Abstract: Life expectancy for persons with intellectual disability has increased over the past 100 years, and today is closer to the life expectancy of the general population (except for Down syndrome). In this study, we looked at trends in the numbers of Arab persons with intellectual disability living in residential care centers in Israel. Analysis of annual questionnaires to the medical clinics in all residential care centers for the period 1998-2006 revealed that the Arab population had increased from 749 to 921 persons in 13 residential care centers (13.5% of the total residential care population). Of the 921 persons in 2006, 58 were children aged 0-9 years and 260 were aged 10-19 years, with the majority having severe or profound intellectual disability. The increase in the number over time can been seen as a longer life expectancy in this population; the lower than expected numbers in residential care can be seen as a result of children staying at home with their families for a longer time than in the Jewish population.
Abstract: Nitric oxide (NO) and interlukin-6 (IL-6) are highly reactive mediators that have been shown to play different roles in a variety of different biological process. The role of NO and IL-6 in the neuropathogenesis of brain seizures is still questionable. In order to evaluate the role of NO and IL-6 in neurological disorders such as seizures, we investigated 19 adults with intellectual disability (ID) who suffer from epilepsy and treated for convulsions. NO metabolites (NOx) and IL-6 levels in serum obtained after night-sleep were significantly high among ID individuals diagnosed with epilepsy versus ID people without epilepsy. These results indicated that NOx and IL-6 may have a pathophysiological role in convulsions. Consequently, we suggest that professionals consider chemical inhibitors that might be helpful against the function of NO and IL-6.
Abstract: Hypothyroidism (HPO) in humans is widely believed to impair health. The biochemical factors mediating decline in health, however, are poorly elucidated. Pathological consequences of HPO point to a high potential for antioxidant imbalance. The objectives of this study were to investigate the major antioxidants in persons with intellectual disability (ID) and HPO in order to find the effect of chronic disease on the level of antioxidative parameters. This is a prospective, nonrandomized study. A total of 11 people with HPO and 11 age-matched healthy participants were examined. The following antioxidative defense were examined: superoxide dismutase (SOD), catalase, glutathione peroxidase (GSH-Px), and glutathione reductase (GR) as well as two biochemical parameters creatinine and albumin. Compared to healthy control subjects without complications, persons with ID and HOP had significantly lower SOD (p<0.05), catalase (p<0.05), GSH-Px (p<0.05), except the GR level (p=NS). A significant correlation was found between age and gender and AO values in experimental group SOD (r=-0.882), catalase (r=-0.724) and GSH-Px (r=-0.782). Our preliminary results confirm the hypothesis that there is a reduction of the antioxidative defense in persons with HPO and in particularly among males.
Abstract: The objective of the study was to study differences in aging phenomena among adults with intellectual disability (ID), who live in community residence versus their peers in residential care centers and to determine the contribution of health status, age, gender, etiology and level of ID to the decline in ADL function with age. Our study was based on matched pairs between persons with ID in community residence (N=101) and their peers living in residential centers (N=101) by age, gender, etiology and level of ID. Fifty-three percent were aged 40-49 years, 23% were aged 50-59 years and 14% were aged 60-71 years. Ten percent had Down syndrome (DS), 16% had cerebral palsy (CP) and the rest had ID with no specific etiology (NSID). Caregivers were interviewed to ascertain health problems, sensory impairments and activity of daily living (ADL). The type of residence alone could not explain the morbidity and health problems of adults with ID, which were affected by age and etiology. Participants with NSID functioned better than those with Down syndrome or cerebral palsy in all ADL areas. MANOVA and regression analysis indicated that age and health status did not contribute to the explained variance of the ADL function of the participants without specific etiology. The CP group had the most vulnerable etiology exposed to medical problems and decline in ADL function with age. Action should be taken to increase the awareness of the staff to health deterioration that can occur among adult persons with ID, especially among various types of etiologies, such as DS and CP.
Abstract: The normal aging process is not in itself a risk factor for constipation, but age-related morbidities, immobility, neurologic impairment or specific drugs are risk factors for constipation. This study was undertaken to examine the prevalence and risk factors for constipation in a large sample of 2400 persons with intellectual disability (ID) aged 40 years and older living in residential care centers in Israel. Constipation was found in 8% of the total sample with no significant increase in the prevalence of constipation with age. Neurological disease, cerebral palsy, immobility and physical inactivity were risk factors associated with constipation. Mobility and physical activity is recommended in order to lower the prevalence of constipation in this population.
Abstract: The "global village" has resulted in the need to tackle cross-cultural issues in the medical school curriculum. The southern region of Israel (the Negev) provides a unique opportunity to study the interaction between medicine and culture. The Negev population is a multicultural society, with Bedouin Arabs comprising almost a fifth of its population. This imposes tremendous challenges to the medical establishment in the region and serves as a "cross-cultural laboratory" for educating medical students in global health issues. Both the traditional Israeli medical school track, as well as the newly established Medical School for International Medicine, incorporate studies of cross-cultural issues in various forms and to different degrees. Studies suggest that the exposure of students to international medical experiences increases their cross-cultural sensitivity and knowledge. We feel that in a region characterized by such ethnic diversity, all medical schools should adopt cross-cultural studies as an integral part of their curriculum.
Abstract: The extension of universal health service insurance to national populations is a relatively new phenomenon. Since 1995, the Israeli National Health Insurance Law (NHIL) has provided universal health services to every resident, but the effect of this law on health and health services among minorities has not been examined sufficiently. The goals of this study were to track some of the first changes engendered by the NHIL among the Negev Bedouin Arabs to examine the effects of universal health care services. Methods included analysis of historical and health policy documents, three field appraisals of health care services (1994, 1995, 1999), a region-wide interview survey of Negev Bedouins (1997), and key informant interviews. For the interview survey, a sample of 515 households was chosen from different Bedouin localities representing major sedentarization stages. Results showed that prior to the NHIL, a substantial proportion of the Negev Bedouins were uninsured with limited, locally available health service. Since 1995, health services, particularly primary care clinics and health manpower, have dramatically expanded. The initial expansion appears to have been a marketing ploy, but real improvements have occurred. There was a high level of health service utilization among the Bedouins in the Negev, especially private medical services, hospitals, and night ambulatory medical services. The NHIL brought change to the structure of health services in Israel, namely the institution of a national health system based on proportional allocation of resources (based on size and age) and open competition in the provision of quality health care. The expansion of the pool of potential members engendered by the new universal coverage had profound effects on the Health Funds' attitudes towards Negev Bedouins. In addition, real consumer choice was introduced for the first time. Although all the health care needs of this rapidly growing population have yet to be met fully, the assurances under the Law and the new level of competition promise a higher level of service in the future.
