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Binder, Louis, Desmond Colohan, Wolfgang Dick, Bernard Nemitz, Yoel Donchin i Noriyoshi Ohashi. "Pregraduate Training in Emergency Medicine". Prehospital and Disaster Medicine 8, nr 1 (marzec 1993): 69–75. http://dx.doi.org/10.1017/s1049023x00040048.
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AbstractA panel session on undergraduate education in Emergency Medicine from a worldwide perspective was conducted at the Seventh World Congress of Emergency and Disaster Medicine in Montreal, in May, 1991. Desmond Colohan MD, of the University of Toronto (Canada) was the panel moderator. Panel speakers were: Louis Binder MD, Texas Tech University Health Services Center (USA); Wolfgang Dick MD, University of Mainz (Germany); Bernard Nemitz MD, Faculty de Medicine d'Ameins (France); Yoel Donchin MD, Hadassa Medical Organization (Israel); and Noriyoshi Ohashi MD, Tsukuba Medical Center (Japan).
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Koch, Noam, Liat Applebaum, Haggi Mazeh, Lilach Katz i Rena Pollack. "Interobserver Variability in Ultrasound Reporting - Tertiary Hospital Radiologists Do Better". Journal of the Endocrine Society 5, Supplement_1 (1.05.2021): A863. http://dx.doi.org/10.1210/jendso/bvab048.1762.
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Abstract Introduction: Thyroid Imaging Reporting and Data System (TI-RADS) was developed to provide a standardized risk-stratification system for patients with thyroid nodules. Single-center studies have demonstrated an acceptable level of interobserver agreement in applying TI-RADS in clinical practice, however data regarding consistency among different centers is limited. In Israel, thyroid nodules are initially evaluated by ultrasound performed by radiologists at the health maintenance organization (HMO) and then patients are referred to tertiary hospitals for ultrasound-guided fine needle aspiration (FNA) biopsy when indicated. Objective: To evaluate the interobserver concordance in TI-RADS classification system reporting between the HMO and a tertiary hospital. Methods: We performed a retrospective analysis of the sonographic features of 370 thyroid nodules TI-RADS category 2 or higher, from 350 patients evaluated by ultrasound at the HMO and at Hadassah Medical Center from January 1, 2018 to December 31, 2019. The primary outcome was concordance between the TI-RADS classification at the HMO compared to the hospital. Additional endpoints included correlation of TI-RADS to the Bethesda category following FNA, and correlation of TI-RADS with malignancy on final pathology. Results: Of 370 nodules, only 73 (19.8%) demonstrated concordance between the HMO and the hospital. The level of agreement was poor, with 277 (74.8%) nodules demonstrating higher TI-RADS at the HMO compared to the hospital, and 20 (5.4%) with lower TI-RADS at the HMO compared to the hospital (p<0.001, weighted Kappa = 0.120). Of the nodules referred to the hospital, 241 (65.1%) were selected for FNA. A strong correlation between the hospital TI-RADS and Bethesda category was demonstrated (p<0.001). Furthermore, 60 (16.2%) nodules were surgically removed. A strong correlation was identified between the hospital TI-RADS and malignancy on final pathology (p<0.001), yet there was no correlation with the TI-RADS of the HMO (p=0.346). Conclusions: There is poor concordance between TI-RADS classification on ultrasound performed in the HMO compared to a tertiary hospital. In patients who underwent FNA and eventually surgery, the hospital TI-RADS strongly correlated with Bethesda category and final risk of malignancy. Standardization of thyroid ultrasound terminology and dedicated training in thyroid imaging are needed to improve the interobserver concordance in clinical practice.
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Steir-Livny, Liat. "One Trauma, Two Narratives: Adamah versus Tomorrow’s a Wonderful Day". Folklore: Electronic Journal of Folklore 83 (sierpień 2021): 135–54. http://dx.doi.org/10.7592/fejf2021.83.steir_livny.
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In the three years after World War II, prominent Jewish organizations in the United States and in the Land of Israel made films aimed at promoting Zionist goals. The film Adamah (Helmar Lerski, 1948) was produced in the Land of Israel with the support of the Jewish-American volunteer women’s organization Hadassah. It tells the rehabilitation story of Benjamin, a Holocaust survivor in the Land of Israel. When the final version was sent to Hadassah for approval, the directorate felt that the American public would not relate to it. Hadassah altered the footage and distributed its own version entitled Tomorrow’s a Wonderful Day (1949). This article presents a comprehensive analysis of the main differences between the two representations of trauma, which were taken from the same footage but shaped into two differing narratives. Based on studies in Zionism and a great deal of archival material, it shows how these films epitomized the differences in the perception of trauma and its representations between the Zionist organizations in the Land of Israel and the USA.
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Kyle, Robert A., i Marc A. Shampo. "Henrietta Szold—Founder of Hadassah Medical Organization". Mayo Clinic Proceedings 63, nr 12 (grudzień 1988): 1268. http://dx.doi.org/10.1016/s0025-6196(12)65418-4.
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West, Debra Gershov, Evan Avraham Alpert i George Braitberg. "Integrating the six C’s of disaster response: Lessons from the mega terrorist attack on October 7, 2023". American Journal of Disaster Medicine 19, nr 2 (1.04.2024): 175–78. http://dx.doi.org/10.5055/ajdm.0476.
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On October 7, 2023, over 2,500 Hamas terrorists infiltrated Israel from Gaza and killed over 1,400 people and injured 2,800, resulting in the largest terrorist attack in Israel’s history. Several models describe the principles of managing a mass casualty event. One of them is an Australian construct known as the six C’s. While command, control, and coordination are familiar concepts, the six C’s emphasize the importance of communication and community (consequences and community connection). We describe how two emergency departments in Israel—Assuta Ashdod and the Hadassah Medical Center-Ein Kerem—responded to this disaster in the context of the six C’s.
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Liebergall, Michal H., Nava Braverman, Shmuel C. Shapira, Orly Picker Rotem, Irene Soudry i Shlomo Mor-Yosef. "Role of Nurses in a University Hospital During Mass Casualty Events". American Journal of Critical Care 16, nr 5 (1.09.2007): 480–84. http://dx.doi.org/10.4037/ajcc2007.16.5.480.
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Mass casualty events due to terror attacks have escalated throughout Israel since September 2000, with a high proportion of these events occurring in the Jerusalem area. Immediately after news of a large-scale terror attack is received, family/public information centers are set up in all local hospitals to meet the needs of members of the public who call or arrive at hospitals anxious to obtain information about relatives who may have been at the site of the attack. The most urgent task facing these centers is the quick and accurate identification of victims whose identity is in question. To date, some 3000 casualties have been treated at Hadassah Hebrew University Medical Center (Hadassah), a level I trauma center. This number accounts for nearly half of Israel’s total number of casualties from terror attacks during this period. Extensive experience has led the hospital to develop a unique organizational model for its family/public information center; in this model, members of the nursing staff identify casualties. The experience and knowledge gained in dealing with terror events also can be applied to other types of mass casualty events, such as major road or work accidents.
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Hawley, Carolyn E., Amy J. Armstrong, Shimon Shiri, Jenna Czarnota, Sara Blumenfeld, Isabella Schwartz i Zeev Meiner. "Post-Traumatic Growth Following Politically Motivated Acts of Violence: 10 Years Post Injury". Australian Journal of Rehabilitation Counselling 23, nr 1 (10.05.2017): 1–18. http://dx.doi.org/10.1017/jrc.2017.6.
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The study explored posttraumatic growth (PTG) and its relationship with the quality of life (QOL), posttraumatic stress, and resilience among survivors of terror attacks over 10 years post-injury. Participants were patients of Hadassah Medical Center, Israel, who were injured in terror attacks between 2000 and 2004 during the second Intifada. Variables of interest were obtained from a survey and patients' medical files. In total, 42 patients participated, 66% were men, and the average age was 41.4 years. Multivariate analysis was utilized to predict PTG from a variety of demographic variables including gender, ethnicity, relationship status, age, education, income, religiosity, and injury/disability type. Additional primary variables of study included current levels of QOL, posttraumatic stress, and resilience. Results revealed that married/partnered individuals had higher levels of PTG than divorced or single individuals. Findings suggest that social support following trauma is important for PTG and should be prioritized in recovery interventions with trauma survivors.
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Yanko, Robert, Yaara Badran, Shirley Leibovitz, Yair Sharav, Yuval Vered, Naama Keshet, Andra Rettman, Doron J. Aframian i Yaron Haviv. "Exploring the Effect of Ethnicity on Chronic Orofacial Pain: A Comparative Study of Jewish and Arab Israeli Patients". Healthcare 11, nr 14 (8.07.2023): 1984. http://dx.doi.org/10.3390/healthcare11141984.
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The relationship between ethnicity and chronic pain has been studied worldwide. The population of Israel includes two main ethnic groups, 75% Jews and 21% Arabs. The purpose of this study was to compare orofacial chronic pain characteristics and treatment outcomes between Jewish and Arab Israeli citizens. Two hundred patients admitted to the Orofacial Pain Clinic at Hebrew University–Hadassah School of Dental Medicine between 2017 and 2022 were selected randomly for this historical cohort study. Our cohort included 159 (79.5%) Jews and 41 (20.5%) Arabs. Twenty-six pain-related variables were compared of which only two differed significantly between the two groups, awakening due to pain and mean muscle sensitivity; both indicators were higher in the Arab group (p < 0.05). No differences were found in any of the other variables such as diagnosis, pain severity, onset, and treatment outcome. This minimal difference may be explained by the equal accessibility to medical services for all citizens, and the diversity of our staff that includes Jew as well as Arab service providers. These factors minimize or even eliminate racial bias, language, and cultural barriers, and is reflected in the minor differences in orofacial pain characteristics found between the two main ethnic groups in Israel.
