Bedouin Children Research Articles

Camel Ownership as a Passage to Adulthood in Omani Bedouin Culture

ABSTRACT The development of adolescent humans through child–pet interaction and attachment is the focus of the current study. The context is the Omani Bedouin culture, which is inseparably linked to camel culture. This culture promotes the importance of nurturing relationships between camels and their cameleers. We suggest that proximity to and contact with camels from an early age helps camel-owning Bedouin children to navigate their journey more smoothly from childhood to adulthood. The study is based on informal conversations, collected over 1 year, with Bedouin children and their parents who have all grown up with camels in Al Wahiba, a Bedouin people of the Sharqiyah, Oman. By analyzing such narratives, we aimed to demonstrate the depth of impact that this contact with camels has on the cognitive, emotional, and social development of Bedouin children. The data suggest that child cameleers experience emotional, social, and cognitive benefits from contact with and attachment to camels. The findings from the parents of these adolescents also suggest that the children demonstrate higher levels of cognitive and emotional maturity and seem to socialize and become integrated into the community more easily compared with their siblings who do not own camels. The novelty of the current study is that it sheds light on how the socio-cultural context embedded in the Bedouin culture affects the degree and nature of a child’s attachment to a pet camel and how that affects development in adolescence. The research took an inclusive approach by including both human and nonhuman agents (camels) in the analysis, and we discuss the findings in a post-colonial context.

Performance of Echinococcosis Serology is Associated with Disease Endemicity, Hydatid Cyst Location, Eosinophilia, Imaging Finding, and Treatment.

We aimed to assess echinococcosis serology performance for diagnosing cystic echinococcosis (CE) in children living in CE-endemic vs. non-endemic populations, and in different clinical settings. A retrospective cohort study, assessing children with ELISA test for echinococcosis, 2005-2021. Sensitivity, specificity, positive and negative predictive values (PPV and NPV) were calculated comparing CE-endemic vs. non-endemic populations, cases with/without eosinophilia, and cases with/without CE-suggestive imaging findings. Additionally, we examined the association between serology titers/levels (values) and clinical characteristics. Of 273 cases, 66 (24%) were confirmed as CE. Overall, 97% of CE were in Bedouin children, and the pre-test probability was 28% vs. 9% (p < 0.001) in CE-endemic vs. non-endemic population, respectively. Sensitivity was higher in hepatic than extra-hepatic CE (74% vs. 47%). Overall specificity was 86%. PPVs were higher in CE-endemic population compared to non-endemic (66% vs. 22%), while NPVs were higher in non-endemic population (100% vs. 87%). Eosinophilia was associated with lower specificity (73% vs. 94%) and PPV (47% vs. 78%). Typical imaging was associated with higher specificity (94% vs. 82%) and PPV (91% vs. 11%), while NPVs were lower in typical imaging cases (77% vs. 98%). Higher titer levels (above median) were associated with typical imaging (76% vs. 49%), higher PPV (79% vs. 43%), albendazole treatment (100% vs. 56%), surgery (60% vs. 19%), and new imaging finding (75% vs. 0%). Echinococcosis serology performance was impacted by disease endemicity, and by various clinical characteristics. These findings may assist physicians in the interpretation of echinococcosis serology results.

Dynamics of Pediatric Antibiotic Use Differ between High- and Low-Prescribing Clinics after Pneumococcal Conjugate Vaccines

