Treatment In Israel Research Articles

Exploring the experiences of English-speaking women who have moved to Israel and subsequently used Israeli fertility treatment services: A qualitative study.

Israel's pronatalist cultures result in a social expectation to have children and drive Israel's fertility rate of 2.9. Israeli policy reflects this through funding unlimited fertility treatment up to two children. Societal pressure to have children exacerbates challenges of fertility treatment. Furthermore, the lack of financial burden creates a culture of perseverance following treatment failures. Whilst the experiences of Israeli women using fertility treatment have been studied, the experiences of women who migrated to Israel and were therefore raised in a different society have not. This study aimed to address this gap in knowledge. A qualitative study using semi-structured interviews to investigate the experiences of 13 English-speaking women who utilised Israeli state funded fertility treatment. Participants were located across Israel and were recruited using purposive sampling through social media. Data was analysed using framework analysis. Despite not being aimed at specific ethnic or religious groups, all respondents were Jewish. Three themes were identified: 1. Systemic factors: The lack of financial burden was positive, however, participants struggled to navigate the bureaucratic healthcare system, especially when experiencing a language barrier. 2. Influence of others: Encountering a cold bedside manner alongside contending with the expectations of a pronatalist society was challenging. Participants utilised support from other migrants who appreciated the same culture shock. Understanding of healthcare professionals regarding shared religious values further improved treatment experiences. 3. Impact of journey: Participants often withdrew socially and the treatment process implicated upon their lives, jobs and relationships. Navigating a bureaucratic system and pronatalist society are difficulties associated with fertility treatment in Israel. The lack of financial burden and an understanding of religious and cultural beliefs by healthcare providers improved treatment experience. Better provision of resources in English and further research into supporting women who are navigating Israel's pronatalist society is required.

Segregation by Design: An Analysis of Apartheid-Enabling Constitutional Provisions

This paper is a critical examination of constitutional provisions that enable apartheid systems, with a focus on how they allow segregation and discrimination to be established and perpetuated. Despite the global condemnation of apartheid following its horrors in South Africa, similar traits are still visible across a number of jurisdictions today, notably in Israel's treatment of Palestinians and Myanmar's oppression of the Rohingya. This study investigates three of such highest laws of the land, analyzing the roles they play in legitimizing such regimes and how they are instrumentalized to sustain segregation by design. Employing a substantive and structural comparative analytical approach, the research scrutinizes the constitutions of South Africa, Israel, and Myanmar, unearthing common denominators that facilitate apartheid practices. These include the creation of identity-based citizenship conditions, provisions allowing discriminatory treatment, constraints on the political participation of marginalized groups, and the entrenchment of power that hinders reformative action. The findings reveal that apartheid-enabling provisions do not necessarily explicitly endorse segregation. Instead, they often afford broad legislative powers that can be exploited to this end, as was the case in Apartheid South Africa. Similarly, the constitutions of Israel and Myanmar offer constitutional protection to selected ethnic groups, legitimizing and institutionalizing segregation. The research concludes with the identification of at least four key elements common across the studied constitutions that contribute to the maintenance of apartheid systems: differentiated citizenship status, legitimized segregationist practices, limited political participation for certain demographics, and entrenched power structures resistant to change.

Health-Related Quality of Life in Chronic Lymphocytic Leukemia Patients in Active Surveillance and Active Treatment in Israel

