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Background and Objectives Population aging has led to an increased interest in cognitive health and, in particular, the role that stress plays in cognitive disparities. This paper extends previous work by characterizing coronavirus disease 2019 (COVID-19) stress type prevalence and its association with cognitive health in metro-Detroit among Black, Middle Eastern/Arab (MENA), and White older adults. Research Design and Methods Data come from a regionally representative sample of adults aged 65+ in metro-Detroit (N = 600; MENA n = 199; Black n = 205; White n = 196). We used generalized linear models to compare groups on sociodemographic, objective stress, and social stress indicators. Multiple group structural equation models evaluated whether COVID-19 stress predicted cognitive health and whether that association varied across racial/ethnic groups. Results MENA and Black older adults reported higher levels of objective stress than Whites. There were no racial/ethnic group differences in social stress. More objective stress was associated with better cognitive health, and more social stress was associated with worse cognitive health. The positive effect of objective stress was especially apparent for White older adults. Discussion and Implications Though it appears that minority stress was not exacerbated in the context of pandemic stress, links between greater objective stress and better cognitive health apparent among White older adults were not evident among MENA or Black older adults. Broadening health disparities research by including underrepresented populations allows us to elevate scientific knowledge by clarifying what is universal and what is unique about the stress process. [ABSTRACT FROM AUTHOR]

Objective: To estimate and compare the proportion of foreign-born Middle Eastern/North African (MENA) children without health insurance, public, or private insurance to foreign- and US-born White and US-born MENA children. Methods: Using 2000 to 2018 National Health Interview Survey data (N = 311 961 children) and 2015 to 2019 American Community Survey data (n = 1 892 255 children), we ran multivariable logistic regression to test the association between region of birth among non-Hispanic White children (independent variable) and health insurance coverage types (dependent variables). Results: In the NHIS and ACS, foreign-born MENA children had higher odds of being uninsured (NHIS OR = 1.50, 95%CI = 1.10-2.05; ACS OR = 2.11, 95%CI = 1.88-2.37) compared to US-born White children. In the ACS, foreign-born MENA children had 2.11 times higher odds (95%CI = 1.83-2.45) of being uninsured compared to US-born MENA children. Conclusion: Our findings have implications for the health status of foreign-born MENA children, who are currently more likely to be uninsured. Strategies such as interventions to increase health insurance enrollment, updating enrollment forms to capture race, ethnicity, and nativity can aid in identifying and monitoring key disparities among MENA children. [ABSTRACT FROM AUTHOR]

To analyze the reasons for refusal of aneuploidy screening in a multicultural Middle Eastern population. The study included patients delivering in a university hospital, who had refused aneuploidy screening during their pregnancy. We evaluated through a questionnaire submitted during the postpartum period the sociodemographic characteristics, beliefs, attitudes, and the main reason underpinning their choice. Religious, ethical, and financial factors, personal beliefs, medical information, perceived media information, and familial input were assessed through a Likert scale. Our pilot study included 70 patients. The main reason (33 %) was the refusal to terminate pregnancy if the screening tests ultimately led to a diagnosis of aneuploidy. Lack of adequate information on the availability and benefits of this screening method (28 %), religious beliefs (17 %), in addition to other minor reasons such as financial considerations, familial recommendations, late pregnancy follow-ups, and media influence were also identified as contributing factors. Aneuploidy screening is routinely offered to couples, with varying uptake rates observed worldwide. Sufficient information on prenatal screening and diagnosis should be provided to all pregnant women, presenting all available options, thus enabling them to make a free and informed choice during their pregnancy. [ABSTRACT FROM AUTHOR]

Intimate partner violence (IPV) affects all communities, but immigrant communities can be distinctively more vulnerable. This study explores the coping strategies of 10 immigrant Middle Eastern Immigrant Survivors of IPV in the United States. A phenomenological design was utilized to explore Middle Eastern immigrant IPV survivors coping strategies. The study participants had similar and different experiences with formal resources and informal help-seeking behaviors. These study results recommended that there is a considerable need for future research to extend the study of this population as well as an urgent need to increase accessible resources to empower immigrant IPV survivors. [ABSTRACT FROM AUTHOR]

Introduction: Few studies have evaluated the health of Middle Eastern and North African (MENA) women and children in the United States. Objectives were to determine the odds of well-visits, preventive behaviors during pregnancy, and low birthweight among foreign-born non-Hispanic MENA women and children compared to their US- and foreign-born non-Hispanic White counterparts after adjusting for covariates (hereafter, reported as MENA and White). Methods: We analyzed 2000–2018 National Health Interview Survey data (411,709 women, 311,961 children). Outcomes included well-woman visits (past 12 months); dentist visits (past 6 months) and current smoking among pregnant women; and low, moderately low, and very low birthweight among children. Covariates included age, family income, and health insurance for children. Education and marital status were also evaluated among women. Results: Over half (53.4%) of foreign-born MENA women were of childbearing age (ages 18–45) compared to 47.7% US-born and 43.2% foreign-born White women. The odds of completing a well-women visit were 0.73 times lower (95% CI = 0.38–0.89) among foreign-born MENA women compared to US-born White women after adjusting for age, education, and marital status. There was no statistically significant difference in dental visits between groups. No foreign-born MENA pregnant women reported current smoking. Foreign-born MENA children had higher odds of low (OR = 1.65; 95% CI = 1.16–2.35) and moderately low birthweight (OR = 1.78; 95% CI = 1.19–2.66) compared to US-born White children in adjusted models. Discussion: MENA women and children are classified as White by the federal government. Our results highlight that the health of foreign-born MENA women and children differ from their White counterparts. Significance: What is already known on this subject?: National studies have evaluated maternal and perinatal health among minoritized groups; however, none have presented results among Middle Eastern and North African (MENA) women and children. The few studies that have evaluated MENA maternal and child health (MCH) outcomes have provided only state and local estimates. What this study adds?: This study provides nationally representative baseline data on the maternal and perinatal health of foreign-born MENA women and children. This is the first study to examine oral health among pregnant MENA women compared to US- and foreign-born pregnant White women. [ABSTRACT FROM AUTHOR]

Prejudice and discrimination against minorities can be a powerful tool for populistic and reactionary political movements, and it is therefore crucial to study its determinants. The aim of this research is to develop the understanding of a possible mechanism of such discrimination: cultural distance. In a pre‐registered survey experiment with a between‐subjects design, we draw on the large increase in intra‐European refugee migration from Ukraine, to test whether refugees from another ongoing conflict in (culturally distant) Yemen are treated differently than (culturally similar) Ukrainian refugees by British participants (N = 1545). We measured stated willingness to help and to hire refugees. Moreover, the participants were offered the chance to donate their own earnings from survey participation to real charity drives aimed at the respective refugee groups. Thus, we are able to examine both stated and actual helping behaviours that captured both autonomy‐ and dependency‐oriented forms of helping. As expected, participants were more willing to help, hire and donate money to Ukrainian refugees, and these effects were mediated by higher perceived similarity and lower perceived threat from Ukrainians compared with Yemenis. [ABSTRACT FROM AUTHOR]