To compare dispensed oral antibiotic prescription rates (DAPRs) after implementation of pneumococcal conjugate vaccine (PCV) in high antibiotic-prescribing clinics (HPC) with low antibiotic-prescribing clinics (LPC) in 2 distinct ethnic groups of children (Jewish and Bedouin children)<5years of age. Clinics with ≥50 insured children, active both pre-PCV (2005-2009) and post-PCV (2010-2018) implementation, were included. HPC and LPC were defined by DAPRs above or below the median in each age and ethnic group. Monthly dispensed antibiotic prescription rate (DAPR) trends (adjusted for age and ethnicity) were calculated using interrupted time series. Mean yearly incidence rate-ratios (late PCV13 vs pre-PCV) were calculated. Bedouin HPC had the highest pre-PCV overall-DAPR per 1000 child-years± SD (2520.4 ± 121.2), followed by Jewish HPC (1885.5 ± 47.6), Bedouin LPC (1314.8 ± 81.6), and Jewish LPC (996.0 ± 19.6). Shortly after PCV implementation, all DAPRs and amoxicillin/amoxicillin-clavulanate DAPRs declined in all groups except Jewish LPC, stabilizing within 4-5years post-PCV. The rates and magnitudes of declines were directly proportional to the pre-PCV DAPR magnitudes, achieving near-complete closure of the pre-PCV DAPR gaps between the 4 groups (rates during late-PCV13 ranging from 1649.4 ± 23.5 [Bedouin HPC] to 1200.3 ± 72.4 [Jewish LPC]). PCVs are a powerful tool in reducing outpatient antibiotic consumption among young children, especially in HPC, resulting in partial closure of DAPR gap between HPC and LPC. The higher impact on HPC suggests that PCV-associated declines of respiratory disease may strongly contribute to a judicious antibiotic approach in clinics with high antibiotic consumption.

The impact of pneumococcal conjugate vaccine on ceftriaxone consumption in the community among young children

ObjectivesFollowing pneumococcal conjugate vaccine (PCV) introduction, community pediatric dispensed prescription rates (DPR) of oral antibiotics declined, in parallel to respiratory tract infection (RTI). We assessed the dynamics of outpatient parenteral ceftriaxone DPR. MethodsComputerized data for children <5 years were examined during 13 years (including 4 pre-PCV years). DPR from clinics with ≥50 insured children, active both before and after PCV implementation were included. Interrupted time series with segmented regression stratified by age and ethnicity, and adjusted for seasonality was applied to show monthly DPR trends. ResultsA total of 29,226 prescriptions were dispensed. No significant trends in ceftriaxone DPR were seen pre-PCV. Shortly after PCV implementation, DPR abruptly and significantly declined, stabilizing in late-PCV period (5 years postimplementation). The dynamics were compared between the two ethnic groups in the region, Jewish and Bedouin children (the latter with higher crowding and respiratory disease rates). Among Jewish children, ceftriaxone was mainly dispensed during winter vs no seasonality among Bedouin children. ConclusionsIn southern Israel, outpatient ceftriaxone DPR declined post-PCV in young children, similar to the trends of RTIs and oral antibiotic prescriptions, suggesting a causative role of PCVs. The differences between the two ethnic groups suggest possible involvement of additional factors.

Risk factors for hospitalization at the pediatric intensive care unit among infants and children younger than 5 years of age diagnosed with infectious diseases.

Children hospitalized with infectious diseases may develop severe, life-threatening conditions, often requiring admission to pediatric intensive care unit (PICU). The objectives of this study were to identify independent risk factors for PICU hospitalization with an infectious disease in children <5 years of age. In southern Israel, two populations live side by side: the middle-high income Jewish population and the low-income Bedouin population, both receiving equal and free medical care at the only tertiary medical center in the area. The study population included all children born in southern Israel and hospitalized at PICU with an infectious disease during 1991-2012. Risk factors for PICU hospitalizations were retrospectively studied by Kaplan-Meier and Cox proportional hazard survival analyses. 9951 Jewish children and 18,002 Bedouin children were enrolled; overall, 1135 episodes of PICU hospitalizations with an infectious disease were recorded (879, 77.4% Bedouin and 256, 22.6% Jewish patients). Bedouin children had a higher risk for PICU hospitalization with an infectious disease compared with Jewish children (adjusted Hazard Ratio [adj. HR] 1.7, 95% CI 1.5-2.0); maternal multiparity and low-birth weight (<2500g) were additional risk factors for PICU hospitalization with an infectious disease compared to firstborns (adj. HR=1.2, 95% CI 1.0-1.5) or to children with a birth weight ≥2500g (adj. HR=1.5, 95% 1.2-1.9). Older age was a protective factor for PICU hospitalization (adj. HR=0.98, 95% CI 0.97-0.99). Children hospitalized with a central nervous system infection had the highest risk of PICU hospitalization (adj. HR 6.8, 95% CI 5.5-8.4), followed by those with urinary tract infections (UTI, adj. HR 3.1, 95% CI 2.5-3.8) and those with lower respiratory tract infections (LRTI, adj. HR 2.9, 95% CI 2.4-3.4). Bedouin ethnicity, low birth weight, maternal multiparity and younger age were significant risk factors for PICU hospitalizations with an infectious disease. Among the infectious diseases analyzed, CNS infection had the highest risk for PICU hospitalization, followed by UTI and LRTI.

