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Giant cell arteritis (GCA), more common in Northern European populations, has limited data in Arabcountries. Our study reports GCA's clinical manifestations in Jordan and reviews published research on GCA across Arab nations. In this retrospective analysis, GCA patients diagnosed from January 2007 to March 2019 at a Jordanian academic medical center were included through referrals for temporal artery biopsy (TAB). A comprehensive search in PubMed, Scopus, and the DOAJ (Directory of Open Access Journals) databases was conducted to identify all relevant English-language manuscripts from Arab countries on GCA without time limitations. Among 59 diagnosed GCA patients, 41 (69.5%) were clinically diagnosed with a negative TAB, and 19 (30.5%) had a positive result. Females comprised 74.6% (n = 44) with 1:3 male-female ratio. The mean age at diagnosis was 67.3 (± 9.5) years, with most presenting within two weeks (n = 40, 67.8%). Headache was reported by 54 patients (91.5%). Elevated ESR occurred in 51 patients (78%), with a mean of 81 ± 32.2 mm/hr. All received glucocorticoids for 13.1 ± 10 months. Azathioprine, Methotrexate, and Tocilizumab usage was 15.3% (n = 9), 8.5% (n = 5), and 3.4% (n = 2), respectively. Remission was observed in 57.6% (n=34), and 40.7% (n = 24) had a chronic clinical course on treatment. Males had higher biopsy-based diagnoses (p =.008), and biopsy-diagnosed patients were older (p =.043). The literature search yielded only 20 manuscripts originating in the Arab world. The predominant study types included case reports and retrospective analyses, with only one case series and onecase-control study. [ABSTRACT FROM AUTHOR]

Procreation has always been one of the main goals of marriage in Muslim society, where it is a religious obligation. Therefore, the inability to conceive is an extremely stressful experience that is liable to have long-term implications for a woman's mental health. These effects may persist even after the problem is resolved and the woman has given birth. The current study therefore examined the personal growth and life satisfaction of Israeli Arab mothers (n = 154) up to two years after childbirth, comparing those who conceived as a result of fertility treatment with those who conceived spontaneously. By completion of electronic questionnaires posted through social media, we explored the contribution of stress and optimism, as well as the moderating effects of religiosity and study group. No differences were found between the groups on level of stress, personal growth, or life satisfaction. For the whole sample, a negative association was found between stress and life satisfaction, and a positive association between optimism and the two outcome variables. In addition, level of religiosity was not significantly associated with either personal growth or life satisfaction, and neither religiosity nor study group was found to moderate the associations between the variables. Finally, a negative linear, rather than curvilinear, link emerged between stress and personal growth. [ABSTRACT FROM AUTHOR]

Background: The progressive improvement in the educational level of the Arab world has been accompanied by a surge of scientific productivity. Mental health research, especially in the last four decades, is one such endeavor. Mental health research output over almost a century, from 1920 to 2018, is reviewed. Method: A literature review was conducted using PubMed, PsychInfo, Cochrane, and the IDRAAC search engine to identify mental health publications over the past 100 years. Trends of mental health research were explored over time with reference to country population and gross domestic product (GDP). Results: A total of 3373 articles were retrieved. The three countries with the highest number of mental health publications in the past century are Egypt, Kingdom of Saudi Arabia (KSA), and Lebanon, representing together 41.5% of the productivity of all 22 Arab countries. The top producers also had the highest collaboration rates with other Arab countries (20%) as well as non-Arab countries. The top three publishers per capita are Lebanon, Kuwait, and Bahrain. When GDP was factored in, the top three countries are Lebanon, Palestine, and Tunisia. Most publications over the last decade (80%) were in international non-local journals. The leading subjects of research were epidemiology, mood disorders, obsessive compulsive behavior, and mental health services. Conclusion: Arab speaking countries have been increasing their mental health productivity over the past 100 years; however, only a handful of those countries were relatively active. Those leaders also had the highest level of Arab and international collaboration. Investing in regional and international collaborations is a solid recommendation of this review. [ABSTRACT FROM AUTHOR]

Textism, which refers to the special language used in text messaging, is widely used in several forms of communication, such as texting, online chatting and emails. This increased use of textism has alarmed the media and the public because this special language can impact the academic writing of the younger generation. This paper aimed at exploring the attitudes of undergraduate Saudi learners of English as a foreign language (EFL) toward using textism in their academic writing. (115) students of different levels of language proficiency completed a survey about the use of textism across several modalities and recipients. Additionally, (240) student essays were analyzed to identify the potential use of textism in student writing. The results showed that students are generally conscious of the appropriate contexts for the use of textism. However, when it comes to the actual use of textism in writing, low-proficient students tend to produce more textism than those who are at medium and high levels of writing competence. [ABSTRACT FROM AUTHOR]

Suicide in the Arab World is grossly understudied. This study sought to understand suicidality among Arabic-speaking individuals visiting an online depression screener. A large sample (N = 23,201) from the Arab World was recruited online. 78.9% (n = 17,042) reported suicidality (thoughts of death or suicide, or a suicide attempt) and 12.4% reported a suicide attempt in the past 2 weeks. Binary logistic regressions indicated that women tended to report more suicidality, and that suicidality tended to decline with age (all ps < 0.001), across all levels of suicidality. Comparing countries with n ≥ 1000 (Algeria, Egypt, Jordan, Morocco, and Saudi Arabia), several 3-way (gender * age * country) and 2-way interactions indicated that some countries departed from the usual pattern of responses. For instance, in Algeria, neither gender nor age differences were observed in reported attempts. Women and younger adults in the Arab World may be at higher risk of suicidality. Differences between and within countries warrant further exploration. [ABSTRACT FROM AUTHOR]

Kawasaki Disease (KD) is still the most common acquired heart disease in children below the age of five years; it has been well described in the developed world; however, data from the Arab world are limited to case reports or single-center case series. In an effort of optimizing KD research in the Arab world, a group of physicians and researchers established the KD Arab Initiative (Kawarabi) in 2021, and published the first survey, which showed disparities in the availability of intravenous immunoglobulin (IVIG); this had prompted Kawarabi to assess the access to care and therapy of KD patients in Arab countries. A 32 structured questions survey was conducted in thirteen Arab countries and addressed KD patients' access to healthcare in urban and rural settings. The survey results showed that access to care was uniform across large, mid-size cities and rural areas in 7/13 (54%) countries, while in 6/13 (46%) countries, it was in favor of large and mid-size cities over rural areas. The quality of medical services received by children with KD in large cities was rated as excellent in 6/13 or good in 7/13 countries compared to fair in 4/13 or poor in 4/13 countries in rural areas. Availability of IVIG was limited (23%) in mid-size cities and almost impossible (23%) in rural areas. The KD patients in mid-size cities and rural areas have limited access to standard healthcare in the Arab world. This survey laid the foundation for future Kawarabi endeavors to improve the care of children with KD. [ABSTRACT FROM AUTHOR]

