Israeli Family Research Articles

Ethiopian Jews Meet Israeli Family Physicians: A Study of Cultural Somatization

Cultural somatization can be defined as the use of the body as a metaphor for personal distress, and is a common feature of illness behaviour in both Western and non-Western societies. This study explores the prevalence of somatization among Ethiopian Jewish immigrants in Israel, the relationship of these symptoms to their psychosocial environment, and approaches that Israeli doctors can pursue in order to better understand and communicate with somatizing patients. Lebi, a heart- centred symptom complex, and the illnesses of zar and kole, which are thought to be caused by spirits, are described in case studies as examples of traditional beliefs about illness which have persisted among Ethiopian Jews in Israel.

Thyroid peroxidase: evidence for disease gene exclusion in Pendred's syndrome.

Pendred's syndrome is an association between congenital neurosensory deafness and goitre with abnormal discharge of iodide following perchlorate challenge, indicating a defect of iodide organification. Although Pendred's syndrome may cause up to 7.5% of all cases of congenital deafness, the molecular basis of the association between the hearing loss and the thyroid organification defect remains unknown. We chose to investigate the role of the thyroid peroxidase (TPO) gene as the genetic defect in Pendred's syndrome. A highly informative variable number tandem repeat (VNTR), located 1.5 kb downstream of exon 10 of the TPO gene, was used to search for genetic linkage in multiple sibships affected by Pendred's syndrome. Seven kindreds were recruited from the UK, each with at least two affected members. We have also examined a large inbred Israeli family with two affected offspring and five unaffected children. Individuals were assigned affected status based on the characteristic clinical features of Pendred's syndrome, namely the presence of congenital sensorineural hearing loss and the appearance in early life of a goitre. Additionally, at least one affected member from each sibship had a characteristic positive perchlorate discharge test (Morgans & Trotter, 1958). PCR amplification of genomic DNA at the TPO VNTR allowed assignment of genotypes to each individual and the calculation of a two-point LOD score. In six of the nine sibships analysed we found obligatory recombination between TPO and Pendred's syndrome. Non-complementation observed in affected parents with an affected offspring excluded TPO in an affected sibship with genotype sharing and supports a hypothesis of genetic homogeneity for Pendred's syndrome. In two sibships, mutation of the TPO gene as the cause of Pendred's syndrome could not be excluded. These data suggest that defects at the thyroid peroxidase locus on chromosome 2 are not the major cause of Pendred's syndrome.

HIV care for Ethiopian immigrants in an Israeli family practice.

HIV care for Ethiopian immigrants in an Israeli family practice.

Parent-Child Communication in Bereaved Israeli Families

The nature of surviving parent-child communication in bereaved Israeli families is examined in terms of the culture of Israeli society. Concern is with the way the culture frames the parent-child relationship in the period shortly after the death. Twenty-three surviving parents and their forty-three children between ages of six and sixteen were interviewed four months after the death. Both parents and children seemed concerned with protecting each other from the pain and sadness associated with the loss. Two types of families were identified. In the open family, language is used to console and inform. Parents see themselves as able to respond to their child(ren)'s needs. Less open families used language to influence the child to avoid their feelings and confronting the death. These surviving parents often saw the deceased as the competent family caregiver.

Genetic linkage analysis of schizophrenia using chromosome 11q13–24 markers in Israeli pedigrees

It is generally agreed that there is a genetic component in the etiology of schizophrenia which may be tested by the application of linkage analysis to multiply-affected families. One genetic region of interest is the long arm of chromosome 11 because of previously reported associations of genetic variation in this region with schizophrenia, and because of the fact that it contains the locus for the dopamine D2 receptor gene. In this study we have examined the segregation of schizophrenia with microsatellite dinucleotide repeat DNA markers along chromosome 11q in 5 Israeli families multiply-affected for schizophrenia. The hypothesis of linkage under genetic homogeneity of causation was tested under a number of genetic models. Linkage analysis provided no evidence for significant causal mutations within the region bounded by INT and D11S420 on chromosome 11q. It is still possible, however, that a gene of major effect exists in this region, either with low penetrance or with heterogeneity.

