Characterization of an injectable, degradable polymer for mechanical stabilization of mandibular fractures.

This study investigated the use of injectable poly(propylene fumarate) (PPF) formulations for mandibular fracture stabilization applications. A full factorial design with main effects analysis was employed to evaluate the effects of the PPF:N-vinyl pyrrolidone (NVP, crosslinking agent) ratio and dimethyl toluidine (DMT, accelerator) concentration on key physicochemical properties including setting time, maximum temperature, mechanical properties, sol fraction, and swelling ratio. Additionally, the effects of formulation crosslinking time on the mechanical and swelling properties were investigated. The results showed that increasing the PPF:NVP ratio from 3:1 to 4:1 or decreasing the DMT concentration from 0.05 to 0.01 v/w % significantly decreased all mechanical properties as well as significantly increased the sol fraction and swelling ratio. Also, increasing the crosslinking time at 37°C from 1 to 7 days significantly increased all mechanical properties and decreased both the sol fraction and swelling ratio. This study further showed that the flexural stiffness of ex vivo stabilized rabbit mandibles increased from 1.7 ± 0.3 N/mm with a traditional mini-plate fixator to 14.5 ± 4.1 N/mm for the 4:1 (0.05 v/w % DMT) PPF formulation at day 1. Overall, the formulations tested in this study were found to have properties suitable for potential further consideration in mandibular fracture fixation applications.

Comparative genomics of the lactic acid bacteria.

Lactic acid-producing bacteria are associated with various plant and animal niches and play a key role in the production of fermented foods and beverages. We report nine genome sequences representing the phylogenetic and functional diversity of these bacteria. The small genomes of lactic acid bacteria encode a broad repertoire of transporters for efficient carbon and nitrogen acquisition from the nutritionally rich environments they inhabit and reflect a limited range of biosynthetic capabilities that indicate both prototrophic and auxotrophic strains. Phylogenetic analyses, comparison of gene content across the group, and reconstruction of ancestral gene sets indicate a combination of extensive gene loss and key gene acquisitions via horizontal gene transfer during the coevolution of lactic acid bacteria with their habitats.

Health knowledge, attitudes, and practice (KAP)--a basis for health promotion policy in Israel.

OBJECTIVE: To review how health promotion policy can be based on research data. DATA SOURCES: The Department of Health Promotion, Ministry of Health, Israel, in collaboration with Midgam Research and Consultation Company and the Israel Center for Disease Control have conducted ongoing research on health knowledge, attitudes, and practice in Israel as a basis for health policy. MAIN FINDINGS: Based on data from 1995 to 2000: 1. There is a positive trend in healthy dietary habits. 2. There is no decrease in smoking rates. 3. There is an increase in drinking rates of wine. 4. There is an increase in aerobic exercise. More Israelis declare they eat healthy foods, but currently this is only for 50% of the population. There is a need for health promotion efforts to further increase positive dietary habits. There is an immediate need for extensive health promotion efforts to decrease smoking rates in Israel. Also, there is a need for health promotion campaigns to decrease drinking in Israel. Although more people are participating in aerobic physical exercise, there is a need to further increase this number. CONCLUSION: Data on health knowledge, attitudes, and practice is an important source for health promotion policy. By trends seen in a national survey of health knowledge, attitudes, and practice conducted every two years, additional health promotion policy can be shaped.

Smoking prevention campaign for youth in Israel.

BACKGROUND: Smoking rates among teenagers have increased in many countries including Israel. Youth smoking prevention programs have developed considerably in recent years and the present study examines results of mass media anti-smoking campaign in Israel. METHODS: Two telephone interviews were conducted one moth and 9 months after exposure to TV advertisements. The two surveys consisted of random samples of Israeli adolescents aged 12-18 years. RESULTS: After one month, 77% of the survey participants remembered the slogan of the TV ads, and 30% used it. After 9 months, 32% remembered it and 6% used it. 28% said they were affected by the TV ads. After 9 months, 25% increased their awareness about anti-smoking behaviors, 2% claimed to have stopped smoking, and 1% claimed to have decreased smoking). Significant changes in anti-smoking awareness were found in survey participants who were exposed to TV ads and also participated in a school program.

Routine childhood screening for hyperlipidemia in Israel.

Screening of children and adolescents for hyperlipidemia is controversial. We performed a cholesterol surveillance study of 806 children aged between 6 and 14 years. The initial cholesterol screening test was done by finger stick in the non-fasting state. Children with cholesterol values exceeding 4.55 mmol/l ("borderline" risk) and their parents had their lipid profiles measured following a 12 h fast by venipuncture. The incidence of coronary risk factors in the families of children with hypercholesterolemia was estimated. Of the initial group, 71 children had total capillary cholesterol levels > or = 4.55 mmol/l, and in 65 of these children serum lipid profile was reexamined after an overnight fast. Fifty-five children were found to have total venous cholesterol (TVC) levels < 4.55 mmol/l, and 27 of the 55 had a low density lipoprotein (LDL) cholesterol level > 3.4 mmol/l ("borderline" risk). A positive correlation was found between TVC and LDL-cholesterol levels. Of the hypercholesterolemic children 49% had a parent with hyperlipidemia and 13% had a family history of premature myocardial infarction (before 55 years of age). We conclude that screening of children based on the presence of hypercholesterolemia or its possible complications in other family members may fail to identify many of the children with hypercholesterolemia. Thus, if thorough identification of young children with hypercholesterolemia is desired, inclusive population screening would be the most effective approach.

