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Concept: Palestinian National Authority

169

Coeliac disease is an important clinical disorder affecting the human gastrointestinal tract leading to multiple signs and symptoms in different body organs. This disease was the subject of a cross sectional descriptive-analytic study conducted in the Gaza Strip during 2010. Objectives were oriented to identify and verify several variables and attributes affecting the prognosis of coeliac disease in the patients. Ninety five children out of 113 patients were arranged into two groups according to age from 2 to 11 years and from 12 to 18 years old. Results showed the poor interest of health professionals regarding coeliac disease in the Gaza Strip. The mean age of study population was 5.47 years for males and 8.93 years for females. The lifestyle of coeliac patients was directly proportional with better nutritional indictors. Poor recognition of the emblem illustrating gluten in foods implicates effective health awareness or promotion. The more knowledgeable patients or mothers (P = 0.036) were the more compliant. The compliance to giving gluten free foods outside home was statistically significant (P = 0.037). Similarly, cautious approach when buying foods or detergents (P = 0.011). According to BMI 74.4%, 23.4% and 3.2% of all patients were normal, underweight and overweight respectively. Albumin blood level was normal in 32.6% and low in 67.4%. Meanwhile, blood calcium level was normal in 76.8%, low in 21.1% and high in 2.1% of all patients. Conclusion: The study showed that recreation and social activities for coeliac patients are substantially missing in the Gaza Strip. Moreover, the study proved that AEI is a reliable centre for care of coeliac disease patients and conducting relevant studies. Recommendation: There is a need for thorough and continuous community and institutional mobilization regarding coeliac disease in the Gaza Strip and in Palestine.

Concepts: Hamas, Coeliac disease, Second Intifada, Gaza, Palestinian National Authority, Palestinian territories, Gaza Strip, Gluten-free diet

30

The present paper examines the talk of three senior figures from the Palestinian Hamas political movement. Data are drawn from a series of journalistic interviews that were conducted in the months leading up to the invasion of Gaza by Israel in December 2007. Using membership categorization analysis, we explore the membership categories and category-bound attributes that interviewers use in questions about responsibility for potentially culpable actions and the ways that these are taken up, challenged, or reworked by interviewees in presenting their own versions. The analytic findings show that interviewers deploy categories bound up with terrorism while interviewees develop alternative categorizations of resistance. Interviewers construct Palestinians as victims of Hamas' actions while interviewees construct them as victims of Israeli aggression and international indifference. In warranting these alternative constructions, the interviewees contrast current behaviours of the international community with those of the past and align current Palestinian actions with those previously taken by Western nations in resisting illegitimate occupations. Through these descriptions of categories and actions, the interviewees attribute to the wider international community responsibility for addressing the events of the ongoing conflict.

Concepts: Palestinian people, Present, Yasser Arafat, Palestinian territories, Palestine Liberation Organization, Gaza Strip, Palestinian National Authority, Israel

27

27

BACKGROUND: β-Thalassemia is a disorder caused by mutations at the hemoglobin β-gene (HBB) locus. Its most important manifestation, the major form, is characterized by severe hypochromic and hemolytic anemia and is inherited in an autosomal recessive mode. In Gaza Strip, Palestine 0.02% of the population has been identified as β-thalassemia major. DESIGN AND METHODS: An assessment of mutations was performed in 49 transfusion dependent patients with β-thalassemia major and in 176 β-thalassemia carriers diagnosed with a mean erythrocyte cell volume (MCV) <80fl and a proportion of HbA(2)>3.5%. In addition 39 individuals suspicious for β-thalassemia carrier status due to a reduced MCV (<80fl) but a normal HBA(2) were screened. RESULTS: By screening with three hybridization assays a proportion of 80% of the thalassemic chromosomes from patients and carriers was identified to carry five different mutations of the hemoglobin (Hb) β-gene. Subsequent DNA sequencing confirmed these and revealed further 9% of the chromosomes to be affected by other mutations. In addition six chromosomes from suspicious carriers were detected to carry β-thalassemia mutations. Of the 15 different HBB mutations identified the variant IVS-I-110 G>A was the most frequent mutation identified in 34% of the thalassemic chromosomes, followed by IVS-I-1 G>A, IVS-I-6 T>C, Codon 39 C>T, and Codon 37 G>A. Three novel HBB variants were discovered by direct sequencing of the gene: 5' UTR-50 (-/G), 5' UTR-43 C>T, and IVS-II-26 T>G. CONCLUSIONS: The spectrum of HBB mutations described is of the Mediterranean type whereby the allele frequencies of the most common mutations differ from those, which were previously described for the population of the Gaza Strip and other Palestinian populations. The data presented may promote the introduction of molecular testing to the Palestinian premarital screening program for β-thalassemia in Gaza Strip, which will improve the screening protocol and genetic counseling in the future.

Concepts: Second Intifada, Hamas, Gaza, Palestinian National Authority, Palestinian territories, Israel, DNA, Gaza Strip

23

Risk factors for B-cell non-Hodgkin lymphoma (B-NHL) have not been assessed among Palestinian Arabs (PA) and Israeli Jews (IJ).

