An-Najah National University Research Articles

Challenges Faced in Distance Learning by Palestinian University Students during the COVID-19 Pandemic: A Student Perspective Study at An-Najah National University and Palestinian Technical University (Khadoury)

This study aimed to explore the challenges faced by Palestinian university students during distance learning in light of the COVID-19 pandemic from the student's perspective. To achieve this goal, the two researchers utilized a questionnaire consisting of 43 items distributed across three domains of challenges (academic, technical, and behavioral). The study was conducted on a random sample comprising 182 students (both male and female) from both universities. The research identified the most crucial challenges faced by university students during the pandemic, which include academic, technical, and behavioral challenges. The study revealed statistically significant differences, at the (α=0.05) significance level, in the degree of challenges faced by university students during distance learning amidst the COVID-19 pandemic, as perceived by the students. These differences were attributed to the variable of gender, favoring females, the university variable, favoring Palestinian Technical University, the academic level variable, favoring diploma students, and the college variable, favoring scientific colleges. In light of the study's results, the researchers have provided a set of recommendations.

Medicine and Pharmacy Students' Knowledge, Attitudes, and Practice regarding Artificial Intelligence Programs: Jordan and West Bank of Palestine.

Artificial intelligence (AI) programs generate responses to input text, showcasing their innovative capabilities in education and demonstrating various potential benefits, particularly in the field of medical education. The current knowledge of health profession students about AI programs has still not been assessed in Jordan and the West Bank of Palestine (WBP). This study aimed to assess students' awareness and practice of AI programs in medicine and pharmacy in Jordan and the WBP. This study was in the form of an observational, cross-sectional survey. A questionnaire was electronically distributed among students of medicine and pharmacy at An-Najah National University (WBP), Al-Isra University (Jordan), and Al-Balqa Applied University (Jordan). The questionnaire consisted of three main categories: sociodemographic characteristics of the participants, practice of AI programs, and perceptions of AI programs, including ChatGPT. A total of 321 students responded to the distributed questionnaire, and 261 participants (81.3%) stated that they had heard about AI programs. In addition, 135 participants had used AI programs before (42.1%), while less than half the participants used them in their university studies (44.2%): for drug information (44.5%), homework (38.9%), and writing research articles (39.3%). There was significantly (48.3%, P<0.005) more conviction in the use of AI programs for writing research articles among pharmacy students from Palestine compared to Jordan. Lastly, there was significantly more (53.8%, P<0.05) AI program use among medicine students than pharmacy students. While most medicine and pharmacy students had heard about AI programs, only a small proportion of the participants had used them in their medical study. In addition, attitudes and practice related to AI programs in their education differs between medicine and pharmacy students and between WBP and Jordan.

Nosocomial infections in the surgical intensive care unit: an observational retrospective study from a large tertiary hospital in Palestine

BackgroundNosocomial infections or hospital-acquired infections are a growing public health threat that increases patient morbidity and mortality. Patients at the highest risk are those in intensive care units. Therefore, our objective was to provide a pattern analysis of nosocomial infections that occurred in an adult surgical intensive care unit (ICU).MethodsThis study was a retrospective observational study conducted in a 6-bed surgical intensive care unit (SICU) at An-Najah National University Hospital (NNUH) to detect the incidence of nosocomial infections from January 2020 until December 2021. The study group included 157 patients who received antibiotics during their stay in the SICU.ResultsThe incidence of nosocomial infections, either suspected or confirmed, in the SICU was 26.9% (95 out of 352 admitted patients). Pneumonia (36.8%) followed by skin and soft tissue infections (35.8%) were the most common causes. The most common causative microorganisms were in the following order: Pseudomonas aeruginosa (26.3%), Acinetobacter baumannii (25.3%), extended-spectrum beta lactamase (ESBL)-Escherichia coli (23.2%) and Klebsiella pneumonia (15.8%). The average hospital stay of patients with nosocomial infections in the SICU was 18.5 days.ConclusionsThe incidence of nosocomial infections is progressively increasing despite the current infection control measures, which accounts for an increased mortality rate among critically ill patients. The findings of this study may be beneficial in raising awareness to implement new strategies for the surveillance and prevention of hospital-acquired infections in Palestinian hospitals and health care centers.

