The effects of the Friendship Online Intervention Program on physical activity, substance abuse, psychosomatic symptoms, and well-being among at-risk youth.

INTRODUCTION: At-risk youth are those who are currently or potentially exposed to physical, mental, or emotional danger. The Friendship Online Intervention Program (FOIP) was created to encourage physical activity (PA) and reduce risky behavior among vocational secondary-school youth in Israel. We wanted to evaluate the effect of FOIP on PA, substance abuse, and psychological factors, including psychosomatic symptoms and well-being. METHODS: From October 2021 to June 2022, nonrandom sampling was employed to select at-risk youth from vocational secondary schools for participation in the FOIP. Before and after the intervention, questionnaires were administered to the intervention and control groups. The effects of FOIP were evaluated by univariate and multivariable analyses. RESULTS: The intervention (n = 103) and control (n = 77) groups showed similar levels of PA, cigarette smoking, and alcohol consumption at the beginning of the study. At follow-up, the intervention group showed a 57% increase in PA versus no change for the control group and decreased levels of smoking compared to the control group (p < .001). Similarly, in the intervention group, the number of psychosomatic symptoms decreased (effect size = 1.68) and life satisfaction increased (effect size = 0.86). Group assignment (intervention or control group) significantly predicted PA level, cigarette smoking, psychosomatic symptoms, and life satisfaction (adjusted R2 = .46, .20, .08, and .28, respectively) with participants in the intervention group showing more favorable results compared with the control group. CONCLUSIONS: FOIP was effective in increasing PA and decreasing risky behaviors among youth. FOIP may help at-risk youth build resilience and promote their physical and mental health.

Medical and social factors influencing the utilization of healthcare services among older adults in Israel during the COVID-19 lockdown.

Background: The corona virus disease 2019 (COVID-19) pandemic significantly impacted older adults. However, most older communities focused on the medical issues. The aims of this study were to identify the medical and social factors linked with the usage of medical services during the COVID-19 lockdown in Israel. Methods: The study was conducted Over two periods of time from February to April in 2019 (P1), before the COVID-19 and from February to April in 2020 (P2), during the first lockdown. The study was conducted on people aged 65 and older in Israel. The variable statistics were analyzed using frequency tabulation, cross-tabulation frequencies, and t-tests. Two hierarchical logistic regressions were conducted over four steps for each period. Results: The participants (n = 102,303) comprised 64.5% female (65,946) and 35.5% male (36,357) (mean age 80.5, SD- 7.46). It was found that participants who had not subscribed to the supportive community services were 7.47 times more likely to access medical services in P1 and 12.417 times more likely to access medical services during the lockdown. This variable was also found to be a strong predictor in the final model. The most significant variable for predicting the participants' needs during P2 was their previous needs in P1. Other social variables were living in assisted living home and living in community settlements. The presence of 12 diseases in this study did not predict service demand. Conclusion: Community support reduces medical service demands during disasters and provides services for older adults. During pandemics, however, social services need to be expanded and made more easily accessible to older adults.

Health promotion programs in prison: attendance and role in promoting physical activity and subjective health status.

Introduction: Maintaining an inmate's health can serve as a challenge due to unhealthy background, risky behavior, and long imprisonment. This study aimed to analyze the prevalence of participation in health promotion activities among Israeli inmates and its association with their physical activity levels and subjective health status. Methods: A cross-sectional study was designed to examine 522 inmates (429 males, 93 females). The data were collected by trained face-to-face interviewers and self-report questionnaires. Results: Most of the participants (82.37%) did not meet the recommended physical activity level. Half of the participants reported that their physical activity levels decreased since they were in prison compared with 29.50% who reported that their physical activity levels increased. Physical activity and subjective health status were significantly higher among younger male inmates. Furthermore, participation in health-promoting activities was associated with higher levels of physical activity and subjective health status. Discussion: Health promotion activities may play an important role in addressing the challenges of maintaining inmate health. Implications of the findings are further discussed.

Academic distress among undergraduate students during COVID-19: the relevance of SES and help-seeking behaviors.

