Jerusalem Residents Research Articles

Flexible compliance: utility and legitimacy in Jerusalem

ABSTRACT Disadvantaged residents in contested cities often mistrust and resist official authorities due to historical deprivation. However, their urgent needs compel them to approach municipal bodies, both formally and informally, exhibiting ‘flexible compliance’. Through interviews with Palestinians and a public opinion survey in Jerusalem, we analysed the preferences of Jewish-Israeli and Palestinian residents for public goods provision. Results indicate that Palestinian residents prefer unofficial institutions, but this varies by location. Inner-city and outer-city East Jerusalem residents prefer the municipal government, while those beyond the separation wall favour the community councils. We elucidate flexible compliance and propose municipal tools to address it.

Holocaust survivors: Health and longevity 70 years later.

Holocaust survivors (HS) alive today form a unique and disappearing population, whose exposure to systematic genocide occurred over 70 years ago. Negative health outcomes were widely documented prior to age 70. We examine the hypothesis that the experience of remote trauma continues to negatively affect health, functional status, and survival between the ages of 85-95. The Jerusalem Longitudinal Study (1990-2022) followed a representative sample of Jerusalem residents born 1920-1921, at ages 85, 90 and 95. Home assessment included medical, social, functional, and cognitive status, and mortality data. Subjects were classified: (1) HS-Camp (HS-C): survived slave-labor, concentration, or death camps; (2) HS-Exposed (HS-E): survived Nazi occupation of Europe; (3) Controls: European descent, outside Europe during WWII. We determined Hazards Ratios (HR), adjusting for gender, loneliness, financial difficulty, physical activity, ADL dependence, chronic ischemic heart disease, cancer, cognitive deficits, chronic joint pain, self-rated health. At ages 85 (n = 496), 90 (n = 524), and 95 (n = 383) the frequency of HS-C versus HS-E versus Controls was 28%/22%/50%, 19%/19%/62%, and 20%/22%/58%, respectively. No consistent significant morbidity differences were observed. Mortality between ages 85-90 and 90-95 years was 34.9% versus 38% versus 32.0%, and 43.4% versus 47.3% versus 43.7%, respectively, with no significant differences in survival rates (log rank p = 0.63, p = 0.81). Five-year mortality adjusted HRs were insignificant for HS-C and HS-E between ages 85-90 (HR 0.87, 95% CI 0.54-1.39; HR 1.14, 95% CI 0.73-1.78) and ages 90-95 (HR 0.72, 95% CI 0.39-1.32; HR 1.38, 95% CI 0.85-2.23). Seventy years following their trauma and suffering during the Holocaust, the significant impairments of health, function, morbidity, and mortality which have accompanied survivors throughout their entire adult life, were no longer observed. Indeed, it is likely that survivors living >85 years old represent a uniquely resilient population of people, whose adaptation to adversity has accompanied them throughout their lives.

Waterslide Architectural Masterpiece: A Descriptive Study of Sabilah Models in Palestine

The interest in water sabils was an ancient habit among the sultans and kings since ancient times, and it had a distinct character among Muslims, as the wealthy Muslims and philanthropists rushed to compete to build sabils to do good, and the princes, sultans, kings and rulers established the sabelah in the streets and alleys and in public places for the sake of reward and reward Therefore, the obligation of charitable giving in the form of charitable acts is numerous, and it was for stopping the aspirations, so what are the means? What is the purpose of its establishment in the Islamic and humanitarian community? An Islamic city is hardly devoid of one or several ways, because of the importance of these architectural installations in public life, and the charitable endowment siblings are among the works of charitable establishments and a form of spending for the sake of God and ongoing charity for the owner of the endowment, and it entails a large reward for the individual, and it falls under the ongoing charity And its reward for the sake of God, and its purpose is to serve Muslims. The history of the spread of the Sabila in Islamic societies, in its well-known form, dates back to the Ayyubid and Mamluk periods, and it increased in the Ottoman period more broadly and larger. Palestine was famous for its wide spread of water traps in the aforementioned periods, as well as spreads in the holy cities in order to provide water for the thirsty and the pilgrims to seek your rewards, and the Holy City of Jerusalem and the Al-Aqsa Mosque received the care of the benevolent Muslim rulers from the Mamelukes, Ayyubids and Ottomans, especially Sultan Suleiman the Magnificent, especially since the city of Jerusalem is less in it Water sources, and many fountains were built to provide water to the residents of Jerusalem and to the worshipers coming to it. The water was supplied from Bark Solomon from the south from the Bethlehem area to the Al-Aqsa Mosque squares. In the old city of Nablus, which is located in the north of the West Bank, many Aselah have spread widely.

