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1.
BMC Med Ethics ; 23(1): 48, 2022 04 30.
Artigo em Inglês | MEDLINE | ID: mdl-35501743

RESUMO

BACKGROUND: Following the increased presence of the Right-to-Die Movement, improved end-of-life options, and the political and legal status of aid-in-dying around the globe, suicide tourism has become a promising alternative for individuals who wish to end their lives. Yet, little is known about this from the perspective of those who engage in the phenomenon. METHODS: This study applied the qualitative research approach, following the grounded theory tradition. It includes 11 in-depth semi-structured interviews with Israeli members of the Swiss non-profit Dignitas who contemplated traveling to Switzerland for aid-in-dying. RESULTS: Seven themes emerged from the data analysis, including health and functioning; feelings regarding survivorship and existence; interacting with the health sector; attitudes regarding death and dying; suicide; choosing death; and choosing suicide tourism. A significant portion of the participants had experienced suicidal thoughts and had even previously attempted suicide, some more than once. Most of them referred to chronic illnesses, functional disability, and social isolation. They understand suffering within the subjective dimension, namely only by the person who is actually subjected to the disease, ailments, and disability. Participants regarded aid-in-dying in Switzerland as positive thanks to its guaranteed outcome: "beautiful death", compared to "disadvantaged dying" which places a burden on the participants' loved ones throughout the prolonged dying. Most of them do not necessarily want to have their loved ones beside them when they die, and they see no significant meaning in dying in a foreign country to which they have no emotional or civil attachment. CONCLUSION: The desirable approval or tragic refusal by Dignitas to participants' requests for suicide tourism enhances the paradox between the perception of aid-in-dying as a mechanism for fulfilling controlled death and its bureaucratic and materialistic characteristics specifically reflected in a paid, formalized approach to aid-in-dying that cultivate dependency and collaboration.


Assuntos
Atitude , Morte , Humanos , Israel , Pesquisa Qualitativa , Suíça
2.
Parasit Vectors ; 15(1): 102, 2022 May 10.
Artigo em Inglês | MEDLINE | ID: mdl-35534871

RESUMO

BACKGROUND: Relapsing fever borreliosis is an infectious disease caused by bacteria of the genus Borrelia, inflicting recurrent episodes of fever and spirochetemia in humans. Borrelia persica, the causative agent of relapsing fever in Israel, is prevalent over a broad geographic area that extends from India to Egypt. It is transmitted by the soft tick Ornithodoros tholozani and causes disease in humans as well as domestic cats and dogs. The goal of this study was to survey domestic dogs and cats in Israel for infection with B. persica. METHODS: Blood, sera and demographic and clinical data were collected from dogs and cats brought for veterinary care in central Israel. PCR followed by DNA sequencing was used to detect B. persica DNA in blood samples, and an enzyme-linked immunosorbent assay (ELISA) was used to detect antibodies reactive with B. persica antigens in sera from the same animals. This is the first serological survey of B. persica in dogs and the first survey for antibodies reactive with a relapsing fever Borrelia sp. in cats globally. RESULTS: Four of the 208 dogs (1.9%) and three of 103 cats (2.9%) sampled were positive by PCR for B. persica DNA, and 24 dogs (11.5%) and 18 cats (17.5%) were seropositive for B. persica antigen by ELISA. The ratio between PCR-positivity and seropositivity in both the dog and cat populations was 1:6. All four PCR-positive dogs and two of three PCR-positive cats were seronegative, suggesting a probable recent infection. Thrombocytopenia showed significant association with seropositivity in dogs (P = 0.003). In cats, anemia had a significant association with seropositivity (P = 0.0001), and thrombocytopenia was associated with the combined prevalence of seropositivity or PCR-positivity (P = 0.022). CONCLUSIONS: Borrelia persica infection is more prevalent and widespread in domestic canine and feline populations in Israel than previously thought. Dogs and cats may play a role as reservoirs and sentinels for human infection. Precautions should be taken to prevent transfusion-transmitted infection between blood donor and recipient animals.


