首页 > 最新文献

Israel Journal of Health Policy Research最新文献

英文 中文
"A picture is worth a thousand words": smoking in multi-unit housing in Israel. “一张图片胜过千言万语”:在以色列的多单元住房中吸烟。
IF 4.5 4区 医学 Q1 HEALTH POLICY & SERVICES Pub Date : 2023-08-07 DOI: 10.1186/s13584-023-00574-9
Mitchell Zeller

A brief commentary on the need for policy change by the Israeli government to address the problem of tobacco smoke incursion in multi-unit housing. The commentary also includes a call for enhanced products, programs, and services to help smokers in Israel quit.

简要评论以色列政府需要改变政策,以解决多单元住房中烟草烟雾入侵的问题。该评论还呼吁加强产品、计划和服务,以帮助以色列的吸烟者戒烟。
{"title":"\"A picture is worth a thousand words\": smoking in multi-unit housing in Israel.","authors":"Mitchell Zeller","doi":"10.1186/s13584-023-00574-9","DOIUrl":"https://doi.org/10.1186/s13584-023-00574-9","url":null,"abstract":"<p><p>A brief commentary on the need for policy change by the Israeli government to address the problem of tobacco smoke incursion in multi-unit housing. The commentary also includes a call for enhanced products, programs, and services to help smokers in Israel quit.</p>","PeriodicalId":46694,"journal":{"name":"Israel Journal of Health Policy Research","volume":"12 1","pages":"26"},"PeriodicalIF":4.5,"publicationDate":"2023-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10405405/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9972237","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Tobacco smoke incursion into private residences in Israel: a cross-sectional study examining public perceptions of private rights and support for governmental policies. 烟草烟雾侵入以色列私人住宅:一项调查公众对私人权利和对政府政策支持的看法的横断面研究。
IF 4.5 4区 医学 Q1 HEALTH POLICY & SERVICES Pub Date : 2023-07-21 DOI: 10.1186/s13584-023-00573-w
Noa Theitler, Vaughan W Rees, Maya Peled-Raz, Michal Bitan, Laura J Rosen

Background: Tobacco smoke incursion (TSI) into private residences is a widespread problem in many countries. We sought to assess the prevalence of self-reported TSI and public attitudes about TSI in Israel, a country with a relatively high smoking prevalence and high population density.

Methods: We conducted a random digit dial survey among residents in Israel (N = 285) in 2017, which examined the frequency, source, correlates of, and attitudes towards TSI and potential regulatory options. The cooperation rate was 63.9%.

Results: Among respondents, 44.7% reported ever experiencing home TSI, with higher exposure among residents of multi-unit housing (MUH) (MUH versus private homes: aOR (Adjusted Odds Ratio): 3.60, CI (Confidence Interval): [1.96, 6.58], p < .001). Most respondents (69.8%), including nearly half of smokers, prioritized the right of individuals to breath smoke-free air in their apartments over the right of smokers to smoke in their apartments. Women and non-smokers were more likely to support the right to breathe smoke-free air (Women versus men: aOR: 2.77 CI: [1.48, 5.16], p = .001; Nonsmokers versus smokers: aOR: 3.21 CI [1.59, 6.48], p = .001). However, only about a quarter (24.8%) of respondents who ever experienced TSI raised the issue with the neighbor who smoked, the neighbor's landlord, or the building committee. The vast majority (85.2%) of all respondents, including three-quarters of smokers, supported smoke-free legislation for multi-unit housing (MUH), with those ever-exposed to TSI and non-smokers more likely to support legislation (ever-exposed versus never-exposed aOR = 2.99, CI [1.28, 6.97], p = 0.011; nonsmokers versus smokers aOR = 3.00, CI [1.28, 7.01], p = 0.011).

Conclusions: Among study participants, tobacco smoke incursion was a common, yet unwelcome experience. Most respondents believed that the right to breathe smoke-free air in one's apartment superseded that of neighbors to smoke anywhere in their home, and most supported legislation to prevent TSI. Though further study is needed to understand better TSI and effective methods for its prevention, our findings suggest that policy interventions, including legal action at the level of the Supreme Court and/or the Knesset, are needed. Regulation, policy initiatives and campaigns to denormalize smoking in proximity to other people and private residences globally could reduce the scope of this widespread problem, protect individuals from home TSI, and improve population health.

背景:烟草烟雾侵入(TSI)进入私人住宅是许多国家普遍存在的问题。我们试图评估以色列自我报告的TSI患病率和公众对TSI的态度,以色列是一个吸烟率和人口密度相对较高的国家。方法:我们于2017年对以色列居民(N = 285)进行了随机数字拨号调查,调查了TSI的频率、来源、相关因素和对TSI的态度以及潜在的监管选择。合作率为63.9%。结果:在受访者中,44.7%的人报告曾经历过家庭TSI,多单元住房(MUH)的居民暴露率更高(MUH与私人住宅:aOR(调整优势比):3.60,CI(置信区间):[1.96,6.58],p)结论:在研究参与者中,烟草烟雾入侵是一种常见但不受欢迎的经历。大多数受访者认为,在自己的公寓里呼吸无烟空气的权利高于邻居在家中任何地方吸烟的权利,大多数人支持立法防止TSI。虽然需要进一步的研究来更好地了解TSI和有效的预防方法,但我们的研究结果表明,需要政策干预,包括最高法院和/或以色列议会的法律行动。在全球范围内禁止在他人和私人住宅附近吸烟的法规、政策举措和运动可以减少这一普遍问题的范围,保护个人免受家中TSI的伤害,并改善人口健康。
{"title":"Tobacco smoke incursion into private residences in Israel: a cross-sectional study examining public perceptions of private rights and support for governmental policies.","authors":"Noa Theitler, Vaughan W Rees, Maya Peled-Raz, Michal Bitan, Laura J Rosen","doi":"10.1186/s13584-023-00573-w","DOIUrl":"10.1186/s13584-023-00573-w","url":null,"abstract":"<p><strong>Background: </strong>Tobacco smoke incursion (TSI) into private residences is a widespread problem in many countries. We sought to assess the prevalence of self-reported TSI and public attitudes about TSI in Israel, a country with a relatively high smoking prevalence and high population density.</p><p><strong>Methods: </strong>We conducted a random digit dial survey among residents in Israel (N = 285) in 2017, which examined the frequency, source, correlates of, and attitudes towards TSI and potential regulatory options. The cooperation rate was 63.9%.</p><p><strong>Results: </strong>Among respondents, 44.7% reported ever experiencing home TSI, with higher exposure among residents of multi-unit housing (MUH) (MUH versus private homes: aOR (Adjusted Odds Ratio): 3.60, CI (Confidence Interval): [1.96, 6.58], p < .001). Most respondents (69.8%), including nearly half of smokers, prioritized the right of individuals to breath smoke-free air in their apartments over the right of smokers to smoke in their apartments. Women and non-smokers were more likely to support the right to breathe smoke-free air (Women versus men: aOR: 2.77 CI: [1.48, 5.16], p = .001; Nonsmokers versus smokers: aOR: 3.21 CI [1.59, 6.48], p = .001). However, only about a quarter (24.8%) of respondents who ever experienced TSI raised the issue with the neighbor who smoked, the neighbor's landlord, or the building committee. The vast majority (85.2%) of all respondents, including three-quarters of smokers, supported smoke-free legislation for multi-unit housing (MUH), with those ever-exposed to TSI and non-smokers more likely to support legislation (ever-exposed versus never-exposed aOR = 2.99, CI [1.28, 6.97], p = 0.011; nonsmokers versus smokers aOR = 3.00, CI [1.28, 7.01], p = 0.011).</p><p><strong>Conclusions: </strong>Among study participants, tobacco smoke incursion was a common, yet unwelcome experience. Most respondents believed that the right to breathe smoke-free air in one's apartment superseded that of neighbors to smoke anywhere in their home, and most supported legislation to prevent TSI. Though further study is needed to understand better TSI and effective methods for its prevention, our findings suggest that policy interventions, including legal action at the level of the Supreme Court and/or the Knesset, are needed. Regulation, policy initiatives and campaigns to denormalize smoking in proximity to other people and private residences globally could reduce the scope of this widespread problem, protect individuals from home TSI, and improve population health.</p>","PeriodicalId":46694,"journal":{"name":"Israel Journal of Health Policy Research","volume":"12 1","pages":"25"},"PeriodicalIF":4.5,"publicationDate":"2023-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10362702/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9955227","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
High out‑of‑pocket spending and financial hardship at the end of life among cancer survivors and their families. 癌症幸存者及其家属在生命末期的高额自付支出和经济困难。
IF 4.5 4区 医学 Q1 HEALTH POLICY & SERVICES Pub Date : 2023-07-06 DOI: 10.1186/s13584-023-00572-x
Jingxuan Zhao, K Robin Yabroff

