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- Item31P-NMR and differential scanning calorimetry studies for determining vesicles drug physical state and fraction in alendronate liposomes(OMICS Publishing Group, 2010-10-15) Afergan, Eyal; Najajreh, Yousef; Gutman, Dikla; Epstein, Hila; Elmalak, Omar; Golomb, GershonBackground: A liposomal delivery system requires a complete understanding of the physicochemical characteristics of the drug– liposome system in order to predict their behavior and stability in-vitro and in-vivo. Objectives: Develop a rapid and simple experimental method to determine the fractions of the drug, alendronate (ALN), encapsulated and as a free form distributed in the liposomal suspension, and the physical state of the encapsulated drug. Methods: 31P-NMR measurements utilizing Ga+3 as a shifting reagent in comparison to HPLC determinations, theoretical calculations and differential scanning calorimetry (DSC) studies of various liposomal ALN formulations. Results: The 31P-NMR demonstrated that titrating liposomal ALN with increasing amounts of Ga+3 induced a signifi cant shift in the exterior fraction without changing the interior fraction. Quantitative determination of the encapsulated and non-encapsulated fractions of ALN has been achieved at Ga+3 concentrations of 3.2-25mM. The DSC study revealed that none of the formulation ingredients is in a solid phase. Conclusions: 31P-NMR was found to be sensitive enough to allow accurate differentiation of the distributed fractions of ALN, encapsulated and the non-encapsulated free form. Based on theoretical calculations and DSC analysis it can be concluded that ALN is dissolved in the aqueous core of the liposome.
- Item50 years of professional public health workforce development. ASPHER's 50th Anniversary Book(The Association of Schools of Public Health in the European Region (ASPHER), 2016-05-20) M., HamdanThe Association of Schools of Public Health in the European Region (ASPHER) is the key independent European organisation dedicated to strengthening the role of public health by improving education and training of public health professionals for both practice and research. ASPHER is a membership organisation of institutions, spread across EU and wider across WHO European Region, which are collectively concerned with the education and training, and professionalism, of those entering and working within the public health workforce
- ItemA case of uniportal VATS thymectomy for Thymoma associated with myasthenia gravis and toxic multinodular goiter(ELSEVIER, 2022-05-11) Osama N. Dukmak; Ruba Dweik; Nadeen Hashlamoun; Rahaf Qawasmeh; Mohammad Eid Al Mohtasib; Yousef Abu AsbehBackground: Thymoma is a rare neoplasm, which may be associated with autoimmune disorders, the occurrence of hyperthyroidism in the patients with thymoma is rare. Clinical presentation: Here we present an extremely rare case of a 56-year-old female patient who was discovered to have malignant thymoma with associated myasthenia gravis and hyperthyroidism due to toxic multinodular goiter. Our patient started to complain of difficulty breathing and swallowing, Chest CT scan was done and revealed an anterior mediastinal mass, measures about 4.1 × 3.1 × 2.2 cm with enlarged lymph node mostly representing thymoma. Complete thymectomy was performed via uniportal video-assisted thoracoscopic surgery, and the patient's postoperative recovery was uneventful. Microscopic histopathology findings corresponded to thymoma type B1. Conclusion: The coexistence of thymoma, MG and toxic multinodular goiter is extremely rare. MG should always be suspected in a patient with thymoma. VATS thymectomy has been increasingly used to treat thymoma as it has several advantages over open surgery.
- ItemA comparative study of five numerical methods for the estimation of Weibull parameters for wind energy evaluation at Eastern Jerusalem, Palestine(ELSEVIER, 2022-04-16) Husain R. Alsamamra; Saeed Salah; Jawad A.H. Shoqeir; Ali J. ManasraWind power provides a clean and feasible solution to generate electricity. The development of wind power applications requires a deep analysis of wind profiles and an accurate prediction of wind energy at a study site. This work explores the distribution of wind speed to estimate the two Weibull parameters (shape and scale) that are widely utilized for modeling and providing an accurate and efficient estimation of wind resource and power. These two parameters are calculated based on measured daily wind speed data from 2008 to 2018, collected in Jerusalem, Palestine. Three assessment criteria were used to assess the goodness of fit; they are Root Mean Square Error (RMSE), Mean Absolute Percentage Error (MAPE), and chi-square. The findings revealed that of the five estimation methods being considered in this study, both the Empirical Method (EM) and the Method of Moment (MoM) were the most accurate in determining the values of the Weibull shape and scale parameters to approximate wind speed distribution at the study site. Based on the goodness-of-fit tests, both methods provide lower values of the used assessment criteria. The statistical performance tests rejected the Energy Pattern Factor Method (EPFM) as an adequate method due to the higher values of chi-square and revealed that the Maximum Likelihood (MLM) and the Modified Maximum Likelihood (MMLM) methods ranked third and fourth, respectively.