Purpose: To analyze the prevalence and progression of fulminant type 1 diabetes (FT1D) in Qatar. Methods: This retrospective study analyzed consecutive index- diabetic ketoacidosis (DKA) admissions (2015–2020) among patients with new-onset T1D (NT1D) in Qatar. Results: Of the 242 patients, 2.5% fulfilled the FT1D diagnostic criteria. FT1D patients were younger (median-age 4-years vs.15-years in classic-T1D). Gender distribution in FT1D was equal, whereas the classic-T1D group showed a female predominance at 57.6% (n = 136). FT1D patients had a mean C-peptide of 0.11 ± 0.09 ng/ml, compared to 0.53 ± 0.45 ng/ml in classic-T1D. FT1D patients had a median length of stay (LOS) of 1 day (1-2.2) and a DKA duration of 11.25 h (11–15). The median (length of stay) LOS and DKA duration in classic-T1D patients were 2.5 days (1-3.9) and 15.4 h (11–23), respectively. The FT1D subset primarily consisted of moderate (83.3%) and severe 916.7%) DKA, whereas classic T1D had 25.4% mild, 60.6% moderate, and 14% severe DKA cases. FT1D was associated with a higher median white cell count (22.3 × 103/uL) at admission compared to classic T1D (10.6 × 103/uL). ICU admission was needed for 66.6% of FT1D patients, compared to 38.1% of classic-T1D patients. None of the patients in the FT1D group had mortality, while two died in the classic-T1D group. Conclusion: This is the first study establishing the existence of FT1D in ME, which presented distinctively from classic-T1D, exhibiting earlier age onset and higher critical care requirements. However, the clinical outcomes in patients with FT1D seem similar to classic T1D. [ABSTRACT FROM AUTHOR]

The short report aims to examine differences in self-rated general health across racialized post-secondary students at a university in Ontario, Canada. Binary logistic regression analysis was used to examine poor health as an outcome among racialized students as whole, as well as across Asian, South Asian, Afro-Caribbean and Middle Eastern student groups in comparison to white Caucasian post-secondary students. After adjusting for several covariates, racialized students as a whole had 2.43 times the odds of reporting poor general health compared to white Caucasian students. Asian (OR = 2.77; CI = 1.84-4.18; p < 0.05) and South Asian (OR = 2.52; CI = 1.56-4.08; p < 0.05) students were significantly more likely to report poor health compared to white Caucasian students. The findings call for further attention to the health needs of racialized post-secondary students living in Canada and creating campuses where diverse student populations feel safe and systemically included. [ABSTRACT FROM AUTHOR]

Research shows that religious identity is associated with health. The aim of this study was to understand the role of religious identity for refugee minors' health in greater detail. Middle Eastern refugee minors resettled in Germany and aged 8–18 years completed questionnaires at baseline (T1, n = 246) and follow-up (T2, n = 122) measurement between 2019 and 2022. Religious identity was assessed with a 4-item measure (Cronbach's α =.89). Associations of religious identity at T1 with health-related quality of life (HRQoL) at T1, change in HRQoL from T1 to T2, and perceived COVID-related stress at T2, as well as the mediating role of resources were examined. The results showed a positive association between religious identity and HRQoL, which was partially mediated by integration into peer group, but not by ethnic identity, sense of coherence or religious practice. No significant associations between religious identity and change in HRQoL or COVID-related stress occurred. Therefore, cross-sectional analyses support the beneficial role of religious identity for HRQoL and the crucial mediating role of integration into peer group, suggesting the promotion of religious identity or peer group integration. However, the absence of significant effects on change in HRQoL from T1 to T2 and COVID-related stress at T2 do not allow drawing any long-term conclusions. [ABSTRACT FROM AUTHOR]

Introduction. In Aotearoa New Zealand (NZ), there is inequity in rates of neural tube defects (NTDs). Among Maaori, NTD occur in 4.58/10 000 live births, and for Pacific peoples, it is 4.09/10 000 live births; this is compared to 2.81/10 000 live births for non-Maaori, non-Pacific peoples. Aim. To describe self-reported pre-pregnancy folic acid supplementation and to determine the association between pregnancy intendedness, ethnicity, parity, maternal age, care provider and pre-pregnancy folic acid supplementation. Methods. Secondary analysis of postpartum survey data collected at Te Whatu Ora Te Toka Tumai and Counties Manukau birthing facilities in 2020 was conducted. Descriptive analyses explored pregnancy intendedness and self-reported folic acid use by demographic variables. Multivariable logistic regression explored independent associations between demographic variables and folic acid use among intended pregnancies. Results. In total, 398 participants completed the survey. The response rate was (140/149) 94% at Counties Manukau and (258/315) 82% at Te Toka Tumai. Pre-pregnancy supplementation was reported by 182 of 398 participants (46%). Use was higher among those who intended their pregnancy (151/262, 58%) compared to those who were 'pregnancy ambivalent' (9/33, 27%) or did not intend to become pregnant (22/103, 21%). Factors independently associated with supplementation among intended pregnancies included: 'Other ethnicity' (European, Middle Eastern, Latin American, African) compared to Maaori (aOR 5.3 (95% CI 1.3, 21.8)), age =30 years compared to <30 years (aOR 2.1 (1.0, 4.1)), and private obstetrician compared to midwifery care (aOR 4.2 (1.6, 10.9)). Discussion. Low rates of pre-pregnancy folic acid supplementation exist in Auckland with significant ethnic disparity. Mandatory fortification of non-organic wheat is important, but supplementation is still recommended to maximally reduce risk. [ABSTRACT FROM AUTHOR]

A critical factor for adaptive psychological functioning is the ability to successfully regulate negative and positive emotions. Various tools and methods have been developed to assess emotion regulation competence. Recently, the Perth Emotion Regulation Competency Inventory (PERCI) was developed to overcome some of the limitations of previous assessment tools including a lack of emotion regulation assessment across both positive and negative emotions. To date, no studies have examined the PERCI's psychometric properties among adolescents and non-Western general populations. To address this gap in the literature, we examined the psychometric properties of the PERCI among Iranian adolescents (n = 557), Iranian adults (n = 926), and American adults (n = 242). Participants also completed Emotion Regulation Questionnaire (ERQ), Toronto Alexithymia Scale-20 (TAS-20), and Depression Anxiety and Stress Scale-21 (DASS-21) for measuring the concurrent validity of the PERCI. Confirmatory factor analyses supported the intended eight-factor structure that distinguishes between different emotion regulation components and negative and positive emotions. The eight-factor structure was also found invariant in terms of gender, age, and culture groups. Furthermore, the PERCI demonstrated good internal consistency, test-retest reliability, as well as expected associations with measures of psychopathology, emotion regulation strategy, and alexithymia. Our findings indicate that the PERCI has strong psychometric properties among both Middle Eastern and Western samples and can also be utilised with adolescents. What is already known about this topic: Difficulties in emotion regulation are contributing to the development, maintenance of numerous forms of psychopathology. The assessment of emotion regulation difficulties has been limited as it primarily focusd only on negative emotions. The Perth Emotion Regulation Competency Inventory (PERCI) was recently developed to provide an integrated and valence-sensitive assessment of emotion regulation ability. What this topic adds: The PERCI can be used to measure emotion regulation competency in both adults and adolescents. The intended eight-factor structure of the PERCI that distinguishes between different emotion regulations components and negative and positive emotions was supported. The intended factor structure of the PERCI found invariant in terms of gender, age, and culture groups. [ABSTRACT FROM AUTHOR]