Abstract: Ancient scripture and paintings together with several medical reports on the effect of alcohol on the newborn over the past 300 years finally led to the description of the fetal alcohol syndrome in the 1970s by French and American research groups. Maternal alcohol abuse during pregnancy can result in the specific pattern of malformations and neurocognitive deficits characteristic of this syndrome. Diagnostic criteria and classifications have been developed and in the 1990s reports showed the long-term consequences for these children. In recent years several studies from different countries have shown that prenatal alcohol exposure will lead to life-long consequences on physical development, intellectual development, behavior, social development, occupation, independence, sexuality or sexual behavior and increased risk of suicidality. In this review of long-term observation studies we found that the prenatal exposure to alcohol have permanent and life-long damage, which impair both the social and occupational future of the person exposed with a need for life-long assistance in order for that person to function at an optimal level. Primary prevention and early intervention with general public health educational efforts seems to be the best way forward.
Abstract: The objective of this paper was to explore the association between diverse factors occurring during the first year of a child's life and the quality of life later as an adult. The design was a prospective cohort study based on material from the Copenhagen Birth Cohort 1959-61 with 7,222 participants and two sets of questionnaires used: one by a physician during the child's first year and one by the "adult child" 31-33 years later. The results showed that a mother's attitude towards her pregnancy, unsuccessful abortions, and/or institutionalization left a permanent trace on the child, since these children, as adults, have a quality of life 3% below the average. Meningitis during the first year of life resulted in a quality of life 11.7% below the average, while other illnesses or accidents did not have an effect. The largest associations were found with psychomotor development, where "walking with support" showed a difference of 14.2% in overall quality of life between the fastest and slowest group. Generally, diet is not correlated with quality of life, however, we find a small, but essential, correlation between the quality of life of the adult and the early cessation of suckling (4%). Full-time institutionalization during the first year of life showed a connection with the quality of life of the adult (7.1%). It is concluded that our quality of life, health and ability as adults are primarily determined by what we ourselves choose to do with our lives as young people and as adults--and only to a marginal degree determined by factors related to our background. This suggests that we as adults have a great freedom to achieve a good life despite our experiences in the beginning of life.
Abstract: The aim of this study was to investigate the effect of physical training on balance, strength, and general well-being in adult people with intellectual disability (ID). This study evaluated how physical training can effect physical and psychological change among 'older' adults with mild ID. Participants consisted of non-randomly selected groups with ID (n=22), between 54 and 66 years of age. Clinical balance functional tests were measured by a modified Timed Get-up and Go test and Functional Reach test. Knee muscles strength were measured on a Biodex dynamometer. The self-concept of well-being was measured by direct interview with a questionnaire consisting of 37 structural statements. Physical training program was conducted three times a week for six consecutive months. Multiple regression analyses suggested positive relations between balance, muscle strength, well-being and physical training between the experimental and control group. This positive relation can support the role and importance of physical training to improve locomotor performance and perception of well-being among 'older' adults with ID.
Abstract: Parenthood in persons with intellectual disability (ID) is an issue of concern for the family, guardians, and professionals as there are many sentiments and problems involved: financial, technical, medical, legal, and above all moral. People with intellectual, developmental, or other disabilities have feelings, want relationships, and are able to have children also. The attitude of society has changed through time from the early eugenic concern with heredity and fertility, to a focus on the risk to the children due to parental neglect or abuse, to acceptance and a search for solutions to parental training and support. This change can be seen as a result of a shift from institutional care to community care and normalization. This paper reviews available research, prevalence, service issues, experience from around the world, and relates to the situation in Israel. Jewish Law has been very progressive regarding the possibility of marriage between persons with ID (in contrast to American Law where historically this right has been denied, until recently). Recent research has shown that, in the case of such a union resulting in children, although they require some supervision, family, friends, and social welfare agencies have scrutinized these families so much they are in constant fear of their child being taken away. There is little information on the number of such cases and an overall dearth of information on the effects on the children, although one recent study from the U.K. has shown a varied picture of resilience and a close, warm relationship later on with the family and especially the mother.
Abstract: Islam prohibits to take your own life, because this way you will interfere with the work of G-d (Allah), which is clear from several places in the Quran. Concerning individual suicide or suicide attempts in various Arab countries the literature is sparse and the incidence low. In this paper we present a review of research from Israel showing that suicide epidemiology among the Arab population of children and adolescents display a low incidence, but an increase has been observed over the past decade, but still much lower than the Jewish population. We believe that there is a need for the development of prevention and intervention strategies in order to keep this incidence low.
Abstract: It has been assumed that impaired intellectual capacity could act as a buffer to suicidality in the population of children and adolescents with intellectual disability. The few studies that have been conducted contest this assumption and in fact the findings showed that the characteristics of suicidality in the population of children and adolescents with intellectual disability are very similar to other adolescents without intellectual disability. This paper reviews the few studies conducted and describe the symptomatology in this population.
Abstract: Intellectual disability (ID) is a life-long disability characterized by impaired cognitive and adaptive skills. Over the past few decades, a shift has occurred in the conceptualization and treatment of people with ID and research in health policy and health-care delivery has become increasingly global with a notable disparity between the developed and developing world. This review presents a literature overview of global health policy for ID with the intent to focus specifically on the policy and treatment within Israel. The methodology involved sites visits to care centers, discussions with stakeholders in health policy, and a literature review. We believe that Israel is in a unique position between a developed and developing culture. In particular, the distinct problems faced by the Arab and Bedouin community in terms of ID must be formally accounted for in Israel's future policies. Research from the developing world would be instructive to this end. The global approach in this presentation led to certain policy recommendations that take into account the uniqueness of Israel's position from a social, economic, religious, and demographic perspective. It is the hope that this paper will lead to an increased awareness of the challenges faced by persons with ID and their providers in all sectors of Israeli society and that the necessary policy recommendations will ultimately be adopted.
