[THE FIGHTS OF OPENING NEW MEDICAL SCHOOLS IN ISRAEL - 1960-2024 - COMPARATIVE PERSPECTIVE].

INTRODUCTION: THE FIGHTS OF OPENING NEW MEDICAL SCHOOLS IN ISRAEL - 1960-2024 - COMPARATIVE PERSPECTIVE.

Medical social workers as mediators between patients, physicians, and the court: the case of former ringworm patients.

Facilitating benefit and resource acquisition to assist clients is a major responsibility of medical social workers, requiring them to have a thorough knowledge of community resources, legislation, and regulations. The aim of the current study was to examine knowledge of the Law for Compensation of Scalp Ringworm Victims and ringworm-related irradiation damage among 101 social workers employed in diverse healthcare settings in Israel. We found that 65.3% of the social workers were aware of the law, but only 40.6% were aware of the health effects of scalp ringworm irradiation. Media coverage and clients who underwent scalp ringworm irradiation were social workers' major sources of knowledge. Working with former ringworm patients had the strongest association with knowledge of the law and of ringworm-related irradiation damage. Results highlight the important contribution of exposure to clients' experiences and knowledge to expand social workers' knowledge of health issues.

Michael Reese Hospital and the Campaign to Warn the US Public of the Long-Term Health Effects of Ionizing Radiation, 1973-1977.

In July 1973, a study at the University of Chicago linked radiation treatment during childhood to a variety of diseases, including thyroid cancer. A few months later, a worker at Michael Reese Hospital in Chicago, Illinois found a registry of 5266 former patients who had been treated with radiation during the 1950s and 1960s. Hospital officials decided to contact these patients and arrange for follow-up medical examinations. Media coverage of the hospital's campaign had a snowball effect that prompted more medical institutions to follow suit, resulting in the National Cancer Institute (NCI) launching a nationwide campaign to warn the public and medical community about the late health effects of ionizing radiation. This study describes how the single action of a hospital in Chicago and the media attention it attracted led to a national campaign to warn those who underwent radiation treatment during childhood.

[MEMORIES OF A JEWISH RURAL DOCTOR IN SOUTH AFRICA DURING THE 1930S AND 1940S].

INTRODUCTION: Providing proper medical care under the laws of racial segregation in South Africa in the 1930s and 1940s involved facing medical and ethical problems. The physician, especially in rural areas, had to take care of a myriad of populations: poor "black" tribal people with little or no education, farmers in remote farms and affluent and better educated "Europeans", without an infrastructure of hospitals and even pharmacies. The lone physician had to make medical decisions on the spot, without being able to consult with other doctors, while maintaining high human, medical and ethical standards. Dr. Jack Karpas, started as a country physician in rustic areas and gained experience in larger hospitals while treating a variety of populations with numerous medical conditions. He later established a prosperous medical practice in Parow (near Cape Town), before immigrating to Israel in 1951. In this excerpt from his memoirs, Dr. Jack Karpas relates some of the exotic incidents and medical problems he encountered.

Health and health care in Israel: an introduction.

Starting well before Independence in 1948, and over the ensuing six decades, Israel has built a robust, relatively efficient public system of health care, resulting in good health statistics throughout the life course. Because of the initiative of people living under the British Mandate for Palestine (1922-48), the development of many of today's health services predated the state's establishment by several decades. An extensive array of high-quality services and technologies is available to all residents, largely free at point of service, via the promulgation of the 1994 National Health Insurance Law. In addition to a strong medical academic culture, well equipped (albeit crowded) hospitals, and a robust primary-care infrastructure, the country has also developed some model national projects such as a programme for community quality indicators, an annual update of the national basket of services, and a strong system of research and education. Challenges include increasing privatisation of what was once largely a public system, and the underfunding in various sectors resulting in, among other challenges, relatively few acute hospital beds. Despite substantial organisational and financial investment, disparities persist based on ethnic origin or religion, other socioeconomic factors, and, regardless of the country's small size, a geographic maldistribution of resources. The Ministry of Health continues to be involved in the ownership and administration of many general hospitals and the direct payment for some health services (eg, geriatric institutional care), activities that distract it from its main task of planning for and supervising the whole health structure. Although the health-care system itself is very well integrated in relation to the country's two main ethnic groups (Israeli Arabs and Israeli Jews), we think that health in its widest sense might help provide a bridge to peace and reconciliation between the country and its neighbours.

