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New Article: Mor & Davidovich, Same-Sex Attraction, Behavior, and Practices of Jewish Men in Israel

Mor, Zohar, and Udi Davidovich. “Same-Sex Sexual Attraction, Behavior, and Practices of Jewish Men in Israel and the Association with HIV Prevalence.” AIDS Care (early view; online first).

 
URL: http://dx.doi.org/10.1080/09540121.2016.1146400
 
Abstract

In order to efficiently direct efforts and resources required for the prevention of HIV and other sexually transmitted infection among men who have sex with men (MSM) in Israel, it is necessary to define their particular behaviors, estimate their size, and assess the HIV-burden. This cross-sectional study included a sub-sample from a random representative National study performed in Israel, which included Jewish males aged 18–44 who completed online anonymous questionnaires regarding their sexual attraction and practices, commercial sex-work, as well as condom and substances’ use. Additionally, participants were asked to identify themselves as gay, bisexual, or heterosexual. National estimates regarding prevalence of risk-behaviors and HIV-infection among MSM were based on the Statistical Abstract of Israel and the National HIV Registry, respectively. Of the total sample of 997 men, 11.9% reported lifetime male sex encounters, while 4.5% and 3.7% self-identified as gay or bisexual, respectively. The estimated population of self-identified Jewish gays/bisexuals aged 18–44 in Israel was 94,176, and in Tel-Aviv 33,839. HIV prevalence among MSM was estimated at 0.7% in Israel and 1.0% in Tel-Aviv. MSM were more likely to live in Tel-Aviv, had higher levels of education, and were scored higher on several determinants of sexual risk in comparison to those attracted to women, including early sexual debut, greater number of sexual partners, ever paid/been paid for sex, sexually coerced, and substance use. In conclusion, MSM were involved in greater risk behaviors than those who only had female sex partners. Most MSM were living in Tel-Aviv and their estimated HIV prevalence was 1.0%.

 

 

 

New Article: Mor et al, Arab Men Who Have Sex with Men in Israel

Mor, Z., Grayeb, E., and A. Beany. “Arab Men Who Have Sex with Men in Israel: Knowledge, Attitudes and Sexual Practices.” HIV Medicine (early view; online first).

 

URL: http://dx.doi.org/10.1111/hiv.12301

 

Abstract

Objectives
Arab men who have sex with men (AMSM) are becoming visible in society, and reports of HIV infection and sexually transmitted infections (STIs) are emerging. This study aimed to assess the knowledge of AMSM regarding HIV transmission, their attitudes towards condom use and their sexual practices compared with Jewish MSM (JMSM), and to evaluate AMSM–JMSM friendships and sexual encounters.

Methods
Participants in this cross-sectional study completed questionnaires in Arabic or Hebrew. The outcome variable was unprotected anal sex (UAI) in the previous 6 months with a partner(s) whose HIV status was discordant or unknown. AMSM and JMSM indicated if they had friends or sexual encounters from the other ethnic group.

Results
The questionnaires were completed by 342 (16.2%) AMSM and 1775 (83.8%) JMSM in 2012. AMSM were more likely to be religious, ‘closeted’ and married than JMSM; their knowledge regarding HIV transmission was inferior and attitudes towards condom use were less favourable. AMSM reported less alcohol and drug use than JMSM, were more likely to be attracted to and have sex with women, and reported a greater number of sexual partners and more UAI. Being AMSM was a predictive variable for UAI in the multivariate model. While 178 AMSM (52.0%) reported that most of their close friends were JMSM, 251 (73.4%) had only/mostly sexual encounters with JMSM. Among JMSM, 41 (2.3%) reported that their close friends were AMSM, and 308 (17.3%) had only/mostly sexual encounters with AMSM.

Conclusions
The knowledge of AMSM regarding HIV transmission and their attitudes towards condom use were less favourable than those of JMSM, and they performed more UAI. AMSM may benefit from targeted interventions, including reconciling their same-sex attraction in positive terms. Same-sex attraction and gay identity may provide common ground to strengthen Arab–Jew communication in Israel.

 

 

New Article: Eyal & Te’eni-Harari, Advertising Food Products on Israeli Television

Eyal, Keren, and Tali Te’eni-Harari. “High on Attractiveness, Low on Nutrition: An Over-Time Comparison of Advertising Food Products on Israeli Television.” Health Communication (early view; online first).

