To assess factors related to the prevalence of dental caries among adolescent schoolchildren attending marginalised schools in the West Bank area of Palestine.
A cross-sectional study was conducted ...in schools participating in the School Support Program (SSP). Fifty schools identified as marginalised by the SSP were stratified by district, student gender and grade level to select a random sample of 20 schools. Students in the 6th and 9th grades were screened by senior dental students to collect data about their weight, height, gingival health and caries experience. In addition, a structured in-person questionnaire was used to collect data about students' oral hygiene practices, dietary habits, mother's education and father's employment.
In total, 1282 students completed interviews and clinical screenings. The mean number of Decayed, Missing and Filled Teeth (DMFT) was 6.4 ± 4.4. Sixty-four percent had moderate gingivitis and 73% had fair oral hygiene. 'Recent visit to the dentist' was associated with mother's level of education (X2 = 22.06, p < 0.001) and father's employment (X2 = 24.02, p < 0.001). The final regression model showed that grade (β = 0.31, p < 0.001), gender (β = 0.06, p < 0.03), recent visit to the dentist (β = -0.06, p < 0.03) and drinking fresh juices (β = -0.05, p < 0.05) were statistically significant in explaining the high level of caries in this sample.
This study indicates that Palestinian adolescents in marginalised governmental schools suffer the highest burden of dental disease and are disproportionally impacted when compared to other same-age students in the region. A high burden of disease was directly associated with unfavourable dietary habits, poor oral hygiene practices and challenges to accessing dental care services, and was indirectly associated with father's employment and mother's level of education.
Assessment of safety culture—safety-related norms and behaviours—in health care settings is receiving increasing attention. Assessment of pharmacy safety culture in the occupied Palestinian territory ...is scarce. We aimed to investigate patient safety culture in Palestinian hospital pharmacies and its association with hospital characteristics (ie, ownership and number of beds) and pharmacy staff characteristics (including sex, age, education, job title, working hours, and years in profession and working in a hospital).
The self-administered safety attitudes questionnaire (SAQ) was translated into Arabic and was then undertaken in February 2012 to April 2012. All pharmacy staff (n=115) working for more than 3 months before taking the survey in 28 public, private, and non-governmental hospitals in the West Bank were targeted. We used IBM-SPSS (version 19) for data analysis.
73 staff completed surveys (response rate 69%). Mean age of participants was 35·3 (SD 6·5) years and 48 (67%) respondents were women. The mean scores for overall safety varied significantly between hospital pharmacies, ranging from 43 (poor safety) to 85 (good safety) on a 0–100 scale (p=0·004). For SAQ domains (including teamwork atmosphere, job satisfaction, safety climate, positive perception of management, stress recognition of respondents, and favourable working conditions), mean scores ranged from 76 (SD 21) for favourable working conditions, to 62 (SD 25) for stress recognition. Only two SAQ domains received 75% or more positive responses from participants, which were for job satisfaction (56 respondents, 77%) and favourable working conditions (56 respondents, 77%). Overall safety score was significantly associated with hospital ownership, with higher scores in private and non-governmental hospitals than in public hospitals (p=0·002). Additionally, participants working in hospitals with less than 50 beds reported higher positive perceptions of management than did their counterparts in hospitals with a greater number of beds (p=0·031). No participant characteristic was significantly related to SAQ domain scores. 45 (62%) respondents did not report any drug-related adverse event recorded by patients in the past year. 64 (87%) participants rated patient safety at their hospital units as excellent or very good, and 9 (13%) rated patient safety as acceptable.
Our results showed that patient safety could be improved in Palestinian hospital pharmacies. Additionally, results showed the interventions that are needed might vary across hospitals.
