Diabetic foot disease management in the Gulf Cooperation Council countries: a scoping review protocol

Interpreting mortality trends in the GCC countries: The healthy migrant effect

Sickle Cell Health Awareness, Perspectives, and Experiences (SHAPE) Survey: Findings on the Burden of Sickle Cell Disease and Impact on the Quality of Life of Patients and Caregivers in Gulf Cooperation Council Countries

Sickle Cell Health Awareness, Perspectives, and Experiences (SHAPE) Survey: Perspectives of Physicians in Gulf Cooperation Council Countries on Sickle Cell Disease

In the GCC countries, date-palm sector is strategically important for the economic, social and environmental development. Therefore, markets globalization has had a huge impact on the comparative advantages of date exports from the GCC countries, highlighting a new range of necessary determinants for competitiveness of these countries on the international date palm date market. The current study is conducted in the framework of the “Development of sustainable date palm production systems in the GCC countries of the Arabian Peninsula” project funded by the Gulf Cooperation Council (GCC) and led by the International Center for Agricultural Research in the Dry Areas (ICARDA), and aims to provide updated estimates of competitiveness indicators of the GCC countries on the international market of date palm.The study starts by a summary description of updated figures concerning date’s production, yields, and consumption trends of the different GCC countries. This first part of the research paper also includes a presentation of the date trade matrix (destinations of exports and imports) of the considered countries. In a second part of this section, a set of competitiveness indicators were calculated to better reflect on the date trade balances performances of each of the GCC countries. The measures of competitiveness indicators conducted in this paper include: i) the Market Share (MS); ii) the Revealed Comparative Advantage (RCA); and iii) the Trade Balance Index (TBI). The Market share indicator was used to identify size advantages and the degree of specialization of a given country on the international market of a given commodity. The RCA has been defined as a measure of performance of international trade competitiveness of a given country for a given commodity. The TBI is used to analyze whether a country has specialization in export (as net-exporter) or in import (as net-importer) for a specific group of products. Data from both FAOSTAT and UN COMTRADE sources was used for the calculation of these indicators. Empirical findings show that GCC and North African countries are holding more than 70% of the international market of dates. The sum of market shares of the 6 GCC countries was about 30% of the international date market during 2015. This is showing that these countries together have strong potential for dominating the international date market. In terms of growth, it was clear that all GCC countries, including the least present on the international market are progressing quite positively with increasing shares from one year to another. In terms of RCA, the highest RCA value was recorded for Saudi Arabia (KSA). It was for about 43.5 in 2013, indicating that the country date export share for 2013 is 43.5% higher than its share in total world export of agricultural goods. Finally, TBI results show the existence of structural differences between KSA and UAE in terms of dates export and import patterns. These two countries are both the main players in date export in the GCC area. However, even though UAE is a net exporter of date palm, which its TBI is much lower than the TBI of KSA, showing that UAE is also importing a higher proportion of its exported dates compared to KSA. The date trade patterns among the GCC countries shows that there is a wide scope of coordination between the different trade strategies of these countries, through specialization and division of tasks. This can generate important opportunities for gaining more weight on the world market of dates.

