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PubMed1987

Culture, religion, and fertility: a global view.

This study tries to assess the effects of culture and religion on fertility after accounting for a country's socioeconomic standing. Analysis of covariance models are estimated for 128 countries with time-series covering the period 1950-1975. The dependent variable is the gross reproduction rate; independent variables are the infant mortality rate, an aggregate indicator of female educational standing, and gross domestic product per person as well as categorical variables for religion and cultural region. It turns out that the European countries have generally lower fertility than could be expected from their socioeconomic standing. In the Arab countries, culture and religion tend to have strong positive effects on fertility. Across cultures, Catholicism has a fertility-increasing effect but it--like the effect of all religions except Islam--is diminishing over time. In contrast, the effect of culture (as measured by a regional variable) on the level of national fertility has been increasing at the expense of socioeconomic effects.

Birth Rate↗

PubMed1998

Coronary risk factors of angiographically assessed patients from Syria.

BACKGROUND: Predictors of coronary artery disease in an Arab population had not been defined well. METHODS: We studied 192 male patients with suspected coronary artery disease, who underwent catheterization. We defined definite coronary artery disease as > 50% stenosis in any of three vessels. The effects of age, obesity, smoking, hypertension, diabetes, and lipid fractions were assessed by means of univariate and multivariate regression analysis. RESULTS: Coronary artery disease was present in 153 men (80%) and absent from 39 men. Patients without coronary artery disease were slightly younger, thinner, smoked less, and had lower cholesterol, low-density lipoprotein cholesterol, and apolipoprotein B levels than did those who had coronary artery disease. By stepwise regression analysis, the best discriminators were body mass index (P = 0.0004), age (P = 0.0005), smoking (P = 0.014) and the apolipoprotein B:A-I ratio (P = 0.041). The strongest Pearson correlation coefficients for coronary artery disease were the ratio of total: high-density lipoprotein cholesterol levels (r = 0.26), the apolipoprotein B:A-I ratio (r = 0.26), and age (r = 0.25), all P < 0.0005. CONCLUSIONS: In this angiographically evaluated Syrian population, previously recognized, well-known risk factors appeared. Obesity, smoking, hypertension, diabetes, and elevated lipid levels are all amenable to correction. Syria should adopt the same secondary prevention strategies as those currently being practiced by non-Arab countries.

Adult↗

PubMed2004

How to improve organ donation in the MESOT countries.

There are more than 29 countries that have membership of the Middle East Society for Organ Transplantation (MESOT) with more than 600 million populations. These include all Arab countries, Iran, Turkey, Pakistan and countries of Central Asia. There are common features of organ transplantation in the Middle East Countries that include inadequate preventive medicine, uneven health infrastructure, poor awareness of the medical community and public at large of the importance of the organ donation and transplantation, high level of ethnicity and poor government support of organ transplantation. In addition, there is lack of team spirit among transplant physicians, lack of planning for organ procurement and transplant centers and lack of effective health insurance. Patients seek commercial transplantation most of the time. Patients on waiting lists for organ transplantation increase with time and there is a considerably growing gap between supply and demand of organs in the MESOT countries. Living organ donation is the most widely practiced type of donation in the Middle East and includes kidney and partial liver. Cadaver organ donation has a great potential in the Middle East. Nevertheless, this source is still not utilized properly due to the continued debate in the medical community about the concept of brain death and inadequate awareness of the public of the importance of organ donation and transplantation in many countries in this region.. There are three dominant and distinctive models for practice including the Saudi, Iranian and Pakistani models. The Saudi model includes the presence of a national organ procurement center as a governmental agency to supervise organ donation and transplantation. The Iranian model consists of renal grafts donation from the living genetically unrelated persons to the benefit of patients with end-stage renal disease. The Pakistani model is an interesting funding model for management of end-stage organ failure in the developing countries. We conclude that organ donation and transplantation are hampered with obstacles in the MESOT countries. Solutions need continuous work on many fronts. Local experiences can be implemented into new improved models that can help overcoming current obstacles.

Cadaver↗

PubMed2006

The incidence of coronary heart disease among Palestinians and Israelis in Jerusalem.