A comparative simulation between monofacial and bifacial PV modules under palestine conditions

During the last period, solar energy gained a lot of attraction and is expected to be the replacement for non-renewable energy due to its great potential and advantages, one of these advantages is that solar energy is scalable, which means it can be used on an industrial scale or lesser, another advantage is that solar energy is a clean source, this means it causes no pollution to the environment, in addition, solar energy is the future, as its cost is going down and non-renewable energy is becoming more and more expensive. This project aims to conduct a comparative analysis of the performance of bifacial and monofacial solar panels under diverse conditions. The investigation involves examining the influence of varying albedo levels and the type of surface beneath the PV panels, including sand, white paint, black asphalt, or artificial grass. The renowned software tool PVsyst will be employed to simulate and analyze PV systems. The location selected for this study is An-Najah National University in Nablus, Palestine. The PV panels will be oriented towards the true south, and a tilt angle of 28˚ will be employed. Through meticulous simulations and thorough analysis, this research seeks to provide comprehensive insights into the contrasting performance characteristics of bifacial and monofacial solar panels across different environmental contexts. The ultimate objective is to contribute valuable knowledge regarding the suitability and optimal utilization of these PV technologies. The study aims to evaluate and compare the electrical output, energy yield, and overall performance of bifacial and monofacial solar panels under different scenarios. The project will analyze factors such as the energy gain achieved by the bifacial panels due to rear-side irradiance reflection, the impact of albedo on the performance of bifacial panels, and the influence of shading on both panel types.

Epidemiology and clinical characteristics of patients with carbapenem-resistant enterobacterales infections: experience from a large tertiary care center in a developing country

BackgroundCarbapenem-resistant Enterobacterales (CREs) are a significant source of healthcare-associated infections. These bacteria are difficult to treat and have a high mortality rate due to high rates of antibiotic resistance. These pathogens are also linked to major outbreaks in healthcare institutions especially those with limited resources in infection prevention and control (IPC). Therefore, our study aimed to describe the epidemiology and clinical characteristics of patients with carbapenem-resistant Enterobacteriaceae in a referral hospital in a developing country.MethodsThis was a retrospective cross-sectional study that included 218 patients admitted to An-Najah National University Hospital between January 1, 2021, and May 31, 2022. The target population was all patients with CRE infection or colonization in the hospital setting.ResultsOf the 218 patients, 135 had CR-Klebsiella pneumoniae (61.9%), and 83 had CR-Escherichia coli (38.1%). Of these, 135 were male (61.9%) and 83 were female (38.1%), with a median age of 51 years (interquartile range 24–64). Malignancy was a common comorbidity in 36.7% of the patients. Approximately 18.3% of CRE patients were obtained from patients upon admission to the emergency department, the largest percentage among departments. Most CRE pathogens were isolated from rectal swabs, accounting for 61.3%. Among the 218 patients, colistin was the most widely used antimicrobial agent (13.3%). CR- E. coli showed resistance to amikacin in 23.8% of the pathogens tested and 85.7% for trimethoprim/sulfamethoxazole compared to CR- K. pneumonia, for which the resistance to trimethoprim/sulfamethoxazole was 74.1%, while for amikacin it was 64.2%. Regarding meropenem minimum inhibitory concentration, 85.7% of CR- E. coli were greater than 16 µg/mL compared to 84% of CR- K. pneumonia isolates.ConclusionThis study found that CRE is frequently reported in this tertiary care setting, implying the presence of selective pressure and transmission associated with healthcare setting. The antibiotics tested showed a variety of resistance rates, with CR-K. pneumoniae being more prevalent than CR-E. coli, and exhibiting an extremely high resistance pattern to the available therapeutic options.

