Israeli Family Research Articles

Healing Amidst Conflict: The Perspective of an Israeli Family Physician During Wartime

Healing Amidst Conflict: The Perspective of an Israeli Family Physician During Wartime

Abnormal synaptic architecture in iPSC-derived neurons from a multi-generational family with genetic Creutzfeldt-Jakob disease

Genetic prion diseases are caused by mutations in PRNP, which encodes the prion protein (PrPC). Why these mutations are pathogenic, and how they alter the properties of PrPC are poorly understood. We have consented and accessed 22 individuals of a multi-generational Israeli family harboring the highly penetrant E200K PRNP mutation and generated a library of induced pluripotent stem cells (iPSCs) representing nine carriers and four non-carriers. iPSC-derived neurons from E200K carriers display abnormal synaptic architecture characterized by misalignment of postsynaptic NMDA receptors with the cytoplasmic scaffolding protein PSD95. Differentiated neurons from mutation carriers do not produce PrPSc, the aggregated and infectious conformer of PrP, suggesting that loss of a physiological function of PrPC may contribute to the disease phenotype. Our study shows that iPSC-derived neurons can provide important mechanistic insights into the pathogenesis of genetic prion diseases and can offer a powerful platform for testing candidate therapeutics.

Becoming Self Employed: Israeli Family Physicians' Push and Pull Factors.

As primary care is an important infrastructure for the entire health system, the employment structure choices of family physicians-whether to work in a managed care organization or be self-employed, can impact all effectiveness parameters of healthcare: quality, access, health equity, patients' experiences, and cost-effectiveness. The aim of this study is to assess the push and pull factors influencing family physicians' employment choices. This study employed a qualitative approach to explore the experiences of family physicians (FPs) who choose to work a self-employment practice. We conducted semi-structured interviews with twenty-seven self-employed FPs in Israel, selected through purposive and snowball sampling. The interviews were conducted via Zoom, recorded, and transcribed verbatim. Data analysis followed thematic analysis framework. The analysis yielded 10 themes, which were organized into two categories: pull and push factors. Pull factors, i.e., factors that attract family physicians to become self-employed, included professional self-fulfillment, higher income, professional and business autonomy, working with secretaries according to one's personal choice, designing the space of the clinic, and flexibility in working hours. Push factors, i.e., factors that demotivated family physicians to work under managed care and pushed them to choose self-employment included low control over the work environment, workload, decreased professional and organizational autonomy, managerial pressures on quality measures, engagement in marketing activities, and tensions with non-medical staff in the Health Maintenance Organization. There are obvious implications of this work for Health Maintenance Organizations' policy makers. Balancing managerial pressure and tensions between family physicians and non-medical administration and ensuring suitable working conditions increased physicians' control over the work environment, and professional autonomy may decrease push factors and retain family physicians as Health Maintenance Organization-employed. Understanding pull factors may help to develop a strategy for maximizing cooperation with self-employed family physicians and reinforce physicians' linkage to the healthcare system's treatment objectives.

Non-formal encounters between Israeli families and African immigrant families foster lifelong learning competence