Assuntos
Infecções por Borrelia , Borrelia , Doenças do Gato , Doenças do Cão , Ornithodoros , Febre Recorrente , Trombocitopenia , Animais , Borrelia/genética , Doenças do Gato/epidemiologia , Doenças do Gato/microbiologia , Gatos , DNA , Doenças do Cão/epidemiologia , Cães , Israel/epidemiologia , Ornithodoros/genética , Febre Recorrente/epidemiologia , Febre Recorrente/microbiologia , Febre Recorrente/veterinária , Estudos Soroepidemiológicos
3.
Parasit Vectors ; 15(1): 147, 2022 May 10.
Artigo em Inglês | MEDLINE | ID: mdl-35534906

RESUMO

BACKGROUND: Three species of Leishmania cause disease in humans in Israel and are endemic in the Middle East: Leishmania infantum, Leishmania tropica and Leishmania major. These species infect dogs and cats, but little is known about their prevalence in pet populations and their clinical manifestations. A study on dog and cat Leishmania infection was conducted in a focus of human L. tropica infection in central Israel with the aim of getting insight on leishmaniosis in pets in an area where human infection is highly prevalent. METHODS: Blood, demographic and clinical data were collected from dogs and cats brought for veterinary care in a focus of human L. tropica infection during 2018-2020. kDNA PCR and internal transcribed spacer1 high-resolution melt analysis PCR (ITS1 HRM PCR) with DNA sequencing were performed for the detection of Leishmania and species determination. RESULTS: Forty-three of 189 dogs (22.8%) and 44 of 152 cats (28.9%) were positive for Leishmania spp. infection by kDNA PCR. The ITS1 HRM PCR detected six dogs (3.3%) infected with L. infantum and one (0.5%) with L. tropica, whereas six cats (3.9%) were found infected by L. infantum and five (3.3%) by L. tropica. Four of the five L. tropica-positive cats suffered from weight loss, four had azotemia, two with mild and two with severe azotemia and progressive renal disease. Three cats had gingivostomatitis; three had skin lesions with abscess and ulcers in two and scales and hair loss in another cat, which was also FIV +. This is the first report of feline L. tropica infection in Israel. Clinical information on cats with this infection from previous studies elsewhere is scarce. CONCLUSIONS: A high rate of Leishmania spp. infection, mostly estimated as sub-clinical, was found in dogs and cats admitted for veterinary care in an L. tropica focus. Among the animals in which infection could be characterized to the species level, more dogs were infected with L. infantum than with L. tropica while 5 of 11 cats were infected with L. tropica and had signs of systemic and skin disease not described before in feline L. tropica infection.


Assuntos
Azotemia , Doenças do Gato , Doenças do Cão , Leishmania infantum , Leishmania tropica , Leishmaniose Visceral , Leishmaniose , Animais , Doenças do Gato/diagnóstico , Doenças do Gato/epidemiologia , Gatos , DNA de Cinetoplasto , Doenças do Cão/diagnóstico , Doenças do Cão/epidemiologia , Cães , Feminino , Humanos , Israel/epidemiologia , Leishmania infantum/genética , Leishmania tropica/genética , Leishmaniose/veterinária , Leishmaniose Visceral/epidemiologia , Leishmaniose Visceral/veterinária , Masculino
4.
Sci Rep ; 12(1): 7463, 2022 May 06.
Artigo em Inglês | MEDLINE | ID: mdl-35523827

RESUMO

This study provides one of the earliest examples of fruit tree cultivation worldwide, demonstrating that olive (Olea europaea) and fig (Ficus carica) horticulture was practiced as early as 7000 years ago in the Central Jordan Valley, Israel. It is based on the anatomical identification of a charcoal assemblage recovered from the Chalcolithic (7200-6700 cal. BP) site of Tel Tsaf. Given the site's location outside the wild olive's natural habitat, the substantial presence of charred olive wood remains at the site constitutes a strong case for horticulture. Furthermore, the occurrence of young charred fig branches (most probably from pruning) may indicate that figs were cultivated too. One such branch was 14C dated, yielding an age of ca. 7000 cal. BP. We hypothesize that established horticulture contributed to more elaborate social contracts and institutions since olive oil, table olives, and dry figs were highly suitable for long-distance trade and taxation.


Assuntos
Ficus , Olea , Frutas , Israel , Jordânia , Árvores
5.
Sci Rep ; 12(1): 7418, 2022 May 06.
Artigo em Inglês | MEDLINE | ID: mdl-35523834

RESUMO

Migraine headaches in children may cause attacks that require abortive treatment. This study evaluated the incidence and efficacy of medications used for relieving migraine headache attacks in the pediatric population in Israel. Children 6-18 years of age who were diagnosed in our pediatric neurology clinic as having migraine headaches were enrolled into the study. Children and their parents recorded the children response to abortive treatment during consecutive migraine attacks. Fifty children, with 116 migraine attacks, were included in the study (30 females; mean age 12; range 6-18). Forty-seven (94%) reported on abortive treatment on the first migraine attack, 43 (86%) on a second migraine attack and 26 (52%) on a third migraine attack. During the first recorded migraine attack, 41 children (87.5%) reported taking only one type of medication for each headache episode, mainly ibuprofen or acetaminophen; less than a quarter used dipyrone (metamizol). Overall the improvement rate after two hours was 65.4% ± 27 for ibuprofen, 59.8 ± 35.3 for acetaminophen and 50.9 ± 27.4 for dipyrone without statistical difference. However, in the first recorded headache episode, males had a significantly better response to acetaminophen, compared to ibuprofen (95% ± 28 vs 75 ± 20). In conclusion, Children with migraine in Israel mainly use a single medication for each headache episode. Ibuprofen is the most commonly used abortive treatment; however, acetaminophen was associated with a better response among some of our patients.


