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Purpose: To develop age-specific reference intervals for physical performance test outcomes relevant to male youth Middle Eastern football players. Methods: We analyzed mixed-longitudinal data (observations range: 1751–1943 assessments) from a sample of 441 male youth outfield football players (chronological age range: 11.7–18.4 y) as part of the Qatar Football Association and Aspire Academy development program over 14 competitive seasons. Semiparametric generalized additive models for location, scale, and shape estimated age-specific reference centiles for 10-m sprinting, 40-m sprinting, countermovement jump height, and maximal aerobic speed variables. Results: The estimated reference intervals indicated that the distribution of the physical performance test scores increased monotonically and nonlinearly with advancing chronological age for sprinting and countermovement jump outcome measures, reaching a plateau after 16 years common to each of these performance variables. The maximal aerobic speed median score increased substantially until ∼14.5 years, with the nonlinear trend flattening off toward relatively older chronological ages. Conclusions: We developed age-related reference intervals for physical performance test outcomes relevant to youth Qatari football players. Country-wide age-specific reference intervals can assist in the longitudinal tracking of the individual players' progress over time against benchmark values derived from the reference population. [ABSTRACT FROM AUTHOR]

The prevalence rates and correlates of mental or physical disability among recently resettled refugees, who undergo strenuous journeys before arriving in the US, remain unknown, masking potential health disparities. Self-reported disability was measured by the 2018 Annual Survey of Refugees (ASR), and defined as having a physical, mental, or other health condition for more than 6 months that precluded one from working. Prevalence rates of self-reported disability and sample correlates were investigated using descriptive and logistic regression analyses. Of N = 4259 participating refugees in ASR (Mean Age = 28.2, SD = 17.2; 52.5% male), 2875 responded to the disability question and 21.4% reported disability. About 33.7% were born in the Middle East region, 29.5% had no formal education, and 35% had an income of less than $15,000. Age (OR = 1.06, 95% Confidence Interval (CI) [1.06,1.07], p < 0.001), region of birth (OR = 1.82, 95% CI [1.31, 2.51], p < 0.001), employment status (OR = 3.31, 95% CI [2.67, 4.11], p < 0.001), and receiving food stamps (OR = 2.09, 95% CI [1.66, 2.62], p < 0.001) were associated with self-reported disability. Disability levels among refugees recently resettled in the United States are comparable to national disability rates in the US. Our results suggest that multiple aspects of the refugee experience (i.e., demographics, socioeconomic status, contextual migration history) need to be considered to understand the risk for health outcomes. Future investigations of disabilities in diverse refugee populations over time and tailored public health interventions to mitigate potential risk factors are warranted to promote health equity. [ABSTRACT FROM AUTHOR]

Background: Infective endocarditis (IE), a severe and economically impactful condition, lacks substantial epidemiological data in the North Africa and Middle East (NAME) region. This study focused on analyzing the trends and burden of IE in NAME from 1990 to 2019, taking into account factors like age, gender, and socio-demographic index (SDI). Methods: The Global Burden of Disease data from 1990 to 2019 was retrieved from the Institute for Health Metrics and Evaluation (IHME) website. Results: Between 1990 and 2019, the age-standardized rates (ASR) for IE incidence increased by 59%, and prevalence and years lived with disability (YLDs) rose by 12% and 9%, respectively, while the ASRs for deaths, disability-adjusted life years (DALYs), and years of life lost (YLLs) saw reductions of 22%, 34%, and 34% in the NAME region. Death rates among children under five declined by 72%. Gender and the SDI did not significantly influence these changes. Saudi Arabia witnessed the most significant increase in ASR of IE incidence since 1990, while Turkey had the highest rates in 2019. The year 2019 also saw the highest death rate among those aged 70 and over, with over 91 000 DALYs from IE. DALYs decreased by 71.5% for children under five from 1990 to 2019 but remained stable for individuals in their seventies. Jordan showed the most notable decrease in ASRs for deaths, DALYs, and YLLs among children under five. Conclusion: This study highlights the changing epidemiology of IE in the NAME region, recommending the establishment of multidisciplinary IE registries, antibiotic prophylaxis guidelines for healthcare-associated IE, and strategies to control antimicrobial resistance as key mitigation measures. [ABSTRACT FROM AUTHOR]

