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1.
Isr J Health Policy Res ; 9(1): 50, 2020 10 06.
Artigo em Inglês | MEDLINE | ID: mdl-33023673

RESUMO

Alzheimer's disease and Alzheimer's disease-related dementias (AD/ADRD) constitute a worldwide public health crisis. In light of the AD/ADRD epidemic now existing within the global COVID-19 pandemic, the need for global action to improve dementia care is greater than ever. The article collection "Dementia- an Interdisciplinary Approach," in the Israeli Journal of Health Policy and Research (IJHPR) highlights the need for interprofessional approaches to improving outcomes for people living with dementia and their care partners, as well as the complexities of conducting dementia care research.


Assuntos
Demência/terapia , Política de Saúde , Pesquisa sobre Serviços de Saúde , Publicações Periódicas como Assunto , Demência/epidemiologia , Humanos , Israel/epidemiologia
2.
BMC Infect Dis ; 20(1): 660, 2020 Sep 07.
Artigo em Inglês | MEDLINE | ID: mdl-32894102

RESUMO

INTRODUCTION: Although women comprise 33% of the HIV-1-carriers in Israel, they have not previously been considered a risk group requiring special attention. Immigration waves from countries in Africa and in East Europe may have changed the local landscape of women diagnosed with HIV-1. Here, we aimed to assess viral and demographic characteristics of HIV-1-positive women identified in Israel between 2010 and 2018. METHODS: All > 16 year-old, HIV-1-infected women, diagnosed in Israel in 2010-2018, (n = 763) registered in the National HIV reference laboratory were included in this cross-sectional study. Demographic and clinical characteristics were extracted from the database. Viral subtypes and transmitted drug resistance mutations (TDRM) were determined in 337 (44.2%) randomly selected samples collected from treatment-naive women. RESULTS: Median age at diagnosis was 38 years. Most (73.3%) women were immigrants from the former Soviet Union (FSU) (41.2%, 314) or sub-Saharan Africa (SSA) (32.2%, 246) and carried subtype A (79.7%) or C (90.3%), respectively. Only 11.4% (87) were Israeli-born women. Over the years, the prevalence of women from SSA decreased while that of women from FSU increased significantly (p < 0.001). The median CD4+ cell count was 263 cells/mm3, and higher (391 cells/mm3) in Israeli-born women. TDRM were identified in 10.4% of the tested samples; 1.8, 3 and 7.1% had protease inhibitors (PI), nucleotide reverse transcriptase inhibitors (NRTI) and non-nucleoside reverse transcriptase inhibitors (NNRTI) TDRM, respectively. The prevalence of women with NNRTI TDRM significantly increased from 4.9% in 2010-2012 to 13.3% in 2016-2018. Israeli-born women had the highest prevalence (16.3%) of NNRTI TDRM (p = 0.014). NRTI A62 (5.6%), NNRTI E138 and K103 (5.6 and 4.2%, respectively) were the most prominent mutated sites. CONCLUSIONS: Most HIV-1-positive women diagnosed in Israel in 2010-2018 were immigrants, with the relative ratio of FSU immigrants increasing in recent years. The high proportion of women diagnosed with resistance mutations, particularly, the yearly increase in the frequency of NNRTI mutations, support the national policy of resistance testing at baseline.


Assuntos
Infecções por HIV/diagnóstico , Infecções por HIV/epidemiologia , HIV-1/genética , Adulto , Antivirais/uso terapêutico , Contagem de Linfócito CD4 , Estudos de Coortes , Estudos Transversais , Farmacorresistência Viral/genética , Emigrantes e Imigrantes , Feminino , Infecções por HIV/tratamento farmacológico , Humanos , Israel/epidemiologia , Pessoa de Meia-Idade , Mutação , Prevalência , Inibidores da Transcriptase Reversa/uso terapêutico
3.
Int J Equity Health ; 19(1): 154, 2020 09 09.
Artigo em Inglês | MEDLINE | ID: mdl-32907581

