Analysis of the Differential Relationship between the Perception of One's Life and Coping Resources among Three Generations of Bedouin Women

Living with lower limb traumas and below-knee amputation in a Jordanian Late Ottoman nomadic community

OBJECTIVE

Paleopathological analysis is combined with ethnohistorical, ethnographic and ethnomedical reports to assess the sociocultural implications for a historical nomadic Bedouin female following her survival of a below-knee amputation and multiple injuries to the stump.

MATERIALS

A middle-aged female recovered from a nomadic-style burial dated to the Late Ottoman Period (1789-1918) in Jordan's Wadi ath-Thamad region.

METHODS

Macroscopic and radiographic assessment.

RESULTS

A supracondylar femur (Hoffa) fracture, knee complex injury and lower leg amputation were observed on the right lower limb. Other pathological lesions that may have affected movement included bilateral os acromiale, intervertebral disc disease, osteoarthritis and right hook of hamate fracture.

CONCLUSIONS

The individual survived a below-knee amputation, two injuries to the stump, and likely experienced lower back pain. Mobility may have been painful, but she likely functioned within the community performing gender-specific daily tasks within the family tent and designated community female workspaces. Ethnohistoric and ethnographic reports suggest that marital demotion by other wives or a return to her father's tent may have occurred.

SIGNIFICANCE

Healed multiple injuries and amputation affecting one limb are rare in paleopathological literature.

LIMITATIONS

It is uncertain whether the amputation or either of the stump injuries occurred during the same event. If they resulted from separate events, slight hip joint osteoarthritis suggests that the amputation preceded the other injuries.

SUGGESTIONS FOR FURTHER RESEARCH

Full pathological assessment of individuals with amputations may provide additional insight into impairment resolution, health problems and injury arising from impairment following amputation.

Correlates of Caregiving Burden among Bedouin-Muslim Mothers of Children Diagnosed with Epilepsy

A paucity of research exists on caregiving burden (CB) and the factors associated with it among minority groups, such as Bedouin mothers of children diagnosed with epilepsy (CDE). The aim of this study was to explore associations between CB and care-recipients' characteristics, contextual factors, and caregivers' characteristics among those mothers.

METHODS

A total of 50 mothers completed self-report questionnaires while visiting pediatric neurology outpatient clinic centers, using valid and reliable measures.

RESULTS

Bivariate associations were found between social support, number of medications, and CB. General self-efficacy and place of residence emerged as significant predictors of caregiver burden.

CONCLUSIONS

These findings provide health professionals with a better understanding of the factors that should be assessed in order to address caregiver burden among Bedouin mothers of CDE. Understanding the unique characteristics and culture of the Bedouin community can help professionals in targeting caregivers with a lower sense of self-efficacy, and those that reside in Bedouin cities, in order to reduce their caregiving burden.

Social Support and Psychological Distress among the Bedouin Arab Elderly in Israel: The Moderating Role of Gender

In Israel, as in other developed countries, mental health problems are common among older adults who are members of disadvantaged ethnic minorities that are experiencing cultural and social changes. The main goals of the current study were: (a) to examine gender differences in the levels of psychological distress and social support among Bedouin elders, and (b) to examine the moderating role of gender in the associations between social support indices and psychological distress. We used a cross-sectional design, and independent t-tests and hierarchical linear regression analysis were performed. The study was conducted in homes and in social clubs and community centers for elderly people and involved face-to-face interviews and self-administered questionnaires. A convenience sample of 170 Bedouin Arab elderly people living in Israel participated in the study. Participants completed self-report questionnaires that assessed psychological distress, perceived social support, instrumental social support, and socio-demographic characteristics. Male elders reported lower levels of psychological distress and higher levels of instrumental support. Female elders, who reported low levels of both perceived and instrumental support, also reported higher levels of psychological distress. Among the women, there were significant associations between psychological distress and perceived social support, and instrumental support only when the levels of support were low. This study underscores the moderating role of gender in the associations between different types of social support and psychological distress among elderly people belonging to ethnic and cultural underprivileged minority groups.