Factors associated with palliative care symptoms in cancer patients in Palestine

Palliative care is critical to redundancy in cancer patients seeking to improve their quality of life. Evaluation should be incorporated into clinical practice routines at all stages of cancer. The Edmonton Symptom Assessment System (ESAS) was used to rate the intensity of ten symptom evaluations designed and validated for cancer patients in various languages and cultures. Therefore, the study aims to assess the symptoms reported using ESAS scores to identify patients who would benefit from palliative care that can improve the integration of palliative care into standard cancer care at An-Najah National University Hospital (NNUH). A cross-sectional study was selected for 271 cancer patients using a convenience sampling method at NNUH. Demographic, clinical, and lifestyle characteristics are described. Furthermore, patients' moderate to severe symptoms (score > 4) were obtained using ESAS-R. The survey consisted of 271 patients, with a response rate of 95%. The average age of the patients was 47 ± 17.7 years, ranging from 18 to 84 years. The male-to-female ratio was approximately 1:1, 59.4% of the patients were outpatients, and 153 (56.5%) had hematologic malignancies. Fatigue (62.7%) and drowsiness (61.6%) were the most common moderate to severe symptoms in ESAS. Furthermore, pain (54.6%), nausea (40.2%), lack of appetite (55.0%), shortness of breath (28.5%), depression (40.6%), anxiety (47.2%) and poor well-being (56.5%) were reported. In conclusion, fatigue and drowsiness were the most reported symptoms according to the ESAS scale among cancer patients, while moderate to severe symptoms were reported in cancer patients using the ESAS. The ESAS is a functional tool for assessing cancer patients' symptoms and establishing palliative care services.

Effect of growth regulators and colchicine on regeneration of two potato cultivars in vitro

The effect of different levels of Benzyl adenine (BA) and Naphthalene acetic acid (NAA) on in vitro regeneration of Spunta and Mondial potato cultivars were studied, in addition, the effect of different levels of colchicine administered either as part of MS media (0.0, 10 μ M, 100 μ M and 1 mM) or by soaking potato buds (0.0, 1, 2 and 3 mM) on in vitro regeneration of two potato cultivars was studied in the Faculty of Agriculture and Veterinary Medicine, An-Najah National University, Tulkarm, Palestine. Higher shoot number was obtained when BA at 1 and 2 ppm were combined with 0.5 ppm NAA or without NAA, with variation between the two cultivars. Root number was significantly affected with the hormone levels, higher root number per bud in Spunta cultivar was obtained when NAA was utilized exclusively at 1 and 0.5 ppm respectively, however with Mondial cultivar, the higher number was observed at 1 ppm NAA. Significant effect of colchicine on shoot multiplication in both cultivars was observed, higher average shoot number for both cultivars (3.25 and 3.07) was recorded when higher level of colchicine ( 1mM and 100 μ M) was added to the media for “Spunta’ and “Mondial” respectively. When potato buds were soaked in colchicine, no significant effect on regeneration ability of the two cultivars was observed. Our results indicated a positive effect of colchicine on in vitro regeneration of two potato cultivars, therefore, protocols of polypolidization of potato through in vitro culture could be implemented.

Cancer-related post-treatment pain and its impact on treatment satisfaction with medication in women with breast cancer: a cross-sectional study from Palestine.

Pain after therapy is an important clinical problem in patients with breast cancer. Unfortunately, cancer patients have a lower quality of life due to inadequate treatment of posttreatment pain; therefore, improving medication management plans and palliative care has become one of the most important targets of cancer therapy. Therefore, the current study aimed to examine the impact of posttreatment pain on medication satisfaction in patients with various stages of breast cancer in Palestine. A cross-sectional analytical study was conducted et al.-Watani Hospital and An-Najah National University Hospital in the Nablus area. Using the Brief Pain Inventory (BPI), the intensity and interference of pain were evaluated. In addition, patients' satisfaction with cancer management medications was measured using the Treatment Satisfaction Questionnaire for Medication (TSQM). Two hundred fifty-four patients were included in this study. All were women, with a mean ± SD age of 53.1 ± 10.7years. The median score for pain severity was 7.0. Pain in the lower extremities was the most reported location. There was a negative association between the global satisfaction domain and the presence of posttreatment pain (p < 0.001). Furthermore, significant differences and negative correlations were found between global satisfaction and posttreatment pain on the day of the interview (p = 0.001), pain medication (p < 0.001), paracetamol use (p < 0.001), and the presence of side effects (p = 0.003). There were significant negative correlations (p < 0.05) between pain severity and interference with effectiveness (r = -0.258, -0.319, respectively), side effects (r = -0.414, -0.514, respectively), convenience (r = -0.274, -0.307, respectively), and global satisfaction domain scores (r = -0.293, -0.287, respectively). Exposure to chemotherapy was the only significant positive correlation with global satisfaction (p = 0.007). The regression analysis results indicated an independent association between chemotherapy use and a higher global satisfaction score (p = 0.011). Patients with posttreatment pain, side effects, and greater interference of pain with their functioning had lower satisfaction scores. Therefore, better management of their treatment medications, side effects, and pain medications is recommended to enhance their satisfaction and quality of life. Several aspects of palliative care should be organized to improve the patient's satisfaction and quality of life in addition to conducting longitudinal studies to evaluate the pain and satisfaction of different types of cancers.