RESUMO

BACKGROUND: The Arab ethnic minority makes up 21% of Israel's population, yet comprised just 8.8% of confirmed cases and 3.6% of deaths from COVID-19, despite their higher risk profile and greater burden of underlying illness. This paper presents differences in patterns of morbidity and mortality from COVID-19 in the Arab, ultra-Orthodox and overall populations in Israel, and suggests possible reasons for the low rates of infection in the Arab population. METHODS: Data were obtained from the Israeli Ministry of Health's (MOH) open COVID-19 database, which includes information on 1270 localities and is updated daily. The database contains the number of COVID-19 diagnostic tests performed, the number of confirmed cases and deaths in Israel. RESULTS: In the first 4 months of Israel's COVID-19 outbreak, just 2060 cases were confirmed in the Arab population, comprising 8.8% of the 23,345 confirmed cases, or 2.38 times less than would be expected relative to the population size. In contrast, the ultra-Orthodox made up 30.1% of confirmed cases yet just 10.1% of the population. Confirmed case rate per 100,000 was twice as high in the general Jewish population compared to the Arab population. The Arab mortality rate was 0.57 per 100,000, compared to 3.37 in the overall population, and to 7.26 in the ultra-Orthodox community. We discuss possible reasons for this low morbidity and mortality including less use of nursing homes, and effective leadership which led to early closure of mosques and high adherence to social distancing measures, even during the month of Ramadan. CONCLUSIONS: Despite a disproportionate burden of underlying illness, the Arab population did not fulfil initial predictions during the first wave of the COVID-19 outbreak and maintained low numbers of infections and deaths. This contrasts with reports of increased mortality in ethnic minorities and economically disadvantaged populations in other countries, and with high rates of infection in the ultra-Orthodox sector in Israel. Effective leadership and cooperation between individuals and institutions, particularly engagement of community and religious leaders, can reduce a group's vulnerability and build resilience in an emergency situation such as the current pandemic.


Assuntos
Adaptação Psicológica , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Disparidades nos Níveis de Saúde , Pandemias/prevenção & controle , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Adulto , Idoso , Árabes/psicologia , Árabes/estatística & dados numéricos , Feminino , Humanos , Israel/epidemiologia , Liderança , Masculino , Grupos Minoritários/psicologia , Grupos Minoritários/estatística & dados numéricos , Papel (figurativo)
4.
Int J Equity Health ; 19(1): 153, 2020 09 09.
Artigo em Inglês | MEDLINE | ID: mdl-32907584

RESUMO

BACKGROUND: The first wave of the Covid-19 pandemic hit Israel in late February 2020. The present study examines patterns of the first wave of Covid-19 morbidity in Israel at the macro level, during the period of late February to early June 2020, when the first wave has faded out. The analysis focuses on the significance of four sociodemographic variables: socioeconomic status, population density, rate of elderly population and minority status (Jewish / Arab identity) of the population in cities with 5000 residents or more. Additionally, we take a closer look into the association between morbidity rates and one SES component - home Internet access. METHODS: The article is a cross sectional study of morbidity rates, investigated on a residential community basis. Following the descriptive statistics, we move on to present multivariate analysis to explore associations between these variables and Covid-19 morbidity in Israel. RESULTS: Both the descriptive statistics and regressions show morbidity rates to be positively associated with population density. Socioeconomic status as well as the size of elderly population were both significantly related to morbidity, but only in Jewish communities. Interestingly, the association was inverse in both cases. i.e., the higher the SES the lower the morbidity and the larger the elderly population, the lower the community's morbidity. Another interesting result is that overall, morbidity rates in Jewish cities were consistently higher than in Arab communities. CONCLUSIONS: We attribute the low morbidity rates in communities with relatively small elderly populations to the exceptionally high fertility rates in ultra-orthodox communities that sustained increased rates of morbidity; the lower morbidity in Arab communities is attributed to several factors, including the spatial Jewish-Arab segregation.


