Northern Palestine Research Articles

Barriers faced by primary healthcare providers in addressing emergencies in the Northern region of Palestine before and during the Gaza war

IntroductionPhysicians working in primary health care (PHC) centers are the first contact for patients and expected to deal with emergencies. Emergency care training in PHC settings has been neglected globally, especially in low to middle income countries. Adequate preparation becomes especially important during periods of conflict. The study objectives are to identify the barriers facing PHC physicians when dealing with emergency cases in the northern region of Palestine during the current conflict.MethodsA cross-sectional study was conducted with 179 physicians working in the 10 PHC centers distributed among 5 northern governances in Palestine. The study period was from July through December 2023. Data were collected electronically using a self-administered questionnaire, which was adapted from a comprehensive literature review. The questionnaire’s internal validity was confirmed by a Cronbach’s alpha coefficient of [0.85], indicating high reliability.ResultsThe ages of the physicians ranged from 25 to 60 years, with a mean ± SD of 35.3 ± 8.15 years. A significant majority (91.6%) were not boarded in any specialty. Most physicians (85.5%) had attended Basic Life Support (BLS) courses, whereas 45.2% and 72% had never attended Advanced Cardiovascular Life Support (ACLS) or Advanced Trauma Life Support (ATLS) courses, respectively. Physicians with emergency department experience (P = 0.002) and those who had attended ACLS courses (P < 0.001) reported significantly higher perceived competence in managing emergency cases.ConclusionEmergency services at PHC centers in northern Palestine are operational but require significant enhancements. There is a critical need for increased availability of essential equipment, supplies, and medications. Additionally, implementing comprehensive training programs in emergency management, particularly ACLS, is essential to improve the competence and performance of PHC physicians in emergency situations.

An evaluation of nutritional impact symptoms and their association with reduced dietary intake in patients with solid tumors at tertiary care hospitals: a multicenter, cross-sectional study from Palestine

BackgroundNutritional impact symptoms (NISs) are proposed to be a key indicator of decreased dietary intake in patients with solid cancer. Cancer patients frequently experience NIS from the disease itself and from disease treatment side effects that impact oral and gastrointestinal health. Thus, this study aimed to investigate the association between NIS and dietary intake among cancer patients in the Nablus district, one of the largest districts in Palestine. This study also sought to identify the types of treatment and other factors related to dietary intake for solid cancer patients.MethodsA cross-sectional study was conducted between October 15, 2021, and October 15, 2022. The convenience sampling technique was used to recruit participants from two primary hospital campuses for cancer treatment in the entire region of Nablus Governorate in northern Palestine. To assess the patients, structured questionnaires completed by interviewers during face-to-face interviews with patients were used. The NIS was assessed using a checklist developed based on a literature review and clinical experience. Univariate and multivariate analyses were used to evaluate the correlations between sociodemographic variables and clinical variables and between the NIS and dietary intake. Multiple binary logistic regression analyses were also performed to determine the most influential variables, sociodemographic, clinical, and NIS, on dietary intake.ResultsData were collected from 290 patients with solid malignancies. The mean age of the participants was 55.04 ± 12.76 years. Multiple binary logistic regressions revealed that dry mouth (odds ratio (OR) = 3.742; 95% confidence interval (CI) = 1.800–7.780; p < 0.001), constipation (OR = 2.707; 95% CI = 1.113–6.581; p = 0.028), taste alteration (OR = 3.620; 95% CI = 1.752–7.481; p = 0.001), and feeling fullness (OR = 8.879; 95% CI = 2.982–26.441; p < 0.001) were significantly related to decreased dietary intake. Biological and hormonal treatments had an inverse association with dietary intake (OR = 0.372; 95% CI = 0.177–0.782; p = 0.009 and OR = 0.383; 95% CI = 0.168–0.874; p = 0.023, respectively).ConclusionsThis study revealed that many solid cancer patients have reduced food intake due to NIS, such as dry mouth and taste changes. These patients may be at risk of malnutrition. Healthcare professionals should consider these NISs to improve dietary plans and decide whether extra feeding support is needed. The results obtained indicate the need for further research focused on removing limitations in food consumption as an effect of treatment and appropriate nutritional strategies to prevent patient malnutrition.

