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1.
Isr J Health Policy Res ; 12(1): 6, 2023 Jan 31.
Artigo em Inglês | MEDLINE | ID: mdl-36721245

RESUMO

In this commentary to Dattner et al. (Israel J Health Policy Res. 11:22, 2022), we highlight similarities and differences in the role that biostatistics and biostatisticians have been playing in the COVID-19 response in Belgium and Israel. We bring out implications and opportunities for our field and for science. We argue that biostatistics has an important place in the multidisciplinary COVID-19 response, in terms of research, policy advice, and science and public communication. In Belgium, biostatisticians located in various institutes, collaborated with epidemiologists, vaccinologists, infectiologists, immunologists, social scientists, and government policy makers to provide rapid and science-informed policy advice. Biostatisticians, who can easily be mobilized to work together in pandemic response, also played a role in public communication.


Assuntos
Bioestatística , COVID-19 , Humanos , Bélgica/epidemiologia , Israel/epidemiologia , Internacionalidade , Política de Saúde
2.
Harefuah ; 162(1): 19-23, 2023 Jan.
Artigo em Hebraico | MEDLINE | ID: mdl-36714937

RESUMO

INTRODUCTION: Langerhans cell histiocytosis (LCH) is a histiocytic disorder which is characterized by a wide variety of clinical presentations and is prevalent mostly in children .This is a single center study reviewing experience in the treatment of LCH in a pediatric hemato-oncology ward over 25 years. We summarized the demographics, the locations of the disease, the treatments administered, the reactivations and the survival of the patients. METHODS: A retrospective analysis of files was performed from patients who were referred and treated at the Dana-Dwek Children's hospital in the Tel-Aviv Sourasky Medical Center between the years 1996-2020. RESULTS: One hundred and six patients with LCH were treated during the period 1996-2020 in the Pediatric Hemato-Oncology division. The diagnosis was confirmed by a biopsy from a lesion. The primary location of the disease was single system in 91% of patients (mostly bone lesions) and 9% multisystem disease. Forty-five patients (42.4%) were treated by upfront chemotherapy according to the Histiocyte Society guidelines. Twenty patients (19%) had reactivation of their disease. Ninety percent of the reactivations occurred in the first four years after diagnosis. There was no mortality in this cohort. CONCLUSIONS: This is a single center study summarizing the experience of a Pediatric Hemato-Oncology division in the Tel-Aviv Medical Center in the treatment of 106 patients with LCH over 25 years and is the first review of a large cohort of patients in Israel. The cohort was characterized by abundance of patients with bone disease and paucity of patients with multisystem disease with risk organ involvement. There was overall good response to treatment and all patients survived.


Assuntos
Histiocitose de Células de Langerhans , Criança , Humanos , Estudos Retrospectivos , Histiocitose de Células de Langerhans/diagnóstico , Histiocitose de Células de Langerhans/terapia , Biópsia , Hospitais Pediátricos , Israel/epidemiologia
3.
Pediatr Infect Dis J ; 42(2): 146-151, 2023 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-36638402

RESUMO

BACKGROUND: To study pediatric acute otitis media (AOM) burden fluctuations before and during the first two COVID years, which were characterized by measures to reduce the spread of airborne diseases. We used urinary tract infection (UTI) as a comparison infection. METHODS: This was a cross-sectional study encompassing three pre-COVID years (March 1, 2017-February 29, 2020) and the first two COVID years (March 1, 2020-February 28, 2021, and March 1, 2021-February 28, 2022). Records were retrieved from the Clalit Health Services database, Israel's largest healthcare maintenance organization. Children 0-15 years with AOM and UTI episodes were categorized according to age (1>, 1-4, 5-15 years). We collected demographics, seasonality, AOM complications, antibiotic prescriptions, and recent COVID-19 infections. The average AOM/UTI rates of the three pre-COVID years vs. two COVID years were used to calculate the incidence rate ratios (IRRs). RESULTS: We identified 1,102,826 AOM and 121,263 UTI episodes. The median age at AOM diagnosis was 2.0 years (IQR, 1.1-4.1). Male predominance, age at presentation, and the dominant age group of 1-4 years did not change during the COVID years. While UTI episode rates decreased during the COVID years (IRR 0.76, 95% CI, 0.68-0.84, P < 0.001), the reduction in AOM episode rates was >2-fold (IRR 0.46, 95% CI, 0.34-0.63, P < 0.001). The largest decrease was observed among children 1-4 years old during the first COVID year (ß=-1,938 AOM episodes/100,00 children, 95% CI, -2,038 to -1,912, P < 0.001). Recent COVID-19 infection was associated with low AOM morbidity (IRR 0.05, 95% CI 0.05-0.05, P < 0.001). CONCLUSIONS: AOM burden substantially decreased during the first COVID year but almost reached pre-pandemic levels during the second year.


