Israel Journal of Health Policy Research最新文献

{"title":"Qualitative insights into nurses' emotional and functional experiences in the 2023 military humanitarian mission to Turkey.","authors":"Sheli Shilman-Nomeisky, Angela Ruban, Irit Bluvstein, Ronen Segev","doi":"10.1186/s13584-026-00747-2","DOIUrl":"10.1186/s13584-026-00747-2","url":null,"abstract":"<p><p>BACKGROUND: Humanitarian aid delegations play a crucial role in assisting victims of disasters worldwide. Nursing and medical teams are involved in treating injuries and illnesses, promoting health, and providing emotional support to patients. Such teams often have long-term emotional, social, and functional impacts. Those impacts can include post-traumatic stress disorder, disrupted social relationships, and decreased professional efficacy. This paper examines the emotional, social, and professional experiences of nurses participating in the Israeli Defence Forces’ (IDF) 2023 humanitarian operation in Turkey and their coping mechanisms. It also examines their perceptions of how this experience may have influenced their response to the events of October 7th and the ongoing war. METHODS: Twenty-seven nurses participated in a personal information form and the Life Events Checklist-5 (LEC-5) questionnaire, which evaluates previous trauma and life events. In-depth semi-structured interviews were conducted through Zoom. Data analyses were conducted using the seven-step method of the Colaizzi approach, and the research followed the COREQ guidelines to ensure comprehensive reporting and rigour. RESULTS: The discussion has revealed four themes and ten subthemes, which were identified and grouped into the following categories: emotional well-being, social and professional functioning, and coping with disaster exposure. The participants’ narratives highlight their remarkable resilience. They were able to achieve emotional balance, address emotional difficulties, increase functional resilience, and cope with disruptions in their family life. Professional resilience, competence, and challenges at work were also discussed. Some of the coping mechanisms that were employed were the use of different types of support, self-control, and the use of psychological support. They recalled the effects of the October 7th events and the Iron Swords War on their lives. The participants provided information about how to deal with natural and human-induced disasters. CONCLUSIONS: The paper highlights the emotional, social, and professional implications of humanitarian aid for nurses and how they cope. To ensure that subsequent experiences with delegation are enhanced, it is crucial to provide continuous psychological support to delegates both during and after their missions. Equally important are operational improvements, such as creating support groups, hiring professional translators, and implementing straightforward operational protocols, which can significantly enhance nurses’ experiences. </p>","PeriodicalId":46694,"journal":{"name":"Israel Journal of Health Policy Research","volume":"15 1","pages":"3"},"PeriodicalIF":2.4,"publicationDate":"2026-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12849552/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146067658","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Geographic access to emergency pediatric dental care during COVID-19: a population-based study from Israel.","authors":"Dana Atia Joachim, Ephraim Shapiro, Thabet Asbi, Doron Haim, Michael V Joachim","doi":"10.1186/s13584-026-00745-4","DOIUrl":"10.1186/s13584-026-00745-4","url":null,"abstract":"<p><strong>Background: </strong>The COVID-19 pandemic created unprecedented challenges for healthcare systems, particularly affecting specialized services like pediatric dental care. This study examined geographic disparities in emergency dental service access for children during the first COVID-19 lockdown in Israel.</p><p><strong>Methods: </strong>We analyzed data from a major healthcare provider serving 25% of Israel's population, comparing 6,024 emergency dental visits of children under 12 across three time periods: pre-pandemic (March-May 2019), first lockdown (March-May 2020), and post-lockdown (March-May 2021). Using spatial analysis methods, we evaluated the distribution and accessibility of emergency dental services across four main geographic regions through metrics including Load Ratio (LR), Geographic Availability Index (GAI), and Rate of Change in Service Utilization (ROCSU).