Introduction: Academic distress has been frequently reported following the COVID-19 pandemic. This study estimates academic distress among undergraduate students, characterizes its nature in relation to economic, social, and health indicators, and examines the level of request for help following mental distress. Students with higher levels of academic distress were expected to show lower socio-economic status, lower social connections, and lower wellbeing indices. Methods: A cross-sectional study based on a structured anonymous questionnaire was delivered online to more than 1,400 undergraduate students from one university in Israel (women, 66.7%). Results: Academic distress was reported by 27.1% of the sample. Students who reported academic distress were more likely to report stress, negative psycho-somatic symptoms, changes in weight since COVID-19, low self-esteem, depressive symptoms, higher COVID-19 concerns, and higher security situation concerns. A hierarchic logistic regression model showed that the probability of reporting academic distress was 2.567 times higher (p < 0.001 95% CI [1.702, 3.871]) for those who reported lower family economic status before COVID-19 and 2.141 times higher (p = 0.004 95% CI [1.284, 3.572]) for those who highly reported depressive symptoms. In contrast, only 15.6% of those who reported academic distress sought help from academic authorities. Discussion: The significant associations of academic distress with health indices indicate that the self-reported distress was real and highly related to adverse health measures. A comprehensive, collaborative model that integrates psychological, economic, and social aspects of intervention is required in times of crisis within academic institutions.

There is more to cluttering than meets the eye: The prevalence of cluttering and association with psychological well-being indices in an undergraduate sample.

BACKGROUND: Cluttering is a fluency disorder characterized by an abnormally fast or irregular speech delivery rate along with disfluencies that are frequent but are not judged to be stuttering. Data on cluttering prevalence in the general population are scarce, as well as its association with psychological well-being indices, such as anxiety, and depressive symptoms. AIMS: To estimate cluttering prevalence among undergraduates, as well as its relationship with psychological and well-being indicators. METHODS & PROCEDURES: To address these issues, a large sample (n = 1582) of undergraduates completed a questionnaire that provided a lay definition of cluttering and were asked to identify themselves as clutterers (SI-Clut), as well as to indicate the presence of several psychological and mental well-being indices. OUTCOMES & RESULTS: A total of 276 respondents (23%) self-identified as clutterers (now or in the past), with 55.1% of those being male. Only 56 respondents (3.5% of the total sample; about 21% of SI-Clut) reported having received speech therapy for cluttering. Relative to students self-identifying as non-clutterers, self-identification of cluttering was associated with higher levels of psychosomatic symptoms, depressive symptoms and stress, indicating a tendency toward internalizing psychopathology, along with lower self-esteem, and lower subjective happiness. CONCLUSIONS & IMPLICATIONS: The current findings point to the high prevalence of students self-identifying as clutterers, along with a significant link between cluttering and mental distress. Therefore, it is important to increase public awareness of cluttering, its diagnosis and treatment. From the clinical perspective, the elevated levels of somatic complaints, anxiety and depression may represent internalizing psychopathology, associated with more covert rather than overt symptomatology. Such symptom manifestation calls for special attention from the speech-language pathologists providing cluttering therapy, using designated well-being or mental health screening tools. Although data on standard cluttering treatment are limited, it should be customized to the client's unique difficulties. Speech-language pathologists' understanding of cluttering, which includes both speech characteristics as well as psychological and social aspects of well-being, may assist them in implementing effective treatments. WHAT THIS PAPER ADDS: What is already known on the subject Cluttering is a fluency disorder characterized by an abnormally fast or irregular speech rate, along with various disfluencies and articulatory imprecision. It may co-occur with other disorders, such as learning disabilities, and attention-deficit/hyperactivity disorder. Data on cluttering prevalence and its association with psychological well-being indices, such as anxiety and depression, are limited. What this paper adds to existing knowledge A total of 276 undergraduates (23%) self-identified as clutterers, of whom 55.1% were males. A total of 56 respondents (3.5% of the total sample, and about 21% of undergraduates self-identified as clutterers) reported having received speech therapy for cluttering. Psychosomatic symptoms, depressive symptoms and stress levels were higher among these students, suggesting a tendency toward internalizing psychopathology, along with a lower sense of self-esteem and subjective happiness. What are the potential or actual clinical implications of this work? The high prevalence of students self-identifying as clutterers, along with the low percentage of respondents who received speech therapy for cluttering, emphasize the need to raise public awareness of the problem, its diagnosis and treatment (Reichel et al., 2010). The association between cluttering and mental distress requires speech-language pathologists to be aware that cluttering may have covert symptomatology, similar to stuttering, which should be addressed in therapy.

