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Biomedical subjects

H Palti

Publications and source records attributed to H Palti.

At least 37 records · Page 2Linked to original sources
PubMed1993

Factors affecting the utilization of prenatal health care services in Jerusalem.

Health service utilization patterns during pregnancy were studied among 780 women from selected neighborhoods of Jerusalem who delivered between December 1, 1985 and June 30, 1986. Factors affecting the choice of care-provider, the timing of the first contact with the prenatal care service and the frequency of visits to prenatal care centers were studied with respect to several demographic, socio-economic and needs variables. About one half of the women visited the Family Health Centers, the traditional site for delivery of prenatal care. Forty percent visited their regular doctor during pregnancy while about 30% sought private care. In all, fifty two percent of women consulted more than one source of medical care service during pregnancy. Logistic regression analysis showed that the choice of care was determined by the type of insurance, need factors and education. The timing of the first visit depended on origin, level of education and parity. The frequency of visits was related to the type of insurance and to perceived health.

Choice Behavior↗
PubMed1992

Utilization of pediatric health services in Jerusalem.

The high rate of utilization of health services and rising health care costs in Israel, have prompted the need for reform of the health care system. Preventive and curative aspects of mother and child health care in Israel have traditionally been addressed by independent but parallel health systems. Prior to the pilot integration of these services, current patterns of utilization of health services by children during their first year of life, and determinants of use, were analyzed. Mothers of 651 children from five neighborhoods, representing the middle-low, middle and upper social class Jewish population were interviewed. Overall, a high degree of compliance with recommended visits to the preventive family health centers was found, with an average of eleven visits to the public health physician or nurse. The children also made an average of 12 visits to curative practitioners. Combined with all other health care consultations, these children averaged 26 health care visits in the first year of life. This pattern of frequent visitations, and its determinants, is discussed in context of the current framework of parallel health care systems. Multivariate analysis revealed that the birth order of the child was the key factor in determining the number of preventive visits, while the mother's perception of her child's health status held the major influence on the number of curative visits. No association between utilization of services and social class was discovered. Comparison of utilization patterns arising from this study with subsequent investigation of the planned integrated services allows for the assessment of the effects of a major change in the structure and delivery of pediatric services.

Adult↗
PubMed1992

Time trends of haemoglobin levels and anaemia prevalence in infancy in a total community.

In order to determine the trends in haemoglobin (Hb) levels and the prevalence of anaemia in infancy in an entire community, 3,147 infants aged 9-11 months attending the Mother and Child Health Clinics of the teaching and research Health Center in Kiryat Hayovel, Jerusalem, were examined. From 1971 to 1979 infants diagnosed as anaemic were given treatment. From 1980 to 1988 supplement was given to all infants from the age of 3 to 12 months. There was a mean increase of 0.6 g/dlHb between the two periods, with a larger increase in the Hb levels in 1980-88 as compared to 1971-79 (P = .0001). The prevalence of anaemia less than 11 g/dlHb decreased from 36% in 1971 to 27% in 1979 and to 19% in 1988. The prevalence of anaemia less than 10 g/dlHb decreased from 13.7% in 1971 to 8.7% in 1979 and to 3.6% in 1988. The time trend is probably due to changes in the socio-demographic characteristics of the population, an overall change in infant feeding practices in relation to iron source and the supplementation programme.

Anemia↗
PubMed1992

Maternal and environmental characteristics as predictors of child behavior problems and cognitive competence.

Maternal and environmental characteristics as predictors of behavioral problems and cognitive competence in 505 Israeli kindergarten children were investigated. Events in closer temporal proximity to assessments of functioning appeared more predictive than those in early infancy. Findings support the need to include variables reflecting maternal characteristics in any prediction of child outcome and to consider the sex of the child in selection of variables.

Achievement↗
PubMed1992

Prevalence of disabilities in a national sample of 7-year-old Israeli children.