This study examined the relationship between parenting styles and practices and the self-esteem of adolescents in middle to late adolescence age from Hebrew-literate Arab-Bedouin families. It aims to inspect this central developmental issue in a culturally traditional Arab sector, where parental authority and the parent-child relationship in the family may differ from western families. The study consisted of parents and their children from 123 Bedouin families, who completed the Parenting Styles and Dimensions Questionnaire (PSDQ: Robinson et al., 2001), the Parental Authority Questionnaire (PAQ; Buri, 1991), and the Rosenberg Self-Esteem Scale (RSES; Rosenberg, 1965). The parents' sample included 71 fathers and 52 mothers, and the adolescents' sample included 78 boys and 45 girls, whose ages ranged from 14 to 18 with a mean age of 16.00 ± 1.40. Most children reporting on their parents' parenting styles perceived them as authoritative (about 45%). The parents' group's parenting styles varied by their education, as authoritative parents were significantly more educated than non-authoritative parents. The findings indicate that adolescents who perceived their parents' parenting style as authoritative reported significantly higher self-esteem in comparison to their counterparts who perceived their parents' parenting style either as authoritarian or permissive. Furthermore, the parents' reports of their parenting styles accounted for about 30% of the variance in the adolescents' self-esteem, with the authoritative parenting being the only style associated with high self-esteem and its association with this variable was considerably stronger than those of the non-authoritative parenting styles. Our findings, drawn from separate reports of parents and their descendants, underscore the merits of authoritative parenting in the context of Bedouin adolescents' self-esteem. Together with other recent evidence, they consolidate the assumption that this style is the cross-culturally preferred style within diverse developmental contexts of children's well-being. [ABSTRACT FROM AUTHOR]

Purpose: To assess the morphometric variables of the superior pubic ramus in an Arab/ Middle Eastern population to establish a safe pubic screw fixation technique. Methods: Cross-sectional retrospective analysis of computed tomography (CT) pelvic images. Morphometric data were extracted including; on pubic ramus length, insertion angles, potential danger zones and ramus diameters. The correlation between pubic rami diameter and patient demographics was also analyzed. Results: A total of 231 participants were included (45% female). The mean pubic ramus length was 104 mm in females and 127 mm in males. The narrowest canal diameters at the para-symphyseal area were; 7.35 mm (males) and 4.75 mm (females). The mediolateral insertion angle was 49.4° in females and 41.8° in males. The cephalic-caudal angle was 49.9° in males and 42.1° in females. The mean distance from the lateral ilium entry point to the joint articular surface was 23.5 mm in males and 19.9 mm in females. The symphysis pubis to tubercle exit point was higher in females than males (24.2 mm vs 16.6 mm, respectively). There was a significant positive correlation between age and pubic ramus diameters in all age groups. Conclusion: The results from this study suggest that percutaneous pubic rami screw fixation using the standard 6.5 or 7.3 mm cannulated screw system may potentially be unsafe in female Arab patients. This subset of patients may require alternative non-cannulated screws (3.5–4.5 mm) or plate options. Further, female patients may have a higher risk of acetabular joint penetration, while males have a potentially higher risk of pudendal nerve injury. [ABSTRACT FROM AUTHOR]

To date, very little is known about the current situation of suicide and its effects on psychological help-seeking attitudes in Arab countries. Therefore, this study aimed to assess the levels of suicide literacy and suicide stigma and their relationships with attitudes towards seeking psychological help among a sample of Arab youth in Jordan. A descriptive, correlational, cross-sectional study was conducted using an anonymous online self-report survey to collect data. This study included a total of 707 Arab youth aged 16–24 years (mean = 18.60, SD = 1.95). Most of the participants were male (n = 398, 56.3%). The participants were found to have very low suicide literacy levels, relatively high suicide stigma levels, and negative attitudes towards seeking psychological help. Family members, relatives, and friends were the most frequently reported sources of psychological help, while mental healthcare professionals were the least frequently reported sources. A significant negative correlation was found between attitudes towards seeking psychological help and both stigmatization and glorification subscales of suicide stigma. While a significant positive correlation was found between attitudes towards seeking psychological help and suicide literacy. The predictors of attitudes towards seeking psychological help were gender, suicide literacy, and glorification of suicide stigma among Arab youth. The results of this study confirm the presence of an urgent need for designing and implementing educational programs and awareness campaigns on suicide and mental health among youth in schools and universities. Such interventions may increase knowledge, decrease stigma, change psychological help-seeking attitudes, and hence improve the use of mental health services and may prevent suicide among this age group. [ABSTRACT FROM AUTHOR]

This study examines the perceptions of sport regulators and executives on national sport. Mann–Whitney test and exploratory factor analyses reveal the lacking of unified interpretations of sport performance and governance between sport state regulators and sport executives. While regulators impose reform policies, sport executives perceive these policies as being jurisdictionally external, bureaucratic, and trespassing. Sport executives resist change by establishing a parallel organisational culture based on their interpretation of good governance and excellence. National sport performance is vulnerable to continuous mismatch as regulators insist on implementing reforms and sport executives seek more state funding and more institutional autonomy. [ABSTRACT FROM AUTHOR]

This essay examines the breast cancer accounts of four Arab female celebrities who have spoken out in public about their illness experience: the Egyptian TV presenter Basma Wahba and the actress Yasmine Ghaith, the Iraqi actress Namaa al-Ward, and the Lebanese pop singer Elissa. By reading their testimonies against the backdrop of critical literature on illness narratives and memoirs, as well as on cancer narratives and activism, the essay asks: how are the accounts of these women’s cancer diagnosis and treatment disclosed and described? In what medium do they communicate and circulate their breast cancer experiences? What significance do these public disclosures have on challenging and breaking the Arab taboo of cancer? In conclusion, the essay argues that these women’s willingness to share their stories in public constitutes an important form of multimedia activist intervention—visual, sonic, and performative—that is playing a key role in the development of a breast cancer movement. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the informational gap and predictors of information-seeking behaviour amongst survivors to inform survivorship planning and supportive cancer services for the population. Methods: A national cross-sectional survey of breast and colorectal cancer survivors was conducted in 2020 using a representative sample of those diagnosed in 2015/2016 as recruited from Jordan's Cancer Registry (JCR). Participants responded to a 3-domain questionnaire: background information (9 items); information typologies (13 items) measured on a 5-point Likert scale (from very interested to extremely not interested); timing of developing the information needs (13 items) (ranging from immediately after diagnosis to after recurrence). Logistic regression was used to determine the independent association between demographics and information-seeking behaviour amongst survivors. The chi-square test was employed to examine the association between categorical variables. ANOVA was used to compare the means of interest in cancer-related information between more than two groups. Results: Results show a relatively high overall information needs amongst survivors (3.68 ± 1.53). The most prevalent typologies were cancer staging (3.77 ± 1.593), treatment options (3.76 ± 1.55), and doctors' communications (3.73 ± 1.62). ANOVA revealed no statistically significant differences between cancer types. 55.8% of patients desired information immediately after diagnosis and 23.3% developed their needs within 2 months. There was a statistically significant difference across all information typologies and educational attainment, age groups, monthly income, and employment (P < 0.05). Age was the only independent predictor of high information requirements amongst cancer survivors. Conclusion: Survivors reported high cancer information needs, suggesting that they may have been under-informed. Effective health communication programmes should be implemented to meet the informational needs. [ABSTRACT FROM AUTHOR]

Studies on Kawasaki disease (KD) in Arab countries are scarce, often providing incomplete data. This along with the benefits of multicenter research collaboratives led to the creation of the KD Arab Initiative [Kawarabi] consortium. An anonymous survey was completed among potential collaborative Arab medical institutions to assess burden of KD in those countries and resources available to physicians. An online 32-item survey was distributed to participating institutions after conducting face validity. One survey per institution was collected. Nineteen physicians from 12 countries completed the survey representing 19 out of 20 institutions (response rate of 95%). Fifteen (79%) institutions referred to the 2017 American Heart Association guidelines when managing a patient with KD. Intravenous immunoglobulin (IVIG) is not readily available at 2 institutions (11%) yet available in the country. In one center (5%), IVIG is imported on-demand. The knowledge and awareness among countries' general population was graded (0 to 10) at median/interquartiles (IQR) 3 (2–5) and at median/IQR 7 (6–8) in the medical community outside their institution. Practice variations in KD management and treatment across Arab countries require solid proactive collaboration. The low awareness and knowledge estimates about KD among the general population contrasted with a high level among the medical community. The Kawarabi collaborative will offer a platform to assess disease burden of KD, among Arab population, decrease practice variation and foster population-based knowledge. [ABSTRACT FROM AUTHOR]

