Population Of Southern Israel Research Articles

Being a Deaf Woman in Bedouin Society.

Israel's Bedouin population, an ethnic minority, has a higher incidence of deafness than that reported in the literature, but is not studied sufficiently. A patriarchal and collective society, in recent years it has undergone accelerated change spurred by Israel's urbanization policy. Deaf women are an inseparable part of Bedouin society, but they are transparent and their needs are not met. In a qualitative study of 23 Bedouin women with congenital deafness who participated in the only social club for the deaf among the Bedouin population in southern Israel, these women were found to exist between dreams and frustration, between hope and despair, between strength and loneliness-induced weakness, and between transparency and visibility. Focusing on these aspects, the authors describe the experience of being a deaf woman in Bedouin society. Their findings are applicable to deaf women who are members of minorities worldwide.

Adolescent Obesity and Type Two Diabetes in Young Adults in the Minority Muslim Bedouin Population in Southern Israel.

Minority populations suffer from adolescent obesity at increasing rates and develop diabetes type 2 at a younger age. To assess the prevalence of adolescent obesity in the minority Bedouin population of Israel and its association with obesity and diabetes type 2 during young adulthood. A retrospective cohort study, based on computerized medical records. The study cohort was comprised of Bedouin adolescents, born in 1988-1990, who had BMI measurements at ages 14-19years in their medical records (N = 3310). The prevalence of obesity was 17.3% in middle adolescence, and 9.6% in late adolescence. The ORs for obesity in young adulthood were 30.1 (95% CI 19.1-49.3) and 40.9 (95% CI 25.7-69.1) for the middle and late adolescent groups, respectively. The incidence of diabetes type 2 per 105 person-years was 494.88 (95% CI 263.55-846.27) vs. 23.06 (95% CI 4.76-67.40) and 446.93 (95% CI 223.11-79 9.68) vs. 113.13 (95% CI 74.55-164.59) among adolescents with and without obesity in the middle and late adolescence groups, respectively. Interventions are needed to reduce the prevalence of adolescent obesity in the vulnerable Muslim Bedouin population in southern Israel.

Analysis of Trauma Injuries Among the Minority Population in Southern Israel-a District-Wide Study.

We compared characteristics of traumatic injury between the Bedouin subpopulation, the largest minority group in southern Israel, and the other residents in this region. We assessed all the patients admitted with traumatic injuries during 2014-2018 to the only regional hospital in southern Israel. The cohort comprised 10,734 patients, 4553 (42.5%) of Bedouin origin. Compared to the non-Bedouin subpopulation, in the Bedouin subpopulation, the proportion of injuries that occurred in males was higher, 74.3% vs. 53.7%, P < 0.001, and the proportion of burn injuries that occurred in children aged 0-14years was higher, 84% vs. 49%. Among the Bedouin and non-Bedouin patients, the respective proportions with penetrating injuries were 10.7 and 5.4%; the respective proportions who arrived at the hospital by private vehicles were 62.0 and 33.1%. In multivariate analysis, the variables that were significant for increased odds for severe trauma were Bedouin origin, male gender, and arrival to the emergency room at night. This study highlights the lack of access to basic infrastructure and healthcare among Bedouins in southern Israel. The high proportion of penetrating injuries in this subpopulation is apparently due to explosions of unexploded ordnance. The unavailability of electricity and waste removal in unrecognized villages contributes to burn injuries among Bedouin children. Poor accessibility of healthcare facilities and emergency medical transportation necessitates travel to hospitals by private car. The findings should direct trauma prevention programs to reduce burn and penetrating injuries and to increase accessibility to healthcare.

Ruppell’s fox movement and spatial behavior are influenced by topography and human activity