Cancer is one of the most expensive medical conditions to treat worldwide, affecting national and local spending, as well as household budgets for patients and their families. In this commentary about a recent paper from Tur‑Sinai et al., we discuss the high out-of-pocket spending and medical and non-medical financial hardship faced by cancer patients and their families at the end-of-life in Israel. We provide recent information about the costs of health care in Israel and other high-income countries with (i.e., Canada, Australia, Japan, and Italy) and without universal health insurance coverage (i.e., United States, a country with high healthcare costs and uninsurance rate), and highlight the role of improving health insurance coverage and benefit design in reducing financial hardship among cancer patients and their families. Recognizing that financial hardship at the end of life affects both patients and their families, developing comprehensive programs and policies in Israel as well as in other countries is warranted.

癌症是世界范围内最昂贵的医疗疾病之一,影响着国家和地方的支出,以及患者及其家属的家庭预算。在这篇关于Tur - Sinai等人最近发表的一篇论文的评论中,我们讨论了以色列癌症患者及其家属在生命末期面临的高额自付支出以及医疗和非医疗经济困难。我们提供了以色列和其他高收入国家(即加拿大、澳大利亚、日本和意大利)和没有全民医疗保险的国家(即美国,一个医疗费用和无保险率高的国家)的医疗保健费用的最新信息,并强调了改善医疗保险覆盖面和福利设计在减少癌症患者及其家属的经济困难方面的作用。认识到生命末期的经济困难会影响病人和他们的家庭,在以色列和其他国家制定全面的计划和政策是有必要的。
{"title":"High out‑of‑pocket spending and financial hardship at the end of life among cancer survivors and their families.","authors":"Jingxuan Zhao,&nbsp;K Robin Yabroff","doi":"10.1186/s13584-023-00572-x","DOIUrl":"https://doi.org/10.1186/s13584-023-00572-x","url":null,"abstract":"<p><p>Cancer is one of the most expensive medical conditions to treat worldwide, affecting national and local spending, as well as household budgets for patients and their families. In this commentary about a recent paper from Tur‑Sinai et al., we discuss the high out-of-pocket spending and medical and non-medical financial hardship faced by cancer patients and their families at the end-of-life in Israel. We provide recent information about the costs of health care in Israel and other high-income countries with (i.e., Canada, Australia, Japan, and Italy) and without universal health insurance coverage (i.e., United States, a country with high healthcare costs and uninsurance rate), and highlight the role of improving health insurance coverage and benefit design in reducing financial hardship among cancer patients and their families. Recognizing that financial hardship at the end of life affects both patients and their families, developing comprehensive programs and policies in Israel as well as in other countries is warranted.</p>","PeriodicalId":46694,"journal":{"name":"Israel Journal of Health Policy Research","volume":"12 1","pages":"24"},"PeriodicalIF":4.5,"publicationDate":"2023-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10324154/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9802466","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Correction: Cytomegalovirus (CMV) seroprevalence among women at childbearing age, maternal and congenital CMV infection: policy implications of a descriptive, retrospective, community-based study. 更正:巨细胞病毒(CMV)在育龄妇女、产妇和先天性巨细胞病毒感染中的血清患病率:一项描述性、回顾性、基于社区的研究的政策意义。
IF 4.5 4区 医学 Q1 HEALTH POLICY & SERVICES Pub Date : 2023-05-25 DOI: 10.1186/s13584-023-00571-y
Assaf Ben Shoham, Yechiel Schlesinger, Ian Miskin, Ziva Kalderon, Rachel Michaelson-Cohen, Yonit Wiener-Well
{"title":"Correction: Cytomegalovirus (CMV) seroprevalence among women at childbearing age, maternal and congenital CMV infection: policy implications of a descriptive, retrospective, community-based study.","authors":"Assaf Ben Shoham,&nbsp;Yechiel Schlesinger,&nbsp;Ian Miskin,&nbsp;Ziva Kalderon,&nbsp;Rachel Michaelson-Cohen,&nbsp;Yonit Wiener-Well","doi":"10.1186/s13584-023-00571-y","DOIUrl":"https://doi.org/10.1186/s13584-023-00571-y","url":null,"abstract":"","PeriodicalId":46694,"journal":{"name":"Israel Journal of Health Policy Research","volume":"12 1","pages":"23"},"PeriodicalIF":4.5,"publicationDate":"2023-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10210446/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9526069","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Where internal medical patients receive intensive interventions: results from a tertiary-care hospital in Israel. 内科病人接受强化干预的情况:以色列一家三级保健医院的结果。
IF 4.5 4区 医学 Q1 HEALTH POLICY & SERVICES Pub Date : 2023-05-24 DOI: 10.1186/s13584-023-00570-z
Gideon Leibner, Shuli Brammli-Greenberg, David Katz, Yaakov Esayag, Nechama Kaufman, Adam J Rose

Background: Patients admitted to internal medicine may be moved to more advanced-care settings when their condition deteriorates. In these advanced care settings, there may be higher levels of monitoring and greater ability to deliver Intensive Medical Treatments (IMTs). To the best of our knowledge, no previous study has examined the proportion of patients at different levels of care who receive different types of IMTs.

Methods: In this retrospective observational cohort study, we examined data from 56,002 internal medicine hospitalizations at Shaare Zedek Medical Center, between 01.01.2016 and 31.12.2019. Patients were divided according to where they received care: general-ward, Intermediate-Care Unit, Intensive Care Unit (ICU), or both (Intermediate-Care and ICU). We examined the rates at which these different groups of patients received one or more of the following IMTs: mechanical ventilation, daytime bi-level positive airway pressure (BiPAP), or vasopressor therapy.

