Comparison of Ocular Monochromatic Higher-order Aberrations in Normal Refractive Surgery Candidates of Arab and South Asian Origin.

PURPOSE: To compare the ocular monochromatic higher-order aberration. (HOA) profile in normal refractive surgery candidates of Arab and South Asian origin. METHODS: This cross-sectional, observational, comparative study was performed in the cornea department of a specialty hospital. Normal refractive surgery candidates with no ocular morbidity except refractive error were recruited. Refractive surgery candidates underwent a preoperative evaluation, including wavefront aberrometry with the iDesign aberrometer (AMO, Inc., Santa Ana, California, United States). The HOA from right eyes were analyzed for HOA signed, absolute, and polar Zernike coefficients. RESULTS: Two hundred Arab participants (group 1) and 200 participants of South-Asian origin (group 2) comprised the study sample. The age and refractive status were comparable between groups. The mean of the HOA root mean square (RMS) was 0.36 ± 17 µ and 0.38 ± 18 µ for Arab and South-Asian eyes, respectively (P < 0.05, rank sum test [RST]). Of the 22 higher order signed Zernike modes, only Z3 (-3), Z3 (-1),3 (1), Z4 (-4), Z4 (-2), Z4 (0), Z4 (4), and Z5 (-5) were significantly different from zero (one sample t-test, P < 0.002, with a Bonferroni correction of 0.05/22). All the signed and absolute Zernike terms were comparable between groups (RST, P > 0.002 [0.05/22]). The polar coefficients for coma, trefoil, spherical aberration, and tetrafoil were comparable between groups (P > 0.05, RST). Combined RMS values of third, fourth, fifth, and sixth order also were comparable between groups (P > 0.05, RST). CONCLUSIONS: Preoperative whole eye HOA were similar for refractive surgery candidates of Arab and South-Asian origin. The values were comparable to historical data for Caucasian eyes and were lower than Asian (Chinese) eyes. These findings may aid in refining refractive nomograms for wavefront ablations.

Women's knowledge about heart disease: Differences among ethnic and cultural groups in the Israeli Women's Health in Midlife Study.

The current investigation aimed to assess levels of knowledge about risk factors for heart disease among midlife Israeli women, and to evaluate the relationship of knowledge to personal risk factors and vulnerability to heart disease. Face-to-face interviews with women aged 45-64 years were conducted during 2004-2006 within three population groups: long-term Jewish residents (LTR), immigrants from the former Soviet Union, and Arab women. The survey instrument included six knowledge statements relating to: the risk after menopause, family history, elevated cholesterol level, diabetes, obesity, and warning signs of a heart attack. The findings showed wide disparities in knowledge by educational level and between immigrants and LTR, after taking into account personal risk factors and education. Personal risk factors were not significantly related to the knowledge items, except for personal history of cardiovascular disease, which was associated with knowledge about "warning signs of a heart attack" and "family history." Women who perceived themselves as more vulnerable to heart disease were more likely to identify several risk factors correctly. These findings stress the need to increase knowledge about heart disease, especially among less educated and minority women, and to emphasize the risk of patients' personal status by health providers.

Arab youth involvement in delinquency and political violence and parental control: The mediating role of religiosity.

This study examines the involvement of Arab youth at risk from East Jerusalem in delinquent behaviors, such as crimes against a person, public disorder offenses, and political violence. The contribution of religiosity and parental control factors in explaining these different types of youth involvement in illegal behaviors is assessed. A total of 161 young males, aged 15-21, participated in the study. We found that the greater the parental control and the more religious the adolescent, the less likely they are to engage in delinquent behaviors and political violence. The relationship between parental control and youth involvement in delinquency and political violence was mediated by youth level of religiosity, after controlling for age and family socioeconomic status. (PsycINFO Database Record

Iraqi, Syrian, and Palestinian Refugee Adolescents' Beliefs About Parental Authority Legitimacy and Its Correlates.