Since the early 2000s in many countries of the Global North, Muslim religious identities have become racialised through the global 'war on terror', the ascendancy of right-wing populists, and localised but high-profile disturbances in disadvantaged urban areas. The racialisation of religion, which conflates concerns about the religious Other with race and ethnicity, has led to an environment where those from non-white ethnic backgrounds are mistakenly presumed to be Muslim. Drawing on theorisations of misrecognition by Taylor and Fraser, the present study contributes to the emergent literature on misrecognition as Muslim by exploring a novel case study, Middle Eastern Christians in the UK. Findings are based on qualitative research with Coptic, Iraqi and Assyrian Christian communities in London and central Scotland, involving 53 semi-structured interviews and six focus groups with members of the case study communities. We identify three main types of response by those who are misrecognised, namely education, resignation, and differentiation. Following Taylor, the education and differentiation responses are interpreted as forms of cultural defence, yet such responses also risk producing the 'problem of reification' theorised by Fraser, exerting pressure on members to conform to a unitary fixed view of the group. [ABSTRACT FROM AUTHOR]

Outcomes after hospital admission for heart failure are likely affected by cultural and ethnic factors. We obtained data from a large health system in Southeast Michigan on all patients admitted for heart failure from 2008 to 2015. Middle Eastern patients were identified through self-identification and a surname algorithm. Multivariate linear, logistic, and Cox regression models were used to evaluate length of stay and readmission rates compared to Caucasian patients. Mortality data was collected from the National Death Index. 7,784 white and 642 Middle Eastern patients were identified. Middle Eastern patients were younger, had higher rates of comorbid conditions, and had a greater mean hospital length of stay (7.96 vs 7.03 days, p = 0.015). Middle Eastern patients had similar thirty-day hospital readmission risk (4.25% vs 4.47%, p = 0.370) but greater ninety-day readmission risk (9.01% vs 8.35%, p = 0.043); after controlling for covariates these differences were not significant. Middle Eastern patients had lower mortality risk (HR = 0.79, p = 0.003). After a hospital admission for heart failure, Middle Eastern patients had longer hospital lengths of stay, similar risk of hospital readmission, but lower all-cause mortality. [ABSTRACT FROM AUTHOR]

Children with Type 1 diabetes (T1D) from different ethnic backgrounds are growing in proportion in clinical practice and tend to have a higher risk of poor health outcomes. The study aimed to investigate the perspectives of culturally and linguistically diverse families in the management of children with T1D in Western Australia. A generic qualitative approach was used. Families of children and adolescents with T1D with first-generation African, Asian or Middle Eastern background were invited to participate in a semi-structured interview. The interviews were audio-recorded, transcribed and analysed thematically. Demographic, clinical and socio-economic data were collected from all participants. Fifteen families (27% African, 33% Middle Eastern, 40% Asian) participated in the study. The mean (SD) age of the child with T1D was 10.2 (5.1) years, had diabetes for 2.9 (1.6) years and an average HbA1c of 67 (15) mmol/mol. Four main themes were identified through qualitative analysis. 'Dietary challenges': lack of adequate food resources posed a barrier to determine carbohydrate amount in traditional meals; 'Linguistic challenges': inadequate reading and language skills affected comprehension of written information and the desire for pictorial resources was reported; 'Limited Support': absence of extended family made management of T1D difficult; and 'Knowledge': a key facilitator, which was acquired through clinic education, enabled families to develop skills to effectively manage T1D. The study highlights the need to consider cultural diversity, psychosocial needs, English proficiency and health literacy when assessing and planning diabetes education. These findings will be useful to formulate a more culturally sensitive approach to diabetes education to improve care and outcomes for young people with T1D from culturally and linguistically diverse families. [ABSTRACT FROM AUTHOR]

Norway is perceived as an egalitarian society, providing freedom for diverse minority groups to live their lives without facing discriminatory practices. However, the lived experiences of groups who simultaneously occupy multiple minority positions might be testimony to the complex ways a society enables or hinders identity formation. Taking an intersectional approach and drawing upon in-depth, semi-structured interviews with nine queer individuals with an ethnic minority background, we explored how they negotiate where they belong, relating to social and structural elements of Norwegian society. We also examined how having multiple minority positions may affect belonging to a collective where they are or are not problematized. We developed five themes from the participants' interviews: 1) exclusion based on being visibly different, 2) having to explain oneself, 3) struggling with heteronormativity, 4) non-acceptance by family and ethnic ingroup, and 5) majority queer community as a place of exclusion. Our analysis underlines the potentially dilemmatic 'nature' of having multiple minority identities. Dealing with both majority's expectations and demands and tackling the norms and demands of family and ethnic ingroup is construed as a problem by our participants. We detail and discuss the ways in which our participants experience and relate to majority culture, racism, and heteronormativity. [ABSTRACT FROM AUTHOR]

The 32 bp deletion in the chemokine receptor (C-C motif) 5 gene (CCR5Δ32) is a natural loss of function polymorphism that prevents the protein from locating on the cell surface. This genetic variation acts as a double-edge sword in the pathogenesis/defense mechanism of different health conditions, such as viral infections, autoimmune diseases, and cancers. Here, we evaluated the prevalence of the CCR5Δ32 polymorphism in the Turkmen population of Golestan province, northeast of Iran. Blood samples were collected from 400 randomly selected Turkmen populations (199 women and 201 men), and genomic DNA was extracted. Characterization of CCR5Δ32 genotypes was performed by PCR using primers flanking the 32-nucleotide deletion in the CCR5 gene. The amplified DNA fragments were visualized on 2% agarose gel electrophoresis with cybergreen staining under UV light. All individuals were of Turkmen ethnicity and lived in the Golestan province, northeast of Iran. The mean age of all participants was 35.46 years, with a 20-45 year range. All the studied subjects were healthy without any severe conditions such as autoimmune disease and viral infections. All individuals had no history of HIV infection. The PCR product visualization showed that all the samples are at the 330 bp size, which means the CCR5Δ32 allele was utterly absent from the study population. The presence of the CCR5Δ32 allele among Turkmens may be attributed to the admixture with European descent people. We conclude that the CCR5Δ32 polymorphism may be absent in the Iranian Turkmen population, and further studies with a large population are needed. [ABSTRACT FROM AUTHOR]

Background/Aims: A short interpregnancy interval is associated with several maternal and neonatal complications. In Oman, the incidence of short interpregnancy interval is well documented in the annual health report, but evidence is lacking on its impact on adverse pregnancy outcomes. This study examined short interpregnancy interval, its risk factors and its association with the prevalence of adverse pregnancy outcomes among Omani pregnant women. Methods: A retrospective matched case–control design was adopted. Data were collected from medical records between January and December 2020. A total of 597 pregnant women from two tertiary care hospitals in Oman were included. Results: There was a significant relationship between interpregnancy interval and the prevalence of adverse maternal and perinatal outcomes, including postpartum haemorrhage, iron deficiency anemia, preterm birth and low birth weight. Significant risk factors for a short interpregnancy interval were advanced maternal age, young age at first birth, low parity and previous perinatal loss. Conclusions: Encouraging acceptance of birth spacing through the use of contraception would signify a notable change in cultural values that can act as a barrier to birth spacing. This would therefore improve pregnancy outcomes. [ABSTRACT FROM AUTHOR]