Changing Capitalist Structures and Settler-Colonial Land Purchases in Northern Palestine, 1897–1922

AbstractBy tracing Zionist and German Templer efforts to buy arable private property in Palestine between 1897 and 1922, I show the ways in which the changing balance of Ottoman and Levantine forces over land and labor—as well as political and economic institutions and social structures—facilitated settler-colonialism in northern Palestine. In this article, I examine official records of the Ottoman state, Jewish organizations, and Levantine, Jewish, and Templer real estate papers. I argue that changing capitalist practices in northern Palestine, driven especially by interactions of Beirut-based companies with the changing global capitalist market, facilitated settler-colonialism in the region. Specifically, Ottoman state-sponsored violence during World War I increased peasant dispossessions in the fertile region of northern Palestine, already in progress since at least the mid-19th century, making settler colonies possible.

Assessment of Health-Related Quality of Life for Patients with Inflammatory Bowel Diseases in Palestine

Background: Inflammatory bowel disease (IBD) has a significant impact on quality of life (QoL). Disease activity has been suggested as an important indicator for QoL in patients with IBD. The aim of this study was to examine the association between disease activity and patient QoL.&#x0D; Methods: A correlation cross-sectional study was conducted from July 2017 to February 2018. We collected a convenience sample from three major hospitals in southern and northern Palestine. A disease-specific inflammatory bowel disease questionnaire (IBDQ) was used to examine QoL and the results were analyzed using SPSS version 20.&#x0D; Findings: 132 patients were involved in this study. The mean age was 34 years (SD 13) and 77 (58.3%) patients were men. Active disease had been reported in 81 participants (61.4%) in the previous six months. The average IBDQ scores were 150.72 ± 30.08. Emotional and bowel domains were more disrupted than other domains. Active disease was the major significant factor associated with IBD patients’ QoL in all-dimensional scores (p&lt;0.001). Regression analysis revealed that patients in remission (r2 = 0.436, p&lt;0.001), with high educational status (r2 =0.035, p=0.009) and using azathioprine (r2 =0.017, p=0.034) were independently associated with high QoL.&#x0D; Conclusions: This study showed a low QoL among Palestinian IBD patients compared to other countries, and identified a number of significant associated factors that should be considered when dealing with IBD.

Eternal Victory

Starting in the ninth century but gaining momentum the late tenth century Byzantium reclaimed its territories in the East: capturing Crete, Antioch, and northern Palestine. These victories were celebrated with triumphal processions in Constantinople. New chants were written specifically to be performed in the Great Church and the palatine chapels. Some of the poetry and music was composed by the emperor himself. Analyzing the melodic contour of some of these songs shows how they strategically used the acoustics of the dome to offer a glittering vision of power. And the same time, the figural mosaics in Hagia Sophia and in the palatine chapels gave an anthropomorphic concreteness to the experience of the divine in the reverberant sound. None of these figural programs survives. Yet, a monastery near Thebes (Greece), Hosios Loukas, preserves one of the most extensive Byzantine mosaic cycles. As this analysis will reveal, it channels the Constantinopolitan liturgy and enables us to explore how chant and figural images operated together to shape a vision of the resurgent empire.

CHALLENGES AND PROBLEMS WHICH ENCOUNTER STUDENTS OF BOARDING HOUSES IN BOARDING SCHOOLS: THE ISLAMIC INDUSTRIAL ORPHANAGE INSTITUTION IN JERUSALEM - A MODEL

