Ashkelon Academic College

Background/Objectives: An extensive body of data suggests that inflammation may contribute to the pathophysiological mechanisms of psychiatric illness. Circumstantial evidence implied that low-dose aspirin (LDA) may enhance the therapeutic efficacy of psychotropic drugs. We examined whether LDA administration with psychotropic medications is associated with medication regimen stability and other therapeutic effects in patients with bipolar disorder (BD), schizophrenia, and schizoaffective disorder (SAD). Methods: This retrospective study analyzed data from Clalit Health Services' Southern District database in Israel, including 1924 patients treated between 2017 and 2019. The Study Group consisted of patients treated with LDA plus psychotropic medications, whereas the Control Group included patients treated only with psychotropic medications. Study outcomes included suicide attempts and pharmacotherapy-related negative events, defined as psychotropic dose escalation, augmentation, or switching. Results: The study group included 137 patients (55% males, age 63.3 ± 12.3 years), and the control group included 1787 patients (60% males, age 47 ± 16.9 years). Significant differences were observed across nearly all outcomes, favoring the LDA co-treatment group. Patients in the study group exhibited lower rates of medication dosage increase (40 [29%] vs. 726 [40.5%], p = 0.01); fewer changes and/or additions of psychotropic medications (37 [26.9%] vs. 778 [43.5%], p < 0.001); and a non-significantly lower rate of suicide attempts (0 [0%] vs. 16 [0.9%], p = 0.53). Conclusions: Overall, LDA co-treatment was associated with better clinical outcomes among patients with BD, schizophrenia, and SAD. Follow-up large-scale epidemiological studies and prospective randomized clinical trials are needed to examine the therapeutic potential of add-on LDA to psychotropic medications.

ABSTRACT This article explores the experiences of journalists during wartime, focusing on the complexities and challenges they face while working in difficult conditions. The study involved 24 journalists who worked in conflict zones; qualitative interviews were conducted with them. Data analysis was carried out using Gilligan’s Listening Guide, which aims to uncover the personal narratives of each journalist and understand how they experience journalistic work in a wartime reality. Using this approach, the research reveals the personal and professional dynamics that shape journalists’ experiences, the ethical and moral dilemmas they encounter, and the impact of war on their sense of personal and professional identity. The findings highlight their difficulties, the trauma they confront, and how journalists maintain their professional integrity while navigating societal and political pressures.

Background/Objectives: Vaccination programs are highly effective public health interventions, yet parental hesitancy toward combination vaccines has led to growing demand for alternative vaccination schedules, defined in this study as parental requests to split or replace recommended combination vaccines with single-antigen vaccines for non-clinical reasons. While parental attitudes have been widely studied, little empirical evidence exists on the real-world use of single-antigen vaccines and their public health implications in countries with otherwise high coverage. This study examined the prevalence patterns and parental motivations for requesting such alternative vaccination schedules in Israel, where national guidelines recommend specific combination vaccines, including measles-mumps-rubella-varicella (MMRV) and the pentavalent diphtheria-tetanus-pertussis–inactivated polio–Haemophilus influenzae type b (DTaP+IPV+Hib) vaccines, but informal accommodations exist. Methods: A mixed-methods design was employed: a retrospective cohort analysis of vaccination data from 2018 to 2021 (before and during the COVID-19 pandemic) focused on measles (first dose at 12 months) and pertussis (four-dose primary series), followed by semi-structured interviews with Maternal and Child Health clinic providers, policymakers, and parents. Results: Alternative vaccination schedules involving single-antigen measles or pertussis vaccines are occasionally used despite official policy, accounting for less than 1% of vaccinations overall. Outcomes include delayed administration, lower uptake of combination vaccines, and incomplete protection in certain groups. Parents cited safety concerns, fear of immune overload, and mistrust of authorities. These concerns were often amplified by misinformation, while providers described balancing parental preferences with the need for adequate coverage. Conclusions: This study provides new evidence on how vaccine hesitancy translates into service utilization, highlights the tension between individualized parental decision-making and contribution to collective health, and underscores the need for communication, policy strategies and service designs that sustain high coverage while addressing community-specific concerns.