Abstract: Children, adolescents and adults all benefit from physical exercise and physical fitness can also bring well-being to the person. Tracking physical fitness and activity over time from childhood, adolescence into adulthood will provide information on the benefits and also increase over knowledge on intervention and intervention programs. Many children and adolescents participate in physical activity, but this activity decline in adulthood. This short review provide information from several studies on the benefit of physical exercise and fitness through childhood, adolescence into early adulthood.
Abstract: The goal of this study was to determine the prevalence of vitamin B12 deficiency among intellectually disabled persons in a vegetarian remedial community in Israel. In this community, 47 individuals with intellectual disability (ID) live in 7 enlarged families in a kibbutz style agricultural setting. These 47 individuals and 17 of their caregivers were screened for vitamin B12 deficiency. There were 25.5% of the disabled vs. 11.8% of the caregivers found to have levels of vitamin B12 lower than 157 pg/ml. It is concluded that persons with ID in this vegetarian residential care community seemed to be at a higher risk for vitamin B12 deficiency.
Abstract: Touching is often a forgotten part of medicine. The manual medicine or therapeutic touch (TT) is much more powerful than many modern, biomedically oriented physicians think. Pain and discomfort can be alleviated just by touching the sick area and in this way help the patient to be in better contact with the tissue and organs of their body. Lack of presence in the body seems to be connected with many symptoms that can be readily reversed simply by sensitive touch. When touch is combined with therapeutic work on mind and feelings, holistic healing seems to be facilitated and many problems can be solved in a direct and easy way in the clinic without drugs. This paper gives examples of the strength of manual medicine or therapeutic touch in its most simple form, and points to the power of physical contact between physician and his patient in the context of the theory and practice of holistic healing. Intimacy seems highly beneficial for the process of healing and it is very important to distinguish clearly between intimacy and sexuality for the physician and his patent to be able to give and receive touch without fear and without holding back emotionally.
Abstract: Sexual problems are found in four major forms: lack of libido, lack of arousal and potency, pain and discomfort during intercourse, and lack of orgasm. It is possible to work with a holistic approach to sexology in the clinic in order to find and repair the negative beliefs, repressions of love, and lack of purpose of life, which are the core to problems like arousal, potency, and pain with repression of gender and sexuality. It is important not to focus only on the gender and genitals in understanding the patient"s sexual problems. It is of equal importance not to neglect the body, its parts, and the feelings and emotions connected to them. Shame, guilt, helplessness, fear, disgust, anger, hatred, and other strong feelings are almost always an important part of a sexual problem and these feelings are often "held" by the tissue of the pelvis and sexual organs. The patient with sexual problems can be helped both by healing existence in general and by discharging old painful emotions from the tissues. The later process of local healing is often facilitated by a simple technique: accepting contact via touch. This is a very simple technique, where the self-acceptance of the patient is to be promoted, for example, asking the female patient to put her hand on her stomach (uterus) or vulva, after which the holistic physician puts his hand supportively around hers. When done with care and after obtaining the necessary trust of the patient, this aspect of holding often releases the old negative emotions of shame bound to the touched areas. Afterwards, the emotional problems become a subject for conversational therapy and further holistic processing. Primary vulvodynia seems to be one of the diseases that can be cured after only a few successful sessions of working with acceptance through touch. The technique can be used as an isolated procedure or as a part of a pelvic examination. When touching the genitals with the intention of sexual healing, a written therapeutic contract with the patient is highly recommended and a strict ethical code is necessary to avoid malpractice. As about one woman in three suffers from sexual problems, many of which seemingly can be efficiently alleviated by the simple holistic techniques of "holding and processing", it is very important that the holistic physician is also trained to work in the sexual sphere in order to be able to support his patients fully.
Abstract: Many of the diseases seen in the clinic are actually symptoms of social problems. It is often easier for the physician to treat the symptoms than to be a coach and help the patient to assume responsibility in order to improve quality of life, social situation, and relations. If the physician ignores the signs of the disease as a symptom of social problems, and treats the patient with pharmaceuticals, he can give the patient the best justification in the world not to do anything about the situation. It is very important that the physician is not tricked by the games the socially troubled patient, more or less unconsciously, is playing. A firm and wise attitude that confronts the patient with his or her lack of responsibility for solving social problems seems to be a constructive way out. The physician can give holding and support, but the responsibility must remain with the patient. Often it is better for the patient that the physician abstains from giving drugs that can remedy the symptoms and takes the role of a coach instead. Suffering is not necessarily bad, suffering is actually highly motivating and often the most efficient source of learning. Coaching can help the patient canalize his motivation into highly constructive considerations and behavior. A holistic approach thus gives the patient learning and helps him rehabilitate his social reality. Concerning children with recurrent or chronic pain, we have observed an overuse of painkillers, where we believe part is of a psychosomatic nature due to poor thriving in the family. Here the physician has an important job helping the parents to develop as persons, teaching them the basic holding of awareness, respect, care, acknowledgment and acceptance of their child. Most of the chronic pain and discomfort with children can be improved if the physician understands how to use the holistic medical toolbox.
Abstract: In clinical holistic practice, it is recommended that ample time is spent with the gynecological or pelvic examination, especially in cases of women with suspected old emotional traumas following early childhood cases of incest or sexual abuse. The holistic principles of holding and processing should be followed with the purpose of healing the patient, re-establishing the natural relationship with the body, sexuality, and reproductive organs. Sexual violations are often forcibly repressed. It appears that the tissues that were touched during the violation often bear the trauma. It is characteristic of these patients that their love lives are often problematic and do not provide the necessary support to heal the old wounds in the soul and therapy is therefore indicated. When this is concerned with the reproductive organs, it poses particular difficulties, as the therapy can easily be experienced as a repetition of the original violation, not least due to the risk of projection and transference. There is, therefore, a need for a procedure that is familiar to and safe for the patient, for all work that involves therapeutic touching of sexual organs over and beyond what is standard medical practice. This paper presents one case story of earlier child sexual abuse and one case of temporary infertility. We have established a procedure of slow or extended pelvic examination, where time is spent to make the patient familiar with the examination and accept the whole procedure, before the treatment is initiated. The procedure is carried out with a nurse, and 3 h are set aside. It includes conversation on the present condition and symptoms; concept of boundaries; about how earlier assaults can be projected into the present; establishment of the therapeutic room as a safe place; exercises on when to say "stop"; therapeutic touch; visualization of the pelvic examination step by step beforehand; touching on the outside of the clothes with repetition of the "stop" procedure if necessary; pelvic examination paying special attention to traumatized (damaged/scarred/blocked) areas with feel, acknowledge, and let go of the traumatized areas; postprocessing of emotions and traumas with final healing. The patient cannot be healed until negative decisions are found and dropped with a tour back to the present, to let go of negative sentences and ideas, and a plan for further positive progress.
