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Yassir Turki Suha Saleh Shatha Albaik Yasmeen Barham Dorien van de Vrie Yousef Shahin Majed Hababeh Akihiro Seita 《Lancet》2019
Background
Mental health is a major public health priority, particularly among refugees worldwide. The United Nations Relief and Works Agency for Palestine Refugees (UNRWA) started to integrate mental health and psychosocial support (MHPSS) into its primary health-care services in Jordan in late 2017. This baseline study aimed to assess the knowledge, attitudes, practices, and perceived barriers among UNRWA health staff regarding the implementation of the MHPSS programme.Methods
The UNRWA Health Programme conducted a cross-sectional study of a sample of 220 out of the 390 male and female doctors, dentists, nurses, and midwives who work at 16 of the 25 UNRWA health centres in Jordan during November, 2017. Individuals on duty at the health centres on the day of the survey were included. The 16 health centres were selected based on their size and accessibility to surveyors (reflecting proximity to Amman, and the size of population served). Of the selected health centres, seven were large, seven were medium, and two were small according to the UNRWA classification of health centres (based on the number of medical doctors). A validated self-administered questionnaire was used. Ethics approval was granted by the UNRWA Health Programme ethics committee, and informed written consent was obtained from all participants. Data analysis was performed using SPSS (version 22).Findings
Of the participants, 73% (161 of 220) believed that their knowledge of MHPSS programmes was insufficient, with no significant difference (p=0·116) between different categories of staff. Furthermore, 88% (194 of 220) said that they needed more training, 67% (147 of 220) reported that the number of mental health cases is increasing, and 50% (110 of 220) that dealing with these cases is difficult. Reflecting on the past 12 months, 31% of staff (69 out of 220) reported meeting between one and ten children, and 45% (100 out of 220) reported meeting between one and ten adults suspected of having mental illnesses. The most suspected condition was depression (84%; 150 of 220), followed by epilepsy (64%; 140 of 220). The main perceived barriers to implementation included the limited availability of MHPSS policies (87%; 192 of 220), MH professionals (86%; 190 of 220), resources (86%; 189 out of 220), and lack of privacy (14%; 31 out of 220).Interpretation
Most health staff had positive attitudes towards MHPSS programme implementation but felt they lacked the required knowledge. There is a need for training and clear technical guidelines. Perceived barriers to MHPSS programme implementation need to be tackled with a structured plan of action.Funding
The UNRWA Health Programme, UNRWA Headquarters, Amman, Jordan. 相似文献3.
Belal Azab Raghda Barham Dema Ali Zain Dardas Lana Rashdan Maysa Bijawi Ranad Maswadi Abdelhalim Awidi Hanan Jafar Mohammed Abu-Ameerh Muawyah Al-Bdour Sami Amr Abdalla Awidi 《Canadian journal of ophthalmology. Journal canadien d'ophtalmologie》2019,54(1):51-59
Objective
To identify the disease-causing variants in 2 families with autosomal recessive inherited retinal dystrophies (IRDs) and to characterize phenotypic variability across the affected family members.Design
Exome sequencing and ophthalmic clinical examination study.Participants
Six members from 2 consanguineous Jordanian families with IRD.Methods
Ophthalmic examinations and whole-exome sequencing (WES) were performed to identify IRD-causing variants in affected individuals from each family, followed by segregation analysis of candidate variants in affected and unaffected family members by Sanger sequencing.Results
We identified 2 different homozygous deletion variants in CERKL in each family: a novel pathogenic variant, c.450_451delAT, and a known variant, c.1187_1188delTG. Both variants co-segregated with the disease in all affected family members. The resulting phenotypes further supported that CERKL is associated with cone–rod dystrophy (CRD) rather than retinitis pigmentosa (RP), as originally established.Conclusion
Our study expands the genotypic spectra of CERKL variants, providing insights into the relevant pathogenesis of RP/CRD. We also confirm that the WES approach is a valuable tool for the molecular diagnosis of retinopathies. 相似文献4.
Synovial sarcoma of the esophagus 总被引：1，自引：0，他引：1
The occurrence of synovial sarcoma in sites other than the extremities is rare. Twelve cases in the hypopharynx but none in the esophagus have been described. A case of polypoid synovial sarcoma arising in the upper third of the esophagus in a 25-year-old man is reported. To the authors' knowledge, this is the first report of synovial sarcoma arising in the esophagus. The pathologic findings, ultrastructural studies, and results of surgical management and radiotherapy are discussed. 相似文献
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Noortje Gerritsma Iman Alshanti Ibtissam Ouaali Maisa Dawoud Majed Hababeh Akihiro Seita 《Lancet》2019
Background
Maternal mortality rates in Palestine refugees in Jordan increased by 16% between 2013 and 2016. Action is needed to prevent future maternal deaths. Risk factors for maternal mortality are a young mother (below 20 years of age) and pregnancies that are close together (interval of less than 18 months), which can be prevented through the use of contraception. Contraceptive discontinuation rates increased among Palestine refugees in Jordan by 3% between 2015 and 2016. Sociocultural factors are important in access to contraception. This study assesses sociocultural barriers and opportunities to accessing contraception among Palestine refugees in Jordan.Methods
Focus group discussions were conducted in June, 2017, with female and male patients and health-care workers in rural and urban communities in Jordan. Patients were selected using opportunistic sampling at health centres; health centres and health-care workers were selected using purposive sampling. Only participants who signed the informed consent form were included. Discussions were moderated by a local researcher, tape-recorded, transcribed, translated, and analysed with MaxQDA. Analysis was conducted by two researchers independently using predetermined and emergent themes. Approval was obtained from the UNRWA Ethics Office.Findings
12 discussions were conducted with 84 participants, seven participants per discussion; 40 females, 27 males, and 17 health workers with an age range of 18–67 years. Perceived barriers to accessing or using contraception included husband or family-in-law opposition to contraception use; preferences in terms of the sex of children; pride in having many children; fear of infertility; incorrect use of contraception; a lack of health-care workers to provide contraception; reluctance of staff to provide contraception to females without spousal consent; and costs involved in using contraception. Perceived benefits included the financial advantage of a smaller family; and birth spacing for women's mental and physical health.Interpretation
Despite the use of opportunistic sampling, this study shows that both sociocultural barriers and benefits to accessing contraception exist for Palestine refugees in Jordan. More resources are needed to improve access by further researching sociocultural dynamics related to contraception use.Funding
Share-Net International, Royal Tropical Institute (KIT), the Netherlands. 相似文献9.
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