Cigarette smoking and smokeless tobacco use among male south Asian migrants in the United Arab Emirates: a cross-sectional study.

BACKGROUND: Few data were available on smoking and smokeless tobacco use in South Asian migrants in the United Arab Emirates (UAE). This study aimed to identify the prevalence and correlates of cigarette smoking and smokeless tobacco use in male South Asian migrants in the UAE. METHODS: We used a cross-sectional study to recruit a random representative sample of male South Asian migrants, including Indian (n = 433), Pakistani (n = 383) and Bangladeshi (n = 559) nationalities. We used multivariable logistic regression analysis to identify significant correlates of cigarettes smoking and smokeless tobacco use. RESULTS: 1375 South Asian migrant adult males participated in the study (response rate 76%) with a mean age of 34 years (SD ± 10). The overall prevalence of cigarette smoking was 28% (95%CI 25-30%) and smokeless tobacco use was 11% (95%CI 10-13%). The prevalence of current cigarette smoking was 21, 23, and 37% among participants from India, Pakistan and Bangladesh, respectively. The prevalence of current smokeless tobacco use was 6, 12, and 16% for Indian, Pakistani, and Bangladeshi participants, respectively. Among study participants, Bangladeshi nationality, hypertension, and alcohol use were significant correlates of current cigarette smoking. Significant correlates of smokeless tobacco use included increased age, less than college level education, alcohol use, and Pakistani or Bangladeshi nationality. CONCLUSIONS: Current smoking and smokeless tobacco use in South Asian migrants represent a significant public health burden in the UAE. Effective public health measures are needed to reduce tobacco use in this migrant population.

Genetics of diabetic kidney disease: A follow-up study in the Arab population of the United Arab Emirates.

BACKGROUND: Two genome-wide association studies in European and Japanese populations reported on new loci for diabetic kidney disease (DKD), including FTO. In this study, we have replicated these investigations on a cohort of 410 Type 2 diabetes mellitus (T2DM) patients of Arab origin from the United Arab Emirates (UAE). METHODS AND RESULTS: The cohort included 145 diabetic patients diagnosed with DKD and 265 diabetics free of the disease. In general, we were able to confirm the association between the FTO locus and DKD, as reported in the Japanese population. Specifically, there were significant associations with two single nucleotide polymorphisms (SNPs), namely rs1421086 (p = .013, OR = 1.52 depending on allele G, 95% CI: 1.09-2.11) and rs17817449 (p = .0088, OR = 1.55 depending on allele C, 95% CI: 1.12-2.14) of the FTO locus. Both SNPs were in linkage disequilibrium with rs56094641, also as reported in the Japanese population. While the alleles of both SNPs, which increase the risk of DKD, were associated with higher Body Mass Index (BMI), their associations with DKD were independent of the BMI effects. CONCLUSIONS: This study confirms that FTO is a multiethnic locus for DKD which is independent from any influence of BMI and/or obesity.

HLA class I allele lineages and haplotype frequencies in Arabs of the United Arab Emirates.

The high degree of polymorphism of the HLA system provides suitable genetic markers to study the diversity and migration of different world populations and is beneficial for forensic identification, anthropology, transplantation and disease associations. Although the United Arab Emirates (UAE) population of about nine million people is heterogeneous, information is limited for the HLA class I allele and haplotype frequencies of the Bedouin ethnic group. We performed low-resolution PCR-SSP genotyping of three HLA class I loci at HLA-A, -B and -C for 95 unrelated healthy Bedouins from the cities of Al Ain and Abu Dhabi in the UAE. A total of 54 HLA allele lineages were detected; the most frequent low-resolution allele lineages at each HLA locus were A*02 (0.268), B*51 (0.163) and C*07 (0.216). The inferred estimates for the two most frequent HLA-A and HLA-B haplotypes were HLA-A*02 ~ HLA-B*50 (0.070) and HLA-A*02 ~ HLA-B*51 (0.051), and the most frequent 3-locus haplotype was HLA-A*02 ~ HLA-B*50 ~ HLA-C*06 (0.068). The HLA allele lineage frequencies of the UAE Arabs were compared to those previously reported for 70 other world populations, and a strong genetic similarity was detected between the UAE Arabs and the Saudi Arabians from the west with evidence of a limited gene flow between the UAE Arabs and Pakistani across the Gulf from the east, and the UAE Arabs and Omani from the south of the Gulf Peninsula.

