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The experience of ambiguous loss among the families of Palestinian martyrs whose bodies are detained
(Al-Quds university, 2023-02-01) Lamees Najeeb Ibraheem Farraj; لميس نجيب إبراهيم فراج
The punishment of withholding the corpses of the Palestinian martyrs made the loss
suffered by their families’ incomplete. The loss in such a case is considered to be an
ambiguous loss since the fate of the martyrs remains unknown. The families are
unable to fully grieve their loss; having many questions remains unanswered, and
with the absence of tangible evidence of death; the release of the martyrs' bodies
becomes a crucial issue for their loved ones.
This study aims at exploring the experience of the ambiguous loss and its
psychological and social effects on the families of the Palestinian martyrs whom the
Israeli authority is withholding their bodies. To achieve the aim of the study, the
researcher used a qualitative approach. The study sample consisted of (22)
individuals of first-degree relatives: (father, mother, wife, brother and sister).
The study utilized the semi-structured interview to collect data, as well as the
constant comparative data analysis to analyze the data. The questions were asked in
a way that allows the respondents to tell their story, reflect on their experience, and
express their feelings. The results showed that the loss suffered by the families of
the martyrs corresponds with the theory of ambiguous loss. A set of aspects were
explored as a result of the physical loss of the bodies. One of the most noticeable
was identiting confusion and its impact on their fate.
As for the psychological and social effects, the results confirmed that the families of
the martyrs live in a continuous state of psychological stress. They also face social
and legal consequences, since the body is withheld.
The study recommends that the institutions associated with the mental health sector
develop a framework for building a treatment approach for the families of withheld
martyrs. This can be based on the therapeutic approach of the ambiguous loss
theory.
The necessity of careful follow-up of the numbers of missing martyrs in Palestine in
order to reach the truth about their martyrdom and the loss of their bodies, in order
to alleviate the psychological and social condition experienced by their families due
to the absence of sufficient information about them.
جعلت عقوبة احتجاز جثامين الشهداء الفلسطينيين من الفقدان الذي يعاني منه أهاليهم غير مكتمل، ويعتبر الفقدان فقداناً مُلتَبِساً كون مصير الشهداء يبقى مجهولاً وهذا يبقي ذويهم في حالة مستمرة من التفكير بالشهداء ويبقي الكثير من الأسئلة معلقة بدون إجابات، ومع غياب دليل ملموس على الوفاة أصبح استرداد جثامين الشهداء القضية المحورية لذويهم. هدفت هذه الدراسة الى استكشاف مظاهر الفقدان المُلتَبِس والآثار النفسية والاجتماعية المترتبة عليه والتي يعاني منها عائلات الشهداء الفلسطينيين بسبب قيام السلطات الإسرائيلية باحتجاز جثامين الشهداء. لتحقيق هدف الدراسة استخدمت الباحثة المنهج الكيفي، تكونت عينة الدراسة من (22) فرداً من ذوي الشهداء وكانت صلة القرابة من الدرجة الأولى ما بين (أب، أم، زوجة، أخ وأخت)، استخدمت الباحثة المقابلة شبه المقننة كأداة للدراسة وتم طرح الأسئلة بطريقة تسمح للمبحوثين بسرد قصتهم وعكس تجربتهم والتعبير عن مشاعرهم، إضافة الى استخدام طريقة المقارنة المتواصلة في التحليل من منهج النظرية المجذرة لتحليل البيانات. أظهرت النتائج أن الفقدان الذي يعاني منه عائلات الشهداء يتطابق مع نظرية الفقدان المُلتَبِس، وتم استكشاف مجموعة من المظاهر كنتيجة للفقدان الجسدي وكان أبرزها ارتباك هوية الفاقدين وتأثيره على مصيرهم. أما فيما يتعلق بالآثار النفسية والاجتماعية فقد أكدت النتائج أن ذوي الشهداء يعيشون حالة مستمرة من الضغوطات النفسية، كما ويواجهون عواقب اجتماعية وقانونية خاصة بوضعهم كون الجثمان محتجزا. توصي الدراسة إلى ضرورة المتابعة الدقيقة والمستمرة لأعداد الشهداء المفقودين في فلسطين للوقوف على حقيقة استشهادهم وفقدان جثامينهم، وذلك للتخفيف من الحالة النفسية والاجتماعية التي تعيشها أسرهم بسبب غياب المعلومات الكافية عن حقيقة استشهادهم.