Assuntos
COVID-19 , Otite Média , Criança , Humanos , Masculino , Lactente , Pré-Escolar , Feminino , Israel/epidemiologia , Estudos Transversais , COVID-19/epidemiologia , Otite Média/epidemiologia , Incidência , Doença Aguda
4.
Emerg Infect Dis ; 29(2): 235-241, 2023 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-36692296

RESUMO

Infant botulism (IB) is an intestinal toxemia that manifests as descending paralysis, constipation, and, in some cases, respiratory failure. Laboratory-confirmed IB cases are rare, and recent data in Israel are lacking. We conducted a national multicenter retrospective study of laboratory-confirmed IB cases reported in Israel during 2007-2021. A total of 8 cases were reported during the study period. During 2019-2021, incidence may have increased because of a cluster of 5 cases. Infant median age for diagnosis was 6.5 months, older than previously reported (3 months). Most cases occurred during March-July. Honey consumption was reported in 1 case, and possible environmental risk factors (living nearby rural or construction areas, dust exposure, and having a father who works as a farmer) were reported in 6 cases. Although IB is rare, its incidence in Israel may have increased over recent years, and its epidemiology and risk factors differ from cases reported previously in Israel.


Assuntos
Botulismo , Clostridium botulinum , Lactente , Humanos , Botulismo/diagnóstico , Botulismo/epidemiologia , Botulismo/etiologia , Estudos Retrospectivos , Israel/epidemiologia , Incidência , Estudos Multicêntricos como Assunto
5.
Artigo em Inglês | MEDLINE | ID: mdl-36674236

RESUMO

Stroke is the second most common cause of death and disability in the world. Many studies have found fine particulate matter (PM2.5) exposure to be associated with an increased risk of atherosclerotic cardiovascular disease, mostly focusing on ischemic heart disease and acute myocardial infarction. In a national analysis conducted in Israel-an area with unique climate conditions and high air pollution levels, we estimated the association between short-term PM2.5 exposure and ischemic stroke, intracerebral hemorrhage (ICH), or transient ischemic attacks (TIA). Using the Israeli National Stroke Registry, we obtained information on all stroke cases across Israel in 2014-2018. We obtained daily PM2.5 exposures from spatiotemporally resolved exposure models. We restricted the analytical data to days in which PM2.5 levels did not exceed the Israeli 24 h standard (37.5 µg/m3). We repeated the analysis with a stratification by sociodemographic characteristics and comorbidities. For all outcomes, the exposure-response curves were nonlinear. PM2.5 exposure was associated with a higher ischemic stroke risk, with larger effect estimates at higher exposure levels. Although nonsignificant, the exposure-response curve for TIA was similar. The associations with ICH were nonsignificant throughout the PM2.5 exposure distribution. The associations with ischemic stroke/TIA were larger among women, non-Jewish individuals, older adults, and individuals with diabetes, hypertension, and ischemic heart disease. In conclusion, short-term PM2.5 exposure is associated with a higher risk for ischemic stroke and possibly TIA, even when PM2.5 concentrations do not exceed the Israeli air quality guideline threshold. Vulnerability to the air pollution effects differed by age, sex, ethnicity, and comorbidities.


Assuntos
Poluentes Atmosféricos , Poluição do Ar , Ataque Isquêmico Transitório , AVC Isquêmico , Isquemia Miocárdica , Acidente Vascular Cerebral , Humanos , Feminino , Idoso , Israel/epidemiologia , Exposição Ambiental/efeitos adversos , Exposição Ambiental/análise , Poluição do Ar/efeitos adversos , Poluição do Ar/análise , Acidente Vascular Cerebral/etiologia , Acidente Vascular Cerebral/induzido quimicamente , Material Particulado/análise , Poeira/análise , Hemorragia Cerebral , Isquemia Miocárdica/induzido quimicamente , Poluentes Atmosféricos/análise
6.
Isr J Health Policy Res ; 12(1): 5, 2023 Jan 30.
Artigo em Inglês | MEDLINE | ID: mdl-36717901