This study examined intra- and interindividual variations in parental legitimacy beliefs in a sample of 883 Arab refugee adolescents (M(age) = 15.01 years, SD = 1.60), 277 Iraqis, 275 Syrians, and 331 Palestinians in Amman, Jordan. Confirmatory factor analyses showed distinct latent factors for moral-conventional, prudential, and personal legitimacy items. Older adolescents rated legitimacy lower for personal issues, but higher for prudential issues. Beliefs were associated with socioeconomic status (fathers' education, family size), particularly for personal issues, but were more pervasively associated with displacement-related experiences. Greater war trauma was associated with less prudential legitimacy for all youth and more authority legitimacy over moral-conventional issues for Syrian youth. Greater hopefulness was associated with more authority legitimacy over all but personal issues.

POST TRAUMATIC STRESS DISORDER (PTSD) IN ARAB AMERICAN REFUGEE AND RECENT IMMIGRANT WOMEN.

Routine male circumcision (RMC) has been found effective in preventing HIV infection in Africa; at the same time, incidence of HIV infection has been rising in China. Hence, RMC may be a possible means by which Chinese nationals could address increasing HIV infection rates. A focus group study was conducted to explore perceptions of RMC among mainland Chinese nationals. The results indicated that 1) 90% of participants considered RMC to be an unfamiliar and culturally sensitive topic; 2) 80% felt that being uncircumcised had not created significant health drawbacks for them or males they knew; and 3) the group believed that RMC would not be a good strategy to address rising HIV rates and were dubious about the idea of mandated RMC in China. For Chinese nationals, cultural traditions regarding RMC appear to outweigh concerns about HIV infection.

ACCULTURATION AS A PREDICTOR OF HEALTH PROMOTING AND LIFESTYLE PRACTICES OF ARAB AMERICANS: A DESCRIPTIVE STUDY.

A cross-sectional descriptive study was done using the Acculturation Rating scale of Arab Americans-II, and the Health Promotion and Lifestyle Profile II to assess the relationship between acculturation and health promotion practices among Arab Americans. Findings showed that attraction to American culture was the most important predictor of physical activity; whereas attraction to Arabic culture was the most important predictor of stress management and nutritional practices. Results suggest that, when demographics are controlled, acculturation predicts various health promotion practices in different patterns among members of this group. These findings contribute to a better understanding of acculturation's influence on immigrants' health promotion practices.

Time for an Adolescent Health Surveillance System in Saudi Arabia: Findings From "Jeeluna".

PURPOSE: With the increasing burden of noncommunicable disease, adolescence is viewed as an opportune time to prevent the onset of certain behaviors and promote healthy states. Although adolescents comprise a considerable portion of Saudi Arabia's population, they have received insufficient attention and indicators of their health status, as a first step in a prevention cycle are unavailable. This study was carried out with the aim of identifying the health risk behaviors and health status of adolescents in Saudi Arabia. METHODS: This cross-sectional, school-based study was carried out in all 13 regions of Saudi Arabia. Through multistage, cluster, random sampling, intermediate, and secondary school students were invited to participate. Data were collected by means of a self-administered questionnaire addressing health risk behaviors and health status, clinical anthropometric measurements, and laboratory investigations. RESULTS: A total of 12,575 adolescents participated. Various health risk behaviors, including dietary and sedentary behaviors, lack of safety measures, tobacco use, bullying, and violence were highly prevalent. Twenty-eight percent of adolescents reported having a chronic health condition, 14.3% reported having symptoms suggestive of depression, 30.0% were overweight/obese, and 95.6% were vitamin D deficient. CONCLUSION: Behaviors and conditions known to persist into adulthood and result in morbidity and premature mortality are prevalent among adolescents in Saudi Arabia. Preventive measures and local health policies are urgently needed and can impact adolescents and future adults. Establishing adolescent health surveillance is necessary to monitor trends and impacts of such measures.