 

URL: http://dx.doi.org/10.1080/10410236.2015.1026431

 

Abstract

This content analysis examines Israeli television food advertising. It compares 2008–2009 and 2012–2013, two periods immediately before and several years after regulatory, educational, and public-advocacy efforts have been advanced to raise awareness of and tackle the television–obesity link. Advertisements were drawn from a composite week sample aired on Israeli broadcast channels from 4:00 p.m. until midnight in each of the two periods. Nearly a quarter of ads were for food products, even after a significant drop over the years. The most common food categories included candies and sweetened drinks, whereas fruit and vegetables were among the least common products advertised. The most prevalent central message in food advertisements was that the product makes for an economically sensible purchase, with a much lower focus on the health qualities of the food products. Food advertisements were characterized by a very short duration and an increased reliance on emotional, rather than cognitive, appeal, especially in ads for low-nutrient foods. A significant increase was observed in 2012–2013 in the reliance on thin models in food advertisements, and these were most often associated with high levels of physical attractiveness, promoting the thin ideal. Findings are discussed in light of theory, previous research conducted worldwide, and audience effects. Implications are addressed for health and media industry regulation efforts.

 

 

 

New Article: Elran-Barak et al, Overweight and Obese Midlife Women in Israel

Elran-Barak, Roni, Tzvia Blumstein, Valentina Boyko, Dana Hadar, Adel Farhi, Liat Lerner-Geva, and Yael Benyamini. “Overweight and Obese Midlife Women in Israel: Cultural Differences in Perceived Weight Status.” International Journal of Public Health (early view; online first).

 

URL: http://dx.doi.org/10.1007/s00038-015-0753-0

 

Abstract

 

Objectives

To examine cultural differences in Weight status misperception (WSMP) and identify associations between weight perception and weight control efforts among overweight/obese midlife women in Israel.

Methods

Data from the nationally representative Women’s-Health-in-Midlife-National-Study were used. Participants included overweight (25 ≤ BMI < 30) and obese (BMI ≥ 30) midlife women (45–64 years) from three cultural groups: Long-Term Jewish Residents (LTJR), Immigrants from the former USSR, and Arabs. Interviews included measures of BMI, weight perception, lifestyle, and socio-demographics.

Results

Most overweight/obese women (88 %) perceived their weight status correctly. No significant differences were found in overall WSMP rates across cultural groups. Overweight women of Arab origin were significantly more likely (p < 0.001) to perceive their weight as “about right” relative to LTJR and Immigrants. WSMP was associated with several unhealthy eating patterns [eating red meat (OR = 2.1, 95 % CI = 1.13–3.97), white bread (OR = 2.4, 95 % CI = 1.26–4.58)] and with more perceived barriers to exercising (OR = 1.8, 95 % CI = 1.00–3.42).

Conclusions

Health care providers are encouraged to pay attention to overweight/obese women who misperceive their weight status. These women are more likely to consume unhealthy foods and to be at higher risks of suffering from medical complications associated with obesity.

 

 

New Article: Daoud et al, Readiness to Quit Smoking among a Arab-Male Smokers in Israel

Daoud, Nihaya, Samah Hayek, Ahmad Sheikh Muhammad, Kathleen Abu-Saad, Amira Osman, James F. Thrasher, and Ofra Kalter-Leibovici. “Stages of Change of the Readiness to Quit Smoking among a Random Sample of Minority Arab-Male Smokers in Israel.” BMC Public Health 15 (2015).

URL: http://dx.doi.org/10.1186/s12889-015-1950-8

Abstract

Background
Despite advanced smoking prevention and cessation policies in many countries, the prevalence of cigarette smoking among indigenous and some ethnic minorities continues to be high. This study examined the stages of change (SOC) of the readiness to quit smoking among Arab men in Israel shortly after new regulations of free-of-charge smoking cessation workshops and subsidized medications were introduced through primary health care clinics.

Methods
We conducted a countrywide study in Israel between 2012–2013. Participants, 735 current smokers; 18–64 years old; were recruited from a stratified random sample and interviewed face-to-face using a structured questionnaire in Arabic. We used ordered regression to examine the contribution of socio-economic position (SEP), health status, psychosocial attributes, smoking-related factors, and physician advice to the SOC of the readiness to quit smoking (pre-contemplation, contemplation and preparation).

