The Somali Distress and Resilience Scale: Development of a novel measure for Somali adults.

Although resilience has been identified as an important mediator of negative mental health outcomes among refugee populations, there are few culturally specific measures of resilience among such communities and no such measure among Somalis. In this study we aimed to develop a culturally appropriate measure of resilience specific to Somali adults in San Diego, as an example of a vulnerable refugee community. A community-based, exploratory sequential mixed method investigation was conducted via focus group discussions (n = 4), cognitive interviews (n = 4), and iterative survey adaptation. Somali refugee adults in San Diego (N = 183) were surveyed with this novel scale, a standardized measure of resilience, and assessments of depression, anxiety, and PTSD. Results were analyzed via correlation coefficients and multivariate linear regression modeling. Qualitative findings supported the inclusion of items addressing both barriers and facilitators of good mental health, which resulted in the development of the Somali Distress and Resilience Survey (SDRS). Linear regression analysis revealed that the SDRS demonstrated significant associations with symptoms of depression and PTSD, while the standardized measure of resilience did not demonstrate associations with any of the mental health outcomes assessed. The SDRS identified obstacles to resilience among Somali individuals, placing them at risk of developing negative mental health outcomes. Our novel measure also demonstrated more robust relationships with these outcomes than a standardized measure of resilience, suggesting greater utility of the adapted scale. However, the SDRS's development raises larger questions about the limitations of developing and comprehensively evaluating novel resilience measures in a community-based setting.

A 19-year analysis of hot and cold temperature burdens on mortality in Amman, Jordan.

BACKGROUND: Most studies on climate-induced health effects have primarily focused on developed countries. Jordan, in particular, has seen limited research in quantifying the differential impacts of temperature on mortality. Jordan's unique demographic composition, characterized by significant refugee population influxes, necessitates research in this area to identify vulnerable populations. This study aims to: 1) quantify the mortality burden of hot and cold temperature in Amman, Jordan, and 2) identify vulnerable groups within the population. METHODS: We collected 19 years of daily all-cause mortality records from 2000 to 2018 in Amman, Jordan, aggregated by sex and nationality. We used a time series design in a distributed lag non-linear model for temperature to estimate non-linear associations and lagged effects of temperature on mortality across sex and nationality. We calculated attributable mortality for temperatures above (heat) and below (cold) the minimum mortality temperature for each category. RESULTS: We analyzed 184,166 all-cause mortalities; 106,977 were males, and 22,118 were non-Jordanians. Amman's calculated minimum mortality temperatures were 23.2 °C for males, 21.5 °C for females, 22.3 °C for Jordanians, and 24.7 °C for non-Jordanians. Our findings reveal that females exhibited greater vulnerability to heat, with a 2.59 % (1.54 %, 3.59 %) heat attributable mortality fraction compared to 1.17 % (0.53 %, 1.80 %) for males, while non-Jordanians were susceptible to cold, with an 8.36 % (2.83 %, 14.66 %) cold attributable mortality fraction compared to 5.91 % (4.37 %, 7.41 %) for Jordanians. CONCLUSION: This study highlights the increased vulnerability of marginalized communities in Amman to temperature extremes. It emphasizes the need for further research to identify at-risk groups not only in Amman but also in other cities across Jordan. Such research is crucial for developing targeted protective strategies to safeguard these populations.

Predicting Particulate Matter (PM 10) Levels in Morocco: A 5-Day Forecast Using the Analog Ensemble Method.