RESUMO

BACKGROUND: Early in the coronavirus disease 2019 (COVID-19) pandemic, governments implemented exceptional public health measures (PHMs) in the face of uncertainty. This study aimed to compare mitigation policies implemented by Israel and their timing in the first wave of the pandemic to those of other countries, and to assess whether country characteristics such as democracy, trust, education, economic strength and healthcare reserve were associated with decision-making. METHODS: PHMs and pre-pandemic characteristics, using internationally accepted indices, of 50 countries were collected from 1/1/2020-30/06/2020; and associations between them were assessed. Time to implementation of these measures was compared among the Organisation for Economic Co-operation (OECD) nations. Log-rank test was used for univariate analysis. Cox regression was performed to assess the independent contribution of pre-pandemic characteristics to time-to-implementation of measures. Correlations between timing of specific measures and COVID-19 mortality at 60 days were assessed. RESULTS: Israel ranked in the upper third of the OECD in swiftness to implementation of eight of the ten measures compared. In univariate survival analysis, countries with an education level below the OECD median were more likely to implement a lockdown (p-value = 0.043) and to close restaurants and entertainment venues (p-value = 0.007) when compared to countries above the OECD median. In Cox regression models, controlling for geographic location, democracy level above the OECD median was associated with a longer time-to-implementation of a lockdown (HR=0.35, 95% CI=0.14-0.88, p-value=0.025). Similarly, a high level of GDP per capita was inversely associated with closing schools; and a high level of education inversely associated with closure of restaurants and entertainment venues. Earlier initiation of all PHMs was associated with lower mortality at 60 days, controlling for geographic location. CONCLUSIONS: Israel's initial response to the pandemic was relatively quick, and may have been facilitated by its geographic isolation. Countries with lower pre-pandemic socio-economic indices were quicker to initiate forced social distancing. Early initiation of PHMs was associated with reduced mortality in the short run. Timing of initiation of measures relative to the country-specific spread of disease is a significant factor contributing to short-term early local pandemic control, perhaps more than the exact measures implemented. It is important to note that this study is limited to the initial pandemic response. Furthermore, it does not take into account the broader long-term effects of certain PHMs, which should be a focus of further research.


Assuntos
COVID-19 , Humanos , COVID-19/epidemiologia , COVID-19/prevenção & controle , Pandemias , SARS-CoV-2 , Saúde Pública , Israel/epidemiologia , Controle de Doenças Transmissíveis , Fatores Socioeconômicos
7.
Isr Med Assoc J ; 25(1): 27-31, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36718733

RESUMO

BACKGROUND: Bacterial meningitis (BM) remains a considerable cause of morbidity. OBJECTIVES: To evaluate BM incidence rate trends in diverse age groups. METHODS: We conducted a retrospective cohort study based on the Israeli national registry. Inclusion criteria were acute admissions 2000 to 2019 with primary diagnosis of BM. Predefined age groups were neonates (≤ 30 days), infants (31 days to 1 year), younger children (1 ≤ 5 years), older children (5 ≤ 18 years), and adults (≥ 18 years). Average annual incidence rates per 100,000/year were calculated for the entire period and by decade. Incidence rates for neonates and infants were calculated per 100,000 live births (LB). RESULTS: There were 3039 BM cases over 2 decades, 60% were adults. The overall BM incidence rate was 2.0/100,000/year, neonates, 5.4/100,000/year LB, infants 17.6/100,000/year LB. First year of life incidence rate (neonates and infants combined) was 23.0/100,000/year, younger children 1.5/100,000/year, older children 0.9/100,000/year, and adults 1.8/100,000/year. All age groups presented a decrease in incidence rate (last decade vs. previous) except neonates, which increased by 34%. Younger and older children presented the most considerable decrease: 48% and 37% (last decade vs. previous). CONCLUSIONS: Adults showed the highest number of BM cases. The incidence rate was highest during the first year of life (neonates and infants combined). All age groups, except neonates, showed a decreasing trend. Younger and older children presented the most considerable decrease, most likely attributable to vaccination. The observed increase in BM incidence rate in neonates may influence whether preventive strategy is considered.