Level of Knowledge and Extent of Use of Anabolic-Androgenic Steroids among Physical Education University Students: A Cross-Sectional Study from Palestine

Background: Androgenic-anabolic steroids (AAS) use has increased in the last years, especially among athletes, due to their effect on body shape and performance. These agents could have serious side effects among this highly susciptable population.&#x0D; Methods: Cross-sectional study that included physical education students at An-Najah National University over the period of November 2020 to January 2021, using an electronic questionnaire. The main outcome was to measure the level of knowledge and use of AAS.&#x0D; Results: A total of 380 students were included. The mean age of the students was 21 years (SD= 4.2), and study participants were distributed almost equally according to sex. About one fourth of the students were smokers. Eighty percent of the study participants are from West Bank while the remaining 20 % are from Jerusalem and 48 territories. Furthermore, most of the students live with their families, half of them live in cities, while about 40% live in villages and only 8% in camps. The average level of knowledge about AAS was 2.95 over 8 (37/100) with a median of three. Furthermore, only 36 (10%) participants had satisfactory knowledge, scoring 80% or more. Regarding the use of AAS, eleven participants (2.9%), all males, confirmed that they are currently using AAS. Additionally, about 28 (7%) had previously used them while 30 (8%) are planning to try them in the future. Overall, 221(58%) confirmed using vitamins and minerals.&#x0D; Conclusion: Our study showed that the majority of participants have a substantial lack of information regarding the potential side-effects of AAS while the level of use is comparable with other populations.

Spectrum and Antibiotic Resistance in the Community and Hospital-Acquired Urinary Tract Infected Adults

Background: Urinary tract infection (UTI) is the most common infection in the community. The causative agents and antibiotic resistance differ between community-acquired and hospital-acquired urinary tract infections.&#x0D; Objectives: This study aimed at identifying the etiologic agents in both community-acquired as well as hospital-acquired urinary tract infections and to determine the antibiotic resistance pattern of the most frequent organisms.&#x0D; Methods: This is a retrospective cross sectional study of positive urine cultures of adult patients attending An-Najah National University Hospital (NNUH) between the period of Jan 2019 and Dec 2020.&#x0D; Each patient’s age, sex, and urine culture results were obtained from the microbiology lab of NNUH. Microbiology reports included the isolated microorganisms and their antibiotic susceptibility patterns.&#x0D; Results: A total of 798 patients were included in the study, of which 472 (59.1%) were female. Escherichia coli was the most common uropathogen, accounting for 37.8% of the CAUTI and 25.1% of the HAUTI. In CAUTI, E. coli was followed by E. faecalis (16.4%), Klebsiella pneumoniae (13.7%), E. faecium (6.5%), and Streptococcus agalactia (4.9%). Among HAUTIs, the second most common was Klebsiella pneumoniea (21.4%) followed by E. faecium (19.3%), E. faecalis (13.4%), and Pseudomonas aeruginosa (7%). The rates of ESBL-producing strains of E. coli were similar between CAUTI (54.1%) and HAUTI (53.2%).&#x0D; &#x0D; coli from CAUTI and HAUTI was sensitive to carbapenems, amikacin, and nitrofurantoin. The antibiotics with the highest resistance rates were ampicillin, cefuroxime, cotrimoxazole, and ciprofloxacin. Resistance rates were higher in HAUTI than in CAUTI.&#x0D; &#x0D; Conclusions: The UTI etiological profiles and antibiotic resistance patterns varied between CAUTI and HAUTI; thus, a different antibiotic therapy for various categories should be considered when initiating empirical antimicrobial therapies.

