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1.
Womens Health (Lond) ; 18: 17455057221125366, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36366970

RESUMO

OBJECTIVE: This study aimed to describe Israeli maternity departments' policies regarding cesarean delivery on maternal request, and factors associated with obstetricians' support for cesarean delivery on maternal request in specific scenarios. METHODS: This multicenter cross-sectional study included 22 maternity department directors and 222 obstetricians from the majority of Israeli hospitals. Directors were interviewed and completed a questionnaire about their department's cesarean delivery on maternal request policy, and obstetricians responded to a survey presenting case scenarios in which women requested cesarean delivery on maternal request. The scenarios represented profiles referring to the following factors: maternal age, poor obstetric history, pregnancy complications, and psychological problems. The survey also included the obstetricians' socio-demographic information and questions about other issues associated with cesarean delivery on maternal request. The main outcome measures were department policies regarding cesarean delivery on maternal request and obstetricians' support for cesarean delivery on maternal request in specific cases. RESULTS: Policies were divided between allowing and prohibiting cesarean delivery on maternal request (n = 10 and 12, respectively), and varied regarding issues such as informed consent and pre-surgery consultation. Most of the obstetricians (96.5%) did not support cesarean delivery on maternal request in the "reference scenario" describing a young woman with no obstetric complications. Additional factors increased the rate of support. Support was greater among obstetricians aged > 45 (odds ratio = 2.11; 95% confidence intervals 1.33-3.36) and lower among females (odds ratio = 0.58; 95% confidence intervals 0.39-0.86). Obstetricians whose department policy was less likely to allow cesarean delivery on maternal request reported lower rates of support for cesarean delivery on maternal request in most cases. CONCLUSION: Policies and obstetricians' support for cesarean delivery on maternal request vary broadly depending on clinical profiles and physician characteristics. Department policy has an impact on obstetricians' support for cesarean delivery on maternal request. Health policy will benefit from a framework in which the organizations, physicians, and patients are consulted.


Assuntos
Obstetrícia , Médicos , Feminino , Humanos , Gravidez , Israel , Estudos Transversais , Atitude do Pessoal de Saúde , Padrões de Prática Médica , Médicos/psicologia , Políticas
2.
Nat Commun ; 13(1): 6961, 2022 Nov 15.
Artigo em Inglês | MEDLINE | ID: mdl-36379951

RESUMO

The Centers for Disease Control (CDC) recommend a third dose of COVID-19 vaccine for pregnant women, although data regarding effectiveness during pregnancy are lacking. This national, population-based, historical cohort study of pregnant women in Israel, delivering between August 1, 2021 and March 22, 2022, aims to analyze and compare the third and second doses' vaccine effectiveness in preventing COVID-19-related hospitalizations during pregnancy during two COVID-19 waves (Delta variant in the summer of 2021 and Omicron, BA.1, variant in the winter of 2022). Time-dependent Cox proportional-hazards regression models estimate the hazard ratios (HR) and 95% confidence intervals (CI) for COVID-related outcomes according to vaccine dose, and vaccine effectiveness as 1-HR. Study includes 82,659 and 33,303 pregnant women from the Delta and Omicron waves, respectively. Compared with the second dose, the third dose effectively prevents overall hospitalizations with SARS-CoV-2 infections, with estimated effectiveness of 92% (95% CI 83-96%) during Delta, and enhances protection against significant disease during Omicron, with effectiveness of 92% (95% CI 26-99%), and 48% (95% CI 37-57%) effectiveness against hospitalization overall. A third dose of the BNT162b2 mRNA COVID-19 vaccine during pregnancy, given at least 5 months after the second vaccine dose, enhances protection against adverse COVID-19-related outcomes.


