'It's Just Not Working', a Qualitative Exploration of the Weight-Related Healthcare Experiences of Individuals of Arab Heritage With Higher Weight in Australia.

INTRODUCTION: Culturally and linguistically diverse population groups disproportionately experience higher weight and other non-weight-related discrimination in healthcare settings outside of their ancestral country. Little is known about the experiences of individuals with Arab heritage. This study aimed to qualitatively explore the intersectional weight-related healthcare experiences of individuals of Arab heritage with higher weight in Australia. METHODS: A general inductive enquiry approach was used. Purposive, convenience and snowball sampling was used to recruit individuals of Arab heritage residing in Australia. Individuals were invited to participate in an online semistructured interview. Interviews were recorded, transcribed and thematically analysed. RESULTS: Fifteen participants took part in the study. Of these participants, 93% were female (n = 14), 80% were aged between 18 and 44 years (n = 12), 73% were university educated (n = 11), 53% were born outside of Australia (n = 8) and all were Muslim (n = 15). Four main themes were identified: (1) appearance-based judgement, (2) generalised advice and assumptions, (3) cultural responsiveness and (4) healthcare system constraints. CONCLUSION: Individuals of Arab heritage with higher weight in Australia, namely, females, often perceive their healthcare experiences as dismissive of their cultural and religious needs and driven by causality assumptions around weight. It is crucial that care delivered encompasses cultural humility, is weight-inclusive and acknowledges systemic constraints. Cultural safety training benchmarks, healthcare management reform and weight-inclusive healthcare approaches are recommended to assist healthcare providers in delivering effective, holistic and culturally safe care. PATIENT OR PUBLIC CONTRIBUTION: Insights gained from conversations with Arab heritage community members with lived experiences regarding weight-related healthcare encounters informed the study design and approach.

Unraveling Trust Issues Towards Mental Health Professionals Among Bedouin-Arab Minority in Israel.

Trust in mental health professionals and services profoundly impacts health outcomes. However, understanding trust in mental health professionals, especially in ethnic minority contexts, is lacking. To explore this within the Bedouin-Arab minority, a qualitative study conducted semi-structured interviews with 25 Bedouins in southern Israel. Participants were primarily female (60%) married (60%), averaging 34.08 years old. Employing grounded theory, three themes emerged. Firstly, concerns about confidentiality were central, eroding trust due to societal repercussions. Secondly, factors influencing confidentiality concerns and distrust were tied to Bedouin-Arab social structures and cultural values rather than professional attributes. Lastly, the consequences of distrust included reduced help-seeking. This study enriches the understanding of trust in mental health professionals among non-Western ethnic minorities, highlighting how cultural factors shape perceptions of mental health services and distrust. Addressing confidentiality worries demands Bedouin mental health professionals to acknowledge hurdles, build community ties, and demonstrate expertise through personal connections and events.

Knowledge, Attitude and Perceptions of Healthcare Workers in Arab Countries Regarding Basic Life Support; a Systematic Review and Meta-Analysis.

Introduction: Effective Basic Life Support (BLS) interventions, including cardiopulmonary resuscitation (CPR), are essential for enhancing survival rates. This review aimed to evaluate the knowledge, attitudes, and perceptions (KAP) of healthcare professionals regarding BLS in Arab countries. Methods: We conducted a systematic search on PubMed, Cochrane, Scopus, Web of Science, and EMBASE, to identify relevant studies. We included studies performed in Arab countries that included healthcare workers' KAP assessment towards BLS. The meta-analysis was carried out utilizing the OpenMeta Analyst Software, and a subgroup analysis was performed for Nursing staff category. The quality of the included cross-sectional studies was assessed through Newcastle-Ottawa quality assessment scale. Results: A total of 18 studies were included in our study, and eight of them entered the analysis. The study showed that 61.3% (95% confidence interval (CI): 48.9%, 73.7%, p<0.001) of health care workers were knowledgeable about the correct CPR ratio, and 62.1% (95% CI: 51.7%, 72.5%, p<0.001) answered the location of chest compression correctly. While, only 36.5% (95% CI: 23.5%, 49.6%, p<0.001) had correct answers regarding the compression rate, 48.1% (95% CI: 38.1%, 58.0%, p<0.001) were aware of the compression depth, and 34.8% (95% CI: 22.9%, 46.7%, p<0.001) answered the sequence correctly. Conclusion: The study revealed a gap regarding the BLS KAP of healthcare workers in different Arab countries, which crucially requires taking actions, in terms of frequent certified training sessions, assessments, and clear protocols.