The prevalence of chronic conditions and illnesses causing disability in Israeli Jewish children aged 7 years born in 1975 was studied on the basis of a national sample (n = 7,739). Eighty medical conditions causing disability were defined. The study showed a total disability rate of 17.5%, which is higher than that reported on a similar national sample of 3 year olds (prevalence of 6.9%). The percentage of disabilities among very low birthweight children and those with family problems was four times greater than in the total population. Mild retardation and undefined learning problems were more prevalent among children of mothers with low educational level and among children whose birth order was fourth or more. Asthma and spastic bronchitis were more prevalent among children whose mothers were of European/American origin (P less than 0.05). Behavior and mental disorders, learning problems, speech and language disorders were more prevalent among male children. Two-thirds of the children with a diagnosed problem also had at least one functional disability. There were relatively more children from lower social classes in the special education schools than in the national sample. Increased prevalence of disabilities among children of very low birthweight, low maternal educational level, high birth order, and those from families whose origin is Asian/African and from families with intrafamilial problems defines the children at risk for disabilities and placement in special education schools.

Birth Order↗
PubMed1991

The incidence of childhood and adolescent injuries and their outcome: a population-based study.

A study of injuries was carried out among 123,630 Jewish children aged 0-17 in the city of Jerusalem. A 25% sample of emergency room (ER) visits to the four hospitals and the first-aid station and all hospitalizations and deaths were studied from 1 January to 31 December 1986. The incidence of visits to the ER was 980.7/10,000 child-years [confidence intervals (CI) = 963.3-998.3/10,000 child-years]. The rate of hospitalizations was 24.5/10,000 child-years (CI = 21.8-27.4/10,000 child-years). The death rate was 0.6/10,000 (CI = 0.2-1.2/10,000). For each case of death there were 43 hospitalizations and 1,732 visits to the ER. Twice as many boys as girls visited the ER and 1.8 times more boys were hospitalized for childhood injuries. Falls and being struck by a blunt or shap object were the most frequent cause of injury among the ER visits. Poisonings, road accidents and burns required longer hospitalization than other causes of injury. The injury severity score ranged from 1-30 and was higher for road accidents and falls than for other causes of injury. In planning prevention and health promotion programs toddlers and adolescents should be considered as the high risk groups for intervention.

Adolescent↗
PubMed1990

[Family health center follow-up in preschool children].

The duration of follow-up at family health centers (FHC) was determined from a national prevalence study of chronic conditions and illnesses causing disability in preschool children. The sample comprised 8,702 children (12% of the 71,372 in the national Jewish birth cohort of 1980) who had reached the age of 3 years at the time of the study. The sample originated from 118 of the 870 FHC in areas of Jewish population which included FHC managed by municipalities, sick funds and the Ministry of Health. With increase in age there was a significant decrease in attendance at the FHC. Thus at 6 months of age, 97% of the sample attended the FHC, while at 3.5 years the follow-up rate had fallen to 33%. Children of mothers of Asian origin, of mothers with less than 10 years of schooling, and of mothers 19 years old or less on delivery, as well as first-born children, showed a higher rate of attendance at age 3 than the others. Higher attendance at age 3 was also registered in the south of the country, especially rural areas. More children with diagnosed medical problems attended at age 3 than healthy children. More children born with birth weights of 1,500 g or less dropped out of the FHC during their first year of life. The findings suggest that the purpose, content and efficiency of FHC be reexamined in light of changes in the needs of the target population due to educational and technological progress.

Age Factors↗
PubMed1990

[Segev health promotion project in Jerusalem elementary schools].

The health-promotion and education project, Segev, is an Israeli version of the American Health Foundation's Know Your Body project. The aim of this cohort study was to change knowledge, attitudes, health behavior and risk factors for cardiovascular disease in elementary school children. We present the results of questionnaires about knowledge of, and attitudes to health in 656 Jewish children who started first grade in 1983-4 and completed 4 questionnaires in the first and third grades. The results indicate a statistically significant increase in knowledge and attitude scores in the experimental group after 1 and 3 years of intervention. They indicate that changes in knowledge of, and attitudes to health are possible after even a relatively short school health education program.

Attitude to Health↗
PubMed1990

Primary prevention of cardiovascular diseases in childhood: changes in serum total cholesterol, high density lipoprotein, and body mass index after 2 years of intervention in Jerusalem schoolchildren age 7-9 years.

