Complementary and alternative medicine use among pediatrics in Palestine: a cross-sectional study

Background Recent use of complementary and alternative medicine (CAM) is growing in children worldwide, so there is a need to evaluate CAM’s use among pediatrics in Palestine. This study aimed to estimate the prevalence of CAM use among a sample of Palestinian children, investigate the factors that affect the use of CAMs, identify the types of CAM used, and assess the purposes of using them. Methods A cross-sectional descriptive study of parents who had children aged 6 years and below was carried out. A convenient sample of about 420 participants was collected; from Primary care to Motherhood and Childhood Centers in Nablus city in Palestine. Parents who agreed to participate were asked to answer a survey that consists mainly of closed-ended questions. The analysis was performed using SPSS version 16.0. Results The use of CAM was detected in all interviewers 420 (100%). The most common treatment used was herbal therapy (n = 400, 95.2%), and anise was the most common herbal therapy used (n = 334; 79.5%). A total of 371 (88.3%) of the respondents used CAM for digestive system problems. The main reason for using CAM was making the child more comfortable (n = 365; 86.9%). Parents who are 30 years or older were significantly using more CAM than younger parents (P = 0.001). In addition, regarding the number of children in the family, parents who have five children or more used more CAM subtypes significantly more than parents with less than this number (P = 0.025). Moreover, parents living in a refugee camp used more CAM than parents who lived in urban or rural areas (P = 0.031). Conclusions Parents of children use CAM frequently. All parents used CAM, and physicians were not mainly among the sources of CAM information, and almost all parents were unaware of the side effects of CAM. Future research is necessary to direct pediatricians in formulating recommendations for children on CAM modalities, including possible risks and benefits and interactions with conventional medications.

Prevalence of post-traumatic stress disorder among Palestinian children and adolescents exposed to political violence: A systematic review and meta-analysis

Objective We undertook a systematic review of the literature to explore the prevalence of post-traumatic stress disorder (PTSD) in Palestinian children and adolescents exposed to political violence. This is the first systematic review and meta-analysis of the prevalence of PTSD in this population. Methods PubMed, Embase, PsycInfo, Google Scholar and Cochrane library were searched until June 2020. To estimate the prevalence of PTSD, sub-group and meta-analysis were conducted. Results The search resulted in 2786 studies, of which 28 articles representing 32 samples with a total of 15,121 participants from Gaza Strip and West Bank met either the DSM-4 or DSM-5 criteria and were included. The pooled prevalence of PTSD was 36% (95% CI 30–41%; I2 98.6%) and ranged from 6% to 70%. Sub-group analysis showed that the PTSD prevalence did not differ according to region (West Bank, Gaza Strip) and tended to decrease after including only studies using a representative sample (p<0.001), and among those with low risk of bias (p<0.001). Visual inspection of the included studies revealed significant discrepancies in study design and assessment measures. Conclusion We identified high prevalence of PTSD among Palestinian children and adolescents exposed to political violence. However, the pooled results should be interpreted with caution, due to the high heterogeneity and risk of bias in the included studies. These limitations also reflect the challenge in conceptualizing and measuring PTSD in the Palestinian context with a background of continuous and cumulative trauma. Understanding the contextual factors and developing locally adapted survey measures are of relevance to future research, public health planning, and the provision of mental healthcare in Palestine.

The Psychological Wellbeing of Palestinian Children Living among Israeli Settlements in Hebron Old City

For more than ten decades, the Palestinian Occupied Territories are marked by a protracted political conflict. During this conflict, more than 300 settlements have been built inside West Bank, Gaza, and East Jerusalem “Occupied Palestinian Territories”, since that time the conflict between Palestinian and Israeli occupation forces is still ongoing. One of the most important results of this occupation and conflict is the suffering of Palestinian living among these Israeli settlements. Therefore, this study aimed at gaining insight into the impact of living within this situation on children and adolescents’ psychological wellbeing. 357 8-18 years old Palestinian children took part; Two self-report questionnaires: the UCLA-PTSD-Reaction Index, investigating symptoms of posttraumatic stress, and the Strengths and Difficulties Questionnaires, looking at overall psychological problems, were filed by children themselves, mothers, and teachers. Descriptive analyses investigated mental health differences between both variables, gender, and age, and the mental health outcomes. This study shows the important impact of being lived among Israeli settlements on the psychological wellbeing of Palestinian, above, girls, younger adolescents, also reported higher scores on both questionnaires, the study urges for more psychological care and support for family members – in particular children.

Measuring agency in children: the development and validation of the War Child Agency Assessment Scale - Palestinian version (WCAAS-Pal).

