Strip and their newborns. Main outcome measured Measure of the load of heavy metals in mother and newborn hair by inductively coupled plasma-mass spectrometry (ICP-MS). Comparison of metal loads with the reference RHS, between groups with different exposures to attacks and house/agriculture chemicals, and between mothers and newborns. Data for birth registry and for exposures to war and other known risk factors were obtained at interview with the mothers. Photographic documentation of damage from military attacks was obtained. Results The whole cross sectional convenience sample had a significantly higher load of heavy metals than the reference RHS. Women exposed to military attacks had a significantly higher load of heavy metals than those not exposed; the load in newborns correlated positively with the mothers’ load. No significant difference was found between users/non-users of house/agriculture chemicals. No other known confounder was identified. Conclusions High heavy metal loads in mothers, reflected in those of their newborns, were associated with exposure to

A cross sectional study of the relationship between the exposure of pregnant women to military attacks in 2014 in Gaza and the load of heavy metal contaminants in the hair of mothers and newborns.

PubMed

Manduca, Paola; Diab, Safwat Y; Qouta, Samir R; Albarqouni, Nabil Ma; Punamaki, Raiija-Leena

2017-08-02

Metal contamination of humans in war areas has rarely been investigated. Weaponry's heavy metals become environmentally stable war remnants and accumulate in living things. They also pose health risks in terms of prenatal intake, with potential long term risks for reproductive and children's health. We studied the contribution of military attacks to the load of 23 metals in the hair of Palestinian women in the Gaza Strip, who were pregnant at the time of the military attacks in 2014, and their newborns. We compared the metal load in the mothers with values for adult hair from outside the war area (RHS) as the reference. We investigated heavy metals trans-passing in utero, and assessed if the heavy metal intake could derive from sources unrelated to the war. Cross sectional study. Cross sectional convenience sample of 502 mothers delivering in the Gaza Strip and their newborns. Measure of the load of heavy metals in mother and newborn hair by inductively coupled plasma-mass spectrometry (ICP-MS). Comparison of metal loads with the reference RHS, between groups with different exposures to attacks and house/agriculture chemicals, and between mothers and newborns. Data for birth registry and for exposures to war and other known risk factors were obtained at interview with the mothers. Photographic documentation of damage from military attacks was obtained. The whole cross sectional convenience sample had a significantly higher load of heavy metals than the reference RHS. Women exposed to military attacks had a significantly higher load of heavy metals than those not exposed; the load in newborns correlated positively with the mothers' load. No significant difference was found between users/non-users of house/agriculture chemicals. No other known confounder was identified. High heavy metal loads in mothers, reflected in those of their newborns, were associated with exposure to military attacks, posing a risk of immediate and long term negative outcomes for pregnancy and

Conflict between Israel and Hamas

DTIC Science & Technology

2015-06-12

this plan, war erupted, leading to the free -for-all Arab land grab. The Egyptians usurped Gaza. The Jordanians occupied the West Bank. Then Israel took...102 Yaacov Amidror, “Line in the Sand ,” The BESA Center, February 2, 2015, accessed March 12, 2015, http://besacenter.org/?s=Line+in+the+ Sand . 69...Laub and Fares Akram, “Hamas Consolidates Its Grip on Gaza as Reconstruction Stalls Gaza City,” ABC News, accessed April 28, 2015, http

The effect of prolonged exposure to war-related stress among hospital personnel with different affect types: lessons from the Second Lebanon War and the Gaza "Cast Lead" operation.

PubMed

Palgi, Yuval; Ben-Ezra, Menachem; Shrira, Amit

2012-01-01

Two studies examined peritraumatic symptoms due to war-related stress among hospital personnel with different affect types. In Study 1, we examined 80 Israeli hospital personnel during the period they were exposed to frequent missile attacks in the Second Lebanon War. In Study 2, we examined 67 and 74 Israeli hospital personnel during the time they were exposed and were not exposed, respectively, to missile attacks in the Gaza "Cast Lead" operation. In both studies, hospital personnel completed measures of posttraumatic stress disorder symptoms as well as of positive- and negative-affect items (PA and NA, respectively). Exposed personnel with a positive congruent (high PA and low NA) or a deflated incongruent (low PA and low NA) affective types had a lower level of peritraumatic symptoms compared to those with a negative congruent (low PA and high NA) or an inflated incongruent (high PA and NA) affective types. Study 2 further showed that among non-exposed personnel, only personnel with a negative congruent affective type had a higher level of peritraumatic symptoms compared to personnel with other affective types. Clinical implications and required future studies are discussed.

Understanding the perceptions, roles and interactions of stakeholder networks managing health-care waste: A case study of the Gaza Strip.

PubMed

Caniato, M; Tudor, T; Vaccari, M

2015-01-01

The sustainable management of waste requires a holistic approach involving a range of stakeholders. What can often be difficult is to understand the manner in which different types of stakeholder networks are composed and work, and how best to enhance their effectiveness. Using social network analysis and stakeholder analysis of healthcare waste management stakeholders in the case study region of the Gaza Strip, this study aimed to understand and examine the manner in which the networks functioned. The Ministry of Health was found to be the most important stakeholder, followed by municipalities and solid waste management councils. Some international agencies were also mentioned, with specific roles, while other local institutions had a limited influence. Finally while health-care facilities had a strong interest in waste management, they were generally poorly informed and had limited links to each other. The manner in which the networks operated was complicated and influenced by differences in perception, sharing of information, access to finance and levels of awareness. The lack of a clear legal framework generated various mistakes about roles and responsibilities in the system, and evidently regulation was not an effective driver for improvement. Finally stakeholders had different priorities according to the waste management issues they were involved with, however segregation at the source was identified as a key requirement by most. Areas for improving the effectiveness of the networks are suggested. The analysis utilized an innovative methodology, which involved a large number of stakeholders. Such an approach served to raise interest and awareness at different levels (public authorities, health providers, supporting actors, others), stimulate the discussion about the adoption of specific policies, and identify the effective way forward. Copyright © 2014 Elsevier Ltd. All rights reserved.

Shared War reality effects on the professional quality of life of mental health professionals.

PubMed

Pruginin, Itay; Segal-Engelchin, Dorit; Isralowitz, Richard; Reznik, Alexander

2016-01-01

To date, studies on the outcomes of a shared war reality among mental health professionals (MHPs) in southern Israel have focused only on those residing and working in Otef Gaza. The aim of this study is to determine the impact of different exposure levels to shared trauma on the professional quality of life of MHPs in southern Israel. This study compares the level of secondary traumatic stress, burnout, and compassion satisfaction of social workers from Otef Gaza to social workers living and working in the Beer-Sheva area who experience occasional missile attacks. The Professional Quality of Life Scale was used to examine the level of secondary traumatic stress, burnout, and compassion satisfaction of 125 social workers living and working in the Negev: 72 from Beer-Sheva and 53 from the regional councils of Otef Gaza. No statistically significant differences were found in the three professional quality of life variables between the Otef-Gaza and Beer-Sheva groups. The lack of secondary traumatic stress and burnout differences between the study groups, despite the chronic exposure to terror attacks among the Otef Gaza social workers, may be explained by the strong sense of belonging and support evidenced by many Otef Gaza residents as well as by the comprehensive trauma training MHPs receive for work in the region. The results of this study are important for health policy geared to trauma prevention efforts, moderating the effects of work under shared war reality, and promoting the professional quality of life of MHPs in conflict areas.

New Insights on β-Thalassemia in the Palestinian Population of Gaza: High Frequency and Milder Phenotype Among Homozygous IVS-I-1 (HBB: c.92+1G>A) Patients with High Levels of Hb F.

PubMed

Ghoti, Hussam; Fibach, Eitan; Rachmilewitz, Eliezer A; Jeadi, Hisham; Filon, Dvora

2017-03-01

β-Thalassemia (β-thal) is a very common disease in the Palestinian population of the Gaza Strip. We studied their mutation frequency and clinical features. Thirteen different mutations were identified. The most common mutation was IVS-I-1 (G>A) (HBB: c.92+1G>A), which was prevalent in 31.5% of the thalassemia alleles studied. The IVS-I-110 (G>A) (HBB: c.93-21G>A) mutation was found in 25.0% of the alleles. Homozygotes for the IVS-I-1 mutation had higher mean hemoglobin (Hb) levels, required less blood transfusions, and lower transferrin saturation than the homozygotes for the IVS-I-110 mutation. This milder phenotype was, most likely, the result of the persistent production of Hb F; it was 9-fold higher in absolute terms (g/dL) and 7.7-fold higher in relative terms (percentage of total Hb). About half of our IVS-I-1 patients carried the XmnI polymorphism, which is known to be associated with elevated Hb F levels.

Treatment seeking for posttraumatic stress in Israel Defense Forces veterans deployed in the Second Lebanon War (2006) and "Operation Cast Lead" in the Gaza Strip (2009): a comparative study.

PubMed

Levi, Ofir; Lubin, Gadi

2018-05-01

The goal of the study was to determine the long-term prevalence of combat-related treatment seeking and posttraumatic stress disorder (PTSD) in Israel's veterans deployed to the Second Lebanon War (2006) and "Operation Cast Lead" in the Gaza Strip (2009). The prevalence of treatment seeking and DSM-IV-TR diagnoses among Israel Defense Force (IDF) veterans was assessed using seven and five year's surveillance and records. The whereabouts and combat exposure of veterans during the war was determined based on the IDF's Operations Directorate records. Overall prevalence of treatment seeking was 1.32% and 0.38% in the Second Lebanon War and "Operation Cast Lead", respectively. The prevalence of treatment-seeking veterans from the Second Lebanon War and in "Operation Cast Lead" was significantly higher in soldiers deployed to high combat-exposure zones (2.19% and 3.1%, respectively), relative to low combat-exposure zones (0.24% and 0.06%, respectively), and relative to soldiers deployed elsewhere (0.26% and 0.02%, respectively). PTSD prevalence was similar among treatment-seeking veterans deployed in high combat-exposure zones in both combats. There is a gap of anywhere between 3% and 11% between treatment seeking by IDF veterans following war deployment and the actual prevalence of PTSD in this soldier population.

Understanding the perceptions, roles and interactions of stakeholder networks managing health-care waste: A case study of the Gaza Strip

DOE Office of Scientific and Technical Information (OSTI.GOV)

Caniato, M., E-mail: marcocaniato@gmail.com; Tudor, T.; Vaccari, M.

Highlights: • We systematically review scientific literature about health-care waste management. • We identify and discuss gaps, trends, efforts, and key-factors. • We suggest areas for improvement and best practices reported in literature. • We include recommendations for policy makers, practitioners and researchers. • We promote a holistic and harmonized approach to health-care waste management. - Abstract: The sustainable management of waste requires a holistic approach involving a range of stakeholders. What can often be difficult is to understand the manner in which different types of stakeholder networks are composed and work, and how best to enhance their effectiveness. Usingmore » social network analysis and stakeholder analysis of healthcare waste management stakeholders in the case study region of the Gaza Strip, this study aimed to understand and examine the manner in which the networks functioned. The Ministry of Health was found to be the most important stakeholder, followed by municipalities and solid waste management councils. Some international agencies were also mentioned, with specific roles, while other local institutions had a limited influence. Finally while health-care facilities had a strong interest in waste management, they were generally poorly informed and had limited links to each other. The manner in which the networks operated was complicated and influenced by differences in perception, sharing of information, access to finance and levels of awareness. The lack of a clear legal framework generated various mistakes about roles and responsibilities in the system, and evidently regulation was not an effective driver for improvement. Finally stakeholders had different priorities according to the waste management issues they were involved with, however segregation at the source was identified as a key requirement by most. Areas for improving the effectiveness of the networks are suggested. The analysis utilized an innovative

Anthropogenic desertification by high-albedo pollution Observations and modeling

NASA Technical Reports Server (NTRS)

Otterman, J.; Rosenberg, N. W.; Rosenberg, E.

1974-01-01

ERTS-1 MSS albedo data of Western Negev, Sinai and the Gaza strip are presented. A sharp contrast in albedo exists across the Negev-Sinai and Negev-Gaza strip borders. Anthropogenic desertification has occurred on the Arab side due to overgrazing and Bedouin agriculture, whereas natural vegetation grows much more abundantly on the Israeli side.

Close Range Photogrammetry Applied to the Documentation of AN Archaeological Site in Gaza Strip, Palestine

NASA Astrophysics Data System (ADS)

Alby, E.; Elter, R.; Ripoche, C.; Quere, N.; de Strasbourg, INSA

2013-07-01

In a geopolitical very complex context as the Gaza Strip it has to be dealt with an enhancement of an archaeological site. This site is the monastery of St. Hilarion. To enable a cultural appropriation of a place with several identified phases of occupation must undertake extensive archaeological excavation. Excavate in this geographical area is to implement emergency excavations, so the aim of such a project can be questioned for each mission. Real estate pressure is also a motivating setting the documentation because the large population density does not allow systematic studies of underground before construction projects. This is also during the construction of a road that the site was discovered. Site dimensions are 150 m by 80 m. It is located on a sand dune, 300 m from the sea. To implement the survey, four different levels of detail have been defined for terrestrial photogrammetry. The first level elements are similar to objects, capitals, fragment of columns, tiles for example. Modeling of small objects requires the acquisition of very dense point clouds (density: 1 point / 1 mm on average). The object must then be a maximum area of the sensor of the camera, while retaining in the field of view a reference pattern for the scaling of the point cloud generated. The pictures are taken at a short distance from the object, using the images at full resolution. The main obstacle to the modeling of objects is the presence of noise partly due to the studied materials (sand, smooth rock), which do not favor the detection of points of interest quality. Pretreatments of the cloud will be achieved meticulously since the ouster of points on a surface of a small object results in the formation of a hole with a lack of information, useful to resulting mesh. Level 2 focuses on the stratigraphic units such as mosaics. The monastery of St. Hilarion identifies thirteen floors of which has been documented years ago by silver photographs, scanned later. Modeling of pavements is

Analysis of recurring sinking events of armored tracked vehicles along dirt roads in the agricultural periphery of the Gaza Strip

NASA Astrophysics Data System (ADS)

Roskin, Joel

2013-04-01

The second (Al-Aqsa) intifada (Arab violent uprising) which erupted across Israel in 2000 eventually led the Israel Defense Forces to deploy armored tracked vehicles (ATVs) (tanks, armored personal carriers, and D-9 bulldozers) within Israel's agricultural periphery of the Gaza Strip, following daily attempts by Arab terrorists and guerillas to penetrate Israel. Combat movement of the ATVs was mainly concentrated to dirt roads, between agricultural fields, wherever possible. As a result of semi-arid Mediterranean (climate) winter rains, annually averaging 250 - 350 mm, it was reported that ATVs often sank in muddy terrain. This study investigated what caused ATVs to sink. The main data collected concerning the types of vehicles that sank related to: land-use characteristics, soil type, and daily rainfall. Interviews with commanders were also conducted for additional details. Between the fall and spring, surveys and weekly / bi-weekly field soil cone penetrometer tests were conducted at ten sites with different pedological and land-use characteristics. The loess soils, especially in agricultural fields, were generally found to be conducive to ATV traffic, even shortly after rainstorms of 10-30 mm. However, following several rainfall events exceeding 10 mm, ATVs and tanks regularly sank into local topographic depressions in the undulating landscape. These consisted of short segments of dirt roads where runoff and suspended sediment collected. After the early rains in late fall, tank ruts fossilize and become conduits of concentrated runoff and fine particles eroded by ATV activity during the summer months. Tank track ruts that formed in mud, compacted the soil, drastically altered drainage patterns by directing significant surface flow, and suspended sediment into these depressions, creating "tank-traps" whose trafficability ranged from "untrafficable" to "trafficable with constraints." This study shows that intense, routine, defensive military activity operated

Seasonal PrEP for partners of migrant miners in southern Mozambique: a highly focused PrEP intervention

PubMed Central

Cremin, Ide; Morales, Fernando; Jewell, Britta L; O'Reilly, Kevin R; Hallett, Timothy B

2015-01-01

Introduction To be used most effectively, pre-exposure prophylaxis (PrEP) should be prioritized to those at high risk of acquisition and would ideally be aligned with time periods of increased exposure. Identifying such time periods is not always straightforward, however. Gaza Province in southern Mozambique is characterized by high levels of HIV transmission and circular labour migration to mines in South Africa. A strong seasonal pattern in births is observable, reflecting an increase in conception in December. Given the potential for increased HIV transmission between miners returning in December and their partners in Gaza Province, PrEP use by the latter would be a useful means of HIV prevention, especially for couples who wish to conceive. Methods A mathematical model was used to represent population-level adult heterosexual HIV transmission in Gaza Province. Increased HIV acquisition among partners of miners in December, coinciding with the miners’ return from South Africa, is represented. In addition to a PrEP intervention, the scale-up of treatment and recent scale-up of male circumcision that have occurred in Gaza are represented. Results Providing time-limited PrEP to the partners of migrant miners, as opposed to providing PrEP all year, would improve the cost per infection averted by 7.5-fold. For the cost per infection averted to be below US$3000, at least 85% of PrEP users would need to be good adherers and PrEP would need to be cheaper than US$115 per person per year. Uncertainty regarding incidence of HIV transmission among partners of miners each year in December has a strong influence on estimates of cost per infection averted. Conclusions Providing time-limited PrEP to partners of migrant miners in Gaza Province during periods of increased exposure would be a novel strategy for providing PrEP. This strategy would allow for a better prioritized intervention, with the potential to improve the efficiency of a PrEP intervention considerably, as well

Assessment of the nutritional status of preschool-age children during the second Intifada in Palestine.

PubMed

Abdeen, Ziad; Greenough, P Gregg; Chandran, Aruna; Qasrawi, Radwan

2007-09-01

The Palestinian economy has dramatically deteriorated at all levels since the Al-Aqsa Intifada (uprising) began in 2000, resulting in an unprecedented catastrophe to the livelihoods of the Palestinians residing in the West Bank and Gaza. It was also marked by lack of household physical and financial access to food and health care, which placed children at increased risk of malnutrition and poor health. This prompted a significant increase in food aid from 2002 until the summer of 2003. To assess the nutritional status of children 6 to 59 months of age after 1 year of food assistance. In the West Bank and Gaza, a nationally representative sample of children 6 to 59 months of age was randomly selected with a validated multistage clustered design, with the Health Survey 1999 sample used as the sampling frame. The sample was stratified according to governorate, place of residence (urban, nonurban, or refugee camp), locality, and size of locality (number of households). A cross-sectional survey of nutritional status was carried out. Data were collected by interviews with the primary caregivers of the children. Measurements were made of children's weight and height or length. Food-intake data were collected by the 24-hour food-recall method with the use of a booklet of photographs of foods commonly eaten in Palestine. A total of 3,089 children were assessed, of whom 3.1% in the West Bank and 3.9% in the Gaza Strip were suffering from acute malnutrition; the prevalence of chronic malnutrition was 9.2% in the West Bank and 12.7% in the Gaza Strip (p = .02). Sex, refugee status, locality, and maternal education were not significantly associated with acute malnutrition by logistic regression analysis, whereas infants 6 to 23 months of age were significantly at risk. Calorie and protein intakes were generally lower than recommended dietary allowances. The prevalence rates of both acute and chronic malnutrition among children in the West Bank and Gaza are significantly higher

Advocating change in Palestine. Advocacy for reproductive health: Palestine.

PubMed

Wolmuth, P

1996-01-01

The Palestinian Family Planning and Protection Association (PFPPA) recently implemented a new strategic plan based on the Strategic Plan of the International Planned Parenthood Federation (IPPF) aimed at the empowerment of women. Advocacy is the central part of the program with preparing the services and dealing with the issue of population. In early 1995 a round of meetings in the West Bank and the Gaza Strip launched the plan with new programs for women, youth, men, information, education, and communication, and service provision to start in January 1996. In Gaza the Youth Program is well under way. Five members were selected from each of 50 groups for a 1-week training course in Gaza City in November 1995. The topics included: mutual respect between husband and wife, discussion of the role of family planning in the context of Islam, the rights and wrongs of polygamy, and the hotly debated issue of sex segregation in education. The PFPPA staff was initially apprehensive about the new youth and women's program plans to broaden family planning to women's empowerment and sexual and reproductive health. An IPPF-sponsored video was also shown in Hebron, West Bank, on the problem of early marriage. It featured Palestinian women: one with 12 children who was married at age 13; a mother whose husband wanted to marry off their 12-year-old daughter; and portrayed pressure from husbands and other family members to produce many children. The new strategy engendered debate in the West Bank and Gaza among village women and young people, while in the meantime the training of government health workers started in sexual and reproductive health counseling. In the village of Tkooi, near Bethlehem, a counselor held sessions on the oppression of women and psycho-physiological problems and stress. A lawyer also summarized women's economic and property rights, which most of them were unaware of.

Is ideology a risk factor for PTSD symptom severity among Israeli political evacuees?

PubMed

Oren, Lior; Possick, Chaya

2010-08-01

To study the role of ideology in situations of extreme stress, a research questionnaire, measuring posttraumatic stress disorder (PTSD), settlement ideology (the importance of Jewish settlement in Gaza), and type of evacuation was administered to 326 Jewish residents who were evacuated from Gaza settlements by the Israeli government. Forty percent of the participants met the criteria of probable PTSD. Forcibly evicted individuals reported higher levels of settlement ideology and higher levels of PTSD symptom severity compared to voluntarily evacuated individuals. Contrary to previous studies, ideology was found to be positively associated with PTSD symptom severity. The results are explained by the conservation of resources and terror management theories. Theoretical and practical implications are discussed.

Does political ideology moderate stress: the special case of soldiers conducting forced evacuation.

PubMed

Shechner, Tomer; Slone, Michelle; Bialik, Gadi

2007-04-01

This study examined the moderating role of political ideology on psychological outcomes for Israeli soldiers participating in the forced evacuation of Jewish settlements from Gaza. Change in psychopathology and well-being was assessed for 3 concurrent mission groups differing in their political ideological contentiousness--forced evacuation, Gaza security, and Northern border security. After soldiers in each mission group were classified on the basis of relatively left- or right-wing political ideological tendencies, the authors examined differential impact of each mission on soldiers of differing political ideology. Results confirmed strong moderation effects of political ideology on psychological outcomes in these extreme contexts. Implications for research, prevention, and treatment are discussed. 2007 APA, all rights reserved

UNRWA and the health of Palestinian refugees. United Nations Relief and Works Agency.

PubMed

Lilienfield, L S; Rose, J C; Corn, M

1986-08-28

The United Nations Relief and Works Agency for Palestine refugees (UNRWA) has provided health, education, and welfare services since 1949. A team of physicians from Georgetown University visited UNRWA Health Centers and refugee camps in Jordan, Lebanon, the West Bank, and the Gaza Strip, as well as some affiliated hospitals. Living conditions of refugees vary widely. In Jordan and the West Bank, fewer than one third live in camps, whereas in the Gaza Strip and Lebanon, conditions are more crowded. Effective programs for health education, maternal and child health, and immunization have markedly improved the health of the refugees over the years of UNRWA's operation. The general health of the population is good, primarily as a result of wise emphasis on public health and preventive medicine measures.

Eyeless in Gaza, Part II.

ERIC Educational Resources Information Center

Gatto, John Taylor

1997-01-01

Suggests that modern schooling was founded on elitist principles and has resulted in making people dumber, weakening families, replacing religion, lowering incomes, reproducing the class structure by dividing children into classes that correlate closely with family income, and concentrating wealth and power in the hands of a small fraction of the…

Youth from Fundamentalist Societies: What are Their Attitudes Toward War and Peace and Their Relations with Anxiety Reactions?

PubMed

Kalagy, Tehila; Braun-Lewensohn, Orna; Abu-Kaf, Sara

2017-06-01

The present study was conducted during "Protective Edge," a long-lasting military operation between the State of Israel and Hamas in Gaza, during which hundreds of rockets were fired from Gaza into various regions across the country. At the same time, Israeli forces bombed Gaza and sent in ground forces. The military operation ended after 50 days of fighting, with a cease-fire between the warring sides. The aim of this study was to compare attitudes and perceptions of youth from different religious fundamentalist societies, toward the war and their readiness for peace during this specific violent struggle, and attitudes toward the Israeli-Palestinian (I-P) conflict in general. Furthermore, we wanted to examine the links between these attitudes, personal sense of coherence and state anxiety. We compared two groups of adolescents who belong to religious minorities in Israel: ultra-Orthodox and national religious. The sample included a total of 107 subjects from both groups. The young people responded to a questionnaire, distributed during the military operation, while they were still under rocket fire from the Gaza Strip. The questionnaire included: socio-demographic characteristics; attitudes toward the military operation; ways to resolve the Israeli-Palestinian conflict; sense of coherence and state anxiety. Results indicate that both groups thought that the I-P conflict would not be resolved peacefully and that there were more wars to come. Furthermore, both national religious and ultra-Orthodox adolescents thought that this operation would have limited success for only a limited time. Regarding the differences between the groups, sense of coherence was higher among the ultra-Orthodox and this group also believed more than their counterparts that everything was in God's hands. Interesting results emerged with peaceful resolution being linked to more anxiety among the national religious group, while among the ultra-Orthodox group no relationships were indicated on

Re-designing the Mozambique vaccine supply chain to improve access to vaccines.

PubMed

Lee, Bruce Y; Haidari, Leila A; Prosser, Wendy; Connor, Diana L; Bechtel, Ruth; Dipuve, Amelia; Kassim, Hidayat; Khanlawia, Balbina; Brown, Shawn T

2016-09-22

Populations and routine childhood vaccine regimens have changed substantially since supply chains were designed in the 1980s, and introducing new vaccines during the "Decade of Vaccine" may exacerbate existing bottlenecks, further inhibiting the flow of all vaccines. Working with the Mozambique Ministry of Health, our team implemented a new process that integrated HERMES computational simulation modeling and on-the-ground implementers to evaluate and improve the Mozambique vaccine supply chain using a system-re-design that integrated new supply chain structures, information technology, equipment, personnel, and policies. The alternative system design raised vaccine availability (from 66% to 93% in Gaza; from 76% to 84% in Cabo Delgado) and reduced the logistics cost per dose administered (from $0.53 to $0.32 in Gaza; from $0.38 to $0.24 in Cabo Delgado) as compared to the multi-tiered system under the current EPI. The alternative system also produced higher availability at lower costs after new vaccine introductions. Since reviewing scenarios modeling deliveries every two months in the north of Gaza, the provincial directorate has decided to pilot this approach diverging from decades of policies dictating monthly deliveries. Re-design improved not only supply chain efficacy but also efficiency, important since resources to deliver vaccines are limited. The Mozambique experience and process can serve as a model for other countries during the Decade of Vaccines. For the Decade of Vaccines, getting vaccines at affordable prices to the market is not enough. Vaccines must reach the population to be successful. Copyright © 2016. Published by Elsevier Ltd.

Re-designing the Mozambique vaccine supply chain to improve access to vaccines

PubMed Central

Lee, Bruce Y.; Haidari, Leila A.; Prosser, Wendy; Connor, Diana L.; Bechtel, Ruth; Dipuve, Amelia; Kassim, Hidayat; Khanlawia, Balbina; Brown, Shawn T.

2017-01-01

Introduction Populations and routine childhood vaccine regimens have changed substantially since supply chains were designed in the 1980s, and introducing new vaccines during the “Decade of Vaccine” may exacerbate existing bottlenecks, further inhibiting the flow of all vaccines. Methods Working with the Mozambique Ministry of Health, our team implemented a new process that integrated HERMES computational simulation modeling and on-the-ground implementers to evaluate and improve the Mozambique vaccine supply chain using a system-re-design that integrated new supply chain structures, information technology, equipment, personnel, and policies. Results The alternative system design raised vaccine availability (from 66% to 93% in Gaza; from 76% to 84% in Cabo Delgado) and reduced the logistics cost per dose administered (from $0.53 to $0.32 in Gaza; from $0.38 to $0.24 in Cabo Delgado) as compared to the multi-tiered system under the current EPI. The alternative system also produced higher availability at lower costs after new vaccine introductions. Since reviewing scenarios modeling deliveries every two months in the north of Gaza, the provincial directorate has decided to pilot this approach diverging from decades of policies dictating monthly deliveries. Discussion Re-design improved not only supply chain efficacy but also efficiency, important since resources to deliver vaccines are limited. The Mozambique experience and process can serve as a model for other countries during the Decade of Vaccines. For the Decade of Vaccines, getting vaccines at affordable prices to the market is not enough. Vaccines must reach the population to be successful. PMID:27576077

31 CFR 595.508 - Official activities of certain international organizations; U.S. person employees of certain...

Code of Federal Regulations, 2010 CFR

2010-07-01

... governments of states bordering the West Bank or Gaza are authorized to engage in all transactions and... Secretariat, specifically including, among others, the World Bank, the International Monetary Fund, the World Food Programme, and the World Health Organization. [71 FR 27201, May 10, 2006] ...

31 CFR 594.510 - Official activities of certain international organizations; U.S. person employees of certain...

Code of Federal Regulations, 2010 CFR

2010-07-01

... governments of states bordering the West Bank or Gaza are authorized to engage in all transactions and... Secretariat, specifically including, among others, the World Bank, the International Monetary Fund, the World Food Programme, and the World Health Organization. [71 FR 27200, May 10, 2006] ...

How to Contain Iranian Influence in the Levant

DTIC Science & Technology

2011-03-10

although not necessarily having complete authoritative control over Hezbollah’s military wing. Economic support to Lebanon is estimated between...existent since mid-2007?20 Economically in FY 2009 the West Bank and Gaza received U.S. funding to support Basic Education, Maternal and Child Health

1979 and the Re-Emergence of the Islamic Empire

DTIC Science & Technology

2009-05-21

war created even more hostility as Egypt became embroiled in the geopolitics of the Arabian Peninsula, something Saudi Arabia viewed as clearly...Organization structure . At the same time that Arafat and the PLO organization were consolidating their position, a rival group was growing in the Gaza

USSR Report, Engineering and Equipment

DTIC Science & Technology

1984-04-17

MEKHANIKA ZHIDKOSTI I GAZA, No 5, May 83). 17 Wave Drag of Elongated Astroid Bodies at Moderate Supersonic Flight Velocities (M, I. Follej...mechanical components of such a test stand include an electric drive motor with speed regulation, a Belt transmission, a worm gear for speed

U.S. Foreign Aid to the Palestinians

DTIC Science & Technology

2009-07-16

Gaza conflict took place in Sharm al-Sheikh, Egypt on March 2, 2009. At the conference, Secretary of State Hillary Rodham Clinton pledged $900...part. Fayyad produced a Palestinian Reform and Development Plan for 2008-2010 (PRDP) that—even before the March 2009 donors’ conference in Sharm al

"Denial or Faith?" Therapy versus Messianism in Preparing for the Evacuation of Israeli Settlements

ERIC Educational Resources Information Center

Amrami, Galia Plotkin

2015-01-01

This article offers an ethnographic account of the professional activities of mental health practitioners, employed by the state's religious education system. I analyze various models implemented by practitioners for the purposes of preparing pupils for the state-mandated evacuation of Jewish settlers from Gaza and the West Bank. By focusing on…

Efficiency of Secondary Education in Selected OIC Countries

ERIC Educational Resources Information Center

Arshad, Mohd Nahar Mohd

2014-01-01

The purpose of this study is to investigate the level of technical efficiency of secondary education in 16 selected Organisation of Islamic Conference (OIC) countries (including West Bank and Gaza). Educational efficiency has become an important issue given many countries' pressing levels of public deficit and debt. Since the educational sector…

Contextualized Emotional Images in Children's Dreams: Psychological Adjustment in Conditions of Military Trauma

ERIC Educational Resources Information Center

Helminen, Elisa; Punamaki, Raija-Leena

2008-01-01

This study examines the impact of military trauma on contextualized emotional images in children's dreams, and the function of the intensity and valence of the emotional images in protecting mental health from negative trauma impact. Participants were 345 Palestinian children and adolescents (aged 5-16 years) belonging to high trauma (Gaza) and…

Israel: Background and U.S. Relations

DTIC Science & Technology

2014-07-31

59 End- Use Monitoring...conflict on July 6-7, 2014. Israel began a ground operation in Gaza on July 17 with the stated objective of destroying tunnels used by militants to...means of close-quarters combat (including the use of improvised explosive devices, or IEDs) have proven substantially lethal and damaging. According

Temperament-Based Learning Styles of Palestinian and US Children

ERIC Educational Resources Information Center

Oakland, Thomas; Alghorani, Mohammed Adnan; Lee, Dong Hun

2007-01-01

Temperament styles of 400 Palestinian children living in Gaza are described, examined for possible gender and age differences, and compared with those of 3,200 US children in light of Jung's theory of temperament as modified by Myers and Briggs. The results show that Palestinian children generally prefer practical to imaginative, feeling to…

Child Development and Family Mental Health in War and Military Violence: The Palestinian Experience

ERIC Educational Resources Information Center

Qouta, Samir; Punamaki, Raija-Leena; El Sarraj, Eyad

2008-01-01

The article reviews developmental research among Palestinians living in Gaza. The aims are, first, to analyze how exposure to traumatic events associates with children's mental health and their cognitive, emotional and social development. Second, we aimed to model familial and symbolic processes that can either harm or protect the mental health of…

Afghanistan and Pakistan Reconstruction Opportunity Zones (ROZs), H.R. 1318/H.R. 1886/H.R. 2410 and S. 496: Issues and Arguments

DTIC Science & Technology

2009-06-18

amended by the 1996 West Bank and Gaza Strip Free Trade Benefits Act (P.L. 104-234). Both encourage co-operative production by two or more countries...apparel items are covered in this category: coats, nightgowns and pajamas , and a few shirts and blouses. • Table A-2 includes textile and apparel

Rift Valley Fever Outbreak in Livestock, Mozambique, 2014.

PubMed

Fafetine, José M; Coetzee, Peter; Mubemba, Benjamin; Nhambirre, Ofélia; Neves, Luis; Coetzer, J A W; Venter, Estelle H

2016-12-01

In early 2014, abortions and death of ruminants were reported on farms in Maputo and Gaza Provinces, Mozambique. Serologic analysis and quantitative and conventional reverse transcription PCR confirmed the presence of Rift Valley fever virus. The viruses belonged to lineage C, which is prevalent among Rift Valley fever viruses in southern Africa.

Increasing disability-free life expectancy among older adults in Palestine from 2006 to 2010.

PubMed

Brønnum-Hansen, Henrik; Duraidi, Mohammed; Qalalwa, Khaled; Jeune, Bernard

2015-04-01

The population of Palestine comprises almost 200 000 Palestinians aged 60 or older. The purpose of the study was to estimate disability-free life expectancy for Palestinians living in the West Bank and Gaza Strip and to evaluate changes from 2006 to 2010. The study combined mortality data and prevalence of activity limitation derived from the Palestinian Family Health Surveys carried out in 2006 and 2010. Based on questions about the ability to perform five basic daily activities, disability-free life expectancy was estimated. Changes between 2006 and 2010 were decomposed into contributions from changes in mortality and disability. Life expectancy at age 60 increased from 17.1 years in 2006 to 17.3 years in 2010 for men and from 18.7 years to 19.0 years for women. Disability-free life expectancy increased significantly, by 1.3 years for 60-year-old men (from 12.8 years to 14.1 years) and 1.8 years for 60-year-old women (from 12.6 years to 14.4 years). This increase was seen in the Gaza Strip as well as in the West Bank. While the modest contribution of the mortality effect did not differ between gender and regions, the strong contributions from the disability effects varied, being greatest for women in the Gaza Strip. The significant increase in disability-free life expectancy for both genders is remarkable and, to our knowledge, not seen in other low-income countries. This change may be due to decreasing incidence of disability and greater recovery from disability as a result of better prevention, care and rehabilitation of chronic diseases. © The Author 2014. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

[Assessment of community health care services delivery during operation "Cast Lead"--a cross sectional survey].

PubMed

Savyon, Michal; Keinan-Boker, Lital; Enav, Teena; Rozentraub, Tammy; Laor, Danny; Shohat, Tamy

2010-12-01

On December 27th, 2008, the Israeli Defense Forces initiated operation "Cast Lead", aiming to strike the infrastructure of the terror organizations in the Gaza Strip. An emergency situation was declared on the home front, allowing the security forces special jurisdiction over the area. The Home Front Command's Medical Operation Center, in cooperation with the Superior National Health Authority of the Ministry of Health, coordinated the delivery of community health services. The objective of this study was to evaluate the delivery of community health services to the Israeli civilian population living in proximity to the Gaza Strip during operation "Cast Lead". A telephone household survey was initiated on the 20th day of the operation until two days after a cease-fire was declared. The sample was drawn from the Jewish population living within a radius of 40 kilometers from the Gaza Strip. Questions included the need and use of health care services, satisfaction with health care services and demographic variables. Overall, 901 interviews were conducted. Findings revealed that: 91.3%, 76.2% and 89.6% of those who needed primary physician, a specialist or a renewal of a drug prescription received these services, respectively; 87.1% of those who needed medical emergency services received them. The reported satisfaction with health care services during the combat period was very high; 91% reported high or very high satisfaction with their HMO's function during that period. The delivery of community health care services during operation "Cast Lead" efficiently addressed the needs of the population in the area. The delivery of medical emergency services and the access to medical specialists should be reassessed. It is important to plan ahead surveys such as the survey described above, and to cooperate with the HMO's and the Israel Defense Forces (IDF) in order to improve emergency preparedness.

The impact of occupation on child health in a Palestinian refugee camp.