Arab-American Hookah Smokers: Initiation, and Pros and Cons of Hookah Use.

OBJECTIVES: To examine initiation, pros and cons of hookah tobacco smoking among Arab Americans. METHODS: In this descriptive cross-sectional study, we recruited a community-based convenience sample of 458 adult Arab-American hookah smokers, mean age 28.4 years, who completed self-administered questionnaires. RESULTS: Irrespective of sex, most participants initiated hookah tobacco use by young adulthood in private homes or hookah lounges influenced by friends and family. Women initiated hookah use later than men. Ever dual smokers (hookah smokers who ever smoked a cigarette) initiated hookah use later than cigarettes; however, early hookah initiators < 18 years initiated hookah and cigarettes concurrently. Participants enjoyed the flavors of hookah tobacco, and complained about coughing, dizziness, and headaches. CONCLUSIONS: Early and late initiation of hookah tobacco use warrant prevention programs targeting the youth and older adults in communities, colleges, and middle and high schools that include health education campaigns, and encouragement of voluntary smokefree home rules. Tobacco control policies aimed to prevent initiation of hookah use should include regulation of hookah tobacco flavors, and should target the physical environments in neighborhoods, especially around schools and colleges, to reduce the proliferation of hookah lounges. Dual hookah tobacco and cigarette use warrant continuous monitoring.

HLA Class I and Class II Alleles and Haplotypes Confirm the Berber Origin of the Present Day Tunisian Population.

In view of its distinct geographical location and relatively small area, Tunisia witnessed the presence of many civilizations and ethnic groups throughout history, thereby questioning the origin of present-day Tunisian population. We investigated HLA class I and class II gene profiles in Tunisians, and compared this profile with those of Mediterranean and Sub-Sahara African populations. A total of 376 unrelated Tunisian individuals of both genders were genotyped for HLA class I (A, B) and class II (DRB1, DQB1), using reverse dot-blot hybridization (PCR-SSO) method. Statistical analysis was performed using Arlequin software. Phylogenetic trees were constructed by DISPAN software, and correspondence analysis was carried out by VISTA software. One hundred fifty-three HLA alleles were identified in the studied sample, which comprised 41, 50, 40 and 22 alleles at HLA-A,-B,-DRB1 and -DQB1 loci, respectively. The most frequent alleles were HLA-A*02:01 (16.76%), HLA-B*44:02/03 (17.82%), HLA-DRB1*07:01 (19.02%), and HLA-DQB1*03:01 (17.95%). Four-locus haplotype analysis identified HLA-A*02:01-B*50:01-DRB1*07:01-DQB1*02:02 (2.2%) as the common haplotype in Tunisians. Compared to other nearby populations, Tunisians appear to be genetically related to Western Mediterranean population, in particular North Africans and Berbers. In conclusion, HLA genotype results indicate that Tunisians are related to present-day North Africans, Berbers and to Iberians, but not to Eastern Arabs (Palestinians, Jordanians and Lebanese). This suggests that the genetic contribution of Arab invasion of 7th-11th century A.D. had little impact of the North African gene pool.

"On the Sidelines": Access to Autism-Related Services in the West Bank.

We examined access to autism-related services among Palestinians (N = 24) raising children with autism spectrum disorder (ASD) in the West Bank. Using qualitative methods, we identified five primary interview themes. Poor screening, diagnostic, and psychoeducational practices were prevalent, as parents reported service providers minimized parental concerns and communicated ineffectively with the caregivers regarding treatment options. Geographic barriers and financial burdens prevented many families from seeking or maintaining services. Limited service availability was a dominant barrier: parents reported limited or denied access to education, community-based services, and ASD-specific interventions. Consequently, several families noted their children did not receive any services whatsoever. Research, practices and policies to address the shortage of services for children with ASD are urgently needed in the West Bank.

Comparative Evaluation of the Corneal and Anterior Chamber Parameters Derived From Scheimpflug Imaging in Arab and South Asian Normal Eyes.