Non-alcoholic fatty liver disease (NAFLD) is the most common liver disease. We aimed to investigate the potential similarities and differences regarding the disease among Arabs and Jews. Retrospective study included all patients older than 18 years with NAFLD diagnosis according to ICD-10 codes. Data regarding demographics, comorbidities, and outcomes were retrieved using the MdClone platform from “Clalit” in Israel. Data concerning 34,090 Arab patients and 173,500 Jewish patients with NAFLD were included. Arab patients were significantly younger at diagnosis (35.0 ± 13 years vs. 43.6 ± 15 years, p < 0.001) and had higher rates of obesity and diabetes mellitus (69.5% vs. 56.5% and 27.0% vs. 22.7%, p < 0.001, respectively). Arab patients had higher rates of cirrhosis and portal hypertension-related complications (2.5% vs. 2.0%, p < 0.001), esophageal varices (0.9% vs. 0.5%, p < 0.001), spontaneous bacterial peritonitis (0.3% vs. 0.1%, p < 0.001), and hepatorenal syndrome (0.3% vs. 0.1%, p < 0.001). There was no significant difference in the prevalence of hepatocellular carcinoma between study groups (0.4% vs. 0.5%, p = 0.156). Liver transplantation was performed in 0.2% of Arab NAFLD patients compared to 0.07% of Jewish NAFLD patients (p < 0.001). Lower rates of all-cause mortality were found among the Arab NAFLD patients versus Jewish NAFLD patients (7.7% versus 11.5%, p < 0.001). According to the Cox regression model, Arab ethnicity is a risk factor for death with OR of 1.36. Significant differences regarding comorbidities, complications, liver transplantations rates, and all-cause mortality were found among NAFLD patients of different ethnicities, hence specific population need specific consideration in prevention, early diagnosis and follow up. [ABSTRACT FROM AUTHOR]

Many studies have examined the coping strategies and depression of mothers of children with disabilities, but most have involved Western families and only a few refer to unique and traditional cultures. The main goal of the current study was to assess depression among Bedouin Israeli mothers raising children with developmental disability (DD) and how it is linked to their coping strategies. The study included a sample of 95 Bedouin mothers of adolescents with and without DD in Israel. Self-report measures of CES-D and Brief Cope were used to measure depression and coping strategies. Findings revealed an alarmingly high prevalence of severe depression among Bedouin mothers, especially among those raising a child with DD. Mothers raising a child with a developmental disability tended to use avoidant coping more often, while the use of active coping strategies did not differ between the two groups. Adaptivity of planning and behavioral disengagement was found to be context dependent. Findings underscore the vulnerability of Bedouin mothers living in Israel, and particularly Bedouin mothers raising a child with a DD which are a double jeopardy group. [ABSTRACT FROM AUTHOR]

Background: Child maltreatment is a global risk factor for mental health. The burden of child maltreatment is heaviest in low- and lower-middle-income countries, where most of the world's children live. This study sheds light on the occurrence of child maltreatment within Egypt's upper social class stratum, countering a long-held belief that violence against children only occurs within low-income households. In addition, the study examines the association between exposure to child maltreatment and psychopathology, life satisfaction and resilience among emerging adults in Egypt, and whether emotion dysregulation mediates these relationships. Participants were 171 college students who were selected based on a series of questionnaires about exposure to child abuse and neglect, psychopathology, satisfaction with life, and resilience, as well as difficulties in emotion regulation. Results: A rate of 48% of exposure to at least one type of child maltreatment before the age of 18 was found. Experiencing antipathy and/or sexual abuse was most strongly associated with PTSD and depression, while exposure only to antipathy contributed to lower life satisfaction and resilience. Emotion dysregulation mediated the associations between antipathy and PTSD, depression, life satisfaction, and resilience, as well as the associations between sexual abuse and PTSD and depression. Conclusions: The present study hints at a comparably high rate of exposure to child maltreatment among the higher social class stratum, producing data that highlights the association between child maltreatment and mental health in emerging adults in Egypt. These findings emphasize that child maltreatment transcends social class, and that attempting to address the issue requires changing social and cultural belief systems that bolster violent behavior. [ABSTRACT FROM AUTHOR]

Purpose of Review: There is a growing body of work that documents the impact of 9/11 and the war on terror on Arab and Muslim children and families. This review is designed to provide a brief overview and suggest new ways to better understand this understudied population. Recent Findings: Several studies show anti-Arab and anti-Muslim sentiments at its highest levels since 9/11. There is strong evidence that Arab and Muslim children and families experience some of the highest levels of discrimination, and as a result, they report higher levels of mental health symptoms. Summary: Given the limited data, we need future studies (a) to focus on populations outside of the USA and Europe; (b) to use longitudinal designs; (c) to pay attention to within group variations by race, gender, social class, and immigration status; and (d) to use culturally validated instruments. [ABSTRACT FROM AUTHOR]

Like other Arab countries, Jordan must find ways of responding to the rapid processes of change affecting many aspects of social life. This is particularly urgent in healthcare, where social and technical change is often manifested in tensions about ethical decision-making in the clinic. To explore the attitudes, beliefs and concerns relating to ethical decision-making among health professionals in Jordanian hospitals, a qualitative study was conducted involving face-to-face interviews with medical personnel in four hospitals in Amman, the capital of Jordan. Data were analysed thematically in relation to a pre-existing set of ethical categories. Interviews were conducted with thirty-eight doctors covering most medical specialities. Five major themes emerged from the interviews: ethical awareness, ethical issues, the impact of religion on ethical decision-making, practical and theoretical resources for ethical decision-making, and challenges. While uncertainty was expressed about some aspects of Western approaches to ethics, participants strongly supported adoption of a range of Western bioethical principles, including cultural and ethical diversity, along with adherence to Islamic religious norms. A range of serious ethical challenges facing the Jordanian health system were identified, covering social, legal, managerial, and technical issues. Ethical decision-making in Jordan is complex, having to accommodate the needs of patients, the opinions of doctors and their families, the views of religious authorities, managerial considerations, and both local norms and international standards. Health professionals struggle with three sets of tensions that emerge out of the struggle between traditional, community-embedded forms of social organization and the demands generated by globalization and the influence of Western culture: the tensions between tradition and modernity, conservatism and pragmatism, and religion and secularism. Doctors in Jordan prefer approaches to ethical decision-making that realize a balance between the extremes, although the exact nature of where that balance should lie remains uncertain. [ABSTRACT FROM AUTHOR]

Introduction: Intimate partner violence (IPV) remains a serious human rights violation and an important health concern during the ongoing COVID-19 pandemic. The study aims to estimate the proportion of IPV among adult Arab women before and during the COVID-19 lockdown and to identify its possible predictors during the lockdown. Methods: A cross-sectional study was conducted between April and June 2020 using an online questionnaire. The sample included 490 adult Arab women aged 18 years and above, who live with their husbands. Data was collected using a Google forms designed questionnaire that included the socio-demographic characteristics, nature of lockdown, and exposure to different types of IPV before and during COVID-19 lockdown and the frequency of their occurrence. McNemar's test was used to determine differences in the exposure to IPV before and during the lockdown, while logistic regression analysis was performed to identify the predictors of exposure to IPV during the lockdown. Results: Half of women reported that they were ever exposed to IPV with psychological violence ranking 1st. Exposure to any type of IPV and exposure to psychological, physical, and sexual violence have significantly increased during the lockdown compared to before the lockdown. The frequency of exposure to the different types of IPV ranged from 1–3 times per month to almost every day, but the most commonly reported was 1–3 times per month. Predictors of exposure to IPV during the COVID-19 lockdown included country of residence, family income, and whether the husband lost his job during lockdown. Conclusions: IPV has increased during the COVID-19 pandemic lockdown in the Arab countries, and it was associated with the socioeconomic consequences of the pandemic on families. Actions towards raising awareness about the problem among professionals and the community, early detection, and provision of appropriate services are mandatory. [ABSTRACT FROM AUTHOR]