</p><p><strong>Results: </strong>During the lockdown, emergency visits decreased by 40.2% compared to the pre-pandemic period, with significant regional variations ranging from 31.2% in the Northern region to 44.8% in the Central region. The mean age of children seeking emergency care during lockdown (6.2 years) was significantly lower than in both pre-pandemic (7.1 years) and post-lockdown periods (6.8 years). Analysis revealed substantial regional disparities in service burden, with the highest Load Ratio in the Central region (1.86) and lowest in the Northern region (1.24), despite the Central region having the highest Geographic Availability Index (2.46). The Jerusalem area had the highest proportion of invasive treatments (40.4%) and swelling/abscess cases (22.4%). Ultra-Orthodox neighborhoods demonstrated distinct utilization patterns, with a lower decrease in emergency visits (29.8-36.8%) compared to the national average (40.2%).</p><p><strong>Conclusions: </strong>This study identified significant geographic inequities in emergency dental care access during crisis periods, with a paradoxical relationship between service availability and utilization across regions. Our analysis suggests that emergency dental service planning should incorporate strategic facility placement to minimize travel barriers, consideration of population-specific utilization patterns, and balanced resource allocation that maintains proportional service capacity across diverse geographic contexts. These findings provide important insights for health system preparedness to ensure equitable access to essential pediatric dental services during future crises.</p>","PeriodicalId":46694,"journal":{"name":"Israel Journal of Health Policy Research","volume":"15 1","pages":"2"},"PeriodicalIF":2.4,"publicationDate":"2026-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12794264/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145953195","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The personal and the public in residents' burnout: a cross-sectional investigation.","authors":"Yehonatan Sonvani, Shoval Madmon Sarikov, Tony Gutentag","doi":"10.1186/s13584-025-00742-z","DOIUrl":"10.1186/s13584-025-00742-z","url":null,"abstract":"<p><p>BACKGROUND: Medical residents are especially prone to burnout. Burnout has historically been viewed as a work-related condition. Burnout also occurs in life domains other than work, such as relationships and parenthood. The present investigation takes a holistic view of resident burnout, considering both public (i.e., work-related) and personal (i.e., couple, parental) burnout. The present investigation examines the interplay between resident burnout in different life domains, their antecedent (i.e., work-family conflict), and outcomes (i.e., job, couple, and parental satisfaction; turnover and breakup intentions). METHODS: A pre-registered, cross-sectional study using questionnaires was conducted with 200 residents (M = 34.27 years, SD = 4.18; 63% female) in relationships and with children. We assessed work-related, couple, and parental burnout. The burnout antecedent was work-family conflict. The burnout outcomes included job, couple, and parental satisfaction, as well as turnover and breakup intentions. RESULTS: As hypothesized, greater work-related burnout was associated with greater personal burnout. Work-family conflict was associated with higher levels of burnout, both work-related and personal. Higher work-related burnout was associated with lower job satisfaction and higher turnover intentions, showing domain-specificity. Higher couple burnout was associated with lower relationship satisfaction and higher breakup intentions, showing domain-specificity. Greater parental burnout was associated with lower parental satisfaction, as expected. However, this association was not domain-specific, contrary to the prediction: parental satisfaction was associated with all forms of burnout to the same extent (i.e., parental, couple, work-related). CONCLUSIONS: The findings shed light on the less-spoken, personal aspect of resident burnout. Burnout was domain-specific in some life domains (i.e., work, romantic relationship) but also spilled over from one life domain into another (i.e., parenthood). These findings underscore the importance of adopting a holistic bio-psycho-social perspective on residents’ well-being. Resident well-being is not only an individual matter but also a strategic priority for building a resilient, high-performing, and sustainable health workforce. </p>","PeriodicalId":46694,"journal":{"name":"Israel Journal of Health Policy Research","volume":"15 1","pages":"1"},"PeriodicalIF":2.4,"publicationDate":"2026-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12766938/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145901299","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improving blood culture procurement: a prospective 5-year hospital-wide study.","authors":"Shmuel Benenson, Miriam Dreyer, Bath Sheva Ezagui, Ilana Dery, Todd Zalut, Naama Bagrish, Rona Lujan, Marc V Assous, Amos M Yinnon, Oshrat Ayalon","doi":"10.1186/s13584-025-00744-x","DOIUrl":"10.1186/s13584-025-00744-x","url":null,"abstract":"<p><strong>Background: </strong>Appropriate procurement of blood cultures (BC) is essential for diagnosis of bacteremia and susceptibility testing. This includes (1) adequate preparation of the venipuncture site to minimize contamination; (2) obtaining ≥ two sets with a time interval before starting antibiotics. Although these recommendations are standard since the 1960s, adherence is far less than expected - which may adversely impact on the management of bacteremic patients.