Cardiovascular risk profiles clusters among children and adolescents with disabilities.

BACKGROUND: Cardiovascular diseases (CVD) are a precursor for disabilities and death worldwide. Being overweight or obese in combination with physical inactivity and smoking habits may increase the risk for CVD and other health problems such as lower limb osteoarthritis, diabetes, stroke, and various cancer types among children and adolescents. The literature emphasizes the need to follow such groups and evaluate the risk of individuals developing CVD diseases. Therefore, the current study explores the variety of cardiovascular risks in children and adolescents' profiles clusters with and without disabilities. METHODS: Data from 42 countries including Israel, was collected with the support of the world health organization (WHO, Europe) through a questionnaire from 11-19 years old school-aged. RESULTS: The study finding shows that children and adolescents with disabilities demonstrated a higher prevalence of overweight than those who completed the HBSC youth behavior survey. Moreover, the prevalence of tobacco smoking and alcohol use was statisticaly significantly higher among the disabled group than the non-disabled group. In addition, socioeconomic status of responders who presented a very high CVD risk was found as significantly lower than those from the first and second low risk groups. CONCLUSION: This led to the conclusion that children and adolescents with disability were at a higher risk of developing CVDs than their non-disabled peers. In addition, intervention programs tailored to the needs of adolescents with disability should consider lifestyle habit change and promoting healthy living thus improving their quality of life as well as reducing their risk of being exposed to severe CVD diseases.

Socio-demographic characteristics and their relation to medical service consumption among elderly in Israel during the COVID-19 lockdown in 2020 as compared to the corresponding period in 2019.

PURPOSE: The COVID-19 pandemic has led to the isolation of the population in Israel, including the elderly. The present study aimed to compare the consumption of medical services among adults over the age of 65 in Israel at the time of the first COVID-19 lockdown relative to the corresponding period the year before. METHODS: We conducted a retrospective longitudinal observational quantitative research based on the Natali Healthcare Solutions Israel database of subscribers. Company subscribers over the age of 65 (N = 103,955) were included in the sample (64.5% women) in two time periods, before the COVID-19 outbreak-P1, in 2019, and during the first COVID-19 lockdown- P2 in 2020. Logistic regression was applied to examine service consumption for study variables. RESULTS: The average number of referrals to services was lower during the COVID-19 lockdown period (M = 0.3658, SD = 0.781) compared to the corresponding period in the previous year (M = 0.5402, SD = 0.935). The average number of ambulance orders, doctor home visits and service refusals were higher when compared to the same period in the previous year. During both time periods, women (P1- M = 0.5631, SD = 0.951; P2- M = 0.3846, SD = 0.800) required significantly more (p < .000) services than men (P1- M = 0.5114, SD = 0.910; P2- M = 0.3417, SD = 0.753). Older, widowed people, living in non-Jewish/mixed localities, or in average or below average socioeconomic status localities required relatively more services to those with opposite socio-demographic traits (p < .000). SUMMARY AND CONCLUSIONS: In a large sample of elderly in Israel, findings indicate a decrease in referrals to medical care during the first COVID-19 lockdown period, yet an increase in ambulance orders, doctor visits and service refusals. Socio-demographic characteristics showed a similar effect in both time periods. The period of the first COVID-19 lockdown was characterized by a higher incidence of medical service refusals as compared to the equivalent period in the previous year.

The Effects of a Physical Activity Online Intervention Program on Resilience, Perceived Social Support, Psychological Distress and Concerns among At-Risk Youth during the COVID-19 Pandemic.

BACKGROUND: COVID-19 restrictions have led to social isolation affecting youth's health, particularly at-risk youth. OBJECTIVES: We examined whether an online mentoring health intervention (OMHI) would strengthen characteristics that can prevent risky behaviors: resilience, perceived social support, psychological distress, and crisis concerns. METHODS: Fifty-six secondary-school students participated, 27 in the intervention group and 29 in the control group (mean age 16.18, SD 0.83 vs. 16.62, SD 0.82, respectively). The study took place between March and August 2020. RESULTS: The intervention group was less resilient pre-test, with similar resilience levels as the control group post-test. Intervention group participants presented a significantly higher crisis level pre- and post-test than the control group, as well as an increase in resilience (effect size = 1.88) and social support (effect size = 1.22), while psychological distress significantly decreased (effect size = -1.03). Both groups (intervention vs. control) predicted changes from pre-to-post test for resilience and crisis (adjusted R2 = 0.33, p = 0.001 and R2 = 0.49, p = 0.0001 respectively). CONCLUSIONS: OMHI participation was associated with improved resilience and social support, and decreased psychological distress, making it an effective strategy in health promotion for at-risk youth. An online intervention program combining mentoring in physical activity and interpersonal connections may constitute an effective health promotion strategy for at-risk youth, especially in times of crisis.