Assuntos
Árabes/estatística & dados numéricos , Infecções por Coronavirus/epidemiologia , Judeus/estatística & dados numéricos , Grupos Minoritários/estatística & dados numéricos , Pandemias , Pneumonia Viral/epidemiologia , Características de Residência/estatística & dados numéricos , Idoso , Estudos Transversais , Humanos , Israel/epidemiologia , Morbidade/tendências , Densidade Demográfica , Classe Social
5.
Antimicrob Resist Infect Control ; 9(1): 148, 2020 09 04.
Artigo em Inglês | MEDLINE | ID: mdl-32887658

RESUMO

BACKGROUND: Healthcare workers (HCWs) are on the front line of the COVID-19 outbreak, and their constant exposure to infected patients and contaminated surfaces puts them at risk of acquiring and transmitting the infection. Therefore, they must employ protective measures. In practice, HCWs in Israel were not fully prepared for this sudden COVID-19 outbreak. This research aimed to identify and compare: (1) Israeli HCWs' perceptions regarding the official COVID-19 guidelines' applicability and their protective value, and (2) HCWs executives' response to HWCs' concern regarding personal protective equipment (PPE) shortage. METHODS: A mixed-methods sequential explanatory design consists of: (1) An online survey of 242 HCWs about the application of the guidelines and PPE, and (2) Personal interviews of 15 HCWs executives regarding PPE shortage and the measures they are taking to address it. RESULTS: A significant difference between the perceived applicability and protective value was found for most of the guidelines. Some of the guidelines were perceived as more applicable than protective (hand hygiene, signage at entrance, alcohol rub sanitizers at entrance, and mask for contact with symptomatic patients). Other were perceived as less applicable than protective (prohibited gathering of over 10 people, maintaining a distance of 2 m', and remote services). CONCLUSIONS: HCWs need the support of the healthcare authorities not only to provide missing equipment, but also to communicate the risk to them. Conveying the information with full transparency, while addressing the uncertainty element and engaging the HCWs in evaluating the guidelines, are critical for establishing trust.


Assuntos
Infecções por Coronavirus/prevenção & controle , Pessoal de Saúde/psicologia , Controle de Infecções/métodos , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Adulto , Atitude do Pessoal de Saúde , Betacoronavirus/isolamento & purificação , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/transmissão , Infecções por Coronavirus/virologia , Infecção Hospitalar/epidemiologia , Infecção Hospitalar/prevenção & controle , Infecção Hospitalar/transmissão , Infecção Hospitalar/virologia , Feminino , Fidelidade a Diretrizes/normas , Fidelidade a Diretrizes/estatística & dados numéricos , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , Israel/epidemiologia , Masculino , Pessoa de Meia-Idade , Equipamento de Proteção Individual , Pneumonia Viral/epidemiologia , Pneumonia Viral/transmissão , Pneumonia Viral/virologia , Inquéritos e Questionários
6.
Nat Commun ; 11(1): 4439, 2020 09 07.
Artigo em Inglês | MEDLINE | ID: mdl-32895375

RESUMO

At the COVID-19 pandemic onset, when individual-level data of COVID-19 patients were not yet available, there was already a need for risk predictors to support prevention and treatment decisions. Here, we report a hybrid strategy to create such a predictor, combining the development of a baseline severe respiratory infection risk predictor and a post-processing method to calibrate the predictions to reported COVID-19 case-fatality rates. With the accumulation of a COVID-19 patient cohort, this predictor is validated to have good discrimination (area under the receiver-operating characteristics curve of 0.943) and calibration (markedly improved compared to that of the baseline predictor). At a 5% risk threshold, 15% of patients are marked as high-risk, achieving a sensitivity of 88%. We thus demonstrate that even at the onset of a pandemic, shrouded in epidemiologic fog of war, it is possible to provide a useful risk predictor, now widely used in a large healthcare organization.


Assuntos
Infecções por Coronavirus/mortalidade , Modelos Estatísticos , Pneumonia Viral/mortalidade , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Betacoronavirus/isolamento & purificação , Criança , Estudos de Coortes , Infecções por Coronavirus/virologia , Feminino , Previsões , Humanos , Israel/epidemiologia , Masculino , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/virologia , Curva ROC , Estudos Retrospectivos , Fatores de Risco , Adulto Jovem
7.
Isr Med Assoc J ; 8(22): 410-416, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32812714