Results
Of the current smokers, 61.8 % were at the pre-contemplation stage, 23.8 % were at the contemplation stage, and only 14.4 % were at the preparation stage. In the multinomial analysis, factors significantly (P < 0.05) contributing to contemplation stage compared to pre-contemplation stage included [odds ratio (OR), 95 % confidence interval (CI)]: chronic morbidity [0.52, (0.31-0.88)], social support [1.35, (1.07-1.70)], duration of smoking for 11–21 years [1.94, (1.07-3.50)], three or more previous attempts to quit [2.27, (1.26-4.01)], knowledge about smoking hazards [1.75, (1.29-2.35)], positive attitudes toward smoking prevention [1.44, (1.14-1.82)], and physician advice to quit smoking [1.88, (1.19-2.97)]. The factors significantly (P < 0.05) contributing to preparation stage compared to pre-contemplation stage were [OR, (95 % CI)]: chronic morbidity [0.36, (0.20-0.67)], anxiety [1.07, (1.01-1.13)], social support [1.34, (1.01-1.78)], duration of smoking 5 years or less [2.93, (1.14-7.52)], three or more previous attempts to quit [3.16, (1.60-6.26)], knowledge about smoking hazards [1.57, (1.10-2.21)], and positive attitudes toward smoking prevention [1.34, (1.00-1.82)].

Conclusions
Most Arab men who currently smoke are in the pre-contemplation stage, indicating low readiness to quit smoking. New policies of free-of-charge smoking-cessation group sessions and subsidized medications introduced through primary health care clinics in Israel may be less effective among Arab men. For these policies to promote cessation more successfully, tailored interventions and campaigns may be needed to increase the readiness to quit smoking in this population, especially for those at the pre-contemplation stage.

New Article: Pines and Bernstein, Solving the Worldwide Emergency Department Crowding Problem – What Can We Learn from an Israeli ED?

Pines, Jesse M., and Steven L. Bernstein. “Solving the Worldwide Emergency Department Crowding Problem – What Can We Learn from an Israeli ED?” Israel Journal of Health Policy Research 4 (2015): 52.

 

URL: https://dx.doi.org/10.1186/s13584-015-0049-0

 

Abstract

ED crowding is a prevalent and important issue facing hospitals in Israel and around the world, including North and South America, Europe, Australia, Asia and Africa. ED crowding is associated with poorer quality of care and poorer health outcomes, along with extended waits for care. Crowding is caused by a periodic mismatch between the supply of ED and hospital resources and the demand for patient care. In a recent article in the Israel Journal of Health Policy Research, Bashkin et al. present an Ishikawa diagram describing several factors related to longer length of stay (LOS), and higher levels of ED crowding, including management, process, environmental, human factors, and resource issues. Several solutions exist to reduce ED crowding, which involve addressing several of the issues identified by Bashkin et al. This includes reducing the demand for and variation in care, and better matching the supply of resources to demands in care in real time. However, what is needed to reduce crowding is an institutional imperative from senior leadership, implemented by engaged ED and hospital leadership with multi-disciplinary cross-unit collaboration, sufficient resources to implement effective interventions, access to data, and a sustained commitment over time. This may move the culture of a hospital to facilitate improved flow within and across units and ultimately improve quality and safety over the long-term.

 

 

New Article: Schmittdiel, Patient-Centered Health Care Systems to Improve Outcomes and Reduce Disparities

Schmittdiel, Julie A. “Creating Patient-Centered Health Care Systems to Improve Outcomes and Reduce Disparities.” Israeli Journal of Health Policy Research 42 (2015).

 

URL: http://dx.doi.org/10.1186/s13584-015-0039-2

 

Abstract
Health care delivery systems that are designed to understand and meet patient preferences for care have the potential to improve health outcomes and reduce disparities. Studies that rigorously assess patient care preferences in minority and underserved populations, stakeholder engagement, and policies that promote a diverse health care workforce that can address patient preferences are important levers for improving care for vulnerable populations.

 

 

New Article: Horev et al, Preservatives in Cosmetics in Israel Conform to EU Legislation

Horev, L.,  M. Isaksson, M. Engfeldt, L. Persson, A. Ingber, and M. Bruze. “Preservatives in Cosmetics in the Israeli Market Conform Well to the EU Legislation.” Journal of the European Academy of Dermatology and Venereology 29.4 (2015): 761-6.

 

URL: http://dx.doi.org/10.1111/jdv.12676

 

Abstract

Background

Preservatives are important and frequent skin sensitizers, found in a wide range of products for personal and occupational use. According to the European legislation, some cosmetic ingredients are restricted in terms of quantity and a detailed list of ingredients must be present on the product or packaging.

Objectives

To examine the use of preservatives in common cosmetics on the Israeli market.