Assuntos
Acetaminofen , Transtornos de Enxaqueca , Acetaminofen/uso terapêutico , Adolescente , Criança , Dipirona , Feminino , Cefaleia , Humanos , Ibuprofeno/uso terapêutico , Israel/epidemiologia , Masculino , Transtornos de Enxaqueca/tratamento farmacológico , Transtornos de Enxaqueca/epidemiologia
6.
Sci Rep ; 12(1): 7524, 2022 May 07.
Artigo em Inglês | MEDLINE | ID: mdl-35525885

RESUMO

Herod "the Great", king of Judea in the second half of the first century BC, was known for his building projects, wealth, and political power. Two of his personal calcite-alabaster bathtubs, found in the Kypros fortress and the palace of Herodium, are among the very limited archaeological evidence of his private life. It seemed plausible that they were imported from Egypt, the main source of calcite-alabaster in ancient periods. Yet, the recent identification of a calcite quarry in the Te'omim cave, Israel, challenges this hypothesis. Here, we developed an approach for identification of the source of calcite-alabaster, by combination of four analytical methods: ICP, FTIR, ssNMR and isotope ratio. These methods were then applied to Herod's bathtubs demonstrating that they were indeed quarried in Israel rather than in Egypt.


Assuntos
Carbonato de Cálcio , Sulfato de Cálcio , Arqueologia , Egito , História Antiga , Israel
7.
Nat Commun ; 13(1): 2202, 2022 Apr 22.
Artigo em Inglês | MEDLINE | ID: mdl-35459237

RESUMO

With the COVID-19 pandemic ongoing, accurate assessment of population immunity and the effectiveness of booster and enhancer vaccine doses is critical. We compare COVID-19-related hospitalization incidence rates in 2,412,755 individuals across four exposure levels: non-recent vaccine immunity (two BNT162b2 COVID-19 vaccine doses five or more months prior), boosted vaccine immunity (three BNT162b2 doses), infection-induced immunity (previous COVID-19 without a subsequent BNT162b2 dose), and enhanced infection-induced immunity (previous COVID-19 with a subsequent BNT162b2 dose). Rates, adjusted for potential demographic, clinical and health-seeking-behavior confounders, were assessed from July-November 2021 when the Delta variant was predominant. Compared with non-recent vaccine immunity, COVID-19-related hospitalization incidence rates were reduced by 89% (87-91%) for boosted vaccine immunity, 66% (50-77%) for infection-induced immunity and 75% (61-83%) for enhanced infection-induced immunity. We demonstrate that infection-induced immunity (enhanced or not) provides more protection against COVID-19-related hospitalization than non-recent vaccine immunity, but less protection than booster vaccination. Additionally, our results suggest that vaccinating individuals with infection-induced immunity further enhances their protection.


Assuntos
COVID-19 , COVID-19/epidemiologia , COVID-19/prevenção & controle , Vacinas contra COVID-19 , Hospitalização , Humanos , Israel/epidemiologia , Pandemias , SARS-CoV-2
8.
Int J Public Health ; 67: 1604533, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35450127

RESUMO

Objectives: This study explores associations between trust in directives and compliance with physical distancing by comparing two populations in Israel. Methods: Following two lockdowns, we conducted two cross-sectional surveys among the Arab minority and Jewish citizens of Israel (first survey, N = 613; second survey, N = 542). We conducted multivariable logistic regression analyses for the association between trust and compliance with physical distancing separately for each group in each survey. Results: In both surveys trust levels were significantly lower among Arabs than Jews (p < 0.001). Compared to Jews, Arabs were less likely to report compliance with physical distancing in the first and second surveys (OR = 0.52, 95% CI 0.32-0.84 and OR = 0.62, 95% CI 0.39-0.98, respectively). In both surveys trusting the directives was an important determinant of compliance with physical distancing among Jews only. Conclusion: Our findings indicate that momentum is important in building and maintaining public trust and compliance during pandemics. Policymakers should note the lack of trust among Arabs, which warrants further research and interventions.


