Workplace violence (WPV) against healthcare workers, a serious public health problem with profound implications, has worsened during the COVID-19 pandemic. This study examined the incidence of different types of WPV in a public hospital... more
Workplace violence (WPV) against healthcare workers, a serious public health problem with profound implications, has worsened during the COVID-19 pandemic. This study examined the incidence of different types of WPV in a public hospital in Israel during the pandemic and analyzes the factors associated with its occurrence. A cross-sectional study was performed via an online questionnaire with 486 workers at a government hospital in Israel. Data were collected about sociodemographic and occupational characteristics, exposure to different forms of WPV over the preceding six months, and the responsibility and reasons for WPV from the workers’ perspective. Approximately 71% of respondents were exposed to WPV and 64% perceived that WPV escalated during the pandemic. The prevalence of verbal/psychological and physical WPV were 69 and 11%, respectively. The main reason for WPV was frustration over long wait times (70%). The escalation during the pandemic can be attributed to patients’ or re...
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BACKGROUND While family presence during resuscitation has been researched extensively in the international and especially American medical literature, in Israel this subject has rarely been researched. Because such policies have become... more
BACKGROUND While family presence during resuscitation has been researched extensively in the international and especially American medical literature, in Israel this subject has rarely been researched. Because such policies have become common practice in many countries, it is important to investigate the attitudes of health care staff in Israeli emergency departments to better understand the potential implication of adopting such policies. OBJECTIVES To examine the attitudes of the physicians and nurses in the ED of Soroka Medical Center to FPDR. METHODS The methods we used were both qualitative (partly structured open interviews of 10 ED staff members from various medical professions) and quantitative (an anonymous questionnaire that collected sociodemographic, professional, and attitude data). RESULTS The qualitative and quantitative results showed that most staff members opposed FPDR. The main reasons for objecting to FPDR were concern about family criticism, the added pressure t...
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In early 2020, the COVID-19 pandemic revealed a faceless, non-adversarial threat that endangered Israelis and Palestinians with the same ferocity. However, the capacities of the health systems to address it were not equal, with Israel... more
In early 2020, the COVID-19 pandemic revealed a faceless, non-adversarial threat that endangered Israelis and Palestinians with the same ferocity. However, the capacities of the health systems to address it were not equal, with Israel more equipped for the outbreak with infrastructure, resources, manpower and later, vaccines. The pandemic demonstrated the life-saving benefits of cooperation and the self-defeating harms brought by non-cooperation. These trends are explored here by an international team of public health and environmental scholars, including those from different sides of the Israeli–Palestinian conflict. This article explores the importance of recognizing the Israeli and Palestinian jurisdictions as a single epidemiological unit, and illustrates how doing so is a pragmatic positioning that can serve self-interest. We demonstrate how despite political shocks precipitating non-cooperation, there has been a recurrent tendency towards limited cooperation. The paper conclud...
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This study aims to explore what medical associations in Israel do to promote public health, what values underpin their activities, and how their actions can be interpreted. For this purpose, an analysis of both individual and... more
This study aims to explore what medical associations in Israel do to promote public health, what values underpin their activities, and how their actions can be interpreted. For this purpose, an analysis of both individual and organizational levels was applied in an effort to yield a more nuanced understanding of the relationship between society and the medical profession. In-depth interviews with senior physicians were conducted, combined with a review of policy and public initiatives of medical associations between 2008 and 2018. The findings of this study reveal that medical associations engage in a range of social and policy initiatives designed to promote public health, but, at the same time, they tend to construct socially related health issues as medical problems in a manner that fits their sectorial agendas. This may reflect organized medicine’s efforts to extend its dominance over society through the application of the biomedical model to social issues. It is necessary to in...