Accurate prediction of Particulate Matter (PM 10) levels, an indicator of natural pollutants such as those resulting from dust storms, is crucial for public health and environmental planning. This study aims to provide accurate forecasts of PM 10 over Morocco for five days. The Analog Ensemble (AnEn) and the Bias Correction (AnEnBc) techniques were employed to post-process PM 10 forecasts produced by the Copernicus Atmosphere Monitoring Service (CAMS) global atmospheric composition forecasts, using CAMS reanalysis data as a reference. The results show substantial prediction improvements: the Root Mean Square Error (RMSE) decreased from 63.83 µg/m 3 in the original forecasts to 44.73 µg/m 3 with AnEn and AnEnBc, while the Mean Absolute Error (MAE) reduced from 36.70 µg/m 3 to 24.30 µg/m 3. Additionally, the coefficient of determination (R 2) increased more than twofold from 29.11% to 65.18%, and the Pearson correlation coefficient increased from 0.61 to 0.82. This is the first use of this approach for Morocco and the Middle East and North Africa and has the potential for translation into early and more accurate warnings of PM 10 pollution events. The application of such approaches in environmental policies and public health decision making can minimize air pollution health impacts.

The Role of Biodiversity in the Development of Asthma and Allergic Sensitization: A State-of-the-Science Review.

BACKGROUND: Changes in land use and climate change have been reported to reduce biodiversity of both the environment and human microbiota. These reductions in biodiversity may lead to inadequate and unbalanced stimulation of immunoregulatory circuits and, ultimately, to clinical diseases, such as asthma and allergies. OBJECTIVE: We summarized available empirical evidence on the role of inner (gut, skin, and airways) and outer (air, soil, natural waters, plants, and animals) layers of biodiversity in the development of asthma, wheezing, and allergic sensitization. METHODS: We conducted a systematic search in SciVerse Scopus, PubMed MEDLINE, and Web of Science up to 5 March 2024 to identify relevant human studies assessing the relationships between inner and outer layers of biodiversity and the risk of asthma, wheezing, or allergic sensitization. The protocol was registered in PROSPERO (CRD42022381725). RESULTS: A total of 2,419 studies were screened and, after exclusions and a full-text review of 447 studies, 82 studies were included in the comprehensive, final review. Twenty-nine studies reported a protective effect of outer layer biodiversity in the development of asthma, wheezing, or allergic sensitization. There were also 16 studies suggesting an effect of outer layer biodiversity on increasing asthma, wheezing, or allergic sensitization. However, there was no clear evidence on the role of inner layer biodiversity in the development of asthma, wheezing, and allergic sensitization (13 studies reported a protective effect and 15 reported evidence of an increased risk). CONCLUSIONS: Based on the reviewed literature, a future systematic review could focus more specifically on outer layer biodiversity and asthma. It is unlikely that association with inner layer biodiversity would have enough evidence for systematic review. Based on this comprehensive review, there is a need for population-based longitudinal studies to identify critical periods of exposure in the life course into adulthood and to better understand mechanisms linking environmental exposures and changes in microbiome composition, diversity, and/or function to development of asthma and allergic sensitization. https://doi.org/10.1289/EHP13948.

Can evidence drive health equity in the COVID-19 pandemic and beyond?

Using scoping review methods, we systematically searched multiple online databases for publications in the first year of the pandemic that proposed pragmatic population or health system-level solutions to health inequities. We found 77 publications with proposed solutions to pandemic-related health inequities. Most were commentaries, letters, or editorials from the USA, offering untested solutions, and no robust evidence on effectiveness. Some of the proposed solutions could unintentionally exacerbate health inequities. We call on health policymakers to co-create, co-design, and co-produce equity-focussed, evidence-based interventions with communities, focussing on those most at risk to protect the population as a whole. Epidemiologists collaborating with people from other relevant disciplines may provide methodological expertise for these processes. As epidemiologists, we must interrogate our own methods to avoid propagating any unscientific biases we may hold. Epidemiology must be used to address, and never exacerbate, health inequities-in the pandemic and beyond.

Suicidality Among Syrian Refugee Children in Jordan.