Results: Most IMTs were delivered in a general-ward setting - ranging from 45.9% of IMT-treated hospitalizations involving combined mechanical ventilation and vasopressor therapy to as high as 87.4% of IMT-treated hospitalizations involving daytime BiPAP. Compared to ICU patients, Intermediate-Care Unit patients were older (mean age 75.1 vs 69.1, p < 0.001 for this and all other comparisons presented here), had longer hospitalizations (21.3 vs 14.5 days), and were more likely to die in-hospital (22% vs 12%). They were also more likely to receive most of the IMTs compared to ICU patients. For example, 9.7% of Intermediate-Care Unit patients received vasopressors, compared to 5.5% of ICU patients.

Conclusion: In this study, most of the patients who received IMTs actually received them in a general-bed and not in a dedicated unit. These results imply that IMTs are predominantly delivered in unmonitored settings, and suggest an opportunity to re-examine where and how IMTs are given. In terms of health policy, these findings suggest a need to further examine the setting and patterns of intensive interventions, as well as a need to increase the number of beds dedicated to delivering intensive interventions.

背景:入住内科的患者在病情恶化时可能会转移到更高级的护理机构。在这些高级护理环境中,可能会有更高水平的监测和更强的能力来提供强化医疗(IMTs)。据我们所知,之前没有研究调查过不同护理水平的患者接受不同类型imt的比例。方法:在这项回顾性观察队列研究中,我们分析了2016年1月1日至2019年12月31日期间Shaare Zedek医疗中心56,002例内科住院患者的数据。患者根据接受护理的地点进行分组:普通病房、中级护理病房、重症监护病房(ICU)或两者兼而有之(中级护理和ICU)。我们检查了这些不同组的患者接受以下一种或多种imt的比率:机械通气、日间双水平气道正压通气(BiPAP)或血管加压治疗。结果:大多数imt是在普通病房进行的,从45.9%的imt治疗住院,包括机械通气和血管加压治疗,到高达87.4%的imt治疗住院,包括日间BiPAP。与ICU患者相比,中间护理病房患者年龄较大(平均年龄75.1 vs 69.1, p)。结论:在本研究中,大多数接受IMTs的患者实际上是在普通病房接受的,而不是在专门的病房接受的。这些结果表明,imt主要是在不受监测的环境中提供的,这表明有机会重新审查在哪里以及如何提供imt。在卫生政策方面,这些调查结果表明,需要进一步审查强化干预措施的环境和模式,并需要增加专门用于提供强化干预措施的床位数量。
{"title":"Where internal medical patients receive intensive interventions: results from a tertiary-care hospital in Israel.","authors":"Gideon Leibner,&nbsp;Shuli Brammli-Greenberg,&nbsp;David Katz,&nbsp;Yaakov Esayag,&nbsp;Nechama Kaufman,&nbsp;Adam J Rose","doi":"10.1186/s13584-023-00570-z","DOIUrl":"https://doi.org/10.1186/s13584-023-00570-z","url":null,"abstract":"<p><strong>Background: </strong>Patients admitted to internal medicine may be moved to more advanced-care settings when their condition deteriorates. In these advanced care settings, there may be higher levels of monitoring and greater ability to deliver Intensive Medical Treatments (IMTs). To the best of our knowledge, no previous study has examined the proportion of patients at different levels of care who receive different types of IMTs.</p><p><strong>Methods: </strong>In this retrospective observational cohort study, we examined data from 56,002 internal medicine hospitalizations at Shaare Zedek Medical Center, between 01.01.2016 and 31.12.2019. Patients were divided according to where they received care: general-ward, Intermediate-Care Unit, Intensive Care Unit (ICU), or both (Intermediate-Care and ICU). We examined the rates at which these different groups of patients received one or more of the following IMTs: mechanical ventilation, daytime bi-level positive airway pressure (BiPAP), or vasopressor therapy.</p><p><strong>Results: </strong>Most IMTs were delivered in a general-ward setting - ranging from 45.9% of IMT-treated hospitalizations involving combined mechanical ventilation and vasopressor therapy to as high as 87.4% of IMT-treated hospitalizations involving daytime BiPAP. Compared to ICU patients, Intermediate-Care Unit patients were older (mean age 75.1 vs 69.1, p < 0.001 for this and all other comparisons presented here), had longer hospitalizations (21.3 vs 14.5 days), and were more likely to die in-hospital (22% vs 12%). They were also more likely to receive most of the IMTs compared to ICU patients. For example, 9.7% of Intermediate-Care Unit patients received vasopressors, compared to 5.5% of ICU patients.</p><p><strong>Conclusion: </strong>In this study, most of the patients who received IMTs actually received them in a general-bed and not in a dedicated unit. These results imply that IMTs are predominantly delivered in unmonitored settings, and suggest an opportunity to re-examine where and how IMTs are given. In terms of health policy, these findings suggest a need to further examine the setting and patterns of intensive interventions, as well as a need to increase the number of beds dedicated to delivering intensive interventions.</p>","PeriodicalId":46694,"journal":{"name":"Israel Journal of Health Policy Research","volume":"12 1","pages":"22"},"PeriodicalIF":4.5,"publicationDate":"2023-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10206337/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9607035","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Use and barriers to the use of telehealth services in the Arab population in Israel: a cross sectional survey. 以色列阿拉伯人口使用远程保健服务的情况和障碍:一项横断面调查。
IF 4.5 4区 医学 Q1 HEALTH POLICY & SERVICES Pub Date : 2023-05-23 DOI: 10.1186/s13584-023-00569-6
Nadav Penn, Michal Laron
<p><strong>Background: </strong>Studies conducted in Israel and in other countries show that minority populations typically underuse telehealth services notwithstanding the advantages inherent in the use of these services. The goal of this study was to examine telehealth use patterns and the barriers to the use of telehealth services in the Arab population in Israel, which is a culturally and ethnically varied minority population with a unique language and culture.</p><p><strong>Methods: </strong>A telephone survey was conducted among a representative sample of the adult Arab population in Israel from October 29 to November 4, 2020. Of the randomly sampled 1,192 adult Israeli Arabs 501 participants responded to the entire questionnaire, representing a response rate of 42%.</p><p><strong>Results: </strong>The study found that the majority of the adult Arab population in Israel faced no technology or Internet accessibility barriers. Thus, the majority of adult Israeli Arabs (87%) use the Internet on a daily basis and have smartphones (96%) and an Internet connection (93%). However, although they have high technology and Internet accessibility, their use of telehealth services is mostly a telephone appointment with a doctor (66%). At the same time, significantly lower use rates were found with regard to advanced telehealth services delivered through the Internet, e.g., consultation with a health care provider by email or chat (34%) or video chat (8%) and ordering of medications (14%). It was found that Arab Christians are more likely to use digital services than Arab Muslims, even when background characteristics are statistically controlled. Lack of awareness was found to be the major barrier to the use of telehealth services, specifically advanced services such as ordering of medications (23%) and video medical consultation (15%). A high rate of women cited the unmet need for the discreet provision of telehealth services as a barrier to their use of the services. It was also found that the majority of the adult Arab population had no objection in principle to the use of email or chat (75%) or video chat (51%) for consultation with a health care provider. It was further found that facilitating factors promoting the use of telehealth services include previous acquaintance with the health care provider, a stable internet infrastructure, the provision of the services in the Arabis language, guidance in the use of the service, a recommendation by a health care provider, and the participation of a family member in the online medical consultation.</p><p><strong>Conclusions: </strong>The study findings highlight the need for the provision of accessible and customized telehealth services for minority populations. Whether delivered over the phone or through the Internet, the services have to be culturally (for Muslims and Christians) and linguistically (Arabic) adapted, guidance in the use of the services should be provided, and service marketing should be t