[43 YEARS TO THE ESTABLISHMENT OF THE FACULTY OF MEDICINE IN THE NEGEV].

INTRODUCTION: On March 21, 1973, Israel's Council of Higher Education (CHE) was convened by Yigal Alon, the Council's chair and the Minister of Education, to vote on whether to approve a proposal to establish a school of medicine in the Negev. In the preliminary discussion, Avraham Harman, the president of the Hebrew University in Jerusalem turned to Professor Moshe Prywes, the president of Ben-Gurion University in the Negev and commented: "Be assured, a school of medicine in Beer Sheva won't pass." At the close of the discussion, the twenty members of the CHE were asked to vote. The vote was a tie - 8 in favor, 8 against and 3 refrained. According to the CHE charter, the chairperson was required to break the tie. The minister - Yigal Alon, raised his hand in favor. Thus, by a bare voice, it was decided to establish a medical school in the Negev. This paper describes the processes that culminated in the approval of a school of medicine by the Council of Higher Education in March 1973. It presents the various personalities, agents, bodies and institutions that played a role in this process and their relative weights in the ultimate decision to establish a school of medicine in the Negev.

The mass campaign to eradicate ringworm among the Jewish community in Eastern Europe, 1921-1938.

Between the years 1921 and 1938, 27,600 children were irradiated during a mass campaign to eradicate ringworm among the Jewish community in East Europe. The ringworm campaign was the initiative of the American Jewish Joint Distribution Committee together with the Jewish health maintenance organization OZE (The Society for the Protection of Jewish Health). We describe this campaign that used x-rays to eradicate ringworm and its mission to enhance public health among Jewish communities in Eastern Europe during the period between the world wars. We discuss the concepts behind the campaign, the primary health agents that participated in it, and the latent medical ramifications that were found among children treated for ringworm, many years after treatment--pathologies that can be linked to the irradiation they received as children. Our research is based on historical archival materials in the United States, Europe, and Israel.

Understanding and addressing populations whose prior experience has led to mistrust in healthcare.

BACKGROUND: Policy makers need to maintain public trust in healthcare systems in order to foster citizen engagement in recommended behaviors and treatments. The importance of such commitment has been highlighted by the recent COVID-19 pandemic. Central to public trust is the extent of the accountability of health authorities held responsible for long-term effects of past treatments. This paper addresses the topic of manifestations of trust among patients damaged by radiation treatments for ringworm. METHODS: For this mixed-methods case study (quan/qual), we sampled 600 files of Israeli patients submitting claims to the National Center for Compensation of Scalp Ringworm Victims in the years 1995-2014, following damage from radiation treatments received between 1946 and 1960 in Israel and/or abroad. Qualitative data were analyzed with descriptive statistics, and correlations were analyzed with chi-square tests. Verbal data were analyzed by the use of systematic content analysis. RESULTS: Among 527 patients whose files were included in the final analysis, 42% held authorities responsible. Assigning responsibility to authorities was more prevalent among claimants born in Israel than among those born and treated abroad (χ2 = 6.613, df = 1, p = 0.01), claimants reporting trauma (χ2 = 4.864, df = 1, p = 0.027), and claimants living in central cities compared with those in suburban areas (χ2 = 18.859, df = 6, p < 0.01). Men, younger claimants, patients with a psychiatric diagnosis, and patients from minority populations expressed mistrust in health regulators. CONCLUSIONS: Examining populations' perceived trust in healthcare institutions and tailoring health messages to vulnerable populations can promote public trust in healthcare systems.

Gender Differences in Psychosocial Outcomes of Hair Loss Resulting from Childhood Irradiation for Tinea Capitis.