RESUMO

BACKGROUND: The potential excess flow of patients into emergency departments and community clinics for testing and examination during a pandemic poses a major issue. These additional patients may lead to the risk of viral transmission to other patients and medical teams. To contain the spread of coronavirus disease-2019 (COVID-19), the Israeli Ministry of Health initiated a plan spearheaded by Magen David Adom (MDA), Israel's national emergency medical services (EMS) organization. OBJECTIVES: To describe outbreak containment actions initiated by MDA, including a COVID-19 tele-triage center and home testing by paramedics. METHODS: Retrospective analysis was conducted of de-identified data from the call management and command and control systems during the first period of the COVID-19 outbreak in Israel (23 February 2020-15 March 2020). RESULTS: During the study period, the total number of calls to the dispatch centers was 477,321 with a daily average of 21,696, compared to 6000-6500 during routine times. The total number of COVID-19 related calls was 334,230 (daily average 15,194). There were 28,454 calls (8.51% of all COVID-19 related calls, average 1293/day) transferred to the COVID-19 call center. Of the COVID-19 call center inquiries, 8390 resulted in the dispatch of a dedicated vehicle, including a paramedic wearing personal protective equipment, to collect samples for testing (daily average 381). CONCLUSIONS: Maximizing EMS during a pandemic using phone triage, in addition to dispatching paramedics to perform home testing, may significantly distance infected patients from the public and health care system. These steps can further minimize the spread of disease.


Assuntos
Betacoronavirus , Infecções por Coronavirus/prevenção & controle , Serviços Médicos de Emergência/métodos , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Técnicas de Laboratório Clínico/métodos , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/terapia , Serviços Médicos de Emergência/organização & administração , Humanos , Controle de Infecções/métodos , Controle de Infecções/organização & administração , Israel/epidemiologia , Pneumonia Viral/diagnóstico , Pneumonia Viral/epidemiologia , Pneumonia Viral/terapia , Estudos Retrospectivos , Telemedicina/métodos , Telemedicina/organização & administração , Triagem/métodos , Triagem/organização & administração
9.
JMIR Public Health Surveill ; 6(3): e20872, 2020 08 25.
Artigo em Inglês | MEDLINE | ID: mdl-32750009

RESUMO

BACKGROUND: Reliably identifying patients at increased risk for coronavirus disease (COVID-19) complications could guide clinical decisions, public health policies, and preparedness efforts. Multiple studies have attempted to characterize at-risk patients, using various data sources and methodologies. Most of these studies, however, explored condition-specific patient cohorts (eg, hospitalized patients) or had limited access to patients' medical history, thus, investigating related questions and, potentially, obtaining biased results. OBJECTIVE: This study aimed to identify factors associated with COVID-19 complications from the complete medical records of a nationally representative cohort of patients, with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. METHODS: We studied a cohort of all SARS-CoV-2-positive individuals, confirmed by polymerase chain reaction testing of either nasopharyngeal or saliva samples, in a nationwide health organization (covering 2.3 million individuals) and identified those who suffered from serious complications (ie, experienced moderate or severe symptoms of COVID-19, admitted to the intensive care unit, or died). We then compared the prevalence of pre-existing conditions, extracted from electronic health records, between complicated and noncomplicated COVID-19 patient cohorts to identify the conditions that significantly increase the risk of disease complications, in various age and sex strata. RESULTS: Of the 4353 SARS-CoV-2-positive individuals, 173 (4%) patients suffered from COVID-19 complications (all age ≥18 years). Our analysis suggests that cardiovascular and kidney diseases, obesity, and hypertension are significant risk factors for COVID-19 complications. It also indicates that depression (eg, males ≥65 years: odds ratio [OR] 2.94, 95% CI 1.55-5.58; P=.01) as well as cognitive and neurological disorders (eg, individuals ≥65 years old: OR 2.65, 95% CI 1.69-4.17; P<.001) are significant risk factors. Smoking and presence of respiratory diseases do not significantly increase the risk of complications. CONCLUSIONS: Our analysis agrees with previous studies on multiple risk factors, including hypertension and obesity. It also finds depression as well as cognitive and neurological disorders, but not smoking and respiratory diseases, to be significantly associated with COVID-19 complications. Adjusting existing risk definitions following these observations may improve their accuracy and impact the global pandemic containment and recovery efforts.


