Biomedical subjects

R Gofin

Publications and source records attributed to R Gofin.

At least 37 records · Page 2Linked to original sources

PubMed1994

Cardiovascular risk factors by ethnic group and menstrual status among 13- and 14-year-old Israeli schoolchildren.

BACKGROUND: Ethnic differences in cardiovascular risk factors have been demonstrated previously among Israeli children and adolescents. This study examines the prevalence of selected risk factors and risk factor clusters among 13- and 14-year old Israeli schoolchildren according to ethnic origin and other demographic variables, and takes into account the unique contribution of menstrual status of the girls to risk factor differences. METHODS: Demographic and menstrual status (for the girls) data were obtained for 299 West Jerusalem eighth grade students. Height, weight, and blood pressure were measured, and blood was obtained for total cholesterol, high density cholesterol (HDL), and triglyceride measurements. Differences in mean Body Mass Index (BMI), blood pressure, and lipids, as well as in the percentage of children with specific risk factors or total number of risk factors were tested for among the various demographic and menstrual status groups. RESULTS: BMI was statistically significantly greater among females (20.2 kg/m2) than among males (19.46 kg/m2), (p = .04) and among menstruating females (21.1 kg/m2) compared with non-menstruating females (17.9 kg/m2), (p = .000). Mean systolic blood pressure was higher among menstruating (109.8 mmHg) than non-menstruating (105.9 mmHg) females (p = .09). Statistically nonsignificant differences in mean systolic blood pressure and total cholesterol were found according to paternal country of origin. According to defined cutoff points, 8.7% of the students had elevated BMI, 2.8% had elevated systolic or diastolic blood pressure, and 13.0% had elevated total cholesterol. 17.5% of the students had one cardiovascular risk factor and 3.1% had two risk factors. CONCLUSIONS: The data demonstrate a high prevalence of cardiovascular risk factors without statistically significant ethnic differences in this population. Menstrual status exerted a unique effect upon BMI and systolic blood pressure. Pubertal status should be considered in the assessment of risk factors in early adolescents. Total-community-oriented intervention is recommended for this population.

Adolescent↗

PubMed1993

Injuries in primary care practices.

A study of injuries among 0-15 year old children attending primary care clinics in a low social class and a middle class neighbourhood was carried out during a period of one year. Data were collected in a structured form by the physicians while the patient was in the clinic. The rate of injuries was 121.3/1000 children per year in the clinic from the lower social class neighbourhood and 70.7/1000 children per year in the clinic from the middle class neighbourhood. Injuries in playgrounds, and on pavements and streets occurred in higher proportions in the low social class than in the middle class neighbourhood clinics. The most frequent causes of injuries were falls and being struck and injured by cutting/piercing instruments; these caused mostly contusions and lacerations. The clinic was the first place of treatment in 65% of the cases in the middle class area and in 45% in the lower social class area; 28% and 10% respectively were referred to the hospital for additional treatment. Data from primary care clinics should be considered when estimating the incidence of injuries in the community, in planning intervention programmes, and future research.

Adolescent↗

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↗

PubMed1991

Comparison of the automated vision screening test to the Snellen test.

The comparison of an automatic vision screening machine using the Landolt rings and the usual Snellen Chart was carried out among 123 second grade and 149 fifth grade students in an elementary school in Jerusalem. The sensitivity of the test for a cut-off point of greater than or equal to 6/12 according to the Snellen test was 41.7% (CI = 16.5-71.4) and the specificity was 86.5% (CI 78.1-92.2) for second graders. For fifth graders the values were 50.0% (CI = 20.1-79.9) and 90.6% (CI 83.7-94.8) respectively. Diagnosis by a specialist decreased the number of 'false negatives' and confirmed the pathological cases. The automatic test was well accepted by the children. Though more time is needed for assessment using the automatic test, its advantage is that no professional staff are required.

Child↗

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

[Use of car restraints for children: size of problem, intervention strategies].