PubMed

Basak, Polly

2012-12-01

This article focuses on child health in the Palestinian refugee camp of Dheisheh in the West Bank region of the Occupied Palestinian Territories. Thirty in-depth interviews were carried out with parents to determine their perceptions of their children's health. The questions related to physical, mental and social well-being, access to health facilities, factors that were likely to hinder health and measures that could be implemented to improve child health. The study was carried out prior to and during the Gaza War in December 2008 that resulted in the deaths of 1380 Palestinians including 431 children and 112 women [1]. The effects of occupation, conflict and being a refugee had a detrimental impact on perceptions of health. Interviewees revealed that their perceptions of their children's health were determined by the camp's conditions, the current economic climate, past and current political conflict and financial and social restrictions. The understanding of being healthy incorporated physical and mental health as well as social well-being. As a result, 70% of interviewees deemed that their children were not in good health. This finding accelerated to 100% after the Gaza War, showing the negative effect war has on health perceptions. Findings showed that perceptions of physical health are very much interlinked with mental well-being and parents' perceptions of their children's health, and are closely related to their state of mental health. Consequently, a clear correlation can be discerned between the ongoing occupation and its detrimental effects on mental health. Therapeutic and preventive health programmes such as child therapy and stress management that have already been implemented by the Gaza Community Mental Health Programme would be highly beneficial to both children and adults in Dheisheh refugee camp.

Education, Revolution and Evolution: The Palestinian Universities as Initiators of National Struggle 1972-1995

ERIC Educational Resources Information Center

Zelkovitz, Ido

2014-01-01

Since the concept of nationalism first emerged on the world stage, universities have played a key role in its collective formation and dissemination to the masses. Established under challenging circumstances and subjected to the Israeli occupation of the West Bank and Gaza Strip in the wake of the 1967 war, Palestinian institutions of higher…

Rift Valley Fever Outbreak in Livestock, Mozambique, 2014

PubMed Central

Coetzee, Peter; Mubemba, Benjamin; Nhambirre, Ofélia; Neves, Luis; Coetzer, J.A.W.; Venter, Estelle H.

2016-01-01

In early 2014, abortions and death of ruminants were reported on farms in Maputo and Gaza Provinces, Mozambique. Serologic analysis and quantitative and conventional reverse transcription PCR confirmed the presence of Rift Valley fever virus. The viruses belonged to lineage C, which is prevalent among Rift Valley fever viruses in southern Africa. PMID:27869589

Where's the Outrage Now?

ERIC Educational Resources Information Center

Gordon, Neve; Halper, Jeff

2009-01-01

This article reports that not one of the nearly 450 presidents of American colleges and universities who prominently denounced an effort by British academics to boycott Israeli universities in September 2007 have raised their voice in opposition to Israel's bombardment of the Islamic University of Gaza at the end of December. How should academics…

Lawfare: A Decisive Element of 21st-Century Conflicts?

DTIC Science & Technology

2009-01-01

the best of my knowledge, lawfare as used in today’s context first appeared in my 2001 essay for Harvard University’s Carr Center.2 At that time, the...the_ngo_ front_in_the_gaza_war_lawfare_against_israel>. 41 Lyric Wallwork Winik, “A Marine’s Toughest Mission,” Parade Magazine, January 19, 2003

Justification, Perception of Severity and Harm, and Criminalization of Wife Abuse in the Palestinian Society

ERIC Educational Resources Information Center

Haj-Yahia, Muhammad M.; Wilson, Rula M.; Naqvi, Syed Agha M.

2012-01-01

The purpose of this study was to examine the perceptions of Palestinian adults toward different dimensions of wife abuse. A cross-sectional survey, using a combination of self-administered questionnaires and interviews, was conducted among a systematic random sample of 624 adult Palestinian men and women from the West Bank and Gaza Strip (18 years…

Hard Fighting: Israel in Lebanon and Gaza

DTIC Science & Technology

2011-01-01

mines . Hezbollah itself also proved an unexpectedly formidable adversary. During the years leading up to the Second Lebanon War, Hezbollah forces...hitting Hamas positions and detonating mines and IEDs. IDF engineers used armored D-9 bulldozers to clear paths through the remaining IEDs. Armored...discipline; cellular structure; small formations (squads) • Weapons: small arms; RPGs; mortars; short- range rockets; IEDs/ mines • Command and control

Militarism's Killing Fields: From Gaza to Ferguson

ERIC Educational Resources Information Center

Giroux, Henry

2014-01-01

Militarization and a military definition of life and culture have become normalized in the United States. This article explores the ways in which a military metaphysics has become the new normal for a nation not only at war abroad but also at home, especially with regards to the ongoing assaults waged by the state against youth, immigrants, and…

Quality of life of Syrian refugees living in camps in the Kurdistan Region of Iraq.

PubMed

Aziz, Izaddin A; Hutchinson, Claire V; Maltby, John

2014-01-01

The current study explores the perceived quality of life of Syrian refugees who have entered the Kurdistan Region of Iraq. Two hundred and seventy participants residing in refugee camps in the Erbil region in Kurdistan completed the WHOQOL-BREF, which measures Quality of Life (QOL) within four domains; physical, psychological, social relationships and environment. Syrian refugees in Kurdistan scored significantly lower for general population norms on physical health, psychological and environment QOL, and score significantly lower for physical health and psychological QOL for refugees in the Gaza strip. However, respondents in the current sample scored significantly higher on environment QOL compared to refugees in the Gaza strip, and significantly higher on all the QOL domains than those reported for refugees in West Africa. Finally, Syrian refugees in Kurdistan scored significantly higher than general population norms for social relationships QOL. The current findings provide the first report of QOL domain scores among Syrian refugees in the Kurdistan camps and suggest that social relationships and environmental QOL circumstances are relatively satisfactory, and that further investigation might be focused on physical and psychological QOL.

Use of Different Information Sources for Decision Making by Traditional Farmers in a Progressive Knowledge System.

ERIC Educational Resources Information Center

Blum, Abraham

1989-01-01

A study determined the use of different information sources for decision making used by traditional Arab farmers in Israel. A questionnaire was used to interview 48 farmers from 4 villages in the Nazareth region and 56 farmers from 5 villages in the Gaza strip in their homes. Farmers were asked to name major innovations they had adopted during the…

How Terrorist Groups End: Lessons for Countering al Qa’ida

DTIC Science & Technology

2008-01-01

prophecies of Nostradamus, the Book of Revelation in the Christian Bible , Buddhist scripture, and other personal revelations. In 1993, Asahara publicly...Texas (U.S.) 1995–1998 100s H F RW TC PO Resistenza Corsa (France) 2002–2003 10s H F N TC S Revenge of the Hebrew Babies (Israel, West Bank/Gaza) 2002

Psychosocial Outcomes Related to Subjective Threat from Armed Conflict Events (STACE): Findings from the Israeli-Palestinian Cross-Cultural HBSC Study

ERIC Educational Resources Information Center

Harel-Fisch, Yossi; Radwan, Qasrowi; Walsh, Sophie D.; Laufer, Avital; Amitai, Gabriel; Fogel-Grinvald, Haya; Abdeen, Ziad

2010-01-01

Objective: This study investigates the relationship between exposure to armed conflict and terror events, and an array of mental and behavioral outcomes within a large cross-cultural scientifically representative sample of 24,935 Palestinian (7,430 West Bank and 7,217 Gaza) and Israeli (5,255 Jewish and 6,033 Arab) 11-, 13-, and 15-year-old school…

Sub-Saharan Africa Report Tables of Contents JPRS-SSA-86-096, 17 September 1986-JPRS-SSA-86-125, 30 December 1986

DTIC Science & Technology

1987-02-21

Drought Victims Receive Clothing, Medicine (NOTICIAS, 20 Sep 86) 23 Cashew Nut Tree Planting Campaign in Angoche (NOTICIAS, 23 Sep 86) 25...Cultivation Study (NOTICIAS, 10 Jul 86) 49 Inhambane Cashew Marketing Campaign Ends Successfully (NOTICIAS, 25 Jul 86)... 52 Beira Port...23 Briefs Gaza Cashew Marketing Figures 25 Machanga Salt, Fish Production Hampered 25 Beira Drainage System Soon 26 SWAZILAND Briefs Warning

JPRS Report, Near East & South Asia

DTIC Science & Technology

1989-08-28

especially the cultivation of citrus fruits , produced fruits which represented approximately 26 percent of total production. After occupying what was left...oranges. After Egyptians took over the administration of Gaza, the Egyptian Government once again encouraged the cultivation of citrus fruits there...because there were no employment opportunities. Palestinians managed to cul- tivate approximately 75,000 dunums with citrus fruits . After the 1967

Wonders of the World

ERIC Educational Resources Information Center

Healy, John W.

2006-01-01

The Taj Mahal, the Eiffel Tower, the Leaning Tower of Pisa, the Great Pyramids of Gaza and the Great Wall of China--all are architectural symbols of a national, proudly shared identity of the people who live near these structures. A country's unique architecture can be a form of art to study as well as a symbol of pride and unity. The author of…

Israel: Background and U.S. Relations in Brief

DTIC Science & Technology

2017-02-24

further negotiation . The status of the Gaza Strip is a final status issue to be resolved through negotiations . Israel proclaimed Jerusalem as its...largely anticipated a negotiated conflict-ending outcome that would result in two states.8 In a White House press conference on February 15, 2017...pending negotiations between Israel, Egypt, Jordan, and Palestinian representatives on the territories’ final status. April 1987 – Secret London

Israel: Background and U.S. Relations

DTIC Science & Technology

2012-02-29

security goals and have developed close relations based on common perceptions of shared democratic values and religious affinities. U.S. policymakers...and Christian religious claims in the city. Although Israel withdrew its permanent military presence from the Gaza Strip in 2005, it still controls...trends partly explain why Israel’s current Jewish population is “more nationalistic, religiously conservative, and hawkish on foreign policy and

iss047e057822

NASA Image and Video Library

2016-04-14

ISS047e057822 (04/14/2016) --- The Middle East is seen from 250 miles above in this photo from the International Space Station. Countries seen left to right along the Mediterranean coast include Egypt, Gaza, Saudi Arabia, Israel, Lebanon, Syria, and Turkey. The major waterways shown from left to right are the Nile River, Gulf of Suez, Gulf of Aqaba, and the Red Sea.

The clinical burden of human cystic echinococcosis in Palestine, 2010-2015

PubMed Central

Al-Jawabreh, Amer; Ereqat, Suheir; Dumaidi, Kamal; Nasereddin, Abdelmajeed; Al-Jawabreh, Hanan; Azmi, Kifaya; Al-Laham, Nahed; Nairat, Moath; Casulli, Adriano; Maqboul, Husni; Abdeen, Ziad

2017-01-01

Background Cystic echinococcosis (CE) is classified by the WHO as a neglected disease inflicting economic losses on the health systems of many countries worldwide. The aim of this case-series study was to investigate the burden of human CE in Palestine during the period between 2010 and 2015. Methodology/Principal findings Records of surgically confirmed CE patients from 13 public and private hospitals in the West Bank and Gaza Strip were reviewed. Patients’ cysts were collected from surgical wards and formalin-fixed paraffin-embedded (FFPE) blocks were collected from histopathology departments. Molecular identification of CE species /genotypes was conducted by targeting a repeat DNA sequence (EgG1 Hae III) within Echinococcus nuclear genome and a fragment within the mitochondrial cytochrome c oxidase subunit 1, (CO1). Confirmation of CE species/genotypes was carried out using sequencing followed by BLAST analysis and the construction of maximum likelihood consensus dendrogram. CE cases were map-spotted and statistically significant foci identified by spatial analysis. A total of 353 CE patients were identified in 108 localities from the West Bank and Gaza Strip. The average surgical incidence in the West Bank was 2.1 per 100,000. Spot-mapping and purely spatial analysis showed 13 out of 16 Palestinian districts had cases of CE, of which 9 were in the West Bank and 4 in Gaza Strip. Al-Khalil and Bethlehem were statistically significant foci of CE in Palestine with a six-year average incidence of 4.2 and 3.7 per 100,000, respectively. Conclusions/Significance To the best of our knowledge, this is the first confirmation of human CE causative agent in Palestine. This study revealed that E. granulosus sensu stricto (s.s.) was the predominating species responsible for CE in humans with 11 samples identified as G1 genotype and 2 as G3 genotype. This study emphasizes the need for a stringent surveillance system and risk assessment studies in the rural areas of high

The clinical burden of human cystic echinococcosis in Palestine, 2010-2015.

PubMed

Al-Jawabreh, Amer; Ereqat, Suheir; Dumaidi, Kamal; Nasereddin, Abdelmajeed; Al-Jawabreh, Hanan; Azmi, Kifaya; Al-Laham, Nahed; Nairat, Moath; Casulli, Adriano; Maqboul, Husni; Abdeen, Ziad

2017-07-01

Cystic echinococcosis (CE) is classified by the WHO as a neglected disease inflicting economic losses on the health systems of many countries worldwide. The aim of this case-series study was to investigate the burden of human CE in Palestine during the period between 2010 and 2015. Records of surgically confirmed CE patients from 13 public and private hospitals in the West Bank and Gaza Strip were reviewed. Patients' cysts were collected from surgical wards and formalin-fixed paraffin-embedded (FFPE) blocks were collected from histopathology departments. Molecular identification of CE species /genotypes was conducted by targeting a repeat DNA sequence (EgG1 Hae III) within Echinococcus nuclear genome and a fragment within the mitochondrial cytochrome c oxidase subunit 1, (CO1). Confirmation of CE species/genotypes was carried out using sequencing followed by BLAST analysis and the construction of maximum likelihood consensus dendrogram. CE cases were map-spotted and statistically significant foci identified by spatial analysis. A total of 353 CE patients were identified in 108 localities from the West Bank and Gaza Strip. The average surgical incidence in the West Bank was 2.1 per 100,000. Spot-mapping and purely spatial analysis showed 13 out of 16 Palestinian districts had cases of CE, of which 9 were in the West Bank and 4 in Gaza Strip. Al-Khalil and Bethlehem were statistically significant foci of CE in Palestine with a six-year average incidence of 4.2 and 3.7 per 100,000, respectively. To the best of our knowledge, this is the first confirmation of human CE causative agent in Palestine. This study revealed that E. granulosus sensu stricto (s.s.) was the predominating species responsible for CE in humans with 11 samples identified as G1 genotype and 2 as G3 genotype. This study emphasizes the need for a stringent surveillance system and risk assessment studies in the rural areas of high incidence as a prerequisite for control measures.

Israel: Background and U.S. Relations in Brief

DTIC Science & Technology

2017-01-06

future Israeli-Palestinian negotiations by Secretary of State John Kerry on December 28, 2016, and other statements and actions related to issues of...Interim Agreement; permanent status to be determined through further negotiation . The status of the Gaza Strip is a final status issue to be resolved...through negotiations . Israel proclaimed Jerusalem as its capital in 1950, but the United States, like nearly all other countries, retains its embassy in

CTC Sentinel. Volume 2, Issue 5, May 2009

DTIC Science & Technology

2009-05-01

in Gaza and criticism of Arab leaders, including Egyptian President Hosni Mubarak, Hizb Allah leader Hassan Nasrallah, and Saudi Interior Minister...alleged al-Qa`ida media coordinator formerly affiliated with Egyptian Jama`a al-Islamiyya. Saudi documents charge him with holding a senior...community in February and March 2009, after a handful of Shi`a were manhandled by religious police during a pilgrimage to the tombs of their imams at the

Israel and an Emerging World Order

DTIC Science & Technology

2014-12-01

Tayyip Erdogan to apologize for Israel’s role in the 2010 Mavi Marmara incident. This incident—which resulted in the death of nine Turkish citizens...Israeli relations, particularly Turkey’s relationship with Hamas. Prime Minister Erdogan 56 Oktav, “Regionalism,” 84–85; Efraim Inbar, “Israeli...Minister Erdogan publicly confronted Israeli President Peres about the Gaza offensive and accused him of crimes against humanity.61 Turkish-Israeli

Prospects for Closer Israeli-NATO Cooperation

DTIC Science & Technology

2015-09-01

Prime Minister Recep Tayyip Erdogan , “in the midst of his presidential campaign, equated Israeli policy towards Gaza to a systematic genocide and...Recep Tayyip Erdogan , the Turkish Flotilla incident on May 31, 2010 ended Israeli-Turkish political ties, but not economic relations. Prime Minister...ties. 146 Ibid. 27 Israeli apology, Erdogan stated “there is no chance ‘to have any positive engagement with Israel,’ dismissing any prospect of

Environmental Security: A Strategy for the Mitigation of Regional Instabilities?

DTIC Science & Technology

2003-04-07

Fungal infections and intestinal roundworms are common, particularly in the refugee camps. A cholera outbreak was reported in November of 1994 in Gaza...Saharan Africa is noted for its recurring food shortages. All three types of environmental scarcity have been present in Angola, Ethiopia , Eritrea...approximately 11 million people in Ethiopia alone are facing serious food shortages in 2003.58 A historical perspective of the distribution of the world’s

Conflict, Cooperation, and Viability: Interstate Water Resources and Domestic Water Use in the Middle East

DTIC Science & Technology

2011-03-01

substantial portion of the water used by several Middle Eastern nations, however, comes from nonrenewable groundwater, such as fossil aquifers .37...crosses boundaries. West of the Jordan River, three aquifers are the primary sources of water; and these basins for the most part recharge in the West...Bank and discharge into various areas of Israel.79 The coastal aquifer and Gaza aquifer also provide significant sources of groundwater to Israel

Saddam is Iraq: Iraq is Saddam

DTIC Science & Technology

2002-11-01

Jan. 24, 2001. 75. The Christian Science Monitor, Feb. 2, 2001. 76. See, for example, Nidal al - Mughrabi , reporting from Gaza, Reuters, Jan. 17, 2001...Press Maxwell AFB, AL 36112-6615 8. PERFORMING ORGANIZATION REPORT NUMBER 9. SPONSORING/MONITORING AGENCY NAME(S) AND ADDRESS(ES) 10. SPONSOR...No. 17 and previous papers in this series are available from the USAF Counterproliferation Center, 325 Chennault Circle, Maxwell AFB AL 36112-6427

Factors associated with anemia in refugee children.

PubMed

Hassan, K; Sullivan, K M; Yip, R; Woodruff, B A

1997-11-01

A nutrition survey was performed in 1990 among children 6 through 35 mo of age living in Palestinian refugee camps in Syria, Jordan, the West Bank, Gaza Strip and Lebanon. Overall, 67% [95% confidence interval (CI): 66, 68] were anemic (hemoglobin <110 g/L), ranging from 54% in the West Bank to 75% in Syria. The following factors were significantly associated with anemia in one or more of three age groups (6-11.9, 12-23.9 and 24-35.9 mo) by logistic regression: living in Syria, Lebanon, or Gaza [with prevalence odds ratios (POR) in the range of 1.4-2.6 depending on the age group and area, relative to children living in Jordan]; never having been breast-fed (POR = 1.7); male sex (POR = 1.2); maternal illiteracy (POR = 1.4 relative to those with >/=6 y of education); having a recent (within 2 wk) or current episode of fever or diarrhea; and stunting. Recent or current illness and stunting interacted in two age groups with the general trend of stunted children with recent or current illness having high POR. Early childhood anemia is associated with factors reflecting poor socioeconomic status and recent diarrheal and febrile illnesses in Palestinian refugee camps.

Earth observations taken from shuttle orbiter Columbia

NASA Image and Video Library

1995-10-26

STS073-708-089 (26 October 1995) --- As evidenced by this 70mm photograph from the Earth-orbiting Space Shuttle Columbia, international borders have become easier to see from space in recent decades. This, according to NASA scientists studying the STS-73 photo collection, is particularly true in arid and semi-arid environments. The scientists go on to cite this example of the razor-sharp vegetation boundary between southern Israel and Gaza and the Sinai. The nomadic grazing practices to the south (the lighter areas of the Sinai and Gaza, top left) have removed most of the vegetation from the desert surface. On the north side of the border, Israel uses advanced irrigation techniques in Israel, mainly "trickle irrigation" by which small amounts of water are delivered directly to plant roots. These water-saving techniques have allowed precious supplies from the Jordan River to be used on farms throughout the country. Numerous fields of dark green can be seen in this detailed view. Scientists say this redistribution of the Jordan River waters has increased the Israeli vegetation cover to densities that approach those that may have been common throughout the Mid-East in wetter early Biblical times. A small portion of the Mediterranean Sea appears top right.

Childhood Lead Exposure in the Palestinian Authority, Israel, and Jordan: Results from the Middle Eastern Regional Cooperation Project, 1996–2000

PubMed Central

Safi, Jamal; Fischbein, Alf; Haj, Sameer El; Sansour, Ramzi; Jaghabir, Madi; Hashish, Mohammed Abu; Suleiman, Hassan; Safi, Nimer; Abu-Hamda, Abed; Witt, Joyce K.; Platkov, Efim; Reingold, Steven; Alayyan, Amber; Berman, Tamar; Bercovitch, Matti; Choudhri, Yogesh; Richter, Elihu D.

2006-01-01

In the Middle East, the major sources of lead exposure have been leaded gasoline, lead-contaminated flour from traditional stone mills, focal exposures from small battery plants and smelters, and kohl (blue color) in cosmetics. In 1998–2000, we measured blood lead (PbB) levels in children 2–6 years of age in Israel, Jordan, and the Palestinian Authority (n = 1478), using a fingerstick method. Mean (peak; percentage > 10 μg/dL) PbB levels in Israel (n = 317), the West Bank (n = 344), Jordan (n = 382), and Gaza (n = 435) were 3.2 μg/dL (18.2; 2.2%), 4.2 μg/dL (25.7; 5.2%), 3.2 μg/dL (39.3; < 1%), and 8.6 μg/dL (> 80.0; 17.2%), respectively. High levels in Gaza were all among children living near a battery factory. The findings, taken together with data on time trends in lead emissions and in PbB in children in previous years, indicate the benefits from phasing out of leaded gasoline but state the case for further reductions and investigation of hot spots. The project demonstrated the benefits of regional cooperation in planning and carrying out a jointly designed project. PMID:16759995

The Arab Spring: Comparing U.S. Reactions in Libya and Syria

DTIC Science & Technology

2012-03-22

UNSCR 1973, jointly written by the United Kingdom, France and Lebanon was less strongly worded proposing simply a ban on all flights in Libya...supports and arms Hezbollah in Lebanon and until recently Hamas in Gaza, in its “cold war” against Israel. Hamas 20 maintained a strong leadership...continues to maintain close ties to Iran through its offices in Syria as well as in Lebanon . In Syria, reports surfaced of Iranian intelligence

The Threat of Intentional Oil Spills to Desalination Plants in the Middle East: A U.S. Security Threat

DTIC Science & Technology

1998-04-01

desalination plants.”14 Kuwait and Qatar are almost entirely dependant on desalination plants already for their drinking water and with Qatar’s only aquifer ...rivers), below ground aquifers , and desalination facilities; the focus of this paper. Mary E. Morris most succinctly describes the basic water issues in...with different players and different issues: The first set involves the Jordan and Yarmuk River systems, as well as the West Bank and Gaza aquifers

Qatar: Background and U.S. Relations

DTIC Science & Technology

2012-06-06

previously contested principle that future successors to the throne will follow the line of the emir’s male offspring. The emir’s fourth-oldest son...2009 Gaza war and has not been reopened. In recent years, some observers have viewed Qatar’s diplomatic approach as supportive of Hamas and...support Palestinian call for peace conference,” February 12, 2012. 7 Daily Star (Beirut), “Qatari Mediation Fails to Bridge Hamas-Fatah Gap,” October 11

The United States Navy and Israeli Navy: Background, Current Issues, Scenarios, and Prospects

DTIC Science & Technology

2012-02-01

differed as to the motives they ascribed to Israel for launching the attack. Whatever the motives, tapes declassified by the National Security Agency in...implicated the Israelis. The controversy is unlikely to end until all NSA tapes are declassified. Possibly because the Naval Court of Inquiry had cleared...flotilla to Gaza. That Turkey might do so is a very real possibility: it was first raised by Prime Minister Erdogan in the aftermath of the Mavi Marmara

JPRS Report, Near East & South Asia

DTIC Science & Technology

1989-03-28

Arab Nuclear, CBW Capabilities, Use [Cairo AL-SHA’B 24, 31 Jan ] 3 Egyptian Writer Sees North Sudanese Urging Secession of South [Cairo AL...Economic Difficulties in West Bank, Gaza Described [Al-Dammam AL-1QTISAD WA AL-’AMAL Jan ] 18 EGYPT Port Sa’id Faces Economic, Development...Troubles 20 Free Zone in Decline [ AKHBAR AL-YA WM 3 Dec] 20 Officials, Businessmen Try To Counter Falling Dollar [ AKHBAR AL-YA WM 3 Dec] 21 ISRAEL

A Predictive Logistic Regression Model of World Conflict Using Open Source Data

DTIC Science & Technology

2015-03-26

Added to the United Nations list are Palestine (West Bank and Gaza) and Kosovo. The total number of modeled nations is 182. Not all of these...The 26 variables are listed in Table 4. Also listed in Table 4 are the year the dataset was first collected, the data lag and the number of nation...state of violent conflict in 2015, seventeen of them are new to conflict since the last published list in 2013. A prediction tool is created to allow

The Arc: A Formal Structure for a Palestinian State

DTIC Science & Technology

2007-01-01

migrants will have to overcome divisions among themselves stemming from differences in dialect and habit acquired in their most recent countries of...West Bank and 0.60 in INTRODUCTION [ 3 ] Gaza. In developing countries the ratio is 1.2; in the rest of the Middle East it is 0.96. In developed... countries the ratio is 3.1. The circumstances just described apply to a world in which there has been no large- scale refugee return. If, as anticipated, a

Quantification of leachate discharged to groundwater using the water balance method and the hydrologic evaluation of landfill performance (HELP) model.

PubMed

Alslaibi, Tamer M; Abustan, Ismail; Mogheir, Yunes K; Afifi, Samir

2013-01-01

Landfills are a source of groundwater pollution in Gaza Strip. This study focused on Deir Al Balah landfill, which is a unique sanitary landfill site in Gaza Strip (i.e., it has a lining system and a leachate recirculation system). The objective of this article is to assess the generated leachate quantity and percolation to the groundwater aquifer at a specific site, using the approaches of (i) the hydrologic evaluation of landfill performance model (HELP) and (ii) the water balance method (WBM). The results show that when using the HELP model, the average volume of leachate discharged from Deir Al Balah landfill during the period 1997 to 2007 was around, 6800 m3/year. Meanwhile, the average volume of leachate percolated through the clay layer was 550 m3/year, which represents around 8% of the generated leachate. Meanwhile, the WBM indicated that the average volume of leachate discharged from Deir Al Balah landfill during the same period was around 7660 m3/year--about half of which comes from the moisture content of the waste, while the remainder comes from the infiltration of precipitation and re-circulated leachate. Therefore, the estimated quantity of leachate to groundwater by these two methods was very close. However, compared with the measured leachate quantity, these results were overestimated and indicated a dangerous threat to the groundwater aquifer, as there was no separation between municipal, hazardous and industrial wastes, in the area.

Libraries in the West Bank and Gaza: Obstacles and Possibilities.

ERIC Educational Resources Information Center

Bergan, Erling

This paper provides an overview of Palestinian libraries. The following topics are addressed: historical and political background on Palestine; the Ansari Public Library in East Jerusalem; the Khalidi Family Library in the Old City of Jerusalem; mosque libraries; the Nablus Public Library; the Palestinian Library and Information Association; other…

Detection of Poliovirus Circulation by Environmental Surveillance in the Absence of Clinical Cases in Israel and the Palestinian Authority

PubMed Central

Manor, Y.; Handsher, R.; Halmut, T.; Neuman, M.; Bobrov, A.; Rudich, H.; Vonsover, A.; Shulman, L.; Kew, O.; Mendelson, E.

1999-01-01

The global eradication of poliomyelitis, believed to be achievable around the year 2000, relies on strategies which include high routine immunization coverage and mass vaccination campaigns, along with continuous monitoring of wild-type virus circulation by using the laboratory-based acute flaccid paralysis (AFP) surveillance. Israel and the Palestinian Authority are located in a geographical region in which poliovirus is still endemic but have been free of poliomyelitis since 1988 as a result of intensive immunization programs and mass vaccination campaigns. To monitor the wild-type virus circulation, environmental surveillance of sewage samples collected monthly from 25 to 30 sites across the country was implemented in 1989 and AFP surveillance began in 1994. The sewage samples were processed in the laboratory with a double-selective tissue culture system, which enabled economical processing of large number of samples. Between 1989 and 1997, 2,294 samples were processed, and wild-type poliovirus was isolated from 17 of them in four clusters, termed “silent outbreaks,” in September 1990 (type 3), between May and September 1991 (type 1), between October 1994 and June 1995 (type 1), and in December 1996 (type 1). Fifteen of the 17 positive samples were collected in the Gaza Strip, 1 was collected in the West Bank, and 1 was collected in the Israeli city of Ashdod, located close to the Gaza Strip. The AFP surveillance system failed to detect the circulating wild-type viruses. These findings further emphasize the important role that environmental surveillance can play in monitoring the eradication of polioviruses. PMID:10325305

Cone-rod dystrophy and amelogenesis imperfecta (Jalili syndrome): phenotypes and environs.

PubMed

Jalili, I K

2010-11-01

To report a new phenotype with additional data on the oculo-dental syndrome of cone-rod dystrophy (CRD) and amelogenesis imperfecta (AI) caused by mutations on CNNM4, a metal transporter, with linkage at achromatopsia locus 2q11 (Jalili syndrome). Three siblings aged 5, 6, and 10 years from a six-generation Arab family in Gaza City underwent full systemic, ophthalmic, and dental examinations, investigations and detailed genealogy. Subjects presented at early childhood with visual impairment and abnormal dentition together with photophobia and fine nystagmus increasing under photopic conditions, in the presence of normal fundi. Electrophysiologically, photopic flicker responses were impaired; scotopic responses were extinguished at the age of 10 years. Anterior open bite accompanied AI in all siblings. The syndrome formed 83% of CRD cases in the Gaza Strip, which has a prevalence of 1 : 10,000. On the basis of clinical features and electrophysiology, two phenotypes exist: an infancy onset form with progressive macular lesion and an early childhood onset form with normal fundi. More prevalent than previously thought, Jalili syndrome presents a model of the effect of different mutations of the same genetic defect, observations of the same phenotype at different stages of the natural history of the disease, and the influence of epigenetic and tissue-specific factors as causes of phenotypic variability. The paper calls for action to tackle consanguinity in endogamous communities, addresses the possible role of high fluoride levels in groundwater as a trigger for genetic mutations, and the use of red-tinted filter in cone disorders.

3 CFR - Unexpected Urgent Refugee and Migration Needs Related to Gaza

Code of Federal Regulations, 2010 CFR

2010-01-01

... urgent refugee and migration needs, including by contributions to international, governmental, and nongovernmental organizations and payment of administrative expenses of Bureau of Population, Refugees, and...

Food habits and physical activity patterns among Palestinian adolescents: findings from the national study of Palestinian schoolchildren (HBSC-WBG2004).

PubMed

Al Sabbah, H; Vereecken, C; Kolsteren, P; Abdeen, Z; Maes, L

2007-07-01

To describe the food habits and physical (in)activity patterns and to investigate the relationship with sociodemographic factors among Palestinian adolescents. The Palestinian Health Behaviour in School-aged Children (HBSC) is a cross-sectional survey of grades 6, 8, 10 and 12. Students completed a modified version of the international HBSC questionnaire. A total of 8885 students were included in this analysis; 53% were from the West Bank and 47% from the Gaza Strip. Adolescents in the West Bank consume more fruit, meat, chicken, sweets and soft drinks, but less vegetables than adolescents in Gaza (P<0.01). Girls reported more daily consumption of fruit, vegetables and sweets than boys (P<0.001), and less consumption of soft drinks, milk, meat and chicken (P<0.01). Boys were physically more active than girls (P<0.01), whereas girls reported doing more homework (P<0.001). Both boys and girls reported less physical activity with increasing age (P<0.001). Consumption of fruit and milk was positively associated with both parents' education, while consumption of meat, chicken and soft drinks was positively associated with mother's education only. Having breakfast on schooldays was positively associated with the father's education. Physical activity and television viewing were associated with the mother's education (P<0.01). The parents' level of education had no effect on vegetable consumption and dieting status. This study indicated that there are problems with Palestinian adolescents' eating, dieting and physical activity. Regional, gender and parental socio-economic status differences should be taken into account in developing interventions. More detailed studies are needed with more elaborate instruments about food habits and physical activity of adolescents.

Risk factors for DSM-5 posttraumatic stress symptoms (PTSS) among Israeli civilians during the 2014 Israel-Hamas war.

PubMed

Gil, Sharon; Weinberg, Michael; Shamai, Michal; Ron, Pnina; Harel, Hila; Or-Chen, Keren

2016-01-01

In light of current modifications in the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) diagnostic criteria for posttraumatic stress disorder (PTSD), this study aimed to revalidate well-known PTSD risk factors related to terrorism and war in Israel, namely, proximity to the Gaza Strip, dissociative symptoms, acute stress disorder (ASD) symptoms, and social support. One hundred and sixty Israeli civilians were assessed during the 2014 Israel-Hamas war at 2 time points: 1 week after the beginning of the operation (t1) and 1 month after initial evaluation (t2), using the DSM-5 PTSD Symptom Levels Scale (PSLS; Gil, Weinberg, Or-Chen, & Harel, 2015). A paired t test analysis showed significant reduction in the respondents' posttraumatic stress symptoms (PTSS) 1 month after the initial assessment point. A structural equation model (SEM) showed that higher ASD symptoms at t1 and higher dissociative symptoms at t2 increased the risk for PTSS at t2. Conversely, higher peritraumatic dissociation at t1 decreased the risk for PTSS at t2. Proximity to the Gaza Strip, and social support, failed to demonstrate significant association with PTSS at t2. DSM-5 PTSS 1 month after prolonged traumatic exposure are strongly associated with high ASD symptoms at 1 week as a risk factor; high levels of peritraumatic dissociation at 1 week as a protective factor; and high levels of dissociative symptoms at 1 month as a risk factor. Theoretically and clinically the findings of the study further suggest that ongoing massive terrorism and war cannot be viewed or treated as identical to other traumas. (c) 2016 APA, all rights reserved).

Loss of social resources predicts incident posttraumatic stress disorder during ongoing political violence within the Palestinian Authority.

PubMed

Hall, Brian J; Murray, Sarah M; Galea, Sandro; Canetti, Daphna; Hobfoll, Stevan E

2015-04-01

Exposure to ongoing political violence and stressful conditions increases the risk of posttraumatic stress disorder (PTSD) in low-resource contexts. However, much of our understanding of the determinants of PTSD in these contexts comes from cross-sectional data. Longitudinal studies that examine factors associated with incident PTSD may be useful to the development of effective prevention interventions and the identification of those who may be most at-risk for the disorder. A 3-stage cluster random stratified sampling methodology was used to obtain a representative sample of 1,196 Palestinian adults living in Gaza, the West Bank and East Jerusalem. Face-to-face interviews were conducted at two time points 6-months apart. Logistic regression analyses were conducted on a restricted sample of 643 people who did not have PTSD at baseline and who completed both interviews. The incidence of PTSD was 15.0 % over a 6-month period. Results of adjusted logistic regression models demonstrated that talking to friends and family about political circumstances (aOR = 0.78, p = 0.01) was protective, and female sex (aOR = 1.76, p = 0.025), threat perception of future violence (aOR = 1.50, p = 0.002), poor general health (aOR = 1.39, p = 0.005), exposure to media (aOR = 1.37, p = 0.002), and loss of social resources (aOR = 1.71, p = 0.006) were predictive of incident cases of PTSD. A high incidence of PTSD was documented during a 6-month follow-up period among Palestinian residents of Gaza, the West Bank, and East Jerusalem. Interventions that promote health and increase and forestall loss to social resources could potentially reduce the onset of PTSD in communities affected by violence.

Women's oral and dental health aspects in humanitarian missions and disasters: Jordanian experience.

PubMed

Smadi, Leena; Sumadi, Aiman Al

2016-01-01

The study aimed to review oral and dental health aspects in female patients presented to Jordanian Royal Medical Services (RMS) international humanitarian missions over a 3-year period. Analysis of humanitarian missions of RMS data and records over a 3-year period (2011-2013) in regard to women's oral and dental health issues was done. The data were analyzed in regard to the number of women seen, the presenting conditions, and the prevalence of oral and dental diseases and procedures in these cases. During the 3-year period, 72 missions were deployed in four locations (Gaza, Ram Allah-West Bank, Jeneen-West Bank, and Iraq). The total number of females seen in this period was 86,436 women, accounting for 56 percent of adult patients seen by RMS humanitarian missions. Dental Clinics were deployed to only two missions (Iraq and Gaza), during which they received 13,629 visits; of these, 41 percent were females (5,588 patients), 29 percent were males, and 30 percent were in the pediatric age group. Trauma accounts for only 7 percent of the cases, while nonacute dental problems (caries and gingivitis) were responsible for the majority of cases (31.6 and 28.7 percent, respectively). RMS dental services during humanitarian mission deployment are a vital part of comprehensive healthcare. Women usually seek more dental care than men, with the majority of treatments for nonacute conditions. RMS experiences demonstrate the tremendous need for a well-defined preparedness plan for deployment of humanitarian missions that considers the contributions of all types of health professionals, the appropriate mobile technology to respond to emergent health risks, and a competent workforce ready and able to respond. Such preparation will require our dental education programs to develop disaster preparedness competencies to achieve the desired level of understanding.