“THUS WE LIVE, FOREVER TAKING LEAVE”: THE LAUNCHING STAGE IN THE ISRAELI FAMILY

This study conceptualized family launching processes and investigated the reactions of Israeli parents to the conscription of their eldest son into the army, an event normatively initiating launching in the Israeli family. On the basis of family life cycle and adult developmental theory, parents' reactions were conceptualized in terms of two major launching-related tendencies:Holding, andReleasing. A specially constructed Holding/Releasing Questionnaire (HRQ), was administered to 160 couples whose eldest son had been serving in the army for 20 months or less. Results showed no correlation between Holding and Releasing, suggesting two independent and complementary forces in the launching process. Releasing was generally adopted more strongly than Holding, mothers being higher on Holding than fathers. Both, Holding and Releasing correlated negatively with education, and Holding also correlated negatively with personal well-being. The relationships between the HRQ and country of origin, attitudes and relevant past experience, revealed certain gender differences. Findings are discussed in light of launching processes, family theory and developmental interpretations of this major transition in the adult and family life cycle, with reference to the specific cultural context as well as to more general implications.

Neurofibromatosis type I (NFI) in Israeli families: Linkage analysis as a diagnostic tool

Linkage analysis of 18 neurofibromatosis type I (NFI) families was performed using intragenic and flanking polymorphic markers. The aims of the analysis were prenatal diagnosis of at-risk fetuses, and of asymptomatic individuals who were relatives of NFI patients. Prenatal diagnosis was performed in 9 pregnancies of 7 families; 5 fetuses were diagnosed as affected. In 6 families with an affected spouse, the request was to identify informative polymorphisms to be used in future pregnancies. Presymptomatic diagnosis was performed in 4 families. One individual, a brother of an NFI patient, was found to have Lisch nodules as the only NFI symptom. Linkage analysis indicated that if this person is a carrier of the NFI gene, he must be a product of intragenic crossover. In 2 individuals with a new NFI mutation, the origin of the NFI-bearing chromosomes was paternal. The same observation was noted by others. A summary of published cases shows that some 90% of the NFI-bearing chromosomes of patients with new mutations were of paternal origin. We therefore suggest that for the purpose of prenatal diagnosis in carriers of NFI new (and unidentified) mutations, the paternal chromosome will be considered as the NFI-bearing chromosome.

Comparison: Israeli Families Anxiety from SCUD Missiles Versus Palestinian Families Anxiety Since the Intifada

This is a study of 309 Palestinian families comparing their current trauma with the trauma experienced by Israeli families during the Gulf War during the SCUD missile attacks. Both populations have experienced adaptations of trauma but the Palestinian fathers have generally been more effected than their counterpart Israeli fathers. There are less reported symptoms of trauma when the victims have an active role to resist trauma.

Attitudes of family physicians to nonconventional therapies. A challenge to science as the basis of therapeutics

Eighty-nine Israeli family physicians responded to a questionnaire on their experience with nonconventional therapies (NCTs) and their opinions about the scientific basis and clinical efficacy of these treatments. They were also asked whether they thought that NCTs should be incorporated into regular medical practice. Seventeen percent of the physicians had formal training in some form of NCT and 11% thought the scientific basis of these treatments was sound; however, a majority (54%) thought they may be clinically useful. Forty-two percent had referred patients for such treatments. The majority thought that NCTs should be incorporated into medical practice. Our survey suggests that many physicians are not using the tools of scientific critical appraisal in forming their views on NCTs.

“You gotta know how to tell a story”: Telling, tales, and tellers in American and Israeli narrative events at dinner

ABSTRACTThis study explores the degree of cultural diversity in the dinner-table conversation narrative events of eight middle-class Jewish-American and eight Israeli families, matched on family constellation. Conceptualized in terms of a threefold framework of telling, tales, and tellers, the analysis reveals both shared and unshared narrative event properties. Narrative events unfold in both groups in similar patterns with respect to multiple participation in the telling, the prevalence of personal experience tales, and the respect for children's story-telling rights. Yet cultural styles come to the fore in regard to each realm as well as their interrelations. American families locate tales outside the home but close in time, ritualizing recounts of “today”; Israeli families favor tales more distant in time but closer to home. While most narratives foreground individual selves, Israeli families are more likely to recount shared events that center around the family “us” as protagonist. In modes of telling, American families claim access to story ownership through familiarity with the tale, celebrating monologic performances; but in Israeli families, ownership is achievable through polyphonic participation in the telling. (Ethnography of communication, language and culture, conversation analysis, folklore, narrative).

Evidence for linkage of the gene causing familial Mediterranean fever to chromosome 17q in non-Ashkenazi Jewish families: second locus or type I error?