Global climatic processes have driven an expansion of arid environments, as well as the human populations that depend on these biomes. Human habitation can influence desert ecosystems directly through changes in land use and indirectly through the introduction of alien species that compete with locally adapted fauna. Native species can respond to these processes by spatial or temporal avoidance. Ruppell’s fox is a desert-adapted species inhabiting flat, rocky arid areas that feeds mainly on invertebrates and rodents. We used location data and step selection functions to study the space use of a population in southern Israel. We hypothesized that Ruppell’s fox movement would be influenced by topography due to preference for creeks, where insects and rodents are available, and by human infrastructure as the presence of humans, vehicles and associated animals may induce a fear effect on native species. Ruppell’s fox habitat selection was seasonal. During the dry season, foxes showed preference for flatter areas and creek bottoms and avoided paved roads. During the rainy season, foxes avoided less- trafficked dirt roads. These patterns were likely a consequence of increased territoriality due to denning in the colder season and reduced availability of insects in the dry season. Avoidance of paved and dirt roads may be explained by fear of human presence and perception of risk due to the use of linear features by larger carnivores, such as wolves and red foxes. Our results suggest that current protected, remote and uninhabited areas have an elevated value for the persistence of Ruppell’s fox populations. We recommend limitation of vehicle movement within current reserves and continued monitoring of population trends for this little studied carnivore.

Air pollution and meteorological conditions during gestation and type 1 diabetes in offspring

BackgroundGrowing evidence indicates that air pollution is capable of disrupting the immune system and therefore, might be associated with an onset of Type 1 diabetes (T1D). ObjectivesWe explored possible links of T1D with ambient exposures in the population of southern Israel, characterized by hot and dry climate and frequent dust storms. MethodsWe conducted a matched nested case-control study where exposure to environmental pollutants during gestation in T1D cases was compared to that of healthy children. Up to 10 controls were matched to every case by age, gender and ethnicity, in all 362 cases and 3512 controls. Measurements of pollutants' concentrations, nitrogen dioxide (NO2), sulphur dioxide (SO2), ozone (O3) and particulate matter of size less than 10 and 2.5 μm in diameter (PM10 and PM2.5), as well as the mean daily measurements of meteorological conditions were obtained from the local monitoring stations. The association between T1D and pollution, solar radiation (SR), temperature and relative humidity was adjusted for socioeconomic status, temperature, maternal age and pre-gestational maternal DM, using conditional logistic regression. The environmental exposures were presented as indicators of quartiles averaged over whole pregnancy and by trimesters. ResultsExposure to ozone and solar radiation during gestation were both associated with the T1D in offspring, although at borderline significance. Compared to the lowest quartile, the odds ratio (OR) for exposure to 3rd and 4th quartile of O3 was equal 1.61 (95%CI: 0.95; 2.73) and 1.45 (95%CI: 0.83; 2.53), respectively. Likewise, the ORs for exposure to SR were equal 1.83 (95%CI: 0.92; 3.64), 2.54 (95%CI: 1.21; 5.29) and 2.06 (95%CI: 0.95; 4.45) for to 2nd, 3rd and 4th quartiles, respectively. Exposure to SO2 followed a dose-response pattern, but was not statistically significant. Other environmental factors were not independently related to T1D. Analysis of exposures one year prior to the disease onset indicated a positive association between T1D and SR. ConclusionsWe showed that exposure to high ozone levels and solar radiation during gestation might be related to the T1D. More scientific evidence needs to accumulate to support the study findings.

Incidence of inherited metabolic disorders in southern Israel: a comparison between consanguinity and non-consanguinity communities

BackgroundInherited metabolic disorders (IMDs) are group of rare monogenic diseases, usually derived from reduced or absent activity in a single metabolic pathway. Most of the IMDs are inherited in an autosomal recessive manner. The incidence of IMDs varies from country to country and within different ethnic groups, but data is still scarce. Consanguinity rate among populations is highly contributor factor for IMDs incidence. There are no reports comparing the incidence of IMD in consanguineous and non-consanguineous populations from the same geographic region with the same diagnostic capabilities. Our study objective is to compare the incidence of IMDs between between the relatively low consanguineous Jewish population and the consanguineous Bedouin population, both living in the southern of Israel.ResultsDuring 1990–2017 there were 393,772 live births in the Negev district, of Southern of Israel. Among them 187,049 were of Jewish origin while 206,723 were of Bedouin-Muslim origin. A total of 223 children were diagnosed in this study period with IMDs. Among those 223 children with IMD, 33 were of Jewish origin while the other 190 children were of Bedouin-Muslim origin. The overall incidence for IMDs of the overall Negev population was 56.6/100,000 live birth. The incidence for IMD's among the Bedouin population was significantly higher than among Jewish population.ConclusionsIMDs are extremely more common in the consanguineous Bedouin compared with the relatively non-consanguineous Jewish population of Southern Israel. Health policy makers should consider these data and prepare educational and genetic counselling problems accordingly.