When is an academic degree the best vocational education? Bedouin professionals reflect on their life choices

ABSTRACT We test Foster’s enduring assertion that “the best vocational education is an academic degree” by examining a case study of Israeli Bedouin women and men, young professionals who shared with us their personal stories of their parents taking them out of their local separate but equal schools and moving them to the majority schooling system. The narratives we collected enabled us to follow the education journey of Bedouin children whose achievements are attributable not to institutional initiatives but to grassroot alternatives where parents and their children secured their own vocational future. We outline the professional journey of 16 men and women who moved to a Kibbutz school, mastered the majority language, matriculated, and confidently acquired academic degrees. Their narratives attest to professionalization and self-fulfillment but also awareness of the context of their upbringing and the daily pressures to sustain their social equilibrium. These young professionals fashioned themselves in the interstices between identities, developing both a hunger to participate in the global marketplace and loyalty to the local. Ending up holding jobs that contributed to their own society, and refusing to perform stereotypically minoritized vocational identities, they achieved the kinds of lives they have reason to value. Compelled to honor their journeys, we conclude that our case study corroborates Foster’s finding that the best vocational education is an academic degree, as reflected in professional achievement and enhanced opportunities for social mobility.

Remote Versus In-person Outpatient Clinic Visits and Antibiotic Use Among Children During the COVID-19 Pandemic.

Background:The proportion of remote clinic visits was expected to increase among children during the COVID-19 pandemic which might result in antibiotic overuse.Methods:In southern Israel, 2 ethnic groups, Jewish and Bedouin, live side-by-side. Computerized data on visits for children <18 years were examined from clinics with ≥50 insured children, active both pre-COVID-19 and during the COVID-19 pandemic. Visits were divided into in-person and remote. Monthly infectious diagnoses and dispensed antibiotic prescription rates were calculated by age (<5, 5–17 years) and ethnic groups. Mean monthly rates of 2 parallel seasons (pre-COVID-19 and COVID-19 periods) were compared.Results:Overall 2,120,253 outpatient clinic visits were recorded. Remote clinic visit rates (per 1000 children) increased from 97.04 and 33.86 in the pre-COVID-19 to 179.75 and 50.05 in the COVID-19 period in Jewish and Bedouin children, respectively (P < 0.01) along with a reduction of in-person visit rates in both populations. Comparing pre-COVID-19 and COVID-19 periods, the rates of overall infectious diagnoses in remote visits increased. Nevertheless, dispensed antibiotic prescription rates in remote visits (per 1000 visits) remained unchanged (9.84 vs. 8.67, P = 0.70, in the Jewish population and 14.32 vs. 14.17, P = 1.00, in the Bedouin population in the pre-COVID-19 and COVID-19 periods, respectively) with a similar distribution of antibiotic categories.Conclusions:COVID-19 pandemic resulted in an expansion of remote visits of children <18 years with an increase in infectious diagnoses. However, remote dispensed antibiotic prescription rates remained unchanged. These dynamics were more accentuated in Jewish children, characterized by higher socio-economic conditions, compared to Bedouin children.