The Role of Jerusalemites in Preserving the Palestinian Identity and confronting the Zionist Occupation: 1967-1987

عقب الاحتلال الصهيوني للمدينة المقدسة قام العدو الصهيوني ممثلا بحكومته وجيشه ومؤسساته بجملة من الأعمال التي تصب مجملها في إطار عملية التغيير الديموغرافي والمسخ الحضاري للمدينة المقدسة، بقصد تحويلها إلى منطقة يهودية خالصة. إلا أن سكان مدينة القدس الشريف لم يستسلموا لهذا الواقع الجديد الذي فرضه الاحتلال، بل قاموا بالرد عليه بوسائل مختلفة، وقاوموا بشدة ممارسات الصهاينة، ووقفوا في وجه المحتل دفاعا عن مدينتهم المقدسة وهويتهم المقدسية، وعلى كافة المستويات التعليمية والثقافية والاقتصادية والاجتماعية والدينية. تتناول الدراسة الوسائل التي اتبعها المقدسيون للحفاظ على هويتهم الوطنية وانتمائهم للأرض المقدسة، ومواجهة عدو غاصب محتل يسعى لبسط سيطرته على معظم الأراضي الفلسطينية وخاصة مدينة القدس، وبوسائل عدة منها رفض البرامج التعليمية الصهيونية، المقاومة السلمية ودور المؤسسات الفلسطينية بالقدس في ذلك، والمقاومة المسلحة والانتفاضة الجماهيرية التي أصبحت من أهم وسائل مواجهة العدو الصهيوني بعد عدم الوصول إلى نتائج إيجابية باستخدام الوسائل السلمية في المقاومة.

Correlates of gastroenterology health-services utilization among patients with gastroesophageal reflux disease: a large database analysis

BackgroundGastroesophageal reflux disease (GERD) is associated with high utilization of health care services. Diagnostic tests usually are not required to establish GERD diagnosis, but endoscopy is recommended for patients with alarm symptoms such as dysphagia and unintentional weight loss, and those whose symptoms are not relieved by proton pump inhibitors (PPIs) therapy. Evidence on the correlates of utilization of gastroenterology health services among GERD patients is limited. The study aim was to examine associations of patient and physician’s characteristics with high utilization of gastroenterology services.MethodsIn a cross-sectional study using the database of the second largest integrated care organization in Israel, data of all adult GERD patients (N = 75,219) in 2012–2015 were analyzed. High utilization of services was assessed using two dependent variables analyzed separately: undergoing two or more gastroscopies or having six or more visits to a gastroenterology consultant during the study-period.ResultsOverall, 11,261 (15.0%) patients had two or more gastroscopies and 23,703 (31.5%) had six or more visits to a gastroenterology consultant. The likelihood of high utilization of gastroscopy increased with age; in immigrants from the Former Soviet Union versus patients who were born in Israel; residents of Jerusalem, the south, the north and Haifa districts versus the center district; in patients with high PPI purchases, and in patients who belonged to clinics in which the physician-manger had no board certification. The correlates were similar for visits to a gastroenterology consultant.ConclusionsPatient and physician’s characteristics were related to high utilization of gastroenterology services among GERD patients. The associations with age and country of birth might reflect more severe disease. The regional differences warrant further research and interventions at the district level. Training in gastroenterology of primary care physicians without a board certification is warranted.