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Background Parents in the Arab population of Israel are known to be “pro-vaccination” and vaccinate their children at higher rates than the Jewish population, specifically against human papilloma virus (HPV) and seasonal influenza.... more
Background Parents in the Arab population of Israel are known to be “pro-vaccination” and vaccinate their children at higher rates than the Jewish population, specifically against human papilloma virus (HPV) and seasonal influenza. Objectives This study seeks to identify and compare variables associated with mothers’ uptake of two vaccinations, influenza and HPV, among different subgroups in Arab and Jewish society in Israel. Methods A cross-sectional study of the entire spectrum of the Israeli population was conducted using a stratified sample of Jewish mothers (n = 159) and Arab mothers (n = 534) from different subgroups: Muslim, Christian, Druse and Northern Bedouins. From March 30, 2019 through October 20, 2019, questionnaires were distributed manually to eighth grade pupils (13–14 years old) who had younger siblings in second (7–8 years old) or third (8–9 years old) grades. Results Arab mothers exhibited a higher rate of uptake for both vaccinations (p
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As of March 31, 2021, Israel had administered 116 doses of vaccine for COVID-19 per 100 population (of any age) – far more than any other OECD country. It was also ahead of other OECD countries in terms of the share of the population that... more
As of March 31, 2021, Israel had administered 116 doses of vaccine for COVID-19 per 100 population (of any age) – far more than any other OECD country. It was also ahead of other OECD countries in terms of the share of the population that had received at least one vaccination (61%) and the share that had been fully vaccinated (55%). Among Israelis aged 16 and over, the comparable figures were 81 and 74%, respectively. In light of this, the objectives of this article are: To describe and analyze the vaccination uptake through the end of March 2021 To identify behavioral and other barriers that likely affected desire or ability to be vaccinated To describe the efforts undertaken to overcome those barriers Israel’s vaccination campaign was launched on December 20, and within 2.5 weeks, 20% of Israelis had received their first dose. Afterwards, the pace slowed. It took an additional 4 weeks to increase from 20 to 40% and yet another 6 weeks to increase from 40 to 60%. Initially, uptake ...
The USA closed most of its schools in March–April 2020, which was associated with reduced COVID-19 incidence.1 In August–September 2020, schools reopened, with many schools teaching remotely until they can safely teach physically.2 We... more
The USA closed most of its schools in March–April 2020, which was associated with reduced COVID-19 incidence.1 In August–September 2020, schools reopened, with many schools teaching remotely until they can safely teach physically.2 We analysed COVID-19 incidence from Florida since its database provides incidence at ages 6–13 years (elementary school) and 14–17 years (high school). We extracted incidence by county and matched it with each county’s date of school reopening. We used a 7-day moving average. We aggregated the rates by counties with physical learning and counties with remote learning (the latter were Broward, Miami-Dade and Palm Beach). We calculated time points at which the trends changed in 10 days before reopening and 20 days from reopening, using JoinPoint-Regression. Lastly, we tested if trends were different between counties teaching physically and remotely. Tests were two tailed …
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Every country has vulnerable populations that require special attention from policymakers in their response to a pandemic. This is because those populations may have specific characteristics, culture and behaviours that can accelerate the... more
Every country has vulnerable populations that require special attention from policymakers in their response to a pandemic. This is because those populations may have specific characteristics, culture and behaviours that can accelerate the spread of the virus, and they usually have less access to healthcare, particularly in times of crisis. In order to carry out a comprehensive national intervention plan, policy makers should be sensitive to the needs and lifestyles of these groups, while taking into account structural and cultural gaps.In the context of Israel, the two most prominent and well-defined minority groups are the ultra-Orthodox Jewish community and parts of the Arab population. The government was slow to recognize the unique position of these two groups, public pressure eventually led to a response that was tailored to the ultra-Orthodox community and during the month of Ramadan a similar response has been implemented among the Arab community.
