Dilshad Jaff
I am an adjunct associate professor and a humanitarian fellow at the Gillings School of Global Public Health. I hold a Master of Public Health degree from the Gillings School and have more than 19 years' field experience in complex humanitarian crises working for refugees and IDPs, largely with the International Committee of the Red Cross. I have experience in designing, implementing, supervising and monitoring health projects and programs during and after complex humanitarian emergencies. In addition to my formal studies in medicine and public health, I studied medical microbiology with considerable training in conflict resolution.
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collection. Undergraduate students from various fields of study have had
different attitudes towards people with mental illnesses. Medical students
have better understanding and more positive attitudes than students of the other fields. Male students showed more negative attitudes compared to female students. Furthermore, younger students had more negative attitudes than older students.
Quality problem or issue: There are record-setting numbers of people living in settings of extreme adversity and they continue to increase each year. Initial assessment: There is a paucity of validated data on quality and safety across settings of extreme adversity. Choice of solution: This paper argues for an action framework to address the unique challenges of providing quality in extreme adversity. Implementation: We describe a preliminary Quality in Extreme Adversity framework which has
been informed by—and will continue to be validated through—literature, data collection, WHO expert consultations and through working in settings of extreme adversity with national authorities and NGOs. Lessons learned: Poor quality care costs lives, livelihoods and trust in health services. The recommended framework, based on evidence and experiential lessons, intends to address the WHO goal for 2019–2023 of ‘one billion people better protected from health emergencies’ (9).
The Pittsburgh Sleep Quality Index (PSQI) is a standardized questionnaire that used for subjective assessment of sleep quality. It has been translated into several languages and is widely used in clinical research settings. Since there is no sleep-related scale standardized in the Kurdish language, the present study aimed to translate and validate the PSQI into Kurdish.
Methods:
First, the PSQI was successfully translated into Kurdish then back-translated into English by independent professional bilingual translators. The translated version of PSQI was tested with 230 participants, 150 healthy subjects, 40 subjects with insomnia, and 40 subjects with physical symptoms. Internal consistency was calculated by the Cronbach Alpha method using SPSS-20 software. Spearman correlation via a test-retest process was used for reliability. The General Health Questionnaire (GHQ28) was used to analyze criterion validity. The construct validity of the scale was tested by exploratory factor analysis (EFA). Factor weight was checked by confirmatory factor analysis (CFA) using LISREL software version 8.8.
Results:
The internal consistency and reliability for PSQI global score was acceptable (Cronbach’s alpha = 0.70). The result showed a strong correlation between test and retest after six weeks (r=0.83). Correlations between the global score and components of the PSQI with the GHQ28 were all statistically significant (r=0.23-0.72, p < 0.05). Exploratory factor analysis revealed three factors with a significant correlation between the PSQI global score and these factors. All factor weights were above 0.40.
Conclusion:
The results of this study support the PSQI’s validity and reliability. This study offers a foundation for further studies in Kurdish populations.
inability to address the shortfalls in the public health model. Calls for health system reform in Iraqi Kurdistan Region started in 2004; however, few, if any, significant changes have been achieved since then. This research examines the factors impeding public health system reform in the Iraqi Kurdistan Region, as perceived by the health policy makers, through 11 in-depth, unstructured interviews. Participants attributed the delay in reform to 16 impeding factors that can be categorized into 5 major themes: historical, ethical, cultural, political and institutional. The intricate network of these inter-dependent factors provides a possible explanation for the failure or unsustainability of reform efforts. Reform initiatives might have a better chance of success if they take into consideration the well-established and unique background and social construct in Iraq, as well as the impact of decades of conflict and insecurity, both of which influence the individual and institutional reasoning and behaviour across the entire health system.
norms are sometimes reinforced as a protective mechanism, particularly
for women who may be prevented from following the classic person-to-person consultation protocol. Social media, when used skilfully and properly protected, may help overcome the multiple cultural and social barriers that prevent the application of the more traditional treatment protocol.