Familial Mediterranean fever (FMF) is an autosomal recessive disorder of unknown pathogenesis, characterized by recurrent, self-limited attacks of fever with synovitis, peritonitis, or pleurisy. Using DNAs from affected Israeli families, we have recently mapped the gene causing FMF (designated MEF) to the short arm of chromosome 16, with two-point lod scores in excess of 20. In this report we consider the possibility of a second FMF susceptibility locus. Before discovering linkage to markers on chromosome 16, we had found suggestive evidence for linkage to chromosome 17q, with the following maximal two-point lod scores: D17S74 (pCMM86), Z = 2.47, (theta = 0.20); D17S40 (pLEW101), Z = 2.15 (theta = 0.15); D17S35 (CRI-pP3-1), Z = 1.78 (theta = 0.15); D17S46 (pLEW108), Z = 1.69 (theta = 0.18), D17S254, Z = 2.30 (theta = 0.20). Moreover, multipoint linkage analysis using D17S74 and D17S40 as fixed loci gave Z = 3.27 approximately 10 centimorgans (cM) telomeric to D17S40. Data with the chromosome 17 markers alone in our families suggested locus heterogeneity. Nevertheless, our families were not separable into complementary subsets showing linkage either to chromosome 16 or to chromosome 17. We also examined the possibility that the positive lod scores for chromosome 17 might reflect a secondary, modifying locus. By several measures of disease severity, families with positive lod scores for chromosome 17 loci had no worse disease than those with negative lod scores for these loci. We conclude that chromosome 17 does not encode a major FMF susceptibility gene for some of the families, nor does it encode a disease-modifying gene. Rather, it would appear that linkage to chromosome 17 is a "false positive" (type I) error. These results reemphasize the fact that a lod score of 3.0 corresponds to a posterior probability of linkage of 95%, with an attendant 1 in 20 chance of observing a false positive.

Families under war: Stresses and strains of Israeli families during the Gulf war

This study assessed sources of stress, perception of the situation, and effect of the war upon Israeli families during the first week of the Gulf war. Sixty six families were randomly selected and were telephone interviewed using a semi-structured questionnaire. Responses to questions regarding the stresses and strains of war and their effect on the family are described. Four sources of stress seemed to affect families: Existential fear, ambiguity, war-related hardships, and intrafamily strain. Families perceived the situation along a continuum ranging from catastrophic, through difficult but optimistic, to bearable. The effect of the war situation on families was assessed by respondents as positive, neutral or negative. The findings are discussed in terms of their relation to four types of family response in a shared stressful situation.

Families under war: Stresses and strains of Israeli families during the Gulf war

AbstractThis study assessed sources of stress, perception of the situation, and effect of the war upon Israeli families during the first week of the Gulf war. Sixty six families were randomly selected and were telephone interviewed using a semi‐structured questionnaire. Responses to questions regarding the stresses and strains of war and their effect on the family are described. Four sources of stress seemed to affect families: Existential fear, ambiguity, war‐related hardships, and intrafamily strain. Families perceived the situation along a continuum ranging from catastrophic, through difficult but optimistic, to bearable. The effect of the war situation on families was assessed by respondents as positive, neutral or negative. The findings are discussed in terms of their relation to four types of family response in a shared stressful situation.

Adolescent Visits to an Israeli Family Practice

Adolescent Visits to an Israeli Family Practice

Need for continuing tuberculosis surveillance in previously screened new immigrants.

Despite the advent of effective chemotherapy and improvement in socioeconomic conditions, tuberculosis remains a highly prevalent disease in certain countries. There are an estimated 30 million cases in the world, with an annual incidence of 10 million and a mortality of 3 million. 1 Although the new case rate in the United States in 1989 was 9.5:100,000, tuberculosis was nevertheless the leading cause of death among the 38 communicable diseases reported to the Centers for Disease Control. 2 The general trend toward a decline in tuberculosis incidence has slowed recendy. This decrease has been attributed in part to the reactivation of tuberculosis in persons immunosuppressed by the human immunodeficiency virus. 3 In the initial postindependence period, Israel experienced a high case rate of tuberculosis (216:100,000 in 1950), largely resulting from massive immigration from non-Western countries.4 More recendy (1980 1985) the risk of infection has gradually declined to an average annual case rate of 6.3:100,000.5•6 In contrast with the low national incidence, Halperin recendy reported a relatively high incidence in an Israeli family practice.7 During a 3-year period (19841986) 10 cases of active tuberculosis occurred among recent Ethiopian immigrants wh~ h~d negative chest radiographs and tuberculosIs skin tests when they entered Israel an average of 1.7 years before diagnosis. In an effort to assess the immigration screening program and find an explanation for these cases, we reviewed the results of the primary screening at entrance. to .the co~­ try of all new immigrants to our dIstnct dunng this period.

Mapping of the familial Mediterranean fever gene to chromosome 16.