History of adverse events in childhood is one of the strongest predictors of developing negative mental health outcomes with suicidality being the most devastating consequence. Syrian refugee children are at very high risk of developing mental illness, however, the prevalence and significance of suicidal thoughts among this population remains undocumented. A total of 339 Syrian refugee children and adolescents aged 10 to 17 years and their parents living in Jordan were surveyed to assess resilience, depression and suicidality. Demographics and parental depression were correlated with child suicidality. Multivariate logistic regression analyses were used to determine the predictors of suicidality within this population. A total of 94 (27.7%) children reported suicidal statements. In the multivariate analyses we found that younger children were more likely to state suicidal ideation than older children. Of the children who stated suicidal ideation, 49 were in primary school, 19 in pre-secondary and 26 in upper-secondary school. In the multivariate analyses, mild (OR 2.633 (95% CI 1.283, 5.709)) and high (OR 6.987 (95% CI 3.532, 14.614)) depression levels among the surveyed children were predictive of suicidality. Experiencing bullying was also predictive of suicidality (OR 2.181 (95% CI 1.179, 4.035)) when compared to those who did not report any bullying. We report high rates of suicidal ideation among Syrian refugee children, especially in children with exposure to pre-existing depression or bullying. Prevention through raising awareness, education and early detection of depression are needed to address suicidality in this and other vulnerable populations of children.

Long-term spatiotemporal analysis of the climate related impact on the transmission rate of COVID-19.

BACKGROUND: The association between weather conditions and the spread of COVID-19 was demonstrated by previous studies but focused on specific countries or investigated shorter periods of duration limiting the interpretation of the results. AIM: To make an international comprehensive insight into the association between the weather conditions and the spread of COVID-19 by spanning many regions in the Northern and Southern hemispheres over a period of two years for the COVID-19 Outbreak. METHODS: The data were analyzed by using statistical description, linear and multiple regressions, and the Spearman rank correlation test. Daily and weekly COVID-19 cases, the average temperatures, Wind Speed, the amount of precipitation as well as the relative humidity rates were collected from Irbid, Jordan as the main location of analyses, as well as comparison cities and countries in both hemispheres. RESULTS: we found that certain climate variables are significant factors in determining the transmission rate of COVID-19 worldwide. Where, The temperature in the northern hemisphere regions was the most important climate factor that affects the increase in the transmission rate of COVID-19 (Northern Hemisphere rs = -0.65; Irbid rs = -0.74995; P < 0.001), While in southern hemisphere, the climate factor that affects the increase in the transmission rate of COVID-19 was the humidity (rs = 0.55; P < 0.01), In addition, we found the negligible and oscillated effect of wind speed on the transmission rate of COVID-19 worldwide. Moreover, we found that in Irbid 82% of COVID-19 cases were in the fall and winter seasons, while in summer the percentage of COVID-19 cases didn't exceed 3% during the total study period. CONCLUSION: This study can help develop international strategies and policies against COVID-19-related pandemic peaks, especially during the colder seasons in the Northern Hemisphere regions from the first month of fall to the last month of winter.

A systematic review of cross-cultural measures of resilience and its promotive and protective factors.

As psychological resilience has been increasingly recognized as contextually constructed, mixed methods studies that map out local ecologies of resilience have become increasingly common. However, the direct adaptation of quantitative tools for cross-cultural use based on qualitative findings has been relatively lacking. The current review aims to provide an overview of existing measures of resilience used cross-culturally and to synthesize the protective and promotive factors and processes (PPFP) of resilience identified within these measures into a single resource. A January 2021 search of PubMed for studies of the development of psychological resilience measures that excluded studies of non-psychological resilience yielded 58 unique measures. These measures contain 54 unique PPFP of resilience, ranging from individual to communal-level characteristics. This review is intended to serve as a complementary tool for adapting standardized measures for stakeholders requiring an assessment tool that is attuned to their context for mental health risk assessment and intervention evaluation.

The impact of family income and parental factors on children's resilience and mental well-being.