Hypothermia in a Japanese subtropical climate: Retrospective validation study of severity score and mortality prediction.

IntroductionThis study aimed to clarify the accuracy of an in‐hospital mortality prediction score for patients with hypothermia. The score consists of five variables (age ≥70 years, mean arterial pressure <90 mm Hg, pH < 7.35, creatinine >1.5 mg/dL, and confusion). In contrast to the previously reported population in southern Israel, a desert climate, we apply the score system to a Japanese humid subtropical climate.MethodsThe study included patients with a principal diagnosis of hypothermia who were admitted to our community hospital between January 2008 and January 2019. Using the medical records from initial visits, we retrospectively calculated in‐hospital mortality prediction scores along with sensitivity and specificity.ResultsWe recruited 69 patients, 67 of which had analyzable data. Among them, the in‐hospital mortality rate was 25.4%. Hypothermia was defined as mild (32‐35°C) in 34 cases (50.7%), moderate (28‐32°C) in 23 cases (34.3%), and severe (<28°C) in 10 cases (14.9%). The C‐statistics of the in‐hospital mortality prediction score was 0.703 (95% confidence interval, 0.55‐0.84) for thirty‐day survival prediction. After adjustment of the cutoff point of each item with ROC analysis and selection of the variants, the C‐statistics of the in‐hospital mortality prediction score rose to 0.81 (95% confidence interval, 0.69‐0.92).ConclusionThe in‐hospital mortality prediction scores showed slightly less predictive value than those in the previous report. With some modification, however, the score system could still be applied efficiently in the humid Japanese subtropical climate. An appropriate management strategy could be established based on the predicted mortality risk.

The association between an increase in glucose levels and armed conflict-related stress: A population-based study

Studies have shown stress may lead to diabetes-related morbidities. In recent years during enhanced hostility periods, the population of Southern Israel experienced alert sirens and rocket fire on a daily basis. We investigated whether the exposure to these stressful circumstances, which peaked during three large military operations (MO), was associated with increased glucose levels among the civilian population. We included all fasting serum glucose tests taken between 2007–2014, of Clalit Health Services members in Southern Israel who had at least one fasting glucose test during an MO period and at least one test drawn at other times. We analyzed the association between MO periods and glucose using linear mixed-effects models. We included 408,706 glucose tests (10% during MO periods). Among subjects who reside in proximity to Gaza, glucose levels were 2.10% (95% CI 1.24%; 2.97%) higher in MO days compared to other times. A weaker effect was observed among subjects in more remote locations. In conclusion, we found stress to be associated with increased fasting glucose levels, especially among those who reside in locations in which the intensity of the threat is higher. Since glucose may be a marker of the population at cardiovascular risk, further studies are required.

Diabetes in the Bedouin population in the Israeli Negev – An update 2017

AimsThe Bedouins are an Arab population living in Israel severely impacted by diabetes and obesity. The aim of this research was to update the prevalence of diabetes among Bedouins in the Negev and to observe differences in this population in comparison with non-Bedouins in Israel. MethodsA cross-sectional study was performed using the Clalit Health Services database. Diabetes prevalence among Bedouins was compared with non-Arabs and non-Bedouin Arabs in Israel. Differences in sexes and among Bedouins living in planned cities and unrecognized villages were observed. ResultsThe age-adjusted prevalence of diabetes was 12.3% in the Bedouin population versus 8.2% in the non-Arab population in southern Israel (p < 0.0001). Diabetes prevalence among Bedouins and all Arabs in Israel was similar (12.0%). In all of Israel, age-adjusted diabetes prevalence was 8.8% for men and 7.5% in women (p < 0.0001) compared to 12.0% for men and 12.5% for women in the Bedouin population (p = 0.0008). In the Bedouin population in planned cities, age-adjusted diabetes prevalence was 12.5% versus 10.5% in the Bedouin population in unrecognized villages (p < 0.0001). ConclusionsThis study shows that the prevalence of diabetes among Bedouins is higher than non-Bedouins in Israel. Increasing urbanization of the Bedouin population with their higher diabetes prevalence indicates the need for increased medical intervention as well as continuing investigation into the causes.

