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During a 1-year study, Trichuris adults were obtained after necropsy of Arabian camels (Camelus dromedarius) from a slaughterhouse in Kuwait. Morphological and molecular identification was performed to confirm the identity of the Trichuris specimens obtained from C. dromedarius. Fifteen male Trichuris specimens were selected, and molecular identification was performed using mitochondrial cytochrome c oxidase subunit I, 12S ribosomal RNA, 16S ribosomal RNA genes and the nuclear internal transcribed spacer 2 (ITS2) region. Through phylogenetic analysis, 2 distinct groups were obtained using the mitochondrial genes, where group 1 showed a close relationship to Trichuris globulosa while group 2 showed a close relationship to Trichuris ovis, providing molecular evidence of a possible T. globulosa species complex. Additionally, the nuclear ITS2 region did not provide enough resolution to distinguish between the 2 groups of Trichuris specimens. Observation of morphological characters revealed variations in the shape of the male spicule sheath, where specimens present either a globular posteriorly truncated swelling or the absence of posteriorly truncated swelling. Moreover, the variations in male spicule sheath does not corroborate with the results of molecular data, suggesting the limited use of this character for identification of T. globulosa. In conclusion, molecular analysis suggests a possible species complex in T. globulosa, with the mitochondrial genetic markers successfully differentiating between the 2 groups. The limited use of the male spicule sheath as a diagnostic character for identification of T. globulosa is suggested.
This chapter discusses whether the theoretical framework of this book can explain cases outside of Borneo and the Persian Gulf. Kuwait can readily be explained by the same framework as Qatar and Bahrain. This chapter then analyzes negative cases that meet at least one of the two conditions. It first looks at the West Indies, particularly the case of Trinidad and Tobago. Trinidad was a producer of oil but became part of the West Indies Federation when it was established in 1958, although the federation collapsed four years later. It argues that Trinidad’s initial inclusion into a larger entity can be explained by the absence of the protectorate system. Second, it investigates the case of British protectorates in South Arabia. They had been governed in a similar fashion to lower Gulf sheikhdoms during the colonial period, but many of them had no choice but to join the Federation of South Arabia in 1962. This chapter argues that the difference between those states and successful cases of separate independence lies in the presence of oil. It thus shows that the theory of this book travels to other cases.
In the Middle East and North Africa region, laws organising the judiciary and bilateral agreements on judicial cooperation expressly permit the use of foreign judges on domestic courts. Judicial ‘secondments’ of this type allow host courts to deal with increasing caseloads expeditiously, while providing shadow-training for domestic judges in the long term. This chapter outlines the practice of sharing judges in the region and describes how foreign judges serve on domestic courts in Bahrain, Kuwait, Qatar and the United Arab Emirates, in law and practice. Using the lens of political economy, the analysis highlights two trends in the region. The first is the recruitment of foreign judges to fill skills and knowledge-based gaps among domestic judiciaries. The second is the high degree of executive control over the movement of judges, in both sending and receiving states, with implications for the separation of powers, judicial independence and executive accountability.
The Cold War, oil, and new borders intensified the fight for hegemony in the Middle East. The shah maneuvered around thorny international issues by keeping intact his ties to different US administrations. Iran watched the Vietnam War with concern but maintained a balanced stance. Elsewhere, the creation of the Organization of the Petroleum Exporting Countries (OPEC) brought some regional cooperation. However, in the Persian Gulf, Iran became isolated and faced competition from the Arabian Peninsula and the newly Arab states of the south. Its conflict with Iraq escalated until a short-lived truce was concluded in 1975. Iran also flexed its muscles by supporting the Sultanate in Oman during the conflict in Dhofar, but the shah’s interventions only fueled the domestic unrest against his rule. Student groups and artists increasingly decried the shah’s dictatorial ways.
Bubiyan Island, presently a vast sabkha and salt flat in the westernmost part of the Shatt Al-Arab delta, originated ca. 4000 cal yr BP as prodelta deposits from a paleochannel of the Euphrates River that flowed into a shallow sea. Southeastern Bubiyan Island first surfaced when spits and barrier islands formed on a 1–2 m forebulge caused by heavy sediment load to the northwest; the spits and barriers delineated an incipient shoreline and sheltered a shallow lagoon. Progradation of southeastern Bubiyan Island began when the spits and barriers were gradually stranded as beach ridges during minor sea-level fluctuations and continued marginal uplift. AMS dating of the beach ridges, which are ~1–5 km from the present shoreline, implies that Late Holocene relative sea level fell in three phases: ca. 3700–3400 cal yr BP, ca. 2600–1000 cal yr BP, and ca. 600–500 cal yr BP. Prior to each phase, relative sea level apparently stabilized to near stillstands, allowing spits and barriers to accrete. Torpedo-jar pottery sherds scattered on some of the most prominent beach ridges indicate Sasanian (AD ca. 300–650; 1650–1300 cal yr BP) to early Islamic (AD ca. 650–800; 1300–1150 cal yr BP) periods of human presence, concurrent with the Second phase of beach-ridge formation.
