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There is a significant literature on the value of journaling to support teachers in reflecting on their pedagogical practices as well as their duties and obligations as educators. Institutions of teacher education should therefore provide opportunities for pre-service teachers to develop their self-reflective skills. A mixed-method action research approach was used in this study to examine the perspectives of 71 teacher candidates in the occupied West Bank on reflective journaling (RJ). The development of professionals' reflective and critical thinking is one of the goals of higher education (Berger & Youkeles, 2000). The use of reflective journaling as a teaching tool may be of use to professionals learning the abilities required to lead a classroom. The key question this study addresses is: What are teacher candidates' experiences with RJ during their practicum course? A triangulated, mixed-method approach was employed and converging quantitative and qualitative data were collected through questionnaire responses and interviews. The study's findings suggest teacher candidates benefited significantly from writing reflective journals in developing motivation and self-confidence and strengthening their writing skills.

During the COVID-19 pandemic, the academic world came into contact with a virtual learning environment that allows students and educators to leave the boundaries of space and time and maintain academic interactions at unrestricted times and sites. After three semesters of remote learning, there is a feeling that the return to universities and to closed spaces will deter students and that they will prefer remote learning. Studying from home spares valuable time, time otherwise wasted in traffic jams, as well as petrol and other expenses. Remote learning gives a feeling of freedom, comfort, flexible time, and a better sense of control over one's studies than in the classroom. The current study, conducted about one year after the outbreak of the pandemic, examined students' background variables: gender, years of schooling, marital status, financial and employment status -- with the goal of exploring the association between these variables and students' preference for either face-to-face or digital teaching. It is evident from the research findings that after this experience of e-Learning neither of these two methods shows a clear advantage over the other. Was the e-Learning experience during the crisis a one-time, incidental event? Or perhaps, in light of the crisis, academic institutions should prepare for a different type of learning, one that combines face-to-face with digital learning? The study illuminates an issue that is confronting educational institutions in general and academic institutions in particular, i.e., preparations for teaching and learning in the post-crisis world, after the considerable upheaval to which we were subjected.

This study is a pioneer study examining the significance of retirement in terms of lost investments and outcomes. Research findings on the output of academic faculty and on measures of excellence in higher education indicate that upon retirement the academic institution as an organization loses not only faculty who are still capable of contributing both to research and to teaching, but rather also two other important products: valuable knowledge and experience accumulated by senior faculty in the academic system in light of the institution's investments in them. 107 questionnaires were collected from senior faculty members in a case study of one academic institution. A combined research method was utilized, consisting of qualitative and statistical analysis, with the aim of exploring the significance of retirement in terms of lost input and output, as perceived by academic faculty members. The research findings indicate that indeed, as perceived by the faculty, academic institutions as an organization lose faculty who are still capable of contributing to both research and teaching, as well as valuable knowledge and experience accumulated by senior faculty members within the academic system, after being nurtured by the academic institution.

This paper investigates the short and long-term pernicious impact of armed conflicts on education and educational agents (students, teachers and students' parents), using a multivocal review by means of the integration and qualitative analysis of 60 research reports (voices) found in two databases: Web of Science and PROQUEST in the period between 1995 -date of the first founding paper- until 2014. Through the analysis of source data (voices) and taking the "multivocal review" as a method, the voices have been combined in nine categories, namely: a) Refusal and impediments to a return to education; b) Educational infrastructure damaged or destroyed; c) Cuts in or withdrawal of spending on education; d) Loss of the educational and protective functions of the family; e) Loss of the academic community; f) Non-qualified teaching staff; g) Drastic loss of skills; h) Abandoning school (population movements, destruction of networks and social environment); i) Behavioural problems: traumas, pedagogical roles and self-victimization. These categories have highlighted the serious consequences arising from conflicts, infringing as they do the most basic human rights and in particular the right to a sound education during childhood.

Background: Organizational factors are considered to be the cornerstone in achieving psychological and professional security at work, which in turn are positively reflected in job performance both quantitatively and qualitatively. Aim of the Study: The study aimed to assess night shift and education/training developmental factors on performance of professional nurses in north West Bank governmental hospitals. Subjects and methods: A quantitative descriptive study utilized stratified random sampling of 185 nurses. A self administered questionnaire was developed with a response rate of 97%. The questionnaire was validated by experts, and reliability was obtained by Cronbach's alpha coefficient was (0.86) Data were analyzed using SPSS. Results: The overall level of night shift factor affecting performance of professional nurses was high (79.0%) and ; the education/training developmental factors moderate (68.8%) as perceived by nurses. It was found that there are significant differences at a = 0.05 between the total score of night shift and education/training developmental factors towards workplace in favor to Dr. Nazal Hospital. Conclusion and recommendation: The night shift and education/ training developmental factors affected the performance of the professional nurses. The findings of this study provide recommendations and suggestions to improve the performance of professional nurses in governmental hospitals such as: reduce the strain of long work hours on night shift and motivation. Providing continuous professional development of nurses in service training program.

Background: Organizational factors are considered to be the cornerstone in achieving psychological and professional security at work, which in turn are positively reflected in job performance both quantitatively and qualitatively. Aim of the Study: The study aimed to assess of selected organizational factors (workload, available recourses and manager support) affecting nurses performance in northern region of the West Bank governmental hospitals to improve its current and future performance of professional nurses. Subjects and Methods: A quantitative descriptive study utilized stratified random sampling of 185 nurses. A self administered questionnaire was developed with a response rate of 97%. The questionnaire was validated by experts, and reliability was obtained by Cranach's alpha coefficient was (0.863) Data were analyzed using SPSS. Results: The overall level of selected organizational factors affecting performance of professional nurses was high (74.6 %); the workload rated the highest (79.2 %) among the study dimensions as perceived by nurses, manager support (72.0%), and resources availability (69.8%). Also it was found that there are significant differences at a = 0.05 between the total score due to workplace between Thabet Thabet hospital and Rafedia hospital, in favor Rafedia hospitals. Conclusion and Recommendation: The findings of this study provide recommendations and suggestions to improve the performance of professional nurses in governmental hospitals such as: managers should ensure adequate number of staff and qualification according to work condition and sufficient number of professional nurses in the hospital at all times and shifts.