Blood culture contamination in a tertiary care hospital: a retrospective three-year study

BackgroundBloodstream infections (BSI) are a leading cause of morbidity and mortality in hospitalized patients worldwide. A blood culture is the primary tool for determining whether a patient has BSI and requires antimicrobial therapy, but it can result in an inappropriate outcome if the isolated microorganisms are deemed contaminants from the skin. Despite the development of medical equipment and technology, there is still a percentage of blood culture contamination. The aims of this study were to detect the blood culture contamination (BCC) rate in a tertiary care hospital in Palestine and to identify the departments with the highest rates along with the microorganisms isolated from the contaminated blood samples.MethodBlood cultures that were taken at An-Najah National University Hospital between January 2019 and December 2021 were evaluated retrospectively. Positive blood cultures were classified as either true positives or false positives based on laboratory results and clinical pictures. Statistical analysis was performed using the Statistical Package for Social Sciences (SPSS) version 21. A p-value of less than 0.05 was considered statistically significant for all analyses.ResultsOut of 10,930 blood cultures performed in the microbiology laboratory from 2019 to 2021, 1479 (13.6%) were identified as positive blood cultures that showed microbial growth. Of these, 453 were blood culture contaminations, representing 4.17% of total blood cultures and 30.63% of the positive blood culture samples. The highest rate of contamination was in the hemodialysis unit (26.49%), followed by the emergency department (15.89%). Staphylococcus epidermidis was the most prevalent (49.2%), followed by Staphylococcus hominis (20.8%) and Staphylococcus haemolyticus (13.2%). The highest annual contamination rate was observed in 2019 (4.78%) followed by 2020 (3.95%) and the lowest was in 2021 (3.79%). The rate of BCC was decreasing, although it did not reach statistically significant levels (P value = 0.085).ConclusionThe rate of BCC is higher than recommended. The rates of BCC are different in different wards and over time. Continuous monitoring and performance improvement projects are needed to minimize blood culture contamination and unnecessary antibiotic use.

Exploring Anatomical Variations of Abdominal Arteries Through Computed Tomography: Classification, Prevalence and Implications.

Variations in the branches of the abdominal aorta are relatively prevalent and can impact certain surgeries. The accurate identification and differentiation of these variations pre- and intraoperatively are crucial to avoid negative clinical sequelae. This study aimed to investigate the prevalence of variations in some branches of the abdominal aorta and to identify the most frequent variantsas well as any rare variants not previously classified in the existing classification systems.The study's findings may help improve the understanding and management of these variations. This retrospective study was conducted at the Department of Radiology at An-Najah National University Hospital (NNUH) and included 550 abdominal computed tomography (CT) angiographic scans for patients (51.5% males, 48.5% females) performed between January 2017 and January 2023. Variations were most common in the hepatic arteries (34.7%), followed by the renal arteries (31.3%). Variations in the celiac trunk were the least frequent (9.8%). The gastro-splenic trunk (type V) was the most common celiac trunk variant. The most common hepatic artery variant was the replacement of the right hepatic artery (type III). Accessory renal arteries were more frequent on the left side and among males (P = 0.01). The celiac trunk variations had a significant association with the hepatic artery variations (P = 0.001) and the renal artery variations (P = 0.011), respectively. There is a high prevalence of anatomical variations in the described vessels, and it matches the results in the reported literature. Our findings also suggest the possible coexistence of variants. We have also encountered rare variants, especially in the hepatic arterial system. Some of the hepatic arterial system variants are not included in the older classification systems, calling for an extension of the old systems (Michel's and Hiatt classification systems) or replacement with the newer (CRL or EX-CRL classification systems) to account for rare variants not previously classified. Radiologists and surgeons should be proficient in identifying and differentiating these variations to take precautions and actions for each variant individually.