Perpetual Silence, Not Silence for Moments: Hearing Loss of Children as Perceived by Hearing Bedouin Mothers

The Negev Bedouin population in southern Israel, a minority undergoing great social change, has a higher incidence of hearing loss than that reported elsewhere but has hardly been studied. Caring for a child with hearing loss often engenders parental stress because of the many tasks involved. Difficulty in accessing information and services, the lack of public transportation nearby, and other aspects of the living conditions of Negev Bedouin parents present additional challenges. These difficulties are further compounded by the unique socio-demographic and cultural characteristics of this indigenous population. This article presents the parenting experience of 20 hearing Bedouin mothers of children with hearing loss, explored in a qualitative phenomenological study. The findings indicate that the mothers’ perceptions of the child’s hearing loss affect how they cope with the birth and rearing of the child, their view of the child, and their attitude toward medical interventions. These findings, which portray an experience that is unique in many ways, contribute to the understanding of how an underserved, indigenous, and traditional population responds to congenital hearing loss. The findings also reveal the importance of the terminology with which parents describe their child’s hearing loss and the unique meanings it may have. Such knowledge is of particular importance for culturally sensitive and effective provision of social services and therapeutic interventions.

Relationship of ambient air pollutants and hazardous household factors with birth weight among Bedouin-Arabs

BackgroundAir pollution and meteorology exposures during pregnancy have been suggested to be associated with Birth Weight (BW). Yet, the individual medical background and close household environment is rarely addressed. We aimed to evaluate the independent association of BW with meteorological and air pollution exposures during pregnancy, in addition to individual, parental and household risk factors, among the Bedouin-Arab population in Southern Israel; a semi nomadic population, featured by low socio-economic levels and poor housing and household environment. MethodsIn a retrospective cohort study we enrolled pregnant women upon their arrival in the local hospital for delivery during December 2011–April 2013. We interviewed the women and collected data on socio-demographic characteristics, medical history and household environmental hazards. Air pollution (NO2, SO2, CO, Ozone and Particulate Matter <2.5 μ and 10 μ in diameter) and meteorological data (temperature, relative humidity), retrieved from 13 monitoring sites, were linked to each woman based on the proximity of her residential address. ResultsA total of 959 women were eligible for the study, half of them resided in temporary tribal localities. Ozone IQR elevation in the 3rd trimester was associated with 0.119 gr decrease in BW (95%CI −0.127 gr; −0.112 gr); temperature IQR elevation in the 3rd trimester was associated with 0.002 gr (95%CI −0.004 gr; −0.001 gr) decrease in BW. Waste in the house surroundings was associated with a decrease of 117.27 gr in BW (95%CI −209.19 gr; −25.34 gr). ConclusionAlthough exposure to high levels of temperature and O3 were associated with lower BW, the contribution of poor household environment indicators to BW reduction was substantially higher.

Elevated birth prevalence of conotruncal heart defects in a population with high consanguinity rate.

The aetiology of conotruncal heart defects is poorly understood and the birth prevalence varies geographically. The known risk factors for developing conotruncal heart defects are as follows: CHD in siblings, genetic chromosomal abnormalities, paternal age >30 years, high parity, low birth weight, prematurity, and maternal diabetes. The aim of this study was to characterise conotruncal heart defects, birth prevalence, mortality, and morbidity in the population of southern Israel, of whom 75% are Jewish and the rest are mostly Bedouin Arabs. The data were obtained from Soroka University Medical Center database of births and newborns. Conotruncal heart defects cases were identified by ICD9 codes. During 1991-2011, there were 247,290 singleton live births and 393 conotruncal heart defects in Soroka University Medical Center. The birth prevalence per 10,000 live births of tetralogy of Fallot, transposition of the great arteries, and truncus arteriosus was 9.5, 5, and 1.8, respectively. In the multivariate analysis, Bedouin descent (adjusted odds ratio 2.40, p35 years (1.66, p=0.004), and siblings with congenital heart defects (1.98, p=0.005) were associated with tetralogy of Fallot, and Bedouin descent (1.61, p=0.05), siblings with congenital heart defects (2.19, p=0.004), and diabetes mellitus (7.15, p<0.001) were associated with transposition of the great arteries. In a univariate analysis, Bedouin descent (p=0.004) and congenital heart defects in siblings (p<0.001) were associated with truncus arteriosus. We observed higher birth prevalence of conotruncal heart defects compared with the birth prevalence reported worldwide, specifically among the Bedouins, a population characterised with high consanguinity rate. Therefore, genetic counselling and early fetal echocardiograms should be encouraged, especially in high consanguinity rate populations. Naturally, further educational efforts are needed in order to decrease consanguinity and its related consequences.