Since the discovery of human leukocyte antigens (HLAs), the function of major histocompatibility complex (MHC) gene families in a wide range of diseases have been the subject of research for decades. In particular, the associations of autoimmune disorders to allelic variants and candidate genes encoding the MHC are well documented. However, despite decades of research, the knowledge of MHC associations with human disease susceptibility have been predominantly studied in European origin, with limited understanding in different populations and ethnic groups. This is particularly evident in countries and ethnic populations of the Arabian Peninsula. Human MHC haplotypes, and its association with diseases, of the variable ethnic groups of this region are poorly studied. This review compiled published manuscripts that have reported a list of autoimmune diseases (insulin-dependent diabetes mellitus, systemic lupus erythematosus, myasthenia gravis, rheumatoid arthritis, psoriasis vulgaris, and multiple sclerosis) associated with MHC class I and class II in the populations of the Arabian Peninsula, specifically Bahrain, Kuwait, Oman, Qatar, Saudi Arabia, the United Arab Emirates, and Yemen. Data available was compared with other three ethnic groups, namely Caucasians, Asians, and Africans. The limited data available in the public domain on the association between MHC gene and autoimmune diseases highlight the challenges in the Middle Eastern region. [ABSTRACT FROM AUTHOR]

Estimates of the global prevalence of rheumatoid arthritis (RA) range from 0.24 to 1%, but vary considerably around the globe. A variation in RA prevalence is also expected across Africa and the Middle East, due to ethnic, climate, and socioeconomic differences. To assess the prevalence of RA in Africa and the Middle East, we searched Medline (via PubMed) and databases of major rheumatology conferences. Seventeen journal articles and 0 abstracts met the inclusion criteria. Estimated prevalence ranged from 0.06 to 3.4%. Most studies reported values near or below 0.25%. Consistent with data from other regions, RA was more prevalent among urban than rural populations, and among women than men. The women:men prevalence ratio ranged from 1.3:1 to 12.5:1, which suggests notable differences from the global average of 2:1. Relative increases in prevalence were observed in North Africa and the Middle East (13% since 1990) and Western Sub-Saharan Africa (14%), whereas rates in Eastern, Central, and Southern Sub-Saharan Africa show decreases (4–12%). Low disease awareness, delays to visit rheumatologists, and socioeconomic factors appear to hinder early diagnosis and aggressive treatment. Few countries have developed RA-specific treatment guidelines, and many physicians and patients face limited access to even basic treatments. An improved understanding of the epidemiology and management of RA, and the related socioeconomic consequences is necessary, so that targeted attempts can be made to encourage early diagnosis and treatment. [ABSTRACT FROM AUTHOR]

There has been a noticeable increase in the number of studies assessing perceptions regarding depression (illness representations) among people diagnosed with the disorder. However, these studies have examined mainly younger adults (ages 18 to 65), and very little is known about older adults. This study examined illness representations among younger and older Israeli Arabs with depression based on the Self-Regulation Model (SRM). A total of 12 Israeli Arabs (six younger adults aged 18–64 and six older adults aged 65+) diagnosed with depression took part in semi-structured, in-depth interviews. The majority of the participants in the younger group were female and married, compared to the older group which has a gender equal ratio, half of which are married. The data were analyzed thematically, guided by the SRM illness representations' dimensions (identity; timeline; cause; consequences; control/cure; cyclical and coherence; and emotional representations). Differences between younger and older adults were found in some of the illness representations. Older adults described depression as a chronic illness associated with somatic symptoms, and did not believe in psychological treatment. Younger adults did not perceive depression as chronic, reported cognitive and emotional symptoms, and believed in the efficacy of psychological treatment. Our findings indicated that participants' perceptions about depression appeared to be associated with their age, along with their unique cultural background as they are traditional but undergoing processes of modernization. This study stress the importance of illness representations in intervention programs tailored for different age groups, and considering their specific cultural needs. [ABSTRACT FROM AUTHOR]

Background: Breast cancer is the most common cancer in women globally. Its negative effects on a woman's quality of life are related to the individual and socio-cultural factors. This review aimed to identify and synthesise the reported experiences and quality of life of women with breast cancer in Arab countries.Methods: PubMed, Embase, Web of Science, SCOPUS, PsychInfo, CINAHL, Allied and Complementary Medicine Database, and Index Medicus for the Eastern Mediterranean Region were searched for articles published from start to March 2019 using PRISMA guidelines. These searches were complimented by citation tracking and  hand searching of relevant journals. A thematic synthesis was carried out on the 'findings/results' sections from the identified papers.Results: Of 5228 records identified, 19 were included in the review which represented 401 women from 11 Arab countries. All used qualitative methods of data collection to produce rich descriptions of experiences. Thematic synthesis of the extracted data identified three major themes, Perceptions and reactions, Coping or enduring and Changing roles.Conclusions: This review provides a rich description of the reported quality of life and experiences of women with breast cancer in Arab countries. These are influenced by the women's and society's views of cancer, the women's role in society and family, religious faith and the healthcare context and access to treatment choices and information. [ABSTRACT FROM AUTHOR]

Alcohol, tobacco and other drug use continue to pose serious public health concerns among youth. Bullying victimization has been identified as a risk factor and religiosity a protective factor for adolescent substance use. No previous research has examined the potential moderating role of religiosity. We explore the association between bullying victimization and substance use in adolescents with low and high levels of religiosity. A cross-sectional survey was conducted with a representative sample of high school students in greater Beirut. Binary and multinomial logistic models were used, adjusting for demographics, and stratified by level of religiosity. Of the 986 students responding to the survey, 65% were females; 48% had experienced some form of bullying; and 52% self-rated as low in religiosity. Between 10 and 30% were current users of alcohol or tobacco. Students of lower religiosity levels who had been bullied were more likely to use substances than those who self-rated as high religiosity. Religiosity may be a potential moderator of the association between being bullied and substance use, but the exact mechanisms and underlying reasons need further investigation. [ABSTRACT FROM AUTHOR]

Background: Although cognitive impairment is common in the elderly population, studies investigating its rate in Hajj pilgrims are lacking. Objectives: To estimate the rate of cognitive impairment among a sample of Arabic-speaking elderly Hajj pilgrims and examine its association with their activities of daily living (ADL). Methods: A cross-sectional study was conducted during the Hajj season 1438 Hijri Calendar (August 2017). Hajj pilgrims were recruited using a probability sampling method and were interviewed for demographics, the MINI-Cog and the ADL instrument. Results: Among the 340 recruited pilgrims, 99 (29.2%) had positive results in the MINI-Cog indicating probable cognitive impairment. In multivariate logistic regression, the educational level (odds ratio (OD) 0.456; 95% CI 0.346 to 0.598) and the need for help during Hajj (OD 0.581; 95% CI 0.342 to 0.984) were found significantly associated with positive MINI-Cog. Although no significant differences in the ADL were found between pilgrims with and without positive MINI-Cog, the scores of the ADL and the MINI-Cog were found to be positively correlated but weak (rs = 0.134, P = 0.013) indicating a possible association between better cognitive functions and better ADL performance. Conclusion: Probable cognitive impairment among Arabic elderly Hajj pilgrims was found to be very common. Further diagnostic studies and studies on the impact of cognitive impairment on the performance of Hajj pilgrims are warranted. [ABSTRACT FROM AUTHOR]