Assuntos
Infecções por Coronavirus/complicações , Pneumonia Viral/complicações , Adolescente , Adulto , Idoso , Estudos de Coortes , Infecções por Coronavirus/epidemiologia , Feminino , Humanos , Israel/epidemiologia , Masculino , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/epidemiologia , Fatores de Risco , Adulto Jovem
12.
Viruses ; 12(8)2020 08 05.
Artigo em Inglês | MEDLINE | ID: mdl-32764372

RESUMO

SARS-CoV-2 has become a major global concern as of December 2019, particularly affecting healthcare workers. As person-to-person transmission is airborne, crowded closed spaces have high potential for rapid virus spread, especially early in the pandemic when social distancing and mask wearing were not mandatory. This retrospective study thoroughly investigates a small-scale SARS-CoV-2 outbreak in Israel's central virology laboratory (ICVL) in mid-March 2020, in which six staff members and two related family members were infected. Suspicions regarding infection by contaminated surfaces in ICVL facilities were nullified by SARS-CoV-2 negative real time polymerase chain reaction (PCR) of work surfaces swipe tests. Complete SARS-CoV-2 genomes were sequenced and mutation analyses showed inclusion of all samples to clades 20B and 20C, possessing the spike mutation D614G. Phylogenetic analysis clarified transmission events, confirming S1 as having infected at least three other staff members and refuting the association of a staff member's infected spouse with the ICVL transmission cluster. Finally, serology tests exhibited IgG and IgA antibodies in all infected individuals and revealed the occurrence of asymptomatic infections in additional staff members. This study demonstrates the advantages of molecular epidemiology in elucidating transmission events and exemplifies the importance of good laboratory practice, distancing and mask wearing in preventing SARS-CoV-2 spread, specifically in healthcare facilities.


Assuntos
Betacoronavirus/isolamento & purificação , Infecções por Coronavirus/transmissão , Pneumonia Viral/transmissão , Anticorpos Antivirais/sangue , Infecções Assintomáticas/epidemiologia , Betacoronavirus/genética , Técnicas de Laboratório Clínico/métodos , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/epidemiologia , Pessoal de Saúde , Sequenciamento de Nucleotídeos em Larga Escala/métodos , Humanos , Israel/epidemiologia , Mutação , Pandemias , Filogenia , Pneumonia Viral/diagnóstico , Pneumonia Viral/epidemiologia , Saúde Pública , Estudos Retrospectivos , Testes Sorológicos
13.
Eur J Epidemiol ; 35(8): 775-779, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32785815

RESUMO

Vaccine hesitancy remains a barrier to full population inoculation against highly infectious diseases. Coincident with the rapid developments of COVID-19 vaccines globally, concerns about the safety of such a vaccine could contribute to vaccine hesitancy. We analyzed 1941 anonymous questionnaires completed by healthcare workers and members of the general Israeli population, regarding acceptance of a potential COVID-19 vaccine. Our results indicate that healthcare staff involved in the care of COVID-19 positive patients, and individuals considering themselves at risk of disease, were more likely to self-report acquiescence to COVID-19 vaccination if and when available. In contrast, parents, nurses, and medical workers not caring for SARS-CoV-2 positive patients expressed higher levels of vaccine hesitancy. Interventional educational campaigns targeted towards populations at risk of vaccine hesitancy are therefore urgently needed to combat misinformation and avoid low inoculation rates.


Assuntos
Infecções por Coronavirus/prevenção & controle , Pessoal de Saúde/psicologia , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Vacinação/psicologia , Betacoronavirus , Comunicação , Infecções por Coronavirus/psicologia , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Israel/epidemiologia , Masculino , Pais , Inquéritos e Questionários , Vacinação/estatística & dados numéricos , Vacinas , Vacinas Virais/administração & dosagem , Vacinas Virais/efeitos adversos
14.
Harefuah ; 159(8): 545-549, 2020 Aug.
Artigo em Hebraico | MEDLINE | ID: mdl-32852151

