The Social and Spiritual Factors Affecting Chronic Renal Dialysis Patients in Gaza Strip

Background: End-Stage Renal Disease (ESRD) is a progressive worsening of kidney function over a period of months or years. It is a complex debilitating disease that needs a lifelong treatment. Because patients with ESRD cannot be cured of their underlying conditions and mostly underwent hemodialysis program, it usually leads to many physical and medical consequences and complications, and beside them, there are lots of concealed social and spiritual factors that can affect people who have this disease or are on renal dialysis. Some studies about medical and clinical consequences of ESRD and renal dialysis were conducted but this study will be the first one to determine the factors affecting the social and spiritual wellbeing of patients who are on renal dialysis in Gaza Strip. Objectives: It is important to give a detailed picture about the social and spiritual wellbeing of patients who are on renal dialysis to

Awareness and factors influencing breast reconstruction in the Gaza Strip: a cross-sectional study

Background Women are usually given two options after a mastectomy. They can either wear a prosthesis or have a breast reconstruction. Unfortunately, many women in the Gaza Strip are unaware of these options. The aim of this study was to shed light on the awareness and sociocultural factors in women who underwent mastectomy before choosing between options. Methods In this cross-sectional study, we recruited patients who underwent mastectomy in the Gaza Strip. All participants completed a face-to-face questionnaire between Aug 1, 2015, and April 30, 2016. Verbal consent was obtained from all participants. Findings 173 women with a mean age 51 years (SD 10) were enrolled in this study. 90 (52%) women had low income, and 36 (21%) women had a first-degree relative with breast cancer. 133 (77%) women underwent radical mastectomy, and 29 (17%) women had breast-conserving surgery. 96 (55

Impact of mastectomy on the social well-being and family dynamics of breast cancer female patients in the Gaza Strip

Background: The impact of mastectomy on social well-being (SWB) and family dynamics (FD) may involve the individual, social role and perception of the usefulness of social and family support affects. The purpose of the current study is to identify that impact and its related implications on SWB and FD. Methods: This was a cross-sectional study in which a total of 173 female patients who had mastectomy in GS hospitals completed a face-to-face questionnaire designed by the researchers; which contains 3 sections including: socio-demographic data, SWB and FD. All measures utilized a five-point Likert-type scale ranging from 1 (worst outcome) to 5 (best outcome). The study was conducted at European Gaza Hospital (n= 60) and Alshifaa Hopsital (n= 113) in the GS from August 2015 to September 2016. The data was analyzed using SPSS software. Results: Among 173 female patients, the mean age was 51 years

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication

SRH Needs of Syrian Refugees in Jordan Nine Years Post Crisis: with Emphasis on MISP Implementation and Transition into Comprehensive SRH Services

Abstract Background: Millions of Syrians have been forcibly displaced since the start of civil war in March 2011. The vast majority of these refugees live in neighbouring countries including Jordan as one of the affected countries in the Middle East. Adolescent girls and women are among the most vulnerable populations in this humanitarian crisis. MISP/SRH interventions and programs have been implemented by various humanitarian organizations, governments, and other health care providers, to prevent and manage the consequences of sexual violence, reduce HIV transmission, minimize maternal/neonatal morbidity and mortality, reduce unintended pregnancies and unmet family planning needs, and plan for comprehensive SRH services as soon as the situation permits. After almost nine years of the protracted Syrian crisis, it is essential to examine available evidence around the effectiveness of SRH interventions for Syrian refugees in Jordan in order to inform the humanitarian community including the government by identifying best practices, essential gaps, bottlenecks, and lessons learnt. Methods: In 2018, an assessment using a previously validated MISP/SRH survey tool and combining both quantitative and qualitative research methods was conducted in four governorates of Jordan (Amman, Irbid, Zarqa and Mafraq) to evaluate the availability of MISP/SRH interventions and programs. Data were obtained from interviews with key informants (KIs). For the analysis SPSS-IBM statistical software was used.Results: Overall, 58 KIs affiliated with a total of 15 different entities/agencies were were selected for this assessment. KIs/respondents had different levels of knowledge and sources of information about the MISP/SRH services and had variable engagement in implementation. The results of this assessment highlighted significant knowledge gaps about the implementation of the different MISP objectives and priorities, even after almost nine years of the initial onset of the crisis. Among the different MISP activities, family planning, maternal health, condom distribution, and newborn health services had the highest level of preparation and implementation, while availability of antiretrovirals (ARVs) for prevention of mother-to-child transmission (PMTCT) and access to safe blood had the lowest level of preparation and implementation. This assessment also showed lack of national coordination in the provision of the different SRH services, lack of a national plan for capacity building, and lack of adequate logistics support systems and funding. Conclusions: Important gaps in the knowledge and implementation of MISP/SRH activities continue to exist in Jordan, almost nine years into the protracted Syrian displacement. Areas in need of focus included: national coordination in the provision of SRH services, developing a national plan for capacity building, improving logistics support systems, and allocating sufficient funding for the provision of MISP/SRH services. Areas, particularly, in need of additional funding included: Capacity building of services provides with specific focus on MISP training activities around the different MISP/SRH services, facilitating emergency preparedness, improving coordination, and improving referral systems.</jats:p

SRH needs of Syrian refugees in Jordan nine years post crisis: with emphasis on MISP implementation and transition into comprehensive SRH services

Abstract Background: Millions of Syrians have been forcibly displaced since March 2011. Most of them live in neighbouring countries, including Jordan, with adolescent girls and women as the most vulnerable populations. After almost nine years of the protracted crisis, it was essential to examine available evidence around the effectiveness of MISP/SRH interventions implemented for them in Jordan to inform the humanitarian community and the government by identifying best practices, essential gaps, bottlenecks, and lessons learnt. Methods: Using a previously validated MISP/SRH survey tool and combining quantitative and qualitative research methods, an assessment was conducted in 2018 in four governorates of Jordan to evaluate the availability of MISP/SRH interventions/programs. Data were obtained by trained data collectors and analyzed in SPSS-IBM.Results: Overall, 58 key informants (KIs) from 15 different entities/agencies participated in the assessment. KIs/respondents had various levels of knowledge/sources of information about the MISP/SRH services and had variable engagement in implementation. The results of this assessment highlighted significant knowledge gaps about the implementation of MISP objectives and priorities, even after almost nine years of the onset of the crisis. Among different MISP activities, family planning, maternal health, condom distribution, and newborn health services had the highest level of preparation and implementation, while availability of antiretrovirals (ARVs) for prevention of mother-to-child transmission (PMTCT) and access to safe blood had the lowest level of preparation and implementation. This assessment also showed lack of national coordination in the provision of different SRH services, lack of a national plan for capacity building, and lack of adequate logistics support systems and funding. Conclusions: Important gaps in the knowledge and implementation of MISP/SRH activities continue to exist in Jordan almost nine years into the Syrian displacement. Areas in need of focus include: national coordination in the provision of SRH services, a national plan for capacity building, logistics support systems, and funding for MISP/SRH services provision. Additional funding needs include: Capacity building of service providers with focus on training activities around different MISP/SRH services, facilitating emergency preparedness, improving coordination, and improving referral systems.</jats:p