Age-related differences in depressive symptoms and coping strategies during the COVID-19 pandemic in Japan: A longitudinal study

OBJECTIVE

The coronavirus 2019 (COVID-19) pandemic has particularly influenced the mental health of younger adults; accordingly, this study investigated age-related factors related to mental health and provided suggestions related to mental health recovery.

METHODS

A web-based longitudinal survey was conducted from 2020 to 2021 in Japan. The survey consisted of the Patient Health Questionnaire-9 (PHQ-9), used to measure depressive symptoms as a response variable, and an anger questionnaire and coping strategy scale to assess explanatory variables.

RESULTS

A total of 1468 participants were analyzed (valid response rate = 54.2%); 368 were younger adults (age range = 20-39), 667 were middle-aged adults (age range = 40-64), and 433 were aged adults (age range = 65-79). The PHQ-9 scores in the younger adults worsened over the three survey timepoints. State anger was strongly related to PHQ-9 scores in all age groups (standardized beta = 0.39-0.47), and state anger in the younger group was highest at all survey times, In the younger group, only nonadaptive coping strategies were related to PHQ-9 scores. Emotional support, venting, and humor adaptive strategies used by middle-aged and aged adults were most commonly used by younger adults; however, there were no significant relationships of these strategies with PHQ-9 scores in the younger group.

CONCLUSION

The level of depressive symptoms among the younger adults might be considerably worse than the middle-aged and aged adult. The younger adults might not make use of strategies, hence, they might need advice and skill training of strategies.

Correlates of participation in physical activity among older women in Israel: does ethno-cultural background matter?

Osteoporosis and its related fractures are major public health concerns. Physical activity (PA) is crucial for bone density preservation and fractures prevention. Yet, gaps in understanding exist regarding how ethno-cultural backgrounds might shape attitudes, intentions and actual PA participation. Based on the theory of planned behaviour (TPB) for predicting PA, the aims of this study were: (i) to compare attitudes, subjective norms, perceived control, intentions and knowledge, across four ethno-cultural groups; (ii) to evaluate the fit of the model we constructed across four ethno-cultural groups of women: Israeli-born Jews and Israeli-born Bedouin-Muslims, immigrants from the Former Soviet Union (FSU) and Ethiopian immigrants. Four hundred women (one hundred from each group), aged >65, completed valid and reliable questionnaires assessing knowledge, TPB components and actual PA. The level of knowledge on osteoporosis was relatively low among all four ethno-cultural groups. Intention to participate in PA was the only variable that directly predicted actual PA. Intention to participate in PA served as a mediator among attitudes, subjective norms, perceived control and actual PA. The structural equation models (SEMs) revealed that among Israeli-born Jews and Ethiopian immigrants, TPB components mediated the link between knowledge and intention to participate in PA. Among FSU immigrants and Israeli Bedouin-Muslims, the knowledge variable was not included in the final model, as its contribution was not significant. It is essential to better understand and augment interventions that enhance PA in the community, and to address the unique needs of each ethno-cultural group.

Between a woman and her fetus: Bedouin women mediators advance the health of pregnant women and babies in their society

INTRODUCTION

Bedouin women in Israel confront a challenging circumstance between their traditional patriarchal society and transition to modernity. In terms of reproductive health, they face grave disparities as women, pregnant women and mothers. In this article we aim to understand the challenges of Bedouin women who work as mediators in the promotion of Bedouin women's perinatal health. We explore their challenges with the dual and often conflictual role as health peer-instructors-mediators in mother-and-child clinics, and also as members of a Bedouin community, embodying a status as women, mothers, and family caretakers. Drawn upon a feminist interpretative framework, the article describes their challenges in matters of perinatal health. Our research question is: how do women who traditionally suffer from blatant gender inequality utilize health-promotion work to navigate and empower themselves and other Bedouin women.

