Mistreatment of women during childbirth in West Bank, Palestine : development and validation of questionnaire, prevalence and associated factors, and its relationship with satisfaction and perceived quality of care

Mistreatment during childbirth phenomenon should be understood among Palestinian women because it has not been adequately addressed in Palestine. This study aimed to measure the prevalence, types of mistreatment, associated factors and its association with satisfaction of care and perceived quality of care in West Bank, Palestine. It was conducted in two phases using a multi-method approach. Phase one involved the development and validation of questionnaire. Development of the questionnaire was achieved through literature review and qualitative study using face-to-face interviews with six purposively selected postpartum women and five healthcare providers to explore how women were treated during childbirth. Thematic analysis was conducted. Exploratory and confirmatory factor analysis was conducted for validation of satisfaction of care and perceived quality of care domains. This validation study involved 400 women attending maternal and child health clinics within the first 16 weeks postpartum who were selected using purposive sampling. For phase two, a cross sectional study was done among 269 women within the first 16 weeks postpartum from the six governorates located in north area of West Bank by using proportionate stratified random sampling. Multiple logistic regression analysis was used to determine factors associated with mistreatment. The associations of mistreatment with satisfaction of care and perceived quality of care wereanalysed using simple linear regression. The new questionnaire was designed in Arabic language and consisted of 87 items; experience of mistreatment during childbirth (43 items), satisfaction of care (10 items), perceived quality of care (16 items), and 18 items related to socio-demographic and obstetric characteristics. The Mistreatment, Satisfaction and Quality of Care Questionnaire (MSQ-Q) had good psychometric properties and reliability. The overall prevalence of mistreatment was 97.8%; with each type was 88.5% for poor rapport between women and providers, physical abuse (76.6%), failure to meet professional standard of care (75.8%), verbal abuse (24.5%), stigma and discrimination (11.9%), and health system conditions and constraints (22.3%). The significant factors associated with mistreatment during childbirth were age, type of labour, type of facility, mode of delivery, residency, duration of labour, education, pain killer received and parity. Women who experienced any types of mistreatment except physical abuse had significantly lower satisfaction of care and perceived quality of care scores. In conclusion, the majority of the participants encountered at least one type of mistreatment during childbirth. Women who delivered at public childbirth facility were more prone to face all the reported six types of mistreatment. Furthermore, the limitations in childbirth facilities, poor working environment, some recent policies such as preventing childbirth companion should be modified especially at public facilities to reduce mistreatment during childbirth

Exposure assessment of radon in the drinking water supplies: a descriptive study in Palestine

<p>Abstract</p> <p>Background</p> <p>Radon gas is considered as a main risk factor for lung cancer and found naturally in rock, soil, and water. The objective of this study was to determine the radon level in the drinking water sources in Nablus city in order to set up a sound policy on water management in Palestine.</p> <p>Methods</p> <p>This was a descriptive study carried out in two phases with a random sampling technique in the second phase. Primarily, samples were taken from 4 wells and 5 springs that supplied Nablus city residents. For each source, 3 samples were taken and each was analyzed in 4 cycles by RAD 7 device manufactured by Durridge Company. Secondly, from the seven regions of the Nablus city, three samples were taken from the residential tap water of each region. Regarding the old city, ten samples were taken. Finally, the mean radon concentration value for each source was calculated.</p> <p>Results</p> <p>The mean (range) concentration of radon in the main sources were 6.9 (1.5-23.4) Becquerel/liter (Bq/L). Separately, springs and wells' means were 4.6 Bq/L and 9.5 Bq/L; respectively. For the residential tap water in the 7 regions, the results of the mean (range) concentration values were found to be 1.0 (0.9-1.3) Bq/L. For the old city, the mean (range) concentration values were 2.3 (0.9-3.9) Bq/L.</p> <p>Conclusions</p> <p>Except for Al-Badan well, radon concentrations in the wells and springs were below the United State Environmental Protection Agency maximum contaminated level (U.S EPA MCL). The level was much lower for tap water. Although the concentration of radon in the tap water of old city were below the MCL, it was higher than other regions in the city. Preventive measures and population awareness on radon's exposure are recommended.</p

Static magnetic field selects undifferentiated myelomonocytes from low-glutamine concentration stimulated U937 cells

An increasing number of evidence indicates that static magnetic fields (SMF) are capable of altering apoptosis, mainly through modulation of Ca2+ influx. Here we present data that suggest apoptotic-related gene expression as an alternative pathway, through which exposure to 6 milliTesla (mT) SMF can interfere with apoptosis. Exposure to 6 mT SMF affects the apoptotic rate (spontaneous and drug-induced) and [Ca2+]i in isolated human lymphocytes; the aged cells are more susceptible to exposure than fresh ones. The exposure to 6 mT exerted a protective effect on chemical or physical-induced apoptosis, irrespective of the age of the cells. The investigation of the gene expression of bcl-2, bax, p53 and hsp70 in freshly isolated and in culture aged human lymphocytes indicates that these genes are modulated by SMF exposure in the experimental conditions used, in a gene-, age- and time- dependent manner. The exposure of isolated lymphocytes to SMF for up 24 h modulated increased bax and p53 and decreased hsp70, and bcl-2. The amount of increment and/or decrement of the proteins varied for each gene examined and was independent of the apoptotic inducers. Finally, the same stress applied to freshly isolated or aged lymphocytes resulted in different modulation of bcl-2, bax and hsp70

Static magnetic field selects undifferentiated myelomonocytes from low-glutamine concentration stimulated U937 cells.