背景:在以色列和其他国家进行的研究表明,尽管使用远程保健服务具有固有的优势,但少数民族人口通常未充分利用这些服务。本研究的目的是审查以色列阿拉伯人口使用远程保健的模式和使用远程保健服务的障碍,这是一个文化和种族多样化的少数民族人口,拥有独特的语言和文化。方法:于2020年10月29日至11月4日对以色列成年阿拉伯人口的代表性样本进行电话调查。在随机抽样的1192名成年以色列阿拉伯人中,有501人回答了整个问卷,回复率为42%。结果:研究发现,以色列的大多数成年阿拉伯人没有技术或互联网接入障碍。因此,大多数成年以色列阿拉伯人(87%)每天都使用互联网,拥有智能手机(96%)和互联网连接(93%)。然而,尽管他们拥有高科技和互联网接入,但他们使用远程保健服务的方式主要是通过电话预约医生(66%)。与此同时,通过互联网提供的先进远程保健服务的使用率明显较低,例如,通过电子邮件或聊天(34%)或视频聊天(8%)向保健提供者咨询以及订购药物(14%)。研究发现,阿拉伯基督徒比阿拉伯穆斯林更有可能使用数字服务,即使背景特征在统计上受到控制。调查发现,缺乏认识是使用远程保健服务的主要障碍,特别是订购药物(23%)和视频医疗咨询(15%)等高级服务。很高比例的妇女指出,对谨慎提供远程保健服务的需求未得到满足,这是她们使用这些服务的一个障碍。调查还发现,大多数阿拉伯成年人口原则上不反对使用电子邮件或聊天(75%)或视频聊天(51%)向保健提供者咨询。进一步发现,促进使用远程保健服务的便利因素包括:以前熟悉保健提供者、稳定的互联网基础设施、以阿拉伯语提供服务、使用服务的指导、保健提供者的建议以及家庭成员参与在线医疗咨询。结论:研究结果强调需要为少数民族人口提供可获取和定制的远程保健服务。无论是通过电话还是通过互联网提供,这些服务都必须适应文化(针对穆斯林和基督徒)和语言(阿拉伯语),应提供使用服务的指导,并应针对目标少数民族人口进行服务营销。应制定具体的解决办法,谨慎地向妇女提供远程保健服务,在与保健提供者进行在线咨询时保护她们的隐私,同时应明确指出让家庭成员参与在线医疗咨询的选择。此外,应通过在文化上适应阿拉伯社会的宣传活动,例如通过家庭医生的建议,提高对远程保健服务的认识。
{"title":"Use and barriers to the use of telehealth services in the Arab population in Israel: a cross sectional survey.","authors":"Nadav Penn,&nbsp;Michal Laron","doi":"10.1186/s13584-023-00569-6","DOIUrl":"https://doi.org/10.1186/s13584-023-00569-6","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Studies conducted in Israel and in other countries show that minority populations typically underuse telehealth services notwithstanding the advantages inherent in the use of these services. The goal of this study was to examine telehealth use patterns and the barriers to the use of telehealth services in the Arab population in Israel, which is a culturally and ethnically varied minority population with a unique language and culture.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A telephone survey was conducted among a representative sample of the adult Arab population in Israel from October 29 to November 4, 2020. Of the randomly sampled 1,192 adult Israeli Arabs 501 participants responded to the entire questionnaire, representing a response rate of 42%.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The study found that the majority of the adult Arab population in Israel faced no technology or Internet accessibility barriers. Thus, the majority of adult Israeli Arabs (87%) use the Internet on a daily basis and have smartphones (96%) and an Internet connection (93%). However, although they have high technology and Internet accessibility, their use of telehealth services is mostly a telephone appointment with a doctor (66%). At the same time, significantly lower use rates were found with regard to advanced telehealth services delivered through the Internet, e.g., consultation with a health care provider by email or chat (34%) or video chat (8%) and ordering of medications (14%). It was found that Arab Christians are more likely to use digital services than Arab Muslims, even when background characteristics are statistically controlled. Lack of awareness was found to be the major barrier to the use of telehealth services, specifically advanced services such as ordering of medications (23%) and video medical consultation (15%). A high rate of women cited the unmet need for the discreet provision of telehealth services as a barrier to their use of the services. It was also found that the majority of the adult Arab population had no objection in principle to the use of email or chat (75%) or video chat (51%) for consultation with a health care provider. It was further found that facilitating factors promoting the use of telehealth services include previous acquaintance with the health care provider, a stable internet infrastructure, the provision of the services in the Arabis language, guidance in the use of the service, a recommendation by a health care provider, and the participation of a family member in the online medical consultation.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;The study findings highlight the need for the provision of accessible and customized telehealth services for minority populations. Whether delivered over the phone or through the Internet, the services have to be culturally (for Muslims and Christians) and linguistically (Arabic) adapted, guidance in the use of the services should be provided, and service marketing should be t","PeriodicalId":46694,"journal":{"name":"Israel Journal of Health Policy Research","volume":"12 1","pages":"21"},"PeriodicalIF":4.5,"publicationDate":"2023-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10204005/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9610820","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A call to readjust the Israeli school feeding program. 呼吁重新调整以色列学校供餐计划。
IF 4.5 4区 医学 Q1 HEALTH POLICY & SERVICES Pub Date : 2023-05-10 DOI: 10.1186/s13584-023-00568-7
Dorit Nitzan

The COVID-19 pandemic challenged the food and nutrition security status of thousands of children in Israel. This commentary argues that policymakers should urgently readjust the Israeli school feeding program based on experts' advice. Children should have the right to select food items, grow the items, prepare the meals, and clean and care for the waste together. They should eat as a community in suitable school dining rooms. Access to the school feeding program should also be ensured during emergencies, school closures, isolation and quarantine, treatment, and rehabilitation of children. The food provided through the program should be integrated into the food baskets of their families, aimed at improving their households' food and nutrition security. It is important to activate a universal school feeding program that does not differentiate, separate, and stigmatize children, their households, their communities, and their schools. The United States National School Lunch Program is briefly reviewed, highlighting the importance of the program's routine monitoring, evaluation, and improvement. Engaging the children in planning the meals and in the production, preparedness, provision, and waste management processes are key to improving their involvement, health literacy and promotion, and their families' resilience. Implementing a holistic Food System Approach, including school gardening and "Farm to School," is suggested. It is recommended to urgently formulate a modern, universal, and comprehensive Israeli Food and Nutrition Security Plan, with a dedicated chapter for the upgraded School Feeding Programe with a section on its implementation in emergency preparedness, response, and Resilience. It should be anchored in the Food Systems framework and the One Health Approach.