Mode of delivery and offspring adiposity in late adolescence: The modifying role of maternal pre-pregnancy body size.

ObjectiveTo study the association between mode of delivery and offspring BMI in late adolescence in a large cohort that predated the obesity epidemic, and assess the role of maternal pre-pregnancy BMI (ppBMI) in this association.Study designWe conducted a historical prospective study in the setting of the Jerusalem Perinatal Study (JPS), a population-based cohort that includes all 17,003 births to residents of West Jerusalem, between 1974 and 1976. Offspring’s BMI at age 17 was obtained upon army recruitment and was available for 11,001 of cohort participants. The associations were examined using logistic regressions, adjusting for socio-demographic characteristics and for proxies for indication for C-Section birth. Analyses were then stratified by quartiles of ppBMI.ResultsC-Section was associated with offspring overweight/obesity, with adjusted OR of 1.44 (95%CI:1.14–1.82). Significant interaction of ppBMI with mode of delivery was observed, such that the associations of C-Section with overweight/obesity were limited to the upper quartile of ppBMI (adjusted OR = 1.70, 95%CI:1.18–2.43). Restricting the analyses to singleton first births and excluding pregnancies complicated with toxemia and gestational diabetes yielded similar findings.ConclusionsC-Section was positively associated with being overweight/obese at age 17. Importantly, ppBMI modified this association, with a significant association between C-Section and overweight/obesity evident only among offspring born to mothers in the highest ppBMI quartile. In light of the growing rates of obesity in women of reproductive age, these results should be considered in patient-doctor shared decisions related to selection of mode of delivery, in the absence of a clear medical indication.

Prevalence and determinants of serological evidence of atrophic gastritis among Arab and Jewish residents of Jerusalem: a cross-sectional study

ObjectiveUnderstanding the correlates of premalignant gastric lesions is essential for gastric cancer prevention. We examined the prevalence and correlates of serological evidence of atrophic gastritis, a premalignant gastric condition, using...

Correlates of infection with Helicobacter pylori positive and negative cytotoxin-associated gene A phenotypes among Arab and Jewish residents of Jerusalem.

We examined the prevalence and correlates of Helicobacter pylori (H. pylori) infection according to cytotoxin-associated gene A (CagA) phenotype, a main virulence antigen, among the ethnically diverse population groups of Jerusalem. A cross-sectional study was undertaken in Arab (N = 959) and Jewish (N = 692) adults, randomly selected from Israel's national population registry in age-sex and population strata. Sera were tested for H. pylori immunoglobulin G (IgG) antibodies. Positive samples were tested for virulence IgG antibodies to recombinant CagA protein, by enzyme-linked immunosorbent assay. Multinomial regression models were fitted to examine associations of sociodemographic factors with H. pylori phenotypes. H. pylori IgG antibody sero-prevalence was 83.3% (95% confidence interval (CI) 80.0%-85.5%) and 61.4% (95% CI 57.7%-65.0%) among Arabs and Jews, respectively. Among H. pylori positives, the respective CagA IgG antibody sero-positivity was 42.3% (95% CI 38.9%-45.8%) and 32.5% (95% CI 28.2%-37.1%). Among Jews, being born in the Former Soviet Union, the Middle East and North Africa, vs. Israel and the Americas, was positively associated with CagA sero-positivity. In both populations, sibship size was positively associated with both CagA positive and negative phenotypes; and education was inversely associated. In conclusion, CagA positive and negative infection had similar correlates, suggesting shared sources of these two H. pylori phenotypes.