‘Bedouin Boy With Camel’: An Analysis of Archival Photographs of Bedouin Children in Palestine

ABSTRACT This study analyzes photographs found in historical archives of Bedouin children in Palestine from over a hundred years ago. The Bedouin children were photographed in their natural environment by foreign European photographers touring the Holy Land. Young children were photographed held by their mothers, at work, on a path, or near the tent. The research unravels the context in which the pictures were constructed, documented, and archived. The study explores how colonialist photography in the region generated tropes of presentation of Bedouin children and examines its effects on forms of representation of their childhood of the time. The Bedouin women’s inferior status in society and its impact on the documentation of women and children are also examined. The study highlights notions of other children dressing up as ‘Hebrew Bedouins’ for studio portraiture as part of an orientalist cliché.

Agency and life satisfaction in Bedouin children in occupied Palestinian territory: a cross-lagged longitudinal study

BackgroundBedouin children living in occupied Palestinian territory are at risk of developing trauma-related pathologies because of chronic exposure to political and military violence. Little is known about psychological wellbeing and life satisfaction in this group of children, or their coping skills and survival skills in adjusting to these conditions. MethodsOur longitudinal study aimed to assess the function of agency in predicting life satisfaction as a moderator for traumatic stress. We reasoned that the more that children show agency over time in activating domains of life satisfaction, the more they can be satisfied with their life and the less they will present signs of trauma. A cross-lagged path model (CLPM) was used to assess 143 children living in Bedouin communities located northeast of Jerusalem (area E1, Al Khan Al-Ahmar). The CLPM, a discrete time structural equation model to analyse panel data in which two or more variables are repeatedly measured at different timepoints, was run in January, 2019 (Time 1) and after 6 months (Time 2). We used the Children's Hope Scale (CHS) as a measure of agency, the Multidimensional Student Life Satisfaction Scale (MSLSS), and the Children's Revised Impact of Event Scale (CRIES). FindingsThe mean age of participants was 12·02 years (SD 2·05); 65 (46%) were male and 78 (55%) were female. Agency scores had a medium total positive standardised effect on life satisfaction (β=0·25 [95% CI 0·149 to 0·449]; p=0·004) and a small direct standardized effect on trauma symptoms (β=0·08 [0·139 to 0·450]; p=0·023). The indirect effect of agency on trauma was –0·04 (95% CI –0·119 to –0·101]; p=0·044). Life satisfaction had a small statistically significant effect on trauma (β=–0·17 [–0·484 to –0·191]; p=0·037). Statistically significant total standardised effects were found between agency, life satisfaction (β=0·25 [0·161 to 0·476]; p=0·010), and trauma symptoms (β=–0·13 [–0·317 to 0·203]; p=0·044) at Time 1. Similarly, agentic competencies were found to be more related to life satisfaction (β=0·14 [0·025 to 0·338]; p=0·047;) than to trauma symptoms (β=–0·10 [–0·543 to 0·036]; p=0·145) at Time 2. The inclusion of the cross-lagged paths increased the fit of the model significantly. InterpretationChildren are acting for their wellbeing, mobilising personal and contextual resources. Such agentic attitudes contribute to easing their lives under occupation and minimising negative effects on their mental health despite the prevailing chronic traumatic conditions. Children implement skills of resilience rather than yield to the negative effects of political and military violence. The more that children perceive themselves as agentic in activating life satisfaction, the more effectively they deploy their survival skills and resilience. FundingNone.

Ethnic and socioeconomic disparities in survival of children and adolescents with CNS tumors in Southern Israel.

This study sought to evaluate survival of pediatric and adolescent patients with central nervous system (CNS) cancer in southern Israel, outline disparities between ethnic and socioeconomic groups (Bedouin Arabs compared to Jews) and evaluate the role of socioeconomic status (SES) in ethnic disparities. A retrospective study was conducted among 91 patients aged one to 20 years, who were diagnosed with CNS tumors between 2001 and 2017, and followed-up through 2020. Ethnic differences in survival were measured by age, sex, stage, histology and SES. One and 3-year survival rates were calculated. Multivariable regression analysis was used to estimate adjusted ethnic differences in survival rates. Ethnic differences in survival existed within all studied variables. All Bedouin patients lived in low SES settlements (All Bedouin settlement in Southern Israel are ranked in lower socioeconomic deciles). Twenty-eight patients had medulloblastoma. Seven (25%) presented with leptomeningeal disease or distant metastases. Medulloblastoma molecular subgroups were not assessed for logistic reasons. Three-year overall survival of Bedouins was 50% compared to 92.3% for Jews. Adjusted risk of death at 3 years was significantly higher for Bedouin patients (aHR 3.36, 95% CI 1.41-7.98, P = .006). We conclude that Bedouin children with CNS tumors have significantly lower survival rates compared to Jewish children, and SES seems to play a major part in these disparities. Factors influencing these disparities should be addressed and public health interventions to eliminate these disparities should be developed.