The prospective cohort Dialysis Outcomes and Practice Patterns Study (DOPPS) initiated data collection in national samples of hemodialysis (HD) units (total of 41 study sites) in all six Gulf Cooperation Council (GCC) countries (Bahrain, Kuwait, Oman, Qatar, Saudi Arabia, and the United Arab Emirates) in late 2012. Here, we report initial results regarding mineral bone disorders (MBDs) and its management in the GCC countries. Forty-one randomly selected HD facilities, treating >23 HD patients each, were sampled and represent care for >95% of GCC HD patients. Descriptive results for the GCC countries based on a random sample of 20-30 HD patients in each study facility. Initial results for the GCC are from 931 HD patients treated at 41 dialysis units (ranging from 1 unit in Bahrain to 21 in Saudi Arabia). Results are presented as weighted estimates, accounting for the sampling fraction in each unit. Baseline descriptive statistics (e.g., mean, median, or percentage), weighted by facility sampling fraction were calculated for the study sample. For analyses examining the percent of facility patients having (a) serum phosphorus >6.0 mg/dL or (b) parathyroid hormone (PTH) >600 pg/mL, analyses were restricted to facilities having at least 10 HD patients with a reported serum phosphorus or PTH measurement, respectively. Logistic regression analyses of the indicated binary outcomes were based on the use of generalized estimating equations and were adjusted for GCC country, patient age category (<45 years, 45-65 years, and >65 years old), sex, and whether the patient was diagnosed with diabetes mellitus. Logistic models accounted for clustering of patients within facilities, assuming an exchangeable working correlation matrix. Mean age of HD patients in the GCC countries was 53 years vs. 61-64 years in the three other DOPPS regions. MBD markers showed slightly lower mean serum Calcium in the GCC countries, similar mean serum phosphorus, and intermediate median PTH levels compared with the three other DOPPS regions. Among GCC countries, the country mean value of MBD markers ranged from 8.6-9.0 mg/dL for serum calcium, 4.4-5.4 mg/dL for serum phosphorus, whereas median PTH ranged from 163-389 pg/mL. Similar to other DOPPS regions, PTH was higher among patients who were younger or without diabetes, and serum phosphorus was lower with older age (P <0.001 for each). History of parathyroidectomy was lower in the GCC countries versus other regions but did not differ when adjusted for age and dialysis vintage. Among treatments used for managing MBD, the GCC countries showed one of the highest uses of cinacalcet (24%) and phosphorus binder use (81%), whereas intravenous Vitamin D use (24%) was slightly higher than that in EURANZ. A much larger fraction of HD patients in the GCC countries had a dialysate calcium bath ≥3.5 mEq/L (43%) versus 0-4% in the three other DOPPS regions. Although many aspects of MBD management and MBD marker achievement are similar in the GCC countries to that seen in other DOPPS study regions, large variability was seen across countries and facilities in the GCC. Mean serum calcium was lower in the GCC despite the much greater use of dialysate Ca of ~3.5 mEq/L which may be due to the relatively low use of vitamin D and higher cinacalcet use, meriting further study. Future work will focus on GCC facility HD practices and patient characteristics most strongly related to the achievement of MBD target levels and associated outcomes.

Korean Abstract: 본 연구는 최근 국제유가 하락에 따라 한ㆍ중동 경제협력이 위축될 것이라는 우려가 있지만, 유가 하락이 중동 산유국에는 오히려 경제 체질을 개선할 수 있는 기회가 될 수 있고, 우리는 이러한 기회요인을 적극적으로 활용하여 향후 한ㆍ중동 동반성장을 위한 지속적인 경협관계를 만들어나가야 한다는 점을 제시한다는 데 의의가 있다. English Abstract: The aim of the research is to suggest economic cooperation framework between Korea and the Middle East in the times of lower oil prices. A rapid decline of oil prices since the second half of 2014 has negatively impacted on economy of the GCC(Gulf Cooperation Council) countries which heavily depend on oil and gas sector. GCC countries are facing economic recession with the worsening of the financial situation, lack of liquidity and decrease of investment. The sharp drop in oil revenues due to lower oil prices caused government fiscal distress and made the GCC countries use accumulated foreign exchange reserves and sovereign wealth fund. They also prioritize projects focusing on social infrastructure including education and public services, leading to decrease of number of project contracts awarded in the GCC region. In response to the economic slowdown and fiscal burden, GCC countries have strengthened policy measures for economic diversification. They have promoted various supporting policies to nurture their strategic industries - most notably the renewable energy sector - and competitive small and medium-sized enterprises in the region. In order to regain fiscal soundness, GCC countries have been trying to cut their energy subsidies and revise the tax system, expanding government loans and privatization of their state-owned companies than the past. Moreover, they are making more efforts to increase foreign direct investment inflows with improvement of business environment and PPP(Public-Private Partnership) procedures. The economic difficulties facing the GCC countries due to lower oil prices is causing a significant concern over dwindling economic cooperation between Korea and the GCC countries. In response to this, a new cooperation framework is needed to strengthen bilateral ties for shared growth. Four fields of cooperation can be identified as follows. First, industrial cooperation should be reinforced to expand economic diversification and job creation in the GCC countries. Second, energy cooperation should be broadened into the fields of renewable energy development and energy efficiency technology other than energy trade. Third, investment cooperation need to be strengthened to facilitate joint investment in the region including joint ventures. Fourth, institutional cooperation between governments is needed to share Korean institutional reforms in the fields of tax, subsidy, privatization, FDI and so on, deepening mutual understanding of economic partners for co-development.