Incidental findings in genomic data have been studied in great detail in the recent years, especially from population-scale data sets. However, little is known about the frequency of such findings in ethnic groups, specifically the Middle East, which were not previously covered in global sequencing studies. The availability of whole exome and genome data sets for a highly consanguineous Arab population from Qatar motivated us to explore the incidental findings in this population-scale data. The sequence data of 1005 Qatari individuals were systematically analyzed for incidental genetic variants in the 59 genes suggested by the American College of Medical Genetics and Genomics. We identified four genetic variants which were pathogenic or likely pathogenic. These variants occurred in six individuals, suggesting a frequency of 0.59% in the population, much lesser than that previously reported from European and African populations. Our analysis identified a variant in RYR1 gene associated with Malignant Hyperthermia that has significantly higher frequency in the population compared to global frequencies. Evaluation of the allele frequencies of these variants suggested enrichment in sub-populations, especially in individuals of Sub-Saharan African ancestry. The present study thereby provides the information on pathogenicity and frequency, which could aid in genomic medicine. To the best of our knowledge, this is the first comprehensive analysis of incidental genetic findings in any Arab population and suggests ethnic differences in incidental findings. [ABSTRACT FROM AUTHOR]

Background: The effect of passive smoking (PS) on breast cancer (BC) is controversial, and may be modified by polymorphism of the N-Acetyl-transferase (NAT) 2 enzyme which is involved in tobacco carcinogen metabolism. We aimed to evaluate the relationship between PS and BC by NAT2 variants in Arab–Israeli women, a unique population with low active smoking rates, and high exposure to PS.Methods: A population-based case-control study was carried out on non-smoking 137 prevalent breast cancer patients and 274 population-based controls, aged 30–70 years. Data on past and current PS, sociodemographic, and other characteristics were retrieved through interviews, and buccal smears were provided for NAT2 analyses. Logistic regression models adjusting for potential confounders assessed the odds ratios (ORs) and 95% confidence intervals (95% CI) of the association between PS and BC.Results: Ever PS was associated with increased BC risk: OR = 2.22, 95% CI 1.28–3.87. Higher lifetime PS exposure was associated with higher BC risk: Compared to never exposed women, women exposed to PS most of their lives had a threefold higher BC risk (OR = 3.16, 95% CI 1.70–5.87, Ptrend < 0.001). NAT2 polymorphism did not modify these associations.Conclusions: PS exposure in non-smoking Israeli Arab women is significantly associated with increased risk for BC, potentially allowing for specific intervention; NAT2 polymorphism does not modify this association. [ABSTRACT FROM AUTHOR]

The present study sheds light upon critical factors that help explain the entrepreneurial success among Muslim women living in a democratic Tunisia, a Muslim-majority country considered by many to be the lone Arab Spring success story. We hypothesized that successful entrepreneurs need social capital, including the capital that comes from marriage and high levels of wasta (the Arabic concept of having personal connections with influential others). Moreover, given the lack of empirical attention paid to the role of the culture, language, and customs associated with Islam on women's empowerment, we examine whether religiosity is related to entrepreneurial performance among Tunisian women. Data collected with 84 female entrepreneurs participating in entrepreneurship training programs across Tunisia reveal that two forms of social capital, marital status and wasta, are related to training center directors' ratings of women entrepreneurs' performance, suggesting that social capital is a critical asset for Muslim women entrepreneurs. Religiosity, on the other hand, had no statistically significant relationship with entrepreneurial performance. Our study contributes to research on entrepreneurship by identifying wasta as a form of social capital that may be necessary for women entrepreneurs to succeed in the Middle East and North Africa and by taking an initial step towards better understanding the empirical (and controversial) relationship between religiosity and career success among Muslim women. We recommend that training organizations supporting entrepreneurs directly assist women in the development of social capital and acknowledge, rather than ignore, that nepotism and wasta are linked to entrepreneurial success in some cultures. [ABSTRACT FROM AUTHOR]

The recent global increase in environmental regulation does not necessarily signal improvement in firms' ecological imprints. Like many markets, the Arab world is struggling to implement environmental compliance measures among local firms. For Arab countries, the reliance solely on formal policies to improve local firms' ecological footprints may be risky given the evident institutional challenges to enforce environmental regulations, specially post the Arab Spring. Drawing from the literature highlighting the merits of combining formal and informal controls to ensure successful implementation of a strategy, we argue that the emphasis for regulation must be accompanied by an emphasis for developing environmental ethics of individuals, who are the expected implementers of any environmental policy. In that light, we propose that the Eco-Islam phenomenon can serve as an influential and effective foundation for building organizational cultures with stronger environmental ethics among local small and medium enterprises (SMEs). We explain the underlying maxims of Eco-Islam then conduct qualitative research among experts preaching or practicing the concept to gain better insights into the potential of leveraging it in Muslim-majority Arab countries. Finally, we conclude with insightful implications for local SMEs in the region. [ABSTRACT FROM AUTHOR]

This study describes the disease characteristics and outcome of Arab children with juvenile dermatomyositis (JDM) and compares the findings with other ethnicities. We retrospectively reviewed the hospital registries of the participating hospitals for children with JDM seen between 1990 and 2016 in three Arab countries. All patients fulfilled Bohan and Peter criteria for JDM, diagnosed before 14 years of age and were of Arab ethnicity. Clinical and laboratory features as well as the long-term outcomes including accrual disease damage were collected at the last follow-up visit. A total of 92 JDM patients (58 girls) were included. Mean age at the onset was 6 ± 3 years, with a mean follow-up duration of 5 ± 4.4 years. Forty-three patients (46.7%) had polycyclic disease course, 34 (36.9%) had a monocyclic course, while 15 (16.3%) had a continuous progressive course. Forty-five patients (48.9%) had arthritis, 14 (15.2%) patients had an upper airway and dysphagia, and 10 patients (10.9%) had lung involvement. Eight patients (8.7%) were admitted to the intensive care unit (ICU), 4 of them required mechanical ventilation. Methotrexate had been the most frequently used immunosuppressive drug (86%) and rituximab was used in eight patients. Additionally, 31 patients received IVIG. Most of the patients achieved a complete clinical response, but 16 ended up with permanent skin changes and 12 had a residual muscle weakness. Twenty-seven patients developed calcinosis. There were two deaths due to infection during the follow-up period. We report the largest phenotypic data on Arab children with JDM. Our patients have similar characteristics to previously described cohorts. Majority of the patients remained with inactive disease. [ABSTRACT FROM AUTHOR]

Scant research has been conducted on gender in the Arab world; one explanation is due to a lack of Arabic measures on gender-related issues. To advance scientific work on gender in the Arab world, we developed the Arab Adolescents Gender Roles Attitude Scale (AAGRAS) , the first known reliable and valid Arabic measure of gender-role attitudes. To develop this measure, we conducted two studies based on data collected from 776 high school students 15-19 years-old from the state of Qatar. Exploratory factor analysis and confirmatory factor analysis produced 12 items divided equally into two subscales. One subscale assesses traditional gender-role attitudes, whereas the other measures egalitarian gender-role attitudes. Our findings indicate that young men are more likely to resist gender equality than young women are. Moreover, those who hold traditional attitudes are more likely to disapprove of women occupying positions of authority. The AAGRAS is a useful assessment tool that policymakers, researchers, practitioners, and educators can use to study gender-role attitudes in the Arab world and to develop educational and intervention programs that encourage adolescents to identify, confront, and avoid prejudice and discrimination against women and ultimately adopt more egalitarian gender roles. [ABSTRACT FROM AUTHOR]

