Biomedical subjects

R Gofin

Publications and source records attributed to R Gofin.

At least 19 recordsLinked to original sources

PubMed2004

Association of parental consanguinity with congenital malformations among Arab newborns in Jerusalem.

The aim of this work was to determine the impact of parental consanguinity on congenital malformations in a mixed urban and rural Arab community in Jerusalem, Israel. Arab mothers admitted to four hospitals in west Jerusalem were interviewed after delivery. Demographic and obstetric data were recorded. Neonatal data were extracted from the medical records of the nursery. When malformations were suspected, a 4- to 10-month follow up was achieved for confirming the diagnosis. Of 561 infants, 253 (45%) were born to consanguineous couples. The incidence of major congenital malformations in the offspring was 8.7, 7.1 and 2.6% in cases of first cousins, all consanguineous, and non-consanguineous couples, respectively. No association was found between parental consanguinity and prematurity (p = 0.357) or low birth weight (p = 0.589). Parental consanguinity was also associated with an increased incidence of death in previous siblings (p < 0.000). The increased incidence of congenital malformations and infant mortality in cases of inbreeding prompt the necessity of establishing programs to avoid these complications in the offspring.

Adult↗

PubMed2002

Bullying in Jerusalem schools: victims and perpetrators.

The objectives of this study were to determine the prevalence of bullying among adolescents studying in Jerusalem schools and to identify the characteristics of its victims and perpetrators. Pupils in the 8th and 10th grade (ages 14-16 y) in 11 schools in Jerusalem (n=1182) anonymously completed the World Health Organization questionnaire from the 'Health Behavior in School Children' study. Bullying others or being bullied at least once in the last term was reported. The independent variables studied were socio-demographic characteristics, and personal and school-related factors. Bullying was reported by 57.1% of boys and 27.0% of girls, and being bullied by 50.3% of boys and 39.5% of girls. The factors associated with bullying others were lack of support from teachers for both genders and poor mental health among boys. Variables related to social exclusion among girls and social isolation among boys were associated with being bullied. Health professionals should be active in all levels of prevention to deal with this problem that affects the health and well-being of so many children and adolescents.

Adolescent↗

PubMed2001

Does parity affect the neonatal outcome of very-low-birth-weight infants ?

OBJECTIVE: To evaluate the impact of parity on the neonatal outcome (survival, bronchopulmonary dysplasia and severe intraventricular hemorrhage) of very-low-birth-weight infants, accounting for sociodemographic, obstetric and perinatal variables. STUDY DESIGN: One hundred and eleven singleton premature infants with birth weights of 750--1250 grams, delivered between 1990 and 1994 and treated in the Hadassah University Hospitals in Jerusalem, were evaluated. In the analyses, variables with statistically significant association with the outcome variables were identified and entered together with parity as explanatory variables in a logistic regression. The results were analyzed with and without the inclusion of respiratory distress syndrome, representing an index of initial illness severity, in the multivariate model. RESULTS: Neonatal mortality was higher in the 2--11 parity group when compared with first born infants. This association was of borderline statistical significance (OR=3.3; P=0.09), and was evident only upon exclusion of respiratory distress syndrome from the equation. There was no association between parity and the development of bronchopulmonary dysplasia. The risk for developing severe intraventricular hemorrhage was higher in offsprings of multiparous women (OR=4.6; P=0,08 for parity 2-4, and OR=7.6; P=0.03 for parity 5--11). Respiratory distress syndrome was significantly associated with all the outcome variables and, to some extent, masked the relevance of pregnancy duration. A short hospitalization period before delivery was associated with increased mortality and with higher incidence of severe intraventricular hemorrhage. High initial Apgar scores appeared protective against severe intraventricular hemorrhage and bronchopulmonary dysplasia. CONCLUSION: Our results demonstrate a trend for increased survival of first born premature infants when compared with offsprings of subsequent deliveries, and an association between advanced parity and the development of severe intraventricular hemorrhage. Confirmation of these data by other studies is required before resultant implications are considered.