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Zahran, Shadi, Ran Nir-Paz, Ora Paltiel, Chen Stein-Zamir i Yonatan Oster. "Are Healthcare Workers Infected with SARS-CoV-2 at Home or at Work? A Comparative Prevalence Study". International Journal of Environmental Research and Public Health 19, nr 19 (10.10.2022): 12951. http://dx.doi.org/10.3390/ijerph191912951.
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Prior to the widespread use of vaccinations, healthcare workers (HCWs) faced the double burden of caring for unprecedented numbers of critically ill COVID-19 patients while also facing the risk of becoming infected themselves either in healthcare facilities or at home. In order to assess whether SARS-CoV-2-positivity rates in HCWs reflected or differed from those in their residential areas, we compared the SARS-CoV-2-positivity rates during 2020 among HCWs in Hadassah Hebrew University Medical Centers (HHUMC), a tertiary medical center in Jerusalem, Israel, to those of the general population in Jerusalem, stratified by neighborhood. Additionally, we compared the demographic and professional parameters in every group. Four percent of the adult population (>18 years) in Jerusalem tested positive for SARS-CoV-2 during 2020 (24,529/605,426) compared to 7.1% of HHUMC HCWs (317/4470), rate ratio 1.75 (95% CI 1.57–1.95), with wide variability (range 0.38–25.0) among different neighborhoods. Of the 30 neighborhoods with more than 50 infected HCWs, 25 showed a higher positivity rate for HCWs compared to the general population. The higher risk of HCWs compared to residents representing the general population in most neighborhoods in Jerusalem may be explained by their behavior in and out of the hospital.
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Soskolne, Varda, Omer Bonne, Atara Kaplan Denour i Arieh Y. Shalev. "Depressive Symptoms in Hospitalized Patients: A Cross-Sectional Survey". International Journal of Psychiatry in Medicine 26, nr 3 (wrzesień 1996): 271–85. http://dx.doi.org/10.2190/v1ah-4bnn-wddy-ynfd.
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Objective: To evaluate the level of depressive symptoms among medical inpatients, and to examine the associations with sociodemographic, medical, and psychosocial characteristics. Method: A point prevalence study (1 day) of all adult medical patients hospitalized at Hadassah University Hospital. Patients who were too incapacitated to be interviewed were excluded. The questionnaire included sociodemographic data, social supports (MOS Social Support Scale), Multidimensional Health Locus of Control (MHLC), and depressive symptoms (CES-D scale). Medical data were collected from the patients' charts. Of the 331 eligible patients, 256 (77%) were interviewed. Results: The level of depressive symptoms was high (mean = 21, s.d. = 12). About 60 percent of the patients had scores above 16, which is the suggested cut-off point for psychopathology. A multifactorial analysis of covariance showed that higher scores of depression were significantly ( p < 0.01) associated with being a female, with lower scores of internal and higher scores of external health locus of control and only marginally ( p = .08) with medical diagnosis (multiple R2 = .33, multiple R = .58). Depressive symptoms were not associated with age, education, marital status, social supports, type of admission, ward, or length of stay prior to evaluation. Conclusions: The high levels of depressive symptoms found across medical and most of the personal and social characteristics in this first survey of its kind in Israel may reflect a reaction to the event of hospitalization; sex and locus of control may be suggested as risk markers of elevated depression to be used for screening and prompt psychiatric consultation in this population.
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Dann, Eldad J., Neta Goldschmidt, Vered Heffes, Tanya Mashiach, Moshe E. Gatt i Netanel A. Horowitz. "Addition of Intermediate-Dose Methotrexate Is Beneficial in Terms of Both Progression-Free Survival and Overall Survival for Patients with Diffuse Large B Cell Lymphoma Receiving Either R-CHOP or CHOP". Blood 128, nr 22 (2.12.2016): 1877. http://dx.doi.org/10.1182/blood.v128.22.1877.1877.
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Abstract Introduction: Patients with diffuse large B cell lymphoma (DLBCL) and high International Prognostic Index (IPI) or extra-nodal disease are at an increased risk of systemic and central nervous system (CNS) relapse. Presently, the management of DLBCL patients at the Rambam Health Care Campus (Haifa, Israel) and Hadassah Medical Center (Jerusalem, Israel) includes 6 cycles of R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone) along with 4 doses of intrathecal (IT) methotrexate (MTX), which may be followed by 2 additional cycles of an intermediate dose (3 g/m2) of intravenousMTX (ID-MTX). The current study compared progression-free survival (PFS), overall survival (OS) and CNS relapse rate in a cohort of DLBCL patients with risk factors for CNS relapse who did or did not undergo prophylactic therapy with ID-MTX. Methods: Four hundred and eighty DLBCL patients treated at two tertiary care centers (Rambam and Hadassah) between the years 1991 and 2013 were retrospectively evaluated. The cohort included 224 females and 256 males at a median age of 58 years (range18-76). OS, PFS and CNS involvement at relapse were analyzed. The study incorporated all patients with the primary diagnosis of DLBCL and risk factors for CNS relapse, i.e., Waldeyer ring (2%), breast (1%), testicular (3%) or orbita (1%) involvement, bone marrow involvement (21%), stage IV disease (64%), LDH higher than normal (70%), ≥1 extra-nodal site (28%), IPI ≥3 (36%). Eight percent of patients had stage I-IE disease, 17% - stage II-IIE, 11% - stage III, 64% - stage IV, 29% had B symptoms. Patients with CNS involvement at diagnosis were excluded from the analysis. Results: Four hundred and seventy three patients (99%) were treated with either CHOP or CHOP-like regimen, and 384 (80%) patients received rituximab (R). In the R-CHOP cohort, 23% of patients with IPI 0/1, 28% with IPI 2 and 42% with IPI ≥3 were given prophylaxis. One hundred and thirty patients received ID-MTX (27%), 35 patients (7%) received IT-MTX only, while no prophylaxis was administered to 315 patients (66%). The cumulative incidence of CNS relapse at 5 years was 6%, with no difference in the incidence between the patients who received prophylaxis with ID-MTX, IT-MTX or were given no prophylaxis at all. Patients with IPI ≥3 treated with ID-MTX had a decreased overall relapse rate and significantly superior OS and PFS (Table 1; Figure 1). Conclusion: In the current study, the addition of two cycles of ID-MTX to the standard R-CHOP regimen resulted in improved 5-year PFS and OS of DLBCL patients with IPI ≥3. These data need to be further confirmed in a randomized controlled study. Disclosures No relevant conflicts of interest to declare.
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Mimouni, Michael, Yinon Shapira, Janan Jadon, Shahar Frenkel i Eytan Z. Blumenthal. "Assessing Visual Function Behind Cataract: Preoperative Predictive Value of the Heine Lambda 100 Retinometer". European Journal of Ophthalmology 27, nr 5 (26.05.2017): 559–64. http://dx.doi.org/10.5301/ejo.5000993.
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Purpose To analyze the accuracy of the Lambda 100 (Heine) potential visual acuity (VA) measurements in subjects undergoing cataract surgery. Methods The medical records of all consecutive patients who underwent clear corneal incision phacoemulsification cataract surgery by a single surgeon between 2010 and 2012 at the Department of Ophthalmology, Hadassah Medical Center, a tertiary care hospital in Jerusalem, Israel, were reviewed. Subjects age 18 or older with a follow-up time of at least 30 days were included. Subjects with previous ocular comorbidities other than glaucoma were excluded. In addition, patients with intraoperative or perioperative complications that could affect final VA were excluded. Analyses were performed to analyze the accuracy of preoperative retinometer potential VA as a predictor of postoperative best-corrected VA. Results A total of 374 operated eyes were included. There was a moderate positive correlation between Lambda estimated VA potential and postoperative achieved best-corrected VA (BCVA) (β coefficient 0.35, p<0.0001). Overall Lambda accurately (within 2 Snellen lines) estimated postoperative BCVA results in 60% of cases. The accuracy of prediction was significantly better in moderate cataracts when compared with advanced cataracts (p<0.01) with a twofold tendency towards underestimation in advanced cataracts. A Lambda ≥0.5 decimal has a calculated positive predictive value of 82% and a negative predictive value of 40% for predicting postoperative BCVA outcome ≥0.5 decimal. Conclusions Lambda may be used to relatively accurately predict postoperative BCVA in cataract patients, specifically in those with moderate cataracts.
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Porat, Nurit, Orly Picker-Rotem, Amalia Shneider, Efrat Weingart-Eimerl, Ofra Vaknin, Orly Toren, Galit Dayan, Nira Bartal i Revital Zelker. "Creating a Vision for Nursing Practice in a Tertiary Medical Organization in Israel". Journal for Nurses in Staff Development (JNSD) 27, nr 1 (styczeń 2011): 18–24. http://dx.doi.org/10.1097/nnd.0b013e3182061ccc.
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Shemer, Joshua, Ori Heller i Jakov Adler. "Lessons from the Israel Defense Forces Medical Corps' Experience in the Organization of International Medical Disaster Relief Forces". Prehospital and Disaster Medicine 7, nr 3 (wrzesień 1992): 282–84. http://dx.doi.org/10.1017/s1049023x00039649.
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Natural and man-made disasters continue to be a major cause of morbidity and mortality. Natural disasters include earthquakes, storms such as hurricanes, floods, fires, drought. Man-made disasters include fires, explosions, chemical and radioactive releases, major transportation accidents, terrorism, and war. The effects of disaster include injury, death, damage to infrastructure, environmental exposure, population movement, and increased incidence of communicable diseases.
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Weiss, Dorit. "The Polio Epidemic in Israel, 1949-1956". Iyunim, Multidisciplinary Studies in Israeli and Modern Jewish Society 34 (1.12.2020): 172–99. http://dx.doi.org/10.51854/bguy-34a107.