BACKGROUND: Lifestyle factors relevant to coronary risk factors differ between Palestinians and Israelis. Both have been exposed, albeit differently, to the stressors of the long-term conflict. We determined the incidence of coronary heart disease, previously unreported in Palestinians, in these Mediterranean populations and made international comparisons with the MONICA Programme. METHODS: We applied the rigorous World Health Organization MONICA protocol, which enables standardized international population-based comparisons, to determine all acute myocardial infarction events and coronary deaths among Palestinians and Israelis aged 25-74, residents of the Jerusalem district in 1997. RESULTS: We confirmed a total of 265 coronary events among 76,200 Arabs and 698 among 226,500 Jews. Rates among Arabs were substantially higher than in Jews, particularly so in women. Age-adjusted rate ratios (RRs) for coronary events were 1.58 [95% confidence interval (95% CI) 1.34-1.87] among men and 2.37 (95% CI 1.81-3.10) among women. When restricted to coronary deaths, Arab: Jewish RRs were 2.79 (95% CI 2.09-3.73) in men and 2.66 (95% CI 1.77-4.00) in women. Compared with MONICA populations in 20 countries, Arabs ranked first in total coronary event rates and first in non-fatal myocardial infarction rates, exceeded populations in Finland, Scotland, and Northern Ireland, and showed striking differences from the participating Mediterranean centres. CONCLUSIONS: Coronary risk appears to be particularly high in Palestinian Arabs. Determinants of these unexpected findings should be sought and prevention programmes initiated.

Adult↗

PubMed2005

A review of suicide behavior among Arab adolescents.

Islam prohibits to take your own life, because this way you will interfere with the work of G-d (Allah), which is clear from several places in the Quran. Concerning individual suicide or suicide attempts in various Arab countries the literature is sparse and the incidence low. In this paper we present a review of research from Israel showing that suicide epidemiology among the Arab population of children and adolescents display a low incidence, but an increase has been observed over the past decade, but still much lower than the Jewish population. We believe that there is a need for the development of prevention and intervention strategies in order to keep this incidence low.

Adolescent↗

PubMed2005

Beliefs about health and diabetes in men of different ethnic origin.

AIM: This paper reports the findings of a study exploring the health and illness beliefs of men with diabetes, who were from different cultural backgrounds and living in Sweden. BACKGROUND: No studies have been reported that have focused on the beliefs about health and illness in men with diabetes mellitus of different ethnic origin. Beliefs may affect self-care and care-seeking behaviour. METHOD: An explorative study design and purposive sampling procedure was used. Focus-group interviews were held with 35 men with diabetes and aged between 39 and 78 years. Fourteen participants were born in Arabic countries, 10 in former Yugoslavia and 11 in Sweden. FINDINGS: Important factors for health were the ability to be occupied/employed and economically independent and, especially among Arabs and former Yugoslavians, sexual functioning. Swedes focused on heredity, lifestyle and management of diabetes, while non-Swedes claimed the influence of supernatural factors and emotional stress related to the role of being an immigrant and migratory experiences as factors related to development of diabetes and having a negative influence on health. Swedes and Arabs described health as "freedom from disease" in contrast to many former Yugoslavians who described health as "wealth and the most important thing in life". Knowledge about diabetes was limited among the men studied, but Arabs showed an active information-seeking behaviour compared with Swedes and former Yugoslavians. Non-Swedish respondents, particularly Arabs, had sought help from health care professionals to a greater extent than Swedes, who were more likely to use self-care measures. CONCLUSION: Being occupied/employed and having knowledge about the body and management of diabetes are important for positive health development. There are dissimilarities in beliefs about health and diabetes that influence self-care behaviour and health care seeking. Men's cultural backgrounds and spiritual beliefs need to be considered in diabetes care.

Adult↗

PubMed2003

Cross-cultural adaptation and validation of an Arabic Health Assessment Questionnaire for use in rheumatoid arthritis patients.