Background: Oral disorders are still a major global public health challenge, considering their perpetuating and chronic nature. Currently, there is no direct index to measure the quality of care on a population scale. Hence, we aim to propose a new index to measure the quality of care for oral disorders worldwide. Methods: We generated our database using the data from the Global Burden of Disease (GBD) study 2017. Among different variables such as prevalence, incidence, years lived with disability, and disability-adjusted life years, we utilised principal component analysis (PCA) to determine the component that bears the greatest proportion of information to generate the novel quality of care index (QCI) for oral disorders. Results: Global QCI for oral disorders gradually increased from 1990 to 2017 (from 70.5 to 74.6). No significant gender disparity was observed during this period, and the gender disparity ratio (GDR) was considered optimal in 1990 and 2017. Between 1990 and 2017, the age-standardised QCI for all oral disorders increased in all the SDI regions. The highest QCI for all oral disorders in 2017 belonged to high-middle SDI countries (=80.24), and the lowest YLDs rate was seen in the low SDI quintile. In 1990, the quality of care in European, Central Asian, and Central and South American countries was in the lowest quintiles, whereas the North American, East Asian, Middle Eastern, and some African countries had the highest quality of dental care. Maynmar (=100), Uganda (=92.5), Taiwan (=92.0), China (=92.5), and the United States (=89.2) were the five countries with the highest age-standardised QCI. Nicaragua (=41.3), Belgium (=40.2), Venezuela (=38.4), Sierra Leone (=30.5), and the Gambia (=30.3) were the five countries with the least age-standardised QCI values. Conclusion: The quality of care for all oral disorders showed an increasing trend on a global scale from 1990 to 2017. However, the QCI distribution was not homogenous among various regions. To prevent the exacerbation of imminent disparities in this regard, better attention to total tooth loss in high-income countries and prioritising primary healthcare provision in low-income countries are recommended for oral disorders. [ABSTRACT FROM AUTHOR]

Introduction: COVID-19 has had an important effect on nursing students, with some having their clinical practice cancelled or suspended and others suffering from the virus. Objective: The purpose of this study was to assess the psychological status in terms of stress, anxiety, and depression of nursing students during COVID-19 pandemic. Methods: The study was cross-sectional, carried out by a convenience sample of 320 participants of nursing students between May and June 2020. Data collection was performed by "Depression Anxiety Stress-21 Scale" (DASS-21). Results: The results revealed that 78 (24.3%) of participants reported stress; 121 (37.8%) reported anxiety; and 72 (22.5%) reported depression. Also, grade and socioeconomic status had statistically significant effect on anxiety, stress, and depression. In addition, age had statistically significant effect on depression, place of residence had statistically significant effect on anxiety, and gender had statistically significant effect on stress. Conclusion: The study confirmed an alarming number of nursing students who experienced anxiety, stress, and depression. This study serves as an evidence concerning nursing students' mental health issues as a consequence of the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

Summary : Due to the high prevalence of low bone mineral density in North Africa and Middle East region, estimating its attributable burden would help to a better understanding of this neglected condition for policymakers and health researchers. This study presented the number of attributable deaths has doubled from 1990 to 2019. Purpose: This study provides the latest estimates of the burden of low bone mineral density (BMD) from 1990 to 2019 in North Africa and Middle East (NAME) region. Methods: The data were extracted from the global burden of disease (GBD) 2019 study to estimate epidemiological indices such as deaths, disability-adjusted life years (DALYs), and summary exposure value (SEV). SEV is a measure of the exposure of the population to a risk factor that considers the amount of exposure by the level of risk. Results: Our findings showed that in 1990–2019, the number of deaths and DALYs attributable to low BMD had almost doubled in the region and caused 20,371 (95% uncertainty intervals: 14,848–24,374) deaths and 805,959 (630,238–959,581) DALYs in 2019. However, DALYs and death rates showed a decreasing trend after age standardization. Saudi Arabia had the highest, and Lebanon had the lowest age-standardized DALYs rates in 2019, with rates of 434.2 (329.6–534.3) and 90.3 (70.6–112.1) per 100,000, respectively. The highest burden attributable to low BMD was in the 90–94 and over 95 age groups. Also, there was a decreasing trend in age-standardized SEV to low BMD for both sexes. Conclusion: Despite the decreasing trend of age-standardized burden indices, considerable amounts of deaths and DALYs were attributable to low BMD, especially in the elderly population, in the region in 2019. As the positive effects of proper interventions will be detectable in the long term, robust strategies and comprehensive stable policies are the ultimate solutions to achieving desired goals. [ABSTRACT FROM AUTHOR]