The study concentrates on the importance of circulating the school visions and its management message in terms of achieving its goals and strategies. This study scope was limited to the orphan’s Islamic school as a population under this study, which is school that is considered one of the well-known boarding schools in the northern Palestine and mainly in Jerusalem, the school is monitored by the Palestinian Ministry of AL-Awqaf and Religious Affairs. As aforementioned above the study was developed to focus on the reality and life experienced by the boarding students in this school, whom joined the school for different reasons in which among them there are orphans, whether father or mother or both parents together, and officially registered in the Palestinian civil registry, and some of them are registered as a social status, which face many different family issues and social problems such as but not limited to: divorce, abandonment by parents. These students are officially registered in the Palestinian Ministry of Community Affairs, and some of them for other reasons of family poverty and others. Total number of internal students reached (35) students in the second semester of the academic year 2021-2022, in the period expanding from February until the period of preparing this research. in addition to the body supervising them to sustain their life. In order to achieve the objectives of this study, the researchers adopted the qualitative research methodology "case study”. Detailed description of the case (boarding students in the Dar Al-Aytam Islamic Industrial School) through the use of approved data collection tools such as type of studies, which are interviews (students, internal supervisors, administrative and teaching staff), context-based observations and analysis of permitted official documents, such as recordings Audio and video, official school publications and official records. This study attempted to answer the questions. The main points from the point of view of its participants are: 1- What does your presence in Dar Al-Aytam Islamic Industrial School offer you? 2- How did your presence in this school affect your social, educational and professional life? 3- What are the challenges and problems that you face in the Dar Al-Aytam Islamic Industrial School? In addition to the sub-questions that arose during the interviews and related to the societal and family context, where a representative number of boarding students of various age, social and family groups, supervisors, administrative staff and educational counselors were interviewed. According to the case study methodology, the names of those participants in the interviews will not be disclosed, and we will suffice to give the codes to the names. It is worth noting that this study came to further emphasize the role of this Institutions to stand by this category of society, especially in our Palestinian society. Keywords: The Islamic Industrial Orphanage Institution, Challenges and Problems

No evidence of Rift Valley fever antibodies in veterinarians and sheep in Northern Palestine.

Background and Aim:Rift Valley fever virus (RVFV) is a vector-borne virus that causes RVF in humans and ruminants. The clinical symptoms in humans and animals are non-specific and often misdiagnosed, but abortions in ruminants and high mortality in young animals are characteristic. Since the initial outbreak in the Rift Valley area in Kenya, the disease has spread to most African countries and the Middle East. The presence and epidemiological status of RVFV in humans and animals in Palestine are unknown. This study aimed to investigate the presence and risk factors for RVF seroprevalence in veterinarians, as occupational hazard professionals, and sheep, as highly susceptible animals, in Northern Palestine.Materials and Methods:A cross-sectional study was conducted. Data and blood samples of 280 Assaf sheep and 100 veterinarians in close occupational contact with sheep were collected between August and September 2020 using an indirect enzyme-linked immunosorbent assay.Results:No evidence of RVF antibodies was found in any human or animal sample.Conclusion:Our results suggest that RVFV has not circulated in livestock in Northern Palestine, yet. Surveillance and response capabilities and cooperation with the nearby endemic regions are recommended. The distribution of competent vectors in Palestine, associated with global climate change and the role of wild animals, might be a possible route for RVF spreading to Palestine from neighboring countries.

Molecular characterization of methicillin resistant Staphylococcus aureus isolated from hospitals environments and patients in Northern Palestine

&#x0D; BACKGROUND: Staphylococcus aureus (S. aureus) is considered one of the most common pathogen to humans. Infections caused by this mocroorganism can be acquired through both hospital and community settings. This study was carried out to investigate molecular characterization of MRSA strains isolated from the patients and their environment in two hospitals (Rafidia hospital and Thabet hospital) inNorthern Palestine, and to determine the clonal identity between these strains and their possible contribution to nosocomial infections.&#x0D; METHODS: Two hundred sixty five swabbed samples were collected from these hospitals, S. aureus was isolated, antibiotic resistant genes were Panton–Valentin leukocidin (PVL) gene were detected and SCCmec and spA were typed by PCR and/or sequencing.&#x0D; RESULTS: The prevalence of MRSA among S. aureus isolates was 29% and 8.2% in Rafidia hospital and Thabet hospital, respectively. All strains resistant to oxacilllin disk were carried mecA gene. Majority of strains (84.6%) carried SCCmec type II (n = 11), type IVa and non-typeable were also detected. In addition, PVL was detected in 2 (14.3%) clinical strains. ERIC PCR patterns revealed that 2 strains recovered from patient bed and nasal swab isolated from Thabet Hospital were nontypeable, spA typing showed that they belonged to type t386 and have identical DNA sequences. Other 2 clinical isolates were spa typed, one belonged to clone t044, while the other is new clone not exist in database.&#x0D; CONCLUSIONS: Results may give evidence that environmental contamination possibly contributing to nosocomial infections.&#x0D;