Throughout the mid-1980s, the Soviet-American rivalry in the Muslim world had remained a “zero-sum game.” Even after Mikhail Gorbachev embraced perestroika and Ronald Reagan toned down his Cold War rhetoric, the two superpowers continued to butt heads. Then between 1988 and 1991, the “end of history” seemed to arrive and George H. W. Bush trumpeted the emergence of a new world order based on cooperation, not confrontation, between capitalist America and communist Russia, even in volatile places like the Persian Gulf. By the early 1990s, however, American and Russian policymakers recognized that the Cold War was more likely to be followed by ethnic and religious conflict than by global peace and prosperity. In late 1991, Gorbachev lost his battle to reform the Soviet Union. Muslims in Chechnya and other non-Russian minorities sought independence. Elsewhere, the multiethnic regime in Yugoslavia disintegrated, with Christian Serbs slaughtering Bosnian Muslims; Islamists won elections in Algeria' and Islamic radicals toppled the pro-Soviet junta in Afghanistan. By January 1993, both Bush and Gorbachev were gone and all the hope for a new world order had been replaced by the fear that the post-Cold War Muslim world was becoming the epicenter of a “clash of civilizations.”
This study aimed to examine age-specific trends in the prevalence of overweight and obesity in schoolchildren in Kuwait over a 13-year period (2007 to 2019) using the WHO, the Centers for Disease Control and Prevention (CDC) and the International Obesity Taskforce (IOTF) definitions.
Design:
Using cross-sectional approach, Kuwait Nutrition Surveillance System (KNSS) objectively measured weight and height of schoolchildren over a 13-year period. Log-binomial regression models were used to examine age-specific trends of obesity and overweight over the study period.
Setting:
Public primary, middle and high schools in all provinces of Kuwait.
Participants:
Schoolchildren aged 5–19 years (n 172 603).
Results:
According to the WHO definition, the prevalence of overweight and obesity in schoolchildren, respectively, increased from 17·73 % and 21·37 % in 2007 to 20·19 % and 28·39 % in 2019 (Pfor trend < 0·001). There is evidence that the obesity in females (but not males) has levelled off in the period 2014–2019 according to the three definitions of obesity, which is corroborated by a similar trend in the mean of BMI-for-age Z-score.
Conclusion:
The prevalence of obesity and overweight in schoolchildren in Kuwait has risen over the last 13 years and trends are similar across all definitions. Obesity is no longer increasing at the same pace and there is evidence that the prevalence of obesity in females has plateaued. The current level of childhood overweight and obesity is too high and requires community-based and school-based interventions.
This chapter examines how the first Bush administration built domestic and international coalitions to respond to Saddam Hussein's invasion of Kuwait in August 1990. I argue that Bush's plan for the Persian Gulf War was to weaken Saddam as much as possible and then establish a system of containment based on multilateral sanctions, inspections, and military deterrence in the aftermath. The administration hoped Saddam would fall from power as a result of the conflict but did not make this a policy goal to avoid breaking up the international coalition and bogging the United States down in occupying Iraq. Lastly, this chapter examines domestic political debates on Iraq during the Gulf Crisis and explores the conflict between “minimalists,” who wanted to focus on ejecting Saddam from Kuwait, and “maximalists,” who wanted to use the crisis to ensure Saddam's removal.”
This article examines ʿAbd al-Ilah al-Qinaʿi's early 20th-century melding of local, imperial, and transoceanic health practices alongside his 21st-century reemergence as a protonational Kuwaiti doctor. In the early 20th century, geographically and ideologically expansive horizons of health care fostered the emergence of hybrid medical practices. Facilitated by his access to multiple medical spheres and his proximity to Kuwait's rulers, ʿAbd al-Ilah was uniquely positioned to meet the demands of health-seeking consumers. In the 21st century, Kuwaitis' search for a national history that naturalizes claims to citizenship has resulted in ʿAbd al-Ilah's new designation as Kuwait's first doctor. Both processes—the interplay between local cultures of health and emergent institutions and the imagining of medical history as a nativist teleology—demonstrate how health-seeking and history-writing efforts of a range of historical actors have placed medicine at the center of politics in Kuwait.
