Death, Dying, and End-of-Life Care in the US and the Netherlands: A Scoping Review

Introduction: The aim of End of Life (EOL)-care in any setting is to improve the quality of life of patients and families through medical or non-medical interventions. The study aims at identifying gaps in the literature produced on the topic and informs areas for future research in the field. Objective: To identify articles that discuss death and dying, with the elderly > = 70, living at home, or in nursing homes, in assisted living, or community centres, in hospice or palliative care, in hospitals or emergency care. Methods: A scoping review of studies in the U. S. and in the Netherlands. Using the inclusion and exclusion criteria, the selected studies were analysed and categorized by themes, and then summarized based on positive, negative and ambiguous views on death discussions at all four (4) levels of discussion. Results: From a total of one hundred and fifty-nine studies, twenty-five studies passed the selection criteria. Twenty-one were for the U. S., and four were for the Netherlands. The selected studies were analysed and categorized by themes. Conclusion: The review pointed to a dearth of material that measured the outcome of discussions on the subject of death and dying with the elderly. Future studies could consider discussions on death and dying from the perspective of patients’ anxiety and distress, instead of concerns over financial support, religious and ethnic issues, ethical and legal parameters, and extra medical training.publishedVersio

Consumption patterns and side effects of energy drinks among university students in Palestine: crosssectional study

This study describes the patterns of energy drinks consumption and associated factors among University students in Palestine. A cross-sectional study was conducted at An-Najah National University in Nablus, West Bank-Palestine. The study included 279 students of three colleges: Medicine, Physical Education and Engineering. Data were collected using a 25-item self-administered questionnaire. Energy-drink consumption was significantly higher among male students, as 80.5% of energy-drink users involved in this study was males. It was higher among those with higher monthly expenditure. The most common cause for using energy drinks among users was to stay awake at night (68.6%), while most of those who never tried energy drinks in their lives didn’t do so because they thought energy drinks are unhealthy. About two thirds (64.4%) of the participants didn’t know the main constituents of energy drinks and about half (53.6%) stated that they knew that there might be side effects associated with the use of energy drinks. More than half of the current users (56.8%) consumed less than 1 bottle/day. Energy-drink usage is common among university students in Palestine and higher among males and those with higher monthly expenditure. Campaigns should be encouraged in order to spread awareness about the contents and possible side effects of energy drinks

Impact of design characteristics of daylight elements to creating healthy internal environment for school buildings evaluation the status of schools in Mosul city

The current research deals with impact of design characteristics that creates attractive and healthy internal environments for school building , as one of the most important issue on evaluating random position of local school building in Mosul city .Because they are describes as limited efficiency of educational performance and lake of healthy feature . This paper addresses the issue of daylight effects factors that supports efficiency of interiors in school building by using specific quality of design characteristics that related building composition in one hand , and elements of classes daylight in the other. The objective of this paper is to determine the key design properties affecting to achieves healthy spatial environment , which are related on two main daylight factors :solarization average for building at all ,and homogeneity of daylight at work surface in classroom space . The study employed (Velux Daylight Visualizer – 2012) in deign research methodology to evaluate three school building types that used in Mosul city .Finding of this study confirmed that the deign properties related two factors of daylight have effective role in creating healthy interiors and increase educational productivity. The result of this study are useful reference for architects ,planner ,landscape ,and researcher in this field , the municipality of Mosul

Numerical modelling investigation of rock mass behaviour under gravity dams

The study of rock mass behaviour is a broad subject in the rock mechanics field which still needs more research and investigation, especially for geotechnical issues associated with dam construction. Since it is difficult to study rock mass behaviour at a large scale in the laboratory, the numerical modelling technique is an alternative method which can be used efficiently in this field. In this thesis two codes have been selected for this purpose. The first code was a continuum code FLAC (Fast Lagrangian Analysis of Continua), which was used to study the effect of a weak rock joint on the stability of a concrete gravity dam as well as to model the gravity dam with its foundation as a continuum. The second code was the Distinct Element Method (DEM) software package UDEC (Universal Distinct Element Code), which was used to study the fully jointed rock mass behaviour under the gravity dam. The equivalent strength and deformability parameters of jointed rock masses were also studied using UDEC. Furthermore, the cause of strain hardening behaviour in jointed rock samples was studied using UDEC and experimental methods. Based on UDEC models, it was concluded that only the low dip angle of the joints on downstream side, dipping upstream had a significant effect on the evaluated deformation of the dam. This was confirmed by using FLAC to model a single weak joint (using interfaces), which may exist in the upstream or downstream direction, on the stability of the dam. Furthermore, to obtain a better understanding of the rock mass behaviour, the equivalent strength parameters as well as the deformation modulus of a rock mass were determined using UDEC. A novel FISH (imbedded language in UDEC) function was developed for this purpose. A range of numerical simulations of uniaxial compressive strength (UCS) and triaxial tests were conducted on the numerical rock mass samples for these purposes. To validate this, the deformation modulus of the rock mass predicted by an analytical equation, quoted from literature, was compared with the numerical results that were given by UDEC. It was found that UDEC can efficiently be used to determine the strength and deformability parameters of rock masses and that at certain specific joint configurations, the rock mass behaviour was similar to granular material. In addition, it was concluded, for the first time, that the non-uniform distribution of axial loading on the jointed rock sample was the main cause of strain hardening especially for a joint that has a dip angle of 60 degree. To overcome this problem, a new loading configuration was developed for applying a uniform distribution of axial stress on the jointed rock samples in order to reduce the effect of platen-rock interaction on the axial stress-strain relationship, using UDEC and laboratory tests. Finally, the study of rock mass strength and deformability parameters of Surqawshan dam’s foundation in Iraq were determined using UDEC and the results were compared with rock classification systems: RMR and GSI. According to the UDEC results all methods give a similar evaluation of friction angle; however, GSI overestimates the cohesion. The UDEC and GSI gave reasonable estimations of deformation modulus, whereas RMR overestimated it. Generally, for rapid estimation of deformability and strength parameters, especially for weak sedimentary rock, the deformation modulus can be predicted from the GSI system, whereas the strength parameters can be estimated using RMR