Birth Weight↗

PubMed2001

Community-oriented oral health promotion for infants in Jerusalem: evaluation of a program trial.

OBJECTIVES: This study sought to measure the effect of a community health education program on reported infants' bottle-feeding practices and infants' toothbrushing behavior, with or without distribution of toothpaste and toothbrushes. METHODS: In this quasi-experimental comparison group design study conducted in mother and child health centers in Jerusalem, parents of 727 children were surveyed by telephone at baseline and six months later. The cohort of infants was aged 6-12 months at baseline. The program group received structured health education. The control group received no organized educational intervention. Within the program and control groups, half of the centers were randomly given toothpaste and toothbrushes. RESULTS: Parents' reports revealed a secular 32.5 percent increase in toothbrushing for infants with no intervention, 45.1 percent for infants only receiving toothpaste and toothbrushes, 43.7 percent for infants only receiving the health education program, and a 60.4 percent increase for infants receiving health education together with toothpaste and toothbrushes (chi-square, P = .0002). Modification of bottle-drinking practices, in this program, was unsuccessful. CONCLUSION: The free distribution of toothpaste and toothbrushes, together with an oral health education program, is recommended as a potentially practical and effective method of promoting early oral hygiene practices.

Arabs↗

PubMed2000

Intentional injuries among the young: presentation to emergency rooms, hospitalization, and death in Israel.

PURPOSE: To study the incidence and outcome of intentional injuries requiring emergency room (ER) care among children and adolescents in a national sample. METHOD: The population included 0- to 17-year-olds who presented to the ER for injuries in 23 hospitals over a 1-year period. A 6% to 9% random sample of days was selected in each hospital, and for each selected day the relevant ER record was reviewed for cause, nature, and outcome of injuries and sociodemographic information. RESULTS: The annual incidence for intentional injuries resulting in ER visits was 19.6 in 10,000 children and adolescents aged 0 to 17 [95% confidence interval (CI) 17.4-21.8 in 10,000]. Fights/assaults constituted 54.1% of the presentations, abuse and rape, 10.3%, and self-inflicted injuries, 10.8%. Overall rates were higher among 10- to 17 year olds than at younger ages. The rates were higher among boys than girls for fights/assaults and abuse, whereas attempted suicide and rape were three times higher among girls than boys. Nearly twice as many Jewish children and adolescents presented to the ER for intentional injuries than Arab children and adolescents, with the ratio becoming even greater for attempted suicide. Of all the intentionally injured, 21.7% were hospitalized. The mortality rate was 1.1 in 100,000 (95% CI =.7-1.7/100,00) with no significant gender difference observed. No cases of suicide were reported for the Arab population. CONCLUSIONS: Adolescents aged 10 years and older are at higher risk for intentional injuries than younger children. The ethnic differences evident in this study, especially for attempted and completed suicide, may be real or the result of differential disclosure of information owing to sociocultural norms or differential recording by health professionals.

Adolescent↗

PubMed2000

Fighting among Jerusalem adolescents: personal and school-related factors.

PURPOSE: To study the prevalence of physical fighting among youth and its association with personal and school-related factors. METHODS: Pupils in the 8th and 10th grades (n = 1182, ages 13-16 years) in 11 Jerusalem secular and religious schools anonymously completed the World Health Organization questionnaire from the Health Behavior in School Children study. The unit of analysis was defined as the number of times the student was involved in physical fighting during the past year. The independent variables studied were sociodemographic characteristics, personal, and school-related factors including teachers, peers, and family. RESULTS: Fighting at least once was reported by 76% of boys and 26% of girls; 6% of boys who were involved in fights at least once and 16% more than once required medical treatment. For boys, bullying others, poor health and mental health score, and perception of teachers that the pupil was a below-average student significantly increased the odds ratio (OR) for fighting more than once in the past year. Among girls, poor mental health, poor parental support on school matters, bullying, and being bullied by others increased the OR for fighting. CONCLUSIONS: Fighting is a highly prevalent behavior among adolescents irrespective of their socioeconomic background. Determinants differ by gender, and intervention programs should focus on the gender-specific determinants.