English

Teaching conversation skills is a difficult task for teachers and requires careful attention when selecting the textbook that best suits learners&#39; needs and interests in addition to their different learning dispositions. This study proposes a system for analyzing the content of the conversation English textbook for second-year undergraduate students in An-Najah National University according to five major rubrics: topic consistency, frequency of drill use, type of syllabus, self-expressing activities, and the appropriate type of language they use. These rubrics, which include the different learning dispositions, determine the appropriateness or the inappropriateness of the textbook used for teaching oral communication depending on the level of existence or absence in the textbook. After analyzing the content of the conversation textbook, it was found that it lacks creative and interactive activities. Besides, it is revealed that there are not enough exercises to practise the language naturally and authentically. Based on these results, the researcher recommended specialists and conversation textbook designers to include adequate role-playing activities and problem-solving activities that enhance students&#39; interaction, motivation and develop their speaking ability in constructing further conversation textbooks. &nbsp; Key words: conversation English textbook, second-year undergraduate students, rubrics for analyzing oral communication, interactive activities.

Fostering a culture of qualitative research and scholarly publication in a leading university in the West Bank: a Palestinian-UK capacity-building collaboration

ABSTRACT Research practices in Arab universities, especially the use of qualitative methods, tend to fall behind international standards of excellence; hence, the relatively small number of qualitative journal articles published by Arab academics. Conducting research in Palestine is particularly problematic due to the continued Israeli occupation and its negative impact on Palestinian education. Certain cultural and historical factors pose further difficulties, specifically for qualitative researchers. To address the challenges with conducting qualitative research for its own staff and students, An-Najah National University (West Bank) collaborated with Coventry University (UK) to design and deliver a joint researcher-development programme on the uses of qualitative research methods, and the process and requirements of scholarly publication. Whilst implementing the programme, the team of British and Palestinian academics sought to examine the socio-cultural challenges of capacity-building between higher education institutions in the Global North and South – specifically in relation to qualitative research practice – and answer the question of how an equitable partnership between Global North and South institutions can be built. By engaging in Action Research, the North-South collaborators observed and analysed how Western researcher-development practices and assumptions were questioned, re-examined and adapted to give rise to a near-symmetrical relationship between the two institutions.

Assessment of epilepsy awareness, knowledge, and attitudes among preclinical and clinical medical students in the West Bank of Palestine

ObjectiveThe purpose of this research was to evaluate the level of epilepsy-related awareness, knowledge, and attitude exhibited by medical students at a specific medical school in Palestine, as well as the students' reactions to the treatment and social activities provided to patients with epilepsy. MethodsA cross-sectional, observational research of 306 medical students at An-Najah National University in the West Bank, Palestine, was conducted. We used a validated survey taken from previous publications. We split the medical students into preclinical (2nd and 3rd year) and clinical (4th, 5th, and 6th year) groups to see if there were significant differences in their awareness, knowledge, attitude, and their practices toward patients with epilepsy. Several elements, such as sociodemographics, awareness, knowledge, attitude, and practices regarding epilepsy, were included in the survey. The data were analyzed using the Statistical Package for the Social Sciences (SPSS) 29.0. Quantitative data were expressed as mean and standard deviation, whereas qualitative data as frequencies and percentages. The chi-square test was used to compare groups.Any P-value below 0.05 was considered statistically significant. ResultsIn general, clinical medical students exhibited better epilepsy awareness, knowledge, and attitude than preclinical students. Of note, 73.6% of clinical students believe epilepsy is a treatable disorder, compared to 44.6% of preclinical students (P-value < 0.001). Some students believe that depression/anxiety (39.6%), psychosis (35.7%), jinns (evil spirit) (7.8%), evil eye (5.8%), and punishment from God (4.5%) cause epilepsy. Clinical students were more likely than preclinical students to have rotated in a neurology clinic or department (40% vs. 4.6%, P-value < 0.001). In total, 95.5% of clinical students and 86.9% of preclinical students (P-value = 0.006) thought patients with epilepsy should marry. Clinical stage students were more likely than preclinical stage students to think that patients with epilepsy can have children (92.7% vs. 83.1%, P-value = 0.009). Preclinical stage students were more likely than clinical stage students to believe that students with epilepsy should not play sports (22.3% versus 13%, P-value = 0.030). Generally, there were no significant gender differences in awareness, knowledge, and attitudes. ConclusionThe study found that medical students knew little about epilepsy types, causes, triggers, and first aid. Negative attitudes toward people with epilepsy living alone and discrimination against people with epilepsy were also observed. Students' perceptions of this prevalent disease must be improved through educational programs that provide increased opportunities for clinical exposure to this condition as well as proper inclusion of epilepsy in the regular curriculum.