Background: Newly diagnosed chronic lymphocytic leukemia (CLL) patients are monitored regularly for disease progression to delay the impact of treatments on the patients' quality of life (QoL). However, studies have reported mixed results on the QoL between active surveillance patients compared to active treatment patients. Herein we performed a cross-sectional study to examine the impact of active surveillance and active treatment on health-related QoL in CLL patients. Methods: We included 210 CLL patients in Israel, who completed an online survey with demographic and disease characteristics questions; the Functional Assessment of Cancer Therapy-General (FACT-G), a general health scale including the following subscales: physical well-being, social well-being, emotional well-being, and functional well-being; symptoms and concerns related to leukemia (FACT-LeuS); and FACT-Leukemia (FACT-LEU), a total score derived from the FACT-G and FACT-LeuS scores. Among participants, 63 were in active surveillance, 115 in active treatment (71 in BTKi based treatment and 44 in venetoclax based treatment), and 32 completed their treatments. We compared CLL patients in the surveillance group versus the active treatment group using the Student's T test. Analyses were also stratified by sex. In addition, we compared CLL patients in four groups: active surveillance, treated with BTKi, treated with Venetoclax based treatments, and completed treatments, using ANOVA, and the Hochberg's adjusted P value. For all analyses we estimated the effect size between each two groups using the Cohen's d measure and 95% confidence intervals (CI). Results: Overall, the mean age of participants was 64 (SD=10) with 40% males in the active surveillance group, and mean age of 67 (SD=10) with 54% males in the active treatment group. Patients in the surveillance group reported lower QoL scores compared to the active treatment group in the social/family well-being subscale (19.0±6.7 vs 22.1±4.7, P=0.002) with a medium effect size [-0.56, CI:(-0.87,-0.25)], however, in the physical well-being subscale they reported a higher QoL scores (22.8±5.5 vs 20.5±6.3, P=0.017), with a small effect size [0.38, CI:(0.07,0.69)]. Among males, patients in the surveillance group reported higher QoL scores compared to the active treatment group in the physical well-being subscale (25.2±3.8 vs 19.7±7.0, P=0.0), with a high effect size [0.87, CI:(0.38,1.35)], FACT-LeuS score (51.5±9.7 vs 42.8±12.1, P=0.002), with a medium effect size [0.76, CI:(0.28-1.23)], and the FACT-LEU score (135.9±26.1 vs 120.5±27.8, P=0.02), with a medium Effect size [0.56, CI:(0.09-1.03)]. Among females, patients in the surveillance group reported lower Qol scores compared to active surveillance in the social/family well-being subscale (18.9±7.1 vs 22.5±5.7, P=0.008), with a medium effect size [-0.58, CI):-1.0,-0.15)]; emotional well-being subscale (15.5±4.5 vs 18.2±3.9, P=0.003), with a medium effect size [-0.66, CI):-1.09,-0.23)]; FACT-G (74.6±15.2 vs 83.3±15.2, P=0.009), with a medium effect size [-0.58, CI):-1.0,-0.14)]; and FACT-LEU (116.7±20.7 vs 128.3±22.5, P=0.014), with a medium effect size [-0.53, CI):-0.96,-0.11)]. When comparing the four groups of treatments, we found significant differences in the physical well-being subscale (P=0.029), which was driven by the lower score in the Venetoclax based treatment group compared to the surveillance group [19.6±7.3 vs 22.8±5.5, medium effect size 0.49, CI:(0.10,0.88)]; and social/family well-being subscale (P=0.005), which was driven by the higher score in the BTKi based treatment group compared to the surveillance group [22.3±4.3 vs 19.0±6.7, medium effect size -0.53, CI:(0.87,-0.19)]. Conclusions: In general, males in active surveillance reported better health-related QoL than those in active treatment, while females in active treatment reported better health-related QoL than those in active surveillance. Interventions for improving QoL in CLL patients should include gender-based perspectives.

The perspectives of intimate partner violence service providers regarding men as clients: between ‘gender’ and ‘gender-inclusive’

ABSTRACT Practitioners who work in IPV services have over the years addressed core questions regarding causes and accountability for IPV. Accordingly, service providers’ perspectives on IPV and treatment of men reveal that different organisations hold different ideologies, policies, and practices. The present study focused on the perspectives of directors of IPV services in Israel about IPV and men’s treatment, and the way they are reflected in practice and policy. 29 directors of centres for violence prevention and treatment in Israel participated in in-depth, semi-structured focus group interviews. The analysis offered three main themes: (1) A process of changing from a ‘gender’ to a ‘gender-inclusive’ perspective. (2) A question of whether service providers should confront men about their role as aggressors at the beginning of treatment. (3) Who is the main client? The study reveals a tension that exists between a ‘gender’ and ‘gender-inclusive’ approach and stresses the need to raise professionals’ awareness about assumptions and stereotypes regarding gender roles, and the way they reflected in policy and practice. In addition, the study emphasises the need to extend training to a variety of stakeholders, allowing them to see IPV as a complex problem, thus, improving policy, treatment, and working models of IPV.