- ItemA Mathematical-Based Model for Estimating the Path Duration of the DSDV Routing Protocol in MANETs(MDPI, 2022-05-12) Saeed Salah; Raid Zaghal; Mada AbdeljawadMobile Ad Hoc Networks (MANETs) are kind of wireless networks where the nodes move in decentralized environments with a highly dynamic infrastructure. Many well-known routing protocols have been proposed, with each having its own design mechanism and its own strengths and weaknesses and most importantly, each protocol being mainly designed for specific applications and scenarios. Most of the research studies in this field used simulation testbeds to analyze routing protocols. Very few contributions suggested the use of analytical studies and mathematical approaches to model some of the existing routing protocols. In this research, we have built a comprehensive mathematical-based model to analyze the Destination-Sequenced Distance Vector protocol (DSDV), one of the main widely deployed proactive protocols and studied its performance on estimating the path duration based on the concepts of the probability density function and the expected values to find the best approximation values in real scenarios. We have tested the validity of the proposed model using simulation scenarios implemented by the Network Simulator tool (NS3). The results extracted from both the mathematical model and the simulation have shown that the path duration is inversely proportional to both the speed of the node and the hop count. Furthermore, it had shown that the path duration estimated from the DSDV protocol is less than the actual path duration, due to the implementation of the settling time concept and keeping the “periodic routes’ update” parameter at a constant level, despite the fact that the node’s speed reduces the effective path utilization.
- ItemAccelerations in the Lactonization of Trimethyl Lock Systems Aredue to Proximity Orientation and not to Strain Effects(Hindawi Publishing Corporation, 2009-02-10) Karaman, RafikDFT at B3LYP/6-31G(d, p) and HF at 6-31G and AM1 semiempirical calculations of thermodynamc and kinetic parameters for the trimethyl lock system (an important enzyme model) indicate that the remarkable enhancement in the lactonizations is largely the result of a proximity orientation as opposed to the currently advanced strain effect.
- ItemAccuracy of Intracavitary Applicator Reconstruction for Cervix Cancer Brachytherapy(Springer, 2019-12-03) ALMasri, Hussein; Kakinohana, Yasumasa; Toita, Takafumi; Ariga, Takuro; Kasuya, Goro; Murayama, SadayukiThe accuracy of intracavitary applicator reconstruction for cervical cancer was assessed. A homemade phantom that mimics clinical applicator placement and reference points was used. Three stainless steel (15°, 30°, and 45°) tandems, x-ray markers, and three reference points were used to compare radiography- and CT-based systems. For CT reconstructions, two Fletcher CT compatible (15° and 30°) tandems, two ovoids, and two reference points, with and without inserted x-ray markers, were used. A 2.5-mm CT slice thickness was used. To check for inter- and intra-operator variations in CT, only a 30° tandem without x-ray markers and 1.25-mm CT slice thickness were used. Applicators were reconstructed three times for each image set to verify the operator reproducibility. A 6 Gy dose was prescribed and normalized at AL-point. Source dwell times were compared to check for dose variation at A-point. Maximum standard deviations SD (σ) for radiography and CT reconstructions were 0.35 and 0.83mm, respectively. Analysis of variance for the means of 15° and 30° tandems showed no significant difference. Levene’s test proved insignificant difference for 15° tandem (p value = 0.131), whereas it showed a significant difference for 30° tandem (p value = 0.011). This phantom study showed that the variance of dwell times between the two methods for 30° tandem was statistically significant due to increased applicator curvature. CT proves superiority to radiography. X-ray marker method was more accurate but has less image quality. Inter- and intra-oncologist variations showed good agreement.