The Dialogue Method in Small Groups and Its Impact on The Achievement of Primary School Students From the teachers' point of view in schools in northern Palestine: أسلوب الحوار في المجموعات الصغيرة وأثره في تحصيل طلبة المرحلة الابتدائية من وجهة نظر المعلمين في مدارس شمال فلسطين

This study aimed to identify the effect of the dialogue method in small groups on the achievement of primary school students. The study targeted a community of primary school teachers in northern Palestine, and the sample includes approximately (70-100) male and female teachers, whom are selected according to the available sample. The data has been processed using the Statistical Package for Social Sciences (SPSS), where the tests included descriptive statistics; t-test for independent samples, one way Anova test, simple linear regression test and Cronbach's alpha coefficient. In order to achieve the objectives of the research, the researchers have used the descriptive survey method by adopting the form as a data collection tool, whereas the form will consist of; a consent to participate in the study, demographic data of the participants, as well as the questionnaire’s paragraphs and fields, which will be evaluated according to the five-point Likert scale. The study resulted to the presence of statistically significant differences between the averages of students' achievement; The use of the small group dialogue method has a positive effect in teaching, which may show the presence of differences between students in their academic achievement.

Health-related quality of life and treatment satisfaction in Palestinians with rheumatoid arthritis: a cross-sectional study

BackgroundStudying health-related quality of life (HRQoL) and treatment satisfaction have helped in understanding how to optimize rheumatoid arthritis (RA) treatment outcomes and find ways to alleviate signs and symptoms among patients.ObjectiveIn this study, our objective was to evaluate the association between satisfaction with care and HRQoL among RA patients from northern Palestine. In addition, this study also aimed to determine the associations between the clinical characteristics of patients with RA with treatment satisfaction and HRQoL.MethodsThis was a multicenter cross-sectional study conducted between July and October 2018. Patients with RA diagnosis who presented at rheumatology clinics were interviewed. The SF-36 short questionnaire was used to assess HRQoL and Treatment Satisfaction Questionnaire for Medication (TSQM) version 1.4 to assess treatment satisfaction among study groups. We use descriptive and comparative statistics to present the results.ResultsA total of 283 patients were included. Several sociodemographic and clinical characteristics were found to be associated with poor HRQoL scores and low treatment satisfaction. The physical component summary (PCS) was negatively associated with age, patients’ self-reported disease activity, duration of the disease, and the total number of medications taken by the patient, and was positively associated with educational background, employment, and household income. The mental component summary (MCS) was negatively associated with patients’ self-reported disease activity and the patient's total number of comorbid diseases. The number of comorbid diseases was negatively associated with effectiveness. All HRQoL subscales were significantly correlated with treatment satisfaction. The range of correlation with PCS was between 0.272 for convenience and 0.425 for side effects (p < 0.001). Similarly, the highest correlation with MCS was 0.458 for side effects, and the lowest was 0.337 for convenience (p < 0.001).ConclusionsThe current study found that HRQoL was significantly correlated with treatment satisfaction. Furthermore, the results of this study showed that HRQoL and treatment satisfaction are likely to be affected by sociodemographic and clinical characteristics. These results may be beneficial in clinical practice, mainly in the early treatment of patients with RA, at a stage where it is still possible to increase treatment satisfaction.

Exploring the factors influencing mobile technology integration in higher education

ABSTRACT This study proposed and tested an empirical model to examine the relationships between the factors influencing mobile technology integration in higher education from the students’ and faculty points of view. A sequential mixed method was used to meet the aim of the study. The findings of the qualitative phase were used to develop the quantitative instrument. The participants in the qualitative data collection were 39 students and faculty members. In addition, the participants were 300 graduate students from two large universities in northern Palestine. The findings of the study revealed that the proposed model helps in explaining factors affecting students’ mobile technology integration and exploring relationships between the factors. Furthermore, students’ attitudes and beliefs, the quality of service, patronisation, the cost of service and the instructors had a significant impact on students’ mobile technology integration in higher education.

