Ethno-cultural origins, health beliefs and mothers' behavior regarding infant vaccinations in Israel.

To compare the health beliefs and infant vaccination behavior of mothers of four different ethno-cultural backgrounds: Israeli-born Jewish and Arab-Bedouin and immigrants from the Former Soviet Union and Ethiopia; to examine the associations between initial and subsequent infant vaccination behaviors of mothers and to identify predictors of vaccination behaviors. A comparative cross-sectional study was conducted in selected community neighborhoods. A quota sample included 100 mothers with infants aged 18-24 months (N = 400) from each of the four ethno-cultural groups. Data were collected through questionnaires and examination of the infant vaccination cards. Both groups of immigrant mothers had the lowest adherence to the recommended vaccination regime. Our findings indicate that maternal behaviors regarding infant vaccinations were determined mainly by the behavior at the previous recommended vaccination stage. Different ethno-cultural groups presented different sociodemographic predictors of vaccination behaviors. These predictors only affected the vaccinations at the early stage of 2 months. Policy makers should be aware that mother's vaccination behaviors vary according to ethno-cultural groups to establish culturally tailored intervention programs.

Coping strategies, satisfaction with life, and quality of life in Crohn's disease: A gender perspective using structural equation modeling analysis.

OBJECTIVE: To identify coping strategies and socio-demographics impacting satisfaction with life and quality of life in Crohn's disease (CD). METHODS: 402 patients completed the Patient Harvey-Bradshaw Index, Brief COPE Inventory, Satisfaction with Life Scale (SWLS), Short Inflammatory Bowel Disease Questionnaire (SIBDQ). We performed structural equation modeling (SEM) of mediators of quality of life and satisfaction with life. RESULTS: The cohort comprised: men 39.3%, women 60.1%; P-HBI 4.75 and 5.74 (p = 0.01). In inactive CD (P-HBI≤4), both genders had SWLS score 23.8; men had SIBDQ score 57.4, women 52.6 (p = 0.001); women reported more use of emotion-focused, problem-focused and dysfunctional coping than men. In active CD, SWLS and SIBDQ scores were reduced, without gender differences; men and women used coping strategies equally. A SEM model (all patients) had a very good fit (X2(6) = 6.68, p = 0.351, X2/df = 1.114, SRMR = 0.045, RMSEA = 0.023, CFI = 0.965). In direct paths, economic status impacted SWLS (ß = 0.39) and SIBDQ (ß = 0.12), number of children impacted SWLS (ß = 0.10), emotion-focused coping impacted SWLS (ß = 0.11), dysfunctional coping impacted SWLS (ß = -0.25). In an indirect path, economic status impacted dysfunctional coping (ß = -0.26), dysfunctional coping impacted SIBDQ (ß = -0.36). A model split by gender and disease activity showed that in active CD economic status impacted SIBDQ in men (ß = 0.43) more than women (ß = 0.26); emotional coping impacted SWLS in women (ß = 0.36) more than men (ß = 0.14). CONCLUSIONS: Gender differences in coping and the impacts of economic status and emotion-focused coping vary with activity of CD. Psychological treatment in the clinic setting might improve satisfaction with life and quality of life in CD patients.

Religiosity: Its Impact on Coping Styles Among Women Undergoing Fertility Treatment.

The Israeli worldview places great significance on childbearing. This could create emotional and ethical difficulties for women coping with fertility issues in addition to their treatments. This study examined the relations between coping strategies and level of religiosity in 159 women undergoing infertility treatment. Statistically significant relations were found between the problem-solving coping style and religious observance (p < 0.01) and religious beliefs (p < 0.05). An inverse correlation was found between the emotional coping style and religious beliefs (p < 0.001). Health professionals should recognize the patient's coping styles and understand the patient's religious belief system as part of an ongoing fertility treatment.

Cell-free DNA and telomere length among women undergoing in vitro fertilization treatment.

PURPOSE: The current research is aimed at finding potential non-invasive bio-markers that will help us learn more about the mechanisms at play in failed assisted reproduction treatment. This exploratory pilot study examined the relationship between cell-free DNA (CFD) in plasma and telomere length in lymphocytes among women undergoing in vitro fertilization (IVF) and compared telomere length and CFD levels to a healthy control group. METHODS: Blood of 20 women undergoing IVF was collected at three time points during the IVF cycle. We assessed the relationship between CFD and telomere length as well as controlling for morning cortisol levels. We also collected blood of 10 healthy controls at two time points (luteal and follicular phases of the menstrual cycle) and compared mean telomere length, CFD, and cortisol levels between the IVF patients and healthy controls. RESULTS: The results revealed an inverse relationship between CFD levels and telomere lengths at several time points that remained significant even after controlling for cortisol levels. Women undergoing IVF had statistically significant higher levels of CFD and shorter telomeres compared to healthy controls. CONCLUSIONS: The relationship between telomere length and CFD should be further explored in larger studies in order to uncover potential mechanisms that cause both shortened telomere length and elevated CFD in women undergoing IVF.

A comparison of Israeli Jewish and Arab women's birth perceptions.