Assuntos
COVID-19 , Vacinas contra Influenza , Influenza Humana , Complicações Infecciosas na Gravidez , Feminino , Humanos , Gravidez , Vacinas contra COVID-19 , Influenza Humana/prevenção & controle , Vacina BNT162 , RNA Mensageiro , COVID-19/epidemiologia , COVID-19/prevenção & controle , Israel/epidemiologia , Estudos de Coortes , SARS-CoV-2 , Vacinação , Complicações Infecciosas na Gravidez/epidemiologia , Complicações Infecciosas na Gravidez/prevenção & controle
3.
BMC Health Serv Res ; 22(1): 1335, 2022 Nov 10.
Artigo em Inglês | MEDLINE | ID: mdl-36357854

RESUMO

BACKGROUND: Very few studies have evaluated physician participation in screening tests and vaccinations. The aim was to evaluate attitudes and actual practice of screening tests and vaccinations among hospital-based physicians and to identify factors that predict actual performance. METHODS: A cross-sectional study including 220 physicians in various specializations. The study was conducted between January 1, 2017 and December 10, 2017. The statistical analysis was performed during October, 2020 and completed in October 25, 2020. RESULTS: The vast majority of physicians (94%) believed in the importance of screening tests for physicians, but less than half actually underwent the tests themselves. A high percentage of physicians measured their BMI (84.5%) and had a serum lipid profile test (67.7%) and complete blood counts (75%) over the previous five years, but less than a third of female physicians over 50 years of age had a mammogram and only 8% of the physicians over 50 had a fecal occult blood test. A high percentage of physicians were vaccinated for Hepatitis A and B, chickenpox and measles (66-96% for the various vaccinations), but only 41% had an influenza vaccination in the previous year. In a multivariate logistic regression model, physicians who believed that hospital physicians bore a responsibility for recommending screening tests to their patients were more likely to have their BMI and their blood pressure checked (OR = 2.234, P = 0.007). They were more likely to undergo laboratory testing (OR = 4.082, P < 0.0001) and tended to get vaccinated more (OR = 1.907, P = 0.051). CONCLUSION: The rate of screening tests and vaccinations among hospital-based physicians is sub-optimal and very low for fecal occult blood testing and mammograms. Structured programs are required to implement screening tests and vaccinations among physicians.


Assuntos
Médicos , Vacinação , Humanos , Feminino , Pessoa de Meia-Idade , Estudos Transversais , Israel/epidemiologia , Hospitais
4.
Artigo em Inglês | MEDLINE | ID: mdl-36360839

RESUMO

The detection and treatment of mental illness during pregnancy and postpartum are essential for the well-being of both mother and child. For this study, we set out to estimate the prevalence of perinatal depression among Bedouin mothers in southern Israel and determine if the latent structure of responses to the Edinburgh Postpartum Depression Scale (EPDS)-including depression, anxiety, and anhedonia-previously reported also applies to this population. A total of 332 women completed the EPDS during pregnancy (26-38 weeks) and again 2-4 months postpartum. Confirmatory factor analyses were performed to determine if first-order factors were correlated, or instead measure a second- or higher-order latent construct. We next performed temporal invariance analyses to compare the latent structure of EPDS responses over time. When pregnant, 35% of women provided EPDS responses suggestive of elevated depressive symptomology; this decreased to 23% postpartum. At both points, each EPDS factor significantly measures a higher-order, latent construct. The EPDS appears to measure three factors, labeled sadness, anxiety, and anhedonia. This latent structure appears stable (i.e., during pregnancy and postpartum). Further research is needed to validate EPDS responses versus structured clinical interviews. The construct validity of EPDS factors should be examined across other at-risk groups and over time.


Assuntos
Depressão Pós-Parto , Mães , Gravidez , Criança , Feminino , Humanos , Depressão Pós-Parto/epidemiologia , Depressão Pós-Parto/diagnóstico , Árabes , Anedonia , Israel/epidemiologia , Escalas de Graduação Psiquiátrica , Período Pós-Parto , Depressão/diagnóstico
5.
Artigo em Inglês | MEDLINE | ID: mdl-36360994