Recent studies have linked hair loss due to childhood irradiation for tinea capitis, a fungal infection of the scalp, to adverse psychosocial and health outcomes in women. However, no study to date has examined gender differences in the outcomes of this type of hair loss. The current study aimed to investigate gender differences in health and psychosocial outcomes of hair loss resulting from childhood irradiation for tinea capitis, and to identify the risk factors associated with depression in both men and women. Medical records held at the archives of the Israel National Center for Compensation of Scalp Ringworm Victims were retrospectively reviewed for 217 women and 105 men who received maximum disability compensation due to severe hair loss resulting from irradiation for tinea capitis. We found that women were at increased risk of developing psychosocial symptoms, including depression. Gender emerged as a significant predictor of depression, distinct from other predictors, such as marital status, age at radiation, exposure to verbal and physical bullying, low self-esteem, social anxiety, and physical health problems. Thus, the psychosocial needs of patients, particularly female patients, who were irradiated for tinea capitis during childhood need to be taken into account by the healthcare professionals treating them.

[The influence of the relationship between physicians and pharmaceutical companies on the patient from the point of view of policy-makers in Israel].

BACKGROUND: The relationship between doctors and pharmaceutical companies is an integral part of the health system in Israel and the whole world. The mutual need for such a relationship requires us, as a society, to examine its influence on the individual and the system as a whole. AIM: This research examines the relationship from the points of view of the relevant parties within the health system and outside the health system (decision-makers). METHODS: The authors used in-depth interviews and qualitative research methods in order to examine and understand the various positions of decision-makers. FINDINGS AND CONCLUSION: The position of the decision-makers, regarding all the aspects of this relationship, expresses their wishes and depends on their point of view. The impact of the relationship between the doctors and the pharmaceutical companies was examined with regard to the prescription behavior of the doctor. All the government representatives, all the physicians' representatives and those of the health funds, believe that the physicians' prescription behavior is impacted by the relationship. There are those who perceive this to be a negative trend and some doctors believe it to be a positive trend. With regard to possible harm to the patient, the parties believe that the relationship does not harm the patient, whereas most of the government representatives identify harm to the patients, both on the economic and health levels. The authors believe that the "influence" which exists or could exist on the part of the pharmaceutical companies is the main stumbling block in this relationship, which is expressed in the decision-makers' perspective.

[The struggle over the establishment of the central hospital in the Negev--the Soroka Medical Center].

In December 1959 the Central Hospital for the Negev (today, the Soroka University Medical Center) opened its doors. This event was preceded by an arduous political battle over the Location of hospital facilities for inhabitants of Israel's south. On one side was the presiding Prime Minister David Ben-Gurion, who opposed the establishment of a hospital in Beer Sheba by the Clalit Sick Fund. On the other side were Beer Sheba's residents, led by David Tuviyahu--mayor of Beer Sheba, and Moshe Soroka--a member of the Clalit Sick Fund's management, who sought to bring about the immediate establishment of a hospital in the city itself, following the decision of the Hadassah Women's Organization to close the temporary hospital they had operated in Beer Sheba since 1948. The work at hand describes the ideological and political struggle between the two sides, the conflicting interests of the Government of Israel and the Labor Federation regarding the health needs of the city, and the factors that, in the end, led to the establishment of the hospital by the Federation's Clalit Sick Fund. The research is based on both archival material and on input from informants from the period who constitute primary sources.

Does Severity of Hair Loss Matter? Factors Associated with Mental Health Outcomes in Women Irradiated for Tinea Capitis in Childhood.