Adolescent↗

PubMed2000

Urbanization and the risk of asthma among schoolchildren in the Palestinian Authority.

The aim of the present survey was to compare the prevalence of symptoms suggestive of asthma in boys and girls aged 6-7 and 13-14 years in a rural and an urban area in the West Bank. For this purpose, the International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire was issued to 970 schoolchildren in the two regions. The response rate was 92.2%. The prevalences of ever wheezing in the urban and rural areas were 16.4% and 12.0%, respectively (p < 0.05); the 12-month prevalences of wheezing were 10.5% and 5.5%, respectively (p < 0.05); the prevalences of more severe wheeze were 4.5% and 1.7%, respectively (p < 0.05); and prevalences of diagnosed asthma were 4.2% and 2.8%, respectively (p = NS). When controlling for age by stratification, the significant association between prevalence rates and place of residence persisted in the 13-14-year age group. These results also show that the prevalence of asthma among Palestinian children is moderately high in comparison with that reported from developing countries, but lower than those reported from Western countries. This survey, the first epidemiological survey on asthma in the West Bank, demonstrates a marked difference between urban and rural areas. The findings emphasize the need for further study of the environmental determinants of the disease among Palestinian children.

Adolescent↗

PubMed2000

Birthweight recall by mothers of Israeli children.

The objective of this study was to examine the reliability and validity of maternally recalled birthweight (BW) in a population of 6-y-old children in Jerusalem. The study population consisted of 259 children entering the first grade in two schools in the city. We compare the recalled BW at entrance to school and the BW values as recorded in the Mother and Child Health Clinic of the Hadassah Community Health Center. The mean recalled BW was 11.7 g lower than the mean recorded BW (P>0.05). There were no statistical differences in mean BW values between the two data sources (according to socio-demographic characteristics) except for mother's age and origin, where no trends could be detected. Fifty-eight percent of the mothers accurately recalled the BW of their children to within 100 g and 80% recalled the BW to within 500 g. Seventy-three percent of mothers of low-birthweight children recalled a BW value of less than 2500 g and 99% of mothers of normal BW children recalled a BW of 2500 g or more. Correlation coefficients between the two sources ranged from 0.89 to 0.96. Given the high degree of accuracy, maternally recalled birthweight is a reliable and valid measure of birthweight 6 y post-partum and its use is justified when no records of birthweight are available. Public Health (2000) 114, 161-163

Birth Weight↗

PubMed1999

Neonatal outcome of inborn and transported very-low-birth-weight infants: relevance of perinatal factors.

OBJECTIVE: To compare the neonatal outcome (survival, intraventricular hemorrhage and bronchopulmonary dysplasia) of inborn and outborn very-low-birth-weight infants accounting for sociodemographic, obstetric and perinatal variables. STUDY DESIGN: Ninety-one premature infants with birth weights of 750-1250 g delivered between 1990 and 1994 in a hospital providing neonatal intensive care were compared with 76 premature babies delivered in a referring hospital. In the statistical analysis, variables with a statistically significant association with the outcome variables and dissimilar distributions in the two hospitals were identified and entered together with the hospital of birth as explanatory variables in a logistic regression. RESULTS: No statistically significant differences between the outcome variables of the two populations examined were observed, whether before or after accounting for the covariates. The odds ratios (outborns relative to inborns) were 1.18 for mortality, 1.25 for bronchopulmonary dysplasia and 1.53 for severe intraventricular hemorrhage. In the multivariate analyses, respiratory distress syndrome was significantly associated with mortality; both low birth weight and the presence of respiratory distress syndrome were associated with the development of bronchopulmonary dysplasia; the evolvement of severe intraventricular hemorrhage was associated with respiratory distress syndrome, initial low Apgar score, advanced multiparity and delivery at the 28-29th week compared to the 23rd-27th week. Antenatal steroid administration had a protective effect. CONCLUSION: Our results concur with the notion that a tertiary center is the optimal location for delivery of the high risk neonate. Improvement in medical and nursing care prenatally and at delivery and transportation, including frequent administration of antenatal steroids and earlier administration of surfactant prior to transportation, may minimize the disadvantage of delivery in a referring hospital.

