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Background: Since 1990, the maternal mortality significantly decreased at global scale as well as the North Africa and Middle East. However, estimates for mortality and morbidity by cause and age at national scale in this region are not available. Method(s): This study is part of the Global Burden of Diseases, Injuries, and Risk Factors study (GBD) 2019. Here we report maternal mortality and morbidity by age and cause across 21 countries in the region from 1990 to 2019. Result(s): Between 1990 and 2019, maternal mortality ratio (MMR) dropped from 148.8 (129.6-171.2) to 94.3 (73.4-121.1) per 100 000 live births in North Africa and Middle East. In 1990, MMR ranged from 6.0 (5.3-6.8) in Kuwait to 502.9 (375.2-655.3) per 100 000 live births in Afghanistan. Respective figures for 2019 were 5.1 (4.0-6.4) in Kuwait to 269.9 (195.8-368.6) in Afghanistan. Percentages of deaths under 25 years was 26.0% in 1990 and 23.8% in 2019. Maternal hemorrhage, indirect maternal deaths, and other maternal disorders rank 1st to 3rd in the entire region. Ultimately, there was an evident decrease in MMR along with increase in socio-demographic index from 1990 to 2019 in all countries in the region and an evident convergence across nations. Conclusion(s): MMR has significantly declined in the region since 1990 and only five countries (Afghanistan, Sudan, Yemen, Morocco, and Algeria) out of 21 nations didn't achieve the Sustainable Development Goal (SDG) target of 70 deaths per 100 000 live births in 2019. Despite the convergence in trends, there are still disparities across countries.Copyright © 2022 Academy of Medical Sciences of I.R. Iran. All rights reserved.
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With a selected focus on Europe and the Middle East and North Africa (MENA), Knowledge production in higher education presents a reflexive understanding of how Europe is taught and studied at MENA universities and how knowledge about the MENA is produced in Europe. This focus is based on the observation that higher education is rarely an apolitical space and an acknowledgement of how ‘every view is a view from somewhere'. It therefore explores the politics of institutes of higher education in view of often competing scholarly practices. Furthermore, it examines the historical evolution of French, German and Italian scholarship on the MENA;analyses the cases of Malta, Palestine and Turkey with their respective liminal characteristics in between the MENA and Europe, and how these impact on higher educational approaches to the study of the Other;considers critique as the driving force not only of the higher educational establishment but of liberal and illiberal contexts, with a specific focus on Denmark, the Netherlands and Egypt;and examines influences upon knowledge production including gender, the COVID-19 pandemic (with a focus on the UK and Syria) and think tanks. © Manchester University Press 2023.
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Non-invasive ventilation (NIV) might be successful if carefully selected in adult patients with cardiac dysfunction presenting with community-acquired pneumonia. The main objective of this study was to identify the early predictors of NIV failure. Adult patients with left ventricle ejection fraction (LV EF) <50% admitted to the intensive care unit (ICU) with community-acquired pneumonia and acute respiratory failure were enrolled in this multicenter prospective study after obtaining informed consents (study registrationID: ISRCTN14641518). Non-invasive ventilation failure was defined as the requirement of intubation after initiation of NIV. All patients were assessed using the Acute Physiology and Chronic Health Evaluation II (APACHE II) and sequential organ failure assessment (SOFA) scores at admission, while their Heart rate Acidosis Consciousness Oxygenation and Respiratory rate (HACOR) and lung ultrasound (LUS) scores in addition to blood lactate were assessed at NIV initiation and 12 and 24 hours later. A total of 177 patients were prospectively enrolled from February 2019 to July 2020. Of them, 53 (29.9%) had failed NIV. The mean age of the study cohort was 64.1+or- 12.6 years, with a male predominance (73.4%) and a mean LV EF of 36.4 +or- 7.8%. Almost 55.9% of the studied patients had diabetes mellitus, 45.8% had chronic systemic hypertension, 73.4% had ischemic heart disease, 20.3% had chronic kidney disease, and 9.6% had liver cirrhosis. No significant differences were observed between the NIV success and NIV failure groups regarding underlying morbidities or inflammatory markers. Patients who failed NIV were significantly older and had higher mean SOFA and APACHE II scores than those with successful NIV. We also found that NIV failure was associated with longer ICU stay (p < 0.001), higher SOFA scores at 48 hours (p < 0.001) and higher mortality (p < 0.001) compared with the NIV success group. In addition, SOFA (Odds Ratio (OR): 4.52, 95% Confidence Interval (CI): 2.59-7.88, p < 0.001), HACOR (OR: 2.01, 95% CI: 0.97-4.18, p = 0.036) and LUS (OR: 1.33, 95% CI: 1.014-1.106, p = 0.027) scores and blood lactate levels (OR: 9.35, 95% CI: 5.32-43.26, p < 0.001) were independent factors for NIV failure. High initial HACOR and SOFA scores, persistent hyperlactatemia and non-decrementing LUS score were associated with early NIV failure in patients with cardiac dysfunction presenting with community-acquired pneumonia, and could be used as clinical and paraclinical variables for early decision making regarding invasive ventilation.