OBJECTIVE: To test the reliability and validity of a modified and translated version of the original Health Assessment Questionnaire (HAQ) on patients with rheumatoid arthritis (RA). METHOD: A cohort of 184 RA patients from different Arabic countries (Egypt, Saudi Arabia, Sudan, Syria, Bahrain, Kuwait and Morocco) were recruited and asked to participate in the study. Two questions had been changed to suit the Arabic culture and to tackle some aspects that are commoner to be performed in the Arabic culture. After modification, translation and retranslation of the questionnaire, it was administered to the selected patients and tested for internal consistency, reliability and construct validity by correlating the yield of the questionnaire with other disease activity parameters. The questionnaire was administered again after a 1-week interval for evaluation of the reliability of this test. The modified questions were tested for their loyalty to the principal component and comparing their correlation with that of the other unchanged items. RESULTS: Test-retest showed strong reliability with a high percentage of agreement and high values for Kappa. Internal consistency showed a high value for standardized alpha (Cronbach's): 0.979 that did not show any significant change if any of the 20 items had been eliminated. The modified questionnaire had shown a strong validity when correlating its results with other disease activity parameters. This correlation was the strongest with tender joint count (TJC), Ritchie articular index (RAI), morning stiffness (MS) and visual analogue scale (VAS) and the least (but still significant) with rheumatoid factor (RF). CONCLUSION: The Arabic HAQ is a reliable and valid instrument that can be self-administered to Arabic RA patients to evaluate their functional disability. Its measurement properties were comparable to versions in other languages.

Activities of Daily Living↗

PubMed2001

Beard dermatitis due to para-phenylenediamine use in Arabic men.

The most common active ingredient in hair coloring is para-phenylenediamine (PPDA), which can produce contact dermatitis, particularly in persons who dye their scalp hair and in hairdressers. We have identified another group of patients also at risk, namely men from Arab countries, who commonly grow beards and dye them. We searched the computerized patient database at the Mayo Clinic for patients with beard dermatitis associated with dye use. Eight Arabic men presented to the Mayo Clinic between 1994 and 1999 with beard dermatitis and a positive patch test to PPDA. The lesions were described as pruritic, erythematous, papular eruptions that developed in the jaw area after each application of beard dye. The symptoms subsided after the patients discontinued use of the PPDA-containing dye and received treatment with topical corticosteroids. Allergic contact dermatitis in the beard area due to PPDA occurs in Arabic men as a result of their propensity to dye their beards.

Arabs↗

PubMed2004

Development and validation of an Arabic rheumatoid hand disability scale.

PURPOSE: To develop a rheumatoid hand disability scale in the Arabic language adapted for local sociocultural specificities and to test its psychometric properties. METHODS: The choice of hand activities was based on several published indices. The selected items were translated by the forward and backward translation procedures, several modifications were made, and after some questions were added, a provisional scale was obtained. In- and outpatients with rheumatoid arthritis (RA) according to the ACR criteria were chosen to answer the provisional scale and to assess the final scale. Impairment outcome measures (pain as measured on a visual analogue scale, morning stiffness, hand swelling, tenderness), and assessment of disability (on Lee's and Revel's functional indices) were also recorded. The intraclass correlation coefficient and the Bland and Altman methods were used to assess reliability. Construct (convergent and divergent) validity was investigated with use of Spearman's rank correlation, and a factor analysis was performed. RESULTS: The provisional scale had 21 questions. The adaptation process left 10 questions about hand activity, with four levels of answers. Eighty patients with RA were recruited for the validation of the final scale. The intra- and interrater reliabilities of the scale were 0.96 and 0.94, respectively. Analysis by the Bland and Altman method showed no systematic trend. The scale had good construct validity, with expected convergence with Lee's functional index (r(s)=0.79) and Revel's functional index (r(s)=0.81) and divergence with age (r(s)=0.05), morning stiffness (r(s)=0.40), pain (r(s)=0.32), and tenderness (r(s)= -0.48). The factorial structure of the scale was satisfying, with two factors explaining 73% of the variance. CONCLUSION: We developed an Arabic index that assesses hand disability due to RA and suits Tunisian people. Further studies are needed to confirm the validity of the scale in other Arabic countries.

Adolescent↗

PubMed2006

Construction of the perceived parental acculturation behaviors scale.

This article reports preliminary development of the Perceived Parental Acculturation Behaviors Scale (PPABS) based on a sample of 44 college students whose parents immigrated to America from Arab countries. The PPABS proposes two independent scales, whose contents characterize the respondents' perceptions of how much their parents evidence (a) openness to the American culture and (b) preservation of Arab culture.

Acculturation↗

PubMed2006

[One hundred and forty years of Turkish civilian and Turkish military hospital in Sarajevo].

