A novel CHST3 allele associated with spondyloepiphyseal dysplasia and hearing loss in Pakistani kindred.

Skeletal dysplasias (SDs) are highly heterogeneous disorders composed of 40 clinical sub-types that are part of 456 well-delineated syndromes in humans. Here, we enrolled consanguineous kindred from a remote area of Sindh province of Pakistan, with 14 affected individuals suffering with short stature, kyphoscoliosis, joint dislocations, clubfoot, heart valve anomalies and progressive bilateral mixed hearing loss. To identify pathogenic variants in this family, whole exome sequencing (WES) was performed in one affected and one normal individual, which revealed a novel transversion mutation (c.802G>T; p.Glu268*) in CHST3 associated with the phenotype. CHST3 encodes a chondroitin 6-O-sulfotransferase-1 (C6ST-1) enzyme that is essential for the sulfation of proteoglycans found in cartilages. Previously, mutations in CHST3 have largely been reported in sporadic cases of SD, primarily with severe spinal abnormalities, joint dislocations, joint contractures, and clubfoot. Clinical and radiological examination of the affected individuals in this family provides new insights into phenotypic spectrum of CHST3 alleles and disease progression with age.

Obesity among Kuwaitis aged 50 years or older: prevalence, correlates, and comorbidities.

OBJECTIVES: Obesity is a serious global health problem. Our objectives are to assess the prevalence of overweight and obesity among elderly Kuwaitis aged 50 or older, examine their sociodemographic correlates, and analyze the association between obesity and its comorbidities. METHODS: A cross-sectional face-to-face interview survey using a structured questionnaire was conducted among 2,443 Kuwaiti men and women aged 50 or older. Height and weight were measured and body mass index (BMI) was calculated. RESULTS: About 81% respondents were overweight of whom 46% were obese. Mean BMI was 30.0 (31.2 for women and 28.1 for men). Multinomial logistic regression analysis revealed that relatively young elderly Kuwaitis (50-59) were 1.7 and 2.2 times more likely to be overweight and obese, respectively, compared with those aged 70 or older. Married individuals had 2.3 times higher risk to be overweight or obese than non-married individuals. Women were 3.6 times more likely to suffer from obesity than men. Overweight and obesity were found to be independent risk factors for hypertension (OR = 1.3 and 1.9, respectively), diabetes (OR = 1.4), and osteoarthritis (OR = 1.8 and 1.6, respectively). CONCLUSIONS: Prevalence of overweight and obesity is alarmingly high among elderly Kuwaitis. The associated disease burden is substantial. Stakeholders should address the problem and launch national extensive health-promoting campaigns targeting perceptible lifestyle changes.

Decline in co-residence of parents and children among older Kuwaiti men and women: what are the significant correlates?

A trend towards decline in co-residence with children is apparent in several countries while it is absent in others. The objectives of this paper are to address the patterns of co-residence with children among older Kuwaiti men and women aged 60+ and to assess the determinants of such patterns within the context of rapid socioeconomic changes occurring in the country (n = 1588). The data for this paper were collected as part of a household survey on the psychosocial health and disability among 2487 older Kuwaitis aged 50+. Forward step-wise logistic regression was run to assess the significant socio-demographic and health related correlates of living without any co-resident children. We found that the percentage living without any co-resident children increased from 5% in 1999 to 24% in 2005/6. About 13% women and 1% men were living alone in 2005/6. In the multivariate analysis, older age, female gender, non-Bedouin cultural background, a smaller number of children, higher educational level, and the presence of one or more domestic helpers were positively associated with the absence of co-resident children. On the other hand, those who were not married were less likely to reside without co-resident children, as were those with higher family incomes. Except for self-rated health none of the health related variables, such as chronic illnesses or depressive symptom experience, emerged as significant. Modernization forces seem to be at the core of the observed decline in co-residence with children.

Prevalence and correlates of major chronic illnesses among older Kuwaiti nationals in two governorates.