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Oilseeds are grown mainly for the extraction of vegetable oils and for its by-products needed in livestock feed and in other industrial uses. The oils obtained from them are becoming a staple food used in daily cooking in several countries, and as a result the world demand is constantly increasing. This situation, combined with the exponential increase in the world population and other cyclical factors, is leading to a surge pricing, especially in importing countries. This increase in prices is fueled by soaring oil prices and disruption in supplies following Covid-19 pandemic and geopolitical tensions in the Black Sea. Morocco is directly impacted by these fluctuations given that the country imports almost its total needs in vegetable oils, oilseeds and meals. The high dependence on imported vegetable oils and oilseed products has a detrimental effect on the economy of Morocco and weighs heavily on the country's trade balance. Considering their increasingly important role in society, the development of a local oilseed sector to reduce Morocco's dependence on imports and cope with the vagaries of global markets has never been more topical in the current context of sustainable agriculture and food sovereignty.
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This article describes experiences of improving complementary feeding practices using a systems approach with particular focus on health systems strengthening. Achievements included: the development of national guidelines for optimum complementary feeding for children 6-23 months of age, inclusion of a specific indicator for complementary feeding in the new National Food and Nutrition Strategy, updated training packages to improve health worker counselling skills and strengthened social behaviour change communication activities. A systems approach requires strong coordination between all partners across sectors to ensure communities benefit from the synergistic effects of complementary interventions, while system strengthening was noted to improve the resilience of the Ministry of Health and Population to withstand the shocks of the COVID-19 pandemic and the subsequent Ukraine crisis.
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The taxonomic diversity and the richness of the region of Seraidi (North-East Algeria) in medicinal plants, as well as the appearance of diseases of viral origin, in particular, the current pandemic of SARS-CoV-2, led us to the realization of an ethnobotanical survey of plants with antiviral interests. The survey was conducted based on a pre-established quiz, with 120 people from different categories of the population of Seraidi, with the aim of listing the medicinal plants used in the treatment of viral diseases and collecting as much information as possible on this subject. After analyzing, the information provided by the people interviewed, we listed 32 species belonging to 20 families, of which the Lamiaceae family is the most represented. Older women are the most affected by the use of plants;people without a higher intellectual level have the most knowledge about the use of plants with antiviral interest. The leaf is the most widely used organ, in the form of a decoction or infusion, administered orally.
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Our study's objective was to retrospectively evaluate the pandemic Coronavirus Infection Disease first appeared in 2019 (COVID-19) in Algeria from July 2020 until February 2022 by studying the evolution and relationship between three variables: the number of new cases, the number of new deaths, and the number of cases hospitalized in intensive care. Data were obtained from "Our world in Data Organisation" (https://ourworldindata.org/coronavirus) on 01 March 2022. They were proceeded by descriptive and multivariate analysis. The correlation between the three variables and the analysis of individual principal components (PCA) were conducted. The number of new cases shot up the month of January 2022 with 33685 cases, the peak number of cases in intensive care was recorded in July 2021 with 1261 cases whereas the number of new deaths reached its peak in the month of August 2021 with 1015 cases. A significant linear dependence has been identified between the number of new cases and the number of cases in intensive care (R2>0.5). The PCA analysis allowed us to distinguish the months of August 2020, November 2020, July 2021, August 2021, September 2021, and January 2022. They were characterized by high levels of new confirmed cases, new deaths and/or cases in intensive care. During the study period, the pandemic COVID-19 in Algeria passed by three waves characterized by peaks in the number of new cases and new deaths.
