The Humanitarian Crisis in Gaza: A Look at the Health Infrastructure Before, During and Immediately after the December-January Attacks

In late December and early January, Israel\u27s bombing of the Gaza Strip captured international headlines. While a political solution was often discussed, and a shaky ceasefire was ultimately agreed upon, the health care situation in Gaza before, during and after these bombings was hardly addressed. The ongoing Israeli occupation of the West Bank and Gaza Strip has had deleterious effects on health and health care delivery among the Palestinian population, particularly in Gaza where Israeli blockades have created a U.N.-declared humanitarian crisis. This article attempts to shed new light on the health care situation in the Gaza Strip and potential humanitarian injustices committed by the Israeli government

A Primer for a New Terrain: Palestinian Schooling in Jordan, 1950

This article offers a close reading of the first geography textbook printed by the Ministry of Education after the Hashemite Kingdom of Jordan annexed the West Bank in 1950. Examining the Hashemite regime's early curricular attempts to incorporate its new Palestinian citizens, refugees and otherwise, the article highlights the tactics used to achieve these ends, namely a topographic centralization of Jordan, an erasure of human geography in favor of a natural one, and the foreclosure of other forms of national attachment and belonging. The discussion seeks to expand our understanding of one of the most significant narrative materials confronted by Palestinians in the aftermath of the Nakba, seeing in it a possible mechanism by which to understand the challenges to Palestinian demands for a self-determined education

Past is Present: Settler Colonialism in Palestine

The editors introduce this special issue of settler colonial studies focusing on settler colonialism in Palestine

Measles, a re-emerging disease in Albania: Epidemiology and clinical presentations

Aim: Measles is a highly contagious disease caused by the measles virus. Albania is one of many European countries that have successfully interrupted endemic transmission of this disease. However, during the years 2018-2019, an outbreak of measles occurred in Albania. The aim of this study was to describe the clinical features and complications of hospitalized measles patients in Tirana, Albania, as related to age-group and risk factors. Methods: All patients hospitalized for over 24 hours from January 2018 to December 2019 at the Service of Infectious Diseases, University Hospital Centre “Mother Teresa” in Tirana were included in this study. We included patients over 14 years old as this is an Infectious Diseases Service for adult patients only. Clinical and laboratory data were analysed. Results: Of the 318 hospitalized patients (139 females), about 35%, 26%, 17%, 14%, and 7% were 15-24, 25-34, 35-44, 45-54, and over 55 years old, respectively. Females constituted 37% of the total number of patients. The average and median ages were 30.9 years and 28.5 years, respectively. Average time from the first symptom to the hospital presentation was 3.8 days. Contact with other patients with measles was noted in 21% of the patients. Body rashes were identified as maculopapular in 96% of the patients. Pathognomonic enanthema or Koplik spots and conjunctivitis were detected in 62% and 52% of the patients, respectively. Measles-related complications were noted in 53% of the patients; pneumonia/pneumonitis, hepatitis, neurological complications were presented by 24%, 26%, and 3% of the patients, respectively. Average duration of hospitalization was 5.4 days, whereas mortality was 0.3%. Conclusion: This study provides valuable evidence about the distribution and clinical features of measles in Albania. Measles is a highly contagious disease and, as long as the measles virus is circulating, the risk of transmission remains high. &nbsp

Prevalence of drug-herb and drug-supplement interactions in older adults : A cross-sectional survey

© British Journal of General PracticeBackground Polypharmacy is common among older adults, with increasing numbers also using prescription drugs with herbal medicinal products (HMPs) and dietary supplements. There is no reliable evidence from the UK on concurrent use of HMPs and dietary supplements with prescription drugs in older adults. Aim To establish prevalence of concurrent prescription drugs, HMPs, and dietary supplements among UK community-dwelling older adults and identify potential interactions. Design and setting Cross-sectional survey of older adults registered at two general practices in South East England. Method A questionnaire asking about prescription medications, HMPs, and sociodemographic information was posted to 400 older adults aged ≥65 years, identified as taking ≥1 prescription drug. Results In total 155 questionnaires were returned (response rate = 38.8%) and the prevalence of concurrent HMPs and dietary supplements with prescriptions was 33.6%. Females were more likely than males to be concurrent users (43.4% versus 22.5%; P = 0.009). The number of HMPs and dietary supplements ranged from 1 to 8, (mean = 3, median = 1; standard deviation = 1.65). The majority of concurrent users (78.0%) used dietary supplements with prescription drugs. The most commonly used dietary supplements were cod liver oil, glucosamine, multivitamins, and Vitamin D. Others (20.0%) used only HMPs with prescription drugs. Common HMPs were evening primrose oil, valerian, and Nytol Herbal® (a combination of hops, gentian, and passion flower). Sixteen participants (32.6%) were at risk of potential adverse drug interactions. Conclusion GPs should routinely ask questions regarding herbal and supplement use, to identify and manage older adults at potential risk of adverse drug interactions.Peer reviewe

Overview on epidemiological and clinical manifestation of COVID-19 in Albanian adults