Sero-prevalence of Helicobacter pylori CagA immunoglobulin G antibody, serum pepsinogens and haemoglobin levels in adults

Associations observed of Helicobacter pylori infection with haemoglobin levels are inconsistent. We examined associations of H. pylori sero-prevalence and serum pepsinogens (PGs), as non-invasive markers of atrophic gastritis, with haemoglobin levels. A cross-sectional study was undertaken among 654 Jewish and 937 Arab residents of Jerusalem, aged 25–78 years, randomly selected from Israel’s national population registry in age-sex and population strata. Sera were tested for H. pylori IgG, cytotoxin–associated gene A (CagA) antigen IgG antibody and PGs levels. Multivariable models were fitted to account for confounders. Participants with atrophic gastritis (PGI < 30 μg/L or a PGI: PGII < 3.0) had lower haemoglobin levels than those without: beta-coefficient −0.34 (95% CI −0.59, −0.09); in men −0.27 (95% CI −0.67, 0.12), and in women −0.43 (95% CI −0.74, −0.12). Lower haemoglobin levels were noted in persons with CagA antibody than in those H. pylori sero-negative or H. pylori-CagA sero-negative: beta-coefficient −0.14 (95% CI −0.29, 0.01). Anaemia was more common among women and men with than without atrophic gastritis: adjusted OR 2.58 (95% CI 1.48, 4.48) and 1.52 (95% CI 0.59, 3.95), respectively. In conclusion, independent of known correlates, atrophic gastritis and apparently CagA sero-positivity, a marker of H. pylori virulent strains, are associated with lower haemoglobin levels.

Rapid shortening of leukocyte telomeres is associated with poorer pulmonary function among healthy adults.

The study aimed to examine the association between leukocyte telomere length (LTL) attrition over 13 years (between mean age 30 and mean age 43) and lung function at mean age 50. In a longitudinal observational study LTL was determined twice on a population-based sample of 481 Jewish residents of Jerusalem at mean ages 30 and 43 years. Pulmonary function was determined at mean age 50 years. Multiple linear regression and multivariable ordinal logistic modeling were applied. Akaike's Information Criteria (AIC) was used for model selection. RESULTS: In unadjusted analysis, Forced Expiratory Volume in 1 s (FEV1%) was inversely associated with the LTL attrition rate (standardized beta = -0.110, P = 0.023) but not with the baseline LTL. Forced Vital Capacity (FVC%) was inversely associated with the LTL attrition rate (standardized beta = -0.108, P = 0.026). Multivariable adjustment mildly attenuated the association with the LTL attrition rate (standardized beta = -0.100, P = 0.034 for FEV1% and -0.093, P = 0.042 for FVC%). This would be consistent with a 3.3% [95% Confidence Interval (CI): 3.1-3.4%] decline in FEV1% and a 3.0% (95% CI:2.8-3.1%) decline in FVC% per year. In linear regression models the LTL-pulmonary function association did not differ by sex, social mobility, pack-years smoking exposure, or level of GlycA, a novel systemic inflammatory marker. Greater LTL attrition between mean age 30 and mean age 43 was associated with poorer lung function at mean age 50 years. The availability of longitudinal data on LTL attrition for the first time in the current study strengthens the case for LTL change preceding change in lung function.

How religiosity affects the attitudes of communities towards tourism in a sacred city: The case of Jerusalem

Sacred cities are not only venerable focal point for tourists; they also mainly attract believers to take up residence in them, creating potential tension between residents and tourists. This study examines the role of religiosity as an influence on the attitudes of communities towards tourism. We examine Jerusalem as a case study, a city sacred to three religions: Judaism, Christianity, and Islam. We focus on the practical inevitability of Jewish resident interaction with a variety of tourists. A survey was used to gauge the impact of tourism on social, economic, and environmental conditions. Participants were asked to identify their level of religious observance. Of the 1776 Jewish residents who participated in the survey, 200 defined themselves as ultra-orthodox, 994 as orthodox or traditional, and the remaining 496 as secular. Socio-demographic variables were measured, including amount of financial benefit gained from tourism. Overall, subjects acknowledged tourism as a contributor to personal benefit and the prosperity of Jerusalem. As such, our findings indicate that religiosity exerts an important influence on community attitudes. Consistent with Social Distance Theory, we found that the more extreme the religious group, measured as self-segregation from external influence, the less affirmative they were towards tourism. The findings also suggest that individuals who profit financially from tourism were more affirmative towards tourism. This connection is explained according to Social Exchange Theory (SET). The latter variable interacts with religious characteristics, suggesting a more complex picture of Jerusalem residents. These results point to a major contribution of religiosity to perceptions of tourism, the implications of which should be considered when planning urban developments, especially those linked with sacred sites or landmarks.