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Background: COVID-19 has emerged as a serious pandemic that emerged during since the end of 2019. The dissemination and survival of coronaviruses have been demonstrated to be affected by ambient temperature in epidemiological and laboratory research. The goal of this investigation was to see if temperature plays a role in the infection produced by this novel coronavirus. Methods: Between March 29, 2020, and September 29, 2020, daily confirmed cases and meteoro-logical parameters in many Gulf countries were collected. Using a generalized additive model, we investigated the nonlinear relationship between mean temperature and COVID-19 confirmed cases.. To further investigate the association, we employed a piecewise linear regression. Results: According to the exposure-response curves, the association between mean temperature and COVID-19 cases was nearly linear in the window of 21 - 30C while it is almost flat beyond that window. When the number was below 21C (lag 0-14), each 1C increase was associated with a 4.861 percent (95 percent CI: 3.209 - 6.513) increase in mean temperature (lag 0-14). Our sensitiv-ity analysis confirmed these conclusions. Conclusions: Our findings show a positive linear association between mean temperature and the number of COVID-19 cases with a threshold of 21C. There is little evidence that COVID-19 case numbers would rise as the weather becomes colder, which has important consequences for making health strategy and decision.
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This study is a qualitative investigation of education policies and decision making during COVID-19 pandemic in five Middle East and North Africa Region (MENA) countries: Kuwait, Lebanon, Morocco, Palestine, and Qatar. It aims at scrutinizing how these countries responded to the education disruption caused by the pandemic between February 2020 and July 2021 and how they managed the resulting turbulence. We also investigate the extent to which these decisions were equitable and innovative. Data were collected from Ministerial notes, media content, and international organizations reports about the situation of education in the region. Walt and Gilson's (1994) policy analysis triangle and the Cynefin framework (Kurtz & Snowden, 2003) guided the objectives and the analysis of the data. Findings revealed that these countries muddled through the education policy at the beginning of the pandemic, centralized decision making, and faced difficulties to implement online and distance learning. In the second phase, most of these countries tried to save education, but were halted by structural challenges. Some differences were witnessed among these countries in how they have dealt with the evolving crisis. However, some similarities have also been noticed at the levels of context, process and actors. The decisions taken often lacked innovation and led to less equitable outcomes. The discussion of the findings has some implications for education policy and education management in turbulent times in the MENA region. © The Author(s) 2023.
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The COVID-19 pandemic has offered China a unique opportunity for worldwide deployment of its longstanding health diplomacy, renamed the Health Silk Road (HSR), now an integral part of its Belt and Road Initiative. As a self-proclaimed South-South collaborator and developer,11Niall Duggan, ‘China's changing role in its all-weather friendship with Africa', In, Sebastian Harnisch, Sebastian Bersick, and Jörn-Carsten Gottwald (Eds). China's International Roles: Challenging or Supporting International Order? (Role Theory and International Relations) (London: Routledge, 2015), pp. 207-225..Beijing has assumed a leadership role, grounded in ‘moral realism', in the world's health governance. Beijing's health diplomacy has received acclaim in the Middle East and North Africa (MENA). However, the pandemic has exacerbated preexisting tensions between China, the United States (US) and European Union (EU). Western countries, wary of China's rising power, reacted resentfully, confirming underlying systemic rivalry. This article argues that the currently disputed, or shifting, world order accounts for the diametrically opposed reactions between the West and the MENA toward China's Health Silk Road.
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PurposeThis study examined the level of knowledge, attitudes and practices (KAP) of Jordanian dairy employees about coronavirus disease 2019 (COVID-19) characteristics and the effect of precautionary measures on food safety risk during the pandemic.Design/methodology/approachA cross-sectional study was conducted between Dec 17, 2020 and Feb 22, 2021, involving a total of 428 participants across 34 random chosen dairy facilities in Jordan. KAP related to COVID-19 were measured by 46 items, while 13 items were used to examine perceived notions regarding COVID-19 precautionary measures on food safety.FindingsThe results indicated that 32.2% of the respondents had sufficient knowledge, 60.3% had a good attitude, and 27.1% followed correct practices concerning COVID-19. Moreover, female respondents had higher total KAP scores of COVID-19 characteristics than males. Furthermore, older and more experienced respondents had higher total KAP scores than younger respondents. This study also observed that the total KAP scores were not affected by education, marital status, and job position. Characteristics and measures taken by the dairy industry were at large significantly associated with (p < 0.05) knowledge and practice of employees about COVID-19 attributes. Results of this study suggested that Jordanian dairy workers were not adequately aware about COVID-19.Originality/valueNo such study on dairy workers has been conducted previously to the best of the authors' knowledge. Moreover, studies which analyse the association of industry response and characteristics on the KAP of employees are very limited.