Hair loss resulting from childhood irradiation for tinea capitis has been linked to mental health effects in women. However, the association of hair loss severity with mental health in this population is unknown. To address this gap, this study examined the association between hair loss severity and mental health outcomes in women irradiated for tinea capitis in childhood as well as the factors that contribute to these outcomes. Medical records, held at the archives of the Israel National Center for Compensation of Scalp Ringworm Victims, were retrospectively reviewed for 2509 women who received compensation for full or partial alopecia resulting from irradiation for tinea capitis. Mental health outcomes were determined by the number of mental health conditions reported. The results show that among women with more hair loss, risk was increased for a range of mental health problems, especially social anxiety (RR 2.44, 95% CI 2.09-2.87). Hair loss severity emerged as a significant predictor of mental health, adding to the effects of other predictors such as family, social and physical health problems (ß = 0.13, 95% CI 0.27, 0.56). The effects of hair loss severity on mental health outcomes were mediated by women's negative social experiences (indirect = 0.72, 95% bias-corrected confidence interval, 0.53-1.08). Healthcare professionals supporting women with hair loss after irradiation for childhood tinea capitis should be alert to a history of severe levels of hair loss.

Correction to: Hair loss due to scalp ringworm irradiation in childhood: health and psychosocial risks for women.

An amendment to this paper has been published and can be accessed via the original article.

Hair loss due to scalp ringworm irradiation in childhood: health and psychosocial risks for women.

BACKGROUND: Until 1960, hundreds of thousands of children worldwide had been treated for scalp ringworm by epilation via irradiation. The discovery of late health effects in adulthood prompted investigation of the medical aspects of irradiation in childhood and led to the establishment of strict protocols for the use of X-ray irradiation. These studies ignored alopecia, which affects some individuals who underwent irradiation for scalp ringworm as children. This study examined the impact of alopecia due to irradiation for scalp ringworm on the health and psychosocial status of affected women. METHODS: We analysed a random sample of 130 medical files of women recognised by Israel's state committees as suffering from permanent hair loss as a result of scalp ringworm irradiation in childhood. The coded medical data included demographic variables, self-reported mental health conditions, self-reported physical health conditions, self-reported social conditions, and spousal relationship. RESULTS: Compared with the general population of women in Israel, research participants reported significantly higher rates of depression, anti-depressant and/or anti-anxiety drug use, psychotherapy or psychiatric hospitalisation, attempted suicide, migraines, cancer, and divorce. Many described humiliating social experiences due to their appearance, both in childhood and adulthood, that led them to curtail their social interactions. The participants also reported that alopecia negatively affected their spousal relationships. CONCLUSIONS: Life with hair loss from scalp ringworm irradiation in childhood has a negative impact on women's health status and psychosocial state. Health policy-makers must broaden their approach to women who underwent scalp ringworm irradiation by addressing the effects of their hair loss in addition to the effects of the radiation treatment per se. This may be achieved by guiding physicians who provide medical services to these women to take into account the psychosocial and health risks related to hair loss in their diagnosis and treatment as well as by creating a cadre of specially trained mental health professionals who can address their unique psychosocial needs. They must also consider including the specialized mental health services tailored for these women's unique needs in the Healthcare Basket.

[The forgotten ringworm campaign of OZE-TOZ in Poland].

In 1921, the JOINT-JDC [the American Jewish WeLfare Organization) together with the Jewish health organizations of Eastern Europe (OZE, TOZ) initiated a campaign to eradicate ringworm of the scalp, which was one of the major medical causes that prevented Jews from immigrating to the West. This campaign continued until 1938. During the years 1921-1938, 27,760 children were irradiated (x-rayed) as part of the treatment. This study, based on archival sources in Israel and abroad, presents the story of this unique campaign to eradicate ringworm in the Eastern European Jewish communities, the ideology behind this initiative, the health and medical factors that played a role and its outcomes. This research was conducted at The Gertner Institute for Epidemiology and Health Policy Research and The School of Public Health at Tel Aviv University.

Correction to: Hierarchy of hair loss stigma: media portrayals of cancer, alopecia areata, and ringworm in Israeli Newspapers.

The original publication of this article [1] contained an incorrect title.

Hierarchy of hair loss stigma: media portrayals of cancer, alopecia areata, and cancer in Israeli newspapers.