Materials/Methods

Sixty different Israeli brand cosmetics, including shampoos, liquid soaps, body creams and hand creams were randomly selected. Ingredient labels were examined. The products were investigated by the chromotropic acid method for release of formaldehyde and by high performance liquid chromatography for the presence of formaldehyde, DMDM hydantoin and methylchloroisothiazolinone/methylisothiazolinone (MCI/MI) and MI content.

Results

All products but one contained a detailed list of ingredients printed on the package. According to labelling, the most prevalent preservatives in Israeli shampoos and liquid soaps were DMDM hydantoin and MCI/MI. Hand creams and body creams contained mainly parabens but also iodopropynyl butylcarbamate, phenoxyethanol and DMDM hydantoin. Formaldehyde in doses from 4 to 429 ppm, and DMDM hydantoin were detected in 38 and 16 (63% and 27%) of the products, respectively. MCI/MI was detected in 11 (18%) of the products, with highest prevalence in rinse- off products (55%). Excluding one hand cream which measured 106 ppm MI, the amount of formaldehyde, DMDM hydantoin, MCI/MI and MI was within the allowed concentrations by the European directive in all cases.

Conclusions

In Israel, adaptation of the European directive prevails, as shown by the measurements we performed on randomly selected products.

 
 
 
 

New Article: Rosen & Peled-Raz, Tobacco Policy in Israel: 1948–2014

Rosen, Laura J., and Maya Peled-Raz. “Tobacco Policy in Israel: 1948–2014 and Beyond.” Israel Journal of Health Policy Research (early view; online first).

 
URL: http://dx.doi.org/10.1186/s13584-015-0007-x

 

Abstract

Background
Tobacco is the only consumer product known to kill half of its users, and is a significant cause of death and disability to exposed nonsmokers. This presents a unique conundrum for modern democracies, which emphasize personal liberty, yet are obligated to protect citizens.

In Israel, the death toll in 2014 from smoking is expected to reach 8000 deaths; nearly a fifth of the population smokes, and over two-thirds of the population are exposed to tobacco smoke.

Aim
This paper provides an overview of tobacco policy in Israel since the inception of the State, presents the development of the National Tobacco Control Plan, and recommends future actions.

Methods
Sources for this article included the Knesset (Israeli Parliament) and Ministry of Health websites, Health Minister Reports to the Knesset on Smoking, and the scientific literature.

Results
Israel has an impressive record on tobacco control policy, beginning with taxation in 1952, landmark smoke-free air and marketing legislation in the early 1980’s, tax increases and expansions of smoke-free air and marketing legislation in the ensuing years, and the addition of subsidized smoking cessation technologies in 2010. Until 2011, actions were taken by various organizations without formal coordination; since the passage of the National Tobacco Control Plan in 2011, the Ministry of Health has held responsibility for coordinating tobacco control, with an action plan.

The plan has been partially implemented. Smoke-free air laws were expanded, but enforcement is poor. Passage of critical marketing and advertising restrictions is stalled. Requested funds for tobacco control did not materialize.

Recommendations
In order to prevent hundreds of thousands of preventable premature deaths in the coming decades, Israel should considerably strengthen tobacco control policies to include: guaranteed funding for tobacco control; strong curbs on advertising, promotion and sponsorship of tobacco and smoking products; public education; law enforcement; protection of children from exposure to tobacco; regulation of electronic cigarettes and other alternative harm-reducing products; tobacco control research; and systematic monitoring of, and periodic updates to, the National Tobacco Control Plan. Israel should also begin discussions of Endgame scenarios, and consider abolition of tobacco, as it continues its progress towards making smoking history.

 
 
 
 

Conference Program: APHA, Chicago, November 2015

Annual Meeting of the American Public Health Association, Chicago, 2015

Papers related to Israel:

 

Daoud, Nihaya. “Challenges for Maternal and Child Health Research in The Bedouin Indigenous Minority In Israel.” November 2, 2015, 8:50am.

This presentation focuses on the challenges and opportunities of maternal and child health research among Indigenous Arab Bedouin mothers in Israel.

Bedouins are Israeli citizens who have been living in the south for many decades. They are Israel’s most economically deprived minority and have poor health status. Bedouin infants have higher morbidity and mortality rates compared to their counterparts.

We conducted this study in 2007-2008 to better understand maternal experiences of infant care while drawing on social-ecological approaches to raise Bedouin mothers’ voices and inform policy and interventions.