Changes and trends in medication-assisted treatment in Israel

BackgroundAs opioid prescription in Israel is increasing, there is a growing need for monitoring opioid use disorder and providing opioid agonist therapy. Our goal is to describe, sub-analyze, and identify obstacles in the treatment of opioid misuse in the Israeli medication assisted treatment centers.MethodsData on methadone, buprenorphine, and buprenorphine combined with naloxone for the indication of opioid addiction treatment for the period 2013–2020 were obtained from pharmaceutical companies that distribute them in Israel. Data on utilization of these drugs were also extracted from the database maintained by the Israel Ministry of Health's Pharmaceutical Administration Division. The data were converted to defined daily doses (DDD)/1000 inhabitants/day.ResultsThe number of patients receiving medication assisted treatment increased by 10% since 2013, with a shift from buprenorphine alone to buprenorphine/naloxone in government-run centers. Methadone remains the most popular maintenance drug.ConclusionsThe change in opioid maintenance prescription does not match the significant increase in opioid consumption. Optimization of treatment can be achieved by the creation of a comprehensive database, cooperation between healthcare organizations and the government and further development of non-stigmatic and accessible services.

679-P: Costs and Cost-Effectiveness of the FreeStyle Libre System vs. Blood Glucose Self-Monitoring in Patients with Type 2 on MDI Insulin Treatment in Israel

Introduction: Frequent glucose monitoring is essential to obtaining glucose control. We assessed the costs and cost-effectiveness of using the FreeStyle Libre® Flash Continuous Glucose Monitoring system (FSL) compared to self-monitoring of blood glucose (SMBG) in people with type 2 diabetes treated with multiple daily insulin injections (T2D MDI) from a healthcare payer perspective in Israel. Methods: We calculated the incremental cost per quality adjusted life year (QALY) gained. Glucose monitoring costs are based on actual costs of FreeStyle Libre®, strips and lancets, assuming full adherence to monitoring. Severe hypoglycemic events (SHE) and diabetic ketoacidosis (DKA) costs are based on real-world data from Israel and the Israeli Ministry of Health list price. Costs are presented in Israeli Shekel (ILS) and $US. The incidence rates of SHE and DKA are based on real-world data from a large cohort of patients in France. Due to the short time horizon of this analysis, we assumed no mortality differences between the two monitoring alternatives. Utility increments for the use of CGM vs. SMBG, decrease in HbA1C and disutility for SHE and DKA events are based on estimates from the literature. The analysis was conducted over a 5-year time horizon, applying an annual discount rate of 3% on costs and outcomes. One way sensitivity analyses were performed on difference in costs. Results: FreeStyle Libre® use is associated with a cost increase of ILS 27,021 ($US 8,444) and an increase of 0.26 QALYs, generating an incremental cost-effectiveness ratio of ILS 103,977 ($US 32,493) per QALY gained. These results are highly sensitive to changes in costs of glucose monitoring. Conclusion: Assuming a willingness to pay threshold of $US 43,600 per QALY gained (GDP per capita in Israel in 2020) , the FreeStyle Libre® system is a highly cost-effective glucose monitoring alternative to SMBG for T2D MDI patients in Israel. Disclosure D.Greenberg: Advisory Panel; Abbott Diabetes, Consultant; Geffen Medical, Israel.

The Incidence and Nature of Claims against Dentists Related to Periodontal Treatment in Israel during the Years 2005-2019.

Background: In recent years, worldwide dental malpractice claims have dramatically increased. The purpose of the present study is to analyze periodontal therapy related claims in Israel that led to legal decisions. Methods: This retrospective cohort study includes malpractice claims against dental practitioners related to periodontology between 2005 and 2019. Only closed cases where a final decision was made were included. The chi-square test or Fisher exact test for categorical variables were performed and a p value of <0.05 was considered statistically significant. Results: During the study period there were 508 legal claims related to periodontal disease. Most plaintiffs were women (63.4%), and 71.3% of the patients were >35 years old. Most claims (82.8%) were settled out of court and ended in compromise. Claims concerning the treatment of periodontal disease by periodontists accounted only for 4.5% (23/508) of the cases while 95.5% (485/508) of the claims were for complications secondary to another treatment. Prosthodontic treatment was involved with the highest number 54.5%, followed by dental implants 17.7%, and endodontics 11.6%. The allegations were related to pain and distress (84.8%), aggravation of existent periodontal disease (83.3%), tooth loss (78.1%), and violation of autonomy (47%). Conclusions: The main cause for lawsuits was related to aggravation of periodontal disease during prosthetic or implant therapy and related to suspected faulty or inexistent preoperative diagnosis and planning. Practical implications: Periodontal consultation before dental treatment may reduce malpractice risks, adverse events, and un-necessary changes of treatment plans.