The study assessed the prevalence and predictors of post-traumatic symptomatology and emotional and behavioral difficulties in siblings of children who incurred war-related injuries. It was predicted that injury severity, gender and attributional style would account for a significant amount of the variance in post-traumatic stress symptoms and emotional and behavioral difficulties in those siblings. The sample consisted of 406 siblings of both genders with a mean age of 12.50 years. The results indicated that injury severity, gender and attributional style were related to emotional and behavioral difficulties and symptoms of post-traumatic stress, except for gender and post-traumatic stress .Siblings of children with severe injury appeared to be at greater risk for intrusive thoughts and avoidance as well as emotional and behavioral difficulties. Females exhibited more emotional and behavioral problems than did males. Siblings with more maladaptive attributional styles endorsed more emotional-behavioral problems and symptoms of post-traumatic stress. Techniques for strengthening coping abilities designed to enhance cognitive control may be used with siblings at risk, particularly females and siblings of children who sustained a severe injury. Treatments such as trauma-focused cognitive behavior therapy may incur positive results. (Contains 3 tables.)

The purpose of this paper is to share the evolution of a sociological framework to investigate the experience of teaching and learning music in relation to the Edward Said National Conservatory of Music in the occupied Palestinian territories. The primary foundation of the framework is Christopher Small's (1998) theory of musicking, supported by the concept of third place from urban sociologist Ray Oldenburg (1999) and the reconceptualization of music education as cultural practice suggested by educational researcher Rubén Gaztambide-Fernández (2007, 2011). Preliminary findings suggest that Small's theory is particularly apt because of its focus on ideal relationships between infinite combinations of people, places, and sounds. [This paper was presented at the 9th International Symposium on the Sociology of Music Education (2015).]

Rooted in graffiti culture and its attitude toward the world, street art is regarded as a postgraffiti movement. Street art encompasses a wide array of media and techniques, such as traditional spray-painted tags, stickers, stencils, posters, photocopies, murals, paper cutouts, mosaics, street installations, performances, and video projections displayed in urban streets. It represents the desire of humans to leave traces of their existence in the public sphere. As a vernacular art form, street art, such as the work of British artist Banksy, deals with activism, reclamation, and subversion and allows artists a platform to reach a broader audience than traditional art forms. Street art can serve to engage students in critical dialogue about art and visual culture while they collectively explore the issues it raises. This Instructional Resource describes a learning unit for high school students where they can address social and political issues by studying street art, specifically the work of Banksy. (Contains 5 figures, 3 online resources and 4 endnotes.)

Social scientists have explained the rise of suicide bombing since the early 1980s by focusing on the characteristics of suicide bombers, the cultural matrix in which they operate, and the strategic calculations they make to maximize their gains. The authors offer an alternative approach that emphasizes the interaction between Palestinian suicide bombings and Israeli government actions, analyzing the motivations, organizational rationales and precipitants for the 138 suicide bombings that took place in Israel, the West Bank and Gaza between October 2000 and July 2005. Using several sources, including Arabic newspapers, this study finds that much of the impetus for Palestinian suicide bombing can be explained by the desire to retaliate against Israeli killings of Palestinians; and that much of the impetus for Israeli killings of Palestinians can be explained by the desire to retaliate for suicide bombings.

This article addresses cultural adaptation of Western-Palestinian intermarried couples. Using in-depth interviews, information was gathered from 16 participants, 7 Western women and 9 Palestinian men, living in Palestinian cities in the West Bank. Adaptation strategies are typified by the extent to which each spouse embraces the partner's culture. The data suggest that intermarriage engenders a multidirectional adaptation process. Patriarchy and East-West power relations affect mainly the women, having to face marginalization on the basis of their gender and their foreignness. The men undergo a double process of cultural adaptation: to the Western culture and to their native culture after their return. Both the husbands' extended family and the Israeli-Palestinian conflict were found to affect both partners' adaptation.

Making a career decision becomes a major priority for adolescents during the last year of high school. The present study examined the taxonomy of career decision-making difficulties among 1,613 Arab 12th-grade students attending schools in East Jerusalem, areas in the West Bank under the Palestinian National Authority, and Israel. No significant differences were found among the three locations; gender differences were found in the major category Lack of Readiness and in four scales (lack of motivation, general indecisiveness, lack of information about additional sources, and external conflicts). Implications for counseling high-school students are discussed.

Describes the introduction of an Education Management and Information System in the West Bank and Gaza Strip (led by the Palestinian Ministry of Education) in terms of educational goals targeted, usefulness of this system for rational organization and management of an educational system, and the impact of the availability and sound use of data on improving quality. Describes the political and educational circumstances of Palestine through September 2000. (SM)

The objective of the present study was to investigate the morphological variations among collections of okra landraces in order to improve local varieties in Palestine. Eighteen okra accessions from various locations in the West-Bank region were evaluated for morphological variation. Different sixteen morphological traits were used for okra collection evaluation. The results revealed significant differences in seed color, leaf rib color, stem color, branching patterns, and fruit characteristics. Cluster and similarity analysis classified into two main clusters (I and II) with further sub-clusters. Genetic proximity did not strictly align with geographical boundaries, suggesting that factors beyond location influence genetic similarity. Cluster I exhibited greater diversity, with sub-clusters hinting at potential local adaptation. In contrast, Cluster II was smaller and less diverse, implying potentially distinct genetic origins. These findings provide insights for breeding strategies and germplasm conservation. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Arts & Social Sciences (JASS) is the property of Sultan Qaboos University and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Despite advancements in family planning (FP) services, several barriers persist in the Occupied Palestinian territory (oPt), blocking women's access to suitable, high-quality and equitable FP services. The aim of this study was to understand how healthcare providers perceive their abilities, barriers and opportunities in providing good quality FP services. Furthermore, it seeks to explore knowledge and training regarding FP among healthcare providers engaged in providing FP services. Methods: A qualitative study was undertaken from August to September 2022 in seven Primary Health Care (PHC) clinics distributed in three governorates and operating under the Palestinian Ministry of Health (MoH) in the West Bank. Semi-structured, in-depth face-to-face interviews were conducted with 13 health providers (Physicians, midwives and nurses), using an interview guide in Arabic language. Transcripts were subsequently analyzed using the six phases of reflexive thematic analysis. Results: FP services face various challenges, including shortages in resources such as staff, supplies, infrastructures and FP methods. Midwives possess significant potentials to offer accessible, high-quality, efficient and equitable FP services, yet, their capacities remain underutilized, representing a missed opportunity for a country like Palestine. The study provided a current overview of FP services while illustrating the need for quality FP services and the need for an updated continuous education and training, updated standardized guidelines and protocols and supportive supervision are needed across all levels of healthcare providers. Finally, providers reported a wide range of structural barriers to FP services. Conclusions: It is crucial to meticulously address both community-related and health system factors to enhance the fulfillment of FP needs and reduce unintended and closely spaced pregnancies. Policymakers should invest in the development of laws and regulations regarding FP services, promoting a comprehensive and holistic approach to FP services. This includes formulating supportive policies, capacity building of human resources and maintaining security of FP commodities. [ABSTRACT FROM AUTHOR]