</p><p><strong>Aims of study: </strong>This single-center study conducted in Shaare Zedek Medical Center aimed to decrease the proportion of contaminated BCs and to increase the percentage of obtaining two sets of BC/ blood-culture-taking episode.</p><p><strong>Methods: </strong>Determination of both markers at baseline, then monthly for one year, then subsequently on a quarterly basis; showing data from all departments in real-time to all department directors; and providing short educative lectures during departmental staff meetings, at baseline and after 1-2 years. These markers were adopted as one of the hospital-wide quality measures.</p><p><strong>Results: </strong>In the 20-year period 2000-2019 more than 1 million BCs were obtained, of which 70% were from patients ≤ 72 h in hospital. During the 5-year study (2020-2024), the percent of blood-culture-taking episodes from which two culture sets were obtained increased annually by ± 16% from a baseline of 27% (9010/33306) in 2020, to 46% (18462/40191) in 2024 (Incidence Rate Ratios, IRR 1.16 [95%CI 1.13-1.18], p < 0.001). This improvement was observed in almost all departments and was especially profound in the emergency department (ED), starting at a baseline of 19% (1979/10326) and increasing to 53% (5304/9915)(IRR 1.33 [95%CI 1.27-1.39], p < 0.001). During the same period, the annual proportion of false-positive BCs, from which only contaminants were isolated, decreased annually by 18% from 2.4% (1592/65230) in 2020 to 1.3% (895/68991) in 2024 (IRR 0.82 [95%CI 0.77-0.88], p < 0.001). This improvement was observed in all departments: in the emergency department, this rate decreased from 3.3% (676/20529) to 1.56% (272/17459) (IRR 0.79 [95%CI 0.75-0.83], p < 0.001).</p><p><strong>Conclusion: </strong>A simple educational intervention, combined with meticulous data mining and presentation of each department's results, with comparison of all other departments, led to significant and sustained improvement in measurable markers.</p>","PeriodicalId":46694,"journal":{"name":"Israel Journal of Health Policy Research","volume":"14 1","pages":"81"},"PeriodicalIF":2.2,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12754872/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145865904","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The majority of opioid prescriptions in Israel between 2010 and 2020 involved a small minority of physicians and of patients: policy implications.","authors":"Ehud Kaliner, Matan J Cohen, Adam J Rose, Reuven L Dressler","doi":"10.1186/s13584-025-00743-y","DOIUrl":"10.1186/s13584-025-00743-y","url":null,"abstract":"<p><strong>Background: </strong>We sought to examine patterns of opioid prescriptions in Israel, focusing on the extent to which patients received prescriptions from multiple physicians and physicians prescribed opioids to few or many patients.</p><p><strong>Methods: </strong>We conducted a historical cohort analysis using a data repository of Clalit Health Services (CHS), Israel's largest health maintenance organization (serving about five million individuals), between 2010 and 2020. We included all non-oncological adult patients registered with CHS who received opioids during the study period. We examined the number of physicians prescribing opioids to each patient and the number of patients prescribed opioids per physician. We also assessed the difference in opioid prescription patterns based on whether patients were registered with the prescribing physicians.</p><p><strong>Results: </strong>During the study period, 868,499 adult patients filled 5,600,598 opioid prescriptions. Half of the patients received opioid prescriptions from a single physician, filling 3% of the total morphine milligram equivalents (MME) dispensed. In contrast, 11% received opioid prescriptions from more than five physicians, filling 85% of all MME dispensed. There were 9008 physicians who prescribed opioids in 2010, and 15,486 in 2020. The percentage of physicians prescribing opioids to more than 50 patients/year increased from 7% in 2010 to 12% in 2020. The proportion of MMEs prescribed by those physicians increased from 36% in 2010 to 81% in 2020.</p><p><strong>Conclusion: </strong>We found that a small number of patients received the great majority of opioids, and a small number of physicians prescribed the great majority of opioids. Based on our results, we suggest policy options that would have minimal impact on most patients and most prescribers but would make a meaningful contribution to limiting opioid overprescription.