Background: Hypertension (HTN) is a major global public health problem. Knowledge of the risk factors and repercussions of HTN is crucial to preventing the disease. Rural populations have lower levels of knowledge of the disease than urban populations. However, no studies have assessed the levels of awareness of HTN and their determinants in rural regions of Saudi Arabia. Objectives: This study aimed to assess the awareness of HTN and its determinants among a rural population of Jazan region, Saudi Arabia. Methodology: We conducted a cross-sectional analytical study among six primary healthcare centers selected randomly from the rural areas of Jazan region. We targeted all Saudi adults visiting these centers. Information was gathered using interview questionnaires completed by 607 people. SPSS was utilized to analyze the collected data. Results: In all population groups, the prevalence of diagnosed HTN increased with age, particularly gradually increasing in those aged younger than 40 years and then rapidly and sharply increasing in those aged 40 years and over. The women (43.3%) had a higher prevalence of HTN than the men (34.6%), which is comparable with findings in other areas in Saudi Arabia and the Middle East. Approximately 65.6% of the participants without HTN and 34.4% of the participants with HTN did not know their normal blood pressure. Approximately 61.7% of the participants without HTN and 59.0% of the participants with HTN felt that pharmaceuticals are insufficient in curing HTN, while 60.7% and 64.7% believed that HTN can be cured. Conclusions: The global prevalence of HTN is increasing annually owing to rapid changes in lifestyle and dietary habits. Furthermore, because adherence to antihypertensives is poor in rural Jazan, the Ministry of Health and researchers advocate implementing a program to increase awareness and assess patient adherence to prescribed medication for the control of HTN. [ABSTRACT FROM AUTHOR]

Oral-health professionals play a critical role in the early recognition and prevention of oral cancer; however, most patients are diagnosed in the advanced stages that demonstrate poor prognosis. Therefore, this study aimed to investigate the knowledge, opinions, and clinical practices of practicing dentists related to oral cancer prevention and oral mucosal screening in Palestine. This research used an online cross-sectional questionnaire design. Practicing dentists in Palestine completed the 44-item questionnaire encompassing the following four sections: (a) personal data (6 items); (b) oral cancer knowledge (21 items); (c) opinions and beliefs related to oral cancer (10 items); and (d) clinical practices related to oral cancer (7 items). The questionnaire was sent to all eligible participants (N = 650) between July and September of 2022. The response rate was 39.1% (N = 254). About 70.1% of the respondents had poor knowledge of oral cancer and its risk factors, and almost 84.3% had positive opinions related to oral cancer prevention and oral mucosal screening. Concerning the clinical practices, only 29.9% routinely examined their patients every time their patients visited. More experienced dentists showed significantly more positive opinions and better clinical practices related to oral cancer prevention and screening; however, they had significantly lower knowledge scores compared with the younger dentists (p < 0.05). Inadequate training was the most reported perceived boundary against routine oral cancer screening. Palestinian dentists appeared to have positive opinions related to oral cancer prevention and oral mucosal screening. However, the assessment of the knowledge and clinical practices revealed deficiencies in this regard. [ABSTRACT FROM AUTHOR]