Major Risk Factors in the Onset of End-Stage Renal Disease

Aims: The incidence of chronic End-Stage Renal Disease (ESRD) is rapidly increasing among the Palestinian population in the last few years. Therefore, it is important to study the factors that influence this increase. This study is aimed to investigate the major risk factors that led to increased ESRD that requires hemodialysis in Northern West Bank. Methods: A literature review was conducted to determine the causes of ESRD, treatment, complications, incidence and preva-lence in developing and developed countries. Results: The major risk factors that are significantly associated with the onset of ESRD include diabetes mellitus, hypertension, cardiovascular disease, recurrent taken analgesic drugs and infection of the urinary tract. Conclusion: Identifying major risk factors affecting ESRD is an important topic. There should be more attention to improve the quality of renal replacement therapy and facilities. This could be achieved through increasing the number of qualified staff and the dialysis machines. Furthermore, knowing the causes will help to focus on prevention and early treatment. This will reduce health system costs associated with ESRD

Modeling Users’ Empowerment in E-Health Systems

In conventional e-health initiatives, customers (patients) are mostly perceived as recipients of medical care, where they play little roles in the process of health decision making. Empowerment in e-health enables individuals to access their health data and consult online with medical staff. The proposed concept is intended to improve the existing e-health theory in relation to patient empowerment. The study suggests a model that expands the role of customers (patient) in three dimensions: as an individual health actor, social health agent, and medical partner. This study is theoretically significant because it explores a comprehensive approach of patient empowerment in e-health systems to achieve best practice customer service, establish long-term customer relationships to improve customer satisfaction, and achieve better health literacy of individuals.publishedVersio

Numerical modelling investigation of rock mass behaviour under gravity dams

The study of rock mass behaviour is a broad subject in the rock mechanics field which still needs more research and investigation, especially for geotechnical issues associated with dam construction. Since it is difficult to study rock mass behaviour at a large scale in the laboratory, the numerical modelling technique is an alternative method which can be used efficiently in this field. In this thesis two codes have been selected for this purpose. The first code was a continuum code FLAC (Fast Lagrangian Analysis of Continua), which was used to study the effect of a weak rock joint on the stability of a concrete gravity dam as well as to model the gravity dam with its foundation as a continuum. The second code was the Distinct Element Method (DEM) software package UDEC (Universal Distinct Element Code), which was used to study the fully jointed rock mass behaviour under the gravity dam. The equivalent strength and deformability parameters of jointed rock masses were also studied using UDEC. Furthermore, the cause of strain hardening behaviour in jointed rock samples was studied using UDEC and experimental methods. Based on UDEC models, it was concluded that only the low dip angle of the joints on downstream side, dipping upstream had a significant effect on the evaluated deformation of the dam. This was confirmed by using FLAC to model a single weak joint (using interfaces), which may exist in the upstream or downstream direction, on the stability of the dam. Furthermore, to obtain a better understanding of the rock mass behaviour, the equivalent strength parameters as well as the deformation modulus of a rock mass were determined using UDEC. A novel FISH (imbedded language in UDEC) function was developed for this purpose. A range of numerical simulations of uniaxial compressive strength (UCS) and triaxial tests were conducted on the numerical rock mass samples for these purposes. To validate this, the deformation modulus of the rock mass predicted by an analytical equation, quoted from literature, was compared with the numerical results that were given by UDEC. It was found that UDEC can efficiently be used to determine the strength and deformability parameters of rock masses and that at certain specific joint configurations, the rock mass behaviour was similar to granular material. In addition, it was concluded, for the first time, that the non-uniform distribution of axial loading on the jointed rock sample was the main cause of strain hardening especially for a joint that has a dip angle of 60 degree. To overcome this problem, a new loading configuration was developed for applying a uniform distribution of axial stress on the jointed rock samples in order to reduce the effect of platen-rock interaction on the axial stress-strain relationship, using UDEC and laboratory tests. Finally, the study of rock mass strength and deformability parameters of Surqawshan dam’s foundation in Iraq were determined using UDEC and the results were compared with rock classification systems: RMR and GSI. According to the UDEC results all methods give a similar evaluation of friction angle; however, GSI overestimates the cohesion. The UDEC and GSI gave reasonable estimations of deformation modulus, whereas RMR overestimated it. Generally, for rapid estimation of deformability and strength parameters, especially for weak sedimentary rock, the deformation modulus can be predicted from the GSI system, whereas the strength parameters can be estimated using RMR