This introduction aims to frame the texts it predates, to highlight their common theoretical and thematic concerns, and to set them against what we envision as a relevant common backdrop for the issues they raise. To this end, we begin from how insufficient acknowledgement of the current genocidal violence carried out against Palestinians in the Gaza Strip and the West Bank by Western feminism is symptomatic of its enmeshment with colonial rationales and imperialist violence. We question the extent of its liberating and emancipatory politics, reading them against the semiperipheral iterations of what Adam Tooze describes as the "polycrisis." Focused on the gendered aspects of democratic backsliding - broadly understood as a weakening of faith in liberal democracy and the electoral invigoration of the far-right -, the articles included here trace cultural negotiations of gender justice, as it wanes or strengthens across the region. Variously located within broader networks of transnational transfers and global concerns, the articles included here complement relevant work conducted outside the bounds of academic writing. We gesture towards such feminist, anticolonial and antiracist movements which have emerged in Romania, specifically in the literary field, and to their contestation of the patriarchal and deeply unequal national cultural system. [ABSTRACT FROM AUTHOR]

Background: Worldwide mothers are suffering from postpartum depression (PPD) which impairs mothers' well-being, children, and families, and leads to adverse outcomes for mothers and their growing newborns. Low and middle-income countries have a higher prevalence of PPD and limited studies about it. This study assessed the percentage of Palestinian mothers experiencing PPD nationally, identified mothers at a higher risk of PPD, and studied the correlation between PPD and mistreatment during childbirth. Methods: The study is based on a secondary data analysis from a cross-sectional study in the occupied Palestinian territory (oPt). A total of 745 telephone-based interviews with mothers were done within 2–4 weeks post-childbirth. The Patient Health Questionnaire (PHQ-9) was used as a screening tool for PPD. The Statistical Package for Social Science (SPSS) was used for analyzing the data. Results: In the context of descriptive epidemiology, we observed that 12.6% of the selected Palestinian mothers experienced PPD, with a higher occurrence of PPD among mothers living in the Gaza Strip, a politically and economically unstable region in Palestine, compared to mothers living in the West Bank (Adjusted Odd Ratio (AOD: 2.2, Confidence Interval (CI): 1.4–3.44). Older mothers were two times more likely to develop PPD compared to young mothers (AOR: 2.03, CI: 1.070–3.84). Mothers who experienced disrespectful behaviors represented by any abuse, negligence, abandonment, ineffective communication, or poor pain management in childbirth settings were more likely to report PPD than those who were not exposed to the disrespect. Conclusion: A notable percentage of Palestinian mothers were identified as experiencing PPD, especially among mothers who experienced mistreatment in childbirth settings. It is essential to support healthcare providers to improve their practices and attitudes to eliminate mistreatment and abusive behaviors of mothers during childbirth. [ABSTRACT FROM AUTHOR]

This study determined the prevalence and the associated factors with meeting the recommended amount of physical activity among type 2 diabetes mellitus (T2DM) patients receiving care in resource-limited settings of the West Bank of Palestine. Physical activity was assessed using the World Health Organization's Global Physical Activity Questionnaire. Associations were examined using multivariate logistic regression. Of the 302 patients included, 117 (38.7%) met the recommended amount of physical activity. Being younger than 58 years [aOR = 2.1 (95% CI 1.0–4.3], were employed [aOR = 2.3 (95% CI 1.1–4.9)], had high income [aOR = 3.9 (95% CI 1.3–11.9)], had thought that physical activity was crucial for T2DM patients [aOR = 32.7 (95% CI 3.9–275.5)], did not have comorbidities [aOR = 2.2 (95% CI 1.1–4.4)], had normal weight [aOR = 2.8 (95% CI 1.3–6.0)], and those who were overweight [aOR = 2.6 (95% CI 1.1–6.0)] were more likely to meet the recommended amount of physical activity compared to the patients who were 58 years or older, had low income, did not think that physical activity was crucial for T2DM patients, had comorbidities, and were obese, respectively. There is a need to increase physical activity among T2DM patients in resource limited settings. [ABSTRACT FROM AUTHOR]

Background: One of the largest problems facing the world today is the morbidity and mortality caused by antibiotic resistance in bacterial infections. A major factor in antimicrobial resistance (AMR) is the irrational use of antibiotics. The objective of this study was to assess the prescribing pattern and cost of antibiotics in two major governmental hospitals in the West Bank of Palestine. Methods: A retrospective cohort study was conducted on 428 inpatient prescriptions containing antibiotics from two major governmental hospitals, they were evaluated by some drug use indicators. The cost of antibiotics in these prescriptions was calculated based on the local cost. Descriptive statistics were performed using IBM-SPSS version 21. Results: The mean ± SD number of drugs per prescription (NDPP) was 6.72 ± 4.37. Of these medicines, 38.9% were antibiotics. The mean ± SD number of antibiotics per prescription (NAPP) was 2.61 ± 1.54. The average ± SD cost per prescription (CPP) was 392 ± 744 USD. The average ± SD antibiotic cost per prescription (ACPP) was 276 ± 553 USD. The most commonly prescribed antibiotics were ceftriaxone (52.8%), metronidazole (24.8%), and vancomycin (21.0%). About 19% of the antibiotics were prescribed for intra-abdominal infections; followed by 16% used as prophylactics to prevent infections. Almost all antibiotics prescribed were administered intravenously (IV) 94.63%. In general, the average duration of antibiotic therapy was 7.33 ± 8.19 days. The study indicated that the number of antibiotics per prescription was statistically different between the hospitals (p = 0.022), and it was also affected by other variables like the diagnosis (p = 0.006), the duration of hospitalization (p < 0.001), and the NDPP (p < 0.001). The most commonly prescribed antibiotics and the cost of antibiotics per prescription were significantly different between the two hospitals (p < 0.001); The cost was much higher in the Palestinian Medical Complex. Conclusion: The practice of prescribing antibiotics in Palestine's public hospitals may be unnecessary and expensive. This has to be improved through education, adherence to recommendations, yearly immunization, and stewardship programs; intra-abdominal infections were the most commonly seen infection in inpatients and ceftriaxone was the most frequently administered antibiotic. [ABSTRACT FROM AUTHOR]