Objective: We aimed to report the burden of bulimia nervosa (BN) in the Middle East and North Africa (MENA) region by age, sex, and sociodemographic index (SDI), for the period 1990–2019. Methods: Estimates of the prevalence, incidence, and disability‐adjusted life‐years (DALYs) attributable to BN were retrieved from the Global Burden of Disease study 2019, between 1990 and 2019, for the 21 countries in the MENA region. The counts and age‐standardized rates (per 100,000) were presented, along with their corresponding 95% uncertainty intervals. Results: In 2019, the estimated regional age‐standardized point prevalence and incidence rates of BN were 168.3 (115.0–229.6) and 178.6 (117.0–255.6) per 100,000, which represented 22.0% (17.5–27.2) and 10.4% (7.1–14.7) increases, respectively, since 1990. Moreover, in 2019 the regional age‐standardized DALY rate was 35.5 (20.6–55.5) per 100,000, which was 22.2% (16.7–28.2) higher than in 1990. In 2019, Qatar (58.6 [34.3–92.5]) and Afghanistan (18.4 [10.6–29.2]) had the highest and lowest age‐standardized DALY rates, respectively. Regionally, the age‐standardized point prevalence of BN peaked in the 30–34 age group and was more prevalent among women. In addition, there was a generally positive association between SDI and the burden of BN across the measurement period. Discussion: In the MENA region, the burden of BN has increased over the last three decades. Cost‐effective preventive measures are needed in the region, especially in the high SDI countries. Public Significance: This study reports the estimated burden of BN in the MENA region and shows that its burden has increased over the last three decades. [ABSTRACT FROM AUTHOR]

Cancer, especially breast cancer, remains a public health problem because of its negative consequences, which require long-term programs to alleviate its devastating effects. This study aimed to examine unmet supportive care needs and health-related quality of life of females with breast cancer. A cross-sectional study with a mixed-method design was employed. A simple, randomly selected sample of 352 females attending Al-Rantisi and Al-Amal hospitals was included in this study. A validated Arabic version of the Supportive Care Needs Survey (34 items) and The European Organization for Research and Treatment of Cancer Quality of Life (EORTC QLQ-C15-PAL) were used. Moreover, twenty-five semi-structured interviews were performed (13 females, eight husbands, and four healthcare workers). Quantitative data were analysed using descriptive and inferential analysis, whereas thematic analysis was used for qualitative data to highlight main themes. The highest unmet need reported by females with breast cancer was psychological needs (63%), followed by health-related systems and information (62%) and physical and daily life (61%). Pain and fatigue were the most reported symptoms (65.8% and 62.5%, respectively), followed by emotional distress, physical function, and physical symptoms; 55.8%, 54.3%, and 51.5%, respectively. These unmet needs and health-related quality of life-related dimensions were highlighted and elicited by qualitative data analysis. Unmet needs are high among married females, on conservative treatments, young females (< 40 years old), and females in the first year of diagnosis. The presence of chronic diseases did not increase needs. However, health-related quality of life was affected. Six themes are subtracted: availability of anticancer therapy, affordability of healthcare, family and social support, psychological support, health education, and self-image & intimate relationship. Many needs are unmet. Caring for females with breast cancer should be comprehensive to fill gaps, including psychological care, health information and education, physical care and support, and medical care. [ABSTRACT FROM AUTHOR]

We used routinely collected programme data on people living with HIV in Oman who started ART in 2014–2018 to assess retention on ART, viral suppression, attrition (mortality or loss to follow-up [LTFU]) and treatment failure (attrition or HIV viral load of > 1000 copies/mL) 12 months after antiretroviral therapy (ART) initiation. We identified 726 patients; 72% were male. Overall, 12 months retention on ART and viral suppression (intention-to-treat [ITT] analysis) were 85.7% and 74.5%, respectively. Attrition occurred in 14.3% (mortality of 7% and LTFU of 7.3%). Retention increased from 78.8% (93/118) to 90.6% (144/159) among patients who started ART in 2014 and 2018, respectively. Similarly, ITT and on-treatment analyses revealed that viral suppression 12 months after ART initiation increased from 57.6% (68/118) and 73.1% (68/93) among patients who initiated therapy in 2014–80.5% (128/159) and 88.8% (128/144) among patients started treatment in 2018, respectively. On multivariate analysis, older age, having "Other" as an HIV risk factor (compared to heterosexual) and receiving HIV care outside the capital Muscat independently predicted both attrition and treatment failure. Our findings have been useful in identifying factors at the individual and programme level that influenced the risk of attrition and treatment failure. [ABSTRACT FROM AUTHOR]