RESUMO

Active travel (AT) is a core physical activity (PA) indicator for children and youth; contributing to health and wellbeing, at both the individual and societal levels. This analysis explores patterns of adolescent active school travel (AST) and cycling and associations with different PA measures. Secondary analysis of the cross-sectional 2018-2019 Health Behaviour in School Age Children study in Israel included an extended PA module with walking, cycling and e-cycling modes. The nationally representative sample includes students in grades 6-12 (n = 4407). Analysis of weighted data included descriptive analyses, inferential statistics, and regression analyses. AST was reported by 61.9% of adolescents; 39.3% reported 20 min or more daily AST; 27.1% reported habitual cycling (HC) and 17.4% reported habitual e-cycling (HEC). There are mixed results for socio-economic status and environment. AST and HC were associated with less sedentary hours daily (odds ratio [OR] = 1.190 and 1.397, respectively); HC was associated with positive sports self-rating (OR = 2.394). Stepwise regression analysis found that lower AST duration, time in minutes, was associated with watching television with the family. Promotion of adolescent AT may be associated with increased PA and joint parent-adolescent AT, and was utilized across different socio-demographic groups in Israel.


Assuntos
Exercício Físico , Instituições Acadêmicas , Criança , Adolescente , Humanos , Estudos Transversais , Israel , Caminhada , Viagem , Meios de Transporte
6.
Artigo em Inglês | MEDLINE | ID: mdl-36361428

RESUMO

HIV-1 patients place an economic burden on the health system. The objectives of this study were to estimate the direct HIV-1 costs and cost-related factors of HIV-1 patients in Israel and identify cost predictors. We conducted a retrospective study of randomly selected HIV-1 patients aged ≥18 who visited a large outpatient clinic in 2015 and/or 2019. Yearly costs of physician and nurse visits, antiretroviral therapy (ART) and laboratory tests were calculated in USD using the 2020 purchasing power parities. Associations between disease characteristics and costs were analyzed using univariate and multivariable analysis. The median (IQR) total direct costs per patient per year were USD 12,387 (9813-14,124) and USD 12,835 (11,651-13,970) in 2015 (n = 284) and 2019 (n = 290), respectively. ART accounted for approximately 77% of all direct costs, followed by laboratory tests (20%) and medical visits (3%) in both studied years. Being female (USD +710), first yearly viral load <50 c/mL (+$1984) and ≥20 years with HIV-1 (USD +1056) were independently associated with higher costs. In conclusion, HIV-1 cost was stable in the studied period. Viral load and time since diagnosis were the major determinants associated with HIV-1 costs. ART and laboratory tests accounted for 97% of the costs. Therefore, these factors should be considered when planning future expenditures.


Assuntos
Infecções por HIV , Soropositividade para HIV , HIV-1 , Humanos , Feminino , Masculino , Estudos Retrospectivos , Custos de Cuidados de Saúde , Israel/epidemiologia , Infecções por HIV/tratamento farmacológico , Infecções por HIV/epidemiologia , Assistência Ambulatorial
7.
Child Abuse Negl ; 134: 105945, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-36356425

RESUMO

BACKGROUND: Studies on child sexual abuse (CSA) have greatly contributed to theoretical and empirical developments, advancing policy and practice. However, studies on CSA in closed societies are still scarce. OBJECTIVE: The current study focuses on CSA in the Muslim Arab community in Israel while delving into the peritraumatic responses of survivors to CSA. PARTICIPANTS AND SETTING: Twenty-eight Muslim Arab survivors of CSA provided written testimonies for an independent inquiry. METHODS: The exploration of the Muslim Arab survivors' peritraumatic responses to CSA, according to their testimonies, was guided by an inductive thematic analysis and Braun and Clarke's (2006) six steps of analysis. RESULTS: The results indicated that, as most of the abusive incidents were committed by an extended family member, the survivors experienced an inability to understand what had happened to them while simultaneously feeling guilt and self-blame. Furthermore, the survivors discussed feeling trapped by all of the systems and social expectations in their lives, leaving them feeling extremely lonely and with the understanding that seeking help and disclosing the abuse was not relevant for them. CONCLUSION: The discussion addresses the developments in the research on peritraumatic responses that require further examination. This includes top-down processes that might explain survivors' peritraumatic responses, which are not merely instinctual. In addition, when perpetrators are family members, survivors are expected to stay in contact with them, which demands enormous resources and survival strategies from the survivors.