Over the last six decades, the reliance of the Gulf Cooperation Council (GCC) countries’ economy on expatriate workforce has increased incessantly. The majority of the private sector workforce in the Gulf Cooperation Council (GCC) countries are expatriates. Recent attempts by governments in the GCC countries to localise the workforce, through their workforce nationalisation programmes, have offered limited results. Thus, dependence on expatriate workforce will continue in the near future and GCC countries, short of professionally and technically qualified local workers will need to employ a large number of expatriates to support their economic and social development plans. This calls for a systematic approach to understand the specific challenges faced by expatriates of different nationalities in the GCC countries, so that these challenges can be addressed to enable the GCC countries to become a preferred destination for technically and professionally qualified expatriate workers. This paper presents an overview of the GCC countries; the reasons for their dependence on expatriate workforce; key current challenges faced by expatriates in the GCC countries and suggestions for facilitating adjustment of expatriate workers in the GCC countries.

BackgroundAsthma control is influenced by multiple factors. These factors must be considered when appraising asthma interventions and their effectiveness in the Gulf Cooperation Council (GCC) countries (Bahrain, Kuwait, Oman, Qatar, Saudi Arabia and United Arab Emirates [UAE]). Based on published studies, the most prevalent asthma treatment in these countries are fixed dose combinations (FDC) of inhaled corticosteroid and long-acting beta-agonist (ICS/LABA). This study is a rapid review of the literature on: (a) factors associated with asthma control in the GCC countries and (b) generalisability of ICS/LABA FDC effectiveness studies.MethodsTo review local factors associated with asthma control and, generalisability of published ICS/LABA FDC studies, two rapid reviews were conducted. Review 1 targeted literature pertaining to asthma control factors in GCC countries. Eligible studies were appraised, and clustering methodology used to summarise factors. Review 2 assessed ICS/LABA FDC studies in conditions close to actual clinical practice (i.e. effectiveness studies). Eligibility was determined by reviewing study characteristics. Evaluation of studies focused on randomised controlled trials (RCTs). In both reviews, initial (January 2018) and updated (November 2019) searches were conducted in EMBASE and PubMed databases. Eligible studies were appraised using the Critical Appraisal Skills Program (CASP) checklists.ResultsWe identified 51 publications reporting factors associated with asthma control. These publications reported studies conducted in Saudi Arabia (35), Qatar (5), Kuwait (5), UAE (3), Oman (1) and multiple countries (2). The most common factors associated with asthma control were: asthma-related education (13 articles), demographics (11articles), comorbidities (11 articles) and environmental exposures (11 articles). Review 2 identified 61 articles reporting ICS/LABA FDC effectiveness studies from countries outside of the GCC. Of these, six RCTs were critically appraised. The adequacy of RCTs in informing clinical practice varied when appraised against previously published criteria.ConclusionsAsthma-related education was the most recurring factor associated with asthma control in the GCC countries. Moreover, the generalisability of ICS/LABA FDC studies to this region is variable. Hence, asthma patients in the region, particularly those on ICS/LABA FDC, will continue to require physician review and oversight. While our findings provide evidence for local treatment guidelines, further research is required in GCC countries to establish the causal pathways through which asthma-related education influence asthma control for patients on ICS/LABA FDC therapy.