COVID-19 大流行对以色列成千上万儿童的食品和营养安全状况提出了挑战。本评论认为,政策制定者应根据专家建议紧急调整以色列学校供餐计划。儿童应有权选择食品、种植食品、准备饭菜,并共同清理和处理垃圾。他们应在合适的学校餐厅集体用餐。在紧急情况、学校关闭、隔离检疫、治疗和儿童康复期间,也应确保学校供餐计划的实施。学校供餐计划提供的食物应纳入儿童家庭的菜篮子,以改善其家庭的粮食和营养安全状况。重要的是,要启动一项不对儿童、其家庭、社区和学校进行区分、隔离和污名化的普及学校供餐计划。本文简要回顾了美国全国学校午餐计划,强调了该计划日常监测、评估和改进的重要性。让儿童参与膳食规划以及生产、准备、供应和废物管理过程,是提高他们的参与度、健康知识普及和促进以及家庭复原力的关键。建议实施全面的食品系统方法,包括学校园艺和 "农场到学校"。建议紧急制定一项现代、普遍和全面的《以色列粮食和营养安全计划》,其中专门有一章论述升级后的 "学校供餐计划",并有一节论述该计划在应急准备、响应和复原力方面的实施情况。该计划应立足于粮食系统框架和 "一个健康 "方法。
{"title":"A call to readjust the Israeli school feeding program.","authors":"Dorit Nitzan","doi":"10.1186/s13584-023-00568-7","DOIUrl":"10.1186/s13584-023-00568-7","url":null,"abstract":"<p><p>The COVID-19 pandemic challenged the food and nutrition security status of thousands of children in Israel. This commentary argues that policymakers should urgently readjust the Israeli school feeding program based on experts' advice. Children should have the right to select food items, grow the items, prepare the meals, and clean and care for the waste together. They should eat as a community in suitable school dining rooms. Access to the school feeding program should also be ensured during emergencies, school closures, isolation and quarantine, treatment, and rehabilitation of children. The food provided through the program should be integrated into the food baskets of their families, aimed at improving their households' food and nutrition security. It is important to activate a universal school feeding program that does not differentiate, separate, and stigmatize children, their households, their communities, and their schools. The United States National School Lunch Program is briefly reviewed, highlighting the importance of the program's routine monitoring, evaluation, and improvement. Engaging the children in planning the meals and in the production, preparedness, provision, and waste management processes are key to improving their involvement, health literacy and promotion, and their families' resilience. Implementing a holistic Food System Approach, including school gardening and \"Farm to School,\" is suggested. It is recommended to urgently formulate a modern, universal, and comprehensive Israeli Food and Nutrition Security Plan, with a dedicated chapter for the upgraded School Feeding Programe with a section on its implementation in emergency preparedness, response, and Resilience. It should be anchored in the Food Systems framework and the One Health Approach.</p>","PeriodicalId":46694,"journal":{"name":"Israel Journal of Health Policy Research","volume":"12 1","pages":"20"},"PeriodicalIF":4.5,"publicationDate":"2023-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10171145/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9528916","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Perspective: lessons learned from the COVID-19 pandemic concerning the resilience of the population. 观点:从2019冠状病毒病大流行中吸取的关于人口复原力的教训。
IF 4.5 4区 医学 Q1 HEALTH POLICY & SERVICES Pub Date : 2023-05-02 DOI: 10.1186/s13584-023-00557-w
Bruria Adini, Shaul Kimhi

Background: A vital stakeholder in the successful management of the COVID-19 pandemic is the public. The degree of involvement of the population in managing the pandemic, and the leadership perception of the public, had a direct impact on the resilience of the population and level of adherence to the issued protective measures.

Main body: Resilience refers to the ability to 'bounce back' or 'bounce forward' following adversity. Resilience facilitates community engagement which is a crucial component of combating the COVID-19 pandemic. The article highlights six insights recognized in studies conducted in Israel during and following the pandemic concerning the resilience of the country's population. (1) Contrary to varied adversities in which the community serves as an important support system to the individuals, this type of support was substantially impaired during the COVID-19 pandemic, due to the need to maintain isolation, social distancing, and lockdowns. (2) Policy-making during the pandemic should be based on evidence-based data, rather than on assumptions made by decision-makers. This gap led the authorities during the pandemic to adopt measures that were ineffective, such as risk communication based on 'scare tactics' concerning the virus, when the highest risk perceived by the public was political instability. (3) Societal resilience is associated with the public's behavior, such as with vaccine hesitancy and uptake. (4) Factors that affect the levels of resilience include, among others, self-efficacy (impacts individual resilience); social, institutional, and economic aspects as well as well-being (impact community resilience); and hope and trust in the leadership (impact societal resilience). (5) The public should be perceived as an asset in managing the pandemic, thus becoming a vital part of the 'solution'. This will lead to a better understanding of the needs and expectations of the population and an applicable 'tailoring' of the messages that address the public. (6) The gap between science and policymaking must be bridged, to achieve optimal management of the pandemic.

Conclusions: Improving preparedness for future pandemics should be based on a holistic view of all stakeholders, including the public as a valued partner, connectivity between policymakers and scientists, and strengthening the public's resilience, by enhancing trust in authorities.