Aflatoxin B1 contamination of wheat flour, coffee, and pistachios consumed in Northern Palestine

The objective of the present work was to investigate the levels of aflatoxin B1 (AFB1) in some commonly consumed food items (wheat flour, roasted coffee beans, and pistachios) at the markets of Palestine. The samples were collected from the cities in the Northern West Bank (Nablus, Tulkarm, and Jenin). The pistachio and coffee samples were collected from the main toasters in these cities, while the flour samples were collected from the major bakeries in these cities. A total of 90 samples were collected, 30 from each city. The samples were analysed by a direct quantitative competitive enzyme-linked immunosorbent assay (ELISA) to determine the amounts of AFB1. AFB1 contamination was detected in all of the collected samples. The percentage of samples exceeding the permissible limit prescribed by the European Commission (EC) Regulation of Maximum Residual Levels (MRL) was 33.3%. AFB1 contamination levels in the flour samples ranged between 0.4 - 2 µg/kg, with a mean of 0.75 µg/kg. All of the tested samples were below the EC-MRL level of 12 µg/kg. The amount of AFB1 in the roasted coffee beans ranged between 12 - 49 µg/kg, with a mean of 25.03 µg/kg. All of the tested samples exceeded the EC-MRL level of 5 µg/kg. The pistachios had a contamination level between 0.7- 2.20 µg/kg, with a mean of 1.28 µg/kg, and none exceeded the EC-MRL level of 8 µg/kg for direct human consumption. No differences were observed between the targeted areas (p &gt; 0.05). The results obtained on the contamination levels of AFB1 indicated a serious public health issues. Further improvement of food handling and storage conditions must be exercised.

Impact of Technostress on Continuance Intentions to Use Mobile Technology

With rapid development of emerging technologies, teachers have been required to integrate mobile technology into their practices to improve learning outcomes. However, teachers have been reluctant to integrate technology into teaching because of technostress. Many studies have investigated the reasons and consequences of technostress in different contexts more than education, specifically teachers in K-12. To shed light on the boundary condition of using new technology, this study investigated technostress as a boundary condition that influences perceived usefulness for continuance intentions of using portable technology. Therefore, the authors introduced a model to describe the relationship among technostress, perceived usefulness, and K-12 teacher attitudes toward and continuance intentions to using mobile technology in the Palestinian context. 367 teachers from different backgrounds participated in the quantitative study. SPSS and AMOS were used to find the path coefficients of the model. The findings revealed that technostress has non-significant direct effects on continuance intentions of using portable technology, where perceived usefulness plays a crucial role in continuance intentions. Technostress has negative effects on both perceived usefulness and teachers’ attitudes toward mobile technology. Participants in the study were from northern Palestine, which limited generalizing the findings on other technological tools. Longitudinal future studies are recommended to understand the impact of perceived usefulness and its relationship with technostress, which is important to deepening our understanding of continuance intentions in using mobile technology.

Occupational Exposure Assessment and Seroprevalence of Brucella Specific Antibodies Among Veterinarians in the Northern Palestine.

Background: Brucellosis is one of the most popular zoonosis in the world caused by bacteria belonging to the genus Brucella. The disease is considered an occupational risk to persons dealing with animals and animal products. Brucellosis is endemic in livestock in Palestine. Yet, few studies investigated human brucellosis in Palestine. We aimed to estimate Brucella seropositivity among veterinary healthcare professionals in Northern Palestine, and to assess the associated risk factors.Methods: A cross-sectional study was conducted in four governorates in the Northern West Bank (Jenin, Nablus, Qalqylia, and Tulkarm). A sample of 100 veterinarians was collected. Participants were interviewed using a structured questionnaire to assess risk factors. Blood samples were collected to be screened for the presence of anti-Brucella IgG using the Enzyme-Linked Immunosorbent Assay (ELISA).Results: The seroprevalence of Brucellosis by ELISA was 76%. Risk factors included working in the public sector, dealing with animals' vaccination, longer period of exposure, and advancing in age.Conclusions: Brucellosis is a high-risk occupational disease among veterinarians. Its prevalence rate among veterinary healthcare workers in the Northern West Bank, Palestine was very high compared to neighboring countries and internationally.