Assuntos
COVID-19 , Judeus , Árabes , COVID-19/epidemiologia , Controle de Doenças Transmissíveis , Estudos Transversais , Humanos , Israel/epidemiologia , Pandemias , Distanciamento Físico , Confiança
9.
Front Public Health ; 10: 836675, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35462805

RESUMO

The upturn in life expectancy and its consequence, population aging, are challenging labor, pension, and social-security systems throughout the developed world. The focal aim of this study is to measure the extent of out-of-pocket funding of healthcare services by the older adult population. The study has three objectives: to profile the healthcare services for which older adults pay out of pocket, profile the older adults who pay out of pocket for medical services and detect changes over the years, and identify predictors of out-of-pocket healthcare services funding by older adults. The study is predicated on the SHARE-Israel database (SHARE-Survey of Health, Ageing and Retirement in Europe). Relating to information yielded by the last two waves of SHARE-Israel (Wave 7 and Wave 8), it sheds light on the characteristics of those who reported having paid out-of-pocket for medical services. A large majority of the older-adult population in Israel that consumes healthcare services is asked to pay for services out of pocket. Having supplemental health insurance, personal state of health and changes in it, and economic resources are found to have the strongest effect on the probability of out-of-pocket funding. The motive of financial and/or social support that older adults receive from and/or give to their immediate surroundings makes it more likely that they will pay out of pocket for healthcare services. The probability of such funding varies between nationalities and immigration statuses. It is found with emphasis that the share of out-of-pocket funding of healthcare in older adult households' total annual income is trending upward. Furthermore, economic motives are central in determining whether such expenditure will stabilize over time. The findings stress the need to enhance the healthcare system's awareness of the profile of older adults who find it necessary to pay out of pocket for healthcare services.


Assuntos
Gastos em Saúde , Seguro Saúde , Europa (Continente) , Serviços de Saúde , Israel
10.
Front Immunol ; 13: 868915, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35432335

RESUMO

Background: Immunomodulatory/immunosuppressive activity of multiple sclerosis (MS) disease modifying therapies (DMTs) might affect immune responses to SARS-CoV-2 exposure or vaccination in patients with MS (PwMS). We evaluated the effect of DMTs on humoral and cell-mediated immune responses to 2 and 3 vaccinations and the longevity of SARS-Cov-2 IgG levels in PwMS. Methods: 522 PwMS and 68 healthy controls vaccinated with BNT162b2-Pfizer mRNA vaccine against SARS-CoV-2, or recovering from COVID-19, were recruited in a nation-wide multi-center study. Blood was collected at 3 time-points: 2-16 weeks and ~6 months post 2nd vaccination and 1-16 weeks following 3rd vaccination. Serological responses were measured by quantifying IgG levels against the spike-receptor-binding-domain of SARS-CoV-2, and cellular responses (in a subgroup analysis) by quantifying IFNγ secretion in blood incubated with COVID-19 spike-antigen. Results: 75% PwMS were seropositive post 2nd or 3rd vaccination. IgG levels decreased by 82% within 6 months from vaccination (p<0.0001), but were boosted 10.3 fold by the 3rd vaccination (p<0.0001), and 1.8 fold compared to ≤3m post 2nd vaccination (p=0.025). Patients treated with most DMTs were seropositive post 2nd and 3rd vaccinations, however only 38% and 44% of ocrelizumab-treated patients and 54% and 46% of fingolimod-treated patients, respectively, were seropositive. Similarly, in COVID-19-recovered patients only 54% of ocrelizumab-treated, 75% of fingolimod-treated and 67% of cladribine-treated patients were seropositive. A time interval of ≥5 months between ocrelizumab infusion and vaccination was associated with higher IgG levels (p=0.039 post-2nd vaccination; p=0.036 post-3rd vaccination), and with higher proportions of seropositive patients. Most fingolimod- and ocrelizumab-treated patients responded similarly to 2nd and 3rd vaccination. IFNγ-T-cell responses were detected in 89% and 63% of PwMS post 2nd and 3rd vaccination, however in only 25% and 0% of fingolimod-treated patients, while in 100% and 86% of ocrelizumab-treated patients, respectively. Conclusion: PwMS treated with most DMTs developed humoral and T-cell responses following 2 and 3 mRNA SARS-CoV-2 vaccinations. Fingolimod- or ocrelizumab-treated patients had diminished humoral responses, and fingolimod compromised the cellular responses, with no improvement after a 3rd booster. Vaccination following >5 months since ocrelizumab infusion was associated with better sero-positivity. These findings may contribute to the development of treatment-stratified vaccination guidelines for PwMS.