Hemato-oncology Tourism in Israel: A Retrospective Review.

PURPOSEDespite the significant increase in medical tourism worldwide, data on medical tourist (MT) clinical characteristics and treatment outcomes are lacking. Many MTs who choose Israel to receive medical services are individuals diagnosed with hematologic malignancies. The purpose of this study was to describe hemato-oncology MTs and to compare their disease characteristics and treatment outcomes to a control group of local (Israeli) hemato-oncology patients.MATERIALS AND METHODSIn this retrospective review, we analyzed hospital records of all hemato-oncology tourists and Israeli patients diagnosed and/or treated at the Institute of Hematology, Assuta Medical Center, between 2014 and 2016. MT and local patient demographics, clinical characteristics, and treatment outcomes were compared. MT data were also analyzed according to their commitment to treatment in Israel.RESULTSData on 110 MTs (median age, 51.0 years; 53.6% women) and 122 local patients (median age, 65.0 years; 41.8% women) diagnosed with non-Hodgkin lymphoma (NHL), Hodgkin lymphoma, and multiple myeloma were analyzed. The most common hematologic malignancy in both MTs and local patients was NHL (54.5% and 73.0%, respectively). Among MTs, 32.7% were fully committed to treatment in Israel, 32.7% were partially committed, and 34.6% were not committed. In 25.9% of MTs, a review of their biopsy resulted in a more definitive or different diagnosis. The percentage of patients who achieved complete response to treatment was similar among MTs and local patients.CONCLUSIONMTs often require a pathologic review of their initial diagnosis and are more likely to present with advanced stages of disease. Treatment of MTs according to the appropriate clinical parameters is expected to yield similar outcomes to those of local patients.

Harm reduction drug policy in Israel: what has been accomplished and what still needs to be done?

The leading formal drug policy in Israel is the traditional approach of abstinence, probation, and punitive measures based on three main pillars: Enforcement, Treatment and Rehabilitation, and Prevention. However, under the treatment pillar, Israel has adopted a number of harm reduction services, focused mostly on people who use heroin and people who inject drugs. These include Methadone Maintenance Treatment, Buprenorphine Maintenance Treatment, and Needle and Syringe Exchange Programs. More specialized services are designated mostly for people who use drugs, who frequent the largest open drug scene in Tel-Aviv. These include a health clinic, an emergency apartment for female addict sex-workers, and a ‘First Step’ center. Even so, the harm reduction approach has remained controversial, stigmatized, and is considered a sub-category for total-abstinence treatment in Israel. This paper follows the evolution of harm reduction interventions in Israel among people who use drugs and sheds light on the lack of a comprehensive, well-planned, formal national harm reduction drug policy. Additionally, this article expresses concern over the uncertain future of Israel’s comprehensive and balanced drug treatment policies caused by the structural changes in abolishing the Israel Anti-Drug Authority, the statutory authority and central body in Israel that promoted and coordinated all national policies related to treatment and harm reduction.ConclusionsAlthough it is a major challenge to translate worldwide evidence and research findings into action and social change, recommendations are offered to implement a comprehensive harm reduction drug policy led by a multidisciplinary group of policy-makers across all areas of drug policy. These focus on expanding and developing more services for Opioid Maintenance Therapy patients and people who inject drugs as well as a national effort to reduce high levels of stigma and discrimination against them, encompassing other common substances and focusing on populations such as adolescents and young adults that engage in other types of substance use such as cannabis, amphetamine-type stimulants, and hallucinogens.

The Existential Underpinnings of Intergroup Helping: When Normative and Defensive Motivations Collide.