6th century Amphorae with Menorah Representation from Phanagoria

During excavations in 2019 in Phanagoria at the Lower City site, two amphorae with red paint dipinto representing a seven-lamp menorah were found in a fire layer dating from around the middle of the 6th century. Representations of seven-armed candelabrum on amphorae and generally on containers were a sign that they contained a kosher food, i.e. suitable for consumption according to Halakha – a corpus of laws guiding activities of a Jew. Thus, the published amphorae attest to the presence of a Jewish community in the city in early Byzantine time and fill a chronological gap in a short list of archaeological and written evidence about the Jewish community of Phanagoria, moreover, the fact that the vessels were found at a fairly close distance from each other in a narrowly dated gated complex may indicate the presence of a Jewish quarter there. The finds are of particular importance due to the fact that the number of amphorae and other vessels with dipinti representing a menorah known to date is rather insignificant. Their findings are known only from excavations in several centres of the Northern Pontic and Palestine.

Infrastructure Development and Waterfront Transformations: Physical and Intangible Borders in Haifa Port City

Constructed on its natural bay as a fortified Muslim town in the late 18th century, Haifa’s port city transformed into a modern cosmopolitan port city in the second half of the 19th century. Significant technological, administrative, and social changes made Haifa into the transportation and economic hub of northern Palestine: Its harbor, the first in the region, became a gate to the east for commodities, pilgrimages, and ideas. British imperialism enlarged it with landfill areas and added an industrial function, constructing refineries and a connecting pipeline with Iraq. Haifa port served as the main entry port for immigration and goods for the newly founded Israeli state. Privatization and neo-liberalization transformed it from national port to international corporate hub, reshaping both port and city. Individual entrepreneurs, local governments, and imperial actions shaped and reshaped the landscape; perforating new access points, creating porous borders, and a new socioeconomic sphere.&lt;strong&gt; &lt;/strong&gt;This process persisted through the Late Ottoman era, the British Mandate, and the Israeli state. From the first Ottoman landfills to the sizeable British harbor of 1933, the market economy led urban planning of Haifa’s waterfront and its adjacent railroad to the current Chinese petrol-harbor project. What were the city’s tangible and intangible borders? How did these changes, influenced by local and foreign agendas, unfold? Tapping into built-environment evidence; archival documents (architectural drawings, plans, maps, and photographs); and multidisciplinary academic literature to examine Haifa’s urban landscape transformation, this article studies the history of Haifa’s planned urban landscape—focusing on transformations to the port and waterfront to adjust to new technologies, capital markets, and political needs. We thus explore Haifa port history as a history of porosity and intangibility—rather than the accepted history of European modernization—building upon theoretical literature on global networks and urban form, regional dynamics of port cities, and tangible and intangible border landscapes.

Seroprevalence and risk factors of West Nile virus infection in veterinarians and horses in Northern Palestine

Background and Aim:West Nile fever (WNF) is a neurotropic, mosquito-borne disease affecting humans and domesticated animals, caused by a member of the genus Flavivirus. Over the last decades, this virus has been responsible for several cases of illness in humans and animals. The current epidemiological status of WNF in horses is insufficient, and in veterinarians, as an occupational hazard is unknown. This study aimed to investigate and determine the seroprevalence and risk factors for WNF in veterinarians and horses in Palestine.Materials and Methods:In this study, serum samples from 100 veterinarians and 87 horses were collected between August 2020 and September 2020 from different cities of Northern Palestine. West Nile virus (WNV) antibodies were detected using an enzyme-linked immunosorbent assay.Results:Our results showed that 60.9% of the horse serum samples were positive in all investigated cities. In horses, location is a risk factor for the seropositivity for WNF, whereas age, sex, breed, and intended use of the horses, were not associated with increased WNF seropositivity. In veterinarians, 23.0% of the serum samples were positive. Positive samples were detected in all locations, age groups, experience length, and work sectors. However, the seropositivity for WNF was not influenced by these variables.Conclusion:The results revealed that WNV circulates in most regions of Palestine. Our results will help determine the risk of infection in animals and humans and control WNV transmission. Surveillance studies on humans, vectors, and animals are needed to better define endemic areas.