Motor vehicle accidents are a leading cause of mortality and disability in children. Most of the fatalities and serious injuries to children travelling in cars can be prevented by use of appropriate car restraints. However, according to 2 studies carried out in Jerusalem, most children are not properly restrained when riding in motor vehicles. In a study of 500 children up to the age of 14, only 8% were properly restrained. In a study of 400 women after childbirth, only 8% reported that they planned to take their infants home from hospital properly restrained. This important public health problem should be addressed through health promotion programs. The programs should include amending the present law, education and information, increasing accessibility of car restraints by cost reduction and/or arrangements for loan, and the use of incentives. Parents, health professionals, decision-makers and the community should consider passenger safety in motor vehicles as a high-priority issue.

Adolescent↗

PubMed1990

Epidemiological studies on head lice infestation in Israel. I. Parasitological examination of children.

Of 3,079 children in a medium-sized community near Jerusalem, 11.2% were found to be infested with living lice and eggs and another 23.4% had only nits. Boys and girls were equally infested. The incidence of infestation was highest among children 4-11 years of age. About 78% of the infested children had from one to ten lice. Approximately 80% of the infested children had nits that were 2-5 cm away from the scalp. Boys with medium length hair and girls with short hair showed the highest incidence of lice infestation. Children with brown and red hair were more infested than those with black and blond hair. Boys and girls with straight and wavy hair were more infested than those with curly and frizzy hair.

Adolescent↗

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

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↗

PubMed1988

Tracking of blood pressure over an eight year period in Jerusalem school children.

Tracking of blood pressure (BP) over an 8-year period between the age of 6 and 14 years and the effect of weight, height, BMI and weight gain has been studied in a population of school children in Jerusalem (n = 533). Pearson's correlation coefficients were 0.65 for weight, 0.61 for height, 0.32 for systolic BP and 0.29 for diastolic BP over an 8-year period. Children maintaining their percentile rank for weight or BMI showed higher correlations than those increasing or decreasing their percentile rank. Girls' menarcheal status did not have a significant effect on the level of BP at 14 years of age. The prevalence of significant and severe BP as defined by the NHLBI Task Force was 1% at 6 years and 0.4% at 14 years. The predictive value of the BP at 6 years for 14 years of age was low even for those with hypertension levels: for SBP 16-33% and for DBP 0-37%. Based on the present study and others, large scale screening of BP is not recommended, rather community based programs aimed at modifying health behaviour in order to prevent development of cardiovascular risk factors and associated morbidity and mortality should be introduced.

Blood Pressure↗

PubMed1987

Peripheral vascular disease in a middle-aged population sample. The Jerusalem Lipid Research Clinic Prevalence Study.

Peripheral artery status and prevalence of peripheral vascular disease were studied in a sample of 1,036 men and 556 women, residents of Jerusalem. Ankle blood pressures determined by the Doppler ultrasound technique (Parks Electronic Lab, USA), were higher in men than in women and increased with age. In a multivariable regression analysis, systolic blood pressure and plasma cholesterol levels were significantly and inversely related to the ankle/arm blood pressure in men, and alcohol intake was inversely associated in women. The prevalence of peripheral vascular disease, as determined by symptoms of intermittent claudication, was 1.3% in men and 1.8% in women; absent pedal pulses were found in 1.1% of the men and in 2.0% of the women; leg pain on the treadmill was a reason for termination of exercise in 3.7% of the men and in 5.4% of the women and an ankle/arm blood pressure ratio of less than 0.90 in 4.2% of the men and in 5.4% of the women. The overlapping of the diagnostic criteria was low. No consistent determinants of the various measures of peripheral vascular status were found. In multivariable logistic models, cigarette smoking was significantly associated with intermittent claudication [Odd ratio (OR) = 3.03, 95% confidence interval (CI) 1.27 to 7.26], age was associated with leg pain on the treadmill (OR = 1.91, 95% CI 1.08 to 3.40 in men and OR 3.52, 95% CI 1.52 to 8.16 in women), body mass index was associated with absent and diminished pulses in women (OR = 1.61, 95% CI 1.07 to 2.42, systolic blood pressure was associated with an ankle/arm ratio of less than 0.90 in men (OR = 1.35, 95% CI 1.01 to 1.81), and glucose was associated with absent and diminished pulses in women (OR = 1.20, 95% CI 1.00 to 1.44).