Five studies examined defensive intergroup helping-when responsibility for an out-group victim's injury decreases helping, whereas lack of responsibility increases helping when death is salient. In Study 1 ( N = 350), implicit death primes increased petition signings to allow a Palestinian child to receive medical treatment in Israel, when the child was a victim of Palestinian fire. When the child was a victim of Israeli fire, however, death primes decreased petition signings. Study 2 ( N = 200) partially replicated these effects on commitment to donate blood to an injured Palestinian child. Study 3 ( N = 162) found that moral affirmation primes moderate defensive helping effects. Study 4 ( N = 372) replicated defensive helping, but failed to replicate the moral affirmation effect found in Study 3. Study 5 ( N = 243) partially replicated defensive helping and found that different framings of existential threat moderate the effect. Overall, results indicate that self-protective concerns underlie prosocial responses to out-group members in need.

Asthma Education Delivered in the Emergency Department: Does it Encourage Asthma Self-management?

Background: The rates of optimal asthma control and compliance to treatment in Israel are reportedly low. We postulated that adults attending our emergency department (ED) with asthma exacerbation were not using self-management strategies optimally. Objectives: This pilot study aims to: (a) verify the above hypothesis and, if applicable, (b) determine whether an asthma education intervention (AEI) administered in the ED would encourage post-discharge use of a written asthma action plan (AAP). Methods: Thirty-eight adults (>18 yr.) visiting the ED with asthma exacerbation received a 30-min AEI including a written AAP. Prior asthma education was assessed by questionnaire. Follow-up, carried out by phone ≥ 12 months after discharge, assessed AAP use, asthma control (GINA), and exacerbations in the past year. Results: At baseline, participants denied previous education on asthma selfmanagement and AAP use. Of 27 patients available for follow-up, only 5 (18.5%) were using the AAP, assisted by their care-provider. Eighteen subjects (66.7%) presented uncontrolled asthma while, as a whole, the group reported significantly more exacerbation episodes than at enrolment (mean (SD)=5.1 (6.5) vs. 2.7 (3.0) (p=0.0498)). Finally, compared with AAP non-users (n=22) AAP users (n=5) tended to have better asthma control (60% vs. 18%) and fewer episodes of exacerbations (mean (SD)=2.8 (2.2) vs 5.9 (6.9)) but the differences did not reach significance. Conclusion: Delivery to adults of a short AEI in the ED was of limited efficiency in post-discharge boosting of patient/doctor partnership, resulting in sub-optimal AAP use. Feasibility of the AEI in a crowded ED, however, justifies further research on AEI delivery coupled with alternative follow-up strategies targeting patient and doctor perception of AAPs.

Revolutionary Ideas: An Intellectual History of the French Revolution from The Rights of Man to Robespierre, by Jonathan Israel

Revolutionary Ideas: An Intellectual History of the French Revolution from Rights of Man to Robespierre, by Jonathan Israel. Princeton, Princeton University Press, 2014. 870 pp. $39.95 US (cloth). of his massive four-volume series tracing the Enlightenment from Baruch Spinoza through the end of the eighteenth century, Jonathan Israel offers a characteristically ambitious and original interpretation of the French Revolution certain to spark widespread debate. Israel shows little patience for any preceding school of Revolutionary historiography. Social interpretations and the study of broad political cultures, in his view, only enrich the background (p. 10). Francois Furet's intellectual history-based revisionism viewing the Rousseauianism of Robespierre as the Revolution's purest discourse, which dominated the field in recent decades, he declares, needs rejecting just as comprehensively (p. 28). In their place, Israel--building from some revolutionaries' contemporary interpretations and early nineteenth-century histories of the Revolution--looks to interpret the Revolution as the product of la philosophic, which he interprets to mean the Enlightenment he explores in his preceding 2011 volume. Consciously looking for a single dramatic factor (p. 14) to explain the era's radicalism, Israel--albeit with characters shiftily coming and going in his grand narrative--looks to identify a coterie sponsoring a comprehensive series of drastic changes. The Revolution, Israel argues, above all a process of emancipation, democratization, and fundamental renewal on the basis of human rights (p. 12). Of course, the French Revolution was also many other things besides a movement for Enlightenment, but Israel ably traces his cause's influence through the era. Israel begins his Revolution not with the Parlements or local Cahiers de Doleances, but rather with the Committee of Thirty, a coterie of radical pamphleteers operating out of Paris' Palais Royal which would most famously influence the production of member Emmanuel-Joseph Sieyes' What is the Third Estate? Though Israel does not add to the little evidence surviving of the Committee's workings, and the figures involved are not normally described as neither a unified group nor uniformly republican, (p. 35) as Israel calls his protagonists, he sees their influence as predominant. Israel tracks such radical ideas' influence through the early Revolution through their enactment into the Declaration of the Rights of Man and Citizen. Thereafter, Israel takes on the challenge of tracing the role of democratic thinkers and factions in their battles against during the Revolution's first years, and the radical alternative of authoritarian populism (p. 695) he sees Robespierre's faction as embodying. Though not a French Revolutionist by training, Israel gamely approaches Revolutionary debates and infighting--but with an often-excessive polarization matching outlying Revolutionaries' most excessive rhetoric. constitutional monarchism of Revolution's middle years is often neglected in Israel's treatment. Despite virtually all Revolutionaries' desire to end the Revolution and enact a compromise order, Israel remains adamant that so powerful a philosophique republican undercurrent (p. 141) could not remain ignored for long. break with Catholicism is described as wholly certain from the outset, (p. 181) while the push toward the overthrow of the monarchy is primarily attributed to [Jacques-Pierre] Brissot, [the Marquis de] Condorcet and their colleagues (p. 253) in the National Assembly rather than a contingent action of the federe and Parisian popular movements in the final insurrection of August 10, 1792. Israel's culmination of the Radical Enlightenment tendency (p. 348) is the Constitution of February 1793. Curiously, for a movement Israel has traced over a century and a half, he describes its final triumph as one of moderation, which after having vanquished monarchy sought a judicious middle path between the Scylla of direct and the Charybdis of pure representative democracy (p. …