Abstract: 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.
Abstract: This study was undertaken to examine the association between the immunological impact of HIV (measured by CD4 count) and global self-assessed quality of life (QOL) (measured with QOL1) for people suffering from HIV, to see if the connection was large and statistically strong enough to support our hypothesis of a strong QOL-immunological connection through the nonspecific, nonreceptor-mediated immune system, and thus to give a rationale for a holistic cure for HIV. This cross-sectional population study in Uganda included 20 HIV infected persons with no symptoms of AIDS and a CD4 count above 200 mill./liter. The main outcome measures were CD4 count, global QOL measured with the validated questionnaire QOL1, translated to Luganda and translated back to English. We found a large, clinically significant correlation between the number of T-helper cells (CD4) and global self-assessed quality of life (QOL1) (r = 0.57, p = 0.021), when controlled for age, gender, and years of infection. Together with other studies and holistic medicine theory, the results have given rationale for a holistic cure for HIV. We suggest, based on our findings and theoretical considerations, that HIV patients who improve their global QOL, also will improve their CD4 counts. Using the technique of holistic medicine based on the life mission theory and the holistic process theory of healing, we hypothesize that the improvement of QOL can have sufficient biological effect on the CD4, which could avoid or postpone the development of AIDS. A holistic HIV/AIDS cure improving the QOL draws on hidden resources in the person and is thus affordable for everybody. Improving global QOL also means a higher consciousness and a more ethical attitude, making it more difficult for the HIV-infected person to pass on the infection.
Abstract: The modern physician is often multiparadigmatic as he serves many different types of people in many different existential circumstances. The physician basically often has three, very different sets of technologies or "toolboxes" at his disposal, derived from three different medical paradigms: classical, manual medicine; biomedicine; and holistic or consciousness-oriented medicine. For lack of a better term, we have called the extended medical science--integrating these three different paradigms and their three strands of tools and methods--the "new medicine". The excellent physician, mastering the "new medicine", uses the most efficient way to help every patient, giving him or her exactly what is needed under the circumstances. The excellent physician will choose the right paradigm(s) for the person, the illness, or the situation, and will use the case record to keep track of all the subjective and objective factors and events involved in the process of healing through time. The case or medical record has the following purposes: A. REFLECTION: To keep track of facts, to provide an overview, to encourage causal analysis, to support research and learning, and to reveal mistakes easily. B. COMMUNICATION: To communicate with the patient with a printout of the case record to create trust and help the patient to remember all assignments and exercises. C. EVIDENCE AND SAFETY: To provide evidence and safety for the patient or to be used in case of legal questions. D. SELF-DISCIPLINE: To encourage discipline, as a good case record is basically honest, sober, brief, and sticks to the point. It forces the physician to make an effort to be more diligent and careful than a busy day usually allows. The intention of the case or medical record is ethical: to be sure that you, as a physician, give the best possible treatment to your patient. It helps you to reflect deeply, communicate efficiently, provide evidence and safety, and back your self-discipline, never to be carried away by the high speed of modern-day clinical work to give less than the optimal treatment. The patient"s life, now and in the future, is in the palm of your hand, and to assume this huge responsibility, the physician must be anxious and careful about the quality of the medical record. Much too often, the essence of the session is nowhere to be found in the case record, so most of the generated value is lost between consultations.
Abstract: Onychomycosis is a common nail disease responsible for approximately 50% of diseases of the nail. It occurs more in the elderly, though several cases have been reported among children. Several factors influence, such as climate, geography, and migration. The two dermatophytes most commonly implicated in onychomycosis are Trichophyton rubrum and T. mentagrophytes, accounting for more than 90% of onychomycoses. Nonetheless, several other toxigenic molds have been implicated. For convenience, onychomycosis is divided into four major clinical presentations: distal subungal, which is the most common form of the disease; proximal subungal, which is the most common form found in patients with human immunodeficiency virus infection; superficial; and total dystrophic onychomycosis. Epidemiology of onychomycosis in adults and children is evaluated and the most common clinical symptoms addressed. Although the risk factors are discussed, the multifactorial nature of onychomycosis makes this inexhaustible. The diagnosis and treatments are difficult and the choice of appropriate antifungal drugs complex and require the knowledge of the chemical structures of the metabolites of the molds that cause onychomycosis and their interaction with the antifungal drugs. This is true because most of the antifungal drugs are derived from mold/fungal metabolism. Treatment with griseofulvin and amphotericin is displaced by the use of newer drugs from azole compounds, pyrimidines, and allylamines derivatives. Amorolfine, itraconazole, and ciclopirox nail lacquer solution 8 have gained support globally, but the side effects, drug resistance, and persistence of the disease are still a serious concern to the patients, just as economics and quality of life. Hence, the search for safer and more efficacious drug treatments are continuing.
Abstract: This paper evaluates the possible reasons for consistent vitamin B12 deficiency in chronic toxigenic mold exposures and the synergistic relationships with the possible mycotoxic effects on one-carbon metabolism that lead to the manifestations of clinical neuropathological symptomology. Vitamins are first defined in general and the nutritional sources of vitamin B12 are evaluated in particular. Since patients with chronic exposures to toxigenic molds manifest vitamin B12 deficiencies, the role of mycotoxins in vitamin B12 metabolism is assessed, and since vitamin B12 plays important biochemical roles in one-carbon metabolism, the synergistic effects with mycotoxins on humans are reviewed. An outline of the proposed mechanism by which mycotoxins disrupt or interfere with the normal functions of vitamin B12 on one-carbon metabolism is proposed. The overall functions of vitamin B12 as a source of coenzymes, in intracellular recycling of methionine, in methionine synthase reaction, in the prevention of chromosome breakage, in methylation, and in maintaining a one-carbon metabolic balance are reviewed. Signs, symptoms, and clinical neurological indications of vitamin B12 deficiency are also cited. By implication and derivation, it is likely that the interruption of the structure and function of vitamin B12 would in turn interfere with the one-carbon metabolism leading to the neurological manifestations. This review is an attempt to formulate a basis for an ongoing research investigation on the subject.