Mapping the landscape of medical research in the Arab world countries: A comprehensive bibliometric analysis.

OBJECTIVES: To describe the productivity, performance, and impact of medical research in the Arab world countries. METHODS: We carried out a bibliometric analysis using Clarivate Analytics databases from January 2017 to March 2023. We reported research productivity, national and international research collaboration patterns, impact of Arab medical research output compared to the global average, top medical journals publishing Arab-affiliated research, and performance of the most productive Arab institutions. RESULTS: The Arab world contributed 2.72% to global medical research publication, with a citation impact of 11.98 compared to the global impact of 12.02. Qatar, Lebanon, and Saudi Arabia led medical research publications per million population among Arab countries, ranking 26th, 36th, and 37th globally. Medical research publications increased by 87% annually from 2017-2022, with 70% of research originating from Saudi Arabia and Egypt. National collaborations accounted for 15% of Arab world publications, while international collaborations represented 66%. The median impact factor across the top 20 medical journals with Arab-affiliated authors was 5.14, with 50% being quartile one journals. The top 10 Arab-origin medical journals had a median impact factor of 3.13. Approximately 80% of the top 20 Arab institutions were academic, with a median publication count of 3,162.5 and a median citation impact of 14.5. CONCLUSION: The study provides insights into the state of medical research in the Arab countries, indicating room for improvement in the region's medical research.

Arab male physicians' perceptions about their own smoking behaviors: a qualitative study.

BACKGROUND: Smoking remains the leading preventable cause of disease, disability, and death worldwide. Although physicians have high levels of health literacy with awareness of the consequences of smoking and their essential role in smoking cessation of patients, some physicians continue to smoke. Rates of smoking among Arab male physicians are high. This study aimed to gain insights into Arab male physician's perceptions of their own smoking behaviors and their professional role in health promotion. METHODS: Using purposive sampling, we recruited 25 Arab male physicians working in hospital and community clinic settings who currently smoke. Semi-structured, hour-long, interviews were held during January-June 2022. We then performed a thematic analysis of the interview data. RESULTS: The analysis revealed three categories, two sub-categories, and 15 emerging themes. The category 'Antecedents: prior to becoming a physician' revealed the themes: smoking experience during adolescence; social and ethnic culture; stress during medical studies; and on & off periods of quitting smoking. The category 'Physicians' perception of smoking' was sorted into two sub-categories: (1) Personal aspects, including the themes 'relaxation from stress', 'self-compensation', 'addiction', and 'enjoyable experience', and (2) Professional aspects, including the themes 'lack of knowledge about cessation', 'inadequate workplace support', 'motivation to consult patients', and 'awareness of their role as primary care physicians'. The category'Impacts' revealed the themes 'personal health and well-being', 'professional competence', and 'professional image in public'. CONCLUSIONS: This study provides an in-depth understanding of the personal, socio-cultural, and professional aspects of the phenomenon of Arab male smoking physicians from their perspective. Based on this information, we recommend developing programs that support and empower all physicians to cope better with their personal and professional stress as well as instituting programs that will provide all physicians with specific knowledge and skills related to smoking cessation. These programs should improve the ability of physicians to serve as positive role models for their patients for preventing and ceasing smoking, thus enhancing the image of the medical profession and, most importantly, improving the health of the public.

Mental health literacy among Arab men living in high-income Western countries: A systematic review and narrative synthesis.