BACKGROUND: birth is a normal physiological process, but can also be experienced as a traumatic event. Israeli Jewish and Arab women share Israeli residency, citizenship, and universal access to the Israeli medical system. However, language, religion, values, customs, symbols, and lifestyle differ between the groups. OBJECTIVES: to examine Israeli Arab and Jewish women's perceptions of their birth experience, and to assess the extent to which childbirth details and perceptions predict satisfaction with the birth experience and the extent of assessing the childbirth as traumatic. METHODS: this study was conducted in two post partum units of two major public hospitals in the northern part of Israel. The sample included 171 respondents, including 115 Jewish Israeli and 56 Arab Israeli women who gave birth to their first (33%) or second (67%) child. Respondents described their childbirth experiences using a self-report questionnaire 24-48 hours after childbirth. FINDINGS: the Arab women were much less likely to attend childbirth preparation classes than the Jewish women (5% versus 24%). Forty-three per cent of the respondents reported feeling helpless, and 68% reported feeling lack of control during childbirth. Twenty per cent of the women rated their childbirth experience as traumatic, a rate much lower than the rate of medical indicators of traumatic birth (39%). The rate of self-reported traumatic birth was significantly higher among the Arab women than among the Jewish women (32% versus 14%). A higher percentage of the Arab women reported being afraid during labour (χ(2)=4.97, p<.05), expressed fear for their newborn's safety (χ(2)=12.44, p<.001), and reported that the level of medical intervention was excessive in their opinion, as compared to the Jewish women (χ(2)=5.09, p<.05; χ(2)=7.33, p<.01). However, both the Arab and Jewish women reported similar numbers of medical interventions and levels of satisfaction with their medical treatment. CONCLUSIONS: despite universal access to the Israeli health care system, Arab Israeli women use fewer perinatal medical resources and subjectively report more birth trauma than Jewish Israeli women. Yet, they give birth in the same hospitals with the same practitioners and report similarly high levels of satisfaction with the medical services. Taking into account the fact that perceptions of the birth experience differ between ethno-cultural groups will enable professionals to better tailor intervention and support throughout childbirth in order to increase satisfaction and minimise trauma from the experience.

Are coping resources related to humoral reaction induced by academic stress? An analysis of specific salivary antibodies to Epstein-Barr virus and cytomegalovirus.

The aim of the present study was to investigate whether coping resources mediated the changes in Epstein-Barr virus (EBV) and human cytomegalovirus (HCMV) specific salivary antibodies caused by academic stress. Fifty-four first-year female students of nursing and physiotherapy completed pencil and paper written questionnaires and concurrently donated saliva samples. The instrument included the short version of the Sense of Coherence (SOC) scale, measures of social support, current health, health practices, the scale of psychological distress, and state anxiety questionnaire. Data and saliva samples were collected one month after the beginning of the first semester, during term examinations period and a month into the second semester. Statistically significant changes in the level of specific salivary EBV and HCMV antibodies were observed between the four study points. State anxiety and psychological distress were significantly associated with HCMV-specific salivary antibody level increase during examinations and its decrease after the stress was over. Coping resources, however, were not associated with changes in any of the antibodies studied.

Human cytomegalovirus salivary antibodies as related to stress.

Human cytomegalovirus (HCMV) is prevalent in 50-80% of the population worldwide. After primary infection it remains in a latent state until reactivation. Stressful events induce the release of corticosteroids which activate HCMV. The effect of examination stress on HCMV reactivation among first year female students was studied by detecting the values of HCMV specific salivary IgG and IgA antibodies before, during and after two important examinations. Hepatitis A virus (HAV) salivary antibodies served as a non-latent virus control. A statistically significant increase in the level of HCMV specific IgG and IgA antibodies was detected in saliva samples collected during the two examinations, as compared with the samples collected one month before them and two weeks after the grades were posted (p<0.05), whereas HAV antibody levels did not change significantly.

Epstein-Barr virus specific salivary antibodies as related to stress caused by examinations.

Epstein-Barr virus (EBV) is prevalent in 90% of the population. After primary infection it remains in a latent state and the majority of the virus carriers are asymptomatic during their life. Among the immunocompromized patients such as organ and bone marrow transplant recipients, individuals lacking T cell immunity, and patients treated with corticosteroid, cancer, and AIDS patients EBV primary infection and reactivation can cause life threatening diseases. Immunosupression may occur also during stressful events, which induce corticosteroid release and thus activate EBV. The effect of examination stress on EBV reactivation among female students was studied by detecting the values of EBV specific IgG and IgA salivary antibodies. Sequential saliva samples were obtained from first year female students before, during, and after two important examinations. EBV specific IgG and IgA salivary antibodies were tested by enzyme-linked immunosorbent assay (ELISA). Hepatitis A virus (HAV) salivary antibodies served as a non-latent virus control. A statistically significant increase in the values of EBV specific IgG and IgA antibodies was detected in samples collected during the examinations, as compared to the samples collected two months before and one month after the exams (P < 0.05). HAV antibody levels did not change significantly between the four time points. The menstrual cycle had no significant effect on the results. No significant symptoms were reported during the whole study. These results indicate that among female students who endure stress during academic examinations, a significant increase in EBV specific IgG and IgA salivary antibody values could be detected. EBV reactivation should be confirmed by measuring salivary EBV DNA or infectious virus.