Although there is robust evidence on the intergenerational transmission of trauma-related distress, much less is known about the relation of family income and parental resilience on the resilience and mental well-being of traumatized children. We aimed to determine the association between parental resilience and perceived financial stability, and the resilience and depression of their children among Syrian refugees in Jordan. We carried out a survey of 363 parent-child dyads from a refugee clinic in Northern Jordan. Measures of resilience, trauma, symptoms of mental illnesses, and demographics were reported by the mother and child. We evaluated the associations between parental resilience and their children's mental health. Resilience was highest among parents who reported that their income met their financial needs, (65.77 [standard deviation (SD) 15.96]), and lower for those who reported less income or who stated that their income met their needs only fairly well (62.77 [SD 17.56]). Resilience was lowest for those who reported that that income met their needs poorly (48.02 [SD 23.24]). Parent resilience was positively correlated with child resilience (ß = 0.076 [95% confidence interval 0.035-0.12], p < 0.001). Depression and resilience of parents were most closely correlated with the depression and resilience scores of their children, among parents who reported the highest financial stability. Income plays a modifying role in the parent-child resilience and depression associations, with this association being least pronounced within those families who were financially less secure. These findings can help develop interventions to target parental transgenerational impacts according to income status.

Comparison of urinary telomerase, CD44, and NMP22 assays for detection of bladder squamous cell carcinoma.

Background: Squamous cell carcinoma (SCC) of the bladder is common in many regions around the world. Prognosis is very poor, as most cases are diagnosed at an advanced stage due to a lack of affordable and valid screening markers for this type of cancer. The diagnostic accuracy of urinary nuclear matrix protein-22 (NMP22), telomerase activity, and CD44 were evaluated in urine samples of patients with bladder SCC. Materials and methods: We conducted a case-control study comprised of 60 consecutive newly diagnosed bladder SCC patients diagnosed by cystoscopy and histopathological examination, and controls were 60 outpatients with benign urologic conditions and healthy clinic visitors. Urine samples collected from each subject underwent testing for NMP22, telomerase activity, and CD44. Descriptive and correlational statistical analysis of cases and controls were carried out and receiver operating characteristic curve analysis was used to determine optimal cut-off points for the three assays. Results: Area under the curve was calculated at 0.96, 0.93, and 0.62 for NMP22, telomerase, and CD44, respectively. Urine levels of NMP22 and telomerase activity were significantly higher in the SCC group compared to controls (p < 0.001). Urine CD44 levels were not significantly higher in the SCC group compared to controls (p = 0.111). The overall sensitivity of NMP22, telomerase, and CD44 was 96.7%, 87%, and 45%, respectively, while the specificity was 85%, 88.6%, and 86.7%, respectively. Conclusions: Urinary telomerase activity, followed by NMP22 urine levels, showed high diagnostic yield and could hold potential promise as urinary biomarkers for the diagnosis of bladder SCC.

Relationship between Meteorological and Air Quality Parameters and COVID-19 in Casablanca Region, Morocco.

The aim of this study was to investigate the relationship between meteorological parameters, air quality and daily COVID-19 transmission in Morocco. We collected daily data of confirmed COVID-19 cases in the Casablanca region, as well as meteorological parameters (average temperature, wind, relative humidity, precipitation, duration of insolation) and air quality parameters (CO, NO2, 03, SO2, PM10) during the period of 2 March 2020, to 31 December 2020. The General Additive Model (GAM) was used to assess the impact of these parameters on daily cases of COVID-19. A total of 172,746 confirmed cases were reported in the study period. Positive associations were observed between COVID-19 and wind above 20 m/s and humidity above 80%. However, temperatures above 25° were negatively associated with daily cases of COVID-19. PM10 and O3 had a positive effect on the increase in the number of daily confirmed COVID-19 cases, while precipitation had a borderline effect below 25 mm and a negative effect above this value. The findings in this study suggest that significant associations exist between meteorological factors, air quality pollution (PM10) and the transmission of COVID-19. Our findings may help public health authorities better control the spread of COVID-19.

Foundations of Somali resilience: Collective identity, faith, and community.