RESUMO

BACKGROUND: Melanoma is a malignant tumor of melanocytes, whose prevalence has been increasing in recent decades. Early diagnosis allows removal of the tumor prior to the metastatic stage and may lead to a complete recovery. OBJECTIVES: To compare melanoma incidence among different epidemiological groups in northern Israel, and to assess the impact of migration on the increase in incidence of the disease. METHODS: A retrospective review was conducted of the medical records of all patients diagnosed with melanoma and treated in the Plastic Surgery Department at the Rambam Health Care Campus in 2016. Demographic data of 130 patients and tumor characteristics were collected and analyzed. RESULTS: European and American immigrants were found to carry an increased risk for melanoma compared to African and Asian immigrants. Increased melanoma risk was also found among a large subset of European immigrants from the former Soviet Union. This sub-group accounted for 32% of study group patients, while they only comprise 9% of the population (p <0.05). Most melanoma tumors in this sub-group were found in upper and lower extremities (60%). Disease was diagnosed at a younger age compared to the other European immigrants (p <0.05), with a trend towards a more advanced disease than the rest of the patients. CONCLUSIONS: Study findings imply an increased melanoma risk in immigrants from the former Soviet Union. Raising awareness of this population to preventative measures and the importance of early diagnosis may reduce morbidity and mortality caused by the disease. Further research is needed to determine whether routine screening tests should be applied to this population.


Assuntos
Emigração e Imigração , Melanoma/epidemiologia , Humanos , Incidência , Israel/epidemiologia , Estudos Retrospectivos , U.R.S.S./epidemiologia
15.
PLoS One ; 15(8): e0237734, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32817681

RESUMO

BACKGROUND: Over the last decades, health systems worldwide have faced a decline in public trust. For marginalized minority populations, who generally suffer from poverty and political exclusion, the roots of this trend go much deeper, establishing a state of bi-directional distrust between them and health institutions. Although studied to a lesser extent compared to trust, distrust does impede health initiatives, such as infectious diseases prevention programs, mostly of so-called Neglected Zoonotic Diseases (NZDs). Where distrust prevails, even trust building actions such as defining rights and obligations, prioritizing "the greater good" and increasing transparency, are prone to failure. In this study, we deepen the understanding of the concept of distrust through a unique case study of Brucellosis, a prevalent bacterial zoonotic disease endemic to disadvantaged Bedouin communities in southern Israel. METHODS: In the years 2015-2019, we qualitatively studied socio-political aspects in a governmental Brucellosis control campaign in southern Israel. We used in-depth interviews with 38 governmental and private health workers, agriculture and nature preservation workers, livestock owners and community leaders. Further, we conducted participant observation in 10 livestock pens and in policymaking meetings, and collected policy and media documents in order to triangulate the results. RESULTS: We conceptualize three different types of distrust between authorities and marginalized communities-"intention-based distrust", "values-based distrust" and "circular distrust"-to better explain how distrust originates and reinforces itself, reproducing the endemicity of NZDs. Based on that, we portray a practical framework to reduce distrust in health policies, by reframing local discourses, reshaping disease monitoring schemes from enforcement-based to participation-based, and promoting political inclusion of disadvantaged communities. CONCLUSIONS: The suggested analysis and framework redirect health policy objectives to not only acknowledge, contain and reduce the consequences of distrust, but also to strive for societal justice as a tool for health promotion.


Assuntos
Brucelose/epidemiologia , Programas Governamentais , Política de Saúde , Zoonoses/epidemiologia , Animais , Árabes/psicologia , Brucelose/microbiologia , Feminino , Humanos , Relações Interpessoais , Israel/epidemiologia , Masculino , Doenças Negligenciadas/epidemiologia , Doenças Negligenciadas/microbiologia , Formulação de Políticas , Confiança/psicologia , Zoonoses/microbiologia
16.
Am J Geriatr Psychiatry ; 28(10): 1020-1024, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32771312

RESUMO

OBJECTIVE: To explore older people's use of the Internet for coping with stress posed by the COVID-19 pandemic. METHODS: An online survey with a random sample of 407 Internet users aged 60 years and over (Mean = 69.14). RESULTS: Participants reported a significant increase in 7 of 12 Internet-based functions following the pandemic onset. Stress levels were moderate-to-high and participants appeared more worried about others than about themselves. Significant positive associations were found between stress and increase in Internet use for interpersonal communication and online errands. Linear regression analysis revealed a significant negative association between stress and subjective wellbeing, but it was only increased Internet use for leisure that associated significantly with enhanced wellbeing. CONCLUSION: The changes in Internet use clearly reflected coping efforts that were apparently ineffective in enhancing wellbeing. Paradoxically, the only online functions that could improve wellbeing, Internet use for leisure, are precisely those whose use hardly increased.