Assuntos
Meningites Bacterianas , Lactente , Criança , Recém-Nascido , Adulto , Humanos , Adolescente , Incidência , Israel/epidemiologia , Estudos Retrospectivos , Meningites Bacterianas/epidemiologia , Morbidade
8.
Isr Med Assoc J ; 25(1): 18-22, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36718731

RESUMO

BACKGROUND: Population screening for the BRCA mutations in Ashkenazi Jewish women was recently implemented in Israel and is expected to lead to a 10-fold increase in the diagnosis of asymptomatic carriers. Performing the screening follow-up within multidisciplinary dedicated clinics for carriers is recommended for early detection and risk reduction. OBJECTIVES: : To determine the availability, capacity, and practices of dedicated screening clinic for BRCA carriers in Israel. METHODS: A telephone-based survey of all public hospitals in Israel was conducted October 2020 to August 2021 to determine whether they had a dedicated clinic. Dedicated clinics were defined as multidisciplinary screening clinics offering at least breast and gynecological screening and risk reducing services on site. The clinic director or nurse navigator answered a questionnaire about screening practices followed by a semi-structured interview. RESULTS: Of the ten dedicated BRCA clinics found in Israel, nine participated. Approximately 4500 BRCA carriers are currently being followed. No specialized clinics are available in the southern district or in the northernmost half of the northern district of Israel, leading to a disparity between periphery and center. Screening recommendations, although asserted as adhering to international guidelines, vary among clinics including age at initiating of clinical exam, use of adjunct imaging modalities, and follow-up during lactation and after risk reducing surgery. CONCLUSIONS: There is a suboptimal distribution of dedicated clinics for BRCA carriers in Israel. Nationally centralized attempt to create guidelines that will unify screening practices is warranted, especially considering the expected increase in demand.


Assuntos
Neoplasias da Mama , Ginecologia , Neoplasias Ovarianas , Humanos , Feminino , Mutação , Israel/epidemiologia , Heterozigoto , Mama , Neoplasias da Mama/diagnóstico , Neoplasias da Mama/genética , Proteína BRCA1/genética , Proteína BRCA2/genética
9.
Epidemiol Infect ; 151: e16, 2023 01 04.
Artigo em Inglês | MEDLINE | ID: mdl-36698161

RESUMO

The impact of individual symptoms reported post-COVID-19 on subjective well-being (SWB) is unknown. We described associations between SWB and selected reported symptoms following SARS-CoV-2 infection. We analysed reported symptoms and subjective well being from 2295 participants (of which 576 reporting previous infection) in an ongoing longitudinal cohort study taking place in Israel. We estimated changes in SWB associated with reported selected symptoms at three follow-up time points (3-6, 6-12 and 12-18 months post infection) among participants reporting previous SARS-CoV-2 infection, adjusted for key demographic variables, using linear regression. Our results suggest that the biggest and most sustained changes in SWB stems from non-specific symptoms (fatigue -7.7 percentage points (pp), confusion/ lack of concentration -10.7 pp, and sleep disorders -11.5pp, P < 0.005), whereas the effect of system-specific symptoms, such as musculoskeletal symptoms (weakness in muscles and muscle pain) on SWB, are less profound and more transient. Taking a similar approach for other symptoms and following individuals over time to describe trends in SWB changes attributable to specific symptoms will help understand the post-acute phase of COVID-19 and how it should be defined and better managed. Post-acute COVID19 symptoms were associated with a significant decrease in subjective well being up to 18 months after initial infection.


Assuntos
COVID-19 , Humanos , SARS-CoV-2 , Israel/epidemiologia , Estudos Longitudinais
10.
Am J Orthopsychiatry ; 93(1): 97-106, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36634010

RESUMO

Israel's Bedouin population is undergoing a change from a traditional, collectivist society to one that is modern and individualistic. Settlement in urban localities has harmed the tribal framework of the society and weakened its traditional structure. Young Bedouin men are an inseparable part of the social fabric and the process of change and its ramifications. They are caught between their personal wishes and those of the tribe, between individualistic aims and commitment to the collective. This qualitative study using a phenomenological paradigm was conducted among 20 educated young Bedouin men. The findings reveal that they encounter many challenges arising from the tribal, patriarchal social structure of Bedouin society and from their status as members of an ethnic-religious minority in a country with a different ethnic-religious majority. The article describes these challenges and the importance of raising the awareness of social workers who work with young Bedouin men. (PsycInfo Database Record (c) 2023 APA, all rights reserved).