Abstract: The biomedical paradigm is so convincing from a biochemical point of view, and highly efficient in many cases of acute medical problems and emergencies, but unfortunately most patients do not get much better only treated with drugs; they need to do something about their lives themselves. It is highly important for the modern physician to understand the strengths and weaknesses of the modern biomedical paradigm, to understand when and when not to administer drugs to their patients. Often a symptom can be eliminated for a while with drugs, but this is not always good as the patient might need to learn to study the imbalances in life that cause the disturbances and symptoms. For the elderly patient, sometimes life can be extended in spite of the subjective fact that life has come to its end. Sometimes treatment with a drug can teach the patient that quality of life is the responsibility of the physician and not the patient. This learned attitude can give the patient problems later or make them less active in helping themselves (responsibility transfer in the wrong direction). This paper gives a number of examples where medical drugs really are the treatment of choice in general practice and some more doubtful examples of using of the biomedical paradigm.
Abstract: In this paper, we suggest a psychological theory of dependency as an escape from feeling existential suffering and a poor quality of life. The ways in which human beings escape hidden existential pains are multiple. The wide range of dependency states seems to be the most common escape strategy used. If the patient can be guided into the hidden existential pain to feel, understand, and integrate it, we believe that dependency can be cured. The problem is that the patient must be highly motivated, sufficiently resourceful, and supported to want such a treatment that is inherently painful. Often, the family and surrounding world is suffering more than the dependent person himself, because the pattern of behavior the patient is dependent on makes him or her rather insensitive and unable to feel. If the patient is motivated, resourceful, and trusts his physician, recovery from even a severe state of dependency is not out of reach, if the holistic medical tools are applied wisely. The patient must find hidden resources to take action, then in therapy confront and feel old emotional pain, understand the source and inner logic of it, and finally learn to let go of negative attitudes and beliefs. In this way, the person can be healed and released of the emotional suffering and no longer be a slave to the dependency pattern.
Abstract: This paper evaluates the monthly, quarterly, and seasonal variation of antigenic bacterial infections among the working class in the inner city of Houston using the Wellcogen Rapid Test methods. One of the aims was to demonstrate how this method could be used effectively in screening patients at risk and preventing the spread of antigenic bacteria such as Streptococcus pneumoniae, Haemophilus influenzae b, Streptococcus (Strep b), and Neisseria meningitidis (mainly group c and b). A total of 2,837 patients were screened for bacterial infections; 908 (32%) were male and 1,929 (68%) were female. The age range was between 2 and 70 years. Of the total group, 356 (12.5%) patients were positive; 203 (57%) were female while 153 (43%) were male (male/female ratio of 1:1.3). Medically underserved and immune suppressed populations are the most affected by these bacterial infections. Blacks are the most affected (48%) compared to Native Americans (1%), but children under 10 years of age have the highest incidence. This research showed, in addition, that the Wellcogen Rapid Tests are effective (356 cases identified) for a rapid screening of infectious bacteria. Explanation for these results was probably due to poor living conditions, poor hygiene, and viral immune suppression in adults and immature immune systems in neonates and children under 10 years of age.
Abstract: We believe that the consciousness-based/holistic medical toolbox has a serious additional offer to cancer patients and, as a consequence, designed a treatment for the patient with metastasized cancer. From a holistic perspective, cancer can be understood as a simple disturbance of the cells, arising from the tissue holding on to a trauma with strong emotional content. This is called "a blockage", where the function of the cells is allocated from their original function in the tissue to a function of holding emotions. We hope to be able not only to improve the quality of life, but also to improve survival and in some cases even induce spontaneous remission of the metastasized cancer. This paper describes how work with a patient with metastasized cancer can be done in the holistic clinical practice in 14 days on an individual basis, helping the patient to recover her human character, purpose of life, coherence, and will to live, thus improving quality of life and possibly also survival time. The holistic therapeutic work includes (1) teaching existential theory, (2) working with life perspective and philosophy of life, (3) helping the patient to acknowledge the state of the disease and the feelings connected to it, and finally (4) getting the patient into the holistic state of healing: (a) feeling old repressed emotions, (b) understanding why she got sick from a holistic point of view, and finally (c) letting go of the negative beliefs and decisions that made her sick according to the holistic theory of nongenetic diseases. The theory of the human character, the quality of life theories, the holistic theory of cancer, the holistic process theory of healing, the theory of (Antonovsky) coherence, and the life mission theory are the most important theories for the patient to find hope and mobilize the will to fight the cancer and survive. The patient went through the following phases: (1) finding the purpose of life and hidden resources; (2) confronting denial; (3) taking responsibility for being very ill; (4) severe existential crises with no wish to live while still fighting; (5) integration of many repressed feelings and negative decisions thus rehabilitating character; (6) confronting lack of intimacy and trust in others and this way rehabilitating the ability to love; (7) rehabilitating the will to live, breaking through and falling in love with life; (8) assuming responsibility for the social relations; and sometimes (9) quality of life is improved radically with indications of spontaneous remission of the liver tumors.
Abstract: Malaria is a protozoan disease caused in humans by the genus Plasmodium of which four species are known: P. falciparum, P. vivax, P. ovale, and P. malariae. It is transmitted through the bite of infected female mosquitoes of the genus Anopheles. Malaria is endemic in tropical and subtropical regions of the world. It is characterized by extreme exhaustion associated with paroxysms of high fever, sweating, shaking chills, and anemia. Approximately 40% of the world''s population, mostly those living in the poorest nations, are at risk. Much of the deaths due to malaria occur in Africa, mostly among children. The search for prevention and control interventions that are effective and sustainable remains an abiding challenge for national governments and international health agencies. To this end, the World Health Organization and several nongovernmental organizations are investing in the use of insecticide-treated mosquito nets (ITMNs) as a viable option. Trials of ITMNs in the 1980s and 1990s showed that they reduce deaths in young children by an average of 20% and multilateral agencies, spearheaded by Roll Back Malaria (RBM), seek to have 60% of the populations at risk sleeping under ITMNs by 2005. All pesticides are toxic by nature and present risks of adverse effects that depend on toxicity of the chemical and the degree of exposure. While there is agreement that ITMNs can be effective in reducing malaria morbidity and mortality under field trials, a number of factors relating to their sustainability and contribution to health improvement in less-developed countries have yet to be determined. In particular, the adverse effects associated with their long-term use and misuse has yet to be fully evaluated. Although this paper examines potential neurotoxic and neurobehavioral effects of long-term use of ITMNs and discusses priority public health actions for protecting the health of users, it forms the basis for further research.