BackgroundEducation of nurses may be compromised during a crisis. On October 7, 2023, the “Iron Swords” war broke out in Israel. The academic year was postponed, and nursing education was disrupted. Despite the acknowledged importance of continuing nurse training during emergencies, research on this topic is scarce.AimTo examine nursing school management activities and describe the adaptive strategies of academic frameworks during the war in Israel.Design and methodsThis qualitative study was conducted in nursing schools in Israel that were directly affected by the Iron Swords War (October 7, 2023). We interviewed five of the seven chairs of nursing departments in Iron Swords conflict zones, content analyzed the interview text, and employed COREQ reporting guidelines for this qualitative study.ResultsSix main themes were identified: Management and leadership under uncertainty; Resilience and preparedness; Supporting well-being and inclusivity; Adaptability and innovation in the educational process; Fostering a sense of community; and Engagement of students and faculties in the crisis response. One of the most remarkable findings was the blending of personal and professional roles, as manifested in the immediate response and re-organization by the academic and administrative staff.DiscussionThe ability of academia to maintain function and make decisions under conditions of uncertainty is of paramount importance. This requires collaborative decision-making, leveraging diverse perspectives, fostering inclusivity, and enhancing the effectiveness of responses. Maintaining routines creates a feeling of belonging, promotes setting and realization of goals, provides meaning, and maintains motivation.ConclusionsThe results provide insights into the management of nursing education during prolonged emergencies and health policy implications. Although focused on a war scenario, the findings have broader implications and offer strategies applicable to more general crises.

<title>Abstract</title> <bold>Background:</bold> The global healthcare system is grappling with a severe shortage of nursing staff, a deficit exacerbated by the prevalent Second Victim Phenomenon (SVP), where nurses experience significant emotional, physical, and professional distress after involvement in adverse events (AEs). Research consistently links SVP to nurse absenteeism and turnover, underscoring the critical need for effective support systems. Unlike many countries with established SVP support, Israel lacks systemic national and organizational level strategies, leading to potential underreporting of AEs and a hidden burden of distress among caregivers. This study examined the association between SVP and absenteeism and turnover intentions among Israeli nurses, specifically investigating the roles of direct managers and the organization. <bold>Methods:</bold> A culturally diverse sample of 174 postgraduate nurses who reported experiencing an adverse event the Hebrew-validated Second Victim Experience and Support Tool (H-SVEST), assessing psychosocial factors and employment outcomes (turnover intentions, absenteeism). <bold>Results:</bold> Over 90% of nurses reported psychological and physical distress following AEs. Physical distress emerged as a primary driver for both turnover intentions and absenteeism. In contrast, professional self-efficacy and various forms of organizational support (from colleagues, supervisors, and the institution) acted as critical protective factors, significantly reducing these negative outcomes. The path analysis model explained 52.7% of the variance in turnover intentions and 39.2% in absenteeism. Notably, supervisor support significantly and negatively predicted absenteeism (B = -0.243, p &lt; .01). <bold>Conclusions:</bold> This study provides the first quantitative examination of SVP among Israeli nurses, affirming its profound impact on workforce stability. Our findings highlight the significant role of physical distress in predicting turnover and absenteeism in the Israeli context. The crucial role of various forms of organizational support and professional self-efficacy as mitigating factors underscores the urgent need for structured, systematic support systems within Israeli healthcare

ABSTRACT Objectives Financial exploitation (FE) is associated with negative social and health consequences. This study examined the relationship between objective/subjective vision abilities and FE vulnerability among older adults. Methods 97 community-dwelling older adults aged 60 and over completed self-report questionnaires assessing subjective vision difficulties, FE vulnerability, and history of FE experiences. Additionally, participants underwent objective vision assessments (distance, near and contrast sensitivity) conducted by a certified gerontological optometrist. Results Multiple linear regression and logistic regression models showed that self-reported vision difficulties were associated with FE vulnerability (β = .355, p < .001) and self-reported FE experiences (OR = 7.866, p = .005), while objective vision measures were not. Conclusions Self-perceived vision difficulties are more strongly linked to FE than objective measures. Subjective vision may reflect a cognitive averaging of vision ability not fully captured in well-controlled environments characteristic of objective assessments. Clinical Implications These findings advance our understanding of FE risk factors by highlighting the importance of subjective vision abilities, and suggest practical approaches for identifying and supporting at-risk older adults through patient-reported visual assessments.

It is generally assumed that nonresponsive people in comatose states are unconscious, especially when it is known that their neuronal circuits are not functioning normally, for example, due to severe anoxia and medically induced comas. Nevertheless, occasional reports suggest that sometimes, patients in such conditions can be fully aware of everything that happens around them. The present publication introduces a well-documented case of this kind. It concerns a patient in Israel who was diagnosed with cerebral edema and suffered severe anoxic brain damage that had already affected his brain stem. He was put in an induced coma to minimize the brain’s oxygen consumption. Still, he was expected to die within hours. However, the patient recovered unexpectedly. It turned out he had been fully conscious throughout the 44 hours he was in this coma. As a result, he was able to describe in detail every occurrence and conversation that had been held at his bedside throughout this time. This locked-in experience had an utterly traumatic impact on the patient. As a result, practices for coma patient care have been adapted and improved in Israel. We argue that it is important to raise awareness regarding the occurrence of such “paradoxical awareness” and hope that this increased recognition will help to improve the practices for coma patient care, also in other countries. Moreover, such individual case studies are vital for advancing the knowledge about the brain conditions under which it is possible to be aware – a largely neglected field of research that may have further important implications, for instance, in the context of organ donation.