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Health Care Providers’ Knowledge, Practice and Barriers to Newborn and Mother Skin-to-Skin Contact in Gaza Strip, Palestine
(Al-Quds University, 2022-11-26) Yasmin Ismail Abed Alqader Alhabil; ياسمين إسماعيل عبد القادر الهبيل
Mother-infant skin-to-skin contact (SSC) is placing infant directly on mothers' chest or abdomen immediately after delivery early and should be continuous at least 60 minutes. (SSC) have many benefits for mother and newborn due to stabilization of newborns' temperature, heart rate, respiratory rate and blood glucose level, as well as decrease postpartum hemorrhage and increase oxytocin level for mother. SSC started in Gaza strip since 2017 but faced many challenges and barriers. This study aimed to identify health care providers' (HCP) knowledge, practice and barriers to newborn and mother skin-to-skin contact. The study used descriptive, analytical and cross-sectional design and targeted the health care providers who work at four governmental maternity hospital (Shifa, Tahreer, Aqsa and Emarati). The sample consisted of 267 HCPs (midwives who work in labor rooms were 62, obstetricians 153 and pediatricians 52). The study used self-constructed and administered questionnaire that content validity was done by 7 experts and the reliability of the tool was high as Cronbach alpha was 0.84. Data Analysis was performed using SPSS version 25. The result showed that 35.2% study participants were from Al-Shifa hospital, 28.5% were from Al-Threer, 18,4% were from Al-Aqsa hospital, and 18% were from Al-Emaratee hospital, also 23.2% were midwives, 57.3% were obstetricians, and 19.5% were pediatricians, in addition to 45.3% have an experience less than five years, 14.2% have an experience of 15 years and more. HCPs had very good knowledge about SSC with mean percent 82%, and good practice with mean percent 72%, while 86.1% had training on Early Essential Newborn Care (EENC) and SSC. Midwives had the best practice among HCPs with mean 3.197, also training and work place recorded statically significant relationship with knowledge and practice Main barriers respectively were lack of mothers' awareness, lack of social support and motivation and lack of privacy. According to the result of this study HCPs were not committed to non-urgent separation policy of newborns and thus they need more training on this policy. The study recommended to increase mothers' awareness about the importance of SSC through antenatal visits, maintain privacy, and to decrease the barriers of SSC at the maternity hospitals.
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Pomegranate peel (Punica granatum L.) versusـ Juice: Properties and Benefits
(Al-Quds University, 2022-08-12) Eman Hasan Ismail Amar; ايمان حسن إسماعيل اعمر
The presence of antioxidants and polyphenols in pomegranate peels and juice has been linked to several medical benefits. In the juice, you'll find vitamins and minerals. It is possible to understand the pomegranate's features and benefits, which are beneficial for treating a variety of disorders, by using various extracts (alcoholic extract and ethyl acetate). To develop treatments for diverse ailments, this study is crucial.
In this study, the pomegranate peel was extracted using the Soxhlet extraction apparatus, which was able to essentially remove all of the active compounds from this plant.
The Folin-Ciocalteu test was used to measure the total phenolic content (TPC) of pomegranate peel extracts and juice. All tests were performed using a UV-Visible spectrophotometer. Pomegranate juice and peel were shown to have antioxidant capabilities and high phenolic content. While the total phenolic content (TPC) of pomegranate peel extracted with ethanol 99% produced a result of (78.81mg/g) higher than that of pomegranate peel extracted with, ethanol 35% which is (74.94mg/g) and ethyl acetate (56.61 mg/g) and juice(23.88 mg/g), where the total flavonoids content (TFC) ended with a result of pomegranate extract with ethanol 35% (18.09 mg/g) higher than the extracted with ethanol 99% (7.95 mg/g) and pomegranate juice (0.0547 mg/g).