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The polio epidemic broke out in Israel in July 1949, soon after the establishment of the State and during a period of mass immigration. The fledgling Ministry of Health was in the stage of creating the medical system and infrastructure and was still in the process of formulating policy. The new State of Israel now faced a complex, multifaceted challenge, at a time when it was vigorously seeking acceptance and recognition of its standing in the UN and the World Health Organization (WHO). The healthcare system battled the epidemic for over four years. In view of the severity of the situation and the lack of alternative solutions, the heads of the healthcare system adopted their own independent policy. Demonstrating professional courage, they undertook the manufacture of vaccines and initiated a mass vaccination campaign. Israel’s handling of the epidemic boosted the country’s standing and reputation among medical professionals worldwide and in the WHO. In addition to laboratories for producing vaccines, Israel developed treatment, rehabilitation and monitoring systems. The impressive response of the Israeli public health authorities to the epidemic established its position among the leading countries worldwide in the field of preventive medicine.
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Karol, Dalia. "The Power of Global Surgery: A Medical Student’s Experience At Save A Child’s Heart (SACH)". University of Ottawa Journal of Medicine 8, nr 1 (7.05.2018): 75–77. http://dx.doi.org/10.18192/uojm.v8i1.2351.
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This elective report provides an overview of the experience of a 1st year medical student completing a global pediatric cardiac surgery elective at Save A Childs Heart (SACH), an Israeli Non-Governmental Organization (NGO). SACH provides life saving cardiac surgery to children from developing countries who would otherwise not have access to care. Children are screened in their home countries, and brought to Israel for these complex surgical procedures. This elective is unique, as it exposes medical students to leading experts in cardiac surgery, cardiology, pediatric ICU, as well as international residents and international patients.
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Shushan, Asher, Ora Paltiel, Jose Iscovich, Uri Elchalal, Tamar Peretz i Joseph G. Schenker. "Human menopausal gonadotropin and the risk of epithelial ovarian cancer **Supported in part by a grant from the Joint Research Fund of the Hebrew University and Hadassah Medical Center, Jerusalem, Israel." Fertility and Sterility 65, nr 1 (styczeń 1996): 13–18. http://dx.doi.org/10.1016/s0015-0282(16)58020-0.
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Zherebovich, Irena, Avishay Goldberg, Amir Ben Tov i Dagan Schwartz. "Resuscitation in Community Healthcare Facilities in Israel". International Journal of Environmental Research and Public Health 18, nr 12 (19.06.2021): 6612. http://dx.doi.org/10.3390/ijerph18126612.
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Background: Out-of-hospital cardiac-arrest (OHCA) is a major public health challenge. Community health care providers (CHP) may play an important role through early identification, basic life support and defibrillation. Few studies have evaluated the incidence and characteristics of OHCAs initially cared for by CHP, most finding improved survival. This study combined CHP treated OHCA case analysis, with assessment of provider resuscitation preparedness. Methods: An analysis of all CHP initiated resuscitations in a large Health Maintenance Organization (HMO) reported over 42 months, coupled with an online survey assessing CHP resuscitation knowledge, experience, training and self-confidence. Results: 22 resuscitations met inclusion criteria. In 21 CHP initiated chest-compressions but in only 8 cases they utilized the clinic’s automated external defibrillator (AED) prior to emergency medical services (EMS) arrival. There were 275 providers surveyed. Of the surveyed providers, 89.4% reported previous basic life support (BLS)/advanced cardiovascular life support (ALS) training, 67.9% within the last three years. Previous resuscitation experience was reported by 72.7%. The lowest scoring knowledge question was on indications for AED application −56.3%. Additionally, 44.4% reported low confidence in their resuscitation skills. CHP with previous cardiopulmonary resuscitation (CPR) experience reported higher confidence. Longer time since last CPR training lowered self-confidence. Conclusions: Early AED application is crucial for patients with OHCA. All clinics in our study were equipped with AED’s and most CHP received training in their use, but remained insecure regarding their use, often failing to do so.
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Kertes, Jennifer, Sharon Baruch Gez, Yaki Saciuk, Lia Supino-Rosin, Naama Shamir Stein, Miri Mizrahi-Reuveni i Anat E. Zohar. "Effectiveness of mRNA BNT162b2 Vaccine 6 Months after Vaccination among Patients in Large Health Maintenance Organization, Israel". Emerging Infectious Diseases 28, nr 2 (luty 2022): 338–46. http://dx.doi.org/10.3201/eid2802.211834.
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Lichtenberger, Paola, Ian N. Miskin, Gordon Dickinson, Mitchell J. Schwaber, Omer E. Ankol, Marcus Zervos, Rafael E. Campo, Susanne Doblecki-Lewis, Mark Alain Déry i L. Silvia Munoz-Price. "Infection Control in Field Hospitals after a Natural Disaster: Lessons Learned after the 2010 Earthquake in Haiti". Infection Control & Hospital Epidemiology 31, nr 9 (wrzesień 2010): 951–57. http://dx.doi.org/10.1086/656203.
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After the January 12, 2010, earthquake in Haiti, Project Medishare and the University of Miami organized, built, and staffed a 200-bed field hospital (the University of Miami Hospital in Haiti [UMHH] ) on the outskirts of Port-au-Prince. We describe the operational challenges of providing a safe environment at the UMHH. Furthermore, we compared how these issues were addressed at this ad hoc hospital with how they were addressed at the field hospital of the Israel Defense Force, a fully deployable hospital with an organization fine-tuned as a result of prior disaster situations, also in Haiti.
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Bar-Haim, Ronit, Vered Amitzi i Keren Holzman. "Resilience Trustees Program in Hospitals–A Case Study: Wolfson Hospital, Israel". Prehospital and Disaster Medicine 38, S1 (maj 2023): s211. http://dx.doi.org/10.1017/s1049023x23005393.
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Introduction:Medical and paramedical staff endure a psychological toll of burn-out as part of the heavy personal consequences of their work, with an immeasurable increase during the Covid-19 pandemic outbreak. In Israel, there is an added stress of the highly unstable political situation, including war and racial-riots with direct hits of missiles leading to mass casualty events. Members often had to stay in the hospitals for days as the roads home were blocked. Wolfson Medical Center (WMC) is a medium size, level II hospital in the center of Israel. It serves a complex population, most from low to medium socioeconomic status, and a large population of displaced persons. The responsibilities of the staff weigh heavy, leading to psychological trauma, with clear signs of anxiety, depression and suicide.Israel Trauma Coalition (ITC) is a non-profit organization collaborating with over 40 organizations to create a continuum of care in psycho-trauma, response and preparedness.Method:ITC has initiated a Resilience-Trustees program, establishing a strong and active group within the organization, with adequate representation from each department and profession. Training the team to identify a colleague in distress, to respond adequately and to refer to professional help as needed. The program has started implementation in various hospitals in Israel, including WMC.Results:The expected results of this program is a change in the organization's culture of discourse and daily interaction so as to promote resilience and mutual trust and to help cope favorably with crisis situations. The actual results will be shown through a case study of the WMC team of Resilience Trustees, in accordance with the steps of the program (resilience in the original team, then the overall staff).Conclusion:This initiative will promote awareness and acceptance of mental, personal and team difficulties, as well as reduce risks of secondary traumatization, burnout and other disorders.
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Chodick, Gabriel, Varda Shalev, Yariv Gerber, Anthony D. Heymann, Haim Silber, Virginia Simah i Ehud Kokia. "Long-term persistence with statin treatment in a not-for-profit health maintenance organization: A population-based retrospective cohort study in Israel". Clinical Therapeutics 30, nr 11 (listopad 2008): 2167–79. http://dx.doi.org/10.1016/j.clinthera.2008.11.012.
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Majkić-Singh, Nada. "Neighboring countries: The same professional aim in development laboratory medicine". Journal of Medical Biochemistry 38, nr 2 (3.03.2019): 196–200. http://dx.doi.org/10.2478/jomb-2019-0007.
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Summary During 15th Belgrade Symposium for Balkan Region (April 11 and 12, 2019, Belgrade, www.dmbj.org.rs) Society of Medical Biochemists of Serbia organized scientific and professional program with aim to discuss laboratory medicine topics of mutual interest for all the countries of the Region, such as: Laboratory Medicine Planning and Organization Type of Medical Laboratory and Strategy Laboratory Medicine Management Leadership Skills Accreditation and Competences Environmental Health and Safety Laboratory Standards in Balkan Countries Experiences of Young Scientists Students Achievements Together with the countries from Balkan Region the countries from our neighborhood as Italy, Austria, Hungary, Cyprus and Israel have been invited to discuss this important topics and exchange the mutual experiances with aim to improve the laboratory medicine in our countries and to help our colleagues to improve daily laboratory practice in our countries. Also participation in the Symposium took colleagues from France and Belgium.
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Breuer, William, Hussam Ghoti, Hesham Jeadi, Ada Goldfarb, Eliezer A. Rachmilewitz i Zvi Ioav Cabantchik. "Comparison of Overt and Cryptic Labile Plasma Iron In Thalassemia Patients In Israel and Gaza-Palestine". Blood 116, nr 21 (19.11.2010): 5166. http://dx.doi.org/10.1182/blood.v116.21.5166.5166.