Multiple factors embedded in Bedouins’ political and historical context complicate research, mainly land disputes with Israeli governments, changes in societal socioeconomic structure from monadic to semi-urban, and socio-cultural transitions including family structure and gender relations. Israeli governments do not recognize Bedouins as an indigenous minority, 40% of them live in legally unrecognized villages with houses that are continually threatened with demolition. These villages lack basic infrastructure including water, electricity, primary care clinics and social services. Conducting research among Bedouins requires building trust and recognizing their health and human rights while understanding their complex political, historical, and social contexts. Building on local knowledge is crucial and requires outstanding research methods. Other issues include attaining ethics approval, maintaining confidentiality, and overcoming language barriers as mothers lack basic reading and writing skills. Funding opportunities and scholarly publication requires additional effort and time. Recognizing these challenges might provide an opportunity for more advanced research among Bedouins and other indigenous populations.

 

Shapiro, Ephraim and Irit Elroy. “Mental Health Care Utilization Among the Most Traditionally Religious Jews and Muslims in Israel in an Era of Reform.” November 3, 2015, 2:30pm.

Background: Israel recently implemented mental healthcare system policy reform, with uncertain impact on utilization among subgroups. The most traditionally religious segments of Israeli society, including both Jews and Muslims,  have distinctive attitudes, behaviors and demographics, all of which can impact mental healthcare usage and the reform’s success. Prior research found some underutilization among the most religious Israelis despite universal health insurance ,  for reasons such as stigma,   yet the topic has been understudied.

Research Questions: 1) To what extent do Haredi/ultraorthodox Jews and traditional Arab Muslims in Israel seek and/or receive mental healthcare 2) Do results vary by key subgroups including religion and socioeconomic status?  3)What interventions can potentially be developed to increase use of needed mental health services among religious groups?

Methodology/Results: A random-sample survey of health utilization among all Israelis conducted in 2013 was analyzed. Outcomes included Mental healthcare utilization measures and attitudinal measures related to potential barriers. Religious group was categorized by self-report. Univariate and bivariate analyses were performed using health, religious, and socioeconomic factors. Chi-square statistics were produced. Over 2000 Israelis were surveyed including 275 Haredi/ultraorthodox  Jews and 225 traditional Muslims.  Variations were found by some but not all religious and socioeconomic subgroups. In addition, key informant interviews with religious, community and medical leaders were conducted and faith-based intervention opportunities identified

Conclusions:  Culturally-sensitive interventions can potentially be developed to increase appropriate mental health care utilization for religious Israelis. This issue is particularly timely after mental health reform when opportunities to change relevant attitudes and behaviors exist.

 

Shapira, Stav, Limor Aharonson-Daniel,Yaron Bar-Dayan, Deanna Sykes, and Bruria Adini. “Is Earthquake Preparedness a Generic Achievement? Similarities and Differences between Preparedness of Canadian and Israeli Hospital Personnel.” November 3, 2015, 4:30pm.

Background: Healthcare workers (HCW) willingness to report to work (WTR) during a disaster is essential to implementing an efficient response. A better understanding of the mechanisms underlying this matter may contribute to reduced absenteeism in future disasters. Assessing preparedness and WTR in an earthquake scenario, in different social contexts and preparedness approaches (Canada and Israel) may shed light on the complexity of these issues.

Objectives: 1) To assess knowledge, perceptions, attitudes and WTR of HCW in Canada and Israel concerning earthquakes and 2) To evaluate the relationship between these factors and WTR.

Methods: A validated questionnaire including questions about demographic characteristics, knowledge, perceptions, attitudes and WTR in an earthquake scenario was distributed in two tertiary care hospitals located in risk regions, to a random sample of 131 Israeli and 381 Canadian HCW.

Results: Knowledge, perceptions of efficacy, as well as WTR were generally higher among Israeli HCWs. ‘Concern for family’s well-being’ and ‘professional commitment to care’ were reported by the largest proportion of HCW as factors that might influence WTR. Significant predictors of WTR amongst both Israeli and Canadian HCW were the belief that ‘colleagues will also report to work’ and ‘professional commitment’.

Conclusions: Significant differences were found in levels of knowledge, perceptions, attitudes and WTR in an earthquake scenario between Israeli and Canadian HCW. Social and professional solidarity seems to be cross-cultural factors that mitigate other potential barriers to WTR. This may help formulate new methods of improving hospital personnel preparedness to future events.