Assuntos
Abuso Sexual na Infância , Criança , Humanos , Árabes , Islamismo , Israel , Sobreviventes , Culpa
8.
Euro Surveill ; 27(44)2022 11.
Artigo em Inglês | MEDLINE | ID: mdl-36330820

RESUMO

We evaluated neutralising antibody titres against wild type (WT) SARS-CoV-2 and four Omicron variants (BA.1, BA.2, BA.5 and BA.2.75) in fully vaccinated (three doses of Comirnaty vaccine) healthcare workers (HCW) in Israel who had breakthrough BA.1/BA5 infections. Omicron breakthrough infections in vaccinated individuals resulted in increased neutralising antibodies against the WT and Omicron variants compared with vaccinated uninfected HCW. HCW who recovered from BA.1 or BA.5 infections showed similar neutralising antibodies levels against BA.2.75.


Assuntos
COVID-19 , SARS-CoV-2 , Humanos , Israel/epidemiologia , SARS-CoV-2/genética , Anticorpos Neutralizantes , Anticorpos Antivirais
9.
BMC Public Health ; 22(1): 2099, 2022 Nov 17.
Artigo em Inglês | MEDLINE | ID: mdl-36384549

RESUMO

BACKGROUND: Researchers are increasingly acknowledging the importance of understanding patterns of engagement in multiple, as opposed to isolated, health behaviours. Accordingly, several studies, targeting various geographical regions, have begun to identify and characterize unique classes of individuals in terms of their engagement in health behaviours, towards gaining insights that might guide tailored health interventions. Our study extends this stream of research to the Israeli context, as well as examines whether certain sociodemographic characteristics tend to be associated with affiliation to a specific group of individuals, i.e., class membership. METHODS: Two large representative samples were obtained from the 2010 and 2017 National Social Surveys of the Israel Central Bureau of Statistics. Latent Class Analysis was used to identify different classes, based on levels of engagement in five health behaviours: fruit-and-vegetable consumption, physical activity, smoking avoidance, sleep, and influenza vaccination. Multinomial logistic regression was applied to test the associations between sociodemographic characteristics (age, gender, religion, education level) and class membership. RESULTS: We identified three distinct classes (denoted "healthy", "unhealthy", and "mixed"). Overall, the "healthy" class was characterized by healthy levels of fruit-and-vegetable consumption and physical activity, a low rate of currently-smoking individuals, and a high proportion of influenza vaccination. The "mixed" class was characterized by healthy levels of fruit-and-vegetable consumption and sleep duration, moderate levels of physical exercise, a high proportion of currently light smokers, and a low rate of vaccination. The "unhealthy" class was marked by relatively low levels of engagement in health behaviours. Generally, older, Jewish, and more-educated individuals were more likely to belong to the "healthy" class, while young, non-Jewish, and less-educated individuals were more likely to belong to the "unhealthy" class. We further identified differences between the 2010 and 2017 samples (e.g., differences in men's likelihood of being in the "unhealthy" class), suggesting that some behavioural patterns might have changed over time. CONCLUSION: This research identified three classes of engagement in health behaviours across two large and representative samples. Moreover, the classes were associated with unique sociodemographic characteristics. Consequently, our findings can highlight health-behavioural patterns relevant to different sub-populations that should be considered in public health interventions.