While interest in mental health literacy (MHL) is growing rapidly, cross-cultural research focusing on MHL is developing more slowly. This inaugural systematic review explored the recognition and beliefs about the causes of mental health disorders amongst Arab men living in high income Western countries (HIWC), their help-seeking beliefs, behaviors, and sources of help, as well as barriers and facilitators to help-seeking. Six electronic database searches were conducted using Medline, Embase, ProQuest Dissertations & Theses Global, PsycINFO, Scopus, and Web of Science. These searches yielded a total of 9,460 citations. After applying inclusion criteria through both database and manual hand searches, 46 studies were identified. The findings corresponded with four of the socioecological model's five factors: intrapersonal, interpersonal, societal, and institutional. Intrapersonal factors included attributing mental health illness to life and migration stressors, and religious reasons. Interpersonal and societal factors included men favoring informal help-seeking sources as stigma was a barrier to formal help-seeking. Institutional factors around the perceived cultural competence of healthcare professionals and access difficulties were obstacles to seeking formal help. The growth in Arab migration to HIWC highlights the need for culturally tailored care. Research is needed to understand the perspectives of healthcare providers working with Arab men in addition to how men's stigmatizing attitudes are an obstacle to formal help-seeking. Interventions should be designed to address the unique mental health needs of Arab men, recognizing that some explanatory beliefs may not align with current Western models of mental health. Moreover, efforts should be made to integrate men's informal sources of support into treatment planning.

The Mediterranean diet: a historical perspective.

The Mediterranean diet, which was born in the Mediterranean basin, was initially quite poor and simple, essentially based on the products that grew almost spontaneously along the shores of the Mediterranean, i.e., olives, grapes, and wheat, which were long cultivated in the Mediterranean region. The invasions of the Roman Empire by barbarian populations, between 400 and 800 AD, made the diet enriched with products from wild uncultivated areas, meat from game and pigs, and vegetables. With the arrival of the Arabs in southern Italy in the ninth century, the focus of the diet shifted to carbohydrates, particularly to dried pasta and to other new ingredients. The Arabs primarily brought a new imaginative spirit to the kitchen by introducing and using an infinity of condiments and seasonings. The discovery of the Americas and the arrival of new ingredients from the New World brought the final adjustments to the Mediterranean diet: new meat (turkey), new vegetables (potatoes, broad beans, corn, tomatoes,) new fruits (strawberries, pineapples, coconuts, peanuts), chocolate, coffee and sugar completed the list of components of the Mediterranean diet as we know it today.

Determinants of intentions to seek formal mental health help among Palestinian adolescents in Israel.

BACKGROUND: Mental health challenges are widespread among adolescents undergoing significant physical, emotional, social, and academic changes. However, rates of formal help-seeking remain low, particularly among those from ethnic minorities. AIMS: This study investigated the determinants of intentions to seek formal mental health help among Palestinian adolescents in Israel, focusing on mental health literacy (MHL) and trust in formal sources of information. METHODS: A total of 178 adolescents (Mage = 16.24 ± 1.24 years, 61.8% female) completed measures assessing intention for formal help-seeking, psychological distress, MHL, trust in formal sources of information, sociodemographic, and clinical characteristics. RESULTS: Findings revealed low levels of intention to seek formal help and psychological distress, alongside average or above-average levels on all MHL dimensions and trust in formal sources for information. Our analysis identified socioeconomic status (ß = .17, p < .05), psychological distress (ß = .18, p < .05), trust in formal sources of information (ß = .28, p < .001), and two MHL dimensions: knowledge of where to seek information (ß = .25, p < .01) and attitudes that promote recognition or appropriate help-seeking behavior (ß = .16, p < .05) - as the main determinants of intention for formal help-seeking. CONCLUSIONS: This study underscores the critical role of trust in formal sources of information and MHL in seeking formal help among adolescents from ethnic minorities. Interventions aiming to improve access to mental health-related information, address and enhance attitudes, and foster trust in formal professionals and institutions may contribute to an increased tendency for formal mental health help-seeking among this population and others.

Outcome of transcatheter aortic valve replacement in Israeli Jews and Arabs.

Background: Ethnic minorities may face disparities in access to health care and clinical outcomes. Transcatheter aortic valve replacement (TAVR) has an established role in treatment of patients with severe symptomatic aortic stenosis, however outcome of these procedures among different demographics within the multi-ethnic Israeli society is unknown. We sought to compare mortality following TAVR between Jewish and Arab patients in Israel. Methods: A prospective single-center TAVR registry in northern Israel was analyzed. We compared post-procedural survival among Arab and Jewish patients who underwent TAVR, presenting the estimated hazard ratio (HR) using Cox regression. Results: Of 923 subjects who underwent TAVR between 2010-2021, 172 (19%) were Arab and 751 (81%) were Jewish. The Arab patient population was younger (mean 77 vs. 81 years, P<0.001), had lower prevalence of coronary artery disease (34%, vs. 43%, P=0.02), hypertension (80% vs. 88%, P<0.01) and calculated procedural mortality (EuroScore II: mean 4.6 vs. 4.9, P=0.02), and higher percentage of females (65% vs. 53%, P=0.01), body mass index (mean 30 vs. 28, P<0.001) and creatinine clearance (mean 67 vs. 59 mL/min, P<0.001). Arab patients had similar post-procedural mortality compared to Jewish patients [7-day mortality: adjusted HR 1.51, 95% confidence interval (CI): 0.39-5.77, P=0.55; 30-day mortality: adjusted HR 1.79, 95% CI: 0.62-5.18, P=0.29; 1-year mortality: adjusted HR 1.24, 95% CI: 0.72-2.12, P=0.43]. Conclusions: Arab patients undergoing TAVR were younger and had lower predicted mortality than Jewish counterparts, however, these characteristics did not translate into improved post-procedural survival.