Eyeless in Gaza: Some Reflections on Teaching Early English Literature in Israel

ERIC Educational Resources Information Center

Ebel, Julia

1973-01-01

The author makes, in her words, a simplistic parallel between the rejection of white culture by American Negroes and the rejection of western literature, particularly the predominantly Christian literature of the Medieval and Renaissance periods in England. (MM)

The Abstract Thinking Levels of the Science-Education Students in Gaza Universities

ERIC Educational Resources Information Center

Darwish, Ata H.

2014-01-01

The purpose of this study was to determine the abstract thinking levels of the science students attending the first and fourth year at two Palestinian Universities (Al-Aqsa and Al-Azhar). The sample consisted of 133 students from Science Education Departments (SE). The tool, used to measure abstract thinking, was one of the Science Reasoning Tasks…

Sinai Peninsula, Middle East as seen from STS-66 orbiter Atlantis

NASA Image and Video Library

1994-11-14

A high oblique view of the Middle East centered at approximately 28.0 degrees north and 34.0 degrees east. Portions of the countries of Egypt, Israel, Jordan and Saudi Arabia are visible. The Dead Sea Rift Valley continuing into the Gulf of Aqaba marks the boundary between Israel and Jordan. The vegetation change in the Sinai Peninsula is the border between the Gaza Strip and Egypt. In Egypt, the Suez Canal connects the Gulf of Suez with the Mediterranean Sea and forms the western boundary of the Sinai Peninsula. The green ribbon of the Nile River is in marked contrast to this arid region. Even the Jordan River does not support large scale agriculture.

Flying bullets and speeding cars: analysis of child injury deaths in the Palestinian Territory.

PubMed

Shaheen, A; Edwards, P

2008-01-01

Despite the fact that children account for over half the Palestinian population, little attention has been paid to the problem of child injuries. We examined the types of injury mortality in children aged 0-19 years in the West Bank and Gaza Strip (Palestinian Territory) and compared these with similar data for children in Israel and England and Wales. We used data from death certificates covering 2001-2003. Death rates per 100 000 children per year were estimated. The leading cause of injury mortality in Palestinian children was accidents caused by firearms missiles (9.6). In comparison, transport accidents were the leading cause of death in children in both Israel (5.0) and England and Wales (3.5).

Attention deficit-hyperactivity symptoms among Palestinian children.

PubMed

Thabet, A M; Al Ghamdi, H; Abdulla, T; Elhelou, M-W; Vostanis, P

2010-05-01

We aimed to establish the prevalence and distribution of attention deficit-hyperactivity disorder (ADHD) symptoms and other associated comorbid mental health problems in Palestinian schoolchildren. Thus 349 children aged 6-15 years were randomly selected from 23 schools in Gaza and the West Bank and were rated by their parents and teachers using both the ADHD DSM-IV Checklist and the Strengths and the Difficulties Questionnaire, which also measures conduct and emotional problems. There was a significant agreement between parents and teachers, with 4.3% of the children rated above the established cut-off scores on both the parent and teacher DSM-IV Checklist. Male gender, family size and living in an area of socioeconomic deprivation were independently associated with ADHD symptoms.

A longitudinal study of posttraumatic stress disorder, depression, and generalized anxiety disorder in Israeli civilians exposed to war trauma.

PubMed

Neria, Yuval; Besser, Avi; Kiper, Dasha; Westphal, Maren

2010-06-01

This 3-wave longitudinal study examined the mental health consequences of the Israel-Gaza 2008-2009 war among young Israeli civilians. Data on posttraumatic stress disorder (PTSD), major depressive disorder (MDD), and generalized anxiety disorder (GAD), and their predictors were collected during the war, and 2 and 4 months after cease fire. Results showed a sharp decline in symptom levels of PTSD, MDD, and GAD over time. Perceived social support during the war moderated the effects of immediate emotional response on subsequent levels of PTSD, MDD, and GAD. These findings underscore the importance of social support and immediate emotional response to trauma in predicting trauma-related psychopathology, and highlight the potential need for providing early care to exposed individuals exhibiting immediate and severe emotional responses.

Group crisis intervention for children during ongoing war conflict.

PubMed

Thabet, Abdel Aziz; Vostanis, Panos; Karim, Khalid

2005-08-01

The aim of this study was to evaluate the short-term impact of a group crisis intervention for children aged 9-15 years from five refugee camps in the Gaza Strip during ongoing war conflict. Children were selected if they reported moderate to severe posttraumatic stress reactions, and were allocated to group intervention (N=47) encouraging expression of experiences and emotions through storytelling, drawing, free play and role-play; education about symptoms (N=22); or no intervention (N=42). Children completed the CPTSD-RI and the CDI pre- and post-intervention. No significant impact of the group intervention was established on children's posttraumatic or depressive symptoms. Possible explanations of the findings are discussed, including the continuing exposure to trauma and the non-active nature of the intervention.

Community Resilience of Civilians at War: A New Perspective.

PubMed

Eshel, Yohanan; Kimhi, Shaul

2016-01-01

A new concept of community resilience pertaining to the community's post adversity strength to vulnerability ratio was associated with five determinants: individual resilience, national resilience, well-being, community size, and sense of coherence. The data was collected four months after Israel's war in the Gaza Strip in 2014. Participants were 251 adult civilians living in southern Israel who have recently been threatened by massive missile attacks, and 259 adults living in northern Israel, which has not been under missile fire recently. The investigated variables predicted community resilience, and their effects were mediated by sense of coherence. Results which were similar for both samples were discussed in terms of the nature of resilience and in terms of proximal and distal exposure to war.

How Personality Affects Vulnerability among Israelis and Palestinians following the 2009 Gaza Conflict

PubMed Central

Canetti, Daphna; Kimhi, Shaul; Hanoun, Rasmiyah; Rocha, Gabriel A.; Galea, Sandro; Morgan, Charles A.

2016-01-01

Can the onset of PTSD symptoms and depression be predicted by personality factors and thought control strategies? A logical explanation for the different mental health outcomes of individuals exposed to trauma would seem to be personality factors and thought control strategies. Trauma exposure is necessary but not sufficient for the development of PTSD. To this end, we assess the role of personality traits and coping styles in PTSD vulnerability among Israeli and Palestinian students amid conflict. We also determine whether gender and exposure level to trauma impact the likelihood of the onset of PTSD symptoms. Five questionnaires assess previous trauma, PTSD symptoms, demographics, personality factors and thought control strategies, which are analyzed using path analysis. Findings show that the importance of personality factors and thought control strategies in predicting vulnerability increases in the face of political violence: the higher stress, the more important the roles of personality and thought control strategies. Thought control strategies associated with introverted and less emotionally stable personality-types correlate positively with higher levels of PTSD symptoms and depression, particularly among Palestinians. By extension, because mental health is key to reducing violence in the region, PTSD reduction in conflict zones warrants rethinking. PMID:27391240

Evaluation of a Group-Based Trauma Recovery Program in Gaza: Students' Subjective Experiences

ERIC Educational Resources Information Center

Barron, Ian; Abdullah, Ghassan

2012-01-01

Internationally, evaluation of group-based trauma recovery programs has relied upon normative outcome measures, with no studies systematically analyzing children's subjective experience for program development. In contrast, the current study explored children's experience of a Gazan recovery program "in their own words." Twenty-four…

How Personality Affects Vulnerability among Israelis and Palestinians following the 2009 Gaza Conflict.

PubMed

Canetti, Daphna; Kimhi, Shaul; Hanoun, Rasmiyah; Rocha, Gabriel A; Galea, Sandro; Morgan, Charles A

2016-01-01

Can the onset of PTSD symptoms and depression be predicted by personality factors and thought control strategies? A logical explanation for the different mental health outcomes of individuals exposed to trauma would seem to be personality factors and thought control strategies. Trauma exposure is necessary but not sufficient for the development of PTSD. To this end, we assess the role of personality traits and coping styles in PTSD vulnerability among Israeli and Palestinian students amid conflict. We also determine whether gender and exposure level to trauma impact the likelihood of the onset of PTSD symptoms. Five questionnaires assess previous trauma, PTSD symptoms, demographics, personality factors and thought control strategies, which are analyzed using path analysis. Findings show that the importance of personality factors and thought control strategies in predicting vulnerability increases in the face of political violence: the higher stress, the more important the roles of personality and thought control strategies. Thought control strategies associated with introverted and less emotionally stable personality-types correlate positively with higher levels of PTSD symptoms and depression, particularly among Palestinians. By extension, because mental health is key to reducing violence in the region, PTSD reduction in conflict zones warrants rethinking.

Perceived family social support buffers against the effects of exposure to rocket attacks on adolescent depression, aggression, and severe violence.

PubMed

Shahar, Golan; Henrich, Christopher C

2016-02-01

The authors compared the protective effects of 3 sources of perceived social support-from family members, friends, and school personnel-on internalizing and externalizing symptoms in adolescents exposed to rocket attacks. Data were based on 362 Israeli adolescents (median age = 14), chronically exposed to rockets from the Gaza Strip, for whom robust effects of exposure on internalizing and externalizing symptoms were reported during the 2009-2010 period (Henrich & Shahar, 2013). New analyses revealed that perceived family social support assessed in 2009 buffered against the effect of exposure to rocket attacks on depression, aggression, and severe violence during 2009-2010. Findings are consistent with a human-ecological perspective exposure to political violence and encourage the employment of family-based preventive interventions in afflicted areas. (c) 2016 APA, all rights reserved).

Access to healthcare for children in Palestine.

PubMed

Waterston, Tony; Nasser, Dina

2017-01-01

Currently, 5 million Palestinian refugees live in Palestine, Jordan, Syria and Lebanon and around 40% of these are children. Mortality rates for Palestinian children are comparable to neighbouring Arab countries but the speed of reduction has faltered in recent years. Morbidity is greatly affected by the occupation which has increased violence towards children, mental health problems and poor nutrition, particularly in Gaza which is experiencing a health crisis. Access to healthcare for children in Palestine is constrained as a result of the requirement for visas to travel into Jerusalem where specialist hospitals are sited, by difficulties with ambulance transfers, by shortages of equipment in hospitals and by lack of trained staff. Palestinian health workers are developing new initiatives in healthcare and show a high level of resilience, despite the very considerable stress affecting most citizens.

Ischaemic stroke management at Al-Shifa Hospital in the Gaza Strip: a clinical audit.

PubMed

Abukaresh, Amir; Al-Abadlah, Rami; Böttcher, Bettina; El-Essi, Khamis

2018-02-21

In the 2014 Palestinian annual health report, cerebrovascular accident was ranked as the third leading cause of death in the occupied Palestinian territory. Cerebrovascular accident is also one the most common causes of disability worldwide. Good management decreases mortality and morbidity. The aim of this study was to assess the current management of patients with ischaemic stroke at the Al-Shifa Hospital and to compare this with international guidelines. For this clinical audit, we used simple random sampling to select files of patients admitted with the diagnosis of ischaemic stroke to the Al-Shifa Hospital. Data collection sheets were completed, and clinical practice was compared with the 2013 American Stroke Association guidelines. Between January and June, 2016, 254 patients were admitted with ischaemic stroke, haemorrhagic stroke, or transient ischaemic attack. We selected 55 patient files. The International Classification of Diseases coding for cerebral infarction in patient files was relatively good, with 92% of files correctly coded. However, we found a substantial weakness in the documentation of duration, progression of symptoms (documented in 20% of files only), and physiotherapy assessment. Most essential acute investigations were done on time (for all [100%] patients needing blood count, renal function tests, and CT scan and for 42 [76%] patients needing ECG). However, thrombolytic drugs were not used because they were not available. Long-term antiplatelet therapy was provided properly to 51 (92%) patients discharged from hospital. However, the initial doses of antiplatelet therapy were generally lower than the international recommendations. Findings also showed a marked inconformity of blood pressure management, especially with respect to the treatment decision and the choice of antihypertensive drug. No local guidelines exist. Furthermore, the lack of availability of thrombolysis medication and the poor deviation in blood pressure management show a lack of evidence-based practice. These findings point to the urgent need for the development of local, evidence-based guidelines. None. Copyright © 2018 Elsevier Ltd. All rights reserved.

Child Protection Assessment in Humanitarian Emergencies: Case Studies from Georgia, Gaza, Haiti and Yemen

ERIC Educational Resources Information Center

Ager, Alastair; Blake, Courtney; Stark, Lindsay; Daniel, Tsufit

2011-01-01

Objectives: The paper reviews the experiences of conducting child protection assessments across four humanitarian emergencies where violence and insecurity, directly or indirectly, posed a major threat to children. We seek to identify common themes emerging from these experiences and propose ways to guide the planning and implementation of…

Tobacco use, exposure to secondhand smoke, and cessation counseling training of dental students around the world.

PubMed

Warren, Charles W; Sinha, Dhirendra N; Lee, Juliette; Lea, Veronica; Jones, Nathan; Asma, Samira

2011-03-01

The Global Health Professions Student Survey (GHPSS) has been conducted among third-year dental students in schools in forty-four countries, the Gaza Strip/West Bank, and three cities (Baghdad, Rio de Janeiro, and Havana) (all called "sites" in this article). In more than half the sites, over 20 percent of the students currently smoked cigarettes, with males having higher rates than females in thirty sites. Over 60 percent of students reported having been exposed to secondhand smoke in public places in thirty-seven of forty-eight sites. The majority of students recognized that they are role models in society and believed they should receive training on counseling patients to quit using tobacco, but few reported receiving formal training. Tobacco control efforts must discourage tobacco use among dentists, promote smoke-free workplaces, and implement programs that train dentists in effective cessation-counseling techniques.

Access to healthcare for children in Palestine

PubMed Central

Waterston, Tony; Nasser, Dina

2017-01-01

Currently, 5 million Palestinian refugees live in Palestine, Jordan, Syria and Lebanon and around 40% of these are children. Mortality rates for Palestinian children are comparable to neighbouring Arab countries but the speed of reduction has faltered in recent years. Morbidity is greatly affected by the occupation which has increased violence towards children, mental health problems and poor nutrition, particularly in Gaza which is experiencing a health crisis. Access to healthcare for children in Palestine is constrained as a result of the requirement for visas to travel into Jerusalem where specialist hospitals are sited, by difficulties with ambulance transfers, by shortages of equipment in hospitals and by lack of trained staff. Palestinian health workers are developing new initiatives in healthcare and show a high level of resilience, despite the very considerable stress affecting most citizens. PMID:29637139

The Middle East population puzzle.

PubMed

Omran, A R; Roudi, F

1993-07-01

An overview is provided of Middle Eastern countries on the following topics; population change, epidemiological transition theory and 4 patterns of transition in the middle East, transition in causes of death, infant mortality declines, war mortality, fertility, family planning, age and sex composition, ethnicity, educational status, urbanization, labor force, international labor migration, refugees, Jewish immigration, families, marriage patterns, and future growth. The Middle East is geographically defined as Bahrain, Egypt, Iraq, Jordan, Kuwait, Lebanon, Oman, Qatar, Saudi Arabia, Syria, United Arab Emirates, Yemen, Gaza and the West Bank, Iran, Turkey, and Israel. The Middle East's population grew very little until 1990 when the population was 43 million. Population was about doubled in the mid-1950s at 80 million. Rapid growth occurred after 1950 with declines in mortality due to widespread disease control and sanitation efforts. Countries are grouped in the following ways: persistent high fertility and declining mortality with low to medium socioeconomic conditions (Jordan, Oman, Syria, Yemen, and the West Bank and Gaza), declining fertility and mortality in intermediate socioeconomic development (Egypt, Lebanon, Turkey, and Iran), high fertility and declining mortality in high socioeconomic conditions (Bahrain, Iraq, Kuwait, Qatar, Saudi Arabia, and the United Arab Emirates), and low fertility and mortality in average socioeconomic conditions (Israel). As birth and death rates decline, there is an accompanying shift from communicable diseases to degenerative diseases and increases in life expectancy; this pattern is reflected in the available data from Egypt, Kuwait, and Israel. High infant and child mortality tends to remain a problem throughout the Middle East, with the exception of Israel and the Gulf States. War casualties are undetermined, yet have not impeded the fastest growing population growth rate in the world. The average fertility is 5 births

Demography and the shaping of Israel's borders.

PubMed

Soffer, A

1989-01-01

"This paper will show that the demographic map of the Land of Israel in its present form is essentially the principal factor in shaping the extent of Jewish settlement in this generation, and that there is little possibility of changing this pattern except for making small and insignificant adjustments." The author describes the changing demographic picture in Palestine from the late nineteenth century to the present day, particularly changes in the ethnic composition of the population. He concludes that the presence of a majority Arab population in the Occupied Territories of Judea, Samaria, and the Gaza Strip will oblige Israel to compromise with regard to granting cultural and political autonomy. Furthermore, three large Arab enclaves in Israel proper--Galilee, the triangle, and the Bedouin Negev--will have to be given up if current settlement patterns do not radically change, which is itself unlikely. excerpt

Threatened or Threatening? How Ideology Shapes Asylum Seekers’ Immigration Policy Attitudes in Israel and Australia

PubMed Central

Canetti, Daphna; Snider, Keren L. G.; Pedersen, Anne

2016-01-01

Can different political ideologies explain policy preferences regarding asylum seekers? We focus on attitudes regarding governmental policy towards out-group members and suggest that perceptions of threat help to shape these policy attitudes. Study 1 compared public opinion regarding asylum policy in Israel (N = 137) and Australia (N = 138), two countries with restrictive asylum policies and who host a large number of asylum seekers; Study 2, a longitudinal study, was conducted during two different time periods in Israel—before and during the Gaza conflict. Results of both studies showed that threat perceptions of out-group members drive the relationship between conservative political ideologies and support for exclusionary asylum policies among citizens. Perceptions of threat held by members of the host country (the in-group) towards asylum seekers (the out-group) may influence policy formation. The effect of these out-groups threats needs to be critically weighed when considering Israeli and Australian policies towards asylum seekers. PMID:28190933

Sacred values in the Israeli-Palestinian conflict: resistance to social influence, temporal discounting, and exit strategies.

PubMed

Sheikh, Hammad; Ginges, Jeremy; Atran, Scott

2013-09-01

Conflicts over sacred values may be particularly difficult to resolve. Because sacred values are nonfungible with material values, standard attempts to negotiate, such as offering material incentives to compromise, often backfire, increasing moral outrage and support for violent action. We present studies with Palestinians in the West Bank and Gaza demonstrating three other ways sacred values may make conflict more intractable, focusing on what we call devoted actors, people who regard issues central to the Israel-Palestine conflict as sacred values. We show that devoted actors (1) were less amenable to social influence, (2) perceived conflict-related events in the past as well as expected events in the future to be temporally closer, and (3) were blind to individual opportunities to escape the conflict. These results suggest that sacred values may affect decision making in a number of ways, which, when combined, contribute to common defense and continuation of conflict. © 2013 New York Academy of Sciences.

Threatened or Threatening? How Ideology Shapes Asylum Seekers' Immigration Policy Attitudes in Israel and Australia.

PubMed

Canetti, Daphna; Snider, Keren L G; Pedersen, Anne; Hall, Brian J

2016-12-01

Can different political ideologies explain policy preferences regarding asylum seekers? We focus on attitudes regarding governmental policy towards out-group members and suggest that perceptions of threat help to shape these policy attitudes. Study 1 compared public opinion regarding asylum policy in Israel ( N = 137) and Australia ( N = 138), two countries with restrictive asylum policies and who host a large number of asylum seekers; Study 2, a longitudinal study, was conducted during two different time periods in Israel-before and during the Gaza conflict. Results of both studies showed that threat perceptions of out-group members drive the relationship between conservative political ideologies and support for exclusionary asylum policies among citizens. Perceptions of threat held by members of the host country (the in-group) towards asylum seekers (the out-group) may influence policy formation. The effect of these out-groups threats needs to be critically weighed when considering Israeli and Australian policies towards asylum seekers.

Disappointment expression evokes collective guilt and collective action in intergroup conflict: the moderating role of legitimacy perceptions.

PubMed

Solak, Nevin; Reifen Tagar, Michal; Cohen-Chen, Smadar; Saguy, Tamar; Halperin, Eran

2017-09-01

Research on intergroup emotions has largely focused on the experience of emotions and surprisingly little attention has been given to the expression of emotions. Drawing on the social-functional approach to emotions, we argue that in the context of intergroup conflicts, outgroup members' expression of disappointment with one's ingroup induces the complementary emotion of collective guilt and correspondingly a collective action protesting ingroup actions against the outgroup. In Study 1 conducted immediately after the 2014 Gaza war, Jewish-Israeli participants received information about outgroup's (Palestinians) expression of emotions (disappointment, fear, or none). As predicted, outgroup's expression of disappointment increased collective guilt and willingness to participate in collective action, but only among those who saw the intergroup situation as illegitimate. Moreover, collective guilt mediated the relationship between disappointment expression and collective action, moderated, again, by legitimacy perception. In Study 2, we replicated these results in the context of racial tension between Black and White Americans in the US. We discuss the theoretical and applied implications of the findings.

Measles during the Gulf War: a public health threat in Israel, the West Bank, and Gaza.

PubMed

Tulchinsky, T H; Belmaker, I; Raabi, S; Acker, C; Arbeli, Y; Lobel, R; Abed, Y; Toubassi, N; Goldberg, E; Slater, P E

A measles outbreak began in Ramallah District in the West Bank in the period just before the outbreak of the Gulf War in 1991. After a local control program, the outbreak was contained to a total of 236 reported cases, including one death, but sporadic cases appeared over the ensuing months. An epidemic of measles followed 2-3 weeks later in Beer Sheva district in Israel, initially among the Bedouin population just prior to the outbreak of the war, then spreading to the Jewish population. The epidemic reached its peak during the war in February, continuing into March. There were a total of over 433 reported cases, with 203 hospitalizations and 7 deaths. The epidemic was slowed by curtailment of school and other civilian activities, and a mass vaccination campaign reaching 60,000 children, but was spread by crowded conditions in hospital, and was spread to other parts of the country by internal population migration. An epidemic of a preventable disease occurring during a national emergency adds to the burdens of the health system. The public health system must be prepared to contain epidemics and other public health threats in wartime, employing standard control methods developed and practiced during peacetime. Routine immunization policies should take into account the possibility of a civilian epidemic during national emergencies, and the need to assure protection of both the civilian and military population in preparation for such contingencies.

17 beta-hydroxysteroid dehydrogenase 3 deficiency in the Mediterranean population.

PubMed

Rosler, Ariel

2006-08-01

Eighty-five males with 17 beta-HSD3 were identified among a highly inbred Arab population in Israel and 57 studied over a period of 25 years. The founders of this defect originated in the mountainous regions of present Lebanon and Syria, but most of the families now live in Jerusalem, Hebron, the Tel-Aviv area and, in particular, in Gaza, where the frequency of affected males is estimated at 1 in 100 to 150. Affected individuals are born with ambiguity of the external genitalia and reared as females until puberty. Thereafter marked virilization occurs, leading in many cases to the spontaneous adoption of a male gender identity and role. Adults develop a male habitus with abundant body hair and beard and the phallus and testes enlarge to adult proportions. Gender reassignment in infancy was only possible when enough erectile tissue was present at birth and developed into a normal size penis with testosterone. 17 beta-HSD3 deficiency can be reliably diagnosed by endocrine evaluation and mutation analysis. In adults the defect is characterized by markedly increased concentrations of androstenedione (A) with borderline low to normal testosterone (T) levels and a high A/T ratio. 5a-dihydrotestosterone (DHT) concentrations are moderately decreased, normal or high and dehydroepiandrosterone (DHEA) levels are high. The estrogen pathway is also impaired, even though both estrone (E-1) and estradiol-17 beta (E-2) levels are high. Children have low basal levels of all androgens, but the defect may be demonstrated after prolonged stimulation with human chorionic gonadotropin (HCG). LH and FSH levels are very high after puberty and normal in childhood. 17 beta-HSD3 isozyme is encoded by the chromosome 9q22 17 beta-HSD3 gene and expressed exclusively in testes. A point mutation in exon 3, codon 80 of the 17 beta-HSD3 gene, R80Q, caused by a single base substitution from CGG ( arginine) to CAG ( glutamine) was identified in both alleles of 24 individuals from 9 extended Arab

Social considerations of inflammatory bowel disease in Southern Israel.

PubMed

Taylor, Jonathan; Neff, Chase

2017-07-17

Chronic diseases pose unique social challenges beyond traditional health considerations that require specific attention. In this report, we examine the case of a middle-aged woman with ulcerative colitis, living in Southern Israel. Trust between the patient and physician is shown to positively influence a variety of therapeutic outcomes and should be considered a fundamental component of successful care. In context of the military conflict between Israel and Gaza, the needs of patients with chronic diseases cannot be forgotten. The work environment is also identified as an area of particular concern, as a supportive work environment is essential in order to maintain satisfaction in the workplace and sustain a high quality of life. Out-of-pocket costs for medications are confirmed to be a significant barrier to adherence. Better understanding of patients’ financial capabilities, along with affordable therapeutic interventions, will alleviate healthcare-related financial burdens and improve health outcomes. © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Emotional display rules in Palestine: Ingroup/outgroup membership, status of interaction partner and gender.

PubMed

Flicker, Sharon M; Ayoub, Haneen J S; Guynn, Melissa J

2017-05-05

This study investigates emotional display rules within the Palestinian context, focusing on the seven basic emotions in a sample of 150 college students from the Gaza Strip and the West Bank. Overall, participants felt that it was more appropriate to express positive emotions (happiness and surprise) than negative powerful (anger, contempt and disgust) or negative powerless (fear and sadness) emotions. They also perceived it to be more appropriate to express positive and negative powerless emotions to ingroup than outgroup members and to express negative powerful emotions to lower status compared to higher status individuals. Gender differences were also found: men endorsed greater expression of both powerful and, surprisingly, powerless emotions than women, but only when interacting with outgroup members. Results are interpreted in terms of the cultural values of individualism-collectivism and power distance as well as cultural differences in emotional expressiveness between collectivistic societies. This study is one of the first to examine emotional display rules in an Arab population, thus expanding our current knowledge base. © 2017 International Union of Psychological Science.

In times of war, adolescents do not fall silent: Teacher-student social network communication in wartime.

PubMed

Ophir, Yaakov; Rosenberg, Hananel; Asterhan, Christa S C; Schwarz, Baruch B

2016-01-01

Exposure to war is associated with psychological disturbances, but ongoing communication between adolescents and teachers may contribute to adolescents' resilience. This study examined the extent and nature of teacher-student communication on Social Network Sites (SNS) during the 2014 Israel-Gaza war. Israeli adolescents (N = 208, 13-18 yrs) completed information about SNS communication. A subset of these (N = 145) completed questionnaires on social rejection and distress sharing on SNS. More than a half (56%) of the respondents communicated with teachers via SNS. The main content category was 'emotional support'. Adolescents' perceived benefits from SNS communication with teachers were associated with distress sharing. Social rejection was negatively associated with emotional support and perceived benefits from SNS communication. We conclude that SNS communication between teachers and students may provide students with easy access to human connections and emotional support, which is likely to contribute to adolescents' resilience in times of war. Copyright © 2015 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.

Factors affecting the prevalence of chronic diseases in Palestinian people: an analysis of data from the Palestinian Central Bureau of Statistics.

PubMed

Abukhdeir, H F; Caplan, L S; Reese, L; Alema-Mensah, E

2013-04-01

This study determined whether there are significant differences in the prevalence of diabetes, hypertension, cardiovascular disease (CVD) and cancer among Palestinians with respect to different demographic variables using secondary data from the Palestinian Central Bureau of Statistics. Living in the Gaza Strip was a protective factor, with this group being 21% less likely to have diabetes, 35% less likely to have hypertension, and 48% less likely to have CVD than those living in the West Bank. No significant difference was found for cancer. Being a refugee was a significant risk factor for diabetes and CVD while being married/engaged or divorced/ separated/widowed was a risk factor for diabetes and hypertension. Gender was a risk factor for hypertension with females being 60% more likely to have hypertension than males. Living in a rural setting was protective against hypertension. As expected, age was a risk factor for diabetes, hypertension and CVD; the magnitude of this increased risk was alarming, 36 to 434 times greater in those aged 40-65 years compared with those aged 0-19 years.

Justification, perception of severity and harm, and criminalization of wife abuse in the Palestinian society.

PubMed

Haj-Yahia, Muhammad M; Wilson, Rula M; Naqvi, Syed Agha M

2012-07-01

The purpose of this study was to examine the perceptions of Palestinian adults toward different dimensions of wife abuse. A cross-sectional survey, using a combination of self-administered questionnaires and interviews, was conducted among a systematic random sample of 624 adult Palestinian men and women from the West Bank and Gaza Strip (18 years or older). Study results indicated a strong tendency to justify wife beating in different situations, such as when the wife is perceived as having an affair with another man or as physically attacking her husband. Participants considered the following acts of husband's violence against wife as most severe: using a weapon (86%), having sex with the wife against her will (67%), and hitting her with his fist (57%). The majority of participants thought that wife beating should be considered a crime (82.3%). Traditional marital role expectations was the main significant predictor for all of the study criterion variables. Gender, place of residence, age, and marital status were significant predictors of some of the criterion variables.

Isolation and genetic characterization of a novel 2.2.1.2a H5N1 virus from a vaccinated meat-turkeys flock in Egypt.

PubMed

Salaheldin, Ahmed H; Veits, Jutta; Abd El-Hamid, Hatem S; Harder, Timm C; Devrishov, Davud; Mettenleiter, Thomas C; Hafez, Hafez M; Abdelwhab, Elsayed M

2017-03-09

Vaccination of poultry to control highly pathogenic avian influenza virus (HPAIV) H5N1 is used in several countries. HPAIV H5N1 of clade 2.2.1 which is endemic in Egypt has diversified into two genetic clades. Clade 2.2.1.1 represents antigenic drift variants in vaccinated commercial poultry while clade 2.2.1.2 variants are detected in humans and backyard poultry. Little is known about H5N1 infection in vaccinated turkeys under field conditions. Here, we describe an HPAI H5N1 outbreak in a vaccinated meat-turkey flock in Egypt. Birds were vaccinated with inactivated H5N2 and H5N1 vaccines at 8 and 34 days of age, respectively. At 72 nd day of age (38 days post last vaccination), turkeys exhibited mild respiratory signs, cyanosis of snood and severe congestion of the internal organs. Survivors had a reduction in feed consumption and body gain. A mortality of ~29% cumulated within 10 days after the onset of clinical signs. Laboratory diagnosis using RT-qPCRs revealed presence of H5N1 but was negative for H7 and H9 subtypes. A substantial antigenic drift against different serum samples from clade 2.2.1.1 and clade 2.3.4.4 was observed. Based on full genome sequence analysis the virus belonged to clade 2.2.1.2 but clustered with recent H5N1 viruses from 2015 in poultry in Israel, Gaza and Egypt in a novel subclade designated here 2.2.1.2a which is distinct from 2014/2015 2.2.1.2 viruses. These viruses possess 2.2.1.2 clade-specific genetic signatures and also mutations in the HA similar to those in clade 2.2.1.1 that enabled evasion from humoral immune response. Taken together, this manuscript describes a recent HPAI H5N1 outbreak in vaccinated meat-turkeys in Egypt after infection with a virus representing novel distinct 2.2.1.2a subclade. Infection with HPAIV H5N1 in commercial turkeys resulted in significant morbidity and mortality despite of vaccination using H5 vaccines. The isolated virus showed antigenic drift and clustered in a novel cluster designated here

Burnout among workers in emergency Departments in Palestinian hospitals: prevalence and associated factors.

PubMed

Hamdan, Motasem; Hamra, Asma'a Abu

2017-06-15

Working in Emergency Departments (EDs) entails high work pressure and stress due to witnessing human suffering and the unpredictable nature of the work. This environment puts personnel at risk of burnout. This analysis aims to assess burnout levels and associated risk factors among health workers in EDs in Palestinian hospitals. Also, it examines the association between burnout and workplace violence, as well as with job turnover. Cross-sectional design utilising a self-administered questionnaire was used to collect data from all workers at 14 EDs; 8 from the West Bank and 6 from the Gaza Strip. Burnout was measured using Maslach Burnout Inventory-Human Services Survey. A total of 444 workers (response rate 74.5%) participated: 161(36.3%) nurses, 142(32.0%) physicians and 141(31.7%) administrative personnel. Results showed high levels of burnout among EDs workers; 64.0% suffered from high emotional exhaustion, 38.1% from high depersonalization and 34.6% from low personal accomplishment. In addition, high levels of emotional exhaustion (72.3%) was significantly prevalent among physicians compared to nurses (69.8%) and administrative workers (51.4%) (p < 0.05). In comparison, high levels of depersonalization was significantly prevalent among nurses (48.8%) compared to physicians (32.1%) and administrative workers (31.9%) (p < 0.05). However, there were no significant differences in the levels of personal accomplishment burnout among the three groups (p > 0.05). Moreover, high degree of burnout was more prevalent among EDs workers in the West Bank than among those working in the Gaza Strip (OR 2.02, 95% CI = 1.11-3.69, p = 0.019), and higher among younger workers (aged ≤30 years old) than their older counterparts (OR 2.4, 95% CI = 1.302-4.458, p = 0.005). Exposure to physical violence was significantly associated with having a high degree of burnout (OR 2.017 95% CI = 1.121-3.631, p = 0.019), but no association was observed with regards to

Air Operations in Israel’s War Against Hezbollah: Learning from Lebanon and Getting It Right in Gaza

DTIC Science & Technology

2011-01-01

alongside the 113 Steven Erlanger, “As Israel Begins to Pull Troops Out, Lebanon and the UN Prepare to Replace Them,” New York Times, August 16...engagement. Then, just before pulling abreast of the Ababil, he fired a Python 4 infrared missile using his helmet-mounted sight for high off-boresight...shock for two weeks after the Wehrmacht’s surprise attack on the Soviet Union in 1941, Nasrallah pulled himself back together fairly quickly. Shortly

Perspectives on induced abortion among Palestinian women: religion, culture and access in the occupied Palestinian territories.

PubMed

Shahawy, Sarrah; Diamond, Megan B

2018-03-01

Induced abortion is an important public health issue in the occupied Palestinian territories (OPT), where it is illegal in most cases. This study was designed to elicit the views of Palestinian women on induced abortion given the unique religious, ethical and social challenges in the OPT. Sixty Palestinian women were interviewed on their perceptions of the religious implications, social consequences and accessibility of induced abortions in the OPT at Al-Makassed Islamic Charitable Hospital in East Jerusalem. Themes arising from the interviews included: the centrality of religion in affecting women's choices and views on abortion; the importance of community norms in regulating perspectives on elective abortion; and the impact of the unique medico-legal situation of the OPT on access to abortion under occupation. Limitations to safe abortion access included: legal restrictions; significant social consequences from the discovery of an abortion by one's community or family; and different levels of access to abortion depending on whether a woman lived in East Jerusalem, the West Bank, or Gaza. This knowledge should be incorporated to work towards a legal and medical framework in Palestine that would allow for safe abortions for women in need.

Community resilience and sense of coherence as protective factors in explaining stress reactions: comparing cities and rural communities during missiles attacks.

PubMed

Braun-Lewensohn, Orna; Sagy, Shifra

2014-02-01

Based on the salutogenic theory, the aim of this study was to examine sense of coherence and communal resiliency as related to stress reactions during missile attacks. Data were gathered in August 2011 while missiles were being shot from Gaza to the Negev communities in Israel from approximately 150 participants, aged 15-85. Participants lived in cities and different types of small rural villages. Self reported questionnaires were administered via the internet and included demographic data, coping resource of sense of coherence and community resiliency as coping resources, as well as state anxiety, state anger and psychological distress as stress reaction outcomes. Overall, the participants in our study reported strong personal and communal resources and relatively low levels of stress reactions. Personal and communal resources were linked negatively to the different stress reactions. However, some differences emerged when we compared participants from different types of communities. The most resilient group was composed of people who lived in the rural and communal communities. Differences also emerged on patterns of relationships between the community resource and state anxiety. While among the rural citizens, community resilience was strongly linked to anxiety, no relationships were revealed in the urban citizens group.

Byzantine maritime trade in southern Jordan: The evidence from Port of Aila ('Aqaba).

NASA Astrophysics Data System (ADS)

Al-Nasarat, Mohammed

Eusebius of Caesarea, in (Onomasticon) said that: "Ailath (Aila) is situated at the extremity of Palestine between the southern desert and the Red Sea where cargo was transported by ship from both Egypt and India". There is no doubt that port of Aila- 'Aqaba was important for the sea trade during the Byzantine Period and ancient times. Aila acquired significance in the Byzantine Empire commerce and seafaring according to the information derived from the Byzantine historians, documents and pilgrim's archaeological excavations. This paper focuses on Byzantine Maritime Trade in port of Aila during the period between the fourth and seventh centuries A.D, its importance in the flourishing of trade of southern Jordan, and its relations with other major trade centers such as Gaza, Alexandria and Ethiopia. It appears that port of Aila played a major role in the economy of Byzantine Empire and international trade as attested in the accounts of historians, pilgrims who visited the area during this period, and archaeological excavations which revealed that Aila was at least a transit point and perhaps even a production site for fish sauce or related products in the Byzantine period.