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Abstract Migrating irregularly, without access to support, may increase female asylum-seekers’ vulnerability to sexual violence. In this study, the authors applied a public health lens to explore the risk for sexual violence experienced... more
Abstract Migrating irregularly, without access to support, may increase female asylum-seekers’ vulnerability to sexual violence. In this study, the authors applied a public health lens to explore the risk for sexual violence experienced by female asylum-seekers en route from Eritrea to Israel. The study team conducted 13 in-depth interviews and 8 focus groups with Eritreans in Israel between April and September of 2013. Participants in the study described their experiences occurring in three segments. The combination of irregular movement through dangerous, difficult and often isolated terrain, dependence on human smugglers, and vulnerability to traffickers led to the systematization and normalization of sexual violence en route. Such factors heighten vulnerability to sexual violence among these Eritrean women asylum-seekers, as well as others who find themselves in similar circumstances.
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Health systems worldwide need to be adapted to cope with growing numbers of migrants and to climate-exacerbated morbidity. Heatwaves, water stress, desertification, flooding, and sea level rise are environmental stressors that increase... more
Health systems worldwide need to be adapted to cope with growing numbers of migrants and to climate-exacerbated morbidity. Heatwaves, water stress, desertification, flooding, and sea level rise are environmental stressors that increase morbidity, mortality, and poor mental health in Sub-Saharan Africa. While most migration is intra-African, climate change is also affecting migration patterns outside the continent. To tackle the health challenges induced by these events, such as infectious diseases and malnutrition, health care providers in Sub-Saharan Africa and in receiving countries in Europe must adapt their systems to provide appropriate health services to these communities. While health systems differ greatly across the global north and south, adaptation measures are similar and should be integrated. We present recommendations for adaptation of health systems to climate-related migration, including strengthening health systems, providing access to healthcare, culturally-appropriate services, policy-oriented research and training, and inter-sectoral collaboration.
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By expecting another 1918, history itself becomes prophecy (p. 66). The historical writings about the 1918 pandemic are no longer just records of past happenings, but predictive texts, meant to be interpreted by scientific prophets and... more
By expecting another 1918, history itself becomes prophecy (p. 66). The historical writings about the 1918 pandemic are no longer just records of past happenings, but predictive texts, meant to be interpreted by scientific prophets and used to proselytize the coming plague to the masses. Caduff places this pandemic prophecy at the intersection of reason and faith, suggesting that faith “operates at the heart of reason, not at its limits or margins” (p. 21). One has to have faith in the coming pandemic for it to function as the center of a billion-dollar research and preparedness industry. The histories of past pandemics and outbreaks are used to ground faith in a coming plague. Events that happen aren’t important unless they can be read through this prophetic past. Prophetic speech about the coming plague is interesting to Caduff precisely because it always fails to produce the thing it anticipates (p. 22). The next pandemic is always becoming, forever still on its way. This, as Caduff shows, is a very effective rhetoric, even in the face of a few high-profile dissenters. The voices against this prophecy are all but drowned out in the cacophony of prophetic speech. The one deficit here is a glaring lack of any exploration of the well-trod relationship among magic, science, religion, and medicine. Caduff doesn’t locate his argument or analysis of pandemic prophecy within the significant literature on healing rituals in medical anthropology or medical history. This would have greatly strengthened his arguments by providing readers with a nuanced understanding of how faith has always been intimately embedded in medicine and medical practices. Still, Caduff’s book adds much to the history and social science of public health and infectious disease and will be of value to anyone interested in global health, influenza, or epidemiology.
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The medical encounter is one of the most important channels of communication between the patient and his or her caretaker. Apart from its therapeutic effect, the medical encounter serves to convey information about a symptom or disease;... more
The medical encounter is one of the most important channels of communication between the patient and his or her caretaker. Apart from its therapeutic effect, the medical encounter serves to convey information about a symptom or disease; construct a diagnosis and give information about the expected course of a disease (“prognosis”); and discuss treatment plans, including risks and benefits. The centrality of the medical encounter makes ethical considerations fundamental, not only within the clinical context but also within the broader context of health promotion. Furthermore, since the medical encounter is characterized by asymmetry and dependence, it can create problems of abuse of power or subordination. The current dominant liberal bioethical approach tends not to take into account the power relations within the medical encounter, or the social context in which the medical encounter takes place. It is in this sense that a republican egalitarian approach to bioethics can be of use....