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Abstract Abstract 5166 Background. Systemic iron overload (SIO) is characterized by persistently high levels of plasma iron that often surpass transferrin's (Tf) binding capacity and generate chemical forms identified as non-Tf bound iron (NTBI). These forms have been perceived as: a. clinically important indicators of SIO per se and of impending organ damage, because cells chronically exposed to iron overloaded plasma attain iron levels and ensuing ROS formation that override their antioxidant capacities and b. as pharmacological targets for chelation and thereby of prevention of tissue iron overload. However, NTBI determination in the clinical setting has been confounded by the chemical heterogeneity of iron forms found in fluids like plasma/sera of SIO patients, the presence of residual amounts of undefined chelates or chelators and the need to dislodge NTBI from native ligands with agents that facilitate its detection. We have assayed the overt forms of NTBI that represent the native pool of labile (= redox-active, chelatable and membrane permeant) iron in plasma/serum. We defined it as ‘labile plasma iron' or LPI and analyzed it by the Aferrix FeROS™ test (1) and used it to asses chelation regimens in their ability to maintain patients' plasma at relatively low (basal) LPI levels (<0.4 μ M, ref. 2). Detection of NTBI forms with both low redox activity and poor chelator accessibility (defined as cryptic LPI) can also be done with the FeROS™ test by supplementing samples with an agent (nitrilotriacetate= NTA < 0.5 mM) that in plasma “extracts” iron from native NTBI. Thus whereas LPI measures overtly labile NTBI in native plasma (i.e. LPI), LPIplus detects both overt + cryptic forms, as in classical NTBI assays that involve either mobilization + filtration (3) or in the DCI (directly chelatable iron) assay that measures deferrioxamine chelatable NTBI (4). Aim. To compare SIO parameters in polytransfused thalassemia major patients, chelated and non-chelated, as revealed by measurements of overt and cryptic LPI. Methods. The studies involved: 1. The Hadassah Medical Center (HMC) in Jerusalem, where 15–20 (randomly selected, age 14–35) patients were under regular transfusion/chelation treatment and 2. The European Medical Center in Gaza (EMC), where regularly transfused patients (age 10–22) were only sporadically chelated. NTBI assays were performed on sera prepared from blood, (where applicable taken after >10 hrs drug washout, as described for LPI (1,2) and DCI (4); for LPIplus, the LPI test was conducted in the presence of 0.5 mM NTA. Results. As shown previously (2,4), LPI was detected only in patients with >70% Tf-saturation. In HMC, the mean LPI of n=18 patients rose from 0.51±0.41 μ M to 1.00 ±0.46 μ M in the presence of NTA, matching the DCI level of 0.91±0.7 μ M. The LPI rise was detected in 12/15 (= 80%) of samples with LPI>0.4 μ M (≂p 66% of the entire cohort). Thus, despite chelation, a substantial number of patients had relatively low but significant levels of both overt and cryptic NTBI. Among the 3 patients with no significant LPI or DCI (0.2-0.4 μ M), 2/3 became LPI positive (0.6-0.8 μ M) when tested with NTA. Unexpectedly, in EMC-Gaza, among 20 transfused unchelated patients with serum ferritins > 5000 ng/ml and Tf saturation >100%, 8/20 of them (≂p 40%) had undetectable levels of overt LPI but substantial cryptic NTBI. In the remaining 12/20, the mean overt LPI of 0.69±0.65 μ M rose significantly (p<0.01) to 2.05 ±1.56 μ M when the cryptic component (NTA-extractable) was added. Discussion. Overt and cryptic NTBI components were detected by two modalities of the LPI assay in both regularly chelated and unchelated thalassemia patients, although to different extents and proportions. Compared to chelated patients, those unchelated had significantly higher mean values of both overt and cryptic NTBI components, despite the higher proportion of patients with only cryptic NTBI. On an individual basis, the persistent appearance of either/both LPI component(s) of NTBI could provide a measure of SIO and/or the success of individual chelation regimens. However, remaining to be established is the pathophysiological role of each component of NTBI to SIO, disease progression and treatment success. Supported by ISF and the Canadian Friends of HUJI. 1. Esposito et al. Blood 102:2670-7 (2003); 2. Zanninelli et al. Br. J. Hematol. 147: 744–51(2009); 3. Hider R. Eur J Clin Invest 32:S50–4 (2002); 4. Pootrakul et al. Blood 104: 1504–10 (2004). Disclosures: Cabantchik: Aferrix Ltd: Consultancy, Membership on an entity's Board of Directors or advisory committees.
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Shuster, Shirley, Zane Brickman, Dalia Karol i Itai Malkin. "Save a Child’s Heart: A Unique Global Health Model". University of Ottawa Journal of Medicine 8, nr 1 (7.05.2018): 23–28. http://dx.doi.org/10.18192/uojm.v8i1.2440.
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Save a Child’s Heart (SACH) is a UN-sponsored Israeli non-pro t organization that provides free, life-saving cardiac treatment to children from developing countries who would otherwise be unable to receive sufficient medical care in their home country. SACH utilizes a unique model of care involving several areas of focus including a tertiary care centre in Israel, international screening missions, training local healthcare professionals (HCPs), establishing local care facilities in partner countries, and engaging local and international volunteers. Through these efforts, SACH has been successful in providing cardiac care to 4599 children, training 116 HCPs, and establishing four independent surgical centres internationally. This model has proven its efficacy and can be applied to other tertiary surgical endeavors.
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Dickman, Nomy, Basem Hijazi, Abraham O. Samson i Lea Even. "Tutors Matter: The Relationship between Medical Students’ Satisfaction from Their Tutor and Their Overall Satisfaction from Clinical Rotations". International Medical Education 2, nr 3 (22.06.2023): 124–30. http://dx.doi.org/10.3390/ime2030012.
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Background and Aim: Medical students are required to complete a number of clinical rotations in hospital departments, affiliated with the Azrieli Faculty of Medicine, under the supervision of a department tutor. Our experience shows that departments receiving good scores typically also receive good feedback for their tutor. Accordingly, our aim was to assess the tutor contribution to students’ overall satisfaction from clinical rotations in hospital departments across northern Israel. Methods: Here, we recorded the students’ reported satisfaction with tutors as well as the satisfaction with clinical rotations in different departments of Galilee Medical Center (GMC) in Naharia, and Baruch Padeh Medical Center in Poria. The students’ reported satisfaction was assessed numerically and verbally using questionnaires over a period of three years. Results: We find that the students reported satisfaction with a clinical rotation is positively and significantly correlated with the student satisfaction with the tutor, and less with other factors such as hospital organization and department facilities, geographical distance from home, working hours, etc. Conclusion: Our findings suggest that medical schools can increase students’ satisfaction through investment in good tutors.
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Goshen, Ran, Eran Choman, Ayelet Ran, Efrat Muller, Revital Kariv, Gabriel Chodick, Nachman Ash, Steven Narod i Varda Shalev. "Computer-Assisted Flagging of Individuals at High Risk of Colorectal Cancer in a Large Health Maintenance Organization Using the ColonFlag Test". JCO Clinical Cancer Informatics, nr 2 (grudzień 2018): 1–8. http://dx.doi.org/10.1200/cci.17.00130.
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Purpose To evaluate in a sample of adults who had been noncompliant with colorectal cancer (CRC) screening whether screening could be enhanced by an automated patient recall system based on identifying high-risk individuals using the ColonFlag test and an electronic medical record database. Methods A total of 79,671 individuals who were determined to be noncompliant with current screening recommendations were identified in the Maccabi Health Services program in Israel. Their cancer risk was determined by ColonFlag using information on age, sex, and CBC results. Doctors of individuals who were flagged as high risk were notified and asked to follow up with their patients. Results The ColonFlag identified 688 men and women who scored in the highest 0.87 percentile. Of these individuals, 254 had colonoscopies performed by Maccabi physicians, and 19 CRCs (7.5%) were found. An additional 15 cancers primarily identified outside of Maccabi were found through code matching. Conclusion The ColonFlag test is a rapid, efficient, and inexpensive test that can be applied to scan electronic medical records to identify individuals at high risk of CRC who would otherwise avoid screening.
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Dopelt, Keren, Almog Amar, Nickol Yonatan i Nadav Davidovitch. "Knowledge, Attitudes, and Practices Regarding Antibiotic Use and Resistance: A Cross-Sectional Study among Students in Israel". Antibiotics 12, nr 6 (8.06.2023): 1028. http://dx.doi.org/10.3390/antibiotics12061028.
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Antibiotic resistance is one of the biggest threats to human health, food security, and development. This study aimed to examine the level of knowledge and awareness regarding antibiotic resistance while comparing students from health sciences to students in other disciplines. A cross-sectional study was conducted based on the “antibiotic resistance” questionnaire developed by the World Health Organization. A total of 371 students participated in the study. All respondents had taken antibiotics in the past. A tenth had taken them on their own without a prescription, and 14% had not received an explanation regarding the use of antibiotics. The average for the knowledge questions was 15.49 ± 5.35 (out of 27). Many students mistakenly associated antibiotics with viral diseases. Despite these misconceptions, there was a high level of awareness and understanding regarding the ways to treat antibiotic resistance. Still, the awareness of the severity of antibiotic resistance was not high. Differences were found between the disciplines in general knowledge and the level of awareness and understanding about the ways to treat antibiotic resistance, where health science students had the highest scores, followed by social science students and finally, computer and management students. No differences were found in the perception of the severity of the phenomenon. This information is essential to developing educational interventions to improve knowledge, attitudes, and practices regarding antibiotic use among students, especially those unrelated to the health sciences.
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Molad, Michal, Ayala Gover, Zaki Marai, Karen Lavie-Nevo, Irina Kessel, Lilach Shemer-Meiri i Marina Soloveichik. "Neurodevelopmental Outcome of Very Low Birth Weight Infants in the Northern District of Israel: A Cross-Sectional Study". Children 10, nr 8 (31.07.2023): 1320. http://dx.doi.org/10.3390/children10081320.