Assuntos
Comportamentos Relacionados com a Saúde , Influenza Humana , Masculino , Humanos , Israel , Estilo de Vida Saudável , Exercício Físico , Verduras
10.
Int J Equity Health ; 21(1): 156, 2022 Nov 07.
Artigo em Inglês | MEDLINE | ID: mdl-36345031

RESUMO

BACKGROUND: A growing body of research demonstrates that economic conditions and racial and ethnic disparities result in excessive overuse of emergency departments (EDs) by a small group of socioeconomically marginalized residents. Knowledge and understanding of these issues on the part of the healthcare team can promote equality by providing structurally competent care. This study aims to identify the major social and structural factors related to patterns of ED visits by Arab and Jewish patients in Israel, where access to health services is covered by universal national health insurance. METHODS: A cross-sectional study was conducted using questionnaires of ED patients in a tertiary care medical center in Jerusalem. The hospital is the largest of the three EDs in Jerusalem with over 90,000 adult patient visits a year. The sample was stratified by ethnicity, including 257 Jewish patients and 170 Arab patients. The outcome variable was repeat visits for the same reason to the ED within 30 days. RESULTS: There were differences between Jewish and Arab patients' social and structural characteristics, including health status, socioeconomic status, feeling of safety, and social support. There were also significant differences in some of the characteristics of health service utilization patterns, including ED repeat visits, language barriers when seeking healthcare in the community, and seeking information about medical rights. The variables associated with repeat visits were different between the two groups: among the Arab patients, repeat visits to the ED were associated with concerns about personal safety, whereas among the Jewish patients, they were associated with poverty. CONCLUSION: The study illustrates the gaps that exist between the Arab and Jewish population in Israel. The findings demonstrated significant differences between populations in both health status and access to health services. In addition, an association was found in each ethnic group between different structural factors and repeat ED requests. This study supports previous theories and findings of the relationship between structural and social factors and patterns of health services utilization.


Assuntos
Árabes , Judeus , Adulto , Humanos , Estudos Transversais , Serviço Hospitalar de Emergência , Classe Social , Israel/epidemiologia
11.
PLoS One ; 17(11): e0277757, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36395155

RESUMO

Grounded in an ecodevelopment perspective, in the current study we examined unique and moderating effects of daily COVID-19 prevalence (social contexts) on effects of COVID-19 related risk and protective factors such as emotional distress (individual contexts) and employment (working from home and unemployment status; family contexts) on family functioning among 160 recent immigrant families in Israel. In general, results indicate several unique effects of COVID-19 related factors (such as COVID-19 emotional distress, unemployment, and remote work arrangements) on both parents' and adolescents' reports of family functioning. However, results indicated that there were more significant associations between COVID-19 factors (e.g., emotional distress and COVID-19 prevalence) and family functioning indicators with adolescents, than with parents. The effects of COVID-19 factors (e.g., emotional distress and remote work arrangements) were moderated by daily COVID-19 prevalence (new cases and deaths). We discuss ways in which interventionists can contribute to pandemic-related research to promote optimal family functioning among immigrant families.


Assuntos
COVID-19 , Emigrantes e Imigrantes , Angústia Psicológica , Adolescente , Humanos , Prevalência , COVID-19/epidemiologia , Israel/epidemiologia , Emprego , Surtos de Doenças
12.
Isr J Health Policy Res ; 11(1): 39, 2022 11 23.
Artigo em Inglês | MEDLINE | ID: mdl-36419188

RESUMO

BACKGROUND: The accurate and timely publication of scientific findings is a key component of the global response to the COVID-19 pandemic. This article explores the role of Israeli researchers in the scientific literature regarding COVID-19 vaccines. METHODS: Content and bibliometric analysis of articles included in the Web of Science database regarding COVID-19 vaccines, that were published between January 2020 and June 2022. RESULTS: The Web of Science includes 18,596 articles regarding COVID-19 vaccines that were published between January 2020 and June 2022. 536 (3%) of those articles had at least one Israeli author. These "Israeli articles" accounted for 11% of the NEJM articles on COVID-19 vaccines, 9% of such articles in Nature Medicine, and 4% of such articles in the Lancet. 80 of the 536 Israeli articles (15%) were recognized as "Highly Cited Papers" (articles that rank in the top 1% by citations for field and publication year). Most of the Israeli Highly Cited Papers (HCPs) analyzed the safety and/or efficacy of the COVID-19 vaccine developed by Pfizer and BioNTech (BNT162b2). Most of the Israeli HCPs made use of detailed and comprehensive individual data available from Israel's health plans, hospitals, or Ministry of Health. The 15% HCP rate (i.e., the number of HCPs divided by the number of all articles) for the Israeli articles was triple the HCP rate for all articles on COVID-19 vaccines (5%). A key factor contributing to Israel's prominent role in rapid publication of vaccination impact studies was Israel's being a world leader in the initial vaccination rollout, the administration of boosters, and the vaccination of pregnant women. Other contributing factors include Israeli researchers' access to well-developed electronic health record systems linking vaccinations and outcomes, the analytic strengths of leading Israeli researchers and research institutions, collaborations with leading research institutions in other countries, and the ability to quickly identify emerging research opportunities and mobilize accordingly. Recent developments in the priorities and selection criteria of leading journals have also played a role; these include an increased openness to well-designed observational studies and to manuscripts from outside of Europe and North America. CONCLUSIONS: Israeli researchers, Israeli research institutions, and the Israeli government can, and should, take concrete steps to build upon lessons learned in the course of the recent surge of high-quality publications related to COVID-19 vaccines (such as the value of linking data across organizations). These lessons can be applied to a wide range of fields, including fields that go well beyond vaccines and pandemic responses.