Analysis of Trauma Injuries Among the Minority Population in Southern Israel-a District-Wide Study.

We compared characteristics of traumatic injury between the Bedouin subpopulation, the largest minority group in southern Israel, and the other residents in this region. We assessed all the patients admitted with traumatic injuries during 2014-2018 to the only regional hospital in southern Israel. The cohort comprised 10,734 patients, 4553 (42.5%) of Bedouin origin. Compared to the non-Bedouin subpopulation, in the Bedouin subpopulation, the proportion of injuries that occurred in males was higher, 74.3% vs. 53.7%, P &lt; 0.001, and the proportion of burn injuries that occurred in children aged 0-14years was higher, 84% vs. 49%. Among the Bedouin and non-Bedouin patients, the respective proportions with penetrating injuries were 10.7 and 5.4%; the respective proportions who arrived at the hospital by private vehicles were 62.0 and 33.1%. In multivariate analysis, the variables that were significant for increased odds for severe trauma were Bedouin origin, male gender, and arrival to the emergency room at night. This study highlights the lack of access to basic infrastructure and healthcare among Bedouins in southern Israel. The high proportion of penetrating injuries in this subpopulation is apparently due to explosions of unexploded ordnance. The unavailability of electricity and waste removal in unrecognized villages contributes to burn injuries among Bedouin children. Poor accessibility of healthcare facilities and emergency medical transportation necessitates travel to hospitals by private car. The findings should direct trauma prevention programs to reduce burn and penetrating injuries and to increase accessibility to healthcare.

Impact of Dental Fluorosis on Quality of Life of a group of Bedouin Children in a Rural Region in South Sinai

Impact of Dental Fluorosis on Quality of Life of a group of Bedouin Children in a Rural Region in South Sinai

Global epidemiology of childhood bone and joint infection: a systematic review.

Childhood bone and joint infection (BJI) is a potentially severe disease that may have permanent sequelae, including growth impairment and limb deformity. It has been characterised in the literature with a focus on Western epidemiology; there are currently no reports detailing global epidemiology and bacteriology. This omits key data from determining temporal trends, appropriate antibiotic therapy, and resource allocation. This review aims to identify studies that characterise the incidence of childhood bone and joint infection or provide detailed bacteriology within their region. A systematic review of the literature was performed from 01/01/1980 to 31/12/2020. Data hasbeen analysed to give incidence of disease per 100,000 children, primary pathogen by country where available, and risk ratio (RR) for disease by ethnicity. This is applicable for areas that experience race-related inequitable burden of disease. Forty-four articles met the inclusion area; of these, seven were population-wide studies, primarily from Europe or the United States, and the remainder were cohort studies. Incidence could be derived from 26 studies compromising over 34, 000 children. Information on bacteriology was available from 39 publications (10, 957 cases). Methicillin-sensitive Staphylococcus aureus is the most common pathogen in the West. Recently, disease secondary to Kingella kingae and methicillin-resistant S. aureus has increased. Salmonella remains a dominant pathogen in African regions. Increased risk of disease is observed in Aboriginal, New Zealand Māori, Pacific, Indigenous Fijian, and Bedouin children. The current state of the literature detailing incidence of childhood BJI focuses on disease patterns from the West. There is a paucity of high-quality publications in the developing world. Despite these limitations, global trends in burden of disease show race-related inequitable risk of BJI. Temporal and regional variation in bacteriology can be demonstrated. III.

Diagnostic Yield and Economic Implications of Whole-Exome Sequencing for ASD Diagnosis in Israel.