An increasing number of evidence indicates that static magnetic fields (SMF) are capable of altering apoptosis, mainly through modulation of Ca2+ influx. Here we present data that suggest apoptotic-related gene expression as an alternative pathway, through which exposure to 6 milliTesla (mT) SMF can interfere with apoptosis. Exposure to 6 mT SMF affects the apoptotic rate (spontaneous and drug-induced) and [Ca2+]i in isolated human lymphocytes; the aged cells are more susceptible to exposure than fresh ones. The exposure to 6 mT exerted a protective effect on chemical or physical-induced apoptosis, irrespective of the age of the cells. The investigation of the gene expression of bcl-2, bax, p53 and hsp70 in freshly isolated and in culture aged human lymphocytes indicates that these genes are modulated by SMF exposure in the experimental conditions used, in a gene-, age- and time- dependent manner. The exposure of isolated lymphocytes to SMF for up 24 h modulated increased bax and p53 and decreased hsp70, and bcl-2. The amount of increment and/or decrement of the proteins varied for each gene examined and was independent of the apoptotic inducers. Finally, the same stress applied to freshly isolated or aged lymphocytes resulted in different modulation of bcl-2, bax and hsp70

Differentiation of monocytic U937 cells under static magnetic field exposure

We present here a morphological, cytochemical and biochemical study of the macrophagic differentiation of human pro-monocytic U937 cells exposed to moderate intensity (6 mT) static magnetic fields (MF). It was found that the following substances induced differentiation in U937 cells to a progressively lower degree: 50 ng/mL 12-0-tetradecanoyl-13-phorbol acetate (TPA), low concentration of glutamine (0,05 mM/L), 10% dimethyl sulfoxide (DMSO) and 100 mM/L Zn++. Differentiated U937 cells shift from a round shape to a macrophage-like morphology, from suspension to adhesion growth and acquire phagocytotic activity, the cytoskeleton adapting accordingly. Exposure to static MF at 6 mT of intensity decreases the degree of differentiation for all differentiating molecules with a consequent fall in cell adhesion and increased polarization of pseudopodia and cytoplasmic protrusions. Differentiation alone, or in combination with exposure to static MFs, affects the distribution and quantity of cell surface sugar residues, the surface expression of markers of macrophage differentiation, and phagocytotic capability. Our results indicate that moderate-intensity static MFs exert a considerable effect on the process of macrophage differentiation of pro-monocytic U937 cells and suggest the need for further studies to investigate the in vivo possible harmful consequences of this

Differentiation of monocytic U937 cells under static magnetic field exposure

We present here a morphological, cytochemical and biochemical study of the macrophagic differentiation of human pro-monocytic U937 cells exposed to moderate intensity (6 mT) static magnetic fields (MF). It was found that the following substances induced differentiation in U937 cells to a progressively lower degree: 50 ng/mL 12-0-tetradecanoyl-13-phorbol acetate (TPA), low concentration of glutamine (0,05 mM/L), 10% dimethyl sulfoxide (DMSO) and 100 mM/L Zn++. Differentiated U937 cells shift from a round shape to a macrophage-like morphology, from suspension to adhesion growth and acquire phagocytotic activity, the cytoskeleton adapting accordingly. Exposure to static MF at 6 mT of intensity decreases the degree of differentiation for all differentiating molecules with a consequent fall in cell adhesion and increased polarization of pseudopodia and cytoplasmic protrusions. Differentiation alone, or in combination with exposure to static MFs, affects the distribution and quantity of cell surface sugar residues, the surface expression of markers of macrophage differentiation, and phagocytotic capability. Our results indicate that moderate-intensity static MFs exert a considerable effect on the process of macrophage differentiation of pro-monocytic U937 cells and suggest the need for further studies to investigate the in vivo possible harmful consequences of this

Biological effects of 6 mT static magnetic fields: a comparative study in different cell types

Aim of the present work was the comparative study of the bio-effects induced by exposure to 6 mT static magnetic field (MF) on several primary cultures and cell lines. A particular attention was dedicated to apoptosis. Cell viability, proliferation, intracellular Ca2+ concentration and morphology were also examined during the exposure of cells to static MF. Primary culture of human lymphocytes, mice thymocytes and cultures of 3DO, U937, HeLa, HepG2 and FRTL-5 cells were cultured in the presence of 6 mT static MF and different apoptosis-inducing drugs (i.e. cycloheximide, H2O2, puromycin, heat shock, etoposide). On all the different cells examined biological effects of static MF exposure were found. They were cell type-dependent but apoptotic inducer-independent. A common effect of the exposure to static MF was the promotion of apoptosis and mitosis but not of necrosis and modifications of the cell shape. Increase of the intracellular levels of Ca2+ ions were also observed. When pro-apoptotic drugs were added to static MF, the majority of cell types rescued from apoptosis. On the contrary, apoptosis of 3DO cells was significantly increased under simultaneous exposure to static MF and incubation with pro-apoptotic drugs. From these data it derives that 6 mT static MF exposure interfered with apoptosis in a cell type- and exposure time- dependent manner while the effects of static MF exposure on the apoptotic program were independent of the drugs used