PURPOSE: To evaluate the differences in the normal corneal and anterior segment Scheimpflug parameters in Arab and South Asian eyes. METHODS: This hospital-based study was performed at a cornea and refractive surgery service in Abu Dhabi. A total of 600 consecutive normal candidates of South Asian (group 1, n = 300) and Arab (group 2, n = 300) origins underwent Scheimpflug imaging (Sirius; Costruzione Strumenti Oftalmici, Italy). One eye was randomly selected for evaluation. RESULTS: The age and sex distributions in both groups were comparable. The pachymetric variables were statistically higher in group 2 (group 2 vs. group 1, 544.3 ± 32.2 µm vs. 535.1 ± 31.4 µm for central corneal thickness, 541.0 ± 32.6 µm vs. 531.9 ± 31.5 µm for minimum corneal thickness, 571.7 ± 43.2 µm vs. 558.1 ± 42.3 µm for apical thickness, and 58.1 ± 4.2 vs. 57.3 ± 4.3 mm³ for the corneal volume; P < 0.05). The anterior chamber volume (group 2 vs. group 1: 166.4 ± 16.4 vs. 161.6 ± 20.5 mm³) and angle (group 2 vs. group 1: 44.6 ± 6.2 vs. 43.5 ± 5.8 degrees) were also higher for group 2 (P < 0.05). Central corneal curvature and apical corneal curvature (apex K) were higher in group 1 (P < 0.05) with comparable astigmatism. The flat keratometry (K), steep K, and apex K were 43.6 ± 2.2 diopters (D), 44.9 ± 1.8 D, and 45.7 ± 1.8 D for group 1, and 43.1 ± 2.2 D, 44.5 ± 2 D, and 45.2 ± 1.9 D for group 2. The effect size (Cohen d) for significant parameters ranged from 0.2 to 0.3. CONCLUSIONS: Normal eyes of Arab ethnicity tend to have statistically thicker and flatter corneas and less-crowded anterior segments than those of the South Asian counterparts. These epidemiological differences have a mild to moderate biological effect size (Cohen d), but they should be considered when evaluating these eyes for anterior segment or corneal procedures.

Expectations About Ethnic Peer Group Inclusivity: The Role of Shared Interests, Group Norms, and Stereotypes.

This study investigated three factors that contribute to social exclusion: group norms, individual characteristics, and stereotypes. Non-Arab American 12- and 16-year-olds (N = 199) judged their expectations about the inclusivity of Arab American and non-Arab American peer groups toward new peers characterized by: (a) different ethnic identity but similar interests (e.g., hobbies) and (b) same ethnic identity but different interests. Participants expected that when groups had exclusive norms, Arab American peers would base inclusion decisions on ethnic identity, but that their own non-Arab group would base decisions on shared interests. Participants who reported stereotypes expected their in-group to be ethnically less inclusive. With age, ethnic-based exclusion increased. The findings are discussed in light of current research on developmental intergroup relationships.

Knowledge and Adherence to Medications among Palestinian Geriatrics Living with Chronic Diseases in the West Bank and East Jerusalem.