Abstract: This paper shows how consciousness-based holistic medicine can be used in the case of asthma, allergy, and eczema. We have many fine drugs to relieve patients from the worst of these symptoms, where many children and adults suffer health problems related to hyper-reactivity of the immune system. Many symptoms remain throughout life because the drugs do not cure the allergy and allergy today is the sixth leading cause of chronic illness. The etiology of the immune disturbances is mostly unknown from a biomedical perspective. Consciousness-based holistic medicine could therefore be used to treat these diseases if the patient is willing to confront hidden existential pain, is motivated to work hard, and is dedicated to improve quality of life, quality of working life, and personal relationships. Improving quality of life is not always an easy job for the patient, but it can be done with coaching from the physician. An increased physical health is often observed after only a few sessions with a physician skilled in using holistic medical tools and able to coach the patient successfully through a few weeks of dedicated homework. Children with allergy and asthma can also be helped if their parents are able to do work on personal development, to improve the general quality of life in the family and their relationship with the child.
Abstract: The Arab family in Israel is still embedded in the traditional society with extended family support systems, but we see a population in transition influenced by the surrounding society. This paper looks at the different religious attitudes toward the exceptional people in our society (i.e., the family reaction to a child born with intellectual or developmental disability), reviews recent studies on the Arab and Bedouin families in Israel, and presents data on the Arab population in residential care centers. Today, out of 57 residential care centers in Israel for persons with intellectual disability, 13 (22.8%) are providing service to the non-Jewish population. The Arab population constitutes 12-13% of the total residential care population, lower than the 19-20% in the total population. In residential care, the Arab population is characterized by younger children with severe and profound intellectual disability. The informal family support system is still a very important factor in the Arab family in Israel, a fact that we believe should be strengthened by implementing the British and Danish model of nurse home visitation.
Abstract: Adolescents with blindness or visual impairment, in order to go through the trying time of adolescence, require extra strength to overcome their disability. This short communication looks at prevalence data for blindness in children and adolescents that range from about 3 per 10,000 children in developed countries (60 blind children per million total population) to 15 per 10,000 in the poorest countries (600 blind children per million total population). Data from the year 2000 in Israel showed a total of 18,509 persons with blindness registered in Israel, including 168 children between the age 0-5 years and 788 between 6-18 years. Children and adolescents comprised 5.2% of the total with a small male dominance (520 males, 436 females). The total prevalence rate for children and adolescents (0-18 years) in Israel was 4.5 per 10,000 and 5.3 per 10,000 for the 6-18 year olds. The causes of blindness for children and adolescents in Israel are also presented, with optic atrophy the most common cause.
Abstract: Change in the attitudes of staff or the public towards people with intellectual disability (ID) can impact their life and health, but that change has not been studied among physicians who belong to an ethnic minority undergoing dramatic social and economic transition. The goal of this study was to explore the change of attitudes of Negev Bedouin physicians serving their community and their satisfaction with policy, care, and knowledge in the field of ID. Seventeen community physicians (7 Bedouins and 10 Jewish) were interviewed using a simple questionnaire that consisted of items measuring attitude and satisfaction. The vast majority of the Bedouin and Jewish physicians had positive attitudes toward inclusion of those in the community with ID and were ready to provide the care needed in the community with special assistance. There was a need for further education in ID and more resources. There was a belief that there is discrimination between the Bedouin and Jewish community in the provision of care to people with ID. General dissatisfaction was expressed about the policy, resources, care provision, and expertise offered to Bedouins with ID. More efforts must be directed to empower the physicians with knowledge, expertise, and resources to handle the care of Bedouins with ID in a culturally appropriate way.
Abstract: 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.
Abstract: Obesity in adolescence has increased significantly over the past 30-40 years and a recent international comparison study (13 European countries, Israel and the US) showed that the highest prevalence in adolescents was found in the US (12.6% in 13 year old boys, 10.8% in girls; 13.9% in 15 year old boys and 15.1% in 15 year old girls) and the lowest in Lithuania. This increase in adolescence is a public health concern, because most obese adolescents continue their obesity into adulthood with serious risk for chronic disease. Focus should therefore be on prevention programs that increase healthier patterns of lifestyle and physical activity.
Abstract: 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.
Abstract: 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.
Abstract: 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.
Abstract: 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.
Abstract: We believe a holistic approach to problems in childhood and adolescence will benefit the child, adolescent, and the whole family. As a rule, children have far less to say in the family than their parents. Therefore, it is the parents who set the agenda and decide how things are done at home and in relation to the child. Most often, it is also the parents who have a problem when the child is not thriving. The child thus acts as the thermometer of the family. When children are not feeling well or are sick, the parents are not doing well either. Most problems arising from dysfunctional patterns are almost impossible for the parents to solve on their own, but with help and support from the holistically oriented physician, we believe that many problems can be discovered and solved. Not only can health problems be addressed, but also problems of poor thriving in the family in general. With the physician in the role of a coach, the family can be provided with relevant exercises that will change the patterns of dysfunction. Consciousness-based medicine also seems to be efficient with children and adolescents, who are much more sensitive to the psychosocial dimensions than adults. Five needs seem to be essential for the thriving and health of the child: attention, respect, love, acceptance (touch), and acknowledgment. The physician should be able to see if the child lacks fulfillment in one or more of these needs, and he can then demonstrate to the parents how these needs should be handled. This should be followed by simple instructions and exercises for the parents in the spirit of coaching. This approach is especially relevant when the child is chronically ill.
Abstract: When the problems of sex and living together are understood as symptoms of underlying old existential wounds in need of healing, and when the physician accepts the role as coach supporting the patient to confront these emotional pains, then the patient can heal existentially in order to obtain the wanted closeness and intimacy. The change of perspective from: "He or she is not all right in..." to "I see that this is really about me, and what I have to learn is..." is where the patient assumes responsibility and this is often efficient in helping the patient with problems in his/her sex- and love life. Intimacy is the most difficult art, where sexuality cannot exist without trust, vulnerability, and surrender. This is often only possible after the patient has found his or her true self, including the purpose of life. The physician who will give "holding" (care) and processing to the patient with the intention of healing the "wounded child inside" who cannot love and open up, can often help the patient to improve self-insight and change the whole quality and atmosphere of the relationship. The healing will end a series of symptoms of poor thriving, physically, emotionally, and mentally, and make life worth living. Sometimes a few successful holistic sessions are enough to change the whole picture and solve an emotional "knot" that has the potential to destroy the relationship.