Assuntos
Vacinas contra COVID-19 , COVID-19 , Gravidez , Feminino , Humanos , Israel , Vacina BNT162 , Pandemias , COVID-19/prevenção & controle
13.
Isr J Health Policy Res ; 11(1): 38, 2022 11 10.
Artigo em Inglês | MEDLINE | ID: mdl-36357912

RESUMO

BACKGROUND: The Ecology of medical care was first published in 1961. The graphical square model showed that 75% of the population in the US and England experience a feeling of illness during a given month, 25% seek medical help and only one percent are hospitalized. In 2001, Green and colleagues found the same findings despite the many changes that occurred over the past decades. The frequency of illness, the desire for assistance and the frequency of seeking and getting medical assistance may differ in different populations due to cultural, economic, social, demographic background and local Health policy. This work describes the ecology of medical care consumption in Israel for the first time and examines the socio-demographic effects on consumption. METHODS: This is a Nationwide cross-sectional study. A telephone survey was conducted among a representative sample of the adult population (> 15 years) in Israel. Subjective morbidity rate in the preceding month, the rate of those considering medical assistance and those who got assistance were calculated. Correlation between socio-demographic variables and patterns of morbidity and medical care consumption was examined using a t-test and chi square for continuous quantitative and categorical variables. Logistic regression was used for multivariate analysis. RESULTS: A total of 1862 people participated; 49.5% reported having symptoms in the previous month, 45% considered seeking medical advice, 35.2% sought out medical assistance and only 1.5% were hospitalized. The vast majority chose to contact their family physician (58%) and the primary care setting provided their needs in 80% of the cases; Subjective morbidity and medical care consumption differed significantly between Israeli Jews and Arabs. Gaps in the availability of medical services were observed as residents of the periphery forewent medical services significantly more than others (OR = 1.42, p = 0.026). CONCLUSIONS: Subjective morbidity is less common in Israel than in other countries, but paradoxically consumption of medical services is higher. An Israeli who feels ill will usually consider receiving assistance and will indeed receive assistance in most cases. However, a greater tendency to forego medical services in the periphery indicates barriers and inequality in the provision of health services. Different cultural perceptions, lack of knowledge and low accessibility to medical services in the periphery probably contribute to the contrast shown between low consumption of medical services and high prevalence of chronic illness in Arab society. The prevailing preference for family medicine and its ability to deal with most requests for assistance suggest that strengthening family medicine in the periphery may reduce those barriers and inequalities.