- ItemThe Achievement of Both Justice and Consent in Financial Transaction Contracts(2020-10-20) Assaf, Mohammad Motleq MohammadThis study clarifies that the basis on which contracts are established is mutual consent, whereby property shall not be taken away from a person without their consent. The indication of mutual consent is the apparent wording of offer and acceptance under the condition of the absence of coercion that cancels consent. This coercion is illegal coercion that is unjust and that unlawfully infringes the right of others to exercise free will. However, if the opposite occurs, namely, if the right of agreement and consent in a contract leads to injustice or harm to others, then achieving both justice and consent by using coercion is the right thing to do. This type of coercion aims to achieve a rightful purpose that ensures justice and eliminates injustice and provides for restitution as well.
- ItemAchievements and barriers of renewable energy in Palestine: Highlighting Oslo Agreement as a barrier for exploiting RE resources(Elsevier Ltd., 2021-06-01) Abboushi, Nour; Alsamamra, HusainOslo agreement was signed in 1993 between the Palestinians and the Israelis as a gesture of hope for the autonomy of the Palestinians on their lands. Palestinians lands was divided into three administrative regions: Areas A, B, and C. These divisions were signed as a temporary transitional period of 5 years, during which the transfer of control over areas C and B to the Palestinian National Authority, was not implemented until the time of writing this research. This work aims to shed light on the impact of the geopolitical division on the possibility of exploiting renewable energy resources on C areas, and the role of that in achieving the Palestinian vision of reducing total dependency on the Israeli side as a net importer of Energy. To conclude, 96% of the total potential of solar energy is in West Bank, while Gaza has only 163 MW. Area C obsesses over 62% of solar energy potential, while about 75% of the potential in area (A þ B) is upon the roof tops. It is expected, 98% of the total renewable energy potential is solar energy potential. Only 0.12% of the total A and B lands are suitable for producing solar electricity.
- ItemAcidic whey as a novel coupling agent for composites based on E-Glass fibers and low-density polyethylene(An-Najah University, 2022-02-02) Shadi Sawalha; Raed Ma’ali; Hussein Mushatti; Mohammad MakharzehIn order to enhance the interfacial-adhesion between short E-glass fibers and low-density polyethylene (LDPE), acidic whey; a dairy byproduct was applied as coupling agent. The fibers were immersed in acidic whey for 12, 24, 36, 48 and 60 hours. Composite materials containing 20 wt.% E- glass fibers and LDPE were prepared by extrusion process. The tensile strength and modulus of the produced composites were improved by using acidic whey, and the improvement in those properties was strongly affected by the immersion time of E-glass fibers in acidic whey. An increase of about 289%, 107%, 291% and 721% in modulus of elasticity, tensile strength, modulus efficiency and strength efficiency factors respectively were achieved after 60 hours of immersion of glass fibers in acidic whey. The effects of acidic whey on tensile properties and efficiency factors could be ascribed to the mend in interfacial-dhesion between glass fibers and LDPE polymer.
- ItemAcinetobacterlwoffii Induced Cellulitis with Allergy-like Symptoms(Internet Scientific Publications, 2012-01-10) Barghouthi, S.; Hammad, G.; Kurdi, M.Few reports document the misdiagnosis of Acinetobacterlwoffii skin infections for allergic reactions. In addition, A. lwoffii is frequently misidentified when applying conventional diagnostic methods. The bacterium has been reported to cause a multitude of diseases including skin and wound infections. The application of the newly established method “The Universal Method” allowed definite identification of the bacterium isolated from a leg and foot cellulitis case (Isolate QUBC mk1) that was misdiagnosed as an allergic reaction and was treated with intramuscular injections of diclofeneac sodium, anonsteroidal antiinflammatory drug.The isolate was identified as A. lwoffii, it failed to grow on MacConkey agar, and it was sensitive to ciprofloxacin but resistant to cefazolin. The 51-year old male patient was successfully treated with intravenous administration of ciprofloxacin, doxacillin, and cefazolin. He was released in good health after ten days.This work emphasizes the importance of distinguishing between skin infections and allergies. It also stresses the importance of prompt and accurate identification of A. Lwoffii and its possible relationship to allergic reactions. Misdiagnosis isdiscussed in the context of “The Hygiene Hypothesis”.