Associations of social environment, socioeconomic position and social mobility with immune response in young adults: the Jerusalem Perinatal Family Follow-Up Study

ObjectivesImmune response to cytomegalovirus (CMV) impacts adult chronic disease. This study investigates associations of childhood and adulthood social environment, socioeconomic position (SEP) and social mobility with CMV response in young...

Cardiac structure and function predicts functional decline in the oldest old.

Background This study examined the association between cardiac structure and function and the deterioration in activities of daily living (ADLs) in an age-homogenous, community-dwelling population of patients born in 1920-1921 over a five-year follow-up period. Design Longitudinal cohort study. Methods Patients were recruited from the Jerusalem Longitudinal Cohort Study, which has followed an age-homogenous cohort of Jerusalem residents born in 1920-1921. Patients underwent home echocardiography and were followed up for five years. Dependence was defined as needing assistance with one or more basic ADL. Standard echocardiographic assessment of cardiac structure and function, including systolic and diastolic function, was performed. Reassessment of ADLs was performed at the five-year follow-up. Results A total of 459 patients were included in the study. Of these, 362 (79%) showed a deterioration in at least one ADL at follow-up. Patients with functional deterioration had a significantly higher left ventricular mass index and left atrial volume with a lower ejection fraction. There was no significant difference between the diastolic parameters the groups in examined. When the data were examined categorically, a significantly larger percentage of patients with functional decline had an abnormal left ventricular ejection fraction and left ventricular hypertrophy. The association between left ventricular mass index and functional decline remained significant in all multivariate models. Conclusions In this cohort of the oldest old, an elevated left ventricular mass index, higher left atrial volumes and systolic, but not diastolic dysfunction, were predictive of functional disability.

Quality of life for families living in East Jerusalem's Kafr ‘Aqab urban sprawl: a qualitative study

BackgroundSince 1967, about 14 000 Palestinians have had their Jerusalem residency rights revoked by Israel, and thousands more struggle to maintain their permanent residency. As stipulated by the “centre of life” policy, Jerusalem residents must provide regular proof of residence within Israeli-defined municipal boundaries. In 2003, an amendment to the Israeli Nationality Law prohibited Jerusalem residents who were married to Palestinians from the occupied Palestinian territories to apply for residency rights to live in Jerusalem. The location of Jerusalem's Kafr ‘Aqab neighbourhood was physically separated from the city by the Separation Wall and Israeli military checkpoint, but was included within Israeli-defined administrative Jerusalem municipal boundaries. This inclusion allowed families who held different legal status to live together and maintain their Jerusalem residency. We aimed to investigate the effect of disrupted family life and insecurity on health and wellbeing of Palestinians living in this area. MethodsIn-depth qualitative interviews with 25 women were done with a locally-developed semistructured interview schedule that explored living conditions and quality of life. We selected participants through purposeful-convenience sampling methods to include Palestinians with Jerusalem residency who were married to residents of the occupied Palestinian territory, and vice versa. The Institute of Community and Public Health (ICPH) Research Ethics Committee granted ethical approval. Data were analysed by reading and rereading transcripts for recurring themes and subthemes. FindingsResidents of Kafr ‘Aqab were exposed to various life stressors, including anxiety resulting from legal and administrative battles to maintain residency, increased financial strains, economic exploitation, and the distress of relocating to areas with poor living-conditions to maintain Jerusalem residency, and at the same time living with spouses who are residents of the occupied Palestinian territory. Most women expressed strong feelings of insecurity for the future of their families' residency, given Kafr ‘Aqab's situation outside the Separation Wall. Heightened by fear of local Palestinian investigators working with the National Insurance Institute and perceived increase in crime, some women noted that they increasingly mistrusted newcomers and did not feel part of a community or integrated social fabric. Physical barriers (ie, the Qalandia-checkpoint and Separation Wall) restrict access to families and social support, and pose obstacles to access health-care services in Jerusalem. Most women reported harmful environmental conditions (including filth, sewage, and water concerns) because of increased urban sprawl and inadequate access to municipality services, despite taxation. InterpretationThe Kafr ‘Aqab predicament attests to poor conditions to live in for a vulnerable group, ruled with ambiguity and uncertainty, existing within an already volatile context. As a result, this raises concerns of the effects on health and wellbeing of families living in these conditions. FundingReproductive Health Working Group, Arab World and Turkey.