Symbolic boundary work: Jewish and Arab femicide in Israeli Hebrew newspapers.

We analyze 391 news reports in Israeli newspapers between 2013 and 2015, covering murders of women and their family members by other family members and intimate partners. We compare articles where the perpetrators and victims are Jewish to those where the perpetrators and victims are Palestinian citizens of Israel (henceforth PCI). We found that articles tend to provide much more details about Jewish culprits than about PCI ones. As for ascribed motives, most murder cases by Jews were framed as an outcome of individual personality or the pathology of the culprit. Conversely, when Palestinian citizens were the killers, culture and tradition were invoked as the main motives. We suggest that the routine work of narration that the Israeli media preform when covering femicide is a case of political use of cultural stereotypes to gain moral ground in the intractable conflict between Jews and Palestinians.

Cross-cultural modification of the University of Pennsylvania smell identification test for the Saudi Arabian population: Validation and normative values.

OBJECTIVES: To develop a reliable version of the Saudi Arabian-University of Pennsylvania smell identification test (SA-UPSIT) and to establish normative values for both genders. METHODS: This cross-sectional study was carried out on voluntarily recruited normal participants in King Saud University Medical City, Riyadh, Saudi Arabia, from April 2018 to May 2023. Culture-familiar odors were chosen and the kit was translated into Arabic for the study. The test was modified 3 times in 4 versions. Following this, a random sample was collected to carry out a re-test after 6 weeks. RESULTS: A total of 288 subjects participated in the development of the SA-UPSIT across all versions, including 146 females and 142 males. The average age of the participants was 28.4±9.9 years. In the final version, 111 participants scored an average of 34.5±2.5 for the total score, 35±2.3 for females, and 34.1±2.6 for males. The test-retest reliability coefficient was 0.73, indicating acceptable reliability. CONCLUSION: The new changes carried out to the SA-UPSIT increased the average scores and demonstrated good reliability, making it clinically applicable for diagnosing and monitoring olfactory dysfunction.

Ethnic disparities in the incidence of gynecologic malignancies among Israeli Women of Arab and Jewish Ethnicity: a 10-year study (2010-2019).

Background: Ethnic disparities in healthcare outcomes persist, even when populations share the same environmental factors and healthcare infrastructure. Gynecologic malignancies are a significant health concern, making it essential to explore how these disparities manifest in terms of their incidence among different ethnic groups. Objective: To investigate ethnic disparities in the incidence of gynecologic malignancies incidence among Israeli women of Arab and Jewish ethnicity. Design: Our research employs a longitudinal, population-based retrospective cohort design. Method: Data on gynecologic cancer diagnoses among the Israeli population from 2010 to 2019 was obtained from a National Registry. Disease incidence rates and age standardization were calculated. A comparison between Arab and Jewish patients was performed, with Poisson regression models being used to analyze significant rate changes. Results: Among Jewish women, the age-standardized ratio (ASR) for gynecologic malignancies decreased from 288 to 251 (p < 0.001) between 2014 and 2019. However, there was no significant change in the ASR among Arab women during the same period, with rates going from 192 to 186 (p = 0.802). During the study period, the incidence of ovarian cancer decreased significantly among Jewish women (p = 0.042), while the rate remained stable among Arab women (p = 0.102). A similar trend was observed for uterine cancer. The ASR of CIN III (Cervical Intraepithelial Neoplasia Grade 3) in Jewish women notably increased from 2017 to 2019, with an annual growth rate of 43.3% (p < 0.001). A similar substantial rise was observed among Arab women, with an annual growth rate of 40.5% (p < 0.001). In contrast, the incidence of invasive cervical cancer remained stable from 2010 to 2019 among women of both ethnic backgrounds. Conclusion: Our findings indicate that Arab women in Israel have a lower incidence rate of gynecologic cancers, warranting further investigation into protective factors. Both ethnic groups demonstrate effective utilization of cervical screening.