背景:公众是成功管理COVID-19大流行的重要利益攸关方。民众参与管理大流行病的程度,以及领导人对公众的看法,对民众的复原力和遵守已颁布的保护措施的程度有直接影响。正文:弹性是指在逆境中“反弹”或“反弹”的能力。韧性促进社区参与,这是抗击COVID-19大流行的关键组成部分。这篇文章强调了在大流行期间和之后在以色列进行的有关该国人口复原力的研究中所确认的六项见解。(1)在各种逆境中,社区都是个人的重要支持系统,但在2019冠状病毒病大流行期间,由于需要保持隔离、保持社交距离和封锁,这种支持严重受损。(2)大流行期间的决策应基于循证数据,而不是决策者的假设。这一差距导致当局在大流行期间采取了无效的措施,例如在公众认为的最大风险是政治不稳定的情况下,基于“恐吓战术”的风险通报。(3)社会恢复力与公众行为有关,如疫苗犹豫和接种。(4)影响心理弹性水平的因素包括自我效能感(影响个体心理弹性);社会、制度和经济方面以及福祉(影响社区复原力);以及对领导层的希望和信任(影响社会恢复力)。(5)应将公众视为管理大流行的资产,从而成为“解决方案”的重要组成部分。这将有助于更好地了解人口的需要和期望,并对面向公众的信息进行适用的“量身定制”。(6)必须弥合科学与决策之间的差距,以实现对大流行的最佳管理。结论:加强对未来大流行的防范应基于对所有利益攸关方的整体看法,包括作为重要伙伴的公众、决策者和科学家之间的联系,以及通过增强对当局的信任来增强公众的抵御能力。
{"title":"Perspective: lessons learned from the COVID-19 pandemic concerning the resilience of the population.","authors":"Bruria Adini,&nbsp;Shaul Kimhi","doi":"10.1186/s13584-023-00557-w","DOIUrl":"https://doi.org/10.1186/s13584-023-00557-w","url":null,"abstract":"<p><strong>Background: </strong>A vital stakeholder in the successful management of the COVID-19 pandemic is the public. The degree of involvement of the population in managing the pandemic, and the leadership perception of the public, had a direct impact on the resilience of the population and level of adherence to the issued protective measures.</p><p><strong>Main body: </strong>Resilience refers to the ability to 'bounce back' or 'bounce forward' following adversity. Resilience facilitates community engagement which is a crucial component of combating the COVID-19 pandemic. The article highlights six insights recognized in studies conducted in Israel during and following the pandemic concerning the resilience of the country's population. (1) Contrary to varied adversities in which the community serves as an important support system to the individuals, this type of support was substantially impaired during the COVID-19 pandemic, due to the need to maintain isolation, social distancing, and lockdowns. (2) Policy-making during the pandemic should be based on evidence-based data, rather than on assumptions made by decision-makers. This gap led the authorities during the pandemic to adopt measures that were ineffective, such as risk communication based on 'scare tactics' concerning the virus, when the highest risk perceived by the public was political instability. (3) Societal resilience is associated with the public's behavior, such as with vaccine hesitancy and uptake. (4) Factors that affect the levels of resilience include, among others, self-efficacy (impacts individual resilience); social, institutional, and economic aspects as well as well-being (impact community resilience); and hope and trust in the leadership (impact societal resilience). (5) The public should be perceived as an asset in managing the pandemic, thus becoming a vital part of the 'solution'. This will lead to a better understanding of the needs and expectations of the population and an applicable 'tailoring' of the messages that address the public. (6) The gap between science and policymaking must be bridged, to achieve optimal management of the pandemic.</p><p><strong>Conclusions: </strong>Improving preparedness for future pandemics should be based on a holistic view of all stakeholders, including the public as a valued partner, connectivity between policymakers and scientists, and strengthening the public's resilience, by enhancing trust in authorities.</p>","PeriodicalId":46694,"journal":{"name":"Israel Journal of Health Policy Research","volume":"12 1","pages":"19"},"PeriodicalIF":4.5,"publicationDate":"2023-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10153045/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9467588","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Antimicrobial resistance in food-producing animals: towards implementing a one health based national action plan in Israel. 食用动物的抗菌药耐药性:在以色列实施以健康为基础的国家行动计划。
IF 3.5 4区 医学 Q1 HEALTH POLICY & SERVICES Pub Date : 2023-04-26 DOI: 10.1186/s13584-023-00562-z
Tali Sarah Berman, Zohar Barnett-Itzhaki, Tamar Berman, Eli Marom

Background: Development of antimicrobial resistance poses a major threat to human and animal health worldwide. Antimicrobials are frequently used in animal husbandry, making food-producing animals a widespread and important source of antimicrobial resistance. Indeed, recent evidence demonstrates that antimicrobial resistance in food-producing animals poses a threat to the health of humans, animals and the environment. To address this threat, national action plans have been implemented based on a 'One Health' approach, which integrates actions across human and animal health sectors to combat antimicrobial resistance. Although under development, Israel has yet to publish a national action plan against antimicrobial resistance, despite alarming findings of resistant bacteria in food-producing animals in the country. Here we review several national action plans against antimicrobial resistance around the world in order to suggest approaches to develop a national action plan in Israel.

Main body: We investigated worldwide national action plans against antimicrobial resistance based on a 'One Health' approach. We also conducted interviews with representatives of relevant Israeli ministries to understand antimicrobial resistance policy and regulatory frameworks in Israel. Finally, we present recommendations for Israel towards implementing a 'One Health' national action plan against antimicrobial resistance. Many countries have developed such plans, however, only a few are currently funded. Furthermore, many countries, especially in Europe, have taken action to reduce the use of antimicrobials and the spread of antimicrobial resistance in food-producing animals by banning the use of antimicrobials to promote growth, reporting data on the use and sales of antimicrobials in food-producing animals, operating centralized antimicrobial resistance surveillance systems and preventing the use of antimicrobials important to human medicine to treat food-producing animals.

Conclusions: Without a comprehensive and funded national action plan, the risks of antimicrobial resistance to the public health in Israel will escalate. Thus, several actions should be considered: (1) Reporting data on the use of antimicrobials in humans and animals. (2) Operating a centralized surveillance system for antimicrobial resistance in humans, animals and the environment. (3) Improving awareness regarding antimicrobial resistance in the general public and in health practitioners from both human and animal sectors. (4) Composing a list of critically important antimicrobials to human medicine that's use should be avoided in food-producing animals. (5) Enforcing best practices of antimicrobial use at the farm-level. (6) Reducing incidence of infection through farm biosecurity. (7) Supporting research and development of new antimicrobial treatments, vaccines and diagnostic tools.