Assuntos
Árabes , Judeus , Adulto , Humanos , Estudos Transversais , Israel/epidemiologia , Acesso aos Serviços de Saúde
14.
Bull World Health Organ ; 100(11): 739-743, 2022 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-36324558

RESUMO

Problem: Hearing rehabilitation with hearing aids is a complex process which requires professional expertise and the involvement of audiologists or hearing-care specialists. Professional care, however, requires extra resources, making it tempting to rely solely on technology and reduce the role of professional counselling. Approach: To reduce the out-of-pocket share for adults needing hearing rehabilitation, in 2011 the Israeli government tripled the subsidy for adult hearing aids by converting 3 years of subsidies into a triennial, enlarged fund. Regulations for providing hearing rehabilitation and a set of rules for tenders for the supply of hearing aids were issued. Local setting: Auditory diagnosis and rehabilitation are included in the Israeli national health insurance system. Before 2011, the annual government-funded subsidy for hearing aids was negligible; hearing aids were expensive and bought mostly with patients' own resources. Relevant changes: A series of tenders for companies to supply hearing aids, aiming to control public and individual expenses, resulted in a large reduction in prices, which in turn raised the demand for hearing aids and increased public expenditure. As the price of hearing aids fell markedly, hearing rehabilitation is approaching a point of becoming limited to supplying hearing devices, while reducing the importance placed on professional elements of the rehabilitation course. Lessons learnt: Lowering out-of-pocket costs for patients should not be the only consideration in hearing rehabilitation. Our goal should be to control public expenditure but also provide affordable hearing aids with sufficient intervention of hearing-care specialists, to ensure access to advanced technologies and proper professional care.


Assuntos
Auxiliares de Audição , Perda Auditiva , Adulto , Humanos , Audiologistas , Israel , Perda Auditiva/diagnóstico , Testes Auditivos
16.
Sci Rep ; 12(1): 16869, 2022 Oct 07.
Artigo em Inglês | MEDLINE | ID: mdl-36207354

RESUMO

To examine the challenges faced by free-ranging Rousettus aegyptiacus living at the northern edge of their distribution, we performed a retrospective analysis of 2196 clinical cases reported by a bat rescue NGO over a period of 36 months, from throughout Israel. All cases of injured bats were evaluated and categorized according to date, place, sex, age, and etiology of the morbidity. The data analysis revealed an increase in all types of morbidity during the wintertime, with more than two-fold the number of cases per week compared to in the summer, over three consecutive years. Moreover, we found that the number of abandoned pups peaked during spring and summer, when adult morbidity is minimal. We characterized two prominent types of previously undescribed morbidities in R. aegyptiacus. We also employed GPS tracking to monitor the movement and foraging of dozens of bats, and to examine the potential correlates of elevated winter morbidity. Our results suggest that it is mainly harsh weather that drives the observed winter morbidity, with food limitations playing a minor-role. We hypothesize that R. aegyptiacus, of tropical origin, is facing major seasonal survival difficulties near the northern edge of its distribution, probably limiting its spread further northwards still.


Assuntos
Quirópteros , Animais , Israel , Estudos Retrospectivos , Estações do Ano
17.
Proc Natl Acad Sci U S A ; 119(44): e2209117119, 2022 11.
Artigo em Inglês | MEDLINE | ID: mdl-36279453

RESUMO

The Hebrew Bible and other ancient Near Eastern texts describe Egyptian, Aramean, Assyrian, and Babylonian military campaigns to the Southern Levant during the 10th to sixth centuries BCE. Indeed, many destruction layers dated to this period have been unearthed in archaeological excavations. Several of these layers are securely linked to specific campaigns and are widely accepted as chronological anchors. However, the dating of many other destruction layers is often debated, challenging the ability to accurately reconstruct the different military campaigns and raising questions regarding the historicity of the biblical narrative. Here, we present a synchronization of the historically dated chronological anchors and other destruction layers and artifacts using the direction and/or intensity of the ancient geomagnetic field recorded in mud bricks from 20 burnt destruction layers and in two ceramic assemblages. During the period in question, the geomagnetic field in this region was extremely anomalous with rapid changes and high-intensity values, including spikes of more than twice the intensity of today's field. The data are useful in the effort to pinpoint these short-term variations on the timescale, and they resolve chronological debates regarding the campaigns against the kingdoms of Israel and Judah, the relationship between the two kingdoms, and their administrations.


