Child health and human development domain after one year.
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Child↗
Biomedical subjects
Isack Kandel
Publications and source records attributed to Isack Kandel.
Health needs of adults with intellectual disability relevant for the family physician.
People with developmental disability, mental retardation, or intellectual disability are living longer and becoming prone to age-related health problems and diseases of old age much like the general population. This worldwide trend is also seen in Israel, where today 39.8% of persons with intellectual disability in residential care are 40 years old and above. There is a need for service and staff providers to receive training; a need for more research and better service for this aging population. This review presents health concerns for older persons with different levels of intellectual disability, health concerns in persons with Down syndrome, and persons with epileptic seizures and cerebral palsy in relation to general practice and family medicine. The review is concluded with recommendations on health and aging in adults with intellectual disabilities and the call for formalized training in the topic for specialists in family medicine.
Adult↗
Late termination of pregnancy. Professional dilemmas.
Abortion is an issue as long as history and hotly debated in all societies and communities. In some societies and countries it is legal, while other countries have no legal basis, and some countries have made it a crime. Today up to 90% of abortions take place in the first trimester, about 9% in the second trimester, and the rest in the third trimester. This paper deals with the issue of late termination of pregnancy, the practical medical aspects, legal issues, international aspects, and the dilemma for the professional. In early history, abortion was accepted by clergy and societies, but in recent history it is more restricted and in some countries prohibited. It does not seem that restriction leads to a lower abortion rate, but rather an active contraceptive policy, campaign, and availability to prevent pregnancies that are unwanted. In countries where abortion is restricted, the trend has been an increase in illegal abortion that leads to unsafe abortion with complications, permanent injuries, and maternal mortality. Unsafe and illegal abortion is a public health concern that governments should try to prevent and instead find ways to strengthen their commitments toward better and safer health and family planning services for women. Late termination of pregnancies is an issue of grave concern with many practical medical aspects, ethical questions, and professional dilemmas. This is especially of concern because of the viability of the fetus and should only take place in order to prevent harm to the physical and mental health of the mother or due to an anomaly or disability of the fetus.
Abortion, Induced↗
The birth of a child with disability. Coping by parents and siblings.
When a child is born, the life of the family changes significantly and each of its members must adapt to the new situation. When the child is born with a disability, in addition to regular adaptation, the family must cope with stress, grief, disappointments, and challenges, which may lead to a serious crisis or even disruption of family life. Parents must coordinate assessments, evaluations, and various treatments while maintaining contact with many professionals and numerous institutions or services. They find themselves faced with important decisions on behalf of the child, decisions on management of the child with disability, and economic decisions that will affect the whole family. This paper reviews the literature on the topic of coping when a child with disability is born and also studies the question as to whether a connection exists between parental orientation toward feelings of guilt and the family relationships system. The event of a child born with a disability is always a tragedy for the family, but early intervention and support may help the family to adjust and become positively involved in the care and development of the child, even if that child is different and in need of special treatment.
Adaptation, Psychological↗
Medical services for persons with intellectual disability in Israel.
BACKGROUND: The first school for children with intellectual disability (ID) was opened in Tel Aviv in 1929; the first boarding school for children with ID was established in Jerusalem in 1931; and the first center for assessment of children with ID established in Tel Aviv in 1936. With the establishment of the State of Israel in 1948, there was a total of four residential care centers providing services for 150 children with ID. OBJECTIVE: This paper will describe the history and development of the public health work with persons with intellectual disability from the birth of the State of Israel in 1948 until today, with a focus on medical and nursing care and ideas for future work with this population. DATA SOURCES: Studies and documents from the Office of the Medical Director, Division for Mental Retardation of the Ministry of Social Affairs in Israel. DATA EXTRACTION: The Division for Mental Retardation is in contact with approximately 23,000 persons of all ages. Residential care is provided to about 6,000 persons in 54 institutions countrywide. In addition, 2,000 persons receive residential care in hostels or protected apartments within the community. More than 50 other settings provide vocational and educational services to 15,000 persons--day-care kindergartens, day-treatment centers, sheltered workshops, or integrated care within the community. DATA SYNTHESIS: Data on the health profile, morbidity, and mortality of the residents in residential care centers are used to illustrate the medical and nursing work with this population. CONCLUSIONS: We recommend that the direction in Israel should be a combination of both community and institutional care for the population of persons with ID. We recommend the establishment of a subspecialty for physicians and nurses in intellectual disability and the establishment of a Health Division within the Ministry of Social Affairs to facilitate better service, education, and research.