- ItemAcute pancreatitis with giant pancreatic pseudocyst as a complication of extracorporeal shock wave lithotripsy: A case report and literature review(2021-05-26) Alzeerelhouseini, Hussam I.A.; Abuzneid, Yousef S.; Ashhab, Hazem A.ntroduction: Extracorporeal shock wave lithotripsy has been confirmed as the least invasive and the most widely used treatment for kidney and ureteral stones. However, as with any other type of therapy, potential compli-cations do exist. Case presentation: Herein, we describe a 55-year-old male patient who developed symptoms of acute pancreatitis one day after extracorporeal shock wave lithotripsy for left renal stones. The patient used to manage himself with NSAIDs till he presented to the emergency department with severe epigastric pain and tenderness due to giant pancreatic pseudocyst formation. The pseudocyst was treated by endoscopic cystogastrostomy using metallic stent with uneventful recovery. In addition, we extensively reviewed all available literature studies of pancre-atitis and pancreatic pseudocyst occurring after extracorporeal shock wave lithotripsy. We summarized all re-ported cases and presented them in a comprehensive table. Discussion: Post ESWL acute pancreatitis is a rare clinical entity with only 11 reported cases. In all cases, abdominal pain was the most common symptom that occurs in less than 24h following ESWL treatment. So it should be considered in the differential diagnosis of acute abdominal pain after ESWL. Conclusion: Although ESWL is generally considered safe and effective treatment; however, major complications have been reported to occur in less than 1% of patients. One of the extremely rare complications is the devel-opment of pancreatitis and pancreatic pseudocyst.
- ItemAcute Respiratory Tract Infections among HospitalizedPalestinian Patients (2011–2016): A Retrospective Study(Hindawi, 2021-05-04) Abu Seir, Rania; Njoum, Wafa’; Najajrah, Rawan; Najjar, Dania; Ashour, Mariam; Asakra, Bassam; Samman, Nahla; Najjar, OsamaRespiratory tract infections (RTIs) are a major public health concern. (is study aims to investigate the profiles and epide-miological characteristics of acute RTIs and respiratory pathogens in Palestinian hospitalized patients. Clinical samples fromhospitalized patients with symptoms of acute RTIs admitted between January 2011 and December 2016 were referred to thePalestinian Central Public Health Laboratory (PHCL) to identify the causative pathogen. Patients’ demographic information andthe results of the molecular identification were retrieved from the electronic database at the PHCL. A total of 15413 patients withacute RTIs were hospitalized during the study period. (e causal agent was identified only in 28.7% of the patients. Overall,influenza viruses were the most common cause of RTIs among hospitalized Palestinian patients in the West Bank. Children andelderlies were the most affected with RTIs. (e elderly population (≥60 years old) had the highest rates. After influenza A virus,respiratory syncytial virus (RSV), andBordetella pertussis(B. pertussis) were the most common causes of acute RTIs amonghospitalized Palestinian patients. Children showed the highest hospitalization rates for RSV,B. pertussis,adenovirus, enterovirus,andStreptococcus pneumoniae.On the other hand, elderlies had the highest rates of influenza. Outbreaks of RTIs occurred mainlyduring winter (between December and March). (e resurgence ofB. pertussisin spite of vaccination is alarming and requiresfurther investigation.
- ItemAcute Severe Hyponatremia following Hysteroscopic Procedure in a Young Patient: A Case Report and Review of the Literature(Hindawi, 2021-09-21) Atieh, Anwar S.; Abu Shamma, Omar K.; Abdelhafez, Mohammad O.; Baniowda, Muath A.; Abed, Samia; Babaa, Basheer H.; Hamadah, Abdurrahman; Gharaibeh, Kamel A.Background. Hysteroscopic surgery is a minimally invasive procedure used to diagnose and treat intrauterine pathologies. It requires distension of the uterine cavity for the adequate visualization of the operative field. Glycine (1.5%) is one of the most commonly used solutions because it is nonconductive and also has good optical properties. However, acute hyponatremia is a critical complication that can develop after the absorption of a sufficient amount of the irrigation medium. Case Presentation. We report a case of a 43-year-old female patient who developed acute symptomatic hyponatremia (104 mEq/L) and pulmonary edema secondary to hysteroscopic resection of leiomyoma and hastily approached with rapid sodium correction measures. Conclusion. Multiple strategies can be taken to reduce the risk of fluid absorption and subsequent hyponatremia. Moreover, attention should be paid to the treatment approach for patients with acute hyponatremia following hysteroscopic procedures; rapid correction of acute hyponatremia for such patients might be safe, although there is no consensus in the literature, and further trials are needed.