Assuntos
Bíblia , Militares , Humanos , História Antiga , Arqueologia , Israel , Artefatos
18.
Sci Data ; 9(1): 652, 2022 10 26.
Artigo em Inglês | MEDLINE | ID: mdl-36289228

RESUMO

Freshwater bodies are critical components of terrestrial ecosystems. The microbial communities of freshwater ecosystems are intimately linked water quality. These microbes interact with, utilize and recycle inorganic elements and organic matter. Here, we present three metagenomic sequence datasets (total of 182.9 Gbp) from different freshwater environments in Israel. The first dataset is from diverse freshwater bodies intended for different usages - a nature reserve, irrigation and aquaculture facilities, a tertiary wastewater treatment plant and a desert rainfall reservoir. The second represents a two-year time-series, collected during 2013-2014 at roughly monthly intervals, from a water reservoir connected to an aquaculture facility. The third is from several time-points during the winter and spring of 2015 in Lake Kinneret, including a bloom of the cyanobacterium Microcystis sp. These datasets are accompanied by physical, chemical, and biological measurements at each sampling point. We expect that these metagenomes will facilitate a wide range of comparative studies that seek to illuminate new aspects of freshwater microbial ecosystems and inform future water quality management approaches.


Assuntos
Cianobactérias , Metagenoma , Ecossistema , Israel , Lagos
19.
Isr J Health Policy Res ; 11(1): 35, 2022 10 10.
Artigo em Inglês | MEDLINE | ID: mdl-36217171

RESUMO

BACKGROUND: Medication is a significant component of the cost of mental health care. Studies from different countries indicate that physicians are often not aware of medication costs, despite the impact of such knowledge on treatment plans. The purpose of this study was to examine Israeli psychiatrists' knowledge regarding the cost of medication and rates of disability pension, and the impact of these factors on treatment decisions. METHODS: Cross-sectional study. A questionnaire was distributed by e-mail to psychiatry specialists and residents, including: (a) socio-demographic and professional information; (b) knowledge regarding rates of National Insurance disability pension and medications' costs; (c) attitudes regarding relevance of knowledge of treatment costs. Correlations between socio-demographic variables and knowledge regarding treatment costs and attitudes were examined. RESULTS: Of the 175 psychiatrists who completed the questionnaire, 55% were men. The level of knowledge regarding cost of psychotropic medication and disability pension rates was low. Sixty-eight percent rated economic considerations as important or very important, yet 75% were informed of medication prices by their patients, and 57% by pharmaceutical companies. Doctors who worked in regions other than the center of the state were more aware of the economic aspects of treatment. Physicians who reported easy access to information regarding drug prices were less likely to err in estimating the price of medications. CONCLUSIONS: Psychiatrists in Israel are not sufficiently informed of the costs of psychotropic medications, despite their awareness of the relevance of affordability to treatment compliance. Awareness of economic issues relating to treatment should be included in residency programs, and access to relevant information of medication cost and disability pensions should be more accessible to physicians both on national and local levels, by the government and health maintenance ogranizations (HMOs).


Assuntos
Atitude do Pessoal de Saúde , Psiquiatria , Estudos Transversais , Feminino , Custos de Cuidados de Saúde , Humanos , Israel , Masculino , Pensões , Preparações Farmacêuticas
20.
Isr J Health Policy Res ; 11(1): 36, 2022 10 20.
Artigo em Inglês | MEDLINE | ID: mdl-36266704

RESUMO

Mathematical and statistical models have played an important role in the analysis of data from COVID-19. They are important for tracking the progress of the pandemic, for understanding its spread in the population, and perhaps most significantly for forecasting the future course of the pandemic and evaluating potential policy options. This article describes the types of models that were used by research teams in Israel, presents their assumptions and basic elements, and illustrates how they were used, and how they influenced decisions. The article grew out of a "modelists' dialog" organized by the Israel National Institute for Health Policy Research with participation from some of the leaders in the local modeling effort.


Assuntos
COVID-19 , Humanos , Pandemias/prevenção & controle , SARS-CoV-2 , Israel/epidemiologia , Modelos Estatísticos
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