None.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK, ZRSKP
Objective. To assess the prevalent patient safety culture in Palestinian public hospitals. Design. A cross-sectional design, Arabic translated version of the Hospital Survey on Patient Safety Culture ...was used. Setting. All the 11 general public hospitals in the West Bank. Participants. A total of 1460 clinical and non-clinical hospital staff. Intervention(s). No. Main Outcome Measures. Twelve patient safety culture composites and 2 outcome variables (patient safety grade and events reported in the past year) were measured. Results. Most of the participants were nurses and physicians (69.2%) with direct contact with patients (92%), mainly employed in medical/surgical units (55.1%). The patient safety composites with the highest positive scores were teamwork within units (71%), organizational learning and continuous improvement (62%) and supervisor/manager expectations and actions promoting patient safety (56%). The composites with the lowest scores were non-punitive response to error (17%), frequency of events reported (35%), communication openness (36%), hospital management support for patient safety (37%) and staffing (38%). Although 53.2% of the respondents did not report any event in the past year, 63.5% rated patient safety level as 'excellent/very good'. Significant differences in patient safety scores and outcome variables were found between hospitals of different size and in relation to staff positions and work hours. Conclusions. This study highlights the existence of a punitive and blame culture, under-reporting of events, lack of communication openness and inadequate management support that are key challenges for patient safe hospital care. The baseline survey results are valuable for designing and implementing the patient safety program and for measuring future progress.
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BFBNIB, NMLJ, NUK, PNG, UL, UM, UPUK
Dental caries is still the most prevalent chronic disease worldwide. In the occupied Palestinian territory, data about oral health status and its determinants are scarce. This study aimed to assess ...the prevalence of dental caries and associated factors among schoolchildren in a random sample of marginalised schools in the West Bank.
Marginalised schools (according to the School Support Program SPP criteria) were stratified by district, gender, and grade level to select a random sample of 20 schools. Students in the sixth and ninth grades were interviewed by senior dental students about their oral hygiene and diet habits. Students' weight, height, gingival health, and dental caries experience were assessed. Senior dental students were trained and calibrated to carry out the interviews and the examinations. Parental informed consents were collected by school administrative staff. Ethics approval for the study was obtained from the Al-Quds University Scientific Research Ethics Committee.
In total, 1282 students completed the interviews and the clinical screening. The mean decayed, missing and filled teeth (DMFT) index was 6·4 (SD 4·4). According to the WHO dental caries experience classification, 49% (309 of 623) of the sixth grade students and 74% (484 of 658) of the ninth grade students fell in the high and very high categories. The mother's level of education and recent visit to the dentist correlated negatively with DMFT score (ρ=–0·06, p=0·029; ρ=–0·063, p=0·024). BMI was correlated positively with DMFT (r=0·092, p=0·001). Drinking milk and fresh juices was related to lower DMFT scores (r=–0·077, p=0·006 and r=–0·072, p=0·010). In the final model, grade (β=0·314, p<0·0001), gender (β=0·058, p=0·034), recent visit to the dentist (β=–0·059, p=0·029) and drinking fresh juices (β=–0·054, p=0·047) were significant factors in explaining the high level of dental caries in this sample.
Students in the marginalised schools of the West Bank have high DMFT scores that indicate high prevalence of dental caries. Access to dental care and bad oral health habits are associated with high disease prevalence. Interventions to improve access to care and increase awareness about healthy diet and hygiene habits are crucial to alleviate the burden of oral disease in this population.
AMIDEAST School Support Program (SSP).
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK, ZRSKP
The study investigated the associations of religiosity, religious coping and suicide acceptance to suicide ideation and attempts in 7427 young adults affiliating with Islam from 11 Muslim countries.
...A self-administered questionnaire was used to collect the data. We used F and χ2 tests and correlation analyses to report descriptive statistics. Multi-group path models with (i) a zero-inflated Poisson distribution and, (ii) a Binomial distribution were used to model the number of occurrences of suicidal ideation, and occurrence of a suicide attempt, respectively.
Religiosity was negatively associated with acceptability of suicide, but it was positively related to punishment after death across the 11 countries. Religiosity was negatively associated with ever experiencing suicidal ideation, both directly and indirectly through its association with attitudes towards suicide, especially the belief in acceptability of suicide. Neither positive nor negative religious coping were related to suicidal ideation. However, religiosity was negatively related to suicide attempts among those who experienced suicidal ideation at least once. This association was mediated through the belief in acceptability of suicide and religious coping. Negative religious coping was positively associated with suicide attempts probably because it weakened the protective effects of religiosity.