On March 9, 2020 the first two cases of Sars-Cov-2 were identified and hospitalized in Albania. In this paper we present a retrospective analysis of 3000 consecutive COVID-19 confirmed cases in Albanian adults admitted at the Infectious Diseases Service which includes three tertiary care wards, part of Tirana University Hospital Center “Mother Teresa”. The period included in this analysis is from March 2020 – April 30, 2021. The paper provides a general overview including demographic distribution, symptomatic diversity and clinical signs manifested among cases, as well as the association observed with underlying pathologies. The analysis included 1944 males and 1056 females. Overall, the age groups included range from 15 to 99 years (median 65 years; mean value 63.4±13.4 years). There were no statistically significant age differences between males and females (mean ages were: 63.5±13.1 in females and 63.3±13.5 in males; median ages were: 64 years in females and 65 years in males; P=0.67). There was evidence of a statistically significant difference between sexes regarding the presence of symptoms, which were more predominant in males (P<0.001). On the whole, we observed 19 cases with specific signs and symptoms, most of them (82.9%) among patients who reported the presence of such symptoms 5-14 days before hospitalization. The comorbidities encountered were ranked according to systems and organs, classifying them in 22 categories, among which the most frequent were hypertension (52%) and diabetes mellitus (26.4%). Age was a strong risk factor for severe illness, complications, and death. Analyzing symptom onset with total symptoms and comorbidities, it showed that some patients were affected for many days with few symptoms and few comorbidities. It seems they started as mild cases for many days unpredictably precipitating. There were also a few cases with many comorbidities, but a few symptoms upon hospital admission. &nbsp

Use of prescription medications with cardiovascular adverse effects among older adults in the United States

Background: Many commonly used prescription medications have cardiovascular adverse effects, yet the cumulative risk of cardiovascular events associated with the concurrent use of these medications is unknown. We examined the association between the concurrent use of prescription medications with known risk of a major adverse cardiovascular event (MACE) (“MACE medications”) and the risk of such events among older adults. Methods: A multi-center, population-based study from the Atherosclerosis Risk in Communities (ARIC) study of a cohort of 3669 community-dwelling adults aged 61–86 years with no history of cardiovascular disease who reported the use of at least one medication between September 2006 and August 2013 were followed up until August 2015. Exposure defined as time-varying and time-fixed use of 1, 2 or ≥3 MACE medications with non-MACE medications serving as negative control. Primary outcome was incident MACE defined as coronary artery revascularization, myocardial infarction, fatal coronary heart disease, stroke, cardiac arrest, or death. Results: In fully adjusted models, there was an increased risk of MACE associated with use of 1, 2, or ≥3 MACE medications (1 MACE: hazards ratio [HR], 1.21; 95% confidence interval [CI], 0.94–1.57); 2 MACE: HR 1.89, CI 1.42–2.53; ≥3 MACE: HR 2.22, CI 1.61–3.07) compared to use of non-MACE medications. These associations persisted in propensity score-matched analyses and among new users of MACE medications, never users of cardiovascular medications and subgroups of participants with increased risk of MACE. There was no association between the number of non-MACE medications used and MACE. Conclusions and Relevance: In this community-based cohort of older adults with no prior cardiovascular disease, the use of MACE medications was independently and consistently associated with an increased risk of such events in a dose–response fashion

Concurrent use of prescription drugs and herbal medicinal products in older adults: A systematic review

This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/), which permits any noncommercial use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.The use of herbal medicinal products (HMPs) is common among older adults. However, little is known about concurrent use with prescription drugs as well as the potential interactions associated with such combinations. Objective Identify and evaluate the literature on concurrent prescription and HMPs use among older adults to assess prevalence, patterns, potential interactions and factors associated with this use. Methods Systematic searches in MEDLINE, PsycINFO, EMBASE, CINAHL, AMED, Web of Science and Cochrane from inception to May 2017 for studies reporting concurrent use of prescription medicines with HMPs in adults (≥65 years). Quality was assessed using the Joanna Briggs Institute checklists. The Evidence for Policy and Practice Information and Co-ordinating Centre (EPPI-Centre) three stage approach to mixed method research was used to synthesise data. Results Twenty-two studies were included. A definition of HMPs or what was considered HMP was frequently missing. Prevalence of concurrent use by older adults varied widely between 5.3% and 88.3%. Prescription medicines most combined with HMPs were antihypertensive drugs, beta blockers, diuretics, antihyperlipidemic agents, anticoagulants, analgesics, antihistamines, antidiabetics, antidepressants and statins. The HMPs most frequently used were: ginkgo, garlic, ginseng, St John’s wort, Echinacea, saw palmetto, evening primrose oil and ginger. Potential risks of bleeding due to use of ginkgo, garlic or ginseng with aspirin or warfarin was the most reported herb-drug interaction. Some data suggests being female, a lower household income and less than high school education were associated with concurrent use. Conclusion Prevalence of concurrent prescription drugs and HMPs use among older adults is substantial and potential interactions have been reported. Knowledge of the extent and manner in which older adults combine prescription drugs will aid healthcare professionals can appropriately identify and manage patients at risk.Peer reviewedFinal Published versio

Effect of the Bathing Without a Battle Training Intervention on Bathing-Associated Physical and Verbal Outcomes in Nursing Home Residents with Dementia: A Randomized Crossover Diffusion Study

To evaluate the effectiveness of the Bathing Without a Battle intervention in reducing physical and verbal aggressive behaviors for nursing home residents with dementia