HPLC analysis of polyphenolic standards compounds and flavonoids was detected and identified by comparing the peaks retention times in the sample chromatogram of pomegranate peel (extracted using ethanol) with that of the standard. After conducting the HPLC analysis, the results showed, Rutin and Gallic acid
By scavenging free radicals with the DPPH method, the antioxidant activity (AA) of pomegranate peel extracts was identified. Pomegranate peel was extracted using ethanol 99.9% and ethanol 35% as a solvent, yielding results of (51.9 mg/g), (9.86 mg/g), and juice (16.79 mg/g), as opposed to (76.8 mg/g) when ethyl acetate was used as the solvent.
The extracts from peel pomegranate (extracted using ethanol 99.9%) antibacterial activity were determined in vitro using the agar disc diffusion method The existence
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of positive control. the result showed antibacterial activities against Pseudomonas aeruginosa, Escherichia coli, Methicillin-resistant Staphylococcus aureus (MRSA), Staphylococcus aureus and the juice does not have a direct effect on the bacteria, as the bacteria appeared diluted.
The anti-glycation formation of the end product was assessed using an in vitro glucose-bovine serum albumin (BSA) test. The results of the study showed that pomegranate peel extract with ethanol has an anti-glycation effect, whereas pomegranate juice has less of it.
The cream was made based on pomegranate peel extracted using ethanol and had several features, including moisturizing, and smoothing, has a pleasant scent, absorption rapidly (without leaving a film), does not irritate the skin (pH= 5.5-6), has excellent color, easily distributed on the skin
The enzyme HMG-CoA(3-hydroxy-3-methylglutaryl-coenzyme A) reductase is essential for the mevalonate pathway that produces cholesterol. The liver produces less cholesterol when HMG-CoA reductase is present. Pomegranate peel (extracted with 99.9% ethanol) had a 45% inhibitory effect, and pomegranate juice had a 74% inhibitory effect.
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Favorable attributes and biological effects of Hibiscus Sabdariffa
(Al-Quds University, 2022-12-18) Iman Ibrahim Mohammad Shafout; إيمان إبراهيم محمد شعفوط
The hibiscus Sabdariffa calyx extract was studied for its antioxidant activity and some biological effects. Three different solvents were used to extract the hibiscus sabdariffa calyx (Ethanol 99%, ethanol 35% and ethyl acetate. Antioxidant capacity was determined in these three different hibiscus extracts by DPPH assay. The extract exhibited inhibition of the DPPH activity in three extracts reaching 87.85% in ethanol 99% extract, 69.64% in ethanol 35% extract and 81.6% in ethyl acetate extract. By using Gallic acid as a standard, the Folin-Ciocalteau method was used to determine the total phenolic content. The total phenolic content was found to be 95.37 ± 0.3 mg gallic acid/ g in ethanol 35% extract, 55.8 ± 0.3 mg gallic acid/ g in ethanol 99%, and 48.73 ± 1.5 mg gallic acid /g in Ethyl acetate extract. The total flavonoids content was estimated by the aluminum chloride method. The total flavonoids content was found to be the highest amount with ethanol 35% extract which reached 64.8 ± 0.88 mg/g, while it was 24.59 ± 1.7 mg/g and 20.1 ± 0.9 mg/g in ethyl acetate, respectively. The hibiscus extract was examined using an HPLC device at a wavelength of 280 nm, and the result was that it contained a group of compounds: Gallic acid, chlorogenic, vanillic acid, caffeic acid, syringic acid, and sinapic acid. The main enzyme in the mevalonate pathway, which creates cholesterol, is 3-hydroxy-3-methyl-glutaryl-coenzyme A (HMG-CoA) reductase. When HMG-CoA reductase is inhibited, the liver produces less cholesterol. Statins, a class of synthetic medications, are frequently used to treat hypercholesterolemia. Natural HMG-CoA reductase inhibitors of plant origin are required because statin side effects exist. In this study, the anti-HMG-CoA reductase activity of Hibiscus sabdariffa ethanolic extracts was examined. The therapy reduced LDL cholesterol by 41.7±0.87%. Meanwhile the hibiscus sabdariffa microemulsion reduced the LDL by 24% Although the concentration of the active substance is 12.9% of the first concentration. The anti-glycation synthesis of end products was assessed using an in vitro glucose-bovine serum albumin (BSA) assay.. The obtained results show that Concentrations of (10.7, 8, 6.7, 5.3, and 2.6). mg/mL of Hibiscus sabdariffa ethanolic extract could inhibit AGE-formation by 17%, 14%, 6%, 5.68%, - 5% respectively.