Social Factors Contributing to Healthcare Service Requirements during the First COVID-19 Lockdown among Older Adults.

This study examined social characteristics and their relations to healthcare service demand among older adults during the first COVID-19 lockdown in 2020. The sample was based on a cohort of 103,955 adults over the age of 65. A general index of needs was composed based on healthcare service use data and was predicted in a multi-nominal logistic regression. The frequency of the total needs significantly (p < 0.000) declined while supportive community services (4.9%, 2.0%), living in a community framework (27.0%, 15.2%), and living in a private residence (29.7%, 20.1%) were significantly associated (p < 0.000) with less frequent needs compared to the complementary groups. Supportive communities turned out to be an extremely important service for older adults. Policy makers should consider expanding supportive community services for older adults, as it was shown to have a positive correlation with lower healthcare service use, which might be an indicator of better overall health.

Cost-Effectiveness Threshold for Healthcare: Justification and Quantification.

Every public health expenditure, including the one that saves lives or extends life expectancy of particular persons (target population), bears a cost. Although cost-effectiveness analysis (CEA) is routinely performed in health policy, ethical justification of CEA is rarely discussed. Also, there is neither consensus value nor even consensus method for determining cost-effectiveness threshold (CET) for life-extending measures. In this study, we performed ethical analysis of CEA by policy impact assessment based on connection of health and wealth (poorer people have statistically shorter life expectancies) and concluded that CEA is not only a practical but also an ethical necessity. To quantify CET, we used three independent methods: (1) literature survey of analyzing salaries in risky occupations, (2) utilizing Prospect Theory suggesting that people value their lives in monetary terms twice more than their lifetime earnings, and (3) literature survey of the U.S. current legal practice. To the best of our knowledge, nobody applied method (2) to determine CET. The three methods yielded rather similar results with CET about 1.0 ± 0.4 gross domestic product per capita (GDPpc) per quality-adjusted life-year. Therefore, a sum of not higher than 140% GDPpc is statistically sufficient to "purchase" an additional year of life-or, alternatively, to "rob" one year of life if taken away. Therefore, 140% GDP per capita per quality-adjusted life-year should be considered as the upper limit of prudent and ethically justified expenditure on life extension programs.

Risk Behaviors, Family Support, and Emotional Health among Adolescents during the COVID-19 Pandemic in Israel.

We investigated the prevalence of risk behaviors among Israeli adolescents (tobacco smoking, alcohol consumption, drug use) during the COVID-19 pandemic. Associations between different risk behaviors were examined and so was whether specific characteristics could predict risk behaviors in adolescents. The study consisted of 1020 Israeli adolescents aged 15-18. Study subjects completed an online survey between the first and second lockdowns in Israel (April 2020 to September 2020). Participants reported the frequency at which they engaged in four different risky behaviors: general risky behavior, tobacco smoking, alcohol consumption (binge drinking), and cannabis use. The most prevalent risky behavior in the sample was binge drinking (33.8%). The four measured risky behaviors were significantly correlated. Among participants who had previously engaged in a risky behavior assessed, most did not change the behavior frequency during the pandemic. All independent variables (sociodemographic characteristics, family support, and emotional, health excluding friends' support, physical activity volume, and coronavirus restrictions) were significantly different between participants engaging vs. not engaging in risky behaviors. Our findings suggest that family support is one of the most influential factors in preventing risky behavior during the pandemic, and they emphasize the importance of family-based interventions with children and adolescents from elementary to high school.

Identifying Cardiovascular Risk Profiles Clusters among Mediterranean Adolescents across Seven Countries.