Whole-exome sequencing (WES) is an effective approach to identify the susceptibility of genetic variants of autism spectrum disorder (ASD). The Israel Ministry of Health supports WES as an adjunct tool for ASD diagnosis, despite its unclear diagnostic yield and cost effectiveness. To address this knowledge gap, we applied WES to a population-based sample of 182 Bedouin and Jewish children with ASD from southern Israel, and assessed its yield in a gene panel of 205 genes robustly associated with ASD. We then compared the incremental cost-effectiveness ratios (ICERs) for an ASD diagnosis by WES, chromosomal microarray analysis (CMA), and CMA + WES. Overall, 32 ASD candidate variants were detected in 28 children, corresponding to an overall WES diagnostic yield of 15.4%. Interestingly, the diagnostic yield was significantly higher for the Bedouin children than for the Jewish children, i.e., 27.6% vs. 11.1% (p = 0.036). The most cost-effective means for genetic testing was the CMA alone, followed closely by the CMA + WES strategy (ICER = USD 117 and USD 124.8 per child). Yet, WES alone could become more cost effective than the other two approaches if there was to be a 25% increase in its yield or a 50% decrease in its cost. These findings suggest that WES should be recommended to facilitate ASD diagnosis in Israel, especially for highly consanguineous populations, such as the Bedouin.

Creating safe spaces to prevent unintentional childhood injuries among the Bedouins in southern Israel: A hybrid model comprising positive deviance, community-based participatory research, and entertainment-education.

BackgroundDespite several intervention programs, the Bedouin population living in the Southern District of Israel has the highest mortality rate among children and adolescents from unintentional injuries. Our research questions asked: (1) How does increasing the involvement and participation of Bedouin community members influence the issue of unintentional injuries among children? (2) How does reframing of the technical issue of safety into security influence community involvement and cooperation?Objectives1) To identify effective and efficacious positive deviance practices through community-based participatory research with adults, children, and professionals in the Bedouin community. 2) To create wider and deeper connections and cohesion between and among diverse Bedouin communities by seeding and sparking opportunities for social networking and cross-learning.MethodsThe study used a qualitative multi-method approach to generate a hybrid intervention model for reducing unintentional childhood injuries among the Bedouins. To frame the issue of unintentional injuries from the lived perspective of the Bedouins, we employed the Positive Deviance (PD) and Community Based Participatory Research (CBPR) approach. Drawing upon theatrical traditions, entertainment-education (EE), was employed as a way to narratively engage and persuade the Bedouins.ResultsOur research resulted in: (1) the emergence of several PD ideas and practices for preventing and avoiding children’s injuries; (2) the actual creation of a safe and secure playroom for children at a neighborhood mosque; and (3) the creation of cascading and cross-learning social networks between and among members of the Bedouin community spread across various locations.ConclusionThis study helped in reframing the technical issue of accidents and safety into the notion of sacredness and security, enhanced the association between emotions and cognition by means of experiential and EE methods, and stimulated creative thinking and the emergence of new culturally and contextually relevant ideas and practices through the PD process. It demonstrated the synergistic power of using a hybrid model that combined the rigor and vigor of different health communication approaches to address a significant disparity in the burden of child accidents faced by the Bedouins. Our study generated solutions that emerged from, and directly benefitted, Bedouin children—those, who face overwhelming risk of injury and death from preventable accidents.

Design and implementation of a multifaceted injury prevention intervention in Bedouin children in southern Israel

BackgroundChild injury is prevalent in the Bedouin community of southern Israel, with higher injury rates compared with the general population. Bedouin children aged 0–4 were twice as likely as children...

A proposed service model for early identification of autism spectrum disorder in ethnic communities in Southern Israel.