OBJECTIVE: To provide community-based information on the prevalence of diabetes, hypertension and heart disease and to highlight their significant correlates. MATERIALS AND METHODS: Data were collected in a cross-sectional household survey of 2,487 Kuwaiti nationals aged 50 and over in 2005/2006. A proportionately representative sample of 1,451 respondents from a relatively more urban area (Capital) and 1,036 respondents from a relatively less urban area (Ahmadi) were interviewed. A proxy respondent was used in 5.4% of cases. Among the 2,605 potentially eligible persons approached, 2,487 (95.5%) participated. RESULTS: Doctor-diagnosed prevalences of hypertension, diabetes and heart disease in the two governorates were reported to be 53.4, 50.6 and 17.5%, respectively. If the prevalence in the two governorates is reflective of the nation, a remarkable increase seems to have occurred since 1996. The prevalence of each of the three diseases increased linearly by age among both sexes. Comorbidity of the three diseases increased from 3.6 to 9.4 and to 20.9% among those aged 50-59, 60-69 and > or =70 years, respectively. Logistic regression showed the prevalence of chronic illnesses to be significantly higher among persons who were older, retired, non-Bedouin, less educated, had higher income, were less socially active, were obese and had poorer exercise behavior. The prevalence of diabetes and heart disease was significantly lower among women than men. CONCLUSION: Judging from data on two governorates, the prevalence of diabetes, hypertension and heart disease is likely to have increased to alarmingly high levels among older Kuwaitis, highlighting the need for focused intervention programs in order to reduce morbidity and increase healthy life years.

Job satisfaction of nurses with multicultural backgrounds: a questionnaire survey in Kuwait.

BACKGROUND: Nurses working in Ministry of Health hospitals in Kuwait come from 35 countries, and only 12% of them are Kuwaitis. This study explores factors that influence the job satisfaction of nurses of multicultural background working in five general hospitals in Kuwait. OBJECTIVES: This study aims to identify factors related to the job satisfaction of nurses and the effect of selected background characteristics (e.g., age, gender, nationality, educational qualification, marital status, monthly salary, experience in other countries, and years of experience) on the global satisfaction scale by using the McCloskey-Mueller Satisfaction Scale. METHODS: A stratified random sample size of 500 subjects was selected, and a questionnaire was distributed among them. Four hundred thirty-six completed questionnaires were returned, resulting in a response rate of 87.2%. RESULTS: Factor analysis identified five factors: satisfaction with (a) professional opportunities; (b) praise and recognition; (c) scheduling of duty; (d) control and responsibility, and (e) extrinsic rewards. These together explained 59.5% of the total variance. Nurses were found to be dissatisfied with two of five factors: professional opportunities and extrinsic rewards. Nurses were satisfied with the remaining three factors, although levels of satisfaction were not very high. The relationship of job satisfaction with nationality and marital status was positive and significant. However, a higher level of educational qualification showed an inverse relationship with job satisfaction. CONCLUSIONS: Two issues identified here concerned aspects of nurses' professional development and extrinsic rewards, which have to be addressed as prerequisites to any improvement in the quality of nursing care in Kuwait. Based on our findings, we recommend a concerted action in developing a strategy to improve various aspects of nurses' professional development and extrinsic rewards. This will have a positive impact on the quality of health care of the Kuwaiti population.

Effect of carbimazole induced hypothyroidism and thyroxine replacement on the growth of the long bones in albino rats of different age groups.

To evaluate the effect of carbimazole induced hypothyroidism and thyroxine replacement, on the growth of long bones of albino rats of different age groups. Experimental albino rats were developed with carbimazole and carbimazole plus thyroxine for a period of six weeks. At the end of the experiment the animals were sacrificed, fixed and processed to demonstrate the bony and cartilaginous parts. The ulna and tibia of both sides were measured for intact bone length & diameter and the data compared. The reduction in length and circumference observed, at the end of experiment, in ulna was 10.89%, & 11.94% and in tibia it was 12.52%, 14.81% in carbimazole treated group respectively, while in carbimazole plus thyroxin treated group the reduction in length & circumference of ulna was 1.37% & 1.88% and in tibia it was 1.86% & 3.08% respectively. They were compared to their age matched controls. The reduction in length and circumference in ulna was 5.58% & 6.25% and 6.42% and 5.88% in tibia respectively among the carbimazole treated animals while in the carbimazole plus thyroxine treated animals the reduction was only 0.63% and 3.12% in ulna and 0.91% and 1.06% in tibia respectively. The results show that hypothyroidism and its replacement therapy affects the endochondral as well as periosteal bone growth and results in reduction in length as well as circumference of long bones.

Factors influencing nurses' attitudes towards the use of computerized health information systems in Kuwaiti hospitals.