Assuntos
COVID-19 , Esclerose Múltipla , COVID-19/prevenção & controle , Vacinas contra COVID-19 , Cloridrato de Fingolimode/uso terapêutico , Humanos , Imunidade Celular , Imunoglobulina G/uso terapêutico , Israel , Esclerose Múltipla/tratamento farmacológico , RNA Mensageiro/uso terapêutico , SARS-CoV-2 , Vacinação , Vacinas Sintéticas
11.
Am J Occup Ther ; 76(3)2022 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-35471501

RESUMO

IMPORTANCE: Children diagnosed with autism spectrum disorder (ASD) are often referred to occupational therapy practitioners so their sensory features and their repetitive and restricted behaviors and interests (RRBIs) can be addressed. RRBIs include an insistence on sameness, narrow interests, rigid routines, and rituals. However, there is a paucity of knowledge concerning the association between sensory features-across patterns, modalities, and contexts-and high-order RRBIs among children with ASD who are cognitively able. OBJECTIVE: To examine the association between sensory features across sensory patterns, modalities, and contexts and high-order RRBIs in children with ASD. DESIGN: Correlational clinical study based on parent questionnaire responses. SETTING: General education system in Israel. PARTICIPANTS: Parents of 39 cognitively able school-age children with ASD (ages 6-10 yr; 34 boys and 5 girls), recruited by means of convenience sampling. OUTCOMES: High-order RRBIs were assessed with relevant subscales from the Repetitive Behavior Scale-Revised (RBS-R), and sensory features across patterns, modalities, and contexts were examined with the Sensory Experiences Questionnaire, Version 2.1. The study hypotheses were formulated before data were collected. RESULTS: Significant correlations were observed between the high-order RRBIs of children with ASD and their sensory features across patterns, sensory modalities, and contexts. Fifty-one percent of the total RBS-R scores were predicted by sensory hyperresponsiveness, and an additional 11% were predicted by sensory-seeking behaviors. CONCLUSIONS AND RELEVANCE: The hypotheses concerning the association between sensory features and high-order RRBIs were confirmed. The findings enhance occupational therapy practitioners' understanding of this association and may assist in the planning of more efficient interventions. What This Article Adds: The findings enhance clinical knowledge concerning the association between sensory features and high-order RRBIs and may lay a better foundation for occupational therapy interventions for children with ASD and their families.


Assuntos
Transtorno do Espectro Autista , Transtorno do Espectro Autista/diagnóstico , Criança , Feminino , Humanos , Israel , Masculino , Pais , Inquéritos e Questionários
12.
Isr J Health Policy Res ; 11(1): 22, 2022 Apr 20.
Artigo em Inglês | MEDLINE | ID: mdl-35443682

RESUMO

The COVID-19 pandemic cast a dramatic spotlight on the use of data as a fundamental component of good decision-making. Evaluating and comparing alternative policies required information on concurrent infection rates and insightful analysis to project them into the future. Statisticians in Israel were involved in these processes early in the pandemic in some silos as an ad-hoc unorganized effort. Informal discussions within the statistical community culminated in a roundtable, organized by three past presidents of the Israel Statistical Association, and hosted by the Samuel Neaman Institute in April 2021. The meeting was designed to provide a forum for exchange of views on the profession's role during the COVID-19 pandemic, and more generally, on its influence in promoting evidence-based public policy. This paper builds on the insights and discussions that emerged during the roundtable meeting and presents a general framework, with recommendations, for involving statisticians and statistics in decision-making.


Assuntos
COVID-19 , Humanos , Israel/epidemiologia , Pandemias/prevenção & controle , Política Pública
13.
PLoS One ; 17(4): e0267279, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35436312