Purpose This study aims to examine the contribution of informal encounters outside the school walls between local Israeli families from “Waldorf Education” and immigrant families from Africa from formal state education and explore the consequences of these encounters on the development of lifelong learning competences. Research questions are as follows: In what way do non-formal encounters lead to the development of lifelong learning ability? What are the challenges and consequences of non-formal activity for research participants, families and educators from the pedagogical, social and personal perspectives? Design/methodology/approach The research uses a qualitative-interpretive case study approach that allows for in-depth observation of the phenomenon within the context of reality to understand the case, a non-formal encounter between two groups of parents from different cultures, languages and educational attitudes. In this case study, it is possible to generalize from the local to the global and examine processes, actions and behaviors in the studied case (Creswell et al., 2018; Yin, 2009). This empirical study allows description, analysis, understanding and explanation of the challenges and actions in organizing and holding non-formal encounters from personal experiences as a first source. Findings The analysis of the data brought up two main categories that represent the actions and insights from the non-formal encounters for developing lifelong learning competences: create a personal dialogue to strengthen trust and confidence; foster parental involvement. Non-formal encounters between families from different cultural-social backgrounds may promote lifelong learning competences such as tolerance, inclusion and openness. However, external intervention by a social association is required to organize, support and operate them. Research limitations/implications The research’s limitation was that it was conducted in the country’s center. Therefore, the findings must be considered in the context in which they are presented and not generalized to other regions or communities from other cultures in Israel and the world. A few limited encounters may affect the author’s interpretation of the study data. In addition, expressions of “social desire” that may be expressed in interviews must be considered. Practical implications This study emphasizes social activism. Despite all the differences and tensions, creating an equal space in the families’ encounters is essential for lifelong learning. The immigrant parents participated in decision-making, the stages of organization and the activities themselves during the encounters. This partnership strengthened their commitment and responsibility. Because they are a powerless minority group, it should not be assumed that two encounters will improve their self-confidence. The proof is that fewer participants came to the last encounter. Education experts must maintain consistency and continuity in forming partnerships with immigrant families over time and as part of lifelong learning. Social implications The non-formal encounters between the two groups of families create an atmosphere of equality: all are parents of children seeking to inculcate humane and social values. The collaborative atmosphere contributed to the understanding that closeness overpowers distance. Everyone is troubled by similar issues of parenting, enjoyment of children, nutritious food and a shared desire to be good citizens while maintaining tolerance, reciprocity and respect. Originality/value Non-formal encounters are actively performed to create belonging when the “others and we” join together for the community and the children. This is an extensive, open and accessible platform for strengthening social consciousness and understanding the connection between teaching, culture and society to promote equality in education. This study will allow schools to expand the boundaries of communication with parents and initiate additional activities with other social groups to foster children’s integration. It will enrich the academic knowledge about connections and communication of educators, families from Israel and immigrant families in developing a partnership in the school to promote lifelong learning.

The Correlation Between Exposure to Violence and Parental Monitoring: Differences Between Mothers and Fathers From Palestinian–Israeli Families

ABSTRACTIn this study, I investigated the correlations between retrospectively reported experiences of child abuse in the family‐of‐origin and exposure to community violence as adults on parental monitoring among Palestinian–Israeli parents. A sample of 760 parents (453 mothers, 59.6%) participated in the study. A self‐administered questionnaire was used. Results showed that both experiencing child abuse and community violence victimization were associated with high levels of parental stress, and experiencing child abuse was also associated with low levels of parental monitoring. Indirect effects of parental stress were found between both types of violence exposure and parental monitoring. Among mothers, there were additional indirect effects between violence exposure and parental monitoring. These findings suggest that exposure to multiple contexts of violence correlated with parental behaviours, and parenting programmes should focus on reducing parental stress and improving parental monitoring, considering the gender differences. Overall, this study highlights the importance of addressing the outcomes of trauma on parenting monitoring, which can have significant implications for public health.

Adults With IDD in Supported Accommodation During COVID-19 Lockdown: The Families' Perspective.

The present study aims to understand and describe family caregivers' perceptions and experiences regarding contact and relationships with their adult relatives with intellectual and developmental disabilities (IDD) living in supported accommodation during the COVID-19 lockdown. A qualitative phenomenological approach was applied in which 19 Israeli family caregivers (parents and siblings) were interviewed. Inductive thematic analysis revealed themes at the microsystem level (the resident, the caregiver, and their relationship), and at the mesosystem level (the caregivers' interactions with service providers and other residents' families). The findings highlight the pivotal role of family caregivers in times of uncertainty and the need to develop explicit policies and mechanisms to facilitate family engagement in the residents' lives.

Apparent mineralocorticoid excess in Israel: a case series and literature review.

Apparent mineralocorticoid excess (AME) syndrome is an ultra-rare autosomal-recessive tubulopathy, caused by mutations in HSD11B2, leading to excessive activation of the kidney mineralocorticoid receptor, and characterized by early-onset low-renin hypertension, hypokalemia, and risk of chronic kidney disease (CKD). To date, most reports included few patients, and none described patients from Israel. We aimed to describe AME patients from Israel and to review the relevant literature. Retrospective cohort study. Clinical, laboratory, and molecular data from patients' records were collected. Five patients presented at early childhood with normal estimated glomerular filtration rate (eGFR), while 2 patients presented during late childhood with CKD. Molecular analysis revealed 2 novel homozygous mutations in HSD11B2. All patients presented with severe hypertension and hypokalemia. While all patients developed nephrocalcinosis, only 1 showed hypercalciuria. All individuals were managed with potassium supplements, mineralocorticoid receptor antagonists, and various antihypertensive medications. One patient survived cardiac arrest secondary to severe hyperkalemia. At last follow-up, those 5 patients who presented early exhibited normal eGFR and near-normal blood pressure, but 2 have hypertension complications. The 2 patients who presented with CKD progressed to end-stage kidney disease (ESKD) necessitating dialysis and kidney transplantation. In this 11-year follow-up report of 2 Israeli families with AME, patients who presented early maintained long-term normal kidney function, while those who presented late progressed to ESKD. Nevertheless, despite early diagnosis and management, AME is commonly associated with serious complications of the disease or its treatment.