Abstract: Biomedical prevention of diseases seems very difficult, but we believe that holistic medicine offers a simple and seemingly efficient solution that is useful for both physicians and dentists in their clinics, with a focus on improvement of quality of life as an important supplement to improving their patients' lifestyles. Quality of life is improved when the patient's personal philosophy of life is adjusted in accordance with life and its fundamental purpose. The relevant concept of personal growth can be introduced to the motivated patient in the clinic, during the conversation with the dentist. To prevent health problems in the future, personal development must focus on improving the quality of life of the patient by: 1) increasing self insight to obtain knowledge and understanding of the purpose of life; 2) recovery of character to be the good person the patient really is; and 3) full expression of talent in private and professional life in order to be optimally valuable to the patient and others. It is also important to work on the ethics of the patient to prevent the patient from destroying personal relationships and harm others, because such deeds will almost always also damage the patient. Parallel to clinical work, we believe that dentists can make an impact on their patients and inspire an improvement in their quality of life. The dentist, who sees the patient at shorter intervals, can coach his patient and often efficiently help him/her to improve intimacy and personal relationships, consciousness of responsibility, and quality of life which might be highly beneficial for the patient's health.
Abstract: Biomedicine focuses on the biochemistry of the body, while consciousness-based medicine--holistic medicine--focuses on the individual"s experiences and conscious whole (Greek: holos, whole). Biomedicine perceives diseases as mechanical errors at the micro level, while consciousness-based medicine perceives diseases as disturbances in attitudes, perceptions, and experiences at the macro level--in the organism as a whole. Thus, consciousness-based medicine is based on the whole individual, while biomedicine is based on its smallest parts, the molecules. These two completely different points of departure make the two forms of medicine very different; they represent two different mind sets and two different frames of reference or medical paradigms. This paper explains the basic tools of clinical holistic medicine based on the life mission theory and holistic process theory, with examples of holistic healing from the holistic medical clinic.
Abstract: The holistic medical approach seems to be efficient and can also be used in adolescent medicine. Supporting the teenager to grow and develop is extremely important in order to prevent many of the problems they can carry into adulthood. The simple consciousness-based, holistic medicine--giving love, winning trust, giving holding, and getting permission to help the patient feel, understand, and let go of negative beliefs--is easy for the physician interested in this kind of practice and it requires little previous training for the physician to be able to care for his/her patient. A deeper insight into the principles of holistic treatment and a thorough understanding of our fellow human beings are making it work even better. Holistic medicine is not a miracle cure, but rather a means by which the empathic physician can support the patient in improving his/her future life in respect to quality of life, health, and functional capacity--through coaching the patient to work on him/herself in a hard and disciplined manner. When the patient is young, this work is so much easier. During our lifetime, we have several emotional traumas arranged in the subconscious mind with the smallest at the top, and it is normal for the person to work on a large number of traumatic events that have been processed to varying degrees. Some traumas have been acknowledged, some are still being explored by the person, and yet others are still preconscious, which can be seen for example in the form of muscle tension. Sometimes the young dysfunctional patient carries severe traumas of a violent or sexual nature, but the physician skilled in the holistic medical toolbox can help the patient on his/her way to an excellent quality of life, full self-expression, a love and sex life, and a realization of his/her talents--all that a young patient is typically dreaming about. Biomedicine is not necessary or even recommended when the physical or mental symptoms are caused by disturbances in the personal development that can be corrected with love and understanding. If possible, biomedicine must be avoided, even if this means suffering for the young person, who needs to confront the tough realities of life in order to grow into an able and sound adult.
Abstract: To determine their health status, we studied 2,282 Israeli adults with intellectual disability who were at least 40 years of age and lived in residential care. Results showed that age is a significant factor in health status. The frequency of different disease categories (e.g., cardiovascular disease, cancer, and sensory impairments) increased significantly with age for both genders. Cardiovascular disease in this population was less prevalent when compared to the general population, suggesting that underdiagnosis of some diseases or conditions may be prevalent in this population. The patterns of organ-system morbidity with increasing age were similar to those in other studies conducted in several countries, suggesting that health status and outcomes could be independent of cultural factors.
Abstract: The recovery of the human character and purpose of life with consciousness-based medicine seems to be able to induce spontaneous remissions in several diseases. On two different occasions, we observed breast tumors reduced to less than half their original diameters (clinically judged) during a holistic session, when working with the patients in accordance with the holistic process theory of healing, the life mission theory, and the theory of human character. One tumor was histologically diagnosed as malign breast cancer prior to the session, while the other was under examination. As both patients had the affected regions of the breast surgically removed immediately after the session, we are unable to determine if they were actually healed by the holistic treatment. We find it extremely interesting that the size of a tumor can be reduced dramatically within a few hours of holistic treatment, when the patient is highly motivated for personal development. The reduction of tumor size is in accordance with the holistic view that many types of cancer are caused by emotional and existential disturbances. From a holistic perspective, cancer can be understood as a simple disturbance of the cells, arising from the tissue holding on to a trauma with strong emotional content. This is called "a blockage", where the function of the cells is changed from their original function in the tissue to a function of holding emotions. The reduction of the tumor in the two cases happened when old painful emotions were identified in the tissues, in and around the tumor, and processed into understanding; when the patients finally did let go of negative beliefs and attitudes that had kept the feeling(s) repressed to that part of the body, the tumor first softened and then disappeared, presumably by apoptosis. We believe that the consciousness-based/holistic medical toolbox has a serious additional offer to cancer patients, and we will therefore strongly encourage the scientific society to explore these new possibilities. Our holistic medical research meets both ethical dilemmas and practical difficulties, as it obviously is important for the research in induced spontaneous remissions that surgery and chemotherapy is not used before it is absolutely necessary. On the other hand, is it important for the patient"s survival that they receive any well-documented treatment as soon as possible. An additional aspect for the patient who is able to cure her own cancer is that she is much less likely to get cancer again and much better prepared to deal with other diseases and challenges in life. Knowing that one can fight even cancer gives a strong belief in life and the need to improve quality of life. The high incidence of secondary cancers and the physical and emotional wounds from the biomedical treatment seem to justify a focus on prevention and additional holistic treatment modules. To support the patient in learning the mastery of coherence of body and life, using the crisis of cancer to recover the human character and the purpose of life, seems turning a personal potential disaster into the greatest gift of all. When it comes down to it, life is not just about surviving; what is more important is to live fully, to learn from the great challenges of life, and to obtain the optimal quality of life while being here.