Objective: Anti-dementia medications such as acetylcholinesterase inhibitors are an important part of the management pathway for dementia. However, there are limited data in New Zealand that have examined the rates and patterns of use of funded anti-dementia medication and how use differs with ethnicity, age and sex. Methods: This was a retrospective population-based descriptive study. Using the Integrated Data Infrastructure, we identified individuals of all ages coded for a diagnosis of dementia and estimated the proportion dispensed funded anti-dementia medication – donepezil tablets and rivastigmine patches – between 1 July 2016 and 30 June 2020. Rates of medication use in five main ethnic groups (Māori, Pacific peoples, Asian, European, and Middle Eastern, Latin American and African) in the <65, 65–79 and 80 and over (80+) age groups were compared and also between males and females in all sub-groups. Logbinomial models were used to calculate relative risks to determine any differences in anti-dementia medication use in the five ethnic groups and the three age groups and between males and females in each of the four study years. Results: Overall, one-third of the dementia population received a funded anti-dementia medication in the total population (all ages) between 2016 and 2020. Donepezil tablets were dispensed in 31.6–34.0% and rivastigmine patches in 1.4–2.1% across the four study years. Compared to people of European ethnicity, Māori, Pacific peoples, and Middle Eastern, Latin American and African groups were less likely to be dispensed an anti-dementia medication (Māori: relative risk = 0.79–0.81, p < 0.0001; Pacific peoples: relative risk = 0.72–0.74, p < 0.0001; Middle Eastern, Latin American and African: relative risk = 0.73–0.78, p < 0.05). Compared to the age 80+ group, the 65–79 age group was more likely (relative risk = 1.50–1.54, p < 0.0001), while the age <65 group was less likely (relative risk = 0.67–0.71, p < 0.0001) to be dispensed an anti-dementia medication. There were no statistically significant differences in anti-dementia medication use between males and females. Conclusion: This study provides important information about funded anti-dementia medication use in New Zealand and how this differs by ethnicity, age and sex. Despite higher dementia prevalence in Māori and Pacific peoples, these groups were less likely to receive funded anti-dementia medication. [ABSTRACT FROM AUTHOR]

Background: Protective behavioral strategies (PBS) are cognitive-behavioral strategies that students use to prevent risky drinking. Prior work supports PBS as a mechanism of change following a brief motivational intervention (BMI) among college students. This study investigated the necessity of discussing PBS by examining changes in PBS use and drinking following an alcohol intervention that used the parent method of Motivational Interviewing (MI), or Pure MI. Methods: Data came from a pilot study that looked at the effects of Pure MI that targeted risky social drinking behavior. The study comprised 42 college students who endorsed hazardous drinking in the last 2 weeks and social anxiety symptoms. Participants completed measures of safe and heavy drinking behaviors at baseline and one-month follow-up. Results: The results showed that PBS use increased from baseline to one-month follow-up. Further, the reduction in heavy drinking in social situations was partially explained by an increase in PBS use from pre- to post-intervention. Conclusions: Despite not introducing PBS into discussions during the MI intervention, we found that students who used more PBS reported reduced heavy drinking in social situations. Implications from the study suggest that interventions focused on student motivation rather than knowledge can promote safe and reduce hazardous drinking behaviors. [ABSTRACT FROM AUTHOR]

BACKGROUND: Migrating to Australia to work as a midwife can be challenging, particularly for those from non-English speaking backgrounds, since they must achieve strict qualification standards, English language skills, and professional competence to be eligible for registration. AIM: The purpose of this study was to explore the registration experiences of Middle Eastern-qualified midwives in Australia. METHODS: Multiple case narrative study, underpinned by structuration theory, involving 19 Middle Eastern-qualified midwives from different states of Australia. Individual semi-structured interviews were conducted between November 2020 and September 2021 and digitally recorded and then transcribed. Transcriptions were analyzed in three stages, with categories generated in the second stage and core categories developed in the third. RESULTS: This study found that Middle Eastern-qualified midwives' registration experiences were significantly impacted by evolutions in policies in Australia. The accounts of participants who applied for registration at varying stages suggested the process became more complicated over time. Overall, four categories emerged with varying prominence from the accounts of participants who applied for registration at different times including: language barrier, variation in the process, inadequate orientation, and misdirection. Systemic issues were identified as significant barriers to the registration of Middle Eastern-qualified midwives in Australia. CONCLUSION: With Australia's reliance on internationally qualified midwives, strategies should be developed to identify the language support, appropriate orientation, and regulatory adjustment necessary to reduce the underutilization of Middle Eastern-qualified midwives. [ABSTRACT FROM AUTHOR]

People are better at recognizing faces from their own racial or ethnic group compared with faces from other racial or ethnic groups, known as the other‐'race' effect (ORE). Several theories of the ORE assume that memory for other‐race faces is impaired because people have less contact with members of other racial or ethnic groups, resulting in lower visual expertise. The present research investigates contact theories of the ORE, using self‐report contact measures and objective measures of potential outgroup exposure (estimated from participants' residential location and from GPS tracking). Across six studies (total N = 2660), we observed that White American and White German participants displayed better memory for White faces compared with Black or Middle Eastern faces, whereas Black American participants displayed similarly equal or better memory for White compared with Black faces. We did not observe any relations between the ORE and objective measures of potential outgroup exposure. Only in Studies 2a and 2b, we observed very small correlations (rs = −.08 to.06) between 4 out of 30 contact measures and the ORE. We discuss methodological limitations and implications for theories of the ORE. [ABSTRACT FROM AUTHOR]

Bereaved fathers dealing with political loss provide an under-examined experience of living with unbearable pain. Drawing on an anti-colonial feminist framework, this article analyzes the written and visualized pain of bereaved Palestinian fathers posted on Facebook. This study approaches cyberspace as a meaningful site for theorizing the suffering of a people living under state violence. I focus on three portraits shared by fathers, which include texts, photos, e-comments, and e-interpretations. By considering the narratives and reactions evoked by these portraits, this study reveals complex transformations of individual and collective pain, loss, and grief. The study further suggests that visualizing fathers' pain on social media provides a space for fathers to navigate trauma. They achieve this by traversing traumatic confusion into a state of survival and agency while challenging structures of dehumanization, dispossession, and death. [ABSTRACT FROM AUTHOR]