Multiple genetic variations confer risks for obesity and type 2 diabetes mellitus in arab descendants from UAE.

BACKGROUND: The United Arab Emirates (UAE) is one of the countries most threatened with obesity. Here we investigated associations between hundreds of single-nucleotide polymorphisms (SNPs) and the following obesity indicators: body mass index (BMI), waist circumference (WC), and height. We also investigated the associations between obesity-related genes with type 2 diabetes mellitus (T2DM). METHODS: We tested 87, 58, and 586 SNPs in a previous genome-wide significance level for associations with BMI (n = 880), WC (n = 455), and height (n = 897), respectively. For each trait, we used normally transformed Z scores and tested them with SNPs using linear regression models that incorporated age and gender as covariates. The weighted polygenic risk scores for significant SNPs for each trait were tested with the corresponding Z scores using linear regression models with the same covariates. We further tested 145 obesity loci with T2DM (464 cases, 415 controls) using a logistic regression model including age, gender, and BMI Z scores as covariates. RESULTS: The Mean BMI was 29.39 kg/m2, and mean WC was 103.66 cm. Hypertension and dyslipidemia were common obesity comorbidities (>60%). The best associations for BMI was in FTO, LOC284260 and USP37, and for WC in RFX7 and MYEOV. For height, the best association was in NSD1 followed by MFAP2 and seven other loci. The polygenic scores revealed stronger associations for each trait than individual SNPs; although they could only explain <1% of the traits' Z scores variations. For T2DM, the strongest associations were with the TCF7L2 and MC4R loci (P < 0.01, OR ~1.70), with novel associations detected with KCNK3 and RARB. CONCLUSIONS: In this first study of Arab descendants, we confirmed several known obesity (FTO, USP37, and RFX7), height (NSD1, MFAP2), and T2DM (TCF7L2, MC4R) associations; and report novel associations, like KCNK3 and RARB for T2DM.

City and cosmology: genetics, health, and urban living in Dubai.

In light of increasingly high rates of diabetes, heart disease, and obesity among citizens of the Arabian Gulf, popular health discourse in the region has emphasised the emergent Arab genome as the primary etiological basis of major health conditions. However, after many years of public dissemination of genomic knowledge in the region, and widespread acceptance of this knowledge among Gulf Arab citizens, the rates of chronic illness continue to increase. This paper briefly explores the clash between indigenous Islamic knowledge systems and biomedical knowledge systems imported into the United Arab Emirates. It presents vignettes collected from interviews and participant observation in Dubai as part of nearly four years of ethnographic research, completed as part of the author's doctoral work on 'Anxiety and Identity in Southeast Arabia'. Rather than radically informing health seeking behaviours among many UAE citizens, the emphasis on the 'Arab Genome' has instead reconfirmed the authority of Bedouin cosmological understandings of disease, reshaping the language that people use to engage with their bodies and their health. Local cosmology remains a powerful discursive element that often operates in contention, in sometimes powerfully subtle ways, with novel health initiative regimes. For many people in the region, genomic information, as it is often discussed and propagated in the UAE, shares an intimate relationship with ideas of fate and national identity, and sometimes serves to mitigate the increasingly uncertain terms of engagement that people share between the body, their health, and rapidly changing urban landscapes.

Holy anorexia: Eating disorders symptomatology and religiosity among Muslim women in the United Arab Emirates.