- ItemAcute Stress Disorder in Palestinian Children in the Gaza Strip(SCIENCEDOMAIN, 2015-06-06) Thabet, Abdelaziz Mousa; Thabet, Sanaa S.Aim: This study aimed to describe the range of acute traumatic stress disorder symptoms in a sample of displaced and non-displaced children and adolescents in the Gaza Strip. Methods: This was descriptive analytic study. The study sample consisted of 381 children and adolescents ranging in age from 7 to 18 years. Regarding displacement status, 190 of them were non-displaced (50.1%) and 191 were displaced (49.91%). Ninety-four of displaced children were boys (49.22%), while, 73 of non-displaced children were boys (38.41%). One hundred seventeen of displaced children were girls (61.6%), 97 of non-displaced children were girls (50.8%). Children were assessed by a socio demographic questionnaire, the Gaza Traumatic Events Checklist, and Acute Stress Disorder Scale. Results: The highest frequencies of reported traumatic events for both groups (displaced and nondisplaced) were hearing shelling of the area, hearing the loud voice of Drones, and watching mutilated bodies in TV. However, displaced children reported more traumatic event such as forced to leave home with family members due to shelling, receiving pamphlets from Airplane to leave home at the border area to the city center, threatened by telephone to leave their homes for bombardment of homes, destruction of their personal belongings during incursion. Displaced children reported more traumatic events than non-displaced ones (Mean= 13.6 vs. 9.08). Boys reported more traumatic events. Using the DSM-V criteria, 10.0% of non-displaced children and 18.4% of displaced children had acute traumatic stress disorder. Displaced children reported more acute stress disorder, dissociative, re-experiencing, avoidance, and hyperarousal symptoms. Traumatic events were associated acute traumatic stress, re-experiencing, and hyperarousal symptoms. Conclusion and recommendations: This study showed that Palestinian children and adolescents are victims of continuous war and trauma, and will develop new symptoms of acute stress disorder after exposure to war in the Gaza Strip. Such findings highlight the needs for better mental health services for children especially displaced populations who are not able to return to their homes due to the siege, in order to increase their coping abilities and resilience in face of adversities.
- ItemAdapting Modernity: Designing with Modern Architecture in East Jerusalem, 1948–1967(Oxford University Press on behalf of The Design History Society, 2021-04-05) Samman, Maha; Saifi, YaraThis study examines the influence of modernity on residential buildings as a new form of expansion built during the Jordanian Rule (1948–1967) outside the Old City of East Jerusalem. Through investigating a sample of houses, the study shows how building typologies, layouts and architectural characteristics depict and inform reinterpretations and adaptations of modernity. Unlike the modernity that emerged out of the western locus, these buildings do not ignore their vernacular roots but adapt to the Palestinian socio-cultural lifestyle, and at the same time borrow from the aesthetic and ideological characteristics of the modern idiom. Based on architectural documentation and ethnographic research, the analyses show that the peasants (Fallahin) made an important contribution to the adaptive modernity of residential buildings in East Jerusalem. The designs were influenced by some aspects of modernity but were also subject to local and cultural determinants. The study contributes to the literature on ‘other modernities’ outside the west, and to an architectural history that is informed by people’s private and individual experience rather than by those working in the profession. This is considered to be a neglected heritage that this article aims to redress.
- ItemAdaptive Control of Congestion in Tough Wireless Environments Using DCM+ Algorithm(Scientific Research Publishing, 2019-08-28) Hamamreh, Rushdi; Khader, DerarThe aim of this paper is to present DCM+, a new congestion control protocol for data networks. It stands for Dynamic Congestion control for Mobile networks. New metrics have been newly invented and introduced like normalized advancing index (NAI) and complete transmission time (CTT). The simulations are done for a simple single-hop-topology (sender-router-receiver ). The outcomes of this protocol are excellent and, in most cases, better than other approaches. The excellent properties of our proposed protocol were possible through tracking the available slow-start threshold. We achieved performance improvement, minimized end-to-end delay and large reduction in transmission time. DCM+ was able to combine many advantages at same time of the protocols NewReno and Westwood+. The results show, that DCM+ is extremely adequate for different types of networks. Feedback as main principle of control theory was used to control the congestion in the network. The parameters Round-Trip-Time (RTT) and Retransmission Timeout (RTO) are used as feedback signals to adjust the next congestion window (cwnd).