Cardiovascular diseases (CVDs) are the number one cause of death globally and are partially due to the inability to control modifiable lifestyle risk factors. The aim of this study was to analyze the profiles of adolescents from seven Mediterranean countries (Greece, Israel, Italy, Macedonia, Malta, Portugal, Spain) according to their modifiable lifestyle risk factors for CVD (overweight/obesity, physical activity, smoking, alcohol consumption). The sample consisted of 26,110 adolescents (52.3% girls) aged 11, 13, and 15 years who participated in the Health Behavior in School-aged Children (HBSC) survey in 2018 across the seven countries. Sociodemographic characteristics (sex, age, country of residence, socioeconomic status) and CVD modifiable lifestyle risk factors (overweight/obesity, physical activity, smoking, alcohol consumption) were recorded. A two-step cluster analysis, one-way analysis of variance, and chi-square test were performed. Four different cluster groups were identified: two low-risk groups (64.46%), with risk among those with low physical activity levels; moderate-risk group (14.83%), with two risk factors (unhealthy weight and low physical activity level); and a high-risk group (20.7%), which presented risk in all modifiable lifestyle risk factors. Older adolescents reported a higher likelihood of being in the high-risk group. Given that the adolescence period constitutes an important time for interventions aimed at CVD prevention, identifying profiles of moderate- and high-risk adolescents is crucial.

The Mediated Role of Credibility on Information Sources and Patient Awareness toward Patient Rights.

Although patient rights are an important issue, this remains an understudied research area. Patients are unaware of their rights, lacking control of health care treatments they might deserve. This can contribute to sustaining inequality as well as failure in achieving welfare policy goals. Drawing on channel complementarity theory, the current study explored patients' awareness toward their rights, and the credibility of information sources related to patient rights. In a web-based survey, 994 Israeli participants, suffering from chronic illness and using health services, were recruited. To examine the study's theoretical framework and relationships among the constructs and test the hypotheses, a path analysis was conducted using Structural Equation Modeling. The research model depicts direct and indirect relationships between constructs, and the relevant coefficients. The results show a direct and positive interaction between information credibility and patient rights awareness (ß = 0.10, p = 0.019). Information credibility partially mediates the relationship between public service information sources and patient rights awareness (bootstrap with 95% CI: 0.01-0.07; p = 0.015). The mass media information sources construct is directly and positively related to information credibility (ß = 0.36, p = 0.000). Age was found as a moderator, indicating that information credibility is a factor only at lower ages. Therefore, patient rights should be systematically and reliably accessible in order to raise the awareness and trust of chronic patients regarding information about patient rights. Using planned health communication campaigns mainly via public service sources that are perceived as trustworthy can help contribute to approach patients more effectively and provide them with accessible and detailed information about their rights.

Barriers in implementing the dying patient law: the Israeli experience - a qualitative study.

BACKGROUND: Coping with end-of-life issues is a major challenge for governments and health systems. Despite progress in legislation, many barriers exist to its full implementation. This study is aimed at identifying these end-of-life barriers in relation to Israel. METHODS: Qualitative in-depth interviews using professionals and decision makers in the health-care and related systems (n = 37) were carried out, along with two focus groups based on brainstorming techniques consisting of nurses (n = 10) and social workers (n = 10). Data was managed and analyzed using Naralyzer software. RESULTS: Qualitative analysis showed identification of six primary barriers: 1) law, procedures, and forms; 2) clinical aspects; 3) human aspects; 4) knowledge and skills of medical teams; 5) communication; and 6) resource allocation. These were further divided into 44 sub area barriers. CONCLUSIONS: This study highlights the role of the family doctor in end-of-life by training physicians in decision-making workshops and increasing their knowledge in the field of palliative medicine. Effectively channeling resources, knowledge, and support for medical teams, by accounting for the structure and response of the units for home treatment will improve patient's access to information on and support for end-of-life laws, as well as reduce legislative barriers in other countries that face the same issues.

Characteristics Related to Choice of Obstetrician-Gynecologist among Women of Ethiopian Descent in Israel.