Maximizing the potential of psychology for the Israeli mental health reform.

The author comments on Nirel and Samuel’s article showing that psychologists in Israel reported practicing inconsistently with the likely demands of an upcoming Israel mental health reform. Some of the reasons for the differences in preparedness between psychologists and psychiatrists are considered. In addition, incorporating the knowledge from psychology to improve access, assessment, treatment and training in Israel is discussed as a way to help both the reform and psychologists advance treatments in Israel. Finally, a suggestion for 21st century models of service delivery is suggested.

Is the upgrading of wastewater treatment facilities to meet more stringent standards economically justified: The case of Israel

The global use of wastewater for irrigation in agriculture is increasing, as are the requirements for more stringent wastewater treatment standards, to prevent environmental and health risks. The aim of this paper is to display a cost-benefit analysis of introducing more stringent standards for wastewater treatment in Israel, and to examine whether upgrading the wastewater treatment facilities is economically justified. The findings indicate that the introduction of the stringent standards as well as upgrading the treatment facilities are economically justified.

Compulsory Treatment in Anorexia Nervosa: The Case of Israel

Anorexia Nervosa (AN) is a serious mental illness associated with high morbidity and mortality rates. Nevertheless, patients with AN are prone to refusing treatment despite life-threatening complications, requiring at times compulsory intervention. Involuntary treatment of eating disorders (EDs) through legal commitment is a controversial issue. In such cases, patient autonomy may conflict with protection of his or her best interest. In many industrialized countries, it is impossible to legally mandate treatment of patients with severe and even life threatening AN. In the last decade the ethical and legal concerns about compulsory treatment in Israel have been on the rise. According to the current law in Israel, it is illegal, with a few exceptions, to enforce treatment against the patient’s will. The aim of this paper is to review the existing literature about the legal and ethical dilemmas associated with compulsory treatment in AN and the effectiveness of its treatment outcomes. Research findings included in this review address both perspectives of the debate and discuss the patient’s competence to make this decision. Additionally, this paper focuses on the legal process in Israel in the last decade, illustrating the dilemmas in two case studies. This review raises important questions and clinical implications that must be addressed in further research.

Mortality of tuberculosis patients during treatment in Israel, 2000-2010.