</p>","PeriodicalId":46694,"journal":{"name":"Israel Journal of Health Policy Research","volume":"14 1","pages":"80"},"PeriodicalIF":2.2,"publicationDate":"2025-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12751447/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145858167","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lessons from a large national \"hospital at home\" program.","authors":"Alexander Lustman, Talish Razi, Maya Lerner Shikory, Naama Katz, Ruth Baruch, Shlomit Yaron, Ronen Arbel, Doron Netzer","doi":"10.1186/s13584-025-00741-0","DOIUrl":"10.1186/s13584-025-00741-0","url":null,"abstract":"<p><p>BACKGROUND: Hospital at Home (HAH) is a potential solution to the increasing demand for hospital beds, but concerns remain about its scalability. This study examines safety, effectiveness, and patient satisfaction in a large-scale HAH program. METHODS:  This retrospective cohort study utilized data from Clalit Health Services (CHS). The study population included all patients participating in the HAH program during 2022 who were discharged with a primary diagnosis of pneumonia, congestive heart failure, urinary tract infection, or cellulitis. These individuals were matched with patients admitted to general medical wards, and logistic regression analysis was performed to evaluate the association between admission type and outcomes. The primary safety endpoint was all-cause mortality at 30 days, while the primary effectiveness endpoint was rehospitalization within 30 days. Patient experience was measured using a telephone questionnaire. RESULTS: A total of 3,335 HAH patients were matched to 3,335 hospital patients. At 30 days, mortality was 192 (5.8%) for HAH patients and 305 (9.1%) for hospital patients, with an adjusted odds ratio of 0.6 (CI 0.49–0.73, P < 0.001). Readmissions at 30 days were 435 (13%) among HAH patients and 526 (16%) in hospital patients, adjusted OR 0.8 (CI 0.70–0.92, p = 0.002). 84% of patients indicated a preference for HAH over hospital admission for future care. CONCLUSIONS:  HAH can provide a safe and effective setting to treat patients who need hospital-level care, with high levels of patient satisfaction. HAH has the potential to provide a scalable solution for the ever-increasing demand for hospital beds. Trial registration The study was approved by the CHS (community) institutional ethics and data utilization committee (0169–21). </p>","PeriodicalId":46694,"journal":{"name":"Israel Journal of Health Policy Research","volume":"14 1","pages":"79"},"PeriodicalIF":2.4,"publicationDate":"2025-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12720458/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145805991","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Changes in trends of visits and service utilization by mental health patients in the community: a twelve-year study in Israel.","authors":"Marina Mor Shalom, Avner Kantor, Eyal Azuri, Daniella Tsulker Pirian, Jennifer Kertes, Beatriz Hemo, Tali Shmueli","doi":"10.1186/s13584-025-00735-y","DOIUrl":"10.1186/s13584-025-00735-y","url":null,"abstract":"<p><p>BACKGROUND: Mental health conditions, notably depression and anxiety, affect one in eight individuals globally, with 17.6% of Israelis reporting mood and anxiety disorders. Rising multimorbidity in primary care, with poorer health outcomes when combined with depression or anxiety, poses a challenge for primary care physicians (PCPs). This study aimed to track patient visits for depression and anxiety to PCPs over a period that included a national mental health reform, the COVID-19 pandemic, and the Iron Swords war, to characterize these patients and describe their health care service utilization. METHODS: This observational study used data from Maccabi Healthcare Services, which serves over 2.7 million people in Israel. The study included patients aged eighteen and older who visited a PCP between 2013 and 2024. Patients were categorized into three groups for each year: depression/anxiety, severe mental illness (SMI), and a comparison group. ANOVA was used to compare mean PCP visit rates, and logistic regression to compare service utilization between the three groups. RESULTS: Depression and anxiety patients were mainly female, older, of lower socioeconomic status, and had chronic illness. From 2013 to 2024, the number of patients increased, particularly during the COVID-19 pandemic and the Iron Swords war. Medical service utilization among these patients was more frequent than in the general population, averaging 14.2 primary care visits per year compared to 9.8, higher rates of emergency room and secondary care visits, hospitalizations, and polypharmacy. CONCLUSION: The study underscores the increasing impact of mental