Emergency situations and deaf people in Israel: Communication obstacles and recommendations.

The absence of the ability to hear sounds in deaf people is an obstacle to optimal communication in a predominantly hearing world. Emergency situations harbor sufficient challenge for the hearing person and pose even greater barriers for the deaf and hard of hearing. During disasters and emergency situations, deaf people have great difficulty in obtaining and sharing information, increasing their dependence on others. This article focuses on the experience of deaf people during a period of security threat, when missiles from the Gaza strip were aimed at the civilian population in Southern Israel, in 2009. The aim of this article is to illustrate the complexities that deaf citizens experienced, and describe their coping mechanisms. A qualitative study including 15 heterogeneous-background Deaf participants interviewed by a researcher that belongs to the deaf community using a multiple-method facilitated questionnaire. Data was analyzed using grounded theory methodology principles. Main categories that arose from data analysis were communication problems during emergencies, the pager as a questionable warning device about emergencies (due to timing and content/context issues of its use), and the implications of the location of deaf people at time of emergency. Various channels for conveying information should be examined and created in order to maximize the heterogeneous deaf community's ability to receive vital information during an emergency. Professional sign language interpreters are necessary during emergencies, helping to reduce both dependence on informal sources (such as family members, including minors, friends, neighbors, by-standers) and risk. The development of new technologies may bear potential help for deaf persons during emergencies. Being a socio-linguistic minority, it is recommended to ensure these technologies will be accessible to the whole deaf community.

P1-23 Analysis of changing effect of climate on health over long period of time: methodology and application

IntroductionRecently, analysis of health effects of climate change has become a global issue. This new and complicated problem calls for a new approach, since existing models cannot analyse changing effect...

Importance of ethnic foods as predictors of and contributors to nutrient intake levels in a minority population

To evaluate the role of ethnic foods as predictors of intake levels of selected nutrients that are important during pregnancy among the Bedouin Arab minority population in southern Israel, and to compare the main food predictors for Bedouin intakes of the selected nutrients with those for the region's Jewish majority population. Ethnic foods/recipes (n=122) reported in the Bedouin Nutrition Study (BNS) were added to a preexisting, validated Israeli food composition table using European Food Information Resource standard criteria. Food items reported by the 519 BNS participants were combined into 146 food groups that distinguished between existing foods and new ethnic recipes and were entered into a stepwise multiple regression model to identify the main predictors of intake levels of the selected nutrients. The results were compared with those of an identical analysis for the selected nutrients using 24 h recall data from the majority Jewish population. Over 80% of the BNS between-person variability in the intake of all selected nutrients was explained by 34 food groups, of which 13 (38.2%) were ethnic foods. Homemade whole wheat bread was a main predictor of intake levels for five of the eight selected nutrients, and other ethnic foods/recipes (for example, za'atar, leafy dark green vegetables and camel milk) emerged as predictors of iron, folate, calcium and ω-3 fatty acid intakes. Breads explained 60 and 44% of the between-person variation, and 38 and 36% of the total intakes of iron and zinc intakes in the BNS sample, respectively, whereas for the Jewish population, animal sources and fortified foods predominated as main predictors and contributors of these nutrients. The addition of ethnic foods to food composition databases is important, as some of these foods are main predictors of nutrient intake levels in ethnic minority populations. In turn, this should facilitate the development of more sensitive dietary assessment tools and more effective diet-based health interventions for ethnic minorities.

The rate of consanguineous marriages among parents of schizophrenic patients in the Arab Bedouin population in Southern Israel

Consanguinity may contribute to the incidence of schizophrenia in offspring despite the usually accepted polygenic model of schizophrenia inheritance. Bedouin Arab families in southern Israel have a high rate of cousin marriages as do families throughout most Arab societies. We studied consanguinity in the parents of schizophrenic patients admitted in a defined catchment area of southern Israel, compared to a control group of parents of all infants born to Bedouin mothers in this catchment area. There was a small but significant increase in the rate of cousin marriages among the parents of schizophrenia patients compared to parents of infant controls. These results are consistent with claims that inbreeding can contribute to the incidence of schizophrenia even as a polygenic illness. However, the absence of a better matched control group limits confidence in the results.