Trading off natural resources and rural livelihoods. A framework for sustainability assessment of small-scale food production in water-limited regions

NASA Astrophysics Data System (ADS)

Recanati, Francesca; Castelletti, Andrea; Dotelli, Giovanni; Melià, Paco

2017-12-01

Enhancing local production is key to promoting food security, especially in rural households of low-income countries, but may conflict with limited natural resources and ecosystems preservation. We propose a framework integrating the water-food nexus and a sustainable livelihoods perspective to assess small-scale food production in water-poor regions. We demonstrate it by assessing alternative production scenarios in the Gaza Strip at different spatial scales. At the scale of a single farm, there is a clear conflict among objectives: while cash crops ensure good incomes but contribute scarcely to domestic protein supply, crops performing well from the nutritional and environmental viewpoint are among the worst from the economic one. At the regional scale, domestic production might cover an important fraction of nutritional needs while contributing to household income, but water scarcity impairs the satisfaction of food demand by domestic production alone. Pursuing food security under multiple constraints thus requires a holistic perspective: we discuss how a multidimensional approach can promote the engagement of different stakeholders and allow the exploration of trade-offs between food security, sustainable exploitation of natural resources and economic viability.

Effectiveness of psychosocial intervention enhancing resilience among war-affected children and the moderating role of family factors.

PubMed

Diab, Marwan; Peltonen, Kirsi; Qouta, Samir R; Palosaari, Esa; Punamäki, Raija-Leena

2015-02-01

The study examines, first, the effectiveness of a psychosocial intervention based on Teaching Recovery Techniques (TRT) to increase resiliency among Palestinian children, exposed to a major trauma of war. Second, it analyses the role of family factors (maternal attachment and family atmosphere) as moderating the intervention impacts on resilience. School classes in Gaza were randomized into intervention (N=242) and control (N=240) groups. The percentage of girls (49.4%) and boys (50.6%) were equal, and the child age was 10-13 years in both groups. Children reported positive indicators of their mental health (prosocial behaviour and psychosocial well-being) at baseline (T1), post-intervention (T2) and at a six-month follow-up (T3). At T1 they accounted their exposure to war trauma. Mothers reported about their willingness to serve as an attachment figure, and the child reported about the family atmosphere. Resilience was conceptualized as a presence of positive indications of mental health despite trauma exposure. Against our hypothesis, the intervention did not increase the level of resilience statistically significantly, nor was the effect of the intervention moderated by maternal attachment responses or family atmosphere. Copyright © 2014 Elsevier Ltd. All rights reserved.

Psychological distress of parents in conflict areas: the mediating role of war atrocities, normative stressors and family resources.

PubMed

Khamis, Vivian

2017-04-01

Despite the ongoing controversy regarding which types of stressors or resources contribute to psychological distress, there has been little research examining the relationship between war trauma, normative stressors, family resources for management and psychopathology. This study investigated the differences between mothers and fathers in psychological distress, normative stressors and war atrocities experienced, and family's resources for management. It was hypothesized that a combination of risk variables and protective variables would be predictive of psychological distress in parents. Questionnaires were used with 205 Palestinian parents from Gaza Strip. Mothers had more psychiatric disorders than did fathers. Although, mothers and fathers were exposed to comparable levels of normative stressors, mothers concerns about intrafamily strains, and family legal violations were greater than they were for fathers. Results revealed that fathers possess a larger repertoire of resources for management when compared to mothers reflected in esteem and communication, mastery and health, extended family social support and financial well-being. However, mastery and health seem to buffer the effect of war traumas and normative stressors on neuroticism in both parents. The different patterns of predictor-outcome relations have practical as well as theoretical implications.

Cost containment: the Middle East. Israel.

PubMed

Stern, Z; Altholz, J; Sprung, C L

1994-08-01

The Israeli Health Service was established with the intent of providing an equal standard of care to the entire Israeli population. The Health Service has dealt with changes over the years, including the governing of large populations of Judea, Samaria, and Gaza. In 1990, mass immigration brought 500,000 more individuals to Israel, putting an additional burden on medical services. ICUs in Israel began to emerge after the Six Day War in 1967. The government's Ministry of Health has approved a limited amount of ICU beds. Beyond this set amount, hospital directors decide whether to establish additional ICU beds, weighing departmental pressures from within the hospital to create beds against the knowledge that the hospital will not be reimbursed more than the per diem rate of an ordinary hospital bed ($US 265). Hospital directors and administrators, knowing that the average daily cost of an ICU bed is close to $US 800, turn to their supporting organization to finance the uncontrollable deficit, seek aid from the Ministry of Health to make the per diem rates or diagnosis-related group reimbursements more realistic, and/or implement hospital policies aimed at cutting costs and personnel.

The enemy as animal: Symmetric dehumanization during asymmetric warfare.

PubMed

Bruneau, Emile; Kteily, Nour

2017-01-01

Historically, dehumanization has enabled members of advantaged groups to 'morally disengage' from disadvantaged group suffering, thereby facilitating acts of intergroup aggression such as colonization, slavery and genocide. But is blatant dehumanization exclusive to those at the top 'looking down', or might disadvantaged groups similarly dehumanize those who dominate them? We examined this question in the context of intergroup warfare in which the disadvantaged group shoulders a disproportionate share of casualties and may be especially likely to question the humanity of the advantaged group. Specifically, we assessed blatant dehumanization in the context of stark asymmetric conflict between Israelis (Study 1; N = 521) and Palestinians (Study 2; N = 354) during the 2014 Gaza war. We observed that (a) community samples of Israelis and Palestinians expressed extreme (and comparable) levels of blatant dehumanization, (b) blatant dehumanization was uniquely associated with outcomes related to outgroup hostility for both groups, even after accounting for political ideologies known to strongly predict outgroup aggression, and (c) the strength of association between blatant dehumanization and outcomes was similar across both groups. This study illuminates the striking potency and symmetry of blatant dehumanization among those on both sides of an active asymmetric conflict.

The enemy as animal: Symmetric dehumanization during asymmetric warfare

PubMed Central

2017-01-01

Historically, dehumanization has enabled members of advantaged groups to ‘morally disengage’ from disadvantaged group suffering, thereby facilitating acts of intergroup aggression such as colonization, slavery and genocide. But is blatant dehumanization exclusive to those at the top ‘looking down’, or might disadvantaged groups similarly dehumanize those who dominate them? We examined this question in the context of intergroup warfare in which the disadvantaged group shoulders a disproportionate share of casualties and may be especially likely to question the humanity of the advantaged group. Specifically, we assessed blatant dehumanization in the context of stark asymmetric conflict between Israelis (Study 1; N = 521) and Palestinians (Study 2; N = 354) during the 2014 Gaza war. We observed that (a) community samples of Israelis and Palestinians expressed extreme (and comparable) levels of blatant dehumanization, (b) blatant dehumanization was uniquely associated with outcomes related to outgroup hostility for both groups, even after accounting for political ideologies known to strongly predict outgroup aggression, and (c) the strength of association between blatant dehumanization and outcomes was similar across both groups. This study illuminates the striking potency and symmetry of blatant dehumanization among those on both sides of an active asymmetric conflict. PMID:28746412

'This is ordinary behaviour': categorization and culpability in Hamas leaders' accounts of the Palestinian/Israeli conflict.

PubMed

McKinlay, Andy; McVittie, Chris; Sambaraju, Rahul

2012-12-01

The present paper examines the talk of three senior figures from the Palestinian Hamas political movement. Data are drawn from a series of journalistic interviews that were conducted in the months leading up to the invasion of Gaza by Israel in December 2007. Using membership categorization analysis, we explore the membership categories and category-bound attributes that interviewers use in questions about responsibility for potentially culpable actions and the ways that these are taken up, challenged, or reworked by interviewees in presenting their own versions. The analytic findings show that interviewers deploy categories bound up with terrorism while interviewees develop alternative categorizations of resistance. Interviewers construct Palestinians as victims of Hamas' actions while interviewees construct them as victims of Israeli aggression and international indifference. In warranting these alternative constructions, the interviewees contrast current behaviours of the international community with those of the past and align current Palestinian actions with those previously taken by Western nations in resisting illegitimate occupations. Through these descriptions of categories and actions, the interviewees attribute to the wider international community responsibility for addressing the events of the ongoing conflict. ©2011 The British Psychological Society.

Operational problems of an iron supplementation programme for pregnant women: an assessment of UNRWA experience.

PubMed Central

Pappagallo, S.; Bull, D. L.

1996-01-01

Assessed is a large-scale iron supplementation programme for the 70 000 pregnant refugee women cared for by the United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA). For this purpose, a retrospective survey of 1267 antenatal records was conducted in health centres located in the West Bank, Gaza, Syrian Arab Republic, Jordan, and Lebanon. The following operational problems were identified: late entry to antenatal care; high drop-out rate from antenatal care; low compliance in follow-up haemoglobin examinations; and misdirected continued testing of women who were not anaemic at registration. Routine iron supplementation of all pregnant women should be considered only in those countries where severe anaemia is prevalent and should always be coupled with additional interventions that are effective at improving iron deficiency anaemia in a given population. In most countries attention should be directed towards changing dietary habits to enhance the availability of local foodstuffs that are rich in iron. One initial haemoglobin test may help in focusing on the relatively few initially anaemic subjects who need further attention. Repeated testing during pregnancy is unwarranted. PMID:8653813

Impact of an intervention programme on knowledge, attitude and practice of healthcare staff regarding pharmaceutical waste management, Gaza, Palestine.

PubMed

Tabash, M I; Hussein, R A; Mahmoud, A H; El-Borgy, M D; Abu-Hamad, B A

2016-09-01

To assess knowledge, attitude and practice (KAP) of healthcare staff regarding pharmaceutical waste management; and to determine the impact of an educational programme on the KAP survey items. Pre-post-test intervention study. The pre-intervention phase was performed using a sample of 530 out of 1500 healthcare workers. A predesigned interview questionnaire was used to assess KAP. Next, an educational programme was designed and offered to a subsample of 69 healthcare workers. KAP were re-assessed for the programme attendees using the same interview questionnaire, both immediately (post-test) and six months after the end of the programme (follow-up test). The parametric paired sample t-test was used to assess the difference between pre-test and follow-up test results. Poor knowledge and poor practice levels (scores 50%) detected in the pre-intervention phase were found to improve to satisfactory levels (scores ≥75%) in the follow-up phase. Attitude was found to be positive (score ≥75%) in all phases of the study. The educational programme led to a significant improvement in KAP of healthcare staff regarding pharmaceutical waste management (P<0.001). Copyright © 2016. Published by Elsevier Ltd.

Multiple risk behaviors and suicidal ideation and behavior among Israeli and Palestinian adolescents.

PubMed

Harel-Fisch, Yossi; Abdeen, Ziad; Walsh, Sophie D; Radwan, Qasrowi; Fogel-Grinvald, Haya

2012-07-01

Based conceptually on Problem Behavior Theory, Normalization Theory and theories of adolescent ethnic identity formation this study explores relationships between individual and cumulative multiple risk behaviors and suicidal ideation and behavior among mid-adolescents in three different populations in the Middle East. Data from the 2004 Health Behavior in School-Aged Children in the Middle-East (HBSC-ME) study included 8345 10th-grade pupils in three populations: Jewish Israelis (1770), Arab Israelis (2185), and Palestinians in Gaza and the West Bank (4390). We considered risk behaviors and factors including tobacco use, bullying, medically-attended injuries, excessive time with friends, parental disconnectedness, negative school experience, truancy and poor academic performance. Substantial population differences for suicidal tendency and risk behaviors were observed, with notably high levels of suicidal ideation and behavior among Arab-Israeli youth and higher levels of risk behaviors among the Jewish and Arab-Israeli youth. For all populations suicidal tendency was at least 4 times higher among adolescents reporting 4+ risk behaviors, suggesting that similar psychosocial determinants affect patterns of risk behaviors and suicidal tendency. Results highlight the importance of understanding cultural contexts of risk behaviors and suicidal ideation and behavior. Copyright © 2012 Elsevier Ltd. All rights reserved.

Attitude of Palestinian Nursing Students Toward Caring for Dying Patients: A Call for Change in Health Education Policy.

PubMed

Abu-El-Noor, Nasser Ibrahim; Abu-El-Noor, Mysoon Khalikl

2016-06-01

Death is a natural process that occurs each day. Some nursing students may encounter the experience of taking care of a dying patient while others do not. Therefore, their attitude toward death and caring for dying patients may vary. The purpose of this study was to assess Palestinian student nurses' attitudes toward death and caring for dying patients and their families. In a cross-sectional, descriptive study, all fourth-year students at the College of Nursing, Islamic University of Gaza, Palestine, were invited to participate in this study. A total of 141 students completed the Frommelt Attitude Toward Care of the Dying Scale Form B (FATCOD-B). Results revealed that the mean score on the FATCOD-B was (96.96 ± 8.30). Overall, nursing students in the sample demonstrated a relatively low attitude toward caring for dying patients and their families. No statistically significant differences of students' attitudes toward caring for dying patients were found between male and female students nor between students who attended death cases and those who did not. The results suggest that theoretical nursing education should place more emphasis on palliative care to improve the quality of care at the end of life. © The Author(s) 2015.

Downscaling of RCM outputs for representative catchments in the Mediterranean region, for the 1951-2100 time-frame

NASA Astrophysics Data System (ADS)

Deidda, Roberto; Marrocu, Marino; Pusceddu, Gabriella; Langousis, Andreas; Mascaro, Giuseppe; Caroletti, Giulio

2013-04-01

Within the activities of the EU FP7 CLIMB project (www.climb-fp7.eu), we developed downscaling procedures to reliably assess climate forcing at hydrologically relevant scales, and applied them to six representative hydrological basins located in the Mediterranean region: Riu Mannu and Noce in Italy, Chiba in Tunisia, Kocaeli in Turkey, Thau in France, and Gaza in Palestine. As a first step towards this aim, we used daily precipitation and temperature data from the gridded E-OBS project (www.ecad.eu/dailydata), as reference fields, to rank 14 Regional Climate Model (RCM) outputs from the ENSEMBLES project (http://ensembles-eu.metoffice.com). The four best performing model outputs were selected, with the additional constraint of maintaining 2 outputs obtained from running different RCMs driven by the same GCM, and 2 runs from the same RCM driven by different GCMs. For these four RCM-GCM model combinations, a set of downscaling techniques were developed and applied, for the period 1951-2100, to variables used in hydrological modeling (i.e. precipitation; mean, maximum and minimum daily temperatures; direct solar radiation, relative humidity, magnitude and direction of surface winds). The quality of the final products is discussed, together with the results obtained after applying a bias reduction procedure to daily temperature and precipitation fields.

War trauma and maternal-fetal attachment predicting maternal mental health, infant development, and dyadic interaction in Palestinian families.

PubMed

Punamäki, Raija-Leena; Isosävi, Sanna; Qouta, Samir R; Kuittinen, Saija; Diab, Safwat Y

2017-10-01

Optimal maternal-fetal attachment (MFA) is believed to be beneficial for infant well-being and dyadic interaction, but research is scarce in general and among risk populations. Our study involved dyads living in war conditions and examined how traumatic war trauma associates with MFA and which factors mediate that association. It also modeled the role of MFA in predicting newborn health, infant development, mother-infant interaction, and maternal postpartum mental health. Palestinian women from the Gaza Strip (N = 511) participated during their second trimester (T1), and when their infants were 4 (T2) and 12 (T3) months. Mothers reported MFA (interaction with, attributions to, and fantasies about the fetus), social support, and prenatal mental health (post-traumatic stress disorder, depression, and anxiety) at T1, newborn health at T2, and the postpartum mental health, infant's sensorimotor and language development, and mother-infant interaction (emotional availability) at T3. Results revealed, first, that war trauma was not directly associated with MFA but that it was mediated through a low level of social support and high level of maternal prenatal mental health problems. Second, intensive MFA predicted optimal mother-reported infant's sensorimotor and language development and mother-infant emotional availability but not newborn health or maternal postpartum mental health.

The collection of birds from Mozambique at the Instituto de Investigação Científica Tropical of the University of Lisbon (Portugal)

PubMed Central

Monteiro, Miguel; Figueira, Rui; Melo, Martim; Mills3,4, Michael Stuart Lyne; Beja, Pedro; Bastos-Silveira, Cristiane; Ramos, Manuela; Rodrigues, Diana; Neves5,7, Isabel Queirós; Consciência, Susana; Reino, Luís

2017-01-01

Abstract The Instituto de Investigação Científica Tropical of the University of Lisbon, which resulted from the recent merger (in 2015) of the former state laboratory Instituto de Investigação Científica Tropical in the University of Lisbon, holds an important collection of bird skins from the Portuguese-speaking African Countries (Angola, Mozambique, São Tomé and Príncipe, Guinea Bissau and Cape Verde), gathered as a result of several scientific expeditions made during the colonial period. In this paper, the subset from Mozambique is described, which was taxonomically revised and georeferenced. It contains 1585 specimens belonging to 412 taxa, collected between 1932 and 1971, but mainly in 1948 (43% of specimens) and 1955 (30% of specimens). The collection covers all eleven provinces of the country, although areas south of the Zambezi River are better represented than those north of the river. The provinces with the highest number of specimens were Maputo, Sofala, and Gaza. Although it is a relatively small collection with a patchy coverage, it adds significantly to Global Biodiversity Information Facility, with 15% of all records available before and during the collecting period (1830–1971) being the second largest dataset for that period for Mozambique. PMID:29118634

Use of cigarettes and other tobacco products among students aged 13-15 years--worldwide, 1999-2005.

PubMed

2006-05-26

The use of tobacco in any form is a major preventable cause of premature death and disease. Globally, nearly 5 million persons die every year from tobacco-related illnesses, with disproportionately higher mortality occurring in developing countries. The Global Youth Tobacco Survey (GYTS), initiated in 1999 by the World Health Organization (WHO), CDC, and the Canadian Public Health Association, is a school-based survey that includes questions on prevalence of cigarette and other tobacco use; attitudes toward tobacco; access to tobacco products; exposure to secondhand smoke, school curricula on tobacco, media, and advertising; and smoking cessation. This report presents estimates of self-reported cigarette and other tobacco-product use during 1999-2005 in 132 different countries and the Gaza Strip/West Bank. The data are aggregated within each of the six WHO regions. GYTS data indicate that nearly two of every 10 students reported currently using a tobacco product, with no statistically significant difference between the proportion of those reporting cigarette smoking (8.9%) and other tobacco use (11.2%). Use of tobacco by adolescents is a major public health problem in all six WHO regions. Worldwide, more countries need to develop, implement, and evaluate their tobacco-control programs to address the use of all types of tobacco products, especially among girls.

The emotional impact of national music on young and older adults differing in posttraumatic stress disorder symptoms.

PubMed

Bensimon, Moshe; Bodner, Ehud; Shrira, Amit

2017-10-01

In spite of previous evidence regarding the function of national songs as a contextual stimulus, their effect on the emotional state of older adults living with different levels of posttraumatic stress disorder (PTSD) symptoms has not be been examined. Following the 2014 Israel-Gaza conflict, we examined the emotional effects of listening to happy national songs (songs of Independence Day) and sad national songs (Memorial Day songs) on young (N = 144, mean age = 29.4) and older adults (N = 132, mean age = 68.5). Respondents were exposed to happy or sad national songs, and completed measures of exposure to missile attacks, related PTSD symptoms, and positive and negative emotions. Sad national songs were related to higher negative affect among young adults who were lower on PTSD symptoms, but not among their older counterparts. In contrast, sad national songs were related to higher negative affect among older adults who were higher on PTSD symptoms, but not among their young counterparts. These findings support the strength and vulnerability model, as they demonstrate that relative to young adults, older adults are generally more capable to withstand negative stimuli, yet are more sensitive to negative stimuli when they suffer from chronic vulnerability, as in the case of higher level of PTSD symptoms.

Determinants of birthweight: gender based analysis.

PubMed

Halileh, Samia; Abu-Rmeileh, Niveen; Watt, Graham; Spencer, Nick; Gordon, Nahida

2008-09-01

The objective of this cross sectional study is to look at determinants of birth weight and their association with the gender of the baby in 2,795 full term children living in the occupied Palestinian territory, derived from a stratified random sample of 2,994 households in the West Bank and 2,234 households in the Gaza Strip. The response rate was 85%. Multivariable analysis using analysis of variance for mixed models showed that sex and birth order, maternal age and education and to a lesser extent region were determinants of birth weight for all children. The effect of maternal education on birth weight differed for female and male infants, tending to be relatively unchanged for male infants and with mean birth weights increasing with maternal education in female infants. The effect of birth order differed by maternal age, with mean birth weight increasing with maternal age for first and second births; but being unaffected by maternal age for infants of birth order greater than two. We conclude that birth weight is influenced by common biological determinants across cultures, but is also influenced by social, ethnic, and environmental factors that are culture specific, of which some might be gender related.

Operation Protective Edge - A Unique Challenge for a Civilian EMS Agency.

PubMed

Jaffe, Eli; Strugo, Refael; Wacht, Oren

2015-10-01

During July through August 2014, Operation Protective Edge, a military conflict between Israel and the Hamas regime in Gaza, dramatically affected both populations. Magen David Adom (MDA), the Israeli national Emergency Medical Service (EMS) and a member of the Red Cross, faced a unique challenge during the conflict: to continue providing crucial service to the entire civilian population of Israel, which was under constant missile threat. This challenge included not only providing immediate care for routine EMS calls under missile threat, but also preparing and delivering immediate care to civilians injured in attacks on major cities, as well as small communities, in Israel. This task is a challenge for a civilian EMS agency that normally operates in a non-military environment, yet, in an instant, must enhance its capability to respond to a considerable threat to its population. During Operation Protective Edge, MDA provided care for 842 wounded civilians and utilized a significant amount of its resources. Providing EMS services for a civilian population in a mixed civilian/military scenario is a challenging task on a national level for an EMS system, especially when the threat lasts for weeks. This report describes MDA's preparedness and operations during Operation Protective Edge, and the unique EMS challenges and dilemmas the agency faced.

Does war beget child aggression? Military violence, gender, age and aggressive behavior in two Palestinian samples.

PubMed

Qouta, Samir; Punamäki, Raija-Leena; Miller, Thomas; El-Sarraj, Eyad

2008-01-01

We examined, first, the relations between children's exposure to military violence and their aggressive behavior and the role of age and gender in that relation in two Palestinian samples. Second, we tested parenting practices as a moderator of the relation between exposure to military violence and aggressive behavior, and third, whether exposure to military violence of different nature (direct victimization versus witnessing) has specific associations with different forms of aggression (reactive, proactive and aggression-enjoyment). Study I was conducted in a relatively calm military-political atmosphere in Palestine-Gaza, and included 640 children, aged 6-16 years whose parents (N=622) and teachers (N=457) provided reports. Older children (> or =12 years) provided self-reports (N=211). Study II included 225 Palestinian children aged 10-14-year, who participated during a high-violence period of the Al Aqsa Intifada characterized by air raids, killing and destruction. Results showed that witnessing severe military violence was associated with children's aggressive and antisocial behavior (parent-reported) in study I, and with proactive, reactive and aggression-enjoyment (child-reported) in the study II. As hypothesized, good and supporting parenting practices could moderate the link between exposure to military violence and aggressive behavior. Aggr. Copyright 2007 Wiley-Liss, Inc.

MATERNAL TRAUMA AFFECTS PRENATAL MENTAL HEALTH AND INFANT STRESS REGULATION AMONG PALESTINIAN DYADS.

PubMed

Isosävi, Sanna; Diab, Safwat Y; Kangaslampi, Samuli; Qouta, Samir; Kankaanpää, Saija; Puura, Kaija; Punamäki, Raija-Leena

2017-09-01

We examined how diverse and cumulated traumatic experiences predicted maternal prenatal mental health and infant stress regulation in war conditions and whether maternal mental health mediated the association between trauma and infant stress regulation. Participants were 511 Palestinian mothers from the Gaza Strip who reported exposure to current war trauma (WT), past childhood emotional (CEA) and physical abuse, socioeconomic status (SES), prenatal mental health problems (posttraumatic stress disorder and depression symptoms), and perceived stress during their secondtrimester of pregnancy as well as infant stress regulation at 4 months. While all trauma types were associated with high levels of prenatal symptoms, CEA had the most wide-ranging effects and was uniquely associated with depression symptoms. Concerning infant stress regulation, mothers' CEA predicted negative affectivity, but only among mothers with low WT. Against hypothesis, the effects of maternal trauma on infant stress regulation were not mediated by mental health symptoms. Mothers' higher SES was associated with better infant stress regulation whereas infant prematurity and male sex predisposed for difficulties. Our findings suggest that maternal childhood abuse, especially CEA, should be a central treatment target among war-exposed families. Cumulated psychosocial stressors might increase the risk for transgenerational problems. © 2017 Michigan Association for Infant Mental Health.

The Limits of Resilience: Distress Following Chronic Political Violence among Palestinians

PubMed Central

Hobfoll, Stevan E.; Mancini, Anthony D.; Hall, Brian J.; Canetti, Daphna; Bonanno, George A.

2011-01-01

We examined posttraumatic stress disorder (PTSD) and depression symptom trajectories during ongoing exposure to political violence, seeking to identify psychologically resilient individuals and the factors that predict resilience. Face-to-face interviews were conducted with a random sample of 1196 Palestinian adult residents of the West Bank, Gaza, and East Jerusalem across three occasions, six months apart (September, 2007–November,2008). Latent growth mixture modeling identified PTSD, and depression symptom trajectories. Results identified three PTSD trajectories: moderate-improving (73% moderate symptoms at baseline, improving over time), severe-chronic (23.2% severe and elevated symptoms over the entire year); and severe-improving (3.5% severe symptoms at baseline and marked improvement over time). Depression trajectories were moderate-improving (61.5%); severe-chronic (24.4%); severe-improving (14.4%). Predictors of relatively less severe initial symptom severity, and improvement over time for PTSD were less political violence exposure and less resource loss; and for depression were younger age, less political violence exposure, lower resource loss, and greater social support. Loss of psychosocial and material resources was associated with the level of distress experienced by participants at each time period, suggesting that resource-based interventions that target personal, social and financial resources could benefit people exposed to chronic trauma. PMID:21440348

Changes in smoking habits of smokers under bombing by rockets.

PubMed

Keinan-Boker, L; Enav, T; Rozentraub, T; Shohat, T

2011-03-01

Stress is known to impact smoking. This survey assessed changes in smoking behaviour of smokers in Southern Israel during a military operation (December 2008-January 2009) that exposed several civilian communities to intensive rocket bombing and acute stress. Households with an active land telephone line in Jewish Gaza vicinity communities were sampled. Inclusion criteria were age (18+ years) and being a daily or an occasional smoker. A telephone interview was carried out, focusing on socio-demographic characteristics and change in smoking behaviour during the military operation. Personal, demographic and circumstantial correlates of smoking behaviour were assessed using univariate and multivariate analyses. A total of 425 smokers took part in the survey. Most (85%) reported being daily smokers, and smoked, on average, 10-20 cigarettes/day before the operation. During the operation, 38% of the smokers changed their smoking habits and most (88%) reported higher than usual smoking rates. Correlates significantly associated with higher smoking during the operation were sex (female), education (lower) and not working due to the operation. Exposure to acute stress has an impact on smoking rates, especially in certain subgroups of smokers. Relevant smoking cessation interventions should address the special needs of smokers exposed to stressful circumstances.

Trauma and autobiographical memory: contents and determinants of earliest memories among war-affected Palestinian children.

PubMed

Peltonen, Kirsi; Kangaslampi, Samuli; Qouta, Samir; Punamäki, Raija-Leena

2017-11-01

The contents of earliest memories (EM), as part of autobiographical memory, continue to fascinate scientists and therapists. However, research is scarce on the determinants of EM, especially among children. This study aims, first, to identify contents of EM of children living in war conditions, and, second, to analyse child gender, traumatic events and mental health as determinants of the contents of EM. The participants were 240 Palestinian schoolchildren from the Gaza Strip (10-12 years, M = 11.35, SD = 0.57; 49.4% girls). They responded to an open-ended EM question, and reported their trauma exposures (war trauma, losses and current traumatic events), posttraumatic stress, depressive symptoms and psychosocial well-being, indicating mental health. The EM coding involved nature, social orientation, emotional tone and specificity. Results showed, first, that 43% reported playing or visiting a nice place as EM, and about a third (30%) traumatic events or accidents (30%) or miscellaneous events (27%). The individual and social orientation were almost equally common, the emotional tone mainly neutral (45.5%), and 60% remembered a specific event. Second, boys remembered more EM involving traumatic events or accidents, and girls more social events. Third, war trauma was associated with less positive emotional tone and with more specific memories.

Engagement in community activities and trust in local leaders as concomitants of psychological distress among Israeli civilians exposed to prolonged rocket attacks.

PubMed

Zanbar, Lea; Kaniasty, Krzysztof; Ben-Tzur, Navit

2018-07-01

Present study, conducted in the aftermath of the 2014 Israel-Gaza conflict, investigated psychological toll of exposure to rockets attacks in a sample of residents of central and southern Israel. Analyses focused on the distress-protective functions of collectively grounded resources: engagement in community activities and trust in local leadership. This cross-sectional study was conducted between 2 and 3 months after the hostilities. Participants (N = 764) were recruited by an online survey company that distributed a questionnaire assessing, in addition to focal predictors, sociodemographic factors and prior exposure to trauma. The outcome variables were post-traumatic stress disorder (PTSD) and nonspecific distress symptoms. Conservative regression analyses revealed that greater exposure to rocket attacks was predictive of higher levels of posttraumatic stress symptoms. Higher engagement in community activities exhibited a partial trauma-buffering function. However, higher levels of trust in local leaders appeared to exacerbate, rather than diminish, negative impact of rocket exposure on PTSD. Symptoms of psychological distress were not influenced neither by trauma exposure nor by stressor interactions with resources. Trust in local leadership exerted a beneficial main effect on distress. Collectively based resources are important for coping in times of community-wide stressors, yet their role is complex.

Palestinian mothers' perceptions of child mental health problems and services

PubMed Central

THABET, ABDEL AZIZ; EL GAMMAL, HOSSAM; VOSTANIS, PANOS

2006-01-01

The aim of this study was to explore Palestinian mothers' perceptions of child mental health problems and their understanding of their causes; to determine Palestinian mothers' awareness of existing services and sources of help and support; to identify professionals in the community whom Palestinian mothers would consult if their child had mental health problems; and to establish their views on ways of increasing awareness of child mental health issues and services. Checklists exploring the above issues were completed by 249 Palestinian mothers living in refugee camps in the Gaza Strip. Palestinian mothers equally perceived emotional, behavioural and psychotic symptoms as suggestive of mental ill health in childhood. Mothers perceived multiple causes of child mental health problems, including family problems, parental psychiatric illness and social adversity. A substantial proportion (42.6%) had knowledge of local child mental health care services. Overall, mothers preferred Western over traditional types of treatment, and were keen to increase mental health awareness within their society. Despite a different cultural tradition, Palestinian mothers appear open to a range of services and interventions for child mental health problems. As in other non-Western societies, child mental health service provision should be integrated with existing primary health care, schools, and community structures. PMID:16946953

Impact of an educational program on knowledge and practice of health care staff toward pharmaceutical waste management in Gaza, Palestine.

PubMed

Tabash, Mohammed I; Hussein, Rim A; Mahmoud, Aleya H; El-Borgy, Mohamed D; Abu-Hamad, Bassam A

2016-04-01

In health care facilities, pharmaceutical waste is generally discharged down the drain or sent to landfill. Poor knowledge about their potential downstream impacts may be a primary factor for improper disposal behavior. The objective of this study was to determine the impact of an intervention program on knowledge and practice of health care staff regarding pharmaceutical waste management. The study was designed as a pre/posttest intervention study. Total sample size was 530 in the pre-intervention phase, and then a subsample of 69 individuals was selected for the intervention and the post-intervention phases. Paired-sample t test was used to assess the difference between pretest and follow-up test results. A statistically significant improvement in knowledge and practice was achieved (P<0.001). Poor knowledge and poor practice levels (scores<50%) were found to improve to satisfactory levels (scores≥75%). Therefore, educational programs could be considered as an effective tool for changing health care staff practice in pharmaceutical waste management. In health care facilities, pharmaceutical waste is generally discharged down the drain or sent to landfill. A lack of knowledge about the potential impacts of this type of waste may be a leading factor in improper disposal behavior. Following an educational program, statistically significant improvement in knowledge and practice of health care staff as regards to pharmaceutical waste management (PWM) was achieved. It is thus recommended that authorities implement training-of-trainers (TOT) programs to educate health care staff on PWM and organize refreshment workshops regularly.

Measuring and decomposing socioeconomic inequality in healthcare delivery: A microsimulation approach with application to the Palestinian conflict-affected fragile setting.

PubMed

Abu-Zaineh, Mohammad; Mataria, Awad; Moatti, Jean-Paul; Ventelou, Bruno

2011-01-01

Socioeconomic-related inequalities in healthcare delivery have been extensively studied in developed countries, using standard linear models of decomposition. This paper seeks to assess equity in healthcare delivery in the particular context of the occupied Palestinian territory: the West Bank and the Gaza Strip, using a new method of decomposition based on microsimulations. Besides avoiding the 'unavoidable price' of linearity restriction that is imposed by the standard methods of decomposition, the microsimulation-based decomposition enables to circumvent the potentially contentious role of heterogeneity in behaviours and to better disentangle the various sources driving inequality in healthcare utilisation. Results suggest that the worse-off do have a disproportinately greater need for all levels of care. However with the exception of primary-level, utilisation of all levels of care appears to be significantly higher for the better-off. The microsimulation method has made it possible to identify the contributions of factors driving such pro-rich patterns. While much of the inequality in utilisation appears to be caused by the prevailing socioeconomic inequalities, detailed analysis attributes a non-trivial part (circa 30% of inequalities) to heterogeneity in healthcare-seeking behaviours across socioeconomic groups of the population. Several policy recommendations for improving equity in healthcare delivery in the occupied Palestinian territory are proposed. Copyright © 2010 Elsevier Ltd. All rights reserved.

Sense of Threat as a Mediator of Peritraumatic Stress Symptom Development During Wartime: An Experience Sampling Study.

PubMed

Lapid Pickman, Liron; Greene, Talya; Gelkopf, Marc

2017-08-01

Exposure and sense of threat have been associated with stress symptoms, yet these relationships have not been clarified during the peritraumatic period. We investigated the mediating role of sense of threat in the link between exposure to rocket warning sirens and stress symptoms during wartime, and the effect of severe mental illness (SMI) status and gender on this mediation. A 30-day twice-daily smartphone-based intensive assessment of exposure to sirens, sense of threat, and peritraumatic stress symptoms was performed during the 2014 Israel-Gaza conflict. Participants included 182 highly exposed individuals with or without SMI. Multilevel structural equation modeling analysis was performed, with SMI status and gender as confounders. Exposure affected the level of peritraumatic stress symptoms both directly, b = 1.07, p < .001, 95% CI [0.32, 1.82], and indirectly, b = 0.78, p < .001, 95% CI [0.24, 1.33], through sense of threat. The effect of sense of threat on stress symptoms was larger in the SMI group, b = 0.86, p < .001, 95% CI [0.31, 1.40]. Gender did not have a significant effect. Sense of threat has a key role in symptom development during the peritraumatic timeframe. Intervention and prevention efforts should start early and focus on promoting a sense of safety, particularly with people with SMI. Copyright © 2017 International Society for Traumatic Stress Studies.

Charcoal production in the Mopane woodlands of Mozambique: what are the trade-offs with other ecosystem services?

PubMed Central

Baumert, Sophia; Vollmer, Frank; Grundy, Isla; Fisher, Janet; Fernando, Jone; Luz, Ana; Lisboa, Sá N.

2016-01-01

African woodlands form a major part of the tropical grassy biome and support the livelihoods of millions of rural and urban people. Charcoal production in particular is a major economic activity, but its impact on other ecosystem services is little studied. To address this, our study collected biophysical and social datasets, which were combined in ecological production functions, to assess ecosystem service provision and its change under different charcoal production scenarios in Gaza Province, southern Mozambique. We found that villages with longer histories of charcoal production had experienced declines in wood suitable for charcoal, firewood and construction, and tended to have lower perceived availabilities of these services. Scenarios of future charcoal impacts indicated that firewood and woody construction services were likely to trade-off with charcoal production. However, even under the most extreme charcoal scenario, these services were not completely lost. Other provisioning services, such as wild food, medicinal plants and grass, were largely unaffected by charcoal production. To reduce the future impacts of charcoal production, producers must avoid increased intensification of charcoal extraction by avoiding the expansion of species and sizes of trees used for charcoal production. This is a major challenge to land managers and policymakers in the area. This article is part of the themed issue ‘Tropical grassy biomes: linking ecology, human use and conservation’. PMID:27502380

Earth Observation taken by the Expedition 29 crew

NASA Image and Video Library

2011-11-03

ISS029-E-037471 (3 Nov. 2011) --- Egypt?Israel borderlands, northern Sinai Peninsula and northern Negev Desert are featured in this image photographed by an Expedition 29 crew member on the International Space Station. A clearly visible line that marks approximately 50 kilometers of the international border between Egypt and Israel?10-60 kilometers from the Mediterranean Sea to the northwest (not shown)?crosses the center of this photograph from left to right. The reason for the color difference is likely the slightly higher level of grazing by the animal herds of Bedouin herdsmen on the Egyptian side of the border. A major highway also follows the border, making the demarcation more prominent in this recent image taken from the space station. A patch of the Gaza Strip appears under scattered cloud at far right. In the arid to semiarid climate of the region illustrated in the image the natural grass vegetation is sparse at best. Irrigated commercial agriculture in Israel nearest the Mediterranean coast appears as a series of large angular patterns and circular center pivot fields, with darker greens indicating growing crops (right). Smaller plot sizes appear on the Egyptian side of the border at upper right. The image shows how the active sand dunes, which dominate most of the landscape in this view, mark the southern limit of the agriculture.

Women's decision-making autonomy and children's schooling in rural Mozambique.