背景:抗菌药耐药性的产生对全球人类和动物健康构成了重大威胁。抗菌素经常被用于畜牧业,因此食用动物是抗菌素耐药性广泛而重要的来源。事实上,最近的证据表明,食用动物的抗菌药耐药性对人类、动物和环境的健康构成了威胁。为应对这一威胁,以色列已在 "一体健康 "方法的基础上实施了国家行动计划,该方法整合了人类和动物卫生部门的行动,以抗击抗生素耐药性。尽管以色列正在制定国家行动计划,但尚未公布抗菌药耐药性国家行动计划,尽管在该国的食用动物中发现了令人担忧的耐药细菌。在此,我们回顾了全球多个国家的抗菌药耐药性行动计划,以便为以色列制定国家行动计划提出建议:我们以 "一个健康 "的方法为基础,调查了世界各国的抗菌药耐药性行动计划。我们还采访了以色列相关部委的代表,以了解以色列的抗菌药耐药性政策和监管框架。最后,我们向以色列提出了实施 "同一健康 "抗菌药耐药性国家行动计划的建议。许多国家已经制定了此类计划,但目前只有少数国家获得了资助。此外,许多国家(尤其是欧洲国家)已经采取行动,通过禁止使用抗菌药促进生长、报告食用动物中抗菌药的使用和销售数据、运行中央抗菌药耐药性监测系统以及防止使用对人类医学非常重要的抗菌药治疗食用动物等措施,减少抗菌药的使用和抗菌药耐药性在食用动物中的传播:结论:如果没有一个全面的、资金充足的国家行动计划,抗菌药耐药性对以色列公众健康造成的风险将不断上升。因此,应考虑采取以下几项行动:(1)报告人类和动物使用抗菌药物的数据。(2) 对人类、动物和环境中的抗菌素耐药性实施集中监控。(3) 提高公众以及人类和动物卫生从业人员对抗菌素耐药性的认识。(4) 编制一份清单,列出应避免在食用动物中使用的、对人类医学极为重要的抗菌素。(5) 在农场一级实施使用抗菌剂的最佳做法。(6) 通过农场生物安全降低感染率。(7) 支持研究和开发新的抗菌治疗方法、疫苗和诊断工具。
{"title":"Antimicrobial resistance in food-producing animals: towards implementing a one health based national action plan in Israel.","authors":"Tali Sarah Berman, Zohar Barnett-Itzhaki, Tamar Berman, Eli Marom","doi":"10.1186/s13584-023-00562-z","DOIUrl":"10.1186/s13584-023-00562-z","url":null,"abstract":"<p><strong>Background: </strong>Development of antimicrobial resistance poses a major threat to human and animal health worldwide. Antimicrobials are frequently used in animal husbandry, making food-producing animals a widespread and important source of antimicrobial resistance. Indeed, recent evidence demonstrates that antimicrobial resistance in food-producing animals poses a threat to the health of humans, animals and the environment. To address this threat, national action plans have been implemented based on a 'One Health' approach, which integrates actions across human and animal health sectors to combat antimicrobial resistance. Although under development, Israel has yet to publish a national action plan against antimicrobial resistance, despite alarming findings of resistant bacteria in food-producing animals in the country. Here we review several national action plans against antimicrobial resistance around the world in order to suggest approaches to develop a national action plan in Israel.</p><p><strong>Main body: </strong>We investigated worldwide national action plans against antimicrobial resistance based on a 'One Health' approach. We also conducted interviews with representatives of relevant Israeli ministries to understand antimicrobial resistance policy and regulatory frameworks in Israel. Finally, we present recommendations for Israel towards implementing a 'One Health' national action plan against antimicrobial resistance. Many countries have developed such plans, however, only a few are currently funded. Furthermore, many countries, especially in Europe, have taken action to reduce the use of antimicrobials and the spread of antimicrobial resistance in food-producing animals by banning the use of antimicrobials to promote growth, reporting data on the use and sales of antimicrobials in food-producing animals, operating centralized antimicrobial resistance surveillance systems and preventing the use of antimicrobials important to human medicine to treat food-producing animals.</p><p><strong>Conclusions: </strong>Without a comprehensive and funded national action plan, the risks of antimicrobial resistance to the public health in Israel will escalate. Thus, several actions should be considered: (1) Reporting data on the use of antimicrobials in humans and animals. (2) Operating a centralized surveillance system for antimicrobial resistance in humans, animals and the environment. (3) Improving awareness regarding antimicrobial resistance in the general public and in health practitioners from both human and animal sectors. (4) Composing a list of critically important antimicrobials to human medicine that's use should be avoided in food-producing animals. (5) Enforcing best practices of antimicrobial use at the farm-level. (6) Reducing incidence of infection through farm biosecurity. (7) Supporting research and development of new antimicrobial treatments, vaccines and diagnostic tools.</p>","PeriodicalId":46694,"journal":{"name":"Israel Journal of Health Policy Research","volume":"12 1","pages":"18"},"PeriodicalIF":3.5,"publicationDate":"2023-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10132406/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9828066","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Cytomegalovirus (CMV) seroprevalence among women at childbearing age, maternal and congenital CMV infection: policy implications of a descriptive, retrospective, community-based study. 育龄妇女巨细胞病毒(CMV)血清阳性率、孕产妇和先天性巨细胞病毒感染:一项描述性、回顾性、基于社区的研究对政策的影响。
IF 3.5 4区 医学 Q1 HEALTH POLICY & SERVICES Pub Date : 2023-04-25 DOI: 10.1186/s13584-023-00566-9
Assaf Ben Shoham, Yechiel Schlesinger, Ian Miskin, Ziva Kalderon, Rachel Michaelson-Cohen, Yonit Wiener-Well
<p><strong>Background: </strong>Maternal CMV infection during pregnancy, either primary or non-primary, may be associated with fetal infection and long-term sequelae. While guidelines recommend against it, screening for CMV in pregnant women is a prevalent clinical practice in Israel. Our aim is to provide updated, local, clinically relevant, epidemiological information about CMV seroprevalence among women at childbearing age, the incidence of maternal CMV infection during pregnancy and the prevalence of congenital CMV (cCMV), as well as to provide information about the yield of CMV serology testing.</p><p><strong>Methods: </strong>We performed a descriptive, retrospective study of women at childbearing age who were members of Clalit Health Services in the district of Jerusalem and had at least one gestation during the study period (2013-2019). We utilized serial serology tests to determine CMV serostatus at baseline and at pre/periconception and identified temporal changes in CMV serostatus. We then conducted a sub-sample analysis integrating inpatient data on newborns of women who gave birth in a single large medical center. cCMV was defined as either positive urine CMV-PCR test in a sample collected during the first 3 weeks of life, neonatal diagnosis of cCMV in the medical records, or prescription of valganciclovir during the neonatal period.</p><p><strong>Results: </strong>The study population Included 45,634 women with 84,110 associated gestational events. Initial CMV serostatus was positive in 89% women, with variation across different ethno-socioeconomic subgroups. Based on consecutive serology tests, the detected incidence rate of CMV infection was 2/1000 women follow-up years, among initially seropositive women, and 80/1000 women follow-up years, among initially seronegative women. CMV infection in pregnancy was identified among 0.2% of women who were seropositive at pre/periconception and among 10% of women who were seronegative. In a subsample, which included 31,191 associated gestational events, we identified 54 newborns with cCMV (1.9/1000 live births). The prevalence of cCMV among newborns of women who were seropositive at pre/periconception was lower than among newborns of women who were seronegative (2.1 vs. 7.1/1000). Frequent serology tests among women who were seronegative at pre/periconception detected most primary CMV infections in pregnancy that resulted in cCMV (21/24). However, among women who were seropositive, serology tests prior to birth detected none of the non-primary infections that resulted in cCMV (0/30).</p><p><strong>Conclusions: </strong>In this retrospective community-based study among women of childbearing age characterized by multiparity and high seroprevalence of CMV, we find that consecutive CMV serology testing enabled to detect most primary CMV infections in pregnancy that led to cCMV in newborns but failed to detect non-primary CMV infections in pregnancy. Conducting CMV serology tests among seropositi