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Background: Currently, no local database in Israel collects neurodevelopmental outcomes of very low birth weight (VLBW) preterm infants. We investigated neurodevelopmental outcomes in one district of the largest healthcare organization in Israel. Methods: A cross-sectional study including all VLBW (<1500 g) preterm infants born between 1 January 2006 and 31 December 2016 who were followed in any of seven child development centers in Israel’s Northern District. Data were retrospectively collected from the computerized medical record database. Results: Out of 436 participants, 55.1% had normal developmental outcomes. A total of 8.9% had cerebral palsy (CP), 12.2% had a global developmental delay (GDD), and 33.4% had a language delay. Out of the extremely preterm infants (n = 109), 20.2% had CP, 22.0% had GDD, and 44.9% had language delay. We found a statistically significant higher rate of abnormal neurodevelopment outcomes in non-Jews compared to Jews (57% vs. 37.8%, respectively, p < 0.0001). Conclusions: We found a relatively high overall rate of CP in our local population and a significant difference in neurodevelopmental outcomes between Jews and non-Jews. This study emphasizes the need for an expanded and detailed national database collecting post-discharge outcomes, as well as an assessment of national healthcare resource allocation and inequalities in preterm infants’ post-discharge care.
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Meretoja, Atte, Monica Acciarresi, Rufus O. Akinyemi, Bruce Campbell, Dar Dowlatshahi, Coralie English, Nils Henninger i in. "Stroke doctors: Who are we? A World Stroke Organization survey". International Journal of Stroke 12, nr 8 (28.03.2017): 858–68. http://dx.doi.org/10.1177/1747493017701150.
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Background Specialist training provides skilled workforce for service delivery. Stroke medicine has evolved rapidly in the past years. No prior information exists on background or training of stroke doctors globally. Aims To describe the specialties that represent stroke doctors, their training requirements, and the scientific organizations ensuring continuous medical education. Methods The World Stroke Organization conducted an expert survey between June and November 2014 using e-mailed questionnaires. All Organization for Economic Co-operation and Development countries with >1 million population and other countries with >50 million population were included ( n = 49, total 5.6 billion inhabitants, 85% of global strokes). Two stroke experts from each selected country were surveyed, discrepancies resolved, and further information on identified stroke-specific curricula sought. Results We received responses from 48 (98%) countries. Of ischemic stroke patients, 64% were reportedly treated by neurologists, ranging from 5% in Ireland to 95% in the Netherlands. Per thousand annual strokes there were average six neurologists, ranging from 0.3 in Ethiopia to 33 in Israel. Of intracerebral hemorrhage patients, 29% were reportedly treated by neurosurgeons, ranging from 5% in Sweden to 79% in Japan, with three neurosurgeons per thousand strokes, ranging from 0.1 in Ethiopia to 24 in South Korea. Most countries had a stroke society (86%) while only 10 (21%) had a degree or subspecialty for stroke medicine. Conclusions Stroke doctor numbers, background specialties, and opportunities to specialize in stroke vary across the globe. Most countries have a scientific society to pursue advancement of stroke medicine, but few have stroke curricula.
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Darr, Asaf. "Palestinian Arabs and Jews at Work: Workplace Encounters in a War-Torn Country and the Grassroots Strategy of ‘Split Ascription’". Work, Employment and Society 32, nr 5 (21.07.2017): 831–49. http://dx.doi.org/10.1177/0950017017711141.
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What are the workplace manifestations of ongoing ethno-national conflict? How do co-workers on rival sides in war-torn countries cope with these manifestations? Interviews with nurses, nursing assistants and physicians in a Palestinian-Arab hospital and in a Jewish retirement home reveal how the broader ethno-national conflict in Israel penetrates the workplace. Problems arise for them when violence related to the conflict erupts outside the workplace and when patients express racist views during interactions with medical staff. This study finds that staff members respond with ‘split ascription’, a grassroots coping strategy that differentiates between a cooperative work environment and discriminatory structural elements of the employing organization. Split ascription challenges existing theories of interethnic relations in the workplace, as it combines both interactional and structural elements within a single coping strategy.
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Steinberg, David M., Moshe Kaplan, Joav Merrick i Shlomo Wientroub. "Design and Implementation of a Multinational Computerized Patient Survey: The European Paediatric Orthopaedic Society Down Syndrome Survey". Scientific World JOURNAL 4 (2004): 256–63. http://dx.doi.org/10.1100/tsw.2004.26.
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In 1997, the European Paediatric Orthopaedic Society (EPOS) initiated an international survey of musculoskeletal problems in individuals with Down syndrome. The goals of the study were far-reaching and ambitious in order to obtain a clear picture of the variety of orthopedic problems associated with Down syndrome, to relate their occurrence to other medical conditions, and to record and compare methods of treatment. The survey was to be international in scope, including orthopedic surgeons and departments across Europe and outside Europe. The study was coordinated from the Tel Aviv University in Israel as a multicenter study using electronic technology. This paper describes the organization and implementation of the EPOS Down Syndrome Survey, with special emphasis on the sophisticated electronic data entry instrument that was developed especially for the survey. It is concluded that computerized data entry forms like the one that we developed for the EPOS Down Syndrome Survey are valuable tools for medical surveys. They are especially important for multicenter and multinational studies.
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Wolf, Ido, Galit Hirsh-Yechezkel, Angela Chetrit i Sivan Ben-Avraham. "Oncology treatments during COVID-19 pandemic in Israel: ONCOR study." Journal of Clinical Oncology 38, nr 29_suppl (10.10.2020): 50. http://dx.doi.org/10.1200/jco.2020.38.29_suppl.50.
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50 Background: The SARS-CoV-2 pandemic outbreak declared by the World Health Organization in March 2020 challenged health systems in affected countries and raised concerns for its potential direct and indirect impact on cancer patients. Cancer patients are at high risk for COVID-19 infections and complications due to factors related to their underlying condition and treatments. We aimed to evaluate the impact of COVID-19 on clinical activity of the oncology departments in Israel, and to assess the implementation of measures aimed at containment of COVID-19 diffusion, while allowing continuation of quality cancer care. Methods: A national survey among 18 of 19 oncology departments in Israel was conducted on April 2020 focusing on the institute's preparedness for treatment of their cancer patients during the COVID-19 pandemic. Results: Prevention measures against COVID-19 spread were taken prior to patients' arrival and at arrival or while staying at the departments. most participants reported employing a quick triage of patients and caregivers, prior to their entrance to the oncology units. Most departments limited the entrance of caregivers; one third not allowing entrance of any caregivers and more than half allowing entrance of only one caregiver. Some differences between large and small/medium sized medical centers were observed, with less strict measures taken by the smaller hospitals. Most departments implemented steps aimed at reducing unnecessary visits to the clinic. These included a shift to telephone interactions or telemedicine (78%) and switching to oral therapies, rather than intravenous ones, when possible. This approach was taken mostly by the medium/small hospitals compared to large hospitals (60% vs. 92%, p = 0.1). Conclusions: Oncology departments in Israel were able to prepare and adapt their services to guidelines and requirements related to the COVID-19 pandemic with little harm to their treatment capacity. However, some differences between large and small hospitals were noted. These findings call for either better allocation of resources in case of an epidemic.
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Khurami, Mir Oko, A. Akhmedov, R. A. Tursunov i D. A. Olimov. "ISSUES OF MEDICAL CARE ORGANIZATION IN THE LIGHT OF THE CURRENT MODELS OF HEALTH CARE SYSTEMS IN THE WORLD. ANALYTICAL REVIEW". Social Aspects of Population Health 68, nr 3 (2022): 6. http://dx.doi.org/10.21045/2071-5021-2022-68-3-6.
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Significance. Changes in the social and economic development of any society pose fundamentally new challenges for the medical industry aimed at creating an accessible and effective health care system. Currently, the whole world is looking for ways to reasonably regulate the health сare system in a market economy. The purpose of the study is to conduct a chronological description of the main models of health care systems in the world and an assessment of modern trends in medical care provision to the population Material and methods. To analyze scientific literature, results of modern research on implementing various models in health care systems of the highly developed countries were used. Results. The main characteristics of the models of health care systems in the world, which are fundamentally different from each other, have been outlined: the state-funded (budgetary, public system), which is most comprehensively and conspicuously realized in the UK; predominantly the insurance system (most fully and clearly implemented in Germany and Israel) and the private (paid) system (most typical of the U.S. healthcare). Conclusion. Analysis of the global trends in health care development shows that there is no ideal model of the health care system in the world. Therefore, in order to organize an effective system of public health, it is necessary to adopt the experience of the developed countries on the basis of the state regulation of the health care system, taking into account various trends in the market economy.
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Ben-Shimol, Shalom, Ron Dagan, Noga Givon-Lavi, Dekel Avital, Jacob Bar-Ziv i David Greenberg. "Use of Chest Radiography Examination as a Probe for Pneumococcal Conjugate Vaccine Impact on Lower Respiratory Tract Infections in Young Children". Clinical Infectious Diseases 71, nr 1 (15.08.2019): 177–87. http://dx.doi.org/10.1093/cid/ciz768.
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Abstract Background Community-acquired alveolar pneumonia (CAAP) is considered a bacterial disease, mainly pneumococcal. CAAP rates markedly declined following 7- and 13-valent pneumococcal conjugate vaccine (PCV) introductions worldwide. In contrast, non-CAAP lower respiratory tract infections (NA-LRIs) are generally not considered pneumococcal diseases. We assessed CAAP, NA-LRIs, and overall visits with chest radiograph (CXR) examination rates in the pediatric emergency room in southern Israel before and after PCV implementation. Methods This was an ongoing, prospective observational study. Our hospital serves a captive population of approximately 75 000 children aged <5 years, enabling incidence calculation. PCV7 and PCV13 were implemented in Israel in July 2009 and November 2010, respectively. All CXRs were analyzed according to the World Health Organization Standardization of Interpretation. We calculated CAAP, NA-LRI, and CXR examinations annual incidences from 2004 to 2017 and incidence rate ratios comparing the PCV13 (2014–2017) with the pre-PCV (2004–2008) periods. Results Overall, 72 746 CXR examinations were recorded: 14% CAAP and 86% NA-LRI. CAAP, NA-LRI, and CXR examination visit rates declined by 49%, 34%, and 37%, respectively. This pattern was seen in Jewish and Bedouin children (the 2 ethnically distinct populations), with steeper declines observed among Jewish children and children aged >12 months. Conclusions PCV7/PCV13 implementation resulted in a marked decline in CAAP and overall visits with CXR examination rates in young children. Overall, approximately 14 750 hospital visits with CXR were prevented annually per 100 000 population aged <5 years. These findings suggest that although NA-LRIs are usually not considered pneumococcal, many can be prevented by PCVs. Pneumococcal conjugate vaccine (PCV7/PCV13) implementation resulted in significant declines in community-acquired alveolar pneumonia (CAAP) and overall chest radiography examination rates in young children. Although non-CAAP lower respiratory tract infections are usually not considered pneumococcal, many can be prevented by PCVs.