- ItemAdaptive neuro-fuzzy inference system for predicting alpha band power of EEG during muslim prayer (SALAT)(Singapore, World Scientific, 2016-12-19) Doufesh, Hazem; Ibrahim, Fatimah; Ismail, Noor Azina; Ahmad, Wan Azman WanThe features of electroencephalographic (EEG) signals include important information about the function of the brain. One of the most common EEG signal features is alpha wave, which is indicative of relaxation or mental inactivity. Until now, the analysis and the feature extraction procedures of these signals have not been well developed. This study presents a new approach based on an adaptive neuro-fuzzy inference system (ANFIS) for extracting and predicting the alpha power band of EEG signals during Muslim prayer (Salat). Proposed models can acquire information related to the alpha power variations during Salat from other physiological parameters such as heart rate variability (HRV) components, heart rate (HR), and respiration rate (RSP). The models were developed by systematically optimizing the initial ANFIS model parameters. Receiver operating characteristic (ROC) curves were performed to evaluate the performance of the optimized ANFIS models. Overall prediction accuracy of the proposed models were achieved of 94.39%, 92.89%, 93.62%, and 94.31% for the alpha power of electrodes positions at O1, O2, P3, and P4, respectively. These models demonstrated many advantages, including e±ciency, accuracy, and simplicity. Thus, ANFIS could be considered as a suitable tool for dealing with complex and nonlinear prediction problems.
- ItemAddressing Coherence in English-Arabic Subtitling by Amateur Aficionados(2017-01-12) Thawabteh, Mohammad Ahmad; Musallam, SulafaThe present article discusses coherence in terms of linguistic, cultural and polysemiotic channels. Subtitlers are often faced with major stumbling blocks to get the message across in a cohesive and coherent fashion within the scope of various semiotic modalities, typically underpinning the construction of meaning. The present study is based on the data excerpted from the famous American sitcom, The Fresh Prince of Bel Air first aired in 1990, subtitled by two amateur subtitling aficionados and one MA translation student (who will be referred to as student subtitler) enrolled on Audiovisual Translation course at Al-Quds University for the school year 2014/2015. The article employs a comparative analysis of the subtitles made by the amateur subtitlers and a trained subtitler. The article reveals that the student subtitler seems to be more aware of the specificities of subtitling and capable of rendering the accurate coherent semiotic meaning(s) of the uttered communication in the American sitcom than the other subtitlers. The article finally proposes a number of implications for the work of amateur subtitling aficionados and student subtitler and makes various recommendations that might assist in improving the translation quality.
- ItemAdolescent access to health services infragile and conflict-affected contexts: Thecase of the Gaza Strip(2021-05-13) Abu Hamad, Bassam; Jones, Nicola; Gercama, IngridBackground:Enjoyment of physical and mental health is not only recognized as a human right but also as an integral partof development, as reflected in Sustainable Development Goal 3–to ensure healthy lives and promote well-being for all atall ages. The rapid physical and psychosocial changes that take place during adolescence have a strong influence on the restof a person’s life course, so investments in adolescent health services constitute a unique opportunity to reap inter-generational dividends. Yet the evidence base on adolescents’access to health services, particularly in conflict-affectedcontexts, remains thin. This article explores adolescents’access to health services in the Gaza Strip, and their experiences andperceptions of those services.Methods:The article draws on mixed methods research in the Gaza Strip conducted in 2016 and 2017 as partof the Gender and Adolescence: Global Evidence research programme. Data were collected from 240 maleand female adolescents combining in-depth interviews, focus group discussions and a tablet-based survey.This study also draws on a participatory action pilot project engaging 12 boys and 23 adolescent girls aged15–19 years old.Results:The findings underscore that gender norms—especially those pertaining to adolescent girls’sexual purity––shape adolescent health in multiple ways. Girls face increasing restrictions on their mobility, leaving them with limitedopportunities for leisure or exercise, socializing with peers or seeking health services and information. Adolescent boysin Gaza do not face the same restrictions, but given the multiple political, economic and familial stressors, they are athigh risk of substance abuse including smoking and involvement in peer violence. Moreover, our findings suggest thata range of socioeconomic, cultural and structural barriers prevent adolescents in Gaza from accessing quality andappropriate health care. Study participants cited the main challenges being an absence of preventive adolescenthealth initiatives and limited information on sexual and reproductive health, as well as drug shortages, high treatmentcosts, and inappropriate interactions with service providers.Conclusions:The article highlights the importance of designing and implementing conflict-sensitive and age- andgender-appropriate adolescent services and information and promoting preventive services targeted at adolescents.