Hospitals, General↗

PubMed1999

Incidence and impact of childhood and adolescent injuries: a population-based study.

BACKGROUND: The study of disabilities, use of health services, and absenteeism of parents among 0- to 17-year-old residents of Jerusalem (n = 432) hospitalized for unintentional injuries. METHODS: Telephone interviews with parents, 6 months after hospitalization. Disabilities among 4 to 17 year olds were measured by a 25-item scale derived from the International Classification of Impairments, Disabilities, and Handicaps and by limitations of activities. RESULTS: Six months after the injury, limitations ranged from 8.3% (daily activities) to 19.4% (sport activities). About one in three presented at least one disability in the 25-item scale. All disabilities were present in higher proportions among adolescents. The more severe injuries whether to the head or other parts of the body presented higher percentages of disabilities. Burns and traffic crashes were associated with higher proportions of disabilities than other causes and with more frequent work absenteeism by their parents. CONCLUSION: A relatively large proportion of children remain with long-term disabilities irrespective of cause and body part injured. Because the sequelae of injuries is multifaceted, rehabilitation should include coordination between health and other services.

Activities of Daily Living↗

PubMed1999

Prenatal lead exposure in Israel: an international comparison.

BACKGROUND: Prenatal lead exposure (umbilical cord blood lead concentration > 10 (micrograms/dl) may impair cognitive development. Childhood lead poisoning is infrequent in Israel, and there are no data on lead exposure in immigrants to Israel from the former Soviet Union. OBJECTIVES: To evaluate prenatal blood lead concentrations in Israeli newborns whose mothers were born in Israel and in those whose mothers recently immigrated from Russia, and to compare data of prenatal lead exposure in Israel with those reported from other countries. METHODS: We compared the UCBLC of 35 newborns of new immigrants from Russia with a group of 35 newborns whose mothers were born in Israel. Venous BLC was also measured in 50 mothers. Data are compared with similar reports on prenatal lead exposure internationally. RESULTS: The UCBLC in all 70 newborns (mean +/- SD) was 3.53 +/- 1.6 micrograms/dl, and mothers' BLC (mean +/- SD) was 3.90 +/- 1.39 micrograms/dl. UCBLC and BLC in the 50 mother-newborn pairs correlated (r = 0.36, P < 0.01). All newborns except one had UCBLC < 8.0 micrograms/dl. There was no significant difference between UCBLC in the two groups. CONCLUSIONS: Prenatal lead exposure among the study subjects in both groups was low. In this sample the newborns of mothers born in Israel and those whose mothers recently immigrated from Russia were not found to be at risk for lead poisoning. Prenatal lead exposure in this sample was low compared to that reported from various parts of the world.

Adult↗

PubMed1998

Variables influencing parental perception of inherited metabolic diseases before and after genetic counselling.

The present study was undertaken to characterize the variables that influence parental perception of metabolic disorders and their genetic origin before and after genetic counselling, the effect of counselling on parental attitudes towards prenatal diagnosis and pregnancy termination, and the factors affecting parental coping with burden. Parents of children with metabolic diseases from 32 Arab-Muslim families were interviewed, answering a pre-structured questionnaire. These interviews indicate the following. (1) Traditional belief and religious commitment are more important determinants than education in parental perception of inherited metabolic diseases. (2) The number of affected children has a greater impact on parental evaluation of the burden than the number of healthy children. The social component, i.e. the way families are viewed by society, is the most significant factor of the burden. (3) Parents use different techniques to divide responsibility regarding reproduction. Having a healthy child and the availability of prenatal diagnosis and pregnancy termination were the two most important factors in parental reproductive decision making. In the absence of a healthy child and when the burden was perceived as too heavy, parents tended 'not to decide'. (4) Parental attitude to pregnancy termination was dependent on two factors: religious commitment (leading to objection) and severity of disease (leading to flexibility and approval). (5) In almost all families, genetic counselling altered parental perception of the disease and its hereditary origin. We conclude that genetic counselling and population education may be helpful in the prevention of consanguineous marriages and in family planning, even in a society that values traditional beliefs very highly.