Adolescent↗
Female HIV-infected adolescents are now becoming pregnant.
Mortality of AIDS (Acquired Immunodeficiency Syndrome) has increased in parts of the world and resulted in a growing number of children becoming orphans. It is estimated that by year 2010, AIDS will leave 20 million children alone in Africa without one or both parents. In the developed world there has since 1996 been observed a decline in AIDS related deaths, as a result of active antiretroviral (ARV) treatment and the number of people now receiving treatment. A recent report from Puerto Rico on ten pregnancies in perinatally HIV infected adolescents is presented and discussed. It is concluded that a new public health issue will arise due to progress in AIDS treatment, but the sample is too small and follow-up too short to make solid conclusions.
Adolescent↗
Trends in adolescent violence.
Adolescent or youth violence is a very visible violence in modern society and in 1996 the World Health Assembly declared violence a leading public health issue. In order to understand the scope of the problem, we looked at the epidemiology of global adolescent violence. In 2000 it was estimated that 199,000 adolescent homicides (9.2 per 100,000) occurred globally or about 565 adolescents died each day due to interpersonal violence with variations around the globe. One type of prevention program that has proven effective is prenatal and early childhood home visitation with long-term follow-up that has shown to be cost effective.
Adolescent↗
Smoking and adolescence.
Nicotine is one of the most addictive substances known and tobacco use started in adolescence can over time become a serious addiction with long-term health consequences. Tobacco was brought from America to Europe and has been used not only in Indian rituals, but also for medical purposes. In the 1950s and 1960s the adverse effects were revealed and the health community came out against tobacco smoking. This short communication presents recent trends in American and Israeli adolescent smoking. Recent surveys have shown a decrease in adolescent smoking, but it is still important to continue to reduce the numbers of adolescents who become nicotine dependent. Both American and Israeli youth had a current prevalence of smoking of 28%, so clinicians and practitioners must therefore do their utmost to help prevent smoking onset and try to intervene early to stop smoking among adolescents.
Adolescent↗
Physical activity, children and adolescents.
Adolescents and young adults benefit from physical activity, which should be continued later on in life. Healthy habits in adolescence must continue in adulthood. A majority of children and adolescents participate in physical activity, but this activity declines in adulthood. Data from several surveys on children and adolescents in the United States and Israel is presented.
Adolescent↗
Disability and health.
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Health Services↗
Adolescents with Down syndrome.
Adolescence is a period of transition that can create stress for both adolescents and parents. Adolescents with Down syndrome (DS) go through the same stages as other adolescents, but due to lack of cognitive and behavioral factors they and their parents may find this period particularly challenging. This paper reviews several studies, especially from the United Kingdom, of groups of adolescents with Down syndrome and their controls followed from childhood, through adolescence into adulthood. There are special medical problems for this population that require annual medical examinations and surveillance, but the focus has shifted from health problems to social maturation, developing independence, and transition from school to employment or work activity. Medical transition from a pediatric to family physician provider is mentioned with recommendations as to how that transition can be made as smooth as possible.
Adolescent↗
Adolescence, chronic illness and disability.
The prevalence of chronic illness or disability in adolescence has increased in recent years. In the past, children with certain chronic diseases did not reach adolescence, but over the last decade the survival rate has increased manyfold. The old morbidity (infectious disease, poor housing, poverty, lack of immunisation) has been exchanged with a new morbidity of adolescence, where a longer life expectancy is followed by an increase in lifelong disability. This review discusses issues concerned with the definition of disability in adolescence, reviews prevalence studies in several countries, the causes of disability, disparities, access and expenditure of health care, psychosocial aspects, and how to promote better outcomes.
Adaptation, Psychological↗
Trends in autism.