PubMed

Luz, Luciana; Agadjanian, Victor

2015-03-24

Women's decision-making autonomy in developing settings has been shown to improve child survival and health outcomes. However, little research has addressed possible connections between women's autonomy and children's schooling. To examine the relationship between rural women's decision-making autonomy and enrollment status of primary school-age children living in their households and how this relationship differs by child's gender. The analysis uses data from a 2009 survey of rural households in four districts of Gaza province in southern Mozambique. Multilevel logistic models predict the probability of being in school for children between 6 and 14 years old. The results show a positive association of women's decision-making autonomy with the probability of being enrolled in primary school for daughters, but not for sons. The effect of women's autonomy is net of other women's characteristics typically associated with enrollment and does not mediate the effects of those characteristics. Based on the results, we argue that women with higher levels of decision-making autonomy may have a stronger preference for daughters' schooling and may have a greater say in making and implementing decisions regarding daughters' education, compared to women with lower autonomy levels. Results also illustrate a need for considering a broader set of autonomy-related characteristics when examining the effects of women's status on children's educational outcomes.

War and Well-Being: The Association between Forgiveness, Social Support, Posttraumatic Stress Disorder, and Well-Being during and after War.

PubMed

Weinberg, Michael; Harel, Hila; Shamani, Michal; Or-Chen, Keren; Ron, Pnina; Gil, Sharon

2017-10-01

Exposure to war can lead to numerous traumatic experiences affecting the daily lives and personal well-being of the civilian population. However, no research to date has examined the associations between postwar well-being and posttraumatic stress disorder (PTSD) symptoms, tendency to forgive, and social support during and following war. Authors examined a sample of 160 Israeli civilians who were exposed to rocket and missile fire during the 2014 Gaza War. Time 1 (Tl) started approximately one week after the beginning of the war and ended four weeks later following the first 72-hour ceasefire declaration by the United Nations. Respondents were re-approached by personal e-mail approximately one month after T1. A structural equation model design showed that higher postwar tendency to forgive, and social support, are associated with higher postwar well-being. It is notable that higher social support during the war had a negative effect on postwar well-being. In addition, higher posttraumatic symptoms and well-being during the war had a positive effect on higher postwar well-being. The study findings reinforce the importance of personal variables in postwar well-being. However, increased awareness of both social support and PTSD symptoms as "double-edged sword" resources is advisable, considering the different effects of social support and PTSD symptoms on well-being both during and after the war. © 2017 National Association of Social Workers.

The impact of the peace treaty on psychological well-being: a follow-up study of Palestinian children.

PubMed

Qouta, S; Punamäki, R L; el Sarraj, E

1995-10-01

This research examined the impact of the Israeli-Palestinian peace treaty and Palestinian children's perception of it on their self-esteem and neuroticism. We also studied the relative importance of earlier exposure to traumatic experiences and psychosocial resources indicated by the children's creativity, intelligence and political activity in influencing their psychological well-being after the peace treaty. The sample used was a follow-up group of 64 Palestinian children of 11-12 years of age, living in the Gaza Strip. The results showed that the level of neuroticism was significantly lower after the peace treaty than before. The children's earlier exposure to traumatic experiences was still significantly related to high neuroticism and low self-esteem after the peace treaty. Acceptance of the treaty and participating in the subsequent festivities mitigated the negative impact of the traumatic experiences on their well-being. Increased neuroticism and decreased self-esteem were found only among children who refused to accept the peace treaty and did not participate in the festivities. Creativity and Intifada activity promoted their post-peace treaty well-being, in terms of psychosocial resources. The more creative the children were, the more their neurotic symptoms decreased because of the treaty and the higher self-esteem they had after it. The more active the children were during the Intifada, the more their self-esteem increased because of the treaty.

Multivariate methods for indoor PM10 and PM2.5 modelling in naturally ventilated schools buildings

NASA Astrophysics Data System (ADS)

Elbayoumi, Maher; Ramli, Nor Azam; Md Yusof, Noor Faizah Fitri; Yahaya, Ahmad Shukri Bin; Al Madhoun, Wesam; Ul-Saufie, Ahmed Zia

2014-09-01

In this study the concentrations of PM10, PM2.5, CO and CO2 concentrations and meteorological variables (wind speed, air temperature, and relative humidity) were employed to predict the annual and seasonal indoor concentration of PM10 and PM2.5 using multivariate statistical methods. The data have been collected in twelve naturally ventilated schools in Gaza Strip (Palestine) from October 2011 to May 2012 (academic year). The bivariate correlation analysis showed that the indoor PM10 and PM2.5 were highly positive correlated with outdoor concentration of PM10 and PM2.5. Further, Multiple linear regression (MLR) was used for modelling and R2 values for indoor PM10 were determined as 0.62 and 0.84 for PM10 and PM2.5 respectively. The Performance indicators of MLR models indicated that the prediction for PM10 and PM2.5 annual models were better than seasonal models. In order to reduce the number of input variables, principal component analysis (PCA) and principal component regression (PCR) were applied by using annual data. The predicted R2 were 0.40 and 0.73 for PM10 and PM2.5, respectively. PM10 models (MLR and PCR) show the tendency to underestimate indoor PM10 concentrations as it does not take into account the occupant's activities which highly affect the indoor concentrations during the class hours.

Assessment on the ownership and use of mosquito nets in Mozambique.

PubMed

Arroz, Jorge Alexandre Harrison; Chirrute, Francisco; Mendis, Chandana; Chande, Marta Honesta; Kollhoff, Veronique

2016-12-22

To assess the ownership and use of mosquito nets in 2014, in Mozambique. This observational and cross-sectional study assessed, in February and March 2015, 69 districts (nine of 11 provinces of Mozambique) that have benefited from the mass distribution of mosquito nets. The Lot Quality Assurance Sampling methodology was used. Each locality was denominated supervision area. The Lot Quality Assurance Sampling opts for a minimum of 19 households (in this case, we decided for a minimum of 100 households per district) from each supervision area to assess an indicator (in this case, two indicators were assessed: ownership and use of mosquito nets). Two questions guided the research: a) received a mosquito net; b) used a mosquito net the night before. A total of 6,725 households were assessed. Eighty three percent of them had received mosquito nets in the campaign. Of the 6,232 respondents, 82.0% said they used mosquito nets the night before. The districts of the provinces with low coverage of ownership and use were Tete (69.5% and 60.0%, respectively), Zambezia (79.0% and 60.0%, respectively), and Gaza (81.6% and 70.7%, respectively). The largest coverage of ownership and use were observed in the districts of Nampula (96.7% and 93.8%, respectively) and Niassa (86.0% and 85.4% respectively). In the districts assessed, the progression of ownership and use of mosquito nets is satisfactory. Nampula and Niassa are the only provinces where ownership and use are at desired levels. Avaliar a posse e o uso das redes mosquiteiras no ano de 2014 em Moçambique. Este estudo observacional transversal avaliou, em fevereiro e março de 2015, 68 distritos (nove das 11 províncias de Moçambique) que se beneficiaram da distribuição de redes em massa. Usou-se a metodologia Lot Quality Assurance Sampling. Cada localidade foi designada de área de supervisão. O Lot Quality Assurance Sampling opta por um mínimo de 19 agregados familiares (neste caso decidiu-se um mínimo de 100 agregados

Women’s decision-making autonomy and children’s schooling in rural Mozambique

PubMed Central

Luz, Luciana; Agadjanian, Victor

2015-01-01

BACKGROUND Women’s decision-making autonomy in developing settings has been shown to improve child survival and health outcomes. However, little research has addressed possible connections between women’s autonomy and children’s schooling. OBJECTIVE To examine the relationship between rural women’s decision-making autonomy and enrollment status of primary school-age children living in their households and how this relationship differs by child’s gender. METHODS The analysis uses data from a 2009 survey of rural households in four districts of Gaza province in southern Mozambique. Multilevel logistic models predict the probability of being in school for children between 6 and 14 years old. RESULTS The results show a positive association of women’s decision-making autonomy with the probability of being enrolled in primary school for daughters, but not for sons. The effect of women’s autonomy is net of other women’s characteristics typically associated with enrollment and does not mediate the effects of those characteristics. CONCLUSIONS Based on the results, we argue that women with higher levels of decision-making autonomy may have a stronger preference for daughters’ schooling and may have a greater say in making and implementing decisions regarding daughters’ education, compared to women with lower autonomy levels. Results also illustrate a need for considering a broader set of autonomy-related characteristics when examining the effects of women’s status on children’s educational outcomes. PMID:26491400

Kindler syndrome with severe mucosal involvement in a large Palestinian pedigree.

PubMed

El Hachem, May; Diociaiuti, Andrea; Proto, Vittoria; Fortugno, Paola; Zambruno, Giovanna; Castiglia, Daniele; Naim, Majdy

2015-01-01

Kindler syndrome (KS) is a rare autosomal recessive disease of skin fragility, photosensitivity and progressive poikiloderma. Mucous membranes may also be involved. KS is caused by mutations in the FERMT1 gene encoding kindlin-1. We report the clinical and molecular features of the largest kindred with KS to date, comprising 18 affected family members (age range: 12-63 years) from the Gaza Strip. All the affected family members were clinically examined. In addition a skin biopsy for immunofluorescence testing was obtained from the index case. Molecular analysis of the FERMT1 gene was performed on genomic DNA extracted from peripheral blood of 5 patients. All patients presented skin and eye photosensitivity, cutaneous atrophy, dyschromia and poikiloderma, oral cavity involvement, dysphagia and constipation with anal fissures. In addition, nail dystrophy and digit webbing were observed in most of them. Ocular manifestations detected in all patients comprised ectropion and keratoconjunctivitis, with early development of symblepharon in 17 out of 18 cases and blindness in one. Of note, 17 out of 18 affected family members also suffered from urethral strictures since childhood. Diagnosis was supported by immunofluorescence findings and definitely confirmed by FERMT1 sequencing which identified the homozygous frame-shift mutation c.137_140delTAGT. The high rate of mucosal involvement, its early onset and progressive course are noticeable features of our kindred. Also noteworthy is the lack of muco-cutaneous malignancies, despite the sunny habitat.

Spatial and seasonal variation of particulate matter (PM10 and PM2.5) in Middle Eastern classrooms

NASA Astrophysics Data System (ADS)

Elbayoumi, Maher; Ramli, Nor Azam; Md Yusof, Noor Faizah Fitri; Al Madhoun, Wesam

2013-12-01

Monitoring of PM10 and PM2.5 particularly in school microenvironments is extremely important due to their impact on the global burden of disease. PM10 and PM2.5 levels were monitored inside and outside the classrooms of twelve naturally ventilated schools located in Gaza strip, Palestine. The measurements were carried out using hand held particulate matter instrument during fall, winter and spring seasons from October 2011 to May 2012. The average concentration of indoor PM10 was 349.49 (±196.57) μg m-3 and for PM2.5 was 103.96 (±84.96) μg m-3. The indoor/outdoor ratios for PM10 and PM2.5 were found to be much greater than 1.00 for all case study schools due to resuspension of deposited particles from the floors. Furthermore, strong correlations were found between indoor-outdoor PM10 and PM2.5. The variations of PM10 and PM2.5 concentrations were significant for the three seasons. During winter, the mean indoor PM10 was 1.30 and 2.50 times higher than fall and spring concentrations respectively. Meanwhile, PM2.5 concentration in winter was 3.00 times higher than fall and spring concentrations. In relation to spatial variation, the concentration of PM10 in the lower storey level was significantly higher than the classrooms located in the higher storey level.

Intergenerational effects of war trauma among Palestinian families mediated via psychological maltreatment.

PubMed

Palosaari, Esa; Punamäki, Raija-Leena; Qouta, Samir; Diab, Marwan

2013-11-01

We tested the hypothesis that intergenerational effects of parents' war trauma on offspring's attachment and mental health are mediated by psychological maltreatment. Two hundred and forty children and their parents were sampled from a war-prone area, Gaza, Palestine. The parents reported the number and type of traumatic experiences of war they had had during their lifetime before the child's birth and during a current war when the child was 10-12 years old. The children reported their war traumas, experiences of psychological maltreatment, attachment security, and symptoms of posttraumatic stress (PTSS), depression, and aggression. The direct and indirect intergenerational effects of war trauma were tested in structural equation models. The hypotheses were confirmed for father's past war exposure, and disconfirmed for mother's war exposure. The father's past war trauma had a negative association with attachment security and positive association with the child's mental health problems mediated by increased psychological maltreatment. In contrast, the mother's past war trauma had a negative association with the child's depression via decreased psychological maltreatment. The mother's current war trauma had a negative association with the child's depression and aggression via decreased psychological maltreatment. Among fathers, past war exposure should be considered as a risk factor for psychological maltreatment of children and the associated attachment insecurity and mental health problems. Among mothers, war exposure as such could be given less clinical attention than PTSS in the prevention of psychological maltreatment of children. Copyright © 2013 Elsevier Ltd. All rights reserved.

Favism, the commonest form of severe hemolytic anemia in Palestinian children, varies in severity with three different variants of G6PD deficiency within the same community.

PubMed

Reading, N Scott; Sirdah, Mahmoud M; Shubair, Mohammad E; Nelson, Benjamin E; Al-Kahlout, Mustafa S; Al-Tayeb, Jamal M; Aboud, Lina N; Shaban, Maysaa Abu; Luzzatto, Lucio; Prchal, Josef T

2016-09-01

Glucose-6-phosphate dehydrogenase (G6PD) deficiency is a common genetic abnormality known to predispose to acute hemolytic anemia (AHA), which can be triggered by certain drugs or infection. However, the commonest trigger is fava beans (Vicia faba) ingestion, causing AHA (favism), which may be life-threatening especially in children. G6PD deficiency is genetically highly heterogeneous, as nearly 200 different mutations have been observed. We have investigated the hematological features of acute favism in the Palestinian Gaza community that is characterized by the polymorphic coexistence of three different G6PD deficiency genes (G6PD A-, G6PD Cairo, G6PD Med). We have found by comparison to the general population (485 adults and 466 newborns) that children with favism, in terms of relative frequency, G6PD A- was under-represented, whereas G6PD Med was over-represented. We also found that the severity of anemia was significantly greater with G6PD Med and G6PD Cairo than with G6PD A-; and with G6PD Cairo, compared to the other two variants, there was greater hyperbilirubinemia, as well as persistence of mild anemia and reticulocytosis for as long as 4months after recovery from favism. This is the first report determining a differential impact of different G6PD mutations on the clinical features of favism in the same population and the same environment. Copyright © 2016. Published by Elsevier Inc.

Snow in the Middle East

NASA Image and Video Library

2017-12-08

This image from the Aqua satellite's MODIS instrument taken at 11:10 UTC on December 16, 2013 shows areas of snow in Syria, Jordan, Israel and the Palestinian Territory. Snow storms in the Middle East are not frequent but not uncommon either. However, this one was unusually early in the winter and more intense than normal. The storm paralyzed Jerusalem with 30 to 50 centimeters (12 to 20 inches) of snow, knocking out power for roughly 15,000 households. The snow closed mountain roads leading into the city, effectively cutting Jerusalem off. Amman, Jordan, received about 45 cm (18 inches) of snow, and Lebanon and Syria also were unusually cold and snowy. Lower elevations near the coast received torrential rain during the storm, resulting in flooding. Some 40,000 people were forced to evacuate flooded areas in Gaza, according to the Associated Press. The floods are not visible at this scale, but tan and green plumes of sediment are visible along the Mediterranean Sea coast. Such plumes can be caused by floods and run off, though stormy, turbid waters may also bring sediment to the surface. NASA image use policy. NASA Goddard Space Flight Center enables NASA’s mission through four scientific endeavors: Earth Science, Heliophysics, Solar System Exploration, and Astrophysics. Goddard plays a leading role in NASA’s accomplishments by contributing compelling scientific knowledge to advance the Agency’s mission. Follow us on Twitter Like us on Facebook Find us on Instagram

Low infant mortality among Palestine refugees despite the odds.

PubMed

Riccardo, Flavia; Khader, Ali; Sabatinelli, Guido

2011-04-01

To present data from a 2008 infant mortality survey conducted in Jordan, Lebanon, the Syrian Arab Republic, the Gaza Strip and the West Bank and analyse infant mortality trends among Palestine refugees in 1995-2005. Following the preceding birth technique, mothers who were registering a new birth were asked if the preceding child was alive or dead, the day the child was born and the date of birth of the neonate whose birth was being registered. From this information, neonatal, infant and early child mortality rates were estimated. The age at death for early child mortality was determined by the mean interval between successive births and the mean age of neonates at registration. In 2005-2006, infant mortality among Palestine refugees ranged from 28 deaths per 100 000 live births in the Syrian Arab Republic to 19 in Lebanon. Thus, infant mortality in Palestine refugees is among the lowest in the Near East. However, infant mortality has stopped decreasing in recent years, although it remains at a level compatible with the attainment of Millennium Development Goal 4. Largely owing to the primary health care provided by the United Nations Relief and Works Agency (UNRWA) for Palestine Refugees in the Near East and other entities, infant mortality among Palestine refugees had consistently decreased. However, it is no longer dropping. Measures to address the most likely reasons - early marriage and childbearing, poor socioeconomic conditions and limited access to good perinatal care - are needed.

Optimization of leachate treatment using persulfate/H2O2 based advanced oxidation process: case study: Deir El-Balah Landfill Site, Gaza Strip, Palestine.

PubMed

Hilles, Ahmed H; Abu Amr, Salem S; Hussein, Rim A; Arafa, Anwar I; El-Sebaie, Olfat D

2016-01-01

The objective of this study was to investigate the performance of employing H2O2 reagent in persulfate activation to treat stabilized landfill leachate. A central composite design (CCD) with response surface methodology (RSM) was applied to evaluate the relationships between operating variables, such as persulfate and H2O2 dosages, pH, and reaction time, to identify the optimum operating conditions. Quadratic models for the following two responses proved to be significant with very low probabilities (<0.0001): chemical oxygen demand (COD) and NH3-N removal. The obtained optimum conditions included a reaction time of 116 min, 4.97 g S2O8(2-), 7.29 g H2O2 dosage and pH 11. The experimental results were corresponding well with predicted models (COD and NH3-N removal rates of 81% and 83%, respectively). The results obtained in the stabilized leachate treatment were compared with those from other treatment processes, such as persulfate only and H2O2 only, to evaluate its effectiveness. The combined method (i.e., /S2O8(2-)/H2O2) achieved higher removal efficiencies for COD and NH3-N compared with other studied applications.

Dynamic networks of PTSD symptoms during conflict.

PubMed

Greene, Talya; Gelkopf, Marc; Epskamp, Sacha; Fried, Eiko

2018-02-28

Conceptualizing posttraumatic stress disorder (PTSD) symptoms as a dynamic system of causal elements could provide valuable insights into the way that PTSD develops and is maintained in traumatized individuals. We present the first study to apply a multilevel network model to produce an exploratory empirical conceptualization of dynamic networks of PTSD symptoms, using data collected during a period of conflict. Intensive longitudinal assessment data were collected during the Israel-Gaza War in July-August 2014. The final sample (n = 96) comprised a general population sample of Israeli adult civilians exposed to rocket fire. Participants completed twice-daily reports of PTSD symptoms via smartphone for 30 days. We used a multilevel vector auto-regression model to produce contemporaneous and temporal networks, and a partial correlation network model to obtain a between-subjects network. Multilevel network analysis found strong positive contemporaneous associations between hypervigilance and startle response, avoidance of thoughts and avoidance of reminders, and between flashbacks and emotional reactivity. The temporal network indicated the central role of startle response as a predictor of future PTSD symptomatology, together with restricted affect, blame, negative emotions, and avoidance of thoughts. There were some notable differences between the temporal and contemporaneous networks, including the presence of a number of negative associations, particularly from blame. The between-person network indicated flashbacks and emotional reactivity to be the most central symptoms. This study suggests various symptoms that could potentially be driving the development of PTSD. We discuss clinical implications such as identifying particular symptoms as targets for interventions.

Assessment on the ownership and use of mosquito nets in Mozambique

PubMed Central

Arroz, Jorge Alexandre Harrison; Chirrute, Francisco; Mendis, Chandana; e, Marta Honesta Chande; Kollhoff, Veronique

2016-01-01

ABSTRACT OBJECTIVE To assess the ownership and use of mosquito nets in 2014, in Mozambique. METHODS This observational and cross-sectional study assessed, in February and March 2015, 69 districts (nine of 11 provinces of Mozambique) that have benefited from the mass distribution of mosquito nets. The Lot Quality Assurance Sampling methodology was used. Each locality was denominated supervision area. The Lot Quality Assurance Sampling opts for a minimum of 19 households (in this case, we decided for a minimum of 100 households per district) from each supervision area to assess an indicator (in this case, two indicators were assessed: ownership and use of mosquito nets). Two questions guided the research: a) received a mosquito net; b) used a mosquito net the night before. RESULTS A total of 6,725 households were assessed. Eighty three percent of them had received mosquito nets in the campaign. Of the 6,232 respondents, 82.0% said they used mosquito nets the night before. The districts of the provinces with low coverage of ownership and use were Tete (69.5% and 60.0%, respectively), Zambezia (79.0% and 60.0%, respectively), and Gaza (81.6% and 70.7%, respectively). The largest coverage of ownership and use were observed in the districts of Nampula (96.7% and 93.8%, respectively) and Niassa (86.0% and 85.4% respectively). CONCLUSIONS In the districts assessed, the progression of ownership and use of mosquito nets is satisfactory. Nampula and Niassa are the only provinces where ownership and use are at desired levels. PMID:28099655

Peritraumatic Reaction Courses During War in Individuals With Serious Mental Illness: Gender, Mental Health Status, and Exposure.

PubMed

Gelkopf, Marc; Lapid Pickman, Liron; Grinapol, Shulamit; Werbeloff, Nomi; Carlson, Eve B; Greene, Talya

2017-01-01

We assessed in vivo symptom courses of early psychological responses during war and investigated the influence of exposure, gender, and a prior diagnosis of severe mental illness (SMI). Participants were 181 highly exposed individuals from the general population and community psychiatric rehabilitation centers. A 30-day twice-daily Internet-smartphone-based intensive assessment two weeks into the 2014 Israel-Gaza war estimated peritraumatic symptom clusters, sense of threat, negative emotions and cognitions, and siren exposure during two periods that varied in exposure level. Piecewise growth curve modeling procedures were performed. We found different courses for most variables, gender, and SMI status. Women were more reactive two weeks into the war but reduced their reactivity level at a faster pace than males, reaching lower symptom levels one month later. Women's courses were characterized by arousal, negative emotionality, sense of threat, and reactivity to siren exposure. No-SMI men had a stable course followed by a significant reduction in arousal, negative emotions, avoidance, and perceived threat during a "return to routine" lower-level intensity period of the war. Individuals with SMI had higher reactivity levels at study onset; but while women with SMI improved over time, men with SMI worsened. SMI reactivity was characterized by negative cognitions, intrusions, and avoidance. Early reactions during prolonged exposure to war are variable, dynamic, and affected by exposure context. Symptoms, emotions, and cognitions develop differentially over time and are affected by gender and mental health status. The identification of various early stress courses should inform primary intervention strategies.

Research on psychosocial aspects of asthma in the Arab world: a literature review.

PubMed

Al-Khateeb, Anas J; Al Khateeb, Jamal M

2015-01-01

The importance of psychosocial factors in the management of bronchial asthma has long been recognized. This paper offers a review of research published in the English language related to psychosocial aspects of bronchial asthma in Arab countries. Several databases (PubMed, Science Direct, Springer Link, ERIC, and PsychInfo) were searched using the following keywords: bronchial asthma, Arab countries, Algiers, Bahrain, Comoros, Djibouti, Egypt, Iraq, Jordan, Kuwait, Lebanon, Libya, Mauritania, Morocco, Oman, Palestine (West Bank, Gaza), Qatar, Saudi Arabia, Syria, Tunisia, Sudan, Somalia; United Arab Emirates, and Yemen. Thirty-two studies were conducted in 9 Arab countries. Almost all studies found were published in the last fourteen years with an apparent increasing rate in the last five years. In descending order, these studies addressed: knowledge of and attitudes toward asthma, quality of life, behavioral and emotional problems and factors related to academic achievement. The main results of the studies reviewed were: (a) physicians', school staff's, and parents' knowledge of and attitudes toward asthma were generally unsatisfactory, (b) in-service asthma education programs significantly impacted parent and staff knowledge and attitudes, and asthma management practices, (c) quality of life in children and adolescents was significantly adversely affected by asthma, (d) asthma was a common cause of school absenteeism, and had a significant negative impact on academic achievement of students, and (e) students with asthma had significantly higher rates of behavioral and emotional difficulties compared to students without asthma. The paper concludes with a discussion about the implications of these results and a call for further research in this area.

Travel patterns and demographic characteristics of malaria cases in Swaziland, 2010-2014.

PubMed

Tejedor-Garavito, Natalia; Dlamini, Nomcebo; Pindolia, Deepa; Soble, Adam; Ruktanonchai, Nick W; Alegana, Victor; Le Menach, Arnaud; Ntshalintshali, Nyasatu; Dlamini, Bongani; Smith, David L; Tatem, Andrew J; Kunene, Simon

2017-09-08

As Swaziland progresses towards national malaria elimination, the importation of parasites into receptive areas becomes increasingly important. Imported infections have the potential to instigate local transmission and sustain local parasite reservoirs. Travel histories from Swaziland's routine surveillance data from January 2010 to June 2014 were extracted and analysed. The travel patterns and demographics of rapid diagnostic test (RDT)-confirmed positive cases identified through passive and reactive case detection (RACD) were analysed and compared to those found to be negative through RACD. Of 1517 confirmed cases identified through passive surveillance, 67% reported travel history. A large proportion of positive cases reported domestic or international travel history (65%) compared to negative cases (10%). The primary risk factor for malaria infection in Swaziland was shown to be travel, more specifically international travel to Mozambique by 25- to 44-year old males, who spent on average 28 nights away. Maputo City, Inhambane and Gaza districts were the most likely travel destinations in Mozambique, and 96% of RDT-positive international travellers were either Swazi (52%) or Mozambican (44%) nationals, with Swazis being more likely to test negative. All international travellers were unlikely to have a bed net at home or use protection of any type while travelling. Additionally, paths of transmission, important border crossings and means of transport were identified. Results from this analysis can be used to direct national and well as cross-border targeting of interventions, over space, time and by sub-population. The results also highlight that collaboration between neighbouring countries is needed to tackle the importation of malaria at the regional level.

Canine echinococcosis: genetic diversity of Echinococcus granulosus sensu stricto (s.s.) from definitive hosts.

PubMed

Boufana, B; Lett, W; Lahmar, S; Griffiths, A; Jenkins, D J; Buishi, I; Engliez, S A; Alrefadi, M A; Eljaki, A A; Elmestiri, F M; Reyes, M M; Pointing, S; Al-Hindi, A; Torgerson, P R; Okamoto, M; Craig, P S

2015-11-01

Canids, particularly dogs, constitute the major source of cystic echinococcosis (CE) infection to humans, with the majority of cases being caused by Echinococcus granulosus (G1 genotype). Canine echinococcosis is an asymptomatic disease caused by adult tapeworms of E. granulosus sensu lato (s.l.). Information on the population structure and genetic variation of adult E. granulosus is limited. Using sequenced data of the mitochondrial cytochrome c oxidase subunit 1 (cox1) we examined the genetic diversity and population structure of adult tapeworms of E. granulosus (G1 genotype) from canid definitive hosts originating from various geographical regions and compared it to that reported for the larval metacestode stage from sheep and human hosts. Echinococcus granulosus (s.s) was identified from adult tapeworm isolates from Kenya, Libya, Tunisia, Australia, China, Kazakhstan, United Kingdom and Peru, including the first known molecular confirmation from Gaza and the Falkland Islands. Haplotype analysis showed a star-shaped network with a centrally positioned common haplotype previously described for the metacestode stage from sheep and humans, and the neutrality indices indicated population expansion. Low Fst values suggested that populations of adult E. granulosus were not genetically differentiated. Haplotype and nucleotide diversities for E. granulosus isolates from sheep and human origin were twice as high as those reported from canid hosts. This may be related to self-fertilization of E. granulosus and/or to the longevity of the parasite in the respective intermediate and definitive hosts. Improved nuclear single loci are required to investigate the discrepancies in genetic variation seen in this study.

Incidence of Echinococcus granulosus in Domestic Dogs in Palestine as Revealed by Copro-PCR

PubMed Central

Al-Jawabreh, Amer; Dumaidi, Kamal; Ereqat, Suheir; Nasereddin, Abedelmajeed; Al-Jawabreh, Hanan; Azmi, Kifaya; Al-Laham, Nahed; Abdeen, Ziad

2015-01-01

Hydatidosis or echinococcosisis considered a neglected zoonotic disease despite its high burden in the livestock industry and the high risk of infection by humans in endemic areas. In a cross-sectional study we estimated the copro-Incidence and also genotyped Echinococcus granulosus isolates from domestic dogs using polymerase chain reaction (PCR). Medical archives in nine major hospitals in Palestine were reviewed to determine incidence of E. granulosus infection detected in humans during surgery. Faecal samples were collected from 93 domestic dogs in three districts with the highest number of human cases: Al-Khalil (Hebron), Tubas and Jenin. Genomic DNA was extracted from dog faecal samples and amplified by PCR targeting the repeat DNA sequence (EgG1 Hae III) followed by sequencing of five positive samples. Genotyping was determined by sequencing and BLAST searching of mitochondrial cytochrome c oxidase subunit (CO1). The incidence of E. granulosus infection detected in humans at surgery was 1.2 per 100,000 in the West Bank and 1.0 per 100,000 in Gaza Strip. Seventeen of 93 domestic dogs (18%) were positive, based upon comparison with the Echinococcus DNA control. The five sequenced samples were confirmed to be E. granulosus. Successfully genotyped sample belonged to E.granulosus sensu stricto (formerly G1-G3 complex, sheep strain). For domestic dogs, age group (13-24 months) and sex were identified as two risk factors for contracting E. granulosus. The study identified the high incidence of E. granulosus sensu stricto in dogs in Palestine. PMID:26181591

Older Adults Exposed to Ongoing versus Intense Time-Limited Missile Attacks: Differences in Symptoms of Posttraumatic Stress Disorder.

PubMed

Shrira, Amit; Shmotkin, Dov; Palgi, Yuval; Hoffman, Yaakov; Bodner, Ehud; Ben-Ezra, Menachem; Litwin, Howard

2017-01-01

The potentially different psychological effects of ongoing trauma vis-à-vis an intense time-limited exposure to trauma have not been examined in older adults. Therefore, this study examined posttraumatic stress disorder (PTSD) symptoms and their health concomitants in two groups of older adults in Israel: those exposed to ongoing missile attacks and those exposed to an intense time-limited period of missile attacks. In the third administration of the Israeli component of the Survey of Health, Ageing, and Retirement in Europe (SHARE-Israel), 297 older adults reported ongoing exposure to missile attacks due to the Israel-Gaza conflict (mean age = 66.97), while 309 older adults reported exposure to an intense period of missile attacks during the Second Lebanon War (mean age = 66.63). Participants completed measures of PTSD symptoms, and physical, cognitive, and mental health. Older adults with ongoing exposure reported higher PTSD symptom level relative to those with intense time-limited exposure. The groups also differed in health variables related to PTSD symptoms. Namely, impaired physical and cognitive health were related to a higher level of PTSD symptoms in ongoing exposure, while impaired mental health was related to a higher PTSD symptom level following intense time-limited exposure. The findings suggest that physical and cognitive health involves resources that are vital for daily survival when living under ongoing warfare threat, whereas mental health involves resources that are needed in dealing with psychological effects of warfare trauma. Accordingly, different interventions may be necessary when helping older adults exposed to ongoing versus intense time-limited trauma.

A single, improvised "Kassam" rocket explosion can cause a mass casualty incident: a potential threat for future international terrorism?

PubMed

Schwartz, D; Ostfeld, I; Bar-Dayan, Y

2009-04-01

Over 2000 improvised rockets (called "Kassam" rockets) have been targeted at the south of Israel from the Gaza strip since 2001. Most of them have injured relatively few people. The first known case of a multicasualty incident (MCI) caused by the landing of a single, improvised rocket is described. The event is described according to the disastrous incidents systematic analysis through components, interactions and results methodology (DISAST-CIR). The rocket hit a military training tent camp in the south of Israel at 01:18 hours. At that time, all soldiers were in bed and were not using any protective gear. A total of 76 soldiers was injured (three severe, eight moderate and 65 mild). The most prevalent types of injuries were upper extremity (33%) and lower extremity (30%) trauma, tinnitus (30%) and acute stress reactions (32%). A total of 67 casualties was evacuated to the nearest level two hospital, Barzilai, in a two-phase distribution characterised by different patterns of injury severity and type. All urgent casualties arrived at hospitals within 1 h 24 minutes, whereas most stress casualties arrived in the later phase. Seven casualties were secondarily transported to level one trauma centres. 42 of the casualties were hospitalised and 17 needed urgent surgery. None has died. A single low-tech mortar with poor accuracy and small warhead (estimated weight of 10 kg only) can cause a large-scale MCI. As international terrorist organisations can easily gain access to improvised rockets, the latter may become a threat in many countries. Emergency systems should thus be prepared for that adverse possibility.

MOZART - A seismological investigation of Central Mozambique

NASA Astrophysics Data System (ADS)

Domingues, Ana; Chamussa, Jose; Helffrich, George; Fishwick, Stewart; Ferreira, Ana; Custodio, Susana; Silveira, Graca; Manhica, Vladimiro; Fonseca, Joao

2013-04-01

Project MOZART (MOZAmbique Rift Tomography) aims to investigate the geological structure and current tectonic activity of the Mozambique sector of the East African Rift System (EARS). Space geodesy has indicated in recent years that the border between Nubia and the Somalian plate at these latitudes (16°S to 24°S) encompasses the Rovuma microplate, but little is known about its geometry or seismotectonics. The M7 Machaze earthquake of 2006 highlighted the relevance of the associated deformation, and motivated the MOZART deployment. Besides the regional seismotectonics, other targets of the project are the illumination of the Mesoproterozoic structures of the Mozambique Belt, and the study of its role in the current incipient rifting. The seismic network is composed of 30 VBB seismographic stations on loan from NERC's SEIS-UK Pool (Guralp CMG-3T 120s sensors) covering Central Mozambique (Manica, Sofala, Gaza and Inhambane provinces) with average inter-station spaces of the order of 100 km. Four stations are across the border in South Africa (Kruger Park). Data acquisition started in March 2011, and decommissioning is foreseen for August 2013. Data processing is underway, and includes local seismicity analysis, receiver function estimation and the study of surface wave dispersion (both ambient noise and teleseismic). Once a preliminary velocity model is developed with these techniques, further refinements will be attempted through waveform tomography. For this purpose, SPECFEM waveform modelling with a 3D velocity model is currently being implemented. Preliminary results of the ongoing data processing and analysis will be presented.

Natural-derived contaminants and their resolution in transboundary water resources in the Middle East

NASA Astrophysics Data System (ADS)

Vengosh, A.; Weinthal, E.

2005-12-01

The rapidly growing population in the Middle East and the ensuing increase in exploitation have led to the degradation its renewable aquifers. In turn, countries in the Middle East have been forced to search for alternative resources like non- renewable (fossil) groundwater and to develop new technologies such as desalination. Here, we show that most of the contamination of the transboundary water resources in the Middle East is due to natural processes. We integrate hydrogeological, geochemical, and isotopic investigations to show that salinization of groundwater in the Gaza Strip, the Jordan River, and the groundwater along the Jordan and Arava valleys are natural phenomena triggered by over-exploitation and distraction of the fragile balance of the hydrological systems in the region. Recent investigations also show that fresh and brackish groundwater from the Nubian Sandstone aquifer in Israel and Jordan contains high level of natural radioactivity. Groundwater from similar basins in Egypt and Libya may also suffer from similar problems of high natural radioactivity in the groundwater. The scientific evidences that most of the contamination is natural raises new challenges for political and legal solutions for such transboundary water resources. Unlike the traditional upstream/downstream conflicts associated with transboundary water resources, the natural contamination demands a reevaluation of water resource management approaches in the Middle East. We argue that regional cooperation must be based upon political bargaining and side-payments rather than just international water law in order to not only foster cooperation, but, more important, to address the poor water quality situation in the Middle East.

Comorbidity of PTSD and depression among refugee children during war conflict.

PubMed

Thabet, Abdel Aziz Mousa; Abed, Yehia; Vostanis, Panos

2004-03-01

We examined the prevalence and nature of comorbid post-traumatic stress reactions and depressive symptoms, and the impact of exposure to traumatic events on both types of psychopathology, among Palestinian children during war conflict in the region. The 403 children aged 9-15 years, who lived in four refugee camps, were assessed by completing the Gaza Traumatic Events Checklist, the Child Post Traumatic Stress Reaction Index (CPTSD-RI), and the Short Mood and Feelings Questionnaire (MFQ). Children reported experiencing a wide range of traumatic events, both direct experience of violence and through the media. CPTSD-RI and MFQ scores were significantly correlated. Both CPTSD-RI and MFQ scores were independently predicted by the number of experienced traumatic events, and this association remained after adjusting for socioeconomic variables. Exposure to traumatic events strongly predicted MFQ scores while controlling for CPTSD-RI scores. In contrast, the association between traumatic events and CPTSD-RI scores, while controlling for MFQ scores, was weak. The CPTSD-RI items whose frequency was significantly associated with total MFQ scores were: sleep disturbance, somatic complaints, constricted affect, impulse control, and difficulties in concentration. However, not all remaining CPTSD-RI items were significantly associated with exposure to traumatic events, thus raising the possibility that the association between depression and PTSD was due in part to symptom overlap. Children living in war zones are at high risk of suffering from PTSD and depressive disorders. Exposure to trauma was not found to have a unique association with PTSD. The relationship between PTSD and depressive symptomatology requires further investigation.

