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Primary care is the backbone of many health care systems around the world. (1) With 15 years of experience in primary care, 6 of those as a family physician, and [...], Providing care for families under occupation has always been marked by scarce resources and too many patients. The current war in Gaza has dramatically worsened conditions in the Occupied Territories of Palestine (OTP). A family physician and her team in the southern West Bank describe their own challenges and give voice to the physicians in the OTP they interviewed to better understand the professional and personal challenges of living and working during the uncertainty of war.

Author(s): Marah Abu Zant [sup.1] , Zaher Nazzal [sup.2] , Layali Qaddoumi [sup.1] , Rana Abdallah [sup.1] , Beesan Maraqa [sup.1] , Khalid Najjar [sup.1] Author Affiliations: (1) grid.11942.3f, 0000 [...], Mental morbidities have been widely investigated at Primary Health Care (PHC) worldwide, but no data available in Palestine have discussed these diseases' burden. This study aimed to assess the prevalence of psychological morbidity among primary health care attendees and related factors. A cross-sectional design was adopted in this research. We collected data from primary healthcare center attendees from Sept 2019 to Jan 2020, using an interviewer-administered questionnaire called the Four-Dimensional Symptom Questionnaire. It is a valid tool that can be used in a primary healthcare setting. The Chi-square test explored psychological morbidity risk factors, and the multivariable logistic regression model was used to adjust for confounders. The study included four hundred clients >18 years of age; 287 (71.8%) were females, and 209 (52.3%) were > 50 years of age. The prevalence for high psychological morbidity of any type was 63.9% (95% CI: 58.8%-68.7%), while 24.9% (99 clients) reported very high psychological morbidity. Very high psychological morbidity was significantly higher among unmarried [adjusted OR = 2.7 (95%CI = 1.4-5.4)], lower educational level (less than 12 years schooling) [adjusted OR = 4.0, 95%CI (1.8-4.8)], and clients with high distress [adjusted OR = 15.6, 95%CI (7.9-30.9)]. In conclusion, the high prevalence of psychological morbidity identified in this study highlights the importance of early detection and management, especially among unmarried, less educated, and distressed primary health care attendants. Early interventions are of high value to reduce patient suffering, decrease the financial strain on the health system, and improve the quality of care.

Background: Secondhand smoke (SHS) exposure remains a critical public health concern, especially for adolescents, who are more susceptible to its harmful effects and may initiate smoking as a result. SHS, comprising both mainstream and sidestream smoke, contains over 7000 chemicals, many of which are carcinogenic. Adolescents exposed to SHS are more likely to experiment with smoking due to environmental influences, peer pressure, and familial smoking behavior. Objective: This study aims to examine the relationship between SHS exposure and smoking attitudes and behaviors among adolescents aged 13-15 in the Gaza Strip, where SHS exposure and tobacco use remain prevalent. Methods: Data were obtained from the 2019 Global Youth Tobacco Survey (GYTS), a cross-sectional, school-based survey targeting students in Gaza. The study employed a two-stage cluster sampling design to ensure a representative sample. SHS exposure was assessed in multiple contexts, including home, public enclosed spaces, and outdoor areas. Smoking attitudes, initiation behaviors, and demographic variables were also analyzed using descriptive statistics, Chi-square tests, and multivariable logistic regression to identify predictors of smoking behaviors. Results: Of the 1536 adolescents surveyed, 62.3% reported SHS exposure at home, and 53.9% reported exposure in enclosed public spaces. Adolescents exposed to SHS were significantly more likely to experiment with smoking, with curiosity (62.2%) and peer influence being key motivators. Additionally, SHS exposure in both indoor and outdoor environments was associated with a higher likelihood of shisha experimentation. Females reported higher SHS exposure rates than males across all environments (P <.001). Conclusion: SHS exposure significantly increases the risk of smoking initiation among adolescents in the Gaza Strip. These findings emphasize the need for targeted public health interventions, including stricter smoke-free legislation, parental education, and awareness campaigns aimed at reducing SHS exposure and preventing smoking uptake in youth. [ABSTRACT FROM AUTHOR]

Background/Aim: Hypomagnesaemia has been shown to have a significant impact on both glycaemic control and diabetes complications in type 2 diabetes mellitus (T2DM) patients. This study aims to assess the prevalence of hypomagnesaemia in T2DM patients and find the association between serum magnesium levels and outcomes relevant to glycaemic control and diabetic complications in primary care unit. Methods: A cross-sectional study was conducted and included 373 patients (222 males and 151 females) from primary care unit. Serum magnesium levels were measured by the colorimetric endpoint method using the Cobas C501 system. Hypomagnesaemia was determined to be a serum magnesium level <1.6 mg/dL. In addition, the following data was also obtained: patients' characteristics, anthropometric measurements, smoking status, HbA1c, comorbidities and therapeutic management. Results: Patients' mean age was 56.2 ± 10.8 years, 24.6% were smokers, and most were overweight or obese. About 60% have a history of hypertension, and the majority have had diabetes for more than 10 years. Their mean HbA1c level was 8.5 ± 2%. The prevalence of hypomagnesaemia was 11% (95% CI: 8%–14.6%). It was found to be significantly higher among females (adjusted OR: 2.7, 95%CI: 1.2%–5.8%), patients with HbA1c ≥8% (adjusted OR: 2.4, 95%CI: 1.1%–5.5%) and patients with a history of diabetic retinopathy (adjusted OR: 2.7, 95%CI: 1.1%–7.1%). Conclusion: The study showed that hypomagnesaemia is more prevalent in females and is associated with diabetic retinopathy and poor glycaemic control. Having a sufficient magnesium level may be associated with better glycaemic control and a reduced occurrence of complications. [ABSTRACT FROM AUTHOR]