This year BIH health celebrates two anniversaries: One hundred and forty years of Turkish civilian and Turkish military hospital in Sarajevo. During Ottoman period in Bosnian pasha region, Oman authorities have founded several military (in each bigger center it has been established military hospital of the Turkish Army) and five civil hospitals, mostly financed from vakuf (Islamic charity) funds. However, first hospital institution in BIH was located in Hadzi Sinan tekija at Mihrivode in Sarajevo, where was located special room for treatment, of mostly physiological patients, using zikr (spiritual ritual). By second half of 19th century civil populations were cured in homes, and wealthy citizens had their own private physicians who used to come with purpose or temporary from Dalmatian or neighboring countries bringing with them appropriate medications. By establishment of mentioned hospitals, other populations were treated by barbers, ranar (specialist for wounds), travar (person who treats patients with grass), and attars who had attar shops with medications purchased from Osman imperia or neighboring western countries. Drugs were prescribed to patients from Ijekarusa (drug prescription book), who were copied from generations and religion books, religion authorities of all confessions or from originals and copies of Arabic medical books which were brought by individuals going to Arabic countries (Mecca, Istanbul, Cairo, etc.). Mentioned hospitals, founded during Osman period (Sarajevo, Tuzla, Mostar, Travnik, Bihac) had key role in the history of BIH health, and they were basis for latter established regional and municipality hospitals founded in the Austria-Hungarian period. In the paper are described Turkish military and Turkish civil hospital established in June 1866 and in October 1866.

Bosnia and Herzegovina↗

PubMed2004

From the biomedical model to the Islamic alternative: a brief overview of medical practices in the contemporary Arab world.

Following its climax in the 8th century under the Abbasids of Baghdad, the Arab world entered a prolonged period of division and decadence. "Western" medicine was introduced in the 19th century with the support of the general population. The historical participation of Arabs in the elaboration of that "Western" biomedical model and its apparently consensual re-introduction into the Arab world diffused any sense of cognitive alienation vis-à-vis practices promoted initially by non-Arab doctors. In the late 1960s, Islamist thinkers started proposing "Islamic medicine" as an alternative to the encroachment of the "Western" biomedical model within Arab and Muslim nations. In Islamic medicine, disease is attributed to lack of attention to the spiritual dimension of human beings, yet intermediate causal pathways are not provided. Alongside "orthodox" concepts, Islamic medicine promotes some herbal remedies, in addition to faith-healing through prayer and the recitation of holy verses. While most of those practices may be beneficial, they may cause some harm to patients if they entail delaying or denying timely recourse to "orthodox" medical care. There are currently no Islamic medicine training programs in any Arab country, and Islamic medicine has not emerged as a comprehensive health alternative comparable to other non-Western health models.

Arab World↗

PubMed1995

Relevance of cholesterol screening in the United Arab Emirates. A preliminary study.

The incidence of ischemic heart disease is rising rapidly in many of the affluent Arab countries and it is known that hypercholesterolemia is a well established risk factor for coronary artery disease. This community-based study was undertaken to determine if elevated cholesterol is a problem in the United Arab Emirates in order to be able to evaluate the contribution of cholesterol as a risk factor for atherosclerosis in this environment. Volunteers were recruited at busy urban public sites. Data on age, sex, nationality, weight, blood pressure and smoking history were collected, and blood samples were taken for estimation of total cholesterol, hemoglobin and individual blood group. A raw data set was developed, with calculation of body mass index and subsequent statistical analysis carried out on a PC using the SPSS programme. In the 834 patients, there were 19 nationalities represented which were pooled into 7 groups (5 Arab and 2 non Arab) according to their ethnic origins. The prevalence of hypercholesterolemia varied from 47.2-53% in the Arab Nationals and from 22.7 to 44.5% in the non Arabs. The mean cholesterol levels of the Arab subgroups were similar and showed no difference, statistically. However, they were significantly higher than non Arabs, i.e. Indians (p < 0.001) and Iranians (p < 0.001). Similarly, within the Arab subgroups, the median cholesterol levels were no different but were higher than the non Arabs, i.e. Indians (p < 0.05) and Iranians (p < 0.001). No statistical difference was found in the distribution of cholesterol (high, borderline high or desirable levels) among the seven ethnic groups. Hypercholesterolemia appears to be a problem in most nationalities living within the UAE. Overall, it afflicts nearly 50% of the adult population. Although the ethnic Arab groupings have a wide range of socioeconomic attributes, the similarity of the distribution of cholesterol may point to an underlying innate genetic etiology or an environmental cause such as dietary overindulgence, or both. Urgent public health measures such as education, case finding and further screening programs are required.

Adult↗

PubMedDate not supplied

[Imbalance of distribution of physicians in the Arab world].