A cross-sectional study to assess the patient safety culture in the Palestinian hospitals: a baseline assessment for quality improvement.

PubMed

Elsous, Aymen; Akbari Sari, Ali; Rashidian, Arash; Aljeesh, Yousef; Radwan, Mahmoud; AbuZaydeh, Hatem

2016-12-01

To measure and establish a baseline assessment of the patient safety culture in the Palestinian hospitals. A cross-sectional descriptive study using the Arabic version of the Safety Attitude Questionnaire (Short Form 2006). A total of 339 nurses and physicians returned the questionnaire out of 370 achieving a response rate of 91.6%. Four public general hospitals in the Gaza Strip, Palestine. Nurses and physicians were randomly selected using a proportionate random sampling. Data analysis performed using Statistical Package for the Social Sciences software version 20, and p value less than 0.05 was statistically significant. Current status of patient safety culture among healthcare providers and percentage of positive attitudes. Male to female ratio was 2.16:1, and mean age was 36.5 ± 9.4 years. The mean score of Arabic Safety Attitude Questionnaire across the six dimensions on 100-point scale ranged between 68.5 for Job Satisfaction and 48.5 for Working Condition. The percentage of respondents holding a positive attitude was 34.5% for Teamwork Climate, 28.4% for Safety Climate, 40.7% for Stress Recognition, 48.8% for Job Satisfaction, 11.3% for Working Conditions and 42.8% for Perception of Management. Healthcare workers holding positive attitudes had better collaboration with co-workers than those without positive attitudes. Findings are useful to formulate a policy on patient safety culture and targeted a specific safety culture dimension to improve the safety of patients and improve the clinical outcomes within healthcare organisations.

Low infant mortality among Palestine refugees despite the odds

PubMed Central

Khader, Ali; Sabatinelli, Guido

2011-01-01

Abstract Objective To present data from a 2008 infant mortality survey conducted in Jordan, Lebanon, the Syrian Arab Republic, the Gaza Strip and the West Bank and analyse infant mortality trends among Palestine refugees in 1995–2005. Methods Following the preceding birth technique, mothers who were registering a new birth were asked if the preceding child was alive or dead, the day the child was born and the date of birth of the neonate whose birth was being registered. From this information, neonatal, infant and early child mortality rates were estimated. The age at death for early child mortality was determined by the mean interval between successive births and the mean age of neonates at registration. Findings In 2005–2006, infant mortality among Palestine refugees ranged from 28 deaths per 100 000 live births in the Syrian Arab Republic to 19 in Lebanon. Thus, infant mortality in Palestine refugees is among the lowest in the Near East. However, infant mortality has stopped decreasing in recent years, although it remains at a level compatible with the attainment of Millennium Development Goal 4. Conclusion Largely owing to the primary health care provided by the United Nations Relief and Works Agency (UNRWA) for Palestine Refugees in the Near East and other entities, infant mortality among Palestine refugees had consistently decreased. However, it is no longer dropping. Measures to address the most likely reasons – early marriage and childbearing, poor socioeconomic conditions and limited access to good perinatal care – are needed. PMID:21479095

Place, Time and Experience: Barriers to Universalization Of Institutional Child Delivery in Rural Mozambique

PubMed Central

Agadjanian, Victor; Yao, Jing; Hayford, Sarah R.

2017-01-01

CONTEXT Although institutional coverage of childbirth is increasing in the developing world, a substantial minority of births in rural Mozambique still occur outside of health facilities. Identifying the remaining barriers to safe professional delivery services can aid in achieving universal coverage. METHODS Survey data collected in 2009 from 1,373 women in Gaza, Mozambique, were used in combination with spatial, meteorological and health facility data to examine patterns in place of delivery. Geographic information system–based visualization and mapping and exploratory spatial data analysis were used to outline the spatial distribution of home deliveries. Multilevel logistic regression models were constructed to identify associations between individual, spatial and other characteristics and whether women’s most recent delivery took place at home. RESULTS Spatial analysis revealed high- and low-prevalence clusters of home births. In multivariate analyses, women with a higher number of clinics within 10 kilometers of their home had a reduced likelihood of home delivery, but those living closer to urban centers had an increased likelihood. Giving birth during the rainy, high agricultural season was positively associated with home delivery, while household wealth was negatively associated with home birth. No associations were evident for measures of exposure to and experience with health institutions. CONCLUSIONS The results suggest the need for a comprehensive approach to expansion of professional delivery services. Such an approach should complement measures facilitating physical access to health institutions for residents of harder-to-reach areas with community-based interventions aimed at improving rural women’s living conditions and opportunities, while also taking into account seasonal and other variables. PMID:28770025

Comparative assessment of medicine procurement prices in the United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA).

PubMed

Ewen, Margaret; Al Sakit, Maisa; Saadeh, Rawan; Laing, Richard; Vialle-Valentin, Catherine; Seita, Akihiro; Bunders, Joske

2014-01-01

The United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA), the main primary healthcare provider for 4.9 million Palestinian refugees, spent USD18.3 million on essential medicines dispensed free-of-charge through clinics in five areas of operation ('fields'): Gaza, Jordan, Lebanon, Syria, and the West Bank (2010). Faced with budget contraints and an increasing demand for medicines to treat chronic conditions, the objective of our study was to assess UNRWA's medicine procurement prices to see if savings could be possible. In July 2011, data was collected from UNRWA headquarters in Jordan. Price analyses focused on the top 80 medicines by value, accounting for 93% of pharmaceutical expenditure from the General Fund, with comparisons to international, regional and national references. Prices were also compared for the few medicines procured both through UNRWA's central tender (centrally) and by the fields directly (locally). Central procurement prices did not differ markedly from reference prices: median ratios of UNRWA prices to Management Sciences for Health's International Drug Price Indicator Guide, Jordan's Joint Procurement Department, Gulf Cooperation Council, and IDA Foundation bulk packs were 0.99, 1.00, 0.98 and 1.12 respectively. Applying the lowest comparator price to five comparatively higher priced medicines would yield savings of USD1.4 million. Local procurements were generally less cost-effective than central tender procurement, with notable differences across fields and medicines. Overall, UNRWA's procurement prices were competitive despite the relatively small quantities procured. Regular monitoring of procurement prices and quantities is needed in order to make informed decisions. Our evaluation also underscores the heavy burden of antidiabetic medicines and antimicrobials on UNRWA procurement expenditure.

Foreign students' experience during a time of war.

PubMed

Madsen, Annetta M; Pope, Rachel; Samuels, Ayol; Margolis, Carmi Z

2013-03-01

Due to the war in Gaza in 2009, Ben-Gurion University's Medical School for International Health with a student body of 165 international multicultural students canceled a week of classes. Third-year students continued clerkships voluntarily and fourth-year students returned to Israel before departing for electives in a developing country. A debriefing session was held for the entire school. To assess the academic and psychological effects of political conflict on students. We asked all students to fill out an anonymous Google electronic survey describing their experience during the war and evaluating the debriefing. A team of students and administrators reviewed the responses. Sixty-six students (40% of the school) responded (first year 26%, second year 39%, third year 24%, fourth year 8%, taking time off 3%, age 23-40 years old). Eighty-three percent were in Israel for some portion of the war and 34% attended the debriefing. Factors that influenced individuals' decision to return/stay in the war zone were primarily of an academic and financial nature. Other factors included family pressure, information from peers and information from the administration. Many reported psychological difficulties during the war rather than physical danger, describing it as "draining" and that it was difficult to concentrate while studying. As foreigners, many felt their role was undefined. Although there is wide variation in the war's effect on daily activities and emotional well-being during that time, the majority (73%) reported minimal residual effects. This study lends insight to the way students cope during conflict and highlights academic issues during a war. Open and frequent communication and emphasis on the school as a community were most important to students.

The effect of vitamin C and/or E supplementations on type 2 diabetic adult males under metformin treatment: A single-blinded randomized controlled clinical trial.

PubMed

El-Aal, Ali Abd; El-Ghffar, Eman A Abd; Ghali, Asmaa Abu; Zughbur, Mohammed R; Sirdah, Mahmoud M

2018-03-16

Recently, there has been an increasing interest in the influence of antioxidant vitamins on the efficacy of oral hypoglycemic therapy in type 2 diabetic patients (T2DM). This single-blinded randomized controlled clinical trial aimed to investigate the effect of vitamin C and/or E supplementation on the efficacy of oral hypoglycemic therapy in T2DM Palestinian male patients from the Gaza Strip. Forty T2DM male patients aged 40-60 years on metformin treatment were randomly divided into four groups, each group received an additional one of the following daily oral supplements for 90 days: placebo; vitamin C; vitamin E and vitamin C plus vitamin E. After overnight fasting, venous blood specimens were collected from all individuals into K3-EDTA tubes and serum tubes for measuring the biochemical and hematological parameters of the study at baseline and after 90 days of vitamins supplementation. The results revealed that vitamin C and/or E improve fasting blood sugar (FBS), HbA1c, lipid profile, insulin, homeostasis model assessment of insulin resistance (HOMA-IR), reduced glutathione (GSH); and Quantitative Insulin Sensitivity Check Index (QISCI) compared with diabetic patients group that received placebo. This study provided additional evidence on the beneficial effects of supplementing antioxidant vitamins in T2DM which could improve the clinical condition and attenuate or prevent diabetic pathogenesis and complications that, secondly to poor glycemic control, could attribute to the imbalance between the decline in the endogenous antioxidants and increasing production of the reactive oxygen species leading to the oxidant-mediated damage present in the diabetic context. Copyright © 2018 Diabetes India. Published by Elsevier Ltd. All rights reserved.

[Polio, the long walk to the endgame].

PubMed

García-Sánchez, José Elías; García-Sánchez, Enrique; García-Merino, Enrique; Fresnadillo-Martínez, María José

2015-12-01

Although the WHO original target date for the global eradication of poliomyelitis was the year 2000 -thanks to vaccination and institutional, public and private, resources for that purpose-, in 2013 the disease remained endemic in three countries, Afghanistan, Pakistan and Nigeria, and some cases were described in five others. The circulation of wild type 1 poliovirus in Israel, Gaza and the West Bank and the cases in Syria were a wakeup call, as at that time there were polioviruses derived from the oral vaccine that are still circulating among the human population and can cause the development of the disease. Travelling "from" and "to" endemic areas are factors to consider in poliovirus exportation and in its spread when it reaches areas with poor immunogenicity. Wars, terrorism, intolerance, lack of culture and proliferation of anti-vaccine groups and the rise of the anti-vaccination movement are important factors in the maintenance and expansion of the virus and in the "non-vaccination" against it. Based on the international situation to date, the Emergency Committee of WHO met in May 2014 to address the problem. It is still necessary to enhance the knowledge of the disease and its agent. In the first case to perform a differential diagnosis of flaccid paralysis and to continue vaccination programs, and in the second case to keep studying and looking for the poliovirus in environmental samples, which is a model for the study of many other viruses. Copyright © 2014 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

Trajectories of posttraumatic stress symptoms (PTSS) after major war among Palestinian children: Trauma, family- and child-related predictors.

PubMed

Punamäki, Raija-Leena; Palosaari, Esa; Diab, Marwan; Peltonen, Kirsi; Qouta, Samir R

2015-02-01

Research shows great individual variation in changes in posttraumatic stress symptoms (PTSSs) after major traumas of terrorist attacks, military combat, and natural disasters. Earlier studies have identified specific mental health trajectories both in children and adults. This study aimed, first, to identify potential PTSS-related trajectories by using latent class growth analyses among children in a three-wave assessment after the 2008/2009 War on Gaza, Palestine. Second, it analyzed how family- and child related factors (e.g., attachment relations, posttraumatic cognitions (PTCs), guilt, and emotion regulation) associate with the trajectory class membership. The sample consisted of 240 Palestinian children (49.4% girls and 50.6% boys) of 10-13 years of age (M=11.29, SD=0.68), who completed PTSS (CRIES) assessments at 3 (T1), 5 (T2), and 11 (T3) months after the war. Children reported their personal exposure to war trauma, attachment style, cognitive trauma processing, and emotion regulation, and their parents reported family war trauma exposure and attachment style. Results revealed a three-trajectory solution, a majority of children belonging to the Recovery trajectory (n=183), and a minority belonged either to Resistant trajectory (n=29) or to Increasing symptoms trajectory (n=28). Low levels of negative posttraumatic cognitive appraisals, feelings of guilt and emotion regulation were characteristic of children in the Resistant trajectory as compared to Increasing symptoms trajectory. Father׳s attachment security was further associated with the Resistant trajectory membership. Children׳s attachment avoidance and high parental trauma were typical to children in Recovery trajectory (as compared to the Increasing symptoms trajectory). Copyright © 2014 Elsevier B.V. All rights reserved.

Well-being and associated factors among adults in the occupied Palestinian territory (oPt).

PubMed

Harsha, Nouh; Ziq, Luay; Ghandour, Rula; Giacaman, Rita

2016-08-30

The World Health Organization (WHO) incorporated well-being into its definition of health in 1948. The significance given to this concept is due to its role in the assessment of people's quality of life and health. Using the WHO Well-being Index, we estimated well-being among adults and identified selected associated factors in the occupied Palestinian territory (oPt) using data obtained from the National Time Use Survey conducted by the Palestinian Central Bureau of Statistics (PCBS) 2012-2013 on a representative sample of persons living in the West Bank and Gaza Strip. Univariate and bivariate analyses were conducted among participants 18 years old and above. Multivariate analysis (Regression) was performed with factors found significant in cross-tabulations, using SPSS® version 20. Overall, 33.8 % (2395) of respondents reported low levels of well-being (ill-being). Neither age, nor sex, nor region were found significant in regression analysis. People who were married, working 15 h or more, with a higher standard of living, who reported participating in community, cultural, and social events, or in religious activities reported high levels of well-being. Those who reported regularly following the mass media, or living in Palestinian refugee camps reported low levels of wellbeing. Overall, about one-third of adult Palestinians reported low levels of well-being (ill-being), a finding which in itself requires attention. Marriage, employment, high living standards, community participation, and religious activities were found to be protective against ill-being. Further investigations are required to determine additional causes of ill-being in the oPt, taking into consideration the possible effects of chronic exposure to political violence on subjective well-being.

Factors associated with lack of postnatal care among Palestinian women: A cross-sectional study of three clinics in the West Bank

PubMed Central

Dhaher, Enas; Mikolajczyk, Rafael T; Maxwell, Annette E; Krämer, Alexander

2008-01-01

Background Only about one-third of women in Palestine (West Bank and Gaza) obtain postpartum care. Therefore, the goal of this study was to assess factors associated with lack of postnatal care, women's reasons for not obtaining postnatal care, and their attitudes towards its importance. Methods In early 2006, a cross-sectional survey was conducted at three clinics run by the Ministry of Health providing Mother and Child Health Care in West Bank, Palestine. A total of 264 postpartum women attending the clinics were interviewed face-to-face, using a structured questionnaire. Results Although the majority of women considered postnatal care necessary (66.1%), only 36.6% of women obtained postnatal care. The most frequent reason for not obtaining postnatal care was that women did not feel sick and therefore did not need postnatal care (85%), followed by not having been told by their doctor to come back for postnatal care (15.5%). Based on a multivariable analysis, use of postnatal care was higher among women who had experienced problems during their delivery, had a cesarean section, or had an instrumental vaginal delivery than among women who had a spontaneous vaginal delivery. Use of postnatal care was also higher among women who delivered in a private hospital as compared to those who delivered in a public hospital. In addition, we found regional differences. Conclusion The higher use of postnatal care among high-risk women is appropriate, but some clinically dangerous conditions can also occur in low-risk women. Future efforts should therefore focus on providing postnatal care to a larger number of low-risk women. PMID:18638395

Psychosocial support for adolescent girls in post-conflict settings: beyond a health systems approach

PubMed Central

Samuels, Fiona; Jones, Nicola; Abu Hamad, Bassam

2017-01-01

Abstract Adaptive and adequately resourced health systems are necessary to achieve good health outcomes in post-conflict settings, however domains beyond the health system are also critical to ensure broader wellbeing. This paper focuses on the importance of psychosocial support services for adolescent girls in fragile contexts. Its starting point is that adolescence is a pivotal time in the life course but given the physical, cognitive and emotional changes triggered by the onset of puberty, it can also be a period of heightened sensitivity and vulnerability to trauma, social isolation, bullying by peers, a lack of supportive adults and gender-based and sexual violence. Our findings highlight why humanitarian and biomedical approaches in their current form are inadequate to address these complexities. Drawing on qualitative fieldwork (consisting of in-depth and key informant interviews as well as group discussions in Gaza, Liberia and Sri Lanka involving a total of 386 respondents across the three countries), we argue that going beyond biomedical approaches and considering the social determinants of health, including approaches to tackle discriminatory gendered norms and barriers to service access, are critical for achieving broader health and wellbeing. While all three case study countries are classified as post-conflict, the political economy dynamics vary with associated implications for experiences of psychosocial vulnerabilities and the service environment. The study concludes by reflecting on actions to address psychosocial vulnerabilities facing adolescent girls. These include: tailoring services to ensure gender and age-sensitivity; investing in capacity building of service providers to promote service uptake; and enhancing strategies to regulate and coordinate actors providing mental health and psychosocial support services. PMID:29244106

Interrogating resilience in health systems development.

PubMed

van de Pas, Remco; Ashour, Majdi; Kapilashrami, Anuj; Fustukian, Suzanne

2017-11-01

The Fourth Global Symposium on Health Systems Research was themed around 'Resilient and responsive health systems for a changing world.' This commentary is the outcome of a panel discussion at the symposium in which the resilience discourse and its use in health systems development was critically interrogated. The 2014-15 Ebola outbreak in West-Africa added momentum for the wider adoption of resilient health systems as a crucial element to prepare for and effectively respond to crisis. The growing salience of resilience in development and health systems debates can be attributed in part to development actors and philanthropies such as the Rockefeller Foundation. Three concerns regarding the application of resilience to health systems development are discussed: (1) the resilience narrative overrules certain democratic procedures and priority setting in public health agendas by 'claiming' an exceptional policy space; (2) resilience compels accepting and maintaining the status quo and excludes alternative imaginations of just and equitable health systems including the socio-political struggles required to attain those; and (3) an empirical case study from Gaza makes the case that resilience and vulnerability are symbiotic with each other rather than providing a solution for developing a strong health system. In conclusion, if the normative aim of health policies is to build sustainable, universally accessible, health systems then resilience is not the answer. The current threats that health systems face demand us to imagine beyond and explore possibilities for global solidarity and justice in health. © The Author 2017. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Public perception of hazardousness caused by current trends of municipal solid waste management.

PubMed

Al-Khatib, Issam A; Kontogianni, Stamatia; Abu Nabaa, Hendya; Alshami, Ni'meh; Al-Sari', Majed I

2015-02-01

Municipal solid waste (MSW) piling up is becoming a serious problem in all developing countries (DC) as a result of inequitable waste collection and treatment. Citizens' collaboration is partly based on understanding their views and their active involvement in MSW planning; on the other hand the assessment of the perception of hazardousness related with MSW is considered rather important as well since the identification of the weak points of the applied MWM strategy is eased and the level of required training is determined. Researchers implemented a case study in the West Bank (WB) and Gaza Strip (GS) regions of Palestine, taking into consideration previous researches in other developing countries. They reached to safe and useful conclusions regarding the parameters which mean the greatest in the waste management field as far as DC are concerned. Lack of skilled manpower, irregular collection services, inadequate equipment used for waste collection, inadequate legal provisions, and resource constraints are additional factors that are confirmed to be challenging the waste management scenarios in all DCs today. The research takes those factors under consideration but focuses on the educational gap and the results revealed interesting trends a significant relationship between respondent's educational attainment and their awareness of hazardous waste (hazard perception); the results will indicate the measure taking required to avoid accidents occurred in those regions (burns from toxics, cuts from sharps, etc). National policy and legislation development based on the research outcomes will ensure equitable and accessible services are in place in order to move towards a healthier environment. Specialized health education and training programs on national scale are also needed to enhance awareness on hazardous waste. Copyright © 2014 Elsevier Ltd. All rights reserved.

Combined live and inactivated poliovirus vaccine to control poliomyelitis in a developing country--five years after.

PubMed

Lasch, E E; Abed, Y; Marcus, O; Gerichter, C B; Melnick, J L

1986-01-01

The Gaza Strip is an area in transition which in the 1960's had a high prevalence of malnutrition and infectious diseases. The infant mortality was approximatively 140 per 1000 live births. Pediatric Services were almost non-existant. Trivalent oral poliovaccine (TOPV) has been used since 1967. Coverage however did not exceed 70%. From 1973 a network of comprehensive Child Health Centers was spread throughout the area, a set of laws was passed which made vaccination obligatory and the community became heavily involved in health education. These measures resulted in a vaccination coverage, from fixed centers, of over 90% of the susceptible infant population. Though infant mortality decreased rapidly, poliomyelitis was less affected and the mean annual incidence of the paralytic disease until 1977 continued to be 10 per 100,000 inhabitants. Two outbreaks caused by poliovirus Type 1 were registered in 1974 and 1976 with an incidence of 18 per 100,000 inhabitants. In these outbreaks 34% and 50% of the affected children, respectively, had received 3-4 doses of (TOPV). A new vaccination schedule was implemented in 1978 combining TOPV and inactivated polio vaccine in the form of an injectable quadruple vaccine. In the first three years following this change the annual incidence of the paralytic disease dropped from 10 to 2.2 per 100,000 inhabitants. In the following 5 years (1981-1985) only 4 cases of paralytic poliomyelitis were discovered, an annual incidence of 0.16 per 100,000 inhabitants. A serosurvey was done in 1980 on 117 immunized children age 6 months to three years.(ABSTRACT TRUNCATED AT 250 WORDS)

Detection of NDM-2-producing Acinetobacter baumannii and VIM-producing Pseudomonas aeruginosa in Palestine.

PubMed

Sjölander, Isabella; Hansen, Frank; Elmanama, Abdelraouf; Khayyat, Rasha; Abu-Zant, Alaeddin; Hussein, Ayman; Taha, Adham Abu; Hammerum, Anette M; Ciofu, Oana

2014-06-01

The aim of this study was to screen for carbapenem-resistant Gram-negative bacteria in Palestine and subsequently to identify and investigate the mechanisms of resistance. For a period of 6 weeks, all Gram-negative isolates were collected from six Palestinian hospital laboratories and were tested for susceptibility using 10μg meropenem disks. Isolates showing resistance to meropenem were further investigated. The presence of carbapenemases was assessed by PCR. In addition, antimicrobial susceptibility testing, an efflux pump inhibitor assay and pulsed-field gel electrophoresis (PFGE) were performed. Isolates producing carbapenemases were further investigated by multilocus sequence typing (MLST). In total, 248 Gram-negative isolates were collected from the six laboratories. Among the 248 tested isolates, 15 Acinetobacter baumannii and 6 Pseudomonas aeruginosa were resistant to meropenem. One A. baumannii from Gaza produced NDM-2 and belonged to ST103. Thirteen of the carbapenem-resistant A. baumannii isolates possessed the intrinsic upregulated bla OXA-66 gene and one isolate carried bla OXA-51 . All but one of the OXA-66-producing A. baumannii belonged to ST2; the remaining isolate belonged to ST183. One of the carbapenem-resistant P. aeruginosa was classified as VIM-4-producing and three were VIM-2-producing isolates. The three VIM-2-producing isolates belonged to three new sequences types (ST1562, ST1563 and ST1564). All of the carbapenemase-producing isolates were multiresistant non-fermenters. To the best of our knowledge, this is the first report on NDM-producing A. baumannii and VIM-producing P. aeruginosa from Palestine. Copyright © 2013 International Society for Chemotherapy of Infection and Cancer. Published by Elsevier Ltd. All rights reserved.

Association Between Maternal and Child Health Handbook and Quality of Antenatal Care Services in Palestine.

PubMed

Kitabayashi, Harumi; Chiang, Chifa; Al-Shoaibi, Abubakr Ahmed Abdullah; Hirakawa, Yoshihisa; Aoyama, Atsuko

2017-12-01

Objectives The Maternal and Child Health (MCH) handbook is an integrated home-based record allowing clients to keep records on the continuum of care for mothers and children. This study aimed to assess associations between MCH handbook ownership and receipt of selected content of antenatal care services in Palestine. Methods Distribution of the MCH handbook in Palestine was launched in 2008. We used an anonymous data set of the Palestinian Family Survey 2010 and analyzed the data of 2026 women who had live births within the past 12 months. Descriptive statistical analysis was conducted to assess differences between MCH handbook holders and non-holders. Multivariable logistic regression models were used to estimate adjusted odds ratios of the effects of MCH handbook use according to proxy indicators of antenatal care quality. Results Accounting for about 60% (n = 1202) of study participants, handbook holders were more likely to be primipara, live in the Gaza Strip, live in refugee camps, and live within a 30-min distance to antenatal care facilities; however, household wealth levels for handbook holders were lower compared with non-holders. Handbook users had significantly higher odds of receiving all three kinds of medical tests and receiving information on five or more health education topics as part of antenatal care. The higher odds remained after adjusting for possible confounding variables, such as household wealth, region, residential area, birth order of the child, frequency of antenatal care, and time required to reach antenatal care facilities. Conclusions for Practice Use of the handbook as a portable checklist possibly promoted providers' higher adherence to the national guideline.

Ethnobotanical survey in Canhane village, district of Massingir, Mozambique: medicinal plants and traditional knowledge

PubMed Central

2010-01-01

Background Medicinal plants are used by 80% of people from developing countries to fulfill their primary health needs, occupying a key position on plant research and medicine. Taking into account that, besides their pharmaceutical importance, these plants contribute greatly to ecosystems' stability, a continuous documentation and preservation of traditional knowledge is a priority. The objective of this study was to organize a database of medicinal plants including their applications and associated procedures in Canhane village, district of Massingir, province of Gaza, Mozambique. Methods In order to gather information about indigenous medicinal plants and to maximize the collection of local knowledge, eleven informants were selected taking into account the dimension of the site and the fact that the vegetation presents a great homogeneity. The data were collected through intensive structured and semi-structured interviews performed during field research. Taxonomical identification of plant species was based on field observations and herbarium collections. Results A total of 53 plant species have been reported, which were used to treat 50 different human health problems. More than half of the species were used for stomach and intestine related disturbances (including major diseases such as diarrhea and dysentery). Additionally, four species with therapeutic applications were reported for the first time, whose potential can further be exploited. The great majority of the identified species was also associated with beliefs and myths and/or used as food. In general, the community was conscientious and motivated about conservational issues and has adopted measures for the rational use of medicinal plants. Conclusions The ethnomedicinal use of plant species was documented in the Canhane village. The local community had a rich ethnobotanical knowledge and adopted sound management conservation practices. The data compiled in this study show the social importance of the

Emergency situations and deaf people in Israel: Communication obstacles and recommendations

PubMed Central

Tannenbaum-Baruchi, Carolina; Feder-Bubis, Paula; Adini, Bruria; Aharonson-Daniel, Limor

2014-01-01

The absence of the ability to hear sounds in deaf people is an obstacle to optimal communication in a predominantly hearing world. Emergency situations harbor sufficient challenge for the hearing person and pose even greater barriers for the deaf and hard of hearing. During disasters and emergency situations, deaf people have great difficulty in obtaining and sharing information, increasing their dependence on others. This article focuses on the experience of deaf people during a period of security threat, when missiles from the Gaza strip were aimed at the civilian population in Southern Israel, in 2009. The aim of this article is to illustrate the complexities that deaf citizens experienced, and describe their coping mechanisms. A qualitative study including 15 heterogeneous-background Deaf participants interviewed by a researcher that belongs to the deaf community using a multiple-method facilitated questionnaire. Data was analyzed using grounded theory methodology principles. Main categories that arose from data analysis were communication problems during emergencies, the pager as a questionable warning device about emergencies (due to timing and content/context issues of its use), and the implications of the location of deaf people at time of emergency. Various channels for conveying information should be examined and created in order to maximize the heterogeneous deaf community's ability to receive vital information during an emergency. Professional sign language interpreters are necessary during emergencies, helping to reduce both dependence on informal sources (such as family members, including minors, friends, neighbors, by-standers) and risk. The development of new technologies may bear potential help for deaf persons during emergencies. Being a socio-linguistic minority, it is recommended to ensure these technologies will be accessible to the whole deaf community. PMID:28229005

The protective role of maternal posttraumatic growth and cognitive trauma processing among Palestinian mothers and infants.

PubMed

Diab, Safwat Y; Isosävi, Sanna; Qouta, Samir R; Kuittinen, Saija; Punamäki, Raija-Leena

2018-02-01

War survivors use multiple cognitive and emotional processes to protect their mental health from the negative impacts of trauma. Because mothers and infants may be especially vulnerable to trauma in conditions of war, it is urgent to determine which cognitive and emotional processes are effective for preventing negative trauma impacts." This study examined whether mothers' high posttraumatic growth (PTG) and positive posttraumatic cognitions (PTC) protected (a) their own mental health and (b) their infants' stress regulation and sensorimotor and language development from the effects of war trauma. The participants were 511 Palestinian mothers and their infants living in the Gaza strip. The mothers were interviewed in their second trimester of pregnancy (T1) as well as when the infant was four months (T2) and twelve months (T3). Mothers reported posttraumatic growth (PTG; Tedeschi & Calhoun, 1996) at T1 and posttraumatic cognitions (PTCI; Foa et al., 1999) at T2. They also reported their exposure to traumatic war events both at T1 and T3 and described their mental health conditions (e.g., PTSD and/or depressive and dissociation symptoms) at T3. The Infant Behaviour Questionnaire (IBQ) was used to measure infants' stress regulation at T2 and sensorimotor and language development at T3. The results, based on regression analyses with interaction terms between trauma and PTG, showed that high levels of traumatic war events were not associated with high levels of PTSD, depressive, or dissociation symptoms among mothers showing high levels of PTG. This suggests that PTG may protect maternal mental health from the effects of trauma. In turn, positive maternal PTCs appeared to protect the infants' stress regulation from the effects of war trauma. The study concludes by discussing ways to develop and implement preventive interventions for mother-infant dyads in war conditions. Copyright © 2017 Elsevier Inc. All rights reserved.

Modelling the spatial distribution of five natural hazards in the context of the WHO/EMRO Atlas of Disaster Risk as a step towards the reduction of the health impact related to disasters

PubMed Central

El Morjani, Zine El Abidine; Ebener, Steeve; Boos, John; Abdel Ghaffar, Eman; Musani, Altaf

2007-01-01

Background Reducing the potential for large scale loss of life, large numbers of casualties, and widespread displacement of populations that can result from natural disasters is a difficult challenge for the individuals, communities and governments that need to respond to such events. While it is extremely difficult, if not impossible, to predict the occurrence of most natural hazards; it is possible to take action before emergency events happen to plan for their occurrence when possible and to mitigate their potential effects. In this context, an Atlas of Disaster Risk is under development for the 21 Member States that constitute the World Health Organization's (WHO) Eastern Mediterranean (EM) Region and the West Bank and Gaza Strip territory. Methods and Results This paper describes the Geographic Information System (GIS) based methods that have been used in order to create the first volume of the Atlas which looks at the spatial distribution of 5 natural hazards (flood, landslide, wind speed, heat and seismic hazard). It also presents the results obtained through the application of these methods on a set of countries part of the EM Region before illustrating how this type of information can be aggregated for decision making. Discussion and Conclusion The methods presented in this paper aim at providing a new set of tools for GIS practitioners to refine their analytical capabilities when examining natural hazards, and at the same time allowing users to create more specific and meaningful local analyses. The maps resulting from the application of these methods provides decision makers with information to strengthen their disaster management capacity. It also represents the basis for the reflection that needs to take place regarding populations' vulnerability towards natural hazards from a health perspective. PMID:17343733

World Witnesses a Tumultuous Year while India Reports an Eventful Decade in the Long Story of Polio Eradication.

PubMed

Chaturvedi, Sanjay

2014-04-01

With recent outbreaks in Syria and Horn of Africa, silent circulation of wild poliovirus type 1 (WPV1) in Israel, West Bank, and Gaza, and fresh spate of violence against vaccinators and their security personnel in Pakistan, the world is facing a turbulent final ascent to the summit of polio eradication. On the positive side, we may also be witnessing the end of wild poliovirus type 3 (WPV3) and defused programmatic crisis caused by funding gaps, while India registers third consecutive polio-free year. Having a cogent endgame plan 2013-2018, informed by some cardinal lessons learned from an eventful decade in India, is also a very significant development. Now, there is a parallel pursuit against WPV and vaccine-derived poliovirus (VDPV). Endgame would also involve integration of at least one dose of affordable inactivated polio vaccine (IPV) to up-scaled routine immunization (RI), switch from trivalent oral polio vaccine (tOPV) to bivalent oral polio vaccine (bOPV) in 144 countries before 2018, stockpiling of mOPV, and simultaneous global cessation of bOPV before 2020. Role of antivirals in post-eradication era is still unclear. Some specific threats emerging at this stage are as follows: Global buildup of new birth cohorts in non-endemic countries with weak RI and downscaled supplementary immunization activities (SIAs), tremendous pressure on peripheral health workers, and fatigued systems. Cultural resistance to transnational programs is taking a violent shape in some areas. Differential interpretations of 'right to say no', on both sides of the divide, are damaging a global cause. Amidst all these concerns, let us not forget to underline the sacrifice made by frontline vaccinators working in some of the most challenging circumstances.

Rehabilitation of torture survivors in five countries: common themes and challenges

PubMed Central

2010-01-01

Background Torture continues to be a global problem and there is a need for prevention and rehabilitation efforts. There is little available data on torture survivors from studies designed and conducted by health professionals in low income countries. This study is a collaboration between five centres from Gaza, Egypt, Mexico, Honduras and South Africa who provide health, social and legal services to torture survivors, advocate for the prevention of torture and are part of the network of the International Rehabilitation Council for Torture Victims (IRCT). Methods Socio-demographic, clinical and torture exposure data was collected on the torture survivors attending the five centres at presentation and then at three and six month follow-up periods. This sample of torture survivors is presented using a range of descriptive statistics. Change over time is demonstrated with repeated measures analysis of variance. Results Of the 306 torture survivors, 23% were asylum seekers or refugees, 24% were socially isolated, 11% in prison. A high level of traumatic events was experienced. 64% had suffered head injury whilst tortured and 24% had ongoing torture injury problems. There was high prevalence of symptoms of anxiety, depression, post traumatic stress as well as medically unexplained somatic symptoms. The analysis demonstrates a modest drop in symptoms over the six months of the study. Conclusions Data showed that the torture survivors seen in these five centres had high levels of exposure to torture events and high rates of clinical symptoms. In order to provide effective services to torture survivors, health professionals at torture rehabilitation centres in low income countries need to be supported to collect relevant data to document the needs of torture survivors and to evaluate the centres' interventions. PMID:20565852

Transitioning mental health & psychosocial support: from short-term emergency to sustainable post-disaster development. Humanitarian Action Summit 2011.

PubMed

Patel, P P; Russell, J; Allden, K; Betancourt, T S; Bolton, P; Galappatti, A; Hijazi, Z; Johnson, K; Jones, L; Kadis, L; Leary, K; Weissbecker, I; Nakku, J

2011-12-01

The Working Group (WG) on Mental Health and Psychosocial Support participated in its second Humanitarian Action Summit in 2011. This year, the WG chose to focus on a new goal: reviewing practice related to transitioning mental health and psychosocial support programs from the emergency phase to long-term development. The Working Group's findings draw on a review of relevant literature as well as case examples. The objective of the Working Group was to identify factors that promote or hinder the long term sustainability of emergency mental health and psychosocial interventions in crisis and conflict, and to provide recommendations for transitioning such programs from relief to development. The Working Group (WG) conducted a review of relevant literature and collected case examples based on experiences and observations of working group members in implementing mental and psychosocial programming in the field. The WG focused on reviewing literature on mental health and psychosocial programs and interventions that were established in conflict, disaster, protracted crisis settings, or transition from acute phase to development phase. The WG utilized case examples from programs in Lebanon, the Gaza Strip, Sierra Leone, Aceh (Indonesia), Sri Lanka, and New Orleans (United States). The WG identified five key thematic areas that should be addressed in order to successfully transition lasting and effective mental health and psychosocial programs from emergency settings to the development phase. The five areas identified were as follows: Government and Policy, Human Resources and Training, Programming and Services, Research and Monitoring, and Finance. The group identified several recommendations for each thematic area, which were generated from key lessons learned by working group members through implementing mental health and psychosocial support programs in a variety of settings, some successfully sustained and some that were not.

Water resource conflicts in the Middle East.