OBJECTIVE: To examine perceptions and experiences of adversity and resilience among Somalis living in San Diego. METHOD: A community-driven, qualitative investigation was conducted through virtual focus group discussions (n = 4) with male and female Somali refugee adults in San Diego (a total of 22 individuals). Barriers to well-being and the historical, religious, and cultural supports that enable participants to overcome adversity were discussed. Qualitative data were analyzed in Dedoose using thematic analysis to identify the most salient themes and relationships between them. RESULTS: Participants identified the primary barriers to good mental health as difficulties in accessing resources (housing, employment, healthcare) and discrimination due to racism, xenophobia, and Islamophobia. In contrast, resilient responses to adversity are supported by a collective identity as survivors, their Islamic faith and its perspective on making sense of adversity, and a sense of communal oneness that encourages reciprocal helping behaviors. CONCLUSIONS: These findings suggest that resilient outcomes among Somalis in San Diego are more likely to be promoted by community-based interventions that promote existing strengths and supports rather than focusing on individual coping mechanisms. There is a benefit to investing in community organizations and programs that support resilience-based interventions to overcome common mental disorders in this high-risk population. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Rapid Review of COVID-19 Vaccination Access and Acceptance for Global Refugee, Asylum Seeker and Undocumented Migrant Populations.

Objectives: Refugees, asylum seekers, and undocumented migrants globally have been disproportionally impacted by COVID-19. Vaccination has been a major tool to reduce disease impact, yet concerns exist regarding equitable allocation and uptake. Methods: A rapid literature review was conducted based on PRISMA guidelines to determine COVID-19 vaccination acceptance rates and level of access for these population groups globally. Results: Relatively high COVID-19 vaccine acceptance levels were commonly reported in these populations, although, trust in host governments was a frequently expressed concern, especially for undocumented migrants. Outreach efforts and access to comprehensive information from a trusted source and in appropriate language were found to be major determinants of COVID-19 vaccine acceptance. COVID-19 vaccination access and policies varied considerably across host countries despite urgings by international organizations to include migrants and refugees. While most governments endorsed inclusive policies, evidence of successful program implementation was frequently lacking, creating difficulty to better tailor and implement COVID-19 outreach programs. Conclusion: This review identifies impactful improvements to be implemented to ensure equitable COVID-19 vaccinations and to reduce disease burden on refugees, asylum seekers, and undocumented migrants.

Resilience and Mental Health Among Syrian Refugee Children in Jordan.

Refugee populations are at high risk of experiencing trauma and developing negative mental health outcomes. The resilience of Syrian refugee children is not well established as far as modifying the association between trauma and mental illness. A total of 339 Syrian refugee children aged 10 to 17 were surveyed to assess resilience, depression and history of trauma. All children reported exposure to at least one traumatic event, 48.6% reported exposure to highly salient traumatic events such as being held hostage, kidnapping or imprisonment. High rates of suicidal ideation and depression symptomatology were found. Resilience was strongly inversely related to depression. Relational support was found to be the most protective resilience factor and was the most highly correlated with less depressive symptomatology. Empowering children and families to build resilience through social support may be a viable prevention and management approach to other unaffordable or unavailable treatments for mental illnesses.

An Ethical Roadmap for Prioritizing Medical Resources Within Muslim Societies During the COVID-19 Pandemic.

Profound ethical challenges have been generated by the emergence of the COVID-19 pandemic. The unprecedented plights that have arisen have led nations to devise ethical roadmaps for handling their finite resources. Muslim countries are no exception and must continue to endure the effects of the pandemic, as more waves of infections from new strains are being reported. Given the scarcity of resources available to some countries, it is critical to adopt a roadmap to prioritize these limited resources based on ethical guidelines that are acceptable to Muslim communities. This work describes the concept of "ijtihad", a process frequently used by Muslim scholars to develop novel solutions to deal with unprecedented events, such as the recent pandemic. In this manuscript, Islamic perspectives were discussed on social justice and equality and how limited resources can be used in a way consistent with such perspectives. Relying on previous experiences of the Muslim community, such as the plague of Amwas, in which social distancing and quarantine strategies were used effectively to control the disease, and utilizing available guidelines such as "Al-Qawaid Al-Fiqhiyyah" and "Fiqh Al-Nawazel", we propose a practical protocol and roadmap that can be applied in the current crisis. Managing and prioritizing limited medical resources requires a just and ethically acceptable system. Islamic leaders should immediately develop a roadmap that emphasizes ethical values such as ihsan and altruism to help Muslim countries prioritize the limited medical resources available to medical staff to guarantee the sustainability of health services.