The Arab world, as a whole, now has 8.5 medical doctors per 10,000 population. This average covers a great diversity of national situations; for example 0.6 doctors per 10,000 population in Somalia, and 17.5 doctors per 10,000 population in Qatar. From the viewpoint of medical staffing, the Arab countries can be grouped into four categories: (i) Countries with low medical density: their national staff is scarce, they do not have a long academic tradition, and they have to rely on foreign physicians (Yemen, Djibouti, Somalia, Mauritania). (ii) Countries with acceptable medical density: they have strengthened their medical training system during the last decades, their production of medical graduates is now fairly high, and there is seemingly a threat of oversupply (Algeria, Tunisia, Syria, Iraq). (iii) Countries with relatively high medical density: their medical staffing is below that of developed countries, but their economic possibilities are reduced, which leads to an oversupply; these countries are exporters of medical manpower (Egypt, Jordan). (iv) Countries that import medical manpower although their own medical density is quite high: their medical training is recent or non-existent and their health system relies to a great extent on foreign doctors (Saudi Arabia, Bahrain, Qatar, United Arab Emirates, Libya, Kuwait). They are all oil producers. In brief, a shortage and an oversupply of medical doctors coexist in the Arab world, and concerted action is required.

Africa, Northern↗

PubMedDate not supplied

Ayurveda during Abbasid's period.

This is a historical paper which deals with a brief account of Abbasid's period. In this article the existence of Ayurveda in Arab countries, arrival of Ayurvedic physicians to Baghdad, their eminence, authenticity and literary additions in medical field has been studied and presented.

Arab World↗

PubMed2006

CTGA: the database for genetic disorders in Arab populations.

The Arabs comprise a genetically heterogeneous group that resulted from the admixture of different populations throughout history. They share many common characteristics responsible for a considerable proportion of perinatal and neonatal mortalities. To this end, the Centre for Arab Genomic Studies (CAGS) launched a pilot project to construct the 'Catalogue of Transmission Genetics in Arabs' (CTGA) database for genetic disorders in Arabs. Information in CTGA is drawn from published research and mined hospital records. The database offers web-based basic and advanced search approaches. In either case, the final search result is a detailed HTML record that includes text-, URL- and graphic-based fields. At present, CTGA hosts entries for 692 phenotypes and 235 related genes described in Arab individuals. Of these, 213 phenotypic descriptions and 22 related genes were observed in the Arab population of the United Arab Emirates (UAE). These results emphasize the role of CTGA as an essential tool to promote scientific research on genetic disorders in the region. The priority of CTGA is to provide timely information on the occurrence of genetic disorders in Arab individuals. It is anticipated that data from Arab countries other than the UAE will be exhaustively searched and incorporated in CTGA (http://www.cags.org.ae).

Arabs↗

PubMed2000

Culturally sensitive social work practice with Arab clients in mental health settings.

Several culturally specific practical considerations should inform social work interventions with ethnic Arab peoples in Arab countries or in Western nations. These include taking into account gender relations, individuals' places in their families and communities, patterns of mental health services use, and, for practice in Western nations, the client's level of acculturation. Such aspects provide the basis for specific guidelines in working with ethnic Arab mental health clients. These include an emphasis on short-term, directive treatment; communication patterns that are passive and informal; patients' understanding of external loci of control and their use of ethnospecific idioms of distress; and, where appropriate, the integration of modern and traditional healing systems.

Acculturation↗

PubMed2006

Death obsession in Palestinians.

The authors explored death obsession level and correlates among a sample (N = 601) of Palestinians living in the city of Beit Jala, the village of Al-Khader, and the Aida refugee camp in the Bethlehem area. They live in war conditions; the houses of half of them have been demolished. The Death Obsession Scale (DOS) was administered. Its alpha reliability was .92, denoting high internal consistency. Among women, it yielded 1 factor, (General Death Obsession), whereas among men it yielded 3 factors: Death Rumination, Death Dominance, and Death Idea Repetition. Palestinian men and women attained significantly lower DOS mean scores than participants from 4 Arab countries: Egypt, Kuwait, Syria, and Lebanon in 7 out of 8 comparisons. However, Palestinian women had significantly higher DOS mean score than their Spanish, American and British counterparts, whereas Palestinian men had significantly higher mean DOS score than Spanish peers. The low DOS scores of Palestinians, in proportion to other Arab samples, may reflect their adaptation to strife and violence.

Anxiety↗