背景:妊娠期母体 CMV 感染(无论是原发性还是非原发性)可能与胎儿感染和长期后遗症有关。虽然指导原则建议不要对孕妇进行 CMV 筛查,但这在以色列的临床实践中非常普遍。我们的目的是提供有关育龄妇女中 CMV 血清流行率、孕期母体 CMV 感染率和先天性 CMV(cCMV)流行率的最新本地临床流行病学信息,并提供有关 CMV 血清学检测结果的信息:我们对耶路撒冷地区 Clalit 卫生服务机构的育龄妇女进行了一项描述性回顾研究,这些妇女在研究期间(2013-2019 年)至少有过一次妊娠。我们利用序列血清学测试来确定基线和孕前/围产期的 CMV 血清状态,并确定 CMV 血清状态的时间变化。cCMV 的定义是:出生后 3 周内采集的尿液样本中 CMV-PCR 检测呈阳性、病历中新生儿诊断为 cCMV 或新生儿期开具了缬更昔洛韦处方:研究对象包括 45,634 名妇女和 84,110 例相关妊娠事件。89%的妇女最初的 CMV 血清呈阳性,不同种族-社会经济亚群之间存在差异。根据连续的血清学检测,在最初血清呈阳性的妇女中,CMV 感染的检测发病率为 2/1000,在最初血清呈阴性的妇女中,CMV 感染的检测发病率为 80/1000。在孕前/围产期血清反应呈阳性的妇女中,有 0.2%的人在怀孕期间感染了 CMV,而在血清反应呈阴性的妇女中,有 10%的人在怀孕期间感染了 CMV。在包括 31 191 例相关妊娠事件的子样本中,我们发现 54 名新生儿感染了巨细胞病毒(1.9/1000 例活产)。孕前/围产期血清反应阳性妇女的新生儿中 cCMV 感染率低于血清反应阴性妇女的新生儿(2.1 对 7.1/1000)。在孕前/围产期血清学检测呈阴性的妇女中,通过频繁的血清学检测发现了大多数导致 cCMV 的妊娠期原发性 CMV 感染(21/24)。然而,在血清反应呈阳性的妇女中,分娩前的血清检测没有发现导致 cCMV 的非原发性感染(0/30):在这项以社区为基础的回顾性研究中,我们发现在多胎妊娠和 CMV 血清高流行率的育龄妇女中,连续的 CMV 血清学检测能够发现大多数导致新生儿患上 cCMV 的妊娠期原发性 CMV 感染,但未能发现妊娠期非原发性 CMV 感染。尽管有指南建议,但在血清反应阳性的妇女中进行 CMV 血清学检测并没有临床价值,而且成本高昂,还会带来更多的不确定性和困扰。因此,我们建议不要对之前血清学检测呈阳性的妇女进行常规 CMV 血清学检测。我们建议仅在已知血清阴性或血清状态不明的妇女怀孕前进行 CMV 血清学检测。
{"title":"Cytomegalovirus (CMV) seroprevalence among women at childbearing age, maternal and congenital CMV infection: policy implications of a descriptive, retrospective, community-based study.","authors":"Assaf Ben Shoham, Yechiel Schlesinger, Ian Miskin, Ziva Kalderon, Rachel Michaelson-Cohen, Yonit Wiener-Well","doi":"10.1186/s13584-023-00566-9","DOIUrl":"10.1186/s13584-023-00566-9","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Maternal CMV infection during pregnancy, either primary or non-primary, may be associated with fetal infection and long-term sequelae. While guidelines recommend against it, screening for CMV in pregnant women is a prevalent clinical practice in Israel. Our aim is to provide updated, local, clinically relevant, epidemiological information about CMV seroprevalence among women at childbearing age, the incidence of maternal CMV infection during pregnancy and the prevalence of congenital CMV (cCMV), as well as to provide information about the yield of CMV serology testing.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We performed a descriptive, retrospective study of women at childbearing age who were members of Clalit Health Services in the district of Jerusalem and had at least one gestation during the study period (2013-2019). We utilized serial serology tests to determine CMV serostatus at baseline and at pre/periconception and identified temporal changes in CMV serostatus. We then conducted a sub-sample analysis integrating inpatient data on newborns of women who gave birth in a single large medical center. cCMV was defined as either positive urine CMV-PCR test in a sample collected during the first 3 weeks of life, neonatal diagnosis of cCMV in the medical records, or prescription of valganciclovir during the neonatal period.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The study population Included 45,634 women with 84,110 associated gestational events. Initial CMV serostatus was positive in 89% women, with variation across different ethno-socioeconomic subgroups. Based on consecutive serology tests, the detected incidence rate of CMV infection was 2/1000 women follow-up years, among initially seropositive women, and 80/1000 women follow-up years, among initially seronegative women. CMV infection in pregnancy was identified among 0.2% of women who were seropositive at pre/periconception and among 10% of women who were seronegative. In a subsample, which included 31,191 associated gestational events, we identified 54 newborns with cCMV (1.9/1000 live births). The prevalence of cCMV among newborns of women who were seropositive at pre/periconception was lower than among newborns of women who were seronegative (2.1 vs. 7.1/1000). Frequent serology tests among women who were seronegative at pre/periconception detected most primary CMV infections in pregnancy that resulted in cCMV (21/24). However, among women who were seropositive, serology tests prior to birth detected none of the non-primary infections that resulted in cCMV (0/30).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;In this retrospective community-based study among women of childbearing age characterized by multiparity and high seroprevalence of CMV, we find that consecutive CMV serology testing enabled to detect most primary CMV infections in pregnancy that led to cCMV in newborns but failed to detect non-primary CMV infections in pregnancy. Conducting CMV serology tests among seropositi","PeriodicalId":46694,"journal":{"name":"Israel Journal of Health Policy Research","volume":"12 1","pages":"16"},"PeriodicalIF":3.5,"publicationDate":"2023-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10131385/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9573078","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
期刊
Israel Journal of Health Policy Research
全部 Acc. Chem. Res. ACS Applied Bio Materials ACS Appl. Electron. Mater. ACS Appl. Energy Mater. ACS Appl. Mater. Interfaces ACS Appl. Nano Mater. ACS Appl. Polym. Mater. ACS BIOMATER-SCI ENG ACS Catal. ACS Cent. Sci. ACS Chem. Biol. ACS Chemical Health & Safety ACS Chem. Neurosci. ACS Comb. Sci. ACS Earth Space Chem. ACS Energy Lett. ACS Infect. Dis. ACS Macro Lett. ACS Mater. Lett. ACS Med. Chem. Lett. ACS Nano ACS Omega ACS Photonics ACS Sens. ACS Sustainable Chem. Eng. ACS Synth. Biol. Anal. Chem. BIOCHEMISTRY-US Bioconjugate Chem. BIOMACROMOLECULES Chem. Res. Toxicol. Chem. Rev. Chem. Mater. CRYST GROWTH DES ENERG FUEL Environ. Sci. Technol. Environ. Sci. Technol. Lett. Eur. J. Inorg. Chem. IND ENG CHEM RES Inorg. Chem. J. Agric. Food. Chem. J. Chem. Eng. Data J. Chem. Educ. J. Chem. Inf. Model. J. Chem. Theory Comput. J. Med. Chem. J. Nat. Prod. J PROTEOME RES J. Am. Chem. Soc. LANGMUIR MACROMOLECULES Mol. Pharmaceutics Nano Lett. Org. Lett. ORG PROCESS RES DEV ORGANOMETALLICS J. Org. Chem. J. Phys. Chem. J. Phys. Chem. A J. Phys. Chem. B J. Phys. Chem. C J. Phys. Chem. Lett. Analyst Anal. Methods Biomater. Sci. Catal. Sci. Technol. Chem. Commun. Chem. Soc. Rev. CHEM EDUC RES PRACT CRYSTENGCOMM Dalton Trans. Energy Environ. Sci. ENVIRON SCI-NANO ENVIRON SCI-PROC IMP ENVIRON SCI-WAT RES Faraday Discuss. Food Funct. Green Chem. Inorg. Chem. Front. Integr. Biol. J. Anal. At. Spectrom. J. Mater. Chem. A J. Mater. Chem. B J. Mater. Chem. C Lab Chip Mater. Chem. Front. Mater. Horiz. MEDCHEMCOMM Metallomics Mol. Biosyst. Mol. Syst. Des. Eng. Nanoscale Nanoscale Horiz. Nat. Prod. Rep. New J. Chem. Org. Biomol. Chem. Org. Chem. Front. PHOTOCH PHOTOBIO SCI PCCP Polym. Chem.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1