Bicycle helmets in Israel: observed change in usage following a nationwide campaign.

Bicycle-related head injuries are an important cause of injury and death among bicycle riders. The use of bicycle helmets could reduce the rate of serious head trauma among bicyclists involved in accidents. A nationwide survey was conducted in Israel to determine the usage of such helmets. This survey preceded a media campaign encouraging the use of bicycle helmets. A second survey compared the rates of helmet usage following the media campaign with those rates prior to the campaign. A modest but significant increase in the use of bicycle helmets was observed. In order to further increase this rate, additional educational campaigns are needed and possibly the enactment of legislation.

Trends in the prevalence of dental caries in Israel.

This study's objective was to assess the prevalence of dental caries in five-year-olds and twelve-year-olds in Jerusalem, Israel. A total of 166 children comprised the younger group; and 147 children represented the twelve- to thirteen-year-olds. Examinations took place in the classrooms under natural lighting, using a mouth mirror and a probe. It was found that 27.7 percent of the younger children were caries-free, with a mean dif(t) value of 3.65 +/- 3.58. At the age of twelve years, only 4.8 percent were caries-free, with a mean DMF (T) value of 4.9 +/- 3.09. Nearly 58 percent of these carious permanent teeth had been treated. In Jerusalem, fluoridation of the water supply was implemented only recently. There are signs of increased public awareness of prevention methods.

Utilization of preventive services by pregnant women in Jerusalem--a cross sectional study.

A study was made of health service utilization patterns during pregnancy of 279 young mothers, a representative sample of the Jewish population in Jerusalem. Only 47% reported that they used the municipal family health centers (FHCs) for prenatal care. Some 82% reported that they had resorted to more than one source of care during pregnancy. Sources other than the FHC were: regular Sick Fund doctor service (33%); private practitioners (25%); hospital-based services (25%). Among the FHC users, there was an unexpectedly high percentage of women of Asian-African origin and of those living in remote neighborhoods. Under-utilization was frequent among wealthy women, those with higher education and members of the Orthodox religious sector. While there was general satisfaction with the service, lower gratification was associated with higher utilization. This phenomenon may intimate that there may be a process of negative selection among women who use the service, when other alternatives are not readily available.

[Segev health promotion project in Jerusalem elementary schools].

The health-promotion and education project, Segev, is an Israeli version of the American Health Foundation's Know Your Body project. The aim of this cohort study was to change knowledge, attitudes, health behavior and risk factors for cardiovascular disease in elementary school children. We present the results of questionnaires about knowledge of, and attitudes to health in 656 Jewish children who started first grade in 1983-4 and completed 4 questionnaires in the first and third grades. The results indicate a statistically significant increase in knowledge and attitude scores in the experimental group after 1 and 3 years of intervention. They indicate that changes in knowledge of, and attitudes to health are possible after even a relatively short school health education program.

Primary prevention of cardiovascular diseases in childhood: changes in serum total cholesterol, high density lipoprotein, and body mass index after 2 years of intervention in Jerusalem schoolchildren age 7-9 years.

A school health education and promotion program, the Israeli version of the American Health Foundation's "Know Your Body" program, was developed by the Department of Public Health of the Municipality of Jerusalem in 1983. Eight experimental and eight control schools participated in this cohort study of Arab and Jewish first-grade children. After the first 2 years of intervention, comparison of experimental and control groups showed a significant increase in serum high density lipoproteins among Jewish children and a decrease in serum total cholesterol and body mass index among both Jewish and Arab children. These results indicate that changes in cardiovascular disease risk factors such as blood total cholesterol, high density lipoproteins, and body mass index are possible after a health education program is introduced to first-grade students for a relatively short period of time.

The prevalence of middle ear pathologies in Jerusalem school children.

In the years 1984-85, 2,664 Jerusalem school children aged between 8 and 13 years were checked for middle ear pathologies. This pilot study was part of a preventive medicine project that was also on the alert for cases where hearing problems had led to academic underachievement. The children were checked at school by an otolaryngologist using a pneumatic otoscope. 1.5% of them suffered from secretory otitis media, 3% from attic retractions, 0.3% from chronic otitis media, and 0.07% from cholesteatoma. The total number of children who had middle ear pathologies was 132 (4.95%). In a parallel group of 2,486 children checked by the routine pass/fail portable audiometry test performed by a nurse, only 1% were found to have middle ear pathologies. According to these middle ear findings, we concluded that the vast majority of the pathologies can be detected by a simple tympanometry and we recommend routine audiometric and tympanometric examinations for school children in grades A and B, and a repeated tympanometry at age 10 years.