Assuntos
Adaptação Psicológica , Comércio , Comunicação , Infecções por Coronavirus/epidemiologia , Internet/estatística & dados numéricos , Atividades de Lazer , Pneumonia Viral/epidemiologia , Estresse Psicológico , Idoso , Idoso de 80 Anos ou mais , Betacoronavirus , Correio Eletrônico , Feminino , Humanos , Israel/epidemiologia , Modelos Lineares , Masculino , Pessoa de Meia-Idade , Redes Sociais Online , Pandemias , Inquéritos e Questionários
17.
Environ Health ; 19(1): 90, 2020 08 26.
Artigo em Inglês | MEDLINE | ID: mdl-32847589

RESUMO

BACKGROUND: Lower respiratory tract infections (LRTI) in early life, including pneumonia, bronchitis and bronchiolitis, can lead to decreased lung function, persistent lung damage and increased susceptibility to various respiratory diseases such as asthma. In-utero exposure to particulate matter (PM) during pregnancy may disrupt biological mechanisms that regulate fetal growth, maturation and development. We aimed to estimate the association between intrauterine exposure to PM of size < 2.5 µm in diameter (PM2.5) and incidence of LRTIs during the first year of life. METHODS: A retrospective population-based cohort study in a population of mothers and infants born in Soroka University Medical Center (SUMC) in the years 2004-2012. All infants < 1 year old that were hospitalized due to LRTIs were included. The main exposure assessment was based on a hybrid model incorporating daily satellite-based predictions at 1 km2 spatial resolution. Data from monitoring stations was used for imputation of main exposure and other pollutants. Levels of environmental exposures were assigned to subjects based on their residential addresses and averaged for each trimester. Analysis was conducted by a multivariable generalized estimating equation (GEE) Poisson regression. Data was analyzed separately for the two main ethnic groups in the region, Jewish and Arab-Bedouin. RESULTS: The study cohort included 57,331 deliveries that met the inclusion criteria. Overall, 1871 hospitalizations of infants < 1 year old due to pneumonia or bronchiolitis were documented. In a multivariable analysis, intrauterine exposure to high levels of PM2.5 (> 24 µg/m3) in the first and second trimesters was found to be adversely associated with LRTIs in the Arab-Bedouin population (1st trimester, RR = 1.31, CI 95% 1.08-1.60; 2nd trimester: RR = 1.34, CI 95% 1.09-1.66). CONCLUSION: Intrauterine exposure to high levels of PM2.5 is associated with a higher risk of hospitalizations due to lower respiratory tract infections in Arab-Bedouin infants.


Assuntos
Poluentes Atmosféricos/efeitos adversos , Exposição Materna/efeitos adversos , Material Particulado/efeitos adversos , Efeitos Tardios da Exposição Pré-Natal/epidemiologia , Infecções Respiratórias/epidemiologia , Feminino , Hospitalização , Humanos , Incidência , Lactente , Recém-Nascido , Israel/epidemiologia , Masculino , Gravidez , Efeitos Tardios da Exposição Pré-Natal/induzido quimicamente , Infecções Respiratórias/induzido quimicamente
18.
PLoS One ; 15(8): e0236994, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32854110