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ABSTRACT
Background.Many studies use questionnaires to determine smoking status and age of smoking onset. This study aimed to determine the reliability of self-reported smoking history and age of smoking initiation.
Research Interests: Preventive medicine, Adolescent, Medicine, Israel, Multivariate Analysis, and 15 moreHumans, Smoking, Questionnaire, Tobacco Use, Male, Reliability, Consistency, Questionnaires, Adult, Public health systems and services research, Curriculum and Pedagogy, Reproducibility of Results, Military Personnel, Logistic Models, and Age of Onset
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Second opinion is a decision-support tool for ratification or modification of a suggested treatment, by another physician. Second opinion may have a critical influence on the diagnosis, treatment and prognosis. The patient can benefit... more
Second opinion is a decision-support tool for ratification or modification of a suggested treatment, by another physician. Second opinion may have a critical influence on the diagnosis, treatment and prognosis. The patient can benefit from treatment optimization and avoid unnecessary risks. The physician can benefit from less exposure to legal claims, and healthcare organizations can benefit from increased treatment, quality assurance and costs saving from unnecessary surgery and treatments. Nevertheless, injudicious use of this tool can provoke unnecessary medical costs. In recent years, many patients prefer to seek a second opinion on their disease and available treatments. Private and public insurance companies are trying to control surgery costs by urging and even demanding a second opinion before surgery. Although second opinions are common in medical practice, relatively little is known on this subject. Most of the studies reviewed in this article evaluated the clinical benefi...
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Research Interests: Epidemiology, Decision Making, Science, Medicine, Veterinary, and 3 moreHuman, Animal, and One Health
The COVID-19 pandemic mandating isolation, quarantine, and social distancing has accelerated and expanded the use of telemedicine. This study examines the extent of the use of telemedicine and the relationship between eHealth literacy and... more
The COVID-19 pandemic mandating isolation, quarantine, and social distancing has accelerated and expanded the use of telemedicine. This study examines the extent of the use of telemedicine and the relationship between eHealth literacy and satisfaction with using telemedicine during the pandemic. A total of 156 participants from a clinic in a peripheral community in southern Israel completed an online questionnaire. We found that 85% knew how to use the internet for health information, but only one third felt safe using it to make health decisions. Furthermore, 93% used the internet for technical needs, such as renewing prescriptions or making a doctor’s appointment. Even lower use for telemedicine was found (38%) for consultation or treatment sessions. A positive association was found between eHealth literacy and satisfaction variables with using telemedicine (rp = 0.39, p < 0.001). Although respondents understood the benefits of telemedicine, they were not satisfied nor interest...
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Social distancing is an effective population-level mitigation strategy to prevent COVID19 propagation but it does not reduce the number of susceptible individuals and bears severe social consequences—a dire situation that can be overcome... more
Social distancing is an effective population-level mitigation strategy to prevent COVID19 propagation but it does not reduce the number of susceptible individuals and bears severe social consequences—a dire situation that can be overcome with the recently developed vaccines. Although a combination of these interventions should provide greater benefits than their isolated deployment, a mechanistic understanding of the interplay between them is missing. To tackle this challenge we developed an age-structured deterministic model in which vaccines are deployed during the pandemic to individuals who do not show symptoms. The model allows for flexible and dynamic prioritization strategies with shifts between target groups. We find a strong interaction between social distancing and vaccination in their effect on the proportion of hospitalizations. In particular, prioritizing vaccines to elderly (60+) before adults (20-59) is more effective when social distancing is applied to adults or uni...