Findings from this study suggest that the effects of religiosity in the suicidal process operate through attitudes towards suicide. We therefore conclude that clinical assessment as well as research in suicidology may benefit from paying due attention to attitudes towards suicide.
•Religiosity deters suicide through its effects on attitudes towards suicide.•Acceptability of suicide has the strongest links to suicidal thoughts and attempts.•Neither positive nor negative religious coping are related to suicidal ideation.•Negative religious coping is positively associated with suicide attempts.•Positive religious coping does not deter suicide attempts.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
This study investigated the prevalence of suicidal behavior and psychological distress in university students across 12 nations. A total of 5,572 university students from 12 countries were surveyed ...about suicide ideation, suicide attempts, and psychological distress by means of a self-administered questionnaire. Almost 29% of the samples reported having contemplated suicide and 7% reported attempting suicide. Of the total sample, 51.1% scored above the General Health Questionnaire-12 ≥ 3 cut-off points, 41.6% above the GHQ-12 ≥ 4 cut-off points, and 33.8% scored above the GHQ-12 ≥ 5 cut-off points. While odds of suicide ideation were elevated in Austria and the UK, reduced ORs were detected for China, Italy, Saudi Arabia, Tunisia, and Turkey. Similarly, while odds of suicide attempt were high in Jordan, Palestine, Saudi Arabia, and to some extent in Turkey, reduced ORs were observed for Austria, China, Italy, Japan and the United States. Elevated ORs for psychological distress were seen in Japan, Jordan, Palestine, Saudi Arabia, Tunisia, and Turkey but reduced ORs were noted in Austria, China, Iran, Italy, and the United States. Psychological distress was strongly associated with reports of suicide ideation and attempts. Suicide ideation, suicide attempt, and psychological distress are common in university students but their rates vary depending on the sociocultural context. Due attention should be devoted to the mental health needs of young adults enrolled in higher educational institutions and more cross-cultural research is warranted to better understand the etiology of the observed intersocietal variations in suicidal behavior and psychological distress.
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BFBNIB, IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
•Suicide acceptance and negative life-events were associated with suicidal ideation.•Perceived social support was negatively related to suicidal ideation.•Those who had interdependent self-construal ...were less accepting of suicide.•Number of life-events was the strongest predictor of ever attempting suicide.•Interdependence attenuated the association of negative life-events with suicide attempts.
Research on suicidality in low to middle-income countries is scarce. We addressed this issue by investigating suicidality in a cross-national college student samples from 11 predominantly low to middle-income majority Muslim countries.
The sample consisted of 7427 college students (56% female) who reported to be affiliated with Islam. Data on self-construal, social support, negative life-events, acceptability of suicide, suicidal ideation, and suicide attempts were collected with self-administered questionnaires.
Acceptability of suicide and the experience of negative life-events were positively, and perceived social support was negatively associated with suicidal ideation. Interdependent self-construal was negatively related to the acceptability of suicide and positively associated with perceived social support, implying a negative indirect effect on suicidal ideation although its direct effect was positive. The number of negative life-events was the strongest positive predictor of ever attempting suicide. The interdependent self-construal moderated the association of negative life-events with suicide attempts.
Cross-sectional and self-report nature of the study were its major limitations. Participants may have suppressed their responses about suicide because of religious and legal reasons.
Remarkable similarities across 11 country samples emerged in the linkages between cultural and interpersonal factors with suicidality. Our findings highlight the value of a nuanced approach to suicidality, that can recognize the differences in the processes associated with suicidal ideation and suicide attempts, as well as the need to consider the interplay of a broad range of personal, interpersonal, and cultural influences.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Non-governmental organizations (NGOs) have had an important role in the Palestinian health sector before and after the creation of the Palestinian Ministry of Health (PMoH) in 1994. Few studies have ...addressed the role of NGOs in the Palestinian health sector. The aim of this study was to investigate the current role of local and international NGOs (INGOs) in the development of the Palestinian health system's policies and programmes.
A qualitative study of nine semi-structured interviews was conducted with key representatives from the main actors in the Palestinian health sector: the PMoH, five local NGOs and three INGOs. After obtaining verbal consent, interviews were conducted from October to December 2014, and focused on the NGO's scope of work, priority setting, regulation, coordination and influence on national health policies.