Assuntos
Árabes , Masculino , Humanos , Pesquisa Qualitativa , Israel/epidemiologia
11.
Public Health ; 214: 69-72, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36521274

RESUMO

OBJECTIVES: High age, male sex and pre-existing comorbidities are risk factors for a more severe development of COVID-19, and individuals surviving COVID-19 may experience persistent symptoms afterwards referred to as 'post-COVID-19 condition', which represents a range of symptoms after recovering from COVID-19. This study aims at identifying risk factors of post-COVID-19 conditions among people aged ≥50 years. STUDY DESIGN: We conducted a cross-sectional study based on data from the Survey of Health, Ageing and Retirement in Europe. METHODS: A multiple logistic regression model was used to investigate age, sex, education, comorbidities, smoking, body mass index, and COVID-19 hospitalisation as risk factors of post-COVID-19 condition. RESULTS: Participants aged ≥70 years (odds ratio [OR] 1.61) with medium (OR 2.38) and lower (OR 2.14) educational levels have a higher risk of post-COVID-19 conditions. In addition, when considering the severity of the COVID-19 disease, those who were hospitalised due to COVID-19 had a 26 times higher risk of post-COVID-19 conditions compared with those who were only tested positive (OR 25.9). CONCLUSIONS: This study supports that health inequalities exist across educational levels with respect to post-COVID-19 conditions, although misclassification may be more common among lower educated participants. The results suggest that policy makers should increase educational interventions towards increasing health literacy.


Assuntos
COVID-19 , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , COVID-19/complicações , COVID-19/epidemiologia , Estudos Transversais , Europa (Continente)/epidemiologia , Israel/epidemiologia , Fatores de Risco , Idoso
12.
Environ Res ; 216(Pt 4): 114804, 2023 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-36379234

RESUMO

BACKGROUND: In recent years, temperature fluctuations and adverse weather events have become major concerns, influencing overall mortality and morbidity. While the association between extreme temperatures and atrial fibrillation (AF) has been supported by research, there is limited evidence on the ability of AF patients to adapt to the changing temperatures. We explored this question among AF patients in Israel featured by extreme temperature conditions. METHODS: We examined the association between exposure to extreme temperatures and hospitalizations related to AF in a nationwide cohort in Israel. A case-crossover design with a distributed nonlinear model (DLNM) was applied to assess possible effects of temperature fluctuations during each season. We considered the 7 days prior to the event as the possible window period. RESULTS: During 2004-2018 we recorded a total of 54,909 hospitalizations for AF. Low temperatures in winter and high in summer adversely affected AF-related hospitalizations. The effect recorded for the first few weeks of each season was of higher magnitude and decreased or faded off completely as the seasons progressed (OR in winter: from 1.14, 95%CI 0.98, 1.32 to 0.90, 95%CI: 0.77, 1.06;OR in summer: from 1.95, 95%CI: 1.51, 2.52 to 1.22, 95%CI: 0.90, 1.65). Patients living in the south region and patients with low socioeconomic status were more susceptible to extreme temperatures. CONCLUSIONS: Although extreme hot and cold temperatures are associated with an increased risk of hospitalization for AF, the patients are likely to adapt to temperature change over the course of the first weeks of the season.


Assuntos
Fibrilação Atrial , Humanos , Fibrilação Atrial/epidemiologia , Temperatura Baixa , Hospitalização , Temperatura Alta , Israel/epidemiologia , Estações do Ano , Temperatura , Estudos Cross-Over
13.
Clin Infect Dis ; 76(1): 113-118, 2023 Jan 06.
Artigo em Inglês | MEDLINE | ID: mdl-36484301

RESUMO

BACKGROUND: The short-term effectiveness of a 2-dose regimen of the BioNTech/Pfizer BNT162b2 vaccine for adolescents has been demonstrated. However, little is known about the long-term effectiveness in this age group. It is known, however, that waning of vaccine-induced immunity against infection in adult populations is evident within a few months. METHODS: Leveraging the database of Maccabi Healthcare Services (MHS), we conducted a matched case-control design for evaluating the association between time since vaccination and the incidence of infections, where 2 outcomes were evaluated: documented SARS-CoV-2 infection (regardless of symptoms) and symptomatic infection (COVID-19). Cases were defined as individuals aged 12-16 with a positive polymerase chain reaction (PCR) test occurring between 15 June and 8 December 2021, when the Delta variant was dominant in Israel. Controls were adolescents who had not tested positive previously. RESULTS: We estimated a peak vaccine effectiveness between 2 weeks and 3 months following receipt of the second dose, with 85% (95% confidence interval [CI]: 84-86%) and 90% (95% CI: 89-91%) effectiveness against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and coronavirus disease 2019 (COVID-19), respectively. However, in line with findings for adults, waning effectiveness was evident. Long-term protection was reduced to 73% (95% CI: 68-77%) against infection and 79% (95% CI: 73-83%) against COVID-19 3-5 months after the second dose and waned to 53% (95% CI: 46-60%) against infection and 66% (95% CI: 59-72%) against COVID-19 after 5 months. CONCLUSIONS: Although vaccine-induced protection against both infection and COVID-19 continues over time in adolescents, the protection wanes with time since vaccination, starting 3 months after inoculation and continuing for more than 5 months.