BACKGROUND: Over 300,000 people in Israel cope with temporary or permanent hair loss (alopecia) that results from diseases and medical treatments. For women, hair loss can be a highly traumatic event that may lead to adverse psychosocial consequences and health outcomes. Nevertheless, this phenomenon has been mostly ignored by health professionals as it is primarily considered an aesthetic-rather than as a health-related issue. Only recently the Healthcare Basket Committee approved financial assistance for the purchase of wigs by patients coping with hair loss. Given the important role that the media plays in shaping health policies related to diagnoses, treatment and support services, the current study sought to enrich our understanding of how the media portrays disease-related hair-loss. METHODS: Using framing and agenda-setting theories, this study examined the media portrayals of hair loss associated with three diseases-cancer, alopecia areata, and ringworm, depicted in Israeli newspapers in 1994-2016. The sample consisted of 470 articles about the three diseases: 306 on cancer, 36 on AA, and 128 on ringworm. RESULTS: Textual and visual analysis revealed the ways media marginalize this physical flaw. Cancer was framed in medical terms, and patients were portrayed as older Israeli-born people whose hair loss was absent from their experience. Ringworm was framed as a fear-inducing disease; patients were portrayed as faceless, unidentified immigrants that coped with visible hair loss. Articles on AA provided the greatest focus on the patient's experience of hair loss, but patients were portrayed as young foreign people. CONCLUSIONS: Our results revealed a hierarchy of stigmas against hair loss, in which the media coverage marginalized this experience. The omission of hair loss by the media may explain, at least in part, why health professionals often ignore the psychosocial needs of these patients. Health insurance funding of wigs is a helpful but nevertheless insufficient solution to coping with feminine hair loss. Our findings may encourage media leaders to conduct planned media interventions to increase awareness of clinicians and health policymakers about the unique challenges faced by women coping with hair loss and promote health policy-making aimed at the well-being of these women.

Women's preferences for their gynecologist or obstetrician.

OBJECTIVE: The objective of this study was to evaluate women's preferences in selecting their gynecologist or obstetrician. METHODS: This cross-sectional study was performed at the Women's Health Center "Netka", Tel Aviv over a 1-month period in 2006 and included 287 participants. Women were asked to complete an anonymous questionnaire. RESULTS: Most women (60.3%) reported that the gender of their gynecologist or obstetrician was not an important consideration when choosing a gynecologist or an obstetrician. The major determinants in their choice of a gynecologist or an obstetrician included professionalism (98.9%), courtesy (96.6%) and board certification (92%). The rating of the two most important factors in their choice revealed the following order: professionalism (45.3%), courtesy (25.8%), board certification (10.8%), availability (10.1%), comprehension (6.5%) and communication (1.5%). CONCLUSION: Israeli women's model of choice of their gynecologist involved physicians' professionalism and courtesy while availability and physician's gender was significantly less important. PRACTICE IMPLICATIONS: The presented data may help health providers during patients' education and counseling along with facilitating better understanding of patients' needs.

Relative perceptions of the needs of inpatients with schizophrenia and schizoaffective disorders.

BACKGROUND: Although there is a consensus that mental health services should be provided on the basis of need, the concept of client needs differs substantially among professionals, patients and involved family members. The aim of the present study was to identify the needs of patients repeatedly hospitalized with schizophrenia and schizoaffective disorders and to compare them with the needs rated by their nursing staff and relatives. METHOD: Using the Camber well Assessment of Need (CAN), we surveyed 52 consecutive voluntarily re-admitted inpatients aged 18- 65 fulfilling the ICD-10 criteria for schizophrenia and schizoaffective disorders. Analysis of variance and post-hoc t-test single comparisons were performed to examine the between-groups differences in the number of unmet needs rated by patients, clinical staff and family members. RESULTS: Significant differences in the perceptions of the patients and staff occurred in only 6 of the 22 CAN domains, with the patients rating higher the needs for "information on condition and treatment" and "benefits," and the staff member rating higher the patients' needs for "intimate relationships,"; "safety for others," "self-care" and "daytime activities." The analogical differences occurred between the patients and their relatives in the same need areas. CONCLUSIONS: Comparing the needs assessments from different perspectives provides a powerful means of patient evaluation and is potentially valuable information for care planning.