Nijmegen breakage syndrome is an autosomal recessive disorder caused by biallelic mutation in NBN gene. It is characterized by microcephaly, growth retardation, immuno-deficiency and cancer predisposition. The monoallelic carriers of NBN gene are also reported to be at increased risk of developing various types of malignancy. We have investigated an individual with lung cancer from an extended family segregating different types of hereditary cancer over several generations, including lung, breast, ovarian, colon, prostate and renal cancers. By using next generation whole exome sequencing approach, we identified a rare heterozygous frameshift mutation in NBN gene; c.93_94delTG (Ala32HisfsTer4), which is predicted to be pathogenic together with 3 other variants; 2 being in the BRCA1 gene, c.1648A > C (p.Asn550His) and c.536A > G (p.Tyr179Cys), and one in RAD50 gene, c.3539G > A (p.Arg1180Gln). Some of the variants were also found in six out of eight clinically normal relatives, but in different combinations. To our knowledge, this is the first report of NBN gene mutation in an individual with lung cancer in the Arab world. Reporting such findings may aid in variants' risk classification and clinical decision in the future. [ABSTRACT FROM AUTHOR]

This article expands the limited literature on civil society legislative advocacy in the Arab world by examining the frequency of Civil Society Institutions' (CSIs) legislative advocacy in Jordan, an Arab competitive authoritarian monarchy. The article explores the impact of authoritarian control and organizational factors on CSIs' legislative advocacy. Based on 82 semi-structured interviews, this qualitative study finds that there is a low frequency of legislative advocacy among Jordanian CSIs. Financial resources, access to legislators, and perceptions of legislators' interest in advocacy affect CSI legislative advocacy. In contrast, public funding and the law governing CSIs do not affect CSI legislative advocacy. The findings add to both the literature on advocacy in general and on legislative advocacy in particular, and open up new areas for research. [ABSTRACT FROM AUTHOR]

Hereditary cancer comprises more than 10% of all breast cancer cases. Identification of germinal mutations enables the initiation of a preventive program that can include early detection or preventive treatment and may also have a major impact on cancer therapy. Several recurrent mutations were identified in the BRCA1/2 genes in Jewish populations however, in other ethnic groups in Israel, no recurrent mutations were identified to date. Our group established panel sequencing in cancer patients to identify recurrent, founder, and new mutations in the heterogeneous and diverse populations in Israel, We evaluated five breast cancer patients of Arab descent diagnosed with cancer before the age of 50 years and identified the previously described TP53 mutation, c.541C> T, R181C (rs587782596), in two women from unrelated Arab families. The two probands were diagnosed with breast cancer at a young age (27 and 34 years) and had significant family history spanning a wide range of tumors (breast cancer (BC), papillary thyroid cancer, glioblastoma multiform (GBM), colon cancer and leukemia). The R181C variant is expected to disrupt p53 at the ASPP2 binding domain but not the DNA binding domain and is defined by Clinvar as likely pathogenic and in HGMD as disease mutation. We further tested 85 unrelated Arab cancer patients and father of a BC carrier patient for TP53 c.541C> T using a real time polymerase chain reaction (RT-PCR) approach and identified four additional carriers, two with BC one with lung cancer, and the father of a BC carrier patient, diagnosed with GBM. Another carrier suffering from BC was identified using a Myriad panel, suggesting a recurrent mutation in this population with a frequency of 5/42 (11.9%) of our selected BC patients. We suggest testing Arab women with a breast cancer at a young age, Arab patients with multiple malignancies, or with suggestive family history for TP53 c.541C> T. [ABSTRACT FROM AUTHOR]

ECHS1 is a mitochondrial matrix enzyme that catalyzes an important step in the β-oxidation spiral of fatty acid catabolism, and individuals with mutations in the ECHS1 gene suffer from an autosomal recessive condition typified by delayed psychomotor development, mitochondrial encephalopathy, hypotonia, and cardiomyopathy. Here we report the first Arab case of ECHS1 Deficiency. The patient was born to consanguineous parents with all growth parameters being low for gestational age, and was persistently desaturated. Cord blood gas and later blood analysis showed severe metabolic acidosis. Tandem MS revealed increased levels of valine, and Leucine/Isoleucine and decreased level of Glutamine. There was also a large patent ductus arteriosus with right to left shunt and a possible small muscular ventricular septal defect. Whole Exome Sequencing revealed a novel homozygous missense mutation in the ECHS1 gene; c.842 A > G (p.Glu281Gly). In-silico analysis suggests that the residue affected by this mutation may be involved in an important functional or structural role. [ABSTRACT FROM AUTHOR]

The purpose of this study was to examine the differences in cyberbullying (bystanders, victims, bullies) between Jewish and Arab adolescents in Israel. The findings could uncover critical implications for children, educators, and policymakers for understanding Cyberbullying in a diverse society. In particular, the differences in cyberbullying between collective and individualistic societies and the effect of gender bias on the likelihood of engaging in cyberbullying. Two cultural contexts in Israel were explored: one representing a collectivist orientation (Arab-Muslim and Arab-Christian culture), the other representing a more individualistic orientation (Jewish culture). The study included 901 junior high and high school students (501 Jewish-Israelis and 400 Arab-Israelis), which filled in an online cyberbullying survey. Findings revealed that Jewish adolescents reported being cybervictims and cyberbystanders more than Arab adolescents, yet contrary to expectation, Arab adolescents reported being cyberbullies more than Jewish adolescents. Contrary to expectation, no gender differences in being a bully were found among Jewish adolescents, while among Arab adolescents, girls reported higher bullying than boys. The cultural difference was significant among girls, revealing that Jewish girls were higher than Arab girls on bystanding and victimization, yet Arab girls were higher than Jewish girls on bullying in cyberspace. The cultural difference was not significant among boys. Using online communication as a theoretical framework, this study observed aspects of cyberbullying in the diverse and multicultural society of Israel through the lenses of individualistic versus collectivist cultures. The findings and their implications are further discussed and shed more light on cyberbullying in a diverse and multicultural society. [ABSTRACT FROM AUTHOR]

The epidemiology of toxoplasmosis in pregnancy is a major issue for public health. Primary infection in pregnant women can lead to serious sequelae. This review examined current sero-epidemiology and risks factor data for Toxoplasma gondii in pregnant women in Arab and African countries. A systematic electronic search of published literature was conducted. Data were extracted from relevant studies. Seropositivity is high in both regions. African countries have higher seropositivity than Arab countries due to differences in risk factors. Data on T. gondii infection in pregnancy are scant in many countries, especially where there is lack of political stability. Identified risk factors included eating raw meat, proximity with cats, undercooked food, and increasing maternal age. Toxoplasmosis in pregnancy in Arab and African countries is an underestimated health problem. Further research is needed. This report is a foundation for strategies and policies for intervention needed to combat the consequences of congenital toxoplasmosis. [ABSTRACT FROM AUTHOR]

A growing body of literature links particular parenting practices with negative child outcomes including greater anxiety symptoms among western societies. However, the effects of cultural differences on such linkages have not been adequately addressed in the anxiety literature. This study therefore aimed to examine the relationship between perceived parenting style and anxiety among Malay, Chinese, Indian, Arab and European/American (Caucasian) origins adolescents and the possible cultural group influences on this relationship was studied. Using multiple cluster sampling, a total of 227 students (122 boys and 105 girls) aged 13-18 years was selected. They completed questionnaires measuring parental rearing behaviors (EMBU-C) and anxiety symptoms scale (SCAS). Results indicated that in comparison to the European/American; Asian samples reported greater anxiety symptoms on all subscales of anxiety. Parental rejection, anxious rearing and control/over protection were correlated to higher anxiety independent of cultural group but these associations were stronger for Caucasians. Parenting styles as predictor of anxiety were found to be cross culturally different. Although European/American adolescents rated their parents as least over controlling, it was significant predictor of anxiety. This study provides evidence for the notion that relationship between parenting factors and anxiety were different across cultural contexts. [ABSTRACT FROM AUTHOR]