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Over the past decade, there has been a growing development of innovative technologies to treat cancer. Many of these technologies are expensive and not funded by health funds. The present study examined physicians’ perceptions of the... more
Over the past decade, there has been a growing development of innovative technologies to treat cancer. Many of these technologies are expensive and not funded by health funds. The present study examined physicians’ perceptions of the ethical and clinical aspects of the recommendation and use of unfunded technologies for cancer treatment. This mixed-methods study surveyed 127 oncologists regarding their perceptions toward using unfunded innovative cancer treatment technologies, followed by in-depth interviews with 16 oncologists. Most respondents believed that patients should be offered all treatment alternatives, regardless of their financial situation. However, 59% indicated that they often face dilemmas regarding recommending new unfunded treatments to patients with financial difficulties and without private health insurance. Over a third (38%) stated that they felt uncomfortable discussing the cost of treatment with patients. A predictive model found that physicians facing patien...
The aim of this study was to describe the experiences of healthcare workers during the first wave of the coronavirus crisis. In a mixed-methods study, data were collected through an online survey completed by 263 hospital staff members,... more
The aim of this study was to describe the experiences of healthcare workers during the first wave of the coronavirus crisis. In a mixed-methods study, data were collected through an online survey completed by 263 hospital staff members, as well as 10 semi-structured, in-depth interviews with physicians, nurses, and medical technologists working on coronavirus wards. Respondents expressed extremely high levels of concern for family members, but they were less apprehensive about their own health and safety. Nurses displayed more apprehension and burnout compared to healthcare workers in other professional roles. The in-depth interviews reinforced and supplemented the survey findings and deepened our understanding of the experience of healthcare workers directly involved in the first wave of coronavirus patient care. The findings of this study illuminate the main concerns of hospital staff during the first wave of the COVID-19 pandemic and deepen our understanding of issues that requir...
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Israel’s vaccination percentage was among the highest recorded worldwide. The Israeli government opted for a model using a proof-of-vaccine document (“Green Pass”). However, the “Green Pass” policy raises practical, legal and ethical... more
Israel’s vaccination percentage was among the highest recorded worldwide. The Israeli government opted for a model using a proof-of-vaccine document (“Green Pass”). However, the “Green Pass” policy raises practical, legal and ethical concerns. While immunisation passports could be utilised to protect one’s health, significant legal difficulties arise from their usage as a vaccination encouragement scheme. Protecting health is a proper purpose, particularly as minimising the pandemic ameliorates the human rights violations that stem from the COVID-19 response, enables individuals to return to their daily lives and enhances economic activity. However, any privileges or restrictions guided by one’s COVID-19 immunisation status must be designed with the utmost attention to prevent a disproportionate violation of the human rights of the non-vaccinated and the public at large. Furthermore, as “Green Pass” policies might entrench existing discriminatory structures, ensuring equality is vit...
The COVID-19 crisis poses challenges to healthcare systems and requires micro- and macro-organizational adaptations. This study examined the organizational atmosphere in Israeli hospitals by evaluating workers’ perceptions and concerns... more
The COVID-19 crisis poses challenges to healthcare systems and requires micro- and macro-organizational adaptations. This study examined the organizational atmosphere in Israeli hospitals by evaluating workers’ perceptions and concerns about the COVID-19 crisis and its management. At the end of the pandemic’s first wave in Israel, 547 healthcare workers responded to an online survey, which inquired about COVID-19 concerns at the individual and family level, perceptions at the national and organizational level, perceptions of the way the crisis was managed, self-assessment of coping with the crisis and burnout, and demographics. Findings showed that healthcare workers expressed deep concerns for family members and apprehension at a national level. Respondents noted that they were coping well with the crisis while expressing negative perceptions of how the crisis was managed. A regression model showed that the low self-assessment of medical staff of coping with the crisis, deep concer...
