Parenting a High and Growing Population of Youth in the Arab Region: A Scoping Review for an Evidence-Informed Research Agenda

The Arab region is experiencing the largest youth cohort in its history. Parental influence is a clear factor in the well-being of this demographic. This scoping review serves as the first consolidated synthesis of existing research on parenting in the Arab world, aimed at identifying research gaps and informing future research agendas. Searches of 18 databases resulted in 4,758 records (1995-2018) in all languages. Using Arksey and O'Malley's methodological framework, eligible studies (n = 152) underwent duplicate data abstraction. An evidence gap map was developed using 3i.e.'s platform. Studies were mostly published in English (88%), and lead authors' affiliations were mostly from Arab institutions. Included studies were mostly cross-sectional (89%), quantitative (96%), conducted in a school/university (83%), and surveyed children and adolescents (70%). Most studies (79%) examined parenting influences on youth outcomes. Fewer examined parenting measurement (30%) or evaluated interventions (1%). Mental health and school performance were the most commonly investigated outcomes. The evidence gap map allows researchers who study youth in the Arab world to efficiently and visually delineate the gaps and strategically prioritize research needs. Future studies should employ robust mixed methods study designs, focus on evaluation and psychometric research, engage youth in the research process and explore a more diverse set of outcomes.

Osteoporotic hip and vertebral fractures in the Arab region: a systematic review

Asia is projected to account for the largest proportion of the rising burden of osteoporotic fractures worldwide. Data from the Middle East is scarce. We performed a systematic review on the epidemiology of vertebral and hip osteoporotic fractures in 22 Arab League countries, using Scopus, PubMed, and Embase. We identified 67 relevant publications, 28 on hip and 39 on vertebral fractures. The mean age of patients was 70-74 years, female to male ratio 1.2:2.1. Age-standardized incidence rates, to the UN 2010 population, were 236 to 290/100,000 for women from Kuwait and Lebanon, lower in Morocco. Risk factors for hip fractures included lower BMD or BMI, taller stature, anxiolytics, and sleeping pills. Most patients were not tested nor treated. Mortality derived from retrospective studies ranged between 10 and 20% at 1 year, and between 25 and 30% at 2-3 years. Among 39 studies on vertebral fractures, 18 described prevalence of morphometric fractures. Excluding grade 1 fractures, 13.3-20.2% of women, mean age 58-74 years, had prevalent vertebral fractures, as did 10-14% of men, mean age 62-74 years. Risk factors included age, gender, smoking, multiparity, years since menopause, low BMD, bone markers, high sclerostin, low IgF1, hypovitaminosis D, abdominal aortic calcification score, and VDR polymorphisms. Vertebral fracture incidence in women from Saudi Arabia, mean age 61, was 6.2% at 5 years, including grade 1 fractures. Prospective population-based fracture registries, prevalence studies, predictive models, fracture outcomes, and fracture liaison services from Arab countries are still lacking today. They are the pillars to closing the care gap of this morbid disease.

Gaps and opportunities for nutrition research in relation to non-communicable diseases in Arab countries: Call for an informed research agenda

Effective public health nutrition interventions are needed to curb the escalating prevalence of non-communicable diseases (NCDs) in many Arab countries. In order to generate the scientific evidence needed for the success of these interventions, an informed research agenda should be developed. The purpose of this review is to identify gaps and opportunities for research on nutrition and NCDs among Arab countries, which is an important step towards the formulation of this research agenda. Published papers that addressed nutrition and NCDs in Arab countries between the years 2006 and 2015 were reviewed (n=824). The main gaps identified were related to the predominance of laboratory-based studies with few cohort and intervention studies, and the small percentage of articles examining dietary patterns. While food frequency questionnaires were the main dietary assessment method used, only 35% were validated. Very few studies included children and the majority considered nutrition in isolation, excluding other environmental factors. Opportunities identified included the promising momentum in studying nutrition and NCDs among Arab countries, evidenced by an increasing number of articles published over the years, that may be guided in future nutrition research to fill the identified gaps. In addition, the higher number of articles in high-income countries coupled with the impact of papers in middle-income countries suggests an opportunity of synergistic collaboration among these countries. The identified gaps and opportunities in this review may serve as basis for Arab countries to start developing a research agenda in the area of nutrition and NCDs.