Introduction: Non-traditional tobacco products, such as waterpipes and e-cigarettes, are perceived to be less harmful than cigarettes. The north of the West Bank has become the site for growing tobacco production and consumption. This study aimed to estimate the current prevalence of nontraditional tobacco smoking (waterpipes and e-cigarettes) and associated risk factors among men in the West Bank. Methods: In a cross-sectional study, a self-administered questionnaire was distributed among males aged ≥16 years in 2022 from the largest three governorates in the north of the West Bank (n=1241). Body mass index and waist circumferences were measured. Results: The final number of participants was 1204, aged 16–58 years; 58.9% were singles, 69.4% were young adults, 22.1% were adolescents, 67.5% were cigarette smokers (53.9% heavy smokers), 35.3% were waterpipe smokers, and 15% e-cigarette smokers. Adjusted logistic regression results revealed that risk factors associated with waterpipe smoking were e-cigarette smoking (AOR=3.29; 95% CI: 2.30–4.70), energy drink intake (AOR=1.62; 95% CI: 1.24–2.13), young adult age (AOR=2.15; 95% CI: 1.15–4.03), being a student without work (AOR=1.95; 95% CI: 1.09–3.50) or a working student (AOR=2.73; 95% CI: 1.32–5.65), and less likely to be associated with cigarette smoking (AOR=0.23; 95% CI: 0.18– 0.31). In addition, an increased likelihood of central obesity was associated with waterpipe smoking (AOR=2.15; 95% CI: 1.15–4.03) and decreased with coffee intake (AOR=0.44; 95% CI: 0.27–0.87). Conclusions: Non-traditional tobacco smoking is an emerging hazard among male Palestinians, with waterpipe smoking linked to increased central obesity. Further research is needed to investigate the health consequences of this trend in the West Bank. [ABSTRACT FROM AUTHOR]

The 10 major cities in the West Bank (WB), Palestine—Nablus, Ramallah and Al-Bireh, Jenin, Qalqilia, Salfit, Tubas, Jericho, Bethlehem, Tulkarem, and Hebron—are experiencing rapid urban transformation and changing land cover. This study explores the relationship between land cover (built-up and unbuilt areas) and soil type in these cities across benchmark years 1995, 2000, 2005, 2010, 2015, and 2021. In addition to the former, the paper argues that the expansion and increase of the built-up area and the change in soil type of the aforementioned cities in the West Bank, Palestine, are leading to changes in the land surface temperature (LST). This conclusion was reached through a methodological framework that was developed to measure the relationship between the changing land cover (built-up and unbuilt-up areas), soil type, and LST in the 10 major cities in the region. The framework relies on data retrieved through remote sensing in the years from 1995 to 2021. The results of the analysis conducted through this methodological framework showed that there is an inverse relationship between the increase in built-up areas and LST; however, LST is less inside the built-up areas than in the surrounding areas (open spaces) due to different land cover (unbuilt area with grass and shrubs) and different soil type. [ABSTRACT FROM AUTHOR]

Background: The measurement of patient satisfaction is a vital metric that enhances stakeholders to take proactive steps in improving the quality of healthcare services within medical care systems. This study assessed patient satisfaction receiving pharmaceutical services from primary health care centers in the Palestinian Ministry of Health (PMoH) governorate directorates in the West Bank. Methods: A total of 938 patients, all aged 18 years or older, completed a self-administered questionnaire. The assessment of general satisfaction was based on selected questions. Analyses were conducted to explore demographic characteristics. Mean and standard deviation (S.D.) were reported. Likert method was used to average scale satisfaction. To examine statistically significant differences, Chi-square analysis and binary logistic analysis were employed. Results: 56.8% of the survey respondents were women, 57.2% were 40 years or older, and 63.2% had graduated from high school. The general satisfaction score averaged 4.10 ± 0.77 indicating good satisfaction. Patients were satisfied with interpersonal relationships, with a mean score of 4.19 ± 0.70. However, satisfaction with therapy management was lower, with a mean score of 3.99 ± 0.77 indicating moderate satisfaction. A significant factor can affect patient's satisfaction such as the location of the pharmacy (OR = 1.720, P = 0.012), the waiting area (OR = 1.671, P = 0.002) and the cleanness of pharmacy (OR = 2.307, P = 0.001). Conclusion: This study underlines the main components of patient satisfaction who receive pharmaceutical services in PMoH. It is highly recommended that PMoH must address patient dissatisfaction points in a total quality management plan. [ABSTRACT FROM AUTHOR]