This study aimed to determine anthropometric cut-points for screening diabetes and the metabolic syndrome (MetS) in Arab and South Asian ethnic groups in Kuwait and to compare the prevalence of the MetS based on the ethnic-specific waist circumference (WC) cut-point and the International Diabetes Federation (IDF) and American Heart Association/National Heart, Lung, and Blood Institute WC criteria. The national population-based survey data set of diabetes and obesity in Kuwait adults aged 18–60 years was analysed. Age-adjusted logistic regression and receiver operating characteristic (ROC) analyses were conducted to evaluate for 3589 individuals the utility of WC, waist:height ratio (WHtR) and BMI to discriminate both diabetes and ≥3 CVD risk factors. Areas under the ROC curve were similar for WC, WHtR and BMI. In Arab men, WC, WHtR and BMI cut-offs for diabetes were 106 cm, 0·55 and 28 kg/m2 and for ≥3 CVD risk factors, 97 cm, 0·55 and 28 kg/m2, respectively. In Arab women, cut-offs for diabetes were 107 cm, 0·65 and 33 kg/m2 and for ≥3 CVD risk factors, 93 cm, 0·60 and 30 kg/m2, respectively. WC cut-offs were higher for South Asian women than men. IDF-based WC cut-offs corresponded to a higher prevalence of the MetS across sex and ethnic groups, compared with Kuwait-specific cut-offs. Any of the assessed anthropometric indices can be used in screening of diabetes and ≥3 CVD risk factors in Kuwaiti Arab and Asian populations. ROC values were similar. The WC threshold for screening the MetS in Kuwaiti Arabs and South Asians is higher for women.
Most medical emergencies requiring first-aid occur at home. Little is known about the prevalence of these medical emergencies.
Objective:
The objective of this study is to describe medical emergencies occurring at people’s homes requiring first aid; characteristics, burdens and impact on functional outcome, and to address the national public knowledge and practice of first aid.
Method:
A confidential, cross-sectional survey, primarily based on the 2015 American Heart Association (AHA) and American Red Cross first aid guidelines, was conducted among adults (>18 years) from 12 educational centers, under the Ministry of Awqaf and Islamic affairs, State of Kuwait.
Results:
A total of 3000 self-administered questionnaires were distributed from September 16 2019 to November 30, 2019. The response rate was 34% (n = 1033 participants) of which 1% (n = 11) were partially answered questionnaires leaving 1022 questionnaires for valid statistical analysis. The prevalence of medical emergencies was 118.5 out of 100000 per year and the level of public knowledge was 19%. Medical emergencies were more likely to occur in Hawali province (49%, n = 149), women were more likely to encounter medical emergencies (78%, n = 238). Victims above 18 years of age were more likely to experience hypoglycemia (39%, n = 55) and children were more likely to suffer from hypoglycemia (19%, n = 22) or burns (17%, n = 20). Compliance with First aid guidelines was seen in hypoglycemia (31%, n = 44) but lacking in burn incidents (44%, n = 15). Participants called the ambulance in seizures (50%, n = 13), with 62% of medical emergencies requiring attendance at a health-care facility and 29% requiring hospital admission. Of the victims, 15% missed school or a day of work, and 25% had impaired functional outcomes.
Conclusion:
Medical emergencies occurring at home are relatively common in Kuwait, and public training on first aid is low. Kuwait has unique medical emergencies, with hypoglycemia, seizures and burns being the most frequent emergencies that occur at home. These emergencies cause a burden on the health-care system with a quarter of them having negative impact on the victim’s functional outcome.
Individuals with obesity tend to perform less well than their non-obese peers in tertiary education, but there is little evidence from non-Western countries and recent studies. The present study aimed to test whether academic attainment differed between female undergraduates with obesity (defined by body mass index (BMI)), and those who were non-obese in Kuwait, a country with very high obesity prevalence. In 400 female Kuwaiti first- and second-year Social Science students (mean age 18⋅0, sd 0⋅6 years), educational attainment was defined as the Grade Point Average (GPA) across all subjects (from 1⋅00 to 4⋅00). The mean GPA (2⋅51, sd 0⋅53) among students defined as obese by the BMI (n 163) was significantly lower than among the students defined as non-obese by the BMI (n 237; 2⋅80, sd 0⋅63; P < 0⋅001), and those defined as obese were more likely to be in the lowest quartile for the GPA (OR 3⋅03; 95% CI 1⋅90, 4⋅85), independent of socio-economic status. Similar differences were observed between students defined as having high versus normal body fatness. Female undergraduates in Kuwait with obesity have lower academic attainment than their non-obese peers, and universities should consider measures to mitigate reduced attainment among their female undergraduates.