This study found that patients in refugee camps and communities would
benefit from receiving palliative care services that are often either unavailable or inaccessible. Training humanitarian teams and primary care providers to implement pain management, offer psychosocial support services and address emotional, spiritual, and psychological conditions could ameliorate many of the problems faced by this vulnerable group.
collection. Undergraduate students from various fields of study have had
different attitudes towards people with mental illnesses. Medical students
have better understanding and more positive attitudes than students of the other fields. Male students showed more negative attitudes compared to female students. Furthermore, younger students had more negative attitudes than older students.
Quality problem or issue: There are record-setting numbers of people living in settings of extreme adversity and they continue to increase each year. Initial assessment: There is a paucity of validated data on quality and safety across settings of extreme adversity. Choice of solution: This paper argues for an action framework to address the unique challenges of providing quality in extreme adversity. Implementation: We describe a preliminary Quality in Extreme Adversity framework which has
been informed by—and will continue to be validated through—literature, data collection, WHO expert consultations and through working in settings of extreme adversity with national authorities and NGOs. Lessons learned: Poor quality care costs lives, livelihoods and trust in health services. The recommended framework, based on evidence and experiential lessons, intends to address the WHO goal for 2019–2023 of ‘one billion people better protected from health emergencies’ (9).
The Pittsburgh Sleep Quality Index (PSQI) is a standardized questionnaire that used for subjective assessment of sleep quality. It has been translated into several languages and is widely used in clinical research settings. Since there is no sleep-related scale standardized in the Kurdish language, the present study aimed to translate and validate the PSQI into Kurdish.
Methods:
First, the PSQI was successfully translated into Kurdish then back-translated into English by independent professional bilingual translators. The translated version of PSQI was tested with 230 participants, 150 healthy subjects, 40 subjects with insomnia, and 40 subjects with physical symptoms. Internal consistency was calculated by the Cronbach Alpha method using SPSS-20 software. Spearman correlation via a test-retest process was used for reliability. The General Health Questionnaire (GHQ28) was used to analyze criterion validity. The construct validity of the scale was tested by exploratory factor analysis (EFA). Factor weight was checked by confirmatory factor analysis (CFA) using LISREL software version 8.8.
Results:
The internal consistency and reliability for PSQI global score was acceptable (Cronbach’s alpha = 0.70). The result showed a strong correlation between test and retest after six weeks (r=0.83). Correlations between the global score and components of the PSQI with the GHQ28 were all statistically significant (r=0.23-0.72, p < 0.05). Exploratory factor analysis revealed three factors with a significant correlation between the PSQI global score and these factors. All factor weights were above 0.40.
Conclusion:
The results of this study support the PSQI’s validity and reliability. This study offers a foundation for further studies in Kurdish populations.
inability to address the shortfalls in the public health model. Calls for health system reform in Iraqi Kurdistan Region started in 2004; however, few, if any, significant changes have been achieved since then. This research examines the factors impeding public health system reform in the Iraqi Kurdistan Region, as perceived by the health policy makers, through 11 in-depth, unstructured interviews. Participants attributed the delay in reform to 16 impeding factors that can be categorized into 5 major themes: historical, ethical, cultural, political and institutional. The intricate network of these inter-dependent factors provides a possible explanation for the failure or unsustainability of reform efforts. Reform initiatives might have a better chance of success if they take into consideration the well-established and unique background and social construct in Iraq, as well as the impact of decades of conflict and insecurity, both of which influence the individual and institutional reasoning and behaviour across the entire health system.
norms are sometimes reinforced as a protective mechanism, particularly
for women who may be prevented from following the classic person-to-person consultation protocol. Social media, when used skilfully and properly protected, may help overcome the multiple cultural and social barriers that prevent the application of the more traditional treatment protocol.
This study found that patients in refugee camps and communities would
benefit from receiving palliative care services that are often either unavailable or inaccessible. Training humanitarian teams and primary care providers to implement pain management, offer psychosocial support services and address emotional, spiritual, and psychological conditions could ameliorate many of the problems faced by this vulnerable group.