Background: Colorectal cancer (CRC) is the second most widespread cancer among Palestinian patients. As cancer care improves in hospitals across the West Bank, services like palliative care, targeted therapy, bone marrow transplantation, and individualized therapy are still limited. This study aimed to assess the CRC stages, treatment protocols, and survival rates of patients in the West Bank. Methodology: This retrospective study collected data from the medical records of Al-Najah University Hospital (NUH), which specializes in the care of cancer patients. Patients with confirmed CRC (stages I–IV) undergoing surgical or medical treatment were included in the study. Data collection was standardized by using a data collection form to gather information from the medical records included in the study. All statistical analyses were performed using SPSS (version v27), and survival was assessed using a regression analysis of the number of days from the time of diagnosis to the most recent visit against the type of treatment (e.g., surgery, chemotherapy, radiotherapy). Results: A sample of 252 patients with CRC from NUH was collected, including 143 males and 109 females aged between 27 and 86 years, with the average age being 60.6 ± 11.4 years. The sample included 183 patients (72.6%) diagnosed with colon cancer only, 29 patients (11.5%) diagnosed with rectal cancer only, and 40 patients (15.9%) diagnosed with both. Diagnosis took place at CRC stage I for 3 patients (1.2%), stage II for 33 patients (13.1%), stage III for 57 patients (22.6%), and stage IV for 159 patients (63.1%). Surgery was the most prevailing mode of treatment for 230 patients (91.3%), while 227 patients (90.1%) received chemotherapy treatment, and 38 patients (15.1%) received radiotherapy. Of the 252 patients, 40 patients (15.8%) received FOLFOX (i.e., folinic acid, fluorouracil, oxaliplatin), and 25 patients (9.9%) received FOLFIRI (i.e., folinic acid, fluorouracil, irinotecan), while the 187 remaining patients (74.2%) were treated with capecitabine, oxaliplatin, bevacizumab, cetuximab, regorafenib, cisplatin, etoposide, gemcitabine, or a combination thereof. The sample was categorized into six outcomes: (1) death, (2) cure, (3) disease progression, (4) disease recurrence, (5) under-treatment, and (6) unknown. Mortality was high, with 104 patients (41.3%) dying within a short time after diagnosis, and may have been attributable to delayed diagnosis. Surgical treatment had a positive impact on increasing the survival years, and it was significant (p = 0.033). Conclusions: A high percentage of patients were diagnosed in advanced CRC stages. The treatment modes were adopted from general international guidelines; however, the cure rates were low, and mortality was high. More studies need to be undertaken to investigate the actual application of chemotherapy protocols, and survival would benefit from the involvement of clinical pharmacists in the chemotherapy protocol selection, dosing, frequency, and follow-up. The present study advocates for greater public awareness of CRC and attests to the merits of screening by primary care professionals, which can help to avoid this serious illness and to promote a better prognosis. [ABSTRACT FROM AUTHOR]

Traumatic experiences in childhood can lead to trauma symptoms and impaired mental health, especially when children are exposed to war and political violence. Despite significant attention to child's exposure to traumas, few instruments to detect potentially traumatic events have been validated psychometrically. Our study aimed to develop, adapt and validate a user-friendly traumatic events checklist in Palestinian children living in three areas affected by low-intensity war and ongoing political and military violence. 965 Palestinian children (494 males and 471 females) living in the Gaza Strip, West Bank and East Jerusalem were administered with a tailor-made Traumatic Events checklist, Children Impact of Events scale, and Strengths and Difficulties Scale. Exploratory and Confirmatory factor analysis was run to detect the factorial structure of the checklist. Furthermore, ANOVA was performed to identify statistically significant demographic differences among participants. A three factors structure emerged with Political violence-related traumatic experiences (PVTE), military violence against individuals (MVI), and military violence against individuals and families (MVF). Gaza children and adolescents resulted in being the most exposed to potentially traumatic events. The instrument can clearly portray potentially traumatic experiences in children exposed to violent events and adverse childhood experiences. [ABSTRACT FROM AUTHOR]

Background/Objetives: Cardiovascular disease (CVD) remains a significant contributor to global morbidity and mortality rates. Coronary artery bypass graft (CABG) surgery is a critical intervention for patients with coronary artery disease, yet it poses psychological challenges that can impact recovery. Methods: This prospective cohort study, conducted across six hospitals in the West Bank/Palestine, aimed to assess changes in depression, anxiety, and stress levels among CABG patients and identify associated factors. The Arabic version of the Depression Anxiety Stress Scales (DASS-21) was administered before (one week) and after surgery (two and three weeks). Results: Of the 200 participants, 116 were men (58%). High levels of depression, anxiety, and stress were observed both before and after surgery, with statistically significant reductions in all these variables after surgery (p < 0.001). Regarding demographic factors, age displayed a weak positive correlation with depression (r = 0.283; p < 0.001), anxiety (r = 0.221; p = 0.002), and stress (r = 0.251; p < 0.001). Sex showed a weak correlation with stress pre-surgery (r = −0.160; p = 0.024). Conclusions: Patient outcomes could be improved by early identification and the provision of efficient treatments such as psychosocial therapy both before and after surgery. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Arts & Social Sciences (JASS) is the property of Sultan Qaboos University and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Class size is one of the predominant topics in educational policy debate, as its impact on academic performance has not always yielded consistent findings. Nevertheless, less emphasis was paid to noncognitive outcomes such as well‐being and behavioral issues. This study employs rich administrative and survey data to investigate the effects of class size on students' bullying and violent behavior as well as cognitive abilities tests. The study uses the maximum class size rule to create a regression discontinuity (RD) relation between cohort enrollment size and class size in the public and the United Nations Relief and Works Agency school system in the West Bank. Further, this study provides evidence that there is no violation of the RD assumptions resulting from discontinuities in the relationship between enrollment and students' household background at cutoff points induced by a maximum class size rule. The findings suggest that class size reduction improves the quality of life for children by mitigating bullying and violent behavior among pupils, which might have long‐term adverse effects on academic attainment. Finally, peer relationships and mental health problems are identified as potential mechanisms through which class size influences self‐reported levels of bullying and violent behavior among students. [ABSTRACT FROM AUTHOR]

Background: The satisfaction of healthcare employees in their jobs is crucial due to its impact on the quality of services provided. Additionally, the presence of adequate job satisfaction is essential to avoid negative consequences in healthcare delivery, such as high turnover rates and low performance.Objectives: This study aimed to address the knowledge gap regarding the measurement of current job satisfaction levels among healthcare providers in both governmental and private hospitals in the West Bank.Methods: This research follows a cross-sectional design and utilizes a quantitative approach. Data were collected from a total of 370 employees working in the healthcare sector, including both private and public hospitals. To assess job satisfaction, the researchers employed a self-administered Mueller/McCloskey satisfaction scale, which was based on previous studies conducted by Clinton in 2015. This scale was administered to employees across various departments and specialties.Results: In various aspects, healthcare providers express a satisfaction level of over 30%. These aspects include their monthly salary, annual leave and holidays, working hours, weekend arrangements, interactions with supervisors and colleagues, social communication during work hours, collaboration with healthcare professionals from different specialties, work environment, and working conditions. The results indicate that a majority of healthcare providers (54.9%) are generally content, scoring between 60% and less than 80%. Conversely, approximately one-third of them (33.6%) express general dissatisfaction, scoring below 60%.Conclusion: More than half of the healthcare providers in both governmental and private hospitals in the West Bank expressed a general sense of satisfaction. Married and older healthcare providers are more satisfied with their jobs compared to younger and single employees.