Knowledge, attitudes, ethical and social perspectives towards fecal microbiota transplantation (FMT) among Jordanian healthcare providers.

BACKGROUND: Fecal microbiota transplant (FMT) is a treatment modality that involves the introduction of stool from a healthy pre-screened donor into the gastrointestinal tract of a patient. It exerts its therapeutic effects by remodeling the gut microbiota and treating microbial dysbiosis-imbalance. FMT is not regulated in Jordan, and regulatory effort for FMT therapy in Jordan, an Islamic conservative country, might be faced with unique cultural, social, religious, and ethical challenges. We aimed to assess knowledge, attitudes, and perceptions of ethical and social issues of FMT use among Jordanian healthcare professionals. METHODS: An observational, cross-sectional study design was used to assess knowledge, attitudes, and perceptions of ethical and social issues of FMT among 300 Jordanian healthcare professionals. RESULTS: A large proportion (39 %) thought that the safety and efficacy of this technique are limited and 29.3 % thought there is no evidence to support its use. Almost all (95 %) responded that they would only perform it in certain cases, if ethically justified, and 48.3 % would use it due to treatment failure of other approaches. When reporting about reasons for not using it, 40 % reported that they would not perform it due to concerns about medical litigation, fear of infections (38 %), and lack of knowledge of long safety and efficacy (31.3 %). Interestingly, all practitioners said they would perform this procedure through the lower rather than upper gastrointestinal tract modality and the majority will protect the patient's confidentiality via double-blinding (43.3 %). For a subset of participants (n = 100), the cultural constraints that might affect the choice of performing FMT were mainly due to donor's religion, followed by dietary intake, and alcohol consumption. CONCLUSIONS: Our healthcare practitioners are generally reluctant to use the FMT modality due to religious and ethical reasons but would consider it if there was a failure of other treatment and after taking into consideration many legislative, social, ethical and practice-based challenges including safety, efficacy and absence of guidelines.

A review of constituents identified in e-cigarette liquids and aerosols.

INTRODUCTION: Identification of chemicals present in e-liquids and aerosols is a vital first step in assessing the human health effects of e-cigarettes. We aim to identify the qualitative and quantitative constituents present in e-cigarette liquids and aerosols. METHODS: A comprehensive search of scientific databases included literature up to July 2020. A total of 28 articles met inclusion criteria; 18 articles assessed e-liquid constituents and 15 articles assessed aerosol constituents. Of these, 5 assessed constituents present in both mediums. We included English-language publications that examine qualitative and/or quantitative constituents in e-cigarette liquids and aerosols. RESULTS: In total, articles identified 60 compounds in e-liquids and 47 compounds in aerosols. A total of 22 compounds were identified in both e-liquids and aerosols. These are: acenaphthylene, acetaldehyde, acetol, antimony, benzaldehyde, benzene, chromium, copper, diacetyl, formaldehyde, glycerol, lead, limonene, naphthalene, nickel, nicotine, nicotine-N'-oxides, 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK), N-Nitrosonornicotine (NNN), propylene glycol, toluene, and vegetable glycerin. Some of the identified chemicals have been labeled as harmful, toxic, or cancerous through human, animal, and cell line studies. A variety of laboratory methods were used for analyses, which made reported levels less consistent. CONCLUSIONS: E-liquids and aerosols contain a variety of chemicals with potential health effects from inhaling them. Further, secondhand health effects are unknown because of limited understanding of the dose of exposure by non-users. Identification of constituents in e-cigarettes is the first step to determine their risks to humans and support evidence-based regulations and health policies.