Whole exome sequencing of 491 individuals with inherited retinal diseases reveals a large spectrum of variants and identification of novel candidate genes

BackgroundInherited retinal diseases (IRDs) include a range of vision loss conditions caused by variants in different genes. The clinical and genetic heterogeneity make identification of the genetic cause challenging. Here,...

Implication of transcription factor FOXD2 dysfunction in syndromic congenital anomalies of the kidney and urinary tract (CAKUT)

Congenital anomalies of the kidney and urinary tract (CAKUT) are the predominant cause for chronic kidney disease below age 30 years. Many monogenic forms have been discovered due to comprehensive genetic testing like exome sequencing. However, disease-causing variants in known disease-associated genes only explain a proportion of cases. Here, we aim to unravel underlying molecular mechanisms of syndromic CAKUT in three unrelated multiplex families with presumed autosomal recessive inheritance. Exome sequencing in the index individuals revealed three different rare homozygous variants in FOXD2, encoding a transcription factor not previously implicated in CAKUT in humans: a frameshift in the Arabic and a missense variant each in the Turkish and the Israeli family with segregation patterns consistent with autosomal recessive inheritance. CRISPR/Cas9-derived Foxd2 knock-out mice presented with a bilateral dilated kidney pelvis accompanied by atrophy of the kidney papilla and mandibular, ophthalmologic, and behavioral anomalies, recapitulating the human phenotype. In a complementary approach to study pathomechanisms of FOXD2-dysfunction-mediated developmental kidney defects, we generated CRISPR/Cas9-mediated knock-out of Foxd2 in ureteric-bud-induced mouse metanephric mesenchyme cells. Transcriptomic analyses revealed enrichment of numerous differentially expressed genes important for kidney/urogenital development, including Pax2 and Wnt4 as well as gene expression changes indicating a shift towards a stromal cell identity. Histology of Foxd2 knock-out mouse kidneys confirmed increased fibrosis. Further, genome-wide association studies suggest that FOXD2 could play a role for maintenance of podocyte integrity during adulthood. Thus, our studies help in genetic diagnostics of monogenic CAKUT and in understanding of monogenic and multifactorial kidney diseases.

The quasi-devolution of policy design during Covid-19 in Israel – The case of family centers for children with disabilities

How does the way in which a policy is formulated affect its dynamics and implementation? To answer this question, we analyze the process of designing a policy to provide services to Israeli families of children with disabilities during COVID-19 as a bricolage. This term refers to a policy design process involving incremental modifications or reformulations of existing policies to deal with a large-scale challenge. We describe the interactions among the multiple layers of governance involved in delivering these services nationwide. Although the macro-level policy was designed to be equivalent throughout the country, budget cuts and the devolution of power made local authorities close services during the first COVID-19 lockdown. We conclude that the devolution of power to local governments in times of crisis works only partially. At the micro level, social workers as directors of services acted as bricoleurs to deliver services. Therefore, national government officials must work with local authorities to find solutions for financially unstable municipalities and develop tools to deal with micro-level challenges. Practical and theoretical implications of the findings are discussed in the context of a civilian-centric emergency and the COVID-19 crisis.

Family leadership among Israeli families of children with disabilities during the 2019 coronavirus disease pandemic

AbstractThe objective of this study was to investigate family leadership in family centres for families of children with disabilities in Israel amid the 2019 coronavirus disease (COVID‐19) pandemic. The study focuses on mapping family leadership activities within these family centres during the COVID‐19 pandemic and explores potential associations between participation in family leadership groups and family outcomes. Thirty‐five parents who were involved in family leadership groups and 42 parents of a control group completed an online survey. The survey included the Family Leadership Activity Measure, the Sense of Community Index, the Emergency Families Centre Services Index, the Sense of Sharing Index, the Brief Family Distress Scale and the Beach Center Family Quality of Life Scale. Significant differences were found among groups with regard to barriers to services usage, family centre services usage, family's satisfaction with services, sense of community with the family centre and sense of sharing. Parents who were involved in family leadership groups demonstrated favourable outcomes. No significant differences were found between the groups in family quality of life and distress. It is determined that in times of local or national crises, family leadership may promote more family‐centred supports.