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Kobliner-Friedman, RN, MPH, Deganit, Ofer Merin, MD, Eran Mashiach, MD, Reuven Kedar, MD, Shai Schul, MHA i Evan Avraham Alpert, MD. "Implementing the Sphere Project’s standards for patient’s healthcare rights in the disaster zone: The experience of the Israeli field hospital in post-quake Nepal". American Journal of Disaster Medicine 16, nr 1 (1.01.2021): 59–66. http://dx.doi.org/10.5055/ajdm.2021.0387.
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Emergency medical teams (EMTs) encounter chaos upon arriving at the scene of a disaster. Rescue efforts are utilitarian and focus on providing the technical aspects of medical care in order to save the most lives at the expense of the individual. This often neglects the basic healthcare rights of the patient. The Sphere Project was initiated to develop universal humanitarian standards for disaster response.The increase in the number of EMTs led the World Health Organization (WHO) to organize standards for disaster response. In 2016, the WHO certified the Israel Defense Forces Field Hospital (IDF-FH) as the first to be awarded the highest level of accreditation (EMT-3). This paper presents the IDF-FH’s efforts to protect the patient’s healthcare rights in a disaster zone based on the Sphere Principles.These core Sphere Principles include the right to professional medical treatment; the right to dignity, privacy, and confidentiality; the right for information in an understandable language; the right to informed consent; the obligation to maintain private medical records; the obligation to adhere to universal ethical standards, to respect culture and custom and to care for vulnerable populations; the right to protection from sexual exploitation and violence; and the right to continued treatment.
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Gray, Dean. "Handbook of Medicinal Plants Edited by Z. Yaniv and U. Bachrach (Agricultural Research Center of Israel and Hebrew University-Hadassah Medical School in Jerusalem, respectively). Haworth Press, Binghamton, NY. 2005. xxii + 500 pp. 6 × 81/4in. $59.95 (soft). ISBN 1-56022-995-0." Journal of Natural Products 69, nr 5 (maj 2006): 859–60. http://dx.doi.org/10.1021/np068220z.
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Ganzel, Chezi, Galina Pogrebijsky, Svetlana Krichevsky, Tzahi Neuman i Dina Ben-Yehuda. "The Separate Diagnosis of Hodgkin Lymphoma (HL) and Non-Hodgkin Lymphoma (NHL) In a Single Patient May Not Signify a Common Clonal Origin". Blood 116, nr 21 (19.11.2010): 4824. http://dx.doi.org/10.1182/blood.v116.21.4824.4824.
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Abstract Abstract 4824 Background: HL and NHL have traditionally been considered as two distinct entities. However, there have been reported rare cases of patients that over time develop both diseases. It is an unresolved issue whether the origin of the two diseases is from the same clone. The literature is replete with anecdotal reports but it has never been prospectively or retrospectively evaluated in consecutive patients from a large series. In this study we attempted to retrospectively investigate this phenomenon by reviewing the clinical and molecular aspects of a group of patients who developed both lymphomas. Although not absolutely definitive, a differing gene rearrangement (GR) pattern is currently thought to be highly suggestive of a different clonal origin. Methods: Study patients were all patients treated at the Hadassah University Medical Center, Jerusalem, Israel, who developed both kinds of lymphoma throughout their lives and were treated for at least one of the lymphomas during the period 1989–2010. The clinical and pathologic records of these patients were reviewed. Archival, formalin fixed, paraffin embedded tissue samples from all the patients that had available samples from both diseases were obtained. The rearranged immunoglobulin heavy-chain variable region genes from both diagnoses were amplified by polymerase chain reaction (PCR) and were compared to each other. Results: There were 26 patients who presented with two diagnoses. Twelve had HL as the primary disorder and the majority of these (75%) presented with aggressive lymphoma as the second lymphoma. The mean survival from the second lymphoma was 4.06 years. Five patients are still alive. In contrast, in the 11 patients where NHL was the primary disorder, this was usually (82%) of low grade histology. The mean survival in this case was 2.16 years. Four patients are still alive. Three patients were diagnosed concurrently with both diseases. For 11 patients there were available diagnostic samples for molecular analyses from both diagnoses of HL and NHL. In 6 of these 11 patients gene rearrangement studies were informative providing data for both diagnoses. The same GR was not found in any of the 6 patients. DLBCL=Diffuse Large B Cell Lymphoma, CLL/SLL=Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma, marginal=marginal zone lymphoma, low grade=low grade B cell lymphoma unspecified Although the numbers are small, these data suggest that it is likely that in the case of two different lymphoproliferative disorders they are of separate clonal origin. Conclusions: The development of HL and NHL at different time points should be assumed to be a different biologic disease, until proven otherwise. Disclosures: No relevant conflicts of interest to declare.
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SHARABI-NOV, Adi, i Stefan COJOCARU. "PREVALENCE OF GROUP B STREPTOCOCCUS AND LEVEL OF RELIGIOSITY OF JEWISH MOTHERS IN NORTHERN ISRAEL - IS THERE A CONNECTION?" Social Research Reports 13, nr 1 (15.09.2021): 9–17. http://dx.doi.org/10.33788/srr13.1.1.
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Group B streptococcus (GBS) during pregnancy is associated with increased risk of preterm delivery and is a leading cause of invasive infections in newborns. Rates of vaginal GBS prevalence in pregnant women vary among ethnic groups and geographical regions, with a range of 0.5-38%. The aim is to assess the prevalence rate of GBS bacteria among Jewish pregnant mothers in northern Israel, according to their level of religiosity. A cross-sectional study was pursued in 303 Jewish mothers at Ziv Medical Center, Safed of whom 89 (29.4%) were secular, 59 (19.5%) traditional, 60 (19.8%) Orthodox and 95 (31.3%) ultra-Orthodox, from December 2019-July 2020. All participants were tested for GBS from pregnancy week 35 as part of the routine medical care at their Health Maintenance Organization (HMO) and submitted the GBS test result upon arrival at the hospital delivery room. The overall prevalence of GBS was 33.7%: 16.9% of the secular mothers, 25.4% of the traditional women and 46.5% of the Orthodox and ultra-Orthodox group (p<0.001). In a univariate regression model the risk of GBS carriage in Orthodox mothers was 2.5 times higher and 6 times higher in ultra-Orthodox mothers than in secular mothers (p for trend <0.001). The prevalence of GBS was directly and significantly associated with the level of the birthing mother's religiosity. This study shows the need for systematic GBS screening of all pregnant women, particularly of Orthodox and ultra-Orthodox women, prior to their arrival in the delivery room.
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Olanrewaju, Rashidah Funke, S. Noorjannah Ibrahim, Ani Liza Asnawi i Hunain Altaf. "Classification of ECG signals for detection of arrhythmia and congestive heart failure based on continuous wavelet transform and deep neural networks". Indonesian Journal of Electrical Engineering and Computer Science 22, nr 3 (1.06.2021): 1520. http://dx.doi.org/10.11591/ijeecs.v22.i3.pp1520-1528.
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According to World Health Organization (WHO) report an estimated 17.9 million lives are being lost each year due to cardiovascular diseases (CVDs) and is the top contributor to the death causes. 80% of the cardiovascular cases include heart attacks and strokes. This work is an effort to accurately predict the common heart diseases such as arrhythmia (ARR) and congestive heart failure (CHF) along with the normal sinus rhythm (NSR) based on the integrated model developed using continuous wavelet transform (CWT) and deep neural networks. The proposed method used in this research analyses the time-frequency features of an electrocardiogram (ECG) signal by first converting the 1D ECG signals to the 2D Scalogram images and subsequently the 2D images are being used as an input to the 2D deep neural network model-AlexNet. The reason behind converting the ECG signals to 2D images is that it is easier to extract deep features from images rather than from the raw data for training purposes in AlexNet. The dataset used for this research was obtained from Massachusetts Institute of Technology-Boston's Beth Israel Hospital (MIT-BIH) arrhythmia database, MIT-BIH normal sinus rhythm database and Beth Israel Deaconess Medical Center (BIDMC) congestive heart failure database. In this work, we have identified the best fit parameters for the AlexNet model that could successfully predict the common heart diseases with an accuracy of 98.7%. This work is also being compared with the recent research done in the field of ECG Classification for detection of heart conditions and proves to be an effective technique for the classification.
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Benis, Arriel, Refael Barak Barkan, Tomer Sela i Nissim Harel. "Communication Behavior Changes Between Patients With Diabetes and Healthcare Providers Over 9 Years: Retrospective Cohort Study". Journal of Medical Internet Research 22, nr 8 (11.08.2020): e17186. http://dx.doi.org/10.2196/17186.