 

Shapiro, Ephraim and Rachel Nisanholtz. “Community Nurses and Chronic Disease in Israel, the United States, and the United Kingdom: A Comparative Analysis.” November 4, 2015, 11:00am.

Background: The growing worldwide trend of chronic disease harms not only the public’s health but increases costs. Public health and other community nurses can play important roles in its prevention and control. These nurses can play vital roles in advancing national health system objectives. However, despite this there has been inadequate comparative study of community nurses’ role in preventing and controlling chronic disease.

Objectives: 1)What roles do public health and other community nurses play for  chronic disease prevention and control? 2)What trends and related challenges exist for these nurses in terms of chronic disease prevention and control? 3)How do these nurses’ roles, trends and challenges vary across Israel, the U.S., and the U.K and what lessons can be learned?

Methodology:  Key informant interviews and a comprehensive literature review were performed and themes related to the objectives analyzed. An average of 10 interviews was performed among nursing leaders and/or academic experts in each of the three countries.

Key Findings/Conclusions: The role of nurses in non-hospital settings has grown rapidly; further growth is expected to occur, with variations by type of nurse. They have a multiplicity of roles and can reach a wide variety of groups. There are important implications for reducing health disparities as nurses can play important roles in monitoring social determinants. While there is much overlap, important differences exist between community nurses in different settings; countries can learn from each other’s successes and challenges although contextual differences such as cultural, institutional, and policy and differences need to be understood.

New Article: Moran et al, Socioeconomic and Spatial Dimensions of Adolescent Obesity

Moran, Mika, R. Goldblatt, P. Plaut, R. Endevelt, and O. Baron-Epel. “The Socioeconomic and Spatial Dimensions of Adolescent Overweight and Obesity: The Case of Arab and Jewish Towns in Israel.” Journal of Environment and Health Sciences (early view; online first).

 

URL: http://dx.doi.org/10.15436/2378-6841.15.012

 

Abstract

Childhood and adolescent overweight/obesity is a major burden on public health worldwide. A growing body of empirical evidence highlights the impact of community characteristics of childhood obesity. This study explored socioeconomic and spatial variations of adolescent overweight/obesity in Israel by using an ecological approach. Towns’ socioeconomic and spatial characteristics were found associated with adolescent overweight/obesity in opposite directions in Jewish and Arab towns. Adolescent overweight/obesity was found to be more prevalent in Jewish towns characterized by lower socioeconomic rank (SER) and higher peripherality levels and in Arab towns characterized by higher SER and lower peripheraliy levels. Additionally, inequalities were found to be positively related to adolescent overweight/obesity in Jewish towns. After adjusting for SER, the associations between peripherality and adolescent overweight/obesity were attuned in Jewish towns, but not in Arab towns. These findings correspond with the literature, as the results obtained for the Jewish and Arab towns are consistent with studies conducted in developed and in developing countries, respectively. Therefore, the findings highlight the importance of macro level factors enhancing obesity, and suggest that national policy may benefit from town-level interventions addressing adolescent overweight/ obesity. Several explanations to the study’s findings are discussed, involving social, environmental and individual factors.

New Article: Mor et al, HIV/AIDS Prevalence in Israeli Prisons: Is There a Need for Universal Screening?

Mor, Zohar, Jonathan R. Eisenberg, Itamar Grotto, and Dini Tishler-Aurkin. “HIV/AIDS Prevalence in Israeli Prisons: Is There a Need for Universal Screening?” Journal of Public Health Policy (early view; online first).

 

URL: http://dx.doi.org/10.1057/jphp.2015.21

 

Abstract

This study aimed to assess HIV/AIDS point-prevalence among inmates and evaluate costs related to universal screening as currently practiced and appraise its necessity. All inmates newly incarcerated in Israel (2003–2010) underwent HIV tests and their medical files were cross-matched the with the national HIV/AIDS registry to who had been newly infected and detected on prison entry. They were classified by key risk-groups. Of 108866 new inmates during the period, 215 (0.2 per cent) were diagnosed with HIV/AIDS, 44 of those (0.04 per cent) were not aware of their infection. A large majority (94.2 per cent) of the infected inmates were members of a key-risk group: drug-users, homosexuals, or originating from a high-HIV prevalence country. The direct cost of detecting a single HIV-infected inmate who was not previously recorded was 12386. The HIV/AIDS-screening process can be improved by interviewing the new inmates and performing targeted HIV-testing for those who are members of a known risk-group. These data from Israel are pertinent to developed countries with low HIV prevalence, because they present a picture of all newly infected inmates over an 8-year period within the paradigm of a fully functional HIV surveillance system.