PubMed

Drake, C

1997-01-01

This article discusses the causes and sources of water resource conflict in the 3 major international river basins of the Middle East: the Tigris-Euphrates, the Nile, and the Jordan-Yarmuk. The physical geography of the Middle East is arid due to descending air, northeast trade winds, the southerly location, and high evaporation rates. Only Turkey, Iran, and Lebanon have adequate rainfall for population needs. Their mountainous geography and more northerly locations intercept rain and snow bearing westerly winds in winter. Parts of every other country are vulnerable to water shortages. Rainfall is irregular. Water resource conflicts are due to growing populations, economic development, rising standards of living, technological developments, political fragmentation, and poor water management. Immigration to the Jordan-Yarmuk watershed has added to population growth in this location. Over 50% of the population in the Middle East lives in urban areas where populations consume 10-12 times more water than those in rural areas. Water is wasted in irrigation schemes and huge dams with reservoirs where increased evaporation occurs. Technology results in greater water extraction of shallow groundwater and pollution of rivers and aquifers. British colonial government control led to reduced friction in most of the Nile basin. Now all ethnic groups have become more competitive and nationalistic. The Cold War restrained some of the conflict. Israel obtains 40% of its water from aquifers beneath the West Bank and Gaza. Geopolitical factors determine the mutual goodwill in managing international water. The 3 major water basins in the Middle East pose the greatest risk of water disputes. Possible solutions include conservation, better management, prioritizing uses, technological solutions, increased cooperation among co-riparians, developing better and enforceable international water laws, and reducing population growth rates.

Health ramifications of the Gush Katif evacuation.

PubMed

Kory, Ronen; Carney, Alon; Naimer, Sody

2013-03-01

Following the 2005 evacuation of Gush Katif, a community of Jewish settlements located in the greater Gaza Strip, many evacuees reported a deterioration in their health status. To determine if and to what degree the evacuation of Gush Katif caused a worsening in the health status of the evacuees. In this retrospective cohort study we assessed the medical records of 2962 evacuees for changes in prevalence of diabetes, hypertension and ischemic heart disease in the period beginning 1 year before and ending 5 years after the evacuation. The findings were compared to those for the general israeli population. A questionnaire was distributed to 64 individuals to assess lifestyle and social change. An increase in diabetes and hypertension was found in men aged 45-64. The prevalence of diabetes mellitus in the 45-54 male group rose from 8.7% in 2004 to 12.6% in 2007 to 18.7% in 2010; in the 55-64 age group it rose from 24.6% in 2004 to 29.9% in 2007 to 32.9% in 2010. Hypertension in 45-64 year old men rose from 27.1% in 2004 to 35.12% in 2010. The increases in diabetes were significant and higher than those in the general population. The increases in hypertension were of similar magnitude. The prevalence of heart disease did not change and is similar to that in the general population. The questionnaire sample showed an increase in depression and overweight. The Gush Katif evacuation appears to be associated with increased morbidity of chronic disease. This may be attributed to any of several mechanisms, with unemployment, depression, inactivity and overweight playing significant roles. Preventive medical interventions and measures should be employed to screen and treat this population which underwent a major stressful event and as a result seem at greater risk than their peers.

Stress-related responses after 3 years of exposure to terror in Israel: are ideological-religious factors associated with resilience?

PubMed

Kaplan, Zeev; Matar, Michael A; Kamin, Ram; Sadan, Tamar; Cohen, Hagit

2005-09-01

The inhabitants of 3 different types of population centers in Israel were assessed as to stress-related symptomatology during 2003 and 2004. These centers have been exposed to 2 distinct forms of violence-sporadic, large-scale terror attacks in the metropolitan areas in the heart of Israel and daily "war-zone" conditions in the settlements beyond the 1967 borders of Israel. A semistructured interview and questionnaire survey of a random sample of 314 inhabitants of a suburb of Tel-Aviv, a settlement in the West Bank (Kiryat-Arba), and the Gush-Katif settlement cluster in the Gaza Strip was performed. Symptoms of acute stress and chronic (posttraumatic) stress as well as symptoms of general psychopathology and distress were assessed. The inhabitants of Gush-Katif, in spite of firsthand daily exposure to violent attacks, reported the fewest and least severe symptoms of stress-related complaints, the least sense of personal threat, and the highest level of functioning of all 3 samples. The most severely symptomatic and functionally compromised were the inhabitants of the Tel-Aviv suburb, who were the least frequently and least directly affected by exposure to violent attacks. Because the Gush-Katif population is exclusively religious, the data were reassessed according to religiousness. The religious inhabitants of Kiryat-Arba had almost the same symptom profile as the Gush-Katif population, whereas secular inhabitants of Kiryat-Arba reported faring worse than did either population in the Tel-Aviv suburb. Deeply held belief systems affecting life-views may impart significant resilience to developing stress-related problems, even under extreme conditions. Religiousness combined with common ideological convictions and social cohesion was associated with substantial resilience as compared to a secular metropolitan urban population.

Effects of structured group psychosocial support sessions on psychosocial wellbeing of children and their caregivers: a descriptive study.

PubMed

Humeid, Jasem

2018-02-21

Children aged 7-12 years and their caregivers participated in a series of group psychosocial support sessions, using standard manuals specifically developed for facilitating such sessions such as Children Affected by Armed Conflict and Joint Sessions. The sessions used various activities, including drawing, storytelling, folk games, and other activities, to provide participants with opportunities to express their feelings, learn and practice new coping skills, and interact with others. The aim of this study was to measure the effects of structured psychosocial support sessions on the psychosocial wellbeing of children and their caregivers in the Gaza Strip. This descriptive study involved children and female caregivers selected from six locations using a stratified sampling technique. External numerators collected data before and after the group sessions. Two interview questionnaires with questions about psychological and social status were used, one for children and one for caregivers. The caregivers' questionnaire also assessed their psychosocial knowledge. Adult participants and caregivers of participating children provided verbal consent. Data were analysed with SPSS, and a p value less than 0·05 indicated significance. 155 children (77 [50%] boys and 78 [50%] girls) and 155 female caregivers were enrolled from a population of 1720 children (50% boys and 50% girls) and 1720 female caregivers. The sessions improved psychosocial wellbeing in participants, with the average psychosocial wellbeing score increasing from 58% to 87% in children and from 69% to 84% in caregivers. Caregivers' knowledge increased from 70% to 82%. Improvement was found in the various aspects of psychosocial wellbeing. No differences were found with respect to location, sex, and age. Structured group sessions improved psychosocial wellbeing in children and caregivers and improved caregivers' knowledge. Given the design of this study, it is difficult to fully attribute these results to the

Mental Suffering in Protracted Political Conflict: Feeling Broken or Destroyed.

PubMed

Barber, Brian K; McNeely, Clea A; El Sarraj, Eyad; Daher, Mahmoud; Giacaman, Rita; Arafat, Cairo; Barnes, William; Abu Mallouh, Mohammed

2016-01-01

This mixed-methods exploratory study identified and then developed and validated a quantitative measure of a new construct of mental suffering in the occupied Palestinian territory: feeling broken or destroyed. Group interviews were conducted in 2011 with 68 Palestinians, most aged 30-40, in the West Bank, East Jerusalem, and the Gaza Strip to discern local definitions of functioning. Interview participants articulated of a type of suffering not captured in existing mental health instruments used in regions of political conflict. In contrast to the specific difficulties measured by depression and PTSD (sleep, appetite, energy, flashbacks, avoidance, etc.), participants elaborated a more existential form of mental suffering: feeling that one's spirit, morale and/or future was broken or destroyed, and emotional and psychological exhaustion. Participants articulated these feelings when describing the rigors of the political and economic contexts in which they live. We wrote survey items to capture these sentiments and administered these items-along with standard survey measures of mental health-to a representative sample of 1,778 32-43 year olds in the occupied Palestinian territory. The same survey questions also were administered to a representative subsample (n = 508) six months earlier, providing repeated measures of the construct. Across samples and time, the feeling broken or destroyed scale: 1) comprised a separate factor in exploratory factor analyses, 2) had high inter-item consistency, 3) was reported by both genders and in all regions, 4) showed discriminate validity via moderate correlations with measures of feelings of depression and trauma-related stress, and 5) was more commonly experienced than either feelings of depression or trauma-related stress. Feeling broken or destroyed can be reliably measured and distinguished from conventional measures of mental health. Such locally grounded and contextualized measures should be identified and included in

Peritraumatic dissociation predicts posttraumatic stress disorder symptoms via dysfunctional trauma-related memory among war-affected children.

PubMed

Peltonen, Kirsi; Kangaslampi, Samuli; Saranpää, Jenni; Qouta, Samir; Punamäki, Raija-Leena

2017-01-01

Background : Among adults there is strong evidence about peritraumatic dissociation (PD) predicting posttraumatic stress disorder (PTSD), yet evidence among children is very limited. It has been suggested that disturbances in memory functioning might explain the association between PD and PTSD, but this has not yet been empirically tested. Objective : We aimed to test the hypotheses that greater PD would be associated with more posttraumatic stress disorder (PTSD) symptoms, and that some of this association would be mediated by disorganized and non-verbal memories about the traumatic event. Method : The sample included 197 Palestinian children (10-12-years) living in the Gaza Strip, participating in the aftermath of the 2008/9 war. Self-report questionnaires were used to measure PD (Peritraumatic Dissociative Experiences Questionnaire) three months post-war, as well as trauma-related memory (Trauma Memory Quality Questionnaire) and PTSD symptoms (Children's Revised Impact of Event Scale) six months later. Exposure to war trauma was assessed by a checklist. Structural equation modelling was used to examine direct and indirect paths from PD to posttraumatic PTSS, controlling for number of traumatic war events. Results : Structural equation modelling results showed that greater self-reported PD predicted higher levels of PTSS nine months post-war, and that a significant part, but not all, of this relationship was mediated via the quality of trauma-related memories. Conclusions : This study provided empirical evidence that, among war-affected children, greater PD during traumatic events is linked with higher levels of PTSD symptoms several months later, even when accounting for their personal exposure to war trauma. Further, the study supported the idea that the detrimental effects of dissociation during a traumatic event may be due to dysfunctional memories characterized by disorganization and lack of access to verbal and coherence. Further tests of these

Quality of life in the Palestinian context: an inquiry in war-like conditions.

PubMed

Giacaman, Rita; Mataria, Awad; Nguyen-Gillham, Viet; Safieh, Rula Abu; Stefanini, Angelo; Chatterji, Somnath

2007-04-01

This study aims to elucidate the concept of quality of life (QOL) in a unique environment characterized by protracted and ongoing conflict, beginning with the utilization of the WHOQOL-Bref as a starting point for discussion. It works to determine important health-related quality of life domains and items within each domain, and evaluate issues pertinent to the Palestinian population's understanding of life quality in the Occupied Palestinian Territory. Focus group discussions (FGD) were conducted with individuals living in the Gaza Strip and Ramallah District of the West Bank. Participants were asked if they understood the term QOL; and about the determinants of their own QOL, using open-ended questions. Participants were then presented with the WHOQOL-Bref questions and requested to assess their relevance and importance in determining their own QOL, and encouraged to suggest additional ones. A total of 150 men and women of various ages and socioeconomic classes participated in 13 FGD. A major finding is the all-encompassing impact of the political context on Palestinians' QOL assessment. The study demonstrates that political freedom, self-determination, participation in democratic processes and feeling involved in political decision-making are considered important contributors to people's QOL. The study raises the option of adding a new domain to the WHOQOL-Bref, allowing the study of its psychometric properties and its relationship to the rest of the instrument. This contribution should be particularly relevant to societies and cultures in conflict-affected zones and locales where violence and insecurity constitute an important part of life. The documentation of QOL, beyond fatal and non-fatal health outcomes, must remain an important objective of all evaluations in order to guide policy and resource allocation decisions directed towards improving peoples' lives in general and their health in particular.

Becoming a nurse - A study of career choice and professional adaptation among Israeli Jewish and Arab nursing students: A quantitative research study.

PubMed

Halperin, Ofra; Mashiach-Eizenberg, Michal

2014-10-01

The growing shortage of nurses is a global issue, with nursing recruitment and retention recognized as priorities worldwide. Israeli Jews and Israeli Arabs share residency and citizenship. However, language, religion, values, customs, symbols and lifestyle differ between the groups. This research covers only Arab citizens of Israel and not those in the occupied territories, the West Bank and Gaza. The future of the profession lies in the ability to recruit and retain the next generation of nurses. To examine career choice and professional adaptation among Israeli Jews and Israeli Arab nursing students by addressing motivation, materialistic factors and professional adaptation. 395 students, which comprised the total number of students in the first five years of the nursing program's existence, in the nursing faculty at an academic college in Israel. A questionnaire was created and administered to the students in the first week of their first year in the nursing program. Altruistic motivation, such as the opportunity to help others, was the primary factor that influenced students to choose nursing as a profession followed by professional interest. Materialistic factors, such as social status and good salary, had less influence. A significant positive correlation was found between professional adaptation and all three dimensions of role perception - teamwork, professional knowledge, and treatment skills. The female students perceived those components as more important than the male students and the Jewish students perceived themselves as more suitable for nursing than the Arab students. Career choice and professional adaptation are influenced by multiple factors. Future recruitment and retention strategies used to address the critical nursing shortage should consider these factors, as well as the role of mentors, peers, and role models in the formulation of career expectations and career choice decisions. © 2013.

Patterns of global tobacco use in young people and implications for future chronic disease burden in adults.

PubMed

Warren, C W; Jones, N R; Eriksen, M P; Asma, S

2006-03-04

Tobacco use is a leading preventable risk factor for many chronic disorders, which are expected to account for an increasing share of the global disease burden. As part of the Global Youth Tobacco Survey (GYTS), we aimed to assess the effect of tobacco use by young people on global mortality. GYTS is a school-based survey of students aged 13-15 years. The survey was undertaken at 395 sites in 131 countries and the Gaza Strip and West Bank. We questioned students about current tobacco use, susceptibility to smoking among non-smokers, and exposure to secondhand smoke at home and in public places. The difference in current cigarette smoking between boys and girls is narrower than expected in many regions of the world. Use of tobacco products other than cigarettes by students is as high as cigarette smoking in many regions. Almost one in five never-smokers reported they were susceptible to smoking in the next year. Student exposure to secondhand smoke was high both at home (more than four in ten) and in public places (more than five in ten). Never-smokers were significantly less likely than current smokers to be exposed to secondhand smoke at home (prevalence 39.1% [95% CI 36.6-41.6] vs 72.8% [64.0-81.6]) and in public places (49.5% [46.7-52.3] vs 81.2% [74.2-88.2]). Our findings are troubling for the future of chronic disease and tobacco-related mortality. Reduction of tobacco consumption will require a redoubling of efforts to prevent initiation and promote cessation among the large proportion of young people who currently use tobacco. High exposure to secondhand smoke suggests a need for countries to pass strong and effective smoke-free policies.

Molecular analysis of Hurler syndrome in Druze and Muslim Arab patients in Israel: Multiple allelic mutations of the IDUA gene in a small geographic area

DOE Office of Scientific and Technical Information (OSTI.GOV)

Bach, G.; Moskowitz, S.M.; Tieu, P.T.

1993-08-01

The mutations underlying Hurler syndrome (mucopolysaccharidosis IH) in Druze and Muslim Israeli Arab patients have been characterized. Four alleles were identified, using a combination of (a) PCR amplification of reverse-transcribed RNA or genomic DNA segments, (b) cycle sequencing of PCR products, and (c) restriction-enzyme analysis. One allele has two amino acid substitutions, Gly[sub 409][yields]Arg in exon 9 and Ter[yields]Cys in exon 14. The other three alleles have mutations in exon 2 (Tyr[sub 64][yields]Ter), exon 7 (Gln[sub 310][yields]Ter), or exon 8 (Thr[sub 366][yields]Pro). Transfection of mutagenized cDNAs into Cos-1 cells showed that two missense mutations, Thr[sub 366][yields]Pro and Ter[yields]Cys, permitted themore » expression of only trace amounts of [alpha]-L-iduronidase activity, whereas Gly[sub 409][yields]Arg permitted the expression of 60% as much enzyme as did the normal cDNA. The nonsense mutations were associated with abnormalities of RNA processing: (1) both a very low level of mRNA and skipping of exon 2 for Tyr[sub 64][yields]Ter and (2) utilization of a cryptic splice site for Gln[sub 310][yields]Ter. In all instances, the probands were found homozygous, and the parents heterozygous, for the mutant alleles, as anticipated from the consanguinity in each family. The two-mutation allele was identified in a family from Gaza; the other three alleles were found in seven families, five of them Druze, residing in a very small area of northern Israel. Since such clustering suggests a classic founder effect, the presence of three mutant alleles of the IDUA gene was unexpected. 28 refs., 4 figs., 3 tabs.« less

Effect of vitamin C on inflammation and metabolic markers in hypertensive and/or diabetic obese adults: a randomized controlled trial

PubMed Central

Ellulu, Mohammed S; Rahmat, Asmah; Patimah, Ismail; Khaza’ai, Huzwah; Abed, Yehia

2015-01-01

Background Obesity is well associated as being an interfering factor in metabolic diseases such as hypertension and diabetes by increasing the secretion of proinflammatory markers from adipose tissue. Having healthy effects, vitamin C could work as an anti-inflammatory agent through its antioxidant capacity. Registration Registration number: FPSK_Mac [13]04. Objective The aim of the study reported here was to identify the effect of vitamin C on reducing the levels of inflammatory markers in hypertensive and/or diabetic obese adults. Subjects and methods Sixty-four obese patients, who were hypertensive and/or diabetic and had high levels of inflammatory markers, from primary health care centers in Gaza City, Palestine, were enrolled into one of two groups in an open-label, parallel, randomized controlled trial. A total of 33 patients were randomized into a control group and 31 patients were randomized into an experimental group. The experimental group was treated with 500 mg vitamin C twice a day. Results In the experimental group, vitamin C significantly reduced the levels of high-sensitivity C-reactive protein (hs-CRP), interleukin 6 (IL-6), fasting blood glucose (FBG), and triglyceride (TG) after 8 weeks of treatment (overall: P<0.001); no changes appeared in total cholesterol (TC). In the control group, there were significant reductions in FBG and TG (P=0.001 and P=0.026, respectively), and no changes in hs-CRP, IL-6, or TC. On comparing the changes in the experimental group with those in the control group at the endpoint, vitamin C was found to have achieved clinical significance in treating effectiveness for reducing hs-CRP, IL-6, and FBG levels (P=0.01, P=0.001, and P<0.001, respectively), but no significant changes in TC or TG were found. Conclusion Vitamin C (500 mg twice daily) has potential effects in alleviating inflammatory status by reducing hs-CRP, IL-6, and FBG in hypertensive and/or diabetic obese patients. PMID:26170625

Diffusion of e-health innovations in 'post-conflict' settings: a qualitative study on the personal experiences of health workers.

PubMed

Woodward, Aniek; Fyfe, Molly; Handuleh, Jibril; Patel, Preeti; Godman, Brian; Leather, Andrew; Finlayson, Alexander

2014-04-23

Technological innovations have the potential to strengthen human resources for health and improve access and quality of care in challenging 'post-conflict' contexts. However, analyses on the adoption of technology for health (that is, 'e-health') and whether and how e-health can strengthen a health workforce in these settings have been limited so far. This study explores the personal experiences of health workers using e-health innovations in selected post-conflict situations. This study had a cross-sectional qualitative design. Telephone interviews were conducted with 12 health workers, from a variety of cadres and stages in their careers, from four post-conflict settings (Liberia, West Bank and Gaza, Sierra Leone and Somaliland) in 2012. Everett Roger's diffusion of innovation-decision model (that is, knowledge, persuasion, decision, implementation, contemplation) guided the thematic analysis. All health workers interviewed held positive perceptions of e-health, related to their beliefs that e-health can help them to access information and communicate with other health workers. However, understanding of the scope of e-health was generally limited, and often based on innovations that health workers have been introduced through by their international partners. Health workers reported a range of engagement with e-health innovations, mostly for communication (for example, email) and educational purposes (for example, online learning platforms). Poor, unreliable and unaffordable Internet was a commonly mentioned barrier to e-health use. Scaling-up existing e-health partnerships and innovations were suggested starting points to increase e-health innovation dissemination. Results from this study showed ICT based e-health innovations can relieve information and communication needs of health workers in post-conflict settings. However, more efforts and investments, preferably driven by healthcare workers within the post-conflict context, are needed to make e-health more

Time-resolved particle image velocimetry measurements of the 3D single-mode Richtmyer-Meshkov instability

NASA Astrophysics Data System (ADS)

Xu, Qian

The Richtmyer-Meshkov Instability (RMI) (Commun. Pure Appl. Math 23, 297-319, 1960; Izv. Akad. Nauk. SSSR Maekh. Zhidk. Gaza. 4, 151-157, 1969) occurs due to an impulsive acceleration acting on a perturbed interface between two fluids of different densities. In the experiments presented in this thesis, single mode 3D RMI experiments are performed. An oscillating speaker generates a single mode sinusoidal initial perturbation at an interface of two gases, air and SF6. A Mach 1.19 shock wave accelerates the interface and generates the Richtmyer-Meshkov Instability. Both gases are seeded with propylene glycol particles which are illuminated by an Nd: YLF pulsed laser. Three high-speed video cameras record image sequences of the experiment. Particle Image Velocimetry (PIV) is applied to measure the velocity field. Measurements of the amplitude for both spike and bubble are obtained, from which the growth rate is measured. For both spike and bubble experiments, amplitude and growth rate match the linear stability theory at early time, but fall into a non-linear region with amplitude measurements lying between the modified 3D Sadot et al. model ( Phys. Rev. Lett. 80, 1654-1657, 1998) and the Zhang & Sohn model (Phys. Fluids 9. 1106-1124, 1997; Z. Angew. Math Phys 50. 1-46, 1990) at late time. Amplitude and growth rate curves are found to lie above the modified 3D Sadot et al. model and below Zhang & Sohn model for the spike experiments. Conversely, for the bubble experiments, both amplitude and growth rate curves lie above the Zhang & Sohn model, and below the modified 3D Sadot et al. model. Circulation is also calculated using the vorticity and velocity fields from the PIV measurements. The calculated circulation are approximately equal and found to grow with time, a result that differs from the modified Jacobs and Sheeley's circulation model (Phys. Fluids 8, 405-415, 1996).

Epidemiology of rotavirus A diarrhea in Chókwè, Southern Mozambique, from February to September, 2011.

PubMed

Langa, Jerónimo S; Thompson, Ricardo; Arnaldo, Paulo; Resque, Hugo Reis; Rose, Tatiana; Enosse, Sonia M; Fialho, Alexandre; de Assis, Rosane Maria Santos; da Silva, Marcelle Figueira Marques; Leite, José Paulo Gagliardi

2016-10-01

Acute diarrhea disease caused by Rotaviruses A (RVA) is still the leading cause of morbidity and mortality in children ≤5 years old in developing countries. An exploratory cross-sectional study was conducted between February and September, 2011 to determine the proportion of acute diarrhea caused by RVA. A total of 254 stool specimens were collected from children ≤5 years old with acute diarrhea, including outpatients (222 children) and inpatients (32 children), in three local health centers in Chókwè District, Gaza Province, South of Mozambique. RVA antigens were detected using enzyme immunoassay (EIA); the RVA G (VP7) and P (VP4) genotypes were determined by RT-PCR or analysis sequencing. Sixty (24%) out of 254 fecal specimens were positive for RVA by EIA; being 58 (97%) from children ≤2 years of age. RVA prevalence peaks in June and July (coldest and drier months) and the G[P] binary combination observed were G12P[8] (57%); G1P[8] (9%); G12P[6] (6%); and 2% for each of the following genotypes: G1P[6], G2P[6] G4P[6], and G9P[8]. Non-Typeable (NT) G and/or P genotypes were observed as follows: G12P [NT] (6%); G1P [NT], G3P[NT] and GNTP[NT] (4%). Considering the different GP combinations, G12 represented 67% of the genotypes. This is the first data showing the diversity of RVA genotypes in Mozambique highlighting the epidemiological importance of these viruses in acute diarrhea cases in children ≤2 years old. In addition, these findings will provide a baseline data before the introduction of the RVA monovalent (Rotarix(®) ) vaccine in the National Immunization Program in September 2015. J. Med. Virol. 88:1751-1758, 2016. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

Family systems approach to attachment relations, war trauma, and mental health among Palestinian children and parents

PubMed Central

Punamäki, Raija-Leena; Qouta, Samir R.; Peltonen, Kirsi

2017-01-01

ABSTRACT Background: Trauma affects the family unit as a whole; however, most existing research uses individual or, at most, dyadic approaches to analyse families with histories of trauma. Objective: This study aims to identify potentially distinct family types according to attachment, parenting, and sibling relations, to analyse how these family types differ with respect to war trauma, and to explore how children’s mental health and cognitive processing differ across these family types. Method: Participants included Palestinian mothers and fathers (N = 325) and their children (one per family; 49.4% girls; 10–13 years old; mean ± SD age = 11.35 ± 0.57 years) after the Gaza War of 2008–2009. Both parents reported their exposure to war trauma, secure attachment availability, and parenting practices, as well as the target child’s internalizing and externalizing symptoms [Strengths and Difficulties Questionnaire (SDQ)]. Children reported their symptoms of post-traumatic stress disorder (on the Children’s Revised Impact Event Scale), depression (Birleson), and SDQ, as well as their post-traumatic cognitions (Children’s Post Traumatic Cognitions Inventory). Results: A cluster analysis identified four family types. The largest type reflected secure attachment and optimal relationships (security and positive family relationships, 36.2%, n = 102), and the smallest exhibited insecurity and problematic relationships (insecurity and negative family relationships, 15.6%; n = 44). Further, families with discrepant experiences (23.0%; n = 65) and moderate security and neutral relationships (25.2%; n = 71) emerged. The insecurity and negative relationships family type showed higher levels of war trauma; internalizing, externalizing, and depressive symptoms among children; and dysfunctional post-traumatic cognitions than other family types. Conclusion: The family systems approach to mental health is warranted in war conditions, and therapeutic

Children and adolescents facing a continuous security threat: Aggressive behavior and post-traumatic stress symptoms.

PubMed

Nuttman-Shwartz, Orit

2017-07-01

There is extensive research evidence indicating that children and youth are the most vulnerable population for developing psychological symptoms relating to war and terror. Although studies have documented a wide range of detrimental emotional and behavioral effects of such exposure, much less is known about the effects of exposure to a continuous security threat for children and adolescents. Against this background, the current article examined the implications of continuous exposure to missile attacks among 1096 children and adolescents enrolled in public schools near the Israeli border with Gaza. Participants filled out quantitative questionnaires, which relate to the pathological consequences of continuous exposure to security threats, and to the role of the school and the community as a protective environment against disruptive behavior resulting from such exposure. The findings revealed that PTSS responses were mainly related to the security threat, whereas interpersonal aggression resulted from other types of traumatic events. Significant differences were found between aggression and posttraumatic symptoms, by age and gender. PTSS was found to be lower for older participants and higher for girls, whereas aggression was higher for boys and higher for older participants. Furthermore, the sense of belonging to the place of residence was negatively associated with PTSS as well as with aggressive behavior: the higher the participants' sense of belonging, the lower their levels of PTSS and aggressive responses. In contrast, the sense of belonging to the school was negatively associated only with aggressive behavior: the higher the participants' sense of belonging to the school, the lower their aggressive responses. The findings are discussed in the light of trauma theories and in light of the results of previous research. The study contributed to knowledge about the differential consequences of exposure to a security threat, and highlighted the importance of

Family systems approach to attachment relations, war trauma, and mental health among Palestinian children and parents.

PubMed

Punamäki, Raija-Leena; Qouta, Samir R; Peltonen, Kirsi

2017-01-01

Background : Trauma affects the family unit as a whole; however, most existing research uses individual or, at most, dyadic approaches to analyse families with histories of trauma. Objective : This study aims to identify potentially distinct family types according to attachment, parenting, and sibling relations, to analyse how these family types differ with respect to war trauma, and to explore how children's mental health and cognitive processing differ across these family types. Method: Participants included Palestinian mothers and fathers ( N  = 325) and their children (one per family; 49.4% girls; 10-13 years old; mean ±  SD age = 11.35 ± 0.57 years) after the Gaza War of 2008-2009. Both parents reported their exposure to war trauma, secure attachment availability, and parenting practices, as well as the target child's internalizing and externalizing symptoms [Strengths and Difficulties Questionnaire (SDQ)]. Children reported their symptoms of post-traumatic stress disorder (on the Children's Revised Impact Event Scale), depression (Birleson), and SDQ, as well as their post-traumatic cognitions (Children's Post Traumatic Cognitions Inventory). Results: A cluster analysis identified four family types. The largest type reflected secure attachment and optimal relationships (security and positive family relationships, 36.2%, n  = 102), and the smallest exhibited insecurity and problematic relationships (insecurity and negative family relationships, 15.6%; n  = 44). Further, families with discrepant experiences (23.0%; n  = 65) and moderate security and neutral relationships (25.2%; n  = 71) emerged. The insecurity and negative relationships family type showed higher levels of war trauma; internalizing, externalizing, and depressive symptoms among children; and dysfunctional post-traumatic cognitions than other family types. Conclusion: The family systems approach to mental health is warranted in war conditions, and therapeutic interventions for

Measuring the efficiency of Palestinian public hospitals during 2010-2015: an application of a two-stage DEA method.

PubMed

Sultan, Wasim I M; Crispim, José

2018-05-29

limited to public hospitals in West Bank. For a better understanding of the Palestinian market, further research on private hospitals and hospitals in Gaza Strip will be useful.

Teaching in conflict contexts: dimensions of subjective wellbeing in Palestinian teachers living in Israel and the occupied Palestinian territory.

PubMed

Pepe, Alessandro; Addimando, Loredana; Dagdouke, Jamal; Yagi, Shaher; Veronese, Guido

2018-02-21

Subjective wellbeing can be defined in terms of good mental state, including positive and negative evaluations that people make of their affect and lives. The aim of this study was to identify specific domains of wellbeing that are salient to Palestinian teachers living in three different contexts (West Bank, Gaza Strip, and Israel) and to map how components of subjective wellbeing vary between the three cohorts. Data were gathered from interviews of teachers participating in 16 focus groups and from 36 key informants (including psychologists, counsellors, school principals, lawyers). Participants were divided into three groups according to their working locations. Data were analysed by using a mixed-method approach. We used thematic textual analysis, and data were cross-validated with results of statistical significance of lexical specificities (ie, domain-specific terms extracted from specific participants' lexicon) and semantic network analysis. We interviewed 104 teachers. First-order hierarchical categorisation of thematic analysis revealed four dimensions of subjective wellbeing: psychosocial, professional-related, economic issues, and contextual factors. Some second-order subcategories were quality of teaching work, personality aspects, emotional dimensions, political dimensions, and psychological dimensions. Analysis of lexical specificities and results of semantic network analysis revealed that the importance of different components of subjective wellbeing varied across geographical cohorts. Overall, the results of qualitative and quantitative data analysis showed a clear relationship between the teachers' subjective wellbeing and the places they lived. General themes were common in all populations, but the three cohorts differed in terms of the relative salience of each theme. The prominent themes for the Gazan group were quality of teaching, social dimensions, and religion. The key themes for the West Bank group were economic, social dimensions, and

Long-term exposure to political violence: The particular injury of persistent humiliation.

PubMed

Barber, Brian K; McNeely, Clea; Olsen, Joseph A; Belli, Robert F; Doty, Samuel Benjamin

2016-05-01

This study assessed the association between exposure to political violence over a 25-year period and adult functioning among a population that has experienced protracted and severe political conflict. Instead of aggregating exposure to political violence across time and type of exposure, as is commonly done, the event history calendar pioneered in this study assessed exposure to five forms of political violence annually from 1987 to 2011 in a representative sample of 1788 adults, aged 37 on average, in the occupied Palestinian territories (West Bank, East Jerusalem, and the Gaza Strip). This method allowed for the identification of trajectories of exposure to political violence from childhood to adulthood using latent profile analysis. We then correlated the trajectories of exposure to measures of economic, political, community, family, psychological, and health functioning. As expected, being shot at, having one's home raided, being hit or kicked, being verbally abused, and witnessing someone close being humiliated were all elevated during periods of heightened political conflict (the first intifada (1987-1993) and, less so, the second intifada (2000-2005)). In addition, 12% of women and men reported high and persistent levels of exposure to humiliation (being verbally abused and/or witnessing someone close being humiliated) across the entire 25-year period. These individuals lived predominantly in neighborhoods with a high Israeli military presence. Compared to those who experienced periodic exposure to political violence, persistently humiliated men and women reported significantly lower health, economic, political, and psychological functioning, as well as higher social cohesion and political expression. Relevant literatures are reviewed when concluding that persistent humiliation is a neglected form of political violence that is best represented as a direct (versus structural), acute (versus chronic), macro (versus micro), and high-grade (versus low

Global Tobacco Surveillance System (GTSS): purpose, production, and potential.

PubMed

2005-01-01

The World Health Organization (WHO), Centers for Disease Control and Prevention (CDC), and Canadian Public Health Association (CPHA) developed the Global Tobacco Surveillance System (GTSS) to assist all 192 WHO Member States in collecting data on youth and adult tobacco use. The flexible GTSS system includes common data items but allows countries to include important unique information at their discretion. It uses a common survey methodology, similar field procedures for data collection, and similar data management and processing techniques. The GTSS includes collection of data through three surveys: the Global Youth Tobacco Survey (GYTS) for youth, and the Global School Personnel Survey (GSPS) and the Global Health Professional Survey (GHPS) for adults. GTSS data potentially can be applied in four ways. First, countries and research partners can disseminate data through publications, presentations, and an active GTSS web site. Second, countries can use GTSS data to inform politicians about the tobacco problem in their country, leading to new policy decisions to prevent and control tobacco use. Third, GTSS can provide countries with valuable feedback to evaluate and improve Country National Action Plans or develop new plans. Fourth, in response to the WHO FCTC call for countries to use consistent methods and procedures in their surveillance efforts, GTSS offers such consistency in sampling procedures, core questionnaire items, training infield procedures, and analysis of data across all survey sites. The GTSS represents the most comprehensive tobacco surveillance system ever developed and implemented. As an example, this paper describes development of the GYTS and discusses potential uses of the data. Sample data were drawn from 38 sites in 24 countries in the African Region, 82 sites in 35 countries in the Americas Region, 20 sites in 17 countries and the Gaza Strip/West Bank region in the Eastern Mediterranean Region, 25 sites in 22 countries in the European

Characteristics of De Novo Acute Myeloid Leukemia Patients in Palestine: Experience of An-Najah National University Hospital

PubMed

Abuhelwa, Ziad; Al Shaer, Qasem; Taha, Sari; Ayoub, Khubaib; Amer, Riad

2017-09-27

Objective: To describe the characteristics of de novo acute myeloid leukemia (AML) in the Palestinian population. Study design and setting: A retrospective chart review study was conducted at An-Najah National University Hospital (NNUH) during the period of January, 2014 to December, 2016. Methodology: The medical records of AML patients treated at NNUH were reviewed. All patients at least 16 years of age diagnosed with de novo AML and started on induction chemotherapy were included. Descriptive statistics were employed to analyze the data. Results: Out of 88 patients diagnosed with AML during the study period, 64 had de novo AML and were included. Median age at diagnosis was 36 years, with a male to female ratio of 1.13:1. Two thirds of the cases were from the West Bank and the remainder were from Gaza. Major complaints at presentation were fatigue (64.1%), fever (46.9%), respiratory tract infections (39.1%) and bruising (28.1%). Hepatomegaly was present in 23.4% and splenomegaly in 34.4%. At presentation, the median white blood cells (WBC) count, hemoglobin (Hb) concentration and platelet count were 30. 5x109/L, 9.3g/ dL, and 39.5 x109/L, respectively. According to the French American British (FAB) classification, M4 was the most common subtype (32.8%) followed by M3 (21.9%). After a single cycle of induction chemotherapy complete remission (CR) was seen in 26 (41.9%) and non-remission (NR) in 17 (27.4%), while 19 patients (30.6%) died during the first admission for induction. Conclusion: The characteristics of de novo AML in Palestinian patients are comparable to published data elsewhere. M4 was the most common subtype. The outcome of the first cycle of induction chemotherapy was slightly inferior to the published data for M3 patients. Further studies are warranted to identify possible causes. Creative Commons Attribution License

Public perception of hazardousness caused by current trends of municipal solid waste management

DOE Office of Scientific and Technical Information (OSTI.GOV)

Al-Khatib, Issam A., E-mail: ikhatib@birzeit.edu; Kontogianni, Stamatia; Abu Nabaa, Hendya

Highlights: • Contribution to the scientific literature by examining the relationship between concern for the environment and waste disposal in the frame of household waste treatment mechanism specifically in developing countries. • The awareness of the citizens satisfaction level and the local existing capacities in developing countries significantly contribute to decision making on MSW management sustainability in Palestine and other developing countries when applied. • Identification of the differences and similarities among DC resulting to failures or success in WM field. - Abstract: Municipal solid waste (MSW) piling up is becoming a serious problem in all developing countries (DC) asmore » a result of inequitable waste collection and treatment. Citizens’ collaboration is partly based on understanding their views and their active involvement in MSW planning; on the other hand the assessment of the perception of hazardousness related with MSW is considered rather important as well since the identification of the weak points of the applied MWM strategy is eased and the level of required training is determined. Researchers implemented a case study in the West Bank (WB) and Gaza Strip (GS) regions of Palestine, taking into consideration previous researches in other developing countries. They reached to safe and useful conclusions regarding the parameters which mean the greatest in the waste management field as far as DC are concerned. Lack of skilled manpower, irregular collection services, inadequate equipment used for waste collection, inadequate legal provisions, and resource constraints are additional factors that are confirmed to be challenging the waste management scenarios in all DCs today. The research takes those factors under consideration but focuses on the educational gap and the results revealed interesting trends a significant relationship between respondent’s educational attainment and their awareness of hazardous waste (hazard

Building the evidence base for global tobacco control.

PubMed Central

Corrao, M. A.; Guindon, G. E.; Cokkinides, V.; Sharma, N.