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Background Health organizations and patients interact over different communication channels and are harnessing digital communications for this purpose. Assisting health organizations to improve, adapt, and introduce new patient–health care practitioner communication channels (such as patient portals, mobile apps, and text messaging) enhances health care services access. Objective This retrospective data study aims to assist health care administrators and policy makers to improve and personalize communication between patients and health care professionals by expanding the capabilities of current communication channels and introducing new ones. Our main hypothesis is that patient follow-up and clinical outcomes are influenced by their preferred communication channels with the health care organization. Methods This study analyzes data stored in electronic medical records and logs documenting access to various communication channels between patients and a health organization (Clalit Health Services, Israel). Data were collected between 2008 and 2016 from records of 311,168 patients diagnosed with diabetes, aged 21 years and over, members of Clalit at least since 2007, and still alive in 2016. The analysis consisted of characterizing the use profiles of communication channels over time and used clustering for discretization purposes and patient profile building and then a hierarchical clustering and heatmaps to visualize the different communication profiles. Results A total of 13 profiles of patients were identified and characterized. We have shown how the communication channels provided by the health organization influence the communication behavior of patients. We observed how different patients respond differently to technological means of communication and change or don’t change their communication patterns with the health care organization based on the communication channels available to them. Conclusions Identifying the channels of communication within the health organization and which are preferred by each patient creates an opportunity to convey messages adapted to the patient in the most appropriate way. The greater the likelihood that the therapeutic message is received by the patient, the greater the patient's response and proactiveness to the treatment will be. International Registered Report Identifier (IRRID) RR2-10.2196/10734
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Klein, I., R. Balicer, L. Aharonson-Daniel i E. Jaffe. "(P2-10) Emergency Medical Services Workers' Willingness to Work during Pandemic Influenza". Prehospital and Disaster Medicine 26, S1 (maj 2011): s138. http://dx.doi.org/10.1017/s1049023x11004547.
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BackgroundEmergency medicine services (EMS) will play a key role in any response to a flu epidemic. In order to devise an effective preparedness plan for coping with pandemic, it is necessary to comprehend the factors affecting the willingness of EMS workers to respond during an outbreak.AimsThis study aims to: (1) examine the willingness of the workers of Israeli EMS (Magen David Adom (MDA)) to come to work during a pandemic flu; and (2) identify the factors that will increase the willingness of workers to come to work and the obstacles that will keep them from working during a flu pandemic.MethodsBetween November 2009 and January 2010, a representative sample of MDA workers in Israel were given questionnaires asking about their knowledge and attitudes in regard to pandemic flu, and concerning factors that may influence their willingness to come to work. Data analysis included descriptive statistics, central and dispersion measures, analyzes of variance, and an exploratory factor analysis.ResultsThe study population included 365 people (290 men and 75 women), with 84% aged 20–49 years. Of the respondents, 92% expressed willingness to come to work during a flu pandemic, even if they were asked and not obligated to report to work. An increase in willingness to come to work was found to be associated with the significance of the role of the workers, the guidance that they receive from the organization, their trust in the system, their knowledge, and their feeling of being protected.ConclusionWorkers' perception of the significance of their role and their trust in the system were found to be central factors in determining workers willingness to come to work during a time of an emergency.
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Bahat Dinur, Anat, Gideon Koren, Ilan Matok, Arnon Wiznitzer, Elia Uziel, Rafael Gorodischer i Amalia Levy. "Fetal Safety of Macrolides". Antimicrobial Agents and Chemotherapy 57, nr 7 (6.05.2013): 3307–11. http://dx.doi.org/10.1128/aac.01691-12.
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ABSTRACTMacrolide antibiotics are largely used in pregnancy for different bacterial infections. Their fetal safety has been studied by several groups, yielding opposing results. In particular, there have been studies claiming an association between macrolides and cardiovascular malformations. Exposure in early infancy has been associated with pyloric stenosis and intussusception. This has led to an avoidance in prescribing macrolides to pregnant women in several Scandinavian countries. The Objectives of the present study was to investigate the fetal safety of this class of drug by linking a large administrative database of drug dispensing and pregnancy outcome in Southern Israel. A computerized database of medications dispensed from 1999 to 2009 to all women registered in the Clalit health maintenance organization in southern Israel was linked with two computerized databases containing maternal and infant hospitalization records. Also, medical pregnancy termination data were analyzed. The following confounders were controlled for: maternal age, ethnicity, maternal pregestational diabetes, parity, and the year the mother gave birth or went through medical pregnancy termination. First- and third-trimester exposures to macrolide antibiotics as a group and to individual drugs were analyzed. During the study period there were 105,492 pregnancies among Clalit women that met the inclusion criteria. Of these, 104,380 ended in live births or dead fetuses and 1,112 in abortion due to medical reasons. In the first trimester of pregnancy, 1,033 women were exposed to macrolides. There was no association between macrolides and either major malformations [odds ratio (OR), 1.08; 95% confidence interval (CI), 0.84 to 1.38)] or specific malformations, after accounting for maternal age, parity, ethnicity, prepregnancy diabetes, and year of exposure. During the third trimester of pregnancy, 959 women were exposed to macrolides. There was no association between such exposure and perinatal mortality, low birth weight, low Apgar score, or preterm delivery. Similarly, no associations were demonstrated with pyloric stenosis or intussusception. Use of macrolides in the first trimester of pregnancy is not associated with an increased risk of major malformations. Exposure in the third trimester is not likely to increase neonatal risks for pyloric stenosis or intussusception in a clinically meaningful manner.
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Babkoff, Aryeh, Tal Keidar Haran, Aviad Zick, Ayala Hubert i Albert Grinshpun. "Clinical and molecular characterization of HER2-low metastatic colorectal cancer." Journal of Clinical Oncology 41, nr 16_suppl (1.06.2023): e15573-e15573. http://dx.doi.org/10.1200/jco.2023.41.16_suppl.e15573.
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e15573 Background: HER2 is a well-established biomarker and target in multiple tumor types, including metastatic colorectal cancer (mCRC). Despite the lack of HER2 amplification, certain HER2-low tumors were recently found to respond to novel HER2-directed antibody-drug conjugates, warranting an exploration of the clinical and molecular features of these entities. Yet, the real-world prevalence and the clinicopathologic characteristics of HER2-low mCRC are largely unknown. Here, we aim to describe the features of HER2-low mCRC and compare them to HER2-0 colorectal tumors. Methods: We retrospectively reviewed clinicopathologic data from consecutive patients with mCRC undergoing HER2 testing (immunohistochemistry [IHC] and in-situ hybridization [ISH], when appropriate) between 2017 and 2021 at Hadassah Medical Center, Israel. Tumors were defined HER2-positive (HER2+) if scored IHC 3 + or IHC 2+/ISH positive; HER2-low if scored IHC 2+/ISH negative or IHC 1+; HER2-0 if scored IHC 0. Genomic alterations were determined through a targeted next-generation sequencing (NGS) panel. Clinicopathologic and genomic data were compared between the cohorts with the Mann-Whitney or Fisher's exact test, and survival using Log-rank test. Results: A total of 100 consecutive mCRC patients were found eligible for our study, including 4 (4%) with HER2+, 30 (30%) with HER2-low, and 66 (66%) with HER2-0 disease. In the HER2-low group, five tumors were HER2 +2 / ISH negative, and 25 were scored HER2 +1. The fraction of female patients was 40% in HER2-low group, and 42% in the HER2-0 cohort (p > 0.99). The prevalence of mismatch repair deficient (MMR-D) tumors was also similar, with one MMR-D tumor in the HER2-low group, compared to 3 tumors in the HER2-0 (p > 0.99). 60% of the primary tumors in both groups originated in the left colon and rectum. Also, the prevalence of mucinous histology was comparable between the HER2-low and the HER2-neg cohorts (7.4% vs. 4.8%, p = 0.64). Among patients receiving local somatic NGS testing (n = 61), the fractions of patients with KRAS, BRAF, and TP53 mutations were largely comparable between the cohorts (Table 1). With a median follow up of 37 months, the median overall survival was 41 months for the HER2-low group and 51 months for the HER2-neg group (p = 0.15). Conclusions: In our cohort of patients with HER2-negative mCRC, the clinicopathologic and genomic characteristics of HER2-low and HER2-0 tumors did not differ significantly. However, our data suggest that HER2-low tumors represent a significant portion of mCRC, supporting further development of novel HER2-directed therapies for this population. Additionally, our data also support the notion that HER2-low, as currently defined, is not a distinct molecular subtype of mCRC. [Table: see text]
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Peleg, Kobi, i Bella Savitsky. "Terrorism-Related Injuries Versus Road Traffic Accident–Related Trauma: 5 Years of Experience in Israel". Disaster Medicine and Public Health Preparedness 3, nr 4 (grudzień 2009): 196–200. http://dx.doi.org/10.1097/dmp.0b013e3181c12734.
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ABSTRACTBackground: Terrorism victims comprise the minority among trauma injured people, but this small population imposes a burden on the health care system. Thirty percent of the population injured in terrorist activities experienced severe trauma (injury severity score ≥16), more than half of them need a surgical procedure, and 25% of the population affected by terrorism had been admitted to intensive care. Furthermore, compared with patients with non–terrorism-related trauma, victims of terrorism often arrive in bulk, as part of a mass casualty event. This poses a sudden load on hospital resources and requires special organization and preparedness. The present study compared terrorism-related and road accident–related injuries and examined clinical characteristics of both groups of patients.Methods: This study is a retrospective study of all patients injured through terrorist acts and road traffic accidents from September 29, 2000 to December 31, 2005, and recorded in the Israel Trauma Registry. Data on the nature of injuries, treatment, and outcome were obtained from the registry. Medical diagnoses were extracted from the registry and classified based on International Classification of Diseases coding. Diagnoses were grouped to body regions, based on the Barell Injury Diagnosis Matrix.Results: The study includes 2197 patients with terrorism-related injuries and 30,176 patients injured in road traffic accidents. All in all, 27% of terrorism-related casualties suffered severe to critical injuries, comparing to 17% among road traffic accident–related victims. Glasgow Coma Scale scores ≤8, measured in the emergency department, were among 12.3% of terrorism victims, in contrast with 7.4% among people injured on the roads. The terrorism victims had a significantly higher rate of use of intensive care facilities (24.2% vs 12.4%). The overall inpatient death rate was 6.0% among terrorism victims and 2.4% among those injured in road traffic accidents.Conclusions: Casualties from terrorist events are more severely injured and require more resources relative to casualties from road traffic accidents. (Disaster Med Public Health Preparedness. 2009;3:196–200)
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Hagoel, Lea, Gad Rennert i Efrat Neter. "Translational Research in Cancer Screening: Long-Term Population-Action Bridges to Diffuse Adherence". International Journal of Environmental Research and Public Health 18, nr 15 (26.07.2021): 7883. http://dx.doi.org/10.3390/ijerph18157883.
