Effect of Body Mass and Smoking on Development of Stroke In Gaza Strip: Retrospective Study

The aim of the present study was to elucidate the effect of Body Mass (BM) and smoking on the development of stroke in a representative retrospective design among men and women in Gaza strip (GS). Methods: We analyzed a data base of 200 men and women aged between 35-70 years and selected by convenience sample. Those patients have been diagnosed with stroke and history of hypertension only and the diagnosis of stroke has been confirmed with physician and computed tomography scan. Self report structure interview was used to collect data by trained interviewers in Arabic language for ease of comprehension by the patient and family. Statistical Package of Social Science (SPSS) was used to analyze the obtained data. Results: There was a significant difference of BM (overweight and obesity) on the development of stroke as evidence by (Chi-square test 40.6 and P value 0.000) while there was no significant difference of smoking on development of stroke as evidence by (Chi-square test. 98 and P value 0.322). On the other hand, our finding revealed a significant difference of smoking on development of stroke only among male smokers after adjustment of female gender (Chisquare test 39.1 and P value 0.000). Conclusions: BM was associated with the development of stroke in general among men and women but smoking was associated with development of stroke among smokers' men only. Further study is recommended to identify the effect of BM in different subtypes of stroke (ischemic, thrombus and hemorrhagic). Therefore, smoking cessation and reducing body weight programs should be an important strategy for reducing

Mapping Stakholders of the Palestinian Health Research System

Background: There is a growing international and regional interest in Health Research Systems (HRSs) in light of a global strategy for HRS stakeholders’ (HRSSHs) active involvement. HRSSHs in Palestine have rarely been investigated with regard to uncertainties. Aims: This study aimed to analyse perceptions of HRSSHs in order to understand their roles and involvement, identify gaps, and offer policy solutions for stakeholders’ engagement in the Palestinian HRS. Methods: This qualitative study targeted three local Palestinian health sectors, government, academia, and local and international agencies. Data were collected through 52 in-depth interviews (IDIs) and 6 focus group discussions (FGDs) and then analysed using MAXQDA 12 software. Participants and institutions were selected purposively based on a set of criteria and peer review. Results: The overall HRS stakeholders’ roles were unsatisfactory, with low involvement from society, the private sector, and local and international sectors. The important role of academia and the Ministry of Health is moderate while that of international agencies is weak due to conflicting agendas and lack of a guiding body. Most universities have poor representation in public decision-making and potential scarcity in health research. Interest–power imbalance among stakeholders is reported where political, organizational, and technical shortfalls were indicative of weak roles and low involvement, along with a lack of health research culture, structure, resources, defined roles, and network. Conclusions: Tackling the inadequate roles, interests’ disparity, and poor involvement of HRSSHs is imperative for HRS strengthening. Redefining HRSSHs’ roles and involving all stakeholders is key through strategic dialogue, consolidated leadership, and resource mobilization.Background: There is a growing international and regional interest in Health Research Systems (HRSs) in light of a global strategy for HRS stakeholders’ (HRSSHs) active involvement. HRSSHs in Palestine have rarely been investigated with regard to uncertainties. Aims: This study aimed to analyse perceptions of HRSSHs in order to understand their roles and involvement, identify gaps, and offer policy solutions for stakeholders’ engagement in the Palestinian HRS. Methods: This qualitative study targeted three local Palestinian health sectors, government, academia, and local and international agencies. Data were collected through 52 in-depth interviews (IDIs) and 6 focus group discussions (FGDs) and then analysed using MAXQDA 12 software. Participants and institutions were selected purposively based on a set of criteria and peer review. Results: The overall HRS stakeholders’ roles were unsatisfactory, with low involvement from society, the private sector, and local and international sectors. The important role of academia and the Ministry of Health is moderate while that of international agencies is weak due to conflicting agendas and lack of a guiding body. Most universities have poor representation in public decision-making and potential scarcity in health research. Interest–power imbalance among stakeholders is reported where political, organizational, and technical shortfalls were indicative of weak roles and low involvement, along with a lack of health research culture, structure, resources, defined roles, and network. Conclusions: Tackling the inadequate roles, interests’ disparity, and poor involvement of HRSSHs is imperative for HRS strengthening. Redefining HRSSHs’ roles and involving all stakeholders is key through strategic dialogue, consolidated leadership, and resource mobilization