There is a substantial body of literature reporting a negative association between religiosity and psychiatric symptoms. In the context of eating disorders, however, this relationship appears to be reversed. The few studies exploring the relationship between religiosity and eating disorders have mostly focused on the Judeo-Christian religious traditions in Western nations. The present study examines this relationship among Muslim college women from the United Arab Emirates (UAE). All participants (N = 1069) independently completed the religious commitment inventory (RCI-10) and the eating attitudes test (EAT-26). As hypothesised, there was a positive association between religiosity and eating disorders symptoms. Furthermore, those scoring above the EAT-26 cut-off reported significantly greater levels of religiosity. These findings suggest that heightened religiosity among young Emirati women may represent a vulnerability factor for eating disorders. Preventative initiatives in the UAE should consider focusing on religiosity.

Intestinal parasitic infections among expatriate workers in various occupations in Sharjah, United Arab Emirates.

Intestinal parasitic infections are prevalent throughout many countries. This study aimed to determine the prevalence of intestinal parasite carriers among 21,347 expatriate workers, including food handlers and housemaids attending the public health center laboratory in Sharjah, UAE. Stool sample collection was performed throughout the period between January and December 2013. All samples were examined microscopically. Demographic data were also obtained and analyzed. Intestinal parasites were found in 3.3% (708/21,347) of the studied samples (single and multiple infections). Among positive samples, six hundred and eighty-three samples (96.5%) were positive for a single parasite: Giardia lamblia (257; 36.3%) and Entamoeba histolytica/Entamoeba dispar (220; 31.1%), respectively, whereas mono-infections with helminths accounted for 206 (29.1%) of the samples. Infection rates with single worms were: Ascaris lumbricoides (84; 11.9%), Hookworm (34; 4.8%), Trichuris trichiura (33; 4.7%), Taenia spp. (27; 3.81%), Strongyloides stercoralis (13; 1.8%), Hymenolepis nana (13; 1.8%), and Enterobius vermicularis (2; 0.28%), respectively. Infections were significantly associated with gender (x2 = 14.18; p = 0.002) with males as the most commonly infected with both groups of intestinal parasites (protozoa and helminths). A strong statistical association was noted correlating the parasite occurrence with certain nationalities (x2= 49.5, p <0.001). Furthermore, the study has also found a strong statistical correlation between parasite occurrence and occupation (x2= 15.60; p = 0.029). Multiple infections were not common (3.5% of the positive samples), although one individual (0.14%) had four helminth species, concurrently. These findings emphasized that food handlers with different pathogenic parasitic organisms may pose a significant health risk to the public.

The Effects of Korean Medical Service Quality and Satisfaction on Revisit Intention of the United Arab Emirates Government Sponsored Patients.

PURPOSE: The purpose of this study was to investigate medical service quality, satisfaction and to examine factors influencing hospital revisit intention of the United Arab Emirates government sponsored patients in Korea. METHODS: A total of 152 UAE government sponsored patients who visited Korean hospitals participated in the questionnaire survey from August to November 2016. Stepwise multiple regression was used to identify the factors that affected the revisit intention of the participants. RESULTS: The mean scores of medical service quality, satisfaction, and revisit intention were 5.72 out of 7, 88.88 out of 100, 4.59 out of 5, respectively. Medical service quality and satisfaction, Medical service quality and revisit intention, satisfaction and revisit intention were positively correlated. Medical service of physician, visiting routes and responsiveness of medical service quality explained about 23.8% of revisit intention. CONCLUSIONS: There are needs for physicians to communicate with patients while ensuring sufficient consultation time based on excellent medical skills and nurses to respond immediately for the patients' needs through an empathic encounter in order to improve medical service quality and patient satisfaction so that to increase the revisit intention of the United Arab Emirates government sponsored patients. Further, it is necessary for the hospitals to have support plans for providing country specialized services in consideration of the UAE culture to ensure that physicians' and nurses' competencies are not undervalued by non-medical service elements such as interpreters and meals.