The Threat of BDS

The Threat of BDS

Cardiac Structure and Function and Frailty in Subjects Aged 85 and 86 Years

Frailty is a biologic syndrome reflecting a state of decreased physiological reserve of increasing importance in cardiovascular disease given the aging of the population. The relation between frailty and indexes of cardiac structure and function remains unclear, particularly in the "oldest old." The objective of this study was to examine the association between cardiac function and frailty in an age-homogenous, community-dwelling population of subjects aged 85 and 86 years. Subjects were recruited at ages 85 to 86 from the Jerusalem Longitudinal Cohort Study that has followed an age-homogenous cohort of Jerusalem residents. Subjects underwent echocardiography at their place of residence with standard assessment of cardiac structure and function. Frailty was defined according to the "phenotype of frailty" including at least 3 of the following: weakness, slowness, low physical activity level, exhaustion, and weight loss; 405 subjects (193 men and 212 women) were enrolled in the study. Subjects defined as frail had significantly lower ejection fraction compared with the non-frail group (53.7 ± 0.09% vs 56.4 ± 0.09%; p <0.04). In addition, frail subjects had increased LV mass index (130.6 ± 36.2g/m(2) vs 119.2 ± 31.1g/m(2); p <0.03) and LA volume index (41.9 ± 14.7cm(3)/m(2) vs 36.7 ± 13.1cm(3)/m(2); p <0.001). Indexes ofdiastolic function (E/e)' were not significantly different in the 2 groups (11.5 vs 11.8; p=NS). In this age-homogenous cohort of the oldest old, structural changes and indexes of systolic but not diastolic function were associated with frailty.

Small and medium sized HDL particles are protectively associated with coronary calcification in a cross-sectional population-based sample

Background and aimsFailure of trials to observe benefits by elevating plasma high-density lipoprotein cholesterol (HDL-C) has raised serious doubts about HDL-C’s atheroprotective properties. We aimed to identify protective HDL biomarkers by examining the association of nuclear magnetic resonance (NMR) measures of total HDL-particle (HDL-P), large HDL-particle, and small and medium-sized HDL-particle (MS-HDL-P) concentrations and average HDL-particle size with coronary artery calcification (CAC), which reflects the burden of coronary atherosclerosis, and compare with that of HDL-C. MethodsUsing a cross-sectional design, 504 Jerusalem residents (274 Arabs and 230 Jews), recruited by population-based probability sampling, had HDL measured by NMR spectroscopy. CAC was determined by multidetector helical CT-scanning using Agatston scoring. Independent associations between the NMR measures and CAC (comparing scores ≥100 vs. <100) were assessed with multivariable binary logistic models. ResultsComparing tertile 3 vs. tertile 1, we observed protective associations of HDL-P (multivariable-adjusted OR 0.42, 95% CI 0.22–0.79, plinear trend = 0.002) and MS-HDL-P (OR 0.36, 95% CI 0.19–0.69), plinear trend = 0.006 with CAC, which persisted after further adjustment for HDL-C. HDL-C was not significantly associated with CAC (multivariable-adjusted OR 0.59, 95% CI 0.27–1.29 for tertiles 3 vs. 1, plinear trend = 0.49). Large HDL-P and average particle size (which are highly correlated; r = 0.83) were not associated with CAC: large HDL-P (OR 0.77, 95% CI 0.33–1.83, plinear trend = 0.29) and average HDL-P size (OR 0.72, 95% CI 0.35–1.48, plinear trend = 0.58). ConclusionsMS-HDL-P represents a protective subpopulation of HDL particles. HDL-P and MS-HDL-P were more strongly associated with CAC than HDL-C. Based on the accumulating evidence, incorporation of MS-HDL-P or HDL-P into the routine prediction of CHD risk should be evaluated.