BACKGROUND: Adequate patient knowledge about medications is essential for appropriate drug taking behavior and patient adherence. This study aims to assess and quantify the level of knowledge and adherence to medications among Palestinian geriatrics living with chronic diseases and to investigate possible associated socio-demographic characteristics. METHODS AND FINDINGS: We conducted a cross-sectional study during June 2013 and January 2014 among Palestinian geriatrics ≥ 60 years old living with chronic disease in the West Bank and East Jerusalem. A stratified random sample was selected and a questionnaire-assisted interview was applied for data collection. T-test was applied for bivariate analyzing and one-way ANOVA test was applied for multivariate analyses. RESULTS: A total of 1192 Palestinian geriatrics were studied. The average age was 70.3 (SD = 8.58) years and ranged from 60-110 years. The sample comprised 659 (55.3%) females and 533 (44.7%) males. The global knowledge and global adherence scores were (67.57%) and (89.29%), respectively. Adequate levels of knowledge were 71.4%, and of adherence 75%, which were recorded for 705 (59.1%) and 1088 (91.3%) participants, respectively. Significant higher levels of global knowledge and global adherence were recorded for males, and for participants who hold a Bachelor's degree, those who live on their own, and did physical activity for more than 40 hours/week (p-value < 0.05). Furthermore, workers, participants with a higher monthly income, and non-smokers have a higher knowledge level with (p-value < 0.05). We found positive correlation between participants' global adherence and global knowledge (r = 0.487 and p-value < 0.001). Negative correlation was found between participants' global knowledge and adherence with age (r = -0.236, p-value < 0.001 and r = -0.211 and p-value < 0.001, respectively. Negative correlation between global knowledge and the number of drugs taken (r = -0.130, p-value < 0.001) was predicted. CONCLUSION: We concluded that patients with a higher level of knowledge are more adherent to their medications and that better understanding of socio-demographic factors has a clear influence on the level of knowledge and adherence to medications and thus contributes to the development of guidelines for treatment and may consequently lead to favourable clinical outcomes and savings of health care costs.

Prevalence of occupational exposure to carcinogens among workers of Arabic, Chinese and Vietnamese ancestry in Australia.

BACKGROUND: Although job-related diseases result in more deaths per year than job-related injuries, most research concerning ethnic minority workers has concerned accidents and injuries rather than disease-causing exposures such as carcinogens. METHODS: We conducted a telephone-based cross-sectional survey to estimate the prevalence of occupational exposure to carcinogens among a sample of ethnic minority workers in Australia, and compared their exposure prevalence to that of a sample of the general Australian-born working population ('Australian workers'). RESULTS: One-third of the ethnic minority workers were exposed to at least one carcinogen at work. The likelihood of exposure to carcinogens was not significantly different from that of Australian workers, although the likelihood of exposure to individual carcinogens varied by ethnicity. CONCLUSION: Knowing the prevalence of exposure to carcinogens in the workplace in different ethnic groups will allow better targeted and informed occupational health and safety measures to be implemented where necessary.

The influence of childbirth experiences on women׳s postpartum traumatic stress symptoms: A comparison between Israeli Jewish and Arab women.

BACKGROUND: childbirth is a positive experience for most women yet some women express distress after birth. Traumatic experience can sometimes cause post-traumatic stress disorder (PTSD) in relation to childbirth. Prevalence of traumatic birth experience and PTSD after childbirth differs between cultures. OBJECTIVES: to examine the subjective recall of childbirth experiences and PTSD symptoms of Israeli Jewish and Arab women; to examine comparatively the prevalence of PTSD symptoms six to eight weeks after childbirth and to establish the factors that predict PTSD symptoms. METHODS: a prospective study was conducted in a region characterised by wide variations in ethnocultural groups. The study was comprised of two time points: Time 1 (T1) interviews were conducted at the bedside of the women in the maternity ward of each hospital 24-48 hours after childbirth. Time 2 (T2), all 171 women participating in T1 were interviewed by phone six to eight weeks after childbirth. FINDINGS: 34 women (19.9%) reported their labour as traumatic 24-48 hours after birth (T1), and six to eight weeks later (T2) 67 women (39.2%) assessed their experience as traumatic. More Arab women (69.6%) than Jewish women (56.5%) had a positive memory of childbirth, but this difference only approached statistical significance (p=.09). Results showed rather low frequencies of PTSD symptoms, and no ethnic difference. PTSD symptoms were significantly and positively predicted by subjective recollection of childbirth experience (Time 2). PTSD symptoms were higher for women who did not have a vaginal birth, and more women with PTSD symptoms were not breast feeding. CONCLUSIONS: we found more similarities than differences between Arab and Jewish women׳s experience of their births and no differences between them on the prevalence of PTSD symptoms after birth. The results suggest that non-vaginal birth (instrumental or caesarean section) and negative recollection of the childbirth experience are important factors related to the development of PTSD symptoms after birth, and that women with PTSD symptoms are less likely to breast feed.