Abstract Background Postpartum depression (PPD) has a huge negative impact on the health of the mother and the family, both physically and mentally. Few postpartum depression studies have been done in Palestine. This study aimed to examine the prevalence and the most probable risk factor of PDD among Palestinian women in the northern West Bank. Methods This is a cross-sectional study of 380 mothers, ages 18 and 44 years, visiting vaccination clinics with their infants after 7-12 weeks of delivery between 1 May 2022 and 30 June 2022. Postpartum women seeking care at the seven largest primary health care centers of the Ministry of Health in four cities in the Northern West Bank in Palestine were asked to complete a self-administered questionnaire that included the Edinburgh Postnatal Depression Scale and demographic and birth details. A score of 13 or higher was used to indicate PPD risk. Descriptive and analytical analyses were performed using SPSS version 20. The level of significance was set at 5%. Results The median age of the participants was 27 years with a range of 26 years. A total of 129 women had an EPDS score of 13 or more, giving a prevalence rate of post-partum depression of 33.9%. The predictors of postpartum depression were stressful life events during pregnancy (p-value 0.003, OR: 2.1, 95% CI [1.27-3.4]), vacuum use during delivery p-values 0.002, OR: 4, 95% CI: [1.64-9.91]), low social support (p-value less than 0.001, OR: 2.5, 95%CI: [1.7-4.2]) and husband’s low level of education (p-value less than 0.001, OR: 5.2, 95%CI: [2.7-10]). Conclusion The study showed a high prevalence of PPD among Palestinian mothers in the northern West Bank. Our study found that PPD risk factors include lack of social support, the husband’s low education, and stressful events during pregnancy. This will emphasize the importance of PPD screening and early intervention, especially among vulnerable women.

AbstractAnalysts strive to predict future scenarios of the Palestinian-Israeli conflict, concentrating on the question of whether Palestinians will be willing to pay the costs of violent struggle. In contrast with various policy assessments, this paper takes political trust as a factor that enables us to anticipate Palestinian social reactions as a point of departure. We interviewed 90 West Bank inhabitants, focusing on six major issues: the armed struggle against Israel, democracy and human rights, the internal PLO-Hamas rift, the standard of living, corruption in the PA, and political trust in the PA. Our findings match the quantitative results of Khalil Shikaki’s PCPSR public opinion polls of the West Bank. We conclude that the lack of democracy, the continuing internal rift, the low standard of living, and the manifestations of governmental corruption erode political trust within Palestinian society. Based on research from other places around the globe, such a loss of trust dissuades recruiting people for national struggles. Accordingly, a new popular intifada seems unlikely. However, the Palestinians interviewed also objected to the occupation and its ramifications, which is not an encouraging insight for peace-seekers in the Middle East.

Background: In Palestine, women face a challenging environment and a demanding lifestyle, which puts them at a higher risk of experiencing complications during pregnancy. This study aimed to examine the risk factors linked with abnormal hemoglobin (Hb) levels, gestational diabetes (GD), and gestational hypertension (GH) among pregnant women. The results was compared between women residing in cities or villages areas and those in refugee camps. Methods: Medical records (N = 7889) for pregnant women at primary healthcare centers in the North West Bank were reviewed for sociodemographic and medical data along with the reported fasting blood sugar, hemoglobin, and blood pressure in the first and second trimesters from July 2018 to July 2020. However, only 6640 were included in the analysis as 1249 were excluded for having multiple pregnancy or lost to follow up. Complications and risk factors were defined according to the available global guidelines. Then, descriptive analysis was used to show the percentages of different risk factors and complications among them. The correlation between the several characteristics and variables with these complications was assessed by calculating the odds ratios (OR) using logistic regression. P-values of <0.05 were considered significant. Results: The prevalence of adolescent pregnancy was the highest among women living in rural areas (9.8%) and grand multigravidity among refugee women (22%). The overall prevalence of anemia was higher in the second-trimester (16.2%) than in the first-trimester (11.2%), with anemic women in the first-trimester being more likely to be anemic in the second-trimester (OR = 8.223, P-value<0.001). Although anemia was less common in the first-trimester among refugees than among women living in urban areas (OR = 0.768, P-value = 0.006), it was more prevalent in the second-trimester (OR = 1.352, P-value<0.001). Moreover, refugee women were at lower risk than women living in urban areas of having GD (OR = 0.687, P-value<0.001) and diabetes mellitus (OR = 0.472, P-value<0.001) in the second-trimester. GH was associated with GD (OR = 1.401, P-value = 0.003) and DM (OR = 1.966, P-value<0.001). Conclusion: The findings of this study provide evidence-based data on the considerable prevalence of pregnancy complications, anemia, GD, and GH among Palestinian pregnant women living in the north of the West Bank. Multi gravida, gestational age, Hb levels, and the type of settings were strong predictors of pregnancy complications. Therefore, a national plan is needed to ensure adequate maternal care for all, especially disadvantaged women, those in rural areas and refugee camps. [ABSTRACT FROM AUTHOR]

Background: Drug use during pregnancy can cause unfavorable fetal and maternal outcomes. Information sharing is essential for pharmacists' role within intricate, modern healthcare systems. Community pharmacists (CPs) have demonstrated unsatisfactory knowledge across various pharmacological domains in most developing countries. This study aimed to explore the knowledge and practices of CPs regarding medications and herb safety during pregnancy. Methods: A cross-sectional study was conducted in a developing country using a self-administered questionnaire. A sample of CPs working in the northern governorates of the West Bank was selected by convenience sampling. The questionnaire included questions on sociodemographic characteristics, practices and knowledge. Descriptive and inferential statistics were calculated using the Statistical Package for the Social Sciences (SPSS) to analyze the data. Results: A total of 207 questionnaires were completed. Most respondents had only a bachelor's degree (89.9%) but did not participate in continuous professional development (CPD) (71.0%). Almost one-third of the CP workload involved dispensing drugs to pregnant women. The majority of the participants reported that they inquire about pregnancy status (59.9%), refer to scientific sources (82.6%), and contact a prescribing physician (51.2%) in cases of uncertainty. A higher knowledge score was associated with receiving a master's degree and CPD programs. Most CPs identified folic acid, paracetamol and amoxicillin as safe, while tetracycline, isotretinoin, enalapril, pseudoephedrine and ibuprofen were among the drugs mostly reported as unsafe. Castor oil, Senna, St. John's wort and ginseng were the most frequently reported herbs as unsafe. Conclusions: Despite the gaps in knowledge about herb pharmacology, CPs demonstrated acceptable knowledge and practice regarding drug safety during pregnancy. CPD is recommended for addressing gaps in knowledge and practice. Future research evaluating knowledge and practice may benefit from developing a specific, accurate, validated instrument. [ABSTRACT FROM AUTHOR]