Who gets to cross the border? The impact of mobility restrictions on labor flows in the West Bank

This paper examines the impact of labor mobility restrictions such as border closures, physical obstacles and unequally accessed ID cards and work permits on the labor flows of West Bank residents. The results demonstrate that for Jerusalem residents, mobility restrictions reduce out-migration but they are much more pronounced in impeding out-migration to Israel proper than to Israeli settlements. Additionally, an increase in the number of border closures per quarter has a positive and significant impact on the odds of facing unemployment for all groups, but is especially high for migrant workers residing outside of Jerusalem. A lower bound estimate of the economic cost of a 50day increase in the number of border closures (1.78 standard deviations) per quarter is about USD 1.7 million per day in the subsequent quarter. The paper also concludes that the determinants of out-migration differ from those of return-migration. For example, while border closures and unemployment status during previous visits are strong determinants of out-migration, the decision to return is driven by relatively low wages and lacking the necessary legal documentation to enter Israel. The findings in this paper are consistent with international studies that ascribe inefficiency in labor markets to restrictions on labor mobility across regions.

Respiratory hospitalizations of children and residential exposure to traffic air pollution in Jerusalem.

Although exposure to traffic-related air pollution has been reported to be associated with respiratory morbidity in children, this association has not been examined in Israel. Jerusalem is ranked among the leading Israeli cities in transport-related air pollution. This case-control study examined whether pediatric hospitalization for respiratory diseases in Jerusalem is related to residential exposure to traffic-related air pollution. Cases (n=4844) were Jerusalem residents aged 0-14 years hospitalized for respiratory illnesses between 2000 and 2006. These were compared to children admitted electively (n=2161) or urgently (n=3085) for non-respiratory conditions. Individual measures of exposure included distance from residence to nearest main road, the total length of main roads, traffic volume, and bus load within buffers of 50, 150, and 300m around each address. Cases were more likely to have any diesel buses passing within 50m of their home (adjusted odds ratios=1.16 and 1.10, 95% confidence intervals 1.04-1.30 and 1.01-1.20 for elective and emergency controls, respectively). Our findings indicated that older girls (5-14) and younger boys (0-4) had increased risks of respiratory hospitalization, albeit with generally widened confidence intervals due to small sample sizes. Our results add to the limited body of evidence regarding associations between diesel exhaust particles and respiratory morbidity. The findings also point to possible differential associations between traffic-related air pollution and pediatric hospitalization among boys and girls in different age groups.

Lower pon1 lactonase activity explains part of the increased cardiovascular risk among arab versus jewish residents of jerusalem

Objectives: Coronary heart disease incidence and mortality in Jerusalem is substantially higher in the Arab than the Jewish residents. PON1, carried by HDL, protects LDL and macrophages from oxidation via its lactonase activity, which is considered its physiological, cardioprotective function. In this first report we focus on hypothesized differences in PON1 functional phenotype and lactonase activity between Arab and Jewish residents of Jerusalem that may contribute to the increased risk among Arabs.