BACKGROUND: Patient satisfaction with the quality of health care services is complex with many known factors impacting upon satisfaction, among them the choice of physician. Previous studies examined characteristics of a woman's choice of gynecologist, but information regarding reasons for these choices among women of Ethiopian descent is lacking. The objective of this study was to identify characteristics related preference of an obstetrician-gynecologist based on gender among women of Ethiopian descent. METHOD: Analysis of anonymous self-reported questionnaire distributed to 500 women of Ethiopian descent who visited an obstetrician-gynecologist at least once in the past three years (Mean age 29.5; SD = 8.2). Trust in physician was examined using the TPS scale; service quality was checked using the SERVQUAL; and the 5Qs model was used to measure patient's satisfaction of health care. RESULTS: Very religious (84.1%) and religious (53.6%) women of Ethiopian descent were more likely to prefer a female obstetrician-gynecologist compared to traditional (39.3%) or secular (34.4%) women (p < 0.001). Participants had higher probability to prefer a male gynecologist if they had more employment hours (OR = 3.57, 95% CI = 1.72-7.42, p < 0.001), and the responsiveness of the physician was less important to them (OR = 0.77, 95% CI = 0.60-0.99, p < 0.05). Age of participants, country of birth, years in Israel, family status, being a mother, education or health status were not associated with choosing a female obstetrician-gynecologist. Religious women would prefer to wait longer for a female gynecologist due to modesty imperatives, even at the cost of compromising their health as a result of waiting longer. CONCLUSIONS: The findings of this research highlight the importance of accessibility to female obstetrician-gynecologists for women of Ethiopian descent and demonstrate that determinants in the host population rather than immigrant's past culture, affect the women's decision. This study demonstrates the importance of the health care system in Israel to enable more female obstetrician-gynecologists to treat women of Ethiopian descent.

Israeli Willingness to be Treated by a Physician Assistant.

Are Israelis willing to be seen by a physician assistant (PA) instead of a doctor if they can save time? PAs were introduced into Israel emergency departments 2 years prior to this study and few if any knew about them. A survey containing a series of scenarios involving hypothetical injuries was electronically distributed in 2019; over 7000 Israeli citizens responded. They were asked to choose between seeing a PA within half an hour or waiting for a doctor (MD) in 4 h. Over 90% of the respondents chose the PA and preferences changed slightly as the time gap narrowed to 2 h. A large majority picked the PA in all three scenarios. Parsing the respondents by age, gender, and health conditions revealed little statistical differences. There was a positive correlation between the perceived urgency of the situation and choosing the PA as respondents were more likely to see a PA in more stressful scenarios (e.g., a child's head laceration). These results suggest that most Israelis would be willing to accept care from a healthcare provider, in this case the PA, who is not a doctor, if they sense value added in the encounter, such as quicker access to care.

Attitudes of Nurses Towards Searching Online for Medical Information for Personal Health Needs: Cross-Sectional Questionnaire Study.

BACKGROUND: Use of online clinical health care information has become part of the skill set required by medical teams. Nurses believe that information quality and availability affect nursing care and methods. However, nurses tend not to exploit professional medical databases for evidence-based medical information for their personal needs. This phenomenon has received little research attention. OBJECTIVE: This study aimed to address the knowledge gap around nurses' attitudes towards searching online for medical information for their personal needs (ie, for themselves and their families) by (1) evaluating the level of exposure to medical information and the effect on attitudes towards the use of online search options, (2) assessing the effect of the choice of a primary means of searching for medical information on the attitudes towards the use of online search options, and (3) gauging the influence of sociodemographic data and health status on nurses' attitudes towards searching online for medical information. METHODS: Nurses employed in general departments in a general hospital (34/210, 16.2%), nursing home (42/200, 21.0%), and geriatric medical center (45/180, 25.0%) in Israel were invited to complete the eHealth Impact Questionnaire (alpha=.95). Questionnaires were distributed by nurses in charge of the general hospitalization wards. The data collection period was February to March 2018. The response rate was 40.3% (121/300). RESULTS: Nurses tended to search for medical information for personal needs on social media (24/121, 19.8%) and TV (eg, health programs, health news; 23/121, 19.0%). Nurses who chose social media as their primary means of receiving general information had a positive attitude about using the online environment as a source for medical information compared to nurses who found information through other means (t119=4.44, P<.001). Nurses exposed to medical information via social media had a positive attitude towards the use of the internet to find medical information compared to nurses who were not exposed to social media (t119=3.04, P=.003). The attitudes of nurses towards the utility of online medical information for personal needs increased with better participant health status (F2,118=3.63, P=.03). However, the attitudes of participants with a chronic disease did not differ from those of healthy participants. CONCLUSIONS: Nurses in Israel are less likely to use their professional skills and knowledge to search in professional databases for evidence-based medical information for their personal needs. Instead, they prefer medical information that is easy to access and not evidence-based, such as that on social media and TV. However, these search patterns for personal use may affect their clinical role, impair quality of care, and lead to incorrect medical decisions for their patients in the health care system. Therefore, during nursing education, training for searching skills, retrieval skills, and online search techniques for evidence-based medical information is vital for evidence-based practice.