Well-being theory, also known as the PERMA model (Seligman in Flourish: a visionary new understanding of happiness and well-being, Free Press, New York, ), proposes five pathways by which individuals can pursue happiness. The first pathway, the pleasant life, concerns the maximization of positive emotions. The second pathway, the engaged life, combines flow with engagement, while the third, the meaningful life, concerns purpose in life and meaning. The last two pathways involve positive relationships and achievements. While research in positive psychology focuses on happiness, there is a dearth of information within the literature about the ways in which the PERMA model is experienced by other cultures, and how it can highlight areas of development. This present study aimed to determine whether descriptions of happiness provided by a sample of Emirati university students would align with the PERMA model pathways. The results showed that the way in which happiness was described overlapped with the PERMA pathways in culturally consistent ways. The PERMA model was effective in highlighting opportunities and challenges for intervention in the United Arab Emirates. Finally, the study suggests that as researchers aim to increase well-being and as nations strive to improve the satisfaction of their citizens, cultural structures may be impacted. [ABSTRACT FROM AUTHOR]

Neuropsychological tests (NPTs) are highly dependent on education, culture differences as well as age and sex. It is therefore essential to take these factors into consideration when translating NPTs to be used in screening for cognitive impairment. Translations into Arabic must respect the principles of linguistic relativity and cultural specificity of the population under study. The objective is to assess feasibility and outcome of translating neuropsychological tests to Arabic. A team of Lebanese professionals selected a battery of screening NPTs. These tests were translated into Arabic and independently back translated by a team of sociolinguists and cultural specialists. The translations were adapted to suit the Lebanese culture. The final NPT translated versions were reached by consensus of an expert panel and tested on a group of independently living community-dwelling elderly. Translated items had to be modified when: (1) terms could not be translated using one word as required by the test; (2) Concepts were foreign to the culture; (3) Translated words carried multiple meanings; (4) Words were rarely used in Lebanon; (5) Sentences did not have an equivalent; and (6) Words had letters pronounced differently by subgroups in Lebanon. Despite all measures to maintain cultural sensitivity in translations, non-linguistic challenges remained. A battery of cognitive screening tests were translated into Arabic and adapted for the Lebanese population. These adaptations allow for a better assessment of cognitive abilities since they reflect the thought patterns of the population. The challenge is to establish local normative data. [ABSTRACT FROM AUTHOR]

Subjective vitality is an indicator of eudaimonic well-being that refers to the feeling of being alive and full of energy. According to Self-Determination Theory (SDT), awareness of what is truly occurring in the present is conducive to subjective vitality. The current study examined the construct validity of the Subjective Vitality Scale and its relation to sociodemographic variables and Experiential Self-Knowledge (ESK), a theoretically relevant awareness construct, in the Lebanese cultural context. A convenient sample of 301 Lebanese adults residing in the Greater Beirut Area completed the Arabic translations of the 6-item Subjective Vitality Scale (SVS) and the 13-item ESK Scale. Exploratory and confirmatory factor analyses supported a unidimensional factor structure for the Arabic SVS. Multiple-group confirmatory factor analyses also provided evidence of configural, metric, structural, and scalar invariance across sex. With respect to sociodemographic variables, sex was the only significant correlate and predictor of subjective vitality, with males reporting greater levels of subjective vitality than females. Consistent with Self-Determination Theory (SDT), awareness as assessed by the ESK Scale was found to be a positive correlate and predictor of subjective vitality such that those who scored higher on experiential self-knowledge also reported greater levels of subjective vitality. These findings provide preliminary support for the construct validity of the Arabic translation of the SVS in the Lebanese context and highlight the potential role of awareness in eudaimonic well-being. [ABSTRACT FROM AUTHOR]

The purpose of this study was to provide a critical perspective on the needs of aging Muslims by focusing on a diverse group of older adults including those with ancestry from African American, South Asian, Arab, and Albanian origins. Four focus group discussions were conducted with adults aged 60+ recruited from four Muslim centers in the metro-Detroit area. Grounded analysis uncovered themes related to needs, strengths and challenges in the Muslim community, as well as suggestions for the way forward in addressing aging issues. Needs identified include quality of life and social relations. Strengths included references to tradition and scripture. Challenges named referred to conflict both within and outside of the family. Finally, the way forward consisted of the desire for options to support aging families within the community, often in small steps, though not necessarily only through mosques. Findings also suggested that women may be a key agent of change within the Muslim community. In sum, this study uncovered areas of overlap and at times disagreement between and within groups, underlining the fact that there is no one kind of Muslim aging, and that any approach to caring for Muslims must combine cultural sensitivity with flexibility in order to minimize anxiety and stress for both elders and their families. [ABSTRACT FROM AUTHOR]

U.S. racial and ethnic populations can be defined by a number of census questions-race/ethnicity, ancestry, place of birth, and/or language-but little is known about how using alternative definitions of identity affect the size and characteristics of different groups. This article examines this question using combined data from the 1 % and 5 % Public Use Microdata Samples in census 2000, using Mexicans and Arabs as case studies. The analysis uses the standard method of classifying these groups (Hispanic origin and Arab ancestry) as a baseline to explore differences across the range of possible permutations of ethnic identity. In the Arab case, persons captured using alternative definitions of identity (Arabic language at home and/or born in an Arab country) are lesser educated, more likely to be in poverty, and more likely to identify as non-white or multi-racial than the Arab population as a whole. In contrast, persons in the Mexican alternative definition group (Mexican ancestry and/or born in Mexico) are more highly educated, less likely to be in poverty, and more likely to identify as white than the Mexican population as a whole. The article concludes with research and policy implications of these findings. [ABSTRACT FROM AUTHOR]

Haemoglobinopathies including the thalassemias and sickle cell disease are known to be prevalent inherited disorders in most Arab countries with varying prevalence rates and molecular characterisation. β-thalassemia is encountered in polymorphic frequencies in almost all Arab countries with carrier rates of 1-11 % and a varying number of mutations. The most widespread mutation in Lebanon, Egypt, Syria, Jordan, Tunisia and Algeria is the IVS-I-110 (G>A). In the Eastern Arabian Peninsula, the Asian Indian mutations (IVS-I-5 (G>C), codons 8/9 (+G) and IVS-I (−25 bp del)) are more common. The α-thalassemias are encountered in the majority of Arab countries in frequencies ranging from 1 to 58 % with the highest frequencies reported from Gulf countries. The (−α) mutation is the most frequent followed by the non-deletional α2 polyadenylation signal mutation (AATAA A>AATAA G) and the α2 IVS1 5-bp deletion. The rates of sickle cell trait in Arab countries range from 0.3 to 30 %, with the Benin, the Arab-Indian and the Bantu haplotypes constituting the bulk of the haplotypes, leading to two major phenotypes; a mild one associated with the Arab-Indian and a severe one with the Benin and Bantu haplotypes. Public health approaches targeting prevention of haemoglobinopathies in Arab countries include newborn screening for sickle cell disease, and premarital screening for carriers of β-thalassemia and sickle cell disease. These services are still patchy and inadequate in many Arab countries recommending the upgrade of these services with strengthening of the education and training of health care providers and raising public awareness on the feasibility of prevention and care for haemoglobinopathies. [ABSTRACT FROM AUTHOR]