Assuntos
COVID-19 , Vacinas , Adulto , Adolescente , Humanos , Israel/epidemiologia , Vacina BNT162 , SARS-CoV-2 , COVID-19/epidemiologia , COVID-19/prevenção & controle
14.
Psychiatry Res ; 319: 115004, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36525902

RESUMO

We examine the volume and characteristics of psychiatric ED visitations through a perspective of four COVID-19 lockdowns. All adult visitations to the ED of Shalvata Mental Healthcare center (Israel) during 2020-2021 were retrieved and statistically analysed and data from 2017 to 2019 was considered as control. Voluntary and involuntary ED visitations were considered, separately and combined. We find that the significant decrease in the volume of voluntary ED visitations during the 1st lockdown was quickly overturned, roughly returning to the pre-pandemic state following its conclusion. In parallel, the volume of involuntary ED visitations has dramatically increased, with the most striking levels observed during the second and third lockdowns. Elapsed time since the first occurrence of COVID-19 in Israel and the level of governmental restrictions is significantly associated with the increase in the volume of ED visits and admissions, the admission rate and the rate of involuntary visits. The prolonged consequences associated with the pandemic and the measures taken to control it suggest that it is unreasonable to expect a return to normal ED utilization in the near future. As such, alternatives to strict lockdowns should be favored when possible and urgent strengthening of psychiatric care is warranted.


Assuntos
COVID-19 , Adulto , Humanos , Estudos Retrospectivos , Israel/epidemiologia , Controle de Doenças Transmissíveis , Serviço Hospitalar de Emergência
15.
Environ Res ; 216(Pt 1): 114471, 2023 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-36208787

RESUMO

BACKGROUND: Industrial complex (IC) residence is associated with higher cancer incidence in adults and children. However, the effect on young adults and the residence duration are not well described. Since the beginning of the 20th century, the Haifa bay area (HBA) has a major IC area with petrochemical industry complex and many other industries. The objectives of the current study were to estimate the association between IC residence and cancer incidence and to evaluate the effect of the residence duration. METHODS: This study is a registry-based cohort (N = 1,022,637) with a follow-up of 21 years. Cox regression models were used to evaluate the associations (hazards ratios (HR) and its 95% confidence intervals (CIs)) between HBA residence and incidence of all cancer sites (n = 62,049) and for site-specific cancer types including: lung cancer (n = 5398), bladder cancer (n = 3790), breast cancer (n = 11,310), prostate cancer (n = 6389) skin cancer (n = 4651), pancreatic cancer (n = 2144) and colorectal cancer (n = 8675). We evaluated the effect of the duration of exposure as categories of 7 years for those with 15 years of follow-up. RESULTS: IC residence was associated with higher risk for all cancer sites (HR:1.09, 95% CI: 1.06-1.12), for site-specific cancer incidence including: lung cancer (HR:1.14, 95% CI: 1.04-1.23), bladder cancer (HR:1.11, 95% CI: 1.01-1.23), breast cancer (HR:1.04, 95% CI: 0.98-1.10), prostate cancer (HR:1.07, 95% CI: 0.99-1.16), skin cancer (HR:1.22, 95% CI: 1.12-1.33) and colorectal cancer (HR:1.10, 95%CI: 1.03-1.17). Similar risk was also observed among young adults (HR: 1.10, 95% CI: 1.00-1.20). In the analyses for the duration of exposure, IC residence was associated with higher risk for all cancer site for the longest residence duration (15-21 years: HR: 1.08, 95% CI: 1.04-1.13). CONCLUSIONS: Harmful associations were found between IC residence and incidence of all cancer sites and site-specific cancers types. Our findings add to the limited evidence of associations between IC residence and cancer in young adults.