New Article: Popper-Giveon & Keshet, Choice of a Medical Career Among the Arab Minority in Israel

Popper-Giveon, Ariela, and Yael Keshet. “‘It’s Every Family’s Dream’: Choice of a Medical Career Among the Arab Minority in Israel.” Journal of Immigrant and Minority Health (early view; online first).

 

URL: http://dx.doi.org/10.1007/s10903-015-0252-7

 

Abstract
Application to medical studies and the choice of medicine as a career are influenced by many factors, some internal (academic ability, intellectual curiosity, interests) and some external (parental pressure, peer pressure, teacher and school expectations). Ethnicity plays a role in motivational orientation and belonging to an ethnic minority group may influence both internal and external motives and priorities in choosing medicine as a career. In this article, we present a qualitative study of the motives that impel Arab physicians in Israel to choose a medical career. As a theoretical framework, we apply self-determination theory (SDT) (Ryan and Deci in Am Psychol 55:68–78, 2000), consisting of three principal categories situated along a continuum: Amotivation, extrinsic motivation and intrinsic motivation. We show that extrinsic motivation is dominant among Arab physicians in Israel, demonstrating specifically the unique political context and cultural characteristics of Arab society in Israel. These findings, and the attention to the unique motivations of people from different ethnic minority groups who choose medical career, may increase the number of physicians from minority groups, a step known to decrease health gaps in multi-cultural contexts.

 

 

New Article: Southern et al, Varied Utilisation of Health Provision by Arab and Jewish Residents in Israel

Southern, Jo, Hector Roizin, Muhannad Daana, Carmit Rubin, Samantha Hasleton, Adi Cohen, Aviva Goral, Galia Rahav, Meir Raz, and Gili Regev-Yochay. “Varied Utilisation of Health Provision by Arab and Jewish Residents in Israel.” International Journal for Equity in Health (early view; online first).

 

URL: http://link.springer.com/article/10.1186/s12939-015-0193-8

 

Abstract

Introduction

Provision of healthcare is considered a basic human right. Delivery and uptake is affected by many complex factors. Routine vaccinations are provided free of charge in Israel to all residents. The Palestinian Israeli Collaborative Research (PICR) group conducted research on vaccine impact at eight primary care facilities in east Jerusalem (EJ) and central Israel (IL) which allowed assessment and comparison of interactions of these Arab and Jewish populations, respectively, with healthcare services.

Methods

Families attending clinic with a child under five years old were invited to participate. Utilisation of healthcare was assessed using data from standardise questionnaires completed after enrolment, using proxies of vaccination status, antibiotic use, primary care physician and hospital visits as well as demographics such as household size. Differences between EJ and IL were assessed using chi squared tests; univariate analyses identified potential confounders which were tested in a multiple logistic regression model for any independent associations between region and outcome.

Results

Children in EJ were significantly more likely to live in larger households, with tobacco smokers, to have been breastfed, hospitalised and used antibiotics recently than those in IL, who were significantly more likely to have recently seen a primary care physician (all p < 0.01). Receipt of routine vaccinations, given at well baby clinics, was similar between the regions at above 95 % (p = 0.11), except for influenza which was delivered separately at primary physician clinics to 5 % (EJ) and 12 % (IL). Receipt of pneumococcal vaccine when paid for separately was significantly higher in IL than EJ (3 % vs 31 %). Multivariate analysis identified the most important independent predictors of these differences as region, age and household size.

Conclusions

Healthcare in Israel is of a very high standard, but it is not uniformly utilised within the community in all geographical areas, though in some key areas, such as uptake of most routine childhood vaccination, equality seems to be achieved. To ensure excellent healthcare is achieved across the population, inequalities must be addressed, for instance in health promotion and other activities, which could improve and normalise health outcomes.

 
 
 
 

New Article: Na’amnih et al, Continuous Decrease of Consanguineous Marriages

Na’amnih, Wasef, Orly Romano-Zelekha, Ahmed Kabaha, Liza Pollack Rubin, Natalya Bilenko, Lutfi Jaber, Mira Honovich, and Tamy Shohat. “Continuous Decrease of Consanguineous Marriages among Arabs in Israel.” American Journal of Human Biology 27.1 (2015): 94-98.

 

URL: http://dx.doi.org/10.1002/ajhb.22610

 

Abstract

Objectives

To describe the trend in the rate of consanguineous marriages among the Israeli Arab population and to identify factors associated with this custom shift in recent years.