Aims: This interview study focuses on the needs and wishes of Arabic‐speaking migrant women in the Netherlands to culturally adapt and optimize the digital support platform SAFE (safewomen.nl) for intimate partner violence and abuse (IPVA) for their use. Design: This is a qualitative interview‐based study. Methods: We conducted the study between March 2020 and 2021. The study entailed 16 semi‐structured interviews with Arabic‐speaking women in the Netherlands with a migration background. Results: Findings suggest that a cultural gap, a lack of knowledge of the Dutch law, and the prevalence of restrictive gender roles amongst the participants and their spouses affected their acknowledgement of the different forms of IPVA. Furthermore, mental health consequences of IPVA were also strongly stigmatized. Clear information in their native language, summarizing infographics and potential interactive features should be main components of any eHealth intervention for this target group. Conclusion: The participants in our study deemed e‐help a potentially valuable support option for women experiencing IPVA in their community. The impact of IPVA on mental health is currently overlooked within this target group and should be emphasized in future interventions. Impact Cultural sensitivity proved crucial in understanding the concepts of IPVA amongst women with migrant backgrounds. To ensure effective eHealth interventions for migrant women, they should be involved in the design and delivery of these interventions. [ABSTRACT FROM AUTHOR]

The seeking and use of Complementary and Alternative Medicine (CAM) modalities by people to treat mental disorders has increased and it is necessary for psychologists to have the necessary information in this field. This study aims to evaluate the use and perception of CAM by Iranian psychologists. This cross-sectional study was conducted on 100 psychologists selected by the census in 2019. Data collection tools consisted of four sections of the demographic section, the CAM questionnaire for psychologists, awareness of CAM, and use of CAM. The validity and reliability of this questionnaire were confirmed. The mean (standard deviation) scores of attitude and educational needs were 40.45 (11.36) and 33.93 (5.96), respectively. Only 19.25% of psychologists had sufficient knowledge of CAM, and most of them (56.34%) reported that there is an educational need for CAM. In this study, 64% of psychologists used CAM for themselves. There was a significant relationship between the attitude toward CAM modalities and the suggestion of CAM to the clients (p=0.025). There was also a significant relationship between the use of CAM by psychologists and the suggestion of these modalities to their clients (p<0.001). Psychologists had not sufficient awareness about CAM and had a moderate attitude. Most of the psychologists reported that there is educational need for CAM. Therefore, it is necessary to design and implement appropriate training courses for psychologists toward CAM modalities. [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]

Objective: University students face high levels of stress-related factors, such as an unfamiliar environment, challenging workload, and uncertainty about their ability to succeed. Participants: A total of 370 students in Qatar who consented to participate between February 2017 and February 2018. Methods: This cross-sectional study assessed perceived stress [using a validated 4-point perceived stress scale (PSS-4)], as well as diet, exercise, body mass index, sleep, and life satisfaction. Results: Among students aged 18–39 (mean = 20.1 ± 3.0 years), PSS-4 scores varied between 0 and 16 (mean = 7.4 ± 3.4). Elevated stress was significantly associated with female sex, country of origin, residing off-campus, eating when bored, lack of self-discipline, disturbed sleep, and low levels of life satisfaction. Furthermore, students with PSS-4 scores above the median level were 2.3 times likelier to report difficulty concentrating on academic work. Conclusion: Elevated stress levels are present in university students in Qatar. Strengthening coping skills may improve health and academic performance. [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]

Background: Culturally diverse students face barriers to success in nursing school. One troublesome obstacle is the faculty-student relationship. This study explored Middle Eastern nursing students in Jordan and identified Eastern-Western cultural differences that may occur in the United States. Method: Existential descriptive phenomenology and feminist theoretical framework were used to design, collect data, and analyze results for 24 final-semester students. Six themes were identified: dissatisfaction, time, negativity, gender, culture, and utopia. Findings indicate Middle Eastern students and families have a different view of nursing than U.S. faculty members. Results: Strong influences of family, culture, and community directly relate this study's conclusions to Middle Eastern students studying in the U.S. These findings may prevent faculty-student misunderstandings, diminished student academic performance, and loss of culturally diverse U.S. nurses. Conclusion: The faculty-student relationship benefits from an understanding of the cultural challenges and experiences identified by Middle Eastern nursing students studying in the U.S. [J Nurs Educ. 2022;61(10):570–578.] [ABSTRACT FROM AUTHOR]

This paper presents findings on Middle Eastern immigrant entrepreneurs in Australia. The extent to which perceived discrimination and acculturation influence their social and psychological capital, and the effects of social and psychological capital on their firm performance, are explored. We found that such immigrants, who are highly acculturated to the mainstream culture, not only tend to have many social interactions outside their community but also possess strong psychological capital. Although perceived discrimination has been associated with low social involvement outside an immigrant community, we found that perceived discrimination does not exert a statistically significant effect on psychological capital. Importantly, both social and psychological capital are found to exert positive effects on firm performance. The findings have implications for enhancing the capacity of policy makers to provide high impact to immigrant entrepreneurs. Specific interventions are suggested to assist such entrepreneurs to leverage their social and psychological capital. [ABSTRACT FROM AUTHOR]

The article discusses the contrasting responses to Ukrainian and Middle Eastern refugees at the borders of Poland. Topics include the mass displacement of people due to the war in Ukraine; the compassionate welcome of Ukrainian refugees and the violent response to Middle Eastern refugees; and the tension between politics of compassion and repression in the treatment of displaced people.

Background: The integration of immigrating physicians has become a challenge for many societies and health care systems worldwide. Facilitating the integration process may benefit both the uptaking country and the immigrating physicians. Previous studies have approached this problem from a system integration perspective. The present study explores the degree of social integration of an exemplary group of Middle Eastern physicians following their migration to Germany from an individual perspective.Methods: Based on social constructivist epistemology, a series of fifteen interviews and two focus groups with immigrated Middle Eastern physicians (n = 23, purposively sampled) were conducted between 2017 and 2020 in Germany. The audio recordings were transcribed, translated into English and analysed deductively based on Esser's model of social integration, consisting of four dimensions: acculturation, positioning, interaction and identification.Results: The social integration of the participants showed a multifaceted picture. The early phase was characterized by disorientation and trial and error. Cultural differences were of major importance. Acculturation was facilitated by German language acquisition and increased over time, although some cultural difficulties remained. Professional positioning was facilitated by the need for physicians and a relatively low-hurdle relicensing procedure. Interaction and identification depended on the efforts of the individual physicians.Conclusions: This study provides a comprehensive picture of the individual social integration of Middle Eastern physicians in Germany. Language and cultural adaptation are identified as being of primary importance. Social integration can be facilitated through orientation programmes or cross-cultural training that benefits the uptaking countries as well as the immigrating physicians. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to explore the influence of differences in relative skeletal maturity on performance test outcomes in elite youth soccer players from the Middle East. Methods: We integrated skeletal age and performance assessments using mixed-longitudinal data available for 199 outfield players (chronological age range, 11.7 to 17.8 yr) enrolled as academy student-athletes (annual screening range, 1 to 5 visits). Skeletal age was determined as per the Tanner–Whitehouse II protocol. Relative maturity was calculated as the difference (∆) between Tanner–Whitehouse II skeletal age minus chronological age. Performance test outcomes of interest were 10-m sprinting, 40-m sprinting, countermovement jump height, and maximal aerobic speed. Separate random-effects generalized additive models quantified differences in performance test outcomes by relative skeletal maturity. Estimated differences were deemed practically relevant based on the location of the confidence interval (95% CI) against minimal detectable change values for each performance test outcome. Results: For 40-m sprinting, differences of +0.51 s (95% CI, +0.35 to +0.67 s) and +0.62 s (95% CI, +0.45 to +0.78 s) were practically relevant for relative maturity status of ∆ = −1.5 yr versus ∆ = +0.5 and ∆ = +1 yr, respectively. For countermovement jump height, a difference of −8 cm (95% CI, −10 to −5 cm) was practically relevant for ∆ = −1.5 yr versus ∆ = +1 yr relative maturity status comparison. Effects for 10-m sprinting and maximal aerobic speed were unclear. Conclusions: Integration of skeletal age and performance assessments indicated that conventional maturity status classification criteria were inconsistent to inform player development processes in our sample. Between-player differences in test performance may depend on a substantial delay in skeletal maturation (∆ ≤ −1.5 yr) and the performance outcome measure. [ABSTRACT FROM AUTHOR]