Purpose: to determine COVID-19 vaccination coverage among pregnant women and investigate the factors affecting vaccine uptake. Design: Analytical cross-sectional study. Setting: Palestinian health care facilities. Between October and November 2021 – eight months after the country's first COVID-19 vaccination. Sample: We needed 820 people to estimate vaccination coverage among pregnant women with a precision rate of 3%. Therefore, we invited 950 pregnant Palestinian women who were eligible and had a response rate of 91.6%. Measures: An interviewer-administered questionnaire examined vaccination uptake, attitudes, and concerns about the COVID-19 vaccine. Analysis: Bivariable and multivariable analysis using SPSS. Results: vaccination uptake was reported by 219 pregnant women [25.5%, 95% CI: 22.6% −28.5%]. Knowledge (aOR=2.0; 95% CI: 1.2-3.1), perceived benefits (aOR=1.1; 95% CI: 1.06-1.16), employment (aOR=5; 95% CI: 3.1-8.1), and underlying medical condition (aOR=2.1; 95% CI: 1.1-4.1) predicted uptake. Reporting vaccine barriers reduces vaccine uptake (aOR=.92; 95% CI:.89-95). Conclusions: Pregnant women's COVID-19 vaccination rates are low. Concerns regarding the COVID-19 vaccine for infants affected their decision. COVID-19 vaccination regulations and legislative nudges drove maternal vaccination. Vaccine fears and misconceptions among pregnant women should be addressed. [ABSTRACT FROM AUTHOR]

Objectives: Adolescents are increasingly consuming energy drinks (EDs), prompting worries about their potential mental health impacts. The association between ED use and psychological effects among Palestinian teenagers, particularly the impact of smoking habits such as waterpipes, electronic cigarettes, and cigarettes, is little studied. This study explores the correlation between ED consumption and mental health outcomes such as depression, insomnia, and stress among adolescents in Palestine., Methods: A cross-sectional study was conducted from February to June 2024, involving adolescents aged 12-18 recruited from schools in the West Bank. Data collection utilized a structured questionnaire assessing ED consumption, smoking habits, depression (PHQ-9), insomnia (ISI), and stress (Adolescent Stress Scale). Data were analyzed using SPSS version 29., Results: The research involved 1,668 adolescents, with a mean age of 15.67 years (±1.57 years). ED consumption was prevalent at 74.7 % (95 % CI: 76.5-72.7). Males and smokers, especially those using traditional cigarettes and waterpipes, exhibited a higher likelihood of consuming energy drinks (aPR: 2.18; 95 %CI: 1.64-2.91), (aPR: 2.99; 95 %CI: 1.49-5.59), and (aPR: 2.54; 95 %CI: 1.23-5.19). Depression exhibited a significant relationship with ED consumption (aPR: 2.25; 95%CI: 1.51-3.37). A dose-response relationship was identified between insomnia and ED consumption, with an adjusted prevalence ratio (aPR) of 2.42 (95 % CI: 1.56-3.47) for moderate severity and 2.95 (95 % CI: 1.28-6.75) for severe insomnia., Conclusions: ED consumption is associated with poorer mental health outcomes, particularly among smokers. Interventions targeting both ED use and smoking behaviors are crucial to improving mental health in Palestinian adolescents. The study was conducted during the Gaza war, a period marked by heightened stress levels among participants due to increased security checks and economic hardships. These challenges may have influenced participants' stress levels and impacted their purchasing behaviors for EDs and tobacco shisha products. Further research is needed to explore the long-term effects of these behaviors., (© 2025 the author(s), published by De Gruyter, Berlin/Boston.)

Background: Family medicine, often known as general practice, is the foundation of sustainable and universal healthcare worldwide. As a new specialty in the Eastern Mediterranean Region (EMR), it must recruit doctors and gain public acceptability, which has traditionally favored specialists., Aim: This research examined studies on Arab populations' attitudes toward family medicine and the specialty to discover barriers to creating and embracing this vital specialty., Design & Setting: This review was based on the PRISMA guidelines and encompassed peer-reviewed articles from reputable sources such as PsychNet, Web of Science, PubMed, Embase, Scopus, and grey literature., Method: A comprehensive search was conducted across databases for peer-reviewed studies that explored Arabs' awareness, perceptions, and attitudes toward family medicine and physicians., Results: After a rigorous selection process, nineteen studies were deemed suitable for analysis. These studies encompassed diverse participants, including medical students, physicians, patients, and the general public. The overall perception of family medicine was positive, but it was noted that few had direct exposure to family physicians during their medical education or in the clinical setting., Conclusion: Our review suggests five significant efforts: 1) an education campaign for the general public about the role of Family Medicine; 2) increasing training capacity for family physicians; 3) early exposure to family physicians during medical school; 4) developing a process for continually improving the education and quality of family physician, 5) Further research on the challenges to FM practice in Arab countries are required to understand the situation better and work toward its improvement., (Copyright © 2024, The Authors.)