Methods

The study was conducted between November 2009 and January 2010 in Family Health Centers. A questionnaire was presented to parents during routine visits to the center with their children.

Results

Information on 6,437 couples was collected. The rate of consanguineous marriages decreased from 35.8% among those married before 2000, to 28.2% among those married in 2000–2004, and to 24.0% among those married in 2005–2009 (P for trend <0.001). First cousin marriages were the most common type of consanguineous marriages in all the time periods. Consanguineous marriages were associated with consanguinity between the couples’ parents (both husband and wife), a high consanguinity rate in the place of residence and younger age at marriage (wife).

Conclusions

The rates of consanguineous marriages among Israeli Arabs are decreasing but still high. Because consanguineous marriages are widely acceptable, the role of public health professionals and primary care personnel is to provide comprehensive information about the potential genetic risks of consanguinity on offspring health and to increase the accessibility of premarital and preconception counseling services.

New Article: Sharkia et al, Utilization of Genetic Counseling Services among Israeli Arab Women

Sharkia, R., J. Tarabeia, A. Zalan, E. Atamany, M. Athamna, and S. Allon-Shalev. “Factors Affecting the Utilization of Genetic Counseling Services among Israeli Arab Women.” Prenatal Diagnosis 35.4 (2015): 370-375.

URL: http://dx.doi.org/10.1002/pd.4550

Abstract

Objectives

To assess the factors associated with utilization of genetic counseling services among pregnant Israeli Arab women.

Methods

A case–control study was conducted among 414 pregnant Arab women who were referred by a family physician or a perinatologist to genetic counseling services between 2008 and 2011. Data was collected using interviews, with both groups ‘users’ and ‘non-users’ of genetic counseling, based on a structured questionnaire including demographic, socio-economic, medical and cultural variables.

Results

In multivariate analysis, factors affecting women’s utilization of genetic counseling service were high income level (OR 3.44, 95%CI 1.8–6.5, p < 0.001), high service accessibility (OR 0.75, 95%CI 0.67–0.84, p = 0.001), more positive attitude toward genetic counseling (OR 0.43, 95%CI 0.27–0.67, p = 0.012) and lower religiosity level (OR 1.40, 95%CI 0.94–2.09, p = 0.04). However, when we examined the following variable: pregnant woman’s age, woman’s education, consanguinity and pregnancy’ age, knowledge level and the perspective toward abortion, no significant differences were found between the users and non-users groups.

Conclusions

The underutilization of genetic counseling services among pregnant Israeli Arab women was associated with the following: lower income level, attitude toward genetic counseling, accessibility to service and religiosity. Thus, it is advisable to expand genetic counseling service within this community

New Article: Meydan et al, Managing the Shortage of Acute Care Hospital Beds

Meydan, Chanan, Ziona Haklai, Barak Gordon, Joseph Mendlovic, and Arnon Afek. “Managing the Increasing Shortage of Acute Care Hospital Beds in Israel.” Journal of Evaluation in Clinical Practice 21.1 (2015): 79-84.

 

URL: http://dx.doi.org/10.1111/jep.12246

 

Abstract

Rationale, aims and objectives

Israel’s healthcare system has been facing increasing hospital bed shortage over the last few decades. Community-based services and shortening length of stay have helped to ease this problem, but hospitals continue to suffer from serious overload and saturation. The objective of this study is to present hospitalization trends in Israel’s internal medicine departments.

Methods

The data is based on the National Hospital Discharges database (NHDR) in the Israeli Health Ministry, pertaining to hospitalizations in all internal medicine departments nationwide between 2000 and 2012.

Results

Total yearly hospitalization days, representing healthcare burden, had increased by 4.2% during the study period, driven mainly by the most advanced age groups. The rate of total hospitalization days per 100,000 people for all the age groups has decreased by 17.6%, but the oldest patient group had a modest reduction in comparison (7.5%). The parameter of age correlated with length of stay and readmission rates, and neither decreased during the surveyed years.

Conclusions

These results demonstrated that the healthcare burden on acute internal medicine services has been reduced mostly for middle-aged populations but only modestly for elderly populations. The length of hospital stay and the readmission rates have reached and maintained a plateau in recent years, regardless of age. The findings of this study call for planning specific to elderly populations in light of changing demographics. Possible directions may include renewed emphasis on internal medicine and geriatric medicine, and efforts to shorten hospitalization time by extended utilization of multidisciplinary primary care.