Impact of an antibiotic stewardship program on antibiotic utilization, bacterial susceptibilities, and cost of antibiotics

Antimicrobial misuse is a worldwide issue, and antimicrobial resistance is considered the most challenging aspect of health care. It has been reported that as much as 30–50% of antimicrobials prescribed in hospitals are deemed unnecessary or inappropriate. Antibiotic stewardship programs (ASPs) include policies that apply continuous management of judicious anti-infectious treatment in the clinical setting. Therefore, the objectives of this study were to evaluate the effect of ASPs on antibiotic consumption, the costs of antibiotic expenditure, and the sensitivity of antimicrobials. A retrospective, quasi-experimental study was performed to assess the effect of ASP at An-Najah National University Hospital, a tertiary care hospital in the West Bank, Palestine, over a period of 20 months before and 17 months after the implementation of the ASP. Data on antibiotic consumption were reported monthly as days of therapy per 1000 patient-days and monthly costs (USD/1000 patient-days). A total of 2367 patients who received one or more of the targeted antibiotics (meropenem, colistin and tigecycline) during their hospital stay were included in the study. They have split into two groups: 1710 patients in the pre-ASP group, and 657 patients in the post ASP group. The most significant reduction in DOT per 1000 patient-days was seen with tigecycline, with a percentage of change of − 62.08%. Furthermore, the mean cost of the three antibiotics decreased significantly by 55.5% in the post-ASP phase compared to the pre-ASP phase. After the implementation of ASP, there was a statistically significant increase in susceptibility to meropenem, piperacillin and piperacillin/tazobactam with respect to Pseudomonas aeruginosa. However, changes in mortality rates were not statistically significant (p = 0.057). ASP positively reduced costs and antimicrobial consumption, with no statistically significant effect on the overall mortality rate. However, a long-term evaluation of the ASP's impact is needed to conclude its lasting impact on infection-related mortality and antimicrobial susceptibility pattern.

Growing a peritoneal dialysis program in Palestine from zero to 178 patients in 5 years: a single-center experience

IntroductionKidney failure is rapidly rising in Palestine, as the number of patients receiving maintenance dialysis has quadrupled in the last 15 years. In this study, we share an overview of our experience growing a peritoneal dialysis (PD) program from zero to 178 patients in 5 years at An-Najah National University Hospital in Palestine, presenting some challenges and ways to overcome them.MethodsThis was a single-center retrospective study of patients treated with PD from November 2016 to December 2021. Demographic and clinical data were obtained for each patient. In addition, PD discontinuation, peritonitis, and mortality rates were calculated and presented as the primary patient outcomes.ResultsA total of 158 patients were eligible for the study. The mean age was 51.8 ± 16.4 years, and 53.8% of patients were male. Diabetic nephropathy was the most common cause of kidney failure. 63 episodes of peritonitis were diagnosed in 48 patients (30.4%) for a rate of 1 episode/ 38.2 patient-months (0.31 episodes/ patient-years). 20 patients had their PD treatment discontinued, mainly due to psychosocial reasons and infectious and mechanical complications. Death was the fate of 27 patients, with cardiovascular disease and COVID-19 being the two main causes.ConclusionThe outcomes of this experience proved favorable and showed that PD could serve as a viable option for kidney failure patients in Palestine. Moreover, this study can serve as an example for other places where circumstances are challenging to take the initiative of starting their PD programs.