PurposeThis paper aims to compare and analyse the aspects of Shariah screening methodologies within the selected Gulf Cooperation Council (GCC) countries as well as comparing the methodologies with the USA, and to examine how Shariah screening methodologies affect financing and investing activities of a firm.Design/methodology/approachShariah screening methodologies within the selected GCC countries and between the GCC countries and the USA are compared on the basis of the data collected from secondary sources.FindingsDesign, qualification and Shariah governance set the Shariah screening methodologies within the GCC countries apart. Feasibility, duration, economic viability and funds required differentiate these Shariah screening methodologies between the GCC countries and the USA. Shariah screening methodologies implied in the USA is more stringent than in the GCC countries.Research limitations/implicationsThe suggestions in this study include using a longer research timeline, examining many more number of countries’ Shariah screening methodologies and exploring other types of Shariah screening methodologies.Practical implicationsThe possibility of generalising the implementation of strict and uniform Shariah screening methodologies across all the country-specific Shariah indices amongst Muslim nations, globally, is likely to benefit all the Muslim countries, by strengthening the understanding, interaction and economic co-operation amongst these countries.Social implicationsPeople’s needs can be tended to if Maqasid Al-Shariah (objectives of Shariah) is achieved through flexibility, dynamism and creativity within the social policy.Originality/valueAspects of Shariah screening methodologies are compared and contrasted within the selected GCC countries as well as between the GCC countries and the United States and the role of Shariah screening methodologies is examined in order to determine the extent of what is Shariah-Compliant and what is Non-Shariah Compliant for a firm.

In general, foreign direct investments (FDIs) play a crucial role in driving a country's economic development, promoting diversification, and enhancing competitiveness. The Gulf Cooperation Council (GCC) countries, which heavily rely on the oil and gas sectors, are particularly vulnerable to fluctuations in commodity prices. However, these countries have recognized the imperative of economic diversification and have increasingly turned to inward FDIs to achieve it. By attracting capital, advanced technology, and expertise from foreign investors, FDIs enable the GCC countries to expand their economic base beyond the oil and gas sectors. This diversification not only creates employment opportunities but also fosters resilient economic growth, ultimately leading to an improvement in the living standards of the local population. This study investigates the macroeconomic and environmental factors that potentially attract foreign direct investment (FDI) inflows into the Gulf Cooperation Council (GCC) countries in the long run. Additionally, the study explores the causal relationship between these factors and FDI inflows. The panel autoregressive distributed lag (ARDL) approach to co-integration is the primary analytical technique used, utilizing long time-series data from six GCC countries, including Bahrain, Kuwait, Oman, Qatar, Saudi Arabia, and the United Arab Emirates (UAE) during the period 1990-2019. The empirical results indicate that, in the long run, almost all independent variables significantly influence FDI in GCC countries. Variables such as GDP growth (GDPG), inflation (INFL), carbon dioxide emissions (CO2), and urbanization (URB) are found to be highly significant (p≤0.01) in their impact on FDI. Moreover, unemployment (UNEMP) also positively and significantly influences FDI in these countries in the long run. Based on the key findings, strategies aimed at reducing persistently high unemployment rates, maintaining population growth, viewing FDI as a driver for GDP growth, and continuing with infrastructure development and urbanization are expected to attract more FDI inflows into GCC countries in the long run. Additionally, fostering both long-term economic incentives and creating a conducive business infrastructure for investors are vital for attracting inward FDI into any nation, including those in the GCC. This research would benefit various stakeholders, including governments, local businesses, investors, academia, and the local society, by providing valuable knowledge and informing decision-making processes related to economic development, diversification, and investment promotion.