Computed-tomography evaluation of parietal foramen topography in adults: a retrospective analysis.

BACKGROUND: The parietal foramen (PF) of the skull is a variable anatomic feature with important implications for venous drainage, infection, and injury. Its topography is clinically relevant for neurosurgeons for intracranial navigation and preoperative planning. METHODS: PF topography was investigated in a series of 440 head computed-tomography scans of Omani subjects at Sultan Qaboos University Hospital. The mean age of the patients was 52 ± 17 years and there were 160 males and 280 females. The topography features of the PF, including frequency, diameter, patency, and relative position in relation to the superior sagittal sinus (SSS), were recorded. Additionally, sex and laterality differences in PF parameters were analyzed using a Chi-square test. RESULTS: The overall prevalence of PF was 72.3% (318/440). The bilateral presence of PF was identified in 34% of skulls. Unilateral right-side prevalence was 18.2%, while left prevalence was 13.2% (p = 0.62). The prevalence of unilateral accessory PF on the right side was 1.8%, while it was 1.1% on the left (p = 0.69). PF within the sagittal suture/or intra-sutural PF was observed in 6.8% of skulls, with a frequency of 9.4% in men and 5.4% in women (p = 0.29). The diameter of the PF was 1.45 ± 0.74 mm on the right side, and 1.54 ± 0.99 mm on the left side (p = 0.96). There were 2% of incomplete PF. The PF was located over the SSS in 70.3% on the right side and 53.8% on the left side. No significant differences were observed between the PF topography parameters and sex or laterality. CONCLUSION: The present study for the first time reports the baseline data of PF topography in a large sample of CT scans in the Arab population. The geography and race influence the PF topography differences. PF may be used as a reliable landmark of SSS. The morphological characteristics and distribution of PF reported in this study have clinical implications for imaging diagnosis, intracranial navigation of vascular disorders, and treatment.

Perspectives on Human Papilloma Virus Vaccination Barriers, Knowledge and Beliefs, and Practices: Providers Serving Arab-American Populations.

Little is known of HPV vaccination (HPVV) recommendation practices among healthcare providers who treat the Arab American community. Evidence indicates that HPVV patient uptake is low in this population. A survey was administered to healthcare providers (N = 46, 63% response rate) who treated ≥ 5% Arab American patients aged 9-26 years in areas of New York City and New Jersey with large Arab American populations. They were asked about barriers to HPVV recommendation and uptake among their Arab American patients. Providers (Doctors of Medicine and Osteopathy, Nurse Practitioners, and Physician Assistants) mostly worked in pediatrics (41%), primary care/internal medicine (26%), obstetrics/gynecology (20%), and family medicine (15%). Most (91%) were confident in their ability to effectively counsel their patients on HPVV. The most frequent provider-reported barriers to administering the HPVV to Arab American patients were patient cultural/religious practices (reported by 67%) and patient and provider difficulties with insurance reimbursement (44%). Most providers (84%) agreed that organizations/programs to increase HPVV uptake among Arab American patients were needed. Providers felt that HPVV uptake could be increased with educational materials in the patients' native languages ("very useful," 81%) and provider cultural competency training ("very useful," 65%). In responses to open-ended questions, cultural and religious HPVV barriers were a salient topic, as were linguistic barriers and provider burdens related to HPVV costs and regulations. HPVV uptake could potentially be improved with Arabic language education materials, provider education that is culturally and linguistically tailored to the Arab American community, and policies to address HPVV financial and regulatory burdens.

The psychology of romantic relationships: motivations and mate preferences.