AIM: This paper reports a survey of nurses' attitudes towards computerized health information systems, the characteristics that influence these attitudes and the level of nurses' skills in computer use. BACKGROUND: The use of such systems in developed countries and in some developing countries has already become a reality. However, nurses as a group of care providers have been found to resist computerization, seeing computerized health information systems as dehumanizing, confusing and uncaring. Nurses with more computer experience tend to have more positive views; education and training positively influence attitudes; and younger and less experienced nurses may have more positive attitudes. METHODS: A structured questionnaire was used to measure the attitudes of nurses working in Kuwait towards computerization. A random sample of 574 nurses working in Ministry of Health hospitals were sent a questionnaire, and 530 replies were received (response rate 92.3%). The data were collected from November 2002 to January 2003. FINDINGS: Respondents generally had positive attitudes toward computerized health information systems. Analysis of variance revealed statistically significant differences in attitudes in relation to nationality, level of education, previous experience in computer use, and computer skills (P < 0.05). Multiple regression analysis showed that gender, nationality, education levels, and duration of computer use were statistically significant predictors of attitudes toward computerized health information systems (P < 0.05). CONCLUSION: With adequate computerized health information system training, the implementation of computerized health information systems could be effective for nurses in providing quality health care, as found in other studies.

Unmet need for contraception in Kuwait: issues for health care providers.

Based on a nationally representive household survey of Kuwaiti women held in 1999 (n = 1502) unmet need for contraception was analyzed in Kuwait, an oil-rich Muslim country. It was found that 9.7% currently married women had an unmet need for contraception. Of those, 6.1% wanted to stop child bearing, while 3.6% wanted to space their children. A bivariate comparison of the women with unmet need and current contraceptors showed that the unmet need group comprised of relatively older women with a significantly higher level of parity and ones where husband or wife disapproved of contraception. Also, larger percentages of the unmet need group belonged to relatively lower socio-economic status and were Bedouins. Among the reasons for current non-use, two-third believed that they had a low risk of pregnancy due to infrequent sexual activity or sub-fecundity, and 22% were not using a method because of health concerns. A significantly larger percentage of the unmet need group disapproved of contraception, and believed that Islam forbids family planning, compared to current users (30% and 15%, respectively). The logistic regression analysis showed that the wife's perception of the husband's disapproval of contraceptive use had the strongest negative association with unmet need. We conclude that the contraceptive needs of about 90% of all non-pregnant currently married women who wanted to delay or limit children were being met adequately despite the absence of a formal family planning program, while about 10% women had an unmet need. Issues for health care providers are discussed and family planning counseling is recommended for higher risk older women with unmet need.

Determinants of job satisfaction among nurses in Kuwait.

OBJECTIVE: Job satisfaction among nurses working in five general hospitals in Kuwait was analysed using a global scale based on the McClosky Mueller Satisfaction Scale (MMSS) in relation to selected background characteristics (eg age, gender, nationality, educational qualification, monthly salary and the departments in which they worked. DESIGN: The questionnaire was distributed to 500 nurses using a stratified random sample. The response rate was 87.2%. RESULTS: Age, nationality and the department worked in had a positive significant relationship with job satisfaction. However, a higher level of educational qualification and previous work experience in other countries showed an inverse relationship with job satisfaction. CONCLUSION: Based on our findings, we recommend that expatriate staff should be provided with an understanding of cultural differences and how to cope with them. Special attention should be paid to the norms regarding interaction among males and females and social interaction among professionals from the opposite gender. Intensive courses in the languages to be used in the care provision process should be provided to impart requisite language competency.

International allied health education and cross-cultural perspectives.

International partnerships develop long-lasting friendships among colleagues. This is a dividend that is of immense value in this otherwise terribly divided globe with health care issues being a major concern. The framework and lessons learned proposed herein should be of value to individuals in colleges and universities to promote a true learning experience for both partners that are enduring and replicable models of international cooperation.

Living arrangements of older women and men in Kuwait.

The main objectives of this article are to analyze the correlates of living arrangements of persons aged 60 or above in the oil-rich, Muslim country of Kuwait and to examine whether or not patterns of co-residence differ by gender. Data were obtained from a nationally representative survey of households of Kuwaiti nationals, and this paper is based on the 687 older Kuwaiti residents of these households. Living arrangements were generally similar for women and men. Eighty nine percent of women and 94 percent of men co-reside in households with at least one son or daughter. Only 0.3 percent of men and 1.9 percent of women live alone. Socio-demographic characteristics of women and men differed significantly; 58 percent of women were widowed compared with 5 percent of men. Logistic regression analysis showed that women had two times higher odds than men of living without their children. The odds of residing without children also increased with the respondent's age and education but decreased with increasing wealth. Continued rapid demographic, socioeconomic, and cultural change in Kuwait foretells continued decline in co-residence with children, and the implications of such change in a small city-state merits further research.