The Association of Cyber-Bullying and Adolescents in Religious and Secular Schools in Israel.

Internet usage during leisure time is a growing area of research, especially among adolescents. Our aim was to evaluate the association between Internet usage patterns of religious and secular adolescents, exposure to cyber-bullying, and psychosomatic symptoms in Israel. A cross-sectional study was carried out using questionnaires administered to 7166 students aged 11-17 (4223 secular; 2943 religious). Cyber-bullying was more common among secular students (11.4%) than religious students (8.4%). Multiple logistic regression predicting cyber-bullying showed significant results for boys, primary school age, Internet usage, bad moods, sleeping disorders, and dizziness. A comparison across school levels and between the education sectors did not show major differences in the probability to experience bullying. However, different characteristics played the role in explaining propensity to that experience. These findings can help to plan school-level oriented intervention programs to educate adolescents on prudent use of the Internet to combat the spread of cyber-bullying.

Health care access and satisfaction in Judean and Samarian communities: opportunities for improving care.

BACKGROUND: There are distinctive potential barriers to optimal health care in Judea and Samaria because of access and satisfaction levels, including obstacles such as its isolation and health care capacity. However, there is a lack of research focusing on health care for the Jewish communities in this region, often referred to as the West Bank. RESEARCH QUESTIONS: What is the level of health care access and satisfaction for Israelis living in the Jewish communities in Judea and Samaria? How do these results compare to parallel results for Israelis in general? How do these results vary by subgroups, in particular by location? METHODS: Two hundred fourty six residents of Judea and Samaria in six diverse, Jewish communities were surveyed, with a 76% response rate. Descriptive analyses were performed for all variables. Bivariate analyses for access and satisfaction measures were performed by key demographic variables. Comparisons were also made with Israelis in general (the vast majority of whom do not live in Judea or Samaria), by comparing our survey results to the results of 2016 Myers-JDC-Brookdale Institute national satisfaction survey. Our survey questions were based on this national survey, tested and used for several cohorts. RESULTS: Of those surveyed, 14% decided to forego treatment because of the distance, although only 3% declined treatment because of cost. There was a diversity of results in terms of satisfaction measures, although in no categories were even half of respondents very satisfied; results ranged from 7% very satisfied with health care system overall to 47% very satisfied with their family physician's attitude. Variations were found by community with local council communities generally, but not always, having the highest satisfaction. Compared to Israelis in general, Israeli residents of Judea and Samaria reported generally lower satisfaction, including 9% fewer being very satisfied with the health plan overall and 10% fewer being very satisfied with referrals. However, 7% more had confidence in getting the best treatment. CONCLUSIONS: Access to care involves more than just coverage. Health care system problems among Israelis living in Judea and Samaria include not just quantity, but quality of services offered. There is a need for improvement not only in health care resources, but also in the level of access and satisfaction in this region.

The patient as a client: a model for evaluation of Israel Defense Forces.

The Israel Defense Forces (IDF) Medical Corps provides medical services-routine and emergency--to all IDF personnel (conscripts, career personnel, and reservists). Despite the fact that there are no differences in prevalence of disease in the IDF compared with the civil sector, health consumer appraisal, in the military, of the medical services they receive during peacetime at IDF medical clinics is not high. The objective of this research was to develop an effective and differential tool for monitoring the quality of medical service at IDF clinics drawn from service quality indexes based on the perspective of the soldier patient. The research tool used was an anonymous questionnaire comprised of five demographic questions and 21 components of quality index measurements that participants were asked to rank in terms of importance during a visit to their IDF medical clinic. Those categories found to influence the client's perception of quality medical service were accessibility and availability of services, information provided by the clinic, and the efficiency of staff. The factors found to be less influential in the clients' perceptions of quality were staffing and infrastructure. Quality control using these significant indexes will allow monitoring programs to focus on components that are important from the soldier's perspective, without overlooking other significant aspects of the soldier's perceptions of the quality of medical service as a client.