Early signals detection of crisis in main governmental hospitals in Gaza Strip

The Study aimed to assess the crisis early signals detection in main governmental hospitals in the Gaza Strip. The design of this study descriptive, analytic, a combination of qualitative and quantitative methods (mixed method) was used to address the research questions. The study was conducted at the main governmental Gaza governorates hospitals including Al- Shifamedical hospital, European Gaza hospital, Nasser medical hospital, Al-Aqsa hospital. A structured self-administered questionnaire was distributed to samples who were working in governmental hospitals. In addition, validated by experts and reliability analysis was performed using Cranach’s Alpha test (0.954). The questionnaire was used with a response rate of 84% .the study sample included 442 eligible subjects who were work as head of departments in four main governmental hospitals .In this study, the researcher used a key informant sample of public health and crisis management experts from Palestine. These experts have highly experience in crisis management. The respondent's evaluation according to their responses to crisis early signal detection was (68%). There are no statistical differences between crisis management responseand gender, scientific qualification, managerial position, age and experience of work (sig. > 0.05). There was a statistical difference between crisis early signal detection according to hospitals, the outcome showed significant differences found in favor of Al-Aqsa Hospital. also, there was a statistical difference between crises responses according to the profession, the outcome showed significant differences found in favor of administrative. The researcher recommended that there is need to strengthen crisis early signal detection in hospitals and establishment of specialized crisis early signal detection teams in several areas of hospitals, the involvement of employees in the emergency plan, and need to bridge the gap between hospitals and different professions in the concepts of crisis managementThe Study aimed to assess the crisis early signals detection in main governmental hospitals in the Gaza Strip. The design of this study descriptive, analytic, a combination of qualitative and quantitative methods (mixed method) was used to address the research questions. The study was conducted at the main governmental Gaza governorates hospitals including Al- Shifamedical hospital, European Gaza hospital, Nasser medical hospital, Al-Aqsa hospital. A structured self-administered questionnaire was distributed to samples who were working in governmental hospitals. In addition, validated by experts and reliability analysis was performed using Cranach’s Alpha test (0.954). The questionnaire was used with a response rate of 84% .the study sample included 442 eligible subjects who were work as head of departments in four main governmental hospitals .In this study, the researcher used a key informant sample of public health and crisis management experts from Palestine. These experts have highly experience in crisis management. The respondent's evaluation according to their responses to crisis early signal detection was (68%). There are no statistical differences between crisis management responseand gender, scientific qualification, managerial position, age and experience of work (sig. > 0.05). There was a statistical difference between crisis early signal detection according to hospitals, the outcome showed significant differences found in favor of Al-Aqsa Hospital. also, there was a statistical difference between crises responses according to the profession, the outcome showed significant differences found in favor of administrative. The researcher recommended that there is need to strengthen crisis early signal detection in hospitals and establishment of specialized crisis early signal detection teams in several areas of hospitals, the involvement of employees in the emergency plan, and need to bridge the gap between hospitals and different professions in the concepts of crisis managemen

Maternity Departments’ supervisors

This course will enable the supervisor midwife to participate in the research process in midwifery. Contents will focus on problem identification, research design, sampling, data collection and analysis and interpretation of findings. Special attention will be given to develop the ability to criticize research studies in women's and maternal issues and to the selection of a researchable problem and the development of a plan

Determinants of low back pain among operating room nurses in gaza governmental hospitals