Objectives: To estimate and compare the prevalence of cognitive limitations among Middle Eastern and North African (MENA) immigrants compared to US- and foreign-born non-Hispanic Whites from Europe (including Russia/former USSR) and examine differences after controlling for risk factors. Methods: Cross-sectional data using linked 2000-2017 National Health Interview Survey and 2001–2018 Medical Expenditure Panel Survey data (ages >=65 years, n = 24,827) were analyzed. Results: The prevalence of cognitive limitations was 17.3% among MENA immigrants compared to 9.6% and 13.6% among US- and foreign-born non-Hispanic Whites from Europe. MENA immigrants had higher odds (OR = 1.88; 95% CI = 1.06–3.34) of reporting a cognitive limitation than US-born non-Hispanic Whites after controlling for age, sex, education, hearing loss, hypertension, depression, social isolation, and diabetes. Discussion: To further examine cognitive health among the MENA aging population, policy changes are needed to identify this group that is often absent from research because of their federal classification as non-Hispanic Whites. [ABSTRACT FROM AUTHOR]

Purpose: This review aims to describe the up‐to‐date knowledge of the prevalence of mental health disorders among Middle Eastern immigrants women living in the United States (U.S.) and the factors affecting mental health status. Conclusion: High prevalence of mental health disorders and low utilization of mental health services among Middle Eastern immigrants were reported. The factors affecting mental health disorders included socio‐demographics, immigration‐related factors, and previous mental and physical health problems. Practice Implications: Further research is needed to understand the factors affecting mental health disorders and attitudes associated with the utilization of mental health services among Middle Eastern women in the U.S. [ABSTRACT FROM AUTHOR]

Objective: To augment the international scientific approach to raising public mental health through active lifestyle among adults, we added the evidence of the association between physical activity and subjective wellbeing in the Middle East and North Africa region by emphasizing the mediator—COVID-19. This study aimed to identify the correlations between active mobility and subjective wellbeing during the COVID-19 pandemic in a sample from Tabriz, Iran, which has not yet been tackled in previous study. Methods: We finalized an online survey (N = 603) from adults between 5 June and 15 July 2021. This group reported their individual and socio-economic characteristics and their perception features and location (e.g., home, work) during COVID-19. The paper developed three ordinal logistic regression (OLR) models to examine the association between active mobility types such as commute, non-commute, frequency of active travel to parks and services per week, and different subjective wellbeing including: 1- life satisfaction, 2- feeling energetic, and 3- peaceful mind while controlling for socio-economic variables (e.g., age, gender, education, job, and income) and objective commute distance. We also incorporated the most relevant objective (street length, land-use mix, number of intersections, and building and population density) and subjective (perceived distance to different services, perceived walking places, and perceived facilities attractiveness) factors. Results: Positive response relationships between four types of physical activity levels and subjective wellbeing scores were demonstrated in all of the three developed models (with significant levels of 0.05, and 0.1) with appropriate model fits, which confirmed the existing literature. However, these relationships showed different patterns (varied significant levels) for each type of subjective wellbeing. In addition, the factors including street length (p value: 0.004), perceived walkable places (p value: 0.021, 0.068, 0.017, and 0.025) (positively), population density, and perceived distance to shopping malls (p value: 0.076, <0.0001, and 0.059 (negatively) were associated with different indicators of subjective wellbeing. Conclusion: As for the implication of our study, special actions by urban authorities such as increasing mixed-use and creating attractive places will be required to enhance the walkability of the neighborhoods. Moreover, notifying the adults regarding the benefits of physical activity is much more needed. [ABSTRACT FROM AUTHOR]