Summary: The study was conducted to establish the association of Schmorl's nodes and osteoporosis in a Middle Eastern cohort. The prevalence of SN in this sample was 41.1%. It was most frequent in the lumbar spine typically solitary central lesions. Over 88% Schmorl's node cases were osteoporotic/osteopenic and only 11.6% normal. Introduction: This study aims to identify the prevalence of Schmorl's nodes (SNs) in a cohort of Omani nationals, and also to determine any relation between osteoporosis and Schmorl's nodes. Methods: This retrospective observational study was conducted on Omani nationals. One thousand three hundred and forty-eight DEXA scan patients were included. Of these, 545 patients had complete X-rays and MRI scans that would help determine the SN status. The X-rays and sagittal, coronal, and axial T2-weighted MR images were used to identify the presence and exact location of the Schmorl nodes by one orthopedic trainee and confirmed by the senior author. The correlation of each parameter with the presence of SN was analyzed by the independent-samples T test and one-way ANOVA. Results: The overall prevalence of SN in this population sample appeared to be 41.1%. Over 88% of the SN-positive cases were either osteopenic or frankly osteoporotic by the WHO definition. Vast majority of SNs (87.1%) occurred in the lumbar spine and were central in location and mostly solitary. Statistical analysis of the data revealed significant correlation between osteopenia or osteoporosis and the presence of SNs. Conclusions: The prevalence of SN in the sample of Omanis studied was 41.1% and was most frequently seen in older men in the lumbar spine. It is strongly associated with osteoporosis/osteopenia (88.4%) and frequently presents as solitary central lesions. [ABSTRACT FROM AUTHOR]

Background. The critical shoulder angle (CSA) has been used as a tool for identifying patients with high risk of developing a rotator cuff tear (RCT). A CSA angle larger than 35 degrees has been shown to be associated with increased risk of RCT. The aim of this study was to determine if this concept is applicable to a Middle Eastern cohort of patients. Methods. This retrospective observational study included 44 patients who underwent rotator cuff repair between 2016 and 2021 in KFUH was compared to 45 patients with normal shoulders. The CSA was measured by two independent observers on anterior-posterior radiographs. The collected data was analyzed. P-values of < 0.05 were considered statistically significant. Results. The mean ± standard deviation (SD) CSA measured on pre-operative radiographs was significantly higher in patients with RCT (36.66° ± 4.62°) compared to patients with normal shoulder (31.97° ± 3.37°), P-value < 0.033. Conclusions. Our current study confirms that the association of high CSA with risk of rotator cuff tears is applicable in a cohort of Middle Eastern patients, as the CSA was higher in patients who underwent RCT repair when compared to patients with normal shoulders. [ABSTRACT FROM AUTHOR]

Background: Crohn's disease (CD) frequently recurs after intestinal resection. Azathioprine (AZA) and biological therapies have shown efficacy in preventing postoperative recurrence (POR). Data on POR from Middle Eastern populations is lacking. This study aimed to evaluate the rate of endoscopic POR in a cohort of CD patients who underwent ileocecal resection (ICR), and to assess the effectiveness of AZA and biological therapies in reducing the risk of disease recurrence. Methods: We performed a retrospective cohort study on 105 CD patients followed at our center, who underwent ileal resection and were at moderate to high risk for POR. Clinical and laboratory data were collected; the primary endpoint was post ICR endoscopic recurrence at 24 months defined by Rutgeerts' score of i2 or more despite treatment. Results: In total, 105 patients with Crohn's disease met our inclusion criteria; 76.2% were in remission and did not have endoscopic POR at 24 months. Further, 41.9% were on biological therapy, and 34.3% were mainly on AZA. Out of the 28.2% who had POR, approximately 15% were on biological therapies. Penetrating phenotype was the only predictive factor for decreasing POR (OR = 0.19, 95% CI: 0.04–0.98, P = 0.04) as identified in multiple logistic regression analysis. Conclusions: The use of biological therapies post-surgery was not superior than AZA in reducing the endoscopic POR for mod- high risk CD patients. Only penetrating behavior of the CD was associated with significantly lower risk of endoscopic recurrence. This finding is worth further investigation in more robust study designs and among larger samples of patients. [ABSTRACT FROM AUTHOR]

To examine whether Andersen's model explains health care utilization among Middle Eastern immigrants and to examine gender and ethnic differences in health care utilization of Middle Eastern, Hispanic/Latino, and Asian immigrants in the United States. Using data from the 2000–2017 National Health Interview Surveys (NHIS), this study compares patterns of health care utilization among Middle Eastern (ME) immigrants to those among Hispanic/Latino and Asian immigrants in the U.S. Specifically, we use Andersen's Behavioral Model of Health Care Utilization to model the likelihood of seeing a doctor in the past 12 months for these three immigrant groups. Additionally, the current study emphasizes the predisposing factor of gender and its differences across and within these groups. Andersen's behavioral framework is partially suited to predict the likelihood of seeing a doctor in the past 12 months among ME immigrants. Immigrant women, regardless of their ethnicity, are significantly more likely than men to report seeing a doctor in the past 12 months. Moreover, the effects of the predisposing, need, and enabling characteristics for Hispanics and Asians are significantly different from those for ME immigrants. Additionally, although Asians are significantly less likely to utilize the health care system than ME immigrants, there are no significant differences comparing Hispanics/Latinos to ME immigrants. Furthermore, Andersen's behavioral framework explains ethnicity and gender differences particularly when comparing Asian men to ME men and Asian women to ME women. This study highlights the importance of considering ethnicity and gender differences when examining health outcomes of immigrants. [ABSTRACT FROM AUTHOR]

Social factors (e.g. housing, food security, etc.) contribute significantly to health. The purpose of this study is to describe social risk and social exclusion factors in one of the largest Middle Eastern and North African (MENA) populations in the U.S. and their association with health outcomes. We conducted a cross-sectional study with a community convenience sample of 412 adults who self-identify as MENA. Weighted, adjusted linear regression models were used to examine relationships of interest. Prevalent social risks included transportation barriers to healthcare (33%), food insecurity (33%), and financial strain (25%). In adjusted models, perception of being treated unfairly (Estimate (SE) 0.08 (0.04), p < 0.05) and fear of deportation (0.26 (0.06), p < 0.001) were associated with more social risk factors. More social risk factors were associated with worse self-reported health (0.09 (0.03), p < 0.01), more chronic conditions (0.11 (0.03), p < 0.004), and more mental health symptoms (0.34 (0.14) p < 0.01).Social risk is high among those perceiving unfairness and fear deportation. Those with more social risk factors reported worse health. These findings have implications for social needs screening and referral models that can best serve U.S. MENA sub-populations. [ABSTRACT FROM AUTHOR]