Globally, Low Back Pain (LBP) comprises a significant occupational hazard in nursing profession. This study aimed to identify determinants of LBP among operating room nurses at Governmental hospitals in Gaza governorates. The design of this study is a quantitative, descriptive, analytical, cross-sectional one. To ensure validity of the instrument; face, content and criterion related validity were carried out and to test reliability of the instrument; small scale reliability test and Cronbach’s Alpha coefficient were carried out. The study population consisted of 159 nurses who represented all the target population. The researcher used a self-constructed, self administered questionnaire. In total, 143 respondents completed the questionnaire with a response rate of 89.9%. Different statistical procedures were used for data analysis including cross tabulation, percentages, mean and Chi square test. The results revealed that the overall prevalence of low back pain among operating room nurses was 70.6%. The prevalence of pain was 68.2% among males and 78.8% among females. The highest complaint of low back pain (100.0%) was reported among those who have a long work experience (23–36 years). The prevalence of LBP was 82.8% among those who have body mass index (BMI) more than 30. There were no significant differences between (gender, years of experience and BMI) and LBP distribution. Prolonged time standing during surgery was the main risk factor for low back pain (67.1%), followed by work overload (65.0%), lifting and transferring patients (62.9%). The study concluded that work related LBP was high among operating room nurses

Impact of Hypertension on the Quality Of Life among Patients Attending Two Palestinian Communities

The aim of this study was to evaluate the quality of life among hypertensive patients attending governmental and UNRWA clinics. It used a descriptive analytical cross sectional design, the study sample included 340 subjects aged between 40–71 years old, and who had hypertension at least for two years. Two settings were chosen randomly one belong to the government and the other belong to UNRWA. Subjects were recruited by using non probability convenient sample method, 170 subjects from each setting comprising 85 males and 85 females. Subjects were told to sign consent in order to participate in the study. A face to face structured interview was used to collect data from the participants by using demographic information sheet and the WHOQOL–BREEF questionnaire. Results of the study revealed that, the percentage of the total scores of the QOL among the whole study sample 65.63%, the highest domain was the social at (70.14%), and the lowest one was the environmental at (62.40%). Demographic characteristics including, age, sex, marital status, educational attainment, duration of disease, monthly income, family size, working status and clinic being visited, was statistically significant except for some domains pertaining to some groups. Physical, psychological and social domains were lower in the group of monthly income 3000NIS and above in comparison with the group of monthly income 2001–3000NIS at level of significance (f= 12.51, 15.85, 13.61) respectively. In regard to marital status psychological and social domains were higher in the married group in comparison with divorced group, but the physicals domain in the

Patients' Satisfaction with the Quality of Health Services Provided at the Outpatient Department at Al-Shifa Hospital

This study aims to assess the patient's level of satisfaction with health services provided at Outpatients' Department at Al-Shifa Hospital. The design of this study is quantitative, descriptive, analytical, cross-sectional one. Interviewed questionnaire was developed and focused on patient's satisfaction. Probability systematic random sample was used in this study and 450 participants were interviewed with a response rate of 90%. Validity and reliability of the instrument were tested and the total instrument reliability test (Cronbach's Alpha) was 0.91. Five dimensions of patients' satisfaction were considered in this study; namely, access to care, physical environment, patients' expectations, waiting time in addition to information and interaction. The overall patients' level of satisfaction was 63.9%. The patients' expectation dimension reported the highest level of satisfaction (68.1%), while, the waiting time dimension reported