This article fills a gap in the literature by quantifying impacts of fossil fuel subsidy reform on trade (inflow and outflow) in an oil-producing, “almost small”, economy, using Kuwait as an example. It employs a two-region economy-wide model with oligopoly behaviour in a general equilibrium framework. The model embodies unique elements of Kuwait's economic structure, idiosyncratic rigidities, and distortions, including oligopolistic industrial structure and labour markets. Simulations show that energy subsidies have minimal effects on trade and on non-energy exports, largely due to the pervasiveness of oligopolies that sustain large markups and their collusive pricing. Reforming energy subsidies generates higher pro-trade effects if implemented during low (not high) oil prices because its negative effects are partially offset by efficiency gains and reduction in oligopoly markups. Yet, contrary to claims by proponents of reforms, these effects remain largely constrained unless appropriate incentives are introduced. These results have important policy implications. In developing oil-exporting economies with pervasive oligopolies, microeconomic reform can be a channel through which to achieve pro-trade effects of energy subsidy reform. Further, benefits beyond export expansion, such as higher economic efficiency, could be better motivators of energy subsidy reform in oil economies.
In the years following World War I, the British Government of India began taking greater interest in internal security challenges in the Gulf. Aside from small detachments of sepoys in Manama and Muscat, Britain did not have forces stationed in the area to prevent plots against rulers or defend against unexpected tribal attacks from the desert. There were very few incentives for Britain to fill this power gap by garrisoning troops, but plenty of disincentives: hostile inhabitants, an unforgiving climate in summer and malaria in winter. In keeping with its hands-off approach, Britain wanted the rulers to secure their own positions by developing militaries. In Muscat, the British actively encouraged the sultan to develop a force that could dominate the land approaches to Muscat. Britain supported the establishment of the Bahrain Levy Corps in 1924 to protect the regent from relatives. In Kuwait, the threat was external: raids by the Ikhwan (religiously inspired tribal fighters) into Kuwaiti territory. In all cases, the British Government of India wanted the local rulers to take greater responsibility for securing their own territories rather than continually seeking British military assistance in a crisis.
When money-sensitive civil servants questioned British expenditure on local forces, supporters of this spending argued that it was less costly in the long run as greater indigenous capabilities would reduce the likelihood of Britain having to intervene directly and could reduce defence expenditure in the long term. This was the logic applied in Kuwait after independence from Britain in 1961. This was especially true after 1966 when Britain reduced its defence commitment to Kuwait air support only. Unlike Kuwait, the build-up of military capabilities in the Trucial States and Bahrain was not seen as a security gain for Britain. Accepting its reduced ability to shape events in the Gulf, however, Britain reasoned that if it could not stop the rulers from setting up their own armed forces – or prevent them from expanding too rapidly – then it might as well try to steer them in the right direction. The right direction for Britain meant, if possible, that British officers (contract or loan service) should command and train these forces and that they should use weaponry produced by British manufacturers.
This study aimed to report the WHO infant and young child feeding (IYCF) indicators from Kuwait and to investigate the associations between these indicators and anthropometric measurements.
Design:
The Kuwait Nutritional Surveillance System uses observational cross-sectional approach to collects data by face-to-face interviews with mothers or child guardians using a structured questionnaire that was developed based on the WHO IYCF indicators. The weight and height of infants and young children were measured using digital scales in a standardised manner.
Setting:
Vaccination centres in all governorates (provinces) of Kuwait.
Participants:
Infants and young Kuwaiti children aged 0–23 months (N 5839).
Results:
The prevalence of exclusive breastfeeding and age-appropriate breastfeeding were 8·0 and 7·4 %, respectively. The prevalence of stunting and wasting was 7·5 and 2·4 %, respectively, while the prevalence of overweight and obesity was 6·5 and 1·6 %, respectively. In the multivariable analysis, exclusive breastfeeding and age-appropriate breastfeeding were more common in children with stunted growth (AOR 1·71 (95 % CI 1·08, 2·70; P = 0·021) and 1·44 (95 % CI 1·01, 2·06; P = 0·046), respectively). The introduction of solid/semisolid or soft foods was inversely associated with stunting (AOR 0·52; 95 % CI 0·30, 0·90; P = 0·021). Only age-appropriate breastfeeding was inversely associated with overweight (AOR 0·62; 95 % CI 0·39, 0·98; P = 0·043).