Prevalence of Dental Developmental Anomalies in Patients Attending a Faculty of Dentistry in Ajman, United Arab Emirates

Objective: To determine the prevalence of dental developmental anomalies among patients visiting the dental clinics at Ajman University, United Arab Emirates. Material and Methods: This retrospective study consisted of 425 digital panoramic radiographs. The study sample included people in the United Arab Emirates who have visited the outpatient dental clinics at the Faculty of Dentistry, at Ajman University. These OPGs have been evaluated for the presence of dental anomalies such as: Macrodontia, Microdontia, Talon cusp, Taurodontism, Dilaceration, Ectopic Eruption, Supernumerary teeth or roots, Fusion, Gemination, and Concrescense. Results: 80.7% had at least 1 anomaly, with the maximum of 5 anomalies presented in 1.2% of the sample. Dilacerations were the most commonly identified anomaly (61.4%), followed by missing third molars (22.8%), and Ectopic Eruption (15.5%) where (12.9%) of this anomaly has affected the maxillary canines. Hypercementosis (10.2%) followed by Microdontia (4.6%), which was mostly seen in the Upper laterals. Taurodontism accounted for (4.1%), Macrodontia (2.3%) and Talon cusp (2.3%). Gemination, Dens Invaginatus, and Concrescence were separately present in 1.1%, each one, of the cases observed. Conclusion: Variations in data and results among different studies suggest the impact of racial, genetic and environmental factors. The high frequency of dental anomalies emphasize the need of early detection and diagnosis which can be achieved through radiographic imaging, this would aid in further awareness to minimize any means of complexity in dental problems.

Incidence and prevalence of systemic lupus erythematosus among the native Arab population in UAE.

Background and objectives There is a paucity of information about the epidemiology of systemic lupus erythematosus (SLE) amongst Arabs. The objective of this study was to determine the incidence and prevalence of SLE among the native Arab population of United Arab Emirates (UAE). Methods Patients with SLE were identified from three sources: medical records of two local tertiary hospitals (four years; 2009 to 2012), laboratory requests for serum double stranded deoxyribonucleic acid and serum anti-nuclear antibody and confirmed histopathologic diagnosis of SLE (skin and kidney biopsy specimens). All the patients identified with SLE met the criteria of the American College of Rheumatology. Incidence and prevalence were calculated using the state records of the UAE native population as the denominator. The age-adjusted incidence was calculated by direct standardization using the World Health Organization world standard population 2000-2025. Results Sixteen new cases (13 females and three males) fulfilled the American College of Rheumatology SLE criteria. The mean (±SD) age at time of diagnosis was 28.6 ± 12.4 years. The crude incidence ratio (per 100,000 population) was 3.5, 1.1, 2.1 and 2.1 in years 2009, 2010, 2011, 2012, respectively. The age-standardized incidence per 100,000 population for the four years was 8.6 (95% confidence interval 4.2-15.9). The age-standardized prevalence of SLE among the native population according to the 2012 population consensus was 103/100,000 population (95% confidence interval 84.5-124.4). Conclusion The age-adjusted incidence and prevalence among UAE Arabs is higher than has been reported among most other Caucasian populations. Furthermore, the prevalence of SLE in UAE seems much higher than other similar Arab countries in the Gulf region.

Medical Cosmopolitanism in Global Dubai: A Twenty-first-century Transnational Intracytoplasmic Sperm Injection (ICSI) Depot.

Dubai-one of the seven United Arab Emirates and the Middle East's only "global city"-is gaining a reputation as a transnational medical tourism hub. Characterized by its "medical cosmopolitanism," Dubai is now attracting medical travelers from around the world, some of whom are seeking assisted conception. Dubai is fast becoming known as a new transnational "reprohub" for intracytoplasmic sperm injection (ICSI), the variant of in vitro fertilization designed to overcome male infertility. Based on ethnographic research conducted in one of the country's most cosmopolitan clinics, this article explores the ICSI treatment quests of infertile men coming to Dubai from scores of other nations. The case of an infertile British-Moroccan man is highlighted to demonstrate why ICSI is a particularly compelling "masculine hope technology" for infertile Muslim men. Thus, Muslim men who face barriers to ICSI access in their home countries may become "reprotravelers" to Dubai, an emergent ICSI depot.