RESUMO

BACKGROUND: The issue of whether to include seasonal influenza vaccinations in school-located vaccination programs (SLIV) has been examined in many countries, mainly in the context of economic effectiveness and morbidity prevention. Yet not enough studies have examined the impact of parental risk perceptions, health literacy and SLIV on parental vaccination uptake. OBJECTIVES: The most recent statistics in Israel point to a higher rate of seasonal influenza vaccination among Arab children (aged 7-9 years) than among Jewish children in the same age group. The present study attempts to explain this high vaccination uptake among mothers from Arab society by comparing their risk perceptions regarding seasonal influenza vaccination and disease to those of Jewish mothers. The study further examines the impact of SLIV on parental risk perceptions and influenza vaccination uptake. METHODS: This cross-sectional study included mothers of children in the second and third grades faced with the decision of whether their children should receive the seasonal influenza vaccination at school. The study population included a stratified sample of Jewish mothers (n = 159) and Arab mothers from all the Arab population sub-groups: Muslim, Christian, Druse and Bedouin (n = 534). RESULTS: A comparison of the Arab and Jewish populations revealed a significant difference in vaccination rates; 61.7% among Arab mothers compared to 33.5% among Jewish mothers (χ2(1) = 39.15, P<0.0001). Moreover, significant differences emerged between the Arab and Jewish populations in health literacy and ability to seek information regarding the seasonal influenza vaccination (t (691) = -5.81, p < 0.0001). While no differences emerged in mothers' perceptions regarding influenza as a disease (t (691) = 1.20, p = 0.2318), Arab mothers perceived the vaccination to be safer than Jewish mothers (t (691) = 2.74, p = 0.0063) and saw its inclusion in the school-located vaccination program as providing more legitimacy (Z = -6.6719, P < .0001). CONCLUSION: This study showed that the factors influencing vaccination uptake among both the Arab and the Jewish populations include perceived influenza risk, perceived vaccination risk, inclusion in the school-located vaccination program and health literacy. Moreover, influenza vaccination uptake is higher among those who have positive attitudes toward vaccinations, low risk perceptions regarding the vaccine, and low health literacy that impedes their ability to seek information. The research also points to the need for education and tools to boost health literacy among minority groups so that mothers can make independent and informed decisions about whether or not to vaccinate their children.


Assuntos
Vacinas contra Influenza , Influenza Humana , Árabes , Criança , Estudos Transversais , Feminino , Humanos , Programas de Imunização , Influenza Humana/prevenção & controle , Israel , Judeus , Mães , Instituições Acadêmicas , Estações do Ano , Vacinação
14.
Isr J Health Policy Res ; 11(1): 21, 2022 Apr 11.
Artigo em Inglês | MEDLINE | ID: mdl-35410306

RESUMO

BACKGROUND: Unintentional childhood injuries are a leading cause of morbidity and mortality worldwide. Attempts to prevent child home injuries have rarely been implemented in hospital settings which present an important opportunity for intervention. The SHABI ('Keeping our Children Safe; SHomrim Al BetIchut Yeladenu') program recruits at-risk families presenting with child injury to the Emergency Department. Medical/nursing students conduct two home visits and provide safety equipment and guidance. The objective of this study was to investigate the impact of SHABI on participating families' home-safety. METHODS: The pilot was conducted between May 2019 and March 2020 in northern Israel, an area with high child injury rates. Eligibility included families with preschool children who incurred a home injury. Home-safety was assessed by observation through the 'Beterem' checklist. Parents' views, knowledge, awareness of dangers and report of home injuries were assessed at the start of each visit. RESULTS: 352 of 773 eligible families agreed to be contacted. 135 participated, 98 completed both home visits. Significant improvement in home-safety items was observed 4 months after the first visit (14 [IQR12-16]) vs. (17 [IQR15-19]; p < 0.001), accompanied by an overall increase in home safety (Mean ± SD 71.9% ± 9.5% vs. 87.1% ± 8.6%; p < 0.001). 64% reported greater awareness of dangers, 60% affirmed home was safer, and 70% valued the equipment. No difference was found in the prevalence of injuries (14 of 98 families prior and 8 after the visit; p = 0.17). Home visitors reported benefiting from the experience of working with disadvantaged families. CONCLUSION: The program, which included recruitment in a hospital emergency setting and use of healthcare students as home visitors, was successfully implemented and accompanied by significant improvement in home safety with a non-significant trend of child injury decrease.


Assuntos
Acidentes Domésticos , Equipamentos de Proteção , Acidentes Domésticos/prevenção & controle , Criança , Pré-Escolar , Hospitais , Humanos , Israel/epidemiologia , Segurança
15.
Isr J Health Policy Res ; 11(1): 20, 2022 Apr 11.
Artigo em Inglês | MEDLINE | ID: mdl-35410309

