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Cardiovascular risk factors among Arabic-speaking patients attending Arabic-speaking general practitioners in Sydney, Australia: opportunities for intervention.

BACKGROUND: Australia has a high rate of cardiovascular disease mortality and also a significant proportion of migrants. Little is known about the morbidity experience or cardiovascular risk factors among the larger migrant groups, and this is especially true of the Arabic-speaking population. OBJECTIVES: The objectives of the study were to identify the health profile of Arabic-speaking people in Sydney, Australia, to explore the relationship between level of acculturation and health indicators and to identify the morbidity profile of patients presenting to Arabic-speaking general practitioners (GPs). DESIGN: Adult Arabic-speaking patients aged 18-70 years attending 20 Arabic-speaking GPs in Canterbury, Sydney, during the 2-week study period were asked to complete a self-administered questionnaire in Arabic or English while waiting to see the GP. Data on cardiovascular risk factors, level of acculturation and reasons for seeing the GP were collected. RESULTS: Data were collected from 851 patients (62% response rate). Almost three-quarters (73%) of males and 36% of females were considered overweight or obese (body mass index > 25). Of concern, 37% of males and 28% of females were smokers. Females were significantly less likely to have been tested for diabetes (p < .05) or raised blood pressure (p < 0.05) compared with females in NSW. Respondents consumed less bread per day and more fruits than in NSW overall. Respiratory complaints (flu and colds) were the most frequently reported reasons for patient encounters. Except for the youngest age group, males gave more reasons for encounters than females. CONCLUSIONS: Consecutive sampling of ethnic patients attending a GP who speaks their language holds promise as a method of needs assessment with migrant populations. Further, our results suggest that smoking and weight reduction programs are priorities in the Arabic-speaking community. These risk factors are ideal for intervention by GPs speaking the same language.

Acculturation

The effect of Arabic vowels on the reading comprehension of second- and sixth-grade native Arab children.

This study investigated the effect of Arabic vowels on the reading comprehension of native Arabic speakers. This issue has not been addressed yet. Two groups of native Arabic speakers were randomly sampled, one from two elementary schools in the Haifa area, and the other from two elementary schools in Nazareth. Both groups in both experiments read Arabic texts in two reading conditions, vowelized and unvowelized; the older group (n = 74) answered 10 multiple-choice comprehension questions about each story, and the younger group (n = 71) answered seven multiple-choice comprehension questions. The results revealed that vowels were a significant facilitator of reading comprehension in both age groups. Considering these results, reading in Arabic orthography is not an autonomous word recognition process. An alternative approach is suggested for reading Arabic.

Arabs

Reading in Arabic orthography: the effect of vowels and context on reading accuracy of poor and skilled native Arabic readers in reading paragraphs, sentences, and isolated words.

This study investigated the effect of vowels and context on the reading accuracy of poor and skilled native Arabic readers in reading paragraphs, sentences, and words. Central to this study is the belief that reading theory today should consider additional variables, especially when explaining the reading process in Arabic orthography among poor and normal/skilled readers. This orthography has not been studied. Reading theory today is the sum of conclusions from studies conducted in Latin orthography. The subjects were 77 native Arabic speakers, 34 of them poor readers and 44 normal/skilled readers. The subjects had to read in Arabic 15 paragraphs, 60 sentences, and 210 words. There were three reading conditions: fully vowelized, partially vowelized, and unvowelized texts. The results showed that vowels and contexts were important variables to facilitate word recognition in poor and normal/skilled readers in Arabic orthography.

Adolescent

Internal consistency of an Arabic Adaptation of the Beck Depression Inventory in four Arab countries.

An Arabic version of the revised edition of the Beck Depression Inventory in its complete form was developed. Back translation indicated the translation into modern standard Arabic was adequate. The cross-language equivalence of scores on the Arabic and English forms was .96, denoting high equivalence in meaning. Coefficients alpha were computed for samples of male and female undergraduates recruited from Egypt, Saudi Arabia, Kuwait, and Lebanon (ns = 100, 80, 100, 100, respectively). Values of alpha were .77, .82, .89, and .67, respectively. By and large, the inventory seems viable in the Arabic context so its use in cross-cultural research may be explored.

Adolescent

Hemoglobin SO Arab and hemoglobin CO Arab diseases. Clinical and laboratory study.