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Purpose This paper aims to examine the views of physicians in senior management positions regarding the distinctive characteristics and roles of leaders in the Israeli health-care system and what might be the interactions between... more
Purpose This paper aims to examine the views of physicians in senior management positions regarding the distinctive characteristics and roles of leaders in the Israeli health-care system and what might be the interactions between management and leadership. Design/methodology/approach In total, 13 semi-structured in-depth interviews were conducted with physicians in senior management positions. Interviews were recorded, transcribed and analyzed using the qualitative-phenomenological method. Findings Interviewees discerned leaders as exhibiting traits of transformational leadership and managers, as expressing characteristics of transactional leadership. Most interviewees asserted that physicians should act as social leaders promoting public health and equality in health care, beyond their clinical practice. They agreed that physicians should fill most senior positions in the health-care system, provided they undergo appropriate training in management, leadership and interdisciplinary ...
In disenfranchised communities, untreated greywater (wastewater without sewage) is often environmentally discharged, resulting in potential human exposure to antimicrobial-resistant bacteria (ARB), including extended-spectrum... more
In disenfranchised communities, untreated greywater (wastewater without sewage) is often environmentally discharged, resulting in potential human exposure to antimicrobial-resistant bacteria (ARB), including extended-spectrum beta-lactamase (ESBL) producers. We sought to examine the abundance of ARB, specifically ESBLs, and antimicrobial resistance genes (ARGs) in greywater from off-grid, pastoral Bedouin villages in Southern Israel. Greywater samples (n = 21) collected from five villages were analyzed to enumerate fecal coliforms and Escherichia coli. ESBL producers were recovered on CHROMagar ESBL and confirmed by VITEK®2 (bioMerieux, Marcy l’Etoile, France) for identification and antimicrobial susceptibility testing. Total genomic DNA was extracted from greywater samples and quantitative PCR (qPCR) was used to determine relative abundance (gene copies/16S rRNA gene) of class 1 integron-integrase intI1, blaTEM, blaCTX-M-32, sul1, and qnrS. The mean count of presumptive ESBL-produc...
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The article examines the relationship between humanitarianism, security, and ethics in the case of the provision of medical humanitarian aid by Israel to casualties from the Syrian civil war, between 2013 and 2018. We argue that this... more
The article examines the relationship between humanitarianism, security, and ethics in the case of the provision of medical humanitarian aid by Israel to casualties from the Syrian civil war, between 2013 and 2018. We argue that this humanitarian project differs from the type of humanitarian intervention commonly seen in conflict zones and can be identified as a new form of humanitarian governance. Our case study deals with humanitarian care provided in the country of origin of the medical and security forces involved, rather than in the country of the injured. In this articulation of humanitarianism at home a new nature of life governance and new subjects of security, emerge. We argue that the politics of life shifts and is subordinated to two different ethical frameworks founded on two different logics: that of the human (as in the type of medical treatment seen in traditional humanitarian aid provision, which is often related to short-term immediate treatment) and that of the cit...
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Obstacles to collaborative public health frameworks such as Health in All Policies continue to emerge. Partnership-based public health programs present opportunities to study how public servants and practitioners address these barriers in... more
Obstacles to collaborative public health frameworks such as Health in All Policies continue to emerge. Partnership-based public health programs present opportunities to study how public servants and practitioners address these barriers in real time. To this end, we utilized “Middle-Out,” a socio-technical analytical approach that highlights the importance of Middle Actors-stakeholders positioned between policymakers and grassroots—to policy diffusion, innovation and collaboration in public health. We conducted participatory observation in administrative settings of Israel’s National Program to Promote Active, Healthy Lifestyle, 30 stakeholder interviews and document analysis. We examined two dimensions of impact from the Middle-Out: Directions of Influence—Middle-Up, Middle-Down and Sideways, and Modes of Influence—Enabling, Mediating and Aggregating. Through Middle-Out’s lens, our analysis transcends visible benchmarks such as legislation and macro-level resource-allocation, focusi...