In 2020, COVID-19 was the third leading cause of death among individuals between the ages of 45–84 years (Woolf 325:123–124, 2021). However, systemic inequities and disparities exacerbated the pandemic's effect on racial and ethnic groups (Tai 72:703–706, 2021). The exact impact of the pandemic within the Middle Eastern North African (MENA) community is not well documented or understood due to the lack of federal recognition of MENAs as an ethnic group. Given the lack of COVID-19 research among this community, this study was created to address COVID-19 needs, perceptions, and health-seeking behaviors regarding COVID-19 precautions, mask wearing, and routine healthcare appointments. Between June and July 2020, an anonymous survey was distributed in English and Arabic using a Community Participatory Based Research design in Dearborn, Michigan. Overall, 298 individuals were surveyed and their misconceptions regarding COVID-19 infections, spread, and precautions were identified. It is important to note that about 75% of survey respondents identified as female, while only 24% of survey participants identified as male. Survey participants slightly underestimated the distance in which COVID-19 can be transmitted as 5.5 ± 3.5. Participants severely underestimated COVID-19 deaths in the US, with 23% estimating that under 250,000 individuals would die from COVID-19. Overall, 60% of participants reported that they did not have any difficulty adhering to COVID-19 precautions and self-quarantine rules during Ramadan, while this number dropped to only 36% (87/238) after Ramadan. The goal of this study was to serve as a tool to better understand the misconceptions, difficulties, and needs regarding COVID-19 among this understudied population. The MENA community may be particularly vulnerable to the economic, medical, and social changes brought about by the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

An editorial is presented in which the authors argue that limited data concerning Arab or Middle Eastern and North African Health (MENA) data erodes the credibility of health disparity assessments.

Background: Trans-vaginal natural orifice transluminal endoscopic surgery (vNOTES) is a recently popularised minimally invasive surgical procedure, aimed at minimising abdominal wall scars and improving pain and patient recovery times. Although vNOTES has been studied in the context of post-operative pain and cosmesis, women's acceptance of the technique has only been cursorily examined. In this survey-based observational study, we assessed the acceptability of this technique among a cohort of Middle Eastern women. Materials and methods: A cohort of 175 Middle Eastern women were surveyed using a 13-item questionnaire at a single gynaecology centre. The survey used was a translated version of a questionnaire from a previous study (1) and comprised open-response, five-point Likert Scale and agree-disagree items. Results: Among 175 Middle Eastern women participated in this study most of them holding neutral view on abdominal and gynaecological procedures via vagina. 47% of participants were unsure regarding the effect of surgery via vagina on their sexual function. Although 61% of the participants showed no preference towards vNOTES over laparoscopic cholecystectomy, more than half of them indicated preference if vNOTES shown to be as effective and safe as laparoscopic cholecystectomy. The gender of the surgeon was shown to have no influence on the perspectives of the majority of participants to undergo vNOTES. Conclusions: vNOTES may hold value for women who have conservative upbringing and/or value cosmesis. This study provides information regarding Middle Eastern women's perspectives on vNOTES, which may be of considerable clinical use as the popularity of this surgical technique continues to increase. [ABSTRACT FROM AUTHOR]

Background: Spirometry is a clinically useful test that can be used to assess lung function among children. Different equations had been formulated to determine the spirometric reference values depending on several individual characteristics. However, the widely used equations do not produce perfect suitability for Middle Eastern children. Objectives: This study aims to formulate Middle Eastern‐specific equations that may be applicable for other populations in the region. Methods: The spirometric data were collected from Jordanian children between the ages of 6 and 17 years. The collected data were used to formulate customised reference equations for Middle Eastern children using generalised additive models for location, scale and shape. The newly formulated equation results were compared with Global Lung Initiative 2012 (GLI‐2012) equations predicted values. Results: Spirometric values for 1576 healthy participants (870 males) were used to formulate the new equations. The assessment of z‐scores produced by the present study equations and GLI‐2012 indicated that the new equations were more suitable than GLI‐2012 for Middle Eastern children. In‐depth analysis of the results indicated that the suitability of GLI‐2012 equations varied between different age points. Conclusion: This study formulated new spirometric reference equations for Middle Eastern children that can improve the diagnosis and management of different respiratory conditions. [ABSTRACT FROM AUTHOR]

Background: A better understanding of cancer awareness is critical to allow the appropriate implementation of interventions to improve screening and diagnosis. While the incidence of prostate cancer has been reported to increase over the last decade in the Middle East, data on prostate cancer awareness in this region remains limited. Therefore, an assessment of prostate cancer awareness is critically needed. The present study addresses this urgent need by investigating the level of awareness of prostate cancer among the general public in the Middle East. Method: A cross-sectional survey of men residing in 13 Middle Eastern countries was conducted in 2022. A validated prostate cancer awareness questionnaire was used to assess participants' knowledge on several domains of prostate cancer. Men younger than 40 years of age or history of prostate cancer were excluded from the study. Result: A total of 3,221 men were recruited to the study. The median participant age was 48 years (range: 40 to 81 years). The majority of participants (30%) had primary education and 20% had no formal education. Most participants (90%) were married and 30% had family history of prostate cancer. Most participant (85%) reported hearing about prostate cancer in the past but only 31% of the participants recognized that prostate cancer is the most common malignancy in men. A total of 21% of the participants thought that prostate cancer affects both men and women. Participants thought that majority of prostate cancer patients die from their disease as opposed to old age or another cause of death (mean, 78%). Only 34% of the participants thought that the main thing that men can do to reduce their prostate cancer risk is to go for regular screening. Moreover, only 18% of the participants knew that PSA test is used for prostate cancer screening. Conclusion: Prostate cancer awareness in Middle East is critically low. There is an urgent need to target this population for practical interventions to increase awareness, in addition to screening and earlier diagnosis. [ABSTRACT FROM AUTHOR]

OBJECTIVE: Cystic fibrosis (CF) is the commonest life-limiting inherited illness in the Caucasian population but is uncommon in the Middle East, and so the genotypes and clinical course of disease in this population is not well known. MATERIAL AND METHODS: In this retrospective observational study, we collected and reviewed the data on CF mutations, body mass index (BMI), lung function, microbiology, and the demographics in adult CF patients in the United Arab Emirates (UAE). RESULTS: Data was reviewed for 39 adult CF patients. The median age of adult CF patients presenting to our clinic was 25 years (interquartile range (IQR) 22-31), the median BMI was 19 (IQR 17-22), and the median percentage predicted forced expiratory volume at 1 second (FEV1) was 49.5% (IQR 38.5-62.5). S549R was the commonest mutation (n = 11, 28%) followed by AF508 (n = 9, 23%). Only 5 (13%) out of 39 patients were heterozygote for CF mutations which reflects the high level of consanguinity in the region. Twelve (30%) patients were diagnosed after the age of 16, and in total, 19 (48%) were diagnosed after the age of 10. Thirty-two (82%) of patients are pseudomonas colonized, and 31% had 3 or more exacerbations in the last 12 months. CONCLUSION: The CF mutation patterns in the UAE are different from western populations with low AF508 prevalence, with the presence of rare mutations more specific to this region and a high rate of homozygosity. Late diagnosis, high pseudomonas colonization rate, and exacerbation frequency remain a problem in this region and lead to poor long-term outcomes. [ABSTRACT FROM AUTHOR]