Introduction: Tension-type headache (TTH) is the most prevalent neurological disorder. As there is a gap in the literature regarding the disease burden attributable to TTH in the Middle East and North Africa (MENA) region, the aim of the present study was to report the epidemiological indicators of TTH in MENA, from 1990 to 2019, by sex, age and socio-demographic index (SDI). Methods: Publicly available data on the point prevalence, annual incidence and years lived with disability (YLDs) were retrieved from the global burden of disease (GBD) 2019 study for the 21 countries and territories in MENA, between 1990 and 2019. The results were presented with numbers and age-standardised rates per 100000 population, along with their corresponding 95% uncertainty intervals (UIs). Results: In 2019, the age-standardised point prevalence and annual incidence rates for TTH in the MENA region were 24504.5 and 8680.1 per 100000, respectively, which represents a 2.0% and a 0.9% increase over 1990-2019, respectively. The age-standardised YLD rate of TTH in this region in 2019 was estimated to be 68.1 per 100000 population, which has increased 1.0% since 1990. Iran [29640.4] had the highest age-standardised point prevalence rate for TTH, while Turkey [21726.3] had the lowest. In 2019, the regional point prevalence of TTH was highest in the 35-39 and 70-74 age groups, for males and females, respectively. Furthermore, the number of prevalent cases was estimated to be highest in those aged 35-39 and 25-29 years, in both males and females, respectively. Moreover, the burden of TTH was not observed to have a clear association with SDI. Conclusions: While the prevalence of TTH in the MENA region increased from 1990 to 2019, the incidence rate did not change. In addition, the burden of TTH in MENA was higher than at the global level for both sexes and all age groups. Therefore, prevention of TTH would help alleviate the attributable burden imposed on the hundreds of millions of people suffering from TTH around the region. [ABSTRACT FROM AUTHOR]

Anorexia nervosa, bulimia nervosa, and binge-eating disorder represent the specific eating disorders. Although eating disorders (EDs) are a rare psychiatric problem globally, millions of people are exposed to severe health consequences including impairments in health, psychosocial functioning, and quality of life. Young people and adolescents, particularly females, are associated with a higher rate of disordered eating attitudes and EDs than the general population. The aim of this scoping review was to provide an overview or map of ED and disordered eating attitude prevalence in students in Arab countries, both female and male, and to identify contributing factors. Arksey and O'Malley's six-stage framework for scoping reviews was used to guide the process, which returned a total of 20 relevant articles covering 12 of the 22 member countries in the League of Arab States. The average prevalence of ED was 31.4% in a sample of 17,679 students aged 12-33, with a range from9.6% to 74.5%. Prevalence was higher in female students compared to male students, and the key contributing factors included age, gender, BMI, eating habits, and academic attainment. Given the limitations of this scoping review, especially the lack of a formal critical appraisal process for the included articles, future systematic reviews can use it as a baseline, while empirical researchers and policymakers might pursue its preliminary conclusions. [ABSTRACT FROM AUTHOR]

Background: Although several studies assessing the needs of advanced cancer patients have been conducted globally, most have focused on a specific type of cancer such as lung or breast cancer. The variation across studies has also created difficulties in generalizing the results and applying the findings in other countries. The aim of this study was to provide comprehensive information on the needs of Palestinian advanced cancer patients. The quality of life (QOL), distress levels, depression, anxiety, and spiritual well-being of the patients were also assessed. Methods: A hospital-based study with a cross-sectional design was conducted on a convenience sample of patients aged 18 or above who had been diagnosed with advanced-stage cancer. The unmet needs of the patients were assessed using the Short form of the Supportive Care Needs Survey (SCNS-SF34). Four instruments were utilized to examine their distress, anxiety, depression, QOL, and spirituality. A modified Supportive Care Framework was adopted to guide the design of this study. Descriptive statistics and hierarchical linear regression were utilized to analyse the data. Results: Of the 404 cancer patients invited to the study, 379 patients consented to participate and complete the questionnaire. Of them 96.8% stated that they had at least one 'moderate to high' level unmet need. The most frequent unmet needs were those in the physical aspects of daily living (Mean 58.94; SD ± 20.93) and psychological (Mean 58.84; SD ± 19.49) domains. Most of the patients (91%) were physically ill and reported experiencing physical symptoms. About 78.1% had a high level of distress. Almost 90% reported signs of depression and anxiety. Although they felt that their spiritual well-being was good, their QOL was poor. Hierarchical linear regression analyses confirmed that educational level, age, gender, marital status, cancer stage, cancer type, physical symptoms, depression, anxiety, distress, QOL, and spirituality were independently associated with unmet supportive care needs. Conclusion: Palestinian advanced cancer patients exhibit a significantly higher prevalence of unmet needs than those in other countries, indicating a need to develop a palliative care programme within the healthcare system. They have a great need for physical, emotional/psychosocial, self-management and other services, which should be made available to them, particularly in the routine delivery of cancer care. [ABSTRACT FROM AUTHOR]