Background: Geopolitical and socioeconomic challenges limit faculty development and clinical teaching in Palestine and many other developing countries. The first, and still only, Family Medicine (FM) residency program is a four-year program based out of An-Najah University in the West Bank. Training in primary care clinics occurs in the final two years and there are many challenges to adequate supervision in the clinical setting that were exacerbated during the pandemic. To improve the readiness for practice skills of 13 Palestinian FM residents a three-month tutorial program was organized in 2020. A nongovernmental organization (NGO) that has worked to support Family Medicine development in the region engaged experienced British and American General Practitioners trained as tutors to offer online tutorials. We examined the program as a case study to understand the factors that facilitated or impaired a positive virtual learning environment in a middle/low income country. Methods: The tutors and residents were divided into groups and met virtually between June and September 2020. Evaluations and session reports collected during the program, the text of an online chat, and responses to an online survey two years later were collected. Using thematic analysis techniques, we evaluated the value for the residents at the time and two years later and identified factors that facilitated or impaired a positive virtual learning environment. Results: Themes of knowledge, skills, attitudes, cultural disconnects, and tutorial logistics emerged. The group with the most stable tutor pairing, including one Arabic-speaker familiar with the context, was the most engaged. The all-female group formed a chat group to share real-time case questions during clinical practice and focused on skills (e.g. conducting a thorough medication review) and attitudes (e.g. open to sharing and discussing uncertainties). Other groups were less cohesive. Conclusions: Transnational tutorials that focused on clinical thinking and decision-making skills were most successful when the tutorial pair was stable, offered familiarity with the language and addressed cultural differences. Intrinsic factors such as lacking the motivation to participate and extrinsic factors such as unstable internet and rolling electric cuts, and clinical structures that made applying new skills challenging were more difficult to address but must be considered. [ABSTRACT FROM AUTHOR]

Objective: Investigating the relationship between physical activity (PA) and depressive symptoms is a vital field of research globally. Nonetheless, this association remains unexplored in the context of older Palestinian adults, highlighting the need for additional research on this population. Therefore, this study aimed to examine the association between PA and depressive symptoms among older Palestinian adults. Subjects and Methods: A cross-sectional study was conducted in the West Bank/Palestine with 266 participants. Data were collected using a PA socio-cultural adapted questionnaire (PA-SCAQ), the EuroQuol-5Dimensions-5Levels measure, and the Geriatric depression scale (GDS-15). Independent sample t tests and ANOVA tests were used to investigate mean differences in PA and GDS-15 scores between groups. Furthermore, multiple linear regression analysis was used to examine the relationship between study variables and the impact of the independent variable (PA level) on depressive symptoms. Results: The mean age of the participants was 65.01 ± 8.02 years (range: 55–86), women 51.9%. Lower levels of PA and higher depressive symptoms were recorded among women, participants ≥65 years, and with recorded diagnosed disease (p < 0.05). The regression analysis showed a negative significant correlation between PA and GDS-15 scores (β = −0.235, p < 0.001), when controlling for age (model 2), and for age and sex (model 3), significant associations were recorded, respectively (β = 0.192, p = 0.002), and (β = 0.14, p = 0.015). Conclusion: Participants who recorded higher depressive symptoms had a lower level of PA; regular moderate-intensity aerobic exercises can contribute to prevent depression symptoms in older adults. Highlights of the Study: Levels of physical activity (PA) levels are negatively associated with depressive symptoms in older adults. Women and participants ≥65 years recorded lower PA and higher depressive scores. Participants with musculoskeletal disorders, particularly arthritis, recorded lower PA and higher depression scores. Incorporating moderate-intensity PA interventions into mental health promotion programs can contribute to prevent or treat depression in older adults. [ABSTRACT FROM AUTHOR]

Within the recognized borders of Israel, in the shadow of the West Bank settlement enterprise, a new frontier is in the making. Central planning has designated the space as a burgeoning metropolitan region, and, in a parallel process, a network of Jewish-only settlements has been established. This study asks how the settlement push is narrated to the Israeli public, and thereby adds the Naqab to previous studies exploring the link between colonial settlement and suburbia, and more specifically with the community-settlement model. It analyzes audiovisual material produced by two Zionist organizations and finds that the new frontier is narrated as a space for reenactment of the mythic pioneer trope, and that this ideal is mediated in relation to the new neoliberal ethos of Israel as the "start-up nation." The study moreover expands on the interplay of geographic scales, thus adding an important contribution to scholarly understanding of contemporary settler-colonialism. [ABSTRACT FROM AUTHOR]

Background and objectives: Depression and anxiety are common mental health disorders among the elderly worldwide. In this study, we estimated the prevalence of depression and anxiety and related risk factor among elderly attending Primary Health care (PHC) centers in Palestine. Methods: A cross-sectional study was conducted from February to July 2021 with a sample size of 380 participants aged =60 attending PHC centers in West Bank, using an interviewer-administered questionnaire. We used the Geriatric ***Depression Scale-15 and the Geriatric anxiety Scale to screen for depression and anxiety, respectively. Logistic regression models were used to identify predictors of depression and anxiety. Results: The prevalence of depression and anxiety was 41.1 and 39.2%, respectively. Elderly people living in rural areas (aOR = 2.63; 95% CI: 1.72-4.20), uneducated (aOR = 2.92; 95% CI: 1.41-6.13), and without monthly income (aOR = 3.42; 95% CI: 1.52-7.61) were more likely to have depression. On the other hand, anxiety was independently associated with living in rural areas (aOR = 1.93, 95% CI: 1.23-3.04) and having non-communicable diseases (aOR = 2.01; 95% CI: 1.13-3.49). Conclusion: Depression and anxiety are common in Palestine, a developing country with a lack of elderly related services. This should be emphasized at the national and regional levels where geriatric health care services are scarce. Such information is required by policymakers and external funding agencies in order to develop future agendas. [ABSTRACT FROM AUTHOR]