India and the Gulf Cooperation Council (GCC) countries have age old relations. Indians and people from these countries have frequently travelled to each other’s countries for trade as well as other activities. Indians have been traced in GCC countries for a long time. Indians going to those countries for business, work and other purposes have been a very old phenomenon. Even in pre-oil era, thousands of Indians went to earn a livelihood in GCC countries and many of them settled there forever. However, Indians going to work on a massive scale to these countries is a post-1973 oil era phenomena. The massive inflow of oil revenues consequent to the high rise in global oil price saw unprecedented level of economic development in these countries. However, such development required massive level of manpower, which these countries did not have and this is why these countries are characterized as capital rich labour scarce countries. The economic development in post-1973 oil era in these countries resulted in large scale import of manpower from abroad. As Indians were not new to these lands, the Indian workers also started migrating to these countries in search of employment and better life. Today Indians are present in each sector of economies of GCC countries. Millions of Indian migrant workers abound the GCC countries and contribute their bit in building those economies. However, this benefits them also as well as the Indian economy. These Indian migrant workers are crucial for both Indian as well as GCC countries. This study is a detailed probe into this phenomenon.

In terms of natural water resources, the GCC countries are ranked among the poorest and least secure in the world. During the past 50 years, and as a result of the oil boom, these countries have relied almost entirely on seawater desalination (reliance on desalination to produce freshwater in the GCC countries ranges from 50−90%) to meet the freshwater needs of the various consumption sectors. However, such reliance on desalination comes at a very high price. The extremely high capital and operational costs of seawater desalination have weighed heavily on the financial resources of these countries at the expense of other developmental plans and strategies. For example in Kuwait, the government spends 1.3 billion KD (US$4.55 billion) annually to operate and maintain water desalination and energy production plants. According to a recent study conducted by the Kuwait Institute for Scientific Research (KISR), Kuwait currently uses about 12% of its oil production to provide the fuel needed to operate these plants. This percentage is expected to increase to about 50% by 2050 (El-Sayed et al. 2010). In addition to the high financial burden, these plants pose a serious environmental threat in terms of gaseous emissions into the atmosphere (for example, seawater desalination and power generation plants in Kuwait emit 230 metric tons of nitrogen, sulphur and carbon annually into the atmosphere; El-Sayed et al. 2010). Furthermore, these plants are vulnerable to unexpected shutdowns and/or periodic maintenance, particularly in cases of seawater pollution, environmental catastrophes and war. Therefore, the GCC countries should relentlessly explore all possible avenues to find additional sources of freshwater supplies to meet the increasing demand. Despite its limited quantities and mostly poor quality, groundwater is an indispensable source of water for the GCC countries. It is used for blending with desalinated water to make it potable, as well as in numerous agricultural and some oil-related activities (with the need to enhance recovery and to produce heavy oil reserves, oil companies in the GCC countries are relying more and more on injecting either groundwater or steam produced from it into the oilbearing aquifers to increase their pressure and/or the mobility of oil, thereby increasing the quantity of oil produced). The aforementioned activities have resulted in a significant drop in the groundwater levels and deterioration of its quality. Treated wastewater is one of the emerging water resources in the GCC countries. Dependence on this source of water has increased significantly, particularly during the past few years. The produced water is used for agricultural and landscaping purposes as well as various non-potable activities. Despite the fact that this source of water is the only source that increases with the increase in population, its utilization has been constrained by the “impure” stigma attached to it.

In the six Gulf Cooperation Council (GCC) countries, liberal economic policies of the government have created an economic structure that is highly dependent on an expatriate workforce, thus marginalizing the citizens in terms of the economy and demography. This chapter deals with questions such as “If the profit motive of the private sector is leading to possible social crises in the GCC countries, what is the CSR of the private sector?” and “How are the six GGC governments positioned in influencing CSR?” With an overview of business and its social responsibility in the GCC countries, this chapter undertakes a case study of CSR in the UAE. It shows that social responsibility of business entities in the GCC countries is limited to complying with the corporate governance reporting regulations of the government. The chapter, however, concludes that because the economic and political power structures are entwined (being connected to the social and tribal systems), the GCC governments can influence the business community only through persuasion, not legislation. Therefore, it is unlikely that the character and extent of CSR in the GCC countries will change any time soon.