Background. Obesity has become a significant public health issue worldwide, and it is a major risk factor for many noncommunicable diseases. This systematic review aimed to identify the prevalence of obesity and overweight in the Middle East region and different countries in this region. Materials and Methods. PubMed, Google Scholar, and MEDLINE databases were searched from 2000–2020 to identify relevant studies in the Middle East area. The survey was carried out using combinations of Medical Subject Headings (Mesh) keywords like "body mass index", "obesity", "overweight", "prevalence", "Middle-East", and "Countries in the Middle East area". Analysis of the data was done using STATA-14, and a random-effects model was used to estimate the pooled prevalence. Results. A total of 101 studies with 698905 participants have been identified that met inclusion criteria for this meta-analysis. The pooled estimates of the prevalence of obesity and overweight in the Middle East area were 21.17 (95% CI: 17.05–26.29) and 33.14 (95% CI: 26.87–40.87), respectively. The findings showed that obesity prevalence increased with age so that the highest prevalence of obesity and overweight was observed in people >40 years old. Obesity prevalence in the Middle East area remained steady between 2000–2006 and 2014–2020 (23%). During these time intervals, the prevalence of overweight decreased from 34.83 (95% CI: 32.40–37.45) to 32.85 (95% CI: 31.39–34.38). Conclusions. Despite the relative stabilization of the overweight and obesity trend in the Middle East, current interventions to combat the overweight epidemic need to be maintained and strengthened because the prevalence of overweight and obesity in this region is still very high. The prevalence of obesity increases with age so that people over 40 have the highest percentage of obesity and overweight. Therefore, implementing intervention programs to prevent and control obesity and overweight in the Middle East is essential. [ABSTRACT FROM AUTHOR]

War and conflict impact on women's mental health and experiences of intimate partner violence (IPV), including in the occupied Palestinian Territories (oPT). Drawing on a cross-sectional population representative sample (n=534) collected in February 2017 in the oPT, we sought to (i) characterise the patterning of occupation-related events among women (18+) living in the oPT, (ii) to descriptively assess factors associated with this patterning, (iii) to assess the health impacts of occupation-related events by this patterning, specifically experience of IPV and poor mental health, and (iv) to assess the pathways through which occupation-related events are associated with IPV experience. Using Latent Class Analysis we identified three 'classes' of exposure to occupation-related events: 1 in 20 experienced multiple forms directed at themselves, their families and homes, 42.3% reported experiences against family members and their homes, and half reported relatively few direct experiences of occupation-related violence. Group membership was associated with increased past year IPV experience, and depressive symptoms. Using structural equation modelling we demonstrate that experiences of occupation-related events increased IPV experience via two mediated pathways; increased gender inequitable attitudes, and increased depressive symptoms and quarrelling with their husband. Preventing IPV requires addressing occupation-related events as well as transforming gender norms. [ABSTRACT FROM AUTHOR]

Ensuring diets of children aged 6–23 months meet recommended guidance is crucial for growth and development and for the prevention of malnutrition including stunting, wasting and micronutrient deficiencies. Despite some improvement, indicators related to undernutrition and overnutrition fall short of global targets in the Middle East and North Africa (MENA) region that consist of low‐ and middle‐income countries witnessing political and social changes and a nutrition transition. This research aims at reviewing the situation related to the diets of children aged 6–23 months in five selected countries in the MENA region, examining factors affecting complementary feeding and providing recommendations for guiding effective strategies to improve it. The study triangulated data on complementary feeding status and predictors from semistructured interviews with 30 key informants, and multivariable analysis of household surveys in Egypt, Jordan, Lebanon, State of Palestine and Sudan including data on refugees in Lebanon and Jordan. There remain considerable gaps in complementary feeding differing noticeably among geographic areas. Findings from qualitative and quantitative analyses showed that maternal factors, including maternal education and age, household level factors such as paternal education and wealth, community‐level factors (culture and geographic location), and utilization of health services, were associated with minimum dietary diversity (MDD), minimum meal frequency (MMF) and minimum acceptable diet (MAD) at varied levels in the five countries. Interventions to improve complementary feeding practices should include actions tailored to the needs of the population at multiple levels including at the caregiver's level, household, service use, community and policy level. [ABSTRACT FROM AUTHOR]