Nurses’ Motivation and their Performance at European Gaza Hospital in Gaza Strip

Work motivation plays an important role in enhancing job performance. To maintain effectiveness and development, managers need to adopt a clear and attainable motivational system in their organization. This study aimed to examine the relationships between motivation and performance among nurses working at European Gaza Hospital (EGH). The sample of this study consisted of 170 nurses (96 male and 74 female) and the response rate was 100%. The researchers used two instruments for data collection one for motivation questionnaire: prepared by the researchers and other to Performance appraisal format: prepared by the General Employees council .The researchers used the SPSS program version 13 for data analysis. Different statistical procedures were used for data analysis including cross tabulation, percentage, mean, Pearson correlation, ANOVA and Scheffe and t test. The results showed that the motivation level among the study subjects was 66.2% and the average performance level according to the annual appraisal was 82.1 %. The average performance among nurse subordinates was 80.4% and 83.7% among nurse managers based on the scores obtained from the annual appraisal forms. Participants ranked the motivators of in-service training as the highest one (M = 8.1) followed by working hours schedule (M = 7.00). Salary was ranked as the seventh factor (M= 4.87). The lowest motivator was respect from others (M = 2.78). The study concluded that nurses working at EGH are generally motivated and their performance was high. The results of the study raised the need of training and equitable work schedule to enhance motivation and reinforce performance

Prevalence and Associated Demographic Characteristics of Gestational Diabetes Mellitus in Gaza

ABSTRACT: The aim of the study was to identify the prevalence and sociodemographic characteristics of gestational diabetes mellitus (GDM) in Gaza. A retrospective case-control study that included 189 GDM women were compared with 189 non GDM delivered in 2010 in Gaza. The available data were obtained from 2011 United Nations Relief and Works Agency (UNRWA) primary health care clinics in Gaza. WHO criteria were used for diagnosing GDM. The multivariate logistic regression test was used to identify the odds ratios (ORs) with 95% confidence intervals (CI), and controlling confounder variables. The overall prevalence of GDM women was 1.8%. The mean age and standard deviation for GDM cases was (34.1 yr ±6.56) while for the control group was (34.2 yr ±6.77). The GDM cases showed a similar mean and standard deviation (162.4±5.42) of height in comparison to the control group (162.3 cm ±5.39). The mean and standard deviation of weight (81.1 kg ±13.16) in GDM women was statistically different with a p-value < 0.001 compared to control. The most GDM significant associated demographic factors with a p value <0.005 were low income (OR 0.35, CI 0.14, 0.84) and being overweight before pregnancy (OR 1.07, CI 1.04, 1.09). The prevalence of GDM was found to be average (1.8%) and is increasing. Appropriate interventions are required for individuals matching these socioeconomic characteristics.ABSTRACT: The aim of the study was to identify the prevalence and sociodemographic characteristics of gestational diabetes mellitus (GDM) in Gaza. A retrospective case-control study that included 189 GDM women were compared with 189 non GDM delivered in 2010 in Gaza. The available data were obtained from 2011 United Nations Relief and Works Agency (UNRWA) primary health care clinics in Gaza. WHO criteria were used for diagnosing GDM. The multivariate logistic regression test was used to identify the odds ratios (ORs) with 95% confidence intervals (CI), and controlling confounder variables. The overall prevalence of GDM women was 1.8%. The mean age and standard deviation for GDM cases was (34.1 yr ±6.56) while for the control group was (34.2 yr ±6.77). The GDM cases showed a similar mean and standard deviation (162.4±5.42) of height in comparison to the control group (162.3 cm ±5.39). The mean and standard deviation of weight (81.1 kg ±13.16) in GDM women was statistically different with a p-value < 0.001 compared to control. The most GDM significant associated demographic factors with a p value <0.005 were low income (OR 0.35, CI 0.14, 0.84) and being overweight before pregnancy (OR 1.07, CI 1.04, 1.09). The prevalence of GDM was found to be average (1.8%) and is increasing. Appropriate interventions are required for individuals matching these socioeconomic characteristics

Musculoskeletal Disorders among Radiology Technologists at Governmental Hospitals -Gaza Governorates