Purpose This paper aims to examine the level of Islamic social reporting (ISR) disclosure of Islamic banking in Gulf Cooperative Council (GCC) countries using a checklist based on Accounting and Auditing Organization for Islamic Financial Institution (AAOIFI) standards. Design/methodology/approach A quantitative method – Tobit Model – is adopted in this study. The unweighted disclosure method used to measure the ISR disclosure checklist consist of 51 items in Islamic banks (IBs) in the GCC countries. The stakeholder theory and legitimacy theory are used to investigate the possible banking performance factors affecting the accounting practices such as ISR disclosure in IBs. Findings The findings show that the ISR disclosure index is linked to the IBs’ performance indicators in GCC countries. The result indicates both Islamic banking profitability and age establish positive and statistically significant relationship with ISR disclosure while leverage establishes significant negative relationship with ISR disclosure. This implies that Islamic banking profitability, leverage, and age are essential bank performance indicators that make ISR disclosure worthy of doing even in the presence of Islamic bank stakeholders in GCC countries. This finding linked compliance with the mandatory disclosure recommendations of AAOIFI Standard No. 7, as well as voluntary disclosure. Research limitations/implications This study used cross sectional data for the year 2019, which is considered more recent despite its being a year data analysis. However, future research should consider mix method as well as more analysis tools provided their number of observations are sufficient enough. Social implications The study identifies the factors that may enhance Islamic financial institutions, including Islamic banking in GCC countries, to comply with ISR disclosure. The application of this study supports Accounting standards setters to consider standards that support ISR disclosure in Islamic banking in different countries. Originality/value To the best of the authors’ knowledge, this study is novel in exploring the level of ISR disclosure in Islamic banking in GCC countries by using a checklist based on AAOIFI standard No. 7 and establishes the relationship between ISR disclosure index and IBs profitability, leverage, as well as age of Islamic banking in operation.

The Gulf Cooperation Council (GCC) countries are located in the driest part of the world with an annual per capita water availability of 500 m3 compared to the world average of 6000 m3. Agricultural water demand, which is more than 80% of the total water consumption, is primarily met through the massive exploitation of groundwater. The enormous imbalance between groundwater discharge (27.8 billion m3) and recharge (5.3 billion m3) is causing the excessive lowering of groundwater levels. Therefore, GCC countries are investing heavily in the production of nonconventional water resources such as desalination of seawater and treated wastewater. Currently, 439 desalination plants are annually producing 5.75 billion m3 of desalinated water in the GCC countries. The annual wastewater collection is about 4.0 billion m3, of which 73% is treated with the help of 300 wastewater treatment plants. Despite extreme water poverty, only 39% of the treated wastewater is reused, and the remaining is discharged into the sea. The treated wastewater (TWW) is used for the landscape, forestry, and construction industries. However, its reuse to irrigate food and forage crops is restricted due to health, social, religious, and environmental concerns. Substantial research evidence exists that treated wastewater can safely be used to grow food and forage crops under the agroclimatic conditions of the GCC countries by adopting appropriate management measures. Therefore, GCC countries should work on increasing the use of TWW in the agriculture sector. Increased use of TWW in agriculture can significantly reduce the pressure on freshwater resources. For this purpose, a comprehensive awareness campaign needs to be initiated to address the social and religious concerns of farming communities and consumers. Several internal and external risks can jeopardize the sustainable use of treated wastewater in the GCC countries. These include climate change, increasing costs, technological and market-driven changes, and regional security issues. Therefore, effective response mechanisms should be developed to mitigate future risks and threats. For this purpose, an integrated approach involving all concerned local and regional stakeholders needs to be adopted.