A school health education and promotion program, the Israeli version of the American Health Foundation's "Know Your Body" program, was developed by the Department of Public Health of the Municipality of Jerusalem in 1983. Eight experimental and eight control schools participated in this cohort study of Arab and Jewish first-grade children. After the first 2 years of intervention, comparison of experimental and control groups showed a significant increase in serum high density lipoproteins among Jewish children and a decrease in serum total cholesterol and body mass index among both Jewish and Arab children. These results indicate that changes in cardiovascular disease risk factors such as blood total cholesterol, high density lipoproteins, and body mass index are possible after a health education program is introduced to first-grade students for a relatively short period of time.

Body Mass Index↗
PubMed1990

The use of car restraints by newborns and mothers: knowledge, attitudes and practices.

Knowledge, attitudes and practices with regard to car safety were studied among 403 parturient women in Jerusalem. The mean knowledge score was 22 out of a total of 32. Attitudes towards seat belt use were positive. Regular use of the seat belt was reported by 36% of the women, but the intent to take the newborn in a car seat for the first ride (from the hospital) was reported by only 8% of the mothers. Knowledge of car safety and mother's seat belt use was significantly associated with the intent of car seat use for the newborn. Sociodemographic variables were not associated with the intent to use a car seat for the newborn. We conclude that laws for mandatory use of seat belts in cities and car restraints for children are needed, and we suggest integration of promotion programs within the existing health services.

Adult↗
PubMed1989

Process and outcome evaluation of preventive care for infants in two types of practices.

Process and outcome of preventive and promotive infant care have been evaluated in a maternal and child health (MCH) service and compared with that of a comprehensive care family practice (FP), both serving a low middle class population in West Jerusalem. Both services are provided by the Community Health Center of the Department of Social Medicine. Community oriented primary care is integrated into the practices, including ongoing surveillance of the communities' health status. Preventive and promotive programs have been developed, implemented and evaluated. The process evaluation indicated a similar use of the preventive service in the MCH and FP services. Some of the routines were carried out to a lesser extent in the FP than in the MCH framework, such as growth monitoring, hearing tests and advice on iron supplementation. The small difference in compliance with routines did not affect a child's growth between birth and one year of age, but the anemia rate in the FP practice was higher than in the MCH practice. The high level of care and relatively small differences in process and outcome between the two types of services have been achieved by ongoing inservice training, a high level of personnel, similar protocols and supervision in both practices.

Anemia↗
PubMed1989

A follow-up study of adiposity and growth of Jerusalem schoolchildren from age 6 to 14 years.

This study evaluated growth and change in adiposity from childhood to early adolescence in 587 Jerusalem schoolchildren examined in both the first and eighth grades. Mean body mass index, height, and weight were determined according to demographic variables and menstrual status and were compared to international reference populations. Menstruating females were taller and heavier than nonmenstruating females at both ages and were more overweight at age 14 years. Height and weight were positively correlated with social class for boys, and few differences were found among ethnic groups. Study subjects were shorter than reference subjects, and study girls were more overweight than reference girls at age 14 years. Our findings suggest that previously demonstrated ethnic differences in growth and adiposity among Israeli children are disappearing. Adolescent girls appear to be at greatest risk for developing obesity. The relationship of pubertal status to body size and obesity at and between the two ages is discussed.

Adolescent↗
PubMed1989

Blood pressure and growth at 6 years of age among offsprings of mothers with hypertension of pregnancy.

The association between hypertension of pregnancy and blood pressure (BP) and physical growth of the offspring at 6 years of age has been studied in a historical prospective study. Ninety-four consecutive women who developed hypertension during pregnancy and were hospitalized with a diagnosis of pre-eclampsia and their children were included. The comparison group consisted of individually-matched normal pregnant women. Each mother-child pair was examined when the child was 6 years of age. The mean systolic BP (SBP) of the offspring was 101.3 +/- 10.2 (S.D.) mmHg and that of the controls 99.8 +/- 9.5 mmHg. The mean diastolic BP (DBP) was significantly higher among the cases than among the controls (66.2 +/- 8.3 mmHg and 63.9 +/- 8.0 mmHg, P = 0.03). Among the cases, 11 children had a DBP above the 90th centile, whereas only four among the controls. A low, but significant, correlation was found between maternal and child BP for the cases. The DBP of the children with a positive family history of high BP was significantly higher than those with a negative history. There were no differences in height, weight or obesity index between cases and controls.

Blood Pressure↗
PubMed1989

Effectiveness of iron supplementation compared to iron treatment during pregnancy.