Abortion, Induced↗

PubMed1997

A seven item scale for the assessment of disabilities after child and adolescent injuries.

OBJECTIVES: To develop a scale to assess physical disabilities after child or adolescent injuries. SETTING: The three main hospitals of Jerusalem. METHODS: Telephone interviews pertaining to the injury's effect on the functioning of children 4-17 years old (n = 281) were carried out six months after an injury. Disabilities were recalled by the parents for the period immediately after the injury (short term) and at the time of interview (long term). Of 25 questions derived from the International Classification of Impairments, Disabilities and Handicaps, seven were selected: limitations in walking, running, getting up/lying down, moving in bed, going to the toilet, bathing/keeping personal hygiene, and dressing. Construct validity was tested using the usual, sport, school, and leisure time activities as the gold standard. RESULTS: The prevalence of short term disabilities ranged from 23.8% to 37.7% and of long term disabilities from 0.4% to 11.8%. Cronbach's alpha was 0.91 for the short term scale and over 0.90 for the different categories of the sociodemographic variables. It decreased to 0.66 for the long term scale. Sensitivity of the short term scale ranged from 77% to 89%, but was lower for the long term scale. Specificity varied from 72% to 84% and increased to 88% to 90%, six months after the injury. CONCLUSIONS: This scale could be used to study disability after injury among children and adolescents in different cultures. It is a simple method that does not require expert personnel and has relatively high validity and internal reliability.

Adolescent↗

PubMed1996

Time trends of child development in a Jerusalem community.

The study of the Development Quotient (DQ-according to the Brunet-Lezine test) of two-year-olds living in a geographically defined area in Western Jerusalem was carried out for the birth cohorts of 1971 to 1989 (n = 4314). An 'Early Stimulation' programme was implemented from 1975 through the Mother and Child Health Clinic. The stimulation programme provided mothers with skills to enhance the development of their children through social interaction, play and verbal stimulation from birth to two years of age. The mean DQ at 2 years old increased significantly from 104.6 (SD = 9.8) for the 1972 cohort to 108.9 (SD = 9.1) for those born in 1989. Coordination and posture subscores followed the trends of the total DQ while the trends in language development were less marked. There is indication that children whose mothers had 9-11 years of schooling benefited more than other children. Better achievement on the developmental test as expressed in the mean DQ was probably related to changing socio-demographic characteristics of the population, and the implementation of the 'Early Stimulation' programme. The widening gap of the DQ after an initial decrease among children whose mothers had < or = 8 years of schooling and those in higher educational groups during the 80s may have been caused by the fact that the latter are a very disadvantaged group of families compared with the rest of the population.

Analysis of Variance↗

PubMed1995

The development of disability scales for childhood and adolescent injuries.

Scales for the study of injury-induced disabilities among 0-17 year olds were developed. Telephone interviews were conducted among parents of injured children (n = 432) 6 months after hospitalization in the three main hospitals of Jerusalem, about disabilities immediately following and 6 months after the injury. The scale for 4-17 year olds included 25 items derived from the International Classification of Disabilities, Impairments and Handicaps. Factor analysis revealed three dimensions of disability: personal care and daily activities; motor activities; and communication and sensory activities. The scale and the derived subscales on personal care and daily activities, and on motor activities showed high Cronbach's alpha, especially for disabilities immediately after the injury. The scale or subscales are easy to use, related to everyday activities performed by children in all cultures, are not related to the characteristics of the respondents, and have high consistency-reliability and construct validity. They may be used to assess the prevalence of disabilities in population studies.