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ArgumentThis paper focuses on the Jewish nursing profession in Poland during the interwar period. We argue that the integration of Jewish women in medical activity under the AJDC (American Jewish Distribution Committee) and TOZ... more
ArgumentThis paper focuses on the Jewish nursing profession in Poland during the interwar period. We argue that the integration of Jewish women in medical activity under the AJDC (American Jewish Distribution Committee) and TOZ (Towarzystwa Ochrony Zdrowia Ludności Żydowskiej [the Society for the Protection of the Health of the Jewish People]) emerged in Poland less from the adoption of gender equality and more out of necessity. On the one hand, JDC and TOZ needed Jewish nurses and public health nurses to carry out their health campaigns and build a public health infrastructure. On the other hand, a new generation of Jewish women needed job opportunities that would enable them to make a living and be independent. More broadly this case study shows that the implementation of American “reformative” ideals into the local Polish reality, including in the newly emerging public health field, involved adaptation, negotiation, and in some cases, resentment.
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The livestock industry has numerous and diverse impacts on the environment. In a cross-sectional study using an online questionnaire, 361 students were asked about their knowledge, attitudes, and behavior related to the environmental... more
The livestock industry has numerous and diverse impacts on the environment. In a cross-sectional study using an online questionnaire, 361 students were asked about their knowledge, attitudes, and behavior related to the environmental impact caused by livestock industry. The data were analyzed using correlations, t-tests for independent samples, and linear regression models. We found that students have almost no knowledge about the environmental impact of the food they consume, their attitudes are moderately pro-environmental, yet they are not strict about pro-environmental behavior. Students with higher levels of environmental knowledge demonstrated more pro-environmental attitudes and behavior; attitudes mediate the relationship between level of knowledge and behavior with respect to environmental pollution caused by the livestock industry. In addition, participants that rear/reared animals demonstrated more knowledge and pro-environmental attitudes and behavior, and women demonstr...
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In 2017, there were nearly 80,000 asylum seekers and undocumented migrant workers in Israel, most of whom did not have health insurance. We evaluated trends in medical visits of asylum seekers and undocumented migrant workers who... more
In 2017, there were nearly 80,000 asylum seekers and undocumented migrant workers in Israel, most of whom did not have health insurance. We evaluated trends in medical visits of asylum seekers and undocumented migrant workers who presented to Terem Refugee Clinic (TRC), a large clinic in Tel Aviv available only to uninsured residents of Israel. Data were collected from electronic medical records at TRC from 2013–2017. Diagnoses were grouped into categories using ICD-10-equivalent diagnosis codes. We used a chi-squared test for trends to test the significance of trends 2013 to 2017. There were 99,569 medical visits from 2013 to 2017 at TRC. Visits were lowest in 2013 (11,112), and relatively stable from 2014–2017 (range: 19,712–23,172). Most visits were among adults aged 18–35 (41.2%) and children <2 years old (23.7%). Only 3% of visits were from patients aged >50. The percentage of infectious disease diagnoses decreased over the study period, from 9.4% of all diagnoses in adul...
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In recent years, there has been a mass migration of Eritreans (many seeking political asylum) into Israel after precarious irregular movement across international borders. This study qualitatively explores the structural barriers to... more
In recent years, there has been a mass migration of Eritreans (many seeking political asylum) into Israel after precarious irregular movement across international borders. This study qualitatively explores the structural barriers to family planning (i.e. contraceptive services) for Eritrean women in Israel that are rooted in their temporary legal status and the patchwork of family planning services. From December 2012 to September 2013, we interviewed 25 key informants (NGO workers, researchers, Eritrean community activists, International NGO representatives and Ministry of Health officials) and 12 Eritrean asylum seekers. We also conducted 8 focus groups with Eritrean asylum seekers. Data were analyzed using both inductive and deductive coding. We identified 7 main barriers to accessing family planning services: (1) distance to health facilities; (2) limited healthcare resources; (3) fragmentation of the healthcare system; (4) cost of contraceptive services; (5) low standard of car...