health conditions on primary care services in Israel between 2013–2014, along with the higher utilization rates of health services among anxiety and depression patients. The findings highlight the need for comprehensive care provided by primary care physicians (PCPs) who are proficient in both physical and mental health. Additionally, they stress the importance of enhancing access to community-based mental health interventions. Policy changes are recommended to improve the availability of mental health therapists and enhance PCP training programs to equip physicians better to treat patients with depression and anxiety. </p>","PeriodicalId":46694,"journal":{"name":"Israel Journal of Health Policy Research","volume":"14 1","pages":"78"},"PeriodicalIF":2.4,"publicationDate":"2025-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12715906/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145783191","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Accountability, autonomy, equity, and trust in selected healthcare systems: a comparative analysis.","authors":"Tal Sigawi, Doron Yosef, Orna Tal","doi":"10.1186/s13584-025-00736-x","DOIUrl":"10.1186/s13584-025-00736-x","url":null,"abstract":"<p><strong>Aim: </strong>Healthcare systems struggle to balance priorities within complex settings. This analysis aims to identify cross-national insights and trade-offs in healthcare policy by examining how five high-income countries navigate accountability, autonomy, equity, trust, satisfaction, and system effectiveness - competing parameters that shape system performance and public experience.</p><p><strong>Methods: </strong>A structured comparative analysis was conducted across five national healthcare systems: Israel, the Netherlands, Germany, the United Kingdom (UK), and the United States (US). Publicly available literature, including peer-reviewed studies, policy reports, and population surveys, was synthesized using a narrative approach due to variation in data definitions and context.</p><p><strong>Results: </strong>The Netherlands and Germany demonstrate relatively balanced performance across all parameters, supported by regulated insurance models. Despite universal coverage, the UK system faces sustained access failures and eroding public satisfaction. The US underperforms in equity and satisfaction but demonstrates strengths in specific clinical domains. Israel combines strong statutory coverage with growing reliance on supplementary and private insurance, raising concerns about long-term equity and regulatory coherence.</p><p><strong>Conclusions: </strong>Each system reflects different strengths and trade-offs across the examined dimensions. The findings highlight structural tensions between autonomy and accountability, equity and access, decentralization and fragmentation, and public versus private provision that shape overall system performance. These insights are relevant for health systems seeking to enhance care delivery in an effective and patient-satisfying manner, and they support cross-national dialogue on designing resilient and equitable health systems.</p>","PeriodicalId":46694,"journal":{"name":"Israel Journal of Health Policy Research","volume":"14 1","pages":"71"},"PeriodicalIF":2.2,"publicationDate":"2025-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12709770/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145769488","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gambling behaviors in Israeli adults: findings from a nationally representative sample.","authors":"Belle Gavriel-Fried, Inbar Malka","doi":"10.1186/s13584-025-00733-0","DOIUrl":"10.1186/s13584-025-00733-0","url":null,"abstract":"<p><p>Globally, 46.2% of all adults report having gambled in the previous 12 months. While most experience no negative repercussions from gambling, individuals who are highly engaged in gambling are at greater risk of problem gambling (PG). Studies point to the psycho-social, environmental, and socio-demographic risk factors associated with gambling and PG, and the associated harm to individuals, families, and society, making it a public health concern worldwide. Israel has a relatively regulated conservative gambling market where casinos and electronic gambling machines are banned, and online gambling is only permitted for sports betting. Nevertheless, Israel has a relatively high percentage of PG. This study was designed to characterize involvement in gambling behavior during the previous year in non-gamblers, low-frequency, and high-frequency gamblers as a function of socio-demographic, health, and psycho-social risk and protective factors, and differentiate between problem and non-problem high-frequency gamblers. A representative sample of 3224 Israeli Jews and Arabs filled in an online questionnaire in 2022. The findings showed that 50.7% were non-gamblers, 33.8% were low-frequency