Introduction: This study investigates motivations to engage in romantic relationships. We examine the structure of romantic motivations and their connections with personal values and mate preferences. Method: The study was conducted in Israel among young men and women looking for a romantic partner (n = 1,121, 40% male, age 18-30). Results: Data analysis demonstrated that basic romantic motivations form a circumplex that may be partitioned into four higher-order romantic motivations: love and care, family and children, status and resources, and sex and adventure. The romantic motivations formed a meaningful pattern of connections with higher-order values, thus confirming that context-specific motivations are derived from general motivational goals expressed in values. Personal value preferences and romantic motivations predicted the sought-after partner characteristics over and above sociodemographic variables. Values were indirectly (through romantic motivations) and directly connected to mate preferences. Discussion: The study advances our understanding of romantic relationships among young people and opens new directions for research and counseling.

Sequence Variant Analysis of the APOCII Locus among an Arab Cohort.

Apolipoprotein CII (ApocII) plays a key role in regulating lipoprotein lipase (LPL) in lipid metabolism and transport. Numerous polymorphisms within APOCII are reportedly associated with type 2 diabetes mellitus (T2DM), dyslipidemia, and aberrant plasma lipid levels. Few studies have investigated sequence variants at APOCII loci and their association with metabolic disorders. This study aimed to identify and characterize genetic variants by sequencing the full APOCII locus and its flanking sequences in a sample of the Kuwaiti Arab population, including patients with T2DM, hypertriglyceridemia, non-Arab patients with T2DM, and healthy Arab controls. A total of 52 variants were identified in the noncoding sequences: 45 single nucleotide polymorphisms, wherein five were novel, and seven insertion deletions. The minor allele frequency (MAF) of the 47 previously reported variants was similar to the global MAF and to that reported in major populations. Sequence variant analysis predicted a conserved role for APOCII with a potential role for rs5120 in T2DM and rs7133873 as an informative ethnicity marker. This study adds to the ongoing research that attempts to identify ethnicity-specific variants in the apolipoprotein gene loci and associated LPL genes to elucidate the molecular mechanisms of metabolic disorders.

Examining Ethnic Disparities in Digital Healthcare Services Utilization: Insights from Israel.

Purpose: The purpose of this study was to examine ethnic disparities in the utilization of digital healthcare services (DHS) in Israel and explore the characteristics and factors influencing DHS use among the Arab minority and Jewish majority populations. Methods: A cross-sectional correlational design was employed to collect data from 606 Israeli participants, 445 Jews, and 161 Arabs. Participants completed a digital questionnaire that assessed DHS utilization, digital health literacy, attitudes towards DHS, and demographic variables. Results: The findings reveal significant disparities in DHS utilization and attitudes between these ethnic groups, with Jewish participants demonstrating higher rates of utilization and positive attitudes toward DHS. The study also explores the predictive role of digital health literacy and attitudes in DHS use while considering ethnicity as a potential moderator. Significant predicting factors related to DHS utilization among Jews include positive attitudes and high health literacy. Among the Arabs, only attitudes towards DHS significantly predict the extent of DHS use. Digital health literacy affects the extent of use through attitudes at the two groups of the moderator significantly, but it is stronger among the Arab group. Conclusion: To improve healthcare outcomes and reduce disparities, efforts should focus on ensuring equitable access to DHS for the Arab minority population. Targeted interventions, including digital literacy education, removing technology access barriers, offering services in Arabic, and collaborating with community organizations, can help bridge the gap and promote equal utilization of DHS.

Targeted Metabolomics Analysis of Individuals Carrying the ANGPTL8 R59W Variant.

ANGPTL8 is recognized as a regulator of lipid metabolism through its role in inhibiting lipoprotein lipase activity. ANGPTL8 gene variants, particularly rs2278426 leading to the R59W variant in the protein, have been associated with lipid traits in various ethnicities. We aimed to use metabolomics to understand the impact of the ANGPTL8 R59W variant on metabolites in humans. We used the Biocrates-p400 kit to quantify 408 plasma metabolites in 60 adult male Arab individuals from Kuwait and identify differences in metabolite levels between individuals carrying reference genotypes and those with carrier genotypes at ANGPTL8 rs2278426. Individuals with carrier genotypes (CT+TT) compared to those carrying the reference genotype (CC) showed statistically significant differences in the following metabolites: acylcarnitine (perturbs metabolic pathways), phosphatidylcholine (supports liver function and cholesterol levels), cholesteryl ester (brings chronic inflammatory response to lipoprotein depositions in arteries), α-aminoadipic acid (modulates glucose homeostasis), histamine (regulates glucose/lipid metabolism), sarcosine (links amino acid and lipid metabolism), diacylglycerol 42:1 (regulates homeostasis of cellular lipid stores), and lysophosphatidylcholine (regulates oxidative stress and inflammatory response). Functional aspects attributed to these metabolites indicate that the ANGPTL8 R59W variant influences the concentrations of lipid- and inflammation-related metabolites. This observation further highlights the role of ANGPTL8 in lipid metabolism.