This study aims to determine the prevalence and risk factors of musculoskeletal disorders (MSD) among radiological technologists (RTs) working at governmental hospitals in Gaza Strip. The design of this study is descriptive, analytical, cross-sectional one. The sample of this study consisted of all RTs 172 (136 male and 36 female). A pilot study on 15 RTs was conducted to test validity and reliability of the study instrument. Different statistical procedures used for data analysis including cross tabulation, percentage and Chi square. The results showed that the overall prevalence of MSDs among study participants was 75.6%. MSDs were higher among females (91.7%) compared to males (71.3%). Back was the dominant site for MSDs and it constitutes 31.5% and stiffness was the dominant type of pain (31.5%). Eighty three point five percent of males and 84.8% of females RTs complained of moderate to severe MSP. The majority of RTs (79.2%) have intermittent episodes of pain and 56.2% of them complained of pain for more than 6 months. Regarding pain onset, 90.0% of RTs developed pain after they were employed in radiology department and 10.0% had MSP before working in radiology department. There were no statistical significant differences in MSP in relation to gender, age and years of experience. The highest complain of MSP (61.0%) was among RTs aged 40 years and less and the lowest complain (3.0%) was among RTs aged 51 – 59 years, 44.7% of those who complained of MSP were employed for 1 – 7 years. Among those who complained of pain, 82.3% asked for medical advice. Bending and twisting were the major risk factors for MSDs (88.4%) followed by lifting heavy objects and cassettes (85.5%), lifting and transferring patients (77.9%) and psychological pressure (77.3%), while sitting for long time (32.6%) and office work (19.2%) were the lowest risk factors. Concerning workplace environment, 58.7% of RTs reported that Basma T. Alagha , Yousef I. Aljeesh (102) Journal of Al Azhar University-Gaza (Natural Sciences), 2013, 15 lighting in their workplace was unsuitable, 54.6% of them reported that floor was unsuitable and 58.1% reported that staff number was unsuitable. The study concluded that workplace modifications is needed (lighting and floor) beside the need to increase the number of qualified staff. Priority suggestions to avoid MSDs were decreasing the number of radiology procedures performed each day, distributing assignments fairly between staff and avoiding lifting heavy objects.This study aims to determine the prevalence and risk factors of musculoskeletal disorders (MSD) among radiological technologists (RTs) working at governmental hospitals in Gaza Strip. The design of this study is descriptive, analytical, cross-sectional one. The sample of this study consisted of all RTs 172 (136 male and 36 female). A pilot study on 15 RTs was conducted to test validity and reliability of the study instrument. Different statistical procedures used for data analysis including cross tabulation, percentage and Chi square. The results showed that the overall prevalence of MSDs among study participants was 75.6%. MSDs were higher among females (91.7%) compared to males (71.3%). Back was the dominant site for MSDs and it constitutes 31.5% and stiffness was the dominant type of pain (31.5%). Eighty three point five percent of males and 84.8% of females RTs complained of moderate to severe MSP. The majority of RTs (79.2%) have intermittent episodes of pain and 56.2% of them complained of pain for more than 6 months. Regarding pain onset, 90.0% of RTs developed pain after they were employed in radiology department and 10.0% had MSP before working in radiology department. There were no statistical significant differences in MSP in relation to gender, age and years of experience. The highest complain of MSP (61.0%) was among RTs aged 40 years and less and the lowest complain (3.0%) was among RTs aged 51 – 59 years, 44.7% of those who complained of MSP were employed for 1 – 7 years. Among those who complained of pain, 82.3% asked for medical advice. Bending and twisting were the major risk factors for MSDs (88.4%) followed by lifting heavy objects and cassettes (85.5%), lifting and transferring patients (77.9%) and psychological pressure (77.3%), while sitting for long time (32.6%) and office work (19.2%) were the lowest risk factors. Concerning workplace environment, 58.7% of RTs reported that Basma T. Alagha , Yousef I. Aljeesh (102) Journal of Al Azhar University-Gaza (Natural Sciences), 2013, 15 lighting in their workplace was unsuitable, 54.6% of them reported that floor was unsuitable and 58.1% reported that staff number was unsuitable. The study concluded that workplace modifications is needed (lighting and floor) beside the need to increase the number of qualified staff. Priority suggestions to avoid MSDs were decreasing the number of radiology procedures performed each day, distributing assignments fairly between staff and avoiding lifting heavy objects