Background: Postpartum depression (PPD) has a huge negative impact on the health of the mother and the family, both physically and mentally. Few postpartum depression studies have been done in Palestine. This study aimed to examine the prevalence and the most probable risk factor of PDD among Palestinian women in the northern West Bank. Methods: This is a cross-sectional study of 380 mothers, ages 18 and 44 years, visiting vaccination clinics with their infants after 7-12 weeks of delivery between 1 May 2022 and 30 June 2022. Postpartum women seeking care at the seven largest primary health care centers of the Ministry of Health in four cities in the Northern West Bank in Palestine were asked to complete a self-administered questionnaire that included the Edinburgh Postnatal Depression Scale and demographic and birth details. A score of 13 or higher was used to indicate PPD risk. Descriptive and analytical analyses were performed using SPSS version 20. The level of significance was set at 5%. Results: The median age of the participants was 27 years with a range of 26 years. A total of 129 women had an EPDS score of 13 or more, giving a prevalence rate of post-partum depression of 33.9%. The predictors of postpartum depression were stressful life events during pregnancy (p-value 0.003, OR: 2.1, 95% CI [1.27-3.4]), vacuum use during delivery p-values 0.002, OR: 4, 95% CI: [1.64-9.91]), low social support (p-value less than 0.001, OR: 2.5, 95%CI: [1.7-4.2]) and husband's low level of education (p-value less than 0.001, OR: 5.2, 95%CI: [2.7-10]). Conclusion: The study showed a high prevalence of PPD among Palestinian mothers in the northern West Bank. Our study found that PPD risk factors include lack of social support, the husband's low education, and stressful events during pregnancy. This will emphasize the importance of PPD screening and early intervention, especially among vulnerable women. [ABSTRACT FROM AUTHOR]

Background: The aim of this study is to assess the prevalence of anxiety and depression symptoms among adolescent students in the West Bank region of Palestine, with a particular focus on the impact of electronic device usage on their mental well-being. Methods: This cross-sectional study included a representative sample of 1,140 adolescents enrolled in governmental secondary schools. We targeted schools located in Nablus, Ramallah, and Hebron districts, which, respectively, represent the northern, central, and southern regions of the West Bank. We collected data on their sociodemographic characteristics, patterns of electronic device usage, scores from the Beck Depression Inventory-II, and the 7-item Generalized Anxiety Disorder scale, all gathered through a self-administered online questionnaire. To explore the independent relationship between anxiety, depression, and various factors, we calculated odds ratios and their corresponding 95% CI using a binary logistic regression model. Results: The study revealed a prevalence of moderate to severe anxiety at 35.4% [95% CI: 32.7–38.3%] and moderate to severe depression at 23.9% [95% CI: 21.4–26.4%]. Notably, anxiety scores were significantly higher among females [OR = 3.8, 95% CI: 2.5–5.9], individuals with lower academic performance [OR = 3.4, 95% CI: 2.1–5.4], and smokers [OR = 1.9, 95% CI: 1.1-3.0]. Similarly, significantly elevated depressive scores were observed among females [OR = 2.0, 95% CI: 1.3–3.1], those with lower academic performance [OR = 3.4, 95% CI: 2.1–5.4], and smokers [OR = 1.9, 95% CI: 1.3–2.8]. Conversely, students who used electronic devices for shorter durations were less likely to experience depression [OR = 0.49, 95% CI: 0.32–0.76] or anxiety [OR = 0.47, 95% CI: 0.32–0.69]. Conclusion: Considering the alarming rates of anxiety and depression in adolescents, along with their connection to the time spent using electronic devices, we strongly recommend the creation of initiatives and support networks to alleviate this issue's impact. Encouraging healthier lifestyles, such as reducing screen time and increasing physical activity, could potentially enhance the mental well-being of adolescents. [ABSTRACT FROM AUTHOR]

The article analyzes the future of Christians in the Holy Land after five months of war. In Gaza, Christians represent a small minority of about 1,000 faithful in a population of 2.3 million. They have sought refuge in the Holy Family parish, which has provided them with food, water, and medical attention. In the West Bank, the closure of borders prevents them from accessing their jobs in Jerusalem, and tourism has come to a halt. Emigration puts the survival of Christians in the region at risk, as many no longer see a future there. The situation in Gaza is desperate, with shortages of food, fuel, and medical care. The reconstruction after the war is estimated to last until 2093. Christians residing in the West Bank and East Jerusalem are facing a desperate situation due to the war in Gaza and the escalating tensions between Israelis and Palestinians. The region is experiencing a widespread economic crisis, with a record unemployment rate of 72%. The lack of pilgrims has left the local economy in ruins, affecting sectors such as religious tourism and the sale of souvenirs. Christians in the Holy Land are struggling for their survival and are calling for international solidarity to preserve the sacred sites. Aid to the Church in Need (ACN) has announced a second emergency aid package for Christians affected by the war in Gaza, which includes medicine, food vouchers, and support for education and housing. ACN will also support training programs for young Christians, providing them with new skills and employment opportunities. [Extracted from the article]

The article discusses the book "Against Zionism - Portrait of a Colonial and Racist Doctrine" by Breno Altman, an anti-Zionist journalist of Jewish origin. The book addresses the genocide in Gaza and the ethnic cleansing in the West Bank, presenting exhibitions made by the author on the program "20 Minutes" of the channel World Tensions. Altman describes Zionism as a brutal, racist, and colonial regime, and highlights the legitimate resistance of the Palestinian people. The author also discusses the transformation of Gaza into a ghetto and the normalization of Israel with Arab regimes. The book is a call to fight for the liberation of Palestine. [Extracted from the article]

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Many students face various obstacles when going to school, including poor physical infrastructure and exposure to conflict. We investigate the costs of conflict-induced substandard infrastructure in terms of educational performance. We focus on students in the West Bank over 2000–2006 during the Israeli–Palestinian conflict. This conflict is characterized by a system of mobility restrictions enforced through physical barriers, such as checkpoints, which increase commuting costs and the likelihood of encounters with security forces. We find that the introduction of checkpoints near a school reduces the probability of passing the final high school exam by one percentage point and the overall score by 0.04 standard deviations. Direct encounters with checkpoints have strong negative effects on performance, suggesting that time loss due to delays or the psychological impact of encountering security personnel may be important mechanisms. [ABSTRACT FROM AUTHOR]