Concept recognition deficiency among Palestinian learners of English vocabulary: cross-cultural communication

Inasmuch the process of learning English by Palestinian students is fraught with cultural linguistic gaps, this study pinpoints the notion that Palestinian learners of English, as a source language (SL), misinterpret or misperceive some English words or expressions that are SL-culture oriented, assuming their easiness and simplicity, thus dispensing of English dictionary consultation. The study demonstrates that, in many cases, Palestinian learners fall in the trap of an assumed understanding of some relatively straightforward and familiar English words or expressions, but, actually, due to a lack of appropriate exposure to English culture, these English-culture bound words or expressions become unconsciously conceptually misperceived by the learners. To this end, students of basic English courses, particularly Palestinian students of Remedial English at An-Najah National University, with two classes of a representative sample of eighty students, are the subjects of the study. The authors will test students’ awareness of some words or expressions that they think students deem to be of relative easiness, but, in point of fact, they are cross-culturally problematic in the authors’ own perspective. Apart from the few examples with cross-culturally problematic words or expressions the authors will provide, the majority of examples are from the Remedial English course. The study concludes that Palestinian learners of English vocabulary and expressions really get tricked by these ostensibly easy words, mainly due to a cultural gap; therefore, it provides recommendations that would bridge the gap and enhance understanding and accommodation of the other.

Content Analysis of Study Plans for Bachelor's Social Work in Palestinian Universities

The study aimed to analyze the content of study plans for bachelor’s Social Work programs in Palestinian universities, that is (The Islamic University, Al-Quds Open University, Al-Azhar University, Al-Aqsa University, An-Najah National University, Bethlehem University, Palestine Ahliya University, and Al-Quds University). In light of the quality standards set by the Ministry of Higher Education in Palestine, The study used the qualitative approach to analyze data through the (MAXQDA, 2020) qualitative analysis program, the study used a content analysis tool. Prepared by the researcher to analyze the content of the study plans. After making sure of its validity and reliability. The results of the study found that there is great homogeneity in the number of hours of the study plans for Bachelor's social work programs in Palestinian universities and that there is some homogeneity at the level of the field training courses, and courses of basic and secondary methods of social work, and general courses in the field of social work, while there was homogeneity between the study plans for the Bachelor's of social work programs in Palestinian universities at level of courses in the fields of social work.

Patterns of microbial resistance in bloodstream infections of hemodialysis patients: a cross-sectional study from Palestine

Bloodstream infections (BSIs) are a prominent cause of death and hospitalization among hemodialysis (HD) patients. The emergence of multidrug-resistant organisms (MDRO) is making the management of these infections more challenging. This study describes the clinical characteristics, microbial profiles and antibiotic resistance patterns in patients with BSIs. A retrospective cross-sectional study was conducted at An-Najah National University Hospital from January 2019 to December 2020. Clinical and demographic data regarding BSIs were collected from the hospital information system. Data regarding bacterial isolates and the antimicrobial resistance of BSIs were collected from the microbiology lab. Data were entered and analyzed using version 21 of the Statistical Package for Social Sciences program (IBM-SPSS). 111 BSIs occurred during the study period, with a rate of 1.5 infections per 100 patient-months. These patients had been on HD for the median duration of 747 (360, 1825) days and 62.2% had already had a BSI before the study period. 118 microorganisms were isolated; 99 (83.89%) were gram-positive and 19 (16.1%) were gram-negative. Among the gram-positive isolates, coagulase-negative staphylococci (CoNS) (88, 74.57%) were predominant. As for the gram-negative isolates, the most frequent were both Stenotrophomonas maltophilia and Escherichia coli, with five (4.23%) positive cultures each. Among the latter, two were Extended-Spectrum Beta-Lactamase producing (ESBL) (1.69%). The most frequently used empiric antibiotics were a combination of vancomycin and gentamicin (27%), followed by vancomycin alone (24.3%). Regarding gram-positive isolates, vancomycin was the most frequently used and effective antibiotic after cultures, whereas for gram-negative bacteria, it was found to be gentamicin. MDROs were defined as those resistant to at least one agent in three or more antimicrobial categories. 89 (75.4%) isolates were found to be MDRO, 85 (85.85%) gram-positive bacteria and 4 (21%) gram-negative bacteria. When comparing patients according to the type of vascular access, 66 (75%) infections with MDRO were found among patients with central venous catheters (CVCs). However, no statistically significant relationship was found between the type of vascular access and infection with MDRO (p = 0.523). MDRO cause a remarkably high proportion of BSIs in Palestinian patients. The results of this study support the empiric use of vancomycin and gentamicin to treat these infections. It is vital that health care providers prevent these infections via instituting and adhering to infection control policies in hemodialysis centers and providing proper antibiotic therapy of limited use and duration when necessary to avoid breeding resistance.