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To assess the prevalence of microvascular and macrovascular complications of type 2 diabetes (T2DM) among Palestinians. 1308 diagnosed T2DM attending four main Primary Health Care Clinics on the Southern West Bank of Palestine examined by... more
To assess the prevalence of microvascular and macrovascular complications of type 2 diabetes (T2DM) among Palestinians. 1308 diagnosed T2DM attending four main Primary Health Care Clinics on the Southern West Bank of Palestine examined by a Mobile Diabetes Clinic team. All diabetes patients visiting the clinics during a one-month period for each clinic were included. Interviews, anthropometric measurements, physical examination, and laboratory tests: HbA1c, lipid profile, and kidney function tests analyzed in a central laboratory were obtained RESULTS: 1308 diabetes patients, including 839 females (64%), with a mean age of 57 years (SD=8.7), and mean diabetes duration 7.1 years(SD=6.25), participated. 95.3% presented as overweight (BMI &amp;amp;gt;25kg/m) or obese (BMI&amp;amp;gt;30kg/m) with mean BMI of 33.46 (SD=5.95). The mean HbA1c (tested in 1221 patients) was 9.21(SD=2). Only 16.1% had HbA1c &amp;amp;lt;7.0%. Hypertension (blood pressure&amp;amp;gt;140/90mmHg) were found in 23%, and dyslipidemia (total cholesterol&amp;amp;gt;200mg/dl) was present in 37.3% of patients. 213(16.3%) had a history of the macrovascular disease (previous myocardial infarction or stroke), and 290 (25.9%) had microvascular complications. Moreover, 40 (4.9%) had advanced kidney disease with serum creatinine&amp;amp;gt;1.4mg/dl. The present cross-sectional study shows poor glycemic control in Palestine, while blood pressure and lipids are less poorly controlled. The study emphasizes the need to optimize the glucose-lowering treatment and to implement diabetes care program that could face the challenge of high uncontrolled diabetes as well as complications of diabetes.
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Elucidating the heterogeneous etiologies of autism will require investment in comprehensive longitudinal data acquisition from large community based cohorts. With this in mind, we have established a hospital-university-based (HUB)... more
Elucidating the heterogeneous etiologies of autism will require investment in comprehensive longitudinal data acquisition from large community based cohorts. With this in mind, we have established a hospital-university-based (HUB) database of autism which incorporates prospective and retrospective data from a large and ethnically diverse population. The collected data includes social-demographic characteristics, standardized behavioral testing, detailed clinical history from electronic patient records, genetic samples, and various neurological measures. We describe the initial cohort characteristics following the first 18 months of data collection (188 children with autism). We believe that the Negev HUB autism database offers a unique and valuable resource for studying the heterogeneity of autism etiologies across different ethnic populations.
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During the summer of 2013, after samples of poliomyelitis virus were found in sewage, Israel launched an intensive national oral polio vaccine (OPV) campaign. The clinical objective of the campaign was rather clear. With not a single case... more
During the summer of 2013, after samples of poliomyelitis virus were found in sewage, Israel launched an intensive national oral polio vaccine (OPV) campaign. The clinical objective of the campaign was rather clear. With not a single case of infantile paralysis and with a population already highly protected with IPV (a dead version of the vaccine), the goal was to foster collective immunity so that risk populations could also be protected. This, however, entailed a rather unusual issue: how to persuade parents whose children already received an IPV to re-vaccinate their children, now with a live yet attenuated version of the virus that was excluded from the national vaccination program in 2004. The challenge therefore was a call for social solidarity - asking parents to vaccinate their children mainly for the sake of protecting unknown at risk populations and to take part in the larger global goals of the polio eradication program. This challenge stands at the core of our investigat...