Creating a Framework for Medical Professionalism: An Initial Consensus Statement From an Arab Nation.

Background Medical professionalism has received increased worldwide attention, yet there is limited information on the applicability and utility of established Western professionalism frameworks in non-Western nations. Objective We developed a locally derived consensus definition of medical professionalism for the United Arab Emirates (UAE), which reflects the cultural and social constructs of the UAE and the Middle East. Methods We used a purposive sample of 14 physicians working in the UAE as clinical and education leaders. This expert panel used qualitative methods, including the world café, nominal group technique, the Delphi method, and an interpretive thematic analysis to develop the consensus statement. Results The expert panel defined 9 attributes of medical professionalism. There was considerable overlap with accepted Western definitions, along with important differences in 3 aspects: (1) the primacy of social justice and societal rights; (2) the role of the physician's personal faith and spirituality in guiding professional practices; and (3) societal expectations for professional attributes of physicians that extend beyond the practice of medicine. Conclusions Professionalism is a social construct influenced by cultural and religious contexts. It is imperative that definitions of professionalism used in the education of physicians in training and in the assessment of practicing physicians be formulated locally and encompass specific competencies relevant to the local, social, and cultural context for medical practice. Our goal was to develop a secular consensus statement that encompasses culture and values relevant to professionalism for the UAE and the Arab region.

Implicit out-group preference is associated with eating disorders symptoms amongst Emirati females.

Studies exploring the relationship between acculturation and eating disorders symptoms have proven equivocal. Socially desirable responding associated with the use of explicit measures may account for these mixed findings. This study explores the relationship between in-group identity, acculturation and eating disorders symptoms using both implicit and explicit assessments. Emirati female college students (N=94) completed an affective priming task (APT) designed to implicitly assess Emirati in-group evaluations. Participants also completed explicit measures, including the Westernization Survey and the Multicomponent In-group Identification Scale. Eating disorders symptoms were assessed using the Eating Attitudes Test. Only implicit in-group evaluations were correlated with eating disorders symptoms. Specifically, increases in in-group preference were associated with lower levels of eating disorders symptomatology. Furthermore, participants with an actual out-group preference had significantly higher levels of eating disorders symptomatology compared with those demonstrating an in-group preference. These findings support the acculturative stress hypothesis, and suggest that the relationship between eating disorders and acculturation may be better understood with reference to implicit rather than explicit in-group evaluations.

Prevalence and subtype distribution of Blastocystis in healthy individuals in Sharjah, United Arab Emirates.

Blastocystis is estimated to be one of the most common parasites of the intestinal tract of humans, comprising multiple subtypes (ST). Meanwhile, the distribution of Blastocystis ST in many communities and countries remains unknown. In the present work, we aimed to identify the prevalence of Blastocystis and the ST distribution in human stool samples collected from healthy expatriates from different geographical regions and residing in Sharjah, United Arabian Emirates (UAE). A total of 133 samples were screened and subtyped using partial small subunit ribosomal RNA gene sequencing. Fifty-nine (44.4%) samples were identified as positive. Among these, 39 were successfully sequenced and subtyped. The ST distribution was as follows: ST3, 58.9% (23/39); ST1, 28.2% (11/39); and ST2, 7.6% (3/39). No correlation between geographic origin and infection (χ(2)=11.006; P=0.528) nor gender and infection (χ(2)=1.264; P=0.261) was observed. The data were compared with those available for other Middle Eastern and North African neighboring countries. This study is the first to provide data concerning the prevalence of Blastocystis and the frequency of various STs in the UAE, confirming the absence of ST4 and the commonness of ST1, ST2, and ST3 in this geographical region.