Concepts: Lymphoma, Jews, Jerusalem, Jordan, Palestinian National Authority, Palestinian people, Arab citizens of Israel, Israel

12

The late president of the Palestinian Authority, Yasser Arafat, died in November 2004 in Percy Hospital, one month after having experienced a sudden onset of symptoms that included severe nausea, vomiting, diarrhoea and abdominal pain and which were followed by multiple organ failure. In spite of numerous investigations performed in France, the pathophysiological mechanisms at the origin of the symptoms could not be identified. In 2011, we found abnormal levels of polonium-210 ((210)Po) in some of Arafat’s belongings that were worn during his final hospital stay and which were stained with biological fluids. This finding led to the exhumation of Arafat’s remains in 2012. Significantly higher (up to 20 times) activities of (210)Po and lead-210 ((210)Pb) were found in the ribs, iliac crest and sternum specimens compared to reference samples from the literature (p-value <1%). In all specimens from the tomb, (210)Po activity was supported by a similar activity of (210)Pb. Biokinetic calculations demonstrated that a (210)Pb impurity, as identified in a commercial source of 3MBq of (210)Po, may be responsible for the activities measured in Arafat's belongings and remains 8 years after his death. The absence of myelosuppression and hair loss in Mr Arafat's case compared to Mr Litvinenko's, the only known case of malicious poisoning with (210)Po, could be explained by differences in the time delivery-scheme of intake. In conclusion, statistical Bayesian analysis combining all the evidence gathered in our forensic expert report moderately supports the proposition that Mr Arafat was poisoned by (210)Po.

Concepts: Fatah, Hamas, Mahmoud Abbas, Gaza Strip, Palestinian people, Second Intifada, Palestinian National Authority, Yasser Arafat

11

Metal contamination of humans in war areas has rarely been investigated. Weaponry’s heavy metals become environmentally stable war remnants and accumulate in living things. They also pose health risks in terms of prenatal intake, with potential long term risks for reproductive and children’s health. We studied the contribution of military attacks to the load of 23 metals in the hair of Palestinian women in the Gaza Strip, who were pregnant at the time of the military attacks in 2014, and their newborns. We compared the metal load in the mothers with values for adult hair from outside the war area (RHS) as the reference. We investigated heavy metals trans-passing in utero, and assessed if the heavy metal intake could derive from sources unrelated to the war.

Concepts: Second Intifada, Gaza, Palestinian territories, Israel, Palestinian National Authority, Childbirth, Heavy metal music, Gaza Strip

5

Humanity is facing a biodiversity crisis. To solve environmental problems, we bring people from Israel, Jordan, and the Palestinian Authority to the same table. Conservation efforts are beneficial for all communities and facilitate constructive dialog across divides in conflict zones. This pleads for the integration of nature conservation into peacebuilding interventions.

Concepts: Gaza Strip, Jerusalem, Palestinian National Authority, Second Intifada, Palestinian territories, Yasser Arafat, Palestinian people, Israel

4

To improve maternal health services in rural areas, the Palestinian Ministry of Health launched a midwife-led continuity model in the West Bank in 2013. Midwives were deployed weekly from governmental hospitals to provide antenatal and postnatal care in rural clinics. We studied the intervention’s impact on use and quality indicators of maternal services after 2 years' experience.

Concepts: Palestine Liberation Organization, Jordan, Palestinian National Authority, Palestine, Gaza Strip, Israel, Nablus, Palestinian territories

3

The aim of this article is to provide an overview of theoretical perspectives and practical research knowledge in relation to ‘resilience’, the resilience of Palestinians in particular and the related concept of ‘Sumud’. ‘Sumud’ is a Palestinian idea that is interwoven with ideas of personal and collective resilience and steadfastness. It is also a socio-political concept and refers to ways of surviving in the context of occupation, chronic adversity, lack of resources and limited infrastructure. The concept of ‘resilience’ has deep roots, going back at least to the 10th century when Arabic scholars suggested strategies to cope with life adversity. In Europe, research into resilience extends back to the 1800s. The understanding of resilience has developed over four overlapping waves. These focus on individual traits, protective factors, ecological assets and (in the current wave) social ecological factors. The current wave of resilience research focuses on the contribution of cultural contextualisation and is an approach that is discussed in this article, which draws on Arabic and English language literature located through a search of multiple databases (CINAHL, British Nursing Index, ASSIA, MEDLINE, PsycINFO and EMBASE). Findings suggest that ‘Sumud’ is linked to the surrounding cultural context and can be thought of as an innovative, social ecological, approach to promoting resilience. We show that resilience is a prerequisite to ‘Sumud’, meaning that the individual has to be resilient in order to stay and not to leave their place, position or community. We close by pressing the case for studies which investigate resilience especially in underdeveloped countries such as Palestine (occupied Palestinian territories), and which reveal how resilience is embedded in pre-existing cultural contexts.

Concepts: Palestinian National Authority, Ecology, Palestinian territories, Jordan, Palestine Liberation Organization, Israel, Palestinian people, Palestine