2000-01-01

The tobacco control movement needs a global information system permitting routine monitoring of the tobacco trade, tobacco farming, the tobacco industry, the prevalence of tobacco use, associated mortality, and national resources for combating tobacco. The Tobacco Control Country Profiles database, a data collection initiative led by the American Cancer Society in collaboration with WHO and the Centers for Disease Control and Prevention, represents the first step in the development of such a system. Baseline data on several indicators of tobacco use were obtained from 191 Member States of WHO, two Associate Members, Hong Kong Special Administrative Region of China (Hong Kong SAR), China (Province of Taiwan) and the West Bank and Gaza Strip. The methods used to compile the data are described in the present paper. Selected indicators from the database were analysed in order to demonstrate the potential utility and value of data derived from an information system devoted to tobacco control. The analyses covered gender-specific smoking prevalence by WHO Region, per capita cigarette consumption by Human Development Index (HDI) category, and average real annual percentage changes in cigarette prices between 1990 and 1999 for selected countries in each category. In 1998, men were almost four times more likely than women to be smokers. The prevalence of smoking among men was highest in the Western Pacific Region. The differential in gender-specific smoking prevalence was narrowest in the Region of the Americas and the European Region. It was wider in the South-East Asia Region and the Western Pacific Region. The lowest and highest per capita consumption of manufactured cigarettes occurred in the lowest and highest HDI categories respectively. In the medium HDI category, China's growing cigarette consumption after 1975 had a major bearing on the rise in per capita consumption. Cigarette price trends suggest that there is considerable scope for increasing taxes on tobacco

Comparing estimates of child mortality reduction modelled in LiST with pregnancy history survey data for a community-based NGO project in Mozambique

PubMed Central

2011-01-01

Background There is a growing body of evidence that integrated packages of community-based interventions, a form of programming often implemented by NGOs, can have substantial child mortality impact. More countries may be able to meet Millennium Development Goal (MDG) 4 targets by leveraging such programming. Analysis of the mortality effect of this type of programming is hampered by the cost and complexity of direct mortality measurement. The Lives Saved Tool (LiST) produces an estimate of mortality reduction by modelling the mortality effect of changes in population coverage of individual child health interventions. However, few studies to date have compared the LiST estimates of mortality reduction with those produced by direct measurement. Methods Using results of a recent review of evidence for community-based child health programming, a search was conducted for NGO child health projects implementing community-based interventions that had independently verified child mortality reduction estimates, as well as population coverage data for modelling in LiST. One child survival project fit inclusion criteria. Subsequent searches of the USAID Development Experience Clearinghouse and Child Survival Grants databases and interviews of staff from NGOs identified no additional projects. Eight coverage indicators, covering all the project’s technical interventions were modelled in LiST, along with indicator values for most other non-project interventions in LiST, mainly from DHS data from 1997 and 2003. Results The project studied was implemented by World Relief from 1999 to 2003 in Gaza Province, Mozambique. An independent evaluation collecting pregnancy history data estimated that under-five mortality declined 37% and infant mortality 48%. Using project-collected coverage data, LiST produced estimates of 39% and 34% decline, respectively. Conclusions LiST gives reasonably accurate estimates of infant and child mortality decline in an area where a package of community

The modern Nile sediment system: Processes and products

NASA Astrophysics Data System (ADS)

Garzanti, Eduardo; Andò, Sergio; Padoan, Marta; Vezzoli, Giovanni; El Kammar, Ahmed

2015-12-01

We trace compositional changes of Nile sediments for 7400 km, from their sources in equatorial rift highlands of Burundi and Rwanda to their sink in the Mediterranean Sea. All chemical and physical controls on sediment petrography, mineralogy and geochemistry, including weathering, grain-size, hydraulic sorting, mechanical breakdown, anthropic impact, mixing and recycling are investigated in detail. The Nile course is controlled along its entire length by the East African-Red Sea Rift. In this anorogenic setting, detritus is derived in various proportions from volcanic fields associated with tectonic extension (Anorogenic Volcanic provenance) and from igneous, metamorphic and sedimentary rocks uplifted on the rift shoulders or exposed on the craton (Continental Block provenance). The entire spectrum of such detrital signatures is displayed in the Nile catchment. Volcaniclastic Atbara sand is generated by focused erosion of the Ethiopian basaltic plateau in semiarid climate, whereas quartzose White Nile sand reflects low erosion rates, extensive weathering and sediment trapping in lakes and swamps at equatorial to subequatorial latitudes. In the main Nile, as in its main tributary the Blue Nile, suspended load is volcaniclastic, whereas feldspatho-quartzose bedload is derived largely from basement sources, with fine to medium-grained eolian sand added along the lower course. Mixing of detrital populations with different provenance and grain size is reflected in diverse violations of settling-equivalence relationships in fluvial and deltaic sediments. Sediment delivery from Sudan has been cut off after closure of the Aswan High Dam and accelerated erosion of deltaic cusps is leading to local formation of placer lags dominated by ultradense Fe-Ti-Cr oxides, but mineralogical changes caused by man's radical modification of fluvial regimes have been minor so far. In beaches of Sinai, Gaza and Israel, the Nile volcaniclastic trace gets progressively diluted by quartzose

Diffusion of e-health innovations in ‘post-conflict’ settings: a qualitative study on the personal experiences of health workers

PubMed Central

2014-01-01

Background Technological innovations have the potential to strengthen human resources for health and improve access and quality of care in challenging ‘post-conflict’ contexts. However, analyses on the adoption of technology for health (that is, ‘e-health’) and whether and how e-health can strengthen a health workforce in these settings have been limited so far. This study explores the personal experiences of health workers using e-health innovations in selected post-conflict situations. Methods This study had a cross-sectional qualitative design. Telephone interviews were conducted with 12 health workers, from a variety of cadres and stages in their careers, from four post-conflict settings (Liberia, West Bank and Gaza, Sierra Leone and Somaliland) in 2012. Everett Roger’s diffusion of innovation-decision model (that is, knowledge, persuasion, decision, implementation, contemplation) guided the thematic analysis. Results All health workers interviewed held positive perceptions of e-health, related to their beliefs that e-health can help them to access information and communicate with other health workers. However, understanding of the scope of e-health was generally limited, and often based on innovations that health workers have been introduced through by their international partners. Health workers reported a range of engagement with e-health innovations, mostly for communication (for example, email) and educational purposes (for example, online learning platforms). Poor, unreliable and unaffordable Internet was a commonly mentioned barrier to e-health use. Scaling-up existing e-health partnerships and innovations were suggested starting points to increase e-health innovation dissemination. Conclusions Results from this study showed ICT based e-health innovations can relieve information and communication needs of health workers in post-conflict settings. However, more efforts and investments, preferably driven by healthcare workers within the post

Climate induced changes on the hydrology of Mediterranean basins - assessing uncertainties and quantifying risks

NASA Astrophysics Data System (ADS)

Ludwig, Ralf

2014-05-01

According to current climate projections, the Mediterranean area is at high risk for severe changes in the hydrological budget and extremes. With innovative scientific measures, integrated hydrological modeling and novel field geophysical field monitoring techniques, the FP7 project CLIMB (Climate Induced Changes on the Hydrology of Mediterranean Basins; GA: 244151) assessed the impacts of climate change on the hydrology in seven basins in the Mediterranean area, in Italy, France, Turkey, Tunisia, Egypt and the Gaza Strip, and quantified uncertainties and risks for the main stakeholders of each test site. Intensive climate model auditing selected four regional climate models, whose data was bias corrected and downscaled to serve as climate forcing for a set of hydrological models in each site. The results of the multi-model hydro-climatic ensemble and socio-economic factor analysis were applied to develop a risk model building upon spatial vulnerability and risk assessment. Findings generally reveal an increasing risk for water resources management in the test sites, yet at different rates and severity in the investigated sectors, with highest impacts likely to occur in the transition months. Most important elements of this research include the following aspects: • Climate change contributes, yet in strong regional variation, to water scarcity in the Mediterranean; other factors, e.g. pollution or poor management practices, are regionally still dominant pressures on water resources. • Rain-fed agriculture needs to adapt to seasonal changes; stable or increasing productivity likely depends on additional irrigation. • Tourism could benefit in shoulder seasons, but may expect income losses in the summer peak season due to increasing heat stress. • Local & regional water managers and water users, lack, as yet, awareness of climate change induced risks; emerging focus areas are supplies of domestic drinking water, irrigation, hydropower and livestock. • Data

Psychosocial outcomes related to subjective threat from armed conflict events (STACE): Findings from the Israeli-Palestinian cross-cultural HBSC study.

PubMed

Harel-Fisch, Yossi; Radwan, Qasrowi; Walsh, Sophie D; Laufer, Avital; Amitai, Gabriel; Fogel-Grinvald, Haya; Abdeen, Ziad

2010-09-01

This study investigates the relationship between exposure to armed conflict and terror events, and an array of mental and behavioral outcomes within a large cross-cultural scientifically representative sample of 24,935 Palestinian (7,430 West Bank and 7,217 Gaza) and Israeli (5,255 Jewish and 6,033 Arab) 11-, 13-, and 15-year-old school children. The children of the Middle East have been subjected to exposure from armed conflict and terrorism repeatedly with no adequate research or interventions aimed at shielding them from the hazards of such exposure to their mental and social well-being. This paper studies the relationship between a newly developed scale (STACE) measuring levels of subjective perceptions of threat/fear due to exposure to armed conflict events and its predicting association with six psychosocial and behavioral outcomes covering (1) poor mental health, (2) positive well-being, and (3) risk behaviors. It also examines the role of parental support in "buffering" the effects of exposure to armed conflict events within the four target populations. Results showed that STACE has significant and strong effects on all six dependent variables representing (1) mental post trauma, (2) diminished well-being, and (3) elevated risk behaviors. STACE strongly affects all four populations with the greatest impact among the Jewish Israeli population and the least impact shown for the Arab Israeli youth. Parental support ("significant adult") has both a direct main effect on the outcomes of all six variables as well as a significant "buffering" effect on the impact of STACE on certain outcome variables (posttraumatic symptoms, life satisfaction, positive life perceptions, and tobacco use). Regardless of the type of armed conflict events, the perception of threat and fear that a child experiences has a universal significant negative impact on mental, social, and behavioral well-being. The importance of the existence of a supporting significant adult in exposed

Glycemic control of diabetes patients under continuous rocket attacks.

PubMed

Soskolne, Varda; Dekel, Rachel; Vinker, Shlomo

2016-01-01

Evidence regarding the detrimental effects of exposure to stress on glycemic control among diabetes patients has mainly focused on personal life events or acute trauma. However, the effects of continuous exposure to extreme stress on type 2 diabetes patients have rarely been studied. The aim of the current study was to examine the association of continuous exposure to rocket attacks with glycemic control and with risk factors for diabetes complications among civilian type 2 diabetes patients. We focus on patients residing in the Western Negev in the south of Israel that has been subjected to rocket attacks fired from Gaza since the end of 2001. A two-arm retrospective cohort study of type 2 diabetes patients, aged 35-70 years, residing in a region with chronic exposure to rocket attacks (N = 1697) and in a non-exposed comparison region in Israel (N = 3000). Data were retrieved from the Health Maintenance Organization (HMO)'s database for four time periods representing exposure: chronic-2008; elevated-2009 (post'Cast Lead' operation); return to chronic-2010, 2011. Data included socio-demographic variables, HbA 1c , BMI, LDL cholesterol, blood pressure. General Linear Models (GLM) were used for analysis. For HbA 1c , the model yielded a significant main effect for time, a borderline significance main effect for region, and a significant time by region interaction: no differences in HbA 1c levels between the regions in 2008 and 2009, followed by significant differences between the regions in 2010 and 2011 when HbA 1c continued to increase in the exposed region but decreased in the comparison region. Regarding risk factors, a significant main effect for time for LDL cholesterol only, and significant main effects for region were found in all factors: BMI and LDL cholesterol were higher in the exposed than in the comparison region, but blood pressure values were lower. Continuous exposure to rocket attacks is associated with glycemic control and risk factors in a

A resolution recognizing the right of Israel to defend itself against attacks from Gaza and reaffirming the United States' strong support for Israel in its battle with Hamas, and supporting the Israeli-Palestinian peace process.

THOMAS, 111th Congress

Sen. Reid, Harry [D-NV

2009-01-08

Senate - 01/08/2009 Submitted in the Senate, considered, and agreed to without amendment and with a preamble by Unanimous Consent. (All Actions) Tracker: This bill has the status Agreed to in SenateHere are the steps for Status of Legislation:

Humiliation: the invisible trauma of war for Palestinian youth.

PubMed

Giacaman, Rita; Abu-Rmeileh, Niveen M E; Husseini, Abdullatif; Saab, Hana; Boyce, William

2007-08-01

To investigate the influence of exposure to humiliation in war-like conditions on health status in 10th- and 11th-grade students living in the Ramallah District, West Bank, Occupied Palestinian Territory. A stratified single-stage cluster sample of 3415 students from cities, towns, villages and refugee camps of the Ramallah District. Survey questions were derived from the World Health Organization's Health Behaviour in School-aged Children Survey, the Gaza Community Mental Health Programme Traumatic Event Checklist, and focus group discussions with young people. The survey questionnaire was completed by students in their classrooms, under the supervision of a trained field worker. There was a significant association between a high number of subjective health complaints and demographic variables, particularly for females compared with males, and refugee camp dwellers compared with village dwellers. In addition, exposure to humiliation was significantly associated with an increased number of subjective health complaints. Students experiencing three forms of humiliation were found to be 2.5 times more likely to report a high number of subjective health complaints compared with those who had never been exposed to humiliation (52% vs 21%), while those experiencing four forms of humiliation were three times more likely to report a high number of subjective health complaints (62% vs 21%). A multiple logistic regression model revealed that humiliation was significantly associated with a high number of subjective health complaints, even after adjusting for sex, residence and other measures of exposure to violent events. The odds ratio of reporting a high number of subjective health complaints increased as the number of forms of humiliation increased, with values of 1.69, 2.67, 4.43 and 7.49 for reporting a high number of subjective health complaints when exposed to one, two, three or four forms of humiliation, respectively, compared with those who had never been exposed to

The Consensus Process at the Water Science and Technology Board, National Research Council

NASA Astrophysics Data System (ADS)

Logan, W. S.

2001-12-01

Whereas the very birth of the U.S. Geological Survey arose from the recommendations of a National Academy of Sciences report, water science has not always had a prominent place at that institution. Prior to the 1980s, water issues were dealt with on an ad hoc basis by various boards related to science, engineering, and policy. With the birth of the Water Science and Technology Board (WSTB) in 1982, a diversity of water-related issues are now handled under one roof. The "business" of the WSTB is to produce consensus reports on a spectrum of topics in water science. Some of the projects that the WSTB works on are self-generated. The majority are generated either by Congress, or by government agencies. The WSTB takes on several different kinds of studies. Some of these are designed to advance the science of hydrology itself. This category would include the report Opportunities in the Hydrologic Sciences, which helped to establish hydrologic science as something separate from applied hydrology in Congress, the White House, and agencies such as NSF. However, the majority of the board's consensus studies involve hydrology in the interests of improving the natural and human environment. For example, Water for the Future: The West Bank and Gaza Strip, Israel, and Jordan outlined consensus principles backed by scientists from all of these entities for sustaining freshwater resources of the region. Closer to home, but no less controversial, a WSTB committee recently reached consensus on improving the process by which states determine which water bodies are polluted enough to require clean-up, and develop Total Maximum Daily Loads for these pollutants. Another committee recently sorted through the scientific bases for using natural attenuation for various contaminants in ground water and soil. And an ongoing committee is trying to help the South Florida scientific community to determine the best strategies for restoring the Everglades to some semblance of its former self

CLIMB - Climate induced changes on the hydrology of mediterranean basins - Reducing uncertainties and quantifying risk

NASA Astrophysics Data System (ADS)

Ludwig, Ralf

2010-05-01

According to future climate projections, Mediterranean countries are at high risk for an even pronounced susceptibility to changes in the hydrological budget and extremes. These changes are expected to have severe direct impacts on the management of water resources. Threats include severe droughts and extreme flooding, salinization of coastal aquifers, degradation of fertile soils and desertification due to poor and unsustainable water management practices. It can be foreseen that, unless appropriate adaptation measures are undertaken, the changes in the hydrologic cycle will give rise to an increasing potential for tension and conflict among the political and economic actors in this vulnerable region. The presented project initiative CLIMB, funded under EC's 7th Framework Program (FP7-ENV-2009-1), has started in January 2010. In its 4-year design, it shall analyze ongoing and future climate induced changes in hydrological budgets and extremes across the Mediterranean and neighboring regions. This is undertaken in study sites located in Sardinia, Northern Italy, Southern France, Tunisia, Egypt and the Palestinian-administered area Gaza. The work plan is targeted to selected river or aquifer catchments, where the consortium will employ a combination of novel field monitoring and remote sensing concepts, data assimilation, integrated hydrologic (and biophysical) modeling and socioeconomic factor analyses to reduce existing uncertainties in climate change impact analysis. Advanced climate scenario analysis will be employed and available ensembles of regional climate model simulations will be downscaling. This process will provide the drivers for an ensemble of hydro(-geo)logical models with different degrees of complexity in terms of process description and level of integration. The results of hydrological modeling and socio-economic factor analysis will enable the development of a GIS-based Vulnerability and Risk Assessment Tool. This tool will serve as a platform

Lessons From Analyzing the Medical Costs of Civilian Terror Victims: Planning Resources Allocation for a New Era of Confrontations.

PubMed

Ellenberg, Eytan; Taragin, Mark I; Hoffman, Jay R; Cohen, Osnat; Luft-Afik, Daniella; Bar-On, Zvia; Ostfeld, Ishay

2017-12-01

Policy Points: Across the globe, the threat from terrorist attacks is rising, which requires a careful assessment of long-term medical support. We found 3 major sources of costs: hospital expenditures, mental health services dedicated to acute stress reactions, and ambulatory follow-up. During the first year, most of the costs were related to hospitalization and support for stress relief. During the second year, ambulatory and rehabilitation costs continued to grow. Public health specialists should consider these major components of costs and their evolution over time to properly advise the medical and social authorities on allocating resources for the medical and nonmedical support of civilian casualties resulting from war or terror. Across the globe, the threat from terrorist attacks is rising, which requires a careful assessment of long-term medical support. Based on an 18-month follow-up of the Israeli civilian population following the 2014 war in Gaza, we describe and analyze the medical costs associated with rocket attacks and review the demography of the victims who filed claims for disability compensation. We then propose practical lessons to help health care authorities prepare for future confrontations. Using the National Insurance Institute of Israel's (NII) database, we conducted descriptive and comparative analyses using statistical tests (Fisher's Exact Test, chi-square test, and students' t-tests). The costs were updated until March 30, 2016, and are presented in US dollars. We included only civilian expenses in our analysis. We identified 5,189 victims, 3,236 of whom presented with acute stress reactions during the conflict. Eighteen months after the conflict, the victims' total medical costs reached $4.4 million. The NII reimbursed $2,541,053 for associated medical costs and $1,921,792 for associated mental health costs. A total of 709 victims filed claims with the NII for further support, including rehabilitation, medical devices, and disability

Risk factors for vitamin A and D deficiencies among children under-five in the state of Palestine.

PubMed

Chaudhry, Aeysha Bushra; Hajat, Shakoor; Rizkallah, Najwa; Abu-Rub, Ala'a

2018-01-01

Vitamin A and D are essential for the proper growth and development of a child. Due to the complex political circumstances in the state of Palestine, research on micronutrient deficiency is scarce. The Palestinian Ministry of Health (MOH) and UNICEF conducted a national cross-sectional survey in 2013 after the implementation of various micronutrient supplementation and fortification programs. Risk factors for levels of vitamin A ( n  = 1054) and vitamin D ( n  = 150) were assessed among children aged 6 to 59 months using chi-square tests and logistic regression with each of the outcome variables, vitamin A and D deficiencies. A child was considered to be deficient in vitamin A and D if he/she had a serum level < 1.05 μmol/L and < 50 nmol/L respectively. Multiple logistic regression models were developed to identify independent risk factors for vitamin deficiencies. The prevalence of vitamin A and D deficiency was 73.1% and 60.7% respectively. Children in Gaza were 1.34 (95%CI 0.78-2.31) and 1.96 times (95%CI 0.67-5.71) more likely to be deficient in vitamin A and D respectively compared to children in the West Bank. Anaemic children were 1.5 times more likely to be deficient in vitamin A (95%CI 1.08-2.10). Older children (> 1 year-old) were more likely to be deficient in vitamin D, and females were 2.72 times more likely to be deficient than males (95%CI 1.21-6.01). Results suggest no association between maternal education levels, feeding practices such as breastfeeding and complementary feeding and vitamin A and D deficiency. Although not reaching conventional levels of statistical significance, it was observed that children who received their vitamin drops from the MOH were more likely to have vitamin A and D deficiencies than those children receiving the supplements from the United Nations Relief and Works Agency for Palestine Refugees (UNRWA). Using these results, the MOH may consider specifically targeting at risk children to increase

Migration of refugees and non-refugees to Amman, 1948-1977.

PubMed

Samha, M

1980-12-01

The migration to the city of Amman, Jordan during periods of war and peace over the past 3 decades was studied in an attempt to discover patterns of migration to Amman, to better understand their nature, to determine the constraints of migration, and to discover its motivation by resorting in part to classification and in part to analysis. The data were derived from a household survey of the amman population that covered 1750 randomly selected households and was conducted in 1977. The study was confined to compulsory migration resulting from the events in Palestine in 1948 and from the occupation of the West Bank of Jordan in 1965 and to voluntary internal migration arising from the lack of equal social and economic opportunities in different parts of the country. The 1977 survey, which covered 1355 households that had migrated to Amman, revealed that 703 were refugee households, representing the equivalent of 52% of all migrant households. The occupation of Palestine in 1948 led to a sharp influx of refugees to Amman with refugees making up 34.4% of the total number of migrants to Amman. In 1967 refugees from Gaza and the West Bank constituted 59.2% of the total number of migrants to Amman. Around 23% of all refugees are refugees for the 2nd time. Most of the refugees went directly to Amman with only a small minority (14%) moving to the city in stages, and most of these were 1948 refugees. The size and trend of migration to Amman was linked to a great extent, to the movement of refugees, which represented more than 1/2 of the migration to the city. The occupation of Palestine in 1948 led to the concentration of economic activities in the East Bank of Jordan. This meant migration east as far as the refugees from occupied Palestine and the migrants from the West Bank were concerned. As a consequence, Amman became the major attraction. The sample icluded 532 households that had migrated internally to Amman. It represented the voluntary migration to Amman from the

Health and socio-demographic profile of women of reproductive age in rural communities of southern Mozambique

PubMed Central

Sacoor, Charfudin; Payne, Beth; Augusto, Orvalho; Vilanculo, Faustino; Nhacolo, Ariel; Vidler, Marianne; Makanga, Prestige Tatenda; Munguambe, Khátia; Lee, Tang; Macete, Eusébio; von Dadelszen, Peter; Sevene, Esperança

2018-01-01

Reliable statistics on maternal morbidity and mortality are scarce in low and middle-income countries, especially in rural areas. This is the case in Mozambique where many births happen at home. Furthermore, a sizeable number of facility births have inadequate registration. Such information is crucial for developing effective national and global health policies for maternal and child health. The aim of this study was to generate reliable baseline socio-demographic information on women of reproductive age as well as to establish a demographic surveillance platform to support the planning and implementation of the Community Level Intervention for Pre-eclampsia (CLIP) study, a cluster randomized controlled trial. This study represents a census of all women of reproductive age (12–49 years) in twelve rural communities in Maputo and Gaza provinces of Mozambique. The data were collected through electronic forms implemented in Open Data Kit (ODK) (an app for android based tablets) and household and individual characteristics. Verbal autopsies were conducted on all reported maternal deaths to determine the underlying cause of death. Between March and October 2014, 50,493 households and 80,483 women of reproductive age (mean age 26.9 years) were surveyed. A total of 14,617 pregnancies were reported in the twelve months prior to the census, resulting in 9,029 completed pregnancies. Of completed pregnancies, 8,796 resulted in live births, 466 resulted in stillbirths and 288 resulted in miscarriages. The remaining pregnancies had not yet been completed during the time of the survey (5,588 pregnancies). The age specific fertility indicates that highest rate (188 live births per 1,000 women) occurs in the age 20–24 years old. The estimated stillbirth rate was 50.3/1,000 live and stillbirths; neonatal mortality rate was 13.3/1,000 live births and maternal mortality ratio was 204.6/100,000 live births. The most common direct cause of maternal death was eclampsia and

Surgical Care of Pediatric Patients in the Humanitarian Setting: The Médecins Sans Frontières Experience, 2012-2013.

PubMed

Trudeau, Maeve O'Neill; Baron, Emmanuel; Hérard, Patrick; Labar, Amy S; Lassalle, Xavier; Teicher, Carrie Lee; Rothstein, David H

2015-11-01

Little is known about the scope of practice and outcomes in pediatric surgery performed by humanitarian organizations in resource-poor settings and conflict zones. This study provides the largest report to date detailing such data for a major nongovernmental organization providing humanitarian surgical relief support in these settings. To characterize pediatric surgical care provision by a major nongovernmental organization in specialized humanitarian settings and conflict zones. A retrospective cohort study was conducted from August 15, 2014, to March 9, 2015, of 59,928 surgical interventions carried out from January 1, 2012, to December 31, 2013, by the Médecins Sans Frontières Operational Centre Paris (MSF-OCP) program in 20 locations, including South Sudan, Yemen, Syria, Gaza, Pakistan, Nigeria, Central African Republic, Democratic Republic of Congo, and the Philippines. Surgical interventions were primarily for general surgical, traumatic, and obstetric emergencies and were categorized by mechanism, type of intervention, American Society of Anesthesia risk classification, and urgency of intervention. Operative indications, type of intervention, and operative case mortality. Among all age groups, 59,928 surgical interventions were performed in dedicated trauma, obstetric, and reconstructive centers for 2 years. Nearly one-third of interventions (18,040 [30.1%]) involved preteen patients (aged <13 years) and 4571 (7.6%) involved teenaged patients (aged 13-17 years). The proportion of violence-related injuries in the preteen group was significantly lower than in the teenage group (4.8% vs 17.5%; P < .001). Burns (50.1%), other accidental injuries (16.4%), and infections (23.4%) composed the bulk of indications in the preteen group. Interventions in the teenage group were principally caused by trauma-related injuries (burns, 22.9%; traffic accidents, 10.1%; gunshot wounds, 8.0%). Crude perioperative case mortality rates were 0.07% in the preteen group, 0

Health and socio-demographic profile of women of reproductive age in rural communities of southern Mozambique.

PubMed

Sacoor, Charfudin; Payne, Beth; Augusto, Orvalho; Vilanculo, Faustino; Nhacolo, Ariel; Vidler, Marianne; Makanga, Prestige Tatenda; Munguambe, Khátia; Lee, Tang; Macete, Eusébio; von Dadelszen, Peter; Sevene, Esperança

2018-01-01

Reliable statistics on maternal morbidity and mortality are scarce in low and middle-income countries, especially in rural areas. This is the case in Mozambique where many births happen at home. Furthermore, a sizeable number of facility births have inadequate registration. Such information is crucial for developing effective national and global health policies for maternal and child health. The aim of this study was to generate reliable baseline socio-demographic information on women of reproductive age as well as to establish a demographic surveillance platform to support the planning and implementation of the Community Level Intervention for Pre-eclampsia (CLIP) study, a cluster randomized controlled trial. This study represents a census of all women of reproductive age (12-49 years) in twelve rural communities in Maputo and Gaza provinces of Mozambique. The data were collected through electronic forms implemented in Open Data Kit (ODK) (an app for android based tablets) and household and individual characteristics. Verbal autopsies were conducted on all reported maternal deaths to determine the underlying cause of death. Between March and October 2014, 50,493 households and 80,483 women of reproductive age (mean age 26.9 years) were surveyed. A total of 14,617 pregnancies were reported in the twelve months prior to the census, resulting in 9,029 completed pregnancies. Of completed pregnancies, 8,796 resulted in live births, 466 resulted in stillbirths and 288 resulted in miscarriages. The remaining pregnancies had not yet been completed during the time of the survey (5,588 pregnancies). The age specific fertility indicates that highest rate (188 live births per 1,000 women) occurs in the age 20-24 years old. The estimated stillbirth rate was 50.3/1,000 live and stillbirths; neonatal mortality rate was 13.3/1,000 live births and maternal mortality ratio was 204.6/100,000 live births. The most common direct cause of maternal death was eclampsia and tuberculosis

Barriers and facilitators to health care seeking behaviours in pregnancy in rural communities of southern Mozambique.

PubMed

Munguambe, Khátia; Boene, Helena; Vidler, Marianne; Bique, Cassimo; Sawchuck, Diane; Firoz, Tabassum; Makanga, Prestige Tatenda; Qureshi, Rahat; Macete, Eusébio; Menéndez, Clara; von Dadelszen, Peter; Sevene, Esperança

2016-06-08

In countries, such as Mozambique, where maternal mortality remains high, the greatest contribution of mortality comes from the poor and vulnerable communities, who frequently reside in remote and rural areas with limited access to health care services. This study aimed to understand women's health care seeking practices during pregnancy, taking into account the underlying social, cultural and structural barriers to accessing timely appropriate care in Maputo and Gaza Provinces, southern Mozambique. This ethnographic study collected data through in-depth interviews and focus group discussions with women of reproductive age, including pregnant women, as well as household-level decision makers (partners, mothers and mothers-in-law), traditional healers, matrons, and primary health care providers. Data was analysed thematically using NVivo 10. Antenatal care was sought at the heath facility for the purpose of opening the antenatal record. Women without antenatal cards feared mistreatment during labour. Antenatal care was also sought to resolve discomforts, such as headaches, flu-like symptoms, body pain and backache. However, partners and husbands considered lower abdominal pain as the only symptom requiring care and discouraged women from revealing their pregnancy early in gestation. Health care providers for pregnant women often included those at the health facility, matrons, elders, traditional birth attendants, and community health workers. Although seeking care from traditional healers was discouraged during the antenatal period, they did provide services during pregnancy and after delivery. Besides household-level decision-makers, matrons, community health workers, and neighbours were key actors in the referral of pregnant women. The decision-making process may be delayed and particularly complex if an emergency occurs in their absence. Limited access to transport and money makes the decision-making process to seek care at the health facility even more complex

Assessing the impacts of climate change in Mediterranean catchments under conditions of data scarcity

NASA Astrophysics Data System (ADS)

Meyer, Swen; Ludwig, Ralf

2013-04-01

According to current climate projections, Mediterranean countries are at high risk for an even pronounced susceptibility to changes in the hydrological budget and extremes. While there is scientific consensus that climate induced changes on the hydrology of Mediterranean regions are presently occurring and are projected to amplify in the future, very little knowledge is available about the quantification of these changes, which is hampered by a lack of suitable and cost effective hydrological monitoring and modeling systems. The European FP7-project CLIMB is aiming to analyze climate induced changes on the hydrology of the Mediterranean Basins by investigating 7 test sites located in the countries Italy, France, Turkey, Tunisia, Gaza and Egypt. CLIMB employs a combination of novel geophysical field monitoring concepts, remote sensing techniques and integrated hydrologic modeling to improve process descriptions and understanding and to quantify existing uncertainties in climate change impact analysis. The Rio Mannu Basin, located in Sardinia; Italy, is one test site of the CLIMB project. The catchment has a size of 472.5 km2, it ranges from 62 to 946 meters in elevation, at mean annual temperatures of 16°C and precipitation of about 700 mm, the annual runoff volume is about 200 mm. The physically based Water Simulation Model WaSiM Vers. 2 (Schulla & Jasper (1999)) was setup to model current and projected future hydrological conditions. The availability of measured meteorological and hydrological data is poor as common to many Mediterranean catchments. The lack of available measured input data hampers the calibration of the model setup and the validation of model outputs. State of the art remote sensing techniques and field measuring techniques were applied to improve the quality of hydrological input parameters. In a field campaign about 250 soil samples were collected and lab-analyzed. Different geostatistical regionalization methods were tested to improve the

Infiltration in layered loessial deposits: Revised numerical simulations and recharge assessment

NASA Astrophysics Data System (ADS)

Dafny, Elad; Šimůnek, Jirka

2016-07-01

The objective of this study is to assess recharge rates and their timing under layered loessial deposits at the edge of arid zones. Particularly, this study is focused on the case of the coastal plain of Israel and Gaza. First, results of a large-scale field infiltration test were used to calibrate the van Genuchten parameters of hydraulic properties of the loessial sediments using HYDRUS (2D/3D). Second, optimized soil hydraulic parameters were used by HYDRUS-1D to simulate the water balance of the sandy-loess sediments during a 25-year period (1990-2015) for three environmental conditions: bare soil, and soil with both sparse and dense natural vegetation. The best inverse parameter optimization run fitted the infiltration test data with the RMSE of 0.27 d (with respect to a moisture front arrival) and R2 of 96%. The calibrated model indicates that hydraulic conductivities of the two soil horizons, namely sandy loam and sandy clay loam, are 81 cm/d and 17.5 cm/d, respectively. These values are significantly lower than those previously reported, based on numerical simulations, for the same site. HYDRUS-1D simulation of natural recharge under bare soil resulted in recharge estimates (to the aquifer) in the range of 21-93 mm/yr, with an average recharge of 63 mm/yr. Annual precipitation in the same period varied between 100 and 300 mm/yr, with an average of 185 mm/yr. For semi-stabilized dunes, with 26% of the soil surface covered by local shrub (Artemisia monosperma), the mean annual recharge was 28 mm. For the stabilized landscape, with as much as 50% vegetation coverage, it was only 2-3 mm/yr. In other words, loessial sediments can either be a source of significant recharge, or of no recharge at all, depending on the degree of vegetative cover. Additionally, the time lag between specific rainy seasons and corresponding recharge events at a depth of 22 m, increased from 2.5 to 5 years, and to about 20 years, respectively, with an increasing vegetative cover. For

The protective role of maternal post-traumatic growth and cognitive trauma processing in Palestinian mothers and infants: a longitudinal study.

PubMed

Diab, Safwat Y; Isosävi, Sanna; Qouta, Samir R; Kuittinen, Saija; Punamäki, Raija-Leena

2018-02-21

Women at pre partum and post partum are especially susceptible to war trauma because they struggle to protect their infants from danger. Trauma research suggests increased problems in maternal mental health and infant development. Yet many cognitive-emotional processes affect the trauma survivors' mental health, such as post-traumatic growth and post-traumatic cognition. The aim of this study was to examine whether a mother's high post-traumatic growth and optimal post-traumatic cognition could protect their own mental health and their infant's stress regulation from the effects of traumatic war experiences. This three-wave prospective study involved Palestinian women living in the Gaza Strip who were at the second trimester of pregnancy (T1), women with infants aged 4 months (T2), and women with children aged 12 months (T3) months. The participants reported their war experiences in a 30-item checklist of losses, destruction, and atrocities in the 2008-09, 2012, and 2014 military offensives. Post-traumatic growth was assessed by a 21-item scale and post-traumatic cognition by a 36-item scale. Maternal mental health was assessed by post-traumatic stress disorder (PTSD), depressive, anxiety, and dissociation symptoms at T1 and T3, and infants' stress regulation was assessed with the Infant Behaviour Questionnaire at T2 and T3. We included 511 women at T1, 481 women at T2, and 454 women at T3. High maternal post-traumatic growth and post-traumatic cognition had protective roles. Post-traumatic growth had a protective effect on maternal mental health since severe exposure to traumatic war experiences was not associated with maternal PTSD, depression, and dissociation if women showed high post-traumatic growth, as indicated by the significant interaction effect between post-traumatic growth and war trauma on each of the three symptoms. Post-traumatic cognition had a protective effect on infant development since severe exposure was not associated with dysfunctional

Global youth tobacco surveillance, 2000-2007.

PubMed

Warren, Charles W; Jones, Nathan R; Peruga, Armando; Chauvin, James; Baptiste, Jean-Pierre; Costa de Silva, Vera; el Awa, Fatimah; Tsouros, Agis; Rahman, Khalil; Fishburn, Burke; Bettcher, Douglas W; Asma, Samira

2008-01-25

Tobacco use is a major contributor to deaths from chronic diseases. The findings from the Global Youth Tobacco Survey (GYTS) suggest that the estimate of a doubling of deaths from smoking (from 5 million per year to approximately 10 million per year by 2020) might be an underestimate because of the increase in smoking among young girls compared with adult females, the high susceptibility of smoking among never smokers, high levels of exposure to secondhand smoke, and protobacco indirect advertising. This report includes GYTS data collected during 2000-2007 from 140 World Health Organization (WHO) member states, six territories (American Samoa, British Virgin Islands, Guam, Montserrat, Puerto Rico, and the U.S. Virgin Islands), two geographic regions (Gaza Strip and West Bank), one United Nations administered province (Kosovo), one special administrative region (Macau), and one Commonwealth (Northern Mariana Islands). For countries that have repeated GYTS, only the most recent data are included. For countries with multiple survey sites, only data from the capital or largest city are presented. GYTS is a school-based survey of a defined geographic site that can be a country, a province, a city, or any other geographic entity. GYTS uses a standardized methodology for constructing sampling frames, selecting schools and classes, preparing questionnaires, conducting field procedures, and processing data. GYTS standard sampling methodology uses a two-stage cluster sample design that produces samples of students in grades associated with students aged 13-15 years. Each sampling frame includes all schools (usually public and private) in a geographically defined area containing any of the identified grades. In the first stage, the probability of schools being selected is proportional to the number of students enrolled in the specified grades. In the second sampling stage, classes within the selected schools are selected randomly. All students in selected classes attending