Diabetes education program for people with type 2 diabetes: An international perspective

© 2016 Elsevier Ltd. Background: In the Palestinian community, lifestyle changes, rapid urbanization and socioeconomic development, stress, smoking, and changes in food habits has increased the risk of non-communicable diseases especially diabetes mellitus. Diabetes complications can be prevented if the glycemic status of patients with diabetes is maintained within a nearly normal range. Therefore, patient education is critical in controlling blood glucose levels within the normal range. Objective: This study aimed at measuring the effect of diabetes educational intervention program for patients suffering from type 2 diabetes attending the Diabetes Clinic in Tulkarim Directorate of Health. Methods: A short duration observational study involving pre- and post-test educational intervention program was carried out on a relatively small number of type 2 diabetes patients at the Diabetes Clinic in Tulkarim Directorate of Health. In total, 215 patients attended a group-based 4 h educational intervention session about diabetes. The program included explaining diabetes mellitus-symptoms, risk factors, types, treatment and complications and main aspects of self-care of the disease (foot care, eye care, and blood glucose monitoring), main aspects of dietary management, weight reduction, blood pressure, smoking cessation, periodic investigations, home monitoring and importance of physical activity. Knowledge evaluation questionnaire were evaluated pre- and post-study. Anthropometric measurements such as body weight (WT), body mass index (BMI) and laboratory tests such as fasting blood glucose (FBG), hemoglobin A1C (HbA1c), cholesterol (Chol), and triglycerides (TG) were measured both at the beginning and at the end of the study. Significance of the results was assessed by paired t-test at 95% confidence interval. Results: The participant\u27s mean age was 51.07 that ranged between 31 and 70 years. For a total of 215 participants, 41.4% were males and 58.6% were females. The mean weight before educational intervention was 80.81 ± 14.95 kg (82.6 kg for males and 79.5 kg for females) that decreased to 78.9 ± 14.33 kg (81.1 kg for males and 77.3 kg for females) after educational intervention program. The BMI also decreased significantly after educational intervention. The mean fasting blood sugar was 188.65 ± 71.45 mg/dL before educational intervention that decreased to 177.7 ± 66.11 mg/dL after the educational intervention (p = 0.049). The mean glycosylated hemoglobin was 8.57 ± 1.21 before educational intervention that decreased to 7.95 ± 1.42 after educational intervention. The mean value of cholesterol before educational intervention was 183.27 ± 37.74 mg/dL that decreased to 169.57 ± 34.23 mg/dL after educational intervention. The mean triglycerides value decreased after educational intervention from 209.85 ± 171.04 mg/dL to 183.28 ± 152.4 mg/dL (p = 0.025). The mean score of knowledge questionnaire before educational intervention was 60.6 ± 20.65 that increased to 78.1 ± 13.4 after conducting educational intervention. Conclusions: Diabetes education was found to be effective on BMI, FBG, HbA1c, Chol, TG, and knowledge. Recommendations: Diabetes education is a cornerstone in the management and care of diabetes and should be an integral part of health planning involving patient\u27s family, diabetes care team, community, and decision makers in the education process

Farmers' perceptions of climate change and its impact on gum Talha (Acacia seyal var. seyal) production in Bahar Alarab locality, East Darfur State, Sudan

Acacia seyal var. seyal is an essential source of income to farmers in the Bahar Alarab locality in Sudan. Farmers’ perceptions of current climate conditions and their subsequent repercussions on Gum Talha (Acacia seyal var. seyal) production remains poorly investigated and understood. To fill this gap, a survey was carried out within six villages at Bahar Alarab locality in East Darfur State, Sudan, and a total of 391 randomly selected farmers were included in the study. Moreover, rainfall and temperature data over 30 years (1988 – 2020) were analysed. The results revealed that climate change signs were perceived by farmers based on the size of gum production (27.4%), early falling of leaves (26.1%), decline in production (24.3%), and persistent insect attack (22.3%). Moreover, farmers also reported increases (65%) and decreases (19%) in temperature. In contrast, 46.5% of farmers reported that rainfall deficiency was a decreasing factor of production. Accordingly, 69% of respondents perceived an increase in temperature, whereas 49.4% reported a decrease in rainfall frequency. Additionally, the results showed that there was long-term variability in temperature over the past three decades. The results of multinomial logistic regression highlighted that household size is an important factor contributing to the increasing trend of temperature. In addition, the growth and productivity of acacia trees were found to be determinants of farmers’ perception of temperature and precipitation change over the past 30 years. The study suggests a tailored policy that could reduce climate-induced impacts on gum Talha productivity and increase farmers’ gain to avoid poverty in this locality