Assessment of pain and postoperative nausea and vomiting and their association in the early postoperative period: an observational study from Palestine

BackgroundPostoperative nausea and vomiting (PONV) and postoperative pain (POP) are most commonly experienced in the early hours after surgery. Many studies have reported high rates of PONV and POP, and have identified factors that could predict the development of these complications. This study aimed to evaluate the relationship between PONV and POP, and to identify some factors associated with these symptoms.MethodsThis was a prospective, multicentre, observational study performed at An-Najah National University Hospital and Rafidia Governmental Hospital, the major surgical hospitals in northern Palestine, from October 2019 to February 2020. A data collection form, adapted from multiple previous studies, was used to evaluate factors associated with PONV and POP in patients undergoing elective surgery. Patients were interviewed during the first 24 h following surgery. Multiple binary logistic regression was applied to determine factors that were significantly associated with the occurrence of PONV.ResultsOf the 211 patients included, nausea occurred in 43.1%, vomiting in 17.5%, and PONV in 45.5%. Multiple binary logistic regression analysis, using PONV as a dependent variable, showed that only patients with a history of PONV [odds ratio (OR) = 2.28; 95% confidence interval (CI) = 1.03–5.01; p = 0.041] and POP (OR = 2.41; 95% CI = 1.17–4.97; p = 0.018) were significantly associated with the occurrence of PONV. Most participants (74.4%) reported experiencing pain at some point during the first 24 h following surgery. Additionally, the type and duration of surgery were significantly associated with POP (p-values were 0.002 and 0.006, respectively).ConclusionsPONV and POP are common complications in our surgical patients. Factors associated with PONV include a prior history of PONV and POP. Patients at risk should be identified, the proper formulation of PONV protocols should be considered, and appropriate management plans should be implemented to improve patients’ outcomes.

Speaking Graffiti: Imaging Human Rights from Belfast to the West Bank

The human rights conditions of Northern Ireland and Palestine have been analyzed up, down, and sideways by a robust scholarly literature, this article provides a fresh approach to the analysis of media with respect to cultural aspects of human rights conundrums through images of localized as well as globalized “graffiti.” From the near universal influence of the painting of George Washington and company crossing the Delaware River, to brave but dangerous anti-regime graffiti in North Korea, the political nature of private artists operating in the public realm for human rights is recognized as a potentially destabilizing and regime-busting act. With a lens pointed on Palestine and Northern Ireland, we examine this cultural artifact’s power to get attention, obstruct persecution, and ultimately to mitigate some human rights abuses. How does such graffiti work? What are the similarities and differences in their power for enhancing human dignity through different times and places? We also look at the relationship of human rights graffiti to current political trends internationally. Images are used here as method of analysis that may help explain the broader implications of political graffiti for the study of a particular medium of transmission for the study of cultural and societal norms.

Mammogram uptake and barriers among Palestinian women attending primary health care in North Palestine

Background Breast cancer affects women's lives worldwide, yet early detection is an effective strategy for reducing mortality. The participation of women in mammography screening is linked to their knowledge, attitudes and perceived barriers. Objectives Our study aims to assess mammography screening uptake and barriers among women attending primary healthcare centres (PHCs) in northern Palestine. Methods Using an interviewer administered questionnaire, we used a cross-sectional study design to determine mammography screening uptake, knowledge and barriers among 357 women attending PHCs in Northern Palestine between December 2018 and March 2019. Results The mean age was 50 years. The majority (69.2%) were considered to have adequate knowledge about breast cancer and mammography screening. Mammography screening uptake among the participants was 37%. Almost 85% of the women had a positive attitude towards breastfeeding as a prophylaxis factor against breast cancer, while the most frequent barrier to mammography screening was that the participants believed they did not have any symptoms (28.6%), followed by 22.1% of them who did not want to know if they had breast cancer. Conclusion The findings of this study highlighted the low mammography uptake among Palestinian women despite the adequate knowledge of those women and the fully accessible and free screening programme. Hence, interventional strategies should be implemented at several levels to enhance mammogram uptake.