RESUMO

BACKGROUND: The COVID-19 pandemic has highlighted the important role of professionals in designing and communicating effective policies. The purpose of this study was to evaluate the level of trust in the COVID-19 national public health policy among public health professionals in Israel and its correlates during the first wave of the pandemic. METHODS: A purposive sampling of public health professionals in Israel, through professional and academic public health networks (N = 112). The survey was distributed online during May 2020. Level of trust was measured by the mean of 18 related statements using a 5-point Likert scale, where 1 means not at all and 5 means to a very high extent, and grouped as low and high trust by median (2.75). RESULTS: A moderate level of trust in policy was found among professionals (Mean: 2.84, 95% Cl: [2.70, 2.98]). The level of trust among public health physicians was somewhat lower than among researchers and other health professionals (Mean: 2.66 vs. 2.81 and 2.96, respectively, p = 0.286), with a higher proportion expressing low trust (70% vs. 51% and 38%, respectively, p < 0.05). Participants with a low compared to high level of trust in policy were less supportive of the use of Israel Security Agency tools for contact tracing (Mean = 2.21 vs. 3.17, p < 0.01), and reported lower levels of trust in the Ministry of Health (Mean = 2.52 vs. 3.91, p < 0.01). A strong positive correlation was found between the level of trust in policy and the level of trust in the Ministry of Health (rs = 0.782, p < 0.01). Most professionals (77%) rated their involvement in decision making as low or not at all, and they reported a lower level of trust in policy than those with high involvement (Mean = 2.76 vs. 3.12, p < 0.05). Regarding trust in the ability of agencies to deal with the COVID-19 crisis, respondents reported high levels of trust in the Association of Public Health Physicians (80%) and in hospitals (79%), but very low levels of trust in the Minister of Health (5%). CONCLUSIONS: This study shows that Israeli public health professionals exhibited moderate levels of trust in COVID-19 national public health policy and varied levels of trust in government agencies during the first wave of COVID-19. The level of trust in policy was lower among most of the participants who were not involved in decision making. The level of trust found is worrisome and should be monitored, because it may harm cooperation, professional response, and public trust. Professionals' trust in policy-making during early stages of emergencies is important, and preemptive measures should be considered, such as involving professionals in the decision-making process, maintaining transparency of the process, and basing policy on scientific and epidemiological evidence.


Assuntos
COVID-19 , Pandemias , COVID-19/prevenção & controle , Estudos Transversais , Humanos , Israel/epidemiologia , Pandemias/prevenção & controle , Saúde Pública , Política Pública , Confiança
16.
Isr Med Assoc J ; 24(4): 215-218, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-35415978

RESUMO

BACKGROUND: Guidelines for pandemic preparedness emphasize the role of sentinel and syndromic surveillance in monitoring pandemic spread. OBJECTIVES: To examine advantages and obstacles of utilizing a sentinel influenza surveillance system to monitor community severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) activity based on Israel's experience from mid-March to mid-May 2020. METHODS: Several modifications were applied to the influenza surveillance system. The clinical component relied mainly on pneumonia and upper respiratory infection (URI) consultations with primary care physicians as well as visits to emergency departments (ED) due to pneumonia. The virological data were based on nasopharyngeal swabs obtained from symptomatic patients who visited outpatient clinics. RESULTS: By week 12 of the pandemic, the crude and age-specific primary physician consultation rates due to URI and pneumonia declined below the expected level, reaching nadir that lasted from week 15 until week 20. Similarly, ED visits due to pneumonia were significantly lower than expected from weeks 14 and 15 to week 20. The virological surveillance started on week 13 with 6/253 of the swabs (2.3%) positive for SARS-CoV-2. There was a peak of 13/225 positive swabs on week 145.8%. During weeks 17-20, none of the swabs (47-97 per week) were positive for SARS-CoV-2. This trend was similar to national data. CONCLUSIONS: The virological component of the surveillance system showed the SARS-CoV-2 community spread, but had low sensitivity when virus activity was low. The clinical component, however, had no yield. Sentinel surveillance can assist in monitoring future novel pandemics and should be augmented in revised preparedness plans.


Assuntos
COVID-19 , Influenza Humana , Pneumonia , Infecções Respiratórias , COVID-19/diagnóstico , COVID-19/epidemiologia , Humanos , Influenza Humana/epidemiologia , Israel/epidemiologia , SARS-CoV-2 , Vigilância de Evento Sentinela
17.
Isr Med Assoc J ; 24(4): 246-252, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-35415984

RESUMO

BACKGROUND: Hookah smoking is a common activity around the world and has recently become a trend among youth. Studies have indicated a relationship between hookah smoking and a high prevalence of chronic diseases, cancer, cardiovascular, and infectious diseases. In Israel, there has been a sharp increase in hookah smoking among the Arabs. Most studies have focused mainly on hookah smoking among young people. OBJECTIVES: To examine the association between hookah smoking and socioeconomic characteristics, health status and behaviors, and knowledge in the adult Arab population and to build a prediction model using machine learning methods. METHODS: This quantitative study based is on data from the Health and Environment Survey conducted by the Galilee Society in 2015-2016. The data were collected through face-to-face interviews with 2046 adults aged 18 years and older. RESULTS: Using machine learning, a prediction model was built based on eight features. Of the total study population, 13.0% smoked hookah. In the 18-34 age group, 19.5% smoked. Men, people with lower level of health knowledge, heavy consumers of energy drinks and alcohol, and unemployed people were more likely to smoke hookah. Younger and more educated people were more likely to smoke hookah. CONCLUSIONS: Hookah smoking is a widespread behavior among adult Arabs in Israel. The model generated by our study is intended to help health organizations reach people at risk for smoking hookah and to suggest different approaches to eliminate this phenomenon.