Patterns of psychiatric hospitalizations of Arab and Jewish adults with chronic psychotic disorders, before and after national mental health reforms, Israel, 1991-2016.

BACKGROUND: Members of the Arab minority in Israel are at increased risk of developing mental illness, although less likely to seek care and have accessible treatment. This study compares trends in psychiatric hospitalizations between Arabs and Jews with chronic psychotic disorders, before and after introduction of the Community Rehabilitation of Persons with Mental Disability Law in 2000, and governmental recognition of the need to allocate resources for patients with co-occurring substance use disorder and mental illness in 2010. METHODS: The National Psychiatric Case Registry provided data on 18,684 adults with schizophrenia/schizoaffective disorder, hospitalized in 1991-2016 (at least once in 2010-2015). Repeated-measures ANOVA was used to measure the effect (and interactions) of population-group (Arabs and Jews), time-period (Period1: 1991-2000, Period2: 2001-2009, Period3: 2010-2016) and sex, on average length of stay (LOS), annual number of hospitalizations and hospitalization days. RESULTS: The proportion of Arab patients hospitalized with a diagnosis of chronic psychotic disorder (14.4%) was significantly lower than their proportion in the general population (21%), and their average age at first hospitalization (28.4 years) was older than that of Jewish inpatients (27.0 years). The average number of hospitalization days and LOS of Jewish patients were double that of Arab patients in Period1. Following implementation of the Rehabilitation Law, hospitalization days increased among Arab patients and decreased slightly among Jewish patients, such that by Period3 the average number of hospitalization days was similar among Jewish (41) and Arab (37) patients. The increase in hospitalization days among Arab patients was limited to men with no change noted among women. The number of hospitalization days among Arab women was about half that of Jewish women (p < 0.0001). CONCLUSIONS: The findings reveal a narrowing of disparities in psychiatric hospitalizations between Arab and Jewish patients in Israel over time. However, among Arab women the number of hospitalization days remains considerably lower than that of Jewish women, raising concerns that Arab women may be receiving insufficient care. Further study is needed to fully understand the underpinnings of these disparities, although increasing the number of Arabic-language mental health services and providing psycho-education, will help further close the gap.

Ethnic inequalities in community rehabilitation use and psychiatric hospitalizations among people with chronic psychotic disorder.

PURPOSE: Community rehabilitation is crucial for the long-term treatment of people with chronic psychotic disorder. Ethnic minorities are less likely to seek care and have accessible treatment. This study examines whether the use of rehabilitation services and the relationship between rehabilitation and number of hospitalization days differ between Arabs and Jews. METHODS: Data from the Israel National Psychiatric Case Register on 18,684 adults with schizophrenia/schizoaffective disorders hospitalized in 1963-2016 were merged with data from the national Mental Rehabilitation Register. Associations between the use of rehabilitation services and demographic and clinical characteristics were assessed through logistic regression modeling. Associations between ethnicity and duration of rehabilitation (housing or vocational) and annual hospitalization days during Period1: 2001-2009 and Period2: 2010-2016 were analyzed using ANOVA. RESULTS: Among Jewish patients (N = 2556), 37% and 57% used rehabilitation services during Period1 and Period2, respectively, compared with 18% and 40% among Arab patients (N = 15,145) (p < 0.0001). The use of rehabilitation services was significantly higher among Jews (adjusted OR = 2.26, 95% CI 2.07-2.47). Average duration of housing and vocational rehabilitation services did not differ between Arab and Jewish patients. In both groups, duration of rehabilitation was inversely associated with annual hospitalization days. CONCLUSIONS: The ethnic disparity in the use of rehabilitation services has narrowed over time, yet remains. Although fewer Arab patients use rehabilitation, Jewish and Arab benefit similarly from the services with regard to reduced hospitalization days. To further close the ethnic gap, greater efforts must be made to expand the availability of culturally appropriate rehabilitation services for the Arab minority.