A nine-year-old black female who had been considered to have Hb SC disease was admitted with pain of the leg, neck, and upper chest. She had also been hospitalized approximately 20 times for treatment of recurrent pain. Further investigation by citrate agar gel electrophoresis and peptide mapping disclosed that the child had Hb SO Arab disease. She had mild hepatosplenomegaly and the hemoglobin concentration was 10.2 gm/dl. The clinical presentation of Hb SO Arab disease of our patient resembled that of Hb SD disease and was more severe than is Hb SC disease. The mother was found to have Hb O Arab trait. Two of the patient's siblings from a different father were found to have Hb CO Arab disease, an extremely rare condition. These children, 8 and 12 years old, are clinically asymptomatic. Clinical and laboratory data are presented.

Anemia, Sickle Cell

Distribution of HLA-DQA1 alleles in Arab and Pakistani individuals from Dubai, United Arab Emirates.

PCR-based typing of the HLA-DQA1 locus, using allele specific oligonucleotide (ASO) probes and reverse dot blot methodology was used to determine allelic distributions and construct a database for Arab and Pakistani individuals living in Dubai. Genotype and allelic frequencies were calculated, and the data were tested for departures from Hardy-Weinberg (HWE) equilibrium. The most frequent HLA-DQA1 alleles among Dubaian Arabs are DQA1 4 and 1.2. Among Pakistanis, the most frequent allele is also DQA1 4. No significant deviations from HWE were detected.

Alleles

Distribution of HLA-DQ alpha and polymarker (LDLR, GC, GYPA, HBGG, and D7S8) alleles in Arab and Pakistani populations living in Abu Dhabi, United Arab Emirates.

Randomly collected blood samples from 100 Arabs and 100 Pakistanis residing in Abu Dhabi were analyzed using the HLA-DQ alpha and polymarker (LDLR, GC, GYPA, HBGG, D7S8) PCR based reverse dot blot systems. Allelic frequencies for each allele and observed heterozygosity for each locus were calculated. Departures from Hardy-Weinberg expectations (HWE) were determined using the unbiased estimate of the expected homozygote/ heterozygote frequencies, the likelihood ratio test and the exact test. No significant departures from HWE expectations were detected.

Blood Proteins

The interaction of hemoglobin O Arab with Hb S and beta+ thalassemia among Israeli Arabs.

We have studied 105 individuals in the village of Jasser El Zarka in the Northern Coast of Israel of whom 59% had at least one abnormal hemoglobin. Of the individuals studied 41% were AA, 13.3% AS, 28.6% AOArab, 10.5% SOArab, 0.9% SS, 38% OArab-beta + Thal, and 1.9% beta Thal trait. The SOArab double heterozygotes were characterized by a normal mean corpuscular volume (MCV) and mean corpuscular hemoglobin concentration (MCHC), and an increase of Hb F (11.7 +/- 4.3%) and 2,3-diphosphoglycerate levels (27.8 microns/g Hb). The increase of Hb F is higher than the one seen among OArabs of other ethnic backgrounds. Their clinical course was moderately severe and osteoporosis was quite frequent. The interactions of Hb OArab and Hb S were studied in vitro and it was confirmed the Hb OArab lowers the minimal gelling concentration of mixtures with Hb S (as compared to mixtures of Hb S and Hb A), but that this effect is ionic-strength dependent. Our data are in conflict with previous claims that Hb OArab mixtures with Hb S polymerized almost as much as pure S. Oxygen association curves show a significant displacement of the p50 to the right, but the effect of oxygen dissociation is less apparent. The displacement was not nearly as significant as with SS cells, confirming our gelation data. Blood group determinations establish that these Arab populations had black African admixture. The Hb OArab/beta + Thal double heterozygotes exhibit moderate anemia (10.3 g% of Hb) and the percentage of Hb A was 17.2 +/- 1.8%. The fetal Hb was 5.4 +/- 2.1% and the 2,3-diphosphoglycerate level in two cases was 17.4 mumol/g Hb. The only case of a homozygote SS had moderate anemia (10.3g Hb%), 25.7% of Hb F, and a very benign course.

Adolescent

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

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

Adult

Jewish-Arab relations in Israel: a psychology of adolescence perspective.

Jewish and Arab high school seniors (61 Jewish boys and 51 Jewish girls, 57 Arab boys and 49 Arab girls) participated in a study of future orientation and described their hopes and fears for the future. The present analysis focuses on part of the data pertaining to the respondents' cross-ethnic references. More Arab than Jewish adolescents referred to the other ethnic group. The cross-ethnic references contained hope for peace and fear of war; the Arab statements, however, also showed discontent with Israeli authorities. More Arab than Jewish adolescents referred to collective issues (the people, the state, the world). The percentage of Jewish and Arab adolescents concerned with Jewish-Arab relations relative to the number addressing other aspects of collective concerns were similar (12% for Jews and 16% for Arabs). For Jews, this small number was related to adolescents' egocentrism and for Arabs, to adolescents' ethnocentrism.

Adolescent