METHODS

Based on an interpretive feminist framework, we performed narrative analysis on eleven in-depth interviews with health mediators who worked in a project in the Negev area of Israel. The article qualitatively analyses the ways in which Bedouin women mediators narrate their challenging situations.

RESULTS

This article shows how difficult health mediators' task may be for women with restricted education who struggle for autonomy and better social and maternal status. Through their praxis, women mediators develop a critical perspective without risking their commitments as women who are committed to their work as well as their society, communities, and families. These health mediators navigate their ways between the demands of their employer (the Israeli national mother and child health services) and their patriarchal Bedouin society. While avoiding open conflictual confrontations with both hegemonic powers, they also develop self-confidence and a critical and active approach.

CONCLUSIONS

The article shows the ways by which the mediator's activity involved in perinatal health-promotion may utilize modern perinatal medical knowledge to increase women's awareness and autonomy over their pregnant bodies and their role as caregivers. We hope our results will be applicable for other women as well, especially for women who belong to other traditional and patriarchal societies.

Physical Activity, Resilience, Sense of Coherence and Coping in People with Multiple Sclerosis in the Situation Derived from COVID-19

The confinement forced by COVID-19 can have repercussions on the health of people diagnosed with multiple sclerosis. The objective of this study is to analyze the relationships between physical activity, a sense of coherence, resilience and coping among people diagnosed with Multiple Sclerosis during the health emergency situation. To achieve this goal, this transversal descriptive study included 84 patients that belonged to multiple sclerosis associations during the period of confinement. Participants filled out the Physical Activity (IPAQ-SF), Sense of Coherence (SOC-13), Resilience Scale (ER-14) and coping (COPE-28) questionnaires. The results showed that the average age was 46.9 and that 67.9% had Relapsing Remittent Multiple Sclerosis diagnosed on average 13.9 years ago. They had a high degree (33.3%) and moderate degree (34.5%) of physical activity, high levels of resilience, while the level of a sense of coherence was average and the most commonly used strategies for coping were active confrontation and religion. Physical activity was not related to the rest of the studied variables, but there were correlations between the other variables. The people with multiple sclerosis who belong to patient associations have remained physically active during the obligatory confinement period and have elevated degrees of resilience and an average sense of coherence, as well as using suitable coping strategies, which is why the social-health resource of belonging to a patient association could be boosting these variables that are beneficial to their health.

Emotional distress among the Bedouin Arab and Jewish elderly in Israel: The roles of gender, discrimination, and self-esteem

Mental-health problems are common among older adults, especially those who are members of disadvantaged ethnic minorities. We explored ethnic and gender differences in emotional distress, perceived discrimination, and self-esteem among elderly Bedouin Arab and Jewish individuals in Israel, as well as the moderating role of discrimination in the association between self-esteem and emotional distress among Bedouin Arabs. The sample included 256 older adults (60 years old and above): 147 native-born Israeli Jews and 109 Bedouin Arabs. Participants completed self-report questionnaires that assessed emotional distress, perceived discrimination, self-esteem, and sociodemographic factors. Israeli Jews reported lower levels of emotional distress than Bedouin Arabs. Bedouin Arab women reported more emotional distress than Bedouin Arab men. Among the Bedouin Arabs, gender differences were found in the associations of perceived discrimination and self-esteem with emotional distress. Among the Bedouin men, discrimination and self-esteem were found to be significant predictors of emotional distress. Among the Bedouin women, we found a similar association between self-esteem and emotional distress. However, the protective role of self-esteem disappeared in the context of higher levels of daily discrimination. This study underscores how gender can affect the moderating role of discrimination in the association between self-esteem and emotional distress among the elderly.