Serum cholesterol (total, low-density lipoprotein, and high-density lipoprotein cholesterol), triglyceride levels, and fat consumption among Jerusalem Arab and Jewish schoolchildren.

As part of initial health screening for the "Know Your Body" Program-based comprehensive health education program, 841 Jerusalem first- and second-grade schoolchildren were tested for total serum cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, and triglycerides. The same population, which included 643 Jewish (76.5%) and 198 Arab children (23.5%), had their nutritional habits evaluated by means of a parent-completed food-frequency questionnaire. Arab schoolchildren had significantly lower total, high-density lipoprotein, and low-density lipoprotein cholesterol levels and higher triglyceride levels than the Jewish children studied (total cholesterol: Arab mean, 153.1 mg/dl, Jewish mean, 170.3 mg/dl; high-density lipoprotein cholesterol: Arab mean, 46.4 mg/dl, Jewish mean, 48.5 mg/dl; low-density lipoprotein cholesterol: Arab mean, 90.7 mg/dl, Jewish mean, 108.5 mg/dl; triglycerides: Arab mean, 77.9 mg/dl, Jewish mean, 66.3 mg/dl). No significant differences in consumption level of foods high in saturated fats and/or cholesterol were found between populations, although the Arab children showed a tendency to eat more of these foods. Significant differences in total cholesterol values were also found among Jewish children of different origins, but no significant differences were found in consumption levels of saturated fats and cholesterol. Further studies are needed to determine the reasons for the differences in total cholesterol and lipoprotein levels found between Jewish and Arab schoolchildren.

Occupational therapy in mother and child health care centers.

This paper describes the results of an infant stimulation program that involved mothers and their infants registered at Mother and Child Health Care centers in Jerusalem. A questionnaire was used to evaluate the mothers' knowledge, attitudes, and practices regarding the developmental needs of their infants. A developmental assessment was used to evaluate the infants' reaching and grasping abilities at 4 months of age. The questionnaire was completed by 175 mothers in the program (the experimental group) and a control group of 124 mothers. The results showed that, despite demographic differences that were likely to positively affect the control group's scores, the experimental group's scores were significantly higher. The results of the developmental assessment administered to 107 infants in the experimental group and 74 infants in the control group also indicated that, on 4 out of 5 reaching and grasping items, the experimental group performed significantly better. This study emphasizes the value of structuring a developmental curriculum for newborn infants and their mothers within an occupational therapy program.

Determinants of blood pressure in 7th grade Jerusalem school children.

The determinants of blood pressure level were analyzed in a group of 1154 Jerusalem school children aged 12. After controlling for age, significant differences in blood pressure measurements were found between three groups: boys, pre-menarche girls and post-menarche girls. A comparison of the means of selected biological variables showed that girls who have reached menarche have levels of systolic blood pressure, weight, height and Quetelet's index higher than boys and pre-menarche girls. However, levels of triceps skinfold thickness and pulse rate were similar in the two groups of girls and higher than in boys. Using multiple regression analysis, we found that much of the variance (boys 29%, post-menarche girls 21% and pre-menarche girls 15%) of systolic blood pressure could be explained by a combination of biological variables (Quetelet, pulse rate, triceps skinfold thickness and height) while these variables explained a much smaller proportion (boys 12%, post-menarche girls 17% and pre-menarche 9%) of diastolic blood pressure variance. The predictive power of systolic blood pressure by the measured biological variables was higher in boys than in girls. However, diastolic blood pressure was better predicted by the biological variables in the group of girls with menarche than in other groups. Elevated blood pressure was observed in 3.2% of the examined children. High values for Quetelet's index were observed in 6.4%. The prevalence of elevated measurements of blood pressure and Quetelet's index were significantly higher in girls with menarche. Among children aged 12, the association between sociodemographic characteristics and blood pressure level was weak, as measured in multiple regression analysis.

Use of iron supplements in infancy: a field trial.

Iron-deficiency anaemia in infancy, which is an important public health problem even in countries where gross malnutrition is not prevalent, can be prevented by iron supplementation or by fortification of infant foods with iron. A programme of iron supplementation was carried out in two places in Israel through the Maternal and Child Health services in the course of their routine duties. Though 89% of the mothers complied and gave iron supplements to their infants for a period of 1-9 months, only 26% continued for the full 9 months. A stastically significant difference was found in the haemoglobin and mean erythrocyte volume levels between the iron-supplemented group and the controls. The results indicate that the use of a higher daily dose of iron for a shorter period might lead to better compliance and greater benefits.