Cell shape and plasma membrane alterations after static magnetic fields exposure

The biological effects of static magnetic fields (MFs) with intensity of 6 mT were investigated in lymphocytes and U937 cells in the presence or absence of apoptosis-inducing drugs by transmission (TEM) and scanning (SEM) electron microscopy. Lectin cytochemistry of ConA-FITC conjugates was used to analyze plasma membrane structural modifications. Static MFs modified cell shape, plasma membrane and increased the level of intracellular [Ca++] which plays an antiapoptotic role in both cell types. Modifications induced by the exposure to static MFs were irrespective of the presence or absence of apoptotic drugs or the cell type. Abundant lamellar-shaped microvilli were observed upon 24 hrs of continuous exposure to static MFs in contrast to the normally rough surface of U937 cells having numerous short microvilli. Conversely, lymphocytes lost their round shape and became irregularly elongated; lamellar shaped microvilli were found when cells were simultaneously exposed to static MFs and apoptosis-inducing drugs. In our experiments, static MFs reduced the smoothness of the cell surface and partially impeded changes in distribution of cell surface glycans, both features being typical of apoptotic cells. Cell shape and plasma membrane structure modifications upon static MFs exposure were time-dependent. Lamellar microvilli were clearly observed before the distortion of cell shape, which was found at long times of exposure. MFs exposure promoted the rearrangement of F-actin filaments which, in turn, could be responsible for the cell surface modifications. Here we report data that support biological effects of static MFs on U937 cells and human lymphocytes. However, the involvement of these modifications in the onset of diseases needs to be further elucidated

Cell shape and plasma membrane alterations after static magnetic fields exposure

The biological effects of static magnetic fields (MFs) with intensity of 6 mT were investigated in lymphocytes and U937 cells in the presence or absence of apoptosis-inducing drugs by transmission (TEM) and scanning (SEM) electron microscopy. Lectin cytochemistry of ConA-FITC conjugates was used to analyze plasma membrane structural modifications. Static MFs modified cell shape, plasma membrane and increased the level of intracellular [Ca++] which plays an antiapoptotic role in both cell types. Modifications induced by the exposure to static MFs were irrespective of the presence or absence of apoptotic drugs or the cell type. Abundant lamellar-shaped microvilli were observed upon 24 hrs of continuous exposure to static MFs in contrast to the normally rough surface of U937 cells having numerous short microvilli. Conversely, lymphocytes lost their round shape and became irregularly elongated; lamellar shaped microvilli were found when cells were simultaneosly exposed to static MFs and apoptosis-inducing drugs. In our experiments, static MFs reduced the smoothness of the cell surface and partially impeded changes in distribution of cell surface glycans, both features being typical of apoptotic cells. Cell shape and plasma membrane structure modifications upon static MFs exposure were time-dependent. Lamellar microvilli were clearly observed before the distortion of cell shape, which was found at long times of exposure. MFs exposure promoted the rearrangement of F-actin filaments which, in turn, could be responsible for the cell surface modifications. Here we report data that support biological effects of static MFs on U937 cells and human lymphocytes. However, the involvement of these modifications in the onset of diseases needs to be further elucidated

Cell shape and plasma membrane alterations after static magnetic fields exposure

The biological effects of static magnetic fields (MFs) with intensity of 6 mT were investigated in lymphocytes and U937 cells in the presence or absence of apoptosis-inducing drugs by transmission (TEM) and scanning (SEM) electron microscopy. Lectin cytochemistry of ConA-FITC conjugates was used to analyze plasma membrane structural modifications. Static MFs modified cell shape, plasma membrane and increased the level of intracellular [Ca++] which plays an antiapoptotic role in both cell types. Modifications induced by the exposure to static MFs were irrespective of the presence or absence of apoptotic drugs or the cell type. Abundant lamellar-shaped microvilli were observed upon 24 hrs of continuous exposure to static MFs in contrast to the normally rough surface of U937 cells having numerous short microvilli. Conversely, lymphocytes lost their round shape and became irregularly elongated; lamellar shaped microvilli were found when cells were simultaneously exposed to static MFs and apoptosis-inducing drugs. In our experiments, static MFs reduced the smoothness of the cell surface and partially impeded changes in distribution of cell surface glycans, both features being typical of apoptotic cells. Cell shape and plasma membrane structure modifications upon static MFs exposure were time-dependent. Lamellar microvilli were clearly observed before the distortion of cell shape, which was found at long times of exposure. MFs exposure promoted the rearrangement of F-actin filaments which, in turn, could be responsible for the cell surface modifications. Here we report data that support biological effects of static MFs on U937 cells and human lymphocytes. However, the involvement of these modifications in the onset of diseases needs to be further elucidated