Conclusion:
Our findings showed that indicators of breastfeeding are low in Kuwait. Our findings suggest that the associations between different WHO IYCF indicators and stunting as well as overweight is complex, which highlights the need for a better understanding of WHO IYCF indicators in both low- and high-income countries.
Examines George H. W. Bush’s efforts to establish a new world order and reliance on traditional Cold War strategies and alliances. Assesses Bush Sr.’s successes (e.g. German reunification) and failures (in Yugoslavia and Iraq). Documents beginning of post-Cold War US wars of Muslim liberation, a pattern continued by the presdients that followed him.
Most research on the Gulf states focuses on oil and its impact on state power. The literature on rentier theory almost unanimously agrees that oil rents buy off citizens and lead to socio-political stagnation. Massive protests and government attempts to address citizen demands in Kuwait between 2011 and 2013 call into question that narrative. Since those protests, the Kuwaiti government has taken steps to increase its representation of public officials and accessibility in the public sphere, including by expanding the government's presence on Instagram. How have Kuwaiti citizens voiced their opinions to government accounts? And how has the government responded to online criticism?
This essay looks at the pattern of interactions between the state and Kuwaiti citizens on Twitter and Instagram using a content analysis of government accounts. The findings raise questions about the validity of the payoff thesis and understandings of consent and acquiescence. My analysis illustrates that there is a public dialogue that moves beyond the rigid structure of state and society by which the literature has traditionally understood Gulf rentier societies.
This study sought to explore main barriers and facilitators to implementing health technology assessment (HTA) in Kuwait from the perspective of key stakeholders.
Methods
Semi-structured qualitative interviews were conducted with ten key stakeholders: seven healthcare providers working at various departments of the Kuwaiti Ministry of Health (MOH), and three academics with substantial experience in teaching HTA or related fields. Interviews were conducted face-to-face, audio-recorded, and transcribed verbatim. Data were analyzed using an inductive thematic approach.
Results
Participating stakeholders reported several factors that might act as a barrier to building HTA in Kuwait: minimal awareness of HTA, lack of institutional and human capacity, a fragmented healthcare system, poor communication between researchers and policy makers, the country's wealth, politics, as well as data quality, availability, and sharing. Institutionalizing HTA as a politically empowered body, enforcing its recommendation by law, and benefiting from neighboring countries' experiences were suggested as possible ways to move forward.
Conclusion
Studies exploring the unique challenges that high-income developing countries may face in implementing HTA are still scarce. The results of this study are consistent with evidence coming from other developing countries, while also suggesting that the abundance of financial resources in the country is a double-edged sword; it has the potential to facilitate the development of HTA capacity, but also hinders recognizing the need for it.
The beneficial role of breast-feeding for maternal and child health is now well established. Its possible role in helping to prevent diabetes and obesity in children in later life means that more attention must be given to understanding how patterns of infant feeding are changing. The present study describes breast-feeding profiles and associated factors in Kuwait.
Design/Setting/Subjects
Interviews with 1484 recent mothers were undertaken at immunisation clinics across Kuwait. Descriptive analysis and binary logistic regression of results were performed.
Results
Rates of breast-feeding initiation in Kuwait were high (98·1 %) but by the time of discharge from hospital, only 36·5 % of mothers were fully breast-feeding, 37·0 % were partially breast-feeding and 26·5 % were already fully formula-feeding. Multiple social and health reasons were given for weaning the child, with 87·6 % of mothers who had stopped breast-feeding completely doing so within 3 months postpartum. Nationality (P<0·001), employment status 6 months prior to delivery (P<0·001), mode of delivery (P=0·01), sex of the child (P=0·026) and breast-feeding information given by nurses (P=0·026) were all found to be significantly associated with breast-feeding. Few women (5·6 %) got information on infant nutrition and feeding from nursing staff, but those who did were 2·54 times more likely to be still breast-feeding at discharge from hospital. Over 70 % of mothers had enjoyed breast-feeding and 74 % said they would be very likely to breast-feed again.
Conclusions
In Kuwait where the prevalence of both obesity and type 2 diabetes is growing rapidly, the public health role of breast-feeding must be recognised and acted upon more than it has in the past.