Determinants of Bone Mineral Screening Behavior among Three Ethno-Cultural Groups of Women in Israel

Bone mineral density (BMD) screening is one of the main means to detect and treat osteoporosis. Yet, the manner in which ethno-cultural background is associated with BMD health cognitions and screening behavior remains limited. Several ethno-cultural groups (n = 100 in each group)—Israeli-born Jews, Israeli-born Bedouin-Muslims, and Jewish immigrants from the Former Soviet Union (FSU), mean age 70 (SD = 7.1)—participated in face-to-face interviews in a cross-sectional survey, using valid and reliable questionnaires on BMD screening behavior, knowledge about osteoporosis, and theory of planned behavior (TPB) components. FSU immigrants reported the lowest BMD screening behavior. The multivariate analysis showed that higher knowledge level, positive attitudes, supportive subjective norms, and greater intentions increase the probability of BMD screening behavior. The TPB attitude component had a more pronounced effect on the probability of undergoing BMD screening among Israeli-born Bedouin-Muslims compared to Israeli-born Jews. Our findings contribute to the TPB by deepening our understanding of the associations between TPB components and BMD screening behaviors, from an ethno-cultural perspective. To assure sufficient BMD screening behavior among all ethno-cultural groups, intervention programs—suited to address the unique characteristics of each ethno-cultural group—are required.

Acculturative Stress among Arab Students in Israel: The Roles of Sense of Coherence and Coping Strategies

BACKGROUND

In Israeli colleges and universities, many Arab students experience acculturative stress. Such stress arises from the need to learn new cultural rules, manage the overarching conflict inherent in maintaining elements of their culture of origin (i.e., Arab culture) while incorporating elements of the host culture (i.e., Jewish academic culture), and deal with experiences of prejudice and discrimination present in the host culture.

METHODS

This study investigated the association between acculturative stress and depressive symptoms among 170 Arab undergraduates from northern and central Israel. It also explored the roles of sense of coherence and coping strategies in the relationship between acculturative stress and depressive symptoms. Participants completed questionnaires on acculturative stress, depressive symptoms, sense of coherence, coping strategies, and demographics.

RESULTS

The findings reveal gender differences in the use of different coping strategies and in levels of depressive symptoms. However, academic-year differences were found only in levels of sense of coherence and depressive symptoms. Specifically, female students expressed higher levels of both active and avoidant coping. Moreover, female students and those in their first and second years of university studies reported higher levels of depressive symptoms. Among the male students, acculturative stress was related to depressive symptoms indirectly via sense of coherence and active coping. In contrast, among the female students, acculturative stress was related to depressive symptoms both directly and indirectly via sense of coherence and avoidant coping. Among first- and second-year students, acculturative stress was related to depressive symptoms indirectly via sense of coherence and avoidant coping. However, among third- and fourth-year students, acculturative stress was related to depressive symptoms both directly and indirectly via sense of coherence.

CONCLUSIONS

This article underscores the significance of gender and academic-year differences in pathways involving acculturative stress.

Women in Refugee Camps: Which Coping Resources Help Them to Adapt?

: The present study aimed to explore the coping resources and mental health of women who have fled Syria to a neighboring European country. To that end, we examined the roles of sociodemographic factors, situational factors, and personal and community sense of coherence (SOC and ComSOC, respectively) in mental-health outcomes. One hundred and eleven refugee women aged 19-70 filled out self-reported questionnaires during August 2018 in a refugee camp in Greece. The questionnaires asked the participants for demographic information (i.e., age, level of education level, and time spent in the camp) and also addressed the situational factors of having received aid from various organizations, appraisal of danger during the war in Syria, and exposure to war experiences, as well as the coping resources of SOC and ComSOC. The results show that time spent in the camp, appraisal of danger, SOC, and ComSOC all play significant roles in predicting the variance of various mental-health outcomes. Together, those factors predict 56% of anxiety, 53% of depression, and 58% of somatization. SOC was also found to mediate the relationships between time spent in the camp and outcome variables, as well as the relationships between the appraisal of danger and the outcome variables. This indicates that SOC is crucial for good adaptation. These results will be discussed in light of the salutogenic theory.