Activities of Daily Living↗

PubMed1995

Injury prevention program in primary care: process evaluation and surveillance.

OBJECTIVES: To carry out process evaluation and surveillance in a community oriented primary care program for injury prevention among children 0-2 years old (n = 306). SETTING: Mother and child health clinic in a defined area of Western Jerusalem. METHODS: An injury prevention program was integrated into the routines of the mother and child health clinic. The program consisted of injury surveillance and counselling using a developmental approach, regarding car safety and the prevention of falls, burns, suffocation, poisonings, cuts, drowning, and electrocution. Process evaluation and surveillance were based on records integrated into the child's personal file in the clinic. RESULTS: Process evaluation indicated that counselling coverage was 73% in the 0-5 month age group and decreased to 48% in the second year of life. The mean number of topics discussed with the parents was 6.6 (out of nine) for the 0-5 months age group, 13.6 (out of 18) for the 6-11 month group, and 15.7 (out of 18) for those 1-2 years old. Injury surveillance activities were complete for 66% of the children, incomplete in 32%, and not done in 2%. CONCLUSIONS: The results indicate that it is feasible to integrate an injury prevention program into primary care, and that process evaluation is important in detecting problems and improving performance of the program's activities.

Accident Prevention↗

PubMed1995

Symptom clusters among young adolescents.

This study examines recurrent psychosomatic symptoms and symptom clusters among 5th and 6th grade Israeli school children. A questionnaire which asked about the frequency of eight psychosomatic and eight organic complaints was administered to 259 students. The most frequently reported psychosomatic complaints were abdominal pain, experienced often by 21%, and headache, experienced often by 20% of the pupils. There were statistically significant differences between the sexes, girls having a higher prevalence than boys for eight of the symptoms, and with more girls than boys reporting more than one symptom in each category: 23% of the students had more than one psychosomatic symptom and 16% had more than one organic symptom. Multiple psychosomatic complaints were common, with 28% of those with back or limb pain and 27% of those suffering from "bad mood" reporting an additional three to five complaints. Abdominal pain and headache were each reported as an accompanying complaint in more than 40% of cases for almost every other psychosomatic complaint. The significance of these symptom clusters needs to be explored further as they may have important implications as markers for psychosocial stress.

Child↗

PubMed1995

Evaluation of a community-oriented primary care workshop for family practice residents in Jerusalem.

BACKGROUND: A workshop on community-oriented primary care (COPC) has been integrated into Hebrew University's family practice residency program for several years. The participants of the first three workshops did an evaluation to assess subsequent application of the COPC approach. METHODS: The main objectives of the 45-hour workshop are: a) to learn the principles and practice of COPC as illustrated by the Hadassah Community Health Center programs, and b) to learn skills required in the COPC programs' various stages of development. In the workshop, physicians are required to work in groups of 5-6 to carry out the planning of COPC programs, which will be implemented in their practices. A structured questionnaire was sent 2-4 years after workshop completion to each of the 45 physicians who participated in these workshops. RESULTS: Thirty-six of the 45 physicians responded to the questionnaire. Of the 36 respondents, 75% reported that the content of the workshop was relevant to their daily work. Eighty percent of the physicians who were involved in intervention programs reported that participation in the workshop improved their ability to plan community programs. Fifty-five percent of the respondents reported the application of elements learned in the workshop to their current work, mainly in the performance of three COPC functions: definition of the community, identification of health problems, and planning community health interventions. Few (28%) were involved in evaluation measurements. CONCLUSIONS: A COPC workshop characterized by work groups of family physicians, epidemiological analysis of their practices' data, and the planning of a community program in their communities was positively evaluated according to the reported application of COPC functions by family physicians and residents in their daily work.

Education, Medical, Continuing↗