The majority of the local NGOs focused on primary healthcare and rehabilitation, while most of the INGOs worked on health development and emergency response. Local NGOs and INGOs complemented the work of the PMoH in health-service provision. Both were constrained by the predetermined national health strategy set by the PMoH without the active involvement of other actors. INGOs’ activities were constrained by pre-determined international health agendas, available funding and restrictions related to the military occupation. The coordination mechanism between the PMoH, local NGOs, and INGOs is limited to a health and nutrition cluster, a partnership of organisations that is committed to providing needs and evidence-based responses, with little effect on policies and plans. Despite available methods to avoid duplication and fragmentation of work and to fill service provision gaps, some NGOs agreed that the limited coordination and discontinuity of certain projects restrict their ability to fully meet the health needs of the Palestinian population.
Local and international NGOs have a crucial role in providing essential services for Palestinians, with the PMoH as the main actor. Although there is some coordination between the PMoH, local NGOs and INGOs on meeting community needs, this remains limited by funding constraints. The contribution of NGOs to policy formulation is small. Stakeholders’ active involvement in national health policy development, with a focus on local needs, should be encouraged.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK, ZRSKP
OBJECTIVESTo assess the changes in the patient safety culture between 2011 and 2016 after the implementation of patient safety initiative in Palestinian public hospitals.
METHODSA cross-sectional ...quantitative design employed using the Hospital Survey on Patient Safety Culture to collect data. Participants were 1,229 clinical and nonclinical employees from all public hospitals in the West Bank.
RESULTSSignificant improvements were observed in patient safety culture with positive responses to 10 (83.3%) composite categories and 36 (86.0%) items of the Hospital Survey on Patient Safety Culture since the baseline survey in 2011 (P < 0.05). The increase in the percent of positive responses to the survey composites ranged from 9.1% (P < 0.001) to “Frequency of events reported” to 3.8% for “Teamwork across hospital units” (P < 0.001). Significant decrease in positive responses to “Staffing” (11.4%) was observed (P < 0.05); no significant change was observed in “Organizational learning—continuous improvement” (P > 0.05). Most participants (70.5%) rated patient safety level in their units/hospital as ‘Excellent/Very good’, with an increase of 6.3% from the baseline (P < 0.001); no significant increase in the number of reported events in the past 12 months was observed (P < 0.05).
CONCLUSIONSCompared with the baseline survey results, patients’ safety initiatives and quality improvement programs had positive effect on the safety culture in public Palestinian hospitals.
There is a scarcity of research on suicidal phenomena in the Muslim world. Therefore, this study aimed at investigating the self-reported prevalence of suicidal thoughts, attempts and motives in 12 ...Muslim countries. A total of 8417 (54.4% women) university students were surveyed by means of a self-report questionnaire. Overall, 22% of the participants reported suicidal ideation and 8.6% reported attempting suicide. The odds of suicidal thoughts were elevated in Azerbaijan, Indonesia and Saudi Arabia, while reduced ORs were recorded in Egypt, Jordan, Lebanon and Malaysia. While odds of suicide attempts were high in Azerbaijan, Palestine and Saudi Arabia reduced odds ratios (OR) were detected in Indonesia, Iran, Jordan, Lebanon, Malaysia and Tunisia. Taking drugs and using a sharp instrument were the two most frequently used methods to attempt suicide. Only 32.7% of attempts required medical attention. Escape motives were endorsed more than social motives by participants who attempted suicide. Suicidal behaviors were more frequent in women than in men. Compered to men, fewer attempts by women required medical attention. Moreover, our results show that making suicide illegal does not reduce the frequency of suicidal behavior. Results from this comparative study show that suicidal thoughts and attempts are frequent events in young adults in countries where religious scripture explicitly prohibit suicide and the frequencies of nonfatal suicidal behavior show large variation in nations adhering to the same religion.
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DOBA, EMUNI, FIS, FZAB, GEOZS, GIS, IJS, IMTLJ, IZUM, KILJ, KISLJ, MFDPS, NLZOH, NUK, OBVAL, OILJ, PILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, UILJ, UKNU, UL, UM, UPUK, VKSCE, ZAGLJ
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