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The ubiquitous nature of microplastics (MPs) in nature and the risks they pose on the environment and human health have led to an increased research interest in the topic. Despite being an area of high plastic production and consumption, studies on MPs in the Middle East and North Africa (MENA) region have been limited. However, the region witnessed a research surge in 2021 attributed to the COVID-19 pandemic. In this review, a total of 97 studies were analyzed based on their environmental compartments (marine, freshwater, air, and terrestrial) and matrices (sediments, water columns, biota, soil, etc.). Then, the MP concentrations and polymer types were utilized to conduct a risk assessment to provide a critical analysis of the data. The highest MP concentrations recorded in the marine water column and sediments were in the Mediterranean Sea in Tunisia with 400 items/m3 and 7960 items/kg of sediments, respectively. The number of MPs in biota ranged between 0 and 7525 per individual across all the aquatic compartments. For the air compartment, a school classroom had 56,000 items/g of dust in Iran due to the confined space. Very high risks in the sediment samples (Eri > 1500) were recorded in the Caspian Sea and Arab/Persian Gulf due to their closed or semi-closed nature that promotes sedimentation. The risk factors obtained are sensitive to the reference concentration which calls for the development of more reliable risk assessment approaches. Finally, more studies are needed in understudied MENA environmental compartments such as groundwater, deserts, and estuaries.
Subject(s)
COVID-19 , Water Pollutants, Chemical , Humans , Microplastics/analysis , Plastics/analysis , Ecosystem , Pandemics , Geologic Sediments , Water Pollutants, Chemical/analysis , Environmental Monitoring , Middle East , Water/analysis , TunisiaABSTRACT
Nigella sativa is an annual herb of the buttercup family, native to Western Asia and North Africa. Its seeds are used as a spice, especially in india and the Middle east, but also for medicinal purposes. Nigella sativa seeds contain a large number of bioactive substances, which have a number of pharmacological effects. It is a forgotten medicine and has been used in various systems of traditional medicine for thousands of years, but studies of modern medicine in recent years show that its therapeutic use can be much wider. it is likely that it could also find use in the treatment of mental disorders such as anxiety, depression and some neurodegenerative diseases. Its potential use in COVID-19 therapy is not without interest.Copyright © 2022 TIGIS Spol. s.r.o.. All rights reserved.
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Objective: The Covid-19 viral pneumonia epidemic represents a major public health issue for all hospital structures, including hospital pharmacy, which has an essential role in dealing with this crisis. This study aims to explore the level of stress perceived by hospital pharmacy staff during this pandemic. Method: This is a cross-sectional study that evaluated 82 health professionals in hospital pharmacies in Morocco, using a snowball sampling technique. It evaluated their socio-demographic characteristics, working conditions, perceived stress scale (PSS), emotions and concerns during the epidemic. Statistical analysis was performed using statistical package for social science (SPSS). Results: The majority of participants were women (74.4%) and hospital pharmacists (67%). More than half of the participants showed moderate levels of stress (73.2%). Among the variables examined, only protective measures and information about the situation via the superiors showed a significant association with the PSS value (P = 0.036) and the level of stress according to the ANOVA test and the Chi-2 test respectively. Conclusion: In this study, hospital pharmacy staff showed moderate levels of stress at the beginning of the Covid-19 epidemic. It should be noted that socio-demographic traits had no impact on stress. Consideration of social and health conditions and stress management would help reduce professional stress among hospital pharmacy staff during the pandemic.
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With the coronavirus outbreak, new and strengthened norms of plastic dependency emerged in the Middle East and North Africa region through the desperate demand for products like face masks and other personal protective equipment (PPE), highlighting the tradeoffs between health and the environment. While the rise in demand has been considered as temporary, behavioral barriers and misperceptions might make these norms particularly sticky and hinder society's ability to transition to a circular economy. Fortunately, behavioral science offers valuable insights about why the current pandemic can actually be a catalyst to create new eco-conscious behaviors. As some behaviors are often strenuous to change and require enforcement through traditional policy solutions (e.g. regulations), behavioral science offers complementary tools that will make policies more effective. We have an opportunity to start thinking about ways to leverage behavioral insights to create new norms that promote a circular economy while ultimately ensuring proper adherence to hygiene practices to curb the spread of the virus. (PsycInfo Database Record (c) 2023 APA, all rights reserved)
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The objective of this research was to identify some general characteristics or rural women. Sources of information on which rural woman rely in the areas of health and prevention and their relative importance. The availability.utilization and relative importance of village health services and activities. Level of rural women's knowledge of health and preventive measures in the five areas studied. namely (health education. healthy nutrition. first aid. reproductive health and family planning. prevention of coronavirus) their relative importance and their relationship with independent variables studied. Measuring the gap between the degree of actual and total knowledge of rural women. Level and relative importance of rural women's practice of health and preventive actions in the five areas considered. correlations between them and the above- mentioned independent variables. and Level of rural women's knowledge of health and preventive actions. Measuring the gap between actual and total practice of rural women. this research was conducted in some villages in Sharkia Governorate. The research sample was 168 rural households and data was collected from January to March 2022. One of the most important findinds of the research is the average level of rural women's knowledge. A significant correlation between the degree of rural women's knowledge of health and preventive actions. the trend towards change and the level of exposure to information source and an inverse correlation with wife age. psychological stress and husband age. Rural women's practice is high. A significant association was found wih monthly gourd. the trend towards change. exposure to information sources.