Cultural and Religious Educational Needs of Overseas Nurses Working in the Kingdom of Saudi Arabia and the United Arab Emirates.

A competent transcultural health care service has been identified as essential for the delivery of safe health care in the United Arab Emirates (UAE) and the Kingdom of Saudi Arabia (KSA) and indeed internationally. Delivery of contextually informed educational programs to new employees forms an important component of achieving this requirement. Nurse educators have an essential role in identifying the cultural and religious knowledge needed by new employees and in designing programs to address these needs. The objective of this article was to explore the cultural and religious educational needs of overseas nurses working with Muslim patients in the KSA and the UAE as derived from the experience of nurses themselves. Written narratives from nurses employed to work primarily with Muslim nurses were analyzed using a qualitative descriptive methodology. In the UAE and the KSA context, and perhaps for nurses working with Muslim-Arabic patients worldwide, the culturally and religiously specific topics that need to be a component of preemployment education include the basic Islamic principles (5 daily prayers, Ramadan fasting, Zamzam water, and time management skills to accommodate religious practices within care); Kinship and Social Factors (family structure, gender-related issues, and social support system); and Basic Arabic language skills.

Potential adverse reactions to herbal medicines in patients attending a nephrology clinic in Abu Dhabi, United Arab Emirates.

OBJECTIVE: To provide data on herbal medicine (HM) use and safety in patients attending a nephrology clinic at Sheikh Khalifa Medical City (SKMC), Abu Dhabi, United Arab Emirates (UAE). METHODS: A prospective, 3-month study between June and September 2007, investigated all patients presenting to the Nephrology Clinic of the Sheikh Khalifa Medical center (SKMC) in Abu Dhabi, UAE. A structured questionnaire determined previous and current HM use, and descriptions of associated adverse reactions. Corroborating evidence was sought from the patient's medical records. Causality was assessed by consensus from an expert panel using the Naranjo algorithm. RESULTS: The HM use was widespread (468 of 688; 68%). Over two-thirds (69%) reported currently taking 3 or more herbal preparations. Patients reported using over 100 different HMs, many of them compounded mixtures; 35% could not identify a single ingredient of these mixtures, and 70% had not informed the clinic doctors that they were taking HMs. Just 2 patients had HM use recorded in their medical record. Twenty-eight HM-related adverse reactions were identified in 26 (5.6%) patients; 12 probably and 16 possibly related to HMs. Seven involved HMs alone and 21, a HM/prescription medication (PM) interaction. CONCLUSION: The use of HMs in patients with underlying kidney problems was extensive and contributed additional pathology to the underlying renal disease, either alone or in combination with PMs. The reluctance of patients to inform their healthcare providers of concurrent use highlights a need to take a thorough drug history on clinic registration.

Vertical landscraping, a big regionalism for Dubai.

Dubai's ecologic and economic complications are exacerbated by six years of accelerated expansion, a fixed top-down approach to urbanism and the construction of iconic single-phase mega-projects. With recent construction delays, project cancellations and growing landscape issues, Dubai's tower typologies have been unresponsive to changing environmental, socio-cultural and economic patterns (BBC, 2009; Gillet, 2009; Lewis, 2009). In this essay, a theory of "Big Regionalism" guides an argument for an economically and ecologically linked tower typology called the Condenser. This phased "box-to-tower" typology is part of a greater Landscape Urbanist strategy called Vertical Landscraping. Within this strategy, the Condenser's role is to densify the city, facilitating the creation of ecologic voids that order the urban region. Delineating "Big Regional" principles, the Condenser provides a time-based, global-local urban growth approach that weaves Bigness into a series of urban-regional, economic and ecological relationships, builds upon the environmental performance of the city's regional architecture and planning, promotes a continuity of Dubai's urban history, and responds to its landscape issues while condensing development. These speculations permit consideration of the overlooked opportunities embedded within Dubai's mega-projects and their long-term impact on the urban morphology.