Parent-child quality of sex-related communication before and during the COVID-19 pandemic

Research on parent–child sexual communication has increased in recent years, but we know almost nothing about whether parents correctly perceive the quality of sex-related communication with their children. In the present study, I investigated by longitudinal research whether parents correctly perceive the quality of sex-related communication with their children, whether COVID-19 affects the quality of sex-related communication between parents and children, and the congruence in the perceptions of this quality. The sample comprised 300 Israeli families [triad of mothers, fathers, and one adolescent (39% boys, 61% girls; age 14–18)]. Results indicate that adolescents reported more dysfunctional parent–child communication about sex with their fathers, especially within father-son relationships. Moreover, I found that parent–child congruence was surprisingly high and highly dependent on parents’ and children’s gender and the family’s religiosity. The COVID-19 pandemic positively affected father-child communication, supposedly because of greater paternal involvement. These findings highlight an important and understudied topic in the hope of motivating additional researchers and practitioners to adopt a familial, microsystem perspective on healthy sexual development. This view holds great promise in promoting normal sexual development and decreasing risky sexual behaviors.

Parental practices as predictors of adolescents' compulsive sexual behavior: a 6-month prospective study.

Compulsive sexual behavior (CSB) is a prevalent disorder among adolescents. To date, most studies focused on the self-report assessment of individuals without assessing possible parental practices that might alleviate or exacerbate adolescents' CSB. In the present research, I adopted the family systematic approach, which considers the effects of family context on children's and adolescents' development and examined whether and how parental (fathers' and mothers') support giving, communication, and restrictive mediation relate to children's current and future severity of CSB. The sample comprised 300 Israeli families [triad of mothers, fathers, and one adolescent (39% boys, 61% girls; age 14-18)]. Results indicate that maternal support and paternal quality of communication with children significantly predicted lower severity of current and future CSB, respectively. These findings highlight an important and understudied topic in the hope of motivating additional researchers and practitioners to adopt a familial, microsystem perspective on healthy sexual development-a perspective that holds great promise in promoting normal sexual development and in decreasing risky sexual behaviors.

National cultural capital as out of reach for transnationally mobile Israeli professional families – making a ‘return home’ fraught

ABSTRACT The potentiality of converting capitals in new national fields following migration has been the focus of a number of studies. Another, much smaller, literature examines experiences of return migration. In this paper, we follow 15 Israeli families (where both mothers and children have been interviewed) who have been globally mobile for professional reasons. We examine cultural capital accumulation strategies for the children and how these facilitate the occupation of advantageous social positions while abroad. Having returned to Israel, partly due to the COVID pandemic, the national cultural capital the families have so actively cultivated in their children is evaluated as not authentic enough. Meanwhile, the cosmopolitan cultural capital that has been so valorised abroad, is not recognised as something the children can draw on to position themselves either. The paper contributes to the study of return migration, with a unique focus on globally mobile families returning ‘home’. We also examine how national cultural capital is conceived and differentially assessed as families move from a more transnational space to that of their home country.

Intergenerational Transmission of Philanthropic Values Among Wealthy Israeli Families: Research Findings and Insights

Interest in studying intergenerational transmission of philanthropic values has increased in recent years. However, the studies on this topic are limited in their scope. The goal of this paper is to expand our knowledge and present evidence from a research study that sheds light on the main themes, difficulties, and dilemmas associated with the process of intergenerational transmission of philanthropic values and behaviors. Before describing the findings of our research which is based on interviews with offspring of philanthropic families, we will present a review of past studies and the current state of knowledge. These studies are important and serve as the basis to the conceptual framework of the current research and to the formulation of the questions explored here.

Constitutional regulation of civil marriage in Israel

The purpose of this paper is to review the history of the constitutional regulation of marriage and divorce in British mandate Palestine and the state of Israel from 1918 on. Israel was subject to British rule (mostly under a mandate of the League of Nations) from 1918 to 1948, and was called Palestine at the time. In 1948 some of this territory claimed its sovereignty as an independent state called Israel. The paper will highlight the different constitutional norms and procedures that govern the field of family law in British mandate Palestine and the state of Israel from the beginning of the British mandate to this day.
 The paper is based upon historic scrutiny of the legislation of British Palestine and the state of Israel in the field of family law, analyzing the law in accordance with the historic developments in the region. The results of this scrutiny are that from 1948 to the third decade of the 21st century, the Israeli legislator has repeatedly acted to prevent the constitutional regulation of civil marriage, preserving the archaic millet system, an Ottoman system of marriage within religious communities, that was the basis of the British mandate’s regulation of marriage and divorce in Palestine. But as much as the original millet arrangement was enacted by the British as a voluntary system, it was given new and compulsory features by the Israeli legislator, all the while avoiding a comprehensive constitutional regulation of Israeli family law.
 The paper concludes that a constitutional regulation of civil marriage is probably not possible in Israel, due to the political inability to reach an agreement between religious and secular Jews in Israel. But this did not prevent the Israeli legislature from fundamentally changing the British mandate constitutional arrangement, leaving behind a patchwork of improvised legislation that violates the basic civil rights of Israeli citizens.