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The population-level implementation of innovative, evidence-based medical recommendations for adopting health-behaviors depends on the last link in the translation chain: the users. “User-friendly” medical interventions aimed at engaging users to adopt recommended health behaviors are best developed in a collaborative bio-medical and social sciences setting. In the 1990s, National Breast and Colorectal Cancer Early Detection Programs were launched at the Israeli Department of Community Medicine and Epidemiology. Operating under the largest HMO (Health Maintenance Organization) in Israel (“Clalit Health Services”), the department had direct access to HMO community primary-care clinics’ teams, insured members, and medical records. Academically affiliated, the department engaged in translational research. In a decades-long translational process, this multi-disciplinary unit led a series of interventions built upon basic and applied behavioral/social science phenomena such as framing, “Implementation Intentions,” and “Question-Behavior-Effect”. A heterogeneous team of disciplinary specialists created an integrated scientific environment. In order to enhance screening, the team focused on the establishment of a systematic mechanism actively inviting programs’ “users” (average-risk targeted individuals on the national level), and continuously applied social and health psychology concepts to study individuals’ perceptions, expectations, and needs related to cancer screening. The increase in adherence to screening recommendations was slow and incremental. A decrease in late-stage breast and colorectal cancer diagnoses was observed nationally, but participation was lower than expected. This paper positions screening adherence as a unique challenge and proposes new social and network avenues to enhance future participation.
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Ben-Arye, Eran. "The Role of Dual-Trained Conventional/Complementary Physicians as Mediators of Integration in Primary Care". Evidence-Based Complementary and Alternative Medicine 7, nr 4 (2010): 487–91. http://dx.doi.org/10.1093/ecam/nen033.
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A growing number of physicians study complementary and alternative medicine (CAM). Limited data are available on perspectives of physicians with dual training in conventional medicine and CAM, on issues of communication and collaboration with CAM practitioners (CAMPs). Questionnaires were administered to primary care physicians employed in the largest health maintenance organization (HMO) in Israel and to MD and non-MD CAM practitioners employed by a CAM-related agency of the same HMO. Data for statistical analysis were available from 333 primary care physicians (PCPs) and 241 CAM practitioners. Thirty-one of the 241 CAMPs were dual-trained physicians employed in a CAM-related agency as practitioners and/or triage-consultants. Dual trained physicians and CAMPs shared similar attitudes and supported, more so than PCPs, collaborative physician–CAM practitioner teamwork in clinical practice, medical education and research. Nevertheless, dual trained physicians supported a physician-dominant teamwork model (similar to the PCPs’ approach) in contrast to non-MD CAM practitioners who mainly supported a co-directed teamwork model. Compared to PCPs and non-MD CAM practitioners, dual trained physicians supported significantly more a medical/referral letter as the preferred means of doctor–CAM practitioner communication. Dual trained physicians have a unique outlook toward CAM integration and physician–practitioner collaboration, compared to non-MD CAM practitioners and PCPs. More studies are warranted to explore the role of dual trained physicians as mediators of integration.
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Goldbart, Aviv D., Ran Abuhasira, Jacov Even-Tsur, Adi Shiloh i Ariel Tarasiuk. "0612 Adenotonsillectomy During Childhood Does Not Elevate the Likelihood of Adulthood Overweight". SLEEP 47, Supplement_1 (20.04.2024): A261. http://dx.doi.org/10.1093/sleep/zsae067.0612.
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Abstract Introduction Adenotonsillectomy for pediatric obstructive sleep apnea (OSA) might not promote healthy body weight in the short term, as overweight children could still experience accelerated weight gain and increased risk of obesity. Limited data exists regarding the long-term effect of adenotonsillectomy on body mass index (BMI) as individuals enter their third decade of life. Our study investigated BMI twenty years following adenotonsillectomy or watchful waiting (WW). Methods Between 1998 and 2000, we enrolled 260 children with OSA, as defined in our previous study (PMID: 14754948). Among them, 132 had undergone adenotonsillectomy, 127 WW, and one participant died from cardiac arrest. All patients have been members of Clalit Health Services (CHS), Israel's largest healthcare organization, for over 25 years. CHS offers compulsory healthcare coverage via the National Health Insurance Law and employs a unified medical record system. Polysomnography records were obtained from the sole pediatric Sleep-Wake Laboratory in southern Israel. In June 2023, we received adulthood anthropometric data from the original study participants' electronic medical records. Results Both groups had moderate OSA and showed no differences in their initial BMI z-scores, which were -0.2 ± 1.6 and 0.1 ± 1.4 (p = 0.5) for the WW and adenotonsillectomy groups. The twenty-year follow-up indicated similar BMIs of 26.0 ± 5.8 (kg/m2) for the WW group and 25.5 ± 6.4 (kg/m2) for the adenotonsillectomy group (p = 0.5). However, children with baseline BMI z-scores ≥ median, especially females (p < 0.05), exhibited higher BMIs after 20 years. Following accounting for sex, apnea-hypopnea index, and socioeconomic status, it was found that adenotonsillectomy did not elevate the risk of being overweight (BMI ≥ 26) in the third decade of life. Females had a higher likelihood of being overweight (OR = 2.22, 95% CI: 1.10-4.58), as did individuals with childhood BMI z-scores ≥ median (OR = 4.67, 95% CI: 2.39-9.82). Conclusion Childhood adenotonsillectomy does not increase the risk of being overweight. High BMI z-scores correlate with an increased risk of adult overweight, unaffected by adenotonsillectomy. Adenotonsillectomy does not impact future BMI, highlighting the importance of promoting a healthy childhood lifestyle to prevent adult obesity. Support (if any) Israel Science Foundation grant No 164/2018
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Stasi, Cristina, Barbara Meoni, Fabio Voller i Caterina Silvestri. "SARS-CoV-2 Vaccination and the Bridge between First and Fourth Dose: Where Are We?" Vaccines 10, nr 3 (14.03.2022): 444. http://dx.doi.org/10.3390/vaccines10030444.
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The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has induced the explosion of vaccine research. Currently, according to the data of the World Health Organization, there are several vaccines in clinical (145) and preclinical (195) stages, while at least 10 are already in clinical phase 4 (post-marketing). Vaccines have proven to be safe, effective, and able to reduce the spread of SARS-CoV-2 infection and its variants, as well as the clinical consequences of the development of coronavirus disease-19 (COVID-19). In the two-dose primary vaccination, different time intervals between the two doses have been used. Recently, special attention has been paid to assessing the immunogenicity following booster administration. The third dose of the vaccine against COVID-19 may be administered at least 8 weeks after the second dose. In Israel, a fourth dose has already been approved in immunocompromised groups. The main objective of this review is to describe the principal results of studies on the effectiveness of first-to-fourth dose vaccination to reduce reinfection by variants and the incidence of severe disease/death caused by COVID-19. Vaccines have shown a high level of protection from symptomatic infection and reinfection by variants after a third dose. Accelerating mass third-dose vaccination could potentially induce immunogenicity against variants.
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Milgrom, Yael, Yuval Tal i Aharon S. Finestone. "Comparison of hospital worker anxiety in COVID-19 treating and non-treating hospitals in the same city during the COVID-19 pandemic". Israel Journal of Health Policy Research 9, nr 1 (21.10.2020). http://dx.doi.org/10.1186/s13584-020-00413-1.
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Abstract Background The Hadassah Medical Organization operates two hospitals in Jerusalem. During the COVID-19 pandemic it made an administrative decision to operate one hospital as a COVID-19 treatment hospital (CTH) and to have the second function as a non-COVID-19 treating hospital (NCTH) offering general medical services. The purpose of this study was to assess how this decision affected hospital worker anxiety. Methods From April 27 to May 1, during the COVID-19 pandemic in Israel, while the country was under lock-down, an electronic questionnaire survey was carried out among hospital workers of the CTH and NCTH. The questionnaire includes personal demographics and attitudes about COVID-19 and assesses present anxiety state using the State-Trait Anxiety Inventory for Adults (STAI-S) validated questionnaire. A STAI-S score of ≥45 was considered to represent clinical anxiety. Results Completed questionnaires were received from 1570 hospital employees (24%). 33.5% of responders had STAI-S scores ≥45. Multivariable regression analysis showed that being a resident doctor (odds ration [OR] 2.13; 95% CL, 1.41–3.23; P = 0.0003), age ≤ 50 (OR, 2.08; 95% Cl, 1.62–2.67; P < .0001), being a nurse (OR, 1.29; 95% CL, 1.01–1.64; P = 0.039), female gender (OR, 1.63; 95% CL, 1.25–2.13; P = 0.0003) and having risk factors for COVID-19 (OR, 1.51; 95% CL, 1.19–1.91; P = 0.0007), but not hospital workplace (p = 0.08), were associated with the presence of clinical anxiety. 69% of the responders had been tested for COVID-19, but only nine were positive. CTH workers estimated that the likelihood of their already being infected with COVID-19 to be 21.5 ± 24.7% as compared to the 15.3 ± 19.5% estimate of NCTH workers (p = 0.0001). 50% (545/1099) of the CTH workers and 51% (168/330) of the NCTH workers responded that the most important cause of their stress was a fear of infecting their families (p = 0.7). Conclusions By multivariable analysis the creation of a NCTH during the COVID-19 pandemic was not found to be associated with a decrease in the number of hospital workers with clinical anxiety. Hospital worker support resources can be focused on the at-risk groups identified in this study.