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In the presence of positive controls (Gentamicin (10 mg/disc) and Penicillin) when using the disc diffusion method (10 units), the hibiscus sabdariffa extract showed a good ability to inhibit the action of four different types of bacteria (MRSA, E-coli, S. aureus, and Pseudomonas). The results of the extract’s inhibition on MRSA at concentrations of 100% and 75% were 26±3mm and 8.3±0.6mm, respectively. The results of the extract’s inhibition on E-coli were the concentrations of 100% and 75% were 20.3 ± 1.1 mm and 7 ± 1 mm respectively while the inhibition effect of +ve control Gentamicin was 15 mM Hibiscus extract had an inhibitory effect on S. aureus where the of inhibition for 100% and 75% were 34.3 ± 0.6 mm and 11 ± 1 mm which is higher than the effect of +ve control penicillin 15 mm. The effect of the extract inhibition on Pseudomonas at a concentration of 100% and 75%, respectively, 24.3 ± 0.6 mm and 9.7 ± 1.1 mm, while the effect of +ve control Gentamicin reached 29 mm. In this experiment, a phase diagram was worked out, and two important areas appeared. The microemulsion area centered at the top of the drawing is close to the highest percentage of the surfactant and the crystal liquid area. The preliminary results of the current investigation indicate that the H. sabdariffa extract could lower cholesterol levels by reducing the activity of the enzyme HMG-CoA reductase.. In addition, the Hibiscus extract has antioxidants, phenols, and flavonoid compounds. The hibiscus has also an antibacterial effect.
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Patient Satisfaction toward the Pharmaceutical Care Services provided at the Ministry of Heath Primary Healthcare Pharmacies in Bethlehem Governorate
(Al-Quds University, 2022-12-11) Shireen Jaber Ibrahim Alhoubani; شيرين جابر ابراهيم الحوباني
Background: Patient satisfaction is a humanitarian testimony resulting from practical experience and an integral component of the quality of healthcare aimed to measure the quality of provided health services.
Justification: the sensitivity of the health sector whereas the Palestinian health institutions especially the governmental institutions still struggling to exist despite the technical and political challenges.
General goal: to assess patient satisfaction toward the pharmaceutical services provided by the Ministry of Health primary healthcare pharmacies in Bethlehem Governorate.
Study methodology: A cross-sectional study was conducted over two months, using a self-developed questionnaire, consisting of 5 points Likert scale, the study population was the patients of twenty pharmacies of the ministry of health primary healthcare pharmacies.
Results: The response rate was 100%, the female was 64% and the male was 36%, and the cut-off point was 3. The overall patient satisfaction toward pharmaceutical services was satisfied with M= 3.10, SD= .651, the highest satisfaction was shown toward prescription services infrastructure with M= 3.73, SD= .702 and the pharmacists’ role, performance and characteristics M= 3.34, SD= .772. The lowest satisfaction was shown toward time in the counseling room with M= 2.57, SD=1.176
and time in the waiting room with M= 2.85, 1.095. There are significant differences between geographic location in terms of pharmacist characteristics, performance and role (p= 0.001), prescription Monitoring & screening (p=0,001), time in the counseling room (p=0,003), and dispensing (p=0,012).
IV
Patients were satisfied with pharmaceutical services located in the middle of Bethlehem city (M=3.24, SD= .686) more than north (M=2.95, SD= .590) in terms of overall patients satisfaction (p=<0.001), however patients satisfied with pharmaceutical services located in the south of Bethlehem city (M=3.18, SD= 656) more than the north (M=2.95, SD= .590) in terms of overall patients’ satisfaction (p=0.016). The study indicated there are significant differences between the place of residence (p=<0.001), occupation (p=0.020) and health insurance (p=0.047). Pearson correlation indicated a significant positive small correlation between overall patient satisfaction and the number of beneficiaries from the services provided by the primary health pharmacies to family (r= 0.177, p= <0.001), Furthermore, a significant negative small correlation between overall patient satisfaction and the far of the pharmacy from their place of residence (r= -0.141, p= 0.005).