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The Arab Spring (AS) marked an unprecedented event in the Middle East and North Africa (MENA) region, and it generated political and economic uncertainties and triggered violent conflicts and political rifts. This paper empirically examines the short-run and long-run effects of the AS on foreign direct investment (FDI) inflows to the MENA region and to individual MENA countries. The empirical analysis is implemented through the generalized method of moments (GMM) estimator for dynamic panel models, using different empirical specifications. The benchmark results show that the AS has led to important reductions in FDI inflows to the MENA region. A more detailed empirical analysis reveals significant variations in the AS effects on FDI inflows across MENA countries and it underscores distinct patterns over different time periods. These findings imply that governments in the MENA region are required to maintain political stability, and to adopt distinctive policies that lessen the adverse implications of the AS and that set favorable conditions for FDI inflows in the post-COVID-19 pandemic era.
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The research aimed to identify the behavior of rural women towards food safety and quality at Damanhour Distrct, the simple random sample amounted to 240 respondents, representing 5% of the total. The data were collected through a personal interview by questionnaire. The most important results were: 47.9% of the respondents have a low and medium total level of knowledge of food safety and quality, and 59.5% of them have a low and medium level of implementation of those practices, 52.1% have a negative and neutral attitude towards these practices, 68.3% believe that they have not been previously infected with Covid 19, and 49.2% have not taken the vaccine for Covid 19, the All agreed on the availability of the vaccine, 35% of the respondents have a low and medium level of knowledge of practices related to food safety and quality under Covid 19, and 50.8% have a low and medium level of implementation of those practices. Also, five independent variables together explain 65.4% of the total variance in the respondents' knowledge of practices related to food safety and quality, four independent variables together explain about 62.3% of the total variance in the implementation of practices related to food safety and quality by the respondents. And seven independent variables together explain about 55.4% of the total variance in the attitudes of the rural women respondents towards food safety and quality.
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The research mainly aimed to study the impact of the economic reform policy and the Corona pandemic and seasonal factors on the prices of the most important Egyptian agricultural exports and imports. The most important results were the following: - By studying the trend analysis of the monthly average of the prices of the most important exported and imported commodities, it shows the real price increase over time per month for the exports of 17 commodities represented as "olive oil, dried fruits, Rumi cheese, aromatic oils and resins, dried onions, processed cheese, dried vegetables, white cheese, juices." Its foundations are oily seeds and fruits, onions and garlic, citrus fruits, preserved strawberries, frozen artichokes, processed potatoes, frozen vegetables, and potatoes. - Also found was that the economic reform policy had a statistically significant effect on the average real price of the exports of the 17 commodities under study, as well as the imports of meat, oils, sugar, beans, and wheat, in addition to the imports of the most important production requirements studied, such as seeds, pesticides, disinfectants, and fertilizers. that during the study period. - By studying the impact of the COVID-19 crisis on the real monthly prices of exports and imports of the commodities under study, it was found that the average monthly price decreased in real prices for all commodities under study, except for oils and aromatic resins, but the statistical significance of the rates of decrease during the study period did not prove.
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Objectives: A pandemic is a health disaster that can lead to the disruption of hospital's health care activities. The objective of this work is the presentation of a health emergency plan model applicable to the hospital pharmacy in times of crisis, and the description of the Moroccan National Institute of Oncology's pharmacy experience in fighting COVID-19 pandemic. Method: Establishment of a set of procedures for pharmaceutical organization as a part of a health emergency plan, the creation of a device whose endowment allows the rapid management of 25 simultaneous patient's health care, and a system for managing the risks of shortages. In addition, all the missions carried out by the pharmacy during the COVID-19 pandemic were presented and discussed. Results: Three medical endowment lists of essential therapeutic products were created, with a total of 125 references. The terms of supplies are defined by a procedure for deploying health emergency plan's pharmacy. An interhospital pharmaceutical inventory monitoring system was also put in place during the COVID-19 pandemic. Conclusion: In time of crisis, supply systems are severely disrupted and shortages in therapeutic products are common. An emergency plan is an organization of multidisciplinary actions to deal with a health disasters in which the hospital pharmacy plays a decisive role.