Tuberculosis (TB) epidemiology in Israel is similar to that reported from other industrialised countries where most patients are foreign-born. To assess TB case fatality rate (CFR) and mortality trends during treatment and to identify risk factors associated with mortality. Retrospective cohort study of all TB patients in Israel diagnosed between 2000 and 2010. Cause of death was classified by TB-specific and non-TB-specific causes. During the study period, 451 TB patients died during treatment, representing a CFR of 9.9%. Of these, 72.5% died due to TB-related causes, giving a TB-related CFR of 7.2%. Both the overall and TB-related CFR decreased over the study period. Risk factors for death included male sex, older age, human immunodeficiency virus coinfection, culture positivity and multidrug-resistant TB (MDR-TB). Patients aged ≥65 years comprised 70% of the TB-related deaths, and more than half of these (54.9%) were born in the former Soviet Union, Europe (excluding the former Soviet Union) or the USA. Both the overall and TB-related CFR decreased over the study period. Physicians who treat older male TB patients with MDR-TB or HIV should increase the index of suspicion to include the possibility of a higher risk of mortality.

Care Leavers in Israel: What Contributes to Better Adjustment to Life After Care?

ABSTRACT The present study examines the adjustment of youth leaving residential treatment in Israel in three core areas: military service, accommodation, and financial status. A sample of 277 adolescents (aged 17–18 years old) in educational and welfare residential placements were interviewed a few months before leaving care, and 236 of them were interviewed 1 year after. It was hypothesized that optimism, higher perceived sense of readiness to leave care, and higher social support of family, friends, and staff are associated with better outcomes in adjustment to military service, accommodations, and economic status. Findings show that 70% of care leavers were drafted to the (compulsory) military service, a sign of good adjustment in Israel. Yet, they have significant difficulties in the areas of accommodations and financial status. Optimism and perceived readiness for independent living while still in care were positively correlated with adjustment to the military service. Mother's support was positively correlated with care leavers’ economic status and stability in accommodations. These findings highlight the importance of designing programs that include specific attention to needs and challenges while youth are in care and immediately after they leave. Follow-up and longitudinal studies are suggested.

“Infiltrators” or Refugees? An Analysis of Israel's Policy Towards African Asylum‐Seekers

AbstractThis article adopts a genealogical approach in examining Israeli immigration policy by focusing on the situation confronting African asylum seekers who have been forced back into Egypt, detained and deported but who have not had their asylum claims properly assessed. Based on immigration policies formulated at the time of Israeli independence, whose principle objective was to secure a Jewish majority state, we argue that Israel's treatment of African asylum seekers as ‘infiltrators’/economic migrants stems from an insistence on maintaining immigration as a sovereign issue formally isolated from other policy domains. Such an approach is not only in violation of Israel's commitment to the Refugee Convention, it directly contributes to policies which are ineffective and unduly harsh.

National versus location-specific environmental standards: a cost–benefit analysis of wastewater treatment standards in Israel

Generally, governments set national rather than regional environmental regulations and standards, although their efficiency may differ significantly at a local level. This paper presents a case study assessing the introduction of more stringent standards for wastewater treatment in Israel. A cost–benefit analysis is conducted at both a national and a regional level, comparing their economic net benefit. The findings indicate that by setting wastewater treatment standards for each region according to their specific characteristics, the resulting net benefits are greater than by setting uniform national wastewater treatment standards.

Integration of Religion in Democratizing Societies: Lessons from the Israeli Experience

Throughout the twentieth century, the treatment of religion in the social sciences had been heavily shaped by the premises of modernization theory. This theory was responsible for the development of two concepts—the secularization thesis and the traditional school of civil society—which deny any space for religious content and actors in the public and political spheres. Both concepts rely on the exceptional experience of the west and share deterministic, static and essentially pessimistic assumptions regarding the ability of religion and the state to mutually coexist in democratic settings. In view of the above Israel's treatment of religion stands out. Israel challenged the premises of the secularization thesis and instead granted a significant official role to religious contents and actors in the state. Contrary to common beliefs, this research demonstrates that Israel's policy resulted in mainly positive consequences and contributed to the stabilization of its democratic regime. Furthermore, Israel's inclusive policy on religion proved successful in containing and isolating mounting religious challenges to the state in recent decades and in securing the stability of the democratic regime. Israel's account reveals two important lessons about the nature of the state-religion relationship. First, it offers a dynamic and mutually constitutive perception of the relationship between the state and religion. Second, it advocates development of a case-sensitive approach toward religion, depending on specific social, historical, and cultural attributes. These lessons might prove highly relevant for post Arab spring societies in transition.