Conclusion and recommendations: The results showed patient satisfaction toward the pharmaceutical care services provided and suggested to provide primary health pharmacies with large quantities of medications an infrastructure development including the waiting & counseling rooms and raising consumers’ awareness about their rights to get optimal health care and any health institution should evaluate patient satisfaction continuously.
خلفية الدراسة: رضا المريض هو شهادة إنسانية ناتجة عن الخبرة العملية وعنصر لا يتجزأ من جودة الرعاية الصحية التي تهدف إلى قياس جودة الخدمات الصحية المقدمة.
المبرر: حساسية القطاع الصحي حيث أن المؤسسات الصحية الفلسطينية خاصة المؤسسات الحكومية منها ما زالت تكافح من أجل الاستمرارفي تقديم خدماتها على الرغم من التحديات الفنية والسياسية.
الهدف العام: تقييم رضا المريض حول الخدمات الصيدلانية التي تقدمها صيدليات وزارة الصحة للرعاية الصحية الأولية في محافظة بيت لحم.
منهجية الدراسة: أجريت دراسة مقطعية على مدى شهرين، باستخدام استبيان تم تطويره ذاتيًا ، يحتوي على مقياس ليكرت الخماسي ، وكان مجتمع الدراسة عبارة عن مرضى عشرين صيدلية من صيدليات وزارة الصحة للرعاية الصحية الأولية.
النتائج: معدل الاستجابة كان 100%، نسبة الاناث كانت 64% ونسبة الذكور 36%، القيمة المحددة والفاصلة هي 3، كان هناك رضا عام من قبل المرضى تجاه الخدمات الصيدلانية M = 3.10 ، SD = .651 ، تم إظهار أعلى درجات الرضا تجاه البنية التحتية لخدمات الوصفات الطبية M = 3.73 ، SD = .702 أما دور الصيادلة وأدائهم وخصائصهم M = 3.34 ، SD = .772. أما أقل رضا فكان تجاه الوقت في غرفة المشورة M = 2.57 ، SD = 1.176, الوقت في غرفة الانتظار M = 2.85 ، 1.095. كما اظهرت النتائج فروق ذات دلالة إحصائية بين الموقع الجغرافي من حيث خصائص الصيدلي وأدائه ودوره (0.001(p= ، أما مراقبة وفحص الوصفات (0.001(p=، والوقت في غرفة الاستشارة (0،003p=) ، وصرف الأدوية (0،012p=) .
كان للخدمات الصيدلانية المقدمة في وسط مدينة بيت لحم رضاً (M = 3.24 ، SD = 0.686) أكثر من تلك التي تقدم في الشمال (M = 2.95 ، SD = .590) من حيث الرضا العام للمرضى (p = <0.001) ، ومع ذلك المرضى الراضون عن الخدمات الصيدلانية الواقعة في جنوب مدينة بيت لحم (M = 3.18 ، SD = 656) أكثر من الشمال (M = 2.95 ، SD = .590) من حيث الرضا العام للمرضى (ع = 0.016). كما وأشارت الدراسة إلى وجود فروق ذات دلالة إحصائية بين مكان إقامة المريض(p = <0.001) ، والوظيفة (p = 0.020) والتأمين الصحي (p = 0.047). أشارت علاقة بيرسون إلى وجود علاقة إيجابية بين الرضا العام للمريض وعدد المستفيدين من الخدمات التي تقدمها صيدليات الصحة الأولية للأسرة (r = 0.177 ، p = <0.001) ، علاوة على ذلك ، علاقة سلبية بين الرضا العام للمريض وبُعد الصيدلية عن مكان إقامتهم (r = -0.141 ، p = 0.005).
الخلاصة والتوصيات: أظهرت النتائج رضا المرضى تجاه خدمات الرعاية الصيدلانية المقدمة واقترحت تطوير للبنية التحتية في صيدليات المستوى الصحي الأولي بما في ذلك غرف الانتظار والمشورة ورفع وعي المستهلكين حول حقوقهم في الحصول على الرعاية الصحية المثلى وتوفير كميات أكبر لأنواع الأدوية التي يحتاجها المرضى باستمرار ، كما ويجب على أي مؤسسة صحية تقييم رضا المريض بشكل مستمر