gamblers, and 15.5% were high-frequency gamblers. Compared to non-gamblers, low-frequency and high-frequency gamblers were associated with Jewish ethnicity, low levels of financial self-efficacy and neighborhood cohesion, a greater likelihood to smoke and drink, and having a significant other (family/social network member) with perceived excessive gambling. Male gender and traditional self-perceived religiosity were associated with both low-frequency and high-frequency gamblers as well, but to a greater extent with high-frequency than low-frequency gamblers. Online gambling, stress, low financial self-efficacy, using social welfare allowances for gambling, having a significant other who engages in perceived excessive gambling, and identifying as an Israeli Arab were all associated with PG in high-frequency gamblers. These findings suggest that despite its conservative regulated market, gambling in Israel exceeds international averages. The similarities between low-frequency and high-frequency gamblers in terms of risk factors may hint at a type of gambling normalization. Regulatory reforms informed by public health policies are recommended to decrease access to gambling, including banning online gambling and curbing special gambling offers timed to coincide with welfare payments. Awareness campaigns, culturally sensitive prevention programs are recommended, as well as studies to monitor gambling harm.</p>","PeriodicalId":46694,"journal":{"name":"Israel Journal of Health Policy Research","volume":"14 1","pages":"77"},"PeriodicalIF":2.2,"publicationDate":"2025-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12703892/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145757974","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Post-traumatic stress among adolescents following the October 7th attack in Israel: implications for mental health policy and planning.","authors":"Tehila Refaeli, Agat Sold, Limor Aharonson-Daniel","doi":"10.1186/s13584-025-00740-1","DOIUrl":"10.1186/s13584-025-00740-1","url":null,"abstract":"<p><strong>Background: </strong>The October 7th, 2023, attack in Israel and the ensuing war exposed Israeli youth to intense and prolonged traumatic stress. This study aimed to: (1) examine the prevalence of probable post-traumatic stress disorder (PTSD) among Israeli adolescents, and (2) identify associated risk and resilience factors for PTSD symptoms within the context of prolonged exposure to threat and uncertainty due to ongoing war and conflict.</p><p><strong>Methods: </strong>A cross-sectional digital survey was conducted between October and December 2024. Data were collected from 744 adolescents aged 14-18 years, including the Child PTSD Symptom Scale (CPSS-SR-5), questions about direct war-related consequences and indirect exposure. Personal resilience was assessed using the Connor-Davidson Resilience Scale. Social support was measured using the Multidimensional Scale of Perceived Social Support (MSPSS). Background questions addressed age, gender, health, and adverse events in the past year. Hierarchical multiple regression analysis was used to examine the contribution of background variables, war-related effects, indirect exposure, and resilience factors to PTSD symptoms.</p><p><strong>Results: </strong>The study revealed that 41.9% of participants met the probable diagnostic threshold for PTSD. Gender (female), poorer health status, and previous adverse experiences correlated with increased symptom severity. Among the direct effects, economic status deterioration and direct war impact emerged as significant predictors. Among the indirect exposure factors, frequent news consumption was associated with higher PTSD symptoms. Personal resilience and family support were associated with reduced PTSD symptoms, although resilience factors did not significantly moderate the adverse impacts of war-related experiences.</p><p><strong>Conclusions: </strong>The high prevalence of probable PTSD among Israeli adolescents in the wake of the October 7th, 2023 attack suggests an urgent need for action. Evidence-informed mental health policies and services should prioritize adolescents, with targeted support for high-risk groups. Our findings stress the need for a national mental health policy to incorporate youth-centered trauma response systems, including interventions for indirect media trauma. Strengthening personal resilience and bolstering family support systems is vital in order to mitigate the lasting psychological impact of war-related trauma on youth.</p>","PeriodicalId":46694,"journal":{"name":"Israel Journal of Health Policy Research","volume":"14 1","pages":"76"},"PeriodicalIF":2.2,"publicationDate":"2025-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12699908/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145745068","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}