International Child Abduction and the 1980 Hague Convention in Practice: The Biran Case

Abstract With its Decision of 29 November 2021 (No. 7918/21), the Supreme Court of Tel Aviv has ruled on the case of Eitan Biran, the child who survived the crash disaster of the “Mottarone” cable car in Italy. After the accident, the child was entrusted to his aunt, appointed as legal guardian. However, a few months later, the child was unexpectedly conducted to Israel by his paternal grandfather. The Israeli Family Court and District Court, appointed for the return of the child according to the 1980 Hague Convention on the Civil Aspects of International Child Abduction, have ordered the immediate repatriation in Italy. The decision of the District Court was upheld by the Supreme Court, whose decision represents a good example of correct application of the 1980 Hague Convention. Acknowledging that the guiding principle of the Convention is “zero tolerance for child abductions”, the Court has established that the habitual residence of the child was in Italy and that the transfer to Israel was in breach of the custody rights of the legal guardian according to Articles 3 and 5 of the Convention: in fact, the institute of tutore legale in Italy attributes to a person the responsibility of a child, a circumstance that in this case derived from a judicial decision. Moreover, the Israeli Supreme Court has adhered to a strict interpretation of the exceptions stated in Articles 12(2), 13 and 20, none of which resulted applicable to the case at hand.

Israeli global mobile families returning home: children’s social-cultural identities in transition

ABSTRACT This study used interviews and image-based associations with ten Israeli families (mothers and children) who had undertaken long-term work-related journeys lasting between six and nine years, during which they lived in at least two countries before returning to Israel. We explored their experiences and their children's socio-cultural pattern of identity formation both before and after returning to Israel. We distinguished four consecutive stages in the children’s identity formation. Each stage is characterized by a distinct socio-cultural pattern (mastery abroad, adjustment to returning home, shock and disappointment, and finally a sense of inner confidence and peace) and a matching identity (global-international, glocal-international, glocal-Israeli, and local-Israeli). The first two stages reflect the children’s time in the host countries, and the last two relate to their integration after returning to Israel. The results of this study are positioned in a broader context using two theoretical lenses – the U-Curve Theory of Adjustment and the Cultural Identity Framework. The combination of these two led us to come up with a fresh conceptualization (the GALUT model) to reflect the international-Israeli experience of the “relocation graduates’” return to Israel, which may contribute to the understanding of similar processes among children in various international contexts.

Awareness of Imminent Death: Results From a Mixed Methods Study of Israeli Family Caregivers' Perceptions of Their Awareness and That of the Patients for Whom They Cared.

We studied levels of awareness of impending death in older patients and their family caregivers. Using a mixed methods approach, we interviewed 70 family caregivers in Israel. Of the caregivers, 64% reported having been aware of the impending death, 33% were unaware, and 3% uncertain. Caregivers reported their perception that 36% of patients were aware, 27% unaware, and for 37% they were uncertain about the patient's awareness. Mechanisms that increased caregivers' awareness were specific diagnosis, significant deterioration in health, preparation by a health professional, or patient preparations for death. This study clarifies processes which aid awareness, and the relationship between awareness and actual preparation for dying.

Views on disability and prenatal testing among families with Down syndrome and disability activists: A comparative analysis of interviews from Germany and Israel

The prenatal genetic testing arena has witnessed great changes over the past decades and has been the focus of extensive discussion of its ethical, legal, and social implications. Germany and Israel were previously known for strongly contrasting regulations and attitudes of both professionals and laypeople towards genetic testing. Based on qualitative analysis of 37 semi-structured interviews, this study compares German and Israeli family members of individuals with Down syndrome and disability activists, thereby examining the interplay between lived experience and cultural scripts and their impact on the formation of personal views toward disability and prenatal testing. We have found that the differences between Germany and Israel remain, despite the emergence of new technologies, and that family members and disability activists reflect the norms of their socio-cultural environments, thereby emphasising the role society plays in shaping the views of those with direct experience of disability.