Explaining the frequency of alcohol consumption in a conflict zone: Jews and Palestinians in Israel.

Experiencing stress and exposure to terrorism may have an adverse effect on health risk behaviors. Few studies have examined alcohol use among adults living in Israel under chronic, stressful terrorism-related conditions. In this study, we examined the relationships of demographics, past stressful events, and terrorism exposure to the frequency of alcohol use and the mediating roles of depressive and post-traumatic stress disorder (PTSD) symptoms. We used three waves of data from a 2007-2008 nationally representative sample of Jewish and Palestinian adults in Israel. We assessed past stressful events, in addition to direct and indirect exposures to terrorism. Results indicated that past stressful events and exposure to terrorism were not directly associated with alcohol use, but were indirectly associated and mediated by depressive and PTSD symptomology. Mental health symptoms were differentially associated with alcohol use. More frequent drinking was mediated by higher levels of depression, including for women and Palestinians; however, PTSD symptom severity was related to less frequent drinking. Mental health may play a prominent role in the frequency of alcohol use among adults exposed to terrorism in Israel. Alcohol use, as a coping mechanism, may differ by demographic characteristics (gender and ethnicity) and psychological symptomology for adults living in a conflict zone in Israel.

Arab Adolescents: Health, Gender, and Social Context.

This article reviews the evidence about adolescent health in the Arab world, against the background of social, economic, and political change in the region, and with a particular focus on gender. For the literature review, searches were conducted for relevant articles, and data were drawn from national population- and school-based surveys and from the Global Burden of Disease project. In some parts of the Arab world, adolescents experience a greater burden of ill health due to overweight/obesity, transport injuries, cardiovascular and metabolic conditions, and mental health disorders than those in other regions of the world. Poor diets, insufficient physical activity, tobacco use, road traffic injuries, and exposure to violence are major risk factors. Young men have higher risks of unsafe driving and tobacco use and young women have greater ill-health due to depression. Several features of the social context that affect adolescent health are discussed, including changing life trajectories and gender roles, the mismatch between education and job opportunities, and armed conflict and interpersonal violence. Policy makers need to address risk factors behind noncommunicable disease among adolescents in the Arab region, including tobacco use, unhealthy diets, sedentary lifestyles, unsafe driving, and exposure to violence. More broadly, adolescents need economic opportunity, safe communities, and a chance to have a voice in their future.

Alzheimer's disease and the elderly in Israel: are we paying enough attention to the topic in the Arab population?

With the continuing rise in the elderly population, Alzheimer's disease (AD) and dementia represent an increasing public health concern worldwide. In recent years, research has focused on the relationship between AD and ethnicity. Israel, a multiethnic society, provides a natural laboratory for research on ethnicity and health. The largest ethnic group is that of Israeli Jews, followed by Arab citizens, mostly Arab Muslims, with smaller numbers of Arab Christians in addition to Druze, Circassians, and others. The aim of this review is to clarify ethnic differences in prevalence and risk factors for Alzheimer's disease. We review available literature on ethnic differences in epidemiologic and risk factors for Alzheimer's disease, including genetic differences as well as disparities in health access and quality of health services. We will conclude with research and policy implications.

Autopsy translates in Arabic to al-tashreeh. Could this term influence its acceptability?

It is not unusual for laypersons to object on the conduct of an autopsy of a loved one for fear of disfigurement or burial delays. In this paper, we discuss a new possible reason for objection among Arabic speaking communities related to the language. The Arabic word for autopsy is "al-tashreeh" which, when examining its other linguistic uses, might result in wrong inferences among laypersons.