This study presents the evaluation of an iron supplementation program in a community by comparing 478 pregnant women who received iron supplementation from the 4th month of pregnancy, with 392 pregnant women who received iron treatment only if their Hb level was less than 12 gm/dl, and had no supplementation. In the supplementation group, no statistically significant associations were found between compliance with age, education, social class or parity. Pregnant women of European-American origin showed higher rates of good compliance than those of Asian-African origin. The mean decrease of haemoglobin (Hb) and haematocrit (Hct) between the second and third trimester of pregnancy was smaller in the supplementation group (-0.9 gm/dl Hb, -2.1% Hct) than in the treatment group (-1.1 gm/dl Hb; -3.3% Hct). The differences between the two groups were significant only for the Hct levels (P = 0.022). The mean Hb and Hct levels during the third trimester of pregnancy were higher for good compliers (11.7 gm/dl Hb; 33.6% Hct) than for poor compliers (11.4 gm/dl Hb, 32.6% Hct).

Adult↗
PubMed1989

Childhood injuries: a population-based study of emergency room visits in Jerusalem.

A study of childhood injuries of 0-17-year-old Jewish children based on emergency room records of the four major hospitals and the first aid stations was conducted in Jerusalem during 1986. The incidence of visits was 99.7/1000 child-years with 95% confidence intervals (CI) = 98.0-101.5. The rate was 97.2/1000 child-years (CI = 94.4-100.0) among the 0-5-year-old, 114.6/1000 child-years (CI = 111.3-118.0) in the 6-12 age group, and was 93.6/1000 child-years (CI = 90.1-97.1) among 13-17-year-old. The male to female rate ratio was 1.7 for the 0-5-year-olds, 2.1 for the 6-12-year-olds and 2.3 for the 13-17-year-olds. The most frequent causes of injuries were falls, 38.5/1000 child-years (CI = 37.4-39.6), being struck or caught, 21.1/1000 child-years (CI = 20.3-21.9), and road accidents, 5.4/1000 child-years (CI = 5.0-5.8). Only burns among children aged 6 years and over and poisoning among 13-17-year-olds showed a higher incidence among females than among males. The head was the most frequently injured part of the body (45.2/1000 child-years, CI = 44.0-46.4). Head injuries decreased as age increased, while injuries to the extremities and trunk increased with increasing age. Two per cent of the injured children were admitted to hospital.

Accidental Falls↗
PubMed1989

Prevalence of disabilities in a national sample of 3-year-old Israeli children.

The prevalence of chronic conditions and illnesses causing disability in Israeli Jewish children aged 2 to 3 years, born in 1980, was studied on the basis of a national sample (n = 9,854). Seventy-six principle medical conditions causing disability were defined. The study showed a total disability rate of 8.9%. Very low birth weight and family problems were considered risk factors for developmental delay or for disability. The prevalence of the children at risk was 2.4%. The disability rate among this group was 6 to 7.5 times greater than in the total population. Data were analyzed by selected demographic characteristics. Speech and language disorders and undefined developmental delay were more prevalent among children of mothers with a low educational level. Speech and language disorders were also more prevalent among children born to mothers of Asian origin. Speech and language disorders, asthma and spastic bronchitis, hearing impairment and undefined developmental delay were more prevalent among male children. This is the first comprehensive nation-wide prevalence study of children with disabilities in Israel.

Birth Order↗
PubMed1989

Trends in sibling correlations for height and weight: the effect of age changes (0-24 months) and spacing between siblings (0-10 years).

Familial correlations were studied in a sample of 618 sibships from a western neighborhood of Jerusalem, whose height (H) and weight (W) were measured longitudinally at the same age, from birth to 3 years of age. Covariate adjustments were applied to correct for change in mean of H and W with the sex of child and age of mother and for the effect of origin, education, and socioeconomic status of the mother, parity, and calendar year at birth. The highest sibling correlations were observed at birth or 1 month later (r = 0.45-0.46). Pooled sibling correlations were lower 6 months later (r = 0.33; r = 0.26 for H and W, respectively) and tended to increase again 12-18 months after birth. A clear trend of decline in sib-sib correlation for H and W measured 3 and 12 months after birth with increased spacing between siblings was observed. Our data provide evidence for transient environmental factors as possible sources of the observed temporal variation in sibling correlation for height and weight.

Birth Weight↗