We show that name-induced stereotypes affect the investment choices of U.S. mutual fund investors. Managers with foreign-sounding names have about 10% lower annual fund flows, and this effect is stronger among funds with investor clienteles more likely to be suspicious of foreigners. Foreign-named managers experience lower appreciation (greater decline) in flows following good (bad) performance. Following 9/11, flows to funds with managers with Middle-Eastern-sounding names declined abnormally. In an experimental setting in which skill differences are absent, individuals allocate 11% less money to an index fund managed by a foreign-named manager. This gap widens following the Boston marathon bombings. [ABSTRACT FROM AUTHOR]

This study examined the mental health of Middle Eastern male unaccompanied refugee adolescents in Germany in relation to the mental health of accompanied refugee peers, first- and second-generation immigrant and native peers. In particular, it was investigated whether differences in the mental health of unaccompanied and accompanied refugees and immigrant peers were related to differences in the perception of post-migration stress, and whether this association changed with different acculturation orientations. In a cross-sectional study, 193 adolescents (M age = 18.1 years, SD = 1.74 years; n refugees = 74, n migrants = 59, n natives = 60) completed self-report measures of mental health, trauma, acculturation styles, and post-migration stress. Analyses of variance revealed that unaccompanied refugees suffered most from internalizing and trauma symptoms, while accompanied peers, first- and second-generation immigrant and native adolescents did not differ significantly in internalizing symptoms. Hierarchical regression analysis demonstrated that more integrated adolescents were generally associated with lower internalizing symptoms and integration also buffered against detrimental effects of post-migration stressors. Marginalized adolescents showed more internalizing symptoms, especially in the lights of more post-migration stress. Both assimilation and separation had no direct effects on internalizing symptoms. However, assimilation buffered against detrimental effects of post-migration stress on internalizing symptoms, whereas separation amplified these effects. An involvement in host society and an orientation towards the host culture fosters mental health of acculturating Middle Eastern adolescents in Germany when post-migration stress is perceived, particularly for unaccompanied refugee adolescents. Moreover, additionally maintaining the culture of origin seems to be in general most beneficial. [ABSTRACT FROM AUTHOR]

What is known on the subject?: There is very limited literature on the health of Middle Eastern immigrants in the United States, and the available studies were mostly conducted on small convenient samples in local communities.There is also a need to understand changes in the rates of serious psychological distress (SPD) during the 15 years after 2001, as there were negative effects on Arabs' health since the September 2001 aftermath. What does this paper add to existing knowledge?: The study examined the rates of SPD, the risk of SPD and its associated factors in a national sample of Middle Eastern immigrants in the United States from 2001 to 2015.The study found that serious psychological distress rate was high among Middle Eastern immigrants. Being a female and having obesity were associated with a higher risk of reporting serious psychological distress among this population. What are the implications for practice?: These outcomes necessitate mental health nursing interventions that provide culturally sensitive mental health care to immigrantsFor example, developing community‐based prevention programmes is required to address risk factors of psychological distress and to increase awareness about psychological distress among Middle Eastern immigrants. Introduction: While Middle Eastern immigrants are a fast‐growing population in the United States, there is very limited literature on their mental health. Most of the available studies were conducted on small convenient samples in local communities. Aims: To examine rates of serious psychological distress (SPD) and its associated factors among Middle Eastern immigrants in the United States, compared with US‐born, non‐Hispanic Whites. Methods: Data from the National Health Interview Survey (NHIS) from 2001 to 2015 were analysed. The survey included 1,246 Middle Eastern immigrants and 232,392 US‐born, non‐Hispanic Whites. SPD was measured by the Kessler‐6 psychological distress scale. Survey analysis procedures, sampling weights and variance estimates were conducted. Descriptive statistics and regression analyses were employed to examine differences and factors associated with SPD. Results: SPD rate was the highest among Middle Eastern immigrants (5.99%) between 2006 and 2010. Among Middle Eastern immigrants, being female and obese were significantly associated with a higher risk of SPD. Discussion: Middle Eastern immigrants in the United States suffered high rates of SPD. Gender and obesity were factors associated with SPD risk. Implications: These outcomes indicate the need for mental health nursing interventions that provide culturally sensitive mental health care to immigrants, such as developing community‐based prevention programmes. [ABSTRACT FROM AUTHOR]

Saman Ahmad Nasrollahi,1,* Maede Sabet Nematzadeh,2,* Aniseh Samadi,1 Azin Ayatollahi,1 Somayeh Yadangi,1 Christoph Abels,3 Alireza Firooz11Center for Research & Training in Skin Diseases & Leprosy, Tehran University of Medical Sciences, Tehran, Iran; 2Pharmaceutical Sciences Branch, Islamic Azad University, Tehran, Iran; 3Dr. August Wolff GmbH & Co. KG Arzneimittel, Bielefeld, Germany*These authors contributed equally to this work Background: Melasma is the most common pigmentary skin disorder, especially in females and those with darker complexion. The current study evaluated the safety and efficacy of a triple combination cream containing hydroquinone 4%+tretinoin 0.05%+fluocinolone acetonide 0.01% (Januluma®, cream produced by Janus Pharmaceutical Co, Tehran, Iran) in the treatment of melasma.Patients and methods: Twenty-two female volunteers (mean±standard deviation of age: 39.20±4.16 years) who fulfilled the eligibility criteria participated in this study after signing the informed consent. They were requested to apply the Januluma®,cream every night for 8 weeks. Modified melasma area and severity index (mMASI), skin lightness (L value), and severity of pigmentation (E value) by Visio Face, and skin biophysical parameters including pH, melanin index, erythema index, sebum, hydration, trans epidermal water loss, thickness and density of epidermis, and dermis (using 22 MHz ultrasonography) were measured before and 4 and 8 weeks after treatment. Also patients’ satisfaction was assessed 4 and 8 weeks after treatment using visual analog score.Results: mMASI decreased significantly from 3.37 to 2.60 at week 4, and to 2.40 at week 8 (P-values=0.00 and 0.01, respectively). Also, E and L values improved significantly after 8 weeks of treatment (P=0.01 and 0.00, respectively). Skin melanin index decreased from 237.49 AU to 196.30 AU at week 8 (P=0.01). Also echo density of dermis increased significantly after 8 weeks of treatment (P=0.029). Almost all participants experienced some degrees of pruritus, scaling, and erythema, esspecially during the first month of application, which were generally mild and tolerable. The mean satisfaction of patients with the treatment was 6.77.Conclusion: The triple combination formula was reasonably safe and effective for treatment of melasma in Middle Eastern patients.Keywords: melasma, combination therapy, efficacy assessment, Middle Easterners