Early autism spectrum disorder (ASD) detection is a precondition for effective intervention and facilitates significant improvements in functioning. In Israel, toddlers undergo general developmental screening by public health nurses (PHNs) at maternal and child health centres (MCHCs). Nevertheless, there are disparities among ethnic groups in the reported incidence of ASD. By means of an ecological model (EM), we identified strategies that improve ASD detection in the Bedouin community by investigating the social and policy factors that affect diagnosis. We conducted in-depth interviews with 18 policy makers and service providers and three focus groups of PHNs and paediatricians. We mapped the strategies for identifying toddlers with ASD based on the three EM levels. Correlations were established by comparing the codes within and between the EM levels. At the macro-level, the policy makers' strategy for improving ASD detection in the Bedouin community reflected the ideology, values and goals of the PHNs and included the MCHCs as the sole institution involved in detecting ASD. At the meso-level of the service providers, the key elements of the strategy consisted of actualising the professional potential of PHNs and patients' case management. At the micro-level was the population that utilises the services and complies with recommendations. A correlation was established between the PHNs' values and goals and patients' case management. Actualising their professional potential influenced the population's compliance. To reduce gaps in ASD diagnosis between Bedouin communities and the general population, it is necessary to identify and change the policy factors that influence access to services for children with ASD at every EM level while incorporating PHNs from the Bedouin community in future services. Culturally appropriate policies, screening policies and interventions must be developed to serve the needs of Bedouin children.

Evaluation of an intervention to reduce child injury in Bedouin communities in Southern Israel

BackgroundChild injury is particularly prevalent in low socioeconomic populations and minorities. In Israel, Bedouin children exhibit high rates of injuries and death. A multifaceted community intervention to reduce injury in...

Challenges in measuring “connectedness to nature” among indigenous children: lessons from the Negev Bedouin

Culturally adapted tools for measuring connectedness to nature are important, since attitudes and perceptions toward nature cannot be universalized. They are influenced by a wide range of factors, like individuals’ experience in their home environment, safety concerns and a variety of other sociocultural factors. The purpose of this paper is to introduce a model for a cultural adaptation process, through which suitable nature connectedness questionnaires can be created. Our approach is based on “Third Space Theory,” which laid the groundwork for the development of culturally adapted questionnaires that combine Western categories for measuring nature connectedness with elements that specifically reflect the local culture of an indigenous community. The paper details the adaptation process of a questionnaire designed to learn about the nature connectedness of 5th grade students living in unrecognized Bedouin villages in the Negev Desert. The process enlisted the input of 58 fifth grade students (28 boys and 30 girls) and four professionals from the fields of education and environmental education. It incorporated two different types of interviews, personal, semi-structured interviews, and interviews with small groups of students as they orally completed different iterations of the questionnaire. Thematic content analysis was conducted to reveal the various sociocultural aspects of the relationship between Bedouin children and their natural environment. The results of the paper include: (a) the seven-stage development process of the culturally adapted nature connectedness questionnaire, and (b) examples of the types of information that the culturally adapted questionnaire reveals, which a standard nature connectedness questionnaire might not provide.

Evaluating post-vaccine expansion patterns of pneumococcal serotypes

BackgroundStreptococcus pneumoniae remains a leading cause of morbidity and mortality. Pneumococcal conjugate vaccines (PCVs) are effective but target only a fraction of the more than 90 pneumococcal serotypes. As a result, the introduction of PCVs has been followed by the emergence of non-vaccine serotypes. With higher-valency PCVs currently under development, there is a need to understand and predict patterns of serotype replacement to anticipate future changes. MethodsIn this study, we fit a hierarchical Bayesian regression model to evaluate patterns of change in serotype prevalence post-PCV introduction in Israel from 2009 to 2016. ResultsWe found that the assumption that non-vaccine serotypes increase by the same proportion overestimates changes in serotype prevalence in Jewish and Bedouin children. Furthermore, pre-vaccine prevalence was positively associated with increases in prevalence over the study period. From our analyses, serotypes 12F, 8, 16F, 33F, 9N, 7B, 10A, 22F, 24F, and 17F were estimated to have gained the most cases of invasive pneumococcal disease through serotype replacement in the Jewish population. However, this model also failed to quantify some additional cases gained, suggesting that changes in carriage in children alone may be insufficient to explain serotype replacement in disease. ConclusionsUnderstanding of serotype replacement is important as higher-valency vaccines are introduced.