RESUMO

INTRODUCTION: Prematurity has been identified as a risk factor for Autism Spectrum Disorder (ASD). The link between Autism Spectrum Disorder (ASD) and birth-week has not been strongly evidenced. We evaluated the correlation between the degree of prematurity and the incidence of autism in a cohort of 871 children born prematurely and followed from birth. The cohort was reduced to 416 premature infants born between 2011-2017 who were followed for 2-14 years, and analyzed according to birth week (degree of prematurity), and according to gender. RESULTS: 43 children (10.3%) received a definite diagnosis of ASD. There was a significant correlation between birth week and the risk of ASD, with 22.6% of children diagnosed with ASD when born at 25 weeks, versus 6% of ASD diagnoses at 31 weeks of prematurity. For children born after 32 weeks, the incidence decreased to 8-12.5%. A strong link was found between earlier birth week and increased autism risk; the risk remained elevated during near-term prematurity in boys. A correlation between early birth week and an elevated risk for ASD was seen in all children, but accentuated in females, gradually decreasing as birth week progresses; in males the risk for ASD remains elevated for any birth week. CONCLUSION: A statistically significant increase in rates of autism was found with each additional week of prematurity. Females drove this direct risk related to degree of prematurity, while males had an elevated risk throughout prematurity weeks, even at near-term. We recommend including ASD screening in follow up of infants born prematurely, at all levels of prematurity.


Assuntos
Transtorno Autístico/etiologia , Recém-Nascido Prematuro , Transtorno do Espectro Autista/epidemiologia , Transtorno do Espectro Autista/etiologia , Transtorno Autístico/epidemiologia , Pré-Escolar , Estudos de Coortes , Feminino , Seguimentos , Humanos , Incidência , Recém-Nascido , Recém-Nascido Prematuro/crescimento & desenvolvimento , Recém-Nascido Prematuro/psicologia , Israel/epidemiologia , Masculino , Gravidez , Nascimento Prematuro , Prevalência , Fatores de Risco , Caracteres Sexuais
19.
Nurse Educ Pract ; 46: 102809, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32679465

RESUMO

Anxiety is highly prevalent among nursing students even in normal circumstances. In Israel during the covid-19 pandemic and mandatory lockdown, nursing students encountered a new reality of economic uncertainty, fear of infection, challenges of distance education, lack of personal protection equipment (PPE) at work etc. The objective of this study was to assess levels of anxiety and ways of coping among nursing students in the Ashkelon Academic College, Southern District, Israel. A cross-sectional study was conducted among all 244 students in the nursing department during the third week of a national lockdown. Anxiety level was assessed using the Generalized Anxiety Disorder 7-Item Scale with a cut-off point of 10 for moderate and of 15 for severe anxiety. Factor analysis was used to identify coping components. The prevalence of moderate and severe anxiety was 42.8% and 13.1% respectively. Gender, lack of PPE, and fear of infection were significantly associated with a higher anxiety score. Stronger resilience and usage of humor were associated with significantly lower anxiety levels, while mental disengagement with higher anxiety levels. The nursing department's staff may contribute in lowering student anxiety by maintaining a stable educational framework, providing high quality distant teaching and encouraging and supporting students through this challenging period.


Assuntos
Adaptação Psicológica , Ansiedade/epidemiologia , Infecções por Coronavirus/epidemiologia , Pandemias , Pneumonia Viral/epidemiologia , Estudantes de Enfermagem/psicologia , Adulto , Estudos Transversais , Feminino , Humanos , Israel/epidemiologia , Masculino , Estudantes de Enfermagem/estatística & dados numéricos , Adulto Jovem
20.
Pediatr Infect Dis J ; 39(9): e270-e272, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32658093

RESUMO

Among individuals who tested positive for coronavirus disease 2019, smell and taste sensations were significantly less impaired among children than among adults, in a stepwise manner. Sensory impairment was correlated with recent data of angiotensin-converting enzyme 2 expression in the corresponding age groups. This is the first report to compare sensory impairment in children and adults testing positive for coronavirus disease 2019.


Assuntos
Infecções por Coronavirus/fisiopatologia , Hipestesia/virologia , Peptidil Dipeptidase A/biossíntese , Pneumonia Viral/fisiopatologia , Adolescente , Adulto , Fatores Etários , Betacoronavirus/isolamento & purificação , Criança , Pré-Escolar , Infecções por Coronavirus/enzimologia , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/virologia , Humanos , Hipestesia/enzimologia , Hipestesia/fisiopatologia , Israel/epidemiologia , Pandemias , Peptidil Dipeptidase A/metabolismo , Pneumonia Viral/enzimologia , Pneumonia Viral/epidemiologia , Pneumonia Viral/virologia , Olfato/fisiologia , Paladar/fisiologia , Adulto Jovem
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