Familial Mediterranean fever (FMF) is an autosomal recessive disease characterized by recurrent attacks of fever, synovitis, peritonitis, or pleurisy. Some patients eventually develop systemic amyloidosis. The biochemical cause of the disease is unknown. We have conducted a genome-wide search for the FMF locus using 125 different DNA markers and mapped the FMF gene to the short arm of chromosome 16. The study was performed on 35 Israeli families primarily of North African and Iraqi origin. For the five markers D16S82 (p41-1 Sacl), D16S80 (24-1 Taq1), D16S84 (pCMM65 Taq1), D16S83 (pEKMDA2-1 Rsal), and HBA (5'HVR Rsal) we obtained maximum lod scores of 2.72 (theta = 0.08), 10.34 (theta = 0.04), 9.66 (theta = 0.050, 9.35 (theta = 0.03), and 14.31 (theta = 0.08), respectively. Multipoint analysis with HBA and D16S84 defined as a fixed loci gave a maximum lod score of 19.86 centromeric to D16S84. Crossovers defined by these markers place the FMF gene in an area of approximately 5 cM between D16S80 and D16S84. Other genes mapped to this area (16p13.3) include phosphodiesterase IB (PDE1B), hydroxyacyl-glutathione hydrolase (HAGH), phosphoglycolate phosphatase (PGP), and the gene that causes adult polycystic kidney disease (PKD1). None of these genes bear an obvious pathophysiological relationship to FMF. Using additional markers from this region we hope to localize more precisely the FMF gene and to offer the possibility of prenatal diagnosis in selected cases. Our ultimate goal is to isolate and characterize the FMF gene.

Families in the sealed room: interaction patterns of Israeli families during SCUD missile attacks.

This study attempted to delineate styles of family interaction and behavior during war. Sixty-six families were randomly selected during the first week of the Gulf War and were telephone-interviewed using a semi-structured questionnaire. Qualitative methodology was used to analyze the interview transcripts. Three themes emerged: the emotional atmosphere (degree of expressed stress), mode of family organization, and extent and form of interpersonal relationship. When these categories were considered, four types of families were found: (1) the Anxious Family, characterized by high level of stress, low role distribution, negative interaction style; (2) the Cautious Family, with high stress, clear role allocation, positive interaction among members; (3) the Confident Family, typified by low stress level, clear role allocation, and positive non-interaction; and (4) the Indifferent family, characterized by low stress level, no role allocation, and negative non-interaction. These findings are discussed in terms of recent attempts to clarify the concept and describe the process of family coping, as well as in terms of understanding family behavior in other stressful situations.

Developing Autonomy for Tellers, Tales, and Telling in Family Narrative Events

Abstract Dinner-table conversations are contexts in which children become socialized to local cultural rules regulating storytelling and may be able to achieve autonomy in telling stories, as tellers of stories, and in the content or tale recounted. Conversations from five American and five Israeli middle-class families and five American working-class families matched on family constellation generated 33, 40, and 15 narratives, respectively. Each of the groups demonstrated a different pattern on dimensions such as who participated in telling narratives, who initi-ated narratives, and how secondary narrators participated; Israeli family narra-tives were more collaborative but with relatively little child participation, whereas American middle-class children participated more by initiating their own narratives and American working-class children narrated in response to adult elicitation. All three groups demanded fidelity to truth and coherence in the tales children told, but many more of the narratives told in Israeli families had to do with events known to all the family members, whereas American children told stories about events unfamiliar to at least some family members. (Communication)

Political Contracts

A new creature has been welcomed into Israel's family of law. While some refer to it as a political agreement, and others a public agreement, I prefer to call it a political contract.It was greeted with curiosity, suspicion, and even disapproval. And, although much has been written about it of late, its character has as yet to be determined. What distinguishes it from other agreements? Is it legally binding, or does it merely draw upon the force of public opinion? Is it justiciable? If binding, does it fall within the scope of private law or of public law? And what consequences attach to breach of the agreement?In this article, I will examine the primary questions regarding political agreements, present the existing case law and opinions, and express my views on the subject.

Self‐report measures of attitudes and behaviors among Israeli family child care providers

This study tests the application of attitude and behavior theory to a social action program, family day care in Israel. Specifically 48 family day care providers were queried to determine their attitudes toward the importance of various training and supervision related issues and the extent to which they are addressed. The findings reveal major differences between what care providers consider important and the amount of attention devoted to the priorities. The results of this study tend to reflect a discrepancy that often exists in the context of social programs when the importance of program elements and the extent of energies being given to address priorities are examined. While little connection was found between the self‐report attitudes and behaviors collected, the application of attitude and behavior theory appears to be a valuable methodology for information gathering when applied to social programs for evaluation purposes. Issues of emergency planning, relations with parents and supervisor, as wel...