In the present article, we aimed at construing a new quantitative measure of children's agency in Palestine. Within a socio-ecological and culturally and contextually informed perspective, the study introduces the development of a new instrument to investigate and evaluate children's agentic practices within their living contexts and their daily lives. First, we evaluated the model of measurement of WCAAS-Pal using a sequential exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). Following the principles of testing a quantitative measure in the context of the dual-frame sampling method, the process of validating the quantitative measure was conducted on a group of 1,166 Palestinian children aged 9 to 14 years (m = 11.58, sd = 1.54). Second, a sample of 251 Palestinian children aged between 9 and 14 years (m = 11.82, sd = 1.53) was used to compute the reliability of the instrument along with both convergent and divergent validity using the Children Hope Scale and the Children Revised Impact of Event Scale-Arabic Version measures, respectively. The results of the EFA suggested a baseline seven-factor structure to be further assessed via CFA. A complex web of agency domains that might contribute to the child psychological functioning when forced to leave in conditions of ongoing threat and military violence emerged from the analysis.

Differences in Neuropsychological Performance between Refugee and Non-Refugee Children in Palestine

Neuropsychological studies on refugee children are scarce, but there are even less in the case of Palestinian children. This work aims to study the neuropsychological performance of Palestinian refugee children in Palestine compared to other Palestinian children living outside refugee camps. A comprehensive Neuropsychological battery was administrated to 584 Palestinian school children (464 refugees and 120 non-refugees) aged 6, 7, and 8 years old. Results showed that non-refugee children outperformed refugee children in sustained attention, verbal comprehension, verbal memory, and visual memory. This study is the first to have performed a comprehensive neuropsychological assessment, based on a standardized and validated battery with the Palestinian refugee children. It supports professionals in their evaluation of neurodevelopment and neuropsychological alterations in refugee and non-refugee children in Palestine.

The bigger picture: an examination of socially conscious art and design produced by Armando Milani and John Quigley in collaboration with the United Nations

This thesis explores the ideology of the United Nations (UN) as manifested through external visual communications materials which have been produced in collaboration with artists and graphic designers since the organization’s inception in 1945. Initial research showed frequent usage of the symbols of the dove and olive branch, which have been known to connote “peace” over time and across a variety of cultures. A detailed examination of two specific works of socially conscious art and design, Translating War Into Peace and Pablo Picasso’s Peace Dove by Palestinian Children in Jericho, shows the multilayered and more meaningful adoption of these symbols by their respective designer Armando Milani and artist John Quigley. Using the theoretical framework of visual social semiotics and the “visual grammar” outlined by Gunther Kress and Theo van Leeuwen in their seminal work Reading Images, this paper examines how Milani and Quigley have produced compositions that represent how the UN views peace— namely, as a process that requires not just ending wars but working to continuously build peaceful infrastructures.

The bigger picture: an examination of socially conscious art and design produced by Armando Milani and John Quigley in collaboration with the United Nations

This thesis explores the ideology of the United Nations (UN) as manifested through external visual communications materials which have been produced in collaboration with artists and graphic designers since the organization’s inception in 1945. Initial research showed frequent usage of the symbols of the dove and olive branch, which have been known to connote “peace” over time and across a variety of cultures. A detailed examination of two specific works of socially conscious art and design, Translating War Into Peace and Pablo Picasso’s Peace Dove by Palestinian Children in Jericho, shows the multilayered and more meaningful adoption of these symbols by their respective designer Armando Milani and artist John Quigley. Using the theoretical framework of visual social semiotics and the “visual grammar” outlined by Gunther Kress and Theo van Leeuwen in their seminal work Reading Images, this paper examines how Milani and Quigley have produced compositions that represent how the UN views peace— namely, as a process that requires not just ending wars but working to continuously build peaceful infrastructures.

Palestinian children living amidst political and military violence deploy active protection strategies against psychological trauma: How agency can mitigate traumatic stress via life satisfaction

This exploratory study assessed the association between agency and life satisfaction, as well as the potential for life satisfaction, in its turn, to alleviate trauma symptoms and reduce negative emotion in a group of children exposed to war and military violence in Palestine. Two hundred and fifty Palestinian children, who had been recruited at primary schools in urban and rural areas, and refugee camps, completed the Multilevel Student’s Life Satisfaction Scale, Children’s Hope Scale (CHS), Children’s Impact of Event Scale (CRIES) and Positive and Negative Affect Scales. We performed structural equation modelling to evaluate the effects of agency on negative emotions and trauma symptoms via life satisfaction. The participants appeared to play an agentic role in mobilizing their own life satisfaction, and the more satisfied they were with their lives, the less they suffered from trauma symptoms. In terms of clinical practice, we advocate more active and participatory approaches to fostering children’s agency, a complex construct in need of further investigation via mixed-method quanti-qualitative and ethnographic studies.