Leo Kanner described autism in 1943, and Hans Asperger described the syndrome in 1944. The term Pervasive Developmental Disorders (PDD) was first used in the 1980s to describe a class of disorders that include (1) Autistic disorder, (2) Rett disorder or syndrome, (3) Childhood Disintegrative Disorder, (4) Asperger's disorder or syndrome, and (5) Pervasive Developmental Disorder Not Otherwise Specified, or PDDNOS. Autism prevalence studies published before 1985 showed prevalence rates of 4 to 5 per 10,000 children for the broader autism spectrum, and about 2 per 10,000 for the classic autism definition. Since 1985 there have been higher rates of autism reported from several countries. From the UK a prevalence rate of 16.8 per 10,000 children for autistic disorder was reported, and 62.6 per 10,000 for the entire autistic spectrum disorders. Sweden reported a prevalence of 36 per 10,000 for Asperger and 35 per 10,000 for social impairment, or a total prevalence of 71 per 10,000 for suspected and possible cases. From the US, 40 per 10,000 in three to ten year old children for autistic disorder and 67 per 10,000 children for the entire autism spectrum was reported. From the north region in Israel for children born between 1989-93 in the Haifa area, an incidence rate of 10 per 10,000 was found for autism. In recent years concern has been shown about the possible increase in the prevalence of autistic spectrum disorders. Studies have shown an increase, but during these last twenty years diagnostic criteria and definition have also changed. Although many factors are at play, it is evident that there has been an increase.
Autistic Disorder↗
Trends in adolescent asthma in Israel.
There has been observed a worldwide increase in childhood asthma and this short communication reviews current research on adolescent asthma in Israel. Several studies have found an overall asthma prevalence of 7.8% for Jewish children, 4.9% for Arab children and 3.7% for the total population, while 7.8% was found in Bedouin children in the south of Israel. For the 1980-1997 period for the 5-34 year age group the AMR (asthma mortality rate) per 100,000 was found to be 0.226 with no significant difference between Jews and Arabs. This is a decrease as a result of increase in the use of inhaled corticosteroids (ICS) and a better anti-inflammatory treatment.
Adolescent↗
Anorexia and bulimia in the family.
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Adolescent↗
Burn injuries and adolescents in Israel.
Burn injury is a public health concern often associated with individual pain, emotional stress, prolonged hospitalizations, permanent disfigurement and family stress. In this paper we studied the avaliable data on burn injury among adolescents in Israel through a Medline search and found three relevant studies with data on this population. The incidence rate of burn injury was 0.46 per 1,000 children aged 5-14 years for Jews and 0.91 for Bedouin. Most of the burn injury in this age group was caused by hot liquids, followed by fire and chemical burns for both Jews and Bedouin, but electical burns occurred more often in Bedouins. Mortality was very low for the adolescent group. Prevention programs in schools since the 1980s have been found effective, but the public health focus should now be geared towards groups at risk.
Accident Prevention↗
Adolescent injury risk behavior.
Health-risk behaviors that contribute to the leading causes of morbidity and mortality among adolescents and young adults are often established during adolescence and extended into adulthood. Unintentional motor vehicle injury is the leading cause of mortality in childhood and adolescence in developed countries. This review presents some of the risk factors found in research on unintentional injury and death in adolescence, including risk factors for siblings and adolescents with intellectual disability. These findings should be connected with the findings of a recent study that showed that about one third of all unintentional childhood injury deaths in the United States were preventable. For injury prevention to take place and being effective a multidisciplinary approach is needed to identify host, agent and environmental factors using epidemiology research and biomechanics. In the population of adolescents with intellectual disability there has been little research on injury epidemiology or injury prevention and the service provider will need to focus and educate staff on this issue in order to prevent injury that can result in further disability.
Accident Prevention↗
Trends in adolescent injury mortality in Israel.
Epidemiology is an important and powerful tool in public health used to monitor health, observe trends and identify risk factors for utilization in strategy, policy and planning of services and interventions. Unintentional injury is the leading cause of death in adolescents worldwide with motor vehicle injury and drowning the leading causes. In Israel the mortality rate for motor vehicle mortality rate for adolescents was found to be 10.6 per 100,000 and 1.0 per 100,000 for drowning. Studies have shown a decrease in injury and mortality over time, but there is still much to do and calculation studies have shown that it is possible to prevent further with targeted serious effort and strategies employed.
Accidents↗