Symptoms of Posttraumatic Stress Disorder After Ritual Female Genital Surgery Among Bedouin in Israel

Ritual female genital surgery (RFGS), or female circumcision, is common among certain ethnic groups in Asia and Africa and describes a range of practices involving complete or partial removal of the female external genitalia for nonmedical reasons. Several studies in African populations, in which more severe forms of RFGS are performed, reported an increased prevalence of posttraumatic stress disorder and other psychiatric syndromes among circumcised women than among uncircumcised controls. Among the Bedouin population in southern Israel, RFGS has become a symbolic operation without major mutilation. However, in a study performed in 1999, Bedouin women after RFGS reported difficulties in mother-daughter relationships and trust. This pilot study assessed the mental health of Bedouin women from southern Israel after RFGS compared to age-matched controls without RFGS. The psychological impact of RFGS was assessed in 19 circumcised Bedouin women compared to 18 age-matched controls. The Post Traumatic Stress Disorder Scale, Symptom Checklist, Impact of Event Scale, and a demographics and background questionnaire were used to assess traumatization and psychiatric illnesses. The study was conducted from March to July 2007. No statistically significant differences were found between the 2 groups. The prevailing procedure of RFGS among the Bedouin population of southern Israel had no apparent effect on mental health.

The rate of consanguineous marriages among parents of schizophrenic patients in the Arab Bedouin population in Southern Israel

The rate of consanguineous marriages among parents of schizophrenic patients in the Arab Bedouin population in Southern Israel

Genetics of Arthrogryposis

Arthrogryposis multiplex congenita (AMC) is a heterogeneous group of congenital contracture syndromes, some of which are hereditary. To date, four genetic loci associated with autosomal recessive arthrogryposis syndromes have been identified using the powerful tools of genome-wide linkage analysis and homozygosity mapping. In the consanguineous inbred Bedouin population in southern Israel there is an unusually high incidence of hereditary arthrogryposis. We hypothesized the high incidence of this phenotype in this specific cohort might be due to a founder effect: a mutation that occurred several generations ago, spread throughout various tribes in that population in recent generations and causes the phenotype in its homozygous form. Using linkage analysis studies, we showed the hereditary arthrogryposis in those tribes does not stem from a single genetic defect. Thus, there is genetic heterogeneity of congenital arthrogryposis in this population: the same phenotype is caused by mutations in different genes, yet to be unraveled.

Utilization of Emergency Department Services by the Bedouin Population in Southern Israel

Excessive use of the emergency department (ED) is associated with increased costs and workload in the ED, patients' inconvenience and disruption of the continuity of care. The study's goal was to describe trends in ED utilization among Bedouins living in southern Israel. A retrospective cross-sectional study was conducted in primary care clinics in southern Israel. Patients included Bedouin and Jewish patients insured by Clalit Health Services. Data was retrieved from a central database. The number of visits to the ED and age-adjusted rates of ED visits during 2000-2003 were determined in the Bedouin vs. Jewish population. All visits that ended in hospitalization were excluded. Data was stratified according to patients' residence (semi-nomadic vs. urban Bedouins) and referral origin. Age-adjusted rates of ED visits decreased from 42.9/1000 patients/month in 2000 to 38.3/1000 patients/month in 2003. There were more ED visits in the Bedouin as compared to Jewish population (38.3/1000 vs. 21.8/1000 patients/month). The decrease in ED utilization was more prominent among adult semi-nomadic Bedouins (from 60.8/1000 to 40.3/1000 patients/month). The proportion of referrals by the family physician to ED significantly decreased (among urban Bedouins: from 54.3% to 43.2%, p<0.001; among semi-nomadic Bedouins: from 53.9% to 39.9%, p<0.001), while the proportion of selfreferrals and referrals from physicians other than the family physician increased. A decrease in ED utilization by the Bedouin population during the last years was demonstrated. Utilization of ED services is still increased as compared to the non-Bedouin population. Interventions to control excessive use of ED services in the Bedouin population are currently underway.