Adult↗

PubMed1986

Ten-year evaluation of hypertension, overweight, cholesterol, and smoking control: the CHAD program in Jerusalem. Community Syndrome of Hypertension, Atherosclerosis and Diabetes.

Control of hypertension, overweight, hypercholesterolemia, and smoking is a major objective of the CHAD program, a multifactorial cardiovascular risk factor program built into a family practice, which has operated in a neighborhood of western Jerusalem since 1971. By 1975-1976, there was a significantly larger decrease in risk factors in this population than in a neighboring population receiving ordinary medical care. Follow-up based on clinical records of a cohort of 441 people exposed to the program until 1981 revealed that the mean blood pressures decreased and the prevalence of hypertension continued to decrease between 1976 and 1981, from 12.5 to 9.1%. Prevalence of cigarette smoking among people ages 30 years or more also decreased in this period, mainly due to a decrease in heavy smoking, at a time when national surveys provided no evidence of a smoking decrease in this age group. Effects on overweight and cholesterol were not demonstrated during this period. This 10-year evaluation demonstrates the effects of intervention by primary care practitioners in the framework of a community-oriented program.

Adult↗

PubMed1985

Treadmill exercise testing in a middle-aged Jerusalem population sample. The Jerusalem Lipid Research Clinic Prevalence Study.

We studied determinants of the exercising physical capacity of 1,640 subjects (1,043 men and 597 women) using the Bruce protocol as modified by Sheffield. These participants represented a sample of parents of 17-year-old adolescents living in Jerusalem. Apparently healthy participants underwent a graded treadmill exercise test (88% of the men and 87% of the women). Exercise was terminated when the subject achieved a heart rate of 85 to 90% of the predicted maximal heart rate or could not continue for other reasons, mainly fatigue or weakness. Exercise performance was assessed according to time on the treadmill. On univariate analysis, duration of exercise was related in both sexes to age, country of origin, reported physical exercise, resting heart rate, systolic and diastolic blood pressure, body mass index and plasma lipids and lipoproteins. In multivariate analysis, time was related to age, body mass index, heart rate and habitual physical exercise in both men and women, and to systolic and diastolic blood pressure in men only. Cigarette smoking and plasma lipid levels were not independently related to time on the treadmill in either sex. Ethnic differences were observed.

Age Factors↗

PubMed1984

Bacteriuria in pregnancy and growth and development of the infants.

In the framework of a community-oriented programme in a western neighbourhood in Jerusalem, screening for bacteriuria during pregnancy was introduced. Between the years 1972 and 1979, 30 cases were identified, an incidence of 1.7%. All women diagnosed as having bacteriuria received antibiotic treatment according to sensitivity of the organism. This report presents the pregnancy outcome as measured by physical growth and development of the offspring. Cases of bacteriuria were compared with individually matched nonbacteriuric controls. No statistically significant differences were found in mean birth weight, mean weight and length at 1, 3, 6, 9 and 12 months, and development quotient at 2 years. No low birth weight infants were found among the cases. The fact that no differences were found between cases and controls, the feasibility, validity, acceptability and low cost of the screening test, and the health benefits of the programme justify introduction of routine screening and treatment of bacteriuria in the preventive health services.

Adult↗

PubMed1982

Risk markers for mortality among elderly men-a community study in Jerusalem.

Risk markers for mortality among elderly men were investigated in a community survey in a neighborhood of western Jerusalem. The aim was to develop a practical method of identifying men with a high risk of mortality, for use in community health services caring for the ageing and aged. Men aged 60 yr or more who had been interviewed and examined in 1969-71 were followed up for 5 yr and the characteristic of the 75 who died were compared with those of the 312 who remained alive. The results of stepwise discriminant function analyses were translated into a simple set of criteria for the identification of men with a high risk of dying within 5 yr. The sensitivity of this mortality risk indicator hazard in this sample was 72% and its specificity was 78%. The components were age, inability to work, impaired mobility, impaired memory for recent events, electrocardiographic evidence of coronary heart disease, the presence of moderate or severe illness, diastolic hypertension, hypercholesterolemia and overweight.

Aged↗