Objectives: To (1) highlight the profile of the needs for care among a sample of persons with schizophrenia, using the Camberwell Assessment of Needs (CAN-EU), in comparison with the international data; (2) assess the association of patients' needs with socio-demographics, clinical characteristics and objective quality of life (QOL); and (3) compare the perceptions of patients with those of the staff. Method: Consecutive outpatients in stable condition were interviewed with the CAN-EU and measures of QOL and psychopathology. Results: There were 130 patients (68.5 % men, mean age 36.8). The highest frequency of unmet needs was for money (29.2 %). About a fifth of the subjects expressed unmet needs for six other items, including accommodation. The mean total needs was 8.67(7.1), the total met needs was 5.29 and total unmet needs was 3.38. The dimension with the highest frequency (40 %) of unmet needs (functioning) is constituted by items that are related to family care at home. Staff identified significantly more needs than patients. Higher levels of needs were significantly associated with severity of psychopathology and negative affect, and not participating in outdoor activities. The mean number of needs was similar to reports from developing countries and higher than those from European countries. The met/unmet need ratio was similar to European data. Conclusion: Despite free health services and family support, a number of our treated community-dwelling persons with schizophrenia had problems meeting basic and health-care needs. The findings call for a consideration of techniques for enhancing the capability of families to cope with the care of patients. [ABSTRACT FROM AUTHOR]

Perinatal depression, a prevalent condition with negative consequences for the mother, infant and family, has been reported in many countries. This study aimed to assess the scope of depressive symptoms among pregnant and postnatal Israeli Arab women and to identify possible risk factors. Data were collected from a screening program at 58 Mother-Child Health Care clinics in northern Israel from June to December, 2009. Participants included 1,254 pregnant and 2,326 postnatal women. The rate of antenatal depressive symptoms, i.e., a score of ≥10 on the Edinburgh Postnatal Depression Scale (EPDS) was 20.8%. Women attending clinics with primarily religious or traditional populations had lower rates antenatally than did those described as secular. During the postnatal period 16.3% of the women scored ≥10 on the EPDS. The rate of postnatal depressive symptoms was significantly higher among women living in Moslem than Druze communities (EPDS ≥ 10: 19.0% vs. 13.4%, respectively, P = 0.01). Postnatally, there were no significant differences according to SES cluster, community size, or religious orientation. The rate of antenatal and postnatal depression among Arab women in northern Israel was somewhat higher than that of Jewish Israeli women in the same region, and considerably lower than that of Arab Bedouin women in southern Israel. Given the differences in their life styles and circumstances, health policy authorities should be informed regarding the needs of these various sub-populations. [ABSTRACT FROM AUTHOR]

Objectives: The objectives were first, to assess the lifetime and 12-month prevalence of physical, psychological, and sexual abuse among a stratified random sample of Kuwaiti high school students and second, to explore the association of child abuse with parental characteristics, subjective quality of life (QOL), self-esteem, anxiety, and depression. Method: We assessed the students for experience of abuse by their mothers, fathers, and others, using standard scales on psychological, physical and sexual abuse. They also completed the short version of the World Health Organization's QOL Instrument; the Rosenberg self-esteem scale, and a scale for anxiety and depression. Results: We obtained responses from 4,467 students (49% boys), mean age 16.9 years. About 18, 15, and 18%, indicated that for at least six times in the past 12 months, they experienced psychological abuse by their mothers, fathers and others, respectively. The corresponding figures for lifetime experience were similar. The respective figures for experience of physical abuse during the past 12 months were 4.3, 5.8, and 6.4%. For lifetime experience, the corresponding figures were 3.4, 5.3, and 5.8%. The girls had significantly higher physical/psychological abuse scores. There were no significant gender differences in the prevalence of sexual attacks (8.6%) and someone threatening the subjects with sex (5.9%). The prevalence of someone sexually exposing themselves to the students (15.3%) and unwanted touching of sexual parts (17.4%) was significantly higher among the boys. Over one-third of those abused had experienced multiple abuses. Child abuse was significantly associated with parental divorce, diminished QOL and self-esteem, high scores on anxiety/depression, and difficulty with studies, and social relationships. In the regression analysis involving only the abuse indices, psychological abuse by mothers was the most important predictor of depression, anxiety, and self-esteem (11.5-19.7% of variance). Good quality of parental relationship seemed protective. Conclusion: The findings support the impression that, despite the conservative culture, child abuse is being experienced by a significant number of children in the Arab world. Preventive education in this culture should include limits on child disciplinary measures, the vulnerable groups identified, the impact on psychosocial functioning, and the protective effect of parental harmony. [ABSTRACT FROM AUTHOR]

To study the prevalence of Type 2 Diabetes Mellitus (T2DM) in a population of United Arab Emirates (UAE) residents through the creation of the 'Emirates Family Registry' (EFR). Major hospitals and diabetes centres in the UAE were contacted to establish a bio-banking facility referred to as the EFR. Through assistance made available by the Ministry of Health and collaborators of this network, demographic data of T2DM patients were collected and collated in a database for analysis and longitudinal studies. Clinical specimens were collected for biochemical profiling (such as; glucose, lipids, HbA levels). In the first 24 months of the operation the EFR recruited 23,064 adult volunteers from three major hospitals and nine primary care centres throughout the UAE. Within this cohort, 88% were patients classified as T2DM patients from the medical records. The cohort was divided into age categories with 59% of T2DM patients aged between 40 and 59 years old. UAE nationals comprised 30% of the database of which 21% were diagnosed with T2DM. However the percentage of adults with T2DM was higher in other ethnic groups effecting almost 33% of the Indians who live in the UAE. A total of 741 UAE Nationals consented to donate blood; in phase I of the study; for biochemical testing after which 23% were diagnosed with T2DM, 30% with pre-T2DM and 47% were healthy. This study is consistent with the previously reported high prevalence of T2DM in the UAE. Furthermore, analyses of the factors that predispose to the disease have revealed that obesity, a large waist circumference, consanguineous marriage, family history, lack of physical activity, unhealthy dietary practices, high total cholesterol, and high triglycerides levels were more prevalent in T2DM patients. The classification of these features will contribute to defining more effective and specific plans to screen for and manage diabetes and its complications in UAE and other developing countries. [ABSTRACT FROM AUTHOR]

The association between polymorphisms in the p53 tumor suppressor gene and breast cancer risk has been studied in many human populations with conflicting conclusions. However, similar studies in Arab women are not available, and the status of these polymorphisms in this ethnic population is not known. We investigated the status of four known p53 gene polymorphisms and their possible role in breast cancer risk in Arab women. Genotyping was performed for 288 breast cancer women and 188 controls to determine Pro47Ser, Arg72Pro, Intron 3 Ins16 bp and intron 6 (G > C) polymorphisms. The p53 variant Pro47Ser was detected only in one Kuwaiti breast cancer patient and was not detected in any of the control subjects. Frequency of Arg/Arg at codon 72 was 26.6% in controls and 28.1% in patients, Arg/Pro frequency was 59.6% in controls and 69.4% in patients, the Pro/Pro genotype was 13.8% in controls and 2.4% in patients. We observed that women with Pro/Pro genotype have decreased risk for developing breast cancer (OR = 0.166, 95% CI = 0.067-0.411, p < 0.001). The intron 3 genotypes were A1/A1 (48.9%), A1/A2 (40.6%) and A2/A2 (10.5%) in controls and A1/A1(42.4%), A1/A2 (52.8%) and A2/A2 (4.8%) in cases. The intron 6 genotypes were 92.4% (GG), 7.6% (GC) and 0% (CC) in controls and 96.5% (GG), 3.5% (GC) and 0% (CC) in cases. No statistically significant differences between patients and controls were observed for intron 3 and intron 6 polymorphisms. Our data show that proline homozygosity at p53 codon 72 is associated with decreased breast cancer risk in Arab women. [ABSTRACT FROM AUTHOR]