Assuntos
Neoplasias da Mama , Neoplasias Colorretais , Neoplasias Pulmonares , Neoplasias , Neoplasias da Próstata , Neoplasias Cutâneas , Neoplasias da Bexiga Urinária , Adulto Jovem , Criança , Masculino , Humanos , Seguimentos , Neoplasias da Bexiga Urinária/epidemiologia , Israel/epidemiologia , Neoplasias/epidemiologia , Incidência , Sistema de Registros , Neoplasias da Mama/epidemiologia , Neoplasias Pulmonares/epidemiologia , Fatores de Risco
16.
Child Abuse Negl ; 136: 105999, 2023 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-36565584

RESUMO

BACKGROUND: Extensive research supports the existence of a "cycle of violence" that links exposure to parental violence during childhood (i.e., witnessing interparental violence and child maltreatment) with intimate partner violence (IPV) perpetration. However, there is still a need to explore the mechanisms through which early exposure to parental violence may foster IPV perpetration during adulthood. OBJECTIVE: In this study, we examine the mediating role of attachment insecurities and gender differences in the relationship between exposure to parental violence during childhood and IPV perpetration during adulthood. METHOD, PARTICIPANTS, AND SETTING: We conducted a cross-sectional survey among a representative sample of 604 married Arab adults (M age = 33.5, SD = 6.52; 50.1 % women) in Israel using a self-administered questionnaire. RESULTS: Exposure to physical violence, both as a victim and indirectly as a witness in childhood, was found positively correlated with adulthood IPV perpetration, with effect sizes ranging from weak (f2 = 0.01) to moderate (f2 = 0.15). Further, attachment-related avoidance was found to mediate the association between witnessing interparental physical violence and IPV perpetration. Gender differences were found in this relationship, with a stronger association indicated among male participants than among females. CONCLUSION: Exposure to physical violence may be understood as a risk factor for IPV perpetration directly and indirectly through the development of attachment-related avoidance.


Assuntos
Árabes , Violência por Parceiro Íntimo , Adulto , Feminino , Humanos , Masculino , Estudos Transversais , Israel/epidemiologia , Pais , Fatores de Risco
17.
Soc Sci Med ; 317: 115585, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36563585

RESUMO

BACKGROUND AND METHODS: Based on an established ongoing prospective-longitudinal study examining anxiety in response to COVID-19, a representative sample of 1018 Jewish-Israeli adults were recruited online. A baseline assessment was employed two days prior to the first spread of COVID-19, followed by six weekly assessments. Three classes of general anxiety and virus-specific anxiety were identified: (1) "Panic" (a very high and stable anxiety throughout the spread), (2) "Complacency" (a very low and stable anxiety throughout the spread), and (3) "Threat-Sensitivity" (a linear increase, plateauing at the 5th wave). For general-anxiety only, a fourth, "Balanced," class was identified, exhibiting a stable, middle-level of anxiety. We tested theory-based, baseline, social-cognitive predictors of these classes: self-criticism, perceived social support, and perceptions/attitudes towards the Israeli Ministry of Health. We also controlled for trait anxiety. Multinomial regression analyses in the context of General Mixture Modeling were utilized. RESULTS: Baseline virus-specific anxiety linearly predicted emerging virus-specific anxiety classes. Virus-specific panic has higher trait anxiety than the other two classes. The general anxiety panic class was over-represented by women and exhibited higher baseline general anxiety and self-criticism than all other classes, and higher baseline virus-specific anxiety along with lower perceived support and less positive perceptions of the ministry of health than two of the three other classes. CONCLUSIONS: Preexisting anxiety shapes subsequent anxious responses to the spread of COVID-19. The general-anxiety panic class may be markedly demoralized, requiring targeted public-health interventions.


Assuntos
COVID-19 , Adulto , Feminino , Humanos , COVID-19/epidemiologia , Israel/epidemiologia , Estudos Prospectivos , Estudos Longitudinais , Ansiedade/epidemiologia , Ansiedade/psicologia
18.
J Interpers Violence ; 38(1-2): NP588-NP612, 2023 01.
Artigo em Inglês | MEDLINE | ID: mdl-35354327