Abstract: The modern physician is using pharmaceuticals as his prime tool. Unfortunately, this tool is much less efficient than you might expect from the biochemical theory. The belief in drugs as the solution to the health problems of mankind, overlooking important existing knowledge on quality of life, personal development, and holistic healing seems to be one good reason why approximately every second citizen of our modern society is chronically ill. The biomedical paradigm and the drugs are certainly useful, because in many situations we could not do without the drugs (like antibiotics), but curing infections or diseases in young age is not without consequences, as the way we perceive health and medicine is influenced by such experiences. When we get a more severe disease in midlife, we also believe drugs will make us healthy again. But at this age, the drugs do not work efficiently anymore, because we have turned older and lost much of the biological coherence that made us heal easily when we were younger. Now we need to assume responsibility, take learning, and improve our quality of life. We need a more holistic medicine that can help us back to life by allowing us to access our hidden resources. The modern physician cannot rely solely on drugs, but must also have holistic tools in his medical toolbox. This is the only way we can improve the general health of our populations. Whenever NNT (Number Needed to Treat) is 2 or higher, the likelihood of the drug to cure the patient is less than 50%, which is not satisfying to any physician. In this case, he must ethically try something more in order to cure his patients, which is the crossroads where both traditional manual medicine and the tools of a scientific holistic medicine are helpful.
Abstract: 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.
Abstract: The purpose of this study was twofold: (1) to compare whether children from polygamous family structures significantly differ from children from monogamous family structures with regard to the frequency of parent-child conflict, and (2) whether children from these two structures employ different patterns of family conflict resolution. To address these questions, a random sample of 212 high school students (60.8% monogamous) completed a self-administered survey. The results of MANOVA show no significant differences (p > 0.05) between these two structures with regard to the frequency of parent-child conflict. The results also show similar conflict management styles between these two family structures within each of the following five domains (privacy, school and career, money spending, going out and leisure, and physical appearance). This study is unique in that it is the first empirical research to be conducted in the field of conflict resolution among youth and adolescents in polygamous marital structures and therefore, further investigation is needed to replicate these results utilizing different cross-cultural populations practicing polygamy.
Abstract: School violence has been a new research area since the 1980s, when Scandinavian and British researchers first focused on the subject. This violence has sometimes even resulted in murder. Since the late 1980s the World Health Organization (WHO) has conducted cross-national studies every fourth year on Health Behavior in School Aged Children (HBSC). Today 37 countries participate under the guidance of the WHO-European Office. The HBSC school-based survey is conducted with a nationally representative sample of 11, 13 and 15 year old school children in each country using a standard self-administrated questionnaire. The subject of bullying at school has been part of the questionnaire. Results from these surveys and studies in the United States and Israel are presented and it is hoped that the recent public debate and initiatives by the various government agencies will result in reduced school violence in the future.
Abstract: Child homicide is as old as human history. It can be classified into intra- and extra familial child homicide. Different forms of homicide are discussed, and research findings show that in the age group 0-3 years the majority of cases were within the family. After age 12 years, it is primarily extra familial. With increased age of the child the phenomenon of child perpetrators is seen to be manifested in school homicide and juvenile crime. Risk factors are mentioned and pediatricians and family physicians should be aware of these in order to try preventive measures.
Abstract: Teenage or adolescent pregnancy requires the extensive involvement of health care workers in respect to the medical and social aspects of pregnancy, delivery, and later care of both mother and child. Trends in adolescent pregnancy over the last few years from the United States, Canada, and the United Kingdom are presented and related to data from Israel. Adolescent pregnancy in Israel has been on the decline, but in 1999 it was still 3.4% of all live births (131,936 children) with more pregnancies in this group among the non-Jewish population (7.2%) than in the Jewish population (1.7%).
Abstract: In 1982, Helicobacter pylori (formerly Campylobacter pylori) was identified as a pathogenic factor in peptic ulcer disease by researchers from Australia. Because only a small number of studies of H. pylori infection have been conducted in people with intellectual disability (ID), and none of these were done in Israel, the present authors decided to conduct a pilot study on its prevalence in this population. The Israeli Division for Mental Retardation provides services to over 6000 people in 54 residential care centres (or institutions), and one centre in the south of the country with kibbutz-style living arrangements was selected for this pilot study. The study was performed as part of the yearly routine medical examination of all residents, and blood specimens were drawn for IgG antibodies to H. pylori (ELISA). Out of the 47 individuals screened, 75% (n=36) were seropositive. In addition to the reported high rates of H. pylori infection in residents with ID living in large facilities, the present pilot study suggests that people with ID living in smaller, kibbutz-style arrangements are also at high risk.
Abstract: BACKGROUND: This study examines health and health care attitudes, practices and utilization patterns among the Bedouin Arab minority in the south of Israel. Particular attention is given to the effects of the new National Insurance Law that provides universal coverage for the first time, and to the identification of critical issues for further research. METHODS: Focus groups, adapted to Bedouin culture, were the primary method of data collection. Twelve groups (158 participants) from throughout the Negev met for 3-7 sessions each, using specially trained local moderators and observers. Issues discussed and analyzed included experience and satisfaction with the current health system (both modern and traditional), health service availability/barriers, health care needs, influences of social change, and the National Insurance Law. RESULTS: Participants voice dissatisfaction with modern health services in the Bedouin sector and the state of health of Negev Bedouin. They place great emphasis on the connection between health and the rapid social and economic changes, which this traditionally nomadic group is undergoing. Traditional health care is felt to still exist, but its importance is waning. The National Insurance law is having a major impact on the Bedouin, particularly because it provides universal health insurance coverage where only partial coverage had been in effect. CONCLUSIONS: This study, one of the first of its kind in the Bedouin sector, showed that the focus group method, if properly modified to cultural norms, can be a valuable research tool in traditional communities and in health service research. The findings from this research can be used to direct efforts to improve health policy and health services for this group, as well as preparing the way for further qualitative or quantitative studies.