Assuntos
Árabes , Fumar Cachimbo de Água , Adolescente , Adulto , Algoritmos , Humanos , Israel/epidemiologia , Aprendizado de Máquina , Masculino , Fumar Cachimbo de Água/epidemiologia , Adulto Jovem
18.
Euro Surveill ; 27(13)2022 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-35362408

RESUMO

BackgroundCOVID-19 vaccine safety is of major interest worldwide, since there is no prior experience with it. Israel was one of the first countries to widely use the Comirnaty vaccine.AimWe aimed to assess the vaccine's short-term side effects directly from a large population and to predict influencing factors for self-reporting side effects.MethodsIn a retrospective cohort study, we investigated self-reported systemic vaccine side-effects using electronic surveys sent to vaccinated individuals between 20 December 2020 and 11 March 2021, within 3 days following administration of the first and second dose. We determined predictors for reporting systemic side effects by logistic regression.ResultsA total of 1,213,693 patients received at least one vaccine dose and 301,537 (24.8%) answered at least one survey. Among them, 68,162 (30.4%) and 89,854 (59.9%) individuals filled the first and the second dose surveys, respectively, and reported one or more side effects. Most common side effects were fatigue, headache and myalgia. Several respondents reported facial paraesthesia after first and second dose, respectively (n = 1,675; 0.7% and n = 1,601; 1.1%). Individuals younger than 40 years and women reported side effects more frequently than others, but pregnant women reported less. Pregnancy was a weak predictor for reporting any side effect in general and in particular fatigue, myalgia, headache, chills and fever.ConclusionsWe found further support for minor short-term side effects, within 3 days of receiving the Comirnaty vaccine. These findings from vaccine recipients in general and pregnant women in particular can improve vaccine acceptance.


Assuntos
Vacinas contra COVID-19 , COVID-19 , COVID-19/epidemiologia , COVID-19/prevenção & controle , Vacinas contra COVID-19/efeitos adversos , Feminino , Humanos , Israel/epidemiologia , Gravidez , Estudos Retrospectivos , Inquéritos e Questionários , Vacinação/efeitos adversos
20.
Sci Rep ; 12(1): 6121, 2022 Apr 12.
Artigo em Inglês | MEDLINE | ID: mdl-35414101

RESUMO

Venous thromboembolism (VTE) is considered a leading safety concern during hospitalization. The Padua Predication Score (PPS) is a risk model conceived to predict VTE among non-surgical hospitalized patients. The study aim was to evaluate the PPS ability to predict VTE in Israeli non-surgical hospitalized patients using data from electronic medical records. A single center, large-scale, historic cohort study of hospitalized non-surgical patients was conducted. Outcomes included clinically diagnosed symptomatic VTE events, bleeding events, and mortality during hospitalization and up to 90 days thereafter, and readmission up to 90 days after discharge. 5117 patient records were analyzed after screening and validation. 1120 (22%) patients were defined per PPS as high-risk, of which 277 (24.7%) were prophylactically treated. The low-risk group included 3997 (78%) patients. Prevalence of symptomatic VTE was low. Overall, 14 (0.27%) VTE events were diagnosed: 3 cases in the high-risk group (0.27%) and 11 (0.28%) in the low-risk group, with no significant difference, p = 0.768. Prophylactic treatment among the high-risk patients did not significantly improve VTE incidence: 1/277 (0.36%) treated vs. 2/843 (0.24%), p = 0.343. There was no significant difference between the study groups regarding the rates of bleeding, unexplained mortality or readmission. PPS was not found to be an efficient tool for identification of non-surgical hospitalized patients with high risk for clinically significant VTE.


Assuntos
Tromboembolia Venosa , Anticoagulantes , Estudos de Coortes , Registros Eletrônicos de Saúde , Hospitalização , Humanos , Israel/epidemiologia , Estudos Retrospectivos , Medição de Risco , Fatores de Risco , Tromboembolia Venosa/diagnóstico , Tromboembolia Venosa/epidemiologia , Tromboembolia Venosa/prevenção & controle
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