RESUMO

Exposure to parental violence in childhood is a significant predictor of psychological distress in adulthood. Factors at the individual level may explain the variance in psychological distress among adults exposed to parental violence. The current study examined the effect of exposure to different forms (i.e., physical violence and psychological aggression) and different patterns of parental violence (i.e., witnessing interparental violence, experiencing parental violence) on later psychological distress. The mediating role of sense of coherence (SOC) and the moderating role of gender in this relationship were also examined. A cross-sectional survey was conducted among 604 married Arab adults in Israel (age = 20-60, M = 33.5, SD = 6.52) using a retrospective, self-administered questionnaire. Results indicate a significant positive relationship between all forms and types of parental violence explored in the current study with levels of psychological distress. Furthermore, exposure to parental violence correlated negatively with SOC, and low levels of SOC predicted higher levels of psychological distress. SOC was found to partially mediate the relationship between exposure to parental violence and psychological distress. Gender differences were found only with regard to experiencing physical violence as a predictor of psychological distress, indicating that the relationship between these variables is stronger in females. These results highlight the importance of SOC as a personal resource and its role in promoting psychological wellbeing. Healthcare practitioners should be aware of possible gender differences in psychological distress among Arab adults exposed to parental violence.


Assuntos
Angústia Psicológica , Senso de Coerência , Adulto , Feminino , Humanos , Adulto Jovem , Pessoa de Meia-Idade , Árabes/psicologia , Estudos Transversais , Estudos Retrospectivos , Israel/epidemiologia , Pais/psicologia , Violência
19.
Artigo em Inglês | MEDLINE | ID: mdl-36498141

RESUMO

The identification of demographic factors of vulnerability and resilience in communities facing belligerent conflicts is increasingly relevant today. This representative study aims to examine the effect of protracted violence on the level of fear of the overall Israeli-Jewish population, and the role of the conflict on the connection between socio-economic factors and fears. Sixty-six representative samples were identified and surveyed from 2001 to 2019 (n = 37,190) that occurred during (n = 14,362) and between (n = 22,828) seven conflicts and non-conflict periods. Results show that during military conflicts, civilians declared less fears of physical injury comparing routine time; a slow trend of decline in the level of fears over time was observed; during routine periods, fear was associated with female-gender and with the lowest income level group. Ultra-orthodox and Religious respondents had significantly less fear than the secular and traditional respondents. During military conflicts, the results changed significantly, mainly for the lowest income group, women and ultra-orthodox.


Assuntos
Judeus , Judaísmo , Feminino , Humanos , Medo , Inquéritos e Questionários , Agressão , Israel/epidemiologia
20.
J Headache Pain ; 23(1): 160, 2022 Dec 14.
Artigo em Inglês | MEDLINE | ID: mdl-36517741

RESUMO

BACKGROUND: Understanding migraine epidemiology and its burden is crucial for planning health policies and interventions at the local level as well as at the global level. National policies in Israel rely on global estimations and not on local data since local epidemiologic studies had not previously been performed. In this study, we evaluated the epidemiology of migraine in the southern district of Israel using the electronic medical records database of the largest Israeli health maintenance organization (HMO). METHODS: In this population-based, retrospective, observational cohort study, adult migraine patients were identified in the computerized database of the southern district of the Clalit Health Services HMO (total population, 0.75 million). Patients were identified based on recorded diagnosis (International Classification of Diseases, Ninth Revision) and/or claims for specific anti-migraine medication (triptans) between 2000 and 2018. A 1:2 age-, gender-, and primary care clinic-matched control group was used for evaluation of comorbidities. RESULTS: In 2018, a total of 29,938 patients with migraine were identified out of 391,528 adult HMO members. Most of the patients were women (75.8%), and the mean ± standard deviation age at diagnosis was 36.94 ± 13.61 years. The overall prevalence of migraine (per 10,000) was 764.64 (7.65%), 1143.34 (11.43%) for women and 374.97 (3.75%) for men. The highest prevalence was observed in patients aged 50 to 60 years and 40 to 50 years (1143.98 [11.44%] and 1019.36 [10.19%], respectively), and the lowest prevalence was among patients aged 18 to 30 years and > 70 years (433.45 [4.33%] and 398.49 [3.98%], respectively). CONCLUSIONS: This is the first large-scale epidemiologic study of migraine prevalence in Israel. Compared to international estimations, migraine appears to be underdiagnosed in the southern district of Israel.


Assuntos
Transtornos de Enxaqueca , Cobertura Universal do Seguro de Saúde , Adulto , Masculino , Humanos , Feminino , Israel/epidemiologia , Estudos Retrospectivos , Transtornos de Enxaqueca/tratamento farmacológico , Prevalência
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